Package Costs

Sl. No
1
2
3
4
5
Category
Burns
Burns
Burns
Burns
Burns
Category
Code
Sub Category
S13
S13
S13
S13
S13
Burns Above 50%
Burns Above 50%
Burns Above 50%
Burns Above 50%
Burns Above 50%
Sub
Category
Code
S13N1
S13N1
S13N1
S13N1
S13N1
Procedures
Procedure 100%
code
Rates
Up To -50% Mixed Burns( With Surgeries)
Up To -60% With Scalds ( Conservative)
Upto-50% With Scalds(Conservative)
Up To -40% With Scalds ( Conservative)
Above 60% Mixed Burns( With Surgeries)
S13N1.4
S13N1.5
S13N1.3
S13N1.1
S13N1.7
70000
80000
60000
35000
120000
S13N2
Moderate Contracture Surgeries For Functional Improvement
(including splints, pressure garments And Physiotherapy)
S13N2.2
30000
6
Burns
S13
Burns Post Burn Contracture Surgeries
For Functional Improvement (Package
And Physiotherapy)
7
Burns
S13
Burns Post Burn Contracture Surgeries
For Functional Improvement (Package
And Physiotherapy)
S13N2
Severe Contracture Surgeries For Functional Improvement
(including splints, pressure garments And Physiotherapy)
S13N2.3
40000
S13N2
Mild Contracture Surgeries For Functional Improvement
(including splints, pressure garments And Physiotherapy)
S13N2.1
20000
8
Burns
S13
Burns Post Burn Contracture Surgeries
For Functional Improvement (Package
And Physiotherapy)
9
10
Burns
Burns
S13
S13
Burns Above 50%
Burns Above 50%
S13N1
S13N1
Up To -60% Mixed Burns( With Surgeries)
Upto-40% Mixed Burns( With Surgeries)
S13N1.6
S13N1.2
100000
50000
11
Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
Surgery Without Graft For Arterial Injuries, Venous Injuries
S7F24.1
10000
12
Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
S7F24.4
20000
13
Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
S7F24.3
60000
14
Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
Vascular Injury In Upper Limbs – Axillary,Branchial,Radial
And Ulnar - Repair With Vein Graft - Payable maximum upto
S7F24.2
40000
15
Cardiac And Cardiothoracic Surgery
S7
Cvts Chest
S7F20
Diaphragmatic Eventeration
S7F20.1
40000
16
Cardiac And Cardiothoracic Surgery
S7
S7F19
Transpleural BPF Closure
S7F19.4
50000
17
Cardiac And Cardiothoracic Surgery
S7
S7F19
Myoplasty
S7F19.3
50000
18
Cardiac And Cardiothoracic Surgery
S7
Cvts Chest
S7F20
Diaphragmatic Hernia
S7F20.2
40000
19
Cardiac And Cardiothoracic Surgery
S7
Cardiology
S7F1
ASD Device Closure
S7F1.3
80000
20
Cardiac And Cardiothoracic Surgery
S7
Diaphragmatic Injuries
S7F21
Thoracotomy, Thoraco Abdominal Approach
S7F21.1
40000
Surgical Correction Of
Bronchopleural Fistula
Surgical Correction Of
Bronchopleural Fistula
Minor Vascular Injury Repair- Tibial Vessels In Leg - Payable
maximum upto
Major Vascular Injury -In Lower Limbs-Repair - Payable
maximum upto
Sub
Category
Code
Procedure 100%
code
Rates
Sl. No
Category
Category
Code
21
Cardiac And Cardiothoracic Surgery
S7
Cvts Chest
S7F20
Oesophageal Diverticula /Achlasia Cardia
S7F20.3
40000
22
Cardiac And Cardiothoracic Surgery
S7
Surgical Correction Of
Bronchopleural Fistula
S7F19
Thorocoplasty
S7F19.2
50000
23
Cardiac And Cardiothoracic Surgery
S7
Cvts Lungs
S7F18
Pneumonectomy
S7F18.1
50000
24
Cardiac And Cardiothoracic Surgery
S7
Cvts Valve Repairs
S7F17
Open Mitral Valvotomy
S7F17.4
80000
25
Cardiac And Cardiothoracic Surgery
S7
Cvts Valve Repairs
S7F17
Closed Mitral Valvotomy
S7F17.3
20000
26
Cardiac And Cardiothoracic Surgery
S7
Cvts Lungs
S7F18
Lobectomy
S7F18.2
50000
27
Cardiac And Cardiothoracic Surgery
S7
Cvts Lungs
S7F18
SOL Mediastinum
S7F18.5
50000
28
Cardiac And Cardiothoracic Surgery
S7
Cvts Lungs
S7F18
Lung Cyst
S7F18.4
50000
29
Cardiac And Cardiothoracic Surgery
