ST. JOHN’S MEDICAL COLLEGE HOSPITAL A UNIT OF C.B.C.I. SOCIETY FOR MEDICAL EDUCATION BENGALURU - 560 034

SCHEDULE OF HOSPITAL CHARGES

FINANCIAL YEAR 2020 - 2021

(Effective from 1st June 2020) ST. JOHN’S MEDICAL COLLEGE HOSPITAL, BENGALURU - 34 SCHEDULE OF HOSPITAL CHARGES 2020-2021 INDEX Page No. I. OUT PATIENT REGISTRATION / CONSULTATION ...... 1 II. HOSPITALISATION CHARGES PER DAY ...... 3 A. BED CHARGES & ADMINISTRATIVE CHARGES...... 3 B. CCU PACKAGE PER DAY ...... 4 C. NEONATAL ICU PACKAGE PER DAY ...... 4 D. EMERGENCY ICU PACKAGE PER DAY...... 4 E. ICU PACKAGE PER DAY ...... 4 F. PAEDIATRIC ICU PACKAGE PER DAY ...... 5 G. NEUROSURGERY ICU PACKAGE PER DAY ...... 5 H. HEALTH CHECK-UP PACKAGES ...... 5 I. DIET ...... 6 III. LABORATORY INVESTIGATIONS ...... 9 A. CLINICAL PATHOLOGY ...... 9 A1. CLINICAL PATHOLOGY: ROUTINE HAEMATOLOGY TESTS ...... 9 A2. CLINICAL PATHOLOGY: COAGULATION TESTS ...... 9 A3. CLINICAL PATHOLOGY: HEMOLYTIC WORK UP ...... 10 A4. CLINICAL PATHOLOGY: FLOW CYTOMETRY ...... 10 A5. CLINICAL PATHOLOGY: URINE & FAECES ANALYSIS ...... 10 A6. CLINICAL PATHOLOGY: MISCELLANEOUS TESTS ...... 10 A7. CLINICAL PATHOLOGY: BODY FLUIDS ...... 10 A8. CLINICAL PATHOLOGY: MOLECULAR TESTING...... 11 B. BLOOD BANK ...... 11 B1. BLOOD BANK : IMMUNOHEMATOLOGY ...... 11 B2. THALASSAEMIA, HAEMOPHILIA & SICKLE ANEMIA PATIENTS ...... 11 B3. TESTS OUTSOURCED ...... 11 B4. BLOOD BANK : BLOOD COMPONENTS ...... 12 C. BIOCHEMISTRY LAB ...... 13 C1. BIOCHEMISTRY LAB: BLOOD TESTS...... 13 C2. BIOCHEMISTRY LAB: TUMOUR MARKERS ...... 14 C3. BIOCHEMISTRY LAB: BODY FLUID TESTS ...... 15 C4. BIOCHEMISTRY LAB: URINE TESTS...... 15 C5. BIOCHEMISTRY LAB: PANELS ...... 15 C6. BIOCHEMISTRY LAB: TESTS DONE IN THE COLLEGE ...... 16 C7. BIOCHEMISTRY TESTS OUTSOURCED ...... 17 D. MICROBIOLOGY LAB ...... 18 D1. MICROBIOLOGY: ROUTINE TESTS ...... 18 D2. MICROBIOLOGY: SURVEILLANCE ...... 21 D3. MICROBIOLOGY: TESTS OUTSOURCED ...... 21 D4. MICROBIOLOGY: TESTS DONE AT SJRI ...... 22 E. HISTOPATHOLOGY LAB (COLLEGE) ...... 22 F. CYTOGENETICS TESTS (COLLEGE)...... 23 G. PHARMACOLOGY (COLLEGE) ...... 23 H. EMERGENCY ...... 23 IV. RADIOLOGY INVESTIGATIONS ...... 24 A. PLAIN X-RAY...... 25 B. SPECIAL INVESTIGATIONS ...... 25 C. COLOUR DOPPLER SONOGRAPHY ...... 26 D. ULTRA SOUND IMAGING ...... 27 E. MAMMOGRAPHY ...... 28 F. CT SCAN ...... 28 G. MRI SCAN...... 29 G1. EMERGENCY MEDICINE PACKAGE ...... 31 H. MARROW DENSITOMETRY (BMD) ...... 31 I. NEURO INTERVENTIONAL PROCEDURE ...... 31 ii J. INVESTIGATIONS DONE OUTSIDE ...... 31 J1. PET CT SCANS ...... 31 J2. NUCLEAR MEDICINE ...... 32 V. NON-OPERATIVE PROCEDURES ...... 33 A. GENERAL PROCEDURES ...... 33 1. GENERAL PROCEDURES - CCU ...... 33 2. GENERAL PROCEDURES - ICU ...... 33 3. GENERAL PROCEDURES - PAEDIATRIC ICU ...... 33 4. GENERAL PROCEDURES - NEONATAL ICU ...... 34 5. GENERAL PROCEDURES - ITU / POST OPERATIVE ...... 35 6. GENERAL PROCEDURES - EMERGENCY MEDICINE / EICU ...... 36 7. GENERAL PROCEDURES - OPD / WARD...... 38 8. GENERAL PROCEDURES - UNIT OF HOPE ...... 41 8.1. UoH - NEONATAL...... 42 8.2. UoH - ORTHOPAEDICS ...... 43 8.3. UoH - PHYSICAL MEDICINE & REHABILITATION ...... 43 8.4. UoH - OPHTHALMOLOGY ...... 43 8.5. UoH - ENT : AND SPEECH THERAPY ...... 43 8.6. UoH - CHILD PSYCHIATRY...... 44 8.7. UoH - MEDICO SOCIAL WORK ...... 44 8.8. UoH - SPECIAL EDUCATION ...... 45 8.9. UoH - DENTAL ...... 45 8.10. UoH - PAEDIATRICS ...... 46 8.11. UoH - AUTISM CLINIC ...... 46 8.12. UoH - TEAM CLINIC ...... 46 8.13. UoH - COMDEALL...... 46 8.14. UoH - PHYSIOTHERAPY CLINIC ...... 46 9. GENERAL PROCEDURES - PEDIATRIC EMERGENCY ...... 46 B. SPECIALISED PROCEDURES ...... 48 1.SPECIALISED PROCEDURES - CARDIOLOGY ...... 48 1.1. NON-INVASIVE DIAGNOSTICS ...... 48 1.2. INVASIVE PROCEDURES ...... 48 1.3. INVASIVE DIAGNOSTICS - PACKAGES ...... 48 1.4. NON-CORONARY INTERVENTIONS - PACKAGES ...... 49 1.5. CORONARY INTERVENTIONS - PROCEDURES (CATH LAB) ...... 49 1.6. CORONARY INTERVENTIONS - PACKAGES ...... 49 1.7. ANAESTHESIA CHARGES ...... 50 1.8. PAEDIATRIC CARDIOLOGY PROCEDURE * ...... 50 1.9. ELECTRO PHYSIOLOGY STUDY PROCEDURE ...... 51 2. SPECIALISED PROCEDURES - DENTAL...... 51 2.1. DENTAL ...... 51 2.2. ORTHODONTICS...... 53 2.3 PROSTHODONTICS ...... 54 3. SPECIALISED PROCEDURES - DERMATOLOGY...... 55 4. SPECIALISED PROCEDURES - ENDOCRINOLOGY ...... 58 5. SPECIALISED PROCEDURES - ENT ...... 58 6. SPECIALISED PROCEDURES - GASTROENTEROLOGY ...... 62 7. SPECIALISED PROCEDURES- GENERAL MEDICINE ...... 63 8. SPECIALISED PROCEDURES - IMMUNOLOGY ...... 64 9. SPECIALISED PROCEDURES - PULMONARY MEDICINE...... 64 10. SPECIALISED PROCEDURES - GENERAL SURGERY ...... 65 10.1. STOMA CLINIC PROCEDURE ...... 67 11. SPECIALISED PROCEDURES - NEPHROLOGY ...... 67 12. SPECIALISED PROCEDURES - NEUROSURGERY ...... 68 13. SPECIALISED PROCEDURES - NEUROLOGY ...... 69 14. SPECIALISED PROCEDURES - OBSTETRICS & GYNAECOLOGY...... 70 14.1. DELIVERY CHARGES ...... 72 iii 15. SPECIALISED PROCEDURES - OPTHALMOLOGY ...... 72 16. SPECIALISED PROCEDURES - ORTHOPAEDICS ...... 74 17. SPECIALISED PROCEDURES - PAEDIATRICS ...... 75 17.1. PEDIATRIC ONCOLOGY ...... 75 18. SPECIALISED PROCEDURES - NEONATOLOGY ...... 76 19. SPECIALISED PROCEDURES - PAEDIATRIC NEPHROLOGY ...... 76 20. SPECIALISED PROCEDURES - PAEDIATRIC SURGERY ...... 77 21. SPECIALISED PROCEDURES - PHYSICAL MEDICINE AND REHABILITATION ...... 78 21.1. PMR - MEDICAL REHABILITATION ...... 78 21.2. PMR - OCCUPATIONAL THERAPPY ...... 79 21.3. PMR - ORTHOTIC & PROSTHESTIC ...... 80 21.4. PMR - MEDICO SOCIAL WORK ...... 82 21.5. PMR - SPEECH AND LANGUAGE SECTION...... 82 22. SPECIALISED PROCEDURES - PHYSIOTHERAPY ...... 83 23. SPECIALISED PROCEDURES - PLASTIC SURGERY ...... 83 24. SPECIALISED PROCEDURES - PSYCHIATRY ...... 85 24.1. CHILD PSYCHIATRY ...... 85 24.2. CLINICAL PSYCHOLOGY ...... 85 24.3. PSYCHIATRY SOCIAL WORK ...... 86 24.4. DAY CARE CENTRE ...... 86 24.5. GENERAL ...... 86 25. SPECIALISED PROCEDURES - UROLOGY ...... 87 26. SPECIALISED PROCEDURES - MEDICAL ONCOLOGY...... 88 27. SPECIALISED PROCEDURES - SURGICAL ONCOLOGY ...... 89 28. SPECIALISED PROCEDURES - GYNECOLOGIC ONCOLOGY ...... 89 29. SPECIALISED PROCEDURES - RADIATION ONCOLOGY ...... 91 30. SPECIALISED PROCEDURES - PALLIATIVE MEDICINE ...... 92 31. ANAESTHESIOLOGY ...... 93 C. OTHER PROCEDURES / SERVICES ...... 94 1. OTHER SERVICES: NUTRITION SERVICES ...... 94 1.1. SPECIALISED PROCEDURES DONE IN COLLEGE ...... 94 1.2. LIFE STYLE MANAGEMENT PROGRAMME ...... 94 1.3. TESTS DONE IN PHYSIOLOGY SJMC (BILLING DONE IN SJMC) ...... 94 2. OTHER SERVICES: COMMUNITY HEALTH SERVICES ...... 94 3. OTHER SERVICES: FORENSIC MEDICINE ...... 94 4. OTHER SERVICES: CERTIFICATES ...... 95 5. OTHER SERVICES: MEDICO SOCIAL WORK ...... 96 6. OUTSIDE INVESTIGATIONS...... 96 VI. OPERATIVE PROCEDURES ...... 97 A. CARDIO THORACIC & VASCULAR SURGERY ...... 97 B. GENERAL SURGERY ...... 103 C. GENITO URINARY SURGERY ...... 112 D. GYNAECOLOGY ...... 118 E. OBSTETRICS...... 120 F. OPHTHALMOLOGY ...... 121 G. ORTHOPAEDICS ...... 125 H. ENT ...... 138 I. NEURO SURGERY ...... 148 J. PLASTIC SURGERY ...... 151 K. PAEDIATRIC SURGERY ...... 163 L. NEPHROLOGY ...... 166 M. CADAVERIC ORGAN RETRIEVAL ...... 167 N. PHYSICAL MEDICINE & REHABILITATION ...... 167 O. SURGICAL ONCOLOGY ...... 168 P. GYNAECOLOGIC ONCOLOGY...... 175 Q. UNIT OF HOPE (UoH) ...... 179 R. ANAESTHESIOLOGY ...... 184 iv ST. JOHN’S MEDICAL COLLEGE HOSPITAL, BENGALURU - 560 034 SCHEDULE OF HOSPITAL CHARGES Effective from 1st June, 2020

CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. I. OP REGISTRATION / CONSULTATION

00056 MRD Registration Charges 30

00004 General Consultation 150

00365 General Cross Consultation 80

00032 General Consultation (Revisit within 3 Days) 100

00059 General Super Speciality Consultation 180

00057 General Super Speciality Cross Consultation 100

00058 General Super Speciality Consultation (Revisit within 3 Days) 120

00011 Morning Special Consulation 450

00368 Morning Special Cross consultation 250

00012 Morning Special Consulation (Revisit within 30 Days) 250

00006 Morning Super Special Consultation 500

00367 Morning Super Special Cross Consultation 250

00007 Morning Super Special Consultation (Revisit within 30 Days) 250

00016 Evening Special Consultation 550

00018 Evening Special Cross Consultation 250

00017 Evening Consultation (Revisit within 30 Days) 300

00008 Evening Super Speciallty Consultation 650

00046 Evening Super Special Cross Consultation 300

00009 Evening Super Speciality Conlt. (Revisit within 30 Days) 300

00005 Emergency OP New Registration 250

00366 Emergency OP Cross Consultation 100

00077 Paed. Emergency Consultation 250

1 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs.

00078 Paed. Subspeciality Cross Consultation 100

00374 General OP Registration Psychiatry 250

00378 General Cross Consultation Psychiatry 150

00375 General Consultation - Psychiatry (Revisit within 30 Days) 250

00383 General Consultation Pyschiatry (Revisit After 30 Days) 250

00376 Morning Special Consultation - Psychiatry 750

00379 Morning Special Cross Consultation - Psychiatry 500

00377 Morning Special Consultation -Psychiatry (Revisit within 30 Days) 750

00380 Evening Special Consultation -Psychiatry 750

00381 Evening Consultation Psychiatry (Revisit within 30 Days) 750

00382 Even Special Cross Consultation - Psychiatry 500

00387 General Consultation - Nutrition 250

00386 Special Psychotherapy & Consultation 1000

00085 General Psychotherapy & Consultation 600

00003 Search Fee 20

00015 Visa Consultation 3000

00083 MLC Administrative Charges - OP 250

00084 MLC Adminstrative Charges - IP 1250 1250 1250 1250 1250

Note : Once registered in the morning, patient can be billed only for Cross Consultation in the evening, provided the morningconsultation was also special. Else, he/she sholud be billed in the evening for registration. This applies to emergency as well.For all New MRD Registrations, Code no. 56 Charged along with consultaion and for existing MRD members Code no. 56 optional, Only ConsultaionCharges will be charged.

2 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. II. HOSPITALIZATION (Charges Per Day) :

A. BED CHARGES & ADMINISTRATIVE CHARGES

00022 Bed Charges** 250 400 950 1500 2700/6000

00061 Bed Charges ( ITU / Post Operative Room) 300 1000 1000 1000 1000

00051 Bed Charges - Eclampsia Room 300 1000 1000 1000 1000

00027 Professional & Treatment Charges 300 300 500 850 1900/3100

00062 Professional & Treatment Charges (ITU/ Post OP) 450 500 500 500 500

00052 Professional & Treatment ( Eclampsia Room) 450 500 500 500 500

00066 Professional Treatment Charges for Burns 350 350 550 900 1000

00028 Visiting Fee * 150 200 350 550 600

00063 Visiting Fee ( ITU / Post Op. Room)* 200 400 400 400 400

00053 Visiting Fee (Eclampsia Room) 200 400 400 400 400

00080 Paediatric ITU Package Per Day (Bed, Visiting, Professional) 650 650 800 900 1000

00021 Admission & Discharge Documentation 200 250 300 350 450

00067 Attendent Bed Occupancy Charges**** 300 900 1800 2900 5200/9700

00065 Cross Consultation (IP) 100 150 250 400 450

00020 Day Care Bed Charges (IV,BT,Chemo) 350 400 600 600 600

00369 DayCare Bed Charges (Procedure/Surgery) 600 900

00079 Paediatric Thalassemia Care - Day care 300 300 300 300 300

00035 Insurance Documentation -IP 500 500 500 500 500

15015 Insurance Documentation -OP 100

00031 Room Heater Charges 210 210 210 210 210

3 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. B. CCU PACKAGE Per Day

00090 CCU Charges with Respirator 8500

00088 CCU Charges with Respirator within 12 Hrs 5250

00089 CCU Charges with out Respirator 4750

C. NEONATAL ICU PACKAGE Per Day

00110 Incubator / Open Warmer with Ventilator 3250 3250 3250 6500 8500

00101 Incub/Open Warmer with Respirator (12hrs) 1750 1750 1750 3250 4250

00106 Incubator / Radiant Warner with CPAP Ventilation 1750 1750 2000 2250 4250

00108 Incubator / Open Warner ( Open Air care) 300 350 400 450 500

00102 Observation (includes GRBS, Warmer, ) 500 700 900 1100 1300

00107 Warm Cradle 250 300 330 400 500

D. EMERGENCY ICU PACKAGE Per Day/ITU

00121 Emergency ICU Charges with Respirator 8500

00373 EICU Charges with Respirator (less than 12 hrs) 5250

00122 EICU Charges without Respirator 4750

Note: Patient admitted to EICU,will be billed at Gen.Ward Charges with respect to Lab, Radiology & Procedures

E. ICU PACKAGE Per Day

00130 ICU Charges with Respirator 8500

00128 ICU Charges with Respirator (12 hrs) 5250

00129 ICU Charges without Respirator 4750

00060 ICU NIV 5250

00068 RICU Bed with NIV 5250

00069 RICU Bed without NIV 4750

00070 RICU Bed with Respirator 8500

00075 RICU Bed with Respirator ( less than 12 hours) 5250

4 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. F. PAEDIATRIC ICU PACKAGE Per Day

00166 Paed. ICU with Respirator 4750

00167 Paed. ICU with Respirator (12 Hrs) 2750

00165 Paed. ICU without Respirtator 2350

00175 Paediatric ICU for only Monitoring (Intermediate Care) 1500

00081 PICU with Respirator (SLE) - Regular Use 5500

00082 PICU with Respirator (SLE) - HFOV 7750

G. NEURO SURGERY ICU PACKAGE Per Day

00177 NICU with Respirator 4750

00178 NICU with Respirator (12 Hrs) 2750

00176 NICU without Respirator 2350

NOTE: 1) If a patient is admitted directly to ICU/CCU and discharged and when such patients are shifted from ICU to CCU or CCU to ICU and discharged general ward charges will be charged for Lab Investigations Radiology & General procedureSerumSpecial procedures & Surgery will be billed according to the Ward the patient is transfered from or transferd to, whichever higher.2) If a patient is admitted direcly to ICU/CCU and shifted to any ward the respective ward charges will be charged from the date of transfer.3) If a patient is directly admitted in ITU and shifted to any ward the respective occupied ward charges will be charged and vice versa

H. HEALTH CHECK-UP PACKAGES

00179 Miscellaneous - Health Plan

00180 Simple Health Plan 1550

00181 Senior Citizen above 60 yrs for Men 5500

00182 Senior Citizen above 60 yrs for Women 6000

00183 Executive Health Plan 3800

00185 Comprehensive Heart Check up 6000

00186 Diabetic Profile 4500

00187 Medical/Gynaecology profile 3500

5 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00352 Add On-Diabetic Profile,Comp Heart Check Up -Men 1400

00353 Add On- Diabetic Profile,Comp Heart Check Up-Women 2000

00354 Add On-Comprehensive Heart Check Up-Senior Citizen Men 1000

00356 Add On-Senior Citizen (Men) 1200

00357 Add On-Executive Health Plan 1000

20060 Add On Diabetic Profile (TMT & TSH) 1500

20061 Add On Gynaecology Plan(LFT,Creatine, ECHO) 2000

20062 Add On Gynaecology Plan(LFT,Creatine,Mamography,Oncology) 2300

20063 Add On - Diabetic /Gynaecology 2350

I. DIET

20056 Diet Veg - Normal 180 210 280 280 480

00191 Diet Non Veg - Normal 210 240 280 280 480

20082 Attendant Diet - Daibetic Veg 180 210 260 260 480

20083 Attendant Diet - Diabetic Non Veg 210 240 280 280 480

20081 Attendant Diet - NonVeg (Normal) 210 240 280 280 480

20080 Attendant Diet - Veg(Normal) 180 210 260 260 480

20055 Cutlery Set 140 140 140 140 140

20034 Diet - Clear Liquids-Diabetic 110 140 170 170 200

20036 Diet - Clear Liquids-Diabetic Renal 110 140 170 170 200

20037 Diet - Clear Liquids-High Protein 110 140 170 170 200

20035 Diet - Clear Liquids-Renal 110 140 170 170 200

20028 Diet - Liquids -Diabetic 150 180 250 250 300

20032 Diet - Liquids-Diabetic Renal 150 180 250 250 300

20033 Diet - Liquids-High Protein 150 180 250 250 300

6 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs.

20029 Diet - Liquids-Low FAT 150 180 250 250 300

20030 Diet - Liquids-Milk Free 150 180 250 250 300

20031 Diet - Liquids-Renal 150 180 250 250 300

20010 Diet - NonVeg -Diabetic 210 235 285 285 480

20011 Diet - NonVeg -Low FAT 210 235 285 285 480

20012 Diet - NonVeg -Milk Free 210 235 285 285 480

20013 Diet - NonVeg -Renal 210 235 285 285 480

20014 Diet - NonVeg -Diabetic Renal 210 235 285 285 480

20015 Diet - NonVeg -High Protein 210 235 285 285 480

20022 Diet - Soft Solid -Diabetic 160 200 250 250 300

20026 Diet - Soft Solid -Diabetic Renal 160 200 250 250 300

20027 Diet - Soft Solid -High Protein 160 200 250 250 300

20023 Diet - Soft Solid -Low FAT 160 200 250 250 300

20024 Diet - Soft Solid -Milk Free 160 200 250 250 300

20025 Diet - Soft Solid -Renal 160 200 250 250 300

20016 Diet - Veg -Diabetic 185 210 260 260 480

20020 Diet - Veg -Diabetic Renal 185 210 260 260 480

20021 Diet - Veg -High Protein 185 210 260 260 480

20017 Diet - Veg -Low FAT 170 200 270 270 480

20018 Diet - Veg -Milk Free 170 200 270 270 480

20019 Diet - Veg -Renal 185 210 260 260 480

00194 Diet Counselling Sheet 45 65 85 95 125

00192 Diet -Soft Solids -Normal 160 200 250 250 300

00195 Diet-Clear Liquids-Normal 110 140 170 170 200

7 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00193 Diet-Liquids-Normal 160 200 250 250 300

00351 Extra Charge-Diet

20087 Tube Feed except FJ/JJ 1 litre Per Day- Renal High Protein 240 240 240 240 240

20038 Tube Feed except FJ/JJ 1 litre Per Day-Diabetic 240 240 240 240 240

20039 Tube Feed except FJ/JJ 1 litre Per Day-Low FAT 240 240 240 240 240

20040 Tube Feed except FJ/JJ 1 litre Per Day-Milk Free 240 240 240 240 240

00358 Tube Feed except FJ/JJ 1 litre Per Day-Normal 240 240 240 240 240

20041 Tube Feed except FJ/JJ 1 litre Per Day-Renal 240 240 240 240 240

20088 Tube Feed except FJ/JJ 1.6 litre Per Day- Renal High Protein 310 310 310 310 310

20043 Tube Feed except FJ/JJ 1.6 litre Per Day-Diabetic 310 310 310 310 310

00359 Tube Feed except FJ/JJ 1.6 litres Per Day-Normal 310 310 310 310 310

20047 Tube Feed except FJ/JJ 1.6litre Per Day-High Prote 310 310 310 310 310

20044 Tube Feed except FJ/JJ 1.6litre Per Day-Low FAT 310 310 310 310 310

20045 Tube Feed except FJ/JJ 1.6litre Per Day-Milk Free 310 310 310 310 310

20046 Tube Feed except FJ/JJ 1.6litre Per Day-Renal 310 310 310 310 310

20042 Tube Feed except FJ/JJ 1litre Per Day-High Protein 240 240 240 240 240

20089 Tube Feed except FJ/JJ 2 litre Per Day- Renal High Protein 390 390 390 390 390

20048 Tube Feed except FJ/JJ 2 litre Per Day-Diabetic 390 390 390 390 390

00360 Tube Feed except FJ/JJ 2 litres Per Day-Normal 390 390 390 390 390

20052 Tube Feed except FJ/JJ 2litre Per Day-High Protein 390 390 390 390 390

20049 Tube Feed except FJ/JJ 2litre Per Day-Low FAT 390 390 390 390 390

20050 Tube Feed except FJ/JJ 2litre Per Day-Milk Free 390 390 390 390 390

20051 Tube Feed except FJ/JJ 2litre Per Day-Renal 390 390 390 390 390

8 ST. JOHN’S LABORATORY SERVICES

CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. III. LABORATORY INVESTIGATIONS A. CLINICAL PATHOLOGY LAB A1. Clinical Pathology: Haematology Routine Tests 10001 Absolute Eosinophil Count (AEC) 170 200 220 250 270 10099 Absolute Lymphocyte Count (ALC) 170 200 220 250 270 10098 Absolute Neutrophil Count (ANC) 170 200 220 250 270 10104 Bone Marrow Smear 550 630 720 800 880 10004 Clot Retraction Time (Mac Farlands Method) 70 80 90 100 110 10005 Complete Blood Count 270 310 350 390 430 10006 Complete Haemogram with ESR 370 430 480 540 590 10007 Erythrocyte Sedimentation Rate (ESR) 110 130 140 160 180 10010 Haemoglobin % (HB) 110 130 140 160 180 10117 LE Cells 150 170 200 220 240 10118 Leucocyte Alkaline Phosphatase (LAP) 270 310 350 390 430 10015 Malarial Parasites Smear (MP) & QBC 240 280 310 350 380 10016 Microfilaria Smear (MF) & QBC 240 280 310 350 380 10032 NBT Test 250 290 330 360 400 10018 Packed Cell Volume (PCV) 110 130 140 160 180 10019 Peripheral Smear (PS) & CBC 320 370 420 460 510 10122 Plasma Haemoglobin 110 130 140 160 180 10020 Platelet Count 150 170 200 220 240 10097 Platelet Indices 330 380 430 480 530 10002 Red Cell Indices(MCV,MCH,MCHC and RDW) 170 200 220 250 270 10025 Reticulocyte Count and Reticulocyte Hb 200 230 260 290 320 10096 Reticulocyte Count and Reticulocyte Hb 330 380 430 480 530 10107 Serum Cryoglobulin 110 130 140 160 180 10039 Smear Slide to Outside 100 120 130 150 160 A2. Clinical Pathology: Coagulation Tests 10101 Activated Partial Thromboplastin (APTT) 370 430 480 540 590 10135 Anti Phospholipid Antibody (ACA, B2 Glyco Protein, Lupus Anticoagulant) 3200 3680 4160 4640 5120 10133 Anticardiolipin Antibody (ELISA) 1050 1210 1370 1520 1680 10155 Anti Thrombin III 1500 1720 1950 2180 2400 10154 Beta 2 Glycoprotein 1 and 2 1100 1270 1430 1600 1760 10003 Bleeding Time (BT) 100 120 130 150 160 10105 Complete Coagulation Work up 3200 3680 4160 4640 5120 10112 D-Dimer 1350 1550 1760 1960 2160 10109 Factor Assay 1400 1610 1820 2030 2240 10030 Fibrinogen Assay 630 720 820 910 1010 10132 Inhibitor Studies in Bethesda Units 2750 3160 3580 3990 4400 10134 Lupus Anticoagulant (Coagulation Tests) 1050 1210 1370 1520 1680 10092 Mixing Studies for PT / APTT 1050 1210 1370 1520 1680 10137 Protein C 2550 2930 3320 3700 4080 10138 Protein S 2550 2930 3320 3700 4080 10023 Prothrombin Time (PT) 240 280 310 350 380 10026 Screening Test for Inhibitors 1250 1440 1630 1810 2000 9 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 10110 Test for Factor XIII ( Urea Solubility Test) 150 170 200 220 240 10127 Thrombin Time 270 310 350 390 430 10091 Von Willebrand Factor Antigen Assay 1550 1780 2020 2250 2480 10982 Von Willebrand RICOF Activity 3100 3560 4030 4500 4960 A3. Clinical Pathology: Hemolytic Work-up 10029 Acid Elution Test ( K B Test) 220 250 290 320 350 10031 G6PD Assay 830 950 1080 1200 1330 10045 G6PD Dye Test 220 250 290 320 350 10114 Ham’s Test (Acidified Serum Test) 170 200 220 250 270 10141 HB HPLC 1100 1270 1430 1600 1760 11910 Hb solubility test for Hbs 100 120 130 150 160 10119 Osmotic Fragility Test 370 430 480 540 590 10124 Sickle Cell Preparation 100 120 130 150 160 10125 Sucrose Lysis Test 170 200 220 250 270 A4. Clinical Pathology: Flowcytometry 10149 CD34 Counts 2350 2700 3060 3410 3760 10679 CD4 /CD8 - Counts 1800 2070 2340 2610 2880 10354 Extended Flow Panel for Primary Immunodeficiency 4600 5290 5980 6670 7360 10358 Extended Flowcytometry for Leukemia 9600 11040 12480 13920 15360 10981 Flow for CD 19/20 2300 2650 2990 3340 3680 10985 Flow for Glanzmanns Thrombasthenia 2050 2360 2670 2970 3280 10095 Flow for Platelet Function Disorders 5100 5870 6630 7400 8160 10355 Flowcytometry for DHR 2000 2300 2600 2900 3200 10357 Flowcytometry for HLA Crossmatch 5100 5870 6630 7400 8160 10980 Flow Panel for Primary Immunodeficiency (PID) 3550 4080 4620 5150 5680 10987 Flow for PNH 5600 6440 7280 8120 8960 10094 HLA B27 1700 1950 2210 2470 2720 A5. Clinical Pathology: Urine & Faeces Analysis 10201 Bence Jones Protein 100 120 130 150 160 10203 Demonstration of Hemosiderin in Urine 100 120 130 150 160 10252 Faeces for Occult Blood 70 80 90 100 110 10253 Faeces Routine and Micro 70 80 90 100 110 10984 Urine Haemoglobin 100 120 130 150 160 10204 Urine Ketone Bodies 100 120 130 150 160 10158 Urine Leucocyte Esterase 100 120 130 150 160 10205 Urine Microscopy 120 140 160 170 190 10160 Urine Microscopy for Fat Globules 70 80 90 100 110 10157 Urine Nitrite 100 120 130 150 160 10159 Urine Phase Contrast Microscopy for Dysmorphic RBC 150 170 200 220 240 10207 Urine Protein (Albumin) 100 120 130 150 160 10208 Urine Routine Chemical and Microscopy 200 230 260 290 320 10210 Urine Sugar ( Glucose) 120 140 160 170 190 A6. Clinical Pathology: Miscellaneous Tests 10301 Fern Pattern Only 70 80 90 100 110 10304 Semen Analysis 300 350 390 440 480 10308 Strip (Pregnancy Test) 160 180 200 230 250 A7. Clinical Pathology: Body Fluids 10352 Body Fluids TC and DC 250 290 330 360 400 10 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. A8. Clinical Pathology: Molecular Testing 11913 ALL - RT BCR-ABL 5200 5980 6760 7540 8320 10153 Factor V Leiden 5500 6320 7150 7980 8800 11914 HLA CDC cross match 10000 11500 13000 14500 16000 11915 HLA typing by SSP 12000 13800 15600 17400 19200 10150 Molecular - BCR ABL(RT-PCR) 4500 5180 5850 6530 7200 10151 Molecular- JAK2 5600 6440 7280 8120 8960 11911 MPN Panel 7000 8050 9100 10150 11200 11912 PML / RARA 6600 7590 8580 9570 10560 B. BLOOD BANK B1. Blood Bank : Immunohematology 10801 ABO Antibody Titre 220 250 290 320 350 10156 Abo Antibody Titre for Transplant 2000 2300 2600 2900 3200 11103 ABO Blood Grouping & Rh Typing 270 310 350 390 430 10093 Antibody Identification Panel 750 860 980 1090 1200 11286 Auto Immune Hemolytic Anemia Panel 1000 1150 1300 1450 1600 11284 DCT - Monospecific Extended Panel 600 690 780 870 960 10804 Cold Agglutinin Titre 220 250 290 320 350 10805 Coombs Test - Direct (DCT) 300 350 390 440 480 10806 Coombs Test - Indirect (ICT) 350 400 460 510 560 10809 Crossmatch Charges - Routine 1 1 1 1 1 11105 DCT - Monospecific 320 370 420 460 510 10810 Donor Screening (HB, Group and Typing) 110 130 140 160 180 10866 Donor Unit Sub Group 50 60 70 70 80 10851 Fresh Blood Donor Screening Charges 770 890 1000 1120 1230 10867 Incompatible Crossmatch 50 50 50 50 50 10051 Leucocyte Removal Filtration for Platelet Concentrate 900 900 900 900 900 10048 Leucocyte Removal Filtration for Red Cells 875 875 875 875 875 10817 Professional Charge B 220 250 290 320 350 10812 Rapid Screening - HIV,HCV,HBsAg and VDRL 1050 1210 1370 1520 1680 10821 RBC Antibody Screening 420 480 550 610 670 10816 RhD - Antibody Titre 630 720 820 910 1010 10865 Single Blood Bag 150 170 200 220 240 10937 Stem Cell Pheresis 18000 20700 23400 26100 28800 10052 Wafer 200 230 260 290 320 B2. Thalassaemia & Haemophilia & Sickle Anemia Patients 10900 Thalassaemia / Haemophilia Package - Service Charge 1 1 1 1 1 B3. Tests Outsourced 11503 Acute Leukemia-MRD Panel (MRD &Relapse) (Flowcytometry) 11500 11500 AML Comboquest Ill 7850 11501 AML Comboquest IV 5750 11502 FIPI Ll-PDGFRa 5450 11908 IRMA 9100 11504 MDS In-Situ by FISH 9700 11909 MTHFR Mutation Detection 2750 11588 PML/RA Quantative PCR 7850 11589 TPMT Genotyping Analysis 6600 11 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs.

B4. Blood Bank : Blood Components

10853 Cryoprecipitate 400 400 400 400 400

10858 Fresh Frozen Plasma 632 632 632 632 632

10856 Packed Red Blood Cell Concentrate 1248 1248 1248 1248 1248

10857 Platelet concentrate 632 632 632 632 632

10820 Platelet Pheresis Divided Unit 5500 5500 5500 5500 5500

10819 Platelet Pheresis Single Unit 11000 11000 11000 11000 11000

10852 Whole Blood 1480 1480 1480 1480 1480

12 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. C. BIOCHEMISTRY LAB C1. Biochemistry: Blood Tests 10562 Arterial Blood Gas (ABG) 615 710 800 890 980 10559 Bilurubin -Total Direct & Indirect 155 180 200 220 250 10986 Blood Alcohol 205 240 270 300 330 10604 Fasting Glucose (FBS) 65 70 80 90 100 10585 Glucose Tolerance Test (OGCT) ( 50gms) & 1 hr 95 110 120 140 150 10587 Glycated Haemoglobin (HbA1c) 715 820 930 1040 1140 11155 OGTT 75 Gms, FBS,1hr,2hr 250 290 330 360 400 10586 OGTT 75 gm Glucose - Twice(FBS, 2hrs) 155 180 200 220 250 10881 OGTT 75 gm Glucose load (FBS 1hr,2hr,3hr) 310 360 400 450 500 10635 Plasma Ammonia 360 410 470 520 580 10629 Plasma Bicarbonate 615 710 800 890 980 10887 Plasma Insulin 615 710 800 890 980 10933 Plasma Insulin Fasting 615 710 800 890 980 10650 Plasma Lactate 615 710 800 890 980 10942 Intact Parathormone (PTH) 815 940 1060 1180 1300 10941 Total Vitamin D (25-OH D2 & D3) 1215 1400 1580 1760 1940 11157 Post Glucose (75gms) -60 mins Growth Hormone 865 990 1120 1250 1380 10885 Post Prandial Glucose (PPBS) 65 70 80 90 100 10596 PP Glucose with 75g Glucose 95 110 120 140 150 10884 Random Glucose (RBS) 65 70 80 90 100 10751 Serum ADA 715 820 930 1040 1140 10615 Serum Alanine Transaminase (SGPT) 205 240 270 300 330 10552 Serum Alkaline Phosphatase (ALP) 205 240 270 300 330 11129 Serum AMH (Anti-Mullerian Hormone) 1615 1860 2100 2340 2580 10553 Serum Amylase 310 360 400 450 500 11132 Serum Angiotensin Converting Enzyme (ACE) 865 990 1120 1250 1380 10643 Serum Anti - TPO 765 880 990 1110 1220 11130 Serum Anti CCP 1015 1170 1320 1470 1620 11124 Serum Anti Thyroglobulin 1015 1170 1320 1470 1620 10614 Serum Aspartate Transaminase (SGOT) 205 240 270 300 330 10915 Serum Beta HCG 1015 1170 1320 1470 1620 10564 Serum Calcium 205 240 270 300 330 10622 Serum Carbamazepine 665 760 860 960 1060 10568 Serum Cholesterol 155 180 200 220 250 10569 Serum Cholesterol - HDL 230 260 300 330 370 10570 Serum Cholesterol - LDL 280 320 360 410 450 10574 Serum CK- MB 615 710 800 890 980 11100 Serum Cortisol - Random 615 710 800 890 980 10886 Serum Cortisol (4-6 PM) 615 710 800 890 980 10902 Serum Cortisol (7-9 AM) 615 710 800 890 980 11158 Serum Cortisol 60 mins - ACTH Stimulated 615 710 800 890 980 11159 Serum Cortisol - Dexa Suppressed 615 710 800 890 980 10700 Serum C-Reactive Protein (CRP) 410 470 530 590 660 13 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 10579 Serum Creatine Phosphokinase (CPK) 360 410 470 520 580 10575 Serum Creatinine 105 120 140 150 170 11153 Serum Erythropoietin 1215 1400 1580 1760 1940 10662 Serum Estradiol - E2 715 820 930 1040 1140 10621 Serum Ferritin 765 880 990 1110 1220 10666 Serum Folic Acid 1215 1400 1580 1760 1940 10883 Serum Free T3 (FT3) 310 360 400 450 500 10922 Serum Free T4 (FT4) 310 360 400 450 500 10903 Serum FSH 510 590 660 740 820 10584 Serum Gamma Glutamyl Transferase (GGT) 205 240 270 300 330 11160 Serum GH - 0,60,90 mins Clonidine stimulated 2415 2780 3140 3500 3860 11125 Serum Growth Hormone 815 940 1060 1180 1300 10873 Serum Homocysteine 1365 1570 1770 1980 2180 10626 Serum Ionised Calcium 410 470 530 590 660 10590 Serum Lactate Dehydrogenase 310 360 400 450 500 10906 Serum LH 510 590 660 740 820 10632 Serum Lipase 360 410 470 520 580 10591 Serum Lithium 615 710 800 890 980 10593 Serum Magnesium 205 240 270 300 330 10735 Serum Osmolality 410 470 530 590 660 10623 Serum Phenobarbital 665 760 860 960 1060 10628 Serum Phenytoin 665 760 860 960 1060 10594 Serum Phosphorus 205 240 270 300 330 10612 Serum Potassium 105 120 140 150 170 10908 Serum Prolactin 765 880 990 1110 1220 10602 Serum Sodium 105 120 140 150 170 10913 Serum T3 260 300 340 380 420 11123 Serum Thyroglobulin(TG) 1315 1510 1710 1910 2100 10597 Serum Total Protein & Albumin 410 470 530 590 660 10914 Serum Total T4 260 300 340 380 420 10647 Serum Total Testosterone 510 590 660 740 820 10607 Serum Triglycerides 205 240 270 300 330 10931 Serum Troponin I 510 590 660 740 820 10912 Serum TSH 260 300 340 380 420 10608 Serum Urea 105 120 140 150 170 10611 Serum Uric Acid 165 190 210 240 260 10627 Serum Valproic Acid 665 760 860 960 1060 10934 Serum Vitamin B12 715 820 930 1040 1140 11165 Venous Blood Gas (VBG) 615 710 800 890 980 C2. Biochemistry: Tumour Markers 10701 Serum Alpha Feto Protein (AFP) 615 710 800 890 980 11294 Serum CA 19.9 1215 1400 1580 1760 1940 10734 Serum Cancer Antigen 125 (CA125) 1315 1510 1710 1910 2100 10730 Serum Carcinoembryonic Antigen (CEA) 715 820 930 1040 1140 14 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 10702 Serum Total Prostate Specific Antigen (PSA) 615 710 800 890 980 C3. Biochemistry: Body Fluid Tests 10954 Ascitic Fluid - ADA 715 820 930 1040 1140 10965 CSF - ADA 715 820 930 1040 1140 10618 CSF - Chloride 105 120 140 150 170 10616 CSF - Glucose 105 120 140 150 170 10617 CSF - Protein 155 180 200 220 250 10963 Dialysis Fluid Creatinine 105 120 140 150 170 11138 Dialysis Fluid Glucose 105 120 140 150 170 10964 Dialysis Fluid Urea 105 120 140 150 170 10960 Pericardial Fluid - ADA 715 820 930 1040 1140 10956 Pleural Fluid - ADA 715 820 930 1040 1140 10957 Pleural Fluid Amylase 310 360 400 450 500 10958 Pleural Fluid LDH 310 360 400 450 500 C4. Biochemistry: Urine Tests 11297 Albumin / Creatine Ratio 310 360 400 450 500 10967 Amylase - 24 hrs Urine 400 460 520 580 640 10555 Amylase Random Urine 310 360 400 450 500 10968 Calcium - 24 hrs Urine 300 350 390 440 480 10944 Calcium-Random Urine 160 180 210 230 260 10583 Chloride Random Urine 110 130 140 160 180 11151 Cortisol - 24Hrs Urine 750 860 980 1090 1200 10966 Creatinine - 24 hrs Urine 200 230 260 290 320 10578 Creatinine Clearance - Urine 250 290 330 360 400 10576 Creatinine Random Urine 135 160 180 200 220 10624 Magnesium - 24 hrs Urine 300 350 390 440 480 10949 Magnesium Random Urine 210 240 270 300 340 10625 Microalbumin in Urine 410 470 530 590 660 10750 Osmolality Urine 360 410 470 520 580 10945 Phosphorus - 24 hrs Urine 300 350 390 440 480 10946 Phosphorus Random Urine 210 240 270 300 340 10952 Potasium Random Urine 110 130 140 160 180 10951 Potassium - 24 hrs Urine 200 230 260 290 320 10882 Protein Random Urine 260 300 340 380 420 10598 Protein Total - 24 hrs Urine 300 350 390 440 480 10599 Protein/Creatinine Ratio 310 360 400 450 500 10950 Sodium - 24 hrs Urine 200 230 260 290 320 10603 Sodium Random Urine 110 130 140 160 180 11154 Urea - Random Urine 110 130 140 160 180 10947 Uric Acid - 24 hrs Urine 300 350 390 440 480 10948 Urine Uric Acid Random 170 200 220 250 270 C5. Biochemistry: Panels 11142 Anemia Profile 2515 2890 3270 3650 4020 10953 Ascitic Fluid - Panel (Glucose, Protein, Albumin, Amylase, LDH) 615 710 800 890 980 15 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 10580 CSF Panel (Glucose, Protein, Chloride) 360 410 470 520 580 11145 Diabetic Profile ( Lab Tests Only) 635 730 830 920 1020 10962 Dialysis Fluid Panel (Glucose, Sodium, Potassium, Magnesium) 410 470 530 590 660 11143 Extended Anemia Profile 3015 3470 3920 4370 4820 11146 Extended Diabetic Profile ( Lab Tests Only) 1515 1740 1970 2200 2420 11148 Fertility Profile for Female 1815 2090 2360 2630 2900 11147 Fertility Profile for Male 1765 2030 2290 2560 2820 11149 FSH, LH, PRL, TSH,FT4,Cortisol 7am to 9am 2515 2890 3270 3650 4020 10959 Pericardial Fluid - Panel (Glucose, Protein, Albumin, Amylase, LDH) 615 710 800 890 980 10955 Pleural Fluid - Panel (Glucose, Protein, Albumin) 410 470 530 590 660 11144 Renal Profile (Lab Test Only) 865 990 1120 1250 1380 10633 Serum - Amylase & Lipase 665 760 860 960 1060 10556 Serum - AST & ALT 410 470 530 590 660 10557 Serum - AST, ALT & ALP 615 710 800 890 980 10566 Serum - Calcium, Phosphorus, ALP & Albumin 765 880 990 1110 1220 10565 Serum - Calcium, Phsophorus & Uric Acid 525 600 680 760 840 10582 Serum - Electrolytes 310 360 400 450 500 10605 Serum - Fasting Glucose, Creatinine & Electrolytes 470 540 610 680 750 10606 Serum - Fasting Glucose, Urea & Electrolytes 470 540 610 680 750 10970 Serum - Fasting Glucose, Urea, Creatinine & Electrolytes 575 660 750 830 920 10907 Serum - FSH, LH, PRL 1515 1740 1970 2200 2420 11156 Serum - FSH, LH, Testosterome 1515 1740 1970 2200 2420 10936 Serum - FT3, FT4 & TSH 865 990 1120 1250 1380 10123 Serum - Iron Panel 310 360 400 450 500 10573 Serum - Lipid Profile 855 980 1110 1240 1370 10592 Serum - Liver Function Tests (LFT) 1015 1170 1320 1470 1620 10971 Serum - Post Prandial Glucose, Urea, Creatinine & Electrolytes 575 660 750 830 920 10601 Serum - Random Glucose, Urea, Creatinine & Electrolytes 575 660 750 830 920 10909 Serum - T3, T4 510 590 660 740 820 10910 Serum - T3,T4, TSH 765 880 990 1110 1220 10911 Serum - T3,T4, TSH, FSH, LH, PRL 2265 2600 2940 3280 3620 11240 Serum - TSH, Free T4,TG, Anti-TG 2865 3290 3720 4150 4580 10648 Serum - TSH, FT4, Anti TPO 1315 1510 1710 1910 2100 10609 Serum - Urea & Creatinine 205 240 270 300 330 10961 Synovial Fluid - Panel (Glucose, Protein, Albumin) 410 470 530 590 660 10567 Urine - Calcium, Phosphorus & Uric Acid 575 660 750 830 920 C6. Biochemistry: Tests Done in College 10749 Chromatography for Amino Acids - Serum 750 860 980 1090 1200 10705 Chromatography for Amino Acids-urine 800 920 1040 1160 1280 10746 Chromatography for Sugar - Urine 700 800 910 1020 1120 10756 Gall Stone Analysis 310 360 400 450 500 00340 New Born Screening 800 920 1040 1160 1280 10969 Salivary Calculi Analysis 310 360 400 450 500 10714 Screening for IEM (PKU, Cystine, Homocystine, Arginine, Tyrosine 210 240 270 300 340

16 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 10716 Serum Ceruloplasmin 800 920 1040 1160 1280 11131 Serum Free Light Chains 3250 3740 4230 4710 5200 11166 Serum Immunofixation Electrophoresis Qualitative 5000 5750 6500 7250 8000 10718 Serum Protein Electrophoresis 900 1040 1170 1310 1440 11133 Serum Soluble Transferrin Receptor ( sTfR) 1200 1380 1560 1740 1920 10719 Stool Fat 160 180 210 230 260 11122 Urinary Metanephrine 2500 2880 3250 3630 4000 10720 Urine 5 Hydroxy Indoles (5 - HI) 1750 2010 2280 2540 2800 10727 Urine Galactose ( Screening Test ) 130 150 170 190 210 10711 Urine Mucopolysaccharides 260 300 340 380 420 10755 Urine pH (by pH meter) 110 130 140 160 180 10724 Urine VMA 1500 1720 1950 2180 2400 10710 Whole Blood Methaemoglobin 260 300 340 380 420 C7. Biochemistry Tests Outsourced 11547 1,25 Hydroxy Vit D 2110 11510 17 oh Progesterone 920 11522 24 Hrs Urine Copper 1250 11526 24 hrs Urine Porphobilinogen 2310 11521 Acetyl Choline Receptor Antibodies 2050 11515 ACTH 1020 11587 Aldosterone 1290 11560 Alpa 1 Antitrypsin Level 1980 11565 Anti B2 GPI lgG 690 11566 Anti B2 GPI lgM 690 11563 Anti GAD Antibodies IDM 3370 11564 Anti GAD Antibodies PNS 4290 11549 Anti Ganglioside lgA Antibody 3270 11548 Anti Ganglioside lgG lgA Antibody 3270 11546 Anti GBM Antibodies 1020 11545 Anti Gladin Antibody lgA 1250 11543 Anti Musk Antibodies 4090 11532 Anti NMO Antibodies 2840 11511 Anti Ttg Antibodies (lgA) 760 11524 B2 Microglobulin Serum /Urine 960 11525 B2 Microglobulin Urine 1580 11536 Blood Lead 1160 11517 C- Peptide 730 11534 C1 Esterase level 2480 11537 Calcitonin 1390 11551 Cyclosporin 1720 11519 Digoxin Level 590 11523 Dihydroxy Testosterone 1520 11570 Dual Marker 1490 11542 Electrophoresis-Urine 560 17 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 11518 Free Light Chains-Urine 2970 11555 Free Testosterone 990 11535 GAD 65 3370 11556 Heavy Metal Screening Profile -1 6600 11557 Heavy Metal Screening Profile -2 3960 11516 IGF1 1850 11541 Immuno Electrophoresis 3430 11550 Immuno Fixation 3960 11554 Insulin Auto Antibodies 1320 11559 Lamotrigine Level 4060 11558 Myasthenia Gravis Panel 6530 11544 Oligoclonal Bands 2840 11527 Organic Acid-Urine 1490 11553 Paracetamol Level 730 11562 Plasma Free Metanephrine 2640 11533 Plasma Renin Activity 2640 11520 Pseudo Cholinesterase 660 11512 Quadruple Markers test 1910 11552 Serum Bile Acids 1120 11529 Serum Copper 1250 11530 Serum DHEAS 660 11539 Serum Haptoglobin 3660 11567 Serum Hepcidin Level 1190 11569 Serum Oxcarbazepine 4460 11568 Serum Progesterone 400 11538 Serum Zinc Level 1680 11528 Stone analysis 730 11571 Triple Marker 1650 11531 TSH Receptor Antibodies 2710 11561 Vitamin C 1980 11514 Vitamin E 2640 D. MICROBIOLOGY LAB D1. Microbiology: Routine Tests 10456 Acute Hepatitis Markers 2445 2810 3180 3550 3910 10460 Aerobic Culture and Sensitivity 770 890 1000 1120 1230 10402 AFB Smear 140 160 180 200 220 10403 Albert’s Stain 230 260 300 330 370 11200 Allergy Panel for & Rhinitis 7215 8300 9380 10460 11540 11205 Allergy Panel for ENT allergies 2515 2890 3270 3650 4020 11202 Allergy Panel for Molds 1940 2230 2520 2810 3100 11203 Allergy Panel for Non-Veg Food + House Dust Mite + Animal Dander mix 2515 2890 3270 3650 4020 11204 Allergy Panel for Veg Food + House Dust Mite + Animal Dander mix 3515 4040 4570 5100 5620 10425 Anaerobic Culture (Conventional) 1575 1810 2050 2280 2520 10433 Antibodies to Hepatitis B Surface Antigen(AntiHBs) 730 840 950 1060 1170 18 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 10405 Anti-Streptolysin (ASLO) Quantitative 420 480 550 610 670 10446 Automated Aerobic Culture sensitivity (Blood, Sterile Body Fuids) 850 980 1110 1230 1360 10537 Automated Anaerobic Culture (Blood, Sterile Body Fuids) 850 980 1110 1230 1360 10538 Automated fungal Culture (Blood, Sterile Body Fuids) 850 980 1110 1230 1360 10548 Automated ID & Sensitivity for Candida & Cryptococcus 850 980 1110 1230 1360 10407 Brucella Agglutination Test 420 480 550 610 670 10462 Calcoflour White Stain + KOH 230 260 300 330 370 10532 Chikungunya IgM Rapid Test 595 680 770 860 950 10408 C-Reactive Protein (CRP) Qualitative 240 280 310 350 380 10419 Cryptococcal Ag , Gram Stain , India ink 1290 1480 1680 1870 2060 11110 CSF Bacterial Antigen Detection Panel 590 680 770 860 940 10430 Cytomegalovirus IgM 575 660 750 830 920 10506 Cytomegalovirus IgG 400 460 520 580 640 10542 Dengue Combined Package(NS1+IgM+IgG) 750 750 750 750 750 10534 Dengue IgG 250 250 250 250 250 10522 Dengue IgM 250 250 250 250 250 10541 Dengue NS1 Antigen 250 250 250 250 250 11102 ELISA for Aspergillus Galactomannan Assay 1675 1930 2180 2430 2680 10520 Escherichia coli KI Antigen in CSF 440 510 570 640 700 10449 Febrile Agglutination Package Serology 845 970 1100 1230 1350 11278 Multiplex PCR Blood Culture Panel 8500 8500 8500 8500 8500 11292 Multiplex PCR Lower Respiratory Panel 14500 14500 14500 14500 14500 11280 Multiplex PCR ME + Additional Bacteria and Fungal Panel 17000 17000 17000 17000 17000 11282 Multiplex PCR ME + Additional Bacteria and Fungal Panel + TB 17000 17000 17000 17000 17000 11281 Multiplex PCR ME + TB Panel 8500 8500 8500 8500 8500 11279 Multiplex PCR Meningoencephalitis (ME) Panel 8500 8500 8500 8500 8500 11283 Multiplex PCR Upper Respiratory Panel 8500 8500 8500 8500 8500 10464 Fluorochrome Staining for AFB 230 260 300 340 370 10409 Fungal Culture (Conventional) 600 690 780 870 960 10410 Grams Stain 140 160 180 200 220 10518 Group B Streptococcus Antigen in CSF 440 510 570 640 700 10517 Haemophilus Influenzae b Antigen in C.SerumF 440 510 570 640 700 10436 Hanging Drop for Vibrio Cholerae 120 140 160 170 190 10510 HCV Antibodies 625 720 810 910 1000 10440 Hepatitis A virus IgM 450 520 590 650 720 10452 Hepatitis B e Antibody (AntiHBe) 675 780 880 980 1080 10434 Hepatitis B e Antigen (HBeAg) 675 780 880 980 1080 10511 Hepatitis B Markers Profile 2255 2590 2930 3270 3610 10427 Hepatitis B Surface Antigen ( HBs Ag) 360 410 470 520 580 10513 Hepatitis E Virus IgM 625 720 810 910 1000 10523 Herpes Simplex Virus (HSV) 1 IgG 400 460 520 580 640 10507 Herpes Simplex Virus (HSV) 2 IgG 400 460 520 580 640 10533 Herpes Simplex Virus (HSV) 2 IgM 400 460 520 580 640 10426 Human Immunodeficiency Virus (HIV) Test 460 530 600 670 740 11113 Hydatid Cyst - Wet mount 120 140 160 170 190 19 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 11265 Identification of Fungal Isolate 1000 1000 1000 1000 1000 10435 IgM to Hepatitis B Core Antigen (antiHBcIgM) 735 850 960 1070 1180 10438 India Ink + Gram‘s Stain 240 280 310 350 380 11288 ICTC/PPTCT 75 75 75 75 75 10444 Leptospira IgM 575 660 750 830 920 10524 Malaria Serology 310 360 400 450 500 10519 Meningococcal Antigen Detection in CSF 440 510 570 640 700 10401 Mycobacterial Culture 900 1040 1170 1310 1440 11107 Mycobacterial Culture and Sty to Second Line Drugs 2100 2100 2100 2100 2100 10463 Mycobacterial Culture and Sty to SIRE 3990 4590 5190 5790 6380 11114 Mycobacterial Culture Urine Sample 2 110 130 140 160 170 11115 Mycobacterial Culture Urine Sample 3 110 130 140 160 170 11101 Mycobaterial Culture and Sty to SIRE+PZA 4520 5200 5870 6550 7220 10526 Nugents Score for Bacterial Vaginosis 170 200 220 250 270 11289 Paired Blood Cultures Automated 1250 1440 1630 1810 2000 10411 Paul Bunnel Test 240 280 310 350 380 10516 Pneumococcal Antigen in CSF 440 510 570 640 700 10697 Procalcitonin 1345 1550 1750 1950 2150 11263 Quantiferon TB Assay 2515 2890 3270 3650 4020 10414 R.A.Test (Quantitative) 230 260 300 330 370 10448 Rapid HBs Ag 400 460 520 580 640 10437 Rapid HIV 575 660 750 830 920 10465 Rapid Test for Rotavirus & Adenovirus Antigen 320 370 410 460 500 11290 RNTCP Sptum Smear Microscopy 0.01 0.01 0.01 0.01 0.01 10505 Rubella Virus IgG 400 460 520 580 640 10429 Rubella Virus IgM 575 660 750 830 920 11295 Scrub Typhus Igm 700 800 910 1020 1120 11264 Serotyping for Bacterial Isolate 300 300 300 300 300 10432 Serum Complement C3 Level 575 660 750 830 920 10509 Serum Complement C4 Level 575 660 750 830 920 11226 Specific IgE for Alternaria Alternata 785 900 1020 1140 1260 11231 Specific IgE for Animal mix (Cat, Dog,Cow, Horse Danders) 785 900 1020 1140 1260 11221 Specific IgE for Aspergillus Fumigatus 785 900 1020 1140 1260 11239 Specific IgE for Banana 785 900 1020 1140 1260 11206 Specific IgE for Bermuda grass 785 900 1020 1140 1260 11217 Specific IgE for Cat Dander 785 900 1020 1140 1260 11237 Specific IgE for Chick Pea 785 900 1020 1140 1260 11227 Specific IgE for Cladosporium Herbarum 785 900 1020 1140 1260 11219 Specific IgE for Cockroach 785 900 1020 1140 1260 11215 Specific IgE for Common Pigweed 785 900 1020 1140 1260 11212 Specific IgE for Common Ragweed (Parthenium) 785 900 1020 1140 1260 11216 Specific IgE for Dog Dander 785 900 1020 1140 1260 11228 Specific IgE for Egg (Whole) 785 900 1020 1140 1260 11210 Specific IgE for Elm 785 900 1020 1140 1260 11209 Specific IgE for Eucalyptus (Gum Tree) 785 900 1020 1140 1260 20 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 11229 Specific IgE for Fish (Cod) 785 900 1020 1140 1260 11214 Specific IgE for Goosefoot 785 900 1020 1140 1260 11208 Specific IgE for Grey Alder 785 900 1020 1140 1260 11218 Specific IgE for House Dust Mite 785 900 1020 1140 1260 11207 Specific IgE for Johnson Grass (Jowar) 785 900 1020 1140 1260 11238 Specific IgE for Lemon/Citrus 785 900 1020 1140 1260 11211 Specific IgE for Mesquite 785 900 1020 1140 1260 11232 Specific IgE for Milk 785 900 1020 1140 1260 11220 Specific IgE for Mould mix 785 900 1020 1140 1260 11213 Specific IgE for Mugwort 785 900 1020 1140 1260 11234 Specific IgE for Peanut 785 900 1020 1140 1260 11225 Specific IgE for Penicillium Notatum 785 900 1020 1140 1260 11235 Specific IgE for Red Kidney Bean 785 900 1020 1140 1260 11230 Specific IgE for Shrimp 785 900 1020 1140 1260 11236 Specific IgE for Soyabean 785 900 1020 1140 1260 11233 Specific IgE for Wheat 785 900 1020 1140 1260 10423 Stain for Protozoa 230 260 300 330 370 10424 Staining for Pneumocystis Jiroveci + KOH + Calcofluor 260 300 340 380 420 11296 Total Hepatitis B Core Antibody 700 800 910 1020 1120 10508 TORCH IgG 1345 1550 1750 1950 2150 10431 TORCH IgM 1675 1930 2180 2430 2680 10528 Total Serum IgE 645 740 840 940 1030 10504 Toxoplasma IgG 400 460 520 580 640 10428 Toxoplasma IgM 575 660 750 830 920 10404 TPHA Test for Syphilis 430 490 560 620 690 10416 VDRL (STS) 160 180 210 230 260 10417 Weil Felix Test 200 230 260 290 320 10515 Western Blot for HIV - 1/2 2015 2320 2620 2920 3220 10543 Wet Mount 120 140 160 170 190 10418 Widal Test 210 240 270 300 340 D2. Microbiology: Surveillance 11109 Air Sampling (1Set) 250 250 250 250 250 11260 Biological Indicator Testing 50 50 50 50 50 10050 MDRO Screen (Surface SWAB+Rectal SWAB) - 1 Set 600 600 600 600 600 10049 MRSA Screen 200 200 200 200 200 11251 Post MRSA Follow up (3 Sets) 600 690 780 870 960 10529 RO Water Analysis (1 Set) 300 300 300 300 300 10451 Settle Plates for Biosafety Cabinet 350 350 350 350 350 11259 Sterile Liquid/Disinfectant Testing 250 250 250 250 250 11108 Surveillance of Burns Ward (1 Room) 600 600 600 600 600 10450 Surveillance of Operation Theatre (1 Room) 900 900 900 900 900 11257 Survelliance of ICU (5 Beds) 900 900 900 900 250 10442 Water Analysis 1260 1450 1640 1830 2020 D3. Microbiology: Tests Outsourced 11573 Adenovirus IgG 1490 21 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 11572 Adenovirus IgM 1490 11576 Amoebiasis IgG 1000 11575 Aspergillus IgG 1520 11574 Aspergillus IgM 1620 10693 H1N1 Collection Apparatus 300 10696 H1N1 Real Time RTPCR 2500 11577 HBV Genotyping 5010 11578 HCV Genotyping 5010 11580 Parvovirus B19 1gM 1850 11581 Serum IgG4 Subclass 3540 11583 Total Serum IgA 540 11584 Total Serum IgD 2310 11585 Total Serum IgM 540 D4. Microbiology - Tests Done at SJRI 11250 CMV (Cytomegalovirus) PCR Quantitative 8015 8015 8015 8015 8015 11692 CMV Qualitative 4215 4215 4215 4215 4215 10550 Genexpert - TB 0.01 0.01 0.01 0.01 0.01 11112 HCV Quantitative Viral Load 2600 2600 2600 2600 2600 11691 HBV Qualitative 3515 3515 3515 3515 3515 11690 HBV Quantitative / Viral Load 4215 4215 4215 4215 4215 10467 HIV Viral Load (Quantitative) 2800 2800 2800 2800 2800 11693 RT - PCR for SARS COV-2 4000 4000 4000 4000 4000 E. HISTOPATHOLOGY LAB 11011 ANA by IIF Method 550 630 720 800 880 11014 ANCA by IIF Method 1000 1150 1300 1450 1600 110033 Anti - PLA 2R by IIF Method 3500 4020 4550 5080 5600 110019 Biopsy Paraffin Method Large (IP sample) 1200 1380 1560 1740 1920 110024 Biopsy Paraffin Method Small (IP sample) 600 690 780 870 960 110018 Biopsy Paraffin Method Small (OPD sample) 600 690 780 870 960 110025 Body Fluids for Malignant Cells (more than 3 samples) 500 580 650 730 800 110021 Body Fluids for Malignant Cells(upto 3 samples) 500 580 650 730 800 110030 Dermatology Mosaic by IIF Method 4000 4600 5200 5800 6400 11013 ds - DNA by IIF Method 700 800 910 1020 1120 110040 ELISA for Desmoglein 3 900 1040 1170 1310 1440 110038 ELISA for ds DNA 400 460 520 580 640 11005 FNAC 500 580 650 730 800 110027 FNAC - CT / MRI Guided 900 1040 1170 1310 1440 11008 Frozen Section Including Paraffin Section 1300 1490 1690 1890 2080 110041 HER-2 Testing by FISH 7500 8630 9750 10880 12000 11009 IImmunofluoroscence Studies - Skin 2500 2880 3250 3630 4000 110034 Immunofluoroscence Studies - Kidney 2500 2880 3250 3630 4000 110044 Immunohistochemistry – Single marker (For patient care) 1000 1150 1300 1450 1600 110028 Immunohistochemistry Hormone Receptor Panel 4000 4600 5200 5800 6400 110039 Immunohistochemistry /Pleura Panel 4000 4600 5200 5800 6400 22 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 110029 Immunohistochemistry Lymphoma Panel 5000 5750 6500 7250 8000 11016 Immunohistochemistry Panel - General 4000 4600 5200 5800 6400 11256 Immunohistochemistry Soft Tissue 4000 4600 5200 5800 6400 11015 Immunoline 2000 2300 2600 2900 3200 110043 Issue of Block - Handling charges 80 90 100 120 130 110042 Issue of Duplicate slide – Handling charges 50 60 70 70 80 110023 Liver Mosaic 2 (ANA,AMA,Anti LKM,ASMA) by IIF Mehtod 1200 1380 1560 1740 1920 110032 Liver Profile 1500 1720 1950 2180 2400 110017 Pap Smear 400 460 520 580 640 110036 Slide/Block for Consultation (<4Slides/Blocks) 800 920 1040 1160 1280 110037 Slide/Block for Consultation (>4Slides/Blocks) 1500 1720 1950 2180 2400 110046 Specimen Mounting – Medium 500 580 650 730 800 110045 Specimen Mounting - Small 200 230 260 290 320 110047 Specimen Mounting -Large and Extra large 800 920 1040 1160 1280 F. CYTOGENETICS TESTS DONE IN COLLEGE 10773 Cancer Cytogenetics 4150 4770 5400 6020 6640 11255 Cancer Cytogenetics + FISH panel ALL,AML,CLL,MDS,MM 7000 8050 9100 10150 11200 10781 Chromosome Breakage Studies 4150 4770 5400 6020 6640 10759 Follow-up within 6 Months 600 690 780 870 960 10744 Genetic Counselling 1000 1150 1300 1450 1600 10758 Karyotyping * - Family Member 2150 2470 2800 3120 3440 10743 Karyotyping and Genetic Counselling 4150 4770 5400 6020 6640 10745 Millipore Water (per litre) 500 580 650 730 800 10783 FISH for Microdeletion Syndromes & WCP 5150 5920 6700 7470 8240 10782 FISH for CML,APML 5150 5920 6700 7470 8240 10707 Registration / Referral (Cytogenetics) 150 170 200 220 240 10774 Repeat Karyotyping* - Cancer Follow-up 1800 2070 2340 2610 2880 * Note: Karyotyping per patient’s family member in case the patient is diagnosed with chromosomal abnormality

