INDEX

S. No. INDEX PAGE Nos.

1 GENERAL INFO 2 TO 9 2 HEALTH CHECK-UPS 10 TO 13 3 CATH & DSA PROCEDURES 14 TO 23 4 PHYSIOTHERAPY 24 TO 43 5 BLOOD BANK PROCEDURES 44 TO 48 6 INVESTIGATIONS 49 TO 166

ALLERGY 49 BIO CHEMISTRY 49 TO 67 BLOOD BANK-1 PROCEDURES 67 TO 68 CT SCAN RADIOLOGY 68 TO 77 CARDIOLOGY 77 TO 78 COLOUR DOPPLER 78 DATAR GENETIC OUTSOURCE 78 TO 81 DENTAL 81 TO 82 FEATL MEDICINE 82 TO 84 GASTROENTEROLOGY 84 HAEMATOLOGY 84 TO 93 HISTOPATHOLOGY 93 TO 97 IVF LAB 97 LAB OTHERS 97 MEDICAL 97 MICROBIOLOGY 97 TO 119 MRI RADIOLOGY 119 TO 132 NUCLEAR MEDICINE RADIOLOGY 132 TO 135 ONCOLOGY MEDICAL 136 ONCOLOGY SURGICAL 136 PAEDIATRIC CARDIOLOGY 136 PSYCHIATRY 136 TO 139 PFL 139 TO 140 RADIOLOGY MOLECULAR IMAGING & NUCLEAR MEDICINE 140 TO 142 TMT 142 TRANSPLANTATION IMMUNBOLOGY 142 TO 147 ULTRASOUND RADIOLOGY 147 TO 1150

W.E.F. 1st January 2019 1 1 WARDS OTHERS 150 XRAY 150 TO 166 7 PKG CATH 167 TO 172 8 PKG CABG 173 TO 174 9 PAD CCS 175 TO 179 10 PAD CARDIOLOGY 180 TO 182 11 DAYCARE 183 TO 185 12 IVF PKG 186 13 PKG KIDNEY 187 14 PKG LITH 188 15 PKG GENERAL 189 TO 190 16 ONCOLOGY 191 TO 195 17 LIVER TX 196 18 ALLOGELIC AND AUTOLOGOUS BMT 197 TO 198 19 RADIO IODINE THARAPY 199 20 THERASPHARE Y 90 200 21 NEONATAL & PEAD 201 TO 205 22 BARIATRIC SURGERY 206 23 ORTHOPEDIC 207 24 INVASIVE PROCEDURES 208 TO 308 DENTAL 208 TO 210 ENT 211 TO 217

GENERAL 218 TO 236 IVPM 226 TO 229 NEURO 229 TO 231 O&G 231 TO 241 ONCO 241TO 247 OPTHAL 247 TO 250 ORTHO 250 TO 270 PEAD 270 TO 272 PEAD ORTHO 272 TO 284 PLR 284 TO 292 THOR 292 TO 298 URO 298 TO 304 VASC 304 TO 308 25 NON INVASIVE PROCEDURE 309 TO 376 ANAESTHESIOLOGY 309 TO 317 APOLLO SAARTHAK MENTAL HEALTH SERVICE 317 BODY MIND MEDICINE 317 TO 318

12 A W.E.F. 1st January 2019 CATH LAB 318 CTVS 318 DENTAL 318 TO 323 EAR, NOSE & THROAT 323 TO 326 ENDOCRINOLOGY 326 TO 327 FETAL MEDICINE 327 TO 328 GASTROENTROLOGY 328 TO 334 GENERAL SURGERY 334 HAEMATOLOGY 334 HOLISTIC MEDICINE 334 TO 337 HYPERBARIC 337 TO 338 IVF LAB 338 TO 339 NEONATOLOGY 339 TO 340 NEPHROLOHY 340 TO 342 NEUROLOGY 343 TO 348 OBS & GYNECHOLOGY 348 TO 349 ONCOLOGY SURGICAL 349 TO 355 OPTHALMOLOGY 355 TO 357 PLASTIC & COSMETIC SURGERY 357 TO 366 PUVA THERAPY 366 RHEUMATOLOGY CLINICAL IMMUNOLOGY 366 TO 367 RESPIRATORY MEDICINE OTHERS 367 TO 368 SLEEP LAB 368 TO 369 C T SCAN RADIOLOGY 369 ULTRA SOUND RADIOLOGY 370 TO 371 X RAY RADIOLOGY 371 UROLOGY 371 WARDS OTHERS 371 TO 376

W.E.F. 1st January 2019 1 B 3 GENERAL INFORMATION

OUTPATIENT DEPARTMENT: Tariff

1 ) REGISTRATION FEE Rs 350

2 ) CONSULTATION FEE Tariff

a) OPD Consultation Fees (Platinum Louge) 1500 to 2500

b) OPD Consultation Fees 800 to 1500

c) Diet Consultation 460 d) CMO’s 550 e) Antenatal Classes Course Fees 5500

f) Diet Counselling General Ward 630 Semi Private / ICU 1050 Singal / Delux / Suit 1260

1) INPATIENT DEPARTMENT

BED CHARGES

Category of ward Bed Charges/ Day International (B) International (A)

A/c Multi Bed Unit 5,600 6,200 6,700

Semi Private 8,600 9,500 10,300

Single Room 16,600 18,300 19,900

Deluxe 18,800 20,700 22,600

H1N1 Unit 16,600 18,300 19,900

LDR Room 20,900 23,000 25,100

Suite 41,500 45,700 49,800

High Dependency 9,100 10,000 10,900

ICU 16,600 18,300 19,900

2 W.E.F. 1st January 2019 GENERAL INFORMATION

Isolation Room 12,000 13,200 14,400

Step Down 12,000 13,200 14,400

Emergency Ward 1,100 1,200 1,300 per Hour Subject to Rs 11000 per Day

Triage 1,400 1,500 1,700 per Hour Subject to Rs 14000 per Day

Day Care 1,100 1,200 1,300 per Hour Subject to Rs 11000 per Day

Pediatrics ICU

PICU 8,900 9,800 10,700 (if ventilator used Rs. 2750/-extra)

PHDU 8,900 9,800 10,700

Neonatal ICU/ Nursery

Nursery 5,800 6,400 7,000

NICU (I) 8,900 9,800 10,700 (if ventilator used Rs. 2750/-extra) Labour Room 5,500 6,100 6,600

New Born Baby 2,600 2,900 3,100 Care Charges (One Time Only)

Note

1 When the patient is in ICU/HDU and the patient attendant is allowed to retain the bed, normal bed charges as above will be applicable. 2 Service charges will be added to investigations and procedures wherever they are not defined sepa- rately as per the category of ward. 3 Attendant Room: The Stay is only for ICU/ HDU patient’s attendants from 9 PM to 6 AM. Only one attendant may stay in a room.

W.E.F. 1st January 2019 3 GENERAL INFORMATION

2 ) BILLING OF BED CHARGES:

1. Basis for computing bed charges:

™The Hospital follows a single discharge time at 9.00 a.m. ™ Upto 6 hours is counted as half a day. ™ 6 hours & above upto 24 hours is counted as one day ™ 3 hours grace time is granted on the day of discharge.

2. Bed Transfer: ™ In the event of a bed transfer during the course of treatment, the higher category bed charges will be applicable on the day of transfer. ™ In the event of a bed transfer during the course of treatment, investigation, surgical/procedure charges will be charged as per the higher category of Ward.

3. Admission through Emergency Where a patient is admitted to the emergency ward and the desired category of the bed is not avail able, the charges applicable to desired category of bed is applicable if the same is lower than the emergency ward bed. In any other event, the charges applicable to emergency ward bed would prevail.

4. Admission directly into ICU Where a patient is admitted to ICU bed directly, the charges for procedures/surgeries will be in line with rates applicable for semi-private ward if they are not listed separately. However, if the patient opts for a category which is higher than than Semi-private bed at the time of transfer from ICU, the procedures/surgeries will be charged as per the tariff applicable to the type of higher category of bed. The bed charges will be as per ICU bed charges.

3 ) IN PATIENT CONSULTANT FEE Existing Fee International (B) International (A)

1 A/c Multi Bed Unit 1,100 1,210 1,320 2 Semi Private 1,400 1,540 1,680 3 Single Room 1,700 1,870 2,040 4 Deluxe 1,900 2,090 2,280 5 H1N1 Unit 1,500 1,650 1,800 6 Suite 3,500 3,850 4,200 7 High Dependency 1,400 1,540 1,680

4 W.E.F. 1st January 2019 GENERAL INFORMATION

8 Isolation Room 1,400 1,540 1,680 9 Step Down 1,400 1,540 1,680 10 ICU 1,500 1,650 1,800 11 Emergency Ward/ Day Care 1,400 1,540 1,680 12 Triage 1,400 1,540 1,680 13 Pediatrics ICU Level 2 1,400 1,540 1,680 Level 3 1,400 1,540 1,680 14 Neonatal ICU/ Nursery Neonatal Step Down 1,300 1,430 1,560 Neonatal ICU 1,400 1,540 1,680 15 Pre-Operative Evaluation Fee A/c Multi Bed Unit 1,600 1,760 1,920 Semi Private/ICU/HDU 2,100 2,310 2,520 /Day Care Single Room 2,600 2,860 3,120 Deluxe 3,200 3,520 3,840 Suite 4,200 4,620 5,040

Note I Fees are for visits from 7 A.M. to 10 P.M. II Two visit charges per day are permitted. The visits needs to be marked in the activity sheet by the consultant/treatment team at the time of visit. If the consultant is not physically present, no visit charges can be put. III Any visit after 10 P.M. Will be treated as Emergency visit and 100% extra will be charged. IV Two visit charges per day are permitted in ICU & HDU. V Post operative visit charges by operating Surgeon/ Surgical team will be charged as normal visit fees. IV Where two surgical procedures are carried out in the same site, the surgeon fees for the procedure costing less would be discounted by 50%. This will not be applicable in cases where a second surgeon has been called or where the same Surgeon operates on a different site. VII Consultation Fees for Normal New Born Baby in Apollo Hospital kept in NICU is nil upto 48 Hrs.

W.E.F. 1st January 2019 5 GENERAL INFORMATION

4 ) Billing of Surgery, Anesthesia, Assistant Surgeon & OT Charges

(A) Surgery Fee 1 Surgery fees are as defined in the Surgery tariff section

(B) Anesthesia Fee 1 Anesthetist fees will be equivalent to 1/3 of Surgeon fees. If stand by 1/4 of Surgeon fees. 2 Minimum charges for General Anesthesia is Rs 500/- 3 Pre Anesthesia Checkup Rs 350/-

(C) Assistant Surgeon Fee 1 25% on the Surgeon fee for all surgeries. The Assistant Surgeon fee shall not be applicable for surgeies performed in Day Care/OPD basis 25% on the Surgeon fee for Neuro surgeries.

(D) OT Charges 1 OT charges are 100% of Surgeon Fees. 2 If any surgery done on Day care/OPD basis (Surgery without admission) OT Charges will be 80% of Surgeon fees.

(E) Surgical Stand by Neurophysician 1 25% of Surgeon Fee only

(F) Consumables & Medicines 1 Consumables, Drugs, Medicines etc., during the course of treatment will be charged additionally on the basis of actual usage.

5 ) Equipment,Injections & Others

a) Equipment Tari 1 Alpha Bed Charges (per day) 140 2 Alpha X-Cell Bed Charges(per day) 500 3 DVT Flowtrwon (per day) 750 4 Nimbus Bed Charges (per day) 750 5 Bipap charges (per day) 1,650 6 Cardiac Monitor (per day) 1,360

6 W.E.F. 1st January 2019 GENERAL INFORMATION

7 Ventilator charges (per day) 2,990 8 Ventilator care charges (per day) 700 9 Syringe Pump/ Infusion Pump per quantity 480 10 High Frequency Ventilation(Per Day) 4,000 11 Hand Drill 3,300 12 Glucose Monitoring System (per day ) 440 13 ECMO Initiation Charges: (valid for 1st week) 450,000 14 ECMO Maintenance Charges(After 1st week Every Week) 100,000 15 Sensor Charges Actual + Service Charges

A/c Multi Bed Unit Semi Private ICU/HDU/ Single Dlx Suite room Neonatal ICU/Step Down 16 Cystoscope 680 830 830 1100 1640 2610 17 Arthroscope 1900 1900 1900 2460 2460 2740 18 Laproscope 1650 2460 2460 3150 4790 7880 19 Bilirubin 400 Transcutaneous(Per Day) 20 Co Monitoring 3000 (Etco Monitoring)(Per Day) 21 Flexible 1000 1000 1000 1000 1000 1000 Cystouretroscope 22 Flexible 1000 1000 1000 1000 1000 1000 Ureteroscope 23 Navigation Image 3000 3000 3000 3000 3000 3000 Guide System (NIGS) 24 Nebulizer Charges 160 160 160 160 160 160 25 Photo Therapy Charges 1800 26 C -Arm First 1/2 Above 1/2 Above Above Above for Hrs Hrs to1 Hrs 1 hrs 1-1/2 2 Hrs every to to 2 Hrs 1/2 1-1/2 hrs hrs 940 1820 2610 3520 520

W.E.F. 1st January 2019 7 GENERAL INFORMATION

b) Injections Tari 1 I.M. Injection 60 2 I.V. Injection 70

c) Others Tari 1 Cat Gut 140 2 Intubation 1,100 3 Initiation of Bipap 1,300 4 O 2 Charges per Liter 20 (Subject to Rs. 1160/- per day) 5 P.O.P Application 280 6 Repeat Screening 550 7 New Born BabyCare Charges 2,600 (One Time Only)

6 ) Hospital Services and Treatment Monitoring & Management Charges A/c Multi Semi Private ICU/HDU/ Single Dlx Suite Day Care Bed Unit Neonatal ICU/Step Down 1,500/- 2500/- 2500/- 2500/- 3000/- 3000/- 2000/-

7 ) Patient Diet Charges 450 per day

MISCELLANEOUS

A AMBULANCE CHARGES Tari Tari

Within Delhi Outside Delhi

1 Ambulance charges (Per K.m.) 40 40 2 Ambulance Minimum Charges 500 500 3 Doctor 1200 4000 4 Equipment Charges Nil Nil

B OTHERS Tari

1 Issue of Certificate 350 2 Medical Record fees 500

8 W.E.F. 1st January 2019 GENERAL INFORMATION

3 Medical legal cases(MLC) Charges 690 4 Medical legal cases(MLC) CR X-ray film 120 5 Police Study 690 6 Locker’s Security Deposit (Refundable) 1000 7 Safe Deposit Locker - Rent 100 8 Documentation Charges 350

C Neonatologist Resuscitation Fees

1 Neonatologist Resuscitation fees will be equivalent to 1/3 of Delivery Charges

DISCOUNT ON PROCEDURES

(a) Discount on CT& MRI follow up study (with in a year from the date of 1’st Scan) 1st Follow-up 2nd Follow-up 3rd and subsequent Follow up (b) CT/ MRI (Excluding Contrast Media) following Neuro srugery & SRS/ SRT (Within one year) (C) DSA following SRS or SRT (Within Six Months) (d) DSA following Neuro Surgery (e) 50% Discount on Check angio followed by CABG/ PTCA with in a period of one year.

f) CAG and Renal angio if performed in same sitting only CAG procedure will be charged. (g) Dexa Scan followed by any health check except breast check & Advanced Heart Check- up (h) CAG, if done within 7 days from the date of Apollo Health Chqs(Master/Executive/ Heart/Whole Body) a discount of Rs. 1000/- will be given to the patient on CAG Package.

W.E.F. 1st January 2019 9 HEALTH CHECK UP

SERVICE SERVICENAME Tariff ID 32478 APOLLO 3 PM CHECK 1,800

61515 APOLLO ADVANCE SUGAR PACKAGE - WITH STRESS ECHO 10,500

61514 APOLLO ADVANCE SUGAR PACKAGE - WITHOUT STRESS 7,500 ECHO 1059742 APOLLO ADVANCED CANCER SCREENING PACK 2 12,600 (FEMALE) 1059744 APOLLO ADVANCED CANCER SCREENING PACK 2 (MALE 10,500 LESS THAN 50 YEARS) 1059743 APOLLO ADVANCED CANCER SCREENING PACK 2 (MALE 10,500 MORE THAN 50 YEARS) 21879 APOLLO ADVANCED HEART CHEQ FEMALE 21,000

21710 APOLLO ADVANCED HEART CHEQ MALE 21,000

62274 APOLLO ANNUAL SUGAR PACKAGE WITH STRESS ECHO 16,500

62275 APOLLO ANNUAL SUGAR PACKAGE WITHOUT STRESS 13,500 ECHO 1059731 APOLLO BASIC CANCER SCREENING PACK I (FEMALE LESS 5,100 THAN 40 YEARS) 1059730 APOLLO BASIC CANCER SCREENING PACK I (FEMALE 5,500 MORE THAN 40 YEARS) 1059729 APOLLO BASIC CANCER SCREENING PACK I (MALE LESS 4,000 THAN 50 YEARS) 1059728 APOLLO BASIC CANCER SCREENING PACK I (MALE MORE 5,000 THAN 50 YEARS) 1030029 APOLLO BONES AND JOINTS PACKAGE (HIP) 3,200

1030028 APOLLO BONES AND JOINTS PACKAGE (KNEE) 3,200

22031 APOLLO BREAST CHEQ 2,700

5739 APOLLO CANCER CHECK - FEMALE 3,600

6529 APOLLO CANCER CHECK - MALE 3,600

18890 APOLLO CHILD HEALTH CHEQ 2,100

1061423 APOLLO COMPREHENSIVE LIVER CHECK III (FEMALE) 9,500

10 W.E.F. 1st January 2019 HEALTH CHECK UP

1061422 APOLLO COMPREHENSIVE LIVER CHECK III (MALE) 9,500

1054692 APOLLO DIABETES SCREENING PACKAGE (FEMALE) 3,750

1054691 APOLLO DIABETES SCREENING PACKAGE (MALE) 3,750

14137 APOLLO DIABETIC CHECK PACKAGE FEMALE 5,000

14138 APOLLO DIABETIC CHECK PACKAGE MALE 5,000

4290 APOLLO EXECUTIVE HEALTH CHECK UP FEMALE 5,600

4291 APOLLO EXECUTIVE HEALTH CHECK UP MALE 5,600

22033 APOLLO FAMILY CHECK (CHILDREN) 97,700

21882 APOLLO FAMILY CHECK (DOMESTIC HELP) FEMALE 97,700

21713 APOLLO FAMILY CHECK (DOMESTIC HELP) MALE 97,700

25669 APOLLO FAMILY CHECK (FEMALES) 97,700

25668 APOLLO FAMILY CHECK (MALES) 97,700

22034 APOLLO FETAL PACKAGE 6,000

62256 APOLLO FOOT AND EYE SCREENING WITH STRESS ECHO 7,100

62264 APOLLO FOOT AND EYESCREENING WITHOUT STRESS 4,000 ECHO 22036 APOLLO FUTURE CHECK FEMALE 78,800

22035 APOLLO FUTURE CHECK MALE 78,800

25432 APOLLO HEALTH CHECK UP FEMALE 5,300

25433 APOLLO HEALTH CHECK UP MALE 5,300

14293 APOLLO HEART CHECKUP [FEMALE] 7,900

14294 APOLLO HEART CHECKUP [MALE] 7,900

22037 APOLLO HOUSE HOLD EMPLOYEE CHEQ 500

1055708 APOLLO INSTA CHECK 1,000

W.E.F. 1st January 2019 11 HEALTH CHECK UP

22038 APOLLO KNEE CHECK - ADVANCE (FOR BOTH KNEE) 16,100

22039 APOLLO KNEE CHECK - ADVANCE (SINGLE KNEE) 9,900

22040 APOLLO KNEE CHECK - BASIC 2,700

22041 APOLLO LIVER CHECK 3,400

1061419 APOLLO LIVER CHECK I 2,600

1061420 APOLLO LIVER CHECK II 4,400

1053327 APOLLO OBESITY CHECK 1 6,500

1053328 APOLLO OBESITY CHECK 2 12,900

85501 APOLLO PERSONALISED HEALTH CHECK (30-40 YRS) 6,800 FEMALE 85498 APOLLO PERSONALISED HEALTH CHECK (30-40 YRS) MALE 6,800

85491 APOLLO PERSONALISED HEALTH CHECK (ABOVE 40 YRS) 6,800 FEMALE 85489 APOLLO PERSONALISED HEALTH CHECK (ABOVE 40 YRS) 6,800 MALE 85493 APOLLO PERSONALISED HEALTH CHECK (BELOW 30 YRS) 6,800 FEMALE 85492 APOLLO PERSONALISED HEALTH CHECK (BELOW 30 YRS) 6,800 MALE 1058939 APOLLO SENIOR CITIZENS HEALTH CHECK-I 2,700

1058941 APOLLO SENIOR CITIZENS HEALTH CHECK-II (FEMALE) 10,000

1058940 APOLLO SENIOR CITIZENS HEALTH CHECK-II (MALE) 10,000

22042 APOLLO STROKE CHEQ 5,400

1043730 APOLLO WELL WOMAN CHECK 2 FOR DIABETES 6,600

1043731 APOLLO WELL WOMAN CHECK 2 FOR NON DIABETES 6,600

16592 APOLLO WELL WOMEN CHECKUP 2,600

4614 APOLLO WHOLE BODY CHECK UP FEMALE 10,500

4294 APOLLO WHOLE BODY CHECK UP MALE 10,500

12 W.E.F. 1st January 2019 HEALTH CHECK UP

22067 HC 1 APOLLO CARDIAC REVIEW 3,000

22068 HC 1 APOLLO CARDIAC REVIEW - TMT + ECHO 3,600

22069 HC 1 APOLLO CARDIAC REVIEW-TMT+DOBUTAMISTRESS 5,500 ECHO 1069284 HEALTHY HEART PROGRAM PACKAGE 3,250

W.E.F. 1st January 2019 13 CATH & DSA PROCEDURE

1) Cardiac Cath Lab

Service Sl No. Procedure A/c Semi Single Deluxe Suite Id Multi Private Room Bed Unit 56104 1 Diagnostic Electrophysiology 25,500 25,500 25,500 25,500 25,500 Mini 56105 2 Diagnostic Electrophysiology 51,100 51,100 51,100 51,100 51,100 Full 3 RF Ablation 113,800 116,800 124,200 126,900 148,700

32806 4 Septal Ablation 47,500 47,500 47,500 47,500 47,500

10481 5 IVC Filter 82,600 82,600 82,600 82,600 82,600

1670 6 AICD/Biventricular/Combo 159,300 159,300 159,300 159,300 159,300 Device Implantation 70804 7 Temporary Pacemaking (TPI) 25,500 25,500 25,500 25,500 25,500

78599 8 Permanent Pacemaker (PPI) 84,200 84,200 84,200 84,200 84,200 Single Chamber 56066 9 Permanent Pacemaker (PPI) 112,200 112,200 112,200 112,200 112,200 Double Chamber 56106 10 EECP (Enhanced External 203,200 203,200 203,200 203,200 203,200 Counter Pulsation) 56107 11 EECP (Enhanced External 6,800 6,800 6,800 6,800 6,800 Counter Pulsation) - single sitting 32792 12 Pericardial Tapping 17,600 23,700 29,800 41,500 60,100

56108 13 Endo Venus Laser Therapy 144,500 155,100 172,300 183,300 215,600

Note: INCLUSIONS EXCLUSIONS

Sr no 1 to 3 and 12 Sr no 1 to 3 and 10 Consultant Charges, Cath Charges, & One day Bed charges Investigations, bed charge Sr. No.3 Consumables Medicine

14 W.E.F. 1st January 2019 CATH & DSA PROCEDURE

Sr no 4 Sr no 4 Consultant charges, Cath Charges, Consumables Bed charges Investigations, Medicine, Balloon & Guide wire

Sr no 5 Sr no 5 Consultant charges, Cath Charges, Bed charges,Medicine, IVC Filter De Consumables vice Accerirues, Routine Investigations

Sr no 6 Sr no 6 Consultant charges, Cath Charges, Bed charges, Implantable device and Introducers, Medicine, Routine Investigarions

Sr no 7 Sr no 7 Consultant charges, Cath Charges Bed charges, Investigation, Medicine, Consumables

Sr no 8 and 9 Sr no 8 and 9 Consultant charges, Cath Charges, Consumables Bed charges, Investigation, Medicine, Pacemaker

Sr no 10 Consultant charges, Cath Charges, 2 Echo’s (Dobutamine or Stress)

Sr no 11 Consultant charges, Cath Charges

Sr no 13 Consultant charges, Cath Charges, consumables, Pharmacy (Crepe Bandage)

Investigations (BT,CT,CBC,Peripheral Doppler)

Routine Investigations

Creatinine Electrolytes ECG UreaGlucose Random BT PTINR & APTT/ PTTK CBC (HB, TLC,DLC, ESR) CT Anti HIV (I&II) Elisa /HIV

(Other Cath Lab procedures are listed under package heading)

W.E.F. 1st January 2019 15 CATH & DSA PROCEDURE

2 ) DSA Lab

I Neuro Intervention Procedures.

1) Cardiac Cath Lab

Service Sl No. Procedure A/c Semi Single Deluxe Suite Id Multi Private Room Bed Unit (i) Category (A) 67180 EMBOLIZATION OF ECA 112,000 149,300 186,600 261,800 364,100 TUMORS - (DSA LAB) 67184 EMBOLIZATION OF 112,000 149,300 186,600 261,800 364,100 SPINAL TUMORS - (DSA LAB) 49201 INFERIOR PETROSAL 112,000 149,300 186,600 261,800 364,100 VENOUS SINUS SAMPLING 67258 VERTEBROPLASTY - (DSA 112,000 149,300 186,600 261,800 364,100 LAB) (ii) Category (B) 56079 ANGIOPLASTY OF NECK 143,200 189,000 238,100 333,400 476,200 VESSELS ONLY 56080 EMBOLIZATION OF ICA 143,200 189,000 238,100 333,400 476,200 TUMOR 67173 CEREBRAL 143,200 189,000 238,100 333,400 476,200 THROMBOLYSIS - (DSA LAB) 56081 TESTOCCLUSION 143,200 189,000 238,100 333,400 476,200 (iii) Category (C) 56082 ANGIOPLASTY AND 177,600 236,000 294,200 420,200 590,900 STENTING OF CAROTID AND OTHER ARTERIES 56083 ANGIOPLASTY OF 177,600 236,000 294,200 420,200 590,900 INTRACRANIAL ARTERIES 67172 CEREBRAL AVM 177,600 236,000 294,200 420,200 590,900 EMBOLIZATION(BESIDES VB TERRITORY) - (DSA LAB) 67185 EMBOLIZATION OF 177,600 236,000 294,200 420,200 590,900 TUMORS FED BY BOTH ICA AND ECA - (DSA LAB)

16 W.E.F. 1st January 2019 CATH & DSA PROCEDURE

67189 GLUE EMBOLIZATION OF 177,600 236,000 294,200 420,200 590,900 TUMORS - (DSA LAB) 56086 PROXIMAL OCCLUSION 177,600 236,000 294,200 420,200 590,900 OF ICA (iv) Category (D) 56087 AVM EMBOLIZATION IN 219,900 295,600 365,200 510,300 733,300 THE VERTEBRO -BASILAR TERRITORY 56088 CCF BALLOON 219,900 295,600 365,200 510,300 733,300 OCCLUSION 56089 GDC COILING OF 219,900 295,600 365,200 510,300 733,300 INTRACRANIAL ANEURYSMS 67178 EMBOLISATION OF SPINAL 219,900 295,600 365,200 510,300 733,300 AVM - (DSA LAB) 56090 ANGIOPLASTY 219,900 295,600 365,200 510,300 733,300 AND STENTING OF INVRACRANIAL ARTERIES 56091 EMBOLIZATION OF 219,900 295,600 365,200 510,300 733,300 TUMORS FED BY VA OR/ AND BA 78509 DURAL AVF 219,900 295,600 365,200 510,300 733,300 EMBOLIZATION(DSA) 78510 INTRACRANIAL STENT 219,900 295,600 365,200 510,300 733,300 GRAFT PLACEMENT(DSA) 82233 COILING OF CCF (DSA 219,900 295,600 365,200 510,300 733,300 LAB) 77467 EMBOLIZATION OF 219,900 295,600 365,200 510,300 733,300 DURAL AVF (DSA) (v) Category (E ) STD Injection/ Sclerotherapy 25,900 34,900 43,500 60,800 86,100

67249 TIPSS PROCEDURE - (DSA 277,900 370,300 463,200 648,200 926,000

LAB) 93873 INTRACRANIAL FLOW 274,900 369,400 456,400 637,600 806,800 DIVERTER PLACEMENT Note: 1. If Anaesthetists is required , will be charged extra. 2. If Neurologist is standby for thrombolysis for acute stroke, will be charged extra by 10% of surgeons fees. 3. There will be a 15% Discount on repeat procedures in respect of Surgeons fees and DSA Charges. 4. Postop/ post embolization MRI at 50% discount with in 30 days.

W.E.F. 1st January 2019 17 CATH & DSA PROCEDURE

A/c Semi Pvt Single Dlx Suite Multi / ICU Rm Bed Unit 32833 (vi) CEREBRAL ANGIOGRAM 45,800 54,000 61,000 73,000 85,800

67239 (vii) SPINAL ANGIO - (DSA LAB) 71,300 79,600 88,600 103,700 117,800

67169 (viii) CAROTID ANGIOGRAPHY 45,700 51,500 58,100 73,000 81,800 - (DSA LAB)

Note: 1. The above procedures are inclusinve of DSA Lab charges & Surgeons charges & Assistant fees.

2. If Anaesthetists is required , will be charged extra. 3. All medicine and consumables will be charged separately. 4. Laboratory investigation etc. will be charged separately and additionally except: PT, PTTK, HB, TLC, DLC & RBS 5. If Neurologist is standby for thrombolysis for acute stroke, will be charged extra by 10% of surgeons fees. 6. There will be a 50% Discount on repeat procedures in respect of Surgeons fees and DSA Charges if done with in 30 days of surgery/ emolization. 7. Concessions for Repeat Angios/ embolization after 1 month to within a year: First Repeat: 15% Concession Second Repeat: 20% Concession Third and Subsequent Repeat: 25% Concession 8. Room rent will be charged as applicable.

II Other Interventional procedures Service Sl No. Procedure A/c Semi Pvt Single Dlx Suite Id Multi / ICU Rm Bed Unit 90321 1 ALCOHOL ABLATION DSA 41,400 41,400 41,400 41,400 41,400

56092 2 AORTIC ANGIOPLASTY 87,300 116,300 145,500 203,300 290,200

18 W.E.F. 1st January 2019 CATH & DSA PROCEDURE

80208 3 B/L VEIN ABLATION WITH 254,700 254,700 254,700 254,700 254,700 PERFORATOR ABLATION 32831 4 BRONCHIAL 80,000 106,300 132,900 185,700 264,800 EMBOLIZATION 67168 5 BRTO - (DSA LAB) 109,900 146,500 183,400 256,400 366,000

67174 6 CHEMOEMBOLIZATION 80,000 106,300 132,900 185,700 264,800 OF HEPATIC TUMORS - (DSA LAB) 67175 7 CHOLANGIOGRAM - (DSA 17,600 17,600 17,600 17,600 17,600 LAB) 79354 8 CORONARY ANGIO 127,400 127,400 127,400 127,400 127,400 GUIDED SCLEROTHERAPY 10348 9 EMBOLISATION FOR AVM 177,600 236,000 294,200 420,200 590,900

56095 10 EMBOLIZATION OF G.I. 80,000 106,300 132,900 185,700 264,800 BLEEDS 67182 11 EMBOLIZATION OF 80,000 106,300 132,900 185,700 264,800 HAEMANGIOMAS OR AVMS - (DSA LAB) 67187 12 EMBOLIZATION OF 80,000 106,300 132,900 185,700 264,800 VARICOCELES - (DSA LAB) 68355 13 EMBOLIZATION TUMOR- 80,000 106,300 132,900 185,700 264,800 (DSA LAB) 69654 14 Endovascular AAA Repair 318,400 318,400 318,400 318,400 318,400

82493 15 EXPLANTATION OF AICD 79,600 79,600 79,600 79,600 79,600

42107 16 FRACTIONAL FLOW 36,400 36,400 36,400 36,400 36,400 RESERVE (FFR) 67190 17 HEPATIC VEIN STENTING - 109,900 146,500 183,400 256,400 366,000 (DSA LAB) 67194 18 ILIAC ARTERY STENTING - 109,900 146,500 183,400 256,400 366,000 (DSA LAB) 68359 19 INTERNALIZATION OF 41,400 41,400 41,400 41,400 41,400 PTBD (DSA LAB) 68358 20 INTERNALIZATION 66,600 88,600 110,700 154,700 221,200 OF PTBD POST LIVER TRANSPLANT (DSA LAB) 21 Intra Arterial chemotherapy 66,600 88,600 110,700 154,700 221,200

W.E.F. 1st January 2019 19 CATH & DSA PROCEDURE

56096 22 INTRA ARTERIAL 66,600 88,600 110,700 154,700 221,200 THROMBOLYSIS 67197 23 INTRA-ARTERIAL 66,600 88,600 110,700 154,700 221,200 CHEMOTHERAPHY- RETINOBLASTOMA - (DSA LAB) 89919 24 LEAD REPOSITIONING 25,500 25,500 25,500 25,500 25,500

78508 25 LIVER BIOPSY(DSA) 28,000 28,000 28,000 28,000 28,000

67202 26 LIVER EMBOLIZATION - 80,000 106,300 132,900 185,700 264,800 (DSA LAB) 68361 27 MHV STENTING (DSA LAB) 109,900 146,500 183,400 256,400 366,000

68360 28 MHV THROMBOLYSIS (DSA 87,300 116,300 145,500 203,300 290,200 LAB) 56097 29 PARTIAL SPLENIC 80,000 106,300 132,900 185,700 264,800 EMBOLIZATION 68352 30 PCN/PTBD with ballon 41,400 41,400 41,400 41,400 41,400 dialation(DSA LAB) 68353 31 PCN/PTBD With 52,000 52,000 52,000 52,000 52,000 Stenting(DSA) 68351 32 PCN/PTBD(DSA LAB) 28,000 28,000 28,000 28,000 28,000

10482 33 PERIPHERAL 87,300 116,300 145,500 203,300 290,200 ANGIOPLASTY 88728 34 PERMACATH INSERTION 31,200 31,200 31,200 31,200 31,200 (DSA LAB) 84338 35 PORTAL VEIN PRESSURE 37,800 44,300 50,400 54,200 63,800 MONITORING (DSA LAB) 67220 36 PORTAL VENOUS PALSTY - 87,300 116,300 145,500 203,300 290,200 (DSA LAB) 67221 37 PORTAL VENOUS 109,900 146,500 183,400 256,400 366,000 STENTING - (DSA LAB) 68356 38 PTBD Post Liver Transplant - 87,300 116,300 145,500 203,300 290,200 (DSA LAB) 68354 39 PTC(DSA LAB) 17,600 17,600 17,600 17,600 17,600

68357 40 RENAL TUMOUR 80,000 106,300 132,900 185,700 264,800 EMBOLIZATION - (DSA LAB)

20 W.E.F. 1st January 2019 CATH & DSA PROCEDURE

67231 41 RENAL ANGIOPLASTY - 87,300 116,300 145,500 203,300 290,200 (DSA LAB) 67232 42 RENAL ANGIOPLASTY 109,900 146,500 183,400 256,400 366,000 WITH STENT - (DSA LAB) 78507 43 REPOSITION OF PTBD 17,600 17,600 17,600 17,600 17,600 CATHTER OR CATHER CHANGE(DSA) 87422 44 REVASCULARISATION OF 25,500 25,500 25,500 25,500 25,500 AVF 67237 45 SCLEROTHERAPY - (DSA 27,200 36,600 45,700 63,800 90,400 LAB) 67240 46 SPLENIC ARTERY 80,000 106,300 132,900 185,700 264,800 EMBOLIZATION - (DSA LAB) 67242 47 STENTING OF ANY OTHER 109,900 146,500 183,400 256,400 366,000 ABDOMINAL ARTERY - (DSA LAB) 67243 48 STENTING OF AORTA - 109,900 146,500 183,400 256,400 366,000 (DSA LAB) 67244 49 STENTING OF PERIPHERAL 109,900 146,500 183,400 256,400 366,000 VESSELS - (DSA LAB) 67245 50 STENTING OF RENAL 109,900 146,500 183,400 256,400 366,000 ARTERY - (DSA LAB) 51 Sub Intimal Endovascular 159,300 191,100 191,100 222,900 254,700 Revascularization 78511 52 SUBCLAVIN ARTERY 109,900 146,500 183,400 256,400 366,000 ANGIOPLASTY AND STENTING(DSA) 67252 53 TRANS-JUGULAR LIVER 80,000 106,300 132,900 185,700 264,800 BIOPSY - (DSA LAB) 90695 54 TREPHINE BONE BIOPSY 21,800 29,700 36,400 50,800 72,800 (DSA LAB) 56102 55 TUMOUR EMBOLISATION 80,000 106,300 132,900 185,700 264,800

67254 56 UTERINE ARTERY 87,300 116,300 145,500 203,300 290,200 BALLOON OCCLUSION - (DSA LAB) 67255 57 UTERINE ARTERY 80,000 106,300 132,900 185,700 264,800 EMBOLIZATION - (DSA LAB) 86597 58 WPW MAPPING AND 50,900 50,900 50,900 50,900 50,900 THERAPY

W.E.F. 1st January 2019 21 CATH & DSA PROCEDURE

1059960 59 Cath Lab Procedures 36,800 36,800 36,800 36,800 36,800

1041361 60 CHEMICAL 143,100 189,000 238,100 333,400 476,200 ANGIOPLASTY(DSA LAB) 1036923 61 EMBOLIZATION OF RENAL 100,000 125,000 156,000 195,000 244,000 BLEED (DSA) 1041511 62 INSULIN VENOUS 80,000 106,300 132,900 185,700 264,800 SAMPLING (DSA LAB) Note: 1. Visiting fees of Consultant in Radiodiagnosis will be charges at 50% of the scheduled rates of the Hospital. 2. If Anaesthetists is required , will be charged extra. ( 50% of consultant in radiodiagnosis. If standby 10% of consultant in radiodiagnosis.) 3. If the procedure is repeated ( Except intra arterial Chemotherapy), the patient will be charged for consumables only. 4. Room rent will be charged as applicable. 5. Procedure are inclusive of DSA Lab Charges and Radiodiagnostic Charges.

Angiography/ Aortography/ Venography Tariff

PURPOSED TARIFF General Semi Pvt Single Deluxe Suite Ward Room 67210 1 PERIPHERAL ANGIO/ 37,800 44,300 50,400 54,200 63,800 VDSA/FLUSH AORTOGRAM/ FISTULOGRAM - (DSA LAB) 67229 2 "RENAL/ ANGIO/ VISCERAL 41,100 48,400 54,600 65,600 77,400 ANGIO - (DSA LAB)" 67246 3 SUPER -SELECTIVE 41,000 46,100 52,000 65,600 73,700 ANGIOGRAPHY - (DSA LAB) 67203 4 LOWER/UPPER LIMB 11,200 13,100 14,900 18,000 21,100 VENOGRAM/IVC GRAM - (DSA LAB) 67191 5 HEPATIC VENOGRAM - 37,800 44,300 50,400 54,200 63,800 (DSA LAB)

22 W.E.F. 1st January 2019 CATH & DSA PROCEDURE

67192 6 HEPATIC VENOUS 37,800 44,300 50,400 54,200 63,800 PRESSURE MONITORING - (DSA LAB) 67198 7 IVC AND STENROGRAM - 41,100 48,400 54,600 65,600 77,400 (DSA LAB) 67201 8 LIVER ANGIO - (DSA LAB) 41,100 48,400 54,600 65,600 77,400

67193 9 ILIAC ARTERY ANGIO - 37,800 44,300 50,400 54,200 63,800 (DSA LAB)

1. Emergency Cases done after 8.00 PM on week days and after 1.00 PM on Sundays and Holidays will be charged 10% extra. 2. Consultants in Radiodiagnosis are entitled for Indoor visits charges at the scheduled rates for Consultants. 3. Concessions for Repeat Angios: First Repeat: 15% Concession Second Repeat: 20% Concession Third and Subsequent Repeat: 25% Concession 4. Special Contrast will be charged extra.

W.E.F. 1st January 2019 23 PHYSIOTHERPAY

SERVICE ID SERVICE NAME SERVICE TYPE DEPT IPD Tariff

25223 4 C BRACE Physiotherapy Physiotherapy 12,710 and Rehab Center 25012 ABDUCTION BRACE Physiotherapy Physiotherapy 2,660 (AEROPLANE SPLINT) and Rehab Center 25123 ABDUCTION WEDGE Physiotherapy Physiotherapy 4,040 and Rehab Center 25159 AFO PP IMPORTED Physiotherapy Physiotherapy 2,310 and Rehab Center 1036223 AFO SHOE INSERT (P AND O) Physiotherapy Physiotherapy 3,700 and Rehab Center 25170 AFO WITH ANKLE Physiotherapy Physiotherapy 1,500 ARTICULATION and Rehab Center 25181 AFO WITH D ROTATION Physiotherapy Physiotherapy 580 and Rehab Center 1036313 AIR WALKER LONG (P AND O) Physiotherapy Physiotherapy 16,170 and Rehab Center 1036312 AIR WALKER SHORT (P AND O) Physiotherapy Physiotherapy 12,710 and Rehab Center 25192 AK CALLIPER WITH SHOES WITH Physiotherapy Physiotherapy 3,700 KNEE JOINT JT and Rehab Center 25203 AK PROSTHESIS HYDRUALIC Physiotherapy Physiotherapy 354,820 KNEE WITH DY FOOT -GERMANY and Rehab Center 25214 AK PROTHESIS POLYCENTRIC Physiotherapy Physiotherapy 189,880 KNEE WITH SACH FOOT and Rehab (GERMANY) Center 25225 AK PROTHESIS EBS KNEE WITH Physiotherapy Physiotherapy 498,150 DY MOTION FOOT-GERMANY and Rehab Center

24 W.E.F. 1st January 2019 PHYSIOTHERPAY

25013 AK PROTHESIS PNEUMATIC Physiotherapy Physiotherapy 257,450 KNEE WITH DY. MOTION FOOT and Rehab (GERMANY) Center 25024 AK PROTHESIS STABLISHED Physiotherapy Physiotherapy 48,160 KNEE WITH SACH FOOT and Rehab (GERMANY) Center 25046 AL CALLIPER WITH SHOES Physiotherapy Physiotherapy 2,310 LOCAL ADULT and Rehab Center 1036300 ANKLE BRACE IMPORTED (P AND Physiotherapy Physiotherapy 4,040 O) and Rehab Center 25057 ANTI SPASTIC SPLINT Physiotherapy Physiotherapy 1,620 and Rehab Center 25068 ARCH SUPPORT (B/L) Physiotherapy Physiotherapy 580 and Rehab Center 25079 ARCH SUPPORT (USA) IMPORTED Physiotherapy Physiotherapy 810 and Rehab Center 25090 ASH BRACE DELUXE Physiotherapy Physiotherapy 1,040 and Rehab Center 25101 ASH BRACE REGULAR Physiotherapy Physiotherapy 690 and Rehab Center 25112 ASH BRACE SEMI DELUXE Physiotherapy Physiotherapy 920 and Rehab Center 1036316 ASPEN CERVICAL COLLAR (P Physiotherapy Physiotherapy 8,320 AND O) and Rehab Center 25124 AXION FOOT Physiotherapy Physiotherapy 87,550 and Rehab Center 25135 BACK REST Physiotherapy Physiotherapy 1,270 and Rehab Center 1048407 BANDAGING-1 SESSION Physiotherapy Physiotherapy 1,200 and Rehab Center

W.E.F. 1st January 2019 25 PHYSIOTHERPAY

25146 BK CALLIPER WITH SHOES U/L Physiotherapy Physiotherapy 1,730 and Rehab Center 63353 BK PROTHESIS U/L ALIMCO / Investigations Physiotherapy 6,390 IMPORTED and Rehab Center 25153 BK PROTHESIS WITH DY. Physiotherapy Physiotherapy 81,430 MOTION FOOT (GERMANY) and Rehab Center 25154 BK PROTHESIS WITH HARMONY Physiotherapy Physiotherapy 548,510 SYSTEM (GERMANY) and Rehab Center 25155 BK PROTHESIS WITH POLYMER Physiotherapy Physiotherapy 122,890 LINEAR (GERMANY) and Rehab Center 25156 BK PROTHESIS WITH SACH FOOT Physiotherapy Physiotherapy 48,160 (GERMANY) and Rehab Center 25157 BOSTON BRACE (IMPORTED) Physiotherapy Physiotherapy 12,820 and Rehab Center 25158 BOSTON BRACE (INDIAN) Physiotherapy Physiotherapy 5,310 and Rehab Center 1036317 C P CHAIR (P AND O) Physiotherapy Physiotherapy 9,820 and Rehab Center 25160 C WALK FOOT Physiotherapy Physiotherapy 194,040 and Rehab Center 25161 C. P. CHAIR Physiotherapy Physiotherapy 4,040 and Rehab Center 25162 CDH SPLINT Physiotherapy Physiotherapy 810 and Rehab Center 25163 CDH SPLINT WITH HINGE Physiotherapy Physiotherapy 2,660 and Rehab Center 6492 CERVICAL / LUMBER TRACTION Physiotherapy Physiotherapy 460 and Rehab Center

26 W.E.F. 1st January 2019 PHYSIOTHERPAY

25164 CERVICAL HOT PACK Physiotherapy Physiotherapy 1,160 and Rehab Center 14188 CERVICAL TRACTION Physiotherapy Physiotherapy 580 and Rehab Center 25165 CHEST Physiotherapy Physiotherapy 920 PHYSIOTHERAPHY(NIGHT) and Rehab Center 25166 CHEST PHYSIOTHERAPY Physiotherapy Physiotherapy 580 and Rehab Center 88322 COLD PACK CHARGES (ONCE) Physiotherapy Physiotherapy 460 and Rehab Center 88323 COLD PACK CHARGES (ROUND Physiotherapy Physiotherapy 690 THE CLOCK) and Rehab Center 25167 COMBINATION THERAPHY Physiotherapy Physiotherapy 690 and Rehab Center 25168 COMMODE ELEVATION FOR TKR Physiotherapy Physiotherapy 4,740 and Rehab Center 63354 CONSULTATION (SENIOR Investigations Physiotherapy 1,040 CONSULTANT) and Rehab Center 25169 CPM Physiotherapy Physiotherapy 580 and Rehab Center 25171 CRAWLER Physiotherapy Physiotherapy 3,000 and Rehab Center 25172 CRYOTHERAPY Physiotherapy Physiotherapy 460 and Rehab Center 1048403 CRYOTHERAPY/PARAFFIN WAX Physiotherapy Physiotherapy 11,620 BATH (PWB) AND EXERCISES and Rehab (FOR 10 SESSIONS) Center 25173 CTEV SHOES (LARGE) Physiotherapy Physiotherapy 3,230 and Rehab Center

W.E.F. 1st January 2019 27 PHYSIOTHERPAY

25174 CTEV SHOES (MEDIUM) Physiotherapy Physiotherapy 2,540 and Rehab Center 25175 CTEV SHOES (SMALL) Physiotherapy Physiotherapy 1,850 and Rehab Center 25176 CTEV SPINTS U/L Physiotherapy Physiotherapy 580 and Rehab Center 25177 CTEV SPLINT (ORFIT) Physiotherapy Physiotherapy 1,620 and Rehab Center 25178 CUFF TOP CALIPER (ADULT) Physiotherapy Physiotherapy 6,700 and Rehab Center 25179 CUSTOM MADE PRESSURE Physiotherapy Physiotherapy 1,500 GARMENT ABOVE KNEE and Rehab Center 25180 CUSTOM MADE PRESSURE Physiotherapy Physiotherapy 1,270 GARMENT BELOW KNEE and Rehab Center 25182 D. B. SPLINT Physiotherapy Physiotherapy 2,080 and Rehab Center 1036314 DIEBETIC WALKER (P AND O) Physiotherapy Physiotherapy 20,210 and Rehab Center 25183 DORSAL SPINAL BRACE Physiotherapy Physiotherapy 2,080 and Rehab Center 25185 DY. MOTION FOOT Physiotherapy Physiotherapy 46,200 and Rehab Center 1036302 DYNACROSS BACK SUPPORT (P Physiotherapy Physiotherapy 4,390 AND O) and Rehab Center 25186 DYNAMIC COCK UP SPLINT Physiotherapy Physiotherapy 690 P.P.LIGHT WEIGHT and Rehab Center 25187 ELBOW BRACE (IMPORTED Physiotherapy Physiotherapy 4,390 SHEET) and Rehab Center

28 W.E.F. 1st January 2019 PHYSIOTHERPAY

25188 ELBOW CAGE Physiotherapy Physiotherapy 1,500 and Rehab Center 25189 ELBOW GAITER Physiotherapy Physiotherapy 690 and Rehab Center 25190 ELECTRO DIAGNOSIS(SDC) Physiotherapy Physiotherapy 1,040 and Rehab Center 25191 ELECTRO THERAPHY TENS Physiotherapy Physiotherapy 460 and Rehab Center 25193 ELECTRO THERAPHY-ELECTRIC Physiotherapy Physiotherapy 690 MUSCLE STIMULATION and Rehab Center 25194 ELECTRO THERAPHY-EMG Physiotherapy Physiotherapy 580 BIOFEED BACK and Rehab Center 25195 ELECTRO THERAPHY- Physiotherapy Physiotherapy 810 IONTOPHORESIS and Rehab Center 25196 ELECTRO THERAPHY-LASER Physiotherapy Physiotherapy 690 THERAPHY and Rehab Center 25197 ELECTRO THERAPHY-MICRO Physiotherapy Physiotherapy 460 WAVE DIATHERMY and Rehab Center 25198 ELECTRO THERAPHY-MOIST Physiotherapy Physiotherapy 350 HEAT/INFRA RED and Rehab Center 25199 ELECTRO THERAPHY-PARAFFIN Physiotherapy Physiotherapy 460 WAX THERAPY and Rehab Center 25200 ELECTRO THERAPHY-SHORT Physiotherapy Physiotherapy 460 WAVE DIATHERMY and Rehab Center 63355 ELECTRO THERAPHY-ULTRA Investigations Physiotherapy 640 VOILET RAYS and Rehab Center 25201 ELECTRO THERAPHY- Physiotherapy Physiotherapy 350 ULTRASOUND THERAPHY and Rehab Center

W.E.F. 1st January 2019 29 PHYSIOTHERPAY

25202 ELECTRO THERAPHY-VACCUM/ Physiotherapy Physiotherapy 920 COMPRESSION THERAPHY and Rehab Center 25204 ELECTRO THERAPY PWB Physiotherapy Physiotherapy 8,890 THERAPY/EXERCISE 10days Pack and Rehab Center 25205 ELECTRO THERAPY TENS/MOIST Physiotherapy Physiotherapy 9,820 HEAT/IRR/US 10DAYS Pack and Rehab Center 25206 ELECTRO THERAPY-VACCUM/ Physiotherapy Physiotherapy 9,360 COMPRESSION THERAPY- and Rehab PACKAGE Center 25207 ELECTROTHERAPY PER SESSION Physiotherapy Physiotherapy 460 IFT and Rehab Center 25208 ELECTROTHERAPY PER SESSION Physiotherapy Physiotherapy 460 ULTRASOUND and Rehab Center 25209 ELECTROTHERAPY-ELECTRIC Physiotherapy Physiotherapy 690 MUSCLE STIMULATION and Rehab Center 97782 EQUIPMENT CHARGES (PER Physiotherapy Physiotherapy 350 SESSION) and Rehab Center 1036320 EVOLUTION KNEE BRACE (P AND Physiotherapy Physiotherapy 9,240 O) and Rehab Center 25210 EXERCISE BALL (IMPORTED) Physiotherapy Physiotherapy 230 and Rehab Center 25211 EXERCISE BALL (INDIAN) Physiotherapy Physiotherapy 120 and Rehab Center 25212 EXERCISE THERAPY Physiotherapy Physiotherapy 810 and Rehab Center 25213 EXERCISE THERAPY (OT) Physiotherapy Physiotherapy 810 and Rehab Center 25215 EXERCISE/COMBINATION Physiotherapy Physiotherapy 12,710 THERAPY - PACKAGE (10 DAYS) and Rehab Center

30 W.E.F. 1st January 2019 PHYSIOTHERPAY

25216 EXTENSION ORTHOSIS Physiotherapy Physiotherapy 13,170 and Rehab Center 1036654 FAB (P AND O) Physiotherapy Physiotherapy 4,040 and Rehab Center 25217 FEMORAL CAST BRACE WITH Physiotherapy Physiotherapy 5,310 KNEE WITH ANKLE and Rehab Center 25218 FLAT FT. LARGE Physiotherapy Physiotherapy 810 and Rehab Center 25219 FLAT FT. SHOES MEDIUM Physiotherapy Physiotherapy 690 and Rehab Center 25220 FLAT FT. SHOES SMALL Physiotherapy Physiotherapy 690 and Rehab Center 25221 FOOT PLATE Physiotherapy Physiotherapy 1,730 and Rehab Center 25222 FOREARM BRACE (IMPORTED Physiotherapy Physiotherapy 3,000 SHEET) and Rehab Center 25224 FRO LARGE Physiotherapy Physiotherapy 2,080 and Rehab Center 25226 FRO MEDIUM Physiotherapy Physiotherapy 1,730 and Rehab Center 25227 FRO SMALL Physiotherapy Physiotherapy 1,500 and Rehab Center 25228 GEL SHEET Physiotherapy Physiotherapy 1,730 and Rehab Center 25229 GLOOVE ONLY Physiotherapy Physiotherapy 1,620 and Rehab Center 25230 GROUP EXERCISE PROGRAM Physiotherapy Physiotherapy 690 and Rehab Center

W.E.F. 1st January 2019 31 PHYSIOTHERPAY

25231 GUTTER KNEE BRACE Physiotherapy Physiotherapy 1,500 and Rehab Center 25232 GUTTER WALKER WITH ELBOW Physiotherapy Physiotherapy 3,000 REST and Rehab Center 25233 HALO BRACE Physiotherapy Physiotherapy 17,790 and Rehab Center 25234 HEEL PAD (PAIR) Physiotherapy Physiotherapy 140 and Rehab Center 25235 HEMI SHOULDER SUPPORT Physiotherapy Physiotherapy 810 and Rehab Center 25014 HEMI STIC Physiotherapy Physiotherapy 920 and Rehab Center 25015 HEMI STICK IMPORTED Physiotherapy Physiotherapy 1,620 and Rehab Center 25016 HIGH COMBODE CHAIR Physiotherapy Physiotherapy 1,960 (FOLDING) and Rehab Center 25017 HIGH COMBODE CHAIR (NON Physiotherapy Physiotherapy 1,040 FOLDING) and Rehab Center 25018 HIGH THORACOLUMBAR Physiotherapy Physiotherapy 1,270 CORSET - LARGE and Rehab Center 25019 HIGH THORACOLUMBAR Physiotherapy Physiotherapy 1,040 CORSET SMALL and Rehab Center 25020 HIGH THORACOLUMBAR Physiotherapy Physiotherapy 1,160 CROSET - MEDIUM and Rehab Center 25021 HIP ABDUCTION BRACE Physiotherapy Physiotherapy 4,040 and Rehab Center 25022 HIP DISARTICULATION Physiotherapy Physiotherapy 354,590 PROTHESIS WITH DY. MOTION and Rehab FOOT(GERMANY) Center

32 W.E.F. 1st January 2019 PHYSIOTHERPAY

25023 HIP FLEX EXT. ABD CONTROL Physiotherapy Physiotherapy 5,780 BRACE and Rehab Center 25025 HKAFO U/L (PVC) Physiotherapy Physiotherapy 4,040 QUADILATERIAL SOCKET and Rehab Center 25026 HOT PACK Physiotherapy Physiotherapy 920 and Rehab Center 1048404 HOT PACKS AND EXERCISES (FOR Physiotherapy Physiotherapy 10,340 10 SESSIONS) and Rehab Center 25027 HUMERUS BRAC WITH ELBOW Physiotherapy Physiotherapy 2,080 JOINT and Rehab Center 25028 HUMERUS BRACE Physiotherapy Physiotherapy 1,040 and Rehab Center 25029 HUMERUS BRACE (IMPORTED Physiotherapy Physiotherapy 3,350 SHEET) and Rehab Center 1036226 HYPER EXTENSION BRACE (P Physiotherapy Physiotherapy 19,060 AND O) and Rehab Center 1036215 IMPORTED CUSHION GEL SHEET Physiotherapy Physiotherapy 48,510 (P AND O) and Rehab Center 25139 IMPORTED INSOLE FOR FRAGILE Physiotherapy Physiotherapy 5,780 FEET35/37 and Rehab Center 25140 IMPORTED INSOLE FOR FRAGILE Physiotherapy Physiotherapy 5,890 FEET38/40 and Rehab Center 25141 IMPORTED INSOLE FOR FRAGILE Physiotherapy Physiotherapy 6,120 FEET41/43 and Rehab Center 25142 IMPORTED INSOLE FOR FRAGILE Physiotherapy Physiotherapy 6,240 FEET44/46 and Rehab Center 25143 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 5,660 MULTISPORT35/37 and Rehab Center

W.E.F. 1st January 2019 33 PHYSIOTHERPAY

25144 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 5,890 MULTISPORT38/40 and Rehab Center 25145 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 6,010 MULTISPORT41/43 and Rehab Center 25147 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 6,120 MULTISPORT44/46 and Rehab Center 25148 IMPORTED INSOLE FOR RAPID Physiotherapy Physiotherapy 6,470 SPORT35/37 and Rehab Center 25149 IMPORTED INSOLE FOR RAPID Physiotherapy Physiotherapy 6,580 SPORT38/40 and Rehab Center 25150 IMPORTED INSOLE FOR RAPID Physiotherapy Physiotherapy 7,050 SPORT41/44 and Rehab Center 25151 IMPORTED INSOLE FOR RAPID Physiotherapy Physiotherapy 7,390 SPORT44/46 and Rehab Center 25134 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 6,120 SENSITIVE FEET35/37 and Rehab Center 25136 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 6,350 SENSITIVE FEET38/40 and Rehab Center 25137 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 6,470 SENSITIVE FEET41/43 and Rehab Center 25138 IMPORTED INSOLE FOR Physiotherapy Physiotherapy 6,700 SENSITIVE FEET44/46 and Rehab Center 25030 INTIAL EVALUATION(UP TO Physiotherapy Physiotherapy 920 45MIN) and Rehab Center 25031 JEWETT BRACE Physiotherapy Physiotherapy 7,620 and Rehab Center 25032 KAFO (PVC QUADILATLELRIAL Physiotherapy Physiotherapy 2,890 SOCKET WITH LOCAL KNEE and Rehab JOINT) Center

34 W.E.F. 1st January 2019 PHYSIOTHERPAY

25033 KAFO (PVC WITH Physiotherapy Physiotherapy 3,700 QUADILATERIAL SOCKET) and Rehab Center 25034 KNEE BRACE (ROM TYPE) Physiotherapy Physiotherapy 3,230 and Rehab Center 1036305 KNEE BRACE LIGAFLEX (P AND Physiotherapy Physiotherapy 5,540 O) and Rehab Center 1036306 KNEE BRACE TRUE PULL LITE (P Physiotherapy Physiotherapy 4,040 AND O) and Rehab Center 25036 KNEE BRACE WITH HINGE (OPEN Physiotherapy Physiotherapy 4,270 PATELLA) and Rehab Center 25037 KNEE CAP (EACH) Physiotherapy Physiotherapy 920 and Rehab Center 25038 KNEE CAP WITH HINGE Physiotherapy Physiotherapy 3,810 (NEOPRENE) and Rehab Center 25039 KNEE CAP WITH PATELLA Physiotherapy Physiotherapy 1,270 OPENING and Rehab Center 1036225 KNEE GAITOR (P AND O) Physiotherapy Physiotherapy 2,950 and Rehab Center 1036307 KNEE IMMO LIGAFELX (P AND O) Physiotherapy Physiotherapy 4,850 and Rehab Center 25040 LATERAL RAISING (B/L) Physiotherapy Physiotherapy 810 and Rehab Center 25041 LATERAL WEDGE Physiotherapy Physiotherapy 580 and Rehab Center 1036224 LEAF AFO (P AND O) Physiotherapy Physiotherapy 7,850 and Rehab Center 1036315 LOMBASKIN BINDER (P AND O) Physiotherapy Physiotherapy 2,190 and Rehab Center

W.E.F. 1st January 2019 35 PHYSIOTHERPAY

1036301 LOMBUS RIGID SUPPORT (P AND Physiotherapy Physiotherapy 5,540 O) and Rehab Center 25042 LONG OPPONECE SPLINT Physiotherapy Physiotherapy 810 and Rehab Center 25043 LONGER TRACTION HOUR(PER Physiotherapy Physiotherapy 1,390 DAY) and Rehab Center 25044 LS CORSET (TAILOR MADE) Physiotherapy Physiotherapy 810 and Rehab Center 25045 LS FRAME Physiotherapy Physiotherapy 1,270 and Rehab Center 63356 LUMBAR OR CERVICAL Investigations Physiotherapy 480 TRACTION and Rehab Center 1036321 MEDSURG SHOE (P AND O) Physiotherapy Physiotherapy 7,510 and Rehab Center 25047 MIWAUKEE BRACE LARGE Physiotherapy Physiotherapy 5,200 and Rehab Center 63357 MIWAUKEE BRACE SMALL Investigations Physiotherapy 4,130 and Rehab Center 1048406 MLD-1 SESSION Physiotherapy Physiotherapy 1,200 and Rehab Center 25048 MODIFIED HALO BRACE WITH Physiotherapy Physiotherapy 38,000 TITANIUM PIN and Rehab Center 25049 MODIFIED WALKER Physiotherapy Physiotherapy 2,080 and Rehab Center 1036303 MODIFIED WHEELCHAIR (P AND Physiotherapy Physiotherapy 17,090 O) and Rehab Center 1036304 MODIFIED WHEELCHAIR WITH Physiotherapy Physiotherapy 39,850 HEAD REST (P AND O) and Rehab Center

36 W.E.F. 1st January 2019 PHYSIOTHERPAY

25050 MOLDED CERVICAL COLLOR Physiotherapy Physiotherapy 1,730 and Rehab Center 1043654 NEURO DEVELOPMENTAL Physiotherapy Physiotherapy 13,510 THERAPY-15 SESSIONS and Rehab Center 1043653 NEURO DEVELOPMENTAL Physiotherapy Physiotherapy 1,040 THERAPY-SINGLE SESSION and Rehab Center 25051 NIGHT FOOT SPLINT Physiotherapy Physiotherapy 1,390 and Rehab Center 78612 OCCUPATIONAL THERAPY Physiotherapy Physiotherapy 690 and Rehab Center 25053 ORFIT FINGER SUPPORT Physiotherapy Physiotherapy 690 and Rehab Center 25054 ORFIT HAND SUPPORT Physiotherapy Physiotherapy 2,190 and Rehab Center 1036656 OSTEO MED SPINAL BRACE (P Physiotherapy Physiotherapy 22,870 AND O) and Rehab Center 25055 PARAPLEGIC BOOTS Physiotherapy Physiotherapy 3,000 and Rehab Center 25058 PHYSIOTHERAPY CERVICAL Physiotherapy Physiotherapy 460 TRACTION and Rehab Center 88409 PHYSIOTHERAPY HOME Physiotherapy Physiotherapy 15,250 SERVICES (10 DAYS SESSION) and Rehab Center 88410 PHYSIOTHERAPY HOME Physiotherapy Physiotherapy 22,870 SERVICES (15 DAYS SESSION) and Rehab Center 88408 PHYSIOTHERAPY HOME Physiotherapy Physiotherapy 1,620 SERVICES (DAILY CHARGES) and Rehab Center 25059 PHYSIOTHERAPY LUMBER Physiotherapy Physiotherapy 460 TRACTION and Rehab Center

W.E.F. 1st January 2019 37 PHYSIOTHERPAY

25060 PHYSIOTHRAPIST HOME Physiotherapy Physiotherapy 1,270 SERVICES and Rehab Center 1036318 PNEUMATIC ELBOW SPLINT (P Physiotherapy Physiotherapy 1,850 AND O) and Rehab Center 25061 POST NATAL EXERCISE Physiotherapy Physiotherapy 1,040 and Rehab Center 25062 PRE NATAL EXS Physiotherapy Physiotherapy 1,270 and Rehab Center 25063 PRE WALKER WITH ANKLE JOINT Physiotherapy Physiotherapy 16,520 and Rehab Center 1036323 PRESSURE GARMENT KNEE Physiotherapy Physiotherapy 2,770 LENGTH (P AND O) and Rehab Center 1036322 PRESSURE GARMENT THIGH Physiotherapy Physiotherapy 4,850 LENGTH (P AND O) and Rehab Center 25064 PRE-WALKER FIXED ANKLE Physiotherapy Physiotherapy 11,430 JOINT and Rehab Center 25065 PROTHESIS C-FOOT Physiotherapy Physiotherapy 2,310 and Rehab Center 25066 PROTHESIS GEL LINER Physiotherapy Physiotherapy 16,860 and Rehab Center 25067 PROTHESIS PEDILINE LINER Physiotherapy Physiotherapy 10,160 and Rehab Center 25069 PROTHESIS SILICON SOCKET Physiotherapy Physiotherapy 42,160 and Rehab Center 25152 PROTHESIS U/L ALIMCO / Physiotherapy Physiotherapy 6,470 IMPORTED and Rehab Center 25035 PROTHESIS U/L INDIAN Physiotherapy Physiotherapy 13,510 COMPONENT and Rehab Center

38 W.E.F. 1st January 2019 PHYSIOTHERPAY

25070 PTB BRACE WITH SHOES / WITH Physiotherapy Physiotherapy 2,310 FOOT PLATE and Rehab Center 25071 PTB PROTHESIS Physiotherapy Physiotherapy 5,080 and Rehab Center 25072 PTB PROTHESIS FLEX FOOT Physiotherapy Physiotherapy 60,750 and Rehab Center 25073 PTB PROTHESIS MODULAR WITH Physiotherapy Physiotherapy 30,380 SILICON SOCKET IMPORTED and Rehab Center 25074 PTB PROTHESIS U/L MODULAR Physiotherapy Physiotherapy 20,210 IMPORTED and Rehab Center 25075 PTB+HINGES LOCAL JOINT Physiotherapy Physiotherapy 3,350 and Rehab Center 25076 PVC FUNCTIONAL BRACE WITH Physiotherapy Physiotherapy 4,040 THIGH CORSET and Rehab Center 25077 PVC JACKET UNDERARM BRACE Physiotherapy Physiotherapy 3,700 and Rehab Center 25078 RAISING PER 1/2 INCH Physiotherapy Physiotherapy 120 and Rehab Center 25080 RECIPROCAL WALKER Physiotherapy Physiotherapy 3,000 and Rehab Center 25081 REMEDIAL EXERCISE PACKAGE Physiotherapy Physiotherapy 14,670 (OT) (25 DAYS) and Rehab Center 25082 REMEDIAL EXERCISE PACKAGE Physiotherapy Physiotherapy 14,670 (PT) (25 DAYS) and Rehab Center 25083 RESORTIVE PARAPLEGIC Physiotherapy Physiotherapy 17,790 EXERCISER and Rehab Center 1036655 ROM ELBOW BRACE(P AND O) Physiotherapy Physiotherapy 6,350 and Rehab Center

W.E.F. 1st January 2019 39 PHYSIOTHERPAY

1036319 ROM SOLLUTION BRACE (P AND Physiotherapy Physiotherapy 13,280 O) and Rehab Center 25084 ROTATOR (BABY) Physiotherapy Physiotherapy 2,080 and Rehab Center 25085 ROTATOR (BIG) Physiotherapy Physiotherapy 2,660 and Rehab Center 25086 SHORT OPPONENCE SPLINT Physiotherapy Physiotherapy 350 and Rehab Center 25087 SHORT PERIOD EXERCISE (PT) Physiotherapy Physiotherapy 460 and Rehab Center 63358 SHORT PERIOD EXERCISE (OT) Investigations Physiotherapy 440 and Rehab Center 25088 SHOULDER SUBLUXATION Physiotherapy Physiotherapy 5,430 SPLINT and Rehab Center 25089 SHOULDER SUPPORT Physiotherapy Physiotherapy 12,130 (IMPORTED) and Rehab Center 25091 SHOULDER SUPPORT (INDIAN) Physiotherapy Physiotherapy 2,080 and Rehab Center 25092 SILICON ARCH PAD (INDIAN) Physiotherapy Physiotherapy 1,390 and Rehab Center 25093 SILICON ARCH WITH INSOLE Physiotherapy Physiotherapy 4,160 and Rehab Center 25094 SILICON BALL Physiotherapy Physiotherapy 690 and Rehab Center 25095 SILICON FINGER PROTHESIS Physiotherapy Physiotherapy 13,980 and Rehab Center 25096 SILICON HEEL PAD Physiotherapy Physiotherapy 690 and Rehab Center

40 W.E.F. 1st January 2019 PHYSIOTHERPAY

25097 SILICON INSOLE Physiotherapy Physiotherapy 1,390 and Rehab Center 25098 SILICON INSOLE WITH M.T. PAD Physiotherapy Physiotherapy 3,700 and Rehab Center 25099 SILICON SHEET 10 X20 Physiotherapy Physiotherapy 2,890 and Rehab Center 25100 SOMI BRACE Physiotherapy Physiotherapy 1,620 and Rehab Center 25102 SPINAL BRACE (NEOPRENE) Physiotherapy Physiotherapy 8,780 and Rehab Center 25103 STATIC COCK UP SPLINT (FULL Physiotherapy Physiotherapy 690 HAND) P.P. LIGHT WEIGHT and Rehab DELUX Center 25104 STATIC COCK UP SPLINT (FULL Physiotherapy Physiotherapy 690 HAND) P.P. LIGHT WEIGHT REG. and Rehab Center 25105 STATIC WALKER Physiotherapy Physiotherapy 690 and Rehab Center 25106 STOCKING A / E (FULL HAND) Physiotherapy Physiotherapy 4,160 and Rehab Center 25107 STOCKING B / E (FULL HAND) Physiotherapy Physiotherapy 2,660 and Rehab Center 25108 STROKE REHAB PACKAGE Physiotherapy Physiotherapy 19,520 and Rehab Center 25109 T L BRACE Physiotherapy Physiotherapy 3,230 and Rehab Center 25110 TENODESIS SPLINT Physiotherapy Physiotherapy 1,730 and Rehab Center 1048400 TENS HOT PACKS AND Physiotherapy Physiotherapy 14,810 EXERCISES (FOR 10 SESSIONS) and Rehab Center

W.E.F. 1st January 2019 41 PHYSIOTHERPAY

1036311 THERABAND (P AND O) Physiotherapy Physiotherapy 760 and Rehab Center 25113 THERMOPLASTIC BELGIUM Physiotherapy Physiotherapy 120 and Rehab Center 25114 THIGH BRACE PVC LARGE Physiotherapy Physiotherapy 1,390 and Rehab Center 25115 THIGH BRACE PVC MEDIUM Physiotherapy Physiotherapy 1,160 and Rehab Center 25116 THIGH BRACE PVC SMALL Physiotherapy Physiotherapy 1,040 and Rehab Center 25118 TIBIAL FRACTURE BRACE Physiotherapy Physiotherapy 3,120 and Rehab Center 25119 TLSO Physiotherapy Physiotherapy 5,200 and Rehab Center 25120 TOE PICKUP DEVICE Physiotherapy Physiotherapy 1,730 and Rehab Center 25121 TRIAS FOOT Physiotherapy Physiotherapy 53,010 and Rehab Center 25122 TURN TABLE SYSTEM Physiotherapy Physiotherapy 30,380 and Rehab Center 25125 UNIVERSAL CUFF Physiotherapy Physiotherapy 1,390 and Rehab Center 25126 VON ROSEN SPLINT Physiotherapy Physiotherapy 920 and Rehab Center 25127 WALKER WITH ARM REST Physiotherapy Physiotherapy 4,850 and Rehab Center 25128 WEIGHT CUFF (1 KG) Physiotherapy Physiotherapy 920 and Rehab Center

42 W.E.F. 1st January 2019 PHYSIOTHERPAY

25129 WEIGHT CUFF (1/2 KG) Physiotherapy Physiotherapy 250 and Rehab Center 25130 WEIGHT CUFF (2 KG) Physiotherapy Physiotherapy 580 and Rehab Center 25131 WEIGHT CUFF (3 KG) Physiotherapy Physiotherapy 580 and Rehab Center 25132 WELL PADDED (DIABETIC) Physiotherapy Physiotherapy 2,310 SANDLES and Rehab Center 1023906 WELL PADDED AFO Physio Physiotherapy 5,150 Consumables and Rehab Center 1036222 WELL PADDED AFO (P AND O) Physiotherapy Physiotherapy 5,150 and Rehab Center 1036308 WRIST BRACE MOULDED (P AND Physiotherapy Physiotherapy 2,080 O) and Rehab Center 1036309 WRIST BRACE WITH THUMB Physiotherapy Physiotherapy 2,950 MOULDED (P AND O) and Rehab Center 25133 WRIST SUPPORT WITH THUMP Physiotherapy Physiotherapy 1,040 and Rehab Center

W.E.F. 1st January 2019 43 BLOOD BANK

Service ID Service Name Dept Multi Bed Semi Single Deluxe / Suite Unit Private Room LDR , All ICU's , Day Care ,HDU, Isolation 27200 CROSS MATCHING Blood Bank 1,200 1,200 1,200 1,200 1,200 ( 1 UNIT ) - 1 Products 21465 CRYOPOOR Blood Bank 100 100 100 100 100 PLASMA - ISSUE - 1 Products 21473 NEONATAL/SPLIT Blood Bank 1,600 1,600 1,600 1,600 1,600 UNIT - 1 Products 21478 S/C BUFFY COAT - Blood Bank 900 900 900 900 900 ARRANGE - 1 Products 21479 S/C BUFFY COAT - Blood Bank 700 700 700 700 700 ISSUE - 1 Products 21480 S/C Blood Bank 2,000 2,000 2,000 2,000 2,000 CRYOPRECIPITATE - 1 Products PER UNIT - ARRANGE 21481 S/C Blood Bank 100 100 100 100 100 CRYOPRECIPITATE - 1 Products PER UNIT - ISSUE 21482 FRESH FROZEN Blood Bank 1,000 1,000 1,000 1,000 1,000 PLASMA (FFP) - - 1 Products ARRANGE 21484 S/C GRANULOCYTE Blood Bank 36,200 36,200 36,200 36,200 36,200 COLLECTION ON - 1 Products CELL SEPARATOR -ARRANGE 21485 S/C GRANULOCYTE Blood Bank 100 100 100 100 100 COLLECTION ON - 1 Products CELL SEPARATOR -ISSUE 21486 S/C PBSC ON Blood Bank 37,300 37,300 37,300 37,300 37,300 CELL SEPARATOR - 1 Products -ARRANGE 21487 S/C PBSC ON CELL Blood Bank 100 100 100 100 100 SEPARATOR -ISSUE - 1 Products

44 W.E.F. 1st January 2019 BLOOD BANK

21488 S/C PLASMA ON Blood Bank 19,600 19,600 19,600 19,600 19,600 CELL SEPARATOR - - 1 Products ARRANGE 21489 S/C PLASMA ON Blood Bank 100 100 100 100 100 CELL SEPARATOR - - 1 Products ISSUE 21492 S/C THERAPEUTIC Blood Bank 1,300 1,300 1,300 1,300 1,300 PHLEBOTOMY - 1 Products

22308 IRRADIATION Blood Bank 1,300 1,300 1,300 1,300 1,300 CHARGES FOR - 1 Products BLOOD AND BLOOD PRODUCTS 28526 THERAPEUTIC Blood Bank 30,900 30,900 30,900 30,900 30,900 PLATELET - 1 Products REDUCTION ON CELL SEPARATOR 29476 S/C Blood Bank 16,900 16,900 16,900 16,900 16,900 LEUCOREDUCED - 1 Products PRC FOR INTRAUTERINE TRANSFUSION 42432 PLASMA Blood Bank 75,700 75,700 75,700 75,700 75,700 EXCHANGE WITH - 1 Products FFP 43981 S/C PLASMA Blood Bank 34,900 34,900 34,900 34,900 34,900 EXCHANGE ON - 1 Products CELL SEPARATOR 43987 TRANSFER BAG Blood Bank 300 300 300 300 300 - 1 Products 63071 S/C WASHED RED Blood Bank 1,100 1,100 1,100 1,100 1,100 CELLS - ARRANGE - 1 Products 63072 S/C WASHED RED Blood Bank 9,700 9,700 9,700 9,700 9,700 CELLS - ISSUE - 1 Products 63073 S/C WHOLE BLOOD Blood Bank 1,000 1,000 1,000 1,000 1,000 - ARRANGE - 1 Products 86747 PBSC HARVESTING WITH Blood Bank 114,600 114,600 114,600 114,600 114,600 CRYOPRESEORVATION - 1 Products 86748 PBSC HARVESTING Blood Bank 89,100 89,100 89,100 89,100 89,100 WITHOUT CRYOPRESEORVASTION - 1 Products 97628 AUTOLOGOUS PRP Blood Bank 6,100 6,100 6,100 6,100 6,100 (10-15 ML) - 1 Products

W.E.F. 1st January 2019 45 BLOOD BANK

1019201 CASCADE TPE Blood Bank 103,100 103,100 103,100 103,100 103,100 - 1 Products 1024033 PLASMA Blood Bank 357,800 357,800 357,800 357,800 357,800 EXCHANGE WITH IMMUNOADSORPTION - 1 Products COLUMN 1027633 PACKED RED Blood Bank 4,600 4,600 4,600 4,600 4,600 BLOOD CELLS - 1 Products (LEUKOREDUCED) ISSUE 1027643 RANDOM DONOR Blood Bank 1,000 1,000 1,000 1,000 1,000 PLATELETS - 1 Products (PLATELET CONCENTRATE) - ARRANGE 1027645 APHERESIS Blood Bank 11,000 11,000 11,000 11,000 11,000 PLATELETS (SDP) - 1 Products PLATELET ON CELL SEPARATOR - ARRANGE 954 BLOOD GROUPING Blood Bank 910 910 910 910 910 AND TYPING (ABO - 2 Services and Rh) 959 DIRECT COOMBS Blood Bank 1,310 1,310 1,310 1,310 1,310 TEST - 2 Services 964 INDIRECT Blood Bank 1,420 1,420 1,420 1,420 1,420 ANTIGLOBULIN - 2 Services TEST 971 RH- PHENOTYPING Blood Bank 3,570 3,570 3,570 3,570 3,570 - 2 Services 6273 DIRECT Blood Bank 1,420 1,420 1,420 1,420 1,420 ANTIGLOBULIN - 2 Services TEST 16018 WESTERN BLOT ( Blood Bank 13,090 13,090 13,090 13,090 13,090 HIV ) - 2 Services 18564 INDIRECT COOMBS Blood Bank 1,700 1,700 1,700 1,700 1,700 TEST - 2 Services 21455 ABO ANTIBODY Blood Bank 5,200 5,200 5,200 5,200 5,200 TITRES (IgG + IgM) - 2 Services 21457 ANTI HCV RAPID Blood Bank 1,760 1,760 1,760 1,760 1,760 TEST - 2 Services

46 W.E.F. 1st January 2019 BLOOD BANK

21459 ANTI HIV (I and II) Blood Bank 3,230 3,230 3,230 3,230 3,230 RAPID KIT TEST - 2 Services 21460 ANTIBODY Blood Bank 6,150 6,150 6,150 6,150 6,150 SCREEN AND - 2 Services IDENTIFICATION 21461 AUTOLOGOUS PRP Blood Bank 10,410 10,410 10,410 10,410 10,410 - 2 Services 21462 BLOOD DONOR Blood Bank 6,030 6,030 6,030 6,030 6,030 SCREENING FOR - 2 Services APHERESIS BY NAT 21463 COOMB S Blood Bank 3,030 3,030 3,030 3,030 3,030 TITRE (FOR Rh - 2 Services ANTIBODIES) 21464 CRYOPOOR Blood Bank 1,510 1,510 1,510 1,510 1,510 PLASMA - - 2 Services ARRANGE 21466 DONOR Blood Bank 4,320 4,320 4,320 4,320 4,320 SCREENING FOR - 2 Services APHERESIS (ELISA) 21467 DONOR Blood Bank 3,500 3,500 3,500 3,500 3,500 SCREENING FOR - 2 Services APHERESIS (RAPID) 21470 HBs Ag (RAPID) Blood Bank 1,510 1,510 1,510 1,510 1,510 - 2 Services 21494 SCREENING Blood Bank 1,300 1,300 1,300 1,300 1,300 FOR RED CELL - 2 Services ANTIBODIES 21496 GROUP AND Blood Bank 2,260 2,260 2,260 2,260 2,260 SCREEN - 2 Services 27201 SPLIT BLOOD Blood Bank 1,560 1,560 1,560 1,560 1,560 PRODUCTS / PER - 2 Services UNIT 41328 ABO TITER Blood Bank 5,200 5,200 5,200 5,200 5,200 - 2 Services 60135 MOLECULAR Blood Bank 15,770 15,770 15,770 15,770 15,770 BLOOD TYPING - 2 Services 63241 APHERESIS DONOR Blood Bank 3,470 3,470 3,470 3,470 3,470 SCREENING BY - 2 Services RAPID 63242 APHERESIS DONOR Blood Bank 6,000 6,000 6,000 6,000 6,000 SCREENING BY - 2 Services ELISA AND NAT

W.E.F. 1st January 2019 47 BLOOD BANK

63463 ANTI HCV ELISA Blood Bank 3,160 3,160 3,160 3,160 3,160 - 2 Services 98295 HBsAg ELISA Blood Bank 1,680 1,680 1,680 1,680 1,680 - 2 Services 98317 ANTI HIV (I and II) Blood Bank 2,310 2,310 2,310 2,310 2,310 ELISA - 2 Services 101644 ANTI HBc (IgG + Blood Bank 2,430 2,430 2,430 2,430 2,430 IgM) ELISA - 2 Services 21474 PLASMA Blood Bank 8,500 12,000 14,800 18,100 28,400 EXCHANGE - 2 Services 21477 S/C AUTOLOGOUS Blood Bank 2,200 2,200 2,200 2,200 2,200 TRANSFUSION - 2 Services 1060691 CRYOPRESERVATION FOR Blood Bank 85,000 85,000 85,000 85,000 85,000 STEM CELLS - 1 Products 1042650 S/C RED CELL Blood Bank 20,000 20,000 20,000 20,000 20,000 EXCHANGE ON - 1 Products CELL SEPARATOR 1048534 PBSC Blood Bank 10,000 10,000 10,000 10,000 10,000 CRYOPRESEORVATION ALONE - 1 Products 1061053 THERAPEUTIC Blood Bank 1,000 1,000 1,000 1,000 1,000 LEUCAPHERESIS - 1 Products

48 W.E.F. 1st January 2019 INVESTIGATIONS

SERVICE SERVICENAME DEPTMENT NAME IPD Tariff ID 40147 SKIN TESTING Allergy Department 1,040

40148 DESENSITISATION Allergy Department 1,040

146 ALT(SGPT) - SERUM BioChemistry 670

147 MICROALBUMIN : QUANTITATIVE-24HR BioChemistry 910 URINE 148 ALBUMIN - ASCITIC / PERITONEAL FLUID BioChemistry 640

150 ALBUMIN - FLUID BioChemistry 640

152 ALBUMIN - SERUM BioChemistry 640

153 MICROALBUMIN : QUANTITATIVE-SPOT BioChemistry 910 URINE 158 ALKALINE PHOSPHATASE - SERUM BioChemistry 720

161 ALPHA FETO PROTEIN - SERUM BioChemistry 2,580

168 AMMONIA - PLASMA BioChemistry 2,220

173 AMYLASE - FLUID BioChemistry 910

175 AMYLASE - SERUM/PLASMA BioChemistry 910

177 GALLSTONE ANALYSIS - QUALITATIVE BioChemistry 1,010

180 KIDNEY/RENAL STONE ANALYSIS - BioChemistry 1,010 QUALITATIVE 181 ANGIOTENSIN CONVERTING ENZYME (ACE) BioChemistry 2,560

188 AST (SGOT) - SERUM BioChemistry 670

197 BILIRUBIN TOTAL - SERUM BioChemistry 670

198 BLOOD GAS ANALYSIS - ARTERIAL BioChemistry 1,470

200 CA 125 (CANCER ANTIGEN) - SERUM BioChemistry 6,740

201 CA 15.3 (CANCER ANTIGEN) - SERUM BioChemistry 6,560

202 CA 19.9 (CANCER ANTIGEN) - SERUM BioChemistry 6,560

W.E.F. 1st January 2019 49 INVESTIGATIONS

204 CALCIUM - 24 HR URINE BioChemistry 720

205 CALCIUM - SERUM BioChemistry 670

206 CALCIUM - SPOT URINE BioChemistry 680

207 CALCIUM IONIZED - SERUM BioChemistry 740

208 CARBAMAZEPINE LEVELS -SERUM BioChemistry 2,580

210 CEA: CARCINO EMBRYONIC ANTIGEN - BioChemistry 3,610 SERUM 212 CHLORIDE - 24 HR URINE BioChemistry 720

213 CHLORIDE - CSF BioChemistry 720

215 CHLORIDE - FLUID BioChemistry 720

216 CHLORIDE - SERUM BioChemistry 670

217 CHLORIDE - SPOT URINE BioChemistry 720

220 CHOLESTEROL - SERUM BioChemistry 640

222 CK (CPK) MB (Reflectance Photometry) - SERUM BioChemistry 1,520

223 CK - MB - SERUM / PLASMA BioChemistry 1,700

224 CPK TOTAL - SERUM BioChemistry 1,010

228 CORTISOL – SERUM BioChemistry 2,110

230 CREATININE - 24 HR URINE BioChemistry 720

231 CREATININE - DIALYSIS FLUID BioChemistry 720

232 CREATININE - SERUM BioChemistry 640

233 CREATININE - SPOT URINE BioChemistry 720

235 CREATININE CLEARANCE TEST - 24 HOURS BioChemistry 1,220

238 CYCLOSPORINE: C0 LEVEL - WHOLE BioChemistry 5,530 BLOOD(HPLC MS-MS /Immunoassay )

50 W.E.F. 1st January 2019 INVESTIGATIONS

239 CYCLOSPORINE: C2 LEVEL - WHOLE BioChemistry 5,380 BLOOD(HPLC MS-MS /Immunoassay ) 241 D-XYLOSE EXCRETION TEST BioChemistry 4,140

243 DHEA(S) DEHYDROEPIANDROSTERONE BioChemistry 2,220 SULPHATE - SERUM 245 DIGOXIN LEVELS - SERUM BioChemistry 2,490

246 ESTRADIOL - SERUM BioChemistry 2,110

248 FERRITIN - SERUM BioChemistry 2,430

250 FREE PSA - SERUM BioChemistry 2,530

251 FREE T4 - SERUM BioChemistry 1,290

254 FSH: FOLLICLE STIMULATING HORMONE - BioChemistry 2,110 SERUM 258 GGTP: GAMMA GLUTAMYL TRANSPEPTIDASE BioChemistry 950 - SERUM 268 GLUCOSE - PLASMA (FASTING) BioChemistry 350

269 GLUCOSE - PLASMA (POST PRANDIAL) BioChemistry 340

270 GLUCOSE - PLASMA (RANDOM) BioChemistry 340

272 GLUCOSE - SYNOVIAL FLUID BioChemistry 350

274 GLYCOSYLATED HEMOGLOBIN (HBA1C) - BioChemistry 2,510 WHOLE BLOOD 278 HDL CHOLESTEROL - SERUM BioChemistry 640

283 HOMOCYSTEINE - SERUM / PLASMA BioChemistry 1,940

287 INSULIN - SERUM BioChemistry 1,740

288 IRON - SERUM BioChemistry 1,110

289 IRON BINDING CAPACITY TOTAL - SERUM BioChemistry 1,140

291 LACTATE - PLASMA BioChemistry 1,530

298 LDH: LACTATE DEHYDROGENASE - SERUM BioChemistry 1,060

W.E.F. 1st January 2019 51 INVESTIGATIONS

300 LDL CHOLESTEROL (DIRECT) - SERUM BioChemistry 930

304 LH: LEUTINIZING HORMONE - SERUM BioChemistry 2,110

306 LIPASE - SERUM BioChemistry 1,310

310 Lp(a): LIPOPROTEIN (a) - SERUM BioChemistry 3,390

311 MAGNESIUM - SERUM BioChemistry 1,170

320 OSMOLALITY - 24 HR URINE BioChemistry 1,730

321 OSMOLALITY - SERUM BioChemistry 1,000

322 OSMOLALITY - SPOT URINE BioChemistry 1,730

332 PHOSPHORUS INORGANIC - 24 HR URINE BioChemistry 720

333 PHOSPHORUS INORGANIC - SERUM BioChemistry 670

334 PHOSPHORUS INORGANIC - SPOT URINE BioChemistry 650

338 POTASSIUM - 24 HR URINE BioChemistry 720

344 POTASSIUM - SERUM BioChemistry 640

345 POTASSIUM - SPOT URINE BioChemistry 720

347 PROLACTIN - SERUM BioChemistry 2,110

348 PROGESTERONE - SERUM BioChemistry 2,110

349 PROTEIN ELECTROPHORESIS - 24 HR URINE BioChemistry 3,330

350 PROTEIN ELECTROPHORESIS - SERUM BioChemistry 2,770

351 PROTEIN TOTAL - 24 HR URINE BioChemistry 720

353 PROTEIN - CSF BioChemistry 1,260

355 PROTEIN TOTAL - FLUID BioChemistry 1,220

356 PROTEIN TOTAL - PERICARDIAL FLUID BioChemistry 1,220

357 PROTEIN TOTAL - PLEURAL FLUID BioChemistry 1,220

52 W.E.F. 1st January 2019 INVESTIGATIONS

358 PROTEIN TOTAL - SERUM BioChemistry 650

361 PROTEIN TOTAL - SYNOVIAL FLUID BioChemistry 1,220

372 SODIUM - 24 HR URINE BioChemistry 830

376 SODIUM - SERUM BioChemistry 640

377 SODIUM - SPOT URINE BioChemistry 830

381 TESTOSTERONE - SERUM BioChemistry 2,110

382 THEOPHYLLINE / AMINOPHYLLINE - SERUM BioChemistry 2,580

386 TRIGLYCERIDES - SERUM BioChemistry 640

390 TSH:THYROID STIMULATING HORMONE- BioChemistry 1,680 SERUM 392 UREA - 24 HR URINE BioChemistry 720

393 UREA - DIALYSIS FLUID BioChemistry 720

394 UREA - FLUID BioChemistry 720

395 UREA - SERUM BioChemistry 620

396 UREA - SPOT URINE BioChemistry 720

398 URIC ACID - 24 HR URINE BioChemistry 720

399 URIC ACID - SERUM BioChemistry 670

400 URIC ACID - SPOT URINE BioChemistry 650

411 VALPROIC ACID - SERUM BioChemistry 2,580

417 VITAMIN B12 -SERUM BioChemistry 3,420

421 FOLATE - SERUM BioChemistry 3,070

423 VLDL CHOLESTEROL - SERUM - CALCULATED BioChemistry 640

439 BILIRUBIN CONJUGATED (DIRECT) - SERUM BioChemistry 620

875 IMMUNOGLOBULIN - IgA BioChemistry 3,390

W.E.F. 1st January 2019 53 INVESTIGATIONS

877 IMMUNOGLOBULIN - IgG BioChemistry 2,580

878 IMMUNOGLOBULIN - IgM BioChemistry 3,390

4118 LIVER FUNCTION TEST BioChemistry 2,390

4120 LIPID PROFILE TEST (PACKAGE) BioChemistry 2,190

4285 THYROID PROFILE(FT3,FT4 and TSH) BioChemistry 2,930

4303 ELECTROLYTES - SERUM/PLASMA(Na+,K+,Cl-) BioChemistry 1,110

4435 BIO-CHEMICAL ANALYSIS(Ascitic Fluid) BioChemistry 1,270

5131 CARDIAC ENZYMES(SGOT/CPK/CPK-MB/LDH) BioChemistry 3,000

5611 BIO-CHEMICAL ANALYSIS (PERICARDIAL BioChemistry 1,270 FLUID) 5612 BIO-CHEMICAL ANALYSIS (PLEURAL FLUID) BioChemistry 1,270