S7
Cvts Lungs
S7F18
Decortication
S7F18.3
50000
30
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Ruptured Sinus Of Valsalva Correction
S7F13.13
95000
31
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Surgery For Intracardiac Tumours
S7F13.12
75000
32
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
TAPVC Correction
S7F13.14
95000
33
Cardiac And Cardiothoracic Surgery
S7
Systemic Pulmonary Shunts
S7F14
Systemic Pulmonary Shunts Without Graft
S7F14.2
20000
34
Cardiac And Cardiothoracic Surgery
S7
Systemic Pulmonary Shunts
S7F14
Systemic Pulmonary Shunts With Graft
S7F14.1
20000
35
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Valve Repair With Prosthetic Ring
S7F13.17 100000
36
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
TGA Arterial Switch
S7F13.9
150000
37
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Femoro-Femoral Bypass Without Graft
S7F13.8
25000
38
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
TGA Sennings Procedure
S7F13.10 120000
39
Cardiac And Cardiothoracic Surgery
S7
Ross Procedure Intracardiac Repair Of
Complex Congenital Heart Diseases
S7F16
Ross procedure - Intracardiac repair of complex congenital
heart diseases Without Special Conduits
S7F16.1
95000
40
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Carotid Embolectomy
S7F13.11
50000
Sub Category
Procedures
Sub
Category
Code
Procedure 100%
code
Rates
Sl. No
Category
Category
Code
41
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Femoroileal Bypass With Graft
S7F13.5
45000
42
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Femoroileal Bypass Without Graft
S7F13.6
25000
43
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Femoro Popliteal Bypass Without Graft
S7F13.4
30000
44
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Aorto-Aorto Bypass Without Graft
S7F13.2
45000
45
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Femoro Popliteal Bypass With Graft
S7F13.3
45000
46
Cardiac And Cardiothoracic Surgery
S7
Bronchial Injuries
S7F22
Bronchial Foreign Body Removal With Scope
S7F22.1
20000
47
Cardiac And Cardiothoracic Surgery
S7
Surgical Correction Of
Bronchopleural Fistula
S7F19
Intracardiac Repair Of ASD
S7F19.1
75000
48
Cardiac And Cardiothoracic Surgery
S7
Systemic Pulmonary Shunts
S7F14
Total Correction Of Tetralogy Of Fallots
S7F14.3
95000
49
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Intracardiac Repair Of VSD
S7F13.15
75000
50
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Femoro-Femoral Bypass With Graft
S7F13.7
45000
51
Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Surgery-PDA
S7F13.16
20000
52
Cardiac And Cardiothoracic Surgery
S7
Cad
S7F6
CABG On Pump Without IABP
S7F6.1
125000
53
Cardiac And Cardiothoracic Surgery
S7
Cardiac Injuries
S7F12
Surgery With CPB
S7F12.2
75000
54
Cardiac And Cardiothoracic Surgery
S7
Cardiac Injuries
S7F12
Surgery Without CPB
S7F12.1
40000
55
Cardiac And Cardiothoracic Surgery
S7
Cad
S7F6
Mitral Valve Replacement (With Valve)
S7F6.4
120000
56
Cardiac And Cardiothoracic Surgery
S7
Cad
S7F6
CABG With Aneurysmal Repair
S7F6.3
110000
57
Cardiac And Cardiothoracic Surgery
S7
Cad
S7F6
CABG Off Pump Without IABP
S7F6.2
100000
58
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Carotid Artery Bypass With Synthetic Graft
S7F9.17
100000
59
Cardiac And Cardiothoracic Surgery
S7
Cardiology
S7F1
PDA Stenting
S7F1.5
65000
60
Cardiac And Cardiothoracic Surgery
S7
Cardiology
S7F1
PDA Device Closure
S7F1.6
60000
Sub Category
Procedures
Sub
Category
Code
Procedure 100%
code
Rates
Sl. No
Category
Category