G. PHARMACOLOGY LAB (COLLEGE) 10771 Amphetamine Urine Test 320 340 370 390 420 10766 Benzodiazepine Urine Test 320 340 370 390 420 10770 Cocaine Urine Test 320 340 370 390 420 11052 DD - Xylose in Blood 100 130 140 160 180 11053 DD - Xylose in Urine 80 100 100 120 140 10765 Marijuana (THC) Urine Test 320 340 370 390 420 10769 Methamphetamine Urine Test 320 340 370 390 420 10767 Morphine Urine Test 320 340 370 390 420 10776 Multiple Six Drug Test 1520 1620 1720 1820 1920 10768 Phencyclidine Urine Test 320 340 370 390 420 H. EMERGENCY MEDICINE 11506 Biochem - EMS 400 460 520 580 640 11505 Blood Gas - Total ABG- EMS 400 460 520 580 640 11507 Creatinine - EMS 100 120 130 150 640 11508 NT-proBNP 1620 1860 2110 2350 2590 23 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. IV. RADIOLOGY INVESTIGATIONS A. PLAIN X-RAY 12509 CD Coping for X-Rays 40 50 50 60 60 12062 Cystogram including Flouro Charges( 2 exposures ) 800 920 1040 1160 1280 12508 Film Charges X Ray 17x14 (1 Film) 120 140 160 170 190 12507 Film Charges X-Ray 10 X 8 (1 Film) 50 60 70 70 80 12017 Fluroscopy 350 400 460 510 560 12001 X-Ray Abdomen (KUB) - Adult 240 280 310 350 380 12002 X-Ray Abdomen (KUB) - Child below 10 Years 210 240 270 300 340 12003 X-Ray Acromioclavicular 200 230 260 290 320 12070 X-Ray Age Estimation 280 280 280 280 280 12004 X-Ray Ankle Joint (AP & Lat) 220 250 290 320 350 12005 X-Ray Apicogram 200 230 260 290 320 12006 X-Ray Calcaneum 200 230 260 290 320 12074 X-Ray Calcaneum (2 views) 220 220 220 220 220 12012 X-Ray Cervical Spine (1 exposure 8x10) 200 230 260 290 320 12051 X-Ray Cervical Spine (2 exposures) 310 360 400 450 500 12008 X-Ray Chest - Adult 220 250 290 320 350 12010 X-Ray Chest - Child below 10 Years 200 230 260 290 320 12011 X-Ray Clavicle (1 exposure) 200 230 260 290 320 12013 X-Ray Elbow Joint (AP & Lat) 220 250 290 320 350 12015 X-Ray Femur - Child below 10 Years 230 260 300 330 370 12014 X-Ray Femur (AP & Lat) 300 350 390 440 480 12016 X-Ray Fingers (2 exposures) 220 250 290 320 350 12018 X-Ray Foot AP & Oblique 220 250 290 320 350 12073 X-Ray Foot or Hand or Wrist ( Additional one view ) 200 200 200 200 200 12019 X-Ray Forearm (AP & Lat) 220 250 290 320 350 12020 X-Ray Hand (AP & Lat) 220 250 290 320 350 12021 X-Ray Hip (1 exposure) 220 250 290 320 350 12022 X-Ray Humerus 220 250 290 320 350 12071 X-Ray Infantogram 220 250 290 320 350 12025 X-Ray (AP & Lat) 220 250 290 320 350 12069 X-Ray Knee Skyline Exposure (L/R) 200 230 260 290 320 12026 X-Ray Leg (AP & Lat) 300 350 390 440 480 12063 X-Ray Leg (AP & Lat) - Child below 12 Years 230 260 300 330 370 12028 X-Ray Lumbo Sacral (1 exposure) 220 250 290 320 350 12064 X-Ray Lumbosacral Spine - Child (2 exposures) 300 350 390 440 480 12052 X-Ray Lumbosacral Spine (2 exposures) 340 390 440 490 540 12065 X-Ray Lumbosacral Spine AP with Pelvis 280 320 360 410 450 12029 X-Ray Mandible (per exposure) 200 230 260 290 320 12072 X-Ray Nasal Bone (2 views) 220 250 290 320 350 12068 X-Ray Neck Soft Tissue - Lateral Exposure 200 230 260 290 320 12030 X-Ray Optic Foramen 200 230 260 290 320 12031 X-Ray Pelvis (1 exposure) 220 250 290 320 350 24 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 12067 X-Ray PNS 200 230 260 290 320 12039 X-Ray Ribs (AP) 230 260 300 330 370 12040 X-Ray Sacroiliac (both) 220 250 290 320 350 12041 X-Ray Scapula (1 exposure) 200 230 260 290 320 12042 X-Ray Shoulders Joint (1 exposure) 200 230 260 290 320 12043 X-Ray Skull per exposure (Skull Ap, P.A.Orbit P.N.) 200 230 260 290 320 12044 X-Ray Sternum (1 exposure) 200 230 260 290 320 12049 X-Ray Thoracic Lumbar Spine (1 exposure) 230 260 300 330 370 12045 X-Ray Thoracic Lumbar Spine (2 exposures) 350 400 460 510 560 12048 X-Ray Thoracic Spine (1 exposure 15x12) 230 260 300 330 370 12053 X-Ray Thoracic Spine (2 exposures) 340 390 440 490 540 12047 X-Ray Toes (2 exposures) 220 250 290 320 350 12050 X-Ray Wrist (AP & Lat) 220 250 290 320 350 B. SPECIAL INVESTIGATIONS 12202 Angioplasty (6 exposures) 10000 11500 13000 14500 16000 12530 Atherectomy & Angioplasty 20000 23000 26000 29000 32000 12534 Av Fistulogram 8000 9200 10400 11600 12800 12206 Barium Enema ( 4 exposures) 1500 1720 1950 2180 2400 12208 Barium Meal - Upper GI Tract (3exposures) 750 860 980 1090 1200 12207 Barium Meal Follow Through (6 exposures) 1400 1610 1820 2030 2240 12209 Barium Screening Enema 550 630 720 800 880 12211 Barium Swallow (2 exposures) 650 750 850 940 1040 12210 Barium Swallow Screening 450 520 590 650 720 12531 Biliary Plasty 8000 9200 10400 11600 12800 12290 Biliary Stenting# 10000 11500 13000 14500 16000 12280 Bronchial Artery Embolization 10000 11500 13000 14500 16000 12312 Cavernosography 400 440 510 560 620 12276 Cerebral Angiogram (4 Vessel) 10000 11500 13000 14500 16000 12215 Cystourethrogram (3 exposures) 1100 1270 1430 1600 1760 12249 Dacryocystogram (2 exposures) 600 690 780 870 960 12058 Distal Colonogram/ Loopogram(2 exposures) 800 920 1040 1160 1280 12219 Fluroscopy for major procedure (eg.PCNL etc.,) 500 580 650 730 800 12561 Fluroscopy Time upto 10 Minutes 600 690 780 870 960 12299 Full Lower Limb Scoliogram 800 920 1040 1160 1280 12297 Full Spine Scoliogram AP 800 920 1040 1160 1280 12298 Full Spine Scoliogram Lat 800 920 1040 1160 1280 12532 Gi Bleeder Embolization 10000 11500 13000 14500 16000 12288 Hemo dialysis Fistula Revision 12000 13800 15600 17400 19200 12222 Hysterosalphinogram (2 exposures) 1050 1210 1370 1520 1680 12537 Interventional Radiology- Misc 12281 IVC Filter Placement 10000 11500 13000 14500 16000 12283 IVC Filter Retrieval 7000 8050 9100 10150 11200 12225 IVP (6 exposures) 1220 1410 1580 1770 1960 12296 Knee Rosenberg View 220 250 290 320 350 12293 Mastoids B/L 300 350 390 440 480 25 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 12551 N.J Tube Insertion 1500 1720 1950 2180 2400 12229 Nephrostogram (2 exposures) 850 980 1100 1230 1350 12230 Operative Cholangiogram ( 2 exposures) 800 940 1060 1180 1300 12456 Paediatric Surgery Dye Study ( 1 exposure ) 400 460 520 580 640 12455 Paediatric Surgery MCU ( 2 exposures ) 650 750 850 940 1040 12284 Peripheral Stenting 15000 17250 19500 21750 24000 12277 Peripherial Angiogram 9000 10350 11700 13050 14400 12279 Peripherial Angioplasty 20000 28000 36000 44000 52000 12282 Peripherial Vein Thrombolisis 15000 17250 19500 21750 24000 12287 Permanent Catheter Insertion 15000 17250 19500 21750 24000 12248 PTBD 6000 6900 7800 8700 9600 12235 PTC (6 exposures) 1350 1550 1760 1960 2170 12267 Retrograde Urethrography (RGU + MCU) 1200 1380 1560 1740 1920 12291 RF Ablation of Tumors 18000 20700 23400 26100 28800 12247 RGU (1 Exposure) 600 690 780 870 960 12535 Sclerotherapy 2500 2880 3250 3630 4000 12238 Selective Angiogram 4000 4600 5200 5800 6400 12240 Sialogram (2 exposures) 800 920 1050 1170 1290 12241 Sinogram and Fistulogram (2 exposures) 800 920 1040 1160 1280 12294 Skull (AP&Lat) 320 370 420 460 510 12295 Skull per exposure (Skull AP PA etc) 200 230 260 290 320 12242 Small Bowel Enema - Contrast Study 1400 1610 1820 2030 2240 12278 Transarterial chemoembolization (TACE) * 10000 11500 13000 14500 16000 12536 Trans-Jugular Biopsy 8000 9200 10400 11600 12800 12244 T-Tube Cholangiogram (2 exposures) 600 690 780 870 960 12533 Uterine Artery Embolization 10000 11500 13000 14500 16000 12285 Varicose Veins Laser Ablation 12000 13800 15600 17400 19200 12286 Varicose Veins RF Ablation 20000 23000 26000 29000 32000 12271 Venogram (Ascending + Descending) 2500 2880 3250 3630 4000 12270 Venogram (Descending) 1500 1720 1950 2180 2400 12292 Visceral Embolization 15000 17250 19500 21750 24000 12252 X ray Charges-Portable (extra) 200 230 260 290 320 Note: Portable X-rays & Portable ultrasounds will be charged extra. Any special Catheterether / accessories used for Angiograms / Interventions will becharged extra. Contract media will be charged extra. Each X-ray film will be charged according to the film size.# Stent charges Extra* Embolization Materials/devices/coils/PVA will be as per actuals

C. COLOUR DOPPLER SONOGRAPHY 12425 A V Fistula Duplex Scan 700 800 910 1020 1120 12462 Arterial Doppler-Both Extremities 2400 2760 3120 3480 3840 12461 Arterial Doppler-Single Extremity 1200 1380 1560 1740 1920 12513 AV Fistula Creation Doppler 1300 1490 1690 1890 2080 12512 AV Fistula Patency Doppler 500 580 650 730 800 12304 Carotids and Vertebrals Doppler 1100 1270 1430 1600 1760 12514 Iliac Vessel Doppler (Bilateral) 1350 1550 1760 1960 2160 12471 Mesenteric Doppler 800 920 1040 1160 1280 12511 Neck Vein Doppler 500 580 650 730 800 26 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 12517 Obstetric Anomaly Scan with Uterine Artery Doppler 1500 1720 1950 2180 2400 12306 Obstetrics / Doppler 1100 1270 1430 1600 1760 12515 Pelvic Doppler 700 800 910 1020 1120 12309 Penile Doppler Studies 1500 1720 1950 2180 2400 12454 Perforator Marking 350 400 460 510 560 12305 Portal Venous System Doppler 1100 1270 1430 1600 1760 12469 Renal Doppler 1500 1720 1950 2180 2400 12307 Renal Transplant Doppler 1000 1150 1300 1450 1600 12524 Repeat Doppler Scan 600 690 780 870 960 12523 Review Doppler 350 400 460 510 560 12470 Scrotal Doppler + Scan 800 920 1040 1160 1280 12516 Temporal Artery Doppler 600 690 780 870 960 12510 Twin OB Doppler 1300 1490 1690 1890 2080 12525 Uterine Artery Doppler 400 460 520 580 640 12465 Venous Doppler - Both Extremities 2200 2530 2860 3190 3520 12464 Venous Doppler - Single Extremity 1100 1270 1430 1600 1760 12468 Venous Doppler - Varicose Veins - Both Extremities 2600 2990 3380 3770 4160 12467 Venous Doppler - Varicose Veins - Single Extremity 1300 1490 1690 1890 2080 D. ULTRASOUND IMAGING 12401 Abdominal Ultrasound 800 920 1040 1160 1280 12402 Abdominal Ultrasound - Repeat within 5 days 400 460 520 580 640 12415 Additional Scan for Follicular Monitoring 250 290 330 360 400 12060 AFI/HR ( Single Parameter) 200 230 260 290 320 12504 Anomaly Scan 1400 1610 1820 2030 2240 12473 Anomaly Scan with Fetal Echo 3000 3450 3900 4350 4800 12538 Aspiration (Diagnostic) 1000 1150 1300 1450 1600 12428 Aspiration of Fluid Collection 630 720 830 920 1020 12539 Aspiration- Therapeutic 1200 1380 1560 1740 1920 12547 Biopsy - UltrasoundGuided 1500 1720 1950 2180 2400 12546 Breast Lesion Wire localization - UltrasoundGuided 2000 2300 2600 2900 3200 12404 Breast Ultrasound 800 920 1040 1160 1280 12055 Catheter Drainage of Fluid Collections 1160 1330 1500 1680 1850 12429 Catheterer Drainage of Fluid Collections Repeat 840 890 1000 1260 1470 12405 Chest Scan 500 580 650 730 800 12555 Chest Ultrasound ( Repeat within 5 days ) 250 290 330 360 400 12558 Elastography 900 1040 1170 1310 1440 12424 Extra Charges for Portable Ultrasound 150 170 200 220 240 12472 Fetal Echocardiography 1600 1840 2080 2320 2560 12540 FNAC - UltrasoundGuided 1200 1380 1560 1740 1920 12548 FNAC Guidence - UltrasoundGuided 1000 1150 1300 1450 1600 12518 Hepatobiliary Scan 500 580 650 730 800 12541 IJV Sampling - UltrasoundGuided 2500 2880 3250 3630 4000 12544 Injection OF Drugs - UltrasoundGuided 2000 2300 2600 2900 3200 12559 Intraoperative Ultrasound 1500 1720 1950 2180 2400 12542 IV Access - UltrasoundGuided 1000 1150 1300 1450 1600 27 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 12549 Line Insertion - UltrasoundGuided 2000 2300 2600 2900 3200 12520 Musculoskeletal Scan (other than shoulder and hip) 800 920 1040 1160 1280 12452 Neck Ultrasound 800 920 1040 1160 1280 12521 Nerve Scan - Single Side 750 860 980 1090 1200 12519 Nuchal Translucency (NT) Scan 1100 1270 1430 1600 1760 12474 OB Growth Scan with Fetal Echo 2400 2760 3120 3480 3840 12475 OB Growth Scan with OB Doppler 1800 2070 2340 2610 2880 12458 Obstetric Biophysical Profile 1400 1610 1820 2030 2240 12552 Obstetric Ultrasound ( Dating ) 500 580 650 730 800 12407 Obstetric Ultrasound (Growth scan) 800 920 1040 1160 1280 12505 Obstretic Ultrasound-Twin Gestation 1400 1610 1820 2030 2240 12545 PCN - UltrasoundGuided 2000 2300 2600 2900 3200 12427 Peadiatric Renal Scan 630 720 830 920 1020 12459 Pelvic Ultrasound 500 580 650 730 800 12506 Pelvic Ultrasound - Repeat within 5 days 300 350 390 440 480 12409 Pelvic Ultrasound,Transvaginal and Transabdominal 700 800 910 1020 1120 12476 Penile Ultrasound 800 920 1040 1160 1280 12543 Pigtail Insertion - UltrasoundGuided 1500 1720 1950 2180 2400 12410 Renal Transplant Scan 500 580 650 730 800 12412 Renal Ultrasound 500 580 650 730 800 12411 Renal Ultrasound - Repeat within 5 days 300 350 390 440 480 12426 Review of Untrasound Scan 200 230 260 290 320 12414 Serial Scan Follicular Monitoring (Upto 4 days) 1000 1150 1300 1450 1600 12557 Shoulder / Hip Ultrasound 1000 1150 1300 1450 1600 12417 Thyroid Ultrasound 800 920 1040 1160 1280 12556 Thyroid/Renal/Pelvis/Scrotal ( Repeat within 5 days ) 350 400 460 510 560 12522 Twin Anomaly Scan 2000 2300 2600 2900 3200 12553 Twin NT Scan 1800 2070 2340 2610 2880 12554 Twin NT Scan with Uterine Artery Doppler 2000 2300 2600 2900 3200 12406 Ultrasound - Extremities 400 460 520 580 640 12422 Ultrasound of Brain 450 520 590 650 720 12423 Ultrasound of Brain - Repeat within 5 days 220 250 290 320 350 12421 Ultrasound of Small Parts/Transectal Scan 800 920 1040 1160 1280 12453 UltrasoundGuided Biopsy 2000 2300 2600 2900 3200 12403 UltrasoundGuided Marking 1000 1150 1300 1450 1600 E. MAMMOGRAPHY 12501 Mammography Single Side with Breast Ultrasound 1000 1150 1300 1450 1600 12502 Mammography Both Sides with Breast Ultrasound 2000 2300 2600 2900 3200 12563 Mammography Single Side – 2 Exposures (without Ultrasound) 800 920 1040 1160 1280 12564 Mammography Both Sides – 2 Exposures (without Ultrasound) 1600 1840 2080 2320 2560 12503 Mammography (for each Additional Exposure ) 400 460 520 580 640 F. CT SCAN 90189 10ml Non INOC Contrast 500 500 500 500 500 90194 Brain – Repeat within 3 days 1800 1800 1890 1980 2070 90048 Cardiac Calcium Scoring Screening 4300 4300 4520 4730 4950 28 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 90073 CD Copying 350 350 350 350 350 90071 Cochlear Impalant Package (CT and MRI) 24650 24650 24650 24650 24650 90070 Complimentary CT / MRI 850 850 850 850 850 90012 CT Abdomen / Pelvis 4700 4700 4940 5170 5410 90036 CT Angio Abdomen / Renal / Peripheral / Pulmonary 4300 4300 4520 4730 4950 90037 CT Angio Cranial 3700 3700 3890 4070 4260 90083 CT Angio IC/EC 6100 6100 6410 6710 7010 90196 CT Angiogram – Bilateral lower limb 4300 4300 4520 4730 4950 90084 CT Brain + C.spine + Face 3D (Package) 6000 6000 6300 6600 6900 90025 CT Brain and Orbits / Facial Bone 4200 4200 4410 4620 4830 90039 CT Brain Biopsy 2550 2550 2680 2810 2930 90023 CT Brain Cisternography 4100 4100 4310 4510 4720 90001 CT Brain Plain 3000 3000 3150 3300 3450 90047 CT Cardiac / Coranary CT Angio 5550 5550 5830 6110 6380 90009 CT Cervical Spine 4100 4100 4310 4510 4720 90010 CT Dorsal Spine 4100 4100 4310 4510 4720 90015 CT Extermities 4200 4200 4410 4620 4830 90072 CT for CSF Rhinnohrea 3500 3500 3680 3850 4020 90069 CT for Tracheal Stenosis 2450 2450 2570 2700 2820 90017 CT Guided Biopsy 3500 3500 3680 3850 4020 90046 CT Limited Study 1850 1850 1940 2040 2130 90008 CT Lumbar Spine 4100 4100 4310 4510 4720 90006 CT Neck 4100 4100 4310 4510 4720 90007 CT Orbit 3050 3050 3200 3360 3510 90181 CT Paediatric - One region 2450 2450 2570 2700 2820 90005 CT Paranasal Sinus 2600 2600 2730 2860 2990 90164 CT Scan Reporting charges ( Outside Scanned cases) 300 300 320 330 350 90041 CT Skull Base (PNS,Orbit,Brain CON) 4300 4300 4520 4730 4950 90050 CT Special Technique 1250 1250 1310 1380 1440 90038 CT Stereotactic Procedure 4850 4850 5090 5340 5580 90011 CT Thorax 4500 4500 4730 4950 5180 90014 CT TM Joints 4200 4200 4410 4620 4830 90182 CT Urography / CT KUB 3600 3600 3780 3960 4140 90195 CT Whole Spine 5800 5800 6090 6380 6670 90068 Film Charges for CT/MRI 17x14 (1 Film) 250 250 260 280 290 90100 General Anaesthesia - CT 650 650 680 720 750 90034 HR CT Temoral Bone 4300 4300 4520 4730 4950 90033 HR CT Thorax 4500 4500 4730 4950 5180 90051 Virtual Endoscopy 6150 6150 6460 6770 7070 G. MRI SCAN 90161 100ml Non INOC Contrast 2600 2600 2600 2600 2600 90159 20ml Non INOC Contrast 900 900 900 900 900 90160 50ml Non INOC Contrast 1500 1500 1500 1500 1500 90197 Brachial Plexus – Both sides 10000 10000 10500 11000 11500 90186 Film Charges for CT/MRI 17 x 14 (2-3 films) 600 600 600 600 600 29 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 90177 MR Urography 4500 4500 4730 4950 5180 90067 MRA (Intra or Extra Cranial) 7400 7400 7770 8140 8510 90065 MRA (Peripheral / Renal inclusive of Contrast) 8000 8000 8400 8800 9200 90191 MRA Extra Cranial + Brain Screening 5700 5700 5990 6270 6550 90192 MRA Intra Cranial + Brain Screening 5700 5700 5990 6270 6550 90106 MRI Abdomen 7000 7000 7350 7700 8050 90175 MRI Brachial/Lumbar Plexus 6700 6700 7040 7370 7700 90193 MRI Brain - Epilepsy 6200 6200 6510 6820 7130 90101 MRI Brain / Neck 6700 6700 7040 7370 7700 90081 MRI Brain and Functional MRI 9600 9600 10080 10560 11040 90078 MRI Brain and Perfusion 9600 9600 10080 10560 11040 90172 MRI Brain Limited Study 4200 4200 4410 4620 4830 90062 MRI Brain Perfussion 3100 3100 3260 3410 3560 90082 MRI Brain Screening + MR Angio IC/EC (Package) 9000 9000 9450 9900 10350 90052 MRI Breast 7400 7400 7770 8140 8510 90054 MRI Cardiac / Coronary 6800 6800 7140 7480 7820 90053 MRI Cartigram 3700 3700 3890 4070 4260 90124 MRI Cervical Spine 6000 6000 6300 6600 6900 90107 MRI Chest 7000 7000 7350 7700 8050 90111 MRI Dorsal Spine 6000 6000 6300 6600 6900 90055 MRI DTI and Fibre Tracking 2450 2450 2570 2700 2820 90056 MRI Foetus 6150 6150 6460 6770 7070 90064 MRI Functional (BOLD) 3100 3100 3260 3410 3560 90109 MRI Internal Auditory Canal / Temporal Bone 6700 6700 7040 7370 7700 90187 MRI Joint with 10100 10100 10610 11110 11620 90102 MRI Lumbar Spine 6700 6700 7040 7370 7700 90126 MRI MRCP 4500 4500 4730 4950 5180 90108 MRI Muscular Skeletal Joint 7000 7000 7350 7700 8050 90060 MRI One Region 6550 6550 6880 7210 7530 90059 MRI One Sequence 2000 2000 2100 2200 2300 90105 MRI Orbits 6700 6700 7040 7370 7700 90180 MRI Paediatric - one region/ finger 4500 4500 4730 4950 5180 90199 MRI Pelvis ( Male / Female ) 6700 6700 7040 7370 7700 90110 MRI Pelvis (MSK) 7000 7000 7350 7700 8050 90103 MRI PNS 6700 6700 7040 7370 7700 90165 MRI Scan Reporting Charges ( outside scanned cases) 400 400 420 440 460 90066 MRI Sella with Contrast 8000 8000 8400 8800 9200 90104 MRI Skull Base 6700 6700 7040 7370 7700 90058 MRI Special Technique/10 ml MR Contrast 1850 1850 1940 2040 2130 90063 MRI Spectroscopy 3100 3100 3260 3410 3560 90173 MRI Spine (Cervical /Lumbar) Limited 4200 4200 4410 4620 4830 90179 MRI Spine one region + Rest Screening 8000 8000 8400 8800 9200 90200 MRI TM Joint 6700 6700 7040 7370 7700 90174 MRI Whole Spine Screening 7000 7000 7350 7700 8050 90190 MRI Whole Spine with Contrast 11000 11000 11550 12100 12650 30 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 90178 MRV + Brain Screening 5700 5700 5990 6270 6550 90188 Post MRI Arthrogram 2750 2750 2890 3030 3160 90198 Whole spine screening with Pelvis coronal 8200 8200 8610 9020 9430 G1. EMERGENCY MEDICINE PACKAGE 90184 CT Brain & Cervical Spine Package 4950 4950 5200 5450 5690 90185 CT Thorax+Abdomen & Pelvis Pacakge including contr 8800 8800 9240 9680 10120 H. BONE MARROW DENSITOMETRY (BMD) 90169 BMD Femur 1750 1750 1750 1750 1750 90170 BMD Forearm 1750 1750 1750 1750 1750 90168 BMD Hip Joints 1650 1650 1650 1650 1650 90166 BMD Single Region 1650 1650 1650 1650 1650 90167 BMD Spine 1750 1750 1750 1750 1750 90171 BMD Whole body 4200 4200 4200 4200 4200 I. NEURO INTERVENTIONAL PROCEDURE 27003 Acute Stroke Intrvention 60000 75000 100000 125000 150000 27004 Aneurysm Coiling 70000 85000 110000 135000 160000 27006 AVM/AVF Ebolisation 70000 85000 110000 135000 160000 27008 Ballon Occlusin Test 30000 40000 50000 60000 75000 27002 Carotid Stenting 60000 75000 100000 125000 150000 27010 Cerebral Venous Stenting 60000 75000 100000 125000 150000 27011 Cerebral Venous Thrombolysis 60000 75000 100000 125000 150000 27001 Diagnostic Cerebral Angiogram 12000 15000 20000 25000 30000 27005 Intracranial Stenting 70000 85000 110000 135000 160000 27009 Pre Operative Tumor Ebolistion 30000 40000 50000 60000 75000 27007 Spinal Angiogram 30000 40000 50000 60000 75000 J. INVESTIGATIONS DONE OUTSIDE J1. PET CT SCANS 90557 C11 Choline PET CT Whole Body + MRI Pelvis 31800 31800 31800 31800 31800 90552 C11-Choline PET CT Whole Body 28000 28000 28000 28000 28000 90603 C11-Choline/Methionine PET CT Of Brain Mri Coorelation 17800 17800 17800 17800 17800 90566 Dotonac PET CT Whole Body 25500 25500 25500 25500 25500 90579 F18 PET Bone Scan 7700 7700 7700 7700 7700 90569 FDG Infection Mapping 14000 14000 14000 14000 14000 90567 FDOPA PET CT For Brain 17790 17790 17790 17790 17790 90604 Ga 68 PSMA Limited PET CT Scan 21700 21700 21700 21700 21700 90568 Ga 68 PSMA PET CT Scan 28000 28000 28000 28000 28000 90562 PET CT Ammonia 15000 15000 15000 15000 15000 90606 PET CT Anesthesia Charges 3200 3200 3200 3200 3200 90605 PET CT Simulation For RT 11000 11000 11000 11000 11000 90563 Planning - Limited 15300 15300 15300 15300 15300 90564 Planning - Whole Body 28000 28000 28000 28000 28000 90559 Regional PET CT - Single Region 17000 17000 17000 17000 17000 90560 Regional PET CT - Two Regions 19500 19500 19500 19500 19500 90609 Whole Body Dotonac PET CT - Limited 19700 19700 19700 19700 19700 90565 Whole Body PET CT 16000 16000 16000 16000 16000 90610 Whole Body PET MRI 28000 28000 28000 28000 28000 31 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. J2. NUCLEAR MEDICINE 90570 Catheteryroid Admission 33000 33000 33000 33000 33000 90571 CA Thyroid OPD 22000 22000 22000 22000 22000 90572 Cardiac Evalution For OT 4100 4100 4100 4100 4100 90573 Cell Based Gene Therapy 148500 148500 148500 148500 148500 90574 Dacryocystogram 3900 3900 3900 3900 3900 90575 Dementia Package 18700 18700 18700 18700 18700 90576 DVT 5500 5500 5500 5500 5500 90577 EC Renogram 3900 3900 3900 3900 3900 90578 Epiduralanalgelic Infusion 2400 2400 2400 2400 2400 90580 GER Study 3900 3900 3900 3900 3900 90581 GFR 1000 1000 1000 1000 1000 90582 GI Bleed 5000 5000 5000 5000 5000 90601 Glucotox Theraphy 1 150000 150000 150000 150000 150000 90602 Glucotox Theraphy 2 200000 200000 200000 200000 200000 90583 Hepatobiliary Scan 3300 3300 3300 3300 3300 90584 Hyperthermia 3300 3300 3300 3300 3300 90585 Infarct Imaging 7700 7700 7700 7700 7700 90586 Large Dose Scan 5000 5000 5000 5000 5000 90588 LU 177 Dotatate Therapy Package 1 165000 165000 165000 165000 165000 90589 LU 177 Dotatate Therapy Package 2 220000 220000 220000 220000 220000 90590 LU 177 Psma Therapy 165000 165000 165000 165000 165000 90591 Lung Perfusion Scan 5000 5000 5000 5000 5000 90592 Lymphoscintigraphy 5000 5000 5000 5000 5000 90593 M I B G Scan 16500 16500 16500 16500 16500 90594 MDP Bone Scan 5200 5200 5200 5200 5200 90595 Meckels Diverticulum 3300 3300 3300 3300 3300 90596 MIBG Therapyatactuals 165000 165000 165000 165000 165000 90597 MUGA 3300 3300 3300 3300 3300 90598 Myocardial Perfusion Scan 12000 12000 12000 12000 12000 90599 Myocardial Perfusion Scan For SJIC Only 6400 6400 6400 6400 6400 90600 P32 Therapy 19800 19800 19800 19800 19800 90612 Parathyroid Scan 9100 9100 9100 9100 9100 90613 Parkinsons Package 18200 18200 18200 18200 18200 90614 RBC Study 3900 3900 3900 3900 3900 90615 Renal Scan-DMSA 3780 3780 3780 3780 3780 90616 Renogram-DTPA 4500 4500 4500 4500 4500 90617 Samarium Therapy 27500 27500 27500 27500 27500 90618 SR 89 Therapy (Actuals) 154000 154000 154000 154000 154000 90619 Stress Only M P S 5000 5000 5000 5000 5000 90620 Sulfur Colloid Scan 3900 3900 3900 3900 3900 90621 Testicular Scan 3900 3900 3900 3900 3900 90623 Thyrogen Inj (Actuals) 110000 110000 110000 110000 110000 90624 Thyroid Scan 3300 3300 3300 3300 3300 90625 Thyrotoxicosis Therapy 10-14Mci Of I-131 12700 12700 12700 12700 12700 90626 Thyrotoxicosis Therapy 15Mci - 20Mci Of I-131 15400 15400 15400 15400 15400 90627 Thyrotoxicosis Therapy 29Mci Of I-131 20900 20900 20900 20900 20900 90628 Thyrotoxicosis Therapy Upto 10Mci Of I-131 8800 8800 8800 8800 8800 90629 VUR Study Direct 2800 2800 2800 2800 2800 32 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. V. NON-OPERATIVE PROCEDURES A. GENERAL PROCEDURES 1. GENERAL PROCEDURES - CCU 00071 Arterial Line 250 350 450 550 650 00073 ECG 170 240 310 370 440 00076 Glucometer Random Blood Sugar 65 90 120 140 170 00072 Venesection / Cut Down / CVC 240 340 430 530 620 2. GENERAL PROCEDURES - ICU 00342 ABG GEM Machine ICU 400 460 520 580 640 03192 ABG SIEMENS Machine ICU 400 460 520 580 640 00141 Admission Screening Ultrasound 600 600 600 600 600 00111 Arterial Line 250 350 450 550 650 03184 Bedside ECG 320 450 580 700 830 03187 ETCO2 Monitoring (Continous ) 500 700 900 1100 1300 03188 ETCO2 Monitoring (Intermittent) 150 210 270 330 390 00116 Glucometer Random Blood Sugar 65 90 120 140 170 04000 HFNC-24 Hours 1070 1500 1930 2350 2780 03199 HFNC-6 Hours 360 500 650 790 940 00345 ICU 3000 4200 5400 6600 7800 00349 ICU Percutaneous Tracheostomy 1430 2000 2570 3140 3710 00140 Insulin protocol 1200 1680 2160 2640 3120 00346 Intra Hospital Shift on Portable Ventilator & Monitor 1000 1400 1800 2200 2600 03189 Isolation Precautions 500 500 500 500 500 03191 Isolation with Negative Pressure 500 500 500 500 500 03190 Isolation with Positive Pressure 300 300 300 300 300 00335 Lung Ultrasound 360 500 650 790 940 00336 Marking For Tapping 360 500 650 790 940 00338 Medical ICU -Cross Consultation IP 50 150 250 400 500 00199 Non-Invasive Bipap Ventilator - Package (Per Day) 540 760 970 1190 1400 00348 Pacemaker Insertion Temporary 360 500 650 790 940 00347 Pericardial Tap UltrasoundGuided 360 500 650 790 940 03185 Proning 300 420 540 660 780 00343 SCD:Sequential Compression Device Knee Length 360 500 650 790 940 00344 SCD:Sequential Compression Device Thigh Length 570 800 1030 1260 1490 00334 Screening ECHO 210 300 380 470 550 00341 Screening Ultrasound - Haemodynamic 600 600 600 600 600 00372 Servo Duo Guard Filter 720 720 720 720 720 00337 Ultrasound Guidance for CVC 400 560 720 880 1040 00112 Venesection / Cut down / CVC 240 340 430 530 620 3. GENERAL PROCEDURES - PEADIATRIC ICU 15200 ABG GEM Machine ICU 400 460 520 580 640

33 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00168 Arterial Line 250 350 450 550 650 15231 Bedside ECG 320 450 580 700 830 15201 Bipap (Per Hour) 40 50 60 80 100 15232 Blood Warmer 120 170 220 260 310 15233 Bronchoscopy - PICU 3000 4200 5400 6600 7800 15203 Burns Pad 70 100 120 140 170 15204 Catheterization 80 120 160 180 220 15205 Central Venous Cannulation 360 500 650 790 940 15206 Defibrillator 220 310 400 480 570 00326 Developmental Screening 500 700 900 1100 1300 15207 ECG 170 240 310 370 440 15208 Enema 60 80 110 130 160 15234 ETCO2 Monitoring (Continous ) 500 700 900 1100 1300 15235 ETCO2 Monitoring (Intermittent) 150 210 270 330 390 15209 Extubation 20 40 50 50 60 00170 Forced Alk.Diuresis for Poisoning 360 500 650 790 940 00172 Glucometer Random Blood Sugar 65 90 120 140 170 15210 ICD Insertion 210 300 380 470 550 15211 ICU Haemodialysis 1575 1960 2520 3080 3640 15212 Incision & Drainage 150 210 270 330 390 15214 Incubator / Radiant Warner with CPAP Ventilation 1500 1500 1500 1500 1500 15215 Infusion Pump (Per Day) 210 300 380 470 550 15216 Intra Hospital Shift on Portable Ventilator & Monitor 1000 1400 1800 2200 2600 00174 Intraosseus 50 70 80 110 120 15236 Lung Ultrasound 360 500 650 790 940 15239 Micro ESR 60 80 110 130 160 15237 Nebulization (Per Hour) including Oxygen 50 75 100 150 200 15217 Non-Invasive Bipap Ventilator - Package (Per Day) 540 760 970 1190 1400 15240 Non-Invasive Hemo Dynamic Monitoring 3500 4900 6300 7700 9100 00173 Peritoneal Dialysis 860 1200 1550 1880 2230 00171 Plasma Pheresis 440 620 790 970 1140 15241 Portable Ventilator per use (In House ) 750 1050 1350 1650 1950 15213 Radiant Warmer with monitoring 360 420 470 530 580 15220 Screening ECHO 210 300 380 470 550 15219 Screening Ultrasound - Haemodynamic 360 500 650 790 940 15221 Servo Duo Filter 720 720 720 720 720 15238 Tracheostomy Tube Change 290 410 520 640 740 15222 Ultrasound Guidance for CVC 400 560 720 880 1040 00169 Venesection / Cut down 240 340 430 530 620 4. GENERAL PROCEDURES - NEONATAL ICU 15226 Blood Warmer 120 170 220 260 310

34 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 15229 Breast Pump (per use) 150 150 150 300 500 15230 Bronchoscopy (NICU) 3000 4200 5400 6600 7800 00325 Bubble CPAP 2500 2500 4500 5500 6500 00093 Capillary PCV 120 170 220 260 310 00094 Cardiac Monitoring 300 300 540 660 780 15225 Cental Line Maintenance 120 170 220 260 310 00326 Developmental Screening by Neonatal 1000 1000 1800 2200 2600 00095 Exchange Transfusion - Partial / Complete / DV 500 700 900 1100 1300 00097 Glucometer Random Blood Sugar 65 90 120 140 170 00131 Giraffee Extream Preterm Care ( in addition to Warmer) 1430 2000 2570 3150 3720 00124 Hearing Screening (OAE) 70 100 120 140 170 15223 High Flow Nasal Cannula HFNC 530 740 950 1170 1380 00118 High Risk Delivery 1000 1400 1800 2200 2600 15245 ICD Insertion 210 290 380 460 550 00328 Lactation Counselling 140 200 260 310 370 15246 Low Risk Delivery 360 500 650 790 940 15244 Lumbar Puncture 220 310 400 480 570 00137 Nebulization 50 75 100 150 200 02150 NFC Booklets 200 200 200 200 200 00099 Otoacoustic Emission Test 210 300 380 470 550 00332 Parental Nutrition 70 100 130 150 180 15243 PD Maintainence - Neonatal 530 740 950 1170 1380 15242 Peritoneal Dialysis 860 1200 1550 1880 2230 00127 Phototherapy - Double Surface (Per Day) 300 420 540 660 780 00091 Phototherapy - Single Surface (Per Day) 270 380 490 590 700 00323 Phototherapy - Tripple Surface (Per Day) 400 560 720 880 1040 00333 PICC Lines 350 490 630 770 910 00327 Prenatal Counselling 200 280 360 440 520 15227 ROP Screening in NICU 180 250 320 400 470 00329 Standby Ventilator for Every 24 Hours 360 500 650 790 940 00119 SurfactantAdministration 360 500 650 790 940 00100 Transctaneous Bilirubin Evaluation 120 170 220 260 310 00331 Transport Of Neonate Outside the Hospital 700 980 1260 1540 1820 00330 Transport of Neonate within Hospital 120 170 220 260 310 5. GENERAL PROCEDURES - ITU/POST OPERATIVE PROCEDURES 00151 Arterial Line 250 350 450 550 650 00157 CVP Monitoring 140 200 260 310 370 00158 Defibrillator 220 310 400 480 570 00156 Glucometer Random Blood Sugar 65 90 120 140 170 00164 Infusion Pump (Per Day) 210 300 380 470 550

35 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00153 Intubation (Endotracheal) 240 340 430 530 620 00159 Monitoring (Per Day) 140 200 260 310 370 00160 Oximeter 170 240 310 370 440 00162 Oxygen inhalation (Per Hour) 50 70 90 110 130 00163 Respirator (Per Day) 1000 1400 1800 2200 2600 00154 Stomach Wash for Poisoning 300 420 540 660 780 00152 Venesection / Cut Down / CVC 240 340 430 530 620 6. GENERAL PROCEDURES - EMERGENCY MEDICINE / EICU 11509 ABG - EICU Seimens 400 60033 Aluminium Splint / Inch 60 80 110 130 160 03101 Arterial Line 250 350 450 550 650 03108 Assault Assesment (Consumables) 250 250 250 250 250 03160 Bedside Ultrasound 720 1010 1300 1580 1870 03161 Bipap (Per Hour) 40 50 60 80 100 03158 Bladder Wash 110 150 200 240 290 03169 Bowel Wash 110 150 200 240 290 03159 Burns Pad 70 100 120 140 170 03114 Catheterization 80 120 160 180 220 03152 Central Venous Cannulation 360 500 650 790 940 03150 Closed Reduction Adults 720 1010 1300 1580 1870 03198 CPR/Cardioversion/Defibrillation 500 700 900 1100 1300 60034 Crape Bandage 60 80 110 130 160 03177 CVP Monitoring 140 200 260 310 370 03106 Defibrillator 220 310 400 480 570 03162 Deo Guard 720 720 720 720 720 03118 Dressing - Each Bandage 50 70 80 110 120 03117 Dressing - Pad and Bandage 70 100 130 160 190 03170 Dressing - Service Charges - Large 120 170 220 260 310 03171 Dressing - Service Charges - Medium 85 120 150 190 220 03172 Dressing - Service Charges - Small 70 100 130 150 180 60002 Dynaplaster for IV 10 10 10 10 10 03130 ECG 170 240 310 370 440 03193 ED Nerve Block (Guided) 1000 1400 1800 2200 2600 03196 ED Sonological Assessment 500 700 900 1100 1300 60006 Electrolytes - EMS 210 300 380 470 550 03186 Emergency Medicine -Cross Consultation IP 50 150 250 400 500 03148 Emergency OT Suturing 860 1200 1550 1880 2230 03153 Enema 60 80 110 130 160 03145 Epidural Steroid Injection 1070 1500 1920 2350 2770 03181 ETCO2 monitering 50 60 70 80 90

36 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 03163 Extubation 20 40 50 50 60 03120 Glucometer Random Blood Sugar 65 90 120 140 170 03195 HD Access in ER 300 420 540 660 780 60005 Hemat - EMS 140 200 260 310 370 03139 ICD Insertion 210 300 380 470 550 03121 Incision and Drainage 150 210 270 330 390 03110 Infusion Pump (Per Day) 210 300 380 470 550 03146 Intervenous Cannulation 50 70 80 110 120 03147 Intramuscular Injection 20 40 50 50 60 03173 Intubation (Endotracheal) 240 340 430 530 620 03174 IV Fusion 60 80 110 130 160 03154 Ketostick 60 80 110 130 160 03138 Lumbar Puncture 220 310 400 480 570 60007 Malarial Parasites Smear (MP) - EMS 190 260 340 410 480 03107 Monitoring 140 200 260 310 370 03149 Narcotic Injections 20 40 50 50 60 03140 Nasal Packing 80 110 140 170 200 03155 Nebulization 50 75 100 150 200 03109 Oxygen inhalation (Per Hour) 50 70 90 110 130 03127 Plastering - Major 250 350 460 550 660 03128 Plastering - Minor 210 300 380 470 550 03112 Pleural Aspiration 220 310 400 480 570 03125 POP 10 cm 70 100 120 140 170 03126 POP 15 cm 140 200 260 310 370 03164 Portable Ventilator (Per Hour) 120 170 220 260 310 03151 Professional Charge 140 200 260 310 370 60004 Prothrombin Time (PT) - EMS 200 280 360 430 520 03129 Removal of Foreign Body 140 200 260 310 370 03131 Ryles Tube Introduction 30 40 50 70 80 03165 SCD: Sequential Compression Device Knee Length 370 520 670 810 960 03166 SCD: Sequential Compression Device Thigh Length 580 810 1040 1280 1510 03144 Sengstaken Tube Introduction 860 1200 1550 1880 2230 03178 Steam Inhalation 50 70 90 110 130 03180 Stoma Care Routine 60 80 110 130 160 03167 Stomach Wash - Routine 80 110 140 180 210 03104 Stomach Wash for Poison 300 420 540 660 780 03168 Strip (Pregnancy Test) 160 180 200 230 250 03133 Suture Removal in EMS 60 80 110 130 160 03141 Suturing with Plastic Suture Set 230 320 410 500 590 03142 Suturing with Suture Set 160 220 280 350 410

37 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 03197 TCP in ER 500 700 900 1100 1300 03157 Thomas Splint 650 910 1160 1430 1680 03176 Tracheostomy Care 60 80 110 130 160 03175 Tracheostomy in OPD / Ward 290 410 520 640 740 03182 Transcutaneous pacing 175 250 320 390 460 03156 Triangular Sling 70 70 70 70 70 60003 Troponin-I (EMS) 900 1300 1600 2000 2300 03194 TVP in ER 1500 2100 2700 3300 3900 03183 UltrasoundGuided Procedure 700 980 1260 1540 1820 03179 Wall Suction 30 40 50 70 80 7. GENERAL PROCEDURES - OPD / WARD 73250 6F Sheath 1060 1484 1908 2332 2756 00201 Arterial Line 250 350 450 550 650 00203 Aspiration 220 310 400 480 570 00202 Atropine Anitode Therapy (Excluding Drugs) 380 530 680 840 990 00395 Back Care / Mouth Care 60 80 110 130 160 00207 Bandage -Triangular Bandage 30 40 50 70 80 00208 Biopsy - Cervical 320 450 580 700 830 00210 Biopsy - Transbronchial Lung 900 1260 1620 1980 2340 00211 Bladder Wash 110 150 200 240 290 00212 Bowel Wash 110 150 200 240 290 02697 Burns Pad 70 100 130 150 180 00213 Catheterererization 85 120 150 190 220 00215 Colostomy Care 110 150 200 240 290 73306 Cotton Balls Pack 30 40 50 70 80 00204 Crape Bandage Service Charges 60 80 110 130 160 00371 Culture Tube 10 10 10 10 10 00216 CVP Monitoring 140 200 260 310 370 00217 Debridment 220 310 400 480 570 00218 Defibrillator 220 310 400 480 570 00318 Disposable - Dress Tray Wrapper 10 10 10 10 10 00236 Disposable Needle & Syringe # 00319 Disposable Surgical Pack Wrapper 10 10 10 10 10 00306 Disposable Syringe - 10CC # 00308 Disposable Syringe - 20CC # 00304 Disposable Syringe - 2CC # 00309 Disposable Syringe - 50CC # 00305 Disposable Syringe - 5CC # 00235 Disposible Needle # 00219 Douche 50 70 90 110 130

38 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00220 Drainage (Tubing & Bottling) 50 70 90 110 130 00224 Dressing - Salvon Bath & Dressing 110 150 200 240 290 00227 Dressing - Service Charges - Large 120 170 220 260 310 00226 Dressing - Service Charges - Medium 85 120 150 190 220 00225 Dressing - Service Charges - Small 70 100 130 150 180 73305 Dressing Pad 25 25 25 25 25 72051 Dynaplaster 10 14 18 22 26 00274 ECG 170 240 310 370 440 00231 Hole Suturing with LA 110 150 200 240 290 00370 Elastic Adhesive Bandage per 10cm (10/8 cm) 20 20 20 20 20 00205 Electroplast Service Charges 60 80 110 130 160 00228 Enema 60 80 110 130 160 73307 pad 20 20 20 20 20 00230 Fistula Care (each visit) 50 70 80 110 120 00229 Forced Alk.Diuresis for Barbit Poisoning 360 500 650 790 940 00232 Glucometer Random Blood Sugar 65 90 120 140 170 73304 Gauze Pack 20 20 20 20 20 00299 Hepatitis B - Adult 00300 Hepatitis B - Child 00233 Incision & Drainage 150 210 270 330 390 00296 Incubator / Open Air Care 380 530 680 840 990 00234 Infra Red Lamp Application(10 Minutes) 50 70 90 110 130 00277 Infusion Pump (Per Day) 210 300 380 470 550 00238 Injection Service Charges - Intra Cardiac 70 100 120 140 170 00239 Injection Service Charges - Intravenous 25 40 50 60 70 00243 Intra Articular Pressure Monitoring 250 350 450 550 650 00244 Intubation (Endotracheal) 240 340 430 530 620 00245 Invasive BP Monitoring 260 360 470 570 680 00246 IV Fusion 60 80 110 130 160 00247 Leather Heel - Large 70 100 130 160 190 00248 Leather Heel - Small 60 80 110 130 160 00249 Liver Puncture 220 310 400 480 570 00250 Lumbar Puncture 220 310 400 480 570 00209 Lymph Node Biopsy 320 450 580 700 830 00257 Mantux Test 20 30 40 40 50 00256 Minor Procedure - in Minor OT 220 310 400 480 570 00010 Miscellaneous 00253 Monitoring 140 200 260 310 370 74071 N95 Mask 125 125 125 125 125 00254 Nebuliser - Pipeline 50 70 90 110 130 00255 Nebuliser for Children in OPD 50

39 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00252 Nebuliser- Machine (per use) 50 70 90 110 130 00303 Needle # 00189 Non-Invasive Bipap Ventilator - Package (Per Day) 540 760 970 1190 1400 00398 Non-Invasive Bipap Ventilator - Package (Per Hour) 50 70 90 110 130 00259 Oxygen Inhalation (Per Hour) 50 70 90 110 130 00240 Parental Chemotherapy Charges 150 210 270 330 390 74016 Patient Gown (Pink) 340 340 340 340 340 00261 Pericardial Tap 220 310 400 480 570 00262 Peritoneal Drainage 220 310 400 480 570 00297 Peritoneal Wash 380 530 680 840 990 00295 Phototherapy - Single Surface (Per Day) 270 380 490 590 700 74020 Pink Gown (Child) 180 180 180 180 180 00263 Plasma Pheresis 440 620 790 970 1140 00264 Plaster Of Paris - Local 10 cms 80 110 140 180 210 00265 Plaster of Paris - Local 15 cms 150 210 270 330 390 00270 Plastering / Cast Application - Major 260 360 470 570 680 00271 Plastering / Cast Application - Minor 210 300 380 470 550 00266 Pleural Aspiration 220 310 400 480 570 00269 Pocket Doppler (More than 1 use) 210 300 380 470 550 00268 Pocket Droppler (First Use) 140 200 260 310 370 74068 PPE Kit 550 550 550 550 550 00399 Pre-Operative Skin Preparation 110 150 200 240 290 00258 Pulse Oximeter Monitoring (Per Day) 170 240 310 370 440 74009 Pyjama (A) 180 252 324 396 468 74010 Pyjama (S) 100 140 180 220 260 00272 Removal of Foreign Body in OPD/ward 300 420 540 660 780 00273 Respirator (Per Day) 1000 1400 1800 2200 2600 00275 Ryles Tube Introduction 30 40 50 70 80 00241 SC - Kenacort 70 100 130 150 180 00320 SCD: Sequential Compression Device Knee Length 370 520 670 810 960 00321 SCD: Sequential Compression Device Thigh Length 580 810 1040 1280 1510 00237 Service Charges - Injection IM / SC 20 40 50 50 60 00276 Sitz Bath 60 80 110 130 160 00394 Sponge Bath 60 80 110 130 160 00278 Steam Inhalation 50 70 90 110 130 00350 Sterile Gloves 80 80 80 80 80 60012 Sterile Water 500ml 26 26 26 26 26 00279 Stoma Clinic - Irrigation of Stoma (First) 80 110 140 180 210 00280 Stoma Clinic - Irrigation of Stoma (Subsequent) 50 70 90 110 130 00281 Stoma Clinic - OP Consultation 30 40 50 70 80 00283 Stoma Clinic - Post Op 1st Visit 50 70 100 120 140

40 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs.

