LIST OF PROCEDURES AND PROCEDURES COVERED UNDER THE WEST BENGAL HEALTH SCHEME
(Current as on July 31, 2013)
01 – PROCEDURES
Amount
Claimed
Amount
Admissible
(in `)
(in `)
Name of Procedure / Investigation
Code
GENERAL
Consultation by Medical Officer (OPD)
Consultation by Specialist (OPD)
Visit / Revisit /Consultation by Specialists (Indoor)
(Maximum two visits per day admissible)
Consultation by Super Specialists (OPD)
Visit / Revisit / Consultation by Super-Specialists
(Indoor) (Maximum two visits per day admissible)
Pre-operative Anaesthetic Consultation
Paramedical Consultation
Special Nursing Charge (per shift of 12 hrs.)
Aya / Attendant Charge (per shift 12 hrs.)
Delayed primary suture
Dressing Large
Suturing without local anaesthesia
Suturing of wounds with local anaesthesia
Debridement of wounds
Removal of Benign Tumor
Aspiration Plural Effusion-Therapeutic
Abdominal Aspiration – Therapeutic
Removal of F.B. Superficial
Bone Marrow Aspiration
Joints Aspiration
Strapping
Removal of Stiches
Venesection
Phimosis under LA
Lumbar puncture
Sternal puncture
Injection for Haemorrhoids
Injection for Varicose Veins
Catheterisation
Dilatation of Urethra
Incision & Drainage
Intercostal Drainage
Peritoneal dialysis
Removal of soft tissue or regional block under
general anaesthesia
Dressing Small
Secondary suture of wounds
Bone Marrow Transplantation (inclusive of all)
SKIN
Excision of Moles
Excision of Warts
Excision of Molluscum contagiosum
Excision of Veneral Warts
Excision of Corns
001
01001001
01001002
01001003
150/200/200/-
01001004
01001005
250/250/-
01001006
01001007
01001008
01001009
01001010
01001011
01001012
01001013
01001014
01001015
01001016
01001017
01001018
01001019
01001020
01001021
01001022
01001023
01001024
01001025
01001026
01001027
01001028
01001029
01001030
01001031
01001032
01001033
01001034
200/75/150/75/1,700/160/400/500/1,200/1,100/1,000/1,300/1,200/1,500/1,500/100/60/300/1,500/700/1,500/1,000/1,300/120/1,100/600/1,500/1,800/2,400/-
01001035
01001036
01001037
002
01002001
01002002
01002003
01002004
01002005
100/1,200/10,00,000/600/600/600/600/550/Page 1 of 48
I / D Injection Keloid of Acne
Chemical Cautery (per sittings)
Excision of Sebaceous Cysts
Excision of Superficial Liipoma
Excision of Dermoid Cysts
Surgery of infected corn (Day care)
E.N.T.
Speech therapy per session of 30 – 40 minutes
Removal of foreign body From Nose / Ear / Throat
(Day care package)
Swallowing Therapy
Syringing
Polyp removal under LA
Peritonsillar abscess drainage under LA
Tinnitus Retraining Therapy
Myringoplasty
Staepedectomy
Myringotomy with Grommet insertion
Endoscopic Removal of Fish Bone
Tympanotomy
Paracentesis
Tympanoplasty
Mastoidectomy
Otoplasty
Labyrinthectomy
Skull Base surgery
Facial Nerve Decompression
Septoplasty
Submucous Resection
Septo-rhinoplasty
Rhinoplasty (non-cosmetic)
Fracture Reduction
Intra Nasal Diathermy
Turbinectomy
Endoscopic DCR
Endoscopic Surgery
Septal Perf. Repair
Antrum Puncture
Lateral Rhinotomy
Cranio-facial resection
Ethamoidectomy
Caldwell Luc Surgery
Angiofibroma Excision
Endoscopic Hypophysectomy
Endoscopic Optic Nerve Decompression
Decompression of Orbit
Ranula Excision
Tongue Tie excision
Sub Mandibular Duct Lithotomy
Adenoidectomy
Palatopharyngoplasty
Cleft Palate repair
Pharyngoplasty
Styloidectomy
Uvulo-palatoplasty
01002006
01002007
01002008
01002009
01002010
01002011
003
01003001
01003002
300/120/1,700/2,400/2,450/2,800/-
01003003
01003004
01003005
01003006
01003007
01003008
01003009
01003010
01003011
01003012
01003013
01003014
01003015
01003016
01003017
01003018
01003019
01003020
01003021
01003022
01003023
01003024
01003025
01003026
01003027
01003028
01003029
01003030
01003031
01003032
01003033
01003034
01003035
01003036
01003037
01003038
01003039
01003040
01003041
01003042
01003043
01003044
01003045
01003046
01003047
250/300/800/1,600/250/10,700/12,000/6,000/1,000/8,000/4,300/14,000/15,600/16,500/15,600/50,000/20,000/10,200/10,800/15,000/12,000/9,000/6,000/9,600/13,000/15,000/15,000/3,000/1,350/28,000/17,600/12,000/18,000/25,000/32,000/30,000/9,600/8,100/9,700/8,000/15,100/16,000/18,000/11,500/20,000/-
200/1,500/-
Page 2 of 48
Tympanomastoidectomy
Dacunisation
Tonsilklectomy
Adenotonsillectomy
Synichiolysis
Submucosal Diathermy
Nasal Mass Excision-Simple
Nasal Mass Excision-Endoscopic Removal
FESS
Anterior Nasal Packing
Post Nasal Packing
Nasal Bone Reduction
Excision of Lesion Base of Tongue-per Oral Approach
Unilateral Pre-Auricular Sinus operation
Ophthalmology
Cauterisation of ulcer/subconjuctival injection – One
eye
Cauterisation of ulcer/subconjuctival injection – both
eyes
Retrobular Injection – One eye
Retrobular Injection – Both eyes
Syringing of Lacrimal Sac- For one eye
Syringing of Lacrimal Sac- For both eyes
Paracentesis
Foreign body removal
Refraction / Fundoscopy
Ortho-optic exercises
Plepoptic Exercises
Chalazion operation – One Eye
Chalazion operation – Both Eyes
Dressing (eye)
Clinical Photography
Pterygium
Orbitotomy
Ptosis correction
Ectropion Correction
Xenon Arc Laser
DCR (Dacryo custorhinostomy)
ECCE / ICCE
Epicanthus correction
Squint Correction (one eye)
Squint Correction (both eyes)
Keratoplasty
Trabeculotimy
Iridectomy
Goniotomy
Scleral Bukling (Retinal Detachment surgery)
Syringing & Probing
Vitrectomy
Enucleation
Eviseration
Entropion correction
Cataract with IOL (Cost of lens extra)
Fistulectomy
Glucoma surgery with Glucoma valves
01003048
01003049
01003050
01003051
01003052
01003053
01003054
01003055
01003056
01003057
01003058
01003059
01003060
01003061
004
01004001
15,600/7,000/11,200/13,500/4,200/4,000/11,200/13,500/11,200/4,000/5,000/6,000/6,400/23,400/-
01004002
300/-
01004003
01004004
01004005
01004006
01004007
01004008
01004009
01004010
01004011
01004012
01004013
01004014
01004015
01004016
01004017
01004018
01004019
01004020
01004021
01004022
01004023
01004024
01004025
01004026
01004027
01004028
01004029
01004030
01004031
01004032
01004033
01004034
01004035
01004036
01004037
01004037
200/300/200/300/800/300/90/100/100/800/1,000/100/100/2,200/9,000/6,500/3,600/700/5,700/6,000/2,100/4,000/6,000/14,000/5,700/2,400/2,400/14,000/1,100/11,000/4,000/3,800/3,000/7,500/5,700/5,000/-
200/-
Page 3 of 48
Caliculoplasty
Dacryocystectomy
Ptosis surgery with LPS resection
Ptosis surgery with Sling surgery
Extropion surgery – one lid
Ectropion surgery – both lids
Cheek rotation flap for lid tumors
Telecanthus correction
Fracture orbital repair
Lasik
TTT – Transpupillary thermal therapy
PTK – Phototherapeutic keratectomy
Iris cyst removal
Lid Abscess incision and drainage
Orbital Abscess incision and drainage
Cyclodiathermy
Perforating injury repair
Phaco + IOL (inclusive of Foldable & Non-foldable
lens) Package
YAG Laser Capsulotomy per sitting
YAG Laser Iridectomy per sitting
Argon Laser Trabeculoplasty (ALT) (per sitting) / Diod
Laser
HVF
Cryopexy
ICG including Medicine
ICG – Double including Medicine
Electrolysis (Per sitting)
Cyclocryo / Cyclodiathermy
D.C.T. (OPD)
Silicone Oil (1000)
Silicone Oil (C5)
Silicone Oil Removal
Pneumo Retinopexy
FGE / FAE
Indirect Laser
Endo Laser
SF6 Gas
C3F8 Gas
PFCL
Photodynamic Therapy procedure charges –(Single
eye)
Photodynamic Therapy procedure charges – (both
eyes)
Photodynamic Therapy (Single eye)
Photodynamic Therapy (both eyes)
Intravitreal Avastin (including cost of injection single)
Intravitreal Lucentis (excluding cost of injection
single)
Intravitreal Macugen (excluding cost of injection
single)
Intravitreal injections of antibiotics (cost of
medicines extra)
Retinal Foreign Body Removal
PPV / Victerectomy
01004039
01004040
01004041
01004042
01004043
01004044
01004045
01004046
01004047
01004048
01004049
01004050
01004051
01004052
01004053
01004054
01004055
01004056
3,000/3,000/7,000/7,000/3,000/4,000/8,000/4,000/9,000/18,000/4,000/9,000/1,000/3,000/4,000/2,000/4,000/14,500/-
01004057
01004058
01004059
600/600/1,000/-
01004060
01004061
01004062
01004063
01004064
01004065
01004066
01004067
01004068
01004069
01004070
01004071
01004072
01004073
01004074
01004075
01004076
01004077
500/1,200/2,000/3,600/150/500/800/4,000/4,000/3,500/2,400/1,500/1,000/2,400/2,400/2,400/2,400/15,000/-
01004078
25,000/-
01004079
01004080
01004081
01004082
85,000/1,00,000/6,000/4,000/-
01004083
4,000/-
01004084
2,000/-
01004085
01004086
4,000/6,500/-
Page 4 of 48
Endo Diathermy
Belt Buckle
IVTCA
Membrane Peeling
Anterior Vitrectomy
Lensectomy
Orbitotomy (Multiple Wall)
ERM (Epi Retinal Membrane)
Reti Blue
Corneal Collagen Cross – linking
Biopsies including Histopathological report
(Package)
Biopsy procedure under Local Anaesthesia
Biopsy procedure under General Anaesthesia
Biopsy procedure under Endoscopy
FNAC
Strapping (including Bandage & materials)
Strapping of Finger
Strapping of Toes
Strapping of Wrist
Strapping of Elbow
Strapping of Knee
Strapping of Ankle
Strapping of Chest
Strapping of Shoulder
Nasal bone fracture
Figure of 8 bandage
Colar and cuff sling
Ball bandage
Physiotherapy & Traction
Ultrasonic therapy (per sitting)
S.W. Diathermy (per sitting)
Electrical stimulation (therapeutic) (per sitting)
Infra red (per sitting)
U.V. Therapeutic dose (per sitting)
Electric vibrator (per sitting)
Vibrator belt massage (per sitting)
Intra Lumbar Traction (per sitting)
Intermittent Cervical Traction (per sitting)
Combined Lumbar & Cervical traction (per sitting)
Wax bath
Hot pack
Whirlpool bath (per sitting)
Obesity Exercises (per sitting)
Breathing Exercises & Postural Drainage (per sitting)
Cerebral Palsy – Massage (per sitting)
Post – polio exercise (per sitting)
Basic Gait Training (Per Session)
Traction + IFT
Traction + Stimulation
Traction + SWD
Traction + SWD +IFT
Traction + US
Traction + US + IFT
Traction + US + IFT + SWD
01004087
01004088
01004089
01004090
01004091
01004092
01004093
01004094
01004095
01004096
005
1,600/3,200/800/2,400/5,000/7,500/16,000/3,600/2,400/15,000/-
01005001
01005002
01005003
01005004
006
01006001
01006002
01006003
01006004
01006005
01006006
01006007
01006008
01006009
01006010
01006011
01006012
007
01007001
01007002
01007003
01007004
01007005
01007006
01007007
01007008
01007009
01007010
01007011
01007012
01007013
01007014
01007015
01007016
01007017
01007018
01007019
01007020
01007021
01007022
01007023
01007024
01007025
4,000/6,000/8,000/3,500/200/200/360/400/400/400/500/450/450/450/450/450/70/90/70/90/90/90/90/90/70/70/50/70/90/60/70/90/60/80/150/100/100/200/140/200/260/Page 5 of 48
Traction + US + IFT + SWD
IFT + PWB
Exercise – per sitting
PWB + Knee Joint Spad Fraction
SWD + IFT
US + IFT
US + IFT + Stimulation
US + Knee Joint + Spad Fraction
US + PWB
US + SW + Traction
US + Tens
US + Stimulation
Knee Joints Spad Fraction
Electronic Tilt Training – Per Session
Interferential Therapy
Laser Treatment – Per Session
Microwave Diathermy – Per Session
Quadriceps Chair Training (Per Session)
Tens
Dental
Extraction of tooth including L.A.
Complicated Ext. per Tooth including L.A.
Flap Operation per Tooth
Gingivectomy per tooth
Cyst under L.A. (Small)
Cyst under L.A. (Large)
Impacted Molar including LA
Apisectomy including LA
Fracture wiring including LA
Reduction & immobilisation of fracture – Maxilla
under LA
Reduction & immobilisation of fracture – Mandible
under LA
Splints / Circum mandibular wiring under GA
Internal wire fixation / plate fixation of Maxilla under
LA
Internal wire fixation / plate fixation of Maxilla under
GA
Internal wire fixation / plate fixation of Mandible
under LA/GA
Cyst & Tumour of Maxilla mandible by enucleation /
excision (package)
TM joint ankylosis – under GA (package)
Hemi-mandibulectomy with graft (package)
Hemi-mandibulectomy without graft (package)
Segmental-mandibulectomy with graft (package)
Segmental-mandibulectomy with graft (package)
Maxillectomy – partial with graft (package)
Maxillectomy – partial without graft (package)
Maxillo-facial prosthesis (sal / auricular / orbital /
facial lost part) (package)
Alvelolectomy, Frenectomy per Quadrant
Alvelolectomy (minor)
Amalgam Filling / tooth (compound)
Amalgam Filling / tooth (regular)
01007026
01007027
01007028
01007029
01007030
01007031
01007032
01007033
01007034
01007035
01007036
01007037
01007038
01007039
01007040
01007041
01007042
01007043
01007044
008
01008001
01008002
01008003
01008004
01008005
01008006
01008007
01008008
01008009
01008010
260/150/60/100/100/100/200/100/100/200/100/100/100/100/100/150/150/100/80/120/250/500/300/300/500/800/1,000/80/1,400/-
01008011
3,000/-
01008012
01008013
2,000/4,000/-
01008014
6,000/-
01008015
6,000/-
01008016
2,000/-
01008017
01008018
01008019
01008020
01008021
01008022
01008023
01008024
11,000/7,000/4,000/6,000/2,000/5,000/4,000/5,000/-
01008025
01008026
01008027
01008028
1,150/380/450/380/-
Page 6 of 48
Apicoectomy Molar Tooth
Arch Bar Removal
Bite Plate / Retainers
Cast Rpd (per tooth)
Davis Crown / radicular Screw supported
De Sensitising per sitting
Dento Alveolar fracture Reduction & Splinting/l.a.
Denture Repair (category 1)
Dialation of Whartons Duct under L.A.