Code
61
Cardiac And Cardiothoracic Surgery
S7
Cardiology
S7F1
Coil Closure Single Coil
S7F1.7
20000
62
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Carotid Body Tumour Excision
S7F9.16
45000
63
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Brachioradial Bypass With Synthetic Graft
S7F9.15
50000
64
Cardiac And Cardiothoracic Surgery
S7
Cardiology
S7F1
VSD Device Closure
S7F1.4
80000
65
Cardiac And Cardiothoracic Surgery
S7
Coarctation Of Aorta Repair
S7F11
Intrathoracic Aneurysm-Aneurysm Not Requiring Bypass
(With Graft)
S7F11.4
65000
66
Cardiac And Cardiothoracic Surgery
S7
Coarctation Of Aorta Repair
S7F11
Aneurysm Resection & Grafting
S7F11.3
125000
67
Cardiac And Cardiothoracic Surgery
S7
Coarctation Of Aorta Repair
S7F11
Coarctation Of Aorta Repair Without Graft
S7F11.2
25000
68
Cardiac And Cardiothoracic Surgery
S7
Coarctation Of Aorta Repair
S7F11
Annulus Aortic Ectasia With Valved Conduits
S7F11.7
150000
69
Cardiac And Cardiothoracic Surgery
S7
Coarctation Of Aorta Repair
S7F11
Dissecting Aneurysms
S7F11.6
75000
70
Cardiac And Cardiothoracic Surgery
S7
Coarctation Of Aorta Repair
S7F11
Intrathoracic Aneurysm-Aneurysm Requiring Bypass (With
Graft)
S7F11.5
125000
71
Cardiac And Cardiothoracic Surgery
S7
Coarctation Of Aorta Repair
S7F11
Coarctation Of Aorta Repair With Graft
S7F11.1
32000
72
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Double Valve Replacement (With Valve)
S7F9.3
150000
73
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Tricuspid Valve Replacement
S7F9.2
120000
74
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Aortic Valve Replacement (With Valve)
S7F9.1
120000
75
Cardiac And Cardiothoracic Surgery
S7
Pericardium
S7F10
Pericardiocentesis
S7F10.2
2000
76
Cardiac And Cardiothoracic Surgery
S7
Pericardium
S7F10
Percardectomy
S7F10.1
30000
77
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Percardiostomy
S7F9.4
10000
78
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
A V Fistula At Elbow
S7F9.21
20000
79
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
A V Fistula At Wrist
S7F9.20
10000
80
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Arterial Embolectomy
S7F9.19
20000
Sub Category
Procedures
Sub
Category
Code
Procedure 100%
code
Rates
Sl. No
Category
Category
Code
81
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Small Arterial Aneurysms - Repair
S7F9.7
15000
82
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Vascular Tumours
S7F9.6
40000
83
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
D V T - IVC Filter
S7F9.5
100000
84
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Excision Of AV Malformation Small
S7F9.18
40000
85
Cardiac And Cardiothoracic Surgery
S7
Cad
S7F6
Coronary Bypass Surgery On Pump With IABP
S7F6.5
150000
86
Cardiac And Cardiothoracic Surgery
S7
Angioplasty
S7F5
Vertebral Angioplasty
S7F5.3
75000
87
Cardiac And Cardiothoracic Surgery
S7
Angioplasty
S7F5
Peripheral Angioplasty
S7F5.2
60000
88
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Excision Of AV Malformation Large
S7F9.22
75000
89
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Peripheral Embolectomy Without Graft
S7F9.23
25000
90
Cardiac And Cardiothoracic Surgery
S7
Cad
S7F6
Coronary Bypass Surgery Off Pump With IABP
S7F6.6
125000
91
Cardiac And Cardiothoracic Surgery
S7
S7F4
Coarctation Of Aorta Repair With Stent
S7F4.1
80000
92
Cardiac And Cardiothoracic Surgery
S7
S7F4
Coarctation Of Aorta Repair Without Stent
S7F4.2
30000
93
Cardiac And Cardiothoracic Surgery
S7
Angioplasty
S7F5
Renal Angioplasty
S7F5.1
60000
94
