INTRODUCTION
As one of India's foremost names in healthcare, Moolchand has been setting standards for the past 90+ years and has served to over three generations of Delhites with care and dedication.
At Moolchand, we strive to deliver excellence and value to our customers. As a result we have won numerous quality awards (e.g. Ramakrishna Bajaj National Quality Award for outstanding achievement). Moolchand is the first hospital in India to have JCI and Comprehensive NABH accreditation. We have benchmarked the best global practices to ensure we consistently provide our patients with the highest quality of care.
While a lot has changed, a few things haven’t-compassionate care, integrity, affordable prices and trustworthy service to all.
Using this Schedule of Charges This Schedule of Charges is categorized into multiple categories as outlined in the index. The index serves as a ready reckoner to find the section of interest to you.
This Schedule of Charges is valid with effect from April 01, 2019. These rates are applicable for a period of 1 year or until the next revision of charges.
Despite enormous capital, infrastructure and process investments we have not revised our prices since 2013. As you are well aware, our peer hospitals have implemented 2-3 pricing revisions in this period.
All charges are subject to change without prior intimation. Changes are as per the discretion of Moolchand Management.
Errors and Omissions While the Schedule of Charges has been made with utmost care, typo errors and omissions are possible. In such rare cases, the billed prices will be applicable.
Feedback Please do let us know if there are suggestions on enhancing this tool to ensure that it is user friendly. Suggestions can be forwarded to:
Vibhu Talwar COO, Moolchand Medcity Lajpat Nagar III, New Delhi 110 024 E: [email protected]
1 INDEX
Category Description A General Charges A1 Outpatient registration and consultation A2 Room/bed A3 Category wise computation of charges A4 Inpatient consultation A5 Anaesthesia A6 Operation theatre A7 Mother's nest (delivery suite) A8 Emergency A9 Sterilization A10 HealthCheck+ A11 Other charges
B Outpatient Procedures B1 Children's Clinic B2 Cosmetic and plastic surgery B3 Dental B4 Diabetic Foot Centre B5 Ear, nose and throat B6 Gastroenterology B7 Ophthalmology B8 Physiotherapy B9 Speech and hearing clinic B10 Women's clinic B11 Miscellaneous OP procedures B12 Endoscopic ultrasound
C Inpatient Procedures C1 Critical Care C2 Neonatology C3 Room/ward procedures
D Surgeries D1 Dental D2 Ear, nose and throat D3 Gastrointestinal D4 General D5 Gynaecology D6 Neurosurgery D7 Obstetrics D8 Optthalmology D9 Orthopaedics D10 Paediatrics D11 Pain Clinic D12 Plastic
2 D13 Thoracic/ vascular D14 Urology
E Tests/ Investigations E1 Blood Bank E2 Bone Densitometry E3 Cardiology Lab E4 CT Scan E5 Dental Radiology E6 ECP (external counter pulsation) Lab E7 Fetal and genetic medicine E8 Laboratory medicine E9 Mammography E10 MRI E11 Neurosciences lab E12 Nuclear medicine E13 Respiratory lab E14 Urodynamics E15 Ultrasound E16 X-Ray E17 Sleep Lab
F Speciality Institutes F1 Interventional radiology F2 Moolchand cancer institute F3 Moolchand Fertility & IVF F4 Moolchand heart institute F5 Moolchand renalcare & dialysis
G Ayurveda G1 Panchkarma therapy G2 Shalya karma tharapy G3 Strirog (prasuti tantra) G4 Rejuvenation packages
3 MOOLCHAND SCHEDULE OF CHARGES 2019
SECTION A: GENERAL CHARGES
A1: OUTPATIENT REGISTRATION AND CONSULTATION
1. CHARITABLE CLINIC (GENERAL OPD) SERVICE CODE SERVICE NAME CHARGES (Rs.) RGN01001 First visit 300-500 RGN01002 Each subsequent visit 200-500 RGN01003 Ayurved registration (new) 300-500 RGN01004 Ayurved revisit (after 7 days) 200-500
Note(s): a) Charitable clinic charges are funded by the Moolchand Trust (Moolchand Seva Program) and are free. b) Moolchand Trust has sole discretion with regards to free services. Its decision will be final and binding.
2. MOOLCHAND CLINIC SERVICE CODE SERVICE NAME CHARGES (Rs.) RGN02001 Consultation 500-2,500 RGN02002 Revisit (within 7 days) 400-2,500 RGN02005 Clinic charges 100-300 RGN02007 Dietician consultation 500-800 RGN02008 Registration charges 100-300
3. AYURVEDIC CLINIC SERVICE CODE SERVICE NAME CHARGES (Rs.) RGN03001 Ayurved consultation 500-800 RGN03002 Ayurved revisit 400-700
4. BODY MIND AND SOUL CLINIC SERVICE CODE SERVICE NAME CHARGES (Rs.) RGN04001 Body, mind consultation (single visit) 2,250-4,000 RGN04002 Body, mind consultation (weekly course) 4,500-6,000
5. CHILD DEVELOPMENT AND ADOLESCENT HEALTH CENTRE SERVICE CODE SERVICE NAME CHARGES (Rs.) RGN05001 Child development per session (12 yrs and below) 500-1,000 RGN05002 Child development per session (above 12 yrs) 600-1,000 RGN05003 IQ assessment 3,250-5,000 RGN05004 SLD assessment 3,250-5,000 RGN05005 Combined IQ + SLD 6,500-10,000 RGN05006 Other psychometrics (personality neurocognitive career aptitude etc) 2,500-5,000 RGN05007 Hypnotherapy 1,500-4,000
6. BREAST CLINIC CONSULTATION SERVICE CODE SERVICE NAME CHARGES (Rs.) RGN06001 Breast clinic (first visit) 500-2,500 RGN06002 Breast clinic (revisit) 500-2,500
7. LACTATION CONSULTATION SERVICE CODE SERVICE NAME CHARGES (Rs.)
RGN07001 Lactation consultation4 1,000-2,500 A2: ROOM/BED
1. BASIS FOR COMPUTING BED CHARGES: a) For the purpose of billing, a day is calculated from 12 noon to 12 noon. Full room/bed charges apply even for a part of the day. In special situations, a 3 hours extension will be provided (based on advice of consulting physician). b) When a patient is shifted from one patient area to another bed charges for the accommodation occupied for the maximum number of hours during the day will be charged. c) No charges are leviable for free/indigent patients.
2. BED TRANSFER: a) In case the patient is shifted from a lower to higher category the charges for the consultant visits, investigations, critical care and surgery from the date of admission will be according to the higher category. Transfer to higher category will be accepted only after clearance of the outstanding bill. b) In case of credit patients, the request for transfer to a higher category will require approval from authorized signatory of respective company/TPA/insurance. In case approval is not provided patient will pay the balance amount (other than entitlement) at the time of discharge. c) In case a patient requests a shift to a lower category, the charges will be applicable from date of transfer i) Shift will require consent of treating doctor and approval of Medical Director. ii) Shifting will only be allowed to the next lower category. iii) Transfer to lower category will be accepted only after clearance of the outstanding bill. d) In case of admission directly in ICU, charges will be according to the bed category opted by the patient. In case of transfer to room/ward, charges will be computed as per points 3a and 3c.
3. ADVANCE MONEY TO BE DEPOSITED AT THE TIME OF ADMISSION: a) Bed category wise advance for cash patients will be as per table below:
Category Base amount (Rs.) Advance to be maintained during the Hospitalization estimate stay (Rs.) (%) Surgical/package 25,000 -- 100% Critical care areas - ICU/ICCU/SICU/PICU 100,000 50,000 NA NICU - NICU (Level 1/Level 2) 20,000 10,000 NA - NICU (Level 3) 30,000 15,000 NA Medicine cases: - Presidential suite/VIP suite 50,000 25,000 90% - Single room 40,000 20,000 90% - Twin sharing 30,000 15,000 90% - 3/4 bedded 20,000 10,000 90% - Seva beds (economy) 10,000 -- 90% b) For each patient bed category the advance to be deposited at the time of admission will be the higher of “Base amount” or “Hospitalization estimate (%)”. c) Cut-off time to maintain the advance during the stay is 6 pm everyday. d) For Insurance/TPA/Corporate cases: i) Advance deposit of Rs.10,000 is mandatory at time of admission to cover for non-admissible expenses. ii) If TPA/Insurance company authorization is not received within 12 hours of admission, then admission will be considered 'cash' category. Advance as per point 4a will be applicable.
5 4. CATEGORY WISE BED CHARGES
Category Room (Rs.) ICCU (Rs.) ICU/SICU (Rs.)PICU (Rs.) NICU a Cribs (Rs.) Level 1 Level 2 Level 3 Presidential suite 22,500 11,000 11,000 7,000 6,000(Rs.) 6,500(Rs.) 7,000(Rs.) 2,000 VIP suite 12,000 11,000 11,000 7,000 5,500 6,000 6,500 1,750 Single room 10,500 10,000 10,000 6,500 5,000 5,500 6,000 1,500 2 bedded 6,250 9,250 9,250 5,000 4,000 4,750 5,500 1,250 3/4 bedded 4,750 9,000 9,000 5,000 3,500 4,500 5,000 1,000 Seva beds (economy) c 3,000 8,000 8,000 4,500 3,500 4,500 5,000 750 Day care (upto 4 hours) 3,000 NA NA NA NA NA NA NA
Day care (4 hours to 8 3,750 NA NA NA NA NA NA NA hours) b Oncology day care (upto 2,500 NA NA NA NA NA NA NA 8 hours) b
Note(s): a) NICU level of care is defined as: i) Level 1: Includes nursery. Care covers observation and initial nursery care (i.e washing, tube feeding, oral medicines, etc.) ii) Level 2: Moderate care (i.e. phototherapy, exchange transfusion, oxygen, etc.) iii) Level 3: Extensive care (i.e. ventilator support, post exhaustion for 24 hours, post exchange for 24 hours, dialysis support, cardiac monitoring, etc.) b) If patient is kept in daycare post 8 hours, room rent for ICU/SICU will be charged. c) Seva beds (economy) refers to the cases subsidized by the Moolchand Trust.
6 A3: CATEGORY WISE COMPUTATION OF CHARGES
1. COMPUTATION OF CHARGES FOR INPATIENTS
Inpatient prices are benchmarked to single room category
No Department/Category Presidential/ Single Twin 3/4 Bedded Seva beds VIP suite Room Sharing (economy)** A General charges A4Anaesthesia 175% 100% 80% 70% 60% A6Operation theatre 110% 100% 100% 100% 100% A7Mother's Nest (Delivery Suite) 175% 100% 80% 70% 60% A8Emergency a 100% 100% 100% 100% 100% A9Sterilization 100% 100% 100% 100% 100% A11Other charges 100% 100% 100% 100% 100% B OP procedures (excluding B6, B8 and B12) 100% 100% 100% 100% 100% B6Gastroenterology b 175% 100% 90% 80% 60% B8Physiotherapy 175% 100% 100% 100% 100% B12Endoscopic ultrasound 110% 100% 100% 100% 100% C Inpatient procedures C1Critical care c 175% 100% 80% 70% 60% C2Neonatology 100% 100% 100% 100% 100% C3Room procedures a 175% 100% 80% 70% 60% D Doctor/Surgeon fee 175% 100% 80% 70% 60% E Investigations E1Blood Bank 110% 100% 100% 100% 93% E2Bone densitometry 110% 100% 100% 100% 93% E3Cardiac lab 100% 100% 100% 100% 100% E4CT scan 110% 100% 100% 100% 93% E5Dental radiology 100% 100% 100% 100% 100% E6ECP lab 110% 100% 100% 100% 100% E7Fetal and genetic medicine 110% 100% 100% 100% 93% E8Laboratory medicine 110% 100% 100% 100% 100% E9Mammography 110% 100% 100% 100% 93% E10MRI 110% 100% 100% 100% 93% E11Neurosciences lab 110% 100% 100% 100% 93% E12Nuclear medicine 100% 100% 100% 100% 100% E13Respiratory lab 110% 100% 100% 100% 93% E14Urodynamics lab 110% 100% 100% 100% 93% E15Ultrasound 110% 100% 100% 100% 93% E16X-ray 110% 100% 100% 100% 93% E17Sleep lab 100% 100% 100% 100% 100% F Moolchand Speciality Institutes F1Interventional radiology 175% 100% 80% 70% 70% F2Moolchand Cancer Institute 175% 100% 80% 70% 70% F3Moolchand Fertility and IVF 100% 100% 100% 100% 100% F5Moolchand Renal Care & dialysis d 100% 100% 90% 80% 80% G Ayurved 100% 100% 100% 100% 100%
Note(s): (**) Seva beds (economy) refer to cases subsidized by Moolchand Trust. Admission in this category solely at Moolchand Trust's discretion. a) Minor OT services are subjected to 20% additional minor OT charges b) Gastroenterology: Packages are independent of bed category. Services vary as per bed category. c) Critical care areas include: CCU/ED/ICU/NICU/PICU/SICU/TICU. d) Kidney transplant package is independent of bed category. e) '*' marked services across all departments are independent of bed category.
7 2. COMPUTATION OF CHARGES FOR INVESTIGATIONS AND OP PROCEDURES:
For investigations and OP procedures, prices shown in schedule of charges are for outpatients. Inpatient prices are indexed to outpatient prices as defined below. Inpatient prices are at a premium given significant inpatient support costs.
No Department/Category Inpatient in single room Outpatient
A General charges A9 Sterilization 100% 100% A11 Other charges 100% 100% B OP procedures (excluding B6,B8 and B12) 100% 100% B6 Gastroenterology 140% 100% B8 Physiotherapy 125% 100% B12 Endoscopic Ultrasound 140% 100% E Investigations E1 Blood Bank 140% 100% E2 Bone densitometry 135% 100% E3 Cardiac lab 135% 100% E4 CT scan 135% 100% E5 Dental radiology 135% 100% E6 ECP lab 135% 100% E7 Fetal and genetic medicine 135% 100% E8 Laboratory medicine - Investigations 140% 100% - Packages 150% 100% E9 Mammography 135% 100% E10 MRI 140% 100% E11 Neurosciences lab 135% 100% E12 Nuclear medicine 135% 100% E13 Respiratory lab 135% 100% E14 Urodynamics lab 135% 100% E15 Ultrasound 135% 100% E16 X-ray 135% 100% E17 Sleep lab 135% 100% F Moolchand speciality institutes F1 Interventional radiology 100% 100% F2 Moolchand Cancer Institute 143% 100% F3 Moolchand Fertility and IVF 100% 100% F5 Moolchand Renal Care & dialysis 125% 100% G Ayurved 125% 100%
3. CONSUMABLES AND DRUGS CHARGES a) Wherever applicable, cost of consumable material and drugs will be charged separately. b) Charges for sanitizer (1) and thermometer (1) will be billed for each in-patient admission.
4. EXPRESS INVESTIGATION REPORT CHARGES
25% additional charges will be levied for investigation reports issued on an urgent basis and to all investigation in critical care areas (CCU, ED, ICU, NICU, PICU, OT, SICU, etc.)
5. CONVENIENCE FEE/BANK CHARGES a) Bank charges, as applicable, will be charged in case the payment is made by credit card/online payment gateway. b) Payment in cash against treatment provided will be subject to applicable government regulations. c) Patient/attendant should make necessary arrangements for payment through regular banking channels.
8 A4: INPATIENT CONSULTATION
1. OVERVIEW OF INPATIENT CONSULTATION GUIDELINES: a) Not more than two visits a day will be charged by an individual consultant (excluding emergency visit). b) Intensivist visits (for critical care): i) For admission under non critical care consultant, admitting consultant will charge two visits in addition to one intensivist visit (per day). ii) For admission under critical care consultant, two visits will be charged in addition to one intensivist visit (per day). c) Emergency visits: i) Emergency visit will be charged between 11:00 pm to 6:00 am only. ii) One emergency visit may be charged in addition to the two regular visits of the day. iii) Emergency radiologist visit is applicable between 10:00 pm and 7:00 am only. iv) All emergency calls to consultant must be routed through resident doctor on duty. d) Dietician visits: i) One dietician visit is compulsory for all inpatients. ii) Subsequent dietician visit to be charged based on actual requirement (as specified by treating doctor/patient request). iii) Dietician visit not applicable for new born and NICU admissions. e) While referring, admitting consultant will specify nature of reference: i) Opinion (only one visit will be charged). ii) Management (consultation as per hospital tariff). f) All charges are benchmarked to single room category. Charges in other category will be as per the policy.
2. CONSULTATION CHARGES (CORE CLINICAL DEPARTMENTS) SERVICE CODE SERVICE NAME CHARGES (Rs.) CON01001 First visit 1,000-2,500 CON01002 Subsequent visit 900-2,500 CON01003 Emergency radiologist visit 1,000-2,500 CON01004 Emergency visit 1,250-2,500 CON01006 NICU: First visit 1,000-2,000 CON01007 NICU: Subsequent visit 1,000-2,000 CON01008 NICU: Emergency visit 1,000-2,000 CON01009 PICU: First visit 1,000-2,000 CON01010 PICU: Subsequent visit 1,000-2,000 CON01011 PICU: Emergency visit 1,000-2,000
3. CONSULTATION CHARGES (SUPPORT CLINICAL DEPARTMENTS) SERVICE CODE SERVICE NAME CHARGES (Rs.) CON01005* Dietician visit 400-700 CON01029 RMO Charges 500 -1,000
Note: Applicable RMO charges will be charged on a daily basis
9 A5: ANAESTHESIA
1. ANAESTHETIC CONSUMABLES (DURATION BASIS)
Anaesthetic consumables are independent of bed category (same across all categories)
SERVICE CODE SERVICE NAME CHARGES (Rs.) ANS01007* Isoflurane (every 30 minutes) 1,010 ANS01008* Sevoflurane (upto 15 minutes) 1,010 ANS01009* Sevoflurane (upto 30 minutes) 1,990 ANS01014* Sevoflurane (upto 45 minutes) 2,990 ANS01010* Sevoflurane (upto one hour) 3,970 ANS01017* Isoflurane (every 15 minutes) 520 ANS01018* Isoflurane (every 45 minutes) 1,500 ANS01019* Isoflurane (upto one hour) 1,990
2. ANAESTHETIC CONSUMABLES (PER ML BASIS)
Anaesthetic consumables are independent of bed category (same across all categories)
SERVICE CODE SERVICE NAME CHARGES (Rs.) ANS01015* Isoflurane (per ml) 30 ANS01016* Sevoflurane (per ml) 70
3. DELIVERY SUITE SERVICE CODE SERVICE NAME CHARGES (Rs.) ANS02001 Painless delivery continuous epidural 35% of surgeon fee ANS02002 Painless delivery terminal epidural 15% of surgeon fee ANS02003 Standby for difficult delivery 25% of surgeon fee
4. OPERATION THEATRE SERVICE CODE SERVICE NAME CHARGES (Rs.) ANS01001 General anaesthesia 35% of surgeon fee ANS01002 Epidural anaesthesia 35% of surgeon fee ANS01003 Spinal anaesthesia 35% of surgeon fee ANS01004 Standby anaesthesia in OT (monitored anaesthesia care)-major 25% of surgeon fee
ANS01011 Standby anaesthesia in OT (monitored anaesthesia care)-minor 20% of surgeon fee
ANS01012 Combined spinal and epidural anaesthesia 35% of surgeon fee ANS01013 Regional block 35% of surgeon fee
5. PRE-ANAESTHESIA CHECK UP SERVICE CODE SERVICE NAME CHARGES (Rs.) ANS05001* Pre-anaesthesia check up 1,150 - 1,725 ANS05009* Pre-anaesthesia check up (revisit) 920 - 1,725
6. RADIOLOGY SERVICE CODE SERVICE NAME CHARGES (Rs.) ANS04001 GA for CT (specially for children) 35% of procedure ANS04002 Standby anaesthetist for CT 25% of procedure ANS04003 Standby anaesthetist for IVP 25% of procedure
7. OTHER CHARGES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.)TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ANS05002 Lumber puncture by anaesthetist 2,420 2,760 3,450 6,040 ANS05003 CVP line by anaesthetist 2,420 2,760 3,450 6,040 ANS05004 Arterial line 2,020 2,300 2,880 5,040 ANS05005 Difficult ryle's tube 1,410 1,610 2,020 3,530 ANS05006 Difficult IV line 1,210 1,380 1,730 3,020 ANS05007 Resuscitation charge 2,420 2,760 3,450 6,040 ANS05008 Standby anaesthesia in room procedure 30% of surgeon 30% of surgeon 30% of surgeon 30% of surgeon fee fee fee fee
10 A6: OPERATION THEATRE
1. BASIS FOR BILLING: Service Name Outpatien Daycare Inpatient Surgeon fee 100% 100% 100% Operation theatre charges (% of surgeon fees) 65% 65% 65% Weekend/ Emergency OT charges (% of surgeon fees)c 20% 20% 20% Anaesthesia charges (% of surgeon fee) 35% 35% 35% Standby anaesthesia charges (% of surgeon fee) 20%-25% 20%-25% 20%-25% OT gases (% of surgeon fee)d 10% 10% 15% Special equipment charges (% of surgeon fee)d 15% 15% 15%
Note(s): a) Only twin category and above applicable for daycare surgery. b) Applicable for single room, varies with room category. c) Weekend/Emergency OT charges to be charged from 8:00 pm to 7:00 am (Mon-Sat) and anytime on Sunday in addition to operation theatre charges. d) Wherever applicable. e) Stand by anaesthesia charges (% of surgeon fee): Minor-20%, Major-25%. (refer Section: A5/4)
2. CLARIFICATION ON CHARGES: a) Post operation, no inpatient visit charge for 3 days (maximum 6 visits). b) For stand-by surgeon during operations, the fee charged will have the written consent of the patient and will not exceed 50% of main consultant charges. c) If the patient requests two surgeons, then: i) Both the surgeons may charge their fees separately. ii) OT and anaesthesia charges will be applied based on primary surgeon charges. d) If situation requires two surgeons, then: i) Charges will be one and half times normal fees and will be divided equally between the two ii) Charges should have written consent of patient. iii) OT and anaesthesia charges will be applied based on primary surgeon charges. e) Second operation done by the same surgeon at the same time and same site, charges for the second and subsequent procedures will be 75%. f) For any procedure/operation not specifically stated in the list, charges will be determined by the Medical Director (in consultation with treating surgeon). g) Orthopaedics: when diagnostic arthroscopy is followed by open surgery, patient will be charged for h) If more than one procedures of different/same specialty are performed at the same sitting, then special equipment charges will be applicable only on the procedure for which the equipment is used. i) Booking amount will be forfeited, if booking not utilized.
3. POST-OPERATIVE CRITICAL CARE MONITORING SERVICE CODE SERVICE NAME CHARGES (Rs.) OPT01003* Post-operative critical care monitoring 3,450 (admitted cases upto 6 hours) OPT01004* Post-operative critical care monitoring 5,180 (admitted cases 6 to 8 hours) OPT01005* Post-operative critical care monitoring 6,900 OPT01006* Post-operative(admitted cases critical 12 to 24care hours) monitoring (day 870 care upto 4 hours)
Note(s): a) If patient is kept in post-operative care for more than 8 hours, room rent for ICU/SICU will be
11 4. SPECIAL EQUIPMENT CHARGES SERVICE CODE SERVICE NAME BASIS 3/4 TWIN SINGLE SUITE OPT02001 C-Arm % of surgeon fees 15% 15% 15% 15% OPT02002 Lithocast % of surgeon fees 15% 15% 15% 15% OPT02003 Endoscopes % of surgeon fees 15% 15% 15% 15% OPT02005 Special equipments % of surgeon fees 15% 15% 15% 15% OPT02007 KTP laser system Fixed 110,400 110,400 110,400 121,440
Note(s): a) Endoscope includes arthroscope, bronchoscope, cystoscope, ENT endoscope, fibro optic colinoscope, fibro optic laryngoscope, gastroscope, hysteroscope, laproscope, mediastinoscope, resectoscope, b) Special equipment includes all other equipments used for specific surgeries such as liposuction,
5. SPECIAL EQUIPMENT CHARGES (INDEPENDENT OF BED CATEGORY) SERVICE CODE SERVICE NAME CHARGES (Rs.) OPT01001* Tripole charges (cautery+suction+knife for 2,300 biopsy) OPT02006* OT warmer 580 OPT02012* ENT laser 23,000 OPT02013* Holmium laser (100 watt) 80,500 OPT02014* Flexible uretheoscope 34,500 OPT02015* Thoracoscope 86,250 OPT02016* Holmium laser (Cat A) 34,500 OPT02017* Holmium laser (Cat B) 11,500 OPT02018* Holmium laser (Cat C) 8,630
6. OT GASES SERVICE CODESERVICE NAME BASIS CHARGES (Rs.) OPT02019OT gases (day care) % of surgeon fees 10% OPT02004OT gases (inpatient) % of surgeon fees 15%
7. OT CHARGES SERVICE CODESERVICE NAME BASIS CHARGES (Rs.) OPT03001OT Charges % of surgeon fees 65%
12 A7: MOTHER’S NEST (DELIVERY SUITE)
1. SERVICE CHARGES SERVICE CODE SERVICE NAMEBASIS CHARGES (Rs.) LRC01001 Labour room charges% of surgeon fees 35% LRC01003 LDR charges% of surgeon fees 55% LRC01004 Mother's Nest registrationFixed 870 Weekend/Emergency delivery charges e % of surgeon fees 20%
Note(s): a) Single room/higher categories are eligible for LDR suites only. b) Twin sharing category patients can choose their preferred option (LR or LDR). c) 3/4 bedded/lower categories are eligible for labour room (LR) only. d) At the time of admission into Mother’s Nest a corresponding patient room is blocked for the patient/family. Given this, bed charges are applicable in addition to LR/LDR charges. e) Weekend/Emergency delivery charges to be charged in addition to LR/LDR charges from 8:00 pm to 7:00 am on Monday-Saturday and anytime on Sunday. i) This charge is applicable to Normal delivery (LRC03006), Normal delivery (high risk) (LRC03007), ARM (LRC03009), MRP (LRC03010), Suction evacuation (LRC03011) and Perineal tear suturing (LRC03012).
2. DELIVERY CHARGES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) LRC03006 Normal delivery 20,130 23,000 28,750 50,320 LRC03007 Normal delivery (high risk) 22,540 25,760 32,200 56,350
3. NON STRESS TEST SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) LRC02001 Non stress test for 30 mins 410 460 580 1,010
4. OBSERVATION CHARGES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) LRC03001 Monitoring charges 1,210 1,380 1,730 3,020 LRC03004 New born baby care charges 1,210 1,380 1,730 3,020 LRC03005 Continuous fetal monitoring 2,420 2,760 3,450 6,040
5. VACCINATION SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) LRC03008* Vaccination administration (oral polio and vitamin K) 120 120 120 120
6. OTHER PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) LRC03009 ARM (artificial rupture of membrane) 1,050 1,200 1,500 2,620 LRC03010 MRP (manual removal placenta) 4,830 5,520 6,900 12,080 LRC03011 Suction evacuation 5,240 5,980 7,480 13,090 LRC03013 Mcdonald stitch removal 1,210 1,380 1,730 3,020 LRC03014 Control of postpartum haemorrhage 6,040 6,900 8,630 15,100 LRC03012 Perineal tear suturing 3,390 3,870 4,830 8,460
13 A8: EMERGENCY
1. EMERGENCY PROCEDURES
1.1 GENERAL SERVICES
1.1.1 REGISTRATION AND CONSULTATION SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01025 Registration (valid for 2 days for same procedure) 150-300 EMR01064 EMO consultation 600-2,000 EMR01032 Super specialist consultation 900-2,500
1.1.2 DOCUMENTATION SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01062 Medical legal case (MLC) charge 1,730 EMR01063 Emergency certificate 290 EMR01186 Fitness certificate 290
1.1.3 DRESSING MATERIAL/CONSUMABLES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01050 Dressing material (small) 180 EMR01051 Dressing material (medium) 230 EMR01052 Dressing material (large) 350 EMR01053 Dressing material (very large) 580 EMR01065 Dressing material (special) 1,150
1.1.4 DRESSINGS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01046 Dressing (small) 460 EMR01047 Dressing (medium) 1,150
1.1.5 INJECTIONS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01001 Injection charges 120 EMR01002 IV infusion (first) 230 EMR01003 IV infusion (second) 230 EMR01040 Immunization 230 EMR09039 Infusion pump 520
1.1.6 INVESTIGATIONS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01185 ABG 920 EMR01028 Blood glucose test 230 EMR01026 ECG 410 EMR01187 Ischemic stroke panel 1,840 EMR01180 Troponin I 2,300 EMR09040 2D Echo (bedside) 3,800 EMR09041 3D Echo (bedside) 4,600 EMR09042 Focused assessment with sonography for trauma (FAST) 1,610 EMR09043 X-Ray (Bedside per exposure) 870 14 1.1.7 OBSERVATION AND GASES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01056 ER observation (per hour) 980 EMR01033 O2 inhalation (per hour) 120 EMR09044 Resuscitation room charges (per hour) 1,150
1.1.8 ORTHOPAEDICS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01035 Plaster cutting 870 EMR01021 Skin traction (adult) 1,730 EMR01022 Skin traction (child) 1,150
1.1.9 OTHER PROCEDURES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01015 PC enema 690 EMR01016 Urinary catheterization 1,610 EMR01027 Nebulisation 460 EMR01041 Endotracheal intubation 1,730 EMR01178 Ryle's tube insertion (without anesthesia) 1,730 EMR01179 CVP line insertion 4,030 EMR01183 IV cannulation 290 EMR01184 Folley's catheter removal 460
1.2 EMO SERVICES
1.2.1 CRITICAL LIFE SUPPORT PROCEDURES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01029 DC shock 2,300 EMR01031 External pacing 2,530 EMR07009 Temporary pacing 9,200 EMR07010 Cardio version 2,530 EMR09045 Acute neurology care 2,300 EMR09046 Acute stroke care 2,300 EMR09047 Cardiopulmonary resuscitation 2,300 EMR09048 Cardiac arrest/MI Management 2,300 EMR09049 Critical monitoring 2,300 EMR09050 Paediatric emergency and care 2,300 EMR09051 Trauma management and care 2,300
1.2.2 ENT SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR06041 Anterior nasal packing 4,030 EMR06042 Posterior nasal packing 5,750 EMR06043 Nasal pack removal 2,880 EMR06044 FB removal (superficial) 4,600 EMR06045 Suturing ENT region (small) 1,610 EMR06046 Maggot removal 1,150 EMR06047 Suction ENT region 1,150
15 EMR06048 Paracentesis (unilateral) 2,880 EMR06049 Paracentesis (bilateral) 3,450 EMR06050 Jaw close reduction 1,380
1.2.3 GASTROENTEROLOGY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01013 Gastric lavage 2,300 EMR09052 Digital rectal examination (DRE) 580
1.2.4 GENERAL SERVICES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR03028 Reduction of paraphimosis 4,600 EMR03046 Pleural fluid aspiration (diagnostic) 3,740 EMR03047 Ascitic fluid aspiration (diagnostic) 3,450 EMR03049 Intercostal drainage 9,200 EMR01034 Venesection 2,880 EMR01038 Wound debridement (small) 5,750
1.2.5 ORTHOPAEDICS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR04005 Strapping (major) 1,730 EMR04008 Figure of 8 bandage 1,500 EMR04019 Strapping (minor) 580
1.2.6 OTHER PROCEDURES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01181 Arterial line 2,590 EMR01182 Bowel wash 2,300
1.2.7 PLASTIC SURGERY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR09029 Dressing (very minor) 1,730 EMR09030 Dressing (minor) 2,880 EMR09031 Suturing accidental wounds (small) 6,900 EMR09032 Hand injury (minor) 16,100
1.2.8 SUTURING AND STITCHES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR01054 Suturing (upto 5) 870 EMR01044 Stitch removal (upto 5) 290
1.3 SUPER SPECIALIST SERVICES
1.3.1 CARDIAC SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR07007 Temporary pacing 9,200 EMR07008 Cardio version 2,530
16 1.3.2 DERMATOLOGY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR05002 Intra lesional injection 580 EMR05005 Skin biopsy 2,420 EMR05006 Skin cauterization (single wart) 1,380
1.3.3 ENT SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR06006 Anterior nasal packing 4,030 EMR06007 Posterior nasal packing 5,750 EMR06008 Nasal pack removal 2,880 EMR06012 FB removal (superficial) 4,600 EMR06013 Suturing ENT region (small) 1,610 EMR06015 Maggot removal 1,150 EMR06020 Suction ENT region 1,150 EMR06021 Antral wash 4,600 EMR06023 Paracentesis (unilateral) 2,880 EMR06024 Paracentesis (bilateral) 3,450 EMR06027 Jaw close reduction 1,380
1.3.4 GENERAL SURGERY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR03017 Pleural fluid aspiration (diagnostic) 3,740 EMR03019 Ascitic fluid aspiration (diagnostic) 3,450 EMR03021 Wound debridement (small) 5,750 EMR03029 Intercostal drainage 9,200 EMR03039 Suturing (small wound) 2,880 EMR03045 Reduction of paraphimosis 4,600 EMR01042 Venesection 2,880 EMR04009 Pin/wire removal 2,590
1.3.5 GYNAECOLOGY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR10007 Intra uterine contraceptive device insertion 2,530 EMR10008 IUCD removal 1,730
1.3.6 ORTHOPAEDICS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR04040 Strapping (major) 1,730 EMR04041 Figure of 8 bandage 1,500 EMR04042 Strapping (minor) 580 EMR04025 Intra articular injection 2,020
1.3.7 PLASTIC SURGERY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR09001 Dressing (very minor) 1,730 EMR09002 Dressing (minor) 2,880 EMR09010 Suturing accidental wounds (small) 6,900 EMR09018 Ear piercing 2,070 EMR09023 Hand injury (minor) 16,100
17 2. MINOR OT SERVICES
2.1 EMO SERVICES
2.1.1 DRESSINGS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR03022 Dressing (large) 1,730 EMR03023 Dressing (very large) 2,880 EMR01177 Dressing (special) 2,880
2.1.2 ENT SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR06029 Nasal bone reduction 3,450 EMR06030 I and D (septal abscess) 4,600 EMR06031 Excision Biopsy (small) 1,150 EMR06032 Excision Biopsy (medium) 1,730 EMR06033 Excision Biopsy (large) 2,300 EMR06034 Aspiration cyst/Haemotoma (small) 3,450 EMR06035 Aspiration cyst/Haemotoma (large/deep) 4,600 EMR06036 Nasal endoscopic cauterization 4,600 EMR06037 Ear cautery and patch 3,450 EMR06038 DL scopy and biopsy 2,880 EMR06039 Aural biopsy granulation 1,730
2.1.3 GENERAL SURGERY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR03002 Injection keloids 2,880 EMR03003 Injection haemorrhoids 2,880 EMR03004 Injection ganglion 2,880 EMR03005 I and D (small abscess) 4,030 EMR03007 Urethral dilatation 5,180 EMR03014 Suturing (major wound) 5,180 EMR03015 In growing toe nail removal 4,600 EMR03025 FNAC 1,150 EMR03026 Haemotoma aspiration 1,270 EMR03027 Paronychia 4,030 EMR03050 I and D (large abscess) 4,600 EMR03051 Bone marrow aspiration 4,140
2.1.4 GYNAECOLOGY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR10009 Endometrial biopsy (EB) 2,300 EMR10010 Hydrotubation 1,150
18 2.1.5 ORTHOPAEDIC SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR04006 Closed reduction (without anesthesia) 4,600 EMR04018 Knee aspiration 2,880 EMR04010 Injection epidural 4,030 EMR04011 Injection depomedrol 350 EMR04012 Intra articular injection 2,020 EMR04013 Hip spica 5,750 EMR04014 Shoulder jacket 5,750 EMR04016 POP backslab AK/AE 4,600 EMR04017 POP backslab BK/BE 2,300 EMR04023 POP cast application AK/AE 2,880 EMR04024 POP cast application BK/BE 2,300 EMR04020 Cold abscess aspiration 2,650 EMR01036 Synthetic cast application 980 EMR01037 Synthetic cast cutting 120 EMR09053 Shoulder reduction 5,750
2.1.6 PLASTIC SURGERY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR09024 Dressing (major) 3,450 EMR09025 Mole excision 6,900 EMR09026 Corn removal (single) 4,030 EMR09027 Corn removal (multiple) 8,050 EMR09028 Cold abscess aspiration 2,650
2.1.7 SUTURING AND STITCHES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR03001 Suturing (10 and above) 2,880 EMR01055 Suturing (6 to 10) 1,730 EMR01043 Stitch removal (more than 5) 870
2.2 SUPER SPECIALIST
2.2.1 DERMATOLOGY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR05004 Electro surgery 2,300 EMR05007 Skin cauterization (multiple wart) 2,300
2.2.2 DRESSING SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR03042 Dressing (large) 1,730 EMR03043 Dressing (very large) 2,880
2.2.3 ENT SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR06001 FB removal (deep) 5,750 EMR06003 Nasal bone reduction 3,450
19 EMR06004 I and D (septal abscess) 4,600 EMR06009 Excision biopsy (small) 1,150 EMR06010 Excision biopsy (medium) 1,730 EMR06011 Excision biopsy (large) 2,300 EMR06014 Suturing ENT region (large) 2,300 EMR06017 Aspiration cyst/haemotoma (small) 3,450 EMR06018 Aspiration cyst/haemotoma (large/deep) 4,600 EMR06019 Nasal endoscopic cauterization 4,600 EMR06022 Aural biopsy granulation 1,730 EMR06025 Ear cautery and patch 3,450 EMR06026 DL scopy and biopsy 2,880
2.2.4 GENERAL SURGERY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR03006 I and D (large abscess) 4,600 EMR03018 Ascitic fluid aspiration (therapeutic) 4,600 EMR03020 Bone marrow aspiration 4,140 EMR03040 I and D (small abscess) 4,030 EMR03041 Suturing (major wound) 5,180 EMR03044 Haemotoma aspiration 1,270 EMR03032 Injection keloids 2,880 EMR03033 Injection haemorrhoids 2,880 EMR03034 Injection ganglion 2,880 EMR03035 Urethral dilatation 5,180 EMR03036 In growing toe nail removal 4,600 EMR03037 FNAC 1,150 EMR03038 Paronychia 4,030
2.2.5 GYNAECOLOGY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR10005 Endometrial biopsy (EB) 2,300 EMR10006 Hydrotubation 1,150
2.2.6 ORTHOPAEDIC SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR09054 Shoulder reduction 5,750 EMR04026 Closed reduction without anesthesia 4,600 EMR04027 Knee aspiration 2,880 EMR04030 Injection epidural 4,030 EMR04033 Injection depomedrol 350 EMR04034 POP cast application AK/AE 2,880 EMR04035 POP cast application BK/BE 2,300 EMR04037 Hip spica 5,750 EMR04038 Shoulder jacket 5,750 EMR04028 POP backslab AK/AE 4,600 EMR04029 POP backslab BK/BE 2,300 EMR04031 Synthetic cast application 980 EMR04039 Cold abscess aspiration 2,650
20 2.2.7 PLASTIC SURGERY SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR09003 Dressing (major) 3,450 EMR09004 Mole excision 6,900 EMR09008 Ear lobe repair (one ear) 4,600 EMR09009 Ear lobe repair (both ears) 6,900 EMR09016 Corn removal (single) 4,030 EMR09017 Corn removal (multiple) 8,050 EMR09019 Eye restoration 17,250 EMR09020 Scar revision (single) 17,250 EMR09021 Scar revision (multiple) 23,000 EMR09022 Suturing of wound face (large) 17,250
3. AMBULANCE SERVICES
3.1 AMBULANCE CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR02013 Ambulance without doctor (minimum upto 10 km) 1,730 EMR02010 Ambulance with doctor (minimum upto 10 km) 2,880 EMR02009 Ambulance charges (per additional km after 10 km) 60 EMR09055 Ambulance only for patient transport (min upto 10 km) 1,150
3.2 WAITING CHARGES PER HOUR BEYOND 30 MINS SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR02012 Waiting charges without doctor (per hour beyond 30 minutes) 350 EMR02004 Waiting charges with doctor (per hour beyond 30 minutes) 580
3.3 OTHER CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) EMR02011 Equipment charges 870
21 A9: STERILIZATION
Sterilization charges are independent of bed category (same across all categories)
1. MAJOR SETS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CSD01004 Angiogram set 920 920 920 920 920 CSD01006 Major dressing set 920 920 920 920 920 CSD01007 Intercostal drainage bottle 920 920 920 920 920 CSD01008 Cut open set 920 920 920 920 920 CSD01010 LP set 920 920 920 920 920 CSD01011 Liver biopsy set 920 920 920 920 920 CSD01012 Aspiration set 920 920 920 920 920 CSD01013 Bone marrow set 920 920 920 920 920 CSD01014 Trocar cannula (chest tube) 1,380 1,380 1,380 1,380 1,380 CSD01015 Heimlast valve 1,960 1,960 1,960 1,960 1,960 CSD01016 Pleinal cath and heimlast value 2,530 2,530 2,530 2,530 2,530 CSD01017 Peritoneal dialysis set 920 920 920 920 920 CSD01018 Delivery set 1,150 1,150 1,150 1,150 1,150 CSD01023 Piles injection set 920 920 920 920 920 CSD01024 Tracheostomy set 920 920 920 920 920 CSD01026 HSG set 1,150 1,150 1,150 1,150 1,150 CSD01027 Amnio set 1,150 1,150 1,150 1,150 1,150 CSD01033 Fine suture set 920 920 920 920 920 CSD01034 Suturing set 920 920 920 920 920 CSD01037 Urethra dilator set 920 920 920 920 920
2. MINOR SETS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CSD01001 Minor dressing set 640 640 640 640 640 CSD01002 Catheterization set 640 640 640 640 640 CSD01003 Eye set 640 640 640 640 640 CSD01005 Myelogram set 640 640 640 640 640 CSD01009 Paediatric exchange set 640 640 640 640 640 CSD01019 Stitch removal set 640 640 640 640 640 CSD01020 Per vaginal examination tray 640 640 640 640 640 CSD01021 Bladder irrigation set 640 640 640 640 640 CSD01022 Vaginal packing set 640 640 640 640 640 CSD01025 Arm set 640 640 640 640 640 CSD01035 Minor set 640 640 640 640 640 CSD01036 Hegars dilator set 640 640 640 640 640 CSD01038 IND set 640 640 640 640 640 CSD01039 ENT set 640 640 640 640 640 CSD01040 ENT biopsy set 640 640 640 640 640 CSD01041 Protus cop set 640 640 640 640 640
3. DRESSING MATERIAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CSD01028 Dressing pad 60 60 60 60 60 CSD01029 Gamzee 150 150 150 150 150 CSD01030 Gauze piece 60 60 60 60 60 CSD01031 Gynae pad 60 60 60 60 60 CSD01032 Roller gauze 120 120 120 120 120
22 A10: HEALTHCHECK+
1. PACKAGES FOR MEN SERVICE CODE SERVICE NAME CHARGES (Rs.) EHC0100120-30 years 6,330 EHC0100230-50 years 8,630 EHC01003>50 years 9,780
2. PACKAGES FOR WOMEN SERVICE CODE SERVICE NAME CHARGES (Rs.) EHC0200120-40 years 6,330 EHC0200240-50 years 9,200 EHC02003>50 years 9,780 EHC0200440-50 years (without bone densitometry and 7,480 mammography) EHC02005>50 years (without bone densitometry and 8,050 mammography)
2. EHC CONSULTATION SERVICE CODE SERVICE NAME CHARGES (Rs.) EHC03001 EHC review consultation 500-1,000
3. A GLANCE AT VARIOUS HEALTHCHECK+ PACKAGES Details Men Women 20-30 yrs 30-50yrs >50yrs 20-40 yrs 40-50yrs >50yrs HAEMOGRAM Haemoglobin, PCV, TLC, RBC ▪ ▪▪ ▪ ▪ ▪ count, MCV, MCH, MCHC, platelet count, RDW, DLC, ESR, Bloodperipheral grouping count and Rh typing ▪ ▪▪ ▪ ▪ ▪ SGGTP ▪ ▪▪ ▪ ▪ ▪ SGOT ▪ ▪▪ ▪ ▪ ▪ SGPT ▪ ▪▪ ▪ ▪ ▪ Bilirubin (total/direct/indirect) ▪ ▪▪ ▪ ▪ ▪ Serum calcium and phosphorus ▪ ▪▪ Serum protein ▪ ▪▪ ▪ ▪ ▪ Albumin ▪ ▪▪ ▪ ▪ ▪ Globulin ▪ ▪▪ ▪ ▪ ▪ A/G ratio ▪ ▪▪ ▪ ▪ ▪ Alkaline phosphatase ▪ ▪▪ ▪ ▪ ▪ Lipid profile ▪ ▪▪ ▪ ▪ ▪ BIOCHEMISTRY Uric acid ▪ ▪▪ ▪ ▪ ▪ Blood urea ▪ ▪▪ ▪ ▪ ▪ Serum creatinine ▪ ▪▪ ▪ ▪ ▪ Blood sugar fasting and PP ▪ ▪▪ ▪ ▪ ▪ HBA1c ▪ ▪ NON-INVASIVE CARDIOLOGY TMT/echo ▪▪ ▪▪ PFT ▪ ▪▪ ▪ ▪ ▪ ECG ▪ ▪▪ ▪ ▪ ▪ 23 IMAGING X-Ray AP ▪ ▪▪ ▪ ▪ ▪ Ultrasound abdomen ▪ ▪▪ ▪ ▪ ▪ Bone densitometry ▪ ▪ Mammography ▪ ▪ ENT Audiometry ▪ ▪ PATHOLOGICAL TESTS Urine ▪ ▪▪ ▪ ▪ ▪ Stool (ova and cyst, occult ▪ ▪▪ ▪ ▪ ▪ Serology TSH ▪ ▪▪ ▪ ▪ ▪ PSA ▪ HISTOLOGY Pap smear ▪ ▪ ▪ CONSULTATION Internal medicine ▪ ▪▪ ▪ ▪ ▪ Ophthalmology ▪ ▪▪ ▪ ▪ ▪ Gynaecology ▪ ▪ ▪ Ayurved ▪ ▪▪ ▪ ▪ ▪ Dental ▪ ▪▪ ▪ ▪ ▪ Physiotherapy ▪ ▪▪ ▪ ▪ ▪
24 A11: OTHER CHARGES
Other charges are independent of bed category (same across all categories)
1. ADMISSION CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS01001* Admission fees 400
2. CERTIFICATE CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS01003* Birth certificate 500
3. DOCUMENTATION CHARGES (MOOLCHAND MEDICAL EDUCATOR PROGRAM) SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS01013* JRTSON verification charges 1,000 MIS01014* Experience verification charges 6,000
4. DOCUMENTATION CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS01004* Duplicate pass 50 MIS01011* Transcript fee 2,500 MIS01012* Transcript fee (Intl) 6,500 MIS06004* TPA evaluation charges 500
5. EQUIPMENT CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS03005* Humidifier 460 MIS03006* Alpha-bed charges per day 580 MIS04007* Infusion pump 690
6. GASES IN WARD/CRITICAL CARE AREAS (DURATION BASIS) SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS02001* Oxygen gas charge (upto 6 hours) 520 MIS02002* Oxygen gas charge (6 to 12 hours) 920 MIS02003* Oxygen gas charge (12 hours to 24 hours) 1,610 MIS02004* Carbon dioxide gas charge 290
7. GASES IN WARD/CRITICAL CARE AREA (PER LTR BASIS) SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS02005* Oxygen gas charge (per ltr) 25
Note: a) Moolchand is in the process of transitioning the billing of gases from duration basis to per litre basis. b) Billing will transition based on implementation for a specific area.
