Sr.

Department Service Name OP Rates General Twin Private Deluxe

No. Ward Sharing Room
1 REGISTRATION REGISTRATION CHARGES 100 - - - -
CHARGES
2 REGISTRATION ADMISSION CHARGES - 300 300 300 300
CHARGES
3 REGISTRATION MLC CHARGES 500 2,000 2,000 2,000 2,000
CHARGES
4 REGISTRATION AMBULANCE CHARGES AS PER POLICY
CHARGES
5 ROOM CHARGES DAYCARE BED CHARGES 3 1,500 - - - -
HOURS
6 ROOM RENT BED CHARGES - 1,800 3,200 5,100 6,400
7 ROOM CHARGES RMO CHARGES - 300 350 400 500

8 ROOM CHARGES NURSING CHARGES - 200 250 300 400

9 FOOD & DIET DIET CHARGES 200 200 200 200

TOTAL (6+7+8+9) 2,500 4,000 6,000 7,500
9 CONSULTATION CONSULTATION CHARGES 800 800 1,000 1,000 1,200
MD/MS
10 CONSULTATION REVIEW CONSULTATION 400 400 700 700 800
CHARGES MD/MS
11 CONSULTATION CONSULTATION CHARGES 1,000 1,000 1,200 1,200 1,500
Mch/DM
12 CONSULTATION REVIEW CONSULTATION 500 500 800 800 1,100
CHARGES Mch/DM
13 CONSULTATION DIETICIAN CONSULTATION 350 350 350 350 350
CHARGES
14 CONSULTATION EMO CHARGES 1,500 - - - -

15 EQUIPMENT Alpha Bed Charges - Full day - 800 800 800 800
16 EQUIPMENT BIPAP - Full Day - 2,500 2,500 2,500 2,500
17 EQUIPMENT BIPAP - Half Day - 1,250 1,250 1,250 1,250
18 EQUIPMENT monitor- Full Day - 500 500 800 800
19 EQUIPMENT monitor- Half Day - 300 300 500 500
20 EQUIPMENT C-PAP - Full Day - 2,500 2,500 2,500 2,500
21 EQUIPMENT Oxygen Charges - Full day ( In - 500 500 700 1,000
non critical area )
22 EQUIPMENT Oxygen Charges - Half day ( In - 350 350 400 700
non critical area )
23 EQUIPMENT Oxygen Charges - per hour ( In - 200 200 - -
non critical area )
24 EQUIPMENT Syringe Pump - Full Day ( In non - 350 350 350 500
critical area )
25 EQUIPMENT Ventilator - Full day - - - - -
26 EQUIPMENT Ventilator - Half day - - - - -
27 EQUIPMENT Ventilator Bipap non invasive - - - - -
 Super MICU SICU
Deluxe
- - -

300 300 300

2,000 2,000 2,000

R POLICY

- - -

7,900 6,400 6,400

500 500 500

400 400 400

200 200 200

9,000 7,500 7,500
1,500 1,500 1,500

1,100 1,100 1,100

1,800 1,800 1,800

1,500 1,500 1,500

350 350 350

- - -

800 800 800

3,000 3,000 3,000
2,000 2,000 2,000
800 1,000 1,000
500 700 700
3,000 3,000 3,000
1,200 1,000 1,000

800 700 700

- - -

500 500 500

- 8,100 8,100
- 5,200 5,200
- 3,500 3,500
 - OP Rate General - Twin - Single
- Ward Sharing - MICU
Department- ANESTHESIA Casualty - Day - SICU Deluxe
Care
Sr. No. Service Name OP Rates General Twin Private Deluxe
Ward Sharing Room
1 ANESTHESIA CHARGES - GRADE A 4,250 4,250 5,500 6,800 8,500
2 ANESTHESIA CHARGES - GRADE B 5,350 5,350 6,950 8,550 10,700
3 ANESTHESIA CHARGES - GRADE C 6,350 6,350 8,250 10,200 12,700
4 ANESTHESIA CHARGES - GRADE D 7,500 7,500 9,750 12,000 15,000
5 ANESTHESIA CHARGES - GRADE E 8,500 8,500 11,050 13,600 17,000
6 CAUDAL EPIDURAL BLOCK 4,250 4,250 5,550 6,800 8,500
7 EPIDURAL BLOCK - CERVICAL 15,750 15,750 20,500 25,200 31,500
8 EPIDURAL BLOCK - DORSAL 15,750 15,750 20,500 25,200 31,500
9 EPIDURAL BLOCK - LUMBAR 12,850 12,850 16,700 20,550 25,700
10 FACET BLOCK - MULTIPLE - CERVICAL 12,850 12,850 16,700 20,550 25,700
11 FACET BLOCK - MULTIPLE - LUMBAR 9,700 9,700 12,600 15,550 19,400
12 FACET BLOCK - SINGLE - CERVICAL 9,700 9,700 12,600 15,550 19,400
13 FACET BLOCK - SINGLE - LUMBAR 7,250 7,250 9,500 11,600 14,500
14 I V CANNULATION 850 850 1,100 1,350 1,700
15 INTRATHECAL INJECTION 7,250 7,250 9,500 11,600 14,500
16 INTRATHECAL PUMP IMPLANTATION 42,950 42,950 55,850 68,750 85,900
17 LABOUR ANALGESIA 5,350 5,350 6,950 8,550 10,700
18 LUMBER PUNCTURE BY ANESTHETIST 3,250 3,250 4,250 5,200 6,500
19 NERVE BLOCK - DIAGNOSTIC 5,550 5,550 7,250 8,850 11,100
20 NERVE BLOCK - RF ABLATION 17,000 17,000 22,100 27,200 34,000
21 NERVE BLOCK - THERAPEUTIC 8,500 8,500 11,050 13,600 17,000
22 NEUROLYTIC BLOCK 13,000 13,000 16,900 20,800 26,000
23 PLEXUS BLOCK 9,700 9,700 12,600 15,500 19,400
24 PLEXUS BLOCK - CONTINUOUS 9,700 9,700 12,600 15,500 19,400
25 SELECTIVE NERVE ROOT BLOCK - 12,850 12,850 16,700 20,550 25,700
CERVICAL
26 SELECTIVE NERVE ROOT BLOCK - 23,450 23,450 30,500 37,550 46,900
LUMBER
27 SYMPATHETIC BLOCK - LUMBAR 13,600 13,600 17,700 21,750 27,200
28 TRIGEMINAL NEURALGIA - RF ABLATION 20,800 20,800 27,050 33,300 41,600

29 TRIGGER POINT INJECTION 13,600 13,600 17,700 21,750 27,200

30 US GUIDED COELIAC PLEXUS BLOCK - 17,000 17,000 22,100 27,200 34,000
DIAGNOSTIC / THERAPEUTIC
31 US GUIDED GANGLION IMPAR - 17,000 17,000 22,100 27,200 34,000
DIAGNOSTIC / THERAPEUTIC
32 USG /C ARM GUIDED PERIPHERAL 13,600 13,600 17,700 21,750 27,200
NERVE BLOCK
33 USG /C ARM GUIDED STELLATE 14,800 14,800 19,250 23,700 29,600
GANGLION BLOCK
USG /C ARM GUIDED SUPERIOR HYPOGASTRIC 17,000 17,000 22,100 27,200 34,000
34 BLOCK - DIAGNOSTIC /
THERAPEUTIC
Super
Deluxe

Super
Deluxe
10,650
13,400
15,900
18,750
21,250
10,600
39,400
39,400
32,200
32,200
24,250
24,250
18,200
2,200
18,200
107,400
13,400
8,200
13,900
42,500
21,250
32,500
24,250
24,250
32,200

58,650

34,000
52,000

34,000
42,500

42,500

34,000

37,000

42,500
 - OP Rate General Ward - Twin - Single
- Casualty Sharing - MICU
Department- CRITICAL CARE - Day - SICU
Care
SR. NO. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 ARTERIAL BLOOD GAS ( ABG ) INVESTIGATION 1,200 1,200 1,550 1,950

2 ARTERIAL LINE INSERTION PROCEDURE 3,100 3,100 4,050 4,950

3 ARTERIAL LINE INSERTION - USG PROCEDURE 1,700 1,700 2,200 2,750
GUIDED
4 ASCITIC TAP DIAGNOSTIC - USG PROCEDURE 1,900 1,900 2,450 3,050
GUIDED
5 ASCITIC TAP THERAPEUTIC PROCEDURE 2,800 2,800 3,650 4,500
6 ASPIRATION JOINTS PROCEDURE 9,700 9,700 12,600 15,500
7 BLADDER WASH PROCEDURE 4,250 4,250 5,550 6,800
8 BONE MARROW ASPIRATION PROCEDURE 8,900 8,900 11,550 14,250
9 BRONCHOSCOPY BEDSIDE PROCEDURE 11,500 11,500 14,950 18,400
10 CARDIAC OUTPUT ( PROCEDURE 2,200 2,200 2,850 3,500
HEMODYNAMIC ) MONITORING
11 CENTRAL VENOUS LINE (CVL) - PROCEDURE 3,200 3,200 4,200 5,200
INSERTION
12 CENTRAL VENOUS LINE) INSERTION PROCEDURE 2,900 2,900 3,750 4,650
(CVL) - USG GUIDED
13 DIALYSIS CATHETERIZATION PROCEDURE 4,500 4,500 5,850 7,200
14 DRESSING LARGE PROCEDURE 850 850 1,100 1,350
15 ENDOTRACHEAL INTUBATION PROCEDURE 3,500 3,500 4,550 5,600
16 ENEMA PROCEDURE 500 500 650 800
FEES ( FIBEROPTIC ENDOSCOPIC 3,100 3,100 4,050 4,950
17 EVALUATION OF SWELLING ) PROCEDURE

18 GASTRIC LAVAGE PROCEDURE 550 550 700 850

19 INSERTION CATHETER - PROCEDURE 3,200 3,200 4,200 5,200
EPIDURAL
20 INSERTION CATHETER - FOLEYS PROCEDURE 500 500 650 800
BY DOCTOR
21 INSERTION INTERCOASTAL PROCEDURE 4,700 4,700 6,200 7,550
DRAIN
22 INSERTION OF NASAL PACK PROCEDURE 9,200 9,200 11,950 14,750
23 INSERTION SWAN-GANZ PROCEDURE 5,350 5,350 6,950 8,550
24 INTER COSTAL BLOCK PROCEDURE 2,200 2,200 2,850 3,550
25 INTRAMASCULAR INJECTION PROCEDURE 300 300 400 450
26 INTRAVENOUS INJECTION PROCEDURE 200 200 250 350
27 IV CANNULATION BY DOCTOR PROCEDURE 450 450 590 750
28 LUMBAR PUNCTURE PROCEDURE 2,200 2,200 2,850 3,550
29 MAGSULF DRESSING PROCEDURE 650 650 850 1,050
30 MANUAL EVACUATION OF STOOL PROCEDURE 250 250 350 400

31 MINITRACHEOSTOMY PROCEDURE 1,850 1,850 2,400 2,950

32 NASO GASTRIC TUBE INSERTION PROCEDURE 350 350 450 550
(RYLES TUBE)
33 NEBULIZATION PROCEDURE 300 300 390 500
34 NEEDLE THORACOSTOMY PROCEDURE 800 800 1,050 1,300
35 NON TRAUMA RESUSITATION PROCEDURE 1,700 1,700 2,200 2,750
36 ONCO CENTRAL LINE DRESS PROCEDURE 2,200 2,200 2,850 3,550
AND FLUSH
37 ONCO CHEMOPORT ACCESS PROCEDURE 2,400 2,400 3,200 3,850
AND FLUSH
38 ONCO INTRATHECAL PROCEDURE 4,800 4,800 6,250 7,700
CHEMOTHERAPY
39 ONCO PICC LINE DRESS AND PROCEDURE 1,300 1,300 1,690 2,100
FLUSH
40 PERICARDIOCENTESIS PROCEDURE 11,500 11,500 14,950 18,400
Deluxe Super
Deluxe

Deluxe Super
Deluxe
2,400 3,000

6,200 7,750
3,400 4,250

3,800 4,750

5,600 7,000
19,400 24,250
8,500 10,700
17,800 22,250
23,000 28,750
4,400 5,500

6,400 8,000

5,800 7,250

9,000 11,250
1,700 2,200
7,000 8,750
1,000 1,250
6,200 7,750

1,100 1,400
6,400 8,000

1,000 1,250

9,400 11,750

18,400 23,000
10,700 13,400
4,400 5,500
600 750
400 500
900 1,200
4,400 5,500
1,300 1,650
500 650

3,700 4,650
700 900

600 750
1,600 2,000
3,400 4,250
4,400 5,500

4,800 6,000

9,600 12,000
 2,600 3,250

23,000 28,750
41 PERITONEAL CATHETERISATION PROCEDURE 13,900 13,900 18,000 22,300

42 PIGITAL NEPHROTOMY PROCEDURE 2,200 2,200 2,850 3,550

CATHETER
43 PIGTAIL CATHERIZATION PROCEDURE 4,600 4,600 5,950 7,400
44 PLASMA PHARESIS PROCEDURE 5,600 5,600 7,300 8,950
45 PLEURAL TAPPING - DIAGNOSTIC PROCEDURE 3,400 3,400 4,450 5,450

46 PLEURAL TAPPING - DIAGNOSTIC PROCEDURE 2,200 2,200 2,850 3,550

- USG GUIDED
47 PLEURAL TAPPING - PROCEDURE 2,300 2,300 2,990 3,700
THERAPEUTIC
48 PLEURAL TAPPING - PROCEDURE 3,350 3,350 4,400 5,350
THERAPEUTIC - USG GUIDED
49 RECTAL LAVAGE PROCEDURE 1,100 1,100 1,450 1,750
50 REMOVAL CATHETER - FOLEYS PROCEDURE 200 200 250 350

51 REMOVAL OF INTERCOSTAL PROCEDURE 1,700 1,700 2,200 2,750

TUBE
52 SCVO2 MONITORING - PROCEDURE 2,400 2,400 3,150 3,850
CONTINOUS
53 SKIN TRACTION PROCEDURE 450 450 600 750
54 SPIROMETRY ( Bed Side ) DIAGNOSTIC 1,400 1,400 1,800 2,250
55 SUPRAPUBIC CATHETERIZATION PROCEDURE 2,550 2,550 3,350 4,100
(URINARY)
56 SUTURE REMOVAL LARGE 10-20 PROCEDURE 450 450 600 750
STITCHES
57 SUTURE REMOVAL MEDIUM 5-10 PROCEDURE 750 750 950 1,200
STITCHES
58 SUTURE REMOVAL SMALL 1-5 PROCEDURE 250 250 350 400
STITCHES
59 SYRINGE PUMP INFUSION PROCEDURE 300 300 390 500
60 THORACIC EPIDURAL PROCEDURE 15,900 15,900 20,650 25,450
61 TRACHEOSTOMY PROCEDURE 13,850 13,850 18,000 22,200
62 Tetanus injection PROCEDURE 150 150 200 250
63 Tdap injection PROCEDURE 150 150 200 250
64 URETHRAL CATHETERIZATION PROCEDURE 450 450 600 750
65 US GUIDED VENOUS ACCESS PROCEDURE 2,200 2,200 2,850 3,550
(BED SIDE)
66 USG GUIDED PIGTEL DRAINAGE PROCEDURE 5,800 5,800 7,550 9,300

67 VAC DRESSING LARGE PROCEDURE 6,400 6,400 8,350 10,300

68 VAC DRESSING MEDIUM PROCEDURE 5,350 5,350 6,950 8,550
69 VAC DRESSING SMALL PROCEDURE 3,750 3,750 4,850 6,000
70 VACUUM DRESSING PROCEDURE 2,200 2,200 2,850 3,550
71 WOUND DRESSING - GRADE - 1 PROCEDURE 850 850 1,100 1,400

72 WOUND DRESSING - GRADE - 2 PROCEDURE 1,550 1,550 2,000 2,500

73 WOUND DRESSING - GRADE - 3 PROCEDURE 1,950 1,950 2,550 3,200

74 WOUND DRESSING - GRADE - 4 PROCEDURE 2,550 2,550 3,300 4,100

75 WOUND DRESSING - GRADE - 5 PROCEDURE 3,250 3,250 4,250 5,200

76 WOUND DRESSING - GRADE - 6 PROCEDURE 4,250 4,250 5,550 6,800

77 WOUND DRESSING - GRADE - 7 PROCEDURE 5,350 5,350 6,950 8,500

78 WOUND DRESSING - GRADE - 8 PROCEDURE 6,350 6,350 8,250 10,200

79 WOUND DRESSING - GRADE - 9 PROCEDURE 7,990 7,990 10,400 12,800

 80 WOUND DRESSING - GRADE - 10 PROCEDURE 10,600 10,600 13,750 16,950

81 SUTURING OF LACERATION - PROCEDURE 850 850 1,100 1,400

GRADE - 1
82 SUTURING OF LACERATION - PROCEDURE 1,550 1,550 2,000 2,500
GRADE - 2
83 SUTURING OF LACERATION - PROCEDURE 1,950 1,950 2,500 3,200
GRADE - 3
84 SUTURING OF LACERATION - PROCEDURE 2,550 2,550 3,300 4,000
GRADE - 4
85 SUTURING OF LACERATION - PROCEDURE 3,250 3,250 4,250 5,200
GRADE - 5
86 SUTURING OF LACERATION - PROCEDURE 4,250 4,250 5,550 6,800
GRADE - 6
87 SUTURING OF LACERATION - PROCEDURE 5,350 5,350 6,950 8,550
GRADE - 7
88 SUTURING OF LACERATION - PROCEDURE 6,300 6,300 8,190 10,050
GRADE - 8
89 SUTURING OF LACERATION - PROCEDURE 7,900 7,900 10,300 12,650
GRADE - 9
90 SUTURING OF LACERATION - PROCEDURE 10,600 10,600 13,750 16,950
GRADE - 10
91 DEBRIDEMENT - GRADE - 1 PROCEDURE 850 850 1,100 1,400
92 DEBRIDEMENT - GRADE - 2 PROCEDURE 1,500 1,500 1,950 2,400
93 DEBRIDEMENT - GRADE - 3 PROCEDURE 1,900 1,900 2,450 3,050
94 DEBRIDEMENT - GRADE - 4 PROCEDURE 2,550 2,550 3,350 4,100
95 DEBRIDEMENT - GRADE - 5 PROCEDURE 3,250 3,250 4,250 5,200
96 DEBRIDEMENT - GRADE - 6 PROCEDURE 4,250 4,250 5,550 6,800
97 DEBRIDEMENT - GRADE - 7 PROCEDURE 5,350 5,350 6,950 8,550
98 DEBRIDEMENT - GRADE - 8 PROCEDURE 6,350 6,350 8,300 10,200
99 DEBRIDEMENT - GRADE - 9 PROCEDURE 7,900 7,900 10,300 12,650
100 DEBRIDEMENT - GRADE - 10 PROCEDURE 10,600 10,600 13,800 16,950
101 TRAUMA RESUSITATION - GRADE PROCEDURE 3,250 3,250 4,250 5,200
-1
102 TRAUMA RESUSITATION - GRADE PROCEDURE 6,350 6,350 8,250 10,200
-2
103 TRAUMA RESUSITATION - GRADE PROCEDURE 9,600 9,600 12,500 15,400
-3
104 IMMUNISATION CHARGES PROCEDURE 1,300 1,300 1,690 2,000
105 VACCINATION CHARGES PROCEDURE 450 450 600 750
27,800 34,750

4,400 5,500

9,200 11,500
11,200 14,000
6,800 8,500

4,400 5,500

4,600 5,750

6,700 8,350

2,200 2,750
400 500

3,400 4,250

4,800 6,000

900 1,200
2,800 3,500
5,100 6,400

900 1,200

1,500 1,850

500 650

600 750
31,800 39,750
27,700 34,650
300 400
300 400
900 1,200
4,400 5,500

11,600 14,500

12,800 16,000
10,700 13,400
7,500 9,400
4,400 5,500
1,700 2,200

3,100 3,850

3,900 4,850

5,100 6,400

6,500 8,200

8,500 10,650

10,700 13,400

12,700 15,900

15,950 19,900
21,200 26,500

1,700 2,200

3,100 3,850

3,900 4,850

5,100 6,400

6,500 8,200

8,500 10,650

10,700 13,400

12,600 15,750

15,800 19,750

21,200 26,500

1,700 2,200
3,000 3,750
3,800 4,750
5,100 6,400
6,500 8,400
8,500 10,650
10,700 13,400
12,700 15,900
15,800 19,750
21,200 26,500
6,500 8,200

12,700 15,900

19,200 24,000

2,600 3,250
900 1,200
 - OP Rate General - Twin - Single Deluxe
- Ward Sharing - MICU
Department- CARDIOLOGY Casualty - Day - SICU
Care
SR. Service Name Service Head OP Rates General Twin Private Deluxe
NO. Ward Sharing Room
1 AMBULATORY BP MONITORING INVESTIGATION 1,800 1,800 2,350 2,900 3,600

2 BARORECEPTOR REFLEX SENSITIVITY INVESTIGATION 4,200 4,200 5,450 6,750 8,400

TEST
3 BODY FAT ANALYSIS INVESTIGATION 350 350 450 550 700

4 Carotid IMT (Carotid Intima Media INVESTIGATION 2,100 2,100 2,750 3,400 4,200
Thickness Test)
5 CONTRAST CHARGES - NON IONIC INVESTIGATION 850 850 1,100 1,400 1,700
DYE (50 ML )
6 DOBUTAMINE STRESS ECHO (DSE) INVESTIGATION 3,500 3,500 4,550 5,600 7,000

7 DOBUTAMINE STRESS ECHO (DSE) INVESTIGATION 4,100 4,100 5,350 6,550 8,200
WITH CONTRAST
8 ECG INVESTIGATION 350 350 450 550 700

9 ECHOCARDIOGRAPHY INVESTIGATION 2,600 2,600 3,400 4,700 5,200

10 3 D ECHOCARDIOGRAPHY INVESTIGATION 3,500 3,500 4,550 5,600 7,000

11 4 D ECHOCARDIOGRAPHY INVESTIGATION 4,000 4,000 5,200 6,400 8,000

12 EXERCISE STRESS INVESTIGATION 3,500 3,500 4,550 5,600 7,000

ECHOCARDIOGRAPHY
EXERCISE STRESS ECHOCARDIOGRAPHY WITH
13 CONTRAST INVESTIGATION 4,000 4,000 5,200 6,400 8,000

14 FETAL ECHOCARDIOGRAPHY INVESTIGATION 2,550 2,550 3,300 4,100 5,100

15 FLOW MEDIATED DILATATION (FMD)- INVESTIGATION 1,350 1,350 1,750 2,200 2,700
AUTOMATED
16 FMD-MANUAL INVESTIGATION 450 450 600 750 900

17 HEAD-UP TILT TEST INVESTIGATION 2,200 2,200 2,850 3,550 4,400

18 HOLTER MONITORING INVESTIGATION 3,300 3,300 4,300 5,300 6,600

19 ICD PROCEDURE (PACKAGE) PACKAGE -- 79,900 103,850 127,850 159,800

20 PAEDRIATIC ECHOCARDIOGRAPHY INVESTIGATION 2,550 2,550 3,300 4,100 5,100

21 PAEDRIATIC TRANS ESOPHAGEAL INVESTIGATION 2,900 2,900 3,750 4,650 5,800

ECHOCARDIOGRAPHY
22 PFT/Spirometry INVESTIGATION 1,200 1,200 1,550 1,900 2,400

23 PULMONARY FUNCTION STUDIES + INVESTIGATION 1,400 1,400 1,850 2,250 2,800

GCV + FEVI
24 PULSE WAVE ANALYSIS INVESTIGATION 1,700 1,700 2,250 2,750 3,400

25 REVIEW - CAROTID DOPPLER INVESTIGATION 850 850 1,100 1,350 1,700

26 REVIEW - ECHO INVESTIGATION 850 850 1,100 1,350 1,700

27 REVIEW - PERIPHERAL DOPPLER INVESTIGATION 850 850 1,100 1,350 1,700

28 REVIEW - VASCULAR DOPPLER INVESTIGATION 850 850 1,100 1,350 1,700

29 TRANS ESOPHAGEAL INVESTIGATION 2,800 2,800 3,650 4,500 5,600

ECHOCARDIOGRAPHY (TEE)
30 TRANS THORACIC ECHO (TTE) INVESTIGATION 1,900 1,900 2,500 3,050 3,800

31 TRANSTHORACIC ECHO (TTE) WITH INVESTIGATION 2,700 2,700 3,500 4,350 5,400
CONTRAST
32 TREAD MILL TEST INVESTIGATION 1,900 1,900 2,450 3,050 3,800
Super
Deluxe

Super
Deluxe
4,500

10,500

900

5,250

2,200

8,750

10,250

850

6,500

8,750

10,000

8,750

10,000

6,400

3,400

1,200

5,500

8,250

235,000
6,400

7,250

3,000

3,500

4,250

2,200

2,200

2,200

2,200

7,000

4,750

6,750

4,750
 - Single
- MICU
- SICU
- OP Rate
- Twin Sharing - Transplant
Department- DENTAL - General Ward
- Day Care ICU
Casualty

SR. NO. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
ABOVE WITH BLOWOUT 21,250 27,650 34,000
1 FRACTURE ORBIT SURGEON FEE

2 BIMAXLLARY SURGEON FEE 72,250 93,950 115,600

OSTEOTOMY
BLEACHING_ADDITIO 2,000 2,000 2,600 3,200
3 NAL BLEACH TUBE PROCEDURE

BLEACHING_BLEACH ING 10,100 10,100 13,150 16,200

4 OFFICE GRADE 1 PROCEDURE

BLEACHING_BLEACH ING 9,000 9,000 11,700 14,400

5 OFFICE GRADE 2 PROCEDURE

BLEACHING_BLEACH ING 12,000 12,000 15,600 19,200

6 OFFICE GRADE 3 PROCEDURE

BLEACHING_BLEACH ING 17,000 17,000 22,100 27,200

7 OFFICE GRADE 4 PROCEDURE

8 BLEACHING_BLEACH PROCEDURE 2,500 2,500 3,250 4,000

ING TRAYS
9 BLEACHING_WALKIN PROCEDURE 2,800 2,800 3,650 4,500
G BLEACH
BLOWOUT 21,250 27,650 34,000
10 FRACTURE ORBITAL SURGEON FEE
FLOOR
11 BONE GFRATING PROCEDURE 6,300 6,300 8,200 10,000
GRADE I
12 BONE GFRATING PROCEDURE 8,500 8,500 11,050 13,600
GRADE II
13 BONE GFRATING PROCEDURE 12,750 12,750 16,600 20,400
GRADE III
14 BONE GFRATING PROCEDURE 17,000 17,000 22,100 27,200
GRADE IV
15 BONE PATHOLOGY SURGEON FEE
SURGICAL PROCEDURE
GRADE 1 36,550 47,500 58,500

16 BONE PATHOLOGY SURGEON FEE

SURGICAL PROCEDURE
GRADE 48,450 63,000 77,550
2
CALD WELLUC 10,550 10,550 13,700 16,850
17 OPERATION Grade 1 PROCEDURE

CALD WELLUC 17,000 17,000 22,100 27,200

18 OPERATION Grade 2 PROCEDURE

CIRCUMMANDIBULAR 8,900 11,600 14,250

19 /CIRCUMFERNTIAL SURGEON FEE
WIRING
20 CIRCUMZYGOMATIC SURGEON FEE 11,900 15,450 19,050
FIXATION
 CORRECTION OF 11,900 15,450 19,050
21 MALUNITED SURGEON FEE
FRACTURE
CORRECTION 15,700 20,400 25,200
ZYGOMATIC COMPLEX
22 FRACTURE GRADE 1 SURGEON FEE

CORRECTION 23,800 30,950 38,100

ZYGOMATIC COMPLEX
23 FRACTURE GRADE 2 SURGEON FEE

24 CORRECTION SURGEON FEE

ZYGOMATIC COMPLEX
FRACTURE Grade3 28,000 36,400 44,800

25 COSMETICS SURGEON FEE

CORRECTION OF SOFT
TISSUE GRADE 42,500 55,250 68,000
1
26 COSMETICS SURGEON FEE
CORRECTION OF SOFT
TISSUE GRADE 2 48,500 63,050 77,600

27 COSMETICS SURGEON FEE

CORRECTION OF SOFT
TISSUE GRADE 3 72,250 93,950 115,600

CYST ENUCLEATION 18,250 23,750 29,200

28 Under Grade 1 SURGEON FEE

29 CYST ENUCLEATION PACKAGE

Under Grade 1
(PACKAGE) 63,750 82,900 102,000

CYST ENUCLEATION 21,250 27,650 34,000

30 Under Grade 2 SURGEON FEE

CYST ENUCLEATION 12,250 12,250 15,950 19,600

31 Under LA PROCEDURE

32 DENTAL IMPLANT PROCEDURE 29,750 29,750 38,700 47,600

GRADE 1
33 DENTAL IMPLANT PROCEDURE 34,000 34,000 44,200 54,400
GRADE 2
34 DENTAL IMPLANT PROCEDURE 38,250 38,250 49,750 61,200
GRADE 3
35 DENTAL IMPLANT PROCEDURE 42,500 42,500 55,250 68,000
GRADE 4
DENTO ALOEVLAR - 7,700 7,700 10,000 12,350
36 ISOLATED PROCEDURE
FRACTURE
37 EXCISION OF BONY SURGEON FEE 28,050 36,500 44,850
TUMOUR OR CYST
38 EXTRACTIONS_DENT AL PROCEDURE
SURGICAL REMOVAL OF
TOOTH GRADE 1 3,800 3,800 4,950 6,100

39 EXTRACTIONS_DENT AL PROCEDURE
SURGICAL REMOVAL OF
TOOTH GRADE 2 5,000 5,000 6,500 8,000
40 EXTRACTIONS_DENT AL PROCEDURE
SURGICAL REMOVAL OF
TOOTH 6,300 6,300 8,200 10,100
GRADE 3
41 EXTRACTIONS_IMPA PROCEDURE 6,000 6,000 7,800 9,600
CTION GRADE 1
42 EXTRACTIONS_IMPA PROCEDURE 8,000 8,000 10,400 12,800
CTION GRADE 2
43 EXTRACTIONS_IMPA PROCEDURE 10,000 10,000 13,000 16,000
CTION GRADE 3
44 EXTRACTIONS_IMPA PROCEDURE 16,550 16,550 21,500 26,500
CTION GRADE 4
45 EXTRACTIONS_REM PROCEDURE
OVAL OF DECAYED
ROOT GRADE 1 1,700 1,700 2,200 2,750

46 EXTRACTIONS_REM PROCEDURE
OVAL OF DECAYED
ROOT GRADE 2 3,250 3,250 4,250 5,200

EXTRACTIONS_REM 700 700 900 1,200

OVAL OF DECAYED/
47 OVER RETAINED DEC PROCEDURE
TOOTH 1

EXTRACTIONS_REM 1,100 1,100 1,450 1,750

OVAL OF DECAYED/
48 OVER RETAINED DEC PROCEDURE
TOOTH 3

EXTRACTIONS_REM 1,500 1,500 1,950 2,400

OVAL OF DECAYED/
49 OVER RETAINED DEC PROCEDURE
TOOTH 4

50 EXTRACTIONS_REM PROCEDURE
OVAL OF FRACTURED
TOOTH 2,300 2,300 2,990 3,650

EXTRACTIONS_REM 900 900 1,200 1,450

51 OVAL OF MOBILE PROCEDURE
TOOTH
EXTRACTIONS_REM 12,550 12,550 16,300 20,100
52 OVAL OF ROOT ( PROCEDURE
MAXILLARY SINUS)
EXTRACTIONS_REM 700 700 900 1,200
53 OVAL OF TOOTH GRADE PROCEDURE
1
EXTRACTIONS_REM 1,300 1,300 1,690 2,100
54 OVAL OF TOOTH PROCEDURE
GRADE 2
EXTRACTIONS_REM 1,900 1,900 2,500 3,050
55 OVAL OF TOOTH PROCEDURE
GRADE 3
FIXED APPLIANCE 46,750 46,750 60,750 74,800
THERAPY_CERAMIC
56 BRACES PROCEDURE
TREATMENTGRADE 1

FIXED APPLIANCE 17,000 17,000 22,100 27,200

THERAPY_CERAMIC
57 BRACES PROCEDURE
TREATMENTGRADE 1
INSTALLMENT 1
 FIXED APPLIANCE 17,000 17,000 22,100 27,200
THERAPY_CERAMIC
58 BRACES PROCEDURE
TREATMENTGRADE 1
INSTALLMENT 2
FIXED APPLIANCE 12,750 12,750 16,600 20,400
THERAPY_CERAMIC
59 BRACES PROCEDURE
TREATMENTGRADE 1
INSTALLMENT 3
FIXED APPLIANCE 55,250 55,250 71,850 88,400
THERAPY_CERAMIC
60 BRACES PROCEDURE
TREATMENTGRADE 2

FIXED APPLIANCE
THERAPY_FIXED
ORTHODONTIC
61 TREATMENT WITHOUT PROCEDURE 244,800 244,800 318,250 391,700
BRACES
GRADE 2
FIXED APPLIANCE
THERAPY_FIXED
ORTHODONTIC
62 TREATMENT WITHOUT PROCEDURE 161,500 161,500 209,950 258,400
BRACES GRADE I

63 FIXED APPLIANCE PROCEDURE

THERAPY_GROWTH
MODIFICATION GRADE 1 10,650 10,650 13,850 17,050

64 FIXED APPLIANCE PROCEDURE

THERAPY_GROWTH
MODIFICATION 15,900 15,900 20,650 25,450
GRADE 2
65 FIXED APPLIANCE PROCEDURE
THERAPY_GROWTH
MODIFICATION GRADE 3 21,250 21,250 27,650 34,000

66 FIXED APPLIANCE PROCEDURE

THERAPY_LINGUAL
TREATMENT GRADE 1 68,000 68,000 88,400 108,800

67 FIXED APPLIANCE PROCEDURE

THERAPY_LINGUAL
TREATMENT GRADE 2 102,000 102,000 132,600 163,200

68 FIXED APPLIANCE PROCEDURE

THERAPY_LINGUAL
TREATMENT GRADE 114,750 114,750 149,200 183,600
3
69 FIXED APPLIANCE PROCEDURE
THERAPY_SELF LIGATING
METAL BRACKETS 51,000 51,000 66,300 81,600

FIXED APPLIANCE 3,250 3,250 4,250 5,200

70 THERAPY_SPACE PROCEDURE
MAINTAINER 1
FIXED APPLIANCE 4,250 4,250 5,550 6,800
71 THERAPY_SPACE PROCEDURE
MAINTAINER 2
FIXED APPLIANCE 34,000 34,000 44,200 54,400
THERAPY_SS BRACES
72 TREATMENT GRADE 1 PROCEDURE
 FIXED APPLIANCE 42,500 42,500 55,250 68,000
THERAPY_SS BRACES
73 TREATMENT GRADE 2 PROCEDURE

74 FULL MOUTH PACKAGE

REHABILITATION GRADE
1 (PACKAGE) 106,250 138,200 170,000

75 FULL MOUTH PACKAGE

REHABILITATION GRADE
1 - A (PACKAGE) 159,000 206,700 254,400

76 FULL MOUTH PACKAGE

REHABILITATION GRADE
10 (PACKAGE) 1,062,500 1,381,250 1,700,000

77 FULL MOUTH PACKAGE

REHABILITATION GRADE
10 - A (PACKAGE) 1,116,500 1,451,450 1,786,400

78 FULL MOUTH PACKAGE

REHABILITATION GRADE
2 (PACKAGE) 212,500 276,250 340,000

79 FULL MOUTH PACKAGE

REHABILITATION GRADE
2 - A (PACKAGE) 266,000 345,800 425,600

80 FULL MOUTH PACKAGE

REHABILITATION GRADE
3 (PACKAGE) 318,750 414,400 510,000

81 FULL MOUTH PACKAGE

REHABILITATION GRADE
3 - A (PACKAGE) 372,500 484,250 596,000

82 FULL MOUTH PACKAGE

REHABILITATION GRADE
4 (PACKAGE) 425,000 552,500 680,000

83 FULL MOUTH PACKAGE

REHABILITATION GRADE
4 - A (PACKAGE) 478,500 622,050 765,600

84 FULL MOUTH PACKAGE

REHABILITATION GRADE
5 (PACKAGE) 531,250 690,650 850,000

85 FULL MOUTH PACKAGE

REHABILITATION GRADE
5 - A (PACKAGE) 584,800 760,250 935,700

86 FULL MOUTH PACKAGE

REHABILITATION GRADE
6 (PACKAGE) 637,500 82,850 1,020,000

87 FULL MOUTH PACKAGE

REHABILITATION GRADE
6-A 691,000 898,300 1,105,600
(PACKAGE)
88 FULL MOUTH PACKAGE
REHABILITATION GRADE
7 (PACKAGE) 745,000 968,500 1,192,000
89 FULL MOUTH PACKAGE
REHABILITATION GRADE
7- A (PACKAGE) 797,000 1,036,100 1,275,200

90 FULL MOUTH PACKAGE

REHABILITATION GRADE
8 (PACKAGE) 850,000 1,105,000 1,360,000

91 FULL MOUTH PACKAGE

REHABILITATION GRADE
8-A 903,500 1,174,550 1,445,600
(PACKAGE)
92 FULL MOUTH PACKAGE
REHABILITATION GRADE
9 (PACKAGE) 956,250 1,243,200 1,530,000

93 FULL MOUTH PACKAGE

REHABILITATION GRADE
9 - A (PACKAGE) 100,000 130,000 160,000

94 GENIOPLASTY SURGEON FEE 42,500 55,250 68,000

95 IMPLANT CROWN PROCEDURE 6,800 6,800 8,850 10,850
GRADE 1
96 IMPLANT CROWN PROCEDURE 10,200 10,200 13,300 16,350
GRADE 2
97 IMPLANT CROWN PROCEDURE 13,600 13,600 17,700 21,750
GRADE 3
98 IMPLANT CROWN PROCEDURE 17,000 17,000 22,100 27,200
GRADE 4
99 LASER_ABSCESS PROCEDURE 3,250 3,250 4,250 5,200
DRAINAGE
100 LASER_BLEACHING PROCEDURE 17,850 17,850 23,200 28,550

LASER_CROWN 3,400 3,400 4,450 2,450

101 LENGTHENING PER PROCEDURE
TOOTH
102 LASER_CURRETAGE PROCEDURE 4,250 4,250 5,550 6,800
PER QUADRANT
LASER_DEEP CLEANING 12,750 12,750 16,600 20,400
103 FULL PROCEDURE
MOUTH
LASER_DEEP CLEANING 8,600 8,600 11,200 13,750
104 PER ARCH PROCEDURE

105 LASER_FIBROMA PROCEDURE 3,250 3,250 4,250 5,200

REMOVAL
LASER_FLAP 5,350 5,350 6,950 8,550
106 SURGERY PER PROCEDURE
QUADRANT
107 LASER_FRENECTOM PROCEDURE 5,950 5,950 7,750 9,550
Y OR TONGUE TIE
LASER_GINGIVECTO MY 10,750 10,750 14,000 17,200
108 PER QUADRANT PROCEDURE

LASER_HERPES 2,550 2,550 3,300 4,100

109 TREATMENT PER PROCEDURE
SITTING
110 LASER_OPERCULEC PROCEDURE 3,450 3,450 4,500 5,550
TOMY
111 LASER_ORAL SURGICAL PROCEDURE
PROCEDURES_FREN
ECTOMY 10,650 10,650 13,850 17,100
112 LASER_PULPECTOM PROCEDURE 4,250 4,250 5,550 6,800
Y PER TOOTH
113 LASER_REMOVAL OF PROCEDURE
PRECANCEROUS LESION
12,750 12,750 16,600 20,400

114 LASER_TMJ / MUSCULAR PROCEDURE

SPASM TREATMENT PER
SITTING 2,550 2,550 3,300 4,100

LOCAL ADVANCEMENT 23,800 30,950 38,100

115 FLAP SURGEON FEE

MANDIBULAR FRACTURE 36,550 47,500 58,500

116 - ANGLE SURGEON FEE

MANDIBULAR 48,450 63,000 77,550

117 FRACTURE - CONDYLE SURGEON FEE

MANDIBULAR 36,550 47,500 58,500

118 FRACTURE - SURGEON FEE
PARASYMPHSIS
119 MAXILLARY SURGEON FEE 42,500 55,250 68,000
FRACTURE
120 MEMBRANE GRADE I PROCEDURE 4,250 4,250 5,550 6,800

121 MEMBRANE GRADE II PROCEDURE 8,900 8,900 11,600 14,250

MISCELLANEOUS_BR 1,100 1,100 1,450 1,750

122 EAKAGE CHARGES PROCEDURE

MISCELLANEOUS_CA 650 650 850 1,050

LCIUM HYDROXIDE
123 DRESSING PER VISIT PROCEDURE

124 MISCELLANEOUS_CH EM PROCEDURE

CAUTERIZATION ( PER
SITTING) 650 650 850 1,050

125 MISCELLANEOUS_EN PROCEDURE 650 650 850 1,050

AMELOPLASTY
126 MISCELLANEOUS_OP PROCEDURE 2,500 2,500 3,250 4,000
ERCULECTOMY
127 MISCELLANEOUS_SP PROCEDURE 2,800 2,800 3,650 4,500
LINT GRADE 1
128 MISCELLANEOUS_SP PROCEDURE 3,750 3,750 4,900 6,000
LINT GRADE 2
129 MISCELLANEOUS_ST PROCEDURE 650 650 850 1,050
UDY MODEL
NECK DISSECTION & 42,500 55,250 68,000
WIDE LOCAL EXCISSON
130 + PRIMARY CLOSURE SURGEON FEE
GRADE 1

NECK DISSECTION & 72,250 93,950 115,600

WIDE LOCAL EXCISSON
131 + PRIMARY CLOSURE SURGEON FEE
GRADE 2

132 ORAL PATHOLOGY SURGEON FEE

SURGICAL PROCEDURE
GRADE 1 42,500 55,250 68,000
133 ORAL PATHOLOGY SURGEON FEE
SURGICAL PROCEDURE
GRADE 2 48,450 63,000 77,550

134 ORAL PATHOLOGY SURGEON FEE

SURGICAL PROCEDURE
GRADE 3 72,250 93,950 115,600

135 ORAL SUBMUCOUS SURGEON FEE 36,550 47,500 58,500

FIROSIS GRADE 1
136 ORAL SUBMUCOUS SURGEON FEE 42,500 55,250 68,000
FIROSIS GRADE 2
137 ORAL SUBMUCOUS SURGEON FEE 48,450 63,000 77,550
FIROSIS GRADE 3
138 ORAL SURGICAL SURGEON FEE
PROCEDURES_ BENIGN
TUMOUR EXCISION 36,550 47,500 58,500
GRADE 3
139 ORAL SURGICAL PROCEDURE
PROCEDURES_ALVE
OLECTOMY GRADE 1 2,150 2,150 2,800 3,450

140 ORAL SURGICAL PROCEDURE

PROCEDURES_ALVE
OLECTOMY GRADE 2 3,750 3,750 4,900 6,000

141 ORAL SURGICAL PROCEDURE

PROCEDURES_ALVE
OLECTOMY GRADE 3 4,900 4,900 6,400 7,850

142 ORAL SURGICAL PROCEDURE

PROCEDURES_APEXI
FICATION ( PER VISIT) 650 650 850 1,050

143 ORAL SURGICAL PROCEDURE

PROCEDURES_APEXI
FICATION GRADE 1 3,250 3,250 4,250 5,200

144 ORAL SURGICAL PROCEDURE

PROCEDURES_APEXI
FICATION GRADE 2 5,550 5,550 7,250 8,850

145 ORAL SURGICAL PROCEDURE

PROCEDURES_APEX
OGENESIS ( PER VISIT) 750 750 1,000 1,200

146 ORAL SURGICAL PROCEDURE

PROCEDURES_APEX
OGENESIS GRADE 1 3,800 3,800 4,950 6,100

147 ORAL SURGICAL PROCEDURE

PROCEDURES_APEX
OGENESIS GRADE 2 5,300 5,300 6,900 8,500

148 ORAL SURGICAL PROCEDURE

PROCEDURES_APIC
OECTOMY GRADE 1 8,500 8,500 11,050 13,600

149 ORAL SURGICAL PROCEDURE

PROCEDURES_APIC
OECTOMY GRADE 2 10,200 10,200 13,300 16,350
150 ORAL SURGICAL PROCEDURE
PROCEDURES_APIC
OECTOMY GRADE 3 13,600 13,600 17,700 21,750

151 ORAL SURGICAL PROCEDURE

PROCEDURES_BENI GN
TUMOUR EXCISION 10,650 10,650 13,850 17,050
GRADE 1
152 ORAL SURGICAL PROCEDURE
PROCEDURES_BENI GN
TUMOUR 15,950 15,950 20,750 25,500
EXCISION GRADE 2
ORAL SURGICAL 6,900 6,900 8,950 11,050
153 PROCEDURES_BIOP PROCEDURE
SY ( LARGE)
ORAL SURGICAL 4,700 4,700 6,100 7,550
154 PROCEDURES_BIOP SY PROCEDURE
( MEDIUM)
ORAL SURGICAL 3,250 3,250 4,250 5,200
155 PROCEDURES_BIOP SY PROCEDURE
( SMALL)
ORAL SURGICAL 8,500 8,500 11,050 13,600
156 PROCEDURES_BONE PROCEDURE
GRAFT GRADE 1
ORAL SURGICAL 11,900 11,900 15,500 19,050
157 PROCEDURES_BONE PROCEDURE
GRAFT GRADE 2
ORAL SURGICAL 15,300 15,300 19,900 24,500
158 PROCEDURES_BONE PROCEDURE
GRAFT GRADE 3
ORAL SURGICAL 18,700 18,700 24,300 29,950
159 PROCEDURES_BONE PROCEDURE
GRAFT GRADE 4
160 ORAL SURGICAL PROCEDURE
PROCEDURES_CANI NE
EXPOSURE ( BUCCAL) 5,350 5,350 6,950 8,550

161 ORAL SURGICAL PROCEDURE

PROCEDURES_CANI NE
EXPOSURE ( PALATAL) 8,500 8,500 11,050 13,600

ORAL SURGICAL 5,350 5,350 6,950 8,550

PROCEDURES_CLOS URE
162 OF ORO ANTRAL PROCEDURE
FISTUAL
(OAF) GRADE 1
ORAL SURGICAL 8,500 8,500 11,050 13,600
PROCEDURES_CLOS URE
163 OF ORO ANTRAL PROCEDURE
FISTUAL (OAF) GRADE 2