5613 BIO-CHEMICAL ANALYSIS (SYNOVIAL FLUID) BioChemistry 1,270

5614 BIO-CHEMICAL ANALYSIS (CSF) BioChemistry 1,270

6106 PROSTATE SPECIFIC ANTIGEN (PSA TOTAL) BioChemistry 2,690

6278 IgE (TOTAL) BioChemistry 2,690

6522 GLUCOSE - PLASMA (0.5 HR) BioChemistry 350

6523 GLUCOSE - PLASMA (1HR) BioChemistry 350

6524 GLUCOSE - PLASMA (1.5 HR) BioChemistry 350

6525 GLUCOSE - PLASMA (2 HR) BioChemistry 350

6526 GLUCOSE - PLASMA (2.5 HR) BioChemistry 350

6527 GLUCOSE - PLASMA (3 HR) BioChemistry 350

8266 PHOSPHORUS - SPOT URINE BioChemistry 720

8267 MICRO PROTEIN (MPR) - SPOT URINE BioChemistry 720

8270 AMYLASE - SPOT URINE BioChemistry 1,310

54 W.E.F. 1st January 2019 INVESTIGATIONS

8276 GTT - EXTENDED BioChemistry 1,730

9235 BARBITURATES (SPOT URINE) BioChemistry 1,260

9236 BENZODIAZEPINES (SPOT URINE) BioChemistry 1,140

9237 COCAINE (SPOT URINE) BioChemistry 1,140

9238 CANNABINOIDS / MARIJUANA - SPOT URINE BioChemistry 1,290

9239 METHADONE (SPOT URINE) BioChemistry 1,260

9241 "MDMA (ECSTASY) - SPOT URINE) BioChemistry 1,160

9242 OPIATE - (SPOT URINE) BioChemistry 1,290

9243 "PHENCYCLIDINE (SPOT URINE) BioChemistry 1,260

10958 FREE T3 SERUM BioChemistry 1,290

13955 METHOTREXATE-SERUM BioChemistry 3,030

14097 CSF PROTEIN ELECTROPHORESIS FOR BioChemistry 8,400 OLIGOCLONAL BAND 14098 LACTOSE TOLERANACE TEST BioChemistry 2,190

14210 APO LIPOPROTEIN A1 - SERUM BioChemistry 2,580

14211 APO LIPOPROTEIN B - SERUM BioChemistry 2,580

14218 ISOENZYME ALKALINE PHOSPHATASE - BioChemistry 910 SERUM

14327 PROPOXYPHENE (SPOT URINE) BioChemistry 1,260

14638 GLUCOSE - PLASMA (4 HR) BioChemistry 350

14639 GLUCOSE - PLASMA (5 HR) BioChemistry 350

14694 INSULIN (FASTING) - SERUM BioChemistry 1,970

14695 INSULIN (PP) - SERUM BioChemistry 1,970

W.E.F. 1st January 2019 55 INVESTIGATIONS

14697 PARATHYROID HORMONE [PTH INTACT] - BioChemistry 4,540 SERUM 14843 AMPHETAMINE (SPOT URINE) BioChemistry 1,170

16622 BUN (BLOOD UREA NITROGEN) BioChemistry 620

16676 IMMUNOGLOBULIN PROFILE [IGG,IGM,IGA] BioChemistry 8,090

16703 LIPASE - FLUID BioChemistry 1,270

16717 TROPONIN T QUALITATIVE - WHOLE BLOOD BioChemistry 4,080

17532 IMMUNO TYPING(CAPILLARY) - URINE BioChemistry 17,930

18200 TOTAL PROTEIN AG - RATIO BioChemistry 690

18454 LITHIUM LEVELS - SERUM BioChemistry 1,140

19091 TOTAL CHOLESTEROL / HDL RATIO BioChemistry 800

19165 FIRST TRIMESTER SCREENING BioChemistry 4,030

20049 SPOT URINE PROTIEN / CREATININE RATIO BioChemistry 2,580

20297 24 HRS IMMUNO FIXATION BioChemistry 17,930 ELECTROPHRORESIS 20298 A/G - RATIO BioChemistry 910

20299 BETA-2 MICROGLOBULIN-SERUM BioChemistry 3,730

20300 BHCG PROCEDURE BioChemistry 27,390

20301 BICARBONATE - SERUM/PLASMA BioChemistry 720

20302 BILIRUBIN UNCONJUGATED (INDIRECT) - BioChemistry 720 SERUM 20303 BIO-CHEMICAL ANALYSIS (BODY FLUID) BioChemistry 1,220

20304 CHOLINESTERASE - SERUM BioChemistry 670

20305 G6-PDH(QUANTITATIVE) - WHOLE BLOOD BioChemistry 1,880

20306 GCI / GCT SCREEN PLASMA BioChemistry 620

20307 GLOBULIN - SERUM BioChemistry 460

56 W.E.F. 1st January 2019 INVESTIGATIONS

20308 GLUCOSE TOLERANCE TEST (GTT) BioChemistry 1,730

20309 HCG SERUM / PLASMA BioChemistry 2,580

20310 IMMUNO FIXATION ELECTROPHORESIS - IFE BioChemistry 17,930 (SERUM) 20311 MAU (MICROALBUMIN) - 24HRS URINE BioChemistry 1,270

20312 MAU (MICROALBUMIN) - SPOT URINE BioChemistry 1,310

20314 PHENOBARBITAL LEVEL-SERUM BioChemistry 2,580

20316 PHENYTOIN LEVEL- SERUM BioChemistry 2,580

20317 POST DIALYSIS BUN URR BioChemistry 620

20318 RENAL PROFILE - SERUM BioChemistry 2,750

20319 SAAG (SERUM ASCITIC ALBUMIN GRADIENT) BioChemistry 950

20320 TSH (CORD BLOOD) BioChemistry 2,890

20321 UREA NITROGEN - 24 HR URINE BioChemistry 620

20322 MORPHINE (OPIATES) - SPOT URINE BioChemistry 1,290

20323 VANCOMYCIN (PEAK) - SERUM BioChemistry 3,620

20324 VANCOMYCIN (TROUGH) - SERUM BioChemistry 3,620

20325 VITAMIN D (25 OH) - TOTAL BioChemistry 3,210

24728 (LAL) ACTH BioChemistry 1,480

24729 (LAL) GALL STONE ANALYSIS BioChemistry 1,050

24730 (LAL) COPPER-SERUM BioChemistry 1,300

24731 (LAL) FRUCTOSAMINE- BioChemistry 470 SPECTROPHOTOMETRIC 24732 (LAL) MYOGLOBIN BioChemistry 4,000

24733 (LAL) PAP (PROSTATIC ACID PHOSPHATASE)- BioChemistry 330 SERUM 24734 (LAL) URINARY FREE CORTISOL -- BioChemistry 800

W.E.F. 1st January 2019 57 INVESTIGATIONS

24736 (LAL) CHROMOGRANIN A BioChemistry 6,900

24738 (LAL) CHOLINESTERASE - SERUM BioChemistry 490

24740 (LAL) GASTRIN BioChemistry 1,200

24741 (LAL) HOMOVANILLIC ACID (HVA)-(HPLC) BioChemistry 8,000 URINE 24744 (LAL) IMD PANEL QUANTITATIVE BLOOD BioChemistry 4,000

24745 (LAL) KAPA LAMBDA LIGHT CHAIN FREE BioChemistry 6,500 URINE 24746 (LAL) KAPPA LAMBDA LIGHT CHAIN URINE BioChemistry 6,500

24747 (LAL) KAPPA LAMBDA LIGHT CHAIN FREE BioChemistry 6,500 SERUM 24748 (LAL) LEAD BioChemistry 1,640

24750 (LAL) METABOLIC URINE-BASIC BioChemistry 630

24751 (LAL) METABOLIC URINE-COMPREHENSIVE BioChemistry 1,600

24752 (LAL) METANEPHRINES (24 HR) BioChemistry 10,800

24755 (LAL) OPIATES AND METABOLITES URINE BioChemistry 650

24757 (LAL) SERUM MYGLOBIN BioChemistry 4,000

24758 (LAL) SHBG BioChemistry 2,350

24760 (LAL) ALDOSTERONE BioChemistry 1,600

24761 (LAL) TRANSFERRIN BioChemistry 1,100

24762 (LAL) URANARY OXALATE BioChemistry 1,700

24763 (LAL) URINARY 17-KETOSTEROIDS BioChemistry 5,700

24764 (LAL) URINARY COPPER BioChemistry 1,850

24765 (LAL) URINARY OXALATE BioChemistry 1,700

24766 (LAL) URINE 17 - HYDROXY BioChemistry 6,700 CORTICOSTEROIDS 24767 (LAL) URINE 5 - HIAA (24 HR) BioChemistry 2,650

58 W.E.F. 1st January 2019 INVESTIGATIONS

24768 (LAL) URINE CATECHOLAMINES (24 HR) BioChemistry 4,500

24769 (LAL) URINE COPPER 24 HRS BioChemistry 1,850

24770 (LAL) URINE COPPER RANDOM BioChemistry 1,850

24772 (LAL) URINE HOMO VANILIC ACID BioChemistry 8,000 (RANDOM/24 HR) 24773 (LAL) URINE POPHYRINS BioChemistry 4,400

24774 (LAL) URINE PORPHYRINS (24 HR) BioChemistry 4,400

24775 (LAL) VMA 24-HOUR URINE VANILMANDELIC BioChemistry 3,500 ACID 24776 (LAL) VMA RANDOM URINE VANILMANDELIC BioChemistry 3,500 ACID 24777 (LAL) ZINC -SERUM BioChemistry 1,800

24778 (LAL) ALDOLASE BioChemistry 690

24780 (LAL) ERYTHROPOIETIN BioChemistry 2,000

24781 (LAL) FREE TESTOSTERONE BioChemistry 1,850

24782 (LAL) ALUMINIUM BioChemistry 2,000

24793 (LAL) ANDROSTENEDIONE BioChemistry 1,820

24804 (LAL) ARSENIC-BLOOD BioChemistry 2,750

24811 (LAL) CYSTICFIBROSIS NEWBORN SCREEN BioChemistry 550

24815 (LAL) BENZODIAZEPINES and METABOLITIES BioChemistry 700

24819 (LAL) GALACTOSEMIA NEWBORN SCREEN BioChemistry 250 -R164 24821 (LAL) LEAD BLOOD BioChemistry 1,640

24822 (LAL) LEAD RANDOM URINE BioChemistry 1,640

24824 (LAL) RENAL CALCULUS ANALYSIS BioChemistry 1,050

24826 (LAL) CALCITONIN BioChemistry 2,150

W.E.F. 1st January 2019 59 INVESTIGATIONS

24827 (LAL) SQUAMOUS CELL CARCINOMA BioChemistry 2,450 ANTIGEN 24829 (LAL) GH/HGH/GROWTH HORMONE -- BioChemistry 750

24830 (LAL) 17 OHP - BioChemistry 1,300

24831 (LAL) ACID PHOSPHATASE-(PROSTATIC)- BioChemistry 330 SERUM 24832 (LAL) ACID PHOSPHATASE-(TOTAL)-SERUM BioChemistry 170

24833 (LAL) ACTH STIMULATION TEST (LONG) -- BioChemistry 4,900

24834 (LAL) ACTH STIMULATION TEST (SHORT) -- BioChemistry 2,450

24835 (LAL) ALPHA 1 ANTITRYPSIN BioChemistry 2,000

24836 (LAL) AMIKACIN LEVEL(PEAK)-SERUM BioChemistry 2,650 (IMMUNOTURBIDIMETRIC) 24839 (RANBAXY) LH (LUTEINZING HORMONE) BioChemistry 720

24840 (RANBAXY) PS2 (ESTROGEN-REGULATED BioChemistry 2,860 PROTEIN) 25243 DRUG SCREENING 5 PANEL BioChemistry 4,160

25244 DRUG SCREENING 10 PANEL BioChemistry 7,620

25245 BIO-CHEMICAL ANALYSIS (NASAL FLUID) BioChemistry 1,270

25246 BIO-CHEMICAL ANALYSIS (PANCREATIC BioChemistry 1,270 FLUID) 26757 PRE DIALYSIS BUN URR BioChemistry 620

26758 PROTEIN SPOT URINE BioChemistry 720

26836 TACROLIMUS (HPLC-MS/MS) BioChemistry 10,030

26837 SIROLIMUS (RAPAMYCIN) BioChemistry 8,030

26839 (LAL)PHENYLALANINE- NEWBORN SCREEN BioChemistry 250

26843 (LAL)IMMUNO REACTIVE TRYPSINOGEN(IRT) BioChemistry 1,700

26844 (LAL)CITRATE-24 HOURS URINE BioChemistry 860

60 W.E.F. 1st January 2019 INVESTIGATIONS

27150 AMIKACIN LEVEL(TROUGH)-SERUM BioChemistry 3,730 (IMMUNOTURBIDIMETIC) 27151 GENTAMYCIN LEVEL(PEAK)-SERUM BioChemistry 3,620 (IMMUNOTURBIDIMETIC) 27152 GENTAMYCIN LEVEL(TROUGH)-SERUM BioChemistry 3,620 (IMMUNOTURBIDIMETIC 27153 TRIPLE MARKER 2ND TRIMESTER SCREEN BioChemistry 6,800

27156 (LAL)BIOTINIDASE NEW BORN SCREEN -CODE BioChemistry 690 NO R165 27158 (LAL)GALACTOSEMIA BioChemistry 1,850 CLASSICAL(TRANSFERASE) QUANTITATIVE 27159 (LAL)GLUCOSE-6-PHOSPHATE BioChemistry 250 DEHYDROGENASE(G-6-PD) NEW BORN 27160 (LAL)TSH NEW BORN SCREEN-CODE NO R 159 BioChemistry 250

27427 (LAL)17-OHP NEW BORN SCREEN -CODE NO BioChemistry 250 R163 27662 BUSULFAN BioChemistry 9,960

29096 THYROGLOBULIN BioChemistry 3,030

35032 NTPRO BNP BioChemistry 2,610

42981 SPECIAL LIVER Tx PROFILE BioChemistry 3,470

43926 CERULOPLASMIN-SERUM BioChemistry 2,800

43993 GH / HGH / GROWTH HORMONE BioChemistry 1,960

43995 (LAL)1,25 (OH) VITAMIN D BioChemistry 1,550

44054 (RANBAXY)AFP (ALPHA - FETOPROTEIN) BioChemistry 3,100 TISSUE 44055 (RANBAXY)ALPHA- 1 -ANTI TRYPSIN TISSUE BioChemistry 2,620

44056 (RANBAXY)BETA-HCG TISSUE BioChemistry 3,100

44058 (RANBAXY)BR. MET (BREAST METASTATIC BioChemistry 3,100 MASTER) 44059 (RANBAXY)CALCIBORIUN BioChemistry 3,100

W.E.F. 1st January 2019 61 INVESTIGATIONS

44073 (RANBAXY)EGFR BioChemistry 7,630

44074 (RANBAXY)FSH - TISSUE BioChemistry 3,100

44075 (RANBAXY)GH - TISSUE BioChemistry 3,100

44083 (RANBAXY)PGR ( PROGESTRONE RECEPTOR ) BioChemistry 1,790

44084 (RANBAXY)PLACENTAL ALKALINE BioChemistry 3,100 PHOSPHATE 44087 (RANBAXY)SYNAPTOPHYSIN BLOCK BioChemistry 3,010

55515 (LAL)BIOTINIDASE DEFECIENCY BioChemistry 3,800 QUANTITATIVE, BLOOD ,CODE G129 55516 (LAL) OXALATE, 24 HOUR URINE , CODE U055 BioChemistry 1,700

55517 (LAL) CITRATE, 24 HOUR, URINE , CODE G147 BioChemistry 800

55518 (LAL) MERCURY, 24 HOUR URINE , CODE C028 BioChemistry 3,240

55545 (External) URINE SUCCINYL ACETONE BioChemistry 4,500

55618 BETA 2 MICROGLOBULIN - URINE BioChemistry 3,730

55857 TACROLIMUS(HPLC MS-MS /Immunoassay) BioChemistry 10,030

58739 (LAL) PHENOBARBITONE BioChemistry 920

59763 CSF FOR BIOCHEMICAL ANALYSIS-FLUID BioChemistry 1,290

59795 CSF for Biochemical Analysis BioChemistry 1,250

66867 (LAL) NEURON SPECIFIC ENOLASE BioChemistry 3,200

71450 14-3-3 PROTEIN SPINAL FLUID (SRL RANBAXY) BioChemistry 16,590

76608 (LAL)BETA 2 GLYCOPROTEIN 1 PANEL IgG IgM BioChemistry 2,600 IgA(code-Z547) 77603 (LAL) PORPHYRINS, TOTAL, QUALITATIVE , BioChemistry 4,400 RANDOM URINE 77623 (LAL)VITAMIN A (RETINOL) BioChemistry 6,000

78699 (LAL) AMINO ACID QUALITATIVE 2 BioChemistry 1,210 DIMENSIONAL URINE

62 W.E.F. 1st January 2019 INVESTIGATION

79487 (LAL) AMINO ACID QUANTITATIVE CSF 45 BioChemistry 5,200 AMINO ACID (CODE-G176) 79958 (LAL) ANTI SOLUBLE LIVER ANTIGEN (SLE) BioChemistry 1,350

81419 (LAL)LEPTIN BioChemistry 3,900

81492 (LAL) INHIBIN B BioChemistry 1,900

81988 (LAL) ARGININE VASOPRESSIN/ ANTI BioChemistry 11,510 DIURETIC HORMONE(ADH) PLASMA 82538 (GANGA RAM) GALT BioChemistry 3,760

83291 (LAL) CYSTATIN C BioChemistry 1,200

84536 (LAL) INTERLEUKIN -6 IL-6 BioChemistry 12,630

84537 (LAL) TUMOUR NECROSIS FACTOR (TNF) BioChemistry 3,900 ALPHA 84542 (LAL)PLAMINOGEN ACTIVATOR INHIBITOR -1 BioChemistry 16,010 (PAI-1) ACTIVITY 84575 (LAL) PROINSULIN BioChemistry 10,160

85766 (LAL) IMMUNOGLOBULIN IgG CSF BioChemistry 1,380

85887 CORTISOL (PM)- SERUM BioChemistry 1,920

86541 (RANBAXY) PARACETAMOL LEVELS BioChemistry 1,500

86542 (GANGA RAM) VERY LONG CHAIN FATTY BioChemistry 10,510 ACID (VLCFA) 88172 (GANGA RAM) HEXOSAMINIDASE A PLUS B BioChemistry 6,280 (GM2) 88174 (GANGA RAM) BETA GALACTOSIDASE (GM1) BioChemistry 5,050

88176 (GANGA RAM) BETA GLUCOSIDASE BioChemistry 4,780 (GAUCHER) 88177 (GANGA RAM) MPS (GAG) - URINE BioChemistry 2,870

93983 MAGNESIUM- URINE RANDOM BioChemistry 1,170

94710 (RANBAXY) TOTAL BILE ACIDS BioChemistry 2,600

W.E.F. 1st January 2019 63 INVESTIGATION

94958 BABY SHIELD METABOLIC SCREENING- TMS BioChemistry 6,110 -STANDARD (53 CONDITIONS) -BLOOD AND URINE 94960 BABY SHIELD METABOLIC SCREENING-BASIC BioChemistry 2,370 -7 CONDITIONS-BLOOD 94961 BABY SHIELD METABOLIC SCREENING-BASIC BioChemistry 3,790 Hb- Pathies - 11 CONDITIONS-BLOOD 94962 BABY SHIELD METABOLIC SCREENING- TMS BioChemistry 4,140 -BASIC ( 47 CONDITIONS )-BLOOD AND URINE 94963 BABY SHIELD METABOLIC SCREENING- BioChemistry 5,520 GCMS-111 CONDITIONS-URINE 96801 (LAL) PYRUVATE - PYRUVIC ACID BioChemistry 3,250

97215 AMIODRONE EDTA PLASMA BioChemistry 5,640

97403 (RANBAXY) PLASMA OXALATE BioChemistry 14,800

100089 ALKALINE PHOSPHATASE BONE SPECIFIC BioChemistry 6,780 BASP 100090 P1NP (PROCOLLAGEN TYPE 1 AMINO BioChemistry 2,290 TERMINAL PROPEPTIDE) TOTAL 100785 (LAL)N-TELOPEPTIDE SERUM BioChemistry 11,400

101618 (LAL) AMINO ACID QUANTITATIVE URINE 45 BioChemistry 5,200 AMINO ACID (CODE-G174) 1019647 (LAL) METACHROMATIC LEUCODYSTROPHY BioChemistry 1,900 QUANTITATIVE BLOOD 1025271 (RANBAXY) CATECHOLAMINE PLASMA BioChemistry 9,900

1025361 SPAG SERUM PLEURAL ALBUMIN GRADIENT BioChemistry 950

1025661 (LAL)STONE ANALYSIS WITH PICTURE BioChemistry 1,050

1028606 TROPONIN I QUANTITATIVE SERUM / BioChemistry 4,080 PLASMA (EMERGENCY) 1030008 FIRST TRIMESTER SCREENING BioChemistry 5,460

1030013 LAL(GLUCAGON) BioChemistry 6,560

1030314 BLOOD GAS ANALYSIS ARTERIAL BioChemistry 1,470 EMERGENCY 1033488 ANTI MULLERIAN HORMONE (AMH) BioChemistry 2,540

64 W.E.F. 1st January 2019 INVESTIGATION

1035171 EVEROLIMUS BioChemistry 5,780

1035198 NASAL FLUID FOR GLUCOSE AND PROTEIN BioChemistry

1035200 URINE CALCIUM CREATININE RATIO (SPOT) BioChemistry 1,400

1036012 (LAL) THYROID STIMULATING BioChemistry 14,720 IMMUNOGLOBULIN (TSI) 1036424 DNPH ( DINITROPHENYL - HYDRAZINE BioChemistry 180 )-URINE 1036460 LAL DNPH ( DINITROPHENYL - HYDRAZINE)- BioChemistry 130 URINE 1036547 LAL (AMINO ACID QUANTITATIVE BLOOD 10 BioChemistry 4,100 AMINO ACIDS) 1036548 LAL (AMINO ACID MAPLE SYRUP URINE BioChemistry 4,410 DISEASE (MSUD) PANEL) 1052659 (LAL) INHIBIN A REPRODUCTIVE MARKER BioChemistry 700

1054502 (Ranbaxy) IMMUNOGLOBULIN IgG SUBCLASS BioChemistry 6,750 IV 1059364 (LAL) PLASMA RENIN DIRECT BioChemistry 6,820

1059786 (LAL)MANGANESE BLOOD BioChemistry 1,900

1060163 TROPONIN I - HIGH SENSITIVE BioChemistry 4,080

1060399 MAGNESIUM- 24 HR URINE BioChemistry 1,170

1060646 PLEURAL FLUID-CHOLESTROL BioChemistry 640

1061944 (LAL) MPS URINE BioChemistry 350

1062344 (LAL) COBALT BLOOD BioChemistry 3,200

1062345 (LAL) CHROMIUM BLOOD BioChemistry 3,200

1062346 (RANBAXY) MERCURY SERUM BioChemistry 4,350

1062347 (RANBAXY) MERCURY URINE SPOT BioChemistry 3,400

1064778 (LAL) SERUM CARNITINE BioChemistry 4,000

1066149 (RANBAXY) HOLOTC BioChemistry 1,650 (HOLOTRANSCOBALAMINE)

W.E.F. 1st January 2019 65 INVESTIGATION

1066208 (LAL) CA 72.4 (GASTRIC CANCER MARKER) BioChemistry 1,450

1068685 C-PEPTIDE BioChemistry 1,500

1069033 (LAL) CADMIUM BLOOD BioChemistry 3,200

1036424 DNPH-URINE BioChemistry 180

1077133 TRANSFERRIN SATURATION BioChemistry 2,250

1062346 RANBAXY MERCURY SERUM BioChemistry 4,350

1062347 RANBAXY MERCURY URINE SPOT BioChemistry 3,400

1071136 (LAL) MPS - TYPE1(HURLER) QUANTITATIVE BioChemistry 4,700 BLOOD 1071331 (QUEST) FIRST TRIMESTER SCREENING (PAPP BioChemistry 1,810 - A AND HCG) WITH NT VALUE 1071332 (QUEST) FIRST TRIMESTER SCREENING (PAPP BioChemistry 1,825 - A AND HCG) WITHOUT NT VALUE 1071333 (QUEST) FIRST TRIMESTER DUAL WITHOUT BioChemistry 2,100 NT 1071335 (QUEST) FIRST TRIMESTER TRIPLE WITHOUT BioChemistry 3,800 NT 1071336 (QUEST) FIRST TRIMESTER TRIPLE WITH NT BioChemistry 3,800

1071337 (QUEST) FIRST TRIMESTER QUAD WITHOUT BioChemistry 4,000 NT 1071339 (QUEST) FIRST TRIMESTER TRIPLE WITHOUT BioChemistry 4,800 NT + PREECLAMPSIA RISK ASSESSMENT 1071340 (QUEST) FIRST TRIMESTER TRIPLE WITH NT + BioChemistry 4,800 PREECLAMPSIA RISK ASSESSMENT 1071341 (QUEST) FIRST TRIMESTER QUAD WITHOUT BioChemistry 5,000 NT + PREECLAMPSIA RISK ASSESSMENT 1071343 (QUEST) FIRST TRIMESTER QUAD WITH NT + BioChemistry 5,000 PREECLAMPSIA RISK ASSESSMENT 1071360 (QUEST) FIRST TRIMESTER DUAL WITH NT BioChemistry 2,100

1071361 (QUEST) FIRST TRIMESTER QUAD WITH NT BioChemistry 4,000

1071577 (LAL) SEROTONIN (5-HT) SERUM BioChemistry 12,280

66 W.E.F. 1st January 2019 INVESTIGATION

1072416 (LAL) METANEPHRINES RANDOM URINE BioChemistry 10,800

1073037 (RANBAXY) METANEPHRINE -FREE PLASMA BioChemistry 5,500

1076185 (LAL) PREGNENOLONE BioChemistry 8,430

1076186 (LAL) ESTROGEN TOTAL SERUM BioChemistry 8,800

1076505 (SRL) BISMUTH BLOOD BioChemistry 4,500

1076506 (LAL) VITAMIN-E BioChemistry 6,800

1077607 (LAL) 5-AMINOLEVULINIC ACID (5-ALA) BioChemistry 5,000 QUANTITATIVE URINE 27200 CROSS MATCHING ( 1 UNIT ) Blood Bank - 1 1,200 Products 954 BLOOD GROUPING AND TYPING (ABO and Rh) Blood Bank - 2 910 Services 959 DIRECT COOMBS TEST Blood Bank - 2 1,310 Services 964 INDIRECT ANTIGLOBULIN TEST Blood Bank - 2 1,420 Services 971 RH- PHENOTYPING Blood Bank - 2 3,570 Services 6273 DIRECT ANTIGLOBULIN TEST Blood Bank - 2 1,420 Services 16018 WESTERN BLOT ( HIV ) Blood Bank - 2 13,090 Services 18564 INDIRECT COOMBS TEST Blood Bank - 2 1,700 Services 21455 ABO ANTIBODY TITRES (IgG + IgM) Blood Bank - 2 5,200 Services 21457 ANTI HCV RAPID TEST Blood Bank - 2 1,760 Services 21459 ANTI HIV (I and II) RAPID KIT TEST Blood Bank - 2 3,230 Services 21460 ANTIBODY SCREEN AND IDENTIFICATION Blood Bank - 2 6,150 Services 21461 AUTOLOGOUS PRP Blood Bank - 2 10,410 Services 21462 BLOOD DONOR SCREENING FOR APHERESIS Blood Bank - 2 6,030 BY NAT Services

W.E.F. 1st January 2019 67 INVESTIGATION

21463 COOMB S TITRE (FOR Rh ANTIBODIES) Blood Bank - 2 3,030 Services 21464 CRYOPOOR PLASMA - ARRANGE Blood Bank - 2 1,510 Services 21466 DONOR SCREENING FOR APHERESIS (ELISA) Blood Bank - 2 4,320 Services 21467 DONOR SCREENING FOR APHERESIS (RAPID) Blood Bank - 2 3,500 Services 21470 HBs Ag (RAPID) Blood Bank - 2 1,510 Services 21494 SCREENING FOR RED CELL ANTIBODIES Blood Bank - 2 1,300 Services 21496 GROUP AND SCREEN Blood Bank - 2 2,260 Services 27201 SPLIT BLOOD PRODUCTS / PER UNIT Blood Bank - 2 1,560 Services 41328 ABO TITER Blood Bank - 2 5,200 Services 60135 MOLECULAR BLOOD TYPING Blood Bank - 2 15,770 Services 63241 APHERESIS DONOR SCREENING BY RAPID Blood Bank - 2 3,470 Services 63242 APHERESIS DONOR SCREENING BY ELISA Blood Bank - 2 6,000 AND NAT Services 63463 ANTI HCV ELISA Blood Bank - 2 3,160 Services 98295 HBsAg ELISA Blood Bank - 2 1,680 Services 98317 ANTI HIV (I and II) ELISA Blood Bank - 2 2,310 Services 101644 ANTI HBc (IgG + IgM) ELISA Blood Bank - 2 2,430 Services 1124 C.T. PNS AXIAL AND CORONAL (PLAIN) C T Scan Radiology 8,910

1126 C.T. SCAN ORBITS (EYE) - PLAIN C T Scan Radiology 8,910

1129 C.T. SCAN LOWER ABDOMEN/PELVIS C T Scan Radiology 11,220

1130 C.T. SCAN - CERVICAL SPINE C T Scan Radiology 9,540

1132 C.T. SCAN - LUMBAR SPINE C T Scan Radiology 7,620

68 W.E.F. 1st January 2019 INVESTIGATION

1143 C.T. SCAN BRAIN WITHOUT CONTRAST C T Scan Radiology 5,780

1147 C.T. SCAN NECK C T Scan Radiology 9,150

4543 C.T. CORONARY ANGIO CALCIUM SCREENING C T Scan Radiology 23,680

5220 C.T. ANGIO BRAIN (INTRACRANIAL VESSELS) C T Scan Radiology 17,180

5221 C.T. ANGIO BRAIN AND NECK (INTRA and C T Scan Radiology 30,520 EXTRA CRANIAL VESSELS) 5223 320 CT CORONARY CALCIUM SCORE C T Scan Radiology 11,450

5228 C.T. PULMONARY ANGIO C T Scan Radiology 14,340

5229 C.T. RENAL ANGIO C T Scan Radiology 16,720

5230 C.T. SCAN - DORSAL SPINE (THORACIC) C T Scan Radiology 14,310

5232 C.T. SCAN LIMITED STUDY C T Scan Radiology 4,800

5234 C.T. SCAN UPPER ABDOMEN C T Scan Radiology 11,220

5235 C.T. SCAN WHOLE ABDOMEN C T Scan Radiology 16,760

5236 C.T. SCAN WHOLE BODY C T Scan Radiology 29,430

5521 C.T. CHEST HIGH RESOLUTION (HRCT) C T Scan Radiology 8,380

11388 CT SCAN BRAIN WITH CONTRAST C T Scan Radiology 7,580

14767 CT SCAN 3D FACE C T Scan Radiology 8,910

14769 CT SCAN ABDOMINAL ANGIOGRAPHY C T Scan Radiology 21,810

14772 CT SCAN BOTH FEMUR C T Scan Radiology 9,540

14776 CT SCAN BOTH THIGH C T Scan Radiology 9,540

14781 CT SCAN BRAIN PITUITARY C T Scan Radiology 7,410

14783 CT SCAN CHEST AND ABDOMEN C T Scan Radiology 31,050 ANGIOGRAPHY 14784 CT SCAN CHEST ANGIOGRAPHY C T Scan Radiology 22,550

W.E.F. 1st January 2019 69 INVESTIGATION

14785 CT SCAN CHEST WITH CONTRAST C T Scan Radiology 11,770

14787 CT SCAN CISTERNOGRAPHY C T Scan Radiology 11,220

14789 CT SCAN ELBOW JOINTS C T Scan Radiology 7,410

14791 CT SCAN GUIDED CYTOLOGY FNAC C T Scan Radiology 18,390

14792 CT SCAN KUB PLAIN C T Scan Radiology 16,720

14793 CT SCAN KUB WITH CONTRAST (UROGRAM) C T Scan Radiology 20,440

15683 CT SCAN WRIST JOINTS C T Scan Radiology 7,410

16178 CT SCAN LOWER ABDOMEN WITH C T Scan Radiology 14,980 CONTRAST 16186 CT SCAN PERIPHERAL ANGIOGRAPHY C T Scan Radiology 16,320 (UPPER / LOWER LIMB) 16187 CT SCAN RENAL ANGIO C T Scan Radiology 16,720

16193 CT SCAN SCANOGRAM C T Scan Radiology 1,530

16477 CT SCAN ANKLE JOINTS C T Scan Radiology 7,410

16479 CT SCAN BOTH KNEE JOINTS C T Scan Radiology 9,540

16481 CT SCAN HIP JOINTS C T Scan Radiology 7,410

20159 C.T. SCAN WHOLE ABDOMEN WITH C T Scan Radiology 20,530 CONTRAST 100ML 20815 CT SCAN NECK ANGIOGRAPHY C T Scan Radiology 16,360 (EXTRACRANIAL VESSELS) 20817 C.T. SCAN - DORSAL SPINE (THORACIC) WITH C T Scan Radiology 18,080 CONTRAST 20818 C.T. SCAN - LUMBAR SPINE WITH CONTRAST C T Scan Radiology 11,390

20819 C.T. SCAN NECK WITH CONTRAST C T Scan Radiology 12,890

20820 C.T. PNS AXIAL AND CORONAL WITH C T Scan Radiology 12,650 CONTRAST 20821 C.T. SCAN ORBITS (EYE) - WITH CONTRAST C T Scan Radiology 12,650

20822 CT SCAN FACE AXIAL AND CORONAL C T Scan Radiology 8,910

70 W.E.F. 1st January 2019 INVESTIGATION

20823 CT SCAN FACE AXIAL AND CORONAL WITH C T Scan Radiology 12,650 CONTRAST 20824 CT SCAN INNER EAR/ TEMPORAL BONE C T Scan Radiology 8,910

20825 CT SCAN INNER EAR/ TEMPORAL BONE WITH C T Scan Radiology 12,650 CONTRAST 20826 C.T. SCAN 3D PELVIS WITH HIPS C T Scan Radiology 11,220

20827 C.T. SCAN UPPER ABDOMEN WITH CONTRAST C T Scan Radiology 14,980

20828 CT SCAN WHOLE ABDOMEN AND PELVIS C T Scan Radiology 16,720

20829 CT SCAN WHOLE ABDOMEN AND PELVIS C T Scan Radiology 20,440 WITH CONTRAST 20830 CT SCAN BRAIN POSTERIOR FOSSA C T Scan Radiology 7,580

20831 CT SCAN BRAIN PITUITARY WITH CONTRAST C T Scan Radiology 11,160

20832 CT SCAN 3D VIRTUAL BRONCHOSCOPY C T Scan Radiology 13,050

20833 CT SCAN 3D VIRTUAL COLONOSCOPY C T Scan Radiology 13,050

20835 CT SCAN ARM C T Scan Radiology 9,540

20836 CT SCAN BOTH LEGS C T Scan Radiology 9,540

20837 CT SCAN FOREARM C T Scan Radiology 7,410

20838 CT SCAN SHOULDER JOINT C T Scan Radiology 7,410

20839 CT SCAN SPINE CV JUNCTION C T Scan Radiology 7,410

20840 CT SCAN SPINE CV JUNCTION WITH C T Scan Radiology 11,160 CONTRAST 20841 CT SCAN CHEST and WHOLE ABDOMEN C T Scan Radiology 22,080

20842 CT SCAN CHEST and WHOLE ABDOMEN WITH C T Scan Radiology 25,820 COTNRAST 20843 CT SCAN CHEST and UPPER ABDOMEN C T Scan Radiology 14,770

20844 CT SCAN CHEST and UPPER ABDOMEN WITH C T Scan Radiology 18,500 CONTRAST

W.E.F. 1st January 2019 71 INVESTIGATION

20845 C.T. SCAN WHOLE BODY ANGIOGRAPHY C T Scan Radiology 52,150 PACKAGE (NECK/THORAX/ABDOMEN/ THIGH) 20849 CT SCAN MYELOGRAM (WHOLE SPINE) C T Scan Radiology 22,890

20850 CT SCAN MYELOGRAM (CERVICAL SPINE) C T Scan Radiology 11,160

20851 CT SCAN MYELOGRAM (DORSAL SPINE) C T Scan Radiology 7,410

20852 CT SCAN MYELOGRAM (LUMBAR SPINE) C T Scan Radiology 11,160

20853 CT SCAN LIVER TRIPLE/DUAL PHASE C T Scan Radiology 22,890

20854 CT SCAN LIVER FOR LAI (ATTENUATION C T Scan Radiology 21,160 INDEX) 20855 CT SCAN LIVER ANGIOGRAPHY DONOR C T Scan Radiology 21,810

20856 CT SCAN LIVER ANGIOGRAPHY (POST C T Scan Radiology 17,510 TRANSPLANT) 20860 CT SCAN GUIDED DISCOGRAM C T Scan Radiology 12,830

20861 CT SCAN GUIDED FACET BLOCK C T Scan Radiology 21,340

20862 CT SCAN GUIDED NEURAL BLOCK C T Scan Radiology 7,410

20863 CT SCAN CERVICAL SPINE WITH CONTRAST C T Scan Radiology 13,290

20864 CT SCAN SACRO - COCCYX C T Scan Radiology 16,720

20865 CT SCAN SACRO - COCCYX WITH CONTRAST C T Scan Radiology 18,390

20868 CT SCAN ENTEROCLYSIS C T Scan Radiology 11,160

20869 CT SCAN HAND C T Scan Radiology 7,410

20870 CT SCAN HAND WITH CONTRAST C T Scan Radiology 11,160

20871 CT SCAN WRIST WITH CONTRAST C T Scan Radiology 11,160

20872 CT SCAN FOREARM WITH CONTRAST C T Scan Radiology 11,160

20873 CT SCAN ELBOW WITH CONTRAST C T Scan Radiology 11,160

20874 CT SCAN ARM WITH CONTRAST C T Scan Radiology 13,290

72 W.E.F. 1st January 2019 INVESTIGATION

20875 CT SCAN FEET C T Scan Radiology 7,410

20876 CT SCAN FEET WITH CONTRAST C T Scan Radiology 11,160

20877 CT SCAN ANKLES WITH CONTRAST C T Scan Radiology 11,160

20878 CT SCAN LEGS WITH CONTRAST C T Scan Radiology 13,290

20879 CT SCAN KNEES WITH CONTRAST C T Scan Radiology 13,290

20880 CT SCAN THIGHS WITH CONTRAST C T Scan Radiology 11,160

20881 CT SCAN HIPS WITH CONTRAST C T Scan Radiology 11,160

20882 CT SCAN PELVIS WITH CONTRAST C T Scan Radiology 14,980

20883 CT SCAN WHOLE BODY WITH CONTRAST C T Scan Radiology 20,440

20884 CT SCAN AORTIC ANGIO C T Scan Radiology 18,390

20885 CT SCAN ABDOMINAL AORTA WITH LOWER C T Scan Radiology 40,040 LIMB ANGIO 20886 CT SCAN SINOGRAM/FISTULOGRAM C T Scan Radiology 7,410

20887 CT SCAN VENOGRAM UPPER/LOWER LIMB C T Scan Radiology 11,160

20888 CT SCAN VENOGRAM BRAIN C T Scan Radiology 22,890

25241 CT CORONARY ANGIOGRAPHY C T Scan Radiology 22,550

44045 CT BRAIN IAC (INTERNAL AUDITORY CAN) C T Scan Radiology 7,370

44047 CT CONTRAST STUDY C T Scan Radiology 5,640

44048 CT EXTRA CONTAST CHARGES-I(IONIC) C T Scan Radiology 1,880

44049 CT EXTRA SLIDES (PER SLIDES) C T Scan Radiology 150

44050 IVP (INTRAVENOUS PYLOGRAM) IONIC 50 C T Scan Radiology 4,470

44051 IVP (INTRAVENOUS PYLOGRAM)-NON-IONIC C T Scan Radiology 6,500

44052 MAMMOGRAPHY BIOPSY CHARGES C T Scan Radiology 1,010

44053 MAMMOGRAPHY EXTRA FILMS CHARGES C T Scan Radiology 440

W.E.F. 1st January 2019 73 INVESTIGATION

44106 CT BRAIN CONTRAST - IIIRD and SUBSQT. C T Scan Radiology 5,080 FOLLOW-UP SCAN 44107 CT BRAIN CONTRAST - IIND FOLLOW-UP C T Scan Radiology 5,430 SCAN 44108 CT BRAIN CONTRAST - IST FOLLOW-UP SCAN C T Scan Radiology 5,820

44109 CT BRAIN IAC (INTERNAL AUDITORY CAN) - C T Scan Radiology 4,960 IIIRD and SUBSQT. FOLLOW-UP SCAN 44110 CT BRAIN IAC (INTERNAL AUDITORY CAN) - C T Scan Radiology 5,340 IIND FOLLOW-UP SCAN 44111 CT BRAIN IAC (INTERNAL AUDITORY CAN) - C T Scan Radiology 5,720 IST FOLLOW-UP SCAN 44112 CT BRAIN PLAIN - III and SUBSQT. FOLLOW- C T Scan Radiology 3,770 UP SCAN 44114 CT BRAIN PLAIN - IIND FOLLOW-UP SCAN C T Scan Radiology 4,020

44115 CT BRAIN PLAIN - IST FOLLOW-UP SCAN C T Scan Radiology 4,280

44116 CT BRAIN POSTERIOR FOSSA - IIIRD and C T Scan Radiology 5,080 SUBSQT. FOLLOW-UP SCAN 44117 CT BRAIN POSTERIOR FOSSA - IIND FOLLOW- C T Scan Radiology 5,430 UP SCAN 44118 CT BRAIN POSTERIOR FOSSA - IST FOLLOW- C T Scan Radiology 5,820 UP SCAN 44119 CT BRAIN SELLA (PITUTARY) - IIIRD and C T Scan Radiology 4,960 SUBSQT.FOLLOW-UP SCAN 44120 CT BRAIN SELLA (PITUTARY) - IIND FOLLOW- C T Scan Radiology 5,430 UP SCAN 44121 CT BRAIN SELLA (PITUTARY) - IST FOLLOW- C T Scan Radiology 5,720 UP SCAN 44122 CT CERVICAL SPINE - IIIRD and SUBSQT. C T Scan Radiology 6,650 FOLLOW-UP SCAN 44123 CT CERVICAL SPINE - IIND FOLLOW-UP SCAN C T Scan Radiology 7,230

44125 CT CERVICAL SPINE - IST FOLLOW-UP SCAN C T Scan Radiology 7,670

44126 CT CHEST (CONTRAST) - IIIRD and SUBSQT. C T Scan Radiology 7,820 FOLLOW-UP SCAN 44127 CT CHEST (CONTRAST) - IIND FOLLOW-UP C T Scan Radiology 8,420 SCAN 44128 CT CHEST (CONTRAST) - IST FOLLOW-UP C T Scan Radiology 8,990 SCAN

74 W.E.F. 1st January 2019 INVESTIGATION

44129 CT CISTERNOGRAPHY / MYELOGRAPHY - C T Scan Radiology 7,470 IIIRD and SUBSQT. FOLLOW-UP SCAN 44130 CT CISTERNOGRAPHY / MYELOGRAPHY - C T Scan Radiology 7,950 IIND FOLLOW-UP SCAN 44131 CT CISTERNOGRAPHY / MYELOGRAPHY - IST C T Scan Radiology 8,460 FOLLOW-UP SCAN 44136 CT EXTREMITIES - IIIRD and SUBSQT. FOLLOW- C T Scan Radiology 6,650 UP SCAN 44137 CT EXTREMITIES - IIND FOLLOW-UP SCAN C T Scan Radiology 7,230

44138 CT EXTREMITIES - IST FOLLOW-UP SCAN C T Scan Radiology 7,670

44139 CT JOINTS - IIIRD and SUBSQT. FOLLOW-UP C T Scan Radiology 4,960 SCAN 44140 CT JOINTS - IIND FOLLOW-UP SCAN C T Scan Radiology 5,340

44141 CT JOINTS - IST FOLLOW-UP SCAN C T Scan Radiology 5,720

44142 CT LOWER ABDOMEN - IIIRD and SUBSQT. C T Scan Radiology 7,470 FOLLOW-UP SCAN 44143 CT LOWER ABDOMEN - IIND FOLLOW-UP C T Scan Radiology 7,950 SCAN 44144 CT LOWER ABDOMEN - IST FOLLOW-UP SCAN C T Scan Radiology 8,460

44145 CT LUMBAR SPINE - IIIRD and SUBSQT. C T Scan Radiology 5,340 FOLLOW-UP SCAN 44147 CT LUMBAR SPINE - IIND FOLLOW-UP SCAN C T Scan Radiology 5,790

44148 CT LUMBAR SPINE - IST FOLLOW-UP SCAN C T Scan Radiology 6,070

44149 CT NECK/PHARYNX/LARYNX - IIIRD and C T Scan Radiology 6,350 SUBSQT. FOLLOW-UP SCAN 44150 CT NECK/PHARYNX/LARYNX - IIND FOLLOW- C T Scan Radiology 6,790 UP SCAN 44151 CT NECK/PHARYNX/LARYNX - IST FOLLOW- C T Scan Radiology 7,230 UP SCAN 44152 CT PNS/FACE/ORBITS/INNER EAR - IIIRD and C T Scan Radiology 5,840 SUSQT. FOLLOW-UP SCAN 44153 CT PNS/FACE/ORBITS/INNER EAR - IIND C T Scan Radiology 6,260 FOLLOW-UP SCAN 44154 CT PNS/FACE/ORBITS/INNER EAR - IST C T Scan Radiology 6,700 FOLLOW-UP SCAN

W.E.F. 1st January 2019 75 INVESTIGATION

44155 CT SCAN (LIMITED SUDY) - IIIRD and SUBSQT. C T Scan Radiology 3,220 FOLLOW-UP SCAN 44156 CT SCAN (LIMITED SUDY) - IIND FOLLOW-UP C T Scan Radiology 3,450 SCAN 44158 CT SCAN (LIMITED SUDY) - IST FOLLOW-UP C T Scan Radiology 3,690 SCAN 44159 CT SPINE CV JUNCTION - IIIRD and SUBSQT. C T Scan Radiology 4,960 FOLLOW-UP SCAN 44160 CT SPINE CV JUNCTION - IIND FOLLOW-UP C T Scan Radiology 5,340 SCAN 44161 CT SPINE CV JUNCTION - IST FOLLOW-UP C T Scan Radiology 5,720 SCAN 44162 CT THREE REGIONS - IIIRD and SUBSQT. C T Scan Radiology 14,820 FOLLOW-UP SCAN 44163 CT THREE REGIONS - IIND FOLLOW-UP SCAN C T Scan Radiology 15,900

44164 CT THREE REGIONS - IST FOLLOW-UP SCAN C T Scan Radiology 16,940

44165 CT TWO REGIONS - IIIRD and SUBSQT. C T Scan Radiology 9,910 FOLLOW-UP SCAN 44166 CT TWO REGIONS - IIND FOLLOW-UP SCAN C T Scan Radiology 10,580

44167 CT TWO REGIONS - IST FOLLOW-UP SCAN C T Scan Radiology 11,320

44169 CT UPPER ABDOMEN - IIIRD and SUBSQT. C T Scan Radiology 7,470 FOLLOW-UP SCAN 44170 CT UPPER ABDOMEN - IIND FOLLOW-UP C T Scan Radiology 7,950 SCAN 44171 CT UPPER ABDOMEN - IST FOLLOW-UP SCAN C T Scan Radiology 8,490

44172 CT WHOLE ABDOMEN - IIIRD and SUBSQT. C T Scan Radiology 11,100 FOLLOW-UP SCAN 44173 CT WHOLE ABDOMEN - IIND FOLLOW-UP C T Scan Radiology 11,940 SCAN 44174 CT WHOLE ABDOMEN - IST FOLLOW-UP SCAN C T Scan Radiology 12,710

44175 CT WHOLE BODY (BRN C T Scan Radiology 19,740 CONT+CHEST+WHOLE) - IIIRD and SUBSQT. FOLLOW-UP SCAN 44176 CT WHOLE BODY (BRN C T Scan Radiology 21,130 CONT+CHEST+WHOLE) - IIND FOLLOW-UP SCAN

76 W.E.F. 1st January 2019 INVESTIGATION

44177 CT WHOLE BODY (BRN C T Scan Radiology 22,550 CONT+CHEST+WHOLE) - IST FOLLOW-UP SCAN 44178 HRCT - IIIRD and SUBSQT. FOLLOW-UP SCAN C T Scan Radiology 5,790

44181 HRCT - IIND FOLLOW-UP SCAN C T Scan Radiology 6,070

44182 HRCT - IST FOLLOW-UP SCAN C T Scan Radiology 6,650

52745 RT PLANING CT SCAN C T Scan Radiology 7,890

61474 CT PRE SURGERY PLANNING C T Scan Radiology 7,890

61476 CT TRAUMA PROTOCOL C T Scan Radiology 18,920

63316 CT NECK/PHARYNX/LARYNX C T Scan Radiology 9,110

63317 CT DORSAL SPINE (THORACIC) III and SUB. C T Scan Radiology 9,960 FOLLOWUP SCAN 63318 CT DORSAL SPINE (THORACIC) II FOLLOWUP C T Scan Radiology 10,700 SCAN 63319 CT DORSAL SPINE (THORACIC) I FOLLOWUP C T Scan Radiology 11,410 SCAN 63320 CT CORONARY ANGIO POST ANGIOPLASTY C T Scan Radiology 25,430 FOLLOW-UP 63321 CT CARDIAC FOR CONGENITAL HEART C T Scan Radiology 23,700 DIESEASE 1375 CAROTID DOPPLER CARDIOLOGY 7,110

1639 ECG CARDIOLOGY 710

1641 ECHO SCREENING CARDIOLOGY 2,190

1643 DOBUTAMINE STRESS ECHO CARDIOLOGY 8,380

1645 HOLTER MONITOR CARDIOLOGY 5,290

1646 ECHO-TRANSESOPHAGEAL (TEE) CARDIOLOGY 7,570

5631 2D-ECHO WITH COLOUR DOPPLER CARDIOLOGY 5,550

14734 FETAL ECHOCARDIOGRAPHY CARDIOLOGY 5,930

W.E.F. 1st January 2019 77 INVESTIGATION

15999 TMT (TREAD MILL STRESS TEST) CARDIOLOGY 4,550

19529 STRESS ECHO SCREENING CARDIOLOGY 8,380

21622 2 D ECHO(COLOR DOPPLER) PORTABLE CARDIOLOGY 5,850

21623 B P MONITORING(24 HRS) CARDIOLOGY 1,110

21624 CAROTID DOPPLER(PORTABLE) CARDIOLOGY 7,420

21626 ECHO TRANSESOPHAGEAL (PORTABLE) CARDIOLOGY 8,860

21627 EXERCISE STRESS TEST CARDIOLOGY 4,780

21628 FMD (FASO MEDIA DILATOR) CARDIOLOGY 1,270

21629 HEAD TILT TEST CARDIOLOGY 5,780

21630 IMA (INTERNAL MAMMARY ARTERY) CARDIOLOGY 3,990

21631 IMT (INTIMA MEMBRANE THICKNESS) CARDIOLOGY 1,270

21632 TDI (TISSUE DOPPLER IMAGING) CARDIOLOGY 5,840

21633 VASCULAR DOPPLER / RENAL DOPPLER CARDIOLOGY 7,420 (PORTABLE) 28652 VASCULAR / RENAL DOPPLER CARDIOLOGY 7,420

97394 MYPLATELET (GENOTYPE AND FUNCTION CARDIOLOGY 13,250 TEST) 97395 MYPLATELET FOLLOW-UP (FUNCTION ONLY CARDIOLOGY 11,050 TEST) 1069859 ATHEROPOINT CAROTID ATHERO RISK CARDIOLOGY 3,000 ASESSMENT 19098 BIBBLE TEST FOR PFO Colour Doppler 10,650

19099 CO2 REACTIVITY Colour Doppler 10,650

19105 ROUTINE TCD Colour Doppler 8,670

1047798 BREAST CANCER - Diagnosis (Datar-LB-CT- Datar Genetics 39,520 BC-D) Outsource 1047799 BREAST CANCER - Therapy Management (Datar- Datar Genetics 87,690 LB-CT-BC-TM) Outsource

78 W.E.F. 1st January 2019 INVESTIGATION

1047800 BREAST CANCER - Recurrence Monitoring (Datar- Datar Genetics 39,520 LB-CT-BC-RM) Outsource 1047801 COLON CANCER - Diagnosis (Datar-LB-CT- Datar Genetics 41,990 CC-D) Outsource 1047802 COLON CANCER - Therapy Management (Datar- Datar Genetics 87,690 LB-CT-CC-TM) Outsource 1047803 COLON CANCER - Recurrence Monitoring (Datar- Datar Genetics 41,990 LB-CT-CC-RM) Outsource 1047804 OVARIAN CANCER - Diagnosis (Datar-LB-CT- Datar Genetics 39,520 OC-D) Outsource 1047805 OVARIAN CANCER - Therapy Management Datar Genetics 87,690 (Datar-LB-CT-OC-TM) Outsource 1047806 OVARIAN CANCER - Recurrence Monitoring Datar Genetics 41,990 (Datar-LB-CT-OC-RM) Outsource 1047807 CERVIX CANCER - Diagnosis (Datar-LB-CT- Datar Genetics 41,990 CC-D) Outsource 1047808 CERVIX CANCER - Therapy Management (Datar- Datar Genetics 87,690 LB-CT-CC-TM) Outsource 1047809 CERVIX CANCER - Recurrence Monitoring (Datar- Datar Genetics 41,990 LB-CT-CC-RM) Outsource 1047810 HEAD AND NECK CANCER - Diagnosis (Datar- Datar Genetics 41,990 LB-CT-HNC-D) Outsource 1047811 HEAD AND NECK CANCER - Therapy Datar Genetics 87,690 Management (Datar-LB-CT-HNC-TM) Outsource 1047812 HEAD AND NECK CANCER - Recurrence Datar Genetics 41,990 Monitoring (Datar-LB-CT-HNC-RM) Outsource 1047813 LIVER CANCER - Diagnosis (Datar-LB-CT-LC-D) Datar Genetics 45,700 Outsource 1047814 LIVER CANCER - Therapy Management (Datar-LB- Datar Genetics 95,100 CT-LC-TM) Outsource 1047815 LIVER CANCER - Recurrence Monitoring (Datar- Datar Genetics 45,700 LB-CT-LC-RM) Outsource 1047816 ESOPHAGUS CANCER - Diagnosis (Datar-LB-CT- Datar Genetics 36,080 EC-D) Outsource 1047817 ESOPHAGUS CANCER - Therapy Management Datar Genetics 75,080 (Datar-LB-CT-EC-TM) Outsource 1047818 ESOPHAGUS CANCER - Recurrence Monitoring Datar Genetics 36,080 (Datar-LB-CT-EC-RM) Outsource 1047819 PROSTATE CANCER - Diagnosis (Datar-LB-CT- Datar Genetics 45,700 PC-D) Outsource

W.E.F. 1st January 2019 79 INVESTIGATION

1047820 PROSTATE CANCER - Therapy Management Datar Genetics 95,100 (Datar-LB-CT-PC-TM) Outsource 1047821 PROSTATE CANCER - Recurrence Monitoring Datar Genetics 51,870 (Datar-LB-CT-PC-RM) Outsource 1047822 ENDOMETRIUM CANCER - Diagnosis (Datar- Datar Genetics 45,700 LB-CT-EC-D) Outsource 1047823 ENDOMETRIUM CANCER - Therapy Management Datar Genetics 95,100 (Datar-LB-CT-EC-TM) Outsource 1047824 ENDOMETRIUM CANCER - Recurrence Datar Genetics 45,700 Monitoring (Datar-LB-CT-EC-RM) Outsource 1047825 PANCREAS CANCER - Diagnosis (Datar-LB-CT- Datar Genetics 51,870 PC-D) Outsource 1047826 PANCREAS CANCER - Therapy Management Datar Genetics 107,450 (Datar-LB-CT-PC-TM) Outsource 1047827 PANCREAS CANCER - Recurrence Monitoring Datar Genetics 51,870 (Datar-LB-CT-PC-RM) Outsource 1047828 OTHER SOLID ORGAN - Diagnosis (Datar-LB- Datar Genetics 51,870 CT-OSO-D) Outsource 1047829 OTHER SOLID ORGAN - Therapy Management Datar Genetics 107,450 (Datar-LB-CT-OSO-TM) Outsource 1047830 OTHER SOLID ORGAN - Recurrence Monitoring Datar Genetics 51,870 (Datar-LB-CT-OSO-RM) Outsource 1047831 LUNG CANCER - Diagnosis (Datar-LB-CT-LC-D) Datar Genetics 51,870 Outsource 1047832 LUNG CANCER - Therapy Management (Datar-LB- Datar Genetics 107,450 CT-LC-TM) Outsource 1047833 LUNG CANCER - Recurrence Monitoring (Datar- Datar Genetics 51,870 LB-CT-LC-RM) Outsource 1047834 SARCOMA - Diagnosis (Datar-LB-CT-SAC-D) Datar Genetics 51,870 Outsource 1047835 SARCOMA - Therapy Management (Datar-LB-CT- Datar Genetics 107,450 SAC-TM) Outsource 1047836 SARCOMA - Recurrence Monitoring (Datar-LB- Datar Genetics 51,870 CT-SAC-RM) Outsource 1047837 LYMPHOMA - Therapy Management (Datar-LB- Datar Genetics 107,450 CT-LYC-TM) Outsource 1047838 LYMPHOMA - Recurrence Monitoring (Datar-LB- Datar Genetics 51,870 CT-LYC-RM) Outsource 1047839 LEUKEMIA - Diagnosis (Datar-LB-CT-LEC-D) Datar Genetics 51,870 Outsource

80 W.E.F. 1st January 2019 INVESTIGATION

1047840 LEUKEMIA - Therapy Management (Datar-LB-CT- Datar Genetics 107,450 LEC-TM) Outsource 1047841 LEUKEMIA - Recurrence Monitoring (Datar-LB- Datar Genetics 51,870 CT-LEC-RM) Outsource 1047842 Oncology - Correkt Chemo Sensitivity Test Datar Genetics 39,520 Outsource 1047843 Oncology - Chimerism Test Datar Genetics 18,400 Outsource 1047844 Oncology - Fusion Search Analysis (For Leukemia) Datar Genetics 34,580 Outsource 1047845 Oncology - Minimal Residual Disease (MRD) Datar Genetics 21,000 (RNA Based)- Sarcoma / Leukemia (expect CML) Outsource 1047846 Oncology - Exacta Datar Genetics 296,400 Outsource 1047847 Oncology - Comprehensive EXACTA Datar Genetics 679,250 Outsource 1047848 Oncology - Germline Whole Exome Sequencing Datar Genetics 111,150 Outsource 1047849 Oncology - Tumor Paired Whole Exome Datar Genetics 259,350 Sequencing Outsource 1048494 WAS GENE SEQUENCING (DATAR-LB-CT) Datar Genetics 36,400 Outsource 1047842 Ongcology - Correkt Chemo Sensitivity Test Datar Genetics 39,520 Outsource 1047843 Ongcology - Chimerism Test Datar Genetics 18,400 Outsource 1047844 Ongcology - Fusion Search Analysis (For Leukemia) Datar Genetics 34,580 Outsource 1047845 Ongcology - Minimal Residual Disease (MRD) Datar Genetics 21,000 (RNA Based)- Sarcoma / Leukemia (expect CML) Outsource 1047846 Ongcology - Exacta Datar Genetics 296,400 Outsource 1047847 Ongcology - Comprehensive EXACTA Datar Genetics 679,250 Outsource 1047848 Ongcology - Germline Whole Exome Sequencing Datar Genetics 111,150 Outsource 1047849 Ongcology - Tumor Paired Whole Exome Datar Genetics 259,350 Sequencing Outsource 1940 X-RAY (DENTAL) PONOREX - CEPHALOGRAM Dental 1,560

W.E.F. 1st January 2019 81 INVESTIGATION

1941 X-RAY (DENTAL) PONOREX - O.P.G. Dental 1,040

9457 UPPER COMPLETE DENTURE Dental 43,880

15249 X-RAY DENTAL (OCCLUSAL) Dental 530

22243 X-RAY INTRA ORAL BITEWING Dental 530

22244 X-RAY INTRA ORAL PERIAPICAL Dental 180

22245 X-RAY (DENTAL) SIALOGRAPHY Dental 2,950

5251 FETAL SCAN WITH DOPPLER FETAL MEDICINE 5,490

21022 CERVICAL ASSESSMENT PLUS UTERINE FETAL MEDICINE 1,840 DOPPLER 21028 FETAL WELL BEING SCAN FETAL MEDICINE 5,490

21030 FETAL REDUCTION FETAL MEDICINE 16,430

21031 TWINS PREGNANCY SCAN FETAL MEDICINE 6,270

21032 TRIPLETS PREGNANCY SCAN FETAL MEDICINE 6,270

21033 HIGH ORDER MULTIPLE PREGNANCY SCAN FETAL MEDICINE 7,890

21034 EARLY FETAL VIABILITY SCAN FETAL MEDICINE 2,720

21036 TRIPLETS NUCHAL SCAN FETAL MEDICINE 5,310

21037 HIGH ORDER NUCHAL SCAN FETAL MEDICINE 5,310

21379 ANOMALY SCAN FETAL MEDICINE 5760

26850 QUADRUPLE SCREEN FETAL MEDICINE 3,330

26851 CYSTIC FIBROSIS SCREENING (DELTA 508 FETAL MEDICINE 4,590 MUTATION) 32480 CHROMOSOMAL MICROARRAY FETAL MEDICINE 93,650

41483 AMNIOTIC FLUID EVALUATION FETAL MEDICINE 9,460

60392 NEW GENE NEW BORN FETAL MEDICINE 8,190 SCREENING(EXTERNAL)

82 W.E.F. 1st January 2019 INVESTIGATION

66577 MICROARRAY FETAL MEDICINE 47,300

68248 EARLY PREGNANCY SCAN FETAL MEDICINE 2,370

78841 FETAL P R INTERVAL FETAL MEDICINE 1,590

86972 CHROMOSOMAL GENETIC STUDY FETAL MEDICINE 9,310

97971 (EXTERNAL) DUAL MARKER - LILAC FETAL MEDICINE 2,630

100060 CMV PCR-Lilac FETAL MEDICINE 8,130

1021883 REPEAT MULTIPLE PREGNANCY SCAN FETAL MEDICINE 7,090

1034847 KARYOLITE-LILAC FETAL MEDICINE 17,330

1037743 MICROARRAY ULD+ KARYOTYPE (AGILE LAB) FETAL MEDICINE 34,650

1055409 (LAL) CHROMOSOME SNP MICROARRAY FETAL MEDICINE 22,000 OPTIMA POC 1077992 AMNIOINFUSION FETAL MEDICINE 7,150

1077993 FOLLOW UP DOPPLERS FETAL MEDICINE 3,900

1077991 PLEUROCENTESIS FETAL MEDICINE 13,000

1077982 SINGLETON NUCHAL SCAN FETAL MEDICINE 5,750

1077985 TWIN AMNIOCENTESIS FETAL MEDICINE 19,500

1077984 TWIN ANOMALY SCAN FETAL MEDICINE 7,890

1077986 TWIN CVS FETAL MEDICINE 20,800

1077983 TWIN NUCHAL SCAN FETAL MEDICINE 7,230

1077987 TWIN REDUCTION FETAL MEDICINE 23,400

1077988 VESICOCENTESIS FETAL MEDICINE 13,000

1078847 (AGILE) MICROARRAY-750K FETAL MEDICINE 23,000

1074060 (QUEST) CHROMOSOMAL MICROARRAY FETAL MEDICINE 58,690 PRENATAL CLARISURE (R) OLIGO-SNP 1074057 (QUEST) CHROMOSOME STUDY AMNIOTIC FETAL MEDICINE 6,000 FLUID

W.E.F. 1st January 2019 83 INVESTIGATION

1074061 (QUEST) Q HERIT FETAL MEDICINE 27,220

1071356 (QUEST) QNATAL ADVANCED (NIPT) FETAL MEDICINE 28,000

1074059 (QUEST) SECOND TRIMESTER QUAD FETAL MEDICINE 3,200

1074058 (QUEST) SECOND TRIMESTER TRIPLE FETAL MEDICINE 2,400

1075666 FMT(FECAL MICROBIAL TRANSPLANT) Gastroenterology 61,000

1 ABSOLUTE EOSINOPHIL COUNT Haematology 500

2 ABSOLUTE LYMPHOCYTE COUNT (ALC) Haematology 500

3 ABSOLUTE NEUTROPHIL COUNT Haematology 500

5 ACTIVATED PARTIAL THROMBOPLASTIN Haematology 1,310 TIME 8 BLEEDING TIME Haematology 620

18 CLOT RETRACTION TEST Haematology 440

19 CLOTTING TIME [CT] Haematology 560

21 COMPLETE HAEMOGRAM (CBC/PS/RBC Haematology 1,430 INDICES) 24 D-DIMER Haematology 2,770

25 DLC Haematology 500

26 ESR Haematology 560

27 EUGLOBULIN CLOT LYSIS Haematology 1,010

28 F.D.P. Haematology 2,690

30 FACTOR IX ASSAY Haematology 2,690

32 FACTOR VIII ASSAY Haematology 2,690

39 FLUID CELL COUNT - PLEURAL Haematology 680

40 FLUID CELL COUNT -ASCITIC Haematology 680

44 G6 PD SCREENING Haematology 1,510

84 W.E.F. 1st January 2019 INVESTIGATION

46 HEMOGLOBIN (Hb) Haematology 560

47 HAMS TEST Haematology 1,510

51 L E TEST Haematology 680

52 LEUCOCYTE ALKALINE PHOSPHATASE SCORE Haematology 1,850

53 MALARIAL ANTIGEN DETECTION TEST Haematology 1,510

55 MCH Haematology 460

56 MCHC Haematology 460

57 MCV Haematology 460

58 METHEMOGLOBIN SCREENING Haematology 820

59 MYELOPEROXIDASE Haematology 1,850

62 P A S STAIN Haematology 1,850

63 PCV / HAEMATOCRIT Haematology 500

64 "P/S FOR MALARIAL PARASITE Haematology 830

66 PERIPHERAL SMEAR FOR OPINION Haematology 830

67 PLASMA FIBRINOGEN Haematology 1,840

68 PLASMA HEMOGLOBIN Haematology 680

69 PLATELET AGGREGOMETRY-ADENOSINE Haematology 3,120 DIPHOSPHATE INDUCED 70 PLATELET AGGREGOMETRY-COLLAGEN Haematology 1,890 INDUCED 71 PLATELET AGGREGOMETRY-EPINEPHRINE Haematology 1,890 INDUCED 72 PLATELET AGGREGOMETRY- RISTOCETIN Haematology 3,470 INDUCED 74 PLATELET Count Haematology 50

W.E.F. 1st January 2019 85 INVESTIGATION

75 PLATELET COUNT AND MORPHOLOGY Haematology 830

76 POST COITAL TEST Haematology 720

78 PROTEIN C Haematology 6,880

79 PROTEIN S Haematology 7,420

81 RBC Count Haematology 500

82 RETICULOCYTE COUNT Haematology 500

84 SEMEN ANALYSIS Haematology 2,010

85 SICKLING TEST Haematology 680

91 STOOL FOR REDUCING SUBSTANCES Haematology 440

92 STOOL OCCULT BLOOD Haematology 440

93 STOOL ROUTINE AND MICROSCOPY Haematology 500

94 SUCROSE LYSIS TEST Haematology 1,110

95 SUDAN BLACK B Haematology 1,880

98 THROMBIN TIME Haematology 760

99 TOTAL LEUCOCYTE COUNT (TLC) Haematology 560

102 URINE FOR KETONES Haematology 420

104 URINE- BENCE JONES PROTEINS Haematology 760

105 URINE- BILE PIGMENT AND BILE SALT Haematology 420

109 URINE FOR PH Haematology 420

113 URINE HEMOSIDERIN Haematology 560

114 URINE ROUTINE AND MICROSCOPY Haematology 640

115 URINE SUGAR Haematology 440

116 V.W.FACTOR ANTIGEN ASSAY Haematology 4,220

86 W.E.F. 1st January 2019 INVESTIGATION

120 TOURNIQUET TEST (HESS TEST) Haematology 350

249 FETAL HEMOGLOBIN QUANTITATIVE Haematology 740

335 PORPHOBILINOGEN - SPOT Haematology 420 URINE(QUALITATIVE SCREEN) 2259 BONE MARROW ASPIRATION FOR OPINION Haematology 2,770

2260 "BONE MARROW BIOPSY Haematology 2,780 FOR OPINION" 4080 COAGULATION PROFILE Haematology 4,040

4540 CBC (HB,PCV,ESR,TLC,DLC,PLT C) Haematology 1,160

5162 LEUKEMIA DIAGNOSTIC PANEL -I(ACUTE Haematology 36,580 LEUKEMIA PANEL)

5164 LEUKEMIA DIAGNOSTIC PANEL-II(AML Haematology 25,360 CHARACTERIZATION)

5168 HEAT STABILITY TEST Haematology 720

5172 MCV MCHC MCH Haematology 690

5175 LUPUS ANTI-COAGULANT Haematology 7,420

5177 URINE FOR REDUCING SUBSTANCES Haematology 640

5178 TLC and DLC Haematology 810

6237 CBC WITHOUT ESR (HB,PCV,TLC,DLC,PLT) Haematology 1,160

6240 NASAL SMEAR FOR EOSINOPHILS Haematology 500

6243 RED CELL OSMOTIC FRAGILITY Haematology 1,850

6261 ANTI THROMBIN-III Haematology 6,880

8740 FLUID CELL COUNT - CSF Haematology 680

10563 PT/INR Haematology 960

10799 URINE PREGNANCY TEST Haematology 910

W.E.F. 1st January 2019 87 INVESTIGATION

14118 HEINZ BODY TEST Haematology 500

15006 SPUTUM FOR EOSINOPHILS Haematology 500

15605 DIC PROFILE (PT, APTT, FDP, FIBRINOGEN, Haematology 5,780 D-DIMER)

17531 RED CELL OSMOTIC FRAGILITY WITH Haematology 1,850 INCUBATION 18570 PLATELET AGGRENOMETRY (ADP, Haematology 14,180 EPINEFRINE, RISTOCETIN, COLLAGEN) 20519 ABNORMAL Hb STUDIES (HPLC/ Haematology 2,800 ELECTROPHORESIS) 20520 BONE MARROW ASPIRATION and BIOPSY FOR Haematology 6,000 OPINION 20521 DNA CHIMERISM STUDY Haematology 40,060

20522 FACTOR INHIBITORS SCREENING Haematology 4,880

20523 FLUID CELL COUNT- OTHERS Haematology 680

20524 HB and PCV Haematology 810

20525 HBF CYTOCHEMISTRY(KLEIHAUER TEST) Haematology 460

20526 IMMUNE DEFICIENCY PANEL - I (CD3, CD4, Haematology 12,720 CD8, CD19) 20527 IMMUNE DEFICIENCY PANEL - IV (CD3, CD19) Haematology 5,640

20528 IMMUNE DEFICIENCY PANNEL - II, (CD3, CD4, Haematology 4,820 CD8) 20529 IMMUNE DEFICIENCY PANNEL-III (CD3, CD4) Haematology 4,260

20530 IMMUNOFLOWCYTOMETRY MARKER Haematology 4,270

20531 IRON STAIN (BONE MARROW) Haematology 1,850

20532 LEUKEMIA DIAGNOSTIC PANEL-III(ALL Haematology 25,320 CHARACTERIZATION) 20533 LEUKEMIA DIAGNOSTIC PANEL-IV(CLL/HCL/ Haematology 25,320 SLL BASIC) 20534 LEUKEMIA DIAGNOSTIC PANEL-V(CLL/HCL/ Haematology 36,580 SLL EXPANDED)

88 W.E.F. 1st January 2019 INVESTIGATION

20535 LEUKEMIA DIAGNOSTIC PANEL-VI(ANY FIVE Haematology 16,910 CUSTOMIZED) 20536 MRD FOR ALL Haematology 15,040

20537 PCR FOR ACUTE LEUKEMIA (1 MARKER) Haematology 11,050

20538 PCR FOR AML-ETO (QUALITATIVE) Haematology 10,730

20539 PCR FOR AML-ETO (QUANTITATIVE) Haematology 18,820

20540 PCR FOR BCR ABL (MAJOR) QUALITATIVE Haematology 10,730

20542 PCR FOR BCR ABL (MINOR) QUALITATIVE Haematology 10,730

20543 PCR FOR BCR ABL (MAJOR) QUANTITATIVE Haematology 18,820

20544 PCR FOR CBFB-MYH11A (QUALITATIVE) Haematology 10,730

20545 PCR FOR CBFB-MYH11A (QUANTITATIVE) Haematology 20,140

20547 PCR FOR JAK2 MUTATION ANALYSIS Haematology 11,050

20548 PCR FOR PML-RARA (QUALITATIVE) Haematology 10,730

20549 PCR FOR PML-RARA TRANSLOCATION Haematology 18,820 (QUANTIT) 20550 PNH DIAGNOSTIC PANEL (HAMS TEST, Haematology 15,020 SUCROSE LYSIS, IMMUNOFLOWCYTOMETRY) 20551 QUALITATIVE MULTIPLEX REVERSE Haematology 30,060 TRANSCRIPTASE (ACUTE LEUKEMIA) 20552 STEM CELL COUNT Haematology 10,030

20553 UNSTABLE HAEMOGLOBIN (HI and IP) Haematology 830

20554 UREA CLOT SOLUBILITY Haematology 720

20555 URINE HAEMOGLOBINURIA Haematology 420

20556 URINE PHASE CONTRAST MICROSCOPY Haematology 740

20557 URINE PROTEIN Haematology 420

20558 URINE SPECIFIC GRAVITY Haematology 420

W.E.F. 1st January 2019 89 INVESTIGATION

24784 JAK-2 Haematology 11,050

24787 (LAL) AMIODARONE -(HPLC) Haematology 5,200

24791 (LAL) HAPTOGLOBINE Haematology 1,950

24792 (LAL) URINARY PORPHOBILINOGEN Haematology 3,500

24810 (LAL) CD 8 Haematology 2,390

26852 PCR FOR JAK2 MUTATION (1 MOLECULAR Haematology 11,050 MARKER) 26853 PCR FOR BCR ABL (MINOR) QUANTITATIVE Haematology 19,050

27161 CLOT STABILITY TEST Haematology 720

27162 FACTOR INHIBITORS ASSAY Haematology 6,720

27163 Hb A2 (HPLC) Haematology 1,160

27164 IMMUNOCHEMISTRY MARKER ( 2 MARKER) Haematology 10,730

27165 IMMUNOCHEMISTRY MARKER (3 MARKERS) Haematology 16,140

27166 IMMUNOCHEMISTRY MARKER (4 MARKERS) Haematology 21,400

27167 PNH TESTS Haematology 2,490

27168 THROMBIN AGGREGATION Haematology 2,580

27170 BONE MARROW ASPIRATION AND BIOPSY Haematology 11,100 PROCEDURE 27778 (LAL) von WILLEBRAND FACTOR ANTIGEN Haematology 10,000 vWF Ag 28613 NEPTHOL AD-D CHLOROACETATE ESTERASE Haematology 1,880

28615 SULPHA HEAMOGLOBIN SCREENING Haematology 720

28616 ALDEHYDE SERUM TEST Haematology 440

29241 NSE (Non Specific Estarase) Haematology 1,880

34971 (LAL)FACTOR VII FUNCTIONAL Haematology 3,490

43958 CHOLRACETATE ESTERASE Haematology 1,880

90 W.E.F. 1st January 2019 INVESTIGATION

43980 INVIVO ADHEIVENES TEST Haematology 1,160

43991 ISO PROPANOL PRECIPITATION TEST Haematology 1,160

44002 KAOLIN CLOTTING TIME (KCT) Haematology 950

44013 PF3 AVAILABILITY TEST Haematology 2,170

44024 RESISTANCE TO ACTIVATED PROTEIN C Haematology 9,110

44035 SLE INHIBITOR STUDY Haematology 2,170

44046 SMIG (IGG POLYCOLONIAL) Haematology 3,030

44061 (RANBAXY)CD 15 Haematology 3,100

44062 (RANBAXY)CD 21 Haematology 3,100

44063 (RANBAXY)CD 3 (PAN-T CELL) Haematology 3,100

44064 (RANBAXY)CD 30 ( KI - 1 ) Haematology 3,100

44065 (RANBAXY)CD 4 ( T-HELPER CELL ) Haematology 3,100

44066 (RANBAXY)CD 43 Haematology 3,100

44067 (RANBAXY)CD 45 RA Haematology 3,100

44070 (RANBAXY)CD 45 RB Haematology 3,100

44078 (RANBAXY)HMB 45 Haematology 3,100

44079 (RANBAXY)NP 57 Haematology 3,100

44080 FIBRINOGEN Haematology 2,600

44081 (RANBAXY)P 53 Haematology 3,100

44407 ACID PHOSPHATASE (WITH\WITHOUT Haematology 1,880 TARTARTE) 53609 SLIDE FOR REVIEW HAEMATOLOGY Haematology 1,840

55414 (LAL) FACTOR X Haematology 4,940

65702 MALARIA PARASITE Haematology 850

W.E.F. 1st January 2019 91 INVESTIGATION

65738 (LAL)PLATELET DRIVE GROWTH FACTOR - Haematology 5,200 ALPHA 79027 (External-Oncquest)-PCR for PGDFRa Haematology 6,760

86297 (LAL) FACTOR XII ASSAY (FUNCTIONAL) Haematology 3,200

86298 (LAL) FACTOR XI ASSAY (FUNCTIONAL) Haematology 3,200

86953 ACTIVATED CLOTTING TIME Haematology 530

1021667 (EXTERNAL) AML COMBOQUEST V Haematology 10,500

1028162 (ONCQUEST LAB) CAL RETICULIN MUTATION Haematology 7,180 ANALYSIS 1028450 CBC DENGUE SPECIAL(HB PCV TLC PLT C) Haematology 760

1035474 (EXTERNAL) T-CELL CLONALITY Haematology 14,400

1038277 LAL(FACTOR V FUNCTIONAL) Haematology 3,360

1038279 LAL(FACTOR II FUNCTIONAL) Haematology 7,560

1039428 (LAL) CHIMERISM POST-ENGRAFTMENT Haematology 5,700

1043117 SAPIEN CANASSIST BREAST Haematology 72,650

1051586 (LAL) Chimerism Pre engraftment Donor and Haematology 10,000 Recipient 1051587 (LAL) Chimerism Pre engraftment Haematology 5,700

1056022 DNA CHIMERISM STUDY-SINGLE Haematology 13,510

1059582 (QUEST) JAK 2 EXON 12 MUTATION ANALYSIS Haematology 5,000

1059583 (QUEST) MPL MUTATION ANALYSIS Haematology 7,000

1059584 (QUEST) CALR (CAL RETICULIN) MUTATION Haematology 6,000 ANALYSIS 1063022 ACUTE LEUKEMIA ORIENTATION PANEL Haematology 18,200

1063023 CHRONIC LEUKEMIA ORIENTATION PANEL Haematology 18,200

1068216 MINIMAL RESIDUAL DISEASE DETECTION Haematology 14,300

92 W.E.F. 1st January 2019 INVESTIGATION

1068221 FLOWCYTOMETRY FOR MULTIPLE MYELOMA Haematology 18,200

1069364 THROMBOPHILIA PROFILE II Haematology 19,500 (HAEMATOLOGY) 1071491 (LAL) CANCER GENE - ANY 3 MARKERS Histopathology 13,500

1072239 (LAL) CANCER TARGETED GENE PANEL CNS Histopathology 20,000 TUMOR 1071485 (LAL) MICROSATELLITE INSTABILITY TEST BY Histopathology 7,700 IHC 1071490 (LAL) METHYLGUANINE Histopathology 8,400 METHYLTRANSFERASE (MGMT) 5592 F N A C / F N A B Histopathology 2,770

15509 NEEDLE BIOPSY LIVER Histopathology 5,200

15511 NEEDLE BIOPSY PROSTATE Histopathology 5,200

15512 NEEDLE BIOPSY - BONE MARROW Histopathology 2,560

15513 NEEDLE BIOPSY LUNG Histopathology 5,200

16500 "CYTOLOGY PAP SMEAR (GYNAE CYTOLOGY) Histopathology 1,220 " 16893 TZANCK SMEAR Histopathology 1,760

16906 NEEDLE BIOPSY ( OTHERS ) Histopathology 5,300

16908 NEEDLE BIOPSY KIDNEY Histopathology 5,200

18588 NEEDLE BIOPSY OF TESTIS Histopathology 5,200

20628 COMPREHENSIVE FETAL POSTNATAL Histopathology 10,510 EVALUATION 20629 CYTOLOGY B T A STAT Histopathology 3,370

20630 CYTOLOGY NON GYNAE CYTOLOGY Histopathology 1,850

20631 CYTOLOGY SYNOVIAL FLUID FOR CRYSTALS Histopathology 560

20632 FROZEN SECTION NEURO ( 1ST SPECIMEN) Histopathology 5,310

20633 FROZEN SECTION NEURO (SUBSQT 1 SPEC) Histopathology 800

W.E.F. 1st January 2019 93 INVESTIGATION

20634 FROZEN SECTION NEURO (SUBSQT 2 SPEC) Histopathology 1,510

20635 FROZEN SECTION NEURO (SUBSQT 3 SPEC) Histopathology 2,260

20636 FROZEN SECTION NEURO (SUBSQT 4 SPEC) Histopathology 3,030

20637 FROZEN SECTION NEURO (SUBSQT 5 SPEC) Histopathology 3,740

20638 FROZEN SECTION NON-NEURO ( 1 SPEC) Histopathology 4,630

20639 FROZEN SECTION NON-NEURO (SUBSQT 1 Histopathology 800 SPEC) 20640 FROZEN SECTION NON-NEURO (SUBSQT 2 Histopathology 1,510 SPEC) 20641 FROZEN SECTION NON-NEURO (SUBSQT 3 Histopathology 2,260 SPEC) 20642 FROZEN SECTION NON-NEURO (SUBSQT 4 Histopathology 3,030 SPEC) 20643 FROZEN SECTION NON-NEURO (SUBSQT 5 Histopathology 3,740 SPEC) 20644 IMMUNOFLURESCENCE (COMPLETE PANEL) Histopathology 4,140

20645 IMMUNOFLURESCENCE (SINGLE ANTIBODY) Histopathology 1,760

20646 IMMUNOHISTOCHEMISTRY (1 MARKER) Histopathology 3,430

20647 IMMUNOHISTOCHEMISTRY (2 MARKER) Histopathology 6,730

20648 IMMUNOHISTOCHEMISTRY (3 MARKER) Histopathology 10,040

20649 IMMUNOHISTOCHEMISTRY (4 MARKER) Histopathology 13,430

20650 IMMUNOHISTOCHEMISTRY (5 MARKER) Histopathology 16,730

20651 LARGE SPECIMEN AMPUTATIONS Histopathology 5,200

20652 LARGE SPECIMEN BOWL RESECTION Histopathology 5,200

20653 LARGE SPECIMEN BREAST (MASTECTOMY) Histopathology 5,200

20654 LARGE SPECIMEN HYSTERECTOMY Histopathology 5,200

20655 LARGE SPECIMEN NECK DISSECTIONS Histopathology 5,200

94 W.E.F. 1st January 2019 INVESTIGATION

20656 LARGE SPECIMEN NEPHRECTOMY Histopathology 5,200

20657 LARGE SPECIMEN OTHERS Histopathology 5,200

20658 LARGE SPECIMEN PNEUMONECTOMY Histopathology 5,200

20659 LARGE SPECIMEN PLACENTA Histopathology 5,200

20660 LARGE SPECIMENE HEAD and NECK Histopathology 5,090 MALIGNANCIES 20661 LIMITED FETAL POSTNATAL EVALUATION Histopathology 6,030

20662 MEDIUM SPECIMEN ADRENALS Histopathology 2,560

20663 MEDIUM SPECIMEN BONE Histopathology 2,560

20664 MEDIUM SPECIMEN BREAST LUMP TISSUE Histopathology 2,560

20665 MEDIUM SPECIMEN GALL BLADDER Histopathology 2,640

20666 MEDIUM SPECIMEN LYMPH NODE Histopathology 2,560

20667 MEDIUM SPECIMEN NEUROSERGICAL TISSUE Histopathology 2,640

20668 MEDIUM SPECIMEN ORCHIDECTOMY Histopathology 2,560

20669 MEDIUM SPECIMEN OTHERS Histopathology 2,640

20670 MEDIUM SPECIMEN OVARIES Histopathology 2,560

20671 MEDIUM SPECIMEN PARATHYROID Histopathology 2,560

20672 MEDIUM SPECIMEN T U R PROSTATE Histopathology 2,560

20673 MEDIUM SPECIMEN THYROID Histopathology 2,560

20674 NEEDLE BIOPSY KIDNEY WITH I/F Histopathology 9,400

20675 NEEDLE BIOPSY STEREOTACTIC BRAIN Histopathology 5,200

20676 REVIEW OF SLIDES (SECOND OPINION MORE Histopathology 2,900 THAN 4 SLI ) 20677 REVIEW OF SLIDES (SECOND OPINION UPTO 4 Histopathology 1,840 SLIDES)

W.E.F. 1st January 2019 95 INVESTIGATION

20678 SMALL SPECIMEN APPENDIX Histopathology 1,950

20679 SMALL SPECIMEN ENDOMETRIAL Histopathology 1,950 CURETTINGS 20680 SMALL SPECIMEN G.I. ENDOSCOPIC BIOPSIES Histopathology 2,010

20681 SMALL SPECIMEN HAERT VALVE Histopathology 1,950

20682 SMALL SPECIMEN MUCOSAL BIOPSIES Histopathology 2,010

20683 SMALL SPECIMEN NASAL BIOPSIES Histopathology 1,950

20684 SMALL SPECIMEN OTHER BIOPSIES Histopathology 2,010

20685 SMALL SPECIMEN SKIN BIOPSY Histopathology 2,010

20686 SMALL SPECIMEN VASECTOMY BITS Histopathology 2,150

20687 ISSUE OF SLIDES Histopathology 1,300

26854 LIQUID BASED CYTOLOGY PAP SMEAR Histopathology 3,210 (GYNEA CYTOLOGY) 44000 ISSUE OF SLIDES (FOR SUBSEQUENT 1 SLIDE) Histopathology 290

44001 LARGE SPECIMEN FETUS FOR Histopathology 5,200 HISTOPATHOLOGY 44082 (RANBAXY)PAN - CYTOKERATIN Histopathology 3,100

44380 ISSUE OF SLIDES (FOR SUBSEQUENT 2 SLIDES) Histopathology 660

44381 ISSUE OF SLIDES (FOR SUBSEQUENT 3 SLIDES) Histopathology 870

44382 ISSUE OF SLIDES (FOR SUBSEQUENT 4 SLIDES) Histopathology 1,160

44383 ISSUE OF SLIDES (FOR SUBSEQUENT 5 SLIDES) Histopathology 1,290

57579 (CYTOLOGY) REVIEW OF SLIDES (SECOND Histopathology 1,840 OPINION UPTO 4 SLIDES) 57580 (CYTOLOGY) REVIEW OF SLIDES (SECOND Histopathology 2,900 OPINION MORE THAN 4 SLI ) 1030225 (RANBAXY) 6027F 1P /19Q DELETIONS FISH Histopathology 18,000

1035019 (LAL) KIDNEY BIOPSY FOR ELECTRO Histopathology 7,000 MICROSCOPY

96 W.E.F. 1st January 2019 INVESTIGATION

1037615 (LAL)IMMUNOHISTOCHEMISTRY FOR Histopathology 1,900 GROWTH HORMONE 1056137 (LAL) IMMUNOHISTOCHEMISTRY FOR C myc Histopathology 1,900

1060430 (LAL) IMMUNOHISTOCHEMISTRY FOR IgG4 Histopathology 1,900

1060834 (LAL) FISH FOR ONCOLOGY 1P AND 19Q Histopathology 9,000 CODELETION 15515 TESTICULAR BIOPSY IVF Lab 6,940

21355 FROZEN TESTICULAR BIOPSY IVF Lab 11,100

21358 IUI(USING DONOR SEMEN) IVF Lab 20,670

21359 IUI(USING HUSBAND' S SEMEN) IVF Lab 15,250

21361 SEMEN ANALYSIS(IVF Lab) IVF Lab 2,310

21363 SPERM FUNCTION TEST IVF Lab 9,020

21371 ULTRASOUND GUIDED PER VAGINAL IVF Lab 26,370 OVARIAN CYST ASPIRATION 4282 THALASSEMIA PROFILE Lab Others 4,040

86954 SONOSITE MACHINE (MICU) Medical 530

22 CRYOGLOBULINS Microbiology 2,140

54 MANTOUX ( TUBERCULIN ) TEST Microbiology 1,310

145 ADA : ADENOSINE DEAMINASE -CSF Microbiology 950

706 ELISA HBe Ag Microbiology 2,240

722 ANTI MEASLES ANTIBODIES (IgG ) ELISA/ELFA Microbiology 2,880

723 ANTI MEASLES ANTIBODIES IgM ELISA/ ELFA Microbiology 2,880

724 ELISA ANTI RUBELLA IgG Microbiology 2,240

733 AFB CULTURE [PUS](RAPID MGIT 960) Microbiology 2,370

734 AFB CULTURE [SPUTUM](RAPID MGIT 960) Microbiology 2,370

W.E.F. 1st January 2019 97 INVESTIGATION

735 AFB CULTURE [STOOL](RAPID MGIT 960) Microbiology 2,370

737 AFB CULTURE TIPS [CATH,SUC,TRACL ET] Microbiology 2,370 (RAPID MGIT 960) 738 AFB CULTURE [URETHRAL SWAB] Microbiology 2,370 (RAPID MGIT 960) 739 AFB CULTURE URINE(RAPID MGIT 960) Microbiology 2,370

740 AFB CULTURE [VAGINAL SWAB/HIGH Microbiology 2,320 VAGINAL SWAB/CERVICAL SWAB] 742 AFB STAIN (Z N) / SMEAR EXAM [OTHERS] Microbiology 560

743 AFB STAIN (Z N) / SMEAR EXAM [TIP] Microbiology 560

744 AFB STAIN (Z N) / SMEAR EXAM [PUS] Microbiology 560

745 AFB STAIN (Z N) / SMEAR EXAM [SPUTUM] Microbiology 620

746 AFB STAIN (Z N) / SMEAR EXAM [URINE] Microbiology 560

747 AFB STAIN (Z N) / SMEAR EXAM [BAL] Microbiology 560

748 AFB STAIN (Z N) / SMEAR EXAM [BODY FLUID] Microbiology 560

749 AFB STAIN (Z N) / SMEAR EXAM [CSF] Microbiology 560

756 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,980 [BLOOD] 757 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [BODY FLUIDS] 758 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [BRONCHO-ALVEOLAR LAVAGE [BAL]/TRACH] 759 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [CONJUCTIVAL SWAB] 760 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,110 [CSF] 761 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [NASAL SWAB] 762 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [OTHERS] 763 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [PUS]

98 W.E.F. 1st January 2019 INVESTIGATION

765 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [STOOL] 767 ANAEROBIC CULTURE AND SENSITIVITY TIPS Microbiology 2,150 [CATHETER,SUCTION,TRACHEAL ETC.] 768 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [URETHRAL SWAB] 769 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [URINE] 770 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [VAGINAL/CERVICAL SWAB] 771 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [SEMEN] 772 ELISA ANTI HBe / HBe ANTIGEN COMBINE Microbiology 3,790

778 ELISA ANTI HAV IgM Microbiology 3,370

779 ELISA ANTI HBc IgM Microbiology 4,310

781 ELISA ANTI HCV Microbiology 3,160

782 ELISA ANTI LEPTOSPIRA IGM ANTIBODIES Microbiology 2,260

791 COLD AGGLUTININS Microbiology 780

792 COMPLEMENT LEVEL - C3 Microbiology 2,840

793 COMPLEMENT LEVEL C4 Microbiology 2,840

794 C-REACTIVE PROTEIN (CRP) Microbiology 930

800 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,850 [URINE]

801 AEROBIC CULTURE AND SENSITIVITY Microbiology 3,070 [BLOOD] 802 AEROBIC CULTURE AND SENSITIVITY [C S F] Microbiology 1,840

809 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,760 [OTHERS]

811 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,770 [SPUTUM]

W.E.F. 1st January 2019 99 INVESTIGATION

812 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,770 [THROAT SWAB]

824 DARK GROUND MICROSCOPY - BLOOD Microbiology 930

851 FUNGAL SMEAR / KOH MOUNT - BODY FLUID Microbiology 580

852 FUNGAL SMEAR / KOH MOUNT - CSF Microbiology 580

854 FUNGAL SMEAR / KOH MOUNT - PUS Microbiology 580

855 FUNGAL SMEAR / KOH MOUNT - THROAT Microbiology 580 SWAB

856 FUNGAL SMEAR / KOH MOUNT - TIP Microbiology 580

857 FUNGAL SMEAR / KOH MOUNT - URINE Microbiology 580

858 FUNGAL SMEAR / KOH MOUNT - SPUTUM Microbiology 580

859 FUNGAL SMEAR / KOH MOUNT -BAL Microbiology 580

860 GRAM STAIN [BAL] Microbiology 560

861 GRAM STAIN [BLOOD] Microbiology 560

862 GRAM STAIN [OTHERS] Microbiology 580

863 GRAM STAIN [TIP] Microbiology 560

864 GRAM STAIN [ BODY FLUID] Microbiology 560

865 GRAM STAIN [CSF] Microbiology 580

866 GRAM STAIN [PUS] Microbiology 560

867 GRAM STAIN [SPUTUM] Microbiology 560

868 GRAM STAIN [STOOL] Microbiology 560

869 GRAM STAIN [THROAT SWAB] Microbiology 560

100 W.E.F. 1st January 2019 INVESTIGATION

870 GRAM STAIN [URINE] Microbiology 560

880 INDIA-INK PREPARATION Microbiology 580

882 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT Microbiology 560 -BAL 883 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 500 CSF 884 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 500 TIP 885 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 560 BODY FLUID 886 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 560 STOOL 887 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 560 THROAT 888 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 560 PUS 889 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 560 SPUTUM 890 MOD.Z.N.STAINING FOR NOCARDIA/CRYPT- Microbiology 500 URINE 903 VDRL (QUALITATIVE) - BLOOD Microbiology 620

