LIST OF PROCEDURES AND PROCEDURES COVERED UNDER THE WEST BENGAL HEALTH SCHEME

(Current as on July 31, 2013)

01 – PROCEDURES

Name of Procedure / Investigation / Code / Amount Claimed
(in `) / Amount Admissible
(in `)
GENERAL / 001
Consultation by Medical Officer (OPD) / 01001001 / 150/-
Consultation by Specialist (OPD) / 01001002 / 200/-
Visit / Revisit /Consultation by Specialists (Indoor) (Maximum two visits per day admissible) / 01001003 / 200/-
Consultation by Super Specialists (OPD) / 01001004 / 250/-
Visit / Revisit / Consultation by Super-Specialists (Indoor) (Maximum two visits per day admissible) / 01001005 / 250/-
Pre-operative Anaesthetic Consultation / 01001006 / 200/-
Paramedical Consultation / 01001007 / 75/-
Special Nursing Charge(per shift of 12 hrs.) / 01001008 / 150/-
Aya / Attendant Charge (per shift 12 hrs.) / 01001009 / 75/-
Delayed primary suture / 01001010 / 1,700/-
Dressing Large / 01001011 / 160/-
Suturing without local anaesthesia / 01001012 / 400/-
Suturing of wounds with local anaesthesia / 01001013 / 500/-
Debridement of wounds / 01001014 / 1,200/-
Removal of Benign Tumor / 01001015 / 1,100/-
Aspiration Plural Effusion-Therapeutic / 01001016 / 1,000/-
Abdominal Aspiration – Therapeutic / 01001017 / 1,300/-
Removal of F.B. Superficial / 01001018 / 1,200/-
Bone Marrow Aspiration / 01001019 / 1,500/-
Joints Aspiration / 01001020 / 1,500/-
Strapping / 01001021 / 100/-
Removal of Stiches / 01001022 / 60/-
Venesection / 01001023 / 300/-
Phimosis under LA / 01001024 / 1,500/-
Lumbar puncture / 01001025 / 700/-
Sternal puncture / 01001026 / 1,500/-
Injection for Haemorrhoids / 01001027 / 1,000/-
Injection for Varicose Veins / 01001028 / 1,300/-
Catheterisation / 01001029 / 120/-
Dilatation of Urethra / 01001030 / 1,100/-
Incision & Drainage / 01001031 / 600/-
Intercostal Drainage / 01001032 / 1,500/-
Peritoneal dialysis / 01001033 / 1,800/-
Removal of soft tissue or regional block under general anaesthesia / 01001034 / 2,400/-
Dressing Small / 01001035 / 100/-
Secondary suture of wounds / 01001036 / 1,200/-
Bone Marrow Transplantation (inclusive of all) / 01001037 / 10,00,000/-
SKIN / 002
Excision of Moles / 01002001 / 600/-
Excision of Warts / 01002002 / 600/-
Excision of Molluscum contagiosum / 01002003 / 600/-
Excision of Veneral Warts / 01002004 / 600/-
Excision of Corns / 01002005 / 550/-
I / D Injection Keloid of Acne / 01002006 / 300/-
Chemical Cautery (per sittings) / 01002007 / 120/-
Excision of Sebaceous Cysts / 01002008 / 1,700/-
Excision of Superficial Liipoma / 01002009 / 2,400/-
Excision of Dermoid Cysts / 01002010 / 2,450/-
Surgery of infected corn (Day care) / 01002011 / 2,800/-
E.N.T. / 003
Speech therapy per session of 30 – 40 minutes / 01003001 / 200/-
Removal of foreign body From Nose / Ear / Throat (Day care package) / 01003002 / 1,500/-
Swallowing Therapy / 01003003 / 250/-
Syringing / 01003004 / 300/-
Polyp removal under LA / 01003005 / 800/-
Peritonsillar abscess drainage under LA / 01003006 / 1,600/-
Tinnitus Retraining Therapy / 01003007 / 250/-
Myringoplasty / 01003008 / 10,700/-
Staepedectomy / 01003009 / 12,000/-
Myringotomy with Grommet insertion / 01003010 / 6,000/-
Endoscopic Removal of Fish Bone / 01003011 / 1,000/-
Tympanotomy / 01003012 / 8,000/-
Paracentesis / 01003013 / 4,300/-
Tympanoplasty / 01003014 / 14,000/-
Mastoidectomy / 01003015 / 15,600/-
Otoplasty / 01003016 / 16,500/-
Labyrinthectomy / 01003017 / 15,600/-
Skull Base surgery / 01003018 / 50,000/-
Facial Nerve Decompression / 01003019 / 20,000/-
Septoplasty / 01003020 / 10,200/-
Submucous Resection / 01003021 / 10,800/-
Septo-rhinoplasty / 01003022 / 15,000/-
Rhinoplasty (non-cosmetic) / 01003023 / 12,000/-
Fracture Reduction / 01003024 / 9,000/-
Intra Nasal Diathermy / 01003025 / 6,000/-
Turbinectomy / 01003026 / 9,600/-
Endoscopic DCR / 01003027 / 13,000/-
Endoscopic Surgery / 01003028 / 15,000/-
Septal Perf. Repair / 01003029 / 15,000/-
Antrum Puncture / 01003030 / 3,000/-
Lateral Rhinotomy / 01003031 / 1,350/-
Cranio-facial resection / 01003032 / 28,000/-
Ethamoidectomy / 01003033 / 17,600/-
Caldwell Luc Surgery / 01003034 / 12,000/-
