SVPIMSR –Schedule of Charges (SOC)

AHMEDABAD MUNICIPAL CORPORATION MEDICAL EDUCATION TRUST AMCMET

SARDAR VALLABH BHAI PATEL INSTITUTE OF MEDICAL SCIENCE AND RESEARCH (SVPIMSR), AHMEDABAD, GUJARAT

AHMEDABAD MUNICIPAL CORPORATION MEDICAL EDUCATION TRUST (AMC-MET)

SCHEDULE OF CHARGES 2018-2019

SARDAR VALLABH BHAI PATEL INSTITUTE OF MEDICAL SCIENCE AND RESEARCH (SVPIMSR),

AHMEDABAD, GUJARAT

SVPIMSR –Schedule of Charges (SOC)

1. SVPIMSR - General Information ...... 4 2. General Rules & Regulations ...... 4 3. General Beds/Category ...... 7 OPD Consultation ...... 7 Radiology department Charges ...... 7 CARDIOLOGY INVESTIGATIONS ...... 8 HEALTH CHECKUP PACKAGE CHARGES ...... 8 Lab Charges ...... 12 Operation Charges ...... 13 Other Charges ...... 13 4. Executive Beds/Category ...... 14 OPD Consultation ...... 14 Radiology department Charges ...... 15 CARDIOLOGY INVESTIGATIONS ...... 15 HEALTH CHECKUP PACKAGE CHARGES ...... 16 Lab Charges ...... 20 Operation Charges ...... 20 Other Charges ...... 21 5. Appendix A – List of Radiology tests available in SVPIMSR ...... 22 6. Appendix B – Detailed list of Lab Investigations along with Tariffs – For ALL Category of patients (General and Executive) ...... 32 7. Appendix C – Surgery Categorization (Supra-Major, Major, Minor) ...... 73

SVPIMSR –Schedule of Charges (SOC)

SVPIMSR - General Information

... Approximately 1500 beds ... 22 departments/specialties’ (all except Oncology, Dentistry & Ophthalmology) ... 158 ICU category beds,Emergency & Trauma – 60 beds ... OUT PATIENT DEPARTMENT- All specialty spread at Ground Floor and First Floor ... General wards – 1250 Nos,Paid wards – 200 Nos ... Emergency & trauma beds – 60 beds ... Laboratories and blood bank ... State of the art medical equipments comprising of 2 MRIs,2 CT-scans, all low end diagnostics and cath-lab ... 24 lifts with 2 nos of ramps for easy patient transfer at the time of emergency and fire escape staircase ... All patient accommodation area is centrally air-conditioned

1. General Rules & Regulations

ADMISSION POLICY The day of admission will be charged as full day, irrespective of duration / time of admission. The applicable room rent is calculated on per day basis and charged at admission and every day at 12 midnight. Discharge by 12 noon only.Patient can be discharged after clinical approval when he/she can be moved to the discharge lounge and the bed can be made available for the next patient. Grace time period of 2 hours will be given to the patients (no extra charges applicable). If room is not available or patients are in waiting, r oom cannot be retained for the use of patient attendant while the patient is in ICU. No discounts/concessions are available for all categories of patients. Admissions will be done on the basis of tests/investigations/radiology tests/surgeries etc that are permitted/possible in the hospital (with the constraints of equipments, available consultants). Room / Bed Transfer - EXECUTIVE CATEGORY PATIENTS

If the desired category of room is not available at the time of planned admission, patient will be offered rooms/categories which are available. Based on rooms chosen by the patient, the room rent will be paid. The patient can be shifted to their desired category of room based on availability. In c ase the patient wish es to take transfer from higher to lower category, charges would be revisedaccording to new bed category from the day of admission into the new category. In case the patient wishes to transfer from lower to higher category, the patient will be charged at higher category rates from the first day of admission.

SVPIMSR –Schedule of Charges (SOC)

ADVANCE POLICY For Patient s seeking admission under state/central and insurance schemes, they ha ve to declare eligibility with documentary evidence at time of admission or within a maximum period of 24 hours after admission if he/she is covered under any insurance / corporate / Governmentscheme / Indigent category / weaker Section category. All patients under the above insurance categor ies will be treated as cash patients if proof /evidence is not submitted within 24 hours after admission. SURGERIES For all IP admissions - 50 % of the estimate amount to be collected as advance. Information of amount payable will be notified to the patients / relatives regularly through deposit requisitions. Implants/pharmacy/consumable etc will be procured by patients directly. During the hospital stay of the patient , if the additional requisition deposit is not paid, the hospital reservesthe right to transfer the patient to another hospital (lower category/free bed). Insurance / TPA Policy For a length of stay <=7 days Initial advance of Rupees Five Thousand will be taken from general category patients to recover inadmissible expenses. Initial advance of Rupees Ten Thousand will be taken from executive category patients to recover inadmissible expenses. For a length of stay >7 days Advance mentioned above will be re-charged to the patients as per the above categorization. Till the approval is received from TPA, the patient will be considered as self -paying case. The advance will be refunded (on the basis of authorization / after deducting for the items which are notcovered by the TPA’s) to the patient at the time of discharge. In case of hospitalization to higher category as compared to elig ible category, patient has to pay entiredifference of total bill between the two categories of hospitalization. Prevalent hospital tariff will apply always and patient has to bear the difference between approved amount and prevalent tariff of hospital. Admission - Terms & Conditions Patients covered under state/central/insurance schemes etc. will be admitted by hospital consultants only and mustsign a separate consent form regarding hospital charges prior to admission. In case of any dispute, decision ta ken by hospital management would be considered as final

SVPIMSR –Schedule of Charges (SOC)

Mode of payment & refunds Payments will be accepted by cash, credit / debit cards , digital mode of payments only MLC CASES Rs -700/ - will be charged as a one -time initial charge for MLC case s – OP D & IP (over and above treatment charges). Instructions & Guideline for Indoor Patients/Visitors & Attendees Tobacco product, smoking & alcohol consumption is strictly prohibited in and around hospital premises. Anybody found not adhering to the above rules will be charged Rs.200. Patient's & their attendants are solely responsible for their personal belongings. The hospital will not take responsibility for any loss or damage. Loss of /damage to hospital property by any of the patients relatives or visi tors will be charged for in thepatients bill (as decided by hospital management). ATTENDANTS & VISITORS POLICY Each patient will be issued one ‘Attendant Pass’ and one ‘Visitors Pass’ at the time of admission ATTENDANT’ is the person who must be accompa nying the patient for 24 hours throughout the stay VISITOR’ is ONLY ONE person who is allowed to visit the patient ONLY during visiting hours Only one Visitor at a time per patient shall be allowed VISITING HOURS: Evening: 4:00 PM to 6:00 PM Security stationed at the Front door / Stairs / Lifts / On Floors, Nursing & Ward secretaries are authorized to check on the passes and if necessary, move people out of premises Visitors’ are requested not to sit/lie down on patient beds Children below 12 years o f age, sick and elderly are not allowed as “Visitors” Only Attendant is allowed one time in a day into ICU (as per timings decided by hospital management). Visitors are not allowed into ICU. No outside food, flowers, fruits, toys etc are allowed to be ca rried by attendants/visitors. OT Terms & Condition Use of personal instrument - all consultants are required to use equipment/instrument of the hospital. Outside pharmacy & consumables are not allowed Surgical categories are to be followed as per schedule Radiology policy If anesthetist is required, charges for the same will be levied extra If contrast dye is used, the same would be charged extra as per actual . Any additional film would be charged extra. Note : SVPIMSR Management reserves all rights for amendment or change without intimation.

SVPIMSR –Schedule of Charges (SOC)

2. General Beds/Category OPD Consultation OPD CONSULTATION FEES S.No Particulars General Tariff in INR 1 Consultations Fees (OPD & Emergency) - inclusive of registration Rs.100 2 Follow-up Consultation Fees Rs.50 3 Diet Consultation Rs.50 Emergency Medical Officer Fees (including registration & 4 consultation charge) – During emergency hours Rs.150

1) Emergency : Hours 8.00 pm to 8.00 am 2) Follow-up Fees: If the patient visits the Consultant within SEVEN days of first consultation(registration) , then no follow up visit shall be charged 3) Janmitra card holder will get 10% discount on OPD visit and consultation only Radiology department Charges Xray Charges General tariff in INR Location 25 One view 25 Two View 25 with film 25 with contrast 100 special xray 100 USG One area 50 Two area 100 Special 200 for follow up 50 Intervention 200 MRI Standard 2,000 more than one region 3,500 Contrast 1,000 DOPPLER Single 300 More than 1 region 500 CT Scan One region 1,000 More than one 2,000 Contrast 500 Note : Please refer Appendix A for detailed list of radiology tests available in SVPIMSR

SVPIMSR –Schedule of Charges (SOC)

CARDIOLOGY INVESTIGATIONS S.No Particulars General 1 24 HOURS HOLTER MONITORING 500 2 DOBUTAMINE STRESS ECHO 500 3 ECG 50 4 ECHO SCREENING 300 5 ECHO WITH CASETTE 350 6 ECHO WITHOUT CASSETTE 300 7 HEAD UP TILT TEST 400 8 P WAVE SAECG/TMT 300 9 QRS WAVE - SAECG/TMT 300 10 STRESS ECHO 300 11 TEE 300 12 TREADMILL TEST / STRESS TEST 400

HEALTH CHECKUP PACKAGE CHARGES

1. The hospital services include 15 types of Health Checks/ Health certificates at nominal tariff. 2. General Public/patients – 400 INR - 3000 INR is the range of tariffs for the 15 types of health checks described below.

AMC - MET HEALTH CHECKS 1) MASTER HEALTH CHECKUP – 1000 INR ALKALINE PHOSPHATASE STOOL FOR ROUTINE EXAMINATION ECG BLOOD GLUCOSE (FASTING) BLOOD GLUCOSE (P PRANDIAL/P XRAY CHEST PA VIEW GLUCOSE/RANDOM) COMPLETE HAEMOGRAM CREATININE-SERUM BLOOD UREA VLDL CHOLESTEROL LDL CHOLESTEROL TRIGLYCERIDES GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE CHOLESTEROL/HDL RATIO-SERUM BLOOD GROUP AND RH-TYPING PROTEIN-SERUM URIC ACID-SERUM BILIRUBIN (Direct/Indirect/Total)-SERUM TOTAL CHOLESTEROL URINE FOR ROUTINE EXAMINATION HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING SGOT [AST] PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) SGPT [ALT] 2) EXECUTIVE HEALTH CHECKUP - 1200 INR CREATININE-SERUM TREADMILL TEST / STRESS TEST CHOLESTEROL/HDL RATIO-SERUM BLOOD GLUCOSE (P PRANDIAL/P

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS GLUCOSE/RANDOM) COMPLETE HAEMOGRAM TRIGLYCERIDES BLOOD GLUCOSE (FASTING) SGPT [ALT] BLOOD UREA BILIRUBIN (Direct/Indirect/Total)-SERUM HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING LDL CHOLESTEROL URIC ACID-SERUM VLDL CHOLESTEROL TOTAL CHOLESTEROL ALKALINE PHOSPHATASE PROTEIN-SERUM GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE SGOT [AST] URINE FOR ROUTINE EXAMINATION BLOOD GROUP AND RH-TYPING ECG STOOL FOR ROUTINE EXAMINATION XRAY CHEST PA VIEW PULMONARY FUNCTION TEST PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) 3) WHOLEBODY CHECK – 1500 INR PULMONARY FUNCTION TEST SGOT [AST] BLOOD UREA HBsAg(RAPID) GGTP -GAMMA GLUTAMYL BLOOD GLUCOSE (P PRANDIAL/P TRANSPEPTIDASE GLUCOSE/RANDOM) COMPLETE HAEMOGRAM CREATININE-SERUM BLOOD GLUCOSE (FASTING) URIC ACID-SERUM BILIRUBIN (Direct/Indirect/Total)- SERUM TOTAL CHOLESTEROL ELECTROLYTES [Na,k,cl]-SERUM HDL CHOLESTEROL STOOL FOR ROUTINE EXAMINATION LDL CHOLESTEROL PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) VLDL CHOLESTEROL ECG TRIGLYCERIDES MHC ULTRA SOUND ABDO-SCREEING CHOLESTEROL/HDL RATIO-SERUM ECHO WITHOUT CASSETTE PROTEIN-SERUM TREADMILL TEST / STRESS TEST PHOSPHOROUS - SERUM MAMMOGRAPHY - BOTH BREASTS (FOR FEMALE) XRAY CHEST PA VIEW ALKALINE PHOSPHATASE CALCIUM-SERUM SGPT [ALT] PSA (for males) 4) ADVANCED HEART CHECK – 3000 INR COMPLETE HAEMOGRAM BLOOD GROUP AND RH-TYPING URIC ACID-SERUM STOOL FOR ROUTINE EXAMINATION TOTAL CHOLESTEROL TREADMILL TEST / STRESS TEST SGPT [ALT] [HOMOCYSTEINE-SERUM] GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE APOLIPOPROTEIN A1 ECG APOLIPOPROTEIN B-SERUM

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS SGOT [AST] BLOOD GLUCOSE (FASTING) MHC ULTRA SOUND ABDO-SCREEING CREATININE-SERUM PLASMA FIBRINOGEN VLDL CHOLESTEROL LIPOPROTEIN (A) - SERUM PROTEIN-SERUM BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) ALKALINE PHOSPHATASE BLOOD UREA URINE FOR ROUTINE EXAMINATION HDL CHOLESTEROL PULMONARY FUNCTION TEST LDL CHOLESTEROL ECHO WITH CASETTE TRIGLYCERIDES BILIRUBIN (Direct/Indirect/Total)-SERUM CHOLESTEROL/HDL RATIO-SERUM XRAY CHEST PA VIEW 5) HEART CHECK - 1500 INR COMPLETE HAEMOGRAM VLDL CHOLESTEROL BLOOD GLUCOSE (FASTING) PROTEIN-SERUM BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) SGOT [AST] BLOOD UREA SGPT [ALT] TRIGLYCERIDES BILIRUBIN (Direct/Indirect/Total)-SERUM TREADMILL TEST / STRESS TEST ALKALINE PHOSPHATASE HDL CHOLESTEROL ECG CHOLESTEROL/HDL RATIO-SERUM MHC ULTRA SOUND ABDO-SCREEING GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE PULMONARY FUNCTION TEST XRAY CHEST PA VIEW ECHO WITHOUT CASSETTE ELECTROLYTES [Na,k,cl]-SERUM CREATININE-SERUM URIC ACID-SERUM TOTAL CHOLESTEROL LDL CHOLESTEROL 6) WELL WOMEN CHECK – 1200 INR TLC & DLC ESR (ERYTHROCYTE SEDIMENTATION RATE) URINE FOR ROUTINE EXAMINATION PAP SMEAR /CERVICAL SMEAR STOOL FOR ROUTINE EXAMINATION BLOOD GLUCOSE (RANDOM) XRAY CHEST PA VIEW HAEMOGLOBIN USG PELVIS SCREENING MAMMOGRAM 7) CHILD HEALTH CHECK – 400 INR RBC COUNT XRAY CHEST PA VIEW TLC & DLC MANTOUX TEST BLOOD GROUP AND RH-TYPING HAEMOGLOBIN URINE FOR ROUTINE EXAMINATION ESR (ERYTHROCYTE SEDIMENTATION RATE) STOOL FOR ROUTINE EXAMINATION 8) TOTAL DIABETIC CHECKUP(TDC) – 1000 INR XRAY CHEST PA VIEW SGOT [AST] CREATININE-SERUM BLOOD GLUCOSE (FASTING)

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS BLOOD GLUCOSE (P PRANDIAL/P TOTAL CHOLESTEROL GLUCOSE/RANDOM) HDL CHOLESTEROL CHOLESTEROL/HDL RATIO-SERUM URINE FOR ROUTINE EXAMINATION MICROALBUMIN- URINE LDL CHOLESTEROL ECG HbA1C (Glycosylated Haemoglobin) VLDL CHOLESTEROL SGPT [ALT] TRIGLYCERIDES 9) BREAST CHECK – 600 INR MAMMOGRAPHY - BOTH BREASTS USG BREAST(BOTH) CYTOLOGY FNAC 10) SENIOR CITIZEN CHECK I - 1000 INR MAMMOGRAPHY - BOTH BREASTS (FOR STOOL OCCULT BLOOD FEMALE) or PSA (for males) PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) XRAY CHEST PA VIEW MHC ULTRA SOUND ABDO-SCREEING LFT[LIVER FUNCTION TEST] COMPLETE HAEMOGRAM (with ESR) USG BREAST(BOTH) (FOR FEMALE) BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) BLOOD GLUCOSE (FASTING) 11) STROKE CHECK – 1200 INR ECG CREATININE-SERUM DOPPLER CARTOID BLOOD GLUCOSE (FASTING) BLOOD GLUCOSE (P PRANDIAL/P STOOL FOR ROUTINE EXAMINATION GLUCOSE/RANDOM) XRAY CHEST PA VIEW HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING LDL CHOLESTEROL LFT[LIVER FUNCTION TEST] VLDL CHOLESTEROL TOTAL CHOLESTEROL TRIGLYCERIDES ECHO WITHOUT CASSETTE CHOLESTEROL/HDL RATIO-SERUM BLOOD GROUP AND RH-TYPING URINE FOR ROUTINE EXAMINATION COMPLETE HAEMOGRAM CT BRAIN PLAIN URIC ACID-SERUM 12) SENIOR CITIZEN CHECK II – 1000 INR COMPLETE BLOOD COUNT (CBC) BLOOD GLUCOSE (FASTING) HDL CHOLESTEROL TOTAL CHOLESTEROL LDL CHOLESTEROL CREATININE-SERUM CHOLESTEROL/HDL RATIO-SERUM URINE FOR ROUTINE EXAMINATION XRAY CHEST PA VIEW VLDL CHOLESTEROL ECG TRIGLYCERIDES 13) SENIOR CITIZEN CHECK III – 1200 INR BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) ECG HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING SGOT [AST] TSH-THYROID STIMULATING HORMONE

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS URINE FOR ROUTINE EXAMINATION CALCIUM-SERUM MAMMOGRAPHY - BOTH BREASTS (FOR COMPLETE HAEMOGRAM FEMALE) BLOOD UREA TRIGLYCERIDES CREATININE-SERUM GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE URIC ACID-SERUM XRAY CHEST PA VIEW LDL CHOLESTEROL VLDL CHOLESTEROL BLOOD GLUCOSE (FASTING) CHOLESTEROL/HDL RATIO-SERUM TOTAL CHOLESTEROL SGPT [ALT] PROTEIN-SERUM ALKALINE PHOSPHATASE BLOOD GROUP AND RH-TYPING BILIRUBIN (Direct/Indirect/Total)- SERUM PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) STOOL FOR ROUTINE EXAMINATION 14) SUGAR CHECK – 1100 INR > (0 Days) * Fbs/Plbs * Hba1C * Blood Urea * Serum Creatinine * >(90 Days) * Fbs Urine Albumin * Lipid Profile * Sgpt * >(180 Days) * Fbs/Plbs * Hba1C * Diet & Sgot * Ecg * Foot Examination Lifestyle Counseling * Eye Examination * Diet & Lifestyle Endocrinologist Consultation (Breakfast Counseling * Patient Family Included) Education * Endocrinologist Consultation * Weekly Follow-Up Calls > (270 Days) * Fbs >(360 Days) * Fbs/Plbs * Hba1C * Diet & (Breakfast Included) Lifestyle Counseling 15) PERSONALISED HEALTH CHECK -1300 INR DETAILED MEDICAL HISTORY AND GYANECOLOGY CONSULT WITH PAP SMEAR CLINICAL EXAMINATION TEST & BREAST EXAMINATION HEAMTOLOGY PROFILE FOLLOW UP PHYSICIAN CONSULTATION DIABETIC PROFILE DIET AND LIFESTYLE COUNSELING LIPID PROFILE ADULT VACCINATION COUNSELING CARDIOVASCULAR ASSESSMENT RENAL PROFILE LIVER PROFILE ULTRASOUND AND IMAGING EYE SCREEING

Lab Charges

Please refer “Appendix B” for detailed list of individual tests and individual tariffs for Lab investigations/tests

SVPIMSR –Schedule of Charges (SOC)

Operation Charges Teaching BED tariff in Classification TYPE INR A Minor 3000 B Major 6000 C Supra Major 9000 Note: Please refer Appendix D for detailed categorization of minor, major and supra major surgeries

Example

Category C (Supra Major) Sample Supra major craniotomies : Skull base tumours, Complex Cerebrovascular aneurysm, AVM, Epilepsy Surgery, Parasagittal meningioma, Complex head injury (requiring skull base repair and cranioplasty), lobectomies Complex spine surgeries : spinal dysraphism, scoliosis and kyphosis correction, vertebrectomy and other complex fusion, intramedullary tumour Peripheral nerve surgery : Nerve grafting, DREZ for spasticity, spinal cord stimulation

Category B Sample Discectomy without fusion, multilevel laminectomy Minicraniotomy for abscess, Chronic SDH, meningeal and brain biopsy Shunt Procedures

Category A Sample ICP Monitor External ventricular drain Skull traction

Other Charges

OBG Tariff in INR Normal Delivery 3000 In patient Wards, Rooms Includes: 1. Doctors visit (minimum two) 400 2. Nursing charges 3. Linen charges - Patient gown / pyjama 4. Food – three meals ICU 600 ICU add ons (ventilators, intubation, monitors etc) 200

SVPIMSR –Schedule of Charges (SOC)

CATHLAB Angiogram 6000 Angio plasty procedure charge 30000 OTHERS Dermatology 150 Counselling, Dietary consult 50 As per government Blood and blood products rules CONSULTANT VISITS IP Wards No charge ICU No charge OT Utilization time OT charge Per hour – Emergency theatre in casualty area 200 OT charge Per hour – Regular 300 ICU Charges MICU Rs. 500 CCU Rs. 500 SICU Rs. 500 CTICU Rs. 500 Burns ICU Rs. 1,000 HDU Rs. 300 NICU - I Rs. 400 NICU - II Rs. 500 NICU - III Rs. 600 Barrier Nursing Rs. 750 Emergency Ward * Rs. 100 Day Care Rs. 300

Note : 1 Emergency: Rs. 50/- per hour and maximum patient can stay 6 hours in ER

2 Pediatrics - ICU & Neonatal ICU / Nursery: if ventilator is used, Rs200/- per day will be charged.

3. Executive Beds/Category OPD Consultation OPD CONSULTATION FEES S.No Particulars General Tariff in INR 1 Consultations Fees (OPD & Emergency) - inclusive of registration Rs.300 2 Follow-up Consultation Fees ** Rs.200 3 Diet Consultation Rs.100 Emergency Medical Officer Fees (including registration & 4 consultation charge)-During Emergency hours Rs.150

SVPIMSR –Schedule of Charges (SOC)

Note: 1) Emergency : Hours 8.00 pm to 8.00 am 2) Follow up Fees : If the patient visits the Consultant within SEVEN days of first consultation(registration) , then no follow up visit shall be charged 3) Janmitra card holder will get 10% on OPD visit and consultation only Radiology department Charges Xray Charges Executive Tariff in INR

Location 100 One view 100 Two View 100 with film 100 with contrast 300 special xray 500 USG One area 500 Two area 1,000 Special 1,500 for follow up 500 Intervention 1,000 MRI Standard 4,000 more than one region 6,000 Contrast 5,000 DOPPLER Single 1,500 More 2,000 CT Scan One region 2,000 More than one 3,000 Contrast 3,000 Note : Please refer Appendix A for detailed list of radiology tests available in SVPIMSR CARDIOLOGY INVESTIGATIONS S.No Particulars General 1 24 HOURS HOLTER MONITORING 800 2 DOBITAMIN STRESS ECHO 960 3 ECG 200 4 ECHO SCREENING 800 5 ECHO WITH CASETTE 960 6 ECHO WITHOUT CASSETTE 960 7 HEAD UP TILT TEST 960

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars General 8 P WAVE SAECG/TMT 800 9 PACEMAKER INTEROGATION 400 10 QRS WAVE - SAECG/TMT 800 11 STRESS ECHO/DOBUTAMINE ECHO 1,200 12 TEE 1,200 13 TREADMILL TEST / STRESS TEST 1,600

HEALTH CHECKUP PACKAGE CHARGES

1) The hospital services include 15 types of Health Checks/ Health certificates at nominal tariff.