Direct / indirect Pulp Capping
Drain. of Dento Alveolar Absec (ex. Oral)
Enucleation of Cyst of Oral Cavity
Fibre Post Based Post & Core
Floride Application (per sitting)
Extraction of Impacted Tooth By Operation
Extraction of MISP Tooth by Operation (Open Meth)
GTR (Guided Tissue Regeneration)
Gingivectomy per Quadrant
Glass Ionomer Filling
Glass Ionomes Filling
Interdental Wiring
Intra Articular Inj. Of Steroids in TMJ
Jacket Crown Acrylic
Minor Dento-alveolar Tracture Reduction &
Splinting/la
Post Core/ tooth (cast Post) lab Metal Chgs. Extra
Post Core/ tooth (pin Retain Comp. Core)
Post Core/ tooth Screw/pin Retain. Amalgm.
Preformed Carbonate Jacket Crown
Preformed Steel Crown
Pulpotomy
Reduction of Dislocation of Tmj (Under LA.)
Reimplantation (per Tooth)
Removal Partial Denture (1st Tooth)
Removal Partial Denture (Additional Tooth)
Removal Partial Denture per Tooth (Palatal Bar)
Repair of Facial Soft Tissue Laceration
Repair of Facial Soft Tissue Laceration (minor)
Root Canal Treatment (upto 4 sitting)
Root Canal Treatment (extra sitting)
Root Canal Treatment with Filling and Crown
(package) (Lab. Charges extra)
Scaling per Sitting
Sialolithotomy for Small Stones
Surgical Extraction or Surgical Removal of Impact
(package)
Surgical Removal of Benin Reoplasm of Oral
(package)
Surgical Removal of Soft Tissue Lesion (package)
Surgical Removal of Impact Mesiod. tuber (package)
Disto – impact teeth (two) under G.A.
ITU / CCU CHARGES (Special Care Cases)
ICU/ITU/CCU/NICU/PICU (including – Oxygen;
ECG/SPO2/NIBP/IBP monitoring; 1:2 Nursing c GNM
Nursing; Round the clock Doctor (Resident on spot);
01008029
01008030
01008031
01008032
01008033
01008034
01008035
01008036
01008037
01008038
01008039
01008040
01008041
01008042
01008043
01008044
01008045
01008046
01008047
01008048
01008049
01008050
01008051
01008052
2,250/380/1,150/380/1,900/200/1,500/230/1,500/230/950/2,000/1,900/400/400/1,150/1,900/750/400/450/1,150/900/1,500/950/-
01008053
01008054
01008055
01008056
01008057
01008058
01008059
01008060
01008061
01008062
01008063
01008064
01008065
01008066
01008067
01008068
1,150/750/550/750/1,150/750/1,400/3,400/400/230/750/1,150/750/1,150/400/3,600/-
01008069
01008070
01008071
400/115/1,150/-
01008072
1,500/-
01008073
01008074
01008075
009
01009001
1,150/1,150/30,000/2,400/-
Page 7 of 48
Diet; Syringe Pump)
Ventilator charge (including accessories)per day
Pneupack Ventilator in Nursery (per day)
High Definition Unit / Step Down (including Oxygen)
Exchange Transfusion
O.T. Charges for Exchange transfusion
CRIB (Critical Ward Bed)
Oxygen Charges
Private/ Semi-private/General Ward (per hour)
Burn Cases
Upto 30% Burns 1st Dressing (excluding dressing
materials and medicines)
Upto 30% Burns Subsequent Dressing (excluding
dressing materials and medicines)
30% to 50% Burns 1st Dressing (excluding dressing
materials and medicines)
30% to 50% Burns Subsequent Dressing (excluding
materials and medicines)
Extensive Burn above 50% First Dressing (excluding
dressing materials and medicines)
Extensive Burn above 50% Subsequent dressing
(excluding dressing materials and medicines)
Burn Unit Bed (including Oxygen)
Obstetric & Gynaecology Cases
Normal delivery or with Episiotomy & P. repair
Low Forceps
Low midcavity forceps
Cesarean Section
Cesarean Hysterectomy
Rupture Uterus – closure & repair with Tubal
Ligation
Perforation of Uterus after D/E Laparotomy &
Closure
Laparotomy – peritonitis Lavage and Drainage
Laparotomy-failed laparoscopy to explore
Salphingectomy
Salphingo-Oophorectomy
Ovarean Cystectomy
Oophorectomy
Broad Ligment Haemotoma Drainage
Exploration of perineal Haematoma & Resuturing of
Episiotomy
Exploration of abdominal Haematoma (after
laparotomy + LUCS)
Internal podalic version and extraction
Manual Removal of Placenta
3rd stage Complication MRP for outside delivery etc.
Examination under anaesthesia
Burst – abdomen Repair
Gaping Pareneal Wound Secondary Suturing
Gaping abdominal wound Secondary Suturing
Complete perineal tear – repair
Exploration of PPH-tear – repair
Destructive Operation
01009002
01009003
01009004
01009005
01009006
01009007
010
01010001
1,000/800/1,500/1,200/400/800/60/-
011
01011001
700/-
01011002
700/-
01011003
700/-
01011004
700/-
01011005
1,500/-
01011006
1,500/-
01011007
012
01012001
01012002
01012003
01012004
01012005
01012006
1,500/12,000/12,000/14,000/20,000/22,000/22,000/-
01012007
18,000/-
01012008
01012009
01012010
01012011
01012012
01012013
01012014
01012015
16,000/6,100/14,000/18,000/18,000/15,000/12,000/12,000/-
01012016
12,000/-
01012017
01012018
01012019
01012020
01012021
01012022
01012023
01012024
01012025
01012026
12,000/3,700/4,900/2,500/3,300/2,500/3,700/2,500/4,200/12,000/-
Page 8 of 48
Suction evacuation vesicular mole, Missed abortion
D/E
Colpotomy – drainage P/V needling EUA
Repair of post – coital tear, perineal injury
Excision of urethral carbuncle
Laparoscopy (Gynae)
Shirodkar, Mc. Donalds stich
Laparotomy
Abdominal Hysterectomy
Vaginal Hysterectomy
Myomectomy
Vaginoplasty
Vulvectomy (Simple / Radical)
RVF Repair
Other Major Operations
Manchester Operations
Perineorrhaphy
Colporraphy
Modified Gilliam
Shirodkar’s Operation
Diagnostic Curettage
Fractional Curettage
D & C and Cervical Biopsy
Polypectomy
Other – Minor Operation
Excision Vaginal Cyst / Burtholin Cyst
Excision Vaginal Septum
Laparoscopy Diagnostic
Laparoscopy Diagnostic
Laparoscopy Operative
Laparoscopy LAVH
Drilling of Ovary
Adhesiolysis
Management of Ectopic pregnancy
Hysteroscopy TCRE
Hysteroscopy Removal of IUCD
Hysteroscopy Removal of Septum
Hysteroscopy Diagnostic
Werthimas Hystrectomy for Cancer cervix
Sterilisation Post Pertum
Sterilisation Intravaginal
Abortion – D & C
Abortion – Evacuation
MTP – 1st Trimester
MTP – 2nd Trimester
Extended Hysterectomy
Hydrotubation
General Surgery
Drainage of Abscess
Dressing under G.A.
Aspiration of cold Abscess of Lymphnode
Aspiration of Empyema
Aspiration of Liver Abscess
Open Drainage of Liver Abscess
Drainage of Pelvic Abscess
01012027
5,900/-
01012028
01012029
01012030
01012031
01012032
01012033
01012034
01012035
01012036
01012037
01012038
01012039
01012040
01012041
01012042
01012043
01012044
01012045
01012046
01012047
01012048
01012049
01012050
01012051
01012052
01012053
01012054
01012055
01012056
01012057
01012058
01012059
01012060
01012061
01012062
01012063
01012064
01012065
01012066
01012067
01012068
01012069
01012070
01012071
01012072
013
01013001
01013002
01013003
01013004
01013005
01013006
01013007
4,200/4,200/4,000/6,100/3,700/20,000/22,000/22,000/22,000/22,000/25,000/25,000/25,000/20,000/14,700/14,400/16,900/10,200/2,700/3,400/3,400/3,600/3,600/3,900/5,900/6,000/7,300/12,000/25,000/10,800/17,400/20,000/11,500/5,500/11,500/7,300/30,000/4,700/6,000/3,900/4,200/3,200/4,800/28,000/1,000/2,000/2,400/3,100/2,400/3,000/10,000/10,000/Page 9 of 48
Drainage of Ischiorectal Abscess
Drainage of Subdiaphragmatic Abscess
Open Drainage of Perinepheric Abscess
Drainage of Perigastric Abscess
Drainage of Perotid Abscess
Drainage of Retropharyngeal Abscess
Open Drainage of Psoras Abscess
Open Drainage of Perivertebral Abscess
Fissurectomy/Haemorroidectomy/Correction of Piles
Haemorroidectomy / Correction of Piles with Stapler
Gun (cost of Gun extra)
Excision of Superficial Neurofibroma
Varicose Veins
Excision of Carbuncle
Injury of Superficial Soft Tissues
Interestical (Implant)
Head & Neck
Breast
Soft Tissue Sarcome
GASTROENTROLOGY
Capsule Endoscopy
Complete Double Baloon Enteroscopy
Complete Small Bowel Evaluation
Argan Plasma Coa (Major)
Argan Plasma Coa (Major) (BS)
Argan Plasma Coa (Minor)
Argan Plasma Coa (Minor)(BS)
Band Ligation
Band Ligation (BS)
Biliary Brushing
Biliary Brushing (BS)
Biliary Brushing (M)
Biliary Brushing (M)(BS)
Biliary Brushing (P)
Biliary Brushing (P) (BS)
Cre Balloon Dilatation (BS)
Cre Balloon Dilatation
Dilatation (Stricture)
Dilatation (Stricture) (BS)
EMG Charge (Large)
EMG Charge (Small)
Endoscopic Tube Place
Endoscopic Tube Place (BS)
Oesophageal Transit
Gastrostomy (PEG)
Gastrostomy (PEG) (BS)
Glue Injection
Glue Injection (BS)
Hemosta by Glod Probe
Hemostatic Clip
Hemostatic Clip (BS)
Hepatonorm
Injection Hemostasis
Inejction Hemostasis (BS)
LGI Manometry
01013008
01013009
01013010
01013011
01013012
01013013
01013014
01013015
01013016
01013017
8,000/14,000/14,000/12,000/8,000/8,000/8,000/10,000/16,000/16,000/-
01013018
01013019
01013020
014
015
01015001
01015002
01015003
016
01016001
01016002
01016003
01016004
01016005
01016006
01016007
01016008
01016009
01016010
01016011
01016012
01016013
01016014
01016015
01016016
01016017
01016018
01016019
01016020
01016021
01016022
01016023
01016024
01016025
01016026
01016027
01016028
01016029
01016030
01016031
01016032
01016033
01016034
01016035
2,800/25,000/4,000/-
9,700/9,600/12,000/30,000/18,000/30,000/5,000/6,500/2,200/3,000/3,500/5,500/1,000/1,600/16,000/23,000/13,300/18,000/15,000/9,000/3,000/4,200/3,500/1,500/3,000/4,200/1,200/7,000/11,000/4,500/7,000/7,000/7,000/10,000/700/4,000/6,000/4,000/Page 10 of 48
LGI Manometry (BS)
UGI Manometry
UGI Manometry (BS)
Nasobiliary Drainage
Nasobiliary Drainage (BS)
Nasojejunal Tube Plac
Nasojejunal Tube Plac (BS)
Papilla Cannu Minor
Papilla Cannu Minor (BS)
Pappu Stnt Spingt (M)
Pappu Stnt Spingt (M) (BS)
Polypectomy (Colonic)
Polypectomy (Colonic) (BS)
Polypectomy (Upper GI)
Polypectomy (Upper GI) (BS)
Pre Cutting
Pre Cutting (BS)
Pseudocyst Drainage
Pseudocyst Drainage (BS)
Sclerotherapy
Sclerotherapy (BS)
Small Bowel Enteroscp
Sphincterotomy
Sphincterotomy (BS)
Stone Extraction
Stone Extraction (BS)
Gastric Emptying
Mechanical Lithotripsy
ERCP (Stenting)
Head & Neck
Ear Lobe Repair one side
Excision of Pinna for Growth (Squamous/Basal/
Injuries) Skin only
Excision of Pinna for Growth (Squamous/Basal/
Injuries) Skin and Cartilage
Partial Amputation of Pinna
Total Amputation of Pinna
Total Amputation & Excision of External Auditory
Meatus
Excision of Cystic Hygroma Minor
Excision of Cystic Hygroma Major
Excision of Cystic Hygroma Extensive
Excision of Branchial Cyst
Excision of Branchial Sinus
Excision of Pharyngeal Diverticulum
Mandibulectomy
Operation for Cervical Rib
Pharyngectomy
Stenosis Excisioin
Commando Operation
Block Dissection of Cervical Lymph Nodes
Pharyngectomy & Reconstruction
Operation for Carcinoma Lip – Wedge Excision
Operation for Carcinoma Lip – Vermilionectomy
Operation for Carcinoma Lip – Wedge Excision and
01016036
01016037
01016038
01016039
01016040
01016041
01016042
01016043
01016044
01016045
01016046
01016047
01016048
01016049
01016050
01016051
01016052
01016053
01016054
01016055
01016056
01016057
01016058
01016059
01016060
01016061
01016062
01016063
01016064
017
01017001
01017002
6,000/3,200/4,500/12,000/18,000/3,000/4,200/6,500/8,200/12,000/17,500/3,200/4,800/3,000/4,500/4,500/7,500/9,000/16,000/3,000/3,800/14,000/10,500/16,000/12,000/17,000/2,500/25,000/10,000/-
01017003
6,000/-
01017004
01017005
01017006
6,000/7,500/10,250/-
01017007
01017008
01017009
01017010
01017011
01017012
01017013
01017014
01017015
01017016
01017017
01017018
01017019
01017020
01017021
01017022
5,500/8,000/12,300/11,000/11,000/12,200/25,000/30,000/35,000/17,000/27,000/20,300/40,000/10,000/10,000/12,000/-
600/4,500/-
Page 11 of 48
Vermilionectomy
Estlander Operation
Abbe Operation
Cheek Advancement
Excision of the Maxilla
Excision of the Mandible – Segmental
Hemimandibulectomy
Partial Glossectomy
Hemiglossectomy
Total Glossectomy
Parotidectomy – Superficial
Parotidectomy – Conservative
Parotidectomy – Radical
Parotidectomy – Total
Repair of Parotid Duct
Removal of Submandibular Salivary gland
Hemithyroidectomy
Partial Thyroidectomy
Subtotal Thyroidectomy (Toxic Goitre)
Total Thyroidectomy
Resectional Enucleation of Adenoma
Isthmectomy
Total Thyroidectomy and Block Dissection
Excision of Lingual Thyroid
Excision of Thyroglossal Cyst / Fistula
Excision of Parathyroid Adenoma / Carcinoma
Laryngectomy
Laryngo Pharyngectomy
Sinus & Fistula repair
Lymph Node Excision
Hyoid Suspension
Genioplasty
Direct Laryngoscopy
Phonosurgery
Fibroptic Laryngoscopy
Microlaryngeal Surgery
Laryngofissure
Head & Neck Cancer
Benign Tumour Excisions
Temporal Bone resection
Radical Neck Dissection
Carotid Body Excision (cost of Graft extra)
Total Laryngectomy
Flap Reconstructive Surgery
Parapharyngeal Tumour Excision
Total Thyroidectomy
Breast
Drainage of Abscess
Excision of Lumps
Local Mastectomy (Simple)
Radical Mastectomy (Formal or Modified)
Excision of Mammary Fistula
Segmental Rescection of Breast
Breast Cancer (Tumour excision)
Cardio Respiratory Procedures
01017023
01017024
01017025
01017026
01017027
01017028
01017029
01017030
01017031
01017032
01017033
01017034
01017035
01017036
01017037
01017038
01017039
01017040
01017041
01017042
01017043
01017044
01017045
01017046
01017047
01017048
01017049
01017050
01017051
01017052
01017053
01017054
01017055
01017056
01017057
01017058
018
01018001
01018002
01018003
01018004
01018005
01018006
01018007
01018008
019
01019001
01019002
01019003
01019004
01019005
01019006
01019007
020
9,700/12,000/10,200/23,300/18,100/27,200/6,100/13,500/25,000/24,000/19,700/22,000/15,000/20,400/10,000/15,000/16,000/22,000/23,000/12,500/12,600/31,400/25,650/15,000/25,600/37,150/43,500/14,000/8,000/12,000/12,000/5,400/15,400/3,000/11,000/17,500/11,000/27,600/28,500/36,000/39,050/42,800/32,000/30,000/7,000/10,000/13,500/28,000/16,000/18,300/30,000/-
Page 12 of 48
Tracheostomy
Thoracotomy (Penetrating Wounds)
Intercostal Drainage of empyema
Decortication (Pleurectomy)
Thoracoplasty
Pneumonectomy
Lobectomy
Segmental Resection
Hydatid Cyst – Removal
Video – assisted thoracoscopic lung Surgeries
Lung volume reduction surgery (unilateral / Bilateral)
Thoracoscopic Decortication
Thoracoscopic Pneumonectomy
Thoracoscopic Lobectomy
Thoracoscopic Segmental Resection
Thoracoscopic Cyst excision
Thoracoscopic Sympathectomy
Chest Wall Tumor Excision with Reconstruction
Repair of Congenital Chest Wall Deformities
Multiple Lobectomy
Decortication + Thoracoplasty
Decortication + Lung Resection + Thoracoplasty
Open Lung Biopsy
Medicistinoscopy (cervical)
Video-assisted thoracoscopy (VATS)
Thoracotomy for BPF
Surgery for Destroyed Lung
Sleeve Resection with Lobectomy
Extrapleural Pneumonectomy
Tracheal Stenosis Surgery
Repair of Tracheo Innuminete Fistula
Tracheal Resection for Tracheal Tumour
Segmentectomy
Wedge Resection