Angiofibroma Excision / 01003035 / 18,000/-
Endoscopic Hypophysectomy / 01003036 / 25,000/-
Endoscopic Optic Nerve Decompression / 01003037 / 32,000/-
Decompression of Orbit / 01003038 / 30,000/-
Ranula Excision / 01003039 / 9,600/-
Tongue Tie excision / 01003040 / 8,100/-
Sub Mandibular Duct Lithotomy / 01003041 / 9,700/-
Adenoidectomy / 01003042 / 8,000/-
Palatopharyngoplasty / 01003043 / 15,100/-
Cleft Palate repair / 01003044 / 16,000/-
Pharyngoplasty / 01003045 / 18,000/-
Styloidectomy / 01003046 / 11,500/-
Uvulo-palatoplasty / 01003047 / 20,000/-
Tympanomastoidectomy / 01003048 / 15,600/-
Dacunisation / 01003049 / 7,000/-
Tonsilklectomy / 01003050 / 11,200/-
Adenotonsillectomy / 01003051 / 13,500/-
Synichiolysis / 01003052 / 4,200/-
Submucosal Diathermy / 01003053 / 4,000/-
Nasal Mass Excision-Simple / 01003054 / 11,200/-
Nasal Mass Excision-Endoscopic Removal / 01003055 / 13,500/-
FESS / 01003056 / 11,200/-
Anterior Nasal Packing / 01003057 / 4,000/-
Post Nasal Packing / 01003058 / 5,000/-
Nasal Bone Reduction / 01003059 / 6,000/-
Excision of Lesion Base of Tongue-per Oral Approach / 01003060 / 6,400/-
Unilateral Pre-Auricular Sinus operation / 01003061 / 23,400/-
Ophthalmology / 004
Cauterisation of ulcer/subconjuctival injection – One eye / 01004001 / 200/-
Cauterisation of ulcer/subconjuctival injection – both eyes / 01004002 / 300/-
Retrobular Injection – One eye / 01004003 / 200/-
Retrobular Injection – Both eyes / 01004004 / 300/-
Syringing of Lacrimal Sac- For one eye / 01004005 / 200/-
Syringing of Lacrimal Sac- For both eyes / 01004006 / 300/-
Paracentesis / 01004007 / 800/-
Foreign body removal / 01004008 / 300/-
Refraction / Fundoscopy / 01004009 / 90/-
Ortho-optic exercises / 01004010 / 100/-
Plepoptic Exercises / 01004011 / 100/-
Chalazion operation – One Eye / 01004012 / 800/-
Chalazion operation – Both Eyes / 01004013 / 1,000/-
Dressing (eye) / 01004014 / 100/-
Clinical Photography / 01004015 / 100/-
Pterygium / 01004016 / 2,200/-
Orbitotomy / 01004017 / 9,000/-
Ptosis correction / 01004018 / 6,500/-
Ectropion Correction / 01004019 / 3,600/-
Xenon Arc Laser / 01004020 / 700/-
DCR (Dacryo custorhinostomy) / 01004021 / 5,700/-
ECCE / ICCE / 01004022 / 6,000/-
Epicanthus correction / 01004023 / 2,100/-
Squint Correction (one eye) / 01004024 / 4,000/-
Squint Correction (both eyes) / 01004025 / 6,000/-
Keratoplasty / 01004026 / 14,000/-
Trabeculotimy / 01004027 / 5,700/-
Iridectomy / 01004028 / 2,400/-
Goniotomy / 01004029 / 2,400/-
Scleral Bukling (Retinal Detachment surgery) / 01004030 / 14,000/-
Syringing & Probing / 01004031 / 1,100/-
Vitrectomy / 01004032 / 11,000/-
Enucleation / 01004033 / 4,000/-
Eviseration / 01004034 / 3,800/-
Entropion correction / 01004035 / 3,000/-
Cataract with IOL (Cost of lens extra) / 01004036 / 7,500/-
Fistulectomy / 01004037 / 5,700/-
Glucoma surgery with Glucoma valves / 01004037 / 5,000/-
Caliculoplasty / 01004039 / 3,000/-
Dacryocystectomy / 01004040 / 3,000/-
Ptosis surgery with LPS resection / 01004041 / 7,000/-
Ptosis surgery with Sling surgery / 01004042 / 7,000/-
Extropion surgery – one lid / 01004043 / 3,000/-
Ectropion surgery – both lids / 01004044 / 4,000/-
Cheek rotation flap for lid tumors / 01004045 / 8,000/-
Telecanthus correction / 01004046 / 4,000/-
Fracture orbital repair / 01004047 / 9,000/-
Lasik / 01004048 / 18,000/-
TTT – Transpupillary thermal therapy / 01004049 / 4,000/-
PTK – Phototherapeutic keratectomy / 01004050 / 9,000/-
Iris cyst removal / 01004051 / 1,000/-
Lid Abscess incision and drainage / 01004052 / 3,000/-
Orbital Abscess incision and drainage / 01004053 / 4,000/-
Cyclodiathermy / 01004054 / 2,000/-
Perforating injury repair / 01004055 / 4,000/-
Phaco + IOL (inclusive of Foldable & Non-foldable lens) Package / 01004056 / 14,500/-
YAG Laser Capsulotomy per sitting / 01004057 / 600/-
YAG Laser Iridectomy per sitting / 01004058 / 600/-
Argon Laser Trabeculoplasty (ALT) (per sitting) / Diod Laser / 01004059 / 1,000/-
HVF / 01004060 / 500/-
Cryopexy / 01004061 / 1,200/-
ICG including Medicine / 01004062 / 2,000/-
ICG – Double including Medicine / 01004063 / 3,600/-
Electrolysis (Per sitting) / 01004064 / 150/-
