West Bengal Health Scheme

Guidelines for WBHS 2008.pdf

WBHS Procedure (Revised).pdf

Government of West Bengal Finance Department

Audit Branch Medical Cell

No. 11253(80)-F (MED) Dt. 16-12-2011 From: Shri Samiran Pal, W.B.C.S. (Exe.), Joint Secretary to the Government of West Bengal To: The Managing Director/ Chief Executive Officer/ Medical Director/ Medical Superintendent/ Administrative Officer, __________________________________________________ Hospital/ Institution, ____________________________________________________________________ Sub: Further Guidelines for empanelled Health Care Organisations for Medical Treatment under the West Bengal Health Scheme, 2008 Sir, I am directed to state that your hospital/ medical institution is an empanelled one for rendering services to the State Government employees, Government pensioners and their family members under the West Bengal Health Scheme, 2008. We have issued guidelines to all the empanelled Private hospitals/ medical institutions under the Finance Department Notification No. 796-F (MED), dt. 31-01-2011 and published Revised Rate List thereunder for the Scheme. Yet, it has been noticed that some Health Care Organisations are not following the guidelines and terms and conditions of agreement (MOA) properly. As a result, the beneficiaries of the Scheme are facing problem to get proper services from the H.C.O.s as well as reimbursement of the cost of medical treatment. Under the above background, the West Bengal Health Scheme Authority under the Finance Department examined the matter in detail and advised some additional guidelines for the H.C.O.s. Now, following the advice of the West Bengal Health Scheme Authority, I would request you to follow the guidelines of the above Notification as well as the following further guidelines as appended in this letter while rendering services to the beneficiaries of the Scheme. Yours faithfully, Sd/- Joint Secretary to the Government of West Bengal, Finance Department Further Guidelines for empanelled Health Care Units for Medical Treatment under WBHS, 2008: Non –Package Treatment:

1. Prior permission from the West Bengal Health Scheme Authority is required whenever treatment costs exceed Rs. 2,50,000/-.

2. All drugs prescribed should be in generic names as far as possible. If generic names are not used, the justification for use of branded drugs should be provided. Quality of drugs will not be acceptable as justification for the use of branded drugs. The pharmacy should endeavor to procure and supply the cheapest available generic form of the prescribed drug, keeping in view the quality of the drug procured.

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3. The use of Antibiotics should always be as per the antibiotic policy of the Hospital and based on culture report. ‘Shot gun therapy’ should be strictly avoided. Whenever antibiotics costing more than Rs. 1000/- (One thousand) per dose are used, the Chief of the Hospital infection Control Committee (HICC) should be consulted and together the Consultant in charge of the case and the chief of the HICC should certify that the most cost effective evidence based antimicrobial treatment has been prescribed. The chief of the HICC should be consulted whenever a change in the antibiotic regimen is contemplated in such patients.

4. Whenever the total cost of pharmaceuticals exceed Rs. 10000/- (Rs. Ten Thousand) daily, the Director Medical Services or equivalent shall be consulted and he, along with the Consultant in charge of the case, should certify that evidence based cost effective treatment has been prescribed in the case.

5. In case of cancer chemotherapy whenever the cost of therapy per cycle exceeds Rs. 5000/- (Five Thousand), the prognosis of the patient is to be clearly mentioned along with the justification for the use of the chemotherapy drugs with regard to the expected survival/palliation of the patient.

6. The bed rent shall include the cost of all special mattresses and other such equipments/ devices/ nebulization.

7. The cost of investigations will be inclusive of cost drawing the samples. This also applies to estimation of blood glucose using glucometer.

8. Consultation fees in the ICU/High Definition Unit will be provided for the treating Specialists/ Super Specialists only (Names of doctors with qualification are to be mentioned in the Bill).

9. The use of disposables/consumables should be kept to the levels. The maximum allowable in all cases shall be (non package treatment): a. Gloves -10 pairs (all types included) per day b. Masks- 2 per day c. I. V. sets – 3 per week d. venflon or substitute 3 per week e. B. T. set -3 per week f. Urinary catheters (all types included) – 3 per week g. Urobag – 3 per week h. Suction catheter -1 per day i. Syringes -10 per day (all capacities included)

10. For non adherence to the above guidelines, the additional costs will have to be deducted from the final bills of the HCO.

11. In case of any discrepancy/difficulty, the West Bengal Health Scheme Authority is to be contacted prior to preparation of the final bill.

Package Treatment: 1. The main procedure done is to be shown as the initial package. 2. Sub procedures requiring substantial additional consumables, skill or operative time

is to be shown as subsequent packages. 3. Not more than two packages should normally be performed or planned. Permission

of the West Bengal Health Scheme Authority is necessary for more than three packages.

4. For minimally invasive cases becoming open cases, cost of minimally invasive surgery package will not be allowed for billing.

5. In case of dual chamber pacemaker implantation, the medical reason for the non suitability of single chamber pace maker is to be justified, not just that it is more physiologically suited.

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In case of implantation of drug eluting stent, multiple stenting, opinion of Cardiac Surgeon will be required whether Bye-pass Surgery or PTCA with stenting is medically suitable for the patient. If digital hearing aid is prescribed, the specific reason for conventional hearing aid not being medically suitable is to be mentioned. Permissions of the West Bengal Health Scheme Authority are to be taken in all the cases by the H.C.O.s in advance.

General: 1. Code Nos. of procedures and investigations must be mentioned in the Bill. 2. Name and qualification with Registration No. of the Specialists/ Super Specialists

must be mentioned in the Essentiality Certificate. Sd/- Joint Secretary to the Government of West Bengal, Finance Department

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008

(Notification No. 796-F (MED) dated 31-01-2011)

1

01 – PROCEDURES

CODE NAME OF TREATMENT

PROCEDURE

Maximum Approved Rate (INR) (Rupees)

001 General 01001001

Consultation by Medical

Officer (OPD) 150/-

01001002 Consultation by

Specialists (OPD) 200/-

01001003

Visit/ Revisit/ Consultation by Specialists (Indoor)

(Maximum two visits per day admissible) 200/-

01001004 Consultation by Super-

Specialists (OPD) 250/-

01001005

Visit/ Revisit/ Consultation by Super-Specialists

(Indoor) (Maximum two visits per

day admissible) 250/-

01001006 Pre-operative Anaesthetic

Consultation 200/- 01001007 Paramedical Consultation 75/-

01001008 Special Nursing Charge

(per shift of 12 hrs.) 150/-

01001009 Aya/ Attendant Charge

(per shift of 12 hrs.) 75/-

01001010 Delayed primary suture 1700/- 01001011 Dressings Large 160/-

01001012 Suturing without local

anesthesia 400/-

01001013 Suturing of wounds with

local anesthesia 500/- 01001014 Debridement of wounds 1200/- 01001015 Removal of Benign Tumor 1100/-

01001016 Aspiration Plural Effusion -

Therapeutic 1000/-

01001017 Abdominal Aspiration -

Therapeutic 1300/-

01001018 Removal of F.B.

Superficial 1200/- 01001019 Bone Marrow Aspiration 1500/- 01001020 Joints Aspiration 1500/- 01001021 Strapping 100/- 01001022 Removal of Stitches 60/- 01001023 Venesection 300/- 01001024 Phimosis Under LA 1500/-


PROCEDURE


01001025 Lumbar puncture 700/- 01001026 Sternal puncture 1500/- 01001027 Injection for Haemorrhoids 1000/-

01001028 Injection for Varicose

Veins 1300/- 01001029 Catheterisation 120/- 01001030 Dilatation of Urethra 1100/- 01001031 Incision & Drainage 600/- 01001032 Intercostal Drainage 1500/- 01001033 Peritoneal dialysis 1800/-

01001034

Removal of soft tissue or regional block under general anaesthesia

2400/-

01001035 Dressing Small 100/-

01001036 Secondary suture of

wounds 1200/- 002 Skin

01002001 Excision of Moles 600/- 01002002 Excision of Warts 600/-

01002003 Excision of Molluscum

contagiosum 600/- 01002004 Excision of Veneral Warts 600/- 01002005 Excision of Corns 550/-

01002006 I/D Injection Keloid of

Acne 300/-

01002007 Chemical Cautery (per

sittings) 120/-

01002008 Excision of Sebaceous

Cysts 1700/-

01002009 Excision of Superficial

Liipoma 2400/-

01002010 Excision of Dermoid Cysts 2450/- 003 E.N.T.

01003001 Speech therapy per

session of 30-40 minutes 200/-

01003002

Removal of foreign body From Nose/ Ear/ Throat

(Day care package) 1500/-

01003003 Swallowing Therapy 250/- 01003004 Syringing 300/- 01003005 Polyp removal under LA 800/-

01003006 Peritonsillar abscess drainage under LA 1600/-

01003007 Tinnitus Retraining

Therapy 250/-



2


PROCEDURE


01003008 Myringoplasty 10700/- 01003009 Staepedectomy 12000/-

01003010 Myringotomy with Grommet insertion 6000/-

01003011 Endoscopic Removal of

Fish Bone 1000/- 01003012 Tympanotomy 8000/- 01003013 Paracentesis 4300/- 01003014 Tympanoplasty 14000/- 01003015 Mastoidectomy 15600/- 01003016 Otoplasty 16500/- 01003017 Labyrinthectomy 15600/- 01003018 Skull Base surgery 50000/-

01003019 Facial Nerve

Decompression 20000/- 01003020 Septoplasty 10200/- 01003021 Submucous Resection 10800/- 01003022 Septo-rhinoplasty 15000/-

01003023 Rhinoplasty (non-

cosmetic) 12000/- 01003024 Fracture Reduction 9000/- 01003025 Intra Nasal Diathermy 6000/- 01003026 Turbinectomy 9600/- 01003027 Endoscopic DCR 13000/- 01003028 Endoscopic Surgery 15000/- 01003029 Septal Perf. Repair 15000/- 01003030 Antrum Puncture 3000/- 01003031 Lateral Rhinotomy 1350/- 01003032 Cranio-facial resection 28000/- 01003033 Ethamoidectomy 17600/- 01003034 Caldwell Luc Surgery 12000/- 01003035 Angiofibroma Excision 18000/-

01003036 Endoscopic

Hypophysectomy 25000/-

01003037 Endoscopic Optic Nerve

Decompression 32000/-

01003038 Decompression of Orbit 30000/- 01003039 Ranula Excision 9600/- 01003040 Tongue Tie excision 8100/-

01003041 Sub Mandibular Duct

Lithotomy 9700/- 01003042 Adenoidectomy 8000/- 01003043 Palatopharyngoplasty 15100/- 01003044 Cleft Palate repair 16000/- 01003045 Pharyngoplasty 18000/- 01003046 Styloidectomy 11500/-


PROCEDURE


01003047 Uvulo-palatoplasty 20000/- 01003048 Tympanomastoidectomy 15600/- 01003049 Dacunisation 7000/- 01003050 Tonsillectomy 11200/- 01003051 Adenotonsillectomy 13500/- 01003052 Synichiolysis 4200/- 01003053 Submucosal Diathermy 4000/-

01003054 Nasal Mass Excision-

Simple 11200/-

01003055 Nasal Mass Excision- Endoscopic Removal 13500/-

01003056 FESS 11200/- 01003057 Anterior Nasal Packing 4000/- 01003058 Post Nasal Packing 5000/- 01003059 Nasal Bone Reduction 6000/-

01003060

Excision of Lesion Base of Tongue- per Oral Approach 6400/-

004 Opthalmology

01004001

Cauterisation of ulcer/subconjuctival injection - One eye 200/-

01004002

Cauterisation of ulcer/subconjuctival injection - Both eyes 300/-

01004003 Retrobular Injection - One

Eye 200/-

01004004 Retrobular Injection - Both

Eyes 300/-

01004005 Syringing of Lacrimal Sac

-For one eye 200/-

01004006 Syringing of Lacrimal Sac

- For both eyes 300/- 01004007 Paracentesis 800/- 01004008 Foreign body removal 300/- 01004009 Refraction/Fundoscopy 90/- 01004010 Ortho-optic exercises 100/- 01004011 Plepoptic Exercises 100/-

01004012 Chalazion operation -One

Eye 800/-

01004013 Chalazion operation -

Both Eyes 1000/- 01004014 Dressing (Eye) 100/- 01004015 Clinical Photography 100/- 01004016 Pterygium 2200/- 01004017 Orbitotomy 9000/-



3


PROCEDURE


01004018 Ptosis correction. 6500/- 01004019 Ectropion Correction 3600/- 01004020 Xenon Arc Laser 700/-

01004021 D C R (Dacryo custo-

rhinostomy) 5700/- 01004022 ECCE/ICCE 6000/- 01004023 Epicanthus correction. 2100/-

01004024 Squint Correction (one

eye) 4000/-

01004025 Squint Correction (both

eyes) 6000/- 01004026 Keratoplasty 14000/- 01004027 Trabeculotomy 5700/- 01004028 Iridectomy 2400/- 01004029 Goniotomy 2400/-

01004030 Scleral Bukling (Retinal Detachment Surgery) 14000/-

01004031 Syringing & Probing 1100/- 01004032 Vitrectomy 11000/- 01004033 Enucleation 4000/- 01004034 Eviseration 3800/- 01004035 Entropion correction 3000/-

01004036 Cataract with IOL(Cost of

lens extra) 7500/-

01004037 Fistulectomy 5700/-

01004038 Glucoma surgery with

Glucoma valves 5000/-

01004039 Caliculoplasty 3000/-

01004040 Dacryocystectomy 3000/-

01004041 Ptosis surgery with LPS

resection 7000/-

01004042 Ptosis surgery with Sling

surgery 7000/-

01004043 Ectropion surgery- one lid 3000/-

01004044 Ectropion surgery- both

lids 4000/-

01004045 Cheek rotation flap for lid

tumors 8000/-

01004046 Telecanthus correction 4000/-

01004047 Fracture orbital repair 9000/-


PROCEDURE


01004048 Lasik 18000/-

01004049 TTT- Transpupillary

thermal therapy 4000/-

01004050 PTK- Phototherapeutic

keratectomy 9000/-

01004051 Iris cyst removal 1000/-

01004052 Lid Abscess incision and

drainage 3000/-

01004053 Orbital Abscess incision

and drainage 4000/-

01004054 Cyclodiathermy 2000/-

01004055 Perforating injury repair 4000/-

01004056

Phaco + IOL (inclusive of Foldable & Non-foldable

lens) Package 14500/-

01004057 YAG Laser Capsulotomy

per sitting 600/-

01004058 YAG Laser Iridectomy per

sitting 600/-

01004059

Argon Laser Trabeculoplasty (ALT)

(per sitting) 1000/-

01004060 HVF 500/-

01004061 Cryopexy 1200/-

01004062 ICG including Medicine 2000/-

01004063 ICG- Double including

Medicine 3600/-

01004064 Electrolysis (Per sitting) 150/-

01004065 Cyclocryo/

Cyclodiathermy 500/-

01004066 D.C.T. (OPD) 800/-

01004067 Silicone Oil (1000) 4000/-

01004068 Silicone Oil (C5) 4000/-

01004069 Silicone Oil Removal 3500/-



4


PROCEDURE


01004070 Pneumo Retinopexy 2400/-

01004071 FGE/ FAE 1500/-

01004072 Indirect Laser 1000/-

01004073 Endo Laser 2400/-

01004074 SF6 Gas 2400/-

01004075 C3F8 Gas 2400/-

01004076 PFCL 2400/-

01004077

Photodynamic Therapy procedure charges- single

eye 15000/-

01004078

Photodynamic Therapy procedure charges- both

eyes 25000/-

01004079 Photodynamic Therapy

(single eye) 85000/-

01004080 Photodynamic Therapy

(both eyes) 100000/-

01004081

Intravitreal Avastin (including cost of injection-

single) 6000/-

01004082

Intravitreal Lucentis (excluding cost of injection-single) 4000/-

01004083

Intravitreal Macugen (excluding cost of injection-single) 4000/-

01004084

Intravitreal injections of antibiotics (cost of medicines extra) 2000/-

01004085 Retinal Foreign Body

Removal 4000/-

01004086 PPV/ Victerectomy 6500/-

01004087 Endo Diathermy 1600/-

01004088 Belt Buckle 3200/-

01004089 IVTCA 800/-

01004090 Membrane Peeling 2400/-


PROCEDURE


01004091 Anterior Vitrectomy 5000/-

01004092 Lensectomy 7500/-

01004093 Orbitotomy (Multiple Wall) 16000/-

01004094 ERM (Epi Retinal

Membrane) 3600/-

01004095 Reti Blue 2400/-

01004096 Corneal Collagen Cross-

linking 15000/-

005

Biopsies including Histopathological report

(Package)

01005001 Biopsy procedure under

Local Anaesthesia 4000/-


General Anaesthesia 6000/-


Endoscopy 8000/-

01005004 FNAC 3500/-

006 Strapping (including Bandage & materials)

01006001 Strapping of Finger 200/- 01006002 Strapping of Toes 200/- 01006003 Strapping of Wrist 360/- 01006004 Strapping of Elbow 400/- 01006005 Strapping of Knee 400/- 01006006 Strapping of Ankle 400/- 01006007 Strapping of Chest 500/- 01006008 Strapping of Shoulder 450/- 01006009 Nasal bone fracture 450/- 01006010 Figure of 8 bandage 450/- 01006011 Colar and cuff sling 450/- 01006012 Ball bandage 450/-

007 Physiotheraphy &

Traction

01007001 Ultrasonic therapy (per

sitting) 70/-

01007002 S.W. Diathermy (per

sitting) 90/-

01007003 Electrical stimulation

(therapeutic) (per sitting) 70/- 01007004 Infra red (per sitting) 90/-

01007005 U.V. Therapeutic dose

(per sitting) 90/-



5


PROCEDURE


01007006 Electric vibrator (per

sitting) 90/-

01007007 Vibrator belt massage

(per sitting) 90/-

01007008 Intra Lumbar Traction

(per sitting) 90/-

01007009 Intermittent Cervical traction (per sitting) 70/-

01007010

Combined Lumbar & Cervical traction (per

sitting) 70/-

01007011 Wax bath (per sitting) 50/- 01007012 Hot pack (per sitting) 70/-

01007013 Whirl pool bath (per

sitting) 90/-

01007014 Obesity Exercises (per

sitting) 60/-

01007015

Breathing Exercises & Postural Drainage (per

sitting) 70/-

01007016 Cerebral Palsy – Massage

(per sitting) 90/-

01007017 Post – polio exercise (per

sitting) 60/-

01007018 Basic Gait Training (Per

Session) 80/-

01007019 Traction + IFT 150/-

01007020 Traction + Stimulation 100/-

01007021 Traction + SWD 100/-

01007022 Traction + SWD + IFT 200/-

01007023 Traction + US 140/-

01007024 Traction + US + IFT 200/-

01007025 Traction + US + IFT +

Exercises 260/-

01007026 Traction + US + IFT +

SWD 260/-

01007027 IFT + PWB 150/-

01007028 Exercise- per sitting 60/-


PROCEDURE


01007029 PWB + Knee Joint Spad

Fraction 100/-

01007030 SWD + IFT 100/-

01007031 US + IFT 100/-

01007032 US + IFT + Stimulation 200/-

01007033 US + Knee Joint + Spad

Fraction 100/-

01007034 US + PWB 100/-

01007035 US + SW + Traction 200/-

01007036 US + Tens 100/-

01007037 US + Stimulation 100/-

01007038 Knee Joints Spad Fraction 100/-

01007039 Electronic Tilt Training-

Per Session 100/-

01007040 Interferential Therapy 100/-

01007041 Laser Treatment- Per

Session 150/-

01007042 Microwave Diathermy- Per

Session 150/-

01007043 Quadriceps Chair Training

(Per Session) 100/-

01007044 Tens 80/- 008 Dental

01008001 Extraction of tooth

including LA 120/-

01008002 Complicated Ext. per Tooth including LA 250/-

01008003 Flap Operation per Tooth 500/- 01008004 Gingivectomy per tooth 300/- 01008005 Cyst under LA (small) 300/- 01008006 Cyst under LA (large) 500/-