Lung Resection with Paratracheal L. Node Resection
Lung Resection with Chest Wall Invasion
Lung Resection with Dissection of Lymph Node
Stations
Surgery for Recurrent Pnemothoraxic
Surgery for Aspergillosis (Lung Cavities)
Bronchotomy
Mediostonoscopy
Cardiac / Cardio Thoracic Procedures
Coronary Bypass Surgery (including Pre-Surgery
Profile)
Coronary Bypass Surgery – post Angioplasty
(including Pre-Surgery Profile)
Coronary Balloon Angioplasty (Excluding Cost of
Stents) (including Pre-Surgery Profile) (4 days’
package)
Balloon angioplasty with Valvotomy
(including Pre-Surgery Profile)
Open Heart Procedures
(including Pre-Surgery Profile)
Total correction of Tetralogy of Fallot
01020001
01020002
01020003
01020004
01020005
01020006
01020007
01020008
01020009
01020010
01020011
01020012
01020013
01020014
01020015
01020016
01020017
01020018
01020019
01020020
01020021
01020022
01020023
01020024
01020025
01020026
01020027
01020028
01020029
01020030
01020031
01020032
01020033
01020034
01020035
01020036
01020037
3,700/17,500/5,400/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/18,000/15,000/36,960/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/37,000/-
01020038
01020039
01020040
01020041
021
01021001
37,000/37,000/37,000/15,000/1,50,000/-
01021002
1,50,000/-
01021003
66,000/-
01021004
90,000/-
01021005
1,50,000/-
01021006
1,50,000/-
Page 13 of 48
(including Pre-Surgery Profile)
RSUV correction (including Pre-Surgery Profile)
TAPVC correction (including Pre-Surgery Profile)
Open ASD VSD
(including Pre-Surgery Profile)
Open Pulmonary Valvotomy
(including Pre-Surgery Profile)
Open Aortic Valvotomy
(including Pre-Surgery Profile)
Blalock Taussing Operation (including Pre-Surgery
Profile)
Mitral Valvotomy (including Pre-Surgery Profile)
Mitral Valve Replacement (Excluding Cost of Valve)
(including Pre-Surgery Profile)
Arotic Valve Replacement (Excluding Cost of Valve)
(including Pre-Surgery Profile)
Double Valve Replacement (Excluding Cost of Valves)
(including Pre-Surgery Profile)
Thoraco-Abdomi Aorta Replacement
(including Pre-Surgery Profile)
Coaractation – Aorta Repair of Block Taussing Shunt
(including Pre-Surgery Profile)
Patent Ductus Arteriousus
(including Pre-Surgery Profile)
Mitral Valvotomy (Open) (including Pre-Surgery
Profile)
Pericardiostomy (including Pre-Surgery Profile)
Pericardiectomy (including Pre-Surgery Profile)
Pericardio Contesis
Permanent Pacemaker Implantation (Excluding Cost
of Pace-maker ) (4 days package)
Temporary Pacing Lead Implantation (including use
of Temporary Pacemaker)
Embolectomy
Aneurysm–Resection & Grafting (cost of Graft extra)
Thoracocentesis
Thorachostomy
Exploratory Thorocotomy
Unifocalization with Shunt
(including Pre-Surgery Profile)
Removal of Foreign Body from Trachea or
Oesophagus)
Rib Resection & Drainage
Mediastinal Tumour
Thymectomy
ASD Device Closure (Excluding Cost of Device)
PDA Device Closure (Excluding Cost of Device)
DSA
EPSTUDY
3D RF Ablation
Mini EP Study
Coronary Angiography (1 day’s package)
Fonten
Gunshot injury
Heart transplant
Intra coronary stenting
01021007
01021008
01021009
1,50,000/1,50,000/1,50,000/-
01021010
1,50,000/-
01021011
1,50,000/-
01021012
72,000/-
01021013
01021014
72,000/1,50,000/-
01021015
1,50,000/-
01021016
1,60,000/-
01021017
1,50,000/-
01021018
96,000/-
01021019
72,000/-
01021020
1,50,000/-
01021021
01021022
01021023
01021024
54,000/72,000/3,900/19,400/-
01021025
12,600/-
01021026
01021027
01021028
01021029
01021030
01021031
19,800/96,000/2,000/5,400/37,000/1,50,000/-
01021032
6,000/-
01021033
01021034
01021035
01021036
01021037
01021038
01021039
01021040
01021041
01021042
01021043
01021044
01021045
01021046
11,500/35,000/35,000/40,000/32,000/5,400/8,400/40,000/5,000/11,700/1,70,000/52,000/2,77,000/58,000/Page 14 of 48
Directiol atherectomy
01021047
98,000/Permanent
Pacemaker
Implantation
(DDD)
01021048
25,000/(Pacemaker cost extra) (4 days’ package)
Permanent Pacemaker Implantation (Biventricular)
01021049
30,000/(Pacemaker cost extra) (4 days’ package)
Femoral Poplitial Bypass
01021050
75,000/Iliacfemoral Bypass
01021051
75,000/Aorto Bifemoral Bypass
01021052
75,000/Carotid Subclavian Bypass
01021053
75,000/PA Banding
01021054
55,000/BD Glen
01021055
55,000/Thoracic Aorta / Arch Replacement (including Pre01021056
1,50,000/Surgery Profile)
AICD / ICD Implantation procedure charges (cost of
01021057
60,000/implants extra)
C-PAP/Bi – PAP (per day)
01021058
500/Note: CABG if done along with other Heart Surgeries like Valve Replacement etc. will attract the same rate as
CABG.
Oesophagus
022
Atresia of Oesophagus and Tracheo Oesophageal
01022001
29,700/Fistula
Operations for Replacement of Oesophagus by Colon
01022002
38,000/Oesophagectomy for Carcinoma Esophagus
01022003
38,000/Oesophageal Intubation (Mausseau Barbin Tube)
01022004
15,500/Achalasia Carida Transthoracic
01022005
29,700/Achalasia Carida Abdominal
01022006
14,600/Oesophago Gastrectomy for mid 1/3 lesion
01022007
38,000/Oesophagus Dilatation of Stricture – per visit
01022008
1,500/Colon–Inter position or Replacement of Oesophagus
01022009
38,000/Oesophago Gastrectomy – Lower Corringers
01022010
38,000/procedure
Esophageal Perforation Surgery
01022011
38,000/Installation of Ryles Tube in Ca – Esophagus
01022012
5,000/Esophageal Directiculum Surgery
01022013
38,000/Abdomen
023
Gastroscopy
01023001
1,300/Gastric & Duodenal Biopsy (Endoscopic)
01023002
1,700/Pyleromyotomy
01023003
10,000/Gastrostomy
01023004
12,000/Simple Closure of Perforated peptic Ulcer
01023005
15,000/Vagotomy Pyleroplasty / Gastro Jejunostomy
01023006
30,000/Duodenojejunostomy
01023007
25,000/Partial/Subtotal Gastrectomy for Carcinoma
01023008
30,000/Partial/Subtotal Gastrectomy for Ulcer
01023009
30,000/Operation for Bleeding Peptic Ulcer
01023010
25,000/Gastrojejunostomy & Vagotomy
01023011
27,000/Operation for Gastrojejunal Ulcer
01023012
25,000/Total Gastrectomy for Cancer
01023013
35,000/Highly Selective Vagotomy
01023014
25,000/Selective Vagotomy & Drainage
01023015
25,000/Congenital Diaphragmatic Hernia
01023016
30,000/Hiatus Hernia Repair Abdominal
01023017
30,000/Hiatus Hernia Repair Transthoracic
01023018
30,000/Exploratory Laparotomy
01023019
12,900/Epigastric Hernia Repair
01023020
15,000/-
Page 15 of 48
Umbilical Hernia Repair
Ventral and Scar Hernia Repair
Inguinal Hernia Herniorraphy – unilateral
Inguinal Hernia – Hernioplasty-with mesh-unilateral
Femoral Hernia Repair
Rare Hernias – Repair (Spigalion, Obturator, Lumbar,
Sciatic)
Splenectomy – For Trauma
Splenectomy – For Hypersplenism
Splenorenal Anastomosis
Portocaval Anastomosis
Direct Operation on Oesophagus for Portal
Hypertension
Mesentericocaval Anastomosis
Warren Shunt
Pancerato Duodenectomy
By Pass Procedure for Inoperable Carcinoma of
Pancreas
Cystojejunostomy or Cystogastrostomy
Cholecystectomy
Cholecystectomy & Exploration of CBD
Repair of Common Bile Duct
Operation for Hydatid Cyst of Liver
Cholecystostomy
Hepatic Resections (Lobectomy Hepatectomy)
Operation on Adrenal Glands – Bilateral
Operation on Adrenal Glands–Unilateral for Tumour
Appendicectomy for Acute Appendicitis
Appendicectomy for Chronic Appendicitis
Appendicular Abscess – Drainage
Mesenteric Cyst – Excision
Peritonioscopy / Laparoscopy
Jejunostomy
Ileostomy
Congenital Atresia & Stenosis of Small Intestine
Muconium ileus
Mal – rotation & Volvulus of the Midgut
Resection & Anastomosis of Small Intestine
Excision of Meckle’s Diverticulum
Duodenal Diverticulum
Operation for Intestinal Obstruction
Operation for Intestinal perforation
Benign Tumours of Small Intestine
Benign Tumours of Small Intestine
Excision of Small Intestine Fistula
Operations of the Duplication of Intestines
Operations for Recurrent Intestinal Obstruction
(Noble Plication & Other Operations for the
Adhesions)
Ilieosigmoidostomy
Ilieosigmoidostomy Colostomy
Caecostomy
Loop Colostomy Transverse Sigmoid
Terminal Colostomy
Closure of Colostomy
01023021
01023022
01023023
01023024
01023025
01023026
15,000/18,000/15,000/22,000/22,000/25,000/-
01023027
01023028
01023029
01023030
01023031
25,000/25,000/40,000/40,000/30,000/-
01023032
01023033
01023034
01023035
35,000/35,000/36,000/30,000/-
01023036
01023037
01023038
01023039
01023040
01023041
01023042
01023043
01023044
01023045
01023046
01023047
01023048
01023049
01023050
01023051
01023052
01023053
01023054
01023055
01023056
01023057
01023058
01023059
01023060
01023061
01023062
01023063
01023064
30,000/18,000/22,000/20,000/25,000/14,200/28,000/35,000/20,000/20,000/18,000/12,000/18,000/5,100/18,000/18,000/25,000/20,000/20,000/22,000/22,000/18,000/25,000/25,000/25,000/25,000/25,000/32,000/28,000/-
01023065
01023066
01023067
01023068
01023069
01023070
22,000/22,000/10,000/20,000/24,000/24,000/-
Page 16 of 48
Right Hemi-Colectomy
Left Hemi – Colectomy
Total Colectomy
Operations for Volvulus of Large Bowel
Operations for Sigmoid Diverticulitis
Fissure in Ano - Dilatation
Fissure in Ano – Fissurectomy
Rectal Polyp – Excision
Operation of Haemorrhoids – Lords procedure
Fistula in Ano – High Fistulectomy
Fistula in Ano – Low Fistulectomy
Imperforat Anus – Colostomy
Imperforate Anus – Pull Through Operation
Prolapse Rectum – Theirch Wiring
Prolapse Rectum – Rectopexy
Prolapse Rectum – Grahams Operation
Operations for Hirschsprungs Disease
Excision of Pilonidal Sinus
Abdomino – Perineal Excision of Rectum
Anterior Resection of rectum
Pull through Abdominal Resection
Operations for Neuroblastomka
Fistula / Fistulotomy
Hernioctomy
Nephrology / Genitourinary
Partial Nephrectomy
Nephrolithotomy
Pyelithotomy
Operations for Hydrone – phrosis
Open Drainage of Perinephric Abscess
Cavernostomy
Operations for Cyst of the Kidney
Ureterolithotomy
Nephroureterectomy
Operations for Ureter for – Double Ureters
Operations for Ureter – for Ectopia of Single Ureter
Operations for Vesico-ureteric Reflux
Ureterostomy – Cutaneous
Uretero-Colic anastomosis
Formation of an Ileal Conduit
Ureteric Catheterisation
Dormia Extraction of Calculus
Biopsy of Bladder (Cystoscopic)
Diathermy Destruction of Bladder Neoplasm
Litholapexy
Operations for Injuries of the Bladder
Suprapubic Drainage (Cystostomy/Vesicostomy)
Total Cystectomy
Diverticulectomy
Open Resection of the Bladder Neck
Y-V Plasty of the Bladder Neck
Cystoplasty
Operations for Extrophy of the Bladder
Repair of Ureterocoel
Suprapubic Prostatectomy
01023071
01023072
01023073
01023074
01023075
01023076
01023077
01023078
01023079
01023080
01023081
01023082
01023083
01023084
01023085
01023086
01023087
01023088
01023089
01023090
01023091
01023092
01023093
01023094
024
01024001
01024002
01024003
01024004
01024005
01024006
01024007
01024008
01024009
01024010
01024011
01024012
01024013
01024014
01024015
01024016
01024017
01024018
01024019
01024020
01024021
01024022
01024023
01024024
01024025
01024026
01024027
01024028
01024029
01024030
24,000/24,000/39,000/25,200/22,000/6,800/16,000/8,000/10,000/20,000/12,000/16,000/22,000/15,000/10,000/22,000/22,000/12,300/26,700/26,300/22,000/22,000/12,000/21,000/25,000/25,000/25,000/25,000/15,000/20,400/25,000/20,000/20,000/30,000/27,000/28,000/20,000/20,000/22,000/5,000/6,000/6,000/15,000/15,000/30,000/12,000/35,000/32,000/25,000/25,000/28,000/40,000/25,000/25,000/Page 17 of 48
Restropubic Prostatectomy
Transurethral Resection of Prostate (TURP)/ TUR
Bladder Tumour
Intravesical BCG instillation (cost of BCG extra)
Operations for Injury to Urethra
Internal urethrotomy
Urethral Reconstruction
Operation for Congenital Valves of Urethra
Operations for Incontinence of Urine – Male
Operations for Incontinence of Urine – Female
Reduction of Paraphimosis
Circumcision (under General Anaesthesia)
Meatotomy
Meatoplasty
Operations for Hypospadias – Chordee Correction
Operations for Hypospadias – Second stage or one
stage Repair
Operations for Epispadias
Partial Amputation of the Penis
Total amputation of the Penis
Orchidectomy – Simple
Orchidectomy – Radical
Adreneclectomy Unilateral / Bilateral for Tumour /
For Carcinoma
Operations for Hydrocele – Unilateral
Operations for Hydrocele – Bilateral
Operation for Torsion of Testis
Vasovasostomy
Operations for Varicocele
Block Dissection of Inguinal Nodes – One Side
Block Dissection of Inguinal Nodes – Both Sides
Excision of Filarial Scrotum
Emergency Dialysis Femoral Puncture
Emergency Dialysis Subclavian Puncture
Fistula / Shunt
Dialysis Femoral Catheterisation Bilateral
Haemo Dialysis (All inclusive)
Double Lumen Sub Clavian Catheter
Continuous
Arterio
Venus
Haemofiltration
(CAVH)/CAVD
Subclavian Access
Femoral Access
Plasma Exchange
Donor Nephrectomy
Renal Transplantation
Ureteric Reimplant
Lymphocoel
Transplant Nephrectomy
Nephrouretectomy
Vascular Prosthetic Graft
CAPD (insertion & removal)/Cystoscopic removal of
D-J stent
PCNL – Unilateral
PCNL – Bilateral / PCNL – III
Palomo’s Unilateral
01024031
01024032
25,000/25,000/-
01024033
01024034
01024035
01024036
01024037
01024038
01024039
01024040
01024041
01024042
01024043
01024044
01024045
500/30,000/15,000/32,000/16,000/25,000/25,000/2,450/6,000/3,500/6,800/15,000/24,000/-
01024046
01024047
01024048
01024049
01024050
01024051
22,000/14,000/20,000/14,000/20,000/30,000/-
01024052
01024053
01024054
01024055
01024056
01024057
01024058
01024059
01024060
01024061
01024062
01024063
01024064
01024065
01024066
8,000/12,000/15,000/18,000/15,000/25,000/32,000/16,000/1,200/1,800/8,000/1,500/1,500/3,000/17,000/-
01024067
01024068
01024069
01024070
01024071
01024072
01024073
01024074
01024075
01024076
01024077
1,850/1,750/2,500/50,000/2,50,000/4,200/4,300/35,000/35,000/35,000/8,000/-
01024078
01024079
01024080
30,000/46,000/7,300/-
Page 18 of 48
Palomo’s Bilateral
Endoscopic Teflon Inject
Testicular Biopsy
Gil-Verner’s Extended Pyelo-lithotomy
Radical Nephrectomy Complicated Tumour or
Adhesions
Anderson Hynes Pyeloroplasty
Vasico Vaginal Fistula Repair
Radical Cystectomy
Caeco Cystoplasty
Nephrectomy Simple
Nephrostomy
Ureteric Reimplant
Partial Cystectomy
Epididymectomy
TURP Cystolithotripsy
Open Prostatectomy
Closure of Urethral Fistula
Orchidopexy – Unilateral
Orchidopexy – Bilateral
Cystolithotomy – Suprapubic
Endoscopic Removal of Stone in Bladder
Resection Bladder Neck Endoscopic
Ureteroscopic Removal – with LASER
Ureteroscopic Removal – without LASER
Urethroplasty 1st stage
Optical Urethrotomy
Exploratory Scrototomy
Perineal Urethrostomy
Dilation of Stricture Urethra under G.A.
