Schedule hospital charges 2022 Index

ST. JOHN’S MEDICAL COLLEGE HOSPITALA UNIT OF C.B.C.I. SOCIETY FOR MEDICAL EDUCATION

BENGALURU - 560 034

SCHEDULE OF HOSPITAL CHARGES

FINANCIAL YEAR 2022 - 2023

(Effective from 1st APRIL 2022)

ST. JOHN’S MEDICAL COLLEGE HOSPITAL, BENGALURU - 34SCHEDULE OF HOSPITAL CHARGES 2022-2023

INDEXPage No.

I . OUT PATIENT REGISTRATION / CONSULTATION ................................................................................................................................................ 1I I . HOSPITALISATION CHARGES PER DAY ............................................................................................................................................................. 3

A. BED CHARGES & ADMINISTRATIVE CHARGES............................................................................................................................................... 3B. CCU PACKAGE PER DAY .................................................................................................................................................................................. 4C. NEONATAL ICU PACKAGE PER DAY ................................................................................................................................................................ 4D. EMERGENCY ICU PACKAGE PER DAY............................................................................................................................................................ 4E. ICU PACKAGE PER DAY .................................................................................................................................................................................... 4F. PAEDIATRIC ICU PACKAGE PER DAY .............................................................................................................................................................. 5G. NEUROSURGERY ICU PACKAGE PER DAY .................................................................................................................................................... 5H. HEALTH CHECK-UP PACKAGES ...................................................................................................................................................................... 5I. DIET ..................................................................................................................................................................................................................... 5

I I I . LABORATORY INVESTIGATIONS ........................................................................................................................................................................ 9A. CLINICAL PATHOLOGY .................................................................................................................................................................................... 9

A1. CLINICAL PATHOLOGY: ROUTINE HAEMATOLOGY TESTS ............................................................................................................. 9A2. CLINICAL PATHOLOGY: COAGULATION TESTS ............................................................................................................................... 9A3. CLINICAL PATHOLOGY: HEMOLYTIC WORK UP ............................................................................................................................. 10A4. CLINICAL PATHOLOGY: FLOW CYTOMETRY .................................................................................................................................. 10A5. CLINICAL PATHOLOGY: URINE & FAECES ANALYSIS .................................................................................................................... 10A6. CLINICAL PATHOLOGY: MISCELLANEOUS TESTS ......................................................................................................................... 10A7. CLINICAL PATHOLOGY: BODY FLUIDS ............................................................................................................................................ 10A8. CLINICAL PATHOLOGY: MOLECULAR TESTING ............................................................................................................................. 11A9. TEST OUTSOURCED ........................................................................................................................................................................ 11

B. BLOOD BANK ................................................................................................................................................................................................. 11B1. BLOOD BANK : IMMUNOHEMATOLOGY .......................................................................................................................................... 11B2. THALASSAEMIA, HAEMOPHILIA & SICKLE ANEMIA PATIENTS ...................................................................................................... 11B3. BLOOD BANK : BLOOD COMPONENTS ........................................................................................................................................... 12B4. BLOOD BANK : BLOOD COMPONENTS BPL PATIENTS.................................................................................................................. 12

C. BIOCHEMISTRY LAB ..................................................................................................................................................................................... 13C1. BIOCHEMISTRY LAB: BLOOD TESTS .............................................................................................................................................. 13C2. BIOCHEMISTRY LAB: TUMOUR MARKERS .................................................................................................................................... 14C3. BIOCHEMISTRY LAB: BODY FLUID TESTS .................................................................................................................................... 14C4. BIOCHEMISTRY LAB: URINE TESTS ............................................................................................................................................... 15C5. BIOCHEMISTRY LAB: PANELS ......................................................................................................................................................... 15C6. BIOCHEMISTRY LAB: TESTS DONE IN THE COLLEGE ................................................................................................................. 16C7. BIOCHEMISTRY TESTS OUTSOURCED ......................................................................................................................................... 17

D. MICROBIOLOGY LAB .................................................................................................................................................................................... 18D1. MICROBIOLOGY: ROUTINE TESTS ................................................................................................................................................. 18D2. MICROBIOLOGY: SURVEILLANCE ................................................................................................................................................... 20D3. MICROBIOLOGY: TESTS OUTSOURCED ........................................................................................................................................ 21D4. MICROBIOLOGY: TESTS DONE AT SJRI .......................................................................................................................................... 21

E. HISTOPATHOLOGY LAB (COLLEGE) ............................................................................................................................................................ 21F. CYTOGENETICS TESTS (COLLEGE) ............................................................................................................................................................. 22

F1. CYTOGENETICS TESTS OUTSOURCED ........................................................................................................................................ 23F2. LIFE CELL DIAGONSTICS - OUTSOURCED .................................................................................................................................... 23

G. PHARMACOLOGY (COLLEGE) ...................................................................................................................................................................... 23H. EMERGENCY MEDICINE ............................................................................................................................................................................... 24

IV. RADIOLOGY INVESTIGATIONS ......................................................................................................................................................................... 24A. PLAIN X-RAY .................................................................................................................................................................................................... 24B. SPECIAL INVESTIGATIONS ............................................................................................................................................................................ 25C. COLOUR DOPPLER SONOGRAPHY .............................................................................................................................................................. 26D. ULTRA SOUND IMAGING ................................................................................................................................................................................ 27E. MAMMOGRAPHY ............................................................................................................................................................................................. 29F. CT SCAN ......................................................................................................................................................................................................... 29G. MRI SCAN ........................................................................................................................................................................................................ 30

G1. EMERGENCY MEDICINE PACKAGE ................................................................................................................................................... 31ii

H. NEURO INTERVENTIONAL PROCEDURE .................................................................................................................................................... 31I. INVESTIGATIONS DONE OUTSIDE ................................................................................................................................................................. 32

I1. PET CT SCANS .................................................................................................................................................................................. 32I2. NUCLEAR MEDICINE ......................................................................................................................................................................... 32

V. NON-OPERATIVE PROCEDURES ....................................................................................................................................................................... 33A. GENERAL PROCEDURES .............................................................................................................................................................................. 331. GENERAL PROCEDURES - CCU .................................................................................................................................................................... 332. GENERAL PROCEDURES - ICU ..................................................................................................................................................................... 333. GENERAL PROCEDURES - PAEDIATRIC ICU ................................................................................................................................................ 334. GENERAL PROCEDURES - NEONATAL ICU .................................................................................................................................................. 345. GENERAL PROCEDURES - ITU / POST OPERATIVE .................................................................................................................................... 356. GENERAL PROCEDURES - EMERGENCY MEDICINE / EICU ....................................................................................................................... 367. GENERAL PROCEDURES - OPD / WARD ....................................................................................................................................................... 388. GENERAL PROCEDURES - UNIT OF HOPE .................................................................................................................................................. 41

8.1. UoH - AUDIOLOGY AND SPEECH THERAPY .................................................................................................................................. 428.2. UoH - AUTISM CLINIC ...................................................................................................................................................................... 438.3. UoH - CARE ADD .............................................................................................................................................................................. 438.4. UoH - CHILD PSYCHIATRY.............................................................................................................................................................. 438.5. UoH - COMDEALL ............................................................................................................................................................................. 448.6. UoH - DENTAL .................................................................................................................................................................................. 448.7. UoH - MEDICO SOCIAL WORK ........................................................................................................................................................ 448.8. UoH - NEONATAL.............................................................................................................................................................................. 458.9. UoH - OPHTHALMOLOGY ................................................................................................................................................................ 458.10. UoH - ORTHOPAEDICS .................................................................................................................................................................. 458.11. UoH - PAEDIATRICS ....................................................................................................................................................................... 468.12. UoH - PHYSICAL MEDICINE & REHABILITATION ......................................................................................................................... 468.13. UoH - PHYSIOTHERAPY CLINIC ................................................................................................................................................... 468.14. UoH - SPECIAL EDUCATION ......................................................................................................................................................... 468.15. UoH - TEAM CLINIC ....................................................................................................................................................................... 47

9. GENERAL PROCEDURES - PEDIATRIC EMERGENCY ................................................................................................................................. 47B. SPECIALISED PROCEDURES ...................................................................................................................................................................... 481.SPECIALISED PROCEDURES - CARDIOLOGY ............................................................................................................................................... 48

1.1. NON-INVASIVE DIAGNOSTICS ........................................................................................................................................................ 481.2. INVASIVE PROCEDURES ................................................................................................................................................................. 491.3. INVASIVE DIAGNOSTICS - PACKAGES ........................................................................................................................................... 491.4. NON-CORONARY INTERVENTIONS - PACKAGES ......................................................................................................................... 491.5. CORONARY INTERVENTIONS - PROCEDURES (CATH LAB) ....................................................................................................... 501.6. CORONARY INTERVENTIONS - PACKAGES .................................................................................................................................. 501.7. ANAESTHESIA CHARGES ................................................................................................................................................................ 501.8. PAEDIATRIC CARDIOLOGY PROCEDURE * ................................................................................................................................... 511.9. ELECTRO PHYSIOLOGY STUDY PROCEDURE ............................................................................................................................. 51

2. SPECIALISED PROCEDURES - DENTAL ........................................................................................................................................................ 512.1. DENTAL SURGERY .......................................................................................................................................................................... 512.2. ORTHODONTICS.............................................................................................................................................................................. 532.3 PROSTHODONTICS .......................................................................................................................................................................... 54

3. SPECIALISED PROCEDURES - DERMATOLOGY........................................................................................................................................... 554. SPECIALISED PROCEDURES - ENDOCRINOLOGY ...................................................................................................................................... 595. SPECIALISED PROCEDURES - ENT .............................................................................................................................................................. 596. SPECIALISED PROCEDURES - GASTROENTEROLOGY .............................................................................................................................. 627. SPECIALISED PROCEDURES- GENERAL MEDICINE ................................................................................................................................... 648. SPECIALISED PROCEDURES - IMMUNOLOGY ............................................................................................................................................. 649. SPECIALISED PROCEDURES - PULMONARY MEDICINE ............................................................................................................................. 6510. SPECIALISED PROCEDURES - GENERAL SURGERY ................................................................................................................................ 66

10.1. STOMA CLINIC PROCEDURE ........................................................................................................................................................ 6711. SPECIALISED PROCEDURES - NEPHROLOGY ........................................................................................................................................... 6712. SPECIALISED PROCEDURES - NEUROSURGERY ..................................................................................................................................... 6813. SPECIALISED PROCEDURES - NEUROLOGY ............................................................................................................................................. 6914. SPECIALISED PROCEDURES - OBSTETRICS & GYNAECOLOGY.............................................................................................................. 7015. SPECIALISED PROCEDURES - OPTHALMOLOGY ...................................................................................................................................... 72

iii

16. SPECIALISED PROCEDURES - ORTHOPAEDICS ....................................................................................................................................... 7417. SPECIALISED PROCEDURES - PAEDIATRICS ............................................................................................................................................ 7518. PEDIATRIC ONCOLOGY ................................................................................................................................................................................ 7519. SPECIALISED PROCEDURES - NEONATOLOGY ......................................................................................................................................... 7620. SPECIALISED PROCEDURES - PAEDIATRIC NEPHROLOGY ..................................................................................................................... 7721. SPECIALISED PROCEDURES - PAEDIATRIC SURGERY ............................................................................................................................ 7822. SPECIALISED PROCEDURES - PHYSICAL MEDICINE AND REHABILITATION ......................................................................................... 78

22.1. PMR - MEDICAL REHABILITATION ................................................................................................................................................ 7822.2. PMR - OCCUPATIONAL THERAPPY .............................................................................................................................................. 8022.3. PMR - ORTHOTIC & PROSTHESTIC ............................................................................................................................................. 8022.4. PMR - MEDICO SOCIAL WORK ...................................................................................................................................................... 8222.5. PMR - SPEECH AND LANGUAGE SECTION.................................................................................................................................. 82

23. SPECIALISED PROCEDURES - PHYSIOTHERAPY ..................................................................................................................................... 8324. SPECIALISED PROCEDURES - PLASTIC SURGERY .................................................................................................................................. 8325. SPECIALISED PROCEDURES - PSYCHIATRY ............................................................................................................................................. 85

25.1. CHILD PSYCHIATRY ...................................................................................................................................................................... 8525.2. CLINICAL PSYCHOLOGY ............................................................................................................................................................... 8625.3. PSYCHIATRY SOCIAL WORK ......................................................................................................................................................... 8625.4. DAY CARE CENTRE ....................................................................................................................................................................... 8625.5. GENERAL ........................................................................................................................................................................................ 8725.6. GERIATRIC PSYCHIATRY .............................................................................................................................................................. 87

26. SPECIALISED PROCEDURES - UROLOGY .................................................................................................................................................. 8727. SPECIALISED PROCEDURES - MEDICAL ONCOLOGY............................................................................................................................... 8828. SPECIALISED PROCEDURES - SURGICAL ONCOLOGY ............................................................................................................................ 8929. SPECIALISED PROCEDURES - GYNECOLOGIC ONCOLOGY .................................................................................................................... 9030. SPECIALISED PROCEDURES - RADIATION ONCOLOGY ........................................................................................................................... 9131. SPECIALISED PROCEDURES - PAIN & PALLIATIVE MEDICINE ................................................................................................................. 9232. ANAESTHESIOLOGY ...................................................................................................................................................................................... 93C. OTHER PROCEDURES / SERVICES ............................................................................................................................................................. 941. OTHER SERVICES: NUTRITION SERVICES .................................................................................................................................................. 94

1.1. SPECIALISED PROCEDURES DONE IN COLLEGE ........................................................................................................................ 941.2. LIFE STYLE MANAGEMENT PROGRAMME .................................................................................................................................... 941.3. TESTS DONE IN PHYSIOLOGY SJMC (BILLING DONE IN SJMC) ................................................................................................. 95

2. OTHER SERVICES: FORENSIC MEDICINE .................................................................................................................................................... 953. OTHER SERVICES: CERTIFICATES ............................................................................................................................................................... 954. OTHER SERVICES: MEDICO SOCIAL WORK ................................................................................................................................................. 965. OUTSIDE INVESTIGATIONS............................................................................................................................................................................ 96

VI. OPERATIVE PROCEDURES ................................................................................................................................................................................ 97A. CARDIO THORACIC & VASCULAR SURGERY .............................................................................................................................................. 97B. GENERAL SURGERY .................................................................................................................................................................................... 103C. GENITO URINARY SURGERY ....................................................................................................................................................................... 111D. GYNAECOLOGY ............................................................................................................................................................................................ 117E. OBSTETRICS ................................................................................................................................................................................................. 119F. OPHTHALMOLOGY ........................................................................................................................................................................................ 119G. ORTHOPAEDICS ........................................................................................................................................................................................... 124H. ENT ................................................................................................................................................................................................................ 136I. NEURO SURGERY ......................................................................................................................................................................................... 145J. PLASTIC SURGERY ....................................................................................................................................................................................... 149K. PAEDIATRIC SURGERY ................................................................................................................................................................................ 162L. NEPHROLOGY ............................................................................................................................................................................................... 165M. CADAVERIC ORGAN RETRIEVAL ................................................................................................................................................................ 165N. PHYSICAL MEDICINE & REHABILITATION .................................................................................................................................................. 166O. SURGICAL ONCOLOGY ................................................................................................................................................................................ 168P. GYNAECOLOGIC ONCOLOGY ....................................................................................................................................................................... 174Q. UNIT OF HOPE (UoH) ................................................................................................................................................................................... 179R. ANAESTHESIOLOGY ..................................................................................................................................................................................... 182S. PAIN & PALLIATIVE MEDICINE ...................................................................................................................................................................... 182T. SURGICALGASTROENTEROLOGY & HEPATOPANCREATOBILIARY SURGERY ....................................................................................... 183

iv

1

ST. JOHN’S MEDICAL COLLEGE HOSPITAL, BENGALURU - 560 034SCHEDULE OF HOSPITAL CHARGES

Effective from 1st April, 2022

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

DAYCARE

Rs. Rs. Rs. Rs. Rs.I. OP REGISTRATION / CONSULTATION

00056 MRD Registration Charges 30

00004 General Consultation 150

00365 General Cross Consultation 80

00032 General Consultation (Revisit within 3 Days) 100

00059 General Super Speciality Consultation 180

00057 General Super Speciality Cross Consultation 100

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

00011 Morning Special Consulation 450

00368 Morning Special Cross consultation 250

00012 Morning Special Consulation (Revisit within 30 Days) 250

00006 Morning Super Special Consultation 500

00367 Morning Super Special Cross Consultation 250

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

00016 Evening Special Consultation 550

00018 Evening Special Cross Consultation 250

00017 Evening Consultation (Revisit within 30 Days) 300

00008 Evening Super Speciallty Consultation 650

00046 Evening Super Special Cross Consultation 300

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

00005 Emergency OP New Registration 250

00366 Emergency OP Cross Consultation 100

00077 Paed. Emergency Consultation 250

00078 Paed. Subspeciality Cross Consultation 100

00374 General OP Registration Psychiatry 250

2


DAYCARE

Rs. Rs. Rs. Rs. Rs.

00378 General Cross Consultation Psychiatry 150

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

00383 General Consultation Pyschiatry (Revisit After 30 Days) 250

00376 Morning Special Consultation - Psychiatry 750

00379 Morning Special Cross Consultation - Psychiatry 500

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

00380 Evening Special Consultation -Psychiatry 750

00381 Evening Consultation Psychiatry (Revisit within 30 Days) 750

00382 Even Special Cross Consultation - Psychiatry 500

00387 General Consultation - Nutrition 250

00386 Special Psychotherapy & Consultation 1000

00085 General Psychotherapy & Consultation 600

00003 Search Fee 20

00015 Visa Consultation 3000

00083 MLC Administrative Charges - OP 250

00084 MLC Adminstrative Charges - IP 1250 1250 1250 1250 1250

00396 Tele Consultation 350

02768 General Consultation - Geriatric Psychiatry 250

02769 General Cross Consultation - Geriatric Psychiatry 150

02770 Morning Special Consultation - Geriatric Psychiatry 750

02771 Morning Special Cross Consultation - Geriatric Psychiatry 500

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

3

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

DAYCARE

Rs. Rs. Rs. Rs. Rs.

II. HOSPITALIZATION CHARGES PER DAY:A. BED CHARGES & ADMINISTRATIVE CHARGES

00022 Bed Charges 250 400 950 1500 2700/6000

00142 Bed Charges - New Block 1200 2000/3000 4000 / 6500

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

00051 Bed Charges - Eclampsia Room 300 1000 1000 1000 1000

00184 BMTU Room Charges General 4750 4750 4750 4750 4750

00188 BMTU Room Charges Special 8500 8500 8500 8500 8500

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

00148 Professional & Treatment Charges - New Block 750 1200 2000

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

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

00066 Professional Treatment Charges for Burns 350 450 550 900 1000

00028 Visiting Fee 150 200 350 550 600

00155 Visiting Fee - New Block 550 800 1000

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

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

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

00021 Admission & Discharge Documentation 200 250 300 350 450

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

00065 Cross Consultation (IP) 100 150 250 400 450

00020 Day Care Bed Charges (IV,BT,Chemo) 300 350 550 550 550

00369 DayCare Bed Charges (Procedure/Surgery) 550 850

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

00035 Insurance Documentation -IP 500 500 500 500 500

15015 Insurance Documentation -OP 100

00031 Room Heater Charges 210 210 210 210 210

4


DAYCARE

Rs. Rs. Rs. Rs. Rs.

B. CCU PACKAGE Per Day

00090 CCU Charges with Respirator 8500

00088 CCU Charges with Respirator within 12 Hrs 5250

00089 CCU Charges with out Respirator 4750

C. NEONATAL ICU PACKAGE Per Day

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

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

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

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

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

00107 Warm Cradle 250 300 330 400 500

D. EMERGENCY ICU PACKAGE Per Day/ITU

00121 Emergency ICU Charges with Respirator 8500

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

00122 EICU Charges without Respirator 4750

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

E. ICU PACKAGE Per Day

00130 ICU Charges with Respirator 8500

00128 ICU Charges with Respirator (12 hrs) 5250

00129 ICU Charges without Respirator 4750

00060 ICU NIV 5250

00068 RICU Bed with NIV 5250

00069 RICU Bed without NIV 4750

00070 RICU Bed with Respirator 8500

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

5


DAYCARE

Rs. Rs. Rs. Rs. Rs.

F. PAEDIATRIC ICU PACKAGE Per Day

00166 Paed. ICU with Respirator 5500

00167 Paed. ICU with Respirator (12 Hrs) 3000

00165 Paed. ICU without Respirtator 2500

00175 Paediatric ICU for only Monitoring (Intermediate Care) 2000

00081 PICU with Respirator (SLE) - Regular Use 6000

00082 PICU with Respirator (SLE) - HFOV 8000

G. NEURO SURGERY ICU PACKAGE Per Day

00177 NICU with Respirator 4750

00178 NICU with Respirator (12 Hrs) 2750

00176 NICU without Respirator 2350

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

H. HEALTH CHECK-UP PACKAGES

00179 Miscellaneous - Health Plan

20104 Basic Health Checkup 2400

20105 Master Health Checkup 5200

20106 Cardiac Health Checkup 2900

I. DIET

20056 Diet Veg - Normal 200 230 310 310 510

00191 Diet Non Veg - Normal 230 260 340 340 540

20082 Attendant Diet - Daibetic Veg 200 230 310 310 510

20083 Attendant Diet - Diabetic Non Veg 230 260 340 340 540

20081 Attendant Diet - NonVeg (Normal) 230 260 340 340 540

20080 Attendant Diet - Veg(Normal) 220 250 330 330 530

6


DAYCARE

Rs. Rs. Rs. Rs. Rs.

20055 Cutlery Set 140 140 140 140 140

20034 Diet - Clear Liquids-Diabetic 120 150 180 180 210

20036 Diet - Clear Liquids-Diabetic Renal 120 150 180 180 210

20037 Diet - Clear Liquids-High Protein 120 150 180 180 210

20035 Diet - Clear Liquids-Renal 120 150 180 180 210

20091 Diet - Clear Liquids-Normal Non Veg 140 170 240 240 290

20092 Diet - Clear Liquids-Diabetic NonVeg 140 170 240 240 290

20093 Diet - Clear Liquids-High Protein NonVeg 140 170 240 240 290

20028 Diet - Liquids -Diabetic 160 190 260 260 310

20032 Diet - Liquids-Diabetic Renal 160 190 260 260 310

20033 Diet - Liquids-High Protein 160 190 260 260 310

20029 Diet - Liquids-Low FAT 160 190 260 260 310

20030 Diet - Liquids-Milk Free 160 190 260 260 310

20031 Diet - Liquids-Renal 160 190 260 260 310

20094 Diet - Liquids -Diabetic Non Veg 180 220 270 270 320

20095 Diet - Liquids-High Protein Non Veg 180 220 270 270 320

20096 Diet - Liquids-Low FAT Non Veg 180 220 270 270 320

20097 Diet - Liquids-Milk Free Non Veg 180 220 270 270 320

20010 Diet - NonVeg -Diabetic 230 260 340 340 540

20011 Diet - NonVeg -Low FAT 230 260 340 340 540

20012 Diet - NonVeg -Milk Free 230 260 340 340 540

20013 Diet - NonVeg -Renal 230 260 340 340 540

20014 Diet - NonVeg -Diabetic Renal 230 260 340 340 540

20015 Diet - NonVeg -High Protein 230 260 340 340 540

7


DAYCARE

Rs. Rs. Rs. Rs. Rs.

20022 Diet - Soft Solid -Diabetic 170 210 260 260 310

20026 Diet - Soft Solid -Diabetic Renal 170 210 260 260 310

20027 Diet - Soft Solid -High Protein 170 210 260 260 310

20023 Diet - Soft Solid -Low FAT 170 210 260 260 310

20024 Diet - Soft Solid -Milk Free 170 210 260 260 310

20025 Diet - Soft Solid -Renal 170 210 260 260 310

20098 Diet - Soft Solid -Diabetic Non Veg 190 230 280 280 330

20099 Diet - Soft Solid -Diabetic Renal Non Veg 190 230 280 280 330

20100 Diet - Soft Solid -High Protein Non Veg 190 230 280 280 330

20101 Diet - Soft Solid -Low FAT Non Veg 190 230 280 280 330

20102 Diet - Soft Solid -Milk Free Non Veg 190 230 280 280 330

20103 Diet - Soft Solid -Renal Non Veg 190 230 280 280 330

20016 Diet - Veg -Diabetic 200 225 275 275 495

20020 Diet - Veg -Diabetic Renal 200 225 275 275 495

20021 Diet - Veg -High Protein 200 225 275 275 495

20017 Diet - Veg -Low FAT 200 225 275 275 495

20018 Diet - Veg -Milk Free 200 225 275 275 495

20019 Diet - Veg -Renal 200 225 275 275 495

00194 Diet Counselling Sheet 100 150 200 250 300

20104 Dietician Consultation 50 100 150 200 300

00192 Diet -Soft Solids -Normal 170 210 260 260 310

00195 Diet-Clear Liquids-Normal 120 150 180 180 210

00193 Diet-Liquids-Normal 160 200 250 250 300

8


DAYCARE

Rs. Rs. Rs. Rs. Rs.

00351 Extra Charge-Diet

20087 Tube Feed except FJ/JJ 0.5-1 litre Per Day- Renal High Protein 240 240 240 240 240

20038 Tube Feed except FJ/JJ 0.5-1 litre Per Day-Diabetic 240 240 240 240 240

20039 Tube Feed except FJ/JJ 0.5-1 litre Per Day-Low FAT 240 240 240 240 240

20040 Tube Feed except FJ/JJ 0.5-1 litre Per Day-Milk Free 240 240 240 240 240

00358 Tube Feed except FJ/JJ 0.5-1 litre Per Day-Normal 240 240 240 240 240

20041 Tube Feed except FJ/JJ 0.5-1 litre Per Day-Renal 240 240 240 240 240

20042 Tube Feed except FJ/JJ 0.5-1 litre Per Day-High Protein 240 240 240 240 240

20088 Tube Feed except FJ/JJ 1-2 litre Per Day- Renal High Protein 310 310 310 310 310

20043 Tube Feed except FJ/JJ 1-2 litre Per Day-Diabetic 310 310 310 310 310

00359 Tube Feed except FJ/JJ 1-2 litres Per Day-Normal 310 310 310 310 310

20047 Tube Feed except FJ/JJ 1-2 litre Per Day-High Prote 310 310 310 310 310

20044 Tube Feed except FJ/JJ 1-2 litre Per Day-Low FAT 310 310 310 310 310

20045 Tube Feed except FJ/JJ 1-2 litre Per Day-Milk Free 310 310 310 310 310

20046 Tube Feed except FJ/JJ 1-2 litre Per Day-Renal 310 310 310 310 310

20089 Tube Feed except FJ/JJ 2-3 litre Per Day- Renal High Protein 390 390 390 390 390

20048 Tube Feed except FJ/JJ 2-3 litre Per Day-Diabetic 390 390 390 390 390

00360 Tube Feed except FJ/JJ 2-3 litres Per Day-Normal 390 390 390 390 390

20052 Tube Feed except FJ/JJ 2-3 litre Per Day-High Protein 390 390 390 390 390

20049 Tube Feed except FJ/JJ 2-3 litre Per Day-Low FAT 390 390 390 390 390

20050 Tube Feed except FJ/JJ 2-3 litre Per Day-Milk Free 390 390 390 390 390

20051 Tube Feed except FJ/JJ 2-3 litre Per Day-Renal 390 390 390 390 390

9


DAYCARE

Rs. Rs. Rs. Rs. Rs.

ST. JOHN’S LABORATORY SERVICES

III. LABORATORY INVESTIGATIONSA. CLINICAL PATHOLOGY LABA1. Clinical Pathology: Routine Haematology Tests

10001 Absolute Eosinophil Count (AEC) 180 210 230 260 29010099 Absolute Lymphocyte Count (ALC) 180 210 230 260 29010098 Absolute Neutrophil Count (ANC) 180 210 230 260 29010104 Bone Marrow Smear 600 690 780 870 96010004 Clot Retraction Time (Mac Farlands Method) 70 80 90 100 11010005 Complete Blood Count 300 350 390 440 48010006 Complete Haemogram with ESR 450 520 590 650 72010007 Erythrocyte Sedimentation Rate (ESR) 120 140 160 170 19010010 Haemoglobin % (HB) 120 140 160 170 19010117 LE Cells 150 170 200 220 24010118 Leucocyte Alkaline Phosphatase (LAP) 270 310 350 390 43010015 Malarial Parasites Smear (MP) & QBC 240 280 310 350 38010016 Microfilaria Smear (MF) & QBC 240 280 310 350 38010032 NBT Test 350 400 460 510 56010018 Packed Cell Volume (PCV) 120 140 160 170 19010019 Peripheral Smear (PS) & CBC 350 400 460 510 56010122 Plasma Haemoglobin 120 140 160 170 19010020 Platelet Count 160 180 210 230 26010097 Platelet Indices 350 400 460 510 56010002 Red Cell Indices(MCV,MCH,MCHC and RDW) 200 230 260 290 32010025 Reticulocyte Count 220 260 290 320 36010096 Reticulocyte Count and Reticulocyte Hb 350 400 460 510 56010107 Serum Cryoglobulin 110 130 140 160 18010039 Smear Slide to Outside 100 120 130 150 160

A2. Clinical Pathology: Coagulation Tests10101 Activated Partial Thromboplastin (APTT) 400 460 520 580 64010135 Anti Phospholipid Antibody (ACA, B2 Glyco Protein, Lupus Anticoagulant) 3200 3680 4160 4640 512010155 Anti Thrombin III 1600 1840 2080 2320 256011599 Anti X a assay 5000 5750 6500 7250 800010133 Anticardiolipin Antibody (ELISA) 1050 1210 1370 1520 168010154 Beta 2 Glycoprotein 1 and 2 1100 1270 1430 1600 176010003 Bleeding Time (BT) 250 290 330 360 40010105 Complete Coagulation Work up 5000 5750 6500 7250 800010112 D-Dimer 1350 1550 1760 1960 216010109 Factor Assay 1400 1610 1820 2030 224010896 Factor Assay XIII 1500 1730 1950 2180 240011600 Factor VIII chromogenic assay 5000 5750 6500 7250 800010030 Fibrinogen Assay 1000 1150 1300 1450 160010132 Inhibitor Studies in Bethesda Units 2800 3220 3640 4060 448010134 Lupus Anticoagulant (Coagulation Tests) 1050 1210 1370 1520 168010092 Mixing Studies for PT / APTT 1050 1210 1370 1520 168010137 Protein C 2550 2930 3320 3700 408010138 Protein S 2550 2930 3320 3700 408010023 Prothrombin Time (PT) 250 290 330 360 40010026 Screening Test for Inhibitors 1300 1490 1690 1890 2080

10


DAYCARE

Rs. Rs. Rs. Rs. Rs.10110 Test for Factor XIII ( Urea Solubility Test) 150 170 200 220 24010127 Thrombin Time 350 400 460 510 56010091 Von Willebrand Factor Antigen Assay 1550 1780 2020 2250 248010982 Von Willebrand RICOF Activity 3100 3560 4030 4500 4960

A3. Clinical Pathology: Hemolytic Work-up10029 Acid Elution Test ( K B Test) 500 580 650 730 80010031 G6PD Assay 830 950 1080 1200 133010045 G6PD Dye Test 220 250 290 320 35010114 Ham’s Test (Acidified Serum Test) 170 200 220 250 27010141 HB HPLC 1200 1380 1560 1740 192011910 Hb solubility test for Hbs 100 120 130 150 16010119 Osmotic Fragility Test 370 430 480 540 59010124 Sickle Cell Preparation 150 170 200 220 24010125 Sucrose Lysis Test 170 200 220 250 270

A4. Clinical Pathology: Flowcytometry10149 CD34 Counts 3200 3680 4160 4640 512010679 CD4 /CD8 - Counts 2300 2650 2990 3340 368011601 B ALL MRD by flowcytometry 11000 12650 14300 15950 1760010358 Extended Flowcytometry for Leukemia 10400 11960 13520 15080 1664010354 Extended Panel for Primary Immunodeficiency

(Lymphocyte Subset Analysis,DHR,NBT) 5500 6320 7150 7980 880010981 Flow Cytometry for CD 19/20 2600 2990 3380 3770 416010985 Flow Cytometry for Glanzmanns Thrombasthenia 3000 3450 3900 4350 480010095 Flow Cytometry for Platelet Function Disorders 5100 5870 6630 7400 816010987 Flow for PNH 6000 6900 7800 8700 960010980 Flow Cytometry Panel for Primary Immunodeficiency

(Lymphocyte Subset Analysis,DHR,NBT) 4000 4600 5200 5800 640010355 Flowcytometry for DHR 2500 2880 3250 3630 400010357 Flowcytometry for HLA Crossmatch 5100 5870 6630 7400 816010094 Flow Cytometry for HLA B27 1800 2070 2340 2610 2880

A5. Clinical Pathology: Urine & Faeces Analysis10201 Bence Jones Protein 120 140 160 170 19010203 Demonstration of Hemosiderin in Urine 120 140 160 170 19010252 Faeces for Occult Blood 100 120 130 150 16010253 Faeces Routine and Micro 120 140 160 170 19010984 Urine Haemoglobin 150 170 200 220 24010204 Urine Ketone Bodies 120 140 160 170 19010158 Urine Leucocyte Esterase 110 130 140 160 18010205 Urine Microscopy 130 150 170 190 21010160 Urine Microscopy for Fat Globules 100 120 130 150 16010157 Urine Nitrite 110 130 140 160 18010159 Urine Phase Contrast Microscopy for Dysmorphic RBC 150 170 200 220 24010207 Urine Protein (Albumin) 120 140 160 170 19010208 Urine Routine Chemical and Microscopy 200 230 260 290 32010210 Urine Sugar ( Glucose) 120 140 160 170 190

A6. Clinical Pathology: Miscellaneous Tests10301 Fern Pattern Only 70 80 90 100 11010304 Semen Analysis 350 400 460 510 56010308 Strip (Pregnancy Test) 160 180 200 230 250

A7. Clinical Pathology: Body Fluids10352 Body Fluids TC and DC 320 370 420 460 510

11


DAYCARE

Rs. Rs. Rs. Rs. Rs.A8. Clinical Pathology: Molecular Testing

11913 ALL - RT BCR-ABL 5200 5980 6760 7540 832011602 ALL Mutation panel 8000 9200 10400 11600 1280011603 AML Mutation panel 8000 9200 10400 11600 1280010153 Factor V Leiden 5500 6320 7150 7980 880011914 HLA CDC cross match 3500 4020 4550 5080 560011915 HLA typing by SSP 12000 13800 15600 17400 1920011604 IRMA ( Imatinib resistance mutation analysis) 9500 10930 12350 13780 1520011605 JAK 2 exon 12 mutation 6500 7470 8450 9430 1040010150 Molecular - BCR ABL(RT-PCR) 4500 5180 5850 6530 720010151 Molecular- JAK2 5600 6440 7280 8120 896011911 MPN Panel 7500 8630 9750 10880 1200011912 PML / RARA 6600 7590 8580 9570 10560

A9. Tests Outsourced11503 Acute Leukemia-MRD Panel (MRD &Relapse) (Flowcytometry) 11500 11500 11500 11500 1150011916 AML Comboquest IX 13200 15180 17160 19140 2112011500 AML Comboquest Ill 7850 7850 7850 7850 785011501 AML Comboquest IV 5750 5750 5750 5750 575011502 FIPI Ll-PDGFRa 5450 5450 5450 5450 545011908 IRMA 9100 9100 9100 9100 910011504 MDS In-Situ by FISH 9700 9700 9700 9700 970011909 MTHFR Mutation Detection 2750 2750 2750 2750 275011588 PML/RA Quantative PCR 7850 7850 7850 7850 785011589 TPMT Genotyping Analysis 6600 6600 6600 6600 6600

B. BLOOD BANKB1. Blood Bank : Immunohematology

10801 ABO Antibody Titre 220 250 290 320 35010156 ABO Antibody Titre for Transplant 2000 2300 2600 2900 320011103 ABO Blood Grouping & Rh Typing 270 310 350 390 43011859 Antenatal ICT 500 580 650 730 80010093 Antibody Identification Panel 750 860 980 1090 120011286 Auto Immune Hemolytic Anemia Panel 1000 1150 1300 1450 160010804 Cold Agglutinin Titre 220 250 290 320 35010805 Coombs Test - Direct ( DCT) 500 580 650 730 80010806 Coombs Test - Indirect (ICT) 400 460 520 580 64010809 Crossmatch Charges - Routine 1 1 1 1 110810 Donor Screening (HB, Group and Typing) 110 130 140 160 18010866 Donor Unit Sub Group 50 60 70 70 8010851 Fresh Blood Donor Screening Charges 770 890 1000 1120 123010867 Incompatible Crossmatch 50 50 50 50 5010051 Leucocyte Removal Filteration For Platelet Concentrate 1500 1500 1500 1500 150010048 Leucocyte Removal Filteration For Red Cells 1000 1000 1000 1000 100010817 Professional Charge B 280 320 360 410 45010812 Rapid Screening - HIV,HCV,HBsAg and VDRL 1050 1210 1370 1520 168010821 RBC Antibody Screening 420 480 550 610 67011606 Red Cell phenotyping panel 500 580 650 730 80010816 RhD - Antibody Titre 630 720 820 910 101010865 Single Blood Bag 150 170 200 220 24010937 Stem Cell Pheresis 18000 20700 23400 26100 2880011860 Therapeuttic Apheresis ( Leucapheresis,Plasma Exchange Etc ) 20000 23000 26000 29000 3200010052 Wafer 200 230 260 290 320

B2. Thalassaemia & Haemophilia & Sickle Anemia Patients10900 Thalassaemia / Haemophilia Package - Service Charge 1 1 1 1 1

12


DAYCARE

Rs. Rs. Rs. Rs. Rs.

B3. Blood Bank : Blood Components10853 Processing Charge for Cryoprecipitate 444 444 444 444 444

10858 Processing Charge for Fresh Frozen Plasma 694 694 694 694 694

10856 Processing Charge for Packed Red Bool Cells Concentrate 2136 2136 2136 2136 2136

10857 Processing Charge for Platelet Concentrate 694 694 694 694 694

10820 Processing Charge for Platelet Pheresis Divided Unit 5500 5500 5500 5500 5500

10819 Processing Charge for Platelet Pheresis Single Unit 11000 11000 11000 11000 11000

10863 Processing Charge for Convalescent Plasma 7500 7500 7500 7500 7500

10852 Processing Charge for Whole Blood 2170 2170 2170 2170 2170

B4. Blood Bank : Blood Components for BPL Patients

11853 Processing Charge for Cryoprecipitate (BPL) 222 222 222 222 222

11858 Processing Charge for Fresh Frozen Plasma(BPL) 347 347 347 347 347

11051 Leucocyte Removal Filteration For Platelet Concentrate (BPL) 750 750 750 750 750

11048 Leucocyte Removal Filteration For Red Cells (BPL) 500 500 500 500 500

11856 Processing Charge for Packed Red Bool Cells Concentrate(BPL) 1068 1068 1068 1068 1068

11857 Processing Charge for Platelet Concentrate (BPL) 347 347 347 347 347

11820 Processing Charge for Platelet Pheresis Divided Unit (BPL) 2750 2750 2750 2750 2750

11819 Processing Charge for Platelet Pheresis Single Unit (BPL) 5500 5500 5500 5500 5500

11852 Processing Charge for Whole Blood (BPL) 1085 1085 1085 1085 1085

13


DAYCARE

Rs. Rs. Rs. Rs. Rs.C. BIOCHEMISTRY LABC1. Biochemistry: Blood Tests

10562 Arterial Blood Gas (ABG) 650 750 850 940 104010559 Bilurubin -Total Direct & Indirect 160 180 210 230 26010986 Blood Alcohol 300 350 390 440 48010604 Fasting Glucose (FBS) 70 80 90 100 11010585 Glucose Tolerance Test (OGCT) ( 50gms) & 1 hr 100 120 130 150 16010587 Glycated Haemoglobin (HbA1c) 720 830 940 1040 115010942 Intact Parathormone (PTH) 850 980 1110 1230 136010586 OGTT 75 gm Glucose - Twice(FBS, 2hrs) 175 200 230 250 28010881 OGTT 75 gm Glucose load (FBS 1hr,2hr,3hr) 310 360 400 450 50011155 OGTT 75 Gms, FBS,1hr,2hr 275 320 360 400 44010635 Plasma Ammonia 375 430 490 540 60010629 Plasma Bicarbonate 650 750 850 940 104010887 Plasma Insulin 620 710 810 900 99010933 Plasma Insulin Fasting 615 710 800 890 98020076 Plasma Interleukin-6(IL-6) 2250 2590 2930 3260 360010650 Plasma Lactate 650 750 850 940 104011157 Post Glucose (75gms) -60 mins Growth Hormone 900 1040 1170 1310 144010885 Post Prandial Glucose (PPBS) 70 80 90 100 11010596 PP Glucose with 75g Glucose 100 120 130 150 16010884 Random Glucose (RBS) 70 80 90 100 11010751 Serum ADA 750 860 980 1090 120010615 Serum Alanine Transaminase (SGPT) 205 240 270 300 33010552 Serum Alkaline Phosphatase (ALP) 205 240 270 300 33011129 Serum AMH (Anti-Mullerian Hormone) 1650 1900 2150 2390 264010553 Serum Amylase 320 370 420 460 51011132 Serum Angiotensin Converting Enzyme (ACE) 900 1040 1170 1310 144010643 Serum Anti - TPO 800 920 1040 1160 128011130 Serum Anti CCP 1100 1270 1430 1600 176011124 Serum Anti Thyroglobulin 1100 1270 1430 1600 176010614 Serum Aspartate Transaminase (SGOT) 205 240 270 300 33010915 Serum Beta HCG 1020 1170 1330 1480 163010564 Serum Calcium 220 250 290 320 35010622 Serum Carbamazepine 675 780 880 980 108010568 Serum Cholesterol 175 200 230 250 28010569 Serum Cholesterol - HDL 250 290 330 360 40010570 Serum Cholesterol - LDL 280 320 360 410 45010574 Serum CK- MB 620 710 810 900 99011159 Serum Cortisol - Dexa Suppressed 620 710 810 900 99011100 Serum Cortisol - Random 620 710 810 900 99010886 Serum Cortisol (4-6 PM) 620 710 810 900 99010902 Serum Cortisol (7-9 AM) 620 710 810 900 99011158 Serum Cortisol 60 mins - ACTH Stimulated 620 710 810 900 99010700 Serum C-Reactive Protein (CRP) 425 490 550 620 68010579 Serum Creatine Phosphokinase (CPK) 370 430 480 540 59010575 Serum Creatinine 125 140 160 180 20010662 Serum Estradiol - E2 750 860 980 1090 120010621 Serum Ferritin 780 900 1010 1130 1250

14


DAYCARE

Rs. Rs. Rs. Rs. Rs.10666 Serum Folic Acid 1250 1440 1630 1810 200010883 Serum Free T3 (FT3) 320 370 420 460 51010922 Serum Free T4 (FT4) 320 370 420 460 51010903 Serum FSH 525 600 680 760 84010584 Serum Gamma Glutamyl Transferase (GGT) 205 240 270 300 33011160 Serum GH - 0,60,90 mins Clonidine stimulated 2500 2880 3250 3630 400011125 Serum Growth Hormone 850 980 1110 1230 136010873 Serum Homocysteine 1375 1580 1790 1990 220020077 Serum IGF - 1 2500 2880 3250 3630 400010626 Serum Ionised Calcium 525 600 680 760 84010590 Serum Lactate Dehydrogenase 325 370 420 470 52010906 Serum LH 525 600 680 760 84010632 Serum Lipase 375 430 490 540 60010591 Serum Lithium 650 750 850 940 104010593 Serum Magnesium 215 250 280 310 34010735 Serum Osmolality 450 520 590 650 72010623 Serum Phenobarbital 675 780 880 980 108010628 Serum Phenytoin 675 780 880 980 108010594 Serum Phosphorus 225 260 290 330 36010612 Serum Potassium 125 140 160 180 20010908 Serum Prolactin 800 920 1040 1160 128010602 Serum Sodium 125 140 160 180 20010913 Serum T3 275 320 360 400 44011123 Serum Thyroglobulin(TG) 1325 1520 1720 1920 212010597 Serum Total Protein & Albumin 410 470 530 590 66010914 Serum Total T4 275 320 360 400 44010647 Serum Total Testosterone 550 630 720 800 88010607 Serum Triglycerides 225 260 290 330 36010931 Serum Troponin I 525 600 680 760 84010912 Serum TSH 275 320 360 400 44020079 Serum TSH Receptor Antibody 2600 2990 3380 3770 416010608 Serum Urea 125 140 160 180 20010611 Serum Uric Acid 175 200 230 250 28010627 Serum Valproic Acid 675 780 880 980 108010934 Serum Vitamin B12 800 920 1040 1160 128010941 Total Vitamin D (25-OH D2 & D3) 1250 1440 1630 1810 200011165 Venous Blood Gas (VBG) 650 750 850 940 1040

C2. Biochemistry: Tumour Markers11593 Double Marker (FBHCG ,PAPP-A) 1500 1720 1950 2180 240011594 Dual Marker Test 2000 2300 2600 2900 320010701 Serum Alpha Feto Protein (AFP) 650 750 850 940 104020078 Serum CA 15-3 1225 1410 1590 1780 196011294 Serum CA 19.9 1250 1440 1630 1810 200010734 Serum Cancer Antigen 125 (CA125) 1350 1550 1760 1960 216010730 Serum Carcinoembryonic Antigen (CEA) 750 860 980 1090 120010702 Serum Total Prostate Specific Antigen (PSA) 650 750 850 940 1040

C3. Biochemistry: Body Fluid Tests10954 Ascitic Fluid - ADA 750 860 980 1090 120010965 CSF - ADA 750 860 980 1090 1200

15


DAYCARE

Rs. Rs. Rs. Rs. Rs.10618 CSF - Chloride 125 140 160 180 20010616 CSF - Glucose 115 130 150 170 18010617 CSF - Protein 175 200 230 250 28010963 Dialysis Fluid Creatinine 125 140 160 180 20011138 Dialysis Fluid Glucose 115 130 150 170 18010964 Dialysis Fluid Urea 125 140 160 180 20010960 Pericardial Fluid - ADA 750 860 980 1090 120010956 Pleural Fluid - ADA 750 860 980 1090 120010957 Pleural Fluid Amylase 320 370 420 460 51010958 Pleural Fluid LDH 325 370 420 470 520

C4. Biochemistry: Urine Tests11302 Albumin / Creatine Ratio 500 580 650 730 80010967 Amylase - 24 hrs Urine 400 460 520 580 64010555 Amylase Random Urine 315 360 410 460 50010968 Calcium - 24 hrs Urine 315 360 410 460 50010944 Calcium-Random Urine 220 250 290 320 35010583 Chloride Random Urine 125 140 160 180 20011151 Cortisol - 24Hrs Urine 750 860 980 1090 120010966 Creatinine - 24 hrs Urine 225 260 290 330 36010578 Creatinine Clearance - Urine 275 320 360 400 44010576 Creatinine Random Urine 200 230 260 290 32010624 Magnesium - 24 hrs Urine 300 350 390 440 48010949 Magnesium Random Urine 225 260 290 330 36010625 Microalbumin in Urine 425 490 550 620 68010750 Osmolality Urine 450 520 590 650 72010945 Phosphorus - 24 hrs Urine 300 350 390 440 48010946 Phosphorus Random Urine 225 260 290 330 36010952 Potasium Random Urine 125 140 160 180 20010951 Potassium - 24 hrs Urine 200 230 260 290 32010882 Protein Random Urine 275 320 360 400 44010598 Protein Total - 24 hrs Urine 300 350 390 440 48010599 Protein/Creatinine Ratio 400 460 520 580 64010950 Sodium - 24 hrs Urine 225 260 290 330 36010603 Sodium Random Urine 125 140 160 180 20011154 Urea - Random Urine 125 140 160 180 20010947 Uric Acid - 24 hrs Urine 300 350 390 440 48010948 Urine Uric Acid Random 175 200 230 250 280

C5. Biochemistry: Panels11142 Anemia Profile 2515 2890 3270 3650 402010953 Ascitic Fluid - Panel (Glucose, Protein, Albumin, Amylase, LDH) 615 710 800 890 98010580 CSF Panel (Glucose, Protein, Chloride) 360 410 470 520 58011145 Diabetic Profile ( Lab Tests Only) 635 730 830 920 102010962 Dialysis Fluid Panel (Glucose, Sodium, Potassium, Magnesium) 410 470 530 590 66011143 Extended Anemia Profile 3015 3470 3920 4370 482011146 Extended Diabetic Profile ( Lab Tests Only) 1515 1740 1970 2200 242011148 Fertility Profile for Female 1815 2090 2360 2630 290011147 Fertility Profile for Male 1765 2030 2290 2560 282011149 FSH, LH, PRL, TSH,FT4,Cortisol 7am to 9am 2515 2890 3270 3650 402010959 Pericardial Fluid - Panel (Glucose, Protein, Albumin, Amylase, LDH) 615 710 800 890 980

16


DAYCARE

Rs. Rs. Rs. Rs. Rs.10955 Pleural Fluid - Panel (Glucose, Protein, Albumin) 410 470 530 590 66011144 Renal Profile (Lab Test Only) 865 990 1120 1250 138010633 Serum - Amylase & Lipase 665 760 860 960 106010556 Serum - AST & ALT 410 470 530 590 66010557 Serum - AST, ALT & ALP 615 710 800 890 98010566 Serum - Calcium, Phosphorus, ALP & Albumin 765 880 990 1110 122010565 Serum - Calcium, Phsophorus & Uric Acid 525 600 680 760 84010582 Serum - Electrolytes 310 360 400 450 50010605 Serum - Fasting Glucose, Creatinine & Electrolytes 470 540 610 680 75010606 Serum - Fasting Glucose, Urea & Electrolytes 470 540 610 680 75010970 Serum - Fasting Glucose, Urea, Creatinine & Electrolytes 575 660 750 830 92010907 Serum - FSH, LH, PRL 1515 1740 1970 2200 242011156 Serum - FSH, LH, Testosterome 1515 1740 1970 2200 242010936 Serum - FT3, FT4 & TSH 865 990 1120 1250 138010123 Serum - Iron Panel 310 360 400 450 50010573 Serum - Lipid Profile 855 980 1110 1240 137010592 Serum - Liver Function Tests (LFT) 1015 1170 1320 1470 162010971 Serum - Post Prandial Glucose, Urea, Creatinine & Electrolytes 575 660 750 830 92010601 Serum - Random Glucose, Urea, Creatinine & Electrolytes 575 660 750 830 92010909 Serum - T3, T4 510 590 660 740 82010910 Serum - T3,T4, TSH 765 880 990 1110 122010911 Serum - T3,T4, TSH, FSH, LH, PRL 2265 2600 2940 3280 362011240 Serum - TSH, Free T4,TG, Anti-TG 2865 3290 3720 4150 458010648 Serum - TSH, FT4, Anti TPO 1315 1510 1710 1910 210010609 Serum - Urea & Creatinine 205 240 270 300 33010961 Synovial Fluid - Panel (Glucose, Protein, Albumin) 410 470 530 590 66010567 Urine - Calcium, Phosphorus & Uric Acid 575 660 750 830 920

C6. Biochemistry: Tests Done in College11298 17- OH Progesterone by DBS 400 460 520 580 64011300 G6PD by DBS 400 460 520 580 64011301 Phenylalanine by DBS 400 460 520 580 64011299 Total Galactose by DBS 400 460 520 580 64010749 Chromatography for Amino Acids - Serum 780 900 1010 1130 125010705 Chromatography for Amino Acids-urine 820 940 1070 1190 131010746 Chromatography for Sugar - Urine 720 830 940 1040 115010756 Gall Stone Analysis 350 400 460 510 56000340 New Born Screening 1200 1380 1560 1740 192010969 Salivary Calculi Analysis 310 360 400 450 50010714 Screening for IEM (PKU, Cystine, Homocystine, Arginine, Tyrosine 250 290 330 360 40010716 Serum Ceruloplasmin 800 920 1040 1160 128011131 Serum Free Light Chains 3250 3740 4230 4710 520011166 Serum Immunotyping-Qualitative 5000 5750 6500 7250 800010718 Serum Protein Electrophoresis 1100 1270 1430 1600 176011133 Serum Soluble Transferrin Receptor ( sTfR) 1200 1380 1560 1740 192010719 Stool Fat 200 230 260 290 32011122 Urinary Metanephrine 2500 2880 3250 3630 400010720 Urine 5 Hydroxy Indoles (5 - HI) 1750 2010 2280 2540 280010727 Urine Galactose ( Screening Test ) 200 230 260 290 32010711 Urine Mucopolysaccharides 300 350 390 440 480

17


DAYCARE

Rs. Rs. Rs. Rs. Rs.10755 Urine pH (by pH meter) 120 140 160 170 19010724 Urine VMA 1500 1720 1950 2180 240010710 Whole Blood Methaemoglobin 300 350 390 440 480

C7. Biochemistry Tests Outsourced11547 1,25 Hydroxy Vit D 2110 2110 2110 2110 211011510 17 OH Progesterone 920 920 920 920 92011522 24 Hrs Urine Copper 1250 1250 1250 1250 125011526 24 hrs Urine Porphobilinogen 2310 2310 2310 2310 231011521 Acetyl Choline Receptor Antibodies 2050 2050 2050 2050 205011515 ACTH 1020 1020 1020 1020 102011587 Aldosterone 1290 1290 1290 1290 129011560 Alpha 1 Antitrypsin Level 1980 1980 1980 1980 198011565 Anti B2 GPI lgG 690 690 690 690 69011566 Anti B2 GPI lgM 690 690 690 690 69011563 Anti GAD Antibodies IDM 3370 3370 3370 3370 337011564 Anti GAD Antibodies PNS 4290 4290 4290 4290 429011549 Anti Ganglioside lgA Antibody 3270 3270 3270 3270 327011548 Anti Ganglioside lgG lgM Antibody 3270 3270 3270 3270 327011546 Anti GBM Antibodies 1020 1020 1020 1020 102011545 Anti Gladin Antibody lgA 1250 1250 1250 1250 125011543 Anti Musk Antibodies 4090 4090 4090 4090 409011532 Anti NMO Antibodies 2840 2840 2840 2840 284011511 Anti Ttg Antibodies (lgA) 760 760 760 760 76011524 B2 Microglobulin Serum 960 960 960 960 96011525 B2 Microglobulin Urine 1580 1580 1580 1580 158011536 Blood Lead 1160 1160 1160 1160 116011517 C- Peptide 730 730 730 730 73011534 C1 Esterase level 2480 2480 2480 2480 248011821 CA 19.9 830 830 830 830 83011537 Calcitonin 1390 1390 1390 1390 139011822 Cyclosporin 1720 1720 1720 1720 172011694 Cyclosporine Level 2200 2200 2200 2200 220011519 Digoxin Level 590 590 590 590 59011523 Dihydroxy Testosterone 1520 1520 1520 1520 152011570 Dual Marker 1490 1490 1490 1490 149011542 Electrophoresis-Urine 560 560 560 560 56011518 Free Light Chains-Urine 2970 2970 2970 2970 297011555 Free Testosterone 990 990 990 990 99011535 GAD 65 3370 3370 3370 3370 337011556 Heavy Metal Screening Profile -1 6600 6600 6600 6600 660011557 Heavy Metal Screening Profile -2 3960 3960 3960 3960 396011550 Immuno Fixation 3960 3960 3960 3960 396011554 Insulin Auto Antibodies 1320 1320 1320 1320 132011559 Lamotrigine Level 4060 4060 4060 4060 406011558 Myasthenia Gravis Panel 6530 6530 6530 6530 653011544 Oligoclonal Bands 2840 2840 2840 2840 284011527 Organic Acid-Urine 1490 1490 1490 1490 149011553 Paracetamol Level 730 730 730 730 73011562 Plasma Free Metanephrine 2640 2640 2640 2640 2640

18


DAYCARE

Rs. Rs. Rs. Rs. Rs.11533 Plasma Renin Activity 2640 2640 2640 2640 264011520 Pseudo Cholinesterase 660 660 660 660 66011512 Quadruple Markers test 1910 1910 1910 1910 191011552 Serum Bile Acids 1120 1120 1120 1120 112011529 Serum Copper 1250 1250 1250 1250 125011530 Serum DHEAS 660 660 660 660 66011153 Serum Erythropoietin 1300 1490 1690 1890 208011539 Serum Haptoglobin 3660 3660 3660 3660 366011567 Serum Hepcidin Level 1190 1190 1190 1190 119011569 Serum Oxcarbazepine 4460 4460 4460 4460 446011568 Serum Progesterone 400 400 400 400 40011538 Serum Zinc Level 1680 1680 1680 1680 168011528 Stone analysis 730 730 730 730 73011571 Triple Marker 1650 1650 1650 1650 165011823 U. Electrophoresis 560 560 560 560 56011824 U. Free light Chains 2970 2970 2970 2970 297011825 U. Organic Acid 1490 1490 1490 1490 149011561 Vitamin C 1980 1980 1980 1980 198011514 Vitamin E 2640 2640 2640 2640 2640

D. MICROBIOLOGY LABD1. Microbiology: Routine Tests

10456 Acute Hepatitis Markers 2445 2810 3180 3550 391010460 Aerobic Culture and Sensitivity 800 920 1040 1160 128010402 AFB Smear (Ziehl Neelsen Staining) 140 160 180 200 22010403 Albert’s Stain 230 260 300 330 37011200 Allergy Panel for Asthma & Rhinitis 7215 8300 9380 10460 1154011205 Allergy Panel for ENT allergies 2515 2890 3270 3650 402011202 Allergy Panel for Molds 1940 2230 2520 2810 310011203 Allergy Panel for Non-Veg Food + House Dust Mite + Animal Dander (cat,dog) 2515 2890 3270 3650 402011204 Allergy Panel for Veg Food + House Dust Mite + Animal Dander (cat,dog) 3515 4040 4570 5100 562010425 Anaerobic Culture (Conventional) 1575 1810 2050 2280 252010433 Antibodies to Hepatitis B Surface Antigen(AntiHBs) 730 840 950 1060 117010405 Anti-Streptolysin (ASLO) Quantitative 420 480 550 610 67011597 ART VL HIV 0 0 0 0 010446 Automated Aerobic Culture sensitivity (Blood, Sterile Body Fuids) 950 1090 1240 1380 152010537 Automated Anaerobic Culture (Blood, Sterile Body Fuids) 850 980 1110 1230 136010538 Automated fungal Culture (Blood, Sterile Body Fuids) 850 980 1110 1230 136010407 Brucella Agglutination Test 420 480 550 610 67010462 Calcoflour White Stain + KOH 230 260 300 330 37010532 Chikungunya IgM Rapid Test 595 680 770 860 95011598 Clostridium difficile toxin A&B assay 1800 1800 1800 1800 180010408 C-Reactive Protein (CRP) Qualitative 240 280 310 350 38010419 Cryptococcal Ag , Gram Stain , India ink 1290 1480 1680 1870 206010506 Cytomegalovirus IgG 400 460 520 580 64010430 Cytomegalovirus IgM 575 660 750 830 92010542 Dengue Combined Package(NS1+IgM+IgG) 750 750 750 750 75010534 Dengue IgG 250 250 250 250 25010522 Dengue IgM 250 250 250 250 25010541 Dengue NS1 Antigen 250 250 250 250 250

19


DAYCARE

Rs. Rs. Rs. Rs. Rs.11102 ELISA for Aspergillus Galactomannan Assay 1675 1930 2180 2430 268010449 Febrile agglutination Package Serology

(Widal, Weil felix, Brucella SAT, Paul bunnel) 850 980 1110 1230 136010464 Fluorochrome Staining for AFB 230 260 300 340 37010409 Fungal Culture (Conventional) 600 690 780 870 96010410 Grams Stain 140 160 180 200 22010436 Hanging Drop for Vibrio Cholerae 120 140 160 170 19010440 Hepatitis A virus IgM 450 520 590 650 72010452 Hepatitis B e Antibody (AntiHBe) 675 780 880 980 108010434 Hepatitis B e Antigen (HBeAg) 675 780 880 980 108010511 Hepatitis B Markers Profile 2255 2590 2930 3270 361010427 Hepatitis B Surface Antigen ( HBs Ag) 360 410 470 520 58010510 Hepatitis C virus Antibodies 625 720 810 910 100011780 Hepatitis C Virus CorE Antigen (HCVcAg) 1600 1600 1600 1600 160010513 Hepatitis E Virus IgM 625 720 810 910 100010523 Herpes Simplex Virus (HSV) 1 IgG 400 460 520 580 64010507 Herpes Simplex Virus (HSV) 2 IgG 400 460 520 580 64010533 Herpes Simplex Virus (HSV) 2 IgM 400 460 520 580 64010426 Human Immunodeficiency Virus (HIV) Test 460 530 600 670 74011113 Hydatid Cyst - Wet mount 120 140 160 170 19011288 ICTC/PPTCT 75 75 75 75 7511265 Identification of Fungal Isolate 1000 1000 1000 1000 100010435 IgM to Hepatitis B Core Antigen (antiHBcIgM) 735 850 960 1070 118010438 India Ink + Gram‘s Stain 240 280 310 350 38010444 Leptospira IgM 575 660 750 830 92010524 Rapid malaria antigen test 310 360 400 450 50011278 Multiplex PCR Blood Culture Panel 8500 8500 8500 8500 850011292 Multiplex PCR Lower Respiratory Panel 14500 14500 14500 14500 1450011280 Multiplex PCR ME + Additional Bacteria and Fungal Panel 17000 17000 17000 17000 1700011279 Multiplex PCR Meningoencephalitis (ME) Panel 8500 8500 8500 8500 850010401 Mycobacterial Culture 780 900 1010 1130 125011107 Mycobacterial Culture and Sty to Second Line Drugs 2100 2100 2100 2100 210010463 Mycobacterial Culture and Sty to SIRE 3990 4590 5190 5790 638011114 Mycobacterial Culture Urine Sample 2 110 130 140 160 17011115 Mycobacterial Culture Urine Sample 3 110 130 140 160 17011101 Mycobaterial Culture and Sty to SIRE+PZA 4520 5200 5870 6550 722010526 Nugents Score for Bacterial Vaginosis 170 200 220 250 27011289 Paired Blood Cultures Automated 1300 1490 1690 1890 208010411 Paul Bunnel Test 240 280 310 350 38010697 Procalcitonin 1345 1550 1750 1950 215011263 Quantiferon TB Assay 2515 2890 3270 3650 402010414 RA Test (Quantitative) 230 260 300 330 37010448 Rapid HBs Ag 400 460 520 580 64010437 Rapid HIV 575 660 750 830 92011290 RNTCP Sptum Smear Microscopy 0 0 0 0 010505 Rubella Virus IgG 400 460 520 580 64010429 Rubella Virus IgM 575 660 750 830 92011781 SARS CoV-2 anti-Spike IgG Antibodies 700 800 910 1020 112011295 Scrub Typhus Igm 700 800 910 1020 112011264 Serotyping for Bacterial Isolate 300 300 300 300 300

20


DAYCARE

Rs. Rs. Rs. Rs. Rs.10432 Serum Complement C3 Level 575 660 750 830 92010509 Serum Complement C4 Level 575 660 750 830 92011226 Specific IgE for Alternaria Alternata 785 900 1020 1140 126011221 Specific IgE for Aspergillus Fumigatus 785 900 1020 1140 126011239 Specific IgE for Banana 785 900 1020 1140 126011206 Specific IgE for Bermuda grass 785 900 1020 1140 126011217 Specific IgE for Cat Dander 785 900 1020 1140 126011237 Specific IgE for Chick Pea 785 900 1020 1140 126011227 Specific IgE for Cladosporium Herbarum 785 900 1020 1140 126011219 Specific IgE for Cockroach 785 900 1020 1140 126011215 Specific IgE for Common Pigweed 785 900 1020 1140 126011212 Specific IgE for Common Ragweed (Parthenium) 785 900 1020 1140 126011216 Specific IgE for Dog Dander 785 900 1020 1140 126011228 Specific IgE for Egg (Whole) 785 900 1020 1140 126011210 Specific IgE for Elm 785 900 1020 1140 126011209 Specific IgE for Eucalyptus (Gum Tree) 785 900 1020 1140 126011229 Specific IgE for Fish (Cod) 785 900 1020 1140 126011214 Specific IgE for Goosefoot 785 900 1020 1140 126011208 Specific IgE for Grey Alder 785 900 1020 1140 126011218 Specific IgE for House Dust Mite 785 900 1020 1140 126011207 Specific IgE for Johnson Grass (Jowar) 785 900 1020 1140 126011238 Specific IgE for Lemon/Citrus 785 900 1020 1140 126011211 Specific IgE for Mesquite 785 900 1020 1140 126011232 Specific IgE for Milk 785 900 1020 1140 126011213 Specific IgE for Mugwort 785 900 1020 1140 126011234 Specific IgE for Peanut 785 900 1020 1140 126011225 Specific IgE for Penicillium Notatum 785 900 1020 1140 126011235 Specific IgE for Red Kidney Bean 785 900 1020 1140 126011230 Specific IgE for Shrimp 785 900 1020 1140 126011236 Specific IgE for Soyabean 785 900 1020 1140 126011233 Specific IgE for Wheat 785 900 1020 1140 126010423 Stain for Protozoa 230 260 300 330 37010424 Staining for Pneumocystis Jiroveci + KOH + Calcofluor 260 300 340 380 42010508 TORCH IgG 1345 1550 1750 1950 215010431 TORCH IgM 1675 1930 2180 2430 268011296 Total antibodies to Hepatitis B core antigen (Anti HBcAb) 700 800 910 1020 112010528 Total Serum IgE 645 740 840 940 103010504 Toxoplasma IgG 400 460 520 580 64010428 Toxoplasma IgM 575 660 750 830 92010404 TPHA Test for Syphilis 430 490 560 620 69010416 VDRL (STS) 160 180 210 230 26010417 Weil Felix Test 200 230 260 290 32010515 Western Blot for HIV - 1/2 2015 2320 2620 2920 322010543 Wet Mount 120 140 160 170 19010418 Widal Test 210 240 270 300 340