ORAL SURGICAL 10,800 10,800 14,050 17,300

PROCEDURES_CLOS URE
164 OF ORO ANTRAL PROCEDURE
FISTUAL (OAF) GRADE 3

ORAL SURGICAL 15,950 15,950 20,750 25,500

165 PROCEDURES_CRYO PROCEDURE
THERAPY
166 ORAL SURGICAL PROCEDURE
PROCEDURES_CYST
ENUCLEATION LARGE 11,900 11,900 15,500 19,050
167 ORAL SURGICAL PROCEDURE
PROCEDURES_CYST
ENUCLEATION MEDIUM 8,500 8,500 11,050 13,600

168 ORAL SURGICAL PROCEDURE

PROCEDURES_CYST
ENUCLEATION SMALL 7,250 7,250 9,450 11,600

ORAL SURGICAL 13,600 17,700 21,750

PROCEDURES_CYST
169 MARSUPILIZATION SURGEON FEE
GRADE 1

ORAL SURGICAL 15,750 20,500 25,200

PROCEDURES_CYST
170 MARSUPILIZATION SURGEON FEE
GRADE 2

ORAL SURGICAL 16,050 16,050 20,900 25,700

PROCEDURES_CYST
171 MARSUPILIZATION PROCEDURE
GRADE 3

172 ORAL SURGICAL PROCEDURE

PROCEDURES_DENT AL
SUTURING GRADE 1 1,000 1,000 1,300 1,600

173 ORAL SURGICAL PROCEDURE

PROCEDURES_DENT AL
SUTURING GRADE 2 1,200 1,200 1,550 1,900

174 ORAL SURGICAL PROCEDURE

PROCEDURES_DENT AL
SUTURING GRADE 3 1,700 1,700 2,200 2,750

175 ORAL SURGICAL PROCEDURE

PROCEDURES_DENT AL
SUTURING REMOVAL 650 650 850 1,050

176 ORAL SURGICAL PROCEDURE

PROCEDURES_DRAI
NAGE OF E.O ABSCESS 2,550 2,550 3,300 4,100
GRADE 1
177 ORAL SURGICAL PROCEDURE
PROCEDURES_DRAI
NAGE OF E.O ABSCESS 5,350 5,350 6,950 8,550
GRADE 2
178 ORAL SURGICAL PROCEDURE
PROCEDURES_DRAI
NAGE OF E.O ABSCESS 5,950 5,950 7,750 9,550
GRADE 3
179 ORAL SURGICAL PROCEDURE
PROCEDURES_DRAI
NAGE OF I.0 ABSCESS 4,250 4,250 5,550 6,800
GRADE 2
180 ORAL SURGICAL PROCEDURE
PROCEDURES_DRAI
NAGE OF I.O 2,650 2,650 3,450 4,250
ABSCESS GRADE 1
181 ORAL SURGICAL PROCEDURE
PROCEDURES_DRAI
NAGE OF I.O ABSCESS 7,450 7,450 9,700 11,950
GRADE 3
ORAL SURGICAL 4,500 4,500 5,850 7,200
182 PROCEDURES_FREN PROCEDURE
ECTOMY
 ORAL SURGICAL 12,750 12,750 16,600 20,400
183 PROCEDURES_IMF PROCEDURE
GRADE 1
ORAL SURGICAL 17,000 17,000 22,100 27,200
184 PROCEDURES_IMF PROCEDURE
GRADE 2
ORAL SURGICAL 26,600 26,600 34,600 42,550
185 PROCEDURES_IMF PROCEDURE
GRADE 3
ORAL SURGICAL 18,100 18,100 23,530 28,950
186 PROCEDURES_NERV PROCEDURE
E AVULSION
ORAL SURGICAL 10,650 10,650 13,850 17,050
187 PROCEDURES_RIDG E PROCEDURE
SPLITTING 1
ORAL SURGICAL 15,950 15,950 20,750 25,500
188 PROCEDURES_RIDG E PROCEDURE
SPLITTING 2
ORAL SURGICAL 21,250 21,250 27,650 34,000
PROCEDURES_SINU S
189 LIFT DIRECT ( PER SIDE) PROCEDURE
GRADE 1

ORAL SURGICAL 29,750 29,750 38,700 47,600

PROCEDURES_SINU S
190 LIFT DIRECT ( PER SIDE) PROCEDURE
GRADE 2

ORAL SURGICAL 38,250 38,250 49,750 61,200

PROCEDURES_SINU S
191 LIFT DIRECT ( PER SIDE) PROCEDURE
GRADE 3

192 ORAL SURGICAL PROCEDURE

PROCEDURES_SINU S
LIFT INDIRECT GRADE 1 8,500 8,500 11,050 13,600

193 ORAL SURGICAL PROCEDURE

PROCEDURES_SINU S
LIFT INDIRECT 12,750 12,750 16,600 20,400
GRADE 2
194 ORAL SURGICAL PROCEDURE
PROCEDURES_SOCK ET
CURRETTAGE 1,150 1,150 1,500 1,850

195 ORAL SURGICAL PROCEDURE

PROCEDURES_SUTU
RING LACERATION 2,650 2,650 3,450 4,250

196 ORAL SURGICAL SURGEON FEE

PROCEDURES_TMJ
ARTHOCENTESIS PER 21,250 27,650 34,000
SIDE GRADE 1
197 ORAL SURGICAL SURGEON FEE
PROCEDURES_TMJ
ARTHOCENTESIS 28,050 36,500 44,850
PER SIDE GRADE 2
ORAL SURGICAL 4,250 4,250 5,550 6,800
198 PROCEDURES_TMJ PROCEDURE
DISLOCATION
ORAL SURGICAL 5,350 5,350 6,950 8,550
PROCEDURES_TOOT H
199 RE IMPLANTATION WITH PROCEDURE
SPLINTING
 ORAL SURGICAL 8,500 8,500 11,050 13,600
200 PROCEDURES_VESTI PROCEDURE
BULOPLASTY
201 PALATAL FLAP SURGEON FEE 42,500 55,250 68,000
202 PMMC SURGEON FEE 48,450 63,000 77,550
RECONSTRUCTION
203 RADIOLOGY_BITEWI PROCEDURE 500 500 650 800
NG
204 RADIOLOGY_IOPA PROCEDURE 250 250 350 400
205 RADIOLOGY_OPG PROCEDURE 500 500 650 800
206 RECONSTRUCTION SURGEON FEE 23,800 30,950 38,050
PLATE
207 REHABILITATION - RPD PROCEDURE
FLEXIBLE ADDITIONAL
PER TOOTH 2,500 2,500 3,250 4,000

REHABILITATION_AL L 10,200 10,200 13,300 16,350

208 CERAMIC METAL PROCEDURE
FREE GRADE 1
REHABILITATION_AL L 11,900 11,900 15,500 19,050
209 CERAMIC METAL PROCEDURE
FREE GRADE 2
REHABILITATION_AL L 15,100 15,100 19,650 24,150
210 CERAMIC METAL PROCEDURE
FREE GRADE 3
REHABILITATION_AL 17,250 17,250 22,450 27,600
211 L CERAMIC METAL FREE PROCEDURE
GRADE 4
REHABILITATION_AL 19,500 19,500 25,350 31,200
212 L CERAMIC METAL FREE PROCEDURE
GRADE 5
REHABILITATION_BA ND 3,850 3,850 5,000 6,150
213 & LOOP SPACE PROCEDURE
MAINTAINER
REHABILITATION_CA ST 11,750 11,750 15,300 18,800
214 PARTIAL PROCEDURE
DENTURE GRADE 1
REHABILITATION_CA ST 15,900 15,900 20,700 25,450
215 PARTIAL PROCEDURE
DENTURE GRADE 2
REHABILITATION_CA ST 21,250 21,250 27,650 34,000
216 PARTIAL PROCEDURE
DENTURE GRADE 3
REHABILITATION_CO 21,250 21,250 27,650 34,000
217 MPLETE DENTURE PROCEDURE
GRADE 1
REHABILITATION_CO 29,750 29,750 38,700 47,600
218 MPLETE DENTURE PROCEDURE
GRADE 2
REHABILITATION_CO 47,850 47,850 62,200 76,550
219 MPLETE DENTURE PROCEDURE
GRADE 3
REHABILITATION_CR 4,250 4,250 5,550 6,800
220 OWN & LOOP SPACE PROCEDURE
MAINTAINER
REHABILITATION_CR 700 700 900 1,150
221 OWN REMOVAL ( PROCEDURE
PER TOOTH)
REHABILITATION_DE 6,450 6,450 8,400 10,350
222 NTAL RPD FLEXIBLE PROCEDURE
PLATE
223 REHABILITATION_DIA PROCEDURE 8,500 8,500 11,050 13,600
STEMA CLOSURE
224 REHABILITATION_FE PROCEDURE
EDING APPLIANCE CLEFT
PALATE 5,350 5,350 6,950 8,550

REHABILITATION_FL 47,850 47,850 62,200 76,550

225 EXIBLE DENTURE GRADE PROCEDURE
1
REHABILITATION_FL 53,150 53,150 69,100 85,050
226 EXIBLE DENTURE PROCEDURE
GRADE 2
227 REHABILITATION_LA PROCEDURE 9,700 9,700 12,600 15,500
MINATES GRADE 1
228 REHABILITATION_LA PROCEDURE 13,950 13,950 18,200 22,350
MINATES GRADE 2
229 REHABILITATION_LA PROCEDURE 17,000 17,000 22,100 27,200
MINATES GRADE 3
230 REHABILITATION_LA PROCEDURE 21,250 21,250 27,650 34,000
MINATES GRADE 4
REHABILITATION_ME TAL 2,550 2,550 3,300 4,100
231 BRIDGE PER PROCEDURE
UNIT
REHABILITATION_ME TAL 2,150 2,150 2,800 3,450
232 CROWN GRADE PROCEDURE
1
REHABILITATION_ME TAL 2,900 2,900 3,750 4,650
233 CROWN GRADE PROCEDURE
2
REHABILITATION_ME TAL 3,850 3,850 5,000 6,200
234 CROWN GRADE PROCEDURE
3
235 REHABILITATION_NI PROCEDURE 2,650 2,650 3,450 4,250
GHT GUARD
236 REHABILITATION_OB PROCEDURE 15,900 15,900 20,700 25,450
TURATORS
REHABILITATION_PO 4,250 4,250 5,550 6,800
237 RCELAIN CROWN PROCEDURE
GRADE 1 (PFM)
REHABILITATION_PO 6,450 6,450 8,400 10,350
238 RCELAIN CROWN PROCEDURE
GRADE 2 (PFM)
REHABILITATION_PO 8,600 8,600 11,200 13,750
239 RCELAIN CROWN PROCEDURE
GRADE 3 (PFM)
REHABILITATION_PO 9,700 9,700 12,600 15,500
240 RCELAIN VENEERS PROCEDURE
GRADE 1
REHABILITATION_PO 12,950 12,950 16,850 20,750
241 RCELAIN VENEERS PROCEDURE
GRADE 2
REHABILITATION_PO 17,250 17,250 22,450 27,600
242 RCELAIN VENEERS PROCEDURE
GRADE 3
REHABILITATION_PO ST 2,150 2,150 2,800 3,450
243 AND CORE PROCEDURE
GRADE 1
REHABILITATION_PO ST 3,250 3,250 4,250 5,200
244 AND CORE PROCEDURE
GRADE 2
REHABILITATION_PO ST 4,250 4,250 5,550 6,800
245 AND CORE PROCEDURE
GRADE 3
246 REHABILITATION_RE PROCEDURE 2,150 2,150 2,800 3,450
LINING GRADE 1
247 REHABILITATION_RE PROCEDURE 3,250 3,250 4,250 5,200
LINING GRADE 2
248 REHABILITATION_RE PROCEDURE 4,250 4,250 5,550 6,800
LINING GRADE 3
REHABILITATION_RE 2,150 2,150 2,800 3,450
249 MOVABLE SPACE PROCEDURE
MAINTAINER
250 REHABILITATION_RE PROCEDURE
PAIR WORK OF
FRACTURED DENTURE 1,150 1,150 1,500 1,850
GRADE 1
251 REHABILITATION_RE PROCEDURE
PAIR WORK OF
FRACTURED DENTURE 1,650 1,650 2,200 2,650
GRADE 2
REHABILITATION_RP 650 650 850 1,050
252 D ADDITIONAL TOOTH PROCEDURE

REHABILITATION_RP D 1,100 1,100 1,450 1,750

253 SINGLE TOOTH PROCEDURE
TYPE 1
REHABILITATION_RP D 1,650 1,650 2,200 2,650
254 SINGLE TOOTH PROCEDURE
TYPE 2
REHABILITATION_SIN 15,900 15,980 20,750 25,550
255 GLE COMPLETE PROCEDURE
DENTURE
256 REHABILITATION_SL PROCEDURE 3,250 3,250 4,250 5,200
EEP GUARD
REHABILITATION_SM 15,900 15,900 20,650 25,450
257 ILE DESIGN LOWER PROCEDURE
GRADE 1
REHABILITATION_SM 21,250 21,250 27,650 34,000
258 ILE DESIGN LOWER PROCEDURE
GRADE 2
REHABILITATION_SM ILE 15,900 15,900 20,650 25,450
259 DESIGN UPPER PROCEDURE
GRADE 1
REHABILITATION_SM 21,250 21,250 27,650 34,000
260 ILE DESIGN UPPER PROCEDURE
GRADE 2
REHABILITATION_SP ACE 3,250 3,250 4,250 5,200
261 MAINTAINER PROCEDURE
GRADE 1
REHABILITATION_SP ACE 5,350 5,350 6,950 8,550
262 MAINTAINER PROCEDURE
GRADE 2
REHABILITATION_ST 2,550 2,550 3,350 4,100
263 AINLESS STEEL PROCEDURE
CROWN GRADE 1
REHABILITATION_ST 3,850 3,850 5,000 6,150
264 AINLESS STEEL CROWN PROCEDURE
GRADE 2
REHABILITATION_TE 850 850 1,100 1,350
265 MPORARY CROWN PROCEDURE

266 REHABILITATION_THI PROCEDURE 17,000 17,000 22,100 27,200

NNERS
267 REMOVABLE APPLIANCE PROCEDURE
THERAPY_BITE PLATE
4,250 4,250 5,550 6,800

REMOVABLE APPLIANCE 3,750 3,750 4,850 6,000

THERAPY_HABIT
268 BREAKING APPLIANCE 1 PROCEDURE
 REMOVABLE APPLIANCE 5,350 5,350 6,950 8,550
THERAPY_HABIT
269 BREAKING PROCEDURE
APPLIANCE 2

270 REMOVABLE APPLIANCE PROCEDURE

THERAPY_MOUTHGU
ARDS 3,250 3,250 4,250 5,200

271 REMOVABLE APPLIANCE PROCEDURE

THERAPY_ORAL SCREEN
3,250 3,250 4,250 5,200

272 REMOVABLE APPLIANCE PROCEDURE

THERAPY_PEDIATRI C
OBTURATOR 5,350 5,350 6,950 8,550

REMOVABLE APPLIANCE
THERAPY_REMOVAB LE
APPLIANCE GRADE 1
273 ( RETAINER PROCEDURE 5,900 5,900 7,650 9,450
U/L)

REMOVABLE APPLIANCE
THERAPY_REMOVAB LE
APPLIANCE GRADE 2
274 ( SCREW APPLIANCE) PROCEDURE 9,600 9,600 12,500 15,350

REMOVABLE APPLIANCE
THERAPY_REMOVAB LE
APPLIANCE GRADE 3
275 ( SCREW APPLIANCE) PROCEDURE 10,650 10,650 13,850 17,050

276 REMOVABLE APPLIANCE PROCEDURE

THERAPY_THUMBSU
CKING GRADE 1 6,900 6,900 8,950 11,050

277 REMOVABLE APPLIANCE PROCEDURE

THERAPY_THUMBSU
CKING GRADE 2 7,990 7,990 10,400 12,750

278 REPAIR OF LIP SURGEON FEE 36,550 47,500 58,500

GRADE 1
279 REPAIR OF LIP SURGEON FEE 42,500 55,250 68,000
GRADE 2
280 REPAIR OF PALATE SURGEON FEE 36,550 47,500 58,500
GRADE 1
281 REPAIR OF PALATE SURGEON FEE 42,500 55,250 68,000
GRADE 2
282 RESTORATIONS_CE PROCEDURE 8,500 8,500 11,050 13,600
RAMIC INLAYS
RESTORATIONS_CO 1,650 1,650 2,200 2,650
MPOSITE FILLING
283 CERVICAL ABRASION PROCEDURE
/ CLASS 5 GRADE 1

RESTORATIONS_CO 2,150 2,150 2,800 3,450

MPOSITE FILLING
284 CERVICAL ABRASION PROCEDURE
/ CLASS 5 GRADE 2
 RESTORATIONS_CO 3,750 3,750 4,800 6,000
285 MPOSITE FILLING PROCEDURE
EXTENSIVE
RESTORATIONS_CO 1,150 1,150 1,500 1,850
286 MPOSITE FILLING PROCEDURE
GRADE 1
RESTORATIONS_CO 1,650 1,650 2,200 2,650
287 MPOSITE FILLING PROCEDURE
GRADE 2
RESTORATIONS_CO 2,150 2,150 2,800 3,450
288 MPOSITE FILLING PROCEDURE
GRADE 3
RESTORATIONS_CO 2,650 2,650 3,450 4,250
289 MPOSITE FILLING PROCEDURE
GRADE 4
RESTORATIONS_CO 4,250 4,250 5,550 6,800
290 MPOSITE INLAY DIRECT PROCEDURE

291 RESTORATIONS_CO PROCEDURE 6,800 6,800 8,850 10,850

MPOSITE VENEER
RESTORATIONS_CO RE 1,650 1,650 2,200 2,650
292 BUILD UP GRADE PROCEDURE
1
RESTORATIONS_CO 2,650 2,650 3,450 4,250
293 RE BUILD UP GRADE 2 PROCEDURE

294 RESTORATIONS_DES PROCEDURE

ENSITIVITY TREATMENT
(PER VISIT) 850 850 1,100 1,350

295 RESTORATIONS_FIB PROCEDURE 3,250 3,250 4,250 5,200

RE POST
296 RESTORATIONS_G. I PROCEDURE 850 850 1,100 1,350
FILLING GRADE 1
297 RESTORATIONS_G. I PROCEDURE 1,100 1,100 1,450 1,750
FILLING GRADE 2
298 RESTORATIONS_GI ( PROCEDURE 1,650 1,650 2,200 2,650
LIGHT CURE)
299 RESTORATIONS_IRM PROCEDURE 550 550 700 1,000
FILLING
300 RESTORATIONS_PIT & PROCEDURE
FISSURE SEALANT ( PER
TOOTH) 650 650 850 1,100

301 RINOPLASTY SURGEON FEE 48,450 63,000 77,550

ROOT CANAL 3,350 3,350 4,350 5,400
302 TREATMENT_PULP PROCEDURE
THERAPY 1
ROOT CANAL 4,350 4,350 5,650 6,950
303 TREATMENT_PULP PROCEDURE
THERAPY 2
ROOT CANAL 5,550 5,550 7,250 8,850
304 TREATMENT_PULP PROCEDURE
THERAPY 3
ROOT CANAL 3,400 3,400 4,450 5,450
305 TREATMENT_PULPE PROCEDURE
CTOMY GRADE 1
ROOT CANAL 4,500 4,500 5,850 7,200
306 TREATMENT_PULPE PROCEDURE
CTOMY GRADE 2
ROOT CANAL 2,800 2,800 3,650 4,500
307 TREATMENT_PULPO PROCEDURE
TOMY
 ROOT CANAL 8,500 8,500 11,050 13,600
308 TREATMENT_RCT ( PROCEDURE
RE TREATMENT)
ROOT CANAL 4,250 4,250 5,550 6,800
309 TREATMENT_RCT PROCEDURE
( SINGLE ANTERIOR)
ROOT CANAL 5,350 5,350 6,950 8,550
310 TREATMENT_RCT PROCEDURE
GRADE 1
ROOT CANAL 6,350 6,350 8,250 10,200
311 TREATMENT_RCT PROCEDURE
GRADE 2
ROOT CANAL 7,500 7,500 9,750 12,000
312 TREATMENT_RCT GRADE PROCEDURE
3
ROOT CANAL 8,900 8,900 11,550 14,250
313 TREATMENT_RCT GRADE PROCEDURE
4
ROOT CANAL 3,250 3,250 4,250 5,200
TREATMENT_ROOT
314 CANAL PERFORATION PROCEDURE
REPAIR GRADE 1

ROOT CANAL 5,500 5,500 7,150 8,800

TREATMENT_ROOT
315 CANAL PERFORATION PROCEDURE
REPAIR GRADE 2

316 SALIVARY GLAND SURGEON FEE 36,550 47,500 58,500

TUMORS GRADE 1
317 SALIVARY GLAND SURGEON FEE 42,500 55,250 68,000
TUMORS GRADE 2
318 SALIVARY GLAND SURGEON FEE 48,450 63,000 77,500
TUMORS GRADE 3
319 SINGL JAW SURGEON FEE 42,500 55,250 68,000
SURGERY GRADE 1
320 SINGL JAW SURGEON FEE 48,450 63,000 77,500
SURGERY GRADE 2
321 SOFT TISSUE PROCEDURE
MANAGEMENT_CUR
ETTAGE ( PER TOOTH) 650 650 850 1,050

322 SOFT TISSUE PROCEDURE

MANAGEMENT_FLAP
SURGERY GRADE 1 5,350 5,350 6,950 8,550

323 SOFT TISSUE PROCEDURE

MANAGEMENT_FLAP
SURGERY GRADE 2 6,300 6,300 8,200 10,100

324 SOFT TISSUE PROCEDURE

MANAGEMENT_FLAP
SURGERY GRADE 3 7,500 7,500 9,750 12,000

325 SOFT TISSUE PROCEDURE

MANAGEMENT_FLAP
SURGERY GRADE 4 8,500 8,500 11,050 13,600

SOFT TISSUE 12,750 12,750 16,500 20,400

MANAGEMENT_FLAP
326 SURGERY PLUS BONE PROCEDURE
GRAFT GRADE 1
 SOFT TISSUE 15,900 15,900 20,600 25,450
MANAGEMENT_FLAP
327 SURGERY PLUS BONE PROCEDURE
GRAFT GRADE 2

SOFT TISSUE 7,900 7,900 10,300 12,650

MANAGEMENT_FLAP
328 SURGERY WITH BONE PROCEDURE
GRAFT GRADE 1

SOFT TISSUE 9,000 9,000 11,700 14,400

MANAGEMENT_FLAP
329 SURGERY WITH BONE PROCEDURE
GRAFT GRADE 2

SOFT TISSUE 10,100 10,115 13,150 16,200

MANAGEMENT_FLAP
330 SURGERY WITH BONE PROCEDURE
GRAFT GRADE 3

331 SOFT TISSUE PROCEDURE

MANAGEMENT_FLAP
SURGEY GRADE 2 6,500 6,500 8,450 10,400

332 SOFT TISSUE PROCEDURE

MANAGEMENT_FULL
MOUTH FLAP SURGERY 23,500 23,500 30,550 37,600

SOFT TISSUE 1,300 1,300 1,700 2,100

MANAGEMENT_FULL
333 MOUTH SCALING & PROCEDURE
POLISING GRADE 1

SOFT TISSUE 1,650 1,650 2,200 2,650

MANAGEMENT_FULL
334 MOUTH SCALING & PROCEDURE
POLISING GRADE 2

SOFT TISSUE 2,650 2,650 3,450 4,250

MANAGEMENT_FULL
335 MOUTH SCALING & PROCEDURE
POLISING GRADE 3

SOFT TISSUE 3,750 3,750 4,850 6,000

MANAGEMENT_FULL
336 MOUTH SCALING & PROCEDURE
POLISING GRADE 4

337 SOFT TISSUE PROCEDURE

MANAGEMENT_GING
IVAL CURETTAGE (PER 1,150 1,150 1,500 1,850
TOOTH)
338 SOFT TISSUE PROCEDURE
MANAGEMENT_GING
IVECTOMY ( PER 850 850 1,100 1,350
TOOTH)
SOFT TISSUE 2,650 2,650 3,450 4,250
MANAGEMENT_MUC
339 OGINGIVAL SURGERY PROCEDURE
PER TOOTH GRADE 1

SOFT TISSUE 4,250 4,250 5,550 6,800

MANAGEMENT_MUC
340 OGINGIVAL SURGERY PROCEDURE
PER TOOTH GRADE 2
 SOFT TISSUE 8,500 8,500 11,050 13,600
MANAGEMENT_MUC
341 OGINGIVAL SURGERY PROCEDURE
PER
TOOTH GRADE 3
SOFT TISSUE
MANAGEMENT_SUB
GINGIVAL SCALING&
342 ROOT PLANING GRADE 1 PROCEDURE 1,100 1,100 1,450 1,750
( PER QUADRANT)

SOFT TISSUE
MANAGEMENT_SUB
GINGIVAL SCALING&
343 ROOT PLANING GRADE 2 PROCEDURE 2,150 2,150 2,800 3,450
( PER QUADRANT)

344 SPACE INFECTION ( SURGEON FEE 36,550 47,500 58,500

Under GA )
TEMPOROMANDIBUL AR 36,550 47,500 58,500
345 JOINTS GRADE 1 SURGEON FEE

TEMPOROMANDIBUL AR 48,450 63,000 77,500

346 JOINTS GRADE 2 SURGEON FEE

TEMPOROMANDIBUL AR 85,000 110,500 136,000

347 JOINTS GRADE 3 SURGEON FEE

348 TONGUE FLAP SURGEON FEE 36,550 47,500 58,500

349 TREATING PERI PROCEDURE
IMPLANTITIS AND
IMPLANT EXPOSURE 1,900 1,900 2,500 3,050

TREATMENT OF NON 1,500 1,500 1,950 2,400

350 HEALING ULCER PROCEDURE
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
42,500 53,200

144,500 180,650

4,000 5,000

20,200 25,250

18,000 22,500

24,000 30,000

34,000 42,500

5,000 6,250

5,600 7,000

42,500 53,200

12,600 15,750

17,000 21,250

25,500 31,850

34,000 42,500

73,100 91,400

96,900 121,200

21,100 26,400

34,000 42,500

17,800 22,250

23,800 29,750
 23,800 29,750

31,400 39,250

47,600 59,500

56,000 70,000

85,000 106,250

97,000 121,250

144,500 180,650

36,500 45,650

127,500 159,400

42,500 53,200

24,500 30,650

59,500 74,400

68,000 85,000

76,500 95,650

85,000 106,250

15,400 19,250

56,100 70,200

7,600 9,500

10,000 12,500
12,600 15,750

12,000 15,000

16,000 20,000

20,000 25,000

33,100 41,400

3,400 4,250

6,500 8,200

1,400 1,750

2,200 2,750

3,000 3,750

4,600 5,750

1,800 2,250

25,100 31,400

1,400 1,750

2,600 3,250

3,800 4,750

93,500 116,850

34,000 42,500
 34,000 42,500

25,500 31,850

110,500 138,200

489,600 612,000

323,000 403,750

21,300 26,650

31,800 39,750

42,500 53,200

136,000 170,000

204,000 255,000

229,500 286,850

102,000 127,500

6,500 8,200

8,500 10,650

68,000 85,000
 85,000 106,250

212,500 265,650

318,000 397,500

2,125,000 2,656,250

2,233,000 2,791,250

425,000 531,250

532,000 665,000

637,500 796,850

745,000 931,250

850,000 1,062,500

957,000 1,196,250

1,062,500 1,328,200

1,169,600 1,462,000

1,275,000 1,593,750

1,382,000 1,727,500

1,490,000 1,862,500
1,594,000 1,992,500

1,700,000 2,125,000

1,807,000 2,558,750

1,912,500 2,390,650

200,000 250,000

85,000 106,250
13,600 17,000

20,400 25,500

27,200 34,000

34,000 42,500

6,500 8,200

35,700 44,650

6,800 8,500

8,500 10,650

25,500 31,850

17,200 21,500

6,500 8,200

10,700 13,400

11,900 14,850

21,500 26,850

5,100 6,400

6,900 8,650

21,300 26,650
 8,500 10,650

25,500 31,850

5,100 6,400

47,600 59,500

73,100 91,400

96,900 121,200

73,100 91,400

85,000 106,250

8,500 10,650

17,800 22,250

2,200 2,750

1,300 1,650

1,300 1,650

1,300 1,650

5,000 6,250

5,600 7,000

7,500 9,400

1,300 1,650

85,000 106,250

144,500 180,650

85,000 106,250
 96,900 121,200

144,500 180,650

73,100 91,400

85,000 106,250

96,900 121,200

73,100 91,400

4,300 5,400

7,500 9,400

9,800 12,250

1,300 1,650

6,500 8,200

11,100 13,850

1,500 1,850

7,600 9,500

10,600 13,250

17,000 21,250

20,400 25,500
27,200 34,000

21,300 26,650

31,900 39,850

13,800 17,250

9,400 11,750

6,500 8,200

17,000 21,250

23,800 29,750

30,600 38,250

37,400 46,750

10,700 13,400

17,000 21,250

10,700 13,400

17,000 21,250

21,600 27,000

31,900 39,850

23,800 29,750
17,000 21,250

14,500 18,200

27,200 34,000

31,500 39,400

32,100 40,200

2,000 2,500

2,400 3,000

3,400 4,250

1,300 4,650

5,100 6,400

10,700 13,400

11,900 14,850

8,500 10,650

5,300 6,650

14,900 18,650

9,000 11,250
25,500 31,850

34,000 42,500

53,200 66,500

36,200 45,250

21,300 26,650

31,900 39,850

42,500 53,150

59,500 74,400

76,500 95,650

17,000 21,250

25,500 31,850

2,300 2,900

5,300 6,650

42,500 53,150

56,100 70,150

8,500 10,650

10,700 13,400
17,000 21,250

85,000 106,250
96,900 121,200

1,000 1,250

500 650
1,000 1,250
47,600 59,500

5,000 6,250

20,400 25,500

23,800 29,750

30,200 37,750

34,500 43,200

39,000 48,750

7,700 9,650

23,500 29,400

31,800 39,750

42,500 53,200

42,500 53,200

59,500 74,400

95,700 119,650

8,500 10,650

1,400 1,750

12,900 16,200

17,000 21,250
 10,700 13,400

95,700 119,650

106,300 132,850

19,400 24,250

27,900 34,850

34,000 42,500

42,500 53,200

5,100 6,400

4,300 5,400

5,800 7,250

7,700 9,650

5,300 6,650

31,800 39,750

8,500 10,650

12,900 16,200

17,200 21,500

19,400 24,250

25,900 32,400

34,500 43,200

4,300 5,400

6,500 8,200

8,500 10,650

4,300 5,400

6,500 8,200
 8,500 10,650

4,300 5,400

2,300 2,850

3,300 4,200

1,300 1,650

2,200 2,750

3,300 4,200

31,950 39,950

6,500 8,200

31,800 39,750

42,500 53,150

31,800 39,750

42,500 53,150

6,500 8,150

10,700 13,400

5,100 6,400

7,700 9,650

1,700 2,200

34,000 42,500

8,500 10,650

7,500 9,400
10,700 13,400

6,500 8,150

6,500 8,150

10,700 13,400

11,800 14,750

19,200 24,000

21,300 26,650

13,800 17,250

15,950 19,750

73,100 91,400

85,000 106,250

73,100 91,400

85,000 106,250

17,000 21,250

3,300 4,200

4,300 5,400
 7,500 9,400

2,300 2,900

3,300 4,200

4,300 5,400

5,300 6,650

8,500 10,650

13,600 17,000

3,300 4,200

5,300 6,650

1,700 2,200

6,500 8,150

1,700 2,150

2,200 2,750

3,300 4,200

1,100 1,400

1,300 1,650

96,900 121,200
6,700 8,400

8,700 10,900

11,100 13,900

6,800 8,500

9,000 11,250

5,600 7,000
17,000 21,250

8,500 10,650

10,700 13,400

12,700 15,900

15,000 18,750

17,800 22,250

6,500 8,200

11,000 13,750

73,100 91,400

85,000 106,250

96,900 121,200

85,000 106,250

96,900 121,200

1,300 1,650

10,700 13,400

12,600 15,750

15,000 18,750

17,000 21,250

25,500 31,900
31,800 39,750

15,800 19,750

18,000 22,500

20,250 25,300

13,000 16,250

47,000 58,750

2,600 3,250

3,300 4,200

5,300 6,650

7,500 9,400

2,300 2,900

1,700 2,200

5,300 6,600

8,500 10,650
 17,000 21,250

2,200 2,750

4,300 5,400

73,100 91,400

73,100 91,400

96,900 121,200

170,000 212,500

73,100 91,400

3,800 4,750

3,000 3,750
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate General -
Department- DERMATOLOGY
- Casualty Ward Transplant
ICU

SR. NO. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 BOTOX PROCEDURE PROCEDURE 5,500 5,500 7,150 8,800
CHARGES
2 CHEMICAL PEEL - TCA PROCEDURE 2,600 2,600 3,400 4,200
PEEL
3 CHEMICAL PEEL GLYCOLIC PROCEDURE 2,200 2,200 2,850 3,500
AND OTHERS
4 COMEDONE EXTRACTION PROCEDURE 650 650 850 1,050
(FOR 5)
5 CRYOCAUTERY (UPTO 5) PROCEDURE 2,150 2,150 2,800 3,450

6 CRYOCAUTERY PER PROCEDURE 250 250 350 400

ADDITIONAL LESION
7 DERMAROLLER THERAPY PROCEDURE 2,650 2,650 3,500 4,250

8 EAR PIERCING UNDER LA PROCEDURE 1,650 1,650 2,200 2,650

9 INGROWING NAIL REMOVAL PROCEDURE 1,100 1,100 1,450 1,800

(PER NAIL)
INJECTION INTRADERMAL
10 (UPTO 5 LESIONS) PROCEDURE 650 650 850 1,050

INJECTION INTRADERMAL PER

11 ADDITIONAL LESION PROCEDURE 150 150 200 250

12 MICRODERMABRASION PROCEDURE 2,150 2,150 2,800 3,450

13 MINOR DERMATO PROCEDURE 1,650 1,650 2,200 2,650

PROCEDURES
14 PRP THERAPY PROCEDURE 5,350 5,350 6,950 8,550

15 PULSE THERAPY PROCEDURE 2,150 2,150 2,800 3,450

16 RADIOFREQUENCY T/T PROCEDURE

(WARTS,DPNS,ACROS,
SKINTAGS) PER ADDITIONAL
250 250 350 400
LESION
17 RADIOFREQUENCY T/T PROCEDURE
(WARTS,DPNS,ACROS,
SKINTAGS) UPTO 5 LESIONS
2,150 2,150 2,800 3,450

REMOVAL OF EPIDERMAL/
18 OTHER CYST PROCEDURE 5,350 5,350 6,950 8,550

19 SKIN BIOPSY (PUNCH/ PROCEDURE 1,650 1,650 2,200 2,650

ELLIPTICAL)
SOFT TISSUE FILLER
20 PROCEDURE CHARGES STAGE - PROCEDURE 4,250 4,250 5,550 6,800
I
SOFT TISSUE FILLER
21 PROCEDURE CHARGES STAGE - PROCEDURE 6,800 6,800 8,850 10,850
II
22 SUTURE REMOVAL PROCEDURE 150 150 200 250
(DERMATOLOGY)
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
11,000 13,750

5,200 6,500

4,400 5,500

1,300 1,650

4,300 5,400

500 650

5,300 6,650

3,300 4,200

2,200 2,750

1,300 1,650

300 400

4,300 5,400

3,300 4,200

10,700 13,400

4,300 5,400

500 650

4,300 5,400

10,700 13,400

3,300 4,200

8,500 10,650

13,600 17,000
300 400
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate General -
Department- ENDOCRINOLOGY
- Casualty Ward Transplant
ICU

SR. NO. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 ANCLE BRACHIAL BLOOD DIAGNOSTIC 500 500 650 800
PREMERE INDEX
CARDIAC AUTONOMIC NEUROPATHY 750 750 950 1,200
2 SYSTEM ANALYZER DIAGNOSTIC
(CANS)
3 CGMS(CONTINUOUS GLUCOSE DIAGNOSTIC 4,250 4,250 5,550 6,800
MONITORING SYSTEM)
4 INSULIN TOLERENCE TEST ( ITT) DIAGNOSTIC 3,200 3,200 4,200 5,200

5 SYNACTHEN STIMULATION TEST DIAGNOSTIC 650 650 850 1,050

6 VIBRATION PERCEPTION TEST VPT DIAGNOSTIC 500 500 650 800

(VIBROTHERM DX)
7 WATER DEPRIVATION TEST DIAGNOSTIC 2,200 2,200 2,850 3,500
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
1,000 1,250

1,500 1,850

8,500 10,650

6,500 8,000

1,300 1,650

1,000 1,250

4,500 5,500
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate -
Department- ENT - Casualty
General Ward
Transplant
ICU

SR. NO. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 90 DEGREE TELESCOPY PROCEDURE 1,500 1,500 1,950 2,400
2 ABSCESS PARAPHARYNGEAL SURGEON FEE
- TRANSCERVICAL APPROACH
10,100 13,150 16,150

ADENOIDECTOMY SURGEON FEE 13,500 17,550 21,600

3 ENDOSCOPIC DEBRIDER ASSISTED

ADENOIDECTOMY 42,900 55,750 68,650

4 ENDOSCOPIC DEBRIDER ASSISTED PACKAGE
(PACKAGE)
5 ADVANCED SCHWANNOMAS AND SURGEON FEE
HEMANGIOMAS OF THE FACIAL
NERVE 27,500 35,750 44,000

6 Aided Audiometery PROCEDURE 650 650 850 1,050

7 ANTERIOR NASAL PACKING SURGEON 1,400 1,400 1,850 2,250
FEE
8 AUDIOGRAM ( PTA ) PROCEDURE 1,000 1,000 1,300 1,600
AUDITORY STEADY-STATE 1,500 1,500 1,950 2,400
9 RESPONSE (ASSR) TESTING PROCEDURE

10 Behavioral Observational PROCEDURE 650 650 850 1,100

Audiometery
11 BERA SCREENING PROCEDURE 1,800 1,800 2,350 2,900
12 BIOPSY LYMPH NODE SURGEON 11,500 11,500 14,950 18,400
FEE
13 BIOPSY LYMPH NODE PACKAGE 37,500 48,750 60,000
(PACKAGE)
14 BIOPSY ORAL CAVITY PROCEDURE 11,750 11,750 15,300 18,800
15 BIOPSY UNDER GA SURGEON 3,900 3,900 5,100 6,250
FEE
16 BONE ANCHORED HEARING SURGEON 18,000 23,400 28,800
AID (BAHA) FEE
17 BRANCHIAL CYST SURGEON 10,200 13,300 16,350
FEE
18 CALDWEL LUC B/L SURGEON 7,600 9,800 12,200
FEE
19 CALDWEL LUC U/L SURGEON 6,800 8,850 10,900
FEE
20 CAROTID BODY TUMOUR SURGEON 23,800 30,950 38,100
FEE
21 CAUTERY TURBINATOR SURGEON 2,900 2,900 3,750 4,650
FEE
22 CAUTERY TURBINATOR PACKAGE 17,700 23,000 28,350
(PACKAGE)
23 CHOANAL ATRESIA SURGEON 15,500 20,150 24,800
FEE
24 COCHLEAR IMPLANTATION SURGEON 20,500 26,650 32,800
FEE
25 COCHLEAR IMPLANTATION ( SURGEON 61,500 79,950 98,400
ADVANCE ) FEE
26 CONCHOPLASTY SURGEON 5,000 5,000 6,500 8,000
FEE
27 CONCHOPLASTY (PACKAGE) PACKAGE 18,050 23,500 28,900

28 Condition Play Audiometery PROCEDURE 1,100 1,100 1,450 1,750

29 CORD LATERALISATION SURGEON 15,500 20,150 24,800
FEE
30 CORDECTOMY LASER SURGEON 15,500 20,150 24,800
FEE
31 CRICOPHARYNGEAL SURGEON 13,500 17,550 21,600
MYOTOMY FEE
DEBRIDEMENT MALIGNANT SURGEON FEE 15,500 20,150 24,800
32 OTITIS EXTERNA- DEBRIDEMENT

33 DECOMPRESSION SURGEON 20,500 26,650 32,800

ENDOLYMPHATIC SAC FEE
34 DECOMPRESSION FACIAL SURGEON 18,000 23,400 28,800
NERVE FEE
35 DECOMRESSION OPTIC SURGEON 20,500 26,650 32,800
NERVE - ENDOSCOPIC FEE
36 DEEP EXCISION BIOPSY ( PROCEDURE 11,700 11,700 15,200 18,750
Punch Biopsy )
37 DIRECT LARYNGOSCOPY SURGEON 2,900 2,900 3,750 4,650
FEE
38 DRAINAGE ABSCESS - SURGEON 6,800 8,850 10,900
MAJOR FEE
39 DRAINAGE ABSCESS - MINOR SURGEON 3,200 3,200 4,200 5,150
FEE
40 DRAINAGE ABSCESS NASAL SURGEON 5,800 7,550 9,300
FEE
41 DRAINAGE ABSCESS SURGEON 7,600 9,900 12,200
PAROTID FEE
42 DRAINAGE ABSCESS SURGEON 7,600 9,900 12,200
RETEROPHARYNGEAL FEE
43 DRAINAGE LUDWIGS ANGINA SURGEON 7,600 9,900 12,200
FEE
44 DRESSING MAJOR PROCEDURE 1,550 1,550 2,000 2,500
45 DRESSING MEDIUM PROCEDURE 750 750 980 1,200
46 DRESSING MINOR PROCEDURE 450 450 590 750
47 DROOLING SURGERY SURGEON 10,100 13,200 16,150
FEE
48 EAR LACERATION REPAIR - PROCEDURE 2,800 2,800 3,650 4,500
LARGE
49 EAR LACERATION REPAIR - PROCEDURE 2,550 2,550 3,350 4,100
MEDIUM
50 EAR LACERATION REPAIR - PROCEDURE 1,850 1,850 2,400 2,950
SMALL
51 EAR LOBULE REPAIR B/L PROCEDURE 4,550 4,550 5,900 7,300
52 EAR LOBULE REPAIR U/L PROCEDURE 2,450 2,450 3,200 3,950
53 EAR PIERCING PROCEDURE 1,100 1,100 1,450 1,750
54 ELECTRICAL PROCEDURE 1,800 1,800 2,350 2,900
CAUTERISATION NOSE
ENDOSCOPIC SURGEON FEE 36,200 47,000 57,950
55 DACRYOCYSTORHINOSTOMY

56 ENDOSCOPIC DIVERTICULOTOMY SURGEON FEE

WITH CAUTERY, LASER, OR
STAPLER 7,500 9,750 12,000
57 ENDOSCOPIC EXCISION OF SURGEON 18,000 23,400 28,800
ANGIOFIBROMA FEE
58 ENDOSCOPIC NASAL SURGEON 3,200 3,200 4,200 5,150
BIOPSY/CAUTERY FEE
59 ENDOSCOPIC ORBITAL SURGEON 20,500 26,650 32,800
DECOMPRESSION FEE
60 ENDOSCOPIC SKULL BASE SURGEON 23,800 30,950 38,100
SURGERY FEE
61 EXCISION ANGIOFIBROMA SURGEON 23,800 30,950 38,100
FEE
62 EXCISION ANGIOFIBROMA SURGEON 31,000 40,300 49,600
GOING UPTO SKULL BASE FEE
EXCISION EXTERNAL AUDITORY SURGEON FEE 5,000 5,000 6,500 8,000
63 CANAL OSTEOMA

64 EXCISION GLOMUS SURGEON 23,800 30,950 38,100

JUGULARE FEE
65 EXCISION GLOMUS SURGEON 20,500 26,650 32,800
TYMPANICUM FEE
66 EXCISION NECK SURGEON 20,500 26,650 32,800
LYMPHANGIOMA FEE
67 EXCISION NECK MASS SURGEON 7,500 9,750 12,000
LARGE FEE
68 EXCISION OF BRANCHIAL SURGEON 9,000 11,700 14,400
SINUS FEE
EXCISION OF THYROGLOSSAL SURGEON FEE 7,500 9,750 12,000
69 CYST/FISTULA

EXCISION PARAPHARYNGEAL SURGEON FEE 10,100 13,200 16,150

70 TUMOUR

71 EXCISION PARATHYROID SURGEON 36,200 47,100 57,950

GLAND FEE
72 EXCISION PLUNGING SURGEON 10,100 13,200 16,150
RANULA FEE
EXCISION PSEUDOCYST PINNA 4,700 4,700 6,200 7,550
73 STEROID INJECTION PROCEDURE

EXCISION RECURRENT SURGEON FEE 15,500 20,150 24,800

74 RESPIRATORY PAPILLOMA
PRIMARY
75 EXCISION SUBLINGUAL SURGEON 9,000 11,700 14,400
GLAND FEE
76 EXCISION SUBMANDIBULAR SURGEON 11,500 14,950 18,400
GLAND FEE
77 EXICISON FRONTAL SURGEON 9,000 11,700 14,400
MUCOCELE FEE
78 FB FOREIGN BODY REMOVAL PROCEDURE 750 750 980 1,200
EAR
FUNCTIONAL ENDOSCOPIC SINUS SURGEON FEE 15,500 20,150 24,800
79 SURGERY (FESS) B/L

80 FUNCTIONAL ENDOSCOPIC SINUS PACKAGE

SURGERY (FESS) B/L (PACKAGE)
48,700 63,300 77,950

81 FUNCTIONAL ENDOSCOPIC SINUS SURGEON FEE

SURGERY (FESS) EXTENDED
20,500 26,650 32,800

FUNCTIONAL ENDOSCOPIC SURGEON FEE 9,000 11,700 14,400

82 SINUS SURGERY (FESS) LIMITED
 83 GROMMET B/L SURGEON 3,900 3,900 5,100 6,250
FEE
84 Hearing Aid Trial PROCEDURE 1,400 1,400 1,850 2,250
85 Hemithyroidectomy (PACKAGE) PACKAGE 41,500 53,950 66,400