00282 Stoma Clinic - Pre Op Assessment 50 70 100 120 140 00284 Stomach Wash - Poisoning 300 420 540 660 780 00285 Stomach Wash - Routine 80 110 140 180 210 00206 Strapping (Chest) 70 100 130 150 180 00286 Streptokinase Therapy (Excluding Drugs) 200 300 400 400 400 74000 Striped Sheet (Blue /Pink) 250 350 450 550 650 00287 Sub-Clavian Puncture 220 310 400 480 570 00288 Suture Removal (Dressing Charges Extra) 60 80 110 130 160 00289 Suturing under LA in OPD / Ward 100 130 170 220 250 00290 Suturing without LA in OPD / Ward 60 80 110 130 160 02429 TENS 65 90 120 155 175 74069 Three Layer Mask 12 12 12 12 12 00291 Tracheostomy Care 60 80 110 130 160 00190 Tube Feeding 25 35 45 55 65 60038 Uristix 10 10 10 10 10 15500 Ultrasound Guidance for CVC 400 560 720 880 1040 00302 Vaccuete Tube# 00311 Vacuette Coagulation 10 10 10 10 10 00312 Vacuette EDTA 10 10 10 10 10 00313 Vacuette ESR 10 10 10 10 10 00317 Vacuette Lithium 4ml 10 10 10 10 10 00316 Vacuette Needle 21G 10 10 10 10 10 00315 Vacuette Needle 22G 10 10 10 10 10 00314 Vacutte Serum 4ml 10 10 10 10 10 00292 Varicose Veins Injection 140 200 260 310 370 00293 Venesection / Cut Down / CVC 240 340 430 530 620 00294 Wall Suction 30 40 50 70 80 00301 Water Mattress 60 80 110 130 160 74060 Wrappers Medium (CSSD) 160 224 288 352 416 74061 Wrappers Small (CSSD) 70 98 126 154 182 Note: # Subject to prevailing rates + An additional charge on the procedure amount applicable

8. GENERAL PROCEDURES - UNIT OF HOPE 23561 Catheterization 80 24150 Debridement 175 23552 Disposable - Dress Tray Wrapper 10 23557 Disposable Needle # 23558 Disposable Needle & Syringe # 23551 Disposable Syringe - 10CC # 23549 Disposable Syringe - 2CC # 23550 Disposable Syringe - 5CC # 41 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 24152 Dressing - Each Bandage 50 24153 Dressing - Each Pad 20 24151 Dressing - Pad & Bandage 70 24154 Dressing - Savlon Bath & Dressing 80 24156 Dressing - Service Charges - Medium 85 24155 Dressing - Service Charges - Small 70 23543 ECG 170 23560 Enema 60 23532 Glucometer Random Blood Sugar 65 24143 General Consultation - UoH (Revisit After 30 days) 150 24142 General Consultation - UoH (Within 30 days) 150 23533 Incision & Drainage 150 23535 Injection Service Charges - Intravenous 25 23555 Intraosseous Line 35 23536 Intubation (Endotracheal) 240 23554 IV Infusion / Line 40 23538 Mantoux Test 10 23537 Nebuliser for Children in OPD 50 24141 OP New Registration 150 23559 Oxygen inhalation (Per Hour) 50 23539 Plaster Of Paris - Local 10 cms 80 23540 Plaster of Paris - Local 15cms 120 23542 Plastering / Cast Application - Minor 300 23541 Plastering/Cast application - Major 400 23556 Pulse Oxymetry 120 23562 Ryles Tube Introduction 30 23534 Service Charges - Injection IM/SC 20 23563 Steam Inhalation 50 23553 Sterile Gloves 65 23544 Suture Removal (Dressing Charges Extra) 60 23545 Suturing under LA in OPD / Ward 100 23546 Suturing without LA in OPD / Ward 50 23547 Tracheostomy Care 60 23548 Wall Suction 30 8.1. UoH - NEONATAL 23605 Booklet on Breast Feeding 85 23606 BSID 1000 23603 Developmental Evaluation (DASII) 150 23600 High Risk Neonatal Follow-up 150 23602 OAE (Oto-acoustic emission) 175

42 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 23604 Parent Education Material 55 23601 ROP Screening 240 8.2. UoH - ORTHOPAEDICS 23625 Aspiration 220 23626 Crepe Bandage Service Charges 75 23630 Dressing Service Charges - Large 120 23629 Dressing Service Charges - Medium 85 23628 Dressing Service Charges - Small 70 23631 Incision & Drainage 150 23633 Mantoux Test 10 23632 Minor Procedure - in Minor OT 175 23634 Plastering / Cast Application - Major 300 23635 Plastering / Cast Application - Minor 400 23640 Ponsetti Tenotomy Procedure 350 23636 Removal of Foreign Body 140 23627 Strapping (Chest) 70 23637 Suture Removal (Dressing Charges Extra) 60 23638 Suturing under LA in OPD / Ward 100 23639 Suturing without LA in OPD / Ward 150 8.3. UoH - PHYSICAL MEDICINE & REHABILITATION 23687 Botulinum Toxin Injection Procedure 275 23678 Catheterization 80 23686 Certificate - Medical 120 23675 Dressing Services Charges - Small 70 23685 Phenol Block Injection 175 23682 POP Application - major 120 23681 POP Application - minor 55 23680 POP Wedging 50 23683 Suture Removal 60 8.4 UoH - OPHTHALMOLOGY 24306 Functional Vision 250 23880 Fundus Examination after Drops 100 23903 SquintAssessment 300 23907 Vision Therapy – HBVT – Advice + Assessment 250 23906 Vision Therapy – OBVT package (5session) 1200 23905 Vision Therapy – OBVT single session 250 8.5. UoH - AUDIOLOGY AND SPEECH THERAPY 24329 Articulation/ Phonology Therapy 300 23957 BOA (Behavioural Observation ) 250 23974 Demonstration Therapy 350

43 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 23956 Group Speech Therapy (Per Session) 350 23964 Hearing Aid Trial 150 24326 Home Training Program Level 1 50 24327 Home Training Program- Level 2 120 24328 Home Training Program- Level 3 200 23958 Oae (Oto-Acoustic Emission) 175 23952 Pure Tone Audiometry 250 23965 Speech Assessment Report 150 23962 Speech Evaluation 300 24324 Speech Therapy 300 23973 Speech therapy (10 Sessions) 3000 23972 Speech therapy (5 Sessions) 1500 24325 Speech Therapy - Miscellaneous 150 8.6. UoH - CHILD PSYCHIATRY 24008 Assessment of Intelligence 800 24000 Assessment of Specific Function 600 24001 Assessment of Specific Learning Disability 800 24016 Behavioural Counselling -1 session 475 24007 Certificate 300 24020 Child Psychotherapy - One session 420 24002 Detailed Work- up & Case File 715 24003 Detailed Work-up with Report + Case File 890 24017 Developmental Assessment - Brief 400 24018 Developmental Assessment - Detailed 800 24012 Family Therapy (single sessions) 475 24006 Letters to School 120 24024 Mini Assessment of Autism Spectrum Disorders (1 Session) 1200 24022 Mini Assessment of Hyperactivity (1 Session) 800 24019 Neuropsychological assessment 3565 24043 Play Therapy (5 sessions) 1000 24145 Prolonged Ambulatory EEG 4000 24014 Psycho Education - One Session 475 24144 Routine Ambulatory EEG 2000 24009 School Visit (Transport Extra) 1780 24004 Special Assessment with Questionnaire A 350 24005 Special Assessment with Questionnaire B 600 8.7. UoH - MEDICO SOCIAL WORK 24040 Assessment of Needs 100 24033 Assessment of Socio-economic Status 100 24041 Community Participation 300

44 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 24025 Correspondence 50 24038 Family Counseling 300 24039 Financial Assistance/ Fund Raising 100 24035 Group Therapy / Counselling 500 24026 Guidance & Counselling 300 24028 Health Education (Groups) 600 24029 Health information (Individual) 100 24031 Home Evaluation / Home visit 200 24037 Individual Therapy 200 24042 Letter to Organizations/ Referral Letter 100 24304 Networking with NGOs / GOs / Work place / Schools 250 24030 Pre-vocational assessment 100 24036 Rehabilitation Counselling 200 24027 Vocational Counselling 100 24032 Work Environment Evaluation 100 8.8. UoH - SPECIAL EDUCATION 24098 Education Materials (Customised) Per Set 50 24100 Inpatient Consultation 350 24330 Special Education Assessment/Play Session 350 24099 Special Education Case Summary Report 300 24102 Special Education Consultation 350 24107 Special Education Play Session ( 5 Session) 1750 8.9. UoH - DENTAL 24307 Extraction – Complicated 500 24308 Extraction – Decidious, Mobile, Total 100 24309 Extraction – Simple 200 24316 Filling – Temporary 100 24310 Fillings – Amalgam – CL Small 250 24311 Fillings – Amalgam – CL Large 300 24313 Fillings – Glass Inomer – Large 300 24312 Fillings – Glass Inomer – Small 150 24314 Fillings – Light Cure – Composite Small 400 24315 Fillings – Light Cure Composite Large 700 24318 Miracle Mix – Large 300 24317 Miracle Mix – Small 150 24322 Miscellaneous –1 350 24323 Miscellaneous – 2 500 24319 Pulpectomy 500 24321 Scaling - I 300 24320 Scaling - II 700

45 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 8.10. UoH - PAEDIATRICS 24333 BSID 3 1500 24336 Counseling 200 24337 Medical report 150 24334 Neuromotor Assessment Standardized 150 24335 Unit of Hope Paediatric Consultation and Follow up 200 8.11. UoH - AUTISM CLINIC 24338 Autisim Clinic Consultaion 200 24339 ASD Clinic MSW Consultation 50 8.12. UoH - TEAM CLINIC 24344 Comprehensive Report 300 24345 Group therapy (multidisciplinary) 250 24346 Integrated therapy session 350 24343 IP/OP UOH Single Consultation 200 24342 IP UOH Team Consultation 450 24341 Unit of Hope Cross Consultation 150 24340 Unit of Hope Team Consultation Follow up 450 8.13. UoH - COMDEALL 24351 COMDEALL Individual Therapy Session 350 24352 COMDEALL EI Monthly Fee 4500 24353 COMDEALL Deatiled Assessment 3000 8.14. UoH -PHYSIOTHERAPY CLINIC 23689 UOH Physiotherapy Assessment and Treatment for one session 300 23690 UOH Physiotherapy Assessment and Treatment for five sessions 1400 23691 UOH - NFC Assessment and Home Program - Physiotherapy 150 23692 UOH - Education for the Home Program - Physiotherapy 150 Note: # Subject to prevailing rates + An additional charge on the procedure amount applicable

9. GENERAL PROCEDURES - PEDIATRIC EMERGENCY 15300 Aluminium Splint / Inch 60 80 110 130 160 15301 Arterial Line 250 350 450 550 650 15302 Bandage -Triangular Bandage 30 40 50 70 80 15303 Bedside Ultrasound 720 1010 1300 1580 1870 15304 Bipap (Per Hour) 40 50 60 80 100 15305 Bladder Wash 110 150 200 240 290 15306 Bowel Wash 110 150 200 240 290 15307 Burns Pad 70 100 120 140 170 15308 Catheterization 80 120 160 180 220 15309 Central Venous Cannulation 360 500 650 790 940 15310 Closed Reduction Pediatric 720 1010 1300 1580 1870 15311 Crape Bandage 60 80 110 130 160

46 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 15312 Cross Consultation IP - Pediatric Emergency 50 150 250 400 500 15313 Defibrillator 220 310 400 480 570 15314 Dressing - Each Bandage 50 70 80 110 120 15315 Dressing - Pad and Bandage 70 100 130 160 190 15316 Dressing - Service Charges - Large 120 170 220 260 310 15317 Dressing - Service Charges - Medium 85 120 150 190 220 15318 Dressing - Service Charges - Small 70 100 130 150 180 15319 Dynaplaster for IV 10 10 10 10 10 15320 ECG 170 240 310 370 440 15321 Electrolytes - EMS 210 300 380 470 550 15322 Enema 60 80 110 130 160 15323 Extubation 20 40 50 50 60 15324 Glucometer Random Blood Sugar 65 90 120 140 170 15325 ICD Insertion 210 300 380 470 550 15326 Incision and Drainage 150 210 270 330 390 15327 Infusion Pump (Per Day) 210 300 380 470 550 15328 Intervenous Cannulation 50 70 80 110 120 15329 Intramuscular Injection 20 40 50 50 60 15330 Intubation (Endotracheal) 240 340 430 530 620 15331 IV Fusion 60 80 110 130 160 15332 Ketostick 60 80 110 130 160 15333 Lumbar Puncture 220 310 400 480 570 15334 Monitoring 140 200 260 310 370 15335 Narcotic Injections 20 40 50 50 60 15336 Nasal Packing 80 120 160 180 220 15337 Nebulization 50 75 100 150 200 15338 Oxygen inhalation (Per Hour) 50 70 90 110 130 15339 Plastering - Major 250 350 460 550 660 15340 Plastering - Minor 210 300 380 470 550 15341 Pleural Aspiration 220 310 400 480 570 15342 POP 10 cm 70 100 120 140 170 15343 POP 15 cm 140 200 260 310 370 15344 Professional Charge 140 200 260 310 370 15345 Removal of Foreign Body 140 200 260 310 370 15346 Ryles Tube Introduction 30 40 50 70 80 15359 Service Charge -POP Application 50 70 80 110 120 15360 Service Charge -Subcutaneous Injection 20 40 50 50 60 15358 Service Charge-Gastric AFB Aspiration 30 40 50 70 80 15347 Steam Inhalation 50 70 90 110 130 15348 Stomach Wash - Routine 80 110 140 180 210

47 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 15349 Stomach Wash for Poisoning 300 420 540 660 780 15350 Suture Removal in Pediatric Emergency 60 80 110 130 160 15351 Suturing in OT 860 1200 1550 1880 2230 15352 Suturing with Suture Set 160 220 280 350 410 15353 Thomas Splint 650 910 1160 1430 1680 15354 Tracheostomy Care 60 80 110 130 160 15355 Tracheostomy in Pediatric Emergency 290 410 520 640 740 15356 Triangular Sling 70 70 70 70 70 15357 Wall Suction 30 40 50 70 80 B. SPECIALISED PROCEDURES 1. SPECIALISED PROCEDURES - CARDIOLOGY 1.1. NON-INVASIVE DIAGNOSTICS 00408 24hrs Amb.Blood Pressure Monitoring 1100 1500 2000 2400 2900 00425 Bedside Screening Echo 300 400 500 700 800 00499 Contrast ECHO 2000 2800 3600 4400 5200 00450 Cross Consultation IP-Cardiology 50 150 250 400 500 00410 Dobutamine Stress Echocardiogram 3600 3600 3600 4400 5200 00401 Echocardiography - Adult * 1250 1750 2250 2750 3250 23610 File Charges 50 50 50 50 50 00403 Holter Monitoring - Adult* 1600 2240 2880 3520 4160 00460 INR (Cardio) 300 300 300 350 400 00461 NT-Pro BNP 1620 1860 2110 2350 2590 24504 Rotablation 15000 21000 27000 33000 39000 00402 Stress Test / TMT - Adult * 1400 1500 1600 1800 2000 00405 Transoesophageal Echocardiography - Adult 1500 2000 2500 3000 3500 00498 Troponin-I - CCU 900 1300 1600 2000 2300 1.2. INVASIVE PROCEDURES 00409 Foreign Body Removal (Intravascular) 5000 6000 8000 10000 12000 00487 IABP Insertion Charges 6000 8400 10800 13200 15600 00475 Pericardial Tapping 3000 5000 6000 7000 8000 (Ballon Charges Extra)

1.3. INVASIVE DIAGNOSTICS - PACKAGES 24501 ACT 200 300 400 400 500 00417 Carotid Angiogram (Package) 10000 14000 18000 22000 26000 00411 Coronary Angiography (Package) 9000 12000 15000 20000 25000 00406 Coronary Graft Angiogram 12000 16800 21600 26400 31200 00412 Diagonostic Catheterization Aortogram 6500 9100 11700 14300 16900 00413 Electro Physiological Study 10000 14000 18000 22000 26000 24502 Fluroscopy 350 400 460 510 560 00426 Peripheral Angiogram (Package) 8000 12000 15000 18000 20000

48 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00464 Renal/ Mesenteric / Other Angiogram 6000 8400 10800 13200 15600 00419 Right Heart Catheter.(Includes Oxygen Saturation) 4000 5000 6000 7000 8000 Note: The above include only procedure charges. All other charges including temporary lead will be extra.

PACING 00428 AICD 37400 52400 67300 82300 97200 00489 Biventricular Pace Maker Implantation 65000 91000 117000 143000 169000 00427 Dual Chamber Pacing 25000 35000 45000 55000 70000 00440 ECG with Magnet 200 300 400 400 500 00429 Pacemaker Interrogation 500 500 500 500 500 00421 Pacing - Permanent 15000 20000 25000 30000 35000 00470 Pacing - Temporary * 1500 2500 4000 6000 8000 24503 Temporary Pacemaker Implantation 1000 2000 3500 5000 6000 Note: The Cost of Biventicular Pacemaker will be Extra

1.4. NON-CORONARY INTERVENTIONS - PACKAGES 00436 Aortic Endovascular Intervention 37400 52400 67300 82300 97200 00452 ASD/VSD Closure 25000 35000 45000 55000 65000 00448 Balloon Valvulplasty (half harge) 12400 17400 22300 27300 32200 00434 Bronchial Artery Embolization 10000 20000 30000 40000 50000 00407 Carotid Plasty and Stenting 56000 78400 100800 123200 145600 00424 Chemoport Implantation 6200 8700 11200 13600 16100 00438 IVC Filter Implantation 8000 11200 14400 17600 20800 00433 Non Coronary Cardiac Balloon Intervention 25000 35000 45000 55000 65000 00430 PDA Closure 10000 14000 18000 22000 26000 00432 Peripheral Angioplasty 20000 28000 36000 44000 52000 00446 Peripheral Angioplasty (half charge) 10000 14000 18000 22000 26000 00435 Peripheral Stenting 15000 17250 19500 21750 24000 00439 Re - Synchronization Therapy (dual chamber) 37400 52400 67300 82300 97200 00431 Septostomy/ Embolization/ Swanganz 5000 7000 9000 11000 13000 Note: Actual stent charges will be charged extra

1.5. CORONARY INTERVENTIONS -PROCEDURES (Catheter LAB) 24508 Emergency Coronary Stenting 75000 100000 130000 150000 200000 24507 Emergency Coronary Angiogram 20000 25000 30000 35000 40000 24510 FFR + Coronary Stenting 80000 105000 130000 150000 200000 24511 FFR without Coronary Stenting 30000 35000 45000 50000 60000 24506 IVUS 35000 40000 45000 50000 55000 24509 IVUS Guided Coronary Stenting 90000 115000 140000 150000 205000 1.6. CORONARY INTERVENTIONS - PACKAGES 00451 CD Recording Charges 500 500 500 500 500

49 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00449 Cor.Sep.Emboln.for HOCM 52400 73400 94300 115300 136200 00445 Complex Angioplasty 82000 120000 150000 180000 220000 00444 Coronary Angioplasty (Half Charge) 28000 39200 50400 61600 72800 00471 Coronary Angioplasty (POBA) 50000 70000 90000 110000 130000 00472 Coronary Stenting 60000 85000 110000 130000 175000 00473 Direct Stenting (PTCA charges) 40000 55000 70000 90000 125000 00477 I V C Filter Retrieval 6500 9100 11700 14300 16900 23528 IABP Charges Per Day (Catheterlab / CCU) 1000 1400 1800 2200 2600 00476 Renal Stenting / IVC Stenting / Other Peripheral Stenting 22000 30800 39600 48400 57200 Note: All Angioplasty charges are not inclusive of stents and CD Recording .* 100% concession for staff & dependants 50% concession for staff & dependants (for all Catheterlab Procedures)

1.7. ANAESTHESIA CHARGES 00492 Anaesthesia for Angiogram 900 1300 1600 2000 2300 00494 Anaesthesia for Coronary Intervention 900 1300 1600 2000 2300 00493 Anaesthesia for Non - Coronary intervention 900 1300 1600 2000 2300 00500 General Anaesthesia or Catheter.lab Procedures 350 500 600 800 900 00491 Stand by (Monitored Anaesthesia Care) 250 400 500 600 700 CONDITIONS OF PACKAGE DEAL All categories include professional and treatment charges and visiting fee. Rest of the conditions are as detailed below Procedure Include Does not include Diagnosis 2 Days Stay Any Other Drugs All Pre Cath investigations (HB, TC, DC, Platelets, Urea, Sr Creatinine, Any Other Procedure Sr Electrolytes, HIV, HbsAg, Blood Grouping, RBS, PT, INR) Special Investigations Venflon 20g, Disposable Syringe 2 CC/5CC/10CC, Normal Saline / DNS 500 ml Diet Infusion Set, 3 Way Stop Cock, Disposable Cap, Vauctiner EDTA 2 ml, Vacutainer Gel, Contrast upto 100 ml (Urografin) ECG x 2, Chest X-Ray, CCU for 24 hours if necessary Inj.Avil 1 amp, Inj. Hyderocortisone 1 amp Refreshments for Pvt. Ward patients after Procedure Pacing 3 days stay, including one day in CCU, Any Other Drugs Permanent All Coronary Angiogram investigations Any Other Procedure Tegaderm x 1, Mersilk Suture, Inj. Reflin 1gm - 3 vial, Wycril 3.0 Special Investigations Cost of Pacemaker Diet Coronary 3 days stay, including one day in CCU, Cost of stent Echo/ Interventions / All Coronary Angiogram investigations Stress test Non-Coronary CK, CKMB x 2, ECG x 4, Contrast upto 200 ml (Urografin) Investigations Interventions Disposable Syringe 5CC/10CC, Gloves, Serum Gel, Serum Plain Special Hardware Gel tube, EDTA, Venflon 20g, NS 500ml, IV Set Routine Angioplasty Hardware and one Balloon. If more than one balloon or other hardware is used, the same will be charged extra. Our pharmacy bill will be the supporting document for the extra hardware. Incase of failed Angioplasty unless special hardwares used half charges will be charged to cover the cost of hardware and surgery will be charged as per package. 1.8 PAEDIATRIC CARDIOLOGY PROCEDURE * 23511 ASD Device 20000 28000 40000 60000 80000

50 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 23513 BAV 16000 22400 32000 48000 64000 23515 BMV 16000 22400 32000 48000 64000 23514 BPV 16000 22400 32000 48000 64000 23518 Branch PA Plasty 16000 22400 32000 48000 64000 23516 BTV 16000 22400 32000 48000 64000 23507 Cardiac Catheter Congenital Heart Catheter 8000 11200 16000 24000 32000 23517 Coarctation Plasty 16000 22400 32000 48000 64000 23502 Fetal Echocardiogram 2500 2500 2500 3250 4000 23504 Intra OP/Emergency Echo 3000 3000 3000 3900 4800 23499 Paediatric Cardiology Cross Consultation 400 400 400 400 400 23501 Paediatrics Echocardiogram - Complex 2000 2000 2000 2600 3200 24500 Paediatrics Echocardiogram - Simple 1200 1200 1200 1560 1920 23508 PAH Study Catheter 9000 12600 18000 27000 36000 23509 PDA Coil 16000 22400 32000 48000 64000 23510 PDA Device 20000 28000 40000 60000 80000 23505 Stress Test - Paediatric 2500 2500 2500 3250 4000 23503 Transoesophageal Echocardiography - Paediatric 2500 2500 2500 3250 4000 23512 VSD Device 23000 32200 46000 69000 92000 1.9 ELECTRO PHYSIOLOGY STUDY PROCEDURE 23524 3D Mapping 45000 63000 81000 99000 117000 23521 EP Study ( Study) 15000 21000 27000 33000 39000 23523 Radiofrequency Ablation (Complex) 30000 42000 54000 66000 78000 23522 Radiofrequency Ablation (Simple) 20000 28000 36000 44000 52000 23525 Renal Denervation 40000 56000 72000 88000 104000 * does not include implants

2. SPECIALISED PROCEDURES - DENTAL 2.1. DENTAL SURGERY 02048 Acrylic dentures imported U/L 7000 7000 7000 7000 7000 00502 Alveolectomy (Per Quadrant) 1300 1300 1300 1300 1300 00503 Alveolectomy Full Jaw - Upper And Lower 2500 2500 2500 2500 2500 00501 Alveoloplasty - Simple 700 700 700 700 700 02045 Apexification 3000 3000 3000 3000 3000 00506 Apicectomy - Single Tooth 3000 3000 3000 3000 3000 02050 Begg Retainer 2500 2500 2500 2500 2500 00507 Biopsy Under L.A. 400 400 400 400 400 02042 Bone Graft Large 2000 2000 2000 2000 2000 02041 Bone Graft Small 1000 1000 1000 1000 1000 02049 BPS Dentures upper or lower 13000 13000 13000 13000 13000 00617 Breakage Repair (Single Bracket) 700 700 700 700 700

51 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00574 Cast Post & Core Pin 1250 1250 1250 1250 1250 00560 Ceramic Crown 4000 4000 4000 4000 4000 00542 Complete Dentures - Upper And Lower (Package Include) - Ordinary 6500 6500 6500 6500 6500 00543 Complete Dentures - Upper Or Lower - Ordinary 4500 4500 4500 4500 4500 00697 Cross Consultation Ip - Dental Surgery 50 150 250 400 500 00504 Crown And Bridge - Acrylic Crown 1000 1000 1000 1000 1000 00528 Curettage Per Quadrant 1500 1500 1500 1500 1500 02039 Cyst Enucleation 3000 3000 3000 3000 3000 00512 Extraction - Bony Impaction 3000 3000 3000 3000 3000 00510 Extraction - Complicated 1000 1000 1000 1000 1000 00508 Extraction - Decidious, Mobile, Total 200 200 200 200 200 00511 Extraction - Impactions Soft Tissues 1500 1500 1500 1500 1500 00509 Extraction - Simple 500 500 500 500 500 00513 Extraction - Total Extraction 2500 2500 2500 2500 2500 00622 Fibre Post (each) 1500 1500 1500 1500 1500 00518 Fillings - Glass Inomer I 400 400 400 400 400 00581 Fillings - Glass Inomer II 700 700 700 700 700 00522 Fillings - Light Cure - Composite Small 700 700 700 700 700 00523 Fillings - Light Cure Composite Large 1500 1500 1500 1500 1500 00520 Fillings - Temporary 200 200 200 200 200 00516 Filllings - Amalgam - CL I 500 500 500 500 500 00517 Filllings - Amalgam - CL II 700 700 700 700 700 00524 Flap (Localised) 1500 1500 1500 1500 1500 00525 Flap (Per Quadrant) 3500 3500 3500 3500 3500 00526 Flap with Bone Graft 3500 3500 3500 3500 3500 00634 Frenectomy 2000 2000 2000 2000 2000 00527 Gingivectomy (Per Quadrant) 1500 1500 1500 1500 1500 00569 Impaction Canine 3000 3000 3000 3000 3000 00532 Inter Maxillary Wiring under GA 1540 1540 1540 1540 1540 00535 Intra Oral Space Maintainer 1000 1000 1000 1000 1000 00536 IO X - ray - Occlusal 250 250 250 250 250 00537 IO X - ray - Periapical 200 200 200 200 200 00577 Miracle Mix - I 350 350 350 350 350 00578 Miracle Mix - II 700 700 700 700 700 02043 Miscellaneous I 500 500 500 500 500 02044 Miscellaneous II 1000 1000 1000 1000 1000 02052 MTA Apexification Large 4000 4000 4000 4000 4000 02051 MTA Apexification Small 3000 3000 3000 3000 3000 02038 Mucocele Excision 1500 1500 1500 1500 1500 00558 Nickel Cromium Full Crown 2500 2500 2500 2500 2500

52 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00573 Obturator Definitive 1500 1500 1500 1500 1500 00572 Obturator Interim 500 500 500 500 500 00571 Obturator Surgical 500 500 500 500 500 02046 Ortho Implant Placement 2000 2000 2000 2000 2000 00635 Polishing 200 200 200 200 200 00554 Pulpectomy 1000 1000 1000 1000 1000 00540 Recementing of Crowns 500 500 500 500 500 00541 Refacing of Bridge 300 300 300 300 300 00544 Removable Partial Dentures - Additional Tooth 300 300 300 300 300 00545 Removable Partial Dentures - Single Tooth 800 800 800 800 800 00546 Repair of Dentures (Complicated) 800 800 800 800 800 00550 Repair of Dentures (Selective Grinding) 300 300 300 300 300 00551 Repair of Dentures (Simple) 300 300 300 300 300 00621 Repeat Anterior Root Canal Treatment 3500 3500 3500 3500 3500 00620 Repeat Posterior Root Canal Treatment 4500 4500 4500 4500 4500 00552 Root.can.Treat. Anterior Tooth without X-Ray 2500 2500 2500 2500 2500 00553 Root.can.Treat. Posterior Tooth with out X-Ray 3000 3000 3000 3000 3000 00555 Scaling - I 1250 1250 1250 1250 1250 00556 Scaling - II 750 750 750 750 750 00698 Single Sitting RCT Anterior 2500 2500 2500 2500 2500 00699 Single Sitting RCT Posterior 3500 3500 3500 3500 3500 02040 Socket Preservation 500 500 500 500 500 02047 Splinting Tooth 1500 1500 1500 1500 1500 00570 Surgical Exposure of Tooth - Simple 700 700 700 700 700 02053 Surgical exposure of tooth complicated 2000 2000 2000 2000 2000 00636 Suture Removal 200 200 200 200 200 00580 Temporary Crown 700 700 700 700 700 2.2. ORTHODONTICS 02018 2 x 4 Appliances 12000 12000 12000 12000 12000 02024 Activator 5000 5000 5000 5000 5000 02025 Activator with Head Gear 10000 10000 10000 10000 10000 02023 Bracket / Band - First 3 Months / Breakage 600 600 600 600 600 02021 Buttons / Begg Bracket for Habit Breaking 1000 1000 1000 1000 1000 02012 Coffin Spring Appliance 2500 2500 2500 2500 2500 02002 Feeding Plates 2000 2000 2000 2000 2000 02034 Fluoride Applications 500 500 500 500 500 02027 Frankel Appliance 7500 7500 7500 7500 7500 02013 Habit Breaking Appliance 2500 2500 2500 2500 2500 02014 Habit Breaking Appliance - Fixed 5000 5000 5000 5000 5000 02015 Habit Breaking Appliance - Removable 5000 5000 5000 5000 5000 53 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02028 Hybrid Appliance 1 with Buccal Shield 7500 7500 7500 7500 7500 02022 II Phase Treatment for Class II and Class III 55000 55000 55000 55000 55000 00601 Impressions 400 400 400 400 400 02005 Lingual Arch 5000 5000 5000 5000 5000 02001 NAM 6000 6000 6000 6000 6000 02009 Oral Screen 5000 5000 5000 5000 5000 00618 Orthodontic Checkup for Outside Patient 500 500 500 500 500 00619 Orthodontic Procedure for Outside Patient 1000 1000 1000 1000 1000 00690 Orthodontic Treatment - Complex 35000 35000 35000 35000 35000 00691 Orthodontic Treatment - Complicated 45000 45000 45000 45000 45000 00689 Orthodontic Treatment - Simple 25000 25000 25000 25000 25000 00694 Over Denture - 2 Implants & Denture Single 55000 55000 55000 55000 55000 02032 Pit & Fissure Sealant 600 600 600 600 600 02019 Pre - Prosthetic Appliances 12000 12000 12000 12000 12000 02003 Quad Helix 5000 5000 5000 5000 5000 02006 RME 7500 7500 7500 7500 7500 02020 Screw Based Appliances 12000 12000 12000 12000 12000 02011 Space - Regainers 5000 5000 5000 5000 5000 02017 Space Maintainers - Removable 2500 2500 2500 2500 2500 02010 Space Maintainers - Unilateral Fixed 3000 3000 3000 3000 3000 02033 Stainless Steel Crown 1000 1000 1000 1000 1000 00692 Surgical Cases Package 75000 75000 75000 75000 75000 02016 Tongue Thrust Correction - Soldered 5000 5000 5000 5000 5000 02004 TPA 5000 5000 5000 5000 5000 02026 Twin Block 7500 7500 7500 7500 7500 02007 Upper Expansion Appliance 5000 5000 5000 5000 5000 02008 Upper Z Spring Appliance 5000 5000 5000 5000 5000 2.3. PROSTHODONTICS 00626 Acrylic Dentures - Imported 12000 12000 12000 12000 12000 00623 All Ceramic Crowns-Single Unit 9000 9000 9000 9000 9000 00627 BPS Dentures/Injection Moulded Dentures 24000 24000 24000 24000 24000 00625 Cast Partial Dentures 14000 14000 14000 14000 14000 00632 Confirmer - Complicated 1000 1000 1000 1000 1000 00631 Confirmer - Simple 1000 1000 1000 1000 1000 02030 Hybrid Denture - Single 4 Implants Denture 100000 140000 180000 220000 260000 02029 Hybrid Denture 8 Implants U/L Denture 200000 280000 360000 440000 520000 00696 Implant Prosthesis Phase 11000 11000 11000 11000 11000 00695 Implant Surgical Phase 13000 13000 13000 13000 13000 00629 Maxillofacial Prosthese - Simple 1500 1500 1500 1500 1500 00630 Maxillofacial Prothesis - Complicated 3000 3000 3000 3000 3000

54 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00633 Night Guard 1500 1500 1500 1500 1500 02031 Over Denture - 4 Implants & Denture U/L 100000 140000 180000 220000 260000 00628 Semi Regid Dentures / Single Arch 10000 10000 10000 10000 10000 02035 Semi Regid Harf Arch - Denture 7000 7000 7000 7000 7000 00624 Ziconia Crowns-Single Unit 11000 11000 11000 11000 11000 3. SPECIALISED PROCEDURES - DERMATOLOGY ACNE 00817 Acne Scar Revision per sitting Subscission-(5-10) 1500 1500 1500 1500 1500 00755 Acne Scar Revision (per sitting) Subscission-(< 5) 1000 1000 1000 1000 1000 00848 Dermaroller 1500 1500 1500 1500 1500 00793 Microdermabrasion - Large Area (per sitting) 1500 1500 1500 1500 1500 00782 Punch Elevation (Per Scar) 500 500 500 500 500 ALLERGY 00701 Allergic Prick Test - 0-10 Allergens 500 500 500 500 500 00702 Allergic Prick Test - 10-20 Allergens 1000 1000 1000 1000 1000 00703 Allergic Prick Test - Above 20 Allergens 2000 2000 2000 2000 2000 00841 Patch Test - Footwear Series 1000 1000 1000 1000 1000 00728 Patch Test for Skin allg.- Additional per allergen 150 150 150 150 150 00835 Patchtest Indian Standard Series 2000 2000 2000 2000 2000 CHEMICAL CAUTERY 00705 Chemical Cautery 300 300 300 300 300 COMEDONE/MILIA EXTRACTION 00777 Comedone Extraction (< 10) 500 500 500 500 500 00778 Comedone Extraction (> 10) 1000 1000 1000 1000 1000 CRYOTHERAPY 00743 Cryotherapy Large (>10) 1000 1000 1000 1000 1000 00812 Cryotherapy Medium (4-10) 500 500 500 500 500 00710 Cryotherapy Small (1-3) 300 300 300 300 300 DRESSING 00788 Dressing Service Charges - Large 250 250 250 250 250 00786 Dressing Service Charges - Small 150 150 150 150 150 ELECTROCAUTERY 00843 Electro Cautery - DPN or Tag - Small (<5) 600 600 600 600 600 00846 Electro Cautery - DPN or Tag Extra Large (20-30) 3000 3000 3000 3000 3000 00845 Electro Cautery - DPN or Tag Large (10-20) 1500 1500 1500 1500 1500 00844 Electro Cautery - DPN or Tag Medium (5-10) 1000 1000 1000 1000 1000 00712 Electro Cautery - Small < 5 400 400 400 400 400 00714 Electro Cautery -Large (10 -20 Warts) 1200 1200 1200 1200 1200 00713 Electro Cautery Medium (5-10 Warts) 800 800 800 800 800 ILS 00739 Skin Intralesional Injection - Large 500 500 500 500 500

55 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00847 Skin Intralesional Injection - PPD 300 300 300 300 300 00737 Skin Intralesional Injection - Small (5X5 Cms) 300 300 300 300 300 KELOID SURGERIES 00850 Keloid Surgery - Large 700 700 700 700 700 00849 Keloid Surgery - Small (upto 3 Small Lesions) 400 400 400 400 400 LASER 00857 Ablative Laser Cosmetic Indication (< 5 Lesions) 4000 4000 4000 4000 4000 00858 Ablative Laser Cosmetic Indication (5 - 10 lesion) 8000 8000 8000 8000 8000 00860 Ablative Laser Medical Indication 6000 6000 6000 6000 6000 00859 Ablative Laser Medical Indication (3x3 cm) 3000 3000 3000 3000 3000 00884 Ablative Laser Small (<1x1 cm/ Test Spot) 1500 1500 1500 1500 1500 00865 Laser Hair Removal - Axilla (both) or Lower Abdomen 4000 4000 4000 4000 4000 00878 Laser Hair Removal - Axilla (both) or Lower Abdomen (x 3 package) 10000 10000 10000 10000 10000 00863 Laser Hair Removal - Full Face 5000 5000 5000 5000 5000 00876 Laser Hair Removal - Full Face (x 3 package) 13000 13000 13000 13000 13000 00864 Laser Hair Removal - Legs(Both) or Thighs(Both) or UL (both) 6000 6000 6000 6000 6000 00877 Laser Hair Removal - Legs(Both) or Thighs(Both) orUL (Both) x 3 Package 16000 16000 16000 16000 16000 00862 Laser Hair Removal - Submental or Sideburns or Cheeks or Pre-Sternal 3000 3000 3000 3000 3000 00875 Laser Hair Removal - Submental or Sideburns or Cheeks or Pre-Sternal (x 3 package) 8000 8000 8000 8000 8000 00886 Laser Hair Removal - Upper Back or Lower Back 4000 4000 4000 4000 4000 00887 Laser Hair Removal - Upper Back or Lower Back (x3 Package) 10000 10000 10000 10000 10000 00861 Laser Hair Removal - Upper Lip or Chin - (Small) or 2000 2000 2000 2000 2000 00874 Laser Hair Removal - Upper Lip or Chin - (Small) or Ears (x 3 package) 5000 5000 5000 5000 5000 00838 Laser PIXEL Large ( > 5X5Cms) 5000 5000 5000 5000 5000 00866 ND Yag (Large) 3000 3000 3000 3000 3000 00883 ND Yag (Small) (<5 cm/ Test Spot) 1500 1500 1500 1500 1500 00867 Pigment and Vascular Laser (< 5 cm) 1500 1500 1500 1500 1500 00868 Pigment and Vascular Laser (> 5 cm) 3000 3000 3000 3000 3000 00856 Pixel Laser Small (< 5x5cm) 3000 3000 3000 3000 3000 00831 Skin Rejuvinaton / Toning Full Face 1500 1500 1500 1500 1500 MOLLUSCUM 00709 Curettage of Molluscum Contagiosum - > 10 1000 1000 1000 1000 1000 00707 Currettage of Molluscum Contagiosum - < 5 400 400 400 400 400 00842 Currettage of Molluscum Contagiosum - 5-10 600 600 600 600 600 PARING CHARGES 00814 Paring ( Large) 400 400 400 400 400 00726 Paring (Small) 200 200 200 200 200 PEELS 00880 Chemical Peel - Arms 2000 2000 2000 2000 2000

56 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00879 Chemical Peel - Back 3000 3000 3000 3000 3000 00853 Chemical Peel (Salicylic Acid) 1500 1500 1500 1500 1500 00797 Chemical Peels (Neostrata) 1500 1500 1500 1500 1500 00798 Chemical Peels (TC) 1500 1500 1500 1500 1500 00855 Combination Chemical Peel 2000 2000 2000 2000 2000 00854 Peel Service Charge(Own Peel) 1000 1000 1000 1000 1000 00836 Spot Peel 1000 1000 1000 1000 1000 00837 TCA Cross 1000 1000 1000 1000 1000 PHOTOTHERAPY 00827 Hand & Foot Phototherapy nBUVB 150 150 150 150 150 00826 Hand & Foot Phototherapy PUVA 100 100 100 100 100 00758 Narrow Band UVB (per sitting) 200 200 200 200 200 00744 PUVA Therapy 150 150 150 150 150 00882 Targeted Phototherapy 350 350 350 350 350 PRP 00840 PRP (Cosmetic indications) 3000 3000 3000 3000 3000 00839 PRP (Medical indications) 500 500 500 500 500 RADIOFREQUENCY 00810 Radiofrequency Ablation - Large (10-15cm or 10-20 DPNs/Tags) 2000 2000 2000 2000 2000 00809 Radiofrequency Ablation - Medium (5 - 10cm or 5-10 DPNs/Tags ) 1500 1500 1500 1500 1500 00808 Radiofrequency Ablation - Small (< 5cm or < 5 DPNs/Tags) 1000 1000 1000 1000 1000 VITILIGO SURGERIES 00825 Autologus Melanocyte Transfer - (10X10 Cms) 8000 8000 8000 8000 8000 00819 Blister grafting (Extra Large > 5 Blister) 5000 5000 5000 5000 5000 00784 Blister Grafting (Large - 4 Blister) 3000 3000 3000 3000 3000 00851 Blister Grafting <3 Laser Assisted 5000 5000 5000 5000 5000 00852 Blister Grafting>3 Laser Assisted 7000 7000 7000 7000 7000 00753 Punch Grafting for Vitiligo - Medium (10-20) 3000 3000 3000 3000 3000 00795 Punch Grafting for Vitiligo - Small (1 - 10) 1500 1500 1500 1500 1500 MISCELLANEOUS 00774 Botx Injection 1000 1000 1000 1000 1000 00881 Cross Consultation IP - Dermatology 50 150 250 400 500 00785 Dermabrassion (Manual) 350 350 350 350 350 00711 DNCB Test 300 300 300 300 300 00790 Ear Lobe Repair - Surgical (per ear) 2000 2000 2000 2000 2000 00715 Electrolysis (per sitting) 700 700 700 700 700 00872 Fillers 1000 1000 1000 1000 1000 00723 Fungal Scraping (KOH) 100 100 100 100 100 00759 Skin Lab - Outside Reference 500 500 500 500 500 00870 Hair Transplantion - Base Charge 2000 2000 2000 2000 2000

57 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00871 Hair Transplantion - Per Graft 20 20 20 20 20 00779 Incision & Drainage - Abscess (Small) 300 300 300 300 300 00806 KOH Multiple Sites 150 150 150 150 150 00725 Lontophoresis (per sitting) 200 200 200 200 200 00719 MCR Sandal (1 pair ) NLRU 350 350 350 350 350 00716 MCR Sandal (1 pair) LRU Pt. 240 240 240 240 240 00717 MCR Sheet (1) - 8mm LRU Pt. 65 65 65 65 65 00720 MCR Sheet (1) 3mm NLRU 100 100 100 100 100 00721 MCR Sheet (1) 8mm NLRU 150 150 150 150 150 00718 MCR Slipper (1 pair) LRU Pt. 240 240 240 240 240 00722 MCR Slipper (1pair) NLRU 300 300 300 300 300 00885 Nail Avulsion (per nail) 1500 1500 1500 1500 1500 00781 Nail Biopsy 1000 1000 1000 1000 1000 00873 Podophyllin Application - Large 500 500 500 500 500 00733 Podophyllin for Warts - Small 300 300 300 300 300 00735 Pus Smear (Gram Stain) 100 100 100 100 100 00869 Sclerotherapy 500 500 500 500 500 00815 Skin Biopsy 700 700 700 700 700 00740 Smear for Lepra Bacillus (AFB) 100 100 100 100 100 00741 Smear for TV/ Monilia 100 100 100 100 100 00775 Surgical Excision 1200 1200 1200 1200 1200 00746 Tattooing (Per sitting) 420 420 420 420 420 00757 Trichogram (Hair test) 500 500 500 500 500 00742 Tzank Smear 100 100 100 100 100 00764 Urine Albumin 50 50 50 50 50 00763 Urine Albumin, Sugar, Micro 150 150 150 150 150 00765 Urine Sugar 50 50 50 50 50 4. SPECIALISED PROCEDURES - ENDOCRINOLOGY 02870 ACTH stimulation 200 275 350 430 500 02996 Biothesimeter 50 80 100 120 150 02819 Cardiac Autonomic Neuropathy Analyzer 300 420 540 660 780 02821 Endocrinology -Cross Consultation IP 50 150 250 400 500 02820 Digital Fundus Camera facilty per usage 100 140 180 220 260 02997 File Charges 50 50 50 50 50 02995 Periscope 350 500 630 800 1000 02890 PODO I MAT 150 210 270 330 390 02869 Sensitometer HCP 100 100 125 175 200 5. SPECIALISED PROCEDURES - ENT 02101 90 Degree Videolaryngoscopy 660 920 1190 1450 1720 02118 90 degree videolaryngoscopy (Repeat within 2 weeks) 250 350 450 550 650

58 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02124 Adult Sleep Study 200 280 360 440 520 00987 Aided Audiometry 250 350 450 550 650 00902 Antral Wash under LA - Both side 300 420 540 660 780 00901 Antral Wash under LA - One side 150 210 270 330 390 00993 Audiology - Counselling 200 280 360 440 520 00992 Audiology Special Test 300 420 540 660 780 00940 BAER - Repeat within 6 months 1000 1400 1800 2200 2600 00939 BAER for Differential Diagnosis 1750 2450 3150 3850 4550 00938 BAER for Threshold Estimation 1750 2450 3150 3850 4550 00944 Behavioural Observation Audiometry 250 350 450 550 650 00943 Biopsy - Fibreoptic + Biopsy 700 980 1260 1540 1820 02103 Biopsy - Minor 1500 2100 2700 3300 3900 02116 Bone Conduction – Auditory Brainstem Response (BC-ABR) 1000 1400 1800 2200 2600 00906 Caloric Test 300 420 540 660 780 00907 Chemical Cautery of Bleeding Points in the Nose 400 560 720 880 1040 00952 Computerised Electronystagmography 500 700 900 1100 1300 00950 Computerised Speech Assesment 300 420 540 660 780 00908 Cortisone Injection to Nose/ Oropharynx 500 700 900 1100 1300 02106 Cross Consultation - IP ENT 50 150 250 400 500 02125 Cross Consultation IP Audiology 50 150 250 400 500 02126 Cyclops Evaluation 3000 4200 5400 6600 7800 02117 Dressing 200 280 360 440 520 00942 Diagnostic Nasal Endoscopy(with Image Printout) 600 840 1080 1320 1560 00941 Diagnostic Nasal Endoscopy 500 700 900 1100 1300 02123 Ear Impression taking Per Ear 400 560 720 880 1040 00909 Ear Lobe Repair Per Ear 1000 1400 1800 2200 2600 00935 Ear Piercing Per Ear 600 840 1080 1320 1560 02127 Ear Piercing with Gunshot 1100 1540 1980 2420 2860 02143 Ear Piercing (Both Ears) 1200 1680 2160 2640 3120 02144 Ear Lobe Repair (Both Ears) 2000 2800 3600 4400 5200 02145 Ear Lobe Repair with Gun Shot (Both Ears) 2500 3500 4500 5500 6500 00976 Endoscopic Biopsy - Ear 600 840 1080 1320 1560 00979 Endoscopic Biopsy - Hypopharynx 950 1330 1710 2090 2470 00975 Endoscopic Biopsy - Nose 700 980 1260 1540 1820 00977 Endoscopic Biopsy - Oral Cavity 700 980 1260 1540 1820 00978 Endoscopic Biopsy - Orpharynx 700 980 1260 1540 1820 00985 Endoscopice Suction Clearence - Ear 350 490 630 770 910 00984 Endoscopice Suction Clearence - Nose 500 700 900 1100 1300 00910 ENG 550 770 990 1210 1430 00945 Epleys Maneuver/Dix-Hallpike Test 300 420 540 660 780

59 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00994 Evaluation Report 200 280 360 440 520 02128 FEES (Functional Endoscopic Evaluation of Swallowing ) First Visit 1000 1400 1800 2200 2600 02129 FEES (Functional Endoscopic Evaluation of Swallowing ) Follow up Visit 700 980 1260 1540 1820 00968 Faciomaxillary Botox Injection 1985 2780 3570 4370 5160 00911 Fiberoptic Bronchoscopy 1400 1960 2520 3080 3640 00912 Fiberoptic Bronchoscopy - Repeat within a week 800 1120 1440 1760 2080 00913 Fiberoptic Bronchoscopy and Biopsy 1980 2770 3560 4360 5150 00915 Fiberoptic Laryngoscopy 600 840 1080 1320 1560 02119 Fibreoptic Ikaryngoscopy (Repeat within 2 weeks) 300 420 540 660 780 02112 Fine tuning of hearing aid (Per Visit). 250 350 450 550 650 00973 Foreign Body Removal (Endoscopic) - Ear 600 840 1080 1320 1560 00974 Foreign Body Removal (Endoscopic) - Hypopharynx 1600 2240 2880 3520 4160 00972 Foreign Body Removal (Endoscopic) - Nose 1500 2100 2700 3300 3900 02109 Hearing Aid Trial (one session) 500 700 900 1100 1300 02110 Hearing Aid Troubleshooting. 100 140 180 220 260 02115 Hearing Screening – Follow -up 100 140 180 220 260 00986 High Frequency Audiometry 550 770 990 1210 1430 00991 Impedance Audiometery (Unilateral) 300 420 540 660 780 00919 Impedance Audiometry 550 770 990 1210 1430 00918 Incision & Drainage of Furuncle / Haematoma Auris 600 840 1080 1320 1560 02105 Incision and Drainage - Major 475 670 860 1050 1240 02104 Incision and Drainage - Minor 300 420 540 660 780 00934 Injection into Auricle 500 700 900 1100 1300 00933 Intra Tympanic Amino Glycoside/Steroid 600 840 1080 1320 1560 00967 Laryngeal EMG 1050 1470 1890 2310 2730 00920 Long Term Speech Therapy (Per Sitting) 300 420 540 660 780 00996 Nasal Endoscopic debridement 700 980 1260 1540 1820 02120 Nasal endoscopy (Repeat within 2 weeks) 300 420 540 660 780 00932 Nasal Packing 80 120 160 180 220 00936 Nasendoscopy Biopsy / Cautery 650 910 1170 1430 1690 02147 Nasogastric Tube Insertion 200 280 360 440 520 00921 Neuro Otological Test 1100 1540 1980 2420 2860 00922 Nose Prick (Boring of Nose) 500 700 900 1100 1300 02114 Oto Acoustic Emission (Unilateral) 350 490 630 770 910 00988 Oto Acoustic Emission Test 650 910 1170 1430 1690 00983 Otoendoscopy 300 420 540 660 780 02121 Otoendoscopy (Repeat within 2 weeks) 200 280 360 440 520 00990 Paediatric Sleep Study- Minor 2000 2000 2000 2000 2000 00989 Peadiatric Sleep Study - Major 5600 5600 5600 8800 10400 00923 Pure Tone 500 700 900 1100 1300

60 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 00924 Pure Tone Audiogram - Repeated within 3 months 300 420 540 660 780 02113 Real Ear Measurement. 800 1120 1440 1760 2080 00925 Removal of Foreign Body from Nose/Ear 600 840 1080 1320 1560 00914 Rigid Bronchoscopy 1200 1680 2160 2640 3120 00982 Rigid Laryngoscopy 1420 1990 2560 3120 3690 00937 Saline Nasal Wash 400 560 720 880 1040 02108 Screening ABR 900 1260 1620 1980 2340 02107 Screening OAE 300 420 540 660 780 00926 Speech Evaluation and Therapy/Audiological Consultation 250 350 450 550 650 00927 Suction Clearance 300 420 540 660 780 02102 Suture Removal 60 80 110 130 160 00981 Suturing (Large) 600 840 1080 1320 1560 00980 Suturing (Small) 350 490 630 770 910 02130 Swallowing Assessment 200 280 360 440 520 02131 Swallowing Therapy 250 350 450 550 650 00928 Syringing to Ear ( Per Ear) 300 420 540 660 780 02146 Syringing to Ear ( Both Ear) 600 840 1080 1320 1560 02151 Testing Electro Acoustic Characteristics (EAC) of Hearing Aids 500 700 900 1100 1300 08015 Tracheostomy Decannulation 3000 4200 5400 6600 7800 00929 Tracheostomy Tube care/Change 500 700 900 1100 1300 00971 Tran-cervical Laryngeal Injections 1000 1400 1800 2200 2600 00970 Transoral VF Augmentation 2500 3500 4500 5500 6500 00969 Transoral VF Injection 1600 2240 2880 3520 4160 00930 Vestibular Function Tests 400 560 720 880 1040 00966 Videostroboscopy 1000 1400 1800 2200 2600 ENT Packages: 00958 Ear Piercing with Studs 700 980 1260 1540 1820 00956 Endoscopy Imaging 250 350 450 550 650 00957 Endoscopy Imaging with File (CD) 320 450 580 700 830 00948 Imaging Surchage 55 80 100 120 140 00946 Snoring Evaluation Package 6160 8620 11090 13550 16020 00954 Speech Theraphy using Vaghmi 300 420 540 660 780 00965 VEMP Proceedure 350 490 630 770 910 00947 Protocol 3500 4900 6300 7700 9100 02132 Allergy protocolIncludes : Diagonstic Nasal Endoscopy,Skin Prick Test, Nasal Smear, Total IgE,AECExcludes :CBC,PFT,X-Ray PNS, X-Ray Chest,CT PNS 3510 4910 6320 7720 9130 02133 Swallowing Protocol - First Visit 1200 1680 2160 2640 3120 02134 Swallowing Protocol - Secound Visit OnwardsIncludes : Upper Gatrointestinal Endoscopy,Videoflouroscopy, Neurological Evaluation Excludes :Swallowing Assessment,FEES,Swallowing Therapy 850 1190 1530 1870 2210

61 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. Sleep Study Protocol 02135 Basic Sleep StudyIncludes :EEG,ECG,Chest Expansion, Abdominal Expansion, Pulse Oximetry 6000 8400 10800 13200 15600 02136 Titration Study 3500 4900 6300 7700 9100 02137 SPLIT Study 6500 9100 11700 14300 16900 02138 Level 3 Sleep StudyIncludes : Pulse Oximetry +/- ECG 3000 4200 5400 6600 7800 02139 MSLT 4200 5880 7560 9240 10920 02140 OSA Protocal 1500 2100 2700 3300 3900 Includes :Clinical Assessment,Fibreoptic Endoscopy (Muller’s manoeuvre) 02141 Speech/Voice Protocol 2500 3500 4500 5500 6500 Incudes :Videolaryngoscopy,Stroboscopy,Speech Assessment, Speech Therapy 02142 Vertigo Clinic ( Cyclops)Incudes :Clinical Assessment (-Cerebellar Gait test -otoendoscopy) Dix Hallpike/Epley’s PTA,ENG (Cyclops) 4500 6300 8100 9900 11700 02148 Cochlear Implant Mapping 1000 1400 1800 2200 2600 02149 Voice Evaluation & Advice 200 280 360 440 520 6. SPECIALISED PROCEDURES - GASTROENTEROLOGY 01038 24 Hrs pH Monitoring 1870 2620 3370 4110 4860 01001 Abdominal Paracentesis 220 310 400 480 570 01063 Adrenaline Injection 3080 4310 5540 6780 8010 01059 Argon Plasma Coagulation (APC) 4620 6470 8320 10160 12010 01056 Ascitic Tap Procedure 330 460 590 730 860 01049 Biliary Metal Stenting 7260 10160 13070 15970 18880 01048 Biliary Stricture Dilatation 7260 10160 13070 15970 18880 01066 Biopsy - Endoscopy 400 560 720 880 1040 01004 Biopsy - Liver 330 460 590 730 860 01047 Colonic Stricture Dilatation 3960 5540 7130 8710 10300 01008 Colonoscopy 3410 4770 6140 7500 8870 01061 Colonoscopy - Bed Side 3500 4900 6300 7700 9100 01022 Colonoscopy + Polypectomy 5060 7080 9110 11130 13160 01046 Duodenal Stricture Dilatation 3960 5540 7130 8710 10300 01037 ECG monitoring / Oxygen During Endoscopy 220 310 400 480 570 01062 EGD - Bed Side 2200 3080 3960 4840 5720 01031 Endoscopic Clip Application 2750 3850 4950 6050 7150 01032 Endoscopic Clip Application (Additional) 2750 3850 4950 6050 7150 01043 Endoscopic Cystogastrostomy 7260 10160 13070 15970 18880 01052 Endoscopic Fluoroscopy 275 390 500 610 720 01009 Endoscopic Gastrostomy 4290 6010 7720 9440 11150 01010 Endoscopic Jejunal Biopsy 2200 3080 3960 4840 5720 01045 Enteroscopy 3300 4620 5940 7260 8580

62 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01011 ERCP + Sphincterotomy 5280 7390 9500 11620 13730 01002 ERCP Biliary Drainage 8470 11860 15250 18630 22020 01003 ERCP Biliary Prosthesis 9680 13550 17420 21300 25170 01012 ERCP Diagnostic Only 4100 5700 7400 9000 10700 01051 ERCP Fluoroscopy 330 460 590 730 860 01013 Esophageal Dilatation 3300 4620 5940 7260 8580 01014 Esophageal Dilatation (Repeat within 2 Months) 1870 2620 3370 4110 4860 01033 Esophageal Manometry 2420 3390 4360 5320 6290 01039 Esophageal Stenting 3080 4310 5540 6780 8010 01028 Esophageal Variceal Banding 3080 4310 5540 6780 8010 01015 Esophagogastroduodenoscopy (G.I. Endoscopy) 1500 2100 2700 3300 3900 01016 Esophagogastroduodenoscopy (Repeat within 3 Months 1000 1400 1800 2200 2600 01053 EUS - Diagnostic 4840 6780 8710 10650 12580 01054 EUS - FNAC 8910 12470 16040 19600 23170 01055 EUS-Therapeutic 8600 12040 15480 18920 22360 01025 Fiberoptic Flexible Sigmoidoscopy 700 1000 1300 1500 1800 01023 Foreign Body Removal (Endoscopic) 4400 6160 7920 9680 11440 01100 General Anaesthesia 550 770 990 1210 1430 01029 Glue Injection 3080 4310 5540 6780 8010 01067 Heater Probe Application 4400 6160 7920 9680 11440 01017 Injection Sclerotherapy (1st Session) 3080 4310 5540 6780 8010 01018 Injection Sclerotherapy (Subsequent Session) 1540 2160 2770 3390 4000 01064 Intraoperative Enteroscopy 4950 6930 8910 10890 12870 01050 Liver Ultrasound 330 460 590 730 860 01019 Naso Biliary Drainage 5720 8010 10300 12580 14870 01044 Pancreatic Duct Stenting* 6050 8470 10890 13310 15730 01020 Placement Jejunal Feeding Tubes 2420 3390 4360 5320 6290 01021 Pneumatic Dilatation (Per Session) 3850 5390 6930 8470 10010 01034 Rectal Manometry 1650 2310 2970 3630 4290 01065 RUT (Rapid Urease Test) 110 150 200 240 290 01000 Sengstaken Tube Introduction 2200 3080 3960 4840 5720 01024 Sigmoidoscopic Polypectomy 2750 3850 4950 6050 7150 01057 UltrasoundGuided - Liver Biopsy 2420 3390 4360 5320 6290 01058 UltrasoundGuided - Pancreatic Necrotic Drainage 6050 8470 10890 13310 15730 Note: Extra charges for CD Rs.100/- * Stent extra

7. SPECIALISED PROCEDURES- GENERAL MEDICINE 02801 Abdominal Paracentesis 220 310 400 480 570 02864 Allogenic HSCT Procedure * 300000 300000 300000 300000 300000 03604 Ascitic Tap Under Ultrasound Guidance 300 420 540 660 780 63 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02863 Auto HSCT Procedure * 250000 250000 250000 250000 250000 03602 Bedside USG 150 210 270 330 390 02802 Biopsy - Liver 330 460 590 730 860 02804 Biopsy - Muscle 350 490 630 770 910 02805 Biopsy - Peritonial 250 350 450 550 650 02806 Biopsy - Pleural 400 560 720 880 1040 02807 Biopsy - Trephine 250 350 450 550 650 02808 Bone Marrow Study 750 1050 1350 1650 1950 02857 Chemotheraphy - Level A (Single Day) 350 700 950 1200 1900 02855 Chemotheraphy-Level D Monoclonal Antibodies/Target 700 1400 1900 2400 2800 02862 Chemotherapy Planning Charges (Full Protocol) 365 530 715 1065 1780 02816 Cross Consultation IP - General Medicine 50 150 250 400 500 02835 LP Intrathecal drug 175 250 320 390 460 02866 Pleural Aspiration (Diagnostic) Ultrasound Guidance 300 420 540 660 780 03603 Ultrasound Guidance for CVC 400 560 720 880 1040 * Procedure charges only. Investigations, room rent, drugs, blood bank products / process, diet and other charges extra.