D2. Microbiology: Surveillance11109 Air Sampling (1Set) 250 250 250 250 25011260 Biological Indicator Testing 50 50 50 50 5010050 MDRO Screen (Surface SWAB+Rectal SWAB) - 1 Set 600 600 600 600 600

21


DAYCARE

Rs. Rs. Rs. Rs. Rs.10049 MRSA Screen 200 200 200 200 20011251 Post MRSA Follow up (3 Sets) 600 690 780 870 96010529 RO Water Analysis (1 Set) 300 300 300 300 30010451 Settle Plates for Biosafety Cabinet 350 350 350 350 35011259 Sterile Liquid/Disinfectant Testing 250 250 250 250 25011108 Surveillance of Burns Ward (1 Room) 600 600 600 600 60010450 Surveillance of Operation Theatre (1 Room) 900 900 900 900 90011257 Survelliance of ICU (5 Beds) 900 900 900 900 25010442 Water Analysis 1260 1450 1640 1830 2020

D3. Microbiology: Tests Outsourced11573 Adenovirus IgG 1490 1490 1490 1490 149011572 Adenovirus IgM 1490 1490 1490 1490 149011576 Amoebiasis IgG 1000 1000 1000 1000 100011575 Aspergillus IgG 1520 1520 1520 1520 152011574 Aspergillus IgM 1620 1620 1620 1620 162011826 Brucella IgM EIA 780 780 780 780 78011827 EBV IgM antibody to VCA by CLIA 1040 1040 1040 1040 104011828 Echinococcus(hydatid cyst) IgG EIA 1008 1008 1008 1008 100810693 H1N1 Collection Apparatus 300 300 300 300 30010696 H1N1 Real Time RTPCR 2500 2500 2500 2500 250011577 HBV Genotyping 5010 5010 5010 5010 501011578 HCV Genotyping 5010 5010 5010 5010 501011584 IgD (CD marker) by flowcytometry) 2310 2310 2310 2310 231011829 Mycoplasma pneumoniae IgM EIA 1333 1333 1333 1333 133311580 Parvovirus B19 IgM 1850 1850 1850 1850 185011581 Serum IgG4 Subclass 3540 3540 3540 3540 354011830 Serum Immunoglobulin profile (IgM, IgG and IgA) 1170 1170 1170 1170 117011583 Total Serum IgA 540 540 540 540 54011586 Total serum IgG 490 490 490 490 49011585 Total Serum IgM 540 540 540 540 54011831 Vancomycin level in serum by CLIA 3900 3900 3900 3900 3900

D4. Microbiology - Tests Done at SJRI11250 CMV (Cytomegalovirus) PCR Quantitative/Viral load 8015 8015 8015 8015 801511917 Cartridge Based Isothermal Nucleic Acid Amplification Test for

SARS-CoV-2 [POCT]” 3300 3300 3300 3300 330011697 COVID GeneXpert* 3800 3800 3800 3800 380011696 SARS CoV-2 anti-Nucleocapsid IgG Antibodies 600 690 780 870 96011297 COVID Rapid Antigen Test all inclusive (Swab, PPE, Service)* 400 400 400 400 40011693 COVID RT-PCR excluding VTM Swab charges* 800 800 800 800 80011695 CoviD VTM (Viral Transport Medium) Swab charges* 300 300 300 300 30010550 GeneXpert - TB (TB PCR) 0 0 0 0 011690 HBV PCR Quantitative / Viral Load 4215 4215 4215 4215 421511112 HCV Quantitative Viral Load 2600 2600 2600 2600 260010467 HIV Viral Load (Quantitative) 2800 2800 2800 2800 2800

E. HISTOPATHOLOGY LAB11011 ANA by IIF Method 600 690 780 870 96011014 ANCA by IIF Method 1000 1150 1300 1450 1600110033 Anti - PLA 2R by IIF Method 3500 4020 4550 5080 5600110052 Biopsy for Elecron Microscopy 6300 7300 9500 13800 22100

22


DAYCARE

Rs. Rs. Rs. Rs. Rs.110019 Biopsy Paraffin Method Large (IP sample) 1500 1720 1950 2180 2400110024 Biopsy Paraffin Method Small (IP sample) 800 920 1040 1160 1280110018 Biopsy Paraffin Method Small (OPD sample) 700 800 910 1020 1120110021 Body Fluids for Malignant Cells(upto 3 samples) 600 690 780 870 960110030 Dermatology Mosaic by IIF Method 4000 4600 5200 5800 640011013 ds - DNA by IIF Method 700 800 910 1020 1120110053 ELISA for PR3 & MPO 400 460 520 580 640110040 ELISA for Desmoglein 3 900 1040 1170 1310 1440110038 ELISA for ds DNA 500 580 650 730 80011005 FNAC 700 800 910 1020 1120110027 FNAC - CT / MRI Guided 1000 1150 1300 1450 160011008 Frozen Section Including Paraffin Section 1500 1720 1950 2180 2400110041 HER-2 Testing by FISH 8000 9200 10400 11600 1280011009 IImmunofluoroscence Studies - Skin 2500 2880 3250 3630 4000110034 Immunofluoroscence Studies - Kidney 2700 3100 3510 3920 4320110044 Immunohistochemistry - Single marker (For patient care) 1000 1150 1300 1450 1600110028 Immunohistochemistry Hormone Receptor Panel 4500 5180 5850 6530 7200110039 Immunohistochemistry Lung/Pleura Panel 4500 5180 5850 6530 7200110029 Immunohistochemistry Lymphoma Panel 5500 6320 7150 7980 880011016 Immunohistochemistry Panel - General 4500 5180 5850 6530 720011256 Immunohistochemistry Soft Tissue 4500 5180 5850 6530 720011015 Immunoline 2000 2300 2600 2900 3200110043 Issue of Block - Handling charges 100 120 130 150 160110042 Issue of Duplicate slide - Handling charges 50 60 70 70 80110050 LBC for Cervical Cytology 600 690 780 870 960110023 Liver Mosaic 2 (ANA,AMA,Anti LKM,ASMA) by IIF Mehtod 1500 1720 1950 2180 2400110051 NMOSD screen 4000 4600 5200 5800 6400110017 Pap Smear 400 460 520 580 640110048 Pap Smear for Community screening 150 200 300 500 800110054 Paraneoplastic screening 5000 5750 6500 7250 8000110049 Radical Resection Specimens For Malignancies 4000 4600 5200 5800 6400110036 Slide/Block for Consultation (<4Slides/Blocks) 1000 1150 1300 1450 1600110037 Slide/Block for Consultation (>4Slides/Blocks) 2000 2300 2600 2900 3200110046 Specimen Mounting - Medium 500 580 650 730 800110045 Specimen Mounting - Small 200 230 260 290 320110047 Specimen Mounting -Large and Extra large 800 920 1040 1160 1280

F. CYTOGENETICS TESTS DONE IN COLLEGE10773 Cancer Cytogenetics 4000 4600 5200 5800 640011255 Cancer Cytogenetics + FISH panel ALL,AML,CLL,MDS,MM 7000 8050 9100 10150 1120010781 Chromosome Breakage Studies 4000 4600 5200 5800 640010759 Follow-up within 6 Months 600 690 780 870 96010744 Genetic Counselling 1000 1150 1300 1450 160010758 Karyotyping * - Family Member 2000 2300 2600 2900 320010743 Karyotyping and Genetic Counselling 4000 4600 5200 5800 640010745 Millipore Water (per litre) 500 580 650 730 80010783 FISH for Microdeletion Syndromes & WCP 5000 5750 6500 7250 800010782 FISH for CML,APML 5000 5750 6500 7250 800010707 Registration / Referral (Cytogenetics) 150 170 200 220 24010774 Repeat Karyotyping* - Cancer Follow-up 1800 2070 2340 2610 2880

* Note: Karyotyping per patient’s family member in case the patient is diagnosed with chromosomal abnormality

23


DAYCARE

Rs. Rs. Rs. Rs. Rs.F1. CYTOGENETICS TESTS - OUTSOURCED

11770 Carrier screening - Gold[500 genes NGS & MLPA (SMA 28000 28000 28000 28000 2800011752 Chromosomal Microarray - Affymetrix Cytoscan Optima High resolution genechip14000 14000 14000 14000 1400011761 Chromosomal Microarray - Affymetrix Cytoscan Optima low resolution genechip9000 9000 9000 9000 900011742 Clinical exome - 26MB(80-100x) 15000 15000 15000 15000 1500011751 Clinical Exome Sequencing - Trios 41250 41250 41250 41250 4125011753 MLPA 7200 7200 7200 7200 720011745 Sanger validation [1 variant] 5000 5000 5000 5000 500011760 Sanger validation [2 variant] 7800 7800 7800 7800 780011698 Spinocerebella Ataxia - Repeat Expansion Analysis 15000 15000 15000 15000 1500011750 TRIO - Whole exome sequencing (80-100x) 52000 52000 52000 52000 5200011743 Whole exome sequencing (80-100x) 20000 20000 20000 20000 2000011744 Whole mitochondrial genome sequencing 11700 11700 11700 11700 11700

F2. LIFE CELL DIAGONSTICS - OUTSOURCED11779 MicroArray CytoScan Optima 11400 11400 11400 11400 1140011810 MicroArray CytoScan (750K) 16800 16800 16800 16800 1680011811 MLPA (20 Microdeletion & Microduplication) 4200 4200 4200 4200 420011782 Special Developmental Disorder Package 6300 6300 6300 6300 630011783 Autism Basic Package 21000 21000 21000 21000 2100011784 Autism Advanced Package 40800 40800 40800 40800 4080011785 DMD (MLPA Based 79 exons) 7800 7800 7800 7800 780011786 Spinal Muscular Atrophy ( SMA) 7800 7800 7800 7800 780011787 Cystic Fibrosis ( CF) Common mutations 6000 6000 6000 6000 600011788 Biotinidase Deficiency (BTD) Full gene sequencing 8400 8400 8400 8400 840011789 Congenital Adrenal Hyperplasia ( CAH) - CYP2A12 full gene

sequencing including deletion-duplication 8400 8400 8400 8400 840011790 Phenylketonuria ( PKU) 8400 8400 8400 8400 840011791 Classical Galactosemia ( GALT) 6000 6000 6000 6000 600011792 Glucose - 6 - phosphate deficiency ( G6PD) 6000 6000 6000 6000 600011793 Beta Thalassemia HBB full gene sequencing 3000 3000 3000 3000 300011794 Beta Thalassemia (Prenatal)- Trio Analysis Test HBB full gene sequencing 10200 10200 10200 10200 1020011795 Alpha Thalassemia 7200 7200 7200 7200 720011796 Delta Beta Thalassemia 9600 9600 9600 9600 960011797 MS MLPA ( PWS /AW) 9600 9600 9600 9600 960011798 Fragile-X Trinucleotide Repeat analysis 4200 4200 4200 4200 420011799 Clinical Exome Sequencing ( Focussed Exome) 14400 14400 14400 14400 1440011800 Rapid Clinical Exome ( Focussed ) 21600 21600 21600 21600 2160011801 Carrier screening ( GenePass Advanced) 24000 24000 24000 24000 2400011802 Couple Clinical Exome 26400 26400 26400 26400 2640011803 Couple Whole Exome 38400 38400 38400 38400 3840011804 Whole Exome Sequencing 19200 19200 19200 19200 1920011805 Whole Exome Sequencing + Mitochondrial Sequencing 20400 20400 20400 20400 2040011806 Trio Clinical Exome Sequencing 43200 43200 43200 43200 4320011807 Sanger per variant 3000 3000 3000 3000 300011808 Trio Whole Exome Sequencing 57600 57600 57600 57600 57600

G. PHARMACOLOGY LAB (COLLEGE)10771 Amphetamine Urine Test 320 340 370 390 42010766 Benzodiazepine Urine Test 320 340 370 390 42010770 Cocaine Urine Test 320 340 370 390 420

24


DAYCARE

Rs. Rs. Rs. Rs. Rs.10765 Marijuana (THC) Urine Test 320 340 370 390 42010769 Methamphetamine Urine Test 320 340 370 390 42010767 Morphine Urine Test 320 340 370 390 42010768 Phencyclidine Urine Test 320 340 370 390 420

H. EMERGENCY MEDICINE11506 Biochem - EMS 400 460 520 580 64011505 Blood Gas - Total ABG- EMS 400 460 520 580 64011507 Creatinine - EMS 100 120 130 150 64011508 NT-proBNP 1620 1860 2110 2350 2590

IV. RADIOLOGY INVESTIGATIONSA. PLAIN X-RAY

12509 CD Coping for X-Rays 40 50 50 60 6012062 Cystogram including Flouro Charges( 2 exposures ) 1000 1150 1300 1450 160012579 Duplicate CT/MRI/USGReports 50 50 50 50 5012508 Film Charges X Ray 17x14 (1 Film) 120 140 160 170 19012507 Film Charges X-Ray 10 X 8 (1 Film) 50 60 70 70 8012017 Fluroscopy 400 460 520 580 64012001 X-Ray Abdomen (KUB) - Adult 280 320 360 410 45012002 X-Ray Abdomen (KUB) - Child below 10 Years 230 260 300 330 37012003 X-Ray Acromioclavicular Joint 200 230 260 290 32012576 X-Ray Adult contrast Study (2-3 exposures) 600 690 780 870 96012070 X-Ray Age Estimation 280 280 280 280 28012004 X-Ray Ankle Joint (AP & Lat) 230 260 300 330 37012005 X-Ray Apicogram 200 230 260 290 32012006 X-Ray Calcaneum 200 230 260 290 32012074 X-Ray Calcaneum (2 views) 220 220 220 220 22012012 X-Ray Cervical Spine (1 exposure 8x10) 210 240 270 300 34012051 X-Ray Cervical Spine (2 exposures) 350 400 460 510 56012252 X-Ray Charges-Portable (extra) 220 250 290 320 35012008 X-Ray Chest - Adult 250 290 330 360 40012010 X-Ray Chest - Child below 10 Years 210 240 270 300 34012011 X-Ray Clavicle (1 exposure) 200 230 260 290 32012013 X-Ray Elbow Joint (AP & Lat) 220 250 290 320 35012015 X-Ray Femur - Child below 10 Years 250 290 330 360 40012014 X-Ray Femur (AP & Lat) 300 350 390 440 48012018 X-Ray Foot AP & Oblique 220 250 290 320 35012073 X-Ray Foot or Hand or Wrist ( Additional one view ) 200 200 200 200 20012019 X-Ray Forearm (AP & Lat) 230 260 300 330 37012020 X-Ray Hand (AP & Lat) 220 250 290 320 35012021 X-Ray Hip (1 exposure) 230 260 300 330 37012022 X-Ray Humerus 250 290 330 360 40012071 X-Ray Infantogram 280 320 360 410 45012025 X-Ray Knee (AP & Lat) 250 290 330 360 40012069 X-Ray Knee Skyline Exposure (L/R) 220 250 290 320 35012026 X-Ray Leg (AP & Lat) 300 350 390 440 48012063 X-Ray Leg (AP & Lat) - Child below 12 Years 250 290 330 360 40012582 X-Ray Lumbar spine (Flexion/Extension) 380 440 490 550 61012028 X-Ray Lumbo Sacral (1 exposure) 250 290 330 360 40012064 X-Ray Lumbosacral Spine - Child (2 exposures) 300 350 390 440 480

25


DAYCARE

Rs. Rs. Rs. Rs. Rs.12052 X-Ray Lumbosacral Spine (2 exposures) 380 440 490 550 61012065 X-Ray Lumbosacral Spine AP with Pelvis 280 320 360 410 45012029 X-Ray Mandible (per exposure) 200 230 260 290 32012072 X-Ray Nasal Bone (2 views) 300 350 390 440 48012068 X-Ray Neck Soft Tissue - Lateral Exposure 210 240 270 300 34012583 X-Ray Neck Soft tissue (AP/Lat) 380 440 490 550 61012030 X-Ray Optic Foramen 200 230 260 290 32012577 X-Ray Paediatric Barium / Contrast enema (2-3 exposures) 600 690 780 870 96012578 X-Ray Paediatric Contrast Study (2-3 exposures) 550 630 720 800 88012031 X-Ray Pelvis (1 exposure) 250 290 330 360 40012067 X-Ray PNS 220 250 290 320 35012039 X-Ray Ribs (AP) 230 260 300 330 37012040 X-Ray Sacroiliac Joints (both) 230 260 300 330 37012041 X-Ray Scapula (1 exposure) 200 230 260 290 32012042 X-Ray Shoulders Joint (1 exposure) 200 230 260 290 32012043 X-Ray Skull per exposure (Skull Ap, P.A.Orbit P.N.) 220 250 290 320 35012044 X-Ray Sternum (1 exposure) 200 230 260 290 32012049 X-Ray Thoracic Lumbar Spine (1 exposure) 280 320 360 410 45012045 X-Ray Thoracic Lumbar Spine (2 exposures) 400 460 520 580 64012048 X-Ray Thoracic Spine (1 exposure 15x12) 250 290 330 360 40012053 X-Ray Thoracic Spine (2 exposures) 380 440 490 550 61012047 X-Ray Toes (2 exposures) 220 250 290 320 35012050 X-Ray Wrist (AP & Lat) 220 250 290 320 350

B. SPECIAL INVESTIGATIONS12202 Angioplasty (6 exposures) 10000 11500 13000 14500 1600012530 Atherectomy & Angioplasty 20000 23000 26000 29000 3200012534 Av Fistulogram 8000 9200 10400 11600 1280012206 Barium Enema ( 4 exposures) 1500 1720 1950 2180 240012208 Barium Meal - Upper GI Tract (3exposures) 900 1040 1170 1310 144012207 Barium Meal Follow Through (6 exposures) 1500 1720 1950 2180 240012209 Barium Screening Enema 600 690 780 870 96012211 Barium Swallow (2 exposures) 800 920 1040 1160 128012210 Barium Swallow Screening 550 630 720 800 88012531 Biliary Plasty 8000 9200 10400 11600 1280012290 Biliary Stenting# 10000 11500 13000 14500 1600012280 Bronchial Artery Embolization 10000 11500 13000 14500 1600012584 C Arm Done by Technician in OT for additional 5 Min 500 580 650 730 80012585 C Arm Done by Technician in OT upto 10 Min 1000 1150 1300 1450 160012312 Cavernosography 400 440 510 560 62012276 Cerebral Angiogram (4 Vessel) 10000 11500 13000 14500 1600012215 Cystourethrogram (3 exposures) 1150 1320 1500 1670 184012249 Dacryocystogram (2 exposures) 600 690 780 870 96012058 Distal Colonogram/ Loopogram(2 exposures) 800 920 1040 1160 128012219 Fluroscopy for major procedure (eg.PCNL etc.,) 500 580 650 730 80012561 Fluroscopy Time upto 10 Minutes 600 690 780 870 96012299 Full Lower Limb Scanogram 950 1090 1240 1380 152012297 Full Spine Scoliogram AP 950 1090 1240 1380 152012298 Full Spine Scoliogram Lat 950 1090 1240 1380 152012532 Gi Bleeder Embolization 10000 11500 13000 14500 16000

26


DAYCARE

Rs. Rs. Rs. Rs. Rs.12288 Hemo dialysis Fistula Revision 12000 13800 15600 17400 1920012222 Hysterosalphinogram (2 exposures) 1400 1610 1820 2030 224012537 Interventional Radiology- Misc12281 IVC Filter Placement 10000 11500 13000 14500 1600012283 IVC Filter Retrieval 7000 8050 9100 10150 1120012225 IVP (6 exposures) 1300 1490 1690 1890 208012296 Knee Rosenberg View 230 260 300 330 37012293 Mastoids B/L 320 370 420 460 51012551 N.J Tube Insertion 1500 1720 1950 2180 240012229 Nephrostogram (2 exposures) 850 980 1100 1230 135012230 Operative Cholangiogram ( 2 exposures) 800 940 1060 1180 130012456 Paediatric Surgery Dye Study ( 1 exposure ) 450 520 590 650 72012455 Paediatric Surgery MCU ( 3 exposures ) 700 800 910 1020 112012284 Peripheral Stenting 15000 17250 19500 21750 2400012277 Peripherial Angiogram 9000 10350 11700 13050 1440012279 Peripherial Angioplasty 20000 28000 36000 44000 5200012282 Peripherial Vein Thrombolisis 15000 17250 19500 21750 2400012287 Permanent Catheter Insertion 15000 17250 19500 21750 2400012248 PTBD 6000 6900 7800 8700 960012235 PTC (6 exposures) 1350 1550 1760 1960 217012267 Retrograde Urethrography (RGU + MCU) 1400 1610 1820 2030 224012291 RF Ablation of Tumors 18000 20700 23400 26100 2880012247 RGU (1 Exposure) 700 800 910 1020 112012535 Sclerotherapy 2500 2880 3250 3630 400012238 Selective Angiogram 4000 4600 5200 5800 640012240 Sialogram (2 exposures) 800 920 1050 1170 129012241 Sinogram and Fistulogram (2 exposures) 800 920 1040 1160 128012294 Skull (AP&Lat) 380 440 490 550 61012295 Skull per exposure (Skull AP PA etc) 210 240 270 300 34012242 Small Bowel Enema - Contrast Study 1400 1610 1820 2030 224012278 Transarterial chemoembolization (TACE) * 10000 11500 13000 14500 1600012536 Trans-Jugular Biopsy 8000 9200 10400 11600 1280012244 T-Tube Cholangiogram (2 exposures) 700 800 910 1020 112012533 Uterine Artery Embolization 10000 11500 13000 14500 1600012285 Varicose Veins Laser Ablation 12000 13800 15600 17400 1920012286 Varicose Veins RF Ablation 20000 23000 26000 29000 3200012271 Venogram (Ascending + Descending) 2500 2880 3250 3630 400012270 Venogram (Descending) 1500 1720 1950 2180 240012292 Visceral Embolization 15000 17250 19500 21750 24000

Note: Portable X-rays & Portable ultrasounds will be charged extra. Any special Catheterether / accessories used for Angiograms / Interventionswill becharged extra. Contract media will be charged extra. Each X-ray film will be charged according to the film size.# Stent charges Extra*Embolization Materials/devices/coils/PVA will be as per actualsC. COLOUR DOPPLER SONOGRAPHY

12425 A V Fistula Duplex Scan 700 800 910 1020 112012462 Arterial Doppler-Both Extremities 2400 2760 3120 3480 384012461 Arterial Doppler-Single Extremity 1200 1380 1560 1740 192012513 AV Fistula Creation Doppler 1300 1490 1690 1890 208012512 AV Fistula Patency Doppler 500 580 650 730 80012304 Carotids and Vertebrals Doppler 1100 1270 1430 1600 1760

27


DAYCARE

Rs. Rs. Rs. Rs. Rs.12514 Iliac Vessel Doppler (Bilateral) 1350 1550 1760 1960 216012471 Mesenteric Doppler 800 920 1040 1160 128012511 Neck Vein Doppler 500 580 650 730 80012517 Obstetric Anomaly Scan with Uterine Artery Doppler 1500 1720 1950 2180 240012306 Obstetrics / Doppler 1100 1270 1430 1600 176012515 Pelvic Doppler 700 800 910 1020 112012309 Penile Doppler Studies 1500 1720 1950 2180 240012454 Perforator Marking 350 400 460 510 56012305 Portal Venous System Doppler 1100 1270 1430 1600 176012469 Renal Doppler 1500 1720 1950 2180 240012307 Renal Transplant Doppler 1000 1150 1300 1450 160012524 Repeat Doppler Scan 800 920 1040 1160 128012523 Review Doppler 350 400 460 510 56012470 Scrotal Doppler + Scan 900 1040 1170 1310 144012516 Temporal Artery Doppler 600 690 780 870 96012510 Twin OB Doppler 1300 1490 1690 1890 208012525 Uterine Artery Doppler 400 460 520 580 64012465 Venous Doppler - Both Extremities 2200 2530 2860 3190 352012464 Venous Doppler - Single Extremity 1100 1270 1430 1600 176012468 Venous Doppler - Varicose Veins - Both Extremities 2600 2990 3380 3770 416012467 Venous Doppler - Varicose Veins - Single Extremity 1300 1490 1690 1890 2080

D. ULTRASOUND IMAGING12401 Abdominal Ultrasound 900 1040 1170 1310 144012402 Abdominal Ultrasound - Repeat within 5 days 600 690 780 870 96012415 Additional Scan for Follicular Monitoring 250 290 330 360 40012060 AFI/HR ( Single Parameter) 400 460 520 580 64012504 Anomaly Scan 1400 1610 1820 2030 224012473 Anomaly Scan with Fetal Echo 3000 3450 3900 4350 480012538 Aspiration (Diagnostic) 1000 1150 1300 1450 160012428 Aspiration of Fluid Collection 630 720 830 920 102012539 Aspiration- Therapeutic 1200 1380 1560 1740 192012547 Biopsy - UltrasoundGuided 1500 1720 1950 2180 240012546 Breast Lesion Wire localization - UltrasoundGuided 2000 2300 2600 2900 320012404 Breast Ultrasound 900 1040 1170 1310 144012055 Catheter Drainage of Fluid Collections 1160 1330 1500 1680 185012429 Catheterer Drainage of Fluid Collections Repeat 840 890 1000 1260 147012405 Chest Scan 500 580 650 730 80012555 Chest Ultrasound ( Repeat within 5 days ) 250 290 330 360 40012558 Elastography 900 1040 1170 1310 144012424 Extra Charges for Portable Ultrasound 150 170 200 220 24012472 Fetal Echocardiography 1600 1840 2080 2320 256012540 FNAC - UltrasoundGuided 1200 1380 1560 1740 192012548 FNAC Guidence - UltrasoundGuided 1000 1150 1300 1450 160012518 Hepatobiliary Scan 500 580 650 730 80012541 IJV Sampling - UltrasoundGuided 2500 2880 3250 3630 400012544 Injection OF Drugs - UltrasoundGuided 2000 2300 2600 2900 320012559 Intraoperative Ultrasound 1500 1720 1950 2180 240012542 IV Access - UltrasoundGuided 1000 1150 1300 1450 160012549 Line Insertion - UltrasoundGuided 2000 2300 2600 2900 3200

28


DAYCARE

Rs. Rs. Rs. Rs. Rs.12520 Musculoskeletal Scan (other than shoulder and hip) 800 920 1040 1160 128012452 Neck Ultrasound 900 1040 1170 1310 144012521 Nerve Scan - Single Side 750 860 980 1090 120012586 Nerve Scan (Both sides) 1600 1840 2080 2320 256012519 Nuchal Translucency (NT) Scan 1100 1270 1430 1600 176012474 OB Growth Scan with Fetal Echo 2400 2760 3120 3480 384012475 OB Growth Scan with OB Doppler 1800 2070 2340 2610 288012458 Obstetric Biophysical Profile 1400 1610 1820 2030 224012552 Obstetric Ultrasound ( Dating ) 500 580 650 730 80012407 Obstetric Ultrasound (Growth scan) 800 920 1040 1160 128012505 Obstretic Ultrasound-Twin Gestation 1400 1610 1820 2030 224012545 PCN - UltrasoundGuided 2000 2300 2600 2900 320012427 Peadiatric Renal Scan 630 720 830 920 102012580 Pediatric Renal Doppler (Screening) 800 920 1040 1160 128012581 Pelvic scan with Doppler 700 810 910 1020 112012565 Pelvic scan with renal scan (only for female) 800 920 1040 1160 128012459 Pelvic Ultrasound 500 580 650 730 80012506 Pelvic Ultrasound - Repeat within 5 days 300 350 390 440 48012409 Pelvic Ultrasound,Transvaginal and Transabdominal 700 800 910 1020 112012476 Penile Ultrasound 800 920 1040 1160 128012543 Pigtail Insertion - Ultrasound Guided 3500 4020 4550 5080 560012410 Renal Transplant Scan 500 580 650 730 80012412 Renal Ultrasound 500 580 650 730 80012411 Renal Ultrasound - Repeat within 5 days 300 350 390 440 48012426 Review of Untrasound Scan 200 230 260 290 32012414 Serial Scan Follicular Monitoring (Upto 4 days) 1000 1150 1300 1450 160012557 Shoulder / Hip Ultrasound 1000 1150 1300 1450 160012417 Thyroid Ultrasound 800 920 1040 1160 128012556 Thyroid/Renal/Pelvis/Scrotal ( Repeat within 5 days ) 350 400 460 510 56012567 Triplet – Anomaly scan 3000 3450 3900 4350 480012568 Triplet – Anomaly with uterine artery Doppler 3300 3800 4290 4790 528012569 Triplet – Dating scan 1000 1150 1300 1450 160012570 Triplet – growth scan 2000 2300 2600 2900 320012571 Triplet – NT scan 2400 2760 3120 3480 384012572 Triplet – NT with uterine artery Doppler 2600 2990 3380 3770 416012573 Triplet – OB Doppler 2300 2650 2990 3340 368012522 Twin Anomaly Scan 2000 2300 2600 2900 320012574 Twin anomaly with uterine artery Doppler 2300 2650 2990 3340 368012553 Twin NT Scan 1800 2070 2340 2610 288012554 Twin NT Scan with Uterine Artery Doppler 2000 2300 2600 2900 320012575 Twins – Dating scan 800 920 1040 1160 128012406 Ultrasound - Extremities 400 460 520 580 64012453 Ultrasound Guided Biopsy 3000 3450 3900 4350 480012403 Ultrasound Guided Marking 2000 2300 2600 2900 320012422 Ultrasound of Brain 450 520 590 650 72012423 Ultrasound of Brain - Repeat within 5 days 220 250 290 320 35012421 Ultrasound of Small Parts/Transectal Scan 800 920 1040 1160 1280

29


DAYCARE

Rs. Rs. Rs. Rs. Rs.E. MAMMOGRAPHY

12501 Mammography Single Side - 2 Exposures (without Ultrasound) 1000 1150 1300 1450 160012502 Mammography Both Sides - 2 Exposures (without Ultrasound) 2000 2300 2600 2900 320012563 Mammography Single Side with Breast Ultrasound 1300 1490 1690 1890 208012564 Mammography Both Sides with Breast Ultrasound 2500 2880 3250 3630 400012503 Mammography (for each Additional Exposure ) 500 580 650 730 800

F. CT SCAN90189 10ml Non INOC Contrast 700 700 700 700 70090161 100ml Non INOC Contrast 2700 2700 2700 2700 270090159 20ml Non INOC Contrast 1000 1000 1000 1000 100090160 50ml Non INOC Contrast 1600 1600 1600 1600 160090048 Cardiac Calcium Scoring Screening 1500 1500 1580 1650 173090212 Cardiac CT scan (Adult) Non coronary 7000 7000 7350 7700 805090213 Cardiac CT scan (Paediatric ) 7000 7000 7350 7700 805090073 CD Copying 350 350 350 350 35090214 CD Uploading onto PACS 200 200 210 220 23090071 Cochlear Impalant Package (CT and MRI) 24650 24650 24650 24650 2465090070 Complimentary CT / MRI 850 850 850 850 85090012 CT Abdomen / Pelvis 4700 4700 4940 5170 541090036 CT Angio Abdomen / Renal / Peripheral / Pulmonary 4300 4300 4520 4730 495090037 CT Angio Cranial 3700 3700 3890 4070 426090083 CT Angio IC/EC (Inclusive of contrast) 6700 7700 8710 9720 1072090196 CT Angiogram - Bilateral lower limb 4300 4300 4520 4730 495090084 CT Brain + C.spine + Face 3D (Package) 6000 6000 6300 6600 690090226 CT Brain + IC/EC Angio (Inclusive of contrast) 8000 8000 8400 8800 920090027 CT Brain + PNS 4500 4500 4730 4950 518090025 CT Brain and Orbits / Facial Bone 4200 4200 4410 4620 483090039 CT Brain Biopsy 2550 2550 2680 2810 293090023 CT Brain Cisternography 4100 4100 4310 4510 472090001 CT Brain Plain 3000 3000 3150 3300 345090194 CT Brain - Repeat within 3 days 1800 1800 1890 1980 207090215 CT Brain with perfusion 5000 5000 5250 5500 575090009 CT Cervical Spine 4100 4100 4310 4510 472090216 CT Chest & Abdomen (Plain) 7000 7000 7350 7700 805090217 CT Coronary Angiogram 8000 8000 8400 8800 920090010 CT Dorsal Spine 4100 4100 4310 4510 472090015 CT Extermities 4200 4200 4410 4620 483090072 CT for CSF Rhinnohrea 3500 3500 3680 3850 402090069 CT for Tracheal Stenosis 2450 2450 2570 2700 282090017 CT Guided Biopsy 5000 5750 6500 7250 800090046 CT Limited Study 2000 2000 2100 2200 230090008 CT Lumbar Spine 4100 4100 4310 4510 472090006 CT Neck 4100 4100 4310 4510 472090007 CT Orbit 3050 3050 3200 3360 351090181 CT Paediatric - One region 2450 2450 2570 2700 282090005 CT Paranasal Sinus 2600 2600 2730 2860 299090164 CT Scan Reporting charges ( Outside Scanned cases) 300 300 320 330 35090218 CT Sinogram 4700 4700 4940 5170 541090041 CT Skull Base (PNS,Orbit,Brain CON) 4300 4300 4520 4730 4950

30


DAYCARE

Rs. Rs. Rs. Rs. Rs.90038 CT Stereotactic Procedure 4850 4850 5090 5340 558090011 CT Thorax 4500 4500 4730 4950 518090014 CT TM Joints 4200 4200 4410 4620 483090182 CT Urography / CT KUB 3600 3600 3780 3960 414090195 CT Whole Spine 5800 5800 6090 6380 667090068 Film Charges for CT/MRI 17x14 (1 Film) 300 300 310 330 34090186 Film Charges for CT/MRI 17 x 14 (2-3 films) 700 700 700 700 70090100 General Anesthesia charges for CT / MRI. 1000 1000 1050 1100 115090034 HR CT Temoral Bone 4300 4300 4520 4730 495090033 HR CT Thorax 4500 4500 4730 4950 518090219 Triple rule out CT 9000 9000 9450 9900 1035090051 Virtual Endoscopy 6150 6150 6460 6770 7070

G. MRI SCAN90197 Brachial Plexus - Both sides 10000 10000 10500 11000 1150090220 MR Angio whole Aorta (plain) 8000 8000 8400 8800 920090221 MR Pulmonary angiography (plain) 8000 8000 8400 8800 920090177 MR Urography 4500 4500 4730 4950 518090067 MRA (Intra or Extra Cranial) 7400 7400 7770 8140 851090191 MRA Extra Cranial + Brain Screening 5700 5700 5990 6270 655090192 MRA Intra Cranial + Brain Screening 5700 5700 5990 6270 655090106 MRI Abdomen 7000 7000 7350 7700 805090229 MRI Abdomen & Pelvis (Inclusive of contrast) 11000 12650 14300 15950 1760090231 MRI Additional Sequence 1500 1720 1950 2180 240090232 MRI Additional sequence for Whole body scan 5000 5750 6500 7250 800090175 MRI Brachial/Lumbar Plexus 6700 6700 7040 7370 770090193 MRI Brain - Epilepsy 6700 7700 8710 9720 1072090222 MRI Brain (Stroke protocol - For Emed Patients) 7500 7500 7880 8250 863090101 MRI Brain / Neck 6700 6700 7040 7370 770090081 MRI Brain and Functional MRI 9600 9600 10080 10560 1104090078 MRI Brain and Perfusion 9600 9600 10080 10560 1104090223 MRI Brain contrast completion study 4500 4500 4730 4950 518090172 MRI Brain Limited Study 4400 4400 4620 4840 506090224 MRI Brain Perfusion (Non contrast ASL) 2000 2000 2100 2200 230090062 MRI Brain Perfussion 3100 3100 3260 3410 356090202 MRI Brain screening + Complimentary CT 5200 5200 5460 5720 598090082 MRI Brain Screening + MR Angio IC/EC (Package) 9000 9000 9450 9900 1035090052 MRI Breast 7400 7400 7770 8140 851090225 MRI Cardiac (Plain ) 7000 7000 7350 7700 805090204 MRI Cardiac perfusion with adenosine 9000 9000 9450 9900 1035090053 MRI Cartigram 3700 3700 3890 4070 426090124 MRI Cervical Spine 6000 6000 6300 6600 690090107 MRI Chest 7000 7000 7350 7700 805090111 MRI Dorsal Spine 6000 6000 6300 6600 690090055 MRI DTI and Fibre Tracking 3000 3000 3150 3300 345090056 MRI Foetus 6150 6150 6460 6770 707090064 MRI Functional (BOLD) 3100 3100 3260 3410 356090109 MRI Internal Auditory Canal / Temporal Bone 6700 6700 7040 7370 770090205 MRI Iron Quantification (Liver & Cardiac) 3000 3000 3150 3300 345090187 MRI Joint with Arthrogram 10100 10100 10610 11110 11620

31


DAYCARE

Rs. Rs. Rs. Rs. Rs.90102 MRI Lumbar Spine 6700 6700 7040 7370 770090126 MRI MRCP 4500 4500 4730 4950 518090233 MRI MS Protocol (Inclusive of contrast) 15000 17250 19500 21750 2400090108 MRI Muscular Skeletal Joint 7000 7000 7350 7700 805090234 MRI Navigation Protocol (Inclusive of contrast) 8700 10010 11310 12620 1392090060 MRI One Region 6550 6550 6880 7210 753090059 MRI One Sequence 2000 2000 2100 2200 230090105 MRI Orbits 6700 6700 7040 7370 770090180 MRI Paediatric - one region/ finger 4500 4500 4730 4950 518090199 MRI Pelvis ( Male / Female ) 6700 6700 7040 7370 770090110 MRI Pelvis (MSK) 7000 7000 7350 7700 805090206 MRI Peripheral angiography (Plain) 8000 8000 8400 8800 920090103 MRI PNS 6700 6700 7040 7370 770090176 MRI Renal Angiogram (Plain) 8000 8000 8400 8800 920090165 MRI Scan Reporting Charges ( outside scanned cases) 400 400 420 440 46090066 MRI Sella with Contrast 8100 8100 8510 8910 932090201 MRI SI Joints 5000 5000 5250 5500 575090104 MRI Skull Base 6700 6700 7040 7370 770090058 MRI Special Technique/5 ml MR Contrast 2500 2880 3250 3630 400090228 MRI Contrast 2ml 2000 2300 2600 2900 320090230 MRI Additional Contrast 1250 1440 1630 1810 200090063 MRI Spectroscopy 3100 3100 3260 3410 356090173 MRI Spine (Cervical /Lumbar) Limited 4400 4400 4620 4840 506090179 MRI Spine one region + Rest Screening 8000 8000 8400 8800 920090200 MRI TM Joint 6700 6700 7040 7370 770090235 MRI Whole body scan 15000 17250 19500 21750 2400090203 MRI Whole spine contrast completion study 4000 4000 4200 4400 460090198 MRI Whole spine screening with Pelvis coronal 8200 8200 8610 9020 943090174 MRI Whole Spine Screening 7000 7000 7350 7700 805090190 MRI Whole Spine with Contrast 11000 11000 11550 12100 1265090178 MRV + Brain Screening 5700 5700 5990 6270 655090188 Post MRI Arthrogram 2750 2750 2890 3030 3160

G1. EMERGENCY MEDICINE PACKAGE90184 CT Brain & Cervical Spine Package 4950 4950 5200 5450 569090185 CT Thorax+Abdomen & Pelvis Pacakge including contr 9000 10350 13460 19520 31240

H. NEURO INTERVENTIONAL PROCEDURE27012 Ablation 20000 23000 26000 29000 3200027003 Acute Stroke Intrvention 60000 75000 100000 125000 15000027004 Aneurysm Coiling 70000 85000 110000 135000 16000027013 Angioplasty & Stenting 20000 23000 26000 29000 3200027006 AVM/AVF Ebolisation 70000 85000 110000 135000 16000027008 Ballon Occlusin Test 30000 40000 50000 60000 7500027014 Balloon assisted coiling 30000 34500 39000 43500 4800027002 Carotid Stenting 60000 75000 100000 125000 15000027010 Cerebral Venous Stenting 60000 75000 100000 125000 15000027011 Cerebral Venous Thrombolysis 60000 75000 100000 125000 15000027001 Diagnostic Cerebral Angiogram 12000 15000 20000 25000 3000027015 Inferior petrosal sinus sampling 30000 34500 39000 43500 4800027005 Intracranial Stenting 70000 85000 110000 135000 160000

32


DAYCARE

Rs. Rs. Rs. Rs. Rs.27016 Liquid Embolisation of vascular malformation 30000 34500 39000 43500 4800027017 Middle meningeal artery embolisation 30000 34500 39000 43500 4800027018 Percutaneous Cholecystostomy 5000 5750 6500 7250 800027019 Pigtail Removal 300 350 390 440 48027009 Pre Operative Tumor Ebolistion 30000 40000 50000 60000 7500027007 Spinal Angiogram 30000 40000 50000 60000 7500027020 Stent assisted coiling 30000 34500 39000 43500 48000

I. INVESTIGATIONS DONE OUTSIDEI1. PET CT SCANS

90566 Dotonac PET CT Whole Body 25500 25500 25500 25500 2550090579 F18 PET Bone Scan 7700 7700 7700 7700 770090567 FDOPA PET CT For Brain 17790 17790 17790 17790 1779090568 GA 68 PSMA PET CT Scan 28000 28000 28000 28000 2800090565 Whole Body PET CT 16000 16000 16000 16000 1600090610 Whole Body PET MRI 28000 28000 28000 28000 28000

I2. NUCLEAR MEDICINE90574 Dacryocystogram 3900 3900 3900 3900 390090575 Dementia Package 18700 18700 18700 18700 1870090576 DVT 5500 5500 5500 5500 550090577 EC Renogram 3900 3900 3900 3900 390090580 GER Study 3900 3900 3900 3900 390090581 GFR 1000 1000 1000 1000 100090583 Hepatobiliary Scan 3300 3300 3300 3300 330090584 Hyperthermia 3300 3300 3300 3300 330090585 Infarct Imaging 7700 7700 7700 7700 770090586 Large Dose Scan 5000 5000 5000 5000 500090590 LU 177 Psma Therapy 342000 342000 342000 342000 34200090591 Lung Perfusion Scan 5000 5000 5000 5000 500090592 Lymphoscintigraphy 15030 15030 15030 15030 1503090593 M I B G Scan 16500 16500 16500 16500 1650090595 Meckels Diverticulum 3300 3300 3300 3300 330090597 MUGA 3300 3300 3300 3300 330090599 Myocardial Perfusion Scan For SJIC Only 6400 6400 6400 6400 640090600 P32 Therapy 45000 45000 45000 45000 4500090612 Parathyroid Scan 9100 9100 9100 9100 910090613 Parkinsons Package 18200 18200 18200 18200 1820090614 RBC Study 3900 3900 3900 3900 390090615 Renal Scan-DMSA 4160 4160 4160 4160 416090616 Renogram-DTPA 4500 4500 4500 4500 450090617 Samarium Therapy 45000 45000 45000 45000 4500090618 SR 89 Therapy (Actuals) 154000 154000 154000 154000 15400090619 Stress Only M P S 5000 5000 5000 5000 500090620 Sulfur Colloid Scan 3900 3900 3900 3900 390090621 Testicular Scan 3900 3900 3900 3900 390090623 Thyrogen Inj (Actuals) 110000 110000 110000 110000 11000090624 Thyroid Scan 3300 3300 3300 3300 330090625 Thyrotoxicosis Therapy 10-14Mci Of I-131 12700 12700 12700 12700 1270090626 Thyrotoxicosis Therapy 15Mci - 20Mci Of I-131 15400 15400 15400 15400 1540090627 Thyrotoxicosis Therapy 29Mci Of I-131 20900 20900 20900 20900 2090090628 Thyrotoxicosis Therapy Upto 10Mci Of I-131 8800 8800 8800 8800 880090629 VUR Study Direct 2800 2800 2800 2800 2800

33


DAYCARE

Rs. Rs. Rs. Rs. Rs.V. NON-OPERATIVE PROCEDURESA. GENERAL PROCEDURES1. GENERAL PROCEDURES - CCU

00071 Arterial Line 250 350 450 550 65000073 ECG 180 260 330 400 47000076 Glucometer Random Blood Sugar 70 100 130 160 19000074 Streptokinase Therapy (excluding drugs) 200 300 400 400 40000072 Venesection / Cut Down / CVC 240 340 430 530 620

2. GENERAL PROCEDURES - ICU00342 ABG GEM Machine ICU 400 460 520 580 64003192 ABG SIEMENS Machine ICU 400 460 520 580 64000113 Forced Alk. Diuresis for Barbit Poisoning 300 420 540 660 78000114 Plasma Pheresis 350 490 630 770 91000141 Admission Screening Ultrasound 600 600 600 600 60000111 Arterial Line 250 350 450 550 65003187 ETCO2 Monitoring (Continous ) 500 700 900 1100 130003188 ETCO2 Monitoring (Intermittent) 150 210 270 330 39000116 Glucometer Random Blood Sugar 70 100 130 160 19004000 HFNC-24 Hours 1070 1500 1930 2350 278003199 HFNC-6 Hours 360 500 650 790 94000345 ICU Bronchoscopy 3000 4200 5400 6600 780000349 ICU Percutaneous Tracheostomy 1430 2000 2570 3140 371000140 Insulin protocol 1200 1680 2160 2640 312000346 Intra Hospital Shift on Portable Ventilator & Monitor 1000 1400 1800 2200 260003189 Isolation Precautions 500 500 500 500 50003191 Isolation with Negative Pressure 500 500 500 500 50003190 Isolation with Positive Pressure 300 300 300 300 30000335 FAST, e FAST scans 360 500 650 790 94000336 Marking For Tapping 360 500 650 790 94000338 Medical ICU -Cross Consultation IP 50 150 250 400 50000199 Non-Invasive Bipap Ventilator - Package (Per Day) 540 760 970 1190 140000348 Pacemaker Insertion Temporary 360 500 650 790 94000347 Pericardial Tap UltrasoundGuided 360 500 650 790 94004024 Pigtail insertion- pleura /collection 1500 2100 2700 3300 390000343 SCD:Sequential Compression Device Knee Length 360 500 650 790 94000344 SCD:Sequential Compression Device Thigh Length 570 800 1030 1260 149000334 Screening ECHO 210 300 380 470 55000341 Screening Ultrasound - Haemodynamic 600 600 600 600 60004025 TCD ultrasound 2000 2800 3600 4400 520000337 Ultrasound Guidance for CVC 400 560 720 880 104000112 Venesection / Cut down / CVC 240 340 430 530 620

3. GENERAL PROCEDURES - PEADIATRIC ICU15200 ABG GEM Machine ICU 400 460 520 580 640

34


DAYCARE

Rs. Rs. Rs. Rs. Rs.00168 Arterial Line 250 350 450 550 65015231 Bedside ECG 320 450 580 700 83015201 Bipap (Per Hour) 40 50 60 80 10015232 Blood Warmer 120 170 220 260 31015233 Bronchoscopy - PICU 3000 4200 5400 6600 780015203 Burns Pad 80 120 150 180 21015202 Bone Marrow Aspiration 350 490 630 770 91015218 SCD: Sequential Compression Device Knee Length 300 420 540 660 78015204 Catheterization 100 140 180 220 26015205 Central Venous Cannulation 360 500 650 790 94015206 Defibrillator 220 310 400 480 57015207 ECG 180 260 330 400 47015208 Enema 75 110 140 170 20015234 ETCO2 Monitoring (Continous ) 500 700 900 1100 130015235 ETCO2 Monitoring (Intermittent) 150 210 270 330 39015209 Extubation 20 40 50 50 6000172 Glucometer Random Blood Sugar 70 100 130 160 19015210 ICD Insertion 210 300 380 470 55015211 ICU Haemodialysis 1575 1960 2520 3080 364015212 Incision & Drainage 150 210 270 330 39015214 Incubator / Radiant Warner with CPAP Ventilation 1500 1500 1500 1500 150015215 Infusion Pump (Per Day) 210 300 380 470 55015400 Inhaled Nitric Oxide 15000 15000 15000 15000 1500015216 Intra Hospital Shift on Portable Ventilator & Monitor 1000 1400 1800 2200 260000174 Intraosseus 50 70 80 110 12015236 Lung Ultrasound 360 500 650 790 94015239 Micro ESR 60 80 110 130 16015237 Nebulization (Per Hour) including Oxygen 100 140 180 220 26015217 Non-Invasive Bipap Ventilator - Package (Per Day) 540 760 970 1190 140015240 Non-Invasive Hemo Dynamic Monitoring 3500 4900 6300 7700 910000173 Peritoneal Dialysis 860 1200 1550 1880 223000171 Plasma Pheresis 440 620 790 970 114015247 PICU HD INSERTION (FEMORAL) 2000 2000 2000 2000 200015248 PICU JUGULAR (HD) 2200 2200 2200 2200 220015241 Portable Ventilator per use (In House ) 750 1050 1350 1650 195015213 Radiant Warmer with monitoring 500 700 900 1100 130015220 Screening ECHO 210 300 380 470 55015219 Screening Ultrasound - Haemodynamic 360 500 650 790 94015221 Servo Duo Filter 720 720 720 720 72015238 Tracheostomy Tube Change 290 410 520 640 74015222 Ultrasound Guidance for CVC 400 560 720 880 1040

4. GENERAL PROCEDURES - NEONATAL ICU15226 Blood Warmer 120 170 220 260 310

35


DAYCARE

Rs. Rs. Rs. Rs. Rs.15229 Breast Pump (per use) 150 150 150 300 50015230 Bronchoscopy (NICU) 3000 4200 5400 6600 780000325 Bubble CPAP 2500 2500 4500 5500 650000093 Capillary PCV 120 170 220 260 31000094 Cardiac Monitoring 300 300 540 660 78015249 Defibrillator 220 310 400 480 57000326 Developmental Screening by Neonatal 1000 1000 1800 2200 260000095 Exchange Transfusion - Partial / Complete / DV 500 700 900 1100 130000097 Glucometer Random Blood Sugar 70 100 130 160 19000131 Giraffee Extream Preterm Care (in addition to Warmer) 1430 2000 2570 3150 372000124 Hearing Screening (OAE) 70 100 120 140 17015223 High Flow Nasal Cannula HFNC 530 740 950 1170 138000118 High Risk Delivery 1000 1400 1800 2200 260015245 ICD Insertion 210 290 380 460 55000328 Lactation Counselling 140 200 260 310 37015246 Low Risk Delivery 360 500 650 790 94000137 Nebulization 100 140 180 220 26002150 NFC Booklets 200 200 200 200 20000099 Otoacoustic Emission Test 210 300 380 470 55000332 Parental Nutrition 70 100 130 150 18015243 PD Maintainence - Neonatal 530 740 950 1170 138015242 Peritoneal Dialysis 860 1200 1550 1880 223000127 Phototherapy - Double Surface (Per Day) 300 420 540 660 78000091 Phototherapy - Single Surface (Per Day) 270 380 490 590 70000323 Phototherapy - Tripple Surface (Per Day) 400 560 720 880 104000333 PICC Lines 350 490 630 770 91000327 Prenatal Counselling 200 280 360 440 52015227 ROP Screening in NICU 180 250 320 400 47000329 Standby Ventilator for Every 24 Hours 360 500 650 790 94000119 SurfactantAdministration 360 500 650 790 94000100 Transctaneous Bilirubin Evaluation 120 170 220 260 31000331 Transport Of Neonate Outside the Hospital 700 980 1260 1540 182000330 Transport of Neonate within Hospital 120 170 220 260 310

5. GENERAL PROCEDURES - ITU/POST OPERATIVE PROCEDURES00151 Arterial Line 250 350 450 550 65000157 CVP Monitoring 150 210 270 330 39000158 Defibrillator 220 310 400 480 57000156 Glucometer Random Blood Sugar 70 100 130 160 19000164 Infusion Pump (Per Day) 210 300 380 470 55000153 Intubation (Endotracheal) 240 340 430 530 62000159 Monitoring (Per Day) 150 210 270 330 39000160 Oximeter 170 240 310 370 44000162 Oxygen inhalation (Per Hour) 100 140 180 220 260

36


DAYCARE

Rs. Rs. Rs. Rs. Rs.00163 Respirator (Per Day) 1000 1400 1800 2200 260000154 Stomach Wash for Poisoning 300 420 540 660 78000152 Venesection / Cut Down / CVC 240 340 430 530 620

6. GENERAL PROCEDURES - EMERGENCY MEDICINE / EICU11509 ABG - EICU Seimens 400 460 520 580 64060033 Aluminium Splint / Inch 60 80 110 130 16003101 Arterial Line 250 350 450 550 65003108 Assault Assesment (Consumables) 250 250 250 250 25003160 Bedside Ultrasound 720 1010 1300 1580 187003161 Bipap (Per Hour) 40 50 60 80 10003158 Bladder Wash 130 190 240 290 34003169 Bowel Wash 130 190 240 290 34003159 Burns Pad 80 120 150 180 21003114 Catheterization 100 140 180 220 26003152 Central Venous Cannulation 360 500 650 790 94003150 Closed Reduction Adults 720 1010 1300 1580 187003198 CPR/Cardioversion/Defibrillation 500 700 900 1100 130060034 Crape Bandage 60 80 110 130 16003177 CVP Monitoring 150 210 270 330 39003106 Defibrillator 220 310 400 480 57003162 Deo Guard 720 720 720 720 72003118 Dressing - Each Bandage 60 90 110 140 16003117 Dressing - Pad and Bandage 100 140 180 220 26003170 Dressing - Service Charges - Large 150 210 270 330 39003171 Dressing - Service Charges - Medium 130 190 240 290 34003172 Dressing - Service Charges - Small 100 140 180 220 26060002 Dynaplaster for IV 10 10 10 10 1003130 ECG 180 260 330 400 47003193 ED Nerve Block (Guided) 1000 1400 1800 2200 260003196 ED Sonological Assessment 500 700 900 1100 130015498 EICU Bedside EEG 3200 4480 5760 7040 832015499 EICU Bedside Bronchoscopy 3000 4200 5400 6600 780060006 Electrolytes - EMS 210 300 380 470 55003186 Emergency Medicine -Cross Consultation IP 50 150 250 400 50003148 Emergency OT Suturing 860 1200 1550 1880 223003153 Enema 75 110 140 170 20003145 Epidural Steroid Injection 1070 1500 1920 2350 277003181 ETCO2 monitering 50 60 70 80 9003163 Extubation 20 40 50 50 6003120 Glucometer Random Blood Sugar 70 100 130 160 19003195 HD Access in ER 300 420 540 660 78060005 Hemat - EMS 140 200 260 310 37003139 ICD Insertion 210 300 380 470 550

37


DAYCARE

Rs. Rs. Rs. Rs. Rs.03121 Incision and Drainage 150 210 270 330 39003110 Infusion Pump (Per Day) 210 300 380 470 55003146 Intervenous Cannulation 50 70 80 110 12003147 Intramuscular Injection 25 40 50 60 7003173 Intubation (Endotracheal) 240 340 430 530 62003174 IV Fusion 75 110 140 170 20003154 Ketostick 60 80 110 130 16003138 Lumbar Puncture 250 350 450 550 65060007 Malarial Parasites Smear (MP) - EMS 190 260 340 410 48003107 Monitoring 150 210 270 330 39003149 Narcotic Injections 25 40 50 60 7003140 Nasal Packing 80 110 140 180 21003155 Nebulization 100 140 180 220 26003109 Oxygen inhalation (Per Hour) 100 140 180 220 26003127 Plastering - Major 250 350 460 550 66003128 Plastering - Minor 210 300 380 470 55003112 Pleural Aspiration 220 310 400 480 57003125 POP 10 cm 70 100 120 140 17003126 POP 15 cm 140 200 260 310 37003164 Portable Ventilator (Per Hour) 120 170 220 260 31003151 Professional Charge 140 200 260 310 37060004 Prothrombin Time (PT) - EMS 200 280 360 430 52003129 Removal of Foreign Body 140 200 260 310 37003131 Ryles Tube Introduction 30 40 50 70 8003165 SCD: Sequential Compression Device Knee Length 370 520 670 810 96003166 SCD: Sequential Compression Device Thigh Length 580 810 1040 1280 151003144 Sengstaken Tube Introduction 860 1200 1550 1880 223003178 Steam Inhalation 50 70 90 110 13003180 Stoma Care Routine 60 80 110 130 16003167 Stomach Wash - Routine 80 110 140 180 21003104 Stomach Wash for Poison 300 420 540 660 78003168 Strip (Pregnancy Test) 160 180 200 230 25003133 Suture Removal in EMS 70 100 130 160 19003141 Suturing with Plastic Suture Set 230 320 410 500 59003142 Suturing with Suture Set 160 220 280 350 41003197 TCP in ER 500 700 900 1100 130003157 Thomas Splint 650 910 1160 1430 168003176 Tracheostomy Care 70 100 130 160 19003175 Tracheostomy in OPD / Ward 290 410 520 640 74003182 Transcutaneous pacing 175 250 320 390 46003156 Triangular Sling 70 70 70 70 7060003 Troponin-I (EMS) 900 1300 1600 2000 2300

38


DAYCARE

Rs. Rs. Rs. Rs. Rs.03194 TVP in ER 1500 2100 2700 3300 390003183 UltrasoundGuided Procedure 700 980 1260 1540 182003179 Wall Suction 30 40 50 70 80

7. GENERAL PROCEDURES - OPD / WARD73250 6F Sheath 1060 1484 1908 2332 275650061 ABG/VBG with Creatinine 400 460 520 580 64000201 Arterial Line 250 350 450 550 65000203 Aspiration 220 310 400 480 57000202 Atropine Anitode Therapy (Excluding Drugs) 380 530 680 840 99000395 Back Care / Mouth Care 60 80 110 130 16000207 Bandage -Triangular Bandage 30 40 50 70 8000208 Biopsy - Cervical 320 450 580 700 83000210 Biopsy - Transbronchial Lung 900 1260 1620 1980 234000211 Bladder Wash 130 190 240 290 34000212 Bowel Wash 130 190 240 290 34002697 Burns Pad 80 120 150 180 21000298 Catheter Care 25 40 50 60 7000213 Catheterererization 100 140 180 220 26000215 Colostomy Care 130 190 240 290 34073306 Cotton Balls Pack 35 50 70 80 10000204 Crape Bandage Service Charges 60 80 110 130 16000371 Culture Tube 10 10 10 10 1000216 CVP Monitoring 150 210 270 330 39050012 D-Dimer 750 750 750 750 75000217 Debridment 220 310 400 480 57000218 Defibrillator 220 310 400 480 57000318 Disposable - Dress Tray Wrapper 15 30 30 40 4000319 Disposable Surgical Pack Wrapper 15 30 30 40 4000219 Douche 50 70 90 110 13000220 Drainage (Tubing & Bottling) 50 70 90 110 13000224 Dressing - Salvon Bath & Dressing 200 280 360 440 52000227 Dressing - Service Charges - Large 150 210 270 330 39000226 Dressing - Service Charges - Medium 130 190 240 290 34000225 Dressing - Service Charges - Small 100 140 180 220 26073305 Dressing Pad 30 50 60 70 8072051 Dynaplaster 10 14 18 22 2600231 Ear Hole Suturing with LA 110 150 200 240 29000274 ECG 180 260 330 400 47000370 Elastic Adhesive Bandage per 10cm (10/8 cm) 20 20 20 20 2000205 Electroplast Service Charges 60 80 110 130 16000228 Enema 75 110 140 170 20073307 Eye pad 25 40 50 60 70

39


DAYCARE

Rs. Rs. Rs. Rs. Rs.00230 Fistula Care (each visit) 50 70 80 110 12000229 Forced Alk.Diuresis for Barbit Poisoning 360 500 650 790 94073304 Gauze Pack 25 25 25 25 2500232 Glucometer Random Blood Sugar 70 100 130 160 19000299 Hepatitis B - Adult00300 Hepatitis B - Child00233 Incision & Drainage 150 210 270 330 39000296 Incubator / Open Air Care 380 530 680 840 99000234 Infra Red Lamp Application(10 Minutes) 50 70 90 110 13000277 Infusion Pump (Per Day) 210 300 380 470 55000238 Injection Service Charges - Intra Cardiac 70 100 120 140 17000239 Injection Service Charges - Intravenous 30 50 60 70 8000243 Intra Articular Pressure Monitoring 250 350 450 550 65000244 Intubation (Endotracheal) 240 340 430 530 62000245 Invasive BP Monitoring 260 360 470 570 68000246 IV Fusion 75 110 140 170 20000247 Leather Heel - Large 70 100 130 160 19000248 Leather Heel - Small 60 80 110 130 16000249 Liver Puncture 250 350 450 550 65000250 Lumbar Puncture 250 350 450 550 65000209 Lymph Node Biopsy 320 450 580 700 83000257 Mantux Test 20 30 40 40 5000256 Minor Procedure - in Minor OT 220 310 400 480 57000010 Miscellaneous00253 Monitoring 150 210 270 330 39074071 N95 Mask 105 105 105 105 10500254 Nebuliser - Pipeline 100 140 180 220 26000255 Nebuliser for Children in OPD 10000252 Nebuliser- Machine (per use) 100 140 180 220 26000189 Non-Invasive Bipap Ventilator - Package (Per Day) 540 760 970 1190 140000398 Non-Invasive Bipap Ventilator - Package (Per Hour) 50 70 90 110 13000259 Oxygen Inhalation (Per Hour) 100 140 180 220 26000240 Parental Chemotherapy Charges 150 210 270 330 39074016 Patient Gown (Pink) 340 340 340 340 34000261 Pericardial Tap 220 310 400 480 57000262 Peritoneal Drainage 220 310 400 480 57000297 Peritoneal Wash 380 530 680 840 99000295 Phototherapy - Single Surface (Per Day) 270 380 490 590 70074020 Pink Gown (Child) 180 180 180 180 18000263 Plasma Pheresis 440 620 790 970 114000264 Plaster Of Paris - Local 10 cms 80 110 140 180 21000265 Plaster of Paris - Local 15 cms 150 210 270 330 390

40


DAYCARE

Rs. Rs. Rs. Rs. Rs.00270 Plastering / Cast Application - Major 260 360 470 570 68000271 Plastering / Cast Application - Minor 210 300 380 470 55000266 Pleural Aspiration 220 310 400 480 57000269 Pocket Doppler (More than 1 use) 210 300 380 470 55000268 Pocket Droppler (First Use) 140 200 260 310 37000399 Pre-Operative Skin Preparation 110 150 200 240 29000258 Pulse Oximeter Monitoring (Per Day) 180 260 330 400 47074009 Pyjama (A) 180 252 324 396 46874010 Pyjama (S) 100 140 180 220 26000272 Removal of Foreign Body in OPD/ward 300 420 540 660 78000273 Respirator (Per Day) 1000 1400 1800 2200 260000275 Ryles Tube Introduction 30 40 50 70 8000241 SC - Kenacort 70 100 130 150 18000320 SCD: Sequential Compression Device Knee Length 370 520 670 810 96000321 SCD: Sequential Compression Device Thigh Length 580 810 1040 1280 151003185 Proning 300 420 540 660 78003184 Bedside ECG 320 450 580 700 83000372 Servo Duo Guard Filter 720 720 720 720 72000237 Service Charges - Injection IM / SC 25 40 50 60 7000276 Sitz Bath 70 100 130 160 19000394 Sponge Bath 80 120 150 180 21000278 Steam Inhalation 50 70 90 110 13000350 Sterile Gloves 80 80 80 80 8060012 Sterile Water 500ml 26 26 26 26 2600279 Stoma Clinic - Irrigation of Stoma (First) 80 110 140 180 21000280 Stoma Clinic - Irrigation of Stoma (Subsequent) 50 70 90 110 13000281 Stoma Clinic - OP Consultation 30 40 50 70 8000283 Stoma Clinic - Post Op 1st Visit 50 70 100 120 14000282 Stoma Clinic - Pre Op Assessment 50 70 100 120 14000284 Stomach Wash - Poisoning 300 420 540 660 78000285 Stomach Wash - Routine 80 110 140 180 21000206 Strapping (Chest) 70 100 130 150 18000286 Streptokinase Therapy (Excluding Drugs) 200 300 400 400 40074000 Striped Sheet (Blue /Pink) 250 350 450 550 65000287 Sub-Clavian Puncture 220 310 400 480 57000288 Suture Removal (Dressing Charges Extra) 70 100 130 160 19000289 Suturing under LA in OPD / Ward 100 130 170 220 25000290 Suturing without LA in OPD / Ward 60 80 110 130 16002429 TENS 65 90 120 155 17574069 Three Layer Mask 12 12 12 12 1200291 Tracheostomy Care 70 100 130 160 19000190 Tube Feeding 25 35 45 55 65

41


DAYCARE

Rs. Rs. Rs. Rs. Rs.