Cyclocryo / Cyclodiathermy / 01004065 / 500/-
D.C.T. (OPD) / 01004066 / 800/-
Silicone Oil (1000) / 01004067 / 4,000/-
Silicone Oil (C5) / 01004068 / 4,000/-
Silicone Oil Removal / 01004069 / 3,500/-
Pneumo Retinopexy / 01004070 / 2,400/-
FGE / FAE / 01004071 / 1,500/-
Indirect Laser / 01004072 / 1,000/-
Endo Laser / 01004073 / 2,400/-
SF6 Gas / 01004074 / 2,400/-
C3F8 Gas / 01004075 / 2,400/-
PFCL / 01004076 / 2,400/-
Photodynamic Therapy procedure charges –(Single eye) / 01004077 / 15,000/-
Photodynamic Therapy procedure charges – (both eyes) / 01004078 / 25,000/-
Photodynamic Therapy (Single eye) / 01004079 / 85,000/-
Photodynamic Therapy (both eyes) / 01004080 / 1,00,000/-
Intravitreal Avastin (including cost of injection single) / 01004081 / 6,000/-
Intravitreal Lucentis (excluding cost of injection single) / 01004082 / 4,000/-
Intravitreal Macugen (excluding cost of injection single) / 01004083 / 4,000/-
Intravitreal injections of antibiotics (cost of medicines extra) / 01004084 / 2,000/-
Retinal Foreign Body Removal / 01004085 / 4,000/-
PPV / Victerectomy / 01004086 / 6,500/-
Endo Diathermy / 01004087 / 1,600/-
Belt Buckle / 01004088 / 3,200/-
IVTCA / 01004089 / 800/-
Membrane Peeling / 01004090 / 2,400/-
Anterior Vitrectomy / 01004091 / 5,000/-
Lensectomy / 01004092 / 7,500/-
Orbitotomy (Multiple Wall) / 01004093 / 16,000/-
ERM (Epi Retinal Membrane) / 01004094 / 3,600/-
Reti Blue / 01004095 / 2,400/-
Corneal Collagen Cross – linking / 01004096 / 15,000/-
Biopsies including Histopathological report (Package) / 005
Biopsy procedure under Local Anaesthesia / 01005001 / 4,000/-
Biopsy procedure under General Anaesthesia / 01005002 / 6,000/-
Biopsy procedure under Endoscopy / 01005003 / 8,000/-
FNAC / 01005004 / 3,500/-
Strapping (including Bandage & materials) / 006
Strapping of Finger / 01006001 / 200/-
Strapping of Toes / 01006002 / 200/-
Strapping of Wrist / 01006003 / 360/-
Strapping of Elbow / 01006004 / 400/-
Strapping of Knee / 01006005 / 400/-
Strapping of Ankle / 01006006 / 400/-
Strapping of Chest / 01006007 / 500/-
Strapping of Shoulder / 01006008 / 450/-
Nasal bone fracture / 01006009 / 450/-
Figure of 8 bandage / 01006010 / 450/-
Colar and cuff sling / 01006011 / 450/-
Ball bandage / 01006012 / 450/-
Physiotherapy & Traction / 007
Ultrasonic therapy (per sitting) / 01007001 / 70/-
S.W. Diathermy (per sitting) / 01007002 / 90/-
Electrical stimulation (therapeutic) (per sitting) / 01007003 / 70/-
Infra red (per sitting) / 01007004 / 90/-
U.V. Therapeutic dose (per sitting) / 01007005 / 90/-
Electric vibrator (per sitting) / 01007006 / 90/-
Vibrator belt massage (per sitting) / 01007007 / 90/-
Intra Lumbar Traction (per sitting) / 01007008 / 90/-
Intermittent Cervical Traction (per sitting) / 01007009 / 70/-
Combined Lumbar & Cervical traction (per sitting) / 01007010 / 70/-
Wax bath / 01007011 / 50/-
Hot pack / 01007012 / 70/-
Whirlpool bath (per sitting) / 01007013 / 90/-
Obesity Exercises (per sitting) / 01007014 / 60/-
Breathing Exercises & Postural Drainage (per sitting) / 01007015 / 70/-
Cerebral Palsy – Massage (per sitting) / 01007016 / 90/-
Post – polio exercise (per sitting) / 01007017 / 60/-
Basic Gait Training (Per Session) / 01007018 / 80/-
Traction + IFT / 01007019 / 150/-
Traction + Stimulation / 01007020 / 100/-
Traction + SWD / 01007021 / 100/-
Traction + SWD +IFT / 01007022 / 200/-
Traction + US / 01007023 / 140/-
Traction + US + IFT / 01007024 / 200/-
Traction + US + IFT + SWD / 01007025 / 260/-
Traction + US + IFT + SWD / 01007026 / 260/-
IFT + PWB / 01007027 / 150/-
Exercise – per sitting / 01007028 / 60/-
PWB + Knee Joint Spad Fraction / 01007029 / 100/-
SWD + IFT / 01007030 / 100/-
US + IFT / 01007031 / 100/-
US + IFT + Stimulation / 01007032 / 200/-
US + Knee Joint + Spad Fraction / 01007033 / 100/-
US + PWB / 01007034 / 100/-
US + SW + Traction / 01007035 / 200/-
US + Tens / 01007036 / 100/-
US + Stimulation / 01007037 / 100/-
Knee Joints Spad Fraction / 01007038 / 100/-
Electronic Tilt Training – Per Session / 01007039 / 100/-
Interferential Therapy / 01007040 / 100/-
Laser Treatment – Per Session / 01007041 / 150/-