8. SPECIALISED PROCEDURES - IMMUNOLOGY 02900 Detailed MSK - UltrasoundGuided 800 1120 1440 1760 2080 02898 Hip Joints Injection/Aspiration - Ultrasound Guided 2000 2800 3600 4400 5200 02891 Labial Minor Salivary Gland 600 840 1080 1320 1560 02896 Large Joints Injection/Aspiration - Ultrasound Guided 800 1120 1440 1760 2080 02899 Limited MSK - UltrasoundGuided 500 700 900 1100 1300 03607 Muscles Biopsy with Conchotome 2000 2800 3600 4400 5200 02892 Muscles Biopsy without Conchotome 1500 2100 2700 3300 3900 02885 Nail Fold Capillaroscope 800 1120 1440 1760 2080 02893 Nerve Biopsy 1800 2520 3240 3960 4680 02894 Non Guided Blinds Injection/Aspiration Of Joints 300 420 540 660 780 02895 Small Joints Injection/Aspiration - Ultrasound Guided 500 700 900 1100 1300 02897 Two Joints Injection/Aspiration - Ultrasound Guided 1000 1400 1800 2200 2600 9. SPECIALISED PROCEDURES - PULMONARY MEDICINE 02859 6 Minute Walk Test 250 350 450 550 650 03572 Bipap (Per Day) 500 700 900 1100 1300 02858 Breath Carbon - Monoxide levels 50 70 90 110 130 02809 Bronchial Challenge Test 1200 1200 1200 1200 1200 04512 Bronchoscopic Balloon Dilation for Bronchial / Tracheal stenosis 10000 10000 10000 10000 10000 02825 Bronchoscopic Endotracheal Intubation 1800 1800 1800 1800 1800 02811 Bronchoscopy - Repeat 1950 1950 1950 1950 1950 02810 Bronchoscopy Diagnostic / with BAL 4250 4250 4250 4250 4250 02812 Bronchoscopy With EBB/TBLB/TBNA 5500 7700 9900 12100 14300 04151 Bronchoscopy with Endobronchial Cryobiopsy / Cryotherapy 7500 7500 7500 7500 7500 64 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 04150 Bronchoscopy with TB Crybiopsy 10000 10000 10000 10000 10000 03599 Cardio Pulmonary Exercise Testing 2500 3500 4500 5500 6500 02833 Chemotherapy 500 700 900 1100 1300 02849 Concentration 1:50 ( 0.6 cc and 1cc) 500 700 900 1100 1300 03571 CPAP (Per Day) 500 700 900 1100 1300 03000 CPAP TITRATION - Auto 1000 1400 1800 2200 2600 02841 CPAP Titration Study 2500 3500 4500 5500 6500 03601 Cross Consultation IP - Pulmonary Medicine 50 150 250 400 500 02823 DLCO / Lung Volume 1500 2100 2700 3300 3900 02992 FeNO 500 650 750 1000 1050 04515 Home Sleep Study 3000 4200 5400 6600 7800 03574 Intercostal Drain Tube Insertion 1000 1400 1800 2200 2600 02993 Level 3 Sleep Study 2000 2800 3600 4400 5200 02829 Lung Volume + DLCO 2500 3500 4500 5500 6500 02884 Medical 5500 7700 9900 12100 14300 03583 MEP/MIP 250 350 360 500 550 02842 MSLT / MWT 2000 2800 3600 4400 5200 02830 Pleural Aspiration (Repeat) 300 420 540 660 780 02831 500 700 900 1100 1300 04513 Rigid Bronchoscopy 6000 8400 10800 13200 15600 02832 Sleep Study 6000 8400 10800 13200 15600 04514 Sllep Study + MSLT / MWT 7500 10500 13500 16500 19500 02826 (Repeat) 100 140 180 220 260 02818 Spirometry / Spirometry with BDR 500 700 900 1100 1300 02998 Split Night Sleep Study 6500 9100 11700 14300 16900 02994 Ultrasound Guided -Chest 500 700 900 1100 1300 03579 Ultrasound Guided -Chest (Repeat) 250 350 450 550 650 03582 Ultrasound Guided -Lung Biopsy 1500 2100 2700 3300 3900 03581 Ultrasound Guided -Pigtail Insertion 1500 2100 2700 3300 3900 03580 Ultrasound Guided -Pleural Aspiration ( Diagnostic) 750 1050 1350 1650 1950 02824 Ultrasound Guided Pleural Aspiration (Therapeutic) 900 900 900 900 900 03573 Ultrasound Guided Pleural Biopsy 1000 1400 1800 2200 2600 PULMONARY MEDICINE - OT 03597 Bronchoscopy - OT 5000 7000 9000 11000 13000 03594 Endobronchial Ultrasound 17500 17500 25000 25000 30000 03596 Medical Thoracoscopy in OT 10000 14000 23500 32500 42500 03595 Whole Lung Lavage 15000 20000 25000 30000 40000 10. SPECIALISED PROCEDURES - GENERAL SURGERY 02601 Abdominal Paracentesis 220 310 400 480 570 02602 Aspiration Biopsy / Lymph Node Biopsy 200 280 360 440 520

65 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02643 AV Fistula 475 670 860 1050 1240 02622 Band Ligation of Haemorrhoids 175 250 320 390 460 02604 Biopsy - Liver 330 460 590 730 860 02605 Biopsy - Muscle 350 490 630 770 910 02623 Biopsy - Rectal 175 250 320 390 460 02654 Biopsy Intermediate 250 350 450 550 650 02653 Bladder Wash 110 150 200 240 290 02690 Callus Removal 300 420 540 660 780 02678 Catheterization 80 120 160 180 220 02665 Circumcision 350 490 630 770 910 02652 Colostomy Bag Change 120 170 220 260 310 02624 Colostomy Irrigation 175 250 320 390 460 02677 Crepe Bandage Application 50 70 90 110 130 02693 General Surgery - Cross Consultation IP 50 150 250 400 500 02608 Cryo Surgery for Warts 175 250 320 390 460 02661 Debridement 175 250 320 390 460 02667 Debridement - Major 475 670 860 1050 1240 02656 Distal Loop Washes 175 250 320 390 460 02658 Drain Insertion 175 250 320 390 460 02650 Drain Removal 120 170 220 260 310 02686 Dressing Service Charges - Large 120 170 220 260 310 02685 Dressing Service Charges - Medium 85 120 150 190 220 02679 Dressing Service Charges - Small 70 100 130 150 180 02610 Ear Lobe Repair (Double) 300 420 540 660 780 02611 Ear Lobe Repair (Single) 240 340 430 530 620 02691 Excision Medium 350 490 630 770 910 02612 Excision of Small Swellings, Sebacious Cysts etc., 120 170 220 260 310 02651 Ganglion Aspiration 120 170 220 260 310 02639 ICD 175 250 320 390 460 02657 ICD Insertion 210 300 380 470 550 02648 ICD Removal 120 170 220 260 310 02660 Incision & Drainage 150 210 270 330 390 02632 Incision & Drainage - Major 475 670 860 1050 1240 02631 Incision & Drainage - Minor 175 250 320 390 460 02692 Ingrowing Toe Nail Excision 600 840 1080 1320 1560 02613 Injection Treatment of Haemorrhoids 120 170 220 260 310 02614 Intra Lesional Injections eg. Keloids 120 170 220 260 310 02687 Minor Procedure in Minor OT 55 80 100 120 140 02644 Miscellaneous Operative Procedure Intermediate 175 250 320 390 460 02615 Nose Prick (Boring of Ear/Nose) 120 170 220 260 310

66 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02626 Pleural Tapping 175 250 320 390 460 02688 Removal of Foreign Body in OPD/Ward 300 420 540 660 780 02689 Ryles Tube Introduction 30 40 50 70 80 02666 Segmental Block 475 670 860 1050 1240 02616 Sengs Taken Tube Introduction 715 1000 1290 1570 1860 02659 Seton Change 175 250 320 390 460 02617 Sigmoidoscopy - Flexible Scope 350 490 630 770 910 02619 Sigmoidoscopy - If Procedure Prolonged 300 420 540 660 780 02618 Sigmoidoscopy - Rigid Scope 240 340 430 530 620 02664 SPC 240 340 430 530 620 02649 SPC Removal 120 170 220 260 310 02662 SSG 240 340 430 530 620 02637 Suturing - Intermediate (OPD / Ward) 240 340 430 530 620 02638 Suturing - Major (OPD / Ward) 475 670 860 1050 1240 02636 Suturing - Minor (OPD / Ward) 175 250 320 390 460 2621 Tracheostomy in OPD / Ward 290 410 520 640 740 02655 Water Holding Test 175 250 320 390 460 02668 WristAV Fistula 240 340 430 530 620 02695 Suture Removal - Minor 60 80 110 130 160 02696 Suture Removal - Major 100 130 170 220 250 10.1. STOMA CLINIC PROCEDURE 02674 Banding of Haemorrhoids 175 250 320 390 460 02676 Hemorrhoid Sclero 240 340 430 530 620 02673 Injection Sclerotherapy for Haemorrhage 120 170 220 260 310 02670 Proctoscopy 45 60 80 100 120 02671 Sigmodoscopy 240 340 430 530 620 11. SPECIALISED PROCEDURES - NEPHROLOGY 01401 Abdominal Paracentesis 220 310 400 480 570 01413 Biopsy - Kidney (With Disposable Gun) 900 1260 1620 1980 2340 01498 Biopsy - Kidney (With Reusable Bard Gun) 800 1120 1440 1760 2080 01429 Bone Marrow Aspiration 400 560 720 880 1040 01433 CAPD Catheter Flushing 175 250 320 390 460 01426 CAPD Cycler (24 hrs) 1200 1680 2160 2640 3120 01492 CAPD Dressing 75 110 140 170 200 01500 CAPD Percutaneous Catheter Insertion 4000 5600 7200 8800 10400 01424 CAPD Training 1200 1680 2160 2640 3120 01432 CAPD Transfer Set Change 250 350 450 550 650 01404 Catheter Removal 70 100 130 150 180 01422 CRRT for 24 Hours 4000 5600 7200 8800 10400 01454 Extra Charges for Hemodialysis Beyond 4hrs (Per Hr) 300 300 300 300 300

67 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01455 Extra Charges for Hemodialysis Beyond 4hrs (Per Hr) 300 300 300 300 300 01405 Femoral Access 300 420 540 660 780 01497 Haemodiafiltration 4160 5820 7490 9150 10820 01490 Haemodialysis - Bicarb(C) - OP 1925 01483 Haemodialysis - Bicarb (C) 1925 2450 3150 3850 4550 01453 Hemoperfusion (ICU Setting) 1500 2100 2700 3300 3900 01485 Heparin Free Dialysis - Bicarb (C) 2075 2660 3420 4180 4940 01491 Heparin Free Dialysis - Bicarb (Package) OP 1650 01431 High Flux Dialysis 1450 2030 2610 3190 3770 01427 ICU Haemodialysis 1575 1960 2520 3080 3640 01414 IPD Dialysis - Every 48 hrs 1000 1400 1800 2200 2600 01434 Isolate Ultrafiltration 775 840 1080 1320 1560 01435 Lumbar Puncture 220 310 400 480 570 01451 Lung Ultrasound 360 500 650 790 940 01421 Nephrology -Cross Consultation IP 50 150 250 400 500 01495 Nocturnal Dialysis 1300 1820 2340 2860 3380 01440 Percutaneous CAPD Catheter Insertion 4000 5600 7200 8800 10400 01420 Peritoneal Equilibration Test (PET Test) 1500 2100 2700 3300 3900 01499 Perm Catheter Insertion 4000 5600 7200 8800 10400 01406 Perm Catheter Removal 400 560 720 880 1040 01423 Plasmapheresis 1450 2030 2610 3190 3770 01436 Pleural Tap 175 250 320 390 460 01496 SCUF/ICU 1375 1680 2160 2640 3120 01494 SLED - Sustained Low Efficiency Dialysis 3175 4200 5400 6600 7800 01416 Subclavian Access / Internal Jugular Access 300 420 540 660 780 01450 Ultrasound Marking for Renal Biopsy 500 500 500 500 500 01452 Ultrasound of Kidneys at Bed Side 300 300 300 300 300 12. SPECIALISED PROCEDURES - NEUROSURGERY 01201 Abscess Tapping 920 1290 1660 2020 2390 01200 Biopsy Nerve 610 850 1100 1340 1590 01202 Burrhole Craniostomy 790 1110 1420 1740 2050 01240 CT Guided Procedure - Simple 1100 1540 1980 2420 2860 01251 Cross Consultation IP - Neuro Surgery 50 150 250 400 500 01243 CSF Drainage System 770 1080 1390 1690 2000 01241 CT Guided Procedure - Complex 2200 3080 3960 4840 5720 01245 Diagnostic L P 550 770 990 1210 1430 01250 Head Injury Monitoring (48 Hrs) 1650 2310 2970 3630 4290 01249 Hematoma Evacuation 1960 2740 3530 4310 5100 01206 LP Drainage and Pressure Monitor 720 1010 1300 1580 1870 01244 Medical Documentation-Clinical Photography / Digital imaging 660 920 1190 1450 1720

68 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01231 Nerve Block 550 770 990 1210 1430 01235 Neurogenic Pain Management 1650 2310 2970 3630 4290 01242 Scalp Abscess/ Scalp lession 2290 3210 4120 5040 5950 01210 Skull Traction Application 550 770 990 1210 1430 01212 Subdural Tapping 1100 1540 1980 2420 2860 01213 Tracheostomy 550 770 990 1210 1430 01214 Twist Drill Craniostomy 2060 2880 3710 4530 5360 01215 Urokinase Therapy for ICH 1170 1640 2110 2570 3040 01216 Ventricular Tap - Diagnostic 980 1370 1760 2160 2550 13. SPECIALISED PROCEDURES - NEUROLOGY 01141 24 Hours Video EEG 13300 13300 17100 20900 24700 01102 All Evoked Potential E.E.G 3370 3370 3370 4110 4860 01120 Autonomic Neurophysiological Tests 1190 1670 2140 2620 3090 01101 BAER 1500 1500 1500 1840 2170 01114 Biopsy Muscle 2500 3000 4500 5500 6500 01115 Biopsy Nerve 2500 3000 4500 5500 6500 01155 Botulinum ToxinInjection Service Charge 100 U 3000 4200 5400 6600 7800 01156 Botulinum ToxinInjection Service Charge 50 U 2000 2800 3600 4400 5200 01117 Carpal Tunnel Injection Service Charges 750 1050 1350 1650 1950 01158 Cefaly Stimulation Theraphy (Per Session) 300 420 540 660 780 01140 Cephalalgia Protocol 600 840 1080 1320 1560 01150 Comprehensive Evaluation of Epilepsy 3000 4000 5000 6000 6500 01149 Cortical Stimulation 3565 4990 6420 7840 9270 01159 Cross Consultation - IP Neurology 50 150 250 400 500 01135 Dementia Protocol 2500 3000 4000 5000 6500 01152 DementiaAssessment 600 840 1080 1320 1560 01146 Depth EEG Recording 3565 4990 6420 7840 9270 01131 E.E.G + Brain Mapping 1190 1670 2140 2620 3090 01107 E.E.G Routine 3200 3200 3200 3500 3800 01148 ECOG (Electro Corticography) 3565 4990 6420 7840 9270 01160 EDSS Score 500 700 900 1100 1300 01164 EEG < 4 hours 3500 4900 6300 7700 9100 01165 EEG > 4 hours 7000 9800 12600 15400 18200 01166 EEG Reporting < 4 hours 500 700 900 1100 1300 01167 EEG Reporting > 4 hours 1000 1400 1800 2200 2600 01123 Electro Cochleography 715 1000 1290 1570 1860 01125 Electro Myography 1190 1670 2140 2620 3090 01122 Electro Oculography 1065 1490 1920 2340 2770 01121 Electro Retinography 1065 1490 1920 2340 2770 01163 ENMG + Sudoscan 4000 4000 4000 5000 6000

69 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01103 ENMG-EMG/NCV/Decremental Response 3500 3500 3500 3800 4500 01139 Epilepsy Protocol 600 840 1080 1320 1560 01153 EPSAssessment 600 840 1080 1320 1560 01126 Evoked Potential Studies in Children 1190 1670 2140 2620 3090 01119 F Wave and H Reflex Studies 1485 2080 2670 3270 3860 01130 Intra - Operative Nerve Stimulation 1190 1670 2140 2620 3090 01128 Long Loop Reflex Studies 1190 1670 2140 2620 3090 01144 Long Term Video EEG (Above 4 hours) 7500 7500 7500 8500 9500 01112 Lumbar Puncture 220 310 400 480 570 01113 Lumbar Puncture W Monometer Pressure Evaluation 660 920 1190 1450 1720 01161 Neurology Speciality Clinic Service 540 540 540 660 780 01154 Neuromuscular Assessment 600 840 1080 1320 1560 01137 Neuromuscular Disease Protocol 600 840 1080 1320 1560 01138 Parkinsonism Protocol 600 840 1080 1320 1560 01129 Radicular Stimulation Studies 1190 1670 2140 2620 3090 01124 Repetitive Nerve Stimulation Studies 1190 1670 2140 2620 3090 01142 Short Term Video EEG (1-2 hours) 4500 4500 4500 5500 6500 01143 Short Term Video EEG (2-4 hours) 6660 6660 6660 8140 9620 01127 Silent Period 1190 1670 2140 2620 3090 01110 Somato Sensory Evoked Potential (SSEP) 1290 1290 1290 1570 1860 01108 Special Recording EEG 600 840 1080 1320 1560 01109 Sphenoidal EEG 1190 1670 2140 2620 3090 01147 Sterio EEG Recording 3565 4990 6420 7840 9270 01157 Stroke Assessment 600 840 1080 1320 1560 01136 Stroke Protocol 5000 7000 9000 11000 15000 01162 Sudo scan 1500 1500 1500 2000 3000 01162 Sudoscan:Peripheral Autonomic Testing 2500 3500 4500 5500 6500 01145 Sudural EEG Recording 3565 4990 6420 7840 9270 01132 TPA Charges for Acute Stroke 2500 3500 4500 5500 6500 01134 Vertigo Protocol 3500 4900 6300 7700 9100 01111 Visual Evoked Potential EEG 1500 2100 2700 3300 3900 01151 WADA Test 2375 3330 4280 5230 6180 14. SPECIALISED PROCEDURES - OBSTETRICS & GYNAECOLOGY 01588 Abdominal Ultrasound - Repeat (Within 10 days) 280 330 360 400 480 01591 Abdominal Ultrasound 800 920 1040 1160 1280 01601 Acceleration of Labour 300 420 540 660 780 01597 Additional Scan for Follicular Monitoring 250 290 330 360 400 01593 AFI / HR (Single Parameter/Presentation/Placental) 110 130 140 160 180 01501 Antenatal Cards 50 70 90 110 130 01502 Antinatal Urine Tescting for Revisits 30 40 50 70 80

70 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01620 Artificial Rupture in Membrane 50 100 150 200 250 01600 Baby Care 50 70 90 110 130 01561 Biopsy - Vaginal 500 700 900 1100 1300 01562 Biopsy - Vulval 500 700 900 1100 1300 01505 Biopsy 500 700 900 1100 1300 01599 Bougie Induction 400 560 720 850 1010 01506 Cauterization Cervix 400 560 720 880 1040 01507 Cervix Cytology (Papsmear) - Service Charge 100 140 180 220 260 01508 Cervix Mucus Study 55 80 100 120 140 01510 1000 1400 1800 2200 2600 01511 Colposcopy and Cervix Biopsy 1500 2100 3500 4900 6400 01512 Colposcopy and Pap Smear 1000 1400 1800 2200 2600 01598 Cross Consultation IP - OB & Gynaecology 50 150 250 400 500 01515 Cryo Surgery for Minor Procedure 65 90 120 140 170 01514 Cryosurgery for Cervix 1000 1400 1800 2200 2600 01516 Culdocentesis 500 700 1200 1600 2100 01578 750 1050 1350 1650 1950 01517 Dilation and Evacuation 700 980 1260 1540 1820 01519 Encirclage 1000 1400 1800 2200 2600 01518 300 420 540 660 780 01567 Endometrial Polypectomy 200 280 360 440 520 01619 Etonox Analgesia for Painless Delivery 800 1120 1440 1760 2080 01569 Excision of Vaginal Lesions 500 700 900 1100 1300 01568 Excision of Vulval Lesions 500 700 900 1100 1300 01520 Family Welfare - OM Kit 20 30 40 40 50 01581 Family Welfare & Lactation Counselling 200 280 360 440 520 01570 Fractional Curettage 1000 1400 1800 2200 2600 01547 HPV DNA Test 1485 2080 2670 3270 3860 01527 Hysterosalpingogram 500 700 900 1100 1300 01528 Incision & Drainage 150 210 270 330 390 01606 Induction of Labour 400 560 720 850 1010 01544 IV Tocolysis 120 170 220 260 310 01542 Laminaria Tent Insertion 55 80 100 120 140 01531 Loop Removal 50 100 100 200 250 01586 Mirena Coil Insertion 600 800 1000 1500 1800 01585 Miscellaneous (Family Welfare) 01543 Monitoring of High Risk Pregnancy in Labour 350 490 630 770 910 01533 Non Stress Test (NST) 250 350 450 550 650 01590 Obstetric Biophysical Profile 1400 1610 1820 2030 2240 01589 Obstetric Ultrasound-Anomaly 440 510 570 640 700

71 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01571 Paracentesis - Abdominal 200 280 360 440 520 01595 Pelvic Ultrasound (Trans-Abdominal) 500 700 900 1100 1300 01594 Pelvic Ultrasound (Trans-Vaginal) 500 700 900 1100 1300 01534 Perineal Care 50 70 90 110 130 01535 Polypectomy Cervix 500 700 900 1100 1300 01536 Secondary Suturing (OPD / Ward) 500 700 900 1100 1300 01545 Serial NST for High Risk Pregnancy (1 Week) 600 840 1080 1320 1560 01596 Serial Scan Follicular Monitoring for Three Days 750 860 980 1090 1200 01537 Suture Removal 60 80 110 130 160 01592 Transvaginal Ultrasound Single Parameter (Cervical) 110 130 140 160 180 01539 Use of Doppler - Check.FHS 50 70 90 110 130 01541 Vaginal Cytology - Hormonal 50 70 90 110 130 14.1. DELIVERY CHARGES 01603 Breech Delivery 4000 5600 7200 8800 10800 01604 Breech Extraction 4000 5600 7200 8800 10800 01608 Low Mid-Cavity Forceps Delivery 4000 5600 7200 8800 10800 01609 Normal Delivery 2000 2800 4700 6500 8500 01610 Normal Delivery with Episiotomyperineal Tear Repair 2500 3500 4500 5500 6500 01611 Outlet Forceps Delivery 3000 4200 5400 6600 7800 01612 Twin Delivery 4000 5600 7200 8800 10800 01613 Vaccum Extraction Delivery 3000 4200 5400 6600 7800 15. SPECIALISED PROCEDURES - OPTHALMOLOGY 01778 Abscess Drainage 350 450 540 690 870 01810 Argon Laser Barrage - Each Eye 1200 1680 2160 2640 3120 01701 Argon Laser Focal - Each Eye 600 750 900 1200 1500 01702 Argon Laser Iridotomy - Each Eye 600 750 900 1200 1500 01703 Argon Laser Photo Coagulation PRP (Per Session) - Each Eye 1000 1400 1800 2200 2600 01706 Argon Laser - Each Eye 1000 1400 1800 2200 2600 01707 Artificial Eye Ball (Cost) Service Charges 500 700 900 1100 1300 01708 Auto Plot Perimetry - Additional Test 300 390 450 600 750 01710 Auto Plot Perimetry - Both 800 1120 1440 1760 2080 01709 Auto Plot Perimetry - For Each Eye 400 540 650 840 1050 01794 Basic work-up procedure (ARK, PGP, IOP, Dilatation) 150 210 270 330 390 01801 CCT ‘K’ Reading + Topography 1000 1400 1800 2200 2600 01712 Chalazion I&C - Each Eye 700 980 1260 1540 1820 01717 Contact Lens - Disposable / Cosmetic (Per Lens) 1350 1680 2050 2700 3390 01718 Contact Lens - Fort. Disposables (Per Lens) 1600 2010 2400 3210 3990 01714 Contact Lens - Hard Lens (Per Lens) 450 570 700 900 1140 01715 Contact Lens - RGP Lens (Per Lens) 700 870 1050 1410 1740 01716 Contact Lens - Soft Lens (Per Lens) 700 870 1050 1410 1740

72 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01744 Contact Lens- Special / Premium (Per Lens) 780 900 1150 1560 1950 01720 Contact Lens Testing and Fitting Charges 300 390 450 600 750 01789 Corneal Staining / Foreign Body Removal - Each Eye 100 140 180 220 260 01792 Corneal Topograghy - Each Eye 500 630 750 990 1260 01742 Corneo Scleral Suture Removal with Dressing - Each Eye 200 240 300 390 510 01807 Cross Consultation IP - Opthalmology 50 150 250 400 500 01806 Dilatation, IOP, Perimetry / OCT 1500 2100 2700 3300 3900 01743 Diurnal Variation Test 800 1120 1440 1760 2080 01728 Epilation - Each Eye 200 270 330 420 540 01786 ERG 1000 1400 1800 2200 2600 01804 Eye Irrigation / Wash - Each Eye 100 140 180 220 260 01721 1870 2340 2820 3750 4680 01722 Fluorescein Angioscopy 400 540 650 840 1050 01724 Fundus Examination after Drops 100 140 180 220 260 01750 100 140 180 220 260 01781 GDX (both eyes) 1200 1500 1800 2370 2970 01780 Glaucoma Package II (with OCT, or GDx, Fields Both Eyes) 3600 4500 5400 7200 9000 01767 Glaucoma Work-up (Package) 950 1200 1450 1890 2370 01796 Gonio + IOP + Fundoscopy + Perimetry 1000 1400 1800 2200 2600 01756 Hand Magnifier + 14D 120 150 180 240 300 01757 Hand Magnifier + 20D 600 750 900 1200 1500 01755 Hand Magnifier + 6D 180 240 270 360 450 01761 IIIuminated Hand Magnifier 300 390 450 600 750 01727 Incision for Lacrymal Abscess - Each Eye 500 700 900 1100 1300 01795 IOP only 50 70 90 110 130 01763 Loupe - 2X 1190 1500 1800 2370 2970 01764 Loupe - 3.5X 1500 1890 2250 3000 3750 01752 Low Vision Test 120 150 180 240 300 01772 Low Vision Test - Major 350 450 540 690 870 01811 Manual - Children 200 280 360 440 520 01765 Microscopic Glasses 350 450 540 690 870 01799 OCT (Both eyes) 1500 1890 2250 3000 3750 01769 OCT (One Eye) 1000 1400 1800 2200 2600 01800 OCT Follow up (One Eye) 500 700 900 1100 1300 01785 Pachymeter 120 150 180 240 300 01762 Paper Weight Magnifier 600 750 900 1200 1500 01776 PDT inclusive of Laser 15450 19320 23190 30900 38640 01816 Punctal plug inseration 1 eye 2000 2800 3600 4400 5200 01817 Punctal plug inseration 2 eye 4000 5600 7200 8800 10400 01733 Refraction and Prescription of Spectacles 130 150 200 270 330

73 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01793 Refraction only (ARK) 80 110 140 180 210 01723 Removal of Foreign Body in OPD / Ward - Each Eye 240 300 360 480 600 01813 ROP - LIO 10000 14000 18000 22000 26000 01814 ROP - Cryo 4500 6300 8100 9900 11700 01815 ROP - Intravitreal 4000 5600 7200 8800 10400 01773 ROP Screening 250 350 450 550 650 01805 Schirmers Test 30 40 50 70 80 01749 Slit Lamp Photography 50 60 90 120 150 01782 Specular Microscopy 600 750 900 1200 1500 01775 Squint Assessment 250 350 450 550 650 01758 Stand Magnifier + 8D 260 330 390 510 660 01759 Stand Magnifier +14D 260 330 390 510 660 01760 Stand Magnifier +20D 770 960 1170 1530 1920 01735 Sub Conjunctival Injection - Each Eye 120 150 180 240 300 01748 Sub Tenon’s Injection 240 300 360 480 600 01790 Suture Removal Major 400 510 600 810 990 01737 Syringing Eye 100 120 150 210 240 01738 Tarsorrhapy (Each Eye) 500 700 900 1100 1300 01766 Tonometry with Pachymetry 120 150 180 240 300 01753 Toric Lenses (Conventional) 1780 2220 2670 3570 4440 01754 Toric Lenses (Disposable) 3250 4050 4890 6510 8130 01777 UBM Scan - Each Eye 890 1110 1350 1770 2220 01739 Ultrasound A-Scan Biometry - Each Eye 400 560 720 880 1040 01808 Ultrasound A-Scan Biometry Both Eyes 700 980 1260 1540 1820 01740 Ultrasound B-Scan 400 560 720 880 1040 01809 Ultrasound B-Scan Both Eyes(ONSD/Muscle Thickness) 700 980 1260 1540 1820 01741 Ultrasound Combined A and B Scan One Eye 700 980 1260 1540 1820 01812 YAG Laser - Minor - Each Eye 500 700 900 1100 1300 01747 YAG Laser - Each Eye 1000 1400 1800 2200 2600 01746 YAG Laser Iridotomy - Each Eye 1500 1890 2250 3000 3750 16. SPECIALISED PROCEDURES - ORTHOPAEDICS 01901 Aspiration 220 310 400 480 570 01902 Aspiration of Joint (in Minor O.T.) 300 420 540 660 780 01903 Biopsy - Muscle 350 490 630 770 910 01904 Bone Marrow Aspiration 400 560 720 880 1040 01905 Closed Reductionof Fracture and Dislocation - Child 350 490 630 770 910 01906 Closed Reduction of Fracture and Dislocation - Adults 600 840 1080 1320 1560 01918 Cross Consultation IP - Orthopaedics 50 150 250 400 500 01907 F C B 175 250 320 390 460 01908 Intra Articular Injection 240 340 430 530 620

74 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01909 Major Wound Dressing-Exclusive of Material/Plaster 120 170 220 260 310 01910 Manipulation 275 390 500 610 720 01912 Post Operative Immobiln of Fracture without Manipuln-U & Lex 175 250 320 390 460 01913 Skeletal Traction 300 420 540 660 780 01914 Skin Traction / Thomas Splint 175 250 320 390 460 01916 Strapping 150 130 160 200 230 01911 Suturing - Minor (OPD / Ward) 175 250 320 390 460 01915 Trigger Point Injection in OPD/ward 90 130 160 200 230 01919 Slab Application Procedure 150 210 270 330 390 01920 Pelvic/Cervical Traction 50 70 90 110 130 17. SPECIALISED PROCEDURES - PAEDIATRICS 02201 Abdominal Paracentesis 220 310 400 480 570 02242 Asthma Patient Information Booklet 40 40 40 40 40 02202 Biopsy - Liver 330 460 590 730 860 02207 Bone Marrow Aspiration 400 560 720 880 1040 02241 Cross Consultation IP - Paediatrics 50 150 250 400 500 02208 Exchange Transfusion - Partial / Complete / DV 500 700 900 1100 1300 02209 Fiberoptic Bronchoscopy 1400 1960 2520 3080 3640 02210 Fiberoptic Bronchoscopy - Repeat within 1 week 600 840 1080 1320 1560 02211 Fiberoptic Bronchoscopy and Biopsy 1980 2770 3560 4360 5150 02212 Fiberoptic Laryngoscopy 420 590 760 920 1090 02225 Lumbar Puncture 220 310 400 480 570 02226 Nebulization (Per Hour) Including Oxygen 50 70 90 110 130 02302 Paed. Blood Product Transfusion Monitoring 100 150 200 250 300 02303 Paed. Colonoscopy with/without Biospy 3500 4900 6300 7700 9100 02304 Paed. Upper Gi endoscopy with/without Biopsy 1500 2100 2700 3300 3900 02305 Paed. Well Baby Card (Immunization, Growth) 25 35 45 55 65 02237 Parent Education Material 55 80 100 120 140 02307 Patient Asthma File 90 90 90 90 90 02231 PEFR 50 70 90 110 130 02214 Peritoneal Drainage 220 310 400 480 570 02223 Pleural Aspiration 220 310 400 480 570 02215 Routine Spirometry 240 340 430 530 620 02218 Sigmoidoscopy - Flexible Scope 350 490 630 770 910 02224 Subdural / Ventricular Tap 600 840 1080 1320 1560 02308 Teen Counselling 150 150 300 500 800 02221 Tracheostomy in OPD/ward 290 410 520 640 740 17.1. PEDIATRIC ONCOLOGY 03621 PHO – Bone Marrow Biopsy Procedure 650 910 1170 1430 1690 03625 PHO – Bone Marrow Transplant Counselling 1000 1400 1800 2200 2600

75 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 03624 PHO – Immuno Therapy Infusion 500 700 900 1100 1300 03623 PHO – New Diagnosis Haematology Counselling 500 700 900 1100 1300 02277 PHO — New Diagnosis Oncology Chemotherapy Planning 350 490 630 770 910 03622 PHO – Chemo port Needle Access 300 420 540 660 780 02278 PHO – Chemotherapy Administration Bolus 300 400 500 600 750 02279 PHO – Chemotherapy Administration Infusion 350 500 750 800 1000 03626 PHO – Stem Cell Transplant 300000 300000 300000 300000 300000 (includes transplant planning, protocol, monitoring, nursing, doctors visit, stem cell infusion, blood products administration, immunotherapy) 02280 Intrathecal Chemotherapy 600 840 1250 1500 2000 18. NEONATOLOGY 02294 AEEG 2000 2800 3600 4400 5200 02267 Arterial Line 250 350 450 550 650 02256 Biopsy - Liver 330 460 590 730 860 02257 Biopsy - Muscle 350 490 630 770 910 02258 Bone Marrow Aspiration 400 560 720 880 1040 02281 Booklet on Breast Feeding 85 120 150 250 300 02285 CCHD Screening 120 170 220 260 310 02273 Central Venous line 300 420 540 660 780 02286 HFOV (ventilation extra) 500 700 900 1500 2000 02276 Intercostal Chest Drainage 175 250 500 750 1000 02270 Intraosseus 50 70 90 110 130 02292 Laminar Flow 50 100 150 200 250 02265 Lumbar Puncture 220 310 400 480 570 02293 Nitric Oxide Therapy 15000 15000 15000 15000 15000 02275 Parent Education Material 55 80 100 150 300 02263 Pleural Aspiration 220 310 400 480 570 02287 Routine Delivery Call 300 500 750 1000 1500 02288 Screening Bedside Neurosonogram / Echo 250 350 450 550 650 02264 Subdural / Ventricular Tap 600 840 1080 1320 1560 02261 Tracheostomy in OPD/ward 290 410 520 640 740 02268 Venesection / Cut Down / CVC 240 340 430 530 620 19. SPECIALISED PROCEDURES - PAEDIATRIC NEPHROLOGY 02283 24hrs Amb.Blood Pressure Monitoring(Pediatric) 800 1120 1440 1760 2080 02301 Acute PD Daily Maintenace Charges 500 700 900 1100 1300 02243 Biopsy - Kidney (with Disposable Gun) 1500 2100 2700 3300 3900 03612 CAPD Exit Site Dressing 150 210 270 330 390 03610 CAPD Transfer Set Change 250 350 450 550 650 03616 Continuous Ambulatory PD (CAPD) Re-Training Initial 2400 3360 4320 5280 6240 03615 Continuous Ambulatory PD (CAPD) Training Initial 5000 7000 9000 11000 13000 02250 Continuous Arterio Venous H Difiltration (CVVHD) 2375 3330 4280 5230 6180

76 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02306 Cross Consultation IP -Paediatric Nephrology 50 150 250 400 500 02244 Femoral Catheter 420 590 760 920 1090 02247 Haemodialysis Bicarb 1240 1490 1920 2340 2770 02299 Hemodialysis in ITU 1475 1820 2340 2860 3380 02252 Hemoperfusion 1190 1670 2140 2620 3090 03617 ICU Haemodialysis- < 20kg 3000 4200 5400 6600 7800 03618 ICU Haemodialysis- >20kg 2400 3360 4320 5280 6240 03619 ICU SCUF/ISO UF- < 20kg 2400 3360 4320 5280 6240 03620 ICU SCUF/ISO UF- >20kg 1500 2100 2700 3300 3900 02245 Internal Jugular Catheter 420 590 760 920 1090 02253 PD Cycler 600 840 1080 1320 1560 02298 Pediatric OPD Hemodialsysis 1200 1680 2160 2640 3120 02248 Peritoneal Dialysis (PD) 475 670 860 1050 1240 02251 Peritoneal Equilibration Test (PET) 1190 1670 2140 2620 3090 03611 PIRRT - 24 hours 6600 9240 11880 14520 17160 02254 Plasmapheresis 1450 2030 2610 3190 3770 03613 SCUFF in PICU 1500 2100 2700 3300 3900 02296 SLED - >10 hours 5000 7000 9000 11000 13000 02295 SLED - 6 - 10 hours 4000 5600 7200 8800 10400 02300 Soft Catheter Insertion for acute PD 1000 1400 1800 2200 2600 03614 Ultrafilteration only ( ITU) 1300 1820 2340 2860 3380 Tests Done Outside 11689 Next Generation Sequencing Genetic Testing 20000 20000 20000 20000 20000 20. SPECIALISED PROCEDURES - PAEDIATRIC SURGERY 02901 Abdominal Paracentesis 220 310 400 480 570 02926 Bladder Catheterization 150 210 270 330 390 02924 Bladder Wash 110 150 200 240 290 02925 Bowel Wash 110 150 200 240 290 02910 Central Venous Line, bedside 2500 3500 4500 5500 6500 02927 Colostomy Care 110 150 200 240 290 02940 Cross Consultation IP - Paediatic Surgery 50 150 250 400 500 02939 Dressing under Sedation & Monitoring 600 875 1170 1485 1820 02919 Dressing - Large 120 170 220 260 310 02920 Dressing - Medium 85 120 150 190 220 02921 Dressing - Small 70 100 130 150 180 02922 Enema 60 80 110 130 160 02931 Enteral Tube Change 100 140 180 220 260 02935 Esophageal Foreign Body Extraction 1000 1400 1800 2200 2600 02923 Glucometer Random Blood Sugar 65 90 120 140 170 02929 Incision and Drainage 150 210 270 330 390

77 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02915 Incubator/Open Warmer with Respirator & 2 ABGs 4000 4000 4000 4000 4000 02930 Injection - IV & I.M. 50 75 90 120 140 02904 Intercostal Tube Drainage 1000 1400 1800 2200 2600 02914 Intussusception Reduction(Pneumatic) 5000 7000 9000 11000 13000 02933 Nebulisation 50 70 90 110 130 02937 Prepucial Adhesiolysis 500 700 900 1100 1300 02932 Steam Inhalation 50 75 90 120 140 02911 Subdural / Ventricular Tap 600 840 1080 1320 1560 02934 Suture Removal 60 80 110 130 160 02938 Tracheostomy Tube Change 290 410 520 640 740 02928 Wound Debridement 250 350 450 550 650 21.SPECIALISED PROCEDURES - PHYSICAL MEDICINE AND REHABILITATION 21.1. PMR - MEDICAL REHABILITATION 03461 Assessment using Scales 800 1120 1440 1760 2080 03473 Bladder Wash 110 150 200 240 290 03294 Bowel Wash 110 150 200 240 290 03475 Callus Removal 300 420 540 660 780 02376 Catheterization 80 120 160 180 220 02385 Certificate - Medical 150 210 270 330 390 03510 CIC Training 200 280 360 440 520 03468 Disability Assessment( for Court Case ) - PMR 2000 2800 3600 4400 5200 02372 Dressing Services Charges - Large 200 280 360 440 520 02371 Dressing Services Charges - Medium 150 210 270 330 390 02370 Dressing Services Charges - Small 100 140 180 220 260 03295 Enema 60 80 110 130 160 02377 Incision and Drainage 150 210 270 330 390 03326 Letter/report to school/workplace 200 280 360 440 520 03297 Nebulisation 50 70 90 110 130 03519 NG Tube Change/Insertion 400 560 720 880 1040 02375 Non-Guided Aspiration of Joints 300 420 540 660 780 03469 Non-Guided Botulinum Toxin Motor Point Block 2000 2800 3600 4400 5200 02373 Non-Guided Intra-Articular Injections 400 560 720 880 1040 02384 Non-Guided Phenol/Alcohol Motor Point Block 300 420 540 660 780 02369 PMR - Cross Consultation IP 50 150 250 400 500 02380 POP Application - Major 400 560 720 880 1040 02379 POP Application - Minor 250 350 450 550 650 02378 POP Wedging 150 210 270 330 390 03324 Skin traction(Per Day) 200 280 360 440 520 03474 SPC Change 200 280 360 440 520 03298 Steam inhalation 50 70 90 110 130

78 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 03325 Strapping 150 210 270 330 390 03299 Suture removal 60 80 110 130 160 02382 Suturing under LA 100 140 180 220 260 03464 TBI Assessment 600 840 1080 1320 1560 03296 Tracheostomy care 60 80 110 130 160 03472 Tracheostomy Change / Decannulation 500 700 900 1100 1300 02374 Trigger Point Injection 150 210 270 330 390 03322 VAC dressing with VAC machine 100 140 180 220 260 03323 VAC dressing with wall suction 500 700 900 1100 1300 03517 Wound Debridement - Minor 200 280 360 440 520 03518 Wound Debridement - Major 300 420 540 660 780 Interventions 03330 Musculoskeletal Ultrasound 500 700 900 1100 1300 03498 Ultrasound Guided Aspiration/ Intra-Articular Injections 500 700 900 1100 1300 03331 Ultrasound guided Erector Spinae plane block 600 840 1080 1320 1560 03329 Ultrasound Guided Motor Point Block with Botulinum toxin 2200 3080 3960 4840 5720 03327 Ultrasound Guided Motor Point Block with Bupivacaine/Phenol/ Alcohol(< 3 muscle) 300 420 540 660 780 03328 Ultrasound Guided Motor Point Block with Bupivacaine/ Phenol/Alcohol(> 3 muscle) 500 700 900 1100 1300 03492 Ultrasound Guided Nerve Blocks with Bupivacaine/Phenol/Alcohol 500 700 900 1100 1300 21.2. PMR - OCCUPATIONAL THERAPPY 02486 A.D.L. 200 280 360 440 520 02495 Adaptive Devices 150 210 270 330 390 02457 Assessment and Home Programme for NFC 100 80 100 120 140 03515 Assessment and Home Programme for UOH 100 140 180 220 260 02453 Assessment (Duration 30mins) 250 350 450 550 650 02454 Assessment (Duration 60mins) 300 420 540 660 780 02456 Basic Stimulation 200 280 360 440 520 03245 Bedside Therapy (Duration 30 mins) 200 280 360 440 520 03511 Child / Adult Psychiatry Assessment 400 560 720 880 1040 03287 Cognitive Perceptual Assessment 400 560 720 880 1040 03288 Cognitive Perceptual Retraining (Adult) 400 560 720 880 1040 03289 Cognitive Perceptual Retraining (Child) 350 490 630 770 910 02459 Developmental Therapy (Duration 30mins) 250 350 450 550 650 02497 Ergonomic 150 210 270 330 390 03203 Exercise(Duration 30mins) 100 140 180 220 260

79 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 03285 Group Therapy 250 350 450 550 650 02499 Hand function(Duration 30mins) 250 350 450 550 650 03246 Home Assessment & Evaluation 300 420 540 660 780 03514 Multisensory stimulation (Duration 30mins) 300 420 540 660 780 03290 Neuro-Rehabilitation Assessment and Therapy (Adult) (Duration 30mins) 400 560 720 880 1040 03291 Neuro-Rehabilitation Assessment and Therapy (Child) (Duration 30mins) 300 420 540 660 780 03249 Play Therapy 350 490 630 770 910 03247 Report to School 200 280 360 440 520 02471 Sensory Intergration 350 490 630 770 910 03286 Sensory Profile 500 700 900 1100 1300 03516 Splinting (Miscellaneous) 03248 Vocational Assessment 250 350 450 550 650 03244 Wheelchair Assessment 250 350 450 550 650 21.3. PMR - ORTHOTIC & PROSTHESTIC 03440 Above Knee Socket (Adult) 1800 2490 3200 3920 4630 03450 Above Knee Temporary Pylon Prosthesis 4750 6650 8550 10450 12350 03436 Ankle Foot Orthosis (Adult Single ) 1500 2100 2700 3300 3900 03437 Ankle Foot Orthosis (Adult) Single 850 1190 1530 1870 2210 03316 Arch Support (Adult) 75 110 140 170 200 03317 Arch Support (Child) 50 70 90 110 130 03449 Below Knee Temporary Pylon Prosthesis 6000 8400 10800 13200 15600 03409 Body Shell for Scoliosis Correction 2100 2940 3780 4620 5460 03452 Bohler Iron Articulated 1500 2100 2700 3300 3900 03453 Bohler Iron Non-Articulated 1000 1400 1800 2200 2600 03504 Charcot Restraint Othotic Walker (CROW) 3000 4200 5400 6600 7800 03429 Cockup Splint (Adult) PVC 800 1120 1440 1760 2080 03430 Cockup Splint (Child) PVC 500 700 900 1100 1300 03405 Cosmetic Glove 250 350 450 550 650 03431 Crutch Tip -One Pair 50 70 90 110 130 03425 Customised Collar (Adult) 600 840 1080 1320 1560 03426 Customised Collar (Child) 300 420 540 660 780 03486 Elbow Extension Splint (PVC) - Adult 700 980 1260 1540 1820 03487 Elbow Extension Splint (PVC) - Child 350 490 630 770 910 03400 Gaiter - Extra Small 800 1120 1440 1760 2080 03432 Gaiter (Lower Limb) (Adult) 2500 3500 4500 5500 6500 03433 Gaiter (Lower Limb) (Child) 1750 2450 3150 3850 4550 03438 Gaiter (Upper Limb) (Adult) 1750 2450 3150 3850 4550 03439 Gaiter (Upper Limb) (Child) 1250 1750 2250 2750 3250

80 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 03503 Hip Abduction Splint - PVC (Adult) 700 980 1260 1540 1820 03484 Humeral Sling / Cuff 850 1190 1530 1870 2210 03435 Knee Ankle Foot Orthosis (Adult )Single 5000 7000 9000 11000 13000 03522 Knee Ankle Foot Orthosis (Child) Single 3200 4480 5760 7040 8320 03538 Knee Cap (Child) 200 280 360 440 520 03215 Knee Cap (Adult) 400 560 720 880 1040 03488 Knee Extension Splint - Adult (PVC) 1000 1400 1800 2200 2600 03489 Knee Extension Splint - Child (PVC) 700 980 1260 1540 1820 03460 Limb Prothesis Fittment & Check out 600 840 1080 1320 1560 03410 Lumbo Sacral Corset 1000 1400 1800 2200 2600 03232 MCR Adjustable Sandal 550 770 990 1210 1430 03221 MCR Bata Model Sandal 600 840 1080 1320 1560 03349 MCR Insole One Pair (Adult) 200 280 360 440 520 03224 MCR Insole One Pair (Child) 150 210 270 330 390 03222 MCR Sandal Heel Counter 750 1050 1350 1650 1950 03218 MCR X Model (Adult) 350 490 630 770 910 03351 Metatarsal Bar (Adult) 100 140 180 220 260 03352 Metatarsal Bar (Child) 50 70 90 110 130 03550 Miscellaneous - Footwear PMR 03235 Miscellaneous - Orthotics & Prosthetics PMR 03233 Patellar Tendon Bearing Orthosis (Adult) 3500 4900 6300 7700 9100 03234 Patellar Tendon Bearing Orthosis (Child) 2750 3850 4950 6050 7150 03368 Patellar Tendon Bearing Socket (Adult) (Resin) 2000 2800 3600 4400 5200 03369 Patellar Tendon Bearing Socket (Child) (Resin) 600 840 1080 1320 1560 03521 Patellar Tendon Bearing Socket (Polypropylene) 2000 2800 3600 4400 5200 03505 Pop application - Major 250 350 450 550 650 03506 Pop application - Minor 200 280 360 440 520 03455 Posterior Leaf Spring Orthosis Splint (Adult) 1500 2100 2700 3300 3900 03456 Posterior Leaf Spring Orthosis Splint (Child) 850 1190 1530 1870 2210 03216 PP Ankle Foot Orthosis with Filler (Adult) 1200 1680 2160 2640 3120 03321 Prosthesis Repair - Minor 200 280 360 440 520 03320 Prosthesis Repair - Major 500 700 900 1100 1300 03485 Shoulder Abduction Splint 1200 1680 2160 2640 3120 03383 Stockingnet (60mm/80mm/120mm) 100 140 180 220 260 03408 Taylor Knight Brace 2700 3780 4860 5940 7020 03238 Theraband (Black) 300 420 540 660 780 03454 Thermoplast Splint Modification 150 210 270 330 390 03524 Trans Tibial Prosthesis (PP Socket) (Adult) Endoskeletal 15000 21000 27000 33000 39000 03367 Trans Tibial Prosthesis (Resin Scoket) (Child) Exoskeletal 7000 9800 12600 15400 18200

81 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 03366 Trans Tibial Prosthesis (Resin Socket) (Adult) Exockeletal 9000 12600 16200 19800 23400 03527 Trans Tibial Prosthesis (Resin Socket) (Child) Endoskeletal 16800 23520 30240 36960 43680 03306 Trans-Femoral Prosthesis (Without Shoe) Adult 16000 22400 28800 35200 41600 03307 Trans-Femoral Prosthesis (Without Shoe) Child 12000 16800 21600 26400 31200 03523 Trans-Femoral Socket (Adult) (Polypropylene) 2500 3500 4500 5500 6500 03300 Trans-Humeral Prosthesis (Without Terminal Device) Adult 10700 14980 19260 23540 27820 03301 Trans-Humeral Prosthesis (Without Terminal Device) Child 8400 11760 15120 18480 21840 03318 Trans-Radial Prosthesis (Without Terminal Device) Adult 9500 13300 17100 20900 24700 03319 Trans-Radial Prosthesis (Without Terminal Device) Child 7000 9800 12600 15400 18200 03393 Velcro Strap 1 Pair 100 140 180 220 260 21.4. PMR - MEDICO SOCIAL WORK 03281 Addressing Govt. Advocacy/ Legal Guidence 200 280 360 440 520 03276 Assessment 200 280 360 440 520 03250 Correspondence 50 70 90 110 130 03293 Educational Placement 300 420 540 660 780 03278 Family / Individual/ Marital Counselling 300 420 540 660 780 03279 Follow up & After Care( Per Session) 200 280 360 440 520 03282 Group Therapy(Per Session) 300 420 540 660 780 03283 Psychosocial Intervention & Discharge Plan 250 350 450 550 650 03258 Rehabilitation and Placement Service Charge 600 840 1080 1320 1560 03251 Rehabilitation Counselling 300 420 540 660 780 03280 Visits (Collateral Contacts) 200 280 360 440 520 03292 Vocational Placement 300 420 540 660 780 21.5. PMR -SPEECH AND LANGAUAGE SECTION 03332 Bedside dysphagia screening 150 210 270 330 390 03333 Bedside dysphagia therapy 200 280 360 440 520 03239 Bedside speech & language screening 150 210 270 330 390 03334 Bedside speech & language therapy 200 280 360 440 520 03271 Computerized Speech and Lanuage Assessment 300 420 540 640 760 03262 Dysphagia Assessment 300 420 540 660 780 03263 Dysphagia Therapy 250 350 450 550 650 03335 Follow-up and counselling 100 140 180 220 260 03275 Home Based Training Program 250 350 450 550 650 03267 Oromotor Exercises 200 280 360 440 520 03268 Oromotor Stimulation 200 280 360 440 520 03272 Speech and Language Therapy using Vaghmi Software 200 280 360 440 520 03261 Speech and Lanuage Assessment 300 420 540 660 780 03269 Speech and Lanuage Therapy 300 420 540 660 780 03265 Voice Therapy 200 280 360 440 520 03264 VoiceAssessment 250 350 450 550 650

82 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 22. PHYSIOTHERAPY 03530 Acute Rehabilitation for Patient 200 250 300 350 400 03242 Fitness Program for 1 Month 1200 1680 2160 2640 3120 03535 ICU Patients Twice Daily 285 400 510 630 740 03544 Laser Therapy / ESWT / FES Per Site 400 560 720 880 1040 03478 MSPT for 1 Site 300 420 540 660 780 03509 MSPT for 5 Sessions 1400 1960 2520 3080 3640 03244 OB/Gynac Physiotherapy For 5 Sessions 1000 1400 1800 2200 2600 03243 OB/Gynac Physiotherapy Per Session 200 280 360 440 520 03538 Peadiatric Neuro Rehabilitation Evaluation and Exercise Prescription (1 Session) 300 420 540 660 780 03540 Peadiatric Neuro Rehabilitation Evaluation and Exercise Prescription (5 Sessions) 1400 1960 2520 3080 3640 03542 Peadiatric Neuro Rehabilitation Evaluation and Exercise Prescription (Single Therapy With Concession) 100 140 180 220 260 02387 Physiotheraphy - Cross Consultation IP 50 150 250 400 500 03529 Physiotherapy Consultation and treatment for the first day 350 490 630 770 910 03241 Physiotherapy Evening for 5 Sessions 1900 2660 3420 4180 4940 03240 Physiotherapy Evening for One Session 400 560 720 880 1040 03537 Pulmonary / Cardiac Rehabilitation Evaluation and Exercise Prescription (5 Session) 1500 2100 2700 3300 3900 03508 Rehabilitation 5 Session 2200 3080 3960 4840 5720 03483 Rehabilitation Per Session 450 630 810 990 1170 23. SPECIALISED PROCEDURES - PLASTIC SURGERY 02321 Arch Bar Removal (Per Arch) 200 280 360 440 520 02354 Artery Biopsy 2600 3640 4680 5720 6760 02723 AVF Creation - Major 10000 14000 18000 22000 26000 02722 AVF Creation - Minor 5000 7000 9000 11000 13000 02322 Body Piercing 1000 1400 1800 2200 2600 02343 Botox injection 600 840 1080 1320 1560 02316 Burns Pad 70 100 120 140 170 02331 Closed Reduction and Splinting 120 170 220 260 310 02721 Closed Reduction and Splinting (Multiple) 500 700 900 1100 1300 02726 Collagen Application 1000 1400 1800 2200 2600 02327 Cross Finger Flap 3000 4200 5400 6600 7800 02326 Debridement - Minor 500 700 900 1100 1300 02735 Debridement - Major 1000 1400 1800 2200 2600 02336 Delay of Flaps - Major 1000 1400 1800 2200 2600 02335 Delay of Flaps - Minor 500 700 900 1100 1300 02352 Disability Assessment 475 670 860 1050 1240 02315 Dressing - Service Charges (Large) 200 280 360 440 520

83 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02314 Dressing - Service Charges (Medium) 150 210 270 330 390 02313 Dressing - Service Charges (Small) 75 110 140 170 200 02358 Ear Lobe Repair Biilateral 3000 4200 5400 6600 7800 02359 Ear Lobe Repair Unilateral 2000 2800 3600 4400 5200 02349 Ear Piercing 500 700 900 1100 1300 02727 Excision ( Minor) 1000 1400 1800 2200 2600 02728 Excision ( Moderate) 2000 2800 3600 4400 5200 02729 Excision ( Multiple) 3000 4200 5400 6600 7800 02725 Eyelet Application 500 700 900 1100 1300 02342 Fasciotomy - Major OPD/Ward 1000 1400 1800 2200 2600 02341 Fasciotomy - Minor 500 700 900 1100 1300 02329 Flap Division 240 340 430 530 620 02720 Flap Division and Inset - Minor 1500 2100 2700 3300 3900 02724 Guiding Elastics for IMF 250 350 450 550 650 02324 Incision and Drainage 150 210 270 330 390 02350 Insurance Authentification 500 700 900 1100 1300 02323 Intra Lesional Injection 200 280 360 440 520 02732 Intra Lesional Injection (Multiple) 500 700 900 1100 1300 02734 K- Wire Removal 100 140 180 220 260 02351 Medical / Leave Certificate 240 340 430 530 620 02345 Medical Documentation - Clinical Photography 175 250 320 390 460 02361 Muscle Biopsy 2000 2800 3600 4400 5200 02353 Nerve Biopsy 2600 3640 4680 5720 6760 02367 Plastic Surgery - Cross Consultation IP 50 150 250 400 500 02320 POP Applications 500 700 900 1100 1300 02330 Removal of Foreign Body in OPD/ward 300 420 540 660 780 02362 Revision Amputation Finger Multiple 7000 9800 12600 15400 18200 02363 Revision Amputation Finger Single 2500 3500 4500 5500 6500 02730 Scar Revision - Minor 2500 3500 4500 5500 6500 02731 Scar Revision - Moderate 5000 7000 9000 11000 13000 02325 Splinting 200 280 360 440 520 02333 Split Skin Graft (Medium) 2000 2800 3600 4400 5200 02332 Split Skin Graft (Small) 1000 1400 1800 2200 2600 02364 Suture Removal Large (OPD) 100 140 180 220 260 02365 Suture Removal Medium (OPD) 80 110 140 180 210 02366 Suture Removal Small (OPD) 60 80 110 130 160 02318 Suturing Major 2000 2800 3600 4400 5200 02317 Suturing Minor 1000 1400 1800 2200 2600 02340 Tendon Repair - Major 4000 5600 7200 8800 10400 02339 Tendon Repair - Minor 2000 2800 3600 4400 5200

84 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02733 Tissue Expander Inflation 200 280 360 440 520 02311 VAC Dressing with Vac Machine 100 140 180 220 260 02310 VAC Dressing with Wall Suction 500 700 900 1100 1300 02328 V-Y Flap 2000 2800 3600 4400 5200 24. SPECIALISED PROCEDURES - PSYCHIATRY 02596 Case File 350 350 350 350 350 02516 Case File and Detailed Work Up 800 1120 1440 1760 2080 02505 Counselling (Per Session) 400 560 720 880 1040 02508 E.C.T. 750 1050 1350 1650 1950 02524 ECT-Anaesthesia in Ward 600 840 1080 1320 1560 02587 Psychoeducation 475 670 860 1050 1240 02569 Special Assessment using Questionnaire 400 570 730 890 1050 02588 Special Consultation with 2 Multidisciplinary Team (OP) 800 800 800 800 800 02589 Special Consultation with 3 Multidisciplinary Team (OP) 1000 1000 1000 1000 1000 24.1. CHILD PSYCHIATRY 02556 Assessment of Intelligence - Child 800 1120 1440 1760 2080 02503 Assessment of Specific Learning Disablity 1000 1400 1800 2200 2600 02564 Behavioural Counselling - 1 Session 500 700 900 1100 1300 02563 Behavioural Counselling - 3 Sessions 1200 1680 2160 2640 3120 02555 Certificates - Letters to School 330 500 600 700 900 02572 Child Psychotherapy - One Session 600 840 1080 1320 1560 02550 Detailed Work up 800 1120 1440 1760 2080 02551 Detailed Work up with Report 1200 1680 2160 2640 3120 02567 Developmental Assessment - Brief 400 570 730 890 1050 02568 Developmental Assessment - Detailed 660 900 1200 1500 1700 02750 Diagnostic Assessment - Child 1500 2100 2700 3300 3900 02561 Family Psychotherapy - Child (1 Session) 1200 1680 2160 2640 3120 02553 Letters to School 200 280 360 440 520 02576 Mini Assesment of Autism Spectrum Disorders 1000 1400 1800 2200 2600 02574 Mini Assessment of Hyperactivity (1 Session) 1000 1400 1800 2200 2600 02571 Neuropsychological Assessment - Child 4000 5500 7100 8600 10200 02599 Play Therapy (5 sessions) 1200 1680 2160 2640 3120 02557 School Visit (Transport Extra) 2000 2800 3600 4400 5200 02552 Special Assessment (Using Qustionnaire) 300 420 540 660 780 02575 Systematic Assessment of Autism Spectrum Disorder 5000 7000 9000 11000 13000 02573 Systematic Clinical Assessment of Hyperactivity 4000 5500 7100 8600 10200 24.2. CLINICAL PSYCHOLOGY 02529 Assesment with Clinical Rating Scales 300 420 540 660 780 02577 Assessment of Intelligence - Adult 790 1100 1400 1700 2100 02578 Assessment of Memory 660 840 1080 1320 1560

85 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02514 Assessment of Personality and Interpersonal Relations 1200 1680 2160 2640 3120 02751 Assessment of Specific function 750 1050 1350 1650 1950 02753 Cognitive Behavior Therapy - Single Session 600 840 1080 1320 1560 02527 Detailed Intake 660 900 1200 1500 1700 02757 Dialectical Behavior Therapy - Single Session 600 840 1080 1320 1560 02759 Family Therapy - Single Session 800 1120 1440 1760 2080 02752 Individual Therapy - Single Session 600 840 1080 1320 1560 02756 Interpersonal Therapy - Single Session 600 840 1080 1320 1560 02758 Marital Therapy - Single Session 800 1120 1440 1760 2080 02517 Neuropsychological Assessment - Adult 4750 6650 8550 10450 12350 02755 Psychodynamic PsychoTherapy - Single Session 600 840 1080 1320 1560 02760 Psychoeducation 475 670 860 1050 1240 02754 Supportive PsychoTherapy - Single Session 600 840 1080 1320 1560 24.3. PSYCHIATRY SOCIAL WORK 02767 Customized After-Care Services/Personalized Aftercare Plan for 2 months (Excluding Charges Incurred on Transportation) 1800 2520 3240 3960 4680 02582 Family Assessments / Marital Assesment 500 700 900 1100 1300 02764 Family Counselling/Family Psychoeducation 600 840 1080 1320 1560 02606 Family Therapy/Marital Therapy 800 1120 1440 1760 2080 02581 Group Therapy (Families of the Mentally Ill) 550 770 990 1210 1430 02766 Home Visit/School Visit/Other organisation Visits (Excluding Transportation) 1500 2100 2700 3300 3900 02765 Individual Counselling 500 700 900 1100 1300 02583 Letters to NGOs/GO’s and other Organisations/Referral/Liasion Services 500 700 900 1100 1300 02763 Psychosocial Assessment 350 490 610 790 910 02607 Rehabilitation Counselling - 1 Session 500 700 900 1100 1300 24.4. DAY CARE CENTRE 02535 Recovery Oriented Service -One day Charge (For Inpatients only) 100 100 200 300 400 02536 Recovery Oriented Service- One Week Charge 600 600 1200 1800 2400 02537 Recovery Oriented Service - One Month Charge 6000 02546 Recovery Oriented Service - One Week Trial Period (Only for Outpatients) 1500 24.5. GENERAL 02533 Assessment and Counselling for Patient with ISH (3 Sessions) 700 700 1000 1000 1000 02532 Brief Intervention for Alcholism (3 Sessions) 700 700 1000 1000 1000 02597 Brief Proforma Based In Patient Assessment 250 250 250 250 250 02590 Brief Proforma Based Out Patient Assessment 300 300 300 300 300 02534 Cross Consultation IP - Psychiatry 75 300 600 800 1000 02593 Cross Consultation within Psychiatry Departments - Special 250 450 600 750 750 02598 Detailed Proforma Based In Patient Assessment 500 500 500 500 500 02507 DiagnosticAssessment 1500 2100 2700 3300 3900 02591 General Service Charges in Psychiatry Ward 75 300 700 800 1000

86 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 02762 Geriatric Psychiatry Assessment 100 140 180 220 260 02526 Group (Per Session) 220 310 400 480 570 02510 Group Therapy (ADS 3 groups) 1000 1000 1500 2000 3000 02586 Individual Therapy - Single Session 600 840 1080 1320 1560 02600 MMC Counseling 100 140 180 220 260 02592 Multidisciplinary Team Meeting - 3 Consultants 300 300 1000 1500 2500 02761 Multidisciplinary Team Meeting - 2 Consultants 200 200 900 1400 2400 02547 Perinatal Services (3 Sessions) 300 300 300 300 300 02530 Provision of Typed Assesment Report 120 170 220 260 310 02584 Psychoeducation 475 670 860 1050 1240 02594 Readmission and Reassessment 500 750 1250 2000 2000 02595 Reassessment/Second Opinion 200 400 600 1000 1000 02548 Rehabilitation Admission - Advance 45000 45000 45000 45000 45000 02549 Rehabilitation Admission - Per Month 15000 15000 15000 15000 15000 25. SPECIALISED PROCEDURES - UROLOGY 01301 Aspiration Biopsy 200 280 360 440 520 01302 Biofeed Back (2 Sessions of 10 minutes) 300 420 540 660 780 01303 Biopsy 500 700 900 1100 1300 01311 Biopsy - Prostatic Needle Biopsy 1000 1400 1800 2200 2600 01318 Catheter Calibration 60 80 110 130 160 00214 Cathetererterization (Urology) 85 120 150 190 220 01305 Cavernosometry and Cavernosography 1200 1680 2160 2640 3120 01304 CMG, UPP, EMG and P.F. Study 1500 2100 2700 3300 3900 01364 Cross Consultation IP - Urology 50 150 250 400 500 01307 Cystometrography - Repeat (within 1 month) 1000 1400 1800 2200 2600 01306 Cystometrography (CMG) with P.F. Study 1500 2100 2700 3300 3900 01361 Erectiledysfunction Evaluation (Comprehensive) # 6530 01362 Erectiledysfunction Evaluation (Non vascular) # 4580 06209 Fluroscopy Time upto 10 Minutes 600 690 780 870 960 01308 Intracavernosal Injection of Papaverine (S/C) 300 420 540 660 780 01351 Lithotripsy - A (< 1cm) 10000 14000 18000 22000 26000 01352 Lithotripsy - B (1-2cms) 12000 16800 21600 26400 31200 01353 Lithotripsy - C (2-3cms) 13100 18340 23580 28820 34060 01354 Lithotripsy - D (Additional Sittings) 3600 5040 6480 7920 9360 01355 Lithotripsy - E (Completion Lithotripsy) 2400 3360 4320 5280 6240 01356 Lithotripsy - F (Attempted) 600 840 1080 1320 1560 01323 Miscellaneous - Urology Special Procedures 165 230 300 360 430 01309 P.F. Study 500 700 900 1100 1300 01310 PCN 800 1120 1440 1760 2080 01363 Provocative testing (PIPE test) 120 170 220 260 310 87 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 01312 Residue 150 210 270 330 390 01314 Trocar Suprapubic Cystostomy 900 1260 1620 1980 2340 01315 TRUS 500 700 900 1100 1300 01316 UPP 175 250 320 390 460 01317 Upper Tract Study 300 420 540 660 780 01319 Urethral Dilation 400 560 720 880 1040 01320 Urethral Dilation - Repeat 200 280 360 440 520 01321 Urinary Flow Rate 200 280 360 440 520 01324 Uroflowmetric Analysis 250 350 450 550 650 01322 Video UDE (including Video Cassette) 4000 5600 7200 8800 10400 # 1361 is a package inclusive of one day stay in a private room and penile doppler studies. # 1362 is a package inclusive of one day stay in a pvt.room

26. SPECIALISED PROCEDURES - MEDICAL ONCOLOGY 03564 Auto HSCT Procedure* 250000 250000 250000 250000 250000 03551 Biological Therapy (Monoclonal) 1200 1680 2160 2640 3120 03556 Bone Marrow Aspitation 400 560 720 880 1040 03561 Central Venous Access 330 460 590 730 860 03555 Chemotheraphy Consultation from other Departments 550 770 990 1210 1430 02879 Chemotherapy Administration Charges - Rare Neoplasm 1000 1400 1800 2200 2600 02878 Chemotherapy Administration Charges - Unknown Primary 1000 1400 1800 2200 2600 02877 Chemotherapy Administration Charges ( In Patient) 1200 1680 2160 2640 3120 02876 Chemotherapy Administration Charges (Day Care) 1200 1680 2160 2640 3120 02875 Chemotheray Planning Charges (Full Protocol) 2200 3080 3960 4840 5720 03565 Cross Consultation IP - Medical Oncology 50 150 250 400 500 02883 Infusion Chemo using CADD Pump - Physician charge 250 400 600 800 1100 02882 Infusion Chemo using CADD Pump - Infusion Charge Per Day 600 840 1080 1320 1560 03563 Intra Articular Injection 240 340 430 530 620 02889 Intrathecal Chemotherapy 600 840 1250 1500 2000 03559 Lumbar Puncture 220 310 400 480 570 03554 Miscellaneous Cancer Theraphy 770 1080 1390 1690 2000 02887 Paracentesis - Diagnostic 500 700 900 1100 1300 02888 Paracentesis - Theraputic 700 980 1260 1540 1820 02990 Pleural Aspiration - Repeat 400 560 720 880 1040 02991 Pleural Aspiration - Theraputic 1000 1400 1800 2200 2600 03560 Pleurodesis - with Betadiene 500 700 900 1100 1300 03557 Stem Cell Harvest from Bone 4400 6160 7920 9680 11440 03558 Stem Cell Harvest from Peripheral Blood 3300 4620 5940 7960 8580 03562 Synovial Fluid Aspiration 175 250 320 390 460 03552 Weekly Chemotheraphy Charges 165 230 300 360 430 03553 Weekly Chemotheraphy for any Cancer 500 700 900 1100 1300

88 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. * Procedure charges only. Investigations, room rent, drugs, blood bank products / process, diet and other charges extra.