904 VDRL (QUALITATIVE) - CSF Microbiology 620

905 WATER ANALYSIS [FOR COLIFORM COUNT] Microbiology 2,770

912 AFB CULTURE [BAL/TRACHEAL](RAPID MGIT Microbiology 2,150 960) 913 AFB CULTURE [CONJUNCTIVAL SWAB] Microbiology 2,370 (RAPID MGIT 960) 914 AFB CULTURE [NASAL SWAB](RAPID MGIT Microbiology 2,370 960) 915 YEAST SUSCEPTIBILITY Microbiology 3,620

917 WIDAL TEST Microbiology 720

925 ELISA ANTI CARDIOLIPIN ANTIBODIES IgM Microbiology 4,310

926 ANTI LKM ANTIBODIES Microbiology 3,110

W.E.F. 1st January 2019 101 INVESTIGATION

927 ANTI MITOCHONDRIAL ANTI BODIES (AMA) Microbiology 3,570

932 ANTI CCP ANTIBODIES - ELISA Microbiology 3,390

992 VDRL (QUALITATIVE) Microbiology 560

4225 COMPLETE HEPATITIS PROFILE Microbiology 16,860

4536 PROCALCITIONIN ASSAY (QUANTITATIVE)/ Microbiology 5,720 PCT 5321 ELISA ANTI GBM ANTIBODIES Microbiology 7,400

5486 ELISA - IgM ANTIBODIES TO DETECT DENGUE Microbiology 600 VIRUS 5492 AEROBIC CULTURE AND SENSITIVITY [BAL] Microbiology 1,770

6300 TPHA-TREPONEMA PALLIDIUM Microbiology 2,640 HEMAGGLUTINATION ASSAY 6521 ADA : ADENOSINE DEAMINASE -BODY FLUID Microbiology 950

6542 ANTI TTG (IgA - ELISA) ANTIBODIES Microbiology 2,010

8282 ELISA ANTI CHLAMYDIAL IgA Microbiology 2,770

8283 ELISA ANTI CHLAMYDIAL IgG Microbiology 2,770

8284 ANTI MUMPS ANTIBODIES (IgG) ELISA/ELFA Microbiology 2,880

8285 ANTI MUMPS IGM ANTIBODIES (IgM) ELISA/ Microbiology 2,880 ELFA

8290 ELISA ANTI MYCOPLASMA IgM Microbiology 3,160

8328 HANGING DROP PREPARATION-STOOL Microbiology 580

8332 CRYPTOCOCCUS ANTIGEN DETECTION IN Microbiology 2,140 CSF 8333 CRYPTOCOCCUS ANTIGEN DETECTION IN Microbiology 3,160 SERUM 8349 AEROBIC CULTURE AND SENSITIVITY [PUS] Microbiology 1,840

102 W.E.F. 1st January 2019 INVESTIGATION

8352 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,770 [SEMEN]

8361 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,770 [URETHRAL SWAB]

8362 AEROBIC CULTURE AND SENSITIVITY [NASAL Microbiology 1,770 SWAB]

8363 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,770 [VAGINAL SWAB]

8373 FUNGAL CULTURE [SPUTUM] Microbiology 1,560

8374 FUNGAL CULTURE [THROAT SWAB] Microbiology 1,560

8376 FUNGAL CULTURE [BLOOD] Microbiology 2,930

8377 FUNGAL CULTURE [C S F] Microbiology 2,420

8378 FUNGAL CULTURE [PUS] Microbiology 1,560

8379 FUNGAL CULTURE [BRONCHO-ALVEOLAR Microbiology 1,560 LAVAGE(BAL)/TRACHE]

8380 FUNGAL CULTURE [URINE] Microbiology 1,560

8383 FUNGAL CULTURE [STOOL] Microbiology 1,560

8385 FUNGAL CULTURE [PLEURAL FLUID] Microbiology 1,560

8388 FUNGAL CULTURE [ASCITIC FLUID] Microbiology 1,560

8393 FUNGAL CULTURE [URETHRAL SWAB] Microbiology 1,560

8394 FUNGAL CULTURE VAGINAL/HIGH VAGINAL / Microbiology 1,560 CERVICAL SWAB

8398 AFB CULTURE [C S F](RAPID MGIT 960) Microbiology 2,370

8409 ELISA ANTI RUBELLA IgM Microbiology 2,240

W.E.F. 1st January 2019 103 INVESTIGATION

8685 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,840 [STOOL]

8829 AFB SUSCEPTIBILITY BY MGIT/MBBACT/ Microbiology 25,110 ETEST (10 DRUGS)

9273 H1N1 REALTIME PCR Microbiology 4,500

11205 "ELISA TORCH COMPLEX PROFILE IgG Microbiology 5,310

11206 "ELISA TORCH COMPLEX PROFILE IgM Microbiology 5,310

13295 AFB Culture-Others Microbiology 2,320

13320 "DENGUE VIRUS RT PCR ASSAY Microbiology 6,720

13570 TB QUANTIFERON/GAMMA INTERFERON Microbiology 5,360 ASSAY 13868 AFB SUSCEPTIBILITY BY MGIT/MBBACT/ Microbiology 13,730 ETEST (5 DRUGS) 13878 REAL TIME PCR FOR BK/JC VIRUS (BLOOD) Microbiology 6,030

13892 REAL TIME PCR FOR BK/JC VIRUS (URINE) Microbiology 6,030

14887 ANTI DSDNA ANTIBODIES Microbiology 3,790 (IMMUNOFLUORESCENCE) 14889 ANCA ( IMMUNOFLUORESCENCE ASSAY) Microbiology 3,120

14890 ANCA-(IMMUNOFLOURESCENCE Microbiology 3,950 QULITATIVE) 14894 ANTI NUCLEAR ANTIBODIES/ Microbiology 3,840 ANA(IMMUNOFLUORESCENCE)

14898 ANTI SMOOTH MUSCLE ANTIBODIES/ASMA Microbiology 4,140 (IMMUNOFLUORESCENCE) 15446 CMV RT PCR QUANTITATIVE (WHOLE Microbiology 8,050 BLOOD) 15535 HSV 1 AND 2 RT PCR QUANTITATIVE (PLASMA Microbiology 13,430 EDTA) 16017 ELISA ANTI HEV IgM Microbiology 5,080

104 W.E.F. 1st January 2019 INVESTIGATION

16103 CSF STREPTOCOCCUS PNEUMONIAE Microbiology 1,700 CAPSULAR ANTIGEN 16422 FUNGAL SMEAR / KOH MOUNT - OTHERS Microbiology 580

16423 FUNGAL CULTURE [OTHERS] Microbiology 1,600

16502 ELISA ANTI SPERM Microbiology 2,240

16503 DENGUE NS1 ANTIGEN ELISA Microbiology 600

16506 LEGIONELLA ANTIGEN(URINE) ELISA/ Microbiology 2,150 IMMUNOCHROMATOGRA 17279 FUNGAL CULTURE [CONJUNCTIVAL SWAB] Microbiology 1,560

17281 FUNGAL CULTURE [NASAL SWAB] Microbiology 1,560

17838 AEROBIC CULTURE AND SENSITIVITY Microbiology 1,770 [CONJUNCTIVAL SWAB]

18656 TOXOPLASMA AVIDITY ASSAY (IGG)/(ELISA/ Microbiology 3,120 ELIFA) 19531 ELISA ANTI VARICELLA ZOSTER IgG Microbiology 1,680

19532 ELISA ANTI VARICELLA ZOSTER IgM Microbiology 1,680

20889 AEROBIC CULTURE AND SENSITIVITY [ TIPS - Microbiology 1,840 CATHETER, SUCTION, TRACHEAL ] 20890 AEROBIC CULTURE AND SENSITIVITY [BAL / Microbiology 3,230 TRACHEAL / ENDOTRACHEAL SECRETION] 20891 AEROBIC CULTURE AND SENSITIVITY Microbiology 3,070 [BLOOD - ADULT ON ANTIBIOTIC] 20892 AEROBIC CULTURE AND SENSITIVITY Microbiology 3,070 [BLOOD - PAEDIATRIC and NEONATOLOGY] 20893 AEROBIC CULTURE AND SENSITIVITY [BODY Microbiology 1,770 FLUIDS] 20894 AEROBIC CULTURE AND SENSITIVITY [ENDO Microbiology 3,310 TRACHEAL / TRACHEAL S] 20895 AEROBIC CULTURE AND SENSITIVITY Microbiology 3,080 [QUANTITATIVE BAL /E.T /TRACHEAL SECRETION]

W.E.F. 1st January 2019 105 INVESTIGATION

20896 AFB CULTURE [BODY FLUID](RAPID MGIT Microbiology 2,330 960) 20897 AFB CULTURE [THROAT SWAB] Microbiology 2,260

20898 AFB SUSCEPTIBILITY BY MGIT/MBBACT/ Microbiology 11,450 ETEST (4 DRUGS) 20899 AFB SUSCEPTIBILITY BY MGIT/MBBACT/ Microbiology 4,220 ETEST (ONE DRUG) 20900 ALBERT S STAINING [PUS] Microbiology 560

20901 ALBERT S STAINING [THROAT SWAB] Microbiology 560

20902 AMOEBIC CULTURE [CSF] Microbiology 3,090

20903 AMOEBIC CULTURE [OTHERS] Microbiology 3,230

20904 AMOEBIC CULTURE [STOOL] Microbiology 3,230

20905 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [SPUTUM] 20906 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,150 [THROAT SWAB/WASHINGS] 20907 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,400 BLOOD [ADULT NOT ON ANTIBIOTIC] 20908 ANAEROBIC CULTURE AND SENSITIVITY Microbiology 2,980 BLOOD [ADULT ON ANTIBIOTIC] 20909 ANCA IMMUNOBLOT PROFILE(ANTI MPO,PR3 Microbiology 6,720 AND GBM)LINEBLOT

20910 ANTI CENTROMERE ANTIBODIES Microbiology 4,270 (IMMUNOBLOT ASSAY) 20911 ANTI ENDOMYSIAL ANTIBODIES IgA-IF Microbiology 4,980

20913 ANTI HSV 1 and 2 ANTIBODY ELISA [CSF] Microbiology 4,250

20914 ANTI JO-1 ANTIBODIES ( IMMUNOBLOT Microbiology 4,250 ASSAY) 20915 ANTI RNP/SM ANTIBODIES ( IMMUNOBLOT Microbiology 4,250 ASSAY) 20916 ANTI SCL -70 ANTIBODIES ( IMMUNOBLOT Microbiology 4,260 ASSAY)

106 W.E.F. 1st January 2019 INVESTIGATION

20917 ANTI SMITH ANTIBODIES ( IMMUNOBLOT Microbiology 4,260 ASSAY) 20918 ANTI SSB/LA ANTIBODIES ( IMMUNOBLOT Microbiology 4,260 ASSAY) 20919 ANTI-SSA/RO ANTIBODIES ( IMMUNOBLOT Microbiology 4,260 ASSAY) 20920 ASO/ASLO (ANTI STREPTOLYSIN O ) LATEX/ Microbiology 1,560 NEPHELOMETRY 20921 CHALMYDIA ANTIGEN DETECTION Microbiology 4,880 [CERVICAL/URETHRAL SWAB] 20922 CHLAMYDIA DUO Microbiology 7,620

20923 CLOSTRIDIUM DIFFICILE TOXIN A and B Microbiology 6,990 DETECTION- STOOL 20925 COMBINED ANTIGEN TESTING (COMMON Microbiology 8,780 BACTERIAL PATHOGENS) 20926 COMBINED ANTIGENS CSF-COMMON Microbiology 8,780 BACTERIA (LATEX AGGL) 20927 CRYPTOCOCCAL ANTIGEN DETECTION Microbiology 6,530 (QUANTITATIVE) 20928 CSF N. MENINGITIDIS ANTIGEN (ACYW-135) Microbiology 1,700

20929 CULTURE FOR HELICOBACTER PYLORI Microbiology 2,140

20930 CULTURE FOR NOCARDIA Microbiology 1,680

20931 CULTURE FOR STRONGYLOIDES LARVAE Microbiology 2,260

20932 DARK GROUND MICROSCOPY - OTHERS Microbiology 930

20933 DARK GROUND MICROSCOPY - URETHRAL Microbiology 930 SWAB 20934 DARK GROUND MICROSCOPY - VAGINAL / Microbiology 930 CERVICAL 20935 ELISA ANTI ( HBc HBe and HBs ) Microbiology 6,470

20936 ELISA ANTI AMOEBIC ANTIBODIES Microbiology 2,800

20937 ELISA ANTI CHLAMYDIAL IgM Microbiology 2,770

20938 ELISA ANTI CMV IgG ANTIBODIES Microbiology 2,650

W.E.F. 1st January 2019 107 INVESTIGATION

20939 ELISA ANTI CMV IgM Microbiology 2,770

20940 ELISA ANTI ECHINOCOCCAL (HYDATID) Microbiology 2,770

20941 ELISA ANTI HAV TOTAL Microbiology 2,220

20942 ELISA ANTI HBc Microbiology 2,510

20943 ELISA ANTI HBe Microbiology 2,240

20944 ELISA ANTI HBs Microbiology 2,240

20945 ELISA ANTI HSV 1 and 2 IgM Microbiology 2,240

20946 ELISA ANTI HSV 1 IgG Microbiology 2,240

20947 ELISA ANTI HSV 1 IgM Microbiology 2,240

20948 ELISA ANTI HSV 1 and 2 IgG Microbiology 2,240

20949 ELISA ANTI HSV 2 IgG Microbiology 2,240

20950 ELISA ANTI HSV 2 IgM Microbiology 2,240

20951 ELISA ANTI TOXOPLASMA IgG Microbiology 2,240

20952 ELISA ANTI TOXOPLASMA IgM Microbiology 2,240

20953 ELISA ANTI-CYSTICERCOSIS ANTIBODIES Microbiology 4,310

20954 ELISA FOR HEPATITIS B PROFILE Microbiology 11,090

20955 ELISA MPO-ANCA Microbiology 5,100

20956 ELISA PR-3 - ANCA Microbiology 5,100

20957 ENA IMMUNOBLOT ASSAY PROFILE Microbiology 12,710

20958 EPSTEIN BARR VIRUS(RTPCR) [BLOOD,URINE Microbiology 5,200 SPUTUM,TISSUE] 20959 FUNGAL ANTIGEN - BETA - D - GLUCAN Microbiology 2,840

20960 FUNGAL ANTIGEN - GALACTOMANNAN Microbiology 2,220

20961 FUNGAL ANTIGEN DUO (GALACTOMANNAN, Microbiology 4,850 BETA D GLUCAN)

108 W.E.F. 1st January 2019 INVESTIGATION

20962 FUNGAL COMBINED TESTS (SMEAR, Microbiology 7,050 CULTURE, ANTIGEN) 20963 FUNGAL CULTURE Microbiology 1,560 TIPS(CATHETER,SUCTION,TRACHEAL ETC) 20964 H. INFLUENZAE B ANTIGEN - BLOOD Microbiology 1,700

20965 H. INFLUENZAE B ANTIGEN - CSF Microbiology 1,700

20966 HSV 1 AND 2 RT PCR ASSAY Microbiology 13,430

20967 IMMUNOBLOT ANA PROFILE Microbiology 16,520

20968 INFECTION EARLY MARKER SCREEN Microbiology 3,810 (PROCALCITONIN and CRP) 20969 INFECTIOUSMONONUCLEOSIS IgM Microbiology 4,320 HETEROPHILE ANTIBODIES 20970 INFLAMMATORY SCREEN ASSAY (PCT,CRP and Microbiology 7,160 IL - 6) 20971 LEISHMANIA ANTIBODIES/ KALA AZAR Microbiology 2,290 ANTIBODIES (IgG) 20972 MIC - OTHERS ( MENTION THE ANTIBIOTIC ) Microbiology 900

20973 MIC CEFOPERAZONE/SULBACTAM Microbiology 930

20974 MIC CEFTAZIDIME Microbiology 930

20975 MIC CEFTRIAXONE Microbiology 930

20976 MIC MEROPENEM Microbiology 930

20977 MIC PIPERACILLIN / TAZOBACTAM Microbiology 930

20978 MIC TEICOPLANIN Microbiology 930

20979 MIC TICARCILLIN / CLAVULANIC ACID Microbiology 930

20980 MIC TRIMETHOPRIM / Microbiology 930 SULPHAMETHOXAZOLE 20981 MIC VANCOMYCIN Microbiology 930

20982 MYCOBACTERIUM TB RAPID CULTURE Microbiology 5,360 DIFFERENTIATION RTPPCR 20983 NEONATAL/PEDIATRICS SEPSIS SCREEN - 3 Microbiology 3,700

W.E.F. 1st January 2019 109 INVESTIGATION

20984 NEONATAL/PEDIATRICS SEPSIS SCREEN - 7 Microbiology 5,310

20985 NEONATAL/PEDIATRICS SEPSIS SCREEN-0 Microbiology 5,310

20986 PERINANATAL HEPATITIS AB SCREENING Microbiology 3,930 (ANTI HCV and HBC ) 20987 PNEUMOCYSTIS JIROVECI (DFAT) Microbiology 3,610

20989 PNEUMOCYSTIS JIROVECI STAINING (SILVER Microbiology 930 METHANAMINE) 20990 PNEUMOCYSTIS JIROVECI STAINING Microbiology 930 -SPUTUM 20991 RAPID UREASE TEST Microbiology 620

20992 REAL TIME PCR FOR HUMAN PAPILLIOMA Microbiology 4,620 VIRUS (HPV) 20993 RESPIRATORY PATHOGENS ANTIBODY Microbiology 13,970 PROFILE (IFAT) 20994 RHEUMATOID FACTOR(LATEX Microbiology 1,290 AGGLUTINATION/NEPHELOMETRY) 20995 ROTAVIRUS ANTIGEN (STOOL) Microbiology 2,470

20996 RUBELLA AVIDITY Microbiology 6,480

20997 TGA Microbiology 2,850

20999 TUBERCULOSIS - RTPCR ASSAY Microbiology 5,120

21000 TUBERCULOSIS / MYCOBACTERIA DUO TEST Microbiology 7,260

24735 (LAL) LYME DISEASE SEROLOGY Microbiology 3,300

24742 (LAL) IGF - BP3 Microbiology 4,050

24743 (LAL) IGF - I Microbiology 4,000

24779 (LAL) ANTIPARIETAL CELL ANTIBODY (IGG) Microbiology 1,400 EIA 24785 (LAL) WEIL FELIX TEST Microbiology 800

24788 (LAL) ANTI GAD ANTIBODIES Microbiology 6,200

24794 (LAL) ANTI SPERM ANTIBODY (SERUM) Microbiology 800

110 W.E.F. 1st January 2019 INVESTIGATION

24795 (LAL) ASPERGILLUS ANTIBODY PANEL Microbiology 3,200 (IGG+IGM) 24797 (LAL) CD 4 Microbiology 1,600

24798 (LAL) CRP (HS) Microbiology 750

24799 (LAL) GLIADIN ANTIBODY (IGA) Microbiology 1,700

24800 (LAL) GLIDIN ANTIBODY (IGG) Microbiology 1,700

24801 (LAL) H-PYLORI IGA Microbiology 1,600

24802 (LAL) H-PYLORI IGG Microbiology 1,600

24803 (LAL) PARVO VIRUS IGG Microbiology 2,490

24805 (LAL) PARVO VIRUS IGM Microbiology 2,450

24806 (LAL) SPECIFIC IGE FOR ASPERGILLUS Microbiology 1,700

24808 (LAL) ASPERGILLUS IGG ANTIBODY Microbiology 1,700

24809 (LAL) ASPERGILLUS IGM ANTIBODY Microbiology 1,700

24812 (LAL) ECHOVIRUS ANTIBODY PANEL Microbiology 4,700 (IGG+IGM) 24813 (LAL) ECHOVIRUS IGM ANTIBODY Microbiology 2,450

24814 (LAL) ECHOVIRUS IGG ANTIBODY Microbiology 2,450

24816 (LAL) EPSTEIN BARR VIRUS (IGG) Microbiology 1,600

24817 (LAL) EPSTEIN BARR VIRUS (IGM) Microbiology 1,600

24818 (LAL) GAD-65 Microbiology 6,200

24820 (LAL) INSULIN ANTIBODY Microbiology 2,000

24828 (LAL) BRUCELLA AGGULITINATION Microbiology 700

24837 (RANBAXY) ACETYL CHOLINE RECEPTOR Microbiology 4,940 ANTIBODY 25240 HBs Ag / AUSTRALIA ANTIGEN-ELISA Microbiology 1,640

W.E.F. 1st January 2019 111 INVESTIGATION

26842 (LAL)BNP (B-TYPE NATRIURETIC PEPTIDE) Microbiology 450

26868 RESPIRATORY VIRUSES(SCREENING) PCR Microbiology 13,970 ASSAY 27155 (LAL)ANTIBODIES TO EXTRACTABLE Microbiology 4,700 NUCLEAR ANTIGEN SCREEN (ENA) 27157 (LAL)FILARIAL ANTIGEN DETECTION Microbiology 790

27175 AEROBIC CULTURE (QUANTITATIVE) and Microbiology 3,390 SENSITIVITY BAL. 27176 ANTI MITOCHONDRIAL ANTIBODIES ( Microbiology 4,250 IMMUNOBLOT ASSAY) 27177 ANTI MITOCHONDRIAL ANTIBODIES/ Microbiology 4,140 AMA(IMMUNOFLURESCENCE) 27178 ELISA ANTI HBS TITRES(POST VACCINATION) Microbiology 6,050

27179 ELISA ANTI HDV Microbiology 10,500

27180 ANTI MITOCHONDRIAL ANTIBODIES / AMA Microbiology 3,420 (ELISA) 27621 MTB DETECTION AND DRUG RESISTANCE 1st Microbiology 10,410 LINE (HAIN-Genotype) 27622 MTB DETECTION AND DRUG RESISTANCE 2nd Microbiology 10,410 LINE (HAIN-Genotype) 27623 MTB DIFFERENTIATION FROM CULTURE Microbiology 6,080

27624 COMMON MYCOBACTERIUM Microbiology 8,670 DIFFERENTIATION WHEN CULTURE POSITIVE 27625 UNCOMMON MYCOBACTERIUM Microbiology 8,670 DIFFERENTIATION WHEN CULTURE POSITIVE 27744 (LAL)C1 ESTERASE INHIBITOR - PROTEIN Microbiology 2,200 QUANTITATION 28515 ANTI GLIADIN ANTIBODIES Microbiology 4,980 IgA-IF 28597 NAPTHYL ACETATE ETERASE (ALPHA) Microbiology 1,880

28663 ELISA FOR TUBERCULOSIS (TB) IGA Microbiology 3,910

28665 ELISA FOR TUBERCULOSIS (TB) IGG Microbiology 3,910

28667 ELISA FOR TUBERCULOSIS (TB) IGM Microbiology 3,910

112 W.E.F. 1st January 2019 INVESTIGATION

29877 RUBELLA PCR Microbiology 3,990

44060 (RANBAXY)CATHEPSIN D-TISSUE Microbiology 3,100

44076 (RANBAXY)HEPATITIS B SURFACE ANTIGEN - Microbiology 3,100 TISSUE 44077 (RANBAXY)HEPATITIS B CORE ANTIGEN - Microbiology 3,100 TISSUE 53648 FUNGAL ANTIGEN - GALACTOMANNAN (BAL) Microbiology 2,220

66883 ANTI - THYROID ANTIBODIES Microbiology 5,670

66966 TPO Microbiology 2,740

67630 (LAL) PNEUMOSLIDE IgM Microbiology 2,950

67634 (LAL) ASCA ANTIBODY PANEL IGG/IGA Microbiology 2,500

67636 (LAL) ACETYL CHOLINE RECEPTOR BINDING Microbiology 2,170 ANTIBODY 67894 Epstein -Barr Virus VCA/EA IgG Microbiology 5,520

67904 Epstein -Barr Virus EBNA IgG Microbiology 4,350

67905 Epstein -Barr Virus VCA IgM Microbiology 2,370

68519 (LAL) ASPERGILLUS SPECIFIC IGE Microbiology 2,080

68583 CALPROTECTIN Microbiology 5,200

72182 (LAL) CH-50 Microbiology 7,900

77496 RESPIRATORY PATHOGEN PROFILE PCR ASSAY Microbiology 22,860

77956 REAL TIME PCR FOR INTESTINAL PATHOGENS Microbiology 23,660

77957 REAL TIME PCR FOR DIARRHEOGENIC Microbiology 7,090 ESCHERICHIA COLI 77958 REAL TIME PCR FOR YERSINIA Microbiology 7,090 ENTEROCOLITICA/YERSINIA PSEUDOTUBERCULOSIS 77959 REAL TIME PCR FOR CAMPYLOBACTER Microbiology 7,090

W.E.F. 1st January 2019 113 INVESTIGATION

77960 REAL TIME PCR FOR LISTERIA Microbiology 7,090 MONOCYTOGENES 79925 APOLLO ASTHMA/RHINITIS PANEL ADULT(31 Microbiology 12,610 ALLERGENS) 79926 APOLLO WHEEZE RHINITIS/CHILD (30 Microbiology 12,610 ALLERGENS) 79927 APOLLO ECZEMA PANEL (16 ALLERGENS) Microbiology 15,130

79928 APOLLO COMPREHENSIVE ECZEMA PANEL(43 Microbiology 22,070 ALLERGENS) 79929 APOLLO COMPREHENSIVE ASTHMA/RHINITIS Microbiology 22,070 (52 ALLERGENS) 79930 APOLLO FOOD ALLERGENS VEG (43 Microbiology 14,510 ALLERGENS) 79931 APOLLO FOOD ALLERGENS NON-VEG (23 Microbiology 6,310 ALLERGENS) 79932 APOLLO FOOD ALLERGENS NON-VEG PLUS Microbiology 22,070 VEG (66 ALLERGENS) 79933 APOLLO ALLERGY SCREEN ADULT Microbiology 2,520

79934 APOLLO ALLERGY SCREEN CHILD Microbiology 2,520

79935 APOLLO PHADIATOP Microbiology 1,560

79936 ELISA SYPHILIS (ANTI TREPONEMA Microbiology 1,590 PALLIDUM) IgG ANTIBODIES 79937 CULTURE FOR CAMPYLOBACTER SPP/ Microbiology 2,140 HELICOBACTER PYLORI 82255 CMV ACTIVE DUO ASSAY Microbiology 16,990

82302 PNEUMOCYSTIS JIROVECI DETECTION Microbiology 3,940 – (DFAT AND SILVER METHENAMINE STAINING) 82651 ELISA ANTI DS DNA Microbiology 2,520

82773 ELISA ANTI NUCLEAR ANTIBODIES/FACT Microbiology 2,050 (ANA) 83331 (RANBAXY) FILARIA ANTIBODY Microbiology 4,160

87046 VDRL(QUANTITATIVE)-BLOOD Microbiology 570

87047 VDRL(QUANTITATIVE)-CSF Microbiology 570

114 W.E.F. 1st January 2019 INVESTIGATION

87983 APOLLO-SINGLE ALLERGEN Microbiology 1,440

90100 (LAL) INSULIN ANTIBODIES HIGHLY Microbiology 8,590 SENSITIVE 90101 (LAL) C1 ESTERASE INHIBITOR FUNCTIONAL Microbiology 3,650 ACTIVITY 90648 RAPID TYPHOID TEST Microbiology 690

90720 (LAL) EXTRACTABLE NUCLEAR ANTIGEN Microbiology 7,000 (ENA) - QUANTITATIVE PROFILE 93795 TOXOPLASMA GONDII PCR (SRL) Microbiology 3,960

98713 ANTIMUSK ANTIBODIES (SRL) Microbiology 9,980

101885 URINE FOR EGGS OF SCHISTOSOMA Microbiology 1,500

101886 LIVER IMMUNOBLOT PROFILE Microbiology 4,500

1019204 ELISA ANTI CARDIOLIPIN ANTIBODIES IgM. Microbiology 4,310

1019205 ELISA ANTI CARDIOLIPIN ANTIBODIES IgG. Microbiology 4,310

1019206 ELISA ANTI CARDIOLIPIN ANTIBODIES IgA. Microbiology 4,310

1019428 (LAL) HEPATITIS DELTA ANTIBODY (ANTI- Microbiology 2,470 HDV) IgM 1019701 HHV-6 REAL-TIME PCR (RT-PCR) (BLOOD) Microbiology 16,380

1019702 HHV-6 REAL TIME PCR (RT-PCR) (OTHERS) Microbiology 16,380

1020579 (LALS) HTLV-I/II ANTIBODY SCREEN Microbiology 12,850

1021265 GENEXPERT ASSAY FOR CLOSTRIDIUM Microbiology 5,520 DIFFICILE TOXIN GENOME 1023663 CMV RT PCR QUANTITATIVE(OTHERS) Microbiology 8,050

1025705 GenXpert Assay for Chlamydia trachomatis and Microbiology 5,520 Neisseria gonorrhoeae 1025710 Culture for Neisseria gonorrhoeae Microbiology 1,260

1025829 (LAL) SS-A/Ro Antibody(ELISA) Microbiology 1,450

1027114 Wet mount examination Microbiology 580

W.E.F. 1st January 2019 115 INVESTIGATION

1031019 (RANBAXY) NMO ANTIBODIES Microbiology 5,500

1031357 (RANBAXY) PARVOVIRUS B19 DNA PCR Microbiology 2,500

1033562 (LAL) ENDOMYSIAL ANTIBODY IGA IFA Microbiology 1,700

1035286 ANTI TTG AND GLIADIN IMMUNOBLOT Microbiology 3,470 ASSAY (IgA) 1035669 ANTI PL-7 ANTIBODIES (IMMUNOBLOT Microbiology 4,260 ASSAY) 1035670 ANTI PL-12 ANTIBODIES (IMMUNOBLOT Microbiology 4,260 ASSAY) 1036079 REAL TIME PCR FOR CHICKENPOX (VZV/HZV) Microbiology 5,200

1036617 CARBAPENEM RESISTANCE DETECTION IN Microbiology 6,760 RECTAL SWAB 1038339 (LAL)HYPERSENSITIVITY PNEUMONITIS Microbiology 16,500 SCREEN 1039972 (LAL)PHOSPHOLIPASE A2 RECEPTOR Microbiology 6,200 ANTIBODY 1048199 Chikungunya Detection-RTPCR ASSAY Microbiology 1,500

1048200 Japanese Encephalitis (JE)-RTPCR ASSAY Microbiology 6,010

1048208 Community Infections RTPCR Assay Extended Microbiology 8,660 spectrum (Leishmania,Japanese Encephalitis,Hanta virus,Burkholderia mallei,Burkholderia pseudomallei) 1048209 Carbapenem Resistance detection (Others) Microbiology 6,760

1048210 Culture for Brucella Microbiology 2,260

1048211 GeneXpert Assay(For TB) Microbiology 6,760

1048212 Community Infections General spectrum (Lept Microbiology 10,260 ospira,Rickettsia,Salmonella,Chikungunya,West Nile,Plasmodium) RTPCR Assay 1048269 Community Infections RTPCRAssay Combined Microbiology 15,020 Spectrum(Leptospira,Rickettsia,Salmonella,Chik ungunya,WestNile,Plasmodium,Leishmania,Japa neseEncephalitis,HantaVirus,BurkholderiaMallei ,BurkholderiaPseudomallei 1048571 (LAL) MUMPS VIRUS ANITBODY IgM Microbiology 1,500

116 W.E.F. 1st January 2019 INVESTIGATION

1048573 (LAL) MUMPS VIRUS ANTIBODY IgG Microbiology 1,500

1048574 (LAL) MEASLES ANTIBODY IgG Microbiology 1,500

1048575 (LAL) MEASLES ANTIBODY IgM Microbiology 1,500

1052878 CHIKUNGUNYA - IgM ANTIBODIES (ELISA) Microbiology 600

1053182 NEUROTROPIC VIRUSES PANEL (GENERAL Microbiology 9,770 SPECTRUM) 1053183 NEUROTROPIC VIRUSES PANEL (EXTENDED Microbiology 20,670 SPECTRUM) 1053184 GANGLIOSIDE ANTIBODIES IgM Microbiology 6,930 (IMMUNOBLOT) 1053185 GANGLIOSIDE ANTIBODIES IgG Microbiology 6,930 (IMMUNOBLOT) 1054069 RAPID SEPSIS MOLECULAR ARRAY PANEL Microbiology 22,410 FROM POSITIVE BLOOD CULTURE 1054071 RAPID GASTROENTERITIS MOLECULAR Microbiology 22,410 ARRAY PANEL 1054072 RAPID RESPIRATORY MOLECULAR ARRAY Microbiology 22,410 PANEL 1054073 RAPID MENINGITIS/ENCEPHALITIS Microbiology 23,220 MOLECULAR ARRAY PANEL 1054074 COMMUNITY INFECTIONS(EXOTIC) RT PCR Microbiology 11,270 ASSAY 1054075 BRUCELLA SPP-RT PCR ASSAY Microbiology 5,260

1054076 SCRUB TYPHUS-RT PCR ASSAY Microbiology 5,260

1054077 RICKETTSIAL RTPCR PANEL Microbiology 13,510

1054660 (RANBAXY)PARANEOPLASTIC DISORDER Microbiology 6,000 PROFILE 1055683 (LAL) ANTI NMDA ANTIBODIES (CSF) Microbiology 6,250

1055684 (LAL) VGKC (CSF) VOLTAGE GATED Microbiology 7,000 POTASSIUM CHANNEL 1055685 (LAL) CYTOMEGALOVIRUS (CMV) AVIDITY Microbiology 580 IgG 1055843 (LAL) QUANTITATIVE - HEPATATIS B SURFACE Microbiology 1,390 ANTIGEN( HBs Ag )

W.E.F. 1st January 2019 117 INVESTIGATION

1056023 (LAL) VGKC(BLOOD) VOLTAGE GATED Microbiology 7,000 POTASSUM CHANNEL 1056749 (LAL) ISLET CELL ANTIBODY Microbiology 1,790

1056750 (LAL) ISLET CELL ANTIBODY in dilutions Microbiology 3,300

1060397 REAL TIME PCR ASSAY FOR PNEUMOCYSTIS Microbiology 4,970 JIROVECI 1060532 (LAL)GANGLIOSIDE GD1a ANTIBODY IgG Microbiology 6,050

1060533 (LAL)GANGLIOSIDE GD1ab ANTIBODY IgG Microbiology 6,050

1063949 RTPCR STD PROFILE I (NeisseriGonorrhoe, Microbiology 9,560 Chlamydia Trachoma, Mycoplasma Genital, Trichomonas Vagina, Ureaplasma Urealyti, Ureaplasma Parvum, HSV1, HSV2, Gardnerella Vagina) 1063950 RTPCR STD PROFILE II(Neisseria gonorrhoeae, Microbiology 7,510 Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Trichomonas vaginalis, Ureaplasma urealyticum, Ureaplasma parvum) 1064231 MRSA (METHICILLIN RESISTANT Microbiology 6,400 STAPHYLOCOCCUS AUREUS) CARRIER DETECTION (GENOMIC DETECTION ONLY) 1036079 REAL TIME PCR FOR CHICKENPOX (VZV/HSV) Microbiology 5,200

1048208 Community Infections RTPCR Assay Extended Microbiology 8,660 spectrum (Leishmania Japanese Encephalitis Hanta virus Burkholderia mallei Burkholderia pseudomallei) 1048212 Community Infections General spectrum Microbiology 10,260 (Leptospira Rickettsia Salmonella Chikungunya West Nile Plasmodium) RTPCR Assay 1071492 APOLLO ASPERGILLUS SPECIFIC IgE Microbiology 1,950

1071493 ELISA ANTI ENDOMYSIAL ANTIBODIES IgA Microbiology 1,950

1078219 (LAL) ANTIPHEMIGUS ANTIBODIES (IIF) Microbiology 4,500

1073507 (LAL) HELICOBACTER PYLORI ANTIGEN IN Microbiology 2,100 STOOL 1073508 (SRL) HPV TYPING BY SEQUENCING Microbiology 2,150

118 W.E.F. 1st January 2019 INVESTIGATION

1071494 (LAL) AUTOIMMUNE ENCEPHALITIS PANEL Microbiology 18,000

1072065 (LAL)MYCOPLASMA PNEUMONIAE IGG AND Microbiology 3,600 IGM ANTIBODIES PANEL 1072066 (LAL)MYCOPLASMA PNEUMONIAE IGG Microbiology 2,000

1072067 (LAL) MYCOPLASMA PNEUMONIAE IGM Microbiology 2,000

1162 MRI BRAIN (WITH CONTRAST) MRI Radiology 27,380

1167 MRI CHEST WITH CONTRAST MRI Radiology 27,580

1168 MRI CHEST WITHOUT CONTRAST MRI Radiology 17,550

1169 MRI IAC WITH CONTRAST MRI Radiology 27,650

1170 MRI NASOPHARYNX AND PNS MRI Radiology 17,550

1172 MRI ORBITS MRI Radiology 17,630

1173 MRI CARDIAC IMAGING MRI Radiology 19,320

1175 MRI SHOULDER (BOTH JOINTS) MRI Radiology 18,390

1176 MRI WRIST Left wrist MRI Radiology 10,030

1177 MRI WRIST Right wrist MRI Radiology 10,030

1178 MRI WRIST (BOTH JOINTS) MRI Radiology 18,390

1179 MRI KNEE( Left Knee) MRI Radiology 10,030

1180 MRI KNEE(Right Knee) MRI Radiology 10,030

1181 MRI KNEE(BOTH JOINTS) MRI Radiology 17,600

1182 MRI ANKLE (Left Ankle) MRI Radiology 10,030

1183 MRI ANKLE(Right Ankle) MRI Radiology 10,030

1184 MRI ANKLE(BOTH JOINTS) MRI Radiology 17,600

1185 MRI BOTH HIP JOINTS MRI Radiology 17,600

1186 MRI T M JOINTS MRI Radiology 17,630

W.E.F. 1st January 2019 119 INVESTIGATION

1195 MRI LUMBAR SPINE MRI Radiology 17,630

1196 MRI THORACIC SPINE MRI Radiology 17,630

1197 MRI CERVICAL SPINE MRI Radiology 17,630

5362 MRI VENOGRAPHY BRAIN MRI Radiology 19,390

5363 MRI UPPER ABDOMEN MRI Radiology 18,080

5381 MRI NECK (WITH CONTRAST) MRI Radiology 27,580

5382 MRI NECK (WITHOUT CONTRAST) MRI Radiology 17,550

5396 MRI CSF FLOW MRI Radiology 17,630

6459 MRI WHOLE ABDOMEN MRI Radiology 33,410

6462 MRI SPINE-3 REGION MRI Radiology 50,070

15524 MRI BRAIN WITH CV JUNCTION MRI Radiology 17,630

15527 MRI BRAIN WITH MR ANGIO AND NECK MRI Radiology 26,750 ANGIO 15528 MRI BRAIN WITH MR VENOGRAM MRI Radiology 29,430 (INTRACRANIAL) 15531 MRI BRAIN WITH PITUITARY GLAND MRI Radiology 17,630

15607 MRI CERVICAL SPINE WITH CV JUNCTION MRI Radiology 17,630

15612 MRI ELBOW JOINT (LEFT) MRI Radiology 10,030

15613 MRI ELBOW JOINT (RIGHT) MRI Radiology 10,030

15614 MRI ELBOW JOINTS (BOTH) MRI Radiology 17,600

15615 MRI EXTRA FILM CHARGES(PER FILM) MRI Radiology 470

15616 MRI FISTULOGRAM MRI Radiology 17,630

15617 MRI FOOT (LEFT) MRI Radiology 10,030

15618 MRI FOOT (RIGHT) MRI Radiology 10,030

16113 MRI SHOULDER JOINT (RIGHT) MRI Radiology 10,030

16683 MRI FOREARM (LEFT) MRI Radiology 10,030 120 W.E.F. 1st January 2019 INVESTIGATION

16684 MRI FOREARM (RIGHT) MRI Radiology 10,030

16685 MRI FOREARMS (BOTH) MRI Radiology 18,390

16687 MRI HAND (LEFT) MRI Radiology 16,970

16688 MRI HAND (RIGHT) MRI Radiology 10,030

16690 MRI HIP JOINT (LEFT) MRI Radiology 10,030

16691 MRI HIP JOINT (RIGHT) MRI Radiology 10,030

16692 MRI LEG (LEFT) MRI Radiology 10,030

16693 MRI LEG (RIGHT) MRI Radiology 10,030

16694 MRI LEGS (BOTH) MRI Radiology 18,390

16781 MRI THIGHS (BOTH) MRI Radiology 17,600

16782 MRI UPPER ARM (LEFT) MRI Radiology 18,390

16783 MRI UPPER ARM (RIGHT) MRI Radiology 18,390

16784 MRI UPPER ARMS (BOTH) MRI Radiology 18,390

16787 MRI SHOULDER JOINT (LEFT) MRI Radiology 10,030

18668 MRI BRAIN MRI Radiology 17,630

20167 MRI NASOPHARYNX AND PNS WITHOUT MRI Radiology 17,550 CONTRAST 20173 MRI PELVIS WITH CONTRAST 10ML MRI Radiology 27,510

20177 MRI BREAST WITH CONTRAST 10ML MRI Radiology 27,390

20178 MRI DORSAL SPINE WITH CONTRAST 10ML MRI Radiology 27,670

20179 MRI ABDOMEN WITH CONTRAST 10ML MRI Radiology 40,090

21408 MRI ABDOMEN ANGIOGRAPHY MRI Radiology 16,780

21409 MRI ABDOMEN ANGIOGRAPHY (WITH MRI Radiology 26,330 CONTRAST)

W.E.F. 1st January 2019 121 INVESTIGATION

21414 MRI BRACHIAL PLEXUS (BOTH) MRI Radiology 18,390

21415 MRI BRACHIAL PLEXUS (LEFT) MRI Radiology 10,030

21416 MRI BRACHIAL PLEXUS (RIGHT) MRI Radiology 10,030

21418 MRI BRAIN STEM MRI Radiology 17,630

21419 MRI BRAIN STEM (WITH CONTRAST) MRI Radiology 27,380

21420 MRI BRAIN WITH CV JUNCTION (WITH MRI Radiology 27,380 CONTRAST) 21421 MRI BRAIN WITH MR ANGIO (WITH MRI Radiology 36,790 CONTRAST) 21423 MRI BRAIN WITH MR VENOGRAM MRI Radiology 36,790 (INTRACRANIAL)(WITH CONTRAST) 21424 MRI BRAIN WITH PITUITARY GLAND (WITH MRI Radiology 27,380 CONTRAST) 21427 MRI CERVICAL SPINE (WITH CONTRAST) MRI Radiology 27,650

21428 MRI ENTEROCLYSIS MRI Radiology 30,910

21430 MRI FETAL MRI Radiology 13,870

21431 MRI FOOT (BOTH) MRI Radiology 17,600

21433 MRI LOWER ABDOMEN AND PELVIS MRI Radiology 17,630

21434 MRI LOWER ABDOMEN AND PELVIS (WITH MRI Radiology 27,650 CONTRAST) 21435 MRI LUMBAR SPINE (WITH CONTRAST) MRI Radiology 27,650

21436 MRI MR ANGIOGRAPHY OF HEAD MRI Radiology 16,780

21437 MRI MR ANGIOGRAPHY OF HEAD (WITH MRI Radiology 26,330 CONTRAST) 21438 MRI MR ANGIOGRAPHY OF NECK MRI Radiology 16,780

21439 MRI MR ANGIOGRAPHY OF NECK (WITH MRI Radiology 26,330 CONTRAST) 21440 MRI MR-FLUROSCOPY MRI Radiology 18,390

21441 MRI NASOPHARYNX AND PNS (WITH MRI Radiology 27,580 CONTRAST)

122 W.E.F. 1st January 2019 INVESTIGATION

21442 MRI ORBITS (WITH CONTRAST) MRI Radiology 27,650

21443 MRI POSTERIOR FOSSA MRI Radiology 17,630

21444 MRI POSTERIOR FOSSA (WITH CONTRAST) MRI Radiology 27,650

21445 MRI SPECTROSCOPY MRI Radiology 19,390

21446 MRI SPECTROSCOPY (WITH CONTRAST) MRI Radiology 27,380

21447 MRI THIGHS (BOTH) (WITH CONTRAST) MRI Radiology 28,410

21448 MRI THORACIC SPINE (WITH CONTRAST) MRI Radiology 27,650

21449 MRI TRACTOGRAPHY MRI Radiology 17,630

21450 MRI TWO REGIONS MRI Radiology 33,410

21451 MRI UPPER ABDOMEN (WITH CONTRAST) MRI Radiology 28,540

21453 MRI UROGRAPHY (WITH CONTRAST) MRI Radiology 27,380

21454 MRI WHOLE ABDOMEN (WITH CONTRAST) MRI Radiology 43,440

26871 HIFU SCREENING MRI MRI Radiology 12,520

26872 HIFU FOLLOW UP MRI MRI Radiology 12,520

42777 MRI ANGIOGRAPHY WITH CONTRAST MRI Radiology 28,980

42778 MRI ANKLE SINGLE WITH CONTRAST MRI Radiology 20,080

44037 MRI EMERGENCY CHARGES MRI Radiology 540

44038 MRI EXTRA SLIDES (PER SLIDES) MRI Radiology 150

44040 MRI LOWER (THIGH) (RandL) BOTH MRI Radiology 18,390

44041 MRI LOWER EXTREMITY (THIGH) (RandL) MRI Radiology 10,030

44043 MRI TML (TEMPRO MANDIBULAR JOINTS) MRI Radiology 18,390

44183 MRI MR ANGIOGRAPHY OF ABDOMEN - IIIRD MRI Radiology 12,400 and SUBSQT. FOLLOW-UP SCAN

W.E.F. 1st January 2019 123 INVESTIGATION

44184 MRI MR ANGIOGRAPHY OF ABDOMEN - IIND MRI Radiology 13,310 FOLLOW-UP SCAN 44185 MRI MR ANGIOGRAPHY OF ABDOMEN - IST MRI Radiology 14,130 FOLLOW-UP SCAN 44186 MRI MR ANGIOGRAPHY OF HEAD - IIIRD and MRI Radiology 12,400 SUBSQT. FOLLOW-UP SCAN 44187 MRI MR ANGIOGRAPHY OF HEAD - IIND MRI Radiology 13,310 FOLLOW-UP SCAN 44188 MRI MR ANGIOGRAPHY OF HEAD - IST MRI Radiology 14,130 FOLLOW-UP SCAN 44189 MRI MR ANGIOGRAPHY OF NECK - IIIRD and MRI Radiology 12,400 SUBSQT. FOLLOW-UP SCAN 44190 MRI MR ANGIOGRAPHY OF NECK - IIND MRI Radiology 13,310 FOLLOW-UP SCAN 44192 MRI MR ANGIOGRAPHY OF NECK - IST MRI Radiology 14,130 FOLLOW-UP SCAN 44193 MRI ANKLE JOINT BOTH (RandL) - IIIRD and MRI Radiology 13,550 SUBSQT. FOLLOW-UP SCAN 44194 MRI ANKLE JOINT BOTH (RandL) - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44195 MRI ANKLE JOINT BOTH (RandL) - IST MRI Radiology 15,500 FOLLOW-UP SCAN 44196 MRI ANKLE JOINT SINGLE (R/L) - IIIRD and MRI Radiology 7,470 SUBSQT. FULLOW-UP SCAN 44197 MRI ANKLE JOINT SINGLE (R/L) - IIND MRI Radiology 7,950 FOLLOW-UP SCAN 44198 MRI ANKLE JOINT SINGLE (R/L) - IST FOLLOW- MRI Radiology 8,460 UP SCAN 44199 MRI APPOINTMENT FEE MRI Radiology 1,630

44200 MRI BRACHIAL PLEXUS (R/L) - IIIRD and MRI Radiology 7,470 SUBSQT. FOLLOW-UP SCAN 44203 MRI BRACHIAL PLEXUS (R/L) - IST FOLLOW-UP MRI Radiology 7,950 SCAN 44205 MRI BRAIN - IIND FOLLOW-UP SCAN MRI Radiology 13,990

44206 MRI BRAIN - IST FOLLOW-UP SCAN MRI Radiology 14,850

44207 MRI BRAIN STEM - IIIRD and SUBSQT. MRI Radiology 13,030 FOLLOW-UP SCAN 44208 MRI BRAIN STEM - IIND FOLLOW-UP SCAN MRI Radiology 13,990

44209 MRI BRAIN STEM - IST FOLLOW-UP SCAN MRI Radiology 14,850

124 W.E.F. 1st January 2019 INVESTIGATION

44210 MRI BRAIN WITH CONTRAST - IIIRD and MRI Radiology 20,220 SUBSQT. FOLLOW-UP SCAN 44211 MRI BRAIN WITH CONTRAST - IIND FOLLOW- MRI Radiology 21,640 UP SCAN 44212 MRI BRAIN WITH CONTRAST - IST FOLLOW- MRI Radiology 14,850 UP SCAN 44214 MRI BRAIN WITH MR ANGIOGRAPHY - IIIRD MRI Radiology 18,810 and SUBSQT. FOLLOW-UP SCAN 44215 MRI BRAIN WITH MR ANGIOGRAPHY - IIND MRI Radiology 20,120 FOLLOW UP SCAN 44216 MRI BRAIN WITH MR ANGIOGRAPHY - IST MRI Radiology 21,480 FOLLOW UP SCAN 44217 MRI CHEST/CARDIAC STUDY - IIIRD and MRI Radiology 13,000 SUBSQT. FOLLOW-UP SCAN 44218 MRI CHEST/CARDIAC STUDY - IIND FOLLOW- MRI Radiology 13,860 UP SCAN 44219 MRI CHEST/CARDIAC STUDY - IST FOLLOW- MRI Radiology 14,780 UP SCAN 44220 MRI CV JUNCTION - IIIRD and SUBSQT. MRI Radiology 13,030 FOLLOW-UP SCAN 44221 MRI CV JUNCTION - IIND FOLLOW-UP SCAN MRI Radiology 13,990

44222 MRI CV JUNCTION - IST FOLLOW-UP SCAN MRI Radiology 14,850

44223 MRI ELBOW JOINT (RandL) BOTH - IIIRD and MRI Radiology 13,560 SUBSQT. FOLLOW-UP SCAN 44225 MRI ELBOW JOINT (RandL) BOTH - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44226 MRI ELBOW JOINT (RandL) BOTH - IST MRI Radiology 15,500 FOLLOW-UP SCAN 44227 MRI ELBOW JOINT SINGLE (R/L) - IIIRD and MRI Radiology 7,470 SUBSQT. FOLLOW-UP SCAN 44228 MRI ELBOW JOINT SINGLE (R/L) - IIND MRI Radiology 7,950 FOLLOW-UP SCAN 44229 MRI ELBOW JOINT SINGLE (R/L) - IST MRI Radiology 8,460 FOLLOW-UP SCAN 44230 MRI FOOT JOINT (R/L) BOTH - IIIRD and MRI Radiology 13,560 SUBSQT. FOLLOW-UP SCAN 44231 MRI FOOT JOINT (R/L) BOTH - IIND FOLLOW- MRI Radiology 7,950 UP SCAN

W.E.F. 1st January 2019 125 INVESTIGATION

44232 MRI FOOT JOINT (R/L) BOTH - IST FOLLOW-UP MRI Radiology 15,500 SCAN 44233 MRI FOOT JOINT SINGLE (R/L) - IIIRD and MRI Radiology 7,470 SUBSQT. FOLLOW-UP SCAN 44236 MRI FOOT JOINT SINGLE (R/L) - IST FOLLOW- MRI Radiology 7,950 UP SCAN 44237 MRI HAND JOINT - IIIRD and SUBSQT. MRI Radiology 13,560 FOLLOW-UP SCAN 44238 MRI HAND JOINT - IIND FOLLOW-UP SCAN MRI Radiology 14,510

44239 MRI HAND JOINT - IST FOLLOW-UP SCAN MRI Radiology 15,500

44240 MRI HIP JOINT (Rand/L) BOTH - IIIRD and MRI Radiology 13,550 SUBSQT. FOLLOW-UP SCAN 44241 MRI HIP JOINT (Rand/L) BOTH - IIND FOLLOW- MRI Radiology 14,510 UP SCAN 44242 MRI HIP JOINT (Rand/L) BOTH - IST FOLLOW- MRI Radiology 15,500 UP SCAN 44244 MRI HIP JOINT SINGLE (R/L) - IIND FOLLOW- MRI Radiology 7,950 UP SCAN 44247 MRI IAC (INTERNAL AUDITORY CANALS) - MRI Radiology 13,030 IIIRD and SUBSQT. FOLLOW-UP SCAN 44248 MRI IAC (INTERNAL AUDITORY CANALS) - MRI Radiology 13,990 IIND FOLLOW-UP SCAN 44249 MRI IAC (INTERNAL AUDITORY CANALS) - IST MRI Radiology 14,850 FOLLOW-UP SCAN 44250 MRI KNEE JOINT (RandL) BOTH - IIIRD and MRI Radiology 13,560 SUBSQT. FOLLOW-UP SCAN 44251 MRI KNEE JOINT (RandL) BOTH - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44252 MRI KNEE JOINT (RandL) BOTH - IST FOLLOW- MRI Radiology 15,500 UP SCAN 44253 MRI KNEE JOINT SINGLE (R/L) - IIIRD and MRI Radiology 7,470 SUBSQT. FOLLOW-UP SCAN 44254 MRI KNEE JOINT SINGLE (R/L) - IIND FOLLOW- MRI Radiology 7,950 UP SCAN 44255 MRI KNEE JOINT SINGLE (R/L) - IST FOLLOW- MRI Radiology 8,460 UP SCAN 44256 MRI LOWER (THIGH) (RandL) BOTH - IIIRD and MRI Radiology 13,560 SUBSQT. FOLLOW-UP SCAN

126 W.E.F. 1st January 2019 INVESTIGATION

44258 MRI LOWER (THIGH) (RandL) BOTH - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44259 MRI LOWER (THIGH) (RandL) BOTH - IST MRI Radiology 15,500 FOLLOW-UP SCAN 44260 MRI LOWER ABDOMEN/PELVIS - IIIRD and MRI Radiology 13,030 SUBSQT. FOLLOW-UP SCAN 44261 MRI LOWER ABDOMEN/PELVIS - IIND MRI Radiology 13,990 FOLLOW-UP SCAN 44262 MRI LOWER ABDOMEN/PELVIS - IST FOLLOW- MRI Radiology 14,850 UP SCAN 44263 MRI LOWER EXTREMITY (LEG) (RandL) - IIIRD MRI Radiology 13,560 and SUBSQT. FOLLOW-UP SCAN 44264 MRI LOWER EXTREMITY (LEG) (RandL) - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44265 MRI LOWER EXTREMITY (LEG) (RandL) - IST MRI Radiology 15,500 FOLLOW-UP SCAN 44266 MRI LOWER EXTREMITY (LEG) (R/L) - IIIRD MRI Radiology 7,470 and SUBSQT. FOLLOW-UP SCAN 44267 MRI LOWER EXTREMITY (LEG) (R/L) - IIND MRI Radiology 7,950 FOLLOW-UP SCAN 44269 MRI LOWER EXTREMITY (LEG) (R/L) - IST MRI Radiology 8,460 FOLLOW-UP SCAN 44270 MRI LOWER EXTREMITY (THIGH) (RandL) - MRI Radiology 7,410 IIIRD and SUBSQT. FOLLOW-UP SCAN 44271 MRI LOWER EXTREMITY (THIGH) (RandL) - MRI Radiology 7,950 IIND FOLLOW-UP SCAN 44272 MRI LOWER EXTREMITY (THIGH) (RandL) - MRI Radiology 8,460 IST FOLLOW-UP SCAN 44273 MRI LUMBER SPINE - IIIRD and SUBSQT. MRI Radiology 13,030 FOLLOW-UP SCAN 44274 MRI LUMBER SPINE - IIND FOLLOW-UP SCAN MRI Radiology 13,990

44275 MRI LUMBER SPINE - IST FOLLOW-UP SCAN MRI Radiology 14,850

44276 MRI MR-FLUROSCOPY - IIIRD and SUBSQT. MRI Radiology 13,560 FOLLOW-UP SCAN 44277 MRI MR-FLUROSCOPY - IIND FOLLOW-UP MRI Radiology 14,510 SCAN 44278 MRI MR-FLUROSCOPY - IST FOLLOW-UP SCAN MRI Radiology 15,500

W.E.F. 1st January 2019 127 INVESTIGATION

44280 MRI NASOPHARYNX/LARYNX - IIIRD and MRI Radiology 13,000 SUBSQT. FOLLOW-UP SCAN 44281 MRI NASOPHARYNX/LARYNX - IIND FOLLOW- MRI Radiology 13,860 UP SCAN 44282 MRI NASOPHARYNX/LARYNX - IST FOLLOW- MRI Radiology 14,780 UP SCAN 44283 MRI NECK/THYROID - IIIRD and SUBQT. MRI Radiology 13,000 FOLLOW-UP SCAN 44284 MRI NECK/THYROID - IIND FOLLOW-UP SCAN MRI Radiology 13,860

44285 MRI NECK/THYROID - IST FOLLOW-UP SCAN MRI Radiology 14,780

44286 MRI ORBITS - IIIRD and SUBSQT. FOLLOW-UP MRI Radiology 13,030 SCAN 44287 MRI ORBITS - IIND FOLLOW-UP SCAN MRI Radiology 13,990

44288 MRI ORBITS - IST FOLLOW-UP SCAN MRI Radiology 14,850

44289 MRI POSTERIOR FOSSA - IIIRD and SUBSQT. MRI Radiology 13,030 FOLLOW-UP SCAN 44292 MRI POSTERIOR FOSSA - IIND FOLLOW-UP MRI Radiology 13,990 SCAN 44293 MRI POSTERIOR FOSSA - IST FOLLOW-UP MRI Radiology 14,850 SCAN 44294 MRI SELLA (PITUITAR FOSSA) - IIIRD and MRI Radiology 13,030 SUBSQT. FOLLOW-UP SCAN 44295 MRI SELLA (PITUITAR FOSSA) - IIND FOLLOW- MRI Radiology 13,990 UP SCAN 44296 MRI SELLA (PITUITAR FOSSA) - IST FOLLOW- MRI Radiology 14,850 UP SCAN 44297 MRI SHOULDER JOINT (RandL) BOTH - IIIRD MRI Radiology 13,560 and SUBSQT. FOLLOW-UP SCAN 44298 MRI SHOULDER JOINT (RandL) BOTH - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44299 MRI SHOULDER JOINT (RandL) BOTH - IST MRI Radiology 15,500 FOLLOW-UP SCAN 44300 MRI SHOULDER JOINT (R/L) SIN - IIIRD and MRI Radiology 7,470 SUBSQT. FOLLOW-UP SCAN 44301 MRI SHOULDER JOINT (R/L) SIN - IIND MRI Radiology 7,950 FOLLOW-UP SCAN 44303 MRI SHOULDER JOINT (R/L) SIN - IST FOLLOW- MRI Radiology 8,460 UP SCAN

128 W.E.F. 1st January 2019 INVESTIGATION

44304 MRI SPINE CERVICAL - IIIRD and SUBSQT. MRI Radiology 13,030 FOLLOW-UP SCAN 44305 MRI SPINE CERVICAL - IIND FOLLOW-UP MRI Radiology 13,990 SCAN 44306 MRI SPINE CERVICAL - IST FOLLOW-UP SCAN MRI Radiology 14,850

44307 MRI SPINE CV JUNCTION - IIIRD and SUBSQT. MRI Radiology 13,030 FOLLOW-UP SCAN 44308 MRI SPINE CV JUNCTION - IIND FOLLOW-UP MRI Radiology 13,990 SCAN 44309 MRI SPINE CV JUNCTION - IST FOLLOW-UP MRI Radiology 14,850 SCAN 44310 MRI SPINE THORACIC (DORSAL) - IIIRD and MRI Radiology 13,030 SUBSQT. FOLLOW-UP SCAN 44311 MRI SPINE THORACIC (DORSAL) - IIND MRI Radiology 13,990 FOLLOW-UP SCAN 44312 MRI SPINE THORACIC (DORSAL) - IST MRI Radiology 14,850 FOLLOW-UP SCAN 44314 MRI THREE REGIONS - IIIRD and SUBSQT. MRI Radiology 36,930 FOLLOW-UP SCAN 44315 MRI THREE REGIONS - IIND FOLLOW-UP MRI Radiology 39,590 SCAN 44316 MRI THREE REGIONS - IST FOLLOW-UP SCAN MRI Radiology 42,250

44317 MRI TML (TEMPRO MANDIBULAR JOINTS) - MRI Radiology 13,560 IIIRD and SUBSQT. FOLLOW-UP SCAN 44318 MRI TML (TEMPRO MANDIBULAR JOINTS) - MRI Radiology 14,510 IIND FOLLOW-UP SCAN 44319 MRI TML (TEMPRO MANDIBULAR JOINTS) - MRI Radiology 15,500 IST FOLLOW-UP SCAN 44320 MRI TWO REGIONS - IIIRD and SUBSQT. MRI Radiology 24,660 FOLLOW-UP SCAN 44321 MRI TWO REGIONS - IIND FOLLOW-UP SCAN MRI Radiology 26,440

44322 MRI TWO REGIONS - IST FOLLOW-UP SCAN MRI Radiology 28,170

44323 MRI UPPER ABDOMEN - IIIRD and SUBSQT. MRI Radiology 13,030 FOLLOW-UP SCAN 44325 MRI UPPER ABDOMEN - IIND FOLLOW-UP MRI Radiology 13,990 SCAN 44326 MRI UPPER ABDOMEN - IST FOLLOW-UP SCAN MRI Radiology 14,850

W.E.F. 1st January 2019 129 INVESTIGATION

44327 MRI UPPER EXTREMITY (ARM) (RandL) BOTH - MRI Radiology 13,560 IIIRD and SUBSQT. FOLLOW-UP SCAN 44329 MRI UPPER EXTREMITY (ARM) (RandL) BOTH - MRI Radiology 15,500 IST FOLLOW-UP SCAN 44330 MRI UPPER EXTREMITY (FORE ARM) (RandL) - MRI Radiology 13,560 IIIRD and SUBSQT. FOLLOW-UP SCAN 44331 MRI UPPER EXTREMITY (FORE ARM) (RandL) - MRI Radiology 14,510 IIND FOLLOW-UP SCAN 44332 MRI UPPER EXTREMITY (FORE ARM) (RandL) - MRI Radiology 15,500 IST FOLLOW-UP SCAN 44333 MRI UPPER EXTREMITY (FORE ARM)(R/L) - MRI Radiology 7,470 IIIRD and SUBSQT. FOLLOW-UP SCAN 44336 MRI UPPER EXTREMITY (FORE ARM)(R/L) - IST MRI Radiology 8,460 FOLLOW-UP SCAN 44337 MRI UPPER EXTREMITY(ARM) (RandL) - IIIRD MRI Radiology 7,470 and SUBSQT. FOLLOW-UP SCAN 44338 MRI UPPER EXTREMITY(ARM) (RandL) - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44339 MRI UPPER EXTREMITY(ARM) (RandL) - IST MRI Radiology 8,460 FOLLOW-UP SCAN 44340 MRI WHOLE ABDOMEN - IIIRD and SUBSQT. MRI Radiology 24,660 FOLLOW-UP SCAN 44341 MRI WHOLE ABDOMEN - IIND FOLLOW-UP MRI Radiology 26,440 SCAN 44342 MRI WHOLE ABDOMEN - IST FOLLOW-UP MRI Radiology 28,170 SCAN 44343 MRI WRIST JOINT (RandL) BOTH - IIIRD and MRI Radiology 13,560 SUBSQT. FOLLOW-UP SCAN 44344 MRI WRIST JOINT (RandL) BOTH - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44345 MRI WRIST JOINT (RandL) BOTH - IST MRI Radiology 15,500 FOLLOW-UP SCAN 44347 MRI WRIST JOINT SINGLE (R/L) - IIIRD and MRI Radiology 7,470 SUBSQT. FOLLOW-UP SCAN 44348 MRI WRIST JOINT SINGLE (R/L) - IIND MRI Radiology 7,950 FOLLOW-UP SCAN 44349 MRI WRIST JOINT SINGLE (R/L) - IST FOLLOW- MRI Radiology 8,490 UP SCAN 44350 MRI-BRACHIAL PLEXUS (RandL) - IIIRD and MRI Radiology 13,550 SUBSQT. FOLLOW-UP SCAN

130 W.E.F. 1st January 2019 INVESTIGATION

44351 MRI-BRACHIAL PLEXUS (RandL) - IIND MRI Radiology 14,510 FOLLOW-UP SCAN 44352 MRI-BRACHIAL PLEXUS (RandL) - IST FOLLOW- MRI Radiology 15,500 UP SCAN 49424 MRI BRAIN PLAIN MRI Radiology 19,390

52743 RT PLANING MRI MRI Radiology 11,050

61458 MRI TEMPORAL BONE - COCHLEAR MRI Radiology 17,630

61459 MRI SI JOINTS - SACRO ILLIAC MRI Radiology 17,630

61460 MRI PERIPHERAL ANGIO WITH CONTRAST MRI Radiology 37,670

61461 MRI CSF FLOW WITH BRAIN MRI Radiology 26,750

61462 MRI VENOGRAM BRAIN WITH CONTRAST MRI Radiology 27,650

61463 MRI RENAL ANGIOGRAM MRI Radiology 17,630

61464 MRI RENAL ANGIOGRAM WITH CONTRAST MRI Radiology 27,380

61465 MRI CSF CISTERNOGRAPHY MRI Radiology 17,630

64065 MRI BRAIN IIIRD and SUBSQT. FOLLOW-UP MRI Radiology 13,030 SCAN 64066 MRI EXTREMITY (FORE ARM)(R/L)-II- MRI Radiology 7,960 FOLLOW-UP SCAN 64067 MRI FOOT JOINT (R/L)-II-FOLLOW-UP SCAN MRI Radiology 14,510

64068 MRI FUNCTIONAL BRAIN MRI Radiology 17,640

64069 MRI HIP JOINT SINGLE (RandL)-I-FOLLOW-UP MRI Radiology 8,460 SCAN 64070 MRI HIP JOINT SINGLE (RandL)-IIIRD- MRI Radiology 7,470 andSUBSQT.FOLLOW-UP SCAN 65699 MRI FETAL SCREENING MRI Radiology 7,890

77418 MRI LIVER - DONOR PROTOCOL MRI Radiology 17,980

1019297 MRI T2 STAR IMAGING FOR HEART AND MRI Radiology 7,890 LIVER (NON CONTRAST) 1054248 MRI SPINE SCREENING MRI Radiology 4,500

W.E.F. 1st January 2019 131 INVESTIGATION

1056001 MRI SINGLE THIGH MRI Radiology 10,030

1064599 MRI BRAIN-STROKE PROTOCOL MRI Radiology 16,000

1064600 MRI BRAIN-EXTENDED STROKE PROTOCOL MRI Radiology 19,500

1064601 MRI ADVANCED BRAIN PROTOCOL MRI Radiology 23,400

1064602 MRI BRAIN-EPILEPSY PROTOCOL (WITHOUT MRI Radiology 19,500 CONTRAST) 1064603 MRI BRAIN-EPILEPSY PROTOCOL (WITH MRI Radiology 23,400 CONTRAST) 1064604 MRI BRAIN WITH SCREENING OF ENTIRE MRI Radiology 19,500 SPINE WITHOUT CONTRAST (FOR GAIT DISORDER/MULTIPLE SCLEROSIS) 1064605 MRI BRAIN WITH SCREENING OF ENTIRE MRI Radiology 23,400 SPINE WITH CONTRAST (FOR GAIT DISORDER/MULTIPLE SCLEROSIS) 1064606 MRI HGG PACKAGE MRI Radiology 28,600

1064607 MRI HGG PACKAGE-FOLLOW UP MRI Radiology 23,400

1072054 MRI LUMBAR PLEXUS SCREENING MRI Radiology 3,900

1072055 MRI SCREENING - SINGLE SESSION MRI Radiology 3,900

1072056 MRI SCREENING - TWO REGIONS MRI Radiology 7,800

1071079 MRI CARTIGRAMS - SINGLE KNEE MRI Radiology 3,900

1071080 MRI CARTIGRAMS - BOTH KNEE MRI Radiology 7,800

1433 PET CT CARDIAC VIABILITY (PET AND SPECT) Nuclear Medicine 24,790 Radiology 1462 GASTROESOPHAGEAL REFLUX Nuclear Medicine 4,750 Radiology 1466 N.M LUNG PERFUSION SCAN Nuclear Medicine 13,900 Radiology 1468 N.M MECKELS SCAN Nuclear Medicine 4,750 Radiology 1471 N.M HEPATOBILIARY SCAN Nuclear Medicine 9,930 Radiology 1472 N.M LIVER SPLEEN COLLOID SCAN Nuclear Medicine 6,310 Radiology

132 W.E.F. 1st January 2019 INVESTIGATION

1474 PARATHYROID SCAN Nuclear Medicine 13,900 Radiology 1477 RADIONUCLIDE CISTERNOGRAPHY Nuclear Medicine 17,870 Radiology 1478 N.M GALLIUM SCAN Nuclear Medicine 33,880 Radiology 1482 Tc99m (HMPAO) WBCs SCAN Nuclear Medicine 40,190 Radiology 1483 THYROID SCAN (WITH 99M Tc) Nuclear Medicine 3,990 Radiology 1486 G.I. BLEED STUDY Nuclear Medicine 11,880 Radiology 1488 GASTRIC EMPTYING Nuclear Medicine 6,000 Radiology 1489 DTPA RENOGRAM Nuclear Medicine 7,740 Radiology 1491 Direct Radionuclide Cystogram Nuclear Medicine 5,340 Radiology 1495 3 PHASE BONE SCAN( W.B.Bone Scan) Nuclear Medicine 9,930 Radiology 1497 131 I -MIBG SCAN Nuclear Medicine 49,200 Radiology 1506 N.M SCINTIMAMMOGRAPHY Nuclear Medicine 7,570 Radiology 5343 N.M THALLIUM SCANNING_NM Nuclear Medicine 23,670 Radiology 5357 N.M BRAIN SCAN Nuclear Medicine 24,790 Radiology 16116 NUCLEAR CAPTOPRIL RENOGRAM Nuclear Medicine 11,880 Radiology 16206 NUCLEAR SALIVARY GLAND Nuclear Medicine 3,990 Radiology 16207 NUCLEAR STRESS MUGA Nuclear Medicine 13,900 Radiology 16209 NUCLEAR THYROID UPTAKE Nuclear Medicine 3,990 Radiology 16210 NUCLEAR STRONTIUM THERAPY Nuclear Medicine 157,920 Radiology 18166 DEXA SCAN Nuclear Medicine 11,780 Radiology

W.E.F. 1st January 2019 133 INVESTIGATION

21544 BLOOD POLL STUDY Nuclear Medicine 9,930 Radiology 21545 BONE SCAN Nuclear Medicine 9,360 Radiology 21546 DMSA/GHA RENAL STUDY Nuclear Medicine 11,880 Radiology 21547 DUODENO GASTRIC REFLUX STUDY Nuclear Medicine 6,000 Radiology 21548 DXA SCAN - THREE SITES (LUMBER SPINE, HIP Nuclear Medicine 8,090 and WRIST) Radiology 21549 DXA SCAN - TWO SITES ( LUMBER SPINE and Nuclear Medicine 6,360 HIP) Radiology 21551 GHA BRAIN STUDY Nuclear Medicine 11,880 Radiology 21552 HMPAO BRAIN SPECT Nuclear Medicine 39,530 Radiology 21553 I-131 WHOLE BODY SCAN Nuclear Medicine 9,930 Radiology 21554 LUNG VENTILATION Nuclear Medicine 7,950 Radiology 21555 LYMPHANGIOGRPHY Nuclear Medicine 6,000 Radiology 21556 PET/FDG Nuclear Medicine 21,630 Radiology 21558 RESTING MUGA Nuclear Medicine 13,900 Radiology 21559 TESTICULAR SCAN Nuclear Medicine 3,610 Radiology 21560 TH..1 MCI I-131 Nuclear Medicine 2,850 Radiology 21561 TH..10-15 MCI I-131 Nuclear Medicine 17,870 Radiology 21562 TH..150-250 MCI Nuclear Medicine 54,090 Radiology 21563 TH..2-5 MCI I-131 Nuclear Medicine 9,930 Radiology 21564 TH..50 MCI Nuclear Medicine 23,760 Radiology 21565 TH..6-10 MCI I-131 Nuclear Medicine 13,900 Radiology

134 W.E.F. 1st January 2019 INVESTIGATION

21566 TH..PHOPHOROUS-32 THERAPY Nuclear Medicine 7,570 Radiology 21567 TRANSPLANT EVALUATION Nuclear Medicine 7,570 Radiology 21568 V/Q STUDY Nuclear Medicine 19,720 Radiology 44018 CLONIDINE STIMULATION TEST Nuclear Medicine 9,530 Radiology 44019 COM. ANTERIOR PITUTARY TEST Nuclear Medicine 26,600 Radiology 44020 DMSA (V) TUMOR IMAGING Nuclear Medicine 9,110 Radiology 44021 GLUCOSE SUPPRESSION TEST FOR HGH Nuclear Medicine 9,530 Radiology 44022 INSULIN TOLERANCE TEST Nuclear Medicine 10,700 Radiology 44025 LH-RH Nuclear Medicine 18,080 Radiology 44026 OESOPHAGIAL STUDY Nuclear Medicine 2,740 Radiology 44027 PERCHLORATE TEST Nuclear Medicine 3,180 Radiology 44028 RDS WITH GFR Nuclear Medicine 7,520 Radiology 44029 THALLIUM RE-INJECTION Nuclear Medicine 9,960 Radiology 44030 THALLIUM THROID SCAN Nuclear Medicine 15,910 Radiology 44032 THYROID PERFUSION SCAN Nuclear Medicine 4,050 Radiology 44034 WHOLE BODY THALLIUM Nuclear Medicine 20,220 Radiology 44098 THYROID SCAN Nuclear Medicine 4,050 Radiology 63309 CORD BLOOD FREE T4 TSH Nuclear Medicine 3,030 Radiology 63310 BONE MARROW Nuclear Medicine 3,910 Radiology 63311 RENAL DYNAMIC STUDY Nuclear Medicine 13,870 Radiology

W.E.F. 1st January 2019 135 INVESTIGATION

97398 STRAND-SAPIEN CARDIO GENOMIC TEST Oncology Medical 33,900

97393 STRAND-SAPIEN SINGLE MUTATION Oncology Surgical 11,550 CONFIRMATION TEST 97397 STRAND-SAPIEN GERMLINE CANCER TEST Oncology Surgical 38,260

97399 STRAND-SAPIEN SOMATIC 48 GENE TEST Oncology Surgical 68,400

21348 ECG (ELECTROCARDIOGRAM) PEDIATRIC Paediatric Cardiology 680

21349 ECHOCARDIOGRAM PEDIATRIC Paediatric Cardiology 4,960

21350 HOLTER TEST PEDIATRIC Paediatric Cardiology 5,290

21351 LEVEL III FETAL ECHO PEDIATRIC Paediatric Cardiology 4,960

21352 TILT TEST PEDIATRIC Paediatric Cardiology 8,660

21353 TRANSEOSOPHAGEAL ECHO PEDIATRIC Paediatric Cardiology 7,140

21354 TREADMILL TEST PEDIATRIC Paediatric Cardiology 3,740

44396 CHEST X-RAY PEDIATRIC Paediatric Cardiology 440

78838 REVIEW ECHOCARDIOGRAM PEDIATRIC Paediatric Cardiology 3,000

78839 FETAL ECHOCARDIOGRAM Paediatric Cardiology 5,260

78840 REVIEW FETAL ECHOCARDIOGRAM Paediatric Cardiology 3,000

20559 16-PF TEST Psychiatry 3,820

20560 ADJUSTMENT SCALES Psychiatry 2,610

20561 ANXIETY SCALES Psychiatry 1,390

20562 ATTENTION Psychiatry 1,390

20563 ATTENTION and BEHAVIOR Psychiatry 2,090

20564 BATTERY OF DIFFERENTIAL APITIUDE TESTS Psychiatry 4,520

20565 BATTERY OF TESTS FOR CAREER GUIDANCE Psychiatry 11,100 (P.I.A) 20566 BEHAVIOUR Psychiatry 1,390

136 W.E.F. 1st January 2019 INVESTIGATION

20567 BGT Psychiatry 1,390

20569 BRIEF PSYCHIATRIC RATING SCALE Psychiatry 1,730

20570 CAQ-PERSONALITY TEST Psychiatry 4,520

20572 CHILDHOOD INVENTORY FOR PSYCHIATRIC Psychiatry 2,430 DISORDERS 20573 DEMENTIA TEST Psychiatry 3,310

20574 DEO MOHAN ACHIEVEMENT SCALE Psychiatry 1,220

20575 DETAILED DEVELOPMENTAL SCALES (VABS) Psychiatry 3,120

20576 DEVELOPMENTAL SCALES (VSMS) Psychiatry 1,620

20577 DRAW-A-MAN TEST Psychiatry 2,430

20578 EYESCENK PERSONALITY QUESTIONNAIRE Psychiatry 1,730

20580 FAMILY ENVIRONMENT SCALE Psychiatry 3,120

20581 FULL NEUROPSYCHOLOGICAL BATTERY Psychiatry 7,470

20582 GLOBAL ADJUSTMENT SCALE Psychiatry 3,120

20583 HAMILTION S ANXIETY SCALE Psychiatry 690

20584 HAMILTION S DEPRESSION SCALE Psychiatry 690

20585 HOUSE TREE AND PERSON Psychiatry 2,430

20586 HSPQ Psychiatry 2,090

20587 INCOMPLETE SENTENCE BLANK Psychiatry 1,390

20590 INTELLIGENCE + ACADEMIC TESTING Psychiatry 3,470

20591 INTELLIGENCE TEST / DEVELOPMENT TEST Psychiatry 3,120

20592 INTEREST TEST Psychiatry 1,560

20593 LIFE SATISFACTION SCALE Psychiatry 1,390

20594 MALIN S INTELLIGENCE SCALE FOR Psychiatry 6,080 CHILDREN (MISIC)

W.E.F. 1st January 2019 137 INVESTIGATION

20597 MEDICO-PSYCHOLOGICAL QUESTIONNAIRE Psychiatry 2,090

20598 MEMORY ASSESSMENT TEST Psychiatry 3,310

20599 MINI MENTAL STATE EXAMINATION Psychiatry 1,390

20600 OTHER QUESTIONNAIRES FOR SPECIFIC Psychiatry 4,350 PURPOSES 20601 OTHER RATING SCALES/CHECKLISTS FOR Psychiatry 1,730 SPECIFIC PURPOSES 20602 PARENT CHILD RELATIONSHIP SCALE Psychiatry 1,560

20603 PERCEPTION Psychiatry 2,950

20604 PERSONALITY TEST Psychiatry 1,730

20605 PF STUDY Psychiatry 2,090

20606 PGI HEALTH QUESTIONNAIRE Psychiatry 1,560

20608 PROJECTIVE + PERSONALITY (2 TEST) Psychiatry 3,990

20609 PROJECTIVE + PERSONALITY (3 TEST) Psychiatry 5,040

20610 PSYCHO-PSYSIOLOGICAL STATE INVENTORY Psychiatry 2,090

20611 RAVEN S PROGRESSIVE MATIRCES CPM/APM/ Psychiatry 2,090 SPM 20613 RORSCHACH INK BLOT TEST Psychiatry 5,730

20614 SCID-II Psychiatry 4,520

20615 SEGUIN - FORM BOARD Psychiatry 1,220

20616 SENTENCE COMPLETION TEST Psychiatry 1,390

20617 SINGLE CBT/BT SESSION Psychiatry 1,730

20618 SPECIFIC APITIUDE TEST (TEACHING/SALES Psychiatry 3,120 ETC.) 20619 SPECIFIC EMOTIONAL STATE Psychiatry 1,390 QUESTIONNAIRE 20620 STATE-TRAIT ANXIETY TEST Psychiatry 1,390

138 W.E.F. 1st January 2019 INVESTIGATION

20621 STRESS MEASUREMENT SCALE Psychiatry 2,090

20622 TAT/CAT Psychiatry 5,730

20623 WAIS Psychiatry 4,690

20624 WISC-R Psychiatry 5,040

20625 Y-BOCS Psychiatry 690

20626 YOUNG MANIC RATING SCALE Psychiatry 1,220

20627 ADHD CHECKLIST Psychiatry 1,220

27191 FULL NEUROPSYCOLOGICAL SCREENING Psychiatry 7,470

27192 GUESS WHY GAME Psychiatry 1,390

27193 MARITAL THERAPY Psychiatry 4,350

27194 MEMOREY Psychiatry 3,310

27195 PICTURE FRUSTRATION TEST Psychiatry 1,560

27196 RELAXATION THERAPY - SESSIONS Psychiatry 3,990

27197 RORSCHACH Psychiatry 2,950

27198 SPECIFIC EMOTIONAL STATE QUESH Psychiatry 1,560

27199 WAPIS Psychiatry 3,640

27784 AIIMS NEUROPSYCHOLOGICAL BATTERY Psychiatry 10,410

57238 TAT Psychiatry 1,740

1786 BRONCHIAL PROVOCATION TEST Pulmonary Function 2,800 Lab 1787 "Bronchodilator Study Alone Pulmonary Function 1,200 " Lab 1789 "SPIROMETRY WITH BRONCHODIALATOR Pulmonary Function 2,930 STUDY Lab " 1790 SPIROMETRY(BASIC PFT TEST) Pulmonary Function 2,400 Lab

W.E.F. 1st January 2019 139 INVESTIGATION

21659 BLOOD GAS ANALYSIS (ISE) Pulmonary Function 1,470 Lab 21660 DET / FULL PFT ENCL. DIFFUSION STUDY Pulmonary Function 5,870 Lab 44400 BIPAP / CPAP Pulmonary Function 5,060 Lab 42720 MRI BREAST Radiology Molecular 27,810 Imaging & Nuclear Medicine 42748 MRCP Radiology Molecular 18,250 Imaging & Nuclear Medicine 42749 MR SPECTROSCOPY BREAST(ADDITIONAL) Radiology Molecular 12,010 Imaging & Nuclear Medicine 42750 MR SPECTROSCOPY BRAIN(ADDITIONAL) Radiology Molecular 12,010 Imaging & Nuclear Medicine 42751 MR SPECTROSCOPY PROSTATE(ADDITIONAL) Radiology Molecular 12,010 Imaging & Nuclear Medicine 42752 FUNCTIONAL MRI BRAIN Radiology Molecular 16,280 Imaging & Nuclear Medicine 42768 TRACTROGRAPHY Radiology Molecular 12,010 Imaging & Nuclear Medicine 42769 MR GUIDED BREST BIOPSY Radiology Molecular 80,040 Imaging & Nuclear Medicine 42771 MR GUIDED WIRE LOCALISATION Radiology Molecular 65,640 Imaging & Nuclear Medicine 42772 BIOPSY PLUS CLIP PLACEMENT Radiology Molecular 104,060 Imaging & Nuclear Medicine 53386 STANDING / WEIGHT BEARING MRI - EACH Radiology Molecular 11,820 JOINT Imaging & Nuclear Medicine

140 W.E.F. 1st January 2019 INVESTIGATION

53387 STANDING / WEIGHT BEARING MRI - Radiology Molecular 11,820 CERVICAL SPINE Imaging & Nuclear Medicine 53388 STANDING / WEIGHT BEARING MRI - LUMBAR Radiology Molecular 11,820 SPINE Imaging & Nuclear Medicine 58839 CT EXTRA PER FILM Radiology Molecular 440 Imaging & Nuclear Medicine 58840 MRI EXTRA PER FILM Radiology Molecular 410 Imaging & Nuclear Medicine 1047520 PET MRI WHOLE BODY Radiology Molecular 75,080 Imaging & Nuclear Medicine 1047521 PET MRI PSMA WHOLE BODY Radiology Molecular 75,080 Imaging & Nuclear Medicine 1047522 PET MRI DOTA WHOLE BODY Radiology Molecular 75,080 Imaging & Nuclear Medicine 1047523 PET MRI DOTA FOR BRAIN Radiology Molecular 53,240 Imaging & Nuclear Medicine 1047524 PET MRI BREAST Radiology Molecular 53,240 Imaging & Nuclear Medicine 1047525 PET MRI ABDOMEN Radiology Molecular 53,240 Imaging & Nuclear Medicine 1047526 PET MRI BRAIN WITH FET Radiology Molecular 53,240 Imaging & Nuclear Medicine 1047527 PET MRI PSMA FOR PROSTATE Radiology Molecular 47,780 Imaging & Nuclear Medicine 1047528 PET MRI BRAIN WITH FDG Radiology Molecular 47,780 Imaging & Nuclear Medicine

W.E.F. 1st January 2019 141 INVESTIGATION

1047529 PET MRI SCREENING WITH FDG Radiology Molecular 47,780 Imaging & Nuclear Medicine 1047530 PET CT SINGLE CASE-PSMA Radiology Molecular 51,240 Imaging & Nuclear Medicine 1047531 PET CT SINGLE CASE-DOTA Radiology Molecular 51,240 Imaging & Nuclear Medicine 1047532 PET CT PSMA Radiology Molecular 40,950 Imaging & Nuclear Medicine 1047533 PET CT DOTA Radiology Molecular 40,950 Imaging & Nuclear Medicine 1047534 PET CT WHOLE BODY Radiology Molecular 37,590 Imaging & Nuclear Medicine 1644 CARDIAC STRESS TEST - (TMT) TMT 4,550

4283 Thrombophilia Profile Transplantation 20,510 immunology 5502 RH- GENOTYPING Transplantation 10,410 immunology 8755 PML/RARA - FISH Transplantation 14,040 immunology 8778 BCR/ABL QUANTITATIVE - RT PCR Transplantation 18,030 immunology 8785 AMNIOTIC FLUID - KARYOTYPING Transplantation 24,830 immunology 8788 FISH + KARYOTYPING Transplantation 32,780 immunology 10597 HER2 NEU GENE AMPLIFICATION BY FISH Transplantation 22,060 immunology 18175 HIV P24 ANTIGEN Transplantation 5,890 immunology 18580 BUCCAL SMEAR FOR BARR BODIES Transplantation 3,430 immunology 21497 ABORTUS MATERIAL/POC S Transplantation 15,540 immunology

142 W.E.F. 1st January 2019 INVESTIGATION

21498 ALL PANEL KF Transplantation 32,060 immunology 21499 AML PANEL Transplantation 32,060 immunology 21500 AMNIOTIC FLUID COMBO KF Transplantation 31,660 immunology 21501 CHROMOSOMAL BREAKAGE STUDY Transplantation 16,080 immunology 21502 DNA FINGER PRINTING Transplantation 40,060 immunology 21503 FISH Transplantation 10,730 immunology 21504 FISH (GYN) Transplantation 14,040 immunology 21505 (RANBAXY) HIV 1 - GENOTYPE RESISTANCE Transplantation 12,970 immunology 21506 HLA -B27 MOLECULAR TYPING Transplantation 5,190 immunology 21507 HLA CLASS I - MOLECULAR TYPING Transplantation 13,090 immunology 21508 HLA CLASS -I A,B,C / PCR-SSP -HIGH Transplantation 23,280 RESOLUTION immunology 21509 HLA CLASS II - MOLECULAR TYPING Transplantation 15,570 immunology 21510 HLA CLASS -II A,B,C / PCR - HIGH Transplantation 19,390 RESOLUTION immunology 21511 HLA LYMPHOCYTE CROSSMATCH and HLA Transplantation 65,690 TYPING (DONOR and PATIENT) immunology 21512 KARYOTYPING BLOOD Transplantation 10,880 immunology 21513 KARYOTYPING BONE MARROW Transplantation 10,880 immunology 21514 KARYOTYPING CHORONIC VILLI Transplantation 24,830 immunology 21515 LYMHPOCYTE CROSS MATCH NIH METHODS Transplantation 8,570 immunology 21518 PCR - HBV (QUALITATIVE) Transplantation 13,670 immunology 21519 PCR - HBV (QUANTITATIVE) Transplantation 27,320 immunology

W.E.F. 1st January 2019 143 INVESTIGATION

21520 PCR - HCV (GENOTYPING) Transplantation 10,610 immunology 21521 PCR - HCV (QUALITATIVE) Transplantation 13,670 immunology 21522 PCR - HCV (QUANTITATIVE) Transplantation 27,320 immunology 21523 PCR - HIV (VIRAL LOAD) Transplantation 16,400 immunology 21525 RECURRENT ABORTIONS - KARYOTYPING OF Transplantation 18,640 COUPLE immunology 21526 RIBA - HCV (AB) Transplantation 8,570 immunology 21527 THAL - BETA - 5 COMMON MUTATIONS - Transplantation 13,670 CHILD and PARENTS immunology 21528 THAL - MUTATIONS + XMN POLYMORPHISM Transplantation 18,830 immunology 21529 THALASSEMIA - (8) UNCOMMON MUTATIONS Transplantation 10,280 immunology 21530 THALASSEMIA - 2ND PRENATAL DIAGNOSIS Transplantation 17,080 immunology 21531 THALASSEMIA - ALPHA - DELETIONS (3.7 and Transplantation 15,380 4.2 KB) immunology 21532 THALASSEMIA - ALPHA; BETA AND GAMMA Transplantation 29,070 GENE ANALYSIS immunology 21533 THALASSEMIA - PRENATAL DIAGNOSIS Transplantation 22,200 immunology 25424 METHYLENETETRAHYDROFOLATE Transplantation 7,090 REDUCTASE (MTHFR) immunology 26296 (RANBAXY) HIV1 - DRUG RESISTANCE Transplantation 24,550 immunology 26845 (RANBAXY)HIV-1 GENOTYPIC RESISTANCE Transplantation 13,160 immunology 26846 (RANBAXY)HIV-1 DRUG RESISTANCE Transplantation 21,840 immunology 26848 (RANBAXY)K RAS-CODON12 13 MUTATION Transplantation 9,010 DETECTION-PARAFFIN BLOCK immunology 26849 (RANBAXY)K RAS-CONDON 61 MUTATION Transplantation 5,530 DETECTION-PARAFFIN BLOCK immunology 26858 HLA TYPING WITH FIVE DONOR Transplantation 104,060 immunology

144 W.E.F. 1st January 2019 INVESTIGATION

26861 HLA TYPING WITH ONE DONOR Transplantation 34,680 immunology 26863 HLA TYPING WITH THREE DONOR Transplantation 69,370 immunology 26864 MUTATIONAL ANALYSIS Transplantation 13,870 immunology 26866 HLA TYPING WITH TWO DONOR Transplantation 52,040 immunology 26867 HLA TYPING WITH FOUR DONOR Transplantation 86,720 immunology 27172 CD 4 and CD 8 COUNTS Transplantation 4,120 immunology 27173 FULL KARYOTYPING Transplantation 25,010 immunology 27174 HIV MONITOR-PCR Transplantation 19,390 immunology 27959 DNA STORAGE AND EXTRACTION Transplantation 2,640 immunology 27960 GENE ANALYSIS Transplantation 6,940 immunology 27961 CHROMOSOMAL ANALYSIS Transplantation 8,670 immunology 28649 MDR -MTB DNA Transplantation 9,830 immunology 28653 PCR -SSOP Transplantation 22,280 immunology 38700 FLOWCYTOMETRIC HLA -CROSS MATCH Transplantation 14,190 (EXTERNAL) immunology 39988 HLA DSA (BY LUMINEX) - (EXTERNAL) Transplantation 9,010 immunology 42951 AML COMBO KF Transplantation 32,060 immunology 42952 MULTIPLE MYELOMA PANEL Transplantation 32,060 immunology 42953 MDS COMBO KF Transplantation 32,060 immunology 42954 EGFR TEST Transplantation 22,060 immunology 42955 ALK FISH Transplantation 22,060 immunology