Dilatation of Stricture Urethra without Anesthesia
Retroperitoneoscopy Nephrectomy
Retroperitoneoscopy partial Nephrectomy
Retroperitoneoscopic nephrolithotomy
Retroperitoneoscopic pyelolithotomy
Retroperitoneoscopic operation for Hyderonephrosis
Retroperitoneoscopic surgery for Renal cyst
Retroperitoneoscopic ureterolithotomy
Retroperitoneoscopic Nephroureteroectomy
Laparoscopy assisted orchidopexy
Laparoscopic operation for varicocele
Cystoscopic Basketing of Urethra
Lithotripsy/ESWL (Complete)
Lithotripsy – 1/SMSL (Day care)
Lithotripsy – 2/3 /SMSL (Day care)
Slow Efficienty Dialysis (SLED)
Prosthetic Surgery for urinary incontinence
Helium Laser Prostrate surgery / Optical Internal
urethrotomy
High Intensity Focus Ultrasound (HIFU) Robotic for
Carcinoma
CRRT Procedure
TURP with LASER
Lithoclast (Day care)
Plastic Surgery
01024081
01024082
01024083
01024084
01024085
12,600/5,100/4,350/22,000/50,000/-
01024086
01024087
01024088
01024089
01024090
01024091
01024092
01024093
01024094
01024095
01024096
01024097
01024098
01024099
01024100
01024101
01024102
01024103
01024104
01024105
01024106
01024107
01024108
01024109
01024110
01024111
01024112
01024113
01024114
01024115
01024116
01024117
01024118
01024119
01024120
01024121
01024122
01024123
01024124
01024125
01024126
01024127
25,000/30,000/44,000/26,000/25,000/22,000/25,000/28,000/12,000/30,000/28,000/28,000/15,000/20,000/15,000/18,000/18,000/40,000/18,000/14,000/18,000/10,000/15,000/4,000/2,200/40,000/35,000/35,000/35,000/35,000/35,000/35,000/35,000/22,000/20,000/12,000/30,000/18,000/23,000/4,000/40,000/30,000/-
01024128
1,50,000/-
01024129
01024130
01024131
025
11,000/32,000/16,000/-
Page 19 of 48
Primary Suture of Wound
Injection of Keloids – Ganglion
Injection of Keloids – Haemangioma
Free Grafts – Wolfe Grafts
Free Grafts – Theirech – Small Area 5%
Free Grafts – Large area 10%
Free Grafts – Very Large area 20%
Skin Flaps – Rotation Flaps
Skin Flaps – Advancement Flaps
Skin Flaps – Direct-cross Leg Flaps-Cross Arm Flap
Skin Flaps – Cross Finger
Skin Flaps – Abdominal
Skin Flaps – Thoracic
Skin Flaps – Arm etc.
Subcutaneous Pedicle Flaps Raising
Subcutaneous Pedicle Flaps Delay
Subcutaneous Pedicle Flaps Transfer
Cartilage Grafting
Reduction of Facial Fractures of Nose
Reduction of Facial Fractures of Maxilla
Reduction of Fractures of Mandible & Maxilla – Eye
Let Splinting
Reduction of Fractures of Mandible & Maxilla – Cast
Netal Splints
Reduction of Fractures of Mandible & Maxilla –
Gumming Splints
Internal Wire Fixation of Mandible & Maxilla
Cleft Lip – repair
Cleft Palate Repair Severe Degree
Primary Bone Grafting of Cleft Lip Palate
Secondary Surgery for Cleft Lip Deformity
Secondary Surgery for Cleft Palate
Reconstruction of Eyelid Defects – Minor
Reconstruction of Eyelid Defects – Major
Plastic surgery of Different Regions of the Ear-Minor
Plastic surgery of Different Regions of the Ear-Major
Plastic surgery of the Nose – Minor
Plastic surgery of the Nose – Major
Plastic surgery for Facial Paralysis (Support with
Reanimation)
Pendulous Breast – Mammoplasty
Orthopaedic Surgery Procedure
Application of P.O.P Casts for Upper & Lower Limbs
Application of Functional Cast Brace
Application of Skin Traction
Application of Skeletal Tractions
Bandage & Strappings for Fractures
Aspiration & Intra Articular Injections
Application of P.O.P Spices & Jackets
Close Reduction of Fractures of Limb & P.O.P
Reduction of Compound Fractures
Open Reduction & Internal Fixation of Fingers & Toes
Open Reduction of fracture of Long Bones of Upper /
Lower Limb-Nailing & External Fixation
Open Reduction of fracture of Long Bones of Upper /
01025001
01025002
01025003
01025004
01025005
01025006
01025007
01025008
01025009
01025010
01025011
01025012
01025013
01025014
01025015
01025016
01025017
01025018
01025019
01025020
01025021
3,200/2,700/6,100/18,000/18,500/30,000/32,400/28,750/31,650/35,500/35,500/35,500/34,400/35,500/28,500/27,750/28,500/29,700/9,000/13,800/27,000/-
01025022
27,000/-
01025023
27,000/-
01025024
01025025
01025026
01025027
01025028
01025029
01025030
01025031
01025032
01025033
01025034
01025035
01025036
32,000/32,400/33,800/34,550/32,600/31,350/17,550/30,000/10,000/20,000/10,000/20,000/32,000/-
01025037
026
01026001
01026002
01026003
01026004
01026005
01026006
01026007
01026008
01026009
01026010
01026011
22,550/-
01026012
27,000/-
7,500/7,500/1,650/4,450/1,150/950/6,000/7,500/10,000/18,000/28,000/-
Page 20 of 48
Lower Limb – AO Procedures
Tension Band Wirings
Bone Grafting
Excision of Bone Tumours – Superficial
Excision of Bone Tumours – Deep
Excision of Ganglion
Excision or other Operations for Scaphoid Fractures
Sequestrectomy & Saucerizations-Superficial
Sequestrectomy & Saucerizations – Deep
Sequestrectomy & Saucerizations – Arthrotomy
S.P. Nailing for Fracture Neck Femur
Multiple Pinning Fracture Neck Femur
Nail Plate Fixations for Fracture Neck Femur
A.O. Compression Procedures for Fracture Neck
Femur
Open Reduction of Fracture Neck Femur Muscle
Pedicle Graft and Internal Fixations
Closed Reduction of Dislocations
Open Reduction of Dislocations – Superficial
Open Reduction of Dislocations – Deep
Open Reduction of Fracture Dislocation & Internal
Fixation
Neurolysis /Nerve Suture
Nerve Repair with Grafting
Tendon with Transplant or Graft
Tendon Lengthening/Tendon Sutures
Tendon Transfer
Laminectomy, Excision Disc (Prosthesis extra)
Laminectomy, Excision Disc and Tumours (Prosthesis
extra)
Anterolateral Clearance for tuberculosis
Anterolateral Decompression and Spinal Fusion
Cost Transversectomy
Corrective Ostectomy & Internal Fixation – Minor
Corrective Ostectomy & Internal Fixation – Major
Arthrodisis of – Minor Joints
Arthrodisis of – Major Joints
Soft Tissue Operations for C.T.E.V.
Soft Tissue Operations for Polio (instrumentation
extra)
Partial Hip Replacement (cost of Prosthesis extra)
Operations for Brachial Plexus & Cervical Rib
Amputations – Below Knee
Amputations – Below Elbow
Amputations – Above Knee
Amputations – Above Elbow
Amputations – Forequarter
Amputations – Hind Quarter and Hemipelvectomy
Disarticulations – Major
Disarticulations – Minor
Arthrography & Osteomedullography
Spinal Ostectomy and Internal Fixations
Arthroscopy – Operative
Soft Tissue Operation on Knee
Myocutaneous and Fasciocutaneous Flat Procedures
01026013
01026014
01026015
01026016
01026017
01026018
01026019
01026020
01026021
01026022
01026023
01026024
01026025
6,000/18,000/28,000/40,000/10,000/25,000/20,000/30,000/35,000/35,000/35,000/35,000/35,000/-
01026026
35,000/-
01026027
01026028
01026029
01026030
10,000/20,000/30,000/35,000/-
01026031
01026032
01026033
01026034
01026035
01026036
01026037
25,000/32,000/35,000/25,000/35,000/40,000/60,000/-
01026038
01026039
01026040
01026041
01026042
01026043
01026044
01026045
01026046
32,000/45,000/30,000/15,000/30,000/15,000/30,400/25,000/25,000/-
01026047
01026048
01026049
01026050
01026051
01026052
01026053
01026054
01026055
01026056
01026057
01026058
01026059
01026060
01026061
40000/32,000/25,000/25,000/35,000/30,000/40,000/44,000/30,000/20,000/10,450/40,200/24,250/24,000/24,000/-
Page 21 of 48
for Limbs
Removal of Nails, Wires & Screw
Removal of Plates
Total Hip Replacement–Unilateral (Excluding
Implants)
Total Finger Joint Replacement–Unilateral (Excluding
Implants)
Total Knee Joint Replacement–Unilateral (Excluding
Implants)
Any other Joint Replacement (e.g. elbow, shoulder,
etc.) – Unilateral (cost of Implants extra)
Multiple fractures repair (excluding peripheral limb
injuries)-major (above three fractures) (cost of
implants extra)
Multiple fractures repair (excluding peripheral limb
injuries)-medium (above two fractures) (cost of
implants extra)
Sternal Dehisences Repair
Sternal Dehisences Reconstration
Fingers (post, slab)
Fingers full plaster
Colles Fracture – Below elbow
Colles Fracture – Full plaster
Colles fracture Ant. Or post slab
Above elbow full plaster
Above knee post slab
Below knee full plaster
Below knee post slab
Tube Plaster (or plaster cylinder)
Above knee full plaster
Above knee full slab
Minerva Jacket
Plaster Jacket
Shoulder spica
Single Hip spica
Double Hip spica
Resection of First Rib
Resection of Cerical Rib
Rib resection
Ligament Reconstruction
Neuro – Surgery
Craniotomy and Evacuation of Haematoma-Subdural
Caraniotomy and Evacuation of HaematomaExtradural
Evacuation of Brain Abscess
Excision of Lobe (Frontal, Temporal, Cerebelium etc.)
Excision of Brain Tumours – Supratentotial
Excision of Brain Tumours – Subtentorial
Surgery of Cord Tumours
Ventriculoatrial / Ventriculoperitoneal Shunt
Excision of Cervical Inter – Vertebral Discs.