86 INTRATYMPANIC INJECTION SURGEON 1,450 1,450 1,900 2,350

FEE
87 INTUBATION - DIFFICULT SURGEON 1,450 1,450 1,900 2,350
FEE
KELOID/ CYST/WART COMPLEX / 12,600 12,600 16,400 20,200
88 SEBACEOUS PROCEDURE
CYST
89 LABYRINTHECTOMY SURGEON 20,500 26,650 32,800
FEE
90 LARINGOSCOPY PROCEDURE 10,500 10,500 13,650 16,800
91 LARYNGOFISSURE SURGEON 11,500 14,950 18,400
FEE
92 Mapping ( Per Year ) PROCEDURE 11,700 11,700 15,200 18,750
93 MEDIALISATION OF CORD ( SURGEON 27,500 35,750 44,000
THYROPLASTY ) FEE
94 MESTOIDECTOMY SURGEON 20,500 26,650 32,800
FEE
95 MESTOIDECTOMY PACKAGE 76,500 99,450 122,400
(PACKAGE)
MICRO LARYNGEAL SURGEON FEE 10,100 13,200 16,200
96 SURGERY (MLS) LASER COBLATOR

97 MICROLARYNGEAL SURGERY SURGEON 10,100 13,200 16,200

CYST , POLYP FEE
MICROLARYNGEAL SURGERY CYST 38,500 50,050 61,600
98 , POLYP (PACKAGE) PACKAGE

99 MYRINGOPLASTY SURGEON 9,000 11,700 14,400

FEE
100 MYRINGOPLASTY (PACKAGE) PACKAGE 32,000 41,600 51,200

101 MYRINGOTOMY SURGEON 11,500 14,950 18,400

FEE
102 MYRINGOTOMY WITH SURGEON 11,500 14,950 18,400
GROMMET INSERTION FEE
MYRINGOTOMY WITH 36,800 47,850 58,900
103 GROMMET INSERTION (PACKAGE) PACKAGE

104 NASAL ENDOSCOPY PROCEDURE 5,900 5,900 7,600 9,450

105 NASAL FRACTURE SURGEON 6,800 8,850 10,900
REDUCTION FEE
106 NASAL PACKING PROCEDURE 7,800 7,800 10,150 12,500
MEROCOELE B/L
107 NASOPHARYNGEAL STENOSIS SURGEON FEE
ADHESIONOLYSIS WITH STENTING
7,500 9,750 12,000

108 OAE PROCEDURE 800 800 1,100 1,300

OBSTRUCTIVE SLEEP APNEA (OSA) SURGEON FEE 10,100 13,200 16,200
109 SURGERY ( SIMPLE )

OBSTRUCTIVE SLEEP APNEA (OSA) SURGEON FEE 15,500 20,150 24,800

110 SURGERY COMPLEX

111 OESOPHAGOSCOPY SURGEON 5,000 5,000 6,500 8,000

FEE
112 OROPHARYNGEAL SURGEON 4,500 4,500 5,850 7,200
STRICTURE DILATATION FEE
113 OSCICULOPLASTY SURGEON 11,500 14,950 18,400
FEE
114 PANENDOSCOPY WITH BLIND SURGEON 7,500 9,750 12,000
BIOPSIES- ENT FEE
115 PAROTIDECTOMY EXTENDED SURGEON 23,800 30,950 38,100
- RADICAL FEE
116 PARTICLE REPOSITIONING PROCEDURE 650 650 850 1,050
117 Pediatric Hearing Assesment PROCEDURE 4,900 4,900 6,400 7,850

118 PERI TONSILAR ABCESS- SURGEON 3,900 3,900 5,100 6,250

QUINSY FEE
POSTERIOR CORDECTOMY AND SURGEON FEE 11,500 14,950 18,400
119 ARYTENOIDECTOMY

120 POSTERIOR NASAL PACKING SURGEON 5,550 5,550 7,200 8,850

FEE
121 POSTERIOR PHARYNGOPLASTY SURGEON FEE
FOR VELOPHARYNGEAL
INSUFFICIENCY (VPI) 13,500 17,550 21,600

122 PRE AURICULER SINUS SURGEON 6,800 8,850 10,900

FEE
123 PRE AURICULER SINUS PACKAGE 2,800 3,650 4,500
(PACKAGE)
124 RADICAL MASTOIDECTOMY SURGEON 41,000 53,300 65,600
FEE
125 RANULA MARSUPIALISATION SURGEON 5,000 5,000 6,500 8,000
FEE
126 REMOVAL AIRWAY FOREIGN SURGEON 10,100 13,200 16,200
BODY FEE
127 REMOVAL ESOPHAGEAL SURGEON 7,500 9,750 12,000
FOREIGN BODY FEE
128 REMOVAL PALATAL TUMOR / SURGEON 5,000 5,000 6,500 8,000
CYST FEE
129 REMOVAL RHINOLITH SURGEON 7,500 9,750 12,000
FEE
130 REMOVAL STENT SURGEON 2,800 2,800 3,650 4,500
FEE
131 REMOVAL SUBMANDIBULAR SURGEON FEE
GLAND STONE ( SAIL
ENDOSCOPY )-THERAPEUTIC 9,000 11,700 14,400

132 REPAIR CSF RHINORRHEA SURGEON 20,200 26,300 32,350

FEE
133 REPAIR FACIAL NERVE WITH SURGEON 18,000 23,400 28,800
NERVE GRAFT FEE
134 REPAIR LARYNGEAL CLEFT SURGEON 13,500 17,550 21,600
FEE
RESECTION / DEBRIDEMENT SURGEON FEE 27,500 35,750 44,000
135 TEMPORAL BONE

136 RESECTION CRANIOFACIAL SURGEON 23,800 30,950 38,100

FEE
137 RESECTION END TO END SURGEON 18,000 23,400 28,800
ANASTHOMOSIS TRACHEA FEE
138 RESECTION SUB MUCOSAL SURGEON 7,600 9,850 12,200
FEE
139 RESUTURING OF WOUND SURGEON 1,450 1,450 1,850 2,350
FEE
140 SCLEROTHERAPY SURGEON 3,300 3,300 4,300 5,300
FEE
141 SEPTOPLASTY SURGEON 9,000 11,700 14,400
FEE
142 SEPTOPLASTY (PACKAGE) PACKAGE 32,000 41,600 51,200
143 SEPTORHINOPLASTY SURGEON 23,800 30,950 38,100
FEE
144 SIALOENDOSCOPY ( SURGEON 5,000 5,000 6,500 8,000
DIAGNOSTIC ) FEE
145 SIALOENDOSCOPY SURGEON 10,100 13,200 16,200
THERAPEUTIC FEE
146 SKULL BASE SURGERY SURGEON 27,450 35,700 43,950
COMPLEX FEE
147 SKULL BASE SURGERY SURGEON 18,000 23,400 28,800
SIMPLE FEE
148 SPEECH THERAPY ( per PROCEDURE 300 300 400 500
session )
149 SPHENOIDOTOMY SURGEON 11,500 14,950 18,400
FEE
150 STAPEDECTOMY SURGEON 15,500 20,150 24,800
FEE
151 STAPEDECTOMY (PACKAGE) PACKAGE 55,800 72,550 89,300

152 STROBOSCOPY PROCEDURE 1,800 1,800 2,350 2,900

153 STYLOIDECTOMY B/L SURGEON 15,500 20,150 24,800
FEE
154 STYLOIDECTOMY U/L SURGEON 11,500 14,950 18,400
FEE
155 SUTURING OF LACERATED SURGEON 3,900 3,900 5,100 6,250
WOUND FEE
156 SWALLOW THERAPY PROCEDURE 2,250 2,250 2,950 3,600
157 THYROID LINGUAL SURGEON 6,800 8,850 10,900
FEE
158 THYROIDECTOMY TOTAL SURGEON 15,500 20,150 24,800
FEE
159 THYROIDECTOMY TOTAL PACKAGE 68,700 89,310 109,950
(PACKAGE)
160 THYROIDECTOMY WITH SURGEON 23,800 30,950 38,100
NECK CLEARANCE TOTAL FEE
161 THYROPLASTY TYPE 1 SURGEON 15,500 20,150 24,800
ARYTENOID ADDUCTION FEE
162 THYROPLASTY TYPE 2 SURGEON 15,500 20,150 24,800
FEE
163 THYROPLASTY TYPE 3 SURGEON 13,500 17,550 21,600
FEE
164 THYROPLASTY TYPE 4 SURGEON 11,500 14,950 18,400
FEE
165 TONSILLECTOMY ( SURGEON 18,000 23,400 28,800
COABLATER ) FEE
166 TONSILLECTOMY AND SURGEON 15,500 20,150 24,800
ADENOIDECTOMY FEE
TONSILLECTOMY AND 53,700 69,800 85,950
167 ADENOIDECTOMY PACKAGE
(PACKAGE)
TONSILLECTOMY AND SURGEON FEE 27,500 35,750 44,000
168 ADENOIDECTOMY WITH GROMMET
INSERTION
169 TOUNGE TIE RELEASE SURGEON 3,900 3,900 5,000 6,250
UNDER LA FEE
170 TOUNGE TYRE RELEASE SURGEON 3,900 3,900 5,000 6,250
UNDER GA FEE
171 TRACHEAL STOMA REVISION SURGEON 7,500 9,750 12,000
FEE
TRACHEASTOMY GRANULATION SURGEON FEE 3,900 3,900 5,000 6,250
172 CAUTERY /
LASER EXCISION
TRACHEO-ESOPHAGEAL SURGEON FEE 1,450 1,450 1,900 2,350
173 PROSTHESIS INSERTION/
CHANGE
174 TRACHEO-ESOPHAGEAL SURGEON 7,500 9,750 12,000
PROSTHESIS PUNCTURE FEE
175 TRACHEOPLASTY SURGEON 20,500 26,650 32,800
FEE
176 TRANS ORAL ROBOTIC SURGEON 13,500 17,550 21,600
SURGERY FEE
TRANSNASAL RF SURGEON FEE 10,100 13,150 16,160
177 (RADOIFREQUENCY) VIDIAN
NEURECTOMY
178 TYMPANOMETRY PROCEDURE 550 550 750 850
179 TYMPANOPLASTY SURGEON 15,500 20,150 24,800
FEE
180 TYMPANOPLASTY PACKAGE 54,900 71,350 87,850
(PACKAGE)
181 UVULAPLASTY LASER SURGEON 7,600 9,900 12,150
ASSISTED FEE
182 UVULOPHARYNGOPLASTY SURGEON 15,500 20,150 24,800
FEE
183 VOICE THERAPY PROCEDURE 300 300 400 500
184 WOUND REEXPLORATION SURGEON 2,900 2,900 3,750 4,650
FEE
185 Tymanoplasty - PACKAGE 12,000 18,000 24,000
(PROMOTIONAL PACKAGE)
186 Mastoidectomy - PACKAGE 15,000 25,000 35,000
(PROMOTIONAL PACKAGE)
187 Sinus Surgery(FESS) - PACKAGE 15,000 25,000 35,000
(PROMOTIONAL PACKAGE)
188 Tonsillectomy - PACKAGE 10,000 17,500 25,000
(PROMOTIONAL PACKAGE)
189 Septoplasty - (PROMOTIONAL PACKAGE 10,000 17,500 25,000
PACKAGE)
190 Thyroidectomy - PACKAGE 20,000 30,000 40,000
(PROMOTIONAL PACKAGE)
191 Adenoidectomy - PACKAGE 10,000 17,500 25,000
(PROMOTIONAL PACKAGE)
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
3,000 3,750

20,200 25,250

27,000 33,750

85,800 107,250

55,000 68,750

1,300 1,650
2,800 3,500

2,000 2,500
3,000 3,750

1,300 1,650

3,600 4,500
23,000 28,750

75,000 93,750

23,500 29,400
7,800 9,750

36,000 45,000

20,400 25,500

15,200 19,000

13,600 17,000

47,600 59,500

5,800 7,250

35,400 44,250

31,000 38,750

41,000 51,250

123,000 153,750
10,000 12,500

36,100 45,200

2,200 2,750
31,000 38,750

31,000 38,750

27,000 33,750

31,000 38,750

41,000 51,250

36,000 45,000

41,000 51,250

23,400 29,250

5,800 7,250

13,600 17,000

6,400 8,000

11,600 14,500

15,200 19,000

15,200 19,000

15,200 19,000

3,100 3,900
1,500 1,900
900 1,200
20,200 25,250

5,600 7,000

5,100 6,400

3,700 4,650

9,100 11,400
4,900 6,200
2,200 2,750
3,600 4,500

72,400 90,500

15,000 18,750
36,000 45,000

6,400 8,000

41,000 51,250

47,600 59,500

47,600 59,500

62,000 77,500

10,000 12,500

47,600 59,500

41,000 51,250

41,000 51,250

15,000 18,750

18,000 22,500

15,000 18,750

20,200 25,250

72,400 90,500

20,200 25,250

9,400 11,750

31,000 28,750

18,000 22,500

23,000 28,750

18,000 22,500

1,500 1,900

31,000 38,750

97,400 121,750

41,000 51,250

18,000 22,500
 7,800 9,750

2,800 3,500
8,300 103,750

2,900 3,650

2,900 3,650

25,200 31,500

41,000 21,250

21,000 26,250
23,000 28,750

23,400 29,250
55,000 68,750

41,000 51,250

153,000 191,250

20,200 25,250

20,200 25,250

77,000 9,650

18,000 22,500

64,000 80,000

23,000 28,750

23,000 28,750

73,600 92,000

11,800 14,750
13,600 17,000

15,600 19,500

15,000 18,750

1,600 2,000
20,200 25,250

31,000 38,750

10,000 12,500
 9,000 11,250

23,000 28,750

15,000 18,750

47,600 59,800

1,300 1,650
9,800 12,250

7,800 9,750

23,000 28,750

11,100 13,900

27,000 33,750

13,600 17,000

5,600 7,000

82,000 102,500

10,000 12,500

20,200 25,250

15,000 18,750

10,000 12,500

15,000 18,750

5,600 7,000

18,000 22,500

40,400 50,500

36,000 45,000

27,000 33,750

55,000 68,750

47,600 59,500

36,000 45,000

15,200 19,000

2,900 3,650
 6,600 8,250

18,000 22,500

64,000 80,000
47,600 59,500

10,000 12,500

20,200 25,250

54,900 68,650

36,000 45,000

600 750

23,000 28,750

31,000 38,750

111,600 139,500

3,600 4,500
31,000 38,750

23,000 28,750

7,800 9,750

4,500 5,650
13,600 17,000

31,000 38,750

137,400 171,750

47,600 59,500

31,000 38,750

31,000 38,750

27,000 33,150

23,000 28,750

36,000 45,000

31,000 38,750

107,400 134,250

55,000 68,750

7,800 9,750
 7,800 9,750

15,000 18,750

7,800 9,750

2,900 3,650

15,000 18,750

41,000 51,250

27,000 33,750

20,200 25,250

1,100 1,400
31,000 38,750

109,800 137,250

15,200 19,000

31,000 38,750

600 750
5,800 7,250

- -

- -

- -

- -

- -

- -

- -
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate General -
Department- GASTROENTEROLOGY
- Casualty Ward Transplant
ICU

SR. NO. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 APC PROCEDURE 12,750 12,750 16,550 20,400
2 APC SUBSEQUENT PROCEDURE 7,650 7,650 9,950 12,250
3 ARGON PLASMA PROCEDURE 11,200 11,200 14,550 17,950
COAGULATION
ASCITIC TAP LARGE VOLUME
4 PARACENTESIS (LVP) THERAPY PROCEDURE 2,500 2,500 3,250 4,000

5 ASCITIC TAPING - DIAGNOSTIC PROCEDURE 2,200 2,200 2,850 3,550

6 ASCITIC TAPING - PROCEDURE 5,300 5,300 6,890 8,500

THERAPEUTIC
BANDING (EVL) ENDOSCOPIC
7 VARICEAL LIGATION PROCEDURE 12,750 12,750 16,550 20,400

BIB (BIOENTERICS INTRAGASTRIC

8 BALLOON) PLACEMENT PROCEDURE 12,750 12,750 16,550 20,400

BIB (BIOENTERICS INTRAGASTRIC

9 BALLOON) REMOVAL PROCEDURE 6,800 6,800 8,850 10,850

10 BIB Placement PROCEDURE 12,750 12,750 16,550 20,400

11 BILIARY CRE (CONTROLLED RADIAL PROCEDURE
EXPANSION) BALLON DILATION
ercp ADDITIONA
9,600 9,600 12,500 15,400

12 BILIARY MANOMETRY PROCEDURE 19,200 19,200 24,950 30,750

13 BILIARY SEMS (SELF- PROCEDURE 14,500 14,500 18,850 23,200
EXPANDING METAL STENTS)
14 CAPSULE ENDOSCOPY PROCEDURE 38,500 38,500 50,050 61,600
15 CHROMOENDOSCOPY PROCEDURE 2,200 2,200 2,850 3,550
16 COLONOSCOPY PROCEDURE 7,100 7,100 9,250 11,400
17 COLONOSCOPY LEFT SIDED PROCEDURE 3,800 3,800 4,950 6,100

18 Colonoscopy Therapeutic PROCEDURE 15,900 15,900 20,650 25,450

CRE ( CONTROLLED RADIAL
19 EXPANSION) BALLOON DILATION PROCEDURE 12,750 12,750 16,550 20,400

20 CYSTOGASTROSTOMY PROCEDURE 30,600 30,600 39,750 48,950

21 DILATION SAVARY-GILLAARD PROCEDURE 7,400 7,400 9,650 11,850
22 DUODENOSCOPY PROCEDURE 10,100 10,100 13,200 16,150
23 EMR (ENDOSCOPIC MUCOSAL PROCEDURE 13,800 13,800 17,950 22,100
RESECTION)
24 ERCP - MECHANICAL PROCEDURE 13,300 13,300 17,300 21,300
LITHOTRIPSY
25 ERCP - ROUTINE SURGEON FEE 5,900 5,900 7,650 9,450

26 ERCP - STENTING BILIARY / PROCEDURE 13,300 13,300 17,300 21,300

PANCREATIC
 ERCP + CYSTOGASTROSTOMY
27 - COMPLEX PROCEDURE 27,300 27,300 35,500 43,700

28 ERCP + LITHOTRIPSY PROCEDURE 42,500 42,500 55,250 68,000

29 ERCP Therapeutic PROCEDURE 29,750 29,750 38,650 47,600
30 ESD (ENDOSCOPIC PROCEDURE 18,100 18,100 23,550 28,950
SUBMUCOSAL DISSECTION)
31 ESOPHAGEAL DILATION PROCEDURE 8,500 8,500 11,050 13,600
32 ESOPHAGEAL PROSTHESIS PROCEDURE 12,750 12,750 16,500 20,400
33 Esophagoscopy PROCEDURE 2,900 2,900 3,750 4,650
EST (ENDOSCOPIC
34 SCLEROTHERAPY) // GLUE PROCEDURE 10,600 10,600 13,750 16,950
INJECION
EUS (ENDOSCOPIC ULTRASOUND)-
35 DIAGNOSTIC PROCEDURE 12,700 12,700 16,500 20,350

EUS (ENDOSCOPIC
36 ULTRASOUND) GUIDED PROCEDURE 27,800 27,800 36,200 44,500
CYSTOGASTROSTOMY
37 EUS Biliary Drainage PROCEDURE 15,900 15,900 20,650 25,450
38 Eus Therapeutic PROCEDURE 34,000 34,000 44,200 54,400
EUS(ENDOSCOPIC ULTRASOUND)
39 + FNA (FINE NEEDLE ASPIRATION) PROCEDURE 12,400 12,400 16,200 19,850

40 FIBROSCAN PROCEDURE 3,300 3,300 4,250 5,300

41 FIBROSCAN - PROCEDURE 4,800 4,800 4,250 7,700
PRETRANSPLANT
42 FLOUROSCOPIC CHECK OF DIAGNOSTIC 1,800 1,800 2,350 2,850
PANCREATIC STONES
43 FOREIGN BODY REMOVAL PROCEDURE 23,500 23,500 30,550 37,600
44 FOREIGN BODY REMOVAL - PROCEDURE 15,300 15,300 19,890 24,500
Sharp/ Impacted
45 H-2 BREATH TEST DIAGNOSTIC 3,800 3,800 4,950 6,100
46 MANOMETRY ESOPHAGEAL / PROCEDURE 6,400 6,400 8,350 10,250
RECTAL
47 MICROLITH STUDY DIAGNOSTIC 5,900 5,900 7,650 9,450
48 N J (NASOJEJUNAL TUBE)TUBE PROCEDURE 7,400 7,400 9,650 11,850
PLACEMENT
49 NASO BILIARY DRAIN PROCEDURE 9,700 9,700 12,600 15,550
NBD (NASOBILIARY BILE DRAIN) +
50 EPT(ENDOSCOPIC PAPILLOTOMY) PROCEDURE 10,600 10,600 13,750 16,950

NBD (NASOBILIARY BILE DRAIN)

51 CHECK CHOLANGIOGRAM PROCEDURE 1,900 1,900 2,450 3,100

PEG (PERCUTANEOUS
52 ENDOSCOPIC GASTROSTOMY) PROCEDURE 12,800 12,800 16,650 20,500

53 PEG (PERCUTANEOUS PROCEDURE

ENDOSCOPIC GASTROSTOMY)
REPLACEMENT/ REMOVAL
10,600 10,600 13,750 16,950

54 PH MONITORING PROCEDURE 15,900 15,900 20,650 25,450

55 PILE BANDING PROCEDURE 10,200 10,200 13,250 16,350
56 Polypectomy PROCEDURE 12,700 12,700 16,500 20,350
 57 PROCTOSCOPY PROCEDURE 3,200 3,200 4,200 5,200
SB (SENGSTAKEN-
58 BLAKEMORE)TUBE PLACEMENT PROCEDURE 2,900 2,900 3,750 4,650

59 SEMS (SELF-EXPANDING PROCEDURE 11,500 11,500 14,950 18,400

METAL STENTS)- COLONIC
SEMS (SELF-EXPANDING METAL
60 STENTS)- DUODENAL PROCEDURE 7,500 7,500 9,750 12,000

SEMS (SELF-EXPANDING METAL

61 STENTS)- ESOPHAGEAL PROCEDURE 7,500 7,500 9,750 12,000

62 SIDE VIEWING endoscopy PROCEDURE 5,500 5,500 7,150 8,800

63 SIGMOIDOSCOPY PROCEDURE 5,500 5,500 7,150 8,800
64 STENTING BILIARY / PROCEDURE 14,900 14,900 19,400 23,850
PANCREAS
65 SUBSEQUENT DILATION Savary PROCEDURE 5,500 5,500 7,150 8,800
GILLARD
66 UGI Therapeutic PROCEDURE 15,900 15,900 20,650 25,450
67 UPPER GASTROINTESTINAL PROCEDURE 4,700 4,700 6,100 7,550
ENDOSCOPY
- Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate General -
Department- GEN. SURGERY - Casualty Ward Transplant Deluxe
ICU

SR. NO. Service Name Service Head OP Rates General Twin Private Deluxe
Ward Sharing Room
1 ADHESIOLYSIS - OPEN SURGEON FEE 13,600 17,650 21,700 27,200
2 ADRENALECTOMY U/L - SURGEON FEE 28,050 36,450 44,850 56,100
OPEN
3 AMPUTATION - ABOVE SURGEON FEE 15,700 20,400 25,150 31,400
KNEE
4 AMPUTATION - BELOW SURGEON FEE 10,600 13,800 17,000 21,200
KNEE
5 AMPUTATION - DIGITAL SURGEON FEE 4,700 4,700 6,150 7,550 9,400
6 AMPUTATION - MID TARSAL SURGEON FEE 8,900 11,550 14,250 17,800

7 ANAL SPHINCTER REPAIR SURGEON FEE 18,300 23,800 29,300 36,600

8 ANOPLASTY SURGEON FEE 13,600 17,700 21,800 27,200

9 Appendectomy - LAP ( Acute) SURGEON FEE 23,800 30,950 38,100 47,600

10 Appendectomy - LAP ( Acute) PACKAGE 79,050 102,750 126,500 158,100

(PACKAGE)
11 APPENDICECTOMY - LAP SURGEON FEE 10,600 13,750 17,000 21,200
12 APPENDICECTOMY - LAP PACKAGE 59,900 77,850 95,850 119,800
(PACKAGE)
13 APPENDICECTOMY - OPEN SURGEON FEE 8,900 11,550 14,250 17,800

14 APPENDICECTOMY - OPEN SURGEON FEE 23,800 30,950 38,100 47,600

( Acute)
15 APPENDICECTOMY - OPEN PACKAGE 32,300 41,950 51,700 64,600
(PACKAGE)
ASPIRATION OF GANGLION
16 + LOCAL STEROID INJECTION SURGEON FEE 1,700 1,700 2,200 2,750 3,400
17 ASPIRATION OF SURGEON FEE 1,700 1,700 2,200 2,750 3,400
HAEMATOMA
18 BILIO - PANCREATIC SURGEON FEE 55,250 71,850 88,400 110,500
DIVERSION
19 BIOPSY EXCISION LYMPH SURGEON FEE 5,100 5,100 6,650 8,200 10,200
NODE MULTIPLE
20 BIOPSY EXCISION LYMPH SURGEON FEE 4,700 4,700 6,100 7,500 9,400
NODE SINGLE
21 BIOPSY EXCISIONAL - SURGEON FEE 3,800 3,800 4,950 6,100 7,600
SMALL TUMOR
22 BIOPSY LUNG - LAP SURGEON FEE 11,900 15,500 19,050 23,800
23 BIOPSY MUSCLE SURGEON FEE 3,500 3,500 4,500 5,600 7,000
24 BIOPSY SCALENE NODE SURGEON FEE 4,700 4,700 6,100 7,500 9,400
25 BIOPSY TONGUE SURGEON FEE 3,400 3,400 4,450 5,450 6,800
26 BIOPSY TRANS ANAL SURGEON FEE 3,800 3,800 4,950 6,100 7,600
RECTAL
27 BLEEDING DUODENAL SURGEON FEE 11,900 15,500 19,050 23,800
ULCER
28 BLOCK DISSECTION ILIO SURGEON FEE 21,250 27,650 34,000 42,500
INGUINAL B/L
29 BLOCK DISSECTION ILIO SURGEON FEE 23,800 30,950 38,100 47,600
INGUINAL U/L
30 BRANCHIAL CYST OR SURGEON FEE 13,600 17,700 21,750 27,200
FISTULA/SINUS B/L
31 BRANCHIAL CYST OR SURGEON FEE 11,900 15,500 19,050 23,800
FISTULA/SINUS U/L
BREAST RECONSTRUCTION
32 USING SURGEON FEE 32,300 41,950 51,700 64,600
LD FLAP
33 CBD EXPLORATION - OPEN SURGEON FEE 21,250 27,650 34,000 42,500

34 CHEST TUBE INSERTION SURGEON FEE 2,950 2,950 3,850 4,700 5,900
35 CHOLECYSTECTOMY - LAP SURGEON FEE 15,700 20,400 25,100 31,400

36 CHOLECYSTECTOMY - LAP - SURGEON FEE 21,250 27,650 34,000 42,500

( Acute )
37 CHOLECYSTECTOMY - LAP - PACKAGE 79,900 103,850 127,850 159,800
( Acute ) (PACKAGE)
38 CHOLECYSTECTOMY - LAP PACKAGE 56,950 74,100 91,150 113,900
(PACKAGE)
39 CHOLECYSTECTOMY - SURGEON FEE
LAPAROSCOPIC WITH REPARI -
HERNIA, UMBICAL 28,050 36,450 44,900 56,100

40 CHOLECYSTECTOMY - SURGEON FEE 13,600 17,650 21,800 27,200

OPEN
41 CHOLECYSTECTOMY - PACKAGE 45,050 58,570 72,100 90,100
OPEN (PACKAGE)
CHOLECYSTECTOMY (WITH BILE
42 DUCT SURGEON FEE 21,250 27,650 34,000 42,500
EXCISION) - RADICAL
CHOLECYSTECTOMY (WITHOUT
43 BILE DUCT SURGEON FEE 18,300 23,800 29,300 36,600
EXCISION) - RADICAL
44 CHOLECYSTOSTOMY SURGEON FEE 8,900 11,550 14,250 17,800
45 CLOSURE OF ILEOSTOMY SURGEON FEE 8,900 11,550 14,250 17,800
46 COLECTOMY HEMI RIGHT OR SURGEON FEE
LEFT & TRANSVERSE
COLECTOMY LAP 21,250 27,650 34,000 42,500

47 COLECTOMY HEMI RIGHT OR SURGEON FEE

LEFT & TRANSVERSE
COLECTOMY OPEN 18,300 23,800 29,300 36,600

48 COLECTOMY SIGMOID OR SURGEON FEE 21,250 27,650 34,000 42,500

DESCENDING - LAP
COLECTOMY SIGMOID OR
49 DESCENDING - OPEN SURGEON FEE 18,300 23,800 29,300 36,600

50 COLECTOMY WITH ILEORECTAL SURGEON FEE

ANASTOMOSES- TOTAL - LAP
32,300 42,000 51,700 64,600

51 COLECTOMY WITH ILEORECTAL SURGEON FEE

ANASTOMOSES- TOTAL - OPEN
21,250 27,650 34,000 42,500

52 COLON REPLACEMENT SURGEON FEE 42,500 55,250 68,000 85,000

FOR ESOPHAGUS
53 COLOSTOMY - LAYING SURGEON FEE 18,300 23,800 29,300 36,600
OPEN
COLOSTOMY / ILEOSTOMY
54 (INCLUDING LAYING OPEN) SURGEON FEE 10,600 13,800 16,950 21,200

55 COLOSTOMY CLOSED SURGEON FEE 8,900 11,550 14,250 17,800

LOOP
56 COLOSTOMY CLOSURE SURGEON FEE 10,600 13,800 19,950 21,200
57 CYSTOGASTROSTOMY - SURGEON FEE 18,300 23,800 29,300 36,600
LAP
58 CYSTOGASTROSTOMY - SURGEON FEE 32,300 42,000 51,700 64,600
OPEN
59 DEBRIDEMENT - LARGE ( > SURGEON FEE 8,900 11,550 14,250 17,800
10 CM)
60 DEBRIDEMENT - MEDIUM (5 SURGEON FEE 5,950 5,950 7,750 9,500 11,900
- 10 CM)
61 DEBRIDEMENT - SMALL ( < SURGEON FEE 4,700 4,700 6,100 7,500 9,400
5 CM)
62 DELORMES PROCEDURE SURGEON FEE 18,300 23,800 29,300 36,600

63 DEROOFING OF NON- SURGEON FEE 13,600 17,700 21,800 27,200

HYDATID LIVER CYST
DEROOFING OF NON- HYDATID
64 LIVER CYST - LAP SURGEON FEE 15,700 20,400 25,150 31,400

65 DIAGNOSTIC LAPROSCOPY SURGEON FEE 6,800 8,850 10,900 13,600

DIAGNOSTIC LAPROSCOPY
66 (PACKAGE) PACKAGE 40,900 53,200 65,450 81,800

DRAINAGE (PIGTAIL) LIVER

67 ABSCESS (CLOSED DRAINAGE) SURGEON FEE 4,700 4,700 6,100 7,500 9,400

68 DRAINAGE (PIGTAIL) SURGEON FEE 6,800 8,850 10,900 13,600

PANCREATIC ABSCESS
DRAINAGE / ASPIRATION -
69 SUPERFICIAL ABSCESS SURGEON FEE 2,900 2,900 37,750 4,650 5,800
UNDER ANESTHESIA
70 DRAINAGE ABSCESS SURGEON FEE 8,900 11,550 14,250 17,800
ISCHIORECTAL
DRAINAGE APPENDICULAR
71 ABSCESS - LAP SURGEON FEE 13,600 17,700 21,800 27,200

DRAINAGE APPENDICULAR
72 ABSCESS - OPEN SURGEON FEE 8,900 11,550 14,250 17,800

DRAINAGE INTRA
73 ABDOMINAL COLLECTION - LAP SURGEON FEE 18,300 23,800 29,300 36,600

DRAINAGE INTRA ABDOMINAL

74 COLLECTION - SURGEON FEE 13,600 17,700 21,800 27,200
OPEN
75 DRAINAGE INTRA ABDOMINAL SURGEON FEE
COLLECTION - PERCUTANEOUS
6,800 8,850 10,900 13,600

76 DRAINAGE LIVER ABSCESS SURGEON FEE 15,700 20,400 25,100 31,400

LAP
77 DRAINAGE LIVER ABSCESS SURGEON FEE 11,900 15,500 19,050 23,800
OPEN
78 DRAINAGE OF PSOAS SURGEON FEE 6,800 8,850 10,900 13,600
ABSCESS
DRAINAGE PANCREATIC
79 ABSCESS SURGEON FEE 21,300 27,700 34,100 42,600
NECROSECTOMY - LAP
DRAINAGE PANCREATIC
80 ABSCESS SURGEON FEE 18,300 23,800 29,300 36,600
NECROSECTOMY - OPEN
81 DRAINAGE PAROTID SURGEON FEE 5,950 5,950 7,750 9,500 11,900
ABSCESS
82 DRAINAGE PERIANAL SURGEON FEE 11,900 15,500 19,050 23,800
ABSCESS
83 DRAINAGE PERIANAL PACKAGE 37,400 48,650 59,850 74,800
ABSCESS (PACKAGE)
DRAINAIGE RETROPERITONEAL
84 ABSCESS - LAP SURGEON FEE 15,750 20,500 25,200 31,500

DRAINAIGE RETROPERITONEAL
85 ABSCESS - OPEN SURGEON FEE 13,600 17,700 21,800 27,200

86 DRESSING IN OT SURGEON FEE 1,700 1,700 2,200 2,700 3,400

DUODENAL ULCER
87 PERFORATION REPAIR - SURGEON FEE 18,300 23,800 29,300 36,600
LAP
DUODENAL ULCER
88 PERFORATION REPAIR - SURGEON FEE 13,600 17,700 21,800 27,200
OPEN
89 ENUCLEATION OF LEIOMYOMA SURGEON FEE
OF
OESOPHAGEAL( TRANSTHORACI 13,600 17,700 21,800 27,200
C)
90 EXAMINATION UNDER SURGEON FEE 4,700 4,700 6,100 7,500 9,400
ANESTHESIA
EXCISION & DECORTICATION OF
91 EMPYEMA - LAP SURGEON FEE 18,300 23,800 29,300 36,600

EXCISION & DECORTICATION OF

92 EMPYEMA - OPEN SURGEON FEE 13,600 17,700 21,800 27,200

93 EXCISION CYST SURGEON FEE 2,900 2,900 3,700 4,650 5,800

94 EXCISION DIABETIC SURGEON FEE 6,800 8,850 10,900 13,600
CARBUNCLE
95 EXCISION FISTULA IN ANO - SURGEON FEE 21,250 27,650 34,000 42,500
HIGH END
EXCISION FISTULA IN ANO -
96 HIGH END (PACKAGE) PACKAGE 60,600 78,750 95,950 121,200

97 EXCISION FISTULA IN ANO - SURGEON FEE 11,900 15,500 19,050 23,800

LOW END
EXCISION FISTULA IN ANO -
98 LOW END (PACKAGE) PACKAGE 41,200 53,550 65,950 82,400

99 EXCISION GLOMUS TUMOR SURGEON FEE 4,700 4,700 6,100 7,500 9,400

100 EXCISION INSULINOMA - SURGEON FEE 28,050 36,450 44,900 56,100

LAP
101 EXCISION INSULINOMA - SURGEON FEE 21,250 27,650 34,000 42,500
OPEN
102 EXCISION LARGE SURGEON FEE 6,800 8,850 10,900 13,600
SUPERFICIAL TUMOUR
103 EXCISION LIPOMA SURGEON FEE 5,100 5,100 6,650 8,200 10,200
104 EXCISION LIPOMA PACKAGE 17,500 22,750 28,000 35,000
(PACKAGE)
105 EXCISION MESENTERIC SURGEON FEE 13,600 17,700 21,800 27,200
CYST - LAP
106 EXCISION MESENTERIC SURGEON FEE 13,600 17,700 21,800 27,200
CYST - OPEN
107 EXCISION OF BREAST SURGEON FEE 8,900 11,550 14,250 17,800
LUMP
108 EXCISION OF SURGEON FEE 21,250 27,650 34,000 42,500
CHOLANGIOCARCINOMA
EXCISION OF
109 CHOLANGIOCARCINOMA WITH SURGEON FEE 32,300 41,900 51,700 64,600
HEPATECTOMY
110 EXCISION OF CHOLEDOCHAL SURGEON FEE
CYST AND HEPATICO-
JEJUNOSTOMY - LAP 32,300 41,900 517,000 64,600

111 EXCISION OF CHOLEDOCHAL SURGEON FEE

CYST AND HEPATICO-
JEJUNOSTOMY - 28,050 36,450 44,900 56,100
OPEN
EXCISION OF MULTIPLE
112 SCROTAL SEBACEOUS SURGEON FEE 4,700 4,700 6,100 7,500 9,400
CYSTS
113 EXCISION OF PILONIDAL SURGEON FEE 8,100 10,550 12,950 16,200
SINUS
EXCISION OF PILONIDAL SINUS
114 + PRIMARY SURGEON FEE 13,600 17,700 21,800 27,200
CLOSURE
EXCISION OF PILONIDAL SINUS
115 + PRIMARY PACKAGE 44,300 57,600 70,900 88,600
CLOSURE (PACKAGE)
116 EXCISION PHARYNGEAL POUCH SURGEON FEE
& CRICOPHARYNGEAL
MYTOMY 13,600 17,700 21,800 27,200

117 EXCISION RECTAL POLYP SURGEON FEE 4,700 4,700 6,100 7,500 9,400

EXCISION RETROPERITONEAL
118 TUMOR SURGEON FEE 18,300 23,800 29,300 36,600
119 EXCISION SEBACIOUS SURGEON FEE 2,900 2,900 3,750 4,650 5,800
CYST
120 EXCISION SEBACIOUS SURGEON FEE 4,700 4,700 6,100 7,500 9,400
CYST - LARGE
121 EXCISION SUBMUCOUS SURGEON FEE 3,850 3,850 5,000 6,200 7,700
CYST
EXCISION THYROGLOSSAL
122 CYST/ FISTULA SURGEON FEE 11,900 15,500 19,050 23,800

123 FACIOTOMY PROCEDURE 5,400 5,400 7,000 8,650 10,800

124 FREYS PROCEDURE SURGEON FEE 32,300 42,000 51,700 64,600
125 FUNDOPLICATION - SURGEON FEE 18,300 23,800 29,300 36,600
REVERSAL - OPEN
126 FUNDOPLICATION REDO - SURGEON FEE 28,050 36,500 44,900 56,100
LAP
127 FUNDOPLICATION REDO - SURGEON FEE 23,800 30,950 38,100 47,600
OPEN
128 FUNDOPLICATION( SURGEON FEE 18,300 23,800 29,300 36,600
NISSEN) - LAP
129 FUNDOPLICATION-PARTIAL SURGEON FEE 18,300 23,800 29,300 36,600
- LAP
130 GASTERCTOMY TOTAL - SURGEON FEE 48,450 62,950 77,500 96,900
LAP
131 GASTERCTOMY TOTAL - SURGEON FEE 36,550 47,500 58,500 73,100
OPEN
132 GASTRECTOMY - PARTIAL - SURGEON FEE 42,500 55,250 68,000 85,000
LAP
133 GASTRECTOMY - PARTIAL - SURGEON FEE 21,250 27,650 34,000 42,500
OPEN
134 GASTRECTOMY - RADICAL SURGEON FEE 36,550 47,500 58,500 73,100

GASTRECTOMY SLEEVE - LAP

135 (BARIATRIC SURGERY) SURGEON FEE 42,500 55,250 68,000 85,000

GASTRECTOMY SLEEVE - LAP

136 (BARIATRIC SURGERY) PACKAGE 170,000 221,000 272,000 85,000
(PACKAGE)
137 GASTRIC BAND REVERSAL - SURGEON FEE 42,500 55,250 68,000 85,000
LAP
138 GASTRIC BAND REVERSAL - SURGEON FEE 21,250 27,650 34,000 42,500
OPEN
139 GASTRIC BANDING SURGEON FEE 42,500 55,250 68,000 85,000
ADJUSTABLE- LAP
140 GASTRO JEJUNOSTOM SURGEON FEE 21,250 27,650 34,000 42,500
LOOP - LAP
141 GASTRO JEJUNOSTOM SURGEON FEE 18,300 23,800 29,300 36,600
LOOP - OPEN
GASTRO JEJUNOSTOM ROUX-EN-
142 Y - LAP (NON SURGEON FEE 23,800 30,950 38,100 47,600
BARIATRIC)
GASTRO JEJUNOSTOM ROUX-EN-
143 Y - OPEN (NON SURGEON FEE 21,250 27,650 34,000 42,500
BARIATRIC)
144 GASTROSTOMY - LAP SURGEON FEE 13,600 17,700 21,800 27,200
145 GASTROSTOMY - OPEN SURGEON FEE 11,900 15,500 19,050 23,800
146 GLOSSECTOMY - PARTIAL SURGEON FEE 15,750 20,500 25,200 31,500

147 GLOSSECTOMY - TOTAL SURGEON FEE 23,800 30,950 38,100 47,600

148 HAEMORRHOID BANDING SURGEON FEE 2,400 2,400 3,150 3,850 4,800
149 HAEMORRHOIDECTOMY SURGEON FEE 8,900 11,550 14,250 17,800
150 HAEMORRHOIDECTOMY + SURGEON FEE 13,600 17,700 21,750 27,200
FISSURECTOMY
HAEMORRHOIDECTOMY +
151 FISSURECTOMY PACKAGE 44,200 57,500 70,750 88,400
(PACKAGE)
152 HAEMORRHOIDECTOMY SURGEON FEE 10,600 13,800 19,950 21,200
STAPLED
153 HAEMORRHOIDECTOMY PACKAGE 60,600 78,800 96,950 121,200
STAPLED (PACKAGE)
HEPATICO PORTO-
154 ENTEROSTOMY(KASAIS SURGEON FEE 32,300 42,000 51,700 64,600
OPERATION)
155 HEPATICO-JEJUNOSTOMY - SURGEON FEE 42,500 55,250 68,000 85,000
LAP
156 HEPATICO-JEJUNOSTOMY - SURGEON FEE 36,550 47,500 58,500 73,100
OPEN
157 HERNIA DIAPHRAGMATIC SURGEON FEE 18,300 23,800 29,300 36,600
REPAIR - LAP
158 HERNIA DIAPHRAGMATIC SURGEON FEE 15,750 20,500 25,200 31,500
REPAIR - OPEN
159 HERNIA EPIGASTRIC/ SURGEON FEE 13,600 17,700 21,750 27,200
UMBILICAL - LAP
HERNIA EPIGASTRIC/ UMBILICAL
160 - LAP PACKAGE 51,450 66,900 82,350 102,900
(PACKAGE)
161 HERNIA EPIGASTRIC/ SURGEON FEE 10,700 13,900 17,150 21,400
UMBILICAL - OPEN
HERNIA EPIGASTRIC/ UMBILICAL
162 - OPEN PACKAGE 41,200 53,600 65,950 82,400
(PACKAGE)
163 HERNIA FEMORAL REPAIR - SURGEON FEE 13,600 17,700 21,750 27,200
B/L - OPEN
164 HERNIA FEMORAL REPAIR - SURGEON FEE 8,900 11,600 14,250 17,800
U/L - OPEN
165 HERNIA FEMORAL REPAIR SURGEON FEE 18,300 23,800 29,300 36,600
B/L - LAP
166 HERNIA FEMORAL REPAIR SURGEON FEE 13,600 17,700 21,750 27,200
U/L - LAP
167 HERNIA INCISIONAL SURGEON FEE 18,300 23,800 29,300 36,600
REPAIR - LAP
168 HERNIA INCISIONAL SURGEON FEE 13,600 17,700 21,750 27,200
REPAIR - OPEN
169 HERNIA RARE REPAIR, SURGEON FEE
SPIGELIAN, OBTURATOR,
LUMBAR, SUPRAUMB - LAP 18,300 23,800 29,300 36,600

170 HERNIA RARE REPAIR, SURGEON FEE

SPIGELIAN, OBTURATOR,
LUMBAR, SUPRAUMB - OPEN 10,650 13,850 17,050 21,300

HERNIA RECURRENT INGUINAL

171 REPAIR/ SURGEON FEE 18,300 23,800 29,300 36,600
HERNIOPLASTY - LAP
HERNIA RECURRENT INGUINAL
172 REPAIR/ SURGEON FEE 13,600 17,700 21,750 27,200
HERNIOPLASTY - OPEN
173 HERNIA REPAIR OF SURGEON FEE 21,250 27,650 34,000 42,500
INGUINAL B/L - LAP
HERNIA REPAIR OF INGUINAL
174 B/L - LAP PACKAGE 70,550 91,700 112,900 141,100
(PACKAGE)
175 HERNIA REPAIR OF SURGEON FEE 13,600 17,700 21,750 27,200
INGUINAL B/L - OPEN
HERNIA REPAIR OF
176 INGUINAL B/L - OPEN (PACKAGE) PACKAGE 80,850 105,100 129,350 161,700

177 HERNIA REPAIR OF SURGEON FEE 15,750 20,500 25,200 31,500

INGUINAL U/L - LAP
HERNIA REPAIR OF INGUINAL
178 U/L - LAP PACKAGE 52,200 67,850 83,500 104,400
(PACKAGE)
179 HERNIA REPAIR OF SURGEON FEE 8,950 11,650 14,350 17,900
INGUINAL U/L - OPEN
HERNIA REPAIR OF
180 INGUINAL U/L - OPEN (PACKAGE) PACKAGE 59,450 77,300 95,150 118,900

181 HERNIA REPAIR OF RECURRENT SURGEON FEE

INCISIONAL + MESH - LAP
23,800 30,950 38,100 47,600

182 HERNIA REPAIR OF RECURRENT SURGEON FEE

INCISIONAL + MESH - OPEN
18,300 23,800 29,300 36,600

183 HERNIA REPAIR OF RECURRENT PACKAGE

INCISIONAL + MESH - OPEN
(PACKAGE) 73,300 95,300 117,300 146,600

HERNIA STRANGULATED
184 EXCEPT INCISIONAL - LAP SURGEON FEE 21,250 27,650 34,000 42,500

HERNIA STRANGULATED
185 EXCEPT INCISIONAL - SURGEON FEE 18,300 23,800 29,300 36,600
OPEN
186 HERNIA STRANGULATED SURGEON FEE 21,250 27,650 34,000 42,500
INCISIONAL - LAP
187 HERNIA STRANGULATED SURGEON FEE 18,300 23,800 29,300 36,600
INCISIONAL - OPEN
188 HERNIOTOMY INGUINAL - SURGEON FEE 10,700 13,900 17,150 21,400
LAP
189 HERNIOTOMY INGUINAL - SURGEON FEE 10,700 13,900 17,150 21,400
OPEN
190 HYDATID CYST OF LIVER SURGEON FEE 21,250 27,650 34,000 42,500
EXCISION - LAP
191 HYDATID CYST OF LIVER SURGEON FEE 15,700 20,450 25,200 31,400
EXCISION - OPEN
192 HYDROCELE - B/L PACKAGE 29,250 38,000 46,800 58,500
(PACKAGE)
193 INCISION AND DRAINAGE SURGEON FEE 3,800 3,800 4,950 6,100 7,600
OF ABSCESS
194 INCISION AND DRAINAGE SURGEON FEE 3,800 3,800 4,950 6,100 7,600
OF BREAST ABSCESS
INGROWING TOENAIL REMOVAL
195 IN OPD/WARDS SURGEON FEE 1,700 1,700 2,200 2,750 3,400