W.E.F. 1st January 2019 145 INVESTIGATION

43976 PCR MTB DNA Transplantation 5,900 immunology 43978 TOXOPLASMOSIS - AMNIOTIC FLUID, FETAL Transplantation 12,660 TISSUE, BLOOD immunology 58400 GENE SCREEN (EXTERNAL) Transplantation 21,620 immunology 58415 HLA High Resolution Patient (External) Transplantation 20,480 immunology 58416 HLA High Resolution Patient and 1 Donor Transplantation 40,950 (External) immunology 58417 HLA High Resolution - Patient and 2 Transplantation 61,430 Donors(External) immunology 58569 HLA Typing (Single Person) Transplantation 17,350 immunology 66884 MOLECULAR DIAGNOSIS- Transplantation 8,190 COMMON(EXTERNAL) immunology 69916 HLA - C TYPING Transplantation 6,310 immunology 69917 HLA - DQ TYPING Transplantation 6,310 immunology 88320 HLA B 5701 Transplantation 7,890 immunology 94093 HIV QUALITATIVE Transplantation 13,670 immunology 94094 ABORTUS MATERIAL / POC FISH Transplantation 14,040 immunology 94261 FACTOR V (LEIDEN) (MOLECULAR) Transplantation 7,090 immunology 94262 FACTOR II (MOLECULAR) Transplantation 7,090 immunology 94585 PRA (PANEL REACTIVE ANTIBODY TEST) Transplantation 20,040 immunology 1020768 (SRL) HYPEROXALURIA-GENETIC TEST Transplantation 31,120 immunology 1020991 HLA DSA (BY LUMINEX) Transplantation 10,410 immunology 1021631 HLA - SINGLE ANTIGEN TEST Transplantation 12,370 immunology 1021691 HLA ANTIBODY SCREENING Transplantation 7,090 immunology

146 W.E.F. 1st January 2019 INVESTIGATION

1021692 HLA SCREEN-DSA COMBO Transplantation 15,770 immunology 1024962 HLA MICA AB Transplantation 11,820 immunology 1025422 HLA-ANTIBODY COMPREHENSIVE PACKAGE Transplantation 36,270 immunology 1025871 HLA SCREEN - DSA COMBO Transplantation 15,820 immunology 1033538 KRAS MUTATION Transplantation 10,160 immunology 1055204 TPMT(THIOPURINE METHYL TRANSFERASE Transplantation 6,930 GENOTYPING) immunology 1056024 SINGLE ANTIGEN HLA CLASS I ASSAY Transplantation 34,650 immunology 1056025 SINGLE ANTIGEN HLA CLASS II ASSAY Transplantation 34,650 immunology 1060555 CLL PANEL KF Transplantation 29,140 immunology 1063401 MOLECULAR PANEL FOR LUNG CARCINOMA Transplantation 42,900 immunology 1067676 HLA TESTING - SCREENING Transplantation 7,800 immunology 1202 ULTRASOUND - UPPER ABDOMEN Ultrasound Radiology 2,400

1203 ULTRASOUND - LOWER ABDOMEN (PELVIS) Ultrasound Radiology 2,400

1204 ULTRASOUND - WHOLE ABDOMEN Ultrasound Radiology 3,270

1207 ULTRASOUND - BRAIN (NEUROSONOGRAM) Ultrasound Radiology 1,910

1209 ULTRASOUND BREAST Ultrasound Radiology 1,910

1210 COLOR DOPPLER OF CAROTIDS Ultrasound Radiology 6,790

1212 ULTRASOUND OF CHEST Ultrasound Radiology 1,910

1214 ULTRASOUND ORBITS (EYE) Ultrasound Radiology 2,400

1219 ULTRASOUND KUB Ultrasound Radiology 2,210

1220 ULTRASOUND NECK Ultrasound Radiology 1,910

W.E.F. 1st January 2019 147 INVESTIGATION

1222 ULTRASOUND PREG./FOETAL SCAN WITH Ultrasound Radiology 5,160 DOP. 1223 ULTRSOUND AND C.D RENAL ARTERIES Ultrasound Radiology 7,060

1354 ULTRASOUND THYROID Ultrasound Radiology 2,400

5635 ULTRASOUND - LIMB Ultrasound Radiology 1,910

6432 ULTRASOUND SCREENING WHOLE ABDOMEN Ultrasound Radiology 2,880

11659 ULTRASOUND SCROTUM Ultrasound Radiology 2,400

13599 USG RENAL DOPPLER Ultrasound Radiology 7,420

14151 ULTRASOUND ANKLE LEFT Ultrasound Radiology 1,910

14152 ULTRASOUND ANKLE RIGHT Ultrasound Radiology 1,910

14155 ULTRASOUND HAND LEFT Ultrasound Radiology 1,910

14156 ULTRASOUND HAND RIGHT Ultrasound Radiology 1,910

14157 ULTRASOUND HIP LEFT Ultrasound Radiology 1,910

14158 ULTRASOUND HIP RIGHT Ultrasound Radiology 1,910

14164 ULTRASOUND WRIST LEFT Ultrasound Radiology 1,910

14165 ULTRASOUND WRIST RIGHT Ultrasound Radiology 1,910

14733 EARLY PREGNANCY ULTRASOUND Ultrasound Radiology 2,400

14831 ULTRASOUND (VAGINAL) Ultrasound Radiology 1,840

15436 TRANSVAGINAL ULTRASOUND Ultrasound Radiology 2,400

15540 ULTRASOUND PELVIS Ultrasound Radiology 1,910

15542 ULTRASOUND THIGH Ultrasound Radiology 1,910

15812 MAMMOGRAPHY SINGLE BREAST Ultrasound Radiology 2,210

16916 ULTRASOUND SCREENING Ultrasound Radiology 1,160

19234 ULTRASOUND LEFT FORE FOOT Ultrasound Radiology 1,910

148 W.E.F. 1st January 2019 INVESTIGATION

19235 ULTRASOUND RIGHT FORE FOOT Ultrasound Radiology 1,910

19236 ULTRASOUND LEFT HEEL Ultrasound Radiology 1,910

19237 ULTRASOUND RIGHT HEEL Ultrasound Radiology 1,910

19243 ULTRASOUND LEFT LEG Ultrasound Radiology 1,910

19244 ULTRASOUND RIGHT LEG Ultrasound Radiology 1,910

21391 ULTRASOUND COLOUR DOPPLER Ultrasound Radiology 5,160 TRANSPLANT ORGAN 21392 ULTRASOUND COLOUR VASCULAR DOPPLER Ultrasound Radiology 7,060 (ABDOMEN) 21393 ULTRASOUND EMERGENCY CHARGES Ultrasound Radiology 410

21396 ULTRASOUND FOLLICLE MONITORING Ultrasound Radiology 4,310

21397 ULTRASOUND GROWTH MONITORING Ultrasound Radiology 2,580

21398 ULTRASOUND TRANSRECTAL Ultrasound Radiology 2,400

21399 ULTRASOUND PERIPHERAL ARTERIAL Ultrasound Radiology 4,590

21400 ULTRASOUND PERIPHERAL VENOUS Ultrasound Radiology 4,590

21401 ULTRASOUND PREGNANCY ANAMOLY STUDY Ultrasound Radiology 4,590

21402 ULTRASOUND SCROTAL/PENILE Ultrasound Radiology 2,770

21405 ULTRASOUND DOPPLER LOCAL SWELLING Ultrasound Radiology 4,310

21407 ULTRASOUND KUB and TRUS (MALE) Ultrasound Radiology 4,570

28108 ULTRASOUND PELVIS - MALE Ultrasound Radiology 1,880

41252 ULTRASOUND WHOLE ABDOMEN MALE Ultrasound Radiology 3,470

44401 ULTRA SOUND COLOUR TRANSRANIAL Ultrasound Radiology 7,230 DOPPLER 44402 ULTRA SOUND PORTABLE STUDY Ultrasound Radiology 1,450

61466 USG TRANSPLANT KIDNEY DOPPLER Ultrasound Radiology 7,420

W.E.F. 1st January 2019 149 INVESTIGATION

61467 USG TRANSPLANT LIVER DOPPLER Ultrasound Radiology 7,420

61468 USG KIDNEY DOPPLER Ultrasound Radiology 7,420

61469 USG LIVER DOPPLER Ultrasound Radiology 7,420

61470 USG SMALL PARTS - MISCELLANEOUS Ultrasound Radiology 1,910

63322 ULTRA SOUND SLIDES CHARGES (PER) Ultrasound Radiology 290

63323 ULTRA SOUND TRANSPLANT STUDY Ultrasound Radiology 2,600

82787 ULTRASOUND- CONTRAST ENHANCED Ultrasound Radiology 4,310 PROCEDURE (CEUS) 63315 RBS GLUCOMETER Wards Others 320

1053155 DATRI PACK-1 Wards Others 11,260 Outsource 1053156 DATRI PACK-2 Wards Others 29,650 Outsource 1053159 DATRI PACK-5 Wards Others 1,110 Outsource 1053160 DATRI PACK-6 Wards Others 550 Outsource 1230 X-RAY ABDOMEN (KUB) X Ray 580

1231 X-RAY ABDOMEN ERECT X Ray 580

1232 X-RAY ANKLE AP AND LAT X Ray 1,110

1234 X-RAY BOTH ANKLE AP AND LAT X Ray 1,110

1240 X-RAY BOTH KNEES (AP) X Ray 580

1241 X-RAY BOTH KNEES AP AND LAT X Ray 1,110

1242 X-RAY BOTH KNEES LAT VIEW X Ray 1,060

1243 X-RAY CERVICAL SPINE AP X Ray 580

1244 X-RAY CERVICAL SPINE AP AND LAT X Ray 1,110

1245 X-RAY CERVICAL SPINE LAT X Ray 580

150 W.E.F. 1st January 2019 INVESTIGATION

1246 X-RAY CERVICAL SPINE LT. OBLIQUE X Ray 1,110

1247 X-RAY CERVICAL SPINE RT. OBLIQUE X Ray 1,110

1248 X-RAY CHEST AP X Ray 560

1249 X-RAY CHEST LEFT LAT X Ray 560

1252 X-RAY CHEST PA X Ray 560

1254 X-RAY CLAVICLE AP X Ray 580

1256 X-RAY ELBOW AP AND LAT X Ray 1,110

1258 X-RAY FEMUR AP AND LAT X Ray 1,110

1259 X-RAY FOOT AP AND LAT X Ray 1,110

1262 X-RAY FOREARM AP AND LAT X Ray 1,110

1267 X-RAY HIP JOINT (LEFT) AP X Ray 580

1269 X-RAY HIP JOINT (LEFT) LAT X Ray 580

1270 X-RAY HUMERUS AP AND LAT X Ray 1,110

1275 X-RAY KUB X Ray 580

1277 X-RAY LEFT SHOULDER AP AND LAT X Ray 1,110

1281 X-RAY LUMBAR SPINE AP X Ray 580

1285 X-RAY LUMBAR SPINE RT AND LT OBLIQUE X Ray 1,110

1288 X-RAY MANDIBLE PA X Ray 580

1290 X-RAY NASAL BONES X Ray 580

1292 X-RAY PELVIS AP X Ray 580

1293 X-RAY PNS X Ray 580

1295 X-RAY RIGHT SHOULDER AP AND LAT X Ray 2,140

1298 X-RAY SACRUM AP AND LAT X Ray 1,110

W.E.F. 1st January 2019 151 INVESTIGATION

1299 X-RAY SKULL AP AND LAT X Ray 1,110

1311 BARIUM ENEMA WITH DOUBLE CONTRAST X Ray 6,130

1313 BARIUM SWALLOW X Ray 2,690

1318 FISTULOGRAPHY X Ray 2,930

1328 P.T.C.(PERCUTANEOUS TRANSHEPATIC X Ray 5,850 CHOLANGIOGRAPHY) 1340 X-RAY SMALL BOWEL ENEMA X Ray 8,400

5259 X-RAY TM JOINT X Ray 580

5262 X-RAY SKULL LAT X Ray 580

5263 X-RAY SKULL AP X Ray 580

5271 X-RAY CHEST RIGHT LAT X Ray 560

5272 X-RAY CERVICAL SPINE LATERAL - FLEXION X Ray 1,060

5273 X-RAY CERVICAL SPINE LATERAL - X Ray 580 EXTENSION 5274 X-RAY LUMBER SPINE LATERAL - FLEXION X Ray 580

5275 X-RAY LUMBER SPINE LATERAL - EXTENSION X Ray 580

5276 X-RAY HIP JOINT (RIGHT) AP X Ray 580

5278 X-RAY HIP JOINT (RIGHT) LAT X Ray 580

5525 X-RAY BARIUM MEAL FOLLOW THROUGH X Ray 6,690

6441 X-RAY LUMBAR SPINE LAT X Ray 580

6442 X-RAY SKULL X Ray 580

14044 X-RAY FOREARM AP AND LAT BOTH X Ray 1,110

14045 X-RAY FOREARM AP AND LAT LEFT X Ray 1,110

14046 X-RAY FOREARM AP AND LAT RIGHT X Ray 1,110

14047 X-RAY FOREARM AP LEFT X Ray 580

152 W.E.F. 1st January 2019 INVESTIGATION

14048 X-RAY FOREARM AP RIGHT X Ray 580

14049 X-RAY FOREARM LAT LEFT X Ray 580

14050 X-RAY FOREARM LAT RIGHT X Ray 580

14058 X-RAY HAND LAT LEFT X Ray 580

14059 X-RAY HAND LAT RIGHT X Ray 580

14068 X-RAY HUMERUS AP AND LAT LEFT X Ray 1,110

14130 X-RAY ELBOW LAT RIGHT X Ray 580

14131 X-RAY ELBOWS AP AND LAT BOTH X Ray 1,110

14134 X-RAY FEMUR AP AND LAT BOTH X Ray 1,110

14135 X-RAY FEMUR AP AND LAT LEFT X Ray 1,110

14142 X-RAY ELBOW AP AND LAT LEFT X Ray 1,110

14143 X-RAY ELBOW AP AND LAT RIGHT X Ray 1,110

14144 X-RAY ELBOW AP LEFT X Ray 580

14145 X-RAY ELBOW AP RIGHT X Ray 580

14146 X-RAY ELBOW LAT BOTH X Ray 580

14147 X-RAY ELBOW LAT LEFT X Ray 580

14169 MAMOGRAPHY X Ray 2,900

14171 X-RAY ANKLE AP AND LAT LEFT X Ray 1,110

14172 X-RAY ANKLE AP AND LT RIGHT X Ray 1,110

14173 X-RAY ANKLE AP LEFT X Ray 580

14174 X-RAY ANKLE AP RIGHT X Ray 580

14175 X-RAY ANKLE LAT LEFT X Ray 580

14248 X-RAY ANKLE LAT RIGHT X Ray 580

W.E.F. 1st January 2019 153 INVESTIGATION

14249 X-RAY ANKLES AP AND LAT BOTH X Ray 1,110

14255 X-RAY CALCAMEUM LAT BOTH X Ray 580

14259 X-RAY CHEST APICAL VIEW X Ray 560

14260 X-RAY CHEST FOR RIBS X Ray 560

14262 X-RAY CHEST LORDOTIC VIEW X Ray 560

14264 X-RAY CHEST OBLIQUE LEFT X Ray 560

14265 X-RAY CHEST OBLIQUE RIGHT X Ray 560

14267 X-RAY COCCYX AP X Ray 580

14699 X-RAY FEMUR AP AND LAT RIGHT X Ray 1,110

14800 X-RAY FEMUR AP RIGHT X Ray 580

14801 X-RAY FEMUR LAT RIGHT X Ray 580

14804 X-RAY FOOT AP AND LAT LEFT X Ray 1,110

14805 X-RAY FOOT AP AND LAT RIGHT X Ray 1,110

14806 X-RAY FOOT AP AND OBLIQUE LEFT X Ray 1,110

14807 X-RAY FOOT AP AND OBLIQUE RIGHT X Ray 1,110

14808 X-RAY FOOT AP LEFT X Ray 580

14809 X-RAY FOOT AP RIGHT X Ray 580

14810 X-RAY FOOT LAT LEFT X Ray 580

14811 X-RAY FOOT LAT RIGHT X Ray 580

14846 X-RAY SHOULDER LAT RIGHT X Ray 580

14849 X-RAY STERNUM AP AND LT X Ray 1,110

14850 X-RAY STERNUM OBLIQUE AND LAT X Ray 1,110

14935 X-RAY HUMERUS AP AND LAT RIGHT X Ray 1,110

14937 X-RAY KNEE AP LEFT X Ray 580

154 W.E.F. 1st January 2019 INVESTIGATION

14938 X-RAY KNEE AP RIGHT X Ray 580

14939 X-RAY KNEE LAT LEFT X Ray 580

14940 X-RAY KNEE LAT RIGHT X Ray 580

14941 X-RAY KNEES AP BOTH AND LEFT KNEE LAT X Ray 1,110

14942 X-RAY LEG AP AND LAT LEFT X Ray 1,110

14943 X-RAY LEG AP AND LAT RIGHT X Ray 1,110

14944 X-RAY LEG AP LEFT X Ray 580

14945 X-RAY LEG AP RIGHT X Ray 580

14947 X-RAY LEG LAT LEFT X Ray 580

14948 X-RAY LEG LAT RIGHT X Ray 580

14950 X-RAY LEGS AP AND LAT BOTH X Ray 1,110

14958 X-RAY NECK LAT X Ray 580

15040 X-RAY PANTOMOGRAPHY (OPG) X Ray 1,000

15041 X-RAY PARANASAL SINUSES (PNS) AP AND X Ray 1,110 LAT 15042 X-RAY PATELLA \ SKYLINE VIEW BOTH X Ray 1,110

15043 X-RAY PELVIS LAT X Ray 580

15044 X-RAY PERORBITAL VIEW X Ray 580

15045 X-RAY SACRO ILIAC JOINTS X Ray 580

15046 X-RAY SHOULDER AP AND AXILLA RIGHT X Ray 1,110

15047 X-RAY SHOULDER AP LEFT X Ray 580

15048 X-RAY SHOULDER AP RIGHT X Ray 580

15049 X-RAY SHOULDER LAT LEFT X Ray 580

15499 X-RAY WRIST AND SCAPHOID VIEW RIGHT X Ray 580

W.E.F. 1st January 2019 155 INVESTIGATION

15500 X-RAY WRIST AP AND LAT BOTH X Ray 1,110

15501 X-RAY WRIST AP AND LAT LEFT X Ray 1,110

15502 X-RAY WRIST AP AND LAT RIGHT X Ray 1,110

15503 X-RAY WRIST AP RIGHT X Ray 580

15504 X-RAY WRIST LAT LEFT X Ray 580

15505 X-RAY WRIST LAT RIGHT X Ray 580

15506 X-RAY ABDOMEN AP SUPINE X Ray 580

15583 X-RAY FINGER AP AND LAT MIDDLE X Ray 1,110

15596 X-RAY MANDIBLE X Ray 580

15694 FLUROSCOPY T.TUBE CHOLANGIOGRAM X Ray 3,470

18708 X-RAY KNEE AP X Ray 580

18930 X-RAY CALCANEUM AXIAL X Ray 580

19083 X-RAY FOOT AP X Ray 580

20183 X-RAY KNEE LAT X Ray 580

20184 X-RAY ABDOMEN PRONE X Ray 580

20193 X-RAY ELBOW AP X Ray 580

20194 XRAY ELBOW LATERAL X Ray 580

20217 X-RAY FEMUR AP X Ray 580

20218 X-RAY FEMUR LATERAL X Ray 580

20220 X-RAY FOOT LATERAL X Ray 580

20326 X-RAY SHOULDER AP AND AXILLA LEFT X Ray 1,110

20327 X-RAY KNEE SKYLINE X Ray 580

20328 X-RAY HIP ILLIUM-POST OBLIQUE (BOTH) X Ray 1,110

156 W.E.F. 1st January 2019 INVESTIGATION

20329 X-RAY HIP ILLIUM-POST OBLIQUE (RIGHT / X Ray 580 LEFT) 20330 X-RAY HIP ACETABULUM ANT X Ray 1,110 OBLIQUE(BOTH) 20331 X-RAY HUMERUS AP X Ray 580

20332 X-RAY HUMERUS LATERAL X Ray 580

20333 X-RAY KNEE INTERCPMDAL FOSSA X Ray 580

20334 X-RAY KNEE OBLIQUE X Ray 580

20335 X-RAY L. SPINE CONE VIEW OF L5-S1(LUM) X Ray 580

20336 X-RAY LATERAL FACE X Ray 580

20337 X-RAY ABDOMEN DECUBITUS (R/L/S) X Ray 580

20338 X-RAY HANDS ANY 3 (BOTH) X Ray 1,660

20339 X-RAY ANKLE MORTISE STUDY X Ray 580

20340 X-RAY ANKLE OBLIQUE X Ray 580

20341 X-RAY CALCANEUS LATERAL and AXIAL X Ray 1,110 (BOTH) 20342 X-RAY CALCANEUS LATERAL and AXIAL (R/L) X Ray 1,110

20343 X-RAY CERIVICAL SPINE AP OPEN MOUTH X Ray 580

20344 X-RAY CERIVICAL SPINE CV JUNCTION X Ray 580

20345 X-RAY CERIVICAL SPINE SWIMMERS LATERAL X Ray 580

20346 X-RAY CHEST DECUBITUS (R/L) X Ray 560

20347 X-RAY CHEST INSPIRATION/EXPIRATION S X Ray 560

20348 X-RAY CLAVICLE AC JOINTS (BOTH) X Ray 1,110

20349 X-RAY HANDS ANY THREE (BOTH) X Ray 1,660

20350 X-RAY CLAVICLE AC JOINTS (R/L) X Ray 580

20351 X-RAY ELBOW OBLIQUE X Ray 580

W.E.F. 1st January 2019 157 INVESTIGATION

20352 X-RAY EMERGENCY CHARGES X Ray 910

20353 X-RAY ERECT X Ray 580

20354 X-RAY FACE ZYGOMATIC ARCH X Ray 580

20355 X-RAY FINGERS ANY THREE X Ray 580

20356 X-RAY FINGERS ANY TWO X Ray 580

20357 X-RAY FINGERS LATERAL X Ray 580

20358 X-RAY FINGERS OBLIQUE X Ray 580

20359 X-RAY FINGERS PA X Ray 580

20360 X-RAY HANDS ANY THREE (RIGHT / LEFT) X Ray 1,660

20361 X-RAY HIP ACETABULUM ANTOBLIQUE(R/ X Ray 580 L)1FILM 20362 X-RAY PATELLA AP X Ray 580

20363 X-RAY PATELLA LATERAL X Ray 580

20364 X-RAY PATELLA PA X Ray 580

20365 X-RAY PORTABLE X Ray 910

20366 X-RAY SACRO. JOINT POSTERIOR OBLIQUE X Ray 1,110 BOTH 20367 X-RAY SACRO. JOINT POSTERIOR OBLIQUE R/L X Ray 580

20368 X-RAY SACRO. JOINTS (AP) (AXIAL) (R/L) X Ray 580

20369 X-RAY SACRUM AP X Ray 580

20370 X-RAY VENOGRAM X Ray 8,400

20371 X-RAY SACRUM LATERAL X Ray 580

20372 X-RAY HANDS ANY TWO (BOTH) 2 FILMS X Ray 1,110

20373 X-RAY SKULL CONED VIEWD OF SELLA X Ray 580

20374 X-RAY SKULL OPTIC FORAMEN (R/L) X Ray 580

158 W.E.F. 1st January 2019 INVESTIGATION

20375 X-RAY SKULL PA X Ray 580

20376 X-RAY SKULL STENVERS (R/L) X Ray 580

20377 X-RAY TOES AP X Ray 580

20378 X-RAY TOES LATERAL X Ray 580

20379 X-RAY TOES OBLIQUES X Ray 580

20380 X-RAY WRIST ANY TWO (R/L) X Ray 580

20381 X-RAY WRIST CARPEL TUNNEL X Ray 580

20382 X-RAY HANDS ANY TWO (R / L) 1 FILM X Ray 580

20383 X-RAY WRIST OBLIQUE X Ray 580

20384 X-RAY WRIST AP LEFT X Ray 580

20385 X-RAY WRIST RADIAL DEVIATION X Ray 580

20386 X-RAY WRIST ULNAR DEVIATION X Ray 580

20387 X-RAY WRISTS ANY TWO (BOTH) X Ray 1,110

20388 ALIGNMENT VIEW HIP TO ANKLE B/L X Ray 1,720

20389 ALIGNMENT VIEW HIP TO ANKLE RIGHT X Ray 1,720

20390 ALIGNMENT VIEW HIP TO ANKLE LEFT X Ray 1,720

20392 XRAY SACRO ILIAC JOINT RIGHT X Ray 580

20393 X-RAY HANDS OBLIQUES X Ray 580

20394 X-RAY SACRO ILIAC JOINT LEFT X Ray 580

20395 X-RAY BARIUM COLOGRAM STUDY X Ray 1,500

20396 X-RAY BARIUM DACRYO-CYSTOGRAM X Ray 3,090

20397 X-RAY BARIUM OTHERS X Ray 2,140

20398 X-RAY BARIUM PERORAL PNEMOCOLON X Ray 2,840

W.E.F. 1st January 2019 159 INVESTIGATION

20399 X-RAY BARIUM PHAYNGIOGRAM X Ray 1,770

20400 X-RAY BARIUM UPPER GI GASTROGRAFIN S X Ray 2,320

20401 X-RAY BARIUM HYPOTONIC X Ray 2,320 DUODENOGRAPHY 20402 X-RAY FLUROSCOPY SCR X Ray 1,500

20403 X-RAY GENITO-URINARY ASU X Ray 3,090

20404 X-RAY HANDS PA X Ray 580

20405 X-RAY GENITO-URINARY CAVERNOSOGRAM X Ray 3,000

20406 X-RAY GENITO-URINARY FLUROSCOPY TEST X Ray 1,110

20407 X-RAY GENITO-URINARY IVP IONIC X Ray 4,950

20408 X-RAY GENITO-URINARY IVP NONIONIC X Ray 7,110

20409 X-RAY GENITO-URINARY MCU X Ray 3,690

20410 X-RAY GENITO-URINARY RGP X Ray 4,570

20411 X-RAY GENITO-URINARY VESICULOGRAM X Ray 3,090

20412 X-RAY GYNECOLOGY HSG (HYSTERO SALPIN) X Ray 2,930

20413 X-RAY NEPHROSTOMOGRAM X Ray 2,260

20414 X-RAY GASTROGRAFFIN STUDY X Ray 3,900

20415 X-RAY NEUROLOGY CERVICAL MYLEGRAM X Ray 6,480

20416 X-RAY NEUROLOGY LUMBAR MYLOGRAM X Ray 6,130

20417 X-RAY HEPATO-BILIARY X Ray 3,260 (CHOLANGIOGRAPHY) 20418 X-RAY BARIUM ENEMA X Ray 6,130

20419 X-RAY BARIUM MEAL X Ray 4,080

25239 BILATERAL MAMMOGRAM (BOTH BREASTS) X Ray 2,900

160 W.E.F. 1st January 2019 INVESTIGATION

25454 X-RAY FOREARM AP AND LAT BOTH - 2 FILM X Ray 1,160

26137 XRAY SACROILLIAC JOINTS AP (AXIAL) R AND X Ray 580 L 26139 XRAY SHOULDER AP (R AND L) X Ray 1,160

26141 XRAY SHOULDER AXIAL X Ray 1,160

26143 XRAY SHOULDER AXIAL (LATERAL) (R/L) X Ray 580

26145 X-RAY ANKLE ANY 2 (R/L) 1 FILMS X Ray 580

26146 X-RAY ANKLE ANY 3 (R/L) 2 FILMS X Ray 1,160

26147 X-RAY SHOULDER SCAPULA AP (R/L) X Ray 580

26148 X-RAY CALCANEUS LATERAL X Ray 580

26149 X-RAY SHOULDER SCAPULA LATERAL (R AND X Ray 1,160 L) 26150 X-RAY CHEST PENETRATED PA X Ray 560

26151 X-RAY SHOULDER SCAPULA LATERAL (R/L) X Ray 580

26152 X-RAY FACE PARA NASAL SINUS/WATERS X Ray 580

26154 X-RAY FOOT OBLIQUE X Ray 580

26160 X-RAY MANDIBL OBLIQUES (R and L) X Ray 1,160

26162 X-RAY PATELLA AXIAL (SKY./TANG.)R and L X Ray 1,160 2FILM 26163 X-RAY PATELLA AXIAL (SKY/TANG.) R/L1 FILM X Ray 580

26293 X-RAY SHOULDER SCAPULA AP) (R AND L) X Ray 1,160

26644 XRAY CLAVICLE AP (R AND L) X Ray 1,160

26648 XRAY WRISTS ANY TWO (R AND L) 2 FILMS X Ray 1,160

27260 X-RAY KNEE ANY 2(R/L) 2 FILMS X Ray 1,160

27270 X-RAY LEG LATERAL X Ray 580

28523 XRAY ANKLE LATERAL VIEW X Ray 580

W.E.F. 1st January 2019 161 INVESTIGATION

28524 XRAY ANKLE INVERSION/EVERSION VIEW X Ray 580

28531 X-RAY FOREARM AP X Ray 580

28532 X-RAY FOREARM AP AND LATERAL R OR L- 1 X Ray 580 FILM 28533 X-RAY FOREARM LATERAL X Ray 580

28535 X-RAY HIP LATERAL X Ray 580

28536 X-RAY HIP AP X Ray 580

28538 X-RAY LATERAL LEG AP X Ray 580

28541 X-RAY SHOULDER AP R OR L X Ray 580

28543 X- RAY WRIST LATERAL X Ray 570

32443 X-RAY KNEE ANY 2 (R AND L) 1 FILM X Ray 580

35665 XRAY BARRIUM DCBE (DOUBLE CONTRAST X Ray 6,070 BA) 38709 XRAY ELBOW ANY TWO (R/L) X Ray 580

39644 XRAY CALCANEUS AXIAL X Ray 580

44100 XRAY KNEE ANY 3 (R/L) 3 FILMS X Ray 1,600

44101 XRAY FOOT ANY THREE (RIGHT and LEFT) X Ray 1,600

44403 XRAY ELBOW ANY THREE (R/L) X Ray 1,160

44404 XRAY ANKLE ANY 3 (R AND L) 3 FILMS X Ray 1,600

44405 XRAY FOOT ANY TWO (RIGHT AND LEFT) X Ray 1,160

44406 XRAY FOOT ANY TWO (RIGHT / LEFT) X Ray 1,160

44408 XRAY HEPATO_BILIARY ERCP(ENDOSCOPI) X Ray 5,340

44409 XRAY BARRIUM SIALOGRAM X Ray 2,320

44410 XRAY BARRIUM LARYNIOGRAM X Ray 2,170

44411 XRAY ELBOW ANY TWO (R AND L) X Ray 1,160

162 W.E.F. 1st January 2019 INVESTIGATION

44412 XRAY GENITO-URINARY AGP X Ray 6,070

44413 XRAY NEUROLOGY THORACIC (DORSAL) MYE X Ray 6,070

44414 XRAY NEUROLOGY TWO REGIONS X Ray 1,600 (CERVIC/D) 44415 XRAY PATELLA ANY 3 (R/L) 2 FILM X Ray 1,160

44416 XRAY PATELLA ANY THREE (R/L) 4 X Ray 2,170

44417 XRAY PATELLA ANY TWO (R AND L) 4 X Ray 1,600

44419 XRAY PATELLA ANY TWO (R/L) 4 X Ray 1,160

44420 XRAY TMJ (TEMPRO MAND. JOINT) R and L X Ray 1,160

44421 XRAY WRIST THREE (RandL) -3 FILMS X Ray 1,600

44422 XRAY WRIST THREE (R/L) -2 FILMS X Ray 1,160

44423 XRAY SHOULDER AP and LATERAL (RandL) 4 X Ray 2,170 FILM 44424 XRAY ANKLE AP/LAT X Ray 1,110

44426 XRAY SKULL LATERAL (R/L) X Ray 580

45422 XRAY FOOT LATERAL WEIGHT BEARING X Ray 580

49101 XRAY MASTOIDS RIGHT X Ray 580

50196 X-RAY INFANTOGRAM X Ray 580

61457 X-RAY DORSAL SPINE AP X Ray 580

61472 X-RAY DORSAL SPINE LAT X Ray 580

61473 X-RAY DORSAL SPINE ERECT X Ray 580

61475 X-RAY DORSAL SPINE SUPINE X Ray 580

61477 X-RAY LUMBAR SPINE ERECT X Ray 580

61478 X-RAY LUMBAR SPINE SUPINE X Ray 580

61479 X-RAY THORACIC SPINE AP X Ray 580

W.E.F. 1st January 2019 163 INVESTIGATION

61480 X-RAY THORACIC SPINE LAT X Ray 580

61481 X-RAY THORACIC SPINE ERECT X Ray 580

61482 X-RAY THORACIC SPINE SUPINE X Ray 580

61483 X-RAY ADENOIDS (NASOPHARYNX LAT) X Ray 580

61484 X-RAY PNS (WATERandamp;amp;amp;amp;apos;S X Ray 580 VIEW) 61485 X-RAY PNS(ALDWELLandamp;amp;amp;amp;apo X Ray 580 s;S VIEW) 61486 X-RAY STYLOID PROCESS X Ray 580

61487 X-RAY TM JOINTS X Ray 580

61488 X-RAY SINOGRAM X Ray 2,930

61489 X-RAY HAND (R/L) AP X Ray 580

61490 X-RAY HAND (R/L) LAT X Ray 580

61491 X-RAY BOTH HAND AP X Ray 580

61492 X-RAY BOTH HAND LAT X Ray 580

61493 X-RAY FEET AP X Ray 580

61494 X-RAY FEET LAT X Ray 580

61495 X-RAY RGU X Ray 3,090

61496 X-RAY DIGITAL LOOPOGRAM X Ray 4,500

61497 X-RAY THIGH (R/L) -AP X Ray 580

61500 X-RAY THIGH (R/L) -LAT X Ray 580

61502 X-RAY BOTH THIGH - AP X Ray 580

61503 X-RAY BOTH THIGH - LAT X Ray 580

61504 X-RAY BOTH HIP - AP X Ray 580

61505 X-RAY BOTH HIP - LAT X Ray 580

164 W.E.F. 1st January 2019 INVESTIGATION

61506 X-RAY TIBIA - AP X Ray 580

61508 X-RAY TIBIA - LAT X Ray 580

61509 X-RAY EXTRA FILM (PER) X Ray 150

61528 X-RAY SIALOGRAPHY X Ray 2,930

61529 X-RAY CYSTOGRAM X Ray 3,090

61530 X-RAY NECK - AP X Ray 580

63324 XRAY FEMUR AP and LATERAL (RandL) 2 FILM X Ray 1,160

63325 XRAY FOOT ANY THREE (RIGHT / LEFT) X Ray 1,010

63326 XRAY GASTRIGRAFIN STUDY X Ray 3,910

63327 XRAY BARIUM SINOGRAM/FISTULOGRAM X Ray 2,890

63328 XRAY BARRIUM SMALL BOWEL ENEMA X Ray 8,390

63329 XRAY BARRIUM SWALLOW X Ray 2,740

63330 XRAY BARRIUM MEAL X Ray 4,050

63331 XRAY C.SPINE AP LATERAL (R/L) X Ray 1,160

63332 XRAY CHEST AP FOR RIBS X Ray 560

63333 XRAY CHEST LATERAL (R/L) X Ray 560

63334 XRAY CLAVICLE AP (R/L) X Ray 580

63335 XRAY ELBOW ANY THREE (RandL) X Ray 1,600

63336 XRAY FACE NASAL BONE X Ray 580

63337 XRAY SKULL FERURBITAL X Ray 580

63338 XRAY STERNUM LATERAL X Ray 580

63339 XRAY STERNUM OBLIQUE X Ray 580

63340 XRAY WRIST PA X Ray 580

W.E.F. 1st January 2019 165 63341 XRAY LATERAL LEG AP and LATERAL (RandL) X Ray 1,160

63342 XRAY LATERAL LEG AP and LATERAL (R/L) X Ray 580

63343 XRAY ANKLE ANY TWO 1 FILM X Ray 1,160

63344 XRAY HANDS LATERAL X Ray 580

63345 XRAY HEPATO-BILIARY OCG(ORAL CHOLEC)) X Ray 3,470

63346 XRAY HEPATO-BILIARY PTC(PERCUTANIO) X Ray 6,070

63347 XRAY HUMERUS AP and LAT (RandL) X Ray 1,160

63348 XRAY HUMERUS AP and LAT (R/L) X Ray 580

63349 XRAY KNEE ANY 3 (R/L) 2 FILMS X Ray 1,160

63350 XRAY PANTOMOGRAM X Ray 580

64072 XRAY ELBOW ANY TWO (RandL) X Ray 1,160

64073 XRAY PATELLA ANY TWO (RandL) 4 X Ray 1,600

166 W.E.F. 1st January 2019 PKG CATH

DEPARTMENT : CATH LAB

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

1Coronary Angiography 24,400 28,800 39,500 42,700 60,400

Includes: Excludes: 1. Consultant Charges 1. Omnipaque, Non Ionic Spl. Dye. 2. Cath Lab charges 3. Medicine upto 300/- only 4. Consumables 5 Bed Charges. One day 6. Routine Test: Creatinine Urea Electrolytes Glucose (R) ECG BT CT CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK X-Ray Chest ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag

Note : CAG, if done within 7 days from the date of Apollo Health Chqs. (Master/Exect./Heart/Whole Body), a discount of Rs. 1000/- will be given to the patient.

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

2 Coronary Angioplasty 1,01,700 117,100 127,900 137,200 155,600

Includes: Excludes: 1. Bed Charges for 2 Days. 1. Consumable, Medicine, Stent 2. Consultant Charges. 3. Cath Lab Charges. 4. Routine Test:

W.E.F. 1st January 2019 167 PKG CATH

Creatinine Urea Electrolytes Glucose (R) LFT BT CT CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK X-Ray Chest ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag ECG

Note: If a stand by Cardiologist called for PTCA procedure, 25% of the primary cardiologist fees will be charged as stand by Cardiologist fees.

S. No PACKAGE Tariff

3 Peripheral Angiography 24700

Includes: Excludes: 1. 1 day Bed Charges of Semi Pvt. Room 1. Usage of Omnipaque. 2. Cath lab charges 2. Non Ionic Spl. Dye 3. Consultant charges 4. Medicine & Consumables 5. Routine Test: Creatinine Urea Electrolytes Glucose (R) LFT BT CT CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK X-Ray Chest ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag ECG

168 W.E.F. 1st January 2019 PKG CATH

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

4 Peripheral Angioplasty 101,700 117,100 127,900 137,200 155,600

Includes: Excludes: 1. Bed Charges for 2 Days 1. Medicines, Consumables. 2. Consultant Charges 3. Cath lab Charges. 4. Routine Test: Creatinine Urea Electrolytes Glucose (R) LFT BT CT CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK X-Ray Chest ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag ECG

S. No PACKAGE A/c Multi Bed Unit

5 Valvuloplasty / BMV/ PTMC 91000

Includes: Excludes: 1. Bed Charges for 3 days. 1. Usage of Omnipaque. 2. Cardiologist Fees 2. Echo & CSA. 3. Cath lab charges 4. Medicine & Consumables 5. Routine Test: Creatinine Urea Electrolytes ECG BT CT

W.E.F. 1st January 2019 169 PKG CATH

CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag X-Ray chest. Note: If patients stays in higher category of ward differential bed charges is applicable.

S. No PACKAGE Tariff

6 Rotoblator Athrectomy* 100100

7 Directional Coronary Athrectomy* 105000

* If procedure is done with PTCA 1/3 of procedure charges is applicable.

Includes: Excludes: 1. 3 days bed charges of Semi Private including 1 day ICU 1. Cost of Consumable & Medicine. 2. Consultant Charges. 3. Cath Lab Charges. 4. Routine Test: Creatinine Urea Electrolytes Glucose (R) LFT BT CT CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK ECG ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag X- ray Chest

170 W.E.F. 1st January 2019 PKG CATH

S. No PACKAGE Tariff

8 Day Cath 12700 (For Coronary Angiography)

Includes: Excludes: 1. Bed Charges - 1 day for Multi Bed Unit Omly 1. Omnipaque, Non Ionic Spl. Dye (i.e. same day admis sion & discharge) 2. Consultant Charges 3. Cath Lab charges 4. Medicine & Consumables 5. Routine Test: Creatinine Urea Electrolytes Glucose (R) ECG BT CT CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK X-Ray Chest ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

9 Radiofrequency Ablation Package 113,800 116,800 124,200 126,900 148,700

Includes: 1. Bed Charges - 1 day 2. Consultant Charges 3. Cath Lab charges 4. Consumables

Exclusions: 1. Investigations 2. Medicines 3. Consumables

W.E.F. 1st January 2019 171 PKG CATH

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

10 Heart Transplant Screeing 45,900 50,100 60,300 63,400 80,200

Includes: Excludes: 1. Consultant Charges 1. Omnipaque, Non Ionic Spl. Dye. 2. Cath Lab charges 3. Medicine upto 300/- only 4. Consumables 5. Bed Charges. One day 6. Routine Test: Creatinine Urea Electrolytes Glucose (R) ECG BT CT CBC (HB, TLC,DLC, ESR) Platelet count & APTT/ PTTK X-Ray Chest ABO & RH Grouping Anti HIV (I&II) Elisa /HIV Hbs Ag (Elisa)/ Hbs Ag ELISA ANTI HCV ELISA ANTI CMV IgG ANTIBODIES ELISA ANTI CMV IgM 2D-ECHO WITH COLOUR DOPPLER EGFR TEST LFT ULTRASOUND - WHOLE ABDOMEN PT/INR

7. Consultation By Physician & Psychiatrist

8. Consultation By Gynaecologist (Female) only

172 W.E.F. 1st January 2019 PKG CABG

2) CARDIAC PACKAGES

OPEN HEART SURGERY C A B G

OPEN HEART DOUBLE VALVE CABROL SURGERY/SINGLE REPLACEMENT /BENTOLL VALVE REPLACEMENT NORMAL HIGHRISK REDO CABG+ CLOSED / Beating CAROTID HEART CATEGORY NORMAL HIGH NORMAL HIGH Heart SURGERY RISK RISK A/c Multi 274,200 335,700 315,500 367,700 391,900 274200 335700 349000 393000 161900 Bed Unit Semi 315,500 385,000 386,500 425,100 468,000 315500 385000 432000 456000 184500 Private Single 410,400 485,400 456,000 533,600 533,600 410400 485400 501500 501500 219200 Room Delux** 385,000 478,600 425,100 524,200 493,400 385000 478600 474700 501500 268900

Suite** 501,500 621,700 553,500 681,900 633,800 501500 621700 624400 621700 293000

** Delux and Suite tariff are exclusive of professional fees of Consultants except in regard to Closed Heart Surgery. A discount of Rs 3000/- [THREE THOUSAND]will be given for a case where CT Angiography has been done in this hospital.

1 Thepackage is inclusive of: a “8 days’ (includes 3 days ICU) stay for CABG and Closed Heart surgeries and 10 (includes 4 days ICU) days stay for valve replacement surgery & Open Heart surgeries” b OT charges c Lab investigations (Blood grouping and cross matching, kidney profile, liver profile, routine hematology) d X -rays & ECGs eOne Echo f Two Dopplers (where needed) g Blood transfusion except as mentioned at serial no ( h ) of exclusions mentioned below. h Medical & nursing care i Medicines and Medical consumables j Professional fees of the Consultants in cardiothoracic surgery, cardiac anaesthesia and cardiology for the duration of the package (Not applicable to patients in Delux and Suite) k Diet and physiotherapy i Reopening During the period of package.

W.E.F. 1st January 2019 173 PKG CABG

2 The package does not include: a) Bed charges for stay beyond the duration of the package. b) Swan ganz catheter c) Centrifugal pump head d) Intra - aortic balloon (IABP) e) Echo (additional) at presecribed rates f) Stress, Holter, PFT and other special tests at prescribed rates for each test g) Cost of valve (The cost of valve would range from Rs 65,000/- To 115,000/- depending on the type of valve used ) h) Blood products on cell seperator at prescribed rates i) Valve conduit, when used in open heart surgery, would be charged extra (approximate cost is Rs. 80,000/-) j) The package includes cost of Arterial line filter. However, additional amounts will be charged if the following types of filters are used in lieu of autovent: Leukoguard filter Leukocyte filter k) Re- Opening outside the package Rs 10000/- extra over and above the package. l) TEG Machine Cartridge charges (2nos.)

3 The above charges are exclusive of Angiography for which a separate package is available

4 Visit charges of Consultants, other than those mentioned at serial (j) of 1 above and drugs prescribed by them. However, visits of all Consultants are complimentary on the day of discharge.

5 For transfusion, blood should be donated by patient’s relatives and friends.

6 Any other additional procedure with CABG, Open Heart and Valve replacement surgeries Rs 77100/-- extra will be charged over and above the package. Price of the package will be payable in full at the time of admission. Other amounts,where applicable as above, will be billed seperately during the course of treatment.

174 W.E.F. 1st January 2019 PAD CCS

3) PEDIATRIC CARDIOLOGY & CONGENITAL CARDIAC SURGERY PACKAGES

PEDIATRIC OPEN HEART SURGERY (OHS)

PACKAGE OHS I-A OHS I-B OHS II OHS III-A OHS III-B OHS IV

A/c Multi 220,500 257,300 294,000 331,800 405,300 490,400 Bed SEMI PVT 333,900 371,700 408,500 466,200 483,000 594,300

SINGLE 417,900 464,100 510,300 582,800 603,800 742,400

DELUXE 451,500 500,900 551,300 629,000 651,000 913,500

SUITE 721,400 802,200 840,000 1,054,200 1,158,200 1,521,500

Notes:

1 OHS LEVEL I -A:- STAY DURATION : 5 Days for eg.: a BT shunt/PA plasty on bypass b Surgical atrial septectomy

2 OHS LEVEL I -B:- STAY DURATION : 7 Days for eg.: a BT shunt/PA plasty on bypass b Surgical atrial septectomy

3 OHS LEVEL II :- STAY DURATION : 10 Days For eg.: a ASD - Atrial Septal Defect b PAPVR - Partial Anomalous Pulm. Venous Return c GLENN - Glenn Shunt d VSD - Ventricular Septal Defect e TOF - Tetralogy of Fallot’s f PAVC - Partial AV Canal Defect gDORV

4 OHS LEVEL III -A :- STAY DURATION : 12 Days For eg.: a All Re-do cases b CAVC - Complete AV Canal Defect cFONTAN

W.E.F. 1st January 2019 175 PAD CCS

5 OHS LEVEL III- B :- STAY DURATION : 14 Days For eg.: a All Re-do cases b CAVC - Complete AV Canal Defect cFONTAN

6 OHS LEVEL IV :- STAY DURATION : 21 Days a All cases < 3 months old For eg : Arterial Switch Operation, Truncus Arteriosus PEDIATRIC CLOSE HEART SURGERY (CHS)

PACKAGE CHS I-A CHS I-B CHS I-C CHS II

A/c Multi 172200 196400 220500 245700 Bed SEMI PVT 222600 260400 282500 297200

SINGLE 262500 305600 332900 350700

DELUXE 348600 404300 440000 462000

SUITE 579600 667800 727700 771800

Notes:

1 CHS LEVEL I-A :- STAY DURATION : 3 Days For eg: a CoA - Coarctation of Aorta b Simple Vascular Rings

2 CHS LEVEL I-B :- STAY DURATION : 5 Days For eg: a CoA - Coarctation of Aorta b Simple Vascular Rings

3 CHS LEVEL I-C :- STAY DURATION : 7 Days For eg: a CoA - Coarctation of Aorta b Simple Vascular Rings c Pacemaker Insertion

176 W.E.F. 1st January 2019 PAD CCS

4 CHS LEVEL II: STAY DURATION : 10 Days For eg : Shunts, PAB (Pulmonary Artery Band), Unifocalization, a All Cases less than 3 months For eg : Shunts, PAB (Pulmonary Artery Band), Unifocalization, CoA, Complex Rings

THE OPEN & CLOSED HEART PACKAGES ARE INCLUSIVE OF:

1 Days of stay as per packages listed above. Beyond the stipulated period appropriate add-on tariffs will apply with all the conditions mentioned pertaining to “add on packages”. If one unit than Rs. 500/- 2OT charges 3 Lab Investigation (Hematology, Renal & Liver profile, HIV, Hep B & C serology, Blood Gas Analysis) 4 Medical and Nursing care 5 Medicines and Medical Consumables (list of important consumables is enclosed). 6 X-Rays and ECG’s 7 Echocardiogram: One Transthoracic Echocardiogram per case; One Transesophageal Echocardiogram (where needed). 8 Blood & Blood product transfusions except use of cell separator, cryoprecipitate, leukodeplete units & irradiated blood. Use of these should be charged as per currently prescribed hospital blood bank rates. Rs. 1200/- will be charged in favor of the blood bank in all cases where request for alliquoted blood is made towards three alliquoted units. 9 Professional Fees of the Consultants. 10 Reopening & delayed closure of chest during the period of the package. 11 Chest Physiotherapy- twice daily 12 Diet 13 One head and renal ultrasound for all patients in OHS level IV and CHS level III 14 Peritoneal Dialysis in OHS III and IV and will be included in the package for the duration of the package as mentioned above. Peritoneal dialysis will be initiated and supervised by PCCS consultants, only the dialysis fluid is hereby covered. 15 Total Parental Nutrition in OHS III and IV and CHS III will be included in the package for the duration of the package as mentioned above. 16 Warming systems.

THE OPEN & CLOSED HEART PACKAGES ARE EXCLUSIVE OF

All Valves, Grafts, Conduit, pacemakers and pacemaker leads FOR PATIENTS ON OPEN OR CLOSED HEART SURGERY PACKAGES IF THE PATIENT OVERSTAYS, THE FOLLOWING PACKAGES MAY APPLY WHICH DO NOT INCLUDE THE MEDICINE COSTS:

ADD-ON PACKAGES On VENTILATOR = Rs. 10,000/ Day (All inclusive except medicine) Off VENTILATOR = Rs. 5,000/ Day ( All inclusive except medicine)

W.E.F. 1st January 2019 177 PAD CCS

MEDICINES & MEDICAL CONSUMABLES

FOR OPEN HEART CASES

1 Arterial line placement : Adequate sized I/V cannula, pressure monitoring lines & transducer 2 CVP Placement : Adequate sized double or triple lumen CVP Kit, pressure monitoring line & transducer 3 Peripheral I/V line : Adequate sized I/V cannula, 100 cm line. 4 Anethetic gases : Sevoflurane induction & isoflurane maintenance. 5 Adequate doses based on the body weight of patient of OPOIDS (Morphine, Fentanyl), RELAXANTS (Pavulon or Vecuron or Rocuronium), Sedatives (Midazolam, Diazapam), and special medicines as per requirement (Propofol and Etomidate, Ketamine) 6 INOTROPES & VASODILATORS. 7 Custom tubings as per body weight 8Heparin 9 Oxygenator based on body weight 10Hemofilter. 11 Leukocyte Filter. 12 Arterial line Filter 13 Cardiopledgia and it’s delivery system 14 suture material as per the need of the type of surgery 15 Arterial line and venous drainage canulae as per anatomy and body weight of the patient. 16 Methyl Prednisolone for newborns & patients undergoing deep hypothermiccirculatory arrest. 17 5% albumin: 250cc - oneor 50cc - three in quantity based on the body weight. 18 Antibiotics : Cefuroxime for prophylaxis and vancomycin and Meropenemin cases of sepsis only during the duration of package. 19 Bactroban Ointment. 20 Steristrips and sterile dressing. 21 Chest tubes based on body weight. 22 Syringes 50,20,10,2,1 cc as needed. 23Micropore tape 24 Tegaderm - 5 25 Three-way-stop cocks-approximately 15 26 Endotracheal tube. 27 Aminocaproic acid (AMICAR) will be included in package for OHS-III 28 Crystalloid solutions.

178 W.E.F. 1st January 2019 PAD CCS

MEDICINES & MEDICAL CONSUMABLES

FOR CLOSED HEART CASES

1 Arterial line placement : Adequate sized I/V cannula, pressure monitoring lines & transducer 2 CVP Placement : Adequate sized double or triple lumen CVP Kit, pressure monitoring line & trans ducer 3 Peripheral I/V line : Adequate sized I/V cannula, 100 cm line. 4 Anethetic gases : Sevoflurane induction & isoflurane maintenance. 5 Adequate doses based on the body weight of patient of OPOIDS (Morphine, Fentanyl), RELAXANTS (Pavulon or Vecuron or Rocuronium), Sedatives (Midazolam, Diazapam), and special medicines as per requirement (Propofol and Etomidate, Ketamine) 6 INOTROPES & VASODILATORS. 7 Heparin 8 suture material as per the need of the type of surgery 9 Arterial line and venous drainage canulae as per anatomy and body weight of the patient. 10 5% albumin: 50cc - three in quantity. 11 Antibiotics : Cefuroxime for prophylaxis and vancomycin and Meropenem in cases of sepsis only during the duration of package. 12 Bactroban Ointment. 13 Steristrips and sterile dressing. 14 Chest tubes based on body weight. 15 Syringes 50,20,10,2,1 cc as needed. 16 Micropore tape 17 Tegaderm - 5 18 Crystalloids.

W.E.F. 1st January 2019 179 PAD CARDIO

4) INTERVENTIONAL PEDIATRIC CARDIOLOGY

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

1 BALLOON ATRIAL SEPTOSTOMY 61,500 77,100 95,100 114,200 191,300 (BAS)

INCLUDES:

1 Only Cath lab Charges 2 Consultant Charges for procedure only 3 Routine investigations - ( CBC, Urea, Creatinine, HEP B &C, HIV, Chest X-ray, ECG, Blood grouping) 4 Anaesthesia charges 5 Cost of Medicines, Devices, Consumables used in cath lab only(Cost of 1 balloon included) 6 CD Development

EXCLUDES:

1 Bed charges 2 Non-Ionic Dye 3 Micropuncture set

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

2 VALVULOPLASTY/ANGIOPLASTY 115,600 154,200 191,300 229,700 383,800

INCLUDES:

1 Bed charges for 2 days (inclusive of 1 day ICU charges) 2 Consultant Charges 3 Routine investigations - ( CBC, Urea, Creatinine, HEP B &C, HIV, Chest X-ray, ECG, Blood group- ing) 4 Anaesthesia charges 5 Cost of Medicines, Consumables - includes use of 1 Tyshak/ Mini Tyshak balloon 6 CD Development

EXCLUDES: 1 Non-Ionic Dye 2 Micropuncture set 3. Over and above 1 Tyshak/ mini Tyshak balloon upto Rs. 22000/-

180 W.E.F. 1st January 2019 PAD CARDIO

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

3 PDA DEVICES 105,000 125,000 147,000 165,000 250,000

Inclusions: a) Bed charges for 2 days (inclusive of 1 day ICU charges) b) Routine investigations - 1 Anti Hiv (I And Ii) Rapid Kit Test 3230 2 Group And Screen 2260 3 Creatinine - Serum 640 4 Glucose - Plasma (Random) 340 5 Hbs Ag (Rapid) 1510 6 2D-Echo With Colour Doppler 5550 7 Activated Partial Thromboplastin Time 1310 8 X-Ray Chest Pa 560 9 Urea - Serum 620 10 CBC(Hb,Pcv,Esr,Tlc,Dlc,Plt C) 1160 c) Medicine & consumables upto 20000/-. d) Cardiologist & Anesthetist charges.

Exclusions: a) Any investigation, Lab tests Mentioned as above b) Medicines & Consumable above 20000/-. c) Cost of Device d) Consultation Other than Cardiology

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

4 ASD/VSD DEVICE 125,000 145,000 175,000 195,000 295,000

Inclusions: a) Bed charges for 2 days (inclusive of 1 day ICU charges) b) Routine investigations - 1 Bleeding Time 2 Anti Hiv (I And Ii) Rapid Kit Test 3 Group And Screen 4 Clotting Time [CT] 5 Creatinine - Serum 6 Glucose - Plasma (Random) 7 Hbs Ag (Rapid) 8 PT/INR 9 2D-Echo With Colour Doppler

W.E.F. 1st January 2019 181 PAD CARDIO

10 Activated Partial Thromboplastin Time 11 X-Ray Chest Pa 12 Urea - Serum 13 CBC(Hb,Pcv,Esr,Tlc,Dlc,Plt C) 14 One Unit Packed Red Blood Cells (Leukoreduced) Arrange And Issue c) Medicine & consumables upto 30,500/-. d) Cardiologsit & Anaesthetist charges.

Exclusions: a) Any investigation, Lab tests Mentioned as above b) Medicines & Consumable above 30,500/-. c) Cost of Device d) Consultation Other then Cardiology

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

5 STENT DEPLOYMENT 252,100 to 329,200 to 417,400 to 494,000 to832,000 to (Depending on use of consumables) 341,800 443,900 557,600 671,000 1,117,800

INCLUDES:

1 Bed charges for 3 days (inclusive of 2 day ICU charges) 2 Consultant Charges 3 Routine investigations - ( CBC, Urea, Creatinine, HEP B &C, HIV, Chest X-ray, ECG, Blood grouping) 4 Anaesthesia charges 5 CD Development

EXCLUDES:

1 Non-Ionic Dye 2 Micropuncture set

6 PEDIATRIC ANGIOGRAMS 29,500 INCLUDES

1 Bed charges for 1 day 2 Physician Fee 3 Cath lab Charges

182 W.E.F. 1st January 2019 DAY CARE

4 Anaesthesia Charges 5 Diagnostic Catheters 6 Blood Gas Analysis

7 PROCEDURE

BIOPSY, COILING 88,600 to 133,000 (depending on use of consumables)

5) CATARACT SURGERY (PHACO+IOL)

S No PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

A. CATARACT SURGERY PACKAGE 40,600 47,700 64,500 81,300 93,900 (with Acrysof-single piece lens)

B. CATARACT SURGERY PACKAGE 48,900 51,800 65,800 82,600 95,100 (with Acrysof-Natural lens)

Package Includes :

1 Bed Charges for a day in respective ward / 6 Hrs. in Day Care 2 Surgeon & Anaesthetics fees. 3 Acrysof Lens (as per package opted) 4 Routine Medicines used during hospitalisation (not exceeding Rs.450/-) 5 OT Charges 6 OT Consumables not exceeding Rs. 7900/- (including one Alcon lens & 2 microsurgical blades) 7 Dressing & PHACO Charges 8 One day visit charges of opthalmology consultants

Package Excludes:

1 Room rent beyond a day / 6 hrs. in Day Care 2Investigations 3 Viscoat / Healon / BSS - Plus if used 4 Medicines / Consultation from other diciplines will be charged extra. 5 PAC Clearance will be charged extra

W.E.F. 1st January 2019 183 DAY CARE

6) DAY CARE PACKAGES

A1 THALASSEMIA PACKAGE Tariff

Thalassemia Package - Day Care (One unit of Packed Cell) 3900 Thalassemia Package - Single Room (One unit of Packed Cell) 6500 Thalassemia Package - Single Room (Two unit of Packed Cell) 7700

Package Includes: 1 Hemoglobin estimation and Cross -match. 2 Packed Cells (S/C Whole Blood). 3 Red Cell Filters 4 Bed Charges. 5 Consultation. 6 IV Cannula 7 Tegaderm 8 Gloves, Sryinges & Needles

Note a If second unit of Packed Cell (S/C Whole Blood) required Rs 900/- will be charged extra b Bedside leucocyte filters will be charged extra. c Medicines if used will be charged extra. d A Discount of 20% will be allowed on following investigations. 1 Complete Blood Count 2 Liver Function Test 3 Ferritin 4 Spine X- Rays..

2 DAY PACKAGES OBS. & GYNAECOLOGY Tariff

1 Dilatation & Curettage 17,300 2 First trimester MTP 18,900

Package Includes : a Bed Charges for daycare b OT Charges c Surgeon & Anaesthetist fees d Visiting fees of Surgeon e Consumables

184 W.E.F. 1st January 2019 DAY CARE

4 DAY PACKAGES UROLOGY Tariff

1 BLA Stent Removal 15,400

Package Includes : a Bed Charges for Day care b OT Charges d Surgeon & Anaesthetist fees e Visiting fees of Surgeon f Medicines & Consumables

W.E.F. 1st January 2019 185 IVF PKG

7) IVF Lab Packages: Tariff 1) Workup Package for IVF/ ICSI 21200 Package includes: a Consultant Clinician Charges b Investigations: LH / Estradiol x 6 (in any combination) HCG x 1 Ultrasound Vascular Dopller x 1 Semen Analysis x 1 Aerobic C&C Body Fluid x 1

Tariff 2) IVF Package 82400 3) IVF + ICSI Package 101900

Package 2) & 3) includes: a Consultant Clinician Charges, Anesthetist Charges, Physician & Embryologist Charges. b Pharmacy Medicine and Consumables used in IVF Lab. c Patient Diet charges. d IVF Lab Charges.

Note for Package 2) & 3): 1 If eggs are not retrieved in IVF Package, Rs 7000/- will be credited to the next cycle. 2 If eggs are not retrieved in IVF+ICSI Package, Rs 10000/- will be credited to the next cycle. 3 If eggs are retrieved but no fertilization in IVF/ IVF+ICSI Package, Rs 5000/- will be credited to the next cycle.

Tariff

3) IVF Package with donor sperm 182200 4) IVF + ICSI Package with donor sperm 197400

Package 3) & 4) includes: a Consultant Clinician Charges, Anesthetist Charges, Physician & Embryologist Charges. b Pharmacy Medicine and Consumables used in IVF Lab. c Patient Diet charges. d IVF Lab Charges. e Donor Sperm Charges

Note for Package 3) & 4): 1 If eggs are not retrieved in IVF Package, Rs 7000/- will be credited to the next cycle. 2 If eggs are not retrieved in IVF+ICSI Package, Rs 10000/- will be credited to the next cycle. 3 If eggs are retrieved but no fertilization in IVF/ IVF+ICSI Package, Rs 5000/- will be credited to the next cycle.

186 W.E.F. 1st January 2019 PKG KIDNEY

8) Kidney Transplant

Tariff I Kidney Transplant with Open/Lap Donor Nephrectomy : 544300/- II Kidney Transplant-HIGH RISK 605000/-

Package Includes: 1. 1. Up to 8 Days for both Donor and Recipient. For Donor 2 days in ICU & 6 days ward and for Recipient 5 days in ICU & 3 days ward. One Day Pre-Operative & 7 Days Post-Operative (Donor stay in General Ward & Recipient stay in Single Room) 2. Post Operative lab charges for the Donor & Recipient. 3. Post Operative Radiology Service for Donor & Recipient. 4.Medicines & Medical Consumables 1,15000/- Donor and Recipient 5. Recipient Pathology Services. 6. Two Dialysis . 7. Transfusion services: Four unit of Blood & Three unit of FFP. 8. Surgeon’s fees for Donor & Recipient. 9. Anesthesia service for donor and recipient. . Package Excludes: 1. Pre Operative Donor Work up Or the recipient preparation. 2. Stay more than 8 Days will be charged extra. 3. Medication like Gancyclovir, Hbig, OKT3, FK506, ATG Mycophenalate and other imported medication. including need for TPN. 4. Pre operative Dialysis. 5. Corrective Surgery if any, after transplant for complications or biopsy after 8 days. 6. Any invasive cardiac imaging or intervention for heart disease that is required post operatively. 7. HLA typing & Cross Match. 8. Difference of room rent will be charged additionally if the Donor stays in higher category of ward.

Tariff IV Cadaver Kidney Transplant 605000/- (Inclusions and exclusions as per I & II above)

W.E.F. 1st January 2019 187 PKG LITH

9) Lithotripsy

A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

Stone Less than 1Cm 38,500 44,700 55,500 58,600 89,400 Stone More than 1Cm Less than 2 Cm 44,700 49,200 63,200 66,200 109,400 Stone More than 2Cm 55,500 60,200 70,900 75,500 121,700

Package Includes: Package Excludes 1. Two Days stay in the hospital. 1. Any test/ investigations 2. Two plain X-rays of kub. 2. Bed charges beyond two days. 3. Consultants fees.

188 W.E.F. 1st January 2019 PKG GEN

10) LAPROSCOPIC SURGICAL PACKAGES

1 Laparoscopic Cholecystectomy

A/c Multi Bed Semi Pvt Single R Deluxe Suite Unit

Tariff 65,900 79,200 93,800 124,500 169,900

Package Includes: Package Excludes: 1. Bed charges for Two days stay. 1. Any investigation, Lab tests 2. Operation Theatre Charges. 2. Medicines 3. Consumable used in OT Rs. 7,000/- 3. Visit fees of Physician 4. Surgeon fees, Anaesthetist & Physician’s clearance charges.

2 Lap -Hernia

A/c Multi Bed Semi Pvt Single R Deluxe Suite Unit

Tariff 51,200 64,500 79,200 109,800 155,200

Package Includes: Package Excludes: 1. Bed charges for Two days stay. 1. Any investigation, Lab tests 2. Operation Theatre Charges. 2. Medicines 3. Consumable used in OT subject to exclusions mentioned. 3. Mesh & Stapler 4. Surgeon fees, Anaesthetist & Physician’s clearance charges. 4. Visit fees of Physician

3 Diagnostic Thoracoscopy

A/c Multi Bed Semi Pvt Single R Deluxe Suite Unit

22,700 29,300 38,100 52,800 73,200

Package Includes Package Excludes: Surgeon fees, Anesthetist fees, OT Charges. Bed Chages, Investigations, visit fees of Consumables including video cassette. consultant. Medicines, Stapler & Cartridges.

W.E.F. 1st January 2019 189 PKG GEN

4 Laparoscopic Appendicectomy

A/c Multi Bed Semi Pvt Single R Deluxe Suite Unit

Tariff 42,600 57,200 71,800 102,500 145,100

Package Includes: Package Excludes: 1. Bed charges for Two days stay. 1. Any investigation, Lab tests 2. Operation Theatre Charges. 2. Medicines 3. Consumable used in OT 3. Visit fees of Physician 4. Surgeon fees, Anaesthetist & Physician’s claearnce charges.

5 Haemorrhoidectomy + Sigmoidoscopy

A/c Multi Bed Semi Pvt Single R Deluxe Suite Unit

Tariff 42,600 57,200 71,800 102,500 145,100

Package Includes: Package Excludes: 1. Bed charges for Two days. 1. All Investigations. 2. Operation Theatre Charges. 2. Medicines. 3. Consumable used in Operation Theatre. 3. Mesh & Stapler. 4. Surgeon fees, Anaesthetist & Physician’s clearance charges. 4. Visit fees of Physician

190 W.E.F. 1st January 2019 ONCOLOGY

11) ONCOLOGY PACKAGES

A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

1 Radio Frequency Ablation (Oncology) 148,500 161,000 183,500 219,900 273,200 -Closed under LA

2 Radio Frequency Ablation (Oncology) 169,600 190,600 221,300 264,700 336,200 -Closed under sedation

3 Radio Frequency Ablation (Oncology) 173,700 193,300 227,000 269,000 341,800 -Closed under GA

4 Radio Frequency Ablation (Oncology) 173,700 200,400 233,900 284,300 375,400 -Open under GA

Package Includes: 1 Bed charges for 1 day for Sr. no: 1,2,3 and for 3 days for Sr no: 4. 2 OT / Ward Consumables & Pharmacy Medicines. 3 Procedure Fees of Consultant, Radiologist 4 OT Charges. 5 Cost of Equipment 6 Anaesthetist fee 7 Investigations as listed below. HB TLC DLC PLATELETS COUNT BT PT CT Alpha pheto protein / CEA X -RAY CHEST ECG ULTRASOUND WHOLE ABDOMEN

W.E.F. 1st January 2019 191 ONCOLOGY

A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

Mammographic Localization with 12,600 12,600 12,600 12,600 12,600 J wire Needle

Package Includes a) Radiologist Charges b) Cost Of J-Wire, Mammographic X-Ray Plates c) Ultrasound Charges

Package Excludes a) Investigation Charges b) Medicines c) Bed Charges

A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

6 Sentinel Node Biopsy 14,100 19,600 21,000 26,600 36,400

Package Includes a) Gamma Probe Charges b) Surgeon Charges c) Anaesthetist Charges d) Operation Theatre Charges

Package Excludes a) Bed Charges b) Medicines & Consumable c) Investigation Charges other than Gamma Probe

Day Care

1075665 APCEDEN DENDRITIC CELL THERAPY SURGICAL PACKAGE 680,000 Package Includes a) Bed charges for Day Care (3 to 4 Hrs) b) Investigations

192 W.E.F. 1st January 2019 ONCOLOGY

c) Serum Chemistries d) Serum Immune-globulin e) Coagulation Panel f) CT/MRI Plain g) Apharesis h) Consultations(Oncologist)

Package Excludes a) Medicine b) Consultations other than S.no. (d) c) Investigations other than s.no.(b)

1074625 PIPAC (PACKAGE) SURGICAL PACKAGE A/c Multi Semi Pvt Single R Deluxe Suite Bed Unit

375,000 425,000 495,000 575,000 740,000

Package Includes a) Bed charges for one day stay. b) Operation Theatre Charges c) Medicine & consumables upto 17,000/-. d) Surgeon fees & Anaesthetist charges. e) Cost of Equipment

Package Excludes a) Investigations b) Medicines & Consumable above 17,000/-. c) Consultations

1076071 HIPEC(PACKAGE) SURGICAL PACKAGE A/c Multi Semi Single R Deluxe Suite Bed Unit Pvt

750,000 850,000 1,000,000 1,150,000 1,500,000

Package Includes a) Bed charges for 10 days stay(Inclusive of 3 days ICU Charges) b) Operation Theatre Charges c) Medicine & consumables upto 225000/. d) Surgeon fees & Anaesthetist charges. e) Cost of Equipment f) Physiotherapy Charges upto 7500/ g) Blood Components upto 25000/-

W.E.F. 1st January 2019 193 ONCOLOGY

Package Excludes a) Investigations b) Medicines & Consumable above 225000/-. c) Consultations d) Blood Components over&Above 25000 e) Physiotherapy over&Above 7500/

A/c Multi Bed Unit

1078282 INTERSTITIAL IMPLANT (ACCELERATED PARTIAL 242,800 BREAST IRRADIATION) SURGICAL PACKAGE

1078283 INTERSTITIAL IMPLANT (HEAD NECK/SARCOMA) 242,800 PACKAGE SURGICAL PACKAGE

Package Includes 1 Bed Charge 7 Days General Ward 2 Operation Theatre Charges 3 Consumables 4 Surgeon fees & Anaesthetist charges. 5 Consultation fees Radiation Oncologist

Package Excludes a) Cathter Charges b) Investigations c) Consultations d) Medicine

Brachy Therapy 3 Application(Package)(Without Anesthesia and USG) 48,300

Package Includes 1 Bed Charge Half Day General Ward 2 Operation Theatre Charges 3 Consumables 4 Surgeon fees & Anaesthetist charges. 5 Consultation fees Radiation Oncologist

Package Excludes (a) Investigations (b) Consultations (c ) Medicine (d) Cather Charges

194 W.E.F. 1st January 2019 ONCOLOGY

Brachy Therapy 3 Application(Package) 54600

Package Includes 1 Bed Charge Half Day General Ward 2 Operation Theatre Charges 3 Consumables 4 Surgeon fees & Anaesthetist charges. 5 Consultation fees Radiation Oncologist

Package Excludes (a) Investigations (b) Consultations (c ) Medicine (d) Cather Charges

Brachy Therapy 3 Application(Package)(Without USG) 48,300

Package Includes 1 Bed Charge Half Day General Ward 2 Operation Theatre Charges 3 Consumables 4 Surgeon fees & Anaesthetist charges. 5 Consultation fees Radiation Oncologist

Package Excludes (a) Investigations (b) Consultations (c ) Medicine (d) Cather Charges

Brachy Therapy 3 Application(Package)(Without Anesthesia) 49800

Package Includes 1 Bed Charge Half Day General Ward 2 Operation Theatre Charges 3 Consumables 4 Surgeon fees & Anaesthetist charges. 5 Consultation fees Radiation Oncologist

Package Excludes (a) Investigations (b) Consultations (c ) Medicine (d) Cather Charges

W.E.F. 1st January 2019 195 LIVER TX.

Liver Transplant

Package General Ward/ Single Room Semi Private

1 Adult Transplant Package – Normal 2,540,000 2,801,500

2 Adult Transplant Package – High Risk 3,207,000 3,535,200

3 Peadiatric Transplant Package – Normal 2,006,300 2,201,200

4 Peadiatric Transplant Package – High Risk 2,406,600 2,641,400

Inclusions: a) 21 days (7 days in ICU) stay for recipient and 10 (3 days in ICU) days stay for donor in the single room.” b) Lab Investigations c) Cost of Surgery d) Blood Component e) CT Scan – 2 numbers only f) Medical & Nursing care g) Medicines & Medical Consumables 6,00,000/- Donor and Recepient. (ceiling i.e. donor consumables 1.25 lac, medicine, 65,000/- recipient 1.10 lac ,medicine 3 lac) h) Professional fees of the Surgeon, Anaesthetist, Gastroentrologist, Physician and Radiologist for the duration of the package. I) Diet & physiotherapy j) Reopening during the period of package.

Exclusions: a) Bed Charges and all investigations for stay beyond the duration of the package. b) Medicines & Injections like Ambisome, Caspofungin, IVIG and Hbs Ig Immunoglobulin (Hepabric). c) MRI d) DSA Lab procedures if any. e) Any other additional procedure with Liver Transplant will be charged extra as per applicable tariff over & above the package. f) Visit charges of Consultants, other than those mentioned at serial (h) of Inclusions and drugs prescribed by them.

Please note: a) Price of the package will be payable in full at the time of admission. Other amounts, where applicable as above, will be billed during the course of treatment. b) For transfusion, blood should be donated by patient’s relatives & friends.

196 W.E.F. 1st January 2019 ALLOGENEIC & AUTOLOGOUS BMT

Package Name Tariff

I Allogeneic Bone Marrow Transplant 1,761,000 The Package is inclusive of:

1. Bed Charges for 42 days in ICU/Isolation Room. 2. Platelets up to 30 units 3. Red Cells up to 15 units 4. CBC with Diff, chemistry with renal fn Uric Acid 5. LFT - Twice Weekly 6. Chest X-ray - Weekly 7. Febrile neutropenia – Blood C/S(aerobic/anerobic), fungal cultures, Galactomanaan assay 8. Drug monitoring – tacro limus level (initially twice weekly, then weekly) 9. Immunoglobulin levels, CD4:CD8 10. Bone Marrow transplant fee for consultants

The Package does not include: 1. Bed Charges for stay beyond the duration of the package 2. All investigations beyond the duration of the package 3. Investigations/Professional Fee/Treatment in OPD - Pre Admission and Post Discharge 4. All investigations not included above 5. Drugs and Medicines 6. Drug monitoring – rapamycin level, voriconazole level 7. CMV monitoring, EBV monitoring (if patients recd ATG) 8. Visit Fee and other Professional fee of Doctors excluding BMT consultants

Tariff II Autologous Bone Marrow Transplant Package 1,137,900

Particulars

(A) Bed Charges Upto 21 days covered Only Isolation Ward

(B) Investigation 2 D Echo(Color Doppler) Portable TSH--(Chemiluminescence) CORTISOL --(Chemiluminescence) Electrolytes (Na,K,Cl) (ISE) Calcium-(Spectrophotmetric) Renal Profile-serum (spectrophotometri Potassium (K+) (ISE) Sodium (Na+) (ISE) CBC (Hb,TLC,ESR,PCV,Plt,DLC)

W.E.F. 1st January 2019 197 ALLOGENEIC & AUTOLOGOUS BMT

Immunoflowcytometry Marker Liver Function Test (Spectrophotmetric) Blood Culture, Urine Culture

(C) Blood Components A) Platelets on Cell Separator & Concentrates(@15350*5) B) Red Blood Cells(@4910*4)

(D) Pharmacy( Drug Cost)

(E) Procedure Fees , consultation & Work-up(Professional Fees)

(F) Femoral Line & Central Line Insertion

(G) Consumables

(H) Stem Cell Harvest 2 Sitting Professional fees of Transfusion Medicine(Consultant)

Grand Total Round up

Package Exclusions: Any other investigation apart from above mentioned Like, MRI, CT Scan, GC Based PET/CT Scan (Whole Body),

198 W.E.F. 1st January 2019 RADIO IODINE THERAPY

Radio Iodine Therapy package

Pacakge Single Room 1 RADIO IODINE THERAPY (100 mCi) (PACKAGE) 86900 2 RADIO IODINE THERAPY (150-200-250mCi) (PACKAGE) 121600 3 LUTETIUM - DOTA PRRT THERAPY 100 MCI (PACKAGE) 191000 4 LUTETIUM - DOTA PRRT THERAPY 150 MCI (PACKAGE) 254700 5 LUTETIUM - DOTA PRRT THERAPY 200 MCI (PACKAGE) 318400

Inclusions: Bed Charges (Single Room 2 Days for Radio Iodine Therapy 100 mCi , 3 Days for Radio Iodine Therapy 150mCi and 1 Days for LUTETIUM - DOTA PRRT THERAPY Visit Charges fo Nuclear Medicine Consultant Medicine upto 800/-- only Documentation Charges Post Therapy Scan(I-131 Whole Body Scan) Sodium Iodine Solution Professional charges of Nuclear Medicine Consultant

W.E.F. 1st January 2019 199 THERASPHERE Y-90

(A) Pre - Therasphere Assesment 333,600

Includes Bed Charges Covered for 1 Day (Semiprivate) only Invesigation (Nuclear Medicine) a) Lung Perfusion Professional Charges DSA Lab Charges Abdominal Angiography Abdominal Embolization DSA Consumables

(B) Y-90 Definitive Treatment by Angiogram 1,082,300

Includes Bed Charges Covered for 2 Days (Semiprivate) only Routine Investigation Liver Function Test (Spectrophotmetric) Renal Profile-serum (spectrophotometric) ECG CBC (HB,PCV,ESR,TLC,DLC,Plt C) PT / PT-INR (clotting assay) aPTT/PTTK (Clotting assay) Xray Chest AP Medicine (Nuclear Medicine) Professional Charges DSA Lab Charges DSA Consumables

200 W.E.F. 1st January 2019 NEONATAL & PAED

NEONATAL AND PAEDIATRIC SURGERY PACKAGES

Bed Category NPS 1 NPS 2 NPS 3 NPS 4 NPS 5 NPS 6

A/C Multi Bed 66200 112500 162800 201700 379200 121100

SEMI PVT 87600 148200 210900 273800 514200 157700

SINGLE 105200 176500 255500 336400 625600 188100

DELUXE 142000 236800 331600 409200 750000 251100

SUITE 234600 392300 562300 678000 1240300 409900

Number of 47912217 Packages days

Inclusions:

1 Days of stay as per packages listed above:Beyond the stipulated period appropriateadd-on tariffs will apply with all the conditions mentioned pertaining to “add on packages”.

2 O T Charges

3 Lab Investigation(Hematology,Renal& Liver Profile,HIV,Hep B&C serology, Blood Gas Analysis)

4 Medical and Nursing Care

5 Medicines and Medical Consumables(list of important consumables is enclosed).

6 X-rays and ECG’s

7 CT AND MRI for packae NPS 4

8 Blood& Blood product transfusions except use of cell separator,cryoprecipitate,leukodeplete u n i t s & irradiated blood.Use of these should be charged as per currently prescribed hospital blood bank rates. Rs.1200/ will be charged in favor of the blood bank in all cases where request for alliquoted blood is made towards three alliquoted units. If one unit than Rs.500/

9 Professional Fees of the consultants.

10 Reopening & delayed closure of chest/abdomen during the period of the package.

11 Chest Physiotherapy-twice daily.

W.E.F. 1st January 2019 201 NEONATAL & PAED

12 Diet

13 one head and abdomenal ultrasound for all patients.

14 Peritoneal Dialysis in NPS3 and NPS4 and will be included in the package for the duration of the package as mentioned above.Peritoneal dialysis will be initiated and supervised by consultants,only the dialysis fluid is hereby covered.

15 Total Parental Nurtition in NPS 3 and NPS 4 will be included in the package for the duration of the package as metione above.

MEDICINES & MEDICAL CONSUMABLES

1 Arterial line placement : Adequate sized I/V cannula, pressure monitoring lines & transducer

2 CVP Placement : Adequate sized double or triple lumen CVP Kit, pressure monitoring line & transducer

3 Peripheral I/V line : Adequate sized I/V cannula, 100 cm line.

4 Anethetic gases : Sevoflurane induction & isoflurane maintenance.

5 Adequate doses based on the body weight of patient of OPOIDS (Morphine, Fentanyl), RELAXANTS (Pavulon or Vecuron or Rocuronium), Sedatives (Midazolam, Diazapam), and special medicines as per requirement (Propofol and Etomidate, Ketamine)

6 INOTROPES & VASODILATORS.

7 Heparin

8 suture material as per the need of the type of surgery

9 Arterial line and venous drainage canulae as per anatomy and body weight of the patient.

10 5% albumin: 50cc - three in quantity.

11 Antibiotics : Cefuroxime for prophylaxis and vancomycin a

nd Meropenem in cases of sepsis only during the duration of package.

12 Bactroban Ointment.

13 Steristrips and sterile dressing.

202 W.E.F. 1st January 2019 NEONATAL & PAED

14 Chest tubes based on body weight.

15 Syringes 50,20,10,2,1 cc as needed.

16 Micropore tape

17 Tegaderm - 5

18 Crystalloid solutions.

Exclusions:

Any Implant of any kind.

FOR PATIENTS ON SURGERY PACKAGES IF THE PATIENT OVERSTAYS, THE FOLLOWING PACKAGES MAY APPLY WHICH DO NOT INCLUDE THE MEDICINE COSTS:

ADD-ON PACKAGES

On VENTILATOR = Rs. 10,000/ Day (All inclusive except medicine)

Off VENTILATOR = Rs. 5,000/ Day ( All inclusive except medicine)

W.E.F. 1st January 2019 203 NEONATAL & PAED

2 PAEDIATRIC SURGERY  PACKAGES

TARIFF

Category A/c Multi Semi Pvt. Single Deluxe Room Suite Bed Unit Room A 58,900 78,200 94,300 125,100 168,600

B 41,500 54,100 66,600 87,600 108,500

C 28,400 37,700 46,100 60,700 76,900

D 18,500 24,000 29,300 39,000 49,200

Category A 1 Branchial Sinus Excision 2 Epispadias Repair (Major) 3 Hypospadias Stage I/Hypospadias II/Single Stage (Major) 4 Incisional Hernia Repair 5 Laparoscopic Hernia / Recurrent Hernia Repair 6 Thyroglossal Cyst 7 Any other Procedure (not otherwise specified)

Category B 1 Bronchoscopy & Removal Foreign Body 2 Cystoscopy, MCU, Endoscopic Deflux Injection for VUR 3 Cystoscopy, MCU, Transurethral Fulguration (TUF) of valves 4 Exploration torsion testies 5 Epispadias (Minor) 6 Feminising Genitoplasty 7 Herniotomy 8 Hydrococele 9 Hypospadias Stage I/Hypospadias II/Single Stage (Minor) 10 Laparoscopic Stage I Orchidopexy / Orchidectomy 11 Laparoscopy (Intrabdominal testis,cyst,meckels,CAH) 12 Masculanising Genitoplasty 13 Orchidectomy 14 Orchidopexy 15 Preauricular Sinus 16 Soft Tissue Excision Biopys (Major) 17 Testicular Prosthesis 18 Thoracoscopy & Drainage / ICTD 19 Umbilical Hernia Repair 20 Any other Procedure (not otherwise specified)

204 W.E.F. 1st January 2019 NEONATAL & PAED

Category C 1 Cystoscopy, MCU, RGP, Stenting 2 Cystoscopy, MCU, Bladder Biopsy 3 EUA, MCU, Cystoscopy, Vaginogram, Vaginography 4 Urethral Fistula Closure (Minor) 5 Circumcision, MCU 6Meatoplasty 7 Wound Debridment (major) 8 Central Venous Line Open 9 Oesophasoscopy & Oesophageal dilation (antegrade/retrograde) 10 Laparoscopy (Diagnostic) 11 Bronchoscopy (Diagnostic / Minor Procedure) 12 Thoracoscopy (Diagnostic / Minor Procedure) 13 Any other Procedure (not otherwise specified)

Category D 1 Incision & Drainage 2 Lymphnode Incision Biopsy 3 Meatal Dilation 4 Meatotomy 5 Urethral Dilatation 6 Dressing Change 7EUA 8 Intercoastal Drainage 9 Peritoneal Drainage 10 Debridment Wound (minor) 11 Circumcision 12 VCUG / MCUG 13 Any other Procedure (not otherwise specified)

I. Package Includes: 1 General Ward bed charges for one day 2 Surgeon, Anesthetics fee and OT Charges 3 Investigations (Hb,TLC,DLC,Blood grouping) 4 Professional fees of the Consultants in Paediatric Surgery / Paediatric Anesthesia & Paediatric Physician 5 Medicines & Consumables

II. Package Excludes: 1 Bed Charges for stay beyond the duration of the package 2 Investigations other than covered under the Package 3 Visit charges of Consultants, other than those mentioned at serial (4) of I above

W.E.F. 1st January 2019 205 BARIATRIC SURGERY

Package for Bariatric Surgery

S. No Package Name Package Cost

1 Bariatric Surgery - I 360,000 (Exculding Investigations to be done in OPD on Payment basis) 2 Bariatric Surgery - II 415,000 3 Bariatric Surgery - III 450,000 4 Bariatric Surgery - IV 550,000 5 Bariatric Surgery - V 650,000

Includes : 1. Bed charges for three days stay. 2. Surgeon fees & Anaesthetist charges. 3. Operation Theatre Charges. Assistant Surgeon fees 4. O T Consumables 5.Counsultions charges ( Surgeon, Physician & Anesthesit charges) Excludes : 1. Cost of Ring 2. Cost of Investigations not includes in Bariatric Surgery package -I 3. Consultaion Any other speciality

206 W.E.F. 1st January 2019 ORTHOPEDIC

Department : Orthopedic

1064069 REGROW SURGICAL PACKAGE

A/c Multi Bed Unit A/c Multi Bed Unit A/c Multi Bed Unit A/c Multi Bed Unit 280,000 292,000 306,000 324,000

1064069 REGROW BILATERAL HIPSURGICAL PACKAGE

A/c Multi Bed Unit A/c Multi Bed Unit A/c Multi Bed Unit A/c Multi Bed Unit 510,000 525,000 543,000 567,000

Package Includes a) Bed charges for 2 days stay. b) Operation TheatreCharges c) Medicine & consumables d) Surgeon fees & Anaesthetist charges.