01008007 Impacted Molar including

LA 800/- 01008008 Apisectomy including LA 1000/-

01008009 Fracture wiring including

LA 80/-



6


PROCEDURE


01008010

Reduction & immobilisation of fracture-

Maxilla under LA 1400/-

01008011

Reduction & immobilisation of fracture-

Mandible under LA 3000/-

01008012

Splints/ Circum mandibular wiring under

GA 2000/-

01008013

Internal wire fixation/ plate fixation of Maxilla under

LA 4000/-

01008014

Internal wire fixation/ plate fixation of Maxilla under

GA 6000/-

01008015

Internal wire fixation/ plate fixation of Mandible under

LA/GA 6000/-

01008016

Cyst & Tumour of Maxilla/ mandible by enucleation/

excision (package) 2000/-

01008017 TM joint ankylosis- under

GA (package) 11000/-

01008018 Hemi-mandibulectomy

with graft (package) 7000/-

01008019 Hemi-mandibulectomy without graft (package) 4000/-

01008020

Segmental- mandibulectomy with graft

(package) 6000/-

01008021

Segmental- mandibulectomy without

graft (package) 2000/-

01008022 Maxillectomy- partial with

graft (package) 5000/-

01008023 Maxillectomy- partial

without graft (package) 4000/-

01008024

Maxillo-facial prosthesis (sal/ auricular/ orbital/

facial lost part) (package) 5000/-

01008025 Alvelolectomy,

Frenectomy per Quadrant 1150/- 01008026 Alvelolectomy (minor) 380/-

01008027 Amalgam Filling/tooth

(compound) 450/-

01008028 Amalgam Filling/tooth

(regular) 380/-

01008029 Apicoectomy Molar Tooth 2250/- 01008030 Arch Bar Removal 380/- 01008031 Bite Plate/ Retainers 1150/-


PROCEDURE


01008032 Cast Rpd (per Tooth) 380/-

01008033 Davis Crown/ radicular

Screw supported 1900/- 01008034 De Sensitising per sitting 200/-

01008035 Dento Alveolar Fracture

Reduction & Splinting/l.a. 1500/-

01008036 Denture Repair

(category1) 230/-

01008037 Dialation of Whartons

Duct under L.A. 1150/-

01008038 Direct/ indirect Pulp

Capping 230/-

01008039 Drain. of Dento Alveolar

Absce. (ex. Oral) 950/-

01008040 Enucleation of Cyst of

Oral Cavity 2000/-

01008041 Fibre Post Based Post &

Core 1900/-

01008042 Floride Application (per

sitting) 400/-

01008043 Extraction of Impacted

Tooth By Operation 400/-

01008044 Extraction of MISP Tooth by Operation (Open Meth) 1150/-

01008045 GTR (Guided Tissue

Regeneration) 1900/-

01008046 Gingivectomy per

Quadrant 750/-

01008047 Glass Ionomer Filling 400/-

01008048 Glass Ionomes Filling 450/- 01008049 Interdental Wiring 1150/-

01008050 Intra Articular Inj. of

Steroids in TMJ 900/-

01008051 Jacket Crown Acrylic 1500/-

01008052

Minor Dento-alveolar Tracture Reduction &

Splinting/la 950/-

01008053

Post Core/ tooth (cast Post) lab Metal Chgs.

Extra 1150/-

01008054 Post Core/ tooth (pin Retained.comp.core) 750/-

01008055

Post Core/ tooth Screw/pin Retain.

amalgm. 550/-



7


PROCEDURE


01008056 Preformed Carbonate

Jacket Crown 750/-

01008057 Preformed Steel Crown 1150/-

01008058 Pulpotomy 750/-

01008059 Reduction of Dislocation

of Tmj (Under LA.) 1400/-

01008060 Reimplantation (per

Tooth) 3400/-

01008061 Removal Partial Denture

(1st Tooth) 400/-

01008062 Removable Partial

Denture (Additional Tooth) 230/-

01008063

Removable Partial Denture per Tooth (Palatal

Bar) 750/-

01008064 Repair of Facial Soft

Tissue Laceration 1150/-

01008065 Repair of Facial Soft

Tissue Laceration (minor) 750/-

01008066 Root Canal Treatment

(Upto 4 Sitting) 1150/-

01008067 Root Canal Treatment

(Extra Sitting) 400/-

01008068

Root Canal Treatment with Filling and Crown

(package) (Lab. Charges extra) 3600/-

01008069 Scaling per Sitting 400/-

01008070 Sialolithotomy for Small

Stones 115/-

01008071

Surgical Extraction or Surgical Removal of

Impact (package) 1150/-

01008072

Surgical Removal of Benin Reoplasm of Oral

(package) 1500/-

01008073 Surgical Removal of Soft Tissue Lesion (package) 1150/-

01008074

Surgical Removal of Impact Mesiod.tuber

(package) 1150/-

009 ITU/CCU CHARGES (Special Care Cases)

01009001

ICU/ITU/CCU/NICU/PICU (including:- Oxygen; ECG/SPO2/NIBP/IBP

monitoring; 1:2 Nursing ċ GNM Nursing; Round the Clock Doctor (Resident on 2400/-


PROCEDURE


spot); Diet; Syringe Pump)

01009002

Ventilator charge (including accessories)

per day 1000/-

01009003 Pneupack Ventilator in

Nursery (per day) 800/-

01009004 High Definition Unit/ Step Down (including Oxygen) 1500/-

01009005 Exchange Transfusion 1200/-

01009006 O.T. Charges for

Exchange transfusion 400/- 010 Oxygen Charges

01010001 Private/ Semi-private/

General Ward per hour 60/- 011 Burn Cases

01011001

upto 30% Burns 1st Dressing (excluding

dressing materials and medicines) 700/-

01011002

upto 30% Burns Subsequent Dressing (excluding dressing

materials and medicines) 700/-

01011003

30% to 50% Burns 1st Dressing (excluding

dressing materials and medicines) 700/-

01011004

30% to 50% Burns Subsequent Dressing (excluding dressing


01011005

Extensive Burn above 50% Frist Dressing (excluding dressing


01011006

Extensive Burn above 50% Subsequent dressing

(excluding dressing materials and medicines) 1500/-

01011007 Burn Unit Bed (including

Oxygen) 1500/-

012 Obstetric &

Gynaecology Cases

01012001 Normal delivery or with Episiotomy & P. repair 12000/-

01012002 Low Forceps 12000/- 01012003 Low midcavity forceps 14000/-

01012004 Cesarean Section 20000/-



8


PROCEDURE


01012005 Cesarean Hysterectomy 22000/-

01012006 Rupture Uterus- closure & repair with Tubal Ligation 22000/-

01012007

Perforation of Uterus after D/E Laparotomy &

Closure 18000/-

01012008 Laparotomy-peritonitis Lavage and Drainage 16000/-

01012009 Laparotomy-failed

laparoscopy to explore 6100/-

01012010 Salphingectomy 14000/- 01012011 Salphingo-Oophorectomy 18000/-

01012012 Ovarean Cystectomy 18000/- 01012013 Oopherctomy 15000/-

01012014 Broad Ligment

Haemotoma Drainage 12000/-

01012015

Exploration of perineal Haematoma & Resuturing

of Episiotomy 12000/-

01012016

Exploration of abdominal Haematoma (after

laparotomy + LUCS) 12000/-

01012017 Internal podalic version

and extraction 12000/-

01012018 Manual Removal of

Placenta 3700/-

01012019

3rd stage Complication MRP for outside delivery

etc 4900/-

01012020 Examination under

anaesthesia 2500/- 01012021 Burst-abdomen Repair 3300/-

01012022 Gaping Pareneal Wound

Secondary Suturing 2500/-

01012023 Gaping abdominal wound

Secondary Suturing 3700/-

01012024 Complete perineal tear-

repair 2500/-

01012025 Exploration of PPH-tear

repair 4200/- 01012026 Destructive Operation 12000/-

01012027

Suction evacuation vesicular mole, Missed

abortion D/E 5900/-

01012028 Colpotomy-drainage P/V

needling EUA 4200/-


PROCEDURE


01012029 Repair of post-coital tear,

perineal injury 4200/-

01012030 Excision of urethral

caruncle 4000/- 01012031 Laparoscopy (Gynae) 6100/-

01012032 Shirodhkar, Mc. Donalds

stich 3700/-

01012033 Laparotomy 20000/-

01012034 Abdominal Hysterectomy 22000/-

01012035 Vaginal Hysterectomy 22000/-

01012036 Myomectomy 22000/-

01012037 Vaginoplasty 22000/-

01012038 Vulvectomy

(Simple/Radical) 25000/-

01012039 RVF Repair 25000/-

01012040 Other Major Operations 25000/-

01012041 Manchester Operations 20000/-

01012042 Perineorrhaphy 14700/-

01012043 Colporraphy 14400/-

01012044 Modified Gilliam 16900/-

01012045 Shirodkar’s Operation 10200/-

01012046 Diagnostic Curettage 2700/-

01012047 Fractional Curettage 3400/-

01012048 D & C and Cervical Biopsy 3400/-

01012049 Polypectomy 3600/-

01012050 Other-Minor Operation 3600/-

01012051 Excision Vaginal

Cyst/Burtholin Cyst 3900/-



9


PROCEDURE


01012052 Excision Vaginal Septum 5900/-

01012053 Laparoscopy Diagnostic 6000/-

01012054 Laparoscopy Sterilisation 7300/-

01012055 Laparoscopy Operative 12000/-

01012056 Laparoscopy LAVH 25000/-

01012057 Drilling of Ovary 10800/-

01012058 Adhesiolysis 17400/-

01012059 Management of Ectopic

pregnancy 20000/-

01012060 Hysteroscopy TCRE 11500/-

01012061 Hysteroscopy Removal of

IUCD 5500/-

01012062 Hysteroscopy Removal of

Septum 11500/-

01012063 Hysteroscopy Diagnostic 7300/-

01012064 Werthimas Hystrectomy

for Cancer cervix 30000/-

01012065 Sterilisation Post Pertum 4700/-

01012066 Sterilisation Intravaginal 6000/-

01012067 Abortion- D & C 3900/-

01012068 Abortion- Evacuation 4200/-

01012069 MTP- 1st Trimester 3200/-

01012070 MTP - 2nd Trimester 4800/-

01012071 Extended Hysterectomy 28000/- 013 General Surgery

01013001 Drainage of Abscess 2000/- 01013002 Dressing under G.A. 2400/-

01013003 Aspiration of cold Abscess

of Lymphnode 3100/- 01013004 Aspiration of Empyema 2400/-


PROCEDURE


01013005 Aspiration of Liver

Abscess 3000/-

01013006 Open Drainage of Liver

Abscess 10000/-

01013007 Drainage of Pelvic

Abscess 10000/-

01013008 Drainage of Ischiorectal

Abscess 8000/-

01013009

Drainage of Subdiaphragmatic

Abscess 14000/-

01013010 Open Drainage of

Perinepheric Abscess 14000/-

01013011 Drainage of Perigastric

Abscess 12000/-

01013012 Drainage of Perotid

Abscess 8000/-

01013013 Drainage of

Retropharyngeal Abscess 8000/-

01013014 Open Drainage of Psoas

Abscess 8000/-


Perivertebral Abscess 10000/-

01013016

Fissurectomy/ Haemorroidectomy/ Correction of Piles 16000/-

01013017

Haemorroidectomy/ Correction of Piles with Stapler Gun

(cost of Gun extra) 16000/-

01013018 Excision of Superficial

Neurofibroma 2800/-

01013019 Varicose Veins 25000/-

01013020 Excision of Carbuncle 4000/-

014 Injury Of Superficial Soft

Tissues

015 Interestical (Implant) 01015001 Head & Neck 9700/- 01015002 Breast 9600/- 01015003 Soft Tissue Sarcome 12000/-

016 GASTROENTROLOGY

01016001 Capsule Endoscopy 30000/-



10


PROCEDURE


01016002 Complete Double Baloon

Enteroscopy 18000/-

01016003 Complete Small Bowel

Evaluation 30000/-

01016004 Argan Plasma Coa

(Major) 5000/-


(Major) (BS) 6500/-


(Minor) 2200/-


(Minor) (BS) 3000/-

01016008 Band Ligation 3500/-

01016009 Band Ligation (BS) 5500/-

01016010 Biliary Brushing 1000/-

01016011 Biliary Brushing (BS) 1600/-

01016012 Biliary Pancreatic (M) 16000/-

01016013 Biliary Pancreatic (M) (BS) 23000/-

01016014 Biliary Pancreatic (P) 13300/-

01016015 Biliary Pancreatic (P) (BS) 18000/-

01016016 Cre Ballon Dilatation (BS) 15000/-

01016017 Cre Balloon Dilatation 9000/-

01016018 Dilatation (Stricture) 3000/-

01016019 Dilatation (Stricture) (BS) 4200/-

01016020 EMG Charge (Large) 3500/-

01016021 EMG Charge (Small) 1500/-

01016022 Endoscopic Tube Place 3000/-

01016023 Endoscopic Tube Place

(BS) 4200/-

01016024 Oesophageal Transit 1200/-


PROCEDURE


01016025 Gastrostomy (PEG) 7000/-

01016026 Gastrostomy (PEG) (BS) 11000/-

01016027 Glue Injection 4500/-

01016028 Glue Injection (BS) 7000/-

01016029 Hemosta by Glod Probe 7000/-

01016030 Hemostatic Clip 7000/-

01016031 Hemostatic Clip (BS) 10000/-

01016032 Hepatonorm 700/-

01016033 Injection Hemostasis 4000/-

01016034 Injection Hemostasis (BS) 6000/-

01016035 LGI Manometry 4000/-

01016036 LGI Manometry (BS) 6000/-

01016037 UGI Manometry 3200/-

01016038 UGI Manometry (BS) 4500/-

01016039 Nasobiliary Drainage 12000/-

01016040 Nasobiliary Drainage (BS) 18000/-

01016041 Nasojejunal Tube Plac 3000/-

01016042 Nasojejunal Tube Plac

(BS) 4200/-

01016043 Papilla Cannu Minor 6500/-

01016044 Papilla Cannu Minor (BS) 8200/-

01016045 Pappu Stnt Spingt (M) 12000/-

01016046 Pappu Stnt Spingt (M)

(BS) 17500/-

01016047 Polypectomy (Colonic) 3200/-



11


PROCEDURE


01016048 Polypectomy (Colonic)

(BS) 4800/-

01016049 Polypectomy (Upper GI) 3000/-

01016050 Polypectomy (Upper GI)

(BS) 4500/-

01016051 Pre Cutting 4500/-

01016052 Pre Cutting (BS) 7500/-

01016053 Pseudocyst Drainage 9000/-

01016054 Pseudocyst Drainage (BS) 16000/-

01016055 Sclerotherapy 3000/-

01016056 Sclerotherapy (BS) 3800/-

01016057 Small Bowel Enteroscp 14000/-

01016058 Sphincterotomy 10500/-

01016059 Sphincterotomy (BS) 16000/-

01016060 Stone Extraction 12000/-

01016061 Stone Extraction (BS) 17000/-

01016062 Gastric Emptying 2500/-

01016063 Mechanical Lithotripsy 25000/-

01016064 ERCP (Stenting) 10000/- 017 Head & Neck

01017001 Ear Lobe Repair one side 600/-

01017002

Excision of Pinna for Growth (Squamous/Basal/

Injuries) Skin Only 4500/-

01017003

Excision of Pinna for Growth (Squamous/Basal/

Injuries) Skin and Cartilage 6000/-

01017004 Partial Amputation of

Pinna 6000/- 01017005 Total Amputation of Pinna 7500/-


PROCEDURE


01017006

Total Amputation & Excision of External

Auditory Meatus 10250/-

01017007 Excision of Cystic Hygroma Minor 5500/-

01017008 Excision of Cystic Hygroma Major 8000/-

01017009 Excision of Cystic

Hygroma Extensive 12300/- 01017010 Excision of Branchial Cyst 11000/-

01017011 Excision of Branchial

Sinus 11000/-

01017012 Excision of Pharyngeal

Diverticulum 12200/-

01017013 Mandibulectomy

25000/- 01017014 Operation for Cervical Rib 30000/-

01017015 Pharyngectomy 35000/-

01017016 Stenosis Excision 17000/-

01017017 Commando Operation 27000/-

01017018 Block Dissection of

Cervical Lymph Nodes 20300/-

01017019 Pharyngectomy &

Reconstruction 40000/-

01017020 Operation for Carcinoma

Lip - Wedge Excision 10000/-

01017021 Operation for Carcinoma

Lip - Vermilionectomy 10000/-

01017022

Operation for Carcinoma Lip - Wedge Excision and

Vermilonectomy 12000/- 01017023 Estlander Operation 9700/- 01017024 Abbe Operation 12000/- 01017025 Cheek Advancement 10200/- 01017026 Excision of the Maxilla 23300/-

01017027 Excision of the Mandible -

Segmental 18100/- 01017028 Hemimandibulectomy 27200/- 01017029 Partial Glossectomy 6100/- 01017030 Hemiglossectomy 13500- 01017031 Total Glossectomy 25000/-