15500 Ultrasound Guidance for CVC 400 560 720 880 104060038 Uristix 10 10 10 10 1000311 Vacuette Coagulation # 10 10 10 10 1000312 Vacuette EDTA # 10 10 10 10 1000313 Vacuette ESR # 10 10 10 10 1000317 Vacuette Lithium 4ml # 10 10 10 10 1000316 Vacuette Needle 21G # 10 10 10 10 1000315 Vacuette Needle 22G # 10 10 10 10 1000314 Vacutte Serum 4ml # 10 10 10 10 1000292 Varicose Veins Injection # 140 200 260 310 37000293 Venesection / Cut Down / CVC # 240 340 430 530 62000294 Wall Suction 30 40 50 70 8000301 Water Mattress 60 80 110 130 16074060 Wrappers Medium (CSSD) 160 224 288 352 41674061 Wrappers Small (CSSD) 70 98 126 154 182

Note: # Subject to prevailing rates + An additional charge on the procedure amount applicableOutsourced Services

50049 Air Bed Alpha Active 3 180 180 180 180 18050050 Air Bed Alpha Trancell Deluxe 250 250 250 250 25050051 Air Bed Autologic 110 310 310 310 310 31050052 Air Bed Autologic 200/ Alpha Active 4 370 370 370 370 37050053 Air Bed Nimbus 3 384 384 384 384 38450054 Air Bed Skin IQ365 162 162 162 162 162

8. GENERAL PROCEDURES - UNIT OF HOPE23713 Block Therapy Sessions (3 Sessions) 120023561 Catheterization 10023712 Counselling Session 50024150 Debridement 17523552 Disposable - Dress Tray Wrapper 1524152 Dressing - Each Bandage 6024153 Dressing - Each Pad 3024151 Dressing - Pad & Bandage 10024154 Dressing - Savlon Bath & Dressing 20024156 Dressing - Service Charges - Medium 13024155 Dressing - Service Charges - Small 10023543 ECG 18023560 Enema 7524143 General Consultation - UoH (Revisit After 30 days) 15024142 General Consultation - UoH (Within 30 days) 15023532 Glucometer Random Blood Sugar 7023533 Incision & Drainage 15023535 Injection Service Charges - Intravenous 30

42


DAYCARE

Rs. Rs. Rs. Rs. Rs.23555 Intraosseous Line 3523536 Intubation (Endotracheal) 24023554 IV Infusion / Line 7523538 Mantoux Test 1023537 Nebuliser for Children in OPD 10024141 OP New Registration 15023559 Oxygen inhalation (Per Hour) 10023539 Plaster Of Paris - Local 10 cms 8023540 Plaster of Paris - Local 15cms 12023542 Plastering / Cast Application - Minor 30023541 Plastering/Cast application - Major 40023556 Pulse Oxymetry 12023562 Ryles Tube Introduction 3023534 Service Charges - Injection IM/SC 2523563 Steam Inhalation 5023553 Sterile Gloves 6523544 Suture Removal (Dressing Charges Extra) 7023545 Suturing under LA in OPD / Ward 10023546 Suturing without LA in OPD / Ward 5023547 Tracheostomy Care 7023548 Wall Suction 30

8.1. UoH - AUDIOLOGY AND SPEECH THERAPY23703 AAC-Avaaz 35023957 BOA (Behavioural Observation Audiometry) 25023974 Demonstration Therapy 50023956 Group Speech Therapy (Per Session) 45023964 Hearing Aid Trial 50024326 Home Training Program Level 1 5024327 Home Training Program- Level 2 12024328 Home Training Program- Level 3 20023958 OAE (Oto-Acoustic Emission) 30023702 OPT 50023952 Pure Tone Audiometry 55023965 Speech Assessment Report 25023962 Speech Evaluation 50024324 Speech Therapy - (Major) 45024325 Speech Therapy - (Minor) 25023972 Speech therapy (5 Sessions) 200024549 OPT + Feeding assessment 55024550 NFC Speech assessment 10024551 Speech Therapy - Miscellaneous Major 35024552 Speech Therapy - Counselling 25024553 Report and counselling 500

43


DAYCARE

Rs. Rs. Rs. Rs. Rs.24554 Miscellaneous 15024555 Initial work up + case file 50024556 Follow up visit (show the report) 100

8.2. UoH - AUTISM CLINIC24339 ASD Clinic MSW Consultation 5024338 Autism Clinic Consultation - New 60024355 Autism Clinic Consultation - Old 400

8.3. UoH - CARE ADD24417 Assessment of Specific Function 60024409 Augmentative & Alternative Communication Assessment 30024427 Block Therapy Session ( 3 Sessions) 150024401 Brief Clinical Assessment with Report 150024403 Brief Psychometric Assessment 100024405 Cognitive Assessment 150024415 Cognitive training - Single Session 60024426 Counselling Session / Therapy Session 60024402 Detailed Clinical Assessment with Report 200024404 Detailed Psychometric Assessment 150024412 Group Therapy - Single Session 40024416 Home/School Visit + transport extra 120024413 Individual behaviour therapy - Single Session 50024410 Occupational Therapy Assessment 30024411 Online Therapy - Single Individual Session 50024407 Oro-motor Assessment 30024414 Parent Intervention - Single Session 50024406 Physiotherapy Assessment 30024408 Sensory Profile 60024146 UOH-CARE-ADD Integrated Session 600

8.4. UoH - CHILD PSYCHIATRY24008 Assessment of Intelligence 100024000 Assessment of Specific Function 80024001 Assessment of Specific Learning Disability 90024016 Behavioural Counselling -1 session 50024007 Certificate 30024020 Child Psychotherapy - One session 50024002 Detailed Work- up & Case File 80024003 Detailed Work-up with Report + Case File 89024017 Developmental Assessment - Brief 50024018 Developmental Assessment - Detailed 90024012 Family Therapy (single sessions) 50024006 Letters to School 20024024 Mini Assessment of Autism Spectrum Disorders (1 Session) 150024022 Mini Assessment of Hyperactivity (1 Session) 1000

44


DAYCARE

Rs. Rs. Rs. Rs. Rs.24019 Neuropsychological assessment 125024043 Play Therapy (5 sessions) 100024145 Prolonged Ambulatory EEG 400024014 Psycho Education - One Session 50024144 Routine Ambulatory EEG 200024009 School Visit (Transport Extra) 2000

8.5. UoH - COMDEALL24353 COMDEALL Deatiled Assessment 300024352 COMDEALL EI Monthly Fee 500024351 COMDEALL Individual Therapy Session 50024354 COMDEALL Small Group Therapy 250

8.6. UoH - DENTAL24307 Extraction - Complicated 50024308 Extraction - Decidious, Mobile, Total 10024309 Extraction - Simple 20024316 Filling - Temporary 10024311 Fillings - Amalgam - CL Large 30024310 Fillings - Amalgam - CL Small 25024313 Fillings - Glass Inomer - Large 30024312 Fillings - Glass Inomer - Small 15024314 Fillings - Light Cure - Composite Small 40024315 Fillings - Light Cure Composite Large 70024318 Miracle Mix - Large 30024317 Miracle Mix - Small 15024323 Miscellaneous - 2 50024322 Miscellaneous -1 35024319 Pulpectomy 50024321 Scaling - I 30024320 Scaling - II 700

8.7. UoH - MEDICO SOCIAL WORK24036 Rehabilitation Counselling (Education ) 30024041 Community Participation 30024025 Correspondence 10023716 Facilitating on Disability Certification 30024038 Family and Marital Counseling 35024039 Financial Assistance 15024037 Followup 15024035 Group Therapy (per person) 30024026 Guidance and Counselling (Individual) 30023715 Guidance on Disability Certificate 20024028 Health Education 15024042 Letter to Organisations / Referral Letter 150

45


DAYCARE

Rs. Rs. Rs. Rs. Rs.23717 Liaoning Govt. Advocacy/ Legal Guidance 30024029 Medical Adherence and Reality Orientation 25024304 Networking with NGO’s/ GO’s/ Schools 30024030 Pre- Vocational Counselling 20024040 Psycho- Social Assessment 20024032 School/Work Environment Evaluation 20024033 Socio Economic Assessment 15024031 Visits (Schools/ Home) 25024027 Vocational Counselling 200

8.8. UoH - NEONATAL23605 Booklet on Breast Feeding 8523606 BSID 100023603 Developmental Evaluation (DASII) 15023600 High Risk Neonatal Follow-up 15023602 OAE (Oto-Acoustic Emission) 17523604 Parent Education Material 5523601 ROP Screening 240

8.9. UoH - OPHTHALMOLOGY24306 Functional Vision 25023880 Fundus Examination after Drops 10023903 SquintAssessment 30023907 Vision Therapy - HBVT - Advice + Assessment 25023906 Vision Therapy - OBVT package (5session) 120023905 Vision Therapy - OBVT single session 250

8.10. UoH - ORTHOPAEDICS23625 Aspiration 22023626 Crepe Bandage Service Charges 7524422 CTVE Package 100023630 Dressing Service Charges - Large 15023629 Dressing Service Charges - Medium 13023628 Dressing Service Charges - Small 10023631 Incision & Drainage 15023633 Mantoux Test 1023632 Minor Procedure - in Minor OT 17523634 Plastering / Cast Application - Major 30023635 Plastering / Cast Application - Minor 40023640 Ponsetti Tenotomy Procedure 35023636 Removal of Foreign Body 14023627 Strapping (Chest) 7023637 Suture Removal (Dressing Charges Extra) 7023638 Suturing under LA in OPD / Ward 10023639 Suturing without LA in OPD / Ward 150

46


DAYCARE

Rs. Rs. Rs. Rs. Rs.8.11. UoH - PAEDIATRICS

23704 Counselling - Brief (30-45 Minutes) 30024337 Counselling - Multidisciplinary Team ( > 45 Minutes) 50023705 Detailed work up and Case File 25023707 Developmental and Behavioural evaluation Brief 75024333 Developmental and Behavioural evaluation Detailed 150023706 Developmental Screening 20024336 Medical Report 30024334 Neuromotor assessment – HINE/ Amiel Tison 20024335 Unit of Hope Paed consultation 200

8.12. UoH - PHYSICAL MEDICINE & REHABILITATION23687 Botulinum Toxin Injection Procedure 27523678 Catheterization 10023686 Certificate - Medical 12023675 Dressing Services Charges - Small 10023685 Phenol Block Injection 17523682 POP Application - major 12023681 POP Application - minor 5523680 POP Wedging 5023683 Suture Removal 70

8.13. UoH -PHYSIOTHERAPY CLINIC23692 UoH - Education for the Home Program - Physiotherapy 15023691 UoH - NFC Assessment and Home Program - Physiotherapy 15023690 UoH Physiotherapy Assessment and Treatment for five sessions 140023689 UoH Physiotherapy Assessment and Treatment for one session 300

8.14. UoH - SPECIAL EDUCATION24100 Inpatient Consultation 40024110 SE Assessment (level 1) 150023710 SE Assessment (level 2) 250023711 SE Assessment (level 3) 350024109 SE CommDEALL Assessment (level 1) 100023708 SE CommDEALL assessment (level 2) 200023709 SE CommDEALL assessment (level 3) 300024112 SE Education Material (Medium Set) 10024113 SE Education Material (Mega Set) 15024111 SE Education Material (Mini Set) 5024421 Special Education ADL assessment 10024099 Special Education Case Summary Report 30024420 Special Education Cognitive Screening 10024102 Special Education Consultation 40024424 Special Education Group session 45024418 Special Education Mini-assessment 50024425 Special Education Miscellaneous (Major) 400

47


DAYCARE

Rs. Rs. Rs. Rs. Rs.24419 Special Education Miscellaneous (Minor) 25024330 Special Education Play Based Early Intervention 50024107 Special Education Play Based Early Intervention (5 Session) 250024108 Special Education Screening 400

8.15. UoH - TEAM CLINIC24345 Group therapy (multidisciplinary) 25024346 Integrated therapy session 35024342 IP UoH Team Consultation 50024343 IP/OP UoH Single Consultation 20024341 Unit of Hope Cross Consultation 15024340 Unit of Hope Team Consultation Follow up 50024344 UoH – Multidisciplinary Evaluation Report 300

9. GENERAL PROCEDURES - PEDIATRIC EMERGENCY15300 Aluminium Splint / Inch 60 80 110 130 16015301 Arterial Line 250 350 450 550 65015302 Bandage -Triangular Bandage 30 40 50 70 8015303 Bedside Ultrasound 720 1010 1300 1580 187015304 Bipap (Per Hour) 40 50 60 80 10015305 Bladder Wash 130 190 240 290 34015306 Bowel Wash 130 190 240 290 34015307 Burns Pad 80 120 150 180 21015308 Catheterization 100 140 180 220 26015309 Central Venous Cannulation 360 500 650 790 94015310 Closed Reduction Pediatric 720 1010 1300 1580 187015311 Crape Bandage 60 80 110 130 16015312 Cross Consultation IP - Pediatric Emergency 50 150 250 400 50015313 Defibrillator 220 310 400 480 57015314 Dressing - Each Bandage 60 90 110 140 16015315 Dressing - Pad and Bandage 100 140 180 220 26015316 Dressing - Service Charges - Large 150 210 270 330 39015317 Dressing - Service Charges - Medium 130 190 240 290 34015318 Dressing - Service Charges - Small 100 140 180 220 26015319 Dynaplaster for IV 10 10 10 10 1015320 ECG 180 260 330 400 47015321 Electrolytes - EMS 210 300 380 470 55015322 Enema 75 110 140 170 20015323 Extubation 20 40 50 50 6015324 Glucometer Random Blood Sugar 70 100 130 160 19015325 ICD Insertion 210 300 380 470 55015326 Incision and Drainage 150 210 270 330 39015327 Infusion Pump (Per Day) 210 300 380 470 55015328 Intervenous Cannulation 50 70 80 110 12015329 Intramuscular Injection 25 40 50 60 70

48


DAYCARE

Rs. Rs. Rs. Rs. Rs.15330 Intubation (Endotracheal) 240 340 430 530 62015331 IV Fusion 75 110 140 170 20015332 Ketostick 60 80 110 130 16015333 Lumbar Puncture 250 350 450 550 65015334 Monitoring 150 210 270 330 39015335 Narcotic Injections 25 40 50 60 7015336 Nasal Packing 80 110 140 180 21015337 Nebulization 100 140 180 220 26015338 Oxygen inhalation (Per Hour) 100 140 180 220 26015339 Plastering - Major 250 350 460 550 66015340 Plastering - Minor 210 300 380 470 55015341 Pleural Aspiration 220 310 400 480 57015342 POP 10 cm 70 100 120 140 17015343 POP 15 cm 140 200 260 310 37015344 Professional Charge 140 200 260 310 37015345 Removal of Foreign Body 140 200 260 310 37015346 Ryles Tube Introduction 30 40 50 70 8015359 Service Charge -POP Application 50 70 80 110 12015360 Service Charge -Subcutaneous Injection 25 40 50 60 7015358 Service Charge-Gastric AFB Aspiration 30 40 50 70 8015347 Steam Inhalation 50 70 90 110 13015348 Stomach Wash - Routine 80 110 140 180 21015349 Stomach Wash for Poisoning 300 420 540 660 78015350 Suture Removal in Pediatric Emergency 70 100 130 160 19015351 Suturing in OT 860 1200 1550 1880 223015352 Suturing with Suture Set 160 220 280 350 41015353 Thomas Splint 650 910 1160 1430 168015354 Tracheostomy Care 70 100 130 160 19015355 Tracheostomy in Pediatric Emergency 290 410 520 640 74015356 Triangular Sling 70 70 70 70 7015357 Wall Suction 30 40 50 70 80

B. SPECIALISED PROCEDURES1. SPECIALISED PROCEDURES - CARDIOLOGY1.1. NON-INVASIVE DIAGNOSTICS

00408 24hrs Amb.Blood Pressure Monitoring 1100 1500 2000 2400 290000425 Bedside Screening Echo 300 400 500 700 80000499 Contrast ECHO 2000 2800 3600 4400 520000450 Cross Consultation IP-Cardiology 50 150 250 400 50000410 Dobutamine Stress Echocardiogram 3600 3600 3600 4400 520000401 Echocardiography - Adult * 1400 1960 2520 3080 364023610 File Charges 50 50 50 50 5000403 Holter Monitoring - Adult* 1850 2590 3330 4070 481000460 INR (Cardio) 300 300 300 350 400

49


DAYCARE

Rs. Rs. Rs. Rs. Rs.00461 NT-Pro BNP 1620 1860 2110 2350 259024504 Rotablation 15000 21000 27000 33000 3900000402 Stress Test / TMT - Adult * 1650 2310 2970 3630 429000405 Transoesophageal Echocardiography - Adult 1800 2520 3240 3960 468000498 Troponin-I - CCU 900 1300 1600 2000 2300

1.2. INVASIVE PROCEDURES00409 Foreign Body Removal (Intravascular) 8000 11200 14400 17600 2080000487 IABP Insertion Charges 9000 12600 16200 19800 2340000475 Pericardial Tapping 3000 5000 6000 7000 8000

(Ballon Charges Extra)1.3. INVASIVE DIAGNOSTICS - PACKAGES

24501 ACT 200 300 400 400 50000411 Coronary Angiography (Package) 10000 14000 18000 22000 2600000406 Coronary Graft Angiogram 12000 16800 21600 26400 3120000412 Diagonostic Catheterization Aortogram 7000 9800 12600 15400 1820000413 Electro Physiological Study 12000 16800 21600 26400 3120024502 Fluroscopy 500 700 900 1100 130000426 Peripheral Angiogram (Package) 9000 12600 16200 19800 2340000464 Renal/ Mesenteric / Other Angiogram 8000 11200 14400 17600 2080000419 Right Heart Catheter.(Includes Oxygen Saturation) 6000 8400 10800 13200 15600

Note: The above include only procedure charges. All other charges including temporary lead will be extraPACING

00428 AICD 37400 52400 67300 82300 9720000489 Biventricular Pace Maker Implantation 65000 91000 117000 143000 16900000427 Dual Chamber Pacing 30000 42000 54000 66000 7800000440 ECG with Magnet 230 330 420 510 60000429 Pacemaker Interrogation 500 500 500 500 50000421 Pacing - Permanent 20000 28000 36000 44000 5200000470 Pacing - Temporary * 2500 3500 4500 5500 6500

Note: The Cost of Biventicular Pacemaker will be Extra1.4. NON-CORONARY INTERVENTIONS - PACKAGES

00436 Aortic Endovascular Intervention 37400 52400 67300 82300 9720000452 ASD/VSD Closure 25000 35000 45000 55000 6500000448 Balloon Valvulplasty (half harge) 12400 17400 22300 27300 3220000434 Bronchial Artery Embolization 10000 20000 30000 40000 5000000424 Chemoport Implantation 6200 8700 11200 13600 1610000438 IVC Filter Implantation 8000 11200 14400 17600 2080000433 Non Coronary Cardiac Balloon Intervention 25000 35000 45000 55000 6500000430 PDA Closure 10000 14000 18000 22000 2600000432 Peripheral Angioplasty 20000 28000 36000 44000 5200000446 Peripheral Angioplasty (half charge) 10000 14000 18000 22000 2600000435 Peripheral Stenting 16000 22400 28800 35200 4160000439 Re - Synchronization Therapy (dual chamber) 37400 52400 67300 82300 97200

50


DAYCARE

Rs. Rs. Rs. Rs. Rs.00431 Septostomy/ Embolization/ Swanganz 5000 7000 9000 11000 13000

1.5. CORONARY INTERVENTIONS -PROCEDURES (Catheter LAB)24508 Emergency Coronary Stenting 80000 112000 144000 176000 20800024507 Emergency Coronary Angiogram 20000 25000 30000 35000 4000024510 FFR + Coronary Stenting 80000 105000 130000 150000 20000024511 FFR without Coronary Stenting 30000 35000 45000 50000 6000024506 IVUS 35000 40000 45000 50000 5500024509 IVUS Guided Coronary Stenting 90000 115000 140000 150000 205000

1.6. CORONARY INTERVENTIONS - PACKAGES00451 CD Recording Charges 500 500 500 500 50000449 Cor.Sep.Emboln.for HOCM 52400 73400 94300 115300 13620000445 Complex Angioplasty 82000 120000 150000 180000 22000000444 Coronary Angioplasty (Half Charge) 28000 39200 50400 61600 7280000471 Coronary Angioplasty (POBA) 50000 70000 90000 110000 13000000472 Coronary Stenting 65000 91000 117000 143000 16900000473 Direct Stenting (PTCA charges) 40000 55000 70000 90000 12500000477 I V C Filter Retrieval 6500 9100 11700 14300 1690023528 IABP Charges Per Day (Catheterlab / CCU) 1000 1400 1800 2200 260000476 Renal Stenting / IVC Stenting / Other Peripheral Stenting 22000 30800 39600 48400 57200

Note: All Angioplasty charges are not inclusive of stents and CD Recording.* 100% concession for staff & dependants50% concession for staff & dependants (for all Catheterlab Procedures)1.7. ANAESTHESIA CHARGES

00494 Anaesthesia for Coronary Intervention 1500 2100 2700 3300 390000500 General Anaesthesia for Catheter.lab Procedures/

Cardiac Catheterization Procedure 1500 2100 2700 3300 390000491 Monitored Anaesthesia Care for Cardiac Catheter.lab 700 980 1260 1540 1820

CONDITIONS OF PACKAGE DEALAll categories include professional and treatment charges and visiting fee. Rest of the conditions are as detailed below

Procedure Include Does notincludeDiagnosis 2 Days Stay Any Other Drugs

All Pre Cath investigations (HB, TC, DC, Platelets, Urea, Sr Creatinine, Any Other ProcedureSr Electrolytes, HIV, HbsAg, Blood Grouping, RBS, PT, INR) Special InvestigationsVenflon 20g, Disposable Syringe 2 CC/5CC/10CC, Normal Saline / DNS 500 ml DietInfusion Set, 3 Way Stop Cock, Disposable Cap, Vauctiner EDTA 2 ml,Vacutainer Gel, Contrast upto 100 ml (Urografin)ECG x 2, Chest X-Ray, CCU for 24 hours if necessaryInj.Avil 1 amp, Inj. Hyderocortisone 1 ampRefreshments for Pvt. Ward patients after Procedure

Pacing Any Other DrugsPermanent All Coronary Angiogram investigations Any Other Procedure

Tegaderm x 1, Mersilk Suture, Inj. Reflin 1gm - 3 vial, Wycril 3.0 Special InvestigationsCost of PacemakerDiet

Coronary 3 days stay, including one day in CCU, Cost of stent Echo/Interventions / All Coronary Angiogram investigations Stress test

51


DAYCARE

Rs. Rs. Rs. Rs. Rs.Non-Coronary CK, CKMB x 2, ECG x 4, Contrast upto 200 ml (Urografin) Investigations

Interventions Disposable Syringe 5CC/10CC, Gloves, Serum Gel, Serum Plain Special HardwareGel tube, EDTA, Venflon 20g, NS 500ml, IV SetRoutine Angioplasty Hardware and one Balloon. If more than one balloon or other hardware is used, the same will be charged extra.Our pharmacy bill will be the supporting document for the extra hardware. Incase of failed Angioplasty unless special hardwares usedhalf charges will be charged to cover the cost of hardware and surgery will be charged as per package.

1.8 PAEDIATRIC CARDIOLOGY PROCEDURE *23511 ASD Device 20000 28000 40000 60000 8000023513 BAV 16000 22400 32000 48000 6400023515 BMV 16000 22400 32000 48000 6400023514 BPV 16000 22400 32000 48000 6400023518 Branch PA Plasty 16000 22400 32000 48000 6400023516 BTV 16000 22400 32000 48000 6400023507 Cardiac Catheter Congenital Heart Catheter 8000 11200 16000 24000 3200023517 Coarctation Plasty 16000 22400 32000 48000 6400023502 Fetal Echocardiogram 2500 2500 2500 3250 400023504 Intra OP/Emergency Echo 3000 3000 3000 3900 480023499 Paediatric Cardiology Cross Consultation 400 400 400 400 40023501 Paediatrics Echocardiogram - Complex 2000 2000 2000 2600 320024500 Paediatrics Echocardiogram - Simple 1200 1200 1200 1560 192023508 PAH Study Catheter 9000 12600 18000 27000 3600023509 PDA Coil 16000 22400 32000 48000 6400023510 PDA Device 20000 28000 40000 60000 8000023505 Stress Test - Paediatric 2500 2500 2500 3250 400023503 Transoesophageal Echocardiography - Paediatric 2500 2500 2500 3250 400023512 VSD Device 23000 32200 46000 69000 92000

1.9 ELECTRO PHYSIOLOGY STUDY PROCEDURE23524 3D Mapping 45000 63000 81000 99000 11700023521 EP Study (Electrophysiology Study) 15000 21000 27000 33000 3900023523 Radiofrequency Ablation (Complex) 30000 42000 54000 66000 7800023522 Radiofrequency Ablation (Simple) 20000 28000 36000 44000 5200023525 Renal Denervation 40000 56000 72000 88000 104000

* does not include implants

2. SPECIALISED PROCEDURES - DENTAL2.1. DENTAL SURGERY

02048 Acrylic dentures imported U/L 7000 7000 7000 7000 700000502 Alveolectomy (Per Quadrant) 1300 1300 1300 1300 130000503 Alveolectomy Full Jaw - Upper And Lower 2500 2500 2500 2500 250000501 Alveoloplasty - Simple 700 700 700 700 70002045 Apexification 3000 3000 3000 3000 300000506 Apicectomy - Single Tooth 3000 3000 3000 3000 300002050 Begg Retainer 2500 2500 2500 2500 2500

52


DAYCARE

Rs. Rs. Rs. Rs. Rs.00507 Biopsy Under L.A. 400 400 400 400 40002042 Bone Graft Large 2000 2000 2000 2000 200002041 Bone Graft Small 1000 1000 1000 1000 100002049 BPS Dentures upper or lower 13000 13000 13000 13000 1300000617 Breakage Repair (Single Bracket) 700 700 700 700 70000574 Cast Post & Core Pin 1250 1250 1250 1250 125000560 Ceramic Crown 4000 4000 4000 4000 400000542 Complete Dentures - Upper And Lower (Package Include) - Ordinary 6500 6500 6500 6500 650000543 Complete Dentures - Upper Or Lower - Ordinary 4500 4500 4500 4500 450000697 Cross Consultation Ip - Dental Surgery 50 150 250 400 50000504 Crown And Bridge - Acrylic Crown 1000 1000 1000 1000 100000528 Curettage Per Quadrant 1500 1500 1500 1500 150002039 Cyst Enucleation 3000 3000 3000 3000 300000512 Extraction - Bony Impaction 3000 3000 3000 3000 300000510 Extraction - Complicated 1000 1000 1000 1000 100000508 Extraction - Decidious, Mobile, Total 200 200 200 200 20000511 Extraction - Impactions Soft Tissues 1500 1500 1500 1500 150000509 Extraction - Simple 500 500 500 500 50000513 Extraction - Total Extraction 2500 2500 2500 2500 250000622 Fibre Post (each) 1500 1500 1500 1500 150000518 Fillings - Glass Inomer I 400 400 400 400 40000581 Fillings - Glass Inomer II 700 700 700 700 70000522 Fillings - Light Cure - Composite Small 700 700 700 700 70000523 Fillings - Light Cure Composite Large 1500 1500 1500 1500 150000520 Fillings - Temporary 200 200 200 200 20000516 Filllings - Amalgam - CL I 500 500 500 500 50000517 Filllings - Amalgam - CL II 700 700 700 700 70000524 Flap (Localised) 1500 1500 1500 1500 150000525 Flap (Per Quadrant) 3500 3500 3500 3500 350000526 Flap with Bone Graft 3500 3500 3500 3500 350000634 Frenectomy 2000 2000 2000 2000 200000527 Gingivectomy (Per Quadrant) 1500 1500 1500 1500 150000569 Impaction Canine 3000 3000 3000 3000 300000532 Inter Maxillary Wiring under GA 1540 1540 1540 1540 154000535 Intra Oral Space Maintainer 1000 1000 1000 1000 100000536 IO X - ray - Occlusal 250 250 250 250 25000537 IO X - ray - Periapical 200 200 200 200 20000577 Miracle Mix - I 350 350 350 350 35000578 Miracle Mix - II 700 700 700 700 70002043 Miscellaneous I 500 500 500 500 50002044 Miscellaneous II 1000 1000 1000 1000 100002052 MTAApexification Large 4000 4000 4000 4000 400002051 MTAApexification Small 3000 3000 3000 3000 3000

53


DAYCARE

Rs. Rs. Rs. Rs. Rs.02038 Mucocele Excision 1500 1500 1500 1500 150000558 Nickel Cromium Full Crown 2500 2500 2500 2500 250000573 Obturator Definitive 1500 1500 1500 1500 150000572 Obturator Interim 500 500 500 500 50000571 Obturator Surgical 500 500 500 500 50002046 Ortho Implant Placement 2000 2000 2000 2000 200000635 Polishing 300 300 300 300 30000554 Pulpectomy 1000 1000 1000 1000 100000540 Recementing of Crowns 500 500 500 500 50000541 Refacing of Bridge 300 300 300 300 30000544 Removable Partial Dentures - Additional Tooth 300 300 300 300 30000545 Removable Partial Dentures - Single Tooth 800 800 800 800 80000546 Repair of Dentures (Complicated) 800 800 800 800 80000550 Repair of Dentures (Selective Grinding) 300 300 300 300 30000551 Repair of Dentures (Simple) 300 300 300 300 30000621 Repeat Anterior Root Canal Treatment 3500 3500 3500 3500 350000620 Repeat Posterior Root Canal Treatment 4500 4500 4500 4500 450000552 Root.can.Treat. Anterior Tooth without X-Ray 2500 2500 2500 2500 250000553 Root.can.Treat. Posterior Tooth with out X-Ray 3000 3000 3000 3000 300000555 Scaling - I 1500 1500 1500 1500 150000556 Scaling - II 750 750 750 750 75000698 Single Sitting RCT Anterior 2500 2500 2500 2500 250000699 Single Sitting RCT Posterior 3500 3500 3500 3500 350002040 Socket Preservation 500 500 500 500 50002047 Splinting Tooth 1500 1500 1500 1500 150000570 Surgical Exposure of Tooth - Simple 700 700 700 700 70002053 Surgical exposure of tooth complicated 2000 2000 2000 2000 200000636 Suture Removal 200 200 200 200 20000580 Temporary Crown 700 700 700 700 700

2.2. ORTHODONTICS02018 2 x 4 Appliances 12000 12000 12000 12000 1200002024 Activator 7500 7500 7500 7500 750002025 Activator with Head Gear 10000 10000 10000 10000 1000002054 Begg Retainer 7000 7000 7000 7000 700002023 Bracket / Band - First 3 Months / Breakage 600 600 600 600 60002021 Buttons / Begg Bracket for Habit Breaking 1000 1000 1000 1000 100002012 Coffin Spring Appliance 2500 2500 2500 2500 250002055 Deprogramming Appliance 5000 5000 5000 5000 500002002 Feeding Plates 2000 2000 2000 2000 200002034 Fluoride Applications 500 500 500 500 50002027 Frankel Appliance 15000 15000 15000 15000 1500002013 Habit Breaking Appliance 2500 2500 2500 2500 250002014 Habit Breaking Appliance - Fixed 5000 5000 5000 5000 5000

54


DAYCARE

Rs. Rs. Rs. Rs. Rs.02015 Habit Breaking Appliance - Removable 5000 5000 5000 5000 500002028 Hybrid Appliance 1 with Buccal Shield 15000 15000 15000 15000 1500002022 II Phase Treatment for Class II and Class III 45000 45000 45000 45000 4500000601 Impressions 400 400 400 400 40002056 LBR 3000 3000 3000 3000 300002005 Lingual Arch 6000 6000 6000 6000 600002001 NAM 6000 6000 6000 6000 600002009 Oral Screen 5000 5000 5000 5000 500000618 Orthodontic Checkup for Outside Patient 500 500 500 500 50000619 Orthodontic Procedure for Outside Patient 1000 1000 1000 1000 100000690 Orthodontic Treatment - Complex 45000 45000 45000 45000 4500000691 Orthodontic Treatment - Complicated 55000 55000 55000 55000 5500000689 Orthodontic Treatment - Simple 25000 25000 25000 25000 2500000694 Over Denture - 2 Implants & Denture Single 55000 55000 55000 55000 5500002032 Pit & Fissure Sealant 600 600 600 600 60002019 Pre - Prosthetic Appliances 12000 12000 12000 12000 1200002003 Quad Helix 6000 6000 6000 6000 600002006 RME 10000 10000 10000 10000 1000002020 Screw Based Appliances 12000 12000 12000 12000 1200002011 Space - Regainers 5000 5000 5000 5000 500002017 Space Maintainers - Removable 2500 2500 2500 2500 250002010 Space Maintainers - Unilateral Fixed 3000 3000 3000 3000 300002033 Stainless Steel Crown 1000 1000 1000 1000 100000692 Surgical Cases Package 75000 75000 75000 75000 7500002016 Tongue Thrust Correction - Soldered 5000 5000 5000 5000 500002004 TPA 6000 6000 6000 6000 600002026 Twin Block 15000 15000 15000 15000 1500002007 Upper Expansion Appliance 5000 5000 5000 5000 500002008 Upper Z Spring Appliance 5000 5000 5000 5000 5000

2.3. PROSTHODONTICS02036 Apexification 2500 3500 4500 5500 650000626 Acrylic Dentures - Imported 12000 12000 12000 12000 1200000623 All Ceramic Crowns-Single Unit 9000 9000 9000 9000 900000627 BPS Dentures/Injection Moulded Dentures 24000 24000 24000 24000 2400000625 Cast Partial Dentures 14000 14000 14000 14000 1400000632 Confirmer - Complicated 1000 1000 1000 1000 100000631 Confirmer - Simple 1000 1000 1000 1000 100002030 Hybrid Denture - Single 4 Implants Denture 100000 140000 180000 220000 26000002029 Hybrid Denture 8 Implants U/L Denture 200000 280000 360000 440000 52000000696 Implant Prosthesis Phase 11000 11000 11000 11000 1100000695 Implant Surgical Phase 13000 13000 13000 13000 1300000629 Maxillofacial Prosthese - Simple 1500 1500 1500 1500 150000630 Maxillofacial Prothesis - Complicated 3000 3000 3000 3000 3000

55


DAYCARE

Rs. Rs. Rs. Rs. Rs.00633 Night Guard 1500 1500 1500 1500 150002031 Over Denture - 4 Implants & Denture U/L 100000 140000 180000 220000 26000000628 Semi Regid Dentures / Single Arch 10000 10000 10000 10000 1000002035 Semi Regid Harf Arch - Denture 7000 7000 7000 7000 700000624 Ziconia Crowns-Single Unit 11000 11000 11000 11000 11000

3. SPECIALISED PROCEDURES - DERMATOLOGYACNE SURGERIES

14002 Acne scar revision – subscision (<5) (x 3 package) 2000 2000 2000 2000 200014003 Acne scar revision - Subscision (5 – 10) (x 3 package) 3000 3000 3000 3000 300000755 Acne Scar Revision (per sitting) Subscission-(< 5) 1000 1000 1000 1000 100000817 Acne Scar Revision per sitting Subscission-(5-10) 1500 1500 1500 1500 150000848 Dermaroller 1500 1500 1500 1500 150014001 Dermaroller (x 3 package) 4000 4000 4000 4000 400000793 Microdermabrasion - Large Area (per sitting) 1500 1500 1500 1500 150000782 Punch Elevation (Per Scar) 500 500 500 500 500

ALLERGY00701 Allergic Prick Test - 0-10 Allergens 500 500 500 500 50000702 Allergic Prick Test - 10-20 Allergens 1000 1000 1000 1000 100000703 Allergic Prick Test - Above 20 Allergens 2000 2000 2000 2000 200000841 Patch Test - Footwear Series 1000 1000 1000 1000 100000728 Patch Test for Skin allg.- Additional per allergen 150 150 150 150 15000835 Patchtest Indian Standard Series 2000 2000 2000 2000 2000

CHEMICAL CAUTERY00705 Chemical Cautery 300 300 300 300 300

COMEDONE/MILIA EXTRACTION00777 Comedone Extraction (< 10) 500 500 500 500 50000778 Comedone Extraction (> 10) 1000 1000 1000 1000 1000

CRYOTHERAPY00743 Cryotherapy Large (>10) 1000 1000 1000 1000 100000812 Cryotherapy Medium (4-10) 500 500 500 500 50000710 Cryotherapy Small (1-3) 300 300 300 300 30014006 Cryotherapy Small (x 3 Package) 600 600 600 600 60014007 Cryotherapy Medium (x 3 Package) 1000 1000 1000 1000 100014008 Cryotherapy Large (x 3 Package) 2000 2000 2000 2000 2000

DRESSING00788 Dressing Service Charges - Large 250 250 250 250 25000786 Dressing Service Charges - Small 150 150 150 150 150

ELECTROCAUTERY00843 Electro Cautery - DPN or Tag - Small (<5) 600 600 600 600 60000846 Electro Cautery - DPN or Tag Extra Large (20-30) 3000 3000 3000 3000 300000845 Electro Cautery - DPN or Tag Large (10-20) 1500 1500 1500 1500 150000844 Electro Cautery - DPN or Tag Medium (5-10) 1000 1000 1000 1000 100000712 Electro Cautery - Small < 5 400 400 400 400 400

56


DAYCARE

Rs. Rs. Rs. Rs. Rs.00714 Electro Cautery -Large (10 -20 Warts) 1200 1200 1200 1200 120000713 Electro Cautery Medium (5-10 Warts) 800 800 800 800 800

ILS00739 Skin Intralesional Injection - Large 500 500 500 500 50000847 Skin Intralesional Injection - PPD 300 300 300 300 30000737 Skin Intralesional Injection - Small (5X5 Cms) 300 300 300 300 300

KELOID SURGERIES00850 Keloid Surgery - Large 700 700 700 700 70000849 Keloid Surgery - Small (upto 3 Small Lesions) 400 400 400 400 40014004 Keloid surgery small (x 3 package) 600 600 600 600 60014005 Keloid surgery Large (x 3 package) 1200 1200 1200 1200 1200

LASER00857 Ablative Laser Cosmetic Indication (< 5 Lesions) 4000 4000 4000 4000 400000858 Ablative Laser Cosmetic Indication (5 - 10 lesion) 8000 8000 8000 8000 800000860 Ablative Laser Medical Indication 6000 6000 6000 6000 600000859 Ablative Laser Medical Indication (3x3 cm) 3000 3000 3000 3000 300000884 Ablative Laser Small (<1x1 cm/ Test Spot) 1500 1500 1500 1500 150000865 Laser Hair Removal - Axilla (both) or Lower Abdomen 3000 3000 3000 3000 300000878 Laser Hair Removal - Axilla (both) or Lower Abdomen (x 3 package) 6000 6000 6000 6000 600000863 Laser Hair Removal - Full Face 4000 4000 4000 4000 400000876 Laser Hair Removal - Full Face (x 3 package) 8000 8000 8000 8000 800000864 Laser Hair Removal - Legs(Both) or Thighs(Both) or UL (both) 5000 5000 5000 5000 500000877 Laser Hair Removal - Legs(Both) or Thighs(Both) orUL (Both) x 3 Package 10000 10000 10000 10000 1000000862 Laser Hair Removal - Submental or Sideburns or Cheeks or Pre-Sternal 2000 2000 2000 2000 200000875 Laser Hair Removal - Submental or Sideburns or Cheeks or

Pre-Sternal (x 3 package) 4000 4000 4000 4000 400000886 Laser Hair Removal - Upper Back or Lower Back 4000 4000 4000 4000 400000887 Laser Hair Removal - Upper Back or Lower Back (x3 Package) 10000 10000 10000 10000 1000000861 Laser Hair Removal - Upper Lip or Chin - (Small) or Ears 1500 1500 1500 1500 150000874 Laser Hair Removal - Upper Lip or Chin - (Small) or Ears (x 3 package) 3000 3000 3000 3000 300000838 Laser PIXEL Large ( > 5X5Cms) 5000 5000 5000 5000 500000866 ND Yag (Large) 3000 3000 3000 3000 300000883 ND Yag (Small) (<5 cm/ Test Spot) 1500 1500 1500 1500 150000867 Pigment and Vascular Laser (< 5 cm) 1500 1500 1500 1500 150000868 Pigment and Vascular Laser (> 5 cm) 3000 3000 3000 3000 300000856 Pixel Laser Small (< 5x5cm) 3000 3000 3000 3000 300000831 Skin Rejuvinaton / Toning Full Face 1500 1500 1500 1500 150014016 Laser (Pixel) Large (> 5 x 5 cm) (x 3 Package) 10000 10000 10000 10000 1000014017 Laser (Pixel) Small (< 5 x 5 cm) (x 3 Package) 6000 6000 6000 6000 600014018 ND – YAG (Pigmentation & Tattoo removal) (X 3 Package) 6000 6000 6000 6000 600014019 Laser Hair removal – Axilla (both) or lower abdomen (x 6 Package) 8000 8000 8000 8000 800014020 Laser hair removal – upper lip or chin (small) or Ears (x 6 Package) 5000 5000 5000 5000 5000

57


DAYCARE

Rs. Rs. Rs. Rs. Rs.14021 Laser hair removal submental or sideburns (x 6 package) 6000 6000 6000 6000 600014022 Laser hair removal Full face (x 6 Package) 14000 14000 14000 14000 1400014023 Laser hair removal Legs (both) or thigh (both) (x 6 Package) 16000 16000 16000 16000 1600014024 Ablative laser small (3 x 3cm or < 5 lesions) (x 3 Package) 7000 7000 7000 7000 700014025 Ablative laser Large (more than 3 x 3cm or 5 – 10 lesions) (x 3 Package) 15000 15000 15000 15000 15000

MOLLUSCUM00709 Curettage of Molluscum Contagiosum - > 10 1000 1000 1000 1000 100000707 Currettage of Molluscum Contagiosum - < 5 400 400 400 400 40000842 Currettage of Molluscum Contagiosum - 5-10 600 600 600 600 600

PARING CHARGES00814 Paring ( Large) 400 400 400 400 40000726 Paring (Small) 200 200 200 200 200

PEELS00880 Chemical Peel - Arms 2000 2000 2000 2000 200000879 Chemical Peel - Back 3000 3000 3000 3000 300014015 Chemical Peel ( x 3 Package) 4000 4000 4000 4000 400000853 Chemical Peel (Salicylic Acid) 1500 1500 1500 1500 150000797 Chemical Peels (Neostrata) 1500 1500 1500 1500 150000798 Chemical Peels (TC) 1500 1500 1500 1500 150000855 Combination Chemical Peel 2000 2000 2000 2000 200000854 Peel Service Charge(Own Peel) 1000 1000 1000 1000 100000836 Spot Peel 1000 1000 1000 1000 100000837 TCA Cross 1000 1000 1000 1000 1000

PHOTOTHERAPY14011 Hand & Foot PUVA (x 10 Package) 900 900 900 900 90014013 Hand & Foot Narrow Band UVB (x 10 Package) 1300 1300 1300 1300 130000827 Hand & Foot Phototherapy nBUVB 150 150 150 150 15000826 Hand & Foot Phototherapy PUVA 100 100 100 100 10014014 Narrow Band UVB ( x 10 Package) 1800 1800 1800 1800 180000758 Narrow Band UVB (per sitting) 200 200 200 200 20014012 PUVA (x 10 Package) 1300 1300 1300 1300 130000744 PUVA Therapy 150 150 150 150 15000882 Targeted Phototherapy 350 350 350 350 350

PRP00840 PRP (Cosmetic indications) 3000 3000 3000 3000 300000839 PRP (Medical indications) 500 500 500 500 50014009 PRP Medical Indication (x 3 Package) 1000 1000 1000 1000 100014010 PRP Cosmetic Indication (x 3 Package) 6000 6000 6000 6000 6000

RADIOFREQUENCY00810 Radiofrequency Ablation - Large (10-15cm or 10-20 DPNs/Tags) 2000 2000 2000 2000 200000809 Radiofrequency Ablation - Medium (5 - 10cm or 5-10 DPNs/Tags ) 1500 1500 1500 1500 1500

58


DAYCARE

Rs. Rs. Rs. Rs. Rs.00808 Radiofrequency Ablation - Small (< 5cm or < 5 DPNs/Tags) 1000 1000 1000 1000 1000

VITILIGO SURGERIES00825 Autologus Melanocyte Transfer - (10X10 Cms) 8000 8000 8000 8000 800000819 Blister grafting (Extra Large > 5 Blister) 5000 5000 5000 5000 500000784 Blister Grafting (Large - 4 Blister) 3000 3000 3000 3000 300000851 Blister Grafting <3 Laser Assisted 5000 5000 5000 5000 500000852 Blister Grafting>3 Laser Assisted 7000 7000 7000 7000 700000753 Punch Grafting for Vitiligo - Medium (10-20) 3000 3000 3000 3000 300000795 Punch Grafting for Vitiligo - Small (1 - 10) 1500 1500 1500 1500 1500

MISCELLANEOUS00774 Botx Injection 1000 1000 1000 1000 100000881 Cross Consultation IP - Dermatology 50 150 250 400 50000785 Dermabrassion (Manual) 350 350 350 350 35000711 DNCB Test 300 300 300 300 30000790 Ear Lobe Repair - Surgical (per ear) 2000 2000 2000 2000 200000715 Electrolysis (per sitting) 700 700 700 700 70000872 Fillers 1000 1000 1000 1000 100000723 Fungal Scraping (KOH) 100 100 100 100 10000759 Skin Lab - Outside Reference 500 500 500 500 50000870 Hair Transplantion - Base Charge 2000 2000 2000 2000 200000871 Hair Transplantion - Per Graft 20 20 20 20 2000779 Incision & Drainage - Abscess (Small) 300 300 300 300 30000806 KOH Multiple Sites 150 150 150 150 15000725 Lontophoresis (per sitting) 200 200 200 200 20000719 MCR Sandal (1 pair ) NLRU 350 350 350 350 35000716 MCR Sandal (1 pair) LRU Pt. 240 240 240 240 24000717 MCR Sheet (1) - 8mm LRU Pt. 65 65 65 65 6500720 MCR Sheet (1) 3mm NLRU 100 100 100 100 10000721 MCR Sheet (1) 8mm NLRU 150 150 150 150 15000718 MCR Slipper (1 pair) LRU Pt. 240 240 240 240 24000722 MCR Slipper (1pair) NLRU 300 300 300 300 30000885 Nail Avulsion (per nail) 1500 1500 1500 1500 150000781 Nail Biopsy 1000 1000 1000 1000 100000873 Podophyllin Application - Large 500 500 500 500 50000733 Podophyllin for Warts - Small 300 300 300 300 30000735 Pus Smear (Gram Stain) 100 100 100 100 10000869 Sclerotherapy 500 500 500 500 50000815 Skin Biopsy 700 700 700 700 70000740 Smear for Lepra Bacillus (AFB) 100 100 100 100 10000741 Smear for TV/ Monilia 100 100 100 100 10000775 Surgical Excision 1200 1200 1200 1200 120000746 Tattooing (Per sitting) 420 420 420 420 420

59


DAYCARE

Rs. Rs. Rs. Rs. Rs.00757 Trichogram (Hair test) 500 500 500 500 50000742 Tzank Smear 100 100 100 100 10000764 Urine Albumin 50 50 50 50 5000763 Urine Albumin, Sugar, Micro 150 150 150 150 15000765 Urine Sugar 50 50 50 50 50

4. SPECIALISED PROCEDURES - ENDOCRINOLOGY02870 ACTH stimulation 200 275 350 430 50002996 Biothesimeter 50 80 100 120 15002819 Cardiac Autonomic Neuropathy Analyzer 300 420 540 660 78002821 Endocrinology -Cross Consultation IP 50 150 250 400 50002820 Digital Fundus Camera facilty per usage 100 140 180 220 26002997 File Charges 50 50 50 50 5002995 Periscope 350 500 630 800 100002890 PODO I MAT 150 210 270 330 3904516 Diabetes Complication Screening Tests Package (including Periscope,

PODO I MAT,VPT (Biothesimeter),Senstometer HCP, Digital Fundus per Usage) 450 630 810 990 117002869 Sensitometer HCP 100 100 125 175 200

5. SPECIALISED PROCEDURES - ENTAudiology

00987 Aided Audiometry 300 420 540 660 78000993 Audiology - Counselling 100 140 180 220 26000992 Audiology Special Test 350 490 630 770 91002154 Auditory Late Latency Response (ALLR) 1150 1610 2070 2530 299000940 BAER - Repeat within 6 months 1150 1610 2070 2530 299000939 BERA- Differential Diagnosis 2000 2800 3600 4400 520000938 BERA- Threshold Estimation 2000 2800 3600 4400 520000944 Behavioural Observation Audiometry 250 350 450 550 65002116 Bone Conduction - Auditory Brainstem Response (BC-ABR) 1150 1610 2070 2530 299000950 Computerised Speech Assesment 350 490 630 770 91002125 Cross Consultation IP Audiology 50 150 250 400 50002123 Ear Impression taking Per Ear 400 560 720 880 104000994 Evaluation Report 200 280 360 440 52002112 Fine tuning of hearing aid (Per Visit). 300 420 540 660 78002109 Hearing Aid Trial (one session) 500 700 900 1100 130002110 Hearing Aid Troubleshooting. 100 140 180 220 26002115 Hearing Screening - Follow -up 100 140 180 220 26000986 High Frequency Audiometry 550 770 990 1210 143000991 Impedance Audiometery (Unilateral) 350 490 630 770 91000919 Impedance Audiometry 550 770 990 1210 143000920 Long Term Speech Therapy (Per Sitting) 350 490 630 770 91002114 Oto Acoustic Emission (Unilateral) 400 560 720 880 104000988 Oto Acoustic Emission Test 700 980 1260 1540 1820

60


DAYCARE

Rs. Rs. Rs. Rs. Rs.00923 Pure Tone Audiogram 550 770 990 1210 143000924 Pure Tone Audiogram - Repeated within 3 months 350 490 630 770 91002113 Real Ear Measurement. 800 1120 1440 1760 208002108 Screening ABR 1100 1540 1980 2420 286002107 Screening OAE 300 420 540 660 78000926 Speech Evaluation and Therapy/Audiological Consultation 300 420 540 660 78002130 Swallowing Assessment 200 280 360 440 52002131 Swallowing Therapy 250 350 450 550 65002153 Vestibular Evoked Myogenic Potential 2000 2800 3600 4400 5200

Procedures02101 90 Degree Videolaryngoscopy 660 920 1190 1450 172002118 90 degree videolaryngoscopy (Repeat within 2 weeks) 250 350 450 550 65002124 Adult Sleep Study 200 280 360 440 52000902 Antral Wash under LA - Both side 300 420 540 660 78000901 Antral Wash under LA - One side 150 210 270 330 39000943 Biopsy - Fibreoptic Laryngoscopy + Biopsy 700 980 1260 1540 182002103 Biopsy - Minor 1500 2100 2700 3300 390000906 Caloric Test 300 420 540 660 78000907 Chemical Cautery of Bleeding Points in the Nose 400 560 720 880 104000952 Computerised Electronystagmography 500 700 900 1100 130000908 Cortisone Injection to Nose/ Oropharynx 500 700 900 1100 130002106 Cross Consultation - IP ENT 50 150 250 400 50002126 Cyclops Evaluation 3000 4200 5400 6600 780000941 Diagnostic Nasal Endoscopy 500 700 900 1100 130000942 Diagnostic Nasal Endoscopy(with Image Printout) 600 840 1080 1320 156002117 Dressing 230 330 420 510 60002144 Ear Lobe Repair (Both Ears) 2000 2800 3600 4400 520000909 Ear Lobe Repair Per Ear 1000 1400 1800 2200 260002145 Ear Lobe Repair with Gun Shot (Both Ears) 2500 3500 4500 5500 650002143 Ear Piercing (Both Ears) 1200 1680 2160 2640 312000935 Ear Piercing Per Ear 600 840 1080 1320 156002127 Ear Piercing with Gunshot 1100 1540 1980 2420 286000976 Endoscopic Biopsy - Ear 600 840 1080 1320 156000979 Endoscopic Biopsy - Hypopharynx 950 1330 1710 2090 247000975 Endoscopic Biopsy - Nose 700 980 1260 1540 182000977 Endoscopic Biopsy - Oral Cavity 700 980 1260 1540 182000978 Endoscopic Biopsy - Orpharynx 700 980 1260 1540 182000985 Endoscopice Suction Clearence - Ear 350 490 630 770 91000984 Endoscopice Suction Clearence - Nose 500 700 900 1100 130000910 ENG 550 770 990 1210 143000945 Epleys Maneuver/Dix-Hallpike Test 300 420 540 660 78000968 Faciomaxillary Botox Injection 1985 2780 3570 4370 5160

61


DAYCARE

Rs. Rs. Rs. Rs. Rs.02128 FEES (Functional Endoscopic Evaluation of Swallowing ) First Visit 1000 1400 1800 2200 260002129 FEES (Functional Endoscopic Evaluation of Swallowing ) Follow up Visit 700 980 1260 1540 182000911 Fiberoptic Bronchoscopy 1400 1960 2520 3080 364000912 Fiberoptic Bronchoscopy - Repeat within a week 800 1120 1440 1760 208000913 Fiberoptic Bronchoscopy and Biopsy 1980 2770 3560 4360 515000915 Fiberoptic Laryngoscopy 600 840 1080 1320 156002119 Fibreoptic Ikaryngoscopy (Repeat within 2 weeks) 300 420 540 660 78000973 Foreign Body Removal (Endoscopic) - Ear 600 840 1080 1320 156000974 Foreign Body Removal (Endoscopic) - Hypopharynx 1600 2240 2880 3520 416000972 Foreign Body Removal (Endoscopic) - Nose 1500 2100 2700 3300 390002152 Immunotherapy ( Handling) 1000 1400 1800 2200 260000918 Incision & Drainage of Furuncle / Haematoma Auris 600 840 1080 1320 156002105 Incision and Drainage - Major 475 670 860 1050 124002104 Incision and Drainage - Minor 300 420 540 660 78000934 Injection into Auricle 500 700 900 1100 130000933 Intra Tympanic Amino Glycoside/Steroid 600 840 1080 1320 156000967 Laryngeal EMG 1050 1470 1890 2310 273000996 Nasal Endoscopic debridement 700 980 1260 1540 182002120 Nasal endoscopy (Repeat within 2 weeks) 300 420 540 660 78000932 Nasal Packing 80 120 160 180 22000936 Nasendoscopy Biopsy / Cautery 650 910 1170 1430 169002147 Nasogastric Tube Insertion 200 280 360 440 52000921 Neuro Otological Test 1100 1540 1980 2420 286000922 Nose Prick (Boring of Nose) 500 700 900 1100 130000983 Otoendoscopy 300 420 540 660 78002121 Otoendoscopy (Repeat within 2 weeks) 200 280 360 440 52000990 Paediatric Sleep Study- Minor 2000 2000 2000 2000 200000989 Peadiatric Sleep Study - Major 5600 5600 5600 8800 1040000925 Removal of Foreign Body from Nose/Ear 600 840 1080 1320 156000914 Rigid Bronchoscopy 1200 1680 2160 2640 312000982 Rigid Laryngoscopy 1420 1990 2560 3120 369000937 Saline Nasal Wash 400 560 720 880 104000927 Suction Clearance 300 420 540 660 78002102 Suture Removal 70 100 130 160 19000981 Suturing (Large) 600 840 1080 1320 156000980 Suturing (Small) 350 490 630 770 91002146 Syringing to Ear ( Both Ear) 600 840 1080 1320 156000928 Syringing to Ear ( Per Ear) 300 420 540 660 78002151 Testing Electro Acoustic Characteristics (EAC) of Hearing Aids 500 700 900 1100 130008015 Tracheostomy Decannulation 3000 4200 5400 6600 780000995 Tracheostomy in ICU / Ward 3500 4900 6300 7700 9100

62


DAYCARE

Rs. Rs. Rs. Rs. Rs.

00929 Tracheostomy Tube care/Change 500 700 900 1100 130000971 Tran-cervical Laryngeal Injections 1000 1400 1800 2200 260000970 Transoral VF Augmentation 2500 3500 4500 5500 650000969 Transoral VF Injection 1600 2240 2880 3520 416000930 Vestibular Function Tests 400 560 720 880 104000966 Videostroboscopy 1000 1400 1800 2200 2600

ENT Packages:00958 Ear Piercing with Studs 700 980 1260 1540 182000956 Endoscopy Imaging 250 350 450 550 65000957 Endoscopy Imaging with File (CD) 320 450 580 700 83000948 Imaging Surchage 55 80 100 120 14000946 Snoring Evaluation Package 6160 8620 11090 13550 1602000954 Speech Theraphy using Vaghmi 350 490 630 770 91000965 VEMP Proceedure 350 490 630 770 91000947 Vertigo Protocol 3500 4900 6300 7700 910002132 Allergy protocol 3510 4910 6320 7720 9130

Includes : Diagonstic Nasal Endoscopy,Skin Prick Test,Nasal Smear,Total IgE,AEC Excludes :CBC,PFT,X-Ray PNS,X-Ray Chest,CT PNS

02133 Swallowing Protocol - First Visit 1200 1680 2160 2640 312002134 Swallowing Protocol - Second Visit Onwards 850 1190 1530 1870 2210

Includes : Upper Gatrointestinal Endoscopy,Videoflouroscopy, Neurological Evaluation Excludes :Swallowing Assessment,FEES,Swallowing TherapySleep Study Protocol

02135 Basic Sleep StudyIncludes :EEG,ECG,Chest Expansion, Abdominal Expansion, Pulse Oximetry 6000 8400 10800 13200 15600

02136 Titration Study 3500 4900 6300 7700 910002137 SPLIT Study 6500 9100 11700 14300 1690002138 Level 3 Sleep Study (Includes : Pulse Oximetry +/- ECG) 3000 4200 5400 6600 780002139 MSLT 4200 5880 7560 9240 1092002140 OSA Protocal 1500 2100 2700 3300 3900

Includes:Clinical Assessment,Fibreoptic Endoscopy (Muller’s manoeuvre)02141 Speech/Voice Protocol 2500 3500 4500 5500 6500

Incudes :Videolaryngoscopy,Stroboscopy,Speech Assessment,Speech Therapy

02142 Vertigo Clinic ( Cyclops) : 4500 6300 8100 9900 11700Incudes :Clinical Assessment (-Cerebellar Gait test -otoendoscopy)Dix Hallpike/Epley’s PTA,ENG (Cyclops)

02148 Cochlear Implant Mapping 1000 1400 1800 2200 260002149 Voice Evaluation & Advice 200 280 360 440 520

6. SPECIALISED PROCEDURES - GASTROENTEROLOGY01038 24 Hrs pH Monitoring 2270 3180 4090 4990 590001001 Abdominal Paracentesis 240 340 430 530 62001063 Adrenaline Injection 3730 5220 6710 8210 970001070 Argon Plasma Coagulation ( Multiple) 10160 14220 18290 22350 26420

63


DAYCARE

Rs. Rs. Rs. Rs. Rs.01059 Argon Plasma Coagulation (APC) Limited 6090 8530 10960 13400 1583001056 Ascitic Tap Procedure 400 560 720 880 104001049 Biliary Metal Stenting 8790 12310 15820 19340 2285001048 Biliary Stricture Dilatation 8790 12310 15820 19340 2285001066 Biopsy - Endoscopy 480 670 860 1060 125001004 Biopsy - Liver 400 560 720 880 104001047 Colonic Stricture Dilatation 4800 6720 8640 10560 1248001008 Colonoscopy 4130 5780 7430 9090 1074001061 Colonoscopy - Bed Side 7700 10780 13860 16940 2002001022 Colonoscopy + Polypectomy 6130 8580 11030 13490 1594001046 Duodenal Stricture Dilatation 4800 6720 8640 10560 1248001037 ECG monitoring / Oxygen During Endoscopy 310 430 560 680 81001062 EGD - Bed Side 4840 6780 8710 10650 1258001031 Endoscopic Clip Application 3330 4660 5990 7330 866001032 Endoscopic Clip Application (Additional) 3330 4660 5990 7330 866001043 Endoscopic Cystogastrostomy 9580 13410 17240 21080 2491001052 Endoscopic Fluoroscopy 330 460 590 730 86001009 Endoscopic Gastrostomy 5190 7270 9340 11420 1349001010 Endoscopic Jejunal Biopsy 2660 3720 4790 5850 692001045 Enteroscopy 3990 5590 7180 8780 1037001011 ERCP + Sphincterotomy 6390 8950 11500 14060 1661001002 ERCP Biliary Drainage 10250 14350 18450 22550 2665001003 ERCP Biliary Prosthesis 11720 16410 21100 25780 3047001012 ERCP Diagnostic Only 4960 6940 8930 10910 1290001051 ERCP Fluoroscopy 400 560 720 880 104001013 Esophageal Dilatation 3990 5590 7180 8780 1037001014 Esophageal Dilatation (Repeat within 2 Months) 2060 2880 3710 4530 536001033 Esophageal Manometry 2930 4100 5270 6450 762001039 Esophageal Stenting 4070 5700 7330 8950 1058001028 Esophageal Variceal Banding 3730 5220 6710 8210 970001015 Esophagogastroduodenoscopy (G.I. Endoscopy) 1820 2550 3280 4000 473001016 Esophagogastroduodenoscopy (Repeat within 3 Months) 1100 1540 1980 2420 286001053 EUS - Diagnostic 5850 8190 10530 12870 1521001054 EUS - FNAC 10780 15090 19400 23720 2803001055 EUS-Therapeutic 10410 14570 18740 22900 2707001025 Fiberoptic Flexible Sigmoidoscopy 850 1190 1530 1870 221001023 Foreign Body Removal (Endoscopic) 5810 8130 10460 12780 1511001100 General Anaesthesia 1100 1540 1980 2420 286001029 Glue Injection 3730 5220 6710 8210 970001067 Heater Probe Application 5320 7450 9580 11700 1383001017 Injection Sclerotherapy (1st Session) 3730 5220 6710 8210 970001018 Injection Sclerotherapy (Subsequent Session) 1690 2370 3040 3720 4390

64


DAYCARE

Rs. Rs. Rs. Rs. Rs.01064 Intraoperative Enteroscopy 6000 8400 10800 13200 1560001050 Liver Ultrasound 400 560 720 880 104001019 Naso Biliary Drainage 6920 9690 12460 15220 1799001044 Pancreatic Duct Stenting* 7990 11190 14380 17580 2077001020 Placement Jejunal Feeding Tubes 2930 4100 5270 6450 762001021 Pneumatic Dilatation (Per Session) 4660 6520 8390 10250 1212001068 Polypectomy - every extra polyp 1650 2310 2970 3630 429001069 Recovery Room Charges 440 620 790 970 114001034 Rectal Manometry 2000 2800 3600 4400 520001065 RUT (Rapid Urease Test) 140 200 250 310 36001000 Sengstaken Tube Introduction 2420 3390 4360 5320 629001024 Sigmoidoscopic Polypectomy 3330 4660 5990 7330 866001057 UltrasoundGuided - Liver Biopsy 2930 4100 5270 6450 762001058 UltrasoundGuided - Pancreatic Necrotic Drainage 7330 10260 13190 16130 19060

Note: Extra charges for CD Rs.100/-* Stent extra7. SPECIALISED PROCEDURES- GENERAL MEDICINE

02801 Abdominal Paracentesis 220 310 400 480 57002864 Allogenic HSCT Procedure * 300000 300000 300000 300000 30000003604 Ascitic Tap Under Ultrasound Guidance 300 420 540 660 78002863 Auto HSCT Procedure * 250000 250000 250000 250000 25000003602 Bedside USG 150 210 270 330 39002802 Biopsy - Liver 330 460 590 730 86002804 Biopsy - Muscle 350 490 630 770 91002805 Biopsy - Peritonial 250 350 450 550 65002806 Biopsy - Pleural 400 560 720 880 104002807 Biopsy - Trephine 250 350 450 550 65002808 Bone Marrow Study 750 1050 1350 1650 195002857 Chemotheraphy - Level A (Single Day) 350 700 950 1200 190002855 Chemotheraphy-Level D Monoclonal Antibodies/Target 700 1400 1900 2400 280002862 Chemotherapy Planning Charges (Full Protocol) 365 530 715 1065 178002816 Cross Consultation IP - General Medicine 50 150 250 400 50002835 LP Intrathecal drug 175 250 320 390 46002866 Pleural Aspiration (Diagnostic) Ultrasound Guidance 300 420 540 660 78002852 RIC Sibling/Haplo/MUD Procedure 600000 600000 600000 600000 60000002856 Sibling/Haplo/MUD Procedure 800000 800000 800000 800000 80000003603 Ultrasound Guidance for CVC 400 560 720 880 1040

* Procedure charges only. Investigations, room rent, drugs, blood bank products / process, diet and other charges extra.8. SPECIALISED PROCEDURES - IMMUNOLOGY

02900 Detailed MSK - UltrasoundGuided 1000 1200 1500 2000 250002898 Hip Joints Injection/Aspiration - Ultrasound Guided 2500 2700 3800 4500 600003608 Immunology Department - Cross Consultation 50 150 250 400 50002891 Labial Minor Salivary Gland 700 900 1500 1650 1800

65


DAYCARE

Rs. Rs. Rs. Rs. Rs.02896 Large Joints Injection/Aspiration - Ultrasound Guided 800 1200 1500 1800 250002899 Limited MSK - UltrasoundGuided 600 800 1000 1200 140003607 Muscles Biopsy with Conchotome 2500 3000 3500 4500 550002892 Muscles Biopsy without Conchotome 2000 2200 2700 3500 400002885 Nail Fold Capillaroscope 1000 1500 1600 1800 220002893 Nerve Biopsy 2000 2500 3000 3500 500002894 Non Guided Blinds Injection/Aspiration Of Joints 300 400 500 700 80002895 Small Joints Injection/Aspiration - Ultrasound Guided 600 800 1000 1200 140002897 Two Joints Injection/Aspiration - Ultrasound Guided 1500 1700 2000 2500 3000