Cardiac And Cardiothoracic Surgery
S7
Cardiology
S7F1
Coil Closure Multiple Coils
S7F1.8
30000
95
Cardiac And Cardiothoracic Surgery
S7
Cardiology Balloon Procedures
S7F2
Balloon Valvotomy
S7F2.1
20000
96
Cardiac And Cardiothoracic Surgery
S7
Cardiology Balloon Procedures
S7F2
Balloon Atrial Septostomy
S7F2.2
30000
97
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Axillo Brachial Bypass Using With Synthetic Graft
S7F9.14
65000
98
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Aorto Billac - Bifemoral Bypass With Synthetic Graft
S7F9.10
125000
99
Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Medium Size Arterial Aneurysms With Synthetic Graft
S7F9.9
75000
100 Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Medium Size Arterial Aneurysms - Repair
S7F9.8
50000
Sub Category
Coarctation Of Aorta Repair /
Aortoplasty
Coarctation Of Aorta Repair /
Aortoplasty
Procedures
Sl. No
Category
Category
Code
Sub Category
Sub
Category
Code
Procedures
Procedure 100%
code
Rates
101 Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Femorodistal Bypass With Synthetic Graft
S7F9.13
80000
102 Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Femorodistal Bypass With Vein Graft
S7F9.12
60000
103 Cardiac And Cardiothoracic Surgery
S7
Valve Replacement
S7F9
Axillo Bifemoral Bypass With Synthetic Graft
S7F9.11
100000
104 Cardiac And Cardiothoracic Surgery
S7
Cvts
S7F13
Aorto-Aorto Bypass With Graft
S7F13.1
60000
105 Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
Neck Vascular Injury - Carotid Vessels - Payable maximum
upto
S7F24.8
100000
106 Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
Vascular Injuries Repair With Prosthetic Graft
S7F24.7
40000
107 Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
Surgery With Vein Graft
S7F24.6
15000
108 Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
Abdominal Vascular Injuries - Aorta, Iliac Arteries, IVC, Iliac
Veins - Payable maximum upto
S7F24.9
100000
109 Cardiac And Cardiothoracic Surgery
S7
Cvts Valve Repairs
S7F17
Open Pulmonary Valvotomy
S7F17.2
75000
110 Cardiac And Cardiothoracic Surgery
S7
Cvts Valve Repairs
S7F17
Valve Repair Without Prosthetic Ring
S7F17.1
85000
111 Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
Thoracic Vascular Injuries - Payable maximum upto
S7F24.10 150000
112 Cardiac And Cardiothoracic Surgery
S7
Vascular Injuries
S7F24
113 Cardiac And Cardiothoracic Surgery
S7
Oesophagus Injuries
S7F23
114 Cardiac And Cardiothoracic Surgery
S7
Bronchial Injuries
S7F22
115 Cardiac And Cardiothoracic Surgery
S7
Ross Procedure Intracardiac Repair Of
Complex Congenital Heart Diseases
116
117
118
119
120
121
122
123
124
125
M7
M7
M7
M7
M7
M7
M7
M7
M7
M7
Cardiology
Cardiology
Angioplasty
Cardiology
Cardiology
Angioplasty
Cardiology Pacemaker Implantation
Cardiology Pacemaker Implantation
Angioplasty
Cardiology
Cardiology
Cardiology
Cardiology
Cardiology
Cardiology
Cardiology
Cardiology
Cardiology
Cardiology
Cardiology
Minor Vascular Injury Repair - Vessels In Foot - Payable
maximum upto
Gastro Study Followed By Thoracotomy And Repairs For
Oesophageal Injury For Corrosive Injuries/FB
S7F24.5
20000
S7F23.1
50000
Bronchial Injuries Due To Foreign Body Repair Surgery
S7F22.2
40000
S7F16
Ross procedure - Intracardiac repair of complex congenital
heart diseases With Special Conduits
S7F16.2
125000
M7T1
M7T1
M7F1
M7T1
M7T1
M7F1
M7F3
M7F3
M7F1
M7T1
Refractory Cardiac Failure
Infective Endocarditis
Coronary Ballon Angioplasty
Pericardial Effusion Tamponade
Simple Arrhythmias
PTCA Additional Stent
Temporary Pacemaker Implantation