01017032 Parotidectomy -

Superficial 24000/-



12


PROCEDURE


01017033 Parotidectomy -

Conservative 19700/-

01017034 Parotidectomy - Radical 22000/-

01017035 Parotidectomy - Total 15000/-

01017036 Repair of Parotid Duct 20400/-

01017037

Removal of Submandibular Salivary

gland 10000/-

01017038 Hemithyroidectomy 15000/- 01017039 Partial Thyroidectomy 16000/-

01017040 Subtotal Thyroidectomy

(Toxic Goitre) 22000/-

01017041 Total Thyroidectomy 23000/-

01017042 Resection Enucleation of

Adenoma 12500/-

01017043 Isthmectomy 12600/-

01017044 Total Thyroidectomy and

Block Dissection 31400/-

01017045 Excision of Lingual

Thyroid 25650/-

01017046 Excision of Thyroglossal

Cyst/Fistula 15000/-

01017047 Excision of Parathyroid Adenoma/Carcinoma 25600/-

01017048 Laryngectomy 37150/-

01017049 Laryngo Pharyngectomy 43500/- 01017050 Sinus & Fistula repair 14000/- 01017051 Lymph Node Excision 8000/- 01017052 Hyoid Suspension 12000/- 01017053 Genioplasty 12000/- 01017054 Direct Laryngoscopy 5400/- 01017055 Phonosurgery 15400/- 01017056 Fibroptic Laryngoscopy 3000/- 01017057 Microlaryngeal Surgery 11000/- 01017058 Laryngofissure 17500/-

018 Head & Neck Cancer 01018001 Benign Tumour Excisions 11000/- 01018002 Temporal Bone resection 27600/- 01018003 Radical Neck Dissection 28500/-


PROCEDURE


01018004 Carotid Body Excision

(cost of Graft extra) 36000/- 01018005 Total Laryngectomy 39050/-

01018006 Flap Reconstructive

Surgery 42800/-

01018007 Parapharyngeal Tumour

Excision 32000/-

01018008 Total Thyroidectomy 30000/- 019 Breast

01019001 Drainage of Abscess 7000/- 01019002 Excision of Lumps 10000/-

01019003 Local Mastectomy

(Simple) 13500/-

01019004 Radical Mastectomy (Formal or Modified) 28000/-

01019005 Excision of Mammary

Fistula 16000/-

01019006 Segmental Resection of

Breast 18300/-

01019007 Breast Cancer (Tumour

excision) 30000/-

020 Cardio Respiratory

Procedures 01020001 Tracheostomy 3700/-

01020002 Thoracotomy (Penetrating

Wounds) 17500/-

01020003 Intercostal Drainage of

empyema 5400/-

01020004 Decortication (Pleurectomy) 37000/-

01020005 Thoracoplasty 37000/- 01020006 Pneumonectomy 37000/- 01020007 Lobectomy 37000/- 01020008 Segmental Resection 37000/- 01020009 Hydatid Cyst- Removal 37000/-

01020010

Video-assisted thoracoscopic lung

Surgeries 37000/-

01020011

Lung volume reduction surgery (Unilateral/

Bilateral) 37000/-

01020012 Thoracoscopic Decortication 37000/-

01020013 Thoracoscopic

Pneumonectomy 37000/- 01020014 Thoracoscopic Lobectomy 37000/-



13


PROCEDURE


01020015 Thoracoscopic Segmental

Resection 37000/-

01020016 Thoracoscopic Cyst excision 37000/-

01020017 Thoracoscopic

Sympathectomy 37000/-

01020018

Chest Wall Tumor Excision with


01020019 Repair of Congenital

Chest Wall Defermities 37000/-

01020020 Multiple Lobectomy 37000/-

01020021 Decortication + Thoracoplasty 37000/-

01020022

Decortication + Lung Resection +

Thoracoplasty 37000/-

01020023 Open Lung Biopsy 18000/-

01020024 Medicistinoscopy(cervical) 15000/-

01020025 Video-assisted

thoracoscopy (VATS) 36960/-

01020026 Thoracotomy for BPF 37000/-

01020027 Surgery for Destroyed

Lung 37000/-

01020028 Sleeve Resection with

Lobectomy 37000/-

01020029 Extrapleural

Pneumonectomy 37000/-

01020030 Tracheal Stenosis Surgery 37000/-

01020031 Repair of Tracheo Innuminete Fistula 37000/-

01020032 Tracheal Resection for

Tracheal Tumour 37000/-

01020033 Segmentectomy 37000/-

01020034 Wedge Resection 37000/-

01020035

Lung Resection with Paratracheal L. Node

Resection 37000/-

01020036 Lung Resection with Chest Wall Invasion 37000/-


PROCEDURE


01020037

Lung Resection with Dissection of Lymph Node

Stations 37000/-

01020038 Surgery for Recurrent

Pnemothoraxic 37000/-

01020039 Surgery for Aspergillosis

(Lung Cavities) 37000/- 01020040 Bronchotomy 37000/-

01020041 Mediostonoscopy 15000/-

021 Cardiac / Cardio

Thoracic Procedures

01021001

Coronary Bypass Surgery (including Pre-Surgery

Profile) 150000/-

01021002

Coronary Bypass Surgery-post Angioplasty

(including Pre-Surgery Profile) 150000/-

01021003

Coronary Balloon Angioplasty

(Excluding Cost of Stents) (including Pre-Surgery

Profile) (4 days’ package) 66000/-

01021004

Balloon angioplasty with Valvotomy (including Pre-

Surgery Profile) 90000/-

01021005

Open Heart Procedures (including Pre-Surgery

Profile) 150000/-

01021006

Total Correction of Tetralogy of Fallot


01021007

RSUV Correction (including Pre-Surgery

Profile) 150000/-

01021008

TAPVC Correction (including Pre-Surgery

Profile) 150000/-

01021009 Open ASD VSD (including

Pre-Surgery Profile) 150000/-

01021010

Open Pulmonary Valvotomy (including Pre-

Surgery Profile) 150000/-

01021011

Open Aortic Valvotomy (including Pre-Surgery

Profile) 150000/-

01021012

Blalock Taussig Operation (including Pre-Surgery

Profile) 72000/-



14


PROCEDURE


01021013

Mitral Valvotomy (including Pre-Surgery

Profile) 72000/-

01021014

Mitral Valve Replacement (Excluding Cost of Valve)


01021015

Aortic Valve Replacement (Excluding Cost of Valve)


01021016

Double Valve Replacement (Excluding Cost of Valves) (including


01021017

Thoraco-Abdomi Aorta Replacement (including


01021018

Coarctation-Arota Repair of Block Taussing Shunt (including Pre-Surgery

Profile) 96000/-

01021019

Patent Ductus Arteriousus (including Pre-Surgery

Profile) 72000/-

01021020

Mitral Valvotomy (Open) (including Pre-Surgery

Profile) 150000/-

01021021 Pericardiostomy (including


01021022 Pericardiectomy (including

Pre-Surgery Profile) 72000/- 01021023 Pericardio Centesis 3900/-

01021024

Permanent Pacemaker Implantation (Excluding

Cost of Pacemaker) (4 days’ package) 19400/-

01021025

Temporary Pacing Lead Implantation (Including

use of Temporary Pacemaker) 12600/-

01021026 Embolectomy 19800/-

01021027

Aneurysm- Resection & Grafting (cost of Graft

extra) 96000/-

01021028 Thoracocentesis 2000/-

01021029 Thorachostomy 5400/-

01021030 Exploratory Thorocotomy 37000/-


PROCEDURE


01021031

Unifocalization with Shunt (including Pre-Surgery

Profile) 150000/-

01021032

Removal of Foreign Body from Trachea or

Oesophagus 6000/-

01021033 Rib Resection & Drainage 11500/- 01021034 Mediastinal Tumour 35000/- 01021035 Thymectomy 35000/-

01021036 ASD Device Closure

(Excluding Cost of Device) 40000/-

01021037 PDA Device Closure

(Excluding Cost of Device) 32000/- 01021038 DSA 5400/- 01021039 EP STUDY 8400/- 01021040 3D RF Ablation 40000/- 01021041 Mini EP Study 5000/-

01021042 Coronary Angiography

(1 day’s package) 11700/- 01021043 Fonten 170000/- 01021044 Gunshot injury 52000/- 01021045 Heart transplant 277000/- 01021046 Intra coronary stenting 58000/- 01021047 Directiol atherectomy 98000/-

01021048

Permanent Pacemaker Implantation (DDD)

(Pacemaker Cost extra) (4 days’ package) 25000/-

01021049

Permanent Pacemaker Implantation

(Biventricular) (Pacemaker Cost extra) (4

days’ package) 30000/- 01021050 Femoral Poplitial Bypass 75000/- 01021051 Iliacfemoral Bypass 75000/- 01021052 Aorto Bifemoral Bypass 75000/-

01021053 Carotid Subclavian

Bypass 75000/- 01021054 PA Banding 55000/- 01021055 BD Glen 55000/-

01021056

Thoracic Aorta/ Arch Replacement (including


01021057

AICD/ICD Implantation procedure charges (cost

of implants extra) 60000/-



15


PROCEDURE


Note:- CABG if done along with other Heart Surgeries like Valve Replacement etc. will attract the same rate as

CABG.

022 Oesophagus

01022001

Atresia of Oesophagus and Tracheo

Oesophageal Fistula 29700/-

01022002

Operations for Replacement of

Oesophagus by Colon 38000/-

01022003 Oesophagectomy for

Carcinoma Easophagus 38000/-

01022004 Oesophageal Intubation (Mausseau Barbin Tube) 15500/-

01022005 Achalasia Carida

Transthoracic 29700/-

01022006 Achalasia Carida

Abdominal 14600/-

01022007 Oesophago Gastrectomy

for mid 1/3 lesion 38000/-

01022008 Oesophagus Dilatation of

Stricture- per visit 1500/-

01022009

Colon-Inter position or Replacement of

Oesophagus 38000/-

01022010

Oesophago Gastrectomy – Lower Corringers

procedure 38000/-

01022011 Esophageal Perforation

Surgery 38000/-

01022012 Installation of Ryles Tube

in Ca Esophagus 5000/-

01022013 Esophageal Directiculum

Surgery 38000/- 023 Abdomen

01023001 Gastroscopy 1300/-

01023002 Gastric & Duodenal Biopsy (Endoscopic) 1700/-

01023003 Pyleromyotomy 10000/- 01023004 Gastrostomy 12000/-

01023005 Simple Closure of

Perforated peptic Ulcer 15000/-

01023006 Vagotomy Pyleroplasty /

Gastro Jejunostomy 30000/- 01023007 Duodenojejunostomy 25000/-


PROCEDURE


01023008

Partial/Subtotal Gastrectomy for

Carcinoma 30000/-

01023009 Partial/Subtotal

Gastrectomy for Ulcer 30000/-

01023010 Operation for Bleeding

Peptic Ulcer 25000/-

01023011 Gastrojejunostomy &

Vagotomy 27000/-

01023012 Operation for

Gastrojejunal Ulcer 25000/-

01023013 Total Gastrectomy for

Cancer 35000/-

01023014 Highly Selective

Vagotomy 25000/-

01023015 Selective Vagotomy &

Drainage 25000/-

01023016 Congenital Diaphragmatic

Hernia 30000/-

01023017 Hiatus Hernia Repair

Abdominal 30000/-

01023018 Hiatus Hernia Repair

Transthoracic 30000/- 01023019 Exploratory Laparotomy 12900/- 01023020 Epigastric Hernia Repair 15000/- 01023021 Umbilical Hernia Repair 15000/-

01023022 Ventral and Scar Hernia

Repair 18000/-

01023023 Inguinal Hernia

Herniorraphy- unilateral 15000/-

01023024

Inguinal Hernia – Hernioplasty- with mesh-

unilateral 22000/- 01023025 Femoral Hernia Repair 22000/-

01023026

Rare Hernias - Repair (Spigalion, Obturator,

Lumbar, Sciatic) 25000/-

01023027 Splenectomy - For

Trauma 25000/-

01023028 Splenectomy - For

Hypersplenism 25000/- 01023029 Splenorenal Anastomosis 40000/- 01023030 Portocaval Anastomosis 40000/-

01023031

Direct Operation on Oesophagus for Portal

Hypertension 30000/-



16


PROCEDURE


01023032 Mesentericocaval

Anastomosis 35000/- 01023033 Warren Shunt 35000/- 01023034 Pancerato Duodenectomy 36000/-

01023035

By Pass Procedure for Inoperable Carcinoma of

Pancreas 30000/-

01023036 Cystojejunostomy or Cystogastrostomy 30000/-

01023037 Cholecystectomy 18000/-

01023038 Cholecystectomy & Exploration of CBD 22000/-

01023039 Repair of Common Bile

Duct 20000/-

01023040 Operation for Hydatid Cyst

of Liver 25000/- 01023041 Cholecystostomy 14200/-

01023042 Hepatic Resections

(Lobectomy Hepatectomy) 28000/-

01023043 Operation on Adrenal

Glands - Bilateral 35000/-

01023044

Operation on Adrenal Glands - Unilateral for

Tumour 20000/-

01023045 Appendicectomy for Acute

Appendicitis 20000/-

01023046 Appendicectomy for Chronic Appendicitis 18000/-

01023047 Appendicular Abscess –

Drainage 12000/- 01023048 Mesenteric Cyst- Excision 18000/-

01023049 Peritonioscopy/

Laparoscopy 5100/- 01023050 Jejunostomy 18000/- 01023051 Ileostomy 18000/-

01023052 Congenital Atresia &

Stenosis of Small Intestine 25000/- 01023053 Muconium ileus 20000/-

01023054 Mal-rotation & Volvulus of

the Midgut 20000/-

01023055 Resection & Anastomosis

of Small Intestine 22000/-

01023056 Excision of Meckle’s

Deverticulum 22000/- 01023057 Duodenal Diverticulum 18000/-


PROCEDURE


01023058 Operation for Intestinal

Obstruction 25000/-

01023059 Operation for Intestinal

perforation 25000/-

01023060 Benign Tumours of Small

Intestine 25000/-

01023061 Excision of Small Intestine

Fistula 25000/-

01023062

Operations for Haemorrhage of the Small

Intestines 25000/-

01023063

Operations of the Duplication of the

Intestines 32000/-

01023064

Operations for Recurrent Intestinal Obstruction

(Noble Plication & Other Operations for the

Adhesions) 28000/- 01023065 Ilieosigmoidostomy 22000/- 01023066 Ilieotransverse Colostomy 22000/- 01023067 Caecostomy 10000/-

01023068 Loop Colostomy

Transverse Sigmoid 20000/- 01023069 Terminal Colostomy 24000/- 01023070 Closure of Colostomy 24000/- 01023071 Right Hemi-Colectomy 24000/- 01023072 Left Hemi-Colectomy 24000/- 01023073 Total Colectomy 39000/-

01023074 Operations for Volvulus of

Large Bowel 25200/-

01023075 Operations for Sigmoid

Diverticulitis 22000/- 01023076 Fissure in Ano - Dilatation 6800/-

01023077 Fissure in Ano - Fissurectomy 16000/-

01023078 Rectal Polyp-Excision 8000/-

01023079

Operation of Haemorrhoids -Lords

procedure 10000/-

01023080 Fistula in Ano - High

Fistulectomy 20000/-

01023081 Fistula in Ano - Low

Fistulectomy 12000/-

01023082 Imperforat Anus -

Colostomy 16000/-



17


PROCEDURE


01023083 Imperforate Anus - Pull

Through Operation 22000/-

01023084 Prolapse Rectum -

Theirch Wiring 15000/-

01023085 Prolapse Rectum -

Rectopexy 10000/-

01023086 Prolapse Rectum - Grahams Operation 22000/-

01023087 Operations for

Hirschsprungs Disease 22000/- 01023088 Excision of Pilonidal Sinus 12300/-

01023089 Abdomino-Perineal Excision of Rectum 26700/-

01023090 Anterior Resection of

rectum 26300/-

01023091 Pull Through Abdominal

Resection 22000/-

01023092 Operations for Neuroblastoma 22000/-

01023093 Fistula/ Fistulotomy 12000/-

01023094 Hernioctomy 21000/-

024 Nephrology / Genitourinary

01024001 Partial Nephrectomy 25000/- 01024002 Nephrolithotomy 25000/- 01024003 Pyelolithotomy 25000/-

01024004 Operations for

Hydronephrosis 25000/-


Perinephric Abscess 15000/- 01024006 Cavernostomy 20400/-

01024007 Operations for Cyst of the

Kidney 25000/- 01024008 Ureterolithotomy 20000/- 01024009 Nephroureterectomy 20000/-

01024010 Operations for Ureter for -

Double Ureters 30000/-

01024011 Operations for Ureter -for Ectopia of Single Ureter 27000/-

01024012 Operations for Vesico-

ureteric Reflux 28000/- 01024013 Ureterostomy - Cutaneous 20000/- 01024014 Uretero-Colic anastomosis 20000/- 01024015 Formation of an Ileal 22000/-


PROCEDURE


Conduit 01024016 Ureteric Catheterisation 5000/-

01024017 Dormia Extraction of

Calculus 6000/-

01024018 Biopsy of Bladder

(Cystoscopic) 6000/-

01024019 Diathermy Destruction of

Bladder Neoplasm 15000/- 01024020 Litholapexy 15000/-

01024021 Operations for Injuries of

the Bladder 30000/-

01024022

Suprapubic Drainage (Cystostomy/ Vesicostomy) 12000/-

01024023 Total Cystectomy 35000/- 01024024 Diverticulectomy 32000/-

01024025 Open Resection of the

Bladder Neck 25000/-

01024026 Y-V Plasty of the Bladder

Neck 25000/- 01024027 Cystoplasty 28000/-

01024028 Operations for Extrophy of

the Bladder 40000/- 01024029 Repair of Ureterocoel 25000/- 01024030 Suprapubic Prostatectomy 25000/- 01024031 Retropubic Prostatectomy 25000/-

01024032

Transurethral Resection of Prostate (TURP)/ TUR

Bladder Tumour 25000/-

01024033

Intravesical BCG instillation (Cost of BCG

extra) 500/-

01024034 Operations for Injury to

Urethra 30000/- 01024035 Internal urethrotomy 15000/- 01024036 Urethral Reconstruction 32000/-

01024037 Operation for Congenital

Valves of Urethra 16000/-

01024038

Operations for Incontinence of Urine -

Male 25000/-

01024039

Operations for Incontinence of Urine -

Female 25000/-

01024040 Reduction of Paraphimosis 2450/-

01024041 Circumcision (under

General Anaesthesia) 6000/-



18


PROCEDURE


01024042 Meatotomy 3500/-

01024043 Meatoplasty 6800/-

01024044

Operations for Hypospadias - Chordee

Correction 15000/-

01024045

Operations for Hypospadias - Second

Stage or One Stage Repair 24000/-

01024046 Operations for Epispadias 22000/-

01024047 Partial Amputation of the

Penis 14000/-

01024048 Total amputation of the

Penis 20000/- 01024049 Orchidectomy- Simple 14000/- 01024050 Orchidectomy- Radical 20000/-

01024051

Adreneclectomy Unilateral/Bilateral for

Tumour/For Carcinoma 30000/-

01024052 Operations for Hydrocele -

Unilateral 8000/-

01024053 Operations for Hydrocele -

Bilateral 12000/-

01024054 Operation for Torsion of

Testis 15000/- 01024055 Vasovasostomy 18000/- 01024056 Operations for Varicocele 15000/-