Sympathetectomy – Lumbar
Sympathetectomy – Cervical
Twist Drill Craniostomy
01026062
01026063
01026064
10,000/15,000/60,000/-
01026065
23,000/-
01026066
55,000/-
01026067
55,000/-
01026068
1,00,000/-
01026069
60,000/-
01026070
01026071
01026072
01026073
01026074
01026075
01026076
01026077
01026078
01026079
01026080
01026081
01026082
01026083
01026084
01026085
01026086
01026087
01026088
01026089
01026090
01026091
01026092
027
01027001
01027002
25,000/55,000/300/300/1,200/2,000/1,000/1,000/700/1,000/750/1,450/2,400/2,200/4000/3050/3,350/3,100/3,800/45,000/35,000/12,500/22,000/-
01027003
01027004
01027005
01027006
01027007
01027008
01027009
01027010
01027011
01027012
80,000/80,000/80,000/80,000/60,000/40,000/50,000/18,000/18,000/30,000/-
70,000/70,000/-
Page 22 of 48
Subdural Tapping
Ventricular Tapping
Abscess Tapping
Placement of ICP Monitor
Urokinase Therapy for ICH
Skull Traction Application
Lumber Pressure Monitoring
Vascular Malformations
Peritoneal Shunt
Antrial Shunt
Meningo Encephalocoel
Meningomyelocoel
C,S,F, Rhinorrhaea
Cranioplasty
Posterior Cervical Dissectomy
Anterior Cervical Dissectomy
Brachial Plexus Exploration Miscrosuturing
Median Nerve Decompression
Peripheral Neurectomy (Trigeminal)
Trigeminal Rhiotomy
Cranial Nerve Asstomosis
Meningocoele Excision
Peripheral Nerve Surgery – Major
Peripheral Nerve Surgery – Minor
Ventriculo – Atrial Shunt (Excluding Cost of valve)
Nerve Biopsy (Procedure + Investigation)
Brain Biopsy (Procedure + Investigation)
Anterior Cervical Spine Surgery with fusion
Anterior Lateral Decompression
Brain Mapping
Cervical or Dorsal Laminectomy
Combined Trans-oral Surgery & CV Junction Fusion
C.V. Junction Fusion
Depressed Fracture
Discectomy
Endarterectomy
R.F. Lesion for Trigeminal Neuralgia
Spasticity Surgery
Spinal Fusion Procedure
Spinal Intra Medullary Tumours
Spinal Bifida Surgery Major
Spinal Bifida Surgery Minor
Stereotaxic Procedures – biopsy / aspiration
Trans Sphenoidal Surgery
Trans Oral Surgery
Implantation of DBS – one Electrode
Implantation of DBS – two Electrode
Endoscopic Adueductoplasty
Facial nerve reconstruction
Recanelisation of venous sinuses
Carotid stenting
Cervical disc arthroplasty
Lumber disc arthroplasty
Corpus Callosectomy
Hemishpherectomy
01027013
01027014
01027015
01027016
01027017
01027018
01027019
01027020
01027021
01027022
01027023
01027024
01027025
01027026
01027027
01027028
01027029
01027030
01027031
01027032
01027033
01027034
01027035
01027036
01027037
01027038
01027039
01027040
01027041
01027042
01027043
01027044
01027045
01027046
01027047
01027048
01027049
01027050
01027051
01027052
01027053
01027054
01027055
01027056
01027057
01027058
01027059
01027060
01027061
01027062
01027063
01027064
01027065
01027066
01027067
15,000/12,000/15,000/15,000/15,000/3,400/10,000/1,00,000/15,000/15,000/52,000/42,000/55,000/55,000/50,000/50,000/50,000/40,000/45,000/35,000/60,000/45,000/50,000/40,000/1,00,000/15,000/18,000/60,000/60,000/2,400/45,000/1,10,000/80,000/40,000/45,000/50,000/30,000/90,000/65,000/65,000/65,000/55,000/22,000/65000/1,10,000/1,00,000/1,00,000/1,00,000/50,000/80,000/75,000/35,000/30,000/60,000/80,000/Page 23 of 48
Endoscopic CSF rhinorrhea repair
Microsurgical excision of Acoustic tumour
Microsurgical excision of meningomas
Epilepsy surgery
RF lesion for facet pain syndrome
Cervical laminoplasty
Lateral mass C1 – C2 screw fixation
Microsurgical decompression for Trigemil nerve
Cerebellar stimulation for hemifacial spasm
Cerebellar stimulation for other cranial nerve
neuralgia
IC EC bypass procedures
Stereotactic guided craniotomy
Baclofen pump implantation lesioning for movement
disorder including Parkinsonism
Programmable shunt
Endoscopic sympathectomy
External ventricular drainage
Image guided surgery Excision of tethered
Endoscopic 3rd ventriculostomy
Endoscopic cranial surgery / Biopsy / aspiration/
aneurysm coiling
Endoscopic discectomy
Aneurysm coiling
Endoscopic spil procedure – aneurysm coiling
Surgery for grooving skull fractures–aneurysm coiling
Carpel Tunnel decompression
Clipping of intracranial aneurysm with use of clip
Endoscopic aspiration of intracerebellar haematoma
Stereotactic Radiosurgery for brain pathology (X
knife / Gamma)
Foramen magnum decompression
Foramen magnum decompression with syringo
subarachnoid shunt
Dorsal column stimulation for backache in failed
back syndrome
Surgery for recurrent disc prolapse / epidural fibrosis
Surgery brain stem tumours
Decompressive cranectomy for hemishpherical acute
subdural
Intra arterial thrombolysis with RTPA for ischemic
stroket RTPA – acute
Stereotactic aspiration of intracerebral haematoma
Complex Brain Surgery
Complex Spine Surgery
Dorsal Sympathectomy
Neuro rehabilitisation – package for 25 sittings (bed
charges extra)
Vascular Surgery
Patch Graft Angioplasty
Operations for Stenosis of Renal Arteries
Thrombendarterectomy
Operations for Acquired Arteriovenous Fistula
Congenital Arterio Venous Fistula
Surgery for Arterial Aneurysm – Vertebral
01027068
01027069
01027070
01027071
01027072
01027073
01027074
01027075
01027076
01027077
50,000/60,000/60,000/80,000/40,000/40,000/60,000/60,000/80,000/80,000/-
01027078
01027079
01027080
70,000/70,000/60,000/-
01027081
01027082
01027083
01027084
01027085
01027086
40,000/18,000/12,000/60,000/60,000/60,000/-
01027087
01027088
01027089
01027090
01027091
01027092
01027093
01027094
60,000/80,000/80,000/80,000/40,000/90,000/60,000/1,20,000/-
01027095
01027096
60,000/60,000/-
01027097
50,000/-
01027098
01027099
01027100
60,000/1,00,000/70,000/-
01027101
1,00,000/-
01027102
01027103
01027104
01027105
01027106
50,000/1,30,000/1,10,000/50,000/15,000/-
028
01028001
01028002
01028003
01028004
01028005
01028006
50,000/50,000/50,000/50,000/27,700/80,000/-
Page 24 of 48
Surgery for Arterial Aneurysm – Carotid
Surgery for Arterial Aneurysm – Main Arteries of the
Limb
Dissecting Aneurysms + Implant
Stripping of Short or Long Sephenous Veins
Ligation of Ankle Perforators
Excision and Sking Graft of Venous Ulcer
Venous Thromoectomy
Lymphatics Excision of Subcutaneous Tissues In
Lymphoedema
Trendelenburg Operations
Vascular Procedure – Minor
Surgery for Arterial Aneurysm Spleen Artery
Surgery for Arterial Aneurysm Renal Artery
Paediatric Surgery
Excision of thyroglossal Duct / Cyst
Diaphragmatic Hernia Repair (Thoracic or Abdominal
Approach)
Tracheo Oesophageal Fistula (Correction Surgery)
Colon Replacement of Oesophagus
Omphalo Mesenteric Cyst Excision
Omphalo Mesenteric Duct Excision
Meckels Diverticulecomy
Omphalocele 1st stage (Hernia Repair)
Omphalocele 2nd stage (Hernia Repair)
Gastrochisis Repair
Inguinal Herniotomy
Congenital Hydrocele
Hydrocele of Cord
Torsion Testis Operation
Congenital Pyloric Stenosis – operation
Duodenal – Atresia operation
Pancreatic Ring Operation
Meconium Ileus Operation
Malrotation of Intestines operation
Rectal Biopsy (Megacolon)
Colostomy Transverse
Colostomy Left Iliac
Abdominal Perineal Pull Through (Hirschaprugis
Disease)
Imperforate Anus Low Anomaly – Cut Back operation
Imperforate Anus Low Anomaly – Cut Back operation
Imperforate Anus High Anomaly – Sacroabdomino
Perineal Pull Through
Imperforate Anus High Anomaly – closure of
colostomy
Intususception Operation
Choledochoduodenostomy for Atresia of Extra
Hepatic Billiary Duct
Operation of Choledochal Cyst
Nephrectomy for – Pyonephrosis
Nephrectomy for – Hydronephrosis
Nephrectomy for – Wilms Tumour
Paraortic Lymphadenoctomy with Nephrectomy for
Wilms Tumour
01028007
01028008
42,500/50,000/-
01028009
01028010
01028011
01028012
01028013
01028014
1,50,000/30,000/17,400/15,500/22,100/30,000/-
01028015
01028016
01028017
01028018
029
01029001
01029002
30,000/16,800/40,200/40,200/-
01029003
01029004
01029005
01029006
01029007
01029008
01029009
01029010
01029011
01029012
01029013
01029014
01029015
01029016
01029017
01029018
01029019
01029020
01029021
01029022
01029023
40,000/40,000/30,000/30,000/30,000/28,000/30,000/24,000/24,000/24,000/22,000/25,000/27,000/35,000/45,000/30,000/32,000/25,000/28,000/28,000/35,000/-
01029024
01029025
01029026
22,000/28,000/25,000/-
01029027
21,000/-
01029028
01029029
35,000/35,000/-
01029030
01029031
01029032
01029033
01029034
35,000/35,000/35,000/35,000/40,000/-
30,000/35,000/-
Page 25 of 48
Sacro – Coccygeal Teratoma Excision
Neuroblastoma Debulking
Neuroblastoma Total Excision
Rhabdomyosarcoma wide Excision
Colon Transplant / Conduit Management following
Acid Structure oesophagus
Umbilical
Peripheral Long Line
LP
Peritoneal Tapping
Chest Drainage
General Nursery Care (including Nursing Care etc.)
Phototherapy per day
Neonate Rooming in with mother per day (inclusive
of Nursing Care)
SNCU (Sick New Born Care Unit)
Operation of Trigger finger of children under G.A.
Laproscopic / Endoscopic Operations In Gen.
Surgery / Gastrohepatic / Nephro Diagnostic Laproscopy
Laproscopic Pyloromyotomy
Laproscopic Gastorstomy
Laproscopic Closure of Perforate peptic ulcer
Laproscopic Vagotomy Pyleroplasty / gastro
jejunostomy
Laproscopic umbilical hernia repair
Laproscopic ventral hernia repair
Laproscopic cystogastrostomy
Lap. Cholecystectomy & CBD exploration
Lap. Hydatid of liver surgery
Lap. Hepatic resection
Lap. Assisted small bowel resection
Lap. For intestinal obstruction
Lap. For intestinal perforation
Lap. Assisted Right Hemicolectomy
Lap. Assisted left Hemicolectomy
Lap. Assisted Total Colectomy
Laproscopic rectiokext
Lap. Assisted Abdominoperineal Resection of rectum
Lap. Assisted anterior resection
Laproscopic Cholecystectomy
Laproscopic Appendicectomy
Laproscopic Hernia Repair
Laproscopic Hiatus Hernia Repair
Laproscopic Adhesiolysis
Laproscopic Adrenalectomy
Laproscopic Thyroidectomy
Laproscopic Spleenectomy
Laproscopic Colectomy
Laproscopic Nephrectomy
Inguinal Hernia (Laproscopic)
Laproscopic Pyelolithotomy
Ureterolithotomy
Lap. Ovarian Cystectomy
Laproscopic Hysterectomy
01029035
01029036
01029037
01029038
01029039
30,000/32,000/36,000/40,000/65,000/-
01029040
01029041
01029042
01029043
01029044
01029045
01029046
01029047
500/800/300/500/800/600/400/600/-
01029048
01029049
030
1,600/10,000/-
01030001
01030002
01030003
01030004
01030005
6,600/18,000/21,000/25,000/24,000/-
01030006
01030007
01030008
01030009
01030010
01030011
01030012
01030013
01030014
01030015
01030016
01030017
01030018
01030019
01030020
01030021
01030022
01030023
01030024
01030025
01030026
01030027
01030028
01030029
01030030
01030031
01030032
01030033
01030034
01030035
20,000/25,000/30,000/26,000/28,000/28,000/30,000/30,000/28,000/32,000/32,000/37,000/32,000/37,000/37,000/25,000/21,000/21,000/30,000/18,000/32,000/32,000/32,000/35,000/40,000/20,000/30,000/22,000/22,000/25,000/-
Page 26 of 48
Laproscopic Ectopic
01030036
Foreign body removal
01030037
Nephrolithotomy
01030038
Operations for Hydronephrosis – Pyeloplasty
01030039
Operations for Hydronephrosis – Endopyelotomy
01030040
antegrade
Operations for Cyst of the Kidney
01030041
URSL
01030042
Nephroureterectomy
01030043
Operations for Vesico – ureteric Reflux
01030044
Diverticulectomy
01030045
Repair of Ureterocoel
01030046
Operations for Varicocele Palomo’s – Unilateral
01030047
Operations for Varicocele Palomo’s – Bilateral
01030048
Nephrostomy
01030049
Orchidopexy – Unilateral
01030050
Orchidopexy – Bilateral
01030051
Prostratectomy
01030052
Laproscopic Uro stone
01030053
Incisional Hernioplasty
01030054
Radiotherapy & Chemotherapy (packages)
Nuclear Medicines – Radio Isotope Therapy
031
131 – Iodine Therapy < 15mCi
01031001
131 – Iodine Therapy 15 – 50mCi
01031002
131 – Iodine Therapy 51 – 100mCi
01031003
131 – Iodine Therapy > 100mCi
01031004
Strontium therapy for metastatic bone pain
01031005
palliation
Samarium – 153 therapy for metastatic bone paid
01031006
palliation
Cobalt 60 Therapy
032
Radical Therapy
01032001
Adjustment Therapy – Immobilisation technique
01032002
Palliative Therapy (less than 10 fractions)
01032003
Palliative Therapy (10-25 fractions)
01032004
Palliative Therapy (single fractions)
01032005
Linear Accelerators
033
3 – D Planning (L. Acc. Or Cobalt – 60)
01033001
2 – D Planning (L. Acc. Or Cobalt – 60)
01033002
Intensity Modulated Radio Therapy
01033003
Image Guided Radio Therapy (IGRT)
01033004
IGRT Single Fraction
01033005
3D – CRT (Confirmal Radio Therapy)
01033006
3D – CRT with IGRT
01033007
4D – CRT with IGRT
01033008
Stereotactic Radio Surgery (SRS)
01033009
Stereotactic Radio Therapy (SRT)
01033010
Rapid Arc with IMRT rate
01033011
Palliative Radiation Therapy upto 15 fractions
01033012
Palliative Radiation Therapy upto 25 fractions
01033013
Palliative Radiation single fractions
01033014
Conventional Radiation Therapy CT
01033015
Conventional Radiation Therapy CBCT
01033016
SRS / SRT Neuro interventional charge / case
01033017
Electron Beam (>10 Fractions)
01033018
22,000/4,000/35,000/35,000/35,000/40,000/25,000/50,000/40,000/22,000/35,000/20,000/30,000/16,000/25,000/30,000/45,000/30,000/35,000/-
5,200/16,900/16,900/19,500/7,200/10,700/-
70,000/16,000/15,000/25,000/5,000/6,000/5,000/1,05,000/1,50,000/7,000/65,000/75,000/90,000/85,000/70,000/1,00,000
25,000/35,000/10,000/35,000/45,000/10,000/40,500/-
Page 27 of 48
Electron Beam (<10 Fractions)
Pre-radiation profile
Brachy Therapy
Intra Cavitary Brachytherapy – 1st insertion
Intra Cavitary / Inra Luminal Brachytherapy – 2nd and
subsequent insertion
Intersititial Brach Therapy – 1st insertion
Intersititial Brach Therapy – 2nd insertion
01033019
01033020
034
01034001
01034002
9,000/2,500/-
01034003
01034004
15,000/10,000/-
5,500/3,000/-
Chemotherapy
035
Neoadjuvant
01035001
Adjuvant
01035002
Infusional Chemotherapy
01035003
Chemotherapy wafers for malignant brain tumours
01035004
Multiple drug therapy per day
01035005
Targeted therapy Chemoport facility
01035006
Chemoport facility
01035007
PICC line (Peripherally Inserted Central Canulisation)
01035008
Room Rent (per day)
036
General Ward
01036001
Semi – Private Ward
01036002
Private Ward
01036003
Day Care / Minor (OPD) Surgeries (all categories)
01036004
Admissible Blood Charges
For treatment in Government Hospitals
037
General Beds
01037001
Paying Beds
01037002
Cabin
01037003
For treatment in recognised Private Hospitals /
038
Nursing Homes / Aided Institutions
Whole Blood
01038001
F.F.P.
01038002
Platelet Concentrate
01038003
Platelet Rich Plasma
010358004
Packed Cell
01038005
Frozen Plasma
01038006
Crypoprecipitate
01038007
Washed RBC
01038008
1,000/1,000/1,000/20,000/900/1,000/1,500/1,000/600/1,200/1,800/600/-
50/100/140/-
500/400/400/400/400/350/300/400/-
RATES OF INVESTIGATIONS:
02 - INVESTIGATIONS
NAME OF INVESTIGATION
GENERAL
Aspiration Plural Effusion – Diagnostic
Abdominal Aspiration – Diagnostic
Pericardial Aspiration
Bone Marrow Aspiration
Joints Aspiration
E.C.G.
E.E.G.
Stress test (TMT)
Lumber puncture
CODE
001
02001001
02001002
02001003
02001004
02001005
02001006
02001007
02001008
02001009
Amount
Claimed
Amount
Admissible
(in `)
(in `)
750/900/1,200/800/750/140/800/850/1,000/Page 28 of 48
Sternal puncture
E.N.T.
Pure Tone Audiogram
Impedence & other tests
SISI, Tone Decay & Difference times
Multiple hearing assessment test to Adults
Hearing Aid Selection
Hearing Aid Analysis
Speech Discrimination Score
Speech Assessment
Cold Calorie Test for Vestibular function
Audiometry (MHC)
ABR (Threshold Est.)