196 INTESTINAL FISTULA SURGEON FEE 21,250 27,650 34,000 42,500

REPAIR - LAP
197 INTESTINAL FISTULA SURGEON FEE 18,300 23,800 29,300 36,600
REPAIR - OPEN
198 INTUSSUSCEPTION SURGEON FEE 18,300 23,800 29,300 36,600
REPAIR - LAP
199 INTUSSUSCEPTION SURGEON FEE 18,300 23,800 29,300 36,600
REPAIR - OPEN
 IPOM (INTRAPERITONEAL ONLAY 18,300 23,800 29,300 36,600
POLYTETRAFLUOROETHYL ENE
200 MESH) - LAP SURGEON FEE

IPOM (INTRAPERITONEAL ONLAY 13,600 17,700 21,800 27,200

POLYTETRAFLUOROETHYL ENE
201 MESH) - OPEN SURGEON FEE

202 JEJUNAL INTERPOSITION SURGEON FEE 32,300 42,000 51,700 64,600

203 JEJUNOSTOMY - LAP SURGEON FEE 13,600 17,700 21,750 27,200

204 JEJUNOSTOMY - LATERAL SURGEON FEE 21,250 27,650 34,000 42,500
PANCREATICO
205 JEJUNOSTOMY - OPEN SURGEON FEE 13,600 17,700 21,750 27,200
206 LACERATION REPAIR SURGEON FEE 13,600 17,700 21,750 27,200
LIVER
207 LAP GASTRIC BYPASS SURGEON FEE 48,450 63,000 77,550 96,900
208 LAP GASTRIC BYPASS PACKAGE 204,000 265,200 326,500 408,000
(PACKAGE)
209 LAPAROTOMY SURGEON FEE 8,900 11,600 14,250 17,800
EXPLORATORY
210 LAPAROTOMY EXPLORATORY SURGEON FEE
(INCLUDING SMALL
BIOPSY) 10,700 13,900 17,150 21,400

211 LOBECTOMY LIVER (RIGHT SURGEON FEE 32,300 42,000 51,700 64,600
/ LEFT)
212 LONG SAPHENOUS VEIN SURGEON FEE
VARICOSE VEINS-B/LHIGH
LIGATION AND STRIPPING 21,250 27,650 34,000 42,500

213 LONG SAPHENOUS VEIN SURGEON FEE

VARICOSE VEINS-U/L: HIGH
LIGATION AND STRIPPING 13,600 17,700 21,800 27,200

LUMP/ FIBROADENOMA BREAST

214 EXCISION/ SURGEON FEE 6,800 8,850 10,850 13,600
SECTOR MASTECTOMY
215 LUMP/ FIBROADENOMA BREAST PACKAGE
EXCISION/ SECTOR
MASTECTOMY 27,300 35,500 43,700 54,600
(PACKAGE)
MASTECTOMY SIMPLE -
216 WITHOUT AXILLARY SURGEON FEE 13,600 17,700 21,750 27,200
CLEARANCE
MECKELS DIVERTICULECTOMY -
217 LAP SURGEON FEE 13,600 17,700 21,750 27,200

MECKELS DIVERTICULECTOMY -
218 OPEN SURGEON FEE 10,700 13,900 17,200 21,400

MESTECTOMY
219 SUBCUTANEOUS SURGEON FEE 8,100 10,500 12,950 16,200
( GYNAECOMASTIA)
220 MINI GASTRIC BYPASS - SURGEON FEE 48,450 63,000 77,550 96,900
LAP
MODIFIED RADICAL
221 MASTECTOMY + AXILLARY SURGEON FEE 28,050 36,500 44,850 56,100
CLEARANCE
222 OESOPHAGEAL SURGEON FEE 21,250 27,650 34,000 42,500
CARDIOMYOTOMY - LAP
OESOPHAGEAL
223 CARDIOMYOTOMY - OPEN SURGEON FEE 18,300 23,800 29,300 36,600

224 OESOPHAGECTOMY SURGEON FEE 42,500 55,250 68,000 85,000

IVORLEWIS - LAP
225 OESOPHAGECTOMY SURGEON FEE 32,300 42,000 51,700 64,600
IVORLEWIS - OPEN
226 OESOPHAGECTOMY MC- SURGEON FEE 42,500 55,250 68,000 85,000
KEOWN - LAP
227 OESOPHAGECTOMY MC- SURGEON FEE 32,300 42,000 51,700 64,600
KEOWN - OPEN
228 OESOPHAGECTOMY SURGEON FEE 21,250 27,650 34,000 42,500
TRANSHIATAL - LAP
229 OESOPHAGECTOMY SURGEON FEE 18,300 23,800 29,300 36,600
TRANSHIATAL - OPEN
230 OMENTECTOMY - LAP SURGEON FEE 13,600 17,700 21,750 27,200
231 OMENTECTOMY - OPEN SURGEON FEE 13,600 17,700 21,750 27,200
232 PANCREATECTOMY - SURGEON FEE 21,250 27,650 34,000 42,500
DISTAL - LAP
233 PANCREATECTOMY - SURGEON FEE 21,250 27,650 34,000 42,500
DISTAL - OPEN
234 PARATHYROIDECTOMY SURGEON FEE 18,300 23,800 29,300 36,600
235 PAROTIDECTOMY SURGEON FEE 13,600 17,700 21,750 27,200
SUPERFICIAL
236 PAROTIDECTOMY TOTAL SURGEON FEE 21,250 27,650 34,000 42,500
237 PERFORATION REPAIR SURGEON FEE 18,300 23,800 29,300 36,600
ILEAL - LAP
238 PERFORATION REPAIR SURGEON FEE 18,300 23,800 29,300 36,600
ILEAL - OPEN
239 PORTAL HYPERTENSION - SURGEON FEE 21,250 27,650 34,000 42,500
SHUNT ONLY
240 PROCTOCOLECTOMY - LAP SURGEON FEE 32,300 42,000 51,700 64,600

241 PROCTOCOLECTOMY - SURGEON FEE 21,250 27,650 34,000 42,500

OPEN
PYLOROMOTOMY FOR PYLORIC
242 STENOSIS/ SURGEON FEE 13,600 17,700 21,750 27,200
PYLOROPLASTY - LAP
PYLOROMOTOMY FOR
243 PYLORIC STENOSIS/ SURGEON FEE 13,600 17,700 21,750 27,200
PYLOROPLASTY - OPEN
244 RADICAL NECK SURGEON FEE 23,800 30,950 38,100 47,600
DISSECTION - B/L
245 RADICAL NECK SURGEON FEE 21,250 27,650 34,000 42,500
DISSECTION - U/L
246 RANULA SMALL SURGEON FEE 6,800 8,850 10,850 13,600
247 RECTAL PROLAPSE SURGEON FEE 18,275 23,800 29,250 36,550
REPAIR - LAP
248 RECTAL PROLAPSE SURGEON FEE 13,600 17,700 21,750 27,200
REPAIR - OPEN
RECURRENT PEPTIC ULCER -
249 REVISION SURGEON FEE 18,300 23,800 29,300 36,600
SURGERY
250 REMOVAL OF INFECTED SURGEON FEE 13,600 17,700 21,750 27,200
MESH - LAP
251 REMOVAL OF INFECTED SURGEON FEE 11,900 15,500 19,050 23,800
MESH - OPEN
 REMOVAL OF SUBMANDIBULAR
252 DUCT SURGEON FEE 4,700 4,700 6,100 7,500 9,400
CALCULUS
RESECTION
253 ABDOMINOPERINEAL - LAP SURGEON FEE 32,300 42,000 51,700 64,600

RESECTION
254 ABDOMINOPERINEAL - OPEN SURGEON FEE 21,250 27,650 34,000 42,500

RESECTION AND
255 ANASTOMOSIS HIRSCHSPRUNG SURGEON FEE 21,250 27,650 34,000 42,500

RESECTION AND ANASTOMOSIS

256 SMALL GUT SURGEON FEE 18,300 23,800 29,300 36,600
- LAP
RESECTION AND ANASTOMOSIS
257 SMALL GUT SURGEON FEE 13,600 17,700 21,800 27,200
- OPEN
RESECTION AND ANASTOMOSIS
258 SMALL GUT PACKAGE 57,800 75,150 92,500 115,600
- OPEN (PACKAGE)
259 RESECTION AND SURGEON FEE 8,100 10,550 12,950 16,200
DRAINAGE RIB
260 RESECTION AND REPAIR OF SURGEON FEE
COMMON HEPATIC DUCT - LAP
( CBD EXPLORATION ) 23,800 30,950 38,100 47,600

RESECTION AND REPAIR OF

261 COMMON HEPATIC SURGEON FEE 21,250 27,650 34,000 42,500
DUCT - OPEN
262 RESECTION ANTERIOR SURGEON FEE 32,300 42,000 51,700 64,600
RESECTION - LAP
263 RESECTION ANTERIOR SURGEON FEE 23,800 30,950 38,100 47,600
RESECTION - OPEN
RESECTION PARTIAL LIVER
264 / LATERAL SEGMENTECTOMY SURGEON FEE 18,300 23,800 29,300 36,600

RESECTION/ ANASTOMOSES
265 FOR SURGEON FEE 23,800 30,950 38,100 47,600
VOLVULUS - LAP
RESECTION/ ANASTOMOSES
266 FOR SURGEON FEE 21,300 27,700 34,100 42,600
VOLVULUS - OPEN
267 RF ABLATION OF SURGEON FEE 18,300 23,800 29,300 36,600
VARICOSE VEINS
RF ABLATION OF VARICOSE
268 VEINS PACKAGE 55,950 72,750 89,550 111,900
(PACKAGE)
ROUX-EN -Y
269 CYSTOJEJUNOSTOMY - SURGEON FEE 21,250 27,650 34,000 42,500
LAP
ROUX-EN -Y
270 CYSTOJEJUNOSTOMY - SURGEON FEE 18,300 23,800 29,300 36,600
OPEN
SCALENOTOMY FOR SCALENUS
271 ANTICUS SURGEON FEE 8,900 11,600 14,250 17,800
SYNDROME
272 SETON REMOVAL OR LAYING SURGEON FEE
OPEN OF RESIDUAL FISTULA IN
ANO 6,800 8,850 10,800 13,600

273 SPHINTEROTOMY ANAL SURGEON FEE 8,900 11,600 14,250 17,800

274 SPLENECTOMY - LAP SURGEON FEE 21,250 27,650 34,000 42,500
275 SPLENECTOMY - OPEN SURGEON FEE 18,300 23,800 29,300 36,600
276 SPLENO RENAL SHUNT SURGEON FEE 21,300 27,700 34,100 42,600
277 SUB FACIAL ENDOSCOPIC SURGEON FEE
PERFORATOR SURGERY - SEPS -
LAP 8,900 11,600 14,250 17,800

SUB FACIAL PERFORATOR

278 SURGERY - OPEN SURGEON FEE 8,100 10,550 12,950 16,200

279 SUBMANDIBULAR SURGEON FEE 10,600 13,800 16,950 21,200

SIALADENECTOMY
SUTURING OF LARGE
280 LACERATED WOUND ( >= 10 SURGEON FEE 5,100 5,100 6,650 8,200 10,200
CM)
281 SUTURING OF SURGEON FEE 8,900 11,600 14,250 17,800
SECONDARY WOUND
SUTURING OF SMALL
282 LACERATED WOUND ( < 10 CM) SURGEON FEE 2,950 2,950 3,850 4,750 5,900

283 SYMPATHECTOMY SURGEON FEE 18,300 23,800 29,300 36,600

CERVICAL - LAP
284 SYMPATHECTOMY SURGEON FEE 10,700 13,900 17,200 21,400
CERVICAL- OPEN
285 SYMPATHECTOMY: SURGEON FEE 18,300 23,800 29,300 36,600
LUMBAR - LAP
286 SYMPATHECTOMY: SURGEON FEE 13,600 17,700 21,750 27,200
LUMBAR - OPEN
287 THYROID LOBECTOMY / SURGEON FEE 10,600 17,700 16,950 21,200
HEMI
288 THYROIDECTOMY SURGEON FEE 21,250 27,650 34,000 42,500
(TOTAL/SUBTOTAL)
289 TUBE CAECOSTOMY SURGEON FEE 10,650 13,850 17,050 21,300
290 UMBILECTOMY SURGEON FEE 11,900 15,500 19,050 23,800
291 UNTWISTING OF SIGMOID SURGEON FEE 8,900 11,600 14,250 17,800
VOLVULUS
UPPER ROUX-EN-Y GASTRIC
292 BYPASS ( SURGEON FEE 42,500 55,250 68,000 85,000
BARIATRIC )
293 VAGOTOMY - HIGHLY SURGEON FEE 18,300 23,800 29,300 36,600
SELECTED - LAP
294 VAGOTOMY - HIGHLY SURGEON FEE 13,600 17,700 21,750 27,200
SELECTED - OPEN
295 VAGOTOMY & DRAINAGE - SURGEON FEE 21,250 27,650 34,000 42,500
LAP
296 VAGOTOMY & DRAINAGE - SURGEON FEE 18,300 23,800 29,300 36,600
OPEN
297 WHIPPLES OPERATION - SURGEON FEE 32,300 42,000 51,700 64,600
OPEN
LAP(CHOLE,Appendectomy,S PACKAGE 30,000 40,000 60,000
tapled Haemorrhoidectomy) -
298 (PROMOTIONAL PACKAGE)

LAP(Inguinal PACKAGE 40,000 50,000 70,000

Hernia,Ventral/Incisional
299 Hernia,Femoral Hernia) -
(PROMOTIONAL PACKAGE)

Diagnostic Laproscopy -
300 (PROMOTIONAL PACKAGE) PACKAGE 25,000 35,000 55,000
 GI Bypass - (PROMOTIONAL
301 PACKAGE) PACKAGE 150,000 175,000 200,000

GI Sleeve - (PROMOTIONAL
302 PACKAGE) PACKAGE 100,000 125,000 150,000
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
25,500 31,900
15,300 19,200
22,400 28,000

5,000 6,250

4,400 5,500

10,600 13,250

25,500 31,850

25,500 31,850

13,600 17,000

25,500 31,850

19,200 24,000

38,400 48,000
29,000 36,250

77,000 96,250
4,400 5,500
14,200 17,750
7,600 9,500

31,800 39,750

25,500 31,900

61,200 76,500
14,800 18,500
20,200 25,250
27,600 34,500

26,600 33,250

11,800 14,750

26,600 33,250
54,600 68,250

85,000 106,250
59,500 74,400
36,200 45,250

17,000 21,250
25,500 31,900
5,800 7,250

21,200 26,500

25,400 31,800

55,600 69,500

31,800 39,750
68,000 85,000

24,800 31,000

6,600 8,250
9,600 12,000

3,600 4,500

47,000 58,750
30,600 38,250

7,600 9,500
12,800 16,000

11,800 14,750
14,800 18,500

19,400 24,250

21,200 26,500

3,800 4,750

25,600 32,000

21,200 26,500

31,800 39,750
20,400 25,500
25,400 31,750
 6,400 8,000

5,800 7,250

23,000 28,750

15,000 18,750

15,000 18,750

11,000 13,750
11,000 13,750
29,800 37,250

11,000 13,750

31,800 39,750
9,400 11,750

Super
Deluxe
Deluxe

Deluxe Super
Deluxe
27,200 34,000
56,100 70,200

31,400 39,250

21,200 26,500

9,400 11,750
17,800 22,250

36,600 45,750

27,200 34,000
47,600 59,500

158,100 197,650

21,200 26,500
119,800 149,750

17,800 22,250

47,600 59,500

64,600 80,750

3,400 4,250
 3,400 4,250

110,500 138,200

10,200 12,750

9,400 11,750

7,600 9,500

23,800 29,750
7,000 8,750
9,400 11,750
6,800 8,500
7,600 9,500

23,800 29,750

42,500 53,200

47,600 59,500

27,200 34,000

23,800 29,750

64,600 80,750

42,500 53,200

5,900 7,400
31,400 39,250

42,500 53,200

159,800 199,750

113,900 142,400

56,100 70,200

27,200 34,000

90,100 112,650

42,500 53,200

36,600 45,750

17,800 22,250
17,800 22,250
42,500 23,200

36,600 45,750

42,500 53,200

36,600 45,750

64,600 80,750

42,500 53,200

85,000 106,250

36,600 45,750

21,200 26,500

17,800 22,250

21,200 26,500
36,600 45,750

64,600 80,750

17,800 22,250

11,900 14,850

9,400 11,750

36,600 45,750

27,200 34,000

31,400 39,250

13,600 17,000

81,800 102,250

9,400 11,750

13,600 17,000

5,800 7,250
17,800 22,250

27,200 34,000

17,800 22,250

36,600 45,750

27,200 34,000

13,600 17,000

31,400 39,250

23,800 29,750

13,600 17,000

42,600 53,250

36,600 45,750

11,900 14,850

23,800 29,750

74,800 93,500

31,500 39,400

27,200 34,000

3,400 4,250

36,600 45,750

27,200 34,000

27,200 34,000

9,400 11,750

36,600 45,750

27,200 34,000

5,800 7,250
 13,600 17,000

42,500 53,200

121,200 151,500

23,800 29,750

82,400 103,000

9,400 11,750

56,100 70,200

42,500 53,200

13,600 17,000

10,200 12,750
35,000 43,750

27,200 34,000

27,200 34,000

17,800 22,250

42,500 53,200

64,600 80,750

64,600 80,750

56,100 70,200

9,400 11,750

16,200 20,250

27,200 34,000

88,600 110,750

27,200 34,000

9,400 11,750

36,600 45,750
 5,800 7,250

9,400 11,750

7,700 9,650

23,800 29,750

10,800 13,500
64,600 80,750
36,600 45,750

56,100 70,200

47,600 59,500

36,600 45,750

36,600 45,750

96,900 121,200

73,100 91,400

85,000 106,250

42,500 53,200

73,100 91,400

85,000 106,250

85,000 425,000

85,000 106,250

42,500 53,200

85,000 106,250

42,500 53,200

36,600 45,750

47,600 59,500

42,500 53,200

27,200 34,000
23,800 29,750
31,500 39,400

47,600 59,500
4,800 6,000
 17,800 22,250
27,200 34,000

88,400 110,500

21,200 26,500

121,200 151,500

64,600 80,750

85,000 106,250

73,100 91,400

36,600 45,750

31,500 39,400

27,200 34,000

102,900 128,650

21,400 26,750

82,400 103,000

27,200 34,000

17,800 22,250

36,600 45,750

27,200 34,000

36,600 45,750

27,200 34,000

36,600 45,750

21,300 26,650

36,600 45,750

27,200 34,000

42,500 53,200

141,100 176,400
 27,200 34,000

161,700 202,200

31,500 39,400

104,400 130,500

17,900 22,400

118,900 148,650

47,600 59,500

36,600 45,750

146,600 183,250

42,500 53,200

36,600 45,750

42,500 53,200

36,600 45,750

21,400 26,750

21,400 26,750

42,500 53,200

31,400 39,250

58,500 73,200

7,600 9,500

7,600 9,500

3,400 4,250

42,500 53,200

36,600 45,750

36,600 45,750

36,600 45,750
 36,600 45,750

27,200 34,000

64,600 80,750

27,200 34,000
42,500 53,200

27,200 34,000
27,200 34,000

96,900 121,200
408,000 510,000

17,800 22,250

21,400 26,750

64,600 80,750

42,500 53,200

27,200 34,000

13,600 17,000

54,600 68,250

27,200 34,000

27,200 34,000

21,400 26,750

16,200 20,250

96,900 121,200

56,100 70,200
42,500 53,200

36,600 45,750

85,000 106,250

64,600 80,750

85,000 106,250

64,600 80,750

42,500 53,200

36,600 45,750

27,200 34,000
27,200 34,000
42,500 53,200

42,500 53,200

36,600 45,750
27,200 34,000

42,500 53,200
36,600 45,750

36,600 45,750

42,500 53,200

64,600 80,750

42,500 53,200

27,200 34,000

27,200 34,000

47,600 59,500

42,500 53,200

13,600 17,000
36,550 45,700

27,200 34,000

36,600 45,750

27,200 34,000

23,800 29,750
 9,400 11,750

64,600 80,750

42,500 53,200

42,500 53,200

36,600 45,750

27,200 34,000

115,600 144,500

16,200 20,250

47,600 59,500

42,500 53,200

64,600 80,750

47,600 59,500

36,600 45,750

47,600 59,500

42,600 53,250

36,600 45,750

111,900 139,850

42,500 53,200

36,600 45,750

17,800 22,250

13,600 17,000

17,800 22,250
42,500 53,200
36,600 45,750
42,600 53,250

17,800 22,250

16,200 20,250

21,200 26,500

10,200 12,750

17,800 22,250

5,900 7,400

36,600 45,750

21,400 26,750

36,600 45,750

27,200 34,000

21,200 26,500

42,500 53,200

21,300 26,650
23,800 29,750
17,800 22,250

85,000 106,250

36,600 45,750

27,200 34,000

42,500 53,200

36,600 45,750

64,600 80,750
 - OP Rate - Twin - Single
- Sharing - MICU
Casualty - Day Care - SICU
General
Department- NEPHROLOGY Ward
- Transplant Deluxe
ICU

Sr. No. Service Name Service Head OP Rates General Twin Private Deluxe
Ward Sharing Room
1 ACUTE PD PROCEDURE 6,000 6,000 7,800 9,600 12,000
2 CAPD FLUSHING PROCEDURE 7,050 7,050 9,200 11,300 14,100
3 CAPD TRAINING PROCEDURE 10,600 10,600 13,800 17,000 21,250
4 CRRT PROCEDURE PROCEDURE 9,700 9,700 12,700 15,650 19,550
CHARGES PER DAY
5 AV FISTULA FOR DIALYSIS PACKAGE
(DISTAL/PROXY) (PACKAGE)
22,000 22,000 28,600 35,200 44,000

6 KIDNEY BIOPSY- PROCEDURE 6,500 6,500 8,450 10,400 13,000

NATIVE/GRAFT
7 KIDNEY BIOPSY - PACKAGE 25,000 25,000 32,500 40,000 50,000
PACKAGE
8 RENAL TRANSPLANT PACKAGE - - 600,000 750,000 900,000
SURGERY (PACKAGE)
9 EMERGENCY DIALYSIS PROCEDURE 5,000 5,000 6,500 8,000 8,000
10 FEMORAL PROCEDURE 4,000 4,000 5,200 6,400 8,000
CATHETERIZATION
11 IJ CATHETERIZATION PROCEDURE 4,000 4,000 5,200 6,400 8,000
12 EXIT SITE DRESSING PROCEDURE 1,000 1,000 1,300 1,600 2,000
13 TRANSFER SET CHANGE PROCEDURE 1,200 1,200 1,550 1,950 2,400

14 ISOLATION DIALYSIS PROCEDURE 5,000 5,000 6,500 8,000 8,000

15 PORTABLE DIALYSIS PROCEDURE 5,000 5,000 6,500 8,000 8,000
16 SLEDD 12 HRS PROCEDURE 6,000 6,000 7,500 8,500 8,500
17 SLEDD 8 HRS PROCEDURE 6,000 6,000 7,000 8,000 8,000
18 PLASMAPHERESIS PROCEDURE 6,000 6,000 7,500 8,500 8,500
19 VIP DIALYSIS PROCEDURE 5,000 5,000 6,500 8,000 10,000
20 REGULAR DIALYSIS - PROCEDURE 2,000 2,000 2,600 3,200 4,000
MULTI USE
21 DIALYSIS PACKAGE - 8 PROCEDURE 1,800 1,800 2,350 2,800 3,600
SITTING MULTI USE
22 DIALYSIS PACKAGE - 24 PROCEDURE 1,500 1,500 1,950 2,400 3,000
SITTING MULTI USE
23 DIALYSIS PACKAGE - 48 PROCEDURE 1,200 1,200 1,550 1,950 2,400
SITTING MULTI USE
Super
Deluxe

Super
Deluxe
15,000
17,650
26,500
24,450

55,000

16,250

62,500

950,000

8,000
10,000

10,000
2,500
3,000

8,000
8,000
8,500
8,000
8,500
12,500
5,000

4,500

3,750

3,000
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate
General -
Department- MED. ONCOLOGY -
Ward Transplant
Casualty
ICU

SR. NO. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 BIOPSY BREAST - OPEN PROCEDURE 18,450 18,450 24,000 29,550

2 BIOPSY BREAST - PROCEDURE 5,850 5,850 7,600 9,350

STEREOTACTIC
3 BIOPSY BREAST - ULTRASOUND PROCEDURE 6,650 6,650 8,650 10,650

4 BLOOD AND COMPONENT PROCEDURE 1,100 1,100 1,450 1,750

TRANSFUSION- DAY CARE
5 BONE MARROW ASPIRATION- PROCEDURE 7,900 7,900 10,300 12,650
PROCEDURE
6 BONE MARROW BIOPSY WITH PROCEDURE 11,900 11,900 15,500 19,050
REPORTING
7 BONE MORROW ASPIRATION PROCEDURE 7,250 7,250 9,500 11,600
AND BIOPSY- PROCEDURE
8 CHEMOPORT NEEDLE PROCEDURE 5,100 5,100 6,650 8,200
INSERSION
9 CHEMOPRT REMOVAL PROCEDURE 7,500 7,500 9,750 12,000

CHEMOTHERAPY BIOLOGICAL AGENT 6,400 6,400 8,350 10,250

10 INFUSION - PER DAY PROCEDURE

11 CHEMOTHERAPY BIOLOGICAL PROCEDURE 3,000 3,000 3,900 4,800

AGENT IV PUSH
12 CHEMOTHERAPY BY PUMP - PROCEDURE 3,250 3,250 4,250 5,200
PER DAY
CHEMOTHERAPY CONTINUOUS 2,850 2,850 3,700 4,550
13 INFUSION - PER DAY PROCEDURE

14 CHEMOTHERAPY INJECTION PROCEDURE 1,850 1,850 2,400 2,950

OMMAYA - PER DAY
CHEMOTHERAPY INTRA- 5,350 5,350 6,950 8,550
15 PERITONEAL/INTRAPLEURAL - PER PROCEDURE
DAY
16 CHEMOTHERAPY INTRA- PROCEDURE 4,250 4,250 5,550 6,800
VESICAL - PER DAY
17 CHEMOTHERAPY IV PUSH - PER PROCEDURE 490 490 650 800
DAY
18 CHEMOTHERAPY MAJOR PROCEDURE 5,600 5,600 7,300 8,950
INFUSION - PER DAY
19 CHEMOTHERAPY MINOR PROCEDURE 4,750 4,750 6,200 7,600
INFUSION - PER DAY
20 CHEMOTHERAPY MULTI-AGENT PROCEDURE 3,750 3,750 4,850 6,000
INFUSION
21 CHEMOTHERAPY PLANNING PROCEDURE 6,350 6,350 8,300 10,200
CHARGES
22 CHEMOTHERAPY PROTOCOL PROCEDURE 2,550 2,550 3,350 4,100
CHARGES
23 CHEMOTHERAPY SC OR IM ANTI- PROCEDURE 490 490 650 800
NEOPLASTIC - PER DAY
24 CHEMOTHERAPY SINGLE PROCEDURE 2,200 2,200 2,850 3,550
AGENT INFUSION-PER DAY
25 CHEMOTHERAPY SUPRA- PROCEDURE 7,900 7,900 10,300 12,650
MAJOR INFUSION - PER DAY
 26 EVALUTION UNDER PROCEDURE 5,350 5,350 7,000 8,550
ANESTHESIA
27 INCISIONAL BIOPSY PROCEDURE 5,950 5,950 7,750 9,550

28 INTRA-THECAL PROCEDURE 4,850 4,850 6,300 7,750

CHEMOTHERAPY - PER DAY
29 IV CANULATION CHARGE- PROCEDURE 550 550 750 850
MEDICAL ONCOLOGY
30 IV FLUIDS LONG DURATION - PROCEDURE 1,250 1,250 1,650 2,000
PER DAY
31 IV FLUIDS SHORT DURATION - PROCEDURE 650 650 850 1,050
PER DAY
32 LEUKEMIA INDUCTION PROCEDURE 4,750 4,750 6,200 7,600
CHEMOTHERAPY - PER DAY
33 LUMBER PUNCHER PROCEDURE 7,050 7,050 9,200 11,300
34 NASOLABIAL FLAP CUTTING PROCEDURE 5,350 5,350 6,950 8,550
35 PICC LINE / CENTRAL LINE PROCEDURE 200 200 300 350
DRESSING
36 PICC LINE INSERTION - MEDICAL PROCEDURE 7,650 7,650 9,950 12,250
ONCOLGY
37 PICC LINE REPAIR PROCEDURE 450 450 600 750
38 PUNCH/ KNIFE BIOPSY PROCEDURE 4,250 4,250 5,550 6,800
39 REMOVAL OF PICC / NON PROCEDURE 200 200 250 350
TUNNELED CATHETER
40 SC HORMONAL PELLET PROCEDURE 490 490 650 800
IMPLANTATION
41 TUMOR BIOPSY PROCEDURE 9,300 9,300 12,100 14,850
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
36,900 46,200

11,700 14,650

13,300 16,650

2,200 2,750

15,800 19,750

23,800 29,750

14,500 18,200

10,200 12,750

15,000 18,750

12,800 16,000

6,000 7,500

6,500 8,200

5,700 7,200

3,700 4,650

10,700 13,400

8,500 10,650

1,000 1,300

11,200 14,000

9,500 11,900

7,500 9,400

12,700 15,900

5,100 6,400

1,000 1,250

4,400 5,500

15,800 19,750
10,700 13,400

11,900 14,900

9,700 12,200

1,100 1,400

2,500 3,200

1,300 1,650

9,500 11,900

14,100 17,650
10,700 13,400
400 500

15,300 19,200

900 1,200
8,500 10,650
400 500

950 1,200

18,600 23,250
 - OP Rate General - Twin - Single
- Casualty Ward Sharing - MICU
- Day Care - SICU
Department- NEUROLOGY -
Transplant
ICU

Sr. No. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 APNOEA TEST DIAGNOSTIC 1,650 1,650 2,200 2,650
2 BLINK REFLEX DIAGNOSTIC 1,450 1,450 18=900 2,350
BOTULINUM TOXIN INJECTION
3 FOR - BLEPHAROSPASM PROCEDURE 2,800 2,800 3,650 4,500

BOTULINUM TOXIN INJECTION

4 FOR - CERVICAL DYSTONIA PROCEDURE 2,800 2,800 3,650 4,500

BOTULINUM TOXIN INJECTION

5 FOR - DYSTONIA (EACH SITE) PROCEDURE 2,200 2,200 2,850 3,550

BOTULINUM TOXIN INJECTION

6 FOR - HEADACHE PROCEDURE 3,650 3,650 4,750 5,850

BOTULINUM TOXIN INJECTION

7 FOR - HEMEFACIAL SPASM PROCEDURE 2,800 2,800 3,650 4,500

8 BOTULINUM TOXIN INJECTION PROCEDURE

FOR - SPASMODIC DYSPHONIA
7,350 7,350 9,550 11,750

9 BOTULINUM TOXIN INJECTION PROCEDURE

FOR - SPASTICITY (EACH SITE)
3,650 3,650 4,750 5,850

10 BOTULINUM TOXIN INJECTION PROCEDURE

FOR - WRITER'S CRAMP (EMG
GUIDED) 4,590 4,590 6,000 7,400

11 BRACHIAL PLEXUS DIAGNOSTIC 5,350 5,350 6,950 8,550

SIMPLE
12 BRACHIAL PLEXUS WITH DIAGNOSTIC 7,500 7,500 9,750 12,000
EMG
13 CSF CHARGES PROCEDURE 3,750 3,750 4,900 6,000

14 EEG MONITORING DIAGNOSTIC 3,000 3,000 3,900 4,800

(BEDSIDE)
15 EEG-ROUTINE DIAGNOSTIC 2,650 2,650 3,450 4,250
16 VIDEO EEG - SHORT TERM DIAGNOSTIC 6,150 6,150 8,000 9,850
6 hr.
17 VIDEO EEG - LONG TERM DIAGNOSTIC 12,250 12,250 15,950 19,600
12 hr.
18 ICU SPOT EEG DIAGNOSTIC 3,550 3,550 4,650 5,700
19 ICU - EEG CONTINUE FOR DIAGNOSTIC 15,300 15,300 19,850 24,500
24 hr.
20 EMG DIAGNOSTIC 3,350 3,350 4,350 5,350
ENDOSCOPIC BRAIN & SKULL
21 BASE - DIAGNOSTIC DIAGNOSTIC 32,400 32,400 42,150 51,850
22 EP (BAER) DIAGNOSTIC 2,550 2,550 3,350 4,100
23 EP (SSEP) DIAGNOSTIC 2,650 2,650 3,450 4,250
24 EP (VER) DIAGNOSTIC 2,650 2,650 3,450 4,250
25 HEAD UP TILT TEST DIAGNOSTIC 2,900 2,900 3,750 4,650
INTRAVENOUS WITHOUT
26 THROMBOLYSIS PROCEDURE 10,200 10,200 13,250 16,350

27 INTRAVENOUS WITH PROCEDURE 20,400 20,400 26,550 32,650

THROMBOLYSIS
MISCELLANEOUS - LUMBAR
28 PUNCTURE (NEUROSURGERY) DIAGNOSTIC 7,000 7,000 9,100 11,200

29 MISCELLANEOUS - SCD DIAGNOSTIC 5,100 5,100 6,650 8,200

CHARGE (PER DAY)
30 MISCELLANEOUS - DIAGNOSTIC 6,400 6,400 8,350 10,250
SUBDURAL TAP
31 NCV 2 LIMBS MOTOR + DIAGNOSTIC 5,350 5,350 6,950 8,550
SENSORY
32 NCV 2 LIMBS MOTOR + DIAGNOSTIC 4,600 4,600 5,950 7,350
SENSORY+EMG
33 NCV 4 LIMBS MOTOR + DIAGNOSTIC 5,100 5,100 6,650 8,200
SENSORY
34 NCV4 LIMBS MOTOR+ DIAGNOSTIC 7,650 7,650 9,950 12,250
SENSORY+EMG
35 NECK VENOUS DOPPLER DIAGNOSTIC 2,350 2,350 3,050 3,800

PERCUTANEOUS PAIN
36 PROCEDURES - DISCOGRAPHY DIAGNOSTIC 9,350 9,350 12,150 14,950

PERCUTANEOUS PAIN
37 PROCEDURES - GANGLION DIAGNOSTIC 6,400 6,400 8,350 10,250
BLOCK
38 PERCUTANEOUS PAIN DIAGNOSTIC
PROCEDURES - JOINT
INJECTION PERIPHERAL 6,400 6,400 8,350 10,250

PERCUTANEOUS PAIN
39 PROCEDURES - JOINT DIAGNOSTIC 9,350 9,350 12,150 14,950
INJECTION SPINAL
40 PERCUTANEOUS PAIN DIAGNOSTIC
PROCEDURES -
RADIOFREQUECY ABLATION 9,350 9,350 12,150 14,950

41 RNS-T DIAGNOSTIC 2,550 2,550 3,350 4,100

42 SF EMG DIAGNOSTIC 2,800 2,800 3,650 4,500
43 SYMPATHETIC SKIN DIAGNOSTIC 1,450 1,450 1,900 2,350
RESPONSE
44 SPHENOPALATURE DIAGNOSTIC 3,050 3,050 4,000 4,850
GAPLIN BLOK - B / L
45 SCALP NERVE BLOCK DIAGNOSTIC 2,050 2,050 2,650 3,250
46 NCV CARPEL TUNNEL DIAGNOSTIC 2,550 2,550 3,350 4,100
47 TAP TEST FOR NPH DIAGNOSTIC 5,100 5,100 6,650 8,200
 Super
Deluxe

Deluxe

Deluxe Super
Deluxe
3,300 4,200
2,900 3,650

5,600 7,000

5,600 7,000

4,400 5,500

7,300 9,200

5,600 7,000

14,700 18,400

7,300 9,200

9,200 11,500

10,700 13,500

15,000 18,750

7,500 9,500

6,000 7,500

5,300 6,650
12,300 15,500

24,500 30,650

7,100 8,900
30,600 38,250

6,700 8,400

64,800 81,000
 5,100 6,400
5,300 6,650
5,300 6,650
5,800 7,250

20,400 25,500

40,800 51,000

14,000 17,500

10,200 12,750

12,800 16,000

10,700 13,400

9,200 11,500

10,200 12,750

15,300 19,200

4,700 5,900

18,700 23,400

12,800 16,000

12,800 16,000

18,700 23,400

18,700 23,400

5,100 6,400
5,600 7,000
2,900 3,650

6,100 7,650

4,100 5,200
5,100 6,400
10,200 12,750
 - OP Rate General Ward - Single
- Casualty - MICU
- SICU
- Twin Sharing - Transplant
Department- NEUROLOGY
- Day Care ICU

Sr. No. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 CARPEL TUNNEL RELEASE SURGEON FEE - 21,250 27,650 34,000
BILATERAL
2 CARPEL TUNNEL RELEASE PACKAGE - 82,900 107,750 132,650
BILATERAL (PACKAGE)
3 DEVELOPMENTAL - SURGEON FEE - 63,750 82,900 102,000
CRANIOSYNOSTOSIS
4 DEVELOPMENTAL - SURGEON FEE - 48,450 63,000 77,550
DIASTOMETAMYELIA
DEVELOPMENTAL - DIPOLOMYELIA - 48,450 63,000 77,550
5 WITH BONY SURGEON FEE
SPUR
6 DEVELOPMENTAL - SURGEON FEE - 63,750 82,900 102,000
ENCEPHALOCELE
DEVELOPMENTAL - ENCEPHALOCELE - 85,000 110,500 1,360,000
7 COMPLICATED SURGEON FEE

8 DEVELOPMENTAL - SURGEON FEE - 63,750 82,900 102,000

LIPOMENINGOMYELOCELE
9 DEVELOPMENTAL - SURGEON FEE - 36,550 47,500 58,500
MENINGOCELE
DEVELOPMENTAL - MENINGOMYECELE - 63,750 82,900 102,000
10 WITH INTRADURAL TUMOR SURGEON FEE

11 DEVELOPMENTAL - SURGEON FEE - 36,550 47,500 58,500

MENINGOMYELOCELE
12 DEVELOPMENTAL - REPAIR OF SURGEON FEE - 36,550 47,500 58,500
CONGENITAL DEFECTS
13 DEVELOPMENTAL - SURGEON FEE - 36,550 47,500 58,500
UNTETHERING CORD
14 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 36,550 47,500 58,500
BASE - AQUEDUCTOPLASY
15 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 36,550 47,500 58,500
BASE - CLIVAL TUMOR
ENDOSCOPIC BRAIN & SKULL BASE - - 63,750 82,900 102,000
16 COLLOID CYST REMOVAL SURGEON FEE

17 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 42,500 55,250 68,000

BASE - COMPLEX
18 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 48,450 63,000 77,550
BASE - CSF RHINORRHOEA
ENDOSCOPIC BRAIN & SKULL BASE - - 42,500 55,250 68,000
19 ENDONASAL ODOINTOID REMOVAL SURGEON FEE

ENDOSCOPIC BRAIN & SKULL - 48,450 63,000 77,550

20 BASE - ENDOPORTAL BRAIN TUMOR SURGEON FEE
EXCISION
21 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 48,450 63,000 77,550
BASE - ETHMOID SURGERY
ENDOSCOPIC BRAIN & SKULL BASE - - 48,450 63,000 77,550
22 FRONTAL SINUS SURGERY SURGEON FEE

ENDOSCOPIC BRAIN & SKULL BASE - - 63,750 82,900 102,000

23 OPTIC NERVE DECOMPRESSION SURGEON FEE

ENDOSCOPIC BRAIN & SKULL BASE - - 48,450 63,000 77,550

24 SPHENOID SINUS SURGERY SURGEON FEE

25 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 63,750 82,900 102,000

BASE - TRANSPHENOIDAL
 ENDOSCOPIC BRAIN & SKULL BASE - - 48,450 63,000 77,550
26 VENTRICULAR TUMOR SURGEON FEE
BIOPSY
27 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 28,050 36,500 44,850
BASE - VENTRICULOSCOPY
28 ENDOSCOPIC BRAIN & SKULL SURGEON FEE - 48,450 63,000 77,550
BASE - VENTRICULOSTOMY
29 FUNCTIONAL - CALLOSOTOMY SURGEON FEE - 48,450 63,000 77,550

30 FUNCTIONAL - CINGULOTOMY SURGEON FEE - 48,450 63,000 77,550

31 FUNCTIONAL - CRANIOTOMY SURGEON FEE - 63,750 82,900 102,000

FOR EPILEPSY
32 FUNCTIONAL - SURGEON FEE - 97,750 127,000 156,400
HEMISPHERECTOMY
33 FUNCTIONAL - LESIONECTOMY SURGEON FEE - 48,450 63,000 77,500

34 FUNCTIONAL - RF LESIONING SURGEON FEE - 18,300 23,800 29,300

FOR TRIGEMINAL NEURALGIA
35 FUNCTIONAL - SPECIAL SURGEON FEE - 28,050 36,500 44,900
FUNCTIONAL PROCEDURE
36 FUNCTIONAL - SURGERY FOR SURGEON FEE - 63,750 82,900 102,000
SPASTICITY
37 FUNCTIONAL - TEMPORAL SURGEON FEE - 63,750 82,900 102,000
LOBECTOMY
38 HEAD INJURY/ HAEMATOMAS - SURGEON FEE - 48,450 63,000 77,500
BILATERAL HAEMATOMAS
39 HEAD INJURY/ HAEMATOMAS - SURGEON FEE - 36,550 47,500 58,500
CEREBRAL CONTUSION
HEAD INJURY/ HAEMATOMAS - - 32,300 42,000 51,700
40 CHRONIC SUBDURAL HAEMATOMA SURGEON FEE

HEAD INJURY/ HAEMATOMAS - - 48,450 63,000 77,500

41 CRANIOTOMY FOR HEAD INJURY SURGEON FEE

HEAD INJURY/ HAEMATOMAS - - 190,400 247,500 304,650

42 CRANIOTOMY FOR HEAD INJURY PACKAGE
(PACKAGE)
HEAD INJURY/ HAEMATOMAS - - 48,450 63,000 77,500
43 DECOMPRESSIVE CRANIOTOMY SURGEON FEE

HEAD INJURY/ HAEMATOMAS - - 171,700 223,200 274,750

44 DECOMPRESSIVE CRANIOTOMY PACKAGE
(PACKAGE)
45 HEAD INJURY/ HAEMATOMAS - SURGEON FEE
DECOMPRESSIVE CRANIOTOMY AND
DUROPLASTY
- 63,750 82,900 102,000

HEAD INJURY/ HAEMATOMAS - - 48,450 63,000 77,500

46 DEPRESSED FRACTURE COMPLEX SURGEON FEE

HEAD INJURY/ HAEMATOMAS - - 36,550 47,500 58,500

47 DEPRESSED FRACTURE SIMPLE SURGEON FEE

48 HEAD INJURY/ HAEMATOMAS - SURGEON FEE - 48,450 63,000 77,500

EXTRA DURAL HAEMATOMA
HEAD INJURY/ HAEMATOMAS - - 48,450 63,000 77,500
49 INTRACEREBRAL HAEMATOMA SURGEON FEE

HEAD INJURY/ HAEMATOMAS - - 48,450 63,000 77,500

50 SUBDURAL HAEMATOMA CRANIOTOMY SURGEON FEE

51 MINIMALLY INVASIVE SPINE - SURGEON FEE

ENDOPORTAL ENDOMICROSCOPIC
CANAL DECOMPRESSION
- 48,450 63,000 77,500

52 MINIMALLY INVASIVE SPINE - SURGEON FEE

ENDOPORTAL ENDOMICROSCOPIC
CORPECTOMY
- 63,750 82,900 102,000
53 MINIMALLY INVASIVE SPINE - SURGEON FEE
ENDOPORTAL ENDOMICROSCOPIC
DISCECTOMY
- 63,750 82,900 102,000

MINIMALLY INVASIVE SPINE - - 63,750 82,900 102,000

54 ENDOPORTAL FORAMINOTOMY SURGEON FEE

MINIMALLY INVASIVE SPINE - - 63,750 82,900 102,000

55 ENDOPORTAL INTRADURAL TUMOR SURGEON FEE
REMOVAL
56 MINIMALLY INVASIVE SPINE - SURGEON FEE
ENDOPORTAL TRANSFORAMINAL
INTERBODY FUSION
- 48,450 63,000 77,500

57 MINIMALLY INVASIVE SPINE - SURGEON FEE - 36,550 47,500 58,500

KYPHOPLASTY
MINIMALLY INVASIVE SPINE - - 63,750 82,900 102,000
58 PERCUTANEOUS PEDICLE SCREW SURGEON FEE
PLACEMENT
59 MINIMALLY INVASIVE SPINE - SURGEON FEE - 48,450 63,000 77,500
VERTEBROPLASTY
60 MISCELLANEOUS - BILATERAL SURGEON FEE - 63,750 82,900 102,000
DBS
61 MISCELLANEOUS - SURGEON FEE - 23,800 30,950 38,100
BIOPSY/NERVE/MUSCLE
62 MISCELLANEOUS - CISTERNAL SURGEON FEE - 18,300 23,800 29,300
TAP
63 MISCELLANEOUS - CSF LEAK SURGEON FEE - 28,050 36,500 44,900
REPAIR
MISCELLANEOUS - DBS - 28,050 36,500 44,900
64 CONTRALATERAL LEAD INSERTION SURGEON FEE