01024057 Block Dissection of

Inguinal Nodes - One Side 25000/-

01024058

Block Dissection of Inguinal Nodes - Both

Sides 32000/-

01024059 Excision of Filarial

Scrotum 16000/-

01024060 Emergency Dialysis Femoral Puncture 1200/-

01024061 Emergency Dialysis Subclavian Puncture 1800/-

01024062 Fistula/Shunt 8000/-

01024063 Dialysis Femoral

Catheterisation Bilateral 1500/-

01024064 Haemo Dialysis (All

Inclusive) 1500/-

01024065 Double Lumen Sub Clavian Catheter 3000/-

01024066 Continuous Arterio Venus Haemofiltration (CAVH)/ 17000/-


PROCEDURE


CAVD

01024067 Subclavian Access 1850/- 01024068 Femoral Access 1750/- 01024069 Plasma Exchange 2500/- 01024070 Donor Nephrectomy 50000/- 01024071 Renal Transplantation 250000/- 01024072 Ureteric Reimplant 4200/- 01024073 Lymphocoel 4300/- 01024074 Transplant Nephrectomy 35000/-

01024075 Nephrouretectomy 35000/- 01024076 Vascular Prosthetic Graft 35000/-

01024077 CAPD (insertion &

removal) 8000/- 01024078 PCNL - Unilateral 30000/-

01024079 PCNL – Bilateral/

PCNL-III 46000/- 01024080 Palomo’s Unilateral 7300/- 01024081 Palomo’s Bilateral 12600/- 01024082 Endoscopic Teflon Inject 5100/- 01024083 Testicular Biopsy 4350/-

01024084 Gil-Verner’s Extended

Pyelolithotomy 22000/-

01024085

Radical Nephrectomy Complicated Tumour or

Adhesions 50000/-

01024086 Anderson Hynes

Pyeloroplasty 25000/-

01024087 Vasico Vaginal Fistula

Repair 30000/- 01024088 Radical Cystectomy 44000/- 01024089 Caeco Cystoplasty 26000/- 01024090 Nephrectomy Simple 25000/- 01024091 Nephrostomy 22000/- 01024092 Ureteric Reimplant 25000/- 01024093 Partial Cystectomy 28000/-

01024094 Epididymectomy 12000/- 01024095 TURP Cystolithotripsy 30000/- 01024096 Open Prostatectomy 28000/- 01024097 Closure of Urethral Fistula 28000/- 01024098 Orchidopexy - Unilateral 15000/- 01024099 Orchidopexy - Bilateral 20000/-

01024100 Cystolithotomy -

Suprapubic 15000/-



19


PROCEDURE


01024101 Endoscopic Removal of

Stone in Bladder 18000/-

01024102 Resection Bladder Neck

Endoscopic 18000/-

01024103 Ureteroscopic Removal-

with LASER 40000/-

01024104 Ureteroscopic Removal-

without LASER 18000/-

01024105 Urethroplasty 1st Stage 14000/- 01024106 Optical Urethrotomy 18000/- 01024107 Exploratory Scrototomy 10000/- 01024108 Perineal Urethrostomy 15000/-

01024109 Dilatation of Stricture Urethra under G.A. 4000/-

01024110

Dilatation of Stricture Urethra without

Anesthesia 2200/-

01024111 Retroperitoneoscopy

Nephrectomy 40000/-

01024112 Retroperitoneoscopy partial Nephrectomy 35000/-

01024113 Retroperitoneoscopic

nephrolithotomy 35000/-


pyelolithotomy 35000/-

01024115

Retroperitoneoscopic operation for

Hyderonephrosis 35000/-


surgery for Renal cyst 35000/-


ureterolithotomy 35000/-

01024118 Retroperitoneoscopic Nephroureteroectomy 35000/-

01024119 Laproscopy aassisted

orchidopexy 22000/-

01024120 Laproscopic operation for

varicocele 20000/-

01024121 Cystoscopic Basketing of

Urethra 12000/-

01024122 Lithotripsy/ ESWL

(Complete) 30000/-

01024123 Lithotripsy-1/ SMSL (Day

Care) 18000/-

01024124 Lithotripsy-2/3/ SMSL

(Day Care) 23000/-


PROCEDURE


01024125 Slow Efficiency Dialysis

(SLED) 4000/-

01024126 Prosthetic Surgery for urinary incontinence 40000/-

01024127

Helium Laser Prostrate surgery/ Optical Internal

urethrotomy 30000/-

01024128

High Intensity Focus Ultrasound (HIFU) Robotic

for Carcinoma 150000/- 01024129 CRRT Procedure 11000/- 01024130 TURP with LASER 32000/- 01024131 Lithoclast (Day Care) 16000/-

025 Plastic Surgery 01025001 Primary Suture of Wound 3200/-

01025002 Injection of Keloids -

Ganglion 2700/-

01025003 Injection of Keloids -

Haemangioma 6100/- 01025004 Free Grafts - Wolfe Grafts 18000/-

01025005 Free Grafts - Theirech -

Small Area 5% 18500/-

01025006 Free Grafts - Large Area

10% 30000/-

01025007 Free Grafts - Very Large

Area 20% 32400/-

01025008 Skin Flaps - Rotation

Flaps 28750/-

01025009 Skin Flaps -

Advancement Flaps 31650/-

01025010

Skin Flaps - Direct- cross Leg Flaps- Cross Arm

Flap 35500/-

01025011 Skin Flaps - Cross

Finger 35500/-

01025012 Skin Flaps - Abdominal 35500/-

01025013 Skin Flaps - Thoracic 34400/- 01025014 Skin Flaps - Arm Etc. 35500/-

01025015 Subcutaneous Pedicle

Flaps Raising 28500/-


Flaps Delay 27750/-


Flaps Transfer 28500/- 01025018 Cartilage Grafting 29700/- 01025019 Reduction of Facial 9000/-



20


PROCEDURE


Fractures of Nose

01025020 Reduction of Facial Fractures of Maxilla 13800/-

01025021

Reduction of Fractures of Mandible & Maxilla - Eye

Let Splinting 27000/-

01025022

Reduction of Fractures of Mandible & Maxilla - Cast

Netal Splints 27000/-

01025023

Reduction of Fractures of Mandible & Maxilla -

Gumming Splints 27000/-

01025024 Internal Wire Fixation of

Mandible & Maxilla 32000/-

01025025 Cleft Lip - repair. 32400/-

01025026 Cleft Palate Repair

Severe Degree 33800/-

01025027 Primary Bone Grafting of

Cleft Lip Palate 34550/-

01025028 Secondary Surgery for

Cleft Lip Deformity 32600/-

01025029 Secondary Surgery for

Cleft Palate 31350/-

01025030 Reconstruction of Eyelid

Defects - Minor 17550/-

01025031 Reconstruction of Eyelid

Defects - Major 30000/-

01025032

Plastic Surgery of Different Regions of the

Ear - Minor 10000/-

01025033

Plastic Surgery of Different Regions of the

Ear - Major 20000/-

01025034 Plastic Surgery of the

Nose - Minor 10000/-

01025035 Plastic Surgery of the

Nose - Major 20000/-

01025036

Plastic Surgery for Facial Paralysis (Support with

Reanimation) 32000/-

01025037 Pendulous Breast -

Mammoplasty 22550/-


PROCEDURE


026 Orthopaedic Surgery

Procedure

01026001 Application of P.O.P Casts for Upper & Lower Limbs 7500/-

01026002 Application of Functional

Cast Brace 7500/-

01026003 Application of Skin

Traction 1650/-

01026004 Application of Skeletal

Tractions 4450/-

01026005 Bandage & Strappings for

Fractures 1150/-

01026006 Aspiration & Intra Articular

Injections 950/-

01026007 Application of P.O.P

Spices & Jackets 6000/-

01026008 Close Reduction of

Fractures of Limb & P.O.P 7500/-

01026009 Reduction of Compound

Fractures 10000/-

01026010 Open Reduction & Internal Fixation of Fingurs & Toes 18000/-

01026011

Open Reduction of fracture of Long Bones of

Upper / Lower Limb -Nailing & External Fixation 28000/-

01026012

Open Reduction of fracture of Long Bones of Upper / Lower Limb -AO

Procedures 27000/-

01026013 Tension Band Wirings 6000/-

01026014 Bone Grafting 18000/-

01026015 Excision of Bone Tumours

-Superficial 28000/-

01026016 Excision of Bone Tumours

-Deep 40000/-

01026017 Excision of Ganglion 10000/-

01026018

Excision or other Operations for Scaphoid

Fractures 25000/-

01026019

Sequestrectomy & Saucerizations -

Superficial 20000/-



21


PROCEDURE


01026020 Sequestrectomy &

Saucerizations -Deep 30000/-

01026021

Sequestrectomy & Saucerizations -

Arthrotomy 35000/-

01026022 S.P.Nailing for Fracture

Neck Femur 35000/-

01026023 Multiple Pinning Fracture

Neck Femur 35000/-

01026024 Nail Plate Fixations for Fracture Neck Femur 35000/-

01026025

A.O.Compression Procedures for Fracture

Neck Femur 35000/-

01026026

Open Reduction of Fracture Neck Femur

Muscle Pedicle Graft and Internal Fixations 35000/-

01026027 Closed Reduction of

Dislocations 10000/-

01026028 Open Reduction of

Dislocations - Superficial 20000/-

01026029 Open Reduction of

Dislocations - Deep 30000/-

01026030

Open Reduction of Fracture Dislocation &

Internal Fixation 35000/-

01026031 Neurolysis/Nerve Suture 25000/-

01026032 Nerve Repair with Grafting 32000/-

01026033 Tendon with Transplant or

Graft 35000/-

01026034

Tendon Lengthening/Tendon

Sutures 25000/-

01026035 Tendon Transfer 35000/-

01026036 Laminectomy, Excision Disc (Prosthesis extra) 40000/-

01026037

Laminectomy, Excision Disc and Tumours (Prosthesis extra) 60000/-

01026038 Anterolateral Clearance

for tuberculosis 32000/-

01026039 Antereolateral

Decompression and 45000/-


PROCEDURE


Spinal Fusion

01026040 Costo Transversectomy 30000/-

01026041 Corrective Ostectomy & Internal Fixation - Minor 15000/-

01026042 Corrective Ostectomy & Internal Fixation - Major 30000/-

01026043 Arthrodisis of - Minor

Joints 15000/-

01026044 Arthrodisis of - Major

Joints 30400/-

01026045 Soft Tissue Operations for

C.T.E.V. 25000/-

01026046

Soft Tissue Operations for Polio (instrumentation

extra) 25000/-

01026047 Partial Hip Replacement (Cost of Prosthesis extra) 40000/-

01026048 Operations for Brachial Plexus & Cervical Rib 32000/-

01026049 Amputations - Below

Knee Rs 25000/-

01026050

Amputations - Below

Elbow 25000/-

01026051

Amputations - Above

Knee 35000/-

01026052 Amputations - Above

Elbow 30000/-

01026053 Amputations - Forequarter 40000/-

01026054

Amputations -Hind Quarter and

Hemipelvectomy 44000/-

01026055 Disarticulations - Major 30000/- 01026056 Disarticulations - Minor 20000/-

01026057 Arthrography &

Osteomedullography 10450/-

01026058 Spinal Ostectomy and

Internal Fixations 40200/- 01026059 Arthroscopy - Operative 24250/-

01026060 Soft Tissue Operation on

Knee 24000/-

01026061

Myocutaneous and Fasciocutaneous Flat Procedures for Limbs 24000/-

01026062 Removal of Nails, Wires & 10000/-



22


PROCEDURE


Screw

01026063 Removal of Plates 15000/-

01026064

Total Hip Replacement-Unilateral (Excluding

Implants) 60000/-

01026065

Total Finger Joint Replacement-Unilateral

(Excluding Implants) 23000/-

01026066

Total Knee Joint Replacement-Unilateral

(Excluding Implants) 55000/-

01026067

Any Other Joint Replacement (e.g. elbow, shoulder, etc.)- Unilateral (Cost of Implants extra) 55000/-

01026068

Multiple fractures repair (excluding peripheral limb

injuries)-major (above three fractures) (cost of

implants extra) 100000/-

01026069

Multiple fractures repair (excluding peripheral limb injuries)-medium (above two fractures) (cost of

implants extra) 60000/-

01026070 Sternal Dehisences

Repair 25000/-

01026071 Sternal Dehisences


01026072 Fingers (post, slab) 300/-

01026073 Fingers full plaster 300/-

01026074 Colles Fracture - Below

elbow 1200/-

01026075 Colles Fracture - Full

plaster 2000/-

01026076 Colles fracture Ant. Or

post. slab 1000/-

01026077 Above elbow full plaster 1000/-

01026078 Above Knee post-slab 700/-

01026079 Below Knee full plaster 1000/-

01026080 Below Knee post-slab 750/-


PROCEDURE


01026081 Tube Plaster (or plaster

cylinder) 1450/-

01026082 Above knee full plaster 2400/-

01026083 Above knee full slab 2200/-

01026084 Minerva Jacket 4000/-

01026085 Plaster Jacket 3050/-

01026086 Shoulder spica 3350/-

01026087 Single Hip spica 3100/-

01026088 Double Hip spica 3800/-

01026089 Resection of First Rib 45000/-

01026090 Resection of Cerical Rib 35000/-

01026091 Rib Resection 12500/-

01026092 Ligament Reconstruction 22000/-

027 Neuro-Surgery

01027001

Craniotomy and Evacuation of Haematoma

-Subdural 70000/-

01027002

Craniotomy and Evacuation of Haematoma

-Extradural 70000/-

01027003 Evacuation of Brain

Abscess 80000/-

01027004

Excision of Lobe (Frontal, Temporal, Cerebelium

etc.) 80000/-

01027005 Excision of Brain Tumours

-Supratentotial 80000/-

01027006 Excision of Brain Tumours

-Subtentorial 80000/-

01027007 Surgery of Cord Tumours 60000/-

01027008

Ventriculoatrial /Ventriculoperitoneal

Shunt 40000/-

01027009 Excision of Cervical Inter-

Vertebral Discs 50000/-



23


PROCEDURE


01027010 Sympathetectomy -

Lumbar 18000/-

01027011 Sympathetectomy -

Cervical 18000/-

01027012 Twist Drill Craniostomy 30000/- 01027013 Subdural Tapping 15000/-

01027014 Ventricular Tapping 12000/-

01027015 Abscess Tapping 15000/-

01027016 Placement of ICP Monitor

- 15000/-

01027017 Urokinase Therepy for

ICH - 15000/- 01027018 Skull Traction Application 3400/-

01027019 Lumber Pressure

Monitoring 10000/- 01027020 Vascular Malformations 100000/- 01027021 Peritoneal Shunt 15000/- 01027022 Atrial Shunt 15000/- 01027023 Meningo Encephalocoel 52000/- 01027024 Meningomyelocoel 42000/- 01027025 C.S.F. Rhinorrhaea 55000/- 01027026 Cranioplasty 55000/-

01027027 Posterior Cervical

Dissectomy 50000/-

01027028 Anterior Cervical

Dissectomy 50000/-

01027029 Brachial Plexus

Exploration Microsuturing 50000/-

01027030 Median Nerve

Decompression 40000/-

01027031 Peripheral Neurectomy

(Tirgeminal) 45000/- 01027032 Trigeminal Rhiotomy 35000/-

01027033 Cranial Nerve Astomosis 60000/-

01027034 Meningocoele Excision 45000/-

01027035 Peripheral Nerve Surgery

– Major 50000/-

01027036 Peripheral Nerve Surgery

Minor 40000/-

01027037 Ventriculo-Atrial Shunt (Exclud. Cost of valve) 100000/-

01027038 Nerve Biopsy (Procedure 15000/-


PROCEDURE


+ Investigation)

01027039 Brain Biopsy (Procedure +

Investigation) 18000/-

01027040 Anterior Cervical Spine

Surgery with fusion 60000/-

01027041 Anterior Lateral Decompression 60000/-

01027042 Brain Mapping 2400/-

01027043 Cervical or Dorsal

Laminectomy 45000/-

01027044

Combined Trans-oral Surgery & CV Junction

Fusion 110000/- 01027045 C.V. Junction Fusion 80000/- 01027046 Depressed Fracture 40000/-

01027047 Discectomy 45000/- 01027048 Endarterectomy 50000/-

01027049 R.F. Lesion for Trigeminal

Neuralgia - 30000/- 01027050 Spasticity Surgery - 90000/- 01027051 Spinal Fusion Procedure 65000/-

01027052 Spinal Intra Medullary

Tumours 65000/-

01027053 Spinal Bifida Surgery

Major 65000/-

01027054 Spina/ Bifida Surgery

Minor 55000/-

01027055 Stereotaxic Procedures-

biopsy/ aspiration 22000/- 01027056 Trans Sphenoidal Surgery 65000/- 01027057 Trans Oral Surgery 110000/-