2) Executive category packages – 400 INR to 3000 INR is the range of tariff s for the 15 types of health checks described below.

AMC - MET HEALTH CHECKS 1) MASTER HEALTH CHECKUP – 1500 INR ALKALINE PHOSPHATASE STOOL FOR ROUTINE EXAMINATION ECG BLOOD GLUCOSE (FASTING) BLOOD GLUCOSE (P PRANDIAL/P XRAY CHEST PA VIEW GLUCOSE/RANDOM) COMPLETE HAEMOGRAM CREATININE-SERUM BLOOD UREA VLDL CHOLESTEROL LDL CHOLESTEROL TRIGLYCERIDES GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE CHOLESTEROL/HDL RATIO-SERUM BLOOD GROUP AND RH-TYPING PROTEIN-SERUM URIC ACID-SERUM BILIRUBIN (Direct/Indirect/Total)-SERUM TOTAL CHOLESTEROL URINE FOR ROUTINE EXAMINATION HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING SGOT [AST] PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) SGPT [ALT] 2) EXECUTIVE HEALTH CHECKUP - 2000 INR CREATININE-SERUM TREADMILL TEST / STRESS TEST BLOOD GLUCOSE (P PRANDIAL/P CHOLESTEROL/HDL RATIO-SERUM GLUCOSE/RANDOM) COMPLETE HAEMOGRAM TRIGLYCERIDES BLOOD GLUCOSE (FASTING) SGPT [ALT] BLOOD UREA BILIRUBIN (Direct/Indirect/Total)-SERUM HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING LDL CHOLESTEROL URIC ACID-SERUM VLDL CHOLESTEROL TOTAL CHOLESTEROL

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS ALKALINE PHOSPHATASE PROTEIN-SERUM GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE SGOT [AST] URINE FOR ROUTINE EXAMINATION BLOOD GROUP AND RH-TYPING ECG STOOL FOR ROUTINE EXAMINATION XRAY CHEST PA VIEW PULMONARY FUNCTION TEST PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) 3) WHOLEBODY CHECK – 2500 INR PULMONARY FUNCTION TEST SGOT [AST] BLOOD UREA HBsAg(RAPID) GGTP -GAMMA GLUTAMYL BLOOD GLUCOSE (P PRANDIAL/P TRANSPEPTIDASE GLUCOSE/RANDOM) COMPLETE HAEMOGRAM CREATININE-SERUM BLOOD GLUCOSE (FASTING) URIC ACID-SERUM BILIRUBIN (Direct/Indirect/Total)- SERUM TOTAL CHOLESTEROL ELECTROLYTES [Na,k,cl]-SERUM HDL CHOLESTEROL STOOL FOR ROUTINE EXAMINATION LDL CHOLESTEROL PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) VLDL CHOLESTEROL ECG TRIGLYCERIDES MHC ULTRA SOUND ABDO-SCREEING CHOLESTEROL/HDL RATIO-SERUM ECHO WITHOUT CASSETTE PROTEIN-SERUM TREADMILL TEST / STRESS TEST PHOSPHOROUS - SERUM MAMMOGRAPHY - BOTH BREASTS (FOR FEMALE) XRAY CHEST PA VIEW ALKALINE PHOSPHATASE CALCIUM-SERUM SGPT [ALT] PSA (for males) 4) ADVANCED HEART CHECK – 5000 INR COMPLETE HAEMOGRAM BLOOD GROUP AND RH-TYPING URIC ACID-SERUM STOOL FOR ROUTINE EXAMINATION TOTAL CHOLESTEROL TREADMILL TEST / STRESS TEST SGPT [ALT] [HOMOCYSTEINE-SERUM] GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE APOLIPOPROTEIN A1 ECG APOLIPOPROTEIN B-SERUM SGOT [AST] BLOOD GLUCOSE (FASTING) MHC ULTRA SOUND ABDO-SCREEING CREATININE-SERUM PLASMA FIBRINOGEN VLDL CHOLESTEROL LIPOPROTEIN (A) - SERUM PROTEIN-SERUM BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) ALKALINE PHOSPHATASE BLOOD UREA URINE FOR ROUTINE EXAMINATION

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS HDL CHOLESTEROL PULMONARY FUNCTION TEST LDL CHOLESTEROL ECHO WITH CASETTE TRIGLYCERIDES BILIRUBIN (Direct/Indirect/Total)-SERUM CHOLESTEROL/HDL RATIO-SERUM XRAY CHEST PA VIEW CT Angiography 5) HEART CHECK - 2000 INR COMPLETE HAEMOGRAM VLDL CHOLESTEROL BLOOD GLUCOSE (FASTING) PROTEIN-SERUM BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) SGOT [AST] BLOOD UREA SGPT [ALT] TRIGLYCERIDES BILIRUBIN (Direct/Indirect/Total)-SERUM TREADMILL TEST / STRESS TEST ALKALINE PHOSPHATASE HDL CHOLESTEROL ECG CHOLESTEROL/HDL RATIO-SERUM MHC ULTRA SOUND ABDO-SCREEING GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE PULMONARY FUNCTION TEST XRAY CHEST PA VIEW ECHO WITHOUT CASSETTE ELECTROLYTES [Na,k,cl]-SERUM CREATININE-SERUM URIC ACID-SERUM TOTAL CHOLESTEROL LDL CHOLESTEROL 6) WELL WOMEN CHECK – 2000 INR TLC & DLC ESR (ERYTHROCYTE SEDIMENTATION RATE) URINE FOR ROUTINE EXAMINATION PAP SMEAR /CERVICAL SMEAR STOOL FOR ROUTINE EXAMINATION BLOOD GLUCOSE (RANDOM) XRAY CHEST PA VIEW HAEMOGLOBIN USG PELVIS SCREENING MAMMOGRAM 7) CHILD HEALTH CHECK – 500 INR RBC COUNT XRAY CHEST PA VIEW TLC & DLC MANTOUX TEST BLOOD GROUP AND RH-TYPING HAEMOGLOBIN URINE FOR ROUTINE EXAMINATION ESR (ERYTHROCYTE SEDIMENTATION RATE) STOOL FOR ROUTINE EXAMINATION 8) TOTAL DIABETIC CHECKUP(TDC) – 1500 INR XRAY CHEST PA VIEW SGOT [AST] CREATININE-SERUM BLOOD GLUCOSE (FASTING) BLOOD GLUCOSE (P PRANDIAL/P TOTAL CHOLESTEROL GLUCOSE/RANDOM) HDL CHOLESTEROL CHOLESTEROL/HDL RATIO-SERUM URINE FOR ROUTINE EXAMINATION MICROALBUMIN- URINE LDL CHOLESTEROL ECG HbA1C (Glycosylated Haemoglobin) VLDL CHOLESTEROL

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS SGPT [ALT] TRIGLYCERIDES 9) BREAST CHECK – 2000 INR MAMMOGRAPHY - BOTH BREASTS USG BREAST(BOTH) CYTOLOGY FNAC 10) SENIOR CITIZEN CHECK I - 2000 INR MAMMOGRAPHY - BOTH BREASTS (FOR STOOL OCCULT BLOOD FEMALE) or PSA (for males) PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) XRAY CHEST PA VIEW MHC ULTRA SOUND ABDO-SCREEING LFT[LIVER FUNCTION TEST] COMPLETE HAEMOGRAM (with ESR) BLOOD GLUCOSE (FASTING) BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) 11) STROKE CHECK – 2500 INR ECG CREATININE-SERUM DOPPLER CARTOID BLOOD GLUCOSE (FASTING) BLOOD GLUCOSE (P PRANDIAL/P STOOL FOR ROUTINE EXAMINATION GLUCOSE/RANDOM) XRAY CHEST PA VIEW HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING LDL CHOLESTEROL LFT[LIVER FUNCTION TEST] VLDL CHOLESTEROL TOTAL CHOLESTEROL TRIGLYCERIDES ECHO WITHOUT CASSETTE CHOLESTEROL/HDL RATIO-SERUM BLOOD GROUP AND RH-TYPING URINE FOR ROUTINE EXAMINATION COMPLETE HAEMOGRAM CT BRAIN PLAIN URIC ACID-SERUM 12) SENIOR CITIZEN CHECK II – 1500 INR COMPLETE BLOOD COUNT (CBC) BLOOD GLUCOSE (FASTING) HDL CHOLESTEROL TOTAL CHOLESTEROL LDL CHOLESTEROL CREATININE-SERUM CHOLESTEROL/HDL RATIO-SERUM URINE FOR ROUTINE EXAMINATION XRAY CHEST PA VIEW VLDL CHOLESTEROL ECG TRIGLYCERIDES 13) SENIOR CITIZEN CHECK III – 2500 INR BLOOD GLUCOSE (P PRANDIAL/P GLUCOSE/RANDOM) ECG HDL CHOLESTEROL MHC ULTRA SOUND ABDO-SCREEING SGOT [AST] TSH-THYROID STIMULATING HORMONE URINE FOR ROUTINE EXAMINATION CALCIUM-SERUM MAMMOGRAPHY - BOTH BREASTS (FOR COMPLETE HAEMOGRAM FEMALE) BLOOD UREA TRIGLYCERIDES CREATININE-SERUM GGTP -GAMMA GLUTAMYL TRANSPEPTIDASE URIC ACID-SERUM XRAY CHEST PA VIEW

SVPIMSR –Schedule of Charges (SOC)

AMC - MET HEALTH CHECKS LDL CHOLESTEROL VLDL CHOLESTEROL BLOOD GLUCOSE (FASTING) CHOLESTEROL/HDL RATIO-SERUM TOTAL CHOLESTEROL SGPT [ALT] PROTEIN-SERUM ALKALINE PHOSPHATASE BLOOD GROUP AND RH-TYPING BILIRUBIN (Direct/Indirect/Total)- SERUM PAP SMEAR /CERVICAL SMEAR (FOR FEMALE) STOOL FOR ROUTINE EXAMINATION 14) SUGAR CHECK – 1500 INR > (0 Days) * Fbs/Plbs * Hba1C * Blood Urea * Serum Creatinine * >(90 Days) * Fbs Urine Albumin * Lipid Profile * Sgpt * >(180 Days) * Fbs/Plbs * Hba1C * Diet & Sgot * Ecg * Foot Examination Lifestyle Counseling * Eye Examination * Diet & Lifestyle Endocrinologist Consultation (Breakfast Counseling * Patient Family Included) Education * Endocrinologist Consultation * Weekly Follow-Up Calls > (270 Days) * Fbs >(360 Days) * Fbs/Plbs * Hba1C * Diet & (Breakfast Included) Lifestyle Counseling 15) PERSONALISED HEALTH CHECK -3000 INR DETAILED MEDICAL HISTORY AND GYANECOLOGY CONSULT WITH PAP SMEAR CLINICAL EXAMINATION TEST & BREAST EXAMINATION HEAMTOLOGY PROFILE FOLLOW UP PHYSICIAN CONSULTATION DIABETIC PROFILE DIET AND LIFESTYLE COUNSELING LIPID PROFILE ADULT VACCINATION COUNSELING CARDIOVASCULAR ASSESSMENT RENAL PROFILE LIVER PROFILE ULTRASOUND AND IMAGING EYE SCREEING

Lab Charges

Please refer “Appendix B” for detailed list of individual tests and individual tariffs for Lab investigations/tests Operation Charges Classification TYPE tariff in INR A Minor 10000 B Major 30000 C Supra Major 50000 Example:

Category C (Supra Major)

SVPIMSR –Schedule of Charges (SOC)

Supra major craniotomies : Skull base tumours, Complex Cerebrovascular aneurysm, AVM, Epilepsy Surgery, Parasagittal meningioma, Complex head injury (requiring skull base repair and cranioplasty), lobectomies Complex spine surgeries : spinal dysraphism, scoliosis and kyphosis correction, vertebrectomy and other complex fusion, intramedullary tumour Peripheral nerve surgery : Nerve grafting, DREZ for spasticity, spinal cord stimulation

Category B Discectomy without fusion, multilevel laminectomy Minicraniotomy for abscess, Chronic SDH, meningeal and brain biopsy Shunt Procedures

Category A ICP Monitor External ventricular drain Skull traction Other Charges

OBG Tariff in INR Normal Delivery 10000 C Section 20000 Others, Gynaec 10000 In patient Wards, Rooms - Suite Rooms 2500 Wards, Rooms - Delux Rooms 2000 Wards, Rooms - Semi-Delux Rooms 1500 ICU (average of 12 categories) 3000 ICU add ons (ventilators, intubation, monitors etc) 1500 CATHLAB Angiogram 15000 Angio plasty procedure 75000 OTHERS LDRP Package 35000 Dermatology 500 Counselling, Dietary consult 50 Blood and blood products As per government rules CONSULTANT VISITS IP Wards 500 OT Utilization time OT charge Per hour – Emergency theatre in casualty area 2000

SVPIMSR –Schedule of Charges (SOC)

OT charge Per hour – Regular 3000 ICUs MICU 3000 CCU 3000 SICU 3000 CTICU 3000 Burns ICU 5000 HDU 3000 NICU - I 1500 NICU - II 1750 NICU - III 2000 Barrier Nursing 5000 Emergency Ward * 100 Day Care 1500

Note : 1 Emergency: Rs. 50/- per hour and maximum patient can stay 6 hours in ER

2 Pediatrics - ICU & Neonatal ICU / Nursery: if ventilator is used, 1000 Rs per day will be charged.

4. Appendix A – List of Radiology tests available in SVPIMSR 1. RADIOLOGY - CT SCAN

S.No Particulars 1 CT 3RD FACE 2 CT ABDOMINAL AORTOGRAPHY 3 CT ANGIO BOTH LOWER LIMB 4 CT ANGIO CEREBRAL 5 CT ANGIO CORONARY 6 CT ANGIO LIVER 7 CT ANGIO NECK 8 CT ANGIO PULMONARY 9 CT ANGIO UPPER LIMB 10 CT ANGIO WITH NECK VESSELS 11 CT BRAIN INTRACRANIAL ANGIO 12 CT BRAIN PLAIN 13 CT BRAIN WITH CONTRAST 14 CT BRAIN WITH NECK ANGIO AND INTRACRANIAL ANGIO 15 CT BRAIN WITH NON IONIC CONTRAST 16 CT CERVICAL SPINE 17 CT CHEST CONTRAST 18 CT CHEST HRCT CONTRAST 19 CT CHEST HRCT PLAIN

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 20 CT CHEST PLAIN 21 CT CORONARY ANGIO CALCIUM SCORING 22 CT DORSAL SPINE 23 CT DRAINAGE PIGTAIL 24 CT GUIDED PROCEDURE FNAC 25 CT GUIDED BIOPSY 26 CT GUIDED BONE BIOPSY 27 CT KUB PLAIN 28 CT KUB WITH CONTRAST 29 CT LIVER VOLUMETRY WITHOUT SCAN 30 CT LOWER ABDOMEN PELVIS 31 CT LOWER LIMB CONTRAST 32 CT LOWER LIMB PLAIN 33 CT LUMBO SACRAL SPINE WITH SACROILLIAC JOINTS 34 CT MCU 35 CT MYELOGRAPHY 36 CT NECK CONTRAST 37 CT NECK PLAIN 38 CT OSTEO 39 CT PELVIS 40 CT PNS CONTRAST 41 CT PNS PLAIN 42 CT RENAL ANGIO 43 CT SACROILLIAC JOINT 44 CT SCAN LOWER ABDOMEN/PELVIS PLAIN 45 CT SCAN UPPER ABDOMEN PLAIN 46 CT SHOULDER 47 CT TEMPORAL BONES HIGH RESOLUTION 48 CT UPPER ABDOMEN CONTRAST 49 CT UPPER ABDOMEN WITH TRIPLE PHASE LIVER 50 CT UPPER LIMB CONTRAST 51 CT UPPER LIMB PLAIN 52 CT WHOLE ABDOMEN CONTRAST 53 CT WHOLE ABDOMEN PLAIN 54 CT WRIST 55 EMERGENCY CHARGES FOR CT SCAN 56 WHOLE BODY PET SCAN * 2. RADIOLOGY - DOPPLER STUDY Ser. Particulars Code 1 DOPPLER AORTA ILIAC 2 DOPPLER CAROTID 3 DOPPLER CAROTID[BED SIDE] 4 DOPPLER LIVER TRANSPLANT 5 DOPPLER LOWER LIMB ARTERIAL(1 LIMB) 7 DOPPLER LOWER LIMB VENOUS 2 LIMBS[BED SIDE] 8 DOPPLER LOWER LIMB VENOUS SINGLE[BED SIDE] 9 DOPPLER LOWER LIMB VENOUS(2 LIMBS)

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 10 DOPPLER LOWER LIMB VENOUS(SINGLE) 11 DOPPLER OBSTETRIC 12 DOPPLER PENILE 13 DOPPLER RENAL 14 DOPPLER SCRTOTAL 15 DOPPLER SPLENOPORTAL 16 DOPPLER TRANSPLANT KIDNEY 17 DOPPLER UPPER LIMB ARTERIAL(1 LIMB) 18 DOPPLER UPPER LIMB ARTERIAL(2 LIMBS) 19 DOPPLER UPPER LIMB VENOUS(1 LIMB) 20 DOPPLER UPPER LIMB VENOUS(2 LIMBS) 21 EMERGENCY CHARGES FOR DOPPLER 22 EMR_CAROTID DOPPLER(WITHOUT PRINTED REPORT) 3. RADIOLOGY - MAMMOGRAPHY Ser. Particulars Code 1 MAMMOGRAPHY - BOTH BREASTS 2 MAMMOGRAPHY SINGLE BREAST 4. RADIOLOGY - MRI Ser. Particulars Code 1 EMERGENCY CHARGES FOR MRI 2 MRCP 3 MRI ABDOMEN/RENAL 4 MRI ANKLE 5 MRI ARM 6 MRI BOTH KNEES 7 MRI BOTH LEGS 8 MRI BOTH SHOULDERS 9 MRI BRACHIAL PLEXUS 10 MRI BRAIN - CONTRAST 11 MRI BRAIN (CSF RHINORRHEA) 12 MRI BRAIN EPILEPSY PROTOCOL 13 MRI BRAIN MR SPECTROSCOPY 14 MRI BRAIN PITUITARY PROTOCOL (CONTRAST) 15 MRI BRAIN PLAIN 16 MRI BRAIN WITH CSF FLOW STUDY 17 MRI BRAIN WITH IAM/INTERNAL EAR 18 MRI BRAIN WITH INTRACARNIAL AND NECK ANGIOGRAM 19 MRI BRAIN WITH INTRACRANIAL ANGIOGRAM 20 MRI BRAIN WITH MR VENOGRAM 21 MRI BRAIN WITH ORBIT 22 MRI BRAIN WITH VENOGRAM 23 MRI BREAST CONTRAST 24 MRI CARDIAC 25 MRI CARDIAC CORONARY ANGIO 26 MRI CAROTID WITH INTRACARNIAL ANGIOGRAM 27 MRI CERVICAL SPINE

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 28 MRI CERVICAL SPINE - WITH CONTRAST 29 MRI CHEST MEDIASTANIUM CONTRAST 30 MRI CHEST MEDIASTANIUM PLAIN 31 MRI CONTRAST 32 MRI/CT SCAN SCREENING FOR SPINE POST-OP 33 MRI DORSAL SPINE 34 MRI ELBOW 35 MRI FORE ARM 36 MRI HAND 37 MRI HIP 38 MRI HIP AND THIGH 39 MRI KNEE 40 MRI LEGS 41 MRI LIVER CONTRAST 42 MRI LIVER PLAIN 43 MRI LUMBER SPINE WITH CONTRAST 44 MRI LUMBER SPINE WITH SI JOINTS 45 MRI NECK 46 MRI NECK WITH CONTRAST 47 MRI NECK/NASOPHARYNX & PNS 48 MRI PELVIS CONTRAST 49 MRI PELVIS PLAIN 50 MRI PERFUSION STUDY 51 MRI REGIONS (DORSOL LUMBAR SPINE) 52 MRI SCREENING(WITHOUT FILM) 53 MRI SHOULDER 54 MRI SPECTROSCOPY 55 MRI SPINE [ONE REGION] WITH CONTRAST 56 MRI THIGH 57 MRI THIGH & LEG (ONE SIDE) 58 MRI THORAX AND ABDOMEN 59 MRI THORAX/PULMONARY ANGIO 60 MRI UPPER ABDOMEN CONTRAST 61 MRI UPPER ABDOMEN PLAIN 62 MRI UPPER ABDOMEN WITH MRCP 63 MRI UROGRAM 64 MRI WHOLE ABDOMEN CONTRAST 65 MRI WHOLE ABDOMEN PLAIN 66 MRI WHOLE SPINE 67 MRI WRIST 68 MRI/CT EXTRA CD 5. RADIOLOGY - USG Ser. Particulars Code 1 ASPIRATION USG PROCEDURE 2 ASPIRATION USG PROCEDURE[BED SIDE] 3 BIOPSY (USG PROCEDURE) 4 EMERGENCY CHARGES FOR USG