65 MISCELLANEOUS - DBS LEAD SURGEON FEE - 18,300 23,800 29,300

ADJUSTMENT
66 MISCELLANEOUS - DBS SURGEON FEE - 21,300 27,700 34,100
PACEMAKER INSERTION
67 MISCELLANEOUS - SURGEON FEE - 28,050 36,500 44,900
EXPLORATORY CRANIOTOMY
68 MISCELLANEOUS - EXTERNAL SURGEON FEE - 23,800 30,950 38,100
LUMBAR DRAINAGE
69 MISCELLANEOUS - EXTERNAL SURGEON FEE - 23,800 30,950 38,100
VENTRICULAR DRAINAGE
70 MISCELLANEOUS - SURGEON FEE - 23,800 30,950 38,100
NEUROFIBROMA EXCISION
71 MISCELLANEOUS - UNILATERAL SURGEON FEE - 36,550 47,500 58,500
DBS
72 MISCELLANEOUS - SURGEON FEE - 23,800 30,950 38,100
VENTRICULAR TAP
73 MISCELLANEOUS - SURGEON FEE - 23,800 30,950 38,100
VENTRICULAR TAP DRAIN
74 NERVES - BRACHIAL PLEXUS SURGEON FEE - 48,450 63,000 77,500
INJURY
75 NERVES - CABLE GRAFT & SURGEON FEE - 63,750 82,900 102,000
FASCICULAR SUTURE
76 NERVES - CARPAL TUNNEL SURGEON FEE - 18,300 23,800 29,300
SYNDROME
77 NERVES - CARPAL TUNNEL PACKAGE - 83,150 108,100 133,100
SYNDROME (PACKAGE)
NERVES - ENTRAPMENT NEUROPATHY - 28,050 36,500 44,900
78 DECOMPRESSION SURGEON FEE

NERVES - FACIAL REINNERVATION - 21,250 27,650 34,000

79 PROCEDURE SURGEON FEE

80 NERVES - NERVE EXPLORATION SURGEON FEE - 23,800 30,950 38,100

81 NERVES - NERVE TRANSPLANT SURGEON FEE - 63,750 82,900 102,000

82 NERVES - NERVE SURGEON FEE - 36,550 47,500 58,500

TRANSPOSITION
83 NERVES - NERVE PACKAGE - 163,200 212,200 261,200
TRANSPOSITION (PACKAGE)
84 NERVES - NEUROLYSIS SURGEON FEE - 21,250 27,650 34,000
EXTERNAL/ INTERNAL
PERCUTANEOUS PAIN PROCEDURES - - 23,800 30,950 38,100
85 ADHESINOLYSIS SURGEON FEE

PERCUTANEOUS PAIN PROCEDURES - - 36,550 47,500 58,500

86 STIMULATOR IMPLANTATION SURGEON FEE

87 SCALP & SKULL - BONE FLAP SURGEON FEE - 45,450 59,100 72,750
REMOVAL
88 SCALP & SKULL - BURR HOLE SURGEON FEE - 32,300 42,000 51,700
MULTIPLE
89 SCALP & SKULL - BURR HOLE SURGEON FEE - 23,800 30,950 38,100
SINGLE
SCALP & SKULL - CALVARIAL TUMOR/ - 32,300 42,000 51,700
90 MASS (EXTRA CRANIAL) SURGEON FEE

SCALP & SKULL - FACIAL - 97,750 127,100 156,400

91 RECONSTRUCTION PROCEDURE SURGEON FEE

92 SCALP & SKULL - SCALP SURGEON FEE - 23,800 30,950 38,100

COMPLEX
93 SCALP & SKULL - SCALP SURGEON FEE - 18,300 23,800 29,300
HEMATOMA/ ABSCESS/ MASS
94 SHUNT - OMMAYA RESERVOIR SURGEON FEE - 36,550 47,500 58,500
PLACEMENT
95 SHUNT - SYRINGO SURGEON FEE - 48,450 63,000 77,500
SUBARACHNOID SHUNT
SHUNT - SYRINGOPERITONEAL SHUNT - 48,450 63,000 77,500
96 SURGEON FEE

97 SHUNT - V. A. SHUNT SURGEON FEE - 48,450 63,000 77,500

98 SHUNT - V.P. SHUNT SURGEON FEE - 36,550 47,500 58,500

99 SHUNT - V.P. SHUNT (PACKAGE) PACKAGE - 133,450 173,500 213,550

100 SKULL BASE - ANTERIOR FOSSA SURGEON FEE - 48,450 63,000 77,500
APPROACHES
101 SKULL BASE - FAR LATERAL SURGEON FEE - 48,450 63,000 77,500
APPROACH
102 SKULL BASE - MIDDLE FOSSA SURGEON FEE - 48,450 63,000 77,500
APPROACH
103 SKULL BASE - SKULL BASE SURGEON FEE - 72,250 93,950 115,600
APPROACH – COMPLEX
104 SKULL BASE - SKULL BASE SURGEON FEE - 48,450 63,000 77,500
APPROACH - SIMPLE
SPINE - ANTERIOR OR AL APPROACH - 63,750 82,900 102,000
105 VERTEBRECTOMY SURGEON FEE

106 SPINE - CERVICAL DISCECTOMY SURGEON FEE - 48,450 63,000 77,500

107 SPINE - CERVICAL DISCECTOMY PACKAGE - 172,550 224,350 276,100

(PACKAGE)
108 SPINE - CERVICAL SURGEON FEE - 48,450 63,000 77,500
FORAMINOTOMY
109 SPINE - CERVICAL FUSION - SURGEON FEE - 48,450 63,000 77,500
ANTERIOR
110 SPINE - CERVICAL FUSION - SURGEON FEE - 63,750 82,900 102,000
POSTERIOR
SPINE - CERVICAL/ THORACIC/LUMBAR - 48,450 63,000 77,500
111 LAMINECTOMY SURGEON FEE

SPINE - CERVICAL/ THORACIC/LUMBAR - 48,450 63,000 77,500

112 LAMINOTOMY SURGEON FEE

113 SPINE - COEPECTOMY WITH SURGEON FEE - 48,450 63,000 77,500

FUSION
114 SPINE - CORPECTOMY SURGEON FEE - 63,750 82,900 102,000
CERVICAL
115 SPINE - EXTRADURAL SPINAL SURGEON FEE - 63,750 82,900 102,000
TUMOR
116 SPINE - GIANT SPINAL TUMOR SURGEON FEE - 85,000 110,500 136,000

SPINE - INTRADURAL - 63,750 82,900 102,000

117 EXTRAMEDULLARY SPINAL TUMOR SURGEON FEE

118 SPINE - INTRAMEDULARY SURGEON FEE - 48,450 63,000 77,500

SPINAL TUMOR
119 SPINE - LAMINOPLASTY SURGEON FEE - 48,450 63,000 77,500

120 SPINE - LUMBAR FENESTRATION SURGEON FEE - 48,450 63,000 77,500

SPINE - LUMBAR LAMINECTOMY WITH - 48,450 63,000 77,500

121 DISCECTOMY SURGEON FEE

122 SPINE - LUMBAR SURGEON FEE - 48,450 63,000 77,500

MICRODISCECTOMY
123 SPINE - OPEN DOOR SURGEON FEE - 48,450 63,000 77,500
LAMINOPLASTY
124 SPINE - PLIF/ POSTERIOR SURGEON FEE - 63,750 82,900 102,000
THORACIC FIXATION
125 SPINE - POSTERIOR SURGEON FEE - 36,550 47,500 58,500
DECOMPRESSION ACM
126 SPINE - POSTERIOR FIXATION SURGEON FEE - 48,450 63,000 77,500

SPINE - POSTERIOR OR PL APPROACH - 48,450 63,000 77,500

127 VERTEBRECTOMY SURGEON FEE

128 SPINE - SPECIAL APPROACH TO SURGEON FEE - 36,550 47,500 58,500

SPINAL TUMOR
129 SPINE - SPINAL ENDOSCOPIC SURGEON FEE - 63,750 82,900 102,000
DISCECTOMY
130 SPINE - SPINAL TUMOR SURGEON FEE - 42,500 55,250 68,000
EXCISION WITH FIXATION
131 SPINE - TRANSORAL BIOPSY SURGEON FEE - 28,050 36,500 44,900

SPINE - TRANSORAL DECOMPRESSION - 72,250 93,950 115,600

132 + POST. FIXATION SURGEON FEE

SPINE - TRAUMATIC INTRADURAL - 36,550 47,500 58,500

133 HAEMATOMAS (SPINAL) SURGEON FEE

134 STABILIZATION OF CERVICAL PACKAGE - 36,550 47,500 58,500

SPINE
135 STABILIZATION OF CERVICAL PACKAGE - 120,700 156,900 193,200
SPINE (PACKAGE)
136 STEREOTAXY - DEEP BRAIN SURGEON FEE - 63,750 82,900 102,000
LESIONING
137 STEREOTAXY - FUNCTIONAL SURGEON FEE - 63,750 82,900 102,000
STEREOTAXY
138 STEREOTAXY - STEREO SURGEON FEE - 97,750 127,100 156,400
ENDOSCOPY
139 STEREOTAXY - STEREOTACTIC SURGEON FEE - 48,450 63,000 77,500
BIOPSY
140 STEREOTAXY - STEREOTAXY SURGEON FEE - 48,450 63,000 77,500
DIAGNOSTIC
141 STEREOTAXY - STEREOTAXY SURGEON FEE - 63,750 82,900 102,000
THERAPEUTIC
142 TUMORS AND LESIONS - SURGEON FEE - 48,450 63,000 77,500
ABSCESS EXCISION
143 TUMORS AND LESIONS - SURGEON FEE - 63,750 82,900 102,000
ACOUSTIC SCHWANOMMA
144 TUMORS AND LESIONS - CP SURGEON FEE - 48,450 63,000 77,500
ANGLE TUMOR
145 TUMORS AND LESIONS - SURGEON FEE - 48,450 63,000 77,500
EPIDERMOID
 TUMORS AND LESIONS - FIFTH NERVE - 48,450 63,000 77,500
146 SCHWANNOMMA SURGEON FEE

TUMORS AND LESIONS - INTRA THIRD - 48,450 63,000 77,500

147 VENTRICULAR MASS SURGEON FEE

TUMORS AND LESIONS - - 48,450 63,000 77,500

148 INTRALATERAL VENTRICULAR MASS SURGEON FEE

TUMORS AND LESIONS - MICROSCOPIC - 63,750 82,900 102,000

149 TRANSPHENOIDAL SURGEON FEE

150 TUMORS AND LESIONS - SURGEON FEE - 63,750 82,900 102,000

ORBITAL TUMOR
151 TUMORS AND LESIONS - SURGEON FEE - 48,450 63,000 77,500
POSTERIOR FOSSA SOL
TUMORS AND LESIONS - POSTERIOR - 42,500 55,250 68,000
152 FOSSA SOL DEEP SURGEON FEE

TUMORS AND LESIONS - POSTERIOR - 48,450 63,000 77,500

153 THIRD VENTRICULAR TUMOR SURGEON FEE

154 TUMORS AND LESIONS - SURGEON FEE - 48,450 63,000 77,500

SUPRATENTORIAL SOL
155 TUMORS AND LESIONS - SURGEON FEE - 42,500 55,250 68,000
SUPRATENTORIAL SOL DEEP
156 VASCULAR - ANEURYSM SURGEON FEE - 72,250 93,950 115,600
COMPLEX
157 VASCULAR - ANEURYSM SIMPLE SURGEON FEE - 48,450 63,000 77,500

158 VASCULAR - ARTERO VENOUS SURGEON FEE - 48,450 63,000 77,500

FISTULA
159 VASCULAR - ARTERO VENOUS PACKAGE - 215,050 279,600 344,100
FISTULA (PACKAGE)
VASCULAR - ARTERO VENOUS - 42,500 55,250 68,000
160 MALFORMATION COMPLEX SURGEON FEE

161 VASCULAR - CAROTID SURGEON FEE - 48,450 63,000 77,500

ENDARTERECTOMY
162 VASCULAR - CAROTID LIGATION SURGEON FEE - 42,500 55,250 68,000
AND REPAIR
163 VASCULAR - EXPLORATORY SURGEON FEE - 48,450 63,000 77,500
CRANIOTOMY FOR ANEURYSM
164 VASCULAR - MICROVASCULAR SURGEON FEE - 48,450 63,000 77,500
DECOMPRESSION
165 VASCULAR - STA MCA BYPASS SURGEON FEE - 48,450 63,000 77,500
 Super
Deluxe

Deluxe

Deluxe Super
Deluxe
42,500 53,200

165,800 207,250

127,500 159,400

96,900 121,200

96,900 121,200

127,500 159,400

170,000 212,500

127,500 159,400

73,100 91,400

127,500 159,400

73,100 91,400

73,100 91,400

73,100 91,400

73,100 91,400

73,100 91,400

127,500 159,400

85,000 106,250

96,900 121,200

85,000 106,250

96,900 121,200

96,900 121,200

96,900 121,200

127,500 159,400

96,900 121,200

127,500 159,400
 96,900 121,200

56,100 70,200

96,900 121,200

96,900 121,200

96,900 121,125

127,500 159,400

195,500 244,400

96,900 121,200

36,600 45,750

56,100 70,200

127,500 159,400

127,500 159,400

96,900 121,200

73,100 91,400

64,600 80,750

96,900 121,200

380,800 476,000

96,900 121,200

343,400 429,250

127,500 159,400

96,900 121,200

73,100 91,400

96,900 121,200

96,900 121,200

96,900 121,125

96,900 121,200

127,500 159,400
127,500 159,400

127,500 159,400

127,500 159,400

96,900 121,200

73,100 91,400

127,500 159,400

96,900 121,200

127,500 159,400

47,600 59,500

36,600 45,750

56,100 70,200

56,100 70,200

36,600 45,750

42,600 53,250

56,100 70,200

47,600 59,500

47,600 59,500

47,600 59,500

73,100 91,400

47,600 59,500

47,600 59,500

96,900 121,200

127,500 159,400

36,600 45,750

166,300 207,900

56,100 70,200

42,500 53,200

47,600 59,500

127,500 159,400

73,100 91,400
326,400 408,000

42,500 53,200

47,600 59,500

73,100 91,400

90,900 113,650

64,600 80,750

47,600 59,500

64,600 80,750

195,500 244,400

47,600 59,500

36,600 45,750

73,100 91,400

96,900 121,200

96,900 121,200

96,900 121,200

73,100 91,400

266,900 333,650

96,900 121,200

96,900 121,125

96,900 121,200

144,500 180,650

96,900 121,200

127,500 159,400

96,900 121,200

345,100 431,400

96,900 121,200

96,900 121,200

127,500 159,400

96,900 121,200

96,900 121,200

96,900 121,200
127,500 159,400

127,500 159,400

170,000 212,500

127,500 159,400

96,900 121,200

96,900 121,200

96,900 121,200

96,900 121,200

96,900 121,200

96,900 121,200

127,500 159,400

73,100 91,400

96,900 121,200

96,900 121,200

73,100 91,400

127,500 159,400

85,000 106,250

56,100 70,200

144,500 180,650

73,100 91,400

73,100 91,400

241,400 301,750

127,500 159,400

127,500 159,400

195,500 244,400

96,900 121,200

96,900 121,200

127,500 159,400

96,900 121,200

127,500 159,400

96,900 121,200

96,900 121,200
 96,900 121,200

96,900 121,200

96,900 121,200

127,500 159,400

127,500 159,400

96,900 121,200

85,000 106,250

96,900 121,200

96,900 121,200

85,000 106,250

144,500 180,650

96,900 121,200

96,900 121,200

430,100 537,650

85,000 106,250

96,900 121,200

85,000 106,250

96,900 121,200

96,900 121,200

96,900 121,200
 - Single
- MICU
- SICU
- OP Rate - Twin Sharing - Transplant
Department- ORTHOPAEDICS - Casualty
General Ward
- Day Care ICU

Sr. No. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 ACETABULAR FRACTURE SURGEON FEE 23,800 30,950 38,100
FIXATION
2 ACETABULAR FRACTURE PACKAGE 89,250 116,000 142,800
FIXATION (PACKAGE)
3 CALCANEAL FRACTURE - WITH SURGEON FEE 21,250 27,650 34,000
PLATES
4 CALCANEAL FRACTURE - WITH PACKAGE 74,400 96,750 119,050
PLATES (PACKAGE)
THORACO / LUMBAR -
5 ANTERIOR INTERBODY SURGEON FEE 28,050 36,500 44,800
FIXATION/BONE GRAFT
6 THORACO / LUMBAR - ANTERIOR PACKAGE
INTERBODY FIXATION/BONE GRAFT
(PACKAGE) 108,800 141,450 174,000

7 Amputation - Above knee / Above SURGEON FEE 32,300 42,000 51,700

elbow
8 Amputation - Above knee / Above PACKAGE 109,650 142,550 175,450
elbow (PACKAGE)
9 Amputation - Forearm / Leg/ mid SURGEON FEE 32,300 42,000 51,700
foot
10 Amputation - Minor A SURGEON FEE 3,400 3,400 4,450 5,450

11 Amputation - Minor B SURGEON FEE 13,600 17,700 21,800

12 Amputation - Minor B (PACKAGE) PACKAGE 44,200 57,500 70,750

13 Amputation - Minor C SURGEON FEE 5,950 5,950 7,750 9,500

14 Amputation - Minor D SURGEON FEE 13,600 17,700 21,800

15 Amputation - Minor D (PACKAGE) PACKAGE 51,850 67,400 83,000

16 Amputation - Minor E SURGEON FEE 6,800 8,850 10,800

17 Amputation - Symes SURGEON FEE 5,950 5,950 7,750 9,550

18 Amputation -Below Knee/Below SURGEON FEE 32,300 42,000 51,700

Elbow
Amputation -Below Knee/Below
19 Elbow (PACKAGE) PACKAGE 109,650 142,550 175,450

20 Ankle replacement (Primary) SURGEON FEE 23,800 30,950 38,100

21 Ankle replacement (Revision) SURGEON FEE 42,500 55,250 68,000

22 Application of Skeletal Traction SURGEON FEE 2,350 2,350 3,100 3,750

23 Application of Skeletal Traction B SURGEON FEE 3,400 3,400 4,450 5,450

24 Application of Skeletal Traction C SURGEON FEE 4,700 4,700 6,100 7,550

25 Arthrodesis Ankle / Elbow SURGEON FEE 42,500 55,250 68,000

/Subtalar joint
26 Arthrodesis Ankle / Elbow PACKAGE 135,150 175,700 216,250
/Subtalar joint (PACKAGE)
27 Arthrodesis- Knee Joint SURGEON FEE 18,300 23,800 29,300

28 Arthrodesis –Shoulder SURGEON FEE 18,300 23,800 29,300

29 Arthrodesis –Wrist SURGEON FEE 18,300 23,800 29,300

30 Arthrodesis-Hip SURGEON FEE 21,250 27,650 34,000

31 Arthroscopic Meniscectomy SURGEON FEE 15,750 20,500 25,200

32 Arthroscopic reconstruction of SURGEON FEE 18,050 23,500 28,800

ACL
33 Arthroscopic reconstruction of PACKAGE 99,450 129,300 159,200
ACL (PACKAGE)
34 Arthroscopic reconstruction of SURGEON FEE 28,050 36,500 44,800
PCL
35 Arthroscopic repair of Meniscus SURGEON FEE 23,800 30,950 38,100

36 Arthroscopic repair of Meniscus PACKAGE 85,850 111,600 137,350

(PACKAGE)
37 Arthroscopy Diagnostic - A SURGEON FEE 11,900 15,500 19,000

38 Arthroscopy Diagnostic - B SURGEON FEE 21,250 27,650 34,000

39 Arthroscopy Diagnostic - C SURGEON FEE 28,050 36,450 44,800

40 Arthrotomy Large Joint - A SURGEON FEE 11,900 15,500 19,000

41 Arthrotomy Large Joint - B SURGEON FEE 15,750 20,500 25,200

42 Arthrotomy Large Joint - C SURGEON FEE 21,250 27,650 34,000

43 Arthrotomy Small Joint - A SURGEON FEE 10,700 13,900 17,200

44 Arthrotomy Small Joint - B SURGEON FEE 23,800 30,950 38,100

45 Arthrotomy Small Joint - C SURGEON FEE 18,300 23,800 29,300

46 Benkart Repair SURGEON FEE 28,050 36,500 44,800

47 BILATERAL THR / TKR / TSR / SURGEON FEE 42,500 55,250 68,000

UKR
48 BILATERAL THR / TKR / TSR / PACKAGE 255,000 331,500 408,000
UKR (PACKAGE)
49 Bone Biopsy SURGEON FEE 6,800 8,850 10,800

50 Bone Grafting as Additional SURGEON FEE 5,950 5,950 7,750 9,500

Procedure - A
51 Bone Grafting as Additional SURGEON FEE 15,800 20,550 25,300
Procedure - B
52 Bone Grafting as Special SURGEON FEE 11,900 15,500 19,050
Procedure - A
53 Bone Grafting as Special PACKAGE 86,700 112,700 138,750
Procedure - A (PACKAGE)
54 Bone Grafting as Special SURGEON FEE 23,800 30,950 38,000
Procedure - B
55 Bone Grafting as Special PACKAGE 86,700 112,700 138,750
Procedure - B (PACKAGE)
56 Bone transport for gap Non union - SURGEON FEE 21,250 27,650 34,000
Long Bone
57 Bone transport for gap Non union - SURGEON FEE 15,750 20,500 25,200
Small Bones
58 Change of Dressing - Major SURGEON FEE 5,950 5,950 7,750 9,500

59 Change of Dressing - Minor SURGEON FEE 1,700 1,700 2,200 2,700

60 Closed Reduction - Ankle under SURGEON FEE 42,500 55,250 68,000

sedation / LA
Closed Reduction - Distal Radius
61 under sedation / LA (A) SURGEON FEE 3,850 3,850 5,000 6,200

Closed Reduction - Distal Radius

62 under sedation / LA (B) SURGEON FEE 23,800 30,950 38,100

63 Closed Reduction - Hand/ Foot SURGEON FEE 3,850 3,850 5,000 6,200
/Small bones/LA
Closed Reduction - Hand/ Foot
64 /Small bones/LA (PACKAGE) PACKAGE 17,000 2,100 27,200

65 Closed Reduction - Tibia /Fibula SURGEON FEE 5,950 5,950 7,750 9,500
under sedation
66 Closed Reduction & POP SURGEON FEE 3,850 3,850 5,000 6,200
Application (Major) A
67 Closed Reduction & POP SURGEON FEE 5,100 5,100 6,650 8,200
Application (Major) B
68 Closed Reduction & POP SURGEON FEE 6,800 8,850 10,800
Application (Major) C
69 Closed Reduction & POP SURGEON FEE 11,900 15,500 19,050
Application (Major) D
70 Closed Reduction & POP SURGEON FEE 15,750 20,500 25,200
Application (Major) E
71 Closed Reduction & POP SURGEON FEE 3,850 3,850 5,000 6,200
Application (Minor) A
72 Closed Reduction & POP SURGEON FEE 4,700 4,700 6,100 7,500
Application (Minor) B
73 Closed Reduction & POP SURGEON FEE 5,950 5,950 7,750 9,500
Application (Minor) C
74 Closed reduction -Elbow under SURGEON FEE 5,950 5,950 7,750 9,500
sedation /LA
75 Closed Reduction of Dislocation - SURGEON FEE 5,950 5,950 7,750 9,500
A
76 Closed Reduction of Dislocation - SURGEON FEE 6,800 8,850 10,800
B
77 Closed Reduction of Dislocation - SURGEON FEE 13,600 17,700 21,750
C
78 Closed Reduction of Dislocation - PACKAGE 53,550 69,600 85,700
C (PACKAGE)
79 Closed Reduction -Shoulder under SURGEON FEE 5,950 5,950 7,750 9,500
sedation /LA
80 Club foot Manipulation/ Cast SURGEON FEE 5,950 5,950 7,750 9,500

81 COLLAR AND CUFF SURGEON FEE 2,200 2,200 2,850 3,500

APPLICATION-A
82 COLLAR AND CUFF SURGEON FEE 2,550 2,550 3,300 4,100
APPLICATION-B
83 COLLAR AND CUFF SURGEON FEE 2,900 2,900 3,750 4,650
APPLICATION-C
84 COMPARTMENT RELEASE-A SURGEON FEE 11,900 15,500 19,050

85 COMPARTMENT RELEASE-B SURGEON FEE 15,750 20,500 25,200

 86 COMPARTMENT RELEASE-C SURGEON FEE 21,250 27,650 34,000

87 COMPLEX FRACTURE PLATING SURGEON FEE 18,300 23,800 29,300

-A
88 COMPLEX FRACTURE PLATING SURGEON FEE 28,050 36,500 44,800
-B
89 COMPLEX FRACTURE PLATING SURGEON FEE 48,450 6,300 77,500
-C
Crush Injury - Single finger
90 Reconstruction/Debridement/Fixati SURGEON FEE 21,250 27,650 34,000
on
91 Crush Injury- Hand /Wrist SURGEON FEE 21,250 27,650 34,000
Reconstuction
92 CSTR / PMSTR (Soft tissue SURGEON FEE 23,800 30,950 38,100
release ) in clubfoot
93 Curretage & Bone grafting - Hip SURGEON FEE 28,050 36,500 44,800
/Pelvis/Shoulder LARGE
94 Curretage & Bone grafting - SURGEON FEE 23,800 30,950 38,100
Humerus/Tibia/Pelvis
95 Cyst Excision & bone grafting- SURGEON FEE 23,800 30,950 38,100
Humerus
96 De Quervains Release SURGEON FEE 5,950 5,950 7,750 9,500

97 DEBRIDEMENT AND REPAIR A SURGEON FEE 8,950 11,650 14,350

98 DEBRIDEMENT AND REPAIR B SURGEON FEE 8,950 11,650 14,350

99 DEBRIDEMENT AND REPAIR B PACKAGE 35,700 46,400 57,200

(PACKAGE)
100 DEBRIDEMENT AND REPAIR C SURGEON FEE 15,750 20,500 25,200

101 DEBRIDEMENT AND REPAIR C PACKAGE 64,600 84,000 103,350

(PACKAGE)
DEBRIDEMENT OF COMPOUND
102 FRACTURE / LARGE WOUND SURGEON FEE 5,950 5,950 7,750 9,500

DEBRIDEMENT OF COMPOUND
103 FRACTURE / LARGE WOUND-B SURGEON FEE 15,750 20,500 25,200

DEBRIDEMENT OF COMPOUND
104 FRACTURE / LARGE WOUND-C SURGEON FEE 23,800 30,950 38,100

105 DEBRIDEMENT OF COMPOUND PACKAGE

FRACTURE / LARGE WOUND-C
(PACKAGE) 91,800 119,350 146,800

106 Disarticulaion shoulder / Fore SURGEON FEE 45,450 59,100 72,750

Quarter amputation
107 Disarticulation – Hip / Hind Quarter SURGEON FEE 48,450 63,000 77,550
Amputation
108 Disarticulation-Wrist / Elbow / SURGEON FEE 48,450 63,000 77,550
Ankle /Knee
109 Discetomy - 1 Level SURGEON FEE 18,300 23,800 29,300

110 Discetomy - 2nd/Multiple Level SURGEON FEE 55,250 72,850 88,400

111 Discetomy - Endoscopic SURGEON FEE 28,050 36,500 44,800

112 Discetomy - Microdiscectomy SURGEON FEE 28,050 36,500 44,800

113 DRESSING IN OPERATION PROCEDURE 1,700 1,700 2,200 2,750

THEATRE
114 External Fixation - Crush Hand SURGEON FEE 11,900 15,500 19,050

115 External Fixation- Femur / SURGEON FEE 18,300 23,800 29,300

Humerus / Forearm
116 EXTERNAL FIXATOR - CLUB SURGEON FEE 15,750 20,500 25,200
FOOT
117 EXTERNAL FIXATOR - PELVIS SURGEON FEE 18,300 23,800 29,300

118 EXTERNAL FIXATOR - PELVIS PACKAGE 78,500 102,000 125,600

(PACKAGE)
119 External Fixator (llizarov) SURGEON FEE 28,050 36,500 44,800

120 External Fixator (llizarov) SURGEON FEE 15,750 20,500 25,200

adjustment
121 External Fixator application - SURGEON FEE 13,600 17,700 21,800
Tibia/Fibula
External Fixtor Removal / llizarov
122 removal / Multiple Wires SURGEON FEE 42,500 55,250 68,000

123 FOREIGN BODY REMOVAL - SURGEON FEE 3,850 3,850 5,000 6,200
MULTIPLE SITE
124 FOREIGN BODY REMOVAL - SURGEON FEE 10,650 13,850 17,050
MULTIPLE SITE-B
125 FOREIGN BODY REMOVAL - SURGEON FEE 21,250 27,650 34,000
MULTIPLE SITE-C
126 FOREIGN BODY REMOVAL - SURGEON FEE 3,400 3,400 4,450 5,450
SINGLE SITE
127 FOREIGN BODY REMOVAL - SURGEON FEE 8,950 11,650 14,350
SINGLE SITE-B
128 FOREIGN BODY REMOVAL - PACKAGE 37,400 48,650 59,850
SINGLE SITE-B (PACKAGE)
129 FOREIGN BODY REMOVAL - SURGEON FEE 18,300 23,800 29,300
SINGLE SITE-C
130 FOREIGN BODY REMOVAL - PACKAGE 73,950 93,150 118,350
SINGLE SITE-C (PACKAGE)
131 Ganglion - Foot SURGEON FEE 8,950 11,650 14,350

132 Ganglion –Wrist - A SURGEON FEE 4,700 4,700 6,100 7,550

133 Ganglion –Wrist - B SURGEON FEE 10,650 13,850 17,100

134 Girdlestone-Hip SURGEON FEE 18,300 23,800 29,300

135 GOLFER'S ELBOW + TENNIS PROCEDURE 1,300 1,300 1,700 2,100

ELBOW INJECTION
136 Hallus valgus surgery- Foot / SURGEON FEE 21,250 27,650 34,000
Bunion
137 Halo / Cx traction / Skeletal SURGEON FEE 8,100 10,550 13,000
Traction application HALO
138 Hammer toe correction / Mallet SURGEON FEE 6,800 8,850 10,800
Toe
139 Hemiarthroplasty –Shoulder/Hip SURGEON FEE 23,800 30,950 38,100

140 Hemiarthroplasty –Shoulder/Hip PACKAGE 106,250 138,200 170,000

(PACKAGE)
141 Hemipelvectomy SURGEON FEE 48,450 63,000 77,500

142 Ilizharov procedures-Humerus / SURGEON FEE 28,050 36,500 44,800

Forearm /Tibia/Fibula
143 Ilizharov/ Fixator modifications- SURGEON FEE 5,950 5,950 7,750 9,500
Tibia/Fibula
144 Incision & Drainage of Abcess SURGEON FEE 42,500 55,250 68,000
MEDIUM
145 INFECTED NON UNION MAJOR SURGEON FEE 23,800 30,950 38,100
BONE with AO
146 INFECTED NON UNION MAJOR SURGEON FEE 28,050 36,500 44,800
BONE with ring fixator
147 INFECTED NON UNION MINOR SURGEON FEE 11,900 15,500 19,050
BONES (WITH AO)
148 Int. Fixation In Situ; Of SCFE SURGEON FEE 11,900 15,500 19,050

149 INTERLOCK NAIL REMOVAL SURGEON FEE 11,900 15,500 19,050

150 Interlock nailing - Femur / SURGEON FEE 23,800 30,950 38,100

Humerus
151 Interlock nailing - Femur / PACKAGE 106,250 138,200 170,000
Humerus (PACKAGE)
152 Interlock Nailing - SC SURGEON FEE 15,750 20,500 25,200

153 Interlock nailing- Tibia/Fibula SURGEON FEE 23,800 309,500 38,100

154 Intermediate ORTHO Surgery SURGEON FEE 8,950 11,650 14,350

Unlisted
155 INTRA ARTICULAR INJECTION PROCEDURE 1,300 1,300 1,700 2,100

156 Intra-articular Injection- Knee/ SURGEON FEE 42,500 55,250 68,000

Ankle/ Wrist/ Shoulder/ Elbow
157 Joint Replacements - Small SURGEON FEE 28,050 36,500 44,800
Multiple
158 Joint Replacements - Small Single SURGEON FEE 15,750 20,500 25,200

159 Jones for 1st MT drop SURGEON FEE 15,750 20,500 25,200

160 K Nail / V Nail removal SURGEON FEE 11,900 15,500 19,050

161 K wire fixation in closed fracture- SURGEON FEE 23,800 30,950 38,100
Foot (>4)
162 K wire fixation in closed fracture- SURGEON FEE 6,800 8,850 10,800
Foot (1-2)
K wire fixation in closed fracture-
163 Foot (1-2) (PACKAGE) PACKAGE 32,500 42,250 52,000

164 K wire fixation in closed fracture- SURGEON FEE 8,950 11,650 14,350
Foot (3-4)
165 K wire fixation in closed fracture- SURGEON FEE 11,900 15,500 19,050
Hand (>4)
166 K wire fixation in closed fracture- SURGEON FEE 6,800 8,850 10,800
Hand (1-2)
167 K wire fixation in closed fracture- SURGEON FEE 8,950 11,650 14,350
Hand (3-4)
168 K wire removal (OPD) >2 SURGEON FEE 2,150 2,150 2,800 3,450

169 K wire removal (OPD) 2 SURGEON FEE 1,700 1,700 2,200 2,750

170 k-wire removal Under GA SURGEON FEE 4,700 4,700 6,100 7,500

171 Lacerated wound Repair/ Suturing SURGEON FEE 2,400 2,400 3,100 3,850
(> 10 stitches)
172 Lacerated wound Repair/ Suturing SURGEON FEE 2,200 2,200 2,850 3,550
(5 to 10 sutures)
173 Laminectomy – 1 or 2 Level SURGEON FEE 23,800 30,950 38,100
–Spine
174 Laminectomy - more than 3 livels - SURGEON FEE 32,300 42,000 51,700
Spine
175 Laminectomy & Discectomy – 1 or SURGEON FEE 21,300 27,700 34,100
2 Level –Spine
176 Laminectomy & Discectomy - SURGEON FEE 28,050 36,500 44,800
more than 3 livels -Spine
177 Ligament reconstruction for carpal SURGEON FEE 42,500 55,250 68,000
unstabilities –Wrist
178 LOCAL INJECTIONS-B SURGEON FEE 1,700 1,700 2,200 2,750

179 LOCAL INJECTIONS-C SURGEON FEE 4,700 4,700 6,100 7,550

180 Major ORTHO Surgery Unlisted SURGEON FEE 15,750 20,500 25,200

181 MAJOR TRUMA SURGERY SURGEON FEE 18,300 23,800 29,300

182 MAJOR TRUMA SURGERY-B SURGEON FEE 28,050 36,500 44,800

183 MAJOR TRUMA SURGERY-C SURGEON FEE 48,450 63,000 77,500

184 Minor ORTHO Surgery Unlisted SURGEON FEE 4,700 4,700 6,100 7,500

185 NERVE REPAIR (SINGLE) - A SURGEON FEE 18,300 23,800 29,300

186 NERVE REPAIR (SINGLE)-B SURGEON FEE 23,800 30,950 38,100

187 NERVE REPAIR (SINGLE)-C SURGEON FEE 28,050 36,500 44,800

188 Non union ORIF with bone grafting SURGEON FEE 21,250 27,650 34,000
–Clavicle
189 Non union ORIF with bone grafting PACKAGE 77,850 101,200 124,550
–Clavicle (PACKAGE)
190 Non union Shaft – Femur / Both SURGEON FEE 42,500 55,250 68,000
Bones Forearm
Non union Shaft – Femur / Both
191 Bones Forearm (PACKAGE) PACKAGE 142,800 185,650 228,500

192 Non union shaft- Humerus SURGEON FEE 21,250 27,650 34,000

Old neglected dislocation surgery

193 –Elbow / Shoulder / Hip SURGEON FEE 28,050 36,500 44,800

194 OLECRANON BURSA SURGEON FEE 8,950 11,650 14,350

195 OLECRANON BURSA PACKAGE 74,150 96,400 118,650

(PACKAGE)
196 OPEN Biopsy –Pelvis / Hip SURGEON FEE 8,950 11,650 14,350

197 Open Bone Biopsy Large bone SURGEON FEE 6,800 8,850 10,800

198 Open Bone Biopsy small bone SURGEON FEE 5,950 5,950 7,750 9,500

199 Open reduction dislocation –Hip SURGEON FEE 21,250 27,650 34,000

200 Open reduction dislocation- Knee SURGEON FEE 21,250 27,650 34,000
Joint
201 Open reduction in fracture SURGEON FEE 42,500 55,250 68,000
dislocation- Foot
202 Operative arthroscopy –Elbow SURGEON FEE 23,800 30,950 38,100

203 Operative arthroscopy –Elbow PACKAGE 121,550 158,000 194,500

(PACKAGE)
204 Operative arthroscopy –Wrist SURGEON FEE 23,800 30,950 38,000

205 ORIF-ANKLE - A SURGEON FEE 42,500 55,250 68,000

206 ORIF-ANKLE - A (PACKAGE) PACKAGE 172,550 224,315 276,000

207 ORIF-ANKLE-B SURGEON FEE 23,800 30,950 38,100

208 ORIF-ANKLE-C SURGEON FEE 28,050 36,500 44,800

209 ORIF-ANKLE-D SURGEON FEE 42,500 55,250 68,000

210 ORIF-BOTH BONES - A SURGEON FEE 15,750 20,500 25,200

211 ORIF-BOTH BONES - A PACKAGE 60,000 78,000 96,000

(PACKAGE)
212 ORIF-BOTH BONES-B SURGEON FEE 21,250 27,650 34,000

213 ORIF-BOTH BONES-B PACKAGE 89,250 116,000 142,800

(PACKAGE)
214 ORIF-BOTH BONES-C SURGEON FEE 36,550 47,500 58,500

215 ORIF-DYNAMIC HIP SCREW SURGEON FEE 15,750 20,500 25,200

FIXATION - A
216 ORIF-DYNAMIC HIP SCREW SURGEON FEE 23,800 30,950 38,100
FIXATION-B
217 ORIF-DYNAMIC HIP SCREW PACKAGE 106,250 138,200 170,000
FIXATION-B (PACKAGE)
218 ORIF-DYNAMIC HIP SCREW SURGEON FEE 36,550 47,500 58,500
FIXATION-C
219 ORIF-ELBOW - A SURGEON FEE 21,250 27,650 34,000

220 ORIF-ELBOW-B SURGEON FEE 15,750 20,500 25,200

221 ORIF-ELBOW-B (PACKAGE) PACKAGE 60,350 78,500 96,550

222 ORIF-ELBOW-C SURGEON FEE 23,800 30,950 38,100

223 ORIF-ELBOW-D SURGEON FEE 36,550 47,500 58,550

224 ORIF-ELBOW-E SURGEON FEE 48,450 63,000 77,550

ORIF-LONG BONES (HUMERUS,

225 FEMUR, TIBIA) - A SURGEON FEE 23,800 30,950 38,100

ORIF-LONG BONES (HUMERUS,

226 FEMUR, TIBIA) - A (PACKAGE) PACKAGE 106,250 138,200 170,000

227 ORIF-LONG BONES (HUMERUS, SURGEON FEE 48,450 63,000 77,550

FEMUR, TIBIA)-B
228 ORIF-LONG BONES (HUMERUS, SURGEON FEE 42,500 55,250 68,000
FEMUR, TIBIA)-C
229 ORIF-LONG BONES (RADIUS, SURGEON FEE 32,300 42,000 51,700
ULNA, FIBULA)
230 ORIF-LONG BONES (RADIUS, PACKAGE 101,150 131,500 161,850
ULNA, FIBULA) (PACKAGE)
231 ORIF-LONG BONES (RADIUS, SURGEON FEE 28,050 36,500 44,800
ULNA, FIBULA)-B
232 ORIF-LONG BONES (RADIUS, SURGEON FEE 42,500 55,250 68,000
ULNA, FIBULA)-C
233 ORIF-MAJOR - A SURGEON FEE 23,800 30,950 38,100

234 ORIF-MAJOR - A (PACKAGE) PACKAGE 91,800 119,350 146,800

235 ORIF-MAJOR-B SURGEON FEE 36,550 47,500 58,500

236 ORIF-MAJOR-C SURGEON FEE 48,450 63,000 77,500

237 ORIF-MINOR - A SURGEON FEE 21,250 27,650 34,000

238 ORIF-MINOR-B SURGEON FEE 5,950 5,950 7,750 9,500

239 ORIF-MINOR-C SURGEON FEE 10,650 13,850 17,050

240 ORIF-PATELLAE - A SURGEON FEE 11,900 15,500 19,050

241 ORIF-PATELLAE-B SURGEON FEE 21,250 27,650 34,000

242 ORIF-PATELLAE-B (PACKAGE) PACKAGE 97,750 127,000 156,400

243 ORIF-PATELLAE-C SURGEON FEE 28,050 36,500 44,800

244 Osteotomy- Ankle SURGEON FEE 15,750 20,500 25,200

245 Osteotomy Metatarsal/ Tarsal – SURGEON FEE 18,300 23,800 29,300

Foot - Multiple
246 Osteotomy Metatarsal/ Tarsal – SURGEON FEE 15,750 20,500 25,200
Foot - Single
247 Osteotomy-Tibia/Fibula/HTO SURGEON FEE 18,250 23,750 29,200

248 POP SLAB /CAST - GRADE 1 PROCEDURE 2,200 2,200 2,850 3,500
249 POP SLAB /CAST - GRADE 2 PROCEDURE 4,250 4,250 5,550 6,800
250 POP SLAB /CAST - GRADE 3 PROCEDURE 6,400 6,400 8,350 10,250
251 POP SLAB /CAST - GRADE 4 PROCEDURE 9,600 9,600 12,500 15,400
252 RADIAL HEAD EXCISION - A SURGEON FEE 10,650 13,850 17,050

253 RADIAL HEAD EXCISION-B SURGEON FEE 18,300 23,800 29,300

254 RADIAL HEAD EXCISION-C SURGEON FEE 23,800 30,950 38,100

255 REVISION THR / TKR / TSR / SURGEON FEE 97,750 127,000 156,400
UKR IN ONE STAGE
REVISION THR / TKR / TSR / UKR IN
256 ONE STAGE (PACKAGE) PACKAGE 308,550 401,000 493,700

257 Rotator Cuff Repair -A SURGEON FEE 18,300 23,800 29,300

258 Rotator Cuff Repair -B SURGEON FEE 23,800 30,950 38,100

259 Rotator Cuff Repair -C SURGEON FEE 32,300 42,000 51,700

260 Scaphoid- ORIF with Bone SURGEON FEE 23,800 30,950 38,100
Grafting –Wrist
261 Scaphoid- ORIF with Bone PACKAGE 111,350 144,750 178,200
Grafting –Wrist (PACKAGE)
262 Scoliosis - AP Release SURGEON FEE 28,050 36,500 44,800
Instrumentation - Spine
263 Scoliosis antero - Posterior SURGEON FEE 48,450 63,000 77,500
Release - Spine WITH CAST
264 Scoliosis Correction posterior - SURGEON FEE 28,050 36,500 44,800
Spine
265 screw fixation - fracture femoral SURGEON FEE 21,250 27,650 34,000
neck INSITU
Sequestractomy - Humerus / Femur /
266 Tibia / Fibula / Forearm SURGEON FEE 11,900 15,500 19,050
Bones
 Sequestrectomy - With / without
267 Saucerization -Long bone SURGEON FEE 18,300 23,800 29,300

268 Sequestrectomy-Small bone And SURGEON FEE 11,900 15,500 19,050

Hnad / Foot / Ankle
269 Shoulder Arthroscopy/Open-Sub SURGEON FEE 21,250 27,650 34,000
Acromail Decompression
Shoulder Arthroscopy/Open-Sub
270 Acromail Decompression PACKAGE 68,000 88,400 108,800
(PACKAGE)
271 SHOULDER REDUCTION - BY PROCEDURE 1,450 1,450 1,850 2,350
MANUAL TRACTION
272 SHOULDER REPLACEMENT SURGEON FEE 28,050 36,500 44,800

273 SHOULDER REPLACEMENT PACKAGE 204,000 265,200 326,400

(PACKAGE)
274 Shoulder spica/ Hip Spica SURGEON FEE 15,750 20,500 25,200
Application
275 SI Joint arthrodesis –Pelvis SURGEON FEE 18,300 23,800 29,300

276 Single tendon repair –Hand SURGEON FEE 42,500 55,250 68,000
(subsequent tendon repair)
277 Single tendon transfer STS - Hand SURGEON FEE 42,500 55,250 68,000
/ Foot
278 Skin Grafting - Major SURGEON FEE 21,300 27,700 34,100

279 Skin Grafting - Medium (Ortho) SURGEON FEE 18,300 23,800 29,300

280 Skin Grafting - Minor SURGEON FEE 8,100 10,550 13,950

281 Soft tissue needle biopsy - DEEP SURGEON FEE 4,700 4,700 6,100 7,500

282 Soft tissue needle biopsy - SUP SURGEON FEE 6,800 8,850 10,800

283 Spinal Fracture - Psterior Fixation SURGEON FEE 28,050 36,500 44,800
With Fusion
284 Spine Posterior Debridement and SURGEON FEE 28,050 36,500 44,800
Septopal Insertion
285 SPINE SURGERY-ANTERIOR SURGEON FEE 21,250 27,650 34,000
SPINAL FUSION - A
286 SPINE SURGERY-ANTERIOR SURGEON FEE 28,050 36,500 44,800
SPINAL FUSION B
287 SPINE SURGERY-ANTERIOR SURGEON FEE 42,500 55,250 68,000
SPINAL FUSION C
SPINE SURGERY-ANTERO LATERAL
288 DECOMPRESSION - A SURGEON FEE 21,250 27,650 34,000

SPINE SURGERY-ANTERO LATERAL

289 DECOMPRESSION - B SURGEON FEE 28,050 36,500 44,800

SPINE SURGERY-ANTERO LATERAL

290 DECOMPRESSION - C SURGEON FEE 48,450 63,000 77,500

SPINE SURGERY- LAMINECTOMY &

291 DISCECTOMY SURGEON FEE 21,250 27,650 34,000
-A
SPINE SURGERY- LAMINECTOMY &
292 DISCECTOMY PACKAGE 151,300 196,700 242,100
- A (PACKAGE)
SPINE SURGERY- LAMINECTOMY &
293 DISCECTOMY SURGEON FEE 28,050 36,500 44,800
-B
 SPINE SURGERY- LAMINECTOMY &
294 DISCECTOMY SURGEON FEE 48,450 63,000 77,500
-C
295 Square Nail removal SURGEON FEE 6,800 8,850 10,800

296 Sternomastoid release - STS - SURGEON FEE 18,300 23,800 29,300

Bipolar
297 Sternomastoid release-STS - SURGEON FEE 11,900 15,500 19,050
Unipolar
298 Sub total synovectomy- Knee Joint SURGEON FEE 23,800 30,950 38,100

299 Sub Total Synovectomy-Shoulder SURGEON FEE 21,250 27,650 34,000

Joint / Hip Joint
300 Subsequent tendon repair –Hand SURGEON FEE 42,500 55,250 68,000