8. OTHERS SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS03008* Fumigation charges 520 MIS04001* Mortuary cabinet (upto 24 hours) 4,600 MIS04004* Bed sheet charges 290 MIS03020* Patient meal charge (per day) 580 MIS06001* Extra meal charges (per meal) 290
25 MIS03022* Injection administration charges (including consumables) 210 MIS03019* Miscellaneous consumables charges 100-250 MIS03023* IV Cannulation (incl consumables) 2,300 MIS03024* IV Cannulation (incl consumables + Y connector) 2,880 MIS03025* IV Infusion (including consumables) 410 MIS03026* Initiation of bipap (incl consumables + mask) 8,050 MIS03027* Bathing including consumables 580 MIS03028* Cleaning including consumables 350 MIS03029* Cleaning including consumables and diaper 550 MIS03030* Essential Patient Kit: Ward 1,150 MIS03031* ECG including consumables 810 MIS03032* Dressing material (small) incl. soft swab 320 MIS03033* Dressing material (medium) incl. soft swab 550 MIS03034* Dressing material (large) incl. soft swab 810 MIS03035* Dressing material (very large) incl. soft swab 1,150 MIS03036* Dressing material (special) incl. soft swab 1,440
Note: Applicable miscellaneous consumable charge will be charged on a daily basis
9. PHARMACY HANDLING CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS05004* Pharmacy handling charges 5% of total IP bill
10. MRD CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS03016* MRD charges 580 MIS01010* Duplicate documents (each side) 60
11. SPECIALIZED NURSING SUPPORT SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS05001* Continuous nursing assistance (for 12 hours) 1,250 -1,500 MIS05002* Continuous specialized nursing assistance (for 12 hours) 2,500-3,000
12. VENTILATION/BIPAP CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS03009* Ventilator machine charges (per day) 2,880 MIS03010* Bipap ventilator charges (per day) 2,880 MIS03011* Ventilator care charges (per day) 980 MIS03012* Weaning from ventilation 750 MIS03013* Initiation of bipap 1,380 MIS03015* Initiation of ventilation 3,450
12. NURSING CHARGES SERVICE CODE SERVICE NAME CHARGES (Rs.) MIS03017* Nursing Charges - Ward 450 MIS03018* Nursing Charges - Critical Care 575
Note: Applicable nursing charges will be charged on a daily basis
26 MOOLCHAND SCHEDULE OF CHARGES 2019
SECTION B: OUTPATIENT PROCEDURES
B1: CHILDREN'S CLINIC
1. GENERAL SERVICES
1.1 CONSULTATION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CHC01041 Vaccination administration charges 120 120 120 120 120
B2: DERMATOLOGY
1. OP PROCEDURES
1.1 HAIR TRANSPLANT SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CPS01001 Beard restoration 23,000 23,000 23,000 23,000 23,000 CPS01002 Hair transplantation (per additional follicular 120 120 120 120 120 units) CPS01003 Hair transplantation (upto 750 follicular units) 40,250 40,250 40,250 40,250 40,250 CPS01004 Hair transplantation (upto 1,000 follicular units) 63,250 63,250 63,250 63,250 63,250 CPS01005 Hair transplantation (upto 1,500 follicular units) 80,500 80,500 80,500 80,500 80,500 CPS01006 Moustache restoration 19,550 19,550 19,550 19,550 19,550
1.2 LASER (HAIR REDUCTION) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CPS04001 Full body (6 sessions) 230,000 230,000 230,000 230,000 230,000 CPS04002 Full body (per session) 46,000 46,000 46,000 46,000 46,000 CPS04003 Lower face package (6 sessions) 25,880 25,880 25,880 25,880 25,880 CPS04004 Lower face package (per session) 5,180 5,180 5,180 5,180 5,180 CPS04005 Mid riff package (6 sessions) 34,500 34,500 34,500 34,500 34,500 CPS04006 Mid riff (per session) 6,900 6,900 6,900 6,900 6,900 CPS04007 Back package (6 sessions) 63,250 63,250 63,250 63,250 63,250 CPS04008 Back (per session) 12,650 12,650 12,650 12,650 12,650 CPS04009 Abdomen package (6 sessions) 41,690 41,690 41,690 41,690 41,690 CPS04010 Abdomen (per session) 8,340 8,340 8,340 8,340 8,340 CPS04011 Arms (both) (6 sessions) 41,690 41,690 41,690 41,690 41,690 CPS04012 Arms (both) (per session) 8,340 8,340 8,340 8,340 8,340 CPS04013 Legs (both) (6 sessions) 57,500 57,500 57,500 57,500 57,500 CPS04014 Legs (both) (per session) 12,370 12,370 12,370 12,370 12,370
1.3 LASER (FRACTIONAL CO2) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CPS05001 Full face resufacing (per session) 5,180 5,180 5,180 5,180 5,180 CPS05002 Acne scars cheeks (per session) 6,900 6,900 6,900 6,900 6,900 CPS05003 Scar (small) (per session) 10,350 10,350 10,350 10,350 10,350 CPS05004 Scar (medium) (per session) 18,400 18,400 18,400 18,400 18,400 CPS05005 Scar (large) (per session) 25,590 25,590 25,590 25,590 25,590 CPS05006 Deep wrinkles (face) (per session) 60,380 60,380 60,380 60,380 60,380 CPS05007 Deep wrinkles (face & neck) (per session) 60,380 60,380 60,380 60,380 60,380 CPS05008 Blephroplasty (per session) 6,900 6,900 6,900 6,900 6,900 CPS05009 Abdenoplasty (per session) 14,380 14,380 14,380 14,380 14,380 CPS05010 Rhynophyma (per session) 5,750 5,750 5,750 5,750 5,750 CPS05011 Fine wrinkles (per session) 6,900 6,900 6,900 6,900 6,900 CPS05012 Perioral wrinkles (per session) 5,180 5,180 5,180 5,180 5,180 CPS05013 Chicken pox scars (per session) 9,200 9,200 9,200 9,200 9,200 CPS05014 Stretch marks (small) (per session) 4,030 4,030 4,030 4,030 4,030 CPS05015 Stretch marks (medium) (per session) 9,200 9,200 9,200 9,200 9,200 CPS05016 Stretch marks (large) (per session) 15,240 15,240 15,240 15,240 15,240
27 1.4 RECONSTRUCTIVE SURGERY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CPS02003 Dressing (major) 3,680 3,680 3,680 3,680 3,680 CPS02004 Dressing (minor) 2,530 2,530 2,530 2,530 2,530 CPS02005 Dressing (very minor) 2,070 2,070 2,070 2,070 2,070 CPS02006 Ear piercing 2,300 2,300 2,300 2,300 2,300 CPS02011 Filling tissue expander 18,400 18,400 18,400 18,400 18,400 CPS02012 Hand injury (minor) 13,800 13,800 13,800 13,800 13,800 CPS02014 Scar revision (single) 11,500 11,500 11,500 11,500 11,500 CPS02015 Scar revision (multiple) 17,250 17,250 17,250 17,250 17,250 CPS02016 Small skin graft 11,500 11,500 11,500 11,500 11,500 CPS02019 V-Y flap 16,100 16,100 16,100 16,100 16,100
1.5 SKIN PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CPS03001 Chemical peeling (Glycolic acid 20%) (per 1 ml) 2,880 2,880 2,880 2,880 2,880 CPS03002 Electro surgery 2,530 2,530 2,530 2,530 2,530 CPS03003 Intra lesional injection 810 810 810 810 810 CPS03005 Skin cauterization (single wart) 1,380 1,380 1,380 1,380 1,380 CPS03006 Skin cauterization (multiple wart) 2,300 2,300 2,300 2,300 2,300 CPS03007 Chemical cautery 2,300 2,300 2,300 2,300 2,300 CPS03008 Curettage 1,150 1,150 1,150 1,150 1,150 CPS03009 Milia extraction 580 580 580 580 580 CPS03010 UVL 580 580 580 580 580 CPS03011 Neuromodulator (per unit) (including cost of vial) 520 520 520 520 520 CPS03012 Chemical peeling (Glycolic acid 35%) (per 1 ml) 2,880 2,880 2,880 2,880 2,880 CPS03013 Chemical peeling (Salicylic acid 30%) (per 1 ml) 2,880 2,880 2,880 2,880 2,880
2. MINOR OT PROCEDURES
2.1 RECONSTRUCTIVE SURGERY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CPS02001 Corn removal (single) 6,330 6,330 6,330 6,330 6,330 CPS02002 Corn removal (multiple) 9,200 9,200 9,200 9,200 9,200 CPS02007 Ear lobe repair (one ear) 5,180 5,180 5,180 5,180 5,180 CPS02008 Ear lobe repair (both ears) 8,050 8,050 8,050 8,050 8,050 CPS02009 Excision mole 10,350 10,350 10,350 10,350 10,350 CPS02013 Removal arch bar 6,900 6,900 6,900 6,900 6,900 CPS02017 Suturing of wound face (small) 7,480 7,480 7,480 7,480 7,480 CPS02018 Suturing of wound face (Medium) 16,100 16,100 16,100 16,100 16,100
2.2 SKIN PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CPS03004 Skin biopsy 2,300 2,300 2,300 2,300 2,300
B3: DENTAL
1. GENERAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DEN01001 Consultation 690 690 690 690 690 DEN01002 Consultation (visiting consultant) 690 690 690 690 690 DEN01004 Dressing temporary filling 580 580 580 580 580 DEN01005 Simple extraction 1,150 1,150 1,150 1,150 1,150 DEN01007 Aesthetical filling (single surface) 1,610 1,610 1,610 1,610 1,610 DEN01008 Scaling (1st sitting) 1,730 1,730 1,730 1,730 1,730 DEN01009 Scaling (subsequent sitting) 1,150 1,150 1,150 1,150 1,150 DEN01010 RCT (anterior) 4,600 4,600 4,600 4,600 4,600 DEN01011 RCT (posterior) 6,040 6,040 6,040 6,040 6,040 DEN01012 Surgical (extraction) 4,030 4,030 4,030 4,030 4,030 DEN01013 Biopsy 4,600 4,600 4,600 4,600 4,600 DEN01014 Alveolectomy (minor) 4,030 4,030 4,030 4,030 4,030 DEN01016 Pericoronal flap 2,300 2,300 2,300 2,300 2,300 DEN01017 Spot grinding 350 350 350 350 350 DEN01019 Reimplantation (RCT charges extra) 4,600 4,600 4,600 4,600 4,600 DEN01020 Cementing crown 1,150 1,150 1,150 1,150 1,150
28 DEN01022 Paediatric filling 980 980 980 980 980 DEN01023 Paediatric extraction 690 690 690 690 690 DEN01024 Pulpotomy 2,300 2,300 2,300 2,300 2,300 DEN01025 Pulpectomy 2,880 2,880 2,880 2,880 2,880 DEN01028 Root canal treatment with flexi/rotary files 6,900 6,900 6,900 6,900 6,900 (Single Sitting) DEN01029 Firm extraction 1,730 1,730 1,730 1,730 1,730 DEN01034 Miracle mix/glass Ionomer/silver amalgam 1,150 1,150 1,150 1,150 1,150 (double surface restoration) DEN01035 Aesthetical filling (double surface) 2,300 2,300 2,300 2,300 2,300 DEN01036 Cervical composite 1,150 1,150 1,150 1,150 1,150 DEN01038 Composite laminate (single tooth) 3,450 3,450 3,450 3,450 3,450 DEN01039 Composite crown build up 3,450 3,450 3,450 3,450 3,450 DEN01040 Diastema closure (composite restoration per 2,300 2,300 2,300 2,300 2,300 tooth) DEN01041 Bleaching (single visit) 8,630 8,630 8,630 8,630 8,630 DEN01042 Fluroide treatment (single sitting) 2,300 2,300 2,300 2,300 2,300 DEN01043 Pit and fissure procedure (per tooth) 1,150 1,150 1,150 1,150 1,150 DEN01045 Immediate denture per tooth (extraction 920 920 920 920 920 included) DEN01047 Polishing (per sitting) 920 920 920 920 920 DEN01048 Splinting (per tooth) 2,880 2,880 2,880 2,880 2,880 DEN01050 Addition/repair in pre-existing denture (per 870 870 870 870 870 tooth) DEN01051 Empress crown 20,700 20,700 20,700 20,700 20,700 DEN01052 Procera crown 23,000 23,000 23,000 23,000 23,000 DEN01057 Study model 870 870 870 870 870 DEN01058 Dressing dry socket (per sitting) 1,380 1,380 1,380 1,380 1,380 DEN01059 Surgical suturing 1,150 1,150 1,150 1,150 1,150 DEN01060 Inlay onlay ceramic 6,900 6,900 6,900 6,900 6,900 DEN01061 X-ray (RVG) 460 460 460 460 460 DEN05011 Crown removal 1,440 1,440 1,440 1,440 1,440 DEN01062 Night Guard 4,600 4,600 4,600 4,600 4,600
2. ORTHODONTICS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DEN03001 Upper/lower removal appliance 9,200 9,200 9,200 9,200 9,200 DEN03002 Myofunctional appliance 11,500 11,500 11,500 11,500 11,500 DEN03003 Fixed orthodontic (normal) 46,000 46,000 46,000 46,000 46,000 DEN03004 Fixed orthodontic (ceramic) 69,000 69,000 69,000 69,000 69,000 DEN03005 Upper/lower removable appliance (first visit) 2,880 2,880 2,880 2,880 2,880 DEN03006 Upper/lower removable appliance (subsequent 1,150 1,150 1,150 1,150 1,150 visit) DEN03007 Myofunctional appliance (first visit) 3,450 3,450 3,450 3,450 3,450 DEN03008 Myofunctional appliance (subsequent visit) 2,300 2,300 2,300 2,300 2,300 DEN03009 Fixed orthodontic normal (first visit) 23,000 23,000 23,000 23,000 23,000 DEN03010 Fixed orthodontic normal/ceramic (subsequent 5,750 5,750 5,750 5,750 5,750 visit) DEN03011 Fixed orthodontic ceramic (first visit) 34,500 34,500 34,500 34,500 34,500 DEN03012 Lingual fixed orthodontic treatment (each 28,750 28,750 28,750 28,750 28,750 installment total 4) DEN03013 Retainer upper/lower 6,900 6,900 6,900 6,900 6,900 DEN03014 Fixed orthodontic treatment with retainer (first 8,050 8,050 8,050 8,050 8,050 visit) DEN03015 Fixed orthodontic treatment with retainer 5,750 5,750 5,750 5,750 5,750 (subsequent visit) DEN03016 Appliance 1,150 1,150 1,150 1,150 1,150 DEN03017 Retainer fixed upper/lower 8,050 8,050 8,050 8,050 8,050 DEN03018 Invisible aligners (each installment:total 5) 36,800 36,800 36,800 36,800 36,800 DEN03019 Fixed orthodontic normal/ceramic (each 11,500 11,500 11,500 11,500 11,500 installment)
3. PERIODONTICS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DEN04001 Gingivectomy (per segment) 5,750 5,750 5,750 5,750 5,750 DEN04003 Flap surgery (per segment) 6,900 6,900 6,900 6,900 6,900
29 DEN04007 Frenectomy 3,450 3,450 3,450 3,450 3,450 DEN04012 Currettage (per segment) 4,600 4,600 4,600 4,600 4,600 DEN04013 Bone graft (per tooth) 11,500 11,500 11,500 11,500 11,500
4. PROSTHODONTICS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DEN02001 Dowel crown 2,880 2,880 2,880 2,880 2,880 DEN02002 Crome cobalt crown 2,070 2,070 2,070 2,070 2,070 DEN02003 Complete denture (upper and lower) 14,380 14,380 14,380 14,380 14,380 DEN02004 Complete denture lucitone (upper and lower) 19,550 19,550 19,550 19,550 19,550 DEN02005 Complete denture single acrylic (upper/lower) 8,050 8,050 8,050 8,050 8,050 DEN02006 Complete denture single lucitone (upper/lower) 9,200 9,200 9,200 9,200 9,200 DEN02009 Temporary crown 1,150 1,150 1,150 1,150 1,150 DEN02011 Denture repair 810 810 810 810 810 DEN02013 Metal with soft ceramic (per unit) 6,330 6,330 6,330 6,330 6,330 DEN02014 Metal crown (per unit) 4,030 4,030 4,030 4,030 4,030 DEN02015 Metal ceramic crown (per unit) 8,630 8,630 8,630 8,630 8,630 DEN02016 Cast partial denture unilateral (upper/lower) 11,500 11,500 11,500 11,500 11,500 DEN02017 Partial denture acrylic (upper/lower) (cost of 3,450 3,450 3,450 3,450 3,450 tooth extra) DEN02018 Tooth for partial denture acrylic (single) 920 920 920 920 920 DEN02019 Cast partial denture bilateral (upper/lower) 11,500 11,500 11,500 11,500 11,500 DEN02020 Metal free ceramic (per unit) 12,650 12,650 12,650 12,650 12,650 DEN02021 Precious metal crown (per unit) 18,400 18,400 18,400 18,400 18,400 DEN02022 Ceramic laminates/veneers 5,750 5,750 5,750 5,750 5,750 DEN02023 Cold cure crown acrylic (per tooth) 290 290 290 290 290 DEN02024 Heat cure crown acrylic (per tooth) 520 520 520 520 520 DEN02025 Flexi denture unilateral (upper/lower) 8,050 8,050 8,050 8,050 8,050 DEN02026 Flexi denture bilateral (upper/lower) 12,650 12,650 12,650 12,650 12,650 DEN02031 Additional tooth for dental implant (per tooth) 3,220 3,220 3,220 3,220 3,220 DEN02032 Sinus shift (dental implant) 23,000 23,000 23,000 23,000 23,000 DEN02033 Single prefabricated metal post and core (crown 2,300 2,300 2,300 2,300 2,300 cost extra) DEN02034 Single fibre post and core (crown cost extra) 2,300 2,300 2,300 2,300 2,300 DEN02035 Inceram 11,500 11,500 11,500 11,500 11,500 DEN02036 Bite plate 5,180 5,180 5,180 5,180 5,180 DEN02037 Dental implant 51,750 51,750 51,750 51,750 51,750
5. ORAL SURGERY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DEN05001 Impactions 8,630 8,630 8,630 8,630 8,630 DEN05002 Fracture closed reduction 16,100 16,100 16,100 16,100 16,100 DEN05003 Fracture open reduction 23,000 23,000 23,000 23,000 23,000 DEN05004 Sialoithotomy 6,900 6,900 6,900 6,900 6,900 DEN05005 Cystectomy 6,900 6,900 6,900 6,900 6,900 DEN05006 Apicoectomy 6,900 6,900 6,900 6,900 6,900 DEN05007 Dentoalveolar fracture 9,200 9,200 9,200 9,200 9,200 DEN05008 Frenectomy (lingual) 6,900 6,900 6,900 6,900 6,900 DEN05009 Extraction of impacted tooth 16,100 16,100 16,100 16,100 16,100 DEN05010 TM joint ankylosis (bilateral) 28,750 28,750 28,750 28,750 28,750 DEN05012 Third molar extraction 3,450 3,450 3,450 3,450 3,450 DEN05013 Surgical impaction 6,900 6,900 6,900 6,900 6,900 DEN05014 Reduction of TMJ 8,630 8,630 8,630 8,630 8,630 DEN05015 Inter maxillary fixation 13,800 13,800 13,800 13,800 13,800 DEN05016 Extraction of decayed root/root stump 3,170 3,170 3,170 3,170 3,170
B4: DIABETIC FOOT CARE CENTRE
1. OP PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DFC01001 Comprehensive foot care 1,150 1,150 1,150 1,150 1,150 DFC01002 Nail care (pairing of toe nails etc) 1,150 1,150 1,150 1,150 1,150 DFC01003 Cronic cracks and fissure of sole 1,380 1,380 1,380 1,380 1,380 DFC01004 Silicon/sculptra injection for R/C callus 1,150 1,150 1,150 1,150 1,150 DFC01005 Anesthetic injection for painful metatarsal 3,450 3,450 3,450 3,450 3,450 ganglion
30 DFC01006 Callus removal (per callus) 810 810 810 810 810 DFC01007 Callus removal (multiple) 1,730 1,730 1,730 1,730 1,730 DFC01008 Onychogryphosis (per nail) 1,150 1,150 1,150 1,150 1,150 DFC01009 Dressing of foot ulcer (minor) 1,440 1,440 1,440 1,440 1,440 DFC01010 Dressing of foot ulcer (major) 2,590 2,590 2,590 2,590 2,590 DFC01011 Dressing of foot ulcer (very major) 3,170 3,170 3,170 3,170 3,170 DFC01012 Foot ulcer debridement (small) 1,150 1,150 1,150 1,150 1,150 DFC01013 Foot ulcer debridement (medium) 2,020 2,020 2,020 2,020 2,020 DFC01014 Foot ulcer debridement (large) 2,880 2,880 2,880 2,880 2,880
2. INVESTIGATIONS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DFC01015 VPT 870 870 870 870 870 DFC01016 Peak planter pressure by Harris Met 350 350 350 350 350 DFC01017 ABI (Ankle brachial index) 1,150 1,150 1,150 1,150 1,150
3. MINOR OT PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) DFC01018 Nail removal under local anaesthesia 5,180 5,180 5,180 5,180 5,180 DFC01019 Ingrown toe nail under local anaesthesia 5,750 5,750 5,750 5,750 5,750
B5: EAR, NOSE AND THROAT
1. EAR SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ENT03015 Wax removal 1,380 1,380 1,380 1,380 1,380 ENT03016 Incision and drainage abscess 5,180 5,180 5,180 5,180 5,180 ENT03017 Examination under microscope (EUM) 2,590 2,590 2,590 2,590 2,590 ENT03018 Ear lobule repair (unilateral) 2,880 2,880 2,880 2,880 2,880 ENT03019 Ear lobule repair (bilateral) 4,600 4,600 4,600 4,600 4,600 ENT03020 Aural polypectomy 5,470 5,470 5,470 5,470 5,470 ENT03024 Ear piercing 1,150 1,150 1,150 1,150 1,150
2. ENDOSCOPY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ENT01013 Nasal endoscopy 2,530 2,530 2,530 2,530 2,530 ENT01014 Flexible laryngoscopy 2,300 2,300 2,300 2,300 2,300 ENT03005 Fibroptic laryngoscopy 3,220 3,220 3,220 3,220 3,220 ENT03034 Diagnostic endoscopy 1,440 1,440 1,440 1,440 1,440
3. GENERAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ENT01001 Foreign body removal 4,600 4,600 4,600 4,600 4,600 ENT01004 Wax removal/syringing (unilateral) 1,150 1,150 1,150 1,150 1,150 ENT01005 Ear dressing 870 870 870 870 870 ENT01006 Suction clearence 920 920 920 920 920 ENT01007 Intra nasal injection 1,150 1,150 1,150 1,150 1,150 ENT01008 Chemical cauterization 1,380 1,380 1,380 1,380 1,380 ENT01010 Injection nose/oral cavity/ear 1,150 1,150 1,150 1,150 1,150 ENT01011 Intra lesional injection oral, palate, nose 1,150 1,150 1,150 1,150 1,150 ENT01012 Epley’s maneuver 2,300 2,300 2,300 2,300 2,300 ENT01015 Wax removal/syringing (bilateral) 1,500 1,500 1,500 1,500 1,500 ENT01016 I and D 2,300 2,300 2,300 2,300 2,300 ENT01017 Tracheostomy tube/decanulation 1,730 1,730 1,730 1,730 1,730 ENT01018 Dressing 920 920 920 920 920 ENT03022 Small keloid/cyst/warts 2,530 2,530 2,530 2,530 2,530 ENT03023 Stitching 1,730 1,730 1,730 1,730 1,730 ENT03035 Intratympanic injection 2,300 2,300 2,300 2,300 2,300 ENT03037 Suture Removal 690 690 690 690 690
4. NOSE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ENT03006 Nasal pack removal 2,590 2,590 2,590 2,590 2,590 ENT03007 Incision and drainage ENT abscess 3,680 3,680 3,680 3,680 3,680 ENT03008 Diathermy 3,680 3,680 3,680 3,680 3,680 ENT03009 Rhinoscopy 1,960 1,960 1,960 1,960 1,960
31 ENT03011 Synechia release 2,300 2,300 2,300 2,300 2,300 ENT03012 Reduction of nasal bone 3,450 3,450 3,450 3,450 3,450 ENT03013 Nasal packing (merocoele) 2,880 2,880 2,880 2,880 2,880 ENT03014 Punch biopsy nose/oral cavity 3,450 3,450 3,450 3,450 3,450 ENT03036 Ant basal packing 3,740 3,740 3,740 3,740 3,740
5. THROAT SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ENT03001 Quinsy (incision and drainage) 5,750 5,750 5,750 5,750 5,750 ENT03002 Stone removal from submandibular duct 3,680 3,680 3,680 3,680 3,680 ENT03003 Biopsy (cheek/tongue/gingival) 3,450 3,450 3,450 3,450 3,450 ENT03004 Release of tongue tie under LA 4,030 4,030 4,030 4,030 4,030
B6: GASTROENTEROLOGY
1. GENERAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) GST01001 Colonoscopy (total) 8,630 9,660 10,870 12,080 21,140 GST01003 Colonoscopy (left sided) 5,750 6,440 7,250 8,050 14,090 GST01004 Endoscopy side viewing 5,750 6,440 7,250 8,050 14,090 GST01005 Foreign body removal upper GIT 9,200 10,310 11,600 12,880 22,540 GST01007 Endoscopic variceal ligation 9,200 10,310 11,600 12,880 22,540 GST01010 Fundal varices injection 8,050 9,020 10,150 11,270 19,730 GST01011 Lower GI sigmoidoscopy 4,030 4,510 5,080 5,640 9,870 GST01012 Placement of sengstkein blackmore tube 4,600 5,160 5,800 6,440 11,270 GST01013 Endo placement of ryle’s tube 5,750 6,440 7,250 8,050 14,090 GST01014 PEG (cost of sb set extra) 10,350 11,600 13,050 14,490 25,360 GST01015 Polypectomy (single) 12,650 14,170 15,940 17,710 31,000 GST01016 Polypectomy (multiple) 13,800 15,460 17,390 19,320 33,810 GST01017 Proctoscopy 1,150 1,290 1,450 1,610 2,820 GST01019 Sclerotherapy 8,630 9,660 10,870 12,080 21,140 GST01021 Upper GI endoscopy 5,750 6,440 7,250 8,050 14,090 GST01025 ERCP+mechanical lithotripsy 23,000 25,760 28,980 32,200 56,350 GST01028 Rapid urease test 580 650 730 810 1,410 GST01029 Stent removal 6,900 7,730 8,700 9,660 16,910 GST01030 Endoscopic naso jejunal tube placement 6,900 7,730 8,700 9,660 16,910 GST01031 Argon plasma coagulation 9,200 10,310 11,600 12,880 22,540 GST01032 Asitic tap 5,750 6,440 7,250 8,050 14,090
2. DAYCARE AND CONSUMABLE PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) GST02001* ERCP+naso biliary tube (tube extra) 20,130 28,180 28,180 28,180 28,180 GST02002* ERCP+pappilotomy 16,100 22,540 22,540 22,540 22,540 GST02003* ERCP+stenting (stent cost extra) 17,250 24,150 24,150 24,150 24,150 GST02004* ERCP diagnostic 10,350 14,490 14,490 14,490 14,490 GST02005* Oesophageal pneumatic dilation 9,200 12,880 12,880 12,880 12,880 GST02006* Oesophageal stenting 10,350 14,490 14,490 14,490 14,490 GST02007* Pyloric balloon dilatation 9,200 12,880 12,880 12,880 12,880 GST02008* Achalasia cardia 10,350 14,490 14,490 14,490 14,490 GST02009* Equipment charges for package 1,150 1,610 1,610 1,610 1,610 GST02010* Sedation package 210 290 290 290 290 GST02011* Consumable package 140 200 200 200 200 GST02012* Stone extraction 4,600 6,440 6,440 6,440 6,440 GST02013* Stone crusher 4,600 6,440 6,440 6,440 6,440 GST02014* Pappilotomy 4,600 6,440 6,440 6,440 6,440 GST02015* Stenting (stent cost extra) 4,600 6,440 6,440 6,440 6,440
Guidelines for Daycare and consumable packages: a) Package charges do not vary across bed categories. b) Package includes: i) OT charges ii) Recovery room charges iii) Surgeon fee iv) Routine consumables (inj buscopan, guidewire, ERCP cannula, balloons and sphincterotome). c) Package excludes: i) Medicines, contrast, IV fluid and investigations ii) Special consumables (stent, variceal ligator set, PEG set, naso billiary drain, endosopic-clipping device, scelerotherapy injector needle, etc.) iii) Equipment charges for package iv) Anesthesia charges (if required).
32 4. GASTRIC BALLOON PACKAGE AND PROCEDURE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) GST05001* Gastric balloon package 126,500 177,100 177,100 177,100 177,100 GST05002* Endoscopic placement or removal of balloon 28,750 40,250 40,250 40,250 40,250
Guidelines for gastric balloon package and procedure section: a) Gastric balloon package charge includes: cost of balloon + cost of placement + daycare. If removal of gastric balloon is required then it will be charged separately. b) Services will be provided in daycare, and overnight stay will be charged separately. c) Base price of Gastric balloon package is Rs. 160,000
5. CAPSULE ENDOSCOPY PACKAGE AND PROCEDURE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) GST06001* Capsule endoscopy package 54,630 76,480 76,480 76,480 76,480 GST06002* Capsule endoscopy reading 20,130 28,180 28,180 28,180 28,180
Guidelines for capsule endoscopy package and procedure section: a) Capsule Endoscopy package charge includes: reading CD + cost of capsule + rental of wearable device. b) Services will be provided in daycare, and overnight stay will be charged separately. c) Base price of Capsule endoscopy package is Rs. 65,000
6. ERCP PROCEDURES PERFORMED IN OT
6.1 ERCP PROCEDURES PERFORMED IN OT WITHOUT ANAESTHESIA SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) GST08001* ERCP diagnostic -- 18,400 18,400 18,400 18,400 GST08002* ERCP therapeutic + papillotomy/stone removal -- 23,000 23,000 23,000 23,000 GST08003* ERCP therapeutic + papillotomy/stone removal + -- 28,750 28,750 28,750 28,750 stenting (stent cost extra)
6.2 ERCP PROCEDURES PERFORMED IN OT WITH STANDBY ANAESTHESIA SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) GST08004* ERCP diagnostic -- 19,320 19,320 19,320 19,320 GST08005* ERCP therapeutic + papillotomy/stone removal -- 24,290 24,290 24,290 24,290 GST08006* ERCP therapeutic + papillotomy/stone removal + -- 30,500 30,500 30,500 30,500 stenting (stent cost extra)
6.3 ERCP PROCEDURES PERFORMED IN OT WITH GENERAL ANAESTHESIA SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) GST08007* ERCP diagnostic -- 19,780 19,780 19,780 19,780 GST08008* ERCP therapeutic + papillotomy/stone removal -- 24,940 24,940 24,940 24,940 GST08009* ERCP therapeutic + papillotomy/stone removal + -- 31,380 31,380 31,380 31,380 stenting (stent cost extra)
Guidelines for ERCP procedures performed in OT: a) Package includes: Daycare charges ( Packages to be billed in daycare only), OT charges, Recovery room charges, Gastroenterologist fee, OT equipment charges, Anesthesia charges (if required), Consumables and accessories: Guidewire (1 nos.), ERCP cannula (1 nos.), Balloons (1 nos.), Sphincterome (1 nos.), Stent pusher (plastic (1 nos.), ERCP knife (1 nos.). b) Package excludes: Medicines, contrast, other consumables and investigations. c) Pharmacy will be billed as per actual.