9. SPECIALISED PROCEDURES - PULMONARY MEDICINE02859 6 Minute Walk Test 250 350 450 550 65003572 Bipap (Per Day) 550 770 990 1210 143002858 Breath Carbon - Monoxide levels 50 70 90 110 13002809 Bronchial Challenge Test 1200 1200 1200 1200 120004512 Bronchoscopic Balloon Dilation for Bronchial / Tracheal stenosis 10000 10000 10000 10000 1000002825 Bronchoscopic Endotracheal Intubation 1800 1800 1800 1800 180002811 Bronchoscopy - Repeat 1950 1950 1950 1950 195002810 Bronchoscopy Diagnostic / with BAL 4500 6300 8100 9900 1170002812 Bronchoscopy With EBB/TBLB/TBNA 6000 8400 10800 13200 1560004151 Bronchoscopy with Endobronchial Cryobiopsy / Cryotherapy 7500 7500 7500 7500 750004150 Bronchoscopy with TB Crybiopsy 10000 10000 10000 10000 1000003599 Cardio Pulmonary Exercise Testing 2500 3500 4500 5500 650002833 Chemotherapy 500 700 900 1100 130003571 CPAP (Per Day) 600 840 1080 1320 156003000 CPAP TITRATION - Auto 1250 1750 2250 2750 325002841 CPAP Titration Study 2750 3850 4950 6050 715003601 Cross Consultation IP - Pulmonary Medicine 50 150 250 400 50002823 DLCO / Lung Volume 1750 2450 3150 3850 455002992 FeNO 500 650 750 1000 105004515 Home Sleep Study 3500 4900 6300 7700 910003574 Intercostal Drain Tube Insertion 1000 1400 1800 2200 260002993 Level 3 Sleep Study 2000 2800 3600 4400 520002829 Lung Volume + DLCO 2500 3500 4500 5500 650002884 Medical Thoracoscopy 6000 8400 10800 13200 1560003583 MEP/MIP 250 350 360 500 55002842 MSLT / MWT 2000 2800 3600 4400 520002830 Pleural Aspiration (Repeat) 1250 1750 2250 2750 325002831 Pleurodesis 500 700 900 1100 130004513 Rigid Bronchoscopy 6000 8400 10800 13200 1560002832 Sleep Study 6500 9100 11700 14300 1690004514 Sllep Study + MSLT / MWT 8000 11200 14400 17600 2080002826 Spirometry (Repeat) 100 140 180 220 26002818 Spirometry / Spirometry with BDR 550 770 990 1210 1430

66


DAYCARE

Rs. Rs. Rs. Rs. Rs.02998 Split Night Sleep Study 7500 10500 13500 16500 1950002994 Ultrasound -Chest 500 700 900 1100 130003579 Ultrasound -Chest (Repeat) 250 350 450 550 65003582 Ultrasound Guided -Lung Biopsy 1500 2100 2700 3300 390003581 Ultrasound Guided -Pigtail Insertion 1500 2100 2700 3300 390003580 Ultrasound Guided -Pleural Aspiration ( Diagnostic) 1000 1400 1800 2200 2600

02824 Ultrasound Guided Pleural Aspiration (Therapeutic) 1150 1150 1150 1150 1150

03573 Ultrasound Guided Pleural Biopsy 1000 1400 1800 2200 2600

PULMONARY MEDICINE - OT03597 Bronchoscopy - OT 5000 7000 9000 11000 13000

03594 Endobronchial Ultrasound 17500 17500 25000 25000 3000003596 Medical Thoracoscopy in OT 10000 14000 23500 32500 4250003595 Whole Lung Lavage 15000 20000 25000 30000 40000

10. SPECIALISED PROCEDURES - GENERAL SURGERY02601 Abdominal Paracentesis 220 310 400 480 57002602 Aspiration Biopsy / Lymph Node Biopsy 200 280 360 440 52002622 Band Ligation of Haemorrhoids 175 250 320 390 46002604 Biopsy - Liver 330 460 590 730 86002605 Biopsy - Muscle 350 490 630 770 91002623 Biopsy - Rectal 175 250 320 390 46002654 Biopsy Intermediate 250 350 450 550 65002653 Bladder Wash 130 190 240 290 34002690 Callus Removal 300 420 540 660 78002678 Catheterization 100 140 180 220 26002665 Circumcision 350 490 630 770 91002652 Colostomy Bag Change 250 350 450 550 65002624 Colostomy Irrigation 250 350 450 550 65002677 Crepe Bandage Application 50 70 90 110 13002608 Cryo Surgery for Warts 175 250 320 390 46002661 Debridement 250 350 450 550 65002667 Debridement - Major 475 670 860 1050 124002656 Distal Loop Washes 250 350 450 550 65002658 Drain Insertion 175 250 320 390 46002650 Drain Removal 120 170 220 260 31002686 Dressing Service Charges - Large 150 210 270 330 39002685 Dressing Service Charges - Medium 130 190 240 290 34002679 Dressing Service Charges - Small 100 140 180 220 26002610 Ear Lobe Repair (Double) 300 420 540 660 78002611 Ear Lobe Repair (Single) 240 340 430 530 62002691 Excision Medium 350 490 630 770 91002612 Excision of Small Swellings, Sebacious Cysts etc., 120 170 220 260 31002651 Ganglion Aspiration 120 170 220 260 310

67


DAYCARE

Rs. Rs. Rs. Rs. Rs.02693 General Surgery - Cross Consultation IP 50 150 250 400 50002639 ICD 175 250 320 390 46002657 ICD Insertion 210 300 380 470 55002648 ICD Removal 120 170 220 260 31002632 Incision & Drainage - Major 500 700 900 1100 130002631 Incision & Drainage - Minor 250 350 450 550 65002692 Ingrowing Toe Nail Excision 600 840 1080 1320 156002613 Injection Treatment of Haemorrhoids 120 170 220 260 31002614 Intra Lesional Injections eg. Keloids 120 170 220 260 31002687 Minor Procedure in Minor OT 55 80 100 120 14002644 Miscellaneous Operative Procedure Intermediate 175 250 320 390 46002615 Nose Prick (Boring of Ear/Nose) 120 170 220 260 31002626 Pleural Tapping 175 250 320 390 46002688 Removal of Foreign Body in OPD/Ward 300 420 540 660 78002689 Ryles Tube Introduction 30 40 50 70 8002666 Segmental Block 475 670 860 1050 124002616 Sengs Taken Tube Introduction 715 1000 1290 1570 186002659 Seton Change 175 250 320 390 46002617 Sigmoidoscopy - Flexible Scope 350 490 630 770 91002619 Sigmoidoscopy - If Procedure Prolonged 300 420 540 660 78002618 Sigmoidoscopy - Rigid Scope 240 340 430 530 62002664 SPC 240 340 430 530 62002649 SPC Removal 120 170 220 260 31002696 Suture Removal - Major 200 200 200 200 20002695 Suture Removal - Minor 70 100 130 160 19002638 Suturing - Major (OPD / Ward) 475 670 860 1050 124002636 Suturing - Minor (OPD / Ward) 175 250 320 390 46002621 Tracheostomy in OPD / Ward 290 410 520 640 74002655 Water Holding Test 175 250 320 390 46002668 WristAV Fistula 240 340 430 530 620

10.1. STOMA CLINIC PROCEDURE02674 Banding of Haemorrhoids 750 1050 1350 1650 195002676 Hemorrhoid Sclero 750 1050 1350 1650 195002673 Injection Sclerotherapy for Haemorrhage 120 170 220 260 31002670 Proctoscopy 250 350 450 550 65002671 Sigmodoscopy 240 340 430 530 620

11. SPECIALISED PROCEDURES - NEPHROLOGY01401 Abdominal Paracentesis 220 310 400 480 57001525 Acute Intermittent PD for 24hrs 3500 4900 6300 7700 910001413 Biopsy - Kidney (With Disposable Gun) 900 1260 1620 1980 234001498 Biopsy - Kidney (With Reusable Bard Gun) 800 1120 1440 1760 208001429 Bone Marrow Aspiration 400 560 720 880 1040

68


DAYCARE

Rs. Rs. Rs. Rs. Rs.01433 CAPD Catheter Flushing 175 250 320 390 46001426 CAPD Cycler (24 hrs) 1200 1680 2160 2640 312001492 CAPD Dressing 100 140 180 220 26001500 CAPD Percutaneous Catheter Insertion 4000 5600 7200 8800 1040001424 CAPD Training 1200 1680 2160 2640 312001432 CAPD Transfer Set Change 250 350 450 550 65001404 Catheter Removal 100 140 180 220 26001422 CRRT for 24 Hours 4000 5600 7200 8800 1040001454 Extra Charges for Hemodialysis Beyond 4hrs (Per Hr) 300 300 300 300 30001455 Extra Charges for Hemodialysis Beyond 4hrs (Per Hr) 300 300 300 300 30001405 Femoral Access 300 420 540 660 78001497 Haemodiafiltration 4160 5820 7490 9150 1082001490 Haemodialysis - Bicarb(C) - OP 192501483 Haemodialysis - Bicarb (C) 1925 2450 3150 3850 455001453 Hemoperfusion (ICU Setting) 1500 2100 2700 3300 390001485 Heparin Free Dialysis - Bicarb (C) 2075 2660 3420 4180 494001491 Heparin Free Dialysis - Bicarb (Package) OP 165001431 High Flux Dialysis 1450 2030 2610 3190 377001427 ICU Haemodialysis 1575 1960 2520 3080 364001414 IPD Dialysis - Every 48 hrs 1000 1400 1800 2200 260001434 Isolate Ultrafiltration 775 840 1080 1320 156001435 Lumbar Puncture 250 350 450 550 65001451 Lung Ultrasound 360 500 650 790 94001421 Nephrology -Cross Consultation IP 50 150 250 400 50001495 Nocturnal Dialysis 1300 1820 2340 2860 338001530 Nutritional Advice & Therapy 250 350 450 550 65001440 Percutaneous CAPD Catheter Insertion 4000 5600 7200 8800 1040001420 Peritoneal Equilibration Test (PET Test) 1500 2100 2700 3300 390001499 Perm Catheter Insertion 4000 5600 7200 8800 1040001406 Perm Catheter Removal 400 560 720 880 104001423 Plasmapheresis 1450 2030 2610 3190 377001436 Pleural Tapping 175 250 320 390 46001526 Registration for Renal SWAP transplant 1500 2100 2700 3300 390001496 SCUF/ICU 1375 1680 2160 2640 312001494 SLED - Sustained Low Efficiency Dialysis 3175 4200 5400 6600 780001416 Subclavian Access / Internal Jugular Access 1500 2100 2700 3300 390001527 Transplant video recording & final counselling 1500 2100 2700 3300 390001450 Ultrasound Marking for Renal Biopsy 500 500 500 500 50001452 Ultrasound of Kidneys at Bed Side 300 300 300 300 300

12. SPECIALISED PROCEDURES - NEUROSURGERY01201 Abscess Tapping 920 1290 1660 2020 239001200 Biopsy Nerve 610 850 1100 1340 159001202 Burrhole Craniostomy 790 1110 1420 1740 2050

69


DAYCARE

Rs. Rs. Rs. Rs. Rs.01240 CT Guided Procedure - Simple 1100 1540 1980 2420 286001251 Cross Consultation IP - Neuro Surgery 50 150 250 400 50001243 CSF Drainage System 770 1080 1390 1690 200001241 CT Guided Procedure - Complex 2200 3080 3960 4840 572001245 Diagnostic L P 550 770 990 1210 143001250 Head Injury Monitoring (48 Hrs) 1650 2310 2970 3630 429001249 Hematoma Evacuation 1960 2740 3530 4310 510001206 LP Drainage and Pressure Monitor 720 1010 1300 1580 187001244 Medical Documentation-Clinical Photography / Digital imaging 660 920 1190 1450 172001231 Nerve Block 550 770 990 1210 143001235 Neurogenic Pain Management 1650 2310 2970 3630 429001242 Scalp Abscess/ Scalp lession 2290 3210 4120 5040 595001210 Skull Traction Application 550 770 990 1210 143001212 Subdural Tapping 1100 1540 1980 2420 286001213 Tracheostomy 550 770 990 1210 143001214 Twist Drill Craniostomy 2060 2880 3710 4530 536001215 Urokinase Therapy for ICH 1170 1640 2110 2570 304001216 Ventricular Tap - Diagnostic 980 1370 1760 2160 2550

13. SPECIALISED PROCEDURES - NEUROLOGY01141 24 Hours Video EEG 13300 13300 17100 20900 2470001102 All Evoked Potential E.E.G 3370 3370 3370 4110 486001120 Autonomic Neurophysiological Tests 1190 1670 2140 2620 309001101 BAER 1500 1500 1500 1840 217001114 Biopsy Muscle 2500 3000 4500 5500 650001115 Biopsy Nerve 2500 3000 4500 5500 650001155 Botulinum ToxinInjection Service Charge 100 U 3000 4200 5400 6600 780001156 Botulinum ToxinInjection Service Charge 50 U 2000 2800 3600 4400 520001117 Carpal Tunnel Injection Service Charges 750 1050 1350 1650 195001158 Cefaly Stimulation Theraphy (Per Session) 300 420 540 660 78001140 Cephalalgia Protocol 600 840 1080 1320 156001150 Comprehensive Evaluation of Epilepsy 3000 4000 5000 6000 650001149 Cortical Stimulation 3565 4990 6420 7840 927001159 Cross Consultation - IP Neurology 50 150 250 400 50001135 Dementia Protocol 2500 3000 4000 5000 650001152 DementiaAssessment 600 840 1080 1320 156001146 Depth EEG Recording 3565 4990 6420 7840 927001131 E.E.G + Brain Mapping 1190 1670 2140 2620 309001107 E.E.G Routine 3200 3200 3200 3500 380001148 ECOG (Electro Corticography) 3565 4990 6420 7840 927001160 EDSS Score 500 700 900 1100 130001164 EEG < 4 hours 3500 4900 6300 7700 910001165 EEG > 4 hours 7000 9800 12600 15400 18200

70


DAYCARE

Rs. Rs. Rs. Rs. Rs.01166 EEG Reporting < 4 hours 500 700 900 1100 130001167 EEG Reporting > 4 hours 1000 1400 1800 2200 260001123 Electro Cochleography 715 1000 1290 1570 186001125 Electro Myography 1190 1670 2140 2620 309001122 Electro Oculography 1065 1490 1920 2340 277001121 Electro Retinography 1065 1490 1920 2340 277001163 ENMG + Sudoscan 4000 4000 4000 5000 600001103 ENMG-EMG/NCV/Decremental Response 3500 3500 3500 3800 450001139 Epilepsy Protocol 600 840 1080 1320 156001153 EPSAssessment 600 840 1080 1320 156001126 Evoked Potential Studies in Children 1190 1670 2140 2620 309001119 F Wave and H Reflex Studies 1485 2080 2670 3270 386001130 Intra - Operative Nerve Stimulation 1190 1670 2140 2620 309001128 Long Loop Reflex Studies 1190 1670 2140 2620 309001144 Long Term Video EEG (Above 4 hours) 7500 7500 7500 8500 950001112 Lumbar Puncture 250 350 450 550 65001113 Lumbar Puncture W Monometer Pressure Evaluation 660 920 1190 1450 172001161 Neurology Speciality Clinic Service 540 540 540 660 78001154 Neuromuscular Assessment 600 840 1080 1320 156001137 Neuromuscular Disease Protocol 600 840 1080 1320 156001138 Parkinsonism Protocol 600 840 1080 1320 156001129 Radicular Stimulation Studies 1190 1670 2140 2620 309001124 Repetitive Nerve Stimulation Studies 1190 1670 2140 2620 309001142 Short Term Video EEG (1-2 hours) 4500 4500 4500 5500 650001143 Short Term Video EEG (2-4 hours) 6660 6660 6660 8140 962001127 Silent Period 1190 1670 2140 2620 309001110 Somato Sensory Evoked Potential (SSEP) 1290 1290 1290 1570 186001108 Special Recording EEG 600 840 1080 1320 156001168 Speciality Clinic (BPL Card Holders) 35001169 Speciality Clinic (Non BPL Card Holders) 70001170 Speciality Clinic (Fast Track) 100001109 Sphenoidal EEG 1190 1670 2140 2620 309001147 Sterio EEG Recording 3565 4990 6420 7840 927001157 Stroke Assessment 600 840 1080 1320 156001136 Stroke Protocol 5000 7000 9000 11000 1500001162 Sudoscan:Peripheral Autonomic Testing 2500 3500 4500 5500 650001145 Sudural EEG Recording 3565 4990 6420 7840 927001132 TPA Charges for Acute Stroke 2500 3500 4500 5500 650001134 Vertigo Protocol 3500 4900 6300 7700 910001111 Visual Evoked Potential EEG 1500 2100 2700 3300 390001151 WADA Test 2375 3330 4280 5230 6180

14. SPECIALISED PROCEDURES - OBSTETRICS & GYNAECOLOGY01588 Abdominal Ultrasound - Repeat (Within 10 days) 280 330 360 400 480

71


DAYCARE

Rs. Rs. Rs. Rs. Rs.01591 Abdominal Ultrasound 800 920 1040 1160 128001597 Additional Scan for Follicular Monitoring 250 290 330 360 40001593 AFI / HR (Single Parameter/Presentation/Placental) 110 130 140 160 18001501 Antenatal Cards 50 70 90 110 13001502 Antinatal Urine Tescting for Revisits 30 40 50 70 8001620 Artificial Rupture in Membrane 50 100 150 200 25001600 Baby Care 50 70 90 110 13001561 Biopsy - Vaginal 500 700 900 1100 130001562 Biopsy - Vulval 500 700 900 1100 130001505 Biopsy Cervix 500 700 900 1100 130001506 Cauterization Cervix 400 560 720 880 104001507 Cervix Cytology (Papsmear) - Service Charge 100 140 180 220 26001508 Cervix Mucus Study 55 80 100 120 14001510 Colposcopy 1000 1400 1800 2200 260001511 Colposcopy and Cervix Biopsy 1500 2100 3500 4900 640001512 Colposcopy and Pap Smear 1000 1400 1800 2200 260001598 Cross Consultation IP - OB & Gynaecology 50 150 250 400 50001515 Cryo Surgery for Minor Procedure 65 90 120 140 17001514 Cryosurgery for Cervix 1000 1400 1800 2200 260001516 Culdocentesis 500 700 1200 1600 210001578 Dilation and Curettage 750 1050 1350 1650 195001517 Dilation and Evacuation 700 980 1260 1540 182001518 Endometrial Biopsy 300 420 540 660 78001567 Endometrial Polypectomy 200 280 360 440 52001619 Etonox Analgesia for Painless Delivery 800 1120 1440 1760 208001569 Excision of Vaginal Lesions 500 700 900 1100 130001568 Excision of Vulval Lesions 500 700 900 1100 130001520 Family Welfare - OM Kit 20 30 40 40 5001581 Family Welfare & Lactation Counselling 200 280 360 440 52001570 Fractional Curettage 1000 1400 1800 2200 260001547 HPV DNA Test 1485 2080 2670 3270 386001527 Hysterosalpingogram 500 700 900 1100 130001528 Incision & Drainage 150 210 270 330 39001544 IV Tocolysis 120 170 220 260 31001542 Laminaria Tent Insertion 55 80 100 120 14001531 Loop Removal 50 100 100 200 25001586 Mirena Coil Insertion 600 800 1000 1500 180001585 Miscellaneous (Family Welfare)01543 Monitoring of High Risk Pregnancy in Labour 350 490 630 770 91001533 Non Stress Test (NST) 250 350 450 550 65001590 Obstetric Biophysical Profile 1400 1610 1820 2030 224001589 Obstetric Ultrasound-Anomaly 440 510 570 640 70001571 Paracentesis - Abdominal 200 280 360 440 520

72


DAYCARE

Rs. Rs. Rs. Rs. Rs.01595 Pelvic Ultrasound (Trans-Abdominal) 500 700 900 1100 130001594 Pelvic Ultrasound (Trans-Vaginal) 500 700 900 1100 130001534 Perineal Care 50 70 90 110 13001535 Polypectomy Cervix 500 700 900 1100 130001545 Serial NST for High Risk Pregnancy (1 Week) 600 840 1080 1320 156001596 Serial Scan Follicular Monitoring for Three Days 750 860 980 1090 120001537 Suture Removal 70 100 130 160 19001592 Transvaginal Ultrasound Single Parameter (Cervical) 110 130 140 160 18001539 Use of Doppler - Check.FHS 50 70 90 110 13001541 Vaginal Cytology - Hormonal 50 70 90 110 130

15. SPECIALISED PROCEDURES - OPTHALMOLOGY01778 Abscess Drainage 350 450 540 690 87001810 Argon Laser Barrage - Each Eye 1400 1960 2520 3080 364001701 Argon Laser Focal - Each Eye 800 1120 1440 1760 208001702 Argon Laser Iridotomy - Each Eye 600 750 900 1200 150001703 Argon Laser Photo Coagulation PRP (Per Session) - Each Eye 1200 1680 2160 2640 312001706 Argon Laser Trabeculoplasty - Each Eye 1000 1400 1800 2200 260001707 Artificial Eye Ball (Cost) Service Charges 500 700 900 1100 130001708 Auto Plot Perimetry - Additional Test 300 390 450 600 75001710 Auto Plot Perimetry - Both Eyes 800 1120 1440 1760 208001709 Auto Plot Perimetry - For Each Eye 400 540 650 840 105001794 Basic work-up procedure (ARK, PGP, IOP, Dilatation) 150 210 270 330 39001801 CCT ‘K’ Reading + Topography 1000 1400 1800 2200 260001712 Chalazion I&C - Each Eye 1000 1400 1800 2200 260001717 Contact Lens - Disposable / Cosmetic (Per Lens) 1350 1680 2050 2700 339001718 Contact Lens - Fort. Disposables (Per Lens) 1600 2010 2400 3210 399001714 Contact Lens - Hard Lens (Per Lens) 450 570 700 900 114001715 Contact Lens - RGP Lens (Per Lens) 1000 1400 1800 2200 260001716 Contact Lens - Soft Lens (Per Lens) 700 870 1050 1410 174001744 Contact Lens- Special / Premium (Per Lens) 780 900 1150 1560 195001720 Contact Lens Testing and Fitting Charges 300 390 450 600 75001789 Corneal Staining / Foreign Body Removal - Each Eye 100 140 180 220 26001792 Corneal Topograghy - Each Eye 500 630 750 990 126001742 Corneo Scleral Suture Removal with Dressing - Each Eye 200 240 300 390 51001807 Cross Consultation IP - Opthalmology 50 150 250 400 50001806 Dilatation, IOP, Perimetry / OCT 1500 2100 2700 3300 390001743 Diurnal Variation Test 800 1120 1440 1760 208001728 Epilation - Each Eye 500 700 1180 1630 213001786 ERG 1000 1400 1800 2200 260001804 Eye Irrigation / Wash - Each Eye 100 140 180 220 26001721 Fluorescein Angiography 2000 2800 4700 6500 850001722 Fluorescein Angioscopy 400 540 650 840 105001724 Fundus Examination after Drops 100 140 180 220 260

73

01750 Fundus Photography 250 350 450 550 65001781 GDX (both eyes) 1200 1500 1800 2370 297001780 Glaucoma Package II (with OCT, or GDx, Fields Both Eyes) 3600 4500 5400 7200 900001767 Glaucoma Work-up (Package) 950 1200 1450 1890 237001796 Gonio + IOP + Fundoscopy + Perimetry 1000 1400 1800 2200 260001756 Hand Magnifier + 14D 120 150 180 240 30001757 Hand Magnifier + 20D 600 750 900 1200 150001755 Hand Magnifier + 6D 180 240 270 360 45001761 IIIuminated Hand Magnifier 300 390 450 600 75001727 Incision for Lacrymal Abscess - Each Eye 500 700 900 1100 130001795 IOP only 75 110 140 170 20001763 Loupe - 2X 1190 1500 1800 2370 297001764 Loupe - 3.5X 1500 1890 2250 3000 375001752 Low Vision Test 120 150 180 240 30001772 Low Vision Test - Major 350 450 540 690 87001811 Manual Retinoscopy - Children 200 280 360 440 52001765 Microscopic Glasses 350 450 540 690 87001799 OCT (Both eyes) 2500 3500 4500 5500 650001769 OCT (One Eye) 1500 2100 2700 3300 390001818 OCT Angiography (Both Eyes) 3500 4900 6300 7700 910001819 OCT Angiography (One Eye) 2000 2800 3600 4400 520001820 OCT Angiography Followup (One Eye) 1000 1400 1800 2200 260001822 OCT Anterior Followup ( One Eye) 750 1050 1350 1650 195001821 OCT Anterior Segment ( Both Eyes) 2500 3500 4500 5500 650001823 OCT Anterior Segment ( Both Eye) 1500 2100 2700 3300 390001800 OCT Follow up (One Eye) 750 1050 1350 1650 195001785 Pachymeter 200 280 360 440 52001762 Paper Weight Magnifier 600 750 900 1200 150001776 PDT inclusive of Laser 15450 19320 23190 30900 3864001824 Posterior Subtenons Injection 250 350 450 550 65001816 Punctal plug inseration 1 eye 2000 2800 3600 4400 520001817 Punctal plug inseration 2 eye 4000 5600 7200 8800 1040001733 Refraction and Prescription of Spectacles 130 150 200 270 33001793 Refraction only (ARK) 80 110 140 180 21001723 Removal of Foreign Body in OPD / Ward - Each Eye 500 700 900 1100 130001814 ROP - Cryo 4500 6300 8100 9900 1170001815 ROP - Intravitreal 6600 9240 11880 14520 1716001813 ROP - LIO 12000 16800 21600 26400 3120001773 ROP Screening 400 560 720 880 104001805 Schirmers Test 60 84 108 132 15601749 Slit Lamp Photography 50 60 90 120 15001782 Specular Microscopy (Single Eye) 600 750 900 1200 150001825 Specular Microscopy (Both Eyes) 1000 1400 1800 2200 2600


DAYCARE

Rs. Rs. Rs. Rs. Rs.

74


DAYCARE

Rs. Rs. Rs. Rs. Rs.01775 Squint Assessment 250 350 450 550 65001758 Stand Magnifier + 8D 260 330 390 510 66001759 Stand Magnifier +14D 260 330 390 510 66001760 Stand Magnifier +20D 770 960 1170 1530 192001735 Sub Conjunctival Injection - Each Eye 120 150 180 240 30001748 Sub Tenon’s Injection 300 420 540 660 78001790 Suture Removal Major 500 700 900 1100 130001737 Syringing Eye 100 120 150 210 24001738 Tarsorrhapy (Each Eye) 500 700 900 1100 130001766 Tonometry with Pachymetry 120 150 180 240 30001753 Toric Lenses (Conventional) 1780 2220 2670 3570 444001754 Toric Lenses (Disposable) 3250 4050 4890 6510 813001777 UBM Scan - Each Eye 890 1110 1350 1770 222001739 Ultrasound A-Scan Biometry - Each Eye 400 560 720 880 104001808 Ultrasound A-Scan Biometry Both Eyes 700 980 1260 1540 182001740 Ultrasound B-Scan 500 700 900 1100 130001809 Ultrasound B-Scan Both Eyes(ONSD/Muscle Thickness) 800 1120 1440 1760 208001741 Ultrasound Combined A and B Scan One Eye 800 1120 1440 1760 208001812 YAG Laser - Minor - Each Eye 800 1120 1440 1760 208001747 YAG Laser Capsulotomy - Each Eye 1200 1680 2160 2640 312001746 YAG Laser Iridotomy - Each Eye 1700 2380 3060 3740 4420

16. SPECIALISED PROCEDURES - ORTHOPAEDICS01901 Aspiration 220 310 400 480 57001902 Aspiration of Joint (in Minor O.T.) 300 420 540 660 78001903 Biopsy - Muscle 350 490 630 770 91001904 Bone Marrow Aspiration 400 560 720 880 104001906 Closed Reduction of Fracture and Dislocation - Adults 600 840 1080 1320 156001905 Closed Reductionof Fracture and Dislocation - Child 350 490 630 770 91001918 Cross Consultation IP - Orthopaedics 50 150 250 400 50001907 F C B 175 250 320 390 46001908 Intra Articular Injection 240 340 430 530 62001909 Major Wound Dressing-Exclusive of Material/Plaster 120 170 220 260 31001910 Manipulation 275 390 500 610 72001920 Pelvic/Cervical Traction 50 70 90 110 13001912 Post Operative Immobiln of Fracture without Manipuln-U & Lex 175 250 320 390 46001913 Skeletal Traction 300 420 540 660 78001914 Skin Traction / Thomas Splint 175 250 320 390 46001919 Slab Application Procedure 150 210 270 330 39001916 Strapping 150 130 160 200 23001911 Suturing - Minor (OPD / Ward) 175 250 320 390 46001915 Trigger Point Injection in OPD/ward 90 130 160 200 230

75


DAYCARE

Rs. Rs. Rs. Rs. Rs.17. SPECIALISED PROCEDURES - PAEDIATRICS

02201 Abdominal Paracentesis 350 490 630 770 91002242 Asthma Patient Information Booklet 40 40 40 40 4002202 Biopsy - Liver 500 700 900 1100 130002207 Bone Marrow Aspiration 400 560 720 880 104002241 Cross Consultation IP - Paediatrics 50 150 250 400 50002208 Exchange Transfusion - Partial / Complete / DV 500 700 900 1100 130002209 Fiberoptic Bronchoscopy 1400 1960 2520 3080 364002210 Fiberoptic Bronchoscopy - Repeat within 1 week 600 840 1080 1320 156002211 Fiberoptic Bronchoscopy and Biopsy 1980 2770 3560 4360 515002212 Fiberoptic Laryngoscopy 420 590 760 920 109002225 Lumbar Puncture 250 350 450 550 65002226 Nebulization (Per Hour) Including Oxygen 100 140 180 220 26002302 Paed. Blood Product Transfusion Monitoring 150 210 270 330 39002303 Paed. Colonoscopy with/without Biospy 3500 4900 6300 7700 910002304 Paed. Upper Gi endoscopy with/without Biopsy 1500 2100 2700 3300 390002305 Paed. Well Baby Card (Immunization, Growth) 50 70 90 110 13002237 Parent Education Material 55 80 100 120 14002307 Patient Asthma File 90 90 90 90 9003628 Pediatric Special Clinic – New patient assessment, counselling and file 350 490 630 770 91003627 Pediatric Special clinic service charge (PID clinic ,TB clinic,

Endocrine Clinic ,Gastro clinic, Asthma clinic) 200 280 360 440 52002231 PEFR 50 70 90 110 13002214 Peritoneal Drainage 220 310 400 480 57002223 Pleural Aspiration 220 310 400 480 57002215 Routine Spirometry 240 340 430 530 62002218 Sigmoidoscopy - Flexible Scope 350 490 630 770 91002224 Subdural / Ventricular Tap 600 840 1080 1320 156002308 Teen Counselling 200 280 360 440 52002221 Tracheostomy in OPD/ward 290 410 520 640 740

18. PEDIATRIC ONCOLOGY03634 PHO - Ascitic paracentesis - suspected malignancy 250 350 450 550 65003635 PHO - Bladder catheterisation 250 350 450 550 65003636 PHO - Blood product infusion and monitoring / day 250 350 450 550 65003621 PHO - Bone Marrow Biopsy Procedure 750 1050 1350 1650 195003625 PHO - Bone Marrow Transplant Counselling 1000 1400 1800 2200 260003637 PHO - Central line dressing / chemoport flushing 100 140 180 220 26003622 PHO - Chemo port Needle Access 300 420 540 660 78002278 PHO - Chemotherapy Administration Bolus 300 400 500 600 75002279 PHO - Chemotherapy Administration Infusion 350 500 750 800 100003638 PHO - Chemotherapy administration infusion (24 Hours) 750 1050 1350 1650 195003639 PHO - Chemotherapy protocol new cycles 250 350 450 550 65003640 PHO - Cross consultation - IP 50 70 90 110 130

76


DAYCARE

Rs. Rs. Rs. Rs. Rs.

03641 PHO - Enteral feeding administration/ day 100 140 180 220 26003642 PHO - Enteral tube change 150 210 270 330 39003624 PHO - Immuno Therapy Infusion 500 700 900 1100 130002280 PHO - Intrathecal Chemotherapy 600 840 1250 1500 200003633 PHO - Neutropenic care – room charges / day 1000 1400 1800 2200 260003623 PHO - New Diagnosis Haematology Treatment plan,

Counselling and education material 1000 1400 1800 2200 260002277 PHO - New Diagnosis Oncology Chemotherapy Planning 1000 1400 1800 2200 260003629 PHO - New Patient File 150 150 150 150 15003643 PHO - Non chemotherapy day care injection 100 140 180 220 26003630 PHO - Patient education material 100 100 100 100 10003644 PHO - Peripheral IV Cannulation 50 70 90 110 13003645 PHO - Pleural aspiration - suspected malignancy 250 350 450 550 65003646 PHO - Solid tumor treatment planning 500 700 900 1100 130003647 PHO - Stem cell harvest planning and monitoring 2000 2800 3600 4400 520003626 PHO - Stem Cell Transplant - Autologus 250000 250000 250000 250000 25000003631 PHO - Stem Cell transplant (allogeneic – MSD) 300000 300000 300000 300000 30000003632 PHO - Stem cell transplant (allogeneic – MUD/ Haplo) 400000 400000 400000 400000 400000

(includes transplant planning, protocol, monitoring, nursing, doctors visit,stem cell infusion, blood products administration, immunotherapy)19. NEONATOLOGY

02294 AEEG 2000 2800 3600 4400 520002267 Arterial Line 250 350 450 550 65002256 Biopsy - Liver 330 460 590 730 86002257 Biopsy - Muscle 350 490 630 770 91002258 Bone Marrow Aspiration 400 560 720 880 104002281 Booklet on Breast Feeding 85 120 150 250 30002285 CCHD Screening 120 170 220 260 31002273 Central Venous line 360 500 650 790 94002286 HFOV (ventilation extra) 500 700 900 1500 200000109 Incubator/ open warmer without respirator 60002276 Intercostal Chest Drainage 175 250 500 750 100002270 Intraosseus 50 70 90 110 13002292 Laminar Flow 50 100 150 200 25002293 Nitric Oxide Therapy 15000 15000 15000 15000 1500002275 Parent Education Material 55 80 100 150 30002274 Partial blood exchange 30002263 Pleural Aspiration 220 310 400 480 57003634 Resuscitation requrement in routine delivery 600 840 1080 1320 156003635 Reusable ventilator circuit 1000 1400 1800 2200 260002287 Routine Delivery Call 300 500 750 1000 150000096 Saline transfusion 36002288 Screening Bedside Neurosonogram / Echo 250 350 450 550 650

77


DAYCARE

Rs. Rs. Rs. Rs. Rs.02264 Subdural / Ventricular Tap 600 840 1080 1320 156003636 Surfactant administration 300 420 540 660 78002261 Tracheostomy in OPD/ward 290 410 520 640 74003637 Umbilical arterial catheter insertion 400 560 720 880 104000117 Umbilical cannulation for exchange transfusion 21003638 Umbilical venous catheter insertion 300 420 540 660 78002268 Venesection / Cut Down / CVC 240 340 430 530 62003638 Ventilator use alone 3000 4200 5400 6600 780006817 Well baby card 40

20. SPECIALISED PROCEDURES - PAEDIATRIC NEPHROLOGY14301 12hrs Amb.Blood Pressure Monitoring(Pediatric) 800 1120 1440 1760 208002283 24hrs Amb.Blood Pressure Monitoring(Pediatric) 1400 1960 2520 3080 364002301 Acute PD Daily Maintenace Charges 500 700 900 1100 130002243 Biopsy - Kidney (with Disposable Gun) 1500 2100 2700 3300 390003612 CAPD Exit Site Dressing 150 210 270 330 39003610 CAPD Transfer Set Change 250 350 450 550 65003616 Continuous Ambulatory PD (CAPD) Re-Training Initial 2400 3360 4320 5280 624003615 Continuous Ambulatory PD (CAPD) Training Initial 5000 7000 9000 11000 1300002250 Continuous Arterio Venous H Difiltration (CVVHD) 2375 3330 4280 5230 618002306 Cross Consultation IP -Paediatric Nephrology 50 150 250 400 50002244 Femoral Catheter 500 700 900 1100 130002247 Haemodialysis Bicarb 1240 1490 1920 2340 277002299 Hemodialysis in ITU 1475 1820 2340 2860 338002252 Hemoperfusion 1190 1670 2140 2620 309003617 ICU Haemodialysis- < 20kg 3000 4200 5400 6600 780003618 ICU Haemodialysis- >20kg 2400 3360 4320 5280 624003619 ICU SCUF/ISO UF- < 20kg 2400 3360 4320 5280 624003620 ICU SCUF/ISO UF- >20kg 1500 2100 2700 3300 390002245 Internal Jugular Catheter 750 1050 1350 1650 195002253 PD Cycler 600 840 1080 1320 156002298 Pediatric OPD Hemodialsysis 1200 1680 2160 2640 312002248 Peritoneal Dialysis (PD) 750 1050 1350 1650 195002251 Peritoneal Equilibration Test (PET) 1190 1670 2140 2620 309003611 PIRRT - 24 hours 6600 9240 11880 14520 1716002254 Plasmapheresis 1450 2030 2610 3190 377003613 SCUFF in PICU 1500 2100 2700 3300 390002296 SLED - >10 hours 5000 7000 9000 11000 1300002295 SLED - 6 - 10 hours 4000 5600 7200 8800 1040002300 Soft Catheter Insertion for acute PD 1000 1400 1800 2200 260003614 Ultrafilteration only ( ITU) 1300 1820 2340 2860 338002309 Young Child Dilaysis 1875 2630 3380 4130 4880

78


DAYCARE

Rs. Rs. Rs. Rs. Rs.21. SPECIALISED PROCEDURES - PAEDIATRIC SURGERY

02901 Abdominal Paracentesis 220 310 400 480 57002926 Bladder Catheterization 150 210 270 330 39002924 Bladder Wash 130 190 240 290 34002925 Bowel Wash 130 190 240 290 34002910 Central Venous Line, bedside 3000 4200 5400 6600 780002927 Colostomy Care 130 190 240 290 34002940 Cross Consultation IP - Paediatic Surgery 50 150 250 400 50002939 Dressing under Sedation & Monitoring 1000 1400 1800 2200 260002919 Dressing - Large 150 210 270 330 39002920 Dressing - Medium 130 190 240 290 34002921 Dressing - Small 100 140 180 220 26002922 Enema 75 110 140 170 20002931 Enteral Tube Change 150 210 270 330 39002935 Esophageal Foreign Body Extraction 1500 2100 2700 3300 390002923 Glucometer Random Blood Sugar 70 100 130 160 19002929 Incision and Drainage 250 350 450 550 65002915 Incubator/Open Warmer with Respirator & 2 ABGs 5000 5000 5000 5000 500002930 Injection - IV & I.M. 50 75 90 120 14002904 Intercostal Tube Drainage 1000 1400 1800 2200 260002914 Intussusception Reduction(Pneumatic) 6000 8400 10800 13200 1560002933 Nebulisation 100 140 180 220 26002937 Prepucial Adhesiolysis 500 700 900 1100 130002932 Steam Inhalation 50 75 90 120 14002911 Subdural / Ventricular Tap 600 840 1080 1320 156002934 Suture Removal 100 140 180 220 26002938 Tracheostomy Tube Change 300 420 540 660 78002928 Wound Debridement 300 420 540 660 780

22.SPECIALISED PROCEDURES - PHYSICAL MEDICINE AND REHABILITATION22.1. PMR - MEDICAL REHABILITATION

03461 Assessment using Scales 800 1120 1440 1760 208003473 Bladder Wash 130 190 240 290 34003294 Bowel Wash 130 190 240 290 34003475 Callus Removal 300 420 540 660 78002376 Catheterization 100 140 180 220 26002385 Certificate - Medical 150 210 270 330 39003510 CIC Training 200 280 360 440 52003468 Disability Assessment( for Court Case ) - PMR 2000 2800 3600 4400 520002372 Dressing Services Charges - Large 250 250 250 250 25002371 Dressing Services Charges - Medium 150 150 150 150 15002370 Dressing Services Charges - Small 90 130 170 200 24003295 Enema 75 110 140 170 20002377 Incision and Drainage 150 210 270 330 390

79


DAYCARE

Rs. Rs. Rs. Rs. Rs.03326 Letter/report to school/workplace 200 280 360 440 52003297 Nebulisation 100 140 180 220 26003519 NG Tube Change/Insertion 400 560 720 880 104002375 Non-Guided Aspiration of Joints 300 420 540 660 78003469 Non-Guided Botulinum Toxin Motor Point Block 2000 2800 3600 4400 520002373 Non-Guided Intra-Articular Injections 400 560 720 880 104002384 Non-Guided Phenol/Alcohol Motor Point Block 300 420 540 660 78002369 PMR - Cross Consultation IP 50 150 250 400 50002380 POP Application - Major 400 560 720 880 104002379 POP Application - Minor 250 350 450 550 65002378 POP Wedging 150 210 270 330 39003324 Skin traction(Per Day) 200 280 360 440 52003474 SPC Change 200 280 360 440 52003298 Steam inhalation 50 70 90 110 13003325 Strapping 150 210 270 330 39003299 Suture removal 70 100 130 160 19002382 Suturing under LA 100 140 180 220 26003296 Tracheostomy care 70 100 130 160 19003472 Tracheostomy Change / Decannulation 500 700 900 1100 130002374 Trigger Point Injection 150 210 270 330 39003322 TBI Assessment 100 140 180 220 26003323 VAC dressing with wall suction 500 700 900 1100 130003517 Wound Debridement - Minor 200 280 360 440 52003518 Wound Debridement - Major 300 420 540 660 78014113 Dupuytren’s contracture Injection 150 210 270 330 39014114 Trigger Finger Injection 100 140 180 220 26014115 Large joint bursal Injections 450 630 810 990 117014116 Ganglion cyst Injection 150 210 270 330 39014117 Retrocalcaneal bursitis injection 150 210 270 330 39014118 Plantar Fasciitis injection 150 210 270 330 39014119 Dequervain’s tenosynovitis injection 150 210 270 330 390

Interventions03330 Musculoskeletal Ultrasound 500 700 900 1100 130003566 Platelet Rich Plasma - 1 300 420 540 660 78003567 Platelet Rich Plasma - 2 750 1050 1350 1650 195003568 Platelet Rich Plasma - 3 1500 2100 2700 3300 390003569 Platelet Rich Plasma - 4 2000 2800 3600 4400 520003498 Ultrasound Guided Aspiration/ Intra-Articular Injections 500 700 900 1100 130003331 Ultrasound guided Erector Spinae plane block 600 840 1080 1320 156003329 Ultrasound Guided Motor Point Block with Botulinum toxin 2200 3080 3960 4840 572003327 Ultrasound Guided Motor Point Block with Bupivacaine/Phenol/

Alcohol (< 3 muscle) 300 420 540 660 78003328 Ultrasound Guided Motor Point Block with Bupivacaine/Phenol/

Alcohol (> 3 muscle) 500 700 900 1100 1300

80


DAYCARE

Rs. Rs. Rs. Rs. Rs.03492 Ultrasound Guided Nerve Blocks with Bupivacaine/Phenol/Alcohol 500 700 900 1100 1300

22.2. PMR - OCCUPATIONAL THERAPPY02486 A.D.L. 200 280 360 440 52002495 Adaptive Devices 150 210 270 330 39014101 Assessment & Home Program 250 350 450 550 65002453 Assessment (Duration 30mins) 250 350 450 550 65002457 Assessment and Home Programme for NFC 100 80 100 120 14003515 Assessment and Home Programme for UOH 100 140 180 220 26002456 Basic Stimulation 200 280 360 440 52003245 Bedside Therapy (Duration 30 mins) 200 280 360 440 52003511 Child / Adult Psychiatry Assessment 400 560 720 880 104003287 Cognitive Perceptual Assessment 400 560 720 880 104003288 Cognitive Perceptual Retraining (Adult) 400 560 720 880 104003289 Cognitive Perceptual Retraining (Child) 350 490 630 770 91002459 Developmental Therapy (Duration 30mins) 250 350 450 550 65002497 Ergonomic 150 210 270 330 39003203 Exercise(Duration 30mins) 100 140 180 220 26003285 Group Therapy 250 350 450 550 65002499 Hand function(Duration 30mins) 250 350 450 550 65003246 Home Assessment & Evaluation 300 420 540 660 78003290 Neuro-Rehabilitation Assessment and Therapy (Adult) (Duration 30mins) 400 560 720 880 104003291 Neuro-Rehabilitation Assessment and Therapy (Child) (Duration 30mins) 300 420 540 660 78003249 Play Therapy 350 490 630 770 91003247 Report to School 200 280 360 440 52002471 Sensory Intergration 350 490 630 770 91003286 Sensory Profile 500 700 900 1100 130003516 Splinting (Miscellaneous)03248 Vocational Assessment 250 350 450 550 65003244 Wheelchair Assessment 250 350 450 550 65014102 Wheelchair Training 300 420 540 660 780

22.3. PMR - ORTHOTIC & PROSTHESTIC03440 Above Knee Socket (Adult) 1800 2490 3200 3920 463003450 Above Knee Temporary Pylon Prosthesis 4750 6650 8550 10450 123503700 AFO (Medium) 1100 1540 1980 2420 286014105 AFO Repair ( Major) 250 350 450 550 65014106 AFO Repair ( Minor) 150 210 270 330 39003436 Ankle Foot Orthosis (Adult Single ) 1750 2450 3150 3850 455003437 Ankle Foot Orthosis (Adult) Single 900 1260 1620 1980 234014103 Ankle Foot Orthosis (Extra Small) 600 840 1080 1320 156003316 Arch Support (Adult) 75 110 140 170 20003317 Arch Support (Child) 50 70 90 110 13014107 Articast Removal 100 140 180 220 260

81


DAYCARE

Rs. Rs. Rs. Rs. Rs.03449 Below Knee Temporary Pylon Prosthesis 6000 8400 10800 13200 1560003409 Body Shell for Scoliosis Correction 2100 2940 3780 4620 546003452 Bohler Iron Articulated 1500 2100 2700 3300 390003453 Bohler Iron Non-Articulated 1000 1400 1800 2200 260003504 Charcot Restraint Othotic Walker (CROW) 3000 4200 5400 6600 780003429 Cockup Splint (Adult) PVC 900 1260 1620 1980 23403701 Cock-up Splint (Child) 500 700 900 1100 130003430 Cockup Splint (Child) PVC 500 700 900 1100 130003405 Cosmetic Glove 250 350 450 550 65003431 Crutch Tip -One Pair 50 70 90 110 13003425 Customised Collar (Adult) 600 840 1080 1320 156003426 Customised Collar (Child) 300 420 540 660 78003486 Elbow Extension Splint (PVC) - Adult 700 980 1260 1540 182003487 Elbow Extension Splint (PVC) - Child 350 490 630 770 91003400 Gaiter - Extra Small 800 1120 1440 1760 208003432 Gaiter (Lower Limb) (Adult) 2500 3500 4500 5500 650003433 Gaiter (Lower Limb) (Child) 1750 2450 3150 3850 45503702 Gaiter (Medium) 1250 1750 2250 2750 325003438 Gaiter (Upper Limb) (Adult) 1750 2450 3150 3850 455003439 Gaiter (Upper Limb) (Child) 1250 1750 2250 2750 325003503 Hip Abduction Splint - PVC (Adult) 700 980 1260 1540 182003484 Humeral Sling / Cuff 850 1190 1530 1870 221014104 KAFO with Posterior Offset Knee Joint (Ankle) 6000 8400 10800 13200 1560003435 Knee Ankle Foot Orthosis (Adult )Single 5000 7000 9000 11000 1300003522 Knee Ankle Foot Orthosis (Child) Single 3200 4480 5760 7040 832003215 Knee Cap (Adult) 400 560 720 880 104018211 Knee Cap (Child) 200 280 360 440 52003488 Knee Extension Splint - Adult (PVC) 1000 1400 1800 2200 260003489 Knee Extension Splint - Child (PVC) 700 980 1260 1540 182003460 Limb Prothesis Fittment & Check out 600 840 1080 1320 156003410 Lumbo Sacral Corset 1000 1400 1800 2200 260003232 MCR Adjustable Sandal 650 910 1170 1430 169003221 MCR Bata Model Sandal 750 1050 1350 1650 195003349 MCR Insole One Pair (Adult) 200 280 360 440 52003224 MCR Insole One Pair (Child) 150 210 270 330 39003222 MCR Sandal Heel Counter 850 1190 1530 1870 221003218 MCR X Model (Adult) 350 490 630 770 91003351 Metatarsal Bar (Adult) 100 140 180 220 26003352 Metatarsal Bar (Child) 50 70 90 110 13003550 Miscellaneous - Footwear PMR03235 Miscellaneous - Orthotics & Prosthetics PMR14108 Outrigger Splint ( OT ) 300 420 540 660 78003233 Patellar Tendon Bearing Orthosis (Adult) 3500 4900 6300 7700 9100

82


DAYCARE

Rs. Rs. Rs. Rs. Rs.

03234 Patellar Tendon Bearing Orthosis (Child) 2750 3850 4950 6050 715003368 Patellar Tendon Bearing Socket (Adult) (Resin) 2000 2800 3600 4400 520003369 Patellar Tendon Bearing Socket (Child) (Resin) 600 840 1080 1320 156003521 Patellar Tendon Bearing Socket (Polypropylene) 2000 2800 3600 4400 520003505 Pop application - Major 250 350 450 550 65003506 Pop application - Minor 200 280 360 440 52003455 Posterior Leaf Spring Orthosis Splint (Adult) 1500 2100 2700 3300 390003456 Posterior Leaf Spring Orthosis Splint (Child) 850 1190 1530 1870 221003216 PP Ankle Foot Orthosis with Filler (Adult) 1200 1680 2160 2640 312003320 Prosthesis Repair - Major 500 700 900 1100 130003321 Prosthesis Repair - Minor 200 280 360 440 52003485 Shoulder Abduction Splint 1200 1680 2160 2640 312003383 Stockingnet (60mm/80mm/120mm) 100 140 180 220 26003408 Taylor Knight Brace 2700 3780 4860 5940 702003454 Thermoplast Splint Modification 150 210 270 330 39003524 Trans Tibial Prosthesis (PP Socket) (Adult) Endoskeletal 15000 21000 27000 33000 3900003367 Trans Tibial Prosthesis (Resin Scoket) (Child) Exoskeletal 7000 9800 12600 15400 1820003366 Trans Tibial Prosthesis (Resin Socket) (Adult) Exockeletal 9000 12600 16200 19800 2340003527 Trans Tibial Prosthesis (Resin Socket) (Child) Endoskeletal 16800 23520 30240 36960 4368003306 Trans-Femoral Prosthesis (Without Shoe) Adult 16000 22400 28800 35200 4160003307 Trans-Femoral Prosthesis (Without Shoe) Child 12000 16800 21600 26400 3120003523 Trans-Femoral Socket (Adult) (Polypropylene) 2500 3500 4500 5500 650003300 Trans-Humeral Prosthesis (Without Terminal Device) Adult 10700 14980 19260 23540 2782003301 Trans-Humeral Prosthesis (Without Terminal Device) Child 8400 11760 15120 18480 2184003318 Trans-Radial Prosthesis (Without Terminal Device) Adult 9500 13300 17100 20900 2470003319 Trans-Radial Prosthesis (Without Terminal Device) Child 7000 9800 12600 15400 1820003393 Velcro Strap 1 Pair 100 140 180 220 260

22.4. PMR - MEDICO SOCIAL WORK03281 Addressing Govt. Advocacy/ Legal Guidence 200 280 360 440 52003276 Assessment 200 280 360 440 52003250 Correspondence 50 70 90 110 13003293 Educational Placement 300 420 540 660 78003278 Family / Individual/ Marital Counselling 300 420 540 660 78003279 Follow up & After Care( Per Session) 200 280 360 440 52003282 Group Therapy(Per Session) 300 420 540 660 78003283 Psychosocial Intervention & Discharge Plan 250 350 450 550 65003258 Rehabilitation and Placement Service Charge 600 840 1080 1320 156003251 Rehabilitation Counselling 300 420 540 660 78003280 Visits (Collateral Contacts) 200 280 360 440 52003292 Vocational Placement 300 420 540 660 780

22.5. PMR -SPEECH AND LANGAUAGE SECTION03332 Bedside dysphagia screening 150 210 270 330 390

83


DAYCARE

Rs. Rs. Rs. Rs. Rs.03333 Bedside dysphagia therapy 200 280 360 440 52003239 Bedside speech & language screening 150 210 270 330 39003334 Bedside speech & language therapy 200 280 360 440 52003271 Computerized Speech and Lanuage Assessment 300 420 540 640 76003262 Dysphagia Assessment 300 420 540 660 78003263 Dysphagia Therapy 250 350 450 550 65003335 Follow-up and counselling 100 140 180 220 26003275 Home Based Training Program 250 350 450 550 65003267 Oromotor Exercises 200 280 360 440 52003268 Oromotor Stimulation 200 280 360 440 52003272 Speech and Language Therapy using Vaghmi Software 200 280 360 440 52003261 Speech and Language Assessment 300 420 540 660 78003269 Speech and Language Therapy 300 420 540 660 78003265 Voice Therapy 200 280 360 440 52003264 VoiceAssessment 250 350 450 550 650

23. PHYSIOTHERAPY03570 Acute Cardiac Rehabilitation 1200 1680 2160 2640 312003530 Acute Rehabilitation for Patient 250 350 450 550 65003242 Fitness Program for 1 Month 1200 1680 2160 2640 312003703 Homecare for Physiotherapy 800 1120 1440 1760 208003535 ICU Patients Twice Daily 285 400 510 630 74003544 Laser Therapy / ESWT / FES Per Site 500 700 900 1100 130003704 Modality(single modality for 1 site) 100 140 180 220 26003478 MSPT for 1 Site 300 420 540 660 78003509 MSPT for 5 Sessions 1400 1960 2520 3080 364004104 OB/Gynac Physiotherapy For 5 Sessions 900 1260 1620 1980 234003243 OB/Gynac Physiotherapy Per Session 200 280 360 440 52003538 Peadiatric Neuro Rehabilitation Evaluation and

Exercise Prescription (1 Session) 300 420 540 660 78003540 Peadiatric Neuro Rehabilitation Evaluation and

Exercise Prescription (5 Sessions) 1400 1960 2520 3080 364003542 Peadiatric Neuro Rehabilitation Evaluation and

Exercise Prescription (Single Therapy With Concession) 100 140 180 220 26002387 Physiotheraphy - Cross Consultation IP 50 150 250 400 50003529 Physiotherapy Consultation and treatment for the first day 350 490 630 770 91003241 Physiotherapy Evening for 5 Sessions 1900 2660 3420 4180 494003240 Physiotherapy Evening for One Session 400 560 720 880 104003705 Physiotherapy for Childbirth 300 420 540 660 78003508 Rehabilitation 5 Session 2200 3080 3960 4840 572003483 Rehabilitation Per Session 450 630 810 990 1170

24. SPECIALISED PROCEDURES - PLASTIC SURGERY02321 Arch Bar Removal (Per Arch) 300 420 540 660 78002354 Artery Biopsy 2600 3640 4680 5720 6760

84


DAYCARE

Rs. Rs. Rs. Rs. Rs.

02723 AVF Creation - Major 10000 14000 18000 22000 2600002722 AVF Creation - Minor 5000 7000 9000 11000 1300002322 Body Piercing 1000 1400 1800 2200 260002343 Botox injection 600 840 1080 1320 156002316 Burns Pad 100 140 180 220 26002331 Closed Reduction and Splinting 120 170 220 260 31002721 Closed Reduction and Splinting (Multiple) 500 700 900 1100 130002726 Collagen Application 1000 1400 1800 2200 260002327 Cross Finger Flap 3000 4200 5400 6600 780002326 Debridement - Minor 500 700 900 1100 130002735 Debridement - Major 1000 1400 1800 2200 260002336 Delay of Flaps - Major 1000 1400 1800 2200 260002335 Delay of Flaps - Minor 500 700 900 1100 130002352 Disability Assessment 475 670 860 1050 124002315 Dressing - Service Charges (Large) 250 250 250 250 25002314 Dressing - Service Charges (Medium) 150 150 150 150 15002313 Dressing - Service Charges (Small) 90 130 170 200 24002358 Ear Lobe Repair Biilateral 3000 4200 5400 6600 780002359 Ear Lobe Repair Unilateral 2000 2800 3600 4400 520002349 Ear Piercing 500 700 900 1100 130002727 Excision ( Minor) 1000 1400 1800 2200 260002728 Excision ( Moderate) 2000 2800 3600 4400 520002729 Excision ( Multiple) 3000 4200 5400 6600 780002725 Eyelet Application 500 700 900 1100 130002342 Fasciotomy - Major OPD/Ward 1000 1400 1800 2200 260002341 Fasciotomy - Minor 500 700 900 1100 130002737 Finger Repair Minor 4000 5600 7200 8800 1040002738 Finger Repair Moderate 8000 11200 14400 17600 2080002739 Finger Repair Major 12000 16800 21600 26400 3120002329 Flap Division 240 340 430 530 62002720 Flap Division and Inset - Minor 1500 2100 2700 3300 390002724 Guiding Elastics for IMF 250 350 450 550 65002324 Incision and Drainage 150 210 270 330 39002350 Insurance Authentification 500 700 900 1100 130002323 Intra Lesional Injection 300 420 540 660 78002732 Intra Lesional Injection (Multiple) 500 700 900 1100 130002734 K- Wire Removal 100 140 180 220 26002351 Medical / Leave Certificate 240 340 430 530 62002345 Medical Documentation - Clinical Photography 175 250 320 390 46002361 Muscle Biopsy 2000 2800 3600 4400 520002353 Nerve Biopsy 2600 3640 4680 5720 676002367 Plastic Surgery - Cross Consultation IP 50 150 250 400 50002320 POP Applications 500 700 900 1100 1300

85


DAYCARE

Rs. Rs. Rs. Rs. Rs.02330 Removal of Foreign Body in OPD/ward 300 420 540 660 78002362 Revision Amputation Finger Multiple 7000 9800 12600 15400 1820002363 Revision Amputation Finger Single 2500 3500 4500 5500 650002730 Scar Revision - Minor 2500 3500 4500 5500 650002731 Scar Revision - Moderate 5000 7000 9000 11000 1300002325 Splinting 200 280 360 440 52002333 Split Skin Graft (Medium) 2000 2800 3600 4400 520002332 Split Skin Graft (Small) 1000 1400 1800 2200 260002364 Suture Removal Large (OPD) 150 210 270 330 39002365 Suture Removal Medium (OPD) 100 140 180 220 26002366 Suture Removal Small (OPD) 70 100 130 160 19002318 Suturing Major 4000 5600 7200 8800 1040002736 Suturing Moderate 2000 2800 3600 4400 520002317 Suturing Minor 1000 1400 1800 2200 260002340 Tendon Repair - Major 4000 5600 7200 8800 1040002339 Tendon Repair - Minor 2000 2800 3600 4400 520002733 Tissue Expander Inflation 200 280 360 440 52002311 VAC Dressing with Vac Machine 100 140 180 220 26002310 VAC Dressing with Wall Suction 500 700 900 1100 130002328 V-Y Flap 2000 2800 3600 4400 5200

25. SPECIALISED PROCEDURES - PSYCHIATRY02596 Case File 350 350 350 350 35002516 Case File and Detailed Work Up 800 1120 1440 1760 208002505 Counselling (Per Session) 400 560 720 880 104002508 E.C.T. 750 1050 1350 1650 195002587 Psychoeducation 475 670 860 1050 124002569 Special Assessment using Questionnaire 400 570 730 890 105002588 Special Consultation with 2 Multidisciplinary Team (OP) 800 800 800 800 80002589 Special Consultation with 3 Multidisciplinary Team (OP) 1000 1000 1000 1000 1000

25.1. CHILD PSYCHIATRY02556 Assessment of Intelligence - Child 800 1120 1440 1760 208002503 Assessment of Specific Learning Disablity 1000 1400 1800 2200 260002564 Behavioural Counselling - 1 Session 500 700 900 1100 130002563 Behavioural Counselling - 3 Sessions 1200 1680 2160 2640 312002555 Certificates - Letters to School 330 500 600 700 90002572 Child Psychotherapy - One Session 600 840 1080 1320 156002550 Detailed Work up 800 1120 1440 1760 208002551 Detailed Work up with Report 1200 1680 2160 2640 312002567 Developmental Assessment - Brief 400 570 730 890 105002568 Developmental Assessment - Detailed 660 900 1200 1500 170002750 Diagnostic Assessment - Child 1500 2100 2700 3300 390002561 Family Psychotherapy - Child (1 Session) 1200 1680 2160 2640 312002553 Letters to School 200 280 360 440 520

86


DAYCARE

Rs. Rs. Rs. Rs. Rs.

02576 Mini Assesment of Autism Spectrum Disorders 1000 1400 1800 2200 260002574 Mini Assessment of Hyperactivity (1 Session) 1000 1400 1800 2200 260002571 Neuropsychological Assessment - Child 4000 5500 7100 8600 1020002599 Play Therapy (5 sessions) 1200 1680 2160 2640 312002557 School Visit (Transport Extra) 2000 2800 3600 4400 520002552 Special Assessment (Using Qustionnaire) 300 420 540 660 78002575 Systematic Assessment of Autism Spectrum Disorder 5000 7000 9000 11000 1300002573 Systematic Clinical Assessment of Hyperactivity 4000 5500 7100 8600 10200

25.2. CLINICAL PSYCHOLOGY02529 Assesment with Clinical Rating Scales 300 420 540 660 78002577 Assessment of Intelligence - Adult 790 1100 1400 1700 210002578 Assessment of Memory 660 840 1080 1320 156002514 Assessment of Personality and Interpersonal Relations 1200 1680 2160 2640 312002751 Assessment of Specific function 750 1050 1350 1650 195002753 Cognitive Behavior Therapy - Single Session 600 840 1080 1320 156002527 Detailed Intake 660 900 1200 1500 170002757 Dialectical Behavior Therapy - Single Session 600 840 1080 1320 156002759 Family Therapy - Single Session 800 1120 1440 1760 208002752 Individual Therapy - Single Session 600 840 1080 1320 156002756 Interpersonal Therapy - Single Session 600 840 1080 1320 156002758 Marital Therapy - Single Session 800 1120 1440 1760 208002517 Neuropsychological Assessment - Adult 4750 6650 8550 10450 1235002755 Psychodynamic PsychoTherapy - Single Session 600 840 1080 1320 156002760 Psychoeducation 475 670 860 1050 124002754 Supportive PsychoTherapy - Single Session 600 840 1080 1320 1560

25.3. PSYCHIATRY SOCIAL WORK02767 Customized After-Care Services/Personalized Aftercare Plan for

2 months (Excluding Charges Incurred on Transportation) 1800 2520 3240 3960 468002582 Family Assessments / Marital Assesment 500 700 900 1100 130002764 Family Counselling/Family Psychoeducation 600 840 1080 1320 156002606 Family Therapy/Marital Therapy 800 1120 1440 1760 208002581 Group Therapy (Families of the Mentally Ill) 550 770 990 1210 143002766 Home Visit/School Visit/Other organisation Visits (Excluding Transportation) 1500 2100 2700 3300 390002765 Individual Counselling 500 700 900 1100 130002583 Letters to NGOs/GO’s and other Organisations/Referral/Liasion Services 500 700 900 1100 130002763 Psychosocial Assessment 350 490 610 790 91002607 Rehabilitation Counselling - 1 Session 500 700 900 1100 1300

25.4. DAY CARE CENTRE02535 Recovery Oriented Service -One day Charge (For Inpatients only) 100 100 200 300 40002536 Recovery Oriented Service- One Week Charge 600 600 1200 1800 240002537 Recovery Oriented Service - One Month Charge 600002546 Recovery Oriented Service - One Week Trial Period (Only for Outpatients) 1500

87


DAYCARE

Rs. Rs. Rs. Rs. Rs.