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 5 EMR_USG GUIDED PROCEDURE 6 EXTRA COPY(FILIMS) 7 MHC ULTRA SOUND ABDO-SCREEING 8 OVULATION STUDY - 3DAYS 9 OVULATION STUDY - 6DAYS 10 PCN (USG PROCEDURE) 11 PERCUTANEOUS USG/CT GUIDED ABSCESS DRAINAGE 12 PORTAL VENOUS DOPPLER 13 USG BREAST(BOTH) 14 USG CHEST 15 USG CHEST [BED SIDE] 16 USG DETAILED SECOND TRIMESTER SCAN 17 USG DOPPLER SOFT TISSUE 18 USG DOPPLER SOFT TISSUE[BED SIDE] 19 USG FOLICULAR STUDY - 3DAYS 20 USG FOLICULAR STUDY - 5DAYS 21 USG FOLLOW UP SCAN 22 USG GUIDED ASCITIC TAPPING[BED SIDE] 23 USG GUIDED BIOPSY 24 USG GUIDED FLUID ASPIRATION 25 USG GUIDED FNAC 26 USG GUIDED PLEURAL EFFUSION TAPPING 27 USG GUIDED PLEURAL EFFUSION TAPPING[BED SIDE] 28 USG GUIDED PSEUDOAN EURYSM OBLITE RATION 29 USG GUIDED RENAL BIOPSY 30 USG KIDNEYS 31 USG KIDNEYS[BED SIDE] 32 USG KUB 33 USG KUB SCREEING 34 USG KUB SCREEING[BED SIDE] 35 USG KUB[BED SIDE] 36 USG LOWER ABDOMEN 37 USG LOWER ABDOMEN[BED SIDE] 38 USG LOWER ABDO-SCREEEING[BED SIDE] 39 USG LOWER ABDO-SCREEING 40 USG LOWER ABDO-TRANS SRECTAL 41 USG LOWER ABD-TRANS VAGINAL 42 USG MSK I 43 USG MSK II 44 USG NECK 45 USG NECK SCREENING 46 USG NEUROSONOGRAM 47 USG NEUROSONOGRAM[BED SIDE] 48 USG OBSTETRICS WITH PICTURES FOR 1 2 3 TRIMESTER 49 USG ORBITS 50 USG PELVIS 51 USG PELVIS SCREENING 52 USG PELVIS SCREENING[BED SIDE]

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 53 USG PELVIS[BED SIDE] 54 USG PIGTAIL DRAINAGE 55 USG SCROTUM 56 USG SHOULDER 57 USG SINGLE BREAST 58 USG SMALL PARTS 59 USG THYROID/PAROTID 60 USG TRANSPLANT KIDNEY 61 USG UPPER ABDO SCREEING [BED SIDE] 62 USG UPPER ABDOMEN 63 USG UPPER ABDOMEN[BED SIDE] 64 USG UPPER ABDO-SCREEING 65 USG WHOLE ABDO - SCREENING 66 USG WHOLE ABDO SCREENING[BED SIDE] 67 USG WHOLE ABDOMEN 68 USG WHOLE ABDOMEN[BED SIDE] 6. RADIOLOGY - X-RAY Ser. Particulars Code 1 ASCENDING URETHROGRAM 2 CHONLONGIOGRAM 3 DEXA SCAN * 4 EMERGENCY CHARGES FOR FLUOROSCOPY 5 EMERGENCY CHARGES FOR X-RAY 6 FISTULOGRAM 7 FLUORO SNIFF TEST 8 HSG HISTOSALPINOGRAM 9 ORTHOPANTOMOGRAPH 10 RETROGRADE PYELOGRAM 11 XRAY (L) HIP AP< 12 XRAY (R) HIP AP< 13 XRAY ABDOMEN AP (SUPINE) 14 XRAY ABDOMEN ERRECT 15 XRAY ABDOMEN KUB PLAIN 16 XRAY ABDOMEN PORTABLE 17 XRAY ABDOMEN SITTING[BED SIDE] 18 XRAY ABDOMEN SUPINE[BED SIDE] 19 XRAY BERIUM ENEMA 20 XRAY BERIUM MEAL FOLLOW UP 21 XRAY BERIUM MEAL OF STOMACH & DUODENUM 22 XRAY BERIUM SWALLOW 23 XRAY BOTH ANKLES [AP & LAT] 24 XRAY BOTH ARMS AP & LAT 25 XRAY BOTH CALCANEUM LT 26 XRAY BOTH ELBOWS AP & LAT 27 XRAY BOTH FEET AP 28 XRAY BOTH FEET AP & LAT 29 XRAY BOTH FEET LT

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 30 XRAY BOTH FEMUR AP & LAT 31 XRAY BOTH FOREARM AP & LAT 32 XRAY BOTH HAND &WRIST AP 33 XRAY BOTH HAND &WRIST LT 34 XRAY BOTH HANDS AP & LAT 35 XRAY BOTH HANDS PA 36 XRAY BOTH HEELS LT 37 XRAY BOTH KNEE [AP & LAT] 38 XRAY BOTH KNEE AP VIEW 39 XRAY BOTH KNEE LT 40 XRAY BOTH KNEES AP & LEFT KNEE LAT 41 XRAY BOTH KNEES AP &RIGHT KNEE LAT 42 XRAY BOTH LEGS AP & LAT 43 XRAY BOTH PATELLAE SKYLINE VIEW 44 XRAY BOTH SHOULDER AP VIEW 45 XRAY C SPINE (FLE &EXT) 46 XRAY C.SPINE BOTH AP< [OBLIQUE] 47 XRAY CALCANIUM AP & LT 48 XRAY CERVICAL SPINE AP 49 XRAY CERVICAL SPINE AP & LAT 50 XRAY CERVICAL SPINE AP[BED SIDE] 51 XRAY CERVICAL SPINE LAT 52 XRAY CERVICAL SPINE LAT[BED SIDE] 53 XRAY CHEST 54 XRAY CHEST - AP(SITTING) 55 XRAY CHEST - AP(SITTING) [BED SIDE] 56 XRAY CHEST LATERAL 57 XRAY CHEST ABDOMEN 58 XRAY CHEST AP SUPINE [BED SIDE] 59 XRAY CHEST AP VIEW (SUPINE) 60 XRAY CHEST APICAL VIEW 61 XRAY CHEST LATERAL DECUBITUS 62 XRAY CHEST LORDOTIC 63 XRAY CHEST PA &LAT 64 XRAY CHEST PA VIEW 65 XRAY CLAVICLE AP 66 XRAY DORSAL LUMBAR SPINE AP & LT 67 XRAY DORSAL SPINE AP 68 XRAY DORSAL SPINE AP & LAT 69 XRAY DORSAL SPINE AP[BED SIDE] 70 XRAY DORSAL SPINE LAT 71 XRAY DORSO LUMBAR SPINE AP 72 XRAY ELBOW JOINT 73 XRAY ELBOWS AP &LAT 74 XRAY Extra Film 75 XRAY FEMUR AP 76 XRAY FISTULOGRAM 77 XRAY FOOT AP &LAT

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 78 XRAY FOOT AP &OBLIQUES 79 XRAY FOOT LAT 80 XRAY FOREARM WRIST AP &LAT 81 XRAY FOREARMS AP 82 XRAY FOREARMS LAT 83 XRAY GASTROGRAFFIN STUDY 84 XRAY HANDS AP 85 XRAY HIP AP 86 XRAY HIP AP & LAT [RIGHT / LEFT] 87 XRAY HIP JOINTS 88 XRAY INTRAVENOUS PYELOGRAM IONIC 89 XRAY INTRAVENOUS PYELOGRAM NON IONIC 90 XRAY KNEE (BOTH OBLIQUES) 91 XRAY KNEE JOINT 92 XRAY KUB 93 XRAY LEFT ANKLE AP 94 XRAY LEFT ANKLE AP & LAT 95 XRAY LEFT ANKLE AP & LAT[BED SIDE] 96 XRAY LEFT ANKLE LAT 97 XRAY LEFT ANKLE WITH FOOT AP & LT 98 XRAY LEFT ARM AP&LAT 99 XRAY LEFT ELBOW AP & LAT[BED SIDE] 100 XRAY LEFT ELBOW AP 101 XRAY LEFT ELBOW AP & LT 102 XRAY LEFT ELBOW AP &LAT 103 XRAY LEFT ELBOW LT 104 XRAY LEFT FEMER AP & LAT[BED SIDE] 105 XRAY LEFT FEMUR AP 106 XRAY LEFT FEMUR AP&LAT 107 XRAY LEFT FOOT AP 108 XRAY LEFT FOOT AP & LAT[BED SIDE] 109 XRAY LEFT FOOT AP & LT 110 XRAY LEFT FOOT LT 111 XRAY LEFT FOOT&ANKLE AP & LT 112 XRAY LEFT FOREARM AP 113 XRAY LEFT FOREARM AP & LAT 114 XRAY LEFT FOREARM AP & LAT[BED SIDE] 115 XRAY LEFT FOREARM LAT 116 XRAY LEFT HAND AP 117 XRAY LEFT HAND AP & LAT 118 XRAY LEFT HAND AP & LAT[BED SIDE] 119 XRAY LEFT HAND LAT 120 XRAY LEFT HAND WITH FOREARM AP & LT 121 XRAY LEFT HIP AP & LAT[BED SIDE] 122 XRAY LEFT HIP AP&LAT 123 XRAY LEFT HIP WITH PROXIMAL FEMUR AP VIEW 124 XRAY LEFT HUMERUS AP & LAT[BED SIDE] 125 XRAY LEFT HUMERUS WITH AP & LAT

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 126 XRAY LEFT KNEE AP 127 XRAY LEFT KNEE AP & LAT 128 XRAY LEFT KNEE AP & LAT[BED SIDE] 129 XRAY LEFT KNEE LAT 130 XRAY LEFT LEG AP 131 XRAY LEFT LEG AP & LAT 132 XRAY LEFT LEG AP & LAT[BED SIDE] 133 XRAY LEFT LEG KNEE & ANKLE AP & LT 134 XRAY LEFT LEG LAT 135 XRAY LEFT MANDIBLE OBLIQUE[BED SIDE] 136 XRAY LEFT SHOULDER AP 137 XRAY LEFT SHOULDER AP & LAT 138 XRAY LEFT SHOULDER AP[BED SIDE] 139 XRAY LEFT SHOULDER LAT 140 XRAY LEFT SPINE AP 141 XRAY LEFT WRIST AP 142 XRAY LEFT WRIST AP & LAT 143 XRAY LEFT WRIST AP & LAT[BED SIDE] 144 XRAY LEFT WRIST LAT 145 XRAY LEG ANKLE AP&LAT 146 XRAY LUMBAR SPINE AP 147 XRAY LUMBAR SPINE AP & LT 148 XRAY LUMBAR SPINE LAT FLEXION AND EXTENSION VIEW 149 XRAY LUMBAR SPINE LT 150 XRAY LUMBO DORSAL SPINE AP & LT 151 XRAY LUMBO-SACRAL SPINE AP & LT 152 XRAY MANDABLE 153 XRAY MASTOIDS 154 XRAY MCU 155 XRAY NASAL BONE LAT[BED SIDE] 156 XRAY NASAL BONES 157 XRAY NASOPHARYNX 158 XRAY NECK AP & LAT 159 XRAY NECK LAT 160 XRAY NECK SOFT/TISSUE (NASOPHARYNX) 161 XRAY PARNASAL SINUSES 162 XRAY PELVIS 163 XRAY PELVIS BOTH HIPS AP 164 XRAY PELVIS WITH BOTH HIPS AP FROG VIEW 165 XRAY PELVIS WITH BOTH HIPS AP INLET AND OUTLET VIE 166 XRAY PELVIS WITH BOTH HIPS AP[BED SIDE] 167 XRAY PELVIS WITH BOTH HIPS LAT FROG VIEW 168 XRAY RIBS 169 XRAY RIGHT ANKLE AP 170 XRAY RIGHT ANKLE AP & LAT[BED SIDE] 171 XRAY RIGHT ANKLE AP & LT 172 XRAY RIGHT ANKLE AP LEFT 173 XRAY RIGHT ARM AP & LAT

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 174 XRAY RIGHT ELBOW AP & LAT[BED SIDE] 175 XRAY RIGHT ELBOW LT 176 XRAY RIGHT FEMER AP & LAT[BED SIDE] 177 XRAY RIGHT FEMUR AP 178 XRAY RIGHT FEMUR AP VIEW 179 XRAY RIGHT FEMUR AP&LAT 180 XRAY RIGHT FOOT AP 181 XRAY RIGHT FOOT AP & LAT 182 XRAY RIGHT FOOT AP & LAT[BED SIDE] 183 XRAY RIGHT FOOT AP & OBLIQUE 184 XRAY RIGHT FOOT LAT 185 XRAY RIGHT FOOT&ANKLE AP & LT 186 XRAY RIGHT FOREARM AP 187 XRAY RIGHT FOREARM AP & LAT[BED SIDE] 188 XRAY RIGHT FOREARM AP & LT 189 XRAY RIGHT FOREARM LAT 190 XRAY RIGHT HAND AP 191 XRAY RIGHT HAND AP & LAT[BED SIDE] 192 XRAY RIGHT HAND AP & LT 193 XRAY RIGHT HAND AP&OBLIQUE 194 XRAY RIGHT HAND LAT 195 XRAY RIGHT HAND WITH FOREARM AP & LT 196 XRAY RIGHT HIP AP & LAT[BED SIDE] 197 XRAY RIGHT HIP AP&LAT 198 XRAY RIGHT HIP LT 199 XRAY RIGHT HIP WITH PROXIMAL FEMUR AP 200 XRAY RIGHT HUMERUS AP & LAT[BED SIDE] 201 XRAY RIGHT HUMERUS AP< 202 XRAY RIGHT KNEE AP 203 XRAY RIGHT KNEE AP & LAT 204 XRAY RIGHT KNEE AP & LAT[BED SIDE] 205 XRAY RIGHT KNEE LAT 206 XRAY RIGHT LEG AP 207 XRAY RIGHT LEG AP & LAT 208 XRAY RIGHT LEG AP & LAT[BED SIDE] 209 XRAY RIGHT LEG KNEE & ANKLE AP & LT 210 XRAY RIGHT LEG LAT 211 XRAY RIGHT LOWER LEG AP LATERAL VIEW 212 XRAY RIGHT MANDIBLE OBLIQUE[BED SIDE] 213 XRAY RIGHT SHOULDER AP 214 XRAY RIGHT SHOULDER AP & AXILLARY 215 XRAY RIGHT SHOULDER AP & LAT 216 XRAY RIGHT SHOULDER AP[BED SIDE] 217 XRAY RIGHT SHOULDER LAT 218 XRAY RIGHT TIBIA AP & LT 219 XRAY RIGHT WRIST AP 220 XRAY RIGHT WRIST AP & LAT 221 XRAY RIGHT WRIST AP & LAT[BED SIDE]

SVPIMSR –Schedule of Charges (SOC)

S.No Particulars 222 XRAY SACRO COCCYGEAL JUNCTION AP < 223 XRAY SACRO COCCYGEAL JUNCTION LAT 224 XRAY SACRO ILIAC JOINTS PA 225 XRAY SCAPULA AP&LAT 226 XRAY SHOULDER AP< ONE SIDE 227 XRAY SIGNOGRAM 228 XRAY SINGLE ARM AP & LAT 229 XRAY SINGLE FEMUR AP & LAT 230 XRAY SKULL AP 231 XRAY SKULL AP & LAT 232 XRAY SKULL AP & LAT[BED SIDE] 233 XRAY SKULL LAT 234 XRAY SKULL LAT[BED SIDE] 235 XRAY SKY LINE VIEW OF PATELLA 236 XRAY STERNO CLAVICULAR JOINT BOTH SIDE 237 XRAY TEMPRO MANDIBULAR JOINT-DOUBLE 238 XRAY TEMPRO MANDIBULAR JOINT-SINGLE 239 XRAY TIBIA AP&LAT 240 XRAY TIBIA LEFT 241 XRAY TIBIA RIGHT 242 XRAY UPPER GI SINGLE CONTRAST 243 XRAY VCU 244 XRAY WRIST JOINT

5. Appendix B – Detailed list of Lab Investigations along with Tariffs – For ALL Category of patients (General and Executive) Ser. Particulars General Tariff in INR Code 1 17 HYDROXY PREGENENOLONE * 1,200 2 17 KETO STEROIDS 24 HRS URINE * 400 3 17-HYDROXY PROGESTERONE - SERUM * 300 4 24 HOUR URINE FOR BUN(BLOOD UREA NITROGEN) 30 5 5HIAA 24 HRS URINE * 300 6 ABG(ARTERIAL BLOOD GASES) 50 7 ACE - CSF * 100 8 ACE(ANGIOTENSIN CONVERTING ENZYME) - SERUM * 100 9 ACETONE - SERUM 50 10 ACID LOAD TEST * 200 11 ACID PHOPHATASE TOTAL - SERUM * 50 12 ACID PHOSPHATASE-PROSTATIC * 50 13 ADENOSINE DEAMINASE(ADA) 200 ADRENO CORTICO TROPIC HORMONE(ACTH) - SERUM 14 * 200 15 AFP - CSF 100 16 ALBUMIN - CREATININE RATIO - RANDOM URINE 100

SVPIMSR –Schedule of Charges (SOC)

Ser. Particulars General Tariff in INR Code 17 ALBUMIN - SERUM 50 18 ALCOHOL - BLOOD/RANDOM URINE * 50 19 ALDOLASE - SERUM * 100 20 ALDOSTERONE - SERUM * 100 21 ALKALINE PHOSPHATASE - SERUM 50 22 ALKALINE PHOSPHATASE BONE SPECIFIC - SERUM * 100 23 ALKALINE PHOSPHATASE FRACTIONATION * 100 24 ALKALINE PHOSPHATASE ISOENZYMES * 100 25 ALPHA 1 ANTITRYPSIN * 300 26 ALPHA-FETO PROTEIN(AFP) - SERUM 300 27 ALUMINIUM - BLOOD * 1,000 28 AMINO ACID - SERUM * 500 29 AMINO ACIDS QUALITATIVE - PLASMA * 300 30 AMINO ACID PLASMA QUANTITATIVE SCREENING* 1,500 31 AMINO ACIDS QUALITATIVE URINE(1 DTLC) * 100 32 AMINO ACIDS QUALITATIVE URINE(2 DTLC) * 100 33 AMINOPHYLLINE - SERUM * 200 34 AMMONIA - BLOOD 100 35 AMYLASE - SERUM 100 36 AMYLASE RANDOM URINE 100 37 ANDROSTENDIONE - SERUM * 100 38 ANTI MULLERIAN HORMONE * 100 39 APOLIPOPROTEIN A1 - SERUM 100 40 APOLIPOPROTEIN B - SERUM 100 41 ARSENIC - BLOOD * 1,000 42 ASCITIC FLUID - BIO CHEMICAL ANALYSIS 300 43 ASCITIC FLUID FOR LIPASE 100 44 ASCITIC FLUID FOR AMYLASE 100 45 ASCITIC FLUID FOR BILIRUBIN 100 46 ASCITIC FLUID FOR LDH 100 47 ASCITIC FLUID FOR PROTEIN 100 48 ASCITIC FLUID FOR SUGAR 50 49 BENCE JONES PROTEINS-RANDOM URINE 100 50 BENZODIAZEPAM - URINE * 100 51 BETA 2 MICROGLOBULIN - SERUM/RANDOM URINE * 100 52 BETA - GALACTOSIDE * 1,000 53 BETA HCG - SERUM * 100 54 BICARBONATE - PLASMA 100 55 BILE ACID LEVEL (FASTING) * 200 56 BILIRUBIN - NEONATAL 100 57 BILIRUBIN(DIRECT/INDIRECT/TOTAL) - SERUM 100 58 BLOOD GLUCOSE(2 HRS POST GLUCOSE) 50 59 BLOOD GLUCOSE(FASTING) 50 60 BLOOD GLUCOSE(P PRANDIAL/P GLUCOSE/RANDOM) 50

SVPIMSR –Schedule of Charges (SOC)

Ser. Particulars General Tariff in INR Code 61 BLOOD GLUCOSE(RANDOM) 50 62 BLOOD UREA 50 63 BLOOD UREA - POST DIALYSIS 50 64 BODY FLUID FOR LIPASE 100 65 BODY FLUIDS FOR BIOCHEMICAL ANALYSIS 100 66 B-TYPE NATRIURETIC PEPTIDE(BNP) - SERUM 200 67 BUN(BLOOD UREA NITROGEN) 100 68 C - PEPTIDE ASSAY * 100 69 C S F SUGAR 50 70 CA 15-3 - SERUM * 200 71 CA-19.9 - SERUM 200 72 CALCITONIN - SERUM * 200 73 CALCIUM - CREATININE RATIO - 24 HRS URINE 150 74 CALCIUM - CREATININE RATIO - RANDOM URINE 100 75 CALCIUM - RANDOM URINE 100 76 CALCIUM - SERUM 100 77 CALCIUM 24 HRS URINE/RANDOM URINE 100 78 CANCER ANTIGEN 125(CA-125) - SERUM 400 79 CANNABINOIDS QUALITATIVE RANDOM URINE 300 80 CARBAMAZEPINE/TEGRETOL - SERUM * 200 81 CARCINO - EMBRYONIC ANTIGEN(CEA) - SERUM 300 82 CARDIAC ENZYMES 300 83 CATECHOLAMINES 24 HRS URINE * 400 84 CATECHOLAMINES-SERUM * 400 85 CEA - CSF 300 86 CERULOPLASMIN(COPPER OXIDASE) - SERUM 300 87 CHLORIDE - SERUM 250 88 CHLORIDE 24 HRS URINE/RANDOM URINE 120 89 CHOLESTEROL TOTAL 50 90 CHOLESTEROL/HDL RATIO - SERUM 200 91 CHOLINESTERASE - SERUM * 650 92 CHOLINESTERASE RBC * 700 93 CK - MB - SERUM 300 94 COPPER - SERUM * 400 95 COPPER 24 HRS URINE * 900 96 COPPER RANDOM URINE * 950 97 CORTISOL - SERUM 500 98 CORTISOL 24 HRS URINE * 200 99 CORTISOL RANDOM URINE * 240 100 CPK(CREATINE PHOSPHO KINASE) - SERUM 250 101 CREATINE KINASE WITH CKMB 250 102 CREATININE - SERUM 50 103 CREATININE 24 HRS URINE 40 104 CREATININE CLEARANCE TEST 40