Acoustic Reflex Decay
Eustachian Tube Func
IMP Audiometry
Otoacoustic Est. (OAE)
PEAD Audio Assessment
SRT & SDS
Swallowing Assest
Tympanometry
Voice Assest
Endo Laryngoscopy
ENG
Nasal Endoscopy
Nasopharyngoscopy
LV Dyssynchrony Study
Stroboscopy
Eye
Refraction / Fundoscopy
Ortho-optic check up
Perimetry / field test
Clinical Photography
Electrooculogram
ERG
Flourescein Angiography
A – Scan
Tono Graphy
Ver
Goldmen Perimetry
Specular microscopy
Indo cyaningreen Angiography of Retina
Indo cyaningreen Angiography – IRIS
Automated Perimetry
Corneal endothelial cell count
Corneal topography
Corneal pachymetry
Retinal nerve film analyser studies
Auto Refrectemetry
Biometry
Ultrasound studies – A Scan
Ultrasound studies – B Scan
Retinal / Meter function studies
PANACUTTY METER
Laser interferometry
02001010
002
02002001
02002002
02002003
02002004
02002005
02002006
02002007
02002008
02002009
02002010
02002011
02002012
02002013
02002014
02002015
02002016
02002017
02002018
02002019
02002020
02002021
02002022
02002023
02002024
02002025
02002026
003
02003001
02003002
02003003
02003004
02003005
02003006
02003007
02003008
02003009
02003010
02003011
02003012
02003013
02003014
02003015
02003016
02003017
02003018
02003019
02003020
02003021
02003022
02003023
02003024
02003025
02003026
800/300/300/250/450/100/400/200/200/180/250/650/100/100/300/550/200/150/30/150/250/850/1,300/600/600/1,400/700/150/150/400/100/500/400/800/200/450/300/150/200/1,000/1,000/450/200/200/200/100/60/180/600/600/150/200/1,000/Page 29 of 48
EKGEOG
Dacryocystography (DGC)
Orbital Angio studies
Digital Biometry Reading (Single)
Biometry (Both eyes)
Biometry – corp (Both)
Biometry – corp – Single
Pachymetry (Both Eyes)
Pachymetry (Single)
Multifocal ERG (One eye)
NCT
OCT – NFL Analyser
Schiotz Tonometer
TTT
VEP
Anterior Segment (Fundus) Photography
USG
Physiotherapy
Muscle testing and diagnostic
Dental
Intra oral X – ray (Digital)
Opg Cephalogram
Opg Standard View
Radio Visiograph (per Image)
Genetics
Fragile X Decet & Karyo of Peri Bld Cell
X – Ray (Digital X Ray)
Fluroscopy chest
Occlusal
Abdomen AP or Erect (one film)
Abdomen Lateral View (one film)
Abdomen for Pregnancy
Chest PA view (one film)
Chest Oblique or Lateral (one film)
Mastoids (one film)
Extremities, bones & joints (one film)
Pelvis (one film)
Paranasal sinuses (one film)
T.M. Joints (one film)
Abdomen & pelvis for K.U.B.
Skull A.P. & Lateral
Spine A.P. & Lateral
Barium Swallow
Sinography / Sialography
Cystography / Urethrography
Hystero – Salpaingography
Arthrography
Retrograde Pyelography
Oral or I.V. Cholecystography
Barium Enema
Barium Meal Upper or Lower
Bronchography
I.V. Urography / I.V.P.
Myelography
Pneumo Encephalography
02003027
02003028
02003029
02003030
02003031
02003032
02003033
02003034
02003035
02003036
02003037
02003038
02003039
02003040
02003041
02003042
02003043
004
02004001
005
02005001
02005002
02005003
02005004
006
02006001
007
02007001
02007002
02007003
02007004
02007005
02007006
02007007
02007008
02007009
02007010
02007011
02007012
02007013
02007014
02007015
02007016
02007017
02007018
02007019
02007020
02007021
02007022
02007023
02007024
02007025
02007026
02007027
02007028
500/500/500/180/350/400/300/400/200/800/160/1,600/250/2,500/600/300/550/100/80/210/210/110/3,500/120/130/130/130/130/130/130/150/140/140/140/140/250/250/250/700/750/1,120/1,110/840/1,080/720/1,160/960/1,260/1,350/1,500/1,120/Page 30 of 48
Barium meal Complete
Cerebral / Femoral Angiography
Periapical X-Ray
Barium Enema (Double Cont.)
Barium IC Junction
Gastro Contray Meal
Intravenous Pyelogram
T-Tube Cholangiogram
PTBD Gram
Micturating Cystourethrogram (MCU)
VUR / Cystourethrography (MCU)
Small Bowel Enema
Any XRAY using portable machine – addl handing
charge
Any other XRAY – single Film (Small)
Any other XRAY – single Film (Large)
Conventional X-Ray (70% of Digital X-Ray rates)
Fluroscopy chest
Occlusal
Abdomen AP or Erect (one film)
Abdomen Lateral View (one film)
Abdomen for Pregnancy
Chest PA view (one film)
Chest Oblique or Lateral (one film)
Mastoids (one film)
Extremities, bones & joints (one film)
Pelvis (one film)
Paranasal sinuses (one film)
T.M. Joints (one film)
Abdomen & pelvis for K.U.B.
Skull A.P. & Lateral
Spine A.P. & Lateral
Barium Swallow
Sinography / Sialography
Cystography / Urethrography
Hystero – Salpaingography
Arthrography
Retrograde Pyelography
Oral or I.V. Cholecystography
Barium Enema
Barium Meal Upper or Lower
Bronchography
I.V. Urography / I.V.P.
Myelography
Pneumo Encephalography
Barium meal Complete
Cerebral / Femoral Angiography
Periapical X-Ray
Barium Enema (Double Cont.)
Barium IC Junction
Gastro Contray Meal
Intravenous Pyelogram
T-Tube Cholangiogram
PTBD Gram
Micturating Cystourethrogram (MCU)
02007029
02007030
02007031
02007032
02007033
02007034
02007035
02007036
02007037
02007038
02007039
02007040
02007041
1,230/2,000/100/1,300/750/750/1,400/700/700/750/2600/1150/300/-
02007042
02007043
008
02008001
02008002
02008003
02008004
02008005
02008006
02008007
02008008
02008009
02008010
02008011
02008012
02008013
02008014
02008015
02008016
02008017
02008018
02008019
02008020
02008021
02008022
02008023
02008024
02008025
02008026
02008027
02008028
02008029
02008030
02008031
02008032
02008033
02008034
02008035
02008036
02008037
02008038
130/160/90/90/90/90/90/90/90/100/90/90/90/90/170/160/170/490/520/780/780/590/760/510/810/670/880/950/1050/780/860/1180/70/910/530/530/980/490/490/530/Page 31 of 48
VUR / Cystourethrography (MCU)
Small Bowel Enema
Any XRAY using portable machine – addl handing
charge
Any other XRAY – single Film (Small)
Any other XRAY – single Film (Large)
Ultrasound Investigations
Obstetric First Scan / Follow up
USG : Lower Abdomen / Pelvis
Upper abdomen First Scan / Follow up
Ultrasound – Neurosonogram
USG – Neurosonogram - Screening
Total Abdominal survey or Multiple organ study
Special Procedure & Aspiration etc.
Image Intensifiers
USG : Neck
USG : KUB
USG : Whole Abdomen
USG : Whole Abdomen + Transrectal
USG : Scrotum
USG : Testis
Ultrasound Bladder
Ultrasound Kidney / Renal
USG : Pregnancy + Doppler
USG : Joint (Unilateral)
USG : Joint (Bilateral)
USG : Musculoskeletal
USG : Transrectal
USG : Breast Unilateral
USG : Breast Bilateral
USG : Thyroid
USG : Cgest
USG : Prostate
USG : Single Organ
USG : Follicular Study
USG : Guided Procedure
USG : FNAC
USG : Follow-up-Ovulation
USG : For Congenital Anomaly
Ultrasound Parotid
Ultrasound Thigh
Any USG using portable machine-handling charge
Trans vaginal Sonography
Clinical Pathology
Urine routine
Quantitative Albumin / Sugar
Urine Bile Pigment and Salt
Urine Urobilinogen
Urine Ketones
Urine Occult Blood
Urine total proteins
Urine Sodium
Urine Chloride
Bence Jones protein
Stool routine
02008039
02008040
02008041
1820/810/300/-
02008042
02008043
009
02009001
02009002
02009003
02009004
02009005
02009006
02009007
02009008
02009009
02009010
02009011
02009012
02009013
02009014
02009015
02009016
02009017
02009018
02009019
02009020
02009021
02009022
02009023
02009024
02009025
02009026
02009027
02009028
02009029
02009030
02009031
02009032
02009033
02009034
02009035
02009036
010
02010001
02010002
02010003
02010004
02010005
02010006
02010007
02010008
02010009
02010010
02010011
90/110/500/800/600/900/350/950/1,230/700/850/800/950/1,500/900/600/600/600/2,200/900/1,800/800/800/700/1,050/800/700/550/550/1,250/600/900/600/1,800/800/800/200/800/60/50/50/50/50/50/100/100/100/90/60/Page 32 of 48
Stool occult blood
Post coital smear examination
Smear analysis
Body fluid (CSF / Ascitic Fluid etc.) Chemistry, Sugar,
Protein etc.
Body fluid for Malignant cells
Urinary Porphobilinogen
Urinary Myoglobin
Urine for Immuno electrophoresis
Urine for Protein Electrophoresis
CRK ISO Enzyme Electrophoresis
Hb Electrophoresis
Chyle Test
Semen Analysis
IVF Semen Analysis
Stool Reducing Substance
Stool for OVA, Parasite
Stool for Parasite
Stool Culture & Sensitivity
Urine for Culture & Sensitivity
Karyotype Chromosome Analysis
Genotyping
Glucotyping
Urine for Electrolytes
Urine Amino – aciduria
Urine for Phosphorus
Urine for Z-N Stain
Urine Protein / Creatinine Ratio
Opiates Serum Random Urine
Opiates Random Urine
Urine Ammino Acid, Qualitative, 2 Dimensional
Pre / Post-Dialysis Creatinine
Pre / Post-Dialysis Potassium
Pre / Post-Dialysis Sodium
Pre / Post-Dialysis Urea
Haematology
Haemoglobin (Hb)
Total Leucocytic Count (TLC)
Differential Leucocytic Count (DLC)
E.S.R.
Total Red Cell count
Platelet count
Reticulocyte count
Absolute Eosinophil count
Packed Cell Volume (PCV)
Peripheral Smear Examination
Smear for Malaria parasite
Bleeding & Clotting Time
Clot Retraction Time
R.B.C. Fragility Test
L.E. Cell
Foetal Haemoglobin (Hb-F)
Prothrombin Time (P.T.)
Complete Haemogram
Bone Marrow Smear Examination
02010012
02010013
02010014
02010015
60/100/100/240/-
02010016
02010017
02010018
02010019
02010020
02010021
02010022
02010023
02010024
02010025
02010026
02010027
02010028
02010029
02010030
02010031
02010032
02010033
02010034
02010035
02010036
02010037
02010038
02010039
02010040
02010041
02010042
02010043
02010044
02010045
011
02011001
02011002
02011003
02011004
02011005
02011006
02011007
02011008
02011009
02011010
02011011
02011012
02011013
02011014
02011015
02011016
02011017
02011018
02011019
200/110/400/3500/2800/5000/600/100/280/250/60/70/60/200/250/2400/5000/5000/200/150/220/60/250/450/450/700/100/100/100/80/50/50/50/50/60/80/70/60/50/70/70/60/50/100/120/250/150/180/400/Page 33 of 48
Partial Thromboplastin
Glucose 6 Phosphate Dehydrogenase (G, 6PD)
P.C.V. Haematocrit
RBC Folate
Whole Blood Folate
Sickling Test
Bleeding Time
Clotting Time
D-Dimer Semi Quantitative
Sucrose Lysis Test
Red Cell Osmotic Frag. With Incubato
Heinz Body Test
Fibrinogen
FDP
Plasma Haemoglobin
Factor VIII Studies
Factor IX Functional
Factor V Functional
Factor V Lieden Mutation Analysis
TC, DC, ESR
Absolute Lymphocytes Count
HB, TC, DC
Bone Marrow [Perls Stain]
Cell Type & Cell Count
Nasal Smear for Eosinophils
CSF Cell Counts [TC / DC]
Complete Blood Picture
MCV MCH MCHC
Investigation of ABO / RH
Sinovial Fluid for Analysis
Blood Parasites
Malaria Parasite
Malarial Antigen Detection
Filaria Antigen W. Bancrofti
Lap Score
BAL Cell Count
Cold Agglutination
AT III
AT III Anti Thrombin
Absolute Neutrophil Count
Osmotic Fragility
HLA Typing
T – Cell Cross Matching
Karyotyping for Bone Marrow Cancer (REL)
Sucrose Lysis Test
APTT (50:50)
Immunofixation Electroporesis
Material Antigen Detection
Blood Bank
Blood Group & RHO Type
Cross match
Packed Cells – Proc. Charges
Saline Washed Packed Cells: Proc. Charges
Coomb’s Test Direct / Indirect
Australia Antigen
02011020
02011021
02011022
02011023
02011024
02011025
02011026
02011027
02011028
02011029
02011030
02011031
02011032
02011033
02011034
02011035
02011036
02011037
02011038
02011039
02011040
02011041
02011042
02011043
02011044
02011045
02011046
02011047
02011048
02011049
02011050
02011051
02011052
02011053
02011054
02011055
02011056
02011057
02011058
02011059
02011060
02011061
02011062
02011063
02011064
02011065
02011066
02011067
012
02012001
02012002
02012003
02012004
02012005
02012006
200/220/50/1,350/1,350/120/40/40/900/280/280/120/400/150/190/1,000/1,200/2,500/4,000/120/80/120/750/320/90/170/180/180/360/400/70/70/320/560/400/100/150/650/650/50/120/10,000/5,000/6,000/280/200/7,200/450/140/50/450/450/200/200/Page 34 of 48
RHO, Antibody titer
Platelet rich Plasma – Proc. Charges
Whole Human Blood –I.P. – Proc. Charges
Fresh frozen Plasma: Proc. Charges
Cryoprecipitate: Proc. Charges
Platelet Concent - Proc. Charges
Therapeutic Phlebotomy: Proc. Charges
Granulocyte Conc. : Proc. Charges
Bio-Chemistry
Glucose blood – Fasting / PP / Random
Blood Urea Nitrogen / Blood Urea
Serum Creatinine
Serum Uric Acid
Serum Bilirubin total / direct
Serum Iron
Serum Cholesterol
Total Iron Binding Capacity
CK MB
Serum Calcium
Serum Phosphorus
Total Protein Alb / Glo Ration
S.G.P.T.
S.G.O.T.
Serum amylase
Serum Electrolyte
Triglyceride
Glucose Tolerance Test (GTT)
C.P.K.
L.D.H.