25.5. GENERAL02533 Assessment and Counselling for Patient with ISH (3 Sessions) 700 700 1000 1000 100002532 Brief Intervention for Alcholism (3 Sessions) 700 700 1000 1000 100002597 Brief Proforma Based In Patient Assessment 250 250 250 250 25002590 Brief Proforma Based Out Patient Assessment 300 300 300 300 30002534 Cross Consultation IP - Psychiatry 75 300 600 800 100002593 Cross Consultation within Psychiatry Departments - Special 250 450 600 750 75002598 Detailed Proforma Based In Patient Assessment 500 500 500 500 50002507 DiagnosticAssessment 1500 2100 2700 3300 390002591 General Service Charges in Psychiatry Ward 75 300 700 800 100002762 Geriatric Psychiatry Assessment 100 140 180 220 26002526 Group (Per Session) 220 310 400 480 57002510 Group Therapy (ADS 3 groups) 1000 1000 1500 2000 300002586 Individual Therapy - Single Session 600 840 1080 1320 156002600 MMC Counseling 100 140 180 220 26002592 Multidisciplinary Team Meeting - 3 Consultants 300 300 1000 1500 250002761 Multidisciplinary Team Meeting - 2 Consultants 200 200 900 1400 240002547 Perinatal Services (3 Sessions) 300 300 300 300 30002530 Provision of Typed Assesment Report 120 170 220 260 31002584 Psychoeducation 475 670 860 1050 124002594 Readmission and Reassessment 500 750 1250 2000 200002595 Reassessment/Second Opinion 200 400 600 1000 100002548 Rehabilitation Admission - Advance 45000 45000 45000 45000 4500002549 Rehabilitation Admission - Per Month 15000 15000 15000 15000 15000

25.6. GERIATRIC PSYCHIATRY02772 Breif Assesment - Geriatric Psychiatry 300 300 300 300 30002773 Detailed Assesment - Geriatric Psychiatry 500 500 500 500 500

26. SPECIALISED PROCEDURES - UROLOGY01301 Aspiration Biopsy 200 280 360 440 52001302 Biofeed Back (2 Sessions of 10 minutes) 300 420 540 660 78001303 Biopsy 500 700 900 1100 130001311 Biopsy - Prostatic Needle Biopsy 1500 2100 2700 3300 390001318 Catheter Calibration 100 140 180 220 26000214 Cathetererterization (Urology) 100 140 180 220 26001305 Cavernosometry and Cavernosography 1200 1680 2160 2640 312001304 CMG, UPP, EMG and P.F. Study 1700 2380 3060 3740 442001364 Cross Consultation IP - Urology 50 150 250 400 50001307 Cystometrography - Repeat (within 1 month) 1200 1680 2160 2640 312001306 Cystometrography (CMG) with P.F. Study 1700 2380 3060 3740 442001361 Erectiledysfunction Evaluation (Comprehensive) # 653001362 Erectiledysfunction Evaluation (Non vascular) # 458006209 Fluroscopy Time upto 10 Minutes 600 690 780 870 960

88

01308 Intracavernosal Injection of Papaverine (S/C) 300 420 540 660 78001351 Lithotripsy - A (< 1cm) 10000 14000 18000 22000 2600001352 Lithotripsy - B (1-2cms) 12000 16800 21600 26400 3120001353 Lithotripsy - C (2-3cms) 13100 18340 23580 28820 3406001354 Lithotripsy - D (Additional Sittings) 3600 5040 6480 7920 936001355 Lithotripsy - E (Completion Lithotripsy) 2400 3360 4320 5280 624001356 Lithotripsy - F (Attempted) 600 840 1080 1320 156001323 Miscellaneous - Urology Special Procedures 200 280 360 440 52001309 P.F. Study 500 700 900 1100 130001310 PCN 900 1260 1620 1980 234001363 Provocative testing (PIPE test) 120 170 220 260 31001312 Residue 150 210 270 330 39001314 Trocar Suprapubic Cystostomy 1000 1400 1800 2200 260001315 TRUS 500 700 900 1100 130001316 UPP 175 250 320 390 46001317 Upper Tract Study 300 420 540 660 78001319 Urethral Dilation 400 560 720 880 104001320 Urethral Dilation - Repeat 200 280 360 440 52001321 Urinary Flow Rate 200 280 360 440 52001324 Uroflowmetric Analysis 250 350 450 550 65001322 Video UDE (including Video Cassette) 4000 5600 7200 8800 10400

# 1361 is a package inclusive of one day stay in a private room and penile doppler studies.# 1362 is a package inclusive of one day stay in a pvt.room27. SPECIALISED PROCEDURES - MEDICAL ONCOLOGY

03564 Auto HSCT Procedure* 250000 250000 250000 250000 25000003551 Biological Therapy (Monoclonal) 300 420 540 660 78003556 Bone Marrow Aspitation 200 280 360 440 52003561 Central Venous Access 330 460 590 730 86003555 Chemotheraphy Consultation from other Departments 200 280 360 440 52002879 Chemotherapy Administration Charges - Rare Neoplasm 200 280 360 440 52002878 Chemotherapy Administration Charges - Unknown Primary 200 280 360 440 52002877 Chemotherapy Administration Charges ( In Patient) 200 280 360 440 52002876 Chemotherapy Administration Charges (Day Care) 200 280 360 440 52002875 Chemotheray Planning Charges (Full Protocol) 2200 3080 3960 4840 572003565 Cross Consultation IP - Medical Oncology 50 150 250 400 50002883 Infusion Chemo using CADD Pump - Physician charge 250 400 600 800 110002882 Infusion Chemo using CADD Pump - Infusion Charge Per Day 600 840 1080 1320 156003563 Intra Articular Injection 240 340 430 530 62002889 Intrathecal Chemotherapy 600 840 1250 1500 200003559 Lumbar Puncture 250 350 450 550 65003554 Miscellaneous Cancer Theraphy 770 1080 1390 1690 200002887 Paracentesis - Diagnostic 500 700 900 1100 130002888 Paracentesis - Theraputic 700 980 1260 1540 1820


DAYCARE

Rs. Rs. Rs. Rs. Rs.

89


DAYCARE

Rs. Rs. Rs. Rs. Rs.02990 Pleural Aspiration - Repeat 400 560 720 880 104002991 Pleural Aspiration - Theraputic 1000 1400 1800 2200 260003560 Pleurodesis - with Betadiene 500 700 900 1100 130003557 Stem Cell Harvest from Bone 4400 6160 7920 9680 1144003558 Stem Cell Harvest from Peripheral Blood 3300 4620 5940 7960 858003562 Synovial Fluid Aspiration 175 250 320 390 46003552 Weekly Chemotheraphy Charges 200 280 360 440 52003553 Weekly Chemotheraphy for any Cancer 500 700 900 1100 1300

* Procedure charges only. Investigations, room rent, drugs, blood bank products / process, diet and other charges extra.28. SPECIALISED PROCEDURES - SURGICAL ONCOLOGY

25510 Chemoport Flush 500 700 900 1100 130025511 Chemoport Removal 700 980 1260 1540 182025519 Chemo-Port Removal in OPD/Ward 700 980 1260 1540 182002694 Cross Consultation - Surgical Oncology 50 70 90 110 13025530 Drain/ Catheter insertion 250 350 450 550 65025532 Drain/ Catheter removal 100 140 180 220 26025524 Excision (Complex) 1500 2100 2700 3300 390025522 Excision (Minor) 500 700 900 1100 130025523 Excision (Multiple) 1000 1400 1800 2200 260025515 Excision Breast Lump 500 700 900 1100 130025514 Excision of Small Swelling Sebacious Cyst 120 170 220 260 31025540 Flap Division/ Inset 500 700 900 1100 130025529 Fluid Aspiration 250 350 450 550 65025535 ICD Insertion 500 700 900 1100 130025536 ICD removal 250 350 450 550 65025543 Miscellaneous (Major) 250 350 450 550 65025542 Miscellaneous (Minor) 150 210 270 330 39025518 Oral / Truecut Biopsy 500 700 900 1100 130025516 Otoendoscopy 300 420 540 660 78025534 Paracentesis Diagnostic – Abdominal/ Thoracic 250 350 450 550 65025533 Paracentesis Therapeutic – Abdominal/ Thoracic 500 700 900 1100 130025517 Patient Counselling 50 70 90 110 13025537 Pleurodesis 500 700 900 1100 130025512 Proctoscopy 45 60 80 100 12025521 Punch/ Incision Biopsy 500 700 900 1100 130025531 Ryles tube insertion 100 140 180 220 26025525 Secondary suturing 250 350 450 550 65025527 Stoma Care 250 350 450 550 65025526 Suture removal 100 140 180 220 26025538 Tracheostomy care 500 700 900 1100 130025539 Tracheostomy decanulation 1000 1400 1800 2200 260025541 VAC Dressing 400 560 720 880 104025513 Videolaryngoscopy (IDL) 250 350 450 550 650

90


DAYCARE

Rs. Rs. Rs. Rs. Rs.25528 Wound debridement 250 350 450 550 650

29. SPECIALISED PROCEDURES - GYNECOLOGIC ONCOLOGY25000 Aspiration Biopsy 200 280 360 440 52025001 Aspiration Cytology 300 420 540 660 78025002 Aspiration of Lympocele 300 420 540 660 78025153 Biopsy Cervix / Vagina - Big 600 840 1080 1320 156025154 Biopsy Cervix / Vagina - Small 300 420 540 660 78025155 Biopsy Vulva - Multiple Site 700 980 1260 1540 182025156 Biopsy Vulva - Single Site 350 490 630 770 91025006 Catheter Removal 100 140 180 220 26025145 Catheterisation 250 350 450 550 65025007 Cauterization Cervix 400 560 720 880 104025008 Cervix Cytology (Pap Smear) 200 280 360 440 52025009 Chemo-Port Flushing in OPD/ward 500 700 900 1100 130025010 Chemo-Port Removal in OPD/Ward 700 980 1260 1540 182025610 Chemoport under local 2000 2800 3600 4400 520025011 Chemotherapy Five Days 2500 3500 4500 5500 650025012 Chemotherapy Four Days 2000 2800 3600 4400 520025013 Chemotherapy IV Push 500 700 900 1100 130025014 Chemotherapy Planning 1500 2100 2700 3300 390025015 Chemotherapy Single Day 1000 1400 1800 2200 260025016 Chemotherapy Single Drug 600 840 1080 1320 156025017 Chemotherapy Three Days 1500 2100 2700 3300 390025018 Chemotherapy Two Days 1200 1680 2160 2640 312025140 Cold coagulator for Minor Procedure 1000 1400 1800 2200 260025157 Colposcopy Diagnostic 1500 2100 2700 3300 390025158 Colposcopy Screening 150 210 270 330 39025037 Colposcopy, Pap Smear, Fractional Curettage 600 840 1080 1320 156025135 Cross Consultation IP - Gynaecologic Oncology 50 150 250 400 50025043 Culdocentesis 500 700 900 1100 130025044 Cytology Endometrium 500 700 900 1100 130025048 Dilation and Curettage 750 1050 1350 1650 195025052 Drain Removal 120 170 220 260 31025053 Drainage of Pyometra 1000 1400 1800 2200 260025055 Dressing - Service Charges - Large 150 210 270 330 39025056 Dressing - Service Charges - Medium 130 190 240 290 34025057 Dressing - Service Charges - Small 100 140 180 220 26025147 Endocervical Curettage 350 490 630 770 91025159 Endometrial Biopsy - Complex 1200 1680 2160 2640 312025160 Endometrial Biopsy - Simple 500 700 900 1100 130025059 Excision of Cervical Lesions In OPD 500 700 900 1100 130025060 Excision of Lymph Node in OPD 1500 2100 2700 3300 390025061 Excision of Vaginal Lesions 500 700 900 1100 1300

91


DAYCARE

Rs. Rs. Rs. Rs. Rs.25062 Excision of Vulval Lesions 500 700 900 1100 130025063 FNAC Lymph Node 500 700 900 1100 130025064 FNAC Parametrium 500 700 900 1100 130025161 FNAC Parametrium / POD 500 700 900 1100 130025148 GRBS 60 80 110 130 16025069 HPV DNA Test collection 1000 1400 1800 2200 260025070 Incision and Drainage 150 210 270 330 39025608 LLETZ 2000 2800 3600 4400 520025072 Lletz (charges to be put by Department Staff)25609 LoopExcision Biopsy 500 700 900 1100 130025071 Lucd/Loop/Copper T/ Mirena Coil Removal 250 350 450 550 65025073 Mirena Coil Insertion 600 800 1000 1500 180025074 Office Hysteroscopy & Biopsy 4000 5600 7200 8800 1040025079 Paracentesis Diagnostic - Abdominal 350 490 630 770 91025080 Paracentesis of Lymphocele 750 1050 1350 1650 195025081 Paracentesis Therapeutic - Abdominal 750 1050 1350 1650 195025082 Perineal Care 50 70 90 110 13025083 Peripheral Insertion of Central Line 1000 1400 1800 2200 260025084 Pleural Diagnostic - Pleural 500 700 900 1100 130025085 Pleural Therapeutic - Pleural 1000 1400 1800 2200 260025086 Pleurodesis 1000 1400 1800 2200 260025162 Polypectomy - Big 600 840 1080 1320 156025163 Polypectomy - Small 300 420 540 660 78025092 Residual Urine Measurement 200 280 360 440 52025165 Secondary Suturing - Major 2000 2800 3600 4400 520025166 Secondary Suturing - Minor 500 700 900 1100 130025167 Sentinel Lymph Node Mapping 2000 2800 3600 4400 520025149 Staging for CA Cx Cystoscopy 1750 2450 3150 3850 455025151 Staging for CA Cx Proctoscopy 500 700 900 1100 130025152 Staging for Ca Cx Proctoscopy and biopsy 1500 2100 2700 3300 390025094 Suture/Staple Removal 150 210 270 330 39025611 Thermal Ablation 1500 2100 2700 3300 390025097 Toluidine Blue Test Vulva 250 350 450 550 65025168 Tru Cut Biopsy - Major 1000 1400 1800 2200 260025169 Tru Cut Biopsy - Minor 500 700 900 1100 1300

30. SPECIALISED PROCEDURES - RADIATION ONCOLOGY23001 2DRT Curative (2DRT-C) - Each Instalment 7000 9800 12600 15400 1820023025 2DRT Curative (2DRT-C) - Package 50000 70000 90000 110000 13000023002 2DRT Palliative (2DRT-P) - Each Instalment 7000 9800 12600 15400 1820023026 2DRT Palliative (2DRT-P) - Package 28000 39200 50400 61600 7280023003 3DCRT Curative (3DRT-C) - Each Instalment 12000 12000 12000 12000 1200023027 3DCRT Curative (3DRT-C) - Package 84000 117600 151200 184800 21840023004 3DCRT Palliative (3DRT-P) - Each Instalment 12000 12000 12000 12000 12000

92


DAYCARE

Rs. Rs. Rs. Rs. Rs.23028 3DCRT Palliative (3DRT-P) - Package 36000 50400 64800 79200 9360023039 Blood Irradiation (Whole Blood, Components,P.C) 800 800 800 800 80023022 Brachytherapy - Gyn - Intra Cavity - Package 18000 25200 32400 39600 4680023021 Brachytherapy - Gyn - Sorbo 6000 8400 10800 13200 1560023023 Brachytherapy - Interstitial all Sites - Package 24000 33600 43200 52800 6240023024 Brachytherapy - Intraluminal 6000 8400 10800 13200 1560023040 Brachytherapy Surface Mould 12000 12000 12000 12000 1200091236 Cross Consultation IP - Radiation Oncology 50 150 250 400 50023043 CT Simulation 6000 6000 6000 6000 600023037 Extra-Corporeal Irradiation 10000 14000 18000 22000 2600023036 Hemi-Body Irradiation 15000 21000 27000 33000 3900023007 IGRT Curative (IGRT-C) - Each Instalment 30000 30000 30000 30000 3000023031 IGRT Curative-(IGRT-C) - Package 150000 210000 270000 330000 39000023008 IGRT Palliative (IGRT-P) - Each Instalment 30000 30000 30000 30000 3000023032 IGRT Palliative-(IGRT-P) - Package 90000 90000 90000 90000 9000023029 IMRT Curative (IMRT-C) - Package 108000 151200 194400 237600 28080023005 IMRT Curative (IMRT-C) Each Instalment 12000 12000 12000 12000 1200023006 IMRT Palliative (IMRT-P) - Each Instalment 12000 12000 12000 12000 1200023030 IMRT Palliative (IMRT-P) - Package 48000 67200 86400 105600 12480023038 Per Fraction- Electrons / Photon ( No CT Scan) 3000 4200 5400 6600 780023020 Stereotatic Body Radio Theraphy (SBRT) - Curative 180000 252000 324000 396000 46800023018 Stereotatic Radio Surgery (SRS) - Curative 108000 151200 194400 237600 28080023019 Stereotatic Radio Theraphy (SRT) - Curative 180000 252000 324000 396000 46800023035 Total Body Irradiation 30000 30000 30000 30000 3000023041 VMAT - Each Instalment 32000 32000 32000 32000 3200023033 Volumetric Modulated Arc Therapy Package - Adjuvan 160000 224000 288000 352000 41600023034 Volumetric Modulated Arc Therapy Package - Definit 192000 268800 345600 422400 499200

31. SPECIALISED PROCEDURES - PAIN & PALLIATIVE MEDICINE03034 Acupuncture 500 700 900 1100 130003052 Acupuncture Package/ Session 250 250 250 250 25003011 Ascitic Tap 300 400 500 600 700/80003035 Caudal Injections 1800 2520 3240 3960 468003036 Cervical Medial Branch Block 2000 2800 3600 4400 520003025 Counseling 200 250 300 450 500/60003033 Cross Consultation IP - Palliative Medicine 50 150 250 400 50003056 Dry Needling in OPD/Ward 880 1230 1580 1940 229003038 Ganglion Impar Block 1500 2100 2700 3300 390003018 Home Visit 500 500 500 500 50003024 Inpatient Cross Consultation 50 100 200 350 500/60003057 Intercostal Nerve Blocks in OPD/Ward 500 600 700 800 1000/120003039 Intrathecal Drug Delivery Pump 10000 14000 18000 22000 2600003058 IV Fusion Morphine/Ketamine in OPD/Ward 200 250 300 450 500/600

93


DAYCARE

Rs. Rs. Rs. Rs. Rs.

03059 Ketamine/Morphine Administration & Monitoring in OPD/Ward 400 450 500 600 700/80003061 Lumbar Medial Branch/Facet Joint Injection in OPD/Ward 1800 2520 3240 3960 468003026 Lymphapress Package (6 Sittings) 800 1120 1440 1760 1000/120003016 Lymphedema Treatment 200 250 300 450 500/60003068 Mirror Box Therapy / Session 250 250 250 250 25003053 Needles for Acupuncture 100 100 100 100 10003062 Needles for Dry Needling in OPD/Ward 300 300 300 300 30003041 Neurolytic Nerve Block 5000 7000 9000 11000 1300003063 Peripheral Joint Injection with Imaging in OPD/Ward 600 840 1080 1320 156003064 Peripheral Nerve Injection with Imaging in OPD/Ward 600 840 1080 1320 156003019 Placement of Sub-Cutaneous line 350 490 630 770 91003012 Pleural Tapping 175 250 320 390 46003044 Pulse Radiofrequency 5500 7700 9900 12100 1430003055 Pulse Radiofrequency Add on 1500 2100 2700 3300 390003045 Repeat Pulse Radiofrequency 2500 3500 4500 5500 650003046 Spinal Cord Stimulation Stage 2 10000 14000 18000 22000 2600003014 Stellate Ganglion Blocks 500 600 700 800 100003047 Sympathetic Ganglion Block 2000 2800 3600 4400 520003065 Syringe Driver/PCA Per Day in OPD/Ward 400 450 500 550 60003048 Therapeutic Epidural 1800 2520 3240 3960 468003049 Thermal Radiofrequency 5500 7700 9900 12100 1430003050 Transforaminal Epidural 1800 2520 3240 3960 468003066 Trigger Point Injections in OPD/Ward 250 300 350 400 50003067 Ulrasound Guidance for Day Care/OT Procedures These will be

added extra in OPD/Ward 300 420 540 660 780

32. ANAESTHESIOLOGY03060 Anesthesia Charges for Interventional Neuro Radiology Procedures 5000 7000 9000 11000 13000

09421 Anesthesia for minor neuro radiological procedures 1000 1400 1800 2200 2600

03001 Arterial Line 250 350 450 550 65003002 Central Venous Cannulation 360 500 650 790 94003032 Cross Consultation IP - Anesthesiology Dept 50 150 250 400 50003003 Endotracheal intubation 500 700 900 1100 130003006 Glucometer Random Blood Sugar 70 100 130 160 19003020 I STAT-ABG 400 460 520 580 64073055 Inj.Sensorcaine(Heavy)4ml 28 28 28 28 2873048 Injection Atracrium/Trac. 119 119 119 119 11973083 Injection Bupivacaine 30 42 54 66 7873066 Injection Ephedrine Hcl./ml 25 40 50 60 7073297 Injection Etomidate/Trrodmidate Celodate 520 520 520 520 52073106 Injection Fulsed 5ml 26 26 26 26 2673045 Injection Mephantine 18 18 18 18 1875001 Injection Pethadine 50 mg 45 45 45 45 45

94


DAYCARE

Rs. Rs. Rs. Rs. Rs.

73030 Injection Pethedine 45 45 45 45 4573121 Injection Propafol 20ml 168 168 168 168 16873122 Injection Propafol 50ml 388 543 698 854 100973004 Injection Sod/Thiopenthol 250 44 44 44 44 4473105 Injection Succinyl scoline 50 70 90 110 13073089 Injection Tramadol 27 38 49 59 7073109 Injection Tramadol / Fortwin 27 38 49 59 7073115 Injection Vecuronium 177 248 319 389 46073238 InjectionKenadion 12 12 12 12 1275008 InjectionKetamin 1cc 22 22 22 22 2203004 Lumbar Puncture 250 350 450 550 65073102 Micro Shield - 473114 Micro Shield PVP-P73112 Micro Shield PVP-S03007 Pre Anaesthesia/Post Anaesthesia Checkup (PAC) 250 350 450 550 65073237 Rocronium 304 304 304 304 30403005 Ryles tube 30 40 50 70 8003008 Therapeutic Epidural Steroid Injection 300 420 540 660 780

C. OTHER PROCEDURES / SERVICES1. OTHER SERVICES: NUTRITION SERVICES

04002 Basel Metabolic Rate 400 560 720 880 104004001 Bio-Electrical Impedence 140 200 250 310 36004007 Complete Diet and Physic Activity Assessment 120 170 220 260 31004006 Exercise Testing 1190 1670 2140 2620 309004022 Nutrition Consultation 200 280 360 440 52000198 Nutrition Cross Consultation IP 50 150 250 400 50000196 Nutrition Service Charges 250 290 330 360 40000197 Nutrition Service Consultation - Package (3 visits) 270 380 490 590 70004005 Sleep Study - Advanced 3560 4980 6410 7830 926004004 Sleep Study - Basic 1190 1670 2140 2620 3090

1.1. SPECIALISED PROCEDURES DONE IN COLLEGE04008 Risk Reduction and Weight Management Package 3240 4540 5830 7130 842004009 Screening Sessions for lifestyle Management Programme 220 310 400 480 570

1.2. LIFE STYLE MANAGEMENT PROGRAMME04016 AP Vertebral Assessments 1720 2410 3100 3780 447004012 BMD Femur 1500 2100 2700 3300 390004013 BMD Forearm 860 1200 1550 1890 224004011 BMD Spine 1500 2100 2700 3300 390004015 Fat Analysis 4260 5960 7670 9370 1108004018 Lateral Spine 1500 2100 2700 3300 390004017 Lateral Vertebral Assessments 1720 2410 3100 3780 447004010 Lifestyle Management Programme (10 sessions package) 8640 12100 15550 19010 2246004014 Tissue Quantification 3070 4300 5530 6750 7980

95


DAYCARE

Rs. Rs. Rs. Rs. Rs.1.3. TESTS DONE IN PHYSIOLOGY SJMC

04003 Autonomic Nervous System Testing 1540 2160 2770 3390 400004019 Head Up Tilt Test 750 1050 1350 1650 195004023 Heart Rate Variablity Analysis 500 700 900 1100 130004020 Muscle Function Test 2000 2800 3600 4400 520004021 Passive Muscle Exercise Per Day 330 460 590 730 860

2. OTHER SERVICES: FORENSIC MEDICINE15023 Dressing 1000 1400 1800 2200 260015024 Embalming 4800 6720 8640 10560 1248015029 MLC Brought Dead by Police/Others (Per Day) 160 220 290 350 42015065 MLC Packing After Working Hours 3000 4200 5400 6600 780015012 MLC-Packing 1600 2240 2880 3520 416015090 MLC-Forensic Medicine-THC-Urine 320 370 420 460 51015021 Mortuary Charges for Outsiders (Per Day) 1500 2100 2700 3300 390015000 Mortuary Charges In-Patients (Per Day) 1250 1750 2250 2750 325015013 Packing-MLC Unclaimed/Unknown 115069 Pesticide Panel-Insecticide,Herbicide,Rodenticide 1500 1720 1950 2180 240015070 Insecticide panelCommon Organophosphate-Dimethoate ,Malathion,

Fenthion, Chlorpyrifos, Quinalphos,Monocrotophos,Dichlorvos,Methyl parathion,PhorateCommon Carbamates-Propoxur,Carbofuran,Common Pyrethroids-Fenvalerate, Cypermethrin, Deltamethrin 1250 1440 1630 1810 2000

15071 Herbicide-Paraquat 200 230 260 290 32015072 Rodenticide- Aluminium phospide and Zinc Phospide 200 230 260 290 32015073 Methanol 200 230 260 290 32015030 Unclaimed/Unknown Bodies Brought by Police -Irrespective of the Period 1

3. OTHER SERVICES: CERTIFICATES15014 Additional Certificate for VISA 70015033 Alcohol Certificate 10015001 Billing Details 50 70 90 110 13015002 Birth Certificate 100 140 180 220 26015034 Copies of Case Sheet Per Record - Service Charges 10015035 Copies of MLC Extract 10015017 Correction Charges 5015036 Disability Certificate 20015037 Duplicate Birth Certificate 20015004 Duplicate Certificates 50 50 50 50 5015016 Duplicate Death Certificate 10015026 Duplicate IP Bill-Detail 50 50 50 50 5015028 Duplicate OP Bills 10 10 10 10 1015027 Duplicate Summary Bill / Pharmacy Details 30 30 30 30 3015038 LIC and Other Certificates Per Form 10015008 Medical Certificate for Visa 2700 2700 2700 2700 2700

96


DAYCARE

Rs. Rs. Rs. Rs. Rs.15032 OP Folders -Neurology 100 100 100 100 10015039 OP Treatment Certificate 5015007 Other Certificates 75 75 75 75 7515003 Physical Fitness Certificate 100 100 100 100 10015005 Special Documentation Charges (Admitted ) 225 225 225 225 22515006 Special Documentation Charges (Non Admitted ) 125 125 125 125 12515011 Wound Certificate (Patients Copy) 400

4. OTHER SERVICES: MEDICO SOCIAL WORK15044 Adoption Counselling 550 600 650 700 75015041 Cadaver Counselling 350 400 450 500 55015066 Community Participation 300 350 400 450 50015054 Complete Rehabilitation & Placement Service 650 700 750 800 85015060 Counselling (Per Session General) 350 400 450 500 55015057 Counselling on Effective Parenting 550 600 650 700 75015050 Crisis Intervention 350 400 450 500 55015047 Family Therapy 550 600 650 700 75015052 Fund Raising Letter 250 300 350 400 45015040 Grief Counselling 350 400 450 500 55015064 ID Clinic / Juvenile Diabetic Clinic 250 300 350 400 45015045 Infertility Counselling 550 600 650 700 75015061 Legal Certificate 350 400 450 500 55015051 Letter of Recommendation/Correspondence to NGO,Govt/Referral Letter 150 200 250 300 35015046 Marital Counselling 550 600 650 700 75015068 Pre Vocational Assessment 100 150 200 250 30015049 Psychosocial Intervention - Medical Adherence, Reality Orientation,

Postive Reinforcement, Addressing Stressful Experience,Emotional Ventilation, Discharge Planning and Decision Making 250 300 350 400 450

15062 Rehabilltation 1100 1550 2050 2100 305015063 Rheumatology Counselling 550 600 650 700 75015059 Senior Citizen Care Services 350 400 450 500 55015048 Socio Demographic Economic Assessment 150 200 250 300 35015055 Support Group Monthly (PMR, Nephrology, Burns, Paediatric Oncology,

Stroke, Epilepsy, Adult Oncology) 550 600 650 700 75015058 Teen Counselling 150 150 300 500 80015042 Transplant Counselling 300 350 400 450 50015043 Transplant Work (Full Package) 1000 1050 1100 1150 120015056 Visits (Collateral Contact) 250 300 350 400 45015053 Vocational Counselling / Job Placement 250 300 350 400 45015067 Work / School Environment Evaluation 100 150 200 250 300

5. OUT SIDE INVESTIGATIONS15010 Outside Blood Test15031 Outside Investigation

97

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

Rs. Rs. Rs. Rs. Rs.VI. OPERATIVE PROCEDURESA. CARDIO THORACIC & VASCULAR SURGERYADULT CARDIAC SURGICAL PACKAGES

05220 Aneurysm Resection & Grafting 150000 210000 270000 330000 390000/43500005219 Aortic Root Replacement 150000 210000 270000 330000 390000/43500005212 Aortic Valve Repair 100000 140000 180000 220000 260000/29000005214 Aortic Valve Replacement 110000 154000 198000 242000 286000/31900005216 Aortic+Mitral Valve Replacement 130000 182000 234000 286000 338000/37700005217 Aortic+Mitral+Tricuspid Replacement 130000 182000 234000 286000 338000/37700005200 CABG 150000 210000 270000 330000 390000/43500005201 CABG + IABP 200000 280000 360000 440000 520000/58000005204 CABG + Mitral Valve Repair 200000 280000 360000 440000 520000/58000005205 CABG + Mitral Valve Replaced 150000 210000 270000 330000 390000/43500005206 CABG + Post MI VSD Repair 150000 210000 270000 330000 390000/43500005203 CABG Emergency salvage 170000 238000 306000 374000 442000/49300005202 CABG+LV Aneurysmal Repair 170000 238000 306000 374000 442000/49300005229 Cardiac Injuries Surgery with CPB 100000 140000 180000 220000 260000/29000005230 Cardiac Injuries without CPB 50000 70000 90000 110000 130000/16000005224 Dissecting Aneurysm with CPB 100000 140000 180000 220000 260000/29000005225 Dissecting Aneurysm without CPB 80000 112000 144000 176000 208000/23800005226 Intra Cardiac Tumour Surgery 100000 140000 180000 220000 260000/29000005222 Intra Thoracic Aneurysm on CPB 100000 140000 180000 220000 260000/29000005223 Intra Thoracic Aneurysm without CPB 70000 98000 126000 154000 182000/21200005210 Mitral Valve Repair 110000 154000 198000 242000 286000/31900005213 Mitral Valve Replacement 110000 154000 198000 242000 286000/31900005208 Open Aortic Valvotomy 100000 140000 180000 220000 260000/29000005207 Open Mitral Valvotomy 100000 140000 180000 220000 260000/29000005209 Open Pulmonary Valvotomy 100000 140000 180000 220000 260000/29000005228 Pulmonary Embolectomy/Endartrectomy 100000 140000 180000 220000 260000/29000005218 Ross Procedure 100000 140000 180000 220000 260000/29000005227 Ruptured Sinus of Valsulva Correction 100000 140000 180000 220000 260000/29000005211 Tricuspid Valve Repair 100000 140000 180000 220000 260000/29000005215 Tricuspid Valve Replacement 100000 140000 180000 220000 260000/290000

Closed Heart Procedures05231 Closed Mitral Valvotomy 40000 56000 72000 88000 104000/13400005233 Coarctation Repair 36000 50300 64800 79200 93700/12370005232 PDA - Repair 36000 50300 64800 79200 93700/12370005236 Pericardiectomy 60000 84000 108000 132000 156000/186000

98

05235 Pericardiostomy 12000 16800 21700 26300 31200/61200Congenital Open Heart Procedures

05262 ALCAPA 100000 140000 180000 220000 260000/29000005261 AP Window on CPB 100000 140000 180000 220000 260000/29000005256 Arterial Switch Surgery 100000 140000 180000 220000 260000/29000005246 ASD Closure 100000 140000 180000 220000 260000/29000005248 AVSD/AV Canal Defect Repair 100000 140000 180000 220000 260000/29000005263 Complex TOF/ + Special Conduit 100000 140000 180000 220000 260000/29000005252 Ebsteins Repair 100000 140000 180000 220000 260000/29000005251 Fontan 100000 140000 180000 220000 260000/29000005250 HOCM Surgery 80000 112000 144000 176000 208000/23800005259 Mustards 100000 140000 180000 220000 260000/29000005254 Pulmonary Atresia with/without VSD 100000 140000 180000 220000 260000/29000005260 Pulmonary Conduit 100000 140000 180000 220000 260000/29000005258 Sennings 100000 140000 180000 220000 260000/29000005253 TAPVC 100000 140000 180000 220000 260000/29000005255 TGA - ICR 100000 140000 180000 220000 260000/29000005249 TOF - ICR 100000 140000 180000 220000 260000/29000005257 Truncus Areriosus Surgery 100000 140000 180000 220000 260000/29000005247 VSD Closure 100000 140000 180000 220000 260000/290000

PEDIATRIC CARDIAC SURGERY PACKAGES05243 Aortic Arch anomalies correction 36000 50300 64800 79200 93700/12370005244 AP Window without CPB 36000 50300 64800 79200 93700/12370005240 B T Shunt 36000 50300 64800 79200 93700/12370005242 Central Shunt 36000 50300 64800 79200 93700/12370005241 Glenn Shunt 36000 50300 64800 79200 93700/12370005245 PA Banding 36000 50300 64800 79200 93700/123700

THORACIC SURGERY PROCEDURES PACKAGES05273 Bronchopleural Fistula Correction 60000 84000 108000 132000 156000/18600005268 Decortication 60000 84000 108000 132000 156000/18600005274 Diaphragmatic Eventration Plication 50000 70000 90000 110000 130000/16000005275 Diaphragmatic Hernia Surgery 50000 70000 90000 110000 130000/16000005284 Diaphragmatic Injury Repair 45000 63000 81000 99000 117000/14700005282 Foreign Body Removal by Thorcoscope 30000 42000 54000 66000 78000/10800005265 Lobectomy 80000 112000 144000 176000 156000/1860005269 Lung Cyst Excision / Bullectomy 60000 84000 108000 132000 156000/18600005277 Oesophageal Tumour Exicision 45000 63000 81000 99000 117000/147000


Rs. Rs. Rs. Rs. Rs.

99


Rs. Rs. Rs. Rs. Rs.

05278 Oesophagectomy +/Colon Transposition 70000 98000 126000 154000 182000/21200005276 Oesphageal Diverticula/Achalasia Cardia 50000 70000 90000 110000 130000/16000005267 Pleurectomy 60000 84000 108000 132000 156000/18600005266 Pneumonectomy 100000 140000 180000 220000 260000/29000005272 Pulmonary AV Fistula Surgery 45000 63000 81000 99000 117000/14700005264 Segmentectomy 60000 84000 108000 132000 156000/18600005270 SOL Mediastinum Excision 60000 84000 108000 132000 156000/18600005280 Thoracoplasty 60000 84000 108000 132000 156000/18600005281 Thoracotomy & Lung Injury Repair 45000 63000 81000 99000 117000/14700005283 Thoracotomy-Bronchial Repair of Injury 45000 63000 81000 99000 117000/14700005279 Thymectomy (Thymoma Excision) 45000 63000 81000 99000 117000/14700005285 Traumatic/corrosive Oesophageal Repair 60000 84000 108000 132000 156000/186000

VASCULAR SURGICAL PROCEDURES PACKAGES05304 Aorto Billiac/Bifemoral Bypass 55000 77000 99000 121000 143000/17300005305 Axillo Bifemoral Bypass 55000 77000 99000 121000 143000/17300005308 Axillo Brachial Bypass 55000 77000 99000 121000 143000/17300005309 Brachio-Radial Bypass 55000 77000 99000 121000 143000/17300005298 Carotid Artery Aneurysm Surgery 20000 28000 36000 44000 52000/8200005311 Carotid Artery Bypass 65000 91000 117000 143000 169000/19900005319 Carotid Endartectomy 55000 77000 99000 121000 143000/17300005623 Cervical Rid Resection 20000 28000 36000 44000 52000/8200005288 Distal Abdominal Aortic Aneurysm Surgery 60000 84000 108000 132000 156000/18600005314 DVT - IVC Filter Insertion 20000 28000 36000 44000 52000/8200005310 Excision & Repair Carotid Body Tumour 40000 56000 72000 88000 104000/13400005312 Excision of Large AV Malformation 55000 77000 99000 121000 143000/17300005313 Excision of Small AV Malformation 35000 49000 63000 77000 91000/12100005306 Femoro Distal Bypass 55000 77000 99000 121000 143000/17300005286 Fem-pop Bypass 50000 70000 90000 110000 130000/16000005624 Lung Biopsy - VATS Package 45000 63000 81000 99000 117000/14700005299 Main Limb Arteries Aneurysm Surgery 20000 28000 36000 44000 52000/8200005317 Medium Sized Arterial Aneruysm Repair 55000 77000 99000 121000 143000/17300005351 Patch Graft Angioplasty 20000 28000 36000 44000 52000/8200005303 Peripheral Embolectomy without Graft 20000 28000 36000 44000 52000/8200005289 Proximal Abd.Aortic Aneurysm Surgery 60000 84000 108000 132000 156000/18600005297 Renal Artery Aneurysm Surgery 20000 28000 36000 44000 52000/8200005302 Renal Artery Stenoses Surgery 25000 35000 45000 55000 65000/9500005316 Small Arterial Aneurysm Repair 20000 28000 36000 44000 52000/82000

100


Rs. Rs. Rs. Rs. Rs.

05300 Surgery Acquired AV Fistula 20000 28000 36000 44000 52000/8200005301 Surgery Congenital AV FIstula 20000 28000 36000 44000 52000/8200005294 Surgery Vertebral Artery Aneurysm 25000 35000 45000 55000 65000/9500005287 Thromboembolectomy 20000 28000 36000 44000 52000/8200005295 Vascular Procedure - Major Vessels 25000 35000 45000 55000 65000/9500005296 Vascular Procedure - Minor vessels 15000 21000 27000 33000 39000/6900005315 Vascular Tumour Excision 40000 56000 72000 88000 104000/134000

PACKAGE INCLUDES PACKAGE DOES NOT INCLUDE1. Stay charges for 10 days of Hospitalization 1. Charges outside the period of 10 days.( ie.2 days pre-op & 08 days post op.) 2. Cost of Heart Valves graftsartificial conduitis which will2. All routine investigations required before, during and surgery be charged as actuals-if used.3. All operation charges 3. Some special items which are not commonly required4. ICU Charges 6 days (2 days with respirator & 4 days without respirator) for routine Heart operations after surgery may have to be5. All routine drugs for 10 days used in high risk cases ie. IABP Swan Ganz Cathether etc.6. Cross matching and screening charges for blood donors The use of these if required will be intimated as early as7. Patient’s diet for 10 days possible.

05631 ECMO Package 500000Package Includes Package Does Not Include2 days ICU Stay Charges Outside the period of 10 DaysRoutine Investigations for 2 days Any Investigation after 2nd dayRoutine Drugs for 10 days except AntibioticsBlood ProductsCTVS PROCEDURES PACKAGES (NON_PACKAGED BREAKUP OF CHARGES)

05332 Anterior Lateral Spinal Cord Decompression 22000 30800 51700 71600 9360005625 AV Fistula 10000 14000 23500 32500 4250005383 BPF Repair 16000 22300 37700 52000 6800005352 Bronchoscopy Flexible 1800 2600 4200 5900 770005353 Bronchoscopy Rigid 1800 2600 4200 5900 770005333 Cervical Rib Resection 7000 9800 16600 22800 2980005369 Chest Wall Biopsy 9600 13300 22300 30900 4030005323 Chest Wall Tumour Removal 17000 23800 40000 55300 7230005379 Decortication 16000 22300 37700 52000 6800005384 Diaphragmatic Hernia Surgery 16000 22300 37700 52000 6800005366 Empyema Window Operation 9600 13300 22300 30900 4030005375 Lobectomy 16000 22300 37700 52000 6800005380 Lung Cyst Removal 16000 22300 37700 52000 6800005373 Mediastinal Mass (Small) 12000 16800 28200 39000 5100005365 Mediastinal Node Biopsy 9600 13300 22300 30900 4030005328 Mediastinitis 11800 16600 27700 38300 5020005382 Mediastinotomy 16000 22300 37700 52000 68000

05321 Node Biopsy 2000 2800 4700 6600 8600

101


Rs. Rs. Rs. Rs. Rs.05391 Oesophageal CA 25000 35000 58800 81300 10630005392 Oesophageal CA with Colon Transposition 25000 35000 58800 81300 10630005385 Oesophagectomy Colon 16000 22300 37700 52000 6800005326 Oesophagoscopy 1800 2600 4200 5900 770005389 Omental Transfer Chest 16000 22300 37700 52000 6800005394 Omental Transfer Mediastinum 25000 35000 58800 81300 10630005362 Open Lung Biopsy 10000 14000 18000 22000 2600005363 Open Pleural Biopsy 9600 13300 22300 30900 4030005329 Pericardial Tapping in OT 1300 2000 3300 4700 600005327 Pericardial Tube Drainage 4000 5700 9300 13000 1700005371 Pericardiostomy 12000 16800 28200 39000 5100005331 Pleurodesis 1700 2200 3800 5200 680005376 Pneumonectomy 16000 22300 37700 52000 6800005390 Pulmonary AV Fistula 25000 35000 58800 81300 10630005330 Re-Exploration - Minor 4700 6300 10800 15000 1970005320 Removal of FB (Trachea) 2100 2900 4900 6800 890005403 Repeat BPF Repair 26000 36300 61100 84600 11060005399 Repeat Decortication 26000 36300 61100 84600 11060005404 Repeat Diaphragmatic Hernia Surgery 26000 36300 61100 84600 11060005395 Repeat Lobectomy 26000 36300 61100 84600 11060005400 Repeat Lung Cyst Removal 26000 36300 61100 84600 11060005402 Repeat Mediastinotomy 26000 36300 61100 84600 11060005405 Repeat Oesophagectomy Colon 26000 36300 61100 84600 11060005409 Repeat Omental Transfer Chest 26000 36300 61100 84600 11060005396 Repeat Pneumonectomy 26000 36300 61100 84600 11060005398 Repeat Resection 26000 36300 61100 84600 11060005397 Repeat Segmectomy 26000 36300 61100 84600 11060005401 Repeat SOL Mediastinal Excision 26000 36300 61100 84600 11060005407 Repeat Thoracotomy 26000 36300 61100 84600 11060005406 Repeat Thymectomy 26000 36300 61100 84600 11060005408 Repeat Vascular Procedures (peripheral) 26000 36300 61100 84600 11060005378 Resection 16000 22300 37700 52000 6800005324 Rib Resection and Drainage 7000 9800 16600 22800 2980005364 Scalene Node Biopsy 9600 13300 22300 30900 4030005377 Segmectomy 16000 22300 37700 52000 6800005368 Single Rib Resection 9600 13300 22300 30900 4030005370 Sinus Excision Chest Wall 9600 13300 22300 30900 40300

102


Rs. Rs. Rs. Rs. Rs.

05381 SOL Mediastinal Excision 16000 22300 37700 52000 68000

05372 Thoracic AV Malformation (small) 12000 16800 28200 39000 51000

05387 Thoracotomy 16000 22300 37700 52000 68000

05374 Thoracotomy and Empymectomy (small) 12000 16800 28200 39000 51000

05386 Thymectomy 16000 22300 37700 52000 68000

05393 Trachea Bronchial Repair 25000 35000 58800 81300 106300

05334 Tracheal Reconstruction 22000 30800 51700 71600 93600

05325 Tracheostomy in OT 3000 4200 7100 9800 12800

05626 Transesophageal Echo 1300 1800 3100 4200 5500

05367 Ultrasound Guided Tube Thoracostomy 9600 13300 22300 30900 40300

05388 Vascular Procedures (peripheral) 16000 22300 37700 52000 68000

05632 Wound Debridement + Sceondary Suturing 5000 7000 11800 16300 21300

VIDEO ASSISTED THORACOSCOPIC SURGERY

05335 Diagnostic Thoracoscopy VATS 4600 6300 10700 14700 19100

05339 Hellers Oesophagomyotomy - VATS 22000 30800 51700 71600 93600

05336 Lung Biopsy - VATS 19000 26700 44700 61800 80800

05344 Mediastinal Biopsy -VATS 7800 10300 17300 24100 31600

05340 Mediastinal Tumour Resection -VATS 22000 30800 51700 71600 93600

05337 Partial Pericardiectomy -VATS 19000 26700 44700 61800 80800

05338 Pleurodesis - VATS 19000 26700 44700 61800 80800

05341 Sympathectomy -VATS 19000 26700 44700 61800 80800

GENERAL

05629 ABG - CTVS 400 460 520 580 640

05630 ACT 200 300 400 400 500

02708 Intercostal / Malecot Drainage 210 290 380 460 550

05621 Suture / Staple Removal 210 300 380 470 550

05622 ICD Insertion / Removal 1500 2100 3500 4900 6400

05627 Octopus & Blow Mister 8250 11600 19400 26800 35100

05628 Cardioplegia Solution 150 200 400 500 600

18058 Advanced Microscope Per Hour 800 1100 1900 2600 3400

18057 Basic Microscope Per Hour 400 600 900 1300 1700

05345 Bilateral (50% of Procedure Surgery)

05620 Cross Consultation IP - Cadio Thoaric Surgery 50 150 250 400 500

05633 IABP Charges Per Day ( CVTS ICU ) 1000 1400 2400 3300 4300

18059 Laparoscope Per Hour 700 1000 1600 2300 3000

103


Rs. Rs. Rs. Rs. Rs.

B. GENERAL SURGERYCATEGORY - A

05744 Fistulotomy II Stage-Seton Removal 2000 2800 4700 6600 860005916 Miscell Pleurodesis 2000 2800 4700 6600 860005900 Mucus Cyst Excision 2000 2800 4700 6600 860005901 Oral Cancer biopsy 2000 2800 4700 6600 860005902 Oral Cancer EUA 2000 2800 4700 6600 860005923 Suturing - Minor 2000 2800 4700 6600 8600

CATEGORY - B05704 Amputation of Finger/Toe 3000 4200 7100 9800 1280005920 CAPD 3000 4200 7100 9800 1280005819 Circumcision 3000 4200 7100 9800 1280005731 Cryohaemorrhoidectomy 3000 4200 7100 9800 1280005733 Debridement - Minor 3000 4200 7100 9800 1280005922 Ear Lobe Repair 3000 4200 7100 9800 1280005980 EUA (Perianal Region) 3000 4200 7100 9800 1280005921 Excision of Small Swellings 3000 4200 7100 9800 1280005742 Fissurectomy & Spinecterotomy 3000 4200 7100 9800 1280005756 I & D 3000 4200 7100 9800 1280005859 Lords Dilatation 3000 4200 7100 9800 1280005895 Lymph Node Biopsy 3000 4200 7100 9800 1280005783 Removal of Superficial Tumours - Minor 3000 4200 7100 9800 1280005924 Split Skin Grafting - Minor 3000 4200 7100 9800 1280005926 Suturing - Modearte 3000 4200 7100 9800 12800

CATEGORY - C05929 A V Fistula* 10000 14000 23500 32500 4250005851 Amputation Above Elbow 6000 8300 14100 19600 2560005854 Amputation - Foot 6000 8300 14100 19600 2560005705 Amputation of Hand 6000 8300 14100 19600 2560005706 Amputation Penis - Partial 6000 8300 14100 19600 2560005710 Appendicectomy 6000 8300 14100 19600 2560006079 Axillary Dissection alone for Breast Cancer 6000 8300 14100 19600 2560005938 Brachial Cyst Excision 6000 8300 14100 19600 2560006080 Central Neck Dissection for Thyroid Cancer 6000 8300 14100 19600 2560005730 Colostomy- Loop/Double Barrel 10000 14000 23500 32500 4250005734 Debridement (Intermediate) 6000 8300 14100 19600 2560005735 Dodd and Cockett Subfascial Ligation 6000 8300 14100 19600 25600

104


Rs. Rs. Rs. Rs. Rs.

05933 Early Breast Cancer Excision 6000 8300 14100 19600 2560005737 Feeding Jejunostomy 6000 8300 14100 19600 2560005740 Fibroadenoma Breast (Intermediate) 6000 8300 14100 19600 2560006089 Fistula-in-Ano (I) 6000 8300 14100 19600 2560005743 Fistulectomy/Fistulotomy 6000 8300 14100 19600 2560005747 Gastrostomy 6000 8300 14100 19600 2560005749 Gynaecomastia-Excision(Unilateral) 6000 8300 14100 19600 2560005750 Haemorrhoidectomy 6000 8300 14100 19600 2560005891 Head/neck -Treacheostomy 6000 8300 14100 19600 2560005868 Hernia Epigastric 6000 8300 14100 19600 2560005870 Hernia Paraumbilical without Mesh 6000 8300 14100 19600 2560005983 Hydrocoele (Large) 6000 8300 14100 19600 2560005755 Hydrocoele Operation 6000 8300 14100 19600 2560005757 Ileostomy 6000 8300 14100 19600 2560005758 Incisional Hernia Repair without Mesh 6000 8300 14100 19600 2560005762 Inguinal Hernia Repair (Herniorrhaphy) 6000 8300 14100 19600 2560005761 Inguinal Herniotomy 6000 8300 14100 19600 2560005765 Laparotomy 6000 8300 14100 19600 2560005817 Laproscopy (Diagnostic) 6000 8300 14100 19600 2560005927 Microdochectomy 6000 8300 14100 19600 2560005937 Oral Cavity Benign Cyst/ Tumour 6000 8300 14100 19600 2560005912 Orchidectomy 6000 8300 14100 19600 2560005913 Orchidopexy 6000 8300 14100 19600 2560006082 Pelvic Lymphnode Dissection 6000 8300 14100 19600 2560005781 Pilonidal Sinus Excision - Minor 6000 8300 14100 19600 2560005899 Salivary Calculi Removal 6000 8300 14100 19600 2560005939 Soft Tissue Tumour Excision - Axilla 6000 8300 14100 19600 2560005928 Split Skin Grafting (Intermediate) 6000 8300 14100 19600 2560005813 Umbilical & Paraumbilical Hernia Repair 6000 8300 14100 19600 2560005816 Varicocoele Operation 6000 8300 14100 19600 2560005815 Varicose Veins Stripping 6000 8300 14100 19600 2560006078 Wide excision of Oral Cancers 6000 8300 14100 19600 25600

CATEGORY - D05880 Abscess Drainage- Liver 9000 12700 21200 29300 38300

05702 Amputation - Above Knee 9000 12700 21200 29300 38300

05703 Amputation - Below Knee 9000 12700 21200 29300 38300

05852 Amputation - Shoulder 9000 12700 21200 29300 38300

105


Rs. Rs. Rs. Rs. Rs.05707 Amputation Penis - Total 9000 12700 21200 29300 38300

05952 Angiogram 9000 12700 21200 29300 38300

05847 Assisting Other Department- Minor 9000 12700 21200 29300 38300

05866 Bowel Adhesiolysis 9000 12700 21200 29300 38300

05865 Bowel Malrotation 9000 12700 21200 29300 38300

05941 Cervical Sympathectomy 9000 12700 21200 29300 38300

05722 Cholecystectomy 9000 12700 21200 29300 38300

05724 Cholecystojejunostomy 9000 12700 21200 29300 38300

05725 Cholecystostomy 9000 12700 21200 29300 38300

05871 Choledechojejunostomy 9000 12700 21200 29300 38300

05727 Closure of Colostomy 10000 14000 23500 32500 42500

05728 Closure of Duodenal and Gastric Perforation 9000 12700 21200 29300 38300

05729 Closure of Small Bowel Perforation 9000 12700 21200 29300 38300

05732 Cysto Gastrostomy for Pancreatic Pseudo 9000 12700 21200 29300 38300

05906 Cysto jejunostomy 9000 12700 21200 29300 38300

05984 Debridement - Major 9000 12700 21200 29300 38300

05736 Embolectomy 9000 12700 21200 29300 38300

05738 Femoral Hernia Repair 9000 12700 21200 29300 38300

05884 Head & Neck RND 9000 12700 21200 29300 38300

05751 Heller’s Operation 9000 12700 21200 29300 38300

05940 Hemiglossectomy 9000 12700 21200 29300 38300

05754 Highly Selective Vagotomy 9000 12700 21200 29300 38300

05986 I & D - Major 9000 12700 21200 29300 38300

05759 Incisional Hernia Repair with Mesh 9000 12700 21200 29300 38300

05760 Inguinal Hernioplasty (Mesh) 9000 12700 21200 29300 38300

06097 Inguinal Hernioplasty (Mesh)under LA 9000 12700 21200 29300 38300

05766 Laparotomy with Colostomy 10000 14000 23500 32500 42500

05951 Ligation ofAV fistula 9000 12700 21200 29300 38300

05857 Ltd. Resection of Bowel 9000 12700 21200 29300 38300

05770 Lumbar Sympathectomy 9000 12700 21200 29300 38300

05771 Meckel’s Diverticulectomy 9000 12700 21200 29300 38300

05835 Other LaparoscopicProcedures - Minor 9000 12700 21200 29300 38300

05950 Parathyroid Transplantation 9000 12700 21200 29300 38300

06069 Paraumbilical Hernia Reapir with Mesh 9000 12700 21200 29300 38300

05936 Partial Glossectomy 9000 12700 21200 29300 38300

06076 Portal Vein Embolization 9000 12700 21200 29300 38300

106


Rs. Rs. Rs. Rs. Rs.

05782 Profundo Plasty 9000 12700 21200 29300 38300

06075 Radiofrequency Ablation 9000 12700 21200 29300 3830006085 Recurrent Inguinal Hernia Repair 9000 12700 21200 29300 3830006083 Retroperitonial lymphnode Dissection 9000 12700 21200 29300 3830005794 Simple Mastectomy 9000 12700 21200 29300 3830006084 SMA thrombectomy 9000 12700 21200 29300 3830005796 Small Bowel Resection 9000 12700 21200 29300 3830005797 Small Bowel Stricturoplasty 9000 12700 21200 29300 3830005987 Split Skin Grafting - Major 9000 12700 21200 29300 3830005981 Stapled Haemorrhoidectomy 9000 12700 21200 29300 3830005721 Supra Omo Hyoid Neck Dissection 9000 12700 21200 29300 3830005839 Thoracoscopy Diagnostic 9000 12700 21200 29300 3830005930 Varicose Veins Trendlenburg Operation 9000 12700 21200 29300 3830005907 Vascular Arterial Repair 9000 12700 21200 29300 3830005934 Wide Excision of Tumors 9000 12700 21200 29300 38300

CATEGORY - E05850 Amputation Below Elbow 14000 19700 32900 45600 5960005853 Amputation -Hip 14000 19700 32900 45600 5960005708 Anal Sphincter Repair 14000 19700 32900 45600 5960005846 Assisting Other Dept.- Major 14000 19700 32900 45600 5960005956 AV Fistula at Elbow 14000 19700 32900 45600 5960005957 AV Fistula using PTFE Graft 14000 19700 32900 45600 5960005958 AV Fistula with Transposition of Vein 14000 19700 32900 45600 5960005856 Breast Conservation Surgery 14000 19700 32900 45600 5960006070 Chemoport Insertion 14000 19700 32900 45600 5960005723 Cholecystectomy with C.B.D. Exploration 14000 19700 32900 45600 5960005726 Choledocho Duodenostomy/Transduodenal 14000 19700 32900 45600 59600

05896 Deep Lobe Parotid Excision 14000 19700 32900 45600 59600

05959 Excision of AV Malformation - Minor 14000 19700 32900 45600 59600

05955 Femoro Femoral Crossover Graft 14000 19700 32900 45600 59600

05862 Fundoplication 14000 19700 32900 45600 59600

05745 Gastrectomy - Partial 14000 19700 32900 45600 59600

05893 Head/Neck -Parathyriodectomy 14000 19600 32900 45500 59500

05882 Hydatid Cyst Excision 14000 19700 32900 45600 59600

05834 Laparoscopic Varicoele ligation 14000 19700 32900 45600 59600

05825 Laparoscopic Adhesiolysis 14000 19700 32900 45600 59600

05711 Laproscopic Appendicectomy 14000 19700 32900 45600 59600

107


Rs. Rs. Rs. Rs. Rs.05768 Left Hemicolectomy 14000 19700 32900 45600 5960005943 Modified Radical Mastectomy 14000 19700 32900 45600 5960005881 Packing for Trauma - Liver 14000 19700 32900 45600 5960005777 Pancreatic Jejunostomy 14000 19700 32900 45600 5960005905 Pancreatic Necrosectomy 14000 19700 32900 45600 5960005953 Reconstruction after Limb Conservation/Wide Excision 14000 19700 32900 45600 5960005858 Rectopexy 14000 19700 32900 45600 5960005849 Retroperitonial lymphnode biopsies 14000 19700 32900 45600 5960005784 Right Hemicolectomy 14000 19700 32900 45600 5960005792 Sigmoid Colectomy 14000 19700 32900 45600 5960005795 Simple Mastectomy with Auxillary Clr 14000 19700 32900 45600 5960005898 SMG Excision with Neck Dissection 14000 19700 32900 45600 5960005798 Splenectomy 14000 19700 32900 45600 5960005791 Splenectomy, External Gastric Devasc. 14000 19700 32900 45600 5960005799 Submandibular Gland 14000 19700 32900 45600 5960005801 Subtotal Thyroidectomy 14000 19700 32900 45600 5960005802 Superficial Parotidectomy- Benign 14000 19700 32900 45600 5960005803 Surgery for Hiatus Hernia 14000 19700 32900 45600 5960005841 Thor.Mediastinal Biopsies 14000 19700 32900 45600 5960005843 Thor.Splanchnicectomy 14000 19700 32900 45600 5960005840 Thor.Sympathectomy 14000 19700 32900 45600 5960005842 Thor.Vagotomy 14000 19700 32900 45600 5960005804 Thyroglossal Cyst 14000 19600 32900 45500 5950005805 Thyroid Lobectomy/Hemithyroidectomy 14000 19600 32900 45500 5950005810 Transverse Colectomy 14000 19700 32900 45600 5960005812 Truncal Vagotomy & Gastrojejunostomy 14000 19700 32900 45600 5960005814 Vagotomy and Pyloroplasty 14000 19700 32900 45600 5960005962 Valve Repair for Venous Reflex 14000 19700 32900 45600 5960005965 Varicose Veins Ablation using Laser 14000 19700 32900 45600 5960005960 Venous Thrombectomy 14000 19700 32900 45600 59600

CATEGORY - F05701 Abdomino Perineal Resection 18000 25200 42300 58600 76600

05908 Adrenelectomy 18000 25200 42300 58600 76600

05709 Anterior Resection 18000 25200 42300 58600 76600

05991 Aortic Endarterectomy 18000 25200 42300 58600 76600

05712 Arterial Graft (Using Vein) 18000 25200 42300 58600 76600

05971 Axillo - Axillary bypass 18000 25200 42300 58600 76600

108


Rs. Rs. Rs. Rs. Rs.05969 Axillo Bifemoral 18000 25200 42300 58600 7660005954 Axillo Femoral 18000 25200 42300 58600 7660005719 Block Dissection (Radical) Neck 18000 25200 42300 58600 7660006072 Breast Conserving Surgery (Including Simultaneous Axillary Dissection) 18000 25200 42300 58600 7660005970 Carotid Artery Repair for Trauma 18000 25200 42300 58600 7660005861 Colonic Transposition 18000 25200 42300 58600 7660006010 Combined laparotomy + endoscopic (on table) procedure 18000 25200 42300 58500 7650006071 Compartmental Excision of Limb for Maligant Tumour 18000 25200 42300 58600 7660005996 Distal Sub Total Gastrectomy 18000 25200 42300 58600 7660005879 Enucleations/ Metastasectomy (Liver) 18000 25200 42300 58600 7660005992 Excision of AV Malformation (Intermediate) 18000 25200 42300 58600 7660005739 Femoro Popliteal (Arterial ) Bypass 18000 25200 42300 58600 7660005990 Femoropopliteal Endarterectomy 18000 25200 42300 58600 7660006077 Frey’s Procedure 18000 25200 42300 58600 7660005720 Functional Neck Dissection 18000 25200 42300 58600 7660005867 Gastric Vagotomy Drainage Laparoscopic Assisted 18000 25200 42300 58600 7660005885 Head/neck -Composite Resections 18000 25200 42300 58600 7660005887 Head/neck -Composite Resections Cheek 18000 25200 42300 58600 7660005886 Head/Neck Composite Resections Floor Mouth 18000 25200 42300 58600 7660005894 Head/Neck Laryngophanygo Esophagectomy + Reconstruction 18000 25200 42300 58600 7660005883 Head/neck- Modified Neck Dissection 18000 25200 42300 58600 7660005890 Head/neck- Radical Maxillectomy 18000 25200 42300 58600 7660005888 Head/neck- Subtotal Maxillectomy 18000 25200 42300 58600 7660005889 Head/neck- Total Maxillectomy 18000 25200 42300 58600 7660005892 Head/Neck-ThyroidFND+Mediastinalclear. 18000 25200 42300 58600 76600

05752 Hemimandibulectomy 18000 25200 42300 58600 76600

05875 Hepaticojejunostomy 18000 25200 42300 58600 76600

05753 Hepatico-Jejunostomy-Intra Hepatic 18000 25200 42300 58600 76600

05973 IVC Repair Primary 18000 25200 42300 58600 76600

06011 Laparoscopic assistant to other departments 18000 25200 42300 58500 76500

05764 Laparoscopic Cholecystectectomy 19000 26700 44700 61800 80800

05833 Laparoscopic DU Perforation closure 18000 25200 42300 58500 76500

06092 Laparoscopic Repair of Incisional Hernia 18000 25200 42300 58600 76600

06091 Laparoscopic Repair of Paraumbilical Hernia 18000 25200 42300 58600 76600

05830 Laparoscopicassisted small bowel resection 18000 25200 42300 58600 76600

05997 Laparoscopy Assisted Ostomy 18000 25200 42300 58600 76600

05763 Laproscopic Inguinal Hernia 18000 25200 42300 58600 76600

109


Rs. Rs. Rs. Rs. Rs.05767 Large Soft Tissue Tumour Excision- L 18000 25200 42300 58600 7660005876 Left Lateral Segmentectomy 18000 25200 42300 58600 7660005855 Limb Conservation Surgery for STS 18000 25200 42300 58600 7660005910 lleo Inguinal Block Dissection 18000 25200 42300 58600 7660005772 Oesophago Gastrectomy 18000 25200 42300 58600 7660005779 Partial Pancreatectomy 18000 25200 42300 58600 7660005780 Pelvic Exentration 18000 25200 42300 58600 7660005961 Peripheral Aneurysm Surgery 18000 25200 42300 58600 7660006012 Pitonidal excision + reconstruction sinus 18000 25200 42300 58500 7650005874 Radical Cholecystectomy 18000 25200 42300 58600 7660005873 Radical Choledochectomy 18000 25200 42300 58600 7660005945 Radical Hemicolectomy 18000 25200 42300 58600 7660005897 Radical Parotidectomy with Nerve Graft 18000 25200 42300 58600 7660005966 Re- Resection in Head & Neck Surgery - Minor 18000 25200 42300 58600 7660005918 Relaparotomy(referrals from outside) 18000 25200 42300 58600 7660006088 Re-Operative Procedures 18000 25200 42300 58600 7660005878 Resectional Debridement (Liver) 18000 25200 42300 58600 7660005909 Retroperitoneal Tumor Excision 18000 25200 42300 58600 7660005786 Segmental Hepatic Resection 18000 25200 42300 58600 7660005967 Sentinel Node Basin Excision/ Clearance 18000 25200 42300 58600 7660005848 Subfascial Endoscopic Perforator Surgery 18000 25200 42300 58600 7660005800 Subtotal Colectomy 18000 25200 42300 58600 7660005993 Surgery For Thoracic Outlet Syndrome 18000 25200 42300 58600 7660005911 TFL Flap Reconstruction 18000 25200 42300 58600 7660005773 Thoraco Laprotomy 18000 25200 42300 58600 7660005844 Thoraco Oesophagomyotomy (Heller’S) 18000 25200 42300 58600 7660005806 Total Colectomy/Procto Colectomy 18000 25200 42300 58600 7660005808 Total Parotidectomy 18000 25200 42300 58600 76600

05968 Total Thyroidectomy 18000 25200 42300 58600 76600

05872 Transdoudenal Sphincteroplasty 18000 25200 42300 58600 76600

05989 Trifemorall Endarterectomy 18000 25200 42300 58600 76600

05811 Triple Resection & Resurgery for Peptic Ulcer 18000 25200 42300 58600 76600

05972 Valve Transfer For Venous Reflux 18000 25200 42300 58600 76600

05942 Veins - Valvuloplasty 18000 25200 42300 58600 76600

05974 Venous Bypass Operation 18000 25200 42300 58600 76600

CATEGORY - G05998 Abdominal Aortic Aneurysm Repair 23000 32200 54100 74800 97800

110


Rs. Rs. Rs. Rs. Rs.05716 Aortic Bifemoral 23000 32200 54100 74800 9780005714 Aortic Graft - Bifurcate 23000 32200 54100 74800 9780005713 Aortic Graft - Straight 23000 32200 54100 74800 9780005999 Bypass For Visceral Ischemia 23000 32200 54100 74800 9780005976 Carotid Endarectomy 23000 32200 54100 74800 9780005977 Carotid Subclavian Bypass 23000 32200 54100 74800 9780005947 Centripetal Gastrectomy 23000 32200 54100 74800 9780006013 Combined laparoscopic / endoscopic proced 23000 32200 54100 74800 9780006014 Complex laparoscopic hernia sugery (TEP or ETEP) 23000 32200 54100 74800 9780005790 Distal Spleno Renal Shunt 23000 32200 54100 74800 9780005978 Excision of AV Malformation - Major 23000 32200 54100 74800 9780005877 Extended Right Hepatectomy 23000 32200 54100 74800 9780005746 Gastrectomy - Total 23000 32200 54100 74800 9780005979 IVC Repair Graft 23000 32200 54100 74800 9780005774 IVOR - Lewis 23000 32200 54100 74800 9780005827 Laparoscopic Adrenalectomy 23000 32200 54100 74800 9780005832 Laparoscopic Assisted APR 23000 32200 54100 74800 9780005838 Laparoscopic Assisted Donor Nephrectomy 23000 32200 54100 74800 9780006015 Laparoscopic Bariatric procedure 23000 32200 54100 74800 9780006016 Laparoscopic CBD procedure 23000 32200 54100 74800 9780005837 Laparoscopic Cysto Gastrostomy 23000 32200 54100 74800 9780006017 Laparoscopic Gastrectomy (Partial / total) 23000 32200 54100 74800 9780005863 Laparoscopic Hellers Operation 23000 32200 54100 74800 9780005995 Laparoscopic Hydatid Cyst Excision 23000 32200 54100 74800 9780006018 Laparoscopic Retroperitoreal procedure 23000 32200 54100 74800 9780006019 Laparoscopic Serophegeal procedure 23000 32200 54100 74800 9780005826 Laparoscopic Splenectomy 23000 32200 54100 74800 9780006020 Laparoscopic total colectomy + pouch surgery 23000 32200 54100 74800 9780005831 Laparoscopicassisted Colectomy 23000 32200 54100 74800 9780005828 LaparoscopicFundoplication 23000 32200 54100 74800 9780005829 LaparoscopicTruncal Vagotomy asstd. GJ 23000 32200 54100 74800 9780006087 Laproscopic Anterior Resection 23000 32200 54100 74800 9780006086 Laproscopic Mesh Rectopexy 23000 32200 54100 74800 9780006081 Laproscopic Necrosectomy 23000 32200 54100 74800 9780006073 Laproscopic Reversal Of Hartmanns 23000 32200 54100 74800 9780005769 Left Hemi-Hepatectomy 23000 32200 54100 74800 9780005946 Major Liver Resections 23000 32200 54100 74800 97800

111


Rs. Rs. Rs. Rs. Rs.05775 Mc KEOWN’S 23000 32200 54100 74800 9780005778 Pancreato Duodenectomy - Whipple’s 23000 32200 54100 74800 9780005788 Porta Caval Shunt 23000 32200 54100 74800 9780005789 Proximal Spleno Renal Shunt 23000 32200 54100 74800 9780006000 Radical Gastrectomy 23000 32200 54100 74800 9780006074 Radical Nephrectomy 23000 32200 54100 74800 9780005975 Re- Resection In Head & Neck Surgery Major 23000 32200 54100 74800 9780005785 Right Hemihepatectomy External 23000 32200 54100 74800 9780005787 Shunt Surgery for Portal Hypertension 23000 32200 54100 74800 9780006090 Single Incision Laprosocpy Surgery 23000 32200 54100 74800 9780006021 TEP (Lap inguinal hernia) 23000 32200 54100 74800 9780005845 Thoraco Oesophagectomies 23000 32200 54100 74800 9780005807 Total Colectomy with Pouch 23000 32200 54100 74800 9780005776 Trans Hiatal Esophagectomy 23000 32200 54100 74800 97800

GENERAL18094 Advanced Microscope Per Hour 800 1100 1900 2600 340018093 Basic Microscope Per Hour 400 600 900 1300 170006099 Bilateral (50% Of Proce./Surgery)18151 CUSA 1000 1400 2400 3300 430005820 Fluroscopy Time upto 10 Minutes 600 690 780 870 96005821 Fluroscopy Time upto 15 Minutes 700 800 910 1000 112005822 Fluroscopy Time upto 20 Minutes 800 920 1040 1160 128005823 Fluroscopy Time upto 30 Minutes 900 1040 1170 1300 144005824 Fluroscopy Time(Every Adnl.5Mts) 100 100 200 300 40018150 Intra Operative Ultrasound 1000 1400 2400 3300 430018095 Laparoscope Per Hour 700 1000 1600 2300 300018152 Laser And Cell Saver 1000 1400 2400 3300 430006115 Use Of GI Staplers For Anastomosis 200 300 500 700 900

C. GENITO URINARY SURGERYCATEGORY - A

21001 Biopsy - Urology 2500 3500 5900 8100 1060021003 Circumcision 2500 3500 5900 8100 1060021004 Cystoscopy/ Stent Removal 2500 3500 5900 8100 1060021002 Dorsal Slit 2500 3500 5900 8100 1060021196 Dressing Minor GUS 2500 3500 5900 8100 1060021015 Frenuloplasty 2500 3500 5900 8100 1060021140 I & D Abscess 2500 3500 5900 8100 1060021169 Incision & Drainage - Minor 2500 3500 5900 8100 10600

112


Rs. Rs. Rs. Rs. Rs.21141 Scrotal Cyst Excision 2500 3500 5900 8100 1060021142 Secondary Suturing 2500 3500 5900 8100 1060021013 SPC - Trocar/Open 2500 3500 5900 8100 1060021005 Utrethral Dilatation 2500 3500 5900 8100 1060021170 Wound Debridement - Minor 2500 3500 5900 8100 10600

CATEGORY - B21173 Antegrade Stenting 4000 5600 9400 13000 1700021143 Bladder Injury Repair 4000 5600 9400 13000 1700021006 Cystoscopy + Biopsy 4000 5600 9400 13000 1700021007 Cystoscopy + Clot evacuation 4000 5600 9400 13000 1700021008 Cystoscopy + Fulgration 4000 5600 9400 13000 1700021199 Cystoscopy + Hydro Distention 4000 5600 9400 13000 1700021009 Cystoscopy + RGP 4000 5600 9400 13000 1700021010 Cystoscopy + Stenting (Unilateral) 4000 5600 9400 13000 1700021181 Diagnostic Flexi scopy 4000 5600 9400 13000 1700021179 Diagnostic Flexi URS 4000 5600 9400 13000 1700021200 Dressing Major 4000 5600 9400 13000 1700021014 Fistula Repair 4000 5600 9400 13000 1700021174 Incision & Drainage - Major 4000 5600 9400 13000 1700021011 Intra Op-Consultation 4000 5600 9400 13000 1700021182 PCNL -A 4000 5600 9400 13000 1700021177 Renal Biopsy Open 4000 5600 9400 13000 1700021172 Scrotoplasty 4000 5600 9400 13000 1700021176 Suturing Major 4000 5600 9400 13000 1700021171 Suturing Minor 4000 5600 9400 13000 1700021157 Unilateral Hernia Repair Without Mesh 4000 5600 9400 13000 1700021198 Ureteral Dilatation/ Balloon Dilatation 4000 5600 9400 13000 1700021197 Urethroplasty Stage - II 4000 5600 9400 13000 1700021180 URS A 4000 5600 9400 13000 1700021175 Wound Debridement - Major 4000 5600 9400 13000 17000

CATEGORY - C21187 AVF Construction (Radio Cephalic ) 10000 14000 23500 32500 4250021144 Bilateral Inguinal Hernia Repair Without Mesh 6000 8400 14100 19500 2550021018 Cystolithotomy / Cystolithotripsy 6000 8400 14100 19500 2550021021 Cystoscopy + Bilateral Stenting 6000 8400 14100 19500 2550021184 Deroofing Of Renal Cyst Open 6000 8400 14100 19500 2550021019 Flexiscopy 6000 8400 14100 19500 2550021145 Fourniers Gangering Exploration 6000 8400 14100 19500 25500

113


Rs. Rs. Rs. Rs. Rs.