SVPIMSR –Schedule of Charges (SOC)

Ser. Particulars General Tariff in INR Code 105 CREATININE RANDOM URINE 40 106 CRYOGLOBULINS - QUALITATIVE - SERUM * 150 107 CSF FOR BIOCHEMICAL ANALYSIS 70 108 CSF FOR CHLORIDE 120 109 CYCLOSPORINE - BLOOD * 800 110 CYST FLUID FOR BIOCHEMICAL ANALYSIS 400 111 DEHYDRO EPIANDOSTERONE(DHEA) - SERUM * 400 113 DHEA-S - SERUM * 250 114 DIGOXIN - SERUM * 200 115 DILANTIN/PHENYTOIN/EPTOIN - SERUM 300 116 DIURETIC HORMONE(VASOPRESSIN) * 1,600 117 DRAINAGE TUBE ASPERATE FLUID FOR ANALYSIS 250 DRUG OF ABUSE(9 DRUGS PANEL) URINE 118 QUANTITATIVE 1,600 119 DRUGS OF ABUSE URINE QUALITATIVE SCREENING * 1,200 120 ELECTROLYTES - FLUID 350 121 ELECTROLYTES(Na,k,cl) - SERUM 300 123 ERYTHROPOETIN - SERUM * 650 124 ESTRADIOL - SERUM * 350 125 ESTRIOL - SERUM * 350 126 EVEROLIMUS SERUM * 2000 127 FERRITIN - SERUM 350 128 FLUID FOR AMYLASE 250 129 FLUID FOR BUN(BLOOD UREA NITROGEN) 100 130 FLUID FOR CA - 19.9 700 131 FLUID FOR CEA 500 132 FLUID FOR CHOLESTEROL 200 133 FLUID FOR CREATININE 90 134 FLUID FOR ESTRADIOL * 200 135 FLUID FOR LDH 210 136 FLUID FOR LIPASE 300 137 FLUID FOR PROTEIN 550 138 FLUID FOR SUGAR 110 139 FLUID FOR TRIGLYCERIDES 120 140 FLUID FOR UREA 90 141 FLUID FOR URIC ACID 90 142 FOLATE - RBC * 800 143 FOLIC ACID/FOLATE - SERUM 500 144 FREE T3 - SERUM 100 145 FREE T4 - SERUM 100 146 FREE TESTOSTERONE - SERUM * 500 147 FRUCTOSAMINE - SERUM * 150 148 FSH - SERUM 250 149 GALACTOSE CLASSICAL(TRANSFERASE) * 750

SVPIMSR –Schedule of Charges (SOC)

Ser. Particulars General Tariff in INR Code 150 GALACTOSE-1-PHOSPHATE * 650 151 GASTRIN - SERUM * 500 GGTP - GAMMA GLUTAMYL TRANSPEPTIDASE - 152 SERUM 50 153 GLUCOSE CHALLENGE TEST 60 154 GLUCOSE TOLERANCE TEST EXTENDED 540 155 GLUCOSE TOLERANCE TEST GTT-5 200 156 GLUCOSE TOLERANCE TEST(GTT) - 2 120 157 GLUCOSE TOLERANCE TEST(GTT) - 3 160 158 GROWTH HORMONE - SERUM * 250 159 GTT - GESTATIONAL 170 160 HAPTOGLOBIN - SERUM * 800 161 HBA1C(GLYCOSYLATED HAEMOGLOBIN) - BLOOD 500 162 HCG - CSF * 400 163 HCG - SERUM * 400 164 HDL CHOLESTEROL 150 165 HEAVY METALS ANALYSIS - BLOOD * 2000 166 HEAVY METALS ANALYSIS - URINE COMP. * 5,500 167 HOMOCYSTEINE - SERUM 500 169 IgF - BINDING PROTIEN 3 * 2000 170 IgF -1(INSULIN GROWTH FACTOR -1) - SERUM * 2000 173 INHIBIN - A - SERUM * 400 174 INHIBIN - B SERUM * 600 175 INSULIN - SERUM * 250 176 INSULIN(FASTING) * 300 177 IONISED CALCIUM - SERUM 100 178 IRON - SERUM 100 179 IRON & IRON BINDING CAPACITY - SERUM 350 180 KAPPA LIGHT CHAINS FREE - SERUM * 600 181 KAPPA/LAMBDA LIGHT CHAINS FREE - SERUM * 800 182 LACTATE(CSF) * 300 183 LACTATE(VENOUS/ARTERIAL) * 300 184 LAMBDA LIGHT CHAINS FREE - SERUM * 800 185 LDH - CSF 400 186 LDH ISOENZYMES - SERUM * 700 187 LDH(LACTATE DEHYDROGENASE) - SERUM 100 188 LDL CHOLESTEROL 250 189 LDL/HDL RATIO 400 190 LEAD - BLOOD * 960 191 LFT(LIVER FUNCTION TEST) 500 192 LH(LEUTINIZING HORMONE) - SERUM 250 193 LIPASE - SERUM 400 194 LIPID PROFILE - SERUM 450 195 LIPOPROTEIN(A) - SERUM 600

SVPIMSR –Schedule of Charges (SOC)

Ser. Particulars General Tariff in INR Code 196 LITHIUM-SERUM * 150 197 LIVER BIOPSY FOR COPPER STAIN * 220 198 MAGNESIUM - SERUM 200 199 MAGNESIUM RANDOM/24HRS URINE 130 200 MANGANESE - RANDOM URINE * 950 201 MERCURY - BLOOD * 1,500 202 METANEPHRINE 24 HRS URINE * 800 203 METANEPHRINE - PLASMA * 1,800 204 METHOTREXATE LEVEL - BLOOD * 1,110 205 METHYL MALONIC ACID QUALITATIVE - URINE * 300 206 METHYL MALONIC ACID QUANTITATIVE - URINE * 4,500 METHYLENE DIOXYMETHAN PHETAMINE DRUG - 207 URINE * 250 208 MICROALBUMIN - URINE 200 209 MUCOPOLYSACCHURIDE QUALITATIVE URINE SPOT * 200 210 NORMETANEPHRINE - PLASMA* 1,800 211 OPIATES QUALITATIVE RANDOM URINE 360 212 ORGANIC ACID PANEL - URINE * 2,300 213 OSMOLALITY - SERUM * 300 214 OSMOLALITY - URINE/FLUID * 300 215 OSMOLARITY 24 HRS URINE * 250 216 OSTEOCALCEIN - SERUM * 1,500 217 OXALATE 24 HRS URINE * 950 218 PANGRAF - BLOOD * 1000 219 PARA THORMONE(PTH) - SERUM 500 220 PARACETEMOL LEVEL IN SERUM * 500 221 PERICARDIAL FLUID FOR BIOCHEMICAL ANALYSIS 250 222 PERITONEAL DIALYSIS FLUID FOR CREATININE 90 223 PERITONEAL DIALYSIS FLUID FOR SUGAR 60 224 PERITONEAL FLUID FOR CREATININE 90 225 PERITONEAL FLUID FOR SUGAR 60 226 PHENOBARBITOL - SERUM * 320 227 PHENYLKETONES RANDOM URINE QUALITATIVE * 70 228 PHOSPHOROUS 24 HRS URINE 140 229 PHOSPHOROUS - SERUM 100 230 PHOSPHOROUS RANDOM URINE 150 231 PLEURAL FLUID FOR AMYLASE 240 232 PLEURAL FLUID FOR LDH 300 233 PLEURAL FLUID FOR PROTEIN 130 234 PLEURAL FLUID FOR SUGAR 60 PORPHOBILINOGEN-RANDOM URINE-QUALITATIVE 235 SCREEN 120 236 PORPHYRIN QUALITATIVE - URINE 150 237 PORPHYRIN QUANTITATIVE - URINE * 780

SVPIMSR –Schedule of Charges (SOC)

Ser. Particulars General Tariff in INR Code 238 POSTSSIUM 24 HRS URINE 120 239 POTASSIUM - SERUM 100 240 POTASSIUM RANDOM URINE 120 241 PROCALCITONIN - SERUM 1,340 242 PROGESTERONE - SERUM * 190 243 PROLACTIN - SERUM 250 244 PROSTATIC SPECIFIC ANTIGEN(PSA) TOTAL - SERUM 150 245 PROTEIN - SERUM 70 246 PROTEIN 24 HRS URINE 150 247 PROTEIN ELECTROPHO - CSF * 910 248 PROTEIN ELECTROPHORESIS - CSF * 390 249 PROTEIN ELECTROPHORESIS - SERUM * 540 250 PROTEIN ELECTROPHORESIS - URINE * 390 251 PROTEIN RANDOM URINE 150 252 PSA- FREE - SERUM * 520 253 PSEUDO CHOLINESTERASE SERUM * 400 254 PYRUVATE (VENOUS/ARTERIAL) * 320 255 RENIN ACTIVITY - PLSAMA * 1,800 256 SALICYLATE - SERUM * 520 257 SAPIEN-DATAR ANTI-DIABETIC DRUGS PGX TEST* 4,300 258 SAPIEN-DATAR ANTI-VIRAL DRUGS PGX TEST* 3,500 259 SAPIEN-DATAR ASTHMA DRUGS PGX TEST* 3,220 260 SAPIEN-DATAR CARDIO-VASCULAR DRUGS PGX TEST* 5,620 SAPIEN-DATAR CIRCULATING ENDOTHELIAL CELL 261 DETECTN* 7,700 262 SAPIEN-DATAR HYPERURICEMIA DRUGS PGX TEST* 2,700 SAPIEN-DATAR IMMUNOSUPPRESSION DRUGS PGX 263 TEST* 2,700 SAPIEN-DATAR NEURO-PSYCHIATRY DRUGS PGX 264 TEST* 5,500 SAPIEN-DATAR ONCO PGX TEST-CHEMOTHERAPEUTIC 265 DRUGS* 5,000 SAPIEN-DATAR ONCOLOGY PGX TEST-TARGETED 266 AGENTS* 7,800 267 SAPIEN-DATAR OSTEOPOROSIS DRUGS PGX TEST* 4,500 268 SEROLIMUS - BLOOD * 2,100 269 SEROTONIN - SERUM * 900 270 SEX HORMONE BINDING GLOBULIN * 1,200 271 SGOT(AST) - SERUM 50 272 SGPT(ALT) - SERUM 50 273 SODIUM - SERUM 100 274 SODIUM 24 HRS URINE 120 275 SODIUM RANDOM URINE/24 HRS UNINE 120 276 STONE ANALYSIS * 360

SVPIMSR –Schedule of Charges (SOC)

Ser. Particulars General Tariff in INR Code 277 SWEAT POTASSIUM * 120 278 SYNOVIAL FLUID FOR BIOCHEMICAL ANALYSIS 250 279 T3 - SERUM 80 280 T4 - SERUM 80 281 TACROLIMUS - BLOOD 1,150 282 TESTOSTERONE - SERUM 480 283 THEOPHYLLINE - SERUM * 290 284 THYROGLOBULIN - SERUM * 520 285 THYROID PROFILE(T3,T4 & TSH) - SERUM 520 286 THYROXIN BINDING GLOBULIN * 2,200 287 TIBC(TOTAL IRON BINDING CAPACITY) - SERUM 600 288 TOXIC LAB-A SYSTEM URINE * 960 289 TRANSFERRIN - SERUM * 300 290 TRANSFERRIN RECEPTOR * 520 291 TRIGLYCERIDES - SERUM 20 292 TROPONIN I QUALITATIVE 300 293 TROPONIN I ULTRA(TNIU) QUANTITATIVE 500 294 TROPONIN T QUALITATIVE * 300 295 TROPONIN T QUANTITATIVE * 500 296 TSH-THYROID STIMULATING HORMONE 100 297 UNKNOWN DRUG QALITATIVE URINE * 720 298 UREA - CSF 90 299 UREA 24 HRS URINE/RANDOM URINE 120 300 UREA CLEARANCE TEST 270 301 URIC ACID - SERUM 100 302 URIC ACID 24 HRS URINE/RANDOM URINE 120 303 URINE FOR METABOLIC SCREENING * 860 304 URINE SUGAR(FASTING) 20 305 URINE SUGAR(POST PRANDIAL) 20 306 VALPROIC ACID - SERUM * 290 307 VANCOMYCIN LEVEL - SERUM * 1,200 308 VANCOMYCIN LEVEL(PEAK) - SERUM * 1,300 309 VASOPRESSIN SUPRESSION TEST * 1,100 310 VITAMIN A - SERUM * 1,400 311 VITAMIN B-12 - SERUM 350 312 VITAMIN D 1,25(DIHYDROXY) - SERUM * 1,000 313 VITAMIN D3 - SERUM 1,000 314 VITAMIN E - SERUM * 800 315 VLDL CHOLESTEROL 120 316 VMA 24HRS URINE * 540 317 ZINC - SERUM * 740 318 ZINC RANDOM URINE * 900

2. BLOOD BANK INVESTIGATIONS

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

1 ANTI "A" ANTIBODY TITRE (IgG) 100

2 ANTI "B" ANTIBODY TITRE (IgG) 100

3 ANTI "A" ANTIBODY TITRE (IgM) 100

4 ANTI "B" ANTIBODY TITRE (IgM) 100

5 ANTIBODY IDENTIFICATION TEST 200

6 BLOOD GROUP AND RH-TYPING 100

7 COOMBS TEST [INDIRECT] 150

8 COOMBS TEST (DIRECT) 150

9 RH ANTIBODIES TITRE 150 3. CLINICAL PATHOLOGY INVESTIGATIONS

1 MANTOUX TEST 50

2 OCCULT BLOOD - MATERIAL 50

3 SEMEN ANALYSIS 50

4 STOOL FOR FAT 50

5 STOOL FOR ROUTINE EXAMINATION 50

6 pH - BODY FLUID/URINE 50

7 STOOL OCCULT BLOOD 50

8 STOOL REDUCING SUBSTANCE 50

9 URINARY HAEMOSIDERIN 50

10 URINARY MYOGLOBIN * 100

11 URINE ACETONE 50 12 URINE ANALYSIS BY DIPSTIX

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 50

13 URINE BILE SALT + BILE PIGMENTS 50

14 URINE FOR ALBUMIN 50

15 URINE FOR CHYLOMICRONS * 50

16 URINE FOR EOSINOPHILS 50

17 URINE FOR PROTEIN SEMI QUANTITATIVE 50

18 URINE FOR REDUCING SUBTANCE 50

19 URINE FOR ROUTINE EXAMINATION 50

20 URINE FOR UROBILINOGEN QUANTITATIVE * 50

21 URINE HB/MYOGLOBIN QUALITATIVE * 50

22 URINE PHASE CONTRAST MICROSCOPY * 50

23 URINE SPECIFIC GRAVITY 50

24 URINE UROBILINOGEN 50 4. CYTOLOGY INVESTIGATIONS

1 FLUID FOR CYTOLOGY 100

2 FLUID FOR CYTOLOGY(FLUID FOR MALIGNANT CELLS) 150

3 PAP SMEAR /CERVICAL SMEAR 100 5. HAEMATOLOGY INVESTIGATIONS

1 ABSOLUTE LYNPHOCYTE COUNT(ALC) 50

2 ABSOLUTE NEUTROPHIL COUNT(ANC) 50 ACTIVATED PARTIAL THROMBOPLASTIN TIME(APTT)- 3 PLASMA 50

4 ACTIVATED PROTEIN C RESISTANCE (APC-R) * 300 5 ACUTE LEUKAMIA DIAGNOSTIC PANEL-O*

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 1,000

6 AEC-ABSOLUTE EOSINOPHIL COUNT 50

7 ANTI THROMBIN - III * 100

8 ANTI THROMBIN III FUNCTIONAL * 200

9 ASCITIC FLUID (DC) 50

10 BLOOD INDICES(MCV,MCH,MCHC) 50

11 BLOOD PARASITES (MP BY CARD) DAY 100

12 BLOOD PARASITES (MP BY CARD) NIGHT 100

13 BLOOD PARASITES (MP BY QBC) 50

14 BLOOD PARASITES (MP/MF) BY SMEAR(P/S FOR MP) 50

15 BONE MARROW ASPIRATE SMEAR FOR OPINION 300

16 BT-BLEEDING TIME 50

17 CHROMOGRANIN A LEVEL * 400

18 CLOT RETRACTION TIME * 50

19 CLOT SOLUBILITY TEST FOR FACTOR XIII * 50

20 CLOTTING TIME(CT) 50

21 COAGULATION ANALYSER(PT/INR STRIP TEST) 50

22 COAGULATION CORRECTION STUDY * 1,200

23 COMPLETE BLOOD COUNT & ESR 350

24 COMPLETE BLOOD COUNT (CBC) 150

25 COMPLETE HAEMOGRAM 150

26 D-DIMER - PLASMA 600 27 D-DIMER BY ELISA * 300

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

28 DIC PROFILE 2000

29 ESR (ERYTHROCYTE SEDIMENTATION RATE) 50 FACTOR II MUTATION (PROTHROMBIN 30 GENE MUTATION) * 2000

31 FACTOR IX ASSAY * 2,000

32 FACTOR IX FUNCTIONAL * 650

33 FACTOR IX INHIBITOR STUDY * 1,500

34 FACTOR IX STUDY * 850

35 FACTOR V ASSAY * 1,200

36 FACTOR V LEIDEN MUTATION * 2,800

37 FACTOR V LEIDEN MUTATION ANALYSIS * 2,100

38 FACTOR VIII ASSAY / AHG ASSAY * 1,600

39 FACTOR VIII INHIBITOR STUDY * 3,200

40 FACTOR VIII STUDIES * 510

41 FACTOR VIII STUDY * 750

42 FACTOR X STUDY * 2,300

43 FACTOR XI STUDY * 1,600 44 FACTOR XII STUDY * 1,600 45 FACTOR XIII SCREEN (CLOT SOLUBILITY/STABILITY) * 100 46 FIBRINOGEN - PLASMA 500 47 FIBRINOGEN DEGRADATION PRODUCTS-FDP 500

48 FIBRO METER VIRUS * 1,700

49 FIBROMETER NAFLD * 1,400

50 FLOWCYTOMETRY FOR HAEMATOLOGICAL MALIGNANCY * 5,100

51 FLUID CELL COUNT 140

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

52 FLUID FOR HAEMATOCRIT 150

53 FLUID POLARIZED MICROSCOPY * 240

54 G6 PD DEFECIENCY TEST 260

55 HAEMOGLOBIN 40

56 HAMS TEST * 450

57 HAMS TEST * 450

58 HB ELECTROPHORASIS BY HPLC * 160

59 HB ELECTROPHORESIS ACID * 420

60 HB ELECTROPHORESIS ALKALINE * 420

61 HbA2 QUANTITATIVE * 380

62 HbF QUANTITATIVE * 60

63 IMMUNOPHENOTYPING BY FLOW CYTOMETRY* 4,500

64 IMMUNOPHENOTYPING BY FLOW CYTOMETRY* 4,500

65 IMMUNOPHENOTYPING BY FLOWCYTOMETRY - CD34 * 1,750

66 IMMUNOPHENOTYPING BY FLOWCYTOMETRY * 4,650

67 IMMUNOPHENOTYPING FOR PNH WORKUP * 4,100 68 ISO PROPANOL PRECIPITATION TEST * 200

69 ISSUE OF BLOOD/BONE MARROW SLIDES 110 70 LAP SCORE * 450

71 LE CELL TEST * 90

72 LUPUS ANTICOAGULANT LA STUDY - PLASMA 1,100 73 MCH 40

74 MCHC 40 75 MCV

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 40

76 METH HAEMOGLOBIN [QUANTITATIVE] - BLOOD * 140

77 MIXING STUDY I 570

78 MIXING STUDY II 950

79 MPO (MYELOPEROXIDASE) * 380

80 MRD LEUKAMIA - O* 5,750

81 MYOGLOBIN - SERUM * 480 NBS BASIC PANEL (G6PD,TSH,17 ALPHA 82 HYDROXYPROGESTERONE)* (New Born Baby) 240

83 NBS PANEL - 6 * 720

84 NEONATAL METABOLIC (52 PARAMETERS) * 2,500

85 NEONATAL METABOLIC SCREENING TEST * 1,970

86 OFT - OSMOTIC FRAGILITY TEST * 150

87 PACKED CELL VOLUME [PCV] 90

88 PARASITIC - INDEX 150

89 PC - PLATELET COUNT 100

90 PCR [POLYMERASE CHAIN REACTION] FOR INV - 16 * 1,930

91 PCR For BCR - ABL GENE * 2,090

92 PERICARDIAL FLUID FOR ANALYSIS 250

93 PERIPHERAL SMEAR FOR OPINION(PBF) 90

94 PH - URINE/FLUID 60

95 PROTEIN - C * 1,280

96 PROTEIN - S * 50 97 PROTEIN C & S, ANTITHROMBIN III *

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 2,470

98 PROTEIN C FUNCTIONAL * 1,610 99 PROTEIN S FUNCTIONAL * 1,500

100 PT - PROTHROMBIN TIME - PLASMA 140

101 RBC COUNT 630 102 RETICULOCYTE COUNT 100

103 SAPIEN MYPLATELET (FUNCTIONAL ONLY)* 2,600

104 SICKLE CELL TEST(SICKLING TEST) 140

105 SPERM WASH 760

106 SPUTUM FOR EOSINOPHILIA 210

107 SUCROSE LYSIS TEST * 230

108 SUDAN BLACK "B" 480

109 TEST FOR UNSTABLE HAEMOGLOBINS * 140

110 TLC 100

111 TLC & DLC 110

112 TOTAL NUCLEATED CELLS 440

113 TT - THROMBIN TIME * 270

114 URINE FOR MYOGLOBIN QUANTITATIVE * 320

115 VON WILLEBRAND ANTIGEN * 4,720 6. HISTOPATHOLOGY INVESTIGATIONS

1 ALK MUTATION - O* 5000

2 BONE MARROW TREPHILE(WITHOUT STAINS) 310

3 C4D IMMUNOFLURORESCENCE(SINGLE ANTIBODY) * 740

4 CYSTOSCOPY 500

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

5 CYTOLOGY FNAC 570

6 CYTOLOGY NON GYANE CYTOLOGY 450

7 CYTOLOGY SYNOVIAL FLUID FOR CRYSTALS 100

8 CYTOLOGY TZANCK SMEAR 450

9 EFGFR, ROS-1, ALK * 10,000

10 EGFR - O* 4,500 11 EGFR MUTATION * 3,600

12 ELECTRON MICROSCOPY 2,600

13 EXCISION WITH WIRE GUIDED LOCALIZATION 1,300 14 EXTRA LARGE SPECIMEN 2,000

15 EXTRA MEDIUM SPECIMEN 950

16 FROZEN SECTION NEUROSURGICAL(SUBSEQUENT 1 SPECI) 180

17 FROZEN SECTION NEUROSURGICAL(SUBSEQUENT 2 SPECI) 380

18 FROZEN SECTION NEUROSURGICAL(SUBSEQUENT 4 SPECI) 750

19 FROZEN SECTION NON NEUROSURGICAL(1ST SPECI) 1,150

20 FROZEN SECTION NON NEUROSURGICAL(1ST SPECI) 1,150 21 FROZEN SECTION NON NEUROSURGICAL(SUB 1 SPECI) 200 22 FROZEN SECTION NON NEUROSURGICAL(SUB 2 SPECI) 400