01027058 Implantation of DBS- one

Electrode 100000/-

01027059 Implantation of DBS- two

Electrodes 100000/-

01027060 Endoscopic

Adueductoplasty 100000/-

01027061 Facial nerve

reconstruction 50000/-

01027062 Recanelisation of venous

sinuses 80000/-

01027063 Carotid stenting 75000/-

01027064 Cervical disc arthroplasty 35000/-



24


PROCEDURE


01027065 Lumbar disc arthroplasty

30000/-

01027066 Corpus Callosectomy 60000/-

01027067 Hemishpherectomy 80000/-

01027068 Endoscopic CSF rhinorrhea repair 50000/-

01027069 Microsurgical excision of

Acoustic tumour 60000/-

01027070 Microsurgical excision of

meningomas 60000/- 01027071 Epilepsy surgery 80000/-

01027072 RF lesion for facet pain

syndrome 40000/- 01027073 Cervical laminoplasty 40000/-

01027074 Lateral mass C1-C2 screw

fixation 60000/-

01027075

Microsurgical decompression for

Trigemil nerve 60000/-

01027076 Cerebellar stimulation for

hemifacial spasm 80000/-

01027077

Cerebellar stimulation for other cranial nerve

neuralgia 80000/-

01027078 IC EC bypass procedures 70000/-

01027079 Stereotactic guided

craniotomy 70000/-

01027080

Baclofen pump implantation lesioning for

movement disorder including Parkinsonism 60000/-

01027081 Programmable shunt 40000/-

01027082 Endoscopic

sympathectomy 18000/-

01027083 External ventricular

drainage 12000/-

01027084 Image guided surgery Excision of tethored 60000/-

01027085 Endoscopic 3rd ventriculostomy 60000/-

01027086

Endoscopic cranial surgery/Biopsy/aspiration/

aneurysm coiling 60000/-


PROCEDURE


01027087 Endoscopic discectomy 60000/-

01027088 Aneurysm coiling 80000/-

01027089

Endoscopic spil procedure- aneurysm

coiling 80000/-

01027090

Surgery for grooving skull fractures- aneurysm

coiling 80000/-

01027091 Carpel Tunnel decompression 40000/-

01027092 Clipping of intracranial

aneurysm with use of clip 90000/-

01027093

Endoscopic aspiration of intracerebellar haematoma 60000/-

01027094

Stereotactic Radiosurgery for brain pathology (X

knife/ Gamma) 120000/-

01027095 Foramen magnum

decompression 60000/-

01027096

Foramen magnum decompression with syringosubarachnoid

shunt 60000/-

01027097

Dorsal column stimulation for bachache in failed

back syndrome 50000/-

01027098 Surgery for recurrent disc prolapse/ epidural fibrosis 60000/-

01027099 Surgery for brain stem

tumours 100000/-

01027100

Decompressive cranectomy for

hemishpherical acute subdural 70000/-

01027101

Intra arterial thrombolysis with RTPA for ischemic

stroket RTPA-acute 100000/-

01027102 Stereotactic aspiration of intracerebral haematoma 50000/-

01027103 Complex Brain Surgery 130000/-

01027104 Complex Spine Surgery 110000/-

01027105 Dorsal Sympathectomy 50000/-



25


PROCEDURE


01027106

Neuro rehabilitisation- package for 25 sittings

(bed charges extra) 15000/- 028 Vascular Surgery

01028001 Patch Graft Angioplasty 50000/-

01028002 Operations for Stenosis of

Renal Arteries 50000/-

01028003 Thrombendarterectomy 50000/-

01028004 Operations for Acquired

Arteriovenous Fistula 50000/-

01028005 Congenital Arterio Venous

Fistula 27700/-

01028006 Surgery for Arterial

Aneursysm -Vertebral 80000/-

01028007 Surgery for Arterial Aneursysm Carotid 42500/-

01028008

Surgery for Arterial Aneursysm Main Arteries

of the Limb 50000/-

01028009 Dissecting Aneurysms +

Implant 150000/-

01028010 Stripping of Short or Long

Sephenous Veins 30000/-

01028011 Ligation of Ankle

Perforators 17400/-

01028012 Excision and Skin Graft of

Venous Ulcer 15500/-

01028013 Venous Thromoectomy 22100/-

01028014

Lymphatics Excision of Subcutaneous Tissues In

Lymphoedema 30000/-

01028015 Trendelenburg Operations 30000/-

01028016 Vascular Procedure –

Minor 16800/-


Aneursysm Spleen Artery 40200/-


Aneursysm Renal Artery 40200/-


PROCEDURE


029 Paediatric Surgery

01029001 Excision of thyroglossal

Duct/Cyst 30000/-

01029002

Diaphragmatic Hernia Repair (Thoracic or

Abdominal Approach) 35000/-

01029003

Tracheo Oesophageal Fistula (Correction

Surgery) 40000/-

01029004 Colon Replacement of

Oesophagus 40000/-

01029005 Omphalo Mesenteric Cyst

Excision 30000/-

01029006 Omphalo Mesenteric

Duct- Excision 30000/-

01029007 Meckels Diverticulectomy 30000/-

01029008 Omphalocele 1st Stage

(Hernia Repair) 28000/-

01029009 Omphalocele 2nd Stge

(Hernia Repair) 30000/-

01029010 Gastrochisis Repair 24000/-

01029011 Inguinal Herniotomy 24000/-

01029012 Congenital Hydrocele 24000/- 01029013 Hydrocele of Cord 22000/-

01029014 Torsion Testis Operation 25000/-

01029015 Congenital Pyloric

Stenosis- operation 27000/-

01029016 Duodenal- Atresia

Operation 35000/- 01029017 Pancreatic Ring Operation 45000/- 01029018 Meconium Ileus Operation 30000/-

01029019 Malrotation of Intestines

Operation 32000/-

01029020 Rectal Biopsy (Megacolon) 25000/-

01029021 Colostomy Transverse 28000/-

01029022 Colostomy Left Iliac 28000/- 01029023 Abdominal Perineal Pull 35000/-



26


PROCEDURE


Through (Hirschaprugis Disease)

01029024

Imperforate Anus Low Anomaly -Cut Back

Operation 22000/-

01029025

Imperforate Anus Low Anomaly - Perineal

Anoplasty 28000/-

01029026

Inperforate Anus High Anomaly -Sacroabdomino

Perineal Pull Through 25000/-

01029027

Inperforate Anus High Anomaly - Closure of

Colostomy 21000/- 01029028 Intususception Operation 35000/-

01029029

Choledochoduodenostomy for Atresia of Extra Hepatic Billiary Duct 35000/-

01029030 Operation of Choledochal

Cyst 35000/-

01029031 Nephrectomy for -

Pyonephrosis 35000/-

01029032 Nephrectomy for - Hydronephrosis 35000/-

01029033 Nephrectomy for -Wilms

Tumour 35000/-

01029034

Paraortic Lymphadenoctomy with Nephrectomy for Wilms

Tumour 40000/-

01029035 Sacro- Coccygeal Teratoma Excision 30000/-

01029036 Neuroblastoma Debulking 32000/-

01029037 Neuroblastoma Total

Excision 36000/-

01029038 Rhabdomyosarcoma wide

Excision 40000/-

01029039

Colon Transplant/ Conduit Management following

Acid Structure Oesophagus 65000/-


PROCEDURE


01029040 Umbilical Line 500/-

01029041 Peripheral Long Line 800/- 01029042 LP 300/-

01029043 Peritoneal Tapping 500/-

01029044 Chest Drainage 800/-

01029045

General Nursery Care (including Nursing Care

etc.) 600/-

01029046 Phototherapy per day 400/-

01029047

Neonate Rooming in with mother per day (inclusive

of Nursing care) 600/-

01029048 SNCU (Sick New Born

Care Unit) 1600/-

030

Laproscopic/ Endoscopic Operations

In Gen. Surgery / Gastrohepatic / Nephro-

01030001 Diagnostic Laproscopy 6600/-

01030002 Laproscopic

Pyloromyotomy 18000/- 01030003 Laproscopic Gastrostomy 21000/-

01030004 Laproscopic Closure of Perforated peptic ulcer 25000/-

01030005

Laproscopic Vagotomy Pyleroplasty/ gastro

jejunostomy 24000/-

01030006 Laproscopic umbilical

hernia repair 20000/-

01030007 Laproscopic ventral hernia

repair 25000/-


cystogastrostomy 30000/-

01030009 Lap. Cholecystectomy &

CBD exploration 26000/-

01030010 Lap. Hydatid of liver

surgery 28000/-

01030011 Lap. Hepatic resection 28000/-



27


PROCEDURE


01030012 Lap. Assisted small bowel

resection 30000/-

01030013 Lap. For intestinal

obstruction 30000/-

01030014 Lap. For intestinal

perforation 28000/-

01030015 Lap. Assisted Right

Hemicolectomy 32000/-

01030016 Lap. Assisted left Hemicolectomy 32000/-

01030017 Lap. Assisted Total

Colectomy 37000/-

01030018 Laproscopic Rectopexy 32000/-

01030019

Lap. Asisted Abdominoperineal

Resection of rectum 37000/-

01030020 Lap. Assisted anterior

resection 37000/-


Cholecystectomy 25000/-


Appendicectomy 21000/-

01030023 Laaproscopic Hernia

Repair 21000/-

01030024 Laproscopic Hiatus Hernia

Repair 30000/-

01030025 Laproscopic Adhesiolysis Rs 18000/-


Adrenalectomy 32000/-


Thyroidectomy 32000/-


Spleenectomy 32000/- 01030029 Laproscopic Colectomy 35000/-

01030030 Laproscopic Nephrectomy 40000/-

01030031 Inguinal Hernia (Laproscopic) 20000/-


Pyelolithotomy 30000/- 01030033 Ureterolithotomy 22000/- 01030034 Lap Ovarian Cystectomy 22000/-

01030035 Laparoscopic Hysterectomy 25000/-


PROCEDURE


01030036 Laparoscopic Ectopic 22000/-

01030037 Foreign body removal 4000/-

01030038 Nephrolithotomy 35000/-

01030039

Operations for Hydronephrosis-

Pyeloplasty 35000/-

01030040

Operations for Hydronephrosis-

Endopyelotomy antegrade 35000/-

01030041 Operations for Cyst of the

Kidney 40000/-

01030042 URSL 25000/-

01030043 Nephroureterectomy 50000/-

01030044 Operations for Vesico-

ureteric Reflux 40000/-

01030045 Diverticulectomy 22000/-

01030046 Repair of Ureterocoel 35000/-

01030047 Operations for Varicocele

Palomo’s- Unilateral 20000/-

01030048 Operations for Varicocele

Palomo’s- Bilateral 30000/-

01030049 Nephrostomy 16000/-

01030050 Orchidopexy- Unilateral 25000/-

01030051 Orchidopexy- Bilateral 30000/-

01030052 Prostratectomy 45000/-

01030053 Laparoscopic Uro stone 30000/-

01030054 Incisional Hernioplasty 35000/-

Radiotherapy & Chemotherapy

(packages)

031 Nuclear Medicines-

Radio Isotope Therapy

01031001 131- Iodine Therapy <

15mCi 5200/-



28


PROCEDURE


01031002 131- Iodine Therapy 15-50

mCi 16900/-

01031003 131- Iodine Therapy 51-

100 mCi 16900/-

01031004 131- Iodine Therapy >

100mCi 19500/-

01031005

Strontium therapy for metastatic bone pain

palliation 7200/-

01031006

Samarium-153 therapy for metastatic bone pain

palliation 10700/-

032 Cobalt 60 Therapy

01032001 Radical Therapy 70000/-

01032002 Adjustment Therapy-

Immobilisation technique 16000/-

01032003 Palliative Therapy (less

than 10 fractions) 15000/-

01032004 Palliative Therapy (10-25

fractions) 25000/-

01032005 Palliative Therapy (single

fraction) 5000/-

033 Linear Accelerators

01033001 3-D Planning (L. Acc. or

Cobalt-60) 6000/-

01033002 2-D Planning (L. Acc. or

Cobalt-60) 5000/-

01033003 Intensity Modulated Radio

Therapy (IMRT) 105000/-

01033004 Image Guided Radio

Therapy (IGRT) 150000/-

01033005 IGRT Single Fraction 7000/-

01033006 3D-CRT (Confirmal Radio

Therapy) 65000/-

01033007 3D-CRT with IGRT 75000/-

01033008 4D-CRT with IGRT 90000/-

01033009 Stereotactic Radio

Surgery (SRS) 85000/-

01033010 Stereotactic Radio

Therapy (SRT) 70000/-


PROCEDURE


01033011 Rapid Arc with IMRT rate 100000/-

01033012 Palliative Radiation

Therapy upto 15 fractions 25000/-

01033013 Palliative Radiation

Therapy upto 25 fractions 35000/-

01033014 Palliative Radiation single

fraction 10000/-

01033015 Conventional Radiation

Therapy with CT 35000/-

01033016 Conventional Radiation

Therapy CBCT 45000/-

01033017

SRS/ SRT Neuro interventional charge/

case 10000/-

01033018 Electron Beam (>10

Fractions) 40500/-

01033019 Electron Beam (<10

Fractions) 9000/-

01033020 Pre-radiation profile 2500/-

034 Brachy Therapy

01034001

Intra Cavitary Brachytherapy- 1st

insertion 5500/-

01034002

Intra Cavitary/ Intra Luminal Brachytherapy-

2nd and subsequent insertion 3000/-

01034003 Interstitial Brachy

Therapy- 1st insertion 15000/-

01034004 Interstitial Brachy

Therapy- 2nd insertion 10000/-

035 Chemotherapy

01035001 Neoadjuvant 1000/-

01035002 Adjuvant 1000/-

01035003 Infusional Chemotherapy 1000/-

01035004 Chemotherapy wafers for malignant brain tumours 20000/-

01035005 Multiple drug therapy per

day 900/-



29


PROCEDURE


01035006 Targeted therapy 1000/-

01035007 Chemoport facility 1000/-

01035008

PICC line (Peripherally Inserted Central

Canulisation) 1000/-

036 Room Rent (Per day)

01036001 General Ward 600/-

01036002 Semi-Private Ward 1200/-

01036003 Private Ward 1800/-

01036004 Day Care/ Minor (OPD)

Surgeries (all categories) 600/-

Admissible Blood

Charges

037 For treatment in

Government Hospitals

01037001 General Beds 50/-

01037002 Paying Beds 100/-

01037003 Cabin 140/-

038

For treatment in recognised Private Hospitals/ Nursing

Homes/ Aided Institurions

01038001 Whole Blood 500/-

01038002 F.F.P. 400/-

01038003 Platelet Concentrate 400/-

01038004 Platelet Rich Plasma 400/-

01038005 Packed Cell 400/-

01038006 Frozen Plasma 350/-

01038007 Crypoprecipitate 300/-


PROCEDURE


01038008 Washed RBC 400/-



30

RATES OF INVESTIGATIONS : 02 – INVESTIGATIONS

CODE NAME OF

INVESTIGATION


001 General 02001001

Aspiration Plural Effusion -

Diagnostic 750/-

02001002 Abdominal Aspiration -

Diagnostic 900/-

02001003 Pericardial Aspiration 1200/-

02001004 Bone Marrow Aspiration 800/-

02001005 Joints Aspiration 750/-

02001006 E.C.G. 140/-

02001007 E.E.G. 800/-

02001008 Stress test (TMT) 850/-

02001009 Lumbar puncture 1000/-

02001010 Sternal puncture 800/- 002 E.N.T.

02002001 Pure Tone Audiogram 300/-

02002002 Impedence & other tests 300/-

02002003 SISI, Tone Decay &

Difference times 250/-

02002004 Multiple hearing

assessment test to Adults 450/-

02002005 Hearing Aid Selection 100/-

02002006 Hearing Aid Analysis 400/-

02002007 Speech Discrimination

Score 200/-

02002008 Speech Assessment 200/-

02002009 Cold Calorie Test for Vestibular function 180/-

02002010 Audiometry (MHC) 250/- 02002011 ABR (Threshold Est.) 650/- 02002012 Acoustic Reflex Decay 100/- 02002013 Eustachian Tube Func 100/- 02002014 IMP Audiometry 300/- 02002015 Otoacoustic Est. (OAE) 550/- 02002016 PEAD Audio Assessment 200/- 02002017 SRT & SDS 150/- 02002018 Swallowing Assest 30/-

CODE NAME OF

INVESTIGATION


02002019 Tympanometry 150/- 02002020 Voice Assest 250/- 02002021 Endo Laryngoscopy 850/- 02002022 ENG 1300/- 02002023 Nasal Endoscopy 600/- 02002024 Nasopharyngoscopy 600/- 02002025 LV Dyssynchrony Study 1400/- 02002026 Stroboscopy 700/-

003 Eye

02003001 Refraction/Fundoscopy 150/-

02003002 Ortho-optic check up 150/-

02003003 Perimetry/field test 400/-

02003004 Clinical Photography 100/-

02003005 Electrooculogram 500/-

02003006 ERG 400/-

02003007 Flourescein Angioraphy 800/-

02003008 A-Scan 200/-

02003009 Tono Graphy 450/-

02003010 VER 300/-

02003011 Goldmen Perimetry 150/-

02003012 Specular microsopy 200/-

02003013 Indo cyaningreen

Angiography of Retina 1000/-

02003014 Indo cyaningreen

Angiography - IRIS 1000/-

02003015 Automated Perimetry 450/-

02003016 Corneal endothelial cell

count 200/-

02003017 Corneal topography 200/-

02003018 Corneal pachymetry 200/-

02003019 Retinal nerve film analyzer

studies 100/-

02003020 Auto Refrectemetry 60/-

02003021 Biometry 180/-

02003022 Ultrasound studies - A

Scan 600/-

02003023 Ultrasound studies -- B

Scan 600/-

02003024 Retinal/Meter function

studies 150/-



31

CODE NAME OF

INVESTIGATION


02003025 PAN ACUITY METER 200/-

02003026 Laser interferometry 1000/-

02003027 EKG, EOG 500/-

02003028 Dacryocystography (DGC) 500/-

02003029 Orbital Angio studies 500/-

02003030 Digital Biometry Reading

(Single) 180/-

02003031 Biometry (Both Eye) 350/-

02003032 Biometry-corp (Both) 400/-

02003033 Biometry-corp-Single 300/-

02003034 Pachymetry (Both Eye) 400/-

02003035 Pachymetry (Single) 200/-

02003036 Multifocal ERG (One Eye) 800/-

02003037 NCT 160/-

02003038 OCT- NFL Analyser 1600/-

02003039 Schiotz Tonometer 250/-

02003040 TTT 2500/-

02003041 VEP 600/-

02003042 Anterior Segment (Fundus)

Photography 300/-

02003043 USG 550/- 004 Physiotheraphy

02004001 Muscle testing and diagnostic 100/-

005 Dental 02005001 Intra oral X-ray (Digital) 80/- 02005002 Opg Cephalogram 210/- 02005003 Opg Standard View 210/-

02005004 Radio Visiograph (per Image) 110/-

006 Genetics

02006001 Fragile X Decet & Karyo of

Peri Bld Cell 3500/- 007 X-Ray (Digital X Ray)

02007001 Fluroscopy chest 120/-

02007002 Occlusal 130/-

02007003 Abdomen AP or Erect (one

film) 130/-

02007004 Abdomen Lateral view (one

film) 130/-

CODE NAME OF

INVESTIGATION


02007005 Abdomen for Pregnancy 130/-

02007006 Chest PA view (one film) 130/-

02007007 Chest Oblique or Lateral

(One film) 130/-

02007008 Mastoids (one film) 150/-

02007009 Extremities, bones & Joints

(one film) 140/-

02007010 Pelvis (One film) 140/-

02007011 Paranasal sinuses (One

film) 140/-

02007012 T.M. Joints (One film) 140/-

02007013 Abdomen & pelvis for

K.U.B. 250/-

02007014 Skull A.P. & Lateral 250/-

02007015 Spine A.P. & Lateral 250/-

02007016 Barium Swallow 700/-

02007017 Sinography/ Sialography 750/-

02007018 Cystography/ Urethrography 1120/-

02007019 Hystero-Salpaingography 1110/-

02007020 Arthrography 840/-

02007021 Retrograde Pyelography 1080/-

02007022 Oral or I.V.

Cholecystography 720/-

02007023 Barium Enema 1160/-

02007024 Barium Meal Upper or

Lower 960/-

02007025 Bronchography 1260/-

02007026 I.V. Urography/ I.V.P. 1350/-

02007027 Myelography 1500/-

02007028 Pneumo Encephalography 1120/-

02007029 Barium meal Complete 1230/-

02007030 Cerebral/Femoral

Angiography 2000/-

02007031 Periapical X-Ray 100/-

02007032 Barium Enema (Double

Cont.) 1300/-

02007033 Barium IC Junction 750/-

02007034 Gastro Conray Meal 750/-

02007035 Intravenous Pyelogram 1400/-

02007036 T-Tube Cholangiogram 700/-



32

CODE NAME OF

INVESTIGATION


02007037 PTBD Gram 700/-

02007038 Micturating

Cystourethrogram (MCU) 750/-

02007039 VUR/ Cystourethrography 2600/-

02007040 Small Bowel Enema 1150/-

02007041

Any XRAY using portable machine-addl handling

charge 300/-

02007042

Any other XRAY- single Film (Small)