Permanent Pacemaker Implantation
Angioplasty with Stent(PTCA with Stent)
Pulmonary Embolism
M7T1.5
M7T1.6
M7F1.1
M7T1.10
M7T1.9
M7F1.2
M7F3.2
M7F3.1
M7F1.3
M7T1.7
50000
25000
60000
25000
70000
20000
10000
75000
20000
30000
Sl. No
126
127
128
129
Category
Sub Category
Sub
Category
Code
M7T1
M7T1
M7T1
M7T1
M7
M7
M7
M7
Cardiology
Cardiology
Cardiology
Cardiology
130 Critical Care
M3
Critical Care
M3Q1
131 Critical Care
M3
Critical Care
M3Q1
132 Critical Care
M3
Critical Care
133 Critical Care
M3
Critical Care
134 Critical Care
M3
Critical Care
135 Critical Care
M3
Critical Care
136 Critical Care
M3
Critical Care
137 Critical Care
M3
Critical Care
138 Dermatology
139 Dermatology
M11
M11
Dermatology
Dermatology
140 Dermatology
M11
Dermatology
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
S2
Nose
Throat
Throat
Throat
Throat
Ear
Hearing Aid
Ear
Ear
Throat
Nose
Nose
Nose
Throat
Throat
Nose
Nose
Nose
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
Cardiology
Cardiology
Cardiology
Cardiology
Category
Code
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
ENT Surgery
Procedures
Acute MI Requiring IABP Pump
Thrombolytic Therapy for Acute MI
Acute MI With Cardiogenic Shock
Complex Arrhythmias
Acute Bronchitis And Pneumonia With Respiratory Failure,
Ventilator 10 Days Stay
M7T1.4
M7T1.11
M7T1.3
M7T1.8
50000
15000
30000
95000
M3Q1.3
50000
Septic Shock(ICU Management) With Ventilatory Assistance
M3Q1.8
50000
M3Q1.6
120000
M3Q1.7
30000
M3Q1.4
65000
M3Q1.1
45000
M3Q1.2
70000
M3Q1.5
100000
M11T5.1
M11T5.2
30000
20000
M11T5.3
25000
S2B3.4
S2B2.2
S2B2.5
S2B2.4
S2B2.1
S2B1.2
S2P1.1
S2B1.3
S2B1.1
S2B2.6
S2B3.2
S2B3.3
S2B3.1
S2B2.7
S2B2.3
S2B3.7
S2B3.6
S2B3.5
15000
25000
20000
20000
12000
20000
5000
50000
20000
10000
15000
15000
15000
25000
20000
20000
40000
15000
ARDS Plus DIC (Blood & Blood Products) With Ventilatory
Care
OP Poisoning Requiring Ventilatory Assistance Clinical Photo
M3Q1
- 1 Week Stay
M3Q1 ARDS With Ventilatory Care 14 Days Stay
Acute Severe Asthma With Acute Respiratory Failure 10 Days
M3Q1
Stay
COPD Respiratory Failure (Infective Exacerbation)14 Days
M3Q1
Stay with ventilator support
ARDS With Multi Organ Failure With Ventilatory Care 14
M3Q1
Days Stay
M11T5 Toxic Epidermal Necrolysis 15 Days Stay
M11T5 Stevens- Johnson Syndrome 15 Days Stay
Pemphigus / Pemphigoid Tzanck Clinical Protocol 15 Days
M11T5
Stay
S2B3 Stapedectomy + Veingraft
S2B2 Phono Surgery For Vocal Cord Paralysis
S2B2 Parapharyngeal Tumour Excision
S2B2 Excision Of Tumours In Pharynx
S2B2 Microlaryngeal Surgery
S2B1 Facial Nerve Decompression
S2P1 Behind The Ear Analogue Hearing Aid
S2B1 Temporal Bone Excision
S2B1 Labyrinthectomy
S2B2 Adenoidectomy - Gromet Insertion
S2B3 Mastoidectomy
S2B3 Tympanoplasty
S2B3 Endoscopic Sinus Surgery
S2B2 Uvulo-Palato Pharyngoplasty
S2B2 Laryngo Fissurectomy
S2B3 Endoscopic DCR
S2B3 Angiofibroma Nose
S2B3 Excision Of Benign Tumour Nose
M3Q1
Procedure 100%
code
Rates
Sl. No
Category
159 ENT Surgery
Category
Code
S2
Sub Category
Ent
Sub
Procedures
Category
Code
S2B4 Bronchoscopic Foreign Body Removal
Procedure 100%
code
Rates
S2B4.1
20000
160 Endocrinology
M13
Endocrinology Uncontrolled Diabetes
Mellitus With Infectious Emergencies
M13U1 Cholecystitis - Abd 10 Days Stay
M13U1.3
25000
161 Endocrinology
M13
Endocrinology Uncontrolled Diabetes
Mellitus With Infectious Emergencies
M13U1 Pyelonephritis 10 Days Stay
M13U2.4
20000
162 Endocrinology
M13
Endocrinology Uncontrolled Diabetes
Mellitus With Infectious Emergencies
M13U1 Lower Respiratory Tract Infection 10 Days Stay
M13U1.1
20000
163 Endocrinology