SUBTROCHANTERIC OSTEOTOMY
301 WITH INTERNAL SURGEON FEE 28,050 36,450 44,800
FIXATION
302 SUPRACONDYLAR FEMORAL SURGEON FEE 42,500 55,250 68,000
OSTEOTOMY FIXATION
303 Supracondylar Fracture- MUA & SURGEON FEE 42,500 55,250 68,000
wire- Humerus
304 Supra-Major Ortho Surgery SURGEON FEE 28,050 36,500 44,800
Unlisted
305 Supra-Major Plus Ortho Surgery SURGEON FEE 42,500 55,250 68,000
Unlisted
306 Surgery for CDH/CDK SURGEON FEE 28,050 36,500 44,800

307 Surgery for Dislocation recurrent SURGEON FEE 28,050 36,500 44,800
of shoulder
308 Surgery for Dislocation recurrent SURGEON FEE 28,050 36,500 44,800
of shoulder - OPEN
309 Suture Removal - Large SURGEON FEE 8,100 15,550 12,950

310 Suture Removal - Small SURGEON FEE 2,200 2,200 2,850 3,500

311 Synovectomy - Elbow SURGEON FEE 21,250 27,650 34,000

312 Synovectomy-Wrist / Ankle SURGEON FEE 21,250 27,650 34,000

313 Synovial Biopsy SURGEON FEE 11,900 15,500 19,050

314 Tarsal Coalition Release (TCR)- SURGEON FEE 21,250 27,650 34,000
Ankle
Tendon Achillis Delayed Repair or
315 reconstruction - Ankle SURGEON FEE 28,050 36,500 44,800

316 Tendon Achillis Primary Repair or SURGEON FEE 21,250 27,650 34,000
lengthening - Ankle
317 TENDON REPAIR - CAT A SURGEON FEE 5,950 5,950 7,750 9,500

318 TENDON REPAIR - CAT B SURGEON FEE 15,750 20,500 25,200

319 TENDON REPAIR - CAT C SURGEON FEE 21,250 27,650 34,000

320 TENDON REPAIR - CAT C PACKAGE 90,100 117,500 144,200

(PACKAGE)
Tendon repair in multiple
321 tendons(subsequent tendons) SURGEON FEE 28,050 36,500 44,800
–Hand
Tendon repair in multiple
322 tendons(subsequent tendons) PACKAGE 106,250 138,200 170,000
–Hand (PACKAGE)
323 Tennis Elbow Release SURGEON FEE 18,300 23,800 29,300

324 Tens Nailing (Large bone) SURGEON FEE 13,600 17,700 21,750

325 Total Elbow Joint Replacement – SURGEON FEE 28,050 36,500 44,800
Primary
Total Elbow Joint Replacement –
326 Primary (PACKAGE) PACKAGE 204,000 265,200 326,500

327 Total Elbow Joint Replacement - SURGEON FEE 28,050 36,500 44,800
Revision
328 Trigger finger release – Thumb / SURGEON FEE 5,950 5,950 7,750 9,500
Hand
329 TRIGGER FINGER RELEASE / SURGEON FEE 5,950 5,950 7,750 9,500
DE QUERVAINS RELEASE - A
330 TRIGGER FINGER RELEASE / SURGEON FEE 15,750 20,500 25,200
DE QUERVAINS RELEASE-B
331 TRIGGER FINGER RELEASE / SURGEON FEE 28,050 36,500 44,800
DE QUERVAINS RELEASE-C
332 Triple Arthrodesis (TA)- Ankle SURGEON FEE 21,250 27,650 34,000

333 Triple pelvic osteotomy –Pelvis SURGEON FEE 28,050 36,500 44,800

334 TUMOR SURGERY (MEDIUM) SURGEON FEE 15,750 20,500 25,200

335 TUMOR SURGERY (MEDIUM)-B SURGEON FEE 28,050 36,500 44,800

336 TUMOR SURGERY (MEDIUM)-C SURGEON FEE 48,450 63,000 77,500

337 UL Ecxcision Of Lateral End Of SURGEON FEE 15,750 20,500 25,200

Calvicle
338 UL Fracture Clavicle: Open SURGEON FEE 42,500 55,250 68,000
Reduction & int. fix
339 UL Supra Condylar Corrective SURGEON FEE 42,500 55,250 68,000
Osteotomy
340 UL/LL Acute OSTEOMYLITUS SURGEON FEE 11,900 15,500 19,050
Surg: Decompression
341 UL/LL Arthrodesis Of I.P. Joint SURGEON FEE 11,900 15,500 19,050

342 Ulcer debridement-(Orth) SURGEON FEE 3,850 3,850 5,000 6,200

Unilateral Revision Fusion Of

343 ShoULder (AFTER TOTAL SHOULDER) SURGEON FEE 28,050 36,500 44,800

344 UNILATERAL THR / TKR / TSR / SURGEON FEE 36,550 47,500 58,500
UKR
345 UNILATERAL THR / TKR / TSR / PACKAGE 153,000 198,900 244,800
UKR (PACKAGE)
346 Vertebroplasty PROCEDURE 17,000 17,000 22,100 27,200
347 WOUND DEBRIDEMENT & PROCEDURE 1,100 1,100 1,450 1,750
DRESSING
348 WOUND DEBRIDEMENT & PROCEDURE 1,650 1,650 2,200 2,650
SUTURING
349 Zadeks (Ingrown Toe Nail) SURGEON FEE 4,700 4,700 6,100 7,550
procedure- Foot
350 Total Knee Replacement U/L - PACKAGE 95,000 125,000 165,000
(PROMOTIONAL PACKAGE)
351 Total Knee Replacement B/L - PACKAGE 175,000 225,000 275,000
(PROMOTIONAL PACKAGE)
352 Total Hip Replacement U/L - PACKAGE 95,000 125,000 165,000
(PROMOTIONAL PACKAGE)
 353 Shoulder Arthoscopy - PACKAGE 50,000 80,000 120,000
(PROMOTIONAL PACKAGE)
354 Knee Arthoscopy - PACKAGE 50,000 80,000 120,000
(PROMOTIONAL PACKAGE)
- Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate General -
Department- PULMONOLOGY - Casualty Ward Transplant
Deluxe
ICU

Sr. No. Service Name Service Head OP Rates General Twin Private Deluxe
Ward Sharing Room
1 BRONCHOSCOPY PROCEDURE 11,600 11,600 15,100 18,550 23,200
(BEDSIDE)
BRONCHOSCOPY (FLEXIBLE)
2 - PROCEDURE 10,300 10,300 13,400 16,500 20,600
DIAGNOSTIC ONLY
BRONCHOSCOPY +
BRONCHIAL WASH +
3 ENDOBRONCHIAL PROCEDURE 11,050 11,050 14,400 17,700 22,100
BIOPSY
FOREIGN BODY REMOVAL
WITH FLEXIBLE
4 BRONCHOSCOPY PROCEDURE 13,600 13,600 17,700 21,800 27,200

FOREIGN BODY
5 REMOVAL WITH RIGID PROCEDURE 18,700 18,700 24,350 29,950 37,400
BRONCHOSCOPY
GLUE THERAPY (ADD ON TO
6 BRONCHOSCOPY) PROCEDURE 23,300 23,300 30,290 37,300 46,600

7 PFT ( 6 MINUTE WALK DIAGNOSTIC 850 850 1,200 1,350 1,700

TEST )
8 PFT ( SPIROMETRY ) DIAGNOSTIC 950 950 1,250 1,550 1,900
9 PFT ( SPIROMETRY ) DIAGNOSTIC 950 950 1,250 1,550 1,900
WITH FILTER
PFT WITH
BRONCHODIALATOR
10 REVERSIBILITY TESTING DIAGNOSTIC 1,100 1,100 1,450 1,750 2,200
( BDR )
PFT WITH
BRONCHODIALATOR
11 REVERSIBILITY TESTING DIAGNOSTIC 1,200 1,200 1,550 1,950 2,400
( BDR ) - WITH FILTER

PIGTAIL DRAINAGE OF
12 PLEURAL CAVITY (US PROCEDURE 6,050 6,050 7,850 9,700 12,100
GUIDED)
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
47,600 59,500

178,500 223,200

42,500 53,200

148,800 186,000

56,100 70,200

217,600 272,000

64,600 80,750

219,300 274,200

64,600 80,750

6,800 8,500

27,200 34,000

88,400 110,500

11,900 14,900

27,200 34,000

103,700 129,650

13,600 17,000

11,900 14,900

64,600 80,750

219,300 274,200

47,600 59,500

85,000 106,250

4,700 5,900

6,800 8,500

9,400 11,750

85,000 106,250
270,300 338,900

36,600 45,750

36,600 45,750

36,600 45,750

42,500 53,200

31,500 39,400

36,100 45,200

198,900 248,650

56,100 70,200

47,600 59,500

171,700 214,650

23,800 29,750

42,500 53,200

56,100 70,200

23,800 29,750

31,500 39,400

42,500 53,200

21,400 26,750

47,600 59,500

36,600 45,750

56,100 70,200

85,000 106,250

510,000 637,500

13,600 17,000

11,900 14,850

31,600 39,500

23,800 29,750

173,400 216,750

47,600 59,500

173,400 216,750

42,500 53,200
 31,500 39,400

11,900 14,900

3,400 4,250

85,000 106,250

7,700 9,650

47,600 59,500

7,700 9,650

34,000 42,500

11,900 14,900

7,700 9,650

10,200 12,750

13,600 17,000

23,800 29,750

31,500 39,400

7,700 9,650

9,400 11,750

11,900 14,900

11,900 14,900

11,900 14,900

13,600 17,000

27,200 34,000

107,100 133,900

11,900 14,900

11,900 14,900

4,400 5,500

5,100 6,400

5,800 7,250

23,800 29,750

31,500 39,400
 42,500 53,200

36,600 45,750

56,100 70,200

96,900 121,200

42,500 53,200

42,500 53,200

47,600 59,500

56,100 70,200

47,600 59,500

47,600 59,500

11,900 14,850

17,900 22,400

17,900 22,400

71,400 89,250

31,500 39,400

129,200 161,500

11,900 14,900

31,500 39,400

47,600 59,500

183,600 229,500

90,900 113,650

96,900 121,200

96,900 121,200

36,600 45,750

110,500 138,200

56,100 70,200

56,100 70,200

3,400 4,250
 23,800 29,750

36,600 45,750

31,500 39,400

36,600 45,750

157,000 196,250

56,100 70,200

31,500 39,400

27,200 34,000

85,000 106,250

7,700 9,650

21,300 26,650

42,500 53,200

6,800 8,500

17,900 22,400

74,800 93,500

36,600 45,750

147,900 185,900

17,900 22,400

9,400 11,750

21,300 26,650

36,600 45,750

2,600 3,250

42,500 53,200

16,200 20,250

13,600 17,000

47,600 59,500

212,500 265,650

96,900 121,200

56,100 70,200

11,900 14,900
 85,000 106,250

47,600 59,500

56,100 70,200

23,800 29,750

23,800 29,750

23,800 29,750

47,600 59,500

212,500 265,650

31,500 39,400

47,600 59,500

17,900 22,400

2,600 3,250

85,000 106,250

56,100 70,200

31,500 39,400

31,500 39,400

23,800 29,750

47,600 59,500

13,600 17,000

65,000 81,250

17,900 22,400

23,800 29,750

13,600 17,000

17,900 22,400

4,300 5,400

3,400 4,250

9,400 11,750

4,800 6,000

4,400 5,500

47,600 59,500
 64,600 80,750

42,600 53,250

56,100 70,200

85,000 106,250

3,400 4,250

9,400 11,750

31,500 39,400

36,600 45,750

56,100 70,200

96,900 121,200

9,400 11,750

36,600 45,750

47,600 59,500

56,100 70,200

42,500 53,200

155,700 194,650

85,000 106,250

285,600 357,000

42,500 53,200

56,100 70,200

17,900 22,400

148,300 185,400

17,900 22,400

13,600 17,000

11,900 14,900

42,500 53,200

42,500 53,200

85,000 106,250

47,600 59,500

243,100 303,900
 47,600 59,500

85,000 106,250

345,100 431,400
47,600 59,500

56,100 70,200

85,000 106,250

31,500 39,400

120,000 150,000

425,000 53,200

178,500 223,200

73,100 91,400

31,500 39,400

47,600 59,500

212,500 265,650

73,100 91,400

42,500 53,200

31,500 39,400

12,700 15,900
47,600 59,500

73,100 91,400

96,900 121,200

47,600 59,500

212,500 265,650

96,900 121,200

85,000 106,250

64,600 80,750

202,300 252,900

56,100 70,200

85,000 106,250

47,600 59,500

183,600 229,500
 73,100 91,400

96,900 121,200

42,500 53,200

11,900 14,900

21,300 26,650

23,800 29,750

42,500 53,200

195,500 244,400

56,100 70,200

31,500 39,400

36,600 45,750

31,500 39,400

36,500 45,650

4,400 5,500
8,500 10,650
12,800 16,000
19,200 24,000
21,300 26,650

36,600 45,750

47,600 59,500

195,500 244,400

617,100 771,400

36,600 45,750

47,600 59,500

64,600 80,750

47,600 59,500

222,700 278,400

56,100 70,200

96,900 121,200

56,100 70,200

42,500 53,200

23,800 29,750
 36,600 45,750

23,800 29,750

42,500 53,200

136,000 170,000

29,000 3,650

56,100 70,200

408,000 510,000

31,500 39,400

36,600 45,750

85,000 106,250

85,000 106,250

42,600 53,250

36,600 45,750

16,200 20,250

9,400 11,750

13,600 17,000

56,100 70,200

56,100 70,200

42,500 53,200

56,100 70,200

85,000 106,250

42,500 53,200

56,100 70,200

96,900 121,200

42,500 53,200

302,600 378,250

56,100 70,200
 96,900 121,200

13,600 17,000

36,600 45,750

23,800 29,750

47,600 59,500

42,500 53,200

85,000 106,250

56,100 70,200

85,000 106,250

85,000 106,250

56,100 70,200

85,000 106,250

56,100 70,200

56,100 70,200

56,100 70,200

16,200 20,250

4,400 5,500

42,500 53,200

42,500 53,200

23,800 29,750

42,500 53,200

56,100 70,200

42,500 53,200

11,900 14,900

31,500 39,400

42,500 53,200

180,200 225,250

56,100 70,200

212,500 265,650
 36,600 45,750

27,200 34,000

56,100 70,200

408,000 510,000

56,100 70,200

11,900 14,900

11,900 14,900

31,500 39,400

56,100 70,200

42,500 53,200

56,100 70,200

31,500 39,400

56,100 70,200

96,900 121,200

31,500 39,400

85,000 106,250

85,000 106,250

23,800 29,750

23,800 29,750

7,700 9,650

56,100 70,200

73,100 91,400

306,000 382,500

34,000 42,500
2,200 2,750

3,300 4,200

9,400 11,750
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
23,200 29,000

20,600 25,750

22,100 27,650

27,200 34,000

37,400 46,750

46,600 58,250

1,700 2,200

1,900 2,400
1,900 2,400

2,200 2,750

2,400 3,000

12,100 15,200
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate General -
Department- UROLOGY - Casualty Ward Transplant
ICU

Sr. No. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 ABCESS PERINEPHRIC / SURGEON FEE 11,900 15,500 19,100
RENAL
2 ABSCESS SCROTAL / SURGEON FEE 8,950 11,650 14,350
FOURNIER GANGRENE
3 ADRENALECTOMY - LAP SURGEON FEE 32,300 41,990 51,700
4 ADRENALECTOMY -OPEN SURGEON FEE 23,800 30,950 38,100
5 AUGMENTATION SURGEON FEE 23,800 30,950 38,100
CYSTOPLASTY
6 AV FISTULA EXOLORATION SURGEON FEE 5,950 5,950 7,750 9,500

7 AV FISTULA FOREARM SURGEON FEE 8,950 11,650 14,350

8 AV FISTULA UPPER ARM SURGEON FEE 8,950 11,650 14,350
9 AV FISTULA WITH GRAFT SURGEON FEE 18,300 23,800 29,300
TRAUMAPREVENTION
10 BCG INSTILLATION PROCEDURE 2,650 2,650 3,450 4,250
11 BIOPSY - PENILE TUMOR SURGEON FEE 4,700 4,700 6,100 7,550
BLADDER DIVERTICULECTOMY -
12 LAP SURGEON FEE 18,300 23,800 29,300

BLADDER DIVERTICULECTOMY -
13 OPEN SURGEON FEE 18,300 23,800 29,300

14 BLADDER INJURY - SURGEON FEE 18,300 23,800 29,300

EMERGENCY
15 BLADDER NECK INCISION / SURGEON FEE
TUIP(TRANSURETHRAL INCISION
OF THE PROSTATE) 23,800 30,950 38,100

16 BLADDER STONE - OPEN SURGEON FEE 11,900 15,500 19,050

17 BLADDER STONE SURGEON FEE 11,900 15,500 19,050
(ENDOSCOPIC) < 3.5 CM
18 BLADDER STONE SURGEON FEE 23,800 30,950 38,100
(ENDOSCOPIC) > 3.5 CM
BOTOX INJECTION
19 (INTRAVESICAL/INTRASPHIN SURGEON FEE 13,600 17,700 21,750
TERIC)
20 BUCCAL MUCOSA SURGEON FEE 32,300 41,900 51,700
URETHROPLASTY
21 CAPD (CONTINUOUS SURGEON FEE
AMBULATORY PERITONEAL
DIALYSIS) CATHETER REMOVAL 8,950 11,650 14,350

CAPD (CONTINUOUS 11,900 15,500 19,050

AMBULATORY PERITONEAL
22 DIALYSIS)CATHETER INSERTION SURGEON FEE

23 CAPD CATHETER SURGEON FEE 6,800 8,850 10,850

REPOSITIONING
24 CHANGE OF SURGEON FEE 4,700 4,700 6,100 7,550
NEPHROSTOMY TUBE(LA)
25 CIRCUMCISION SURGEON FEE 8,950 11,650 14,350
26 CIRCUMCISION (PACKAGE) PACKAGE 40,450 52,590 64,750

27 COLPOSUSPENSION / SURGEON FEE 23,800 30,950 38,100

CYSTOCELE REPAIR
28 CYSTECTOMY - PARTIAL SURGEON FEE 18,300 23,800 29,300
29 CYSTECTOMY RADICAL + SURGEON FEE 42,500 55,250 68,000
ILEAL CONDUIT
30 CYSTECTOMY RADICAL + SURGEON FEE 42,500 55,250 68,000
ORTHOTOPIC BLADDER
31 CYSTOSCOPIC CLOT EVACUATION SURGEON FEE
& FULGURATION OF BLEEDER
11,900 15,500 19,100

32 CYSTOSCOPIC CLOT EVACUATION PACKAGE

& FULGURATION OF BLEEDER
(PACKAGE) 39,450 51,300 63,150

CYSTOSCOPY URS WITH DJ

33 STENTING UNILATERAL SURGEON FEE 21,250 27,650 34,000

34 CYSTOSCOPY + BLADDER SURGEON FEE 5,950 5,950 7,750 9,550

BIOPSY
35 CYSTOSCOPY DIAGNOSTIC SURGEON FEE 6,800 8,850 10,900

36 CYSTOSCOPY FLEXIBLE / SURGEON FEE 4,700 4,700 6,100 7,550

DIAGNOSTIC
37 CYSTOSCOPY FLEXIBLE / PACKAGE 20,400 26,500 32,650
DIAGNOSTIC (PACKAGE)
38 CYSTOSCOPY+PCNL+DJ SURGEON FEE 13,600 17,700 21,750
STENTING- BILATERAL
CYSTOSCOPY+PCNL+DJ
39 STENTING- BILATERAL PACKAGE 51,000 66,300 81,600
(PACKAGE)
40 DE-ROOFING OF RENAL SURGEON FEE 18,300 23,800 29,300
CYST - LAP
41 DJ STENT REMOVAL B/L PROCEDURE 3,650 3,650 4,800 5,850
42 DJ STENT REMOVAL U/L PROCEDURE 2,800 2,800 3,650 4,500
43 DJ STENT REMOVAL U/L PACKAGE 850 1,100 1,400
(PACKAGE)
44 DJ STENTING/ STENT SURGEON FEE 11,900 15,500 19,000
INSERTION B/L
45 DJ STENTING/ STENT SURGEON FEE 8,100 10,550 12,950
INSERTION U/L
46 DRESSING - LARGE PROCEDURE 850 850 1,100 1,400
47 DRESSING - MEDIUM PROCEDURE 500 500 650 800
48 DRESSING - SMALL PROCEDURE 350 350 450 550
49 ENDOPYELOTOMY SURGEON FEE 23,800 30,950 38,100
50 ENDOSCOPIC TREATMENT SURGEON FEE 13,600 17,700 21,750
OF VUR - B/L
51 ENDOSCOPIC TREATMENT SURGEON FEE 10,650 13,850 17,050
OF VUR - U/L
ESWL-EXTRA CORPOREAL SHOCK
52 WAVE LITHOTRIPSY SURGEON FEE 10,650 13,850 17,050

53 ESWL-EXTRA CORPOREAL SHOCK PACKAGE

WAVE LITHOTRIPSY (PACKAGE)
40,800 53,050 65,300
54 EXCISION OF EPIDIDYMAL SURGEON FEE 8,950 11,650 14,350
CYST
55 EXCISION OF URACHAL SURGEON FEE 21,250 27,650 34,000
CYST
56 FRENULOPLASTY SURGEON FEE 6,800 8,850 10,900
HOLMIUM LASER ENUCLEATION
57 OF SURGEON FEE 21,250 27,650 34,000
PROSTATE < 90 GRAMS
58 HOLMIUM LASER ENUCLEATION PACKAGE
OF PROSTATE < 90 GRAMS
(PACKAGE) 94,350 122,650 150,950

HOLMIUM LASER
59 ENUCLEATION OF PROSTATE > SURGEON FEE 32,300 41,990 51,700
90 GRAMS
60 HYDROCELE - B/L SURGEON FEE 8,100 10,550 12,950
61 HYDROCELE - U/L SURGEON FEE 6,800 8,850 10,900
62 HYDROCELE - U/L PACKAGE 27,200 35,350 43,550
(PACKAGE)
63 INCONTINENCE SURGERY SURGEON FEE 11,900 15,500 19,050
(INJECTABLE)
64 INCONTINENCE SURGERY SURGEON FEE 18,300 23,800 29,300
(SLING)
65 INFUNDIBULOTOMY SURGEON FEE 13,600 17,700 21,800
66 INSERTION CATHETER - PROCEDURE 850 850 1,100 1,400
FOLEYS - BY UROLOGIST
LAPAROSCOPIC/ROBOTIC PELVIC
67 LYMPHADNECTOMY SURGEON FEE 42,500 55,250 68,000

68 Laser TURP (Holep) SURGEON FEE 36,550 47,500 58,500

69 Laser TURP (Holep) PACKAGE 175,950 228,750 281,550
(PACKAGE)
70 LYMPHADENECTOMY SURGEON FEE 23,800 30,940 38,080
INGUINAL - B/L
71 LYMPHADENECTOMY SURGEON FEE 18,300 23,800 29,300
INGUINAL - U/L
72 MEATOPLASTY SURGEON FEE 5,950 5,950 7,750 9,550
73 MEATOTOMY SURGEON FEE 2,950 2,950 3,850 4,750
74 MEATOTOMY (PACKAGE) PACKAGE 10,200 13,300 16,350
75 MITROFANOFF SURGEON FEE 23,800 30,950 38,100
76 NEPHRECTOMY - LAP - SURGEON FEE 42,500 55,250 68,000
PARTIAL
77 NEPHRECTOMY - LAP - PACKAGE 153,000 198,900 244,800
PARTIAL (PACKAGE)
78 NEPHRECTOMY - LAP - SURGEON FEE 32,300 41,900 51,700
RADICAL
79 NEPHRECTOMY - OPEN - SURGEON FEE 42,500 55,250 68,000
PARTIAL
NEPHRECTOMY
80 NEPHROURETERECTOMY - OPEN - SURGEON FEE 42,500 55,250 68,000
RADICAL
81 NEPHRECTOMY OPEN - SURGEON FEE 28,050 36,450 44,900
SIMPLE
82 NEPHRECTOMY OPEN - PACKAGE 127,500 165,750 204,000
SIMPLE (PACKAGE)
83 NEPHRECTOMY RADICAL + SURGEON FEE 42,500 55,250 68,000
IVC THROMBECTOMY
84 NEPHRECTOMY SIMPLE - SURGEON FEE 32,300 41,900 51,700
LAP
85 NEPHROSTOMY - PCN / SURGEON FEE 10,650 13,850 17,050
PERCUTANEOUS
86 NEPHROURETERECTOMY - SURGEON FEE 42,500 55,250 68,000
LAP - RADICAL
87 NESBIT'S PROCEDURE SURGEON FEE 18,300 23,800 29,300
88 ORCHIDECTOMY - RADICAL SURGEON FEE 18,300 23,800 29,300

89 ORCHIDECTOMY B/L - SURGEON FEE 23,800 30,950 38,100

SIMPLE
90 ORCHIDECTOMY U/L - SURGEON FEE 8,950 11,650 14,350
SIMPLE
91 ORCHIDOPEXY B/L - OPEN SURGEON FEE 23,800 30,950 38,100

92 ORCHIDOPEXY B/L - OPEN PACKAGE 72,250 93,950 115,600

(PACKAGE)
93 ORCHIDOPEXY B/L -LAP SURGEON FEE 42,500 55,250 68,000
94 ORCHIDOPEXY U/L - LAP SURGEON FEE 28,050 36,450 44,900
95 ORCHIDOPEXY U/L - OPEN SURGEON FEE 18,300 23,800 29,300

96 ORCHIDOPEXY U/L - OPEN PACKAGE 62,050 80,650 99,300

(PACKAGE)
97 PCNL - < 2 CM GRADE - A SURGEON FEE 23,800 30,950 38,100
98 PCNL - < 2 CM GRADE - A PACKAGE 92,650 120,450 148,300
(PACKAGE)
99 PCNL - 2ND STAGE SURGEON FEE 13,600 17,700 21,750
100 PCNL - 2ND STAGE PACKAGE 59,700 77,600 95,550
(PACKAGE)
101 PCNL - MINIPERC GRADE - C SURGEON FEE 42,500 55,250 68,000

102 PCNL GRADE - B SURGEON FEE 28,050 36,500 44,900

103 PCNL GRADE - B (PACKAGE) PACKAGE 149,600 194,500 239,350

104 PENECTOMY - PARTIAL SURGEON FEE 23,800 30,950 38,100

105 PENECTOMY - TOTAL SURGEON FEE 42,500 55,250 68,000
106 PENILE FRACTURE SURGEON FEE 18,300 23,800 29,300
107 PENILE IMPLANT SURGEON FEE 42,500 55,250 68,000
108 PERINEAL URETHROSTOMY SURGEON FEE 21,250 27,650 34,000

109 PERMACATH INSERTION SURGEON FEE 23,800 30,950 38,100

110 PERMACATH REMOVAL SURGEON FEE 6,800 8,850 10,900
111 PIPE TEST PROCEDURE
(PHARMACOLOGICALLY INDUCED
PAPAVERINE INJECTION) 1,700 1,700 2,200 2,750

112 PRAIPISM - SHUNT SURGEON FEE 18,300 23,800 29,300

113 PRIAPISM - CORPORAL SURGEON FEE 10,650 13,850 17,050
IRRIGATION
114 PROSTATECTOMY - LAP - SURGEON FEE 42,500 55,250 68,000
RADICAL
115 PROSTATECTOMY - OPEN SURGEON FEE 42,500 55,250 68,000
116 PROSTATECTOMY - SURGEON FEE 42,500 55,250 68,000
RADICAL - OPEN
117 PYELO - LYMPHATIC SURGEON FEE 32,300 41,990 51,700
DISCONNECTION - LAP
118 PYELOLITHOTOMY - LAP SURGEON FEE 42,500 55,250 68,000
119 PYELOLITHOTOMY -OPEN SURGEON FEE 23,800 30,940 38,100
120 PYELOLITHOTOMY -OPEN PACKAGE 72,250 93,950 115,600
(PACKAGE)
121 PYELOPLASTY - SURGEON FEE 42,500 55,250 68,000
LAPAROSCOPIC
122 PYELOPLASTY - OPEN SURGEON FEE 42,500 55,250 68,000
123 REDUCTION OF PROCEDURE 2,200 2,200 2,850 3,550
PARAPHIMOSIS
RENAL AUTO –
124 TRANSPLANTATION SURGEON FEE 42,500 55,250 68,000
SURGERY
125 RENAL INJURY / SURGEON FEE 23,800 30,950 38,100
RENORHAPHY
RETEROGRADE INTRARENAL
126 SCLEROTHERAPY SURGEON FEE 10,650 13,850 17,050

127 RETEROGRADE SURGEON FEE 4,700 4,700 6,200 7,550

PYELOGRAPHY (RGP)
128 RIRS U/L SURGEON FEE 32,300 41,900 51,700
129 RPLND SURGEON FEE 42,500 55,250 68,000
130 SCROTAL EXPLORATION SURGEON FEE 8,950 11,650 14,350
SUPRABUBIC CYSTOSTOMY
131 - ENDOSCOPIC SURGEON FEE 4,700 4,700 6,200 7,550

132 SUTURING - LARGE PROCEDURE 1,650 1,650 2,200 2,650

133 SUTURING - MEDIUM PROCEDURE 1,100 1,100 1,450 1,750
134 SUTURING - SMALL PROCEDURE 550 550 750 900
135 TESTICULAR BIOPSY B/L SURGEON FEE 4,700 4,700 6,100 7,550
136 TESTICULAR BIOPSY B/L PACKAGE 21,200 27,550 33,950
(PACKAGE)
137 TESTICULAR BIOPSY U/L SURGEON FEE 3,400 3,400 4,450 5,450
138 TESTICULAR PROSTHESIS SURGEON FEE 18,300 23,800 29,300
B/L
139 TRANSRECTAL ULTRASOUND SURGEON FEE
(TRUS) GUIDED PROSTATE
BIOPSY 4,700 4,700 6,100 7,550

140 TRUS GUIDED PROSTATE SURGEON FEE 4,700 4,700 6,100 7,550
BIOPSY
141 TRUS GUIDED PROSTATE PACKAGE 27,150 35,300 43,450
BIOPSY (PACKAGE)
142 TUBE/CATHETER/SUTURE PROCEDURE 450 450 590 750
REMOVAL
143 TURBT - GRADE A SURGEON FEE 28,050 36,500 44,900
144 TURBT - GRADE B SURGEON FEE 42,500 55,250 68,000
145 TURBT - GRADE B PACKAGE 192,950 252,850 308,750
(PACKAGE)
146 TURP < 20 GRAM - GRADE A SURGEON FEE 23,800 30,950 38,100

147 TURP < 20 GRAM - GRADE A PACKAGE 86,700 112,700 138,750

(PACKAGE)
148 TURP < 40 GRAMS - GRADE SURGEON FEE 23,800 30,950 38,100
B
149 TURP < 40 GRAMS - GRADE PACKAGE 218,450 284,000 349,550
B (PACKAGE)
150 TURP > 40 GRAM - GRADE C SURGEON FEE 42,500 55,250 68,000

151 TVT-O/ TVT SURGEON FEE 15,750 20,500 25,200

152 URETERIC SURGEON FEE 6,800 8,850 10,900
CATHETERIZATION B/L
153 URETERIC SURGEON FEE 4,700 4,700 6,100 7,500
CATHETERIZATION U/L
154 URETERIC INJURY SURGEON FEE 32,300 41,900 51,700
URETERIC REIMPLANTATION B/L -
155 LAP SURGEON FEE 32,300 41,900 51,700

URETERIC REIMPLANTATION B/L -

156 OPEN SURGEON FEE 42,500 55,250 68,000

URETERIC REIMPLANTATION U/L -

157 LAP SURGEON FEE 32,300 41,900 51,700

URETERIC REIMPLANTATION U/L

158 OPEN SURGEON FEE 21,250 27,600 34,000

URETERIC REIMPLANTATION
159 WITH SURGEON FEE 42,500 55,250 68,000
BOARI FLAP- U/L - LAP
URETERIC REIMPLANTATION
160 WITH SURGEON FEE 42,500 55,250 68,000
BOARI FLAP- U/L - OPEN
161 URETEROLITHOTOMY - LAP SURGEON FEE 42,500 55,250 68,000

162 URETEROLITHOTOMY - SURGEON FEE 28,050 36,500 44,900

OPEN
163 URETEROLYSIS - LAP SURGEON FEE 32,300 41,900 51,700
164 URETEROLYSIS - OPEN SURGEON FEE 28,050 36,500 44,900
165 URETHRAL CALIBRATION PROCEDURE 850 850 1,100 1,400
166 URETHRAL DILATATION PROCEDURE 2,550 2,550 3,350 4,100
167 URETHRAL DILATATION PACKAGE 6,800 8,850 10,900
(PACKAGE)
168 URETHRAL DIVERTICULUM SURGEON FEE 18,300 23,800 29,300
REPAIR
169 URETHRAL FISTUAL REPAIR SURGEON FEE 21,250 27,650 34,000

170 URETHROPLASTY ( SINGLE SURGEON FEE 28,050 36,500 44,900

STAGE )
171 URETHROPLASTY (SECOND SURGEON FEE 28,050 36,500 44,900
STAGE )
172 URETHROPLASTY (THIRD SURGEON FEE 36,550 47,500 58,500
STAGE)
173 URINARY DIVERSION SURGEON FEE 32,300 41,900 51,700
(CONDUIT)
174 URO CYSTOGRAPHY PROCEDURE 2,200 2,200 2,850 3,550
175 URO RETROGRADE PROCEDURE 2,200 2,200 2,850 3,550
URETHROGRAM (RGU)
176 UROFLOWMETRY PROCEDURE 700 700 900 1,200
177 UROFLOWMETRY + PROCEDURE 850 850 1,100 1,400
BLADDER SCAN
178 URS - GRADE A SURGEON FEE 18,300 23,800 29,300
179 URS - GRADE A (PACKAGE) PACKAGE 68,000 88,400 108,800

180 URS - GRADE B SURGEON FEE 21,250 27,650 34,000

181 URS - GRADE B (PACKAGE) PACKAGE 109,650 142,550 175,450

182 URS - GRADE C SURGEON FEE 42,500 55,250 68,000

183 URS WITH STENT - U/L SURGEON FEE 18,300 23,800 28,300
184 URS WITH STENT - U/L PACKAGE 36,950 48,100 59,150
(PACKAGE)
185 V I U - GRADE A SURGEON FEE 10,650 13,850 17,100
186 V I U - GRADE B SURGEON FEE 13,600 17,700 21,800
187 V I U - GREDE A SURGEON FEE 10,650 13,850 17,000
188 V I U - GREDE B SURGEON FEE 13,600 17,700 21,800
189 V I U - GREDE C SURGEON FEE 21,250 27,650 34,000
190 VARICOCELECTOMY SURGEON FEE 21,250 27,650 34,000
191 VARICOCELECTOMY - B/L - SURGEON FEE 28,050 36,500 44,900
LAP
192 VARICOCELECTOMY - U/L - SURGEON FEE 15,750 20,500 25,200
MICROSURGICAL
VARICOCELECTOMY - U/L -
193 MICROSURGICAL PACKAGE 62,050 80,650 99,300
(PACKAGE)
194 VASECTOMY SURGEON FEE 8,950 11,650 14,350
VASOEPIDIDYMAL ANASTOMOSIS
195 - SURGEON FEE 18,300 23,800 29,300
MICROSURGICAL - U/L
VASOVASAL ANASTOMOSIS -
196 MICROSURGICAL SURGEON FEE 21,250 27,650 34,000

197 VIDEOURODYNAMICS SURGEON FEE 5,100 5,100 6,650 8,200

198 VOIDING CYSTOMETRY SURGEON FEE 2,950 2,950 3,850 4,750
199 VVF REPAIR SURGEON FEE 32,300 41,900 51,700
200 PCNL - (PROMOTIONAL PACKAGE 40,000 60,000 80,000
PACKAGE)
201 TURP - (PROMOTIONAL PACKAGE 40,000 60,000 80,000
PACKAGE)
202 URS - (PROMOTIONAL PACKAGE 35,000 55,000 75,000
PACKAGE)
Diagnostic Cystoscopy -
203 (PROMOTIONAL PACKAGE) PACKAGE 8,000 12,000 20,000

Hydrocele Unilateral -
204 (PROMOTIONAL PACKAGE) PACKAGE 25,000 35,000 55,000

Hydrocele Bilateral -
205 (PROMOTIONAL PACKAGE) PACKAGE 35,000 45,000 60,000
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
23,800 29,750

17,900 22,400

64,600 80,750
47,600 59,500
47,600 59,500

11,900 14,900

17,900 22,400
17,900 22,400
36,600 45,750

5,300 6,650
9,400 11,750

36,600 45,750

36,600 45,750

36,600 45,750

47,600 59,500

23,800 29,750
23,800 29,750

47,600 59,500

27,200 34,000

64,600 80,750

17,900 22,400

23,800 29,750

13,600 17,000

9,400 11,750
 17,900 22,400
80,900 101,200

47,600 59,500

36,600 45,750
85,000 106,250

85,000 106,250

23,800 29,750

78,900 98,650

42,500 53,200

11,900 14,900

13,600 17,000

9,400 11,750

40,800 51,000

27,200 34,000

102,000 127,500

36,600 45,750

7,300 9,200
5,600 7,000
1,700 2,200

23,800 29,750

16,200 20,250

1,700 2,200
1,000 1,250
700 900
47,600 59,500
27,200 34,000

21,300 26,650

21,300 26,650

81,600 102,000
 17,900 22,400

42,500 53,200

13,600 17,000

42,500 53,200

188,700 235,900

64,600 80,750

16,200 20,250
13,600 17,000
54,400 68,000

23,800 29,750

36,600 45,750

27,200 34,000
1,700 2,200

85,000 106,250

73,100 91,400
351,900 439,900

47,600 59,500

36,600 45,750

11,900 14,900
5,900 7,400
20,400 25,500
47,600 59,500
85,000 106,250

306,000 382,500

64,600 80,750

85,000 106,250

85,000 106,250

56,100 70,200

255,000 318,750

85,000 106,250
 64,600 80,750

21,300 26,650

85,000 106,250

36,600 45,750
36,600 45,750

47,600 59,500

17,900 22,400

47,600 59,500

144,500 180,650

85,000 106,250
56,100 70,200
36,600 45,750

124,100 155,200

47,600 59,500
185,300 231,650

27,200 34,000
119,400 149,250

85,000 106,250

56,100 70,200
299,200 374,000

47,600 59,500
85,000 106,250
36,600 45,750
85,000 106,250
42,500 53,200

47,600 59,500
13,600 17,000

3,400 4,250

36,600 45,750
21,300 26,650

85,000 106,250

85,000 106,250
85,000 106,250

64,600 80,750
 85,000 106,250
47,600 59,500
144,500 180,650

85,000 106,250

85,000 106,250
4,400 5,500

85,000 106,250

47,600 59,500

21,300 26,650

9,400 11,750

64,600 80,750
85,000 106,250
17,900 22,400

9,400 11,750

3,300 4,200
2,200 2,750
1,100 1,400
9,400 11,750
42,400 53,000

6,800 8,500
36,600 45,750

9,400 11,750

9,400 11,750

54,300 67,900

900 1,200

56,100 70,200
85,000 106,250
385,900 482,400

47,600 59,500

173,400 216,750

47,600 59,500

436,900 546,200
 85,000 106,250

31,500 39,400
13,600 17,000

9,400 11,750

64,600 80,750

64,600 80,750

85,000 106,250

64,600 80,750

42,500 53,200

85,000 106,250

85,000 106,250

85,000 106,250

56,100 70,200

64,600 80,750
56,100 70,200
1,700 2,200
5,100 6,400
13,600 17,000

36,600 45,750

42,500 53,200

56,100 70,200

56,100 70,200

73,100 91,400

64,600 80,750

4,400 5,500
4,400 5,500

1,400 1,750
1,700 2,200

36,600 45,750
136,000 170,000

42,500 53,200
219,300 274,200

85,000 106,250
36,600 45,750
73,900 92,400

21,300 26,650
27,200 34,000
21,300 26,650
27,200 34,000
42,500 53,200
42,500 53,200
56,100 70,200

31,500 39,400

124,100 155,200

17,900 22,400

36,600 45,750

42,500 53,200

10,200 12,750
5,900 7,400
64,600 80,750
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate -
Department- PHYSIO. - Casualty
General Ward Transplant
ICU

Sr. No. Service Name Service Head OP Rates General Twin Private
Ward Sharing Room
1 ANTE NATAL CLASSES PER PROCEDURE 300 300 400 480
SESSION
2 B/L ANKLE ( SPRAIN / STRAIN) - PROCEDURE 4,450 4,450 5,800 7,200
10 SESSIONS
3 B/L ELBOW ( TENNIS / GOLF / PROCEDURE 4,450 4,450 5,800 7,200
SPRAIN) - 10 SESSIONS
4 B/L HIP ( ARTHRITIS / STRAIN ) PROCEDURE 7,650 7,650 9,950 12,250
10 SESSIONS
5 B/L KNEE ( OSTEO ARTHRITIS / PROCEDURE
SPRAIN / STRAIN / ETC) - 10
SESSIONS 7,650 7,650 9,950 12,250

B/L SHOULDER ( PERI ARTHRITIS / 9,600 9,600 12,500 15,400

FROZEN SHOULDER / IMPINGEMENT
6 SYNDROME / TENDINITIS / ETC) - 10 PROCEDURE
SESSIONS

7 BACK / NECK (LUMBAR PROCEDURE

SPONDYLOSIS /
SPONDYLOLESTHESIS / PIVD) - 10 4,350 4,350 5,650 6,950
SESSIONS
8 BALANCE SYSTEM PROCEDURE 650 650 850 1,050
9 BELLS PALSY - 10 SESSIONS PROCEDURE 4,800 4,800 6,250 7,700

10 BIOFEED BACK (7 SITTINGS) PROCEDURE 3,300 3,300 4,290 5,300

11 CHEST PHYSIOTHERAPY & PROCEDURE 500 500 650 800
EXERCISE THERAPY
12 CHEST THERAPY PROCEDURE 500 500 650 800
13 COMBINATION THERAPY 2 PROCEDURE 400 400 550 650
MODALITIES
COMBINATION THERAPY 2
14 MODALITIES + EXERCISE ( 10 DAYS) PROCEDURE 4,000 4,000 5,200 6,400

15 COMBINATION THERAPY PROCEDURE 650 650 850 1,050

UPTO 3 MODALITIES
16 COMBINATION THERAPY PROCEDURE 800 800 1,050 1,300
UPTO 4 MODALITIES
17 COMBINATION THERAPY PROCEDURE 1,020 1,020 1,350 1,600
UPTO 5 MODALITIES
18 ELECTRO THERAPY MOIST PROCEDURE 200 200 250 350
HEAT / INFRA RED
ELECTRO THERAPY VACCUM /
19 COMPRESSION THERAPY PROCEDURE 350 350 450 550

ELECTRO THERAPY-VACCUM /
20 COMPRESSION THERAPY (10 PROCEDURE 3,250 3,250 4,250 5,200
DAYS)
EXERCISE THERAPY + 1
21 ELECTROTHERAPY MODALITY PROCEDURE 350 350 450 550

EXERCISE THERAPY + 3
22 ELECTROTHERAPY MODALITY PROCEDURE 350 350 450 550
 EXERCISE THERAPY + 4
23 ELECTROTHERAPY MODALITY PROCEDURE 700 700 900 1,200

EXERCISE THERAPY + 5
24 ELECTROTHERAPY MODALITY PROCEDURE 850 850 1,100 1,350

25 EXERCISE THERAPY + HOT PROCEDURE 280 280 350 450

PACKS / CRYOTHERAPY
26 EXERCISE THERAPY NEURO PROCEDURE 350 350 450 550
LONG
27 EXERCISE THERAPY NEURO PROCEDURE 300 300 400 450
SHORT
28 EXERCISE THERAPY NEURO PROCEDURE 450 450 600 750
SHORT NIGHT
29 EXERCISE THERAPY ORTHO PROCEDURE 450 450 600 750
LONG
30 EXERCISE THERAPY ORTHO PROCEDURE 350 350 450 550
SHORT
31 EXERCISE THERAPY PER PROCEDURE 350 350 450 550
VISIT (PAEDIATRIC)
32 EXERCISE THERAPY X 25 PROCEDURE 5,350 5,350 6,950 8,550
SITTINGS (PAEDIATRIC)
33 EXERCISE THERAPY X12 PROCEDURE 2,750 2,750 3,600 4,400
SITTING (PAEDIATRIC)
34 GAIT TRAINING PROCEDURE 350 350 450 550
35 GAIT TRAINING + EXERCISE PROCEDURE 550 550 700 850
THERAPY
36 HOME PHYSIOTHERAPY 10 PROCEDURE 3,700 3,700 4,800 5,950
DAYS
37 HOME PHYSIOTHERAPY 20 PROCEDURE 8,600 8,600 11,200 13,750
DAYS
38 HOME PHYSIOTHERAPY PROCEDURE 10,700 10,700 13,900 17,200
30DAYS
39 HOME PHYSIOTHERAPY 90 PROCEDURE 29,750 29,750 38,700 47,600
DAYS
40 MANUAL MUSCLE CHARTING ( PROCEDURE 350 350 450 550
1 LIMB)
41 MANUAL MUSCLE CHARTING PROCEDURE 550 550 700 850
WHOLE BODY
42 MICROWAVE DIATHERMY PROCEDURE 350 350 450 550
43 MODALITY: CONTINUOUS PROCEDURE 350 350 450 550
PASSIVE MOTION
44 MODALITY: GROUP MUSCLE PROCEDURE 270 270 350 450
STIMULATION
45 MODALITY: INTERFERENTIAL PROCEDURE 250 250 350 400
THERAPY
46 MODALITY: LASER THERAPY PROCEDURE 370 370 500 600
MODALITY: OTHER
47 ELECTROTHERAPY ABOVE 5 PROCEDURE 250 250 350 400
MODALITIES
48 MODALITY: PARAFFIN WAX PROCEDURE 250 250 350 400
BATH (1 PART)
49 MODALITY: PARAFFIN WAX PROCEDURE 250 250 350 400
BATH ADDITIONAL PART
50 MODALITY: SHORT WAVE PROCEDURE 350 350 450 550
DIATHERMY
51 MODALITY: TENS PROCEDURE 250 250 350 400
52 MODALITY: TRACTION PROCEDURE 300 300 390 500
53 MODALITY: ULTRASONIC PROCEDURE 250 250 350 400
THERAPY
54 OPD CONSULTATION PROCEDURE 500 500 650 800
55 POST NATAL EXERCISE PER PROCEDURE 550 550 750 850
SESSION
POST OPERATIVE REHABILITATION -
56 10 PROCEDURE 4,000 4,000 5,200 6,400
SESSIONS
57 QUADRIPLEGIA - 10 SESSIONS PROCEDURE 6,650 6,650 8,650 10,650