B7: OPHTHALMOLOGY
1. OPHTHALMIC LAB
1.1 ARGON LASER SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01020 Laser-alttp (glaucoma) (per eye) 5,180 5,180 5,180 5,180 5,180 OPH01021 Laser-argon (per sitting) 4,030 4,030 4,030 4,030 4,030 OPH01023 Pan retinal photocoagulation (per eye) 11,500 11,500 11,500 11,500 11,500 OPH01039 Prophylactic laser for retinal breaks (per eye) 8,050 8,050 8,050 8,050 8,050 OPH01040 Prophylactic laser for ROP (per eye) 12,650 12,650 12,650 12,650 12,650 OPH01072 Rentinopathy of prematurity (package upto 23,000 23,000 23,000 23,000 23,000 maximum 3 sittings both eye laser)
33 1.2 FLUORESCEIN SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01018 Fluorescein angiography 3,740 3,740 3,740 3,740 3,740 OPH01019 Fluorescein angioscopy 1,730 1,730 1,730 1,730 1,730 OPH01041 Iris angiography 1,730 1,730 1,730 1,730 1,730 OPH01042 Fundus photos 1,730 1,730 1,730 1,730 1,730
1.3 GLAUCOMA SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01013 Glaucoma water drinking test 920 920 920 920 920 OPH01014 Glaucoma diurnal variation 1,730 1,730 1,730 1,730 1,730 OPH01026 Gonioscopy (both eyes) 690 690 690 690 690 OPH01033 Provocative glaucoma test 580 580 580 580 580 OPH01044 Field analysis (glaucoma) 1,730 1,730 1,730 1,730 1,730 OPH01045 Field analysis (full field) 2,300 2,300 2,300 2,300 2,300 OPH01051 Glaucoma screening (without field analysis) 1,150 1,150 1,150 1,150 1,150 OPH01052 Glaucoma screening (with field analysis) 2,300 2,300 2,300 2,300 2,300 OPH01057 Tonometery 410 410 410 410 410
1.4 REFRACTION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01024 Indirect ophthalmoscopy 520 520 520 520 520 OPH01027 3 mirror examination 580 580 580 580 580 OPH01029 Post mydriatic test 520 520 520 520 520 OPH01047 Keratometry 1,150 1,150 1,150 1,150 1,150 OPH01050 Pachymetry (per eye) 1,440 1,440 1,440 1,440 1,440 OPH01056 Fundus examination 870 870 870 870 870
1.5 ULTRASOUND SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01015 Ultrasound (A scan) 1,040 1,040 1,040 1,040 1,040 OPH01059 Ultrasound (B scan) 1,730 1,730 1,730 1,730 1,730 OPH01070 Optical coherence tomography 3,450 3,450 3,450 3,450 3,450
1.6 YAG SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01034 Yag capsulotomy 3,740 3,740 3,740 3,740 3,740 OPH01035 Yag iridotomy 4,320 4,320 4,320 4,320 4,320 OPH01036 Yag trabeculoplasty 4,600 4,600 4,600 4,600 4,600 OPH01037 Yag membranectomy 4,600 4,600 4,600 4,600 4,600 OPH01038 Yag vitreolysis 4,600 4,600 4,600 4,600 4,600
2. PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01009 Concretion removal 350 350 350 350 350 OPH01010 Follicle extraction 460 460 460 460 460 OPH01011 Corneal foreign body (deep) 1,150 1,150 1,150 1,150 1,150 OPH01012 Corneal scrapping 580 580 580 580 580 OPH01025 Suture removal 870 870 870 870 870 OPH01028 Aberrant cilia removal 350 350 350 350 350 OPH01030 Lac sac investigation (each eye) 580 580 580 580 580 OPH01031 Schirmer's test 460 460 460 460 460 OPH01032 Sub conjunctival injection 580 580 580 580 580 OPH01043 Suture removal (multiple) 2,300 2,300 2,300 2,300 2,300 OPH01046 Corneal foreign body (superficial) 690 690 690 690 690 OPH01054 Lid repair (minor) 11,500 11,500 11,500 11,500 11,500 OPH01055 Lid repair (major) 17,250 17,250 17,250 17,250 17,250 OPH01058 Chalazion excision 3,450 3,450 3,450 3,450 3,450
3. OTHERS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01002 Contact lens (hard) 870 870 870 870 870 OPH01003 Contact lens (gas permeable) 1,730 1,730 1,730 1,730 1,730 OPH01004 Contact lens (soft) 1,730 1,730 1,730 1,730 1,730
34 4. PROCEDURES DONE BY TECHNICIAN SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPH01001 Refraction 350 350 350 350 350 OPH01053 Refraction without dilatation 230 230 230 230 230 OPH01005 Orthoptic check 350 350 350 350 350 OPH01006 Orthoptic exercises 1,150 1,150 1,150 1,150 1,150
B8: PHYSIOTHERAPY
1. CONSULTATION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01032 Physiotherapy consultation 575-1,150 720-1,440 720-1,440 720-1,440 1,260-2,530 PHY01043 Physiotherapy consultation for referred patient 460-1,150 575-1,440 575-1,440 575-1,440 1,010-2,530
2. ELECTRO THERAPY
2.1 HEATING SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01003 Infra red rays 410 510 510 510 890 PHY01005 Short wave diathermy 410 510 510 510 890 PHY01006 Parafin wax bath 410 510 510 510 890 PHY01031 Cold packs 350 440 440 440 760 PHY01046 UVR 350 440 440 440 760 PHY01047 Hydrocullator pack 350 440 440 440 760
2.2 JOINTS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01049 CPM 350 440 440 440 760
2.3 LASER SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01058 Laser therapy 520 650 650 650 1,140
2.4 MUSCLE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01004 Muscle stimulator 410 510 510 510 890 PHY01048 Relaxation therapy 410 510 510 510 890 PHY01059 Interferential therapy (IFT) 460 580 580 580 1,010 PHY01060 Transcutaneous electrical nerve 460 580 580 580 1,010 stimulation (TENS) 2.5 NEUROLOGY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01025 Tilt table standing 410 510 510 510 890
2.6 SPINE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01001 Cervical traction 460 580 580 580 1,010 PHY01002 Lumbar traction 460 580 580 580 1,010
2.7 ULTRASOUND SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01007 Ultrasound 350 440 440 440 760
3. EXERCISE THERAPY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01008 Remedial exercise (extensive) 810 1,010 1,010 1,010 1,770 PHY01009 Antenatal/postnatal exercise 810 1,010 1,010 1,010 1,770 PHY01011 Remedial exercise (mild) 580 720 720 720 1,260 PHY01018 Upper limb/lower limb exercise program 750 940 940 940 1,640
35 PHY01020 Spine exercise 750 940 940 940 1,640 PHY01023 Post operative nerve injury program 750 940 940 940 1,640 PHY01027 Post operative program 750 940 940 940 1,640 PHY01042 Antenatal care program (single session) 750 940 940 940 1,640 PHY01044 Postnatal physiotherapy program (per visit) 750 940 940 940 1,640 PHY01045 Manual muscle testing 750 940 940 940 1,640 PHY01055 Post operative gynae program 750 940 940 940 1,640 PHY01056 ICU patient physiotherapy 690 870 870 870 1,510 PHY01057 CVA patient physiotherapy 690 870 870 870 1,510
4. PHYSIOTHERAPY PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01012 Charitable physio program (6 sessions) 690 870 870 870 1,510 PHY01041 Antenatal care program (5 sessions) 3,450 4,320 4,320 4,320 7,550 PHY01050 Package module 1 (10 days) 5,750 7,190 7,190 7,190 12,580 PHY01051 Package module 2 (7 days) 4,030 5,040 5,040 5,040 8,810 PHY01052 Package module 3 (5 days) 2,880 3,600 3,600 3,600 6,290
5. PHYSIOTHERAPY REHABILITATION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PHY01014 Paediatrics rehabilitation 690 870 870 870 1,510 PHY01016 Gait re-education 690 870 870 870 1,510 PHY01017 Cardiopulmonary rehabilitation 690 870 870 870 1,510 PHY01022 Orthopaedic rehabilitation 690 870 870 870 1,510 PHY01026 Neurological rehabilitation 690 870 870 870 1,510
B9: SPEECH AND HEARING CLINIC
1. AUDIOMETRY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SHC01001 Pure tone audiometry 810 810 810 810 810 SHC01002 Conditioned audiometry 870 870 870 870 870 SHC01003 Free field audiometry 810 810 810 810 810 SHC01004 Speech audiometry 810 810 810 810 810 SHC01005 Bekesy audiometry 810 810 810 810 810 SHC01006 Impedence 870 870 870 870 870 SHC01007 TDT 810 810 810 810 810 SHC01008 ABLB 810 810 810 810 810 SHC01009 SISI 810 810 810 810 810 SHC01010 Speech assessment 810 810 810 810 810 SHC01011 Tinnitus matching 810 810 810 810 810
2. ELECTOPHYSIOLOGY STUDIES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SHC01012 OAE (screening) 1,150 1,150 1,150 1,150 1,150 SHC01013 OAE (diagnostic) 1,500 1,500 1,500 1,500 1,500 SHC01014 Universal new born screening 1,150 1,150 1,150 1,150 1,150 SHC01015 BERA 3,450 3,450 3,450 3,450 3,450 SHC01016 Bone conductuion BERA 3,450 3,450 3,450 3,450 3,450 SHC01017 Stacked BERA 3,450 3,450 3,450 3,450 3,450 SHC01018 ASSR 4,600 4,600 4,600 4,600 4,600 SHC01019 Aided ASSR 4,600 4,600 4,600 4,600 4,600 SHC01020 BERA+ASSR 4,600 4,600 4,600 4,600 4,600 SHC01021 OAE+BERA+ASSR 6,900 6,900 6,900 6,900 6,900 SHC01022 EABR (post CI) 6,330 6,330 6,330 6,330 6,330 SHC01023 AMLR and cortical AEP 3,450 3,450 3,450 3,450 3,450 SHC01024 VEMP 3,450 3,450 3,450 3,450 3,450 SHC01025 ECochG 1,730 1,730 1,730 1,730 1,730 SHC01026 Spin 580 580 580 580 580 SHC01027 MLB 580 580 580 580 580 SHC01028 MLD 580 580 580 580 580 SHC01029 DDT 580 580 580 580 580 SHC01030 RDT 580 580 580 580 580 SHC01031 ETF 580 580 580 580 580
36 SHC01032 STAT 580 580 580 580 580 SHC01033 ARLT 580 580 580 580 580
3. COCHLEAR IMPLANT RELATED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SHC01034 Cochlear implant mapping 2,300 2,300 2,300 2,300 2,300 SHC01035 Speech therapy package+mapping (12 sessions) 6,900 6,900 6,900 6,900 6,900
4. SPEECH REHABILITATION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SHC01036 Consultation by speech therapist 750 750 750 750 750 SHC01037 Speech therapy 750 750 750 750 750 SHC01038 Speech therapy (12 sessions) 8,050 8,050 8,050 8,050 8,050 SHC01039 APD informal screening 460 460 460 460 460
5. HEARING AID RELATED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SHC01040 Hearing aid trial 810 810 810 810 810
B10: WOMEN'S CLINIC
1. VIDEO COLPOSCOPY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WHC01001 Video colposcopy 5,750 5,750 5,750 5,750 5,750 WHC01002 Video colposcopy (directed biopsy) 8,630 8,630 8,630 8,630 8,630 WHC01003 Video colposcopy+biopsy+cryo 9,200 9,200 9,200 9,200 9,200 WHC01004 Video colposcopy directed 9,200 9,200 9,200 9,200 9,200 biopsy+cryo+endometrial biopsy
2. BIOPSIES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WHC01005 Cervical biopsy 4,890 4,890 4,890 4,890 4,890 WHC01006 Endometrial biopsy 4,890 4,890 4,890 4,890 4,890
3. OTHERS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WHC01007 Cryo 5,750 5,750 5,750 5,750 5,750 WHC01009 Evacuation without GA 5,750 5,750 5,750 5,750 5,750 WHC01010 Hydrotubation 1,730 1,730 1,730 1,730 1,730 WHC01011 Intra uterine contraceptive device insertion 2,880 2,880 2,880 2,880 2,880 WHC01013 Merina insertion 2,880 2,880 2,880 2,880 2,880 WHC01014 Resuturing 2,300 2,300 2,300 2,300 2,300 WHC01015 Resuturing under LA 3,450 3,450 3,450 3,450 3,450 WHC01016 Intra uterine contraceptive device removal 2,880 2,880 2,880 2,880 2,880
B11: MISCELLANEOUS OP PROCEDURES
1. DRESSINGS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPD01007 Dressing (small) 370 370 370 370 370 OPD01018 Dressing (special) 2,590 2,590 2,590 2,590 2,590 OPD01019 Dressing (very large) 2,070 2,070 2,070 2,070 2,070 OPD01020 Dressing (large) 1,440 1,440 1,440 1,440 1,440 OPD01021 Dressing (medium) 750 750 750 750 750 OPD01022 Dressing material charges (small) 180 180 180 180 180 OPD01023 Dressing material charges (large) 350 350 350 350 350 OPD01024 Dressing material charges (very large) 580 580 580 580 580 OPD01025 Dressing material charges (medium) 230 230 230 230 230
2. INJECTION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPD01003 Intravenous infusion charges (first bottle) 180 180 180 180 180 OPD01004 Intravenous infusion charges (subsequent bottle) 180 180 180 180 180 OPD01068 Injection administration charges 120 120 120 120 120
37 3. PREVENTIVE HEART PROGRAM SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPD02001 PHP consultation (per session) 2,300 2,300 2,300 2,300 2,300
4. FAT ANALYSIS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPD08894 Body fat analysis 920 920 920 920 920
5. RESPIRATORY MEDICINE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) OPD03001 Bronchoscopy 6,900 6,900 6,900 6,900 6,900
B12: ENDOSCOPIC ULTRASOUND
1. GENERAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) EUS01001 Endoscopic Ultrasound diagnostic 11,500 16,100 16,100 16,100 17,710
2. GASTROENTEROLOGY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) EUS01002 Endoscopic Ultrasound guided Fine Needle 28,750 40,250 40,250 40,250 44,280 Aspiration (EUS-FNA) EUS01003 EUS guided Celiac Block 31,050 43,470 43,470 43,470 47,820
3. RESPIRATORY MEDICINE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) EUS01004 Endobronchial Ultrasound guided Fine Needle 28,750 40,250 40,250 40,250 44,280 Aspiration (EBUS-FNA)
4. EUS CONSUMABLES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) EUS01005* FNA needle (per procedure) 12,650 12,650 12,650 12,650 12,650
38 MOOLCHAND SCHEDULE OF CHARGES 2019
SECTION C: INPATIENT PROCEDURES
C1: CRITICAL CARE
1. GENERAL SERVICES
1.1 CONSULTATION SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01095 Intensivist visit (per day) 1,000-2,000 1,200-2,400 1,500-2,500 2,200-3,000
1.2 DRESSING MATERIAL/CONSUMABLES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01071* Dressing material (small) 180 180 180 180 ICU01072* Dressing material (medium) 230 230 230 230 ICU01073* Dressing material (large) 350 350 350 350 ICU01074* Dressing material (very large) 580 580 580 580 ICU01090* Dressing material (special) 1,150 1,150 1,150 1,150
1.3 DRESSINGS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01064 Dressing (small) 330 370 460 810 ICU01065 Dressing (medium) 690 790 980 1,720 ICU01114 Dressing (large) 1,610 1,840 2,300 4,030 ICU01115 Dressing (very large) 2,620 2,990 3,740 6,550 ICU01113 Dressing (special) 3,220 3,680 4,600 8,050
1.4 EQUIPMENT AND MONITORING SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01040* Alpha bed charges 580 580 580 580 ICU01042* ECG continuous recording (ICCU/CCU) 1,270 1,270 1,270 1,270 ICU01048* Humidification 460 460 460 460 ICU01093* ABP (per day) 690 690 690 690 ICU01097* DVT pump 1,150 1,150 1,150 1,150 ICU01098* ETCO2 monitoring 290 290 290 290 ICU01144* IV cannulation 1,440 1,440 1,440 1,440 ICU01145* IV Infusion (first) 230 230 230 230 ICU01146* IV Infusion (second) 230 230 230 230 ICU01150* D.C. shock 2,300 2,300 2,300 2,300
1.5 INVESTIGATIONS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01009* ECG 580 580 580 580 ICU01058* Blood glucose test 230 230 230 230 ICU01079* Infusion pump 690 690 690 690 ICU01094 Troponin I 1,700 1,940 2,420 4,230 ICU01096 Critical ultrasound screening 1,210 1,380 1,730 3,020 ICU01143* Arterial blood gases 870 870 870 870
1.6 VENTILATION/BIPAP CHARGES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01117* Intiation of ventilation 3,450 3,450 3,450 3,450 ICU01062* Ventilator charges (per day) 2,880 2,880 2,880 2,880
39 ICU01120* Ventilator care charges (per day) 980 980 980 980 ICU01080* Weaning from ventilation 750 750 750 750 ICU01118* Intiation of bipap 1,380 1,380 1,380 1,380 ICU01063* Bipap ventilator charges (per day) 2,530 2,530 2,530 2,530
1.7 OTHER PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01149 Foley's catheter removal 250 280 350 610
2. INTENSIVIST SERVICES
2.1 CARDIAC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01129 Cardio version 2,420 2,760 3,450 6,040 ICU01137 Pericardial aspiration 6,440 7,360 9,200 16,100 ICU01138 Swan ganz catheter 4,030 4,600 5,750 10,070 ICU01128 Temporary pacing 8,050 9,200 11,500 20,130 ICU01097 Thrombolysis 5,080 5,800 7,250 12,680
2.2 ENT SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01078 Nasal pack removal 2,820 3,220 4,030 7,050 ICU01090 Percutaneous tracheostomy 8,050 9,200 11,500 20,130 ICU01102 Tracheostomy tube change/decannulation 1,610 1,840 2,300 4,030
2.3 GENERAL SURGERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01093 Ascitic tap diagnostic/abdomen 2,620 2,990 3,740 6,550 ICU01136 Ascitic tap therapeutic 5,240 5,980 7,480 13,090 ICU01023 Fine needle aspiration cystology 1,410 1,610 2,020 3,530 ICU01100 Intercostal drainage 8,050 9,200 11,500 20,130 ICU01091 Pleural tap diagnostic 2,820 3,220 4,030 7,050 ICU01092 Pleural tap therapeutic 6,040 6,900 8,630 15,100 ICU01011 Venesection 4,030 4,600 5,750 10,070
2.4 OTHER PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01002 Arterial line 2,020 2,300 2,880 5,040 ICU01081 Adult sedation 1,210 1,380 1,730 3,020 ICU01069 Bowel wash 810 920 1,150 2,020 ICU01124 Central venous line 4,030 4,600 5,750 10,070 ICU01077 Difficult IV line 530 600 750 1,310 ICU01070 Gastric lavage 2,820 3,220 4,030 7,050 ICU01005 Endotracheal intubation 1,610 1,840 2,300 4,030 ICU01099 Injection epidural 4,030 4,600 5,750 10,070 ICU01101 Laryngoscopy 6,040 6,900 8,630 15,100 ICU01125 Lumber puncture 3,430 3,910 4,890 8,560 ICU01010* Nebulisation 460 460 460 460 ICU01068 PC enema 810 920 1,150 2,020 ICU01075 Resuscitation charges 5,240 5,980 7,480 13,090 ICU01076 Ryles tube insertion 810 920 1,150 2,020 ICU01127 Suturing of small wound 1,820 2,070 2,590 4,530 ICU01130 Suture removal 810 920 1,150 2,020 ICU01126 Urinary catherization 2,020 2,300 2,880 5,040
40 2.5 PLASTIC SURGERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01098 Burns dressing/SJS dressing 8,050 9,200 11,500 20,130
2.6 RESPIRATORY MEDICINE SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01123 Bronchoscopy intubation 6,040 6,900 8,630 15,100
3. SUPER SPECIALIST SERVICES
3.1 CARDIAC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01016 Pericardial aspiration 6,040 6,900 8,630 15,100 ICU01024 Swan ganz catheter 4,190 4,790 5,980 10,470 ICU01025 Thrombolysis 5,240 5,980 7,480 13,090 ICU01017 Temporary pacing 6,440 7,360 9,200 16,100 ICU01041 Cardio version 2,420 2,760 3,450 6,040
3.2 DRESSINGS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01050 Dressing (special) 3,220 3,680 4,600 8,050 ICU01066 Dressing (large) 1,610 1,840 2,300 4,030 ICU01067 Dressing (very large) 2,620 2,990 3,740 6,550
3.3 ENT SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01049 Anterior nasal packing 4,030 4,600 5,750 10,070 ICU01141 Foreign body removal ear/nose/throat 3,220 3,680 4,600 8,050 ICU01103 Ear dressing (small) 810 920 1,150 2,020 ICU01140 Epley’s manouvre 2,420 2,760 3,450 6,040 ICU01109 ENT dressing (large) 1,210 1,380 1,730 3,020 ICU01054 Laryngoscopy 5,240 5,980 7,480 13,090 ICU01105 Nasal endoscopy 2,420 2,760 3,450 6,040 ICU01110 Post nasal pack 4,830 5,520 6,900 12,080 ICU01055 Oesophagoscopy 10,070 11,500 14,380 25,160 ICU01107 Quinsy 4,030 4,600 5,750 10,070 ICU01111 Sub mend duct stone removal 4,030 4,600 5,750 10,070 ICU01104 Suction clearance 810 920 1,150 2,020 ICU01108 Tracheostomy tube change/decannulation 1,610 1,840 2,300 4,030 ICU01142 Wax removal 1,210 1,380 1,730 3,020
3.4 GASTROENTEROLOGY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01045 Colonoscopy (total) 8,460 9,660 12,080 21,140 ICU01046 EST (endoscopic sclero therapy) 9,660 11,040 13,800 24,150 ICU01047 EVL (endoscopic variceal ligation) 9,020 10,310 12,880 22,540 ICU01044 Limited colonoscopy 5,640 6,440 8,050 14,090 ICU01043 Oesophago gastro duodenoscopy 2,820 3,220 4,030 7,050 ICU01032 Sigmoidoscopy 4,030 4,600 5,750 10,070
3.5 GENERAL SURGERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01014 Ascitic tap diagnostic/abdomen 2,820 3,220 4,030 7,050 ICU01015 Ascitic tap therapeutic 5,640 6,440 8,050 14,090 ICU01019 Bone marrow biopsy 6,040 6,900 8,630 15,100 ICU01020 Bone marrow aspiration 4,030 4,600 5,750 10,070 ICU01006 Drainage of small abscess 3,630 4,140 5,180 9,060
41 ICU01052 Intercostal drainage 8,050 9,200 11,500 20,130 ICU01106 I and D 3,220 3,680 4,600 8,050 ICU01056 Muscle biopsy 4,030 4,600 5,750 10,070 ICU01012 Pleural tap diagnostic 3,220 3,680 4,600 8,050 ICU01013 Pleural tap therapeutic 6,040 6,900 8,630 15,100 ICU01026 Tracheostomy 14,090 16,100 20,130 35,220 ICU01083 Wound debridement 3,220 3,680 4,600 8,050
3.6 HEPATIC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01018 Liver biopsy/aspiration 4,830 5,520 6,900 12,080
3.7 NEUROLOGY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01027 Hydrocephalus drainage 1,940 2,210 2,760 4,830
3.8 OTHER PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01001 Central venous line 4,030 4,600 5,750 10,070 ICU01051 Injection epidural 4,030 4,600 5,750 10,070 ICU01003 Lumbar puncture 3,430 3,910 4,890 8,560 ICU01007 Suturing of small wound 1,820 2,070 2,590 4,530 ICU01088 Suture removal 810 920 1,150 2,020 ICU01004 Urinary catheterization 2,020 2,300 2,880 5,040
3.9 RENAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01139 CAVHD on CRRT machine 9,660 11,040 13,800 24,150 ICU01030 Kidney biopsy 6,040 6,900 8,630 15,100 ICU01021 Peritoneal dialysis 6,440 7,360 9,200 16,100 ICU01036 Vascular access (nephro) 4,830 5,520 6,900 12,080 ICU01147 Femoral dialysis catheter insertion 3,630 4,140 5,180 9,060 ICU01148 IJV (internal jugular vein) dialysis catheter 4,030 4,600 5,750 10,070 insertion
3.10 RESPIRATORY MEDICINE SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01031 Bronchoscopy 8,050 9,200 11,500 20,130 ICU01084 Bronchoscopy+biopsy/BAL 9,660 11,040 13,800 24,150 ICU01085 Bronchoscopy on ventilated patient 8,050 9,200 11,500 20,130 ICU01086 Bronchoscopy on tracheostomy tube 8,050 9,200 11,500 20,130 ICU01087 Pleurodesis 4,830 5,520 6,900 12,080
3.11 UROLOGY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01028 Suprapubic drainage 4,030 4,600 5,750 10,070 ICU01029 Urethral dilatation 5,640 6,440 8,050 14,090
3.12 ONCOLOGY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ICU01034 Chemotherapy induction 3,020 3,450 4,320 7,550
C2: NEONATOLOGY
1. EQUIPMENTS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NEO01001* Phototherapy (single) 1,150 1,150 1,150 1,150 NEO01002* Phototherapy (double) 1,150 1,150 1,150 1,150
42 NEO01003* Radiant warmer 690 690 690 690 NEO01004* Infant ventilator 2,880 2,880 2,880 2,880 NEO01005* Incubator 1,150 1,150 1,150 1,150 NEO01006* Pulse oximeter 690 690 690 690 NEO01007* Infusion pump 690 690 690 690 NEO01010* Vital sign monitor 810 810 810 810 NEO01011* Open care system 1,150 1,150 1,150 1,150 NEO01029* Nasal C-pap (bubble) (per day) 3,450 3,450 3,450 3,450 NEO01042* Neopuff resuscitator (per hour) 640 640 640 640
2. INVESTIGATIONS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NEO01015* ECG 410 410 410 410 NEO01017* Blood glucose test 180 180 180 180 NEO01040* T.C Bilurubin 580 580 580 580
3. MOTHER'S NEST PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NEO01008* Neonatal resuscitation charges 3,110 3,110 3,110 3,110
4. OTHER PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NEO01016* Nebulisation 350 350 350 350 NEO01009* Exchange transfusion 10,350 10,350 10,350 10,350 NEO01012* Paediatric central venous pressure line/arterial 3,450 3,450 3,450 3,450 line NEO01013* Lumber puncture 3,450 3,450 3,450 3,450 NEO01014* Intubation 1,610 1,610 1,610 1,610 NEO01018* Chest tube insertion 5,750 5,750 5,750 5,750 NEO01019* Intra ventricle tap 2,300 2,300 2,300 2,300 NEO01020* Pleural/ascetic tap 2,880 2,880 2,880 2,880 NEO01021* Suprapubic aspiration of urine 1,150 1,150 1,150 1,150 NEO01022* Surfactant administration 5,750 5,750 5,750 5,750 NEO01023* Paediatric sedation 2,300 2,300 2,300 2,300 NEO01025* Urinary catheterisation 1,380 1,380 1,380 1,380 NEO01026* Neonatal bowel wash 1,150 1,150 1,150 1,150 NEO01027* NG tube insertion 920 920 920 920 NEO01028* Ventilation 2,300 2,300 2,300 2,300 NEO01038* Difficult cannulisation 920 920 920 920 NEO01039* Arterial line 2,300 2,300 2,300 2,300 NEO01031* Ryles tube (paediatric) 1,150 1,150 1,150 1,150 NEO01032* Bone marrow aspiration 3,450 3,450 3,450 3,450 NEO01033* Bone marrow biopsy 4,600 4,600 4,600 4,600 NEO01034* Liver biopsy 5,180 5,180 5,180 5,180
5. VACCINATION SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NEO01024* Vaccination administration charges 120 120 120 120
C3: ROOM / WARD PROCEDURES
1. BED SIDE PROCEDURES
1.1 EAR NOSE AND THROAT SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD06005 ENT dressing (small) 810 920 1,150 2,020 WRD06006 Epley’s manouvre 2,420 2,760 3,450 6,040 WRD06009 Laryngoscopy 4,830 5,520 6,900 12,080
43 WRD06011 Nasal packing removal 2,020 2,300 2,880 5,040 WRD06012 Ryle’s tube insertion 810 920 1,150 2,020 WRD06013 Suction clearance 810 920 1,150 2,020 WRD06015 Wax removal (unilateral) 810 920 1,150 2,020 WRD06016 Post nasal pack 4,830 5,520 6,900 12,080
1.2 GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD01007 Reduction of paraphimosis 3,630 4,140 5,180 9,060 WRD01008 Lumber puncture 3,020 3,450 4,320 7,550 WRD01037 Dressing (small) 410 460 580 1,010 WRD01038 Dressing (medium) 810 920 1,150 2,020 WRD01030 Dressing (large) 2,020 2,300 2,880 5,040 WRD01031 Dressing (very large) 2,820 3,220 4,030 7,050 WRD01039* Blood glucose test 230 230 230 230 WRD01044 IV Cannulation 1,010 1,150 1,440 2,520 WRD01049* Nebulisation 460 460 460 460 WRD01048 PC enema 490 560 690 1,210 WRD01045 IV Infusion (first) 250 280 350 610 WRD01046 IV Infusion (second) 250 280 350 610
1.3 MATERIAL/CONSUMABLES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD01040* Dressing material (small) 230 230 230 230 WRD01041* Dressing material (medium) 410 410 410 410 WRD01042* Dressing material (large) 580 580 580 580 WRD01043* Dressing material (very large) 870 870 870 870
1.4 OTHER PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD08003 Peritoneal dialysis pediatric 4,030 4,600 5,750 10,070 WRD08005 Narco analysis 3,220 3,680 4,600 8,050 WRD08007 Catheterization 1,610 1,840 2,300 4,030 WRD08009 Central venous pressure line 2,420 2,760 3,450 6,040 WRD08010 Temporary pacemaking 6,440 7,360 9,200 16,100 WRD08011 Chest tube drainage 8,050 9,200 11,500 20,130 WRD08013 Anterior nasal packing 3,630 4,140 5,180 9,060 WRD08015 Skeletal traction 3,220 3,680 4,600 8,050 WRD08018 Foley's catheter removal 250 280 350 610
1.5 OPHTHALMOLOGY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD05001 EDTA treatment 1,610 1,840 2,300 4,030
1.6 ORTHOPAEDIC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD04003 Splinting of fractures 2,820 3,220 4,030 7,050 WRD04004 Skin traction 1,210 1,380 1,730 3,020 WRD04005 Joint Aspiration 2,020 2,300 2,880 5,040
1.7 THORACIC / VASCULAR SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD03008 Intercostal drainage haemothorax 8,860 10,120 12,650 22,140 WRD03009 Intercostal drainage empyema 8,860 10,120 12,650 22,140
44 2. MINOR OT PROCEDURES
2.1 EAR NOSE AND THROAT SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD06007 FB removal ear/nose/throat 4,030 4,600 5,750 10,070 WRD06008 I and D 4,830 5,520 6,900 12,080 WRD06010 Nasal endoscopy 2,620 2,990 3,740 6,550 WRD06014 Quinsy 4,030 4,600 5,750 10,070 WRD06017 Submandibular duct stone removal 4,430 5,060 6,330 11,070
2.2 GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD01001 Drainage of small abscess 3,220 3,680 4,600 8,050 WRD01002 Aspiration of sup. cold abscess 2,020 2,300 2,880 5,040 WRD01003 Suturing of small wound 1,610 1,840 2,300 4,030 WRD01005 Trucut needle biopsy 2,580 2,950 3,680 6,440 WRD01006 Injection haemorrhoids 2,020 2,300 2,880 5,040 WRD01009 Percutaneous liver biopsy 3,630 4,140 5,180 9,060 WRD01010 Aspiration spleen 3,630 4,140 5,180 9,060 WRD01011 Aspiration marrow 3,630 4,140 5,180 9,060 WRD01012 Muscle biopsy 4,030 4,600 5,750 10,070 WRD01013 Aspiration of peritoneal fluid 3,630 4,140 5,180 9,060 WRD01014 Aspiration of pleural fluid 3,630 4,140 5,180 9,060 WRD01015 Auxillary lymph node biopsy 4,030 4,600 5,750 10,070 WRD01016 Inguinal lymph node biopsy 4,830 5,520 6,900 12,080 WRD01017 Prostatic biopsy 6,040 6,900 8,630 15,100 WRD01018 Aspiration of empyema 4,030 4,600 5,750 10,070 WRD01019 Aspiration of liver abscess 4,830 5,520 6,900 12,080 WRD01020 Excision biopsy of ulcer 2,820 3,220 4,030 7,050 WRD01021 Percutaneous kidney biopsy 8,460 9,660 12,080 21,140 WRD01022 Marrow biopsy open 6,040 6,900 8,630 15,100 WRD01023 Suprapubic drainage 4,030 4,600 5,750 10,070 WRD01024 Drainage of subdiaphramatic abscess 9,660 11,040 13,800 24,150 WRD01035 Esophageal dilatation under image intensifier ‘C’ 5,640 6,440 8,050 14,090 arm
2.3 NEUROSURGERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD02002 Ventricular puncture 4,830 5,520 6,900 12,080 WRD02003 Cisternal puncture 4,830 5,520 6,900 12,080 WRD02004 Lumber myelogram 3,220 3,680 4,600 8,050 WRD02005 Cisternal myelogram 3,220 3,680 4,600 8,050
2.4 OTHER PROCEDURES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD08001 Percutaneus renal biopsy paediatric 4,830 5,520 6,900 12,080 WRD08002 Peritoneal catherisation paediatric 4,030 4,600 5,750 10,070 WRD08004 Modifed electro convulsive therapy (under GA) 3,220 3,680 4,600 8,050 WRD08012 Tracheostomy 14,090 16,100 20,130 35,220 WRD08016 Venesection 3,220 3,680 4,600 8,050 WRD08017 Shunt removal (renal) 410 460 580 1,010
2.5 ORTHOPAEDIC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD04001 Closed reduction long bones leg/arm 4,830 5,520 6,900 12,080
45 2.6 THORACIC/VASCULAR SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) WRD03001 Chest aspiration (diagnostic) 2,020 2,300 2,880 5,040 WRD03002 Chest aspiration (therapeutic) 3,220 3,680 4,600 8,050 WRD03003 Pericardial aspiration 4,830 5,520 6,900 12,080 WRD03004 Bronchoscopy 5,640 6,440 8,050 14,090 WRD03005 Oesophageoscopy 4,030 4,600 5,750 10,070 WRD03006 Needle biopsy lung, pleura 4,030 4,600 5,750 10,070 WRD03010 Pericardial drainage 9,660 11,040 13,800 24,150
46 MOOLCHAND SCHEDULE OF CHARGES 2019
SECTION D: SURGERIES
D1: DENTAL
1. GENERAL DENTISTRY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.)
SRG01001 Biopsy (dental) 5,670 6,480 8,100 14,175 SRG01003 Abscess incision 4,830 5,520 6,900 12,075 SRG01004 Tumour excision 12,110 13,840 17,300 30,275 SRG01012 Alvolectomy (segmental) 2,870 3,280 4,100 7,175 SRG01013 Alvolectomy (full mouth) 5,670 6,480 8,100 14,175 SRG01016 Cystectomy (enucleation) 12,110 13,840 17,300 30,275 SRG01018 Sequestrectomy 6,090 6,960 8,700 15,225 SRG01019 Peripheral neuronectomy 6,440 7,360 9,200 16,100 SRG01026 Extractions (per tooth) 2,450 2,800 3,500 6,125
2. MAXILLOFACIAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG01024 Resection of jaw 18,130 20,720 25,900 45,325 SRG01025 AO plating jaw 12,110 13,840 17,300 30,275 SRG01027 Facial fracture (unilateral) 32,200 36,800 46,000 80,500 SRG01027 Facial fracture (bilateral) 48,300 55,200 69,000 120,750 SRG01029 Genioplasty (chin augmentation) 30,240 34,560 43,200 75,600 SRG01030 Rhinoplasty 36,260 41,440 51,800 90,650 SRG01031 Face lifts 36,260 41,440 51,800 90,650 SRG01032 Lip augmentation 12,110 13,840 17,300 30,275 SRG01033 Botox 3,220 3,680 4,600 8,050 SRG01034 Facial beautification (per site) 8,050 9,200 11,500 20,125 SRG01035 Facial beautification (full face) 24,150 27,600 34,500 60,375 SRG01036 Bone augmentation 24,150 27,600 34,500 60,375 SRG01037 BSSO (reconstruction facial profile) 60,410 69,040 86,300 151,025
3. ORTHODONTICS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG01017 Cystectomy (marsupalisation) 12,110 13,840 17,300 30,275 SRG01020 Condylectomy 8,890 10,160 12,700 22,225 SRG01021 Leforte fracture 9,660 11,040 13,800 24,150 SRG01022 TM joint ankylosis 19,320 22,080 27,600 48,300 SRG01023 Osteotomy 16,100 18,400 23,000 40,250
4. PROSTHODONTICS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG01002 Extraction (each jaw under GA) (child) 2,870 3,280 4,100 7,175 SRG01038 Dental implant (single sitting) 32,200 36,800 46,000 80,500 SRG01039 Dental implant (second sitting) 16,100 18,400 23,000 40,250
D2: EAR, NOSE AND THROAT
1. EAR SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG02070 Foreign body removal from nose/ear 4,060 4,640 5,800 10,150 SRG02071 Wax removal under GA 2,450 2,800 3,500 6,125
47 SRG02072 Myringotomy (unilateral) 2,450 2,800 3,500 6,125 SRG02073 Myringotomy (bilateral) 4,480 5,120 6,400 11,200 SRG02074 Myringotomy with grommet (one ear) 4,060 4,640 5,800 10,150 SRG02075 Myringotomy with grommet (both ear) 7,280 8,320 10,400 18,200 SRG02076 Aural polypectomy 4,830 5,520 6,900 12,075 SRG02077 Stapedectomy 28,210 32,240 40,300 70,525 SRG02078 Ossiculoplasty 24,150 27,600 34,500 60,375 SRG02079 Mastoidectomy cortical 22,190 25,360 31,700 55,475 SRG02080 Mastoidectomy with tympanoplasty 28,210 32,240 40,300 70,525 SRG02081 Myringoplasty 17,710 20,240 25,300 44,275 SRG02082 Myringoplasty with ossiculoplasty 22,540 25,760 32,200 56,350 SRG02083 Preauricular sinus 7,280 8,320 10,400 18,200 SRG02085 Labyrinthectomy 16,100 18,400 23,000 40,250 SRG02086 Decompression sac 28,210 32,240 40,300 70,525 SRG02087 Facial decompression 36,260 41,440 51,800 90,650 SRG02088 Excision thyroglossal fistula 12,880 14,720 18,400 32,200 SRG02089 Cautery and patch ear 2,870 3,280 4,100 7,175 SRG02090 EUM and suction 2,450 2,800 3,500 6,125 SRG02091 Ear lobule repair (unilateral) 2,450 2,800 3,500 6,125 SRG02092 Ear lobule repair (bilateral) 4,060 4,640 5,800 10,150 SRG02126 Tympanoplasty 24,150 27,600 34,500 60,375 SRG02127 I and D mastoid abscess 8,050 9,200 11,500 20,125 SRG02128 Mastiodectomy modified radical 28,210 32,240 40,300 70,525 SRG02139 Excision of glomous juglare tumour 48,300 55,200 69,000 120,750 SRG02145 Intratympanic injecton 2,450 2,800 3,500 6,125 SRG02159 Myringoplasty small 16,100 18,400 23,000 40,250
2. NOSE SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG02025 Suturing of lacerated wound nose/ear 4,060 4,640 5,800 10,150 SRG02026 Submucous resection/septal correction 8,050 9,200 11,500 20,125 SRG02027 Septoplasty 10,080 11,520 14,400 25,200 SRG02028 Caldwell (luc unilateral) 11,270 12,880 16,100 28,175 SRG02029 Caldwell (luc bilateral) 16,100 18,400 23,000 40,250 SRG02030 External ethmoidectomy 13,720 15,680 19,600 34,300 SRG02032 Radical fronto ethmo sphenodectomy 20,160 23,040 28,800 50,400 SRG02033 Intra nasal ethmoidectomy 12,110 13,840 17,300 30,275 SRG02034 Nasal polypectomy (unilateral) 8,050 9,200 11,500 20,125 SRG02035 Nasal polypectomy (bilateral) 12,880 14,720 18,400 32,200 SRG02036 Antrostomy (unilateral) 4,830 5,520 6,900 12,075 SRG02037 Antrostomy (bilateral) 6,440 7,360 9,200 16,100 SRG02038 Antral wash out (unilateral) 3,640 4,160 5,200 9,100 SRG02039 Antral wash out (bilateral) 4,830 5,520 6,900 12,075 SRG02040 Cauterization turbinates (submucousal diathermy) 7,280 8,320 10,400 18,200 SRG02042 Partial turbinectomy (unilateral) 5,670 6,480 8,100 14,175 SRG02043 Partial turbinectomy (bilateral) 7,700 8,800 11,000 19,250 SRG02044 Lateral rhinotomy 26,180 29,920 37,400 65,450 SRG02046 Sinus antroscopy 2,450 2,800 3,500 6,125 SRG02048 Rhinoplasty 28,210 32,240 40,300 70,525 SRG02049 Anterior nasal packing 4,830 5,520 6,900 12,075 SRG02050 Posterior nasal packing 4,480 5,120 6,400 11,200 SRG02051 Fracture setting (nasal bone) 20,160 23,040 28,800 50,400 SRG02052 Fracture reduction nose with septal correction 20,160 23,040 28,800 50,400 SRG02053 Fracture setting (maxilla) 17,710 20,240 25,300 44,275 SRG02054 Maxillectomy (total) 40,250 46,000 57,500 100,625 SRG02055 Maxillectomy (partial) 28,210 32,240 40,300 70,525 SRG02066 Anterior ethmoidal artery ligation 16,100 18,400 23,000 40,250 SRG02067 Vidian neurectomy (micro) 12,110 13,840 17,300 30,275 SRG02068 Submucous nose injection 1,470 1,680 2,100 3,675 SRG02129 I and D septal abscess/haemotoma 8,050 9,200 11,500 20,125 SRG02130 Release/excision synechia 3,220 3,680 4,600 8,050
48 SRG02131 Closure septal perforation (single) 18,130 20,720 25,900 45,325 SRG02132 Closure septal perforation (multiple) 20,160 23,040 28,800 50,400 SRG02133 Reduction and fixation fracture of mandible 20,160 23,040 28,800 50,400 SRG02134 Reduction and fixation fracture of zygoma 20,160 23,040 28,800 50,400 SRG02135 Reduction and fixation of frontal bone 16,100 18,400 23,000 40,250 SRG02138 Pack removal 3,220 3,680 4,600 8,050 SRG02147 Large angiofibrous excision 44,310 50,640 63,300 110,775 SRG02161 Septorhinoplasty 34,230 39,120 48,900 85,575 SRG02176 Septoplasty+SMD 13,720 15,680 19,600 34,300 SRG02177 Suction clearance (unilateral) 840 960 1,200 2,100 SRG02178 Suction clearance (bilateral) 1,260 1,440 1,800 3,150
3. THROAT SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG02001 Adeno tonsillectomy 14,490 16,560 20,700 36,225 SRG02002 Tonsillectomy 10,500 12,000 15,000 26,250 SRG02003 Adenoidectomy 8,050 9,200 11,500 20,125 SRG02004 Styloidectomy (one side) 12,880 14,720 18,400 32,200 SRG02005 Styloidectomy (both sides) 19,320 22,080 27,600 48,300 SRG02006 Choanal atresia (minor) 22,190 25,360 31,700 55,475 SRG02007 Oro antral fistula 22,190 25,360 31,700 55,475 SRG02009 Retropharyngeal abscess drainage 9,660 11,040 13,800 24,150 SRG02010 Parapharyngeal abscess drainage 9,660 11,040 13,800 24,150 SRG02011 Parapharyngeal (exploration and biopsy) 18,130 20,720 25,900 45,325 SRG02012 Parapharyngeal (tumour excision) 24,150 27,600 34,500 60,375 SRG02013 Release of tongue tie 4,060 4,640 5,800 10,150 SRG02014 Uvulophanyngo plasty 26,180 29,920 37,400 65,450 SRG02015 Pharyngo plasty 26,180 29,920 37,400 65,450 SRG02016 Excision biopsy (oral cavity/pharynx/nose) 6,090 6,960 8,700 15,225 SRG02017 Superficial parotidectomy 28,210 32,240 40,300 70,525 SRG02018 Total parotidectomy 34,230 39,120 48,900 85,575 SRG02113 Thyroplasty 24,150 27,600 34,500 60,375 SRG02117 Arytenoidectomy 24,150 27,600 34,500 60,375 SRG02136 I and D quinsy 4,060 4,640 5,800 10,150 SRG02137 Choanal atresia (major) 24,150 27,600 34,500 60,375 SRG02143 Removal of stone from SM duct 4,480 5,120 6,400 11,200 SRG02148 Palate tumour/cyst removal 16,100 18,400 23,000 40,250 SRG02149 Excision of ranula marsupulization 6,440 7,360 9,200 16,100 SRG02150 Excision lesion/tumour tongue 14,490 16,560 20,700 36,225 SRG02151 Hemiglossectomy 28,210 32,240 40,300 70,525 SRG02155 Thyroplasty (type 1) 26,180 29,920 37,400 65,450 SRG02156 Thyroplasty (type 2) 26,180 29,920 37,400 65,450 SRG02157 Thyroplasty (type 3) 26,180 29,920 37,400 65,450 SRG02158 Incision and drainage of ludwigs angina 14,140 16,160 20,200 35,350 SRG02168 Ranula excision 14,140 16,160 20,200 35,350 SRG02169 Oral tumour excision 12,110 13,840 17,300 30,275
4. HEAD AND NECK SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG02105 Ligation external carotid 16,100 18,400 23,000 40,250 SRG02106 Tracheostomy 14,140 16,160 20,200 35,350 SRG02107 Laryngectomy exicision with pharyngeal division 40,250 46,000 57,500 100,625 SRG02108 Laryngectomy with block dissection 48,300 55,200 69,000 120,750 SRG02109 Laryngo fissure 26,180 29,920 37,400 65,450 SRG02110 Excision submandibular gland 18,130 20,720 25,900 45,325 SRG02111 Excision thyroglossal cyst 14,140 16,160 20,200 35,350 SRG02112 Lymph gland biopsy 6,440 7,360 9,200 16,100 SRG02114 Brachial fistula 12,880 14,720 18,400 32,200 SRG02115 Tracheoplasty 20,160 23,040 28,800 50,400 SRG02116 Tracheal stenosis (end to end anastamosis) 20,160 23,040 28,800 50,400
49 SRG02152 Hemithyroidectomy 21,770 24,880 31,100 54,425 SRG02153 Sub total thyroidectomy 24,150 27,600 34,500 60,375 SRG02154 Total thyroidectomy 28,210 32,240 40,300 70,525 SRG02160 Tracheostomy closure 10,080 11,520 14,400 25,200 SRG02166 Partial glossectomy 17,710 20,240 25,300 44,275 SRG02167 Hemiglossectomy with neck down 32,200 36,800 46,000 80,500 SRG02172 Decanulation of tracheostomy tube (minor) 2,450 2,800 3,500 6,125 SRG02173 Surgical decanulation of tracheostomy tube 5,670 6,480 8,100 14,175 SRG02174 Neck abcess drainage 3,640 4,160 5,200 9,100
5. GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG02140 Suturing (minor) 2,450 2,800 3,500 6,125 SRG02141 Suturing (major) 4,830 5,520 6,900 12,075 SRG02142 Aspiration cyst/haemotoma/cold abscess 2,030 2,320 2,900 5,075 SRG02144 Gland biopsy (small) 2,450 2,800 3,500 6,125 SRG02170 Facial wound repair (minor) 3,220 3,680 4,600 8,050 SRG02171 Facial wound repair (major) 6,440 7,360 9,200 16,100 SRG02175 Sebaceous cyst excision 4,830 5,520 6,900 12,075
6. ENDOSCOPY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG02045 Nasal endoscopy 2,660 3,040 3,800 6,650 SRG02047 Functional endoscopic sinus (FESS) routine 18,130 20,720 25,900 45,325 SRG02056 Functional endoscopic sinus (limited) 16,100 18,400 23,000 40,250 SRG02057 Functional endoscopic sinus (unilateral) 12,110 13,840 17,300 30,275 SRG02059 Functional endoscopic sinus (extensive) 21,770 24,880 31,100 54,425 SRG02060 CSF rhinorrhoea repair 32,200 36,800 46,000 80,500 SRG02061 Endoscopic DCR 16,940 19,360 24,200 42,350 SRG02062 Endoscopic optic nerve decompression 36,260 41,440 51,800 90,650 SRG02063 Endoscopic orbital decompression 36,260 41,440 51,800 90,650 SRG02064 Endoscopic nasal biopsy/cautery 4,060 4,640 5,800 10,150 SRG02065 Endoscopic septoplasty 12,110 13,840 17,300 30,275 SRG02095 Oesophagoscopy and foreign body removal 16,100 18,400 23,000 40,250 SRG02096 Laryngoscopy 5,250 6,000 7,500 13,125 SRG02097 Oesophagoscopy 10,080 11,520 14,400 25,200 SRG02098 Bronchoscopy (diagnostic) 7,280 8,320 10,400 18,200 SRG02099 Bronchoscopy (therapeutic) 14,490 16,560 20,700 36,225 SRG02100 Microlaryngoscopy (diagnostic) 9,660 11,040 13,800 24,150 SRG02101 Microlaryngoscopic surgery (large lesion) 16,940 19,360 24,200 42,350 SRG02102 Microlaryngoscopic surgery (small lesion) 9,660 11,040 13,800 24,150 SRG02103 Microlaryngoscopic surgery (extensive papilloma) 16,940 19,360 24,200 42,350 SRG02104 Dilatation of stricture oesophagus 9,660 11,040 13,800 24,150 SRG02146 Endoscopic excision of Angiofibroma 40,250 46,000 57,500 100,625 SRG02162 Endoscopic adenoidectomy 11,270 12,880 16,100 28,175 SRG02163 Endoscopic tumour excision (large) 20,160 23,040 28,800 50,400 SRG02164 Endoscopic tumour excision (small) 16,100 18,400 23,000 40,250
D3: GASTROINTESTINAL
1. CONVENTIONAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03100 Jejunostomy 18,130 20,720 25,900 45,325 SRG03109 Ileostomy 18,130 20,720 25,900 45,325 SRG03116 Intussusception 18,130 20,720 25,900 45,325 SRG03125 Mesecteric cyst (excision) 20,160 23,040 28,800 50,400 SRG03126 Resection anastomosis (small intestine) 22,190 25,360 31,700 55,475 SRG03127 Excision meckel's diverticulum 20,160 23,040 28,800 50,400 SRG03128 Intestinal obstruction 20,160 23,040 28,800 50,400 SRG03129 Intestinal perforation 20,160 23,040 28,800 50,400 SRG03130 Excision benign tumor (small intestine) 9,660 11,040 13,800 24,150