27. SPECIALISED PROCEDURES - SURGICAL ONCOLOGY 25510 Chemoport Flush 500 700 900 1100 1300 25511 Chemoport Removal 700 980 1260 1540 1820 25519 Chemo-Port Removal in OPD/Ward 700 980 1260 1540 1820 02694 Cross Consultation – Surgical Oncology 50 70 90 110 130 25515 Excision Breast Lump 500 700 900 1100 1300 25514 Excision of Small Swelling Sebacious Cyst 120 170 220 260 310 25518 Oral / Truecut Biopsy 500 700 900 1100 1300 25516 Otoendoscopy 300 420 540 660 780 25517 Patient Counselling 50 70 90 110 130 25512 Proctoscopy 45 60 80 100 120 25513 Videolaryngoscopy (IDL) 250 350 450 550 650 28. SPECIALISED PROCEDURES - GYNECOLOGIC ONCOLOGY 25000 Aspiration Biopsy 200 280 360 440 520 25001 Aspiration Cytology 300 420 540 660 780 25002 Aspiration of Lympocele 300 420 540 660 780 25153 Biopsy Cervix / - Big 600 840 1080 1320 1560 25154 Biopsy Cervix / Vagina - Small 300 420 540 660 780 25155 Biopsy - Multiple Site 700 980 1260 1540 1820 25156 Biopsy Vulva - Single Site 350 490 630 770 910 25006 Catheter Removal 70 100 130 150 180 25145 Catheterisation 250 350 450 550 650 25007 Cauterization Cervix 400 560 720 880 1040 25008 Cervix Cytology (Pap Smear) 200 280 360 440 520 25009 Chemo-Port Flushing in OPD/ward 500 700 900 1100 1300 25010 Chemo-Port Removal in OPD/Ward 700 980 1260 1540 1820 25011 Chemotherapy Five Days 2500 3500 4500 5500 6500 25012 Chemotherapy Four Days 2000 2800 3600 4400 5200 25013 Chemotherapy IV Push 500 700 900 1100 1300 25014 Chemotherapy Planning 1500 2100 2700 3300 3900 25015 Chemotherapy Single Day 1000 1400 1800 2200 2600 25016 Chemotherapy Single Drug 600 840 1080 1320 1560 25017 Chemotherapy Three Days 1500 2100 2700 3300 3900 25018 Chemotherapy Two Days 1200 1680 2160 2640 3120 25140 Cold coagulator for Minor Procedure 1000 1400 1800 2200 2600 25157 Colposcopy Diagnostic 1500 2100 2700 3300 3900 25158 Colposcopy Screening 150 210 270 330 390 25037 Colposcopy, Pap Smear, Fractional Curettage 600 840 1080 1320 1560

89 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 25135 Cross Consultation IP - Gynaecologic Oncology 50 150 250 400 500 25043 Culdocentesis 500 700 900 1100 1300 25044 Cytology 500 700 900 1100 1300 25048 Dilation and Curettage 750 1050 1350 1650 1950 25052 Drain Removal 120 170 220 260 310 25053 Drainage of Pyometra 1000 1400 1800 2200 2600 25055 Dressing - Service Charges - Large 120 170 220 260 310 25056 Dressing - Service Charges - Medium 85 120 150 190 220 25057 Dressing - Service Charges - Small 70 100 130 150 180 25147 Endocervical Curettage 350 490 630 770 910 25159 Endometrial Biopsy - Complex 1200 1680 2160 2640 3120 25160 Endometrial Biopsy - Simple 500 700 900 1100 1300 25059 Excision of Cervical Lesions In OPD 500 700 900 1100 1300 25060 Excision of Lymph Node in OPD 1500 2100 2700 3300 3900 25061 Excision of Vaginal Lesions 500 700 900 1100 1300 25062 Excision of Vulval Lesions 500 700 900 1100 1300 25063 FNAC Lymph Node 500 700 900 1100 1300 25064 FNAC Parametrium 500 700 900 1100 1300 25161 FNAC Parametrium / POD 500 700 900 1100 1300 25069 HPV DNA Test collection 1000 1400 1800 2200 2600 25070 Incision and Drainage 150 210 270 330 390 25072 Lletz (charges to be put by Department Staff) 25071 Lucd/Loop/Copper T/ Mirena Coil Removal 250 350 450 550 650 25073 Mirena Coil Insertion 600 800 1000 1500 1800 25074 Office & Biopsy 4000 5600 7200 8800 10400 25079 Paracentesis Diagnostic - Abdominal 350 490 630 770 910 25080 Paracentesis of Lymphocele 750 1050 1350 1650 1950 25081 Paracentesis Therapeutic - Abdominal 750 1050 1350 1650 1950 25082 Perineal Care 50 70 90 110 130 25083 Peripheral Insertion of Central Line 1000 1400 1800 2200 2600 25084 Pleural Diagnostic - Pleural 500 700 900 1100 1300 25085 Pleural Therapeutic - Pleural 1000 1400 1800 2200 2600 25086 Pleurodesis 1000 1400 1800 2200 2600 25162 Polypectomy - Big 600 840 1080 1320 1560 25163 Polypectomy - Small 300 420 540 660 780 25164 Polypectomy Cervix/Vulva/Vagina 2000 2800 3600 4400 5200 25092 Residual Urine Measurement 200 280 360 440 520 25165 Secondary Suturing - Major 2000 2800 3600 4400 5200 25166 Secondary Suturing - Minor 500 700 900 1100 1300 25167 Sentinel Lymph Node Mapping 2000 2800 3600 4400 5200

90 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 25149 Staging for CA Cx Cystoscopy 1750 2450 3150 3850 4550 25151 Staging for CA Cx Proctoscopy 500 700 900 1100 1300 25152 Staging for Ca Cx Proctoscopy and biopsy 1500 2100 2700 3300 3900 25094 Suture/Staple Removal 150 210 270 330 390 25097 Toluidine Blue Test Vulva 250 350 450 550 650 25168 Tru Cut Biopsy - Major 1000 1400 1800 2200 2600 25169 Tru Cut Biopsy - Minor 500 700 900 1100 1300 29. SPECIALISED PROCEDURES - RADIATION ONCOLOGY 23001 2DRT Curative (2DRT-C) - Each Instalment 5500 5500 5500 5500 5500 23025 2DRT Curative (2DRT-C) - Package 44000 61600 79200 96800 114400 23002 2DRT Palliative (2DRT-P) - Each Instalment 5500 5500 5500 5500 5500 23026 2DRT Palliative (2DRT-P) - Package 22000 30800 39600 48400 57200 23003 3DCRT Curative (3DRT-C) - Each Instalment 11000 11000 11000 11000 11000 23027 3DCRT Curative (3DRT-C) - Package 77000 107800 138600 169400 200200 23004 3DCRT Palliative (3DRT-P) - Each Instalment 11000 11000 11000 11000 11000 23028 3DCRT Palliative (3DRT-P) - Package 33000 33000 59400 72600 85800 23039 Blood Irradiation (Whole Blood, Components,P.C) 800 800 800 800 800 23022 Brachytherapy - Gyn - Intra Cavity - Package 16500 23100 29700 36300 42900 23021 Brachytherapy - Gyn - Sorbo 5500 7700 9900 12100 14300 23023 Brachytherapy - Interstitial all Sites - Package 22000 30800 39600 48400 57200 23024 Brachytherapy - Intraluminal 5500 7700 9900 12100 14300 23040 Brachytherapy Surface Mould 11000 15400 19800 24200 28600 91236 Cross Consultation IP - Radiation Oncology 50 150 250 400 500 23043 CT Simulation 5500 5500 5500 5500 5500 23037 Extra-Corporeal Irradiation 10000 14000 18000 22000 26000 23036 Hemi-Body Irradiation 10000 14000 18000 22000 26000 23007 IGRT Curative (IGRT-C) - Each Instalment 27500 27500 27500 27500 27500 23031 IGRT Curative-(IGRT-C) - Package 137500 192500 247500 302500 357500 23008 IGRT Palliative (IGRT-P) - Each Instalment 22000 22000 22000 22000 22000 23032 IGRT Palliative-(IGRT-P) - Package 66000 92400 118800 145200 171600 23029 IMRT Curative (IMRT-C) - Package 99000 138600 178200 217800 257400 23005 IMRT Curative (IMRT-C) Each Instalment 11000 11000 11000 11000 11000 23006 IMRT Palliative (IMRT-P) - Each Instalment 11000 11000 11000 11000 11000 23030 IMRT Palliative (IMRT-P) - Package 44000 61600 79200 96800 114400 23038 Per Fraction- Electrons / Photon ( No CT Scan) 2000 2800 3600 4400 5200 23020 Stereotatic Body Radio Theraphy (SBRT) - Curative 150000 210000 270000 330000 390000 23018 Stereotatic Radio Surgery (SRS) - Curative 99000 138600 178200 217800 257400 23019 Stereotatic Radio Theraphy (SRT) - Curative 150000 210000 270000 330000 390000 23035 Total Body Irradiation 30000 30000 30000 30000 30000 23041 VMAT - Each Instalment 30000 30000 30000 30000 30000

91 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 23033 Volumetric Modulated Arc Therapy Package - Adjuvan 150000 210000 270000 330000 390000 23034 Volumetric Modulated Arc Therapy Package - Definit 180000 252000 324000 396000 468000 30. SPECIALISED PROCEDURES - PALLIATIVE MEDICINE 03034 Acupuncture 500 700 900 1100 1300 03052 Acupuncture package 5 Sittings 2500 3500 4500 5000 5500 03011 Ascitic Tap 300 400 500 600 700/800 03035 Caudal Injections 1800 2520 3240 3960 4680 03036 Cervical Medial Branch Block 2000 2800 3600 4400 5200 03025 Counseling 200 250 300 450 500/600 03033 Cross Consultation IP - Palliative Medicine 50 150 250 400 500 03037 Dry Needling 880 1230 1580 1940 2290 03038 Ganglion Impar Block 1500 2100 2700 3300 3900 03018 Home Visit 500 500 500 500 500 03024 Inpatient Cross Consultation 50 100 200 350 500/600 03015 Intercostal Nerve Blocks 500 600 700 800 1000/1200 03039 Intrathecal Drug Delivery Pump 10000 14000 18000 22000 26000 03010 IV Fusion Morphine/Ketamine 200 250 300 450 500/600 03023 Ketamine/Morphine Administration & Monitoring 400 450 500 600 700/800 03040 Lumbar Medial Branch/Facet Joint Injection 1800 2520 3240 3960 4680 03026 Lymphapress Package (6 Sittings) 800 1120 1440 1760 1000/1200 03016 Lymphedema Treatment 200 250 300 450 500/600 03053 Needles for Acupuncture 100 100 100 100 100 03054 Needles for Dry Needling 300 300 300 300 300 03041 Neurolytic Nerve Block 5000 7000 9000 11000 13000 03042 Peripheral Joint Injection with Imaging 600 840 1080 1320 1560 03043 Peripheral Nerve Injection with Imaging 600 840 1080 1320 1560 03019 Placement of Sub-Cutaneous line 350 490 630 770 910 03012 Pleural Tap 175 250 320 390 460 03044 Pulse Radiofrequency 5500 7700 9900 12100 14300 03055 Pulse Radiofrequency Add on 1500 2100 2700 3300 3900 03045 Repeat Pulse Radiofrequency 2500 3500 4500 5500 6500 03046 Spinal Cord Stimulation Stage 2 10000 14000 18000 22000 26000 03014 Stellate Ganglion Blocks 500 600 700 800 1000 03047 Sympathetic Ganglion Block 2000 2800 3600 4400 5200 03017 Syringe Driver/PCA Per Day 400 450 500 550 600 03048 Therapeutic Epidural 1800 2520 3240 3960 4680 03049 Thermal Radiofrequency 5500 7700 9900 12100 14300 03050 Transforaminal Epidural 1800 2520 3240 3960 4680 03013 Trigger Point Injections 250 300 350 400 500 03051 Ulrasound Guidance for Day Care/OT Procedures. These will be added extra 300 420 540 660 780

92 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 31. ANAESTHESIOLOGY 03060 Anesthesia Charges for Interventional Neuro Radiology Procedures 5000 7000 9000 11000 13000 03001 Arterial Line 250 350 450 550 650 73094 Automated External Defibrillator (AED) 4000 4000 4000 4000 4000 03002 Central Venous Cannulation 360 500 650 790 940 03032 Cross Consultation IP - Anesthesiology Dept 50 150 250 400 500 03003 Endotracheal intubation 500 700 900 1100 1300 03006 Glucometer Random Blood Sugar 65 90 120 140 170 03020 I STAT-ABG 400 460 520 580 640 73055 Inj.Sensorcaine(Heavy)4ml 28 28 28 28 28 73048 Injection Atracrium/Trac. 119 119 119 119 119 73027 Injection Atropine 4 4 4 4 4 73083 Injection Bupivacaine 30 42 54 66 78 73066 Injection Ephedrine Hcl./ml 20 20 20 20 20 73297 Injection Etomidate/Trrodmidate Celodate 520 520 520 520 520 73033 Injection Fortwin 6 6 6 6 6 73106 Injection Fulsed 5ml 26 26 26 26 26 73101 Injection Isoflurine 11 11 11 11 11 73045 Injection Mephantine 18 18 18 18 18 73031 Injection Morphine 22 22 22 22 22 75001 Injection Pethadine 50 mg 45 45 45 45 45 73030 Injection Pethedine 45 45 45 45 45 73121 Injection Propafol 20ml 168 168 168 168 168 73122 Injection Propafol 50ml 388 543 698 854 1009 73010 Injection Prostigmine 4 4 4 4 4 73011 Injection Scoline 100mg 5 5 5 5 5 73021 Injection Sensorcaine 0.5% ml 4 4 4 4 4 73004 Injection Sod/Thiopenthol 250 44 44 44 44 44 73105 Injection Succinyl scoline 50 70 90 110 130 73089 Injection Tramadol 27 38 49 59 70 73109 Injection Tramadol / Fortwin 27 38 49 59 70 73115 Injection Vecuronium 177 248 319 389 460 73013 Injection Xylocaine (Adr 1 1 1 1 1 73012 Injection Xylocaine 2% 1 1 1 1 1 73014 Injection Xylocaine 5% 1 1 1 1 1 73032 Injection Xylocard 2% 1 1 1 1 1 73084 InjectionFenstrong/Fentanyl 43 43 43 43 43 73238 InjectionKenadion 12 12 12 12 12 75008 InjectionKetamin 1cc 22 22 22 22 22 03004 Lumbar Puncture 220 310 400 480 570 73102 Micro Shield - 4 73114 Micro Shield PVP-P 73112 Micro Shield PVP-S 03007 Pre Anaesthesia/Post Anaesthesia Checkup (PAC) 200 400 700 900 1000 93 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 73237 Rocronium 304 304 304 304 304 03005 Ryles tube 30 40 50 70 80 03008 Therapeutic Epidural Steroid Injection 420 540 660 780 C. OTHER PROCEDURES / SERVICES 1. OTHER SERVICES: NUTRITION SERVICES 04002 Basel Metabolic Rate 400 560 720 880 1040 04001 Bio-Electrical Impedence 140 200 250 310 360 04007 Complete Diet and Physic Activity Assessment 120 170 220 260 310 04006 Exercise Testing 1190 1670 2140 2620 3090 04022 Nutrition Consultation 200 280 360 440 520 00198 Nutrition Cross Consultation IP 50 150 250 400 500 00196 Nutrition Service Charges 200 200 200 200 200 00197 Nutrition Service Consultation - Package (3 visits) 270 380 490 590 700 04005 Sleep Study - Advanced 3560 4980 6410 7830 9260 04004 Sleep Study - Basic 1190 1670 2140 2620 3090 1.1. SPECIALISED PROCEDURES DONE IN COLLEGE 04008 Risk Reduction and Weight Management Package 3240 4540 5830 7130 8420 04009 Screening Sessions for lifestyle Management Programme 220 310 400 480 570 1.2. LIFE STYLE MANAGEMENT PROGRAMME 04016 AP Vertebral Assessments 1720 2410 3100 3780 4470 04012 BMD Femur 1500 2100 2700 3300 3900 04013 BMD Forearm 860 1200 1550 1890 2240 04011 BMD Spine 1500 2100 2700 3300 3900 04015 Fat Analysis 4260 5960 7670 9370 11080 04018 Lateral Spine 1500 2100 2700 3300 3900 04017 Lateral Vertebral Assessments 1720 2410 3100 3780 4470 04010 Lifestyle Management Programme (10 sessions package) 8640 12100 15550 19010 22460 04014 Tissue Quantification 3070 4300 5530 6750 7980 1.3. TESTS DONE IN PHYSIOLOGY SJMC (BILLING DONE IN SJMC) 04003 Autonomic Nervous System Testing 1540 2160 2770 3390 4000 04019 Head Up Tilt Test 750 1050 1350 1650 1950 04023 Heart Rate Variablity Analysis 500 700 900 1100 1300 04020 Muscle Function Test 2000 2800 3600 4400 5200 04021 Passive Muscle Exercise Per Day 330 460 590 730 860 2. OTHER SERVICES: COMMUNITY HEALTH SERVICES 04102 Mugalur - MCH 120 170 220 260 310 04101 Rural Geriatic 130 180 230 290 340 04100 SCHS-HOME 560 780 1010 1230 1460 04103 Service Charge (Community Health) 90 90 90 90 90 3. OTHER SERVICES: FORENSIC MEDICINE 15025 Cold Storage 1200 1200 1200 1200 1200 15023 Dressing 1000 1400 1800 2200 2600 15024 Embalming 4500 4500 4500 4500 4500 15029 MLC Brought Dead by Police/Others (Per Day) 100 15065 MLC Packing After Working Hours 2500 2500 2500 2500 2500 94 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 15012 MLC-Packing 1000 1000 1000 1000 1000 15021 Mortuary Charges for Outsiders (Per Day) 1200 15000 Mortuary Charges In-Patients (Per Day) 1000 1000 1000 1000 1000 15013 Packing-MLC Unclaimed/Unknown 1 15069 Pesticide Panel-Insecticide,Herbicide,Rodenticide 1500 1720 1950 2180 2400 15070 Insecticide panelCommon Organophosphate-Dimethoate ,Malathion, Fenthion, Chlorpyrifos, Quinalphos,Monocrotophos,Dichlorvos, Methyl parathion,PhorateCommon Carbamates-Propoxur,Carbofuran, Common Pyrethroids-Fenvalerate, Cypermethrin, Deltamethrin 1250 1440 1630 1810 2000 15071 Herbicide-Paraquat 200 230 260 290 320 15072 Rodenticide- Aluminium phospide and Zinc Phospide 200 230 260 290 320 15073 Methanol 200 230 260 290 320 15074 Paracetmol 200 230 260 290 320 15075 Phenol 200 230 260 290 320 15076 Dimethoate 200 230 260 290 320 15077 Malathion 200 230 260 290 320 15078 Fenthion 200 230 260 290 320 15079 Chlorpyrifos 200 230 260 290 320 15080 Quinalphos 200 230 260 290 320 15081 Monocrotophos 200 230 260 290 320 15082 Dichlorvos 200 230 260 290 320 15083 Methyl parathion 200 230 260 290 320 15084 Phorate 200 230 260 290 320 15085 Propoxur 200 230 260 290 320 15086 Carbofuran 200 230 260 290 320 15087 Fenvalerate 200 230 260 290 320 15088 Cypermethrin 200 230 260 290 320 15089 Deltamethrin 200 230 260 290 320 15030 Unclaimed/Unknown Bodies Brought by Police -Irrespective of the Period 1 Note: * If the body is kept for more than 18 hours after the Ist day,Rs.650/- will be charged for the day.

4. OTHER SERVICES: CERTIFICATES 15014 Additional Certificate for VISA 700 15033 Alcohol Certificate 100 15001 Billing Details 50 70 90 110 130 15002 Birth Certificate 100 140 180 220 260 15034 Copies of Case Sheet Per Record - Service Charges 100 15035 Copies of MLC Extract 100 15017 Correction Charges 50 15036 Disability Certificate 200 15037 Duplicate Birth Certificate 200 15004 Duplicate Certificates 50 50 50 50 50 15016 Duplicate Death Certificate 100 15026 Duplicate IP Bill-Detail 50 50 50 50 50 15028 Duplicate OP Bills 10 10 10 10 10 95 CODE DESCRIPTION OPD/ GENERAL SEMI PVT. A/C DLX/ COMMON PVT./ SUITE DAY CARE Rs. Rs. Rs. Rs. Rs. 15027 Duplicate Summary Bill / Pharmacy Details 30 30 30 30 30 15038 LIC and Other Certificates Per Form 100 15008 Medical Certificate for Visa 2700 2700 2700 2700 2700 15032 OP Folders -Neurology 100 100 100 100 100 15039 OP Treatment Certificate 50 15007 Other Certificates 75 75 75 75 75 15003 Physical Fitness Certificate 100 100 100 100 100 15005 Special Documentation Charges (Admitted ) 225 225 225 225 225 15006 Special Documentation Charges (Non Admitted ) 125 125 125 125 125 15011 Wound Certificate (Patients Copy) 400 5. OTHER SERVICES: MEDICO SOCIAL WORK 15044 Adoption Counselling 550 600 650 700 750 15041 Cadaver Counselling 350 400 450 500 550 15054 Complete Rehabilitation & Placement Service 650 700 750 800 850 15060 Counselling (Per Session General) 350 400 450 500 550 15057 Counselling on Effective Parenting 550 600 650 700 750 15050 Crisis Intervention 350 400 450 500 550 15047 Family Therapy 550 600 650 700 750 15052 Fund Raising Letter 250 300 350 400 450 15040 Grief Counselling 350 400 450 500 550 15064 ID Clinic 250 300 350 400 450 15045 Infertility Counselling 550 600 650 700 750 15061 Legal Certificate 350 400 450 500 550 15051 Letter of Recommendation/Correspondence to NGO,Govt/Referral Letter 150 200 250 300 350 15046 Marital Counselling 550 600 650 700 750 15049 Psycho Social Intervation- Medical Adherence, Reality Orientation, Postive Reinforcement, Addressing Stressful Experience, Emotionalvetilation, Discharge Planning and Decision Making 250 300 350 400 450 15062 Rehabilltation 1100 1550 2050 2100 3050 15063 Rheumatology Counseling 550 600 650 700 750 15059 Senior Citizen Care Services 350 400 450 500 550 15048 Socio Demographic Economic Assesment 150 200 250 300 350 15055 Support Group Monthly ( PMR, Nephro, Burns, Paediatric Oncology) 550 600 650 700 750 15058 Teen Counselling 150 150 300 500 800 15042 Transplant Counselling 300 350 400 450 500 15043 Transplant Work (Full Package) 1000 1050 1100 1150 1200 15056 Visits (Collateral Contact) 250 300 350 400 450 15053 Vocational Counselling / Job Placement 250 300 350 400 450 15066 Community Participation 300 350 400 450 500 15067 Work Environment Evaluation 100 150 200 250 300 15068 Pre Vocational Assessment 100 150 200 250 300 6. OUT SIDE INVESTIGATIONS 15010 Outside Blood Test 15031 Outside Investigation

96 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. VI. OPERATIVE PROCEDURES * A. CARDIO THORACIC & VASCULAR SURGERY ADULT CARDIAC SURGICAL PACKAGES 05220 Aneurysm Resection & Grafting 150000 210000 270000 330000 390000/435000 05219 Aortic Root Replacement 150000 210000 270000 330000 390000/435000 05212 Aortic Valve Repair 100000 140000 180000 220000 260000/290000 05214 Aortic Valve Replacement 110000 154000 198000 242000 286000/319000 05216 Aortic+Mitral Valve Replacement 130000 182000 234000 286000 338000/377000 05217 Aortic+Mitral+Tricuspid Replacement 130000 182000 234000 286000 338000/377000 05200 CABG 150000 210000 270000 330000 390000/435000 05201 CABG + IABP 200000 280000 360000 440000 520000/580000 05204 CABG + Mitral Valve Repair 200000 280000 360000 440000 520000/580000 05205 CABG + Mitral Valve Replaced 150000 210000 270000 330000 390000/435000 05206 CABG + Post MI VSD Repair 150000 210000 270000 330000 390000/435000 05203 CABG Emergency salvage 170000 238000 306000 374000 442000/493000 05202 CABG+LV Aneurysmal Repair 170000 238000 306000 374000 442000/493000 05229 Cardiac Injuries Surgery with CPB 100000 140000 180000 220000 260000/290000 05230 Cardiac Injuries without CPB 50000 70000 90000 110000 130000/160000 05224 Dissecting Aneurysm with CPB 100000 140000 180000 220000 260000/290000 05225 Dissecting Aneurysm without CPB 80000 112000 144000 176000 208000/238000 05226 Intra Cardiac Tumour Surgery 100000 140000 180000 220000 260000/290000 05222 Intra Thoracic Aneurysm on CPB 100000 140000 180000 220000 260000/290000 05223 Intra Thoracic Aneurysm without CPB 70000 98000 126000 154000 182000/212000 05210 Mitral Valve Repair 110000 154000 198000 242000 286000/319000 05213 Mitral Valve Replacement 110000 154000 198000 242000 286000/319000 05208 Open Aortic Valvotomy 100000 140000 180000 220000 260000/290000 05207 Open Mitral Valvotomy 100000 140000 180000 220000 260000/290000 05209 Open Pulmonary Valvotomy 100000 140000 180000 220000 260000/290000 05228 Pulmonary Embolectomy/Endartrectomy 100000 140000 180000 220000 260000/290000 05218 Ross Procedure 100000 140000 180000 220000 260000/290000 05227 Ruptured Sinus of Valsulva Correction 100000 140000 180000 220000 260000/290000 05211 Tricuspid Valve Repair 100000 140000 180000 220000 260000/290000 05215 Tricuspid Valve Replacement 100000 140000 180000 220000 260000/290000

* In case, any Operative Procedure exceeds 1/2 hour duration from the normal time additional charges per hour as clasified below will be charged. 97 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

Closed Heart Procedures 05231 Closed Mitral Valvotomy 40000 56000 72000 88000 104000/134000 05233 Coarctation Repair 36000 50300 64800 79200 93700/123700 05232 PDA - Repair 36000 50300 64800 79200 93700/123700 05236 Pericardiectomy 60000 84000 108000 132000 156000/186000 05235 Pericardiostomy 12000 16800 21700 26300 31200/61200 Congenital Open Heart Procedures 05262 ALCAPA 100000 140000 180000 220000 260000/290000 05261 AP Window on CPB 100000 140000 180000 220000 260000/290000 05256 Arterial Switch Surgery 100000 140000 180000 220000 260000/290000 05246 ASD Closure 100000 140000 180000 220000 260000/290000 05248 AVSD/AV Canal Defect Repair 100000 140000 180000 220000 260000/290000 05263 Complex TOF/ + Special Conduit 100000 140000 180000 220000 260000/290000 05252 Ebsteins Repair 100000 140000 180000 220000 260000/290000 05251 Fontan 100000 140000 180000 220000 260000/290000 05250 HOCM Surgery 80000 112000 144000 176000 208000/238000 05259 Mustards 100000 140000 180000 220000 260000/290000 05254 Pulmonary Atresia with/without VSD 100000 140000 180000 220000 260000/290000 05260 Pulmonary Conduit 100000 140000 180000 220000 260000/290000 05258 Sennings 100000 140000 180000 220000 260000/290000 05253 TAPVC 100000 140000 180000 220000 260000/290000 05255 TGA - ICR 100000 140000 180000 220000 260000/290000 05249 TOF - ICR 100000 140000 180000 220000 260000/290000 05257 Truncus Areriosus Surgery 100000 140000 180000 220000 260000/290000 05247 VSD Closure 100000 140000 180000 220000 260000/290000 PEDIATRIC CARDIAC SURGERY PACKAGES 05243 Aortic Arch anomalies correction 36000 50300 64800 79200 93700/123700 05244 AP Window without CPB 36000 50300 64800 79200 93700/123700 05240 B T Shunt 36000 50300 64800 79200 93700/123700 05242 Central Shunt 36000 50300 64800 79200 93700/123700 05241 Glenn Shunt 36000 50300 64800 79200 93700/123700 05245 PA Banding 36000 50300 64800 79200 93700/123700 THORACIC SURGERY PROCEDURES PACKAGES 05273 Bronchopleural Fistula Correction 60000 84000 108000 132000 156000/186000 05268 60000 84000 108000 132000 156000/186000

98 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

05274 Diaphragmatic Eventration Plication 50000 70000 90000 110000 130000/160000 05275 Diaphragmatic Hernia Surgery 50000 70000 90000 110000 130000/160000 05284 Diaphragmatic Injury Repair 45000 63000 81000 99000 117000/147000 05282 Foreign Body Removal by Thorcoscope 30000 42000 54000 66000 78000/108000 05265 Lobectomy 80000 112000 144000 176000 156000/186000 05269 Lung Cyst Excision 60000 84000 108000 132000 156000/186000 05271 Mediastinotomy 60000 84000 108000 132000 156000/186000 05277 Oesophageal Tumour Exicision 45000 63000 81000 99000 117000/147000 05278 Oesophagectomy +/Colon Transposition 70000 98000 126000 154000 182000/212000 05276 Oesphageal Diverticula/Achalasia Cardia 50000 70000 90000 110000 130000/160000 05267 Pleurectomy 60000 84000 108000 132000 156000/186000 05266 100000 140000 180000 220000 260000/290000 05272 Pulmonary AV Fistula Surgery 45000 63000 81000 99000 117000/147000 05264 Segmentectomy 60000 84000 108000 132000 156000/186000 05270 SOL Excision 60000 84000 108000 132000 156000/186000 05280 Thoracoplasty 60000 84000 108000 132000 156000/186000 05281 & Lung Injury Repair 45000 63000 81000 99000 117000/147000 05283 Thoracotomy-Bronchial Repair of Injury 45000 63000 81000 99000 117000/147000 05279 Thymectomy (Thymoma Excision) 45000 63000 81000 99000 117000/147000 05285 Traumatic/corrosive Oesophageal Repair 60000 84000 108000 132000 156000/186000 VASCULAR SURGICAL PROCEDURES PACKAGES 05304 Aorto Billiac/Bifemoral Bypass 55000 77000 99000 121000 143000/173000 05305 Axillo Bifemoral Bypass + Synthetic Graft 55000 77000 99000 121000 143000/173000 05308 Axillo Brachial Bypass + Synthetic Graft 55000 77000 99000 121000 143000/173000 05309 Brachio-Radial Bypass + Synthetic Graft 55000 77000 99000 121000 143000/173000 05298 Carotid Artery Aneurysm Surgery 20000 28000 36000 44000 52000/82000 05311 Carotid Artery Bypass + Synthetic Graft 65000 91000 117000 143000 169000/199000 05319 Carotid Endartectomy 55000 77000 99000 121000 143000/173000 05623 Cervical Rid Resection 20000 28000 36000 44000 52000/82000 05292 Dissecting Aneurysm (CPB + Graft) 100000 140000 180000 220000 260000/290000 05293 Dissecting Aneurysm (No CPB/Graft) 80000 112000 144000 176000 208000/238000 05288 Distal Abdominal Aortic Aneurysm Surgery 60000 84000 108000 132000 156000/186000 05314 DVT - IVC Filter Insertion 20000 28000 36000 44000 52000/82000 05310 Excision & Repair Carotid Body Tumour 40000 56000 72000 88000 104000/134000

99 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05312 Excision of Large AV Malformation 55000 77000 99000 121000 143000/173000 05313 Excision of Small AV Malformation 35000 49000 63000 77000 91000/121000 05307 Femor Distal Bypass with Synthetic Graft 55000 77000 99000 121000 143000/173000 05306 Femoro Distal Bypass with Vein Graft 55000 77000 99000 121000 143000/173000 05286 Fem-pop Bypass with Graft 50000 70000 90000 110000 130000/160000 05291 Intrathoracic Aneurysm No Graft & CPB 70000 98000 126000 154000 182000/212000 05290 Intrathoracic Aneurysm with Graft+CPB 100000 140000 180000 220000 260000/290000 05624 Lung Biopsy - VATS Package 45000 63000 81000 99000 117000/147000 05299 Main Limb Arteries Aneurysm Surgery 20000 28000 36000 44000 52000/82000 05318 Medium Sized Arterial Aneruysm Repair + Graft 55000 77000 99000 121000 143000/173000 05317 Medium Sized Arterial Aneruysm Repair 55000 77000 99000 121000 143000/173000 05351 Patch Graft Angioplasty 20000 28000 36000 44000 52000/82000 05303 Peripheral Embolectomy without Graft 20000 28000 36000 44000 52000/82000 05289 Proximal Abd.Aortic Aneurysm Surgery 60000 84000 108000 132000 156000/186000 05297 Renal Artery Aneurysm Surgery 20000 28000 36000 44000 52000/82000 05302 Renal Artery Stenoses Surgery 25000 35000 45000 55000 65000/95000 05316 Small Arterial Aneurysm Repair 20000 28000 36000 44000 52000/82000 05300 Surgery Acquired AV Fistula 20000 28000 36000 44000 52000/82000 05301 Surgery Congenital AV FIstula 20000 28000 36000 44000 52000/82000 05294 Surgery Vertebral Artery Aneurysm 25000 35000 45000 55000 65000/95000 05287 Thromboembolectomy 20000 28000 36000 44000 52000/82000 05295 Vascular Procedure - Major Vessels 25000 35000 45000 55000 65000/95000 05296 Vascular Procedure - Minor vessels 15000 21000 27000 33000 39000/69000 05315 Vascular Tumour Excision 40000 56000 72000 88000 104000/134000 PACKAGE INCLUDES PACKAGE DOES NOT INCLUDE 1. Stay charges for 10 days of Hospitalization 1. Charges outside the period of 10 days. ( ie.2 days pre-op & 08 days post op.) 2. Cost of Heart Valves graftsartificial conduitis which will 2. All routine investigations required before, during and surgery be charged as actuals-if used. 3. All operation charges 3. Some special items which are not commonly required 4. ICU Charges 6 days (2 days with respirator & 4 days without respirator) for routine Heart operations after surgery may have to be 5. All routine drugs for 10 days used in high risk cases ie. IABP Swan Ganz Cathether etc. 6. Cross matching and screening charges for blood donors The use of these if required will be intimated as early as 7. Patient’s diet for 10 days possible. 05631 ECMO Package 500000 Package Includes 2 days ICU Stay Routine Investigations for 2 days Routine Drugs for 10 days except Antibiotics Blood Products 100 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. VASCULAR SURGICAL PROCEDURES PACKAGES (NON_PACKAGED BREAKUP OF CHARGES) 05332 Anterior Lateral Spinal Cord Decompression 22000 30800 51700 71600 93600 05625 AV Fistula 14000 19600 32900 45500 59500 05383 BPF Repair 16000 22300 37700 52000 68000 05352 Bronchoscopy Flexible 1800 2600 4200 5900 7700 05353 Bronchoscopy Rigid 1800 2600 4200 5900 7700 05333 Cervical Rib Resection 7000 9800 16600 22800 29800 05369 Chest Wall Biopsy 9600 13300 22300 30900 40300 05323 Chest Wall Tumour Removal 17000 23800 40000 55300 72300 05379 Decortication 16000 22300 37700 52000 68000 05384 Diaphragmatic Hernia Surgery 16000 22300 37700 52000 68000 05366 Empyema Window Operation 9600 13300 22300 30900 40300 05375 Lobectomy 16000 22300 37700 52000 68000 05380 Lung Cyst Removal 16000 22300 37700 52000 68000 05373 Mediastinal Mass (Small) 12000 16800 28200 39000 51000 05365 Mediastinal Node Biopsy 9600 13300 22300 30900 40300 05328 Mediastinitis 11800 16600 27700 38300 50200 05382 Mediastinotomy 16000 22300 37700 52000 68000 05321 Node Biopsy 2000 2800 4700 6600 8600 05391 Oesophageal CA 25000 35000 58800 81300 106300 05392 Oesophageal CA with Colon Transposition 25000 35000 58800 81300 106300 05385 Oesophagectomy Colon 16000 22300 37700 52000 68000 05326 Oesophagoscopy 1800 2600 4200 5900 7700 05389 Omental Transfer Chest 16000 22300 37700 52000 68000 05394 Omental Transfer Mediastinum 25000 35000 58800 81300 106300 05362 Open Lung Biopsy 10000 14000 18000 22000 26000 05363 Open Pleural Biopsy 9600 13300 22300 30900 40300 05329 Pericardial Tapping in OT 1300 2000 3300 4700 6000 05327 Pericardial Tube Drainage 4000 5700 9300 13000 17000 05371 Pericardiostomy 12000 16800 28200 39000 51000 05331 Pleurodesis 1700 2200 3800 5200 6800 05376 Pneumonectomy 16000 22300 37700 52000 68000 05390 Pulmonary AV Fistula 25000 35000 58800 81300 106300 05330 Re-Exploration - Minor 4700 6300 10800 15000 19700 05320 Removal of FB () 2100 2900 4900 6800 8900 05403 Repeat BPF Repair 26000 36300 61100 84600 110600

101 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

05399 Repeat Decortication 26000 36300 61100 84600 110600 05404 Repeat Diaphragmatic Hernia Surgery 26000 36300 61100 84600 110600 05395 Repeat Lobectomy 26000 36300 61100 84600 110600 05400 Repeat Lung Cyst Removal 26000 36300 61100 84600 110600 05402 Repeat Mediastinotomy 26000 36300 61100 84600 110600 05405 Repeat Oesophagectomy Colon 26000 36300 61100 84600 110600 05409 Repeat Omental Transfer Chest 26000 36300 61100 84600 110600 05396 Repeat Pneumonectomy 26000 36300 61100 84600 110600 05398 Repeat Resection 26000 36300 61100 84600 110600 05397 Repeat Segmectomy 26000 36300 61100 84600 110600 05401 Repeat SOL Mediastinal Excision 26000 36300 61100 84600 110600 05407 Repeat Thoracotomy 26000 36300 61100 84600 110600 05406 Repeat Thymectomy 26000 36300 61100 84600 110600 05408 Repeat Vascular Procedures (peripheral) 26000 36300 61100 84600 110600 05378 Resection 16000 22300 37700 52000 68000 05324 Rib Resection and Drainage 7000 9800 16600 22800 29800 05364 Scalene Node Biopsy 9600 13300 22300 30900 40300 05377 Segmectomy 16000 22300 37700 52000 68000 05368 Single Rib Resection 9600 13300 22300 30900 40300 05370 Sinus Excision Chest Wall 9600 13300 22300 30900 40300 05381 SOL Mediastinal Excision 16000 22300 37700 52000 68000 05372 Thoracic AV Malformation (small) 12000 16800 28200 39000 51000 05387 Thoracotomy 16000 22300 37700 52000 68000 05374 Thoracotomy and Empymectomy (small) 12000 16800 28200 39000 51000 05386 Thymectomy 16000 22300 37700 52000 68000 05393 Trachea Bronchial Repair 25000 35000 58800 81300 106300 05334 Tracheal Reconstruction 22000 30800 51700 71600 93600 05325 Tracheostomy in OT 3000 4200 7100 9800 12800 05626 Transesophageal Echo 1300 1800 3100 4200 5500 05367 Ultrasound Guided Tube Thoracostomy 9600 13300 22300 30900 40300 05388 Vascular Procedures (peripheral) 16000 22300 37700 52000 68000 VIDEO ASSISTED THORACOSCOPIC SURGERY 05335 Diagnostic Thoracoscopy VATS 4600 6300 10700 14700 19100 05339 Hellers Oesophagomyotomy - VATS 22000 30800 51700 71600 93600 05336 Lung Biopsy - VATS 19000 26700 44700 61800 80800

102 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

05344 Mediastinal Biopsy -VATS 7800 10300 17300 24100 31600 05340 Mediastinal Tumour Resection -VATS 22000 30800 51700 71600 93600 05337 Partial Pericardiectomy -VATS 19000 26700 44700 61800 80800 05338 Pleurodesis - VATS 19000 26700 44700 61800 80800 05341 Sympathectomy -VATS 19000 26700 44700 61800 80800 GENERAL 05629 ABG - CTVS 500 710 910 1100 1310 05630 ACT 200 300 400 400 500 02708 Intercostal / Malecot Drainage 210 290 380 460 550 05621 Suture / Staple Removal 210 300 380 470 550 05622 ICD Insertion / Removal 1500 2100 3500 4900 6400 05627 Octopus & Blow Mister 8250 11600 19400 26800 35100 05628 Cardioplegia Solution 150 200 400 500 600 18058 Advanced Microscope Per Hour 800 1100 1900 2600 3400 18057 Basic Microscope Per Hour 400 600 900 1300 1700 05345 Bilateral (50% of Procedure Surgery) 05620 Cross Consultation IP - Cadio Thoaric Surgery 50 150 250 400 500 18200 Enseal 05350 Extra Hours for Major + Surgery (D) 05349 Extra Hours for Major Surgery (C) 05348 Extra Hours for Minor + Surgery (B) 05347 Extra Hours for Minor Surgery(A) 05346 Extra Hours taken for a Surgery 18059 Laparoscope Per Hour 700 1000 1600 2300 3000 B. GENERAL SURGERY CATEGORY - A 05744 Fistulotomy II Stage-Seton Removal 2000 2800 4700 6600 8600 05916 Miscell Pleurodesis 2000 2800 4700 6600 8600 05900 Mucus Cyst Excision 2000 2800 4700 6600 8600 05901 Oral Cancer biopsy 2000 2800 4700 6600 8600 05902 Oral Cancer EUA 2000 2800 4700 6600 8600 05923 Suturing - Minor 2000 2800 4700 6600 8600 CATEGORY - B 05704 Amputation of Finger/Toe 3000 4200 7100 9800 12800 05920 CAPD 3000 4200 7100 9800 12800

103 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05819 Circumcision 3000 4200 7100 9800 12800 05731 Cryohaemorrhoidectomy 3000 4200 7100 9800 12800 05733 Debridement - Minor 3000 4200 7100 9800 12800 05922 Ear Lobe Repair 3000 4200 7100 9800 12800 05980 EUA (Perianal Region) 3000 4200 7100 9800 12800 05921 Excision of Small Swellings 3000 4200 7100 9800 12800 05742 Fissurectomy & Spinecterotomy 3000 4200 7100 9800 12800 05756 I & D 3000 4200 7100 9800 12800 05859 Lords Dilatation 3000 4200 7100 9800 12800 05895 Lymph Node Biopsy 3000 4200 7100 9800 12800 05783 Removal of Superficial Tumours - Minor 3000 4200 7100 9800 12800 05924 Split Skin Grafting - Minor 3000 4200 7100 9800 12800 05926 Suturing - Modearte 3000 4200 7100 9800 12800 CATEGORY - C 05929 A V Fistula* 6000 8300 14100 19600 25600 05851 Amputation Above Elbow 6000 8300 14100 19600 25600 05854 Amputation - Foot 6000 8300 14100 19600 25600 05705 Amputation of Hand 6000 8300 14100 19600 25600 05706 Amputation Penis - Partial 6000 8300 14100 19600 25600 05710 Appendicectomy 6000 8300 14100 19600 25600 06079 Axillary Dissection alone for Breast Cancer 6000 8300 14100 19600 25600 05938 Brachial Cyst Excision 6000 8300 14100 19600 25600 06080 Central Neck Dissection for Thyroid Cancer 6000 8300 14100 19600 25600 05730 Colostomy- Loop/Double Barrel 6000 8300 14100 19600 25600 05734 Debridement (Intermediate) 6000 8300 14100 19600 25600 05735 Dodd and Cockett Subfascial Ligation 6000 8300 14100 19600 25600 05933 Early Breast Cancer Excision 6000 8300 14100 19600 25600 05737 Feeding Jejunostomy 6000 8300 14100 19600 25600 05740 Fibroadenoma Breast (Intermediate) 6000 8300 14100 19600 25600 06089 Fistula-in-Ano (I) 6000 8300 14100 19600 25600 05743 Fistulectomy/Fistulotomy 6000 8300 14100 19600 25600 05747 Gastrostomy 6000 8300 14100 19600 25600 05749 Gynaecomastia-Excision(Unilateral) 6000 8300 14100 19600 25600 05750 Haemorrhoidectomy 6000 8300 14100 19600 25600 05891 Head/neck -Treacheostomy 6000 8300 14100 19600 25600

104 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05868 Hernia Epigastric 6000 8300 14100 19600 25600 05870 Hernia Paraumbilical without Mesh 6000 8300 14100 19600 25600 05983 Hydrocoele (Large) 6000 8300 14100 19600 25600 05755 Hydrocoele Operation 6000 8300 14100 19600 25600 05757 Ileostomy 6000 8300 14100 19600 25600 05758 Incisional Hernia Repair without Mesh 6000 8300 14100 19600 25600 05762 Inguinal Hernia Repair (Herniorrhaphy) 6000 8300 14100 19600 25600 05761 Inguinal Herniotomy 6000 8300 14100 19600 25600 05765 Laparotomy 6000 8300 14100 19600 25600 05817 Laproscopy (Diagnostic) 6000 8300 14100 19600 25600 05927 Microdochectomy 6000 8300 14100 19600 25600 05937 Oral Cavity Benign Cyst/ Tumour 6000 8300 14100 19600 25600 05912 Orchidectomy 6000 8300 14100 19600 25600 05913 Orchidopexy 6000 8300 14100 19600 25600 06082 Pelvic Lymphnode Dissection 6000 8300 14100 19600 25600 05781 Pilonidal Sinus Excision - Minor 6000 8300 14100 19600 25600 05899 Salivary Calculi Removal 6000 8300 14100 19600 25600 05939 Soft Tissue Tumour Excision - Axilla 6000 8300 14100 19600 25600 05928 Split Skin Grafting (Intermediate) 6000 8300 14100 19600 25600 05813 Umbilical & Paraumbilical Hernia Repair 6000 8300 14100 19600 25600 05816 Varicocoele Operation 6000 8300 14100 19600 25600 05815 Varicose Veins Stripping 6000 8300 14100 19600 25600 06078 Wide excision of Oral Cancers 6000 8300 14100 19600 25600 CATEGORY - D 05880 Abscess Drainage- Liver 9000 12700 21200 29300 38300 05702 Amputation - Above Knee 9000 12700 21200 29300 38300 05703 Amputation - Below Knee 9000 12700 21200 29300 38300 05852 Amputation - Shoulder 9000 12700 21200 29300 38300 05707 Amputation Penis - Total 9000 12700 21200 29300 38300 05952 Angiogram 9000 12700 21200 29300 38300 05847 Assisting Other Department- Minor 9000 12700 21200 29300 38300 05866 Bowel Adhesiolysis 9000 12700 21200 29300 38300 05865 Bowel Malrotation 9000 12700 21200 29300 38300 05941 Cervical Sympathectomy 9000 12700 21200 29300 38300 05722 Cholecystectomy 9000 12700 21200 29300 38300 05724 Cholecystojejunostomy 9000 12700 21200 29300 38300

105 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05725 Cholecystostomy 9000 12700 21200 29300 38300 05871 Choledechojejunostomy 9000 12700 21200 29300 38300 05727 Closure of Colostomy 9000 12700 21200 29300 38300 05728 Closure of Duodenal and Gastric Perforation 9000 12700 21200 29300 38300 05729 Closure of Small Bowel Perforation 9000 12700 21200 29300 38300 05732 Cysto Gastrostomy for Pancreatic Pseudo 9000 12700 21200 29300 38300 05906 Cysto jejunostomy 9000 12700 21200 29300 38300 05984 Debridement - Major 9000 12700 21200 29300 38300 05736 Embolectomy 9000 12700 21200 29300 38300 05738 Femoral Hernia Repair 9000 12700 21200 29300 38300 05884 Head & Neck RND 9000 12700 21200 29300 38300 05893 Head/Neck -Parathyriodectomy 9000 12700 21200 29300 38300 05751 Heller’s Operation 9000 12700 21200 29300 38300 05940 Hemiglossectomy 9000 12700 21200 29300 38300 05754 Highly Selective Vagotomy 9000 12700 21200 29300 38300 05986 I & D - Major 9000 12700 21200 29300 38300 05759 Incisional Hernia Repair with Mesh 9000 12700 21200 29300 38300 05760 Inguinal Hernioplasty (Mesh) 9000 12700 21200 29300 38300 06097 Inguinal Hernioplasty (Mesh)under LA 9000 12700 21200 29300 38300 05766 Laparotomy with Colostomy 9000 12700 21200 29300 38300 05951 Ligation ofAV fistula 9000 12700 21200 29300 38300 05857 Ltd. Resection of Bowel 9000 12700 21200 29300 38300 05770 Lumbar Sympathectomy 9000 12700 21200 29300 38300 05771 Meckel’s Diverticulectomy 9000 12700 21200 29300 38300 05835 Other LaparoscopicProcedures - Minor 9000 12700 21200 29300 38300 05950 Parathyroid Transplantation 9000 12700 21200 29300 38300 06069 Paraumbilical Hernia Reapir with Mesh 9000 12700 21200 29300 38300 05936 Partial Glossectomy 9000 12700 21200 29300 38300 06076 Portal Vein Embolization 9000 12700 21200 29300 38300 05782 Profundo Plasty 9000 12700 21200 29300 38300 06075 Radiofrequency Ablation 9000 12700 21200 29300 38300 06085 Recurrent Inguinal Hernia Repair 9000 12700 21200 29300 38300 06083 Retroperitonial lymphnode Dissection 9000 12700 21200 29300 38300 05794 Simple Mastectomy 9000 12700 21200 29300 38300

106 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 06084 SMA thrombectomy 9000 12700 21200 29300 38300 05796 Small Bowel Resection 9000 12700 21200 29300 38300 05797 Small Bowel Stricturoplasty 9000 12700 21200 29300 38300 05987 Split Skin Grafting - Major 9000 12700 21200 29300 38300 05981 Stapled Haemorrhoidectomy 9000 12700 21200 29300 38300 05721 Supra Omo Hyoid Neck Dissection 9000 12700 21200 29300 38300 05839 Thoracoscopy Diagnostic 9000 12700 21200 29300 38300 05804 Thyroglossal Cyst 9000 12700 21200 29300 38300 05805 Thyroid Lobectomy/Hemithyroidectomy 9000 12700 21200 29300 38300 05930 Varicose Veins Trendlenburg Operation 9000 12700 21200 29300 38300 05907 Vascular Arterial Repair 9000 12700 21200 29300 38300 05934 Wide Excision of Tumors 9000 12700 21200 29300 38300 CATEGORY - E 05850 Amputation Below Elbow 14000 19700 32900 45600 59600 05853 Amputation -Hip 14000 19700 32900 45600 59600 05708 Anal Sphincter Repair 14000 19700 32900 45600 59600 05846 Assisting Other Dept.- Major 14000 19700 32900 45600 59600 05956 AV Fistula at Elbow 14000 19700 32900 45600 59600 05957 AV Fistula using PTFE Graft 14000 19700 32900 45600 59600 05958 AV Fistula with Transposition of Vein 14000 19700 32900 45600 59600 05856 Breast Conservation Surgery 14000 19700 32900 45600 59600 06070 Chemoport Insertion 14000 19700 32900 45600 59600 05723 Cholecystectomy with C.B.D. Exploration 14000 19700 32900 45600 59600 05726 Choledocho Duodenostomy/Transduodenal 14000 19700 32900 45600 59600 05896 Deep Lobe Parotid Excision 14000 19700 32900 45600 59600 05959 Excision of AV Malformation - Minor 14000 19700 32900 45600 59600 05955 Femoro Femoral Crossover Graft 14000 19700 32900 45600 59600 05862 Fundoplication 14000 19700 32900 45600 59600 05745 Gastrectomy - Partial 14000 19700 32900 45600 59600 05882 Hydatid Cyst Excision 14000 19700 32900 45600 59600 05837 Laparoscopic Cysto Gastrostomy 14000 19700 32900 45600 59600 05833 Laparoscopic DU Perforation closure 14000 19700 32900 45600 59600 05834 Laparoscopic Varicoele ligation 14000 19700 32900 45600 59600 05825 Laparoscopic Adhesiolysis 14000 19700 32900 45600 59600 05711 Laproscopic Appendicectomy 14000 19700 32900 45600 59600

107 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05768 Left Hemicolectomy 14000 19700 32900 45600 59600 05943 Modified Radical Mastectomy 14000 19700 32900 45600 59600 05881 Packing for Trauma - Liver 14000 19700 32900 45600 59600 05777 Pancreatic Jejunostomy 14000 19700 32900 45600 59600 05905 Pancreatic Necrosectomy 14000 19700 32900 45600 59600 05953 Reconstruction after Limb Conservation/Wide Excision 14000 19700 32900 45600 59600 05858 Rectopexy 14000 19700 32900 45600 59600 05849 Retroperitonial lymphnode biopsies 14000 19700 32900 45600 59600 05784 Right Hemicolectomy 14000 19700 32900 45600 59600 05792 Sigmoid Colectomy 14000 19700 32900 45600 59600 05795 Simple Mastectomy with Auxillary Clr 14000 19700 32900 45600 59600 05898 SMG Excision with Neck Dissection 14000 19700 32900 45600 59600 05798 Splenectomy 14000 19700 32900 45600 59600 05791 Splenectomy, External Gastric Devasc. 14000 19700 32900 45600 59600 05799 Submandibular Gland 14000 19700 32900 45600 59600 05801 Subtotal Thyroidectomy 14000 19700 32900 45600 59600 05802 Superficial Parotidectomy- Benign 14000 19700 32900 45600 59600 05803 Surgery for Hiatus Hernia 14000 19700 32900 45600 59600 05841 Thor.Mediastinal Biopsies 14000 19700 32900 45600 59600 05843 Thor.Splanchnicectomy 14000 19700 32900 45600 59600 05840 Thor.Sympathectomy 14000 19700 32900 45600 59600 05842 Thor.Vagotomy 14000 19700 32900 45600 59600 05810 Transverse Colectomy 14000 19700 32900 45600 59600 05812 Truncal Vagotomy & Gastrojejunostomy 14000 19700 32900 45600 59600 05814 Vagotomy and Pyloroplasty 14000 19700 32900 45600 59600 05962 Valve Repair for Venous Reflex 14000 19700 32900 45600 59600 05965 Varicose Veins Ablation using Laser 14000 19700 32900 45600 59600 05960 Venous Thrombectomy 14000 19700 32900 45600 59600 CATEGORY - F 05701 Abdomino Perineal Resection 18000 25200 42300 58600 76600 05908 Adrenelectomy 18000 25200 42300 58600 76600 05709 Anterior Resection 18000 25200 42300 58600 76600 05991 Aortic Endarterectomy 18000 25200 42300 58600 76600 05712 Arterial Graft (Using Vein) 18000 25200 42300 58600 76600 05971 Axillo - Axillary bypass 18000 25200 42300 58600 76600

108 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05969 Axillo Bifemoral 18000 25200 42300 58600 76600 05954 Axillo Femoral 18000 25200 42300 58600 76600 05719 Block Dissection (Radical) Neck 18000 25200 42300 58600 76600 06072 Breast Conserving Surgery (Including Simultaneous Axillary Dissection) 18000 25200 42300 58600 76600 05970 Carotid Artery Repair for Trauma 18000 25200 42300 58600 76600 05861 Colonic Transposition 18000 25200 42300 58600 76600 06071 Compartmental Excision of Limb for Maligant Tumour 18000 25200 42300 58600 76600 05996 Distal Sub Total Gastrectomy 18000 25200 42300 58600 76600 05879 Enucleations/ Metastasectomy (Liver) 18000 25200 42300 58600 76600 05992 Excision of AV Malformation (Intermediate) 18000 25200 42300 58600 76600 05739 Femoro Popliteal (Arterial ) Bypass 18000 25200 42300 58600 76600 05990 Femoropopliteal Endarterectomy 18000 25200 42300 58600 76600 06077 Frey’s Procedure 18000 25200 42300 58600 76600 05720 Functional Neck Dissection 18000 25200 42300 58600 76600 05867 Gastric Vagotomy Drainage Laparoscopic Assisted 18000 25200 42300 58600 76600 05892 Head/Neck-ThyroidFND+mediastinalclear. 18000 25200 42300 58600 76600 05886 Head/Neck Composite Resections Floor Mouth 18000 25200 42300 58600 76600 05894 Head/Neck Laryngophanygo Esophagectomy + Reconstruction 18000 25200 42300 58600 76600 05887 Head/neck -Composite Resections Cheek 18000 25200 42300 58600 76600 05885 Head/neck -Composite Resections 18000 25200 42300 58600 76600 05883 Head/neck- Modified Neck Dissection 18000 25200 42300 58600 76600 05890 Head/neck- Radical Maxillectomy 18000 25200 42300 58600 76600 05888 Head/neck- Subtotal Maxillectomy 18000 25200 42300 58600 76600 05889 Head/neck- Total Maxillectomy 18000 25200 42300 58600 76600 05752 Hemimandibulectomy 18000 25200 42300 58600 76600 05875 Hepaticojejunostomy 18000 25200 42300 58600 76600 05753 Hepatico-Jejunostomy-Intra Hepatic 18000 25200 42300 58600 76600 05910 lleo Inguinal Block Dissection 18000 25200 42300 58600 76600 05973 IVC Repair Primary 18000 25200 42300 58600 76600 05997 Laparoscopy Assisted Ostomy 18000 25200 42300 58600 76600 05863 Laparoscopic Hellers Operation 18000 25200 42300 58600 76600 05995 Laparoscopic Hydatid Cyst Excision 18000 25200 42300 58600 76600 05831 Laparoscopicassisted Colectomy 18000 25200 42300 58600 76600 05830 Laparoscopicassisted small bowel resection 18000 25200 42300 58600 76600 05828 LaparoscopicFundoplication 18000 25200 42300 58600 76600

109 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05829 LaparoscopicTruncal Vagotomy asstd. GJ 18000 25200 42300 58600 76600 05764 Laparoscopic Cholecystectectomy 19000 26700 44700 61800 80800 06092 Laparoscopic Repair of Incisional Hernia 18000 25200 42300 58600 76600 06091 Laparoscopic Repair of Paraumbilical Hernia 18000 25200 42300 58600 76600 05763 Laproscopic Inguinal Hernia 18000 25200 42300 58600 76600 06086 Laproscopic Mesh Rectopexy 18000 25200 42300 58600 76600 05767 Large Soft Tissue Tumour Excision- L 18000 25200 42300 58600 76600 05876 Left Lateral Segmentectomy 18000 25200 42300 58600 76600 05855 Limb Conservation Surgery for STS 18000 25200 42300 58600 76600 05772 Oesophago Gastrectomy 18000 25200 42300 58600 76600 05779 Partial Pancreatectomy 18000 25200 42300 58600 76600 05780 Pelvic Exentration 18000 25200 42300 58600 76600 05961 Peripheral Aneurysm Surgery 18000 25200 42300 58600 76600 05874 Radical Cholecystectomy 18000 25200 42300 58600 76600 05873 Radical Choledochectomy 18000 25200 42300 58600 76600 05945 Radical Hemicolectomy 18000 25200 42300 58600 76600 05897 Radical Parotidectomy with Nerve Graft 18000 25200 42300 58600 76600 05966 Re- Resection in Head & Neck Surgery - Minor 18000 25200 42300 58600 76600 05918 Relaparotomy(referrals from outside) 18000 25200 42300 58600 76600 06088 Re-Operative Procedures 18000 25200 42300 58600 76600 05878 Resectional Debridement (Liver) 18000 25200 42300 58600 76600 05909 Retroperitoneal Tumor Excision 18000 25200 42300 58600 76600 05786 Segmental Hepatic Resection 18000 25200 42300 58600 76600 05967 Sentinel Node Basin Excision/ Clearance 18000 25200 42300 58600 76600 05848 Subfascial Endoscopic Perforator Surgery 18000 25200 42300 58600 76600 05800 Subtotal Colectomy 18000 25200 42300 58600 76600 05993 Surgery For Thoracic Outlet Syndrome 18000 25200 42300 58600 76600 05911 TFL Flap Reconstruction 18000 25200 42300 58600 76600 05844 Thoraco Oesophagomyotomy (Heller’S) 18000 25200 42300 58600 76600 05773 Thoraco Laprotomy 18000 25200 42300 58600 76600 05806 Total Colectomy/Procto Colectomy 18000 25200 42300 58600 76600 05808 Total Parotidectomy 18000 25200 42300 58600 76600 05968 Total Thyroidectomy 18000 25200 42300 58600 76600 05872 Transdoudenal Sphincteroplasty 18000 25200 42300 58600 76600 05989 Trifemorall Endarterectomy 18000 25200 42300 58600 76600

110 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05811 Triple Resection & Resurgery for Peptic Ulcer 18000 25200 42300 58600 76600 05972 Valve Transfer For Venous Reflux 18000 25200 42300 58600 76600 05942 Veins - Valvuloplasty 18000 25200 42300 58600 76600 05974 Venous Bypass Operation 18000 25200 42300 58600 76600 CATEGORY - G 05998 Abdominal Aortic Aneurysm Repair 23000 32200 54100 74800 97800 05716 Aortic Bifemoral 23000 32200 54100 74800 97800 05714 Aortic Graft - Bifurcate 23000 32200 54100 74800 97800 05713 Aortic Graft - Straight 23000 32200 54100 74800 97800 05999 Bypass For Visceral Ischemia 23000 32200 54100 74800 97800 05976 Carotid Endarectomy 23000 32200 54100 74800 97800 05977 Carotid Subclavian Bypass 23000 32200 54100 74800 97800 05947 Centripetal Gastrectomy 23000 32200 54100 74800 97800 05790 Distal Spleno Renal Shunt 23000 32200 54100 74800 97800 05978 Excision of AV Malformation - Major 23000 32200 54100 74800 97800 05877 Extended Right Hepatectomy 23000 32200 54100 74800 97800 05746 Gastrectomy - Total 23000 32200 54100 74800 97800 05979 IVC Repair Graft 23000 32200 54100 74800 97800 05774 IVOR - Lewis 23000 32200 54100 74800 97800 05827 Laparoscopic Adrenalectomy 23000 32200 54100 74800 97800 05838 Laparoscopic Assisted Donor Nephrectomy 23000 32200 54100 74800 97800 05832 Laparoscopic Assisted APR 23000 32200 54100 74800 97800 05826 Laparoscopic Splenectomy 23000 32200 54100 74800 97800 06087 Laproscopic Anterior Resection 23000 32200 54100 74800 97800 06081 Laproscopic Necrosectomy 23000 32200 54100 74800 97800 06073 Laproscopic Reversal Of Hartmanns 23000 32200 54100 74800 97800 05769 Left Hemi-Hepatectomy 23000 32200 54100 74800 97800 05946 Major Liver Resections 23000 32200 54100 74800 97800 05775 Mc KEOWN’S 23000 32200 54100 74800 97800 05778 Pancreato Duodenectomy - Whipple’s 23000 32200 54100 74800 97800 05788 Porta Caval Shunt 23000 32200 54100 74800 97800 05789 Proximal Spleno Renal Shunt 23000 32200 54100 74800 97800 06000 Radical Gastrectomy 23000 32200 54100 74800 97800 06074 Radical Nephrectomy 23000 32200 54100 74800 97800 05975 Re- Resection In Head & Neck Surgery Major 23000 32200 54100 74800 97800