W.E.F. 1st January 2019 207 INVASIVE PROCEDURE

SERVICE SERVICENAME Code ID MULTI SEMI SINGLE DELUXE SUITE ID BED PRIVATE ROOM UNIT / ICU / HDU / Day Care DENTAL 1025255 BILATERAL SAGITTAL Dent 1 43,400 56,300 71,400 99,400 142,800 SPLIT OSTEOTOMY 1025202 BONE GRAFTING FOR Dent 2 9,100 11,900 15,000 21,000 30,000 IMPLANTS 1025238 BUCCAL FAT PAD Dent 3 31,200 40,500 51,500 71,600 102,700 GRAFTING/NASO LABIAL FLAP 1025270 CLOSED REDUCTION OF Dent 4 22,400 29,200 37,000 51,700 74,100 JAW FRACTURE 1025266 CONDYLECTOMY Dent 5 31,200 40,500 51,500 71,600 102,700

1025269 ELEVATION OF Dent 6 12,300 16,000 20,300 28,100 40,400 ZYGOMATIC COMPLEX ARCH 1025206 ENUCLEATION OF Dent 7 26,400 34,200 43,500 60,400 86,700 BILATERAL CYST 1025204 ENUCLEATION OF Dent 8 22,400 29,200 37,000 51,700 74,100 UNILATERAL CYST 1025207 EXCISION OF TUMOR Dent 9 26,400 34,200 43,500 60,400 86,700 FROM MAXILLA AND MANDIBLE 1025252 FIXATION OF Dent 11 43,400 56,300 71,400 99,400 142,800 DISTRACTION BILATERAL 1025247 FIXATION OF Dent 12 26,400 34,200 43,500 60,400 86,700 DISTRACTOR UNILATERAL 1025241 FIXATION OF Dent 13 31,200 40,500 51,500 71,600 102,700 PLOYETHYLENE IMPLANT 1025235 GAP ARTHROPLASTY Dent 14 43,400 56,300 71,400 99,400 142,800 BILATERAL 1025218 GAP ARTHROPLASTY Dent 15 26,400 34,200 43,500 60,400 86,700 UNILATERAL 1025195 INCISION AND DRAINGE Dent 16 9,900 12,700 16,300 22,600 32,300 OF ABSCESS 1025239 LOCAL SOFT TISSUE FLAP Dent 17 12,300 16,000 20,300 28,100 40,400 ADVANCEMENT

208 W.E.F. 1st January 2019 INVASIVE PROCEDURE

1025217 MALUNITED FRACTURE Dent 18 26,400 34,200 43,500 60,400 86,700

1025209 MARGINAL RESECTION OF Dent 19 18,300 23,700 30,000 41,800 60,100 MANDIBLE 1025201 MAXILLARY SINUS LIFT Dent 20 25,100 32,600 41,500 57,800 82,800 WITH BONE GRAFT 1025182 MINOR DENTO- Dent 21 12,300 16,000 20,300 28,100 40,400 ALVEOLAR SURGERY GARDE -2 1025178 MINOR DENTO- Dent 22 6,100 7,900 10,100 14,000 20,000 ALVEOLAR SURGERY GRADE- 1 1025262 MUSCLE DEBULKING AND Dent 23 31,200 40,500 51,500 71,600 102,700 OSTEOPLASTY 1025268 OPEN REDUCTION Dent 24 43,400 56,300 71,400 99,400 142,800 FIXATION OF JAW FRACTURE MULTIPLE 1025267 OPEN REDUCTION Dent 25 26,400 34,200 43,500 60,400 86,700 FIXATION OF JAW FRACTURE SINGLE 1025216 ORBITAL FLOOR Dent 26 26,400 34,200 43,500 60,400 86,700 FRACTURE 1025198 PERIAPICAL SURGERY Dent 27 12,300 16,000 20,300 28,100 40,400

2527 SINGLE DENTAL Dent 28 3,700 4,800 6,200 8,700 12,400 EXTRACTION 1025199 PERIPHERAL Dent 29 12,300 16,000 20,300 28,100 40,400 NEURECTOMY 1025214 RECONSTRUCTION PLATE Dent 30 31,200 40,500 51,500 71,600 102,700 FIXATION 1025253 REMOVAL OF BONE PLATE Dent 31 18,400 23,800 30,100 42,000 60,400

1025196 REPAIR OF ORO ANTRAL Dent 32 12,300 16,000 20,300 28,100 40,400 FISTULA BY BUCCAL ADVANCEMENT 1025197 REPAIR OF ORO ANTRAL Dent 33 20,300 26,400 33,500 46,500 66,900 FISTULA BY PALATAL ADVANCEMENT 1025236 SAGITTAL SPLIT Dent 34 31,200 40,500 51,500 71,600 102,700 OSTEOTOMY UNILATERAL 1025211 SEGMENTAL RESECTION Dent 35 31,200 40,500 51,500 71,600 102,700 OF MANDIBLE

W.E.F. 1st January 2019 209 INVASIVE PROCEDURE

1025264 SEQUESTRECTOMY Dent 36 31,200 40,500 51,500 71,600 102,700 SAUCERIZATION DECORTICATION IN OSTEOMYELITIS 1025172 SURGICAL EXTRACTION Dent 37 14,600 18,900 24,000 33,500 48,100 OF IMPACTED MANDIBULAR MOLAR GRADE -1 1025174 SURGICAL EXTRACTION Dent 38 19,400 25,200 32,000 44,600 63,900 OF IMPACTED MANDIBULAR MOLAR GRADE- 2 1025171 SURGICAL EXTRACTION Dent 39 12,300 16,000 20,300 28,100 40,400 OF IMPACTED MAXILLARY MOLAR 1025193 TOTAL EXTRACTION Dent 40 18,300 23,700 30,000 41,800 60,100 MANDIBLE 71266 TMJ ARTHROCENTESIS Dent 41 20,300 26,400 33,500 46,500 66,900

1025189 TOTAL EXTRACTION Dent 42 18,300 23,700 30,000 41,800 60,100 MAXILLA 1025215 ZYGOMATIC COMPLEX Dent43 26,400 34,200 43,500 60,400 86,700 FRACTURE 1025194 EXCISIONAL BIOPSY Dent44 9,900 12,700 16,300 22,600 32,300

2999 GAP ARTHROPLASTY Dent45 31,200 40,500 51,500 71,600 102,700 WITH CORONOIDECTOMY 1022670 GENIOPLASTY Dent46 31,200 40,500 51,500 71,600 102,700

27833 INCISSIONAL BIOPSY Dent 47 6,700 8,800 11,100 15,300 22,100

71264 LEFORT I OSTEOTOMY Dent48 31,200 40,500 51,500 71,600 102,700

71263 ORAL SUBMUCOUS Dent 49 31,200 40,500 51,500 71,600 102,700 FIBROSIS -RESECTION OF BANDS 1034578 PARTIAL MAXILLECTOMY Dent50 26,400 34,200 43,500 60,400 86,700

44880 SEGMENTAL OSTEOTOMY Dent 51 26,400 34,200 43,500 60,400 86,700 (EACH) 1034577 TOTAL MAXILLECTOMY Dent52 31,200 40,500 51,500 71,600 102,700

210 W.E.F. 1st January 2019 INVASIVE PROCEDURE

EAR NOSE AND THROAT

13881 ADENO TONSILLECTOMY Ent 1 25,200 33,600 42,300 58,900 84,000

6991 ADENOIDECTOMY Ent 68 25,200 33,600 42,300 58,900 84,000

90655 ATTICOTOMY Ent 119 35,000 45,700 55,700 76,700 108,400

87513 BAHA IMPLANTATION(LT) Ent 69 42,000 52,700 62,700 83,800 115,300

87512 BAHA IMPLANTATION(RT) Ent 70 42,000 52,700 62,700 83,800 115,300

64591 BILATERAL ANTRUM Ent 3 4,300 5,700 7,100 10,100 14,100 PUNCTURE 6994 BILATERAL Ent 4 35,000 43,500 52,000 68,800 93,800 STYLOIDECTOMY 49574 BILATERAL Ent 5 31,600 42,200 52,300 73,200 104,900 TRANS. ANTRAL ETHMOIDECTOMY 21663 BIOPSY Ent134 4,300 5,600 7,000 9,900 14,100

82721 BRANCHIAL FISTULA Ent 71 25,200 33,600 42,300 58,900 84,000 REMOVAL 3130 BRONCHOSCOPE RIGID Ent 6 28,000 32,800 37,400 46,400 60,200 FOREIGN BODY REMOVAL 101849 CANALPLASTY Ent 126 28,000 32,800 37,400 46,400 60,200

63273 CAVITY OBLITERATION Ent 7 35,000 45,700 55,700 76,700 108,400

2347 CHANNEL ATRESIA Ent 8 35,000 45,700 55,700 76,700 108,400 RECANALISATION 86323 CHEEK BIOPSY Ent 72 10,300 14,100 17,500 24,400 35,000

82534 CHONCHA PLASTY Ent 127 28,000 32,800 37,400 46,400 60,200

1047505 COBLATION OF TONGUE Ent139 35,000 45,700 55,700 76,700 108,400 (LARGE) 1047506 COBLATION OF TONGUE Ent140 25,200 33,600 42,300 58,900 84,000 (SMALL) 67976 COBLATION OF TONSILLE Ent 73 35,000 45,700 55,700 76,700 108,400

9350 COCHLEAR IMPLANT Ent 74 42,000 52,700 62,700 83,800 115,300

W.E.F. 1st January 2019 211 INVASIVE PROCEDURE

84099 COCHLEAR IMPLANT Ent 75 42,000 52,700 62,700 83,800 115,300 (LEFT) 84100 COCHLEAR IMPLANT Ent 76 42,000 52,700 62,700 83,800 115,300 (RIGHT) 71305 COCHLEAR Ent 77 84,100 105,100 125,400 167,400 230,600 IMPLANTATION (A) (BILATERAL) 71305 COCHLEAR Ent 77 84,100 105,100 125,400 167,400 230,600 IMPLANTATION (BILATERAL) 3248 COMMANDO'S Ent 9 62,800 83,900 104,900 146,900 209,200

64604 CONCHAPLASTY Ent 78 28,000 32,800 37,400 46,400 60,200

66045 CONCHAPLASTY(LEFT) Ent 79 28,000 32,800 37,400 46,400 60,200

66044 CONCHAPLASTY(RIGHT) Ent 80 28,000 32,800 37,400 46,400 60,200

2469 CORTICAL Ent 10 35,000 45,700 55,700 76,700 108,400 MASTOIDECTOMY, MODIFIED RADICAL 64607 CORTICAL Ent 128 35,000 45,700 55,700 76,700 108,400 MASTOIDECTOMY, MODIFIED RADICAL 2541 DIRECT LARYNGOSCOPY Ent 11 16,900 19,200 20,900 25,300 31,800

66868 DIVISION OF SYNCHIAE Ent 81 28,000 36,400 45,200 61,600 86,700

2605 ENDOLYMPHATIC SAC Ent 12 42,000 52,700 62,700 83,800 115,300 DECOMPRESSION 66585 ENDOSCOPIC Ent 82 25,200 33,600 42,300 57,800 58,500 ADENOIDECTOMY 67339 ENDOSCOPIC Ent 129 30,700 40,700 50,900 72,700 104,400 CAUTERIZATION OF MULTIPLE NASAL BLEEDERS 88382 ENDOSCOPIC DCR Ent 89 34,400 45,700 55,700 76,700 108,400

85867 ENDOSCOPIC NASAL SPUR Ent 93 35,000 45,700 55,700 76,700 108,400 RESECTION 88520 ENDOSCOPIC NASAL Ent 35,000 45,700 55,700 76,700 108,400 TUMOR REMOVAL 93(A)

212 W.E.F. 1st January 2019 INVASIVE PROCEDURE

78758 ENDOSCOPIC Ent 88 28,700 33,400 38,100 47,100 60,800 SPURRECTOMY 93230 EVACUATION OF POST Ent 118 14,100 18,600 22,800 31,000 43,700 OPERATIVE SINUS CAVITY 64633 EXCISION OF Ent 130 42,000 52,700 62,700 83,800 115,300 ANGIOFIBROMA 88383 EXCISION OF EXTERNAL Ent 90 35,000 45,700 55,700 76,700 108,400 CANEL CHOLESTATOMA 69703 EXCISION OF Ent 83 42,000 52,700 62,700 83,800 115,300 NASOPHARYNGEAL MASS 79013 EXCISION OF P.A. SINUS Ent 84 29,300 33,900 38,700 47,800 61,300

81490 EXCISION OF P.A. SINUS Ent 85 58,600 68,000 77,400 95,600 122,700 (BILATERAL) 81488 EXCISION OF P.A. SINUS Ent 86 29,300 33,900 38,700 47,800 61,300 (LEFT) 81489 EXCISION OF P.A. SINUS Ent 87 29,300 33,900 38,700 47,800 61,300 (RIGHT) 3530 EXCISION OF SEBACEOUS Ent 13 16,900 19,300 20,900 25,300 31,900 CYST 3515 EXCISION PHARYNGEAL Ent 14 42,000 52,700 62,700 83,800 115,300 DIVERTICULUM 27591 EXCISIONS Ent 15 42,000 52,700 62,700 83,800 115,300 ANGIOFIBROMA 77600 EXTENDED FESS Ent 91 63,100 78,300 93,100 168,300 123,200 23160 FACIAL NERVE Ent 16 42,000 52,700 62,700 83,800 115,300 DECOMPRESSION 23191 FESS Ent 17 35,000 45,700 55,700 76,700 108,400

82552 FESS (BILATERAL) Ent 94 70,100 91,200 111,300 153,300 216,400

69725 FESS BALLOON Ent 95 35,000 45,700 55,700 76,700 108,400 SINOPLASTY

49575 FOREIGN BODY REMOVAL Ent 18 8,300 9,200 10,300 12,300 15,200 EAR 28864 FRACTURE SETTING Ent 19 23,500 28,400 33,100 42,000 55,700 NASAL BONE 3621 GLOMUSJUGULARE Ent 20 56,100 69,900 84,100 111,600 153,400 TUMOR

W.E.F. 1st January 2019 213 INVASIVE PROCEDURE

1047508 GROMMET INSERTION Ent141 16,900 19,200 20,900 25,300 31,800

1047772 GROMMET INSERTION Ent142 16,900 19,200 20,900 25,300 31,800 (LEFT) 1047771 GROMMET Ent143 16,900 19,200 20,900 25,300 31,800 INSERTION(RIGHT) 50270 HEMI GLOSSECTOMY Ent 21 48,900 63,100 77,200 104,700 146,600 (ENT) 3649 HEMI GLOSSECTOMY Ent 22 63,100 77,000 91,100 118,700 160,400 WITH RADICAL NECK DESSECTION 3650 HEMI LARYNGECTOMY Ent 23 42,000 50,500 59,000 75,800 100,800

6856 HEMITHYROIDECTOMY Ent 24 48,900 63,100 77,200 04,700 146,600

3672 HYPOPHARYNGOSCOPY Ent 25 16,900 19,300 20,900 25,300 31,900 EXAM 49576 LARYNGECTOMY WITH Ent 124 52,300 70,200 87,300 22,100 174,600 BLOCK DISSECTION 7001 LARYNOGOFISSURE Ent 26 48,900 57,500 66,000 82,800 107,600

70224 LASER MICRO LARYNGEAL Ent 96 42,000 54,600 67,700 92,600 130,200 SURGERY 1086154 LINGUAL Ent 145 48,900 63,100 77,200 104,700 146,600 TONSILLECTOMY 19949 LYMPH NODE BIOPSY Ent 27 21,000 22,700 24,600 27,900 33,200

78849 LYMPH NODE Ent138 84,200 45,300 49,200 55,800 66,200 BIOPSY(BILATERAL) 7000 MICRO LARYNGEAL Ent 28 28,000 36,400 45,200 61,600 86,700 SURGERY 82356 MIDDLE MEATAL Ent 98 23,500 28,400 33,100 42,000 55,700 ANTROSTOMY 49577 MODIFIED RADICAL Ent 29 35,000 45,700 55,700 76,700 108,400 MASTOIDECTOMY 6971 MYRINGOPLASTY Ent 30 35,000 43,500 52,000 68,800 93,800

64663 MYRINGOTOMY Ent 31 14,100 18,600 22,800 31,000 43,700

72188 MYRINGOTOMY (LEFT) Ent 99 14,100 18,600 22,800 31,000 43,700

214 W.E.F. 1st January 2019 INVASIVE PROCEDURE

72186 MYRINGOTOMY (RIGHT) Ent 100 14,100 18,600 22,800 31,000 43,700

21667 NASAL CAUTARY Ent 32 11,200 12,400 12,800 14,500 16,400

79690 NASAL CAUTERY Ent 101 22,400 24,700 25,700 28,800 33,000 (BILATERAL) 65665 NASAL PACKING ANT Ent 33 8,300 10,100 12,000 15,200 20,500

65666 NASAL PACKING POST Ent 34 14,100 15,600 17,500 20,900 26,100

76601 NASAL POLYPECTOMY Ent 102 28,000 32,800 37,400 46,400 60,200

49579 OBLITERATION Ent 103 31,600 42,200 52,300 73,200 104,900

49580 OESOPHAGOSCOPY RIGID Ent 35 28,000 32,800 37,400 46,400 60,200 FOREIGN BODY REMOVAL 96821 Optic Nerve Decompression Ent 115 42,000 52,700 62,700 83,800 115,300

49581 OROANTRAL FISTULA Ent 36 35,000 41,600 48,700 63,000 84,000 REPAIR 33005 OSSICULPLASTY Ent 37 35,000 43,500 52,000 68,800 93,800

76599 PALATOPLASTY Ent 104 25,200 33,600 42,300 58,900 84,000

67931 PALTOPLASTY(LASER UP3) Ent 105 35,000 45,700 55,700 76,700 108,400

10249 PARATHYROIDECTOMY Ent 38 48,900 57,500 66,000 82,800 107,600

11674 PARTIAL GLOSSECTOMY Ent 39 42,200 56,100 70,200 97,700 139,700

50271 PARTIAL GLOSSECTOMY Ent 125 48,900 63,100 77,200 104,700 146,600 (ENT) 23894 PARTIAL MAXILLECTOMY Ent 40 48,900 63,000 77,100 104,600 146,500

21669 PERITONSILLAR ABCESS Ent 132 21,000 22,700 24,600 27,900 33,200 DRAINAGE 49571 PERITONSILLAR ABSCESS Ent 41 21,000 25,700 30,500 39,500 53,100 DRAINAGE WITH ANESTHESIA 93235 PLACEMENT OF SEPTAL Ent 117 14,100 18,600 22,800 31,000 43,700 TEFLON PLATE (INTRA OPERATIVE) 26119 RADICAL MASTECTOMY Ent 123 31,600 42,200 52,300 73,200 104,900

W.E.F. 1st January 2019 215 INVASIVE PROCEDURE

64695 RADICAL Ent 43 35,000 45,700 55,700 76,700 108,400 MASTOIDECTOMY 88508 RADICAL NECK Ent 22(B) 98,100 126,100 154,500 209,300 293,200 DESECTION (BILATERAL) 38933 RADICAL Ent 44 48,900 63,100 77,200 146,600 NECKDESECTION 104,700 80287 RANULA EXISION Ent 45 28,000 33,600 42,300 58,900 84,000

78443 REMOVAL OF RHINOLITH Ent 106 28,000 32,800 37,400 46,400 60,200

33032 REMOVAL OF Ent 47 21,000 22,700 24,600 27,900 33,200 SUBMANDIBULAR DUCT CALCULUS 3381 RETRO - PHARYNGEAL Ent 46 28,000 33,600 42,300 58,900 84,000 ABSCESS DRAINAGE 49572 RHINOTOMY Ent 48 48,900 59,600 69,600 90,700 122,200

90264 SEPTAL ABSCESS I AND D Ent 122 16,900 19,300 20,900 25,300 31,900

88413 SEPTAL CORRECTION Ent 120 28,000 32,800 37,400 46,400 60,200

24229 SEPTOPLASTY Ent 49 28,000 32,800 37,400 46,400 60,200

6972 STAPEDECTOMY Ent 50 39,200 49,900 60,000 80,900 112,400 MASTOID CAVITY 6997 SUBMANDIBULAR Ent 51 42,000 52,700 62,700 83,800 115,300 SIALADENECTOMY / GLAND EXCISION 33034 SUBMUCOUS DIATHERMY Ent 52 9,900 12,300 13,900 18,400 24,900

44857 SUBTOTAL Ent 53 48,900 63,100 77,200 104,700 146,600 THYROIDECTOMY 2861 SUPERFICIAL Ent 54 48,900 63,100 77,200 104,700 146,600 PAROTIDECTOMY 49573 SUPRAGLOTTIC Ent 55 48,900 57,500 63,700 82,800 107,600 LARYNGECTOMY 13608 SURGERY FOR Ent 56 28,000 32,600 36,800 45,000 57,800 PARAPHARYNGEAL ABSCESS 85071 T TUBE CHANGE Ent 107 28,000 36,400 45,200 61,600 86,700

64719 T TUBE INSERTION Ent137 19,200 25,000 31,600 44,000 63,400

216 W.E.F. 1st January 2019 INVASIVE PROCEDURE

93773 TEFLAN PLATE REMOVAL Ent 116 16,900 19,300 20,900 25,300 31,900

63291 TERBINOPLASTY Ent 57 28,000 32,800 37,400 46,400 60,200

85532 TERBINOPLASTY Ent 108 56,100 65,500 74,900 93,000 120,200 (BILATERAL) 66047 TERBINOPLASTY(LEFT) Ent 109 28,000 32,800 37,400 46,400 60,200

66046 TERBINOPLASTY(RIGHT) Ent 110 28,000 32,800 37,400 46,400 60,200

27425 THYROPLASTY Ent 58 36,400 43,100 50,300 64,400 85,400

88762 TONSIL BIOPSY Ent 121 18,100 20,500 22,200 26,600 33,200

44861 TOTAL GLOSSECTOMY Ent 59 58,800 74,000 91,100 125,900 178,300

44470 TOTAL LARYNGECTOMY Ent 60 56,100 74,000 91,100 125,900 178,300

11638 TOTAL MAXILLECTOMY Ent 61 56,100 74,000 91,100 125,900 178,300

76716 TOTAL MAXILLECTOMY Ent 111 112,000 147,900 182,200 251,900 356,600 (BILATERAL) 6858 TOTAL OR NEAR TOTAL Ent 62 56,100 74,000 91,100 125,900 178,300 THYROIDECTOMY 11242 TOTAL PAROTIDECTOMY Ent 63 58,800 74,000 91,100 125,900 178,300

24441 TRACHEAL Ent 64 48,900 57,500 66,000 82,800 107,600 RECONSTRUCTION 33796 TRACHEOSTOMY Ent 65 21,000 25,800 30,500 39,500 53,100

65669 TRACHESTOMY TUBE Ent 133 2,000 3,000 3,800 5,300 7,100 CHANGE 6976 TYMPANOPLASTY Ent 66 35,000 45,700 55,700 76,700 108,400

1053136 TYMPANOPLASTY Ent144 52,600 68,500 83,500 115,100 162,500 BILATERAL 6974 TYMPANOTOMY Ent 112 35,000 43,500 52,000 68,800 93,800

63294 UNILATERAL ANTRUM Ent 67 2,000 3,000 3,700 5,300 7,100 PUNCTURE 83988 UP3 Ent 113 25,200 33,600 42,300 58,900 84,000

81367 UVLO PALATO PHARYNGO Ent 114 48,900 63,100 77,200 104,700 146,600 PLASTY (UPPP)

W.E.F. 1st January 2019 217 INVASIVE PROCEDURE

GENERAL SURGERY

44817 ABDOMINOPERINEAL Gen 1 43,900 58,800 73,200 102,500 146,900 PULL THROUGH RESECTION AND ANASTO 22457 ADRENALECTOMY TOTAL Gen 2 42,200 56,100 70,200 97,700 139,700

44818 ANAL SPHINCTER REPAIR Gen 3 42,200 56,100 70,200 97,700 139,700

11375 ANTERIOR RESECTION Gen 4 43,900 58,800 73,200 102,500 146,900

44819 ANY STRANGULATED Gen 5 29,500 39,100 49,100 68,600 97,700 HERNIA EXCEPT INCISIONAL 22502 APPENDECTOMY Gen 6 21,200 27,900 35,000 49,100 70,200

44820 CATHETERISATION Gen 7 2,000 3,000 3,700 5,300 7,100

50273 CERVICAL Gen 8 31,600 42,200 52,300 73,200 104,900 SYMPATHECTOMY (Gen) 2356 CHEST DRAINAGE Gen 9 8,700 11,100 14,100 19,600 27,900

2359 CHOLECYSTECTOMY Gen 10 29,500 39,100 49,100 68,600 97,700 OPEN 23482 CHOLECYSTECTOMY Gen 11 21,200 27,900 35,000 49,100 70,200 LAPROSCOPIC 3218 Gen 12 43,900 58,800 73,200 102,500 146,900

2386 CLOSED LOOP Gen 13 21,200 27,900 35,000 49,100 70,200 COLOSTOMY 33472 COLECTOMY Gen 14 43,900 58,800 73,200 102,500 146,900 WITH LLEORECTAL ANASTOMOSES 44822 COLON REPLACEMENT Gen 15 42,200 56,100 70,200 97,700 139,700

44823 CYST AND BENIGN Gen 16 12,500 17,100 21,200 29,500 42,200 TUMOURS OF PALATE 3325 DECORTICATING Gen 17 31,600 42,200 52,300 73,200 104,900 PLEURECTOMY and EXCISION OF EMPYEMA 3330 DENTAL CYST , Gen 18 43,900 58,800 73,200 102,500 146,900 EXCISION AND JAW RECONSTRUCTION

218 W.E.F. 1st January 2019 INVASIVE PROCEDURE

3335 DIAGNOSTIC Gen 20 10,300 14,100 17,500 24,400 35,000 LAPAROSCOPY 44824 DIVISION OF ADHESIONS / Gen 21 29,500 39,100 49,100 68,600 97,700 BANDS 44825 DRAINAGE Gen 22 21,200 27,900 35,000 49,100 70,200 APPENDICULAR ABSCESS 3380 DRAINAGE OF Gen 23 29,500 39,100 49,100 68,600 97,700 PSEUDOPANCREATIC CYST 44826 EPIGASTRIC/ UMBILICAL Gen 25 14,900 19,600 24,400 33,900 49,100 HERNIA 1720 ESOPHAGEAL Gen 26 6,500 8,700 10,300 14,900 21,200 DILATATION 44827 EX. LARGE SUPERFICIAL Gen 27 14,900 19,600 24,400 33,900 49,100 TUMOUR 44828 EX. SMALL SUPERFICIAL Gen 28 10,300 14,100 17,500 24,400 35,000 TUMOUR 44829 EXCISION BRANCHIAL Gen 29 21,200 27,900 35,000 49,100 70,200 CYST/ FISTULA 44830 EXCISION DIABETIC Gen 30 14,900 19,600 24,400 33,900 49,100 CARBUNCLE 3529 EXCISION OF MULTIPLE Gen 31 10,300 14,100 17,500 24,400 35,000 SCROTAL SABEACEOUS CYST 3517 EXCISION OF PILONIDAL Gen 32 12,500 17,100 21,200 29,500 42,200 SINUS 3516 EXCISION PHARYNGEAL Gen 34 29,500 39,100 49,100 68,600 97,700 POUCH and CRICOPHARYNGEAL MYTOMY 3527 EXCISION Gen 35 37,900 50,500 62,800 88,200 125,700 RETROPERITONAL TUMOR 3538 EXCISION THYROGLOSSAL Gen 36 29,500 39,100 49,100 68,600 97,700 CYST/ FISTULA 50274 EXPLORATORY Gen 37 21,200 27,900 35,000 49,100 70,200 LAPAROTOMY (Gen) 3587 FEMORAL HERNIA Gen 38 21,200 27,900 35,000 49,100 70,200

23235 GASTRO JEJUNOSTOMY Gen 39 21,200 27,900 35,000 49,100 70,200

W.E.F. 1st January 2019 219 INVASIVE PROCEDURE

44832 GASTROSTOMY OR Gen 40 21,200 27,900 35,000 49,100 70,200 JEJUNOSTOMY 3636 HAEMORRHOIDECTOMY Gen 41 21,200 27,900 35,000 49,100 70,200

44833 HEMICOLECTOMY RIGHT Gen 42 29,500 39,100 49,100 68,600 97,700 OR LEFT and TRANSVERSE COLECTOMY 66341 HERNIOPLASTY Gen 43 29,500 39,100 49,100 68,600 97,700

2812 HIGHLY SELECTIVE Gen 44 29,500 39,100 49,100 68,600 97,700 VAGOTOMY 78369 HIRSCHSPRUNG Gen 45 43,900 58,800 73,200 102,500 146,900 RESECTION AND ANASTOMOSIS 13425 HYDATID CYST OF LIVER Gen 46 43,900 58,800 73,200 102,500 146,900

8096 HYDROCOELE ONE SIDE / Gen 47 21,200 27,900 35,000 49,100 70,200 BILATERAL 3694 ILESTOMY/ COLOSTOMY Gen 48 21,200 27,900 35,000 49,100 70,200 ALONE 67761 INCISION AND DRAINAGE Gen 49 8,700 11,100 14,100 19,600 27,900 OF ABSCESS (GENERAL SURGERY) 3729 INCISIONAL HERNIA Gen 50 29,500 39,100 49,100 68,600 97,700 REPAIR 23330 INGUINAL HERNIA Gen 51 21,200 27,900 35,000 49,100 70,200 REPAIR 44835 INGUNIAL HERNIOTOMY Gen 52 14,900 19,600 24,400 33,900 49,100

44836 INSULINOMA EXCISION Gen 53 43,900 58,800 73,200 102,500 146,900

13836 INTESTINAL FISTULA Gen 54 43,900 58,800 73,200 102,500 146,900

6582 INTUSSUSCEPTION Gen 55 29,500 39,100 49,100 68,600 97,700

44837 JEJUNAL INTERPOSITION Gen 56 43,900 58,800 73,200 102,500 146,900

44838 LEFT / RIGHT LOBECTOMY Gen 57 37,900 50,500 62,800 88,200 125,700 LIVER 3489 LINGUAL THYROID Gen 58 12,500 17,100 21,200 29,500 42,200

44839 LUMP/ FIBROADENOMA Gen 59 14,900 19,600 24,400 33,900 49,100 EXCISION/ SECTOR MASTECTOMY

220 W.E.F. 1st January 2019 INVASIVE PROCEDURE

6578 MESENTERIC CYST Gen 61 29,500 39,100 49,100 68,600 97,700 EXCISION 44840 NECROSECTOMY and Gen 62 37,900 50,500 62,800 88,200 125,700 OPEN DRINAGE OF PANCREATIC ABSCESS 8130 OESOPHAGOSCOPY Gen 63 5,500 7,100 9,000 12,400 17,500

6830 OPEN DRAINAGE OF Gen 64 21,200 27,900 35,000 49,100 70,200 LIVER ABSCESS 50275 OPEN LUNG BIOPSY (Gen) Gen 65 21,200 27,900 35,000 49,100 70,200

44841 OPEN REMOVAL OF Gen 66 21,200 27,900 35,000 49,100 70,200 F.B. ESOPHAGUS OR MANAGEMENT OF E 44842 OPERATION FOR HIGH Gen 67 29,500 39,100 49,100 68,600 97,700 FISTULA IN ANO 2691 OPERATION FOR LOW Gen 68 14,900 19,600 24,400 33,900 49,100 FISTULA IN ANO 11623 ORCHIDECTOMY ONE Gen 69 18,900 25,100 31,600 43,900 62,800 SIDE / BILATERAL 13397 ORCHIDOPEXY ONE SIDE / Gen 70 21,200 27,900 35,000 49,100 70,200 BILATERAL 6975 PARACENTESIS Gen 71 4,300 5,700 7,100 10,100 14,100

11624 PARTIAL AMPUTATION OF Gen 73 14,900 19,600 24,400 33,900 49,100 PENIS 34111 PARTIAL GASTRECTOMY Gen 74 29,500 39,100 49,100 68,600 97,700

44843 PARTIAL Gen 76 43,900 58,800 73,200 102,500 146,900 PANCREATECTOMY 44844 PARTIAL RESECTION Gen 77 37,900 50,500 62,800 88,200 125,700 OF LIVER / LATERAL SEGMENTECTOMY 3373 PERIANAL / Gen 78 12,500 17,100 21,200 29,500 42,200 ISCHIORECTAL ABSCESS DRINAGE 33375 PROCTOCOLECTOMY Gen 79 43,900 58,800 73,200 102,500 146,900

44845 PYLOROMYPTOMY Gen 80 21,200 27,900 35,000 49,100 70,200

3767 RADICAL NECK Gen 81 48,900 63,100 77,200 104,700 146,600 DISSECTION

W.E.F. 1st January 2019 221 INVASIVE PROCEDURE

6989 RANULA EXCISION Gen 82 28,000 33,600 42,300 58,900 84,000

44846 RARE HERNIAS, SPIGELIAN Gen 83 29,500 39,100 49,100 68,600 97,700 OBTURATOR, LUMBER SUPRAUMB 44847 RECTAL PROLAPSE REPAIR Gen 84 29,500 39,100 49,100 68,600 97,700

23338 RECURRENT INGUINAL Gen 85 29,500 39,100 49,100 68,600 97,700 HERNIA/ HERNIOPLASTY 3340 REPAIR OF Gen 87 31,600 42,200 52,300 73,200 104,900 DIAPHRAGMATIC HERNIA 24109 REPAIR TORN EAR Gen 88 10,300 14,100 17,500 24,400 35,000 LOBULE EACH 44848 RESECTION and REPAIR OF Gen 89 48,200 64,500 80,000 112,100 160,700 COMMON HEPATIC DUCT 11563 RESECTION AND Gen 90 29,500 39,100 49,100 68,600 97,700 ANASTOMOSES 44849 RESECTION/ Gen 91 43,900 58,800 73,200 102,500 146,900 ANASTOMOSES FOR VOLVULUS 27061 RETROPERITONEAL Gen 92 29,500 39,100 49,100 68,600 97,700 DRINAGE OF ABSCESS 44850 RIB RESECTION and Gen 93 10,300 14,100 17,500 24,400 35,000 DRAINAGE 44851 RIGHT LOBECTOMY / Gen 94 48,200 64,500 80,000 112,100 160,700 LIVER , LUNG 6867 SCALENE NODE BIOPSY Gen 95 5,500 7,100 9,000 12,400 17,500

34372 SCALENOTOMY FOR Gen 96 17,100 22,400 27,900 39,100 56,100 SCALENOUS ANTICUS SYNDROME 33447 SIGMOID COLECTOMY Gen 97 29,500 39,100 49,100 68,600 97,700

44852 SIGMOIDOSCOPY Gen 98 4,300 5,700 7,100 10,100 14,100

50276 PERFORATED ULCER - Gen 99 21,200 27,900 35,000 49,100 70,200 CLOSURE 10502 SPHINTEROTOMY OR Gen 100 12,500 17,100 21,200 29,500 42,200 FISSURECTOMY 29480 SPLENECTOMY Gen 101 29,500 39,100 49,100 68,600 97,700

222 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44854 STRANGULATED Gen 102 29,500 39,100 49,100 68,600 97,700 INCISIONAL HERNIA 44856 SUBMUCOUS CYST Gen 104 16,900 19,300 20,900 25,300 31,900 EXCISION 44858 SUPRAPUBIC DRAINAGE Gen 107 4,300 5,700 7,100 10,100 14,100

6954 SURGERY FOR HIATUS Gen 108 43,900 58,800 73,200 102,500 146,900 HERNIA 10771 SURGERY FOR PORTAL Gen 109 43,900 58,800 73,200 102,500 146,900 HYPERTENSION 44859 SURGERY FOR Gen 110 43,900 58,800 73,200 102,500 146,900 RECURRENT ULCER 23405 SUTURE OF LARGE Gen 111 14,900 19,600 24,400 33,900 49,100 LACERATION 44860 THIERSCH OPERATION Gen 112 10,300 14,100 17,500 24,400 35,000

11734 THYROID LOBECTOMY Gen 113 21,200 27,900 35,000 49,100 70,200

11629 TOTAL AMPUTATION Gen 114 37,900 50,500 62,800 88,200 125,700 OF PENIS WITH BLOCK DISSECTION 24424 TOTAL GASTRECTOMY Gen 115 52,300 70,200 87,300 122,100 174,600

44862 TUBE CAECOSTOMY Gen 118 14,900 19,600 24,400 33,900 49,100

33496 UMBILECTOMY Gen 119 14,900 19,600 24,400 33,900 49,100

44863 UNTWISTING OF SIGMOID Gen 120 29,500 39,100 49,100 68,600 97,700 VOLVULUS 6566 VAGOTOMY and Gen 121 29,500 39,100 49,100 68,600 97,700 DRAINAGE 10508 VENTRAL HERNIA REPAIR Gen 122 29,500 39,100 49,100 68,600 97,700

33132 CHANGE OF SETON Gen 124 10,200 12,700 16,300 23,100 33,700

67619 B/L CHANGE OF SETON Gen 125 20,400 25,500 32,600 46,100 67,600

64619 DEEP ABSCESS DRAINAGE Gen 126 10,300 14,100 17,500 24,400 35,000

84684 EX. LARGE SUPERFICIAL Gen 127 14,900 19,600 24,400 33,900 49,100 TUMOUR (LEFT) 84685 EX. LARGE SUPERFICIAL Gen 128 14,900 19,600 24,400 33,900 49,100 TUMOUR (RIGHT)

W.E.F. 1st January 2019 223 INVASIVE PROCEDURE

70164 EX. SMALL SUPERFICIAL Gen 129 20,700 28,000 35,300 48,600 70,100 TUMOR (BILATERAL) 71352 EX. SMALL SUPERFICIAL Gen 130 10,300 14,100 17,500 24,400 35,000 TUMOUR (LEFT) 71350 EX. SMALL SUPERFICIAL Gen 131 10,300 14,100 17,500 24,400 35,000 TUMOUR (RIGHT) 85622 EXCISION OF ANO RECTAL Gen 132 21,200 28,000 35,000 49,100 70,200 LESION 78345 EXCISION OF PENILE Gen 133 10,300 14,100 17,500 24,400 35,000 LESION 82526 EXCISION OF PERIANAL Gen 134 29,500 39,100 49,100 68,600 97,700 SINUS AND PRIMARY CLOSURE 78120 EXCISION OF SEBACEOUS Gen 135 25,000 34,100 42,600 58,800 84,300 CYST BILATERAL 79608 EXCISION OF SINUS Gen 136 12,500 17,100 21,200 29,500 42,200

41686 HAEMORRHOIDECTOMY Gen 137 42,600 56,100 70,100 98,400 140,400 (BILATERAL) 66779 HEPATECTOMY Gen 138 63,600 95,600 127,400 159,300 191,000

66780 HEPATECTOMY(LEFT) Gen 139 63,600 95,600 127,400 159,300 191,000

66781 HEPATECTOMY(RIGHT) Gen 140 63,600 95,600 127,400 159,300 191,000

66004 HERNIOPLASTY (LEFT) Gen 141 29,500 39,100 49,100 68,600 97,700

2809 HERNIOPLASTY(RIGHT) Gen 142 29,500 39,100 49,100 68,600 97,700

81458 INGUINAL HERNIA Gen 143 42,600 55,800 70,100 98,400 140,400 REPAIR (BILATERAL) 70719 INGUINAL HERNIA Gen 144 21,200 27,900 35,000 49,100 70,200 REPAIR (LEFT) 70718 INGUINAL HERNIA Gen 145 21,200 27,900 35,000 49,100 70,200 REPAIR (RIGHT) 6898 LAPAROSCOPIC Gen 146 44,000 58,600 73,700 102,800 146,500 RECTOPEXY 86761 LAPAROSCOPIC Gen 147 32,000 41,800 52,700 73,700 105,200 VARICOCELE (BILATERAL) 85088 LIVER BIOPSY Gen 148 4,300 5,700 7,100 10,100 14,100

85740 PERIANAL / Gen 149 25,000 34,100 42,600 58,800 84,300 ISCHIORECTAL ABSCESS DRINAGE (BILATERAL) 224 W.E.F. 1st January 2019 INVASIVE PROCEDURE

79598 POLYPECTOMY OF Gen 150 21,000 22,700 24,600 27,900 33,200 PYLONIC MASS 86529 SPLENIC ARTERY Gen 151 31,600 42,200 52,300 73,200 104,900 LIGATION 64716 SURGERY FOR Gen 152 32,000 42,800 53,200 74,600 106,700 GASTROESOPHGEA REFLUX 67681 VIDEO ASSISTED FISTULA Gen 153 25,100 33,500 42,200 58,800 83,900 TREATMENT 80094 WIDE EXCISION SOFT Gen 154 25,500 33,800 42,600 59,100 84,200 TISSUE SWELLING 80093 WIDE EXCISION Gen 155 23,500 28,400 33,100 42,000 55,700 SWELLING BACK 94086 EXTRA PERITONEAL Gen 156 29,500 39,100 49,100 68,600 97,700 MESH REPAIR 94070 LAPAROSCOPIC Gen 157 44,000 58,600 73,700 102,500 146,500 SPLENECTOMY 85621 PEG Gen 158 16,800 22,400 28,000 39,100 55,500

87146 BARIATRIC PROCEDURE Gen 159 29,500 39,100 49,100 68,600 97,700

87856 LAPAROSCOPIC Gen 160 43,900 58,800 73,200 102,500 146,900 CYSTOJEJUNOSTOMY 90490 EXCISION OF POLYP Gen 161 5,500 7,100 9,000 12,400 17,500

64699 RECTAL SUCTION BIOPSY Gen 162 6,500 8,700 10,300 14,900 21,200

64700 REPAIR OF ORO -ANTRAL Gen 163 10,300 14,100 17,500 24,400 35,000 FISTULA 57170 SELECTIVE SPINAL ROOT Gen 164 10,300 14,200 17,600 24,400 34,900 BLOCK- MULTIPLE 69825 LARGE WOUND REPAIR Gen 165 17,100 22,400 27,900 39,100 56,100

64701 RESECTION/ Gen 166 43,900 58,800 73,200 102,500 146,900 ANASTOMOSES FOR VOLVULUS 79277 PIC LINE Gen176 3,900 3,900 3,900 3,900 3,900

13923 EXCISION BIOPSY Gen177 9,900 12,700 16,300 22,600 32,300

64519 SP FACET JOINT Gen178 10,300 13,400 17,000 23,500 33,900 INJECTION : MULTIPLE LEVEL

W.E.F. 1st January 2019 225 INVASIVE PROCEDURE

33718 SP FACET JOINT Gen178 10,300 13,400 17,000 23,500 33,900 INJECTION : MULTIPLE LEVEL 1037122 FISSURECTOMY Gen179 12,500 17,100 21,200 29,500 42,200

1034748 REMOVAL OF MESH Gen180 29,500 39,100 49,100 68,600 97,700

1047564 RESECTION OF WEB AND Gen181 12,500 17,100 21,200 29,500 42,200 DILATATION 1037121 SPHINTEROTOMY Gen182 12,500 17,100 21,200 29,500 42,200

1038256 INCISION AND DRAINAGE Gen183 17,300 22,200 28,100 39,300 55,900 OF ABSCESS(BILATERAL) 1039035 RETROPERITONEAL Gen184 29,500 39,100 49,100 68,600 97,700 DRINAGE OF ABSCESS (RIGHT) 1039036 RETROPERITONEAL Gen185 29,500 39,100 49,100 68,600 97,700 DRINAGE OF ABSCESS (LEFT) 1059991 LOOP BYPASS Gen186 21,200 27,900 35,000 49,100 70,200

1068834 SLEEVE GASTRECTOMY Gen 188 52,300 70,200 87,300 122,100 174,600

87860 ADRENALECTOMY TOTAL Gen 2(a) 84,300 112,000 140,400 195,400 279,200 - BILATERAL 13825 BILATERAL Gen 58,800 78,200 98,400 137,300 195,400 HERNIOPLASTY 43(A) 94079 INCISIONAL HERNIA Gen 58,800 78,200 98,400 137,300 195,400 REPAIR (BILATERAL) 50(A) INTERVEN PAIN MANAGEMENT PROCEDURE 57167 INJECTION FOR NERVE Ivpm 1 3,900 5,300 6,200 8,900 12,600 ENTRAPMENT /POST OP / TRAUMA KELOID / SCAR TISSUE/INTRAVENOUS XYLOCARD INFUSION PER SESSION/ TRIGGER POINT INJECTION-SINGLE GROUP

226 W.E.F. 1st January 2019 INVASIVE PROCEDURE

57168 EPIDURAL STEROID / Ivpm 2 8,300 10,500 13,400 18,500 26,500 PYRIFORMIS INJECTION /CARPAL / TARSAL TUNNEL INJECTION / EPIDUROGRAPHY / TRIGGER POINT INJECTION-MULTIPLE GROUPS 57169 SELECTIVE SPINAL ROOT Ivpm 3 8,300 10,500 13,400 18,500 26,500 BLOCK- SINGLE 64705 SELECTIVE SPINAL ROOT Ivpm 4 10,300 14,200 17,600 24,400 34,900 BLOCK-MULTIPLE 63272 BOTOX INJ/EPIDURAL Ivpm 5 12,900 17,400 21,800 30,000 43,200 ADHESIOLYSIS DISCOGRAPHY 57172 JOINT INJECTIONS- Ivpm 6 7,200 10,100 12,400 17,400 24,400 SINGLE 64650 JOINT INJECTION-MULTIP Ivpm 7 10,300 14,200 17,600 24,400 35,000 LE(FACET,SACROILIAC,CO STOCHO 57174 INTERCOSTAL NERVE Ivpm 8 5,600 7,100 9,100 12,600 18,000 BLOCK-SINGLE 57175 INTERCOSTAL NERVE Ivpm 9 8,300 10,500 13,400 18,500 26,500 BLOCK-MULTIPLE (THORACIC 13) 64685 PERIPHERAL NERVE/ Ivpm 10 8,300 10,500 13,400 18,500 26,500 GANGLION BLOCK 57177 DEEP NERVE / PLEXUS Ivpm 11 13,800 18,000 22,400 31,600 45,200 BLOCK (TRIGEMINAL (GASSERIAN) GANGLION, LUMBAR SYMPATHETIC, COELIAC PLEXUS BLOCK, HYPOGASTRIC PLEXUS) 63288 TRIGGER POINT Ivpm 15 3,900 5,300 6,200 8,900 12,600 INJECTION-SINGLE GROUP 64644 INJ. FOR NERVE Ivpm 16 3,900 5,300 6,200 8,900 12,600 ENTRAPMENT/POST OP/ TRAUMA KELOID/SC 63269 INTRAVENOUS Ivpm 17 3,900 5,300 6,200 8,900 12,600 XYLOCARD INFUSION PER SESSION

W.E.F. 1st January 2019 227 INVASIVE PROCEDURE

64620 DEEP NERVE/PLEXUS Ivpm 18 13,800 18,000 22,400 31,600 45,200 BLOCK 63287 TRIGGER POINT Ivpm 19 8,300 10,500 13,400 18,500 26,500 INJECTION-MULTIPLE GROUPS 64631 EPIDURAL STEROID/ Ivpm 20 8,300 10,500 13,400 18,500 26,500 PYRIFORMIS INJ/CARPAL/ TARSAL TUNN 64706 SELECTIVE SPINAL ROOT Ivpm 21 8,300 10,500 13,400 18,500 26,500 BLOCK-SINGLE 63276 EPIDUROGRAPHY Ivpm 22 8,300 10,500 13,400 18,500 26,500

64651 JOINT INJECTION-SINGLE Ivpm 23 7,200 10,100 12,400 17,400 24,400

57173 JOINT INJECTIONS- Ivpm 24 10,300 14,200 17,600 24,400 35,000 MULTIPLE (FACET JOINT, COSTOCHONDRAL JOINT, SACROILIAC JOINT) - ORTHO 122, 123 57180 TRIAL INJECTION Ivpm 25 8,300 12,400 13,400 18,500 26,500

57184 IMPLANTATION Ivpm 26 52,300 70,200 87,000 174,600 (PERCUTANEOUS) 122,200 57183 TRIAL STIMULATION Ivpm 27 12,900 17,400 21,800 30,000 43,200

76618 PERIPHERAL Ivpm 28 8,300 10,800 13,800 19,100 27,500 NERVE(OCCIPITAL AURICULOTEMPORAL GENITOFEMORAL STELLATE GANGLION GANGLION IMPAR GLOSSOPHARYNGEAL ETC) 64646 INTERCOSTAL NERVE Ivpm29 8,300 10,800 13,800 19,100 27,500 BLOCK-MULTIPLE 64643 ING. NODE DISSECTION Ivpm30 18,500 24,000 30,500 42,400 61,000

64630 ENDOSCOPIC TEFLON Ivpm31 9,300 12,200 15,300 21,400 30,800 INJECTION 64647 INTERPOSITIONING Ivpm32 83,900 109,000 138,500 277,200 GRAFT REPAIR WITH 192,600 GORETEX GRAFT

228 W.E.F. 1st January 2019 INVASIVE PROCEDURE

64648 INTRATHECAL OPIOID/ Ivpm 8,300 12,400 13,400 18,500 26,500 BACLOFEN PUMP 13(a) IMPLANTATION-TRIL 57181 IMPLANTATION Ivpm 52,300 70,200 87,000 122,200 174,600 13(b) 57185 IMPLANTATION Ivpm 14 105,000 139,800 174,600 244,700 348,900 (LAMINECTOMY) (c ) 63299 SPINAL CORD Ivpm 12,900 17,400 21,800 30,000 43,200 STIMULATOR 14(a) IMPLANTATION-TRIAL STIMULAT 63298 SPINAL CORD Ivpm 52,300 70,200 87,000 122,200 174,600 STIMULATOR 14(b) IMPLANTATION- (PERCUTANEOUS) NEUROSURGERY 3284 ALL ELECTIVE Neuro 1 104,900 139,700 174,600 244,700 348,800 CRANIOTOMIES 50277 ALL INTRA-DURAL SPINAL Neuro 2 104,900 139,700 174,600 244,700 348,800 SURGERIES 50278 ALL MICROSCOPIC Neuro 3 104,900 139,700 174,600 244,700 348,800 OPERATIONS EXCEPT DISC 22621 BRACHIAL PLEXUS Neuro 4 104,900 139,700 174,600 244,700 348,800 INJURIES 3141 BURR-HOLE ASPIRATION Neuro 5 52,300 70,200 87,300 122,100 174,600 FOR ABSCESS 2323 CARPAL TUNNEL RELEASE Neuro 6 52,300 70,200 87,300 122,100 174,600

50279 CHRONIC SUB-DUAL Neuro 7 52,300 70,200 87,300 122,100 174,600 HAEMATOMA 2496 CSF SHUNT PROCEDURES Neuro 8 78,300 104,900 130,500 183,300 261,800

33663 EXTERNAL VENTRICULAR Neuro 9 10,300 14,100 17,500 24,400 35,000 DRAIN 3690 ICP MONITORING Neuro 10 3,700 5,300 5,800 8,700 12,300

23616 MANIPULATIONS Neuro 11 10,300 14,100 17,500 24,400 35,000

23646 MICRO- DISCECTOMIES Neuro 12 78,300 104,900 130,500 183,300 261,800 INCLUDING CLOWARD'S PROCEDURE

W.E.F. 1st January 2019 229 INVASIVE PROCEDURE

8120 PERIPHERAL NERVE Neuro 13 52,300 70,200 87,300 122,100 174,600 SURGERY 50280 RADIOFREQUENCY Neuro 14 52,300 70,200 87,300 122,100 174,600 RHIZOTOMY 50281 REVISION SURGERY FOR Neuro 15 104,900 139,700 174,600 244,700 348,800 LUMBAR AND CERVICAL DISC DISEASE 8252 SPINAL FUSION AND Neuro 17 104,900 139,700 174,600 244,700 348,800 DECOMPRESSION 50282 STEREOTACTIC Neuro 18 104,900 139,700 174,600 244,700 348,800 PROCEDURES 50283 TIC INJECTIONS Neuro 19 52,300 70,200 87,300 122,100 174,600

6681 TRANS -SPHENOID Neuro 20 104,900 139,700 174,600 244,700 348,800 OPERATIONS 50284 VENTRICULAR Neuro 21 3,700 3,900 3,900 4,100 4,100 PUNCTURE 71082 ALL ELECTIVE Neuro 22 209,900 279,200 349,100 489,300 697,600 CRANIOTOMIES (BILATERAL) 81339 ALL ELECTIVE Neuro 23 104,900 139,700 174,600 244,700 348,800 CRANIOTOMIES (LEFT) 81338 ALL ELECTIVE Neuro 24 104,900 139,700 174,600 244,700 348,800 CRANIOTOMIES (RIGHT) 82513 ALL MICROSCOPIC Neuro 25 209,900 279,200 349,100 489,300 697,600 OPERATIONS EXCEPT DISC (BILATERAL) 79600 CHRONIC SUB-DUAL Neuro 26 52,300 70,200 87,300 122,100 174,600 HAEMATOMA (LEFT) 79601 CHRONIC SUB-DUAL Neuro 27 52,300 70,200 87,300 122,100 174,600 HAEMATOMA (RIGHT) 86727 CSF SHUNT PROCEDURES Neuro 28 78,300 104,900 130,500 183,300 261,800 (LEFT) 86728 CSF SHUNT PROCEDURES Neuro 29 78,300 104,900 130,500 183,300 261,800 (RIGHT) 68250 EXTERNAL VENTRICULAR Neuro 30 20,700 28,000 35,300 48,600 70,100 DRAIN (BILETRAL) 81333 MANIPULATIONS Neuro 31 20,700 28,000 35,300 48,600 70,100 (BILATERAL) 69855 MANIPULATIONS (LEFT) Neuro 32 10,300 14,100 17,500 24,400 35,000

230 W.E.F. 1st January 2019 INVASIVE PROCEDURE

69856 MANIPULATIONS (RIGHT) Neuro 33 10,300 14,100 17,500 24,400 35,000

68297 MICRO-DISCECTOMIES Neuro 34 156,800 209,900 261,100 366,500 523,400 INCLUDING CLOWARDS PROCEDURE (BILETARAL) 82480 MICRO-DISCECTOMIES Neuro 35 78,300 104,900 130,500 183,300 261,800 INCLUDING CLOWARDS PROCEDURE (LEFT) 82482 MICRO-DISCECTOMIES Neuro 36 78,300 104,900 130,500 183,300 261,800 INCLUDING CLOWARDS PROCEDURE (RIGHT) 78700 POSTERIOR FOSSA Neuro 37 78,300 104,900 130,500 183,300 261,800 SURGERY FOR TUMOR BIOPSY 69724 QUADRICEPS BIOPSY Neuro 38 10,300 14,100 17,500 24,400 35,000

68240 SPINAL FUSION AND Neuro 39 209,900 279,200 349,100 489,300 697,600 DECOMPRESSION (BILATERAL) 69723 SURAL NERVE BIOPSY Neuro 40 10,300 14,100 17,500 24,400 35,000

2495 CSF LEAK REPAIR Neuro 41 35,000 45,700 55,700 76,700 108,400

79976 LUMBER PUNCTURE Neuro 42 3,900 5,400 6,100 9,000 12,600

64697 RADIFREQUENCY Neuro 43 52,300 70,200 87,000 122,200 174,600 RHIZOTOMY/ NUCLEOPLASTY 1020379 RADIOFREQUENCY Neuro 44 104,600 140,500 174,400 244,300 349,200 RHIZOTOMY (BILATERAL) 82044 SKULL TRACTION Neuro 45 14,100 18,400 23,300 32,400 46,800

89911 CARPAL TUNNEL RELEASE Neuro 104,400 140,400 174,500 244,300 349,100 (BILATERAL) 6(A) OBSTRETICS & GYNAECOLOGY

6785 ABDOMINAL O&G 1 25,100 33,500 42,200 58,800 83,900 HYSTERECTOMY 9473 ABDOMINAL O&G 2 25,100 33,500 42,200 58,800 83,900 MYOMECTOMY 89964 ABDOMINAL O&G 25,100 33,500 42,200 58,800 83,900 MYOMECTOMY (LEFT) 2(A)

W.E.F. 1st January 2019 231 INVASIVE PROCEDURE

89965 ABDOMINAL O&G 25,100 33,500 42,200 58,800 83,900 MYOMECTOMY (RIGHT) 2(B) 44701 ABDOMINAL OPERATION O&G 3 25,100 33,500 42,200 58,800 83,900 FOR STRESS INCONTINECE OF URIN 50285 AMNIO INFUSION O&G 4 12,500 17,100 21,200 29,500 42,200

50286 AMNIOCENTERIS O&G 5 8,700 11,100 14,100 19,600 27,900

33642 ANTERIOR AND O&G 6 18,900 25,100 31,600 43,900 62,800 POSTERIOR VAGINAL REPAIR 2418 ANTERIOR O&G 7 12,500 17,100 21,200 29,500 42,200 COLPORRHAPHY 13954 BIOPSY OF CERVIX / O&G 8 4,300 5,700 7,100 10,100 14,100 CERVICAL BIOPSY 50287 CAESARIAN DELIVERY O&G 9 25,100 33,500 42,300 58,800 84,000

2299 CAESARIAN O&G 10 37,900 50,500 62,800 88,200 125,700 HYSTERECTOMY 9523 CERVICAL CERCLAGE O&G 11 12,500 17,100 21,200 29,500 42,200 (SHIRODKAR STITCH) 2419 COLPOSCOPY O&G 12 4,300 5,700 7,100 10,100 14,100

3247 COLPOTOMY AND O&G 13 4,300 5,700 7,100 10,100 14,100 NEEDLING 50288 COMPLEX/ HIGH RISK O&G 14 31,600 42,200 52,300 73,200 104,900 HYSTERECTOMY (TAH + BSO) 33530 CONE BIOPSY OF CERVIX O&G 15 10,300 14,100 17,500 24,400 35,000

3288 CRYOCAUTERY OF CERVIX O&G 16 4,300 5,700 7,100 10,100 14,100

44718 DIAGNOSTIC O&G 18 10,300 14,100 17,500 24,400 35,000 LAPAROSCOPY WITH/ WITHOUT CHROMOTUBATIO 3343 DIATHERMY O&G 19 4,300 5,700 7,100 10,100 14,100 CAUTERISATION OF CERVIX 7009 DILATION and O&G 20 7,200 10,100 12,400 17,300 24,400 CURETTAGE

232 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44720 DRAINAGE OF O&G 21 12,500 17,100 21,200 29,500 42,200 ABDOMINAL WALL HAEMATOMA 3384 DRAINAGE OF VULVAL O&G 22 12,500 17,100 21,200 29,500 42,200 HEMATOME 50289 ERPC EVACUATION OF O&G 24 7,100 9,500 12,000 16,300 23,300 RETAINED PRODUCTS OF CONCEPTION 44728 EXAMINATION UNDER O&G 25 4,200 5,300 6,500 9,000 12,500 GENERAL ANAESTHETIC ( EUA) 44831 EXPLORATORY O&G 29 21,200 27,900 35,000 49,100 70,200 LAPAROTOMY 2673 FENTON'S OPERATION O&G 30 12,500 17,100 21,200 29,500 42,200 FOR RECONSTRUCTION OF VAGINA 3747 FIRST TRIMESTER MTP O&G 31 8,700 11,100 14,100 19,600 27,900

44733 FIRST TRIMESTER MTP O&G 32 17,100 22,400 27,900 39,100 56,100 PLUS STERILISATION 3603 FOREIGN BODY REMOVAL O&G 33 8,700 11,100 14,100 19,600 27,900 FROM VAGINA 44737 HYDROTUBATION O&G 36 1,800 2,200 3,000 4,300 5,800

2826 HYSTEROSALPYNGOGRAPHY O&G 37 4,200 5,300 6,500 9,000 12,500

44739 HYSTEROSCOPIC O&G 38 21,200 27,900 35,000 49,100 70,200 DISSECTION OF UTERINE SYNECHIAE-MILD 50290 HYSTEROSCOPIC O&G 39 25,100 33,500 42,200 58,800 83,900 DISSECTION OF UTERINE SYNECHIAE-SEVE 3683 HYSTEROSCOPIC O&G 40 25,100 33,500 42,200 58,800 83,900 MYOMECTOMY 2827 HYSTEROSCOPIC O&G 41 10,300 14,100 17,500 24,400 35,000 POLYPECTOMY 2828 HYSTEROSCOPIC O&G 42 10,300 14,100 17,500 24,400 35,000 REMOVAL OF IUCD 50291 HYSTEROSCOPIC O&G 43 25,100 33,500 42,200 58,800 83,900 RESECTION OF UTERINE SEPTUM

W.E.F. 1st January 2019 233 INVASIVE PROCEDURE

3687 HYSTEROSCOPY O&G 44 8,700 11,100 14,100 19,600 27,900

2831 HYSTEROTOMY O&G 45 17,100 22,400 27,900 39,100 56,100

2832 HYSTEROTOMY WITH O&G 46 21,200 27,900 35,000 49,100 70,200 TUBAL LIGATION 3713 INCISION OF HYMEN O&G 47 4,300 5,700 7,100 10,100 14,100

44740 IUCD INSERTION O&G 48 2,000 2,700 3,200 4,300 6,500

50293 LAP. / VAGINAL O&G 50 17,100 22,400 27,900 39,100 56,100

50294 LAP. / VAGINAL O&G 51 25,100 33,500 42,200 58,800 83,900 ADHESIOLYSIS 44744 LAPAROSCOIC MULTIPLE O&G 52 17,100 22,400 27,900 39,100 56,100 OVARIAN PUNCTURE/ DRILLING 44745 LAPAROSCOPIC ABLATION O&G 53 17,100 22,400 27,900 39,100 56,100 OF ENDOMETRIOTIC SPOTS 6912 LAPAROSCOPIC O&G 54 25,100 33,500 42,200 58,800 83,900 ADHESIOLYSIS 44746 LAPAROSCOPIC O&G 55 17,100 22,400 27,900 39,100 56,100 ASPIRATION OF CYST 44748 LAPAROSCOPIC BIOPSY O&G 56 12,500 17,100 21,200 29,500 42,200

44749 LAPAROSCORPIC BURCH O&G 57 37,900 50,500 62,800 88,200 125,700

44750 LAPAROSCOPIC O&G 58 37,900 50,500 62,800 88,200 125,700 ENROCELE REPAIR 44751 LAPAROSCOPIC O&G 59 21,200 27,900 35,000 49,100 70,200 FIMBRIOLYSIS 13412 LAPAROSCOPIC O&G 60 25,100 33,500 42,200 58,800 83,900 MYOMECTOMY 11393 LAPAROSCOPIC O&G 61 25,100 33,500 42,200 58,800 83,900 OOPHORECTOMY 11262 LAPAROSCOPIC OVARIAN O&G 62 21,200 27,900 35,000 49,100 70,200 CYSTECTOMY 44752 LAPAROSCOPIC O&G 63 21,200 27,900 35,000 49,100 70,200 OVARIOPLASTY 13367 LAPAROSCOPIC O&G 64 25,100 33,500 42,200 58,800 83,900 PROCEDURE FOR ECTOPIC PREGNANCY

234 W.E.F. 1st January 2019 INVASIVE PROCEDURE

33582 LAPAROSCOPIC REMOVAL O&G 65 17,100 22,400 27,900 39,100 56,100 OF LOST IUCD 33576 LAPAROSCOPIC O&G 66 25,100 33,500 42,200 58,800 83,900 SALPYNGOSTOMY 40036 LAPAROSCOPIC O&G 67 25,100 33,500 42,200 58,800 83,900 SALPYNOGO OOPHORECTOMY 7005 LAPAROSCOPIC O&G 68 12,500 17,100 21,200 29,500 42,200 STERLISATION 44753 LAPAROSCOPIC O&G 69 37,900 50,500 62,800 88,200 125,700 TUBOPLASTY 44754 LAPAROSCOPIC VAULT O&G 70 37,900 50,500 62,800 88,200 125,700 SUSPENSION 50295 LAPAROSCOPICALLY O&G 71 37,900 50,500 62,800 88,200 125,700 ASSISTED VAGINAL HYSTERECTOMY 23290 LAPAROSCOPY and O&G 72 17,100 22,400 27,900 39,100 56,100 HYSTEROSCOPY 44755 LAPAROTOMY FOR O&G 73 21,200 27,900 35,000 49,100 70,200 ECTOPIC PREGNANCY 44757 LARGE LOOP EXCISION OF O&G 74 10,300 14,100 17,500 24,400 35,000 TRANSFORMATION ZONE 50296 LE FORTE'S OPERATION O&G 75 17,100 22,400 27,900 39,100 56,100 FOR GENITAL PROLAPSE 50297 LSCS HIGH RISK O&G 76 31,600 42,300 52,300 73,200 105,000

6791 MANCHESTER O&G 77 25,100 33,500 42,200 58,800 83,900 REPAIR (FOTHERGILL OPERATION) 35948 MANUAL REMOVAL OF O&G 78 10,300 14,100 17,500 24,400 35,000 PLACENTA 33596 MARSUPLIALISATION OF O&G 79 7,200 10,100 12,400 17,300 24,400 BARTHOLIN ABCESS 44761 MC INDOE'S OPERATION O&G 80 37,900 50,500 62,800 88,200 125,700 FOR RECONSTRUCTION OF VAGINA 44764 MTP HIGH RISK O&G 81 10,300 14,100 17,500 24,400 35,000

50298 MULTIPLE PREGNANCY O&G 82 21,200 27,900 35,000 49,100 70,200 REDUCTION (MFPR) 44768 NON DESCENT VAG. HYST. O&G 84 25,100 33,500 42,200 58,800 83,900 SIMPLE

W.E.F. 1st January 2019 235 INVASIVE PROCEDURE

3759 OVARIAN CYSTECTOMY O&G 86 17,100 22,400 27,900 39,100 56,100

44772 OVARIOTOMY O&G 87 17,100 22,400 27,900 39,100 56,100 (OOPHORECTOMY FOR BENIGN OVARIAN TUMOUR) 11713 PAN HYSTERECTOMY FOR O&G 88 37,900 50,500 62,800 88,200 125,700 ENDOMETRIOSIS 44773 PLASTIC REPAIR OF O&G 89 25,100 33,500 42,200 58,800 83,900 UTERUS 65760 POLYPECTOMY(OandG) O&G 90 6,400 8,700 10,300 14,900 21,200

2416 POSTERIOR O&G 91 12,500 17,100 21,200 29,500 42,200 COLPOPERINEORRHAPHY 50301 RADICAL HYSTERECTOMY O&G 92 52,300 70,200 87,300 174,600 FOR CARCINOMA OF 122,100 BODY OF UTER 50302 RADICAL HYSTERECTOMY O&G 93 62,800 83,900 104,900 209,200 PLUS OMENTECTOMY 146,900 FOR OVARIAN 50303 RADICAL VULVECTOMY O&G 94 42,200 56,100 70,200 97,700 139,700

22546 REMOVAL OF BARTHOLIN O&G 95 10,300 14,100 17,500 24,400 35,000 CYST 24529 REMOVAL OF SIMPLE O&G 96 7,200 10,100 12,400 17,300 24,400 VALVAL TUMOUR 44778 REPAIR OF PERINEAL O&G 97 7,200 10,100 12,400 17,300 24,400 TEAR, OLD SECOND DEGREE 44779 REPAIR OF PERINEAL O&G 98 17,100 22,400 27,900 39,100 56,100 TEAR, OLD THIRD DEGREE 50304 REPAIR OF PERINEAL O&G 99 10,300 14,100 17,500 24,400 35,000 TEAR, POST -COITAL OR TRAUMATIC 34122 REPAIR OF RECTO- O&G 100 31,600 42,200 52,300 73,200 104,900 VAGINAL FISTULA 44780 REPARI OF VESICO O&G 101 37,900 50,500 62,800 88,200 125,700 VAGINAL FISTULA 44785 SALPINGO O&G 102 17,100 22,400 27,900 39,100 56,100 OOPHORECTOMY 9447 SECOND TRIMESTER MTP O&G 103 21,200 27,900 35,000 49,100 70,200

236 W.E.F. 1st January 2019 INVASIVE PROCEDURE

24579 SIMPLE VULVECTOMY O&G 104 21,200 27,900 35,000 49,100 70,200

44787 SLING OPERATION O&G 105 25,100 33,500 42,200 58,800 83,900 FOR URINARY STRESS INCONTINENCE 33627 SUBTOTAL O&G 106 25,100 33,500 42,200 58,800 83,900 HYSTERECTOMY 44791 THREE SWABS TEST ( FOR O&G 107 1,800 2,200 3,000 4,300 5,800 VAGINAL FISTULAE) 44793 TRACHELORRHAPHY O&G 108 14,900 19,600 24,400 33,900 49,100

44794 TRANS - CERVICAL O&G 109 31,600 42,200 52,300 73,200 104,900 RESECTION OF ENDOMETRIUM (TCRE) 44796 TUBAL INSUFFLATION O&G 110 3,700 5,300 5,800 8,700 12,300

34263 TUBAL LIGATION O&G 111 12,500 17,100 21,200 29,500 42,200

44798 TUBOPLASTY MICRO O&G 112 37,900 50,500 62,800 88,200 125,700 SURGERY 44799 TUBOPLASTY, MACRO O&G 113 25,100 33,500 42,200 58,800 83,900 SURGERY 44812 VAG. HYST. WITH O&G 114 25,100 33,500 42,200 58,800 83,900 CERVICAL DESCENT COMPLEX 44800 VAG. HYST. WITH O&G 115 25,100 33,500 42,200 58,800 83,900 CERVICAL DESCENT SIMPLE 44801 VAG.HYST.WITH O&G 116 25,100 33,500 42,200 58,800 83,900 RECTOCYSTOCELE REPAIR 33514 VAGINAL BILATERAL O&G 117 25,100 33,500 42,200 58,800 83,900 SALPINGECTOMY 50305 VAGINAL BILATERAL O&G 118 37,900 50,500 62,800 88,200 125,700 SALPINGO - OOPHORECTOMY 44803 VAGINAL BIOPSY O&G 119 12,500 17,100 21,200 29,500 42,200

50306 VAGINAL HYSTERECTOMY O&G 120 37,900 50,500 62,800 88,200 125,700 WITH/WITHOUT ANTERIOR REPAIR 24527 VAGINAL MYOMECTOMY O&G 121 25,100 33,500 42,200 58,800 83,900

W.E.F. 1st January 2019 237 INVASIVE PROCEDURE

44805 VAGINAL O&G 122 21,200 27,900 35,000 49,100 70,200 OOPHORECTOMY 44806 VAGINAL OPERATION FOR O&G 123 17,100 22,400 27,900 39,100 56,100 STRESS INCONTINENCE OF URINE 44807 VAGINAL OVARIAN O&G 124 21,200 27,900 35,000 49,100 70,200 CYSTECTOMY 44808 VAGINAL OVARIAN O&G 125 25,100 33,500 42,200 58,800 83,900 OVARIOPLASTY 33644 VAULT REPAIR O&G 126 25,100 33,500 42,200 58,800 83,900

44813 VALVAL BIOPSY O&G 127 6,500 8,700 10,300 14,900 21,200

44814 WEDGE RESECTION OF O&G 128 17,100 22,400 27,900 39,100 56,100 OVARIES 44815 WERTHEIMS'S O&G 129 52,300 70,200 87,300 122,100 174,600 HYSTERECTOMY 44816 WILLAM'S OPERATION O&G 130 25,100 33,500 42,200 58,800 83,900 FOR RECONSTRUCTION OF VAGINA 87578 ABDOMINI PARA VAGINAL O&G 131 25,100 33,500 42,200 58,800 83,900 MARKS REMOVAL 78862 EXAMINATION UNDER O&G 132 8,100 10,400 12,700 17,700 25,000 GENERAL ANAESTHETIC (BILATERAL) 3545 EXCISION - VAGINAL O&G 133 7,800 10,200 12,700 18,000 25,200 SEPTUM 44730 EXCISION OF URETHRAL O&G 135 6,700 9,200 11,100 15,900 22,100 CARUNCLE 87415 HYSTEROSCOPIC O&G 136 25,100 33,500 42,200 58,800 83,900 MYOMECTOMY MULTIPLE - LEFT 87417 HYSTEROSCOPIC O&G 137 25,100 33,500 42,200 58,800 83,900 MYOMECTOMY MULTIPLE - RIGHT 83570 INCISION OF VAGINAL O&G 138 25,100 33,500 42,200 58,800 83,900 SEPTUM 64645 INSERTION OF MIRENA O&G 139 2,000 2,700 3,200 4,300 6,500

82303 LAPAROSCOPIC O&G 140 25,100 33,500 42,200 58,800 83,900 OOPHORECTOMY (LEFT)

238 W.E.F. 1st January 2019 INVASIVE PROCEDURE

82304 LAPAROSCOPIC O&G 141 25,100 33,500 42,200 58,800 83,900 OOPHORECTOMY (RIGHT) 68502 LAPAROSCOPIC O&G 142 42,600 55,800 70,100 98,400 140,400 OVARIAN CYSTECTOMY (BILETARAL) 81969 LAPAROSCOPIC OVARIAN O&G 143 21,200 27,900 35,000 49,100 70,200 CYSTECTOMY (LEFT) 81970 LAPAROSCOPIC OVARIAN O&G 144 21,200 27,900 35,000 49,100 70,200 CYSTECTOMY (RIGHT) 64654 LASER O&G 145 44,600 50,900 63,600 70,100 95,600 PHOTOCOAGULATION 81289 LASER O&G 146 37,900 50,500 62,800 88,200 125,700 PHOTOCOAGULATION OF ANASTOMOSIS FOR TTTS 69659 LEVATORPLASTY O&G 147 12,500 17,100 21,200 29,500 42,200

9488 SALPINGECTOMY O&G 148 17,100 22,400 27,900 39,100 56,100

87137 OVARIOTOMY O&G 150 34,100 44,900 55,800 78,200 112,000 (OOPHORECTOMY FOR BENIGN OVARIAN TUMOUR)- BILATERAL 44727 EVACUATION OF UTERUS O&G 151 6,700 9,200 11,100 15,900 22,100

52851 STEM CELL COLLECTION O&G 152 8,700 11,100 14,100 19,600 27,900

1019836 TUBAL CANNULATION O&G 153 12,500 17,100 21,200 29,500 42,200

64754 WILLIAM'S OPERATION O&G 154 25,100 33,500 42,200 58,800 83,900 FOR RECONSTRUCTION OF VAGINA 64694 RADICAL HYSTERECTOMY O&G 155 62,800 83,900 104,900 146,900 209,200 PLUS OMENTECTOMY FOR OVARIAN 44706 CERVICAL BIOPSY O&G156 4,300 5,700 7,100 9,900 14,100

64749 VAGINAL HYSTERECTOMY O&G158 37,900 49,200 62,500 86,800 125,100 (WITHORWIHTOUT ANTERIOR REPAIR) 64752 VULVAL BIOPSY O&G160 6,500 8,400 10,700 14,900 21,500

64748 VAG.HYST.WITH O&G161 25,100 33,500 42,200 58,800 83,900 CERVICAL DESCENT COMPLEX

W.E.F. 1st January 2019 239 INVASIVE PROCEDURE

64750 VAGINAL SEPTUM , O&G162 7,400 9,600 12,200 16,900 24,300 EXCISION 71429 OVARIAN CYSTECTOMY O&G163 42,500 55,200 70,100 97,400 140,400 (BILATERAL) 1045190 BIPOLAR CORD O&G167 44,600 50,900 63,600 70,100 95,600 COAGULATION 1040655 LAPAROSCOPIC O&G168 12,500 17,100 21,200 29,500 42,200 TRANSPOSITION OF OVARIES 1040656 LAPAROSCOPIC O&G169 25,000 34,200 42,500 58,900 84,300 TRANSPOSITION OF OVARIES (BILATERAL) 1034767 LAPROSCOPIC O&G170 44,600 50,900 63,600 70,100 95,600 SARCOCOLPOPEXY 1048273 OVARIOPLASTY O&G171 21,200 27,900 35,000 49,100 70,200

1055669 BIPOLAR CORD O&G172 31,600 42,200 52,300 73,200 104,900 COAGULATION FOR MONOCHRONIC TWIN PREGNANCY 1055670 INTERSTITIAL LASSE O&G 173 31,600 42,200 52,300 73,200 104,900 FOR TRAP/OTHER CONDITIONS 1055671 RADIOFREQUENCY O&G 174 31,600 42,200 52,300 73,200 104,900 ABLATION FOR TRAP/ OTHER CONDITIONS 1055672 FETAL SHUNTING O&G 175 31,600 42,200 52,300 73,200 104,900 (PLEURO AMNIOTIC/ VESICOAMNIOTIC) 1040604 LAPAROSCOPIC PARTIAL O&G176 50,100 67,000 84,300 117,600 167,700 SALPINGECTOMY (BILATERAL) 1040437 VAGINAL CYSTECTOMY O&G177 17,100 22,400 27,900 39,100 56,100

1056549 SALPINGO O&G178 17,100 22,400 27,900 39,100 56,100 OOPHORECTOMY (LEFT) 1056551 SALPINGO O&G179 17,100 22,400 27,900 39,100 56,100 OOPHORECTOMY (RIGHT) 44729 EXCISION OF LABIAL CYST O&G180 7,800 9,700 12,200 12,700 24,000

240 W.E.F. 1st January 2019 INVASIVE PROCEDURE

1060725 SECOND TRIMESTER O&G181 21,200 27,900 35,000 49,100 70,200 SUCTION EVACUATION OF IUD 1069112 RE-SUTURING OF RECTUS O&G 182 14,200 18,700 23,200 32,300 46,800 SHEATH 1060922 REMOVAL OF MERSELENE O&G 183 6,400 8,700 10,300 14,900 21,200

1072291 LAPAROSCOPIC PARTIAL O&G 184 25,100 33,500 42,200 58,800 83,900 SALPINGECTOMY (LEFT) 1072292 LAPAROSCOPIC PARTIAL O&G 185 25,100 33,500 42,200 58,800 83,900 SALPINGECTOMY (RIGHT) 1085445 VAGINAL VAULT O&G 186 25,100 33,500 42,200 58,800 83,900 SUSPENSION ONCOLOGY SURGICAL

26290 ABDOMINAL PERINEAL Onco 1 52,300 70,200 87,300 122,100 174,600 RESECTION 44462 ANTERIOR Onco 2 62,800 83,900 104,900 146,900 209,200 EXENTERATION 44490 AXILLARY CLEARANCE Onco 3 31,600 42,200 52,300 73,200 104,900

44972 BILATERAL Onco 4 31,600 42,200 52,300 73,200 104,900 ORCHIDECTOMY 2319 CAROTID BODY TUMOUR Onco 5 52,300 70,200 87,300 122,100 174,600 WITH SHUNT 50307 CHEMOPORT INSERTION Onco 6 15,600 20,100 24,600 34,400 49,800

2423 COMMANDO WITH Onco 7 62,800 83,900 104,900 146,900 209,200 RND WITH PRIMARY RECONSTRUCTION 3264 CONSERVATIVE FOR CA Onco 8 42,200 56,100 70,200 97,700 139,700 LARYNX 2476 CRANIO FACIAL Onco 9 62,800 83,900 104,900 146,900 209,200 RESECTION 44471 DISARTICULATION OF HIP Onco 10 52,300 70,200 87,300 122,100 174,600 / SHOULDER 2548 DISTAL GASTRECTOMY Onco 11 52,300 70,200 87,300 122,100 174,600

2549 DISTAL PANCREACTOMY Onco 12 52,300 70,200 87,300 122,100 174,600 WITH SPLENECTOMY

W.E.F. 1st January 2019 241 INVASIVE PROCEDURE

3510 EXCISION OF PELVIC Onco 13 52,300 70,200 87,300 122,100 174,600 SARCOMA 3528 EXCISION OF SCROTAL Onco 14 31,600 42,200 52,300 73,200 104,900 MASS 3541 EXCISION OF TUMOUR Onco 15 31,600 42,200 52,300 73,200 104,900 PALATE 50308 EXPLORATARY Onco 16 21,200 27,900 35,000 49,100 70,200 LAPOROTOMY 2644 EXTENDED RT. / LT. Onco 17 52,300 70,200 87,300 122,100 174,600 HEMICOLECTOMY 2765 GASTROSTOMY / Onco 18 21,200 27,900 35,000 49,100 70,200 JEJUNOSTOMY / COLOSTOMY 3648 HEMIGLOSSECTOMY Onco 19 48,900 63,100 77,200 104,700 146,600

11725 HEMIGLOSSECTOMY Onco 20 63,100 77,000 91,100 118,700 160,400 WITH RND 2800 HEMIMANDIBULECTOMY Onco 21 52,300 70,200 87,300 122,100 174,600 WITH PRIMARY CLOSURE 50309 HEMIMANDULECTOMY Onco 22 42,200 56,100 70,200 97,700 139,700 WITH PRIMARY CLOSURE 44469 HEMIPELVECTOMY Onco 23 62,800 83,900 104,900 146,900 209,200

2807 HEPATECTOJEJUNOSTOMY Onco 25 52,300 70,200 87,300 122,100 174,600

2811 HIGH ORCHIDECTOMY Onco 26 31,600 42,200 52,300 73,200 104,900

2843 ILEOINGUINAL BLOCK Onco 27 31,600 42,200 52,300 73,200 104,900 DISSECTION 44460 LARYNGOPHARYGECTOMY Onco 28 62,800 83,900 104,900 146,900 209,200 WITH GASTRIC PULLUP 44476 LOBAR RESECTION LEFT Onco 29 52,300 70,200 87,300 122,100 174,600 LOBE LIVER 44464 LOBAR RESECTION RT. Onco 30 62,800 83,900 104,900 146,900 209,200 LOBE LIVER 44477 LOBECTOMY / Onco 31 52,300 70,200 87,300 122,100 174,600 PNEUMONECTOMY 11607 LUMPECTOMY Onco 32 21,200 27,900 35,000 49,100 70,200

44491 LUMPECTOMY WITH Onco 33 31,600 42,200 52,300 73,200 104,900 AXILLARY CLEARANCE 10252 MAXILLECTOMY PARTIAL Onco 34 48,900 63,000 77,100 104,600 146,500

242 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44482 MODIFIED RADICAL Onco 35 42,200 56,100 70,200 97,700 139,700 MASTECTOMY WITH AXILLARY CLEARANC 44465 OESOPHAGEAL Onco 36 62,800 83,900 104,900 146,900 209,200 RESECTION MIDDLE, LOWER 1/3 44461 OMENTECTOMY+PANHYS Onco 37 62,800 83,900 104,900 146,900 209,200 TERECTOMY+LYMPHADE NCTOMY FOR CA 44489 PARTIAL AMPUTATION Onco 38 42,200 56,100 70,200 97,700 139,700 OF PENIS WITH ING DISSECTION 33355 PELVIC EXENTERATION Onco 39 62,800 83,900 104,900 146,900 209,200

11564 POSTERIOR Onco 40 62,800 83,900 104,900 146,900 209,200 EXENTERATION 2274 PRIMARY RECONS BREAST Onco 41 42,200 56,100 70,200 97,700 139,700 IMPLANT 11560 RADICAL Onco 42 52,300 70,200 87,300 122,100 174,600 CHOLECYSTECTOMY 34076 RADICAL CYSTECTOMY Onco 43 62,800 83,900 104,900 146,900 209,200 WITH CONDUIT 11628 RADICAL NEPHRO Onco 44 52,300 70,200 87,300 122,100 174,600 URETERECTOMY 44474 RADICAL SURGERY FOR Onco 45 52,300 70,200 87,300 122,100 174,600 CANCER BODY UTERUS 44473 RADICAL SURGERY FOR Onco 46 52,300 70,200 87,300 122,100 174,600 CANCER CERVIX 44485 RELOOK SURGERY FOR CA Onco 47 42,200 56,100 70,200 97,700 139,700 OVARY 44487 RND Onco 48 48,900 63,100 77,200 104,700 146,600

44479 SEGMENT THREE BYPASS Onco 49 52,300 70,200 87,300 122,100 174,600

44483 SEGMENTAL Onco 50 42,200 56,100 70,200 97,700 139,700 MASTECTOMY WITH AXILLARY CLEARANCE 11604 SIMPLE MASTECTOMY Onco 51 31,600 42,200 52,300 73,200 104,900

44478 STAGING LAPROSCOPY Onco 52 52,300 70,200 87,300 122,100 174,600 FOR HODGKIN 13501 THYMECTOMY Onco 53 52,300 70,200 87,300 122,100 174,600

W.E.F. 1st January 2019 243 INVASIVE PROCEDURE

44481 TOTAL AMPUTATION Onco 54 52,300 70,200 87,300 122,100 174,600 OF PENIS WITH B/L ING DISSECTION 24303 TOTAL GASTRECTOMY Onco 55 52,300 70,200 87,300 122,100 174,600 / SUB TOTAL GASTRECTOMY 11686 TOTAL LAYRANGECTOMY Onco 56 56,100 74,000 91,100 125,900 178,300

10251 TOTAL MAXILECTOMY Onco 57 56,100 74,000 91,100 125,900 178,300

44480 TOTAL PAROTIDECTOMY Onco 59 52,300 70,200 87,300 122,100 174,600 WITH RND 11711 TOTAL VAGINECTOMY Onco 60 31,600 42,200 52,300 73,200 104,900

44467 TRANSHIATAL Onco 61 62,800 83,900 104,900 146,900 209,200 OESOPHAGECTOMY 11572 TRIPLE BYPASS Onco 62 52,300 70,200 87,300 122,100 174,600

44463 TRISEGMENTECTOMY Onco 63 62,800 83,900 104,900 146,900 209,200

83085 ANTERIOR RESECTION Onco 64 52,300 70,200 87,300 122,100 174,600 FOR CARCINOMA RECTOSIGMOID 68553 BONE MARROW Onco 65 12,700 17,300 21,700 29,700 42,500 HARVESTING 67960 CAROTID ARTERY Onco 66 31,600 42,200 52,300 73,200 104,900 LIGATION 87427 COMMON CAROTID Onco 67 48,900 63,100 77,200 104,700 146,600 LIGATION 66077 DISARTICULATION OF Onco 68 52,300 70,200 87,300 122,100 174,600 SHOULDER(LEFT) 66076 DISARTICULATION OF Onco 69 52,300 70,200 87,300 122,100 174,600 SHOULDER(RIGHT) 83090 EXCISION OF LARGE SOFT Onco 70 31,600 42,200 52,300 73,200 104,900 TISSUE TUMOUR 86595 EXCISION BUCCAL Onco 71 31,600 42,200 52,300 73,200 104,900 MUCOSA BILATERAL 65664 CHEMOPORT PLACEMENT Onco 72 15,600 20,100 24,600 34,400 49,800

22288 CHEMOPORT REMOVAL Onco 73 6,100 8,800 10,300 14,800 21,400

244 W.E.F. 1st January 2019 INVASIVE PROCEDURE

78600 EXCISION MULTIPLE Onco 74 62,800 83,900 104,900 146,900 209,200 FIBROMATOSIS WITH NEUROLYSIS 71475 EXCISION LEFT FOREARM Onco 75 52,300 70,200 87,300 122,100 174,600 RECURRENT SOFT TISSUE TUMOUR 83019 EXPLORATARY Onco 76 42,600 55,800 70,100 98,400 140,400 LAPOROTOMY (BILATERAL) 83405 EXCISION OF PELVIC Onco 77 104,400 140,400 174,500 244,300 349,100 SARCOMA (BILATERAL) 71325 EXCISION OF PARATID Onco 78 31,600 42,200 52,300 73,200 104,900 ADENOMA 67336 EXCISION OF SOFT TISSUE Onco 79 62,800 83,900 104,900 146,900 209,200 SARCOMA 22301 INCISION BIOPSY Onco 80 6,100 8,800 10,300 14,800 21,400

71282 INTER MAXILLY FIXATION Onco 81 31,600 42,200 52,300 73,200 104,900

82192 LUMPECTOMY Onco 83 42,600 55,800 70,100 98,400 140,400 (BILATERAL) 70859 LUMPECTOMY (LEFT) Onco 84 21,200 27,900 35,000 49,100 70,200

70858 LUMPECTOMY (RIGHT) Onco 85 21,200 27,900 35,000 49,100 70,200

82462 LUMPECTOMY WITH Onco 86 31,600 42,200 52,300 73,200 104,900 AXILLARY CLEARANCE (LEFT) 79133 MODIFIED RADICAL Onco 88 42,200 56,100 70,200 97,700 139,700 MASTECTOMY WITH AXILLARY CLEARANC (LEFT 79134 MODIFIED RADICAL Onco 89 42,200 56,100 70,200 97,700 139,700 MASTECTOMY WITH AXILLARY CLEARANC (RIGHT) 85739 OROCUTANEOUS FISTULA Onco 90 56,100 74,000 91,100 125,900 178,300

71070 PANCREATICO Onco 91 62,800 83,900 104,900 146,900 209,200 DUODENECTOMY 66296 RADICAL EXCISION OF Onco 92 62,800 83,900 104,900 146,900 209,200 RETROPERITONEAL TUMOR

W.E.F. 1st January 2019 245 INVASIVE PROCEDURE

77749 SEGMENTAL Onco 93 42,200 56,100 70,200 97,700 139,700 MASTECTOMY WITH AXILLARY CLEARANCE (LEFT 77750 SEGMENTAL Onco 94 42,200 56,100 70,200 97,700 139,700 MASTECTOMY WITH AXILLARY CLEARANCE (Right) 10661 THORACOCENTASIS Onco 95 7,600 10,200 12,600 17,600 24,600

44484 WIDE EXCISION OF Onco 96 38,300 50,900 63,700 88,800 126,800 MEDIUM SIZE STS 77576 WIDE EXCISION OFSTS Onco 97 31,600 42,200 52,300 73,200 104,900 (SMALL) 77577 WIDE EXICISION OF STS Onco 98 48,900 63,100 77,200 104,700 146,600 (LARGE) 10269 WIDE LOCAL EXCISION Onco 99 56,100 74,000 91,100 125,900 178,300

87648 WIDE LOCAL EXCISION Onco 100 62,800 83,900 104,900 146,900 209,200 LARGE 63296 WLE SCC RIGHT FACE Onco 101 21,200 27,900 35,000 49,100 70,200

71359 WLE TOUNGUE WITH Onco 102 42,200 56,100 70,200 97,700 139,700 SOHD 44468 WHIPPLES PROCEDURE Onco 103 62,800 83,900 104,900 146,900 209,200

88434 BIOPSY OF GLUTEAL MASS Onco 104 48,900 63,000 77,100 104,600 146,500

88435 BIOPSY OF GROIN MASS Onco 105 48,900 63,000 77,100 104,600 146,500

78935 GASTRECTOMY - D2 Onco 111 62,800 83,900 104,900 146,900 209,200 LYMPHADENECTOMY 85593 ICD INSERTION Onco 113 7,600 10,200 12,600 17,600 24,600

22298 ICD REMOVAL Onco 114 2,400 3,500 3,900 5,600 7,600

3353 DIRECT Onco116 12,600 16,400 20,800 28,900 41,600 MICROLARYNGOSCOPY 69726 ILEO INGUINAL Onco119 52,300 70,200 87,300 122,100 173,000 LYMPHADENCTOMY (BILATERAL) 82463 LUMPECTOMY WITH Onco120 31,600 41,200 52,200 72,600 104,400 AXILLARY CLEARANCE (RIGHT)

246 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44495 EXCISION OF LARGE Onco121 38,100 49,600 63,000 87,600 126,100 FIBROADENOMAS 66734 DRAINAGE OF SARCOMA Onco122 21,200 27,900 35,000 49,100 70,200

1053954 CRS WITH HIPEC Onco123 104,900 139,700 174,600 244,700 348,800

1055217 ILEAL POUCH ANAL Onco124 62,800 83,900 104,900 146,900 209,200 ANASTOMOSIS 1040166 AXILLARY CLEARANCE Onco125 31,600 42,200 52,300 73,200 104,900 (LEFT) 1040167 AXILLARY CLEARANCE Onco126 31,600 42,200 52,300 73,200 104,900 (RIGHT) 1040168 SIMPLE MASTECTOMY Onco127 31,600 42,200 52,300 73,200 104,900 (LEFT) 1040169 SIMPLE MASTECTOMY Onco128 31,600 42,200 52,300 73,200 104,900 (RIGHT) 65753 BILATERAL CONE DUCT Onco129 56,100 74,000 91,100 125,900 178,300 EXCISION 1061038 MICRODOCHECTOMY Onco130 21,200 27,900 35,000 49,100 70,200 (LEFT) 1061039 MICRODOCHECTOMY Onco131 21,200 27,900 35,000 49,100 70,200 (RIGHT) OPHTHALMOLOGY

50310 COMBINED PROCEDURES Opthal 1 27,200 36,600 45,700 63,700 90,700 (CATARACT+GLAUCOMA) 3271 COMPLEX Opthal 2 21,500 26,000 30,100 39,100 56,100 CORNEOSCLERAL PERFORATION 50311 COMPLEX LID REPAIR Opthal 3 17,200 21,500 26,000 27,200 39,100

3262 CONJ FLAP Opthal 4 6,700 9,300 11,100 15,400 22,400

2449 CORNEAL GRAFT WITH Opthal 5 27,200 36,600 45,700 63,700 90,700 CATARACT SURGERY 2450 CORNEAL GRAFT WITH Opthal 6 27,200 36,600 45,700 63,700 90,700 GLAUCOMA SURGERY 3269 CORNEAL GRAFTING Opthal 7 21,200 27,900 35,000 49,100 70,200

9410 CYCLOCRYO Opthal 8 6,700 9,300 11,100 15,400 22,400

2608 DCR Opthal 9 19,500 21,500 23,500 27,200 39,100

W.E.F. 1st January 2019 247 INVASIVE PROCEDURE

22996 ECCE WITH IOL , ECCE Opthal 17,100 22,400 27,900 39,100 56,100 WITHOUT IOD 11 6925 ECCE/ICCE Opthal 12,300 16,000 20,100 28,100 40,300 12 3408 ECTROPION Opthal 12,800 17,200 21,500 27,200 39,100 13 6923 ENTROPION Opthal 12,800 17,200 21,500 27,200 39,100 14 3439 ENUCLEATION / Opthal 10,700 15,200 19,500 23,400 33,500 EVISCERATION 15 10258 EXCENTRATION Opthal 21,200 27,900 35,000 49,100 70,200 16 3616 FUNDUS UNDER GA Opthal 6,600 8,700 10,700 13,500 19,600 EXAMINATION 17 2773 GLAUCOMA SURGERY Opthal 17,100 22,400 27,900 39,100 56,100 18 50312 IOFB REMOVAL ( Opthal 21,200 27,900 35,000 49,100 70,200 INTRAOCULAR FB 19 REMOVAL ) 50313 LENSECTOMY Opthal 17,100 22,400 27,900 39,100 56,100 20 50314 LENSECTOMY WITH Opthal 21,200 27,900 35,000 49,100 70,200 PHACOEMULSIFICATION 21 3475 LID TUMOUR , EXCISION Opthal 10,700 13,000 17,100 23,400 33,500 22 85796 MULTIPLE CORNEAL F. BS Opthal 12,000 15,400 19,600 27,200 39,100 23 50315 NEEDLING Opthal 12,000 15,400 19,600 27,200 39,100 24 50316 P/S and INCUBATION Opthal 12,000 15,400 19,600 27,200 39,100 26 50317 PHACO CHARGES Opthal 2,000 3,000 3,700 5,300 7,100 (ONLY 50% PAID TO 27 CONSULTANT) 24019 PTERYGIUM EXCISION Opthal 12,800 15,200 17,200 19,600 27,900 28 2466 PTOSIS CORRECTION Opthal 21,200 27,900 35,000 49,100 70,200 29 50318 RETINAL CRYO Opthal 10,700 13,000 17,100 23,400 33,500 30

248 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50319 RETINAL SURGERY Opthal 23,300 31,200 38,300 54,000 77,000 (SIMPLE) 31 50320 SIMPLE CORNEAL Opthal 17,200 21,500 26,000 27,200 39,100 PERFORATION 32 3580 EYELID REPAIR Opthal 12,800 17,200 21,500 23,400 33,500 33 94660 SIMPLE LID REPAIR Opthal 12,800 17,200 21,500 23,400 33,500 33 (A) 50321 SQUINT HORIZONTAL Opthal 13,500 18,300 22,800 32,000 45,700 MUSCLES 34 50322 SQUINT VERTICAL Opthal 13,500 18,300 22,800 32,000 45,700 MUSCLES 35 21654 TARSORRAPHY Opthal 10,700 13,000 17,100 23,400 33,500 36 6936 VITRECTOMY Opthal 23,300 31,200 38,300 54,000 77,000 37 50323 VITREO RETINAL Opthal 31,600 42,200 52,300 73,200 104,900 SURGERY 38 3429 ENTROPION-BOTH EYES Ophtal 18,900 25,100 31,600 43,900 62,800 39 71159 CONJ FLAP (RIGHT) Opthal 6,700 9,300 11,100 15,400 22,400 44 64638 FILTERING SURGERY Opthal 17,100 22,400 27,900 39,100 56,100 46 78549 HAEMANGIOMA Opthal 19,500 21,500 23,500 27,200 39,100 EXCISION AND 47 CAUTERISATION/LID/ ORBITAL MARGIN ONE EYE 64877 INTRAVITREAL INJ Opthal 10,700 13,000 17,100 23,400 33,500 48 64649 INTRAVITREAL Opthal 12,000 15,400 19,600 27,200 39,100 INJECTION UNILATERAL 49 80134 LID GROWTH Opthal 17,200 21,500 26,000 27,200 39,100 50 71160 PTERYGIUM Opthal 12,800 15,200 17,200 19,600 27,900 EXCISION(LEFT) 51 71161 PTERYGIUM Opthal 12,800 15,200 17,200 19,600 27,900 EXCISION(RIGHT) 52 64831 SILICON OIL REMOVAL Opthal 15,400 20,800 25,600 36,000 51,200 54

W.E.F. 1st January 2019 249 INVASIVE PROCEDURE

82314 SQUINT HORIZONTAL Opthal 13,500 18,300 22,800 32,000 45,700 MUSCLES (LEFT) 55 82315 SQUINT HORIZONTAL Opthal 13,500 18,300 22,800 32,000 45,700 MUSCLES (RIGHT) 56 6935 SYRINGING AND PROBING Opthal 12,000 15,400 19,600 27,200 39,100 57 88042 SQUINT HORIZONTAL Opthal 27,000 36,400 45,700 63,800 91,200 MUSCLES - BILATERAL 58 71085 CORNEA SURGERY LT EYE Opthal 17,100 22,400 27,900 39,100 56,100 59 71084 CORNEA SURGERY RT EYE Opthal 17,100 22,400 27,900 39,100 56,100 60 21639 CORNEAL F.B. REMOVAL Opthal 12,000 15,400 19,600 27,200 39,100 61 23035 ENUCLEATION Opthal 10,700 15,200 19,500 23,400 33,500 62 67072 FUNDUS UNDER GA Opthal 12,900 17,300 21,700 27,000 39,200 EXAMINATION(BILATERAL) 63 63268 P/ S ONE EYE Opthal 4,600 5,900 7,800 10,600 15,400 64 64708 SINGLE / MULTIPLE Opthal65 4,500 5,900 7,600 10,400 15,000 CORNEAL F.B. REMOVAL 77587 P/S and Incubation (Both Opthal66 24,000 31,200 39,600 55,100 79,400 Eyes) 21640 CYST REMOVAL Opthal68 5,500 7,000 8,900 12,400 17,700

21641 DRAINAGE OF LACRIMAL Opthal69 3,900 5,000 6,500 9,000 12,900 ABSCESS 21642 DRAINAGE OF LID Opthal70 3,900 5,000 6,500 9,000 12,900 ABSCESS 1056141 C3R Opthal71 10,700 13,000 17,100 23,400 33,500

71158 CONJ FLAP (LEFT) Opthal72 6,700 9,300 11,100 15,400 22,400

23548 LIO Opthal73 10,700 10,700 10,700 10,700 10,700

ORTHOPAEDICS

2990 IL ARTHRODESIS Ortho 1 31,600 42,200 52,300 73,200 104,900

3108 IL BONE GRAFTING Ortho 2 21,200 27,900 35,000 49,100 70,200

250 W.E.F. 1st January 2019 INVASIVE PROCEDURE

2470 IL CORTICOTOMY Ortho 3 5,500 7,100 9,000 12,400 17,500

3326 IL DEFORMITY Ortho 4 42,200 56,100 70,200 97,700 139,700 CORRECTION 44502 IL FRESH FRACTURES Ortho 5 31,600 42,200 52,300 73,200 104,900