Microwave Diathermy – Per Session / 01007042 / 150/-
Quadriceps Chair Training (Per Session) / 01007043 / 100/-
Tens / 01007044 / 80/-
Dental / 008
Extraction of tooth including L.A. / 01008001 / 120/-
Complicated Ext. per Tooth including L.A. / 01008002 / 250/-
Flap Operation per Tooth / 01008003 / 500/-
Gingivectomy per tooth / 01008004 / 300/-
Cyst under L.A. (Small) / 01008005 / 300/-
Cyst under L.A. (Large) / 01008006 / 500/-
Impacted Molar including LA / 01008007 / 800/-
Apisectomy including LA / 01008008 / 1,000/-
Fracture wiring including LA / 01008009 / 80/-
Reduction & immobilisation of fracture – Maxilla under LA / 01008010 / 1,400/-
Reduction & immobilisation of fracture – Mandible under LA / 01008011 / 3,000/-
Splints / Circum mandibular wiring under GA / 01008012 / 2,000/-
Internal wire fixation / plate fixation of Maxilla under LA / 01008013 / 4,000/-
Internal wire fixation / plate fixation of Maxilla under GA / 01008014 / 6,000/-
Internal wire fixation / plate fixation of Mandible under LA/GA / 01008015 / 6,000/-
Cyst & Tumour of Maxilla mandible by enucleation / excision (package) / 01008016 / 2,000/-
TM joint ankylosis – under GA (package) / 01008017 / 11,000/-
Hemi-mandibulectomy with graft (package) / 01008018 / 7,000/-
Hemi-mandibulectomy without graft (package) / 01008019 / 4,000/-
Segmental-mandibulectomy with graft (package) / 01008020 / 6,000/-
Segmental-mandibulectomy with graft (package) / 01008021 / 2,000/-
Maxillectomy – partial with graft (package) / 01008022 / 5,000/-
Maxillectomy – partial without graft (package) / 01008023 / 4,000/-
Maxillo-facial prosthesis (sal / auricular / orbital / facial lost part) (package) / 01008024 / 5,000/-
Alvelolectomy, Frenectomy per Quadrant / 01008025 / 1,150/-
Alvelolectomy (minor) / 01008026 / 380/-
Amalgam Filling / tooth (compound) / 01008027 / 450/-
Amalgam Filling / tooth (regular) / 01008028 / 380/-
Apicoectomy Molar Tooth / 01008029 / 2,250/-
Arch Bar Removal / 01008030 / 380/-
Bite Plate / Retainers / 01008031 / 1,150/-
Cast Rpd (per tooth) / 01008032 / 380/-
Davis Crown / radicular Screw supported / 01008033 / 1,900/-
De Sensitising per sitting / 01008034 / 200/-
Dento Alveolar fracture Reduction & Splinting/l.a. / 01008035 / 1,500/-
Denture Repair (category 1) / 01008036 / 230/-
Dialation of Whartons Duct under L.A. / 01008037 / 1,500/-
Direct / indirect Pulp Capping / 01008038 / 230/-
Drain. of Dento Alveolar Absec (ex. Oral) / 01008039 / 950/-
Enucleation of Cyst of Oral Cavity / 01008040 / 2,000/-
Fibre Post Based Post & Core / 01008041 / 1,900/-
Floride Application (per sitting) / 01008042 / 400/-
Extraction of Impacted Tooth By Operation / 01008043 / 400/-
Extraction of MISP Tooth by Operation (Open Meth) / 01008044 / 1,150/-
GTR (Guided Tissue Regeneration) / 01008045 / 1,900/-
Gingivectomy per Quadrant / 01008046 / 750/-
Glass Ionomer Filling / 01008047 / 400/-
Glass Ionomes Filling / 01008048 / 450/-
Interdental Wiring / 01008049 / 1,150/-
Intra Articular Inj. Of Steroids in TMJ / 01008050 / 900/-
Jacket Crown Acrylic / 01008051 / 1,500/-
Minor Dento-alveolar Tracture Reduction & Splinting/la / 01008052 / 950/-
Post Core/ tooth (cast Post) lab Metal Chgs. Extra / 01008053 / 1,150/-
Post Core/ tooth (pin Retain Comp. Core) / 01008054 / 750/-
Post Core/ tooth Screw/pin Retain. Amalgm. / 01008055 / 550/-
Preformed Carbonate Jacket Crown / 01008056 / 750/-
Preformed Steel Crown / 01008057 / 1,150/-
Pulpotomy / 01008058 / 750/-
Reduction of Dislocation of Tmj (Under LA.) / 01008059 / 1,400/-
Reimplantation (per Tooth) / 01008060 / 3,400/-
Removal Partial Denture (1st Tooth) / 01008061 / 400/-
Removal Partial Denture (Additional Tooth) / 01008062 / 230/-
Removal Partial Denture per Tooth (Palatal Bar) / 01008063 / 750/-
Repair of Facial Soft Tissue Laceration / 01008064 / 1,150/-
Repair of Facial Soft Tissue Laceration (minor) / 01008065 / 750/-
Root Canal Treatment (upto 4 sitting) / 01008066 / 1,150/-
Root Canal Treatment (extra sitting) / 01008067 / 400/-
Root Canal Treatment with Filling and Crown (package) (Lab. Charges extra) / 01008068 / 3,600/-
Scaling per Sitting / 01008069 / 400/-