21016 Hydrocelectomy 6000 8400 14100 19500 2550021185 Inguinal Hernia Unilateral 6000 8400 14100 19500 2550021020 Meatoplasty 6000 8400 14100 19500 2550021201 Peri Nephric Collection & Drainage 6000 8400 14100 19500 2550021146 Perm Catheter (Dialysis access ) 6000 8400 14100 19500 2550021147 Renal Biopsy 6000 8400 14100 19500 2550021183 Renal Biopsy Lap 6000 8400 14100 19500 2550021188 Retrograde Treatment for Chyluria 6000 8400 14100 19500 2550021017 Simple Orchidectomy 6000 8400 14100 19500 2550021022 Testicular Biopsy 6000 8400 14100 19500 2550021148 Unilateral Hernia Repair With Mesh 6000 8400 14100 19500 2550021149 Ureteric Injury Repair 6000 8400 14100 19500 2550021186 Uretero Ureterostomy 6000 8400 14100 19500 2550021195 Ureterolithotomy 6000 8400 14100 19500 2550021139 URS - B 6000 8400 14100 19500 2550021023 VIU 6000 8400 14100 19500 25500

CATEGORY - D21025 Amputation of Penis - Partial 8000 11200 18800 26000 3400021035 AVF Construction (Brachio- Cephalic ) 8000 11200 18800 26000 3400021150 Bilateral Inguinal Hernia Repair With Mesh 8000 11200 18800 26000 3400021026 BNI 8000 11200 18800 26000 3400021189 Deroofing Of Renal Cyst Lap 8000 11200 18800 26000 3400021152 Diagnostic Laparoscopy 8000 11200 18800 26000 3400021032 Endo incision of Uereterocele 8000 11200 18800 26000 3400021033 Endoscopic Realignment 8000 11200 18800 26000 3400021027 Endoscopic Removal of F.B. 8000 11200 18800 26000 3400021036 High Orchidectomy 8000 11200 18800 26000 3400021034 I&D/ Debridement 8000 11200 18800 26000 3400021190 Inguinal Hernia Bilateral 8000 11200 18800 26000 3400021131 Laser CLT 8000 11200 18800 26000 3400021030 Laser VIU 8000 11200 18800 26000 3400021028 Open Nephrostomy 8000 11200 18800 26000 3400021132 PCNL - B 8000 11200 18800 26000 3400021031 Shunt for Priapism 8000 11200 18800 26000 3400021191 Uretero Sigmoidostomy 8000 11200 18800 26000 3400021029 URS-C 8000 11200 18800 26000 3400021024 Varicocele Ligation -Unilateral 8000 11200 18800 26000 34000

114


Rs. Rs. Rs. Rs. Rs.

CATEGORY - E21153 AVF PT PF Graft 11000 15400 25900 35800 4680021154 Bladder Repair Laproscopy 11000 15400 25900 35800 4680021155 Brachio Cephalic AVF Construction 11000 15400 25900 35800 4680021053 Burch Colpo Suspension 11000 15400 25900 35800 4680021127 CAPD Catheter Insertion 11000 15400 25900 35800 4680021038 Chordee Correction 11000 15400 25900 35800 4680021133 Diagonstic Lap 11000 15400 25900 35800 4680021052 Fracture Penis Repair 11000 15400 25900 35800 4680021156 Lap CAPD Catheter insertion 11000 15400 25900 35800 4680021046 Orchidectomy For Prostate Cancer 11000 15400 25900 35800 4680021040 Orchidopexy - Unilateral 11000 15400 25900 35800 4680021039 Orchidopexy For Testicular Torsion 11000 15400 25900 35800 4680021047 Perineal Urethrostomy 11000 15400 25900 35800 4680021041 Perinephric Abscess Drainage 11000 15400 25900 35800 4680021044 TUIP/BNR 11000 15400 25900 35800 4680021050 TVT/TOT 11000 15400 25900 35800 4680021049 Urethral Sling for SUI 11000 15400 25900 35800 4680021042 Urethroplasty Stage-1 11000 15400 25900 35800 4680021048 Urology Assistance in Surgery 11000 15400 25900 35800 4680021043 URS - D 11000 15400 25900 35800 4680021045 Varicocele Ligation Bilateral 11000 15400 25900 35800 46800

CATEGORY - F21054 Amputation of Penis - Total 15000 21000 35300 48800 63800

21202 Bladder Augmentation 25000 35000 58800 81300 106300

21055 Bladder Diverticulectomy 15000 21000 35300 48800 63800

21058 Bladder Neck Plasty 15000 21000 35300 48800 63800

21059 Epispadias Repair 15000 21000 35300 48800 63800

21060 Exploration for Renal Trauma 15000 21000 35300 48800 63800

21134 Graft Nephrectomy 15000 21000 35300 48800 63800

21061 Hypospadias-Single Stage repair 15000 21000 35300 48800 63800

21090 Laparoscopic Orchideopexy 15000 21000 35300 48800 63800

21091 Laparoscopic Ureterolithotomy 15000 21000 35300 48800 6380021089 Laparoscopic Varicocele Ligation 15000 21000 35300 48800 6380021063 Partial Cystectomy 15000 21000 35300 48800 6380021192 PCNL - C 15000 21000 35300 48800 6380021067 Prosthesis Implantation 15000 21000 35300 48800 63800

115


Rs. Rs. Rs. Rs. Rs.

21064 Pyelo Lithotomy 15000 21000 35300 48800 6380021079 Pyeloplasty 15000 21000 35300 48800 6380021062 Simple Nephrectomy 15000 21000 35300 48800 6380021070 Surgery For Pyeronies Disease 15000 21000 35300 48800 6380021193 TURBT 15000 21000 35300 48800 6380021065 TURP/TURBT 15000 21000 35300 48800 6380021066 Ureteric Reimplantation 15000 21000 35300 48800 6380021057 Uretero Ureterostomy 15000 21000 35300 48800 6380021069 URS-Bilateral 15000 21000 35300 48800 6380021072 URS-Laser Lithotripsy 15000 21000 35300 48800 6380021071 Vasectomy Reversal 15000 21000 35300 48800 6380021056 Vaso-Epididymal Anastamosis 15000 21000 35300 48800 63800

CATEGORY - G21076 Augmentation Cystoplasty 18500 25900 43500 60100 7860021085 BMG Urethroplasty 18500 25900 43500 60100 7860021074 Boari FLaparoscopic Implantation 18500 25900 43500 60100 7860021075 Inguinal Block Dissection 18500 25900 43500 60100 7860021107 Laparoscopic Pylolithotomy 18500 25900 43500 60100 7860021103 Laparoscopic Pyloplasty 18500 25900 43500 60100 7860021106 Laparoscopic Uretero Ureterostomy 18500 25900 43500 60100 7860021105 Laparoscopic Ureterolysis 18500 25900 43500 60100 7860021093 Laparoscopicaroscopic Pelvic Lympnode disection 18500 25900 43500 60100 7860021092 Laparoscopicaroscopic Simple Nephrectomy 18500 25900 43500 60100 7860021158 Laparoscopicaroscopy Hernia Repair 18500 25900 43500 60100 7860021077 Nephrolithotomy 18500 25900 43500 60100 7860021078 Open Prostatectomy 18500 25900 43500 60100 7860021083 Partial Nephrectomy For Renal Tumor 18500 25900 43500 60100 7860021194 PCNL - D 18500 25900 43500 60100 7860021086 Progressive Perineal Uretrhoplasty 18500 25900 43500 60100 7860021082 Radical Nephrectomy 18500 25900 43500 60100 7860021081 Simple Nephro Ureterectomy 18500 25900 43500 60100 7860021084 TURP + Additional Procedures 18500 25900 43500 60100 7860021080 Turp- Large Gland /Tumor 18500 25900 43500 60100 7860021088 Ureterolysis + Omental Wrapping 18500 25900 43500 60100 7860021094 VVF Repair 18500 25900 43500 60100 78600

CATEGORY - H21098 Adrenalectomy 20000 28000 47000 65000 85000

116


Rs. Rs. Rs. Rs. Rs.21135 Ileal Conduit 20000 28000 47000 65000 8500021128 Laparoscopic Donor Nephrectomy 20000 28000 47000 65000 8500021101 Laparoscopic Partial Nephrectomy 20000 28000 47000 65000 8500021100 Laparoscopic Radical Nephrectomy 20000 28000 47000 65000 8500021102 Laparoscopic Ureteric Reimplantation 20000 28000 47000 65000 8500021104 Laparoscopic VVF Repair 20000 28000 47000 65000 8500021130 Open Donor Nephrectomy 20000 28000 47000 65000 8500021095 Radical Nepho Ureterectomy 20000 28000 47000 65000 8500021097 Radical Prostatectomy 20000 28000 47000 65000 8500021096 Ureteral Replacement 20000 28000 47000 65000 85000

CATEGORY - I21110 Auto Tranplantaion of Kidney 30000 42000 70500 97500 12750021111 Complex VVF Repair 30000 42000 70500 97500 12750021115 Laparoscopic Adrenalectomy 30000 42000 70500 97500 12750021114 Laparoscopic Nephro Uretertectomy 30000 42000 70500 97500 12750021113 Laparoscopic Radical Prostatectomy 30000 42000 70500 97500 12750021123 Laparoscopicaroscopic Radical Cystectomy 30000 42000 70500 97500 12750021108 Radical Cystectomy + Lieal Conduit 30000 42000 70500 97500 12750021109 Radical Cystectomy + Neo Bladder 30000 42000 70500 97500 12750021129 Renal Transplant Recipient 30000 42000 70500 97500 12750021112 RPLND 30000 42000 71500 97500 127500

GENERAL21166 Access Sheath 2000 2750 3000 3500 4000



21116 Bilateral(50% Of Procedure/Surgery)

21168 Flexible Scope 20000 20000 22500 25000 27500

21136 Flexible URS 2000 3000 5000 8000 10000

21126 Fluroscopy Time (Every Adnl.5mts) 100 100 200 300 300

21122 Fluroscopy Time upto 10 Minutes 600 690 780 870 960


21124 Fluroscopy Time upto 20 Minutes 800 920 1040 1160 128021125 Fluroscopy Time upto 30 Minutes 900 1040 1170 1300 144018107 Laparoscopicaroscope Per Hour 700 1000 1600 2300 230021137 Laser Equipment 10000 11000 11500 12000 1500021165 Laser Fiber 5000 5500 7500 8000 900021163 Laser RIRS - Type A 15000 41000 49000 62000 82000

117


Rs. Rs. Rs. Rs. Rs.

21164 Laser RIRS - Type B 20000 46000 54000 67000 8700021161 Laser TURP- Type A 60000 75000 98000 123000 13800021162 Laser TURP- Type B 65000 80000 103000 128000 14300021159 Laser URS- Type A 15000 38000 46000 59000 7900021160 Laser URS- Type B 20000 43000 51000 64000 8400021167 Stone Basket 4000 5000 6000 7000 8000

D. GYNAECOLOGY06601 Abdominal Hysterectomy 8000 11200 18800 26000 3400006602 Abdominal Myomectomy 7600 10600 17700 24300 3190006604 Abdominal Sacro Colpopoexy 10000 14000 23500 32500 4250006661 Adnexal Mass Bilateral 6600 9100 15300 21100 2770006660 Adnexal Mass Unilateral 4600 6300 10700 14700 1910006615 Antero Colporraphy 3600 4900 8200 11300 1490006736 Cervical Biopsy & Biopsies from ST - Cauterization 1800 2600 4200 5900 770006605 Cervical Biopsy & Biopsies from ST - Cryo Surgery 1800 2600 4200 5900 770006649 Cone Biopsy 3000 4200 7100 9800 1280006741 Cryosurgery for Cervix 1000 1400 2400 3300 430006693 Diagnostic Hystero Laparoscopy 7000 9800 16500 22800 2980006606 Dilatation & Curettage 1800 2600 4200 5900 770006607 Dilatation & Evacuation - in O.T. 2500 3500 5900 8100 1060006688 EUA + Colposcopy + Cervical biopsy 2500 3500 5900 8100 1060006648 EUA + D & C 2000 2800 4700 6500 850006646 EUA + Fractional Curetage 2000 2800 4700 6500 850006647 EUA + Polypectomy + D & C 2500 3500 5900 8100 1060006690 Evacuation Of Vesicular Mole 3000 4200 7100 9800 1280006645 Examination Under Anaesthesia 1700 2200 3800 5200 680006650 Excisions Of Vaginal Lesions 3000 4200 7100 9800 1280006651 Excisions Of Vulval Lesions 1800 2600 4200 5900 770006608 Fractional Curettage 2000 2800 4700 6500 850006633 Hysteroscopic Adhesiolysis 4600 6300 10700 14700 1910006637 Hysteroscopic Endometrial Ablation 5300 7700 12700 17700 2300006634 Hysteroscopic Myomectomy 5900 8300 13900 19200 2510006635 Hysteroscopic Polypectomy 4200 5900 9900 13700 1790006609 Hysteroscopy (Diagnostic) 2500 3500 5900 8100 1060006636 Hysteroscopy Directed Biopsies 3600 4900 8200 11300 1490006613 Infertility- Laparoscopy With Chromotubation 3500 4900 8200 11400 1490006631 Laparascopic Adhesiolysis 8200 11600 19300 26700 34900

118


Rs. Rs. Rs. Rs. Rs.

06628 Laparoscopic Assisted Vaginal Hypterectomy 12000 16800 28200 39000 5100006689 Laparoscopic Excision Of T.O Mass 13700 19200 32300 44500 5820006629 Laparoscopic Myomectomy 13700 19200 32200 44600 5820006630 Laparoscopic Ovarian Cystectomy 10000 14000 23500 32500 4250006632 Laparoscopic Salpingectomy Salpingotomy for Ectopic pregnancy 10000 14000 23600 32600 4260006687 Laparoscopic Salpingo Oopherectomy 10000 14000 23500 32500 4250006611 Laparotomy 6000 8400 14100 19500 2550006656 Laparotomy & Biopsy 6700 9200 15600 21600 2810006662 Laparotomy & Colostomy 10000 14000 23500 32500 4250006657 Laparotomy & Partial Omentectomy 7700 12900 17900 23300 3270006733 Laparotomy + Appendecetomy 7000 9800 16500 22800 2980006734 Laparotomy+Biopsy+Appendicectomy+Omentectomy 8000 11200 18800 26000 3400006639 Laproscopic Gonadectomy 13600 18900 31700 43900 5730006641 Laproscopic Ovarian Drilling 4700 6600 11000 15300 2000006638 Laproscopic Salpingostomy 10000 14000 23500 32500 4250006640 Laproscopic treatment of endometriosis 13600 18900 31700 43900 5730006612 Laproscopy (Diagnostic) - Pelvic 4000 5600 9400 13000 1700006692 Operative Hysteroscopy 10000 14000 23600 32600 4260006614 Ovarian Cystectomy (Open) 5000 7000 11800 16300 2130006731 Partial Omentectomy 3000 4200 7100 9800 1280006642 Perineal Floor Repair 5700 7800 13200 18200 2380006616 Polypectomy 1800 2600 4200 5900 770006729 Posterior Colporraphy 3600 4900 8200 11300 1490006659 Re-Laparotomy (Referrals From Outside) 11000 15400 25900 35800 4680006617 Removal of T.O. Mass 5600 7700 12900 17900 2330006655 Repair of Complete Wound Dehiscence 3000 4200 7100 9800 1280006644 Resuturing 2500 3500 5900 8100 1060006710 Sacrocolpopexy with Mesh repair 10000 14000 23500 32500 4250006643 Sacrospinous Colpopexy 5700 7800 13200 18200 2380006618 Sling Operation 7000 9800 16500 22800 2980006654 Suturing Intermediate 2000 2800 4700 6600 860006735 TAH + BSO + Appendicectomy + Omentectomy + RPLND 12600 17600 29300 40700 5310006723 TAH+BSO 8000 11200 18800 26000 3400006724 TAH+USO 7500 10500 17600 24400 3190006740 Total Laproscopic Hystrectomy 15000 21000 35300 48800 6380006620 Tuboplasty 8000 11200 18800 26000 3400006621 Tumour Removal Superficial Cysts,Vaginal Cysts etc 3000 4200 7100 9800 12800

119


Rs. Rs. Rs. Rs. Rs.06627 V.V.F/R.V.F. Repair 5700 7800 13200 18200 2380006622 Vaginal Hysterectomy 8000 11200 18800 26000 3400006695 Vaginal Hysterectomy With Pelvic Floor Repair 10000 14000 23500 32500 4250006696 Vaginal Hysterectomy+B/L Oopherectomy 8500 11900 20000 27600 3610006725 Vaginal Hysterectomy+USO 8500 11900 20000 27600 3610006624 Vagino Plasty 10000 14000 23500 32500 42500

GENERAL06700 Extra Hours Taken For A Surgery18067 Laparoscope Per Hour 700 1000 1600 2300 3000

E. OBSTETRICS06701 Caesarean Hysterectomy 9000 12600 21200 29300 3830006702 Caesarean Section 6000 8300 14100 19600 2560006703 Cervical Encirlage 2000 2800 4700 6500 850006744 External Cephalic Version 1000 1400 2400 3300 430006743 Internal Podalic Version & Breech Extraction 3000 4200 7100 9800 1280006705 Laparotomy for Ectopic Cestation 5700 7800 13200 18200 2380006706 Manual Removal of Placenta 2600 3600 5900 8100 10700

DELIVERY CHARGES01603 Breech Delivery 4000 5600 7200 8800 1080001604 Breech Extraction 4000 5600 7200 8800 1080001608 Low Mid-Cavity Forceps Delivery 4000 5600 7200 8800 1080001609 Normal Delivery 2000 2800 4700 6500 850001610 Normal Delivery with Episiotomyperineal Tear Repair 2500 3500 4500 5500 650001611 Outlet Forceps Delivery 3000 4200 5400 6600 780001612 Twin Delivery 4000 5600 7200 8800 1080001613 Vaccum Extraction Delivery 3000 4200 5400 6600 7800

GENERAL01601 Acceleration Of Labour 300 420 540 660 780

01599 Bougie Induction 400 560 720 850 1010

01606 Induction Of Labour 400 560 720 850 1010

01536 Secondary Suturing (OPD / Ward) 500 700 900 1100 1300

01519 Encirclage 1000 1400 1800 2200 2600

06799 Bilateral (50% Of Proce./Surgery)

F. OPHTHALMOLOGYAnti Glaucoma operation

07030 Bleb Revision 2000 2800 4700 6500 8500

06888 Controlled Trabeculectomy 5000 7000 11800 16300 21300

120


Rs. Rs. Rs. Rs. Rs.

06881 Cyclocryopexy 2000 2800 4700 6500 850006890 Excision of Prolapsed Iris 2500 3500 5900 8100 1060006891 Glaucoma Valve Implant 6000 8400 14100 19500 2550006883 Goniotomy 2600 3600 6100 8500 1110006884 Peripheral Iridectomy 2200 3100 5200 7200 940006814 Phaco + Trab (Combined) 9000 12600 21150 29250 3825006813 Trab + Trabeculotomy 5000 7000 11800 16300 2130006887 Trabeculectomy 4000 5600 9400 13000 1700006811 Trabeculectomy With Controlled Sutures 7000 9800 16500 22800 2980006812 Trabeculotomy Major 4000 5600 9400 13000 17000

Cornea06923 Cornea C3R 21000 29400 49400 68300 8930007054 Cornea C3R Plus 26000 36400 61100 84500 11050006821 Corneal Grafts Processing 2000 2800 4700 6500 850007018 Corneal suturing 2200 3100 5200 7200 940006828 Corneal Tear Repair - Major 8000 11200 18800 26000 3400006827 Corneal Tear Repair - Minor 3500 4900 8200 11400 1490006822 Deep Foreign Body Removal 1800 2500 4200 5900 770006924 Descemet’s Stripping 8000 11200 18800 26000 3400006823 Keratoplasty 10000 14000 23500 32500 4250006824 Removal of Superficial Foreign Body 1300 1800 3100 4200 550007019 Suture Removal 1500 2100 3525 4875 637507020 Therapeutic Keratoplasty 4000 5600 9400 13000 1700007021 Triple Procedure (KP+ IOL) 11000 15400 25850 35750 46750

Extra Ocular Muscles07036 Four Muscle Surgery 6000 8400 14100 19500 2550006953 Squint Correction 5000 7000 11800 16300 2130006832 Squint Correction Major 9000 12600 21200 29300 3830007035 Two Muscle Surgery 3000 4200 7100 9800 12800

Eye Ball06991 Enucleation 2200 3100 5200 7200 9400

06992 Enucleation with Implant 4200 5900 9900 13700 17900

06993 Eviceration 2200 3100 5200 7200 9400

07039 Eviceration with Implant 4200 5880 9870 13650 17850

06995 Removal of Intra Ocular F.B.(Ant.Segment). 4700 6600 11000 15300 20000

Eye Lids06841 Blepharoplasty (Each Eye) 3400 4800 8000 11100 14500

121


Rs. Rs. Rs. Rs. Rs.06842 Canthoplasty (Medial + Lateral Canthoplasty One Eye) 2500 3500 5880 8130 1063007026 Chalazion (Incision & Curettage) 1000 1400 2350 3250 425006809 Contracted Socket Reconstruction & Implant 6500 9100 15300 21100 2760006930 Corneal Processing Charges 2000 2800 4700 6500 850006946 Corneo Scleral Tear Repair (Major) 6500 9100 15300 21100 2760006947 Corneo Scleral Tear Repair (Minor) 4000 5600 9400 13000 1700006843 Deepening Contracted Socket 4300 6000 10100 14000 1830006845 Ectropion Release & Skin Graft 3300 4600 7800 10700 1400007024 Ectropion/Entropion Correction 3000 4200 7100 9800 1280007023 Excision Biopsy 1000 1400 2400 3300 430006844 Excision Of Tumour & Closure 2200 3100 5200 7200 940018127 Frontatis Sling Procedure (One Eye) 5000 7000 11750 16250 2125018128 Fascia Lata Harvest 2000 2800 4700 6500 850006808 Fornix Reconstruction 3000 4200 7100 9800 1280006925 Lacrimal Apparatus DCR with Lacrimal Intubation 5500 7700 12900 17900 2340006926 Lacrimal Syringing Probing Under Endoscopic Guidance 3000 4200 7100 9800 1280006927 Lens Secondary IOL Implantation (Major) 4000 5600 9400 13000 1700006928 Lens Secondary IOL Implantation (Minor) 2000 2800 4700 6500 850006861 Lid Abscess & Drainage 1500 2100 3500 4900 640007025 Lid Tear Repair 2500 3500 5900 8100 1060006846 Ptosis Correction 2300 3200 5400 7500 980006810 Ptosis Major 5500 7700 12900 17900 2340006848 Reconstruction of Each Eye Lid - Minor 3000 4200 7100 9800 1280006849 Reconstuction of Each Eye Lid - Major 4500 6300 10600 14600 1910006929 Refixation of IOL 2000 2800 4700 6500 850006850 Release Synechiae & SSG 3300 4600 7800 10700 1400006931 Scleral Tear Repair (Major) 5500 7700 12900 17900 23400

06945 Scleral Tear Repair (Minor) 3500 4900 8200 11400 14900

07022 Tarsorrhaphy 1000 1400 2400 3300 4300

06853 Telecanthus Reconstuction - Major 5600 7800 13200 18200 23800

06852 Telecanthus Reconstuction - Minor 2200 3100 5200 7200 9400

06854 Tumour Exc.with Reconstruction 4500 6300 10600 14600 19100

Lacrimal Apparatus06971 Canaliculo Rhinostomy 5300 7400 12500 17200 22500

06972 D C R with Lacrimal Intubation 6000 6600 11000 15300 20000

06973 Dacryocycstectomy 2000 2800 4700 6500 8500

07027 Endoscopy Assisted NLD Intubation 7000 9800 16500 22800 29800

122


Rs. Rs. Rs. Rs. Rs.

06862 Lacrimal Abscess & Drainage 1500 2100 3500 4900 640006833 Lacrimal Intubation 2000 2800 4700 6500 850018129 Lacrymal Syringing & Probing 2000 2800 4700 6500 850006974 Lacrymal Syringing & Probing ( Under Endoscopic Guidance) 3000 4200 7050 9750 1275018130 Nasal Endoscpic Assistance 1000 1400 2350 3250 425007028 Punctal Cautery 500 700 1200 1600 210007029 Punctal plugs 1500 2100 3500 4900 6400

Lens06912 Catract Extraction - GA 2800 3900 6700 9100 1190006911 Catract Extraction - LA 2600 3600 6100 8500 1110006920 ECCE with PC IOL 3600 5000 8500 11700 1530006914 Extracapsular Cat.Ext. - GA 3000 4200 7100 9800 1280006913 Extracapsular Cat.Ext. - LA 2800 3900 6600 9100 1190007031 IOL explantation 1500 2100 3500 4900 640006915 Lensectomy - GA 3000 4200 7100 9800 1280006815 Multifocal Implant 8000 11200 18800 26000 3400006919 Phacoemulcilfication 8000 11200 18800 26000 3400006922 Phacoemulcilfication (Non foldable) 6000 8400 14100 19500 2550006816 Phakic IOL 10000 14000 23500 32500 4250007032 Scleral fixated IOL 5000 7000 11750 16250 2125006918 Secondary Implant 3000 4200 7100 9800 1280006916 Small Insicion Cataract Surgery 5000 7000 11750 16250 2125006921 Triple Procedure(Cataract + Trab) 6000 8400 14100 19500 25500

Operation on Conjunctiva06807 Aminotic Membrane + Stem cell Transplants 5000 7000 11750 16250 2125006806 Amniotic Mambrane Overlay 2000 2800 4700 6500 850006805 Conjunctiva Repair 2000 2800 4700 6500 850006801 Excision of Cysts/Tumours 1800 2500 4200 5900 770007044 Mucous Membrane Graft 5000 7000 11750 16250 2125006802 Others Peritomy 1800 2500 4200 5900 770007016 Pterygium Excision With Graft 2500 3500 5900 8100 1060006803 Pteryigium 1800 2500 4200 5900 770006804 Removal of Foreign Body in OT 1500 2100 3500 4900 640007017 Symblepheron Release 1800 2500 4200 5900 7700

Orbit & RB

18131 Anterior Orbitotomy 5000 7000 11750 16250 2125007012 Extenteration of Orbit 4500 6300 10575 14625 19125

123


Rs. Rs. Rs. Rs. Rs.

07015 Optic Nerve Sheath Decompression 7000 9800 16450 22750 2975006864 Orbital Abscess 4500 6300 10575 14625 1912507037 Orbital abscess - Minor 3000 4200 7050 9750 1275007038 Orbital Implant 4000 5600 9400 13000 1700007013 Orbitotomies 8000 11200 18800 26000 3400007014 Reconstruction of Contracted Socket 5000 7000 11750 16250 2125007045 Reconstruction of Contracted Socke with Implant 6000 8400 14100 19500 25500

Retina06820 Intra Vitreal - Major 2500 3500 5875 8125 1062506819 Intra Vitreal - Minor 1800 2520 4230 5850 765006982 Laser Indirect Ophthalmoscopy - Major 1200 1680 2820 3900 510006983 Laser Indirect Ophthalmoscopy - Minor 800 1120 1880 2600 340006936 Retinal Cryopexy 1500 2100 3525 4875 637506834 Retinal Detachment Surgery 12500 17500 29375 40625 5312506817 ROP-LIO 12000 16800 28200 39000 5100006948 Silicon Oil Exchange 2000 2800 4700 6500 850006831 Silicon Oil Removal 2000 2800 4700 6500 850006981 Silicon Oil Removal + Cataract Surgery 4500 6300 10575 14625 1912506980 Vitrectomy + Additional Procedures 15000 21000 35250 48750 6375006835 Vitretctomy 11000 15400 25850 35750 4675006935 Vitretctomy - Minor 4000 5600 9400 13000 17000

Pediatric Ophthalmology & Strabismus06857 EUA / Major 3000 4200 7050 9750 1275006856 EUA / Minor 1500 2100 3525 4875 637506865 Probing & Syringing 2000 2800 4700 6500 850007046 Probing & Syringing under Endoscopic Guidance 3000 4200 7050 9750 1275007047 Lensectomy “! GA 3000 4200 7050 9750 1275007048 LA + PPC + AV 8000 11200 18800 26000 3400007049 LA + PPC + AV + IOL 10000 14000 23500 32500 4250007050 Suture Removal 700 980 1645 2275 297507051 Squint Surgery Major 10000 14000 23500 32500 42500

07052 Squint Minor 6000 8400 14100 19500 25500

07053 Two Muscle Surgery 3000 4200 7050 9750 12750

GENERAL18053 Advanced Microscope Per Hour 800 1100 1900 2600 3400

18125 Amniotic Membrane 1500 1500 1500 1500 1500

18126 Anterior Chamber wash ( Paracentesis ) 500 700 1200 1600 2100

124


Rs. Rs. Rs. Rs. Rs.18052 Basic Microscope Per Hour 400 600 900 1300 1700

07099 Bilateral (50% of Proce./Surgery)

18051 Phaco And Microscope Per Hour 800 1100 1900 2600 3400

18055 UVX Machine usage 20000 20000 20000 20000 20000

G. ORTHOPAEDICSElbow - INTERMEIATE B1

07277 Below Elbow Amputation 7000 9800 16600 22800 29800

07380 Excision Head of Radius 6600 9100 15300 21100 27700

07381 Exploration/Arthrotomy 6600 9100 15300 21100 27700

07374 Intramedullary Nailing (Single Bone) 6000 8300 14100 19600 25600

07278 ORIF Radial Neck/ Head 5600 7700 12900 17900 23300

07386 Synovectomy - Elbow 7000 9800 16600 22800 29800

07388 Tennis Elbow Operation 6600 9100 15300 21100 27700

Elbow - INTERMEIATE B2

07378 Condylar Fracture Fixation 9000 12700 21200 29300 38300

07379 Excision Arthoplasty 9600 13300 22300 30900 34000

07377 External Fixation for Open Fractures 8000 11200 18800 26000 38300

07382 French Osteotomy 9600 13300 22300 30900 40300

07375 Intramedullary Nailing (Both Bones) 9000 12700 21200 29300 40300

07383 Lateral Condylefixation 8000 11200 18800 26000 34000

07384 Single Bone Fracture - ORIF with Bone Grafting 7600 10600 17700 24300 31900

07385 Supracondylar Fracture Fixation 9600 13300 22300 30900 40300

07390 Ulnar Nerve Transposition 7600 10600 17700 24300 31900

Elbow - MAJOR C1

07279 Ender’S Nailing Humerus 9000 12700 21200 29300 38300

07373 Monteggia Fracture ORIF/Galezzi with ORIF 9000 12700 21200 29300 38300

07519 ORIF supracondylar fractures 9600 13400 22600 31200 40800

Elbow - MAJOR C2

07372 Fracture - Both Bones ORIF with Bone Grafting 13000 18200 30700 42300 55300

07520 Interposition Of Arthroplasty 11600 16100 27000 37300 48900

07522 Malunited Fracture Dislocation 10000 14000 23500 32500 42500

07376 Non-Union of Forearm Fracture 13000 18200 30700 42300 55300

07521 Open Reduction Of Neglected Dislocation 11600 16100 27000 37300 48900

07387 Tension Band Wiring 8000 11200 18800 26000 34000

Elbow - SPECIALISED D1

07551 Complex Fracture Both Bones Orif 15000 21000 35300 48800 63800

125


Rs. Rs. Rs. Rs. Rs.

Elbow - SPECIALISED D207523 Arthroscopy Elbow(Procedure Includes Biopsy,Removal Ofloose Bodies,

Debridement, Tennis Elbow,Arthoscopy Assistedradical Head /Capitulum Fracture Fixation) 20000 28000 47000 65000 85000

07281 ORIF Supracondylar + Intercondylar Fracture 20000 28000 47000 65000 8500007389 Total Joint Replacement - Elbow 25000 35000 58800 81300 106300

FOOT & ANKLE - MINOR A107103 Club Foot (CTEV) Manipulation 1500 2100 3500 4900 640007132 Stendler’S Release 3200 4600 7600 10300 1370007555 Lateral Column Lengthening 1500 2100 3500 4900 6400

FOOT & ANKLE - MINOR A207101 Calcaneal Osteotomy 5800 8100 13700 18900 2470007107 Kwiring of Fractures/Dislocation 5000 7000 11800 16300 2130007102 Ray Amputation 3800 5300 8900 12300 1620007122 Tendoachilles Lengthening 3800 5300 8900 12300 1620007556 Tendoachilles Lengthening / Gastroc Release 3800 5300 8900 12300 16200

FOOT & ANKLE - INTERMEDIATE B107105 Hallux Valgus - Correction 7000 9800 16600 22800 2980007140 Hallux Varus - Correction 6000 8300 14100 19600 2560007130 Lisfranks Amputation 5600 7700 12900 17900 2330007138 Metatarsal Osteotomy 6000 8300 14100 19600 2560007131 Orif Jones Fracture 5500 7700 12900 17900 2340007109 Subtalar Fusion (Grice Green) 6600 9100 15300 21100 2770007126 Unimalliolus Fracture - Ankle 5000 7000 11800 16300 21300

FOOT & ANKLE - INTERMEDIATE B207125 Non-Union Medial Malleolus Fracture 7000 9800 16600 22800 2980007118 Repair of Tendoachilles 7000 9800 16600 22800 2980007110 Talectomy 8000 11200 18800 26000 34000

FOOT & ANKLE - MAJOR C107114 Arthrodesis - Foot & Ankle 10600 14700 24700 34100 4470007121 Bimalleolar Fracture ORIF 8000 11200 18800 26000 3400007113 Blair’s Fusion 10600 14700 24700 34100 4470007490 Cong.Vertical Talus Surg. Correction 10600 14700 24700 34100 4470007136 Open Reduction & Internal Fixation Of Fracture Calcane 9000 12700 21200 29300 3830007491 ORIF - Lisfranc Injury 9600 13300 22300 30900 4030007129 ORIF Talus Fractures 9000 12700 21200 29300 3830007570 Osteotomy at Midtarsal Joint 9600 13300 22300 30900 4030007108 Posteromedial Soft Tissue Release for CTEV 8000 11200 18800 26000 34000

126


Rs. Rs. Rs. Rs. Rs.07135 Symes Amputation 9000 12700 21200 29300 3830007134 Tenden Trans For Ft Drop 10600 14700 24700 34100 4470007124 Trimalleolar Fracture ORIF 15000 21000 35300 48800 6380007111 Triple Fusion 10600 14700 24700 34100 44700

FOOT & ANKLE - MAJOR C207127 CTEV Correction using JESS Ext 13000 18200 30700 42300 5530007206 Fracture Dislocation Ankle 10000 14000 23600 32600 4260007112 Pantalar Arthrodesis 10000 14000 23600 32600 4260018002 Supramalleolar Osteotomy 10000 14000 23600 32600 42600

FOOT & ANKLE - Specialized D207531 Ankle Arthroscopy(Procedure Includes Biopsy-Removal Ofloose Bodies,

Debridement,Haglund’S Disease,Impingement decompression-OstrigonumExcision/Decompression,Anterior,Chondroplasty,TA Repair 14000 19700 32900 45600 59600

07532 Ankle Fractures ORIF with Ligament Repair 14000 19700 32900 45600 5960007207 Pilon Fracture Fixation 17000 23800 40000 55300 72300

FORE ARM - INTERMEDIATE B107351 Single Bone Fracture - ORIF 7000 9800 16500 22800 29800

FORE ARM - MAJOR C107352 Both Bones Fracture - ORIF 10600 14700 24700 34100 4470007518 Fasciotomy - Major 10600 14700 24700 34100 44700

HIP - MINOR A207185 Closed Reduction of Hip Dislocation 2750 3800 6500 8900 11700

HIP - INTERMEDIATE B107189 Adductor Tenotomy 5000 7000 11800 16300 2130007190 Iliopsoas Recession 8700 12200 20300 28300 3700007557 Diangostic Hip Arthroplasty 5000 7000 11800 16300 21300

HIP - INTERMEDIATE B207173 Arthrotomy/Exploration - Hip 9600 13300 22300 30900 4030007142 Core Decompression of Femoral Head 8000 11200 18800 26000 3400007177 Excision Arthroplasty (Grindle Stone) 9000 12700 21200 29300 38300

HIP - MAJOR C107172 Arthrodesis - Hip 12000 16800 28200 39000 5100007496 Fracture Dislocation Of Femoral Head 10600 14700 24700 34100 4470007192 Non-Union Femoral Neck Fracture 12000 16800 28200 39000 5100007191 Open Reduction for Dislocation of Hip 10600 14700 24700 34100 4470007181 Osteotomies Around the Hip 12000 16800 28200 39000 5100007183 Slipped Femoral Epiphysis Operation 12500 17500 29400 40600 5310007182 V D O 11000 15300 25900 35800 46800

127


Rs. Rs. Rs. Rs. Rs.HIP - MAJOR C2

07175 Congential Dislocation Hip/Stabilization 14600 20300 34100 47100 6170007534 Core Decompression And Fibular Grafting 11000 15300 25900 35800 4680007176 Dynamic Hip Fixation - Richard’s 12000 16800 28200 39000 5100007498 External Fixation For Pelvic Fractures 12000 16800 28200 39000 5100007497 ORIF Pubicsymphysis 12000 16800 28200 39000 5100007499 Sacroiliac joint ORIF 11000 15400 25760 35800 46800

HIP - Specialized D107179 Hemi Arthroplasty without Bone Cement-Austin Morre 15000 21000 35300 48800 6380007144 Prox. Femoral Nailing 15000 21000 35300 48800 63800

HIP - SPECIALISED D207501 Complex Acetabular Fracture ORIF 28000 39200 65800 91000 11900007535 Hip Arthroscopy(Procedure Includes Biopsy, Removal Of Loose Bodies,

Debridement, Acetabulum Labrum Repair /Balancing,Decompression Of Impingement ) 20000 28000 47000 65000 85000

07536 Modular Bipolar Arthoplasty 18000 25200 42300 58500 7650007194 Open Reduction & Internal fixation of Fracture Acetabulum 24000 33600 56400 78000 10200007569 Open Reduction Congenital Dislocation Hip With Pelvic Isteotomy 20000 28000 47000 65000 8500007143 Reconstuction Nailing Of Femur 21000 29400 49400 68300 8930007195 Total Hip Replacement 26000 36400 61100 84500 110500

HIP - SPECIALISED D3TOTAL HIP REPLACEMENT - PACKAGE07600 Total Hip Replacement (Package) 70000 98000 126000 154000 182000

Package Includes Package does not include1. 10 days hospital stay, counting the operation day as 0 day 1.Drugs2. Surgery, Anaesthesia and O T charges 2.Special Investigations3. Consumables and materials used during surgery 3.Special support system if required4. Routine investigations in post operative phase 4.Special Blood Products5. Surgery of Primary complications-if-any during the first 10 days 5.Diet6. Cross matching upto 2 donors (voluntary) 6.Hospitalisation charges till the day of surgeryKNEE - INTERMEDIATE B1

07252 Arthrotomy/Exploration - Knee 8000 11200 18800 26000 3400007163 Collateral Ligament Repair 6000 8300 14100 19600 2560007254 Hamstring Release 8000 11200 18800 26000 3400007558 Patellar Pull 8000 11200 18800 26000 3400007559 Semi T Transfer / Rectus Transfer 8000 11200 18800 26000 34000

KNEE - INTERMEDIATE B207582 Cannulated Screw Fix Of Femoral Condyle 10000 14000 23500 32500 4250007273 Cannulated Screw Fix Of Femoral 10000 14000 23600 32600 4260007255 High Tibial Osteotomy 11000 15300 25900 35800 4680007272 Lateral Release For Patellas 9000 12700 21200 29300 38300

128


Rs. Rs. Rs. Rs. Rs.07257 Patellectomy or Fixation 9600 13300 22300 30900 4030007258 Quadriceps Plasty 13000 18200 30700 42300 5530007261 Stapling 11000 15300 25900 35800 46800

KNEE - MAJOR CI07251 Arthrodesis - Knee 12000 16800 28200 39000 5100007253 Condylar Plate Fixation 11000 15300 25900 35800 4680007265 Diagnostic Arthroscopy - Knee 10000 14000 23600 32600 4260007166 Femoral Unicondyle 9000 12700 21200 29300 3830007486 High Tibial Osteotomy withh Fixation 11000 15300 25900 35800 4680007164 ORIF Avulsion Fracture ACL 12000 16800 28200 39000 5100007165 ORIF Avulsion Fracture PCL 12000 16800 28200 39000 5100007264 Patella - TBW 9000 12600 21200 29300 3830007509 Percutaneous Unicondylar Femoral Fixation 8000 11200 18800 26000 3400007259 Recurrent Dislocation of Patella 11000 15300 25900 35800 46800

KNEE - MAJOR C207275 Arthoscopic Menisectomy 12000 16800 28200 39000 5100007269 Arthrodesis of Knee using Ilizarov 15000 21000 35300 48800 6380007267 Arthroscopic Lavage 11000 15300 25900 35800 4680007170 Arthroscopic Meniscal Repair 12000 16800 28200 39000 5100007266 Arthroscopy & Proceedure - Knee 13600 18900 31700 43900 5730007169 Femoral Bicondyle 11000 15300 25900 35800 4680007270 Femural Condylar Fracture ORIF 13600 18900 31700 43900 5730007563 Microfracture 11600 16100 27000 37300 4890007271 Operation for Con dis Pat 15000 21000 35300 48800 6380007510 Patellar Tendon Reconstruction 11000 15300 25900 35800 46800

KNEE - SPECIALISED D107268 ACL Reconstruction 17000 23800 40000 55300 7230007198 Femoral Bondylar With Supracondylar Fracture 17000 23800 40000 55300 7230007202 Knee Instability Reconstruction Procedures 17000 23800 40000 55300 7230007197 PCL Reconstruction 20000 28000 47000 65000 8500007203 Postero Lateral Corner Reconstruction 17000 23800 40000 55300 72300

KNEE - SPECIALISED D2

07199 Arthroscopic ACL Reconstruction 18000 25200 42300 58600 7660007200 Arthroscopic PCL Reconstruction 17000 23800 40000 55300 7230007201 Arthroscopic Stabilization Of Fractures 17000 23800 40000 55300 7230007566 Arthroscopy MPFL repair - Knee 14000 19700 32900 45600 5960007564 Mosaicplasty 15000 21000 35300 48800 63800

129


Rs. Rs. Rs. Rs. Rs.

07565 OATS 15000 21000 35300 48800 6380007572 PLC Reconstruction 16000 22300 37700 52000 6800007263 Total Joint Replacement 22000 30800 51700 71500 93500

KNEE - SPECIALISED D307573 Augmented Arthoscopy ACL Reconstruction 25000 35000 58800 81300 10630007543 Revision Arthoscopy ACL Reconstruction 26000 36300 61100 84600 11060007544 Revision Arthoscopy PCL Reconstruction 26000 36300 61100 84600 11060007542 Revision Total Knee Replacement 30000 42000 70600 97600 12760007545 Single Stage ACL PCL Reconstruction 25000 35000 58800 81300 106300

TOTAL KNEE REPLACEMENT - PACKAGE07280 Total Knee Replacement (Package Per Knee) 65000 91000 117000 143000 169000

Package Includes Package does not include1. 10 days hospital stay, counting the operation day as 0 day 1.Drugs2. Surgery, Anaesthesia and O T charges 2.Special Investigations3. Consumables and materials used during surgery 3.Special support system if required4. Routine investigations in post operative phase 4.Special Blood Products5. Surgery of Primary complications-if-any during the first 10 days 5.Diet6. Cross matching upto 2 donors (voluntary) 6.Hospitalisation charges till the day of surgery

LEG - INTERMEDIATE B107485 Fibular Grafting (SHIFT) 5000 7000 11800 16300 2130007146 Fibular Plating 5000 7000 11800 16300 2130007233 Fibulectomy 6600 9100 15300 21100 27700

LEG - INTERMEDIATE B207221 Below Knee Amputation 8000 11200 18800 26000 3400007227 Compartmental Release 8000 11200 18800 26000 3400007502 Percutaneous Intercondylar Fixation 8000 11200 18800 26000 3400007226 Postero Lateral Grafting 10000 14000 23600 32600 42600

LEG - MAJOR C107231 Clo Nailing For Tibial Fracture 10600 14700 24700 34100 4470007222 Compression Plating of Tibia (DCP/Muller) 12000 16800 28200 39000 5100007235 Enders Nailing - Leg 9000 12700 21200 29300 3830007225 External Fixation for Tibial Fracture 9000 12700 21200 29300 3830007148 Hungtington Procedure 9000 12700 21200 29300 3830007229 Non-Union Tibia 12000 16800 28200 39000 5100007228 ORIF for Tibial Condylar Fracture 10000 14000 23600 32600 4260007147 Tibial Condylar Unicondyle 7000 9800 16500 22800 29800

LEG - MAJOR C207223 Congenital Pseudaorthrosis Tibia 13000 18200 30700 42300 5530007503 Exchange Nailing 11000 15300 25900 35800 46800

130


Rs. Rs. Rs. Rs. Rs.

07232 ORIF Tibial Fracture using Ili 15000 21000 35300 48800 63800LEG - SPECIALIZED D1

07505 Congenital Pseudaorthrosis + Iiizarov 19000 26700 44700 61800 8080007504 Congenital Pseudaorthrosis+Fibular Graft 19000 26700 44700 61800 8080007234 Inter Locking Nailing - Leg 14000 19600 32900 45500 5950007540 Locked Compression Plating (Leg) 15000 21000 35300 48800 6380007507 MIPPO 16000 22400 37600 52000 6800007230 Non-Union Tibia Fracture Using Ilizarov 19000 26700 44700 61800 8080007506 Tibia-Multiple Osteotomies + IF 18000 25200 42300 58600 76600

LEG - SPECIALIZED D207562 Polar Fracture with Tibial Shaft Fracture 22000 30800 51700 71600 9360007583 MIPPO D2 22000 30800 51700 71600 93600

SHOULDER & ARM - MINOR A207480 Acromion Excision 6000 8400 14100 19500 2550007332 Closed Reduction of Humerus Fractures 3000 4200 7100 9800 1280018005 MUA 3000 4200 7100 9800 12800

SHOULDER & ARM - INTERMEDIATE B107322 Arthrotomy/Exploration - Shoulder & Arm 10000 14000 23600 32600 42600

SHOULDER & ARM - INTERMEDIATE B207240 Above Elbow Amputation 7000 9800 16600 22800 2980007239 Fixation Of Clavicle Fracture 9000 12600 21200 29300 3830007330 Intramedullary Nailing Humerus 9600 13300 22300 30900 4030007241 Proximal Humerus Fracture CR & Kwiring( CRIF) 7000 9800 16600 22800 2980007326 Supraspinatus Tendinitis & Subacrominal Bursitis 9600 13300 22300 30900 40300

SHOULDER & ARM - MAJOR C107242 Arthroscopy & Lavage - Shoulder & Arm 9600 13300 22300 30900 4030007329 Compression Plating of Humerus 11000 15300 25900 35800 4680007335 Diagnostic Arthroscopy - Shoulder & Arm 10600 14700 24700 34100 4470007333 External Fixation for Open Fractures of Humerus 7000 9800 16600 22800 2980007331 Non-Union Fracture of Humerus 11000 15300 25900 35800 4680007325 Recurrent Dislocation 12000 16800 28200 39000 51000

SHOULDER & ARM - MAJOR C207328 Acromioclavicular Joint Fixation + Ligament Repair 11600 16100 27000 37300 48900

07321 Arthodesis - Shoulder 14600 20300 34100 47100 61700

07244 Arthroscopic Frozen Shoulder Release 11600 16100 27000 37300 48900

07323 Forequarter Amputation 18800 26300 44200 61100 79900

07243 Interlocking Nailing of Humerus 10000 14000 23500 32500 42500

131


Rs. Rs. Rs. Rs. Rs.07324 Proximal Humerus Fracture ORIF 11000 15300 25900 35800 46800

SHOULDER & ARM - SPECIALISED D107247 Arthroscopic Rotator Cuff Repair 17000 23800 40000 55300 7230007249 Arthroscopic Subacromal Decompression 16000 22300 37700 52000 6800007334 Ilizarov Fixation For Non Union Humerus Fracture 20000 28000 47000 65000 8500007549 Locked Compression Plating (Shoulder & Arm) 18000 25200 42300 58500 76500

SHOULDER & ARM - SPECIALISED D207568 Arthoscopic Repair Of AC Joint Instability 19000 26700 44700 61800 8080007567 Arthoscopy Biceps Tenodesis 19000 26700 44700 61800 8080007248 Arthroscopic Stabilization Of Shoulder Instability 19000 26700 44700 61800 8080007245 Hemireplacement Of Shoulder 22000 30800 51700 71600 9360007517 Neers Capsular Shift 19000 26700 44700 61800 8080007513 Open Reduction Of Dislocation Of Shoulder 12000 16800 28200 39000 5100007515 OR + IF Fracture Glenoid 18000 25200 42300 58600 7660007514 OR + IF Fracture Scapula 18000 25200 42300 58600 7660007327 Total Joint Replacement - Shoulder & Arm 25000 35000 58800 81300 106300

SPINE - MINOR A207208 Closed Biopsy 3000 4200 7100 9800 12800

SPINE - INTERMEDIATE B207209 Biopsy - Open 5000 7000 11800 16300 21300

SPINE - MAJOR C107293 Cervical Rib Excision 10000 14000 23500 32500 4250007295 Costo Transversecomy 15000 21000 35300 48800 63800

SPINE - MAJOR C207210 Laminoplasty 11000 15300 25900 35800 46800

SPINE - SPECIALIZED D107292 Anterolateral Decompression 19000 26600 44700 61800 8080007213 Fenestration Disectomy 15000 21000 35300 48800 6380007211 Laminectomy - Multiple 16000 22300 37700 52000 6800007214 Pedicular Fixation Simple 16000 22400 37600 52000 68000

SPINE - SPECIALIZED D207219 A L I F 20000 28000 47000 65000 8500007291 Anterior Spinal Fusion with Decompression 24000 33700 56300 78000 10200007294 Correction Spinal Osteotomy & Fusion 25000 35000 58800 81300 10630007297 Instrumentation & Spinal Fusion for Scoliosis 30000 42000 70600 97600 12760007218 P L I F 18000 25200 42300 58600 7660007220 Pedicular Fixation With Fusion 18000 25200 42300 58600 76600

132


Rs. Rs. Rs. Rs. Rs.07305 Recurrent Disc/Failed Back Syndrome 21000 29300 49300 68300 89300

07302 Spinal Fracture Reduction with Fixation 20000 28000 47000 65000 85000

07215 Surgical Correction Of Kyphosis 25000 35000 58800 81300 106300

07548 Vertebroplasty 19000 26700 44700 61800 80800

07584 Multi Level Decompression+ Instrumental Fixation 19000 26700 44700 61800 80800

SPINE - SPECIALIZED D3

07560 Anterior and Posterior Spinal Surgery 26000 36300 61100 84600 110600

18001 Anterolateral Decompression Instrumention & Fusion 26000 36300 61100 84600 110600

07561 Grade III/ IV Listhesis Surgery 26000 36300 61100 84600 110600

18000 Posterolateral Decompression Instrumention & Fusion 28000 39200 65800 91000 119000

THIGH - INTERMEDIATE B1

07159 A/C Osto. Femor Decompression 6000 8300 14100 19600 25600

07158 Exostoics Excision 6000 8300 14100 19600 25600

THIGH - INTERMEDIATE B2

07151 Above Knee Amputation 12000 16800 28200 39000 51000

THIGH - MAJOR C1

07152 Compression Plating of Femur (DCP/Muller) 11000 15300 25900 35800 46800

07162 Enders Nailing - Thigh 9000 12700 21200 29300 38300

07154 External Fixation for Femus Fractures 9000 12700 21200 29300 38300

THIGH - MAJOR C2

07492 DCP and Bone Grafting 14000 19700 32900 45600 59600

07493 Int. Locking Nailing + Bone Grafting 15000 21000 35300 48800 63800

07155 Non-Union Femur 13000 18200 30600 42300 55300

THIGH - SPECIALIZED D1

07161 Comp. Dis. For Non Le. Fe. 20000 28000 47000 65000 85000

07160 Iliza.Fix.For Op.Fem. Fr. 19000 26700 44700 61800 80800

07157 Int. Locking Nailing Femo 14000 19600 32900 45500 59500

07533 Locked Plating - Thigh 16000 22300 37700 52000 68000

07156 Non-Union Femur Using Ilyzarov 20000 28000 47000 65000 85000

THIGH - SPECIALIZED D2

07494 Exchange Nailing + Bone Grafting 18000 25200 42300 58600 76600

07366 Locked plate for supracondylar T - Y fracture femur 18000 25200 42300 58600 76600

07141 Supracondylar Nailing 18000 25200 42300 58600 76600

WRIST - MINOR A2

07404 De Quervains Disease Decompression 4600 6300 10700 14700 19100

07405 Excision Of Lower End Of Ulna 4600 6300 10700 14700 19100

133


Rs. Rs. Rs. Rs. Rs.

WRIST - INTERMEDIATE B107409 Barton’s Fracture ORIF 5600 7700 12900 17900 2330007402 Bennet’s Fracutre Fixation 6600 9100 15300 21100 2770007412 Ganglion Excision 4600 6300 10700 14700 1910007283 Lunate Excision & Procedure 5600 7700 12900 17900 2330007284 Metacarpel Fixation 5600 7700 12900 17900 2330007407 Synovectomy/Arthrotomy/Exploration 9000 12700 21200 29300 37600

WRIST - INTERMEDIATE B207401 Arthodesis - Wrist 9600 13300 22300 30900 4030007524 Closed Reduc+Percut Pinning Dis Rad & Ulnar Styloi 7000 9800 16500 22800 2980007525 Mallet Finger 7000 9800 16600 22800 2980007410 Orif Scaphoid Fracture 9600 13300 22300 30900 40300

WRIST - MAJOR C107286 Carpal Bone Fracture Dislocated (ORIF/ CRIF) 9000 12700 21200 29300 3830007403 Carpal Tunnel Decompression 5000 7000 11800 16300 2130007526 Malunited Distal Radius -Osteotomy & Procedure 9000 12700 21200 29300 3830007411 Non-Union Scaphoid 10600 14700 24700 34100 4470007527 Radial Shortening For Keinbocks 9000 12700 21200 29300 38300

WRIST - MAJOR C218007 Ligamento Taxis 12000 16800 28200 39000 5100018006 Open TFCC Repair 12000 16800 28200 39000 5100007367 ORIF distal radius fracture with locked plate 12000 16800 28200 39000 5100007406 Proximal Row Carpectomy 12000 16800 28200 39000 51000

WRIST - SPECIALISED D207553 Arthrodesis - Wrist 11000 15300 25900 35800 4680007574 Arthroscopy & TFCC repair 13000 18200 30700 42300 55300

MISCELLANEOUS - MINOR A107431 Amputations - Minor 3200 4600 7600 10300 13700

07433 Application of Special Plasters/MJHSBS/Spica/FCB 2000 2800 4700 6600 8600

07434 Biopsy - Minor 2000 2800 4700 6600 8600

07437 Bone Graft - Minor 3200 4600 7600 10300 13700

07439 Closed Reduction of Fracture/Dislocations - Minor 3200 4600 7600 10300 13700

07442 Compression Bandage (Robert Tones) 2000 2800 4700 6600 8600

07288 Curratage Of Bone Tumor - Minor 2000 2800 4700 6600 8600

07446 Debridement - Minor 2000 2800 4700 6600 8600

07576 Dynamisation 2000 2800 4700 6600 8600

07296 Excision Of Tumor Minor 2000 2800 4700 6600 8600

134


Rs. Rs. Rs. Rs. Rs.

07290 External Fixation Of Fracture - Minor 2000 2800 4700 6600 860007453 Intra Articular Injection in OT 2000 2800 4700 6600 860007454 Joint Aspiration 2000 2800 4700 6600 860007300 Nerve Repair - Minor 2000 2800 4700 6600 860007456 Non-Operative Mgmt.of Fracture (Balanced Traction) 2000 2800 4700 6600 860007457 Ordinary Plaster Cast Application 2000 2800 4700 6600 860007287 Osteotomy - Minor 2000 2800 4700 6600 860007462 PTB Plaster Application 2000 2800 4700 6600 860007306 Release Of Contracture - Minor 2000 2800 4700 6600 860007464 Removal Implants - Minor 3000 4200 7100 9800 1280007468 Skeletal Traction in OT 3200 4600 7600 10300 1370007469 Skin Graft - Minor 3200 4600 7600 10300 1370007471 Skin Traction 2000 2800 4700 6600 860007479 Skull Traction 3700 5200 8700 12000 1570007472 Tendon Repair - Minor 3200 4600 7600 10300 1370007368 Tendon Transfer - Minor 5000 7000 11800 16300 2130007369 Tenotomy - Minor 5000 7000 11800 16300 2130007475 Trigger Point Injection in OT 2000 2800 4700 6600 860007477 Wound Closure - Minor 2000 2800 4700 6600 8600

MISCELLANEOUS - MINOR A207441 Cold Abcess Drainage 3600 4900 8200 11300 1490007474 Tenotomies - Major 7300 10300 17300 24100 31600

MISCELLANEOUS - INTERMEDIATE B107307 Amputations - Intermediate 5600 7700 12900 17900 2330007308 Biopsy - Intermediate 5600 7700 12900 17900 2330007309 Bone Graft - Intermediate 5600 7700 12900 17900 2330007311 Closed Reduction Of Fracture/Dislocations-Inter 5600 7700 12900 17900 2330007314 Curratage Of Bone Tumor - Intermediate 5600 7700 12900 17900 2330007312 Debridement - Intermediate 5600 7700 12900 17900 2330007317 Excision Of Tumor - Intermediate 5600 7700 12900 17900 2330007316 External Fixation - Intermediate 5600 7700 12900 17900 2330007315 Internal Fixation Of Fracture - Intermediate 5600 7700 12900 17900 2330007318 Nerve Repair - Intermediate 5600 7700 12900 17900 2330007458 Ordinary Plating Of Fractures 6600 9100 15300 21100 2770007459 Osteomyelitis Acute Drainage 3800 5300 8900 12300 1620007310 Osteotomy - Intermediate 5600 7700 12900 17900 2330007320 Release Of Contracture - Intermediate 5600 7700 12900 17900 23300

135


Rs. Rs. Rs. Rs. Rs.07337 Removal Implants - Intermediate 5600 7700 12900 17900 2330007466 Rib Resection 5600 7700 12900 17900 2330007319 Tendon Repair - Intermediate 6000 8400 14100 19500 2550007370 Tendon Transfer - Intermediate 6000 8300 14100 19600 2560007313 Wound Closure - Intermediate 5000 7000 11800 16300 21300

MISCELLANEOUS - MAJOR C107432 Amputations - Major 10600 14700 24700 34100 4470007435 Biopsy - Major 7000 9800 16500 22800 2980007436 Bone Block Surgery 10000 14000 23600 32600 4260007438 Bone Graft -Major 9000 12700 21200 29300 3830007440 Closed Reduction Of Fracture/Dislocations - Major 8000 11200 18800 26000 3400007340 Currattage Of Bone Tumor - Major 9000 12700 21200 29300 3830007447 Debridement - Major 9000 12700 21200 29300 3830007343 Excision Of Tumor - Major 9000 12700 21200 29300 3830007342 External Fixation - Major 9000 12700 21200 29300 3830007341 Internal Fixation Of Fracture - Major 9000 12700 21200 29300 3830007396 Mega Prosthesis reconstruction for tumor 10600 14700 24700 34100 4470007344 Nerve Repair - Major 9000 12700 21200 29300 3830007460 Osteomyelitis Chronic Medium Curttage&Auceusation 8600 11900 20000 27700 3610007339 Osteotomy - Major 9000 12700 21200 29300 3830007397 Post tumor excision reconstruction 9000 12700 21200 29300 3830007346 Release Of Contracture - Major 9000 12700 21200 29300 3830007465 Removal Implants - Major 9000 12600 21200 29300 3830007467 Rotation Flap 10600 14700 24700 34100 4470007470 Skin Graft - Major 9000 12700 21200 29300 3830007345 Tendon Repair - Major 9000 12700 21200 29300 3830007473 Tendon Transfer - Major 10600 14700 24700 34100 44700

07338 Wound Closure - Major 7000 9800 16500 22800 29800

ORTHOPAEDIC PROCEDURE IN EMERGENCY07577 Closed Reduction + Cast Application 5000 7000 11800 16300 21300

07578 Closed Reduction + Slab Application 5000 7000 11800 16300 21300

07580 Splinting (Long Bone Fracture,Short Bone Fracture, External Fixation) 5000 7000 11800 16300 21300

07579 Traction Application- Skin Or Skeletal 6000 8300 14100 19600 25600

SPECIALISED D207452 Ilizarov Instrumentation & Corticotomy for Lehgthn 20000 28000 47000 65000 85000

SPECIALISED D307581 Combined Complex Procedure 25000 35000 58800 81300 106300

136


Rs. Rs. Rs. Rs. Rs.