58 U/L ANKLE ( SPRAIN / STRAIN) - PROCEDURE 3,350 3,350 4,350 5,400

10 SESSIONS
59 U/L ELBOW ( TENNIS / GOLF / PROCEDURE 3,350 3,350 4,350 5,400
SPRAIN) - 10 SESSIONS
60 U/L HIP ( ARTHRITIS / STRAIN ) PROCEDURE 4,350 4,350 5,650 6,950
- 10 SESSIONS
61 U/L KNEE ( OSTEO ARTHRITIS PROCEDURE
/ SPRAIN / STRAIN / ETC) - 10
SESSIONS 4,350 4,350 5,650 6,950

U/L SHOULDER ( PERI ARTHRITIS / 4,350 4,350 5,650 6,950

FROZEN SHOULDER / IMPINGEMENT
62 SYNDROME / TENDINITIS / PROCEDURE
ETC) - 10 SESSIONS
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
600 750

8,900 11,200

8,900 11,200

15,300 19,200

15,300 19,200

19,200 24,000

8,700 10,900

1,300 1,650
9,600 12,000

6,600 8,250
1,000 1,250

1,000 1,250
800 1,000

8,000 10,000

1,300 1,650

1,600 2,000

2,040 2,550

400 500

700 850

6,500 8,200

700 850

700 850
 1,400 1,750

1,700 2,200

550 700

700 850

600 750

900 1,200

900 1,200

700 850

700 850

10,700 13,400

5,500 6,900

700 900
1,100 1,400

7,500 9,250

17,200 21,500

21,400 26,750

59,500 74,400

700 900

1,100 1,400

700 900
700 900

550 700

500 650

750 950

500 650

500 650

500 650

700 900

500 650
600 750
 500 650

1,000 1,250
1,100 1,400

8,000 10,000

13,300 16,650

6,700 8,400

6,700 8,400

8,700 10,900

8,700 10,900

8,700 10,900
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate General -
Department- PATHOLOGY - Casualty Ward
Deluxe
Transplant
ICU

Sr. No. Service Name Sub Deptt OP Rates General Twin Private Deluxe
Ward Sharing Room
1 ABG Arterial Blood Gas BIOCHEMISTRY 1,500 1,500 1,650 1,800 1,950
Analysis
2 Acetaminophen ( ACET ) BIOCHEMISTRY 1,200 1,200 1,320 1,440 1,560

3 Albumin Creatinine Ratio BIOCHEMISTRY 1,200 1,200 1,320 1,440 1,560

4 Alcohol BIOCHEMISTRY 1,500 1,500 1,650 1,800 1,950

5 Alkaline Phosphatase BIOCHEMISTRY 350 350 480 530 580
6 Ammonia, EDTA Sample BIOCHEMISTRY 1,200 1,200 1,320 1,440 1,560

7 Amylase, Serum BIOCHEMISTRY 650 650 830 920 990

8 Barbiturates BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
9 Benzodizapines BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
10 BICARBONATE BIOCHEMISTRY 450 450 590 650 710
11 Bilirubin (Total BIOCHEMISTRY 250 250 380 410 450
,Direct,Indirect)
12 Blood Sugar Post Prandial BIOCHEMISTRY 220 220 270 264 330

13 BLOOD SUGAR RANDOM BIOCHEMISTRY 120 120 160 200 220

14 BLOOD UREA BIOCHEMISTRY 250 250 380 410 450

15 BODY FLUID TOTAL BIOCHEMISTRY 220 220 270 264 350
PROTEIN
16 BUN ( Blood Urea Nitrogen BIOCHEMISTRY 250 250 320 350 380
)
17 Calcium 24 hrs. Urine BIOCHEMISTRY 310 310 400 430 470
18 Calcium, Serum BIOCHEMISTRY 300 300 420 450 490
19 Calcium,24hrs Urine BIOCHEMISTRY 450 450 580 640 690
20 Calcium/Creatinine Ratio BIOCHEMISTRY 350 350 385 480 455
24 hrs Urine
21 Calcium/Creatinine Ratio BIOCHEMISTRY 250 250 340 370 400
Random Urine
22 Carbamazepine BIOCHEMISTRY 950 950 1,045 1,140 1,235
23 CARBON DIOXIDE (CO2) BIOCHEMISTRY 350 350 500 550 600

24 Chloride, 24 Hrs Urine BIOCHEMISTRY 250 250 350 380 420

25 Cholesterol BIOCHEMISTRY 310 310 390 430 470
26 Cholesterol HDL Ratio BIOCHEMISTRY 950 950 1,045 1,140 1,235
27 Cholinesterace BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
28 CKD DIABETIC- FULL BIOCHEMISTRY 1,200 1,200 1,320 1,440 1,560
PROFILE
29 CKMB BIOCHEMISTRY 500 500 710 600 850
30 Cocaine Metabolites BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
Congenetal Metabolic
31
Disorder screening Blood Test BIOCHEMISTRY 1,200 1,200 1,320 1,440 1,560

32 C-Peptide,Serum BIOCHEMISTRY 1,300 1,300 1,430 1,560 1,690

33 Creatine Kinase BIOCHEMISTRY 900 900 990 1,080 1,170
(CPK),Serum
34 Creatinine BIOCHEMISTRY 250 250 380 410 450
35 Creatinine Clearance BIOCHEMISTRY 400 400 530 580 640
Test,24Hrs Urine
36 Creatinine, 24 Hrs Urine BIOCHEMISTRY 220 220 280 264 350
37 CSF Chloride BIOCHEMISTRY 250 250 320 350 380
38 CSF Glucose BIOCHEMISTRY 150 150 165 180 195
39 CSF Glucose and Protein BIOCHEMISTRY 250 250 275 300 325

40 CSF Protein BIOCHEMISTRY 250 250 275 300 325

41 CSF-Cell Type& Count, BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
Glucose, Protein
42 Dialysis Water for Calcium BIOCHEMISTRY 250 250 320 350 380

43 Dialysis Water for Inoganic BIOCHEMISTRY 250 250 310 340 370
Phosphorus
44 Dialysis Water for BIOCHEMISTRY 250 250 320 350 380
Magnesium
45 Dialysis Water for BIOCHEMISTRY 250 250 320 350 380
Potassium
46 Dialysis Water for Sodium BIOCHEMISTRY 250 250 320 350 380

47 Digoxin BIOCHEMISTRY 850 850 935 1,020 1,105

48 Direct Bilirubin BIOCHEMISTRY 150 150 20 230 250
49 Direct LDL BIOCHEMISTRY 850 850 935 1,020 1,105
50 DRAIN FLUID BILIRUBIN BIOCHEMISTRY 200 200 280 240 350

51 DRAIN FLUID BIOCHEMISTRY 250 250 360 390 430

CHOLESTROL
52 DRAIN FLUID PROTEIN BIOCHEMISTRY 220 220 310 340 360
53 Drain Fluid Triglyceride BIOCHEMISTRY 320 320 420 460 490
54 DRAIN FLUID UREA BIOCHEMISTRY 130 130 170 156 200
55 Electrolytes (Na, K, CI) BIOCHEMISTRY 700 700 920 990 1,080
Serum
56 Fasting Blood Sugar BIOCHEMISTRY 120 120 170 200 180
57 Ferritin,Serum BIOCHEMISTRY 1,450 1,450 1,595 1,740 1,885
58 Folate , Serum BIOCHEMISTRY 2,200 2,200 2,420 2,640 2,860
59 Gamma GT (GGTP) BIOCHEMISTRY #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!
60 Globulin BIOCHEMISTRY 250 250 350 380 420
61 Glucose Challenge Test BIOCHEMISTRY 250 250 320 350 380
(GCT),Plasma
GLUCOSE TOLERANCE TEST 1,000 1,000 1,100 1,200 1,300
62 (GTT) BIOCHEMISTRY

63 Half hrs. Blood Sugar BIOCHEMISTRY 50 50 70 80 90

64 HDL CHOLESTROL BIOCHEMISTRY 400 400 530 580 650
65 Homocysteine, Quantitative BIOCHEMISTRY 2,100 2,100 2,310 2,520 2,730

66 Indirect Bilirubin BIOCHEMISTRY 200 200 280 240 350

67 Insulin Level (Fasting) BIOCHEMISTRY 900 900 990 1,080 1,170
68 Insulin Level (PP) BIOCHEMISTRY 900 900 990 1,080 1,170
69 Insulin Level (Random) BIOCHEMISTRY 1,000 1,000 1,100 1,200 1,300
70 Ionized Calcium BIOCHEMISTRY 750 750 1,000 100 1,180
Iron Study 1,200 1,200 1,320 1,440 1,560
71 ( Iron,TIBC,Ferritin,Saturatio BIOCHEMISTRY
n)
72 Ketone Blood BIOCHEMISTRY 400 400 530 580 625
73 Kidney Function Test BIOCHEMISTRY 800 800 880 960 1,040
74 Lactate BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
75 Lactate ( CSF ) BIOCHEMISTRY 1,200 1,200 1,320 1,440 1,560
LDH (Lactate 900 900 990 1,080 1,170
76 Dehydrogenase) Total , BIOCHEMISTRY
Serum
77 LDL - CHOLESTEROL BIOCHEMISTRY 850 850 935 1,020 1,105
78 Lipase BIOCHEMISTRY 1,000 1,000 1,100 1,200 1,300
79 Lipid Profile BIOCHEMISTRY 1,300 1,300 1,430 1,560 1,690
80 Lipid Profile - Extended BIOCHEMISTRY 1,900 1,900 2,090 2,280 2,470
81 Lipoprotein(a) ; Lp (a) BIOCHEMISTRY 1,300 1,300 1,430 1,560 1,690
82 Lithium BIOCHEMISTRY 600 600 790 870 940
 83 Liver Function Test BIOCHEMISTRY 700 700 770 840 910
Profile,Serum
84 Magnesium Randam Urine BIOCHEMISTRY 400 400 440 480 520

85 MAU (Microalbumin), BIOCHEMISTRY 400 400 610 480 710

Random Urine
86 MAU / Creatinine Ratio BIOCHEMISTRY 500 500 730 790 860
Urine
87 MB (CKMB/CK RATIO) BIOCHEMISTRY 800 800 1,050 1,200 1,220
88 Methotrexate Serum BIOCHEMISTRY 3,200 3,200 3,520 3,840 4,160
89 Microalbmin 24 hrs. Urine BIOCHEMISTRY 850 850 935 1,020 1,105

90 Microalbumin / Creatinine BIOCHEMISTRY 850 850 935 1,020 1,105

ratio
91 NT-proBNP BIOCHEMISTRY 2,500 2,500 2,750 3,000 3,250
92 One & Half hrs.Blood Sugar BIOCHEMISTRY 50 50 70 80 90

93 One Hrs. Blood Sugar BIOCHEMISTRY 50 50 70 80 90

94 Osmolality, Serum BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
95 Other Fluid - Glucose & BIOCHEMISTRY 350 350 490 530 580
Protein
Other Fluid - LDH (Lactate 700 700 950 1,000 1,090
96 Dehydrogenase) BIOCHEMISTRY

97 Other Fluid- Albumin BIOCHEMISTRY 900 900 990 1,080 1,170

98 Other Fluid Creatinine BIOCHEMISTRY 300 300 420 450 500
99 Other Fluid- Creatinine BIOCHEMISTRY 300 300 420 450 500
100 Other Fluid- lipase BIOCHEMISTRY 600 600 790 860 940
101 Other Fluid- Sodium BIOCHEMISTRY 200 200 280 240 350
102 Other Fluid- Uric Acid BIOCHEMISTRY 250 250 320 350 380
103 Other Fluid-Amylase BIOCHEMISTRY 900 900 990 1,080 1,170
104 Phosphorous Spot Urine BIOCHEMISTRY 200 200 280 240 350

105 Pleural fluid For ADA BIOCHEMISTRY 950 950 1,045 1,140 1,235
106 Post Hemodialysis Urea BIOCHEMISTRY 200 200 250 270 300

107 Potassium, Serum BIOCHEMISTRY 200 200 280 240 350

108 PRE HEMODIALYSIS BIOCHEMISTRY 200 200 250 270 300
UREA
109 Protein/Creatinine Ratio 24 BIOCHEMISTRY 650 650 715 780 845
hrs. Urine
110 Ratio BIOCHEMISTRY 250 250 340 370 400
111 Renal Profile (Without BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
Urine),Serum
112 Renal Profile BIOCHEMISTRY 1,300 1,300 1,430 1,560 1,690
113 SAAG (Serum-Ascites BIOCHEMISTRY 250 250 340 370 400
Albumin Gradient)
114 Salicylate BIOCHEMISTRY 8,200 8,200 9,020 9,840 10,660
115 Saturation BIOCHEMISTRY 350 350 385 420 455
116 Serum ADA BIOCHEMISTRY 110 110 140 150 170
117 Serum Albumin BIOCHEMISTRY 250 250 320 350 380
118 Serum Chloride BIOCHEMISTRY 350 350 500 420 590
119 SERUM IRON BIOCHEMISTRY 750 750 1,020 1,100 1,210
120 Serum Iron and Total Iron BIOCHEMISTRY 750 750 1,020 1,100 1,210
Binding capacity
121 Serum Lipid Profile BIOCHEMISTRY 1,000 1,000 1,100 1,200 1,300
122 SERUM MAGNESIUM BIOCHEMISTRY 650 650 800 860 940
123 SERUM PHOSPHORUS BIOCHEMISTRY 200 200 300 240 350
124 Serum Protein BIOCHEMISTRY 1,300 1,300 1,430 1,560 1,690
Electrophoresis
125 SERUM URIC ACID BIOCHEMISTRY 200 200 300 240 350
126 SGOT ( AST ) BIOCHEMISTRY 250 250 360 390 430
127 SGPT ( ALT ) BIOCHEMISTRY 250 250 340 370 410
128 Sodium, 24 Hrs Urine BIOCHEMISTRY 350 350 480 530 570
129 Sodium, Serum BIOCHEMISTRY 200 200 300 240 350
130 Stool for Reducing BIOCHEMISTRY 250 250 320 350 380
Substance
131 Synovial Fluid - Cell BIOCHEMISTRY 650 650 890 970 1,050
Count/Type & Gluc./Prot.
132 Theophylline BIOCHEMISTRY 1,000 1,000 1,100 1,200 1,300
133 Total Bilirubin BIOCHEMISTRY 350 350 500 420 590
134 TOTAL IRON BINDING BIOCHEMISTRY 750 750 940 900 1,110
CAPACITY (TIBC)
135 Total Protein, Serum BIOCHEMISTRY 350 350 500 420 590
136 Triglycerides, Serum BIOCHEMISTRY 400 400 540 580 640
137 Troponin - I ES BIOCHEMISTRY 1,900 1,900 2,090 2,280 2,470
(Quantitative )
138 TROPONIN-I (SPOT- BIOCHEMISTRY 2,500 2,500 2,750 3,000 3,250
QUALITATIVE)
139 Two hrs. Blood Sugar BIOCHEMISTRY 50 50 70 80 90
140 Urea 24 Hrs Urine BIOCHEMISTRY 250 250 360 390 430
141 UREA/CREAT RATIO BIOCHEMISTRY 250 250 380 410 450
142 Uric Acid, 24 Hrs Urine BIOCHEMISTRY 450 450 590 640 690
143 Uric Acid, Random Urine BIOCHEMISTRY 250 250 320 350 370

144 URINE 24 HR BIOCHEMISTRY 550 550 700 750 820

MAGNESIUM
145 URINE 24 HR BIOCHEMISTRY 150 150 200 220 340
PHOSPORUS
146 Urine 24 hr. Glucose BIOCHEMISTRY 150 150 170 180 200
147 Urine 24 hr.Potassium BIOCHEMISTRY 300 300 400 430 470
148 URINE BIOCHEMISTRY 1,400 1,400 1,540 1,680 1,820
ELECTROPHORESIS
149 Urine for Protein BIOCHEMISTRY 250 250 380 300 450
(Qualitative)
150 Urine For Reducing BIOCHEMISTRY 200 200 240 260 290
Substances
151 URINE OSMOLALITY BIOCHEMISTRY 1,100 1,100 1,210 1,320 1,430
152 Urine Protein ( Quantitative BIOCHEMISTRY 300 300 380 360 450
)
153 Urine Protein 24 hr. BIOCHEMISTRY 300 300 480 530 570
154 URINE RANDOM BIOCHEMISTRY 500 500 340 700 750
AMYLASE
155 URINE RANDOM BIOCHEMISTRY 300 300 420 460 490
CALCIUM
156 URINE RANDOM BIOCHEMISTRY 350 350 385 420 455
CHOLRIDE
157 URINE RANDOM BIOCHEMISTRY 450 450 620 670 730
CREATININE
URINE RANDOM 700 700 920 990 1,100
158 MICROALBUMIN TO BIOCHEMISTRY
CREATININE RATIO
159 URINE RANDOM BIOCHEMISTRY 300 300 390 430 470
POTASSIUM
URINE RANDOM PROTEIN 850 850 935 1,020 1,105
160 CREATININE RATIO BIOCHEMISTRY

161 URINE RANDOM SODIUM BIOCHEMISTRY 350 350 420 450 500

162 Vancomycin BIOCHEMISTRY 6,600 6,600 7,260 7,920 8,580

163 VLDL BIOCHEMISTRY 300 300 410 440 480
164 BJ Protein CLINICAL PATHOLOGY 650 650 890 970 1,050
165 BS/BP CLINICAL PATHOLOGY 120 120 150 200 220
166 BS/BP UROBILINOGEN CLINICAL PATHOLOGY 120 120 150 200 220
167 CHYLE CLINICAL PATHOLOGY 330 330 430 470 510
168 Fluid Examination CLINICAL PATHOLOGY 850 850 935 1,200 1,270
169 PH Body Fluids CLINICAL PATHOLOGY 130 130 170 156 200
170 Ryle Tube Aspiration For CLINICAL PATHOLOGY 1,000 1,000 1,100 1,200 1,300
Occult blood
171 Semen Analysis CLINICAL PATHOLOGY 750 750 970 900 1,150
172 Semen Fructose CLINICAL PATHOLOGY 300 300 420 450 500
173 Stool Routine and CLINICAL PATHOLOGY 200 200 280 240 350
Microscopy
174 Urine for Bile Salt CLINICAL PATHOLOGY 300 300 420 450 500
175 Urine For fat CLINICAL PATHOLOGY 300 300 420 450 500
176 Urine Ketone/Acetone CLINICAL PATHOLOGY 450 450 495 540 585
177 Urine Pregnancy Test CLINICAL PATHOLOGY 300 300 420 460 500
178 Urine Routine and CLINICAL PATHOLOGY 200 200 280 240 350
Microscopy
179 Urine Sugar Fasting CLINICAL PATHOLOGY 200 200 310 340 370
180 Urine Sugar PP CLINICAL PATHOLOGY 200 200 310 340 370
181 Urine Sugar Random CLINICAL PATHOLOGY 200 200 310 340 370
BODY FLUIDS CYTOLOGY- 850 850 935 1,020 1,105
182 CELL COUNT CYTOLOGY

BODY FLUIDS FOR 750 750 970 1,050 1,150

183 MALIGNANT CYTOLOGY CYTOLOGY

184 FNAC REPORTING CYTOLOGY 1,100 1,100 1,550 1,320 1,430

185 FNAC with Procedure CYTOLOGY 7,000 7,000 7,700 8,400 9,100
186 Frozen Section /Intro OP CYTOLOGY 2,100 2,100 2,310 2,520 2,730
Cytology Specimen-2
187 Frozen Section/Intra OP CYTOLOGY 3,200 3,200 3,520 3,840 4,160
Cytology 3 - 5 Specimen
Frozen Section/Intra 1,100 1,100 1,210 1,320 1,430
188 Operative Cytology Per CYTOLOGY
Specimen
Frozen Section/Intra 5,300 5,300 5,830 6,360 6,890
189 Operative Cytology CYTOLOGY
Specimen 5 - 10
190 Pap Smear CYTOLOGY 1,100 1,100 1,210 1,320 1,430
191 PAS Stain CYTOLOGY 1,100 1,100 1,210 1,320 1,430
192 Reviev of Outside Slide > CYTOLOGY 7,500 7,500 8,250 9,000 9,750
10
193 Review of Out Slide 6 To CYTOLOGY 1,100 1,100 1,210 1,320 1,430
10 (CYTO)
194 Review of Outside Slide 3 - CYTOLOGY 850 850 935 1,020 1,105
5 ( Cyto )
195 Review Of Outslide Slide CYTOLOGY 650 650 850 780 980
Upto 2 (Cyto)
196 Slide Review - CYTOLOGY 650 650 850 780 980
Cytopathology
197 Slides Issued For 2nd CYTOLOGY 200 200 210 230 260
Opinion (Per Slide) Cyto
198 Smear for Cytology CYTOLOGY 750 750 970 1,050 1,140
SPUTUM FOR MALIGNANT 550 550 720 660 850
199 CELLS(DAY 1) CYTOLOGY

URINE FOR MALIGNANT 550 550 720 660 850

200 CELLS(DAY 1) CYTOLOGY

201 Absolute Basophil Count HAEMATOLOGY 450 450 495 540 585

202 Absolute Eosinophil Count HAEMATOLOGY 450 450 495 540 585

203 Absolute Lymphocyte HAEMATOLOGY 450 450 495 540 585

Count
204 Absolute Monocyte Count HAEMATOLOGY 450 450 495 540 585

205 Absolute Neutrophil Count HAEMATOLOGY 450 450 495 540 585

APTT (Partial 500 500 700 760 650

206 Thromboplastin Time),Citrate HAEMATOLOGY
Plasma
207 Ascitic Fluid - Cell Count & HAEMATOLOGY 200 200 280 240 350
Type
BETHESDA ASSAY FOR 15,000 15,000 20,700 18,000 19,500
208 FACTOR VIII INHIBITORS HAEMATOLOGY
209 BLEEDING HAEMATOLOGY 250 250 320 350 380
TIME/CLOTTING TIME
210 Blood Grouping and RH HAEMATOLOGY 250 250 370 400 430
Factor
211 Bone marrow Iron Stain HAEMATOLOGY 650 650 850 780 980
212 CBC (Complete Blood HAEMATOLOGY 450 450 590 640 690
Count),EDTA
213 CBC + DIFF + PS HAEMATOLOGY 750 750 970 1,050 1,140
214 Coagulation Profile HAEMATOLOGY 1,700 1,700 1,870 2,040 2,210
215 Control HAEMATOLOGY 50 50 70 75 80
216 Coombs Test Direct HAEMATOLOGY 500 500 750 810 870
217 Coombs Test Indirect HAEMATOLOGY 500 500 750 600 650
D-Dimer, 1,700 1,700 1,870 2,040 2,210
218 (Quantitative),Citrate Plasma HAEMATOLOGY

219 Demonstration Of HEINZ HAEMATOLOGY 300 300 420 460 500

Bodies
220 DIFFERENTIAL HAEMATOLOGY 200 200 260 290 310
LEUCOCYTE COUNT
221 DRAIN FLUID-HB & PCV HAEMATOLOGY 350 350 420 460 500

222 ESR (Westergren),EDTA HAEMATOLOGY 200 200 280 240 350

223 Factor VIII Studies Citrate HAEMATOLOGY 4,500 4,500 4,950 5,400 5,850
Plasma
224 FDP (Fibrinogen HAEMATOLOGY 1,700 1,700 1,870 2,040 2,210
Degradation Products)
225 Fibrinogen HAEMATOLOGY 3,000 3,000 3,300 3,600 3,900
226 G - 6 PD Deficiency HAEMATOLOGY 900 900 990 1,080 1,170
Test,Quantitative,EDTA
227 HAEMOGLOBIN HAEMATOLOGY 250 250 320 350 380
228 Haemogram (CBC Diff. PS HAEMATOLOGY 500 500 760 830 900
ESR)
229 HbA1C ( Glycosulated HAEMATOLOGY 900 900 990 1,080 1,170
Haemoglobin )
230 Hb-Electrophoresis (HPLC) HAEMATOLOGY 1,100 1,100 1,210 1,320 1,430

231 HRP2 (Malaria Antigen) HAEMATOLOGY 900 900 990 1,080 1,170
232 INR HAEMATOLOGY 200 200 280 240 350
233 LE Cells HAEMATOLOGY 500 500 550 600 650
234 Lupus Anticoagulant HAEMATOLOGY 1,600 1,600 1,760 1,920 2,080
235 Malarial Parasite Blood HAEMATOLOGY 300 300 420 450 500
Smear
236 MCH HAEMATOLOGY 50 50 70 80 90
237 MCHC HAEMATOLOGY 50 50 70 80 90
238 MCV HAEMATOLOGY 50 50 70 80 90
239 MPV HAEMATOLOGY 50 50 70 80 90
240 Nasal Smear for HAEMATOLOGY 200 200 280 240 350
Eosinophils
241 Packed Cell Volume PCV HAEMATOLOGY 150 150 165 180 195

242 PCT Platelet Haematocrit HAEMATOLOGY 50 50 70 80 90

243 PDW HAEMATOLOGY 50 50 70 80 90

244 Peripheral Smear HAEMATOLOGY 200 200 300 330 350
Examination
Peripheral Smear 300 300 420 460 500
245 Examination for Micro Filaria HAEMATOLOGY

246 Peripheral Smear for HAEMATOLOGY 550 550 760 830 900
Malarial Parasite
247 Platelet Count HAEMATOLOGY 200 200 280 240 350
248 Prothrombin Time & INR HAEMATOLOGY 500 500 650 710 770

249 RBC Count HAEMATOLOGY 250 250 320 350 380

250 RDW HAEMATOLOGY 50 50 70 80 90
251 Reticulocyte Count HAEMATOLOGY 300 300 420 460 500
252 Sickling Test HAEMATOLOGY 300 300 420 460 500
253 TEST HAEMATOLOGY 50 50 70 80 90
254 Thrombin Time HAEMATOLOGY 1,000 1,000 1,100 1,200 1,300
255 TLC (Total Leukocyte HAEMATOLOGY 250 250 310 340 360
Count)
256 Biopsy Radical HISTOPATHOLOGY 6,000 6,000 6,600 7,200 7,800
Prostectomy
257 Bone Marrow Biopsy HISTOPATHOLOGY 1,600 1,600 1,760 1,920 2,080
Reporting
258 Cell Block Preparation HISTOPATHOLOGY 2,000 2,000 2,200 2,400 2,600
259 Histo Biopsy Kidney / HISTOPATHOLOGY 4,250 4,250 4,675 5,100 5,525
Nephrectomy
260 Histo Biopsy Large (15 Or HISTOPATHOLOGY 4,250 4,250 4,675 5,100 5,525
More Blocks)
261 Histo Biopsy Liver Needle HISTOPATHOLOGY 4,250 4,250 4,675 5,100 5,525
Biopsy
Histo Biopsy Medium 2,200 2,200 2,420 2,640 2,860
262 Specimens ( 5 TO 14 Blocks ) HISTOPATHOLOGY

263 Histo Biopsy Nerve HISTOPATHOLOGY 4,000 4,000 4,400 4,800 5,200
264 Histo Biopsy Prostate HISTOPATHOLOGY 3,500 3,500 3,850 4,200 4,550
265 Histo Biopsy slide review HISTOPATHOLOGY 2,500 2,500 2,750 3,000 3,250
(upto 5 slides)
266 Histo Biopsy Small HISTOPATHOLOGY 1,500 1,500 1,650 1,800 1,950
267 Histo Onco Radical HISTOPATHOLOGY 6,000 6,000 6,600 7,200 7,800
Nephrectomy
268 MPO STAIN HISTOPATHOLOGY 1,100 1,100 1,210 1,320 1,430
269 NSE Stain HISTOPATHOLOGY 1,300 1,300 1,430 1,560 1,690
270 Review Of Outside Slide HISTOPATHOLOGY 1,200 1,200 1,320 1,440 1,560
Upto 2 Slides(Histo)
Slides Issued For Second 200 200 280 240 350
271 Opinion (Per Slide) - Histo HISTOPATHOLOGY

272 A-Antitrypsin ( AAT ) IMMUNOLOGY 2,000 2,000 2,200 2,400 2,600

273 ACE ( Angiotensing IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430
Converting Enzyme )
274 ACTH ( Frozen Plasma ) IMMUNOLOGY 2,500 2,500 2,750 3,000 3,250
Allergy Panel-Food Spices 8,500 8,500 9,350 10,200 11,050
275 Panel 11 Parameters IMMUNOLOGY

276 Allergy Panel-Food IMMUNOLOGY

Vegetarian+Nonvegeterian
Panel 22 Parameters 11,000 11,000 12,100 13,200 14,300

Allergy Panel-Others Adult 11,000 11,000 12,100 13,200 14,300

277 Comprehensive Panel 25 IMMUNOLOGY
Parameters
Allergy Panel-Others 26,000 26,000 28,600 31,200 33,800
278 Asthama/Rhinitis Panel- Adult IMMUNOLOGY
15 Parameters
279 Alpha Feto Protein (AFP) IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
280 Alpha Feto Protein (AFP) IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
Amniotic Fluid
281 Amphetamine IMMUNOLOGY 650 650 850 780 980
282 ANA ( Immunoflurescence ) IMMUNOLOGY 1,300 1,300 1,430 1,560 1,690

283 ANA (Anti Nuclear IMMUNOLOGY 750 750 970 1,050 1,140
Antibody) - ELISA
284 ANCA IMMUNOLOGY 2,300 2,300 2,530 2,760 2,990
Anti Cyclic Citrulinated 2,200 2,200 2,420 2,640 2,860
285 Peptide (Anti CCP Antibody) IMMUNOLOGY

286 Anti Mitochondrial Antibody IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950

287 Anti Mullerian Hormone ( IMMUNOLOGY 2,000 2,000 2,200 2,400 2,600
AMH )
288 Anti NMO Antibody IMMUNOLOGY 5,000 5,000 5,500 6,000 6,500
289 Anti Thrombin-III-Functional IMMUNOLOGY 5,000 5,000 5,500 6,000 6,500
290 Anti Thyroglobulin Antibody IMMUNOLOGY 1,700 1,700 1,870 2,040 2,210
(Anti TG)
Anti Thyroid Peroxidase 1,100 1,100 1,210 1,320 1,430
291 AntiBody (Anti Tpo),Serum IMMUNOLOGY

Anti-ds-DNA Antibody 1,500 1,500 1,650 1,800 1,950

292 (Double Stranded)ELISA IMMUNOLOGY

293 Anti-HAV Total IMMUNOLOGY 2,500 2,500 2,750 3,000 3,250

294 Anti-HBC IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
295 Anti-HBe IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430
296 Anti-HBs IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
297 ANTI HCV IMMUNOLOGY 1,000 1,000 1,400 1,200 1,650
(IMMUNOASSAY)
298 Anti-T. cruzi IMMUNOLOGY 2,300 2,300 2,530 2,760 2,990
299 Appolipoprotein A1 IMMUNOLOGY 600 600 660 720 780
300 Appolipoprotein B1 IMMUNOLOGY 600 600 660 720 780
301 ASMA ( Anti Smooth IMMUNOLOGY 2,300 2,300 2,530 2,760 2,990
Muscle Antibody )
302 Aspergillus Antibody IgG IMMUNOLOGY 2,800 2,800 3,080 3,360 3,640
303 Aspergillus Antibody IgG + IMMUNOLOGY 4,500 4,500 4,950 5,400 5,850
IgM
304 Aspergillus Antibody IgM IMMUNOLOGY 2,800 2,800 3,080 3,360 3,640
305 Aspergillus IgE Specific IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
306 Beta-2 Glycoprotein 1, IgA IMMUNOLOGY 950 950 1,045 1,140 1,235

307 Beta-2 Glycoprotein 1, IgG IMMUNOLOGY 1,400 1,400 1,540 1,680 1,820

308 Beta-2 Glycoprotein 1, IgM IMMUNOLOGY 1,400 1,400 1,540 1,680 1,820

309 Beta-2 Microglobulin ( IMMUNOLOGY 2,200 2,200 2,420 2,640 2,860

Serum )
310 Beta-2 Microglobulin ( IMMUNOLOGY 2,200 2,200 2,420 2,640 2,860
Urine)
Brucella IgG + IgM 2,400 2,400 2,640 2,880 3,120
311 Antibodies( Quantitative ) IMMUNOLOGY

312 Brucella IgG Antibody ( IMMUNOLOGY 1,700 1,700 1,870 2,040 2,210
Quantitative )
313 Brucella IgM Antibody ( IMMUNOLOGY 1,700 1,700 1,870 2,040 2,210
Quantitative )
314 C3 IMMUNOLOGY 650 650 910 990 1,070
315 C4 IMMUNOLOGY 650 650 910 990 1,070
316 CA - 125 (Ovarian Cancer IMMUNOLOGY 1,400 1,400 1,540 1,680 1,820
Marker),Serum
317 CA 19.9 , Serum IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
318 CA15-3 IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
319 Cannabinoids IMMUNOLOGY 600 600 850 720 980
320 CD 8 Count Flow IMMUNOLOGY 2,800 2,800 3,080 3,360 3,640
Cytometry
321 CD4 + CD8 Count Flow IMMUNOLOGY 2,800 2,800 3,080 3,360 3,640
Cytometry
322 CD4-Flow Cytometry IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
CEA (Carcino Embryonic 950 950 1,045 1,140 1,235
323 Antigen),Serum IMMUNOLOGY

324 Clostridium Diffcile Toxin IMMUNOLOGY 2,800 2,800 3,080 3,360 3,640
A&B (Stool)
325 CMV PCR Qualitative IMMUNOLOGY 5,200 5,200 5,720 6,240 6,760
326 Cold Agglutination Test IMMUNOLOGY 600 600 660 720 780
serum
327 Cortisol Evening Sample IMMUNOLOGY 900 900 990 1,080 1,170

328 Cortisol Morning Sample IMMUNOLOGY 900 900 990 1,080 1,170

329 Cortisol Random Sample IMMUNOLOGY 1,000 1,000 1,100 1,200 1,300

330 C-Peptide (Fasting) IMMUNOLOGY 2,300 2,300 2,530 2,760 2,990

331 C-Peptide (PP) IMMUNOLOGY 2,300 2,300 2,530 2,760 2,990
CSF Protein 6,200 6,200 6,820 7,440 8,060
332 Electrophoresis,Oligoclonal IMMUNOLOGY
Bands
333 Dengue Virus RNA PCR IMMUNOLOGY 3,500 3,500 3,850 4,200 4,550
DHEA-S 1,600 1,600 1,760 1,920 2,080
334 (Dehydroepiandrosterone IMMUNOLOGY
Sulphate)
335 Double Marker IMMUNOLOGY 3,500 3,500 3,850 4,200 4,550
336 EBV IgM ( Epstein-Barr IMMUNOLOGY 2,200 2,200 2,420 2,640 2,860
Virus )
337 EBV PCR (Epstein-Barr IMMUNOLOGY 3,600 3,600 3,960 4,320 4,680
Virus) to vca igM
338 EBV PCR (Epstein-Barr IMMUNOLOGY 6,500 6,500 7,150 7,800 8,450
Virus) to VCA Panel
339 Estradiol (Total),E2 Serum IMMUNOLOGY 950 950 1,045 1,140 1,235

340 Estradiol E3 IMMUNOLOGY 1,700 1,700 1,870 2,040 2,210

341 Factor V Leiden Citrate IMMUNOLOGY 7,000 7,000 7,700 8,400 9,100
Plasma
342 Free PSA IMMUNOLOGY 1,000 1,000 1,100 1,200 1,300
343 Free T3,Serum IMMUNOLOGY 750 750 970 1,050 1,200
344 Free T4,Serum IMMUNOLOGY 750 750 970 1,050 1,200
FSH - Follicle Stimulating 750 750 950 1,050 1,130
345 Hormone,Serum IMMUNOLOGY

346 Growth Hormone,Serum IMMUNOLOGY 800 800 1,050 960 1,350

347 H1N1/Swine Flu Real Time IMMUNOLOGY 6,000 6,000 6,600 7,200 7,800
PCR Routine
348 Haptoglobin IMMUNOLOGY 4,000 4,000 4,400 4,800 5,200
349 HBsAg ( Qualitative ) IMMUNOLOGY 900 900 990 1,080 1,170
350 HBV DNA Qualitative PCR IMMUNOLOGY 3,900 3,900 4,290 4,680 5,070

351 HBV DNA Quantitative IMMUNOLOGY 8,000 8,000 8,800 9,600 10,400
PCR
352 HBV -IgM (Hepatitis A IgM) IMMUNOLOGY 7,500 7,500 8,250 9,000 9,750

353 HCV RNA Qualitative PCR IMMUNOLOGY 7,500 7,500 8,250 9,000 9,750

354 HCV RNA Quantitative IMMUNOLOGY 10,000 10,000 11,000 12,000 13,000
PCR
355 Herpes Simplex Virus IgG IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430

356 Herpes Simplex Virus IgM IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430

357 HIV-1 Qualitative Real time IMMUNOLOGY 5,500 5,500 6,050 6,600 7,150
PCR
358 HIV-1 RNA Quantitative IMMUNOLOGY 3,500 3,500 3,850 4,200 4,550
Real Time PCR
359 HLA B-27 ( Flow Cytometry IMMUNOLOGY 3,500 3,500 3,850 4,200 4,550
)
360 HLA Typing IMMUNOLOGY 1,500 1,500 1,650 1,800 1,950
HLA-T & B Cell Lymphocyte 3,500 3,500 3,850 4,200 4,550
361 Cross Match IMMUNOLOGY

362 HPV DNA High risk Hybrid IMMUNOLOGY 2,500 2,500 2,750 3,000 3,250
Capture
363 HSV 1 & 2 Real Time PCR IMMUNOLOGY 4,250 4,250 4,675 5,100 5,525
( CSF )
364 IgA ( Immunoglobulin-A ) IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430

365 IgE ( Immunoglobulin-E ) IMMUNOLOGY 950 950 1,045 1,140 1,235

366 IgG (Immunoglobulin-G) IMMUNOLOGY 950 950 1,045 1,140 1,235

367 IgM (Immunoglobulin-M) IMMUNOLOGY 950 950 1,045 1,140 1,235
Immunofixation 5,600 5,600 6,160 6,720 7,280
368 Electrophoresis ( 24 hrs IMMUNOLOGY
Urine )
369 Immunofixation IMMUNOLOGY 8,500 8,500 9,350 10,200 11,050
Electrophoresis Serum
370 Immunoglobulin Profile ( IMMUNOLOGY 1,800 1,800 1,980 2,160 2,340
IgG, IgM, IgA )
371 IPTH IMMUNOLOGY 2,200 2,200 2,420 2,640 2,860
372 LH-Luteinizing Hormone , IMMUNOLOGY 800 800 1,050 1,150 1,250
Serum
LKM-1 ( Liver Kidney 3,500 3,500 3,850 4,200 4,550
373 Microsomal Type-1 IMMUNOLOGY
Antibody )
374 Measels/Rubella-IgG IMMUNOLOGY 750 750 970 1,050 1,200
375 Measels/Rubella-IgM IMMUNOLOGY 750 750 970 1,050 1,200
376 Methadone IMMUNOLOGY 1,200 1,200 1,320 1,440 1,560
377 Mumps Virus Antibody-IgG IMMUNOLOGY 1,700 1,700 1,870 2,040 2,210

378 Mumps Virus Antibody-IgM IMMUNOLOGY 1,800 1,800 1,980 2,160 2,340

379 Myeloma Profile-New IMMUNOLOGY 7,500 7,500 8,250 9,000 9,750

380 NT BNP IMMUNOLOGY 2,500 2,500 2,750 3,000 3,250
381 Opiates IMMUNOLOGY 650 650 850 780 980
382 P ANCA IMMUNOLOGY 2,400 2,400 2,640 2,880 3,120
383 PCR For HLA B27 IMMUNOLOGY 6,000 6,000 6,600 7,200 7,800
384 PCR For Tuberculosis IMMUNOLOGY 3,700 3,700 4,070 4,440 4,810
385 Phencyclidine IMMUNOLOGY 1,300 1,300 1,430 1,560 1,690
386 Phenobarbitone IMMUNOLOGY 1,000 1,000 1,100 1,200 1,300
387 Phenytoin IMMUNOLOGY 1,300 1,300 1,430 1,560 1,690
388 Prealbumin IMMUNOLOGY 300 300 280 360 350
389 Procalcitonin(PCT) Serum IMMUNOLOGY 2,000 2,000 2,200 2,400 2,600

390 Progesterone OH- IMMUNOLOGY 1,700 1,700 1,870 2,040 2,210

17,Serum
391 Progesterone,Serum IMMUNOLOGY 750 750 1,000 1,100 1,300
392 Prostate Specific Antigen IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430
(PSA) - Total
393 Protein-C IMMUNOLOGY 4,400 4,400 4,840 5,280 5,720
394 Protein-S IMMUNOLOGY 3,800 3,800 4,180 4,560 4,940
395 PTH (Parathyroid IMMUNOLOGY 2,000 2,000 2,200 2,400 2,600
Hormone)
396 Rotavirus Antigen Set IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430
397 Rubella IgG + Rubella IMMUNOLOGY 650 650 850 780 980
IgM,Serum
398 Rubella IgG,Serum IMMUNOLOGY 650 650 870 950 1,030
399 Rubella IgM Serum IMMUNOLOGY 750 750 825 900 975
400 Serum Anti Cardiolipin IMMUNOLOGY 1,000 1,000 1,100 1,200 1,300
Antibody IgA
401 Serum Anti Cardiolipin IMMUNOLOGY 950 950 1,045 1,140 1,235
Antibody IgG
402 Serum Anti Cardiolipin IMMUNOLOGY 950 950 1,045 1,140 1,235
Antibody IgM
Serum Anti Phospholipid 1,200 1,200 1,320 1,440 1,560
403 Antibody IgG IMMUNOLOGY

Serum Anti Phospholipid 1,200 1,200 1,320 1,440 1,560

404 Antibody IgM IMMUNOLOGY

405 Serum Beta HCG Total IMMUNOLOGY 850 850 935 1,020 1,105
406 Serum Ceruloplasmin IMMUNOLOGY 1,200 1,200 1,320 1,440 1,560
407 Serum Cytomegalovirus ( IMMUNOLOGY 850 850 935 1,020 1,105
CMV ) IgM
408 Serum Cytomegalovirus IMMUNOLOGY 850 850 935 1,020 1,105
(CMV) IgG
409 Serum Myoglobin IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430
410 Serum Prolactin IMMUNOLOGY 750 750 825 900 975
411 Serum Thyroglobulin IMMUNOLOGY 2,000 2,000 2,200 2,400 2,600
412 Syphilis TPHA IMMUNOLOGY 1,100 1,100 1,210 1,320 1,430
413 T3 IMMUNOLOGY 650 650 860 940 845
414 T4 IMMUNOLOGY 250 250 340 380 410
415 TB Gold Quantiferon IMMUNOLOGY 4,250 4,250 4,675 5,100 5,525
416 Testosterone, Total,Serum IMMUNOLOGY 850 850 935 1,020 1,105

417 Thyroid Function Test IMMUNOLOGY 650 650 930 780 1,050
(T3,T4,TSH)
418 Thyroid Stimulating IMMUNOLOGY 550 550 750 830 900
Hormone (TSH)
419 TORCH IgG IMMUNOLOGY 2,000 2,000 2,200 2,400 2,600
420 TORCH IgM IMMUNOLOGY 2,000 2,000 2,200 2,400 2,600
421 Toxoplasma Antibody (IgG) IMMUNOLOGY 650 650 870 950 1,030

422 Toxoplasma Antibody (IgM) IMMUNOLOGY 650 650 870 950 1,030

423 Valproic acid IMMUNOLOGY 900 900 990 1,080 1,170

424 VGKC Serum IMMUNOLOGY 10,500 10,500 11,550 12,600 13,650
425 Vitamin B12, Serum IMMUNOLOGY 1,900 1,900 2,090 2,280 2,470
426 Vitamin D3 (25 OH) IMMUNOLOGY 2,800 2,800 3,080 3,360 3,640
427 Aerobic C/S Blood MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
428 Aerobic C/S CSF MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
429 Aerobic C/S Nasal Swab MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430

430 Aerobic C/S PUS MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
431 Aerobic C/S Stool MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
432 Aerobic C/S Throt Swab MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
433 Aerobic C/S Urethral Swab MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430

434 Aerobic C/S Urine MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
Aerobic C/S. (Tip 1,100 1,100 1,210 1,320 1,430
435 Catheter,Suction,Tracheal) MICROBIOLOGY

436 Aerobic C/S. Semen MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
437 Aerobic C/S. Sputam MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
438 Aerobic C/S+Gram Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
439 Aerobic C/S+Gram Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
(Body Fluids)
Aerobic C/S+Gram Stain 1,100 1,100 1,210 1,320 1,430
440 (Broncho-AlveolarLavenge) MICROBIOLOGY

441 Aerobic C/S+Gram Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
(Conjuctival Swab)
442 Aerobic C/S+Gram Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
(CSF)
Aerobic C/S+Gram Stain 1,100 1,100 1,210 1,320 1,430
443 (High Vaginal Swab/Cervical) MICROBIOLOGY

444 Aerobic C/S+Gram Stain MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
(Paeditric & Neonatel)
445 Aerobic C/S+Gram Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
(PUS)
446 Aerobic C/S+Gram Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
(Sputum)
447 Aerobic C/S+Gram Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
(Throt Swab)
448 Aerobic C/S+Gram Stain MICROBIOLOGY
(Tips
Catheter,Suction,Trachial) 1,100 1,100 1,210 1,320 1,430

449 AFB Culture Body Fluids MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
450 AFB Culture CSF MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
451 AFB Culture Stool MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
452 AFB Culture Urine MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
453 AFB Stain (Z N) / Smear.- MICROBIOLOGY 300 300 420 460 500
Sputum
454 AFB Stain (Z N) / Smear- MICROBIOLOGY 300 300 420 460 500
Urine
455 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Amikacin
456 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Capreomycin
457 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Ciprofloxacin
458 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Clofazimine
459 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Ethambutol
460 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Ethionamide
461 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Isoniazid
462 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Kanamycin
463 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Levofloxacin
464 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Linezolid
465 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Moxifloxacin
466 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Ofloxacin
467 AFB Susceptibility : PAS MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
468 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Pyrazinamide
469 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Rifabutin
470 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Rifampicin
471 AFB Susceptibility : MICROBIOLOGY 2,800 2,800 3,080 3,360 3,640
Streptomycin
AFB Susceptibility 10 drugs 12,000 12,000 13,200 14,400 15,600
472 panel (Automated) MICROBIOLOGY