23 FROZEN SECTION NON NEUROSURGICAL(SUB 3 SPECI) 560 24 FROZEN SECTION NON NEUROSURGICAL(SUB 4 SPECI) 800

25 FROZEN SECTION NON NEUROSURGICAL(SUB 5 SPECI) 950

26 GENE FOR CYSTIC FIBROSIS * 2,400

27 GENE FOR CYSTIC FIBROSIS DELTA 508 * 2,080

28 HER 2 NEU BY FISH * 5,060 29 HER 2 NEU*

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 3,800

30 IMMUNOFLURORENCENCE ON SKIN BIOPSIES * 950

31 IMMUNOFLURORESCENCE (SINGLE ANTIBODY) * 410

32 IMMUNOHISTOCHEMISTRY - HER 2 NEU 780

33 IMMUNOHISTOCHEMISTRY ER/PR 1,800

34 IMMUNOHISTOCHEMISTRY ER/PR/Her 2 neu 2,600

35 IMMUNOHISTOCHEMISTRY(8 MARKER) 5,200

36 IMMUNOHISTOCHEMISTRY(ANTIGEN) 830

37 IMMUNOHISTOCHEMISTRY(LYMPHOMA) 5,100 38 IMMUNOHISTOCHEMISTRY(PANEL) 5000

39 IMMUNOHISTOCHEMISTY(1 MARKER) 950 40 IMMUNOHISTOCHEMISTY(2 MARKER) 2000 41 IMMUNOHISTOCHEMISTY(3 MARKER) 3000

42 IMMUNOHISTOCHEMISTY(4 MARKER) 3,600

43 ISSUE OF SLIDES (1ST SLIDE) 180

44 ISSUE OF SLIDES (SUB 1 SLIDE) 60

45 ISSUE OF SLIDES (SUB 2 SLIDES) 110

46 ISSUE OF SLIDES (SUB 3 SLIDES) 170

47 ISSUE OF SLIDES (SUB 4 SLIDES) 240

48 ISSUE OF SLIDES (SUB 5 SLIDES) 300 49 K-RAS MUTATION * 5000

50 KRASG NRAS - O* 7,000 51 LARGE SPECIMEN BOWEL RESECTION 1400 52 LARGE SPECIMEN BREAST 1400 53 LARGE SPECIMEN BREAST LUMP 1400 LARGE SPECIMEN BREAST LUMP WITH AXILLARY 54 DISSECTIO 1400

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 55 LARGE SPECIMEN BREAST(MASTECTOMY) 1400 56 LARGE SPECIMEN GASTRECTOMY 1400 57 LARGE SPECIMEN HEAD & NECK MALIGNANCIES 1400 58 LARGE SPECIMEN HYSTERECTOMY 1400 59 LARGE SPECIMEN LASER ENUCLEATION OF PROSTATE 1400 60 LARGE SPECIMEN NECK DISSECTIONS 1400 61 LARGE SPECIMEN NEPHRECTOMY 1400 62 LARGE SPECIMEN OTHERS BIOPSIES 1400 63 LARGE SPECIMEN PLACENTA 1400 64 LARGE SPECIMEN PNEUMONECTOMY 1400 65 LARGE SPECIMEN PROSTATECTOMY 1400 66 LARGE SPECIMEN RADICAL CYSTECTOMY 3000 67 LARGE SPECIMEN RADICAL PROSTATECTOMY 3000 68 LARGE SPECIMEN SIMPLE MASTECTOMY 1400 69 LARGE SPECIMEN THYROID 1400 70 LARGE SPECIMEN TUR PROSTATE 1400

71 MEDIUM SPECIMEN APPENDIX 700 72 MEDIUM SPECIMEN BONE 700

73 MEDIUM SPECIMEN BREAST LUMP TISSUE 700

74 MEDIUM SPECIMEN GALL BLADDER 700

75 MEDIUM SPECIMEN LYMPHNODE 700

76 MEDIUM SPECIMEN NEUROSURGICAL TISSUE 700

77 MEDIUM SPECIMEN ORCHIDECTOMY 700

78 MEDIUM SPECIMEN OTHERS BIOPSIES 700

79 MEDIUM SPECIMEN OVARIES 700

80 MEDIUM SPECIMEN PARATHYROID 700

81 MEDIUM SPECIMEN THYROID 700

82 MEDIUM SPECIMEN TUR BLADDER 700

83 MEDIUM SPECIMEN TUR PROSTATE 700

84 MET * 4,600 85 MICRO SETELLITE INSTABILITY(MSI) *

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 4,800

86 NEEDLE BIOPSY BONE MARROW 1,320

87 NEEDLE BIOPSY KIDNEY 1,290

88 NEEDLE BIOPSY KIDNEY WITH I/F * 1,800

89 NEEDLE BIOPSY LIVER 1,290

90 NEEDLE BIOPSY OTHER 1,290

91 NEEDLE BIOPSY PROSTATE 1,380

92 PDL-1 * 2,800

93 PDL-1 DAKO * 13,200

94 REVIEW - IHC MARKER * 3,800

95 REVIEW OF SLIDE(SECOND OPINION MORE THAN 4 SLIDES) 750

96 REVIEW OF SLIDE(SECOND OPINION UP TO 4 SLIDES) 440

97 ROS-1 * 5,000

98 SMALL SPECIMEN BIOPSY TONSILLECTOMY 530

99 SMALL SPECIMEN ENDOMETRIAL CURETTINGS 530

100 SMALL SPECIMEN G.I. ENDOSCOPIC BIOPSIES 530

101 SMALL SPECIMEN HEART VALVE 530

102 SMALL SPECIMEN MUCOSAL BIOPSIES 530 103 SMALL SPECIMEN NASAL BIOPSIES 530

104 SMALL SPECIMEN OTHER BIOPIES 530

105 SMALL SPECIMEN SKIN BIOPSY 530

106 SMALL SPECIMEN VASECTOMY BITS 530

107 T. CELL RECEPTOR GENE. RE-ARRENGEMENT * 5,500

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 7. IMMUNOLOGY INVESTIGATIONS

1 13 DELETION - FISH * 2,620

2 13q- , -13 - FISH * 2,250

3 14-3-3 PROTEIN, CSF * 5,240

4 17P- , -17 - FISH * 2,250

5 22q11 (DEL) - FISH * 2,690

6 7Q DEL BY FISH * 1,730

7 ACETYL CHOLINE RECEPTOR ANTIBODIES * 1,510

8 ALL PANEL * 5,060

9 ALLERGEN - ECZEMA/GIT(NON-VEG & VEG) * 2,400

10 ALLERGEN - ECZEMA/GIT(VEG) * 2,640

11 ALLERGEN - FOOD PANEL(FRUITS 1) * 1,600

12 ALLERGEN - HONEY BEE VENOM * 450

13 ALLERGEN ASPERGILLUS FUMIGATUS * 460

14 ALLERGEN ASTHMA PANEL (INHALENT) - ADULT/CHILD * 3,690

15 ALLERGEN DRUG PANEL * 1,400

16 ALLERGEN MILK * 490

17 ALLERGEN PANEL FLEXI (5 ALLERGEN) * 1,220

18 ALLERGY COMPREHENSIVE PROFILE - ADULT * 4,800

19 ALLERGY PANEL FLEXI-3 (19 ALLERGEN)* 4,580

20 ALLERGY SCREENING FOOD PROFILE - NON VEG PANEL 480

21 ALLERGY SCREENING FOOD PROFILE - VAG PANEL 1 480

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

22 ALLERGY SCREENING FOOD PROFILE - VAG PANEL 2 480

23 ALLERGY SCREENING PROFILE - DUST PANEL 480

24 ALLERGY SCREENING PROFILE - MOLD PANEL 480

25 ALLERGY SCREENING PROFILE - VEG PANEL (1+2) 800

26 ALLERGY SCREENING TEST - PHADIATOP ADULT * 500

27 ALLERGY SCREENING TEST - PHADIATOP INFANT * 500

28 ALLERGY SCREENING TESTS - INHALANT * 900

29 ALPHA -I- ANTI TRYPSIN - GENOTYPE * 2,760

30 ALPHA -I- ANTI TRYPSIN - QUANTITATION * 1,000

31 AML PANEL * 4,830

32 AML1/ETO(AML-M2) T (8:21) - FISH * 2,500

33 AMNIOTIC FLUID CYTOGENETICS * 3,590

34 AMNIOTIC FLUID CYTOGENETICS + FISH [FRIGE AHD] * 6,580

35 AMNIOTIC FLUID CYTOGENETICS FISH * 4,790

36 ANA PROFILE 1,900

37 ANGIOEDEMA PACKAGE * 6,980

38 ANTI BETA 2 GLYCOPROTEIN I * 380

39 ANTI CARDIOLIPIN ANTIBODY IgG 700

40 ANTI CARDIOLIPIN ANTOBODY IgM 700

41 ANTI CCP ANTIBODY 620

42 ANTI CHOLINESTERASE RECEPTOR AB * 1,200

43 ANTI DNASE - B * 490

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

44 ANTI DS-DNA ANTIBODY 620

45 ANTI ENDOMYSIAL ANTIBODY IgA * 1,600

46 ANTI ENDOMYSIAL ANTIBODY IgG * 1,600

47 ANTI GBM ANTIBODIES - SERUM * 710

48 ANTI GLIADIN AB IgA * 770

49 ANTI GLIADIN ANTIBODY IgG * 770

50 ANTI LKM ANTIBODIES * 710 51 ANTI MITOCHONDRIAL ANTIBODY * 1,030

52 ANTI NUCLEAR ANTIBODY(ANA) - SERUM 520

53 ANTI PARIETAL CELL ANTIBODY * 960

54 ANTI PHOSPHOLIPID ANTIBODY IgG * 520

55 ANTI PHOSPHOLIPID ANTIBODY IgM * 520

56 ANTI SACHEROMYCES CEREVCIAE Ab, IgA and IgG * 1,540

57 ANTI SMOOTH MUSCLE ANTIBODY (ASMA) * 1,110

58 ANTI SOLUBLE LIVER ANTIGEN * 880

59 ANTI SS-A BY ELISA * 740

60 ANTI SS-B(LA) BY ELISA * 740

61 ANTI THYROGLOBULIN ANTIBODY * 450

62 ANTI THYROID PEROXIDASE ANTIBODY 520

63 MYCARDIO GENETIC TEST* 1,200

64 AQUA FORIN 4 (NMO AB) * 1,330

65 ARYL SULPHATASE A * 1,920 66 ASO (ANTI STREPTOLYSIN-O) TITRE

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 380

67 AUTO IMMUNE ENCEPHALITIS PANEL * 5,600

68 AUTOIMMUNE LIVER PROFILE(LIVER BLOT) 1,440

69 B THALASSAEMIA COUPLE (COMMON MUTATION) * 2,970

70 B THALASSAEMIA SINGLE (23 MUTATIONS) * 2,970

71 BCR/ABL OR T(9:22) FOR CML, ALL - FISH * 1,380

72 BCR/ABL QUANTITATIVE * 2,580

73 BCR/ABL QUANTITATIVE REAL TIME PCR * 3,730

74 BCR/ABL QULITATIVE * 1,840 BCR/ABL TRANSLOCATION-RT PCR-QUANTITATIVE DABUR 75 * 3,860

76 BETA-2-GLYCOPROTEIN 1-IgG * 500

77 BETA-2-GLYCOPROTEIN 1-IgM * 500

78 BRCA 1 & 2 * 12,000

79 C1 ESTERASE INHIBITOR, PROTEIN QUANTITATION * 960

80 C3 - QUANTITATION 420

81 C4 - QUANTITATION * 340 82 C-ANCA - SERUM 1,240

83 C-ANCA BY IMMUNO-FLUORESENCE METHOD * 440

84 CCND - 1 X t x 3 * 1,880

85 CD34 * 1,280

86 CD55 + CD59 * 2,000

87 CEBPA MUTATION * 1,920

88 CEPHALOSPORIN ALLERGY SENSITIVITY TEST * 240

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

89 CH-50 COMPLEMENT * 450

90 CHIMERISM STUDY * 2,390

91 CHROMOSOME ANALYSIS BLOOD/BONE MARROW * 830

92 CHROMOSOME ANALYSIS FOR FETUS (TISSUE)* 2,880

93 CHRONIC MYELOID LEUKEMIA PCR QUALITATIVE * 1,450

94 CHRONIC MYELOID LEUKEMIA PCR QUANTITATIVE * 2,250

95 CKIT - MUTATION * 3,360

96 CLL PANEL * 4,830

97 CML IMATINIB RESISTANCE MUTATION ANALYSIS * 3,450

98 C-MYC BY FISH * 2,090

99 CRP (C-REACTIVE PROTEIN) 250

100 DESMOGLEIN * 1,200

101 DMD - MUTATION ANALYSIS * 2,390

102 DNA PLUS-PERSONAL GENOME ANALYSIS * 5,160

103 DOUBLE MARKER * 740

104 DSA SCREENING * 1,750

105 DSA TITRE * 16,500

106 DUCHENNE & BECKER MUSCULAR DYSTROPHY BY PCR * 1,980

107 ENA PROFILE * 1,980

108 FANCONIS ANEMIA * 3,290

109 FGFR-2 * 1,440 110 FGFR3/IGH * 1,380 111 FISH FOR E2A *

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 1,680

112 FISH FOR WILLIAM SYNDROME * 2,740

113 FLT3 - BY PCR * 2,450

114 FLT3/ITD ALLELIC RATIO * 2,400

115 FRAGILE X - CHROMOSOME BY PCR * 1,610

116 FRIEDREICH ATAXIA * 2,990

117 GAD ANTIBODY* 861

118 GANGLIOSIDE AB IgG * 1,340

119 GANGLIOSIDE AB IgM * 1,340

120 GATA 2 MUTATION * 12,000

121 GLYCOPHORIN A * 1,130

122 H H MUTATION ANALYSIS * 2,210

123 HAEMOCHROMATOSIS GENETIC STUDY (HFE) * 8,000

124 HEPARIN PF-4 COMPLEX ANTIBODY * 1,320

125 HIGH RESOLUTION - BUCCAL SWAB * 6,300

126 HIGH RESOLUTIONS CHROMOSOME STUDY * 1,730

127 HIGH SENSITIVITY (HS-CRP) * 240

128 HLA - A, B, DR (DNA - PCR) * 3,910

129 HLA - A,B,C BY DNA - PCR * 3,910

130 HLA - A,B,C,DQ,DR(DNA-PCR) * 10,470

131 HLA - A,B,C,DR,DQ * 10,380

132 HLA - ABDR * 11,650 133 HLA - ABDR BY PCR *

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 4,600

134 HLA - ABDR EXTRA DONAR * 5,520

135 HLA - B27 (TRANSPLANT IMMUNOLOGY) * 1,110

136 HLA - C (DNA-PCR) * 1,800

137 HLA - DQ BY PCR * 2,450

138 HLA B - 5701 * 1,600

139 HLA TYPING - A B C DQ DR(HIGH RESOLUTION) * 7,680

140 HLA TYPING - B5 * 3,740

141 HLA TYPING - B51 * 3,740

142 HLA TYPING A B DR (HIGH RESOLUTION) * 6,104

143 HLA TYPING ABDR * 4,800

144 IGE TOTAL 380

145 IgG1 * 4,180

146 IgG2 * 4,180

147 IgG3 * 4,180

148 IgG4 SUB CLASS * 1,840

149 IMMUNOGLOBULIN IgA 650

150 IMMUNOGLOBULIN IgG 650

151 IMMUNOGLOBULIN IgM 650

152 IMMUNOGLOBULIN PROFILE (Ig G,IgM,Ig A) 1,620

153 IMMUNOREACTIVE TRYPSINOGEN LEVEL * 210

154 INSULIN ANTIBODIES * 750 155 INTRINSIC FACTOR ANTIBODY *

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 1,120

156 INVERSION 16 - FISH * 1,930

157 ISLET CELL ANTIBODY * 1,000

158 JAK2 - PANEL * 2,880

159 JAK2 MUTATION * 3,150

160 KARYOTYPING - CORD BLOOD * 1,930

161 LYMPHOCYTE CROSS MATCH-DSA * 3,120

162 LYMPHOCYTE CULTURE FOR KARYOTYPING (COUPLE) * 2,250

163 LYMPHOCYTE SUBSET ANALYSIS(T,B,NK CELLS) * 1,920

164 MAF/IGH * 1,380

165 MAYOTONIC DESTROPHY TYPE II * 4,800

166 MDS PANEL * 3,220

167 MICROARAY FOR CHARCOT MARIT TOOTH * 6,400

168 MLL (AML, ALL) - FISH * 1,380 169 MLL GENE - PCR * 2,470

170 MONOSOMY - 5 - FISH * 1,480

171 MONOSOMY - 7 - FISH * 1,480

172 MPL * 2,880

173 MTHFR MUTATION * 1,840

174 MULTIPLE MYELOMA PANEL * 5,520

175 MULTIPLEX PCR FOR LEUKEMIA * 5,750

176 MYEOV/IGH * 1,380

177 NEURONAL ANTIBODY PROFILE(PARANEOPLASTIC) * 2,400

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

178 NGS-AML PANEL * 12,800

179 NGS LUNG CANCER PANEL * 15,360

180 NGS-MDS PANEL * 12,800

181 NGS-MPN PANEL * 12,800

182 NMDA RECEPTON ANTIBODY * 2,640

183 N-MYC BY FISH * 2,690

184 NPM1* 1,680

185 OI PANEL BY NGS * 12,800

186 P1NP - SERUM * 680

187 P-ANCA - SERUM 1,240

188 P-ANCA BY IMMUNO-FLUORESENCE METHOD * 520

189 PAPPA-PREGNANCY ASSOCIATED PLASMA PROTEIN A * 900

190 PATERNITY TESTING BY DNA * 2,680

191 PCR FOR T(12,21) * 1,920

192 PDGFR - A * 1,680

193 PDGFR - B * 1,680

194 PDGFR GENE STUDY - FISH * 1,380

195 PENICILLIN ALLERGY SENSITIVITY TEST * 200

196 PLATELET FACTOR IV ANTIBODY * 2,160

197 PML/RARA - QUALITATIVE * 2,150

198 PML/RARA - QUANTITATIVE * 2,580

199 PML/RARA (APML) (AML-M3) - FISH * 1,380

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

200 PML/RARA (APML) (AML-M3) * 1,380

201 PRODUCTS OF CONCEPTION - CYTOGENETIC ANALYSIS * 2,250

202 PT 20210 * 3,410

203 QUADRAUPLE MARKER TEST * 1,270

204 RA FACTOR 340

205 RA FACTOR - SYNOVIAL FLUID 340

206 RFC * 1,380

207 SAPIEN MYPLATELET (GENOTYPE & FUNCTIONAL)* 3,480

208 SAPIEN-DATAR CTC DETECTION WITH PHOTOGRAPH* 8,300

209 SAPIEN-DATAR CTC DETECTION* 4,520

210 SAPIEN-DATAR CTC DOWNSTREAM ANALYSIS* 10,500

211 SAPIEN-STRAND CARDIOVASCULAR PANEL* 8,700

212 SAPIEN-STRAND HEREDITARY CANCER PANEL* 9,720

213 SAPIEN-STRAND OPHTHALMOLOGY PANEL* 8,700

214 SAPIEN-STRAND SINGLE MUTATION CONFIRMATION* 2,580

215 SAPIEN-STRAND SOMATIC CANCER-BRIDGE* 8,160 SAPIEN-STRAND SOMATIC CANCER-COMPREHENSIVE ADD- 216 ON* 10,240 SAPIEN-STRAND SOMATIC CANCER-FULL PANEL(48- 217 GENES)* 17,390 SCA - I BY PCR * 218 1,440