Sialolithotomy for Small Stones / 01008070 / 115/-
Surgical Extraction or Surgical Removal of Impact (package) / 01008071 / 1,150/-
Surgical Removal of Benin Reoplasm of Oral (package) / 01008072 / 1,500/-
Surgical Removal of Soft Tissue Lesion (package) / 01008073 / 1,150/-
Surgical Removal of Impact Mesiod. tuber (package) / 01008074 / 1,150/-
Disto – impact teeth (two) under G.A. / 01008075 / 30,000/-
ITU / CCU CHARGES (Special Care Cases) / 009
ICU/ITU/CCU/NICU/PICU (including – Oxygen; ECG/SPO2/NIBP/IBP monitoring; 1:2 Nursing c GNM Nursing; Round the clock Doctor (Resident on spot); Diet; Syringe Pump) / 01009001 / 2,400/-
Ventilator charge (including accessories)per day / 01009002 / 1,000/-
Pneupack Ventilator in Nursery (per day) / 01009003 / 800/-
High Definition Unit / Step Down (including Oxygen) / 01009004 / 1,500/-
Exchange Transfusion / 01009005 / 1,200/-
O.T. Charges for Exchange transfusion / 01009006 / 400/-
CRIB (Critical Ward Bed) / 01009007 / 800/-
Oxygen Charges / 010
Private/ Semi-private/General Ward (per hour) / 01010001 / 60/-
Burn Cases / 011
Upto 30% Burns 1st Dressing (excluding dressing materials and medicines) / 01011001 / 700/-
Upto 30% Burns Subsequent Dressing (excluding dressing materials and medicines) / 01011002 / 700/-
30% to 50% Burns 1st Dressing (excluding dressing materials and medicines) / 01011003 / 700/-
30% to 50% Burns Subsequent Dressing (excluding materials and medicines) / 01011004 / 700/-
Extensive Burn above 50% First Dressing (excluding dressing materials and medicines) / 01011005 / 1,500/-
Extensive Burn above 50% Subsequent dressing (excluding dressing materials and medicines) / 01011006 / 1,500/-
Burn Unit Bed (including Oxygen) / 01011007 / 1,500/-
Obstetric & Gynaecology Cases / 012
Normal delivery or with Episiotomy & P. repair / 01012001 / 12,000/-
Low Forceps / 01012002 / 12,000/-
Low midcavity forceps / 01012003 / 14,000/-
Cesarean Section / 01012004 / 20,000/-
Cesarean Hysterectomy / 01012005 / 22,000/-
Rupture Uterus – closure & repair with Tubal Ligation / 01012006 / 22,000/-
Perforation of Uterus after D/E Laparotomy & Closure / 01012007 / 18,000/-
Laparotomy – peritonitis Lavage and Drainage / 01012008 / 16,000/-
Laparotomy-failed laparoscopy to explore / 01012009 / 6,100/-
Salphingectomy / 01012010 / 14,000/-
Salphingo-Oophorectomy / 01012011 / 18,000/-
Ovarean Cystectomy / 01012012 / 18,000/-
Oophorectomy / 01012013 / 15,000/-
Broad Ligment Haemotoma Drainage / 01012014 / 12,000/-
Exploration of perineal Haematoma & Resuturing of Episiotomy / 01012015 / 12,000/-
Exploration of abdominal Haematoma (after laparotomy + LUCS) / 01012016 / 12,000/-
Internal podalic version and extraction / 01012017 / 12,000/-
Manual Removal of Placenta / 01012018 / 3,700/-
3rd stage Complication MRP for outside delivery etc. / 01012019 / 4,900/-
Examination under anaesthesia / 01012020 / 2,500/-
Burst – abdomen Repair / 01012021 / 3,300/-
Gaping Pareneal Wound Secondary Suturing / 01012022 / 2,500/-
Gaping abdominal wound Secondary Suturing / 01012023 / 3,700/-
Complete perineal tear – repair / 01012024 / 2,500/-
Exploration of PPH-tear – repair / 01012025 / 4,200/-
Destructive Operation / 01012026 / 12,000/-
Suction evacuation vesicular mole, Missed abortion D/E / 01012027 / 5,900/-
Colpotomy – drainage P/V needling EUA / 01012028 / 4,200/-
Repair of post – coital tear, perineal injury / 01012029 / 4,200/-
Excision of urethral carbuncle / 01012030 / 4,000/-
Laparoscopy (Gynae) / 01012031 / 6,100/-
Shirodkar, Mc. Donalds stich / 01012032 / 3,700/-
Laparotomy / 01012033 / 20,000/-
Abdominal Hysterectomy / 01012034 / 22,000/-
Vaginal Hysterectomy / 01012035 / 22,000/-
Myomectomy / 01012036 / 22,000/-
Vaginoplasty / 01012037 / 22,000/-
Vulvectomy (Simple / Radical) / 01012038 / 25,000/-
RVF Repair / 01012039 / 25,000/-
Other Major Operations / 01012040 / 25,000/-
Manchester Operations / 01012041 / 20,000/-
Perineorrhaphy / 01012042 / 14,700/-
Colporraphy / 01012043 / 14,400/-
Modified Gilliam / 01012044 / 16,900/-
Shirodkar’s Operation / 01012045 / 10,200/-
Diagnostic Curettage / 01012046 / 2,700/-
Fractional Curettage / 01012047 / 3,400/-