AFB Susceptibility 13 drugs 14,000 14,000 15,400 16,800 18,200

473 panel (Automated) MICROBIOLOGY

AFB Susceptibility 5 drugs 6,500 6,500 7,150 7,800 8,450

474 panel (Automated) MICROBIOLOGY

475 AIR Sampling (OT) MICROBIOLOGY 50 50 70 80 90

476 Albert Staning - Throat MICROBIOLOGY 400 400 540 590 640
Swab
477 BAL (Bronchio Alveolar MICROBIOLOGY 1,500 1,500 1,650 1,800 1,950
Lavage) - AFB Culture
478 BAL (Bronchio Alveolar MICROBIOLOGY 300 300 420 460 500
Lavage) - AFB Stain
479 CSF AFB Stain MICROBIOLOGY 300 300 420 460 500
480 CSF-India Ink Prepration MICROBIOLOGY 300 300 420 460 500

481 Culture Hand swab MICROBIOLOGY 50 50 70 80 90

482 Culture MRSA Screen MICROBIOLOGY 200 200 280 240 350
(Nasal/Axilla/Groin)
483 Culture surface swab MICROBIOLOGY 50 50 70 80 90
484 Dark Ground Microscopy - MICROBIOLOGY 300 300 420 460 500
Blood
485 Dark Ground Microscopy - MICROBIOLOGY 300 300 420 460 500
OTHERS
Dark Ground Microscopy - 300 300 420 460 500
486 Urethral Swab MICROBIOLOGY

Dark Ground Microscopy - 300 300 420 460 500

487 Vaginal /Cervical MICROBIOLOGY

Echinococcus Detection For 750 750 970 1,050 1,200

488 Scolices in Hydatid MICROBIOLOGY
Cyst Fluid
489 Endoscopes final rinse MICROBIOLOGY 50 50 70 80 90
water culture
490 Fungal Culture Blood MICROBIOLOGY 850 850 935 1,020 1,105
491 Fungal Culture Body Fluids MICROBIOLOGY 850 850 935 1,020 1,105

492 Fungal Culture Broncho- MICROBIOLOGY 1,000 1,000 1,100 1,200 1,300
Alveilar Lavage
493 Fungal Culture Conjunctival MICROBIOLOGY 850 850 935 1,020 1,105
Swab
494 Fungal Culture CSF MICROBIOLOGY 850 850 935 1,020 1,105
495 Fungal Culture High MICROBIOLOGY 850 850 935 1,020 1,105
Vaginal Swab / Cervical
496 Fungal Culture PUS MICROBIOLOGY 850 850 935 1,020 1,105
497 Fungal Culture Sputum MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
498 Fungal Culture Stool MICROBIOLOGY 850 850 935 1,020 1,105
499 Fungal Culture Throat MICROBIOLOGY 850 850 935 1,020 1,105
Swab
Fungal Culture Tip Catheter, 850 850 935 1,020 1,105
500 Suction, Tracheal MICROBIOLOGY

501 Fungal Culture Urethral MICROBIOLOGY 850 850 935 1,020 1,105
Swab
502 Fungal Culture Urine MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
503 Gene Xpert MTB with MICROBIOLOGY 2,500 2,500 2,750 3,000 3,250
Rifampicin resistance.
504 Gene Xpert(PLUS ) MICROBIOLOGY 4,700 4,700 5,170 5,640 6,110
505 Gram Stain MICROBIOLOGY 250 250 275 380 410
506 Gram Stain - BAL MICROBIOLOGY 250 250 340 380 410
507 Gram Stain - Body Fluids MICROBIOLOGY 250 250 340 380 410

508 Gram Stain - CSF MICROBIOLOGY 250 250 340 380 410
509 Gram Stain - Pus MICROBIOLOGY 250 250 340 380 410
510 Gram Stain - Sputum MICROBIOLOGY 250 250 340 380 410
511 Gram Stain - Stool MICROBIOLOGY 250 250 340 380 410
512 Gram Stain - Throat Swab MICROBIOLOGY 250 250 340 380 410

513 Gram Stain - Tip MICROBIOLOGY 250 250 340 380 410
514 Gram Stain - Urine MICROBIOLOGY 250 250 340 380 410
515 H1N1( Swine Flu ) MICROBIOLOGY 5,800 5,800 6,380 6,960 7,540
516 HBsAg Rapid Screening MICROBIOLOGY 350 350 480 530 580
Test
517 High Vaginal Swab Culture MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
and Sensitivity
518 Identification and Sensitivity MICROBIOLOGY 850 850 935 1,020 1,105
of Candida
519 KOH Mount - CSF MICROBIOLOGY 250 250 340 380 410
520 KOH Mount - PUS MICROBIOLOGY 250 250 340 380 410
521 KOH Mount - Skin MICROBIOLOGY 300 300 420 460 410
Scrapping
522 KOH Mount - Sputum MICROBIOLOGY 250 250 340 380 410
523 KOH Mount - Throat Swab MICROBIOLOGY 250 250 340 380 410

524 KOH Mount - TIP MICROBIOLOGY 200 200 280 240 350
525 KOH Mount - Urine MICROBIOLOGY 200 200 280 240 350
526 KOH Mount -BAL MICROBIOLOGY 200 200 280 240 350
527 KOH Mount- Body Fluid MICROBIOLOGY 250 250 340 380 410
528 Mod.Z.N.Staining For MICROBIOLOGY 250 250 340 380 410
Nocardia -Urine
Mod.Z.N.Staining For 250 250 340 380 410
529 Nocardia/Crypto-body fluids MICROBIOLOGY

530 Mod.Z.N.Staining For MICROBIOLOGY 250 250 340 380 410

Nocardia/Crypto-Pus
Mod.Z.N.Staining For 250 250 340 380 410
531 Nocardia/Crypto-Sputum MICROBIOLOGY

532 Mod.Z.N.Staining For MICROBIOLOGY 250 250 340 380 410

Nocardia-BAL
533 Mod.Z.N.Staining For MICROBIOLOGY 250 250 340 380 410
Nocardia-CSF
534 Mod.Z.N.Staining For MICROBIOLOGY 250 250 340 380 410
Nocardia-Throat
535 Mod.Z.N.Staining For MICROBIOLOGY 250 250 340 380 410
Nocardia-Tip
536 Mod.Z.N.Staining -Stool MICROBIOLOGY 250 250 340 380 410
537 MRSA Screening (staff) MICROBIOLOGY 200 200 280 240 350
538 Other Fluid - AFB Stain MICROBIOLOGY 300 300 420 460 410
539 Pearls Stain MICROBIOLOGY 500 500 690 760 820
540 Pneumocystis carinii MICROBIOLOGY 300 300 420 460 490
pneumonia stain (PCP)
541 Pus - AFB Culture MICROBIOLOGY 1,200 1,200 1,320 1,440 1,560
542 Pus - AFB Stain MICROBIOLOGY 300 300 420 460 490
543 PUS For Microscopy - MICROBIOLOGY 200 200 280 240 350
Trophozoites
544 Scrub Typhus (Rapid TesT) MICROBIOLOGY 650 650 850 780 970

545 Sputum - AFB Culture MICROBIOLOGY 1,000 1,000 1,100 1,200 1,300
Stool Examination Hanging 200 200 350 380 420
546 Drop Prepration MICROBIOLOGY

547 Stool for Occult Blood MICROBIOLOGY 400 400 550 590 640
548 Sudan Black Stain MICROBIOLOGY 1,100 1,100 1,210 1,320 1,430
549 Urine - Culture & Sensitivity MICROBIOLOGY 800 800 1,050 1,170 1,300

550 Urine for pH MICROBIOLOGY 150 150 170 180 200

551 Acute Inflammatory Panel SEROLOGY 2,000 2,000 2,200 2,400 2,600

552 Anti-HBc IgM SEROLOGY 1,500 1,500 1,650 1,800 1,950

553 ASO (Anti Streptolysin O) SEROLOGY 550 550 690 760 820

554 Blood Grouping (Type and SEROLOGY 500 500 640 700 760
Screen)
555 Chikunguniya-IGM SEROLOGY 1,100 1,100 1,210 1,320 1,430
556 C-Reactive Protien (CRP) SEROLOGY 500 500 650 710 770

557 Cross Matching SEROLOGY 400 400 560 610 660

558 Cryptococus Antigen,CSF SEROLOGY 2,500 2,500 2,750 3,000 3,250

559 Cytomegalo Virus (CMV) - SEROLOGY 400 400 440 480 520
IgG+IgM Serum
560 Dengue Virus ( IgG/IgM, SEROLOGY 1,700 1,700 1,870 2,040 2,210
NS1Ag )
561 EBV PCR (Epstein-Barr SEROLOGY 4,500 4,500 4,950 5,400 5,850
Virus) to vca igG
562 HAV-IgM (Hepatitis A SEROLOGY 750 750 970 1,050 1,200
IgM),Serum
HBeAb (Hepatitis B envelope 750 750 970 1,050 1,200
563 Antibody),Serum SEROLOGY

564 HBeAg (Hepatitis B e SEROLOGY 1,800 1,800 1,980 2,160 2,340

Antigen)
565 HBsAg Quantitaive SEROLOGY 1,000 1,000 1,100 1,200 1,300
566 HCV Antibody Quantitative SEROLOGY 6,500 6,500 7,150 7,800 8,450

567 Hep B Core Antibody- SEROLOGY 1,500 1,500 1,650 1,800 1,950
Total,Serum
568 Hepatitis B Surface SEROLOGY 550 550 690 760 20
Antigen,Serum
Herpes Simplex Virus IgG + 2,500 2,500 2,750 3,000 3,250
569 IgM Combined,Serum SEROLOGY

570 HEV - IgM,Serum SEROLOGY 4,200 4,200 4,620 5,040 5,460

571 HIV I & HIV II (Quantitative) SEROLOGY 850 850 935 1,200 1,105

572 HIV Test I and II Rapid SEROLOGY 600 600 780 850 950
Screening Test
573 Hs CRP (C-Reactive SEROLOGY 950 950 1,045 1,140 1,235
Protein)
574 Hydatid Serology/Anti SEROLOGY 1,800 1,800 1,980 2,160 2,340
Echinococcus,IgG
575 Leptospira Antibody - IgG SEROLOGY 1,400 1,400 1,540 1,680 1,820

576 Leptospira Antibody - IgM SEROLOGY 1,400 1,400 1,540 1,680 1,820

Leptospira Antibody IgG/IgM 2,500 2,500 2,750 3,000 3,250

577 ( Rapid Card Test ) SEROLOGY

578 Mantoux Test SEROLOGY 300 300 400 430 470

579 Rheumatoid Factor( RA SEROLOGY 750 750 950 1,050 1,130
Factor ) Quantitative
580 Serum HCV Antibody SEROLOGY 700 700 900 980 1,070
Rapid Screening Test
581 Serum HCV IgG SEROLOGY 900 900 990 1,080 1,170
582 Troponin- T ( Qualitative ) SEROLOGY 1,900 1,900 2,090 2,280 2,470

583 Typhidot SEROLOGY 500 500 620 680 730

584 VDRL SEROLOGY 500 500 550 600 650
585 VDRL CSF SEROLOGY 500 500 550 600 650
586 Widal Slide Test SEROLOGY 500 500 580 640 690
587 Widal Test (Tube Method) SEROLOGY 400 400 500 480 590
Super
Deluxe

Super
Deluxe
2,100

1,680

1,680

2,100
620
1,680

1,070
1,540
1,540
760
480

308

240

480
370

410

510
530
750
490

440

1,330
640

450
110
1,330
1,540
1,680

700
1,540

1,680

1,820
1,260

480
690

308
410
210
 350

350
1,540

410

400

410

410

410

1,190
280
1,190
280

470

400
530
182
1,160

200
2,030
3,080
#VALUE!
450
410

1,400

110
470
2,940

280
1,260
1,260
1,400
1,280
1,680

470
1,120
1,540
1,680
1,260

1,190
1,400
1,820
2,660
1,820
840
 980

560

560

950

1,320
4,480
1,190

1,190

3,500
110

110
1,540
620

1,200

1,260
530
530
1,100
280
410
1,260
280

1,330
320

280
320

910

440
1,540

1,820
440

11,480
490
200
410
490
1,350
1,350

1,400
1,000
280
1,820

280
470
440
 620
280
410

1,350

1,400
490
1,050

490
690
2,660

3,500

110
470
480
750
410

880

250

210
510
1,960

350

310

1,540
420

620
810

530

490

780

1,160

510

1,190

530

9,240
520
1,140
250
250
550
1,370
250
1,400
 1,350
550
500

530
530
630
530
500

400
400
400
1,190

1,350

1,540
9,800
2,940

4,480

1,540

7,420

1,540
1,540
10,500

1,540

1,190

910

910

300

1,350
770

770

630

630

630

630

630

700

500

21,000
 450

480

910
750

1,350
2,380
90
940
700
2,380

560

370

560

500

6,300

2,380

4,200
1,260

450
1,000

1,260

1,540

1,260
500
700
2,240
530

110
110
110
110
500

210

110

110
380

560

1,000

500
830

420
110
630
 630
110
1,400
410

8,400

2,240

2,800
5,950

5,950

5,950

3,080

5,600
4,900
3,500

2,100
8,400

1,540
1,820
1,680

500

2,800
1,540

3,500
11,900

15,400

15,400

36,400

2,100
2,100

1,120
1,820

1,350

3,220
3,080

2,100

2,800

7,000
7,000
2,380

1,540

2,100

3,500
2,100
1,540
2,100
1,400

3,220
840
840
3,220

3,920
6,300

3,920
2,100
1,330

1,960

1,960

3,080

3,080

3,360

2,380

2,380

1,200
1,200
1,960

2,100
2,100
1,100
3,920

3,920

2,100
1,330

3,920

7,280
840

1,260

1,260

1,400

3,220
 3,220
8,680

4,900
2,240

4,900
3,080

5,040

9,100

1,330

2,380
9,800

1,400
1,350
1,350
1,320

1,120

8,400

5,600
1,260
5,460

11,200

10,500

10,500

14,000

1,540

1,540

7,700

4,900

4,900

2,100
4,900

3,500

5,950

1,540

1,330

1,330
1,330
7,840

11,900
 2,520

3,080
1,350

4,900

1,320
1,320
1,680
2,380

2,520

10,500
3,500
910
3,360
8,400
5,180
1,820
1,400
1,820
500
2,800

2,380

1,500
1,540

6,160
5,320
2,800

1,540
910

1,110
1,050
1,400

1,330

1,330

1,680

1,680

1,190
1,680
1,190

1,190

1,540
1,050
2,800
1,540
910
 490
5,950
1,190

910

1,050

2,800
2,800
1,110

1,110

1,260
14,700
2,660
3,920
1,540
1,540
1,540

1,540
1,540
1,540
1,540

1,540
1,540

1,540
1,540
1,540
1,540

1,540

1,540

1,540

1,540

1,680

1,540

1,540

1,540

1,540

1,680
1,680
1,680
1,680
560

560
 3,920

3,920

3,920

3,920

3,920

3,920

3,920

3,920

3,920

3,920

3,920

3,920

3,920
3,920

3,920

3,920

3,920

16,800

19,600

9,100

110
700

2,100

560

560
560

10
500

110
560

560

560

560

1,320

110

1,190
1,190

1,400

1,190

1,190
1,190

1,190
1,680
1,190
1,190

1,190

1,190

1,540
3,500

6,580
490
490
490

490
490
490
490
490

490
490
8,120
620

1,680

1,190

490
490
490

490
490

500
500
500
490
490

490

490

490

490
 490

490

490

490
500
490
880
530

1,680
420
500

910

1,400
280

560
1,540
1,450

210
2,800

2,100
770

700

1,540
830

720
3,500

560

2,380

6,300

1,350

1,350

2,520

1,400
9,100

2,100

890

3,500

5,880
1,190

1,000
1,330

2,520

1,960

1,960

3,500

510
1,220

1,200

1,260
2,660

790
700
700
750
690
 - Twin - Single
Sharing - MICU
- Day Care - SICU
- OP Rate -
Department- RADIOLOGY - Casualty
General Ward Transplant
ICU

Sr. No. Service Name Sub Deptt OP Rates General Twin Private
Ward Sharing Room
1 USG - INTRA RADIOLOGY - U S G 4,500 4,500 5,850 7,200
OPERATIVE
2 USG 0BSTETIC RADIOLOGY - U S G 2,800 2,800 3,650 4,450
DOPPLER
3 USG 4D 0BSTETIC RADIOLOGY - U S G 5,300 5,300 6,900 8,500
DOPPLER
4 USG AXILLA (SINGLE) RADIOLOGY - U S G 950 950 1,250 1,500

5 USG AXILLAE (BOTH) RADIOLOGY - U S G 1,350 1,350 1,750 2,200

6 USG BOTH BREAST RADIOLOGY - U S G 1,600 1,600 2,100 2,550

7 USG BRAIN RADIOLOGY - U S G 1,300 1,300 1,700 2,100
(NEONATE)
8 USG CHEST RADIOLOGY - U S G 1,200 1,200 1,550 1,950
9 USG CONTRAST RADIOLOGY - U S G 2,650 2,650 3,450 4,250
10 USG DOPPLER (PER RADIOLOGY - U S G 2,200 2,200 2,860 3,550
PART)
11 USG DOPPLER RADIOLOGY - U S G 2,600 2,600 3,400 4,200
ABDOMEN
12 USG DOPPLER RADIOLOGY - U S G 2,200 2,200 2,850 3,500
GROWTH SCAN
13 USG DOPPLER RADIOLOGY - U S G 2,200 2,200 2,850 3,500
AORTA
14 USG DOPPLER BRAIN RADIOLOGY - U S G 2,650 2,650 3,450 4,250
(NEONATE)
15 USG DOPPLER RADIOLOGY - U S G 2,650 2,650 3,450 4,250
CAROTIDS
USG DOPPLER EXTREMITY
16 (SINGLE) RADIOLOGY - U S G 2,650 2,650 3,450 4,250
ARTERIAL
USG DOPPLER
17 EXTREMITY (SINGLE) RADIOLOGY - U S G 2,650 2,650 3,450 4,250
VENOUS
USG DOPPLER EXTREMITY
18 SINGLE RADIOLOGY - U S G 2,200 2,200 2,850 3,500
ARTERIAL
19 USG DOPPLER RADIOLOGY - U S G 2,200 2,200 2,850 3,500
ORBITS
20 USG DOPPLER RADIOLOGY - U S G 3,990 3,990 5,200 6,400
PENILE
21 USG DOPPLER RADIOLOGY - U S G 2,890 2,890 3,750 4,650
RENALS
22 USG DOPPLER RADIOLOGY - U S G 2,750 2,750 3,600 4,400
SCROTUM
23 USG DOPPLER SMALL RADIOLOGY - U S G 2,650 2,650 3,450 4,250
PARTS
24 USG DOPPLER RADIOLOGY - U S G 2,200 2,200 2,850 3,500
SPLENOPORTAL
USG DOPPLER
25 TRANSPLANT RENAL RADIOLOGY - U S G 2,200 2,200 2,850 3,500
26 USG EXTREMITY RADIOLOGY - U S G 1,300 1,300 1,700 2,100
27 USG EYES BOTH RADIOLOGY - U S G 2,200 2,200 2,850 3,500
28 USG EYES SINGLE RADIOLOGY - U S G 1,200 1,200 1,550 1,950
29 USG FOLLICULAR RADIOLOGY - U S G 1,600 1,600 2,100 2,550
MONITORING
30 USG FOR MARKING RADIOLOGY - U S G 950 950 1,250 1,550
SITE
31 USG GUIDED BREAST RADIOLOGY - U S G 3,850 3,850 5,000 6,200
BIOPSY
USG GUIDED BREAST CLIP
32 PLACEMENT RADIOLOGY - U S G 3,850 3,850 5,000 6,200

USG GUIDED BREAST

33 FNAC/ASPIRATION RADIOLOGY - U S G 3,250 3,250 4,250 5,200

34 USG GUIDED PSEUDO- RADIOLOGY - U S G

ANEURYSM
COMPRESSION 2,800 2,800 3,650 4,500

USG
35 JOINT/MUSCULOSKEL RADIOLOGY - U S G 1,450 1,450 1,900 2,350
ETAL
36 SCANOGRAM RADIOLOGY - U S G 1,450 1,450 1,900 2,350
37 USG KUB RADIOLOGY - U S G 1,550 1,550 2,100 2,500
38 USG LOWER RADIOLOGY - U S G 950 950 1,250 1,500
ABDOMEN
USG MAMMOGRAPHY
39 BILATERAL RADIOLOGY - U S G 2,200 2,200 2,850 3,500

USG MAMMOGRAPHY
40 SINGLE RADIOLOGY - U S G 1,350 1,350 1,750 2,200

41 USG MSK RADIOLOGY - U S G 1,700 1,700 2,200 2,700

42 USG MSK WITHOUT RADIOLOGY - U S G 1,700 1,700 2,200 2,700
CONTRAST
43 USG NECK RADIOLOGY - U S G 1,200 1,200 1,550 1,900
44 USG OBSTETIC RADIOLOGY - U S G 1,400 1,400 1,850 2,250
45 USG PELVIS RADIOLOGY - U S G 4,250 4,250 5,550 6,800
USG PREGNANCY 1
46 TRIM (GENETIC SCAN) RADIOLOGY - U S G 1,700 1,700 2,200 2,750
(NT/NB)
47 USG PREGNANCY RADIOLOGY - U S G 3,400 3,400 4,450 5,450
3D/4D
48 USG ANOMALY SCAN RADIOLOGY - U S G 1,700 1,700 2,220 2,750

USG PREGNANCY
49 ANOMALY/DETAILED RADIOLOGY - U S G 2,950 2,950 3,850 4,700
SCAN (TWIN)
USG PREGNANCY
50 BIOPHYSICAL RADIOLOGY - U S G 2,200 2,200 2,850 3,500
PROFILE
51 USG PREGNANCY RADIOLOGY - U S G 950 950 1,250 1,500
EARLY
52 USG PREGNANCY RADIOLOGY - U S G 1,300 1,300 1,700 2,100
GROWTH SCAN
53 USG RENAL GRAFT RADIOLOGY - U S G 2,650 2,650 3,450 4,250
DOPPLER
54 USG RENAL GRAFT RADIOLOGY - U S G 1,200 1,200 1,550 1,950
PLAIN
55 USG SCROTUM RADIOLOGY - U S G 1,700 1,700 2,200 2,700
56 USG SHOULDER RADIOLOGY - U S G 1,450 1,450 1,900 2,350
57 USG SINGLE BREAST RADIOLOGY - U S G 1,100 1,100 1,450 1,800

58 USG SOFT TISSUE RADIOLOGY - U S G 2,650 2,650 3,450 4,250

WITH DOPPLER
59 USG SOFT TISSUE RADIOLOGY - U S G 1,200 1,200 1,550 1,950
WITHOUT DOPPLER
60 USG THYROID GLAND RADIOLOGY - U S G 1,300 1,300 1,700 2,100

61 USG TRANSPLANT RADIOLOGY - U S G 1,700 1,700 2,200 2,750

STUDY
USG TRANSVAGINAL
62 (TVS) RADIOLOGY - U S G 1,650 1,650 2,200 2,650

63 USG UPPER RADIOLOGY - U S G 1,650 1,650 2,200 2,650

ABDOMEN
USG VENOUS DOPPLER
64 STUDY- RADIOLOGY - U S G 2,650 2,650 3,450 4,250
LEFT LOWER LIMB
USG VENOUS DOPPLER
65 STUDY- RADIOLOGY - U S G 2,650 2,650 3,450 4,250
RIGHT LOWER LIMB
USG VENOUS DOPPLER-
66 BOTH RADIOLOGY - U S G 4,750 4,750 6,200 7,600
LOWER LIMBS
67 USG WHOLE RADIOLOGY - U S G 1,650 1,650 2,200 2,650
ABDOMEN
68 USG WHOLE RADIOLOGY - U S G 1,350 1,350 1,750 2,200
ABDOMEN + PELVIS
69 VACCUM ASSISTED RADIOLOGY - U S G
BREAST BIOPSY (UNDER
GUIDENCE) 12,750 12,750 16,600 20,400

70 APICOGRAM RADIOLOGY - X RAY 450 450 580 750

EXTRA X-RAY FILM
71 CHARGES (PER FILM) RADIOLOGY - X RAY 250 250 350 400

72 X-RAY ABDOMEN - RADIOLOGY - X RAY 700 700 900 1,200

ERECT & SUPINE
73 XRAY ABDOMEN ( RADIOLOGY - X RAY 500 500 650 800
ERECT)
XRAY ACROMIO-
74 CLAVICULAR JOINT RADIOLOGY - X RAY 650 650 850 1,050
BOTH
XRAY ACROMIO-
75 CLAVICULAR JOINT RADIOLOGY - X RAY 500 500 650 800
SINGLE
76 X-RAY ANKLE BOTH - RADIOLOGY - X RAY 950 950 1,250 1,500
AP & LATERAL
77 XRAY ANKLE BOTH- RADIOLOGY - X RAY 650 650 850 1,050
AP
78 XRAY ANKLE BOTH- RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
79 XRAY ANKLE SINGLE - RADIOLOGY - X RAY 500 500 650 800
AP
X-RAY ANKLE SINGLE AP
80 & LATERAL RADIOLOGY - X RAY 650 650 850 1,050

81 XRAY ARM BOTH - AP RADIOLOGY - X RAY 550 550 750 800

82 XRAY ARM BOTH - AP RADIOLOGY - X RAY 1,300 1,300 1,700 2,100
& LATERAL
83 XRAY ARM SINGLE - RADIOLOGY - X RAY 450 450 600 750
AP
84 XRAY ARM SINGLE - RADIOLOGY - X RAY 650 650 850 1,100
AP & LATERAL
85 XRAY BARIUM ENEMA RADIOLOGY - X RAY 7,650 7,650 9,950 12,250

86 XRAY BARIUM GER RADIOLOGY - X RAY 5,550 5,550 7,250 8,800

87 XRAY BARIUM MEAL RADIOLOGY - X RAY 5,550 5,550 7,250 8,800
88 XRAY BARIUM RADIOLOGY - X RAY 3,500 3,500 4,550 5,600
SWALLOW ( ADULT )
89 XRAY BOTH HEAL LAT RADIOLOGY - X RAY 450 450 600 750

XRAY CALCANEUM
90 BOTH - AXIAL & LATERAL RADIOLOGY - X RAY 1,300 1,300 1,700 2,100

91 XRAY CALCANEUM RADIOLOGY - X RAY 650 650 850 1,050

BOTH - LATERAL
XRAY CALCANEUM
92 SINGLE - AXIAL & RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
93 XRAY CALCANEUM RADIOLOGY - X RAY 650 650 850 1,050
SINGLE - LATERAL
94 XRAY CHEST - AP RADIOLOGY - X RAY 500 500 650 800
95 XRAY CHEST - PA RADIOLOGY - X RAY 500 500 650 800
96 XRAY CHEST - PA & RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
LATERAL
XRAY CHEST FOR RIBS -
97 AP & OBLIQUE RADIOLOGY - X RAY 1,050 1,050 1,400 1,700

98 XRAY CLAVICLE RADIOLOGY - X RAY 450 450 600 750

BOTH- AP
99 XRAY COCCYX - AP & RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
LATERAL
100 XRAY COCCYX - RADIOLOGY - X RAY 500 500 650 800
LATERAL
XRAY DACROCYSTOGRAM
101 RADIOLOGY - X RAY 5,000 5,000 6,500 8,000

102 XRAY ELBOW BOTH - RADIOLOGY - X RAY 650 650 850 1,050
AP
103 XRAY ELBOW BOTH - RADIOLOGY - X RAY 1,050 1,050 1,350 1,700
AP & LATERAL
104 XRAY ELBOW SINGLE RADIOLOGY - X RAY 550 550 750 800
- AP
XRAY ELBOW SINGLE
105 - AP & LATERAL RADIOLOGY - X RAY 650 650 850 1,050

XRAY FACE NASAL BONE -

106 AP & LATERAL RADIOLOGY - X RAY 650 650 850 1,050

107 XRAY FEMUR BOTH - RADIOLOGY - X RAY 550 550 750 800
AP
108 XRAY FINGERS - AP & RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
109 XRAY FINGERS - AP & RADIOLOGY - X RAY 650 650 850 1,050
OBLIQUE
110 XRAY FOOT BOTH - RADIOLOGY - X RAY 450 450 600 700
AP
111 XRAY FOOT BOTH - RADIOLOGY - X RAY 850 850 1,100 1,400
AP & OBLIQUE
112 XRAY FOOT SINGLE - RADIOLOGY - X RAY 500 500 650 800
AP
113 XRAY FOOT SINGLE - RADIOLOGY - X RAY 650 650 850 1,050
AP & OBLIQUE
XRAY FOREARM BOTH -
114 AP & LATERAL RADIOLOGY - X RAY 850 850 1,100 1,400

115 XRAY FOREARM RADIOLOGY - X RAY 450 450 600 750

BOTH- AP
116 XRAY FOREARM RADIOLOGY - X RAY 550 550 700 800
BOTH- LATERAL
117 XRAY FOREARM RADIOLOGY - X RAY 650 650 850 1,050
SINGLE - AP
XRAY FOREARM SINGLE -
118 AP & RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
LATERAL
119 XRAY HANDS BOTH - RADIOLOGY - X RAY 450 450 600 750
AP
120 XRAY HANDS BOTH - RADIOLOGY - X RAY 950 950 1,250 1,500
AP & OBLIQUE
121 XRAY HANDS SINGLE - RADIOLOGY - X RAY 450 450 600 750
AP
XRAY HANDS SINGLE - AP
122 & OBLIQUE RADIOLOGY - X RAY 650 650 850 1,050

123 XRAY HANDS WITH RADIOLOGY - X RAY 500 500 650 800
WRIST
124 XRAY HIP BOTH - AP RADIOLOGY - X RAY 950 950 1,250 1,500
& LATERAL
125 XRAY HIP BOTH - RADIOLOGY - X RAY 1,300 1,300 1,700 2,100
JUDET'S VIEW
126 XRAY HIP BOTH- AP RADIOLOGY - X RAY 450 450 600 700
XRAY HIP BOTH- LATERAL
127 (FROG LEG RADIOLOGY - X RAY 650 650 850 1,050
VIEW)
128 XRAY HIP SINGLE - AP RADIOLOGY - X RAY 500 500 650 800

129 XRAY HIP SINGLE - AP RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
& LATERAL
130 XRAY HIP SINGLE - RADIOLOGY - X RAY 650 650 850 1,050
JUDET'S VIEW
131 XRAY HUMERUS RADIOLOGY - X RAY 550 550 700 800
BOTH - AP
XRAY HUMERUS BOTH -
132 AP & LATERAL RADIOLOGY - X RAY 1,050 1,050 1,400 1,700

133 XRAY HUMERUS RADIOLOGY - X RAY 500 500 650 800

SINGLE - AP
XRAY HUMERUS SINGLE -
134 AP & RADIOLOGY - X RAY 850 850 1,100 1,400
LATERAL
XRAY HYSTEORO-
135 SALPHINGOGRAPHY RADIOLOGY - X RAY 4,450 4,450 5,800 7,000

136 XRAY IVP RADIOLOGY - X RAY 6,300 6,300 8,200 10,100

137 XRAY KNEE BOTH - RADIOLOGY - X RAY 850 850 1,100 1,400
AP & LATERAL
 XRAY KNEE BOTH - AP,
138 LATERAL & AXIAL RADIOLOGY - X RAY 1,600 1,600 2,100 2,600

139 XRAY KNEE BOTH- AP RADIOLOGY - X RAY 450 450 600 700
(STANDING)
140 XRAY KNEE BOTH- RADIOLOGY - X RAY 550 550 700 800
LATERAL
141 XRAY KNEE SINGLE - RADIOLOGY - X RAY 500 500 650 800
AP
142 XRAY KNEE SINGLE - RADIOLOGY - X RAY 650 650 850 1,050
AP & LATERAL
XRAY KNEE SINGLE - AP,
143 LATERAL & AXIAL RADIOLOGY - X RAY 950 950 1,250 1,500

144 XRAY KUB RADIOLOGY - X RAY 1,050 1,050 1,400 1,700

145 XRAY LEG BOTH - AP RADIOLOGY - X RAY 850 850 1,100 1,400
& LATERAL
146 XRAY LEG BOTH- AP RADIOLOGY - X RAY 450 450 600 750
147 XRAY LEG BOTH- RADIOLOGY - X RAY 550 550 700 800
LATERAL
148 XRAY LEG SINGLE - RADIOLOGY - X RAY 500 500 650 800
AP
149 XRAY LEG SINGLE - RADIOLOGY - X RAY 650 650 850 1,050
AP & LATERAL
150 XRAY LOWER LIMB ( RADIOLOGY - X RAY 550 550 700 800
TIBIA ) AP / LAT
XRAY LUMBOSACRAL
SPINE - NEUTRAL,
FLEXION AND EXTENSION
151 - LATERAL RADIOLOGY - X RAY 1,050 1,050 1,400 1,700

XRAY MADIBLE BOTH

152 SIDE - OBLIQUE RADIOLOGY - X RAY 650 650 850 1,050

XRAY MADIBLE SINGLE

153 SIDE - RADIOLOGY - X RAY 450 450 600 700
OBLIQUE
154 XRAY MANDIBLE - AP RADIOLOGY - X RAY 500 500 650 800

XRAY MANDIBLE BOTH -

155 AP & OBLIQUE RADIOLOGY - X RAY 850 850 1,100 1,400

156 XRAY MCU RADIOLOGY - X RAY 550 550 700 800

157 XRAY NASAL BONE - RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
158 X-RAY RADIOLOGY - X RAY 500 500 650 800
NASOPHARYNX
159 X-RAY OPG RADIOLOGY - X RAY 450 450 600 700
160 XRAY ORBITS RADIOLOGY - X RAY 500 500 650 800
XRAY ORBITS - CALDWELL
161 & RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
XRAY PARANASAL
162 SINUSES ( WATER'S RADIOLOGY - X RAY 450 450 600 700
VIEW)
163 XRAY PATELLA BOTH- RADIOLOGY - X RAY 550 550 700 800
AXIAL
XRAY PATELLA SINGLE
164 SKYLINE / RADIOLOGY - X RAY 450 450 600 700
AXIAL
165 XRAY PELVIS - AP RADIOLOGY - X RAY 500 500 650 800
166 XRAY PNS RADIOLOGY - X RAY 450 450 600 700
167 XRAY SACRUM - AP RADIOLOGY - X RAY 500 500 650 800
168 XRAY SACRUM - AP & RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
LATERAL
169 XRAY SALIOGRAPHY RADIOLOGY - X RAY 550 550 700 800
170 XRAY SCAPHOID RADIOLOGY - X RAY 500 500 650 800
VIEW
171 XRAY SCAPULA BOTH RADIOLOGY - X RAY 550 550 700 800
- AP
XRAY SCAPULA BOTH
172 - AP & LATERAL RADIOLOGY - X RAY 1,050 1,050 1,400 1,700

173 XRAY SCAPULA RADIOLOGY - X RAY 450 450 600 700

SINGLE - AP
XRAY SCAPULA SINGLE -
174 AP & RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
175 XRAY SELLA RADIOLOGY - X RAY 500 500 650 800
176 XRAY SHOULDER RADIOLOGY - X RAY 550 550 700 800
BOTH - AP
XRAY SHOULDER BOTH -
177 AP & RADIOLOGY - X RAY 1,300 1,300 1,700 2,100
AXILLARY
178 XRAY SHOULDER RADIOLOGY - X RAY 500 500 650 800
SINGLE - AP
XRAY SHOULDER
179 SINGLE - AP & AXILLARY RADIOLOGY - X RAY 650 650 850 1,050

180 XRAY SI JOINT - AP RADIOLOGY - X RAY 450 450 600 700

181 XRAY SI JOINTS RADIOLOGY - X RAY 650 650 850 1,050
BOTH OBLIQUE
182 XRAY SKULL - AP & RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
LATERAL
183 XRAY SKULL -AP RADIOLOGY - X RAY 500 500 650 800
184 XRAY SKULL BASE RADIOLOGY - X RAY 450 450 600 750
XRAY SKULL MASTOIDS
185 BOTH - AP RADIOLOGY - X RAY 850 850 1,100 1,400

186 XRAY SKULL MASTOIDS RADIOLOGY - X RAY

BOTH - TOWNE'S & B/L
OBLIQUES 950 950 1,250 1,500

187 XRAY SKULL MASTOIDS RADIOLOGY - X RAY

SINGLE - TOWNE'S &
OBLIQUE 650 650 850 1,050

188 X-RAY SOFT TISSUE RADIOLOGY - X RAY 450 450 600 750
NECK LATERAL
189 XRAY SPINE RADIOLOGY - X RAY 500 500 650 800
CERVICAL - AP
XRAY SPINE CERVICAL -
190 AP & RADIOLOGY - X RAY 950 950 1,250 1,500
LATERAL
XRAY SPINE
191 CERVICAL - BOTH RADIOLOGY - X RAY 850 850 1,100 1,400
OBLIQUES
XRAY SPINE
192 CERVICODORSAL - RADIOLOGY - X RAY 850 850 1,100 1,400
AP & LATERAL
 XRAY SPINE
193 CERVICODORSAL - RADIOLOGY - X RAY 450 450 600 750
LATERAL
XRAY SPINE CV JUNCTION
194 - OPEN RADIOLOGY - X RAY 450 450 600 750
MOUTH
195 XRAY SPINE CV JUNCTION RADIOLOGY - X RAY
- OPEN MOUTH, LAT IN
FLEX 1,050 1,050 1,400 1,700
& EXTN
196 XRAY SPINE DORSAL - RADIOLOGY - X RAY 500 500 650 800
AP
XRAY SPINE DORSAL - AP
197 & LATERAL RADIOLOGY - X RAY 1,050 1,050 1,400 1,700

XRAY SPINE
198 DORSOLUMBAR - AP RADIOLOGY - X RAY 550 550 700 800

XRAY SPINE
199 DORSOLUMBAR - AP RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
& LATERAL
200 XRAY SPINE RADIOLOGY - X RAY 500 500 650 800
LUMBOSACRAL - AP
XRAY SPINE
201 LUMBOSACRAL - AP & RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
LATERAL
XRAY SPINE
202 LUMBOSACRAL - RADIOLOGY - X RAY 850 850 1,100 1,400
BOTH OBLIQUES
XRAY SPINE SACRUM &
203 COCCYX - AP RADIOLOGY - X RAY 650 650 850 1,050

XRAY SPINE SACRUM

204 & COCCYX - AP & RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
LATERAL
XRAY STERNO
205 CLAVICULAR JOINT RADIOLOGY - X RAY 450 450 600 700
BOTH - AP
206 XRAY RADIOLOGY - X RAY
STERNOCLAVICULAR
JOINT SINGLE - AP 500 500 650 800

207 XRAY STERNUM - AP RADIOLOGY - X RAY 650 650 850 1,050

& LATERAL
208 XRAY STERNUM - RADIOLOGY - X RAY 500 500 650 800
LATERAL
209 XRAY STYLOID RADIOLOGY - X RAY 500 500 650 800
PROCESS - AP
210 XRAY STYLOID PROCESS - RADIOLOGY - X RAY
LATERAL & TOWNE'S
850 850 1,100 1,400

211 XRAY THIGH BOTH - RADIOLOGY - X RAY 550 550 700 800
AP
212 XRAY THIGH BOTH - RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
AP & LATERAL
213 XRAY THIGH SINGLE - RADIOLOGY - X RAY 450 450 600 700
AP
XRAY THIGH SINGLE - AP
214 & LATERAL RADIOLOGY - X RAY 650 650 850 1,050

215 XRAY THORACIC RADIOLOGY - X RAY 1,100 1,100 1,450 1,800

SPINE AP/LAT
216 XRAY TMJ (TEMPORO RADIOLOGY - X RAY
MANDIBULAR JOINT)
BOTH - AP 650 650 850 1,050

XRAY TMJ (TEMPORO 850 850 1,100 1,400

MANDIBULAR JOINT)
217 BOTH - LATERAL RADIOLOGY - X RAY

218 XRAY TMJ (TEMPORO RADIOLOGY - X RAY

MANDIBULAR JOINT)
SINGLE - AP 550 550 700 800

XRAY TMJ (TEMPORO 450 450 600 750

MANDIBULAR JOINT)
219 SINGLE - LATERAL RADIOLOGY - X RAY

XRAY TMJOINT BOTH -

220 OPEN & CLOSED RADIOLOGY - X RAY 1,050 1,050 1,400 1,700
MOUTH
XRAY TMJOINT
221 SINGLE - OPEN & CLOSED RADIOLOGY - X RAY 550 550 700 800
MOUTH
222 XRAY TOES - AP RADIOLOGY - X RAY 450 450 600 700
223 XRAY TOES - AP & RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
224 XRAY TOES - AP & RADIOLOGY - X RAY 650 650 850 1,050
OBLIQUE
XRAY URETHROGRAM(
225 RETROGRADE ) RADIOLOGY - X RAY 3,990 3,990 5,200 6,400

226 XRAY WRIST BOTH - RADIOLOGY - X RAY 950 950 1,250 1,500
AP & LATERAL
XRAY WRIST BOTH - AP,
227 LATERAL & RADIOLOGY - X RAY 1,300 1,300 1,700 2,100
ULNAR DEVIATION
228 XRAY WRIST BOTH - RADIOLOGY - X RAY 650 650 850 1,050
LATERAL
229 XRAY WRIST BOTH- RADIOLOGY - X RAY 450 450 600 750
AP
230 XRAY WRIST SINGLE - RADIOLOGY - X RAY 500 500 650 800
AP
XRAY WRIST SINGLE - AP
231 & LATERAL RADIOLOGY - X RAY 650 650 850 1,050

232 XRAY WRIST SINGLE - AP, RADIOLOGY - X RAY

LATERAL & ULNAR
DEVIATION 950 950 1,250 1,500

233 XRAY ZYGOMATIC RADIOLOGY - X RAY 450 450 600 750

ARCH
 Super
Deluxe
Deluxe

Deluxe Super
Deluxe
9,000 11,250

5,600 7,000

10,600 13,250

1,900 2,400

2,700 3,400

3,200 4,000
2,600 3,250

2,400 3,000
5,300 6,650
4,400 5,500

5,200 6,500

4,400 5,500

4,400 5,500

5,300 6,650

5,300 6,650

5,300 6,650

5,300 6,650

4,400 5,500

4,400 5,500

7,950 9,950

5,800 7,250

5,500 6,850

5,300 6,650

4,400 5,500

4,400 5,500
2,600 3,250
4,400 5,500
2,400 3,000
3,200 4,000

1,900 2,400

7,700 9,650

7,700 9,650

6,500 8,200

5,600 7,000

2,900 3,650

2,900 3,650
3,100 3,850
1,900 2,400

4,400 5,500

2,700 3,400

3,400 4,250
3,400 4,250

2,400 3,000
2,800 3,500
8,500 10,650

3,400 4,250

6,800 8,500

3,400 4,250

5,900 7,400

4,400 5,500

1,900 2,400

2,600 3,250

5,300 6,650

2,400 3,000
 3,400 4,250
2,900 3,600
2,200 2,750

5,300 6,600

2,400 3,000

2,600 3,250

3,400 4,250

3,300 4,200

3,300 4,200

5,300 6,650

5,300 6,650

9,500 11,900

3,300 4,200

2,700 3,400

25,500 31,900

900 1,200

500 650

1,400 1,750

1,000 1,250

1,300 1,650

1,000 1,250

1,900 2,400

1,300 1,650

1,300 1,650

1,000 1,250

1,300 1,650

1,100 1,400
 2,600 3,250

900 1,200

1,300 1,650

15,300 19,200

11,100 13,900
11,100 13,900
7,000 8,750

900 1,200

2,600 3,250

1,300 1,650

1,300 1,650

1,300 1,650

1,000 1,250
1,000 1,250
2,100 2,650

2,100 2,650

900 1,200

2,100 2,650

1,000 1,250

10,000 12,500

1,300 1,650

2,100 2,650

1,100 1,400

1,300 1,650

1,300 1,650

1,100 1,400

1,300 1,650

1,300 1,650

900 1,200
 1,700 2,200

1,000 1,250

1,300 1,650

1,700 2,200

900 1,200

1,100 1,400

1,300 1,650

2,100 2,650

900 1,200

1,900 2,400

900 1,200

1,300 1,650

1,000 1,250

1,900 2,400

2,600 3,250

900 1,200

1,300 1,650

1,000 1,250

2,100 2,650

1,300 1,650

1,100 1,400

2,100 2,650

1,000 1,250

1,700 2,200

8,900 11,200

12,600 15,750
1,700 2,200
3,200 4,000

900 1,200

1,100 1,400

1,000 1,250

1,300 1,650

1,900 2,400

2,100 2,650
1,700 2,200

900 1,200
1,100 1,400

1,000 1,250

1,300 1,650

1,100 1,400

2,100 2,650

1,300 1,650

900 1,200

1,000 1,250

1,700 2,200

1,100 1,400
1,300 1,650

1,000 1,250

900 1,200
1,000 1,250

1,300 1,650

900 1,200

1,100 1,400

900 1,200
1,000 1,250
900 1,200
100 1,250
2,100 2,650

1,100 1,400
1,000 1,250

1,100 1,400

2,100 2,650

900 1,200

1,300 1,650

1,000 1,250
1,100 1,400

2,600 3,250

1,000 1,250

1,300 1,650

900 1,200
1,300 1,650

2,100 2,650

1,000 1,250
900 1,200

1,700 2,200

1,900 2,400

1,300 1,650

900 1,200

1,000 1,250

1,900 2,400

1,700 2,200

1,700 2,200
 900 1,200

900 1,200

2,100 2,650

1,000 1,250

2,100 2,650

1,100 1,400

2,100 2,650

1,000 1,250

2,100 2,650

1,700 2,200

1,300 1,650

2,100 2,650

900 1,250

1,000 1,250

1,300 1,650

1,000 1,250

1,000 1,250

1,700 2,200

1,100 1,400

2,100 2,650

900 1,200

1,300 1,650

2,200 2,750
1,300 1,650

1,700 2,200

1,100 1,400

900 1,200

2,100 2,650

1,100 1,400

900 1,200
1,300 1,650

1,300 1,650

7,900 9,950

1,900 2,400

2,600 3,250

1,300 1,650

900 1,200

1,000 1,250

1,300 1,650

1,900 2,400

900 1,200