219 SCA - II BY PCR * 1,440

220 SCA - PANEL * 6,000

221 SERUM TRYPTASE * 3,600

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

222 SMN * 2,720

223 T(8,21) - PCR * 1,930

224 T(8:14) * 1,860

225 THALASSEMIA MUTATION ANALYSIS * 2,470

226 THIOPURINE METHYL TRANSFERASE (TPMT) * 1,980

227 TISSUE TRANSGLUTAMINASE ANTIBODY 760 228 TPMT * 1,610

229 TRANSLOCATION 11;14 - FISH * 2,250

230 TRIPLE MARKER * 960

231 TRISOMY - 8 - FISH * 1,480

232 TRISOMY 11 - FISH * 1,610

233 TRISOMY 15 - FISH * 1,610

234 TRISOMY 21- FISH * 2,690

235 TRISOMY 7 - FISH * 1,610

236 TRISOMY 9 - FISH * 1,610

237 TSH RECEPTOR AB * 1,600

238 TTG DGP * 800

239 VOLTAGE GATED POTASSIUM CHANNEL(VGKC) * 2,880 240 WILSONS DISEASE(ATP-7B) - BLOOD * 10,970

241 XMN1 - POLYMORPHISM * 1,940

242 XX/XY - CHIMERISM STUDY - FISH * 2,150

243 Y-CHROMOSOME-MICRO DELETION BY PCR * 2,160 8. MICROBIOLOGY INVESTIGATIONS

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

1 ABSOLUTE CD4 - CD8 COUNT * 1,120

2 AFB CULTURE 650

3 AFB CULTURE (U.K.) 420

4 BK VIRUS QUANTITATIVE * 1,680

5 AFB SENSITIVITY(10 drugs) * 3,940

6 AFB SENSITIVITY(5 drugs) * 1,960

7 AFB SMEAR 120

8 AFB SMEAR (U.K.) 50

9 AFB SUSCEPTIBILITY (LEVOFLOXAIN) * 480

10 AFB SUSCEPTIBILITY(AUGMENTIN) * 300

11 AFB SUSCEPTIBILITY(CIPROFLOXACIN) * 1,350 12 AFB SUSCEPTIBILITY(CLARITHROMYCIN) * 1,270

13 AFB SUSCEPTIBILITY(ERYTHROMYCIN) * 300

14 AFB SUSCEPTIBILITY(PROTHIONAMIDE) * 300

15 ALBERT STAIN 100 16 ANTI ECHINIOCOCCUS IgG * 450

17 ANTI HBc ANTIBODY IgM 280

18 ANTI HBs ANTIBODIES * 340

19 ANTI HEV IgM * 340

20 ANTIBODY FOR MEASELES IgM * 340

21 ASPERGILLUS FUMIGALUS (M3) IGE * 600

22 ASPERGILLUS FUMIGALUS DNA DETECTION * 3,210

23 ASPERGILLUS NIGER (M207) IGE * 200

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

24 B. PERTUSSIS * 560

25 BIOFIRE MENINGITIS/ENCHAPHALITIS PANNEL * 7,200

26 BIOFIRE RESPIRATORY PANEL * 7,200

27 BRUCELLA AGGLUTINATION TEST * 300

28 BRUCELLA CFT 800

29 C.DIFFICILE DNA PCR * 1,200

30 C.DIFFICILE TOXIN A & B * 1,490

31 CALPROTECTIN * 600

32 CANDIDA ALBICANS DNA DETECTION * 2,970 33 CD3 COUNT * 1,280

34 CHIKUNGUNIA PCR * 1,440

35 CHLAMYDIA PCR * 1,540

36 COMPYLOBACTER SPECIES CULTURE * 390 37 COXSACKIE ANTIBODIES PANEL IgG AND IgM ANTIBODY 1,260

38 COXSACKIE ANTIBODY IgG * 850

39 COXSACKIE ANTIBODY IgM * 850

40 CRYPTOCOCCUS ANTIGEN * 1,320

41 CULTURE & SENSITIVITY - BLOOD (AEROBIC/ANAEROBIC) 710

42 CULTURE & SENSITIVITY(ANAEROBIC) 660

43 CULTURE & SENSITIVITY(BAL) 480

44 CULTURE & SENSITIVITY(BLOOD) 710

45 CULTURE & SENSITIVITY(C S F) 620

46 CULTURE & SENSITIVITY(CATHETER TIP) 560

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

47 CULTURE & SENSITIVITY(CENTRAL LINE TIP) 480

48 CULTURE & SENSITIVITY(CVP TIP) 480

49 CULTURE & SENSITIVITY(FUNGUS) 760

50 CULTURE & SENSITIVITY(GROIN SWAB) 480

51 CULTURE & SENSITIVITY(ICD TUBE) 480

52 CULTURE & SENSITIVITY(NASAL SWAB) 480

53 CULTURE & SENSITIVITY(PA SHEATH/CATHETER TIP) 480

54 CULTURE & SENSITIVITY(PUS) 480

55 CULTURE & SENSITIVITY(RECTAL SWAB) 480

56 CULTURE & SENSITIVITY(ROUTINE) 480

57 CULTURE & SENSITIVITY(RT ICD) 480

58 CULTURE & SENSITIVITY(SEMEN) 480

59 CULTURE & SENSITIVITY(SPUTUM) 480

60 CULTURE & SENSITIVITY(STOOL) 480

61 CULTURE & SENSITIVITY(SWAB) 480

62 CULTURE & SENSITIVITY(THROAT SWAB) 480

63 CULTURE & SENSITIVITY(TISSUE) 480

64 CULTURE & SENSITIVITY(TRACHEAL SECRETIONS) 480

65 CULTURE & SENSITIVITY(URINE) 440

66 CULTURE & SENSITIVITY(VAGINAL SWAB) 480

67 CULTURE & SENSITIVITY(WOUND SWAB) 480

68 CULTURE FOR BRUCELLA 290

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

69 CULTURE FOR FLUID 570

70 CULTURE FOR H PYLORI * 620 71 CULTURE OF FOOD 120

72 CYSTICERCUS ANTIBODIES IgG * 1,400

73 DENGUE AND CHIKUNGUNIA PCR * 2,400

74 DENGUE ANTIBODY IgG 950

75 DENGUE NS1 ANTIGEN 220

76 DENGUE PCR * 1,440

77 DPT ANTIBODIES * 2,270

78 E HISTOLYTICA ANTIGEN * 1,200

79 EBNA IgG * 3,880

80 EBV - VCA IgM * 900

81 EBV - VCA IgG * 900

82 EBV EARLY ANTIGEN IgG ANTIBODIES * 1,050

83 EBV PANEL * 1,400

84 ECHINOCOCCUS ELISA * 840 85 EPSTEIN BAR VIRUS IgG * 1,210

86 EPSTEIN BAR VIRUS IgM * 1,210

87 FILARIA ANTIGEN * 440

88 GALACTOMENON ANTIGEN(ELISA) * 1,980

89 GENE XPERT (MTB/RIF DETECTION) 800

90 GONORRHEA SCREENING 2,400

91 GRAM STAIN 60

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

92 H PYLORI ANTIGEN FROM STOOL * 400

93 H1N1 PCR * 2,400

94 HBeAg * 200

95 HBsAg QUANTITATIVE * 320

96 HBV DNA QUANTITATIVE * 3,200

97 HBV-DNA QUALITATIVE * 2,250

98 HCV(RAPID) 570

99 HHV-6 * 6,280

100 HIV RNA QUANTITATIVE 3,170

101 HPV DNA * 760

102 HSV ANTIBODY IgM * 180

103 HSV TYPE I - CSF - PCR * 1,470

104 HSV-I & II PCR QUALITATIVE * 2,250

105 HSV-I PCR QUALITATIVE * 1,500

106 HSV-II PCR QUALITATIVE * 1,500

107 HYPHAL FUNGUS SENSITIVITY * 1,440

108 IDENTIFICATION ON MALDI-TOF * 480

109 INDIA INK PREPARATION 100

110 KOH PREPARATION 100

111 LEGIONELLA ANTIGEN FROM URINE * 600

112 LEISHMANIA SPECIES CULTURE * 570

113 LEPTOSPIRA CFT 1,200

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

114 LEPTOSPIRA DETECTION * 290

115 LEPTOSPIRA IgG ANTIBODY * 580

116 LEPTOSPIRA IgM ANTIBODY * 580

117 LPA MTB MDR * 800

118 LPA MTB XDR* 2,400

119 LPA NTM CM* 1,000

120 MENINGOENCEPHALITIS PANEL PCR * 3,710

121 MIC(MINIMUM INHIBITORY CONCENTRATION) 34

122 MTB IDENTIFICATION * 190

123 MYCOBACTERIA SPECIATION * 2,880

124 MYCOBACTERIUM TUBERCULOSIS,PCR * 1,120

125 MYCOPLASMA PNEUMONIAE IgM * 790

126 NEISSERIA GONORRHOEAE DNA PCR * 1,490

127 NEUROTROPIC VIRUS PANEL * 3,120

128 NTM/MOTT PANNEL* 1,440

129 P24 ANTIGEN * 760 130 PANFUNGAL DNA DETECTOR * 1,290

131 PARVOVIRUS B - 19 IgM ANTIBODY * 1,420

132 PARVOVIRUS B19 DNA PCR * 1,320

133 PCR FOR M LEPRAE * 1,490

134 PERTUSSIS IgG * 670

135 PNEUMOBACT PANNEL* 1,400 136 Q FEVER COXIELLA BURNETII IgG *

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 940

137 Q FEVER COXIELLA BURNETII IgM * 940

138 QUANTIFARON GOLD TEST * 1,540

139 R T PCR FOR M TUBERCULOSIS * 1,420

140 RUBELLA IgG * 240

141 RUBELLA IgM * 240

142 RUBELLA PCR * 980

143 SEROLOGY FOR EBV VIRUS 520

144 SINGLE DRUG SENSITIVITY * 700

145 SKIN SLIT SMEAR 170 146 SMEAR FOR FUNGUS 150

147 Executive CULTURE* 800

148 SPUTUM AND FLUIDS AFB SMEAR - FLOURESCENCE * 140

149 STAINING FOR PNEUMOCYSTIS CARINII 160

150 SYPHILLIS IgM * 420

151 TB DRUG 1* 400

152 TB DRUG 10 * 4,000

153 TB DRUG 5 (1ST LINE)* 2,000

154 TB GOLD - O* 1,250

155 TETANUS TOXOID - IgG ANTIBODIES * 960

156 TOXOPLASMA PCR * 1,290

157 TPHA 530

158 URINE PREGNANCY TEST 160

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 159 VARICELLA ZOSTER IgG * 640

160 VARICELLA ZOSTER IgM * 640 161 VARICELLA(CHICKEN POX) IgG * 600

162 VARICELLA(CHICKEN POX) IgM * 600

163 WET PREPARATION 30

164 YEAST IDENTIFICATION 410

165 YEAST SUSCEPTIBILITY 420

166 YERSINIA CULTURE * 900 9. SEROLOGY INVESTIGATIONS

1 ADENOVIRUS IgG 760

2 ADENOVIRUS IgM 760

3 ADENOVIRUS PCR 2,300

4 AMOEBIC SEROLOGY 830

5 ANTI HAV IgM ANTIBODY * 660

6 ANTI HAV TOTAL (IgG+IgM) ANTIBODY * 250

7 ANTI HBc ANTIBODIES TOTAL 310

8 ANTI HBC IgG* 820

9 ANTI HBe ANTIBODIES * 240

10 ANTI HCV IgG 830

11 ANTI HEPATITIS Be ANTIBODY 410

12 ANTI HSV IgG (CSF) 190

13 ANTI HSV IgG (SERUM) 190

14 ANTI HSV IgM (CSF) 190

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

15 ANTI HSV IgM (SERUM) 190

16 ANTIBODY FOR MEASELES IgG 370

17 ANTIBODY FOR MUMPS IGG 1,160

18 ANTIBODY FOR MUMPS IGM 1,160

19 ASPERGILLUS IgG 440

20 ASPERGILLUS IgM 440

21 BRUCELLA - IgG ANTIBODY * 340 22 BRUCELLA - IgM ANTIBODY * 410

23 CHALAMYDIA TRACHOMATIS ANTIBODIES 2,100

24 CHIKUNGUNIA (IgM) 1,730

25 CHLAMYDIA TRACHOMATIS IgM ANTIBODIES 1,160

26 CMV ANTIBODY [IgG]* 480 27 CMV ANTIBODY [IgM]* 420

28 CMV DNA QUANTITATIVE * 2000

29 CMV PCR QUALITATIVE * 2,250

30 CMV VIRAL LOAD 6,450

31 COLD AGGLUTINATION TEST 140

32 CYSTICERCOSIS IgG ANTIBODIES 830

33 DENGUE ANTIBODIES - IgG 870

34 DENGUE ANTIBODIES -IGM 870

35 EBV QUANTITATIVE * 1,920

36 ELISA FOR TUBERCULOSIS (IgA) 300

37 ELISA FOR TUBERCULOSIS [IgG] 820

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

38 ELISA FOR TUBERCULOSIS[IgM] 820

39 EPSTEIN - BARR VIRUS DNA PCR * 980 40 GALACTOMENON ANTIGEN 760

41 H PYLORI ANTIGEN * 530

42 H1N1 PCR - CIVIL * -

43 HANTA VIRUS - IgM ANTIBODIES 660 44 HBe ANTIGEN DETECTION 410

45 HBsAg 240

46 HBsAg(RAPID) 440

47 HBsAg[CONFIRMATION & QUANTIFICATION] 360

48 HELICOBACTOR PYLORI (IgG) * 1,080

49 HEPATITIS B VIRUS GENOTYPING * 3,220 50 HEPATITIS C VIRAL RNA GENOTYPING * 3,200

51 HEPATITIS C VIRUS ANTIBODIES 440

52 HEPATITIS C VIRUS RNA QUALITATIVE * 2,250

53 HEPATITIS C VIRUS QUANTITATIVE 3,200

54 HEPATITIS D VIRUS 1,570

55 HEPATITIS D VIRUS IgM 470

56 HEPATITIS E IgG 750

57 HEPATITS C VIRUS RNA QUANTITATIVE * 4,560

58 HERPES SIMPLEX VIRUS DNA PCR 1,920

59 HIV -2 SPECIFIC WESTERN BLOT TEST* 910

60 HIV ANTIBODIES(RAPID) 440 61 HIV DNA QUALITATIVE

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR 1,490

62 HIV GENOTYPING AND DRUG RESISTANCE TEST 13,210

63 HIV I & II ANTI BODIES 440

64 HIV QUANTITATIVE + CD4,CD8 2,720

65 HPV - DNA - DETECTOR * 1,090

66 HTLV I & II ANTIBODIES * 1,880

67 INFLUNZA A AND B IgG ANTIBODY 1,500

68 INFLUNZA A AND B IgM ANTIBODY 1,500

69 JAPANESE ENCEPHALITIS VIRUS IgM ANTIBODIES * 480

70 JAPANESE ENCEPHALITIS VIRUS RNA PCR 1,240

71 JC/BK DNA PCR 2,680

72 LD BODIES DETECTION 600

73 LEISHMANIA ANTIBODY IgG 940

74 LEPTOSPIRA SEROLOGY 750

75 LYME DISEASE IgG & IgM 1,920

76 LYME DISEASE IgM 960

77 RABIES ANTIBODIES * 2,880

78 RAPID PLASMA REAGIN(RPR) TEST 80

79 SCRUB TYPHUS IgM * 720

80 SEROLOGY FOR RICKETTSIA 620 81 TORCH COMPLEX (IGg) * 1,210

82 TORCH COMPLEX (IgM) * 1,210

83 TOXOPLASMA IgG 410

SVPIMSR –Schedule of Charges (SOC)

Ser. Code Particulars Tariff in INR

84 TOXOPLASMA IGM 410

85 Typhoid - IgG 140

86 TYPHOID IgM 170

87 VARICELLA ZOSTER PCR * 1,300

88 WESTERN BLOT FOR HIV 1,730

89 WIDAL TEST 130

90 YERSINIA ENTEROCOLITICA IgG 1,290

91 YERSINIA ENTEROCOLITICA IgM 1,290

6. Appendix C – Surgery Categorization (Supra-Major, Major, Minor)

Classification TYPE A Minor B Major C Supra Major

Particulars Categorization Adenoidectomy A Antral Puncture Bilateral A Bilateral antrum Puncture A Styloidectomy B Bilateral Trans. Antral Ethmoidectomy B Bronchoscope Rigid Foreign body removal A Choanal Atresia Recanalisation A Commando's B Cortical Mastoidectomy, Modified Radical B Direct Laryngoscope A Direct Laryngoscope with Biopsy A Endolymphatic Sac Decompression A Excision Pharyngeal Diverticulum B Excisions Angiofibroma B Facial Nerve Decompression B FESS B

SVPIMSR –Schedule of Charges (SOC)

FESS Bilateral C Foreign Body Removal Ear A Fracture Setting Nasal Bone B Glomusjugulare Tumor B Hemi glossectomy B Hemi glossectomy with radical neckdesection C Hernia Laryngectomy C Hypopharyngoscopy Exam A Laryngectomy with block dissection C Larynogofissure B Mastoidectomy with Tympanoplasty B Micro Laryngeal Surgery B Modified Radical Mastoidectomy B Myringoplasty B Myringotomy A Nasal Cautery under GA A Nasal Packing Ant. A Nasal Packing Post. A Obliteration A Oesophagoscopy rigid foreign body removal B Oroantral fistula repair B Ossiculaplasty B Ossiculoplasty with Prosthesis B Partial Glossectomy B Partial Maxillectomy B Peritonsillar Abscess Drainage with Anesthesia B Peritonsillar Abscess Drainage without Anesthesia A Radical Mastectomy C Radical neckdesection C Retro -Pharyngeal Abscess Dranage B Rhinotomy B Septoplasty B Stapedectomy B Submucous Diathermy A Supragloltie Laryngectomy B Surgery for Parapharyngeal Abscess B Thyroplasty B Total Laryngectomy C Total Maxillectomy C Tracheal Reconstruction C Tracheotomy A Unilateral antrum Puncture A Nasal Sphenoidal Vessel Ligation Coagulation A Carbon Dioxide Laser use A Cervical Lymphnode bipsy - Multiple B Cervical Lymphnode bipsy - Single A

SVPIMSR –Schedule of Charges (SOC)

CSF Otorrhoea Repair B Endoscopic CSF Repair B Endoscopic DCR B Endoscopic Hypophysectomy B Hemithyroidectomy C Nasal Endoscopy B Oesophagoscopy Dilataion A Parotidectomy - Superficial B Redical Mastodiectomy C Rhinoplasty B Submand - Duct Stone Removal under GA A Submandibular Gland Excision B Thyroglossal Cyst Excision B Tonsillectomy A Total Parotidectomy B Total Thyroidectomy C Tympanoplasty B Coblator Use A Catheterisation A Cervical Sympathectomy B Chest Drainage A Corn Excision A Dressing A Ex. Large Superficial Tumour B Ex. Small Superficial Tumour A Excision Branchial Cyst/ Fistula A Excision Diabetic Carbuncle A Excision of Multiple Scrotal Sabeaceous Cyst A Excision of Pilonidal Sinus A Hirschsprung, Resection C Incision and Drainage of Abscess A Ingrowing Toe Nail A Inguinal Herniotomy A Intussusception B Lump in Breast - Excision B Lymph Node Biopsy A Paracentesis A Parathyroidectomy C Pyloromyotomy B Removal of Submandibular Duct Calculus B Repair Torn Ear Lobule Each A Submandibular salivary gland exxcision B Submucous Cyst Excision A Subtotal Thyroidectomy C Superficial Parotidectomy C Suprapubic Drainage A

SVPIMSR –Schedule of Charges (SOC)

Suture of Large/ Multiple Laceration B Suture of Small Laceration A Thyroid Lobectomy B Total Parotidectomy C Varicose Vein B Port Implantation A Multiple Incision & Drainage B Exploratory Laparotomy / Laparoscopy

Exploratory Laparotomy B Diagnostic Laparoscopy B Diagnostic Laparoscopy & Biopsy B Laparoscopic LN biopsy B Laparoscopy and drainage of abscess B Laparotomy and drainage of collection / Abscess B Laparotomy for intestinal obstruction B Laparotomy for perforative peritonitis C Laparotomy for Trauma - Complex C Laparotomy for Trauma - Minor B Lymphnode (LN) Biopsy from Abdomen B Umbilectomy B Retroperitoneal tumour excision C Esophageal Operations: Cardiomyotomy laparoscopic B Cardiomyotomy open B Colonic Transposition C Diverticulectomy open/ laparoscopic B Fundoplication Nissen's laparoscopic B Fundoplication Nissen's Open B Leiomyoma enucleation open/laparoscopic B Three Stage esophagogastrectomy C Transhiatal esophagectomy B Transthoracic esophagectomy B Gastric operations: Antrectomy B Dielafoy Bleed Suture B Duodenal perforation repair C Duodenojejunostomy C Feeding Gastrostomy A Gastric Perforation repair B Gastrojejunosomy (Pouch) B Gastrojejunostoy (Loop) B Gastrojejunostoy (Roux-en-Y) C Lap. Gastrectomy B Lap. GJ + Lap. TV C Post ERCP Bleeding management B Pyloroplasty B

SVPIMSR –Schedule of Charges (SOC)

Subtotal gastrectomy B Total gastrectomy C Truncal Vagotomy B Wedge resection of stomach C Small Intestinal and Colonic Surgeries: Abdomino Perineal Resection C Adhesiolysis Major C Adhesiolysis Minor B Appendicectomy - Laparoscopic B Appendicectomy - Lump / Abscess / Perforation B Appendicectomy - Open B Band release B Completion proctectomy with Ileo-anal pouch with ileostomy C Completion proctectomy with ileostomy C Extended Right Hemicolectomy C Feeding jejeunostomy C High Anterior resection C Ileostomy / Jejunostomy / Colostomy B Ileostomy / jejunostomy / Colostomy closure B Lap. Adhesiolysis Major C Lap. Adhesiolysis Minor B Lap. APR C Lap. Assisted Enteroscopy B Lap. Assisted Hemicolectomy C Lap. Assisted Ileocaecal Resection C Lap. Assisted Int. Resection, Anastomosis C Lap. Closure of Intestinal Perforation B Lap. Feeding Jejunostomy C Left hemicolectomy C Low Anterior resection with covering stoma C Meckel's Diverticulectomy B Mesenteric cyst excision B Mesenteric lymphnode biopsy B Mesenteric tear repair B Omentectomy B Operation for Hirschsprung's Disease B Rectal Prolapse - Delorm's Repair B Rectal Prolapse - Rectopexy - Laparoscopy B Rectal Prolapse - Rectopexy - Open B Resection and Anastomosis B Resection and Anastomosis - Stappled B Resection rectopexy B Right Hemicolectomy C Segmental colonic resection anastomosis C Segmental colonic resection anastomosis with covering stoma C