130/-

02007043 Any other XRAY- single

Film (Large) 160/-

008 Conventional X-Ray (70% of Digital X-Ray rates)

02008001 Fluroscopy chest 90/-

02008002 Occlusal 90/-

02008003 Abdomen AP or Erect (one

film) 90/-

02008004 Abdomen Lateral view (one

film) 90/-

02008005 Abdomen for Pregnancy 90/-

02008006 Chest PA view (one film) 90/-

02008007 Chest Oblique or Lateral

(One film) 90/-

02008008 Mastoids (one film) 100/-

02008009 Extremities, bones & Joints

(one film) 90/-

02008010 Pelvis (One film) 90/-

02008011 Paranasal sinuses (One

film) 90/-

02008012 T.M. Joints (One film) 90/-

02008013 Abdomen & pelvis for

K.U.B. 170/-

02008014 Skull A.P. & Lateral 160/-

02008015 Spine A.P. & Lateral 170/-

02008016 Barium Swallow 490/-

02008017 Sinography/ Sialography 520/-

02008018 Cystography/ Urethrography 780/-

02008019 Hystero-Salpaingography Rs 780/-

02008020 Arthrography 590/-

02008021 Retrograde Pyelography 760/-

CODE NAME OF

INVESTIGATION


02008022 Oral or I.V.

Cholecystography 510/-

02008023 Barium Enema 810/-

02008024 Barium Meal Upper or

Lower 670/-

02008025 Bronchography 880/-

02008026 I.V. Urography/ I.V.P. 950/-

02008027 Myelography 1050/-

02008028 Pneumo Encephalography 780/-

02008029 Barium meal Complete 860/-

02008030 Cerebral/Femoral

Angiography 1180/-

02008031 Periapical X-Ray 70/-

02008032 Barium Enema (Double

Cont.) 910/- 02008033 Barium IC Junction 530/- 02008034 Gastro Conray Meal 530/- 02008035 Intravenous Pyelogram 980/- 02008036 T-Tube Cholangiogram 490/- 02008037 PTBD Gram 490/-

02008038 Micturating

Cystourethrogram (MCU) 530/- 02008039 VUR/ Cystourethrography 1820/- 02008040 Small Bowel Enema 810/-

02008041

Any XRAY using portable machine-addl handling

charge 300/-

02008042

Any other XRAY- single Film (Small)

90/-

02008043

Any other XRAY- single Film (Large)

110/-

009 Ultrasound Investigations

02009001 Obstetric First Scan/

Follow up 500/-

02009002 USG: Lower Abdomen/

Pelvis 800/-

02009003 Upper abdomen First

Scan/ Follow up 600/-

02009004 Ultrasound-

Neurosonogram 900/-

02009005 USG- Neurosonogram-

Screening 350/-



33

CODE NAME OF

INVESTIGATION


02009006 Total Abdominal survey or

Multiple organ study 950/-

02009007 Special procedures &

Aspiration etc. 1230/-

02009008 Image Intensifiers 700/-

02009009 USG: Neck 850/-

02009010 USG: KUB 800/-

02009011 USG: Whole Abdomen 950/-

02009012 USG: Whole Abdomen +

Transrectal 1500/-

02009013 USG: Scrotum 900/-

02009014 USG: Testis 600/-

02009015 Ultrasound Bladder 600/-

02009016 Ultrasound Kidney/ Renal 600/-

02009017 USG: Pregnancy + Doppler 2200/-

02009018 USG: Joint (Unilateral) 900/-

02009019 USG: Joint (Bilateral) 1800/-

02009020 USG: Musculoskeletal 800/-

02009021 USG: Transrectal 800/-

02009022 USG: Breast Unilateral 700/-

02009023 USG: Breast Bilateral 1050/-

02009024 USG: Thyroid 800/-

02009025 USG: Chest 700/-

02009026 USG: Prostate 550/-

02009027 USG: Single Organ 550/-

02009028 USG: Follicular Study 1250/-

02009029 USG: Guided Procedure 600/-

02009030 USG: FNAC 900/-

02009031 USG: Follow-up Ovulation 600/-

02009032 USG: For Congenital

Anomaly 1800/-

02009033 Ultrasound Parotid 800/-

02009034 Ultrasound Thigh 800/-

02009035 Any USG using portable

machine- handling charge 200/-

010 Clinical Pathology

02010001 Urine routine 60/-

02010002 Quantitative Albumin/Sugar 50/-

CODE NAME OF

INVESTIGATION


02010003 Urine Bile Pigment and

Salt 50/-

02010004 Urine Urobilinogen 50/-

02010005 Urine Ketones 50/-

02010006 Urine Occult Blood 50/-

02010007 Urine total proteins 100/-

02010008 Urine Sodium 100/-

02010009 Urine Chloride 100/-

02010010 Bence Jones protein 90/-

02010011 Stool routine 60/-

02010012 Stool occult blood 60/-

02010013 Post coital smear

examination 100/-

02010014 Smear analysis 100/-

02010015

Body fluid (CSF/Ascitic Fluid etc.) Chemistry,

Sugar, Protein etc. 240/-

02010016 Body fluid for Malignant

cells 200/-

02010017 Urinary Porphobilinogen 110/-

02010018 Urinary Myoglobin 400/-

02010019 Urine for

Immunoelectrophoresis 3500/-

02010020 Urine for Protein Electrophoresis 2800/-

02010021 CRK ISO Enzyme

Electrophoresis 5000/-

02010022 Hb Electrophoresis 600/-

02010023 Chyle Test 100/-

02010024 Semen Analysis 280/-

02010025 IVF Semen Analysis 250/-

02010026 Stool Reducing Substance 60/-

02010027 Stool for OVA, Parasite 70/-

02010028 Stool for Parasite 60/-

02010029 Stool Culture & Sensitivity 200/-

02010030 Urine for Culture &

Sensitivity 250/-

02010031 Karyotype Chromosome

Analysis 2400/-

02010032 Genotyping 5000/-

02010033 Glucotyping 5000/-

02010034 Urine for Electrolytes 200/-



34

CODE NAME OF

INVESTIGATION


02010035 Urine Amino-aciduria 150/-

02010036 Urine for Phosphorus 220/-

02010037 Urine for Z-N Stain 60/-

02010038 Urine Protein/Creatinine

Ratio 250/-

02010039 Opiates Serum Random

Urine 450/-

02010040 Opiates Random Urine 450/-

02010041 Urine Ammino Acid,

Qualitative, 2 Dimensional 700/-

02010042 Pre/Post-Dialysis

Creatinine 100/-

02010043 Pre/Post-Dialysis

Potassium 100/-

02010044 Pre/Post-Dialysis Sodium 100/-

02010045 Pre/Post-Dialysis Urea 80/- 011 Haematology

02011001 Haemoglobin (Hb) 50/-

02011002 Total Leucocytic Count

(TLC) 50/-

02011003 Differential Leucocytic

Count (DLC) 50/-

02011004 E.S.R. 50/-

02011005 Total Red Cell count 60/-

02011006 Platelet count 80/-

02011007 Reticulocyte count 70/-

02011008 Absolute Eosinophil count 60/-

02011009 Packed Cell Volume (PCV) 50/-

02011010 Peripheral Smear

Examination 70/-

02011011 Smear for Malaria parasite 70/-

02011012 Bleeding & Clotting Time 60/-

02011013 Clot Retraction Time 50/-

02011014 R.B.C. Fragility Test 100/-

02011015 L.E. Cell 120/-

02011016 Foetal Haemoglobin (Hb-F) 250/-

02011017 Prothrombin Time (P.T.) 150/-

02011018 Complete Haemogram 180/-

02011019 Bone Marrow Smear

Exmination 400/-

02011020 Partial Thromboplastin 200/-

CODE NAME OF

INVESTIGATION


02011021 Glucose 6 Phosphate

Dehydrogenase (G, 6PD) 220/-

02011022 P.C.V. Haematocrit 50/-

02011023 RBC Folate 1350/-

02011024 Whole Blood Folate 1350/-

02011025 Sickling Test 120/-

02011026 Bleeding Time 40/-

02011027 Clotting Time 40/-

02011028 D-Dimer Semi Quantitative 900/-

02011029 Scurose Lysis Test 280/-

02011030 Red Cell Osmotic Frag.

with Incubato 280/-

02011031 Heinz Body Test 120/-

02011032 Fibrinogen 400/-

02011033 FDP 150/-

02011034 Plasma Haemoglobin 190/-

02011035 Factor VIII Studies 1000/-

02011036 Factor IX Functional 1200/-

02011037 Factor V Functional 2500/-

02011038 Factor V Lieden Mutation

Analysis 4000/-



35

CODE NAME OF

INVESTIGATION


02011039 TC, DC, ESR 120/-

02011040 Absolute Lymphocytes

Count 80/-

02011041 HB, TC, DC 120/-

02011042 Bone Marrow [Perls Stain] 750/-

02011043 Cell Type & Cell Count 320/-

02011044 Nasal Smear for

Eosinophils 90/-

02011045 CSF Cell Counts [TC/DC] 170/-

02011046 Complete Blood Picture

[CBP] 180/-

02011047 MCV MCH MCHC 180/-

02011048 Investigation of ABO/RH 360/-

02011049 Sinovial Fluid for Analysis 400/-

02011050 Blood Parasites 70/-

02011051 Malaria Parasite 70/-

02011052 Malarial Antigen Detection 320/-

02011053 Filaria Antigen W. Bancrofti 560/-

02011054 Lap Score 400/-

02011055 BAL Cell Count 100/-

02011056 Cold Agglutination 150/-

CODE NAME OF

INVESTIGATION


02011057 AT III 650/-

02011058 AT III Anti Thrombin 650/-

02011059 Absolute Neutrophil Count 50/-

02011060 Osmotic Fragility 120/-

02011061 HLA Typing 10000/-

02011062 T-Cell Cross Matching 5000/-

02011063 Karyotyping for Bone Marrow Cancer (REL 6000/-

02011064 Sucrose Lysis Test 120/-

02011065 APTT (50:50) 200/-

02011066 Immunofixation Electroporesis 7200/-

012 Blood Bank

02012001 Blood Group & RHO Type 140/-

02012002 Cross match 50/-

02012003 Packed Cells- Proc.

Charges 450/-

02012004 Saline Washed Packed

Cells: Proc. Charges 450/-

02012005 Coomb’s Test Direct/

Indirect 200/-

02012006 Australia Antigen 200/-

02012007 RHO, Antibody titer 250/-

02012008 Platelet rich Plasma-Proc.

Charges 450/-

02012009 Whole Human Blood-I.P.-

Proc. Charges 450/-

02012010 Fresh frozen Plasma: Proc.

Charges 450/-

02012011 Cryoprecipitate: Proc.

Charges 450/-

02012012 Platelet Concent- Proc.

Charges 450/-

02012013 Therapeutic Phlebotomy:

Proc. Charges 450/-



36

CODE NAME OF

INVESTIGATION


02012014 Granulocyte Conc.: Proc.

Charges 450/-

013 Bio-Chemistry

02013001 Glucose blood- Fasting/

PP/ Random 70/-

02013002 Blood Urea Nitrogen/ Blood

Urea 80/-

02013003 Serum Creatinine 100/-

02013004 Serum Uric Acid 110/-

02013005 Serum Bilirubin total/ direct 130/-

02013006 Serum Iron 220/-

02013007 Serum Cholesterol 120/-

02013008 Total Iron Binding Capacity 300/-

02013009 CK MB 390/-

02013010 Serum Calcium 120/-

02013011 Serum Phosphorus 120/-

02013012 Total Protein Alb/Glo Ratio 140/-

02013013 S.G.P.T. 120/-

02013014 S.G.O.T. 120/-

02013015 Serum amylase 250/-

02013016 Serum Electrolyte 250/-

02013017 Triglyceride 220/-

02013018 Glucose Tolerance Test

(GTT) 300/-

02013019 C.P.K. 270/-

02013020 L.D.H. 210/-

02013021 L.D.-1 320/-

02013022 LDH & LD-1 470/-

02013023 T3 300/-

02013024 T4 300/-

02013025 TSH 300/-

02013026 T3, T4, TSH 700/-

02013027 FSH 420/-

02013028 LH 410/-

02013029 FSH & LH 670/-

02013030 Prolactin 470/-

02013031 Blood gas analysis 400/-

02013032 Blood gas analysis with

electrolytes 500/-

CODE NAME OF

INVESTIGATION


02013033 Cortisol 650/-

02013034 HDL Cholestrol 200/-

02013035 VLDL Cholesterol 170/-

02013036 ALDL 480/-

02013037 Lipid Profile 700/- 02013038 LFT [Liver Function Test] 750/-

02013039 Alkaline Phosphatase 150/-

02013040 Acid Phosphatase 300/-

02013041 Leucocyte Alkaline Phosphatase Score 600/-

02013042 Serum Magnesium 170/-

02013043 Serum Copper 500/-

02013044 Serum Lithium 250/-

02013045 Serum Lipase 250/-

02013046 Serum Chloride 150/-

02013047 Serum Inorganic

Phosphorous 160/-

02013048 Serum Ceruloplasmin 750/-

02013049 Serum

Carbamazepine/Tegretol 1400/-

02013050 Carbamazepine 600/-

02013051 Serum Calcitonin 1400/-

02013052 Calcitonin 1200/-

02013053 Myoglobin Serum 2400/-

02013054 Serum C Peptide 800/-

02013055 Serum C Peptide (PP) 500/-

02013057 Serum Eption/Phenytoin 700/-

02013058 Albumin (Serum) 120/-

02013059 Serum Ferritin 720/-

02013060 Serum B12 Level 600/-

02013061 Serum Sodium 240/-

02013062 Serum Folate 720/-

02013063 Folate & Vitamin 12 Serum 1100/-

02013064 Serum Aldolase 400/-

02013065 Serum Acetaminophen 650/-

02013066 Serum Growth Hormone 550/-

02013067 Parathyroid Hormone

(PTH), Intact 1200/-

02013068 Serum Osmolality 250/-



37

CODE NAME OF

INVESTIGATION


02013069 Serum Potassium 150/-

02013070 Serum TIBC 280/-

02013071 Serum Parathormone

Level 900/-

02013072

Serum Homocystine/ Homocystine/ Homocystine

Level 750/-

02013073 Serum Individual Phospolipids-TLC 450/-

02013074 Serum/Plasma Bicarbonate 350/-

02013075 Serum Haptoglobin 850/-

02013076 Serum Testosterone 500/-

02013077 Serum Thyroglobulin 1360/-

02013078 Lactate Plasma 550/-

02013079 CA-19-9 1000/-

02013080 CA 125 800/-

02013081 CA 15.3 160/-

02013082 CA 72.4 Gastric Cancer

Marker 1050/-

02013083 CSF Sugar 100/-

02013084 CSF Protein 100/-

02013085 Lactate (CSF) 400/-

02013086 CSF Protein

Electropherisis 800/-

02013087 CSF-Oligoclinal Band

Analysis 2000/-

02013088 CSF for Biochemical

Analysis 280/-

02013089 CSF Chloride 150/-

02013090 CSF Profile 3200/-

02013091 Sodium Bicarbonate 100/-

02013092 Mucopolysaccharidoses

(MPS) Screening U 500/-

02013093 Renin Activity Plasma,

PRA 4000/-

02013094 Plasma Ammonia 400/-

02013095 Fructosamine 200/-

02013096 GGT-Gamma Glutamyl

Transaminase 320/-

02013097 Globulin 120/-

02013098 Estradiol 520/-

02013099 Estradiol (E2) 420/-

CODE NAME OF

INVESTIGATION


02013100 Glycosylated Haemoglobin

[HBA1C] 520/-

02013101 Alpha I Anti Trypsin Assay 1200/-

02013102 Insulin-P.P./ Fasting/

Random 650/-

02013103 Lactose Tolerance Test 550/-

02013104 DHEA-S (Sulphate) 800/-

02013105 Serum Digoxin/ Serum

Digoxin Level 700/-

02013106 Serum Gastrin 900/-

02013107 Progesterone 450/-

02013108 Beta HCG (B-HCG) 650/-

02013109

Beta HCG Quantitative Trophoblastic Cancer

Marker 600/-

02013110 Cardiac Enzymes 450/-

02013111 LDH Heat Stable Fraction 640/-

02013112 LDH Isoenzymes 1430/-

02013113 Antiphospolipid Antibody

IGG & IGM 1050/-

02013114 Antiphospolipid Antibody

IGM 750/-

02013115 Anti-Sperm Antibody/ ABS 550/-

02013116 Alpha-Feto Protein (AFP)

Cancer Marker 650/-

02013117 Carcino Embryonic Antigen

[CEA] 600/-

02013118 Anti-Thyroid Antibodies 950/-

02013119 Anti-Thyroid Antibodies-TG

Ab 900/-

02013120 Bicarbonate 150/-

02013121 Anti Cardiolipin Antibody-

IgG/ IgM 650/-

02013122 Anti Cardiolipin Antibody

Profile 1700/-

02013123 C_Peptide Assay 350/-

02013124 Cyst Fluid for Analysis 350/-

02013125 Trop-T 820/-

02013126 Troponin T-Qualitative 400/-

02013127 Intracellular Calcium 120/-

02013128 Pleural/ Peritoneal Fluid for

Sugar 80/-

02013129 Peritoneal Dialysis Fluid for

Sugar & Urea 220/-



38

CODE NAME OF

INVESTIGATION


02013130 Apolipo Proteins 500/-

02013131 Free Testosterone 600/-

02013132 Blood Acetone/Ketone 240/-

02013133 Pleural Fluid for Protein 80/-

02013134 Pleural Fluid for LDH 200/-

02013135 Pleural Fluid for Amylase 180/-

02013136 Fluid for LDH 160/-

02013137 Fluid for Amylase 130/-

02013138 Fluid for Creatinine 110/-

02013139 Fluid for Lipase 130/-

02013140 Fluid for Cholesterol 150/-

02013141 Phenytoin Level 720/-

02013142 24 H Ketosteroid & Ketogenic Steroid 1700/-

02013143 Angio Tension Converting

Enzyme (ACE) 780/-

02013144 Phenobarbitone 720/-

02013145 Anti Thyroid Antibodies

TPO Ab 900/-

02013146 Anti TG 550/-

02013147 ACTH 960/-

02013148 ACTH Plasma 960/-

02013149 Intact PTH 700/-

02013150 IGFI 350/-

02013151 IGF-I (Somatomedin-C) 2800/-

02013152 B-2 Microglobulin 960/-

02013153 Valproic Acid 520/-

02013154 Valproate 520/-

02013155 Sex Hormone Binding 1200/-

02013156 Vitamine B-12 Level 800/-

02013157 Vitamin D 25 Hydroxy 1400/-

02013158 17 Hydroxy Corticostiroids 580/-

02013159 Lipoprotein (a) 400/-

02013160 Synovial Fluid for

Biochemistry 480/-

02013161 Plasma Catecholamines 5500/-

02013162 Serum IgA 220/-

02013163 Serum IgG 220/-

02013164 Serum IgM 400/-

CODE NAME OF

INVESTIGATION


02013165 Pericardial Fluid for

Biochemistry 360/-

02013166 Pericardial Fluid Test 100/-

02013167 Peritoneal Fluid-

Biochemistry 450/-

02013168 Aldosterone 1150/-

02013169 Galactosemia Profile 1800/-

02013170 FISH (NH) 2800/-

02013171 FISH for BCR/ ABL 3200/-

02013172 Fluid for TVPCR 1400/-

02013173 Serum Cortisone 380/-

02013174 Transferrin 780/-

02013175 Chromogranin A 5000/-

02013176 Cryo Globulin Screening 780/-

02013177 Cocaine Metabolite Screen 500/-

02013178 Cyclosporine CO 1600/-

02013179 Cytokeratin/ Erythropoietin 1200/-

02013180 Protein C/ S, Functional 2800/- 014 Histopathology

02014001 Pap Smear 240/-

02014002 Histopathology exam per

tissue type 250/-

015 Bactriology & Serology

02015001 Smear gram-strain

examination 100/-

02015002 Sputum smear A.F.B. stain 100/-

02015003 Vaginal Smear Examination 100/-

02015004 V.D.R.L. 120/-

02015005 Widal test 180/-

02015006 Rheumatoid Factor test 300/-

02015007 Culture & Sensitivity (other

specimens) 250/-

02015008 Urine pregnancy test 200/-

02015009 C.R.P. 220/-

02015010 ASO Titer 250/-

02015011 Quantitative H.C.G. 400/-

02015012 Blood culture & sensitivity 250/-

02015013 Vibro cholera culture 250/-



39

CODE NAME OF

INVESTIGATION


02015014 CAPD Fluid for Culture &

Sensitivity 350/-

02015015 CAPD Fluid for Fungal

Stain/ Gram Stain 100/- 02015016 CAPD Fluid-Cytology 200/- 02015017 Rapid Urease Test 250/- 02015018 ASO (Antistreptoysin “O”) 360/-