D & C and Cervical Biopsy / 01012048 / 3,400/-
Polypectomy / 01012049 / 3,600/-
Other – Minor Operation / 01012050 / 3,600/-
Excision Vaginal Cyst / Burtholin Cyst / 01012051 / 3,900/-
Excision Vaginal Septum / 01012052 / 5,900/-
Laparoscopy Diagnostic / 01012053 / 6,000/-
Laparoscopy Diagnostic / 01012054 / 7,300/-
Laparoscopy Operative / 01012055 / 12,000/-
Laparoscopy LAVH / 01012056 / 25,000/-
Drilling of Ovary / 01012057 / 10,800/-
Adhesiolysis / 01012058 / 17,400/-
Management of Ectopic pregnancy / 01012059 / 20,000/-
Hysteroscopy TCRE / 01012060 / 11,500/-
Hysteroscopy Removal of IUCD / 01012061 / 5,500/-
Hysteroscopy Removal of Septum / 01012062 / 11,500/-
Hysteroscopy Diagnostic / 01012063 / 7,300/-
Werthimas Hystrectomy for Cancer cervix / 01012064 / 30,000/-
Sterilisation Post Pertum / 01012065 / 4,700/-
Sterilisation Intravaginal / 01012066 / 6,000/-
Abortion – D & C / 01012067 / 3,900/-
Abortion – Evacuation / 01012068 / 4,200/-
MTP – 1st Trimester / 01012069 / 3,200/-
MTP – 2nd Trimester / 01012070 / 4,800/-
Extended Hysterectomy / 01012071 / 28,000/-
Hydrotubation / 01012072 / 1,000/-
General Surgery / 013
Drainage of Abscess / 01013001 / 2,000/-
Dressing under G.A. / 01013002 / 2,400/-
Aspiration of cold Abscess of Lymphnode / 01013003 / 3,100/-
Aspiration of Empyema / 01013004 / 2,400/-
Aspiration of Liver Abscess / 01013005 / 3,000/-
Open Drainage of Liver Abscess / 01013006 / 10,000/-
Drainage of Pelvic Abscess / 01013007 / 10,000/-
Drainage of Ischiorectal Abscess / 01013008 / 8,000/-
Drainage of Subdiaphragmatic Abscess / 01013009 / 14,000/-
Open Drainage of Perinepheric Abscess / 01013010 / 14,000/-
Drainage of Perigastric Abscess / 01013011 / 12,000/-
Drainage of Perotid Abscess / 01013012 / 8,000/-
Drainage of Retropharyngeal Abscess / 01013013 / 8,000/-
Open Drainage of Psoras Abscess / 01013014 / 8,000/-
Open Drainage of Perivertebral Abscess / 01013015 / 10,000/-
Fissurectomy/Haemorroidectomy/Correction of Piles / 01013016 / 16,000/-
Haemorroidectomy / Correction of Piles with Stapler Gun (cost of Gun extra) / 01013017 / 16,000/-
Excision of Superficial Neurofibroma / 01013018 / 2,800/-
Varicose Veins / 01013019 / 25,000/-
Excision of Carbuncle / 01013020 / 4,000/-
Injury of Superficial Soft Tissues / 014
Interestical (Implant) / 015
Head & Neck / 01015001 / 9,700/-
Breast / 01015002 / 9,600/-
Soft Tissue Sarcome / 01015003 / 12,000/-
GASTROENTROLOGY / 016
Capsule Endoscopy / 01016001 / 30,000/-
Complete Double Baloon Enteroscopy / 01016002 / 18,000/-
Complete Small Bowel Evaluation / 01016003 / 30,000/-
Argan Plasma Coa (Major) / 01016004 / 5,000/-
Argan Plasma Coa (Major) (BS) / 01016005 / 6,500/-
Argan Plasma Coa (Minor) / 01016006 / 2,200/-
Argan Plasma Coa (Minor)(BS) / 01016007 / 3,000/-
Band Ligation / 01016008 / 3,500/-
Band Ligation (BS) / 01016009 / 5,500/-
Biliary Brushing / 01016010 / 1,000/-
Biliary Brushing (BS) / 01016011 / 1,600/-
Biliary Brushing (M) / 01016012 / 16,000/-
Biliary Brushing (M)(BS) / 01016013 / 23,000/-
Biliary Brushing (P) / 01016014 / 13,300/-
Biliary Brushing (P) (BS) / 01016015 / 18,000/-
Cre Balloon Dilatation (BS) / 01016016 / 15,000/-
Cre Balloon Dilatation / 01016017 / 9,000/-
Dilatation (Stricture) / 01016018 / 3,000/-
Dilatation (Stricture) (BS) / 01016019 / 4,200/-
EMG Charge (Large) / 01016020 / 3,500/-
EMG Charge (Small) / 01016021 / 1,500/-
Endoscopic Tube Place / 01016022 / 3,000/-
Endoscopic Tube Place (BS) / 01016023 / 4,200/-
Oesophageal Transit / 01016024 / 1,200/-
Gastrostomy (PEG) / 01016025 / 7,000/-
Gastrostomy (PEG) (BS) / 01016026 / 11,000/-
Glue Injection / 01016027 / 4,500/-
Glue Injection (BS) / 01016028 / 7,000/-
Hemosta by Glod Probe / 01016029 / 7,000/-
Hemostatic Clip / 01016030 / 7,000/-
Hemostatic Clip (BS) / 01016031 / 10,000/-
Hepatonorm / 01016032 / 700/-
Injection Hemostasis / 01016033 / 4,000/-
Inejction Hemostasis (BS) / 01016034 / 6,000/-
LGI Manometry / 01016035 / 4,000/-
LGI Manometry (BS) / 01016036 / 6,000/-
UGI Manometry / 01016037 / 3,200/-
UGI Manometry (BS) / 01016038 / 4,500/-
Nasobiliary Drainage / 01016039 / 12,000/-
Nasobiliary Drainage (BS) / 01016040 / 18,000/-