111 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 05785 Right Hemihepatectomy External 23000 32200 54100 74800 97800 05787 Shunt Surgery for Portal Hypertension 23000 32200 54100 74800 97800 06090 Single Incision Laprosocpy Surgery 23000 32200 54100 74800 97800 05845 Thoraco Oesophagectomies 23000 32200 54100 74800 97800 05807 Total Colectomy with Pouch 23000 32200 54100 74800 97800 05776 Trans Hiatal Esophagectomy 23000 32200 54100 74800 97800 GENERAL 18094 Advanced Microscope Per Hour 800 1100 1900 2600 3400 18093 Basic Microscope Per Hour 400 600 900 1300 1700 06099 Bilateral (50% Of Proce./Surgery) 18151 CUSA 1000 1400 2400 3300 4300 18201 Enseal 06095 Extra Hours For Major + Surgery (D) 06094 Extra Hours For Major Surgery (C) 06093 Extra Hours For Minor + Surgery (B) 05919 Extra Hours For Minor Surgery (A) 06100 Extra Hours Taken For A Surgery 05820 Fluroscopy Time upto 10 Minutes 600 690 780 870 960 05821 Fluroscopy Time upto 15 Minutes 700 800 910 1000 1120 05822 Fluroscopy Time upto 20 Minutes 800 920 1040 1160 1280 05823 Fluroscopy Time upto 30 Minutes 900 1040 1170 1300 1440 05824 Fluroscopy Time(Every Adnl.5Mts) 100 100 200 300 400 18150 Intra Operative Ultrasound 1000 1400 2400 3300 4300 18095 Laparoscope Per Hour 700 1000 1600 2300 3000 18152 Laser And Cell Saver 1000 1400 2400 3300 4300 06115 Use Of GI Staplers For Anastomosis 200 300 500 700 900 C. GENITO URINARY SURGERY CATEGORY - A 21001 Biopsy - Urology 2500 3500 5900 8100 10600 21003 Circumcision 2500 3500 5900 8100 10600 21004 Cystoscopy/ Stent Removal 2500 3500 5900 8100 10600 21002 Dorsal Slit 2500 3500 5900 8100 10600 21015 Frenuloplasty 2500 3500 5900 8100 10600 21140 I & D Abscess 2500 3500 5900 8100 10600 21141 Scrotal Cyst Excision 2500 3500 5900 8100 10600 21142 Secondary Suturing 2500 3500 5900 8100 10600

112 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21013 SPC - Trocar/Open 2500 3500 5900 8100 10600 21005 Utrethral Dilatation 2500 3500 5900 8100 10600 21169 Incision & Drainage - Minor 2500 3500 5900 8100 10600 21170 Wound Debridement - Minor 2500 3500 5900 8100 10600 CATEGORY - B 21173 Antegrade Stenting 4000 5600 9400 13000 17000 21143 Bladder Injury Repair 4000 5600 9400 13000 17000 21182 PCNL -A 4000 5600 9400 13000 17000 21006 Cystoscopy + Biopsy 4000 5600 9400 13000 17000 21007 Cystoscopy + Clot evacuation 4000 5600 9400 13000 17000 21008 Cystoscopy + Fulgration 4000 5600 9400 13000 17000 21009 Cystoscopy + RGP 4000 5600 9400 13000 17000 21010 Cystoscopy + Stenting (Unilateral) 4000 5600 9400 13000 17000 21181 Diagnostic Flexi scopy 4000 5600 9400 13000 17000 21179 Diagnostic Flexi URS 4000 5600 9400 13000 17000 21014 Fistula Repair 4000 5600 9400 13000 17000 21174 Incision & Drainage - Major 4000 5600 9400 13000 17000 21011 Intra Op-Consultation 4000 5600 9400 13000 17000 21177 Renal Biopsy Open 4000 5600 9400 13000 17000 21172 Scrotoplasty 4000 5600 9400 13000 17000 21176 Suturing Major 4000 5600 9400 13000 17000 21171 Suturing Minor 4000 5600 9400 13000 17000 21157 Unilateral Hernia Repair Without Mesh 4000 5600 9400 13000 17000 21180 URS A 4000 5600 9400 13000 17000 21175 Wound Debridement - Major 4000 5600 9400 13000 17000 CATEGORY - C 21187 AVF Construction (Radio Cephalic ) 6000 8400 14100 19500 25500 21144 Bilateral Inguinal Hernia Repair Without Mesh 6000 8400 14100 19500 25500 21018 Cystolithotomy / Cystolithotripsy 6000 8400 14100 19500 25500 21021 Cystoscopy + Bilateral Stenting 6000 8400 14100 19500 25500 21184 Deroofing Of Renal Cyst Open 6000 8400 14100 19500 25500 21019 Flexiscopy 6000 8400 14100 19500 25500 21145 Fourniers Gangering Exploration 6000 8400 14100 19500 25500 21016 Hydrocelectomy 6000 8400 14100 19500 25500

113 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21185 Inguinal Hernia Unilateral 6000 8400 14100 19500 25500 21020 Meatoplasty 6000 8400 14100 19500 25500 21146 Perm Catheter (Dialysis access ) 6000 8400 14100 19500 25500 21147 Renal Biopsy 6000 8400 14100 19500 25500 21183 Renal Biopsy Lap 6000 8400 14100 19500 25500 21188 Retrograde Treatment for Chyluria 6000 8400 14100 19500 25500 21017 Simple Orchidectomy 6000 8400 14100 19500 25500 21022 Testicular Biopsy 6000 8400 14100 19500 25500 21148 Unilateral Hernia Repair With Mesh 6000 8400 14100 19500 25500 21149 Ureteric Injury Repair 6000 8400 14100 19500 25500 21186 Uretero Ureterostomy 6000 8400 14100 19500 25500 21139 URS - B 6000 8400 14100 19500 25500 21023 VIU 6000 8400 14100 19500 25500 21195 Ureterolithotomy 6000 8400 14100 19500 25500 CATEGORY - D 21025 Amputation of Penis - Partial 8000 11200 18800 26000 34000 21035 AVF Construction (Brachio- Cephalic ) 8000 11200 18800 26000 34000 21150 Bilateral Inguinal Hernia Repair With Mesh 8000 11200 18800 26000 34000 21026 BNI 8000 11200 18800 26000 34000 21189 Deroofing Of Renal Cyst Lap 8000 11200 18800 26000 34000 21152 Diagnostic Laparoscopy 8000 11200 18800 26000 34000 21032 Endo incision of Uereterocele 8000 11200 18800 26000 34000 21033 Endoscopic Realignment 8000 11200 18800 26000 34000 21027 Endoscopic Removal of F.B. 8000 11200 18800 26000 34000 21036 High Orchidectomy 8000 11200 18800 26000 34000 21034 I&D/ Debridement 8000 11200 18800 26000 34000 21190 Inguinal Hernia Bilateral 8000 11200 18800 26000 34000 21131 Laser CLT 8000 11200 18800 26000 34000 21030 Laser VIU 8000 11200 18800 26000 34000 21028 Open Nephrostomy 8000 11200 18800 26000 34000 21132 PCNL - B 8000 11200 18800 26000 34000 21031 Shunt for Priapism 8000 11200 18800 26000 34000 21191 Uretero Sigmoidostomy 8000 11200 18800 26000 34000 21029 URS-C 8000 11200 18800 26000 34000

114 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21024 Varicocele Ligation -Unilateral 8000 11200 18800 26000 34000 CATEGORY - E 21153 AVF PT PF Graft 11000 15400 25900 35800 46800 21154 Bladder Repair Laproscopy 11000 15400 25900 35800 46800 21155 Brachio Cephalic AVF Construction 11000 15400 25900 35800 46800 21053 Burch Colpo Suspension 11000 15400 25900 35800 46800 21127 CAPD Catheter Insertion 11000 15400 25900 35800 46800 21038 Chordee Correction 11000 15400 25900 35800 46800 21133 Diagonstic Lap 11000 15400 25900 35800 46800 21052 Fracture Penis Repair 11000 15400 25900 35800 46800 21156 Lap CAPD Catheter insertion 11000 15400 25900 35800 46800 21046 Orchidectomy For Prostate Cancer 11000 15400 25900 35800 46800 21040 Orchidopexy - Unilateral 11000 15400 25900 35800 46800 21039 Orchidopexy For Testicular Torsion 11000 15400 25900 35800 46800 21047 Perineal Urethrostomy 11000 15400 25900 35800 46800 21041 Perinephric Abscess Drainage 11000 15400 25900 35800 46800 21044 TUIP/BNR 11000 15400 25900 35800 46800 21050 TVT/TOT 11000 15400 25900 35800 46800 21049 Urethral Sling for SUI 11000 15400 25900 35800 46800 21042 Urethroplasty Stage-1 11000 15400 25900 35800 46800 21048 Urology Assistance in Surgery 11000 15400 25900 35800 46800 21043 URS - D 11000 15400 25900 35800 46800 21045 Varicocele Ligation Bilateral 11000 15400 25900 35800 46800

CATEGORY - F 21054 Amputation of Penis - Total 15000 21000 35300 48800 63800 21055 Bladder Diverticulectomy 15000 21000 35300 48800 63800 21058 Bladder Neck Plasty 15000 21000 35300 48800 63800 21059 Epispadias Repair 15000 21000 35300 48800 63800 21060 Exploration for Renal Trauma 15000 21000 35300 48800 63800 21134 Graft Nephrectomy 15000 21000 35300 48800 63800 21061 Hypospadias-Single Stage repair 15000 21000 35300 48800 63800 21063 Partial Cystectomy 15000 21000 35300 48800 63800 21067 Prosthesis Implantation 15000 21000 35300 48800 63800 21064 Pyelo Lithotomy 15000 21000 35300 48800 63800

115 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21062 Simple Nephrectomy 15000 21000 35300 48800 63800 21070 Surgery For Pyeronies Disease 15000 21000 35300 48800 63800 21065 TURP/TURBT 15000 21000 35300 48800 63800 21193 TURBT 15000 21000 35300 48800 63800 21066 Ureteric Reimplantation 15000 21000 35300 48800 63800 21057 Uretero Ureterostomy 15000 21000 35300 48800 63800 21069 URS-Bilateral 15000 21000 35300 48800 63800 21072 URS-Laser Lithotripsy 15000 21000 35300 48800 63800 21071 Vasectomy Reversal 15000 21000 35300 48800 63800 21056 Vaso-Epididymal Anastamosis 15000 21000 35300 48800 63800 21079 Pyeloplasty 15000 21000 35300 48800 63800 21089 Laparoscopic Varicocele Ligation 15000 21000 35300 48800 63800 21090 Laparoscopic Orchideopexy 15000 21000 35300 48800 63800 21091 Laparoscopic Ureterolithotomy 15000 21000 35300 48800 63800 21192 PCNL - C 15000 21000 35300 48800 63800 CATEGORY - G 21076 Augmentation Cystoplasty 18500 25900 43500 60100 78600 21085 BMG Urethroplasty 18500 25900 43500 60100 78600 21074 Boari FLaparoscopic Implantation 18500 25900 43500 60100 78600 21075 Inguinal Block Dissection 18500 25900 43500 60100 78600 21093 Laparoscopicaroscopic Pelvic Lympnode disection 18500 25900 43500 60100 78600 21092 Laparoscopicaroscopic Simple Nephrectomy 18500 25900 43500 60100 78600 21158 Laparoscopicaroscopy Hernia Repair 18500 25900 43500 60100 78600 21077 Nephrolithotomy 18500 25900 43500 60100 78600 21078 Open Prostatectomy 18500 25900 43500 60100 78600 21194 PCNL - D 18500 25900 43500 60100 78600 21083 Partial Nephrectomy For Renal Tumor 18500 25900 43500 60100 78600 21086 Progressive Perineal Uretrhoplasty 18500 25900 43500 60100 78600 21082 Radical Nephrectomy 18500 25900 43500 60100 78600 21081 Simple Nephro Ureterectomy 18500 25900 43500 60100 78600 21084 TURP + Additional Procedures 18500 25900 43500 60100 78600 21080 Turp- Large Gland /Tumor 18500 25900 43500 60100 78600 21088 Ureterolysis + Omental Wrapping 18500 25900 43500 60100 78600 21094 VVF Repair 18500 25900 43500 60100 78600

116 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21103 Laparoscopic Pyloplasty 18500 25900 43500 60100 78600 21105 Laparoscopic Ureterolysis 18500 25900 43500 60100 78600 21106 Laparoscopic Uretero Ureterostomy 18500 25900 43500 60100 78600 21107 Laparoscopic Pylolithotomy 18500 25900 43500 60100 78600 CATEGORY - H 21098 Adrenalectomy 20000 28000 47000 65000 85000 21135 Ileal Conduit 20000 28000 47000 65000 85000 21128 Laparoscopic Donor Nephrectomy 20000 28000 47000 65000 85000 21101 Laparoscopic Partial Nephrectomy 20000 28000 47000 65000 85000 21100 Laparoscopic Radical Nephrectomy 20000 28000 47000 65000 85000 21102 Laparoscopic Ureteric Reimplantation 20000 28000 47000 65000 85000 21104 Laparoscopic VVF Repair 20000 28000 47000 65000 85000 21095 Radical Nepho Ureterectomy 20000 28000 47000 65000 85000 21097 Radical Prostatectomy 20000 28000 47000 65000 85000 21096 Ureteral Replacement 20000 28000 47000 65000 85000 21130 Open Donor Nephrectomy 20000 28000 47000 65000 85000 CATEGORY - I 21110 Auto Tranplantaion of Kidney 30000 42000 70500 97500 127500 21111 Complex VVF Repair 30000 42000 70500 97500 127500 21115 Laparoscopic Adrenalectomy 30000 42000 70500 97500 127500 21114 Laparoscopic Nephro Uretertectomy 30000 42000 70500 97500 127500 21113 Laparoscopic Radical Prostatectomy 30000 42000 70500 97500 127500 21123 Laparoscopicaroscopic Radical Cystectomy 30000 42000 70500 97500 127500 21108 Radical Cystectomy + Lieal Conduit 30000 42000 70500 97500 127500 21109 Radical Cystectomy + Neo Bladder 30000 42000 70500 97500 127500 21129 Renal Transplant Recipient 30000 42000 70500 97500 127500 21112 RPLND 30000 42000 71500 97500 127500 GENERAL 18106 Advanced Microscope Per Hour 800 1100 1900 2600 3400 18105 Basic Microscope Per Hour 400 600 900 1300 1700 21116 Bilateral(50% Of Procedure/Surgery) 18202 Enseal 21121 Extra Hours For Major + Surgery (D)# 21120 Extra Hours For Major Surgery (C)#

117 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21119 Extra Hours For Minor + Surgery (B)# 21118 Extra Hours For Minor Surgery (A)# 21117 Extra Hours Taken For A Surgery# 21159 Laser URS- Type A 15000 38000 46000 59000 79000 21160 Laser URS- Type B 20000 43000 51000 64000 84000 21161 Laser TURP- Type A 60000 75000 98000 123000 138000 21162 Laser TURP- Type B 65000 80000 103000 128000 143000 21163 Laser RIRS - Type A 15000 41000 49000 62000 82000 21164 Laser RIRS - Type B 20000 46000 54000 67000 87000 21136 Flexible URS 2000 3000 5000 8000 10000 21122 Fluroscopy Time upto 10 Minutes 600 690 780 870 960 21138 Fluroscopy Time upto 15 Minutes 700 800 910 1000 1120 21124 Fluroscopy Time upto 20 Minutes 800 920 1040 1160 1280 21125 Fluroscopy Time upto 30 Minutes 900 1040 1170 1300 1440 21126 Fluroscopy Time (Every Adnl.5mts) 100 100 200 300 300 21137 Laser Equipment 10000 11000 11500 12000 15000 21165 Laser Fiber 5000 5500 7500 8000 9000 21166 Access Sheath 2000 2750 3000 3500 4000 21167 Stone Basket 4000 5000 6000 7000 8000 21168 Flexible Scope 20000 20000 22500 25000 27500 18107 Laparoscopicaroscope Per Hour 700 1000 1600 2300 2300 D. GYNAECOLOGY 06601 Abdominal 8000 11200 18800 26000 34000 06602 Abdominal Myomectomy 7600 10600 17700 24300 31900 06604 Abdominal Sacro Colpopoexy 10000 14000 23500 32500 42500 06661 Adnexal Mass Bilateral 6600 9100 15300 21100 27700 06660 Adnexal Mass Unilateral 4600 6300 10700 14700 19100 06615 Antero Colporraphy 3600 4900 8200 11300 14900 06736 Cervical Biopsy & Biopsies from ST - Cauterization 1800 2600 4200 5900 7700 06605 Cervical Biopsy & Biopsies from ST - Cryo Surgery 1800 2600 4200 5900 7700 06649 Cone Biopsy 3000 4200 7100 9800 12800 06741 Cryosurgery for Cervix 1000 1400 2400 3300 4300 06693 Diagnostic Hystero Laparoscopy 7000 9800 16500 22800 29800 06606 Dilatation & Curettage 1800 2600 4200 5900 7700

118 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 06607 Dilatation & Evacuation - in O.T. 2500 3500 5900 8100 10600 06688 EUA + Colposcopy + Cervical biopsy 2500 3500 5900 8100 10600 06648 EUA + D & C 2000 2800 4700 6500 8500 06646 EUA + Fractional Curetage 2000 2800 4700 6500 8500 06647 EUA + Polypectomy + D & C 2500 3500 5900 8100 10600 06690 Evacuation Of Vesicular Mole 3000 4200 7100 9800 12800 06645 Examination Under Anaesthesia 1700 2200 3800 5200 6800 06650 Excisions Of Vaginal Lesions 3000 4200 7100 9800 12800 06651 Excisions Of Vulval Lesions 1800 2600 4200 5900 7700 06608 Fractional Curettage 2000 2800 4700 6500 8500 06633 Hysteroscopic Adhesiolysis 4600 6300 10700 14700 19100 06637 Hysteroscopic 5300 7700 12700 17700 23000 06634 Hysteroscopic Myomectomy 5900 8300 13900 19200 25100 06635 Hysteroscopic Polypectomy 4200 5900 9900 13700 17900 06609 Hysteroscopy (Diagnostic) 2500 3500 5900 8100 10600 06636 Hysteroscopy Directed Biopsies 3600 4900 8200 11300 14900 06613 Infertility- Laparoscopy With Chromotubation 3500 4900 8200 11400 14900 06631 Laparascopic Adhesiolysis 8200 11600 19300 26700 34900 06628 Laparoscopic Assisted Vaginal Hypterectomy 12000 16800 28200 39000 51000 06689 Laparoscopic Excision Of T.O Mass 13700 19200 32300 44500 58200 06629 Laparoscopic Myomectomy 13700 19200 32200 44600 58200 06630 Laparoscopic Ovarian Cystectomy 10000 14000 23500 32500 42500 06632 Laparoscopic Salpingotomy for 10000 14000 23600 32600 42600 06687 Laparoscopic Salpingo Oopherectomy 10000 14000 23500 32500 42500 06611 Laparotomy 6000 8400 14100 19500 25500 06656 Laparotomy & Biopsy 6700 9200 15600 21600 28100 06639 Laproscopic Gonadectomy 13600 18900 31700 43900 57300 06662 Laparotomy & Colostomy 6800 9600 16000 22100 28900 06657 Laparotomy & Partial Omentectomy 7700 12900 17900 23300 32700 06733 Laparotomy + Appendecetomy 7000 9800 16500 22800 29800 06734 Laparotomy+Biopsy+Appendicectomy+Omentectomy 8000 11200 18800 26000 34000 06641 Laproscopic Ovarian Drilling 4700 6600 11000 15300 20000 06638 Laproscopic Salpingostomy 10000 14000 23500 32500 42500 06640 Laproscopic treatment of endometriosis 13600 18900 31700 43900 57300

119 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 06612 Laproscopy (Diagnostic) - Pelvic 4000 5600 9400 13000 17000 06692 Operative Hysteroscopy 10000 14000 23600 32600 42600 06614 Ovarian Cystectomy (Open) 5000 7000 11800 16300 21300 06731 Partial Omentectomy 3000 4200 7100 9800 12800 06642 Perineal Floor Repair 5700 7800 13200 18200 23800 06616 Polypectomy 1800 2600 4200 5900 7700 06729 Posterior Colporraphy 3600 4900 8200 11300 14900 06659 Re-Laparotomy (Referrals From Outside) 11000 15400 25900 35800 46800 06617 Removal of T.O. Mass 5600 7700 12900 17900 23300 06655 Repair of Complete Wound Dehiscence 3000 4200 7100 9800 12800 06644 Resuturing 2500 3500 5900 8100 10600 06710 Sacrocolpopexy with Mesh repair 10000 14000 23500 32500 42500 06643 Sacrospinous Colpopexy 5700 7800 13200 18200 23800 06618 Sling Operation 7000 9800 16500 22800 29800 06654 Suturing Intermediate 2000 2800 4700 6600 8600 06735 TAH + BSO + Appendicectomy + Omentectomy + RPLND 12600 17600 29300 40700 53100 06723 TAH+BSO 8000 11200 18800 26000 34000 06724 TAH+USO 7500 10500 17600 24400 31900 06740 Total Laproscopic Hystrectomy 15000 21000 35300 48800 63800 06620 Tuboplasty 8000 11200 18800 26000 34000 06621 Tumour Removal Superficial Cysts,Vaginal Cysts etc 3000 4200 7100 9800 12800 06627 V.V.F/R.V.F. Repair 5700 7800 13200 18200 23800 06622 Vaginal Hysterectomy 8000 11200 18800 26000 34000 06695 Vaginal Hysterectomy With Pelvic Floor Repair 10000 14000 23500 32500 42500 06696 Vaginal Hysterectomy+B/L Oopherectomy 8500 11900 20000 27600 36100 06725 Vaginal Hysterectomy+USO 8500 11900 20000 27600 36100 06624 Vagino Plasty 10000 14000 23500 32500 42500 GENERAL 18203 Enseal 5000 6000 7000 8000 9000 06700 Extra Hours Taken For A Surgery 18067 Laparoscope Per Hour 700 1000 1600 2300 3000 E. OBSTETRICS 06701 Caesarean Hysterectomy 9000 12600 21200 29300 38300 06702 Caesarean Section 6000 8300 14100 19600 25600

120 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 06703 Cervical Encirlage 2000 2800 4700 6500 8500 06743 Internal Podalic Version & Breech Extraction 3000 4200 7100 9800 12800 06705 Laparotomy for Ectopic Cestation 5700 7800 13200 18200 23800 06706 Manual Removal of Placenta 2600 3600 5900 8100 10700 06744 External Cephalic Version 1000 1400 2400 3300 4300 GENERAL 06799 Bilateral (50% Of Proce./Surgery) 18204 Enseal 06795 Extra Hours For Major + Surgery (D) 06794 Extra Hours For Major Surgery (C) 06793 Extra Hours For Minor + Surgery (B) 06792 Extra Hours For Minor Surgery (A) 06800 Extra Hours Taken For A Surgery F. OPHTHALMOLOGY Anti Glaucoma operation 07030 Bleb Revision 2000 2800 4700 6500 8500 06888 Controlled 5000 7000 11800 16300 21300 06881 Cyclocryopexy 2000 2800 4700 6500 8500 06890 Excision of Prolapsed Iris 2500 3500 5900 8100 10600 06891 Glaucoma Valve Implant 6000 8400 14100 19500 25500 06883 Goniotomy 2600 3600 6100 8500 11100 06884 Peripheral 2200 3100 5200 7200 9400 06814 Phaco + Trab (Combined) 8000 11200 18800 26000 34000 06813 Trab + Trabeculotomy 5000 7000 11800 16300 21300 06887 Trabeculectomy 4000 5600 9400 13000 17000 06811 Trabeculectomy With Controlled Sutures 7000 9800 16500 22800 29800 06812 Trabeculotomy Major 4000 5600 9400 13000 17000 06923 Cornea C3R 20000 20000 20000 20000 20000 06821 Corneal Grafts Processing 2000 2800 4700 6500 8500 07018 Corneal suturing 2200 3100 5200 7200 9400 06828 Corneal Tear Repair - Major 6800 9500 16000 22100 28900 06827 Corneal Tear Repair - Minor 3500 4900 8200 11400 14900 06822 Deep Foreign Body Removal 1800 2500 4200 5900 7700 06924 Descemet’s Stripping 8000 11200 18800 26000 34000

121 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 06823 Keratoplasty 7000 9800 16500 22800 29800 06824 Removal of Superficial Foreign Body 1300 1800 3100 4200 5500 07019 Suture Removal 500 700 1200 1600 2100 07020 Therapeutic Keratoplasty 3000 4200 7100 9800 12800 07021 Triple Procedure (KP+ IOL) 8000 11200 18800 26000 34000 Extra Ocular Muscles 07036 Four Muscle Surgery 6000 8400 14100 19500 25500 06953 Squint Correction 5000 7000 11800 16300 21300 06832 Squint Correction Major 9000 12600 21200 29300 38300 07035 Two Muscle Surgery 3000 4200 7100 9800 12800 Eye Ball 06991 Enucleation 2200 3100 5200 7200 9400 06992 Enucleation with Implant 4200 5900 9900 13700 17900 06993 Eviceration 2200 3100 5200 7200 9400 06995 Removal of Intra Ocular F.B.(Ant.Segment). 4700 6600 11000 15300 20000 Eye Lids 06841 (Each Eye) 3400 4800 8000 11100 14500 06842 Canthoplasty 2100 2900 4900 6800 8900 07026 Chalazion (Incision & Curettage) 700 1000 1600 2300 3000 06809 Contracted Socket Reconstruction & Implant 6500 9100 15300 21100 27600 06930 Corneal Processing Charges 2000 2800 4700 6500 8500 06946 Corneo Scleral Tear Repair (Major) 6500 9100 15300 21100 27600 06947 Corneo Scleral Tear Repair (Minor) 4000 5600 9400 13000 17000 06843 Deepening Contracted Socket 4300 6000 10100 14000 18300 06845 Ectropion Release & Skin Graft 3300 4600 7800 10700 14000 07024 Ectropion/Entropion Correction 3000 4200 7100 9800 12800 07023 Excision Biopsy 1000 1400 2400 3300 4300 06844 Excision Of Tumour & Closure 2200 3100 5200 7200 9400 06808 Fornix Reconstruction 3000 4200 7100 9800 12800 06925 DCR with Lacrimal Intubation 5500 7700 12900 17900 23400 06926 Lacrimal Syringing Probing Under Endoscopic Guidance 3000 4200 7100 9800 12800 06927 Lens Secondary IOL Implantation (Major) 4000 5600 9400 13000 17000 06928 Lens Secondary IOL Implantation (Minor) 2000 2800 4700 6500 8500 06861 Lid Abscess & Drainage 1500 2100 3500 4900 6400

122 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

07025 Lid Tear Repair 2500 3500 5900 8100 10600 06846 Ptosis Correction 2300 3200 5400 7500 9800 06810 Ptosis Major 5500 7700 12900 17900 23400 06848 Reconstruction of Each Eye Lid - Minor 3000 4200 7100 9800 12800 06849 Reconstuction of Each Eye Lid - Major 4500 6300 10600 14600 19100 06929 Refixation of IOL 2000 2800 4700 6500 8500 06850 Release Synechiae & SSG 3300 4600 7800 10700 14000 06931 Scleral Tear Repair (Major) 5500 7700 12900 17900 23400 06945 Scleral Tear Repair (Minor) 3500 4900 8200 11400 14900 07022 1000 1400 2400 3300 4300 06853 Telecanthus Reconstuction - Major 5600 7800 13200 18200 23800 06852 Telecanthus Reconstuction - Minor 2200 3100 5200 7200 9400 06854 Tumour Exc.with Reconstruction 4500 6300 10600 14600 19100 Lacrimal Apparatus 06971 Canaliculo Rhinostomy 5300 7400 12500 17200 22500 06972 D C R with Lacrimal Intubation 4700 6600 11000 15300 20000 06973 Dacryocycstectomy 2000 2800 4700 6500 8500 07027 Endoscopy Assisted NLD Intubation 7000 9800 16500 22800 29800 06862 Lacrimal Abscess & Drainage 1500 2100 3500 4900 6400 06833 Lacrimal Intubation 1000 1400 2400 3300 4300 06974 Lacrymal Syringing & Probing ( Under Endoscopic Guidance) 1000 1400 2400 3300 4300 07028 Punctal Cautery 500 700 1200 1600 2100 07029 Punctal plugs 1500 2100 3500 4900 6400 Lens 06912 Catract Extraction - GA 2800 3900 6700 9100 11900 06911 Catract Extraction - LA 2600 3600 6100 8500 11100 06920 ECCE with PC IOL 3600 5000 8500 11700 15300 06914 Extracapsular Cat.Ext. - GA 3000 4200 7100 9800 12800 06913 Extracapsular Cat.Ext. - LA 2800 3900 6600 9100 11900 07031 IOL explantation 1500 2100 3500 4900 6400 06915 Lensectomy - GA 3000 4200 7100 9800 12800 06815 Multifocal Implant 8000 11200 18800 26000 34000 06919 Phacoemulcilfication 7700 8000 11800 16300 21300 06922 Phacoemulcilfication (Non foldable) 5000 7000 11800 16300 21300

123 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

06816 Phakic IOL 8000 11200 18800 26000 34000 07032 Scleral fixated IOL 3500 4900 8200 11400 14900 06918 Secondary Implant 3000 4200 7100 9800 12800 06916 Small Insicion 4000 5600 9400 13000 17000 06921 Triple Procedure(Cataract + Trab) 4500 6300 10600 14600 19100 Operation on Conjunctiva 06807 Aminotic Membrane + Stem cell Transplants 4700 6600 11000 15300 20000 06806 Amniotic Mambrane Overlay 2000 2800 4700 6500 8500 06805 Conjunctiva Repair 2000 2800 4700 6500 8500 06801 Excision of Cysts/Tumours 1800 2500 4200 5900 7700 06802 Others Peritomy 1800 2500 4200 5900 7700 07016 Pterygium Excision With Graft 2500 3500 5900 8100 10600 06803 Pteryigium 1800 2500 4200 5900 7700 06804 Removal of Foreign Body in OT 1500 2100 3500 4900 6400 07017 Symblepheron Release 1800 2500 4200 5900 7700 Orbit & RB 07012 Extenteration of Orbit 4500 6300 10600 14600 19100 07015 Optic Nerve Sheath Decompression 6000 8400 14100 19500 25500 06864 Orbital Abscess 3300 4600 7800 10700 14000 07037 Orbital abscess - Minor 2800 3900 6600 9100 11900 07038 Orbital Implant 3000 4200 7100 9800 12800 07013 Orbitotomies 8000 11200 18800 26000 34000 07014 Reconstruction of Contracted Socket 4500 6300 10600 14600 19100

Retina 06820 Intra Vitreal - Major 2000 2800 4700 6500 8500 06819 Intra Vitreal - Minor 1500 2100 3500 4900 6400 06982 Laser Indirect - Major 1000 1400 2400 3300 4300 06983 Laser Indirect Ophthalmoscopy - Minor 700 1000 1600 2300 3000 06936 R O P Cyro 4500 6300 10600 14600 19100 06834 Retinal Detachment Surgery 12000 16800 28200 39000 51000 06817 ROP-LIO 10000 14000 23500 32500 42500 06948 Silicon Oil Exchange 2000 2800 4700 6500 8500 06831 Silicon Oil Removal 1800 2500 4200 5900 7700 06981 Silicon Oil Removal + Cataract Surgery 3500 4900 8200 11400 14900

124 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 06980 + Additional Procedures 14000 19600 32900 45500 59500 06835 Vitretctomy 10000 14000 23500 32500 42500 06935 Vitretctomy - Minor 3300 4600 7800 10700 14000 GENERAL 18053 Advanced Microscope Per Hour 800 1100 1900 2600 3400 18125 Amniotic Membrane 1500 1500 1500 1500 1500 18126 Anterior Chamber wash ( Paracentesis ) 500 700 1200 1600 2100 18052 Basic Microscope Per Hour 400 600 900 1300 1700 07099 Bilateral (50% of Proce./Surgery) 06857 EUA / Major 2500 3500 5900 8100 10600 06856 EUA / Minor 1000 1400 2400 3300 4300 07095 Extra Hours For Major + Surgery (D) 07094 Extra Hours For Major Surgery (C) 07093 Extra Hours For Minor + Surgery (B) 07092 Extra Hours For Minor Surgery (A) 07100 Extra Hours Taken For A Surgery 18051 Phaco And Microscope Per Hour 800 1100 1900 2600 3400 06865 Syringing 500 700 1200 1600 2100 18055 UVX Machine usage 20000 20000 20000 20000 20000 G. ORTHOPAEDICS Elbow - INTERMEIATE B1 07277 Below Elbow Amputation 7000 9800 16600 22800 29800 07380 Excision Head of Radius 6600 9100 15300 21100 27700 07381 Exploration/ 6600 9100 15300 21100 27700 07374 Intramedullary Nailing (Single Bone) 6000 8300 14100 19600 25600 07278 ORIF Radial Neck/ Head 5600 7700 12900 17900 23300 07386 - Elbow 7000 9800 16600 22800 29800 07388 Tennis Elbow Operation 6600 9100 15300 21100 27700 Elbow - INTERMEIATE B2 07378 Condylar Fracture Fixation 9000 12700 21200 29300 38300 07379 Excision Arthoplasty 9600 13300 22300 30900 34000 07377 for Open Fractures 8000 11200 18800 26000 38300 07382 French 9600 13300 22300 30900 40300 07375 Intramedullary Nailing (Both ) 9000 12700 21200 29300 40300 07383 Lateral Condylefixation 8000 11200 18800 26000 34000

125 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07384 Single Bone Fracture - ORIF with 7600 10600 17700 24300 31900 07385 Supracondylar Fracture Fixation 9600 13300 22300 30900 40300 07390 Ulnar Nerve Transposition 7600 10600 17700 24300 31900 Elbow - MAJOR C1 07279 Ender’S Nailing Humerus 9000 12700 21200 29300 38300 07373 Monteggia Fracture ORIF/Galezzi with ORIF 9000 12700 21200 29300 38300 07519 ORIF supracondylar fractures 9600 13400 22600 31200 40800 Elbow - MAJOR C2 07372 Fracture - Both Bones ORIF with Bone Grafting 13000 18200 30700 42300 55300 07520 Interposition Of 11600 16100 27000 37300 48900 07522 Malunited Fracture Dislocation 10000 14000 23500 32500 42500 07376 Non-Union of Forearm Fracture 13000 18200 30700 42300 55300 07521 Open Reduction Of Neglected Dislocation 11600 16100 27000 37300 48900 07387 8000 11200 18800 26000 34000 Elbow - SPECIALISED D1 07551 Complex Fracture Both Bones Orif 15000 21000 35300 48800 63800 Elbow - SPECIALISED D2 07523 Elbow(Procedure Includes Biopsy, Removal Ofloose Bodies, Debridement, Tennis Elbow, Arthoscopy Assistedradical Head / Capitulum Fracture Fixation) 20000 28000 47000 65000 85000 07281 ORIF Supracondylar + Intercondylar Fracture 20000 28000 47000 65000 85000 07389 Total - Elbow 25000 35000 58800 81300 106300 FOOT & ANKLE - MINOR A1 07103 Club Foot (CTEV) Manipulation 1500 2100 3500 4900 6400 07132 Stendler’S Release 3200 4600 7600 10300 13700 07555 Lateral Column Lengthening 1500 2100 3500 4900 6400 FOOT & ANKLE - MINOR A2 07101 Calcaneal Osteotomy 5800 8100 13700 18900 24700 07107 Kwiring of Fractures/Dislocation 5000 7000 11800 16300 21300 07102 Ray Amputation 3800 5300 8900 12300 16200 07122 Tendoachilles Lengthening 3800 5300 8900 12300 16200 07556 Tendoachilles Lengthening / Gastroc Release 3800 5300 8900 12300 16200 FOOT & ANKLE - INTERMEDIATE BI 07105 Hallux Valgus - Correction 7000 9800 16600 22800 29800 07140 Hallux Varus - Correction 6000 8300 14100 19600 25600

126 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07130 Lisfranks Amputation 5600 7700 12900 17900 23300 07138 Metatarsal Osteotomy 6000 8300 14100 19600 25600 07131 Orif Jones Fracture 5500 7700 12900 17900 23400 07109 Subtalar Fusion (Grice Green) 6600 9100 15300 21100 27700 07126 Unimalliolus Fracture - Ankle 5000 7000 11800 16300 21300 FOOT & ANKLE - INTERMEDIATE B2 07125 Non-Union Medial Malleolus Fracture 7000 9800 16600 22800 29800 07118 Repair of Tendoachilles 7000 9800 16600 22800 29800 07110 Talectomy 8000 11200 18800 26000 34000 FOOT & ANKLE - MAJOR C1 07114 - Foot & Ankle 10600 14700 24700 34100 44700 07121 Bimalleolar Fracture ORIF 8000 11200 18800 26000 34000 07113 Blair’s Fusion 10600 14700 24700 34100 44700 07490 Cong.Vertical Talus Surg. Correction 10600 14700 24700 34100 44700 07136 Open Reduction & Of Fracture Calcane 9000 12700 21200 29300 38300 07491 ORIF - Lisfranc Injury 9600 13300 22300 30900 40300 07129 ORIF Talus Fractures 9000 12700 21200 29300 38300 07570 Osteotomy at Midtarsal Joint 9600 13300 22300 30900 40300 07108 Posteromedial Soft Tissue Release for CTEV 8000 11200 18800 26000 34000 07135 Symes Amputation 9000 12700 21200 29300 38300 07134 Tenden Trans For Ft Drop 10600 14700 24700 34100 44700 07124 Trimalleolar Fracture ORIF 9000 12700 21200 29300 38300 07111 Triple Fusion 10600 14700 24700 34100 44700 FOOT & ANKLE - MAJOR C2 07127 CTEV Correction using JESS Ext 13000 18200 30700 42300 55300 07206 Fracture Dislocation Ankle 10000 14000 23600 32600 42600 07112 Pantalar Arthrodesis 10000 14000 23600 32600 42600 18002 Supramalleolar Osteotomy 10000 14000 23600 32600 42600 FOOT & ANKLE - Specialized D2 07531 Ankle Arthroscopy(Procedure Includes Biopsy-Removal Ofloose Bodies, Debridement,Haglund’S Disease,Impingementdecompression- Ostrigonum Excision/Decompression,Anterior,Chondroplasty,TA Repair 14000 19700 32900 45600 59600 07532 Ankle Fractures ORIF with Ligament Repair 14000 19700 32900 45600 59600 07207 Pilon Fracture Fixation 17000 23800 40000 55300 72300 FORE ARM - INTERMEDIATE B1 07351 Single Bone Fracture - ORIF 7000 9800 16500 22800 29800

127 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. FORE ARM - MAJOR C1 07352 Both Bones Fracture - ORIF 10600 14700 24700 34100 44700 07518 Fasciotomy - Major 10600 14700 24700 34100 44700 HIP - MINOR A2 07185 Closed Reduction of Hip Dislocation 2750 3800 6500 8900 11700 HIP - INTERMEDIATE B1 07189 Adductor Tenotomy 5000 7000 11800 16300 21300 07190 Iliopsoas Recession 8700 12200 20300 28300 37000 07557 Diangostic Hip Arthroplasty 5000 7000 11800 16300 21300 HIP - INTERMEDIATE B2 07173 Arthrotomy/Exploration - Hip 9600 13300 22300 30900 40300 07142 Core Decompression of Femoral Head 8000 11200 18800 26000 34000 07177 Excision Arthroplasty (Grindle Stone) 9000 12700 21200 29300 38300 HIP - MAJOR C1 07172 Arthrodesis - Hip 12000 16800 28200 39000 51000 07496 Fracture Dislocation Of Femoral Head 10600 14700 24700 34100 44700 07192 Non-Union Femoral Neck Fracture 12000 16800 28200 39000 51000 07191 Open Reduction for Dislocation of Hip 10600 14700 24700 34100 44700 07181 Around the Hip 12000 16800 28200 39000 51000 07183 Slipped Femoral Epiphysis Operation 12500 17500 29400 40600 53100 07182 V D O 11000 15300 25900 35800 46800 HIP - MAJOR C2 07175 Congential Dislocation Hip/Stabilization 14600 20300 34100 47100 61700 07534 Core Decompression And Fibular Grafting 11000 15300 25900 35800 46800 07176 Dynamic Hip Fixation - Richard’s 12000 16800 28200 39000 51000 07498 External Fixation For Pelvic Fractures 12000 16800 28200 39000 51000 07497 ORIF Pubicsymphysis 12000 16800 28200 39000 51000 07499 Sacroiliac joint ORIF 11000 15400 25760 35800 46800 HIP - Specialized D1 07179 Hemi Arthroplasty without Bone Cement-Austin Morre 15000 21000 35300 48800 63800 07144 Prox. Femoral Nailing 15000 21000 35300 48800 63800 HIP - SPECIALISED D2 07501 Complex Acetabular Fracture ORIF 28000 39200 65800 91000 119000 07535 Hip Arthroscopy(Procedure Includes Biopsy, Removal Of Loose Bodies, Debridement, Acetabulum Labrum Repair /Balancing, Decompression Of Impingement ) 20000 28000 47000 65000 85000

128 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07536 Modular Bipolar Arthoplasty 18000 25200 42300 58500 76500 07194 Open Reduction & Internal fixation of Fracture Acetabulum 24000 33600 56400 78000 102000 07569 Open Reduction Congenital Dislocation Hip With Pelvic Isteotomy 20000 28000 47000 65000 85000 07143 Reconstuction Nailing Of Femur 21000 29400 49400 68300 89300 07195 Total 26000 36400 61100 84500 110500 HIP - SPECIALISED D3TOTAL HIP REPLACEMENT - PACKAGE 07600 Total Hip Replacement (Package) 70000 98000 126000 154000 182000 KNEE - INTERMEDIATE B1 07252 Arthrotomy/Exploration - Knee 8000 11200 18800 26000 34000 07163 Collateral Ligament Repair 6000 8300 14100 19600 25600 07254 Hamstring Release 8000 11200 18800 26000 34000 07558 Patellar Pull 8000 11200 18800 26000 34000 07559 Semi T Transfer / Rectus Transfer 8000 11200 18800 26000 34000 KNEE - INTERMEDIATE B2 07582 Cannulated Screw Fix Of Femoral Condyle 10000 14000 23500 32500 42500 07273 Cannulated Screw Fix Of Femoral 10000 14000 23600 32600 42600 07255 High Tibial Osteotomy 11000 15300 25900 35800 46800 07272 Lateral Release For Patellas 9000 12700 21200 29300 38300 07257 Patellectomy or Fixation 9600 13300 22300 30900 40300 07258 Quadriceps Plasty 13000 18200 30700 42300 55300 07261 Stapling 11000 15300 25900 35800 46800 KNEE - MAJOR CI 07251 Arthrodesis - Knee 12000 16800 28200 39000 51000 07253 Condylar Plate Fixation 11000 15300 25900 35800 46800 07265 Diagnostic Arthroscopy - Knee 10000 14000 23600 32600 42600 07166 Femoral Unicondyle 9000 12700 21200 29300 38300 07486 High Tibial Osteotomy withh Fixation 11000 15300 25900 35800 46800 07164 ORIF Avulsion Fracture ACL 12000 16800 28200 39000 51000 07165 ORIF Avulsion Fracture PCL 12000 16800 28200 39000 51000 07264 Patella - TBW 9000 12600 21200 29300 38300 07509 Percutaneous Unicondylar Femoral Fixation 8000 11200 18800 26000 34000 07259 Recurrent Dislocation of Patella 11000 15300 25900 35800 46800 KNEE - MAJOR C2 07275 Arthoscopic Menisectomy 12000 16800 28200 39000 51000

129 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07269 Arthrodesis of Knee using Ilizarov 15000 21000 35300 48800 63800 07267 Arthroscopic Lavage 11000 15300 25900 35800 46800 07170 Arthroscopic Meniscal Repair 12000 16800 28200 39000 51000 07266 Arthroscopy & Proceedure - Knee 13600 18900 31700 43900 57300 07169 Femoral Bicondyle 11000 15300 25900 35800 46800 07270 Femural Condylar Fracture ORIF 13600 18900 31700 43900 57300 07563 Microfracture 11600 16100 27000 37300 48900 07271 Operation for Con dis Pat 15000 21000 35300 48800 63800 07510 Patellar Tendon Reconstruction 11000 15300 25900 35800 46800 KNEE - SPECIALISED D1 07268 ACL Reconstruction 17000 23800 40000 55300 72300 07198 Femoral Bondylar With Supracondylar Fracture 17000 23800 40000 55300 72300 07202 Knee Instability Reconstruction Procedures 17000 23800 40000 55300 72300 07197 PCL Reconstruction 20000 28000 47000 65000 85000 07203 Postero Lateral Corner Reconstruction 17000 23800 40000 55300 72300 KNEE - SPECIALISED D2 07199 Arthroscopic ACL Reconstruction 18000 25200 42300 58600 76600 07200 Arthroscopic PCL Reconstruction 17000 23800 40000 55300 72300 07201 Arthroscopic Stabilization Of Fractures 17000 23800 40000 55300 72300 07566 Arthroscopy MPFL repair - Knee 14000 19700 32900 45600 59600 07564 Mosaicplasty 15000 21000 35300 48800 63800 07565 OATS 15000 21000 35300 48800 63800 07572 PLC Reconstruction 16000 22300 37700 52000 68000 07263 Total Joint Replacement 22000 30800 51700 71500 93500 KNEE - SPECIALISED D3 07573 Augmented Arthoscopy ACL Reconstruction 25000 35000 58800 81300 106300 07543 Revision Arthoscopy ACL Reconstruction 26000 36300 61100 84600 110600 07544 Revision Arthoscopy PCL Reconstruction 26000 36300 61100 84600 110600 07542 Revision Total 30000 42000 70600 97600 127600 07545 Single Stage ACL PCL Reconstruction 25000 35000 58800 81300 106300 TOTAL KNEE REPLACEMENT - PACKAGE 07280 Total Knee Replacement (Package Per Knee)(For Terms & Conditions, Please Refer Charge Code:07600) 65000 91000 117000 143000 169000 LEG - INTERMEDIATE B1 07485 Fibular Grafting (SHIFT) 5000 7000 11800 16300 21300

130 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07146 Fibular Plating 5000 7000 11800 16300 21300 07233 Fibulectomy 6600 9100 15300 21100 27700 LEG - INTERMEDIATE B2 07221 Below Knee Amputation 8000 11200 18800 26000 34000 07227 Compartmental Release 8000 11200 18800 26000 34000 07502 Percutaneous Intercondylar Fixation 8000 11200 18800 26000 34000 07226 Postero Lateral Grafting 10000 14000 23600 32600 42600 LEG - MAJOR C1 07231 Clo Nailing For Tibial Fracture 10600 14700 24700 34100 44700 07222 Compression Plating of Tibia (DCP/Muller) 12000 16800 28200 39000 51000 07235 Enders Nailing - Leg 9000 12700 21200 29300 38300 07225 External Fixation for Tibial Fracture 9000 12700 21200 29300 38300 07148 Hungtington Procedure 9000 12700 21200 29300 38300 07229 Non-Union Tibia 12000 16800 28200 39000 51000 07228 ORIF for Tibial Condylar Fracture 10000 14000 23600 32600 42600 07147 Tibial Condylar Unicondyle 7000 9800 16500 22800 29800 LEG - MAJOR C2 07223 Congenital Pseudaorthrosis Tibia 13000 18200 30700 42300 55300 07503 Exchange Nailing 11000 15300 25900 35800 46800 07232 ORIF Tibial Fracture using Ili 15000 21000 35300 48800 63800 LEG - SPECIALIZED D1 07505 Congenital Pseudaorthrosis + Iiizarov 19000 26700 44700 61800 80800 07504 Congenital Pseudaorthrosis+Fibular Graft 19000 26700 44700 61800 80800 07234 Inter Locking Nailing - Leg 14000 19600 32900 45500 59500 07540 Locked Compression Plating (Leg) 15000 21000 35300 48800 63800 07507 MIPPO 16000 22400 37600 52000 68000 07230 Non-Union Tibia Fracture Using Ilizarov 19000 26700 44700 61800 80800 07506 Tibia-Multiple Osteotomies + If 18000 25200 42300 58600 76600 LEG - SPECIALIZED D2 07562 Polar Fracture with Tibial Shaft Fracture 22000 30800 51700 71600 93600 07583 MIPPO 22000 30800 51700 71600 93600 SHOULDER & ARM - MINOR A2 07480 Acromion Excision 6000 8400 14100 19500 25500 07332 Closed Reduction of Humerus Fractures 3000 4200 7100 9800 12800 18005 MUA 3000 4200 7100 9800 12800

131 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. SHOULDER & ARM - INTERMEDIATE B1 07322 Arthrotomy/Exploration - Shoulder & arm 10000 14000 23600 32600 42600 SHOULDER & ARM - INTERMEDIATE B2 07240 Above Elbow Amputation 7000 9800 16600 22800 29800 07239 Fixation Of Clavicle Fracture 9000 12600 21200 29300 38300 07330 Intramedullary Nailing Humerus 9600 13300 22300 30900 40300 07241 Proximal Humerus Fracture CR & Kwiring( CRIF) 7000 9800 16600 22800 29800 07326 Supraspinatus Tendinitis & Subacrominal Bursitis 9600 13300 22300 30900 40300 SHOULDER & ARM - MAJOR C1 07242 Arthroscopy & Lavage - Shoulder & Arm 9600 13300 22300 30900 40300 07329 Compression Plating of Humerus 11000 15300 25900 35800 46800 07335 Diagnostic Arthroscopy - Shoulder & Arm 10600 14700 24700 34100 44700 07333 External Fixation for Open Fractures of Humerus 7000 9800 16600 22800 29800 07331 Non-Union Fracture of Humerus 11000 15300 25900 35800 46800 07325 Recurrent Dislocation 12000 16800 28200 39000 51000 SHOULDER & ARM - MAJOR C2 07328 Acromioclavicular Joint Fixation + Ligament Repair 11600 16100 27000 37300 48900 07321 Arthodesis - Shoulder 14600 20300 34100 47100 61700 07244 Arthroscopic Frozen Shoulder Release 11600 16100 27000 37300 48900 07323 Forequarter Amputation 18800 26300 44200 61100 79900 07243 Interlocking Nailing of Humerus 10000 14000 23500 32500 42500 07324 Proximal Humerus Fracture ORIF 11000 15300 25900 35800 46800 SHOULDER & ARM - SPECIALISED D1 07247 Arthroscopic Rotator Cuff Repair 17000 23800 40000 55300 72300 07249 Arthroscopic Subacromal Decompression 16000 22300 37700 52000 68000 07334 Ilizarov Fixation For Non Union Humerus Fracture 20000 28000 47000 65000 85000 07549 Locked Compression Plating (Shoulder & Arm) 14000 19600 32900 45500 59500 SHOULDER & ARM - SPECIALISED D2 07568 Arthoscopic Repair Of AC Joint Instability 19000 26700 44700 61800 80800 07567 Arthoscopy Biceps Tenodesis 19000 26700 44700 61800 80800 07248 Arthroscopic Stabilization Of Shoulder Instability 19000 26700 44700 61800 80800 07245 Hemireplacement Of Shoulder 22000 30800 51700 71600 93600 07517 Neers Capsular Shift 19000 26700 44700 61800 80800 07513 Open Reduction Of Dislocation Of Shoulder 12000 16800 28200 39000 51000 07515 OR + IF Fracture Glenoid 18000 25200 42300 58600 76600

132 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07514 OR + IF Fracture Scapula 18000 25200 42300 58600 76600 07327 Total Joint Replacement - Shoulder & Arm 25000 35000 58800 81300 106300 SPINE - MINOR A2 07208 Closed Biopsy 3000 4200 7100 9800 12800 SPINE - INTERMEDIATE B2 07209 Biopsy - Open 5000 7000 11800 16300 21300 SPINE - MAJOR C1 07293 Cervical Rib Excision 10000 14000 23500 32500 42500 07295 Costo Transversecomy 15000 21000 35300 48800 63800 SPINE - MAJOR C2 07210 11000 15300 25900 35800 46800 SPINE - SPECIALIZED D1 07292 Anterolateral Decompression 19000 26600 44700 61800 80800 07213 Fenestration Disectomy 15000 21000 35300 48800 63800 07211 - Multiple 16000 22300 37700 52000 68000 07214 Pedicular Fixation Simple 16000 22400 37600 52000 68000 SPINE - SPECIALIZED D2 07219 A L I F 20000 28000 47000 65000 85000 07291 Anterior with Decompression 24000 33700 56300 78000 102000 07294 Correction Spinal Osteotomy & Fusion 25000 35000 58800 81300 106300 07297 Instrumentation & Spinal Fusion for Scoliosis 30000 42000 70600 97600 127600 07218 P L I F 18000 25200 42300 58600 76600 07220 Pedicular Fixation With Fusion 18000 25200 42300 58600 76600 07305 Recurrent Disc/Failed Back Syndrome 21000 29300 49300 68300 89300 07302 Spinal Fracture Reduction with Fixation 20000 28000 47000 65000 85000 07215 Surgical Correction Of Kyphosis 25000 35000 58800 81300 106300 07548 Vertebroplasty 19000 26700 44700 61800 80800 07584 Multi Level Decompression+ Instrumental Fixation 19000 26700 44700 61800 80800 SPINE - SPECIALIZED D3 07560 Anterior and Posterior Spinal Surgery 26000 36300 61100 84600 110600 18001 Anterolateral Decompression Instrumention & Fusion 26000 36300 61100 84600 110600 07561 Grade III/ IV Listhesis Surgery 26000 36300 61100 84600 110600 18000 Posterolateral Decompression Instrumention & Fusion 28000 39200 65800 91000 119000 THIGH - INTERMEDIATE B1 07159 A/C Osto. Femor Decompression 6000 8300 14100 19600 25600

133 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

07158 Exostoics Excision 6000 8300 14100 19600 25600 THIGH - INTERMEDIATE B2 07151 Above Knee Amputation 8000 11200 18800 26000 34000 THIGH - MAJOR C1 07152 Compression Plating of Femur (DCP/Muller) 11000 15300 25900 35800 46800 07162 Enders Nailing - Thigh 9000 12700 21200 29300 38300 07154 External Fixation for Femus Fractures 9000 12700 21200 29300 38300 THIGH - MAJOR C2 07492 DCP and Bone Grafting 14000 19700 32900 45600 59600 07493 Int. Locking Nailing + Bone Grafting 15000 21000 35300 48800 63800 07155 Non-Union Femur 13000 18200 30600 42300 55300 THIGH - SPECIALIZED D1 07161 Comp. Dis. For Non Le. Fe. 20000 28000 47000 65000 85000 07160 Iliza.Fix.For Op.Fem. Fr. 19000 26700 44700 61800 80800 07157 Int. Locking Nailing Femo 14000 19600 32900 45500 59500 07533 Locked Plating - Thigh 16000 22300 37700 52000 68000 07156 Non-Union Femur Using Ilyzarov 20000 28000 47000 65000 85000 THIGH - SPECIALIZED D2 07494 Exchange Nailing + Bone Grafting 18000 25200 42300 58600 76600 07141 Supracondylar Nailing 18000 25200 42300 58600 76600 WRIST - MINOR A2 07404 De Quervains Disease Decompression 4600 6300 10700 14700 19100 07405 Excision Of Lower End Of Ulna 4600 6300 10700 14700 19100 WRIST - INTERMEDIATE B1 07409 Barton’s Fracture ORIF 5600 7700 12900 17900 23300 07402 Bennet’s Fracutre Fixation 6600 9100 15300 21100 27700 07412 Ganglion Excision 4600 6300 10700 14700 19100 07283 Lunate Excision & Procedure 5600 7700 12900 17900 23300 07284 Metacarpel Fixation 5600 7700 12900 17900 23300 07407 Synovectomy/Arthrotomy/Exploration 9000 12700 21200 29300 37600 WRIST - INTERMEDIATE B2 07401 Arthodesis - Wrist 9600 13300 22300 30900 40300 07524 Closed Reduc+Percut Pinning Dis Rad & Ulnar Styloi 7000 9800 16500 22800 29800 07525 Mallet Finger 7000 9800 16600 22800 29800

134 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

07410 Orif Scaphoid Fracture 9600 13300 22300 30900 40300 WRIST - MAJOR C1 07286 Carpal Bone Fracture Dislocated (ORIF/ CRIF) 9000 12700 21200 29300 38300 07403 Carpal Tunnel Decompression 5000 7000 11800 16300 21300 07526 Malunited Distal Radius -Osteotomy & Procedure 9000 12700 21200 29300 38300 07411 Non-Union Scaphoid 10600 14700 24700 34100 44700 07527 Radial Shortening For Keinbocks 9000 12700 21200 29300 38300 WRIST - MAJOR C2 18007 Ligamento Taxis 12000 16800 28200 39000 51000 18006 Open TFCC Repair 12000 16800 28200 39000 51000 07406 Proximal Row Carpectomy 12000 16800 28200 39000 51000 WRIST - SPECIALISED D2 07553 Arthrodesis - Wrist 11000 15300 25900 35800 46800 07574 Arthroscopy & TFCC repair 13000 18200 30700 42300 55300 MISCELLANEOUS - MINOR A1 07431 Amputations - Minor 3200 4600 7600 10300 13700 07433 Application of Special Plasters/MJHSBS/Spica/FCB 2000 2800 4700 6600 8600 07434 Biopsy - Minor 2000 2800 4700 6600 8600 07437 Bone Graft - Minor 3200 4600 7600 10300 13700 07439 Closed Reduction of Fracture/Dislocations - Minor 3200 4600 7600 10300 13700 07442 Compression Bandage (Robert Tones) 2000 2800 4700 6600 8600 07288 Curratage Of Bone Tumor - Minor 2000 2800 4700 6600 8600 07446 Debridement - Minor 2000 2800 4700 6600 8600 07576 Dynamisation 2000 2800 4700 6600 8600 07296 Excision Of Tumor Minor 2000 2800 4700 6600 8600 07290 External Fixation Of Fracture - Minor 2000 2800 4700 6600 8600 07453 Intra Articular Injection in OT 2000 2800 4700 6600 8600 07454 Joint Aspiration 2000 2800 4700 6600 8600 07300 Nerve Repair - Minor 2000 2800 4700 6600 8600 07456 Non-Operative Mgmt.of Fracture (Balanced Traction) 2000 2800 4700 6600 8600 07457 Ordinary Plaster Cast Application 2000 2800 4700 6600 8600 07287 Osteotomy - Minor 2000 2800 4700 6600 8600 07462 PTB Plaster Application 2000 2800 4700 6600 8600 07306 Release Of Contracture - Minor 2000 2800 4700 6600 8600

135 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07464 Removal Implants - Minor 3000 4200 7100 9800 12800 07468 Skeletal Traction in OT 3200 4600 7600 10300 13700 07469 Skin Graft - Minor 3200 4600 7600 10300 13700 07471 Skin Traction 2000 2800 4700 6600 8600 07479 Skull Traction 3700 5200 8700 12000 15700 07472 Tendon Repair - Minor 3200 4600 7600 10300 13700 07475 Trigger Point Injection in OT 2000 2800 4700 6600 8600 07477 Wound Closure - Minor 2000 2800 4700 6600 8600 MISCELLANEOUS - MINOR A2 07441 Cold Abcess Drainage 3600 4900 8200 11300 14900 07474 Tenotomies - Major 7300 10300 17300 24100 31600 MISCELLANEOUS - INTERMEDIATE B1 07307 Amputations - Intermediate 5600 7700 12900 17900 23300 07308 Biopsy - Intermediate 5600 7700 12900 17900 23300 07309 Bone Graft - Intermediate 5600 7700 12900 17900 23300 07311 Closed Reduction Of Fracture/Dislocations-Inter 5600 7700 12900 17900 23300 07314 Curratage Of Bone Tumor - Intermediate 5600 7700 12900 17900 23300 07312 Debridement - Intermediate 5600 7700 12900 17900 23300 07317 Excision Of Tumor - Intermediate 5600 7700 12900 17900 23300 07316 External Fixation - Intermediate 5600 7700 12900 17900 23300 07315 Internal Fixation Of Fracture - Intermediate 5600 7700 12900 17900 23300 07318 Nerve Repair - Intermediate 5600 7700 12900 17900 23300 07458 Ordinary Plating Of Fractures 6600 9100 15300 21100 27700 07459 Osteomyelitis Acute Drainage 3800 5300 8900 12300 16200 07310 Osteotomy - Intermediate 5600 7700 12900 17900 23300 07320 Release Of Contracture - Intermediate 5600 7700 12900 17900 23300 07337 Removal Implants - Intermediate 5600 7700 12900 17900 23300 07466 Rib Resection 5600 7700 12900 17900 23300 07319 Tendon Repair - Intermediate 5600 7700 12900 17900 23300 07313 Wound Closure - Intermediate 5000 7000 11800 16300 21300 MISCELLANEOUS - MAJOR C1 07432 Amputations - Major 10600 14700 24700 34100 44700 07435 Biopsy - Major 7000 9800 16500 22800 29800 07436 Bone Block Surgery 10000 14000 23600 32600 42600

