Annexure-I

Revised Rate List under the West Bengal Health Scheme, 2008

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

As on: 18-09-2012

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/-
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/-
01001037 / Bone Marrow Transplantation (inclusive of all) / 1000000/-
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/-
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/-
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/-
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/-
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)/ Diod Laser (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/-
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/-
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/-
01005002 / Biopsy procedure under General Anaesthesia / 6000/-
01005003 / Biopsy procedure under 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/-
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/-
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/-
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/-
01008032 / Cast Rpd (per Tooth) / 380/-
01008033 / Davis Crown/ radicular Screw supported / 1900/-
01008034 / De Sensitising per sitting / 200/-