SVPIMSR –Schedule of Charges (SOC)

Stricturoplasy B Subtotal colectomy with ileostomy and Hartman's C Total proctocolectomy with ileo-anal pouch with ileostomy C Total proctocolectomy with ileostomy C Ultra-low anterior anastomosis with covering stoma B Perianal Surgery: Anal Papilla / Sentinel Piles - Excision A Fissurectomy A Fistula in ano - High A Fistula in ano - Low A Haemorrhoidectomy A Haemorrhoidectomy - MIPH A Haemorrhoids -Band Ligation of Piles / Injection Sclerotherapy A

Lateral Anal Sphincterotomy A Liver Surgeries: extended left hepatectomy B Extended right hepatectomy B Hydatid cyst cysto-pericystectomy B Hydatid cyst partial cystectomy B Lap. Hydatid cyst surgery B Lap. Liver Abscess Drainage B Left hepatectomy B Left Lateral segmentectomy B Liver Biopsy B Liver Trauma - Complex C Liver Trauma - Minor B Non-anatomical resection C Radical cholecystectomy C Right Anterior sectorectomy C Right hepatectomy C Right posterior sectorectomy C Segmental resection C Biliary Surgeries: Cholecystectomy B Cholecystectomy - Complex / Empyema / Gangrenous C Cholecystectomy - Complex / Empyema / Gangrenous -Lap. C Cholecystectomy - Laparoscopic B Cholecystectomy with CBD excision and Hepatico-jejunostomy C Cholecystectomy with CBD exploration B Cholecysto-jejunostomy B Choledochal cyst excision B Choledocho-duodenostomy B Hepatico-jejunostomy B Pancreatic Surgeries: Ampullectomy B

SVPIMSR –Schedule of Charges (SOC)

Coeliac Plexus block B Cystoenterostomy B Distal Pancreatectomy C Distal pancreatectomy and splenectomy C Duodenum preserving pancreatic head resection (DPPHR) C Enucleation of pancreatic tumor C Exteneded Whipple's operation (vessel resection, and LN C clearance) External drainage of the cyst B Frey's operation C Lap. Cystogastrostomy C Lap. Pancreatico Jejunostomy C Median pancreatectomy C Necrosectomy C Palliative Bypass for Ca Pancreas C Pancreas preserving duodenectomy C Pancreatic Abscess drainage B Pancreatico-jejunostomy C Pseudoaneuryasms of Visceral artery operations C Pylorus preserving pancreatico duodenectomy C Total pancreatectomy C Whipple's operation C Surgeries for spleen & Portal Hypertension: Devascularisation, Transection and Anastomosis C Distal Spleno-renal shunt C Meso-caval shunt C Porto-caval shunt C Splectomy with Proximal Spleno-renal Shunt C Spleenectomy - Laparoscopic B Spleenectomy - Open B Splenectomy and Devascularization B Hernia Surgery: Diaphragmatic Hernia Repair B Hernia Repair - Epigastric B Hernia Repair - Epigastric - Mesh B Hernia Repair - Epigastric / Umbilical / Incisional - Large - B Laparoscopic Hernia Repair - Epigastric / Umbilical / Incisional - Small - B Laparoscopic Hernia Repair - Incisional with Mesh B Hernia Repair - Incisional with Mesh - Complex / Huge / Multiple C

Hernia Repair - Inguinal - Laparoscopic TEP/ TAPP B Hernia Repair - Inguinal - Open B Hernia Repair - Rare / Other with mesh C Hernia Repair - Umbilical B

SVPIMSR –Schedule of Charges (SOC)

Hernia Repair - Umbilical - Mesh B Mesh Removal B Strangulated hernia repair B Other Surgery: Video Assisted Thoratoscopic Surgery C (Vats)

Particulars

Abdominal Hysterectomy B Abdominal Myomectomy B Abdominal Operation for Stress Incontinece of urine B Amnio infusion B Amniocenteris A Anterior and Posterior Vaginal Repair C Anterior Colporrhaphy A Biopsy of Cervix A Caesarian Delivery B Caesarian Hysterectomy B Cervical Cerclage (Shirodkar Stitch) A Cystcole or Rectocele repair with mesh B Colpotomy and Needling USG guided A Complex/ High Risk Hysterectomy (TAH + BSO) C Cone biopsy of Cervix A Cryocautery of Cervix A CTG Monitoring A Diagnostic Laparoscopy with/ Without Chromotubation A Diathermy Cauterisation of Cervix A Dilation & Curettage A Drainage of Abdominal Wall Haematoma B Drainage of vulval Hematome A Evacuation of uterus A Evacuation of Uterus (ERPC) Evacuation of retained products of A conception Examination under General Anaesthetic ( EUA) A Excision of Labial Cyst A Excision of Urethral Caruncle A Excision of Vaginal Septum A Exploratory Laparotomy B Fenton's Operation for Reconstruction of Vagina Plastic C operation First Trimester MTP A First Trimester MTP Plus Sterilisation A Foreign Body Removal from Vagina A

SVPIMSR –Schedule of Charges (SOC)

Fractional Curettage A Gilliam's Ventrosupension A Hydrotubation A Hysterosalpyngography A Hysteroscopic dissection of Uterine Synechiae --Mild A Hysteroscopic dissection of Uterine Synechiae --Severe B Hysteroscopic Myomectomy A Hysteroscopic Polypectomy A Hysteroscopic Removal of IUCD A Hysteroscopic Resection of Uterine Septum A Hysteroscopy ± D&C A Hysterotomy B Hysterotomy with tubal Ligation B Incision of Hymen A Instrumental Delivery A Lap. / Vaginal Adhesiolysis A Laparoscoic Multiple Ovarian Puncture/ Drilling + Tubal Testing B

Laparoscopic Ablation of Endowetriotic Spots B Laparoscopic Adhesiolysis B Laparoscopic Aspiration of Cyst B Laparoscopic biopsy B Laparoscopic Burch B Laparoscopic Enrocele Repair B Laparoscopic Fimbriolysis B Laparoscopic Myomectomy B Laparoscopic Oophorectomy B Laparoscopic Ovarian Cystectomy B Laparoscopic Ovarioplasty B Laparoscopic Procedure for Ectopic Pregnancy B Laparoscopic removal of Lost IUCD B Laparoscopic Salpyngostomy B Laparoscopic Salpynogo Oophorectomy B Laparoscopic Sterlisation B Laparoscopic Tuboplasty B Laparoscopic Vault Suspension B Laparoscopically Assisted Vaginal Hysterectomy C Laparoscopy & Hysteroscopy B Laparotomy for Ectopic Pregnancy C Large loop Excision of Transformation Zone B Le Forte's Operation for Genital Prolapse B

SVPIMSR –Schedule of Charges (SOC)

LSCS High Risk B Manchester Repair (Fothergill Operation) B Manual Removal of Placenta A Marsuplialisation of Bartholin abcess A Mc indoe's operation for Reconstruction of Vagina B MTP High Risk B Multiple Pregnancy Reduction (MFPR) B High Risk Vaginal Delivery B Non Descent Vag. Hyst. Simple A Normal Delivery A Ovarian Cystectomy B Ovariotomy(Oophorectomy for benign Ovarian Tumour) B Pan Hysterectomy for Endometriosis B Plastic Repair of Uterus B Polypectomy A Posterior Colpoperineorrhaphy A Radical Hysterectomy for Carcinoma of Body of Ulterus C Radical Hysterectomy Plus Omentectomy for Ovarian Malignacy C

Radical Vulvectomy C Removal of Bartholin Cyst A Removal of simple valval tumour B Repair of Perineal Tear, Old Second Degree A Repair of Perineal Tear, Old Third Degree B Repair of perineal tear, Post -coital or Traumatic A Repair of Recto-Vaginal Fistula B Repari of Vesico Vaginal Fistula B Salpyngo Oophorectomy B Second Trimester MTP B Simple Vulvectomy A Sling Operation for Urinary Stress Incontinence B Subtotal hysterectomy B Three Swabs Test ( For Vaginal Fistulae) A Trachelorrhaphy A Tran -Cervical Resection of Endometrium (TCRE) A Tubal Insufflation A Tubal Ligation A Tuboplasty Micro Surgery A Tuboplasty, Macro Surgery B Vag. Hyst. with Cystocole with rectocele repair B Vaginal Bilateral Salpingectomy B

SVPIMSR –Schedule of Charges (SOC)

Vaginal Bilateral Salpingo- Oophorectomy B Vaginal Biopsy A Vaginal Myomectomy A Vaginal Operation for Stress Incontinence of Urine / TVT Tape B insertion Vaginal Ovarian Cystectomy A Vault Repair B Vulval Biopsy A Wedge Resection of Ovaries B Wertheims's Hysterectomy B Total Laproscopic Hysterectomy B Vaginal Hysterectomy with cystocole Repair with mesh & B Colpoperrinoraphy Bilateral Internal Iliac Ligation & Ovarian Artery Ligation & Repair B of Uterine Rapture & Brand Ligament Haematoma Ligation

Abdominal Perineal Resection (Apr) C Adrenalectomy C All Type Of Pancreticoduodenectomy C Amputation Above Knee (Ak) B Amputation Below Elbow B Amputation Below Knee (Bk) B Amputation Mid Arm B Amputation Symes B Angle To Angle Mandibulectomy C Anterior Pelvic Exenteration C Anterior Resection (Sigmoid Colectomy) C Axillary Dissection C Bilateral Adrenalectomy C Bilateral Mnd C Bilateral Partial Maxillectomy C Bilateral Rnd C Bilateral Sohnd C Bilateral Total Maxillectomy C Breast Conservation Surgery B Bronchscopy A Choleysto Ieiunostomy (Cj)-Gj-Jj C Colon (Rt. Hemicolectomy, Lt. Hemicolectomy) C Colostomy B Colostomy Clsoure A Deltopectoral Flap C Direct Laryngeal Biopsy (Dlb) A

SVPIMSR –Schedule of Charges (SOC)

Direct Larynoscopic Examination (Dle) A Distal Mandibulectomy B Esophageal Replacement By Colon C Esophagoscopy A Esophagus Left Thoraco Abdominal C Esophagus Trans Hiatal C Examination Under Anaesthesia (Eua) A Excision Of Primary + Neck Dissection B Excision Of Primary + Neck Dissection + Mandibulectomy C

Extended Hemi Mandibulectomy C Feeding Iejunostomy B Fine Needle Aspiratin Cytology (Fnac) A Flexible Laryngoscopis Examination A Forehead Flap B Free Fibula B Free Jejunum B Free Rectus Abdominis B Full Thickness Grafting (Ftg) B Gastro Jejunostomy B Gastro Jejunostomy,Jejuno Jejunostomy(Jj) B Hapatico Jej. Unestomy B Hemi Mandibulectomy B Hemithyrodectomy C Hepaticd Jejunostomy C High Inguinal Orchiectomy B Hip Disariticulation B Hopkins Telescopic Examination A Ivor Lewis B Lap. Anterior Resection C Lap. Apr C Lap. Esophagectomy C Lap. Gasterctomy C Lap. Spleenectomy (Spl) B Large Retroperitoneal Tumer Resection C Laryngopharyngotomy + Gastric Pullup C Latissimus Dorsi Flap C Left Thorachoabdominal Oesophagogatrectomy C Limb Preservation Surgery C Liver Biopsy A Lobectomy (Lung) C

SVPIMSR –Schedule of Charges (SOC)

Local Rotation Flaps B Low Anterior Resection C Lower Partial Maxillectomy B Lumpectomy B Major Liver Resection C Mandible Swing C Marginal Mandibulectomy C Massive Intestinal Resection C Mediastinal Mass Excision C Medical Maxillexctomy B Micro Dochectomy B Minor Liver Resection B Modified Neck Dissection (Mnd) C Modified Radical Mastectomy (Mrm) C Mrm/Rm With Split Thickness Graft(Stg) B Near Total Thyroidectomy C Needle Biopsy A Orbital Exenteration B Parotidectomy With Rnd C Partial / Near Total Laryngectomy C Partial Amputation Of Penis B Partial Gasterctomy B Partial Nephrectomy B Pectorails Major Myocutaneous Flap C Pelvic Exenteration C Penectomy With Bilateral Groin Dissection C Pneumonectomy C Posterior Pelvic Exenteration C Punch Biopsy A Pylorus Preserving Pancretico Duodenectomy C Radial Forearm Free Flap C Radical Cholecystectomy C Radical Excision For Cholangiocarcinorna C Radical Mastectomy (Rm) C Radical Maxillectomy C Radical Neck Dissection (Rnd) C Radical Nephrectomy C Radical Prostatectomy C Radical Total Parotidectomy C Rectus Abdominis Flap C Resection Anastomosis C

SVPIMSR –Schedule of Charges (SOC)

Retroperitoneal Lymph Node Dissection (Rplnd) C Retroperitoneal Mass Excision B Scalp Flap B Segmental Mandibulectomy C Shoulder Disarticulation C Splenectomy B Split Thickness Grafting (Stg) B Superficial Parotidectomy B Superior Mediastinal Dissection C Supra Omohyoid Nd C Suprahyoid Node Desction (Ind) B Suspension Laryngoscopy A Tah + Bso C Thoraco/Lap. Oesophagogastrectomy C Thoracotomy C Three Stage Esophagectomy C Total Abdominal Hysterectomy (Tah) C Total Amputation Of Penis B Total Cystectomy With Ileal Conduit Or Other Diversions C Total Cystectomy With Uretero Sigmoidostomy C Total Gasterctomy C Total Glossectomy C Total Laryngectomy C Total Laryngectomy With Rnd C Total Laryngo Pharyngo Oesophagectomy With Stmach Pullup C

Total Maxillectomy C Total Pancreatectomy C Total Parotidectomy Nerve Sparing C Total Thyroidectomy With Radical Neck Dissection (Rnd) C

Tracheostomy A Trans Abdominal Hysterectomy (Tah) + Bilateral Salpingo C Oophorectomy (Bso) + Omentectomy Trans-Hiatal Esophagectomy C Transthoracic Esophagectomy C Transthoracic Oesophagogatrectomy C Transverse Colectomy B Trapezius Flap C Triple Endoscopy B Vulvectomy B Vulvectomy With Groin Dissection B

SVPIMSR –Schedule of Charges (SOC)

Wertheim'S C Whipple'S Pancreaticodudenectomy C Wide Excision Base Tongue B Wide Excision Bm B Wide Excision Of Lip B Wide Excision Of Tongue (Partial,Hemi,Anterior) B Wide Excision Primary Of Palate B Wide Excision Upper Aiveolectomy B Axillary Clearance C Bilateral Orchidectomy B Bronchoscopic Lazerisation Of Tracheobronchial Tumour C

Carotid Body Tumour With Shunt C Conservative For Ca Larynx C Cranio Facial Resection C Direct Micro Laryngoscopy A Disarticulation Of Hip / Shoulder C Excision Of Large Fibroadenomas B Excision Of Pelvic Sarcoma C Excision Of Scrotal Mass B Excision Of Small Fibroadenoma A Excision Of Tumour Palate B Gastrostomy / Jejunostomy / Colostomy B Hemipelvectomy C Ileoinguinal Block Dissection B Lumpectomy With Axillary Clearance C Omentectomy With Panhysterectomy + Lymphadenctomy For Ca C Ovary Parathyroidectomy C Primary Recons Breast Implant C Radical Cystectomy With Conduit C Radical Surgery For Cancer Body Uterus C Radical Surgery For Cancer Cervix C Relook Surgery For Ca Ovary C Segment Three Bypass C Segmental Mastectomy With Axillary Clearence C Sentinel Node Biopsy B Sigmoidoscopic Laserisation Of Anorectal Tumours C Simple Mastectomy B Staging Laproscopy For Hodgkin B Thymectomy B

SVPIMSR –Schedule of Charges (SOC)

Total Vaginectomy B Wide Compartmental Excision Of Big Sts B Hickman Catheter Insertion A Chemo Port Removal A Amputation multiple toes A Amputation toe A Bony mass excision A Calcaneum Pin Elevation & POP A Calcaneum Plating B Cc screw fixation foot B Clw Suturing A Debridement- Major B Debridement- Minor A Flap repair B Flap Surgery B Foot K wiring A Hallux Valgas Surgery A I & D large A I & D Small A Ingrowing nail partial excision A Ingrowing nail total excision A Jones fracture fixation A Jones procedure A Lis franc dislocation CRIF B Lis franc dislocation k wirinf A Mallet Toe Surgery A Multiple wound repair B Paronychia A Reimplantation of toes B Steindler release A Synovial biopsy [P] A Talus-CC Screw Fixation B Tendone repair B Tendone transfer B Tumor excision foot large B Tumor excision foot medium A Tumor excision foot small A Tumour Excision - Large B Tumour Excision - Small A ACL reconstruction [P] B Arthroscopic lavage [P] A

SVPIMSR –Schedule of Charges (SOC)

Bony tumor excision knee - large B Bony tumor excision knee - medium B Bony tumor excision knee - small A CP surgery large B CP surgery medium B CP surgery small A Debridement- arthroscopic [P] A Diagnostic arthroscopy [P] A HTO HTO Bilateral B I & D knee A I/A Injection A I/A injection and manipulation A Knee _ K wiring A Knee adhesionolysis arthroscopic A Knee adhesionolysis Open A Knee arthrodesis B Knee arthrotomy A Knee Biopsy A Knee CC screw fixation A Knee clw suturing A Knee staple fixation A Manipulation under Anaesthesia A MB Cyst removal B Menisci repair B Menisectomy partial [P] A Multiple CLW suturing B Muscle repair B Nerve repair B Open synovectomy B PCL reconstruction [P] B Polio surgery large B Polio surgery medium B Polio surgery small A Q Plasty Arthroscopic B Q plasty open B Removal of knee implants B Removal of loose bodies arthroscopic B Skin grafting large B Skin Grafting medium B Skin Grafting small A

SVPIMSR –Schedule of Charges (SOC)

Soft tissue tumor excision knee- large B Soft tissue tumor excision knee- medium B Soft tissue tumor excision knee- small A Suturing medium wounds A Suturing large wounds B Suturing small wounds A Synovectomy B Synovial biopsy arthroscopic A Synovial biopsy open A Tumor excision knee B Vascular repair knee C Ankle arthrodesis B Ankle plating B BG Both Bones B BG Tibia B Calcaneam ORIF B Calcaneum CRIF B Calcaneum reduction and plaster A Calcaneum St pin plaster A CC Screws Upper tibia B Corrective osteotomy and fixation B CRIF Ankle B Crif both bones B Crif fibula B Crif tibia B Double plating tibia B Ender nailing Both bones B Ender nailing lower tibia B Ender nailing tibia B Ex Fixation Ankle B Ex Fixation tibia B Fibular graft harvesting B Fibular osteotomy B Fibulectomy B Large I & D B Liss tibia B Lower tibia ORIF B Lower tibia Plating B Medium I & D A Multiple suturing CLWs B ORIF Ankle B

SVPIMSR –Schedule of Charges (SOC)

Orif Both Bones B ORIF upper tibia B Pantalar fusion B Plating upper tibia B Reduction and cast Leg A Reduction and k wiring A Reduction and pin plaster A Skin grafting large B Skin Grafting medium A Skin grafting small A Small I & D A Square nailing fibula B Sub talar fusion B TA Lengthening B TA reconstruction B TA repair B Talectomy B Talus CC screw fixation A Talus CRIF B Talus K wiring A Talus ORIF B TBW ankle B TBW medial malleolus B Ten nailing Both bones B TEN nailing Fibula B TEN nailing Tibia B Tendone repair A Tibia Ilizarov B Tibia lengthening C Trimalleolar fixation B Triple fusion C Above knee amputation B ABP distal femur B ABP for proximal femur B Acetabulam screw fixation B AFN B AFN for proximal femoral fractures B AMP hemi arthroplasty B Amputation stump closure A Ant + post Acetabular fixation B Ant acetabular plating C

SVPIMSR –Schedule of Charges (SOC)

Arthroscopic cruciate lig. Reconstruction [P] B Arthroscopic removal of loose /foreign body [P] A ASR hip B Below knee amputation B Bipolar hemi arthroplasty B Bone grafting femur B Boyd amputation B Bridging ext. fixation B Burgess amputation B CBP distal femur B CC screw distal femur B CC screw for neck femur B CD and BG B Chopart amputation B Close il nailing for femur B Core decompression B/L B Core decompression unilateral B CRIF femur B DCS distal femur B DCS for Proximal femur B DFN B DHS B DHS + CC Screw fixation B DHS + TSP B Ender nailing for I/T B Ender nailing for S/T B Ex Fixation Femur B Femoral Osteotomy and fixation B Femur plating B Femur plating + BG B Girdle stone arthroplasty C Guillotine amputaion C Hind quarter amputation C Hip Arthotomy B Hip Arthrodesis C Hip disarticualtion C Hip manipulation A Hip society screw insertion B I&D Femur A IMSC femur B K wiring femur B

SVPIMSR –Schedule of Charges (SOC)

Knee disarticulation B LISS distal femur B LISS proximal femur B Llizarov fixation for femur B ORIF femur B Patella Pole Excision B Patella Screw fixation B Patella TBW B Patellactomy B Pelvis ex- fixation B PFN B Post acetabular plating B Pubic symphysis plating B RAO procedure B Ray amputation B Removal of ender nails B Removal of femoral nail B Removal of implants distal femur B Removal of implants proximal femur B Removal of implants. Femur B Removal of Screws B Removal of toes A Revision fixation of hip fractures C Revision hip replacement C TEN nailing femur B thompson arthroplasty B THR - cemented B THR- Ceramic B THR- Metal on Metal B THR- removal of implant B THR- Revision C THR- Surface replacement B THR- Uncemented B UTN B Ant cervical discectomy and fusion C Ant cervical discectomy and plate fixation C Caudal Epidural A DIAM fixation B Disc replacement C Spine C Disc replacement L Spine C Discectomy + hemilaminectomy B

SVPIMSR –Schedule of Charges (SOC)