136 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07438 Bone Graft -Major 9000 12700 21200 29300 38300 07440 Closed Reduction Of Fracture/Dislocations - Major 8000 11200 18800 26000 34000 07340 Currattage Of Bone Tumor - Major 9000 12700 21200 29300 38300 07447 Debridement - Major 9000 12700 21200 29300 38300 07343 Excision Of Tumor - Major 9000 12700 21200 29300 38300 07342 External Fixation - Major 9000 12700 21200 29300 38300 07341 Internal Fixation Of Fracture - Major 9000 12700 21200 29300 38300 07344 Nerve Repair - Major 9000 12700 21200 29300 38300 07460 Osteomyelitis Chronic Medium Curttage&Auceusation 8600 11900 20000 27700 36100 07339 Osteotomy - Major 9000 12700 21200 29300 38300 07346 Release Of Contracture - Major 9000 12700 21200 29300 38300 07465 Removal Implants - Major 9000 12600 21200 29300 38300 07467 Rotation Flap 10600 14700 24700 34100 44700 07470 Skin Graft - Major 9000 12700 21200 29300 38300 07345 Tendon Repair - Major 9000 12700 21200 29300 38300 07473 Tendon Transfer - Major 10600 14700 24700 34100 44700 07338 Wound Closure - Major 7000 9800 16500 22800 29800 ORTHOPAEDIC PROCEDURE IN EMERGENCY 07577 Closed Reduction + Cast Application 5000 7000 11800 16300 21300 07578 Closed Reduction + Slab Application 5000 7000 11800 16300 21300 07580 Splinting (Long Bone Fracture,Short Bone Fracture, External Fixation) 5000 7000 11800 16300 21300 07579 Traction Application- Skin Or Skeletal 6000 8300 14100 19600 25600 SPECIALISED D2 07452 Ilizarov Instrumentation & Corticotomy for Lehgthn 20000 28000 47000 65000 85000 SPECIALISED D3 07581 Combined Complex Procedure 25000 35000 58800 81300 106300 GENERAL 18078 Advanced Microscope Per Hour 2000 2800 4700 6500 8500 18077 Basic Microscope Per Hour 1500 2100 3500 4900 6400 07598 Bilateral (50% Of Proce./Surgery) 18206 Enseal 07594 Extra Hours For Major + Surgery (D) 07593 Extra Hours For Major Surgery (C) 07592 Extra Hours For Minor + Surgery (B)

137 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07591 Extra Hours For Minor Surgery (A) 07599 Extra Hours Taken For A Surgery 07391 Fluroscopy Time upto 10 Minutes 600 690 780 870 960 07392 Fluroscopy Time upto 15 Minutes 700 800 910 1000 1120 07393 Fluroscopy Time upto 20 Minutes 800 920 1040 1160 1280 07394 Fluroscopy Time upto 30 Minutes 900 1040 1170 1300 1440 07395 Fluroscopy Time (Every Adnl.5Mts) 100 100 200 300 300 18079 Laparoscope Per Hour 600 800 1400 2000 2600 H. ENT EAR 07601 Atticotomy with 10000 14000 23500 32500 42500 07602 Aural Polypectomy 3000 4200 7100 9800 12800 07643 B A H A 35000 46000 07638 Biopsy - ENT 3000 4200 7100 9800 12800 07604 Cortical Mastoidectomy 10000 14000 23500 32500 42500 07603 Cortical Mastoidectomy with Tympanoplast 10800 15100 25400 35100 45900 07605 Ear Canal Reconstruction 8000 11200 18800 26000 34000 07607 Ear Lobe Repair - Both Ears 3000 4200 7100 9800 12800 07606 Ear Lobe Repair - One Ear 2000 2800 4700 6500 8500 07608 Endolymphatic Sac Decompression 15000 21000 35300 48800 63800 07636 Ex Glom.Jugtumlat.Trans-Temp. 20000 28000 47000 65000 85000 07634 Excis.Ofglom.Jug.Tum. Posta 16000 22400 37600 52000 68000 07633 Excis.Ofglom.Jug.Tum.Foramen 17000 23800 40000 55300 72300 07635 Excis.Ofglom.Jugu.Tum Intratym 13000 18200 30600 42300 55300 07611 F.B. Removal from the External Auditory Canal 3000 4200 7100 9800 12800 07610 F.B. Removal from the Middle Ear 3500 4900 8200 11400 14900 07609 Facial Nerve Decompression - Major 18000 25200 42300 58500 76500 07612 I & D Haematoma Auris 3000 4200 7100 9800 12800 07613 I & D Mastoid Abscess 9000 12600 21200 29300 38300 07639 Keratosis Obturan Removal 5000 7000 11800 16300 21300 07614 Labrinthectomy 13000 18200 30600 42300 55300 07644 M E I H D S 50600 65660 07615 Mid-Cranial Fossa Appr.to Internal Auditory Meatus 19000 26600 44700 61800 80800 07617 Mod.Radical Mastoidectomy w Tympanoplast 16000 22400 37600 52000 68000 07616 Modified Radical Mastoidectomy 17000 23800 40000 55300 72300

138 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07637 Myringoplasty (Transcanal) 9000 12600 21200 29300 38300 07620 5000 7000 11800 16300 21300 07619 Myringotomy with Gromet-Both Ears 8000 11200 18800 26000 34000 07618 Myringotomy with Gromet-One Ear 7000 9800 16500 22800 29800 07831 Otoendoscopic Stapedotomy 17000 23800 40000 55300 72300 07830 Otoendoscopic Surgery - Major 11000 15400 25900 35800 46800 07829 Otoendoscopic Surgery - Minor 10000 14000 23500 32500 42500 07641 P S C C Occlusion 10000 14000 23500 32500 42500 07621 Post-op. Exam. of Mid-Ear/Mastoid Cavity 7 Proce. 3000 4200 7100 9800 12800 07623 Pre-Auricular Sinus Excision - Both Sides 5000 7000 11800 16300 21300 07622 Pre-Auricular Sinus Excision - One Side 7000 9800 16500 22800 29800 07624 Radical Mastoidectomy 16000 22400 37600 52000 68000 07625 Revision Meatoplasty 6000 8400 14100 19500 25500 07626 17000 23800 40000 55300 72300 07627 Temporal Bone Resection - Partial 19000 26600 44700 61800 80800 07628 Temporal Bone Resection - Total 20000 28000 47000 65000 85000 07640 Trans Labrinthine acoustic neuroma excision 19000 26600 44700 61800 80800 07629 Trans Labrinthine vestibular Nerve Section 15000 21000 35300 48800 63800 07630 Tympanoplasty Type I 10000 14000 23500 32500 42500 07631 Tympanoplasty Type II 12000 16800 28200 39000 51000 07632 Tympanotomy 3500 4900 8200 11400 14900 NOSE 07651 Anterior Nasal Packing 2500 3500 5900 8100 10600 07653 Antral Wash - Both Sides 2000 2800 4700 6500 8500 07652 Antral Wash - One Side 2000 2800 4700 6500 8500 07656 Antrochaonal Polypectomy 6000 8400 14100 19500 25500 07657 Antroscopy 2000 2800 4700 6500 8500 07658 Antroscopy Polypectomy 6000 8400 14100 19500 25500 07659 Arterial Ligation on Epistaxis 8500 11900 20000 27600 36100 07660 Biopsy Nose 3000 4200 7100 9800 12800 07662 Caldwell Luc - Both Sides 7000 9800 16500 22800 29800 07661 Caldwell Luc - One Side 4500 6300 10600 14600 19100 07663 Canalization of Nose in Cong. Acq./after Young’s 2500 3500 5900 8100 10600 07689 Choanal Atresia - Transnasal - Bilateral 10000 14000 23500 32500 42500

139 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07690 Choanal Atresia - Transnasal - Unilateral 10000 14000 23500 32500 42500 07691 Choanal Atresia - Transpalatal - Bilateral 10000 14000 23500 32500 42500 07664 Closure of Oroantral Fistula 5500 7700 12900 17900 23400 07665 Cranio Facial Resection Malignancy of Nasal Cavity 20000 28000 47000 65000 85000 07666 Cranio-Facial Resection with Exenteration of Eye 20000 28000 47000 65000 85000 07668 Endoscopic Ethmoidectomy / FESS 16000 22400 37600 52000 68000 07833 Endoscopic Septal Surgery 15000 21000 35300 48800 63800 07670 Excision of Rhinoscleroma Rhinosporidium 10000 14000 23500 32500 42500 07672 External Fronto Ethmoidectomy - Both Sides 10000 14000 23500 32500 42500 07671 External Fronto Ethmoidectomy - One Side 8000 11200 18800 26000 34000 07675 F.B. Removal from Nose 3000 4200 7100 9800 12800 07697 Facial Translocation 21000 29400 49400 68300 89300 07673 Fracture Nasal Bone Reduction 7000 9800 16500 22800 29800 07655 Intranasal Antrostomy -Both Sides 3000 4200 7100 9800 12800 07654 Intranasal Antrostomy -One Side 3000 4200 7100 9800 12800 07678 Maxillectomy - Partial 17000 23800 40000 55300 72300 07679 Maxillectomy - Total 22000 30800 51700 71500 93500 07676 Maxillectomy with Excenteration of Eye Ball 14000 19600 32900 45500 59500 07677 Maxillectomy with Extended Cheek/Exci. & Reconst. 18000 25200 42300 58500 76500 07680 Nasal Endoscopic Examination 3000 4200 7100 9800 12800 07681 Obliterative Surgery of Frontal Sinus 10000 14000 23500 32500 42500 07682 Oroantral Fistula Closure with Caldwell Luc 9000 12600 21200 29300 38300 07683 Post-Nasal & Anter. Nasal Pack 5000 7000 11800 16300 21300 07684 with Nasal Tip 11000 15400 25900 35800 46800 07688 S.M.R. 12000 16800 28200 39000 51000 07685 Septal Abscess or Haematoma Drainage 6000 8400 14100 19500 25500 07696 Septo Rhinoplasty 18000 25200 42300 58500 76500 07686 12000 16800 28200 39000 51000 07836 Septoplasty/SMR + FESS 17000 23800 40000 55300 72300 07687 Sub-mucus Diathermy 6000 8400 14100 19500 25500 07692 Surgery for Choanal Atresia - Transpalatal -Unilat 12000 16800 28200 39000 51000 07693 Transnasal Ethmoidectomy 8000 11200 18800 26000 34000 07694 Turbinectomy 4000 5600 9400 13000 17000 07695 Young’s Operation 7000 9800 16500 22800 29800

140 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. THROAT NASO PHARYNX NASO PHARYNX 07715 Adenoidectomy 7000 9800 16500 22800 29800 07716 Biopsy Nasopharynx 7000 9800 16500 22800 29800 07834 Endoscopic Adenoidectomy 8000 11200 18800 26000 34000 07711 Excision of Angiofibroma - Lateral Rhinotomy 13000 18200 30600 42300 55300 07712 Excision of Angiofibroma - Lateral Temporal 13000 18200 30600 42300 55300 07713 Excision of Angiofibroma - Transnasal 18000 25200 42300 58500 76500 07714 Excision of Angiofibroma - Transpalatal 13000 18200 30600 42300 55300 ORAL CAVITY & ORO PHARYNX 07731 Biopsy Oral Cavity 3000 4200 7100 9800 12800 07733 Closure of Pharyngeal Fistula - Primary Local 12000 16800 28200 39000 51000 07732 Closure of Pharyngeal Fistula - with Flap 13000 18200 30600 42300 55300 07828 Electro Coagulation Tonsillectomy 10000 14000 23500 32500 42500 07735 Exci.of Ca.Cheek Pri. Local Clos. 12000 16800 28200 39000 51000 07737 Exci.of Ca.Cheek with Neck Dissection & Hemimundi. 24000 33600 56400 78000 102000 07738 Exci.of Ca.Cheek with Neck Reconstuctionwith Regl. Flap 17000 23800 40000 55300 72300 07740 Exci.of Hypopharyngeal Diverticulum by Exter.Appr. 12000 16800 28200 39000 51000 07736 Excis.of Ca.Cheek with Neck Dissection with Reconstuction 16000 22400 37600 52000 68000 07734 Excision of Benign Lesion in the Oral Cavity 8000 11200 18800 26000 34000 07739 Excision of Growth Epulis 7000 9800 16500 22800 29800 07741 Excision of Ranula 8000 11200 18800 26000 34000 07742 Excision of Small Growth Tongue Trans-orally 5000 7000 11800 16300 21300 07743 Hemiglossectomy Transal-oral with Local Closure 13000 18200 30600 42300 55300 07744 I & D of Peritonsillar Abscess 12000 16800 28200 39000 51000 07751 I & D of Retropharyngeal Abscess 11000 15400 25900 35800 46800 07745 Nasopharyngeal Examn. & Biopsy 3000 4200 7100 9800 12800 07746 Remvl.of Stone from Submandibular Duct Tran.Orally 3500 4900 8200 11400 14900 07750 Tongue Tie Release 5000 7000 11800 16300 21300 07747 Tonsillectomy 10000 14000 23500 32500 42500 07748 Tonsillectomy & Adeniodectomy T & A 12000 16800 28200 39000 51000 07749 Total Glossectomy with Neck Dissection & Reconstion 23000 32200 54100 74800 97800 LARYNX 07776 Arytenoidectomy 10000 14000 23500 32500 42500 07777 Cordectomy via Laryngo Fissure 10000 14000 23500 32500 42500

141 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07778 Dilatation of Larynx 5000 7000 11800 16300 21300 07779 Direct Laryngoscopy & Biopsy 11000 15400 25900 35800 46800 07780 Endoscopic Cord Lateralisation 10000 14000 23500 32500 42500 07781 Excision of Laryngocole 12000 16800 28200 39000 51000 07832 Injection Thyroplasty 11000 15400 25900 35800 46800 07771 with Modified Neck Dissection 21000 29400 49400 68300 89300 07772 Laryngectomy with Radical Neck Dissection 23000 32200 54100 74800 97800 07773 Laryngo Fissure and Procedures 10000 14000 23500 32500 42500 07782 Lateral or Extended Fronto Lateral Laryngectomy 15000 21000 35300 48800 63800 07783 Micro Surgery of Larynx 13000 18200 30600 42300 55300 07784 Reconstruction Surgery of Larynx 11000 15400 25900 35800 46800 07774 Sub-total Laryngectomy 17000 23800 40000 55300 72300 07785 Supraglottic Laryngectomy 15000 21000 35300 48800 63800 07786 Supraglottic Laryngectomy with Radical Neck Diss. 15000 21000 35300 48800 63800 07787 Suspension Laryngoscopic Proc. 6000 8400 14100 19500 25500 07788 Teflon Inj. to Paralysed Cord 6000 8400 14100 19500 25500 07775 Total Laryngectomy 20000 28000 47000 65000 85000 07789 Total Laryngopharyngo Esophagectomy w Gastric Pull 25000 35000 58800 81300 106300 07791 Vertical Laryngectomy with Laryngoplasty 15000 21000 35300 48800 63800 07792 Woodman’s Operation 10000 14000 23500 32500 42500 NECK 07811 Cricopharyngeal Myotomy 9000 12600 21200 29300 38300 07812 Excision Biopsy of Lymph Node 7000 9800 16500 22800 29800 07813 Excision of Branchial Cyst 12000 16800 28200 39000 51000 07814 Excision of Branchial Fistula 12000 16800 28200 39000 51000 07815 Excision of Submandibular Gland 16000 22400 37600 52000 68000 07816 Excision of Thyroglossal Cyst. 15000 21000 35300 48800 63800 07817 Excision of Thyroglossal Fistula 12000 16800 28200 39000 51000 07818 Hemi Thyroidectomy 17000 23800 40000 55300 72300 07819 I & D of Neck Abscess 13000 18200 30600 42300 55300 07820 I & D of Submandibular Abscess 8000 11200 18800 26000 34000 07821 Mod. Neck Dissection 16000 22400 37600 52000 68000 07822 Radical Neck Dissection 16000 22400 37600 52000 68000 07823 Styloid Process Excision 10000 14000 23500 32500 42500 07824 Supra Omohyoid Dissection 12000 16800 28200 39000 51000

142 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

07825 Thyroidectomy - Total 21000 29400 49400 68300 89300 07826 Total Thyroidectomy with Neck Dissection 23000 32200 54100 74800 97800 07827 Wedge Biopsy Neck Node 6000 8400 14100 19500 25500 OESOPHAGUS 07854 Cervical Oesophagostomy 5000 7000 11800 16300 21300 07851 Dilatation of Oesophageal Stri. 4000 5600 9400 13000 17000 07852 Oesophagoscopy Biopsy/Removal of Foreign Body 10000 14000 23500 32500 42500 TRACHEA & 07875 Bronchoscopy for Biopsy - Removal of Foreign Body 8000 11200 18800 26000 34000 07871 Cervical Tracheal Stenosis Exci.& End to End Anast 20000 28000 47000 65000 85000 07872 TE Puncture 7000 9800 16500 22800 29800 07873 TE Puncture with Myotomy 8000 11200 18800 26000 34000 07874 Tracheostomy in OT/ICU/Emergency 8000 11200 18800 26000 34000 CONSERVATIVE PROCEDURES 07933 Bronchoscopy-Video Endoscope 6000 8400 14100 19500 25500 07912 Graft of Ear & Nose 10000 14000 23500 32500 42500 08010 Coblation - Adenoidectomy 10000 14000 23500 32500 42500 08014 Coblation - Laryngeal/Tracheal Surgery 10000 14000 23500 32500 42500 08011 Coblation - Tonsillectomy 10000 14000 23500 32500 42500 08013 Coblation - Turbinate 10000 14000 23500 32500 42500 08012 Coblation - UPPP 10000 14000 23500 32500 42500 07799 DCR Surgery-Major 12000 16800 28200 39000 51000 07809 Digital Imaging 100 100 100 200 200 07951 Endoscopic Angiofibroma Excision 22000 30800 51700 71500 93500 07918 Endoscopic Closure of CSF Fistula 20000 28000 47000 65000 85000 07794 Endoscopic Ear Surgery -Major 15000 21000 35300 48800 63800 07919 Endoscopic Nasal Cauterization 4000 5600 9400 13000 17000 07950 Endoscopic Pituitary Excision 22000 30800 51700 71500 93500 07949 Endoscopic Skull Base Surgery Major 25000 35000 58800 81300 106300 07946 Endoscopic Sphenopalatine Artery Ligation 15000 21000 35300 48800 63800 07945 Endoscopic Vidian Neurectomy 12000 16800 28200 39000 51000 07921 Extended FESS 12000 16800 28200 39000 51000 07796 FESS-Major 15000 21000 35300 48800 63800 07795 FESS-Minor 9000 12600 21200 29300 38300

143 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07955 Follow Up Laryngeal Surgery 5000 7000 11800 16300 21300 07953 Frontal Sinus Surgery 8000 11200 18800 26000 34000 07943 Hyoid Suspension 12000 16800 28200 39000 51000 07915 Intra Tympanic Gm Inj. 3000 4200 7100 9800 12800 07891 Laryngo - Tracheal Injury Exploration & Repair 12000 16800 28200 39000 51000 07929 Laser Assisted Laryngeal Surgery-Major 10000 14000 23500 32500 42500 07928 Laser Assisted Laryngeal Surgery-Minor 5000 7000 11800 16300 21300 07931 Laser Assisted Stapedotomy 9000 12600 21200 29300 38300 07925 Laser Assited Nasal Surgery-Major 10000 14000 23500 32500 42500 07924 Laser Assited Nasal Surgery-Minor 5000 7000 11800 16300 21300 07927 Laser with FESS-Major 10000 14000 23500 32500 42500 07926 Laser with FESS-Minor 5000 7000 11800 16300 21300 07944 Lateral Canthotomy 10000 14000 23500 32500 42500 07936 L-Tousillectomy 10000 14000 23500 32500 42500 07935 LUAP 10000 14000 23500 32500 42500 07937 Maxillary Sinus Trephination 7000 9800 16500 22800 29800 07800 METP-Type1 10000 14000 23500 32500 42500 07801 METP-Type2 14000 19600 32900 45500 59500 07802 METP-Type3 16000 22400 37600 52000 68000 08009 Microdebrider Assisted Adenoidectomy 10000 14000 23500 32500 42500 08008 Microdebrider Assisted Laryngeal Surgery 10000 14000 23500 32500 42500 07923 Microdebrider Use 1500 2100 3500 4900 6400 07958 Microflab Laryngeal Surgery 10000 14000 23500 32500 42500 07920 Mini FESS 9000 12600 21200 29300 38300 07952 Modified Lothrops Procedure 15000 21000 35300 48800 63800 07804 Neck Exploration-Major 15000 21000 35300 48800 63800 07803 Neck Exploration-Minor 8000 11200 18800 26000 34000 07934 Oesophagoscopy -Video Endoscope 5000 7000 11800 16300 21300 07911 Optic Nerve Decompression 17000 23800 40000 55300 72300 07893 Para Pharyngal Benign Lesion Excision - Cervical 20000 28000 47000 65000 85000 07892 Para Pharyngal Benign Lesion Excision 20000 28000 47000 65000 85000 07913 Parotidectomy - Superficial 21000 29400 49400 68300 89300 07914 Parotidectomy - Total 23000 32200 54100 74800 97800 07806 Phono Surgery-Major 10000 14000 23500 32500 42500 07805 Phono Surgery-Minor 6000 8400 14100 19500 25500

144 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 07940 RF Adenoidectomy 15000 21000 35300 48800 63800 07942 RF Base Tongue Reduction 15000 21000 35300 48800 63800 07941 RF IT Reduction 14000 19600 32900 45500 59500 07939 RFVPP (Radio Frequency Palate Uvulo Palate Pharyngoplasty) 16000 22400 37600 52000 68000 07922 Septal Button Insertion 3000 4200 7100 9800 12800 07957 Sialendoscopy (Diagnostic) 5000 7000 11800 16300 21300 07956 Sialendoscopy (Therapeutic) 6000 8400 14100 19500 25500 07797 Sphenoid Sinus Surgery 10000 14000 23500 32500 42500 07916 T. Tube Insertion 8000 11200 18800 26000 34000 07894 Thyroplasty Medialisation of Cord 10000 14000 23500 32500 42500 07917 Tracheal Dilatation 5000 7000 11800 16300 21300 07930 Tracheal Surgery Laser Assisted 5000 7000 11800 16300 21300 07808 Tracheal Surgery - Major 18000 25200 42300 58500 76500 07807 Tracheal Surgery - Minor 8000 11200 18800 26000 34000 07932 Tracheoscopy/Video Laryngoscopy 8000 11200 18800 26000 34000 07896 Vidian Neurectomy - Transantral 10000 14000 23500 32500 42500 07895 Vidian Neurectomy - Transnasal 10000 14000 23500 32500 42500 ENT-COCHLEAR IMPLANT PACKAGE 07642 Cochlear Implant Package 150000 Package Includes Package Does not Include 1) Stay Charges for 9 days of Hospitalisation. 1) Cost of Implants. 2) All Routine Lab Investigations. 2) Diet 3) All Operation charges. 4) All Routine Drugs for 9 days 5) C.T. & M.R.I. Scan 6) Audiological Investigations (Pre & Post). 7) First 12 sessions of Auditory Verbal Therapy

PACKAGES 08001 Tonsillectomy/Adenotonsillectomy 6000 Package Includes Package Does not Include

1. All Hospitalization charges. 1. Cost of implantable devices if any 2. All Routine Lab Investigations - 2. Cost of ICU stay if any l Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet 3. All Operation charges 4. All Routine Drugs - l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 days l IV Pantocid 40 mg OD x 5-7 days l IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 days l Betadine / Mucobenz mouth gargles TID X 5-7 days l Solspre nasal spray 3 puffs Q4H X 10-15 days l 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 days 5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when needed l X-ray Lateral view soft tissue nasopharynx, CXR

145 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 08002 Septoplasty /SMR 6000

Package Includes Package Does not Include

1. All Hospitalization charges. 1. Cost of implantable devices if any 2. All Routine Lab Investigations 2. Cost of ICU stay if any l Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet 3. All Operation charges 4. All Routine Drugs l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 days l IV Pantocid 40 mg OD x 5-7 days l IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 days l Solspre nasal spray 3 puffs Q4H X 10-15 days l 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 days l Nasowash saline washes TID x 10-15 days 5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when needed l CT - PNS CXR, X-Ray PNS 08003 Tympanoplasty 6000

Package Includes Package Does not Include

1. All Hospitalization charges. 1. Cost of implantable devices if any 2. All Routine Lab Investigations 2. Cost of ICU stay if any l Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet 3. All Operation charges 4. All Routine Drugs l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 days l IV Pantocid 40 mg OD x 5-7 days l IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 days l Tab Stugeron 25 mg SOS (when required) 5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when needed l CT – temporal bone (if required), X-ray mastoid CXR, PTA, Impedance audiometry

08004 ME + TP 8000

Package Includes Package Does not Include

1. All Hospitalization charges. 1. Cost of implantable devices if any 2. All Routine Lab Investigations 2. Cost of ICU stay if any l Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet 3. All Operation charges 4. All Routine Drugs l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 days l IV Pantocid 40 mg OD x 5-7 days l IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 days l Tab Stugeron 25 mg SOS (when required) 5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when needed l CT – temporal bone (if required), X-ray mastoid, CXR,. PTA, Impedance audiometry

146 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 08005 Tracheostomy 6000

Package Includes Package Does not Include

1. All Hospitalization charges. 1. Cost of implantable devices if any 2. All Routine Lab Investigations 2. Cost of ICU stay if any l Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet 3. All Operation charges 4. All Routine Drugs l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 days l IV Pantocid 40 mg OD x 5-7 days l IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 days l Saline nebulisation tid x 5-7 days 5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when needed l CT, MRI (optional) CXR, X-ray lat. View soft tissue neck.

08006 FESS 6000

Package Includes Package Does not Include 1. All Hospitalization charges. 1. Cost of implantable devices if any 2. All Routine Lab Investigations 2. Cost of ICU stay if any l Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet 3. All Operation charges 4. All Routine Drugs l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 days l IV Pantocid 40 mg OD x 5-7 days l IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 days l Solspre nasal spray 3 puffs Q4H X 10-15 days l 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 days l Nasowash saline washes TID x 10-15 days 5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when needed l CT - PNS, CXR, X-Ray PNS 08007 Septoplasty/SMR + FESS 8000

Package Includes Package Does not Include 1. All Hospitalization charges. 1. Cost of implantable devices if any 2. All Routine Lab Investigations 2. Cost of ICU stay if any l Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet 3. All Operation charges 4. All Routine Drugs l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 days l IV Pantocid 40 mg OD x 5-7 days l IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 days l Solspre nasal spray 3 puffs Q4H X 10-15 days l 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 days l Nasowash saline washes TID x 10-15 days 5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when needed l CT - PNS CXR, X-Ray PNS

147 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. GENERAL 18062 Advanced Microscope Per Hour 660 1320 1980 2640 3300 18061 Basic Microscope Per Hour 330 660 990 1320 1650 07999 Bilateral (50% of Proce./Surgery) 07835 Coblation Assisted Surgery 5000 7000 9000 11000 12000 07837 Coblation Instrument charges 18207 Enseal 07995 Extra Hours For Major + Surgery (D) 07994 Extra Hours For Major Surgery (C) 07993 Extra Hours For Minor + Surgery (B) 07992 Extra Hours For Minor Surgery (A) 08000 Extra Hours Taken For A Surgery 18063 Laparoscope Per Hour 660 990 1650 1980 2640 I. NEURO SURGERY 08092 Burrhole (Therapeutic) 7200 10100 16900 23400 30600 08222 Exploratory Burrhole & Proceed (GA) 11000 15400 25900 35800 46800 BASE OF THE SKULL SURGERY 08053 Base of Skull Procedures - Microsurgical 38500 53900 90500 125100 163600 08125 Carotid End Arterectomy - Microsurgical 22000 30800 51700 71500 93500 08126 STMC Anastomosis - Microsurgical 27500 38500 64600 89400 116900 CRANIAL SURGERY - MINOR 08062 Crainotomy/MIS(Under GA) 16500 23100 38800 53600 70100 08219 Cranial Reconstruction 24200 33900 56900 78700 102900 08100 Cranioplasty 9400 13200 22100 30600 40000 08236 Cranioplasty (Complex) 11600 16200 27300 37700 49300 08204 Mini Craniotomy 17600 24600 41400 57200 74800 08095 Scalp Rotation Flap 6100 8500 14300 19800 25900 CRANIAL SURGERY - INTERMEDIATE 08099 Extradural/ Bony Decompressive Procedures 11000 15400 25900 35800 46800 08050 Microsurgical Cranial Procedure(Intermediate) 18700 26200 43900 60800 79500 08101 Re-exploration (Same Admission) 8800 12300 20700 28600 37400 08098 Surface Tumors 13200 18500 31000 42900 56100 CRANIAL SURGERY - MAJOR 08078 Brain Tumors (Endoscope / Image Guided/Assisted) 27500 38500 64600 89400 116900 08216 Complex Cranial (Microsurgical) 41800 58500 98200 135900 177700 08157 Deep Brain Leisions - Minimally Invasive Microsurical 19800 27700 46500 64400 84200

148 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 08077 Deep Brain Tumor (Complex, Microsurgical) 23100 32300 54300 75100 98200 08103 Sub-Occipital Craniectomy 14300 20000 33600 46500 60800 CRANIAL SURGERY - SPECIALISED 08120 Endoscopic Surgery 12100 16900 28400 39300 51400 08121 Endoscopic Surgery (Therapeutic) 16500 23100 38800 53600 70100 08156 Head Injury - Duroplasty/Debridement 27500 38500 64600 89400 116900 08116 Head Injury - Major 22000 30800 51700 71500 93500 08052 Head Injury (Complex) 27500 38500 64600 89400 116900 08237 Head Injury With Haematoma 38500 53900 90500 125100 163600 08112 Percutaenous Vertebroplasty - Ga 8400 11800 19700 27300 35700 SHUNTS 08128 Lumbo- Peritoneal 11000 15400 25900 35800 46800 08238 Microsurgical Infratentorial Surgery 19800 27700 46500 64400 84200 08239 Newer Device/ Imported Shunt 22000 30800 51700 71500 93500 08130 Revision 5500 7700 12900 17900 23400 08054 Shunt Assisted With Guiding Device 16500 23100 38800 53600 70100 08127 Ventriculo Peritoneal 8800 12300 20700 28600 37400 SPINAL SURGERY 08134 Explantation 6100 8500 14300 19800 25900 08147 Laminectomy Simple 9100 12700 21400 29600 38700 08143 Micro Lumbar Disectomy / Fenestration 9900 13900 23300 32200 42100 SPINAL SURGERY - INTERMEDIATE 08138 Instrumentation (Simple) 11000 15400 25900 35800 46800 08079 Micro Surgical Spinal Procedure 18200 25500 42800 59200 77400 08221 Microsurgical Laminectomy/ 14900 20900 35000 48400 63300 08139 Re-exploration (Same Admission) 9900 13900 23300 32200 42100 SPINAL SURGERY - MAJOR 08217 Complex Spinal Fusion (Image Guided And Microsurgical) 41800 58500 98200 135900 177700 08081 Complex Spinal Surgery 19800 27700 46500 64400 84200 08144 Instrumentation (Complex) 14300 20000 33600 46500 60800 08161 Instrumentation With Microscope 18700 26200 43900 60800 79500 08061 Micro Lumbar Disectomy (Complex) 24800 34700 58300 80600 105400 08056 Microsurgical Disc Surgery 13200 18500 31000 42900 56100 08201 Spinal Fusion 24200 33900 56900 78700 102900 OTHER NEUROSURGERIES 08214 Cranial Surgery For Stroke 27500 38500 64600 89400 116900 08210 Cranial Synangosis / Vascular Anastomosis 15400 21600 36200 50100 65500

149 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 08200 Csf Diversion Procedure 18700 26200 43900 60800 79500 08247 Debridement - Simple 1700 2400 4000 5500 7200 08240 Decompressive Cranial Surgery 22000 30800 51700 71500 93500 08226 Dsa Guided Intervention (Complex) 17600 24600 41400 57200 74800 08225 Dsa Guided Intervention (Simple) 15400 21600 36200 50100 65500 08215 Endoscopic Ventriculostomy 23100 32300 54300 75100 98200 08232 Epilepsy Surgery (Image Guided) 22000 30800 51700 71500 93500 08233 Epilepsy Surgery With Ecog 33000 46200 77600 107300 140300 08245 Haematoma Drainage - Major 22000 30800 51700 71500 93500 08234 Hemispheretomy 22000 30800 51700 71500 93500 08212 Microsurgical Cranial 30800 43100 72400 100100 130900 08213 Microsurgical Spinal 33000 46200 77600 107300 140300 08249 Microvascular Decompression (Microsurgical) 27500 38500 64600 89400 116900 08149 Minimal Invasive Procedure - GA 14300 20000 33600 46500 60800 08155 Nerve Entrapment Release 8400 11800 19700 27300 35700 08246 Neurolysis Complex ( Major) 11000 15400 25900 35800 46800 08159 Peripheral Nerve Surgery - Microsurgical 13200 18500 31000 42900 56100 08241 Peripheral Nerve Surgery -Complex 16500 23100 38800 53600 70100 08191 Spinal Extra Dural Tumor 13800 19300 32400 44900 58700 08248 Surgery For Brachial Plexus 22000 30800 51700 71500 93500 08206 Surgery For Epilepsy - Duration - 2 Hours 4700 6600 11000 15300 20000 08207 Surgery For Epilepsy Duration - 4 Hours 9600 13400 22600 31200 40800 08208 Surgery For Epilepsy Duration - 6 Hours 14300 20000 33600 46500 60800 08209 Surgery For Epilepsy Duration - 8 Hours 18700 26200 43900 60800 79500 08227 Surgery For Neuro Device Implantation 22000 30800 51700 71500 93500 08152 Total Vertebroplasty 22000 30800 51700 71500 93500 PROCEDURES DONE UNDER L .A. 08179 4 Vessel Angio 8300 11600 19500 27000 35300 08059 Biopsy - Neurosurgery (L.A) 5000 7000 11800 16300 21300 08178 Cerebral Angiography(Regional) 4600 6400 10800 15000 19600 08058 Crainotomy/Mis 17600 24600 41400 57200 74800 08167 Epidural Procedure 2200 3100 5200 7200 9400 08223 Exploratory Burrhole & Proceed (La) 8800 12300 20700 28600 37400 08083 External Venticular Drainage 6100 8500 14300 19800 25900 08174 Haematoma Drainage 8800 12300 20700 28600 37400 08231 ICP Monitoring 4400 6200 10300 14300 18700 08243 Incission & Drainage / Dressing 1100 1500 2600 3600 4700

150 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 08230 Intracranial Catheter Placement (La) 6600 9200 15500 21500 28100 08203 Mini Craniotomy Under L.A 19800 27700 46500 64400 84200 08194 Minimal Invasive Procedure (La) Cranial / Spinal 13200 18500 31000 42900 56100 08168 Nerve Block 2000 2800 4700 6500 8500 08086 Nerve Block (Simple) 3300 4600 7800 10700 14000 08088 Neurolysis 7200 10100 16900 23400 30600 08173 Percutaneous Image Guided - Complex 4400 6200 10300 14300 18700 08166 Rhizotomy ( Each Level) 2200 3100 5200 7200 9400 08242 Scalp Tumor - Large 9900 13900 23300 32200 42100 08176 Scalp Tumor - Small 5000 7000 11800 16300 21300 08085 Stereotactic Localiser 9900 13900 23300 32200 42100 08060 Stereotactic Procedure - Major 22000 30800 51700 71500 93500 08228 Surgery For Neuro Device Implantation 16500 23100 38800 53600 70100 08193 Trefine Craniotomy 7700 10800 18100 25000 32700 08087 Twist Drill 3300 4600 7800 10700 14000 08084 Urokinase Instillation 6600 9200 15500 21500 28100 08172 Ventricular Drianage 2200 3100 5200 7200 9400 08165 Vertebroplasty ( Each Level) 2800 3900 6600 9100 11900 08170 Wound Repair 2000 2800 4700 6500 8500 GENERAL 18008 Microscope ( 0 to 2 Hours ) 1100 1500 2600 3600 4700 18009 Microscope ( 2 to 3 Hours ) 1700 2400 4000 5500 7200 18010 Microscope ( 3 to 5 Hours ) 2200 3100 5200 7200 9400 18011 Microscope (More Than 5 Hours) 3300 4600 7800 10700 14000 18074 Advanced Microscope Per Hour 900 1300 2100 2900 3800 18073 Basic Microscope Per Hour 400 600 900 1300 1700 18208 Enseal 08250 Navigation - Minor Procedure 6000 8400 10800 13200 15600 08251 Navigation - Major procedure 12000 16800 21600 26400 31200 J. PLASTIC SURGERY AESTHETIC SURGERY 21841 Abdominoplasty - Major 20000 28000 47000 65000 85000 21840 Abdominoplasty - Minor 12000 16800 28200 39000 51000 21955 Abdominoplasty (Moderate) 15000 21000 35300 48800 63800 21842 Abdominoplasty Extensive 26000 36300 61100 84600 110600 21851 Alopecia Reduction - Major 20000 28000 47000 65000 85000 21849 Alopecia Reduction - Minor 5600 7700 12900 17900 23300 21850 Alopecia Reduction- Moderate 12000 16800 28200 39000 51000 21836 Blepharoplasty - Major 12000 16800 28200 39000 51000 21835 Blepharoplasty - Minor 5600 7700 12900 17900 23300

151 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21837 Blepharoplasty - Minor (Bilateral) 10000 14000 23500 32500 42500 21954 Blepharoplasty Bilateral - Major 16000 22400 37600 52000 68000 22001 Blepharoplasty Bilateral Minor 10000 14000 23500 32500 42500 21844 Body Contouring - Major 20000 28000 47000 65000 85000 21843 Body Contouring - Minor 12000 16800 28200 39000 51000 21845 Body Contouring Extensive 32000 44800 75200 104000 136000 21834 Brow Lift - Major 16000 22300 37700 52000 68000 21833 Brow Lift - Minor 9600 13300 22300 30900 40300 21847 Dermabrasion - Major 7000 9800 16600 22800 29800 21846 Dermabrasion - Minor 4000 5700 9300 13000 17000 21848 Dermabrasion Extensive 16000 22300 37700 52000 68000 21839 Face Lift - Major 20000 28000 47000 65000 85000 21838 Face Lift - Minor 12000 16800 28200 39000 51000 21959 Facelift (Moderate) 16000 22400 37600 52000 68000 21956 Fat Grafting - Minor 5000 7000 11800 16300 21300 21958 Fat Grafting - Major 15000 21000 35300 48800 63800 21957 Fat Grafting (Moderate) 10000 14000 23500 32500 42500 21854 Hair Transplant - Major 26000 36300 61100 84600 110600 21852 Hair Transplant - Minor 5600 7700 12900 17900 23300 22002 Hair Transplant - Small 2000 2800 4700 6500 8500 21853 Hair Transplant - Moderate 12000 16800 28200 39000 51000 21831 Liposuction - Major 13000 18200 30700 42300 55300 21829 Liposuction - Minor 4000 5700 9300 13000 17000 21830 Liposuction - Moderate 6000 8300 14100 19600 25600 21832 Liposuction- Extensive 20000 28000 47000 65000 85000 AVF 21969 AVF Secondary Procedure - Major 15000 21000 35300 48800 63800 21968 AVFSecondary Procedure - Minor 10000 14000 23500 32500 42500 21950 Avfistula creation - Major 10000 14000 23500 32500 42500 21949 Avfistula creation - Minor 6000 8400 14100 19500 25500 21951 Rexploration for AVF 2000 2800 4700 6500 8500 22018 Superficialization - Minor 8000 11200 18800 26000 34000 22019 Superficialization - Major 12000 16800 28200 39000 51000 BRACHIAL PLEXUS 21749 Brachial Plexu Surgery - Minor 17000 23800 40000 55300 72300 21752 Brachial Plexus - Ancillary Procedures 8000 11200 18800 26000 34000 21751 Reconstruction Extensive 30000 42000 70600 97600 127600

152 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21750 Reconstruction - Major 24000 33700 56300 78000 102000 BREAST 21787 Gynaecomastia Excision Bilateral - Major 20000 28000 47000 65000 85000 21786 Gynaecomastia Excision Bilateral - Minor 12000 16800 28200 39000 51000 21785 Gynaecomastia Exision Unilateral - Major 16000 22300 37700 52000 68000 21784 Gynaecomastia Exision Unilateral - Minor 5600 7700 12900 17900 23300 21960 Gynecomastia Unilateral - Moderate 10000 14000 23500 32500 42500 21961 Gynecomastia Bilateral - Moderate 15000 21000 35300 48800 63800 BREAST RECONSTRUCTION 21801 Augmentation Mammoplasty Bilateral - Major 24000 33700 56300 78000 102000 21799 Augmentation Mammoplasty Bilateral - Minor 10000 14000 23600 32600 42600 21800 Augmentation Mammoplasty Bilateral - Moderate 20000 28000 47000 65000 85000 21798 Augmentation Mammoplasty Unilateral - Major 20000 28000 47000 65000 85000 21796 Augmentation Mammoplasty Unilateral - Minor 7600 10600 17700 24300 31900 21797 Augmentation Mammoplasty Unilateral - Moderate 14000 19700 32900 45600 59600 21962 Breast Reconstruction - Moderate 15000 21000 35300 48800 63800 21789 Breast Reconstruction - Major 29000 40700 68200 94300 123300 21788 Breast Reconstruction - Minor 10000 14000 23600 32600 42600 21963 Implant Removal - Moderate 10000 14000 23500 32500 42500 21807 Implant Removal - Major 15600 21700 36300 50300 65900 21806 Implant Removal - Minor 4600 6300 10700 14700 19100 21805 Nipple Reconstruction Bilateral - Major 20000 28000 47000 65000 85000 21804 Nipple Reconstruction Bilateral - Minor 10000 14000 23600 32600 42600 21803 Nipple Reconstruction Unilateral - Major 11000 15300 25900 35800 46800 21802 Nipple Reconstruction Unilateral - Minor 5600 7700 12900 17900 23300 21795 Reduction Mammoplasty Bilateral - Major 35000 49000 82300 113800 148800 21793 Reduction Mammoplasty Bilateral - Minor 13000 18200 30700 42300 55300 21794 Reduction Mammoplasty Bilateral - Moderate 25000 35000 58800 81300 106300 21792 Reduction Mammoplasty Unilateral - Major 20000 28000 47000 65000 85000 21790 Reduction Mammoplasty Unilateral - Minor 7600 10600 17700 24300 31900 21791 Reduction Mammoplasty Unilateral - Moderate 14000 19700 32900 45600 59600 CLEFT LIP PALATE AND CRANIOFACIAL CLEFTS 21965 Alveolar Bone Graft - Moderate 12000 16800 28200 39000 51000 21913 Alveolar Bone Graft - Major 16000 22300 37700 52000 68000 21912 Alveolar Bone Graft - Minor 8600 11900 20000 27700 36100 21899 Bilateral Cleft Lip -Complex 20000 28000 47000 65000 85000 21898 Bilateral Cleft Lip -Moderate 12000 16800 28200 39000 51000

153 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21897 Bilateral Cleft Lip - Minor 7600 10600 17700 24300 31900 21964 Cleft Palate And Flap - Major 24000 33600 56400 78000 102000 21903 Cleft Palate Repair And Flap - Minor 16000 22300 37700 52000 68000 21902 Cleft Palate Repair-Complex 20000 28000 47000 65000 85000 21901 Cleft Palate Repair - Major 12000 16800 28200 39000 51000 21900 Cleft Palate Repair - Minor 7600 10600 17700 24300 31900 21916 Facial Cleft Complex 24000 33700 56300 78000 102000 21915 Facial Cleft - Major 16000 22300 37700 52000 68000 21914 Facial Cleft - Minor 9600 13300 22300 30900 40300 21904 Lip And Palate In One 20000 28000 47000 65000 85000 21910 Pharyngeal Flap 12000 16800 28200 39000 51000 21953 Secondary Correction Of Nose - Major 16000 22400 37600 52000 68000 21908 Secondary Correction Of Nose - Minor 7600 10600 17900 24700 32300 21952 Secondary Correction Of Nose Moderate 12000 16800 28200 39000 51000 21907 Secondary Lip Correction Complex 24000 33700 56300 78000 102000 21906 Secondary Lip Correction - Major 16000 22300 37700 52000 68000 21905 Secondary Lip Correction - Minor 7600 10600 17700 24300 31900 21909 Sphincter Pharyngoplasty 9600 13300 22300 30900 40300 21892 Suture Removalin OT - Minor 1600 2100 3600 4900 6300 21896 Unilateral Cleft Lip And Nose 24000 33700 56300 78000 102000 21895 Unilateral Cleft Lip - Complex 20000 28000 47000 65000 85000 21893 Unilateral Cleft Lip - Minor 7600 10600 17700 24300 31900 21894 Unilateral Cleft Lip-Moderate 12000 16800 28200 39000 51000 21911 VPI Correction Complex 24000 33700 56300 78000 102000 CONGENITAL LIMB DEFORMITY 21779 Congenital Limb Deformity - Major 13000 18200 30700 42300 55300 21777 Congenital Limb Deformity - Minor 4600 6300 10700 14700 19100 21778 Congenital Limb Deformity -Moderate 8600 11900 20000 27700 36100 21966 Congenital Hand Deformity ( Complex) 16000 22400 37600 52000 68000 CONTRACTURES 21664 Contracture + Flap - Minor 6600 9100 15300 21100 27700 21663 Contracture Release+SSG-Extensive 17000 23800 40000 55300 72300 21662 Contracture Release+SSG Major 8000 11200 18800 26000 34000 21660 Contracture Release+SSG- Minor 4000 5700 9300 13000 17000 21661 Contracture Release+SSG-Moderate 6000 8300 14100 19600 25600 21666 Contracture+ Flap - Major 18000 25200 42300 58600 76600 21665 Contracture+ Flap- Moderate 9600 13300 22300 30900 40300

154 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. CRANIOFACIAL SURGERY 21882 Bi- Jaw Surgery Total 32000 44800 75200 104000 136000 21862 Bone Graft - Extensive 32000 44800 75200 104000 136000 21861 Bone Graft - Major 20000 28000 47000 65000 85000 21859 Bone Graft - Minor 7600 10600 17700 24300 31900 21860 Bone Graft- Moderate 12000 16800 28200 39000 51000 21870 Cranioplasty - Major 20000 28000 47000 65000 85000 21868 Cranioplasty - Minor 7600 10600 17700 24300 31900 21869 Cranioplasty-Moderate 16000 22300 37700 52000 68000 21890 Facial Assymetry Correction Complex 48000 67200 112800 156000 204000 21889 Facial Assymetry Correction - Major 39000 54700 91700 126800 165800 21875 Facial Bipartition 39000 54700 91700 126800 165800 21858 Facial Contouring - Complex 26000 36300 61100 84600 110600 21856 Facial Contouring - Minor 7600 10600 17700 24300 31900 21857 Facial Contouring - Moderate 16000 22300 37700 52000 68000 21871 Frontal Advancement 20000 28000 47000 65000 85000 21888 Genioplasty - Complex 16000 22300 37700 52000 68000 21887 Genioplasty - Simple 9600 13300 22300 30900 40300 21872 Hypertelorism:Extra Cranial Correction 26000 36300 61100 84600 110600 21873 Hypertelorism:Intra Cranial Correction 32000 44800 75200 104000 136000 21878 Le Fort I Advancement 12000 16800 28200 39000 51000 21879 Le Fort Ii , Iii Advancement 24000 33700 56300 78000 102000 21874 Mono Block Advancement 32000 44800 75200 104000 136000 21967 Orbital Reconstruction - Moderate 16000 22300 37700 52000 68000 21864 Orbital Reconstruction - Major 20000 28000 47000 65000 85000 21863 Orbital Reconstruction - Minor 9000 12700 21200 29300 38300 21881 Sagittal Split Mandible - Bilateral 18000 25200 42300 58500 76500 21880 Sagittal Split Mandible Unilateral 9600 13300 22300 30900 40300 21877 Segmental Osteotomy Multiple 16000 22300 37700 52000 68000 21876 Segmental Osteotomy Single 9600 13300 22300 30900 40300 21867 Skull Base Reconstruction Complex 24000 33700 56300 78000 102000 21866 Skull Base Reconstruction - Major 16000 22300 37700 52000 68000 21865 Skull Base Reconstruction - Minor 9600 13300 22300 30900 40300 21855 Strip Craniectomy 8600 11900 20000 27700 36100 21886 TMJ Ankylosis - Bilateral (Complex) 24000 33700 56300 78000 102000 21884 TMJ Ankylosis - Unilateral (Complex) 16000 22300 37700 52000 68000 21885 TMJ Ankylosis -Bilateral 20000 28000 47000 65000 85000

155 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21883 TMJ Ankylosis -Unilateral 9600 13300 22300 30900 40300 21891 Total Craniofacial Correction 60000 84000 141000 195000 255000 DIVISION AND INSET 21970 Flap Division And Inset - Moderate 6600 9200 15500 21500 28100 EAR RECONSTRUCTION 21932 Ear Lobe Repair - Bilateral 3000 4200 5400 6600 7800 21933 Ear Lobe Repair - Unilateral 2000 2800 3600 4400 5200 21724 Ear Reconstruction - Complex 26000 36300 61100 84600 110600 21723 Ear Reconstruction - Major 14000 19700 32900 45600 59600 21721 Ear Reconstruction - Minor 5000 7000 11800 16300 21300 21722 Ear Reconstruction - Moderate 9600 13300 22300 30900 40300 21725 Ear Reconstruction-Single Stage - Minor 20000 28000 47000 65000 85000 21971 Ear Reconstruction Single Stage - Major 35000 49000 82300 113800 148800 EXCISION AND RESURFACING 21541 Excision And Resurfacing-Complex 26000 36300 61100 84600 110600 21540 Excision And Resurfacing - Major 13000 18200 30700 42300 55300 21538 Excision And Resurfacing - Minor 3000 4200 7100 9800 12800 21539 Excision And Resurfacing-Moderate 6300 8800 14800 20600 26800 EXCISIONS 21535 Excisions - Minor 2600 3600 5900 8100 10700 21536 Excisions-Moderate 6000 8300 14100 19600 25600 21537 Excsions - Major 12000 16800 28200 39000 51000 EYES 21693 Canthoplasty (Complex) 22000 30800 51700 71600 93600 21692 Canthoplasty - Major 14000 19700 32900 45600 59600 21691 Canthoplasty - Minor 6000 8300 14100 19600 25600 21703 Deepening Of Contracted Eye Socket - Major 15000 21000 35300 48800 63800 21702 Deepening Of Contracted Eye Socket - Minor 10000 14000 23600 32600 42600 21690 Ectropion Release (Re-Surfacing Each Eye) 9600 13300 22300 30900 40300 21695 Eyebrow Reconstruction - Major 12000 16800 28200 39000 51000 21694 Eyebrow Reconstruction - Minor 7600 10600 17700 24300 31900 21698 Reconstruction - Major 16600 23100 38800 53700 70100 21696 Eyelid Reconstruction - Minor 6000 8300 14100 19600 25600 21697 Eyelid Reconstruction Moderate 10000 14000 23600 32600 42600 21689 Eyelid Repair - Major 12000 16800 28200 39000 51000 21688 Eyelid Repair - Minor 4600 6300 10700 14700 19100 21701 Ptosis Correction - Major 14000 19700 32900 45600 59600

156 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21700 Ptosis Correction - Minor 10000 14000 23600 32600 42600 21699 Total Eyelid Reconstruction 22000 30800 51700 71600 93600 21973 Eyelid Repair - Moderate 8000 11200 18800 26000 34000 21974 Ectropion Release - Minor 5000 7000 11800 16300 21300 21975 Total Eyelid Reconstruction - Minor 5000 7000 11800 16300 21300 FACE 21687 Facial Laceration - Complex 14000 19700 32900 45600 59600 21686 Facial Laceration - Major 10000 14000 23600 32600 42600 21685 Facial Laceration - Minor 4000 5700 9300 13000 17000 21976 Facial Laceration - Moderate 6000 8300 14100 19600 25600 FLAPS 21546 Flaps - Minor 4000 5700 9300 13000 17000 21549 Flaps-Complex 25000 35000 58800 81300 106300 21548 Flaps - Major 15000 21000 35300 48800 63800 21547 Flaps-Moderate 10000 14000 23600 32600 42600 21550 Division And Inset - Minor 2000 2800 4700 6600 8600 21937 Division And Inset - Moderate 6600 9200 15500 21500 28100 21553 Flaps Delay - Major 5000 7000 11800 16300 21300 21552 Flaps Delay - Minor 2000 2800 4700 6600 8600 21543 Flap Reelevation - Major 5000 7000 11800 16300 21300 21542 Flap Reelevation - Minor 2000 2800 4700 6600 8600 21545 Flap Thinning - Major 10000 14000 23600 32600 42600 21544 Flap Thinning - Minor 3000 4200 7100 9800 12800 21947 Flap Thinning - Moderate 6000 8400 14100 19500 25500 21551 Division And Inset - Major 10000 14000 23500 32500 42500 21972 Flap Thinning - Moderate 6000 8400 14100 19500 25500 GENITALIA RECONSTRUCTION 21811 Fistula Correction - Single - Minor 4600 6300 10700 14700 19100 21810 Fistula Correction Multiple - Minor 14000 19700 32900 45600 59600 21814 Genitalia Reconstruction - Major 15000 21000 35300 48800 63800 21812 Genitalia Reconstruction - Minor 4600 6300 10700 14700 19100 21813 Genitalia Reconstruction - Moderate 8000 11200 18700 25800 33800 21809 Hypospadias Correction - Major (Single Stage) 15000 21000 35300 48800 63800 21808 Hypospadias Correction - Minor (Each Stage) 7600 10600 17700 24300 31900 21977 Hypospadiasis Correction - Moderate Each Stage 10000 14000 23600 32600 42600 21978 Fistula Correction Single - Moderate 8000 11200 18700 25800 33800 21979 Gentalia Reconstruction ( Complex) 26000 36300 61100 84600 110600

157 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. HAND 21986 Carapl Tunnel Release ( Open - Minor) 4000 5600 9400 13000 17000 21942 Carpal Tunnel Release - Major 8000 11200 18800 26000 34000 21941 Carpal Tunnel Release - Minor 4000 5700 9300 13000 17000 21928 Carpal Tunnel Release Endoscopic 12000 16800 21600 26400 31200 21929 Carpal Tunnel Release Open - Major 7000 9800 12600 15400 18200 22015 Composite Reconstruction - Major 20000 28000 47000 65000 85000 22013 Composite Reconstruction - Minor 10000 14000 23500 32500 42500 22014 Composite Reconstruction - Moderate 15000 21000 35300 48800 63800 21996 Duputren’S Contracture Fasciectomy - Minor 4000 5600 9400 13000 17000 21998 Duputrens’S Contracture Fasciectomy - Major 12000 16800 28200 39000 51000 21997 Duputrens’S Contracture Fasciectomy - Moderate 8000 11200 18800 26000 34000 21766 Finger Reconstruction - Complex 20000 28000 47000 65000 85000 21765 Finger Reconstruction - Major 15000 21000 35300 48800 63800 21763 Finger Reconstruction - Minor 5000 7000 11800 16300 21300 21764 Finger Reconstruction - Moderate 10000 14000 23600 32600 42600 21769 Fracture Fixation - Major 15000 21000 35300 48800 63800 21767 Fracture Fixation - Minor 4000 5700 9300 13000 17000 21768 Fracture Fixation - Moderate 10000 14000 23600 32600 42600 21782 Hand Infection - Major 8000 11200 18700 25800 33800 21780 Hand Infection - Minor 1800 2600 4200 5900 7700 21781 Hand Infection - Moderate 4600 6300 10700 14700 19100 21783 Hand Infection - Complex 15000 21000 35300 48800 63800 21758 Hand Resurfacing - Complex 33000 46200 77700 107300 140300 21757 Hand Resurfacing - Major 20000 28000 47000 65000 85000 21755 Hand Resurfacing - Minor 6000 8300 14100 19600 25600 21756 Hand Resurfacing -Moderate 10000 14000 23600 32600 42600 21762 Joint Reconstruction - Complex 26000 36300 61100 84600 110600 21761 Joint Reconstruction - Major 14000 19700 32900 45600 59600 21759 Joint Reconstruction - Minor 2800 3900 6700 9100 11900 21760 Joint Reconstruction - Moderate 7000 9800 16600 22800 29800 21980 Ligamentotaxis 5000 7000 11800 16300 21300 21931 Revision Amputation - Multiple Fingers 8000 11200 18800 26000 34000 21930 Revision Amputation - Single Finger 4000 5600 9400 13000 17000 22011 Tendon Grafting Stage 2- Minor 6000 8400 14100 19500 25500 22010 Tendon Grafting Stage 1- Major 6000 8400 14100 19500 25500 22009 Tendon Grafting Stage 1- Minor 2000 2800 4700 6500 8500

158 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 22012 Tendon Grafting Stage 2- Major 15000 21000 35300 48800 63800 22008 Tendon Grafting Single Stage - Major 15000 21000 35300 48800 63800 22006 Tendon Grafting Single Stage - Minor 5000 7000 11800 16300 21300 22007 Tendon Grafting Single Stage - Moderate 10000 14000 23500 32500 42500 21772 Tendon Repair - Major 11000 15300 25900 35800 46800 21770 Tendon Repair - Minor 4600 6300 10700 14700 19100 21771 Tendon Repair-Moderate 8000 11200 18800 26000 34000 21983 Tendon Transfer - Major 15000 21000 35300 48800 63800 21981 Tendon Transfer - Minor 6000 8400 14100 19500 25500 21982 Tendon Transfer - Moderate 10000 14000 23500 32500 42500 21985 Tenolysis - Major 8000 11200 18800 26000 34000 21984 Tenolysis - Minor 4000 5600 9400 13000 17000 22016 Ulnar Nerve Transposition 6000 8400 14100 19500 25500 21776 Wrist Injury - Complex 26000 36300 61100 84600 110600 21775 Wrist Injury - Major 21000 29300 49300 68300 89300 21773 Wrist Injury - Minor 10000 14000 23600 32600 42600 21774 Wrist Injury - Moderate 15000 21000 35300 48800 63800 LIP 21727 Lip Injury - Major 10000 14000 23600 32600 42600 21726 Lip Injury - Minor 4600 6300 10700 14700 19100 21730 Lip Reconstruction - Complex 22000 30800 51700 71600 93600 21729 Lip Reconstruction - Major 16000 22300 37700 52000 68000 21728 Lip Reconstruction - Minor 10000 14000 23600 32600 42600 21733 Macrostomia Correction - Major 14000 19700 32900 45600 59600 21731 Microstomia - Minor 4600 6300 10700 14700 19100 21732 Microstomia - Major 14000 19700 32900 45600 59600 21948 Microstomia - Moderate 8000 11200 18800 26000 34000 21987 Macrostomia Correction - Minor 8000 11200 18800 26000 34000 LYMPHEDEMA SURGERY 21753 Lymphedema Excision 11000 15300 25900 35800 46800 21754 Microlymphatic Surgery 26000 36300 61100 84600 110600 MAXILLO FACIAL INJURIES 21672 Ach Bar Fixation-Segmental 2600 3600 5900 8100 10700 21673 Arch Bar Fixation-Complete 3800 5300 8900 12300 16200 21675 Arch Bar Removal 1800 2600 4200 5900 7700 21671 Cap Splint Application 3000 4200 7100 9800 12800 21670 Dental Impressions Under GA 2000 2800 4700 6600 8600

159 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21668 Elevation -Nasal Bone - Major 8000 11200 18800 26000 34000 21667 Elevation -Nasal Bone - Minor 4000 5700 9300 13000 17000 21674 Eyelets & IMF 2800 3900 6700 9100 11900 21681 Maxillo Facial Fracture Fixation-Extensive 24000 33700 56300 78000 102000 21680 Maxillo Facial Fracture Fixation - Major 15000 21000 35300 48800 63800 21678 Maxillo Facial Fracture Fixation - Minor 6000 8300 14100 19600 25600 21679 Maxillo Facial Fracture Fixation - Moderate 10000 14000 23600 32600 42600 21988 Miniplate Removal - Moderate 6000 8300 14100 19600 25600 21677 Miniplate Removal - Major 11000 15300 25900 35800 46800 21676 Miniplate Removal - Minor 3000 4200 7100 9800 12800 21684 Pan Facial Fracture Fixation - Major 38000 53200 89300 123600 161600 21683 Pan Facial Fracture Fixation - Moderate 20000 28000 47000 65000 85000 21682 Pan Facial Fracture Fixation - Minor 13000 18200 30700 42300 55300 21669 Zygoma Elevation 4000 5700 9300 13000 17000 MICRO SURGERY 22017 Finger Revision Amputation - Minor 2000 2800 4700 6500 8500 21934 Microvascular Flap Transfer - Minor 10000 14000 23600 32600 42600 21736 Microvascular Flap Transfer - Complex 41000 57300 96300 133300 174300 21734 Microvascular Flap Transfer - Limited 17000 23800 40000 55300 72300 21735 Microvascular Flap Transfer - Moderate 29000 40700 68200 94300 123300 21745 Nerve Reconstruction - Major 11000 15300 25900 35800 46800 21744 Nerve Reconstruction - Minor 6000 8300 14100 19600 25600 21746 Nerve Reconstruction - Complex 22000 30800 51700 71600 93600 21748 Reexploration - Major 7600 10600 17700 24300 31900 21747 Reexploration - Minor 1800 2600 4200 5900 7700 21738 Replant - Major 22000 30800 51700 71600 93600 21737 Replant - Minor 15000 21000 35300 48800 63800 21739 Replant - Complex 37000 51800 87000 120300 157300 21742 Revascularisation - Major 20000 28000 47000 65000 85000 21740 Revascularisation - Minor 5000 7000 11800 16300 21300 21743 Revascularisation - Complex 34000 47700 79900 110600 144600 21741 Revascularisation - Limited 10000 14000 23600 32600 42600 NOSE 21716 Alar Correction - Major 16000 22300 37700 52000 68000 21715 Alar Correction - Minor 10000 14000 23600 32600 42600 21713 Augumentation With Graft - Major 20000 28000 47000 65000 85000 21712 Augumentation With Graft - Minor 14000 19700 32900 45600 59600