50 SRG03131 Excision small intestinal fistula 20,160 23,040 28,800 50,400 SRG03132 Haemorrhage of small intestine 16,100 18,400 23,000 40,250 SRG03133 Duplication of intestine 16,100 18,400 23,000 40,250 SRG03134 Ileo signoidostomy 20,160 23,040 28,800 50,400 SRG03135 Ileotransverse colostomy 20,160 23,040 28,800 50,400 SRG03140 Resection anastomosis (large intestine) 20,160 23,040 28,800 50,400 SRG05011 NBD (naeobiliary drainage) 16,100 18,400 23,000 40,250 SRG05012 PTBD 20,160 23,040 28,800 50,400 SRG05013 PTC 3,640 4,160 5,200 9,100 SRG05017 Esophagus foreign body removal 16,100 18,400 23,000 40,250 SRG05020 Oesophageal variceal ligation complete 28,210 32,240 40,300 70,525 SRG05021 Variceal banding therapy 8,050 9,200 11,500 20,125 SRG05026 Banding piles (single site) 1,610 1,840 2,300 4,025 SRG05027 Banding piles (dual site) 4,060 4,640 5,800 10,150 SRG05028 Banding piles (three sites) 4,830 5,520 6,900 12,075 SRG05034 Proctoscopy banding/injection 2,450 2,800 3,500 6,125 SRG05038 Sclerotherapy injection for ulcer 5,670 6,480 8,100 14,175 SRG05039 Radical cholecystectomy 40,250 46,000 57,500 100,625
2. LAPROSCOPIC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03228 Laparoscopic assisted intestinal resection 25,760 29,440 36,800 64,400 SRG03309 Laparoscopic assisted small bowel resection 25,760 29,440 36,800 64,400 SRG03310 Laparoscopic assisted intestinal obstruction 21,770 24,880 31,100 54,425 SRG03311 Laparoscopic assisted intestinal perforation 25,760 29,440 36,800 64,400
D4: GENERAL
1. ABDOMINAL WALL OESOPHAGUS DUODENUM AND PANCREAS
1.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03062 Gastric and duodenal biopsy 6,440 7,360 9,200 16,100 SRG03070 Open drainage of liver abscess 16,100 18,400 23,000 40,250 SRG03071 Open drainage of pelvic abscess 12,880 14,720 18,400 32,200 SRG03072 Drainage of subdiaphramatic abscess 12,880 14,720 18,400 32,200 SRG03073 Drainage of para gastric abscess 9,660 11,040 13,800 24,150 SRG03075 Drainage of psoas abscess 12,880 14,720 18,400 32,200 SRG03107 Exploratory laparotomy 16,100 18,400 23,000 40,250 SRG03108 Simple closure (peptic perforation) 18,130 20,720 25,900 45,325 SRG03111 Gastrostomy 16,100 18,400 23,000 40,250 SRG03141 Gastrojejunostomy 16,100 18,400 23,000 40,250 SRG03151 Duodenal diverticulum 22,190 25,360 31,700 55,475 SRG03156 Vagotomy and drainage 16,100 18,400 23,000 40,250 SRG03157 Vagotomy and pyloroplasty 26,180 29,920 37,400 65,450 SRG03158 Deodenal jejunostomy 22,190 25,360 31,700 55,475 SRG03166 Partial subtotal gastrectomy for cancer 22,190 25,360 31,700 55,475 SRG03167 Bleeding ulcer (gastro and vagotomy) 30,240 34,560 43,200 75,600 SRG03168 Bleeding ulcer (partial gastrectomy) 28,210 32,240 40,300 70,525 SRG03169 Gastro jejunal ulcer 16,100 18,400 23,000 40,250 SRG03170 Gastro jejuno colic fistula 22,190 25,360 31,700 55,475 SRG03172 Oesophagus (portal hypertension) 26,180 29,920 37,400 65,450 SRG03180 Total gastrectomy for CA 26,180 29,920 37,400 65,450 SRG03184 Pancreatico deodenedtomy 40,250 46,000 57,500 100,625 SRG03194 Oesophagectomy 40,250 46,000 57,500 100,625 SRG03236 Partial subtotal gastrectomy ulcer 26,180 29,920 37,400 65,450 SRG03237 Cystogastrostomy for pseudopancreatic cyst 26,180 29,920 37,400 65,450 SRG03238 Intrabdominal tumors 16,100 18,400 23,000 40,250
51 1.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03301 Laparoscopic pyloromyotomy 22,190 25,360 31,700 55,475 SRG03302 Laparoscopic gastrostomy/jejunostomy 26,180 29,920 37,400 65,450 SRG03303 Laparoscopic closure of perforated peptic ulcer 26,180 29,920 37,400 65,450 SRG03304 Laparoscopic vagotomy pyleroplasty/gastro 26,180 29,920 37,400 65,450 jejunostomy SRG03305 Laparoscopic cystogastrostomy 26,180 29,920 37,400 65,450 SRG03331 Laparoscopic partial gastrectomy 20,160 23,040 28,800 50,400 SRG03332 Laparoscopic total gastrectomy 26,600 30,400 38,000 66,500
2. ABSCESS
2. 1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03001 Drainage of small abscess 4,830 5,520 6,900 12,075 SRG03016 Drainage of large abscess 9,660 11,040 13,800 24,150 SRG03018 Drainage of deep seated abscess 9,660 11,040 13,800 24,150 SRG03019 Drainage of parotid abscess 12,110 13,840 17,300 30,275 SRG03043 Aspiration of liver abscess 6,440 7,360 9,200 16,100 SRG03064 Carbuncle back 12,110 13,840 17,300 30,275 SRG03241 Retroperitoneoscopic drainage of psoas abscess 14,490 16,560 20,700 36,225 (unilateral) SRG03242 Retroperitoneoscopic drainage of psoas abscess 16,100 18,400 23,000 40,250 (bilateral)
3. APPENDIX
3.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03083 Appendicectomy 16,100 18,400 23,000 40,250 SRG03084 Appendicular abscess (drainage) 16,100 18,400 23,000 40,250
3.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03223 Laparoscopic appendectomy 18,130 20,720 25,900 45,325
4. BARIATRIC SURGERY
4.1 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03341 Laparoscopic gastric banding 28,210 32,240 40,300 70,525 SRG03342 Laparoscopic sleave gastrectomy 44,310 50,640 63,300 110,775 SRG03343 Laparoscopic roux-en Y gastric bypass 44,310 50,640 63,300 110,775
5. BILLIARY
5.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03101 Cholecysostomy 16,100 18,400 23,000 40,250 SRG03124 Cholecystectomy 20,160 23,040 28,800 50,400 SRG03153 Cholecystectomy and exploration of CBD 24,150 27,600 34,500 60,375 SRG03154 Bypass (inoperable cancer of pancreas) 20,160 23,040 28,800 50,400 SRG03155 Hydatid cyst of liver 24,150 27,600 34,500 60,375 SRG03181 Porto caval anastomosis 30,240 34,560 43,200 75,600 SRG03182 Mesenteric caval anastomosis 30,240 34,560 43,200 75,600
52 SRG03183 Warren's shunt 28,210 32,240 40,300 70,525 SRG03185 Repair of common bile duct 20,160 23,040 28,800 50,400 SRG03186 Hepatic resection (lobectomy) 30,240 34,560 43,200 75,600
5.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03220 Laparoscopic cholecystectomy 20,160 23,040 28,800 50,400 SRG03306 Laparoscopic cholecystectomy and CBD 26,180 29,920 37,400 65,450 exploration SRG03307 Laparoscopic hydatid of liver surgery 26,180 29,920 37,400 65,450 SRG03308 Laparoscopic hepatic resection 28,210 32,240 40,300 70,525 SRG03334 Lap chole with choledochojejunostomy/ 30,240 34,560 43,200 75,600 duodenostomy
6. BIOPSY
6.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03004 Cervical lymph node biospy 8,050 9,200 11,500 20,125 SRG03005 Axiliary lymph node biopsy 8,050 9,200 11,500 20,125 SRG03006 Inguinal lymph node biopsy 8,050 9,200 11,500 20,125 SRG03007 Excision biopsy (superficial lumps) 8,050 9,200 11,500 20,125 SRG03008 Trucut needle biopsy 3,220 3,680 4,600 8,050 SRG03028 Exicision biopsy for ulcer 3,220 3,680 4,600 8,050 SRG03045 Excision biopsy of large lymph node 10,080 11,520 14,400 25,200 SRG03197 Muscle biopsy 4,060 4,640 5,800 10,150 SRG03198 Excision dermoid cyst (small) 4,060 4,640 5,800 10,150 SRG03200 Excision biopsy (large/multiple node) 8,050 9,200 11,500 20,125
6.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03333 Laparoscopic axillary lymph node sampling 12,110 13,840 17,300 30,275
7. BLADDER
7.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03191 Total cystectomy 17,360 19,840 24,800 43,400 SRG03192 Colocystoplasty 17,360 19,840 24,800 43,400
8. BREAST
8.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03051 Excision (breast lump) (single) 11,270 12,880 16,100 28,175 SRG03061 Excision mammary fistula 12,880 14,720 18,400 32,200 SRG03087 Segmental resection of breast 20,160 23,040 28,800 50,400 SRG03112 Local mastectomy 16,100 18,400 23,000 40,250 SRG03160 Radical mastectomy 20,160 23,040 28,800 50,400 SRG03232 Excision (breast lump) (multiple) 10,080 11,520 14,400 25,200 SRG03257 Pectoral major myocutaneous flap 20,160 23,040 28,800 50,400 SRG03258 Latissimus dorsi myocutaneous flap 36,260 41,440 51,800 90,650 SRG03066 Wedge biopsy (breast) 9,660 11,040 13,800 24,150 SRG03351 Transverse rectus abdominus myocutaneous 20,160 23,040 28,800 50,400 (TRAM) flap SRG03352 Auxillary lymph node dissection 12,110 13,840 17,300 30,275
53 9. COLON RECTUM AND ANAL CANAL
9.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03009 Injection hemorrhoids 3,640 4,160 5,200 9,100 SRG03014 Anal dilatation 6,440 7,360 9,200 16,100 SRG03050 Rectal polyp (excision) 5,460 6,240 7,800 13,650 SRG03052 Thierschs wiring 6,440 7,360 9,200 16,100 SRG03055 Drainage of ischio rectal abscess 12,110 13,840 17,300 30,275 SRG03063 Fissurectomy 11,270 12,880 16,100 28,175 SRG03079 Excision pilonidal sinus 16,100 18,400 23,000 40,250 SRG03080 Fistulectomy 12,110 13,840 17,300 30,275 SRG03081 Haemorrhoidectomy 18,130 20,720 25,900 45,325 SRG03082 Colostomy 18,130 20,720 25,900 45,325 SRG03136 Sigmoid diverticulum 16,100 18,400 23,000 40,250 SRG03143 Diverticulectomy 18,130 20,720 25,900 45,325 SRG03145 Rectopexy 26,180 29,920 37,400 65,450 SRG03148 Left hemicolectomy 22,190 25,360 31,700 55,475 SRG03149 Right hemicolectomy 22,190 25,360 31,700 55,475 SRG03150 Volvlous of large bowel 20,160 23,040 28,800 50,400 SRG03188 Total colectomy 30,240 34,560 43,200 75,600 SRG03189 Abdomino perineal resection 26,180 29,920 37,400 65,450 SRG03190 Anterior resection for CA 24,150 27,600 34,500 60,375 SRG03208 Rectal biopsy 6,090 6,960 8,700 15,225 SRG03235 Stapled haemorrhoidectomy 16,100 18,400 23,000 40,250 SRG03243 Lateral sphinecterotomy 12,110 13,840 17,300 30,275
9.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03227 Laparoscopic assisted hemicolectomy 24,150 27,600 34,500 60,375 SRG03312 Laparoscopic assisted right hemicolectomy 24,150 27,600 34,500 60,375 SRG03313 Laparoscopic assisted left hemicolectomy 24,150 27,600 34,500 60,375 SRG03314 Laparoscopic assisted total colectomy 30,240 34,560 43,200 75,600 SRG03315 Laparoscopic rectopexy 30,240 34,560 43,200 75,600 SRG03316 Lap assisted abdominoperineal resection of 30,240 34,560 43,200 75,600 rectum SRG03317 Laparoscopic assisted anterior resection 30,240 34,560 43,200 75,600 SRG03322 Laparoscopic colectomy 30,240 34,560 43,200 75,600
10. DRESSINGS AND DEBRIDEMENT SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03017 Dressing under GA 2,870 3,280 4,100 7,175 SRG03044 Debridement of wounds (small) 5,250 6,000 7,500 13,125 SRG03231 Debridement of wounds (large) 8,050 9,200 11,500 20,125 SRG03344 Dressing (very minor) 1,610 1,840 2,300 4,025 SRG03345 Dressing (minor) 2,870 3,280 4,100 7,175 SRG03346 Dressing (major) 4,060 4,640 5,800 10,150 SRG03347 Dressing (very major) 6,090 6,960 8,700 15,225
11. HEAD AND NECK
11.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03034 Tongue tie 3,640 4,160 5,200 9,100 SRG03059 Partial amputation of pinna 8,050 9,200 11,500 20,125 SRG03060 Carcinoma lip (wedge excision) 8,050 9,200 11,500 20,125 SRG03067 Excision brachial sinus 14,140 16,160 20,200 35,350 SRG03068 Excision brachial cyst (bilateral) 18,130 20,720 25,900 45,325
54 SRG03088 Excision thyroglossal cyst 14,140 16,160 20,200 35,350 SRG03089 Excision thyroglossal fistula 14,140 16,160 20,200 35,350 SRG03090 Submandibular salivary gland (removal) 18,130 20,720 25,900 45,325 SRG03113 Thyroid adenoma resection enucleation 16,100 18,400 23,000 40,250 SRG03118 Excision pharyngeal diverticulum 24,150 27,600 34,500 60,375 SRG03119 Hemi glossectomy 24,150 27,600 34,500 60,375 SRG03120 Superficial parotidectomy 24,150 27,600 34,500 60,375 SRG03121 Hemi thyroidectomy 22,190 25,360 31,700 55,475 SRG03122 Partial thyroidectomy 24,150 27,600 34,500 60,375 SRG03144 Sub total thyroidectomy 22,190 25,360 31,700 55,475 SRG03161 Block dissection cervical nodes 16,100 18,400 23,000 40,250 SRG03162 Excision of maxilla 16,100 18,400 23,000 40,250 SRG03163 Hemi mandibulectomy 28,210 32,240 40,300 70,525 SRG03164 Excision of parathyroid adenoma 20,160 23,040 28,800 50,400 SRG03165 Laryngectomy 36,260 41,440 51,800 90,650 SRG03173 Total thyroidectomy 30,240 34,560 43,200 75,600 SRG03174 Total glossectomy 34,230 39,120 48,900 85,575 SRG03175 Excision carotid body tumour 36,260 41,440 51,800 90,650 SRG03176 Total pharyngectomy and reconstruction 36,260 41,440 51,800 90,650 SRG03177 Commando’s operation 48,300 55,200 69,000 120,750 SRG03178 Total thyroidectomy and block dissection 48,300 55,200 69,000 120,750 SRG03179 Laryngopharangectomy 48,300 55,200 69,000 120,750 SRG03248 Partial laryngectomy 26,180 29,920 37,400 65,450 SRG03249 Maxillectomy through degloving technique 40,250 46,000 57,500 100,625 SRG03250 Total laryngectomy with total pharyngectomy 40,250 46,000 57,500 100,625 SRG03251 Partial pharyngectomy 14,140 16,160 20,200 35,350 SRG03252 Radial neck dissection post radiotherapy 40,250 46,000 57,500 100,625 SRG03253 Tracheostomy post radiotherapy 12,110 13,840 17,300 30,275 SRG03254 Tracheostomy in cancer patient 12,110 13,840 17,300 30,275 SRG03259 Forehead flap 26,180 29,920 37,400 65,450 SRG03260 Excision of cheek tumor (unilateral) (without 12,110 13,840 17,300 30,275 SRG03261 Excision of cheek tumor (bilateral) (without flap) 16,100 18,400 23,000 40,250 SRG03262 Excision of lip tumor 12,110 13,840 17,300 30,275 SRG03263 Anterior neck dissection 16,100 18,400 23,000 40,250 SRG03264 External carotid ligation (unilateral) 26,180 29,920 37,400 65,450 SRG03265 External carotid ligation (bilateral) 26,180 29,920 37,400 65,450 SRG03266 Total laryngectomy post radiation 36,260 41,440 51,800 90,650 SRG03267 Near total thyroidectomy 20,160 23,040 28,800 50,400 SRG03268 Radical neck dissection 36,260 41,440 51,800 90,650 SRG03269 Functional neck dissection 30,240 34,560 43,200 75,600 SRG03270 Modified neck dissection 30,240 34,560 43,200 75,600 SRG03271 Supraomohyoid neck dissection 24,150 27,600 34,500 60,375 SRG03272 Suprahyoid neck dissection 16,100 18,400 23,000 40,250 SRG03273 Hemi maxillectomy 22,190 25,360 31,700 55,475 SRG03274 Marginal mandibullectomy 20,160 23,040 28,800 50,400 SRG03275 Partial mandibullectomy 32,200 36,800 46,000 80,500 SRG03276 Total laryngectomy partial pharyngectomy 40,250 46,000 57,500 100,625 SRG03277 Partial resection of base of tongue 22,190 25,360 31,700 55,475 SRG03278 Total resection of base of tongue 32,200 36,800 46,000 80,500 SRG03279 Resection of base of tongue with supraglottis 32,200 36,800 46,000 80,500 laryngectomy SRG03280 Deep biopsy of oral cavity tumour 7,280 8,320 10,400 18,200 SRG03281 Orbital exenteration 24,150 27,600 34,500 60,375 SRG03282 Maxillectomy with orbital exenteration 52,360 59,840 74,800 130,900 SRG03283 Permanent tracheostomy 12,110 13,840 17,300 30,275 SRG03284 Laryngo pharyngo oesophagestomy 20,160 23,040 28,800 50,400 SRG03285 Parapharyngeal space tumor excision 24,150 27,600 34,500 60,375 SRG03286 Voice prosthesis 14,140 16,160 20,200 35,350 SRG03288 Temporal bone excision 20,160 23,040 28,800 50,400 SRG03294 Lip tumour (wedge excision) 8,050 9,200 11,500 20,125
55 SRG03295 Excision floor of mouth tumour 20,160 23,040 28,800 50,400 SRG03296 Parathyroidectomy 20,160 23,040 28,800 50,400 SRG03297 Tracheal reconstruction 30,240 34,560 43,200 75,600 SRG03298 Reoperative thyroid surgery 22,190 25,360 31,700 55,475 SRG03353 Excision brachial cyst (unilateral) 12,110 13,840 17,300 30,275
11.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03320 Laparoscopic thyroidectomy/parathyroidectomy 24,150 27,600 34,500 60,375
12. HERNIA
12.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03085 Herniorraphy 14,140 16,160 20,200 35,350 SRG03086 Epigastric hernia 16,100 18,400 23,000 40,250 SRG03093 Femoral hernia 18,130 20,720 25,900 45,325 SRG03102 Rare hernia (spigelion) 22,190 25,360 31,700 55,475 SRG03103 Rare hernia (obturation) 22,190 25,360 31,700 55,475 SRG03104 Rare hernia (lumbar) 22,190 25,360 31,700 55,475 SRG03105 Obstructed hernia (any type) 22,190 25,360 31,700 55,475 SRG03106 Hernioplasty 22,190 25,360 31,700 55,475 SRG03115 Umbilical hernia 14,140 16,160 20,200 35,350 SRG03139 Strangulated hernia 24,150 27,600 34,500 60,375 SRG03142 Hiatus hernia 24,150 27,600 34,500 60,375 SRG03171 Ventral hernia (lipectomy/incisional) 24,150 27,600 34,500 60,375 SRG03196 Incisional hernia 24,150 27,600 34,500 60,375 SRG03354 Open paraumblical hernia 17,710 20,240 25,300 44,275
12.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03221 Laparoscopic inguinal hernia (unilateral) 18,130 20,720 25,900 45,325 SRG03222 Laparoscopic inguinal hernia (bilateral) 22,190 25,360 31,700 55,475 SRG03226 Laparoscopic incisional hernia repair 20,160 23,040 28,800 50,400 SRG03318 Laparoscopic hiatus hernia repair 24,150 27,600 34,500 60,375 SRG03340 Laparoscopic ventral hernia repair 24,150 27,600 34,500 60,375 SRG03355 Lap paraumblical hernia 20,160 23,040 28,800 50,400
13. PENIS TESTIS AND SCROTUM
13.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03032 Vasectomy (bilateral) 4,830 5,520 6,900 12,075 SRG03033 Testicular biopsy (unilateral) 6,090 6,960 8,700 15,225 SRG03041 Circumcision 6,860 7,840 9,800 17,150 SRG03065 Hydrocele (unilateral) 10,080 11,520 14,400 25,200 SRG03076 Orchidopexy (unilateral) 14,140 16,160 20,200 35,350 SRG03077 Epididymectomy 6,440 7,360 9,200 16,100 SRG03078 Orchidectomy 16,100 18,400 23,000 40,250 SRG03092 Excision filarial scrotum/scrotoplasty 18,130 20,720 25,900 45,325 SRG03137 Total amputation of penis 18,130 20,720 25,900 45,325 SRG03138 Block dissection of groin nodes (unilateral) 20,160 23,040 28,800 50,400 SRG03217 Exploration of epididymus (unsuccessful vaso 8,050 9,200 11,500 20,125 vasectomy) SRG03229 Testicular biopsy (bilateral) 10,080 11,520 14,400 25,200 SRG03233 Hydrocele (bilateral) 16,100 18,400 23,000 40,250 SRG03234 Orchidopexy (bilateral) 20,160 23,040 28,800 50,400 SRG03356 Paraphimosis reduction 4,830 5,520 6,900 12,075
56 13.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03224 Lap. varicocelectomy (U/L) 16,100 18,400 23,000 40,250 SRG03225 Lap. varicocelectomy (B/L) 18,130 20,720 25,900 45,325
14. RENAL/KIDNEY
14.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03187 Adrenalectomy 30,240 34,560 43,200 75,600 SRG03329 RPS abscess drainage 16,100 18,400 23,000 40,250
14.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03330 RPS tumour excision 26,180 29,920 37,400 65,450 SRG03319 Laparoscopic adrenalectomy 30,240 34,560 43,200 75,600 SRG03325 Retroperitoneoscopy (RPS) 20,160 23,040 28,800 50,400 SRG03326 RPS/laparoscopic pyelolithotomy 30,240 34,560 43,200 75,600 SRG03327 RPS/Lap uretrolithotomy 30,240 34,560 43,200 75,600 SRG03328 RPS/laparoscopic pyleroplasty 30,240 34,560 43,200 75,600
15. SPLEEN
15.1 CONVENTIONAL SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03123 Splenectomy 26,180 29,920 37,400 65,450
15.2 LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03321 Laparoscopic splenectomy 30,240 34,560 43,200 75,600
16. OTHERS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG03003 Suturing of minor wound 3,640 4,160 5,200 9,100 SRG03010 Injection ganglion 3,640 4,160 5,200 9,100 SRG03011 Injection keloids 3,640 4,160 5,200 9,100 SRG03012 Injection varicose veins 3,640 4,160 5,200 9,100 SRG03023 Excision neurofibroma 6,090 6,960 8,700 15,225 SRG03024 Excision ganglion 6,090 6,960 8,700 15,225 SRG03027 Excision growth (skin) (small) 4,830 5,520 6,900 12,075 SRG03029 Removal foreign body (superficial) 4,830 5,520 6,900 12,075 SRG03035 Excision superficial tumor (lipoma/cyst/neuro 10,920 12,480 15,600 27,300 fibrama < 5) SRG03036 Scalp cyst 12,110 13,840 17,300 30,275 SRG03037 Sebaceous cyst (single) 6,090 6,960 8,700 15,225 SRG03038 Suturing of major wounds 4,830 5,520 6,900 12,075 SRG03040 Delayed primary suture 4,830 5,520 6,900 12,075 SRG03048 Excision pinna for growth (skin) 4,830 5,520 6,900 12,075 SRG03053 Excision multiple cysts and suturing 10,920 12,480 15,600 27,300 SRG03057 Removal of foreign body (deep) 6,440 7,360 9,200 16,100 SRG03193 Bilateral inguinal block dissection 22,190 25,360 31,700 55,475 SRG03199 Lipoma (small) 4,830 5,520 6,900 12,075 SRG03201 Excision dermoid cyst (large) 4,830 5,520 6,900 12,075 SRG03203 Allied small procedures 1,610 1,840 2,300 4,025 SRG03204 Minor incision 1,610 1,840 2,300 4,025 SRG03210 Excision of soft tissue benign tumour (small) 12,110 13,840 17,300 30,275 SRG03211 Excision of soft tissue benign tumour (medium) 16,100 18,400 23,000 40,250 SRG03212 Excision of soft tissue benign tumour (large) 20,160 23,040 28,800 50,400
57 SRG03230 Sebaceous cyst (multiple) 8,050 9,200 11,500 20,125 SRG03239 Ingrowing toe nail (unilateral) 5,670 6,480 8,100 14,175 SRG03240 Ingrowing toe nail (bilateral) 6,440 7,360 9,200 16,100 SRG03244 Exploration of wound+mesh removal 12,110 13,840 17,300 30,275 SRG03245 Exploration of wound+sinus tract/fistula tract 14,490 16,560 20,700 36,225 excision SRG03255 Chemoport insertion 10,080 11,520 14,400 25,200 SRG03256 Chemoport removal 2,870 3,280 4,100 7,175 SRG03348 Lap. adhesiolysis (major) 18,130 20,720 25,900 45,325 SRG03349 Lap. adhesiolysis (minor) 14,140 16,160 20,200 35,350 SRG03357 Removal foreign body (deep) 9,660 11,040 13,800 24,150
D5: GYNAECOLOGY
1. GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG04001 Hydrotubation 1,260 1,440 1,800 3,150 SRG04002 Sacrospinous fixation (single) 12,110 13,840 17,300 30,275 SRG04003 Cervical biopsy 4,060 4,640 5,800 10,150 SRG04004 Electro cauterization/Cryo cautery 3,220 3,680 4,600 8,050 SRG04005 Haemato colpo/excision (vaginal septum) 4,060 4,640 5,800 10,150 SRG04006 Cone biopsy cervix 6,440 7,360 9,200 16,100 SRG04007 Examination under GA 2,660 3,040 3,800 6,650 SRG04008 Endometrial biopsy 2,590 2,960 3,700 6,475 SRG04009 Repair of perineal tear 7,280 8,320 10,400 18,200 SRG04010 Enucleation of vaginal cyst 5,670 6,480 8,100 14,175 SRG04011 Bartholin cyst removal 4,830 5,520 6,900 12,075 SRG04012 Vaginal tear repair 4,480 5,120 6,400 11,200 SRG04013 Bartholin abscess I and D 3,640 4,160 5,200 9,100 SRG04014 Post colpoperineorrhaphy 8,050 9,200 11,500 20,125 SRG04015 Dilatation and curettage 4,480 5,120 6,400 11,200 SRG04016 Hymenectomy 4,480 5,120 6,400 11,200 SRG04017 Fractional curettage 4,480 5,120 6,400 11,200 SRG04018 Simple vulvul tumours removal 5,670 6,480 8,100 14,175 SRG04019 Shirodhkar cervical stitch 7,280 8,320 10,400 18,200 SRG04020 Repair of third degree prolapse 14,140 16,160 20,200 35,350 SRG04021 Anterior repair (cystocele) 8,050 9,200 11,500 20,125 SRG04023 Simple vulvectomy 16,100 18,400 23,000 40,250 SRG04024 Anterior and posterior repair 16,100 18,400 23,000 40,250 SRG04025 Vaginal hysterectomy (simple) 21,770 24,880 31,100 54,425 SRG04026 Abdominal surgery for stress incontinence 16,100 18,400 23,000 40,250 SRG04027 Manchester for prolapse uterus 19,320 22,080 27,600 48,300 SRG04028 Abdominal myomectomy (Simple) 20,160 23,040 28,800 50,400 SRG04029 Salpingoophrectomy 16,100 18,400 23,000 40,250 SRG04030 Ovariotomy 12,880 14,720 18,400 32,200 SRG04031 Ovarian cystectomy (simple) 14,490 16,560 20,700 36,225 SRG04032 Laparotomy for malignant ovarian tumour 24,150 27,600 34,500 60,375 SRG04033 Plastic operation for uterus 8,890 10,160 12,700 22,225 SRG04035 Vesico vaginal fistula repair 24,150 27,600 34,500 60,375 SRG04036 Recto vaginal fistula repair 16,100 18,400 23,000 40,250 SRG04037 Abdominal hysterectomy (Simple) 22,190 25,360 31,700 55,475 SRG04038 Vaginoplasty 24,150 27,600 34,500 60,375 SRG04040 Tuboplasty 20,160 23,040 28,800 50,400 SRG04041 Wertheim's hysterectomy 32,200 36,800 46,000 80,500 SRG04042 Radical vulvectomy 20,160 23,040 28,800 50,400 SRG04043 Leforte operation (prolapse repair) 8,470 9,680 12,100 21,175 SRG04044 Plastic sling operation 16,100 18,400 23,000 40,250 SRG04045 Hysterotomy 14,490 16,560 20,700 36,225 SRG04046 Hysterotomy with ligation 18,130 20,720 25,900 45,325 SRG04047 Tubal ligation 8,050 9,200 11,500 20,125 SRG04048 Laparoscopic sterilization 6,860 7,840 9,800 17,150
58 SRG04050 Excision of urethral caruncle 5,670 6,480 8,100 14,175 SRG04051 Labial cyst 4,060 4,640 5,800 10,150 SRG04053 Abdominal hysterectomy (complicated) 24,150 27,600 34,500 60,375 SRG04054 Cervical polypectomy 3,640 4,160 5,200 9,100 SRG04055 Laser treatment of cervical lesions 8,050 9,200 11,500 20,125 SRG04056 Vulval biopsy 3,640 4,160 5,200 9,100 SRG04057 Trachelorrhaphy 12,110 13,840 17,300 30,275 SRG04058 Vault repair with enterocele 20,160 23,040 28,800 50,400 SRG04059 Resuturing (minor) 4,060 4,640 5,800 10,150 SRG04060 Resuturing (major) 6,440 7,360 9,200 16,100 SRG04061 Suprapubic cystostomy 8,050 9,200 11,500 20,125 SRG04062 Kelly’s repair 6,440 7,360 9,200 16,100 SRG04063 Moscowitz (open) 9,660 11,040 13,800 24,150 SRG04064 Colpotomy 6,440 7,360 9,200 16,100 SRG04065 Mini lap 7,280 8,320 10,400 18,200 SRG04066 Vaginal hysterectomy (complicated) 26,180 29,920 37,400 65,450 SRG04067 Marsuplialisation of bartholin cyst 4,830 5,520 6,900 12,075 SRG04068 Non descent vaginal hysterectomy (Simple) 25,970 29,680 37,100 64,925 SRG04069 Abd. myomectomy (complicated) 26,180 29,920 37,400 65,450 SRG04070 Vault repair 24,150 27,600 34,500 60,375 SRG04071 Hymen repair (plastic) 16,100 18,400 23,000 40,250 SRG04072 Colposcopy (plain) 3,640 4,160 5,200 9,100 SRG04073 Colposcopic directed biopsy 4,830 5,520 6,900 12,075 SRG04074 Vaginal mesh repair (posterior) 14,490 16,560 20,700 36,225 SRG04075 Vaginal mesh repair (anterior) 14,490 16,560 20,700 36,225 SRG04076 Vaginal mesh repair (total) 20,930 23,920 29,900 52,325 SRG04077 Fentons operation 8,050 9,200 11,500 20,125 SRG04078 Complex/non descent vaginal hight 28,210 32,240 40,300 70,525 SRG04079 LEEP 8,050 9,200 11,500 20,125 SRG04080 Abdominal adhesiolyiss 11,270 12,880 16,100 28,175 SRG04097 Mirena insertion 2,450 2,800 3,500 6,125 SRG04128 Abdominal hysterectomy with bilateral salpingo- 30,240 34,560 43,200 75,600 ophrectomy SRG04141 Repair of perineal tear-3rd/4th degree 14,140 16,160 20,200 35,350 SRG04142 Omentectomy 18,130 20,720 25,900 45,325 SRG04143 Internal iliac vessel ligation 16,100 18,400 23,000 40,250 SRG04144 Bladder adhesiolysis 14,140 16,160 20,200 35,350
2. HYSTEROSCOPIC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG04105 LAVH with bilateral salpingoophrectomy 30,240 34,560 43,200 75,600 SRG04121 Hysteroscopic removal of displaced intra uterine 10,080 11,520 14,400 25,200 contraceptive device SRG04122 Hysteroscopic polypectomy 7,700 8,800 11,000 19,250 SRG04124 Ablation of endometrium 12,880 14,720 18,400 32,200 SRG04125 Hysteroscopic synechiolysis 14,140 16,160 20,200 35,350 SRG04126 Hysteroscopic tubal cannulation 14,140 16,160 20,200 35,350 SRG04135 Hysteroscopy guided biopsy 7,280 8,320 10,400 18,200 SRG04136 Hysteroscopic myoma resection 14,490 16,560 20,700 36,225 SRG04137 Hysteroscopic septum resection 16,100 18,400 23,000 40,250 SRG04138 Trans cervical resection of endometrium 16,100 18,400 23,000 40,250
3. LAPAROSCOPIC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG04081 Diagnostic laparoscopy 8,890 10,160 12,700 22,225 SRG04082 Diagnostic hysteroscopy 5,250 6,000 7,500 13,125 SRG04083 Diagnostic lapro with diagnostic hysteroscopy 12,110 13,840 17,300 30,275 SRG04084 Lap. ovarian cystectomy (simple) 16,100 18,400 23,000 40,250 SRG04085 Laparoscopic oophrectomy 14,490 16,560 20,700 36,225 SRG04086 Laparoscopic cyst aspiration 7,280 8,320 10,400 18,200 SRG04087 Laparoscopic biopsy 8,890 10,160 12,700 22,225
59 SRG04088 Lap. multiple puncture of ovaries 12,530 14,320 17,900 31,325 SRG04089 Lap. aspiration of oocyte 8,050 9,200 11,500 20,125 SRG04090 Lap. salpingo ophrectomy 16,100 18,400 23,000 40,250 SRG04091 Lap. salpingostomy 14,140 16,160 20,200 35,350 SRG04092 Lap. salpingectomy 14,140 16,160 20,200 35,350 SRG04093 Lap. fimbriolysis 12,880 14,720 18,400 32,200 SRG04094 Lap. fimbrioplasty 14,140 16,160 20,200 35,350 SRG04095 Lap. adhesiolysis (severe) 16,100 18,400 23,000 40,250 SRG04096 Lap. myomectomy (simple) 22,190 25,360 31,700 55,475 SRG04098 Ablation of endometriotic spot 12,880 14,720 18,400 32,200 SRG04101 Lap myomectomy (Complex) 30,240 34,560 43,200 75,600 SRG04102 Falloposcopy 8,050 9,200 11,500 20,125 SRG04104 Laparoscopic burch operation 22,190 25,360 31,700 55,475 SRG04106 Lap. colposuspension (sacrocolpoplexy) 22,190 25,360 31,700 55,475 SRG04107 Laparoscopic tubal anastomosis 22,190 25,360 31,700 55,475 SRG04108 Lap ovarian cystectomy (complicated) 14,490 16,560 20,700 36,225 SRG04109 Laparoscopic ovarioplasty 14,490 16,560 20,700 36,225 SRG04110 Laparoscopic suturing 7,280 8,320 10,400 18,200 SRG04111 Lap procedure for ectopic pregnancy 20,160 23,040 28,800 50,400 SRG04112 Rudimentary horn laparoscopic excision 22,190 25,360 31,700 55,475 SRG04113 Excision of scar endometrosis 12,880 14,720 18,400 32,200 SRG04114 Laparoscopic wertheims hysterectomy radical 40,250 46,000 57,500 100,625 SRG04115 Lap uterine suspension /sacrohysteropexy 22,190 25,360 31,700 55,475 SRG04116 LUNA 14,490 16,560 20,700 36,225 SRG04118 Excision of endometric lesion/ablation 12,880 14,720 18,400 32,200 SRG04119 Laparoscopic uterine suspension (sling) 18,130 20,720 25,900 45,325 SRG04120 Laparoscopic moscowitz 8,050 9,200 11,500 20,125 SRG04123 Lap removal of IUCD 12,110 13,840 17,300 30,275 SRG04127 Laparoscopic assisted vaginal hysterectomy 24,150 27,600 34,500 60,375 (simple) SRG04129 Laparoscopic assisted vaginal hysterectomy 32,200 36,800 46,000 80,500 (complicated) SRG04130 Total laparoscopic hysterectomy (Simple) 32,200 36,800 46,000 80,500 SRG04131 Lap retroperitoneal node dissection 32,200 36,800 46,000 80,500 (lymphadectomy) SRG04132 Laparoscopic abscess drainage 12,110 13,840 17,300 30,275 SRG04133 Laparoscopic complicated mesh operation 28,210 32,240 40,300 70,525 SRG04134 Lap Omentectomy 18,130 20,720 25,900 45,325 SRG04139 Laparoscopic endometriosis (complicated) 24,150 27,600 34,500 60,375 SRG04140 Mesh laparoscopic vault suspension 22,190 25,360 31,700 55,475 SRG04145 Lap adhesiolysis (Mild) 12,110 13,840 17,300 30,275 SRG04146 Lap adhesiolysis (Moderate) 14,140 16,160 20,200 35,350 SRG04147 Total laparoscopic hysterectomy/TLH (complex) 36,260 41,440 51,800 90,650
4. OTHERS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG04117 TVT 14,490 16,560 20,700 36,225
D6: NEUROSURGERY
1. CATEGORY A SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG06013 Cerebral aneurysm 84,560 96,640 120,800 211,400 SRG06014 AV malformations 84,560 96,640 120,800 211,400 SRG06015 Trans oral micro odontoidectomy 84,560 96,640 120,800 211,400 SRG06016 CP angle tumors 84,560 96,640 120,800 211,400 SRG06017 Supratentorial/posterior fossa meningomas 84,560 96,640 120,800 211,400 SRG06018 Anteriocervical discoidectomy with graft and 84,560 96,640 120,800 211,400 fusion SRG06019 Bitemporal decompression 84,560 96,640 120,800 211,400
60 2. CATEGORY B SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG06001 Brain tumours 64,400 73,600 92,000 161,000 SRG06002 Brain and spinal cord vascular surgeries 72,450 82,800 103,500 181,125 SRG06003 Trans sphenoidal surgery 64,400 73,600 92,000 161,000 SRG06004 Posterior fossa microvascular decompression 72,450 82,800 103,500 181,125 SRG06005 Cranio vertebral anomaly 72,450 82,800 103,500 181,125 SRG06006 Spine (intramedullary tumours) 72,450 82,800 103,500 181,125 SRG06007 Posterior decompression and fusion for spine 64,400 73,600 92,000 161,000 SRG06020 Posterior fossa brain tumor 72,450 82,800 103,500 181,125 SRG06041 Craniostenosis 64,400 73,600 92,000 161,000 SRG06042 Cranioplasty/duroplasty 64,400 73,600 92,000 161,000
3. CATEGORY C SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG06008 Brachial plexus repair 60,410 69,040 86,300 151,025 SRG06009 Carotid endarectomy 44,310 50,640 63,300 110,775 SRG06010 Supratentorial brain tumors 60,410 69,040 86,300 151,025 SRG06021 Brain haemotoma (head injuries) 60,410 69,040 86,300 151,025 SRG06022 Brain haemotoma (hypertensive) 60,410 69,040 86,300 151,025 SRG06023 CSF rhinorrohea 60,410 69,040 86,300 151,025 SRG06024 Anterior encephalocoele 60,410 69,040 86,300 151,025 SRG06025 Spine (extra and intradural tumour) 60,410 69,040 86,300 151,025 SRG06026 Cervical discoidectomy 60,410 69,040 86,300 151,025 SRG06030 Lumbar discoidectomy 60,410 69,040 86,300 151,025 SRG06031 Cervical decompression with laminoplasty 60,410 69,040 86,300 151,025 SRG06033 Cevical ribs (bilateral) 60,410 69,040 86,300 151,025 SRG06034 Microdiscoidectomy lumbar 60,410 69,040 86,300 151,025 SRG06035 Microdiscoidectomy cervical 60,410 69,040 86,300 151,025 SRG06036 Posterior fossa haemotomas 60,410 69,040 86,300 151,025 SRG06037 Posterior CV junction fusion 60,410 69,040 86,300 151,025 SRG06039 Anterior skull base reconstruction 60,410 69,040 86,300 151,025
4. CATEGORY D SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG06027 Spine (anterior decompression) 80,500 92,000 115,000 201,250 SRG06028 Spine (canal stenosis) 80,500 92,000 115,000 201,250
5. CATEGORY E SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG06029 Cervical ribs (unilateral) 48,300 55,200 69,000 120,750 SRG06032 Peripheral nerve surgery 48,300 55,200 69,000 120,750 SRG06038 Lumbar decompression with laminoplasty 48,300 55,200 69,000 120,750 SRG06043 Haemotoma (chronic subdural) 48,300 55,200 69,000 120,750 SRG06044 Meningocoel (occipital/lumbar) 48,300 55,200 69,000 120,750 SRG06045 Shunt 48,300 55,200 69,000 120,750 SRG06048 Peripheral nerve repair 48,300 55,200 69,000 120,750 SRG06052 Temporal rizotomy 48,300 55,200 69,000 120,750 SRG06053 Burr hole 48,300 55,200 69,000 120,750 SRG06064 Duroplasty 48,300 55,200 69,000 120,750 SRG06090 Endoscopic third ventriculostomy 64,400 73,600 92,000 161,000
61 6. OTHERS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG06046 Neurolysis 28,210 32,240 40,300 70,525 SRG06047 Local neurectomy 20,160 23,040 28,800 50,400 SRG06049 Carpal tunnel release 28,210 32,240 40,300 70,525 SRG06061 Skull traction 8,050 9,200 11,500 20,125 SRG06062 Subdural aspiration 6,090 6,960 8,700 15,225 SRG06063 Ventricular puncture 6,090 6,960 8,700 15,225 SRG06071 Lumbar puncture 6,090 6,960 8,700 15,225 SRG06072 Cisternal puncture 6,090 6,960 8,700 15,225 SRG06078 Revision shunt 28,210 32,240 40,300 70,525 SRG06079 Subgleal aspiration 4,060 4,640 5,800 10,150 SRG06089 External ventricular drainage 12,110 13,840 17,300 30,275
D7: OBSTETRICS
1. PROCEDURES PERFORMED IN OT SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG07001 Medical termination of pregnancy 4,480 5,120 6,400 11,200 SRG07002 MTP and laparoscopic sterilization 8,050 9,200 11,500 20,125 SRG07003 Suction evacuation 5,250 6,000 7,500 13,125 SRG07004 MTP (second trimester) (any method) 10,500 12,000 15,000 26,250 SRG07006 Ectopic pregnancy laprotomy (simple) 16,100 18,400 23,000 40,250 SRG07007 Hysterotomy with ligation 12,110 13,840 17,300 30,275 SRG07008 Procedures for ectopic pregnancy (open) 14,140 16,160 20,200 35,350 SRG07009 Resturing of episotomy 6,090 6,960 8,700 15,225 SRG07010 Cervical tear stitching 6,090 6,960 8,700 15,225 SRG07011 Caesarean hysterectomy 24,150 27,600 34,500 60,375 SRG07030 Repair of partially raptured uterus during 6,090 6,960 8,700 15,225 caesarean SRG07031 Hysterotomy 10,500 12,000 15,000 26,250 SRG07032 Ectopic pregnancy laprotomy (complicated) 18,130 20,720 25,900 45,325 SRG07034 Control of postpartum haemorrhage 6,090 6,960 8,700 15,225
1.1 REGULAR DELIVERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG07022 Lower segment caesarean section 20,160 23,040 28,800 50,400 SRG07033 Timed Caesarian (Mahurat) 30,240 34,560 43,200 75,600
1.2 COMPLICATED DELIVERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG07017 Lower segment caesarean section (high risk) 22,540 25,760 32,200 56,350
2. PROCEDURES PERFORMED IN LR SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG07012 ARM (artificial rupture of membrane) 1,050 1,200 1,500 2,625 SRG07013 MRP (manual removal placenta) 4,830 5,520 6,900 12,075
2.1 COMPLICATED DELIVERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG07016 Normal delivery (high risk) 22,540 25,760 32,200 56,350
2.2 REGULAR DELIVERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG07021 Normal delivery 20,160 23,040 28,800 50,400
62 D8: OPTHALMOLOGY
1. GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG08001 Phakic IOL 14,140 16,160 20,200 35,350 SRG08002 Corneal grafting 18,550 21,200 26,500 46,375 SRG08003 Retinal detachment surgery 18,550 21,200 26,500 46,375 SRG08004 Vitrectomy 16,940 19,360 24,200 42,350 SRG08005 Major reconstructive surgery 14,490 16,560 20,700 36,225 SRG08006 Squint (three muscles) 16,100 18,400 23,000 40,250 SRG08007 Excentration 18,550 21,200 26,500 46,375 SRG08008 Socket reconstruction 12,880 14,720 18,400 32,200 SRG08009 Silicon injection 8,050 9,200 11,500 20,125 SRG08010 Gas injection 5,670 6,480 8,100 14,175 SRG08011 Fluid gas exchange 7,280 8,320 10,400 18,200 SRG08013 Glaucoma surgery (trabeculectomy) 12,880 14,720 18,400 32,200 SRG08016 Dacrocytro rhinostomy 12,110 13,840 17,300 30,275 SRG08017 Canaliculo dacrocytro rhinostomy 11,270 12,880 16,100 28,175 SRG08019 Perforating corneo (scleral injury) 17,710 20,240 25,300 44,275 SRG08020 Intraocular foreign body removal 17,710 20,240 25,300 44,275 SRG08021 Enuleation with implant 16,100 18,400 23,000 40,250 SRG08022 Ptosis (single eye) 14,490 16,560 20,700 36,225 SRG08023 Squint (two muscles) 14,490 16,560 20,700 36,225 SRG08024 Cryoretinopexy (open) 6,440 7,360 9,200 16,100 SRG08025 Cryoretinopexy (closed) 6,440 7,360 9,200 16,100 SRG08026 Cyst 5,670 6,480 8,100 14,175 SRG08027 Tumours of iris 5,670 6,480 8,100 14,175 SRG08029 Limbal dermoid removal 5,670 6,480 8,100 14,175 SRG08030 Evisceration 9,660 11,040 13,800 24,150 SRG08031 Enucleation 9,660 11,040 13,800 24,150 SRG08032 Dacryocystectomy 11,270 12,880 16,100 28,175 SRG08033 Exctropion correction (single eye) 11,270 12,880 16,100 28,175 SRG08034 Repair of iris prolapsed 5,670 6,480 8,100 14,175 SRG08035 Small tumour excision lid 8,050 9,200 11,500 20,125 SRG08036 Conjuctiva or cyst 5,670 6,480 8,100 14,175 SRG08037 Anterior chamber wash 6,440 7,360 9,200 16,100 SRG08038 Entropion correction 8,050 9,200 11,500 20,125 SRG08039 Membranectomy 6,440 7,360 9,200 16,100 SRG08040 Capsulotomy 3,640 4,160 5,200 9,100 SRG08041 Buckle removal 3,640 4,160 5,200 9,100 SRG08042 Silicon oil removal 5,670 6,480 8,100 14,175 SRG08043 Pterygium 5,670 6,480 8,100 14,175 SRG08044 Trasorrhaphy (temporary) 3,640 4,160 5,200 9,100 SRG08045 Conjuctival flap 4,480 5,120 6,400 11,200 SRG08046 Cyclocryotherapy 4,060 4,640 5,800 10,150 SRG08047 Syringing and probing 2,870 3,280 4,100 7,175 SRG08048 Symblepharon correction 6,440 7,360 9,200 16,100 SRG08049 Multiple chalazion 4,830 5,520 6,900 12,075 SRG08050 Chalazion surgery 3,220 3,680 4,600 8,050 SRG08051 Wart excision 1,610 1,840 2,300 4,025 SRG08052 Stye 2,030 2,320 2,900 5,075 SRG08053 Tatooing 1,260 1,440 1,800 3,150 SRG08054 Cauterization 1,610 1,840 2,300 4,025 SRG08055 Artificial eye 1,610 1,840 2,300 4,025 SRG08056 Peritomy 1,610 1,840 2,300 4,025 SRG08057 Canthoplasty 8,050 9,200 11,500 20,125 SRG08059 Limbal ring application 1,610 1,840 2,300 4,025 SRG08060 Conjuctival suturing 1,260 1,440 1,800 3,150 SRG08061 Biopsy 5,670 6,480 8,100 14,175 SRG08062 Abscess drainage of lid 2,450 2,800 3,500 6,125 SRG08063 Examination under anaesthesia 2,450 2,800 3,500 6,125
63 SRG08064 Anterior chamber reconstruction 14,490 16,560 20,700 36,225 SRG08065 Pterygium with conjunctival grafting 8,050 9,200 11,500 20,125 SRG08066 Phacoemulsification (cost of lens is extra) 14,490 16,560 20,700 36,225 SRG08067 Cataract 12,110 13,840 17,300 30,275 SRG08068 Trasorrhaphy (permanent) 4,830 5,520 6,900 12,075 SRG08076 Complex lid reconstruction 16,100 18,400 23,000 40,250 SRG08077 Lid reconstruction 11,270 12,880 16,100 28,175 SRG08078 Cosmetic squint surgery (non functional) 6,440 7,360 9,200 16,100 SRG08080 Candicular repair 8,050 9,200 11,500 20,125 SRG08081 Examination of eye under EUA 2,450 2,800 3,500 6,125 SRG08082 Anterior vitrectomy 18,130 20,720 25,900 45,325 SRG08083 Excision of small lid tumour 9,660 11,040 13,800 24,150 SRG08084 Trasorraphy release 1,260 1,440 1,800 3,150 SRG08085 Endocopic DCR 12,110 13,840 17,300 30,275
D9: ORTHOPAEDICS
1. GENERAL ORTHOPAEDICS SERVICE CODE CAT SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG09006 LL Ingrowing toe nail 4,480 5,120 6,400 11,200 SRG09007 SP/LL Aspiration of cold abscess (superficial) 2,660 3,040 3,800 6,650 SRG09016 SP/LL Drainage of abscess cold (deep) 6,440 7,360 9,200 16,100 SRG09017 LL/LL Debridement and closure 7,280 8,320 10,400 18,200 SRG09018 LL/UL Tendon release 6,090 6,960 8,700 15,225 SRG09019 UL Trigger thumb release 6,090 6,960 8,700 15,225 SRG09029 UL/LL Neurolysis 14,140 16,160 20,200 35,350 /SP SRG09030 UL/LL Skin grafting (medium area) 9,660 11,040 13,800 24,150 SRG09038 UL Carpal tunnel release 11,270 12,880 16,100 28,175 SRG09039 UL/LL Sequestrectomy of long bones 14,490 16,560 20,700 36,225 SRG09044 UL Tendon nerve surgery of foot (PML) 11,270 12,880 16,100 28,175 SRG09047 UL Tendon transfer 14,490 16,560 20,700 36,225 SRG09048 UL Tendon repair (one only) 12,880 14,720 18,400 32,200 SRG09049 UL Tendon lengthening (one only) 12,110 13,840 17,300 30,275 SRG09051 UL Dupuytran contracture 8,050 9,200 11,500 20,125 SRG09052 UL/LL Osteotomy (small bone) 12,110 13,840 17,300 30,275 SRG09053 LL Amputation (leg) 16,100 18,400 23,000 40,250 SRG09054 UL Amputation (forearm) 16,100 18,400 23,000 40,250 SRG09055 UL/LL Nerve transplant/release 12,110 13,840 17,300 30,275 SRG09056 UL/LL Skin grafting large area 14,140 16,160 20,200 35,350 SRG09057 UL/LL Tenolysis 12,880 14,720 18,400 32,200 SRG09058 UL/LL Bone biopsy 6,440 7,360 9,200 16,100 SRG09059 UL/LL Excision of accessory bone 10,500 12,000 15,000 26,250 SRG09060 UL/LL Small joint replacement 16,100 18,400 23,000 40,250 SRG09063 UL/LL Excision arthroplasty (joints) 14,140 16,160 20,200 35,350 SRG09068 LL Arthrodesis ankle triple 20,160 23,040 28,800 50,400 SRG09070 UL/LL Girdle stone arthroplasty 14,490 16,560 20,700 36,225 SRG09073 UL/LL Arthrodesis 16,100 18,400 23,000 40,250 SRG09076 UL/LL Nerve repair surgery 14,490 16,560 20,700 36,225 SRG09077 UL/LL Multiple tendon transfer (more than one) 22,190 25,360 31,700 55,475 SRG09080 LL Hip region surgery 18,130 20,720 25,900 45,325 SRG09082 LL Hip nail with osteotomy 18,130 20,720 25,900 45,325 SRG09087 UL/LL Multiple tendon repair 14,140 16,160 20,200 35,350 SRG09089 LL Leg lengthening 24,150 27,600 34,500 60,375 SRG09095 UL/LL Fore quarter/hind quarter amputation 24,150 27,600 34,500 60,375 SRG09097 UL/LL Reconstruction of joint 22,190 25,360 31,700 55,475 SRG09100 UL/LL Bone grafting of cavities 12,880 14,720 18,400 32,200 SRG09107 UL/LL Tendon grafting 16,100 18,400 23,000 40,250 SRG09108 LL Ilizarov fixation 25,760 29,440 36,800 64,400 SRG09109 UL/LL Bone trans plant 20,160 23,040 28,800 50,400 SRG09110 UL/LL Fixater with joint arthrolysis 16,100 18,400 23,000 40,250