Dural tear repair B EA + Manipulation A Endoscopic discectomy B Epidural analgesia and manipulation A Implant removal large B Implant removal small A Intra dural mass removal B Laminectomy + foraminectomy One level B Laminectomy + foraminectomy two level B Laminectomy cervical spine B Laminoplasty B Microdiscectomy one level B Microdiscectomy two level B Occipito cervico fusion B Open discectomy B Para vertebral I and D B Pedicular screw fixation one level B Pedicular screw fixation three level B Pedicular screw fixation two level B PLIF B Post spinous fusion - C spine B Retroperitoneal decompression C Retroperitoneal decompression & fixation C Revision spine surgery C Revision spine surgery ant fixation C Revision spine surgery post fixation C Thorasic Spine fixation C TLIF C Trans pedicular biopsy B Transthoracic decompression and BG B Transthoracic decompression and Cage B Vertebroplasty C Above elbow amputation B AC joint CRIF B Aesculap fixator B Arthroscopic rotator cuff repair B Barton fracture fixation B Below elbow amputation B Bhattacharya procedure B Bony tumour excison large B Bony tumour excison medium B

SVPIMSR –Schedule of Charges (SOC)

Bony tumour excison small A Capitulum fixation B Caplan procedure B Carpal tunnel release A Cervical rib excision B Clavicle Orif B Clavicle ORIF and BG B Clavicle Plating B Close reduction and PO for forarm in A childeren Coccyx Excision B Contracture release A CRIF both Bones B CRIF distal Humerus & POP B CRIF Elbow B CRIF humerus B CRIF proximal humerus - Complex B CRIF Proximal humerus - Simple B CRIF Radius B CRIF ulna B Distal radius K wiring B Distal radius ORIF B DQ release A Duputryn contracture release B Eelbow disarticulation B Ellis Plate fixation B Ex fix Both bones B Ex Fix Elbow B Ex fix Radius B Ex fix removal B EX fix Ulna B Finger amputations B Fore querter amputation C Ganglion excision A Glomus tumor excision A Hebert screw fixation B Hemi arthroplasty Shoulder B Humeras Illizarov B Humerus BG B Humerus close nailing B Humerus Orif and BG B

SVPIMSR –Schedule of Charges (SOC)

Humerus plating B Iliarov forearm B Ilizarov wrist B Implant removal arm B Implant removal elbow B Implant removal forearm B Implant removal nail B Implant removal plate B Implant removal screws B Implant removal small B K wiring distal humerus B K wiring fingers B K wiring metacarpals B K wiring wrist B Keinbock's disease B Lat Condyle fixation & POP B Limited carpal fusion B Madelung deforemity correction B Malunion Humerus ORIF B Medial condyle fixation B Muscle slide operation B Nerve repair B Nerve transposition B Non Union Humerus nailing+ BG B Non union humerus ORIF B NonUnion Humerus BG B Ocecranon CC screw fixation B Olecranon CRIF B Olecranon k wiring B Olecranon ORIF B Olecranon Plating B Olecranon TBW B Open cuff repair B Orif Both bones B ORIF distal humerus B Orif elbow B ORIF galleazzi B ORIF humerus B ORIF monteggia B ORIF radius B Orif Ulna B

SVPIMSR –Schedule of Charges (SOC)

Osteotomy for cubitus deformities B Osteotomy of ulna for ulnar plus B Paronychia I & d B Radial Head excision B Radial head replacement B Radial nerve exploration B Radial styloid fixation B Raw area STG large B Raw area STG Medium B Raw area STG small B Reduction and cast distal radius B Scaphoid BG B Scaphoid ORIF Shoulder arthrotomy B Soft tissue tumour excision Large B Soft tissue tumour excision Medium B Soft tissue tumour excision small B Subacromsil Bursa Excision B Suturing CLW Large B Synostosis excison B Synovial Biopsy wrist,elbow and shoulder B TEN nail fixation forarm in children B Tendon repair B Tendon Repair B Tendone transfers B Tennis elbow release B Total Elbow replacement B Trigger finger release B Trigger thumb release B TSR B Tumour lower end radius excison B Tumour lower raduis scrapping and BG B UHN B Ulnar nerve exploration B Wmetacarpal amputations B Wrist Arthrodesis B Wrist arthrodesis B Wrist disarticulation B Bone Grafting from Illium B Bone Grafting from Tibia B Bone Marrow Aspiration

SVPIMSR –Schedule of Charges (SOC)

Fusiotomy B Tibia I'L Nailing B Tripple fusion B Ligamentotaxis With Indirect Reduction B Of L3

Particulars

Abdomen Perineal Pullthrough B Bronchosopy (Pedi) B Choledochal cyst - Biliary atresia B Colostomy/ Colostomy Closure B Cystoscopy + Ablation of valves B Deep abscess drainage A Diaphragmatic Hernia - Exomphalos B Dilatation Anal or Urethral A Esophageal Atresia complete Correction A Exploratory Laprotomy neonatal intestinal B Exstrophy Bladder Complete Correction B Inguinal Herniotomy - Bilateral (Paed) B Inguinal Herniotomy - Unilateral (Paed) B Lung Lobectomy B Minor Surgery A Neonatal Intestinal Obstruction B Orchidopexy- Bilateral (Paed) B Orchidopexy- Unilateral (Paed) B Pena PSARP / Thoractomy/ Hirschprung B Ramsteds Pyloromyotomy B Rectal Polyp A Rectal suction Biopsy B Sigmoidoscopy (Pead) A Vesicostomy A Complete Subtalar Release With Fixation - Ctev B Medial Release Only - Ctev/Met.Add. B Posterior Release B Limited Post-Med Soft Tissue Release (Pmstr) - Ctev B Suture Removal And Corrective Cast A Pin Removal & Corrective Cast A Dwyers Calcaneal Osteotomy And Pmstr - Ctev A Evan'S Calcaneo-Cuboid Fusion And Pmstr - Ctev B Extensive Soft Tissue & Bony Procedures - Severe Ctev Previously B Op. External Fixator Application - Ctev B

SVPIMSR –Schedule of Charges (SOC)

Calcaneal Osteotomy - Flat Foot B Subtalar Fusion Only B Tendon Transfer Single (Splat / Splpt/ Other ) Only B Modified Jones - Claw Toe B Triple Arthrodesis B Excision & Repair - Polydactyly B Coalition Resection & Interposition - Single B Plantar Fasciotomy Only/Steindler'S Only B Talo - Calcaneal Reduction, Fixation & Splaat - Rockerbottom B Foot 19 + Subtalar Fusion B Posterior Bone Block - Equinus B Small Bone Excision (Met) - Foot B Kidner'S Procedure - Accessory Navicular B Met Osteotomy + Soft Tissue Procedure - Hallux Valgus B Soft Tissue Procedure Only - Hallux Valgus B Or & If - Tillaux Fracture Or & If - Biplanar Fracture Ankle/Severe Ankle Fracture B Manipulation And Ak Casting - Ctev B LEG & KNEE Derotation Osteotomy Tibia With Fixation B Osteotomy Fibula Only B Fibular Shaft Excision (Harvesting Graft) B Fasciotomy Leg (One Incision) Em. B Corrective Osteotomy For Def Correction With Fixation - 1 Level B

Cr & Cast - Leg Bones Fracture B Cr & Ir - Leg Bone Fracture Em B Or & Ir - Leg Bone Fracture Em. B Soft Tissue Procedures - Patellar Dislocation B Soft Tissue And Bony Procedures - Patellar Dislocation B Extensive Soft Tissue Release - Knee Contracture B Baker'S Procedure B Popiliteal Cyst Excision B Eggar'S Procedure B Hemi-Epiphyseodesis Single - Knee (Percut/Open) B THIGH & HIP Medial Hamstring Release B Yount'S Procedure B Cr & If - Femur Fracture (Im Nails) B Or & If Fracture Femur B

SVPIMSR –Schedule of Charges (SOC)

Cr & Spica Fracture Femur Em. B Arthrogram Hip B Cr & Spica - Ddh B Or & Spica - Ddh B Proximal Fem Osteotomy With Fixation B Hip Spica Only B Pelvic Osteotomy With Spica - Ddh B Or & Femoral/Pelvic Osteotomy & Spica - Ddh B Or, Femoral Osteotomy & Pelvic Osteotomy - Ddh B Tenotomy Hip Adductor P/C B Tenotomy Hip Adductors + Neurectomy - Open B Tenotomy Hip Adductors & Psoas Tendon B Arthrotomy Hip - Ac Septic Arthritis B Arthrotomy Hip With Debridement B Hip Aspiration Alone / Instillation Of Steroid Hip B Pinning In Situ - Scfe B Cr & If - Fracture Neck Femur B Core Decompression For Avn B Soutter'S Procedure B Rectus - Sartorius Transfer - Cp B Hip Joint Fusion - Pffd B UPPER LIMB Kessler'S Procedure - Radial Hemimelia B Centralization Procedure - Radial Hemimelia B Pollicization Of Index Finger - Thumb Absence B Single Tendon Transfer - Hand B Jones Transfer Package B Ulnar Nerve Transposition B Darrach Procedure B Trigger Digit Release A Tendon Slide Procedure B Bony & Soft Tissue Procedure For R-U Synostosis B Tendon Graft Reconstuction 1St Stage - Hand B Tendon Graft Reconstuction 2Nd Stage - Hand B Cr (Or) & If - S/C Fracture Humerus - Em. B Cr & Pop - S/C Humerus - Em. B Or & If Lat Condyle - Fracture Humerus - Em. B Cr & Plaster - Fracture Neck Radius - Em. B Cr & If - Fracture Neck Radius - Em. B Cr & Pop - Fracture Forearm (Fa) - Em. B Or & If Single Bone Fracture Fa - Em. B

100

SVPIMSR –Schedule of Charges (SOC)

Osteoclasis And Pop - Fracture Fa - Em. B Cr & Pop - Fracture Humerus - Em. B Corrective Osteotomy & Fixation - Cubitus Varus B Slab/Cast Below Elbow B SLAB/CAST ABOVE ELBOW B SHOULDER & NECK Woodward Procedure - Sprengel'S Shoulder B Morcelization Of Clavicle B Trapezius Transfer B Lattissimus Dorsi Transfer B Biopolar Release Torticollis B Shoulder Spica B SPINE Posterior Spinal Fusion (Psf) And Body Cast C Psf With Instrumentation And Body Cast (No Correction) C

Psr With Instrumentation (Segmental) After Correction C Anterior Spinal Fusion (Asf) (No Instrumentation) C Anterior Spinal Fusion With Instrumentation & Correction C

Asf And Psf With Instrumentation C Body Cast B Excision Of Hemiverterbra (Single), Global Fusion And C Instrument. Spondylolysis Wiring C Posterolat.Fusion - Listhesis C Antero-Lat Decompression With Grafting C Excision Of Lesion/Nidus - Vertebra B 110 + Short Segment Fusion B MISCELLANEOUS Bony Decompression - Ac Om B Saucerization & Sequestrectomy Long Bone B Botox Injection - One Muscle Group A Limb Lengthening Procedure Ilizarov - One Long Bone B Instillation Of Steroids - Cyst Long Bone A Curettage & Bone Grafting - Cyst Long Bone A Bone Biopsy A Muscle Biopsy A Bone Graft Harvesting - Pelvis A Excision Of Tumor Nidus/Brodies - Long Bone A Multiple Osteotomies With Im Rod - Oi B Arthroscopic Repair - Ocd Knee B

101

SVPIMSR –Schedule of Charges (SOC)

Therapeutic Amputation Below Knee B Therapeutic Amputation Above Knee B Therapeutic Knee Disarticulation B Therapeutic Amputation - Foot/Ankle B Revision Of Amputated Stump B Reconstruction Of Hand/Foot Digit With Ssg B Single Polydactyly Excision A Carpal Tunnel Decompression A Emergency Arthrotomy For Septic Arthritis - Large Jt. A Abdominoplasty B Alar Adjustment B Arch Bar Removal B Arch Bar Wiring B B/L Cleft Lip repair B Bat Ear Correction B Blepharoplasty B Breast Augmentation B Breast Reconstruction C Breast Reduction C Burn Dressing in Ward (Large) B Burn Dressing in Ward (Medium) A Burn Dressing in Ward (Small) A Burn Grafting (Extensive) C Burn Grafting Extensive C Burn Grafting Large C Burn Grafting Medium C Burn Grafting Small A Chin Augmentation B Cleft Lip Repair B Cleft Lip Revision B Cleft Palate Repair B Composite Graft B Contracture Release Moderate B Contracture Release Severe C Contracture Rlease Mild B Cosmetic Rhinoplasty B Cranial Bone Grafting B Debridement Large B Debridement Medium B Debridement Small A Dermabrasion Face B

102

SVPIMSR –Schedule of Charges (SOC)

Dressing in OT Small A Dressing in OT Large A Dressing in OT Medium A Dressing in Ward Large A Dressing in Ward Medium A Dressing in Ward Small A Ear Reconstruction 1 st Stage B Ear Reconstruction 2 nd Stage B Epspadias Repair A Excision of Cyst / Mole A Extracranial Osteotomy B Extrophy Bladder B Eyelit Wiring A Fasciocutaneous Flap B Flap Detachment & Final Inset B Small Full Thickness Graft B Large Thickness Graft B Medium Thickness Graft B Hair Transplant (Per Graft) A Hypospadias 1'st Stage A Hypospadias 2'nd Stage B Hypospadias Fistula B Hypospadias Meatotomy A Hypospadias one Stage Repair B Inter Maxillary Fixation A Laceration Large B Laceration Medium A Laceration Multiple B Laceration Small A Lipectomy A Liposuction B Local Flaps B Mandible Orif B Mandibular Osteotomy B Microneural repair B Microvascular Free Flap C Microvascular Repair C Mid Face #'s B Multiple Z/ W Plasty B Myocutaneous Flap B Nasal Bone # Closed Reduction B

103

SVPIMSR –Schedule of Charges (SOC)

Nasal Bone # Open Reduction B Nasal Pack Removal A Nerve grafting /Secondary Repair B Neurovascular Flap B Orbito Zygomatic Complex B Palate Fistula Closure A Pan Facial #'s B Penile Surgery for Erectile Disfunction (Inflatable) B Penile Surgery for Erectile Disfunction (Malliable) B Pharyngoplasty B Polydactyly B Pressure Sore Flap B Reconstructive Rhinoplasty B Replantation Arm and Forearm B Replantation Digit (Multiple, more than Two) B Replantation Digit (Single) B Replantation Digit (Two) B Rhytidectomy B Scar Revision - Large B Scar Revision - Medium A Scar Revision - Small A Scar Revision - Multiple B Secondary Revision Cl. Lip Nasal Deformity A Split Ear Lobule -One A Split Ear Lobule -Two A Split Skin Graft Medium A Split Skin Graft Small A Split Skin Graft Large B Sub Cranial Surgery B Syndactyly B Syndactyly Multiple B T. M. Joint Arthroplasty B T. M. Joint Release (Bilateral) B Tandon Grafting - 1 Stage Prothetic B Tandon Grafting - 1 Stage Prothetic With Pullery Recons B

Tandon Grafting - 2 Stage Prothetic B Tangential Excision Large B Tangential Excision Medium B Tangential Excision Small A Tendon Graft Multiple B

104

SVPIMSR –Schedule of Charges (SOC)

Tendon Grafting Single A Tendon Injury Multiple B Tendon Injury Repair Single A Tendon Transfer (Single) B Tendon Transfer Multiple B Tongue Flap 1'st Stage B Tongue Flap 2'nd Stage B Transcranial Surgery B Vaginoplasty B Vermilion Adjustment , Z Plasty of Lip B Z Plasty A Zygoma # Closed B Zygoma # Orif B Zygomatico Maxillary Complex B Cartilatge Graft B Bone Graft B Muscle transfer Face B Muscle Transfer Limb B Arthrodesis (per joint) B Ptosis Sling Operation B Eye socket reconstructions B Wide Excision & Reconstruction Small B Wide Excision & Reconstruction Medium B Wide Excision & Reconstruction Large C Gender reassignment Surgery Stage I B Gender reassignment Surgery Stage II B Gender reassignment Surgery Stage III B Gender reassignment Surgery Stage IV B Gynecomastia small B Gynecomastia Medium B Gynecomastia Large B A.V. Malformation Small B A.V. Malformation Medium B A.V. Malformation Large B Mandibular Cys. B Dupugtren's Contracture A Escharotomy A Faciotomy A Nerve Exploration Minor B Nerve Exploration Medium B Nerve Exploration Major B

105

SVPIMSR –Schedule of Charges (SOC)

Cystic Hygroma Minor B Cystic Hygroma Medium B Cystic Hygroma Major B Implant Removal Minor A Implant Removal Medium B Implant Removal Major B Orbital Floor Exploration B Orbital Floor Reconstruction B Collumella Lengthening B Celft Lip Nasal Correction Minor B Celft Lip Nasal Correction Major B Tongue Tie Release A Nipple Areola Reconstruction By Graft B Nipple Areola Reconstruction By Flap B Nipple Areola Reconstruction By Graft & Flap B Adrenalectomy ( open) B Adrenalectomy ( Lap) B Cystoscoy ( Diagnostic) A Cystoscoy + Biopsy A Cystolithotomy ( Open ) A Cystolithotomy ( Percutaneous ) B Cystolithotrity B Exostrophy Repair A Mitrofanoff B Radical Cystectomy + Ileal Conduit C Radical Cystectomy + Orthotopic Bladder C Rupture Repair Minor B Rupture Repair Major B Stent Removal A Suprabubic Cystostomy A TURBT B VVF Repair B Bladder Neck Incision/TURP for Grade-I Prostate B Bladder Wash for Clot Removal A Endopyelotomy B Nephrectomy ( Laproscopic ) C Nephrectomy ( Simple Open ) C Nephrectomy ( Partial ) C Nephrectomy ( Radical ) C Nephrostomy ( Open ) B Nephrostomy ( Percutaneous ) PCN B

106

SVPIMSR –Schedule of Charges (SOC)

Pyelolithotomy B PCNL B Pyeloplasty B Diagnostic Nephroscopy+biopsy/Pick up Small Stones B Circumcision A Penectomy ( Partial ) B Penectomy ( Total ) Without Lymphadectomy B Penectomy ( Total ) With Lymphadectomy-B/L B Penile Implant B Abcess Drainage A Biopsy Prostatic Bx + TRUS USG Guided exposure A Bladder Neck Incision / TUIP B Open Prostatectomy B Radical Prostatectomy C TURP / TVP B Epispadias Repair B Hypospadias Repair ( Single Stage ) B Hypospadias Repair ( Two Stage -First Stage ) B Hypospadias Repair ( Two Stage -Second Stage ) B Meatoplasty A Meatotomy A Optical Internal Urethrotomy B Urethroplasty ( Single Stage ) B Urethroplasty ( Two Staged- First Stage ) B Urethroplasty ( Two Staged- Second Stage ) B Perineal Urethrostomy B Urethrovaginal Fistula Repair B D.J Stenting ( Unilateral ) B D.J Stenting ( Bilateral ) B Reimplantation ( Unilateral ) B Reimplantation ( Bilateral ) B Ureteroureterostomy / Boari flap B Ureterolysis ( Unilateral ) A Ureterolysis ( Bilateral ) A Ureteroscopy ( Daignostic ) B Ureteroscopy ( Stone Removal ) B Ureterolithotomy B Vesico Ureteric Junction Meatotomy B Hydrocele ( Unilateral ) A Hydrocele ( Bilateral ) B Orchidectomy ( Unilateral ) A

107

SVPIMSR –Schedule of Charges (SOC)

Orchidectomy ( Bilateral ) B Orchidopexy ( Unilateral ) B Orchidopexy ( Bilateral ) B Testicular biopsy A Varicocelectomy ( Unilateral ) B Varicocelectomy ( Bilateral ) B Vasectomy A Bilateral Testicular Fixation B Sling / Burch / Raz / Stamey B Transpupil Urethroplasty B VEA Micro B Cysto + Retrograde Catheterisation RGC-RGP A CYSTO + RETROGRADE CATHETERISATION RGC-RGP + D.J B STENTING CYSTOSCOPY + URETHRAL DILATATION B DORSAL SLIT A FRENULOPLASTY A GROIN DISSECTION (BILATERAL) B GROIN DISSECTION (UNILATERAL) B HYDRODISTEATION A HYDRODISTENTION + INTRAVESICAL DRUG INSTILLATION A

LAP RP B PCNL (MINI) B PCNL STAGHORN HIGH RISK B PYELOPLASTY (LAPROSCOPIC) B RIRS + D J STENTING B TURP HIGH RISK B TURP HOLEP B URETHRAL DILATATION A URETHRAL DILATATION + FLEXIBLE CYSTOSCOPY A URS + PCNL B VAULT REPAIR PROLAPSE B VIU BNI B VIU LASER B VIU OTIS URETHROTOMY B Abdominal Arotic Aneurysm C Aorto Bifemoral C Aorto Iliac C Axillo femoral Bypass C Carotico Brachial by Pass using Synthetic Graft C

108

SVPIMSR –Schedule of Charges (SOC)

Carotid bypass graft C Carotid endartrectomy B Cervical Sympathectomy B Congenital A.V. Fistula B Endarteractomy of any peripheral Vessel B Excision of Carotid body tumour with use of Shunt B Excision of Carotid body Tumor B Excision of Cervical Rib B Excision of Varicose Veins Double C Excision of Varicose Veins Single B Femoral crossed -Leg Graft B Femoral Embolectomy -Bilateral B Femoral Embolectomy -Unilateral B Femoro popliteal Bypass Using Synthetic graft B Femoropopiliteal Bypass Using Autogenous Vein B Ligation of Esophageal Varices B Lieno renal, Proto caval or Mesocaval Shunt B Lumber Sympathectomy B Management of Politeal Artery Entrapment B Peripheral Aneurysm B Peripheral Vascular Injury Repair B Profundaplasty Using Patch B Resection and or grafting for aneurysms - Thoracic B Subclavian Bypass B Thrombo endertectomy Aorta B Thrombo endertectomy Femoral B Thrombo endertectomy iliac B Thrombo endertectomy Pop B Surgical Pocket Charges for Pacemaker (TPI/Single/Duel B Chamber) Femoro Distal Bypass with Vein Graft B

109