M13
Endocrinology Uncontrolled Diabetes
Mellitus With Infectious Emergencies
M13U1 Fungal Sinusitis Pns 10 Days Stay
M13U1.2
40000
164 Endocrinology
M13
Endocrinology Uncontrolled Diabetes
Mellitus With Infectious Emergencies
M13U1 Hypopitutarism - 1 Week Stay
M13U1.6 100000
Cushings Syndrome Inv - Cortisol Assay After
Dexamethasone, Acth Assay, Dheas, Mri Ituitary Ctabd, Ct
M13U2.2
M13U2
Chest, Dexa Of Hip Spine 1 Week Stay With Post Treatment
Evidence Of Clinical And Lab Investigations
Delayed Puberty Hypogonadism (Ex.Turners Synd, Kleinfelter
M13U2
M13U2.3
Synd) 5 Days Stay
30000
165 Endocrinology
M13
Other Endocrinal Disorders
166 Endocrinology
M13
Other Endocrinal Disorders
167 Endocrinology
M13
Endocrinology Uncontrolled Diabetes
Mellitus With Infectious Emergencies
M13U1 Cavernous Sinus Thrombosis 10 Days Stay
M13U1.4
40000
168 Endocrinology
M13
Endocrinology Uncontrolled Diabetes
Mellitus With Infectious Emergencies
M13U1 Rhinocerebral Mucormycosis 10 Days Stay
M13U1.5
40000
169
170
171
172
173
Endocrinology
GENERAL MEDICINE
GENERAL MEDICINE
GENERAL MEDICINE
GENERAL MEDICINE
M13
M16
M16
M16
M16
Other Endocrinal Disorders
Critical Care Gen Medicine
Critical Care Gen Medicine
Critical Care Gen Medicine
Critical Care Gen Medicine
M13U2
M16Q1
M16Q1
M16Q1
M16Q1
M13U2.1
M16Q1.1
M16Q1.6
M16Q1.7
M16Q1.8
15000
20000
30000
50000
25000
174 GENERAL MEDICINE
M16
Critical Care Gen Medicine
M16Q1
M16Q1.5
20000
175 GENERAL MEDICINE
M16
Critical Care Gen Medicine
M16Q1
M16Q1.9
30000
176 GENERAL MEDICINE
M16
Critical Care Gen Medicine
M16Q1
M16Q1.2
50000
177 GENERAL MEDICINE
M16
Critical Care Gen Medicine
M16Q1
M16Q1.4
20000
Pituitary - Acromegaly 1 Week Stay
Thrombocytopenia With Bleeding Diathesis
TB Meningitis
Snake Bite Requiring Ventilator Support
Scorpion Sting Requiring Ventilator Support
Cerebral Malaria (Falciparum) requiring Ventilatory support
and treatment with Blood and Platelet Transfusion, IV
antibiotics, IV fluids, Mefloquine, IV quinine or IV artesunate,
Paracetamol,
Metabolic Coma Requiring Ventilatory Support
Haemophilia treatment with IV FPP, Factor VIII
/Cryoprecipitate
Chelation Therapy For Thalassemia
12000
Sl. No
Category
Category
Code
Sub Category
Sub
Category
Code
Procedures
Other Coagulation Disorders with Von Wili Brand Factor:
treatment with IV FPP, Factor VIII /Cryoprecipitate
Achalasia Cardia - One Day Stay
Obscure GI Bleed - 1 Week Stay
Cirrhosis With Hepatic Encephalopathy -11 Days Stay
Acute Pancreatitis (Severe) -3 Weeks Stay - Payable maximum
upto
Chronic Pancreatitis With Severe Pain - 7 Days Stay - Payable
maximum upto
Cirrhosis With Hepato Renal Syndrome - 10 Days Stay
Biliary Stricture 3) Sclerosing Cholangitis 7 Days Stay
Oesophageal Perforation- 7 Days Stay
Biliary Stricture 1) Post Op Stent 7 Days Stay
Oesophageal Varices, Variceal Banding One Day Stay
Oesophageal Foreign Body One Day Stay
Corrosive Oesophageal Injury 7 Days Stay
Oesophageal Varices, Sclerotherapy- One Day Stay
Biliary Stricture 2) Post Op Leaks 7 Days Stay
Acute Pancreatitis (Mild) - 1 Week Stay With Post Treatment
Evidence Of - Payable maximum upto
Oesophageal Fistula -3 Days Stay
GAVE (Gastric Antral Vascular Ectasia) - 2 Days Stay
Acute Pancreatitis With Pseudocyst (Infected) 3 Weeks Stay Payable maximum upto
Gastric Varices 3 Days Stay
178 GENERAL MEDICINE
M16
Critical Care Gen Medicine
M16Q1
179 Gastroenterology
180 Gastroenterology
181 Gastroenterology
M14
M14
M14
Gastroenterology
Gastroenterology
Gastroenterology
M14V1
M14V1
M14V1
182 Gastroenterology
M14
Gastroenterology
M14V1
183 Gastroenterology