02015019 High Sensitivity-CRP 400/-

02015020 PUS for Fungal Culture 250/-

02015021 PUS for Fungal Stain 100/-

02015022 PUS for Gram Stain 100/- 02015023 PUS for Z-N Stain 100/-

02015024 Culture & Sensitivity [PUS] 250/- 02015025 Culture & Sensitivity [CSF] 250/-

02015026 Culture & Sensitivity

[Semen] 250/- 02015027 Culture & Sensitivity [Fluid] 250/-


[Sputum] 250/-


[Throat Swab] 250/-

02015030 Culture & Sensitivity for

Vaginal Swab 250/-

02015031 Culture & Sensitivity for

Aspirated Fluid 250/-


[Wound Swab] 250/-

02015033 Wound Swab for Fungal

Stain 100/-

02015034 Wound Swab for Gram

Stain 100/-

02015035 Wound Swab for Z-N Stain 100/-


[Rectal Swab] 250/- 02015037 Nail for Fungal Culture 200/-

02015038 Nail Clipping for KOH

preparation 100/-

02015039 Blood Culture & Sensitivity-

Anaerobic 600/-

02015040 Blood for Culture &

Sensitivity (Paediatric) 600/-

02015041 Tissue for Culture &

Sensitivity 250/-

02015042 Mitral Valve Tissue for Culture & Sensitivity 250/-

CODE NAME OF

INVESTIGATION


02015043 Aortic Valve Tissue for Culture & Sensitivity 250/-

02015044 Arterial Line Tip for Culture

& Sensitivity 250/-

02015045 Ascitic Fluid for Culture &

Sensitivity 600/-

02015046 AC Tap for Culture &

Sensitivity 250/- 02015047 Sputum for AFB Culture 500/-

02015048 Sputum for Fungal Culture 150/-

02015049 Sputum for Fungal Stain 100/-

02015050 Sputum for Z-N Stain 100/-

02015051 Sputum for Grams Stain 100/-

02015052 Esophageal Smear for

Candida 150/-

02015053 Urine for AFB Culture 500/-

02015054 Pleural Fluid for AFB

Culture 500/-

02015055 Pleural Fluid- TBPCR 1200/-

02015056 Culture AFB Antibiotic

Sensitivity- 5 Drug Panel 3000/-

02015057 Urine for Gram Stain 100/-

02015058 Throat Swab for KLB 100/-

02015059 Fungus Culture 150/-

02015060 Clostridium Difficile Toxin A

& B 1200/-

02015061 Yeast Identification and

Susceptibility 350/-

02015062 Non Fermenter Identification 300/-

02015063 Serology for Mumps

IGM/IGG 1000/-

02015064 Torch Profile 1500/-

02015065 Serum Angitens. Conv.

Enzy. Assay 400/-

02015066 P-ANCA 800/-

02015067 C-ANCA 800/-

02015068 Aldehyde Serum Test 80/-

02015069 Elisa Test for Ecinococcus

Antibody Detec 600/-

02015070 Ascitic Fluid Cell Count 200/-

02015071 Anti HBS (Antibody to

Australia-Antigen) 400/-

02015072 Hepatitis B Surface

Antibody 400/-



40

CODE NAME OF

INVESTIGATION


02015073 Anti-HBC Core Antibody

IgM 550/-

02015074 Serum Immunoglobulin 600/-

02015075 Immunoglobulin IGE 500/-

02015076 IGE Allergy Individual 600/-

02015077 Immunoglobulin-IGA 600/-

02015078 Immunoglobulin IGM 600/-

02015079 Immunoglobulin IGG 600/-

02015080 Anti-HAV-IGM-Antibody 1000/-

02015081 Compliment C3 350/-

02015082 Compliment C4 350/-

02015083 Toxoplasma- IgG 370/-

02015084 Toxoplasma- IgG 370/-

02015085 Toxoplasma- IgG + IgM 700/-

02015086 Cysticercosis Antibody/

Antibody IgG 600/-

02015087 Cytomegalovirus, PCR 2000/-

02015088 PCR for AFB 1350/-

02015089 Herpes I(IgG)(HSV Type I) 300/-

02015090 Herpes I(IgM)(HSV Type I) 300/-

02015091 Herpes II (IgG)(HSV Type

II) 300/-

02015092 Herpes II (IgM)(HSV Type

II) 300/-

02015093 Herpes I + II (IgG) 300/-

02015094 Herpes I + II (IgM) 300/-

02015095 TPHA (Treponema

Pallidum Haemagglutinat 340/-

02015096 HBsAg 420/-

02015097 Hydatid Cyst for IgG Elisa 600/-

02015098 Aspergillus Antibody

(IGG/IGM) 1000/-

02015099 Anti HCV IgG/IgM 820/-

02015100 Anti HEV IgG/IgM 840/-

02015101 Allergy Screening- Adult 1200/-

02015102 Dengue Elisa 1000/-

02015103 Dengue Antibodies IgG +

IgM 600/-

02015104 Dengue NS1 Ag Test 600/-

CODE NAME OF

INVESTIGATION


02015105 Screening for C-Pylori

[RUT] 200/-

02015106 Elisa for Tuberculosis

[IGG/IGM/IGA] 350/-

02015107 Febrile Agglutinins

[Widal.Weli-FEl 400/-

02015108 HBe Antigen Detection

(HBe Ag) 550/-

02015109 CMV (Cytomegalo Virus

)Antibody [IGM] 350/-

02015110 Brucella Antibody 420/-

02015111 Breast Cancer ERPR and

HER2/NEU 2400/-

02015112 Anti HCV IIIrd Generation

Elisa 350/-

02015113 Epstein Bar Virus IGM

[VCA Elisa] 600/-

02015114 HEV IgM Elisa 700/-

02015115 Legionella Pneumophila-

Elisa 600/-

02015116 Elisa for Pregnancy 630/-

02015117 Elisa for Mumps (IgG

Antibody) 450/-

02015118 Elisa for Measles (IgG

Antibody) 450/-

02015119 Mumps Elisa (IgM

Antibody) 520/-

02015120 HIV P24 Antigen 600/-

02015121 Vivax Antigen 350/-

02015122 Anti Smooth Muscle

Antibody (ASMA) 500/-

02015123 Anti-Mitochondrial

Antibody-M2 (AMA-M2) 750/-

02015124 Anti-Nuclear Antibody/

ANF/ ANA 450/-

02015125 ANA IFA (HEP-2) Method 960/-

02015126

Anti-Native Deoxyribonucleic Acid (Ds-

DNA) 700/-

02015127 Antismith Antibody 650/-

02015128 Rubella IgG/IgM Antibody 360/-

02015129 Rubella IgG & IgM 650/-

02015130 Rubeola IgG/IgM Antibody 1000/-

02015131 Rubeola Antibodies IgG &

IgM 1400/-

02015132 Leptospira Antibody

IGM/IGG 840/-



41

CODE NAME OF

INVESTIGATION


02015133 Leptospira Antibody IGG &

IGM 1650/-

02015134 Cryptococcus Antigen-Latex Detection (CSF) 1300/-

02015135 Falciparum Antigen 360/-

02015136 ADA (Adenosine

Deaminase- Body Fluid) 450/-

02015137 Mantoux Test 150/-

02015138 Anti HAV-Total (IGG &

IGM) 720/-

02015139 Cytomegalo Virus (CMV

)Antibody [IGG] 320/-

02015140 CMV IgM + IgG 600/-

02015141 Chopra Aldehyde Test 100/-

02015142 Amniotic Fluid-Lecithin

Spingomyl 400/-

02015143 Amoebiais Antibodies [IHA]

Screening 280/-

02015144 Amoebic Serology 800/-

02015145 KOH Mount for Fungal

Elements Detection 100/-

02015146 Campylobacter Jejieni

Antigen Detection I 360/-

02015147 HIV Test (1 & 2) 450/-

02015148 Typhi DOT-M 160/-

02015149 Hepatitis B-Core, total

(HBC total, IGG + IGM) 720/-

02015150 Anti HBC Antibody (IgM) 720/

02015151 Anti HBC Antibody (Total) 720/

02015152 Anti HBE 550/-

02015153 Hepatitis Be Antibody 550/-

02015154 Hepatitis D Virus Antibody 1450/-

02015155 HLA B27 CHN 920/-

02015156

HLA-B27, Disease Association, Flow

Cytometry 1500/-

02015157 HLA-ABC & DR Tissue

Crossmatch 2000/-

02015158 HCV RNA PCR Qualitative 2500/-

02015159 Hepatitis C Viral RNA

Genotype, LIPA 9500/-

02015160 Varicella- Zoster Virus IGG

Titres 520/-

02015161 Varcilla Zoster IgM 720/-

02015162 Varcilla Zoster IgG & IgM 1400/-

CODE NAME OF

INVESTIGATION


02015163 Anti LKM-1 (Liver Kidney

Microsomal-1) Antibo 820/-

02015164 Viable MTB Detection-

PCR 1500/-

02015165 HIV Qualitative (Window

Period Detection) 1200/-

02015166 Anti Sclero 70/ SCL 70 1300/-

02015167 Comprehensive CNS Panel- (Molecular Dia 6800/-

02015168 HIV Proviral DNA Detector

Qualitative 1100/-

02015169 Hepatitis B PCR

Quantitative 1900/-

02015170 Hepatitis B Virus PCR

Qualitative 3000/-

02015171 Anti GBM Antibody+

900/-

02015172 HSV DNA PCR 1500/-

02015173 Anti RNP-Sm Antibody 1000/-

02015174 Antibody to Ribonucleo

Protein IgG 1100/-

02015175 NBT Reduction Test 720/-

02015176 Anti Jo Antibody 520/-

02015177 Anti Jo-1 Antibodies 840/-

02015178 Antibody to SSA/SSB 2000/-

02015179 Antibody to SSB/LA 720/-

02015180 Japanese Encepahilits Virus PCR (JE Virus P 1500/-

02015181

HIV-1 RNS Quantitative RT-PCR with CD-3, CD-4,

CD 3800/-

02015182 RNS Study/ Decrement 350/-

02015183 HIV Viral Load CD4 & CD8 3200/-

02015184 Anti RNP- Sm IgG 1100/-

02015185 Anti Endomysial Antibody

IgA 720/-

02015186 CD-4, CD-8 700/-

02015187 CD 10 1200/-

02015188 CD 20 920/-

02015189 CD 3 920/-

02015190 CD 30 920/-

02015191 HCV RNA Quantitative/

Viral Load 6000/-

02015192 HBV Quantitative 5500/-



42

CODE NAME OF

INVESTIGATION


02015193 HBV DNA Qualitative 1900/-

02015194 Mycobacterium

IgA/IgG/IgM 600/-

02015195 Mycobacterium Serology

IgG/IgM 500/-

02015196 Mycobacterium

Tuberculosis Serology EL 1900/-

02015197 TB PCR (Mycobacterium

tuberculosis PCR) 850/-

02015198 Treponema Pallidum Antibody Detection 300/-

02015199 Treponemal Pallisum,

FTPA-ABF 2000/-

02015200 Autoimmune Hepatitis

Panel 900/-

02015201 Antinuclear antibody Panel

(14 antibody panel) 1100/-

02015202 Anti CCP Antibody 450/-

02015203 Anti Centromere Antibody 800/-

02015204 Serum Procalcitonin 2000/-

02015205 Serum Prealbumin 550/-

02015206 HSV (1+2) IgG/IgM

Antibodies 280/-

02015207 HSV (1+2) IgG and HSV

(1+2) IgM 550/-

02015208 Chikungunya Test 500/-

02015209 ANA/ ANF in Dilution 1000/-

02015210 Bronchial Aspiration for

Culture & Sensitivity 300/-


AFB Culture 500/-


Fungal Stain 100/-


Gram Stain 100/-


TBPCR 1400/-

02015215 CVP Tip for Culture &

Sensitivity 300/-

02015216 Dialysis Catheter Tip for

C/S 300/-

02015217

Ear/ Eye/ Nasal/ Tongue Swab for Culture &

Sensitivity 300/-

02015218 Prostatic Secretion for

Microscopy 150/-

02015219 Prostrate Specific Antigen

(PSA) 500/-

CODE NAME OF

INVESTIGATION


016 Obstetric Cases

02016001 Examination under

anaesthesia 2430/-

02016002 Laparoscopy (Gynae) 6060/-

02016003 Lap. Dye Test with removal

of adhesions 8000/-

017 Biopsies (Specimen processing per tissue type)

02017001 Biopsy [Large] 600/-

02017002 Biopsy [Medium] 500/-

02017003 Biopsy [Small] 350/-

02017004 Biopsy [Extra Large] 800/-

018 Head & Neck Cancer

019 Cardio Respiratory Procedures

02019001 Direct Laryngoscopy 4380/-

02019002 Bronchoscopy 2400/-

02019003 Mediastinoscopy 2880/-

02019004 Pleural Biopsy 3630/-

02019005 Thoracoscopy 6600/-

02019006 Pulmonary function test

BMR 700/-

02019007 Spirometry 700/-

02019008 Spirometry with Helium

Dilution 1620/-

02019009

Spirometry with Helium Dilution with diffusion

capacity studies 1620/-

02019010 Pulmonery exercise testing 940/-

02019011 Punctal Cautery 100/-

02019012 NT Pro BNP 1000/-

02019013 Cardioversion 1400/-

02019014 Cardiac Troponin I 400/-

02019015 TEE with Anesthesia 2500/-



43

CODE NAME OF

INVESTIGATION


02019016 Testicular 800/-

02019017 Flexible Bronchoscopy-

Diagnostic- TBNA 10000/-


Therapeutic 2500/-


Glue 4000/-


Baloon Tampete 4000/-


Toileting 2600/-

02019022 Rigid Bronchoscopy-

Diagnostic 5000/-

02019023 Rigid Bronchoscopy- Massive Haemoplysis 6200/-

02019024 Fibroptic bronchoscopy 2100/-

02019025 Fibroptic Bronchoscopy

with Washing/Biopsy 2500/-

020 Cardiac / Cardio Thoracic Procedures

02020001 Test of Pacemaker 580/-

02020002 Stress Myocardial Study

(MBI/ TR) 7200/-

02020003 Echo Screening 720/-

02020004 Stress Echo/ Dobutamine

Echo 1950/-

02020005 Foetal Echocardiography 1320/-

02020006 Cardio Tocography 360/-

02020007

2 D Echo with colour Doppler/ 2D Echo

Cardiography 1320/-

02020008 Trans Oesophaedral Echo

(TEE) 840/-

02020009

Holter Analysis & Holter Report (with Prd.