44503 IL LIMB LENTHENING Ortho 6 31,600 42,200 52,300 73,200 104,900 -MAJOR BONES (TIBIA) 44504 IL LIMB LENTHENING Ortho 7 21,200 27,900 35,000 49,100 70,200 -MINOR BONE 3751 IL NON UNIONS Ortho 8 42,200 56,100 70,200 97,700 139,700

3757 IL OSTEOCLASIS Ortho 9 3,700 5,300 5,800 8,700 12,300

3597 IL READJUSTMENT OF Ortho 10 10,300 14,100 17,500 24,400 35,000 FIXATOR 3768 IL RECORTICOTOMY AND Ortho 11 17,100 22,400 27,900 39,100 56,100 ADJUSTMENT OF FIXATOR 35988 IL REMOVAL OF FIXATOR Ortho 12 10,300 14,100 17,500 24,400 35,000

2862 IL TENDON RELEASE Ortho 13 5,500 7,100 9,000 12,400 17,500

3783 IL WIRE REPLACEMENT Ortho 14 3,700 5,300 5,800 8,700 12,300

50327 LL AMPUTATION Ortho 15 21,200 27,900 35,000 49,100 70,200 THROUGH THIGH 44505 LL ANKLE FRACTURE MUA Ortho 16 8,700 11,100 14,100 19,600 27,900 AND POP 44506 LL ARTHRODESIS : Ortho 17 25,100 33,500 42,200 58,800 83,900 PANTALAR 35993 LL ARTHRODESIS ANKLE Ortho 18 21,200 27,900 35,000 49,100 70,200

2991 LL ARTHRODESIS KNEE Ortho 19 25,100 33,500 42,200 58,800 83,900

50328 LL ARTHRODESIS OF HIP Ortho 20 31,600 42,200 52,300 73,200 104,900 JOINT 50329 LL ARTHROSCOPIC Ortho 21 42,200 56,100 70,200 97,700 139,700 CRUCIATE LIG. RECONSTRUCTION 44507 LL ARTHROSCOPIC Ortho 22 31,600 42,200 52,300 73,200 104,900 MENISCAL EXCISION 33696 LL ARTHROSCOPIC Ortho 23 37,900 50,500 62,800 88,200 125,700 MENISCAL REPAIR

W.E.F. 1st January 2019 251 INVASIVE PROCEDURE

44508 LL ARTHROSCOPIC Ortho 24 25,100 33,500 42,200 58,800 83,900 POWER SHAVING 63278 LL ARTHROSCOPIC Ortho 25 25,100 33,500 42,200 58,800 83,900 REMOVAL OF LOOSE / FOREIGN BODY 33703 LL ARTHROSCOPY ANKLE Ortho 26 17,100 22,400 27,900 39,100 56,100

64655 LL ARTHROSCOPY OF Ortho 27 17,100 22,400 27,900 39,100 56,100 KNEE / DEBRIDEMENT AND WASHOUT 50330 LL ARTHROSCOPY OF Ortho 28 17,100 22,400 27,900 39,100 56,100 ELBOW 44510 LL ASTRAGALECTOMY Ortho 29 10,300 14,100 17,500 24,400 35,000

44511 LL BI/ TRI MALLEOLAR Ortho 30 21,200 27,900 35,000 49,100 70,200 FRACTURE INT FIXATION 44512 LL CLUB FOOT EXTENSIVE Ortho 31 31,600 42,200 52,300 73,200 104,900 SOFT TISSUE SURGICAL RELEAS 44513 LL CLUB FOOT: MUA and Ortho 32 10,300 14,100 17,500 24,400 35,000 POP 44514 LL CORE DECOMP + Ortho 33 52,300 70,200 87,300 122,100 174,600 MUSCLE PEDICLE HIP 44515 LL CORE DECOMPRESSION Ortho 34 31,600 42,200 52,300 73,200 104,900 HIP 44516 LL CORRECTION CTEV BY Ortho 35 31,600 42,200 52,300 73,200 104,900 EXT. FIXATOR METHOD 44517 LL CORRECTIVE Ortho 36 17,100 22,400 27,900 39,100 56,100 OSTEOTOMY FIRST METATARSAL 50331 LL DISARTICULATION OF Ortho 37 52,300 70,200 87,300 122,100 174,600 HIP andHAND QUARTER AMPUTATION 44518 LL DISLOCATION: ANKLE / Ortho 38 12,500 17,100 21,200 29,500 42,200 PERI TALAR: MUA and POP 44519 LL DISLOCATION: ANKLE Ortho 39 21,200 27,900 35,000 49,100 70,200 /PERI TALAR: OPEN REDUCTIN 22972 LL DISTAL FEMORAL Ortho 40 31,600 42,200 52,300 73,200 104,900 FRACTURE:DCS FIXATION

252 W.E.F. 1st January 2019 INVASIVE PROCEDURE

3391 LL DWYER'S CALCANEAL Ortho 41 17,100 22,400 27,900 39,100 56,100 OSTEOTOMY 44520 LL EXCISION MYOSITIS Ortho 42 25,100 33,500 42,200 58,800 83,900 OSSIFICANS - HIP 3479 LL EXCISION OF Ortho 43 12,500 17,100 21,200 29,500 42,200 GANGLION / EXOSTOSIS FROM FOOT 44521 LL EXTERNAL FIXATION Ortho 44 21,200 27,900 35,000 49,100 70,200 OF PELVIC FRACTURES 64656 LL FEMORAL NECK Ortho 45 35,800 47,100 59,000 83,400 118,800 OSTEOTOMY FOR SUFE EG DUNN'S WITH 28820 LL FRACTURE Ortho 46 25,100 33,500 42,200 58,800 83,900 CALCANEUM : BONE GRAFT and INT. FIX. 28821 LL FRACTURE Ortho 47 8,700 11,100 14,100 19,600 27,900 CALCANEUM : CLOSE REDUCTION andPOP 44523 LL FRACTURE Ortho 48 25,100 33,500 42,200 58,800 83,900 DISLOCATION KNEE 44524 LL FRACTURE HUMERAL Ortho 49 25,100 33,500 42,200 58,800 83,900 SHAFT: INTERNAL FIXATION 33908 LL FRACTURE NECK Ortho 50 29,500 39,100 49,100 68,600 97,700 OF FEMUR : AO SCREW FIXATION 44525 LL FRACTURE NECK Ortho 51 37,900 50,500 62,800 88,200 125,700 FEMUR NON UNION:BONE GRAFT+INTERN 44526 LL FRACTURE NECK Ortho 52 17,100 22,400 27,900 39,100 56,100 OF TALUS : INTERNAL FIXATION. 44527 LL FRACTURE OF Ortho 53 12,500 17,100 21,200 29,500 42,200 PHALANQES and/OR ,METATARSAL : INTER 44528 LL FRACTURE PROX, TIB, Ortho 54 25,100 33,500 42,200 58,800 83,900 CONDYLE INT, FIXATION 34196 LL FRACTURE Ortho 55 25,100 33,500 42,200 58,800 83,900 PROX. FEMUR: DHS / ENDOPROSTHESIS

W.E.F. 1st January 2019 253 INVASIVE PROCEDURE

23219 LL FRACTURE SHAFT Ortho 56 31,600 42,200 52,300 73,200 104,900 FEMUR: OPEN REDUCTION and PLATING 44529 LL FRAC SHAFT OF Ortho 57 37,900 50,500 62,800 88,200 125,700 FEMUR: INT. FIXATION BY AO INTER 44530 LL FRACTURE SHAFT Ortho 58 7,200 10,100 12,400 17,300 24,400 OF FEMUR: MUA AND TRACTION 44531 LL FRACUTRE TIB SHAFT Ortho 59 8,700 11,100 14,100 19,600 27,900 : CLOSE REDUCTION and POP 44532 LL FRACUTRE TIB. SHAFT Ortho 60 31,600 42,200 52,300 73,200 104,900 INTER LOCKING NAILING 23849 LL FRACTURE TIB. SHAFT: Ortho 61 21,200 27,900 35,000 49,100 70,200 OPEN RED. AND PLATING 2771 LL GIRDLE STONE PSEUDO Ortho 62 17,100 22,400 27,900 39,100 56,100 -ARTHROPLASTY 44533 LL GREAT TOE: MTP JOINT Ortho 63 12,500 17,100 21,200 29,500 42,200 ARTHRODESIS 44534 LL GRICE'S PROCEDURE Ortho 64 12,500 17,100 21,200 29,500 42,200 SUB TALAR BONE BLOCK 44535 LL HEAL OSTEOTOMY/ Ortho 65 12,500 17,100 21,200 29,500 42,200 METATARSAL HEAD EXCISION LESSE 13372 LL HIP ARTHROTOMY FOR Ortho 66 21,200 27,900 35,000 49,100 70,200 INFECTION 44536 LL HIP DEFORMITY: Ortho 67 12,500 17,100 21,200 29,500 42,200 SOFT TISSUE RELEASE PROCEDURE 44537 LL HIP -SPICA OR Ortho 68 12,500 17,100 21,200 29,500 42,200 MINERVA OR BODY CAST 50332 LL HYBIRD TOTAL HIP Ortho 69 52,300 70,200 87,300 122,100 174,600 REPLACEMENT 44538 LL INGROWING TOE NAIL: Ortho 70 6,500 8,700 10,300 14,900 21,200 WEDGE EXCISION 44539 LL INGROWING TOE NAIL: Ortho 71 8,700 11,100 14,100 19,600 27,900 ZADEK'S PROCEDURE 44540 LL INT. FIXATION IN SITU; Ortho 72 21,200 27,900 35,000 49,100 70,200 OF SUFE

254 W.E.F. 1st January 2019 INVASIVE PROCEDURE

23352 LL INTER -LOCKING NAIL Ortho 73 12,500 17,100 21,200 29,500 42,200 RIMOVAL 50333 LL INTERNAL FIXATION Ortho 74 52,300 70,200 87,300 122,100 174,600 OF COMPLEX PELVIC FRACTURES 44541 LL JONES PROCEDURE Ortho 75 10,300 14,100 17,500 24,400 35,000 FOR GREAT TOE. 44542 LL KELLERS OPERATION Ortho 76 8,700 11,100 14,100 19,600 27,900

44543 LL LAT. RELEASE AND Ortho 77 18,900 25,100 31,600 43,900 62,800 MEDIAL CAPSULE PLICATION 44545 LL MAL UNION Ortho 78 31,600 42,200 52,300 73,200 104,900 TIBIA CORRECTIVE OSTEOTOMY andINTER LOC 44544 LL MAL UNION Ortho 79 25,100 33,500 42,200 58,800 83,900 TIBIA CORRECTIVE OSTEOTOMY and PLATING 44546 LL MED/ LAT, LIG. REPAIR / Ortho 80 17,100 22,400 27,900 39,100 56,100 RECONSTRUCTION 44547 LL MID FOOT Ortho 81 12,500 17,100 21,200 29,500 42,200 DISLOCATIONS REDUCTIONand KWIRE FIXATION 44548 LL MID -TARSAL Ortho 82 21,200 27,900 35,000 49,100 70,200 CORRECTIVE OSTEOTOMY 44549 LL MUA FOR ACUTE HIP Ortho 83 12,500 17,100 21,200 29,500 42,200 DISLOCATION 44550 LL MUSTARDS OR Ortho 84 12,500 17,100 21,200 29,500 42,200 SHARRARDS OPERATION 44551 LL NON UNION TIBIA Ortho 85 31,600 42,200 52,300 73,200 104,900 BONE GRAFT and INT LOCK NAIL 44552 LL NON UNION TIBIA Ortho 86 25,100 33,500 42,200 58,800 83,900 BONE GRAFT AND PLATING 44553 LL NON UNION TIBIA Ortho 87 21,200 27,900 35,000 49,100 70,200 BONE GRAFTING

W.E.F. 1st January 2019 255 INVASIVE PROCEDURE

44554 LL OPEN CRUTIATE LIG; Ortho 88 31,600 42,200 52,300 73,200 104,900 RECON. BY AUTO GRAFT 44555 LL OPEN CRUTIATE LIG; Ortho 89 31,600 42,200 52,300 73,200 104,900 RECON. BY PROSTHETIC LIG. 44557 LL OPEN FRACURE TIB Ortho 90 25,100 33,500 42,200 58,800 83,900 SHAFT DEBRIDEMENT andEXTERNAL FI 44556 LL OPEN FRACTURE TIB Ortho 91 31,600 42,200 52,300 73,200 104,900 SHAFT DEBRIDEMENT andUNREAMED A 44558 LL OPEN MENISCECTOMY Ortho 92 12,500 17,100 21,200 29,500 42,200

3666 LL OSTEOTOMY HIGH Ortho 93 25,100 33,500 42,200 58,800 83,900 TIBIAL 44559 LL PATELLA Ortho 94 18,900 25,100 31,600 43,900 62,800 INT; FIXATION / PATELLECTOMY 44560 LL PILON ANKLE Ortho 95 25,100 33,500 42,200 58,800 83,900 FRACTURES: INTFIX. and BONE GRAFT. 44561 LL PRE-PATELLAR BURSA Ortho 96 8,700 11,100 14,100 19,600 27,900 EXCISION 44562 LL PROXIMAL ROW Ortho 97 18,900 25,100 31,600 43,900 62,800 CARPECTOMY 33894 LL QUADRICEPS PLASTY Ortho 98 25,100 33,500 42,200 58,800 83,900

44563 LL RE LOCATION OF TIB Ortho 99 17,100 22,400 27,900 39,100 56,100 TUBERCLE (EG HAUSER'S) 23394 LL REMOVAL OF Ortho 8,700 11,100 14,100 19,600 27,900 K-INTRAMEDULLARY 100 NAIL. 44564 LL REPAIR OF QUADS OR Ortho 17,100 22,400 27,900 39,100 56,100 PATELLAR TENDON 101 44565 LL RETRO CALCANEAL Ortho 6,500 8,700 10,300 14,900 21,200 EXOSTOSIS /BURSA 102 EXCISION 44632 LL REVISION TOTAL HIP Ortho 73,200 97,700 122,100 170,700 244,700 REPLACEMENT 103 50334 LL REVISION TOTAL KNEE Ortho 73,200 97,700 122,100 170,700 244,700 REPLACEMENT 104

256 W.E.F. 1st January 2019 INVASIVE PROCEDURE

23847 LL SALTERS PELVIC Ortho 31,600 42,200 52,300 73,200 104,900 OSTEOTOMY 105 44566 LL SKIN TRACTION: Ortho 3,700 5,300 5,800 8,700 12,300 LOWER LIMB 106 44567 LL SUB. TROCH Ortho 21,200 27,900 35,000 49,100 70,200 OSTEOTOMY WITH INT. 107 FIXATION 44568 LL SUPRA CONDYLAR Ortho 31,600 42,200 52,300 73,200 104,900 FEMORAL OSTEOTOMY 108 WITH INT.FIXAT 44569 LL SYMES AMPUTATION. Ortho 17,100 22,400 27,900 39,100 56,100 109 33929 LL TENDO ACHILLIS Ortho 17,100 22,400 27,900 39,100 56,100 LENGTHENING 110 33930 LL TENDO ACHILLIS Ortho 17,100 22,400 27,900 39,100 56,100 REPAIR 111 44631 LL TOTAL HIP Ortho 52,300 70,200 87,300 122,100 174,600 REPLACEMENT/ 112 SHOULDER REPLACEMENT 50335 LL TOTAL KNEE JOINT Ortho 42,000 56,100 70,100 98,100 140,100 REPLACEMENT 113 2863 LL TRIPLE ARTHRODESIS Ortho 31,600 42,200 52,300 73,200 104,900 LAMBRINUDI PROCEDURE 114 50336 LL UNI CONDYLAR KEE Ortho 42,200 56,100 70,200 97,700 139,700 REPLACEMENT 115 44570 LL WATSON -JONES OP Ortho 12,500 17,100 21,200 29,500 42,200 FOR UNSTABLE ANKLE. 116 50337 SP ANT LAT Ortho 42,200 56,100 70,200 97,700 139,700 DECOMPRESSION: TWO 117 OR MORE LEVELS 44571 SP ANT.DRAINAGE Ortho 25,100 33,500 42,200 58,800 83,900 PARAVERTEBRAL ABSCESS 118 and GRAFT 44572 SP BIOPSY SACRO ILIAC Ortho 10,300 14,100 17,500 24,400 35,000 REGION. 119 33746 SP EXCISION OF COCCYX. Ortho 8,700 11,100 14,100 19,600 27,900 120 50338 SP EXCISION OF LARGE Ortho 62,800 83,900 104,900 146,900 209,200 SPINAL TUMOUR and 121 BONE GRAFTING

W.E.F. 1st January 2019 257 INVASIVE PROCEDURE

3583 SP FACET JOINT Ortho 7,200 10,100 12,400 17,300 24,400 INJECTION: ONE LEVEL 123 50339 SP LAMINECTOMY Ortho 78,300 104,900 130,500 183,300 261,800 124 32493 SP MUA CERVICAL / Ortho 6,500 8,700 10,300 14,900 21,200 LUMBER SPINE 125 50340 SP SACRO ILIAC JOINT Ortho 25,100 33,500 42,200 58,800 83,900 ARTHRODESIS 126 44573 SP SKELETAL TRACTION Ortho 10,300 14,100 17,500 24,400 35,000 FOR CERVICAL SPINE 127 50341 SP SPINAL Ortho 78,300 104,900 130,500 183,300 261,800 RECALIBRATION 128 24415 SP TORTICOLLIS: CONG: Ortho 15,900 21,200 26,800 37,300 52,800 SOFT TISSUE RELEASE FOR 129 50342 UL ACROMIOPLASTY Ortho 17,100 22,400 27,900 39,100 56,100 130 44574 UL ADDUCTOR REL. Ortho 31,600 42,200 52,300 73,200 104,900 and OBTURATOR 131 NEURECTOMY 50343 UL AMPUTATION Ortho 21,200 27,900 35,000 49,100 70,200 THROUGH ARM 132 50344 UL AMPUTATION Ortho 17,100 22,400 27,900 39,100 56,100 THROUGH FOREARM 133 50345 UL AMPUTATION: FORE Ortho 42,200 56,100 70,200 97,700 139,700 QUARTER 134 50346 UL ARTHOROSCOPIC Ortho 31,600 42,200 52,300 73,200 104,900 ANKLE SURGERY 135 50347 UL ARTHOSCOPIC Ortho 42,200 56,100 70,200 97,700 139,700 SHOULDER STABLIZATION 136 44575 UL ARTHRODESIS ELBOW Ortho 21,200 27,900 35,000 49,100 70,200 137 2992 UL ARTHRODESIS OF Ortho 31,600 42,200 52,300 73,200 104,900 SHOULDER JOINT 138 44576 UL ARTHRODESIS WRIST Ortho 21,200 27,900 35,000 49,100 70,200 139 50348 UL ARTHROSCOPIC Ortho 31,600 42,200 52,300 73,200 104,900 ELBOW SURGERY 140 34153 UL ARTHROSCOPY Ortho 17,100 22,400 27,900 39,100 56,100 SHOULDER JOINT 142 (DIAGNOSTIC)

258 W.E.F. 1st January 2019 INVASIVE PROCEDURE

64732 UL ARTHROTOMY Ortho 21,200 27,900 35,000 49,100 70,200 AND SUB TOTAL 143 SYNOVECTOMY MAJOR 44578 UL ARTHROTOMY Ortho 17,100 22,400 27,900 39,100 56,100 AND SUB TOTAL 144 SYNOVECTOMY SMALL 44579 UL ASPIRATION / Ortho 1,800 2,200 3,000 4,200 5,700 INJECTION OF A JOINT 145 44580 UL BELOW ELBOW POP Ortho 1,800 2,000 2,700 3,700 5,500 CAST OR SLAB 146 44581 UL COLLES FRACTURE: Ortho 8,700 11,100 14,100 19,600 27,900 MUA 147 44582 UL COLLES FRACTURE: Ortho 17,100 22,400 27,900 39,100 56,100 MUA and EXTERNAL 148 FIXATOR 44583 UL COLLES FRACTURE: Ortho 10,300 14,100 17,500 24,400 35,000 MUA and K- WIRE 149 FIXATION 44584 UL COLLES/ SMITH S Ortho 21,200 27,900 35,000 49,100 70,200 FRACTURE: OPEN RED 150 INT. FIX. 22930 UL DE QUERVAINS Ortho 12,500 17,100 21,200 29,500 42,200 DECOMPRESSION. 151 50349 UL DIS ARTICULATION Ortho 52,300 70,200 87,300 122,100 174,600 THROUGH SHOULDER 152 23010 UL DISLOCATION ELBOW Ortho 8,700 11,100 14,100 19,600 27,900 /MONTAGGIA : MUA 154 50350 UL DISLOCATION Ortho 52,300 70,200 87,300 122,100 174,600 RECURRENT:OPERATIONS 155 BY ARTHROSCOPY 3769 UL DISLOCATION Ortho 42,200 56,100 70,200 97,700 139,700 RECURRENT : 156 OPERATIONS BY OPEN 44585 UL DISLOCATION Ortho 21,200 27,900 35,000 49,100 70,200 SHOULDER : OPEN 157 REDUCTION 23695 UL DISLOCATION Ortho 12,500 17,100 21,200 29,500 42,200 SHOULDER MUA 158 44586 UL DISLOCATION:CARPUS Ortho 21,200 27,900 35,000 49,100 70,200 OR PERI CARPAL:OPEN 159 RED.

W.E.F. 1st January 2019 259 INVASIVE PROCEDURE

44587 UL Ortho 12,500 17,100 21,200 29,500 42,200 DISLOCATIONS;CARPUS 160 OR PERI CARPAL:MUA 44588 UL EXCISION Ortho 21,200 27,900 35,000 49,100 70,200 ARTHROPLASTY OF 161 ELBOW 50351 UL EX.DISTALEND Ortho 42,200 56,100 70,200 97,700 139,700 RADIUSandRECONST. BY 162 UPPEREND OF FI 3469 UL EXCISION DISTAL END Ortho 12,500 17,100 21,200 29,500 42,200 ULNA 163 44590 UL EXCISION MYOSITIS Ortho 17,100 22,400 27,900 39,100 56,100 OSSIFICANS - ELBOW 164 44591 UL ECXCISION OF Ortho 12,500 17,100 21,200 29,500 42,200 LATERAL END OF 165 CALVICLE 44592 UL EXCISION OF RADIAL Ortho 12,500 17,100 21,200 29,500 42,200 SYTLOID PROCESS 166 23688 UL FRACTURE BOTH Ortho 8,700 11,100 14,100 19,600 27,900 BONES FOREARM: MUA 167 andPOP 44593 UL FRACTURE Ortho 12,500 17,100 21,200 29,500 42,200 CAPITELLUM : INT.FIX/ 168 EXCISION 33852 UL FRACTURE CLAVICLE: Ortho 17,100 22,400 27,900 39,100 56,100 OPEN REDUCTION and 169 INT. FIX 44594 UL FRACTURE Ortho 31,600 42,200 52,300 73,200 104,900 NECKOFHUMERUS 170 THREEPART OPENREDUCTION 44595 UL FRACTURE OF Ortho 6,500 8,700 10,300 14,900 21,200 PHALANGES andOR 171 METACARPALS CLOSE RED 36012 UL FRACTURE Ortho 10,300 14,100 17,500 24,400 35,000 OLECRANON: OPEN RED 172 and INT FIXATION 23771 UL FRACTURE RADIUS Ortho 21,200 27,900 35,000 49,100 70,200 and ULNA SHAFT INT 173 FIXATION 44596 UL FRACTURE RADIUS Ortho 14,900 19,600 24,400 33,900 49,100 OR ULNA SHAFT INT 174 FIXATION 260 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44597 UL FRACUTE HUMERAL Ortho 8,700 11,100 14,100 19,600 27,900 SHAFT : MUA and POP 175 44598 UL MUSCLE SLIDE Ortho 21,200 27,900 35,000 49,100 70,200 FOR VOLKMAN 176 CONTRACTURE 23793 UL NON UNION HUMERUS Ortho 31,600 42,200 52,300 73,200 104,900 BONE GRAFT AND INT. 178 FIX. 44600 UL NON UNION OF Ortho 25,100 33,500 42,200 58,800 83,900 CLAVICLE : BONE GRAFT 179 and INT FIX. 44601 UL NON-UNION Ortho 21,200 27,900 35,000 49,100 70,200 SCAPHOID : BONE 180 GRAFTING 44602 UL OLECARNON BURSA Ortho 6,500 8,700 10,300 14,900 21,200 EXCISION 181 44603 UL RADIAL HEAD Ortho 18,900 25,100 31,600 43,900 62,800 FRACTURE: OPENED and 182 INT FIX. 3524 UL RADIUS HEAD Ortho 12,500 17,100 21,200 29,500 42,200 EXCISION 183 50352 UL REVISION FUSION OF Ortho 42,200 56,100 70,200 97,700 139,700 SHOULDER 184 50353 UL REVISION TOTAL Ortho 52,300 70,200 87,300 122,100 174,600 ELBOW REPLACEMENT 185 50354 UL REVISION Ortho 73,200 97,700 122,100 170,700 244,700 TOTAL SHOULDER 186 REPLACEMENT 35817 UL ROTATOR CUFF REPAIR Ortho 21,200 27,900 35,000 49,100 70,200 187 50355 UL SHOULDER HEMI Ortho 31,600 42,200 52,300 73,200 104,900 ARTHROPLASTY BY 188 PROSTHESIS 44604 UL SHOULDER SPICA CAST Ortho 8,700 11,100 14,100 19,600 27,900 189 50356 UL SHOULDER TOTAL Ortho 52,300 70,200 87,300 122,100 174,600 JOINT REPLACEMENT 190 44605 UL SOB -ACROMIAL Ortho 10,300 14,100 17,500 24,400 35,000 BURSECTOMY 191 44606 UL SOFT TISSUE RELEASE Ortho 31,600 42,200 52,300 73,200 104,900 HIP / KNEE / ANKLE 192

W.E.F. 1st January 2019 261 INVASIVE PROCEDURE

64733 UL SUPRA -CONDYLAR Ortho 25,100 33,500 42,200 58,800 83,900 FRACTURE:OPEN RED. 193 INT.FIX. 9495 UL SUPRA CONDYLAR Ortho 21,200 27,900 35,000 49,100 70,200 CORRECTIVE 194 OSTEOTOMY 44608 UL SUPRA -CONDYLAR Ortho 17,100 22,400 27,900 39,100 56,100 FRACTURE :MUA 195 22592 UL SUPRA -CONDYLAR Ortho 21,200 27,900 35,000 49,100 70,200 FRACTURE :MUA and K 196 -WIRE 44609 UL SYNOVECTOMY OF Ortho 17,100 22,400 27,900 39,100 56,100 TENDONS AND WRIST 197 35970 UL TENNIS ELBOW: Ortho 8,700 11,100 14,100 19,600 27,900 SURGICAL RELEASE 198 33937 UL TOTAL ELBOW Ortho 42,200 56,100 70,200 97,700 139,700 REPLACEMENT 199 50358 UL TRAPEZIAL JOINT Ortho 21,200 27,900 35,000 49,100 70,200 REPLACEMENT 200 22560 UL TRIGGER FINGER: Ortho 12,500 17,100 21,200 29,500 42,200 SURGICAL RELEASE 201 33944 UL ULNA NERVE Ortho 21,200 27,900 35,000 49,100 70,200 TRANSPOSITION 202 44610 UL/LL ABOVE ELBOW OR Ortho 3,700 5,300 5,800 8,700 12,300 LOWER LIMB CAST 203 44611 UL/LL ABOVE ELBOW OR Ortho 1,800 2,200 3,000 4,300 5,800 LOWER LIMB POP SLAB 204 44612 UL/LL AC. Ortho 17,100 22,400 27,900 39,100 56,100 OSTEMYELITIS:SURGICAL 205 DECOMPRESSION 44613 UL/LL ACUTE Ortho 17,100 22,400 27,900 39,100 56,100 COMPARTMENTAL 206 SYNDROME: SURG: DECOMPRESSION 2782 UL/LL AMPUTATION Ortho 17,100 22,400 27,900 39,100 56,100 BELOW KNEE 207 2932 UL/LL AMPUTATION OF Ortho 8,700 11,100 14,100 19,600 27,900 MULTIPLE TOES 208 44614 UL/LL AMPUTATION OF Ortho 4,300 5,700 7,100 10,100 14,100 SINGLE TOE 209

262 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44615 UL/LL ARTHRODESIS OF Ortho 8,700 11,100 14,100 19,600 27,900 I.P. JOINT 210 28091 UL/LL BIOPSY SYNOVIAL. Ortho 10,300 14,100 17,500 24,400 35,000 211 35069 UL/LL CHR.ANT.COMP. Ortho 17,100 22,400 27,900 39,100 56,100 SYNDROME : FASCIOTOMY 212 44616 UL/LL CHR. Ortho 31,600 42,200 52,300 73,200 104,900 OSTEOMYELITIS:DEBRIDMENT 213 SAUCC.and BG/MPM 44617 UL/LL CHR. Ortho 17,100 22,400 27,900 39,100 56,100 OSTEOMYELITIS:DEBRIDMENT 214 SAUCC.and BG/MPMI 44619 UL/LL CURRETTAGE and Ortho 31,600 42,200 52,300 73,200 104,900 BONE GRAFT LARGE 216 BONE LESIONS 44620 UL/LL CURRETTAGE and Ortho 21,200 27,900 35,000 49,100 70,200 BONE GRAFT SMALL 217 BONE LESIONS. 44621 UL/LL EXCISION OF Ortho 8,700 11,100 14,100 19,600 27,900 BUNION AND BURSA 218 50359 UL/LL EXCISION OF LARGE Ortho 62,800 83,900 104,900 146,900 209,200 BONE TUMOUR FOR LIMB 219 CONS. 33197 UL/LL EXCISION SUPER Ortho 8,700 11,100 14,100 19,600 27,900 NUMARY DIGIT 220 44622 UL/LL GANGLION Ortho 6,500 8,700 10,300 14,900 21,200 EXCISION 221 64734 UL/LL MP JOINT Ortho 11,100 15,200 18,400 26,100 37,300 ARTHRODESIS 222 44624 UL/LL NEEDLE BIOPSY Ortho 3,700 5,300 5,800 8,700 12,300 BONE / JOINT LEISON 223 64735 UL/LL NON UNIONS - Ortho 25,100 33,500 42,200 58,800 83,900 INFECTED MINOR BONES 224 44626 UL/LL NON UNIONS - Ortho 52,300 70,200 87,300 122,100 174,600 INFECTED MAJOR BONES 225 44627 UL/LL OPEN BIOPSY Ortho 7,200 10,100 12,400 17,300 24,400 MUSCULO -SKELETAL 226 LESION 9485 UL/LL REMOVAL OF DEEP Ortho 10,300 14,100 17,500 24,400 35,000 SCREWS /TENSION BAND 227 WIRE

W.E.F. 1st January 2019 263 INVASIVE PROCEDURE

44628 UL/LL REMOVAL OF Ortho 8,700 11,100 14,100 19,600 27,900 EXOSTOSIS FROM LONG 228 BONE 2645 UL/LL REMOVAL OF Ortho 5,500 7,100 9,000 12,400 17,500 EXTERNAL FIXATOR 229 19720 UL/LL REMOVAL OF Ortho 1,800 2,200 3,000 4,300 5,800 K-WIRES. 230 24098 UL/LL REMOVAL OF PLATE Ortho 10,300 14,100 17,500 24,400 35,000 : RAD.,ULNA, TIB and FIB. 231 44629 UL/LL REMOVAL OF Ortho 12,500 17,100 21,200 29,500 42,200 PLATE: FEMUR, HUM, DCS 232 , DHS 83790 IL FRESH FRACTURES Ortho 63,400 84,300 104,400 146,500 209,900 (BILATERAL) 233 71274 IL FRESH FRACTURES Ortho 31,600 42,200 52,300 73,200 104,900 (LEFT) 234 71273 IL FRESH FRACTURES Ortho 31,600 42,200 52,300 73,200 104,900 (RIGHT) 235 79807 IL NON UNIONS Ortho 84,300 112,000 140,400 195,400 279,200 (BILATERAL) 236 70942 LL ARTHROSCOPIC Ortho 63,400 84,300 104,400 146,500 209,900 MENISCAL EXCISION 237 (BILATERAL) 67614 LL ARTHROSCOPIC Ortho 31,600 42,200 52,300 73,200 104,900 MENISCAL EXCISION 238 (LEFT) 67615 LL ARTHROSCOPIC Ortho 31,600 42,200 52,300 73,200 104,900 MENISCAL EXCISION 239 (RIGHT) 78091 LL ARTHROSCOPIC Ortho 50,300 67,000 84,300 117,700 167,600 POWER SHAVING 240 (BILATERAL) 83380 LL ARTHROSCOPIC Ortho 25,100 33,500 42,200 58,800 83,900 POWER SHAVING (LEFT) 241 77636 LL ARTHROSCOPY OF Ortho 34,100 44,900 55,800 78,200 112,000 KNEE DEBRIDEMENT AND 242 WASHOUT (BILATERAL) 87448 LL CORE DECOMP PLUS Ortho 104,400 140,400 174,500 244,300 349,100 MUSCLE PEDICLE HIP 243 (BILATERAL)

264 W.E.F. 1st January 2019 INVASIVE PROCEDURE

79655 LL CORE DECOMPRESSION Ortho 31,600 42,200 52,300 73,200 104,900 HIP (Left) 244 79656 LL CORE DECOMPRESSION Ortho 31,600 42,200 52,300 73,200 104,900 HIP (Right) 245 83381 LL ARTHROSCOPIC Ortho 25,100 33,500 42,200 58,800 83,900 POWER SHAVING (RIGHT) 246 69098 LL FRACTURE OF Ortho 25,000 34,100 42,600 58,800 84,300 PHALANQES AND/OR 247 METATARSAL -INTER (BILATERAL) 78996 LL FRACTURE Ortho 50,300 67,000 84,300 117,700 167,600 CALCANEUM BONE 248 GRAFT AND INT. FIX. (BILATERAL) 76591 LL INTER LOCKING NAIL Ortho 12,500 17,100 21,200 29,500 39,600 REMOVAL (LEFT) 249 76592 LL INTER LOCKING NAIL Ortho 12,500 17,100 21,200 29,500 39,600 REMOVAL (RIGHT) 250 70105 LL INTER-LOCKING NAIL Ortho 25,000 34,100 42,600 58,800 84,300 REMOVAL (BILATERAL) 251 87414 LL REVISION TOTAL Ortho 146,500 195,400 244,300 341,600 489,300 HIP REPLACEMENT 252 (BILATERAL) 85583 LL REVISION TOTAL KNEE Ortho 73,200 97,700 122,100 170,700 244,700 REPLACEMENT (LEFT) 253 85582 LL REVISION TOTAL KNEE Ortho 73,200 97,700 122,100 170,700 244,700 REPLACEMENT (RIGHT) 254 77933 LL SUPRA CONDYLAR Ortho 63,400 84,300 104,400 146,500 209,900 FEMORAL OSTEOTOMY 255 WITH INT.FIXAT (BILATERAL) 79864 UL SUPRA CONDYLAR Ortho 21,200 27,900 35,000 49,100 70,200 CORRECTIVE 256 OSTEOTOMY (LEFT) 79865 UL SUPRA CONDYLAR Ortho 21,200 27,900 35,000 49,100 70,200 CORRECTIVE 257 OSTEOTOMY (RIGHT) 64731 UL ARTHROSCOPIC Ortho 42,200 56,100 70,200 97,700 139,700 ANKLE STABLIZATION 258 69975 TOTAL HIP Ortho 104,400 140,400 174,500 244,300 349,100 REPLACEMENT(BILATERAL) 259

W.E.F. 1st January 2019 265 INVASIVE PROCEDURE

9512 TOTAL KNEE Ortho 84,100 112,000 140,100 196,100 280,200 REPLACEMENT 260 (BILATERAL) 82270 UL ASPIRATION / Ortho 3,300 4,400 6,100 8,100 11,600 INJECTION OF A JOINT 261 (BILATERAL) 77598 UL DE QUERVAINS Ortho 25,000 34,100 42,600 58,800 84,300 DECOMPRESSION 262 (BILATERAL) 79334 UL ULNA NERVE Ortho 42,600 55,800 70,100 98,400 140,400 TRANSPOSITION 263 (BILATERAL) 82139 UL/LL ABOVE ELBOW Ortho 7,400 10,400 11,800 17,300 24,500 OR LOWER LIMB CAST 264 (BILATERAL) 68186 UL/LL ABOVE ELBOW OR Ortho 3,700 5,300 5,800 8,700 12,300 LOWER LIMB CAST (LEFT) 265 68187 UL/LL ABOVE ELBOW Ortho 3,700 5,300 5,800 8,700 12,300 OR LOWER LIMB CAST 266 (RIGHT) 85673 UL/LL AMPUTATION Ortho 20,500 26,900 33,500 46,800 67,200 ABOVE KNEE 267 84122 UL/LL REMOVAL OF DEEP Ortho 20,700 28,000 35,300 48,600 70,100 SCREWS /TENSION BAND 268 WIRE (BILATERAL) 86729 U/L LL REMOVAL OF Ortho 25,000 34,100 42,600 58,800 84,300 PLATE FEMUR-HUM-DCS- 269 DHS (BILATERAL) 67375 UL/LL REMOVAL OF DEEP Ortho 10,300 14,100 17,500 24,400 35,000 SCREWS 270 67374 UL/LL REMOVAL OF Ortho 10,300 14,100 17,500 24,400 35,000 TENSION BAND WIRE 271 79805 UL/LL REMOVAL OF Ortho 11,000 14,300 17,700 24,700 35,300 EXTERNAL FIXATOR 272 (BILATERAL) 83375 UL/LL NON UNIONS - Ortho 104,400 140,400 174,500 244,300 349,100 INFECTED MAJOR BONES 274 (BILATERAL) 71358 UL LL REMOVAL OF PLATE Ortho 25,000 34,100 42,600 58,800 84,300 FERMUR HUM DCS DHS 275 (BILATERAL)

266 W.E.F. 1st January 2019 INVASIVE PROCEDURE

80104 AMPUTATION ONE Ortho 4,300 5,700 7,100 10,100 14,100 FINGER 276 70289 BALOON KYPHOPLASTY Ortho 52,300 70,200 87,300 122,100 174,600 277 67287 CORTICOTOMY TIBIA Ortho 12,700 17,300 21,500 29,700 42,500 278 82636 EXCISION OF BONE Ortho 31,600 42,200 52,300 67,900 95,000 TUMOR 279 83091 EXCISIION OF SOFT Ortho 62,800 83,900 104,900 146,900 209,200 TISSUE TUMOUR 280 80044 MUA KNEE Ortho 8,700 11,100 14,100 19,600 27,900 281 85602 MIPPO DISTAL LOCKING Ortho 25,100 33,500 42,200 58,800 83,900 PLATES TIBIA 282 80046 RECORTICOTOMY Ortho 9,000 11,700 14,500 20,000 28,500 283 89935 UL TRIGGER FINGER Ortho 12,500 17,100 21,200 29,500 42,200 SURGICAL RELEASE (LEFT) 284 89936 UL TRIGGER FINGER Ortho 12,500 17,100 21,200 29,500 42,200 SURGICAL RELEASE 285 (RIGHT) 33886 POST CERVICAL Ortho 104,900 139,700 174,600 244,700 348,800 DECOMPRESSION 286 50360 ULDISLOCATION Ortho 20,100 26,800 33,500 46,400 66,600 ACROMIOCLAVICULAR 287 JT:OPEN RED.andINT.F 77868 CHRONIC BACKACHE Ortho288 6,100 8,000 10,200 14,100 20,400

66099 EXCISION OF OSTEOMA Ortho289 10,200 13,100 16,800 23,300 33,600 FOREHEAD 1019021 IL BONE GRAFTING Ortho290 42,500 55,200 70,100 97,400 140,400 (BILATERAL) 1019359 L/K EXTENSIVE SOFT Ortho291 78,100 101,500 128,900 179,100 257,900 TISSUE RELEASE- KNEE CONTRACTURE BILATERAL 33695 LL ARTHROSCOPIC Ortho292 25,100 32,600 41,400 57,500 82,800 REMOVAL OF LOOSE / FOREIGN BODY 63279 LL ARTHROSCOPY ANKLE Ortho293 17,100 22,200 28,100 39,200 56,400

W.E.F. 1st January 2019 267 INVASIVE PROCEDURE

44509 LL ARTHROSCOPY OF Ortho294 17,100 22,200 28,100 39,200 56,400 KNEE / DEBRIDEMENT AND WASHOUT 1026807 LL CORRECTIVE Ortho295 34,200 44,500 56,500 78,500 113,100 OSTEOTOMY FIRST METATARSAL BILATERAL 44522 LL FEMORAL NECK Ortho296 35,800 46,500 59,100 82,200 118,400 OSTEOTOMY FOR SUFE EG DUNN'S WITH 98669 LL FRAC SHAFT OF FEMUR Ortho297 75,700 98,400 125,000 173,700 250,200 INT. FIXATION BY AO INTER (BILATERAL) 99885 LL Internal fixation Ortho298 104,600 136,000 172,700 240,000 345,600 of complex pelvic fractures(Bilateral) 69735 T/H OR AND FEMORAL/ Ortho302 65,000 84,500 107,400 149,300 215,000 PELVIC OSTEOTOMY AND SPICA-DDH LEFT 67675 TIBIAL TRACTION Ortho303 10,300 13,400 17,000 23,500 33,900

69734 TT/H OR AND FEMORAL/ Ortho305 65,000 84,500 107,400 149,300 215,000 PELVIC OSTEOTOMY AND SPICA-DDH RIGHT 63289 UL ARTHOSCOPY Ortho306 19,400 25,200 32,000 44,500 63,900 SHOULDER FOR REM OF LOOSE B OR SYNO 63297 UL TRIGGER FINGER: Ortho307 12,500 16,200 20,600 28,600 41,200 SURGICAL RELEASE 44625 UL/LL NON UNIONS - Ortho308 25,100 32,600 41,400 57,500 82,800 INFECTED MINOR BONES 69629 "UL/LL REMOVAL OF Ortho309 20,700 26,900 34,200 47,500 68,400 PLATE : RAD.,ULNA, TIB & FIB. (BILATERAL) " 64736 UNI CONDYLAR KEE Ortho310 39,700 51,700 65,600 91,200 131,500 REPLACEMENT 1048570 LL RETRO CALCANEAL Ortho311 12,900 17,300 20,600 29,800 42,500 EXOSTOSIS /BURSA EXCISION (BILATERAL) 1039873 LL HEMI-ARTHROPLASTY/ Ortho312 38,500 52,700 65,400 91,600 130,900 BIPOLAR HIP REPLACEMENT

268 W.E.F. 1st January 2019 INVASIVE PROCEDURE

1039659 UL FRACTURE CLAVICLE Ortho313 34,200 44,800 55,900 78,100 112,000 OPEN REDUCTION AND INT FIX (BILATERAL) 1055653 UL FRACTURE Ortho314 63,300 84,300 104,700 146,500 209,800 NECKOFHUMERUS THREEPART OPENREDUCTION (BILATERAL) 1040929 T/H PROXIMAL FEMORAL Ortho316 130,100 173,000 216,000 302,400 433,100 RECONSTRUCTION (BILATERAL) 69696 ARTHROSCOPIC Ortho317 22,900 31,300 40,100 56,600 81,700 SUBACROMIAL DECOMPRESSION 1030565 UL/LL AMPUTATION Ortho318 17,100 22,400 27,900 39,100 56,100 BELOW KNEE (LEFT) 1030566 UL/LL AMPUTATION Ortho319 17,100 22,400 27,900 39,100 56,100 BELOW KNEE (RIGHT) 1030888 LL LAT. RELEASE AND Ortho320 18,900 25,100 31,600 43,900 59,900 MEDIAL CAPSULE PLICATION (RIGHT) 1030891 LL LAT. RELEASE AND Ortho321 18,900 25,100 31,600 43,900 59,900 MEDIAL CAPSULE PLICATION (LEFT) 1035946 UL SYNOVECTOMY OF Ortho322 34,200 44,800 55,900 78,100 112,000 TENDONS AND WRIST (BILATERAL) 1056563 UL FRACTURE Ortho323 20,600 28,100 35,100 48,700 70,000 OLECRANON OPEN RED and INT FIXATION (BILATERAL) 1059719 LL CORE DECOMPRESSION Ortho324 31,600 42,200 52,300 73,200 104,900 KNEE 1059720 LL CORE DECOMPRESSION Ortho325 63,300 84,300 104,700 146,500 209,800 KNEE (BILATERAL) 1061017 BIPOLAR SHOULDER Ortho326 38,500 52,700 65,400 91,600 130,900 REPLACEMENT INSERTION OF MEGA Ortho 42,000 56,100 70,100 98,100 140,100 PROSTHESIS 327 85142 LL TOTAL KNEE Ortho 84,100 112,000 140,100 280,100 JOINT REPLACEMENT 113(A) 196,100 (BILATERAL)

W.E.F. 1st January 2019 269 INVASIVE PROCEDURE

89914 IL REMOVAL OF FIXATOR Ortho 20,700 28,000 35,300 48,600 70,100 (BILATERAL) 12(A) 89953 UL ACROMIOPLASTY LEFT Ortho 17,100 22,400 27,900 39,100 56,100 130(A) 89954 UL ACROMIOPLASTY Ortho 17,100 22,400 27,900 39,100 56,100 RIGHT 130(B) 89955 UL ARTHROSCOPY Ortho 17,100 22,400 27,900 39,100 56,100 SHOULDER JOINT 142(A) DIAGNOSTIC LEFT 89956 UL ARTHROSCOPY Ortho 17,100 22,400 27,900 39,100 56,100 SHOULDER JOINT 142(B) DIAGNOSTIC RIGHT 89730 UL DISLOCATION Ortho 12,500 17,100 21,200 29,500 42,200 SHOULDER MUA (LEFT) 158(A) 89732 UL DISLOCATION Ortho 12,500 17,100 21,200 29,500 42,200 SHOULDER MUA (RIGHT) 158(B) 97104 LL ARTHROSCOPIC Ortho 84,300 112,000 140,400 195,400 279,200 CRUCIATE LIG . 21(A) RECONSTRUCTION (BILATERAL) 44623 UL/LL MP JOINT Ortho 11,100 15,200 18,400 26,100 37,300 ARTHRODESIS 222 (A) 93216 LL OPEN FRACURE TIB Ortho 50,300 67,000 84,300 117,700 167,600 SHAFT DEBRIDEMENT 90(A) AND EXTERNAL FI (BILATERAL) PAEDIATRICS

44633 ABDOMEN PERINEAL Pead 1 43,900 58,800 73,200 102,500 146,900 PULLTHROUGH (PAED) 44640 BRONCHOSOPY (PAED) Pead 2 25,100 33,500 42,200 58,800 83,900

44644 CHOLEDOCHAL CYST - Pead 3 60,700 80,400 101,400 141,600 202,500 BILIARY ATRESIA (PAED) 44645 COLOSTOMY/ Pead 4 21,200 27,900 35,000 49,100 70,200 COLOSTOMY CLOSURE (PAED) 64616 CYSTOSCOPY + ABLATION Pead 5 21,200 27,900 35,000 49,100 70,200 OF VALVES 64622 DIAPHRAGMATIC HERNIA Pead 7 42,200 56,100 70,200 97,700 139,700 - EXOMPHALOS

270 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44649 DILATATION ANAL OR Pead 8 6,500 8,700 10,300 14,900 21,200 URETHRAL (PAED) 44654 ESOPHAGEAL ATRESIA Pead 9 52,300 70,200 87,300 122,100 174,600 COMPLETE CORRECTION (PAED) 44657 EXPLORATORY Pead 10 25,100 33,500 42,200 58,800 83,900 LAPROTOMY NEONATAL INTESTINAL (PAED) 44658 EXSTROPHY BLADDER Pead 11 52,300 70,200 87,300 122,100 174,600 COMPLETE CORRECTION (PAED) 44662 INGUINAL HERNIOTOMY Pead 12 25,100 33,500 42,200 58,800 83,900 - BILATERAL (PAED) 44663 INGUINAL HERNIOTOMY Pead 13 17,100 22,400 27,900 39,100 56,100 - UNILATERAL (PAED) 44669 LUNG LOBECTOMY (PAED) Pead 14 42,200 56,100 70,200 97,700 139,700

50361 MINOR SURGERY (PAED) Pead 15 6,500 8,700 10,300 14,900 21,200

44674 NEONATAL INTESTINAL Pead 16 21,200 27,900 35,000 49,100 70,200 OBSTRUCTION (PAED) 44675 ORCHIDOPEXY- Pead 17 31,600 42,200 52,300 73,200 104,900 BILATERAL (PAED) 44676 ORCHIDOPEXY- Pead 18 21,200 27,900 35,000 49,100 70,200 UNILATERAL (PAED) 44677 PENA PSARP / Pead 19 43,900 58,800 73,200 102,500 146,900 THORACTOMY/ HIRSCHPRUNG (PAED) 63285 RAMSTEDS Pead 20 21,200 27,900 35,000 49,100 70,200 PYLOROMYOTOMY 44683 RECTAL POLYP (PAED) Pead 21 17,100 22,400 27,900 39,100 56,100

44688 SIGMOIDOSCOPY (PEAD) Pead 23 5,500 7,100 9,000 12,400 17,500

44697 VESICOSTOMY (PAED) Pead 24 21,200 27,900 35,000 49,100 70,200

80252 ABDOMEN PERINEAL Pead 25 87,900 117,700 146,500 205,200 293,600 PULLTHROUGH (BILATERAL) 80250 ABDOMEN PERINEAL Pead 26 43,900 58,800 73,200 102,500 146,900 PULLTHROUGH (LEFT)

W.E.F. 1st January 2019 271 INVASIVE PROCEDURE

80251 ABDOMEN PERINEAL Pead 27 43,900 58,800 73,200 102,500 146,900 PULLTHROUGH (RIGHT) 64568 ABDOMEN PERINEAL Pead28 43,900 57,000 72,500 100,700 145,100 PULLTHROUGH 1019097 MIS BONY Pead34 39,300 51,000 64,800 90,100 129,700 DECOMPRESSION - AC OM (BILATERAL) 67369 U/L OR AND IF SINGLE Pead37 52,300 68,000 86,400 120,100 173,000 BONE FRACTURE FA-EM (BILATERAL) 44648 DIAPHRAGMATIC HERNIA Pead 7 42,200 56,100 70,200 97,700 139,700 - EXOMPHALOS (PAED) (A) PEDIATRIC ORTHO SURGERY

50362 F/A COMPLETE SUBTALAR PeadOrtho 37,400 49,500 62,200 86,800 124,200 RELEASE WITH FIXATION 1 - CTEV 50363 F/A MEDICAL RELEASE PeadOrtho 21,200 28,100 35,000 49,400 70,800 ONLY - CTEV/MET.ADD 2 50364 F/A POSTERIOR RELEASE PeadOrtho 21,200 28,100 35,000 49,400 70,800 3 50365 F/A LIMITED POST- PeadOrtho 31,600 42,200 52,700 73,200 104,900 MEDSOFT TISSUE 4 RELEASE(PMSTR)CTEV 50366 F/A SUTURE REMOVAL PeadOrtho 6,600 9,000 11,000 15,300 21,800 AND CORRECTIVE CAST 5 50367 F/A PIN REMOVAL and PeadOrtho 6,600 9,000 11,000 15,300 21,800 CORRECTIVE CAST 6 50368 F/A DWYERS CALCANEAL PeadOrtho 51,900 69,000 86,500 121,300 172,800 OSTEOTOMY and PMSTR- 7 CTEV 50369 F/A EVAN'S CALCANEO- PeadOrtho 51,900 69,000 86,500 121,300 172,800 CUBOID FUSION and 8 PMSTR CTEV 50370 F/A EXTEN.SOFT TISSUE PeadOrtho 60,200 80,000 99,800 140,200 200,400 andBONY PROCEDURES- 9 SEVERE CTEV 50371 F/A EXTERNAL FIXATION PeadOrtho 31,600 42,200 52,700 73,200 104,900 APPLICATION - CTEV 10 50372 F/A CALCANEAL PeadOrtho 33,900 45,700 56,800 79,700 113,800 OSTEOTOMY - FLAT FOOT 11

272 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50373 F/A SUBTALAR FUSION PeadOrtho 29,500 39,100 48,900 68,100 97,300 ONLY 12 50374 F/A TENDON TRANSFER PeadOrtho 24,400 32,600 40,500 56,800 81,500 SINGLE (SPLAT/SPLPT/ 13 OTHER)ONLY 50375 F/A MODIFIED JONES - PeadOrtho 22,800 30,100 38,000 52,800 76,000 CLAW TOE 14 50376 F/A TRIPLE ARTHRODESIS PeadOrtho 51,900 69,000 86,500 121,300 172,800 15 50377 F/A EXCISION and REPAIR - PeadOrtho 22,800 30,100 38,000 52,800 76,000 POLYDACTYLY 16 50378 F/A COALITION PeadOrtho 33,900 45,700 56,800 79,700 113,800 RESECTION and 17 INTERPOSITION - SINGLE 50379 F/A PLANTAR PeadOrtho 19,600 26,100 32,600 45,700 65,000 FASCIOTOMY ONLY/ 18 STEINDLER'S ONLY 50380 F/A TALO-CALCANEAL PeadOrtho 42,600 56,300 70,800 98,400 140,800 REDUCTION, 19 FIXATIONandSPLAAT- ROCK 50381 F/A 19+ SUBTALAR FUSION PeadOrtho 51,900 69,000 86,500 121,300 172,800 20 50382 F/A POSTERIOR BONE PeadOrtho 22,800 30,100 38,000 52,800 76,000 BLOCK - EQUINUS 21 50383 F/A SMALL BONE PeadOrtho 19,600 26,100 32,600 45,700 65,000 EXCISION (MET) - FOOT 22 50384 F/A KIDNER'S PROCEDURE PeadOrtho 21,200 28,100 35,000 49,400 70,800 - ACCESSORY NAVICULAR 23 50385 F/A MET PeadOrtho 29,500 39,100 48,900 68,100 97,300 OSTEOTOMY+SOFT 24 TISSUE PROCED-HALLUX VALGUS 50386 F/A SOFT TISSUE PeadOrtho 19,600 26,100 32,600 45,700 65,000 PROCEDURE ONLY - 25 HALLUX VALGUS 50387 F/A OR and IF - TILLAUX PeadOrtho 34,400 45,900 57,500 80,000 114,500 FRACTURE 26 50388 F/A ORandIF-BIPLANAR PeadOrtho 39,100 51,900 65,000 90,700 129,800 FRACTURE ANKLE/ 27 SEVERE ANKLE FRA

W.E.F. 1st January 2019 273 INVASIVE PROCEDURE

50389 F/A MANIPULATION AND PeadOrtho 10,100 12,800 16,300 22,800 32,600 AK CASTING - CTEV 28 50390 L/K BAKER'S PROCEDURE PeadOrtho 21,200 28,100 35,000 49,400 70,800 29 50391 L/K CORRECTIVE PeadOrtho 42,200 56,100 70,200 97,700 139,700 OSTEOTOMY FOR DEF 30 CORRECTION WITH F 50392 L/K PeadOrtho 21,100 28,100 35,000 48,900 70,200 CORRECTIVEOSTEOTOMY 31 FOR DEFCORRECTION WITH F-B 50393 L/K CR and CAST - LEG PeadOrtho 21,200 28,100 35,000 49,400 70,800 BONES FRACTURE 32 50394 L/K CR and IR - LEG BONE PeadOrtho 35,800 47,700 59,000 83,500 119,100 FRACTURE EM 33 50395 L/K DEROTATION PeadOrtho 37,400 49,500 62,200 86,800 124,200 OSTEOTOMY TIBIA WITH 34 FIXATION 50396 L/K EGGAR'S PROCEDURE PeadOrtho 31,200 41,100 51,200 72,200 102,900 35 50397 L/K EXTENSIVE SOFT PeadOrtho 39,100 51,900 65,000 90,700 129,800 TISSUE RELEASE-KNEE 36 CONTRACTURE 50398 L/K FASCIOTOMY LEG PeadOrtho 26,100 34,500 43,200 60,700 86,500 (ONE INCISION) EM 37 50399 L/K FIBULAR SHAFT PeadOrtho 21,200 28,100 35,000 49,400 70,800 EXCISION (HARVESTING 38 GRAFT) 50400 L/K HEMI- PeadOrtho 35,800 47,700 59,000 83,500 119,100 EPIPHYSEODESIS SINGLE 39 - KNEE(PERCUT/OPEN) 50401 L/K OR and IR - LEG BONE PeadOrtho 42,600 56,300 70,800 98,400 140,800 FRACTURE EM 40 50402 L/K OSTEOTOMY FIBULA PeadOrtho 14,900 19,600 24,400 33,900 48,900 ONLY 41 50403 L/K POPILITEAL CYST PeadOrtho 24,400 32,600 40,500 56,800 81,500 EXCISION 42 50404 L/K SOFT TISSUE and BONY PeadOrtho 43,900 58,500 73,000 102,100 146,000 PROCEDURES-PATELLAR 43 DISLOCA

274 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50405 L/K SOFT TISSUE PeadOrtho 31,300 41,200 51,900 72,900 104,200 PROCEDURES - PATELLAR 44 DISLOCATION 50406 MIS ARTHROSCOPIC PeadOrtho 39,100 51,900 65,000 90,700 129,800 REPAIR - OCD KNEE 45 50407 MIS BONE BIOPSY PeadOrtho 12,800 17,300 21,800 30,100 43,200 46 50409 MIS BONY PeadOrtho 19,600 26,100 32,600 45,700 65,000 DECOMPRESSION - AC OM 48 50410 MIS BOTOX INJECTION - PeadOrtho 12,800 17,300 21,800 30,100 43,200 ONE MUSCLE GROUP 49 50411 MIS CARPAL TUNNEL PeadOrtho 52,300 70,200 87,300 122,100 174,600 DECOMPRESSION 50 50412 MIS CURETTAGE and PeadOrtho 31,600 42,200 52,700 73,200 104,900 NONE GRAFTING -CYST 51 LONG BONE 50413 MIS EMERGENCY PeadOrtho 27,700 37,000 46,100 64,500 92,000 ARTHROTOMY FOR 52 SEPTIC ARTHRITIS-L-JT 50414 MIS EXCEISION OF TUMOR PeadOrtho 26,100 34,500 43,200 60,700 86,500 NIDUS / BRODIES - LONG 53 BONE 50415 MIS INSTILLATION OF PeadOrtho 19,600 26,100 32,600 45,700 65,000 STEROIDS - CYST LONG 54 BONE 50416 MIS LIMB LENGTHENING PeadOrtho 31,600 42,200 52,700 73,200 104,900 PROCEDURE ILIZAROV- 55 ONE LONG BONE 50417 MIS MULTIPLE PeadOrtho 39,100 51,900 65,000 90,700 129,800 OSTEOTOMIS WITH IM 56 ROD - OI 50418 MIS MUSCLE BIOPSY PeadOrtho 11,800 15,300 18,900 26,800 38,000 57 50419 MIS RECONSTRUCTION PeadOrtho 24,400 32,600 40,500 56,800 81,500 OF HAND / FOOT DIGIT 58 WITH SSG 50420 MIS REVISION OF PeadOrtho 21,200 28,100 35,000 49,400 70,800 AMPUTATED STUMP 59 50421 MIS SAUCERIZATION and PeadOrtho 26,100 34,500 43,200 60,700 86,500 SEQUESTRECTOMY LONG 60 BONE

W.E.F. 1st January 2019 275 INVASIVE PROCEDURE

50422 MIS SINGLE PeadOrtho 19,600 26,100 32,600 45,700 65,000 POLYDACTYLY EXCISION 61 50423 MIS THERAPEUTIC PeadOrtho 31,600 42,200 52,700 73,200 104,900 AMPUTATION - FOOT / 62 ANKLE 50424 MIS THERAPEUTIC PeadOrtho 31,600 42,200 52,700 73,200 104,900 AMPUTATION ABOVE 63 KNEE 50425 MIS THERAPEUTIC PeadOrtho 31,600 42,200 52,700 73,200 104,900 AMPUTATION BELOW 64 KNEE 50426 MIS THERAPEUTIC KNEE PeadOrtho 31,600 42,200 52,700 73,200 104,900 DISARTICULATION 65 50427 S/N BIOPOLAR RELEASE PeadOrtho 33,900 45,700 56,800 79,700 113,800 TORTICOLLIS 66 50428 S/N LATTISSIMUS DORSI PeadOrtho 32,600 43,200 54,300 76,000 108,000 TRANSFER 67 50429 S/N MORCELIZATION OF PeadOrtho 19,600 26,100 32,600 45,700 65,000 CLAVICLE 68 50430 S/N SHOULDER SPICA PeadOrtho 8,700 11,800 14,100 19,700 28,100 69 50431 S/N TRAPEZIUS TRANSFER PeadOrtho 32,600 43,200 54,300 76,000 108,000 70 50432 S/N WOODWARD PeadOrtho 58,500 78,100 97,300 136,400 195,000 PROCEDURE - SPRENGEL'S 71 SHOULDER 50433 S/P 110 + SHORT SEGMENT PeadOrtho 73,200 97,700 122,700 170,700 244,700 FUSION 72 50434 S/P ANTERIOR PeadOrtho 97,300 129,800 162,300 227,300 324,500 SPINAL FUSION 73 INSTRUMENTATION and CORRE 50435 S/P ANTERIOR SPINAL PeadOrtho 65,000 86,500 108,000 151,200 216,600 FUSION(ASF) NO 74 INSTRUMENTATION 50436 S/P ANTERO-LAT PeadOrtho 58,500 78,100 97,300 136,400 195,000 DECOMPRESSION WITH 75 GRAFTING 50437 S/P ASF AND PSF WITH PeadOrtho 129,800 172,800 216,600 302,900 432,600 INSTRUMENTATION 76 50438 S/P BODY CAST PeadOrtho 16,300 21,800 27,000 38,000 54,300 77

276 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50439 S/P EXCISION OF PeadOrtho 146,000 195,000 243,400 340,800 487,100 HEMIVERTERBRA(SINGLE) 78 GLOBAL FUSION 50440 S/P EXCISION OF LESION/ PeadOrtho 51,900 69,000 86,500 121,300 172,800 NIDUS - VERTEBRA 79 50441 S/P POSTERIOR SPINAL PeadOrtho 60,200 80,000 99,800 140,200 200,400 FUSION(PSF) AND BODY 80 CAST 50442 S/P POSTEROLAT FUSION - PeadOrtho 56,800 76,000 94,900 132,500 189,100 LISTHESIS 81 50443 S/P PSF WITH PeadOrtho 71,400 95,100 119,100 166,600 238,100 INSTRUMENTION 82 and BODYCAST (NO CORRECTION 50444 S/P PSR WITH PeadOrtho 97,300 129,800 162,300 227,300 324,500 INSTRUMENTATION 83 SEGMENTAL AFTER CORRE 50445 S/P SPONDYLOLYSIS PeadOrtho 58,500 78,100 97,300 136,400 195,000 WIRING 84 50446 T/H ARTHROGRAM HIP PeadOrtho 16,300 21,800 27,000 38,000 54,300 85 50447 T/H ARTHROTOMY HIP - PeadOrtho 26,100 34,500 43,200 60,700 86,500 AC SEPTIC ARTHRITIS 86 50448 T/H ARTHROTOMY HIP PeadOrtho 32,600 43,200 54,300 76,000 108,000 WITH DEBRIDEMENT 87 50449 T/H CORE PeadOrtho 31,600 42,200 52,700 73,200 104,900 DECOMPRESSION FOR 88 AVN 50450 T/H CR and IF - FEMUR PeadOrtho 37,900 50,500 62,700 88,200 125,700 FRACTURE (IM NAILS) 89 50451 T/H CR and IF - FRACTURE PeadOrtho 35,800 47,700 59,000 83,500 119,100 NECK FEMUR 90 50452 T/H CR and SPICA - DDH PeadOrtho 26,100 34,500 43,200 60,700 86,500 91 50453 T/H CR and SPICA PeadOrtho 27,700 37,000 46,100 64,500 92,000 FRACTURE FEMUR EM 92 50454 T/H HIP ASPIRATION PeadOrtho 16,300 21,800 27,000 38,000 54,300 ALONE/INSTILLATION 93 STERIOD HIP 50455 T/H HIP JOINT FUSION - PeadOrtho 58,500 78,100 97,300 136,400 195,000 PFFD 94

W.E.F. 1st January 2019 277 INVASIVE PROCEDURE

50456 T/H HIP SPICA ONLY PeadOrtho 12,800 17,300 21,800 30,100 43,200 95 50457 T/H MEDIAL HAMSTRING PeadOrtho 19,600 26,100 32,600 45,700 65,000 RELEASE 96 50458 T/H OR and FEMORAL/ PeadOrtho 65,000 86,500 108,000 151,200 216,600 PELVIC OSTEOTOMY and 97 SPICA - DDH 50459 T/H OR and PeadOrtho 65,000 86,500 108,000 151,200 216,600 FEMORAL/PELVIC 98 OSTEOTOMYandSPICA - DDH 50460 T/H OR and IF FRACTURE PeadOrtho 31,600 42,200 52,700 73,200 104,900 FEMUR 99 63290 T/H OR and SPICA - DDH PeadOrtho 45,700 60,700 76,000 106,200 151,200 100 50462 T/H OR FEMORAL PeadOrtho 97,300 129,800 162,300 227,300 324,500 OSTEOTOMYandPELVIC 101 OSTEOTOMY-DDH 50463 T/H PELVIC OSTEOTOMY PeadOrtho 48,900 65,000 81,500 113,800 162,300 WITH SPICA - DDH 102 50464 T/H PINNING IN SITU - PeadOrtho 32,600 43,200 54,300 76,000 108,000 SCFE 103 50465 T/H PROXIMAL FEM PeadOrtho 40,500 54,300 67,300 94,900 135,300 OSTEOTOMY WITH 104 FIXATION 50466 T/H RECTUS - SARTORIUS PeadOrtho 22,800 30,100 38,000 52,800 76,000 TRANSFER - CP 105 50467 T/H SOUTTER'S PeadOrtho 22,800 30,100 38,000 52,800 76,000 PROCEDURE 106 50468 T/H TENOTOMY HIP PeadOrtho 12,500 17,100 21,200 29,700 42,600 ADDUCTOR P/C 107 50469 T/H TENOTOMY HIP PeadOrtho 24,400 32,600 40,500 56,800 81,500 ADDUCTORS and PSOAS 108 TENDON 50470 T/H TENOTOMY PeadOrtho 19,600 26,100 32,600 45,700 65,000 HIP ADDUCTORS + 109 NEURECTOMY -OPEN 50471 T/H YOUNT'S PROCEDURE PeadOrtho 19,600 26,100 32,600 45,700 65,000 110 50472 U/L BONY andSOFT TISSUE PeadOrtho 51,900 69,000 86,500 121,300 172,800 PROCEDURE FOR R-U 111 SYNOSTOSIS

278 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50473 U/L CENTRALIZATION PeadOrtho 33,900 45,700 56,800 79,700 113,800 PROCEDURE - RADIAL 112 HEMIMELIA 50474 U/L CORRECTIVE PeadOrtho 35,800 47,700 59,000 83,500 119,100 OSTEOTOMY and 113 FIXATION-CUBITUS VARUS 50475 U/L CR and IF - FRACTURE PeadOrtho 27,700 37,000 46,100 64,500 92,000 NECK RADIUS - EM 114 50476 U/L CR and PLASTER - PeadOrtho 21,200 28,100 41,100 49,400 92,000 FRACTURE NECK RADIUS 115 - EM 50477 U/L CR and POP - PeadOrtho 22,800 30,100 38,000 52,800 76,000 FRACTURE FOREARM(FA) 116 - EM 50478 U/L CR and POP - PeadOrtho 19,600 26,100 32,600 45,700 65,000 FRACTURE HUMERUS - EM 117 50479 U/L CR and POP - S/C PeadOrtho 24,400 32,600 40,500 56,800 81,500 HUMERUS - EM 118 50480 U/L CR(OR) and IF -S/C PeadOrtho 39,100 51,900 65,000 90,700 129,800 FRACTURE HUMERUS - 119 EM 50481 U/L DARRACH PeadOrtho 21,200 28,100 35,000 49,400 70,800 PROCEDURE 120 50482 U/L JONES TRANSFER PeadOrtho 58,500 78,100 97,300 136,400 195,000 PACKAGE 121 50483 U/L KESSLER'S PeadOrtho 33,900 45,700 56,800 79,700 113,800 PROCEDURE - RADIAL 122 HEMIMELIA 50484 U/L OR and IF LAT PeadOrtho 37,400 49,500 62,200 86,800 124,200 CONDYLE - FRACTURE 123 HUMERUS-EM 50485 U/L OR and IF SINGLE PeadOrtho 26,100 34,500 43,200 60,700 86,500 BONE FRACTURE FA - EM 124 50486 U/L OSTEOCLASIS AND PeadOrtho 19,600 26,100 32,600 45,700 65,000 POP - FRACTURE FA - EM 125 50487 U/L POLLICIZATION OF PeadOrtho 48,900 65,000 81,500 113,800 162,300 INDEX FINGER - THUMB 126 ABSENCE 50488 U/L SINGLE TENDON PeadOrtho 24,400 32,600 40,500 56,800 81,500 TRANSFER - HAND 127

W.E.F. 1st January 2019 279 INVASIVE PROCEDURE

50489 U/L SLAB/CAST ABOVE PeadOrtho 5,000 6,500 7,200 11,000 15,300 ELBOW 128 50490 U/L SLAB/CAST BELOW PeadOrtho 3,000 4,200 5,300 6,700 10,100 ELBOW 129 50491 U/L TENDON GRAFT PeadOrtho 48,900 65,000 81,500 113,800 162,300 RECONSTUCTION 1ST 130 STAGE-HAND 50492 U/L TENDON GRAFT PeadOrtho 39,100 51,900 65,000 90,700 129,800 RECONSTUCTION 2ND 131 STAGE - HAND 50493 U/L TENDON SLIDE PeadOrtho 21,200 28,100 35,000 49,400 70,800 PROCEDURE 132 50494 U/L TRIGGER DIGIT PeadOrtho 19,600 26,100 32,600 45,700 65,000 RELEASE 133 50495 U/L ULNAR NERVE PeadOrtho 21,200 28,100 35,000 49,400 70,800 TRANSPOSITION 134 50496 F/A COMPLETE SUBTALAR PeadOrtho 18,900 25,100 31,300 43,700 62,100 RELEASE WITH FIXATION- 135 CTEV-B 86309 F/A SUTURE REMOVAL PeadOrtho 12,900 17,700 21,900 30,900 43,600 AND CORRECTIVE CAST 136 (BILATERAL) 87497 F/A PIN REMOVAL AND PeadOrtho 12,900 17,700 21,900 30,900 43,600 CORRECTIVE CAST 137 (BILATERAL) 67066 F/A MANIPULATION PeadOrtho 20,100 25,700 32,600 45,700 65,300 AND AK CASTING - 138 CTEV(BILATERAL) 71249 L/K ACL PeadOrtho 39,100 51,900 65,000 90,700 129,800 RECONSTRUCTION KNEE 139 79246 L/K CORRECTIVE PeadOrtho 84,300 112,000 140,400 195,400 279,200 OSTEOTOMY FOR DEF 140 CORRECTION WITH F (BILATERAL) 68490 L/K Hemi-Epiphyseodesis PeadOrtho 71,600 95,100 118,100 167,200 238,100 Single - Knee(Percut/Open) 141 (Biletaral) 67067 L/K BAKER'S PeadOrtho 42,600 56,300 70,100 98,900 141,600 PROCEDURE(BILATERAL) 142 87719 L/K OSTEOTOMY FIBULA PeadOrtho 29,800 39,200 48,600 68,000 98,100 ONLY (BILATERAL) 143

280 W.E.F. 1st January 2019 INVASIVE PROCEDURE

70919 MIS BONE BIOPSY LEFT PeadOrtho 12,800 17,300 21,800 30,100 43,200 144 70918 MIS BONE BIOPSY RIGHT PeadOrtho 12,800 17,300 21,800 30,100 43,200 145 87031 MIS BONE GRAFT PeadOrtho 48,600 65,300 81,000 113,900 162,800 HARVESTING - PELVIS 146 (BILATERAL) 79521 MIS CURETTAGE AND PeadOrtho 31,600 42,200 52,700 73,200 104,900 NONE GRAFTING - CYST 147 LONG BONE (LEFT) 79522 MIS CURETTAGE AND PeadOrtho 31,600 42,200 52,700 73,200 104,900 NONE GRAFTING - CYST 148 LONG BONE (RIGHT) 79523 MIS CURETTAGE AND PeadOrtho 63,400 84,300 105,100 146,500 209,900 NONE GRAFTING - CYST 149 LONG BONE (BILATERAL) 71248 MIS REMOVAL OF LONG PeadOrtho 19,600 26,100 32,600 45,700 65,000 BONE IMPLANTS 150 81264 MIS REMOVAL OF PeadOrtho 39,200 52,300 65,300 91,200 130,000 LONG BONE IMPLANTS 151 (BILATERAL) 71254 MIS RIB RESECTION PeadOrtho 15,900 21,400 26,600 37,300 53,200 SINGLE 152 85574 MIS EMERGENCY PeadOrtho 55,500 73,800 92,200 128,900 183,900 ARTHROTOMY FOR 153 SEPTIC ARTHRITIS-L-JT (BILATERAL) 87114 MIS MULTIPLE PeadOrtho 78,200 104,000 130,000 181,300 259,600 OSTEOTOMIS WITH IM 154 ROD - OI (BILATERAL) 87032 S/P PSR WITH PeadOrtho 194,900 259,600 324,500 454,700 649,000 INSTRUMENTATION 155 SEGMENTAL AFTER CORRE (BILATERAL) 88005 S/P Body Cast (BILATERAL) PeadOrtho 32,600 43,600 54,000 75,900 108,800 156 88007 S/P Posterior Spinal PeadOrtho 120,200 160,200 199,600 280,500 400,600 Fusion(PSF) and Body Cast 157 (BILATERAL) 71250 T/H GREATER PeadOrtho 35,800 47,700 59,000 83,500 119,100 TROCHANTERIC ARREST 158

W.E.F. 1st January 2019 281 INVASIVE PROCEDURE

71251 T/H GREATER PeadOrtho 45,700 60,700 76,000 106,200 151,200 TROCHANTERIC 159 TRANSFER 69733 T/H HIP SPICA ONLY LEFT PeadOrtho 12,800 17,300 21,800 30,100 43,200 160 69732 T/H HIP SPICA ONLY PeadOrtho 12,800 17,300 21,800 30,100 43,200 RIGHT 161 67068 T/H MEDIAL HAMSTRING PeadOrtho 39,200 52,300 65,300 91,200 130,000 RELEASE(BILATERAL) 162 82214 T/H OR AND SPICIA - DDH PeadOrtho 91,200 121,300 152,100 212,100 302,600 (BILATERAL) 163 78502 T/H PROXIMAL FEM PeadOrtho 81,000 108,800 134,800 190,100 270,700 OSTEOTOMY WITH 164 FIXATION (BILATERAL) 71252 T/H PROXIMAL FEMORAL PeadOrtho 65,000 86,500 108,000 151,200 216,600 RECONSTRUCTION 165 71253 T/H SHELF PROCEDURE PeadOrtho 58,500 78,100 97,300 136,400 195,000 WITH SPICA 166 67069 T/H RECTUS - PeadOrtho 45,700 60,400 75,900 105,300 152,100 SARTORIUS TRANSFER - 167 CP(BILATERAL) 69737 T/H TENOTOMY HIP PeadOrtho 12,500 17,100 21,200 29,700 42,600 ADDUCTOR P/C (LEFT) 168 69736 T/H TENOTOMY HIP PeadOrtho 12,500 17,100 21,200 29,700 42,600 ADDUCTOR P/C (RIGHT) 169 67070 T/H TENOTOMY PeadOrtho 25,000 34,100 42,600 59,200 85,100 HIP ADDUCTOR 170 P/C(BILATERAL) 78257 T/H TENOTOMY HIP PeadOrtho 48,600 65,300 81,000 113,900 162,800 ADDUCTORS AND PSOAS 171 TENDON (BILATERAL) 80047 T/H TENOTOMY HIP PeadOrtho 39,200 52,300 65,300 91,200 130,000 ADDUCTORS PLUS 172 NEURECTOMY-OPEN (BILATERAL 78710 U/L OR AND IF SINGLE PeadOrtho 52,300 69,000 86,400 121,300 172,900 BONE FRACTURE FA - EM 173 (BILATERAL) 67377 U/L SINGLE TENDON PeadOrtho 48,600 65,300 81,000 113,900 162,800 TRANSFER - HAND 174 (BILATERAL)

282 W.E.F. 1st January 2019 INVASIVE PROCEDURE

67378 U/L SLAB/CAST ABOVE PeadOrtho 10,200 12,700 14,600 21,900 30,900 ELBOW (BILATERAL) 175 82168 U/L TRIGGER DIGIT PeadOrtho 39,200 52,300 65,300 91,200 130,000 RELEASE (BILATERAL) 176 67376 U/L JONES TRANSFER PeadOrtho 116,900 156,000 194,900 272,700 390,000 PACKAGE(BILATERAL) 177 1026172 F AND A TALO PeadOrtho 85,200 110,700 140,600 195,400 281,400 CALCANEAL REDUCTION 178 FIXATION and SPLAAT ROCK BILATERAL 1027444 MIS EXCEISION OF PeadOrtho 52,200 67,900 86,300 119,900 172,700 TUMOR NIDUS BRODIES 179 LONG BONE (BILATERAL) 1030912 T/H PELVIC OSTEOTOMY PeadOrtho 98,000 130,100 162,800 227,500 324,600 WITH SPICA - DDH 180 (BILATERAL) 1037407 F/A MET PeadOrtho 58,900 78,100 98,000 136,300 194,800 OSTEOTOMY+SOFT 181 TISSUE PROCED-HALLUX VALGUS (BILATERAL) 1037007 F/A TRIPLE ARTHRODESIS PeadOrtho 103,700 137,900 173,000 242,600 345,600 (BILATERAL) 182 1038023 MIS LIMB LENGTHENING PeadOrtho 63,300 84,300 105,300 146,500 209,800 PROCEDURE ILIZAROV- 183 ONE LONG BONE (BILATERAL) 1041984 T/H OR FEMORAL PeadOrtho 194,800 259,700 324,600 454,700 648,900 OSTEOTOMY and PELVIC 184 OSTEOTOMY-DDH (BILATERAL) 88688 F/A EXTERNAL FIXATION PeadOrtho 63,400 84,300 105,100 146,500 209,900 APPLICATION - CTEV 10(A) (BILATERAL) 93433 U/L SLAB/CAST BELOW PeadOrtho 6,100 8,100 10,400 13,100 20,100 ELBOW (BILATERAL) 129(A)

88699 U/L TENDON SLIDE PeadOrtho 42,600 56,300 70,100 98,900 141,600 PROCEDURE (BILATERAL) 132(A)

50461 T/H OR and SPICIA - DDH PeadOrtho 45,700 60,700 76,000 106,200 151,200 163(A)

W.E.F. 1st January 2019 283 INVASIVE PROCEDURE

89223 F/A EXTEN.SOFT TISSUE PeadOrtho 120,200 160,200 199,600 280,500 400,600 AND BONY PROCEDURES 177(A) - SEVERE CTEV (BILATERAL) 94280 F/A POSTERIOR RELEASE PeadOrtho 42,600 56,300 70,100 98,900 141,600 (BILATERAL) 3(A) 88717 S/N SHOULDER SPICA PeadOrtho 17,300 23,400 28,000 39,500 56,300 (BILATERAL) 69(A) PLASTIC & COSMETIC SURGERY

10509 ABDOMINOPLASTY PLR 1 53,200 71,100 89,300 124,400 178,000

50498 ARCH BAR REMOVAL PLR 3 4,300 5,700 7,100 10,100 14,100

2976 ARCH BAR WIRING PLR 4 17,100 22,400 27,900 39,100 56,100

50499 B/L CLEFT LIP REPAIR PLR 5 37,000 49,100 61,100 85,400 122,100

2237 BAT EAR CORRECTION PLR 6 37,000 49,100 61,100 85,400 122,100

2254 BLEPHAROPLASTY PLR 7 37,000 49,100 61,100 85,400 122,100

22626 BREAST AUGMENTATION PLR 8 53,200 71,100 89,300 124,400 178,000

2276 BREAST PLR 9 65,000 86,500 108,000 151,200 216,600 RECONSTRUCTION 2277 BREAST REDUCTION PLR 10 65,000 86,500 108,000 151,200 216,600

3137 BURN DRESSSING IN PLR 11 11,800 15,300 19,200 27,000 38,300 WARD (LARGE) 3138 BURN GRAFTING PLR 12 65,000 86,500 108,000 151,200 216,600 (EXTENSIVE) 50500 BURN GRAFTING PLR 13 53,200 71,100 89,300 124,400 178,000 EXTENSIVE 20033 BURN GRAFTING LARGE PLR 14 53,200 71,100 89,300 124,400 178,000

11299 BURN GRAFTING MEDIUM PLR 15 27,200 36,600 45,700 63,700 90,700

11327 BURN GRAFTING SMALL PLR 16 17,100 22,400 27,900 39,100 56,100

3043 CHIN AUGMENTATION PLR 17 37,000 49,100 61,100 85,400 122,100

2376 CLEFT LIP REPAIR PLR 18 27,200 36,600 45,700 63,700 90,700

284 W.E.F. 1st January 2019 INVASIVE PROCEDURE

2377 CLEFT LIP REVISION PLR 19 37,000 49,100 61,100 85,400 122,100

22716 CLEFT PALATE REPAIR PLR 20 37,000 49,100 61,100 85,400 122,100

3256 COMPOSITE GRAFT PLR 21 37,000 49,100 61,100 85,400 122,100

2443 CONTRACTURE RELEASE PLR 22 27,200 36,600 45,700 63,700 90,700 MODERATE 2444 CONTRACTURE RELEASE PLR 23 37,000 49,100 61,100 85,400 122,100 SEVERE 2445 CONTRACTURE RLEASE PLR 24 17,100 22,400 27,900 39,100 56,100 MILD 2471 COSMETIC RHINOPLASTY PLR 25 37,000 49,100 61,100 85,400 122,100

3277 CRANIAL BONE PLR 26 42,200 56,100 70,200 97,700 139,700 GRAFTING 3784 DEBRIDEMENT LARGE PLR 27 17,100 22,400 27,900 39,100 56,100

3785 DEBRIDEMENT SMALL PLR 28 11,800 15,300 19,200 27,000 38,300

2529 DERMABRASION FACE PLR 29 37,000 49,100 61,100 85,400 122,100

64626 DRESSING IN OT SMALL PLR 30 3,700 5,300 5,800 8,700 12,300

50502 DRESSING IN OT LARGE PLR 31 11,800 15,300 19,200 27,000 38,300

64627 EAR RECONSTRUCTION 1 PLR 34 37,000 49,100 61,100 85,400 122,100 ST STAGE 64628 EAR RECONSTRUCTION 2 PLR 35 37,000 49,100 61,100 85,400 122,100 ND STAGE 50507 EPSPADIAS REPAIR PLR 36 37,000 49,100 61,100 85,400 122,100

3505 EXCISION OF CYST / MOLE PLR 37 11,800 15,300 19,200 27,000 38,300

2648 EXTRACRANIAL PLR 38 53,200 71,100 89,300 124,400 178,000 OSTEOTOMY 6614 EXTROPHY BLADDER PLR 39 31,600 42,200 52,300 73,200 104,900

50508 EYELIT WIRING PLR 40 17,100 22,400 27,900 39,100 56,100

50509 FASCIOCUTANEOUS FLAP PLR 41 37,000 49,100 61,100 85,400 122,100

50510 FLAP DETACHMENT and PLR 42 27,200 36,600 45,700 63,700 90,700 FINAL INSET

W.E.F. 1st January 2019 285 INVASIVE PROCEDURE

50511 FULL THICKNESS GRAFT PLR 43 27,200 36,600 45,700 63,700 90,700

2790 HAIR TRANSPLANT (PER PLR 44 100 300 300 400 1,300 GRAFT) 28224 HYPOSPADIAS 1'ST STAGE PLR 45 17,100 22,400 27,900 39,100 56,100

28171 HYPOSPADIAS 2'ND STAGE PLR 46 27,200 36,600 45,700 63,700 90,700

3678 HYPOSPADIAS FISTULA PLR 47 27,200 36,600 45,700 63,700 90,700

50512 HYPOSPADIAS PLR 48 7,200 10,100 12,400 17,300 24,400 MEATOTOMY 50513 HYPOSPADIAS ONE STAGE PLR 49 37,000 49,100 61,100 85,400 122,100 REPAIR 50514 INTER MAXILLARY PLR 50 17,100 22,400 27,900 39,100 56,100 FIXATION 50515 LACERATION LARGE PLR 51 27,200 36,600 45,700 63,700 90,700

50516 LACERATION MULTIPLE PLR 52 37,000 49,100 61,100 85,400 122,100

50517 LACERATION SMALL PLR 53 17,100 22,400 27,900 39,100 56,100

50518 LIPECTOMY PLR 54 27,200 36,600 45,700 63,700 90,700

8580 LIPOSUCTION PLR 55 37,000 49,100 61,100 85,400 122,100

50519 LOCAL FLAPS PLR 56 27,200 36,600 45,700 63,700 90,700

50520 MANDIBLE # CLOSED PLR 57 27,200 36,600 45,700 63,700 90,700 REDUCTION 29876 MANDIBLE ORIF PLR 58 37,000 49,100 61,100 85,400 122,100

50521 MANDIBULAR PLR 59 53,200 71,100 89,300 124,400 178,000 OSTEOTOMY 9446 MAXILLARY OSTEOTOMY PLR 60 53,200 71,100 89,300 124,400 178,000

50522 MICRONEURAL REPAIR PLR 61 37,000 49,100 61,100 85,400 122,100

34011 MICROVASCULAR FREE PLR 62 65,000 86,500 108,000 151,200 216,600 FLAP 50523 MICROVASCULAR REPAIR PLR 63 37,000 49,100 61,100 85,400 122,100

50524 MID FACE #'S PLR 64 37,000 49,100 61,100 85,400 122,100

286 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50525 MULTIPLE Z/W PLASTY PLR 65 27,200 36,600 45,700 63,700 90,700

33974 MYOCUTANEOUS FLAP PLR 66 43,900 58,800 73,200 102,500 146,900

3605 NASAL BONE # CLOSED PLR 67 27,200 36,600 45,700 63,700 90,700 REDUCTION 50526 NASAL BONE # OPEN PLR 68 37,000 49,100 61,100 85,400 122,100 REDUCTION 13821 NASAL PACK REMOVAL PLR 69 4,300 5,800 7,100 10,100 14,000

23728 NERVE GRAFTING / PLR 70 53,200 71,100 89,300 124,400 178,000 SECONDARY REPAIR 50527 NEUROVASCULAR FLAP PLR 71 37,000 49,100 61,100 85,400 122,100

50528 ORBITO ZYGOMATIC PLR 72 53,200 71,100 89,300 124,400 178,000 COMPLEX 26310 PALATE FISTULA CLOSURE PLR 73 27,200 36,600 45,700 63,700 90,700

50529 PAN FACIAL #'S PLR 74 65,000 86,500 108,000 151,200 216,600

50530 PENILE SURGERY FOR PLR 75 53,200 71,100 89,300 124,400 178,000 ERECTILE DISFUNCTION (INFLATABL 50531 PENILE SURGERY FOR PLR 76 42,200 56,100 70,200 97,700 139,700 ERECTILE DISFUNCTION (MALLIABLE 23978 PHARYNGOPLASTY PLR 77 37,000 49,100 61,100 85,400 122,100

50532 POLYDACTYLY PLR 78 27,200 36,600 45,700 63,700 90,700

50533 PRESSURE SORE FLAP PLR 79 37,000 49,100 61,100 85,400 122,100

50534 RECONSTRUCTIVE PLR 80 53,200 71,100 89,300 124,400 178,000 RHINOPLASTY 50535 REPLANTATION ARM AND PLR 81 104,900 139,700 174,600 244,700 348,800 FOREARM 50536 REPLANTATION DIGIT PLR 82 75,200 101,100 125,700 175,900 251,300 (MULTIPLE, MORE THAN TWO) 50537 REPLANTATION DIGIT PLR 83 53,200 71,100 89,300 124,400 178,000 (SINGLE) 50538 REPLANTATION DIGIT PLR 84 65,000 86,500 108,000 151,200 216,600 (TWO)

W.E.F. 1st January 2019 287 INVASIVE PROCEDURE

50539 RHYTIDECTOMY PLR 85 65,000 86,500 108,000 151,200 216,600

9403 SCAR REVISION - LARGE PLR 86 27,200 36,600 45,700 63,700 90,700

33966 SECONDARY REVISION CL. PLR 87 37,000 49,100 61,100 85,400 122,100 LIP NASAL DEFORMITY 50540 SPLIT EAR LOBULE -ONE PLR 88 8,700 11,100 14,100 19,600 27,900

50541 SPLIT EAR LOBULE -TWO PLR 89 17,100 22,400 27,900 39,100 56,100

64710 SPLIT SKIN GRAFT PLR 90 17,100 22,400 27,900 39,100 56,100 MEDIUM 64711 SPLIT SKIN GRAFT SMALL PLR 91 11,800 15,300 19,200 27,000 38,300

64712 SPLIT SKIN GRAFT LARGE PLR 92 27,200 36,600 45,700 63,700 90,700

50545 SUB CRANIAL SURGERY PLR 93 60,100 79,700 99,400 138,900 198,800

24079 SYNDACTYLY PLR 94 27,200 36,600 45,700 63,700 90,700

50546 SYNDACTYLY MULTIPLE PLR 95 37,000 49,100 61,100 85,400 122,100

50547 T. M. JOINT PLR 96 62,800 83,900 104,900 146,900 209,200 ARTHROPLASTY 50548 T. M. JOINT RELEASE PLR 97 43,900 58,800 73,200 102,500 146,900 (BILATERAL) 50549 TANDON GRAFTING - 1 PLR 98 27,200 36,600 45,700 63,700 90,700 STAGE PROTHETIC 50551 TANDON GRAFTING-1 PLR 99 37,000 49,100 61,100 85,400 122,100 STAGE PROTHETIC + PULLERY RECONS 50550 TANDON GRAFTING - 2 PLR 100 27,200 36,600 45,700 63,700 90,700 STAGE PROTHETIC 50552 TANGENTIAL EXCISION PLR 101 27,200 36,600 45,700 63,700 90,700 LARGE 50553 TANGENTIAL EXCISION PLR 102 17,100 22,400 27,900 39,100 56,100 MEDIUM 50554 TANGENTIAL EXCISION PLR 103 11,800 15,300 19,200 27,000 38,300 SMALL 50555 TENDON GRAFT PLR 104 53,200 71,100 89,300 124,400 178,000 MULTIPLE 50556 TENDON GRAFTING PLR 105 37,000 49,100 61,100 85,400 122,100

288 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50557 TENDON INJURY PLR 106 53,200 71,100 89,300 124,400 178,000 MULTIPLE 50558 TENDON INJURY REPAIR PLR 107 37,000 49,100 61,100 85,400 122,100

6743 TENDON TRANSFER PLR 108 37,000 49,100 61,100 85,400 122,100 (SINGLE) 50559 TENDON TRANSFER PLR 109 53,200 71,100 89,300 124,400 178,000 MULTIPLE 24404 TONGUE FLAP 1'ST STAGE PLR 110 27,200 36,600 45,700 63,700 90,700

50560 TONGUE FLAP 2'ND STAGE PLR 111 27,200 36,600 45,700 63,700 90,700

50561 TRANSCRANIAL SURGERY PLR 112 65,000 86,500 108,000 151,200 216,600

6787 VAGINOPLASTY PLR 113 37,000 49,100 61,100 85,400 122,100

50562 VERMILION ADJUSTMENT PLR 114 17,100 22,400 27,900 39,100 56,100 , Z PLASTY OF LIP(SINGLE) 24614 Z PLASTY PLR 115 17,100 22,400 27,900 39,100 56,100

2391 ZYGOMA CLOSED PLR 116 17,100 22,400 27,900 39,100 56,100

23857 ZYGOMA # ORIF PLR 117 27,200 36,600 45,700 63,700 90,700

50563 ZYGOMATICO PLR 118 53,200 71,100 89,300 124,400 178,000 MAXILLARY COMPLEX 80105 CONTRACTURE RELEASE PLR 119 54,200 73,400 91,200 127,700 181,300 MODERATE(BILATERAL) 67674 BURN GRAFTING PLR 120 130,000 172,900 216,000 302,600 433,200 EXTENSIVE(BILATERAL) 79952 DEBRIDEMENT LARGE PLR 127 17,100 22,400 27,900 39,100 56,100 (RIGHT) 78905 DEBRIDEMENT SMALL PLR 128 23,400 30,900 38,200 54,000 76,700 (BILATERAL) 82468 DEBRIDEMENT SMALL PLR 129 11,800 15,300 19,200 27,000 38,300 (LEFT) 82469 DEBRIDEMENT SMALL PLR 130 11,800 15,300 19,200 27,000 38,300 (RIGHT) 86310 DRESSING IN OT LARGE PLR 131 23,400 30,900 38,200 54,000 76,700 (BILATERAL) 70130 EXCISION OF CYST/MOLE PLR 132 11,800 15,300 19,200 27,000 38,300 (LEFT)