64 SRG09115 UL/LL Bone transport 16,100 18,400 23,000 40,250 SRG09118 LL Knee region surgery 12,110 13,840 17,300 30,275 SRG09119 UL/LL Osteotomy around hip/knee/elbow 16,100 18,400 23,000 40,250 SRG09137 UL/LL Closed manipulation of joint under anaesthesia 6,090 6,960 8,700 15,225
SRG09138 UL De quiervains release 8,050 9,200 11,500 20,125 SRG09140 UL Intra articular injection 1,610 1,840 2,300 4,025 SRG09141 UL Joint aspiration 1,610 1,840 2,300 4,025 SRG09147 UL Arthrodesis of joint major 20,160 23,040 28,800 50,400 SRG09148 UL Arthrodesis of joint minor 12,110 13,840 17,300 30,275 SRG09149 UL HTO (High Tibial Osteotomy) 18,130 20,720 25,900 45,325 SRG09151 UL Excission arthroplasty 14,490 16,560 20,700 36,225 SRG09155 UL Core decompresion 18,130 20,720 25,900 45,325
2. JOINTS SERVICE CODE CAT SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG09101 UL/LL Total knee joint replacement(TKR)-primary 34,230 39,120 48,900 85,575 SRG09127 UL/LL Total knee joint replacement (TKR)-primary 38,290 43,760 54,700 95,725 complicated SRG09102 UL/LL Total knee joint replacement(TKR)-revision 46,340 52,960 66,200 115,850 SRG09129 UL/LL Total hip joint replacement (THR)-primary 30,240 34,560 43,200 75,600 SRG09128 UL/LL Total hip joint replacement (THR)-primary 34,230 39,120 48,900 85,575 complicated SRG09178 UL/LL Total hip joint replacement (THR)-revision 46,340 52,960 66,200 115,850 SRG09177 UL/LL Total shoulder joint replacement (TSR)-primary 30,240 34,560 43,200 75,600
SRG09078 UL/LL Total shoulder joint replacement (TSR)-revision 46,340 52,960 66,200 115,850
SRG09081 UL/LL Total elbow joint replacement (TER)-primary 32,200 36,800 46,000 80,500 SRG09088 UL/LL Total elbow joint replacement (TER)-revision 46,340 52,960 66,200 115,850 SRG09114 UL/LL Ankle replacement-primary 32,200 36,800 46,000 80,500 SRG09122 UL/LL Ankle replacement-revision 46,340 52,960 66,200 115,850 SRG09124 UL/LL Finger joint replacement (one joint) 16,100 18,400 23,000 40,250 SRG09125 UL/LL Finger joint replacement (two joints) 24,150 27,600 34,500 60,375 SRG09126 UL/LL Finger joint replacement (three or more joints) 28,210 32,240 40,300 70,525
3. ONCOLOGY SERVICE CODE CAT SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG09086 UL/LL Excision (tumours and bone grafts) 24,150 27,600 34,500 60,375 SRG09112 SP Deep bone biopsy (spine) 8,890 10,160 12,700 22,225 SRG09117 UL/LL Simple bone biopsy 6,090 6,960 8,700 15,225 SRG09131 UL/LL Soft tissue tumor excision (small) 12,110 13,840 17,300 30,275 SRG09132 UL/LL Soft tissue tumor excision (large) 20,160 23,040 28,800 50,400
4. PAEDIATRICS SERVICE CODE CAT SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG09008 LL Club foot and CDH manipulation 2,450 2,800 3,500 6,125 SRG09032 UL/LL Epiphysiodesis 12,110 13,840 17,300 30,275 SRG09033 UL/LL Excision, exostosia 11,270 12,880 16,100 28,175 SRG09042 LL Soutar’s release 12,110 13,840 17,300 30,275 SRG09104 LL Open reduction of CDH 20,160 23,040 28,800 50,400 SRG09105 LL Pelvic osteotomy 22,190 25,360 31,700 55,475 SRG09123 LL CDH surgery 24,150 27,600 34,500 60,375 SRG09139 LL Club foot surgery 24,150 27,600 34,500 60,375
65 5. SPINE SERVICE CODE CAT SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG09092 SP Laminectomy/discectomy-lumbar/cervical (one 26,180 29,920 37,400 65,450 level) SRG09093 SP TLIF/PLIF/PL fusion with pedicle screws one level 36,260 41,440 51,800 90,650
SRG09103 SP Anterior decompression and posterior fixation 40,250 46,000 57,500 100,625 SRG09116 SP Anterior decompression with fixation 38,290 43,760 54,700 95,725 SRG09135 SP Vertebroplasty 22,190 25,360 31,700 55,475 SRG09136 SP Kyphoplasty 32,200 36,800 46,000 80,500 SRG09156 SP Root block 6,440 7,360 9,200 16,100 SRG09158 SP C1/C2 fusion 30,240 34,560 43,200 75,600 SRG09159 SP Coccygectomy 12,880 14,720 18,400 32,200 SRG09160 SP Corpectomy with plating cervical spine (multiple 48,300 55,200 69,000 120,750 levels) SRG09161 SP Corpectomy with plating cervical spine (one 36,260 41,440 51,800 90,650 level) SRG09162 SP Disc replacement 32,200 36,800 46,000 80,500 SRG09163 SP Disectomy lumbar/cervical (multiple levels) 26,600 30,400 38,000 66,500 SRG09164 SP Disectomy with plating cervical spine (multiple 48,300 55,200 69,000 120,750 levels) SRG09165 SP Disectomy with plating cervical spine (one level) 32,200 36,800 46,000 80,500
SRG09166 SP Halo application 8,890 10,160 12,700 22,225 SRG09169 SP Laminectomy lumbar/cervical (multiple levels) 34,230 39,120 48,900 85,575 SRG09170 SP Pedicle screw fixation/lateral mass fixation (two 26,600 30,400 38,000 66,500 levels) SRG09171 SP Pedicle screw fixation/lateral mass fixation (> 32,200 36,800 46,000 80,500 two levels) SRG09172 SP Posterior element biopsy 5,670 6,480 8,100 14,175 SRG09173 SP Removal posterior spinal instrumentation 12,110 13,840 17,300 30,275 SRG09174 SP Scoliosis posterior and anterior approach 52,360 59,840 74,800 130,900 SRG09175 SP Scoliosis posterior approach 48,300 55,200 69,000 120,750 SRG09176 SP TLIF/PLIF/PL fusion with pedicle screws (multiple 40,250 46,000 57,500 100,625 levels) SRG09079 SP Antero lateral decompression and fusion 36,260 41,440 51,800 90,650 SRG09091 SP Spinal instrumentation 36,260 41,440 51,800 90,650
6. SPORT MEDICINE SERVICE CODE CAT SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG09009 LL/UL Dislocation-elbow/knee/hip/shoulder 13,300 15,200 19,000 33,250 SRG09066 LL Menisectomy and repair 14,490 16,560 20,700 36,225 SRG09067 LL Synovectomy 13,720 15,680 19,600 34,300 SRG09071 UL/LL Arthroscopic surgery 14,490 16,560 20,700 36,225 SRG09075 UL Recurrent dislocation shoulder/patella 28,210 32,240 40,300 70,525 SRG09106 LL Reconstruction of acl/pcl 26,180 29,920 37,400 65,450 SRG09113 UL Acromion reconstruction and acnomioplasty 13,720 15,680 19,600 34,300 SRG09133 UL/LL Ligament repair 12,110 13,840 17,300 30,275 SRG09134 UL/LL Diagnostic arthroscopy 12,110 13,840 17,300 30,275 SRG09142 UL Shoulder arthroscopy 16,100 18,400 23,000 40,250 SRG09143 UL Rotator cuff repair 18,130 20,720 25,900 45,325 SRG09144 UL Tendon repair/release 13,720 15,680 19,600 34,300 SRG09146 UL AC joint repair 13,720 15,680 19,600 34,300 SRG09152 UL Arthroscopic bankart's repair 25,970 29,680 37,100 64,925 SRG09153 UL Arthroscopic rotator cuff 26,180 29,920 37,400 65,450 SRG09157 U Collateral ligament repair 13,720 15,680 19,600 34,300
66 7. TRAUMA SERVICE CODE CAT SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG09001 L/L Hip spica 6,090 6,960 8,700 15,225 SRG09002 UL Shoulder jacket 6,090 6,960 8,700 15,225 SRG09003 UL/LL Casting of limb (A/K A/E B/E) 3,430 3,920 4,900 8,575 SRG09004 SP/LL Bucks traction (skin) 1,260 1,440 1,800 3,150 SRG09005 SP/LL Skeletal traction 5,670 6,480 8,100 14,175 SRG09010 LL/UL Closed reduction-long bones (leg/arm) 6,090 6,960 8,700 15,225 SRG09011 LL/UL Amputation of finger/digits 9,660 11,040 13,800 24,150 SRG09012 LL/UL Skin grafting (small) 6,090 6,960 8,700 15,225 SRG09013 LL/UL Bone grafting (alone) 12,880 14,720 18,400 32,200 SRG09014 LL/UL Bone grafting (addition to internal fixation) 11,270 12,880 16,100 28,175 SRG09015 LL/UL Close fixation (hand and foot bones) 12,110 13,840 17,300 30,275 SRG09020 UL/LL Open reduction of small joint 12,110 13,840 17,300 30,275 SRG09022 UL/LL Removal of wire/pin 4,830 5,520 6,900 12,075 SRG09023 UL/LL Removal of screw 5,670 6,480 8,100 14,175 SRG09024 UL/LL Splinting of fractures 3,220 3,680 4,600 8,050 SRG09025 UL/LL Cast bracing 6,860 7,840 9,800 17,150 SRG09026 UL/LL Drainage of major joint 10,920 12,480 15,600 27,300 SRG09027 UL Fasciotomy 11,270 12,880 16,100 28,175 SRG09028 LL Tenotomy 7,280 8,320 10,400 18,200 SRG09031 UL/LL External fixation (long bone) 12,110 13,840 17,300 30,275 SRG09034 UL/LL Removal of implant 10,500 12,000 15,000 26,250 SRG09035 UL/LL Emergency close reduction and cast 8,050 9,200 11,500 20,125 SRG09036 UL/LL Internal fixation (small bone) 10,500 12,000 15,000 26,250 SRG09037 LL External fixation of pelvis 15,330 17,520 21,900 38,325 SRG09040 UL/LL Percutaneous fixation of fracture 14,140 16,160 20,200 35,350 SRG09041 LL Vasularized grafting 26,600 30,400 38,000 66,500 SRG09043 LL Patellectomy 12,110 13,840 17,300 30,275 SRG09045 UL/LL Excision head radius 12,110 13,840 17,300 30,275 SRG09046 UL Arthorotomy 14,490 16,560 20,700 36,225 SRG09061 UL/LL Internal fixation (lateral epicondyle) 14,140 16,160 20,200 35,350 SRG09062 UL Fracture olecranon of ulna (ORIF) 14,140 16,160 20,200 35,350 SRG09065 UL Clavicle surgery 15,330 17,520 21,900 38,325 SRG09069 UL/LL Open reduction internal fixation (2 small bones) 15,330 17,520 21,900 38,325
SRG09072 UL/LL Open reduction internal fixation (long bone) 20,160 23,040 28,800 50,400 SRG09074 UL/LL Open reduction (hip knee shoulder elbow) 20,160 23,040 28,800 50,400 SRG09084 LL Bimalleolar fracture fixation 20,160 23,040 28,800 50,400 SRG09085 UL/LL Open reduction internal fixation (2+ small bones) 12,110 13,840 17,300 30,275
SRG09090 LL Dynamic hip screw/dynamic compression screw 20,160 23,040 28,800 50,400 SRG09094 UL/LL ORIF-compound fracture long bone 22,190 25,360 31,700 55,475 SRG09096 LL Acetabulam fractures 28,210 32,240 40,300 70,525 SRG09098 UL/LL Interlocking nail 22,190 25,360 31,700 55,475 SRG09099 UL/LL Joint reconstruction 22,190 25,360 31,700 55,475 SRG09111 UL/LL Pelvic fracture fixation (external) 16,100 18,400 23,000 40,250 SRG09120 LL Pubic symphysis fixation 16,100 18,400 23,000 40,250 SRG09121 LL Trimalleolar fixation 24,150 27,600 34,500 60,375 SRG09145 UL Tension band wire/wiring patella 14,490 16,560 20,700 36,225 SRG09150 UL Hemiarthroplasty 26,180 29,920 37,400 65,450
D10: PAEDIATRICS
1. GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG10001 Colostomy 14,490 16,560 20,700 36,225 SRG10002 Supra pubic drainage (open) 6,860 7,840 9,800 17,150 SRG10003 Cystolithotomy 12,110 13,840 17,300 30,275 SRG10004 Inguinal hernia (unilateral) 12,110 13,840 17,300 30,275 SRG10005 Inguinal hernia (bilateral) 17,710 20,240 25,300 44,275
67 SRG10006 Pyloric stenosis (ramsted OP) 16,100 18,400 23,000 40,250 SRG10007 Orchidopexy (unilateral) 14,490 16,560 20,700 36,225 SRG10008 Orchidopexy (bilateral) 22,540 25,760 32,200 56,350 SRG10009 Neonatal obstruction 20,160 23,040 28,800 50,400 SRG10010 Neonatal intestinal atersia 24,150 27,600 34,500 60,375 SRG10011 Diaphragmatic hernia 28,210 32,240 40,300 70,525 SRG10012 Abdominal perineal pull through 28,210 32,240 40,300 70,525 SRG10013 Esophageal atresia (fistula) 28,210 32,240 40,300 70,525 SRG10014 Tracheo esophageal (fistula) 28,210 32,240 40,300 70,525 SRG10015 Colon transposition 28,210 32,240 40,300 70,525 SRG10016 Lymph node biopsy (superficial) 6,440 7,360 9,200 16,100 SRG10017 Lymph node biopsy (deep) 10,500 12,000 15,000 26,250 SRG10018 Meatotomy 3,220 3,680 4,600 8,050 SRG10019 Incision and drainage 5,670 6,480 8,100 14,175 SRG10020 Gluteal abscess/neck under GA 5,250 6,000 7,500 13,125 SRG10021 Gluteal abscess/neck superficial 2,310 2,640 3,300 5,775 SRG10022 Anal dilatation 5,670 6,480 8,100 14,175 SRG10023 Rectal polyp 5,670 6,480 8,100 14,175 SRG10024 Rectal biopsy 5,670 6,480 8,100 14,175 SRG10025 Urethroplasty (distal) 16,100 18,400 23,000 40,250 SRG10026 Urethroplasty (proximal) 20,160 23,040 28,800 50,400 SRG10027 Chordee correction 16,100 18,400 23,000 40,250 SRG10028 Pyeloplasty 26,180 29,920 37,400 65,450 SRG10029 Pyelolithotomy 26,180 29,920 37,400 65,450 SRG10030 Anal transposition for ectopic anus 24,150 27,600 34,500 60,375 SRG10031 Resection and anastamosis of intestine 20,160 23,040 28,800 50,400 SRG10032 Meckel’s diverticulectomy 16,100 18,400 23,000 40,250 SRG10033 Laparotomy 14,140 16,160 20,200 35,350 SRG10035 Appendicectomy 18,130 20,720 25,900 45,325 SRG10036 Circumcision 6,440 7,360 9,200 16,100 SRG10037 Closure colostomy 16,100 18,400 23,000 40,250 SRG10038 Vesicostomy 14,490 16,560 20,700 36,225 SRG10039 Torsion testis exploration 16,100 18,400 23,000 40,250 SRG10040 Umbilical hernia 14,490 16,560 20,700 36,225 SRG10041 Herniotomy (unilateral) 12,110 13,840 17,300 30,275 SRG10042 Herniotomy (bilateral) 17,710 20,240 25,300 44,275 SRG10043 Thyroglossal cyst/brachial fistula 16,100 18,400 23,000 40,250 SRG10044 Nephrolithotomy 24,150 27,600 34,500 60,375 SRG10045 Intussusception reduction 20,160 23,040 28,800 50,400 SRG10046 Ureterotomy 24,150 27,600 34,500 60,375 SRG10047 Gastrostomy 14,490 16,560 20,700 36,225 SRG10048 Epigastric hernia 14,490 16,560 20,700 36,225 SRG10049 Surgery for intra-abdominal mass/cyst duplication 28,210 32,240 40,300 70,525 SRG10050 Lap retroperitoneal dissection 26,180 29,920 37,400 65,450 SRG10051 Hand/Foot Surgery 16,100 18,400 23,000 40,250 SRG10052 Laceration 12,110 13,840 17,300 30,275 SRG10053 Thoracotomy 24,150 27,600 34,500 60,375
D11: PAIN CLINIC
1. GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG15001 Therapeutic epidural (for back pain) 4,060 4,640 5,800 10,150 SRG15002 Trigeminal nerve block 2,450 2,800 3,500 6,125 SRG15003 Intercostal nerve block 4,060 4,640 5,800 10,150 SRG15004 Stellate ganglion block 4,060 4,640 5,800 10,150 SRG15005 Paravertebral block 2,030 2,320 2,900 5,075 SRG15006 Coelial plexus block 4,060 4,640 5,800 10,150 SRG15007 Thoracic epidural 8,050 9,200 11,500 20,125 SRG15008 Caudal epidural 6,440 7,360 9,200 16,100 SRG15009 Lumbar epidural 6,440 7,360 9,200 16,100
68 D12: PLASTIC
1. GENERAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG11015 Hypospadias (meatotomy) 8,050 9,200 11,500 20,125 SRG11016 Hypospadias (1st stage) 16,100 18,400 23,000 40,250 SRG11017 Hypospadias (single stage) 28,210 32,240 40,300 70,525 SRG11018 Hypospadias (2nd stage) 28,210 32,240 40,300 70,525 SRG11019 Hypospadiasis fistulae 16,100 18,400 23,000 40,250 SRG11020 Hypospadias (complete redo) 17,710 20,240 25,300 44,275 SRG11021 Z plasty peno scrotal webbing 16,100 18,400 23,000 40,250 SRG11022 Vaginoplasty 25,760 29,440 36,800 64,400 SRG11040 Small patch (skin grafting) 12,110 13,840 17,300 30,275 SRG11041 Large patch (skin grafting) 24,150 27,600 34,500 60,375 SRG11048 Excision (Ist cyst/mole) 8,050 9,200 11,500 20,125 SRG11049 Excision (Ist scar) 14,140 16,160 20,200 35,350 SRG11050 Excision (large scars) 20,160 23,040 28,800 50,400 SRG11051 Excision (multiple scars) 24,150 27,600 34,500 60,375 SRG11052 Excision (large mole) 10,080 11,520 14,400 25,200 SRG11053 Excision (large mole skin graft) 14,140 16,160 20,200 35,350 SRG11054 Pre auricular sinus 9,660 11,040 13,800 24,150 SRG11072 Suturing accidental wounds (small cut) 8,050 9,200 11,500 20,125 SRG11073 Suturing accidental wounds (large cut) 12,110 13,840 17,300 30,275 SRG11074 Suturing accidental wounds (multiple large cut) 16,100 18,400 23,000 40,250 SRG11075 Suturing accidental wounds (ext laceration) 16,100 18,400 23,000 40,250 SRG11076 Ext laceration with skin graft 17,710 20,240 25,300 44,275 SRG11077 Burn grafting (small) 12,880 14,720 18,400 32,200 SRG11078 Burn grafting (medium) 18,550 21,200 26,500 46,375 SRG11079 Burn grafting (large) 24,150 27,600 34,500 60,375 SRG11080 Burn grafting (extensive) 32,200 36,800 46,000 80,500 SRG11081 Burn grafting (very extensive) 32,200 36,800 46,000 80,500 SRG11082 Small BCC primary reconstruction and skin graft 11,270 12,880 16,100 28,175 SRG11083 Extensive primary reconstruction and skin graft 16,100 18,400 23,000 40,250 SRG11101 Burn desloughing (small area) 6,440 7,360 9,200 16,100 SRG11102 Burn desloughing (medium area) 8,050 9,200 11,500 20,125 SRG11103 Burn desloughing (large area) 12,110 13,840 17,300 30,275 SRG11104 Release of contractures and grafting (small) 12,110 13,840 17,300 30,275 SRG11105 Release of contractures and grafting (medium) 18,130 20,720 25,900 45,325 SRG11106 Release of contractures and grafting (large) 24,150 27,600 34,500 60,375 SRG11107 Release of contractures and grafting (extensive) 28,210 32,240 40,300 70,525 SRG11108 Release of contractures and grafting (very 32,200 36,800 46,000 80,500 extensive) SRG11109 Dressing (major) 3,640 4,160 5,200 9,100 SRG11110 Dressing (very major) 8,050 9,200 11,500 20,125 SRG11111 Dressing (minor) 2,030 2,320 2,900 5,075 SRG11112 Dressing (very minor) 1,610 1,840 2,300 4,025 SRG11113 Local flap 12,880 14,720 18,400 32,200 SRG11114 Local flap (large) 17,710 20,240 25,300 44,275 SRG11115 Vy plasty 16,100 18,400 23,000 40,250 SRG11116 Small skin graft 14,140 16,160 20,200 35,350 SRG11117 Multiple skin graft 20,160 23,040 28,800 50,400 SRG11118 Epispadius 32,200 36,800 46,000 80,500 SRG11143 Tissue expander insertion 20,160 23,040 28,800 50,400 SRG11144 Tissue expander removal and inset 20,160 23,040 28,800 50,400 SRG11166 Pedicle flap (small) 20,160 23,040 28,800 50,400 SRG11167 Pedicle flap (large) 26,180 29,920 37,400 65,450 SRG11168 Flap delay 8,050 9,200 11,500 20,125
69 SRG11169 Full thickness skin graft (small) 12,110 13,840 17,300 30,275 SRG11170 Full thickness skin graft (large) 20,160 23,040 28,800 50,400 SRG11084 Medium patch (skin grafting) 18,130 20,720 25,900 45,325
2. HAND SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG11023 Syndactyly (1 finger) 20,160 23,040 28,800 50,400 SRG11024 Syndactyly (1 finger skin graft) 24,150 27,600 34,500 60,375 SRG11025 Syndactyly (2 fingers) 20,160 23,040 28,800 50,400 SRG11026 Syndactyly (2 fingers skin graft) 24,150 27,600 34,500 60,375 SRG11027 Syndactyly (3 fingers) 20,160 23,040 28,800 50,400 SRG11028 Syndactyly (3 fingers skin graft) 24,150 27,600 34,500 60,375 SRG11132 Hand tendon (single) 20,160 23,040 28,800 50,400 SRG11133 Hand tendon (multiple) 26,180 29,920 37,400 65,450 SRG11134 Hand major AO 22,190 25,360 31,700 55,475 SRG11155 Replantation (single digit) 36,260 41,440 51,800 90,650 SRG11156 Replantation (2 fingers) 44,310 50,640 63,300 110,775 SRG11157 Nerve graft 28,210 32,240 40,300 70,525 SRG11158 Nerve repair 20,930 23,920 29,900 52,325 SRG11159 Arterial repair 24,150 27,600 34,500 60,375 SRG11160 Revascularisation (digits) 32,200 36,800 46,000 80,500 SRG11161 Revascularisation (extremity) 40,250 46,000 57,500 100,625
3. COSMETIC SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG11029 Split ear lobules (one ear) 4,830 5,520 6,900 12,075 SRG11030 Split ear lobules (two ears) 7,280 8,320 10,400 18,200 SRG11031 Split ear lobules (keloid-1 ear) 5,250 6,000 7,500 13,125 SRG11032 Split ear lobules (keloid-2 ear) 6,090 6,960 8,700 15,225 SRG11033 Bat ear 20,160 23,040 28,800 50,400 SRG11034 Accessing auricles 6,440 7,360 9,200 16,100 SRG11038 Dermabrasion face (part face) 16,100 18,400 23,000 40,250 SRG11039 Dermabrasion face (full face) 26,180 29,920 37,400 65,450 SRG11042 Rhinoplasty (tip work) 20,160 23,040 28,800 50,400 SRG11043 Rhinoplasty (hump reduction) 24,150 27,600 34,500 60,375 SRG11044 Rhinoplasty (full job) 28,210 32,240 40,300 70,525 SRG11045 Rhinoplasty (bone grafting) 30,240 34,560 43,200 75,600 SRG11046 Rhinoplasty (implant) 20,160 23,040 28,800 50,400 SRG11047 Rhinoplasty (manipulation fractured nose) 14,490 16,560 20,700 36,225 SRG11055 Eye lid reduction (cosmetic) 18,130 20,720 25,900 45,325 SRG11056 Breast augmentation (unilateral) 16,100 18,400 23,000 40,250 SRG11057 Breast augmentation (bilateral) 28,210 32,240 40,300 70,525 SRG11059 Breast reduction (small) (upto 500 gms each) 32,200 36,800 46,000 80,500 SRG11060 Breast reduction (medium) (500-1,000 gms each) 36,260 41,440 51,800 90,650 SRG11061 Breast reduction (large) (1,000-1,500 gms each) 40,250 46,000 57,500 100,625 SRG11063 Face lift (mini) 32,200 36,800 46,000 80,500 SRG11064 Face lift (full) 40,250 46,000 57,500 100,625 SRG11065 Liposuctions (small area) 12,880 14,720 18,400 32,200 SRG11066 Liposuctions (medium area) 20,160 23,040 28,800 50,400 SRG11067 Liposuctions (large area) 28,210 32,240 40,300 70,525 SRG11068 Liposuctions (multiple area) 28,210 32,240 40,300 70,525 SRG11069 Lipectomy (minor) 12,110 13,840 17,300 30,275 SRG11070 Lipectomy (major) 20,160 23,040 28,800 50,400 SRG11071 Lipectomy (massive) 20,930 23,920 29,900 52,325 SRG11120 Chin augmentation 20,160 23,040 28,800 50,400 SRG11131 Abdominoplasty+liposuction 40,250 46,000 57,500 100,625 SRG11145 Gynaecomastia (unilateral) 16,940 19,360 24,200 42,350 SRG11146 Gynaecomastia (bilateral) 28,210 32,240 40,300 70,525 SRG11148 Blepharoplasty (2 lids) 20,160 23,040 28,800 50,400 SRG11149 Blepharoplasty (4 lids) 28,210 32,240 40,300 70,525 SRG11163 Breast reconstruction with implant 32,200 36,800 46,000 80,500
70 4. CRANIOFACIAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG11001 Cleft lip (incomplete) 16,940 19,360 24,200 42,350 SRG11002 Cleft lip (complete) 26,180 29,920 37,400 65,450 SRG11003 Cleft lip (with alveolia) 26,180 29,920 37,400 65,450 SRG11004 Cleft lip (with anterior palate) 20,160 23,040 28,800 50,400 SRG11005 Cleft lip (complete redo) 24,150 27,600 34,500 60,375 SRG11006 Cleft lip (bilateral cleft lip both side) 20,930 23,920 29,900 52,325 SRG11007 Cleft palate (soft) 20,160 23,040 28,800 50,400 SRG11008 Cleft palate (complete) 20,160 23,040 28,800 50,400 SRG11009 Cleft palate (secondary) 24,150 27,600 34,500 60,375 SRG11010 Cleft palate (pharyngoplasty) 32,200 36,800 46,000 80,500 SRG11011 Cleft palate (paletal fistula) 24,150 27,600 34,500 60,375 SRG11012 Alar adjustment 13,300 15,200 19,000 33,250 SRG11013 Vermillion adjustment 12,110 13,840 17,300 30,275 SRG11014 Z plasty to lip 8,890 10,160 12,700 22,225 SRG11035 Ear reconstruction (1st stage) 28,210 32,240 40,300 70,525 SRG11036 Ear reconstruction (2nd stage) 21,770 24,880 31,100 54,425 SRG11037 Ear reconstruction (3rd stage) 16,100 18,400 23,000 40,250 SRG11121 Malar (closed) 14,490 16,560 20,700 36,225 SRG11122 Malar (plating) 20,160 23,040 28,800 50,400 SRG11123 Mandible or maxilla fracture 26,180 29,920 37,400 65,450 SRG11124 Mandible and maxilla AO 20,160 23,040 28,800 50,400 SRG11125 Tempo mandibular joint unilateral 20,160 23,040 28,800 50,400 SRG11126 Tempo mandibular joint (rib graft) 24,150 27,600 34,500 60,375 SRG11127 Remove arch bar 4,060 4,640 5,800 10,150 SRG11129 Ptosis 16,940 19,360 24,200 42,350 SRG11130 Eye lid ptosis (bilateral) 16,940 19,360 24,200 42,350
5. RECONSTRUCTIVE MICROSURGERY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG11135 Vas recanalisation magnification 16,100 18,400 23,000 40,250 SRG11147 Free flap reconstruction 40,250 46,000 57,500 100,625 SRG11162 Breast reconstruction with free flap 48,300 55,200 69,000 120,750 SRG11164 Breast reconstruction with pedicle flap 28,210 32,240 40,300 70,525
D13: THORAIC/VASCULAR
1. CONVENTIONAL SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG12001 Chest aspiration (diagnostic) 2,450 2,800 3,500 6,125 SRG12002 Chest aspiration (therapeutic) 4,060 4,640 5,800 10,150 SRG12003 Pericardial aspiration 5,670 6,480 8,100 14,175 SRG12004 Bronchoscopy (diagnostic) 6,090 6,960 8,700 15,225 SRG12005 Oesophageoscopy 4,060 4,640 5,800 10,150 SRG12006 Needle biopsy (lung pleura) 5,250 6,000 7,500 13,125 SRG12008 Intcostal drainage (haemothorax) 8,050 9,200 11,500 20,125 SRG12009 Intercostal drainage (empyoma) 8,050 9,200 11,500 20,125 SRG12010 Lung biopsy (open) 12,110 13,840 17,300 30,275 SRG12011 Mediastinal lymph node biopsy 11,270 12,880 16,100 28,175 SRG12012 Rib resection and drainge empyma 9,660 11,040 13,800 24,150 SRG12013 Pericardial drainage 12,110 13,840 17,300 30,275 SRG12014 Repair pharyngeal diverticulum 12,110 13,840 17,300 30,275 SRG12015 Hiatus hernia repair 24,150 27,600 34,500 60,375 SRG12016 Cervical rib excision 16,100 18,400 23,000 40,250 SRG12017 First rib excision 24,150 27,600 34,500 60,375 SRG12019 Oesophagial devas for protalhypertension 10,500 12,000 15,000 26,250 SRG12020 Mitral valvotomy 12,880 14,720 18,400 32,200 SRG12021 Thoractomy 20,160 23,040 28,800 50,400 SRG12022 Decortication 28,210 32,240 40,300 70,525
71 SRG12023 Pericardiectomy 32,200 36,800 46,000 80,500 SRG12024 Portocaval shunt 28,210 32,240 40,300 70,525 SRG12025 Spleno renal shunt 28,210 32,240 40,300 70,525 SRG12026 Masentrico caval shunt 28,210 32,240 40,300 70,525 SRG12027 Colon replacement of oesophage 14,490 16,560 20,700 36,225 SRG12028 Tracheo oesophageal fistula 28,210 32,240 40,300 70,525 SRG12029 Diaphragmatic hernia 30,240 34,560 43,200 75,600 SRG12030 Segmental resection (pulmonary) 26,180 29,920 37,400 65,450 SRG12031 Pulmonary resection (lobectomy) 36,260 41,440 51,800 90,650 SRG12032 Pulmonary resection (pheumanectomy) 32,200 36,800 46,000 80,500 SRG12033 Blalok shunt 14,490 16,560 20,700 36,225 SRG12034 Varicose veins stripping (unilateral) 22,190 25,360 31,700 55,475 SRG12035 Varicose veins stripping (bilateral) 26,180 29,920 37,400 65,450 SRG12036 External varicose vein stripping (ligation PF) 14,490 16,560 20,700 36,225 SRG12037 Venous thrombectomy 22,190 25,360 31,700 55,475 SRG12038 Venous reconstruction 14,490 16,560 20,700 36,225 SRG12039 Femoral endarectomy-profunda plasty 24,150 27,600 34,500 60,375 SRG12040 Bypass graft IFT endarectomy 24,150 27,600 34,500 60,375 SRG12041 Femoro (poplitial bypass graft) 24,150 27,600 34,500 60,375 SRG12042 Femoro (tibial bypass graft) 24,150 27,600 34,500 60,375 SRG12043 Aeroilial bypass resection abdomen arsm 26,180 29,920 37,400 65,450 SRG12044 Aortafemoral bypass resection abdominal 32,200 36,800 46,000 80,500 SRG12045 Reno vascular hypertension 14,490 16,560 20,700 36,225 SRG12046 Occulion of visceral arteries 18,130 20,720 25,900 45,325 SRG12047 Carotid endarectomy 40,250 46,000 57,500 100,625 SRG12048 Revascularisation of neck vessels 13,720 15,680 19,600 34,300 SRG12049 Peripheral aneurysms surgery 18,130 20,720 25,900 45,325 SRG12050 Arterio venous fistula high risk 16,100 18,400 23,000 40,250 SRG12051 Arterio venous fistula with graft 18,130 20,720 25,900 45,325 SRG12052 Acute peripheral arterial injuries 20,160 23,040 28,800 50,400 SRG12053 Reconstruction in visceral arterial 16,100 18,400 23,000 40,250 SRG12054 Reconstruction in aortic injuries 16,100 18,400 23,000 40,250 SRG12055 Embolectomy (unilateral) 26,180 29,920 37,400 65,450 SRG12056 Embolectomy (bilateral) 30,240 34,560 43,200 75,600 SRG12057 Aortic embolectomy (same sitting) 17,710 20,240 25,300 44,275 SRG12058 Thoracic aortic aneurysm 36,260 41,440 51,800 90,650 SRG12059 Coartation of aorta 28,210 32,240 40,300 70,525 SRG12060 Arterio venous shunt 6,440 7,360 9,200 16,100 SRG12061 Arterio venous fistula (wrist) 12,110 13,840 17,300 30,275 SRG12062 Arterio venous fistula (others) 12,110 13,840 17,300 30,275 SRG12063 Graft operation 16,100 18,400 23,000 40,250 SRG12064 Percutaneous subclavian catheter 4,060 4,640 5,800 10,150 SRG12065 Percutaneous femoral vein catheter 3,080 3,520 4,400 7,700 SRG12066 Removal of shunt in OT 1,610 1,840 2,300 4,025 SRG12067 Thoracic outlet decompression 19,320 22,080 27,600 48,300 SRG12068 Lumber sympathectomy (unilateral) 19,320 22,080 27,600 48,300 SRG12069 Lumber sympathectomy (bilateral) 24,150 27,600 34,500 60,375 SRG12070 Cervical sympathectomy 20,160 23,040 28,800 50,400 SRG12071 Operation for lymphedema 12,110 13,840 17,300 30,275 SRG12072 Small congenital angiometers malformation 4,830 5,520 6,900 12,075 SRG12073 Big congenital angiometers malformation 5,670 6,480 8,100 14,175 SRG12074 Femoral arteriography 5,670 6,480 8,100 14,175 SRG12075 Carotid arteriography 4,830 5,520 6,900 12,075 SRG12076 Venography 4,060 4,640 5,800 10,150 SRG12077 Thoraco plasty 32,200 36,800 46,000 80,500 SRG12078 Intercostal drainage pneumothorax 8,050 9,200 11,500 20,125 SRG12079 Bronchoscopy (foreign body removal) 12,110 13,840 17,300 30,275 SRG12080 Bronchoscopy (therapeutic) 14,490 16,560 20,700 36,225 SRG12081 Aortic abdominal aneurysm surgery 32,200 36,800 46,000 80,500 SRG12082 Excision of carotid body with use of shunt 32,200 36,800 46,000 80,500 SRG12083 Carotid bypass graft 32,200 36,800 46,000 80,500
72 SRG12084 Femoro-femoral cross over graft 24,150 27,600 34,500 60,375 SRG12085 Axillo femoral bypass 28,210 32,240 40,300 70,525 SRG12086 Femoro popliteal bypass (synthetic) 24,150 27,600 34,500 60,375 SRG12087 Any other bypass using vein 26,180 29,920 37,400 65,450 SRG12088 Femoro distal bypass 32,200 36,800 46,000 80,500 SRG12089 Femoro arteriogram 5,670 6,480 8,100 14,175 SRG12090 Re-exploration for bleeding 9,660 11,040 13,800 24,150 SRG12091 Diabetic foot debridement (minor) 4,830 5,520 6,900 12,075 SRG12092 Diabetic foot debridement (major) 7,280 8,320 10,400 18,200 SRG12093 Fasciotomy (small) 3,220 3,680 4,600 8,050 SRG12094 Fasciotomy (large) 9,660 11,040 13,800 24,150 SRG12095 Sclerotherapy for varicose veins 2,870 3,280 4,100 7,175 SRG12096 Bi-illiac artery repair 15,330 17,520 21,900 38,325 SRG12097 Exploration of vessels 14,140 16,160 20,200 35,350 SRG12113 Diagnostic thoracoscopy and drainage 12,110 13,840 17,300 30,275 SRG12114 Diagnostic thoracoscopy with biopsy 16,100 18,400 23,000 40,250 SRG12115 Excision chest wall tumour excluding ribs 32,200 36,800 46,000 80,500 SRG12116 Excision chest wall tumour including ribs 28,210 32,240 40,300 70,525 SRG12117 Thorascopic fenestration of pericardium for 24,150 27,600 34,500 60,375 pericardial effusion SRG12118 Thoracoscopic decortication 32,200 36,800 46,000 80,500 SRG12119 Thoracoscopic segmental resection of lung 32,200 36,800 46,000 80,500 SRG12120 Thoracoscopic bullectomy 32,200 36,800 46,000 80,500 SRG12121 Thoracscopic excision of bronchogenic cyst of 22,540 25,760 32,200 56,350 lungs SRG12122 Thorascopic removal of hydatid cyst of lung 22,540 25,760 32,200 56,350 SRG12123 Thoracotomy and mediastinal lymph node biopsy 12,110 13,840 17,300 30,275 SRG12124 Closure of broncopleural fistula 36,260 41,440 51,800 90,650 SRG12125 Bullectomy 32,200 36,800 46,000 80,500 SRG12126 Rigid bronchoscopy 16,100 18,400 23,000 40,250 SRG12127 Surgery for pericardial or bronchogenic, dermoid, 22,540 25,760 32,200 56,350 hydatid SRG12128 Lung volume reduction surgery 36,260 41,440 51,800 90,650 SRG12129 Thoracotomy, pleurectomy and excision of 28,210 32,240 40,300 70,525 emphysematous bullae SRG12130 Injection varicose veins 2,030 2,320 2,900 5,075 SRG12131 Venesection 8,050 9,200 11,500 20,125 SRG12132 Traumatic vascular repair 28,210 32,240 40,300 70,525 SRG12133 Traumatic vascular anastomosis 28,210 32,240 40,300 70,525 SRG12136 SEPS (perforator ligation for varicose veins) 8,050 9,200 11,500 20,125 SRG12137 SEPS+stripping and ligation 12,110 13,840 17,300 30,275 SRG12138 Operation for cervical rib 24,150 27,600 34,500 60,375
2. LAPAROSCOPIC SURGERIES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG12134 Laparoscopic surgery for varicose vein (unilateral) 24,150 27,600 34,500 60,375 SRG12135 Laparoscopic surgery for varicose vein (bilateral) 28,210 32,240 40,300 70,525 SRG12139 Laparoscopic mediastinal lymph node biopsy 20,160 23,040 28,800 50,400 SRG12140 Laparoscopic sympathectomy 17,710 20,240 25,300 44,275 SRG12141 Thoracoscopic labectomy 28,210 32,240 40,300 70,525 SRG12142 Thoracoscopic lung nodule excision 20,160 23,040 28,800 50,400 SRG12143 Thoracoscopic pneumonectomy 32,200 36,800 46,000 80,500 SRG12144 Medical thoracoscopy 9,660 11,040 13,800 24,150
73 D14: UROLOGY
1. BLADDER SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13004 Litholopaxy 7,700 8,800 11,000 19,250 SRG13041 Cystoscopy 6,440 7,360 9,200 16,100 SRG13042 Bladder tumour (fulgration) 9,660 11,040 13,800 24,150 SRG13043 Biopsy bladder (endoscopic) 5,670 6,480 8,100 14,175 SRG13044 Suprapubic drainage 5,670 6,480 8,100 14,175 SRG13045 Trans urethral fulguration 17,710 20,240 25,300 44,275 SRG13047 Suprapubic cystostomy (open) 9,660 11,040 13,800 24,150 SRG13048 Cystolithotomy 13,720 15,680 19,600 34,300 SRG13052 Operation for injury of bladder 16,100 18,400 23,000 40,250 SRG13053 Cysto jejunostomy 36,260 41,440 51,800 90,650 SRG13054 Cysto gastrostomy 36,260 41,440 51,800 90,650 SRG13055 Vesico uretero reflux (unilateral) 16,520 18,880 23,600 41,300 SRG13056 Partial cystectomy 24,150 27,600 34,500 60,375 SRG13057 Correction of extrophy of bladder 32,200 36,800 46,000 80,500 SRG13114 TURBT 24,150 27,600 34,500 60,375 SRG13115 BNI (bladder neck incision) 17,710 20,240 25,300 44,275 SRG13116 Ileo caeco cystoplasty 40,250 46,000 57,500 100,625 SRG13117 Radical cytectomy with diversion 48,300 55,200 69,000 120,750 SRG13119 Vesico-vaginal fistula 30,240 34,560 43,200 75,600 SRG13167 Endoscopic cystolithotripsy 14,140 16,160 20,200 35,350 SRG13168 TVT-O (Transvaginal Tape-Obturate) 16,100 18,400 23,000 40,250
2. EXTERNAL GENITALIA SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13081 Varicocoel (unilateral) 14,140 16,160 20,200 35,350 SRG13082 Hydrocele (bilateral) 16,100 18,400 23,000 40,250 SRG13083 Torsion testis 24,150 27,600 34,500 60,375 SRG13131 Sex reassignment surgery (female to male) 56,350 64,400 80,500 140,875 SRG13132 Sex reassignment surgery (male to female) 48,300 55,200 69,000 120,750 SRG13133 Correction of peyronie's disease 14,140 16,160 20,200 35,350 SRG13134 Excision of multiple sebaceous cyst of scrotal skin 12,110 13,840 17,300 30,275 SRG13135 Exploratory scrototomy 12,110 13,840 17,300 30,275 SRG13136 Ileo inguinal dissection (unilateral) 22,190 25,360 31,700 55,475 SRG13137 Ileo inguinal dissection (bilateral) 34,230 39,120 48,900 85,575 SRG13138 Inguinal dissection (unilateral) 20,160 23,040 28,800 50,400 SRG13139 Inguinal dissection (bilateral) 26,180 29,920 37,400 65,450 SRG13140 Orchidectomy (unilateral) 12,110 13,840 17,300 30,275 SRG13141 Orchidectomy (bilateral) 17,710 20,240 25,300 44,275 SRG13142 Orchidopexy (unilateral) 16,940 19,360 24,200 42,350 SRG13143 Orchidopexy (bilateral) 22,190 25,360 31,700 55,475 SRG13145 SVG+VEA (unilateral) 18,130 20,720 25,900 45,325 SRG13146 SVG+VEA (bilateral) 24,150 27,600 34,500 60,375 SRG13147 Testicular biopsy 6,440 7,360 9,200 16,100 SRG13148 Vasectomy/male sterilization 8,050 9,200 11,500 20,125 SRG13149 Vasectomy reversal (unilateral) 17,710 20,240 25,300 44,275 SRG13150 Vasectomy reversal (bilateral) 24,150 27,600 34,500 60,375 SRG13154 Varicocoel (bilateral) 18,550 21,200 26,500 46,375 SRG13155 Hydrocele (unilateral) 11,270 12,880 16,100 28,175
3. KIDNEY SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13001 Percutaneous kidney biopsy 8,470 9,680 12,100 21,175 SRG13002 Drainage of psoas abscess 11,270 12,880 16,100 28,175 SRG13005 Operation for cyst of kidney 12,880 14,720 18,400 32,200 SRG13006 Nephrectomy (simple) 28,210 32,240 40,300 70,525 SRG13007 Nephrostomy 15,750 18,000 22,500 39,375 SRG13009 Pyeloplasty and similar procedures 28,210 32,240 40,300 70,525
74 SRG13010 Pyelolithotomy 22,540 25,760 32,200 56,350 SRG13011 Nephrolithotomy 24,990 28,560 35,700 62,475 SRG13012 Partial nephrectomy 40,250 46,000 57,500 100,625 SRG13013 Nephrectomy (renal tumour) 24,150 27,600 34,500 60,375 SRG13014 Nephropexy 28,210 32,240 40,300 70,525 SRG13015 Operation for neoblastoma 16,100 18,400 23,000 40,250 SRG13016 Nephro urectrectomy 36,260 41,440 51,800 90,650 SRG13017 PCNL (single puncture) 30,240 34,560 43,200 75,600 SRG13019 Radical nephrectomy 36,260 41,440 51,800 90,650 SRG13046 Drainage of perinephric abcess 13,720 15,680 19,600 34,300 SRG13099 Retroperitoneal fibrosis (renal) 30,590 34,960 43,700 76,475 SRG13100 Endopyelotomy 27,370 31,280 39,100 68,425 SRG13101 Retroperitoneoscopy 24,150 27,600 34,500 60,375 SRG13103 Gil vernets extended pyelolithotomy 38,290 43,760 54,700 95,725 SRG13104 PCNL (2nd stage) 13,720 15,680 19,600 34,300 SRG13160 CAPD catheter implantation 12,110 13,840 17,300 30,275 SRG13161 CAPD catheter removal 8,050 9,200 11,500 20,125 SRG13186 PCNL bilateral 36,260 41,440 51,800 90,650
4. PENIS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13091 Reduction of paraphiomsis 4,060 4,640 5,800 10,150 SRG13092 Partial amputation of penis 12,110 13,840 17,300 30,275 SRG13156 Total amputation of penis 18,130 20,720 25,900 45,325 SRG13157 Repair of fracture of penis 16,100 18,400 23,000 40,250 SRG13159 Penile implant 40,250 46,000 57,500 100,625
5. PROSTATE SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13071 Prostatic biopsy 6,090 6,960 8,700 15,225 SRG13072 Retropubic prostatectomy 38,290 43,760 54,700 95,725 SRG13073 Trans vesical prostatectomy 32,200 36,800 46,000 80,500 SRG13074 Trans urethra resection of prostate (TURP) 24,150 27,600 34,500 60,375 SRG13152 Arterio-venous fistula for dialysis 10,080 11,520 14,400 25,200 SRG13153 Endoscopic prostatic abscess drainage 18,130 20,720 25,900 45,325 SRG13172 Radical prostatectomy 38,290 43,760 54,700 95,725 SRG13173 Laparoscopic radical prostatectomy 38,290 43,760 54,700 95,725 SRG13178 HIFU (High Intensity Focused Ultrasound) 36,260 41,440 51,800 90,650
6. URETER SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13003 Dormia extraction of calculus 8,050 9,200 11,500 20,125 SRG13031 Endoincision of ureterocele (endoscopy) 8,050 9,200 11,500 20,125 SRG13032 Repair of ureterocle (open) 8,890 10,160 12,700 22,225 SRG13033 Uretrostomy (cutanie) 28,210 32,240 40,300 70,525 SRG13034 Ureterolithotomy 22,190 25,360 31,700 55,475 SRG13035 Operation for double ureter 14,490 16,560 20,700 36,225 SRG13036 Operation for ectopic ureter (unilateral) 16,100 18,400 23,000 40,250 SRG13037 Uretero colic anastomosis 32,200 36,800 46,000 80,500 SRG13038 Uretero renoscopy 17,710 20,240 25,300 44,275 SRG13051 Repair of uretero vaginal fistula 28,210 32,240 40,300 70,525 SRG13105 Operation for ectopic ureter (bilateral) 20,160 23,040 28,800 50,400 SRG13106 Balloon dilatation of ureter 13,720 15,680 19,600 34,300 SRG13108 Endoscopic incision of ureterocoele (bilateral) 19,320 22,080 27,600 48,300 SRG13109 Reimplantation of ureter (unilateral) 24,150 27,600 34,500 60,375 SRG13110 Reimplantation of ureter (bilateral) 30,240 34,560 43,200 75,600 SRG13111 Ureteric basketting 8,050 9,200 11,500 20,125 SRG13112 Uretrolysis for RPF (unilateral) 28,210 32,240 40,300 70,525 SRG13113 Uretrolysis for RPF (bilateral) 34,230 39,120 48,900 85,575
75 7. URETHRA SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13061 Meatotomy 3,640 4,160 5,200 9,100 SRG13062 Uretheral dilatation 3,220 3,680 4,600 8,050 SRG13063 Urethroscopy 3,640 4,160 5,200 9,100 SRG13064 Meatoplasty 6,090 6,960 8,700 15,225 SRG13065 Urethric catheterization (cystoscopy) 4,060 4,640 5,800 10,150 SRG13066 Internal urethrotomy 15,120 17,280 21,600 37,800 SRG13068 Urethral reconstruction 11,270 12,880 16,100 28,175 SRG13069 Urethral injury 12,110 13,840 17,300 30,275 SRG13120 Hypospadias repair (1st stage) 32,200 36,800 46,000 80,500 SRG13121 Hypospadias repair (stage 1 of 2) 17,710 20,240 25,300 44,275 SRG13122 Hypospadias repair (stage 2 of 2) 24,150 27,600 34,500 60,375 SRG13123 Epispadiasis 28,210 32,240 40,300 70,525 SRG13124 Closure of urethral fistula 12,110 13,840 17,300 30,275 SRG13125 EUA and fulguration of cargnoma urethra 7,280 8,320 10,400 18,200 SRG13127 Perineal urethrostomy 13,720 15,680 19,600 34,300 SRG13128 Urethroplasty (1st stage) 17,710 20,240 25,300 44,275 SRG13129 Urethroplasty (2nd stage) 17,710 20,240 25,300 44,275 SRG13130 Urethroplasty (one stage procedure) 30,240 34,560 43,200 75,600 SRG13174 Cystoscopy and fulgration of posterior urethral 14,490 16,560 20,700 36,225 valves SRG13175 Endoscopic teflan inj. (unilateral) 10,500 12,000 15,000 26,250 SRG13176 Endoscopic teflan inj. (bilateral) 17,710 20,240 25,300 44,275
8. LASER (CAT A) SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13203 Holmium laser enucleation of prostate (HOLEP) 32,200 36,800 46,000 80,500 SRG13204 Holmium laser ablation of prostate (HOLAP) 32,200 36,800 46,000 80,500
9. LASER (CAT B) SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13201 Laser incision of stricture urethra 17,360 19,840 24,800 43,400 SRG13202 Laser bladder neck incision 20,370 23,280 29,100 50,925 SRG13206 Laser endopyelotomy 31,220 35,680 44,600 78,050 SRG13207 Laser incision of uretetric stricture 27,790 31,760 39,700 69,475
10. LASER (CAT C) SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13208 Laser lithrotripsy (less than 1 cm) 19,320 22,080 27,600 48,300 SRG13209 Laser lithrotripsy (1 cm and above) 22,540 25,760 32,200 56,350
11. OTHERS SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13162 Double J stenting (unilateral) 7,280 8,320 10,400 18,200 SRG13163 Double J stenting (bilateral) 12,110 13,840 17,300 30,275 SRG13164 Double J stent removal (unilateral) 7,280 8,320 10,400 18,200 SRG13165 Double J stenting removal (bilateral) 8,050 9,200 11,500 20,125 SRG13166 Microsurgical varicocelectomy (unilateral) 17,710 20,240 25,300 44,275 SRG13169 Adrenalectomy 32,200 36,800 46,000 80,500
76 12. PACKAGES SERVICE CODE SERVICE NAME 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SRG13170 RIRS (Retrograde intra-renal surgery) 92,000 103,500 115,000 1,55,250/1, 66,750
Guidelines for the RIRS package: a) Package includes: i) Room charges including diet charges for 1 day ii) Surgeon fee iii) Anesthesia, Pre anesthesia and anesthetic consumables charges iv) OT charges (including gas, equipment and recovery room charges) v)Uretroscope charges vi) Laser charges vii) Routine pharmacy (medicines and consumables) viii) Routine investigations ix) Treating consultant visits x) General charges (including admission fee) b) Package excludes: i) Any out-patient expenses incurred before admission/after discharge ii) Any special medications, consumables and implants required shall be charged extra on actual iii) Any investigation other than routine iv) Extended length of stay v) Any other incidental procedure, not mentioned in inclusions vi) Take home medications.