Nasojejunal Tube Plac / 01016041 / 3,000/-
Nasojejunal Tube Plac (BS) / 01016042 / 4,200/-
Papilla Cannu Minor / 01016043 / 6,500/-
Papilla Cannu Minor (BS) / 01016044 / 8,200/-
Pappu Stnt Spingt (M) / 01016045 / 12,000/-
Pappu Stnt Spingt (M) (BS) / 01016046 / 17,500/-
Polypectomy (Colonic) / 01016047 / 3,200/-
Polypectomy (Colonic) (BS) / 01016048 / 4,800/-
Polypectomy (Upper GI) / 01016049 / 3,000/-
Polypectomy (Upper GI) (BS) / 01016050 / 4,500/-
Pre Cutting / 01016051 / 4,500/-
Pre Cutting (BS) / 01016052 / 7,500/-
Pseudocyst Drainage / 01016053 / 9,000/-
Pseudocyst Drainage (BS) / 01016054 / 16,000/-
Sclerotherapy / 01016055 / 3,000/-
Sclerotherapy (BS) / 01016056 / 3,800/-
Small Bowel Enteroscp / 01016057 / 14,000/-
Sphincterotomy / 01016058 / 10,500/-
Sphincterotomy (BS) / 01016059 / 16,000/-
Stone Extraction / 01016060 / 12,000/-
Stone Extraction (BS) / 01016061 / 17,000/-
Gastric Emptying / 01016062 / 2,500/-
Mechanical Lithotripsy / 01016063 / 25,000/-
ERCP (Stenting) / 01016064 / 10,000/-
Head & Neck / 017
Ear Lobe Repair one side / 01017001 / 600/-
Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin only / 01017002 / 4,500/-
Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin and Cartilage / 01017003 / 6,000/-
Partial Amputation of Pinna / 01017004 / 6,000/-
Total Amputation of Pinna / 01017005 / 7,500/-
Total Amputation & Excision of External Auditory Meatus / 01017006 / 10,250/-
Excision of Cystic Hygroma Minor / 01017007 / 5,500/-
Excision of Cystic Hygroma Major / 01017008 / 8,000/-
Excision of Cystic Hygroma Extensive / 01017009 / 12,300/-
Excision of Branchial Cyst / 01017010 / 11,000/-
Excision of Branchial Sinus / 01017011 / 11,000/-
Excision of Pharyngeal Diverticulum / 01017012 / 12,200/-
Mandibulectomy / 01017013 / 25,000/-
Operation for Cervical Rib / 01017014 / 30,000/-
Pharyngectomy / 01017015 / 35,000/-
Stenosis Excisioin / 01017016 / 17,000/-
Commando Operation / 01017017 / 27,000/-
Block Dissection of Cervical Lymph Nodes / 01017018 / 20,300/-
Pharyngectomy & Reconstruction / 01017019 / 40,000/-
Operation for Carcinoma Lip – Wedge Excision / 01017020 / 10,000/-
Operation for Carcinoma Lip – Vermilionectomy / 01017021 / 10,000/-
Operation for Carcinoma Lip – Wedge Excision and Vermilionectomy / 01017022 / 12,000/-
Estlander Operation / 01017023 / 9,700/-
Abbe Operation / 01017024 / 12,000/-
Cheek Advancement / 01017025 / 10,200/-
Excision of the Maxilla / 01017026 / 23,300/-
Excision of the Mandible – Segmental / 01017027 / 18,100/-
Hemimandibulectomy / 01017028 / 27,200/-
Partial Glossectomy / 01017029 / 6,100/-
Hemiglossectomy / 01017030 / 13,500/-
Total Glossectomy / 01017031 / 25,000/-
Parotidectomy – Superficial / 01017032 / 24,000/-
Parotidectomy – Conservative / 01017033 / 19,700/-
Parotidectomy – Radical / 01017034 / 22,000/-
Parotidectomy – Total / 01017035 / 15,000/-
Repair of Parotid Duct / 01017036 / 20,400/-
Removal of Submandibular Salivary gland / 01017037 / 10,000/-
Hemithyroidectomy / 01017038 / 15,000/-
Partial Thyroidectomy / 01017039 / 16,000/-
Subtotal Thyroidectomy (Toxic Goitre) / 01017040 / 22,000/-
Total Thyroidectomy / 01017041 / 23,000/-
Resectional Enucleation of Adenoma / 01017042 / 12,500/-
Isthmectomy / 01017043 / 12,600/-
Total Thyroidectomy and Block Dissection / 01017044 / 31,400/-
Excision of Lingual Thyroid / 01017045 / 25,650/-
Excision of Thyroglossal Cyst / Fistula / 01017046 / 15,000/-
Excision of Parathyroid Adenoma / Carcinoma / 01017047 / 25,600/-
Laryngectomy / 01017048 / 37,150/-
Laryngo Pharyngectomy / 01017049 / 43,500/-
Sinus & Fistula repair / 01017050 / 14,000/-
Lymph Node Excision / 01017051 / 8,000/-
Hyoid Suspension / 01017052 / 12,000/-
Genioplasty / 01017053 / 12,000/-
Direct Laryngoscopy / 01017054 / 5,400/-
Phonosurgery / 01017055 / 15,400/-
Fibroptic Laryngoscopy / 01017056 / 3,000/-
Microlaryngeal Surgery / 01017057 / 11,000/-
Laryngofissure / 01017058 / 17,500/-
Head & Neck Cancer / 018
Benign Tumour Excisions / 01018001 / 11,000/-
Temporal Bone resection / 01018002 / 27,600/-
Radical Neck Dissection / 01018003 / 28,500/-
Carotid Body Excision (cost of Graft extra) / 01018004 / 36,000/-