W.E.F. 1st January 2019 289 INVASIVE PROCEDURE

70129 EXCISION OF CYST/MOLE PLR 133 11,800 15,300 19,200 27,000 38,300 (RIGHT) 82231 FASCIOCUTANEOUS FLAP PLR 134 73,800 98,400 122,200 170,600 244,300 (BILATERAL) 82615 HYPERTROPHIC TRACUS PLR 135 17,100 22,400 27,900 39,100 56,100

82470 LACERATION SMALL PLR 136 17,100 22,400 27,900 39,100 56,100 (LEFT) 82471 LACERATION SMALL PLR 137 17,100 22,400 27,900 39,100 56,100 (RIGHT) 79706 LIPOSUCTION PLR 138 73,800 98,400 122,200 170,600 244,300 (BILATERAL) 72175 LOCAL FLAPS (LEFT) PLR 139 27,200 36,600 45,700 63,700 90,700

72174 LOCAL FLAPS (RIGHT) PLR 140 27,200 36,600 45,700 63,700 90,700

87998 MICRONEURAL REPAIR- PLR 141 73,800 98,400 122,200 170,600 244,300 BILATERAL 77766 ND YAGN LASER PLR 142 31,300 41,200 51,900 72,900 104,200

78923 MULTIPLE Z/W PLASTY PLR 143 54,200 73,400 91,200 127,700 181,300 (BILATERAL) 78922 SCAR REVISION - LARGE PLR 144 54,200 73,400 91,200 127,700 181,300 (BILATERAL) 78924 SCAR REVISION LARGE PLR 145 27,200 36,600 45,700 63,700 90,700 (LEFT) 78925 SCAR REVISION LARGE PLR 146 27,200 36,600 45,700 63,700 90,700 (RIGHT) 57357 PREAURICULAR SINUS PLR 147 11,800 15,300 19,200 27,000 38,300

77476 SPLIT SKIN GRAFT LARGE PLR 148 27,200 36,600 45,700 63,700 90,700 (RIGHT) 77475 SPLIT SKIN GRAFT LARGE PLR 149 27,200 36,600 45,700 63,700 90,700 LEFT 86303 SYNDACTYLY PLR 150 54,200 73,400 91,200 127,700 181,300 (BILATERAL) 78027 VAC APPLICATION PLR 152 11,800 15,300 19,200 27,000 38,300

90347 TOUNGE BIOPSY PLR 153 17,100 22,400 27,900 39,100 56,100

50544 SPLIT SKIN GRAFT LARGE PLR 154 27,200 36,600 45,700 63,700 90,700

290 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50542 SPLIT SKIN GRAFT PLR 155 17,100 22,400 27,900 39,100 56,100 MEDIUM 50543 SPLIT SKIN GRAFT SMALL PLR 156 11,800 15,300 19,200 27,000 38,300

64703 RHINOTOMY PLR 157 48,900 59,600 69,600 90,700 122,200

63270 EXTROPHY BLADDER PLR 158 31,600 42,200 52,300 73,200 104,900

50505 EAR RECONSTRUCTION 1 PLR 159 37,000 49,100 61,100 85,400 122,100 ST STAGE 50506 EAR RECONSTRUCTION 2 PLR 160 37,000 49,100 61,100 85,400 122,100 ND STAGE 94349 CO2 LASER ABLATION OF PLR 161 37,000 49,100 61,100 85,400 122,100 MULTIPLE KELOIDS 1027861 BURN GRAFTING LARGE PLR162 106,500 138,500 175,900 244,500 352,100 (BILATERAL) 1027862 BURN GRAFTING LARGE PLR163 53,200 69,200 87,900 122,200 176,000 (LEFT) 1027865 BURN GRAFTING LARGE PLR164 53,200 69,200 87,900 122,200 176,000 (RIGHT) 50501 DRESSING IN OT SMALL PLR165 3,700 4,800 6,100 8,500 12,400

64965 BRACHIOPLASTY /ARM PLR166 41,400 53,800 68,300 94,800 136,500 LIFT 1030579 BREAST PLR167 65,000 86,500 108,000 151,300 216,600 RECONSTRUCTION (LEFT) 1030580 BREAST RECONSTRUCTION PLR168 65,000 86,500 108,000 151,300 216,600 (RIGHT) 1031788 BURN GRAFTING MEDIUM PLR169 54,300 73,200 91,200 127,700 181,400 (BILATERAL) 90098 TANGENTIAL EXCISION PLR 27,200 36,600 45,700 63,700 90,700 LARGE (LEFT) 101(A) 90099 TANGENTIAL EXCISION PLR 27,200 36,600 45,700 63,700 90,700 LARGE (RIGHT) 101(B) 79951 DEBRIDEMENT LARGE PLR 17,100 22,400 27,900 39,100 56,100 (LEFT) 127(A) 78072 CONTRACTURE RELEASE PLR 27,200 36,600 45,700 63,700 90,700 MODERATE / 22(A) 79089 CONTRACTURE RELEASE PLR 73,800 98,400 122,200 170,600 244,300 SEVERE (BILATERAL) 23(A) 76700 CONTRACTURE RELEASE PLR 37,000 49,100 61,100 85,400 122,100 SEVERE (LEFT) 23(B)

W.E.F. 1st January 2019 291 INVASIVE PROCEDURE

76701 CONTRACTURE RELEASE PLR 37,000 49,100 61,100 85,400 122,100 SEVERE (RIGHT) 23(C) 71394 DEBRIDEMENT LARGE PLR 34,100 44,900 55,800 78,200 112,000 (BILATERAL) 27(A) 1031789 TANGENTIAL EXCISION PLR170 34,200 44,900 55,800 78,100 112,000 MEDIUM (BILATERAL) 1030280 ZYGOMATICO PLR171 106,500 142,200 178,600 249,000 356,100 MAXILLARY COMPLEX (BILATERAL) CARDIOVASCULAR & THORACIC SURGERY 3504 ANTERIOR MEDIASTINAL Thor 1 58,600 78,200 97,700 137,100 196,200 TUMOUR EXCISION 50569 ANTERIOR MEDIASTINAL Thor 2 64,200 85,400 106,700 149,000 213,200 TUMOUR EXCISION + PERICARDIECTOMY 2344 CERVICAL RIB EXCISION Thor 3 48,100 64,200 79,900 111,900 159,800 IN TOS 63274 CAVOTOMY and Thor 4 48,100 64,200 79,900 111,900 159,800 THROMBECTOMY 3211 CHEST WALL RESSECTION Thor 5 37,300 49,500 62,200 86,800 124,600 and RECONSTRUCTION 2371 CLAMSHELL Thor 6 26,600 35,800 44,700 62,600 89,300 THORACOTOMY 27520 DIAPHRAGMATIC Thor 7 53,200 71,100 88,800 124,600 177,800 RUPTURE 3417 ELOSSER FLAP Thor 8 48,100 64,200 79,900 111,900 159,800 CONSTRUCTION IN BPF 3422 EMERGENCY Thor 9 32,000 42,800 53,200 74,600 106,700 THORACOTOMY IN TRAUMA CHEST 4028 EXTRAPLEURAL Thor 10 64,200 85,400 106,700 149,000 213,200 PNEUMONECTOMY IN MESOTHELIOMA 2281 HARVESTING OF MUSCLE Thor 11 48,100 64,200 79,900 111,900 159,800 PEDICLED GRAFT and REINFORCEMENT OF BRONCHIAL STUMP 50570 HEMICLAMSHELL Thor 12 21,400 28,600 35,600 49,500 71,200 INCISION 50572 IVS TUMOUR RESSECTION Thor 14 64,200 85,400 106,700 149,000 213,200

292 W.E.F. 1st January 2019 INVASIVE PROCEDURE

13492 LOBECTOMY Thor 15 66,900 90,500 113,500 158,300 226,400

50573 LOBECTOMY IN Thor 16 71,800 96,100 119,900 239,700 LIFE-THREATENING 167,800 HEMOPTYSIS 6818 MAXIMAL THYMECTOMY Thor 17 64,200 85,400 106,700 149,000 213,200 (COMBINED CERVICAL EXPLORATION and TRANS STEMAL THYMECTOMY) 50574 MEDIAN STERNOTOMY Thor 18 53,200 71,100 88,800 124,600 177,800

23632 MEDIASTINOSCOPY AND Thor 19 21,400 28,600 35,600 49,500 71,200 STAGING 50575 OESOPHAGEAL Thor 20 37,300 49,500 62,200 86,800 124,600 EXCLUSION IN CHEST TRAUMA 50576 OESOPHAGEAL Thor 21 32,000 42,800 53,200 74,600 106,700 PERFORATION REPAIR 8184 OESOPHAGEAL Thor 22 48,100 64,200 79,900 111,900 159,800 REPLACEMENT SURGERY 50577 OESOPHAGEAL Thor 23 53,200 71,100 88,800 124,600 177,800 STRICTURE 6806 PERICARDIECTOMY Thor 24 66,900 90,500 113,500 158,300 226,400

3324 PLEURECTOMY/ Thor 25 66,900 90,500 113,500 158,300 226,400 DECORTICATION 50578 PLEUROPERITONEAL Thor 26 32,000 42,800 53,200 74,600 106,700 SHUNT/PLEURO VENOUS SHUNT 34347 PNEUMONECTOMY Thor 27 66,900 90,500 113,500 158,300 226,400

50579 PNEUMONECTOMY and Thor 28 79,900 106,700 133,000 186,400 266,400 DIVISION OF DENSE ADHESION/MEDIASTINAL DISSECTION OF LYMPHONODE 33100 PULMONARY Thor 29 58,600 78,200 97,700 137,100 195,600 ARTERIO VENOUS MALFORMATION/ SEQUESTRATION 50580 PULMONARY ARTERY/ Thor 30 64,200 85,400 106,700 149,000 213,200 VEIN REPAIR

W.E.F. 1st January 2019 293 INVASIVE PROCEDURE

50581 RIB FIXATIONS IN Thor 31 42,800 56,800 71,200 99,600 142,400 TRAUMATIVE FLAIL CHEST 35825 RIB RESSECTION AND Thor 32 15,900 21,400 26,600 37,300 53,200 INTERCOSTAL DRAINAGE 3534 SINUS EXCISION CHEST Thor 33 21,400 28,600 35,600 49,500 71,200

50582 SLEEVE RESSECTION AND Thor 34 64,200 85,400 106,700 149,000 213,200 BRONCHOPLASTY 50583 STERNECTOMY IN Thor 35 40,300 53,200 66,900 93,500 133,000 STERNAL WOUND DEHISCENE 34385 SUBCLAVION ARTERY Thor 36 58,600 78,200 97,700 137,100 195,600 RECONSTRUCTION THROUGH THORACOTOMY 50584 SUPERIOR SULUS Thor 37 58,600 78,200 97,700 137,100 195,600 TUMOUR RESSECTION 50585 SURGERY OF GASTRO Thor 38 37,300 49,500 62,200 86,800 124,600 OESOPHAGEAL REFLUX 50586 SURGERY OF GASTRO Thor 39 37,300 49,500 62,200 86,800 124,600 OESOPHAGEAL DIVERTICULUM 50587 THORACIC AORTIC Thor 41 93,500 125,200 156,600 195,600 312,800 ANEURYSM 2961 THORACIC DUCT REPAIR Thor 42 53,200 71,100 88,800 124,600 177,800 (CHYLOTHORAX) 6869 THORACOPLASTY Thor 43 37,300 49,500 62,200 86,800 124,600

88072 THORACOPLASTY- Thor 74,700 99,100 124,300 173,700 249,400 BILATERAL 43(A) 50588 THORACOSTOMY AND Thor 44 15,900 21,400 26,600 37,300 53,200 PLEURODESIS 50589 THORACOTOMY Thor 45 26,600 35,800 44,700 62,600 89,300 (POSTEROLATERAL) 50590 THORACOTOMY AND Thor 46 40,300 53,200 66,900 93,500 133,000 PERICARDIAL WINDOW CONSTRUCTION 24442 TRACHEAL RESSECTION Thor 47 53,200 71,100 88,800 124,600 177,800 AND RECONSTRUCTION 50591 RACHEOESOPHAGEAL Thor 48 53,200 71,100 88,800 124,600 177,800 FISTULA REPAIR

294 W.E.F. 1st January 2019 INVASIVE PROCEDURE

50592 TRANSAXILLARY FIRST Thor 49 48,100 64,200 79,900 111,900 159,800 RIB RESSECTION IN THORACIC OUTLET SYNDROME 85655 Tube Thoracostomy Thor 50 10,500 14,300 18,000 25,200 35,900

63295 VOLUME REDUCTION Thor 51 58,600 78,200 97,700 137,100 195,600 SURGERY FOR EMPHYSEMA 50594 WEDGE RESSECTION OF Thor 52 21,400 28,600 35,600 49,500 71,200 LUNG 64687 PLERURAL BIOPSY(WITH Thor 53 21,400 28,600 35,600 49,500 71,200 THORACOTOMY) 2821 HYDATID CYST Thor 54 66,900 88,800 111,500 155,700 222,400

3032 ASPIRATION PERICARDIAL Thor 55 17,500 23,500 29,700 41,200 59,000 CAVITY/PERICARDIAL TAPPING 3377 DRAINAGE PERICARDIAL Thor 56 53,200 71,100 88,800 124,600 177,800 CAVITY 6956 LUNG BIOPSY OPEN Thor 57 26,600 35,800 44,700 62,600 89,300

50596 MEDIASTINAL BIOPSY Thor 59 37,300 49,500 62,200 86,800 124,600

3195 CERVICAL/ LUMBAR Thor 60 42,800 56,800 71,200 99,600 142,400 SYNPATHECTOMY 3230 COARCTATION OF AORTA Thor 61 53,200 71,100 88,800 124,600 177,800

2287 BULLECTOMY Thor 62 48,100 64,200 79,900 111,900 159,800

50597 PULMONARY AVM Thor 63 66,900 88,800 111,500 155,700 222,400

50598 BRONCHOPLASTY Thor 64 64,200 85,400 106,700 149,000 213,200 PROCEDURE 3132 BRONCHOPLASTY Thor 65 64,200 85,400 106,700 149,000 213,200 FISTULA CLOSURE 6877 SYMPATHECTOMY Thor 66 48,100 64,200 79,900 111,900 159,800 TRANSTHORACIC 50599 PLEURODESIS (3 Thor 67 10,500 14,300 18,000 25,200 35,900 CONSECUTIVE SITTING) 50600 SURGERY FOR Thor 68 66,900 88,800 111,500 155,700 222,400 CHYLOTHORAX

W.E.F. 1st January 2019 295 INVASIVE PROCEDURE

50601 SURGERY FOR Thor 69 32,000 42,800 53,200 74,600 106,700 GASTROESOPHGEAL REFLUX 50602 TRACTOMY and FOREIGN Thor 70 53,200 71,100 88,800 124,600 177,800 BODY REMOVAL 13396 HELLER'S OPERATION Thor 71 32,000 42,800 53,200 74,600 106,700 CARDIO MYOTOMY 64578 AORTA BILETRAL Thor 72 69,900 89,100 108,400 147,500 203,000 CAROTID and AXILLARY BYPASS GRAFTING 70947 AORTIC VALVE Thor 73 48,100 64,200 79,900 111,900 159,800 EXPLORATION 64584 ASCENDING AORTA Thor 74 65,900 83,900 101,500 137,400 190,600 REPLACEMENT 64592 BILATERAL ICD Thor 75 38,300 51,900 59,600 80,900 87,600 INSERTION 64593 BILATERAL MAMMARY Thor 76 65,900 83,900 101,500 137,400 190,600 GRAFTING 64594 BILATERAL Thor 77 85,600 113,900 142,400 199,400 284,800 SYMPATHECTOMY 64595 BILATERAL Thor 78 48,900 59,600 69,600 90,700 122,200 TRANS. ANTRAL ETHMOIDECTOMY 72275 CERVICAL/LUMBAR Thor 79 42,800 56,800 71,200 99,600 142,400 SYNPATHECTOMY (LEFT) 72274 CERVICAL/LUMBAR Thor 80 42,800 56,800 71,200 99,600 142,400 SYNPATHECTOMY (RIGHT) 64621 DESC. THORA AORTIC Thor 81 69,900 89,100 108,400 147,500 203,000 ANEURYSM RESECTION and REPARI 69909 DESCENDING THORACIC Thor 82 139,900 178,300 216,400 294,900 405,600 AORTIC ANEURYSM RESECTION AND REPAIR (BILATERAL) 64634 EXCISION OF CALCIFIED Thor 83 53,200 71,200 89,100 124,400 177,800 PERICARDIUM (PERICADIOTOMY) 63280 MAXIMAL THYMECTOMY Thor 84 64,200 85,400 106,700 149,000 213,200

70948 MITRAL VALVE Thor 85 48,100 64,200 79,900 111,900 159,800 EXPLORATION

296 W.E.F. 1st January 2019 INVASIVE PROCEDURE

64688 PLEUROPERITONEAL Thor 86 32,000 42,800 53,200 74,600 106,700 SHUNT/PLEURO VENUS SHUNT 64689 PNEUMONECTOMY and Thor 87 79,900 106,700 133,000 186,400 266,400 DIVISION OF DENSE 69698 GRAFTING Thor 88 27,200 36,600 45,700 63,700 90,700

67941 RE-SUTURING OF THE Thor 89 10,500 14,300 18,000 25,200 35,900 STERNAL WOUND 78258 REMOVAL OF TUMOR Thor 90 53,200 71,100 88,800 124,600 177,800 FROM IVC AND RA WITH REPAIR OF IVC DEFECT 64702 RESTORATION OF MED Thor 91 42,200 56,100 70,200 97,700 139,700 TIBIAL PLATEAU 78553 RSOV REPAIR Thor 92 44,600 57,400 66,200 79,000 108,400

64714 STERNAL TUMOUR Thor 93 52,300 70,200 87,300 122,100 174,600 EXICISION 82339 SUA AORTIC MEMBRANE Thor 94 37,300 49,500 62,200 86,800 124,600 RESECTION 70949 TRICUSPID VALVE Thor 95 48,100 64,200 79,900 111,900 159,800 EXPLORATION 64725 TRICUSPID VALVE REPAIR Thor 96 53,200 71,200 89,100 124,400 177,800 / EXPLORATION 2186 AORTIC VALVE REPAIR Thor 97 53,200 71,200 89,100 124,400 177,800

26621 AROTIC DISSECTION Thor 98 65,900 83,900 101,500 137,400 190,600

32855 ASCENDING AORTA Thor 99 65,900 83,900 101,500 137,400 190,600 ANEURSM REPAIR 32873 MITRAL VALVE REPAIR Thor 100 53,200 71,200 89,100 124,400 177,800

63275 CHEST WALL RESSECTION Thor 104 37,300 49,500 62,200 86,800 124,600 and RECONSTRUTION 79380 EPIDURAL CATHETER Thor 105 15,400 20,100 24,900 34,500 50,400 INSERTION 69619 BRONCHOSCOPY (RESP) Thor 106 7,400 9,700 12,200 16,900 24,600

69620 BRONCHOSCOPY WITH Thor 107 9,000 11,900 14,900 20,500 29,500 BIOPSY (RESP) 22966 DIAGNOSTIC + Thor 108 5,700 8,700 11,800 17,200 25,700 THORACOSCOPY

W.E.F. 1st January 2019 297 INVASIVE PROCEDURE

63271 HARVESTING OF Thor 109 48,100 64,200 79,900 111,900 159,800 MUSCLE PEDICLED GRAFTandREINFORCEMENT 64657 LOBECTOMY IN Thor 110 71,800 96,100 119,900 167,800 239,700 LIFE-THREATENING HEMOPTYSIS MAXIMAL 63300 SUBCLAVION ARTERY Thor 111 58,600 78,200 97,700 137,100 195,600 RECO THROUGH THORACOTOMY 64723 TRANSAXILLARY FIRST Thor 112 48,100 64,200 79,900 111,900 159,800 RIB RESSECTION IN THOR SUND 1060883 LV (LEFT VENTRICULAR) Thor 113 42,000 52,700 62,700 83,800 115,300 MASS REMOVAL 1063546 RIGHT RADIAL ARTERY Thor 114 47,700 63,700 79,500 111,000 158,600 PSEUDO ANEURYSM REPAIR 1063547 LEFT RADIAL ARTERY Thor 115 47,700 63,700 79,500 111,000 158,600 PSEUDO ANEURYSM REPAIR 1063838 EPICARDIAL LEAD Thor 116 58,600 78,200 97,700 137,100 195,600 PLACEMENT IN LV 1079367 PACING WIRE REMOVAL Thor 117 17,500 23,500 29,700 41,200 59,000

1086537 PACEMAKER BOX Thor 118 26,600 35,800 44,700 62,600 89,300 CHANGE UROLOGY

33282 ADR ADRENALECTOMY URO 1 42,200 56,100 70,200 97,700 139,700 (LAP) 44445 ADR ADRENALECTOMY URO 2 42,200 56,100 70,200 97,700 139,700 (OPEN) 2352 BLA CYSTOSCOY URO 3 10,300 14,100 17,500 24,400 35,000 (DIAGNOSTIC) 3591 BLA CYSTOSCOY + BIOPSY URO 4 10,300 14,100 17,500 24,400 35,000

2513 BLA CYSTOLITHOTOMY URO 5 12,500 17,100 21,200 29,500 42,200 (OPEN) 44446 BLA CYSTOLITHOTOMY URO 6 12,500 17,100 21,200 29,500 42,200 (PERCUTANEOUS) 2515 BLA CYSTOLITHOTRITY URO 7 12,500 17,100 21,200 29,500 42,200

298 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44447 BLA EXOSTROPHY REPAIR URO 8 31,600 42,200 52,300 73,200 104,900

44448 BLA MITROFANOFF URO 9 37,900 50,500 62,800 88,200 125,700

3300 BLA RADICAL URO 10 62,800 83,900 104,900 146,900 209,200 CYSTECTOMY + LLEAL CONDUIT 3301 BLA RADICAL URO 11 52,300 70,200 87,300 122,100 174,600 CYSTECTOMY + ORTHOTOPIC BLADDER 44449 BLA RUPTURE REPAIR URO 12 12,500 17,100 21,200 29,500 42,200 MINOR 44450 BLA RUPTURE REPAIR URO 13 25,100 33,500 42,200 58,800 83,900 MAJOR 24316 BLA SUPRABUBIC URO 15 10,300 14,100 17,500 24,400 35,000 CYSTOSTOMY 4015 BLA TURBT URO 16 31,600 42,200 52,300 73,200 104,900

6640 BLA VVF REPAIR URO 17 37,900 50,500 62,800 88,200 125,700

44451 KID ENDOPYELOTOMY URO 18 31,600 42,200 52,300 73,200 104,900

23456 KID NEPHRECTOMY URO 19 37,900 50,500 62,800 88,200 125,700 (LAPROSCOPIC) 44452 KID NEPHRECTOMY URO 20 31,600 42,200 52,300 73,200 104,900 (SIMPLE OPEN) 9499 KID NEPHRECTOMY URO 22 42,200 56,100 70,200 97,700 139,700 (RADICAL) 6642 KID NEPHROSTOMY URO 23 12,500 17,100 21,200 29,500 42,200 (OPEN) 44454 KID NEPHROSTOMY URO 24 17,100 22,400 27,900 39,100 56,100 (PERCUTANEOUS) 6601 KID PYELOLITHOTOMY URO 25 31,600 42,200 52,300 73,200 104,900

24140 KID PCNL URO 26 31,600 42,200 52,300 73,200 104,900

11323 KID PYELOPLASTY URO 27 15,900 21,100 26,300 36,600 52,300

2370 PEN CIRCUMCISION URO 28 8,700 11,100 14,100 19,600 27,900

23897 PEN PENECTOMY URO 29 14,900 19,600 24,400 33,900 49,100 (PARTIAL

W.E.F. 1st January 2019 299 INVASIVE PROCEDURE

24432 PEN PENECTOMY URO 30 21,200 27,900 35,000 49,100 70,200 (TOTAL) WITHOUT LYMPHADECTOMY 44455 PEN PENECTOMY URO 31 27,200 36,600 45,700 63,700 90,700 (TOTAL) WITHOUT LYMPHADECTOMY - U/L 44456 PEN PENECTOMY URO 32 33,500 45,000 56,100 78,200 111,800 (TOTAL) WITHOUT LYMPHADECTOMY - B/L 50564 KID PENILE IMPLANT URO 33 42,200 56,100 70,200 97,700 139,700

44440 PRO ABCESS DRAINAGE URO 34 21,200 27,900 35,000 49,100 70,200

22854 PRO BIOPSY URO 35 10,300 14,100 17,500 24,400 35,000

44441 PRO BLADDER NECK URO 36 21,200 27,900 35,000 49,100 70,200 INCISION / TUIP 28233 PRO OPEN URO 37 31,600 42,200 52,300 73,200 104,900 PROSTATECTOMY 36093 PRO RADICAL URO 38 62,800 83,900 104,900 146,900 209,200 PROSTATECTOMY 34085 PRO TURP / TVP URO 39 31,600 42,200 52,300 73,200 104,900

2625 UTH EPISPADIAS REPAIR URO 40 2,700 3,500 4,300 5,800 8,700

20224 UTH HYPOSPADIAS URO 41 37,000 49,100 61,100 85,400 122,100 REPAIR (SINGLE STAGE) 3676 UTH HYPOSPADIAS URO 42 17,100 22,400 27,900 39,100 56,100 REPAIR (TWO STAGE - FIRST STAGE) 3677 UTH HYPOSPADIAS URO 43 27,200 36,600 45,700 63,700 90,700 REPAIR (TWO STAGE - SECOND STAGE) 24512 UTH MEATOPLASTY URO 44 10,300 14,100 17,500 24,400 35,000

36126 UTH MEATOTOMY URO 45 5,500 7,100 9,000 12,400 17,500

22820 UTH OPTICAL INTERNAL URO 46 21,200 27,900 35,000 49,100 70,200 URETHROTOMY 36098 UTH URETHROPLASTY URO 47 17,100 22,400 27,900 39,100 56,100 (SINGLE STAGE)

300 W.E.F. 1st January 2019 INVASIVE PROCEDURE

44442 UTH URETHROPLASTY URO 48 31,600 42,200 52,300 73,200 104,900 (TWO STAGED - FIRST STAGE) 24278 UTH URETHROPLASTY URO 49 17,100 22,400 27,900 39,100 56,100 (TWO STAGED - SECOND STAGE) 27638 UTH PERINEAL URO 50 12,500 17,100 21,200 29,500 42,200 URETHROSTOMY 44443 UTH URETHROVAGINAL URO 51 31,600 42,200 52,300 73,200 104,900 FISTULA REPAIR 34239 UTR D.J STENTING URO 52 12,500 17,100 21,200 29,500 42,200 (UNILATERAL) 28060 UTR D.J STENTING URO 53 17,100 22,400 27,900 39,100 56,100 (BILATERAL) 44457 UTR REIMPLANTATION URO 54 25,100 33,500 42,200 58,800 83,900 (UNILATERAL) 24507 UTR REIMPLANTATION URO 55 31,600 42,200 52,300 73,200 104,900 (BILATERAL) 3294 UTR URO 56 31,600 42,200 52,300 73,200 104,900 URETEROURETEROSTOMY / BOARI FLAP 44444 UTR URETEROLYSIS URO 57 25,100 33,500 42,200 58,800 83,900 (UNILATERAL) 34044 UTR URETEROLYSIS URO 58 31,600 42,200 52,300 73,200 104,900 (BILATERAL) 22699 UTR URETEROSCOPY URO 59 17,100 22,400 27,900 39,100 56,100 (DIAGNOSTIC) 44458 UTR URETEROSCOPY URO 60 21,200 27,900 35,000 49,100 70,200 (STONE REMOVAL) 6907 UTR URO 61 18,900 25,100 31,600 43,900 62,800 URETEROLITHOTOMY 44973 SCR HYDROCELE URO 62 12,500 17,100 21,200 29,500 42,200 (UNILATERAL) 6690 SCR HYDROCELE URO 63 17,100 22,400 27,900 39,100 56,100 (BILATERAL) 10472 SCR ORCHIDECTOMY URO 64 18,900 25,100 31,600 43,900 62,800 (UNILATERAL) 10962 SCR ORCHIDECTOMY URO 65 27,200 36,600 45,700 63,700 90,700 (BILATERAL) 8133 SCR ORCHIDOPEXY URO 66 17,100 22,400 27,900 39,100 56,100 (UNILATERAL)

W.E.F. 1st January 2019 301 INVASIVE PROCEDURE

6646 SCR ORCHIDOPEXY URO 67 25,100 33,500 42,200 58,800 83,900 (BILATERAL) 6634 SCR TESTICULAR BIOPSY URO 68 6,500 8,700 10,300 14,900 21,200

24534 SCR VARICOCELOECTOMY URO 69 17,100 22,400 27,900 39,100 56,100 (UNILATERAL) 28076 SCR VASECTOMY URO 70 17,100 22,400 27,900 39,100 56,100

44459 INC SLING / BURCH / RAZ / URO 72 31,600 42,200 52,300 73,200 104,900 STAMEY 63283 PRO HOLMIUM LASER URO 73 39,600 52,800 65,300 91,600 131,300 PROSTATECTOMY 2309 CAPD CATHETER URO 75 15,400 20,100 24,900 34,500 50,400 INSERTION 67957 CYSTOSCOPY- BIOPSY- URO 76 15,400 21,000 26,400 36,500 52,600 ABLATION OF HUNNERS ULCER 2735 FRENULOPLASTY URO 77 9,600 12,300 15,300 21,500 30,800

84788 KID LAPROSCOPIC URO 78 31,500 42,300 52,600 73,400 104,400 PYELOPLASTY 86964 KID NEPHRECTOMY URO 79 75,700 100,900 125,600 176,500 251,500 (LAPROSCOPIC)- BILATERAL 64652 KID NEPHRECTOMY URO 80 47,600 63,200 78,300 109,800 157,400 (PARTIAL) 79131 KID NEPHRECTOMY URO 81 31,600 42,200 52,300 73,200 104,900 (SIMPLE OPEN) (LEFT) 79132 KID NEPHRECTOMY URO 82 31,600 42,200 52,300 73,200 104,900 (SIMPLE OPEN) (RIGHT) 83870 KID NEPHROSTOMY URO 83 17,100 22,400 27,900 39,100 56,100 (PERCUTANEOUS) (LEFT) 83871 KID NEPHROSTOMY URO 84 17,100 22,400 27,900 39,100 56,100 (PERCUTANEOUS) (RIGHT) 70114 KID PCNL (LEFT) URO 85 31,600 42,200 52,300 73,200 104,900

70113 KID PCNL (RIGHT) URO 86 31,600 42,200 52,300 73,200 104,900

67763 LAP ORCHIDECTOMY URO 87 25,100 33,500 42,200 58,800 83,900

76656 LASER INCISON OF URO 88 19,600 26,100 32,600 45,700 65,000 URETEROCELE

302 W.E.F. 1st January 2019 INVASIVE PROCEDURE

78399 REPAIR OF FRACTURE URO 89 27,200 36,600 45,700 63,700 90,700 PENIS 77934 RETRO GRADE URO 90 6,200 8,500 10,600 14,700 21,100 POLYGRAME (RGP) 78684 RETRO GRADE URO 91 12,500 17,100 21,200 29,500 42,200 POLYGRAME (RGP) BILATERAL 78014 RETROGRADE INTRA URO 92 32,000 41,800 52,700 73,700 105,200 RENAL SURGERY (RIRS) 78175 SCR ORCHIDOPEXY URO 93 17,100 22,400 27,900 39,100 56,100 (UNILATERAL) (LEFT) 78176 SCR ORCHIDOPEXY URO 94 17,100 22,400 27,900 39,100 56,100 (UNILATERAL) (RIGHT) 67629 SCR TESTICULAR BIOPSY URO 95 12,700 17,300 20,700 29,800 42,600 (BILATERAL) 79376 UTR URETEROSCOPY URO 96 42,600 55,800 70,100 98,400 140,400 (STONE REMOVAL) BILATERAL 66885 UTR URETEROSCOPY URO 97 17,100 22,400 27,900 39,100 56,100 DIAGNOSTIC RIGHT 66894 UTR URETEROSCOPY URO 98 21,200 27,900 35,000 49,100 70,200 STONE REMOVAL LEFT 66888 UTR URETEROSCOPY URO 99 21,200 27,900 35,000 49,100 70,200 STONE REMOVAL RIGHT 94609 LAPROSCOPIC URO 100 62,800 83,900 104,900 146,900 209,200 URETHROLYSIS 90641 CLOT EVACUATION URO 101 10,300 14,100 17,500 24,400 35,000

90642 URETEROSCOPIC URO 102 17,100 22,400 27,900 39,100 56,100 BALLOON DILATATION 88149 URETEROCELE URO 103 21,200 27,900 35,000 49,100 70,200

66887 UTR URETHEROSCOPY URO105 17,100 22,200 28,100 39,200 56,400 DIAGNOSTIC LEFT 3094 BLA STENT REMOVAL URO106 7,100 7,100 7,100 7,100 7,100

80024 BLA STENT REMOVAL URO107 14,300 14,300 14,300 14,300 14,300 (BILATERAL) 70724 EPIDIDYMAL BIOPSY URO108 6,500 8,700 10,300 14,900 21,200

1030125 KID-CHECK URO109 12,500 17,100 21,200 29,500 42,200 NEPHROSCOPY

W.E.F. 1st January 2019 303 INVASIVE PROCEDURE

1039135 RETROGRADE INTRA URO110 63,900 83,600 105,300 147,400 210,400 RENAL SURGERY (RIRS) - (BILATERAL) 64717 SVG +VEA -BILATERAL URO111 42,500 55,900 70,000 98,200 140,500

64718 SVG +VEA -UNILATERAL URO112 21,200 27,900 35,000 49,100 70,200

9500 PEN PENILE IMPLANT URO 33 42,200 56,100 70,200 97,700 139,700 (A) 22599 SCR VARICOCELECTOMY URO 21,200 27,900 35,000 49,100 70,200 (BILATERAL) 70(A) 89790 SCR VASECTOMY URO 34,100 44,900 55,800 78,200 112,000 (BILATERAL) 70(B) VASCULAR SURGERY

32854 ABDOMINAL AROTIC Vasc 1 47,700 63,700 79,500 111,000 158,600 ANEURYSM 2964 AORTO BIFEMORAL Vasc 2 47,700 63,700 79,500 111,000 158,600 BYPASS 2194 AORTO ILIAC BYPASS Vasc 3 38,300 50,900 63,700 88,800 126,800

33654 AXILLO FEMORAL BYPASS Vasc 4 38,300 50,900 63,700 88,800 126,800

50565 CAROTICO BRACHIAL BY Vasc 5 28,800 38,300 47,700 66,600 95,600 PASS USING SYNTHETIC GRAFT 2320 CAROTID BYPASS GRAFT Vasc 6 47,700 63,700 79,500 111,000 158,600

44897 CAROTID Vasc 7 38,300 50,900 63,700 88,800 126,800 ENDARTRECTOMY 3261 CONGENITAL A.V. Vasc 9 28,800 38,300 47,700 66,600 95,600 FISTULA 3423 ENDARTERACTOMY OF Vasc 10 28,800 38,300 47,700 66,600 95,600 ANY PERIPHERAL VESSEL 64632 EXCISION OF CAROTID Vasc 11 47,700 63,700 79,500 111,000 158,600 BODY TUMOUR WITH USE OF SHUNT 50567 EXCISION OF CAROTID Vasc 12 38,300 50,900 63,700 88,800 126,800 BODY TUMOR 10458 EXCISION OF CERVICAL Vasc 13 47,700 63,700 79,500 111,000 158,600 RIB

304 W.E.F. 1st January 2019 INVASIVE PROCEDURE

69715 EXCISION OF VARICOSE Vasc 14 38,300 50,900 63,700 88,800 126,800 VEINS DOUBLE 3548 EXCISION OF VARICOSE Vasc 15 28,800 38,300 47,700 66,600 95,600 VEINS SINGLE 2666 FEMORAL CROSSED -LEG Vasc 16 38,300 50,900 63,700 88,800 126,800 GRAFT 44911 FEMORAL EMBOLECTOMY Vasc 17 38,300 50,900 63,700 88,800 126,800 -BILATERAL 44913 FEMORAL EMBOLECTOMY Vasc 18 34,400 45,900 57,200 80,300 114,000 -UNILATERAL 44919 FEMORO POPLITEAL Vasc 19 34,400 45,900 57,200 80,300 114,000 BYPASS USING SYNTHETIC GRAFT 44921 FEMOROPOPILITEAL Vasc 20 38,300 50,900 63,700 88,800 126,800 BYPASS USING AUTOGENOUS VEIN 44931 LIENO RENAL, PROTO Vasc 21 47,700 63,700 79,500 111,000 158,600 CAVAL OR MESOCAVAL SHUNT 44933 LIGATION OF Vasc 22 47,700 63,700 79,500 111,000 158,600 ESOPHAGEAL VARICES 23593 LUMBER Vasc 23 28,800 38,300 47,700 66,600 95,600 SYMPATHECTOMY 94875 LUMBER Vasc 57,600 76,700 95,100 133,100 191,000 SYMPATHECTOMY 23(A) (BILATERAL) 44937 MANAGEMENT OF Vasc 24 28,800 38,300 47,700 66,600 95,600 POPLITEAL ARTERY ENTRAPMENT 44942 PERIPHERAL ANEURYSM, Vasc 25 38,300 50,900 63,700 88,800 126,800 LIGATION and REANASTOMOSIS 27781 PERIPHERAL VASCULAR Vasc 26 38,300 50,900 63,700 88,800 126,800 INJURY REPAIR 44945 PROFUNDAPLASTY USING Vasc 27 38,300 50,900 63,700 88,800 126,800 PATCH 44949 RESECTION AND Vasc 28 57,200 76,400 95,600 133,500 190,200 OR GRAFTING FOR ANEURYSMS - THORACIC 44953 SUBCLAVIAN BYPASS Vasc 29 28,800 38,300 47,700 66,600 95,600

W.E.F. 1st January 2019 305 INVASIVE PROCEDURE

44958 THROMBO Vasc 30 38,300 50,900 63,700 88,800 126,800 ENDERTECTOMY AORTA 44960 THROMBO Vasc 31 38,300 50,900 63,700 88,800 126,800 ENDERTECTOMY FEMORAL 44962 THROMBO Vasc 32 38,300 50,900 63,700 88,800 126,800 ENDERTECTOMY ILIAC 44964 THROMBO Vasc 33 38,300 50,900 63,700 88,800 126,800 ENDERTECTOMY POPLITEAL 64637 FEMORAL and POPLITEAL, Vasc 34 38,900 51,800 64,700 90,700 129,400 THROMBO EMB (UNILATERAL) 50568 FEMORAL and Vasc 34 38,900 51,800 64,700 90,700 129,400 POPLITEAL, THROMBO (A) EMBOLECTOMY (UNILATERAL) 44952 SHUNT and FISTULAS FOR Vasc 35 14,800 19,500 24,400 33,700 48,400 HEMODYLYSIS 44967 VARICOSE VEIN SURGERY Vasc 36 53,200 71,200 89,100 124,400 177,800 FOR BOTH LEG 44969 VARICOSE VEIN SURGERY Vasc 37 36,500 48,400 60,700 84,900 121,100 FOR SINGLE LEG 2667 FEMORO DISTAL BYPASS Vasc 38 48,400 64,600 80,700 113,100 161,600

44956 SURGERY FOR THORACIC Vasc 39 60,700 80,700 101,200 141,600 201,900 OUTLET SYNDROME 44916 FEMORO ARTERIOGRAM Vasc 40 8,500 11,300 14,200 19,700 28,600 ON TABLE 44887 ANY OTHER BYPASS Vasc 41 43,700 58,200 72,700 101,600 145,300 USING VEIN 44885 ANY OTHER BYPASS Vasc 42 38,900 51,800 64,700 90,700 129,400 USING SYNTHETIC GRAFT 44954 SUPERIOR VENA CAVA Vasc 43 58,200 77,400 96,800 135,600 193,700 BYPASS 44924 INFERIOR VENA CAVA Vasc 44 58,200 77,400 96,800 135,600 193,700 BYPASS 44940 PALMA DALE PROCEDURE Vasc 45 43,700 58,200 72,700 101,600 145,300

3695 ILIAC VEIN BYPASS Vasc 46 43,700 58,200 72,700 101,600 145,300

306 W.E.F. 1st January 2019 INVASIVE PROCEDURE

3588 FEMORAL VEIN Vasc 47 38,900 51,800 64,700 90,700 129,400 VALVULOPLASTY 44891 AXILLARY VEIN Vasc 48 48,400 64,600 80,700 113,100 161,600 TRANSFER 36039 DIABETIC FOOT vasc 49 19,500 26,000 32,300 45,700 64,700 DEBRIDEMENT 44938 OMENTAL TRANSFER Vasc 50 38,900 51,800 64,700 90,700 129,400

44971 VENOUS Vasc 51 33,700 45,200 56,700 79,500 113,400 THROMBECTOMY 44926 INJ.SCLROTHERAPY(PER Vasc 52 2,500 3,300 4,300 5,000 8,500 SITTING) 44928 INJECTION Vasc 52 2,500 3,300 4,300 5,000 8,500 SCLROTHERAPY (PER (A) SITTING) 64577 AORTA BIFEMORAL Vasc 53 69,900 89,100 108,400 147,500 203,000 BYPASS GRAFTING 3547 EXCISION OF VARICOSE Vasc 54 38,300 50,900 63,700 88,800 126,800 VEINS DOUBLE(LEFT) 64590 EXCISION OF VARICOSE Vasc 55 38,300 50,900 63,700 88,800 126,800 VEINS DOUBLE(RIGHT) 69642 FEMORAL EMBOLECTOMY Vasc 57 34,400 45,900 57,200 80,300 114,000 (LEFT) 69643 FEMORAL EMBOLECTOMY Vasc 58 34,400 45,900 57,200 80,300 114,000 (RIGHT) 69471 FEMORO POPLITEAL Vasc 59 68,800 91,700 114,300 160,400 228,000 BYPASS USING SYNTHETIC GRAFT BILETARAL 69472 FEMOROPOPILITEAL Vasc 60 76,700 101,900 127,700 177,600 253,800 BYPASS USING AUTOGENOUS VEIN BILETARAL 77811 ILIO FEMORAL BYPASS Vasc 61 47,700 63,700 79,500 111,000 158,600

69717 INJECTION Vasc 62 7,700 10,000 12,600 15,200 25,600 SCLROTHERAPY (THREE SITTING) 69716 INJECTION Vasc 63 5,000 6,700 8,300 10,200 17,100 SCLROTHERAPY (TWO SITTING)

W.E.F. 1st January 2019 307 INVASIVE PROCEDURE

63282 PERFORATORS SURGERY Vasc 64 19,200 25,500 31,900 38,200 50,900

80286 PERMACATH INSERTION Vasc 65 15,400 20,100 24,900 34,500 50,400

70689 PERMACATH REMOVAL Vasc 66 6,100 8,800 10,300 14,800 21,400

78694 STEM CELL INJECTION Vasc 67 14,800 19,500 24,400 33,700 48,400

67337 VASCULAR EXPLORATION Vasc 68 25,500 35,700 45,900 63,600 91,700

67338 VASCULAR RE- Vasc 69 12,700 17,200 21,200 29,300 42,000 EXPLORATION 70789 VENOUS Vasc 70 33,700 45,200 56,700 79,500 113,400 THROMBECTOMY ( RIGHT ) 70790 VENOUS Vasc 71 33,700 45,200 56,700 79,500 113,400 THROMBECTOMY (LEFT) 79157 VSD REPAIR Vasc 72 47,700 63,700 79,500 111,000 158,600

28035 CAPD-REMOVAL Vasc 73 6,100 8,800 10,300 14,800 21,400

34335 PERM CATH INSERTION Vasc 74 6,100 8,800 10,300 14,800 21,400

64575 ANTERIOR Vasc75 64,200 83,400 105,900 147,300 212,100 MEDIASTINAL TUMOUR EXC+PERICARDIECTOMY 78066 ANGIOPLASTY Vasc76 61,000 70,400 76,700 82,200 93,500

64576 ANY OTHER BY-PASS Vasc77 43,700 58,200 72,700 101,600 145,300 USING VEIN 77477 SUB. CLAVIAN Vasc79 8,200 10,500 13,500 18,400 26,600 CATHETERISATION/ IJ CATHERISATION 1686 AV FISTULA Vasc80 16,800 16,800 16,800 16,800 16,800

1036553 THROMBOLYSIS Vasc81 8,500 11,300 14,200 19,700 28,600

308 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

SERVICE SERVICENAME Code ID MULTI SEMI SINGLE DELUXE SUITE ID BED PRIVATE ROOM UNIT / ICU / HDU / Day Care ANAESTHESIOLOGY 3181 CARDIO PULMONARY Non 3,900 3,900 3,900 3,900 3,900 RESUSCITATION Invasive Procedure 22470 ANAESTHESIA FOR MRI/ Non 2,400 2,400 2,400 2,400 2,400 CT Invasive Procedure 23590 LUMBAR PUCTURE Non 3,900 5,400 6,100 9,000 12,600 Invasive Procedure 44974 ARTERIAL LINE Non 3,000 3,000 3,000 3,000 3,000 Invasive Procedure 44975 CVP LINE/ PIC LINE Non 3,900 3,900 3,900 3,900 3,900 Invasive Procedure 44976 CHRONIC BACKACHE Non 6,100 6,100 8,300 8,300 12,400 Invasive Procedure 44978 POST OPERATIVE Non 7,000 7,000 7,000 7,000 7,000 ANALGESIA Invasive Procedure 44979 SWANGANZ LINE Non 7,000 7,000 7,000 7,000 7,000 Invasive Procedure 44980 PRECT TRACHOSTOMY Non 4,100 5,700 7,000 5,700 14,300 Invasive Procedure 44981 MINI TRACHOSTOMY Non 2,100 3,000 3,800 5,400 7,000 Invasive Procedure 44984 BRONCHOSCOPE TO Non 6,100 8,800 10,300 14,800 21,400 ASSIST FIBREOPTIC Invasive INTUBATION OR CHECK/ Procedure POSITION E.T. TUBE DURING ANESTHESIA. 44985 SEDATION FOR DRESSING Non 2,000 2,000 2,000 2,000 2,000 Invasive Procedure 57162 ENDOTRACHEAL Non 2,400 2,400 2,400 2,400 2,400 INTUBATION Invasive Procedure

W.E.F. 1st January 2019 309 NON INVASIVE PROCEDURE

57163 INCUBATION Non 2,200 2,200 2,400 2,400 2,400 Invasive Procedure 57164 INITIATION OF Non 5,900 5,900 5,900 5,900 5,900 VENTILATION INC Invasive INTUBATION Procedure 57165 INTUBATION OF BIPAP Non 1,300 1,300 1,300 1,300 1,300 Invasive Procedure 57166 STAND BY ANESTHESIA Non 1,500 1,500 1,500 1,500 1,500 FOR MRI/CT Invasive Procedure 64090 ANEST. FOR LOWER/ Non 1,100 1,100 1,100 1,100 1,100 UPPER LIMB VENOGRAM/ Invasive IVC GRAM Procedure 64091 ANESTHESIA FOR AICD Non 21,200 21,200 21,200 21,200 21,200 Invasive Procedure 64092 ANESTHESIA FOR Non 19,200 25,200 31,900 44,300 63,500 ANGIOPLASTY OF NECK Invasive VESSELS ONLY Procedure 64093 ANESTHESIA FOR AORTIC Non 8,800 11,700 14,600 20,400 29,000 ANGIOPLASTY Invasive Procedure 64094 ANESTHESIA FOR Non 8,000 10,500 13,100 18,600 26,500 BRONCHIAL ARTREY Invasive EMBOLIZATION Procedure 64095 ANESTHESIA FOR CCF Non 29,300 39,400 48,600 68,000 97,800 BALLOON OCCLUSION Invasive Procedure 64096 ANESTHESIA FOR Non 8,000 10,500 13,100 18,600 26,500 CHEMOEMBOLIZATION Invasive OF HEPATIC TUMORS Procedure 64097 ANESTHESIA FOR Non 6,900 6,900 6,900 6,900 6,900 DIAGNOSTIC Invasive ELECTROPHYSIOLOGY Procedure FULL 64098 ANESTHESIA FOR Non 3,400 3,400 3,400 3,400 3,400 DIAGNOSTIC Invasive ELECTROPHYSIOLOGY Procedure MINI 64099 ANESTHESIA FOR EECP- Non 800 800 800 800 800 SINGLE SITTING Invasive Procedure

310 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64100 ANESTHESIA FOR Non 14,900 19,800 24,900 34,900 48,500 EMBOLIZATION OF ECA Invasive TUMORS Procedure 64101 ANESTHESIA FOR Non 8,000 10,500 13,100 18,600 26,500 EMBOLIZATION OF G.I. Invasive BLEEDS Procedure 64102 ANESTHESIA FOR Non 8,000 10,500 13,100 18,600 26,500 EMBOLIZATION OF Invasive HAEMANGIOMAS Procedure ORAVMS 64103 ANESTHESIA FOR Non 19,200 25,200 31,900 44,300 63,500 EMBOLIZATION OF ICA Invasive TUMOR Procedure 64104 ANESTHESIA FOR Non 14,900 19,800 24,900 34,900 48,500 EMBOLIZATION OF Invasive SPINAL TUMORS Procedure 64105 ANESTHESIA FOR Non 8,000 10,500 13,100 18,600 26,500 EMBOLIZATION OF Invasive VARICOCELES Procedure 64106 ANESTHESIA FOR Non 28,500 28,500 28,500 28,500 28,500 ENHANCED EXTERNAL Invasive COUNTER PULSATION Procedure 64107 ANESTHESIA FOR GLUE Non 23,700 31,400 39,200 56,100 78,900 EMBOLIZATION OF Invasive TUMORS Procedure 64108 ANESTHESIA FOR Non 6,700 8,900 11,100 15,300 22,200 INTRA ARTERIAL Invasive CHEMOTHERAPY Procedure 64109 ANESTHESIA FOR INTRA Non 6,700 8,900 11,100 15,300 22,200 ARTERIAL THROMBOLYSIS Invasive Procedure 64110 ANESTHESIA FOR PARTIAL Non 8,000 10,500 13,100 18,600 26,500 SPLENIC EMBOLIZATION Invasive Procedure 64111 ANESTHESIA Non 8,800 11,700 14,600 20,400 29,000 FOR PERIPHERAL Invasive ANGIOPLASTY Procedure 64112 ANESTHESIA FOR Non 15,000 15,000 15,000 15,000 15,000 PERMANENT PACEMAKER Invasive DOUBLE CHAMBER Procedure 64113 ANESTHESIA FOR Non 11,200 11,200 11,200 11,200 11,200 PERMANENT PACEMAKER Invasive SINGLE CHAMBER Procedure

W.E.F. 1st January 2019 311 NON INVASIVE PROCEDURE

64114 ANESTHESIA FOR Non 23,700 31,400 39,200 56,100 78,900 PROXIMAL OCCLUSION Invasive OF ICA Procedure 64115 ANESTHESIA FOR RENAL Non 8,800 11,700 14,600 20,400 29,000 ANGIOPLASTY Invasive Procedure 64116 ANESTHESIA FOR RENAL/ Non 4,200 4,200 4,200 4,200 4,200 ANGIO/ VISCERAL ANGIO Invasive Procedure 64117 ANESTHESIA FOR RF Non 19,100 19,100 19,100 19,100 19,100 ABLATION Invasive Procedure 64118 ANESTHESIA FOR SPLENIC Non 8,000 10,500 13,100 18,600 26,500 ARTERY EMBOLIZATION Invasive Procedure 64119 ANESTHESIA FOR Non 3,500 4,800 6,100 8,500 12,200 STD INJECTION/ Invasive SCLEROTHERAPY Procedure 64120 ANESTHESIA FOR Non 11,000 14,700 18,400 25,600 36,500 STENTING OF AORTA Invasive Procedure 64121 ANESTHESIA FOR Non 11,000 14,700 18,400 25,600 36,500 STENTING OF Invasive PERIPHERAL VESSELS Procedure 64122 ANESTHESIA FOR Non 11,000 14,700 18,400 25,600 36,500 STENTING OF RENAL Invasive ARTERY Procedure 64123 ANESTHESIA FOR Non 5,500 5,300 5,300 5,500 5,300 SUPER -SELECTIVE Invasive ANGIOGRAPHY Procedure 64124 ANESTHESIA FOR Non 3,400 3,400 3,400 3,400 3,400 TEMPORARY Invasive PACEMAKING (TPI) Procedure 64125 ANESTHESIA FOR Non 19,200 25,200 31,600 44,300 63,500 TESTOCCLUSION Invasive Procedure 64126 ANESTHESIA FOR Non 19,200 25,200 31,600 44,300 63,400 THROMBOLYSIS Invasive Procedure 64127 ANESTHESIA FOR TIPSS Non 37,100 49,400 61,600 86,500 123,500 Invasive Procedure 64128 ANESTHESIA FOR Non 8,000 10,500 13,100 18,600 26,500 TUMOUR EMBOLISATION Invasive Procedure

312 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64129 ANESTHESIA FOR VENOUS Non 14,900 19,800 24,900 34,900 48,500 SINUS SAMPLING Invasive Procedure 64130 ANESTHESIA FOR Non 14,900 19,800 24,900 34,900 48,500 VERTEBROPLASTY Invasive Procedure 64131 ANESTHESIA Non 23,700 31,400 39,200 56,100 78,900 FORANGIOPLASTY OF Invasive INTRACRANIAL ARTERIES Procedure 1061797 ANESTHESIA FOR Non 1,800 1,800 1,800 1,800 1,800 CHOLANGIOGRAM - (DSA Invasive LAB) Procedure 1061798 ANESTHESIA FOR Non 23,700 31,400 39,200 56,100 78,900 ANGIOPLASTY AND Invasive STENTING OF CAROTID Procedure AND OTHER ARTERIES 1061799 ANESTHESIA FOR Non 8,000 10,500 13,300 18,600 26,500 UTERINE ARTERY Invasive EMBOLIZATION - (DSA Procedure LAB) 1061800 ANESTHEISA FOR Non 12,700 12,700 12,700 12,700 12,700 CORONARY ANGIO Invasive GUIDED SCLEROTHERAPY Procedure 1061801 ANESTHESIA FOR Non 23,700 31,400 56,100 56,100 78,900 CEREBRAL AVM Invasive EMBOLIZATION(BESIDES Procedure VB TERRITORY) - (DSA LAB) 1061802 ANESTHESIA Non 14,300 18,900 33,400 33,400 47,700 FOR CHEMICAL Invasive ANGIOPLASTY(DSA LAB) Procedure 1061803 ANESTHESIA FOR Non 23,700 31,400 39,200 56,100 78,900 EMBOLIZATION OF Invasive TUMORS FED BY BOTH Procedure ICA AND ECA - (DSA LAB) 1061804 ANESTHESIA FOR Non 17,700 23,600 29,400 42,000 59,100 EMBOLISATION FOR AVM Invasive Procedure 1061805 ANESTHESIA FOR Non 8,800 11,700 14,600 20,400 29,000 UTERINE ARTERY Invasive BALLOON OCCLUSION - Procedure (DSA LAB)

W.E.F. 1st January 2019 313 NON INVASIVE PROCEDURE

1061806 ANESTHESIA FOR Non 31,800 31,800 31,800 31,800 31,800 ENDOVASCULAR AAA Invasive Repair Procedure 1061807 ANESTHESIA FOR AVM Non 29,300 39,400 48,600 68,000 97,800 EMBOLIZATION IN THE Invasive VERTEBRO -BASILAR Procedure TERRITORY 1061809 ANESTHESIA FOR Non 3,700 3,700 3,700 3,700 3,700 FRACTIONAL FLOW Invasive RESERVE (FFR) Procedure 1061810 ANESTHESIA FOR CCF Non 29,300 39,400 48,600 68,000 97,800 BALLOON OCCLUSION Invasive Procedure 1061811 ANESTHEISA FOR Non 11,000 14,700 18,400 25,600 36,600 HEPATIC VEIN STENTING Invasive - (DSA LAB) Procedure 1061812 ANESTHESIA FOR Non 29,300 39,400 48,600 68,000 97,800 GDC COILING OF Invasive INTRACRANIAL Procedure ANEURYSMS 1061814 ANESTHEISA FOR ILIAC Non 11,000 14,700 18,400 25,600 36,600 ARTERY STENTING - (DSA Invasive LAB) Procedure 1061815 ANESTHESIA FOR Non 29,300 39,400 48,600 68,000 97,800 EMBOLISATION OF SPINAL Invasive AVM - (DSA LAB) Procedure 1061817 ANESTHESIA FOR Non 4,100 4,100 4,100 4,100 4,100 INTERNALIZATION OF Invasive PTBD (DSA LAB) Procedure 1061818 ANESTHESIA FOR Non 29,300 39,400 48,600 68,000 97,800 ANGIOPLASTY Invasive AND STENTING OF Procedure INVRACRANIAL ARTERIES 1061819 ANESTHESIA FOR Non 6,700 8,900 11,100 15,300 22,200 INTERNALIZATION Invasive OF PTBD POST LIVER Procedure TRANSPLANT (DSA LAB) 1061820 ANESTHESIA FOR Non 6,700 8,900 11,100 15,300 22,200 INTRA-ARTERIAL Invasive CHEMOTHERAPHY- Procedure RETINOBLASTOMA - (DSA LAB)

314 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

1061821 ANESTHESIA FOR Non 2,200 2,900 3,700 5,000 7,200 TREPHINE BONE BIOPSY Invasive (DSA LAB) Procedure 1061822 ANESTHESIA FOR Non 29,300 39,400 48,600 68,000 97,800 EMBOLIZATION OF Invasive TUMORS FED BY VA OR/ Procedure AND BA 1061823 ANESTHESIA FOR INSULIN Non 8,000 10,500 13,100 18,600 26,500 VENOUS SAMPLING (DSA Invasive LAB) Procedure 1061824 ANESTHESIA FOR DURAL Non 29,300 39,400 48,600 68,000 97,800 AVF EMBOLIZATION(DSA) Invasive Procedure 1061825 ANESTHESIA FOR LEAD Non 2,500 2,500 2,500 2,500 2,500 REPOSITIONING Invasive Procedure 1061826 ANESTHESIA FOR Non 29,300 39,400 48,600 68,000 97,800 INTRACRANIAL STENT Invasive GRAFT PLACEMENT(DSA) Procedure 1061827 ANESTHESIA FOR TRANS- Non 8,000 10,500 13,100 18,600 26,500 JUGULAR LIVER BIOPSY - Invasive (DSA LAB) Procedure 1061828 ANESTHESIA FOR LIVER Non 2,800 2,800 2,800 2,800 2,800 BIOPSY(DSA) Invasive Procedure 1061829 ANESTHESIA FOR Non 29,300 39,400 48,600 68,000 97,800 EMBOLIZATION OF Invasive DURAL AVF (DSA) Procedure 1061831 ANESTHESIA FOR LIVER Non 8,000 10,500 13,100 18,600 26,500 EMBOLIZATION - (DSA Invasive LAB) Procedure 1061832 ANESTHESIA FOR Non 11,000 14,700 18,400 25,600 36,600 SUBCLAVIN ARTERY Invasive ANGIOPLASTY AND Procedure STENTING(DSA) 1061833 ANESTHESIA FOR Non 6,100 7,200 8,100 9,800 11,400 CEREBRAL ANGIOGRAM Invasive Procedure 1061834 ANESTHESIA FOR SPINAL Non 9,600 10,600 11,900 13,900 15,800 ANGIO - (DSA LAB) Invasive Procedure 1061835 ANESTHESIA FOR MHV Non 11,000 14,700 18,400 25,600 36,600 STENTING (DSA LAB) Invasive Procedure

W.E.F. 1st January 2019 315 NON INVASIVE PROCEDURE

1061837 ANESTHESIA FOR MHV Non 8,800 20,400 11,700 14,600 29,000 THROMBOLYSIS (DSA LAB) Invasive Procedure 1061838 ANESTHESIA FOR PCN/ Non 4,100 4,100 4,100 4,100 4,100 PTBD WITH BALLON Invasive DIALATION(DSA LAB) Procedure 1061839 ANESTHESIA FOR SUB Non 16,000 19,100 19,100 22,300 25,500 INTIMAL ENDOVASCULAR Invasive REVASCULARIZATION Procedure 1061840 ANESTHESIA FOR Non 5,600 5,600 5,600 5,600 5,600 ALCOHOL ABLATION DSA Invasive Procedure 1061841 ANESTHESIA FOR Non 5,300 5,300 5,300 5,300 5,300 PCN/PTBD WITH Invasive STENTING(DSA) Procedure 1061842 ANESTHESIA FOR PCN/ Non 2,800 2,800 2,800 2,800 2,800 PTBD(DSA LAB) Invasive Procedure 1061843 ANESTHESIA FOR Non 11,000 14,700 18,400 25,600 36,600 STENTING OF ANY OTHER Invasive ABDOMINAL ARTERY - Procedure (DSA LAB) 1061844 ANESTHESIA FOR B/L Non 25,500 25,500 25,500 25,500 25,500 VEIN ABLATION WITH Invasive PERFORATOR ABLATION Procedure 1061845 ANESTHEISA FOR Non 2,500 2,500 2,500 2,500 2,500 REVASCULARISATION OF Invasive AVF Procedure 1061846 ANESTHESIA FOR BRTO - Non 14,700 19,500 24,500 34,200 48,800 (DSA LAB) Invasive Procedure 1061848 ANESTHESIA FOR Non 8,000 8,000 8,000 8,000 8,000 EXPLANTATION OF AICD Invasive Procedure 1061849 ANESTHESIA FOR Non 6,100 6,800 7,800 9,800 10,900 CAROTID ANGIOGRAPHY Invasive - (DSA LAB) Procedure 1061852 ANESTHEISA FOR Non 3,800 4,400 5,000 5,500 6,400 PORTAL VEIN PRESSURE Invasive MONITORING (DSA LAB) Procedure 1061853 ANESTHESIA FOR PORTAL Non 8,700 11,700 14,600 20,400 29,000 VENOUS PALSTY - (DSA Invasive LAB) Procedure

316 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

1061854 ANESTHESIA FOR PORTAL Non 11,000 14,700 18,400 25,600 36,600 VENOUS STENTING - (DSA Invasive LAB) Procedure 1061855 ANESTHESIA FOR PTBD Non 8,800 11,600 14,600 20,300 29,000 POST LIVER TRANSPLANT Invasive - (DSA LAB) Procedure 1061856 ANESTHESIA FOR Non 1,800 1,800 1,800 1,800 1,800 PTC(DSA LAB) Invasive Procedure 1061857 ANESTHESIA FOR RENAL Non 8,000 10,500 13,100 18,600 26,500 TUMOUR EMBOLIZATION Invasive - (DSA LAB) Procedure 1061858 ANESTHEISA FOR RENAL Non 11,000 14,700 18,400 25,600 36,600 ANGIOPLASTY WITH Invasive STENT - (DSA LAB) Procedure 1061859 ANESTHEISA FOR Non 1,800 1,800 1,800 1,800 1,800 REPOSITION OF PTBD Invasive CATHTER OR CATHER Procedure CHANGE(DSA) APOLLO SAARTHAK MENTAL HEALTH SERVICE

1036288 SINGLE SESSION WITH Non 1,500 2,000 2,400 2,900 3,300 PSYCHOLOGIST/ SOCIAL Invasive WORKER FOR IPD Procedure 1036289 WEEKLY SUPPORT FOR Non 15,000 19,500 24,000 28,500 33,000 ALCOHOL RELAPSE Invasive PREVENTION FOR IPD Procedure BODY MIND MEDICINE

57186 AROMATHERAPY Non 1,900 1,900 2,000 2,000 2,000 CONSULTATION FIRST Invasive VISIT Procedure 57187 AROMATHERAPY Non 1,300 1,300 1,300 1,300 1,300 CONSULTATION Invasive SUBSEQUENT VISITS Procedure 57188 HYPNOTHERAPY Non 1,800 1,800 1,900 1,900 1,900 CONSULTATION: FIRST Invasive VISIT Procedure 57189 HYPNOTHERAPY Non 1,300 1,300 1,300 1,300 1,300 CONSULTATION: Invasive SUBSEQUENT VISITS Procedure

W.E.F. 1st January 2019 317 NON INVASIVE PROCEDURE

57190 MAGIC BEIGNNING Non 23,800 23,800 25,000 25,000 25,000 ENCHANTED LIVES Invasive Procedure 57191 MAGIC HEALING Non 23,800 23,800 25,000 25,000 25,000 Invasive Procedure 57192 PRIMORDIAL SOUND Non 25,500 25,500 26,600 26,600 26,600 MEDITATION (COUPLE) Invasive Procedure 57193 PRIMORDIAL SOUND Non 16,000 16,000 16,600 16,600 16,600 MEDITATION (SINGLE) Invasive Procedure 57194 REGRESSION OF HEART Non 23,800 23,800 25,000 25,000 25,000 DISEASE and AGING Invasive Procedure CATH LAB

19629 CARDIO VERSION Non 5,800 5,800 5,800 5,800 5,800 Invasive Procedure 69608 CDTT WITH Non 318,400 382,100 445,700 509,400 636,700 THROMBECTOMY Invasive Procedure CTVS

66572 INTRA AORTIC BALLOON Non 10,500 10,500 10,500 10,500 10,500 PUMP INSERTION Invasive Procedure DENTAL

1934 ENDO ROOT CANAL Non 7,600 7,600 7,900 7,900 7,900 TREATMENT- Invasive ANTERIOR(EACH) Procedure 1030851 I AND D UNDER L.A Non 140,000 140,000 140,000 140,000 140,000 (MINOR ORAL SURGERY Invasive LIKE TOOTH EXPOSURE Procedure BIOPSY REMOVABLE PERICORNALFLAP) 1935 ENDO ROOT CANAL Non 9,100 9,100 9,600 9,600 9,600 TREATMENT- Invasive POSTERIOR(EACH Procedure 2770 PERIODONTIA- Non 13,700 13,700 14,200 14,200 14,200 GINGIVOPLASTY Invasive QUADRANT Procedure

318 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

15630 LUCITON DENTURE Non 900 900 1,100 1,100 1,100 PARTIAL DENTURE 1 Invasive Procedure 15706 LUCITON DENTURE Non 4,500 4,500 4,600 4,600 4,600 PARTIAL DENTURE 3 Invasive Procedure 22185 CROWN- PORCELAIN Non 10,600 10,600 11,100 11,100 11,100 FUSED METAL Invasive (ANTERIOR) Procedure 22186 CROWN- PORCELAIN Non 10,600 10,600 11,100 11,100 11,100 FUSED METAL Invasive (POSTERIOR) Procedure 22187 CROWN- TEMPORARY Non 900 900 900 900 900 (ANTERIOR) Invasive Procedure 22188 CROWN- TEMPORARY Non 900 900 900 900 900 (POSTERIOR) Invasive Procedure 22189 DENTAL IMPLANT (NOBEL Non 129,500 129,500 135,600 135,600 135,600 BIOCARE) Invasive Procedure 22190 ENDO- APICOECTOMY Non 10,600 10,600 11,100 11,100 11,100 WITH ROOT CANAL Invasive TREAT. Procedure 22191 ENDO- HEMI-SECTION Non 12,200 12,200 12,600 12,600 12,600 WITH ROOT CANAL Invasive TREAT Procedure 22192 ENDO- RE-IMPLANTATION Non 12,200 12,200 12,600 12,600 12,600 Invasive Procedure 22193 REMOVAL Non 7,600 7,600 7,900 7,900 7,900 ORTHODONTICS Invasive APPLIANCES Procedure 22194 PERIODONTIA- BONE Non 36,200 36,200 38,000 38,000 38,000 GRAFT (/ QUADRANT) Invasive Procedure 22195 PERIODONTIA- FLAP Non 42,300 42,300 44,200 44,200 44,200 OPERATIONS FULL Invasive MOUTH Procedure 22196 PERIODONTIA- FLAP Non 10,600 10,600 11,100 11,100 11,100 OPERATIONS QUADRANT Invasive Procedure 22197 PERIODONTIA- OCCLUSAL Non 1,800 1,800 1,800 1,800 1,800 ADJUSTMENT Invasive Procedure

W.E.F. 1st January 2019 319 NON INVASIVE PROCEDURE

22198 PERIODONTIA- Non 7,600 7,600 7,900 7,900 7,900 OSTEOPLASTY Invasive (/QUADRANT) Procedure 22199 PERIODONTIA- Non 2,700 2,700 2,900 2,900 2,900 PAPILLECTOMY Invasive (/ QUADRANT) Procedure 22200 PERIODONTIA- SCALING Non 2,300 2,300 2,400 2,400 2,400 and PROPHYLAXIS Invasive Procedure 22201 PERIODONTIA- SOFT Non 13,700 13,700 14,200 14,200 14,200 TISSUE GRAFT Invasive (/ SURGERY) Procedure 22202 PERIODONTIA- SUB- Non 2,700 2,700 2,900 2,900 2,900 GINGIVAL QUADRANT Invasive Procedure 22203 PERIODONTIA- SUB- Non 10,600 10,600 11,100 11,100 11,100 GINGIVAL FULL MOUTH Invasive Procedure 22204 INLAY - NON-PRECIOUS Non 4,500 4,500 4,900 4,900 4,900 ALLOY/ONLAY Invasive Procedure 22205 MAXILLO- Non 18,300 18,300 18,900 18,900 18,900 ALVOOLECTOMY (FULL Invasive MOUTH) Procedure 22206 MAXILLO- BITE RAISING Non 10,600 10,600 11,100 11,100 11,100 APPLIANCE Invasive Procedure 22207 MAXILLO- DIAGNOSTIC Non 400 400 400 400 400 INJECTS Invasive Procedure 22208 MAXILLO- EXCISION OF Non 3,700 3,700 4,100 4,100 4,100 FLAP PERICORONAL Invasive Procedure 22209 MAXILLO- EXTRACTION 1 Non 3,300 3,300 3,300 3,300 3,300 TOOTH Invasive Procedure 22210 MAXILLO- FRENECTOMY Non 3,700 3,700 4,100 4,100 4,100 Invasive Procedure 22211 MAXILLO- INTERDENTAL Non 13,700 13,700 14,200 14,200 14,200 WIRING and SPLINTING Invasive Procedure 22212 MAXILLO- MINOR ORAL Non 3,700 3,700 4,100 4,100 4,100 SURGERY Invasive Procedure 22213 MAXILLO- SURG. Non 3,700 3,700 4,100 4,100 4,100 EXPOSURE OF A TOOTH Invasive Procedure 320 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

22214 MAXILLO- SURG. Non 7,000 7,000 7,400 7,400 7,400 EXTRACTION OF Invasive IMPACTED TOOTH Procedure 22215 MAXILLO- SURGICAL Non 5,000 5,000 5,300 5,300 5,300 EXTRACTION Invasive Procedure 22216 MAXILLO- Non 400 400 400 400 400 TEMPOROMANDIBULAR Invasive JOINTS INJECT Procedure 22218 ORTHO. PREVENT. and Non 28,100 28,100 29,500 29,500 29,500 COMPR. T.P.-3 TO8 MO Invasive Procedure 22219 ORTHO. RETENTION OR Non 10,600 10,600 11,100 11,100 11,100 SIMPLE CORRECTION Invasive Procedure 22220 ORTHODONTIC TREAT. Non 84,400 84,400 88,100 88,100 88,100 (ADULT) T.P.-8 TO36 MO Invasive Procedure 22221 ORTHODONTIC TREAT. Non 70,200 70,200 73,500 73,500 73,500 (CHILD) T.P.-8 TO36 MO Invasive Procedure 22222 PEDODONTIA- Non 1,800 1,800 1,800 1,800 1,800 FLOURODIATION (/ Invasive QUADRANT) Procedure 22223 PROS.REP. OCCLUSAL Non 11,100 11,100 11,900 11,900 11,900 SPLINT Invasive Procedure 22224 PROS.REP. OF DENTURE Non 2,000 2,000 2,000 2,000 2,000 UPPER/ LOWER Invasive Procedure 22225 PROS.REP. REBASING OF Non 6,400 6,400 6,500 6,500 6,500 DENTURE UP./LOWER. Invasive Procedure 22226 PROS.REP. REPLACING OF Non 1,800 1,800 1,800 1,800 1,800 TEETH (PER TOOTH)IN Invasive REM DENTURE Procedure 22227 PROS.REP. SOFT LINING OF Non 3,700 3,700 3,900 3,900 3,900 DENTURE UPPER/LOWER. Invasive Procedure 22228 RESTORATION- Non 2,300 2,300 2,400 2,400 2,400 COMPOSITE Invasive Procedure 22229 RESTORATION- Non 3,000 3,000 3,300 3,300 3,300 COMPOSITE VENEER Invasive Procedure 22230 RESTORATION-CROWN Non 4,500 4,500 4,900 4,900 4,900 WITH CORE Invasive Procedure

W.E.F. 1st January 2019 321 NON INVASIVE PROCEDURE

22231 RESTORATION-GLASS Non 1,100 1,100 1,100 1,100 1,100 IONOMER Invasive Procedure 22233 RESTORATION-SILVER Non 2,000 2,000 2,200 2,200 2,200 AMALGAM II Invasive Procedure 22234 RESTORATION-TEMP. FILL Non 600 600 600 600 600 WITH KALSINOL CEM Invasive Procedure 22235 VITAL/VIRR DENTURE Non 1,800 1,800 1,800 1,800 1,800 PARTIAL (EVERY ADDI) Invasive Procedure 22237 VITAL/VIRR DENTURE Non 18,300 18,300 18,900 18,900 18,900 PARTIAL (FIRST 3 TEETH) Invasive Procedure 22239 VITAL/VIRR DENTURE Non 54,300 54,300 57,000 57,000 57,000 UPPER and LOWER COMP Invasive Procedure 22241 METAL DENTURE UPPER Non 30,100 30,100 31,600 31,600 31,600 OR LOWER COMP Invasive Procedure 26321 ABUTEMENT DENTAL Non 7,000 7,000 7,000 7,000 7,000 IMPLANT(EXTRA IF Invasive REQUIRED) Procedure 26351 CERAMIC CROWN Non 20,400 20,400 20,400 20,400 20,400 ZARCONIA/LAVA Invasive Procedure 26364 CLOSED REDUCTION Non 32,300 32,300 32,300 32,300 32,300 FRACTURE/MANDIBLE Invasive OR MAXILLA (ARCH Procedure BARS+IMF) 26371 CROWN- DOWL PIN Non 4,500 4,500 4,900 4,900 4,900 Invasive Procedure 26372 CROWN- NICKLE Non 7,600 7,600 7,900 7,900 7,900 CHROME Invasive Procedure 26373 DENTAL IMPLANT Non 63,600 63,600 63,600 63,600 63,600 Invasive Procedure 26400 MAXILLO - SURG Non 18,300 18,300 18,300 18,300 18,300 EXTRACTION OF Invasive IMPACTED TOOTH-III Procedure 26442 PERIODONTIA- BONE Non 30,700 30,700 30,700 30,700 30,700 GRAFT (FULL MOUTH) Invasive Procedure

322 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

26443 RESTORATION-SILVER Non 1,900 1,900 1,900 1,900 1,900 AMALGAM I Invasive Procedure 64220 X-RAY OCCLUSAL VIEW Non 600 600 600 600 600 Invasive Procedure EAR NOSE AND THROAT

1737 IMPEDENCE AUDIOMETRY Investigations 1,590 1,590 1,590 1,590 1,590

1738 PURE TONE AUDIOMETRY Investigations 1,520 1,520 1,520 1,520 1,520

1751 EABR Investigations 5,160 5,160 5,160 5,160 5,160

1776 NASAL ENDOSCOPY Non 3,900 3,900 3,900 3,900 3,900 Invasive Procedure 2960 UNILATERAL ANTRUM Non 2,000 3,000 3,700 5,300 7,100 PUNCTURE (BEDSIDE Invasive PROCEDURE) Procedure 13961 REMOVAL OF FOREIGN Non 10,300 14,300 17,400 24,400 35,000 BODY Invasive Procedure 21664 CALORIC TEST Non 3,900 3,900 3,900 3,900 3,900 Invasive Procedure 21665 HA TRAIL FITING Non 2,100 2,100 2,100 2,100 2,100 Invasive Procedure 21668 NASAL PHARYNGO Non 4,300 4,300 4,300 4,300 4,300 LARYNGO SCOPY Invasive Procedure 21670 PLAY AUDIOMETRAY Non 2,000 2,000 2,000 2,000 2,000 Invasive Procedure 21671 POSTERIOR NASAL Non 7,100 7,100 7,100 7,100 7,100 PACKING Invasive Procedure 21672 SIS/TDT Investigations 2,680 2,680 2,680 2,680 2,680

21673 SPEECH SESSION FOLLOW Non 1,600 1,600 1,600 1,600 1,600 UP Invasive Procedure 21674 SPEECH SESSION IST Non 1,800 1,800 1,800 1,800 1,800 Invasive Procedure

W.E.F. 1st January 2019 323 NON INVASIVE PROCEDURE

49570 BILATERAL ANTRUM Non 4,300 5,700 7,100 10,100 14,100 PUNCTURE Invasive Procedure 50272 TOTAL LARYNGECTOMY Non 52,300 70,200 87,300 122,100 174,600 (ENT) Invasive Procedure 64230 ANTRUM WASH DOUBLE Non 7,100 7,100 7,100 7,100 7,100 Invasive Procedure 64231 ANTRUM WASH SINGLE Non 2,400 2,400 2,400 2,400 2,400 Invasive Procedure 64232 DIRECT LARYNGOSCOPY Non 16,900 19,200 20,900 25,300 31,800 (BEDSIDE PROCEDURE) Invasive Procedure 64233 EXAMINATION UNDER Non 4,300 4,300 4,300 4,300 4,300 MICROSCOPE Invasive Procedure 64234 INTRA OPERATIVE Non 76,400 76,400 76,400 76,400 76,400 NRT MAPPING AND Invasive THERAPHY Procedure 64235 LYMPH NODE BIOPSY Non 21,000 22,700 24,600 27,900 33,200 (BEDSIDE PROCEDURE) Invasive Procedure 64236 MYRINGOTOMY DOUBLE Non 7,100 7,100 7,100 7,100 7,100 Invasive Procedure 64237 NASAL CAUTARY Non 3,900 3,900 3,900 3,900 3,900 Invasive Procedure 64238 NASAL PACKING ANT Non 8,300 10,100 12,000 15,200 20,500 (BEDSIDE PROCEDURE) Invasive Procedure 64239 NASAL PACKING POST Non 14,100 15,600 17,500 20,900 26,100 (BEDSIDE PROCEDURE) Invasive Procedure 64240 PERITONSILLAR ABCESS Non 9,000 9,000 9,000 9,000 9,000 (BEDSIDE PROCEDURE) Invasive Procedure 64241 SUBMUCONS DIATHERMY Non 9,000 9,000 9,000 9,000 9,000 Invasive Procedure 64242 TRACHEOSTOMY Non 21,000 25,700 30,500 39,500 53,100 (BEDSIDE PROCEDURE) Invasive Procedure 64243 TRACHESTOMY TUBE Non 2,000 3,000 3,800 5,300 7,100 CHANGE (BEDSIDE Invasive PROCEDURE) Procedure

324 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64244 WAX REMOVAL FOR EAR Non 2,000 3,000 3,800 5,400 7,100 Invasive Procedure 65614 HEARING TEST Non 1,300 1,300 1,300 1,300 1,300 Invasive Procedure 83195 INJ INTRATYMPANIC Non 5,900 5,900 5,900 5,900 5,900 Invasive Procedure 87035 EPLEYS PARTICLE Non 8,200 8,200 8,200 8,200 8,200 REPOSITIONING Invasive MANUVER Procedure 87514 FIXATION OF IMPLANT Non 25,100 33,500 42,200 58,800 83,900 MAGNET Invasive Procedure 97396 STRAND-SAPIEN EYE Investigations 33,900 33,900 33,900 33,900 33,900 GENOMIC TEST 1030631 NEONATAL HEARING Non 1,300 1,300 1,300 1,300 1,300 SCREENING TEST Invasive Procedure 3401 EAR LOBE REPAIR - Invasive 8,500 8,500 8,500 8,500 8,500 BILATERAL Procedures 1073715 (SPHEAR CLINIC) Non 33,220 33,220 33,220 33,220 33,220 HEARING ASSESSMENT Invasive PEDIATRICS Procedure 1073720 (SPHEAR CLINIC) CI Non 53,600 53,600 53,600 53,600 53,600 SPEECH THERAPY Invasive PACKAGE SHORT TERM Procedure (BILATERAL) 1073719 (SPHEAR CLINIC) CI Non 3,300 3,300 3,300 3,300 3,300 SPEECH THERAPY Invasive PACKAGE SHORT TERM Procedure (UNILATERAL) 1073724 (SPHEAR CLINIC) CI Non 80,000 106,300 132,900 185,700 264,800 SPEECH THERAPY Invasive PACKAGE LONG TERM Procedure (BILATERAL) 1073723 (SPHEAR CLINIC) CI Non 1,000 1,000 1,000 1,000 1,000 SPEECH THERAPY Invasive PACKAGE LONG TERM Procedure (UNILATERAL) 1073722 (SPHEAR CLINIC) CI Non 494,550 494,550 494,550 494,550 494,550 SPEECH THERAPY Invasive PACKAGE MID TERM Procedure (BILATERAL)

W.E.F. 1st January 2019 325 NON INVASIVE PROCEDURE

1073721 (SPHEAR CLINIC) CI Non 15,000 15,000 15,000 15,000 15,000 SPEECH THERAPY Invasive PACKAGE MID TERM Procedure (UNILATERAL) 1073718 (SPHEAR CLINIC) CI Non 50,000 50,000 50,000 50,000 50,000 SWITCHON PACKAGE Invasive (BILATERAL) Procedure 1073717 (SPHEAR CLINIC) CI Non 50,000 50,000 50,000 50,000 50,000 SWITCHON PACKAGE Invasive (UNILATERAL) Procedure 1073729 (SPHEAR CLINIC) EAR Non 75,000 75,000 75,000 75,000 75,000 MOULDS PER EAR'S Invasive Procedure 1073728 (SPHEAR CLINIC) Non 20,000 20,000 20,000 20,000 20,000 HEARING AID Invasive DEMONSTRATIONS Procedure FITTINGS (BILATERAL) 1073727 (SPHEAR CLINIC) Non 20,000 20,000 20,000 20,000 20,000 HEARING AID Invasive DEMONSTRATIONS Procedure FITTINGS (UNILATERAL) 1073716 (SPHEAR CLINIC) Non 45,000 45,000 45,000 45,000 45,000 HEARING ASSESSMENT Invasive ADULTS Procedure 1073715 (SPHEAR CLINIC) Non 50,000 50,000 50,000 50,000 50,000 HEARING ASSESSMENT Invasive PEDIATRICS Procedure 1073725 (SPHEAR CLINIC) Non 35,000 35,000 35,000 35,000 35,000 UPGRADE COCHLEAR Invasive IMPLANT SOUND Procedure PROCESSOR 1073713 COMPLETE HEARING Non 75,000 75,000 75,000 75,000 75,000 ASSEMENT Invasive Procedure 3402 EAR LOBE REPAIR - Invasive 4,300 4,300 4,300 4,300 4,300 UNILATERAL Procedures ENDOCRINOLOGY

64133 BHCG PROCEDURE Non 25,700 25,700 26,900 26,900 26,900 Invasive Procedure 64134 DDAUP PROCEDURE Non 7,200 7,200 7,600 7,600 7,600 Invasive Procedure

326 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64135 GLUCAGON Non 18,400 18,400 19,200 19,200 19,200 STIMULATION Invasive PROCEDURE Procedure 64136 GONADORELINPROCEDURE/ Non 21,800 21,800 22,800 22,800 22,800 HRF PROCEDURE Invasive Procedure 64137 INSULIN STIMULATION Non 14,700 14,700 15,200 15,200 15,200 PROCEDURE Invasive Procedure 64138 PHYSIOLOGICAL Non 12,000 12,000 12,500 12,500 12,500 SYNACTHEN TEST Invasive Procedure 64139 STANDARD SYNACTHEN Non 7,600 7,600 7,900 7,900 7,900 PROCEDURE Invasive Procedure 64140 TRH PROCEDURE Non 7,600 7,600 7,900 7,900 7,900 Invasive Procedure 64141 WATER DEPRIVATION Non 18,400 18,400 19,200 19,200 19,200 PROCEDURE Invasive Procedure FETAL MEDICINE

21023 CHORIONIC VILLOUS Non 12,300 12,300 12,300 12,300 12,300 SAMPLING Invasive Procedure 21025 FETAL BLOOD SAMPLING Non 16,900 16,900 16,900 16,900 16,900 Invasive Procedure 64245 1ST TRIMSETER Non 8,800 8,800 8,800 8,800 8,800 SCREENING Invasive Procedure 64246 AMINOCENTESIS Non 10,700 10,700 10,700 10,700 10,700 Invasive Procedure 64247 AMINODRAINAGE Non 6,600 6,600 6,600 6,600 6,600 Invasive Procedure 64248 AMINOINFUSION Non 4,600 4,600 4,600 4,600 4,600 Invasive Procedure 64250 ANOMALY SCAN Non 4,600 4,600 4,600 4,600 4,600 Invasive Procedure 64251 CERVICAL ASSESSMENT + Non 1,800 1,800 1,800 1,800 1,800 UTERINE DOPPLER Invasive Procedure

W.E.F. 1st January 2019 327 NON INVASIVE PROCEDURE

64252 CVS Non 13,700 13,700 13,700 13,700 13,700 Invasive Procedure 64253 EMBRYO REDUCTION Non 16,800 16,800 16,800 16,800 16,800 Invasive Procedure 64255 FETAL BLOOD Non 21,600 21,600 21,600 21,600 21,600 TRANSFUSION Invasive Procedure 64257 FETAL DOPPLERS / Non 5,000 5,000 5,000 5,000 5,000 DOPPLER SCAN Invasive Procedure 64258 FETAL Non 5,500 5,300 5,300 5,500 5,300 ECHOCARDIOGRAPHY Invasive Procedure 64259 FETAL SHUNTING Non 21,600 21,600 21,600 21,600 21,600 Invasive Procedure 64260 FETAL WELL BEING SCAN Non 5,000 5,000 5,000 5,000 5,000 Invasive Procedure 64262 LATE FETAL REDUCTION Non 15,200 15,200 15,200 15,200 15,200 Invasive Procedure 64263 LATE GESTATION Non 9,200 9,200 9,200 9,200 9,200 POSTNATAL Invasive EXAMINATION Procedure 64264 MULTIPLE PREGNANCY Non 5,800 5,800 5,800 5,800 5,800 SCAN Invasive Procedure 64265 NEW GENE NEW BORN Non 8,800 8,800 8,800 8,800 8,800 SCREENING (EXTERNAL) Invasive Procedure 64266 NUCHAL SCAN / EARLY Non 2,500 2,500 2,500 2,500 2,500 FETAL VIABILITY SCAN Invasive Procedure 64268 VIRTOPSY Non 15,600 15,600 15,600 15,600 15,600 Invasive Procedure 67365 POSTNATAL Non 9,200 9,200 9,200 9,200 9,200 CHROMOSOMAL Invasive ANALYSIS Procedure Gastroenterology and Hepatology "For Gastroenterology Patients, 30% will be charges extra for below tariff if performed on paediatric pateints." 1702 CAPSULE ENDOSCOPY Non 80,100 80,100 80,100 80,100 80,100 Invasive Procedure

328 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

1705 COLONOSCOPY FULL Non 10,300 14,300 17,400 24,400 35,000 LENGTH Invasive Procedure 1709 UGI ENDOSCOPY Non 6,100 8,800 10,300 14,800 21,400 Invasive Procedure 1719 ERCP WITH NASAL Non 25,100 33,500 41,400 58,500 83,800 BILLIARY Invasive Procedure 1725 PEG TUBE REMOVAL Non 6,100 8,800 10,300 14,800 21,400 Invasive Procedure 1727 PEG TUBE PLACEMENT Non 16,600 22,400 28,000 39,100 55,400 Invasive Procedure 1732 PYLORIC DILATATION Non 12,500 16,600 21,400 28,900 41,400 Invasive Procedure 2408 COLONIC DILATATION Non 18,900 25,100 31,600 43,900 62,500 Invasive Procedure 2619 ENTEROSCOPY Non 10,300 14,300 17,400 24,400 35,000 Invasive Procedure 4098 ENDOSCOPIC VARICEAL Non 11,100 15,300 19,200 27,000 38,000 LIGATION Invasive Procedure 4099 ERCP DIAGNOSTIC Non 16,600 22,400 28,000 39,100 55,400 Invasive Procedure 6206 OESOPHAGOEL Non 8,800 11,100 14,300 19,300 28,000 DILATATION Invasive Procedure 6209 ACHALASIA DILATION Non 12,500 16,600 21,400 28,900 41,400 Invasive Procedure 6214 ERCP-STONE EXTRACTION Non 25,100 33,500 41,400 58,500 83,800 Invasive Procedure 6224 ENDOSCOPY GUIDED Non 8,800 11,100 14,300 19,300 28,000 RYELS TUBE INSERTION Invasive Procedure 6591 INJECTION OF Non 10,600 10,600 10,600 10,600 10,600 HAEMORRHOIDS Invasive Procedure

W.E.F. 1st January 2019 329 NON INVASIVE PROCEDURE

6844 LIVER BIOPSY Non 5,300 7,000 9,000 12,400 17,400 PERCUTANEOUS Invasive Procedure 6970 FB REMOVAL Non 10,300 14,300 17,400 24,400 35,000 Invasive Procedure 8212 LITHOTRIPSY Non 17,300 23,400 28,900 40,800 58,500 Invasive Procedure 10572 N.J TUBE PLACEMENT Non 10,300 14,300 17,400 24,400 35,000 Invasive Procedure 13833 ARGON PLASMA Non 18,900 25,000 31,600 43,900 62,500 COAGULATION Invasive Procedure 14824 POLYPECTOMY Non 18,900 25,100 31,600 43,900 62,500 Invasive Procedure 15169 SCLEROTHERAPY EST Non 10,300 14,300 17,400 24,400 35,000 Invasive Procedure 18430 THERAPUTIC Non 5,000 6,700 8,800 12,000 12,900 PARACENTESIS OF Invasive ASCITIC FLUID Procedure 21573 BIB INTRA GASTRIC Non 14,800 19,300 24,400 33,700 48,700 BALLON PLACEMENT Invasive Procedure 21575 COLONOSCOPY LEFT Non 6,100 8,800 10,300 14,800 21,400 LIMITED Invasive Procedure 21578 CRE (CONTROL RADIAL Non 12,500 16,600 21,400 28,900 41,400 EXPANSION) BALLON Invasive DILATATION Procedure 21580 DOUBLE BALLOON Non 31,900 37,300 42,700 48,200 58,600 ENTEROSCOPY Invasive Procedure 21581 ENDOPROSTHESIS (UGI) Non 14,800 19,300 24,400 33,700 48,700 Invasive Procedure 21587 ENDOSCOPIC Non 25,000 33,500 41,400 58,500 83,800 PSEUDOCYST DRANAGE Invasive Procedure 21588 ENDOSCOPIC Non 16,600 22,400 28,000 39,100 55,400 ULTRASOUND Invasive DIAGNOSTIC Procedure

330 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

21590 ENDOSCOPIC Non 28,900 38,900 47,000 64,600 88,200 ULTRASOUND Invasive THERAPEUTIC Procedure 21594 ERCP WITH BILLIARY Non 25,100 33,500 41,400 58,500 83,800 STENTING Invasive Procedure 21597 ERCP WITH PAPILLOTOMY Non 25,100 33,500 41,400 58,500 83,800 Invasive Procedure 21601 ENDO PROSTHESIS Non 19,100 25,100 31,600 43,900 62,500 COLONIC Invasive Procedure 21610 PLACEMENT OF Non 4,100 5,700 7,000 10,100 14,300 SANGESTEKEN TUBE Invasive Procedure 21616 SCLEROTHERAPY OF Non 10,300 14,300 17,400 24,400 35,000 BLEEDING ULCER Invasive Procedure 21619 SIDE VIEWING Non 8,800 11,100 14,300 19,300 28,000 ENDOSCOPY Invasive Procedure 27436 CAPSULE ENDOSCOPY Non 58,700 58,700 58,700 58,700 58,700 PEADIATRIC Invasive Procedure 30741 FIBROSCAN Non 6,500 6,500 6,500 6,500 6,500 Invasive Procedure 57195 EMR Non 14,800 19,300 24,400 33,700 48,700 Invasive Procedure 64269 ANESTHESIA FOR Non 2,100 2,700 3,500 4,800 6,900 ACHALASIA DILATION Invasive Procedure 64270 ANESTHESIA FOR ARGON Non 3,200 4,300 5,300 7,200 10,400 PLASMA COGULATION Invasive Procedure 64271 ANESTHESIA FOR BIB Non 2,400 3,200 4,200 5,600 3,200 INTRA GASTRIC BALLON Invasive PLACEMENT Procedure 64272 ANESTHESIA FOR Non 3,200 4,300 5,300 7,200 10,400 COLONIC DILATATION Invasive Procedure 64273 ANESTHESIA FOR Non 1,900 2,400 2,900 4,200 5,800 COLONOSCOPY FULL Invasive LENGTH Procedure 64274 ANESTHESIA FOR Non 900 1,500 1,900 2,500 3,500 COLONOSCOPY LEFT Invasive LIMITED Procedure W.E.F. 1st January 2019 331 NON INVASIVE PROCEDURE