77 MOOLCHAND SCHEDULE OF CHARGES 2019
SECTION E: TESTS/INVESTIGATIONS
E1: BLOOD BANK
1. ISSUE OF BLOOD AND BLOOD PRODUCTS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.)
BLD01001* Issue of (one unit) whole blood/packed red blood 5,560 5,560 5,560 5,560 5,560 cell BLD01002 Donor screening per individual 290 410 410 410 450 BLD01015* Issue of (one unit) fresh frozen plasma 900 900 900 900 900 BLD01016* Issue of (one unit) platelets 3,140 3,140 3,140 3,140 3,140 BLD01018 Cross match and save 870 1,210 1,210 1,210 1,330 BLD01022* Issue of Leuko reduced (one unit) whole 3,600 3,600 3,600 3,600 3,600 blood/packed red blood cell BLD01012 Aphaeresis-platelets (SDP) 17,250 24,150 24,150 24,150 26,570 BLD01031 Aphaeresis screening package (additional donor) 3,450 4,830 4,830 4,830 5,320
2. BLOOD BANK PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) BLD01004 Therapeutic phlebotomy 1,380 1,940 1,940 1,940 2,130
3. TESTS
3.1 GENERAL SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) BLD01007 RH Antibody titre 460 650 650 650 710 BLD01008 ABO grouping and RH typing 920 1,290 1,290 1,290 1,420 BLD01009 Coomb’s test-direct 920 1,290 1,290 1,290 1,420 BLD01010 Coomb's test-indirect 1,040 1,450 1,450 1,450 1,600
3.2 SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) BLD01032* Anti A titre 460 650 650 650 650 BLD01033* Anti B titre 460 650 650 650 650
4. BLOOD BANK CONSUMABLES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) BLD01017* Transfer bag (single-350ml) 180 250 250 250 250 BLD01027* Transfer bag (double-350ml) 230 330 330 330 330 BLD01028* Transfer bag (double-450ml) 230 330 330 330 330 BLD01029* Transfer bag (triple-450 ml) 350 490 490 490 490 BLD01030* Transfer bag (penta-450ml) 580 810 810 810 810
E2: BONE DENSITOMETRY
1. BONE DENSITOMETRY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) BMD01001 Single site 2,880 3,890 3,890 3,890 4,270 BMD01002 Dual site 3,740 5,050 5,050 5,050 5,560 BMD01003 Three site study 4,600 6,210 6,210 6,210 6,840 BMD01004 Complete study with fat analysis 5,750 7,770 7,770 7,770 8,540
78 E3: CARDIOLOGY LAB
1. BED SIDE ECHO SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CAD02001* Bed side portable CD echo 4,030 5,440 5,440 5,440 5,440 CAD02009* Bed side dobutamine challenge 4,600 6,210 6,210 6,210 6,210 CAD06006* Bed side portable carotid doppler 4,030 5,440 5,440 5,440 5,440 CAD06007* Bed side peripheral venous or arterial doppler 4,030 5,440 5,440 5,440 5,440
2. ECG SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ECG07001* ECG 460 630 630 630 630
3. ECHO SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CAD02005* Screening CD echo 2,880 3,890 3,890 3,890 3,890 CAD02010* Dobutamine stress echo 6,900 9,320 9,320 9,320 9,320 CAD02013* 2D/3D Echo 4,600 6,210 6,210 6,210 6,210 CAD02036* Advanced 2D/3D Echo (with tissue doppler) 5,750 7,770 7,770 7,770 7,770 CAD02011* Echo CD 460 630 630 630 630 CAD02012* Echo film 350 470 470 470 470 CAD02037* Stress Echo 5,750 7,770 7,770 7,770 7,770
4. NON-INVASIVE ELECTRO PHYSIOLOGICAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CAD02023* 48 hours holter 5,750 7,770 7,770 7,770 7,770 CAD02025* Post walk ankle brachial index 1,960 2,640 2,640 2,640 2,640 CAD02026* Event recorder 2,130 2,880 2,880 2,880 2,880 CAD02027* Cardiac autonomic function test 6,900 9,320 9,320 9,320 9,320 CAD02028* Tilt test 4,030 5,440 5,440 5,440 5,440 CAD02030* Pacemaker follow up 1,730 2,330 2,330 2,330 2,330 CAD02031* Pace maker reprogramming 1,730 2,330 2,330 2,330 2,330 CAD02032* Magnet testing of pacemaker 1,560 2,100 2,100 2,100 2,100 CAD02034* Peripheral doppler blood pressure 870 1,170 1,170 1,170 1,170 CAD02035* Flow method dilatation of brachial artery 4,600 6,210 6,210 6,210 6,210 CAD05001* Six minutes walk test 2,880 3,890 3,890 3,890 3,890 CAD05002* Holter monitoring 3,450 4,660 4,660 4,660 4,660 CAD05003* Pacemaker evaluation 1,730 2,330 2,330 2,330 2,330
5. PERIPHERAL VASCULAR SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CAD02015* Varicose veins perforators marking with advanced 4,600 6,210 6,210 6,210 6,210 color doppler CAD02017* Screening endothelial functions 1,730 2,330 2,330 2,330 2,330 CAD02021* Marking for arterial vascular access 1,730 2,330 2,330 2,330 2,330 CAD02022* Advanced color doppler guided FNAC 1,730 2,330 2,330 2,330 2,330 CAD06005* Advanced renal doppler 4,320 5,830 5,830 5,830 5,830 CAD06010* Advanced peripheral venous doppler (both limbs) 5,750 7,770 7,770 7,770 7,770 CAD06011* Advanced peripheral arterial doppler (both limbs) 5,750 7,770 7,770 7,770 7,770 CAD06018* Limited screening colour doppler 3,450 4,660 4,660 4,660 4,660 CAD06031* Ankle brachial index 1,440 1,950 1,950 1,950 1,950 CAD06033* Penile advanced color doppler studies 6,330 8,540 8,540 8,540 8,540
6. TMT SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CAD04001* Tread mill stress test 2,880 3,890 3,890 3,890 3,890 CAD04002* Hand grip/cold pressor/mental stress test 2,070 2,800 2,800 2,800 2,800 CAD04004* Pre and post stress 3D advanced color and tissue 5,750 7,770 7,770 7,770 7,770 doppler
79 7. TRANSESOPHAGEAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CAD06001* Echo guided invasive procedure 3,450 4,660 4,660 4,660 4,660 CAD06002* Multiplane transesophageal CD echo 5,180 6,990 6,990 6,990 6,990
8. VASCULAR CAROTIDS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CAD01001* Limited screening testicular injury/varicocoel 1,440 1,950 1,950 1,950 1,950 CAD01003* Advanced carotid colour doppler study 4,600 6,210 6,210 6,210 6,210 CAD02004* Renal AV fistula screening color doppler 4,600 6,210 6,210 6,210 6,210 CAD02019* Screening intima media thickness 1,960 2,640 2,640 2,640 2,640 CAD06008* Advanced vascular color doppler 4,600 6,210 6,210 6,210 6,210 CAD06009* Trans cranial color doppler 5,750 7,770 7,770 7,770 7,770 CAD06019* Limited screening color doppler carotids 1,960 2,640 2,640 2,640 2,640 CAD06020* Advanced vertebral arteries colour doppler study 4,600 6,210 6,210 6,210 6,210
E4: CT SCAN
1. HEAD SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS02001 CT scan head plain 3,450 4,660 4,660 4,660 5,130
2. FACE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS03001 CT scan face/3D 5,180 6,990 6,990 6,990 7,690
3. MASTOID REGION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS04001 CT scan mastoid region 5,180 6,990 6,990 6,990 7,690 CTS04002 CT scan for styloid process 5,180 6,990 6,990 6,990 7,690
4. PARANASAL SINUS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS05001 CT scan paranasal sinus (axial and coronal) 5,180 6,990 6,990 6,990 7,690 CTS05002 High resolution computer tomography PNS 3,220 4,350 4,350 4,350 4,790 (limited axial/coronal cut)
5. ORBIT SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS06001 CT scan orbit (axial and coronal) 5,180 6,990 6,990 6,990 7,690 CTS06003 Coronal/axial cuts for orbit 3,220 4,350 4,350 4,350 4,790
6. NECK SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS07001 CT scan neck (plain) 5,180 6,990 6,990 6,990 7,690
7. THORAX SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS08001 CT scan whole chest 5,750 7,770 7,770 7,770 8,540 CTS08002 High resolution computer tomography chest 5,180 6,990 6,990 6,990 7,690
8. ABDOMEN SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS09001 CT scan upper abdomen 4,890 6,600 6,600 6,600 7,260 CTS09002 CT scan lower abdomen 4,890 6,600 6,600 6,600 7,260 CTS09003 CT scan whole abdomen 8,050 10,870 10,870 10,870 11,960 CTS09004 CT scan whole abdomen triphasic (dynamic study) 9,200 12,420 12,420 12,420 13,670 CTS09005 Limited study to confirm KUB stones 3,450 4,660 4,660 4,660 5,130 CTS09006 KUB 7,770 10,480 10,480 10,480 11,530
80 9. JOINTS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS10001 CT scan joint (shoulder) 5,180 6,990 6,990 6,990 7,690 CTS10002 CT scan joint (elbow) 5,180 6,990 6,990 6,990 7,690 CTS10003 CT scan joint (wrist) 5,180 6,990 6,990 6,990 7,690 CTS10004 CT scan joint (knee) 5,180 6,990 6,990 6,990 7,690 CTS10005 CT scan joint (ankle) 5,180 6,990 6,990 6,990 7,690 CTS10006 CT scan joint (hip) 5,180 6,990 6,990 6,990 7,690 CTS10007 CT scan joint (foot) 5,180 6,990 6,990 6,990 7,690 CTS10009 Limited study to confirm bone fracture 3,450 4,660 4,660 4,660 5,130
10. ANGIOGRAPHY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS11001 CT angiography (cerebral) 11,500 15,530 15,530 15,530 17,080 CTS11002 CT angiography (pulmonary) 11,500 15,530 15,530 15,530 17,080 CTS11003 CT angiography (abdominal) 11,500 15,530 15,530 15,530 17,080 CTS11004 CT angiography (peripheral) 11,500 15,530 15,530 15,530 17,080
11. SPINE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS12001 CT spine (cervical) 5,180 6,990 6,990 6,990 7,690 CTS12002 CT spine (thoracic) (4 levels) 5,180 6,990 6,990 6,990 7,690 CTS12003 CT spine (lumbar) (4 levels) 5,180 6,990 6,990 6,990 7,690 CTS12004 CT spine extra per level (max 3 levels) 870 1,170 1,170 1,170 1,290
12. CT GUIDED PROCEDURE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS13001 CT guided biopsy 8,050 10,870 10,870 10,870 11,960 CTS13002 CT guided fluid aspiration 6,900 9,320 9,320 9,320 10,250 CTS13003 CT guided fine needle aspiration biopsy 8,050 10,870 10,870 10,870 11,960 CTS13004 CT guidance 2,070 2,800 2,800 2,800 3,080
13. VIRTUAL ENDOSCOPY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS14001 Virtual bronchoscopy 9,200 12,420 12,420 12,420 13,670 CTS14002 Virtual colonoscopy 9,200 12,420 12,420 12,420 13,670 CTS14003 Virtual sinoscopy 9,200 12,420 12,420 12,420 13,670 CTS14004* Extra film (each) 520 700 700 700 700 CTS14005* Video recording (each CD) 520 700 700 700 700 CTS14006 3D reconstruction 2,590 3,500 3,500 3,500 3,850
14. CONTRAST CHARGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS14007 Contrast charges-I 1,730 2,330 2,330 2,330 2,570 CTS14008 Contrast charges-II 2,300 3,110 3,110 3,110 3,420 CTS14009* Contrast charges-III (visipaque) 2,880 3,890 3,890 3,890 3,890
15. OTHERS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CTS15001 CT for focal region 1,730 2,330 2,330 2,330 2,570 CTS15002 CT scan temporal bone 5,180 6,990 6,990 6,990 7,690
E5: DENTAL RADIOLOGY
1. SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) CBT01001* CBCT 2,300 3,110 3,110 3,110 3,110 CBT01003* CBCT with report and color printouts 4,600 6,210 6,210 6,210 6,210 CBT01004* IOPA 410 550 550 550 550 CBT01005* OPG 580 780 780 780 780
81 E6: ECP (EXTERNAL COUNTER PULSATION) LAB
1. SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) ECP01001 ECP package I (10 days) 51,750 69,870 69,870 69,870 76,850 ECP01002 ECP package II (20 days) 97,750 131,970 131,970 131,970 145,160 ECP01003 ECP package III (35 days) 132,250 178,540 178,540 178,540 196,400
E7: FETAL AND GENETIC MEDICINE
1. GENERAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) FGM01001 Nuchal scan with uterine artery doppler (11-13 2,880 3,890 3,890 3,890 4,270 weeks) FGM01002 Foetal anomaly 4,030 5,440 5,440 5,440 5,980 FGM01003 Fetal well being (without doppler) 3,740 5,050 5,050 5,050 5,560 FGM01004 Fetal well being (with doppler) 4,320 5,830 5,830 5,830 6,410 FGM01005 Foetal echo 3,740 5,050 5,050 5,050 5,560 FGM01006 Referral fetal medicine scan (for twins) 5,180 6,990 6,990 6,990 7,690 FGM01007 Referral fetal medicine scan (for triplets) 5,180 6,990 6,990 6,990 7,690 FGM01008 Repeat high risk fetal medicine scan 3,740 5,050 5,050 5,050 5,560 FGM01009 Repeat cervix screening 1,150 1,560 1,560 1,560 1,710 FGM01011 MCA monitoring for RH negative patient 1,380 1,870 1,870 1,870 2,050 FGM01012 Fetal autopsy 5,750 7,770 7,770 7,770 8,540 FGM01013 Amniocentsis 8,630 11,650 11,650 11,650 12,810 FGM01014 Foetal anomaly (level 2 scan, 18-20 weeks) 4,320 5,830 5,830 5,830 6,410 FGM01015 Fetal echo with 4D 4,320 5,830 5,830 5,830 6,410 FGM01016 CVS (chronic villions sampling) 10,350 13,980 13,980 13,980 15,370 FGM01018 Fetal skin sampling 11,500 15,530 15,530 15,530 17,080 FGM01019 Fetal reduction 15,530 20,960 20,960 20,960 23,060 FGM01020 Fetal blood sampling 14,380 19,410 19,410 19,410 21,350 FGM01021 Fetal sampling 11,500 15,530 15,530 15,530 17,080 FGM01023 Pelvic scan/TVS (with doppler) 3,170 4,270 4,270 4,270 4,700 FGM01024 Twin doppler 3,450 4,660 4,660 4,660 5,130 FGM01025 Isolated single doppler 2,300 3,110 3,110 3,110 3,420 FGM01026 Early Pregnancy Scan (4-10 weeks) 2,590 3,500 3,500 3,500 3,850 FGM01027 Pelvic scan/TVS (without doppler) 2,590 3,500 3,500 3,500 3,850 FGM04001* 5D Ultrasound: Level 2 (18-23 weeks) 5,180 5,180 5,180 5,180 5,180 FGM04002* 5D Ultrasound: Growth Scan (24-40 weeks) 4,600 4,600 4,600 4,600 4,600
2. MATERNAL FETAL MEDICINE CLINIC SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) FGM02021* Genetics review 1,380 1,870 1,870 1,870 1,870 FGM02022* Genetic counseling 1,730 2,330 2,330 2,330 2,330 FGM02023* Pregnancy review 1,380 1,870 1,870 1,870 1,870
E8: LABORATORY MEDICINE
1. BIOCHEMISTRY
1.1 GENERAL SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT05001 Glucose (fasting) 180 250 250 250 270 PAT05002 Glucose (P.P) 180 250 250 250 270 PAT05003 Glucose (random) 180 250 250 250 270 PAT05004 Glucose (GCT) 180 250 250 250 270 PAT05005 Urea 220 310 310 310 340 PAT05006 Uric acid (Serum) 290 410 410 410 450 PAT05007 Cholesterol (Serum) 260 360 360 360 390 PAT05008 Creatinine 220 310 310 310 340 PAT05009 Calcium 220 310 310 310 340 PAT05010 Inorganic phosphorus 220 310 310 310 340
82 PAT05011 S.G.O.T. 220 310 310 310 340 PAT05012 S.G.P.T. 220 310 310 310 340 PAT05013 Alkaline phosphatase 220 310 310 310 340 PAT05015 Sodium 220 310 310 310 340 PAT05016 Potassium 220 310 310 310 340 PAT05017 Glucose-6- phosphate dehydrogenase (G6PD) 920 1,290 1,290 1,290 1,420 PAT05019 Electrolyte 640 890 890 890 980 PAT05020 Amylase (serum) 580 810 810 810 890 PAT05021 Total protein albumin/globulin ratio 290 410 410 410 450 PAT05023 Bilirubin (Direct+Indirect) 290 410 410 410 450 PAT05024 Glucose tolerance test (GTT) 610 850 850 850 930 (4 samples) PAT05025 Triglyceride (Serum) 380 530 530 530 580 PAT05026 Lipid profile 1,270 1,780 1,780 1,780 1,950 PAT05027 Acetone 290 410 410 410 450 PAT05028 CK 460 650 650 650 710 PAT05029 C.K.M.B. 610 850 850 850 930 PAT05030 L.D.H. (serum) 490 690 690 690 760 PAT05031 Iron 460 650 650 650 710 PAT05032 Total iron binding capacity 460 650 650 650 710 PAT05033 Gamma GT 350 490 490 490 540 PAT05034 Magnesium 460 650 650 650 710 PAT05035 HB A1C (Glycated Haemoglobin) 1,150 1,610 1,610 1,610 1,780 PAT05036 Troponin Ι 1,730 2,420 2,420 2,420 2,660 PAT05039 Ammonia 980 1,370 1,370 1,370 1,510 PAT05041 Chloride 290 410 410 410 450 PAT05042 HDL cholesterol 350 490 490 490 540 PAT05043 Total protein 290 410 410 410 450 PAT05044 Albumin 230 330 330 330 360 PAT05045 Direct bilirubin 230 330 330 330 360 PAT05046 Indirect bilirubin 230 330 330 330 360 PAT05047 GTT 5 samples 810 1,130 1,130 1,130 1,240 PAT05048 Lipase (Serum) 690 970 970 970 1,070 PAT05049 Aspiration fluid protein 350 490 490 490 540 PAT05050 Aspiration fluid glucose 350 490 490 490 540 PAT05053 Urinary Calcium 350 490 490 490 540 PAT05054 Creatinine clearance 410 570 570 570 620 PAT05055 Estradive 580 810 810 810 890 PAT05057 Micro albumin 810 1,130 1,130 1,130 1,240 PAT05058 Uric Acid (Fluid) 290 410 410 410 450 PAT05059 Cholesterol (Fluid) 260 360 360 360 390 PAT05060 Amylase (Fluid) 520 730 730 730 800 PAT05061 Triglycerides (Fluid) 380 530 530 530 580 PAT05062 L.D.H (Fluid) 490 690 690 690 760 PAT05063 Lipase (Fluid) 640 890 890 890 980 PAT02009 Urine total proteins 350 490 490 490 540 PAT02011 Urine sodium 350 490 490 490 540 PAT02012 Urine potassium 350 490 490 490 540 PAT02013 Urine creatinine 350 490 490 490 540 PAT02018 Urine creatinine clearance 580 810 810 810 890 PAT05255 Iron Studies Iron, TIBC, TS% 870 1,210 1,210 1,210 1,330
1.2 SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT05058* 1, 25 Dihydroxy cholecalciferol (vitamin D) 3,680 5,160 5,160 5,160 5,670 PAT05059* 17 Hydroxy corticosteroids (ketogenic steroids) 2,880 4,030 4,030 4,030 4,430 PAT05065* Adenosine Deaminase (ADA), Ascitic Fluid 690 970 970 970 1,070 PAT05066* Adenosine Deaminase (ADA), CSF 870 1,210 1,210 1,210 1,330 PAT05067* Adenosine deaminase (ADA), pericardial fluid 870 1,210 1,210 1,210 1,330 PAT05068* Adenosine deaminase (ADA), peritonial fluid 870 1,210 1,210 1,210 1,330 PAT05069* Adenosine deaminase (ADA), pleural fluid 750 1,050 1,050 1,050 1,160 PAT05070* Adenosine deaminase (ADA), pus 870 1,210 1,210 1,210 1,330
83 PAT05071* Adenosine deaminase (ADA), serum 870 1,210 1,210 1,210 1,330 PAT05074* Aldosterone, Serum 2,300 3,220 3,220 3,220 3,550 PAT05078* Alpha-1-antitrypsin, serum 2,300 3,220 3,220 3,220 3,550 PAT05086* ANA-anti nuclear antibody by EIA 1,040 1,450 1,450 1,450 1,600 PAT05087* ANA-anti nuclear antibody by IFA 1,500 2,100 2,100 2,100 2,310 PAT05088* ANCA-anti neutrophil cytoplasmic antibody (MPO 2,990 4,190 4,190 4,190 4,610 and Pr3) by IFA PAT05089* ANCA-MPO (panca) 1,730 2,420 2,420 2,420 2,660 PAT05090* ANCA-PR3 (canca) 2,020 2,820 2,820 2,820 3,100 PAT05091* Angiotensin converting enzyme (ACE) 1,150 1,610 1,610 1,610 1,780 PAT05092* APA-phosphalipid antibody IgG, serum 1,150 1,610 1,610 1,610 1,780 PAT05093* APA-phosphalipid antibody IgM, serum 1,150 1,610 1,610 1,610 1,780 PAT05097* Calcium ionised, serum 690 970 970 970 1,070 PAT05098* Cancer antigen 19.9, serum 1,440 2,020 2,020 2,020 2,220 PAT05101* Cardiolipin antibody-IgG 1,150 1,610 1,610 1,610 1,780 PAT05102* Cardiolipin antibody-IgM 1,150 1,610 1,610 1,610 1,780 PAT05103* Catecholamines (adrenaline+nor adrenaline)- 4,030 5,640 5,640 5,640 6,200 urine 24 hours PAT05110* CD 30 IHC single marker, tissue 2,190 3,060 3,060 3,060 3,370 PAT05122* C-er-b2 (her-2/neu) IHC single marker, tissue 2,300 3,220 3,220 3,220 3,550 PAT05124* Ceruloplasmin (copper oxidase) 1,270 1,780 1,780 1,780 1,950 PAT05125* Cholinesterase (pseudo) 1,100 1,530 1,530 1,530 1,690 PAT05126* Copper, serum 1,730 2,420 2,420 2,420 2,660 PAT05128* DNA (double strand) antibody-farr assay, serum 2,190 3,060 3,060 3,060 3,370 PAT05131* Gliadin-IgA antibodies 1,960 2,740 2,740 2,740 3,020 PAT05137* HLA-B 27 2,590 3,630 3,630 3,630 3,990 PAT05139* IgE, serum 870 1,210 1,210 1,210 1,330 PAT05142* Immunoglobulin profile (IgG, IgM, IgA) 2,880 4,030 4,030 4,030 4,430 PAT05146* Kidney renal stone analysis 1,150 1,610 1,610 1,610 1,780 PAT05148* Lipoprotein (A) 1,150 1,610 1,610 1,610 1,780 PAT05150* Microalbumin-urine 24 hours 690 970 970 970 1,070 PAT05151* Mitochondrial (M 2) antibody test (qualitative) 2,070 2,900 2,900 2,900 3,190 PAT05154* Osmolality-osmolarity, urine 920 1,290 1,290 1,290 1,420 PAT05155* Oxalate 1,960 2,740 2,740 2,740 3,020 PAT05159* Protein electrophoresis, serum 980 1,370 1,370 1,370 1,510 PAT05160* Protein electrophoresis-urine 24 hours 3,450 4,830 4,830 4,830 5,320 PAT05167* SCL 70 antibody, serum 1,790 2,500 2,500 2,500 2,750 PAT05168* Sjogren's Syndrome Profile Includes SSA and SSB 3,450 4,830 4,830 4,830 5,320 PAT05170* Smooth muscle antibody (ASMA), serum 2,300 3,220 3,220 3,220 3,550 PAT05174* Testosterone, free 2,020 2,820 2,820 2,820 3,100 PAT05177* Thyroid antibodies-ATAB, serum 2,300 3,220 3,220 3,220 3,550 PAT05178* Transferrin 1,380 1,940 1,940 1,940 2,130 PAT05180* VMA-Vanillylmandelic acid, urine 3,570 5,000 5,000 5,000 5,500 PAT05182* 5 conditions-Heel Prick (CAH, CF, PKU, Gal, Bio) 2,300 3,220 3,220 3,220 3,550 PAT05183* TMS only (47 conditions) 5,750 8,050 8,050 8,050 8,860 PAT05184* Ammonia 1,380 1,940 1,940 1,940 2,130 PAT05185* DNA (Double Strand) Antibody DNA Quantitative 1,560 2,180 2,180 2,180 2,400 PAT05189* Acid Phosphatase Total, Serum 350 490 490 490 540 PAT05190* Allergy panel-Food Fx 5 (For Infants) Panel 7 3,680 5,160 5,160 5,160 5,670 parameters PAT05191* HLA B27 studies Euroarray 2,880 4,030 4,030 4,030 4,430 PAT05192* Thyroglobulin Antibody ATA 1,730 2,420 2,420 2,420 2,660 PAT05193* Maternal screen-1st Trimester Dual Marker test 2,300 3,220 3,220 3,220 3,550 PAT05194* CCP (Antibody Cyclic Citrullinated Peptide) 1,730 2,420 2,420 2,420 2,660 PAT05195* Sodium, Urine 410 570 570 570 620 PAT05196* PTH-Intact Molecule Parathyroid hormone 2,020 2,820 2,820 2,820 3,100 PAT05197* AMH (Mullerian Inhibiting Substance), Serum 2,190 3,060 3,060 3,060 3,370 PAT05198* Maternal screen-2nd Trimester Quadruple Marker 3,220 4,510 4,510 4,510 4,960 test PAT05200* NT-Pro BNP 2,420 3,390 3,390 3,390 3,720 PAT05201* Osmolality, Serum 1,040 1,450 1,450 1,450 1,600
84 PAT05202* IGRAS (Interferon gamma release assay) 2,760 3,870 3,870 3,870 4,260 Quantiferon, Gamma Interferon PAT05204* Drugs Of Abuse Panel-9 Drug Panel 4,370 6,120 6,120 6,120 6,730 PAT05206* HLA B27 studies PCR method Blood 3,450 4,830 4,830 4,830 5,320 PAT05207* Microalbumin/Creatinine Ratio, Urine Spot 870 1,210 1,210 1,210 1,330 PAT05208* tTG Antibody-IgA Tissue Transglutaminase,Celiac 1,380 1,940 1,940 1,940 2,130 disease PAT05210* Drugs Of Abuse Panel-9 Drug Panel, Qualitative 3,570 5,000 5,000 5,000 5,500 PAT05213* ANCA by IFA Reflex end point titre 2,020 2,820 2,820 2,820 3,100 PAT05216* Proteins / Creatinine Ratio 870 1,210 1,210 1,210 1,330 PAT05217* Uric Acid, Urine 24H 320 450 450 450 490 PAT05219* Calcium, Urine 24H 350 490 490 490 540 PAT05220* DNA (Double Strand) Antibody By IFA - Reflex end 1,730 2,420 2,420 2,420 2,660 point titre PAT05222* Phenytoin Eptoin, Dilantin 1,150 1,610 1,610 1,610 1,780 PAT05224* Endomysial Antibody IgA antibody 3,170 4,430 4,430 4,430 4,880 PAT05226* IgA 750 1,050 1,050 1,050 1,160 PAT05227* Intrinsic Factor Antibody 2,880 4,030 4,030 4,030 4,430 PAT05230* Lead, Blood 1,840 2,580 2,580 2,580 2,840 PAT05231* Phosphorus-Inorganic, Urine 24H 350 490 490 490 540 PAT05233* Zinc 2,300 3,220 3,220 3,220 3,550 PAT05234* Allergy screening Phadiatop Adult For > 5 years 1,270 1,780 1,780 1,780 1,950 PAT05237* Cardiolipin Antibody ACL-IgA antibody 1,150 1,610 1,610 1,610 1,780 PAT05239* Drugs Of Abuse Panel-5 Drug Panel, Qualitative 3,450 4,830 4,830 4,830 5,320 PAT05240* ENA Profile Extractable nuclear antigen 7,190 10,070 10,070 10,070 11,070 PAT05241* HLA-Cross Match Lymphocyte (HLA) Total-T and B 1,840 2,580 2,580 2,580 2,840 cells together PAT05242* Immunofixation-quantitative 8,630 12,080 12,080 12,080 13,290 PAT05244* Lactate, Plasma 1,150 1,610 1,610 1,610 1,780 PAT05246* LKM1 by IFA Liver Kidney Microsomes Reflex to 2,130 2,980 2,980 2,980 3,280 end point titre PAT05247* Oligoclonal Band By IEF Multiple sclerosis, CSF 4,600 6,440 6,440 6,440 7,090 and Serum PAT05248* Paracetamol Acetaminophen 1,500 2,100 2,100 2,100 2,310 PAT05250* Rheumatoid Arthritis Panel-2 4,030 5,640 5,640 5,640 6,200 PAT05254* tTG Antibody-IgG Tissue Transglutaminase,Celiac 1,500 2,100 2,100 2,100 2,310 disease
2. CLINICL PATHOLOGY
2.1 GENERAL SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT02001 Semen analysis 580 810 810 810 890 PAT02002 Urine routine & microscopy 290 410 410 410 450 PAT02003 Urine bile pigment & salt 230 330 330 330 360 PAT02004 Urine urobilinogen 230 330 330 330 360 PAT02005 Urine ketones 230 330 330 330 360 PAT02007 Bence jones protein 290 410 410 410 450 PAT02019 Post coital test 290 410 410 410 450 PAT07001 Stool routine & microscopy 230 330 330 330 360 PAT07002 Stool conc method 230 330 330 330 360 PAT07003 Stool occult blood 230 330 330 330 360 PAT07005 PH/reducing substance 230 330 330 330 360 PAT06001 Aspiration fluid (routine cytology) 870 1,210 1,210 1,210 1,330 PAT06002 Routine cytology (pleural fluid) 870 1,210 1,210 1,210 1,330 PAT06003 Routine cytology (ascitic fluid) 870 1,210 1,210 1,210 1,330 PAT06004 Routine cytology (CSF) 870 1,210 1,210 1,210 1,330 PAT02021 Urine pregnancy test 350 490 490 490 540
85 2.2 SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT03039* Alpha feto protein (AFP), serum 920 1,290 1,290 1,290 1,420 PAT03088* Triple test-down's syndrome (maternal) screen-2 3,220 4,510 4,510 4,510 4,960 trimester (B-HCG, AFP and uE3), serum PAT03049* Beta 2, microglobulin, serum 1,610 2,260 2,260 2,260 2,480 PAT03051* BNP (B type natriurectic peptide), plasma 2,420 3,390 3,390 3,390 3,720 PAT03052* CA 125 (cancer antigen 125) 1,500 2,100 2,100 2,100 2,310 PAT03055* CEA-carcino embryonic antigen, serum 870 1,210 1,210 1,210 1,330 PAT03056* CMV-IgG antibodies to cyto meagalo virus, serum 870 1,210 1,210 1,210 1,330 PAT03057* CMV-IgM antibodies to cyto meagalo virus, serum 870 1,210 1,210 1,210 1,330 PAT03058* Cortisol-24 hours urine or spot urine 870 1,210 1,210 1,210 1,330 PAT03059* Cortisol, serum 750 1,050 1,050 1,050 1,160 PAT03060* C-peptide (fasting sample) 1,150 1,610 1,610 1,610 1,780 PAT03061* DHEAS-dihydroepi androstenedione sulphate 1,150 1,610 1,610 1,610 1,780 PAT03062* Erythropoitein (EPO) 2,070 2,900 2,900 2,900 3,190 PAT03065* Folic acid, serum 1,150 1,610 1,610 1,610 1,780 PAT03068* Growth hormone (HGH), serum 980 1,370 1,370 1,370 1,510 PAT03069* HAV-IgM antibodies to hepatitis A virus 1,380 1,940 1,940 1,940 2,130 PAT03070* HBcAb-IgM antibodies to hepatitis B core antigen 1,150 1,610 1,610 1,610 1,780 PAT03071* HBeAg-hepatitis B envelope antibody 1,270 1,780 1,780 1,780 1,950 PAT03072* HBsAb-total antibodies to hepatitis B surface Ag, 1,040 1,450 1,450 1,450 1,600 serum PAT03073* Helicobacter pylori, IgG antibodies 2,300 3,220 3,220 3,220 3,550 PAT03074* Homocysteine, plasma 1,270 1,780 1,780 1,780 1,950 PAT03075* HSV 1 and 2 IgG antibodies to herpes simplex 920 1,290 1,290 1,290 1,420 virus 1 and 2, serum PAT03079* Progesterone (P 4), serum 690 970 970 970 1,070 PAT03080* Rubella (german measles), IgG antibodies 870 1,210 1,210 1,210 1,330 PAT03081* Rubella (german measles), IgM antibodies, serum 870 1,210 1,210 1,210 1,330 PAT03084* Testosterone (total) 920 1,290 1,290 1,290 1,420 PAT03085* Thyroglobulin, serum 1,730 2,420 2,420 2,420 2,660 PAT03087* TPO (microsomal) antibody titer, serum 1,270 1,780 1,780 1,780 1,950 PAT03090* Helicobacter Pylori IgM antibodies 2,300 3,220 3,220 3,220 3,550 PAT03091* Polarising Microscopy For Crystals Includes Cell 750 1,050 1,050 1,050 1,160 count Synovial fluid
3. HAEMATOLOGY
3.1 GENERAL SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT01001 Haemoglobin (Hb) 230 330 330 330 360 PAT01002 Total leucocytic count (TLC) 230 330 330 330 360 PAT01003 Differential leucocytic count (DLC) 290 410 410 410 450 PAT01004 E.S.R. 230 330 330 330 360 PAT01005 Total red cell count 230 330 330 330 360 PAT01006 Packed cell volume (PCV) 290 410 410 410 450 PAT01007 Reticulocyte count 460 650 650 650 710 PAT01008 Platelet count 290 410 410 410 450 PAT01009 Absolute Eosinophil count 290 410 410 410 450 PAT01010 Haemogram (Hb, TLC, DLC, PLT, ESR, PS, PCV, 870 1,210 1,210 1,210 1,330 MCV, MCH, MCHC, RBC) PAT01011 Bleeding time 290 410 410 410 450 PAT01012 Clotting time 230 330 330 330 360 PAT01013 Malaria parasite 350 490 490 490 540 PAT01014 L.E cell 350 490 490 490 540 PAT01015 Peripheral smear examination 410 570 570 570 620 PAT01016 Bone marrow smear examination 1,440 2,020 2,020 2,020 2,220 PAT01019 Sickling test 350 490 490 490 540 PAT01020 Clot retraction test 350 490 490 490 540 PAT01022 Complete blood count (Hb,TLC,DLC,PLT,RBC) 520 730 730 730 800
86 PAT01023 Smear for microfilaria 350 490 490 490 540 PAT01029 MCV 230 330 330 330 360 PAT01030 MCH 230 330 330 330 360 PAT01031 MCHC 230 330 330 330 360 PAT01032 Prothrombine time (PTT) 580 810 810 810 890 PAT01034 Partial thromboplastin time 810 1,130 1,130 1,130 1,240
3.2 SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT01036* Anti thrombin III antigen 7,480 10,470 10,470 10,470 11,520 PAT01037* C 3, serum 870 1,210 1,210 1,210 1,330 PAT01039* CD 3 (Pan T cell marker), blood 2,300 3,220 3,220 3,220 3,550 PAT01044* D-dimer quantification, plasma 1,730 2,420 2,420 2,420 2,660 PAT01045* Factor VIII activity plasma 2,760 3,870 3,870 3,870 4,260 PAT01046* Fibrinogen 1,150 1,610 1,610 1,610 1,780 PAT01047* Haemoglobin variants 980 1,370 1,370 1,370 1,510 PAT01051* Leucocyte alkaline phosphatase (lap score) 1,150 1,610 1,610 1,610 1,780 PAT01052* Lupus anticoagulant 2,300 3,220 3,220 3,220 3,550 PAT01053* Protein C activity (functional) 4,140 5,800 5,800 5,800 6,380 PAT01054* Protein C antigen, quantification 6,900 9,660 9,660 9,660 10,630 PAT01055* Protein S antigen (free), plasma 9,090 12,720 12,720 12,720 14,000 PAT01056* RBC fragility test (osmotic fragility test) 870 1,210 1,210 1,210 1,330 PAT01057* Thalassemia studies 1,730 2,420 2,420 2,420 2,660 PAT01071* Factor V Leiden-Mutant Detection G1691A 6,330 8,860 8,860 8,860 9,750 Mutation, Blood PAT01061* Factor IX Activity Anti Haemophilia B, Citrated 2,530 3,550 3,550 3,550 3,900 plasma PAT01062* Karyotyping by G-Banding, Blood 4,600 6,440 6,440 6,440 7,090 PAT01063* FDP Fibrin degradation products Reflex to end 1,270 1,780 1,780 1,780 1,950 point titre PAT01064* G6PD Quantitative Reflex qualitative 1,150 1,610 1,610 1,610 1,780 PAT01066* Karyotyping by G-Banding Reflex FISH (Chr 13,18, 6,900 9,660 9,660 9,660 10,630 21, X and Y) POC PAT01067* LE Cell Detection 460 650 650 650 710 PAT01068* Protein S Activity Functional 4,140 5,800 5,800 5,800 6,380 PAT01069* CD3 / CD4 / CD8 / CD45 2,300 3,220 3,220 3,220 3,550 PAT01070* Factor V Activity (Proaccelerin) APCR (Activated 3,910 5,480 5,480 5,480 6,030 protein C Resistance), Citrated plasma
4. HISTOPATHOLOGY/CYTOLOGY
4.1 GENERAL SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT04001 Biopsy (large, 4+ slides) 2,070 2,900 2,900 2,900 3,190 PAT04002 Biopsy (small, 2-4 slides) 1,380 1,940 1,940 1,940 2,130 PAT04003 Biopsy (extra slide for opinion) 350 490 490 490 540 PAT04004 Pap smear routine 750 1,050 1,050 1,050 1,160 PAT04005 Pap smear slide for opinion 350 490 490 490 540 PAT04006* Extra slide (per slide) 290 410 410 410 410 PAT04008 Slide opinion cytopathology 1,440 2,020 2,020 2,020 2,220 PAT04009 Fluid cytology 580 810 810 810 890 PAT04010 Slide opinion histopathology 1,440 2,020 2,020 2,020 2,220 PAT04011 Fine needle aspiration cytology 1,610 2,260 2,260 2,260 2,480 PAT04012 Biopsy test (medium) 1,150 1,610 1,610 1,610 1,780 PAT04013 Frozen section (neuro) 2,760 3,870 3,870 3,870 4,260 PAT04014 Frozen section (non neuro) 2,070 2,900 2,900 2,900 3,190 PAT04015 Frozen section (per subsequent specimen) 690 970 970 970 1,070 PAT04017 Biopsy (extra large) oncology specimen 2,420 3,390 3,390 3,390 3,720 PAT04018 FNAC (double site) 1,730 2,420 2,420 2,420 2,660 PAT04019 Bonemarrow (iron stain) 690 970 970 970 1,070 PAT04020 Bonemarrow (MPD) 690 970 970 970 1,070
87 PAT04021 Bonemarrow (SBB) 690 970 970 970 1,070 PAT04059 IHC stain interpretation 1,150 1,610 1,610 1,610 1,780
4.2 SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT04029* CD 79a, blood 2,590 3,630 3,630 3,630 3,990 PAT04038* HMB 45 (melanoma marker), tissue 2,190 3,060 3,060 3,060 3,370 PAT04041* Ki 67, tissue 2,190 3,060 3,060 3,060 3,370 PAT04044* S 100 protein, IHC single marker, tissue 2,190 3,060 3,060 3,060 3,370 PAT04045* IHC Panels with reporting Breast-II ER, PR, c-erb- 4,260 5,960 5,960 5,960 6,560 B2 PAT04046* IHC single marker with reporting CD2 2,300 3,220 3,220 3,220 3,550 PAT04047* IHC single marker with reporting Chromogranin A 2,300 3,220 3,220 3,220 3,550 PAT04048* IHC-Customised panel with reporting Any 7 11,500 16,100 16,100 16,100 17,710 Markers PAT04049* IHC single marker with reporting Bcl-6 2,300 3,220 3,220 3,220 3,550 Oncoprotein PAT04050* IHC single marker with reporting Pax 5 2,300 3,220 3,220 3,220 3,550 PAT04051* IHC stain without interpretation CK 1 1,150 1,610 1,610 1,610 1,780 PAT04052* IHC stain without interpretation Ki 67 1,270 1,780 1,780 1,780 1,950 PAT04053* IHC-Customised panel with reporting Any 2 3,450 4,830 4,830 4,830 5,320 Markers PAT04054* IHC stain without interpretation (Any marker) 1,270 1,780 1,780 1,780 1,950 PAT04055* IHC-Customised panel with reporting Any 3 6,330 8,860 8,860 8,860 9,750 Markers PAT04056* Bcl 2 oncoprotein, IHC single marker, tissue 2,300 3,220 3,220 3,220 3,550 PAT04057* CD 117 IHC single marker, tissue 2,300 3,220 3,220 3,220 3,550 PAT04058* CD 99 (MIC 2) IHC single marker, tissue 2,300 3,220 3,220 3,220 3,550 PAT05108* CD 15 IHC single marker, tissue 2,300 3,220 3,220 3,220 3,550
5. IMMUNOASSAY
5.1 GENERAL SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT03002 FT3 580 810 810 810 890 PAT03003 FT4 580 810 810 810 890 PAT03004 TSH 690 970 970 970 1,070 PAT03012 Protein specific antigen (PSA) 1,100 1,530 1,530 1,530 1,690 PAT03018 Follicular stimulating hormone (FSH) 810 1,130 1,130 1,130 1,240 PAT03019 Leutenising hormone (LH) 810 1,130 1,130 1,130 1,240 PAT03020 Prolactin 810 1,130 1,130 1,130 1,240 PAT03024 CA-125 Ovarian cancer marker 1,840 2,580 2,580 2,580 2,840 PAT03025 B-HCG serum 1,040 1,450 1,450 1,450 1,600 PAT03026 Ferritin 1,040 1,450 1,450 1,450 1,600 PAT03027 Insulin (fasting/PP/random) 1,150 1,610 1,610 1,610 1,780 PAT03028 Vitamin B 12 1,150 1,610 1,610 1,610 1,780 PAT03029 Estradiol 750 1,050 1,050 1,050 1,160 PAT03030 Estriol, unconjugated 1,380 1,940 1,940 1,940 2,130 PAT03031 DHEA-S 1,500 2,100 2,100 2,100 2,310 PAT03032 HBsAG (CLIA) 810 1,130 1,130 1,130 1,240 PAT03033 Vitamin D - Total 2,190 3,060 3,060 3,060 3,370
6. SEROLOGY AND MICROBIOLOGY
6.1 GENERAL SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT07004 Stool hanging drop method 230 330 330 330 360 PAT06005 A.F.B. smear 350 490 490 490 540 PAT06006 Direct smear 350 490 490 490 540 PAT06007 Scrapping for fungus 350 490 490 490 540
88 PAT06009 Blood culture 1,440 2,020 2,020 2,020 2,220 PAT06011 Culture and antibiotic sensitivity 920 1,290 1,290 1,290 1,420 PAT06012 Culture and antibiotic sensitivity (urine) 920 1,290 1,290 1,290 1,420 PAT06013 Culture and antibiotic sensitivity (pus) 920 1,290 1,290 1,290 1,420 PAT06014 Culture and antibiotic sensitivity (sputum) 920 1,290 1,290 1,290 1,420 PAT06015 Culture and antibiotic sensitivity (fluid) 920 1,290 1,290 1,290 1,420 PAT06016 Culture and antibiotic sensitivity (CSF) 920 1,290 1,290 1,290 1,420 PAT06017 Culture and antibiotic sensitivity (vaginal swab) 920 1,290 1,290 1,290 1,420 PAT06018 Culture and antibiotic sensitivity (stool) 920 1,290 1,290 1,290 1,420 PAT06022 Gram's stain 350 490 490 490 540 PAT06027 A.S.L.O (quantitative) 810 1,130 1,130 1,130 1,240 PAT06028 CRP (quantitative) 870 1,210 1,210 1,210 1,330 PAT06029 R.A. TEST (quantitative) 460 650 650 650 710 PAT06031 WIDAL (dilution) 460 650 650 650 710 PAT06032 Fibrinogin degradation PR 1,150 1,610 1,610 1,610 1,780 PAT06034 Toxoplasma IgG 1,150 1,610 1,610 1,610 1,780 PAT06035 Toxoplasma IgM 1,150 1,610 1,610 1,610 1,780 PAT06036 Rubella IgG 870 1,210 1,210 1,210 1,330 PAT06037 Rubella IgM 870 1,210 1,210 1,210 1,330 PAT06038 CMV IGG 870 1,210 1,210 1,210 1,330 PAT06039 CMV IGM 870 1,210 1,210 1,210 1,330 PAT06040 Herpes (I & II) IgG 870 1,210 1,210 1,210 1,330 PAT06041 Herpes (I & II) IgM 870 1,210 1,210 1,210 1,330 PAT06042 HIV (I&II) antibody test 870 1,210 1,210 1,210 1,330 PAT06043 HIV (I & II) screening 870 1,210 1,210 1,210 1,330 PAT06044 Water culture 920 1,290 1,290 1,290 1,420 PAT06047 Polymorphs in gastric aspiration 260 360 360 360 390 PAT06049 Dengue blot IgM 1,730 2,420 2,420 2,420 2,660 PAT06050 Malaria antigen 920 1,290 1,290 1,290 1,420 PAT06051 Culture and sensitivity ( throat swab) 920 1,290 1,290 1,290 1,420 PAT06052 Culture and sensitivity (semen) 920 1,290 1,290 1,290 1,420 PAT06053 Culture and sensitivity (tip) 920 1,290 1,290 1,290 1,420 PAT06054 Procalcitonin 2,880 4,030 4,030 4,030 4,430 PAT06055 ELISA for TB IgA, ANA 920 1,290 1,290 1,290 1,420 PAT06056 Direct smear and fungus for semen 350 490 490 490 540 PAT06057 NS1 Ag + Ab 2,300 3,220 3,220 3,220 3,550 PAT06059 Australia antigen (HBS AG)-rapid 690 970 970 970 1,070 PAT06060 Hepatitis-CAB (elisa) 1,380 1,940 1,940 1,940 2,130 PAT06061 Veneral disease research laboratory (VDRL) 290 410 410 410 450 PAT06062 Typhidot 640 890 890 890 980 PAT06063 Indian Ink for cryptococcus 350 490 490 490 540 PAT06064 Albert stain 350 490 490 490 540 PAT06065 Gram stain- Urethral smear 350 490 490 490 540 PAT06151 Culture and antibiotic sensitivity (swab) 920 1,290 1,290 1,290 1,420 PAT06149* NS1 Ag ELISA for dengue 690 690 690 690 690 PAT06150* IgM ELISA for dengue 690 690 690 690 690 PAT06211 Australia antigen (HBS AG)-elisa 810 1,130 1,130 1,130 1,240