GENERAL18078 Advanced Microscope Per Hour 2000 2800 4700 6500 850018077 Basic Microscope Per Hour 1500 2100 3500 4900 640007598 Bilateral (50% Of Proce./Surgery)07599 Extra Hours Taken For A Surgery07395 Fluroscopy Time (Every Adnl.5Mts) 100 100 200 300 30007391 Fluroscopy Time upto 10 Minutes 600 690 780 870 96007392 Fluroscopy Time upto 15 Minutes 700 800 910 1000 112007393 Fluroscopy Time upto 20 Minutes 800 920 1040 1160 128007394 Fluroscopy Time upto 30 Minutes 900 1040 1170 1300 144018079 Laparoscope Per Hour 600 800 1400 2000 260018135 Neuro monitor use 5000 5500 6000 6500 7000

H. ENTEAR

07601 Atticotomy with Tympanoplasty 10000 14000 23500 32500 42500

07602 Aural Polypectomy 3000 4200 7100 9800 12800

07643 B A H A 35000 46000

07638 Biopsy - ENT 3000 4200 7100 9800 12800

07604 Cortical Mastoidectomy 10000 14000 23500 32500 42500

07603 Cortical Mastoidectomy with Tympanoplast 10800 15100 25400 35100 45900

08016 EAC Mass Excision 8000 11200 18800 26000 34000

07605 Ear Canal Reconstruction 8000 11200 18800 26000 34000

07607 Ear Lobe Repair - Both Ears 3000 4200 7100 9800 12800

07606 Ear Lobe Repair - One Ear 2000 2800 4700 6500 8500

07608 Endolymphatic Sac Decompression 15000 21000 35300 48800 63800

07636 Ex Glom.Jugtumlat.Trans-Temp. 20000 28000 47000 65000 85000

07634 Excis.Ofglom.Jug.Tum. Posta 16000 22400 37600 52000 68000

07633 Excis.Ofglom.Jug.Tum.Foramen 17000 23800 40000 55300 72300

07635 Excis.Ofglom.Jugu.Tum Intratym 13000 18200 30600 42300 5530007611 F.B. Removal from the External Auditory Canal 3000 4200 7100 9800 1280007610 F.B. Removal from the Middle Ear 3500 4900 8200 11400 1490007609 Facial Nerve Decompression - Major 18000 25200 42300 58500 7650007612 I & D Haematoma Auris 3000 4200 7100 9800 1280007613 I & D Mastoid Abscess 9000 12600 21200 29300 3830007639 Keratosis Obturan Removal 5000 7000 11800 16300 2130007614 Labrinthectomy 13000 18200 30600 42300 5530007644 M E I H D S 50600 65660

137


Rs. Rs. Rs. Rs. Rs.

07615 Mid-Cranial Fossa Appr.to Internal Auditory Meatus 19000 26600 44700 61800 8080007617 Mod.Radical Mastoidectomy w Tympanoplast 16000 22400 37600 52000 6800007616 Modified Radical Mastoidectomy 17000 23800 40000 55300 7230007637 Myringoplasty (Transcanal) 9000 12600 21200 29300 3830007620 Myringotomy 5000 7000 11800 16300 2130007619 Myringotomy with Gromet-Both Ears 8000 11200 18800 26000 3400007618 Myringotomy with Gromet-One Ear 7000 9800 16500 22800 2980007831 Otoendoscopic Stapedotomy 17000 23800 40000 55300 7230007830 Otoendoscopic Surgery - Major 11000 15400 25900 35800 4680007829 Otoendoscopic Surgery - Minor 10000 14000 23500 32500 4250007641 P S C C Occlusion 10000 14000 23500 32500 4250007621 Post-op. Exam. of Mid-Ear/Mastoid Cavity 7 Proce. 3000 4200 7100 9800 1280007623 Pre-Auricular Sinus Excision - Both Sides 5000 7000 11800 16300 2130007622 Pre-Auricular Sinus Excision - One Side 7000 9800 16500 22800 2980007624 Radical Mastoidectomy 16000 22400 37600 52000 6800007625 Revision Meatoplasty 6000 8400 14100 19500 2550007626 Stapedectomy 17000 23800 40000 55300 7230007627 Temporal Bone Resection - Partial 19000 26600 44700 61800 8080007628 Temporal Bone Resection - Total 20000 28000 47000 65000 8500007640 Trans Labrinthine acoustic neuroma excision 19000 26600 44700 61800 8080007629 Trans Labrinthine vestibular Nerve Section 15000 21000 35300 48800 6380007630 Tympanoplasty Type I 10000 14000 23500 32500 4250007631 Tympanoplasty Type II 12000 16800 28200 39000 5100007632 Tympanotomy 3500 4900 8200 11400 14900

NOSE07651 Anterior Nasal Packing 2500 3500 5900 8100 10600

07653 Antral Wash - Both Sides 2000 2800 4700 6500 8500

07652 Antral Wash - One Side 2000 2800 4700 6500 8500

07656 Antrochaonal Polypectomy 6000 8400 14100 19500 25500

07657 Antroscopy 2000 2800 4700 6500 8500

07658 Antroscopy Polypectomy 6000 8400 14100 19500 25500

07659 Arterial Ligation on Epistaxis 8500 11900 20000 27600 36100

07660 Biopsy Nose 3000 4200 7100 9800 12800

07662 Caldwell Luc - Both Sides 7000 9800 16500 22800 29800

07661 Caldwell Luc - One Side 4500 6300 10600 14600 19100

07663 Canalization of Nose in Cong. Acq./after Young’s 2500 3500 5900 8100 10600

07689 Choanal Atresia - Transnasal - Bilateral 10000 14000 23500 32500 42500

138


Rs. Rs. Rs. Rs. Rs.07690 Choanal Atresia - Transnasal - Unilateral 10000 14000 23500 32500 42500

07691 Choanal Atresia - Transpalatal - Bilateral 10000 14000 23500 32500 42500

07664 Closure of Oroantral Fistula 5500 7700 12900 17900 23400

07665 Cranio Facial Resection Malignancy of Nasal Cavity 20000 28000 47000 65000 85000

07666 Cranio-Facial Resection with Exenteration of Eye 20000 28000 47000 65000 85000

07668 Endoscopic Ethmoidectomy / FESS 16000 22400 37600 52000 68000

07833 Endoscopic Septal Surgery 15000 21000 35300 48800 63800

07670 Excision of Rhinoscleroma Rhinosporidium 10000 14000 23500 32500 42500

07672 External Fronto Ethmoidectomy - Both Sides 10000 14000 23500 32500 42500

07671 External Fronto Ethmoidectomy - One Side 8000 11200 18800 26000 34000

07675 F.B. Removal from Nose 3000 4200 7100 9800 12800

07697 Facial Translocation 21000 29400 49400 68300 89300

07673 Fracture Nasal Bone Reduction 7000 9800 16500 22800 29800

07655 Intranasal Antrostomy -Both Sides 3000 4200 7100 9800 12800

07654 Intranasal Antrostomy -One Side 3000 4200 7100 9800 12800

07678 Maxillectomy - Partial 17000 23800 40000 55300 72300

07679 Maxillectomy - Total 22000 30800 51700 71500 93500

07676 Maxillectomy with Excenteration of Eye Ball 14000 19600 32900 45500 59500

07677 Maxillectomy with Extended Cheek/Exci. & Reconstruction 18000 25200 42300 58500 76500

07680 Nasal Endoscopic Examination 3000 4200 7100 9800 12800

07681 Obliterative Surgery of Frontal Sinus 10000 14000 23500 32500 42500

07682 Oroantral Fistula Closure with Caldwell Luc 9000 12600 21200 29300 38300

07683 Post-Nasal & Anter. Nasal Pack 5000 7000 11800 16300 21300

07684 Rhinoplasty with Nasal Tip 11000 15400 25900 35800 46800

07688 S.M.R. 12000 16800 28200 39000 51000

07685 Septal Abscess or Haematoma Drainage 6000 8400 14100 19500 25500

07696 Septo Rhinoplasty 18000 25200 42300 58500 76500

07686 Septoplasty 12000 16800 28200 39000 51000

07836 Septoplasty/SMR + FESS 17000 23800 40000 55300 72300

07687 Sub-mucus Diathermy 6000 8400 14100 19500 25500

07692 Surgery for Choanal Atresia - Transpalatal -Unilat 12000 16800 28200 39000 51000

07693 Transnasal Ethmoidectomy 8000 11200 18800 26000 34000

07694 Turbinectomy 4000 5600 9400 13000 17000

07695 Young’s Operation 7000 9800 16500 22800 29800

THROAT NASO PHARYNX NASO PHARYNX07715 Adenoidectomy 7000 9800 16500 22800 29800

139


Rs. Rs. Rs. Rs. Rs.

07716 Biopsy Nasopharynx 7000 9800 16500 22800 2980007834 Endoscopic Adenoidectomy 8000 11200 18800 26000 3400007711 Excision of Angiofibroma - Lateral Rhinotomy 13000 18200 30600 42300 5530007712 Excision of Angiofibroma - Lateral Temporal 13000 18200 30600 42300 5530007713 Excision of Angiofibroma - Transnasal 18000 25200 42300 58500 7650007714 Excision of Angiofibroma - Transpalatal 13000 18200 30600 42300 55300

ORAL CAVITY & ORO PHARYNX07731 Biopsy Oral Cavity 3000 4200 7100 9800 12800

07733 Closure of Pharyngeal Fistula - Primary Local 12000 16800 28200 39000 51000

07732 Closure of Pharyngeal Fistula - with Flap 13000 18200 30600 42300 55300

07828 Electro Coagulation Tonsillectomy 10000 14000 23500 32500 42500

07735 Exci.of Ca.Cheek Pri. Local Clos. 12000 16800 28200 39000 51000

07737 Exci.of Ca.Cheek with Neck Dissection & Hemimundi. 24000 33600 56400 78000 102000

07738 Exci.of Ca.Cheek with Neck Reconstuctionwith Regl. Flap 17000 23800 40000 55300 72300

07740 Exci.of Hypopharyngeal Diverticulum by Exter.Appr. 12000 16800 28200 39000 51000

07736 Excis.of Ca.Cheek with Neck Dissection with Reconstuction 16000 22400 37600 52000 68000

07734 Excision of Benign Lesion in the Oral Cavity 8000 11200 18800 26000 34000

07739 Excision of Growth Epulis 7000 9800 16500 22800 29800

07741 Excision of Ranula 8000 11200 18800 26000 34000

07742 Excision of Small Growth Tongue Trans-orally 5000 7000 11800 16300 21300

07743 Hemiglossectomy Transal-oral with Local Closure 13000 18200 30600 42300 55300

07744 I & D of Peritonsillar Abscess 12000 16800 28200 39000 51000

07751 I & D of Retropharyngeal Abscess 11000 15400 25900 35800 46800

07745 Nasopharyngeal Examn. & Biopsy 3000 4200 7100 9800 12800

07746 Remvl.of Stone from Submandibular Duct Tran.Orally 3500 4900 8200 11400 14900

07750 Tongue Tie Release 5000 7000 11800 16300 21300

07747 Tonsillectomy 10000 14000 23500 32500 42500

07748 Tonsillectomy & Adeniodectomy T & A 12000 16800 28200 39000 51000

07749 Total Glossectomy with Neck Dissection & Reconstion 23000 32200 54100 74800 97800

LARYNX07776 Arytenoidectomy 10000 14000 23500 32500 42500

07777 Cordectomy via Laryngo Fissure 10000 14000 23500 32500 42500

07778 Dilatation of Larynx 5000 7000 11800 16300 21300

07779 Direct Laryngoscopy & Biopsy 11000 15400 25900 35800 46800

07780 Endoscopic Cord Lateralisation 10000 14000 23500 32500 42500

07781 Excision of Laryngocole 12000 16800 28200 39000 51000

140


Rs. Rs. Rs. Rs. Rs.

07832 Injection Thyroplasty 11000 15400 25900 35800 4680007771 Laryngectomy with Modified Neck Dissection 21000 29400 49400 68300 8930007772 Laryngectomy with Radical Neck Dissection 23000 32200 54100 74800 9780007773 Laryngo Fissure and Procedures 10000 14000 23500 32500 4250007782 Lateral or Extended Fronto Lateral Laryngectomy 15000 21000 35300 48800 6380007783 Micro Surgery of Larynx 13000 18200 30600 42300 5530007784 Reconstruction Surgery of Larynx 11000 15400 25900 35800 4680007774 Sub-total Laryngectomy 17000 23800 40000 55300 7230007785 Supraglottic Laryngectomy 15000 21000 35300 48800 6380007786 Supraglottic Laryngectomy with Radical Neck Diss. 15000 21000 35300 48800 6380007787 Suspension Laryngoscopic Proc. 6000 8400 14100 19500 2550007788 Teflon Inj. to Paralysed Cord 6000 8400 14100 19500 2550007775 Total Laryngectomy 20000 28000 47000 65000 8500007789 Total Laryngopharyngo Esophagectomy w Gastric Pull 25000 35000 58800 81300 10630007791 Vertical Laryngectomy with Laryngoplasty 15000 21000 35300 48800 6380007792 Woodman’s Operation 10000 14000 23500 32500 42500

NECK07811 Cricopharyngeal Myotomy 9000 12600 21200 29300 38300

07812 Excision Biopsy of Lymph Node 7000 9800 16500 22800 29800

07813 Excision of Branchial Cyst 12000 16800 28200 39000 51000

07814 Excision of Branchial Fistula 12000 16800 28200 39000 51000

07815 Excision of Submandibular Gland 16000 22400 37600 52000 6800007816 Excision of Thyroglossal Cyst. 15000 21000 35300 48800 63800

07817 Excision of Thyroglossal Fistula 12000 16800 28200 39000 51000

07818 Hemi Thyroidectomy 17000 23800 40000 55300 72300

07819 I & D of Neck Abscess 13000 18200 30600 42300 55300

07820 I & D of Submandibular Abscess 8000 11200 18800 26000 34000

07821 Mod. Neck Dissection 16000 22400 37600 52000 6800007822 Radical Neck Dissection 16000 22400 37600 52000 68000

07823 Styloid Process Excision 10000 14000 23500 32500 42500

07824 Supra Omohyoid Dissection 12000 16800 28200 39000 51000

07825 Thyroidectomy - Total 21000 29400 49400 68300 89300

07826 Total Thyroidectomy with Neck Dissection 23000 32200 54100 74800 97800

07827 Wedge Biopsy Neck Node 6000 8400 14100 19500 25500OESOPHAGUS

07854 Cervical Oesophagostomy 5000 7000 11800 16300 2130007851 Dilatation of Oesophageal Stri. 4000 5600 9400 13000 17000

141


Rs. Rs. Rs. Rs. Rs.

07852 Oesophagoscopy Biopsy/Removal of Foreign Body 10000 14000 23500 32500 42500TRACHEA & BRONCHUS

07875 Bronchoscopy for Biopsy - Removal of Foreign Body 8000 11200 18800 26000 3400007871 Cervical Tracheal Stenosis Exci.& End to End Anast 20000 28000 47000 65000 8500007872 TE Puncture 7000 9800 16500 22800 2980007873 TE Puncture with Myotomy 8000 11200 18800 26000 3400007874 Tracheostomy in OT/ICU/Emergency 8000 11200 18800 26000 34000

CONSERVATIVE PROCEDURES07933 Bronchoscopy-Video Endoscope 6000 8400 14100 19500 2550007912 Cartilage Graft of Ear & Nose 10000 14000 23500 32500 4250008010 Coblation - Adenoidectomy 10000 14000 23500 32500 4250008014 Coblation - Laryngeal/Tracheal Surgery 10000 14000 23500 32500 4250008011 Coblation - Tonsillectomy 10000 14000 23500 32500 4250008013 Coblation - Turbinate 10000 14000 23500 32500 4250008012 Coblation - UPPP 10000 14000 23500 32500 4250007799 DCR Surgery-Major 12000 16800 28200 39000 5100007809 Digital Imaging 100 100 100 200 20007951 Endoscopic Angiofibroma Excision 22000 30800 51700 71500 9350007918 Endoscopic Closure of CSF Fistula 20000 28000 47000 65000 8500007794 Endoscopic Ear Surgery -Major 15000 21000 35300 48800 6380007919 Endoscopic Nasal Cauterization 4000 5600 9400 13000 1700007950 Endoscopic Pituitary Excision 22000 30800 51700 71500 9350007949 Endoscopic Skull Base Surgery Major 25000 35000 58800 81300 10630007946 Endoscopic Sphenopalatine Artery Ligation 15000 21000 35300 48800 6380007945 Endoscopic Vidian Neurectomy 12000 16800 28200 39000 5100007921 Extended FESS 12000 16800 28200 39000 5100007796 FESS-Major 15000 21000 35300 48800 6380007795 FESS-Minor 9000 12600 21200 29300 3830007955 Follow Up Laryngeal Surgery 5000 7000 11800 16300 2130007953 Frontal Sinus Surgery 8000 11200 18800 26000 3400007943 Hyoid Suspension 12000 16800 28200 39000 5100007915 Intra Tympanic Gm Inj. 3000 4200 7100 9800 1280018213 Immunotherapy Handling Charges 1000 1400 1800 2200 260007891 Laryngo - Tracheal Injury Exploration & Repair 12000 16800 28200 39000 5100007929 Laser Assisted Laryngeal Surgery-Major 10000 14000 23500 32500 4250007928 Laser Assisted Laryngeal Surgery-Minor 5000 7000 11800 16300 2130007931 Laser Assisted Stapedotomy 9000 12600 21200 29300 38300

142


Rs. Rs. Rs. Rs. Rs.

07925 Laser Assited Nasal Surgery-Major 10000 14000 23500 32500 4250007924 Laser Assited Nasal Surgery-Minor 5000 7000 11800 16300 2130007927 Laser with FESS-Major 10000 14000 23500 32500 4250007926 Laser with FESS-Minor 5000 7000 11800 16300 2130007944 Lateral Canthotomy 10000 14000 23500 32500 4250007936 L-Tousillectomy 10000 14000 23500 32500 4250007935 LUAP 10000 14000 23500 32500 4250007937 Maxillary Sinus Trephination 7000 9800 16500 22800 2980007800 METP-Type1 10000 14000 23500 32500 4250007801 METP-Type2 14000 19600 32900 45500 5950007802 METP-Type3 16000 22400 37600 52000 6800008009 Microdebrider Assisted Adenoidectomy 10000 14000 23500 32500 4250008008 Microdebrider Assisted Laryngeal Surgery 10000 14000 23500 32500 4250007923 Microdebrider Use 1500 2100 3500 4900 640007958 Microflab Laryngeal Surgery 10000 14000 23500 32500 4250007920 Mini FESS 9000 12600 21200 29300 3830007952 Modified Lothrops Procedure 15000 21000 35300 48800 6380007804 Neck Exploration-Major 15000 21000 35300 48800 6380007803 Neck Exploration-Minor 8000 11200 18800 26000 3400007934 Oesophagoscopy -Video Endoscope 5000 7000 11800 16300 2130007911 Optic Nerve Decompression 17000 23800 40000 55300 7230007893 Para Pharyngal Benign Lesion Excision - Cervical 20000 28000 47000 65000 8500007892 Para Pharyngal Benign Lesion Excision 20000 28000 47000 65000 8500007913 Parotidectomy - Superficial 21000 29400 49400 68300 8930007914 Parotidectomy - Total 23000 32200 54100 74800 9780007806 Phono Surgery-Major 10000 14000 23500 32500 4250007805 Phono Surgery-Minor 6000 8400 14100 19500 2550007940 RF Adenoidectomy 15000 21000 35300 48800 6380007942 RF Base Tongue Reduction 15000 21000 35300 48800 6380007941 RF IT Reduction 14000 19600 32900 45500 5950007939 RFVPP (Radio Frequency Palate Uvulo Palate Pharyngoplasty) 16000 22400 37600 52000 6800007922 Septal Button Insertion 3000 4200 7100 9800 1280007957 Sialendoscopy (Diagnostic) 5000 7000 11800 16300 2130007956 Sialendoscopy (Therapeutic) 6000 8400 14100 19500 2550007797 Sphenoid Sinus Surgery 10000 14000 23500 32500 4250007916 T. Tube Insertion 8000 11200 18800 26000 3400007894 Thyroplasty Medialisation of Cord 10000 14000 23500 32500 42500

143


Rs. Rs. Rs. Rs. Rs.

07917 Tracheal Dilatation 5000 7000 11800 16300 2130007930 Tracheal Surgery Laser Assisted 5000 7000 11800 16300 2130007808 Tracheal Surgery - Major 18000 25200 42300 58500 7650007807 Tracheal Surgery - Minor 8000 11200 18800 26000 3400007932 Tracheoscopy/Video Laryngoscopy 5000 7000 9000 11000 1300007896 Vidian Neurectomy - Transantral 10000 14000 23500 32500 4250007895 Vidian Neurectomy - Transnasal 10000 14000 23500 32500 42500

ENT-COCHLEAR IMPLANT PACKAGE07642 Cochlear Implant Package 150000

Package Includes Package Does not Include1) Stay Charges for 9 days of Hospitalisation. 1) Cost of Implants.2) All Routine Lab Investigations. 2) Diet3) All Operation charges.4) All Routine Drugs for 9 days5) C.T. & M.R.I. Scan6) Audiological Investigations (Pre & Post).7) First 12 sessions of Auditory Verbal TherapyPACKAGES

08001 Tonsillectomy/Adenotonsillectomy 6000Package Includes Package Does not Include1. All Hospitalization charges. 1. Cost of implantable devices if any2. All Routine Lab Investigations - 2. Cost of ICU stay if anyl Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet3. All Operation charges4. All Routine Drugs -l IV Moxclav 25-50mg/kg/day in divided doses X 5-7 daysl IV Pantocid 40 mg OD x 5-7 daysl IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 daysl Betadine / Mucobenz mouth gargles TID X 5-7 daysl Solspre nasal spray 3 puffs Q4H X 10-15 daysl 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 days5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when neededl X-ray Lateral view soft tissue nasopharynx, CXR

08002 Septoplasty /SMR 6000Package Includes Package Does not Include1. All Hospitalization charges. 1. Cost of implantable devices if any2. All Routine Lab Investigations 2. Cost of ICU stay if anyl Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet3. All Operation charges4. All Routine Drugsl IV Moxclav 25-50mg/kg/day in divided doses X 5-7 daysl IV Pantocid 40 mg OD x 5-7 daysl IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 daysl Solspre nasal spray 3 puffs Q4H X 10-15 daysl 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 daysl Nasowash saline washes TID x 10-15 days5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when neededl CT - PNS CXR, X-Ray PNS

144


Rs. Rs. Rs. Rs. Rs.08003 Tympanoplasty 6000

Package Includes Package Does not Include1. All Hospitalization charges. 1. Cost of implantable devices if any2. All Routine Lab Investigations 2. Cost of ICU stay if anyl Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet3. All Operation charges4. All Routine Drugsl IV Moxclav 25-50mg/kg/day in divided doses X 5-7 daysl IV Pantocid 40 mg OD x 5-7 daysl IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 daysl Tab Stugeron 25 mg SOS (when required)5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when neededl CT - temporal bone (if required), X-ray mastoid CXR, PTA, Impedance audiometry

08004 ME + TP 8000Package Includes Package Does not Include1. All Hospitalization charges. 1. Cost of implantable devices if any2. All Routine Lab Investigations 2. Cost of ICU stay if anyl Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet3. All Operation charges4. All Routine Drugsl IV Moxclav 25-50mg/kg/day in divided doses X 5-7 daysl IV Pantocid 40 mg OD x 5-7 daysl IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 daysl Tab Stugeron 25 mg SOS (when required)5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when neededl CT - temporal bone (if required), X-ray mastoid, CXR,. PTA, Impedance audiometry

08005 Tracheostomy 6000Package Includes Package Does not Include1. All Hospitalization charges. 1. Cost of implantable devices if any2. All Routine Lab Investigations 2. Cost of ICU stay if anyl Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet3. All Operation charges4. All Routine Drugsl IV Moxclav 25-50mg/kg/day in divided doses X 5-7 daysl IV Pantocid 40 mg OD x 5-7 daysl IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 daysl Saline nebulisation tid x 5-7 days5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when neededl CT, MRI (optional) CXR, X-ray lat. View soft tissue neck.

08006 FESS 6000Package Includes Package Does not Include1. All Hospitalization charges. 1. Cost of implantable devices if any2. All Routine Lab Investigations 2. Cost of ICU stay if anyl Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet3. All Operation charges4. All Routine Drugsl IV Moxclav 25-50mg/kg/day in divided doses X 5-7 daysl IV Pantocid 40 mg OD x 5-7 daysl IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 daysl Solspre nasal spray 3 puffs Q4H X 10-15 days

145


Rs. Rs. Rs. Rs. Rs.l 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 daysl Nasowash saline washes TID x 10-15 days5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when neededl CT - PNS, CXR, X-Ray PNS

08007 Septoplasty/SMR + FESS 8000Package Includes Package Does not Include1. All Hospitalization charges. 1. Cost of implantable devices if any2. All Routine Lab Investigations 2. Cost of ICU stay if anyl Hb, TC, DC, Plt, PT, APTT, INR, HIV, HBsAg, ECG, S. RBS. Creat 3. Diet3. All Operation charges4. All Routine Drugsl IV Moxclav 25-50mg/kg/day in divided doses X 5-7 daysl IV Pantocid 40 mg OD x 5-7 daysl IV Voveran 25-50 mg BD /Inj Perfalgan 500 mg TID X 3-5 daysl Solspre nasal spray 3 puffs Q4H X 10-15 daysl 0.05 -0.1 % Xylomist nasal drops 3 drops TID X 2-3 daysl Nasowash saline washes TID x 10-15 days5. C.T. / M.R.I. Scan/Radiological/Audiological / Special Investigations when neededl CT - PNS CXR, X-Ray PNSGENERAL

18062 Advanced Microscope Per Hour 660 1320 1980 2640 330018061 Basic Microscope Per Hour 330 660 990 1320 165007999 Bilateral (50% of Proce./Surgery)07835 Coblation Assisted Surgery 5000 7000 9000 11000 1200007837 Coblation Instrument charges08000 Extra Hours Taken For A Surgery18063 Laparoscope Per Hour 660 990 1650 1980 2640

I. NEURO SURGERYCATEGORY - A

08168 Nerve Block 2500 3500 5880 8130 1063008166 Rhizotomy ( Each Level) 2500 3500 5880 8130 1063008172 Ventricular Drainage 2500 3500 5880 8130 1063008170 Wound Repair 2500 3500 5880 8130 10630

CATEGORY - B08178 Cerebral Angiography (Regional) 5000 7000 11750 16250 2125008231 ICP Monitoring 5000 7000 11750 16250 2125008086 Nerve Block (Complex) 5000 7000 11750 16250 2125008176 Scalp Tumor – Small 5000 7000 11750 16250 2125008087 Twist Drill 5000 7000 11750 16250 2125008165 Vertebroplasty ( Each Level) 5000 7000 11750 16250 21250

CATEGORY - C08179 4 Vessel Angio 10000 14000 23500 32500 4250008059 Biopsy - Neurosurgery (LA) 10000 14000 23500 32500 42500

146


Rs. Rs. Rs. Rs. Rs.08092 Burrhole (Single) 10000 14000 23500 32500 4250008101 Cranial Re-exploration (Same Admission) 10000 14000 23500 32500 4250008100 Cranioplasty 10000 14000 23500 32500 4250008134 Explantation 10000 14000 23500 32500 4250008223 Exploratory Burrhole (LA) 10000 14000 23500 32500 4250008230 Intracranial Catheter Placement (LA) 10000 14000 23500 32500 4250008147 Laminectomy Simple 10000 14000 23500 32500 4250008143 Micro Lumbar Discectomy / Fenestration 10000 14000 23500 32500 4250008155 Nerve Entrapment Release 10000 14000 23500 32500 4250008088 Neurolysis 10000 14000 23500 32500 4250008112 Percutaenous Vertebroplasty – GA 10000 14000 23500 32500 4250008095 Scalp Rotation Flap 10000 14000 23500 32500 4250008242 Scalp Tumor – Large 10000 14000 23500 32500 4250008130 Shunt Revision 10000 14000 23500 32500 4250008139 Spine Re-exploration (Same Admission) 10000 14000 23500 32500 4250008193 Trephine Craniotomy 10000 14000 23500 32500 4250008084 Urokinase Instillation 10000 14000 23500 32500 4250008127 Ventriculo Peritoneal Shunt 10000 14000 23500 32500 42500

CATEGORY - D08222 Burrhole (Multiple) 15000 21000 35250 48750 6375008210 Cranial Synangosis / Vascular Anastomosis 15000 21000 35250 48750 6375008236 Cranioplasty 15000 21000 35250 48750 6375008225 DSA Guided Intervention (Simple) 15000 21000 35250 48750 6375008083 External Ventricular Drainage 15000 21000 35250 48750 6375008099 Extradural / Decompressive Craniotomy 15000 21000 35250 48750 6375008174 Haematoma Drainage 15000 21000 35250 48750 6375008128 Lumbo- Peritoneal Shunt 15000 21000 35250 48750 6375008056 Microsurgical Disc Surgery 15000 21000 35250 48750 6375008221 Microsurgical Laminectomy/Foraminotomy 15000 21000 35250 48750 6375008204 Mini Craniotomy 15000 21000 35250 48750 6375008203 Mini Craniotomy Under LA 15000 21000 35250 48750 6375008194 Minimal Invasive Procedure (La) Cranial / Spinal 15000 21000 35250 48750 6375008120 Neuro Endoscopic Surgery Simple 15000 21000 35250 48750 6375008246 Neurolysis Complex (Major) 15000 21000 35250 48750 6375008159 Peripheral Nerve Surgery – Microsurgical 15000 21000 35250 48750 6375008252 Simple Spinal Surgery 15000 21000 35250 48750 6375008191 Spinal Extra Dural Tumor 15000 21000 35250 48750 6375008138 Spinal Instrumentation (Simple) 15000 21000 35250 48750 63750

147


Rs. Rs. Rs. Rs. Rs.

08085 Stereotactic Surgery 15000 21000 35250 48750 6375008103 Sub-Occipital Craniectomy 15000 21000 35250 48750 6375008098 Surface Tumors of Brain 15000 21000 35250 48750 63750

CATEGORY - E08081 Complex Spinal Surgery 20000 28000 47000 65000 85000

08062 Crainotomy 20000 28000 47000 65000 85000

08058 Craniotomy / MIS 20000 28000 47000 65000 85000

08200 CSF Diversion Procedure 20000 28000 47000 65000 85000

08157 Deep Brain Lesion - Minimally Invasive Microsurgical 20000 28000 47000 65000 85000

08226 DSA Guided Intervention (Complex) 20000 28000 47000 65000 85000

08161 Instrumentation With Microscope 20000 28000 47000 65000 85000

08079 Micro Surgical Spinal Procedure 20000 28000 47000 65000 85000

08050 Microsurgical Cranial Procedure 20000 28000 47000 65000 85000

08238 Microsurgical Infratentorial Surgery 20000 28000 47000 65000 85000

08149 Minimally Invasive Procedure – GA 20000 28000 47000 65000 85000

08121 Neuro Endoscopic Surgery Complex 20000 28000 47000 65000 85000

08241 Peripheral Nerve Surgery – Complex 20000 28000 47000 65000 85000

08054 Shunt Assisted With Guiding Device 20000 28000 47000 65000 85000

08144 Spinal Instrumentation (Complex) 20000 28000 47000 65000 85000

08206 Surgery For Epilepsy (Simple) 20000 28000 47000 65000 85000

08228 Surgery For Neuro Device Implantation 20000 28000 47000 65000 85000

CATEGORY - F08125 Carotid Endarterectomy 25000 35000 58750 81250 106250

08219 Cranial Reconstruction 25000 35000 58750 81250 106250

08077 Deep Brain Tumor (Complex, Microsurgical) 25000 35000 58750 81250 106250

08215 Endoscopic Ventriculostomy 25000 35000 58750 81250 106250

08232 Epilepsy Surgery (Image Guided) 25000 35000 58750 81250 106250

08234 Hemispherectomy 25000 35000 58750 81250 106250

08061 Micro Lumbar Discectomy (Complex) 25000 35000 58750 81250 106250

08239 Newer Device/ Imported Shunt 25000 35000 58750 81250 106250

08201 Spinal Fusion 25000 35000 58750 81250 106250

08060 Stereotactic Procedure – Major 25000 35000 58750 81250 106250

08248 Surgery For Brachial Plexus 25000 35000 58750 81250 106250

08208 Surgery For Epilepsy (Complex) 25000 35000 58750 81250 106250

08227 Surgery For Neuro Device Implantation 25000 35000 58750 81250 106250

08152 Total Vertebroplasty 25000 35000 58750 81250 106250

148


Rs. Rs. Rs. Rs. Rs.

CATEGORY - G08078 Brain Tumors (Endoscope / Image Guided) 30000 42000 70500 97500 12750008214 Cranial Surgery For Stroke 30000 42000 70500 97500 12750008240 Decompressive Cranial Surgery 30000 42000 70500 97500 12750008245 Haematoma Drainage – Major 30000 42000 70500 97500 12750008116 Head Injury 30000 42000 70500 97500 12750008249 Microvascular Decompression 30000 42000 70500 97500 12750008126 STMC Anastomosis 30000 42000 70500 97500 127500

CATEGORY - H08233 Epilepsy Surgery With ECoG 35000 49000 82250 113750 14875008156 Head Injury – Duroplasty / Debridement 35000 49000 82300 113800 14880008052 Head Injury (Complex) 35000 49000 82300 113800 14880008212 Microsurgical Cranial 35000 49000 82250 113750 14875008213 Microsurgical Spinal 35000 49000 82250 113750 148750

CATEGORY - I08053 Base of Skull Procedure 40000 56000 94000 130000 17000008237 Head Injury With Haematoma 40000 56000 94000 130000 170000

CATEGORY - J08216 Complex Cranial (Microsurgical) 45000 63000 105750 146250 19125008217 Complex Spinal Fusion (Image Guided And Microsurgical) 45000 63000 105750 146250 191250

PACKAGES50046 Nerve Block (Complex) Package 30000 36000 45000 55000 7000050047 Cranioplasty Package 50000 62000 80000 100000 13000050048 Spinal Instrumentation (Simple) Package 70000 88000 115000 145000 19000050029 Microsurgical Cranial Package 80000 104000 140000 180000 24000050030 Decompressive Cranial Package 100000 130000 175000 225000 30000050031 Head Injury (Complex) Package 120000 156000 210000 270000 36000050032 Microsurgical Cranial Package 140000 182000 245000 315000 42000050033 Head Injury With Haematoma Package 160000 208000 280000 360000 48000050034 Complex Cranial (Microsurgical) Package 180000 234000 315000 405000 540000

GENERAL18218 C-Arm Usage Major 4000 5600 9400 13000 1700018214 C-Arm Usage Minor 2000 2800 4700 6500 850018215 CUSA 5000 7000 11750 16250 2125008247 Debridement – Simple 1700 2400 4000 5500 720008167 Epidural Procedure 2200 3100 5200 7200 940008243 Incision & Drainage / Dressing 1100 1500 2600 3600 4700

149


Rs. Rs. Rs. Rs. Rs.18008 Microscope ( 0 to 2 Hours ) 1100 1500 2600 3600 470018009 Microscope ( 2 to 3 Hours ) 1700 2400 4000 5500 720018010 Microscope ( 3 to 5 Hours ) 2200 3100 5200 7200 940018011 Microscope (More Than 5 Hours) 5000 7000 11750 16250 2125018074 Microscope Per Hour 1000 1400 2350 3250 425018216 Neuro Endoscope 8000 11200 18800 26000 3400018217 Neuro Monitor 5000 7000 11750 16250 2125008251 Neuro Navigation - Major procedure 15000 21000 35250 48750 6375008250 Neuro Navigation - Minor Procedure 10000 14000 23500 32500 4250008173 Percutaneous Image Guided – Complex 5000 7000 11750 16250 21250

Packages:Package should be containing & pertaining to : Package do not Includes:1) Elective surgeries only 1. Diet2) 50046, 50047, 50048 1 & 2; Balance codes 3 & 4 days of ICU and Regular Stay 2. Consultation & Investigations from Other Specialities3) Routine pre-op investigations: 3. Special Insturment Charges like Neuro Navigation,

Complete Blood Count / Platelet Count, Neuro Endoscope, Neuro MonitoringPT, APTT, INR,BU, S.Creatinine, S.Electrolytes,HIV, HbsAg, HCVLFT/TSHBlood Sugar, Blood Urea, Serum Creatinine, Electrolytes,Blood group & typingUrine Routine & MicroChest X-ray,ECG.

J. PLASTIC SURGERYAESTHETIC SURGERY

21841 Abdominoplasty - Major 17000 23800 40000 55300 7230021840 Abdominoplasty - Minor 10000 14000 23500 32500 4250021955 Abdominoplasty (Moderate) 13000 18200 30600 42300 5530021842 Abdominoplasty Extensive 22000 30800 51700 71500 9350021851 Alopecia Reduction - Major 17000 23800 40000 55300 7230021849 Alopecia Reduction - Minor 5600 7700 12900 17900 2330021850 Alopecia Reduction- Moderate 12000 16800 28200 39000 5100021836 Blepharoplasty - Major 12000 16800 28200 39000 5100022041 Blepharoplasty - Moderate 8000 11200 18800 26000 3400021835 Blepharoplasty - Minor 5600 7700 12900 17900 2330021837 Blepharoplasty - Minor (Bilateral) 10000 14000 23500 32500 4250021954 Blepharoplasty Bilateral - Major 16000 22400 37600 52000 6800022042 Blepharoplasty Bilateral - Moderate 13000 18200 30600 42300 5530022001 Blepharoplasty Bilateral Minor 10000 14000 23500 32500 4250021844 Body Contouring - Major 17000 23800 40000 55300 7230022043 Body Contouring - Moderate 13600 19000 32000 44200 57800

150


Rs. Rs. Rs. Rs. Rs.

21843 Body Contouring - Minor 10200 14300 24000 33200 4340021845 Body Contouring Extensive 27200 38100 63900 88400 11560021834 Brow Lift - Major 13600 19000 32000 44200 5780022044 Brow Lift - Moderate 10200 14300 24000 33200 4340021833 Brow Lift - Minor 8160 11400 19200 26500 3470021847 Dermabrasion - Major 10000 14000 23500 32500 4250022045 Dermabrasion - Moderate 7000 9800 16500 22800 2980021846 Dermabrasion - Minor 4000 5700 9300 13000 1700021848 Dermabrasion Extensive 16000 22300 37700 52000 6800021839 Face Lift - Major 20000 28000 47000 65000 8500021838 Face Lift - Minor 12000 16800 28200 39000 5100021959 Facelift (Moderate) 16000 22400 37600 52000 6800021956 Fat Grafting - Minor 5000 7000 11800 16300 2130021958 Fat Grafting - Major 15000 21000 35300 48800 6380021957 Fat Grafting (Moderate) 10000 14000 23500 32500 4250021854 Hair Transplant - Major 26000 36300 61100 84600 11060021852 Hair Transplant - Minor 5600 7700 12900 17900 2330022002 Hair Transplant - Small 2000 2800 4700 6500 850021853 Hair Transplant - Moderate 12000 16800 28200 39000 5100021831 Liposuction - Major 13000 18200 30700 42300 5530021829 Liposuction - Minor 4000 5700 9300 13000 1700021830 Liposuction - Moderate 6000 8300 14100 19600 2560021832 Liposuction- Extensive 20000 28000 47000 65000 85000

AVF21969 AVF Secondary Procedure - Major 15000 21000 35300 48800 6380021968 AVFSecondary Procedure - Minor 10000 14000 23500 32500 4250021950 Avfistula creation - Major 10000 14000 23500 32500 4250021949 Avfistula creation - Minor 7000 9800 16500 22800 2980021951 Rexploration for AVF 2000 2800 4700 6500 850022018 Superficialization - Minor 8000 11200 18800 26000 3400022019 Superficialization - Major 12000 16800 28200 39000 51000

BRACHIAL PLEXUS21749 Brachial Plexu Surgery - Minor 17000 23800 40000 55300 7230022046 Brachial Plexu Surgery - Moderate 20000 28000 47000 65000 8500021752 Brachial Plexus - Ancillary Procedures 8000 11200 18800 26000 3400021751 Reconstruction Extensive 30000 42000 70600 97600 12760021750 Reconstruction - Major 24000 33700 56300 78000 102000

151


Rs. Rs. Rs. Rs. Rs.BREAST

21787 Gynaecomastia Excision Bilateral - Major 20000 28000 47000 65000 8500021786 Gynaecomastia Excision Bilateral - Minor 12000 16800 28200 39000 5100021785 Gynaecomastia Exision Unilateral - Major 16000 22300 37700 52000 6800021784 Gynaecomastia Exision Unilateral - Minor 5600 7700 12900 17900 2330021960 Gynecomastia Unilateral - Moderate 10000 14000 23500 32500 4250021961 Gynecomastia Bilateral - Moderate 15000 21000 35300 48800 63800

BREAST RECONSTRUCTION21801 Augmentation Mammoplasty Bilateral - Major 20000 28000 47000 65000 8500021799 Augmentation Mammoplasty Bilateral - Minor 8500 11900 20000 27600 3610021800 Augmentation Mammoplasty Bilateral - Moderate 17000 23800 40000 55300 7230021798 Augmentation Mammoplasty Unilateral - Major 17000 23800 40000 55300 7230021796 Augmentation Mammoplasty Unilateral - Minor 6500 9100 15300 21100 2760021797 Augmentation Mammoplasty Unilateral - Moderate 12000 16800 28200 39000 5100021962 Breast Reconstruction - Moderate 13000 18200 30600 42300 5530021789 Breast Reconstruction - Major 25000 35000 58800 81300 10630021788 Breast Reconstruction - Minor 8500 11900 20000 27600 3610021963 Implant Removal - Moderate 8500 11900 20000 27600 3610021807 Implant Removal - Major 13250 18600 31100 43100 5630021806 Implant Removal - Minor 4000 5600 9400 13000 1700021805 Nipple Reconstruction Bilateral - Major 17000 23800 40000 55300 7230021804 Nipple Reconstruction Bilateral - Minor 8500 11900 20000 27600 3610021803 Nipple Reconstruction Unilateral - Major 9500 13300 22300 30900 4040021802 Nipple Reconstruction Unilateral - Minor 4750 6700 11200 15400 2020021795 Reduction Mammoplasty Bilateral - Major 30000 42000 70500 97500 12750021793 Reduction Mammoplasty Bilateral - Minor 11000 15400 25900 35800 4680021794 Reduction Mammoplasty Bilateral - Moderate 21250 29700 49900 69100 9030021792 Reduction Mammoplasty Unilateral - Major 17000 23800 40000 55300 7230021790 Reduction Mammoplasty Unilateral - Minor 6500 9100 15300 21100 2760021791 Reduction Mammoplasty Unilateral - Moderate 12000 16800 28200 39000 51000

CLEFT LIP PALATE AND CRANIOFACIAL CLEFTS21965 Alveolar Bone Graft - Moderate 12000 16800 28200 39000 51000

21913 Alveolar Bone Graft - Major 16000 22300 37700 52000 68000

21912 Alveolar Bone Graft - Minor 8600 11900 20000 27700 36100

21899 Bilateral Cleft Lip -Complex 20000 28000 47000 65000 85000

21898 Bilateral Cleft Lip -Moderate 12000 16800 28200 39000 51000

21897 Bilateral Cleft Lip - Minor 7600 10600 17700 24300 31900

152


Rs. Rs. Rs. Rs. Rs.21964 Cleft Palate And Flap - Major 24000 33600 56400 78000 10200021903 Cleft Palate Repair And Flap - Minor 16000 22300 37700 52000 6800021902 Cleft Palate Repair-Complex 20000 28000 47000 65000 8500021901 Cleft Palate Repair - Major 12000 16800 28200 39000 5100022046 Cleft Palate Repair - Moderate 10000 14000 23500 32500 4250021900 Cleft Palate Repair - Minor 7600 10600 17700 24300 3190021916 Facial Cleft Complex 24000 33700 56300 78000 10200021915 Facial Cleft - Major 16000 22300 37700 52000 6800021914 Facial Cleft - Minor 9600 13300 22300 30900 4030021904 Lip And Palate In One 20000 28000 47000 65000 8500021910 Pharyngeal Flap 12000 16800 28200 39000 5100021953 Secondary Correction Of Nose - Major 16000 22400 37600 52000 6800021908 Secondary Correction Of Nose - Minor 7600 10600 17900 24700 3230021952 Secondary Correction Of Nose Moderate 12000 16800 28200 39000 5100021907 Secondary Lip Correction Complex 24000 33700 56300 78000 10200021906 Secondary Lip Correction - Major 16000 22300 37700 52000 6800021905 Secondary Lip Correction - Minor 7600 10600 17700 24300 3190021909 Sphincter Pharyngoplasty 9600 13300 22300 30900 4030021892 Suture Removalin OT - Minor 1600 2100 3600 4900 630021896 Unilateral Cleft Lip And Nose 24000 33700 56300 78000 10200021895 Unilateral Cleft Lip - Complex 20000 28000 47000 65000 8500021893 Unilateral Cleft Lip - Minor 7600 10600 17700 24300 3190021894 Unilateral Cleft Lip-Moderate 12000 16800 28200 39000 5100022047 Unilateral Cleft Lip-Major 16000 22400 37600 52000 6800021911 VPI Correction Complex 24000 33700 56300 78000 102000

CONGENITAL LIMB DEFORMITY21779 Congenital Limb Deformity - Major 13000 18200 30700 42300 5530021777 Congenital Limb Deformity - Minor 4600 6300 10700 14700 1910021778 Congenital Limb Deformity -Moderate 8600 11900 20000 27700 3610021966 Congenital Hand Deformity ( Complex) 16000 22400 37600 52000 68000

CONTRACTURES21664 Contracture + Flap - Minor 6600 9100 15300 21100 2770021663 Contracture Release+SSG-Extensive 17000 23800 40000 55300 7230021662 Contracture Release+SSG Major 8000 11200 18800 26000 3400021660 Contracture Release+SSG- Minor 4000 5700 9300 13000 1700021661 Contracture Release+SSG-Moderate 6000 8300 14100 19600 2560021666 Contracture+ Flap - Major 18000 25200 42300 58600 76600

153


Rs. Rs. Rs. Rs. Rs.21665 Contracture+ Flap- Moderate 9600 13300 22300 30900 40300

CRANIOFACIAL SURGERY21882 Bi- Jaw Surgery Total 32000 44800 75200 104000 13600021862 Bone Graft - Extensive 32000 44800 75200 104000 13600021861 Bone Graft - Major 20000 28000 47000 65000 8500021859 Bone Graft - Minor 7600 10600 17700 24300 3190021860 Bone Graft- Moderate 12000 16800 28200 39000 5100021870 Cranioplasty - Major 20000 28000 47000 65000 8500021868 Cranioplasty - Minor 7600 10600 17700 24300 3190021869 Cranioplasty-Moderate 16000 22300 37700 52000 6800021890 Facial Assymetry Correction Complex 48000 67200 112800 156000 20400021889 Facial Assymetry Correction - Major 39000 54700 91700 126800 16580021875 Facial Bipartition 39000 54700 91700 126800 16580021858 Facial Contouring - Complex 26000 36300 61100 84600 11060021856 Facial Contouring - Minor 7600 10600 17700 24300 3190021857 Facial Contouring - Moderate 16000 22300 37700 52000 6800021871 Frontal Advancement 20000 28000 47000 65000 8500021888 Genioplasty - Complex 16000 22300 37700 52000 6800021887 Genioplasty - Simple 9600 13300 22300 30900 4030021872 Hypertelorism:Extra Cranial Correction 26000 36300 61100 84600 11060021873 Hypertelorism:Intra Cranial Correction 32000 44800 75200 104000 13600021878 Le Fort I Advancement 12000 16800 28200 39000 51000

21879 Le Fort Ii , Iii Advancement 24000 33700 56300 78000 102000

21874 Mono Block Advancement 32000 44800 75200 104000 136000

21967 Orbital Reconstruction - Moderate 16000 22300 37700 52000 68000

21864 Orbital Reconstruction - Major 20000 28000 47000 65000 85000

21863 Orbital Reconstruction - Minor 9000 12700 21200 29300 38300

21881 Sagittal Split Mandible - Bilateral 18000 25200 42300 58500 76500

21880 Sagittal Split Mandible Unilateral 9600 13300 22300 30900 40300

21877 Segmental Osteotomy Multiple 16000 22300 37700 52000 68000

21876 Segmental Osteotomy Single 9600 13300 22300 30900 40300

21867 Skull Base Reconstruction Complex 24000 33700 56300 78000 102000

21866 Skull Base Reconstruction - Major 16000 22300 37700 52000 68000

21865 Skull Base Reconstruction - Minor 9600 13300 22300 30900 40300

21855 Strip Craniectomy 8600 11900 20000 27700 36100

21886 TMJ Ankylosis - Bilateral (Complex) 24000 33700 56300 78000 102000

21884 TMJ Ankylosis - Unilateral (Complex) 16000 22300 37700 52000 68000

154


Rs. Rs. Rs. Rs. Rs.

21885 TMJ Ankylosis -Bilateral 20000 28000 47000 65000 8500021883 TMJ Ankylosis -Unilateral 9600 13300 22300 30900 4030021891 Total Craniofacial Correction 60000 84000 141000 195000 255000

DIVISION AND INSET21970 Flap Division And Inset - Moderate 6600 9200 15500 21500 28100

EAR RECONSTRUCTION21932 Ear Lobe Repair - Bilateral 3000 4200 5400 6600 780021933 Ear Lobe Repair - Unilateral 2000 2800 3600 4400 520021724 Ear Reconstruction - Complex 26000 36300 61100 84600 11060021723 Ear Reconstruction - Major 14000 19700 32900 45600 5960021721 Ear Reconstruction - Minor 5000 7000 11800 16300 2130021722 Ear Reconstruction - Moderate 9600 13300 22300 30900 4030021725 Ear Reconstruction-Single Stage - Minor 20000 28000 47000 65000 8500021971 Ear Reconstruction Single Stage - Major 35000 49000 82300 113800 148800

EXCISION AND RESURFACING21541 Excision And Resurfacing-Complex 26000 36300 61100 84600 11060021540 Excision And Resurfacing - Major 13000 18200 30700 42300 5530021538 Excision And Resurfacing - Minor 3000 4200 7100 9800 1280021539 Excision And Resurfacing-Moderate 6300 8800 14800 20600 26800

EXCISIONS21535 Excisions - Minor 2600 3600 5900 8100 1070021536 Excisions-Moderate 6000 8300 14100 19600 2560021537 Excsions - Major 12000 16800 28200 39000 5100022048 Excsions - Complex 20000 28000 47000 65000 85000

EYES21693 Canthoplasty (Complex) 22000 30800 51700 71600 9360021692 Canthoplasty - Major 14000 19700 32900 45600 5960022049 Canthoplasty - Moderate 10000 14000 23500 32500 4250021691 Canthoplasty - Minor 6000 8300 14100 19600 2560021703 Deepening Of Contracted Eye Socket - Major 15000 21000 35300 48800 6380022050 Deepening Of Contracted Eye Socket - Moderate 12000 16800 28200 39000 5100021702 Deepening Of Contracted Eye Socket - Minor 10000 14000 23600 32600 4260021690 Ectropion Release (Re-Surfacing Each Eye) 9600 13300 22300 30900 4030021695 Eyebrow Reconstruction 12000 16800 28200 39000 5100021694 Eyebrow Reconstruction - Minor 7600 10600 17700 24300 3190021698 Eyelid Reconstruction - Major 16600 23100 38800 53700 7010021696 Eyelid Reconstruction - Minor 6000 8300 14100 19600 25600

155


Rs. Rs. Rs. Rs. Rs.

21697 Eyelid Reconstruction Moderate 10000 14000 23600 32600 4260021689 Eyelid Repair - Major 12000 16800 28200 39000 5100021688 Eyelid Repair - Minor 4600 6300 10700 14700 1910021701 Ptosis Correction - Major 14000 19700 32900 45600 5960021700 Ptosis Correction - Minor 10000 14000 23600 32600 4260021699 Total Eyelid Reconstruction 22000 30800 51700 71600 9360021973 Eyelid Repair - Moderate 8000 11200 18800 26000 3400021974 Ectropion Release - Minor 5000 7000 11800 16300 2130021975 Total Eyelid Reconstruction - Minor 5000 7000 11800 16300 21300

FACE21687 Facial Laceration - Complex 14000 19700 32900 45600 5960021686 Facial Laceration - Major 10000 14000 23600 32600 4260021685 Facial Laceration - Minor 4000 5700 9300 13000 1700021976 Facial Laceration - Moderate 6000 8300 14100 19600 25600

FLAPS21546 Flaps - Minor 4000 5700 9300 13000 1700021549 Flaps - Complex 25000 35000 58800 81300 10630021548 Flaps - Major 15000 21000 35300 48800 6380021547 Flaps - Moderate 10000 14000 23600 32600 4260021550 Division And Inset - Minor 2000 2800 4700 6600 860021937 Division And Inset - Moderate 6600 9200 15500 21500 2810021553 Flaps Delay - Major 5000 7000 11800 16300 2130021552 Flaps Delay - Minor 2000 2800 4700 6600 860021543 Flap Reelevation - Major 5000 7000 11800 16300 2130021542 Flap Reelevation - Minor 2000 2800 4700 6600 860021545 Flap Thinning - Major 10000 14000 23600 32600 4260021544 Flap Thinning - Minor 3000 4200 7100 9800 1280021947 Flap Thinning - Moderate 6000 8400 14100 19500 2550021551 Division And Inset - Major 10000 14000 23500 32500 4250021972 Flap Thinning - Moderate 6000 8400 14100 19500 25500

GENITALIA RECONSTRUCTION21811 Fistula Correction - Single - Minor 4600 6300 10700 14700 1910021810 Fistula Correction Multiple - Minor 14000 19700 32900 45600 5960021814 Genitalia Reconstruction - Major 15000 21000 35300 48800 6380021812 Genitalia Reconstruction - Minor 4600 6300 10700 14700 1910021813 Genitalia Reconstruction - Moderate 8000 11200 18700 25800 3380021809 Hypospadias Correction - Major (Single Stage) 15000 21000 35300 48800 63800

156


Rs. Rs. Rs. Rs. Rs.21808 Hypospadias Correction - Minor (Each Stage) 7600 10600 17700 24300 3190021977 Hypospadiasis Correction - Moderate Each Stage 10000 14000 23600 32600 4260021978 Fistula Correction Single - Moderate 8000 11200 18700 25800 3380021979 Gentalia Reconstruction ( Complex) 26000 36300 61100 84600 110600

HAND21986 Carapl Tunnel Release ( Open - Minor) 4000 5600 9400 13000 1700021942 Carpal Tunnel Release - Major 8000 11200 18800 26000 3400021941 Carpal Tunnel Release - Minor 4000 5700 9300 13000 1700021928 Carpal Tunnel Release Endoscopic 12000 16800 21600 26400 3120021929 Carpal Tunnel Release Open - Major 7000 9800 12600 15400 1820022015 Composite Reconstruction - Major 20000 28000 47000 65000 8500022013 Composite Reconstruction - Minor 10000 14000 23500 32500 4250022014 Composite Reconstruction - Moderate 15000 21000 35300 48800 6380021996 Duputren’S Contracture Fasciectomy - Minor 4000 5600 9400 13000 1700021998 Duputrens’S Contracture Fasciectomy - Major 12000 16800 28200 39000 5100021997 Duputrens’S Contracture Fasciectomy - Moderate 8000 11200 18800 26000 3400021766 Finger Reconstruction - Complex 20000 28000 47000 65000 8500021765 Finger Reconstruction - Major 15000 21000 35300 48800 6380021763 Finger Reconstruction - Minor 5000 7000 11800 16300 2130021764 Finger Reconstruction - Moderate 10000 14000 23600 32600 4260021769 Fracture Fixation - Major 15000 21000 35300 48800 63800

21767 Fracture Fixation - Minor 4000 5700 9300 13000 17000

21768 Fracture Fixation - Moderate 10000 14000 23600 32600 4260021782 Hand Infection - Major 8000 11200 18700 25800 33800

21780 Hand Infection - Minor 1800 2600 4200 5900 7700

21781 Hand Infection - Moderate 4600 6300 10700 14700 19100

21783 Hand Infection - Complex 15000 21000 35300 48800 63800

21758 Hand Resurfacing - Complex 33000 46200 77700 107300 140300

21757 Hand Resurfacing - Major 20000 28000 47000 65000 8500021755 Hand Resurfacing - Minor 6000 8300 14100 19600 25600

21756 Hand Resurfacing -Moderate 10000 14000 23600 32600 42600

21762 Joint Reconstruction - Complex 26000 36300 61100 84600 110600

21761 Joint Reconstruction - Major 14000 19700 32900 45600 59600

21759 Joint Reconstruction - Minor 2800 3900 6700 9100 11900

21760 Joint Reconstruction - Moderate 7000 9800 16600 22800 2980021980 Ligamentotaxis 5000 7000 11800 16300 21300

21931 Revision Amputation - Multiple Fingers 8000 11200 18800 26000 34000

157


Rs. Rs. Rs. Rs. Rs.21930 Revision Amputation - Single Finger 4000 5600 9400 13000 17000

22011 Tendon Grafting Stage 2- Minor 6000 8400 14100 19500 25500

22010 Tendon Grafting Stage 1- Major 6000 8400 14100 19500 25500

22009 Tendon Grafting Stage 1- Minor 2000 2800 4700 6500 8500

22012 Tendon Grafting Stage 2- Major 15000 21000 35300 48800 63800

22008 Tendon Grafting Single Stage - Major 15000 21000 35300 48800 63800

22006 Tendon Grafting Single Stage - Minor 5000 7000 11800 16300 21300

22007 Tendon Grafting Single Stage - Moderate 10000 14000 23500 32500 42500

21772 Tendon Repair - Major 11000 15300 25900 35800 46800

21770 Tendon Repair - Minor 4600 6300 10700 14700 19100

21771 Tendon Repair-Moderate 8000 11200 18800 26000 34000

21983 Tendon Transfer - Major 15000 21000 35300 48800 63800

21981 Tendon Transfer - Minor 6000 8400 14100 19500 25500

21982 Tendon Transfer - Moderate 10000 14000 23500 32500 42500

21985 Tenolysis - Major 8000 11200 18800 26000 34000

21984 Tenolysis - Minor 4000 5600 9400 13000 17000

22016 Ulnar Nerve Transposition 6000 8400 14100 19500 25500

21776 Wrist Injury - Complex 26000 36300 61100 84600 110600

21775 Wrist Injury - Major 21000 29300 49300 68300 89300

21773 Wrist Injury - Minor 10000 14000 23600 32600 42600

21774 Wrist Injury - Moderate 15000 21000 35300 48800 63800

22030 Forearm laceration minor to add 10000 14000 23600 32600 42600

22031 Forearm laceration moderate to add 15000 21000 35300 48800 63800

22032 Forearm laceration major to add 21000 29300 49300 68300 89300

LIP

21727 Lip Injury - Major 10000 14000 23600 32600 42600

22026 Lip Injury - Moderate 6000 8400 14100 19500 25500

21726 Lip Injury - Minor 4600 6300 10700 14700 19100

21730 Lip Reconstruction - Complex 22000 30800 51700 71600 93600

21729 Lip Reconstruction - Major 16000 22300 37700 52000 68000

21728 Lip Reconstruction - Minor 10000 14000 23600 32600 42600

21733 Macrostomia Correction - Major 14000 19700 32900 45600 59600

21731 Microstomia - Minor 4600 6300 10700 14700 19100

21732 Microstomia - Major 14000 19700 32900 45600 59600

21948 Microstomia - Moderate 8000 11200 18800 26000 34000

21987 Macrostomia Correction - Minor 8000 11200 18800 26000 34000

158


Rs. Rs. Rs. Rs. Rs.LYMPHEDEMA SURGERY

21753 Lymphedema Excision 11000 15300 25900 35800 4680021754 Microlymphatic Surgery 26000 36300 61100 84600 110600

MAXILLO FACIAL INJURIES21672 Ach Bar Fixation-Segmental 2600 3600 5900 8100 1070021673 Arch Bar Fixation-Complete 3800 5300 8900 12300 1620021675 Arch Bar Removal 1800 2600 4200 5900 770021671 Cap Splint Application 3000 4200 7100 9800 1280021670 Dental Impressions Under GA 2000 2800 4700 6600 860021668 Elevation -Nasal Bone - Major 8000 11200 18800 26000 3400021667 Elevation -Nasal Bone - Minor 4000 5700 9300 13000 1700021674 Eyelets & IMF 2800 3900 6700 9100 1190022051 Maxillo Facial Fracture Fixation-Complex 45000 63000 105800 146300 19130021681 Maxillo Facial Fracture Fixation-Extensive 35000 49000 82300 113800 14880021680 Maxillo Facial Fracture Fixation - Major 25000 35000 58800 81300 10630021678 Maxillo Facial Fracture Fixation - Minor 10000 14000 23600 32600 4260021679 Maxillo Facial Fracture Fixation - Moderate 15000 21000 35300 48800 6380021988 Miniplate Removal - Moderate 6000 8300 14100 19600 2560021677 Miniplate Removal - Major 11000 15300 25900 35800 4680021676 Miniplate Removal - Minor 3000 4200 7100 9800 1280021684 Pan Facial Fracture Fixation - Major 45000 63000 105800 146300 19130021683 Pan Facial Fracture Fixation - Moderate 20000 28000 47000 65000 8500021682 Pan Facial Fracture Fixation - Minor 13000 18200 30700 42300 5530021669 Zygoma Elevation 4000 5700 9300 13000 17000

MICRO SURGERY22017 Finger Revision Amputation - Minor 2000 2800 4700 6500 850021934 Microvascular Flap Transfer - Minor 15000 21000 35250 48750 6375021736 Microvascular Flap Transfer - Complex 41000 57300 96300 133300 17430021734 Microvascular Flap Transfer - Limited 20000 28000 47000 65000 8500021735 Microvascular Flap Transfer - Moderate 25000 35000 58800 81300 10630022040 Microvascular Flap Transfer - Major 30000 42000 70500 97500 12750021745 Nerve Reconstruction - Major 18000 25200 42300 58500 7650022027 Nerve Reconstruction - Moderate 11000 15300 25900 35800 4680021744 Nerve Reconstruction - Minor 6000 8300 14100 19600 2560021746 Nerve Reconstruction - Complex 22000 30800 51700 71600 9360021748 Reexploration - Major 7600 10600 17700 24300 3190021747 Reexploration - Minor 1800 2600 4200 5900 7700

159


Rs. Rs. Rs. Rs. Rs.21738 Replant - Major 22000 30800 51700 71600 9360021737 Replant - Minor 10000 14000 23600 32600 4260022029 Replant - Moderate 15000 21000 35300 48800 6380021739 Replant - Complex 37000 51800 87000 120300 15730021742 Revascularisation - Major 20000 28000 47000 65000 8500021740 Revascularisation - Minor 5000 7000 11800 16300 2130021743 Revascularisation - Complex 34000 47700 79900 110600 14460021741 Revascularisation - Limited 10000 14000 23600 32600 42600