M14
Gastroenterology
M14V1
184
185
186
187
188
189
190
191
192
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
M14
M14
M14
M14
M14
M14
M14
M14
M14
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
Gastroenterology
M14V1
M14V1
M14V1
M14V1
M14V1
M14V1
M14V1
M14V1
M14V1
193 Gastroenterology
M14
Gastroenterology
M14V1
194 Gastroenterology
195 Gastroenterology
M14
M14
Gastroenterology
Gastroenterology
M14V1
M14V1
196 Gastroenterology
M14
Gastroenterology
M14V1
197 Gastroenterology
M14
M14V1
198 General Surgery
S1
Gastroenterology
Abdomen Stomach, Duodenum,
Jejunum
199 General Surgery
S1
Abdomen Small Intestine
S1A8
200
201
202
203
204
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
S1
S1
S1
S1
S1
S1A8
S1A8
S1A8
S1A8
S1A8
205 General Surgery
S1
S1A7
206 General Surgery
S1
207 General Surgery
S1
208 General Surgery
S1
Abdomen Small Intestine
Abdomen Small Intestine
Abdomen Small Intestine
Abdomen Small Intestine
Abdomen Small Intestine
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Small Intestine
Operations For Recurrent Intestinal Obstruction (Noble
Plication Other)
Operation For Haemorrhage Of The Small Intestine
Resection & Anastomosis Of Small Intestine
Ileostomy Closure
Ileostomy
Operation For Acute Intestinal Perforation
Procedure 100%
code
Rates
M16Q1.3
50000
M14V1.3 7000
M14V1.13 50000
M14V1.14 30000
M14V1.10 150000
M14V1.12 20000
M14V1.15
M14V1.18
M14V1.2
M14V1.16
M14V1.4
M14V1.1
M14V1.20
M14V1.5
M14V1.17
40000
75000
25000
50000
10000
5000
20000
5000
75000
M14V1.9
75000
M14V1.6
M14V1.7
30000
20000
M14V1.11 30000
M14V1.8
15000
S1A7.7
40000
S1A8.5
35000
S1A8.4
S1A8.6
S1A8.8
S1A8.7
S1A8.3
40000
35000
20000
20000
30000
Gastrostomy
S1A7.9
20000
S1A7
Pyloromyotomy
S1A7.8
20000
S1A7
Gastrostomy Closure
S1A7.10
20000
S1A8
Operation For Acute Intestinal Obstruction
S1A8.2
30000
S1A7
Partial/Subtotal Gastrectomy For Ulcer
Sl. No
Category
Category
Code
209 General Surgery
S1
210 General Surgery
S1
211 General Surgery
S1
212 General Surgery
S1
213 General Surgery
S1
214
215
216
217
218
219
220
221
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
S1
S1
S1
S1
S1
S1
S1
S1
222 General Surgery
S1
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
Sub Category
Abdomen Small Intestine
Head And Neck Thyroid Non
Malignant
Head And Neck Thyroid Non
Malignant
Head And Neck Thyroid Non
Malignant
Head And Neck Thyroid Non
Malignant
Head And Neck
Abdomen Hernia
Abdomen Hernia
Abdomen Hernia
Abdomen Hernia
Head And Neck
Breast
Abdomen Hernia
Head And Neck Thyroid Non
Malignant
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Abdomen Hernia
Spleen
Spleen
Abdomen Large Intestine
Adrenals
Abdomen Large Intestine
Spleen
Sub
Category
Code
S1A8 Intussusception
Procedures
Procedure 100%
code
Rates
S1A8.1
30000
S1A2
Subtotal Thyroidectomy
S1A2.5
20000
S1A2
Isthmectomy
S1A2.2
20000
S1A2
Partial Thyroidectomy
S1A2.3
20000
S1A2
Resection Enucleation
S1A2.4
20000
S1A1
S1A4
S1A4
S1A4
S1A4
S1A1
S1A3
S1A4
Parathyroidectomy
Femoral Hernia
Hiatus Hernia Repair Abdominal
Rare Hernias (Spigalion,Obuturator,Sciatic)
Epigastric Hernia With Mesh
Excision Of Thyroglossal Cyst Fistula
Simple Mastectomy(NM)
Epigastric Hernia Without Mesh
S1A1.18
S1A4.3
S1A4.4
S1A4.5
S1A4.2
S1A1.19
S1A3.1
S1A4.1
30000
15000
35000
20000
30000
15000
20000
15000
S1A2
Hemithyroidectomy
S1A2.1
20000
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A1
S1A4
S1A13
S1A13
S1A14
S1A12
S1A14
S1A13
Branchial Sinus Excision
Hemimandibulectomy
Segmental Mandible Excision
Parotid Duct Repair
Brachial Cyst Excision
Cervical Rib Excision