64275 ANESTHESIA FOR CRE Non 2,100 2,700 3,500 4,800 6,900 BALLOON DILATATION Invasive Procedure 64276 ANESTHESIA FOR DOUBLE Non 5,400 6,200 7,100 8,000 9,900 BALLOON ENTEROSCOPY Invasive Procedure 64277 ANESTHESIA FOR EMR Non 2,400 3,200 4,200 5,600 8,100 Invasive Procedure 64278 ANESTHESIA FOR Non 2,400 3,200 4,200 5,600 8,100 ENDOPROSTHESIS (UGI) Invasive Procedure 64279 ANESTHESIA FOR Non 1,500 1,900 2,400 3,200 1,900 ENDOSCOPIC PLACEMENT Invasive OF RYLES TUB Procedure

64280 ANESTHESIA FOR Non 4,300 5,600 6,900 9,700 13,900 ENDOSCOPIC Invasive PSEUDOCYST DRANAGE Procedure 64281 ANESTHESIA FOR Non 2,700 3,700 4,700 6,600 9,300 ENDOSCOPIC Invasive ULTRASOUND Procedure DIAGNOSTIC 64282 ANESTHESIA FOR Non 4,800 6,500 7,900 10,700 14,700 ENDOSCOPIC Invasive ULTRASOUND Procedure THERAPEUTIC 64283 ANESTHESIA FOR Non 1,800 2,400 2,900 4,200 5,800 ENTEROSCOPY Invasive Procedure 64284 ANESTHESIA FOR ERCP Non 2,700 3,700 4,700 6,600 9,300 DIAGNOSTIC Invasive Procedure 64285 ANESTHESIA FOR ERCP Non 4,300 5,600 6,900 9,700 14,000 WITH BILLIARY STENTING Invasive Procedure 64286 ANESTHESIA FOR ERCP Non 4,300 5,600 6,900 9,700 14,000 WITH NASAL BILLIARY Invasive Procedure 64287 ANESTHESIA FOR ERCP Non 4,300 6,900 5,600 9,700 14,000 WITH PAPILLOTOMY Invasive Procedure 64288 ANESTHESIA FOR Non 1,900 2,500 3,200 4,500 6,500 EXDOSCOPIC VARICEAL Invasive LIGATION -EVL Procedure

332 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64289 ANESTHESIA FOR FIBRO Non 1,100 1,100 1,100 1,100 1,100 SCAN Invasive Procedure 64290 ANESTHESIA FOR Non 1,800 2,400 2,900 4,200 5,800 FOREIGN BODY REMOVAL Invasive Procedure 64291 ANESTHESIA FOR Non 2,900 4,100 4,800 6,800 9,700 MECHANICAL Invasive LITHOTRIPSY Procedure 64292 ANESTHESIA FOR NJFT Non 1,800 2,400 2,900 4,200 5,800 Invasive Procedure 64293 ANESTHESIA FOR PEG Non 900 1,500 1,800 2,400 3,500 REMOVAL Invasive Procedure 64294 ANESTHESIA FOR Non 800 1,100 1,600 2,100 2,900 PEROUTANEOUS LIVER Invasive BIOPSY Procedure 64295 ANESTHESIA FOR Non 600 900 1,100 1,800 2,400 PLACEMENT OF Invasive SANGESTEKEN TUBE Procedure 64296 ANESTHESIA FOR Non 3,200 4,300 5,400 7,400 10,400 POLYPECTOMY Invasive Procedure 64297 ANESTHESIA FOR Non 2,100 2,700 3,500 7,400 6,900 PYLORIC DILATATION Invasive Procedure 64298 ANESTHESIA FOR Non 1,800 2,400 2,900 4,200 5,800 SCLEROTHERAPY EST Invasive Procedure 64299 ANESTHESIA FOR Non 1,800 2,400 2,900 4,200 5,800 SCLEROTHERAPY OF Invasive ULCER Procedure 64300 ANESTHESIA FOR SIDE Non 1,500 1,900 2,400 3,200 4,700 VIEWING ENDOSCOPY Invasive Procedure 64301 ANESTHESIA FOR Non 800 1,100 1,500 2,100 2,200 THERAPEUTIC Invasive PARACENTESIS Procedure 64302 ANESTHESIA FOR UGI Non 900 1,500 1,800 2,400 3,500 ENDOSCOPY Invasive Procedure 64307 ENDOSCOPIC UGI Non 6,100 8,800 8,800 14,800 21,400 Invasive Procedure

W.E.F. 1st January 2019 333 NON INVASIVE PROCEDURE

64308 EXDOSCOPIC VARICEAL Non 11,100 15,300 19,200 27,000 38,000 LIGATION -EVL Invasive Procedure 64311 LIVER TRANSPLANT Non 127,400 127,400 127,400 127,400 127,400 EVALUATION- Invasive Procedure 67308 ENDOSCOPIC PLACEMENT Non 8,800 11,100 14,300 19,300 28,000 OF RYLES TUBE Invasive Procedure 76604 ANAESTHESIA FOR ERCP Non 2,700 3,800 4,700 6,600 9,200 DIAGNOSTICS Invasive Procedure 76776 ANAESTHESIA FOR PEG Non 2,700 3,800 4,700 6,600 9,200 PLACEMENT Invasive Procedure 76777 ANAESTHESIA FOR Non 1,500 1,900 2,400 3,300 4,700 OESOPHAGOEL Invasive DILATATION Procedure GENERAL SURGERY

3386 DRESSING Non 2,000 3,000 3,700 5,300 7,100 Invasive Procedure 1073904 HANSATRONICS VAC Non 13,800 13,800 13,800 13,800 13,800 DRESSING LARGE Invasive Procedure 1073903 HANSATRONICS VAC Non 12,600 12,600 12,600 12,600 12,600 DRESSING MEDIUM Invasive Procedure 1073902 HANSATRONICS VAC Non 11,400 11,400 11,400 11,400 11,400 DRESSING SMALL Invasive Procedure 65977 SUTURE OF LARGE Non 14,900 19,600 24,400 33,900 49,100 LACERATION (BEDSIDE Invasive PROCEDURE) Procedure HAEMATOLOGY 27169 BONE MARROW BIOPSY Non 5,900 7,600 9,600 13,500 19,300 PROCEDURE Invasive Procedure 27171 BONE MARROW Non 3,900 5,400 6,600 9,100 12,800 ASPIRATION PROCEDURE Invasive Procedure HOLISTIC MEDICINE 57198 AURICULAR Non 900 900 1,100 1,100 1,100 Invasive Procedure

334 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

57199 BIO ENERGY HEALING Non 1,900 1,900 1,900 1,900 1,900 Invasive Procedure 57200 CUPPING Non 800 800 800 800 800 Invasive Procedure 57201 ELECTRO/TENS Non 700 700 700 700 700 Invasive Procedure 57202 EMBDIING Non 2,000 2,000 2,200 2,200 2,200 Invasive Procedure 57203 HOLISTIC DIET Non 900 900 1,100 1,100 1,100 COUNSELLING Invasive Procedure 57204 LASER ACCUPUNCTURE Non 1,900 1,900 1,900 1,900 1,900 Invasive Procedure 57205 MEGNETOTHERAPY 'A' Non 800 800 800 800 800 Invasive Procedure 57206 MEGNETOTHERAPY 'B' Non 1,100 1,100 1,300 1,300 1,300 Invasive Procedure 57207 MOXIBUSTION Non 600 600 600 600 600 Invasive Procedure 57208 PACKAGE -A Non 20,900 20,900 21,800 21,800 21,800 (TEN SESSIONS + Invasive CONSUMABLES) Procedure 57209 PACKAGE -B Non 23,500 23,500 24,600 24,600 24,600 (TEN SESSIONS + Invasive CONSUMABLES) Procedure 57210 PACKAGE -F Non 42,000 42,000 44,000 44,000 44,000 (DOMICILLIARY) (TEN Invasive SESSION +CONS) Procedure 57211 PACKAGE -G Non 50,700 50,700 52,900 52,900 52,900 (DOMICILLIARY) Invasive (TWENTY SESSION Procedure +CONS) 57212 PACKAGE -I(TWENTY Non 63,800 63,800 66,900 66,900 66,900 SESSION +CONSUMABLES) Invasive Procedure 57213 PACKAGE -J(TWENTY Non 76,500 76,500 80,100 80,100 80,100 SESSION +CONSUMABLES) Invasive Procedure

W.E.F. 1st January 2019 335 NON INVASIVE PROCEDURE

57214 PACKAGE Non 127,700 127,700 133,500 133,500 133,500 -M(DOMICILLIARY) Invasive (TWENTY SESSION Procedure +CONS) 57215 PACKAGE Non 153,200 153,200 160,200 160,200 160,200 -N(DOMICILLIARY) Invasive (TWENTY SESSION +CONS Procedure ) 57216 PACKAGE C (TEN SESSIONS Non 26,300 26,300 27,300 27,300 27,300 + CONSUMABLES) Invasive Procedure 57217 PACKAGE D Non 32,600 32,600 34,200 34,200 34,200 (TEN SESSIONS Invasive +CONSUMABLES) Procedure 57218 PACKAGE E (TEN SESSIONS Non 39,300 39,300 41,200 41,200 41,200 +CONSUMABLES) Invasive Procedure 57219 PACKAGE G Non 52,400 52,400 54,700 54,700 54,700 (TWENTY SESSIONS Invasive +CONSUMABLES) Procedure 57220 PACKAGE Non 58,800 58,800 61,500 61,500 61,500 H(TWENTY SESSIONS Invasive +CONSUMABLES) Procedure 57221 PACKAGE I Non 65,400 65,400 68,400 68,400 68,400 (TWENTY SESSIONS Invasive +CONSUMABLES) Procedure 57222 PCKAGE Non 65,400 65,400 68,400 68,400 68,400 -K(DOMICILLIARY) (TEN Invasive SESSSION +CONS) Procedure 57223 REFLEXOLOGY Non 900 900 1,100 1,100 1,100 Invasive Procedure 57224 REIKI/PRANIC HEALING Non 900 900 1,100 1,100 1,100 Invasive Procedure 57225 SUJOK Non 900 900 1,100 1,100 1,100 Invasive Procedure 57226 TRADITIONAL Non 1,900 1,900 1,900 1,900 1,900 Invasive Procedure 57227 ULTRASONIC Non 900 900 1,100 1,100 1,100 Invasive Procedure

336 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

57228 YOGA/MEDITATION/ Non 1,900 1,900 1,900 1,900 1,900 PRANAYAMA THERAPY Invasive Procedure HYPERBARIC OXYGEN THERAPY

21038 HBO 10 THERAPIES Non 83,900 109,200 134,700 184,600 285,100 ANOXIC Invasive ENCEPHALOPATHY PKG Procedure LYING

21039 HBO PER THERAPY-10- Non 71,100 94,600 118,200 165,900 236,800 LYING POSITION-PKG Invasive Procedure 21040 HBO PER THERAPY-10- Non 51,100 67,700 84,600 118,200 169,400 SITTING POSITION-PKG Invasive Procedure 21041 HBO 20 THERAPIES Non 167,800 218,100 268,600 369,100 570,200 ANOXIC Invasive ENCEPHALOPATHY PKG Procedure LYING 21043 HBO PER THERAPY-20- Non 133,700 178,100 223,000 312,000 445,600 LYING POSITION-PKG Invasive Procedure 21044 HBO PER THERAPY-20- Non 95,700 127,500 159,200 223,000 318,400 SITTING POSITION-PKG Invasive Procedure 21045 HBO PER THERAPY-5- Non 37,300 50,000 63,000 87,600 125,700 LYING POSITION-PKG Invasive Procedure 21046 HBO 5 THERAPIES Non 26,900 36,000 44,500 62,600 90,200 SITTING POSITION Invasive Procedure 21047 HBO PER THERAPY- Non 32,000 32,000 32,000 32,000 32,000 EMERGENCY SITTING/ Invasive LYING POSITION Procedure

21048 HBO PER THERAPY - Non 8,800 11,200 13,800 19,600 28,100 LYING POSITION Invasive Procedure 21049 HBO PER THERAPY - Non 23,400 23,400 23,400 23,400 23,400 SINGLE PATIENT IN Invasive CHAMBER Procedure

W.E.F. 1st January 2019 337 NON INVASIVE PROCEDURE

21050 HBO PER THERAPY - Non 6,600 8,500 11,100 15,000 21,800 SITTING POSITION Invasive Procedure 21051 HBO-20 THERAPIES Non 154,500 154,500 161,500 161,500 161,500 NEUROREHAB LYING Invasive Procedure 64315 EMERGENCY and HIGH Non 6,500 6,500 6,800 6,800 6,800 RISK (SITTING/ LYING Invasive POSITION) Procedure 64319 EMERGENCY and HIGH Non 27,200 27,200 28,500 28,500 28,500 RISK 5 0(SITTING/ LYING Invasive POSITION Procedure 64320 HBO 10 THERAPIES Non 72,500 72,500 75,700 75,700 75,700 -EMERGENCY and HIGH Invasive RISK Procedure 64321 HBO 20 THERAPIES Non 136,100 136,100 142,300 142,300 142,300 -EMERGENCY and HIGH Invasive RISK Procedure 64322 HBO 5 THERAPIES- Non 38,200 38,200 39,900 39,900 39,900 EMERGENCYand HIGH Invasive RISK Procedure 64323 HBO PER THERAPY - Non 32,000 32,000 32,000 32,000 32,000 EMERGENCY and HIGH Invasive RISK - SIT/ LY Procedure 64332 PATIENT POSITION PER Non 4,600 4,600 5,000 5,000 5,000 LYING Invasive Procedure IVF LAB 14480 CRYOPRESERVATION OF Non 33,200 33,200 33,200 33,200 33,200 EMBRYOS Invasive (SUT 1 Y) Procedure 14481 RENEWAL STORAGE Non 17,600 17,600 17,600 17,600 17,600 FACILITY OF Invasive CRYOPRESERVATION OF Procedure EMBRYOS 21357 FROZEN EMBRYO Non 41,400 41,400 41,400 41,400 41,400 REPLACEMENT Invasive Procedure 21360 PERCOLL / SEMEN Non 4,100 4,100 4,100 4,100 4,100 WASHUP PREPARATION Invasive Procedure 21368 RENEWAL STORAGE Non 5,600 5,600 5,600 5,600 5,600 FACILITY OF FROZEN Invasive SEMEN (SU 1 YEAR) Procedure

338 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

21369 RENEWAL STORAGE Non 5,600 5,600 5,600 5,600 5,600 FACILITY OF FROZEN Invasive TESTICULAR BIOPSY (SF 1 Procedure Y) 26874 US GUIDED PER Non 21,400 21,400 21,400 21,400 21,400 VAGINAL OVARIAN CYST Invasive ASPIRATION Procedure 57229 CERVICAL BOVINE Non 9,000 9,000 9,000 9,000 9,000 PENETRATION Invasive Procedure 57230 SEMEN FREEZING Non 7,000 7,000 7,000 7,000 7,000 +STORAGE FOR 1 YEAR Invasive Procedure 57231 FREESING OF TESTICULAR Non 9,000 9,000 9,000 9,000 9,000 OVARIAN BIOPSY FOR 1 Invasive YEAR Procedure 64333 ANDROLOGY-B(SPERM Non 9,100 9,100 9,300 9,300 9,300 FREEZING) Invasive Procedure 64334 ANDROLOGY-C(SPERUM Non 9,100 9,100 9,300 9,300 9,300 FUNCTION TEST) Invasive Procedure 64335 ANDROLOGY-D(CERVICAL Non 11,800 11,800 12,400 12,400 12,400 BOVINE PENETRATION) Invasive Procedure NEONATOLOGY

22263 ENDOTRACHEAL Non 2,500 2,500 2,500 2,500 2,500 INTUBATION Invasive Procedure 22264 EXCHANGE TRANSFUSION Non 11,200 11,200 11,200 11,200 11,200 INCLUDING Invasive CANNULATION Procedure 22265 INCISION AND DRAINAGE Non 8,700 11,100 14,100 19,600 27,900 OF ABCESS Invasive Procedure 22266 INITIATION OF Non 4,600 4,600 4,600 4,600 4,600 VENTILATOR INCLUDING Invasive INTUBATION Procedure 22267 INTRA VENTRICULAR TAP Non 4,600 4,600 4,600 4,600 4,600 Invasive Procedure 22269 NEONATAL PERIPHERAL Non 3,500 3,500 3,500 3,500 3,500 ARTERIAL LINE Invasive Procedure

W.E.F. 1st January 2019 339 NON INVASIVE PROCEDURE

22270 PAEDIATRICS ARTERIAL Non 3,500 3,500 3,500 3,500 3,500 LINE Invasive Procedure 22271 PAEDIATRICS CHEST TUBE Non 8,200 8,200 8,200 8,200 8,200 INSERTION Invasive Procedure 22272 PAEDIATRICS CVP LINE/ Non 4,600 4,600 4,600 4,600 4,600 PIC LINE Invasive Procedure 22273 PAEDIATRICS SEDATION Non 3,400 3,400 3,400 3,400 3,400 FOR MRI/ CT Invasive Procedure 22274 PAEDIATRICS STAND BY Non 1,300 1,300 1,300 1,300 1,300 SEDATION FOR MRI/CT Invasive Procedure 22276 PLEURAL TAP/ ASCITIC Non 4,600 4,600 4,600 4,600 4,600 TAP Invasive Procedure 22277 SUPRAPUBIC ASPIRATE OF Non 1,500 1,500 1,500 1,500 1,500 URINE Invasive Procedure 22278 SURFACTANT Non 3,500 3,500 3,500 3,500 3,500 ADMINISTRATION Invasive Procedure 22279 UMBLICAL Non 3,500 3,500 3,500 3,500 3,500 CATHETERISATION Invasive ARTERIAL /VENOUS Procedure 22280 PAEDIATRIC KIDNEY Non 17,200 19,500 21,600 23,700 26,000 BIOPSY Invasive Procedure 22281 PAEDIATRIC KIDNEY Non 19,500 21,600 23,700 26,000 28,100 GRAFT BIOPSY Invasive Procedure 22283 PAEDIATRIC MCU Non 9,900 9,900 9,900 9,900 9,900 Invasive Procedure 81733 FECAL MICROBIOME Non 31,900 31,900 31,900 31,900 31,900 TRANSPLANTATION Invasive Procedure 64343 INCISION AND DRAINAGE Non 8,200 8,200 8,200 8,200 8,200 OF ABCESS(BEDSIDE Invasive PROCEDURE) Procedure NEPHROLOGY

1687 AV Shunt_Nephrology 12,200 12,200 12,200 12,200 12,200 Non Invasive Procedure 340 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

1076986 HAEMODIAFILTRATION Non 6,800 6,800 6,800 6,800 6,800 DIALYSIS Invasive Procedure 1689 CAPD Catheter Implantation Non 19,700 26,600 33,300 46,600 66,000 Invasive Procedure 1690 CAPD TRG + Follow up Non 23,500 31,800 39,500 55,400 79,700 Invasive Procedure 1692 Femoral Catheterisation Non 2,700 3,700 5,300 6,600 9,200 Invasive Procedure 1693 Sub. Clavian Catheterisation/ Non 8,200 10,500 13,500 18,400 26,600 IJ Catherisation Invasive Procedure 1696 PERITONEAL Non 12,200 16,300 19,700 28,100 39,500 DIALYSIS(CAPD) Invasive Procedure 14474 HIGH FLUX Non 6,900 6,900 6,900 6,900 6,900 HAEMODIALYSIS Invasive Procedure 16716 HAEMODIALYSIS (Single Non 5,600 5,600 5,600 5,600 5,600 Use) Invasive Procedure 20696 CRRT PROCEDURE Non 17,300 22,800 28,400 39,200 56,300 Invasive Procedure 20697 EMERGENCY Non 4,700 5,600 6,100 7,400 8,800 HEMODIALYSIS (REUSE) Invasive Procedure 20698 EMERGENCY Non 6,400 6,700 7,400 8,800 10,300 HEMODIALYSIS (SINGLE Invasive USE) Procedure 20699 ISOLATION (POSITIVE) Non 6,800 6,800 7,000 7,000 7,000 DIALYSIS Invasive Procedure 20700 KIDNEY BIOPSY (NATIVE) Non 8,500 8,500 8,500 8,500 8,500 Invasive Procedure 20701 KIDNEY BIOPSY Non 10,100 10,100 10,100 10,100 10,100 (ALLOGRAFT) Invasive Procedure 20702 HAEMODIALYSIS (REUSE) Non 3,900 3,900 3,900 3,900 3,900 Invasive Procedure

W.E.F. 1st January 2019 341 NON INVASIVE PROCEDURE

20703 MARS PROCEDURE Non 30,900 30,900 30,900 30,900 30,900 (PHYSICIAN) Invasive Procedure 20704 MARS PROCEDURE Non 3,500 3,500 3,500 3,500 3,500 (TECHNICIAN) Invasive Procedure 20705 PAEDIATRIC KIDNEY Non 17,200 19,500 21,600 23,700 26,000 BIOPSY (NATIVE) Invasive Procedure 20706 PAEDIATRIC KIDNEY Non 19,500 21,600 23,700 26,000 28,100 BIOPSY (ALLOGRAFT) Invasive Procedure 20708 PAEDIATRIC Non 12,900 14,100 15,200 17,200 25,800 PERCUTAENOUS LIVER Invasive BIOPSY Procedure 20709 PLASMA EXCHANGE PER Non 8,500 12,000 14,800 18,100 28,400 SITTING (PHYSICIAN Invasive CHARGES) Procedure 20710 PORTABLE DIALYSIS Non 6,700 6,700 7,400 8,800 10,300 Invasive Procedure 69854 CONTINUOUS Non 10,300 14,100 17,500 24,400 35,000 ARTERIO VENOUS Invasive HAEMOFILTRATION Procedure 89172 CYTOSORB KIT Non 30,900 30,900 30,900 30,900 30,900 IMPLEMENTATION Invasive CHARGES (DOCTORS) Procedure 89173 CYTOSORB KIT Non 3,500 3,500 3,500 3,500 3,500 IMPLEMENTATION Invasive CHARGES (TECHNICIAN) Procedure 89174 POLYMYXIN KIT Non 30,900 30,900 30,900 30,900 30,900 IMPLEMENTATION Invasive CHARGES (DOCTORS) Procedure 89175 POLYMYXIN KIT Non 3,500 3,500 3,500 3,500 3,500 IMPLEMENTATION Invasive CHARGES (TECHNICIAN) Procedure 1020607 PORTABLE DIALYSIS (8 Non 13,400 13,400 14,800 17,400 20,700 HOURS) Invasive Procedure 1020608 PORTABLE DIALYSIS (12 Non 20,000 20,000 22,200 26,300 31,000 HOURS) Invasive Procedure

342 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

NEUROLOGY

1603 SEP (Somatosensory Evoked Non 5,000 5,300 5,400 5,400 5,600 Potential ) Invasive Procedure 1636 ELECTROMYOGRAM Non 5,700 5,900 6,100 6,100 6,700 Invasive Procedure 6659 SKULL TRACTION Non 3,700 3,900 3,900 4,100 4,100 APPLICATION Invasive Procedure 6933 VER Non 5,000 5,300 5,400 5,400 5,600 Invasive Procedure 14835 EEG ROUTINE Non 3,800 3,900 4,100 4,100 4,100 Invasive Procedure 14838 EEG(BED SIDE) Non 9,100 9,200 10,200 10,300 10,500 Invasive Procedure 14839 EEG -SLEEP DEPRIVATION Non 5,300 5,400 5,400 5,600 5,600 Invasive Procedure 21336 CISTERNAL PUNCTURE Non 3,700 3,900 3,900 4,100 4,100 Invasive Procedure 21337 EEG -NIGHT SLEEP Non 27,000 28,400 29,800 30,000 30,900 Invasive Procedure 21338 EVOKE POTENTIAL BEAR Non 5,000 5,300 5,400 5,400 5,600 Invasive Procedure 21342 NCV -MOTOR +SENSORY Non 12,400 12,900 13,700 13,700 14,300 +EMG Invasive Procedure 21343 NCV -MOTOR UPPER/ Non 3,700 3,900 4,100 4,100 4,100 LOWER Invasive Procedure 21344 NCV -SENSORY UPPER/ Non 3,700 3,900 4,100 4,100 4,100 LOWER Invasive Procedure 21346 SUBDURAL TAPPING Non 3,700 3,900 3,900 4,100 4,100 Invasive Procedure 22268 LUMBER PUNCTURE Non 3,900 5,400 6,100 9,000 12,600 Invasive Procedure

W.E.F. 1st January 2019 343 NON INVASIVE PROCEDURE

27925 ACUTE NEURO CARE Non 7,000 7,000 7,000 7,000 7,000 PACKAGE Invasive Procedure 27926 INTRAVENOUS Non 21,000 21,000 21,000 21,000 21,000 THROMBOLYSIS PACKAGE Invasive Procedure 41543 NCV ALL FOUR LIMBS Non 14,200 15,000 16,100 16,100 16,100 Invasive Procedure 41557 NCV PLUS EMG ALL FOUR Non 33,300 20,000 20,000 20,000 20,000 LIMBS Invasive Procedure 41558 SSEP MEDIAN PLUS TIBIAL Non 10,100 12,200 12,200 12,200 12,200 NERVE Invasive Procedure 64344 ACUTE NEUROLOGY Non 6,500 6,500 6,500 6,500 6,500 CARE Invasive Procedure 64345 ACUTE STROKE CARE Non 6,500 6,500 6,500 6,500 6,500 Invasive Procedure 64346 BAER AUDIOMETRY Non 8,300 8,300 8,300 8,300 8,300 Invasive Procedure 64347 EMG ALL FOUR LIMBS Non 11,800 11,800 11,800 11,800 11,800 Invasive Procedure 64348 EMG PORTABLE Non 15,200 15,200 15,200 15,200 15,200 Invasive Procedure 64349 EMG TWO LIMBS Non 6,900 6,900 6,900 6,900 6,900 Invasive Procedure 64350 EVOKE POTENTIAL BLINK Non 5,000 5,300 5,000 5,400 5,600 REFLEX Invasive Procedure 64352 EXTERNAL VENTRICULAR Non 10,300 14,100 17,500 24,400 35,000 DRAIN (BEDSIDE Invasive PROCEDURE) Procedure 64354 ICP MONITORING Non 3,700 5,300 5,800 8,700 12,300 (BEDSIDE PROCEDURE) Invasive Procedure 64355 INTRA OPERATIVE Non 7,700 7,700 7,700 7,700 7,700 MONITORING Invasive Procedure 64356 MANIPULATIONS Non 10,300 14,100 17,500 24,400 35,000 (BEDSIDE PROCEDURE) Invasive Procedure

344 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64357 NCV ALL FOUR LIMBS Non 15,600 15,600 15,600 14,900 14,900 Invasive Procedure 64358 NCV PORTABLE Non 13,800 13,800 13,800 13,800 13,800 Invasive Procedure 64359 NCV+EMG ALL FOUR Non 20,000 20,000 20,000 20,000 20,000 LIMBS Invasive Procedure 64360 NCV+EMG LOWER LIMBS Non 15,600 15,600 15,600 15,600 15,600 Invasive Procedure 64361 NCV+EMG UPPER LIMBS Non 15,600 15,600 15,600 15,600 15,600 Invasive Procedure 64362 NCV- LOWER LIMBS Non 8,800 8,800 8,800 8,800 8,800 Invasive Procedure 64363 NCV- UPPER LIMBS Non 8,800 8,800 8,800 8,800 8,800 Invasive Procedure 64364 PHYS. CHARGES- Non 26,300 34,900 43,700 61,100 87,300 ALL MICROSCOPIC Invasive OPERATIONS EXP DISC Procedure 64365 PHYS.CHARG.-MICRO- Non 19,500 26,300 32,600 45,900 65,400 DISCECTOMIES INCL. Invasive CLOWARD'S PROC Procedure 64366 PHYSICIAN CHARGES ALL Non 26,300 34,900 43,700 61,100 87,300 ELECTIVE CRANIOTOMIES Invasive Procedure 64367 PHYSICIAN CHARGES ALL Non 26,300 34,900 43,700 61,100 87,300 INTRA-DURAL SPINAL Invasive SURGERIES Procedure 64368 PHYSICIAN CHARGES- Non 26,300 34,900 43,700 61,100 87,300 BRACHIAL PLEXUS Invasive INJURIES Procedure 64369 PHYSICIAN CHARGES- Non 13,000 17,500 21,800 30,700 43,700 BURR-HOLE ASPIRATION Invasive FOR ABSCESS Procedure 64370 PHYSICIAN CHARGES- Non 13,000 17,500 21,800 30,700 43,700 CARPAL TUNNEL RELEASE Invasive Procedure 64371 PHYSICIAN CHARGES- Non 13,000 17,500 21,800 30,700 43,700 CHRONIC SUB-DUAL Invasive HAEMATOMA Procedure

W.E.F. 1st January 2019 345 NON INVASIVE PROCEDURE

64372 PHYSICIAN CHARGES-CSF Non 19,500 26,300 32,600 45,900 65,400 SHUNT PROCEDURES Invasive Procedure 64373 PHYSICIAN CHARGES- Non 2,500 3,500 4,400 6,100 8,800 EXTERNAL VENTRICULAR Invasive DRAIN Procedure 64374 PHYSICIAN CHARGES-ICP Non 900 1,400 1,500 2,200 3,000 MONITORING Invasive Procedure 64375 PHYSICIAN CHARGES- Non 2,500 3,500 4,400 6,100 8,800 MANIPULATIONS Invasive Procedure 64376 PHYSICIAN CHARGES- Non 13,000 17,500 21,800 30,700 43,700 PERIPHERAL NERVE Invasive SURGERY Procedure 64377 PHYSICIAN CHARGES- Non 13,000 17,500 21,800 30,700 43,700 RADIOFREQUENCY Invasive RHIZOTOMY Procedure 64378 PHYSICIAN CHARGES- Non 2,500 3,500 4,400 6,100 8,800 SKULL TRACTION Invasive Procedure 64379 PHYSICIAN CHARGES- Non 26,300 34,900 43,700 61,100 87,300 SPINAL FUSION AND Invasive DECOMPRESSION Procedure 64380 PHYSICIAN CHARGES- Non 26,300 34,900 43,700 61,100 87,300 STEREOTACTIC Invasive PROCEDURES Procedure 64381 PHYSICIAN CHARGES-TIC Non 13,000 17,500 21,800 30,700 43,700 INJECTIONS Invasive Procedure 64382 PHYSICIAN CHARGES- Non 26,300 34,900 43,700 61,100 87,300 TRANS -SPHENOID Invasive OPERATIONS Procedure 64383 PHYSICIAN CHARGES- Non 900 1,400 1,500 2,200 3,000 VENTRICULAR Invasive PUNCTURE Procedure 64384 SKULL TRACTION Non 3,700 3,900 3,900 4,100 4,100 (BEDSIDE PROCEDURE) Invasive Procedure 64386 SSEP MEDIAN+TIBIAL Non 12,200 12,200 12,200 12,200 12,200 NERVE Invasive Procedure 64387 SSEP TIBIAL NERVE Non 6,100 6,100 6,100 6,100 6,100 Invasive Procedure

346 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64388 VENTRICULAR Non 3,700 3,900 3,900 4,100 4,100 PUNCTURE (BEDSIDE Invasive PROCEDURE) Procedure 64389 VIDEO EEG 12 HOURS Non 16,900 16,900 16,900 16,900 16,900 Invasive Procedure 64390 VIDEO EEG 24 HRS Non 22,400 22,400 22,400 22,400 22,400 Invasive Procedure 64391 VIDEO EEG 48 HRS Non 44,900 44,900 44,900 44,900 44,900 Invasive Procedure 64392 VIDEO EEG 72 HOURS Non 53,900 53,900 53,900 53,900 53,900 Invasive Procedure 77414 CARPAL TUNNEL RELEASE Non 52,300 70,200 87,300 122,100 174,600 Invasive Procedure 77415 PERIPHERAL NERVE Non 52,300 70,200 87,300 122,100 174,600 SURGERY Invasive Procedure 1061249 EEG -SLEEP DEPRIVATION Non 6,700 6,700 6,700 6,700 6,700 PORTABLE Invasive Procedure 1061250 NCV- LOWER LIMBS Non 11,600 11,600 11,600 11,600 11,600 PORTABLE Invasive Procedure 1061251 NCV- UPPER LIMBS Non 11,600 11,600 11,600 11,600 11,600 PORTABLE Invasive Procedure 1061252 NCV ALL FOUR LIMBS Non 18,600 18,600 18,600 18,600 18,600 PORTABLE Invasive Procedure 1061253 NCV AND EMG ALL FOUR Non 26,100 26,100 26,100 26,100 26,100 LIMBS PORTABLE Invasive Procedure 1061255 NCV AND EMG LOWER Non 20,400 20,400 20,400 20,400 20,400 LIMBS PORTABLE Invasive Procedure 1061258 NCV AND EMG UPPER Non 20,400 20,400 20,400 20,400 20,400 LIMBS PORTABLE Invasive Procedure 1061259 EMG ALL FOUR LIMBS Non 15,400 15,400 15,400 15,400 15,400 PORTABLE Invasive Procedure 1061260 VER PORTABLE Non 6,700 6,700 6,700 6,700 6,700 Invasive Procedure

W.E.F. 1st January 2019 347 NON INVASIVE PROCEDURE

1061261 EVOKE POTENTIAL BEAR Non 6,700 6,700 6,700 6,700 6,700 PORTABLE Invasive Procedure 1061262 BAER AUDIOMETRY Non 10,900 10,900 10,900 10,900 10,900 PORTABLE Invasive Procedure 1061263 REPETITIVE NERVE Non 6,100 6,100 6,100 6,100 6,100 SIMULATION PORTABLE Invasive Procedure 1061264 EVOKE POTENTIAL BLINK Non 6,700 6,700 6,700 6,700 6,700 REFLEX PORTABLE Invasive Procedure 1061265 FACIAL MOTOR STUDY Non 6,100 6,100 6,100 6,100 6,100 PORTABLE Invasive Procedure 1061266 SSEP MEDIAN NERVE Non 8,200 8,200 8,200 8,200 8,200 PORTABLE Invasive Procedure 1061267 SSEP MEDIAN AND TIBIAL Non 13,100 13,100 13,100 13,100 13,100 NERVE PORTABLE Invasive Procedure 1061268 SSEP TIBIAL NERVE Non 7,200 7,200 7,200 7,200 7,200 PORTABLE Invasive Procedure 1061270 EMG TWO LIMBS Non 9,300 9,300 9,300 9,300 9,300 PORTABLE Invasive Procedure OBSTRETICS & GYNAECOLOGY

57232 EPIDURAL PAINLESS Non 10,300 10,300 10,300 10,300 10,300 DELIVERY Invasive Procedure 57233 NEONATAL Non 8,300 11,200 14,100 19,600 28,000 RESUSCITATION Invasive Procedure 57234 NEONATAL Non 10,500 14,100 17,400 24,400 35,000 RESUSCITATION HIGH Invasive RISK Procedure 64337 CTG MONITORING Non 1,800 2,200 3,000 4,300 5,800 Invasive Procedure 64338 INSTRUMENTAL Non 25,100 33,500 42,300 58,900 84,000 DELIVERY Invasive Procedure 64339 LABOUR ROOM Non 5,500 5,500 5,500 5,500 5,500 Invasive Procedure

348 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64340 NORMAL DELIVERY Non 25,100 33,500 42,300 58,900 84,000 Invasive Procedure 64341 NORMAL DELIVERY HIGH Non 31,600 42,300 52,300 73,200 105,000 RISK Invasive Procedure 64514 REPAIR OF PERINEAL Non 7,200 10,100 12,400 17,300 24,400 TEAR,OLD SECOND Invasive DEGREE Procedure 64515 REPAIR OF PERINEAL Non 17,100 22,400 27,900 39,100 56,100 TEAR,OLD THIRD DEGREE Invasive Procedure 65787 VALVAL BIOPSY (BEDSIDE Non 6,500 8,700 10,300 14,900 21,200 PROCEDURE) Invasive Procedure 26870 HIFU GYNAE -MRG HIFU Non 140,100 140,100 140,100 140,100 140,100 Invasive Procedure ONCOLOGY

2355 "CHEMOPORT Non 15,600 20,000 24,600 34,400 49,800 PLACEMENT Invasive (BEDSIDE PROCEDURE)" Procedure 1075754 VACUUM ASSISTED Oncology 58,500 58,500 58,500 58,500 58,500 BREAST BIOPSY - Surgical THERAPEUTIC 1075755 VACUUM ASSISTED Oncology 45,500 45,500 45,500 45,500 45,500 BREAST BIOPSY - Surgical DIAGNOSTIC 19116 "ASCITIC TAPPING Non 3,400 3,900 5,400 6,700 9,600 (DIAGNOSTIC) Invasive " Procedure 22284 ASCITIC TAPPING Non 7,600 10,200 12,600 17,600 24,600 (THERAPEUTIC) Invasive Procedure 22287 CHEMOPORT ACCESS/ Non 2,000 2,200 2,700 3,700 5,300 FLUSH Invasive Procedure 22289 CHEMOTHERAPY (PER Non 4,100 5,700 7,000 10,100 14,300 DAY) Invasive Procedure 22291 CORE BIOPSY Non 2,400 3,500 3,900 5,600 7,600 Invasive Procedure 22293 EXTENDED / COMPLEX Non 81,000 81,000 81,000 81,000 81,000 PALLIATIVE MULTIPLE Invasive SITE Procedure W.E.F. 1st January 2019 349 NON INVASIVE PROCEDURE

63312 IV REMICADE INFUSION Non 2,400 3,200 3,900 5,600 7,600 Invasive Procedure 64400 ATO THERAPY Non 4,100 5,700 7,000 10,100 14,300 Invasive Procedure 64401 AXILLARY DISSECTION Non 38,100 38,100 39,600 39,600 39,600 Invasive Procedure 64402 BRONCHOSCOPIC Non 38,100 38,100 39,600 39,600 39,600 LASERISATION OF Invasive TRACHEOBRONCIAL Procedure TUMO 64403 CHEMOPORT INSERTION Non 15,600 20,000 24,600 34,400 49,800 Invasive Procedure 64404 CHEMOPORT REMOVAL Non 6,100 8,800 10,300 14,800 21,400 Invasive Procedure 64405 DIRECT MICRO Non 12,600 12,600 13,100 13,100 13,100 LARYNGOSCOPY Invasive Procedure 64409 I/V INFUSION ANTI Non 3,200 3,200 3,200 3,200 3,200 OSTEOPOROTIC THERAPY Invasive Procedure 64412 INTRA ARTICULAR INJ Non 2,000 2,000 2,000 2,000 2,000 Invasive Procedure 64413 IV BIOLOGICAL INFUSION Non 2,000 2,000 2,000 2,000 2,000 Invasive Procedure 64415 PROBE CHARGES Non 3,900 3,900 3,900 3,900 3,900 Invasive Procedure 64416 SENTINEL NODE BIOPSY Non 12,600 12,600 13,100 13,100 13,100 Invasive Procedure 64417 SENTINEL NODE Non 2,300 2,300 2,300 2,300 2,300 GUIDANCE Invasive Procedure 64418 STEREOTACTIC Non 315,500 315,500 315,500 315,500 RADIOTHEARPY(SRT) Invasive 315,500 NOVALISTX WITH FRAME Procedure 64419 THORACCOCENTESIS Non 7,600 10,200 12,600 17,600 24,600 THERAPEUTIC Invasive Procedure

350 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

65660 DIRECT Non 12,600 12,600 13,100 13,100 13,100 MICROLARYNGOSCOPY Invasive (BED SIDE PROCEDURE) Procedure 65663 CHEMOPORT REMOVAL Non 6,100 8,800 10,300 14,800 21,400 (BED SIDE PROCEDURE) Invasive Procedure 66037 BT 1A WITHOUT Non 39,500 39,500 39,500 39,500 39,500 ANAESTHESIA AND USG Invasive Procedure 66904 HARMONAL THERAPY Non 2,400 3,500 3,900 5,600 7,600 Invasive Procedure 70808 STEM CELL HARVESTING Non 12,700 17,300 22,400 29,700 42,500 Invasive Procedure 72280 MOULD ROOM ACTIVITY Non 15,200 15,200 15,200 15,200 15,200 Invasive Procedure 82788 DUCTOSCOPY Non 14,900 19,600 24,400 33,900 49,100 Invasive Procedure 22285 CANCER Non 2,400 3,500 3,900 5,600 7,600 BISPHOSPHONATES (PER Invasive DAY) Procedure 22286 CANCER Non 2,300 3,400 3,900 5,600 7,600 IMMUNOTHERAPY (PER Invasive DAY) Procedure 22290 COMPLEX CURATIVE Non 139,000 139,000 139,000 139,000 139,000 RADATION Invasive Procedure 22292 ELECTRON BEAM WITH Non 158,400 158,400 158,400 158,400 158,400 LINEAR ACCELERATOR Invasive Procedure 22299 IGRT Non 294,200 294,200 294,200 294,200 294,200 Invasive Procedure 22300 IMRT Non 231,100 231,100 231,100 231,100 231,100 Invasive Procedure 22309 LIMITED FRACTIONS Non 32,300 32,300 32,300 32,300 32,300 RADIOTHEARPY SINGLE Invasive FRACTION Procedure 22310 LIMITED FRACTIONS Non 40,600 40,600 40,600 40,600 40,600 RADIOTHEARPY UPTO Invasive FIVE FRACTION Procedure

W.E.F. 1st January 2019 351 NON INVASIVE PROCEDURE

22312 PALLIATIVE Non 58,200 58,200 58,200 58,200 58,200 RADIOTHEARAPY SINGLE Invasive SITE Procedure 22313 RAPID ARC WITH IGRT Non 315,200 315,200 315,200 315,200 315,200 Invasive Procedure 22314 RAPID ARC WITH IMRT Non 242,800 242,800 242,800 242,800 242,800 Invasive Procedure 22315 SBRT Non 404,600 404,600 404,600 404,600 404,600 Invasive Procedure 22318 SIMPLE CURATIVE Non 105,300 105,300 105,300 105,300 105,300 RADATION Invasive Procedure 22319 STEREOTACTIC Non 304,100 304,100 304,100 304,100 304,100 RADIOSURGERY(SRS) Invasive WITH FRAME Procedure 22320 STEREOTACTIC Non 380,300 380,300 380,300 380,300 380,300 RADIOSURGERY(SRS) Invasive NOVALISTX FRAMELESS Procedure 22321 STEREOTACTIC Non 126,200 126,200 126,200 126,200 126,200 RADIOTHEARPY (SRT) Invasive Procedure 22323 STEREOTACTIC Non 315,500 315,500 315,500 315,500 315,500 RADIOTHEARPY(SRT) Invasive NOVALIS TX WITH FRAME Procedure 26519 STEREOTACTIC Non 380,300 380,300 380,300 380,300 380,300 RADIOSURGERY(SRS) Invasive NOVALISTX FRAMELESS-V Procedure 26524 STEREOTACTIC Non 202,300 202,300 202,300 202,300 202,300 RADIOTHEARPY(SRT - Invasive NOVALISTX Procedure 26532 EXTENDED/COMPLEX Non 81,000 81,000 81,000 81,000 81,000 PALLIATIVE RADIATION Invasive Procedure 51625 BRACHY THERAPY 3 Non 48,300 48,300 48,300 48,300 48,300 APPLN (GYN CASES Invasive AKA VAGINAL APPLNS Procedure SORBO(WITHOUT ANESTHESIA AND USG 51673 BRACHY THERAPY 3 Non 54,600 54,600 54,600 54,600 54,600 APPLICATION (GYNAE Invasive CASES AKA VAGINAL Procedure APPLICATIONS / SORBO

352 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

51674 BRACHY THERAPY Non 26,600 26,600 26,600 26,600 26,600 SINGLE APPLICATION Invasive (GYNAE CASES AKA Procedure VAGINAL APPLICATIONS / SORBO 51675 BRACHY THERAPY 3 Non 48,300 48,300 48,300 48,300 48,300 APPLICATION (GYNAE Invasive CASES AKA VAGINAL Procedure APPLICATIONS / SORBO (WITHOUT USG 51676 BRACHY THERAPY Non 24,500 24,500 24,500 24,500 24,500 SINGLE APPLICATION Invasive (GYNAE CASES AKA Procedure VAGINAL APPLICATIONS / SORBO (WITHOUT USG 51677 BRACHY THERAPY Non 24,500 24,500 24,500 24,500 24,500 SINGLE APPLICATION Invasive (GYNAE CASES AKA Procedure VAGINAL APPLICATIONS / SORBO (WITHOUT ANESTHESIA 51678 Brachy Therapy Single Non 23,800 23,800 23,800 23,800 23,800 Applctn (Gynae Cases) Invasive aka Vaginal applctns / Procedure SORBO(without Anesthesia and USG) 51679 Brachy Therapy 3 Application Non 49,800 49,800 49,800 49,800 49,800 (Gynae Cases) aka Vaginal Invasive applications / SORBO Procedure (without Anesthesia) 67020 BRACHY THERAPHY 3 Non 48,300 48,300 48,300 48,300 48,300 APPLICATION (GYNAE Invasive CASES) AKA VAGINAL Procedure APPLICATIONS / SORBO WITHOUT USG 67060 BRACHY THERAPHY Non 17,200 17,200 17,200 17,200 17,200 SINGLE APPLICATION Invasive GYNAE CASES AKA Procedure VAGINAL APPLICATIONS SORBO (WITHOUT USG) 76778 RT PLANNING CHARGES Non 7,700 7,700 7,700 7,700 7,700 Invasive Procedure

W.E.F. 1st January 2019 353 NON INVASIVE PROCEDURE

83882 INTERSTITIAL IMPLANT Non 231,100 231,100 231,100 231,100 Invasive 231,100 Procedure 96893 STEREOTACTIC Non 315,500 315,500 315,500 315,500 RADIOTHEARPY(SRS) Invasive 315,500 NOVALISTX WITH FRAME Procedure 6810 THORACO CENTESIS(ICD) Non 3,400 3,900 5,400 6,700 9,600 Invasive Procedure 6965 TRACHEOSTOMY(BEDSIDE Non 14,200 18,400 23,400 32,600 46,100 PROCEDURE) Invasive Procedure 10757 SRS Non 388,900 388,900 406,800 406,800 406,800 Invasive Procedure 13832 PUNCH BIOPSY Non 5,000 6,100 7,600 11,100 15,300 Invasive Procedure 22295 HEPATIC ARTERY Non 6,100 8,800 14,800 14,800 21,400 INFUSION Invasive Procedure 22297 ICD INSERTION Non 7,600 10,200 12,600 17,600 24,600 Invasive Procedure 22302 INTRA ARTERIAL HEAD Non 6,100 8,800 10,300 14,800 21,400 AND NECK Invasive Procedure 22303 INTRA ARTERIAL LIMBA Non 6,100 8,800 10,300 14,800 21,400 PERFUSION Invasive Procedure 22304 INTRA PERITONEAL Non 6,100 8,800 10,300 14,800 21,400 Invasive Procedure 22305 INTRAPLEURAL Non 6,100 8,800 10,300 14,800 21,400 Invasive Procedure 22306 INTRATHECAL/OMAYA Non 6,100 8,800 10,300 14,800 21,400 RESORVOIR Invasive Procedure 22307 INTRAVESICAL Non 6,100 8,800 10,300 14,800 21,400 Invasive Procedure 22324 SRS (BOOST/MALIGNANT) Non 201,600 201,600 210,800 210,800 210,800 Invasive Procedure 22325 SRS (BENINGN)/IMRS Non 368,100 368,100 384,700 384,700 384,700 Invasive Procedure

354 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

22326 SRT + SRS (BOOST) Non 305,300 305,300 319,200 319,200 319,200 Invasive Procedure 1070852 RADIOLOGIST (RT) Non 12,000 12,000 12,000 12,000 12,000 PLANNING CHARGES Invasive Procedure 62321 Incision Biopsy (Bed Side) Non 6,100 8,800 10,300 14,800 21,400 Invasive Procedure 62324 Bone Marrow Biopsy and Non 9,000 11,600 15,000 21,800 28,700 Aspiration Invasive Procedure OPHTHALMOLOGY

1797 A SCAN Non 1,800 1,800 1,800 1,800 1,800 Invasive Procedure 1814 FLUORESCENE Investigations 6,100 6,100 6,100 6,100 6,100 ANGIOGRAPHY 2227 B SCAN Non 3,000 3,000 3,000 3,000 3,000 Invasive Procedure 7592 ORTHOPTIC CHECKUP Investigations 680 680 680 680 680

11702 PERIMETRY TEST-One Eye Investigations 1,730 1,730 1,730 1,730 1,730

21635 ARGON LASER Non 21,000 21,000 21,000 21,000 21,000 PROCEDURE (PRP.) MIN 3 Invasive SITTING/ EYE Procedure 21643 EYE EXERCISES PER 10 Non 2,000 2,000 2,000 2,000 2,000 EXERCISE COURSE Invasive Procedure 21644 GLAUCOMA WORKOUT Non 5,300 5,300 5,300 5,300 5,300 (INCLUDING PERIMETERY Invasive + FUNDOS PHOTOS) Procedure 21645 GONIOSCOPY Non Invasive 900 900 900 900 900 Procedure 21646 INDIRECT Non 700 700 700 700 700 OPHTALMOSCOPY(FUNDUS Invasive EXAMINATION) Procedure 21647 LATTICE and BREAKS - 1 Non 8,200 8,200 8,200 8,200 8,200 QUADRANT Invasive Procedure 21648 LATTICE and BREAKS - Non 11,700 11,700 11,700 11,700 11,700 MORE THAN 1 QUADRANT Invasive Procedure

W.E.F. 1st January 2019 355 NON INVASIVE PROCEDURE

21649 OCT (OPTICAL Non 5,900 5,900 5,900 5,900 5,900 COHERENCE Invasive TOPOGRAPHY) Procedure 21651 PARALYTIC SQUINT Non 1,800 1,800 1,800 1,800 1,800 WORKUP Invasive Procedure 21653 REFRACTION Non 700 700 700 700 700 Invasive Procedure 27186 CONTACT LENSES TRIAL Investigations 2,090 2,090 2,090 2,090 2,090 CHARGES 27187 LASIK LASER FOR 1 EYE Non 60,900 60,900 60,900 60,900 60,900 Invasive Procedure 27188 LASIK LASER FOR BOTH Non 111,700 111,700 111,700 111,700 111,700 EYES Invasive Procedure 27189 PHOTO REFRACTIVE Investigations 41,270 41,270 41,270 41,270 41,270 KERATECTOMY 1 EYE 27190 PHOTO REFRACTIVE Investigations 77,870 77,870 77,870 77,870 77,870 KERATECTOMY BOTH EYES 57236 BJERRUM SCREEN Non 1,500 1,500 1,500 1,500 1,500 Invasive Procedure 63313 IOL POWER CALC. Investigations 1,730 1,730 1,730 1,730 1,730 (A-SCAN) 63314 CORNAL F.B. REMOVAL Investigations 2,170 2,170 2,170 2,170 2,170

64421 ANESTHESIA FOR LASIK Non 12,900 12,900 12,900 12,900 12,900 LASER FOR 1 EYE Invasive Procedure 64422 ANESTHESIA FOR LASIK Non 23,700 23,700 23,700 23,700 23,700 LASER FOR BOTH EYES Invasive Procedure 64423 ANESTHESIA FOR Non 8,800 8,800 8,800 8,800 8,800 PHOTO REFRACTIVE Invasive KERATECTOMY 1 EYE Procedure 64424 ARGON LASER Non 7,000 7,000 7,000 7,000 7,000 PROCEDURE (SINGLE Invasive SITTING) Procedure 64426 B- SCAN Non 3,000 3,000 3,000 3,000 3,000 Invasive Procedure

356 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64427 COLOUR PHOTOS (SLIDES/ Non 1,500 1,500 1,500 1,500 1,500 PRINT) Invasive Procedure 64429 FLUO ANGIOGRAPHY Non 5,300 4,900 4,900 5,300 4,900 Invasive Procedure 64431 INDIRECT Non 700 700 700 700 700 OPHTALMOSCOPY Invasive Procedure 64434 P/S and INCUBATION Non 12,000 15,400 19,600 27,200 39,100 (BEDSIDE PROCEDURE) Invasive Procedure 64435 PACHYMETER Non 1,800 1,800 1,800 1,800 1,800 Invasive Procedure 64436 PERIMETERY Non 3,800 3,800 3,800 3,800 3,800 COMPUTERIZED (BOTH Invasive EYES) Procedure 64437 PHOTODYNAMIC Non 193,900 193,900 193,900 193,900 193,900 THERAPY(PER SITTING) Invasive Procedure 64439 ROP - 2 QUADRANTS Non 21,500 21,500 21,500 21,500 21,500 (BEDSIDE PROCEDURE) Invasive Procedure 64440 ROP - 3 Non 26,000 26,000 26,000 26,000 26,000 QUADRANTS(BEDSIDE Invasive PROCEDURE) Procedure 64441 ROP - 4 Non 32,300 32,300 32,300 32,300 32,300 QUADRANTS(BEDSIDE Invasive PROCEDURE) Procedure 64443 UNCOMPLICATED LID Non 5,900 5,900 5,900 5,900 5,900 TEAR REPAIR Invasive Procedure 21656 YAG LASER IRIDOTOMY Non 7,200 7,200 7,200 7,200 7,200 Invasive Procedure 64444 YAG LASER Non 5,900 5,900 5,900 5,900 5,900 CAPSULOTOMY Invasive Procedure 64446 YAG LASER Non 7,600 7,600 7,600 7,600 7,600 TRABECULOPLASTY Invasive Procedure PLASTIC & COSMETIC SURGERY

43378 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) BECKER NEVUS Invasive SMALL Procedure

W.E.F. 1st January 2019 357 NON INVASIVE PROCEDURE

43379 Q - SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) BECKER NEVUS Invasive MEDIUM Procedure

43380 Q - SWITCH (COLOR Non 17,200 17,200 17,200 17,200 17,200 TONING) BECKER NEVUS Invasive LARGE Procedure 43381 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) NEVUS OF OTA Invasive SMALL Procedure 43382 Q - SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) NEVUS OF OTA Invasive MEDIUM Procedure 43383 Q - SWITCH (COLOR Non 17,200 17,200 17,200 17,200 17,200 TONING) NEVUS OF OTA Invasive LARGE Procedure 43384 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) FRECKLES Invasive (CHEECKS) Procedure 43385 Q - SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) FRECKLES (FULL Invasive FACE) Procedure 43386 Q - SWITCH (COLOR Non 24,900 24,900 24,900 24,900 24,900 TONING) LENTIGO Invasive SIMPLEX Procedure 43387 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) AGE SPOTS Invasive Procedure 43388 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) CAFÉ AU LAIT Invasive SPOT (LESS AREA/SMALL Procedure LESION) 43389 Q - SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) CAFÉ AU LAIT Invasive SPOT (MEDIUM AREA/ Procedure SMALL LESION) 43390 Q - SWITCH (COLOR Non 17,200 17,200 17,200 17,200 17,200 TONING) CAFÉ AU LAIT Invasive SPOT (LARGE AREA/ Procedure SMALL LESION) 43391 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) SPITZ NEAVUS Invasive Procedure

358 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

43392 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) MELASMA Invasive (SMALL) Procedure 43393 Q - SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) MELASMA Invasive (LARGE) Procedure 43394 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) FINE WRINKLE Invasive (SMALL) Procedure 43395 Q - SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) FINE WRINKE Invasive (LARGE) Procedure 43396 Q - SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) PIGMENTATION Invasive (SMALL) Procedure 43397 Q - SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) PIGMENTATION Invasive (LARGE) Procedure 43401 CO2 LASER MOLE Non 3,900 3,900 3,900 3,900 3,900 REMOVALS(PER LESION) Invasive Procedure 43402 CO2 LASER VIRAL Non 14,100 14,100 14,100 14,100 14,100 WARTS(4-10 LESION) Invasive Procedure 43403 CO2 LASER VIRAL WARTS Non 22,300 22,300 22,300 22,300 22,300 (MORE THAN 10 PER Invasive LESION) Procedure 43404 CO2 LASER SEBORRHEIC Non 3,200 3,200 3,200 3,200 3,200 KERATOSIS (PER LESION) Invasive Procedure 43405 CO2 LASER SEBORRHEIC Non 14,100 14,100 14,100 14,100 14,100 KERATOSIS (4-10 PER Invasive LESION) Procedure 43406 CO2 LASER SEBORRHEIC Non 22,300 22,300 22,300 22,300 22,300 KERATOSIS (MORE THAN Invasive 10 PER LESION) Procedure 43407 CO2 LASER CO2 LASER Non 7,700 7,700 7,700 7,700 7,700 FRACTIONAL HEAD - Invasive SMALL SCAR Procedure 43408 CO2 LASER FRACTIONAL Non 17,200 17,200 17,200 17,200 17,200 HEAD - LARGE SCAR Invasive Procedure

W.E.F. 1st January 2019 359 NON INVASIVE PROCEDURE

43409 CO2 LASER FRACTIONAL Non 24,900 24,900 24,900 24,900 24,900 HEAD - FULL FACE Invasive Procedure 50497 ALAR ADJUSTMENT Non 17,100 22,400 27,900 39,100 56,100 Invasive Procedure 50503 DRESSING IN WARD Non 3,700 5,300 5,800 8,700 12,300 LARGE (BEDSIDE Invasive PROCEDURE) Procedure 50504 DRESSING IN WARD Non 2,000 2,700 3,500 5,000 6,500 SMALL (BEDSIDE Invasive PROCEDURE) Procedure 55677 Q-SWITCH (COLOR Non 5,000 5,000 5,000 5,000 5,000 TONING) TATTOO(SMALL) Invasive Procedure 55678 Q-SWITCH Non 10,200 10,200 10,200 10,200 10,200 (COLOR TONING) Invasive TATTOO(MEDIUM) Procedure 55679 Q-SWITCH (COLOR Non 15,200 15,200 15,200 15,200 15,200 TONING) TATTOO(LARGE) Invasive Procedure 55873 CO2 Laser Viral Warts (per Non 3,900 3,900 3,900 3,900 3,900 lesion) Invasive Procedure 55887 Q SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) VENOUS Invasive MALFORMATIONS Procedure 55889 Q SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) PERI-ORBITAL Invasive VEINS ND YAG LASER Procedure MEDIUM 55890 Q SWITCH (COLOR Non 24,900 24,900 24,900 24,900 24,900 TONING) PERI ORBITAL Invasive VEINS ND YAG LASER Procedure LARGE 55891 Q SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) LEG VEINS/ Invasive TELANGIECTASIA SMALL Procedure 55892 Q SWITCH (COLOR Non 24,900 24,900 24,900 24,900 24,900 TONING) LEG VEINS/ Invasive TELANGIECTASIA LARGE Procedure 57554 Q-SWITCH (COLOR Non 5,700 5,700 5,700 5,700 5,700 TONING) PER- ORBITAL Invasive VEINS ND YAG LASER Procedure SMALL

360 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

57555 Q-SWITCH (COLOR Non 11,600 11,600 11,600 11,600 11,600 TONING) LEG VEINS/ Invasive TELANGIECTASIA Procedure MEDIUM 57558 CO2 LASER PLANTAR Non 7,700 7,700 7,700 7,700 7,700 WARTS (UPTO 4 LESIONS) Invasive Procedure 57564 CO2 LASER PLANTAR Non 15,200 15,200 15,200 15,200 15,200 WARTS (MORE 4 LESIONS) Invasive Procedure 64142 HAIR REMOVAL (UPPER Non 34,400 34,400 34,400 34,400 34,400 LIP +CHIN+LOWER LIP) 6 Invasive SITTING Procedure 64143 HAIR REMOVAL (UPPER Non 5,700 5,700 5,700 5,700 5,700 LIP +CHIN+LOWER LIP)/ Invasive SITTING Procedure 64144 HAIR REMOVAL Non 5,700 5,700 5,700 5,700 5,700 AXILLA(BOTH) PER Invasive SITTING Procedure 64145 HAIR REMOVAL Non 34,400 34,400 34,400 34,400 34,400 AXILLA(BOTH) PKJ 6 Invasive SITTING Procedure 64146 HAIR REMOVAL BETWEEN Non 2,500 2,500 2,500 2,500 2,500 EYEBROWS PER SITTING Invasive Procedure 64147 HAIR REMOVAL BETWEEN Non 15,200 15,200 15,200 15,200 15,200 EYEBROWS PKJ 6 SITTING Invasive Procedure 64148 HAIR REMOVAL BIKINI Non 9,000 9,000 9,000 9,000 9,000 LINE PER SITTING Invasive Procedure 64149 HAIR REMOVAL BIKINI Non 53,400 53,400 53,400 53,400 53,400 LINE PKJ 6 SITTING Invasive Procedure 64150 HAIR REMOVAL BOTH Non 14,700 14,700 14,700 14,700 14,700 BUTTOCKS PER SITTING Invasive Procedure 64151 HAIR REMOVAL BOTH Non 87,900 87,900 87,900 87,900 87,900 BUTTOCKS PKJ 6 SITTING Invasive Procedure 64152 HAIR REMOVAL BOTH Non 9,000 9,000 9,000 9,000 9,000 FOREARM PER SITTING Invasive Procedure 64153 HAIR REMOVAL BOTH Non 17,200 17,200 17,200 17,200 17,200 FULL ARMSandHANDS PER Invasive SITTING Procedure

W.E.F. 1st January 2019 361 NON INVASIVE PROCEDURE

64154 HAIR REMOVAL BOTH Non 103,200 103,200 103,200 103,200 103,200 FULL ARMSandHANDS PKJ Invasive 6 SITTING Procedure 64155 HAIR REMOVAL BOTH Non 11,600 11,600 11,600 11,600 11,600 LEGS(BELOW KNEE) PER Invasive SITTING Procedure 64156 HAIR REMOVAL BOTH Non 68,800 68,800 68,800 68,800 68,800 LEGS(BELOW KNEE) PKJ 6 Invasive SITTING Procedure 64157 HAIR REMOVAL BOTH Non 14,700 14,700 14,700 14,700 14,700 THIGHS PER SITTING Invasive Procedure 64158 HAIR REMOVAL BOTH Non 87,900 87,900 87,900 87,900 87,900 THIGHS PKJ 6 SITTING Invasive Procedure 64159 HAIR REMOVAL BOTH Non 9,000 9,000 9,000 9,000 9,000 UPPER ARM PER SITTING Invasive Procedure 64160 HAIR REMOVAL BOTH Non 53,400 53,400 53,400 53,400 53,400 UPPER ARM PKJ 6 SITTING Invasive Procedure 64161 HAIR REMOVAL CHEEKS Non 5,700 5,700 5,700 5,700 5,700 PER SITTING Invasive Procedure 64162 HAIR REMOVAL CHEEKS Non 34,400 34,400 34,400 34,400 34,400 PKJ 6 SITTING Invasive Procedure 64163 HAIR REMOVAL CHEST Non 9,000 9,000 9,000 9,000 9,000 ONLY PER SITTING Invasive Procedure 64164 HAIR REMOVAL CHEST Non 53,400 53,400 53,400 53,400 53,400 ONLY PKJ 6 SITTING Invasive Procedure 64165 HAIR REMOVAL CHIN PER Non 4,500 4,500 4,500 4,500 4,500 SITTING Invasive Procedure 64166 HAIR REMOVAL CHIN PKJ Non 26,800 26,800 26,800 26,800 26,800 6 SITTING Invasive Procedure 64167 HAIR REMOVAL Non 4,500 4,500 4,500 4,500 4,500 CLEAVAGE PER SITTING Invasive Procedure 64168 HAIR REMOVAL Non 26,800 26,800 26,800 26,800 26,800 CLEAVAGE PKJ 6 SITTING Invasive Procedure

362 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64169 HAIR REMOVAL COSTAL Non 11,600 11,600 11,600 11,600 11,600 MARGIN TO PUBIS(FULL)/ Invasive SITTING Procedure 64170 HAIR REMOVAL COSTAL Non 68,800 68,800 68,800 68,800 68,800 MARGIN TO PUBIS(FULL)6 Invasive SITTING Procedure 64171 HAIR REMOVAL EARS PER Non 3,900 3,900 3,900 3,900 3,900 SITTING Invasive Procedure 64172 HAIR REMOVAL EARS PKJ Non 22,900 22,900 22,900 22,900 22,900 6 SITTING Invasive Procedure 64173 HAIR REMOVAL ENTIRE Non 149,000 149,000 149,000 149,000 149,000 THIGH+LEGS+FEET 6 Invasive SITTING Procedure 64174 HAIR REMOVAL ENTIRE Non 24,900 24,900 24,900 24,900 24,900 THIGH+LEGS+FEET PER Invasive SITTING Procedure 64175 HAIR REMOVAL Non 3,200 3,200 3,200 3,200 3,200 FOOT(EACH) PER SITTING Invasive Procedure 64176 HAIR REMOVAL Non 19,200 19,200 19,200 19,200 19,200 FOOT(EACH) PKJ 6 Invasive SITTING Procedure 64177 HAIR REMOVAL Non 3,900 3,900 3,900 3,900 3,900 FOREHEAD PER SITTING Invasive Procedure 64178 HAIR REMOVAL Non 22,900 22,900 22,900 22,900 22,900 FOREHEAD PKJ 6 SITTING Invasive Procedure 64179 HAIR REMOVAL Non 82,800 82,800 82,800 82,800 82,800 FULL BODY(EXCEPT Invasive FACEandNECK )/SITTING Procedure 64180 HAIR REMOVAL Non 496,700 496,700 496,700 496,700 496,700 FULL BODY(EXCEPT Invasive FACEandNECK )6 SITTING Procedure 64181 HAIR REMOVAL FULL Non 573,000 573,000 573,000 573,000 573,000 BODY(INCLUDING Invasive FACEandNECK)6 SITTI Procedure 64182 HAIR REMOVAL FULL Non 95,600 95,600 95,600 95,600 95,600 BODY(INCLUDING Invasive FACEandNECK)SITTING Procedure

W.E.F. 1st January 2019 363 NON INVASIVE PROCEDURE

64183 HAIR REMOVAL FULL Non 68,800 68,800 68,800 68,800 68,800 FACE PKJ 6 SITTING Invasive Procedure 64184 HAIR REMOVAL FULL Non 11,600 11,600 11,600 11,600 11,600 FACE PER SITTING Invasive Procedure 64185 HAIR REMOVAL HALF Non 14,700 14,700 14,700 14,700 14,700 BACK UPPER PER SITTING Invasive Procedure 64186 HAIR REMOVAL HALF Non 87,900 87,900 87,900 87,900 87,900 BACK UPPER PKJ 6 Invasive SITTING Procedure 64187 HAIR REMOVAL Non 2,500 2,500 2,500 2,500 2,500 HAND(EACH) PER Invasive SITTING Procedure 64188 HAIR REMOVAL Non 15,200 15,200 15,200 15,200 15,200 HAND(EACH) PKJ 6 Invasive SITTING Procedure 64189 HAIR REMOVAL HEMI- Non 24,900 24,900 24,900 24,900 24,900 TRUNK PER SITTING Invasive Procedure 64190 HAIR REMOVAL HEMI- Non 144,000 144,000 144,000 144,000 144,000 TRUNK PKJ 6 SITTING Invasive Procedure 64191 HAIR REMOVAL Non 5,700 5,700 5,700 5,700 5,700 NECK(BACK) PER SITTING Invasive Procedure 64192 HAIR REMOVAL Non 34,400 34,400 34,400 34,400 34,400 NECK(BACK) PKJ 6 Invasive SITTING Procedure 64193 HAIR REMOVAL Non 4,500 4,500 4,500 4,500 4,500 NECK(FRONT) PER Invasive SITTING Procedure 64194 HAIR REMOVAL Non 26,800 26,800 26,800 26,800 26,800 NECK(FRONT) PKJ 6 Invasive SITTING Procedure 64195 HAIR REMOVAL NIPPLE Non 4,500 4,500 4,500 4,500 4,500 PER SITTING Invasive Procedure 64196 HAIR REMOVAL NIPPLE Non 26,800 26,800 26,800 26,800 26,800 PKJ 6 SITTING Invasive Procedure 64197 HAIR REMOVAL Non 5,700 5,700 5,700 5,700 5,700 SIDEBURNS PER SITTING Invasive Procedure

364 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64198 HAIR REMOVAL Non 34,400 34,400 34,400 34,400 34,400 SIDEBURNS PKJ 6 SITTING Invasive Procedure 64199 HAIR REMOVAL Non 26,800 26,800 26,800 26,800 26,800 UMBILICUS TO Invasive PUBIS(CENTRAL PART)/ Procedure PKJ6 64200 HAIR REMOVAL Non 4,500 4,500 4,500 4,500 4,500 UMBILICUS TO Invasive PUBIS(CENTRAL PART)/ Procedure SITT 64201 HAIR REMOVAL Non 7,700 7,700 7,700 7,700 7,700 UMBILICUS TO Invasive PUBIS(FULL)PER SITTING Procedure 64202 HAIR REMOVAL Non 45,900 45,900 45,900 45,900 45,900 UMBILICUS TO Invasive PUBIS(FULL)PKJ 6 SITTING Procedure 64203 HAIR REMOVAL UPPER LIP Non 4,500 4,500 4,500 4,500 4,500 +LOWER LIP PER SITTING Invasive Procedure 64204 HAIR REMOVAL UPPER LIP Non 26,800 26,800 26,800 26,800 26,800 +LOWER LIP PKJ 6 SITTING Invasive Procedure 64205 HAIR REMOVAL UPPER LIP Non 3,900 3,900 3,900 3,900 3,900 PER SITTING Invasive Procedure 64206 HAIR REMOVAL UPPER LIP Non 22,900 22,900 22,900 22,900 22,900 PKJ 6 SITTING Invasive Procedure 65767 DEBRIDEMENT LARGE Non 17,100 22,400 27,900 39,100 56,100 (BEDSIDE PROCEDURE) Invasive Procedure 65768 DEBRIDEMENT SMALL Non 11,800 15,300 19,200 27,000 38,300 (BEDSIDE PROCEDURE) Invasive Procedure 68510 NASAL PACK REMOVAL Non 4,300 5,700 7,100 10,100 14,100 (BEDSIDE) Invasive Procedure 1076328 HYALASE INJECTION TO Non 7,000 7,000 7,000 7,000 7,000 DISSOLVE FILLER - LARGE Invasive AREA Procedure 1076329 HYALASE INJECTION TO Non 3,500 3,500 3,500 3,500 3,500 DISSOLVE FILLER - SMALL Invasive AREA Procedure 1076347 FACE LIFT - 2 THREADS Non 25,000 25,000 25,000 25,000 25,000 Invasive Procedure W.E.F. 1st January 2019 365 NON INVASIVE PROCEDURE

1076350 FACE LIFT - 4 THREADS Non 37,500 37,500 37,500 37,500 37,500 Invasive Procedure 1076352 FACE LIFT - 6 THREADS OR Non 55,000 55,000 55,000 55,000 55,000 MORE Invasive Procedure PUVA THERAPY

21326 BATH PUVA FOR TEN Non 11,800 11,800 12,400 12,400 12,400 SESSION BATCH Invasive Procedure 21327 BATH PUVA PER THERAPY Non 1,300 1,300 1,300 1,300 1,300 Invasive Procedure 21328 HAND and FOOT PUVA Non 8,500 8,500 8,500 8,500 8,500 FOR TEN SESSION BATCH Invasive Procedure 21329 HAND and FOOT PUVA Non 900 900 900 900 900 PER THERAPY Invasive Procedure 21330 ORAL PUVA FOR TEN Non 11,800 11,800 11,800 11,800 11,800 SESSION BATCH Invasive Procedure 21331 ORAL PUVA PER THERAPY Non 1,300 1,300 1,300 1,300 1,300 Invasive Procedure 21332 TOPICAL PUVA FOR TEN Non 8,500 8,500 8,500 8,500 8,500 SESSION BATCH Invasive Procedure 21333 TOPICAL PUVA PER Non 900 900 900 900 900 THERAPY Invasive Procedure 21334 UVB FOR TEN SESSION Non 8,500 8,500 8,500 8,500 8,500 BATCH Invasive Procedure 21335 UVB PER THERAPY Non 900 900 900 900 900 Invasive Procedure RHEUMATOLOGY CLINICAL IMMUNOLOGY

64560 MULTIPLE JOINT Non 3,900 3,900 4,100 4,100 4,100 Invasive Procedure 1070858 RHEUMATOLOGY Non 1,300 1,300 1,300 1,950 1,300 INFUSION (CYTOTOXIC/ Invasive IVIG/MISCELL) Procedure

366 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

1070853 RHEUMATOLOGY Non 1,950 1,950 1,950 1,950 1,950 PROCEDURE (I) Invasive Procedure 1070854 RHEUMATOLOGY Non 2,700 2,700 2,700 2,700 2,700 PROCEDURE (II) Invasive Procedure 1070855 BIOLOGIC INFUSION (A) Non 1,500 1,500 1,500 1,500 1,500 Invasive Procedure 1070856 BIOLOGIC INFUSION (B) Non 2,500 2,500 2,500 2,500 2,500 Invasive Procedure 1070857 BIOLOGIC INFUSION (C) Non 3,500 3,500 3,500 3,500 3,500 Invasive Procedure 64561 SINGLE JOINT Non 2,500 2,500 2,600 2,600 2,600 Invasive Procedure RESPIRATORY MEDICINE  OTHERS

1859 INTERCOSTAL DRAINAGE Non 8,800 11,200 14,300 19,300 28,000 TUBE Invasive Procedure 15993 PLEURAL ASPIRATION Non 3,500 5,300 5,700 7,600 11,200 DIAGNOSTIC Invasive Procedure 15994 PLEURAL BIOPSY Non 7,100 10,100 12,400 17,400 24,400 Invasive Procedure 20711 BRONCHOSCOPY WITH FB Non 14,800 19,300 24,400 33,700 49,100 REMOVAL Invasive Procedure 20712 BRONCHOSCOPY WITH Non 18,000 23,700 29,800 41,100 58,900 TRANSBRONCHIAL Invasive BIOPSY/ Procedure TRANSBRONCHIAL NEEDLE ASPIRATION 20713 COMPLETE Non 14,800 19,300 24,400 33,700 49,100 BRONCHOSCOPY Invasive INCLUDING BAL/BRUSH Procedure 20714 PLEURAL ASPIRATION Non 5,600 7,000 9,000 12,400 17,600 THERAPEUTIC Invasive Procedure 20715 PLEURODESIS Non 3,500 4,100 5,600 7,100 10,300 Invasive Procedure

W.E.F. 1st January 2019 367 NON INVASIVE PROCEDURE

64557 ANESTHESIA FOR Non 2,400 3,200 4,200 5,600 8,100 BRONCHOSCOPY WITH FB Invasive REMOVAL Procedure 64558 CARINAL BIOPSY Non 14,300 14,300 15,100 15,100 15,100 WITH SCREENING OR Invasive BRONCHIAL Procedure 64559 EBUS Non 39,000 43,500 48,500 58,000 73,400 Invasive Procedure 81956 DYNAMIC SLEEP Non 15,200 15,200 15,200 15,200 15,200 ENDOSCOPIES Invasive Procedure 87938 BALLOON DILATATION Non 8,700 13,900 19,500 29,600 46,000 Invasive Procedure 87940 ELECTRO Non 5,900 11,000 16,700 26,800 43,200 CAUTERIZATION Invasive Procedure 87941 TRACHEAL OR Non 23,200 28,400 33,900 44,200 60,400 BRONCHIAL STENT Invasive PLACEMENT Procedure 87942 ADHENOLYSIS WITH STK Non 3,200 3,700 5,000 6,500 9,300 Invasive Procedure 101866 MEDICO THORACOSCOPY Invasive 42,500 54,600 60,700 72,800 91,000 Procedures SLEEP LAB

20690 COMPLETE OVERNIGHT Investigations 29,720 29,720 29,720 29,720 29,720 POLYSOMNOGRAPHY (COP) 20691 COMPLETE OVERNIGHT Investigations 38,210 38,210 38,210 38,210 38,210 POLYSOMNOGRAPHY WITH CPAP and MSLT (COP WITH CPAP and MSLT) 20692 LIMITED SLEEP STUDY Investigations 15,280 15,280 15,280 15,280 15,280

20693 MSLT Investigations 15,280 15,280 15,280 15,280 15,280

20694 MSLT (IF COP USED Investigations 8,980 8,980 8,980 8,980 8,980 EARLIER) 20695 PULSE OXIMETRY Investigations 5,090 5,090 5,090 5,090 5,090

368 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64562 COMPLETE OVERNIGHT Non 22,900 22,900 22,900 22,900 22,900 POLYSOMNOGRAPHY Invasive WITH CPAP (COP WITH Procedure CPAP) C T SCAN RADIOLOGY

13348 CT guided FNAC Non 10,300 14,300 17,600 24,400 34,900 Invasive Procedure 20859 CT SCAN GUIDED Non 19,100 25,100 31,600 43,900 62,500 DRAINAGE Invasive Procedure 24720 CT GUIDED CHEMO Non 19,100 25,100 31,600 43,900 62,500 ABLATION Invasive Procedure 24721 CT GUIDED PLEURAL Non 10,300 14,300 17,600 24,400 34,900 ASPIRATION Invasive Procedure 24722 CT GUIDED Non 14,800 19,300 24,400 33,700 48,700 THERAUPEUTIC Invasive ASPIRATION Procedure 24723 CT GUIDED TRUCTUT Non 17,300 21,900 28,000 39,100 55,400 BIOPSY Invasive Procedure 64207 ANAESTHESIA FOR PCN/ Non 3,700 3,700 3,700 3,700 3,700 PTBD Invasive Procedure 64208 ANAESTHESIA FOR PCN/ Non 5,500 5,500 5,500 5,500 5,500 PTBD WITH BALLON Invasive DIALATION Procedure 64209 ANAESTHESIA FOR PCN/ Non 6,900 6,900 6,900 6,900 6,900 PTBD WITH STENTING Invasive Procedure 64212 CT GUIDED CATHETER Non 19,100 25,100 31,600 43,900 62,500 DRAINAGE Invasive Procedure 64214 INTERNAL EXTERNAL Non 38,200 38,200 38,200 38,200 38,200 DRAINAGE Invasive Procedure 64215 INTRA OPERATIVE Non 10,200 10,200 10,200 10,200 10,200 DRAINAGE Invasive Procedure 64216 PROSTATE BIOPSY Non 10,300 14,100 17,500 24,400 35,000 Invasive Procedure 64219 ULTRASOUND TRUCUT Non 9,200 12,600 15,600 21,800 31,600 BIOSPY Invasive Procedure

W.E.F. 1st January 2019 369 NON INVASIVE PROCEDURE

ULTRASOUND RADIOLOGY

6439 ULTRASOUND GUIDED Non 7,000 10,100 12,400 17,400 24,600 ASPIRATION/BIOPSY Invasive Procedure 11658 ULTRASOUND GUIDED Non 7,100 10,100 12,400 17,400 24,600 FNAC Invasive Procedure 13345 USG GUIDED DIAGNOSTIC Non 7,100 10,100 12,400 17,400 24,600 ASPIRATION Invasive Procedure 13347 USG guided Therapeutic Non 10,500 14,300 17,600 25,100 35,400 aspiration Invasive Procedure 24716 ULTRASOUND GUIDED Non 14,800 19,300 24,400 33,700 48,700 CATHETER DRAINAGE Invasive Procedure 24717 ULTRASOUND GUIDED Non 14,800 19,300 24,400 33,700 48,700 CHEMO ABLATION Invasive Procedure 24718 ULTRASOUND GUIDED Non 3,700 5,400 6,100 9,200 15,600 FNAC (BREAST PACKAGE) Invasive Procedure 24719 ULTRASOUND GUIDED Non 9,200 12,600 15,600 21,800 31,600 TRUCUT BIOPSY Invasive Procedure 24725 GUIDANCE (MTP IN O.T.) Non 3,800 3,800 3,800 3,800 3,800 Invasive Procedure 24726 GUIDANCE (OTHERS IN Non 5,600 5,600 5,600 5,600 5,600 O.T.) Invasive Procedure 24727 GUIDANCE MARKING Non 2,100 2,100 2,100 2,100 2,100 Invasive Procedure 67380 RAILROADING OF PTBD Non 38,200 38,200 38,200 38,200 38,200 Invasive Procedure 67381 EXTERNAL/INTERNAL Non 34,400 34,400 34,400 34,400 34,400 DRAINAGE OF PTBD Invasive Procedure 67383 ULTRASOUND GUIDED Non 10,500 14,300 17,600 25,100 35,400 THERAPEUTIC Invasive ASPIRATION Procedure 67384 ULTRASOUND GUIDED Non 7,100 10,100 12,400 17,400 24,600 DIAGNOSTIC ASPIRATION Invasive Procedure

370 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

90278 USG VENOUS MAPPING Non 3,200 3,200 3,200 3,200 3,200 Invasive Procedure X RAY RADIOLOGY

9511 PCN/PTBD Non 28,000 28,000 28,000 28,000 28,000 Invasive Procedure 24711 PCN/PTBD WITH BALLON Non 41,400 41,400 41,400 41,400 41,400 DIALATION Invasive Procedure 24712 PCN/PTBD WITH Non 52,000 52,000 52,000 52,000 52,000 STENTING Invasive Procedure 24713 PTC Non 17,600 17,600 17,600 17,600 17,600 Invasive Procedure UROLOGY

21315 CAVERNOSOMETRY Non 6,100 8,800 12,400 12,400 24,400 Invasive Procedure 21316 CYSTOMETRY +EMG Non 8,300 12,400 16,200 16,200 32,400 Invasive Procedure 21320 UROFLOWMETRY Non 2,000 2,400 3,900 3,900 6,100 Invasive Procedure 21321 VOIDING CYSTOMETRY Non 6,500 10,100 12,700 12,700 24,400 Invasive Procedure WARDS OTHERS

64448 AMNIO Non 12,500 17,100 21,200 29,500 42,200 INFUSION(BEDSIDE Invasive PROCEDURE) Procedure 64449 AMNIOCENTERIS (BEDSIDE Non 8,700 11,100 14,100 19,600 27,900 PROCEDURE) Invasive Procedure 64450 ANESTHESIA FOR IVC Non 11,100 11,100 11,100 11,100 11,100 FILTER Invasive Procedure 64451 AV SHUNT CONNECTOR Non 400 400 400 400 400 Invasive Procedure 64452 AV SHUNT TIPS Non 1,400 1,400 1,400 1,400 1,400 Invasive Procedure

W.E.F. 1st January 2019 371 NON INVASIVE PROCEDURE

64453 AV SHUNT TUBE Non 2,400 2,400 2,600 2,600 2,600 Invasive Procedure 64454 BANK OF 4, THREE WAY Non 2,000 2,000 2,200 2,200 2,200 CONNECTOR Invasive Procedure 64455 BILATERAL ICD Non 38,300 51,900 59,600 80,900 87,600 INSERTION Invasive Procedure 64456 BIOPSY NEEDLE Non 5,300 5,300 5,500 5,500 5,500 MICROVASIC (ASAP)/ Invasive BARD BIOPSY NEEDLE Procedure 64457 BURN DRESSING IN WARD Non 11,800 15,300 19,200 27,000 38,300 LARGE PLR-11 Invasive Procedure 64458 CAPD FLUID 1.5% Non 900 900 900 900 900 DEXTROSE BAG OF Invasive 2000/1500 ML Procedure 64459 CAPD FLUID 2.3% Non 900 900 900 900 900 DEXTROSE BAG OF Invasive 2000/1500 ML Procedure 64461 CAPD FLUID 4.25% Non 900 900 900 900 900 DEXTROSE BAG OF Invasive 2000/1500 ML Procedure 64462 CATHETERIZATION Non 2,000 3,000 3,700 5,300 7,100 Invasive Procedure 64463 CAVH WITH AV TUBING Non 17,700 17,700 18,700 18,700 18,700 Invasive Procedure 64464 CAVHD WITH AV TUBING Non 17,700 17,700 18,700 18,700 18,700 Invasive Procedure 64465 CHEST DRAINAGE Non 8,200 11,100 14,100 19,600 27,900 Invasive Procedure 64466 CONSUMABLE - EVL Non 14,100 14,100 14,800 14,800 14,800 Invasive Procedure 64468 DIALYSER PEDIATRIC Non 4,400 4,400 4,500 4,500 4,500 WITH AV TUBING Invasive Procedure 64469 DIALYSER WITH AV Non 6,200 6,200 6,400 6,400 6,400 TUBING Invasive Procedure

372 W.E.F. 1st January 2019 NON INVASIVE PROCEDURE

64473 DOUBLE LUMEN Non 5,300 5,300 5,500 5,500 5,500 CATHETER 12F X 16CM Invasive Procedure 64474 DOUBLE LUMEN Non 5,300 5,300 5,500 5,500 5,500 CATHETER 5F X 13 CM Invasive Procedure 64475 DOUBLE LUMEN Non 5,300 5,300 5,500 5,500 5,500 CATHETER 8F X 13CM Invasive Procedure 64476 DRAIN BAG FOR PD Non 3,400 3,400 3,500 3,500 3,500 NIGHT CYCLER Invasive Procedure 64477 DRESSING NORMAL Non 2,000 3,000 3,500 5,300 7,100 Invasive Procedure 64478 DRESSING LARGE PLR-32 Non 3,700 5,300 5,900 8,800 12,200 Invasive Procedure 64479 DRESSING SMALL PLR-33 Non 2,000 2,700 3,700 5,300 6,500 Invasive Procedure 64482 EX. LARGE SUPERFICIAL Non 14,900 19,600 33,900 33,900 49,100 TUMOUR Invasive Procedure 64483 EX. SMALL SUPERFICIAL Non 10,300 14,100 17,500 24,400 35,000 TUMOUR Invasive Procedure 64485 FEMORAL CATHETER Non 900 900 900 900 900 GUIDWIRE 70 CM Invasive Procedure 64486 FEMORAL CATHETER Non 1,300 1,300 1,300 1,300 1,300 LARGE 20 CM Invasive Procedure 64487 FEMORAL CATHETER Non 900 900 900 900 900 SMALL 13.4 CM Invasive Procedure 64488 FIRST TRIMESTER Non 8,700 11,100 14,100 19,600 27,900 MTP(BEDSIDE Invasive PROCEDURE) Procedure 64489 FRACTIONAL CURETTAGE Non 7,200 10,100 12,400 17,300 24,400 Invasive Procedure 64490 GILLIAM'S Non 10,300 14,100 17,500 24,400 35,000 VENTROSUPENSION Invasive Procedure 64491 H1N1 SCREENING Non 600 600 600 600 600 ACCESSORIES Invasive Procedure

W.E.F. 1st January 2019 373 NON INVASIVE PROCEDURE

64492 HIGHFLUX DIALYSER F50 Non 6,200 6,200 6,400 6,400 6,400 WITH AV TUBING SET Invasive Procedure 64493 HIGHFLUX DIALYSER F60 Non 7,000 7,000 7,400 7,400 7,400 WITH AV TUBING SET Invasive Procedure 64495 INJECTION Non 2,500 3,300 4,300 5,000 8,500 SCLROTHERAPY (PER Invasive SITTING)(BEDSIDE Procedure PROCEDURE) 64497 INTERNAL JUGULAR Non 5,300 5,300 5,500 5,500 5,500 CATHETER 12 F X 13 CM Invasive Procedure 64498 INTRODUCER NEEDLE/ Non 300 300 300 300 300 CATHTER 14 G Invasive Procedure 64499 IUCD INSERTION(BEDSIDE Non 2,000 2,700 3,200 4,300 6,500 PROCEDURE) Invasive Procedure 64500 LL MUA FOR ACUTE HIP Non 12,500 17,100 21,200 29,500 42,200 DISLOCATION(BEDSIDE Invasive PROCEDURE) Procedure 64501 LL SKIN TRACTION: Non 3,700 5,300 5,800 8,700 12,300 LOWER LIMB(BEDSIDE Invasive PROCEDURE) Procedure 64503 M.L.C CHARGE Non 700 700 700 700 700 Invasive Procedure 64504 MANNUAL EVACUATION Non 2,000 3,000 3,800 5,400 7,100 Invasive Procedure 64505 MANUAL REMOVAL OF Non 10,300 14,100 17,500 24,400 35,000 PLACENTA(BEDSIDE Invasive PROCEDURE) Procedure 64508 MULTIPLE PREGNANCY Non 21,200 27,900 35,000 49,100 70,200 REDUCTION(MFPR) Invasive Procedure 64509 PERITONEAL DIALYSIS Non 1,400 1,400 1,400 1,400 1,400 CATHETER ADULT Invasive Procedure 64512 PERITONEAL DIALYSIS Non 400 400 400 400 400 FLUID TRANSFER SET Invasive Procedure 64513 RBS GLUCOMETER (2) Non 400 400 400 400 400 Invasive Procedure

374 W.E.F. 1st January 2019 64516 REPAIR OF PERINEAL Non 10,300 14,100 17,500 24,400 35,000 TEAR,POST-COITAL OR Invasive TRAUMATIC Procedure 64517 SECOND TRIMESTER Non 21,200 27,900 35,000 49,100 70,200 MTP(BEDSIDE Invasive PROCEDURE) Procedure 64518 SILLICONE PERM Non 19,400 19,400 20,400 20,400 20,400 CATHETER FOR Invasive SUBCLAVIAN Procedure 64520 SP FACET JOINT Non 7,200 10,100 12,400 17,300 24,400 INJECTION: ONE LEVEL Invasive Procedure 64522 SP MUA CERVICAL / Non 6,500 8,700 10,300 14,900 21,200 LUMBER SPINE(BEDSIDE Invasive PROCEDURE) Procedure 64524 SP SKELETAL TRACTION Non 10,300 14,100 17,500 24,400 35,000 FOR CERVICAL Invasive SPINE(BEDSIDE Procedure PROCEDURE) 64525 SPINAL NEEDLE Non 300 300 300 300 300 DISPOSABLE Invasive Procedure 64526 SUTURING Non 2,000 3,000 3,800 5,000 6,800 Invasive Procedure 64527 TECKHOFF CATHETER Non 12,000 12,000 12,500 12,500 12,500 ADULT (B. BROWN) Invasive Procedure 64528 TECKHOFF CATHETER Non 17,200 17,200 18,300 18,300 18,300 ADULT (FRESINIUS) Invasive Procedure 64529 TENCKHOFF CATHETER Non 12,000 12,000 12,500 12,500 12,500 PEAD(B. BROWN) Invasive Procedure 64530 TENCKHOFF CATHETER Non 17,200 17,200 18,300 18,300 18,300 PEAD(FRESINIUS) Invasive Procedure 64531 THORACENTESIS(BEDSIDE Non 5,600 7,100 9,200 12,500 18,000 PROCEDURE) Invasive Procedure 64532 THORACIC DRESSING Non 6,500 9,600 10,700 12,200 16,000 Invasive Procedure 64533 TROCAR DRAINAGE TUBE Non 1,300 1,300 1,300 1,300 1,300 FOR PLEURAL DRAINAGE Invasive FR 10 Procedure

W.E.F. 1st January 2019 375 64534 TROCAR DRAINAGE TUBE Non 1,900 1,900 1,900 1,900 1,900 FOR PLEURAL DRAINAGE Invasive FR 14 Procedure 64535 TROCAR DRAINAGE TUBE Non 1,900 1,900 1,900 1,900 1,900 FOR PLEURAL DRAINAGE Invasive FR 18 Procedure 64536 TROCAR DRAINAGE TUBE Non 1,300 1,300 1,300 1,300 1,300 FOR PLEURAL DRAINAGE Invasive FR 8 Procedure 64537 TRUCTU BIOPSY NEEDLE Non 2,000 2,000 2,200 2,200 2,200 14G, 7.6 CM/11.4 CM/15CM Invasive Procedure 64540 UL ASPIRATION / Non 1,800 2,200 3,000 4,200 5,700 INJECTION OF A Invasive JOINT(BEDSIDE Procedure PROCEDURE) 64541 UL BELOW ELBOW POP Non 1,800 2,000 2,700 3,700 5,500 CAST OR SLAB(BEDSIDE Invasive PROCEDURE) Procedure 64542 UL DISLOCATION Non 12,500 17,100 21,200 29,500 42,200 SHOULDER MUA(BEDSIDE Invasive PROCEDURE) Procedure 64543 UL/LL ABOVE ELBOW Non 3,700 5,300 5,800 8,700 12,300 OR LOWER LIMB Invasive CAST(BEDSIDE Procedure PROCEDURE) 64544 UL/LL ABOVE ELBOW Non 1,800 2,200 3,000 4,300 5,800 OR LOWER LIMB Invasive POP SLAB(BEDSIDE Procedure PROCEDURE) 64545 UROGRAPHIN Non 400 400 400 400 400 Invasive Procedure 64546 VAC DRESSING Non 11,800 15,300 19,200 27,000 38,300 Invasive Procedure

376 W.E.F. 1st January 2019