160 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21714 Augumentation With Graft - Complex 30000 42000 70600 97600 127600 21711 Partial Nasal Reconstruction - Major 22000 30800 51700 71600 93600 21709 Partial Nasal Reconstruction - Minor 9600 13300 22300 30900 40300 21710 Partial Nasal Reconstruction - Moderate 14000 19700 32900 45600 59600 21708 Reduction Rhinoplasty - Major 22000 30800 51700 71600 93600 21707 Reduction Rhinoplasty - Minor 12000 16800 28200 39000 51000 21989 Reduction Rhinoplasty - Moderate 16000 22400 37600 52000 68000 22005 Secondary Correction of Nose - Major 16000 22400 37600 52000 68000 22003 Secondary Correction of Nose - Minor 8000 11200 18800 26000 34000 22004 Secondary Correction of Nose - Moderate 12000 16800 28200 39000 51000 21990 Septorhinoplasty - Minor 5000 7000 11800 16300 21300 21991 Septorhinoplasty - Major 15000 21000 35300 48800 63800 21717 Septorhinoplasty - Moderate 10000 14000 23600 32600 42600 21718 Septorhinoplasty Plus CCG 24000 33700 56300 78000 102000 21719 Single Stage Total Nasal Reconstruction 33000 46200 77700 107300 140300 SCAR REVISION 21559 GBLE Complex 13000 18200 30700 42300 55300 21558 Geometric Broken Line Excision - Minor 6600 9100 15300 21100 27700 21557 Scar Revision - Complex 26000 36300 61100 84600 110600 21556 Scar Revision - Major 14000 19700 32900 45600 59600 21554 Scar Revision - Minor 4000 5700 9300 13000 17000 21555 Scar Revision - Moderate 10000 14000 23600 32600 42600 WOUNDS AND BURNS 21946 Collagen Application - Major 15000 21000 35300 48800 63800 21944 Collagen Application - Minor 5000 7000 11800 16300 21300 21945 Collagen Application - Moderate 10000 14000 23500 32500 42500 21513 Debridement - Extensive 10000 14000 23600 32600 42600 21512 Debridement - Major 8000 11200 18800 26000 34000 21510 Debridement - Minor 2000 2800 4700 6600 8600 21511 Debridement - Moderate 4000 5700 9300 13000 17000 21992 Dressing - Extensive 6000 8400 14100 19500 25500 21509 Dressing - Major 4800 6700 11300 15700 20300 21508 Dressing Moderate 3000 4200 7100 9800 12800 21507 Dressing - Minor 1600 2100 3600 4900 6300 21504 Extensive Suturing 10000 14000 23600 32600 42600 21531 Fasciotomy - Major 5000 7000 11800 16300 21300 21530 Fasciotomy - Minor 1800 2600 4200 5900 7700

161 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 21521 Homograft Harvest - Major 4600 6300 10700 14700 19100 21519 Homograft Harvest - Minor 1800 2600 4200 5900 7700 21520 Homograft Harvest - Moderate 2800 3900 6700 9100 11900 21534 Implant Removal - Major 8000 11200 18800 26000 34000 21532 Implant Removal - Minor 3000 4200 7100 9800 12800 21533 Implant Removal - Moderate 4600 6300 10700 14700 19100 21995 Incision And Drainage - Major 10000 14000 23500 32500 42500 21993 Incision And Drainage - Minor 2000 2800 4700 6500 8500 21994 Incision And Drainage - Moderate 5000 7000 11800 16300 21300 21528 Limb Amputation - Major 12000 16800 28200 39000 51000 21526 Limb Amputation - Minor 4600 6300 10700 14700 19100 21527 Limb Amputation - Moderate 10000 14000 23500 32500 42500 21529 Limb Amputation (Multiple) 18000 25200 42300 58600 76600 21503 Major Suturing 4600 6300 10700 14700 19100 21501 Minor Suturing 2000 2800 4700 6600 8600 21502 Moderate Suturing 3000 4200 7100 9800 12800 21514 SSG - Small area 2000 2800 4700 6600 8600 21518 SSG - Extensive 13000 18200 30700 42300 55300 21515 SSG - Limited area 4000 5700 9300 13000 17000 21517 SSG - Major 10000 14000 23600 32600 42600 21516 SSG - Moderate 6000 8303 14100 19600 25600 21506 Suture Removal in OT - Moderate 2600 3600 5900 8100 10700 21505 Suture Removal in OT - Minor 1600 2100 3600 4900 6300 21522 Tangential Excision - Minor 8000 11200 18800 26000 34000 21525 TE - Extensive 28000 39200 65800 91000 119000 21524 TE - Major 16000 22300 37700 52000 68000 21523 TE - Moderate 12000 16800 28200 39000 51000 GENERAL 18082 Advanced Microscope Per Hour 800 1100 1900 2600 3400 21926 Artery Biopsy 2600 3640 4680 5720 6760 18081 Basic Microscope Per Hour 400 600 900 1300 1700 21819 Body Piercing - Minor 3000 4200 7100 9800 12800 21820 Body Piercing - Moderate 4600 6300 10700 14700 19100 21821 Body Piercing - Complex 11000 15300 25900 35800 46800 21935 Double Tissue Biopsy 4000 5700 9300 13000 17000 21999 Examination under anaesthesia ( EUA) 1000 1400 2400 3300 4300 21818 Intraleisonal Steroid - Minor 1800 2600 4200 5900 7700

162 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

21927 Muscle Biopsy 2000 2800 3600 4400 5200 21828 Nerve Biospy - Major 6600 9100 15300 21100 27700 21826 Nerve Biospy - Minor 2600 3600 5900 8100 10700 21827 Nerve Biospy - Moderate 4000 5700 9300 13000 17000 21924 Scelerotherapy 2600 3600 5900 8100 10700 21943 Tissue Biopsy 2700 3700 6100 8500 11100 21940 Tissue Expansion Stage 2 - Major 14000 19600 32900 45500 59500 21938 Tissue Expansion Stage 2 - Minor 10000 14000 23500 32500 42500 21939 Tissue Expansion Stage I - Major 10000 14000 23500 32500 42500 22000 Tissue Expansion Stage I - Minor 4000 5600 9400 13000 17000 21936 Triple Tissue Biopsy 6600 9100 15300 21100 27700 K. PAEDIATRIC SURGERY CNS 09001 Encephalocele Repair 14000 19600 32900 45500 59500 09002 Laminectomy 24000 33600 56400 78000 102000 09003 Meningomyelocol and Meningocoel Repair 16000 22400 37600 52000 68000 09004 V.P. Shunt 14000 19600 32900 45500 59500 09005 V.P. Shunt Revision 10000 14000 23500 32500 42500 09280 V.P.Shunt Exteriorization 2500 3500 5900 8100 10600 GIT 09157 Anorectal Malformation (PSARP) 18000 25200 42300 58500 76500 09149 Appendectomy 12000 16800 28200 39000 51000 09158 Cloaca (PSARVP) 20000 28000 47000 65000 85000 09155 Colostomy Closure 12000 16800 28200 39000 51000 09145 Pyloromyotomy 10000 14000 23500 32500 42500 09153 EUA 3000 4200 7100 9800 12800 09159 Lap Diagnostic 12000 16800 28200 39000 51000 09160 Lap Appendectomy 15000 21000 35300 48800 63800 09161 Lap Splenectomy 20000 28000 47000 65000 85000 09162 Lap Cholecystectomy 16000 22400 37600 52000 68000 09142 Formation , Enteral Stoma/Levelling Stoma 10000 14000 23500 32500 42500 09143 Heller’s Cardiomyotomy/Fundoplication 12000 16800 28200 39000 51000 09146 Ladd’S Procedure 15000 21000 35300 48800 63800 09141 Laparotomy (Cyst Excision/Biopsy) 15000 21000 35300 48800 63800 09148 Meckel’s Diverticulectomy 12000 16800 28200 39000 51000 09156 Abdominal Pull Though For Hirschsprung’s Disease 20000 28000 47000 65000 85000 09147 Operations for Intestinal Obstructions 15000 21000 35300 48800 63800

163 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

09154 Rectal Biopsy 5000 7000 11800 16300 21300 09283 Secondary Suturing 3000 4200 7100 9800 12800 09282 Transanal Endorectal Pull Through 20000 28000 47000 65000 85000 HEPATOBILIARY & PANCREATIC 09205 Cholecystectomy 15000 21000 35300 48800 63800 09206 Pancreatectomy 18000 25200 42300 58500 76500 09209 Drainage of Pseudo Pancreatic Cyst 12000 16800 28200 39000 51000 09204 Excision of Choledochal Cyst & Biliary-Enteric An. 20000 28000 47000 65000 85000 09202 Hepatic Cyst Excision 15000 21000 35300 48800 63800 09201 Hepatic Resections 20000 28000 47000 65000 85000 09203 Kasai’s Portoenterostomy 20000 28000 47000 65000 85000 09211 Operations for Portal Hypertension 22000 30800 51700 71500 93500 09208 Pancreatico - Enteric Anastmosis 20000 28000 47000 65000 85000 09284 POC,Liver Biopsy 10000 14000 23500 32500 42500 09212 Spelenectomy 15000 21000 35300 48800 63800 HERNIAS 09233 Bilateral Inguinal Herniotomies 15000 21000 35300 48800 63800 09231 Herniotomies (Umbilical/Inguinal) 12000 16800 28200 39000 51000 NEONATAL SURGERY 09063 Anoplasty 8000 11200 18800 26000 34000 09062 Colostomy (Formation) 10000 14000 23500 32500 42500 09057 Congenital Diaphragmatic Hernia 18000 25200 42300 58500 76500 09060 Duodenal Atresia 18000 25200 42300 58500 76500 09064 Gastroschisis 16000 22400 37600 52000 68000 09056 Gastrostomy 8000 11200 18800 26000 34000 09061 Neonatal Intestinal Obstruction 18000 25200 42300 58500 76500 09055 TEF/EA - Primary Repair 15000 21000 35300 48800 63800 09054 Pure EA - esophagostomy , gastrostomy 10000 14000 23500 32500 42500 09066 Omphalocele - Major 16000 22400 37600 52000 68000 09065 Omphalocele - Minor 18000 25200 42300 58500 76500 09067 Sacrococcygeal Teratoma 20000 28000 47000 65000 85000 09053 Tracheostomy 8000 11200 18800 26000 34000 PAEDIATRIC GENERAL SURGERY - HEAD & NECK 09106 Branchial Apparatus Excision (Cyst/Sinus) 10000 14000 23500 32500 42500 09102 Excision of Cystic Hygroma & Teratomas in Neck 10000 14000 23500 32500 42500 09104 Excision of Salivary Glands 12000 16800 28200 39000 51000 09101 Excision of Superficial Lessions/Lymp Node Biopsy 6000 8400 14100 19500 25500

164 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 09108 Sternomastoid Release 6000 8400 14100 19500 25500 09103 Thyroglossal Cyst - Excision 10000 14000 23500 32500 42500 09281 Tongue Tie Release 3000 4200 7100 9800 12800 PAEDIATRIC UROLOGY 09273 Bilateral Reimplant Of Ureter 20000 28000 47000 65000 85000 09288 Bladder Augmentation 22000 30800 51700 71500 93500 09241 Bladder Exstrophy Closure 15000 21000 35300 48800 63800 09263 Bladder Neck Repair 15000 21000 35300 48800 63800 09276 CAPD Catheter Insertion 14000 19600 32900 45500 59500 09286 CAPD Catheter Removal 5000 7000 11800 16300 21300 09243 Circumscision 7000 9800 16500 22800 29800 09261 Closure Of Urethrocutanous Fistula 8000 11200 18800 26000 34000 09268 CVAD Insertion - percut 5000 7000 11800 16300 21300 09269 CVAD Insertion - tunneled 6500 9100 15300 21100 27600 09248 Cystolithotomy 8000 11200 18800 26000 34000 09249 Cystoscopy 7500 10500 17600 24400 31900 09292 Endourologic Procedure 8000 11200 18800 26000 34000 09266 Epispadias Repair 15000 21000 35300 48800 63800 09262 Feminizing 14000 19600 32900 45500 59500 09215 Hemodialysis Catheter Placement 6000 8400 14100 19500 25500 09224 Incision And Drainage Of Abscess 3500 4900 8200 11400 14900 09291 Lap for DSD 18000 25200 42300 58500 76500 09290 Lap Orchidopexy 22000 30800 51700 71500 93500 09265 Malones (ACE) 15000 21000 35300 48800 63800 09264 Mitrofanoff Procedure 15000 21000 35300 48800 63800 09250 Nephrectomy / Nephroureterectomy 12000 16800 28200 39000 51000 09244 Orchidectomy 14000 19600 32900 45500 59500 09246 Orchidopexy - Bilateral 7000 9800 16500 22800 29800 09245 Orchidopexy - Unilateral 15000 21000 35300 48800 63800 09289 Posterior Urethral Stricture Repair 12000 16800 28200 39000 51000 09251 Pyelollithotomy / Nephrolithotomy 15000 21000 35300 48800 63800 09247 Pyeloplasty 18000 25200 42300 58500 76500 09293 Radical Nephroureterectomy 18000 25200 42300 58500 76500 09275 Repair of US Sinus 18000 25200 42300 58500 76500 09252 Surgery For Distal Hypospadias / Chordee Correction 14000 19600 32900 45500 59500 09220 Suturing Of Superficial Wounds 2500 3500 5900 8100 10600 09255 Transurethral Fulgration 8500 11900 20000 27600 36100

165 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs.

09257 Unilateral Reimplant of Ureter 16000 22400 37600 52000 68000 09256 Ureterolithotomy 9000 12600 21200 29300 38300 09285 Urethral Calibration 2000 2800 4700 6500 8500 09253 Urethroplasty For Proximal Hypospadias 16000 22400 37600 52000 68000 09258 Urinary Diversion Permanent 18000 25200 42300 58500 76500 09259 Urinary Diversion Temporary 10000 14000 23500 32500 42500 09260 Urinary Undiversion 15000 21000 35300 48800 63800 09219 Wound Debridement 3000 4200 7100 9800 12800 THORAX 09121 Bronchoscopic Removal of F.B 10000 14000 23500 32500 42500 09124 Decortication 15000 21000 35300 48800 63800 09123 Esophageal Substitution/Resection 20000 28000 47000 65000 85000 09122 Esophagoscopy and Dilatation / FB removal 6000 8400 14100 19500 25500 09126 Eventeration of Diaphragm Repair 15000 21000 35300 48800 63800 09127 Lobectomy - Pulmonary 20000 28000 47000 65000 85000 09129 Thoracic Tumor And Cyst Excision 16000 22400 37600 52000 68000 09125 Thoracotomy (Biopsy/Drainage) 14000 19600 32900 45500 59500 09131 VATS - Major 16000 22400 37600 52000 68000 09130 VATS - Minor 14000 19600 32900 45500 59500 18210 Enseal 09296 Injection Sclerotherapy 3000 4200 7100 9800 12800 09297 Lithotripsy 2000 2800 4700 6500 8500 09295 Muscle biopsy 3500 4900 8200 11400 14900 09294 Percutaneous Interventions 6000 8400 14100 19500 25500 09299 Ultrasound Guidance 1500 2100 3500 4900 6400 L. NEPHROLOGYTRANSPLANTATION PROGRAMME RENAL TRANSPLANTATION 06508 Processing Fee to ZCCK for Cadaver Transplant 25000 25000 25000 25000 25000 06507 Renal Transplantation 150000 210000 270000 330000 390000/435000 06502 Donor Nephrectomy - Open (Adult) 100000 140000 180000 220000 260000/290000 06503 Donor Nephrectomy - Laproscopic (Adult) 110000 154000 198000 242000 286000/319000 09274 Processing fee to ZCCK towards Cadaver Transplant (Not Included in PACKAGE) 25000 25000 25000 25000 25000 09270 Paediatric Renal Transplantation 81000 85000 109300 133600 157800/187800 09271 Donor Nephrectomy- Open (Paediatric) 37800 40700 52200 63800 75300/105300 09272 Donor Nephrectomy -Laparoscopic (Paediatric) 43200 45600 58600 71600 84600/114600

166 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. M. CADAVERIC ORGAN RETRIEVAL 09504 Heart 7400 10400 17400 24100 31500 09502 Kidney - Double (Cadaver) 7400 10400 17400 24100 31500 09501 Kidney - Single 5500 7700 12900 17900 23400 09503 Liver 7400 10400 17400 24100 31500 09522 Deceased Donor Liver Transplantation 09521 Live Donor Liver Transplantation N. PHYSICAL MEDICINE & REHABILITATION 09558 Adductor Tenotomy 2100 2900 4900 6800 8900 09557 Adductor Tenotomy & Obturator Neurectomy 2600 3600 5900 8100 10700 09563 C . P Diplegia Correction 14000 19700 32900 45600 59600 09568 Debridement - Major 4600 6300 10700 14700 19100 09567 Debridement - Minor 2300 3200 5300 7600 9800 09579 Excision Ischeal Sore&Flap Closure 8700 12200 20300 28300 37000 09578 Excision Ischeal Sore & Direct Closure 4900 6900 11600 15900 20800 09580 Flap - Major 13300 18700 31300 43200 56600 09562 Fractional Hamstring Lengthening 3000 4200 7100 9800 12800 09551 Hallux Valgus -Correction 4000 5700 9300 13000 17000 09560 Iliposoas Recession 6600 9100 15300 21100 27700 09552 Ingrowing Toe Nail 2600 3600 5900 8100 10700 09559 Obturator Neurectomy 2100 2900 4900 6800 8900 09569 Ordinary Plaster Cast Application 1600 2100 3600 4900 6300 09553 Posteromedial Soft Tissue 8200 11600 19300 26700 34900 09582 Raising of TFL Flap 6600 9100 15300 21100 27700 09570 Release of Contractures 4000 5700 9300 13000 17000 09581 Revision Amputation 5300 7700 12700 17700 23000 09571 Rotation Flap 13000 18200 30700 42300 55300 09577 Skin Grafting- Large Area 3000 4200 7100 9800 12800 09576 Skin Grafting Small Area 2600 3600 5900 8100 10700 09561 Soutters Younts Procedure 4700 6300 10800 15000 19700 09556 Stendler’S Release 2100 2900 4900 6800 8900 09575 Suture of Wounds - Major 2100 2900 4900 6800 8900 09574 Suture of Wounds - Minor 1600 2100 3600 4900 6300 09555 Tendoachilles Lengthening 3000 4200 7100 9800 12800 09572 Tenotomies - Minor 3900 5600 9200 12700 16700 09583 TFL Flap Closure 4600 6300 10700 14700 19100 09554 Vulpius Slide 2500 3600 5900 8100 10700

167 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 09584 Wilson’s procedure 8600 11900 20000 27700 36100 09585 Yount’s procedure 1900 2700 4600 6200 8100 GENERAL 09588 Bilateral (50% Of Procedure) 09592 Extra Hours For - Major + Surgery (D) 09591 Extra Hours For - Major Surgery (C) 09590 Extra Hours For - Minor + Surgery (B) 09589 Extra Hours For - Minor Surgery (A) O. SURGICAL ONCOLOGY ABDOMINAL ONCOSURGERY - Minor 17104 Colostomy 8000 11200 18800 26000 34000 17107 Colostomy Closure 8000 11200 18800 26000 34000 17622 Diagnostic Laparoscopy 8000 11200 18800 26000 34000 17102 EUA + Biopsy Anal/Rectal Cancer 8000 11200 18800 26000 34000 17103 Feeding Gastrostomy 8000 11200 18800 26000 34000 17101 Feeding Jejunostomy 8000 11200 18800 26000 34000 17105 Ileostomy 8000 11200 18800 26000 34000 17108 Ileostomy Closure 8000 11200 18800 26000 34000 17110 Minor Abdominal Wall Tumour Resection 8000 11200 18800 26000 34000 17111 Omental Biopsy 8000 11200 18800 26000 34000 17106 Staging Laparotomy 8000 11200 18800 26000 34000 ABDOMINAL ONCOSURGERY - Intermediate 17113 Cholecystojejunostomy 11000 15300 25900 35800 48600 17116 Gastrojejunostomy 11000 15300 25900 35800 48600 17117 Intestinal Bypass 11000 15300 25900 35800 48600 17112 Laparotomy & Colostomy 11000 15300 25900 35800 48600 17114 Limited Bowel Resection 11000 15300 25900 35800 48600 17623 Omentectomy 11000 15300 25900 35800 48600 17025 Open Cholecystectomy 11000 15300 25900 35800 48600 17193 Pancreaticojejunostomy 11000 15400 25900 35800 46800 17119 Partial Cystectomy 11000 15300 25900 35800 48600 17115 Partial Gastrectomy 11000 15300 25900 35800 48600 17118 Pelvic Lymph Node Dissection 11000 15300 25900 35800 48600 17120 Retroperitoneal Lymphnode Biopsies 11000 15300 25900 35800 48600 17121 Splenectomy 11000 15300 25900 35800 48600 ABDOMINAL ONCOSURGERY - Major 17146 Abdominoperineal Resection 25000 35000 58800 81300 106300

168 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 17152 Ant 25000 35000 58800 81300 106300 17145 Anterior Resection 25000 35000 58800 81300 106300 17132 Distal Pancreaticosplenectomy 25000 35000 58800 81300 106300 17125 Distal Radical Gastrectomy 25000 35000 58800 81300 106300 17137 Extended L Hemihepatectomy 25000 35000 58800 81300 106300 17138 Extended R Hemihepatectomy 25000 35000 58800 81300 106300 17129 Hepaticojejunostomy 25000 35000 58800 81300 106300 17194 Ivor Lewis Oesophagectomy 25000 35000 58800 81300 106300 17135 L Hemihepatectomy 25000 35000 58800 81300 106300 17142 L Radical Hemicolectomy 25000 35000 58800 81300 106300 17140 Major Small Bowel Resection 25000 35000 58800 81300 106300 17124 Oesophago-Gastrectomy 25000 35000 58800 81300 106300 17153 Post Pelvic Exenteration 25000 35000 58800 81300 106300 17136 R Hemihepatectomy 25000 35000 58800 81300 106300 17141 R Radical Hemicolectomy 25000 35000 58800 81300 106300 17127 Radical Cholecystectomy 25000 35000 58800 81300 106300 17128 Radical Choledochectomy 25000 35000 58800 81300 106300 17150 Radical Cystectomy 25000 35000 58800 81300 106300 17149 Radical Nephrectomy 25000 35000 58800 81300 106300 17144 Radical Sigmoid Colectomy 25000 35000 58800 81300 106300 17143 Radical Transverse Colectomy 25000 35000 58800 81300 106300 17151 Retroperitoneal Lymph Node Dissection 25000 35000 58800 81300 106300 17148 Retroperitoneal Tumour Resection 25000 35000 58800 81300 106300 17134 Segmental Liver Resections 25000 35000 58800 81300 106300 17126 Subtotal Radical Gastrectomy 25000 35000 58800 81300 106300 17147 Total Colectomy 25000 35000 58800 81300 106300 17154 Total Pelvic Exenteration 25000 35000 58800 81300 106300 17122 Transhiatal Oesophagectomy 25000 35000 58800 81300 106300 17123 Transhthoracic Oesophagectomy 25000 35000 58800 81300 106300 17130 Triple Bypass For Pancreatic Cancer 25000 35000 58800 81300 106300 17139 Trisegmentectomy 25000 35000 58800 81300 106300 17133 Wedge Liver Resections 25000 35000 58800 81300 106300 17131 Whipple’S Pancreaticoduodenectomy 25000 35000 58800 81300 106300 ABDOMINAL ONCOSURGERY: SPECIALISED 17026 Colonic Conduit 19700 27580 35460 43340 51220 17165 D2 Gastrectomy 29000 40700 68200 94300 123300 17624 Extended Radical Colectomy 29000 40700 68200 94300 123300

169 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 17164 Laparoscopic Adrenalectomy 29000 40700 68200 94300 123300 17161 Laparoscopic Assisted Anterior Resection 32000 44800 75200 104000 136000 17162 Laparoscopic Assisted Apr 29000 40700 68200 94300 123300 17166 Laparoscopic Assisted Gastrectomy 32000 44800 75200 104000 136000 17160 Laparoscopic Assisted Hemicolectomy 32000 44800 75200 104000 136000 17167 Laparoscopic Assisted Oesophagectomy 32000 44800 75200 104000 136000 17157 Laparoscopic Assisted Ostomy In Oncology 14000 19700 32900 45600 59600 17159 Laparoscopic Assisted Small Bowel Resection 14000 19700 32900 45600 59600 17163 Laparoscopic Assisted Splenectomy 29000 40700 68200 94300 123300 17158 Laparoscopic Stoma Reversal 14000 19700 32900 45600 59600 17156 Laparoscopy And Biopsy 14000 19700 32900 45600 59600 17195 Laparoscopic Radical Nephrectomy 30000 42000 70500 97500 127500 17196 Laparoscopic Whipple’s procedure 35000 49000 82300 113800 148800 17625 Multivisceral Resections 32000 44800 75200 104000 136000 17155 Staging Laparoscopy 14000 19700 32900 45600 59600 17636 Staging Laparoscopy Combined With Other Operative 6000 8300 14100 19600 25600 17168 Three Field Oesophagectomy 29000 40700 68200 94300 123300 BREAST ONCOSURGERY - Minor 17201 Excision Biopsy Breast Tumour 3300 4700 7800 10700 14000 17202 Incision Biopsy Breast Tumour 3300 4700 7800 10700 14000 17203 Microdochectomy 3300 4700 7800 10700 14000 BREAST ONCOSURGERY - Intermediate 17206 Axillary Dissection Alone For Breast Cancer 10000 14000 23600 32600 42600 17205 Simple Mastectomy 10000 14000 23600 32600 42600 17204 Wide Excision Breast Tumour 10000 14000 23600 32600 42600 BREAST ONCOSURGERY - Major 17207 Modified Radical Mastectomy 16000 22300 37700 52000 68000 BREAST ONCOSURGERY - SPECIALISED 17209 BCS (Including Axillary Dissection) 18000 25200 42300 58600 76600 17626 Image Guided Biopsy Breast Tumour 12000 16800 28200 39000 51000 17208 Sentinel Node Biopsy 12000 16800 28200 39000 51000 CRS and HIPEC 17183 Cytoreductive surgery 30000 42000 70500 97500 127500 17184 HIPEC 25000 35000 58800 81300 106300 17184 Cytoreductive surgery + HIPEC 40000 56000 94000 130000 170000 ENDOCRINE ONCOSURGERY - Minor 17501 Parathyroid Autotransplantation 3300 4700 7800 10700 14000

170 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 17502 Simple Orchidectomy 3300 4700 7800 10700 14000 ENDOCRINE ONCOSURGERY - Intermediate 17503 Hemithyroidectomy 13000 18200 30700 42300 55300 17506 For Breast Cancer 13000 18200 30700 42300 55300 17505 Radical Orchidectomy 13000 18200 30700 42300 55300 17504 Simple Parathyroidectomy 13000 36700 55300 42300 55300 ENDOCRINE ONCOSURGERY - Major 17510 Adrenalectomy 16000 22300 37700 52000 68000 17511 Pancreatic Islet Tumour Resection 16000 22300 37700 52000 68000 17508 Radical Parathyroidectomy 16000 22300 37700 52000 68000 17507 Total Thyroidectomy 16000 22300 37700 52000 68000 ENDOCRINE ONCOSURGERY - SPECIALISED 17514 Laparoscopic Adrenalectomy 21000 29300 49300 68300 89300 17515 Laparoscopic Oophorectomy 21000 29300 49300 68300 89300 17516 Miniparathyroidectomy 10000 14000 23600 32600 42600 17512 Radical Thyroidectomy 21000 29300 49300 68300 89300 17513 Total Thyroidectomy + Neck Dissection 21000 29300 49300 68300 89300 HEAD & NECK ONCOSURGERY - Minor 17003 Cervical LN Biopsy 3300 4800 8000 11100 14600 17004 Excision Of Skin Tumours 3300 4800 8000 11100 14600 17002 H&N Cancer EUA 3300 4800 8000 11100 14600 17001 Mucosal Biopsy 3300 4800 8000 11100 14600 17006 Tracheostomy in OT 3300 4800 8000 11100 14600 HEAD & NECK ONCOSURGERY - Intermediate 17008 Central Neck Dissection 13000 18200 30700 42300 55300 17012 Hemi Glossectomy 13000 18200 30700 42300 55300 17011 Partial Glossectomy 13000 18200 30700 42300 55300 17027 Partial Laryngectomy 13000 18200 30700 42300 55300 17010 Selective Neck Dissection 13000 18200 30700 42300 55300 17013 Submandibular Gland Resection 13000 18200 30700 42300 55300 17009 Supraomohyoid Neck Dissection 13000 18200 30700 42300 55300 17007 Wide Excision - Oral Cancer 13000 18200 30700 42300 55300 HEAD & NECK ONCOSURGERY - Major 17018 Functional Neck Dissection 16000 22300 37700 52000 68000 17016 Mandibular Resections 16000 22300 37700 52000 68000 17017 Modified Neck Dissections 16000 22300 37700 52000 68000 17019 Radical Maxillectomy 16000 22300 37700 52000 68000

171 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 17015 Radical Neck Dissection 16000 22300 37700 52000 68000 17022 Radical Parotidectomy 16000 22300 37700 52000 68000 17620 Subtotal Glossectomy 16000 22300 37700 52000 68000 17014 Superficial Parotidectomy - Malignant 16000 22300 37700 52000 68000 17021 Total Conservative Parotidectomy 16000 22300 37700 52000 68000 17020 Total Laryngectomy 16000 22300 37700 52000 68000 HEAD & NECK ONCOSURGERY - SPECIALISED 17621 Combined Oral Cancer Resection And Neck Dissection 29000 40700 68200 94300 123300 17024 Composite H&N Resections 21000 29300 49300 68300 89300 17023 Total Laryngopharyngeoesophagectomy 21000 29300 49300 68300 89300 LIMB ONCOSURGERY - Minor 17301 Excision Biopsy 3300 4700 7800 10700 14000 17303 Excision Of Superficial Tumours 3300 4700 7800 10700 14000 17302 Incision Biopsy 3300 4700 7800 10700 14000 17304 Minor Amputation - Fingers 3300 4700 7800 10700 14000 17305 Minor Amputation - Toes 3300 4700 7800 10700 14000 LIMB ONCOSURGERY - Intermediate 17310 Intermediate Amputation - Below Elbow 10000 14000 23600 32600 42600 17311 Intermediate Amputation - Below Knee 10000 14000 23600 32600 42600 17309 Intermediate Amputation - Foot 10000 14000 23600 32600 42600 17308 Intermediate Amputation - Hand 10000 14000 23600 32600 42600 17307 Wide Excision Of Tumours 10000 14000 23600 32600 42600 LIMB ONCOSURGERY - Major 17312 Compartmental Excision 16000 22300 37700 52000 68000 17316 Major Amputation - Forequarter 16000 22300 37700 52000 68000 17317 Major Amputation - Hindquarter 16000 22300 37700 52000 68000 17314 Major Amputation - Hip Disarticulation 16000 22300 37700 52000 68000 17315 Major Amputation - Shoulder Disarticulation 16000 22300 37700 52000 68000 17319 Regional Reconstruction Following - Major Resection 19000 26700 44700 61800 80800 17313 Resection Of Large Soft Tissue Or Bone Tumour 16000 22300 37700 52000 68000 LIMB ONCOSURGERY - SPECIALISED 17324 Hemipelvectomy 24000 33700 56300 78000 102000 17320 Limb Conservation Surgery 24000 33700 56300 78000 102000 17323 Pelvic Bone Resections 24000 33700 56300 78000 102000 17322 Scapular Resection 23700 33700 56300 78000 102000 SURGICAL & GYNAEC ONCOLOGY - INTERMEDIATE 17173 Extrafascial Hysterectomy 10000 14000 23500 32500 42500

172 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 17174 Extrafascial Hysterectomy + BSO 12000 16800 28200 39000 51000 SURGICAL & GYNAEC ONCOLOGY - MAJOR 17175 Radical Hysterectomy 15000 21000 35300 48800 63800 17176 Radical Hysterectomy + PLND 20000 28000 47000 65000 85000 17177 Radical Hysterectomy + PLND + RPLND 25000 35000 58800 81300 106300 17178 Debulking surgery 15000 21000 35300 48800 63800 17179 Radical 15000 21000 35300 48800 63800 SURGICAL & GYNAEC ONCOLOGY - SPECIALISED 17180 Laparoscopic Radical Hysterectomy 25000 35000 58800 81300 106300 17181 Laparoscopic Radical Hysterectomy + PLND 30000 42000 70500 97500 127500 17182 Laparoscopic Radical Hysterectomy + PLND + RPLND 30000 42000 70500 97500 127500 THORACIC ONCOSURGERY - Minor 17402 Minor Chest Wall Tumour Excision 9000 12700 21200 29300 38300 17404 Open Lung Biopsy 9000 12700 21200 29300 38300 17405 Pleurodesis 9000 12700 21200 29300 38300 17403 Thoracotomy & Biopsy 9000 12700 21200 29300 38300 THORACIC ONCOSURGERY - Intermediate 17407 Minor Mediastinal Tumour Excision 11000 15300 25900 35800 46800 17409 Re-Exploration - Major 11000 15300 25900 35800 46800 17406 Thymectomy 11000 15300 25900 35800 46800 17408 Lung 11000 15300 25900 35800 46800 THORACIC ONCOSURGERY - Major 17410 Lobectomy 25000 35000 58800 81300 106300 17414 Major Chest Wall Tumour Resection 25000 35000 58800 81300 106300 17412 Mediastinal Tumour Resection 25000 35000 58800 81300 106300 17411 Pneumonectomy 25000 35000 58800 81300 106300 17413 Thoracotomy & Oesophagectomy 25000 35000 58800 81300 106300 THORACIC ONCOSURGERY - SPECIALISED 17419 Misecellaneous VATS 14000 19700 32900 45600 59600 17415 Staging Thoracoscopy 14000 19700 32900 45600 59600 17637 Staging Thoracoscopy Comined With Other Operative 6000 8300 14100 19600 25600 17416 Thoracoscopy & Biopsy 14000 19700 32900 45600 59600 17418 Thoracoscopy Assisted Oesophagectomy 29000 40700 68200 94300 123300 17169 VATS metastasectomy 20000 28000 47000 65000 85000 17170 VATS Lung lobectomy 30000 42000 70500 97500 127500 17171 VATS Lung lobectomy + MLND 38000 53200 89300 123500 161500

173 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 17172 VATS Thymectomy 30000 42000 70500 97500 127500 MISCELLANEOUS ONCOSURGERY - Minor 17604 Circumcision 3300 4700 7800 10700 14000 17627 Minor Debridement 3300 4700 7800 10700 14000 17602 Minor Excisions 3300 4700 7800 10700 14000 17605 Minor Split Skin Grafting 3300 4700 7800 10700 14000 17601 Minor Suturing 3300 4700 7800 10700 14000 MISCELLANEOUS ONCOSURGERY - Intermediate 17628 Assisting Other Department 10000 14000 23600 32600 42600 17608 Local Flap Reconstruction 12000 16800 28200 39000 51000 17607 Major Split Skin Grafting 10000 14000 23600 32600 42600 17606 Partial Penectomy 10000 14000 23600 32600 42600 17639 Venous Access Device Insertion 10000 14000 23600 32600 42600 17609 Wide Excision Misc Tumours 10000 14000 23600 32600 42600 MISCELLANEOUS ONCOSURGERY - Major 17615 Assisting Other Department 16000 22300 37700 52000 68000 17613 Ilioinguinal Lymphnode Dissection 16000 22300 37700 52000 68000 17612 Inguinal Lymphnode Dissection 16000 22300 37700 52000 68000 17629 Major Debridement 16000 22300 37700 52000 68000 17614 Major Oncoplastic Reconstructions 16000 22300 37700 52000 68000 17186 Regional Flap Reconstruction 18000 25200 42300 58500 76500 17187 Reduction Mammoplasty 15000 21000 35300 48800 63800 17611 Radical Penectomy 16000 22300 37700 52000 68000 17610 Total Penectomy 16000 22300 37700 52000 68000 MISCELLANEOUS ONCOSURGERY - SPECIALIZED 17616 Chemoport Insertion 3000 4200 7100 9800 12800 17630 Image Guided Excisions 12000 16800 28200 39000 51000 17191 Implant reconstruction 20000 28000 47000 65000 85000 17188 LD Flap 20000 28000 47000 65000 85000 17618 Re-Operative Procedures - Referrals 18000 25200 42300 58600 76600 17192 Rigid reconstruction (Titanium Plates/ Bone cements etc) 20000 28000 47000 65000 85000 17617 Sentinel Node Excision 3000 4200 7100 9800 12800 17638 Sentinel Node Excision Combined With Other Operati 6000 8300 14100 19600 25600 17189 TRAM 25000 35000 58800 81300 106300 17190 VRAM 25000 35000 58800 81300 106300

174 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. GENERAL 18086 Advanced Microscope Per Hour 800 1100 1900 2600 3400 18085 Basic Microscope Per Hour 400 600 900 1300 1700 17619 Bilateral (50% Of Procedure/Surgery) 18212 Enseal 17635 Extra Hours For - Major + Surgery (D)# 17634 Extra Hours For - Major Surgery (C)# 17633 Extra Hours For - Minor + Surgery (B)# 17632 Extra Hours For - Minor Surgery (A)# 17631 Extra Hours Taken For A Surgery# 18087 Laproscope Per Hour 700 1000 1600 2300 3000 P. GYNAECOLOGIC ONCOLOGY 25200 Aspiration Biopsy In OT 1800 2600 4200 5900 7700 25201 Aspiration Biopsy La 1600 2200 3800 5200 6800 25202 Aspiration Cytology In OT 1800 2600 4200 5900 7700 25203 Aspiration Cytology LA 1600 2200 3800 5200 6800 25443 Cold Coagulator For - Minor Procedure in OT 1500 2100 3500 4900 6400 25478 Cone Biopsy Deep 5000 7000 11800 16300 21300 25204 Cone Biopsy In OT 2000 2800 4700 6600 8600 25479 Cone Biopsy Superficial 2500 3500 5900 8100 10600 25480 Cryosurgery Lgt 2000 2800 4700 6600 8600 25481 Debulking Surgery 18000 25200 42300 58500 76500 25212 Dilatation & Curettage 3000 4200 7100 9800 12800 25214 Drainage Of Pyometra 2500 3500 5900 8100 10600 25218 Drainage Of Vulvar Abscess 2500 3500 5900 8100 10600 25482 EUA+Biopsy Cervix/Vulva/Vagina/EB 2500 3500 5900 8100 10600 25237 Evacuation Of Vesicular Mole 3500 4900 8200 11400 14900 25238 Examination Under Anaesthesia 2200 3100 5200 7200 9400 25483 Excision Of Cervix/Vulva/Vaginal Lesion 3500 4900 8200 11400 14900 25249 Insertion Of Chemo-Port 2500 3500 5900 8100 10600 25250 Insertion Of Chemo-Port LA 2200 3100 5200 7200 9400 25251 Insertion Of Mirena Coil 2400 3400 5600 7800 10200 25247 Insertion Of Peritioneal Catheter 2200 3100 5200 7200 9400 25253 LLETZ 2400 3400 5600 7800 10200 25254 LLETZ LA 2200 3100 5200 7200 9400 25255 Peripheral Insertion Of Central Catheter LA 2200 3100 5200 7200 9400

175 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 25256 Polypectomy Cervix 2000 2800 4700 6500 8500 25258 Polypectomy Endometrium 2200 3100 5200 7200 9400 25260 Removal Of Superficial Cysts/Vaginal Cysts/Vulvar 3000 4200 7100 9800 12800 25261 Removal Of Superficial Cysts/Vaginal Cysts/Vulvar Cys LA 2800 3900 6600 9100 11900 25446 Staging For CA Cx Cystoscopy And Biopsy 1800 2000 3300 4600 6000 25447 Staging For CA Cx Proctoscopy And Biopsy 1600 700 1200 1600 2100 HYSTEROSCOPY 25440 Diagnostic Laparoscopy 4000 3600 6100 8500 11100 25392 Hysteroscopy (Diagnostic) 4400 6200 10300 14300 18700 25393 Hysteroscopy + Polypectomy 4500 6300 10600 14600 19100 25171 Hysteroscopy +Polypectomy/Biopsy/Curettage 4500 6600 11000 15300 20000 25473 Laparoscopic Assessment 2000 2800 4700 6500 8500 25441 Laparoscopy + Biopsy 5200 6600 11000 15300 20000 LAPROSCOPY LEVEL 2 25397 Laproscopic Adhesiolysis 7600 10600 17900 24700 32300 25400 Laproscopic Ovarian Cystecomy 13000 18200 30600 42300 55300 25448 Laproscopic Ovarian Transfixation 12000 16800 28200 39000 51000 LAPROSCOPY LEVEL3 25174 Laparoscopic TH+BSO/USO 14000 19600 32900 45500 59500 25403 Laproscopic Total Hysterectomy 12000 16800 28200 39000 51000 25406 LAVH+/-BSO/USO 12000 16800 28200 39000 51000 LAPROSCOPY LEVEL 4 25408 Laprosopic Hysterectomy + PLND 22000 30800 51700 71500 93500 25450 Laprosopic Hysterectomy + RPLND 22000 30800 51700 71500 93500 25451 TLH + BSO + Oment + PLND 20000 28000 47000 65000 85000 25409 TLH + BSO + Oment + RPLND 25000 35000 58800 81300 106300 CERVIX LEVEL 1 25340 Class 1/Type A Radical Hysterectomy 9000 12600 21200 29300 38300 25452 Diversion Colostomy 3500 4900 8200 11400 14900 25453 Diversion Ileostomy 3500 4900 8200 11400 14900 CERVIX LEVEL 2 25469 Class 1/Type A Radical Hysterectomy+PLND 9000 12600 21200 29300 38300 CERVIX LEVEL 3 25343 Class II/Type B Radical Hysterectomy +RPLND 18000 25200 42300 58500 76500 25344 Class III /Type C1 Radical Hysterectomy + PLND 20000 28000 47000 65000 85000 25345 Class III/Type C1 Radical Hysterectomy +RPLND 21000 29400 49400 68300 89300

176 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 25346 Class III /Type C2 Radical Hysterectomy +PLND 21000 29400 49400 68300 89300 25347 Class III/Type C2 Radical Hysterectomy + RPLND 23000 32200 54100 74800 97800 25348 Radical Trachelectomy +PLND 21000 29400 49400 68300 89300 25352 Vaginal Radical Hysterectomy +RPLND 21000 29400 49400 68300 89300 CERVIX LEVEL 4 25353 Class IV/Type D Radical Hysterectomy 35000 49000 82300 113800 148800 25355 Class V Radical Hysterectomy + RPLND 35000 49000 82300 113800 148800 ENDOMETRIUM / BODY OF LEVEL 1 25475 Completion Endometrial Staging Surgery 9000 12600 21200 29300 51000 25603 Systematic Endometrial Surgical Staging 1500 2100 3500 4900 6400 ENDOMETRIUM / BODY OF UTERUS LEVEL 2 25476 Completion Endometrial Staging Surgery 13000 18200 30600 42300 55300 25604 Systematic Endometrial Surgical Staging 17000 23800 40000 55300 72300 ENDOMETRIUM / BODY OF UTERUS LEVEL 3 25605 Systematic Endometrial Surgical Staging 18000 25200 42300 58500 76500 / TUBE LEVEL 1 25275 Ovarian Cystectomy Bilateral/Unilateral 6000 8400 14100 19500 25500 25191 Removal Of TO Mass - Complex 8000 11200 18800 26000 34000 25192 Removal Of TO Mass - Simple 5000 7000 11800 16300 21300 OVARY / TUBE LEVEL 2 25606 TAH+BSO - Complex 14000 19600 32900 45500 59500 25607 TAH+BSO - Simple 8000 11200 18800 26000 34000 OVARY / TUBE LEVEL 3 25175 Limited Surgical Staging Early Ov Ca 12000 16800 28200 39000 51000 25477 Completion Staging Ovary 14000 19600 32900 45500 59500 25601 Surgical Staging - Early Ov Ca - Fertility Sparing 10000 14000 23500 32500 42500 25602 Surgical Staging Early Ov Ca - Non-Fertility Sparing 17000 23800 40000 55300 72300 OVARY / TUBE LEVEL 4 25172 Interval Cytoreduction Level 1 14000 19600 32900 45500 59500 25173 Interval Cytoreduction Level 2 18000 25200 42300 58500 76500 25185 Primary Cytoreductive Surgery Level 1 17000 23800 40000 55300 72300 25186 Primary Cytoreductive Surgery Level 2 20000 28000 47000 65000 85000 25187 Primary Cytoreductive Surgery Level 3 25000 35000 58800 81300 106300 25188 Primary Cytoreductive Surgery Level 4 30000 42000 70500 97500 127500 25196 Secondary Cytoreduction 18000 25200 42300 58500 76500 25197 Secondary Cytoreduction Level 1 12000 16800 28200 39000 51000

177 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 25198 Secondary Cytoreduction Level 2 20000 28000 47000 65000 85000 VAGINA 25376 RH + BSO + PLND + Total 25000 35000 58800 81300 106300 25193 RH Type A + BSO - Complex 12000 16800 28200 39000 51000 25194 RH Type A + BSO - Simple 8000 11200 18800 26000 34000 25195 RH+BSO+PLND+Partial Vaginectomy 22000 30800 51700 71500 93500 25378 Vaginectomy Partial 20000 28000 47000 65000 85000 25380 Total Vaginectomy + PLND 22000 30800 51700 71500 93500 VULVA LEVEL 1 25360 Skinning Vulvectomy 4500 6300 10600 14600 19100 25456 Wide Local Excision Of Vulval Lesion 4500 6300 10600 14600 19100 25361 Vulvectomy Simple 4500 6300 10600 14600 19100 VULVA LEVEL 2 25362 Unilateral GND 6600 9200 15500 21500 28100 VULVA LEVEL 3 25366 Bilateral GND 10000 14000 23500 32500 42500 25176 Modified Radical Vulvectomy - Complex 10000 14000 23500 32500 42500 25177 Modified Radical Vulvectomy - Simple 6500 9100 15300 21100 27600 25435 Radical Vulvectomy 11000 15400 25900 35800 46800 VULVA LEVEL 4 25367 Modified Radical Vulvectomy+Unilateral GND 12000 16800 28200 39000 51000 25363 Modified Radical Vulvectomy+Bilateral GND 16000 22400 37600 52000 68000 25436 Radical Vulvectomy + Bilateral Inguinofemoral Dissection 18000 25200 42300 58500 76500 25437 Radical Vulvectomy + Unilateral Inguinofemoral Dissection 16000 22400 37600 52000 68000 25189 Radical Vulvectomy + Vulvar Reconstruction 15000 21000 35300 48800 63800 25190 Radical Vulvectomy + Vulvar Reconstruction+Gnd 20000 28000 47000 65000 85000 OTHERS 25459 Exploratory laporotomy 6000 8400 14100 19500 25500 25410 Intraoperative Consultation for Another Department 5000 7000 11800 16300 21300 25411 Laparotomy + Biopsy 5000 7000 11800 16300 21300 25412 Laparotomy + Closure of Colostomy 4000 5600 9400 13000 17000 25413 Laparotomy + Colostomy 4000 5600 9400 13000 17000 25178 Other Laparotomy + Procedures Level 1 10000 14000 23500 32500 42500 25179 Other Laparotomy + Procedures Level 2 15000 21000 35300 48800 63800 25180 Other Laparotomy + Procedures Level 3 20000 28000 47000 65000 85000 25415 Perineal Floor Repair 6000 8400 14100 19500 25500

178 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 25416 Posterior Colporraphy 2500 3500 5900 8100 10600 25468 Re-exploration of Abdomen 3000 4200 7100 9800 12800 25417 Re-Laparotomy (Referrals From Outside) 12000 16800 28200 39000 51000 25418 Repair of Complete Wound Dehiscence (Burst abdomen) 4000 5600 9400 13000 17000 25419 Repair of Superficial Wound Dehiscence 2500 3500 5900 8100 10600 25421 Retroperitoneal Lymph Node Biopsies 10000 14000 23500 32500 42500 25422 Retroperitoneal Tumour Excision 16000 22400 37600 52000 68000 25423 Sacrocolpopexy With Mesh Repair 8000 11200 18800 26000 34000 25424 Sacrospinous Colpopexy 5000 7000 11800 16300 21300 25425 Vaginal Hysterectomy 9000 12600 21200 29300 38300 25461 Vaginal Hysterectomy + BS/BSO/USO 9000 12600 21200 29300 38300 25426 Vaginal Hysterectomy with Pelvic Floor Repair +/US 11000 15400 25900 35800 46800 GENERAL 25429 Advanced Microscope Per Hour 400 600 900 1300 1700 25428 Basic Microscope Per Hour 25433 Dvt Phlebo Press 50 115 150 175 200 25427 Enseal 500 700 1200 1600 2100 25432 Extra Hours Taken For A Surgery# 25462 Fluroscopy Time upto 10 Minutes 600 690 780 870 960 25463 Fluroscopy Time upto 15 Minutes 700 800 910 1020 1120 25464 Fluroscopy Time upto 20 Minutes 800 920 1040 1160 1280 25465 Fluroscopy Time upto 30 Minutes 900 1040 1170 1310 1440 25466 Fluroscopy Time(Every Adnl.5Mts) 100 100 200 300 400 25467 Head Lamp + Loupe 100 100 200 300 400 25430 Laproscope Per Hour 700 1000 1600 2300 3000 Q. UNIT OF HOPE (UoH) ELBOW & FOREARM 24260 UoH - Arthrotomy and Lavage (Elbow Joint) 5000 24261 UoH - Centralization of Ulna/Radius 7500 24262 UoH - Compartment Syndrome(Fasciotomy Forearm) 6000 24263 UoH - Cutis Interposition Arthroplasty 6000 24264 UoH - Deformity Correction/Radial Club Hand Correction 10000 24265 UoH - Elbow Dislocation (Open Reduction) 7500 24266 UoH - Fractional Release/Muscle Slides (Elbow/Forearm) 7500 24292 UoH - French Osteotomy 8000 24267 UoH - IIizarov/small Bone Fixator (Forearm) 12000 24293 UoH - Intramedullary Nailing (Both Bones) 9000

179 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 24294 UoH - Lateral Condylefixation 6000 24268 UoH - Nancy Nail/Rush Pin Fixation (Forearm) 7500 24297 UoH - Open Reduction of Neglected Dislocation 7500 24298 UoH - ORIF Supracondylar Fractures 8000 24295 UoH - Supracondylar Fracture Fixation 7500 24269 UoH - Surgical Fusion (Elbow) 10000 24270 UoH - Surgical Procedures for Volkmann’s Contracture 8000 24271 UoH - Tendon/Muscle Transfers (Forearm) 8000 24296 UoH - Ulnar Nerve Transposition 5800 FEMUR 24201 UoH - Femur Shortening/Osteotomy and Plating 10000 24203 UoH - Telescoping Nail/FDNail - Femur 12000 24204 UoH - TEN’s/Enders Nailing Femur 10000 24205 UoH - Valgus/Varus Derotation Osetetomy Femur 10000 24202 UoH - IIIizarov/LRS/TSF Frame Femur 12000 FOOT & ANKLE 24200 UoH - “Z” Lengthening of TA 5000 24175 UoH - Abductor Hallucis Release in CTEV 4200 24176 UoH - Amputation Metatarsal Single Ray 5000 24177 UoH - Amputation’s - Foot and Ankle 7500 24178 UoH - Arthrodesis Subtalar Joint 5800 24179 UoH - Arthrotomy and Lavage Ankle Joint 5800 24300 UoH - Calcaneal Osteotomy 6000 24180 UoH - Corrective Osteotomy of Metatarsal/Midtarsal 6000 24181 UoH - CTEV Steindler’s Release 3500 24182 UoH - Curly Toes Correction 3400 24183 UoH - Evan’s Calcaneal Oseteotomy 8000 24184 UoH - Excision of Accessory Bones 7500 24185 UoH - Excision of Talus (CTEV/MMC) 7500 24186 UoH - Fusions Around Ankle and Foot Joints 10000 24187 UoH - Great Toe Deformity Correction 8000 24188 UoH - HOKE TA Lengthening 3500 24190 UoH - KKR Procedure for Vertical Talus Correction 10000 24191 UoH - K-wire Fixation of Fractures in Children 4200 24285 UoH - Lateral Column Lenghtrixting 8000 24287 UoH - Lateral Column Lengthening and Medical Column Shortening 9500

180 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 24286 UoH - Lateral Column Lengthening Foot 8000 24189 UoH - llizarov Correction in Club Foot 12000 24192 UoH - Manipulation CTEV + Cast 2400 24349 UoH - Pantalar Arthrodesis 7500 24193 UoH - Percutaneous Supramalleolar Oseteotomy 7500 24194 UoH - Ponsetti Tenotomy 2200 24195 UoH - Soft Tissue Release in Club Foot 7500 24301 UoH - Subtalar Fusion (grice green) 7500 24302 UoH - Symes Amputation 7500 24196 UoH - Synovial Excision - Foot & Ankle 5000 24197 UoH - Tarsal Osteotomies 7500 24303 UoH - Tenden Trans for Ft Drop 7500 24198 UoH - Tendon Recession in MMC 4200 24199 UoH - Tendon Transfer - Foot & Ankle 8400 24348 UoH - Triple Fusion 8000 HIP 24255 UoH - Fracture dislocation of femoral head 9000 24206 UoH - Adductor Tenotomy 3800 24254 UoH - Arthrodesis - Hip 7500 24207 UoH - Arthrotomy and Lavage - Hip 6200 24208 UoH - Closed Reduction + Adductor Tenotomy + Hip Spica 10000 24209 UoH - Closed Reduction Hip + Hip Spica in DDH 8800 24350 UoH - Core Decompression of Femoral Head 5000 24210 UoH - DDH - Open Reduction and Capsuloraphy 10000 24211 UoH - DDH Open Reduction + Femoral Shortening + Pelvic Ostetomy 12000 24212 UoH - DEGA Osteotomy 8000 24213 UoH - DHS/Angled Blade Plate - Paediatric 10000 24214 UoH - Fascia/muscle Release in Polio 7500 24215 UoH - Femoral Head Excision in PSO 7500 24216 UoH - Fracture Non Union Fixation - Femur 10000 24217 UoH - Pauwells Oseteotomy 12000 24219 UoH - Pelvic Support Oseteotomy 16000 24218 UoH - Pelvic/Hip/Femur Osteotomies 10000 24220 UoH - Percutaneous Insitu Fixation in SCFE 10000 24221 UoH - Psoas Release at Brim 6000 24222 UoH - Screw Fixation Head and Neck Femur 12000

181 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 24223 UoH - Surgical Fusion Hip Joint 12000 24224 UoH - Trochanteric Apo-physiodesis 8200 24256 UoH - VDO 7500 KNEE JOINT & LEG 24361 UoH - Exchange Nailing 9000 24362 UoH - Above Knee Amputation 8000 24359 UoH - Quadriceps Plasty 7500 24225 UoH - ‘8’ Plate Fixation around Knee & Ankle 8000 24226 UoH - Arthorotomy and Lavage Knee 7500 24251 UoH - Arthrotomy and Lavage Shoulder 5200 24227 UoH - Baumann’s Gastroc Release 6000 24360 UoH - Below Knee Amputation 8000 24228 UoH - Bone Grafting (postero lateral) - Tibia 7500 24229 UoH - Compartment Syndrome - Fasciotomy Leg 8000 24230 UoH - Congenital Pseudaorthrosis + Fibular Graft + Nailing 10000 24231 UoH - Congenital Pseudaorthrosis + IIizarov 12000 24252 UoH - Deformity Correction and Osteotomies in Hume 8000 24232 UoH - Distalisation of Tibial Tuberosity 8000 24233 UoH - Femoral 7500 24234 UoH - Femoral Osteotomies 8000 24235 UoH - Fractional Hamstring Release 6200 24253 UoH - Fractional Lengthenins Muscle in CP/AMC 7500 24236 UoH - Fulkerson’s Osteotomy 8000 24237 UoH - IIizaroav/TSF/LRS - Tibia 12000 24254 UoH - IM Nail/Plating/K-wire Fixation Humeru 10000 24238 UoH - Judets Quadriceps Plasty with Femoral Short 12000 24358 UoH -Lateral Release for Patellas 5200 24255 UoH - LRS/IIizarov Fixator - Humerus 10000 24256 UoH - Malunited Supracondylar Fracture Correction 8000 24239 UoH - Muscle/Tendon Transfers around his/Knee joins 8000 24240 UoH - Osteotomy and Plate/K-wire fixation - Tibia 10000 24241 UoH - Pan Genu Epiphysiodesis 10000 24242 UoH - Percutaneous Quadriceps Recession 6000 24243 UoH - Physeal Arrest Surgeries 10000 24288 UoH - Physical Arrest Surgery 8000 24289 UoH - PhysIcal Assest Surgery Minor / Moderate 8000

182 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 24244 UoH - Proximalm/Distal Realignment Surgery in Patelar dislocation 10000 24257 UoH - Scalpa Mobilization in Sprengel Shoulder 10000 24357 UoH - Semi Transfer / Rectus Transfer 5200 24258 UoH - Surgical Fusion - Shoulder 11000 24245 UoH - Surgical Fusion of Knee 10000 24246 UoH - Telescoping Nail/FDNail - Tibia 12000 24247 UoH - Tibial Epiphysiodesis 7500 24248 UoH - Tibial Shortening and Plating 12000 24249 UoH - Tibia-multilple Osteotomies + IM Nailing 12000 24259 UoH - Unipolar/Bipolar Release in Torticollis 8000 24250 UoH - V-Y Quadriceps Plasty 10000 OPTHALMOLOGY - SURGICAL 23915 UoH - Cataract Surgery 4000 23913 UoH - EVA Major 2500 23914 UoH - EVA Minor 1000 23908 UoH - Goniotomy 3500 23912 UoH - Lacrymal Syringing & Probing 2000 23919 UoH - Ptosis Repair 4000 23918 UoH -Retina Surgery 8000 23916 UoH - Secondary Implant 3000 23917 UoH - Squint Miscellaneous 3000 23910 UoH - Squint surgery (Major) 10000 23911 UoH - Squint surgery (Minor) 6000 23909 UoH - Trabeculectomy 5500 WRIST 24272 UoH - Carpal Bone Excision 8000 24273 UoH - External Fixator/Small Fragment Fixator (Wrist) 10000 24363 UoH - Ganglion Excision 4600 24274 UoH - Surgical Fusion (Wrist) 10000 24275 UoH - Tendon Transfers (Hand) 7800 24364 UoH - TFCC Excision in Madelung deformity 6000 24276 UoH - Wrist Deformity in CP/AMC Correction 10000 GENERAL

24365 UoH - AmputationsUoH -Minor 4000

24366 UoH - Application of Special Plasters/MJHSBS/Spica/FCB 2000

24277 UoH - Arthrogram Joints 2500

183 CODE DESCRIPTION COMMON GENERAL SEMI PVT. A/C DLX/ PVT. SUITE

Rs. Rs. Rs. Rs. Rs. 24367 UoH - Biopsy -Minor 2000 24368 UoH - Bone Graft -Minor 2500 24278 UoH - Bone Grafting and Curettage in Bone Tumours 8000 24279 UoH - Closed Reduction and Cast Application 3500 24374 UoH - Combined Complex Procedure 12000 24369 UoH - Curratage of Bone Tumor -Minor 2500 24280 UoH - Decompression of Bone in Acute OM 6000 24281 UoH - Exostocis Excision 6000 24282 UoH - Joint Debridement and Synovectomy 6000 24370 UoH - Nerve Repair - Minor 2500 24283 UoH - Non-Union Fracture Fixation 8000 24373 UoH - Osteomyelitis Chronic Medium Curettage & Automation 6000 24284 UoH - Percutaneous Tenotomies 2500 24371 UoH - Release of Contracture - Minor 2500 24372 UoH - Removal ImplantsUoH -Minor 2500 24290 UoH - Unipolar Release in Torticollis 6000 R. ANAESTHESIOLOGY 03028 Anaesthesia for Cardioversion 1000 1400 2400 3300 4300 03029 Anaesthesia for Cath Lab 1000 1400 2400 3300 4300 09418 Anaesthesia for CT Scan 1000 1400 2400 3300 4300 03027 Anaesthesia for ECT 1000 1400 2400 3300 4300 09417 Anaesthesia for Endoscopy 1000 1400 2400 3300 4300 09419 Anaesthesia for Radiotherapy 1000 1400 2400 3300 4300 09411 Chemical Sympathectomies 1000 1400 2400 3300 4300 09401 Epidural Injection 1000 1400 2400 3300 4300 09404 Extra Hours taken for a Surgery 09405 Glucometer Random Blood Sugar done in O T 100 100 100 100 100 03030 Labour Analgesia 2000 2800 4700 6500 8500 09408 Local Anaesthesia 1000 1400 2400 3300 4300 03031 LP Out side OT 1000 1400 2400 3300 4300 09407 Nerve block - Major 1500 2100 2700 3300 3900 09406 Nerve Block - Minor 1000 1400 2400 3300 4300 09402 Pain Clinic 100 100 200 300 400 09409 Post-OP Epidural Analgesia (Package) for 24 hrs. 1100 1500 2600 3600 4700 09410 Post-OP Epidural Analgesia (Package) for 48 hrs. 1700 2400 4000 5500 7200 09416 Specialised Anaesthesia Care 1000 1400 2400 3300 4300

184