L.D. – 1
LDH & LD – 1
T3
T4
TSH
T3, T4, TSH
FSH
LH
FSH & LH
Prolactin
Blood gas analysis
Blood gas analysis with electrolytes
Cortisol
HDL Cholesterol
VLDL Cholesterol
ALDL / LDL Cholesterol
Lipid Profile
L.F.T. [Liver Function Test]
Alkaline Phosphatase
Acid Phosphatase
Leucocyte Alkaline Phosphatase Score
Serum Magnesium
Serum Copper
Serum Lithium
Serum Lipase
Serum Chloride
02012007
02012008
02012009
02012010
02012011
02012012
02012013
02012014
013
02013001
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02013019
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02013027
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02013032
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02013035
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02013037
02013038
02013039
02013040
02013041
02013042
02013043
02013044
02013045
02013046
250/450/450/450/450/450/450/450/70/80/100/110/130/220/120/300/390/120/120/140/120/120/250/250/220/300/270/210/320/470/300/300/300/700/420/410/670/470/400/500/650/200/170/480/700/750/150/300/600/170/500/250/250/150/Page 35 of 48
Serum Inorganic Phosphorous
Serum Ceruloplasmin
Serum Carbamazepine / Tegretol
Carbamazepine
Serum Calcitonin
Calcitonin
Myoglobin Serum
Serum C Peptide
Serum C Peptide (PP)
Serum Eption /Phenytoin
Albumin (Serum)
Serum Eption / Phenytoin
Albumin (Serum)
Serum Sodium
Serum Folate
Folate & Vitamin 12 Serum
Serum Aldolase
Serum Acetaminophen
Serum Growth Hormone
Parathyroid Hormone (PTH), Intact
Serum Osmolality
Serum Potassium
Serum TIBC
Serum Parathormone Level
Serum Homocystine / Homocystine/ Homocystine Level
Serum Individual Phospolipids – TLC
Serum / Plasma Bicarbonate
Serum Haptoglobin
Serum Testosterone
Serum Thyroglobulin
Lactate Plasma
CA – 19-9
CA – 125
CA – 15.3
CA – 72.4 Gastric Cancer Marker
CSF Sugar
CSF Protein
Lactate (CSF)
CSF – Protein Electropherisis
CSF – Oligoclinal Band Analysis
CSF for Biochemical Analysis
CSF Chloride
CSF Profile
Sodium Bicarbonate
Mucopolysaccharidoses (MPS) Screening U
Renin Activity Plasma, PRA
Plasma Ammonia
Fructosamine
GGT – Gamma Glutamy l Transaminase
Globulin
Estradiol
Estradiol (E2)
Glycosylated Haemoglobin [HBAIC]
Alpha I Anti Trypsin Assay
Insulin-P.P. / Fasting / Random
02013047
02013048
02013049
02013050
02013051
02013052
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02013054
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02013080
02013081
02013082
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02013084
02013085
02013086
02013087
02013088
02013089
02013090
02013091
02013092
02013093
02013094
02013095
02013096
02013097
02013098
02013099
02013100
02013101
02013102
160/750/1,400/600/1400/1200/2400/800/500/700/120/720/600/240/720/1,110/400/650/550/1,200/250/150/280/900/750/450/350/850/500/1,360/550/1,000/800/160/1,050/100/100/400/800/2,000/280/150/3,200/100/500/4,000/400/200/320/120/520/420/520/1,200/650/Page 36 of 48
Lactose Tolerance Test
DHEA-S (Sulphate)
Serum Digoxin / Serum Digoxin Level
Serum Gastrin
Progesterone
Beta HCG (B – HCG)
Beta HCG Quantitative Trophoblastic Cancer Marker
Cardiac Enzymes
LDH Heat Stable Fraction
LDH Isoenzymes
Antiphospolipid Antibody IGG & IGM
Antiphospolipid Antibody IGM
Anti – Sperm Antibody / ABS
Alpha – Feto Protein (AFP) Cancer Marker
Carcino Embryonic Antigen [CEA]
Anti – Thyroid Antibodies
Anti – Thyroid Antibodies – TG Ab
Bicarbonate
Anti Cardiolipin Antibody – Ig G / IgM
Anti Cardiolipin Antibody Profile
C _ Peptide Assay
Cyst Fluid for Analysis
Trop – T
Troponin T – Qualitative
Intracellular Calcium
Pleural / Peritoneal Fluid for Sugar & Urea
Peritoneal Dialysis Fluid for Sugar & Urea
Apolipo Proteins
Free testosterone
Blood Acetone / Ketone
Pleural Fluid for Protein
Pleural Fluid for LDH
Pleural Fluid for Amylase
Fluid for LDH
Fluid for Amylase
Fluid for Creatinine
Fluid for Lipase
Fluid for Cholesterol
Phenytoin Level
24H Ketosteroid & Ketogenic Steroid
Angio Tension Converting Enzyme (ACE)
Phenobarbitone
Anti Thyroid Antibodies TPO Ab
Anti TG
ACTH
ACTH Plasma
Intact PTH
IGFI
IGFI – I (Somatomedin – C)
B – 2 Microglobulin
Valporic Acid
Valproate
Sex Hormone Binding
Vitamin B – 12 Level
Vitamin D 25 Hydroxy
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02013112
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02013146
02013147
02013148
02013149
02013150
02013151
02013152
02013153
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02013155
02013156
02013157
550/800/700/900/450/650/600/450/640/1,430/1,050/750/550/650/600/950/900/150/650/1,700/350/350/820/400/120/80/220/500/600/240/80/200/180/160/130/110/130/150/720/1,700/780/720/900/550/960/960/700/350/2,800/960/520/520/1,200/800/1,400/Page 37 of 48
17 Hydroxy Corticostiroids
Lipoprotein (a)
Synovial Fluid for Biochemistry
Plasma Catecholamines
Serum IgA
Serum IgG
Serum IgM
Pericardial Fluid for Biochemistry
Pericardial Fluid Test
Peritoneal Fluid – Biochemistry
Aldosterone
Galactosemia Profile
FISH (NH)
FISH for BCR / ABL
Fluid for TVPCR
Serum Cortisone
Transferrin
Chromogranin A
Cryo Globulin Screening
Cocaine Metabolite Screen
Cyclosporine CO
Cytokeratin / Erythropoietin
Protein C / S, Functional
Histopathology
Pap Smear
Histopathology exam per tissue type
Bacteriology & Serology
Smear gram – stain examination
Sputum smear A.F.B. stain
Vaginal Smear Examination
V.D.R.L.
Widal test
Rheumatoid Factor test
Culture & Sensitivity (other specimens)
Urine pregnancy test
C.R.P.
ASO Titer
Quantitative H.C.G.
Blood culture & sensitivity
Vibro Cholera culture
CAPD Fluid for Culture & Sensitivity
CAPD Fluid for Fungal Stain / Gram Stain
CAPD Fluid – Cytology
Rapid Urease Test
ASO (Antistreptoysin “O”)
High Sensitivity – CRP
PUS for Fungal Culture
PUS for Fungal Stain
PUS for Gram Stain
PUS for Z – N Stain
Culture & Sensitivity [PUS]
Culture & Sensitivity [CSF]
Culture & Sensitivity [Semen]
Culture & Sensitivity [Fluid]
Culture & Sensitivity [Sputum]
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02013177
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02013180
014
02014001
02014002
015
02015001
02015002
02015003
02015004
02015005
02015006
02015007
02015008
02015009
02015010
02015011
02015012
02015013
02015014
02015015
02015016
02015017
02015018
02015019
02015020
02015021
02015022
02015023
02015024
02015025
02015026
02015027
02015028
580/400/480/5,500/220/220/400/360/100/450/1,150/1,800/2,800/3,200/1,400/380/780/5,000/780/500/1,600/1,200/2,800/240/250/100/100/100/120/180/300/250/200/220/250/400/250/250/350/100/200/250/360/400/250/100/100/100/250/250/250/250/250/Page 38 of 48
Culture & Sensitivity [Throat Swab]
Culture & Sensitivity for Vaginal Swab
Culture & Sensitivity for Aspirated Fluid
Culture & Sensitivity [Wound Swab]
Wound Swab for Fungal Stain
Wound Swab for Gram Stain
Wound Swab for Z – N Stain
Culture & Sensitivity [Rectal Swab]
Nail for Fungal Culture
Nail Clipping for KOH preparation
Blood Culture & Sensitivity – Anaerobic
Blood Culture & Sensitivity [Paediatric]
Tissue for Culture & Sensitivity
Mitral Valve Tissue for Culture & Sensitivity
Aortic Valve Tissue for Culture & Sensitivity
Arterial Line Tip for Culture & Sensitivity
Ascitic Fluid for Culture & Sensitivity
AC Tap for Culture & Sensitivity
Sputum for AFB Culture
Sputum for Fungal Culture
Sputum for Fungal Stain
Sputum for Z – N Stain
Sputum for Grams Stain
Esophageal Smear for Candida
Urine for AFB Culture
Pleural Fluid for AFB Culture
Pleural Fluid – TBPCR
Culture AFB Antibiotic Sensitivity – 5 Drug Panel
Urine for Gram Stain
Throat Swab for KLB
Fungus Culture
Clostridium Difficile Toxin A & B
Yeast Identification and Susceptibility
Non – Fermenter Identification
Serology for Mumps IGM / IGG
Torch Profile
Serum Antigens Conv. Enzy.
P – ANCA
C – ANCA
Aldehyde Serum Test
Elisa Test for Ecinococcus Antibody Detec
Ascitic Fluid Cell Count
Anti HBS (Antibody to Australia – Antigen)
Hepatitis B Surface Antibody
Anti – HBC Core Antibody IgM
Serum Immunoglobulin
Immunoglobulin IGE
IGE Allergy Individual
Immunoglobulin - IGA
Immunoglobulin – IGM
Immunoglobulin – IGG
Anti – HAV – IGM – Antibody
Compliment C3
Compliment C4
Toxoplasma – IgG
02015029
02015030
02015031
02015032
02015033
02015034
02015035
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02015083
250/250/250/250/100/100/100/250/200/100/600/600/250/250/250/250/600/250/500/150/100/100/100/150/500/500/1,200/3,000/100/100/150/1,200/350/300/1,000/1,500/400/800/800/80/600/200/400/400/550/600/500/600/600/600/600/1,000/350/350/370/Page 39 of 48
Toxoplasma – IgM
Toxoplasma – IgG + IgM
Cysticercosis Antibody / Antibody IgG
Cytomegalovirus, PCR
PCR for AFB
Herpes I (IgG)(HSV Type I)
Herpes I (IgM)(HSV Type I)
Herpes I (IgG)(HSV Type II)
Herpes I (IgM)(HSV Type I)I
Herpes I + II (IgG)
Herpes I + II (IgM)
TPHA (Treponema Pallidum Haemagglutinat)
HBsAG
Hydatid Cyst for IgG Elisa
Aspergillus Antibody (IGG / IGM)
Anti HCV IgG / IgM
Anti HEV IgG / IgM
Allergy Screening – Adult
Dengue Elisa
Dengue Antibodies IgG + IgM
Dengue NSI Ag Test
Screening for C – Pylori [RUTI]
Elisa for Tuberculosis [IGG / IGM / IGA]
Febrile Agglutinis [Widal. Weli – FEI]
HBe Antigen Detection (HBeAg)
CMV (Cytomegalo Virus) Antibody [IGM]
Brucella Antibody
Breast Cancer ERPR and HER2 / NEU
Anti HCV IIIrd Generation Elisa
Epstein Bar Virus IGM [VCA Elisa]
HEV IgM Elisa
Legionella Pneumophila – Elisa
Elisa for Pregnancy
Elisa for Mumps (IgG Antibody)
Elisa for Measles (IgG Antibody)
Mumps Elisa (IgM Antibody)
HIV P24Antigen
Vivax Antigen
Anti Smooth Muscle Antibody (ASMA)
Anti-Mitochondrial Antibody – M2(AMA – M2)
Anti – Nuclear Antibody / ANF / ANA
ANAIFA (HEP – 2) Method
Anti – Native Deoxyribonucleic Acid (Ds-DNA)
Antismith Antibody
Rubella IgG /IgM Antibody
Rubella IgG & IgM
Rubeola IgG /IgM Antibody
Rubeola Antibodies IgG & IgM
Leptospira Antibody IGM/IGG
Leptospira Antibody IGG & IGM
Cyptococcus Antigen – Latex Detection (CSF)
Falciparum Antigen
ADA (Adenosine Deaminase – Body Fluid)
Mantoux Test
Anti – HAV – Total (IGG & IGM)
02015084
02015085
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02015087
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02015112
02015113
02015114
02015115
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02015120
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02015122
02015123
02015124
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02015134
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02015138
370/700/600/2,000/1,350/300/300/300/300/300/300/340/420/600/1,000/820/840/1,200/1,000/600/600/200/350/400/550/350/420/2,400/350/600/700/600/630/450/450/520/600/350/500/750/450/960/700/650/360/650/1,000/1,400/840/1,650/1,300/360/450/150/720/Page 40 of 48
Cytomegalo Virus (CMV) Antibody [IGG]
CMV IgM + IgG
Chopra Aldehyde Test
Amniotic Fluid – Lecithin Spingomyl
Amoebiais Antibodies [IHA] Screening
Amoebic Serology
KOH Mount for Fungal Elements Detection
Campylobacter Jejieni Antigen Detection I
HIV Test ( 1 &2)
Typhi DOT – M
Hepatitis B-Core, total (HBC total, IGG + IGM)
Anti HBC Antibody (IgM)
Anti HBC Antibody (Total)
Anti HBE
Hepatitis Be Antibody
Hepatitis D Virus Antibody
HLAB27CHN
HLA – B27, Disease Association Flow Cytometry
HLA – ABC & DR Tissue Cross match
HCV RNA PCR Qualitative
Hepatitis C Viral RNA Genotype, LIPA
Varicella – Zoster Virus IGG Titres
Varicella Zoster IgM
Varicella Zoster IgG & IgM
Anti LKM-1 (Liver Kidney Microsomal – 1)Antibody
Viable MTB Detection – PCR
HIV Qualitative (Window Period Detection)
Anti Sclero 70 / SCL 70
Comprehensive CNS Panel – (Molecular Dia)
HIV Proviral DNA Detector Qualitative
Hepatitis B PCR Quantitative
Hepatitis B Virus PCR Qualitative
Anti GBM Antibody +
HSV DNA PCR
Anti RNP – Sm Antibody
Antibody to Ribonucleo Protein IgG
NBT Reduction Test
Anti Jo Antibody
Anti Jo – 1 Antibodies
Antibody to SSA / SSB
Antibody to SSA / LA
Japanese Encephalitis Virus PCR (JE Virus P)
HIV – 1 RNS Quantitative RT-PCR with CD-3, CD-4, CD
RNS Study / Decrement
HIV Viral Load CD4 & CD8
Anti RNP – Sm IgG
Anti Endomysial Antibody IgA
CD – 4, CD – 8
CD 10
CD 20
CD 3
CD 30
HCV RNA Quantitative / Viral Load
HBV Quantitative
HBV DNA Qualitative
02015139
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02015190
02015191
02015192
02015193
320/600/100/400/280/800/100/360/450/160/720/720/720/550/550/1,450/920/1,500/2,000/2,500/9,500/520/720/1,400/820/1,500/1,200/1,300/6,800/1,100/1,900/3,000/900/1,500/1,000/1,100/720/520/840/2,000/720/1,500/3,800/350/3,200/1,100/720/700/1,200/920/920/920/6,000/5,500/1,900/Page 41 of 48
Mycobacterium IgA / IgG / IgM
Mycobacterium IgG / IgM
Mycobacterium Tuberculosis Serology EL
TB PCR (Mycobacterium tuberculosis PCR)
Treponema Pallidum Antibody Detection
Treponemal Pallisum, FTPA – ABF
Autoimmune Hepatitis Panel
Antinuclear antibody Panel (14 antibody panel)
Anti CCP Antibody
Anti Centromere Antibody
Serum Procalcitonin
Serum Prealbumin
HSV (1 + 2)IgG/IgM Antibodies
HSV (1+2) IgG and HSV (1 + 2) IgM
Chikungunya Test
ANA / ANF in Dilution
Bronchial Aspiration for Culture & Sensitivity
Bronchial Aspiration for AFB Culture
Bronchial Aspiration for Fungal Stain
Bronchial Aspiration for Gram Stain