6.2 SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT06064* AFB, rapid culture, BAL 1,380 1,940 1,940 1,940 2,130 PAT06065* AFB, rapid culture, blood 1,380 1,940 1,940 1,940 2,130 PAT06066* AFB, rapid culture, body fluid 1,380 1,940 1,940 1,940 2,130 PAT06067* AFB, rapid culture, CSF 1,380 1,940 1,940 1,940 2,130 PAT06068* AFB, rapid culture, endomitrium 1,380 1,940 1,940 1,940 2,130 PAT06069* AFB, rapid culture, pus 1,380 1,940 1,940 1,940 2,130 PAT06070* AFB, rapid culture, sputum 1,380 1,940 1,940 1,940 2,130 PAT06071* AFB, rapid culture, urine 1,380 1,940 1,940 1,940 2,130 PAT06072* Aldehyde chopra test for kala azar 580 810 810 810 890 PAT06073* Amoebiasis antibodies-IgG, IHA for amoebiasis 1,440 2,020 2,020 2,020 2,220 PAT06074* Anti HDV-total antibodies to hepatites delta virus 2,190 3,060 3,060 3,060 3,370 PAT06076* Brucella antibodies IgG antibody, Serum 1,270 1,780 1,780 1,780 1,950
89 PAT06077* Chikungunya-DNA by PCR, blood 4,320 6,040 6,040 6,040 6,650 PAT06078* Chikungunya-IgM antibody, CSF 1,150 1,610 1,610 1,610 1,780 PAT06087* Culture and Identification, fungal, blood 1,150 1,610 1,610 1,610 1,780 PAT06090* Echinococcus detection 1,730 2,420 2,420 2,420 2,660 PAT06095* HCV-IgM antibody, serum 1,730 2,420 2,420 2,420 2,660 PAT06096* HCV total antibodies to hepatitis C virus 1,730 2,420 2,420 2,420 2,660 PAT06097* HCV-RNA detection (qualitative), plasma 5,750 8,050 8,050 8,050 8,860 PAT06098* HCV-RNA quantification (viral load), plasma 9,200 12,880 12,880 12,880 14,170 PAT06100* HEV-IgG antibodies (to hepatitis E virus) 1,500 2,100 2,100 2,100 2,310 PAT06101* HEV-IgM antibodies (to hepatitis E virus) 1,730 2,420 2,420 2,420 2,660 PAT06103* HPV-DNA detection and typing, vaginal swab 3,400 4,750 4,750 4,750 5,230 PAT06108* HSV 1 and 2 (IgM antibodies to herpes simplex 2,300 3,220 3,220 3,220 3,550 virus 1 and 2 by western blot), serum PAT06109* HSV 1 and 2 profile (IgG and IgM asntobodies to 1,610 2,260 2,260 2,260 2,480 herpes simplex virus 1), serum PAT06113* HSV 2 (IgM antibodies to herpes simplex virus 2), 1,040 1,450 1,450 1,450 1,600 serum PAT06114* HSV 2 profile (IgG and IgM antibodies to herpes 1,610 2,260 2,260 2,260 2,480 simplex virus 1), serum PAT06115* HSV 1 (IgG antibodies to herpes simplex virus 1), 2,880 4,030 4,030 4,030 4,430 CSF, serum PAT06116* HSV 1 (IgG antibodies to herpes simplex virus 1), 1,040 1,450 1,450 1,450 1,600 serum PAT06117* HSV 1 (IgM antibodies to herpes simplex virus 1), 1,040 1,450 1,450 1,450 1,600 serum PAT06119* HSV-DNA detection for type 1 and 2 virus, CSF 5,750 8,050 8,050 8,050 8,860 PAT06122* JEV-RNA (japanese encephalitis virus), blood 4,600 6,440 6,440 6,440 7,090 PAT06123* JEV-RNA (japanese encephalitis virus), CSF 4,600 6,440 6,440 6,440 7,090 PAT06126* Leptospira-IgG antibody 1,270 1,780 1,780 1,780 1,950 PAT06131* Mumps, IgM antibody, serum 1,730 2,420 2,420 2,420 2,660 PAT06132* AFB-detection of DNA (by Real time PCR), Sputum 2,420 3,390 3,390 3,390 3,720 PAT06137* Rubeola (measles) IgM antibodies, serum 1,730 2,420 2,420 2,420 2,660 PAT06140* Torch 4 IgG, serum 2,300 3,220 3,220 3,220 3,550 PAT06141* Torch 4 IgM, serum 2,300 3,220 3,220 3,220 3,550 PAT06147* Western blot for HIV 1 specific and 2 indicative, 3,220 4,510 4,510 4,510 4,960 serum PAT06148* Western blot for HIV 2 specific, serum 3,220 4,510 4,510 4,510 4,960 PAT06149* AFB-Xpert panel by Genexpert M.Tb detection & 2,880 4,030 4,030 4,030 4,430 Rifamipicin resistance, Sputum, BAL, other respiratory samples PAT06150* AFB-Xpert panel by Genexpert M.Tb detection & 2,880 4,030 4,030 4,030 4,430 Rifamipicin resistance, Extra pulmonary samples PAT06155* Galactomannan, Aspergillus Antigen test 5,870 8,220 8,220 8,220 9,040 PAT06159* H1N1 (Swine Flu) RNA detection, Nasopharyngeal 5,750 8,050 8,050 8,050 8,860 swab PAT06161* Flu panel (Viral) 7,190 10,070 10,070 10,070 11,070 PAT06162* Kala azar 2,070 2,900 2,900 2,900 3,190 PAT06163* VDRL CSF 410 570 570 570 620 PAT06164* AFB-detection of DNA (by Real time PCR), Tissue 2,420 3,390 3,390 3,390 3,720 and biopsy PAT06167* Dengue IgM antibody 1,150 1,610 1,610 1,610 1,780 PAT06168* AFB-detection of DNA (by Real time PCR), Body 2,420 3,390 3,390 3,390 3,720 Fluid PAT06170* Hepatitis B Virus (HBV) HbsAg-Screening Surface 690 970 970 970 1,070 antigen PAT06171* Hepatitis B Virus (HBV) HBV-DNA quantitative 8,630 12,080 12,080 12,080 13,290 Viral load Serum Or plasma PAT06173* AFB-detection of DNA (by Real time PCR), BAL 2,420 3,390 3,390 3,390 3,720 and other respiratory samples PAT06176* AFB-detection of DNA (by Real time PCR), CSF 2,420 3,390 3,390 3,390 3,720 PAT06177* Aspergillosis IgG antibodies, Serum 2,190 3,060 3,060 3,060 3,370
90 PAT06179* Hepatitis C Virus (HCV) HCV-Genotyping by 9,200 12,880 12,880 12,880 14,170 sequencing Serum or Plasma PAT06180* HPV-Human Papilloma Virus DNA Detection And 2,880 4,030 4,030 4,030 4,430 Typing Cervical scrapping PAT06181* AFB-detection of DNA (by Real time PCR), Urine 2,420 3,390 3,390 3,390 3,720 PAT06183* Aspergillosis IgM antibodies, Serum 1,840 2,580 2,580 2,580 2,840 PAT06184* Dengue IgG antibody 1,150 1,610 1,610 1,610 1,780 PAT06185* Hepatitis A Virus (HAV) HAV-IgG antibody 1,440 2,020 2,020 2,020 2,220 PAT06186* Hepatitis B Virus (HBV) Anti HbcAg-IgM Core 1,500 2,100 2,100 2,100 2,310 antibody IgM PAT06187* Hepatitis B Virus (HBV) HbsAg-Confirmation 1,150 1,610 1,610 1,610 1,780 Surface antigen PAT06188* Leptospira IgM antibodies 1,730 2,420 2,420 2,420 2,660 PAT06189* AFB-detection of DNA (by Real time PCR), Pus, 2,420 3,390 3,390 3,390 3,720 abscess and aspirates PAT06190* Cryptococcus Antigen detection, CSF 2,530 3,550 3,550 3,550 3,900 PAT06191* Fungal stain, culture and identification Nail 1,270 1,780 1,780 1,780 1,950 PAT06192* Hepatitis B Virus (HBV) HbeAg Envelope Antigen 1,150 1,610 1,610 1,610 1,780
PAT06194* Rota virus Antigen detection 1,440 2,020 2,020 2,020 2,220 PAT06195* Autoimmune Encephalitis Panel 14,950 20,930 20,930 20,930 23,030 PAT06196* Clostridium Difficile GDH Reflex Toxin A/ B 2,880 4,030 4,030 4,030 4,430 PAT06197* Coxiella Burnetti IgG antibody 2,300 3,220 3,220 3,220 3,550 PAT06198* Clostridium Difficile, Stool 3,450 4,830 4,830 4,830 5,320 PAT06199* Fungal stain, culture and identification BAL, E.T 1,380 1,940 1,940 1,940 2,130 Secretion Respiratory Sample PAT06200* HsCRP High Sensitivity CRP 920 1,290 1,290 1,290 1,420 PAT06201* HIV-1 Viral load by Taqman 6,900 9,660 9,660 9,660 10,630 PAT06203* Scrub typhus profile Weil felix and scrub typhus- 1,380 1,940 1,940 1,940 2,130 IgM PAT06204* Scrub typhus IgM 1,150 1,610 1,610 1,610 1,780 PAT06205* TORCH-10 3,740 5,240 5,240 5,240 5,760 PAT06206* TORCH-5 IgG 2,530 3,550 3,550 3,550 3,900 PAT06207* TORCH-5 IgM 2,530 3,550 3,550 3,550 3,900 PAT06208* VZV-Varicella Zoster Virus IgG antibody 1,730 2,420 2,420 2,420 2,660 PAT06209* Brucella antibodies IgM antibody, Serum 1,270 1,780 1,780 1,780 1,950 PAT06210* Brucella antibodies Total antibodies, 810 1,130 1,130 1,130 1,240 Serum
7. DRUGS
7.1 SPECIALIZED SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT09001* Alcohol ethanol quantitative, serum 920 1,290 1,290 1,290 1,420 PAT09002* Amphetamine (quantative) 920 1,290 1,290 1,290 1,420 PAT09003* Benzodiazepine (quantitative) 1,040 1,450 1,450 1,450 1,600 PAT09005* Digoxin (lanoxin) 980 1,370 1,370 1,370 1,510 PAT09007* Opiates (morphine) (qualitative) 920 1,290 1,290 1,290 1,420 PAT09008* THC (cannabis) (marijuana), urine qualitative 1,150 1,610 1,610 1,610 1,780 PAT09010* Valproic acid (valparin) 1,040 1,450 1,450 1,450 1,600
8. LAB PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT08001 Cardiac panel I 1,670 2,510 2,510 2,510 2,760 PAT08002 Cardiac panel II 3,450 5,180 5,180 5,180 5,700 PAT08003 Liver panel I 1,560 2,330 2,330 2,330 2,570 PAT08004 Liver panel II 2,480 3,710 3,710 3,710 4,080 PAT08005 Kidney profile 1,840 2,760 2,760 2,760 3,040 PAT08006 Antenatal I 580 870 870 870 950 PAT08007 Antenatal II 6,900 10,350 10,350 10,350 11,390
91 PAT08008 Coagulation screen 1,670 2,510 2,510 2,510 2,760 PAT08009 Pre Dialysis panel 5,750 8,630 8,630 8,630 9,490 PAT08011 Arthritis panel 2,300 3,450 3,450 3,450 3,800 PAT08012 Torch panel (IgG & IgM) 4,600 6,900 6,900 6,900 7,590 PAT08013 Torch panel (IgG) 2,900 4,350 4,350 4,350 4,790 PAT08014 Torch panel (IgM) 2,900 4,350 4,350 4,350 4,790 PAT08015 Thyroid profile 1,560 2,330 2,330 2,330 2,570 PAT08016 Diabetes screening 580 870 870 870 950 PAT08017 Diabetes panel I 1,150 1,730 1,730 1,730 1,900 PAT08018 Diabetes panel II 3,110 4,660 4,660 4,660 5,130 PAT08019 Fever panel I 1,610 2,420 2,420 2,420 2,660 PAT08020 Fever panel II 2,070 3,110 3,110 3,110 3,420 PAT08021 General health panel 4,600 6,900 6,900 6,900 7,590 PAT08022 Hypertension panel 2,420 3,630 3,630 3,630 3,990 PAT08023 Pancreatic panel 1,670 2,510 2,510 2,510 2,760 PAT08024 Pre anaesthetic panel I 3,110 4,660 4,660 4,660 5,130 PAT08025 Pre anaesthetic panel II 6,100 9,150 9,150 9,150 10,060 PAT08026 Dialysis Panel I 1,730 2,590 2,590 2,590 2,850 PAT08027 Dialysis Panel II 4,140 6,210 6,210 6,210 6,840 PAT08028 Dialysis Panel III 4,830 7,250 7,250 7,250 7,970 PAT08029 Dengue (viral) Panel 5,520 8,280 8,280 8,280 9,110 PAT08030 Dengue haemorrhagic panel 6,960 10,440 10,440 10,440 11,480
9. GENERAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PAT05051* Home collection charges 210 210 210 210 210
E9: MAMMOGRAPHY
1. MAMMOGRAPHY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MAM01001 Single breast 1,440 1,950 1,950 1,950 2,140 MAM01002 Both breast 2,880 3,890 3,890 3,890 4,270
E10: MRI
1. MRI BRAIN SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI01001 MRI brain 9,490 13,290 13,290 13,290 14,620 MRI01002 MRI brain+MRI diffusion 11,500 16,100 16,100 16,100 17,710 MRI01003 MRI brain+MRI perfusion 16,100 22,540 22,540 22,540 24,800 MRI01004 MRI brain with epilepsy protocol 11,500 16,100 16,100 16,100 17,710 MRI01005 MRI spectroscopy 9,490 13,290 13,290 13,290 14,620 MRI01006 MRI brain+MRI spectroscopy 13,800 19,320 19,320 19,320 21,260 MRI01007 MRI brain angiography 9,490 13,290 13,290 13,290 14,620 MRI01008 MRI brain venography 9,490 13,290 13,290 13,290 14,620 MRI01009 MRI brain+MRI angiography 14,950 20,930 20,930 20,930 23,030 MRI01010 MRI brain+MRI venography 15,530 21,740 21,740 21,740 23,910 MRI01011 MRI cisternography 9,200 12,880 12,880 12,880 14,170 MRI01012 MRI brain+MRI cisternography 11,500 16,100 16,100 16,100 17,710 MRI01013 MRI brain+MRI inner ear (3D cochlea) 11,500 16,100 16,100 16,100 17,710 MRI01014 MRI sella/pituitary 9,200 12,880 12,880 12,880 14,170 MRI01015 MRI dynamic contrast study pituitary 9,200 12,880 12,880 12,880 14,170 MRI01016 MRI brain+MRI pituitary 11,500 16,100 16,100 16,100 17,710 MRI01017 MRI brain radiotherapy plan (RadTxPlan) 11,500 16,100 16,100 16,100 17,710
2. MRI HEAD AND NECK SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI02001 MRI orbit 9,200 12,880 12,880 12,880 14,170 MRI02002 MRI brain+MRI orbit 11,500 16,100 16,100 16,100 17,710 MRI02003 MRI paranasal sinus 9,200 12,880 12,880 12,880 14,170
92 MRI02004 MRI face 9,200 12,880 12,880 12,880 14,170 MRI02005 MRI neck 9,200 12,880 12,880 12,880 14,170 MRI02006 MRI face+MRI neck 11,500 16,100 16,100 16,100 17,710 MRI02007 MRI thyroid 9,200 12,880 12,880 12,880 14,170 MRI02008 MRI angiography neck vessels 10,930 15,300 15,300 15,300 16,830 MRI02009 MRI angiography brain+MRI neck 16,100 22,540 22,540 22,540 24,800
3. MRI THORAX SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI03001 MRI chest 9,200 12,880 12,880 12,880 14,170 MRI03002 MRI cardiac 10,350 14,490 14,490 14,490 15,940
4. MRI ABDOMEN SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI04001 MRCP 9,200 12,880 12,880 12,880 14,170 MRI04002 MRI upper abdomen 9,200 12,880 12,880 12,880 14,170 MRI04003 MRI upper abdomen+MRCP 11,500 16,100 16,100 16,100 17,710 MRI04004 MRI whole abdomen 16,100 22,540 22,540 22,540 24,800 MRI04005 MRI angiography abdomen 16,100 22,540 22,540 22,540 24,800 MRI04006 MRI triple phase study 12,650 17,710 17,710 17,710 19,490 MRI04007 MRI renal angiography 12,650 17,710 17,710 17,710 19,490 MRI04008 MRI urography 9,200 12,880 12,880 12,880 14,170 MRI04009 MRI upper abdomen+urography 11,500 16,100 16,100 16,100 17,710 MRI04010 MRI pelvis 9,200 12,880 12,880 12,880 14,170 MRI04011 MRI prostate 9,200 12,880 12,880 12,880 14,170 MRI04012 MRI pelvic floor dynamic study 10,350 14,490 14,490 14,490 15,940 MRI04013 MRI fistulogram/sinogram 9,200 12,880 12,880 12,880 14,170
5. MRI SPINE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI05001 MRI CV junction 9,200 12,880 12,880 12,880 14,170 MRI05002 MRI cervical spine 9,200 12,880 12,880 12,880 14,170 MRI05003 MRI dorsal spine 9,200 12,880 12,880 12,880 14,170 MRI05004 MRI lumbar spine 9,200 12,880 12,880 12,880 14,170 MRI05005 MRI both SI joints 9,200 12,880 12,880 12,880 14,170 MRI05006 MRI whole spine screening 9,200 12,880 12,880 12,880 14,170 MRI05007 MRI brain+MRI one part spine screening 11,500 16,100 16,100 16,100 17,710 MRI05008 MRI one part spine+one part spine screening 11,500 16,100 16,100 16,100 17,710 MRI05009 MRI one part spine+two part spine screening 11,500 16,100 16,100 16,100 17,710
6. MRI EXTREMITIES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI06001 MRI shoulder joint 9,200 12,880 12,880 12,880 14,170 MRI06002 MRI elbow joint 9,200 12,880 12,880 12,880 14,170 MRI06003 MRI wrist joint 9,200 12,880 12,880 12,880 14,170 MRI06004 MRI hand 9,200 12,880 12,880 12,880 14,170 MRI06005 MRI hip joint 9,200 12,880 12,880 12,880 14,170 MRI06006 MRI knee joint 9,200 12,880 12,880 12,880 14,170 MRI06007 MRI ankle joint 9,200 12,880 12,880 12,880 14,170 MRI06008 MRI foot 9,200 12,880 12,880 12,880 14,170 MRI06009 MRI two joints 16,100 22,540 22,540 22,540 24,800 MRI06010 MRI brachial plexus 9,200 12,880 12,880 12,880 14,170 MRI06011 MRI angiography single limb 9,200 12,880 12,880 12,880 14,170 MRI06012 MRI venography single limb 9,200 12,880 12,880 12,880 14,170 MRI06013 MRI angiography both limbs 14,950 20,930 20,930 20,930 23,030 MRI06014 MRI venography both limbs 14,950 20,930 20,930 20,930 23,030
7. MRI SPECIAL STUDIES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI07001 MRI one anatomical area 9,200 12,880 12,880 12,880 14,170 MRI07002 MRI thoracic aorta+MRI abdomen aorta 12,650 17,710 17,710 17,710 19,490 MRI07003 MRI bilateral TM joint 9,200 12,880 12,880 12,880 14,170
93 MRI07004 MRI radiotherapy planning study 9,200 12,880 12,880 12,880 14,170 MRI07005 MRI antenatal 7,480 10,470 10,470 10,470 11,520
8. MRI CONTRAST CHARGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI08001 Contrast charges-I 4,030 5,640 5,640 5,640 6,200 MRI08002 Contrast charges-II 7,480 10,470 10,470 10,470 11,520
9. OTHER CHARGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MRI09001* Anaesthesia charges 1,730 2,420 2,420 2,420 2,420 MRI09002* CD charges 580 810 810 810 810 MRI09003* Single extra film 690 970 970 970 970
E11: NEUROSCIENCES LAB
1. EEG LAB SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NUR01001 EEG routine for initial hour 2,590 3,500 3,500 3,500 3,850 NUR01002 EEG bed side 4,320 5,830 5,830 5,830 6,410 NUR01003 Video EEG for initial hour 3,450 4,660 4,660 4,660 5,130 NUR01004* Digital image/CD 350 470 470 470 470 NUR01005 Video EEG for every additional hour 1,440 1,950 1,950 1,950 2,140 NUR01006 Overnight video EEG 11,500 15,530 15,530 15,530 17,080 NUR01022 Sleep deprived EEG 2,880 3,890 3,890 3,890 4,270
2. EMG LAB SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NUR01007 EMG per limb 3,170 4,270 4,270 4,270 4,700 NUR01008 NCS per limb 3,170 4,270 4,270 4,270 4,700 NUR01009 NCS+EMG limited study 3,800 5,130 5,130 5,130 5,640 NUR01010 NCS+EMG per limb 4,600 6,210 6,210 6,210 6,840 NUR01011* EMG needle 810 1,090 1,090 1,090 1,090 NUR01012 Blink reflex 2,300 3,110 3,110 3,110 3,420 NUR01023 NCS Two Limbs 4,600 6,210 6,210 6,210 6,840 NUR01024 NCS Four Limbs 5,750 7,770 7,770 7,770 8,540
3. EVOKED POTENTIAL LAB SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NUR01013 ABER (auditory brain stem evoked response) 3,450 4,660 4,660 4,660 5,130 NUR01014 ERP (event related potentials) P300 2,880 3,890 3,890 3,890 4,270 NUR01015 SSEP (somat sensory evoked potentials) UL/LL 2,880 3,890 3,890 3,890 4,270 NUR01016 VEP (visual evoked potentials) 3,450 4,660 4,660 4,660 5,130
4. SPECIALIZED NEUROLOGY PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NUR01019 Botox therapy for neurological disorders per 3,570 4,820 4,820 4,820 5,300 sitting NUR01020 Tensilon/neostigm line test 2,880 3,890 3,890 3,890 4,270
5. EQUIPMENT CHARGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NUR01021* Portable conduction charges 1,150 1,560 1,560 1,560 1,560
6. OTHERS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NUR01017 Decrement 2,300 3,110 3,110 3,110 3,420 NUR01018 SSR (sympathetic skin response) 2,300 3,110 3,110 3,110 3,420
94 E12: NUCLEAR MEDICINE
1. GAMMA CAMERA
1.1 BRAIN SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI01001* ECD brain 11,500 15,530 15,530 15,530 15,530 NMI01002* GHA 8,630 11,650 11,650 11,650 11,650 NMI01003* HMPAO brain spect 13,800 18,630 18,630 18,630 18,630 NMI01004* MIBI 10,350 13,980 13,980 13,980 13,980 NMI01005* Radionuclide cisternography only scan charges 9,780 13,200 13,200 13,200 13,200
1.2 CARDIOTHORACIC VASCULAR SYSTEM SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI02001* Gated stress myocardial perfusion study 11,500 15,530 15,530 15,530 15,530 NMI02002* Lymphangiography 3,450 4,660 4,660 4,660 4,660 NMI02003* Resting MUGA 5,180 6,990 6,990 6,990 6,990 NMI02004* Stress MUGA 6,620 8,930 8,930 8,930 8,930 NMI02005* Venography 6,040 8,160 8,160 8,160 8,160
1.3 GASTROINTESTINAL TRACT SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI03001* Blood pool study for GI bleed 6,900 9,320 9,320 9,320 9,320 NMI03002* Gastric emptying 5,750 7,770 7,770 7,770 7,770 NMI03003* Gastro esophageal reflux study 4,600 6,210 6,210 6,210 6,210 NMI03004* GER and gasteric emptying 4,600 6,210 6,210 6,210 6,210 NMI03005* Hepato biliary scan 6,900 9,320 9,320 9,320 9,320 NMI03006* Hepatosplenic scan 5,180 6,990 6,990 6,990 6,990 NMI03007* Meckel's study 4,600 6,210 6,210 6,210 6,210 NMI03008* Radionuclide peritoneography 6,330 8,540 8,540 8,540 8,540 NMI03009* RBC scan (heat denatured) 6,620 8,930 8,930 8,930 8,930 NMI03010* Salivary gland study 2,300 3,110 3,110 3,110 3,110
1.4 GENITOURINARY SYSTEM SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI04001* Captopril DTPA study 9,200 12,420 12,420 12,420 12,420 NMI04002* DMSA scan 6,330 8,540 8,540 8,540 8,540 NMI04003* DRCG scan 5,180 6,990 6,990 6,990 6,990 NMI04004* DTPA scan 6,330 8,540 8,540 8,540 8,540 NMI04005* DTPA scan and GFR by sample method 6,900 9,320 9,320 9,320 9,320 NMI04006* GFR by sample method 4,600 6,210 6,210 6,210 6,210 NMI04007* Testicular scan 5,180 6,990 6,990 6,990 6,990 NMI04008* Transplant evaluation 5,180 6,990 6,990 6,990 6,990
1.5 INFECTION IMAGING SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI06001* Infection (ciprofloxacin) scan 11,500 15,530 15,530 15,530 15,530 NMI06002* Leukocyte scan for infection 23,000 31,050 31,050 31,050 31,050
1.6 RESPIRATORY SYSTEM SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI07001* Lung perfusion 7,480 10,100 10,100 10,100 10,100 NMI07002* Lung ventilation and perfusion 10,350 13,980 13,980 13,980 13,980 NMI07003* Lung ventilation 4,600 6,210 6,210 6,210 6,210 NMI07004* Lung ventilation perfusion and venography 12,650 17,080 17,080 17,080 17,080
1.7 SKELETAL SYSTEM SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI08001* Bone marrow imaging 4,030 5,440 5,440 5,440 5,440 NMI08002* Bone scan 5,750 7,770 7,770 7,770 7,770 NMI08003* Samarium therapy 17,250 23,290 23,290 23,290 23,290 NMI08004* Spect bone scan 6,900 9,320 9,320 9,320 9,320
95 1.8 THYROID IMAGING SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI05001* 1-131 Full body scan 6,620 8,930 8,930 8,930 8,930 NMI05002* 1-131 Therapy for thyrotoxicosis 10-15 MCI 11,500 15,530 15,530 15,530 15,530 NMI05003* 1-131 Therapy for thyrotoxicosis upto 10 MCI 8,630 11,650 11,650 11,650 11,650 NMI05004* 1-131 Uptake and scan 5,180 6,990 6,990 6,990 6,990 NMI05005* 99m TC thyroid scan 5,180 6,990 6,990 6,990 6,990 NMI05006* High dose 1-131 therapy 9,200 12,420 12,420 12,420 12,420
1.9 TUMOUR IMAGING SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) NMI09001* 1-131 MIBG scan 32,200 43,470 43,470 43,470 43,470 NMI09002* Gallium scan 17,250 23,290 23,290 23,290 23,290 NMI09003* Indium labelled octreotide scan 92,000 124,200 124,200 124,200 124,200 NMI09004* Parathyroid scan 10,350 13,980 13,980 13,980 13,980 NMI09005* Scintimammography 9,200 12,420 12,420 12,420 12,420 NMI09006* Tecktroyd scan 63,250 85,390 85,390 85,390 85,390
2. PET CT SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) PCT01001* Cardiac PET CT plain 23,000 31,050 31,050 31,050 31,050 PCT01002* High resolution F 18 PET bone scan 8,050 10,870 10,870 10,870 10,870 PCT01003* High resolution F 18 PET bone scan with whole 13,800 18,630 18,630 18,630 18,630 body contrast limited CT PCT01004* High resolution F 18 PET scan with limited CT 10,350 13,980 13,980 13,980 13,980 PCT01005* High resolution F 18 PET scan with whole body CT 17,250 23,290 23,290 23,290 23,290 PCT01006* High resolution F 18 PET scan with whole body 21,850 29,500 29,500 29,500 29,500 contrast enhanced CT PCT01007* PET CT angiogaphy brain with contrast 22,430 30,280 30,280 30,280 30,280 PCT01008* PET CT brain plain 19,550 26,400 26,400 26,400 26,400 PCT01009* PET CT brain plain with contrast 20,700 27,950 27,950 27,950 27,950 PCT01010* PET CT guided procedure 11,500 15,530 15,530 15,530 15,530 PCT01011* PET CT myocardial viability and perfusion study 23,580 31,830 31,830 31,830 31,830 plain PCT01012* PET CT myocardial viability and perfusion with CT 31,630 42,700 42,700 42,700 42,700 coronary angiography with contrast PCT01013* PET CT somatostalin receptor imaging (Ga 68- 53,480 72,200 72,200 72,200 72,200 dotatoc) PCT01014* PET CT whole body plain 25,880 34,940 34,940 34,940 34,940 PCT01015* PET CT whole body with contrast 28,750 38,820 38,820 38,820 38,820
E13: RESPIRATORY LAB
1. GENERAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RSP01001 Spirometry with bronchodilator 1,730 2,330 2,330 2,330 2,570 RSP01002 Pulmonary function test (PFT) including diffusion 2,590 3,500 3,500 3,500 3,850 RSP01007 Basic lung function (bed side) 1,150 1,560 1,560 1,560 1,710 RSP01010 Maximum inspiratory/expiratory pressures 1,150 1,560 1,560 1,560 1,710
2. ALLERGENS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RSP01012 Skin Prick test against 34 allergic Rhinitis (Pollen 8,050 10,870 10,870 10,870 11,960 + Insects + Fungi + Dust + Dander+Fabric) RSP01013 Skin Prick test against 27 Food allergens(Juicy, 6,900 9,320 9,320 9,320 10,250 Non Juicy, Non-veg) RSP01014 Skin Prick test against 6 Insects allergens 2,880 3,890 3,890 3,890 4,270 RSP01015 Skin Prick test against 6 Fungi allergens 2,880 3,890 3,890 3,890 4,270 RSP01016 Skin Prick test against 7 Pollens allergens 2,880 3,890 3,890 3,890 4,270 RSP01017 Skin Prick test against 6 Dusts allergens 2,880 3,890 3,890 3,890 4,270
96 RSP01018 Skin Prick test against 3 Dander allergens 2,880 3,890 3,890 3,890 4,270 RSP01019 Skin Prick test against 6 Fabric allergens 2,880 3,890 3,890 3,890 4,270 RSP01020 Skin Prick test against 2 Wood allergens 2,020 2,720 2,720 2,720 2,990 RSP01021 Skin Prick test against Brewers Yeast allergen 1,440 1,950 1,950 1,950 2,140
E14: URODYNAMICS
1. URODYNAMICS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) URO01001 Uroflowmetry (UFM) 2,300 3,110 3,110 3,110 3,420 URO01002 Complete CMG 8,050 10,870 10,870 10,870 11,960 URO01003* Consumable (if procedure not done) 870 1,170 1,170 1,170 1,170
E15: ULTRASOUND
1. ULTRASOUND SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) USG01001 US whole abdomen 2,300 3,110 3,110 3,110 3,420 USG01002 US upper abdomen 1,610 2,180 2,180 2,180 2,400 USG01003 US lower abdomen 1,610 2,180 2,180 2,180 2,400 USG01004 US KUB 1,500 2,020 2,020 2,020 2,230 USG01005 US obstetrics 1,610 2,180 2,180 2,180 2,400 USG01006 US small parts (thyroid) 1,610 2,180 2,180 2,180 2,400 USG01007 US small parts (scrotum) 1,610 2,180 2,180 2,180 2,400 USG01008 US small parts (ophthalmic) 1,610 2,180 2,180 2,180 2,400 USG01009 Trans vaginal ultrasonography (TVS) 1,610 2,180 2,180 2,180 2,400 USG01010 US trans rectal ultrasound with KUB 2,070 2,800 2,800 2,800 3,080 USG01011 Trans rectal ultrasound 1,960 2,640 2,640 2,640 2,910 USG01012 Follicular monitoring (full) (maximum 5 sittings) 2,300 3,110 3,110 3,110 3,420 USG01013 Follicular monitoring (single sitting) 690 940 940 940 1,030 USG01014 US Screening of abdomen 1,150 1,560 1,560 1,560 1,710 USG01015 Sonomammography (single breast US) 1,610 2,180 2,180 2,180 2,400 USG01016 US chest 1,500 2,020 2,020 2,020 2,230 USG01017 Neuro sonogram 1,500 2,020 2,020 2,020 2,230 USG01018 US guided (FNAC/procedure charges) 4,600 6,210 6,210 6,210 6,840 USG01020 US obstetrics with manning scoring 2,300 3,110 3,110 3,110 3,420 USG01021 US joints (hip/shoulder) 1,730 2,330 2,330 2,330 2,570 USG01022 Salivary gland (per side) 1,730 2,330 2,330 2,330 2,570 USG01023 Muscular skeleton (per region) 1,730 2,330 2,330 2,330 2,570 USG01027 Obst level II (anamoly study) 2,880 3,890 3,890 3,890 4,270 USG01028 Sonomammography (both breast US) 2,530 3,420 3,420 3,420 3,760 USG01029 TRUS guided prostate biopsy 3,450 4,660 4,660 4,660 5,130
2. US DOPPLER
2.1 VASCULAR SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) USG02001 Peripheral venous doppler (one limb) 3,450 4,660 4,660 4,660 5,130 USG02002 Peripheral arterial doppler (one limb) 4,030 5,440 5,440 5,440 5,980 USG02003 Carotid doppler 3,740 5,050 5,050 5,050 5,560
2.2 OBSTETRICS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) USG02004 Obst. doppler 3,450 4,660 4,660 4,660 5,130 USG02005 Obst. doppler with USG 3,450 4,660 4,660 4,660 5,130
2.3 SMALL PARTS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) USG02006 Thyroid (small part) doppler 1,840 2,490 2,490 2,490 2,740 USG02007 Scrotum (small part) doppler 1,840 2,490 2,490 2,490 2,740 USG02008 Ophthalmic (small part) doppler 1,840 2,490 2,490 2,490 2,740
97 2.4 OTHER DOPPLERS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) USG02009 Renal doppler 3,450 4,660 4,660 4,660 5,130 USG02010 Color doppler imaging abdomen 3,450 4,660 4,660 4,660 5,130 USG02011 Lower abdomen with doppler 1,730 2,330 2,330 2,330 2,570 USG02012 Penile doppler 5,750 7,770 7,770 7,770 8,540 USG02014 Trans rectal ultrasound with doppler 2,300 3,110 3,110 3,110 3,420 USG02015 Kidney, ureter, bladder doppler 2,300 3,110 3,110 3,110 3,420 USG02016 Extra charges for follicular monitoring 580 780 780 780 860 USG02017 Color doppler for two limb 3,740 5,050 5,050 5,050 5,560 USG02018 Doppler lower limb (arterial+venous) 3,450 4,660 4,660 4,660 5,130 USG02020 USG for focal swelling 1,150 1,560 1,560 1,560 1,710 USG02021 Doppler both lower limbs (arterial+venous) 5,180 6,990 6,990 6,990 7,690
2.5 ELASTOGRAPHY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) USG04001 US Elastography – Breast 4,600 6,210 6,210 6,210 6,840 USG04002 US Elastography – Liver 4,600 6,210 6,210 6,210 6,840 USG04003 US Elastograpgy - Prostate 4,600 6,210 6,210 6,210 6,840 USG04004 US Elastography - Scrotum 4,600 6,210 6,210 6,210 6,840 USG04005 US Elastography - Thyroid 4,600 6,210 6,210 6,210 6,840
3. OTHER CHARGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) USG01019* US portable machine (extra) 1,040 1,400 1,400 1,400 1,400 USG02022* US guidance 2,590 3,500 3,500 3,500 3,500
E16: X-RAY
1. SINGLE FILM INVESTIGATION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) XRA01001 Chest (AP) 460 630 630 630 690 XRA01002 Abdomen (KUB) 460 630 630 630 690 XRA01003 Hypochondrium 460 630 630 630 690 XRA01004 Ribs 460 630 630 630 690 XRA01005 Paranasal sinuses 460 630 630 630 690 XRA01006 Pelvis 460 630 630 630 690 XRA01007 Femur AP and lateral 810 1,090 1,090 1,090 1,200 XRA01008 Leg AP and lateral 810 1,090 1,090 1,090 1,200 XRA01009 Arm AP and lateral 810 1,090 1,090 1,090 1,200 XRA01010 Forearm AP and lateral 810 1,090 1,090 1,090 1,200 XRA01011 Foot AP and lateral 810 1,090 1,090 1,090 1,200 XRA01012 Knee AP and lateral 810 1,090 1,090 1,090 1,200 XRA01013 Mandible 460 630 630 630 690 XRA01014 Nasal bones 460 630 630 630 690 XRA01015 Shoulder 460 630 630 630 690 XRA01016 Scapula 460 630 630 630 690 XRA01017 Clavicle 460 630 630 630 690 XRA01018 Skull lateral only 460 630 630 630 690 XRA01019 Chest (lateral) 460 630 630 630 690 XRA01020 Hip joints AP 460 630 630 630 690 XRA01021 Hip joints lateral 460 630 630 630 690 XRA01022 Cervical spine lateral 460 630 630 630 690 XRA01023 Dorsal spine AP 460 630 630 630 690 XRA01024 Lumbar spine AP 460 630 630 630 690 XRA01025 Lumbosacral SP/AP 460 630 630 630 690 XRA01026 Chest PA 460 630 630 630 690 XRA01027 Fingers AP/lateral 460 630 630 630 690 XRA01028 Hand AP/oblique 460 630 630 630 690 XRA01029 Ankle AP standing 460 630 630 630 690
98 XRA01030 Knee AP standing 460 630 630 630 690 XRA01031 Knee axial 460 630 630 630 690 XRA01032 Skull for styloid 460 630 630 630 690 XRA01033 Skull town's 460 630 630 630 690 XRA01034 Mandible AP 460 630 630 630 690 XRA01035 Mandible R/L lateral/oblique 460 630 630 630 690 XRA01036 Dorsal spine lateral/oblique 460 630 630 630 690 XRA01037 LS spine lateral/oblique 460 630 630 630 690 XRA01038 Elbow AP/lateral 460 630 630 630 690 XRA01039 Orbits 460 630 630 630 690 XRA01040 Maxilla 460 630 630 630 690 XRA01041 Wrist AP/lateral 460 630 630 630 690 XRA01042 Bladder 460 630 630 630 690 XRA01043 Abdomen lateral/erect 460 630 630 630 690 XRA01044 Cervico (dorsal lateral) 460 630 630 630 690 XRA01045 Heel axial/lateral 460 630 630 630 690 XRA01046 Abdomen supine 460 630 630 630 690 XRA01091 Sacrum/coccyx AP/lateral 520 700 700 700 770 XRA01092 Sternum oblique one side 460 630 630 630 690 XRA01093 SC joint AP 460 630 630 630 690 XRA01094 Ankle AP/lateral 460 630 630 630 690 XRA01095 Adenoids lateral 460 630 630 630 690 XRA01096 SI joints AP 460 630 630 630 690 XRA01097 SI joints oblique one side 460 630 630 630 690
2. DOUBLE FILM INVESTIGATION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) XRA01047 Abdomen (supine and erect) 920 1,250 1,250 1,250 1,370 XRA01048 Skull AP and lateral 920 1,250 1,250 1,250 1,370 XRA01049 Mastoids 920 1,250 1,250 1,250 1,370 XRA01050 Tempo mandibular joints 920 1,250 1,250 1,250 1,370 XRA01051 Hip joints AP and lateral 920 1,250 1,250 1,250 1,370 XRA01052 Foot and ankle 920 1,250 1,250 1,250 1,370 XRA01053 Cervicle spine AP and lateral 920 1,250 1,250 1,250 1,370 XRA01054 Dorsal spine AP and lateral 920 1,250 1,250 1,250 1,370 XRA01055 Lumber spine AP and lateral 920 1,250 1,250 1,250 1,370 XRA01056 Lumbosacral SP AP and lateral 920 1,250 1,250 1,250 1,370 XRA01057 Optic formina 920 1,250 1,250 1,250 1,370 XRA01058 Foreign localization 920 1,250 1,250 1,250 1,370 XRA01059 KUB 920 1,250 1,250 1,250 1,370
3. X-RAY WITH CONTRAST SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) XRA01060 Cystogram 3,800 5,130 5,130 5,130 5,640 XRA01061 Micurating urethrogram 3,800 5,130 5,130 5,130 5,640 XRA01062 Hystero salpingogram 3,800 5,130 5,130 5,130 5,640 XRA01063 Retrograde pyelography (x-ray) 3,800 5,130 5,130 5,130 5,640 XRA01064 Retrograde pyelography (bilateral) 3,800 5,130 5,130 5,130 5,640 XRA01065 Barium/upper GIT 3,800 5,130 5,130 5,130 5,640 XRA01067 Urographin upper GIT 3,800 5,130 5,130 5,130 5,640 XRA01068 Barium meal complete 4,600 6,210 6,210 6,210 6,840 XRA01069 Barium swallow heart shadow 3,800 5,130 5,130 5,130 5,640 XRA01070 Esophagus (urographin) 2,300 3,110 3,110 3,110 3,420 XRA01071 Barium enema 4,600 6,210 6,210 6,210 6,840 XRA01072 Double contrast/barium enema 4,600 6,210 6,210 6,210 6,840 XRA01073 Sinogram 3,800 5,130 5,130 5,130 5,640 XRA01074 T tube cholengiogram 3,740 5,050 5,050 5,050 5,560 XRA01075 Operative cholengiogram 3,740 5,050 5,050 5,050 5,560 XRA01076 Sialography (one side) 2,300 3,110 3,110 3,110 3,420 XRA01077 Sialography (both side) 4,030 5,440 5,440 5,440 5,980 XRA01078 Intra venous pyelography with omnipaque 4,600 6,210 6,210 6,210 6,840 XRA01079 Lumber myelogram 4,600 6,210 6,210 6,210 6,840
99 XRA01080 Cisternal myelogram 4,600 6,210 6,210 6,210 6,840 XRA01083 Ventriculogram 5,870 7,920 7,920 7,920 8,710 XRA01084 Fluoroscopy (chest) 2,300 3,110 3,110 3,110 3,420 XRA01099 Tilt test 3,220 4,350 4,350 4,350 4,790 XRA01100 Apicogram 460 630 630 630 690
4. X-RAY IN OPERATION THEATRE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) XRA01088 Pace making (temporary) 2,990 4,040 4,040 4,040 4,450 XRA01089 Pace making (permanent) 2,990 4,040 4,040 4,040 4,450 XRA01090 Endoscopic retrograde cholangio pancreatography 2,300 3,110 3,110 3,110 3,420
5. OTHER CHARGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) XRA01085* Portable x-ray machine (extra) 750 1,010 1,010 1,010 1,010 XRA01086* Omnipaque (350 per vial) (max of 30 ml) 810 1,090 1,090 1,090 1,090 XRA01087* Urographin (per ampoule) 460 630 630 630 630 XRA01098* Extra film in special procedure 350 470 470 470 470
E17: SLEEP LAB
1. POLYSOMNOGRAPHY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SPL01001* Full night complete diagnostic polysomnography 19,320 26,090 26,090 26,090 26,090 PSG SPL01002* Split night studies (polysomnography with CPAP 17,250 23,290 23,290 23,290 23,290 titration) SPL01003* Full night diagnostic PSG followed by a second 28,750 38,820 38,820 38,820 38,820 full night of positive airway pressure titartion SPL01004* Full night diagnostic polysomnography with MSLT 18,400 24,840 24,840 24,840 24,840 (multiple sleep latency test) SPL01005* Split night polysomnography with MSLT (multiple 21,850 29,500 29,500 29,500 29,500 sleep latency test) with CPAP titration
2. ASSESSMENT SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SPL02001* Assessment of insomnia 15,530 20,960 20,960 20,960 20,960 SPL02002* Assessment of day time sleepiness (only MSLT) 7,480 10,100 10,100 10,100 10,100 SPL02003* Assessment of narcolepsy 20,130 27,170 27,170 27,170 27,170 SPL02004* Assessment of cheyne-stokes breathing 15,530 20,960 20,960 20,960 20,960 SPL02005* Assessment of hypoventilation 15,530 20,960 20,960 20,960 20,960 SPL02006* Assessment of sleep disorders 15,530 20,960 20,960 20,960 20,960 SPL02007* Assessment of periodic limb movements during 15,530 20,960 20,960 20,960 20,960 sleep SPL02008* Assessment of delta (slow wave) sleep 15,530 20,960 20,960 20,960 20,960 parasomnias SPL02009* Assessment of rapid eye movement (REM) sleeps 15,530 20,960 20,960 20,960 20,960 behavior disorders SPL02010* Assessment of unexplained nocturnal seizures 15,530 20,960 20,960 20,960 20,960 SPL02011* Sleep evaluation in heart failure 17,250 23,290 23,290 23,290 23,290 SPL02012* Sleep evaluation in uncontrolled hypertension 17,250 23,290 23,290 23,290 23,290 SPL02013* Sleep evaluation in obesity 15,530 20,960 20,960 20,960 20,960
3. PORTABLE SLEEP STUDY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) SPL03001* Overnight portable sleep studies (type 1, in sleep 13,800 18,630 18,630 18,630 18,630 lab) SPL03002* Overnight portable sleep studies (type 2, outside 9,200 12,420 12,420 12,420 12,420 lab) SPL03003* Overnight portable sleep studies (type 3, four 11,500 15,530 15,530 15,530 15,530 physiologic variables)
100 SPL03004* Overnight portable sleep studies (type 4-AASM, 1- 11,500 15,530 15,530 15,530 15,530 2 variables: continuos single or dual bioparameter device) SPL03005* Overnight portable sleep studies (type 4-CMS, 3 11,500 15,530 15,530 15,530 15,530 variables) SPL03006* Overnight portable sleep studies (type 4-Pulse 11,500 15,530 15,530 15,530 15,530 oximetery alone) SPL03007* Portable sleep reassessment study 8,050 10,870 10,870 10,870 10,870