Total Laryngectomy / 01018005 / 39,050/-
Flap Reconstructive Surgery / 01018006 / 42,800/-
Parapharyngeal Tumour Excision / 01018007 / 32,000/-
Total Thyroidectomy / 01018008 / 30,000/-
Breast / 019
Drainage of Abscess / 01019001 / 7,000/-
Excision of Lumps / 01019002 / 10,000/-
Local Mastectomy (Simple) / 01019003 / 13,500/-
Radical Mastectomy (Formal or Modified) / 01019004 / 28,000/-
Excision of Mammary Fistula / 01019005 / 16,000/-
Segmental Rescection of Breast / 01019006 / 18,300/-
Breast Cancer (Tumour excision) / 01019007 / 30,000/-
Cardio Respiratory Procedures / 020
Tracheostomy / 01020001 / 3,700/-
Thoracotomy (Penetrating Wounds) / 01020002 / 17,500/-
Intercostal Drainage of empyema / 01020003 / 5,400/-
Decortication (Pleurectomy) / 01020004 / 37,000/-
Thoracoplasty / 01020005 / 37,000/-
Pneumonectomy / 01020006 / 37,000/-
Lobectomy / 01020007 / 37,000/-
Segmental Resection / 01020008 / 37,000/-
Hydatid Cyst – Removal / 01020009 / 37,000/-
Video – assisted thoracoscopic lung Surgeries / 01020010 / 37,000/-
Lung volume reduction surgery (unilateral / Bilateral) / 01020011 / 37,000/-
Thoracoscopic Decortication / 01020012 / 37,000/-
Thoracoscopic Pneumonectomy / 01020013 / 37,000/-
Thoracoscopic Lobectomy / 01020014 / 37,000/-
Thoracoscopic Segmental Resection / 01020015 / 37,000/-
Thoracoscopic Cyst excision / 01020016 / 37,000/-
Thoracoscopic Sympathectomy / 01020017 / 37,000/-
Chest Wall Tumor Excision with Reconstruction / 01020018 / 37,000/-
Repair of Congenital Chest Wall Deformities / 01020019 / 37,000/-
Multiple Lobectomy / 01020020 / 37,000/-
Decortication + Thoracoplasty / 01020021 / 37,000/-
Decortication + Lung Resection + Thoracoplasty / 01020022 / 37,000/-
Open Lung Biopsy / 01020023 / 18,000/-
Medicistinoscopy (cervical) / 01020024 / 15,000/-
Video-assisted thoracoscopy (VATS) / 01020025 / 36,960/-
Thoracotomy for BPF / 01020026 / 37,000/-
Surgery for Destroyed Lung / 01020027 / 37,000/-
Sleeve Resection with Lobectomy / 01020028 / 37,000/-
Extrapleural Pneumonectomy / 01020029 / 37,000/-
Tracheal Stenosis Surgery / 01020030 / 37,000/-
Repair of Tracheo Innuminete Fistula / 01020031 / 37,000/-
Tracheal Resection for Tracheal Tumour / 01020032 / 37,000/-
Segmentectomy / 01020033 / 37,000/-
Wedge Resection / 01020034 / 37,000/-
Lung Resection with Paratracheal L. Node Resection / 01020035 / 37,000/-
Lung Resection with Chest Wall Invasion / 01020036 / 37,000/-
Lung Resection with Dissection of Lymph Node Stations / 01020037 / 37,000/-
Surgery for Recurrent Pnemothoraxic / 01020038 / 37,000/-
Surgery for Aspergillosis (Lung Cavities) / 01020039 / 37,000/-
Bronchotomy / 01020040 / 37,000/-
Mediostonoscopy / 01020041 / 15,000/-
Cardiac / Cardio Thoracic Procedures / 021
Coronary Bypass Surgery (including Pre-Surgery Profile) / 01021001 / 1,50,000/-
Coronary Bypass Surgery – post Angioplasty (including Pre-Surgery Profile) / 01021002 / 1,50,000/-
Coronary Balloon Angioplasty (Excluding Cost of Stents) (including Pre-Surgery Profile) (4 days’ package) / 01021003 / 66,000/-
Balloon angioplasty with Valvotomy
(including Pre-Surgery Profile) / 01021004 / 90,000/-
Open Heart Procedures
(including Pre-Surgery Profile) / 01021005 / 1,50,000/-
Total correction of Tetralogy of Fallot
(including Pre-Surgery Profile) / 01021006 / 1,50,000/-
RSUV correction (including Pre-Surgery Profile) / 01021007 / 1,50,000/-
TAPVC correction (including Pre-Surgery Profile) / 01021008 / 1,50,000/-
Open ASD VSD
(including Pre-Surgery Profile) / 01021009 / 1,50,000/-
Open Pulmonary Valvotomy
(including Pre-Surgery Profile) / 01021010 / 1,50,000/-
Open Aortic Valvotomy
(including Pre-Surgery Profile) / 01021011 / 1,50,000/-
Blalock Taussing Operation (including Pre-Surgery Profile) / 01021012 / 72,000/-
Mitral Valvotomy (including Pre-Surgery Profile) / 01021013 / 72,000/-
Mitral Valve Replacement (Excluding Cost of Valve) (including Pre-Surgery Profile) / 01021014 / 1,50,000/-
Arotic Valve Replacement (Excluding Cost of Valve) (including Pre-Surgery Profile) / 01021015 / 1,50,000/-
Double Valve Replacement (Excluding Cost of Valves) (including Pre-Surgery Profile) / 01021016 / 1,60,000/-