Specification) 1470/-

02020010

Cardiac Cath Angiography (Without Coronary

Angioplasty) 13200/-

CODE NAME OF

INVESTIGATION


02020011 Aortogram 3900/-

02020012

Package charges for Cardiovascular investigation 410/-

02020013 Stress Thallium 3600/-

02020014 Muga (Resting) 1440/-

02020015 Muga (Stress) 1800/-

02020016 Echo Colour Doppler

1440/-

02020017 Check Angio 7000/-

021 Abdomen/ Gastroentrology

02021001 Gastroscopy 1170/-

02021002

Gastric & Duodenal Biopsy (Endoscopic) 1560/-

02021003 ERCP 4000/-

02021004 ERCP Fluroscopy 2200/-

02021005 Upper G.I. Endoscopy 1100/-

02021006

Upper G.I. Endoscopy with Biopsy 1300/-

02021007 Sigmoidoscopy (rigid) 1400/-

02021008 Sigmoidoscopy (flexible) 1200/-

02021009 Oesophagoscopy 1100/-

02021010 Colonoscopy 1800/-



44

CODE NAME OF

INVESTIGATION


02021011

Colonoscopy-Full (GAS-PKG) 2000/-

02021012 24 H PH Metry 4000/-

02021013 24 H PH Metry (BS) 5500/-

022 Nephrology / Genitourinary

02022001 Biopsy of Bladder

(Cystoscopic) 8000/-

02022002 Urethroscopy 6000/-

02022003 Glomerular Filtration Rate 500/-

02022004 Urethral dialatation-

Diagnostics 1000/-

02022005 Visually Evoked Potential 500/-

02022006 Uroflow Study (Micturometry) 600/-

02022007 Urodynamic Study

(Cystometry) 1200/-

02022008

Cystoscopy with Retrograde Catheter

Unilateral 4000/-

02022009

Cystoscopy with Retrograde Catheter

Bilateral 6000/- 02022010 Cystoscopy Diagnostic 5000/- 02022011 Cortisol-blood 240/- 02022012 Voiding-cysto-urethrogram 360/-

02022013 Renal Transplant

Evaluation 1500/-

023 Orthopaedic Surgery Procedure

02023001 Arthrography &

Osteomedullography 11000/-

02023002 Arthroscopy - Diagnostic 11000/- 024 Neurology

02024001 Placement of ICP Monitor - 6000/-

02024002 Lumber Pressure

Monitoring 6100/-

02024003 Nerve Biopsy 8500/-

02024004 Brain Biopsy 8500/-

CODE NAME OF

INVESTIGATION


02024005 Brain Mapping 3000/-

02024006 Ambulatory Electro Ence 5000/- 02024007 Blink Reflex 500/- 02024008 Decrement Test 650/- 02024009 EMG Four Limbs 900/- 02024010 EMG Two Limbs 480/- 02024011 NCV Four Limbs 900/- 02024012 NCV Two Limbs 500/- 02024013 EMG-Facial 500/- 02024014 NCV-Facial 500/- 02024015 NCV+EMG-Facial 950/-

02024016 Spincter-EMG 550/-

02024017 H Reflex 500/- 02024018 SSEP (Lower Limbs) 550/-

02024019 SSEP (Upper Limbs) 550/-

02024020 SSEP-UL/LL 1000/- 02024021 VEP (Flash) 550/-

02024022 VEP (PR) 550/-

02024023 Counsl of INH Patient 200/- 02024024 Spl Edu Assessment 250/- 02024025 Baer Study 550/-

02024026 Baer/ Threshold 1000/- 02024027 Councelling & Therapy 200/- 02024028 IQ Assessment 300/- 02024029 Neuro Psychological T 850/- 02024030 Personality & IQ Child 450/- 02024031 Personality Development T 650/- 02024032 SSR 700/-

02024033 Lumbar puncture with CSF

Monitoring 1500/-

02024034 HER-2/ NEU 1200/- 025 Breast

02025001 Mammography (Single side) 800/-

02025002 Mammography (Both sides) 1500/-



45

CODE NAME OF

INVESTIGATION


026 Gynae, Operation Charges

02026001 Diagnostic Curettage 3000/-

02026002 Fractional Curettage 3400/-

02026003 Hysteroscopy Diagnostic 7500/-

027 Laproscopic Operations

In Gen. Surgery / Gastrohepatic / Nephro-

02027001 Diagnostic Laproscopy 7000/-

028 Specialised Procedures / Investigations/ C.T. Scan

02028001 Cat Scan (C.T.) Head 1600/-

02028002 C.T. Head Scan Involv.

Spl. Investigation 2300/-

02028003 C.T. Scan Brain 1600/-

02028004 HRCT Chest Thorax 6000/- 02028005 C.T. Chest (HRCT) 4000/- 02028006 C.T. Scan Chest 3500/-

02028007

C.T. Spine (Cervical,Dorsal, Lumbar,Sacral) 3500/-

02028008 CT Angiogram of Cervical

and Intra 7200/-

02028009 C.T. Cervical C.T. 3D Reconstruction only -- 1200/-

02028010 C.T. Guided Biopsy 2000/-

02028011 C.T. Guided percutaneous

cath drainage 2500/-

02028012 C.T. Myelogram (Cervical Spine) 3500/-

02028013 C.T. Myelogram

(Lumbar Spine or D/S) 3500/-

02028014 CT Pelvis with Hip Joints 3000/-

02028015 CT KUB (Plain) 3500/- 02028016 CT Sacro Iliac Joint 2500/- 02028017 CT Pituitary/ Sella 2500/- 02028018 CT Cisternography 1600/- 02028019 CT Petrous Temporal Bone 3000/-

CODE NAME OF

INVESTIGATION


02028020 CT Sacrum & Coccyx 3500/- 02028021 C.T. Scan Upper Abdomen 3000/-

02028022 C.T. Scan Lower Abdomen 3000/- 02028023 C.T. Scan Whole Abdomen 5000/-

02028024

C.T. Shoulder Joint/ Knee Joint/ Elbow Joint/ Any

Other Joint (Plain) 3500/- 02028025 CT Base of Neck 2000/-

02028026 C.T. Scan Neck (Thyroid

Soft Tissue) 3000/-

02028027 CT Ankle with Foot 2000/- 02028028 C.T. Scan Orbits/Eye 3000/-

02028029

CT Arm/ Humerus/ Forearm/ Radius-Ulna/

Leg/ Tibia-Fibula/ Thigh/ Femur (Single) Plain 4500/-

02028030 C.T. Scan Limbs 2500/- 02028031 CT Both Thigh 2000/- 02028032 C.T. Scan Whole Body 10000/- 02028033 CT Extremities 2000/-

02028034 C.T. Scan of Para Nasal

Sinus 3000/-

02028035 CT guided FNAC 2500/-

02028036 CT Angiography of Brain/

Carotid/ Thorax/ Neck 5400/-

02028037 CT 64 Coronary

Angiography 10000/-

02028038

CT Angiography of Brain/ Carotid/ Thorax/ Neck/ Abdomen/ Extremities/ Renal area/ Peripheral

area/ Pulmonary area with Visipaque 6500/-

02028039 CT Renal Angiography 5000/-

02028040 CT Angio Both Lower

Limbs 10000/-

02028041 CT Angiography of Neck

Vessels 5000/-

02028042

CT Angiography of Abdomen/ Extremities/ Renal area/ Peripheral area/ Pulmonary area 6000/-



46

CODE NAME OF

INVESTIGATION


02028043

PET CT Scan (Whole Body)

(including Flurodeoxy Glucose) 20000/-

02028044 Therapeutic Aspiration- CT 3000/-

02028045 Diagnostic Aspiration- CT 1600/-

02028046 Ionic Contrast (20 C.C.) 270/-

02028047 Ionic Contrast (50 C.C.) 675/-

02028048 Non-ionic Contrast (10

C.C.) 500/-


C.C.) 750/-


C.C.) 1250/-


C.C.) 2100/-

02028052 3D Reconstruction charge 1200/- 029 MRI

02029001

MRI Brain/ Brain with Protocol/ CSF Study/

Internal Ear 6000/- 02029002 MRI Base of Skull 5400/- 02029003 MRI Orbits 6000/- 02029004 MRI Face 5400/-

02029005 MRI Nasopharynx and

PNS 6000/-

02029006 MRI Pharynx 5400/- 02029007 MRI Neck 6000/- 02029008 MRI Pituitary 5400/-

02029009 MRI Thyroid/ Cranio-

Vertebral (C.V.) Junction/ 5000/-

02029010 MRI Temporal Bones

(Unilateral) 6000/-

02029011 MRI Venography/

Angiography 5400/-

02029012 MRI Arm/ Fore Arm/ Thigh/

Femur/ Leg/ Foot 5400/-

02029013 MRI Arm (Humerus) (Left/

Right) 5400/- 02029014 MRI- Single Joint 5400/-

CODE NAME OF

INVESTIGATION


02029015 MRI- Both Joints 9000/- 02029016 MRI Sacro Iliac Joints 5400/-

02029017

MRI Spine (Cervical/ Dorsal/ Lumbar/ Cervico-Dorsal/ Dorso-Lumbar/

Lumbo-Sacral) 5400/-

02029018 MRI Lumbar Spine &

Sacroiliac Joint 6000/-

02029019 Double Region Plain (Brain

& Spine) 9000/-

02029020 Tripple Region Plain (Brain

& Spine) 13000/- 02029021 MRI CSF Flow Study 1500/- 02029022 MRI Spectroscopy 1500/-

02029023 MRI Diffusion Tensor

Imaging (DTI) 1500/-

02029024 MRI SWI (Susceptibility

Weighted Image) 1500/- 02029025 MRI Hip 6000/- 02029026 MRI Urogram 5400/- 02029027 MRI Pelvis 6000/- 02029028 MRCP 5000/- 02029029 MRI Extremities 6000/-

02029030 MRI Upper Abdomen with

MRCP 6000/-

02029031 MRI Temporomandibular

Single Joint 5000/-

02029032 MRI Temporomandibular

Double Joints 6000/-

02029033 MRI Upper Abdomen 5400/-

02029034 MRI Upper Thigh & Lower

Abdomen 7000/- 02029035 MRI Whole Abdomen 9000/-

02029036 MRI Lower Abdomen/

Pelvis 5400/- 02029037 MRI Breast 6000/- 02029038 MRI Thoracic Outlet 5400/- 02029039 MRI Spine Screening 5400/- 02029040 MRI Brachial Plexus 5400/- 02029041 MRI Chest 5400/-

02029042 MRI Brain with Spectroscopy 6000/-

02029043 MRI Brain with Perfusion 7300/-



47

CODE NAME OF

INVESTIGATION


02029044 MRI Brain with Orbit/ PNS/

Angio/ Neck Angio 6500/-

02029045

MRI Brain with DTI (Diffusion Tensor Imaging)/

SWI (Susceptibility Weighted Image)/ Cranial

Nerve Evaluation 6000/- 02029046 MRI Perfusion Study 3500/- 02029047 MRI Screening 5400/-

02029048 Screening Single Area with

Films 1500/-

02029049 Screening Double Area

with Films 3000/- 02029050 MRI Small Part 4000/- 02029051 MRI Other Region 5400/- 02029052 Contrast (Ionic/ Non-ionic) 2500/-

030 Other Investigations 02030001 Fluoroscopic Screening 120/- 02030002 Oxygen Saturation 120/-

02030003 Bone Densitometry Single

site 800/-

02030004 Bone Densitometry Two

sites 1200/-

02030005

Bone Densitometry Three sites ( Spine , Hip & one

extremity) 1600/-

02030006 Bone Densitometry Whole

body 2200/- 02030007 A.V. Fistula 3000/-

031 Immunology 02031001 Hepatitis B DNA 5200/-

02031002 HBV DNA Quantitative/

Viral Load 6000/- 032 Nuclear Medicines

02032001 Isotope Venography 3500/-

02032002 Gallium-67 Scan/Ghallium

Scan 8500/- 02032003 Thyroid Scan 1800/- 02032004 Iodine-131 Thyroid Scan 2500/- 02032005 Thyroid (Tc99m) Scan 1800/- 02032006 Para Thyroid Scan 6000/- 02032007 Thallium Scan 9000/-

02032008 Spect Myocardial Perfusion

Scan (Thalium/ Tetro) 11000/-

CODE NAME OF

INVESTIGATION


02032009 Spect Myo Perfusion Rest Scan (Thalium/ Tero/ Mie 5500/-

02032010 Nuclear Blood Pool Scan 2000/-

02032011 Radio-Isotope Ureteric

Reflux (Indirect) 3000/-

02032012 Whole Body Tc-V-DMSA

Scan 3500/-

02032013 Brain Spect (Tumour

Imaging) 2500/- 02032014 Tumour Immagery 5000/-

02032015 Bone Scan Spect (Single

Region) 1800/-

02032016 Bone Scan- three phase

(Single Region) 2700/-

02032017 Bone Scan Spect (whole

body) 3000/- 02032018 Tc 99m DMSA Renal Scan 2000/-

033 Profiles 02033001 Lipid Profile 700/- 02033002 Thyroid Profile 1200/- 02033003 Total Diabetic Profile 1000/- 02033004 Pre Cath Profile 850/- 02033005 Coagulation Profile 550/- 02033006 LFT [Liver Function Test] 750/-

02033007 Pre Dialysis Serology 600/- 02033008 Dialysis Profile 500/- 02033009 Hepatitis B Profile 3000/- 02033010 Hepatitis Panel 1800/- 02033011 Neuro Profile 2000/- 02033012 Septic Profile 900/- 02033013 Paediatric Septic Profile 1800/-

02033014 Basic Metabolic Panel

(BMP) 320/-

02033015 Comprehensive Metabolic

Panel (CMP) 500/- 02033016 Anaemia Screen (HAEM1) 2800/-

02033017 Thrombocytopenia Screen

(HAEM2) 3400/-

02033018 Mycloma Screen (HAEM3)

2700/-

02033019 Lymphoma Screen

(HAEM4) 2000/- 02033020 Polycythaemia (HAEM5) 1800/-



48

CODE NAME OF

INVESTIGATION


02033021 Thallasaemia Patient

Screen (HAEM6) 3000/-

02033022 Thallasaemia Counselling

Serum (HAEM7) 1200/- 02033023 CRBSI 550/- 02033024 ACTH Stim 1900/- 02033025 Growth Hormone Stim 2000/- 02033026 Male GnRH Stim 3500/- 02033027 Female GnRH Stim 3300/- 02033028 Bone Marrow Profile 550/- 02033029 EP Screening Profile 1100/- 02033030 Torch Profile 1500/- 02033031 Renal Profile 330/-



49

RATES FOR IMPLANTS 03- IMPLANTS

CODE NAME OF THE ITEM Maximum Approved Rate (INR)

(Rupees)

001 Cardiology Implantation Devices

03001001 Pacemaker (Single Chamber)- Ordinary (SSI Autocapture) 45,000/- or the actual cost, whichever is less

03001002 Pacemaker (Single Chamber)- With rate modulation (SSIR) 68,000/- + VAT or the actual cost, whichever is less

03001003 Pacemaker (Dual Chamber) (DDD/DDDR/VDDR) 1,20,000/- + VAT or the actual

cost, whichever is less

03001004 CRT (Cardiac Resynchronization Therapy) 2,50,000/- or the actual cost, whichever is less

03001005 AICD (Automatic Implantable Cardioverter Defibrillater) 3,50,000/- or the actual cost,

whichever is less

03001006 CRT + AICD combination 5,00,000/- or the actual cost, whichever is less

03001007 BMS (Bare Metal Stent)(made of Steel) 30,000/- + VAT or the actual cost, whichever is less

03001008 BMS (Bare Metal Stent)(made of alloy e.g. Cobalt, Chromium,

etc.) 40,000/- + VAT or the actual


03001009 DES (Drug Eluting Stent)- Sirolimus-eluting e.g. Cypher, etc. 95,000/- + VAT or the actual cost, whichever is less

03001010 DES (Drug Eluting Stent)- Higher Sirolimus derivatives e.g.

Endeavour, Promus, Xcience, etc. 1,05,000/- + VAT or the actual


03001011 DES (Drug Eluting Stent)- Paclitaxel-eluting e.g. Taxus, etc. 80,000/- + VAT or the actual cost, whichever is less

03001012 PDA- closure device 50,000/- + VAT or the actual cost,

whichever is less

03001013 ASD/ VSD- closure device 80,000/- + VAT or the actual cost,

whichever is less

03001014 Mitral Baloon, e.g. Inoue Baloon 40,000/- + VAT or the actual cost, whichever is less

03001015 Pulmonary Valvoplasty Baloon 20,000/- + VAT or the actual cost, whichever is less

03001016 Mitral/ Aortic Heart Valve 50,000 + VAT or the actual cost,

whichever is less

03001017 TTK Chitra (Mitral/ Aortic Heart Valve) 30,000 + VAT or the actual cost,

whichever is less

03001018 Heart Valves- Annuloplasty Ring 24,000/- + VAT or the actual cost, whichever is less

002 Opthalmology 03002001 Hydrophobic Foldable IOL 5,000/- 03002002 Silicon Foldable IOL 4,000 /-



50


(Rupees)

03002003 Hydrophilic Acrylic Lens 6,000 /-

03002004 PMMA IOL 500/- 003 ENT

03003001 One-sided Hearing Aid (Body worn/Pocket/Behind the ear type or

in the canal type (conventional) 10,000/-

03003002 Bilateral Hearing Aid 20,000/-

03003003 Digital Hearing Aid (to be purchased with the permission of the

West Bengal Health Scheme Authority) 30,000/-

004 Neuro Implants

Type of Neuro-implant Prescribing Authority

Ceiling Rate

Life of Battery

Cost of Battery

03004001 DBS Implants Neurologist of a recognised

hospital 3,60,000/- 3-5 years 2,50,000/-

03004002 Intra-thecal Pumps 2,62,000/- 7 years 2,25,000/-

03004003 Spinal Cord Stimulators

Any two specialists of concerned speciality/ HoD

of Neurology/ Neurosurgery/

Anaesthesiology of recognized hospital

2,62,000/- 3-5 years 2,00,000/-

03004004 CPAP Machine 50,000/- 03004005 BIPAP Machine 1,00,000/-

005 Orthopaedic implants Maximum Ceiling Rates (Rupees)

03005001 Depuy (TKR) Knee 75,000/- 03005002 Zimmer (USA) Knee 74,880/- 03005003 Cemented Bipolar Hip (Zimmer) 41,080/- 03005004 Uncemented Total Hip (Zimmer) 69,992/- 03005005 Cemented Bipolar Hip (Depuy) 38,500/- 03005006 Uncemented Total Hip (Depuy) 77,000/- 03005007 Cemented Total Hip (Depuy) 46,500/- 03005008 DHS Plate Screw 3,500/- 03005009 Proximal Femur Nail 5,720/- 03005010 Locking Plate & Screw- for Humerous 5,500/- 03005011 Locking Plate & Screw- for Distal Tibia 6,500/- 03005012 Locking Plate & Screw- for Proximal Tibia 5,500/- 03005013 Locking Plate & Screw- for Proximal Femur 6,500/- 03005014 Locking Plate & Screw- for Shaft Femur 9,000/- 03005015 Locking Plate & Screw- for Radius Ulna 2,500/-

03005016 Locking Plate & Screw- for Distal Humerous & Elbow

Joint 4,500/-

03005017 Locking Plate & Screw- for Shaft Humerous 5,500/-



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(Rupees) 03005018 Locking Plate & Screw- for Buttress Plate & Screw 5,500/- 03005019 ISO-Elastic Nail (Per Piece) 2,500/- 03005020 Interlocking Nail for Tibia & Femur 3,500/- 03005021 PFN Nail for Proximal Femur 8,000/- 03005022 DHS Plate Screw for Trochanteric Fracture 3,500/- 03005023 Humerous Plate 3,500/- 03005024 Humerous locking Plate & Screw 5,500/- 03005025 Humerous locking T- Buttress Plates & Screw 4,500/- 03005026 Elbow Joint- fixation by locking Plate & Screw 3,500/- 03005027 Replacement of Elbow Joint 20,000/- 03005028 Radius Ulna- Locking Plates & Screw 4,500/- 03005029 Wrist joint with locking Plate & Screw 2,500/- 03005030 Soldier Joint- With Jess Fixator 6,500/- 03005031 External & ILLIZAROV- Femur 7,000/- 03005032 External & ILLIZAROV- Tibia 7,000/- 03005033 External & ILLIZAROV- Pelvis 7,000/-

Date post:	21-Oct-2015
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West Bengal Health Scheme

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