NOSE21716 Alar Correction - Major 16000 22300 37700 52000 6800021715 Alar Correction - Minor 10000 14000 23600 32600 4260021713 Augumentation With Graft - Major 20000 28000 47000 65000 8500021712 Augumentation With Graft - Minor 14000 19700 32900 45600 5960021714 Augumentation With Graft - Complex 30000 42000 70600 97600 12760021711 Partial Nasal Reconstruction - Major 22000 30800 51700 71600 9360021709 Partial Nasal Reconstruction - Minor 9600 13300 22300 30900 4030021710 Partial Nasal Reconstruction - Moderate 14000 19700 32900 45600 5960021708 Reduction Rhinoplasty - Major 22000 30800 51700 71600 9360021707 Reduction Rhinoplasty - Minor 12000 16800 28200 39000 5100021989 Reduction Rhinoplasty - Moderate 16000 22400 37600 52000 6800022005 Secondary Correction of Nose - Major 16000 22400 37600 52000 6800022003 Secondary Correction of Nose - Minor 8000 11200 18800 26000 3400022004 Secondary Correction of Nose - Moderate 12000 16800 28200 39000 5100021990 Septorhinoplasty - Minor 5000 7000 11800 16300 2130021991 Septorhinoplasty - Major 15000 21000 35300 48800 6380021717 Septorhinoplasty - Moderate 10000 14000 23600 32600 4260021718 Septorhinoplasty Plus CCG 24000 33700 56300 78000 10200021719 Single Stage Total Nasal Reconstruction 33000 46200 77700 107300 140300

SCAR REVISION21559 GBLE Complex 13000 18200 30700 42300 5530021558 Geometric Broken Line Excision - Minor 6600 9100 15300 21100 2770021557 Scar Revision - Complex 26000 36300 61100 84600 11060021556 Scar Revision - Major 14000 19700 32900 45600 5960021554 Scar Revision - Minor 4000 5700 9300 13000 1700021555 Scar Revision - Moderate 10000 14000 23600 32600 42600

WOUNDS AND BURNS21946 Collagen Application - Major 15000 21000 35300 48800 63800

160


Rs. Rs. Rs. Rs. Rs.21944 Collagen Application - Minor 5000 7000 11800 16300 2130021945 Collagen Application - Moderate 10000 14000 23500 32500 4250021513 Debridement - Extensive 10000 14000 23600 32600 4260021512 Debridement - Major 8000 11200 18800 26000 3400021510 Debridement - Minor 2000 2800 4700 6600 860021511 Debridement - Moderate 4000 5700 9300 13000 1700021992 Dressing - Extensive 6000 8400 14100 19500 2550021509 Dressing - Major 4800 6700 11300 15700 2030021508 Dressing Moderate 3000 4200 7100 9800 1280021507 Dressing - Minor 1600 2100 3600 4900 630021504 Extensive Suturing 10000 14000 23600 32600 4260021531 Fasciotomy - Major 5000 7000 11800 16300 2130021530 Fasciotomy - Minor 1800 2600 4200 5900 770021521 Homograft Harvest - Major 4600 6300 10700 14700 1910021519 Homograft Harvest - Minor 1800 2600 4200 5900 770021520 Homograft Harvest - Moderate 2800 3900 6700 9100 1190021534 Implant Removal - Major 8000 11200 18800 26000 3400021532 Implant Removal - Minor 3000 4200 7100 9800 1280021533 Implant Removal - Moderate 4600 6300 10700 14700 1910021995 Incision And Drainage - Major 10000 14000 23500 32500 4250021993 Incision And Drainage - Minor 2000 2800 4700 6500 850021994 Incision And Drainage - Moderate 5000 7000 11800 16300 2130021528 Limb Amputation - Major 12000 16800 28200 39000 5100021526 Limb Amputation - Minor 4600 6300 10700 14700 1910021527 Limb Amputation - Moderate 10000 14000 23500 32500 4250021529 Limb Amputation (Multiple) 18000 25200 42300 58600 7660021503 Major Suturing 8000 11200 18800 26000 3400021501 Minor Suturing 2000 2800 4700 6600 860021502 Moderate Suturing 5000 7000 11800 16300 2130022033 Complex Suturing 10000 14000 23500 32500 4250021514 SSG - Small area 2000 2800 4700 6600 860021518 SSG - Extensive 22000 30800 51700 71600 9360021515 SSG - Limited area 4000 5700 9300 13000 1700021517 SSG - Major 16000 22300 37700 52000 6800021516 SSG - Moderate 10000 14000 23600 32600 4260021506 Suture Removal in OT - Moderate 2600 3600 5900 8100 1070021505 Suture Removal in OT - Minor 1600 2100 3600 4900 630021522 Tangential Excision - Minor 8000 11200 18800 26000 34000

161


Rs. Rs. Rs. Rs. Rs.21525 TE - Extensive 28000 39200 65800 91000 11900021524 TE - Major 16000 22300 37700 52000 6800021523 TE - Moderate 12000 16800 28200 39000 51000

GENERAL18082 Advanced Microscope Per Hour 800 1100 1900 2600 340021926 Artery Biopsy 2600 3640 4680 5720 676018081 Basic Microscope Per Hour 400 600 900 1300 170021821 Body Piercing - Complex 11000 15300 25900 35800 4680021819 Body Piercing - Minor 3000 4200 7100 9800 1280021820 Body Piercing - Moderate 4600 6300 10700 14700 1910021935 Double Tissue Biopsy 4000 5700 9300 13000 1700022052 Endoscopic Assisted Surgery - Major 6000 8400 14100 19500 2550022053 Endoscopic Assisted Surgery - Minor 2000 2800 4700 6500 850022054 Endoscopic Assisted Surgery - Moderate 4000 5600 9400 13000 1700022025 Examination Under Anaesthesia - Major 6000 8303 14100 19600 2560022023 Examination Under Anaesthesia - Minor 2000 2800 3600 4400 520022024 Examination Under Anaesthesia - Moderate 4000 5700 9300 13000 1700021999 Examination under anaesthesia ( EUA) 1000 1400 2400 3300 430022022 Exploration and Proceed - Major 12000 16800 28200 39000 5100022020 Exploration and Proceed - Minor 4000 5700 9300 13000 1700022021 Exploration and Proceed - Moderate 8000 11200 18800 26000 3400022036 Foot injury major 12000 16800 28200 39000 5100022034 Foot injury Minor 4000 5700 9300 13000 1700022035 Foot injury moderate 8000 11200 18800 26000 3400022055 Foreign body removal - Major 5000 7000 11800 16300 2130022056 Foreign body removal - Minor 3000 4200 7100 9800 1280022057 Hand Exploration and Closure - Major 5000 7000 11800 16300 2130022058 Hand Exploration and Closure - Minor 2000 2800 4700 6500 850021818 Intraleisonal Steroid - Minor 1800 2600 4200 5900 770021927 Muscle Biopsy 2000 2800 3600 4400 520021826 Nerve Biospy - Minor 2600 3600 5900 8100 1070021828 Nerve Biospy - Major 6600 9100 15300 21100 2770021827 Nerve Biospy - Moderate 4000 5700 9300 13000 1700021924 Scelerotherapy 2600 3600 5900 8100 1070021943 Tissue Biopsy 2700 3700 6100 8500 1110021940 Tissue Expansion Stage 2 - Major 14000 19600 32900 45500 5950021938 Tissue Expansion Stage 2 - Minor 10000 14000 23500 32500 4250021939 Tissue Expansion Stage I - Major 10000 14000 23500 32500 42500

162


Rs. Rs. Rs. Rs. Rs.22000 Tissue Expansion Stage I - Minor 4000 5600 9400 13000 17000

22059 Tissue harvest Major 6000 8400 14100 19500 25500

22060 Tissue harvest Minor 2000 2800 4700 6500 8500

22061 Tissue harvest Moderate 4000 5600 9400 13000 17000

22039 Toe injury major 4000 14000 23500 32500 42500

22037 Toe injury minor 2000 2800 3600 4400 5200

22038 Toe injury moderate 4000 5700 9300 13000 17000

21936 Triple Tissue Biopsy 6600 9100 15300 21100 27700

K. PAEDIATRIC SURGERYCNS

09001 Encephalocele Repair 14000 19600 32900 45500 5950009002 Laminectomy 24000 33600 56400 78000 10200009003 Meningomyelocol and Meningocoel Repair 16000 22400 37600 52000 6800009004 V.P. Shunt 15000 21000 35300 48800 6380009005 V.P. Shunt Revision 12000 16800 28200 39000 5100009280 V.P.Shunt Exteriorization 5000 7000 11800 16300 21300

GIT09157 Anorectal Malformation (PSARP) 22000 30800 51700 71500 9350009149 Appendectomy 15000 21000 35300 48800 6380009158 Cloaca (PSARVP) 20000 28000 47000 65000 8500009155 Colostomy Closure 10000 14000 23500 32500 4250009145 Pyloromyotomy 12000 16800 28200 39000 5100009153 EUA 3000 4200 7100 9800 1280009159 Lap Diagnostic 12000 16800 28200 39000 5100009160 Lap Appendectomy 17000 23800 40000 55300 7230009161 Lap Splenectomy 20000 28000 47000 65000 8500009162 Lap Cholecystectomy 16000 22400 37600 52000 6800009142 Formation , Enteral Stoma/Levelling Stoma 12000 16800 28200 39000 5100009143 Heller’s Cardiomyotomy/Fundoplication 14000 19600 32900 45500 5950009146 Ladd’S Procedure 16000 22400 37600 52000 6800009141 Laparotomy (Cyst Excision/Biopsy) 16000 22400 37600 52000 6800009148 Meckel’s Diverticulectomy 13000 18200 30600 42300 5530009156 Abdominal Pull Though For Hirschsprung’s Disease 22000 30800 51700 71500 9350009147 Operations for Intestinal Obstructions 15000 21000 35300 48800 6380009154 Rectal Biopsy 5000 7000 11800 16300 2130009283 Secondary Suturing 3000 4200 7100 9800 1280009282 Transanal Endorectal Pull Through 20000 28000 47000 65000 85000

163


Rs. Rs. Rs. Rs. Rs.HEPATOBILIARY & PANCREATIC

09205 Cholecystectomy 15000 21000 35300 48800 6380009206 Pancreatectomy 18000 25200 42300 58500 7650009209 Drainage of Pseudo Pancreatic Cyst 13000 18200 30600 42300 5530009204 Excision of Choledochal Cyst & Biliary-Enteric An. 20000 28000 47000 65000 8500009202 Hepatic Cyst Excision 15000 21000 35300 48800 6380009201 Hepatic Resections 25000 35000 58800 81300 10630009203 Kasai’s Portoenterostomy 20000 28000 47000 65000 8500009211 Portosystemic Shunt Operations 25000 35000 58800 81300 10630009208 Pancreatico - Enteric Anastmosis 22000 30800 51700 71500 9350009284 POC,Liver Biopsy 12000 16800 28200 39000 5100009212 Spelenectomy 15000 21000 35300 48800 63800

HERNIAS09233 Bilateral Inguinal Herniotomies 16000 22400 37600 52000 6800009231 Herniotomies (Umbilical/Inguinal) 13000 18200 30600 42300 55300

NEONATAL SURGERY09063 Anoplasty 12000 16800 28200 39000 51000

09062 Colostomy (Formation) 10000 14000 23500 32500 42500

09057 Congenital Diaphragmatic Hernia 18000 25200 42300 58500 76500

09060 Duodenal Atresia 18000 25200 42300 58500 76500

09064 Gastroschisis 16000 22400 37600 52000 68000

09056 Gastrostomy 10000 14000 23500 32500 42500

09061 Neonatal Intestinal Obstruction 18000 25200 42300 58500 76500

09055 TEF/EA - Primary Repair 18000 25200 42300 58500 76500

09054 Pure EA - esophagostomy , gastrostomy 15000 21000 35300 48800 63800

09066 Omphalocele - Major 18000 25200 42300 58500 76500

09065 Omphalocele - Minor 16000 22400 37600 52000 68000

09067 Sacrococcygeal Teratoma 20000 28000 47000 65000 85000

09053 Tracheostomy 10000 14000 23500 32500 42500

PAEDIATRIC GENERAL SURGERY - HEAD & NECK09106 Branchial Apparatus Excision (Cyst/Sinus) 12000 16800 28200 39000 51000

09102 Excision of Cystic Hygroma & Teratomas in Neck 12000 16800 28200 39000 51000

09104 Excision of Salivary Glands 12000 16800 28200 39000 51000

09101 Excision of Superficial Lessions/Lymp Node Biopsy 8000 11200 18800 26000 34000

09108 Sternomastoid Release 8000 11200 18800 26000 34000

09103 Thyroglossal Cyst - Excision 12000 16800 28200 39000 51000

09281 Tongue Tie Release 5000 7000 11800 16300 21300

164


Rs. Rs. Rs. Rs. Rs.PAEDIATRIC UROLOGY

09273 Bilateral Reimplant Of Ureter 20000 28000 47000 65000 8500009288 Bladder Augmentation 25000 35000 58800 81300 10630009241 Bladder Exstrophy Closure 15000 21000 35300 48800 6380009263 Bladder Neck Repair 15000 21000 35300 48800 6380009276 CAPD Catheter Insertion 15000 21000 35300 48800 6380009286 CAPD Catheter Removal 5000 7000 11800 16300 2130009243 Circumscision 8000 11200 18800 26000 3400009261 Closure Of Urethrocutanous Fistula 9000 12600 21200 29300 3830009268 CVAD Insertion - Percut 7000 9800 16500 22800 2980009269 CVAD Insertion - Tunneled 8500 11900 20000 27600 3610009248 Cystolithotomy 8000 11200 18800 26000 3400009249 Cystoscopy 7500 10500 17600 24400 3190009292 Endourologic Procedure 10000 14000 23500 32500 4250009266 Epispadias Repair 15000 21000 35300 48800 6380009262 Feminizing Genitoplasty 15000 21000 35300 48800 6380009215 Hemodialysis Catheter Placement 8000 11200 18800 26000 3400009224 Incision And Drainage Of Abscess 3500 4900 8200 11400 1490009291 Lap for DSD 18000 25200 42300 58500 7650009290 Lap Orchidopexy Stage 2 22000 30800 51700 71500 9350009265 Malones (ACE) 15000 21000 35300 48800 6380009264 Mitrofanoff Procedure 15000 21000 35300 48800 6380009250 Nephrectomy / Nephroureterectomy 15000 21000 35300 48800 6380009244 Orchidectomy 14000 19600 32900 45500 5950009246 Orchidopexy - Bilateral 15000 21000 35300 48800 6380009245 Orchidopexy - Unilateral 10000 14000 23500 32500 4250009289 Posterior Urethral Stricture Repair 15000 21000 35300 48800 6380009251 Pyelollithotomy / Nephrolithotomy 15000 21000 35300 48800 6380009247 Pyeloplasty 20000 28000 47000 65000 8500009293 Radical Nephroureterectomy 20000 28000 47000 65000 8500009275 Repair of UG Sinus 18000 25200 42300 58500 7650009252 Surgery For Distal Hypospadias / Chordee Correction 15000 21000 35300 48800 6380009220 Suturing Of Superficial Wounds 3500 4900 8200 11400 1490009255 Transurethral Fulgration 10000 14000 23500 32500 4250009257 Unilateral Reimplant of Ureter 16000 22400 37600 52000 6800009256 Ureterolithotomy 10000 14000 23500 32500 4250009285 Urethral Calibration 2000 2800 4700 6500 850009253 Urethroplasty For Proximal Hypospadias 16000 22400 37600 52000 68000

165


Rs. Rs. Rs. Rs. Rs.09258 Urinary Diversion Permanent 18000 25200 42300 58500 7650009259 Urinary Diversion Temporary 10000 14000 23500 32500 4250009260 Urinary Undiversion 15000 21000 35300 48800 6380009219 Wound Debridement 4500 6300 10600 14600 19100

THORAX09301 ASARP/ Limited PSARP 18000 25200 42300 58500 7650009121 Bronchoscopic Removal of F.B 12000 16800 28200 39000 5100009124 Decortication 16000 22400 37600 52000 6800009302 Devascularisation 20000 28000 47000 65000 8500009123 Esophageal Substitution/Resection 22000 30800 51700 71500 9350009122 Esophagoscopy and Dilatation / FB removal 10000 14000 23500 32500 4250009126 Eventeration of Diaphragm Repair 15000 21000 35300 48800 6380009303 Excision Pilonidal sinus/Coccygectomy 10000 14000 23500 32500 4250009296 Injection Sclerotherapy 5000 7000 11800 16300 2130009304 Lap- Stage I orchidopexy 15000 21000 35300 48800 6380009297 Lithotripsy 2500 3500 5900 8100 1060009127 Lobectomy - Pulmonary 20000 28000 47000 65000 8500009295 Muscle biopsy 4000 5600 9400 13000 1700009294 Percutaneous Interventions 6000 8400 14100 19500 2550009300 Suture removal 500 700 1200 1600 210009129 Thoracic Tumor And Cyst Excision 16000 22400 37600 52000 6800009125 Thoracotomy (Biopsy/Drainage) 15000 21000 35300 48800 6380009299 Ultrasound Guidance 1500 2100 3500 4900 640009131 VATS - Major 16000 22400 37600 52000 6800009130 VATS - Minor 14000 19600 32900 45500 59500

L. NEPHROLOGY TRANSPLANTATION PROGRAMME (Non Packages)RENAL TRANSPLANTATION

06503 Donor Nephrectomy - Laproscopic (Adult) 11000006502 Donor Nephrectomy - Open (Adult) 8000009272 Donor Nephrectomy -Laparoscopic (Paediatric) 11000009271 Donor Nephrectomy- Open (Paediatric) 8000006507 Renal Transplantation 12000006508 Processing Fee to ZCCK for Cadaver Transplant 2500009270 Paediatric Renal Transplantation 120000

M. CADAVERIC ORGAN RETRIEVAL09522 Deceased Donor Liver Transplantation09504 Heart 7400 10400 17400 24100 3150009502 Kidney - Double (Cadaver) 7400 10400 17400 24100 31500

166


Rs. Rs. Rs. Rs. Rs.09501 Kidney - Single 5500 7700 12900 17900 2340009521 Live Donor Liver Transplantation09503 Liver 7400 10400 17400 24100 31500

N. PHYSICAL MEDICINE & REHABILITATION09558 Adductor Tenotomy 2100 2900 4900 6800 890009557 Adductor Tenotomy & Obturator Neurectomy 2600 3600 5900 8100 1070009563 C . P Diplegia Correction 14000 19700 32900 45600 5960009568 Debridement - Major 4600 6300 10700 14700 1910009567 Debridement - Minor 2300 3200 5300 7600 980009579 Excision Ischeal Sore&Flap Closure 8700 12200 20300 28300 3700009578 Excision Ischeal Sore & Direct Closure 4900 6900 11600 15900 2080009580 Flap - Major 13300 18700 31300 43200 5660009562 Fractional Hamstring Lengthening 3000 4200 7100 9800 1280009551 Hallux Valgus -Correction 4000 5700 9300 13000 1700009560 Iliposoas Recession 6600 9100 15300 21100 2770009552 Ingrowing Toe Nail 2600 3600 5900 8100 1070009559 Obturator Neurectomy 2100 2900 4900 6800 890009569 Ordinary Plaster Cast Application 1600 2100 3600 4900 630009553 Posteromedial Soft Tissue 8200 11600 19300 26700 3490009582 Raising of TFL Flap 6600 9100 15300 21100 2770009570 Release of Contractures 4000 5700 9300 13000 1700009581 Revision Amputation 5300 7700 12700 17700 2300009571 Rotation Flap 13000 18200 30700 42300 5530009577 Skin Grafting- Large Area 3000 4200 7100 9800 1280009576 Skin Grafting Small Area 2600 3600 5900 8100 1070009561 Soutters Younts Procedure 4700 6300 10800 15000 1970009556 Stendler’S Release 2100 2900 4900 6800 890009575 Suture of Wounds - Major 2100 2900 4900 6800 890009574 Suture of Wounds - Minor 1600 2100 3600 4900 630009555 Tendoachilles Lengthening 3000 4200 7100 9800 1280009572 Tenotomies - Minor 3900 5600 9200 12700 1670009583 TFL Flap Closure 4600 6300 10700 14700 1910009554 Vulpius Slide 2500 3600 5900 8100 1070009584 Wilson’s procedure 8600 11900 20000 27700 3610009585 Yount’s procedure 1900 2700 4600 6200 8100

UPPER EXTREMITY09599 Biceps/ Brachialis Lengthening 5000 7000 11800 16300 2130009600 Pronator Flexor release 5000 7000 11800 16300 21300

167


Rs. Rs. Rs. Rs. Rs.09601 Thumb in Palm deformity correction -Release and tendon transfer 12000 16800 28200 39000 5100009602 Claw Hand deformity correction-Release and Tendon transfer 12000 16800 28200 39000 5100009603 Carpal tunnel decompression 5000 7000 11800 16300 2130009604 Tennis Elbow Operation 5000 7000 11800 16300 2130009605 De Quervain’s Disease Decompression 4500 6300 10600 14600 1910009606 Intraarticular injection in OT 1500 2100 3500 4900 640009607 Wrist Arthrodesis 9000 12600 21200 29300 3830009608 Congenital Limb deformity correction 8000 11200 18800 26000 3400009609 Mallet Finger 6000 8400 14100 19500 2550009610 Tendon Transfer -Wrist, finger 7000 9800 16500 22800 2980009611 Surgical fusion of the shoulder 13000 18200 30600 42300 5530009612 Shoulder Adductor release 6000 8400 14100 19500 2550009613 L’Episcopo procedure (latissimus dorsi and teres major muscle transfer) 12000 16800 28200 39000 5100009614 Excision of ulnar head (Darrach’s Procedure) 3000 4200 7100 9800 1280009615 Arthrodesis of small joints of small joints 6000 8400 14100 19500 2550009616 Correction of Pronation deformity/Rerouting of Pronator teres 6000 8400 14100 19500 2550009617 Green’s Procedure (FCU to ECRB tendon transfer) 6000 8400 14100 19500 2550009618 Trigger Finger release 4500 6300 10600 14600 1910009619 Ganglion cyst excision 3500 4900 8200 11400 1490009620 Dupyutrens contracture release 4500 6300 10600 14600 19100

LOWER EXTREMITY09621 SEMLS procedure 10000 14000 23500 32500 4250009622 Semitendinosis Transfer/Rectus transfer 7000 9800 16500 22800 2980009623 Rectus Femoris release 5000 7000 11800 16300 2130009624 Tendon Transfer for foot drop 6000 8400 14100 19500 2550009625 Stendler’s Release- Subcutaneous 2500 3500 5900 8100 1060009626 Stendler’s Release-Open 3500 4900 8200 11400 1490009627 Congenital Limb deformity correction 10000 14000 23500 32500 4250009628 Claw toe deformity 5000 7000 11800 16300 2130009629 Arthrodesis of large joints 13000 18200 30600 42300 55300

DIABETIC FOOT09630 Arthrodesis- Foot & Ankle 10000 14000 23500 32500 4250009631 Triple Fusion 10000 14000 23500 32500 42500

AMPUTATIONS09632 Ray Amputation 3000 4200 7100 9800 1280009633 Lisfrancs Amputation 6000 8400 14100 19500 25500

GENERAL09588 Bilateral (50% Of Procedure)

168


Rs. Rs. Rs. Rs. Rs.O. SURGICAL ONCOLOGYABDOMINAL ONCOSURGERY - Minor

17104 Colostomy 10000 14000 23500 32500 4250017107 Colostomy Closure 10000 14000 23500 32500 4250017622 Diagnostic Laparoscopy 8000 11200 18800 26000 3400017102 EUA + Biopsy Anal/Rectal Cancer 8000 11200 18800 26000 3400017103 Feeding Gastrostomy 8000 11200 18800 26000 3400017101 Feeding Jejunostomy 8000 11200 18800 26000 3400017105 Ileostomy 8000 11200 18800 26000 3400017108 Ileostomy Closure 8000 11200 18800 26000 3400017110 Minor Abdominal Wall Tumour Resection 8000 11200 18800 26000 3400017111 Omental Biopsy 8000 11200 18800 26000 3400017106 Staging Laparotomy 8000 11200 18800 26000 34000

ABDOMINAL ONCOSURGERY - Intermediate17113 Cholecystojejunostomy 11000 15300 25900 35800 4860017116 Gastrojejunostomy 11000 15300 25900 35800 4860017117 Intestinal Bypass 11000 15300 25900 35800 4860017112 Laparotomy & Colostomy 10000 14000 23500 32500 4250017114 Limited Bowel Resection 11000 15300 25900 35800 4860017623 Omentectomy 11000 15300 25900 35800 4860017025 Open Cholecystectomy 11000 15300 25900 35800 4860017193 Pancreaticojejunostomy 11000 15400 25900 35800 4680017119 Partial Cystectomy 11000 15300 25900 35800 4860017115 Partial Gastrectomy 11000 15300 25900 35800 4860017118 Pelvic Lymph Node Dissection 11000 15300 25900 35800 4860017120 Retroperitoneal Lymphnode Biopsies 11000 15300 25900 35800 4860017121 Splenectomy 11000 15300 25900 35800 48600

ABDOMINAL ONCOSURGERY - Major17146 Abdominoperineal Resection 25000 35000 58800 81300 10630017152 Ant Pelvic Exenteration 25000 35000 58800 81300 10630017145 Anterior Resection 25000 35000 58800 81300 10630017132 Distal Pancreaticosplenectomy 25000 35000 58800 81300 10630017125 Distal Radical Gastrectomy 25000 35000 58800 81300 10630017137 Extended L Hemihepatectomy 25000 35000 58800 81300 10630017138 Extended R Hemihepatectomy 25000 35000 58800 81300 10630017129 Hepaticojejunostomy 25000 35000 58800 81300 10630017194 Ivor Lewis Oesophagectomy 25000 35000 58800 81300 10630017135 L Hemihepatectomy 25000 35000 58800 81300 106300

169


Rs. Rs. Rs. Rs. Rs.17142 L Radical Hemicolectomy 25000 35000 58800 81300 10630017140 Major Small Bowel Resection 25000 35000 58800 81300 10630017124 Oesophago-Gastrectomy 25000 35000 58800 81300 10630017153 Post Pelvic Exenteration 25000 35000 58800 81300 10630017136 R Hemihepatectomy 25000 35000 58800 81300 10630017141 R Radical Hemicolectomy 25000 35000 58800 81300 10630017127 Radical Cholecystectomy 25000 35000 58800 81300 10630017128 Radical Choledochectomy 25000 35000 58800 81300 10630017150 Radical Cystectomy 25000 35000 58800 81300 10630017149 Radical Nephrectomy 25000 35000 58800 81300 10630017144 Radical Sigmoid Colectomy 25000 35000 58800 81300 10630017143 Radical Transverse Colectomy 25000 35000 58800 81300 10630017151 Retroperitoneal Lymph Node Dissection 25000 35000 58800 81300 10630017148 Retroperitoneal Tumour Resection 25000 35000 58800 81300 10630017134 Segmental Liver Resections 25000 35000 58800 81300 10630017126 Subtotal Radical Gastrectomy 25000 35000 58800 81300 10630017147 Total Colectomy 25000 35000 58800 81300 10630017154 Total Pelvic Exenteration 25000 35000 58800 81300 10630017122 Transhiatal Oesophagectomy 25000 35000 58800 81300 10630017123 Transhthoracic Oesophagectomy 25000 35000 58800 81300 10630017130 Triple Bypass For Pancreatic Cancer 25000 35000 58800 81300 10630017139 Trisegmentectomy 25000 35000 58800 81300 10630017133 Wedge Liver Resections 25000 35000 58800 81300 10630017131 Whipple’S Pancreaticoduodenectomy 25000 35000 58800 81300 106300

ABDOMINAL ONCOSURGERY: SPECIALISED

17026 Colonic Conduit 19700 27580 35460 43340 51220

17165 D2 Gastrectomy 29000 40700 68200 94300 123300

17624 Extended Radical Colectomy 29000 40700 68200 94300 123300

17164 Laparoscopic Adrenalectomy 29000 40700 68200 94300 123300

17161 Laparoscopic Assisted Anterior Resection 32000 44800 75200 104000 136000

17162 Laparoscopic Assisted Apr 29000 40700 68200 94300 123300

17166 Laparoscopic Assisted Gastrectomy 32000 44800 75200 104000 136000

17160 Laparoscopic Assisted Hemicolectomy 32000 44800 75200 104000 136000

17167 Laparoscopic Assisted Oesophagectomy 32000 44800 75200 104000 136000

17157 Laparoscopic Assisted Ostomy In Oncology 14000 19700 32900 45600 59600

17159 Laparoscopic Assisted Small Bowel Resection 14000 19700 32900 45600 59600

17163 Laparoscopic Assisted Splenectomy 29000 40700 68200 94300 123300

170


Rs. Rs. Rs. Rs. Rs.17158 Laparoscopic Stoma Reversal 14000 19700 32900 45600 5960017156 Laparoscopy And Biopsy 14000 19700 32900 45600 5960017195 Laparoscopic Radical Nephrectomy 30000 42000 70500 97500 12750017196 Laparoscopic Whipple’s procedure 35000 49000 82300 113800 14880017625 Multivisceral Resections 32000 44800 75200 104000 13600017642 Nephron Sparing Surgery 25000 35000 58800 81300 10630017155 Staging Laparoscopy 14000 19700 32900 45600 5960017636 Staging Laparoscopy Combined With Other Operative 6000 8300 14100 19600 2560017168 Three Field Oesophagectomy 29000 40700 68200 94300 123300

BREAST ONCOSURGERY - Minor17201 Excision Biopsy Breast Tumour 3300 4700 7800 10700 1400017202 Incision Biopsy Breast Tumour 3300 4700 7800 10700 1400017203 Microdochectomy 3300 4700 7800 10700 14000

BREAST ONCOSURGERY - Intermediate17206 Axillary Dissection Alone For Breast Cancer 10000 14000 23600 32600 4260017205 Simple Mastectomy 10000 14000 23600 32600 4260017204 Wide Excision Breast Tumour 10000 14000 23600 32600 42600

BREAST ONCOSURGERY - Major17207 Modified Radical Mastectomy 16000 22300 37700 52000 68000

BREAST ONCOSURGERY - SPECIALISED17209 BCS (Including Axillary Dissection) 18000 25200 42300 58600 7660017626 Image Guided Biopsy Breast Tumour 12000 16800 28200 39000 5100017208 Sentinel Node Biopsy 12000 16800 28200 39000 51000

CRS and HIPEC17183 Cytoreductive surgery 30000 42000 70500 97500 12750017184 HIPEC 25000 35000 58800 81300 10630017197 Cytoreductive surgery + HIPEC 40000 56000 94000 130000 170000

ENDOCRINE ONCOSURGERY - Minor17501 Parathyroid Autotransplantation 3300 4700 7800 10700 1400017502 Simple Orchidectomy 3300 4700 7800 10700 14000

ENDOCRINE ONCOSURGERY - Intermediate17503 Hemithyroidectomy 13000 18200 30700 42300 5530017506 Oophorectomy For Breast Cancer 13000 18200 30700 42300 5530017505 Radical Orchidectomy 13000 18200 30700 42300 5530017504 Simple Parathyroidectomy 13000 18200 30700 42300 55300

ENDOCRINE ONCOSURGERY - Major17510 Adrenalectomy 16000 22300 37700 52000 68000

171


Rs. Rs. Rs. Rs. Rs.17511 Pancreatic Islet Tumour Resection 16000 22300 37700 52000 6800017508 Radical Parathyroidectomy 16000 22300 37700 52000 6800017507 Total Thyroidectomy 16000 22300 37700 52000 68000

ENDOCRINE ONCOSURGERY - SPECIALISED17514 Laparoscopic Adrenalectomy 21000 29300 49300 68300 8930017515 Laparoscopic Oophorectomy 21000 29300 49300 68300 8930017516 Miniparathyroidectomy 10000 14000 23600 32600 4260017512 Radical Thyroidectomy 21000 29300 49300 68300 8930017513 Total Thyroidectomy + Neck Dissection 21000 29300 49300 68300 89300

HEAD & NECK ONCOSURGERY - Minor17003 Cervical LN Biopsy 3300 4800 8000 11100 1460017004 Excision Of Skin Tumours 3300 4800 8000 11100 1460017002 H&N Cancer EUA 3300 4800 8000 11100 1460017001 Mucosal Biopsy 3300 4800 8000 11100 1460017006 Tracheostomy in OT 3300 4800 8000 11100 14600

HEAD & NECK ONCOSURGERY - Intermediate17008 Central Neck Dissection 13000 18200 30700 42300 5530017012 Hemi Glossectomy 13000 18200 30700 42300 5530017011 Partial Glossectomy 13000 18200 30700 42300 5530017027 Partial Laryngectomy 13000 18200 30700 42300 5530017010 Selective Neck Dissection 13000 18200 30700 42300 5530017013 Submandibular Gland Resection 13000 18200 30700 42300 5530017009 Supraomohyoid Neck Dissection 13000 18200 30700 42300 5530017007 Wide Excision - Oral Cancer 13000 18200 30700 42300 55300

HEAD & NECK ONCOSURGERY - Major17018 Functional Neck Dissection 16000 22300 37700 52000 68000

17016 Mandibular Resections 16000 22300 37700 52000 68000

17017 Modified Neck Dissections 16000 22300 37700 52000 68000

17019 Radical Maxillectomy 16000 22300 37700 52000 68000

17015 Radical Neck Dissection 16000 22300 37700 52000 68000

17022 Radical Parotidectomy 16000 22300 37700 52000 68000

17620 Subtotal Glossectomy 16000 22300 37700 52000 68000

17014 Superficial Parotidectomy - Malignant 16000 22300 37700 52000 68000

17021 Total Conservative Parotidectomy 16000 22300 37700 52000 68000

17020 Total Laryngectomy 16000 22300 37700 52000 68000

HEAD & NECK ONCOSURGERY - SPECIALISED

17621 Combined Oral Cancer Resection And Neck Dissection 29000 40700 68200 94300 123300

172


Rs. Rs. Rs. Rs. Rs.17024 Composite H&N Resections 21000 29300 49300 68300 8930017023 Total Laryngopharyngeoesophagectomy 21000 29300 49300 68300 89300

LIMB ONCOSURGERY - Minor17301 Excision Biopsy 3300 4700 7800 10700 1400017303 Excision Of Superficial Tumours 3300 4700 7800 10700 1400017302 Incision Biopsy 3300 4700 7800 10700 1400017304 Minor Amputation - Fingers 3300 4700 7800 10700 1400017305 Minor Amputation - Toes 3300 4700 7800 10700 14000

LIMB ONCOSURGERY - Intermediate17310 Intermediate Amputation - Below Elbow 10000 14000 23600 32600 4260017311 Intermediate Amputation - Below Knee 10000 14000 23600 32600 4260017309 Intermediate Amputation - Foot 10000 14000 23600 32600 4260017308 Intermediate Amputation - Hand 10000 14000 23600 32600 4260017307 Wide Excision Of Tumours 10000 14000 23600 32600 42600

LIMB ONCOSURGERY - Major17312 Compartmental Excision 16000 22300 37700 52000 68000

17316 Major Amputation - Forequarter 16000 22300 37700 52000 68000

17317 Major Amputation - Hindquarter 16000 22300 37700 52000 68000

17314 Major Amputation - Hip Disarticulation 16000 22300 37700 52000 68000

17315 Major Amputation - Shoulder Disarticulation 16000 22300 37700 52000 68000

17319 Regional Reconstruction Following - Major Resection 19000 26700 44700 61800 80800

17313 Resection Of Large Soft Tissue Or Bone Tumour 16000 22300 37700 52000 68000

LIMB ONCOSURGERY - SPECIALISED17324 Hemipelvectomy 24000 33700 56300 78000 102000

17320 Limb Conservation Surgery 24000 33700 56300 78000 102000

17323 Pelvic Bone Resections 24000 33700 56300 78000 102000

17322 Scapular Resection 23700 33700 56300 78000 102000

SURGICAL & GYNAEC ONCOLOGY - INTERMEDIATE17173 Extrafascial Hysterectomy 10000 14000 23500 32500 42500

17174 Extrafascial Hysterectomy + BSO 12000 16800 28200 39000 51000

SURGICAL & GYNAEC ONCOLOGY - MAJOR17641 Bilateral PLND 20000 28000 47000 65000 85000

17178 Debulking surgery 15000 21000 35300 48800 63800

17175 Radical Hysterectomy 15000 21000 35300 48800 6380017176 Radical Hysterectomy + PLND 20000 28000 47000 65000 8500017177 Radical Hysterectomy + PLND + RPLND 25000 35000 58800 81300 10630017179 Radical Vulvectomy 15000 21000 35300 48800 63800

173


Rs. Rs. Rs. Rs. Rs.17640 Unilateral PLND 16000 22300 37700 52000 68000

SURGICAL & GYNAEC ONCOLOGY - SPECIALISED17180 Laparoscopic Radical Hysterectomy 25000 35000 58800 81300 10630017181 Laparoscopic Radical Hysterectomy + PLND 30000 42000 70500 97500 12750017182 Laparoscopic Radical Hysterectomy + PLND + RPLND 35000 49000 82250 113750 148750

THORACIC ONCOSURGERY - Minor17402 Minor Chest Wall Tumour Excision 9000 12700 21200 29300 3830017404 Open Lung Biopsy 9000 12700 21200 29300 3830017405 Pleurodesis 9000 12700 21200 29300 3830017403 Thoracotomy & Biopsy 9000 12700 21200 29300 38300

THORACIC ONCOSURGERY - Intermediate17407 Minor Mediastinal Tumour Excision 11000 15300 25900 35800 4680017409 Re-Exploration - Major 11000 15300 25900 35800 4680017406 Thymectomy 11000 15300 25900 35800 4680017408 Wedge Resection Lung 11000 15300 25900 35800 46800

THORACIC ONCOSURGERY - Major17410 Lobectomy 25000 35000 58800 81300 10630017414 Major Chest Wall Tumour Resection 25000 35000 58800 81300 10630017412 Mediastinal Tumour Resection 25000 35000 58800 81300 10630017411 Pneumonectomy 25000 35000 58800 81300 10630017413 Thoracotomy & Oesophagectomy 25000 35000 58800 81300 106300

THORACIC ONCOSURGERY - SPECIALISED

17419 Misecellaneous VATS 14000 19700 32900 45600 59600

17415 Staging Thoracoscopy 14000 19700 32900 45600 59600

17637 Staging Thoracoscopy Comined With Other Operative 6000 8300 14100 19600 25600

17416 Thoracoscopy & Biopsy 14000 19700 32900 45600 59600

17418 Thoracoscopy Assisted Oesophagectomy 29000 40700 68200 94300 123300

17169 VATS metastasectomy 20000 28000 47000 65000 85000

17170 VATS Lung lobectomy 30000 42000 70500 97500 127500

17171 VATS Lung lobectomy + MLND 38000 53200 89300 123500 161500

17172 VATS Thymectomy 30000 42000 70500 97500 127500

MISCELLANEOUS ONCOSURGERY - Minor

17604 Circumcision 3300 4700 7800 10700 14000

17627 Minor Debridement 3300 4700 7800 10700 14000

17602 Minor Excisions 3300 4700 7800 10700 14000

17605 Minor Split Skin Grafting 3300 4700 7800 10700 14000

17601 Minor Suturing 3300 4700 7800 10700 14000

174


Rs. Rs. Rs. Rs. Rs.MISCELLANEOUS ONCOSURGERY - Intermediate

17628 Assisting Other Department 10000 14000 23600 32600 4260017608 Local Flap Reconstruction 12000 16800 28200 39000 5100017607 Major Split Skin Grafting 10000 14000 23600 32600 4260017606 Partial Penectomy 10000 14000 23600 32600 4260017639 Venous Access Device Insertion 10000 14000 23600 32600 4260017609 Wide Excision Misc Tumours 10000 14000 23600 32600 42600

MISCELLANEOUS ONCOSURGERY - Major17615 Assisting Other Department 16000 22300 37700 52000 6800017613 Ilioinguinal Lymphnode Dissection 16000 22300 37700 52000 6800017612 Inguinal Lymphnode Dissection 16000 22300 37700 52000 6800017629 Major Debridement 16000 22300 37700 52000 6800017614 Major Oncoplastic Reconstructions 16000 22300 37700 52000 6800017186 Regional Flap Reconstruction 18000 25200 42300 58500 7650017187 Reduction Mammoplasty 15000 21000 35300 48800 6380017611 Radical Penectomy 16000 22300 37700 52000 6800017610 Total Penectomy 16000 22300 37700 52000 68000

MISCELLANEOUS ONCOSURGERY - SPECIALIZED17616 Chemoport Insertion 3000 4200 7100 9800 12800

17630 Image Guided Excisions 12000 16800 28200 39000 51000

17191 Implant reconstruction 20000 28000 47000 65000 85000

17188 LD Flap 20000 28000 47000 65000 85000

17618 Re-Operative Procedures - Referrals 18000 25200 42300 58600 76600

17192 Rigid reconstruction (Titanium Plates/ Bone cements etc) 20000 28000 47000 65000 85000

17617 Sentinel Node Excision 3000 4200 7100 9800 12800

17638 Sentinel Node Excision Combined With Other Operati 6000 8300 14100 19600 25600

17189 TRAM 25000 35000 58800 81300 106300

17190 VRAM 25000 35000 58800 81300 106300

GENERAL18086 Advanced Microscope Per Hour 800 1100 1900 2600 3400


17619 Bilateral (50% Of Procedure/Surgery)

18087 Laproscope Per Hour 700 1000 1600 2300 3000

P. GYNAECOLOGIC ONCOLOGY25200 Aspiration Biopsy In OT 1800 2600 4200 5900 7700

25201 Aspiration Biopsy La 1600 2200 3800 5200 6800

25202 Aspiration Cytology In OT 1800 2600 4200 5900 7700

175


Rs. Rs. Rs. Rs. Rs.25203 Aspiration Cytology LA 1600 2200 3800 5200 680025443 Cold Coagulator For - Minor Procedure in OT 1500 2100 3500 4900 640025478 Cone Biopsy Deep 5000 7000 11800 16300 2130025204 Cone Biopsy In OT 2000 2800 4700 6600 860025479 Cone Biopsy Superficial 2500 3500 5900 8100 1060025480 Cryosurgery Lgt 2000 2800 4700 6600 860025481 Debulking Surgery 18000 25200 42300 58500 7650025212 Dilatation & Curettage 3000 4200 7100 9800 1280025214 Drainage Of Pyometra 2500 3500 5900 8100 1060025218 Drainage Of Vulvar Abscess 2500 3500 5900 8100 1060025482 EUA+Biopsy Cervix/Vulva/Vagina/EB 2500 3500 5900 8100 1060025237 Evacuation Of Vesicular Mole 3500 4900 8200 11400 1490025238 Examination Under Anaesthesia 2200 3100 5200 7200 940025483 Excision Of Cervix/Vulva/Vaginal Lesion 3500 4900 8200 11400 1490025249 Insertion Of Chemo-Port 2500 3500 5900 8100 1060025250 Insertion Of Chemo-Port LA 2200 3100 5200 7200 940025251 Insertion Of Mirena Coil 2400 3400 5600 7800 10200

25247 Insertion Of Peritioneal Catheter 2200 3100 5200 7200 9400

25253 LLETZ 2400 3400 5600 7800 10200

25254 LLETZ LA 2200 3100 5200 7200 9400

25255 Peripheral Insertion Of Central Catheter LA 2200 3100 5200 7200 9400

25256 Polypectomy Cervix 2000 2800 4700 6500 8500

25258 Polypectomy Endometrium 2200 3100 5200 7200 9400

25260 Removal Of Superficial Cysts/Vaginal Cysts/Vulvar 3000 4200 7100 9800 12800

25261 Removal Of Superficial Cysts/Vaginal Cysts/Vulvar Cys LA 2800 3900 6600 9100 11900

25446 Staging For CA Cx Cystoscopy And Biopsy 1800 2000 3300 4600 6000

25447 Staging For CA Cx Proctoscopy And Biopsy 1600 2200 3800 5200 6800

HYSTEROSCOPY25440 Diagnostic Laparoscopy 4000 3600 6100 8500 11100

25392 Hysteroscopy (Diagnostic) 4400 6200 10300 14300 18700

25393 Hysteroscopy + Polypectomy 4500 6300 10600 14600 19100

25171 Hysteroscopy +Polypectomy/Biopsy/Curettage 4500 6600 11000 15300 20000

25473 Laparoscopic Assessment 2000 2800 4700 6500 8500

25441 Laparoscopy + Biopsy 5200 6600 11000 15300 20000

LAPROSCOPY LEVEL 225397 Laproscopic Adhesiolysis 7600 10600 17900 24700 3230025400 Laproscopic Ovarian Cystecomy 13000 18200 30600 42300 55300

176


Rs. Rs. Rs. Rs. Rs.25448 Laproscopic Ovarian Transfixation 12000 16800 28200 39000 51000

LAPROSCOPY LEVEL325174 Laparoscopic TH+BSO/USO 14000 19600 32900 45500 5950025403 Laproscopic Total Hysterectomy 12000 16800 28200 39000 5100025406 LAVH+/-BSO/USO 12000 16800 28200 39000 51000

LAPROSCOPY LEVEL 425408 Laprosopic Hysterectomy + PLND 22000 30800 51700 71500 9350025450 Laprosopic Hysterectomy + RPLND 22000 30800 51700 71500 9350025451 TLH + BSO + Oment + PLND 20000 28000 47000 65000 8500025409 TLH + BSO + Oment + RPLND 25000 35000 58800 81300 106300

CERVIX LEVEL 125340 Class 1/Type A Radical Hysterectomy 9000 12600 21200 29300 3830025452 Diversion Colostomy 10000 14000 23500 32500 4250025453 Diversion Ileostomy 3500 4900 8200 11400 14900

CERVIX LEVEL 225469 Class 1/Type A Radical Hysterectomy+PLND 9000 12600 21200 29300 38300

CERVIX LEVEL 325343 Class II/Type B Radical Hysterectomy +RPLND 18000 25200 42300 58500 7650025344 Class III /Type C1 Radical Hysterectomy + PLND 20000 28000 47000 65000 8500025345 Class III/Type C1 Radical Hysterectomy +RPLND 21000 29400 49400 68300 8930025346 Class III /Type C2 Radical Hysterectomy +PLND 21000 29400 49400 68300 8930025347 Class III/Type C2 Radical Hysterectomy + RPLND 23000 32200 54100 74800 9780025348 Radical Trachelectomy +PLND 21000 29400 49400 68300 8930025352 Vaginal Radical Hysterectomy +RPLND 21000 29400 49400 68300 89300

CERVIX LEVEL 4

25353 Class IV/Type D Radical Hysterectomy 35000 49000 82300 113800 148800

25355 Class V Radical Hysterectomy + RPLND 35000 49000 82300 113800 148800

ENDOMETRIUM / BODY OF UTERUS LEVEL 1

25475 Completion Endometrial Staging Surgery 9000 12600 21200 29300 51000

25603 Systematic Endometrial Surgical Staging 15000 21000 35300 48800 63800


25476 Completion Endometrial Staging Surgery 13000 18200 30600 42300 55300




OVARY / TUBE LEVEL 1

25275 Ovarian Cystectomy Bilateral/Unilateral 6000 8400 14100 19500 25500

177


Rs. Rs. Rs. Rs. Rs.25191 Removal Of TO Mass - Complex 8000 11200 18800 26000 34000

25192 Removal Of TO Mass - Simple 5000 7000 11800 16300 21300


25606 TAH+BSO - Complex 14000 19600 32900 45500 59500

25607 TAH+BSO - Simple 8000 11200 18800 26000 34000


25175 Limited Surgical Staging Early Ov Ca 12000 16800 28200 39000 51000

25477 Completion Staging Ovary 14000 19600 32900 45500 59500

25601 Surgical Staging - Early Ov Ca - Fertility Sparing 10000 14000 23500 32500 42500

25602 Surgical Staging Early Ov Ca - Non-Fertility Sparing 17000 23800 40000 55300 72300


25172 Interval Cytoreduction Level 1 14000 19600 32900 45500 59500

25173 Interval Cytoreduction Level 2 18000 25200 42300 58500 76500

25185 Primary Cytoreductive Surgery Level 1 17000 23800 40000 55300 72300




25196 Secondary Cytoreduction 18000 25200 42300 58500 76500

25197 Secondary Cytoreduction Level 1 12000 16800 28200 39000 51000

25198 Secondary Cytoreduction Level 2 20000 28000 47000 65000 85000

VAGINA

25376 RH + BSO + PLND + Total Vaginectomy 25000 35000 58800 81300 106300

25193 RH Type A + BSO - Complex 12000 16800 28200 39000 51000

25194 RH Type A + BSO - Simple 8000 11200 18800 26000 34000

25195 RH+BSO+PLND+Partial Vaginectomy 22000 30800 51700 71500 93500

25378 Vaginectomy Partial 20000 28000 47000 65000 85000

25380 Total Vaginectomy + PLND 22000 30800 51700 71500 93500

VULVA LEVEL 1

25360 Skinning Vulvectomy 4500 6300 10600 14600 19100

25361 Vulvectomy Simple 4500 6300 10600 14600 19100

25456 Wide Local Excision Of Vulval Lesion 4500 6300 10600 14600 19100

VULVA LEVEL 2

25362 Unilateral GND 6600 9200 15500 21500 28100

VULVA LEVEL 3

25366 Bilateral GND 10000 14000 23500 32500 42500

25176 Modified Radical Vulvectomy - Complex 10000 14000 23500 32500 42500

178


Rs. Rs. Rs. Rs. Rs.25177 Modified Radical Vulvectomy - Simple 6500 9100 15300 21100 27600

25435 Radical Vulvectomy 11000 15400 25900 35800 46800

VULVA LEVEL 4

25367 Modified Radical Vulvectomy+Unilateral GND 12000 16800 28200 39000 51000

25363 Modified Radical Vulvectomy+Bilateral GND 16000 22400 37600 52000 68000

25436 Radical Vulvectomy + Bilateral Inguinofemoral Dissection 18000 25200 42300 58500 76500

25437 Radical Vulvectomy + Unilateral Inguinofemoral Dissection 16000 22400 37600 52000 68000

25189 Radical Vulvectomy + Vulvar Reconstruction 15000 21000 35300 48800 63800

25190 Radical Vulvectomy + Vulvar Reconstruction+Gnd 20000 28000 47000 65000 85000

OTHERS

25459 Exploratory laporotomy 6000 8400 14100 19500 25500

25618 Extrafascial hysterectomy + BSO 9000 12600 21200 29300 38300

25612 Extrafascial hysterectomy + BSO+ SLNB 11000 15400 25900 35800 46800

25410 Intraoperative Consultation for Another Department 5000 7000 11800 16300 21300

25411 Laparotomy + Biopsy 5000 7000 11800 16300 21300

25412 Laparotomy + Closure of Colostomy 10000 14000 23500 32500 42500

25413 Laparotomy + Colostomy 10000 14000 23500 32500 42500

25178 Other Laparotomy + Procedures Level 1 10000 14000 23500 32500 42500



25415 Perineal Floor Repair 6000 8400 14100 19500 25500

25416 Posterior Colporraphy 2500 3500 5900 8100 10600

25468 Re-exploration of Abdomen 3000 4200 7100 9800 12800

25417 Re-Laparotomy (Referrals From Outside) 12000 16800 28200 39000 51000

25418 Repair of Complete Wound Dehiscence (Burst abdomen) 4000 5600 9400 13000 17000

25419 Repair of Superficial Wound Dehiscence 2500 3500 5900 8100 10600

25421 Retroperitoneal Lymph Node Biopsies 10000 14000 23500 32500 42500

25422 Retroperitoneal Tumour Excision 16000 22400 37600 52000 68000

25614 Risk Reducing Salpingo-oophorectomy-laproscopy 8000 11200 18800 26000 34000

25615 Risk Reducing Salpingo-oophorectomy—Open 6000 8400 14100 19500 25500

25423 Sacrocolpopexy With Mesh Repair 8000 11200 18800 26000 34000

25424 Sacrospinous Colpopexy 5000 7000 11800 16300 21300

25613 Sentinel Lymph Node Biopsy 2000 2800 4700 6600 8600

25617 Thermal Ablation 2500 3500 5900 8100 10600

25616 USO 4000 5600 9400 13000 17000

25425 Vaginal Hysterectomy 9000 12600 21200 29300 38300

179


Rs. Rs. Rs. Rs. Rs.25461 Vaginal Hysterectomy + BS/BSO/USO 9000 12600 21200 29300 38300

25426 Vaginal Hysterectomy with Pelvic Floor Repair +/US 11000 15400 25900 35800 46800

GENERAL


25428 Basic Microscope Per Hour

25433 Dvt Phlebo Press 50 115 150 175 200

25432 Extra Hours Taken For A Surgery#





25466 Fluroscopy Time(Every Adnl.5Mts) 100 100 200 300 400

25467 Head Lamp + Loupe 100 100 200 300 400

25430 Laproscope Per Hour 700 1000 1600 2300 3000

Q. UNIT OF HOPE (UoH) ELBOW & FOREARM

24470 UoH - Closed reduction fracture / Dislocation 5000

24471 UoH - Corrective Osteotomy 7500

24472 UoH - External fixation of fracture 7500

24473 UoH - Internal fixation fractures (closed /open) 7000

24474 UoH - Open reduction and internal / fixation fracture / dislocation 8500

24475 UoH - Open reduction fracture / Dislocation 7000

24476 UoH - Tendon transfer upper limb 6000

FEMUR

24477 UoH - External fixator 7500

24478 UoH - Internal fixation 6000

24479 UoH - Osteotomy 6000

FOOT & ANKLE

24480 UoH - Amputations Major 8000

24481 UoH - Amputations Minor 6000

24482 UoH - Growth modulation ankle 7000

24483 UoH - Illizarov for deformity correction 10000

24484 UoH - Osteotomy Intermediate 6000

24485 UoH - Osteotomy Major 7500

24486 UoH - Osteotomy Minor 4500

24487 UoH - Soft tissue release intermediate 4500

24488 UoH - Soft tissue release major 6000

180


Rs. Rs. Rs. Rs. Rs.24489 UoH - Soft tissue release minor 3000

24490 UoH - Tendon Transfer - Intermediate 4500

24491 UoH - Tendon Transfer - Major 6000

24492 UoH - Tendon Transfer - Minor 3000

HIP

24493 UoH - DDH - Closed reduction 5000

24494 UoH - DDH - Open reduction 8000

24495 UoH - Fracture fixation 8000

24496 UoH - Osteotomy - Acetabulum 4000

24497 UoH - Osteotomy - Femur 4000

24498 UoH - SCFE fixation 8000

24499 UoH - Soft tissue release hip 5000

KNEE JOINT & LEG

24531 UoH - Epiphysiodesis 5000

24532 UoH - Growth Modulation 8000

24533 UoH - ILLIZAROV major (lengthening) 12000

24534 UoH - ILLIZAROV Minor (CTEV / CPT) 9000

24535 UoH - Osteotomy Intermediate 6500

24536 UoH - Osteotomy Major 8000

24537 UoH - Osteotomy Minor 5000

24538 UoH - Physeal bar excision 7500

24539 UoH - Soft tissue Procedure intermediate 7500

24540 UoH - Soft tissue Procedure Major 8000

24541 UoH - Soft tissue Procedure Minor 6000

WRIST

24272 UoH - Carpal Bone Excision 8000

24273 UoH - External Fixator/Small Fragment Fixator (Wrist) 10000

24363 UoH - Ganglion Excision 4600

24274 UoH - Surgical Fusion (Wrist) 10000

24275 UoH - Tendon Transfers (Hand) 7800

24364 UoH - TFCC Excision in Madelung deformity 6000

24276 UoH - Wrist Deformity in CP/AMC Correction 10000

GENERAL

24365 UoH - AmputationsUoH -Minor 4000

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

24277 UoH - Arthrogram Joints 2500

181


Rs. Rs. Rs. Rs. Rs.24367 UoH - Biopsy -Minor 2000

24368 UoH - Bone Graft -Minor 2500

24278 UoH - Bone Grafting and Curettage in Bone Tumours 8000

24279 UoH - Closed Reduction and Cast Application 3500

24374 UoH - Combined Complex Procedure 12000

24369 UoH - Curratage of Bone Tumor -Minor 2500

24280 UoH - Decompression of Bone in Acute OM 6000

24281 UoH - Exostocis Excision 6000

24282 UoH - Joint Debridement and Synovectomy 6000

24370 UoH - Nerve Repair - Minor 2500

24283 UoH - Non-Union Fracture Fixation 8000

24373 UoH - Osteomyelitis Chronic Medium Curettage & Automation 6000

24284 UoH - Percutaneous Tenotomies 2500

24371 UoH - Release of Contracture - Minor 2500

24372 UoH - Removal ImplantsUoH -Minor 2500

24542 UoH - Tumor Excision Minor 6000

24543 UoH - Tumor Excision Intermediate 7500

24544 UoH - Tumor Excision major 9000

24545 UoH - Tumor - Megaprosthesis reconstruction 12000

24546 UoH - Tumor - Limb reconstruction 10000

24290 UoH - Unipolar Release in Torticollis 6000

OPTHALMOLOGY - SURGICAL

23915 UoH - Cataract Surgery 4000

23913 UoH - EVA Major 2500

23914 UoH - EVA Minor 1000

23908 UoH - Goniotomy 3500

23912 UoH - Lacrymal Syringing & Probing 2000

23919 UoH - Ptosis Repair 4000

23918 UoH -Retina Surgery 8000

23916 UoH - Secondary Implant 3000

23917 UoH - Squint Miscellaneous 3000

23910 UoH - Squint surgery (Major) 10000

23911 UoH - Squint surgery (Minor) 6000

23909 UoH - Trabeculectomy 5500

182


Rs. Rs. Rs. Rs. Rs.R. ANAESTHESIOLOGY

03028 Anaesthesia for Cardioversion 1000 1400 2400 3300 430003029 Anaesthesia for Cath Lab 1000 1400 2400 3300 430009418 Anaesthesia for CT Scan 1000 1400 2400 3300 430003027 Anaesthesia for ECT 800 1100 1900 2600 340009417 Anaesthesia for Endoscopy 1000 1400 2400 3300 430009419 Anaesthesia for Radiotherapy 1000 1400 2400 3300 430009423 Bronchial Blocker Use in OT 800 1100 1900 2600 340009422 Code for CMAC D Blade use in OT 500 700 1200 1600 210009401 Epidural Injection 1000 1400 2400 3300 430009404 Extra Hours taken for a Surgery09405 Glucometer Random Blood Sugar done in O T 100 140 180 220 26009424 Intra Venous Line Out side OT 200 280 470 660 86003030 Labour Analgesia 2000 2800 4700 6500 850009408 Local Anaesthesia 1000 1400 2400 3300 430003031 LP Out side OT 500 700 1200 1600 210009407 Nerve block - Major 1500 2100 2700 3300 390009406 Nerve Block - Minor 1000 1400 2400 3300 430009402 Pain Clinic 100 100 200 300 40024547 Patient controlled analgesia (PCA for 24 hrs) 600 800 1400 2000 260024548 Patient controlled analgesia (PCA for 48hrs) 800 1100 1900 2600 340009409 Post-OP Epidural Analgesia (Package) for 24 hrs. 1200 1700 2800 3900 510009410 Post-OP Epidural Analgesia (Package) for 48 hrs. 1800 2500 4200 5900 770009416 Specialised Anaesthesia Care 1000 1400 2400 3300 430009425 Ultrasound Machine Use in OT 500 700 1200 1600 210009420 Video Laryngoscope Usage 300 400 700 1000 1300

S. Pain & Palliative Medicine03037 Dry Needling in OT 880 1230 1580 1940 229003015 Intercostal Nerve Blocks in OT 500 600 700 800 1000/120003010 IV Fusion Morphine/Ketamine in OT 200 250 300 450 500/60003023 Ketamine/Morphine Administration & Monitoring in OT 400 450 500 600 700/80003040 Lumbar Medial Branch/Facet Joint Injection in OT 1800 2520 3240 3960 468003054 Needles for Dry Needling in OT 300 300 300 300 30003042 Peripheral Joint Injection with Imaging in OT 600 840 1080 1320 156003043 Peripheral Nerve Injection with Imaging in OT 600 840 1080 1320 156003017 Syringe Driver/PCA Per Day in OT 400 450 500 550 60003013 Trigger Point Injections in OT 250 300 350 400 50003051 Ulrasound Guidance for Day Care/OT Procedures

These will be added extra in OT 300 420 540 660 780

183


Rs. Rs. Rs. Rs. Rs.T. SURGICALGASTROENTEROLOGY & HEPATOPANCREATOBILIARY SURGERYBILIARY

22570 Laparoscopic Cholecystectomy 18000 25200 42300 58600 7660022579 Roux-Y- Hepaticojejunostomy 27000 37800 63600 87800 114800

LAPAROTOMY22601 Laparotomy 18000 25200 42300 58600 7660022612 Suturing (major) 8300 11700 19600 27000 35300

PANCREAS22554 Frey’s Procedure 22000 30800 51700 71600 9360022548 Whipples’ Pancreato - Duodenectomy 27000 37800 63600 87800 114800

LIVER22546 Liver Surgery (major) 30000 42000 70600 97600 127600

LAPAROSCOPY22662 Advanced Laparoscopic Procedure 31000 43300 72900 100800 131800

OESOPHAGUS22504 Esophagocoloplasty (clonic conduit) 18000 25200 42300 58600 7660022505 Heller’s Operation 8000 11200 18800 26000 3400022502 Sub-total Esophago-gastrectomy 23000 32200 54100 74800 9780022500 Transhiatal Esophagectomy (THE) 22000 30800 51700 71600 93600

STOMACH & SMALL INTESTINE22620 Closure of Small Bowel Perforation 5600 7700 12900 17900 2330022519 D2 Gastrectomy 23000 32200 54100 74800 9780022509 Distal Gastrectomy 18000 25200 42300 58600 7660022726 Small Bowel Resection (limited) 8000 11200 18800 26000 3400022665 Small Bowel Resection (major) 22000 30800 51700 71600 9360022510 Subtotal Gastrectomy 12000 16800 28200 39000 5100022512 Total Gastrectomy 18000 25200 42300 58600 7660022517 Truncal Vagotomy + Gastrojejunostomy 8000 11200 18800 26000 34000

LIVER22538 Enucleations / Metastasectomy (Liver) 18000 25200 42300 58600 7660022527 Hemi-Hepatectomy 23000 32200 54100 74800 9780022532 Left Lateral Segmentectomy 18000 25200 42300 58600 7660022540 Liver Hydatid Cyst Excision 12000 16800 28200 39000 5100022536 Packing for Trauma-Liver 8000 11200 18800 26000 3400022526 Segmental Hepatic Resection 18000 25200 42300 58600 76600

BILIARY22576 Cholecystostomy with C.B.D Exploration 12000 16800 28200 39000 5100022584 Hepaticojejunostomy 18000 25200 42300 58600 7660022580 Radical Cholecystostomy 18000 25200 42300 58600 76600

184


Rs. Rs. Rs. Rs. Rs.PANCREAS

22560 Cysto Jejunostomy 8000 11200 18800 26000 3400022550 Distal Pancreatectomy 22000 30800 51700 71600 9360022564 Pancreatic Necrosectomy 12000 16800 28200 39000 5100022568 Pancreato-jejunostomy 12000 16800 28200 39000 5100022549 Triple Bypass for Pancreatic Cancer 22000 30800 51700 71600 93600

COLORECTAL SURGERY22721 Anteroir Resection 18000 25200 42300 58600 7660022691 Closure of Colostomy 5600 7700 12900 17900 2330022686 Colostomy 8000 11200 18800 26000 3400022671 Hemicolectomy 22000 30800 51700 71600 9360022720 Pilonidal Sinus Excision 17600 24600 41100 56900 7430022693 Sigmoid Colectomy 12000 16800 28200 39000 5100022677 Subtotal Colectomy 18000 25200 42300 58600 7660022682 Total Colectomy with Pouch 23000 32200 54100 74800 97800

LAPAROSCOPY22626 Diagnostic Laparoscopy 5600 7700 12900 17900 2330022656 Lap Fundoplication 23000 32200 54100 74800 9780022654 Lap Hydatid Cyst Excision 18000 25200 42300 58600 7660022517 Lap Truncal Vagotomy + GJ 23000 32200 54100 74800 9780022740 Laparoscopic Repair of Incision Hernia 23000 32200 54100 74800 9780022663 Laparoscopic Adhesiolysis 12000 16800 28200 39000 5100022640 Laparoscopic Reveresal of Hartmann’s 23000 32200 54100 74800 9780022649 Lap-assisted Anterior Resection 25000 35000 58800 81300 10630022651 Lap-assisted APER 25000 35000 58800 81300 10630022648 Lap-assisted Colectomy 23000 32200 54100 74800 9780022653 Lap-assisted Gastrectomy 22000 30800 51700 71600 9360022645 Lap-assisted Hemicolectomy 25000 35000 58800 81300 10630022652 Lap-assisted Oesophagectomy 25000 35000 58800 81300 10630022639 Lap-assisted Ostomy 18000 25200 42300 58600 7660022642 Lap-assisted Small Bowel Resection 23000 32200 54100 74800 9780022595 Lap-assisted Splenectomy 22000 30800 51700 71600 9360022506 Lap-Hellers Operation 23000 32200 54100 74800 9780022655 Laproscopic Appendicectomy 11600 16100 27000 37300 4890022657 Single Incision Laparoscopic Surgery 23000 32200 54100 74800 97800

MISCELLANEOUS PROCEDURES22762 Feeding Jejunostomy 5600 7700 12900 17900 2330022599 Splenectomy 12000 16800 28200 39000 5100022588 Porto-Caval Shunt 23000 32200 54100 74800 9780022702 EUA + Biopsy 5600 7700 12900 17900 23300

Schedule hospital charges 2022 Index

Documents

Transcript of Schedule hospital charges 2022 Index