Bronchial Aspiration for TBPCR
CVP Tip for Culture & Sensitivity
Dialysis Catheter Tip for C / S
Ear / Eye / Nasal / Tongue Swab for Culture & Sensitivity
Prostatic Secretion for Microscopy
Prostrate Specific Antigen (PSA)
BCR abl transcript quantification
Aerobic by Bactec
Dengue Serology lgG & lgM
Obstetric Cases
Examination under anaesthesia
Laparoscopy (Gynae)
Lap. Dye Test with removal of adhesions
Biopsies (Specimen processing per tissue type)
Biopsy [Large]
Biopsy [Medium]
Biopsy [Small]
Biopsy [Extra Large]
Head & Neck Cancer
Cardio Respiratory Procedures
Direct Laryngoscopy
Bronchoscopy
Mediastinoscopy
Pleural Biopsy
Thoracoscopy
Pulmonary function test BMR
Spirometry
Spirometry with Helium Dilution
Spirometry with Helium Dilution with diffusion capacity
studies
Pulmonery exercise testing
Punctal Cautery
NT Pro BNP
Cardioversion
Cardiac Troponin I
02015194
02015195
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02015197
02015198
02015199
02015200
02015201
02015202
02015203
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02015205
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02015207
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02015209
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02015211
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02015214
02015215
02015216
02015217
02015218
02015219
02015220
02015221
02015222
016
02016001
02016002
02016003
017
02017001
02017002
02017003
02017004
018
019
02019001
02019002
02019003
02019004
02019005
02019006
02019007
02019008
02019009
600/500/1,900/850/300/2,000/900/1,100/450/800/2,000/550/280/550/500/1,000/300/500/100/100/1,400/300/300/300/150/500/4,000/900/1,200/-
02019010
02019011
02019012
02019013
02019014
940/100/1,000/1,400/400/-
2,430/6,060/8,000/600/500/350/800/-
4,380/2,400/2,880/3,630/6,600/700/700/1,620/1,620/-
Page 42 of 48
TEE with Anesthesia
Testicular
Flexible Bronchoscopy – Diagnostic – TBNA
Flexible Bronchoscopy – Therapeutic
Flexible Bronchoscopy – Glue
Flexible Bronchoscopy – Baloon Tampete
Flexible Bronchoscopy – Toileting
Rigid Bronchoscopy – Diagnostic
Rigid Bronchoscopy – Massive Haemoplysis
Fibroptic bronchoscopy
Fibroptic Bronchoscopy with Washing / Biopsy
Cardiac / Cardio Thoracic Procedures
Test of Pacemaker
Stress Myocardial Study (MBI / TR)
Echo Screening
Stress Echo / Dobutamine Echo
Foetal Echocardiography
Cardio Tocography
2D Echo with colour Doppler/ 2D Echo Cardiography
Trans Oesophaedral Echo (TEE)
Holter Analysis & Holter Report (with Prd. Specification)
/ Tilt Table Test
Cardiac Cath Angiography (Without Coronary
Angioplasty)
Aortogram
Package charges for Cardiovascular investigation
Stress Thallium
Muga (Resting)
Muga (Stress)
Echo Colour Doppler
Check Angio
Doppler Carotid Artery
Flow tron Excel (DVT)
Abdomen / Gastroenterology
Gastroscopy
Gastric & Duodenal Biopsy (Endoscopic)
ERCP
ERCP Fluroscopy
Upper G.I. Endoscopy
Upper G.I. Endoscopy with Biopsy
Sigmoidoscopy (rigid)
Sigmoidoscopy (flexible)
Oesophagoscopy
Colonoscopy
Colonoscopy – Full (GAS-PKG)
24 H PH Metry
24 H PH Metry (BS)
Nephrology / Genitourinary
Biopsy of Bladder (Cystoscopic)
Urethroscopy
Glomerular Filtration Rate
Urethral dialatation – Diagnostics
Visually Evoked Potential
Uroflow Study (Micturometry)
Urodynamic Study (Cystometry)
02019015
02019016
02019017
02019018
02019019
02019020
02019021
02019022
02019023
02019024
02019025
020
02020001
02020002
02020003
02020004
02020005
02020006
02020007
02020008
02020009
2,500/800/10,000/2,500/4,000/4,000/2,600/5,000/6,200/2,100/2,500/-
02020010
13,200/-
02020011
02020012
02020013
02020014
02020015
02020016
02020017
02020018
02020019
021
02021001
02021002
02021003
02021004
02021005
02021006
02021007
02021008
02021009
02021010
02021011
02021012
02021013
022
02022001
02022002
02022003
02022004
02022005
02022006
02022007
3,900/410/3,600/1,440/1,800/1,440/7,000/1,700/500/-
580/7,200/720/1,950/1,320/360/1,320/840/1,470/-
1,170/1,560/4,000/2,200/1,100/1,300/1,400/1,200/1,100/1,800/2,000/4,000/5,500/8,000/6,000/500/1,000/500/600/1,200/-
Page 43 of 48
Cystoscopy with Retrograde Catheter Unilateral
Cystoscopy with Retrograde Catheter Bilateral
Cystoscopy Diagnostic
Cortisol – blood
Voiding – cysto – urethrogram
Renal Transplant Evaluation
Orthopaedic Surgery Procedure
Arthrography & Osteomedullography
Arthroscopy – Diagnostic
Neurology
Placement of ICP Monitor –
Lumber Pressure Monitoring
Nerve Biopsy
Brain Biopsy
Brain Mapping
Ambulatory Electro Ence
Blink Reflex
Decrement Test
EMG Four Limbs
EMG Two Limbs
NCV Four Limbs
NCV Two Limbs
EMG – Facial
NCV – Facial
NCV + EMG – Facial
Spincter – EMG
H Reflex
SSEP (Lower Limbs)
SSEP (Upper Limbs)
SSEP – UL / LL
VEP (Flash)
VEP (PR)
Counsl of INH Patient
Spl Edu Assessment
Baer Study
Baer / Threshold
Councelling & Therapy
IQ Assessment
Neuro Psychological T
Personality & IQ Child
Personality Development T
SSR
Lumbar puncture with CSF Monitoring
HER – 2 / NEU
Breast
Mammography (Single side)
Mammography (Both side)
Gynae, Operation Charges
Diagnostic Curettage
Fractional Curettage
Hysteroscopy Diagnostic
Laproscopic Operations in Gen. Surgery /
Gastrohepatic /Nephro –
Diagnostic Laproscopy
Specialised Procedures / Investigations / C.T. Scan
02022008
02022009
02022010
02022011
02022012
02022013
023
02023001
02023002
024
02024001
02024002
02024003
02024004
02024005
02024006
02024007
02024008
02024009
02024010
02024011
02024012
02024013
02024014
02024015
02024016
02024017
02024018
02024019
02024020
02024021
02024022
02024023
02024024
02024025
02024026
02024027
02024028
02024029
02024030
02024031
02024032
02024033
02024034
025
02025001
02025002
026
02026001
02026002
02026003
027
02027001
028
4,000/6,000/5,000/240/360/1,500/11,000/11,000/6,000/6,100/8,500/8,500/3,000/5,000/500/650/900/480/900/500/500/500/950/550/500/550/550/1,000/550/550/200/250/550/1,000/200/300/850/450/650/700/1,500/1,200/800/1,500/3,000/3,400/7,500/-
7,000/-
Page 44 of 48
Cat Scan (C.T.) Head
C.T. Head Scan Involv. Spl. Investigation
C.T. Scan Brain
HRCT Chest Thorax
C.T. Chest (HRCT)
C.T. Scan Chest
C.T. Spine (Cervical, Dorsal, Lumber, Sacral)
C.T. Angiogram of Cervical and Intra
C.T. Cervical C.T. 3D Reconstruction only -C.T. Guided Biopsy
C.T. Guided percutaneous cath drainage
C.T. Myelogram (Cervical Spine)
C.T. Myelogram (Lumber Spine or D/S)
CT Pelvis with Hip Joints
CT KUB (Plain)
CT Sacro Iliac Joint
CT Pituitary / Sella
CT Cisternography
CTPetrous Temporal Bone
CT Sacrum & Coccyx
CT Scan Upper Abdomen
CT Scan Lower Abdomen
CT Scan Whole Abdomen
CT Shoulder Joint / Knee Joint / Elbow Joint/ Any Other
Joint (Plain)
CT Base of Neck
CT Scan Neck (Thyroid Soft Tissue)
CT Ankle with Foot
C.T. Scan Orbits / Eye
CT Arm / Humerus / Forearm / Radius –Ulna/ Leg /
Tibia-Fibula/ Thigh / Femur (Single) Plain
C.T. Scan Limbs
CT Both Thigh
C.T. Scan Whole Body
CT Extremities
C.T. Scan of Para Nasal Sinus
CT guided FNAC
CT Angiography of Brain / Carotid / Thorax / Neck
CT 64 Coronary Angiography
CT Angiography of Brain / Carotid / Thorax / Neck /
Abdomen / Extremities / Renal area/ Peripheral area/
Pulmonary area with Visipaque
CT Renal Angiography
CT Angio Both Lower Limbs
CT Angiography of Neck Vessels
CT Angiography of Abdomen / Extremities / Renal area/
Peripheral area/ Pulmonary area
PET CT Scan (Whole Body) (including Flurodeoxy
Glucose)
Therapeutic Aspiration – CT
Diagnostic Aspiration – CT
Ionic Contrast (20 C.C.)
Ionic Contrast (50 C.C.)
Non-Ionic Contrast (10 C.C.)
Non-Ionic Contrast (25 C.C.)
02028001
02028002
02028003
02028004
02028005
02028006
02028007
02028008
02028009
02028010
02028011
02028012
02028013
02028014
02028015
02028016
02028017
02028018
02028019
02028020
02028021
02028022
02028023
02028024
1,600/2,300/1,600/6,000/4,000/3,500/3,500/7,200/1,200/2,000/2,500/3,500/3,500/3,000/3,500/2,500/2,500/1,600/3,000/3,500/3,000/3,000/5,000/3,500/-
02028025
02028026
02028027
02028028
02028029
2,000/3,000/2,000/3,000/4,500/-
02028030
02028031
02028032
02028033
02028034
02028035
02028036
02028037
02028038
2,500/2,000/10,000/2,000/3,000/2,500/5,400/10,000/6,500/-
02028039
02028040
02028041
02028042
5,000/10,000/5,000/6,000/-
02028043
20,000/-
02028044
02028045
02028046
02028047
02028048
02028049
3,000/1,600/270/675/500/750/-
Page 45 of 48
Non-Ionic Contrast (50 C.C.)
Non-Ionic Contrast (100 C.C.)
3D Reconstruction charge
CT Dual Phase Study – Liver
Fibroscan
MRI
MRI Brain /Brain with Protocol / CSF Study / Internal Ear
MRI Base of Skull
MRI Orbits
MRI Face
MRI Nasopharynx and PNS
MRI Pharynx
MRI Neck
MRI Pituitary
MRI Thyroid / Cranio-Vertebral (C.V.) Junction /
MRI Temporal Bones (Unilateral)
MRI Venography / Angiography
MRI Arm/ Fore Arm/ Thigh/ Femur/ Leg/ Foot
MRI Arm (Humerus)(Left / Right)
MRI – Single Joint
MRI – Both Joints
MRI Sacro Iliac Joints
MRI Spine (Cervical/ Dorsal/ Lumber/ Cervico-Dorsal/
Dorso-Lumbar/ Lumbo-Sacral)
MRI Lumbar Spine & Sacroiliac Joint
Double Region Plain (Brain & Spine)
Tripple Region Plain (Brain & Spine)
MRI CSF Flow Study
MRI Spectroscopy
MRI Diffusion Tensor Imaging (DTI)
MRI SWI (Susceptibility Weighted Image)
MRI Hip
MRI Urogram
MRI Pelvis
MRCP
MRI Extremities
MRI Upper Abdomen with MRCP
MRI Temporomandibular Single Joint
MRI Temporomandibular Double Joints
MRI Upper Abdomen
MRI Upper Thigh & Lower Abdomen
MRI Whole Abdomen
MRI Lower Abdomen/ Pelvis
MRI Breast
MRI Thoracic Outlet
MRI Spine Screening
MRI Brachial Plexus
MRI Chest
MRI Brain with Spectroscopy
MRI Brain with perfusion
MRI Brain with Orbit/PNS/Angio/Neck Angio
MRI Brain with DTI (Diffusion Tensor Imaging)/ SWI
(susceptibility Weighted Image)/ Cranial Nerve
Evaluation
MRI Perfusion Study
02028050
02028051
02028052
02028053
02028054
029
02029001
02029002
02029003
02029004
02029005
02029006
02029007
02029008
02029009
02029010
02029011
02029012
02029013
02029014
02029015
02029016
02029017
1,250/2,100/1,200/5,000/3,500/-
02029018
02029019
02029020
02029021
02029022
02029023
02029024
02029025
02029026
02029027
02029028
02029029
02029030
02029031
02029032
02029033
02029034
02029035
02029036
02029037
02029038
02029039
02029040
02029041
02029042
02029043
02029044
02029045
6,000/9,000/13,000/1,500/1,500/1,500/1,500/6,000/5,400/6,000/5,000/6,000/6,000/5,000/6,000/5,400/7,000/9,000/5,400/6,000/5,400/5,400/5,400/5,400/6,000/7,300/6,500/6,000/-
02029046
3,500/-
6,000/5,400/6,000/5,400/6,000/5,400/6,000/5,400/5,000/6,000/5,400/5,400/5,400/5,400/9,000/5,400/5,400/-
Page 46 of 48
MRI Screening
Screening Single Area with Films
Screening Double Area with Films
MRI Small Part
MRI Other Region
Contrast (Ionic / Non-ionic)
Other Investigation
Fluoroscopic Screening
Oxygen Saturation
Bone Densitometry Single site
Bone Densitometry Two sites
Bone Densitometry Three sites
(Spine, Hip & one extremity)
Bone Densitometry Whole Body
A.V. Fistula
Immunology
Hepatitis B DNA
HBV DNA Quantitative / Viral Load
Nuclear Medicines
Isotope Venography
Gallium – 67 Scan / Gallium Scan
Thyroid Scan
Iodine – 131 Thyroid Scan
Thyroid (Tc99m) Scan
Para Thyroid Scan
Thallium Scan
Spect Myocardial Perfusion Scan (Thalium/ Tetro)
Spect Myo Perfusion Rest Scan (Thalium / Tero / Mie)
Nuclear Blood Pool Scan
Radio-Isotope Ureteric Reflux (Indirect)
Whole Body Tc – V – DMSA Scan
Brain Spect (Tumour Imaging)
Tumour Immagery
Bone Scan Spect (Single Region)
Bone Scan – three phase (Single Region)
Bone Scan Spect (whole body)
Tc 99m DMSA Renal Scan
Profiles
Lipid Profile
Thyroid Profile
Total Diabetic Profile
Pre Cath Profile
Coagulation Profile
LFT [Liver Function Test]
Pre Dialysis Serology
Dialysis Profile
Hepatitis B Profile
Hepatitis Panel
Neuro Profile
Septic Profile
Paediatric Septic Profile
Basic Metabolic Panel (BMP)
Comprehensive Metabolic Panel (CMP)
Anaemia Screen (HAEMI)
Thrombocytopenia Screen (HAEM2)
02029047
02029048
02029049
02029050
02029051
02029052
030
02030001
02030002
02030003
02030004
02030005
5,400/1,500/3,000/4,000/5,400/2,500/-
02030006
02030007
031
02031001
02031002
032
02032001
02032002
02032003
02032004
02032005
02032006
02032007
02032008
02032009
02032010
02032011
02032012
02032013
02032014
02032015
02032016
02032017
02032018
033
02033001
02033002
02033003
02033004
02033005
02033006
02033007
02033008
02033009
02033010
02033011
02033012
02033013
02033014
02033015
02033016
02033017
2,200/3,000/-
120/120/800/1,200/1,600/-
5,200/6,000/3,500/8,500/1,800/2,500/1,800/6,000/9,000/11,000/5,500/2,000/3,000/3,500/2,500/5,000/1,800/2,700/3,000/2,000/700/1,200/1,000/850/550/750/600/500/3,000/1,800/2,000/900/1,800/320/500/2,800/3,400/Page 47 of 48
Mycloma Screen (HAEM3)
Lymphoma Screen (HAEM4)
Polycythaemia (HAEM5)
Thallasaemia Patient Screen (HAEM6)
Thallasaemia Counselling Serum (HAEM7)
CRBSI
ACTH Stim
Growth Hormone Stim
Male GnRH Stim
Female GnRH Stim
Bone Marrow Profile
EP Screening Profile
Torch Profile
Renal Profile
Septic Profile (Hb, TC, DC, Platelets, ESR, P. Smear, Toxic
Granules, Bad Cell, CRP)
02033018
02033019
02033020
02033021
02033022
02033023
02033024
02033025
02033026
02033027
02033028
02033029
02033030
02033031
02033032
2,700/2,000/1,800/3,000/1,200/550/1,900/2,000/3,500/3,300/550/1,100/1,500/330/780/
Page 48 of 48