101 MOOLCHAND SCHEDULE OF CHARGES 2019
SECTION F: MOOLCHAND SPECIALITY INSTITUTES
F1: INTERVENTIONAL RADIOLOGY
1. ANGIOGRAPHY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.)
IR001001 Aortogram (includes carotid) -- 24,150 27,600 34,500 60,375 IR001002 Arterio-portogram -- 32,200 36,800 46,000 80,500 IR001003 Venogram (central, arm); diagnostic -- 12,075 13,800 17,250 30,188 IR001004 Cerebral angiogram -- 28,980 33,120 41,400 72,450 IR001005 Percutaneous transhepatic cholangiogram -- 12,075 13,800 17,250 30,188 IR001006 Peripheral angiography (one Limb)/renal artery -- 32,200 36,800 46,000 80,500 angiography/uretric stent (double pigtail/J) (right/left ) IR001007 Post PTBD check cholangiogram (pre/intra/post -- 12,075 13,800 17,250 30,188 procedure) IR001008 Spinal angiogram -- 36,225 41,400 51,750 90,563 IR001009 Uterine artery/pelvic angiography (diagnostic) -- 21,735 24,840 31,050 54,338
2. ANGIOPLASTY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR002001 Angioplasty for carotid/vertebral artery stenosis -- 80,500 92,000 115,000 201,250 IR002002 Aortic angioplasty/stenting -- 56,350 64,400 80,500 140,875 IR002003 GI ischemia intervention (angioplasty/stenting) -- 56,350 64,400 80,500 140,875 IR002004 Ilaic angioplasty/inferior vena cava -- 56,350 64,400 80,500 140,875 membranotomy angioplasty IR002005 Intracranial angioplasty/stenting -- 72,450 82,800 103,500 181,125 IR002006 PCN/PTBD with stenting -- 56,350 64,400 80,500 140,875 IR002007 Peripheral arterial angioplasty (right/left)/renal -- 56,350 64,400 80,500 140,875 artery angioplasty IR002008 Post SAH intracranial angioplasty for spasm -- 80,500 92,000 115,000 201,250
3. EVALUATIONS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR003001 Bronchial artery evaluation -- 19,320 22,080 27,600 48,300 IR003002 Evaluation for nasal bleeding/nasal -- 36,225 41,400 51,750 90,563 IR003003 Head & neck vessels evaluation -- 33,810 38,640 48,300 84,525 (cerebral,carotid,subclavian,vertebral) for tumour/hemanioma IR003004 GI Bleed and ischemia (triple vessel) evaluation -- 24,150 27,600 34,500 60,375 IR003005 Pre/post procedure USG evaluation for -- 4,025 4,600 5,750 10,063 fibroids/adenomyosis/uterus/body IR003006 Pudendal artery evaluation/vericoseal -- 26,565 30,360 37,950 66,413
4. EMBOLIZATIONS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR004001 Aortic stent graft endoleak embolization -- 60,375 69,000 86,250 150,938 IR004002 AVM embolization in the vertebroblsilar territory -- 80,500 92,000 115,000 201,250 IR004003 Bronchial artery embolization -- 48,300 55,200 69,000 120,750 IR004004 Cerebral AVM embolization (besides VB territory)-- 80,500 92,000 115,000 201,250 IR004005 Chemoembolization of hepatic tumour/mets -- 64,400 73,600 92,000 161,000 IR004006 Embolization of tumours fed by both ICA and -- 80,500 92,000 115,000 201,250
102 IR004007 Embolization of tumours fed by VA or/and -- 80,500 92,000 115,000 201,250 BA/glue emboliza IR004008 Emperical any artery embolisation -- 48,300 55,200 69,000 120,750 IR004009 External carotid artery/single vessel for tumour -- 52,325 59,800 74,750 130,813 embolization IR004010 GI bleed embolisation -- 40,250 46,000 57,500 100,625 IR004011 Nasal bleeding/sinus mass/pre-op embolization -- 40,250 46,000 57,500 100,625 IR004012 Partial splenic embolization -- 60,375 69,000 86,250 150,938 IR004013 Pelvic congestion syndrome (ovarian vein) -- 48,300 55,200 69,000 120,750 embolization IR004014 Peripheral hemangioma embolisation -- 36,225 41,400 51,750 90,563 (transarterial) IR004015 Portal vein embolisation -- 48,300 55,200 69,000 120,750 IR004016 Renal artery embolization -- 32,200 36,800 46,000 80,500 IR004017 Spinal AVM embolization/AVF embolization -- 80,500 92,000 115,000 201,250 IR004018 Spinal tumour embolization -- 32,200 36,800 46,000 80,500 IR004019 USG guided aneurysm embolisation -- 16,100 18,400 23,000 40,250 IR004020 Uterine artery embolization for fibroids/pre -- 32,200 36,800 46,000 80,500 myomectomy IR004021 Uterine artery/pelvic embolization for post -- 40,250 46,000 57,500 100,625 partum hemorrhage (embolisation) IR004022 Vertebral body hemangioma/mets embolization -- 48,300 55,200 69,000 120,750
5. THROMBOSIS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR005001 Intra arterial thrombolysis -- 52,325 59,800 74,750 130,813 IR005002 Intracranial mechanical thrombosis -- 80,500 92,000 115,000 201,250 IR005003 Management of dural sinus thrombosis -- 80,500 92,000 115,000 201,250 IR005004 Peripheral arterial thrombolysis right/left -- 48,300 55,200 69,000 120,750
6. PROCEDURES
6.1 CHEST SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR006001 Abdominal aortic aneurysm graft -- 72,450 82,800 103,500 181,125 IR006002 Intra vascular catheter/foreign body removal -- 8,456 9,664 12,080 21,140
6.2 GYNAECOLOGY/OBSTETRICS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR007001 Fallopian tube catheterization (for blocked tube)-- 32,200 36,800 46,000 80,500
6.3 HEPATOBILIARY (VASCULAR AND NON-VASCULAR)/GASTROINTESTINAL PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR008001 Naso jejunal intubation -- 7,245 8,280 10,350 18,113 IR008002 PTBD-post operative/biliary leak/external -- 28,175 32,200 40,250 70,438 drainage (single) IR008003 PTBD-externo-internalisation -- 24,150 27,600 34,500 60,375 IR008004 PTBD-internalisation -- 16,100 18,400 23,000 40,250 IR008005 Tipss (trans-jugular porto-systemic shunt) -- 80,500 92,000 115,000 201,250 interventional IR008006 Trans arterial chemotherapy infusion -- 32,200 36,800 46,000 80,500 IR008007 Transjuglar liver biopsy -- 32,200 36,800 46,000 80,500
6.4 NEURO-INTERVENTIONAL SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR009001 Balloon occlusion test -- 48,300 55,200 69,000 120,750 IR009002 CCF occlusion -- 72,450 82,800 103,500 181,125 IR009003 Coiling of intracranial aneurysm -- 80,500 92,000 115,000 201,250 IR009004 Coiling of intracranial aneurysm attempted -- 48,300 55,200 69,000 120,750 IR009005 Coiling of multiple aneurysm -- 96,600 110,400 138,000 241,500 IR009006 GDC coiling of intracranial aneurysms with -- 80,500 92,000 115,000 201,250 IR009007 Intracranial drug therapy for post SAH -- 56,350 64,400 80,500 140,875
103 IR009008 Proximal occlusion of internal carotid artery -- 48,300 55,200 69,000 120,750 IR009009 Venous sinus sampling (petrosal sinus) -- 40,250 46,000 57,500 100,625 IR009010 Vertebroplasty (verteral body/pelvic -- 64,400 73,600 92,000 161,000 bone/specific bone)
6.5 PERIPHERAL (LOWER/UPPER/PELVIC) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR010001 Peripheral hemangioma sclerotherapy (direct) -- 8,050 9,200 11,500 20,125 IR010002 Peripheral hemangioma sclerotherapy -- 32,200 36,800 46,000 80,500 (transarterial) IR010003 Peripheral trauma interventional -- 42,266 48,304 60,380 105,665 IR010004 Vericoseal interventional -- 56,350 64,400 80,500 140,875
6.6 RENAL VASCULAR/NON VASCULAR SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR011001 Follow up for nephrostomy drainage catheter -- 5,635 6,440 8,050 14,088 IR011002 Percutanous nephrostomy and drainage -- 24,150 27,600 34,500 60,375 (right/left)
6.7 VENOUS ACCESS/HEAMODIALYSIS INTERVENTIONS SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR012001 Chest port insertion for chemotherapy -- 14,490 16,560 20,700 36,225 IR012002 Dialysis catheter insertion (IJ, femoral) -- 24,150 27,600 34,500 60,375 tunnelled/exchange IR012003 Image guided dialysis catheter insertion -- 16,100 18,400 23,000 40,250 (IJ,subclavian,femoral) non-tunnelled IR012004 Image guided peripheral insertion of central -- 12,075 13,800 17,250 30,188 catheter (PICC) IR012005 Central veins/arm vein interventional -- 40,250 46,000 57,500 100,625 IR012006 IVC filter retrieval -- 32,200 36,800 46,000 80,500 IR012007 Mediastinal syndromes interventional -- 40,250 46,000 57,500 100,625 IR012008 Venous sampling (adrenal and renal vein) -- 32,200 36,800 46,000 80,500
7. RADIOFREQUENCY ABLATION SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) IR013001 Radiofrequency ablation of hepatic -- 56,350 64,400 80,500 140,875
Guidelines for the Interventional radiology procedures: a) Daycare/ IP procedure only. b) Day care shall be equivalent to single room charge and above. c) IP prices will vary as per bed category. Presidential suite 175%, single 100%, twin sharing 80%, 3/4 bedded 70%. d) The procedure price is inclusive od Surgeon fee and DSA lab charges only. e) General Anaesthesia if required will be additional to procedure fee and shall be 12% of the procedure fee. f) Standby anaesthesia if required will be charged at 8% of the procedure fee. g) If Neurologist/Specialist is standby,it will be charged at 5% of Procedure charge. h) All consumables, medicines, investigations, bed charges etc will be additional to the procedure fee.
F2: MOOLCHAND CANCER INSTITUTE
1. DAY CARE/OP PROCEDURES SERVICE CODE SERVICE NAME OPD/DAY CARE 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) (Rs.) ONC01001 Chemotherapy-targeted therapy 3,450 3,453 3,947 4,934 8,634 ONC01002 Chemotherapy-multiple drug 3,680 3,684 4,210 5,262 9,209 ONC01003 Chemotherapy-high dose 4,030 4,034 4,610 5,763 10,085 ONC01004 Chemotherapy-induction 4,030 4,034 4,610 5,763 10,085 ONC01005 Immunotherapy 3,220 3,223 3,684 4,605 8,058 ONC01006 Bisphosphonate therapy 2,300 2,302 2,631 3,289 5,756 ONC01007 Bone marrow biopsy 5,750 5,756 6,578 8,223 14,389 ONC01008 Bone marrow aspiration 3,450 3,453 3,947 4,934 8,634 ONC01009 Fine needle aspiration 1,730 1,732 1,979 2,474 4,329 ONC01010 Lumbar puncture (diagnostic) 3,450 3,453 3,947 4,934 8,634 ONC01011 USG guided biopsy 5,180 5,185 5,926 7,407 12,963 ONC01028 CT guided trucut biopsy 7,480 7,487 8,557 10,696 18,719
104 ONC01029 Comprehensive bone marrow (aspiration + 6,900 6,907 7,894 9,867 17,267 biopsy) ONC01030 Chemoport flushing 580 581 664 829 1,451 ONC01031 Chemotherapy planning 2,590 2,593 2,963 3,704 6,481
2. IP PROCEDURES SERVICE CODE SERVICE NAME OPD/DAY CARE 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) (Rs.) ONC01012 Chemotherapy-intra-peritoneal 4,600 4,605 5,262 6,578 11,512 ONC01013 Chemotherapy-intra-thecal 4,600 4,605 5,262 6,578 11,512 ONC01014 Pleurodesis charges 6,900 6,907 7,894 9,867 17,267 ONC01015 Alcohol ablation of tumours 21,280 21,301 24,344 30,430 53,253 ONC01016 Gun biopsy 4,030 4,034 4,610 5,763 10,085 ONC01017 Chemo embolisation 51,750 51,802 59,202 74,003 129,504 ONC01018 Bone marrow transplant (autologus) 72,380 72,452 82,803 103,503 181,131 ONC01021 Radio frequency ablation 34,500 34,535 39,468 49,335 86,336 ONC01033 Chemotherapy-intra-vesical 4,600 4,605 5,262 6,578 11,512
3. OPERATION THEATRE PROCEDURES SERVICE CODE SERVICE NAME OPD/DAY CARE 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) (Rs.) ONC01022 Chemoport insertion under LA -- 8,050 9,200 11,500 20,125 ONC01023 Chemoport removal under LA -- 7,245 8,280 10,350 18,113 ONC01024 Open biopsy (excision biopsy) -- 5,236 5,984 7,480 13,090 ONC01026 PTBD (percutaneous transhepatic biliary) -- 18,116 20,704 25,880 45,290 ONC01027 Bone marrow harvesting -- 14,490 16,560 20,700 36,225
Note(s): a) Onco day care bed charges will be Rs.2,500/- for 8 hrs; beyond 8 hours, patient will be admitted.
F3: MOOLCHAND FERTILITY AND IVF
1. GENERAL PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM01001 IUI 6,900 6,900 6,900 6,900 6,900
2. LAB PROCEDURES (IUI AND IVF) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM02002 Provision of donor sperm 5,750 5,750 5,750 5,750 5,750 RPM02012 Processing of donor sperm 2,300 2,300 2,300 2,300 2,300 RPM02003 Semen analysis 1,440 1,440 1,440 1,440 1,440 RPM02005 Sperm processing (double density) 4,600 4,600 4,600 4,600 4,600 RPM02006 Sperm processing (swim up) 4,030 4,030 4,030 4,030 4,030
3. SUBSCRIPTION SERVICES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM02001 Embryo cryopreservation (for 6 months) 28,750 28,750 28,750 28,750 28,750 RPM02011 Embryo cryopreservation (for additional 6 17,250 17,250 17,250 17,250 17,250 months) RPM02007 Oocyte cryopreservation (for 6 months) 34,500 34,500 34,500 34,500 34,500 RPM02008 Testicular tissue cryopreservation (for 6 months) 8,050 8,050 8,050 8,050 8,050 RPM02009 Semen cryopreservation (for 3 months) 5,750 5,750 5,750 5,750 5,750 RPM02004 Semen cryopreservation (for 6 months) 9,200 9,200 9,200 9,200 9,200 RPM02010 Semen cryopreservation (for 1 year) 17,250 17,250 17,250 17,250 17,250
4. RADIOLOGY PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM03001 Follicular monitoring with consultation (6 4,600 4,600 4,600 4,600 4,600 sessions) RPM03002 Follicular monitoring without consultation (6 3,110 3,110 3,110 3,110 3,110 sessions) RPM03003 Follicular monitoring without consultation 690 690 690 690 690 (single session) RPM03004 Ultrasonography 1,150 1,150 1,150 1,150 1,150
105 5. OT PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM04001 PESA/TESA -- 23,000 23,000 23,000 23,000 RPM04002 Testicular biopsy -- 23,000 23,000 23,000 23,000
Guidelines for the OT package: a) Package includes: i) Consultant fee ii) Anaesthesia charges iii) OT charges iv) IUI and IVF lab charges v) OT gases vi) Recovery room charges for day care vii) Routine media and disposables used in IUI and IVF lab b) Package excludes: i) Consumables and medicines required in the OT ii) Extended length of stay, if required iii) Incidental procedure, if any
6. IVF PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM05001 FERT (frozen embryo replacement treatment) -- 46,000 46,000 46,000 46,000 RPM05002 IVF package -- 94,880 94,880 94,880 94,880 RPM05006 IVF repeat package (within 6 months) -- 86,250 86,250 86,250 86,250 RPM05003 Oocyte retrival -- 51,750 51,750 51,750 51,750 RPM05004 Thawing, fertilization and embryo transfer of -- 51,750 51,750 51,750 51,750 oocyte RPM05005 Blastocyst transfer -- 14,380 14,380 14,380 14,380
Guidelines for the IVF package: a) Package includes: i) Follicular monitoring with consultation (6 sessions) ii) Embryologist charges iii) Consultant fee iv) Anaesthesia charges v) OT charges vi) IUI and IVF lab charges vii) OT gases viii) Recovery room for day care ix) Routine media and disposables used in IUI and IVF lab b) Package excludes: i) Consumables and medicines required in the OT ii) Extended length of stay, if required iii) Incidental procedure, if any
7. DONOR PROGRAMMES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM06001 Egg donation 40,250 40,250 40,250 40,250 40,250 RPM06002 Embryo donation 40,250 40,250 40,250 40,250 40,250
8. SERVICES IN ADDITION TO IVF PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RPM06003 ICSI -- 23,000 23,000 23,000 23,000 RPM06004 Assisted hatching -- 20,130 20,130 20,130 20,130 RPM06005 IMSI -- 20,130 20,130 20,130 20,130
F4: MOOLCHAND HEART INSTITUTE
1. ANGIOGRAPHIES SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH01001 Coronary angiography 17,830 18,400 20,700 27,600 40,250 MHH01002 Carotid angiography 16,100 16,680 18,400 24,730 36,230 MHH01003 Peripheral angiography 17,830 18,400 20,700 27,600 40,250 MHH01004 Renal angiography 17,830 18,400 20,700 27,600 40,250 MHH01005 Check angiographya 15,530 16,100 18,400 25,300 37,950 MHH01006 Coronary plus any one of carotid, peripheral or 27,030 28,750 31,050 36,230 44,850 renal angiography
Guidelines for Angiography packages: a) Package includes procedure charges, cath lab charges, cardiologist charges, 1 day room/daycare charge, recovery room, charges, investigations (as per Annexure 1: Angiography package details), routine consumables and drugs (excluding dyes) upto the defined limits. b) Package excludes all other investigations, consumables, drugs and any other procedure which will be billed as per actual.
Note(s): a) Refers to repeat angiography performed within 1 year of the procedure being done at Moolchand.
106 PACKAGE LIMITS SERVICE CODE SERVICE NAME PHARMACY (Rs.) INVESTIGATIONS MHH01001 Coronary angiography 6,000 Annexure 1 MHH01002 Carotid angiography 4,200 Annexure 1 MHH01003 Peripheral angiography 4,200 Annexure 1 MHH01004 Renal angiography 4,200 Annexure 1 MHH01005 Check angiography 4,200 Annexure 1 MHH01006 Coronary plus any one of carotid, peripheral or 6,000 Annexure 1 renal angiography
2. ANGIOPLASTY
CLARIFICATION OF CHARGES a) Cath lab charges to charged over and above the package price incase more than one stent is used as follows: SERVICE CODE SERVICE NAME CHARGES (Rs.) MHH02010* Cath lab charges per stent (more than 1 stent) 23,000
SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH02001 Coronary (PTCA) non complex -- 172,500 195,500 230,000 253,000 MHH02003 Balloon mitral valvulopasty -- 80,500 92,000 103,500 138,000 MHH02004 Peripheral angioplasty -- 149,500 172,500 207,000 270,250 MHH02005 Carotid angioplasty -- 149,500 172,500 207,000 270,250 MHH02006 Renal angioplasty -- 149,500 172,500 207,000 270,250 MHH02007 Directional atherectomy -- 161,000 207,000 230,000 270,250 MHH02008 Rotablator atherectomy -- 161,000 207,000 230,000 270,250
Guidelines for Angioplasty packages: a) Package includes 2 days stay including 1 day in ICU, doctor charges, investigations (as per Annexure 2: Angioplasty package details), routine consumables and drugs upto the defined limits and cath lab charges (for one stent only). Incase more than 1 stent is used, cath lab charges of Rs.20,000 per stent will be applicable as defined in this section. b) In addition to the above limit, one balloon, one guidewire and one guiding catheter is also part of package. c) Package excludes all other investigations, consumables, non-ionic dyes, drugs and any other procedure which will payable as per actual. d) Cost of stent, extra balloon, extra guide wire and extra guiding catheter if used will be charged extra.
PACKAGE LIMITS SERVICE CODE SERVICE NAME PHARMACY (Rs.) INVESTIGATIONS MHH02001 Coronary (PTCA) non complex 26,500 Annexure 2 MHH02003 Balloon mitral valvulopasty 12,500 Annexure 2 MHH02004 Peripheral angioplasty 22,500 Annexure 2 MHH02005 Carotid angioplasty 22,500 Annexure 2 MHH02006 Renal angioplasty 22,500 Annexure 2 MHH02007 Directional atherectomy 23,000 Annexure 2 MHH02008 Rotablator atherectomy 23,000 Annexure 2
3. PRIMARY / EMERGENCY/ COMPLEX ANGIOPLASTY SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH02002 Coronary (PTCA) complex -- 201,250 230,000 258,750 299,000 MHH02009 Primary angioplasty -- 207,000 230,000 258,750 287,500
Guidelines for Primary/Complex Angioplasty packages: a) Package includes 2 days stay including 1 day in ICU, doctor charges, investigations (as per Annexure 2: Angioplasty package details), routine consumables and drugs upto the defined limits and cath lab charges (for one stent only). Incase more than 1 stent is used, cath lab charges of Rs.20,000 per stent will be applicable as defined in this section. b) In addition to the above limit, two balloons, one guidewire and one guiding catheter are also part of package. c) Package excludes all other investigations, consumables, non-ionic dyes, drugs and any other procedure which will payable as per actual. d) Cost of stent, extra balloon, extra guide wire and extra guiding catheter if used will be charged extra.
PACKAGE LIMITS SERVICE CODE SERVICE NAME PHARMACY (Rs.) INVESTIGATIONS MHH02002 Coronary (PTCA) complex 26,500 Annexure 2 MHH02009 Primary angioplasty 26,500 Annexure 2
107 4. PACEMAKER SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH03002 Single chamber -- 34,500 37,950 40,250 51,750 MHH03003 Double chamber -- 46,000 49,450 51,750 63,250 MHH03004 Bi-ventricular -- 51,750 57,500 63,250 74,750 MHH03005 ICD -- 57,500 63,250 69,000 80,500 MHH03006 Combo device -- 57,500 63,250 69,000 80,500
Guidelines for Pacemaker packages: a) Package includes procedure charges and cath lab charges. b) Package excludes room rent, visit charges, investigations, consumables, medicines, device charges, etc.
5. EPS AND RADIOFREQUENCY ABLATION SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH04001 EPS basic -- 13,800 14,380 14,950 16,100 MHH04002 EPS complete -- 23,000 25,300 27,600 29,900 MHH04003 RF ablation with EP -- 51,750 57,500 63,250 69,000 MHH04004 Septal ablation -- 103,500 120,750 149,500 207,000
Guidelines for packages: a) Package includes procedure charges and cath lab charges. b) Package excludes room rent, visit charges, investigations, consumables, medicines, device charges, etc.
6. OTHER PROCEDURES SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH03001 Temporary pacemaker -- 11,500 13,800 16,100 17,250 MHH05001 Sternal wire removal -- 8,050 10,350 13,800 16,100 MHH05002 IVC filter -- 46,000 51,750 57,500 63,250 MHH05003 IABP -- 12,650 14,380 16,100 19,550 MHH05004 Pericardial tapping -- 5,750 6,900 8,050 9,200 MHH05005 Pleural tapping -- 2,300 2,880 3,450 4,600 MHH05007* Emergency bedside screening ECHO -- 2,880 2,880 2,880 2,880
Guidelines for packages: a) Package includes procedure charges and cath lab charges. b) Package excludes room rent, visit charges, investigations, consumables, medicines, device charges, etc.
7. CARDIAC SURGERY SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH06001 CABG (bypass surgery)-off pump -- 258,750 287,500 345,000 460,000 MHH06007 CABG (bypass surgery)-on pump -- 281,750 304,750 368,000 483,000 MHH06002 Aortic valve replacement (AVR) -- 270,250 299,000 356,500 471,500 MHH06003 Mitral valve replacement (MVR) -- 270,250 299,000 356,500 471,500 MHH06004 Double valve replacement (DVR) -- 287,500 322,000 373,750 483,000 MHH06005 Redo case -- 322,000 368,000 431,250 632,500 MHH06006 Closed heart surgery -- 115,000 132,250 166,750 224,250 MHH06008 Open heart surgery -- 276,000 322,000 379,500 483,000
Guidelines for Cardiac surgery packages: a) Package includes room rent for 8 days (3 days in heart command/CCU), surgeon’s fee, anaesthetist’s fee, OT charges, recovery room charges, oxygen charges, ventilation charges, investigations (as per Annexure 2: Cardiac surgeries package details), routine consumables and drugs, dressing charges, 9 units of blood (upto 2 FFP, 4 whole blood/PRBC and 4 platelet concentrate units), blood transfusion charges, consultant visits, arterial line filter, TEG m/c cartridges upto 2 units, physiotherapy and diet charges. b) Package excludes swan ganz catheter, centrifugal pump head, IABP, cost of valve, conduit, leucocyte filter,leucoguard filter, blood products on cell separator and cell saver kit (autotransfusion set).
Notes: a) All high risk surgeries will be charged 15% above package cost. b) Cost of valves, conduits, grafts are not included in the package and will be charged extra. c) Procedures (carotid, TMR, AVR, MVR, DVR) in addition to a CABG will be charged 30% extra.
108 8. OTHER CHARGES SERVICE CODE SERVICE NAME DAY CARE (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) MHH05006 CD charges 1,150 1,150 1,150 1,150 1,150 MHH02010* Cath lab charges per stent (more than 1 stent) -- 23,000 23,000 23,000 23,000
GENERAL CLARIFICATION a) Consultant charges of all specialties other than cardiologist/cardiac surgeons (as per specifics of package) shall be charged extra as per bed category. b) Any incidental procedure other than that specified in the package will be charged extra. c) The schedule of charges is liable to change without prior notice. d) VAT and other taxes applicable as per the rules of Government of India. e) Extra stay (over and above the package duration), any special drug/consumables used, investigations required over and above package shall be charged extra.
ANNEXURE 1: ANGIOGRAPHY PACKAGE DETAILS i) CBC (1) ii) Serum creatinine (1) iii) Blood glucose (random) (1) iv) HBsAg (1) v) Hepatitis C (1) vi) HIV (only with consent) (1) vii) ECG (1) viii) Blood grouping and cross matching (1) ix) Potassium (1)
ANNEXURE 2: ANGIOPLASTY PACKAGE DETAILS (i) CBC (Hb, TLC,DLC, PLT, RBC) (3) (ii) Serum Creatinine (3) (iii) Blood glucose (random) (6) (iv) Packed cell volume (PCV) (1) (v) Prothrombin time (PT) (1) (vi) HbsAg (1) (vii) Partial thromboplastin time (APTT) (1) (viii) Serum Electrolyte (3) (ix) Serum Urea (3) (x) Anti-HCV (1) (xi) HIV (only with consent) (1) (xii) Complete urine examination (1) (xiii) X- Ray (chest) (1) (xiv) ECG (5) (xv) Blood Grouping and Cross Matching (1) (xvi) Liver panel (1) (xvii) CPK-MB (2) (xviii) Potassium (3) (xix) Echo (1)
ANNEXURE 3: CARDIAC SURGERIES PACKAGE DETAILS i) CBC (6) ii) Blood urea (6) iii) Haemoglobin and hematocrit (6) iv) Serum creatinine (6) v) RBS (as appropriate) vi) PI (6) vii) APTT (1) viii) Serum electrolyte (6) ix) HBsAG (1) x) HCV-anti (1) xi) HCV (only with consent) (1) xii) Complete urine examination (1) xiii) X-ray (chest) (6) xiv) ECG (as appropriate) xv) Blood grouping and cross matching (4) xvi) LFT (1) xvii) CPK (4) xviii) CPK-MB (4) xix) ABG (as appropriate) xx) Glucose by glucometer (as appropriate) xxi) Blood culture (only for SVR/DVR cases) (2) xxii) Echo (2) xxiii) Color doppler (carotid+IMA+renal) only for cardiac surgeries (3) xxiv) Color doppler (carotid or venous or peripheral) only for vascular surgeries (1) xxv) PFT (1) xxvi) ABI hand held (for vascular surgeries) (1)
F5: MOOLCHAND RENALCARE AND DIALYSIS
GUIDELINES: a) Dialysis packages include professional fee of nephrologists, haemodialysis kit and cost of dialyser. b) Emergency dialysis is applicable to non routine cases (patients after 8:00 pm or on holidays). c) Indigent patients will not be charged dialysis fees. Dialysis will be done as an acute life saving measure and will be capped at two dialysis/patient. Patient will have to provide necessary materials.
1. DIALYSIS PACKAGES (PREMIUM) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RCC01001 Dialysis (with single use dialyser) 4,000 4,000 4,500 5,000 5,000 RCC01002 Dialysis (with multiple use dialyser) 2,750 2,750 3,094 3,438 3,438 RCC01003 Emergency dialysis (with single use dialyser) 4,200 4,200 4,725 5,250 5,250
2. DIALYSIS PACKAGES (REGULAR) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RCC01004 Dialysis (with single use dialyser) 3,300 3,300 3,713 4,125 4,125 RCC01005 Dialysis (with multiple use dialyser) 2,550 2,550 2,869 3,188 3,188 RCC01006 Emergency dialysis (with single use dialyser) 3,800 3,800 4,275 4,750 4,750 RCC01010 Haemodiafiltration - HDF (with single use 4,400 4,400 4,950 5,500 5,500 dialyser)
3. DIALYSIS PACKAGES (ISOLATION) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RCC01007 Dialysis (with single use dialyser) 3,600 3,600 4,050 4,500 4,500 RCC01008 Dialysis (with multiple use dialyser) 2,500 2,500 2,813 3,125 3,125 RCC01009 Emergency dialysis (with single use dialyser) 4,000 4,000 4,500 5,000 5,000
109 4. OUTPATIENT DIALYSIS PROCEDURES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RCC02001 AV fistula charges 9,000 9,000 10,125 11,250 11,250 RCC02002 Femoral catherization 2,350 2,350 2,644 2,938 2,938 RCC02003 Kidney biopsy 6,500 6,500 7,313 8,125 8,125 RCC02004 Subclavian/jugular catheterization 4,000 4,000 4,500 5,000 5,000
5. INPATIENT DIALYSIS PROCEDURES (CRITICAL CARE/ROOMS) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RCC03001 CAVHD on CRRT m/c -- 12,800 14,400 16,000 16,000 RCC03002 Continuous ambulatory peritoneal dialysis -- 10,800 12,150 13,500 13,500 RCC03003 Peritoneal dialysis -- 4,800 5,400 6,000 6,000 RCC03004 Plasma pharasis (per exchange) -- 8,000 9,000 10,000 10,000 RCC03005 SLEDD (slow low efficient daily dialysis) -- 5,600 6,300 7,000 7,000
6. CAPD TRAINING SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RCC04001 CAPD training for one week 13,800 13,800 15,530 17,250 17,250
7. KIDNEY TRANSPLANT PACKAGE SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) RCC05001* Kidney transplant with open donor nephrectomy -- 661,250 661,250 661,250 661,250
Guidelines for the package: a) Packages include: i) Room rent for 10 days for recipient and 6 days for donor (including 1 day pre-op stay and recovery room stay) ii) Surgeons, nephrologist, anaesthetist fee and visit charges for urologist and nephrologist iii) OT charges and OT gases iv) Medicines and consumables are included in the package to the extent of 15,000/- in OT for donor and recipient and 20,000/- in ward for both donor and recipient v) Investigations (as per details given below) vi) One dialysis Investigations included in package: Recipient investigations: Haemogram-12, urea-12, creatinine-12, electrolyte-12, sugar-5, coagulation profile (BT/CT)-3, calcium-4, phosphorus-4, LFT-2, x-ray (chest) PA-2, USG (KUB)-1, urine routine-4 Donor investigations: Haemogram-3, urea-3, creatinine-3, electrolyte-3, x-ray (chest) PA-2 b) Packages exclude: i) Pre operative donor work up or the recipient preparation ii) Room rent for more than 10 days for recipient and 6 days for donor iii) All immunosuppresants, induction therapy, drug assays. Medications like gancyclovir, OKT31 Hbig, FKSO6, ATG, azathioprine, omnacortii, methyl prednisolone, mycophenaiate, TPN, and high end medication iv) Corrective surgery if any, after transplant for complications or biopsy after 10 days v) Invasive cardiac imaging or intervention for heart disease required post operatively vi) HLA typing and cross match investigations vii) Blood transfusion viii) Cross speciality consultation charges
110 MOOLCHAND SCHEDULE OF CHARGES 2019
SECTION G: AYURVED
G1: PANCHKARMA THERAPY
1. PANCHKARMA THERAPY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.)
AYU02001* Antah shodhan (vaman) (per karma) 1,800 2,250 2,250 2,250 2,250 AYU02002* Antah shodhan (virechan) (per karma) 1,800 2,250 2,250 2,250 2,250 AYU02003* Antah snehan (per karma) 400 500 500 500 500 AYU02004* Anuwasan vasti (per karma) 400 500 500 500 500 AYU02005* Bahya snehan (per karma) 400 500 500 500 500 AYU02006* Bringhan nasya (per karma) 500 630 630 630 630 AYU02007* Bringhan vasti (per karma) 400 500 500 500 500 AYU02012* Draw swedan (per karma) 650 820 820 820 820 AYU02013* Ekanga pinda swedan (per karma) 250 320 320 320 320 AYU02014* Ekanga rooksha swedan 300 380 380 380 380 AYU02015* Ekanga shodhan (per karma) 250 320 320 320 320 AYU02016* General pinda swedan (per karma) 400 500 500 500 500 AYU02017* Kati vasti (per karma) 400 500 500 500 500 AYU02018* Lekhan vasti (per karma) 400 500 500 500 500 AYU02019* Niruhan vasti (per karma) 400 500 500 500 500 AYU02020* Piccha vasti (per karma) 400 500 500 500 500 AYU02021* Pizhichil (per karma) 2,800 3,500 3,500 3,500 3,500 AYU02022* Sarwanga abhyanga (per karma) 450 570 570 570 570 AYU02023* Sarwanga pinda swedan (per karma) 450 570 570 570 570 AYU02024* Sarwanga rooksha swedan (per karma) 900 1,130 1,130 1,130 1,130 AYU02025* Sarwanga samanya shodhan 300 380 380 380 380 AYU02026* Sarwanga taildhara swedan (per karma) 1,500 1,880 1,880 1,880 1,880 AYU02027* Sarwanga vashpa swedan (per karma) 500 630 630 630 630 AYU02028* Shashthik shali sweda for adult (per karma) 800 1,000 1,000 1,000 1,000 AYU02029* Shashthik shali sweda for child (per karma) 500 630 630 630 630 AYU02030* Shiro abhyanga (per karma) 200 250 250 250 250 AYU02031* Shirodhara (per karma) 400 500 500 500 500 AYU02032* Shodhan nasya (per karma) 400 500 500 500 500 AYU02033* Shrovasti karma (per karma) 900 1,130 1,130 1,130 1,130 AYU02034* Takra dhara (per karma) 500 630 630 630 630 AYU02035* Upnah swedan 300 380 380 380 380 AYU02036* Uttar vasti (per karma) 500 630 630 630 630 AYU02037* Ekang tail dhara 600 750 750 750 750 AYU02038* Greeva basti 500 630 630 630 630 AYU02039* Pristha basti 750 940 940 940 940 AYU02049* Nadi sweda (per limb) 500 630 630 630 630 AYU02050* Nadi sweda (full body) 750 940 940 940 940
2. PANCHKARMA THERAPY/PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) AYU02010* Bahya snehan and shiro abhyanga (5 sittings) 2,200 2,750 2,750 2,750 2,750 AYU02008* Sarwanga pinda swedan and sarwanga vashpa 4,000 5,000 5,000 5,000 5,000 swedan (5 sittings) AYU02009* Uttar vasti and sarwanga pinda swedan (5 4,000 5,000 5,000 5,000 5,000 sittings) AYU02040* Bringhan nasya and shiro abhyanga (5 sittings) 2,500 3,130 3,130 3,130 3,130 AYU02041* Draw swedan and lekhan vasti (5 sittings) 4,500 5,630 5,630 5,630 5,630 AYU02042* Shashthik shali swedan for adult and general 5,250 6,570 6,570 6,570 6,570 pinda swedan (5 sittings)
111 AYU02043* Shashthik shali swedan for child and sarwanga 3,400 4,250 4,250 4,250 4,250 abhyanga (5 sittings) AYU02044* Kati vasti and sarwang abhyanga (5 sittings) 3,400 4,250 4,250 4,250 4,250 AYU02045* Greeva basti and general pinda swedan (5 4,000 5,000 5,000 5,000 5,000 sittings) AYU02046* Pristha basti and general pinda swedan (5 4,000 5,000 5,000 5,000 5,000 sittings) AYU02047* Shiro abhyanga and shrovasti (5 sittings) 3,400 4,250 4,250 4,250 4,250 AYU02048* Shirodhara and shiro abhyanga (5 sittings) 2,600 3,250 3,250 3,250 3,250
112 G2: SHALYA KARMA THERAPY
1. SHALYA KARMA THERAPY SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) AYU03001* Agni karma (per karma) 450 570 570 570 570 AYU03002* Bhagandar pradhan karma kaphaj 3,750 4,690 4,690 4,690 4,690 AYU03003* Bhagandar pradhan karma pittaj 5,000 6,250 6,250 6,250 6,250 AYU03004* Bhagandar pradhan karma vataj 8,000 10,000 10,000 10,000 10,000 AYU03005* General karma shalya (per karma) 1,500 1,880 1,880 1,880 1,880 AYU03006* Jaloka karma 750 940 940 940 940 AYU03007* Kshar karma (per karma) 600 750 750 750 750 AYU03008* Kshar pichu karma 300 380 380 380 380 AYU03009* Kshar sutra parivartan (per karma) 600 750 750 750 750 AYU03010* Kshar sutra primary ligation (per karma) 2,200 2,750 2,750 2,750 2,750 AYU03011* Kshar sutra secondary ligation (per karma) 600 750 750 750 750 AYU03012* Kshar sutra secondary threading (per karma) 600 750 750 750 750 AYU03013* Kshar sutra/ligation for piles 2,200 2,750 2,750 2,750 2,750 AYU03014* Kshar suttr/ligation for piles kaphaj 3,600 4,500 4,500 4,500 4,500 AYU03015* Kshar suttr/ligation for piles pittaj 5,000 6,250 6,250 6,250 6,250 AYU03016* Kshar suttr/ligation for piles vatik 8,000 10,000 10,000 10,000 10,000 AYU03017* Kshar varti karma 300 380 380 380 380 AYU03018* Parikartika pashchat karma (per karma) 350 440 440 440 440 AYU03019* Parikartika pradhan karma (per karma) 1,200 1,500 1,500 1,500 1,500 AYU03020* Parikartika pradhan karma kaphaj 2,200 2,750 2,750 2,750 2,750 AYU03021* Parikartika pradhan karma pittaj 4,500 5,630 5,630 5,630 5,630 AYU03022* Parikartika pradhan karma vatik 3,000 3,750 3,750 3,750 3,750 AYU03023* Siravedh (per karma) 450 570 570 570 570 AYU03024* Sthanik samgya haran 700 880 880 880 880 AYU03025* Vrinopachar (per karma) 100 130 130 130 130
113 G3: STRIROG (PRASUTI TANTRA)
1. STRIROG (PRASUTI TANTRA) SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) AYU04001* Garbhashaya dosh har snehvasti (per karma) 300 380 380 380 380 AYU04002* Garbhashaya mukh kala chhedan (per karma) 700 880 880 880 880 AYU04003* Garbhashaya mukhkala lekhan (per karma) 450 570 570 570 570 AYU04004* Garbhashaya patra pinda puran (per karma) 250 320 320 320 320 AYU04005* Garbhashshaya kala lekhan (per karma) 900 1,130 1,130 1,130 1,130 AYU04006* Garbhini paricharya karma (per karma) 300 380 380 380 380 AYU04007* General karma stri rog (per karma) 150 190 190 190 190 AYU04008* Jalodara toya nirharan (per karma) 350 440 440 440 440 AYU04009* Kshar karma (per karma) 250 320 320 320 320 AYU04010* Phalvahi srotus pariksha (per karma) 350 440 440 440 440 AYU04011* Pichu dharan (per karma) 150 190 190 190 190 AYU04012* Prasawottar swasthya karma (per karma) 600 750 750 750 750 AYU04013* Shalya nirharan (per karma) 200 250 250 250 250 AYU04014* Stan vidradhi patan (per karma) 350 440 440 440 440 AYU04015* Stan vidradhi ropan and bandhan (per karma) 200 250 250 250 250 AYU04016* Uttar vasti (per karma) 300 380 380 380 380 AYU04017* Vrana shodhanartha uttarvasti (per karma) 300 380 380 380 380 AYU04018* Vrinopchar (stri rog) (per karma) 150 190 190 190 190 AYU04019* Yoni dhupan (per karma) 200 250 250 250 250 AYU04020* Yoni swedan (per karma) 200 250 250 250 250 AYU04021* Yonyarsh nirharan (per karma) 450 570 570 570 570
114 G4: REJUVENATION PACKAGES
1. REJUVENATION PACKAGES SERVICE CODE SERVICE NAME OPD (Rs.) 3/4 BEDDED (Rs.) TWIN (Rs.) SINGLE (Rs.) SUITE (Rs.) AYU05001* Rejuvenate and antistress (5 sitting) 8,000 10,000 10,000 10,000 10,000 AYU05002* Anti obesity (5 sitting) 10,000 12,500 12,500 12,500 12,500 AYU05003* Skin treatment (8 sitting) 12,000 15,000 15,000 15,000 15,000
115