Removal Of Submandibular Salivary Gland
Carotid Body-Tumours Excision
Wedge Excision& Vermilionectomy Inv
Wedge Excision
Cystic Hygroma Excision-Major
Vermilionectomy
Partial Glossectomy
Cystic Hygroma Excision-Extensive
Abbe Operation
Umbilical Hernia Without Mesh
Splenectomy For Hypersplenism
Splenorenal Anastomosis
Colostomy
Operation On Adrenal Glands Unilateral For Tumour
Colostomy Closure
Warren Shunt
S1A1.5
S1A1.6
S1A1.7
S1A1.4
S1A1.1
S1A1.2
S1A1.3
S1A1.8
S1A1.13
S1A1.14
S1A1.15
S1A1.12
S1A1.9
S1A1.10
S1A1.11
S1A4.6
S1A13.1
S1A13.2
S1A14.7
S1A12.2
S1A14.8
S1A13.3
20000
25000
25000
20000
20000
15000
10000
30000
20000
15000
20000
15000
15000
20000
15000
15000
35000
60000
20000
25000
20000
60000
Sl. No
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
Category
Category
Code
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
S1
263 General Surgery
S1
264 General Surgery
S1
265 General Surgery
S1
266 General Surgery
S1
267 General Surgery
S1
268 General Surgery
S1
269
270
271
272
273
General Surgery
General Surgery
General Surgery
General Surgery
General Surgery
S1
S1
S1
S1
S1
274 General Surgery
S1
275
276
277
278
S1
S1
S9
S9
General Surgery
General Surgery
Genitourinary System
Genitourinary System
Sub Category
Abdomen Large Intestine
Abdomen Large Intestine
Abdomen Large Intestine
Abdomen Large Intestine
Abdomen Large Intestine
Adrenals
Liver
Gall Bladder
Liver
Abdomen Rectum And Anus
Abdomen Rectum And Anus
Gall Bladder
Gall Bladder
Gall Bladder
Gall Bladder
Gall Bladder
Gall Bladder
Abdomen Large Intestine
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Stomach, Duodenum,
Jejunum
Abdomen Hernia
Abdomen Hernia
Abdomen Hernia
Abdomen
Abdomen
Head And Neck Thyroid Non
Malignant
Head And Neck
Head And Neck
Corrective Procedures
Urology Corrective Procedures
Sub
Category
Code
S1A14
S1A14
S1A14
S1A14
S1A14
S1A12
S1A10
S1A11
S1A10
S1A9
S1A9
S1A11
S1A11
S1A11
S1A11
S1A11
S1A11
S1A14
Procedures
Procedure 100%
code
Rates
Operation Of The Duplication Of The Intestines
Operation For Volvulus Of Large Bowel
Left Hemi Colectomy
Total Colectomy
Right Hemi Colectomy
Operation Of Adrenal Glands, Bilateral For Tumour
Portocaval Anastomosis
Cholecystectomy
Operation For Hydatid Cyst Liver
Pull Through Abdominal Resection
Anterior Resection
Lap.Cholecystectomy
Cystogastrostomy
Repair Of CBD
Cystojejunostomy
Cholecystectomy & Exploration CBD
Lap Cholecystostomy With Exploration CBD
Mal-Rotation & Volvulus Of The Midgut
S1A14.3
S1A14.2
S1A14.4
S1A14.6
S1A14.5
S1A12.1
S1A10.2
S1A11.1
S1A10.1
S1A9.1
S1A9.2
S1A11.2
S1A11.6
S1A11.7
S1A11.5
S1A11.3
S1A11.4
S1A14.1
40000
35000
30000
40000
30000
40000
80000
20000
30000
30000
40000
25000
40000
25000
40000
25000
30000
35000
S1A7
Selective Vagotomy Drainage
S1A7.3
40000
S1A7
Duodenal Perforation
S1A7.2
20000
S1A7
Vagotomy Pyloroplasty
S1A7.4
30000
S1A7
Operation For Bleeding Peptic Ulcer
S1A7.6
40000
S1A7
Gastrojejunostomy & Vagotomy
S1A7.5
30000
S1A7
Highly Selective Vagotomy
S1A7.1
25000
S1A4
S1A4
S1A4
S1A5
S1A5
Ventral and Scar Hernia Without Mesh
Umbilical Hernia With Mesh
Ventral And Scar Hernia With Mesh
AppendIcular Perforation
Lap. Appendectomy
S1A4.8
S1A4.7
S1A4.9
S1A5.2
S1A5.1
20000
25000
30000
7000
22000
S1A2
Total Thyroidectomy
S1A2.6
20000
S1A1
S1A1
S9H5
S9H8
Cystic Hygroma Excision-Minor
Excision Of Lingual Thyroid
Hypospadius Adult Double Stage - Stage-2
Perineal Urethrostomy
S1A1.16
S1A1.20
S9H5.7
S9H8.5
10000
25000
35000
20000
Sl. No
Category
Category
Code
Sub Category
279 Genitourinary System
280 Genitourinary System
S9
S9
Corrective Procedures
Urology Kidney Stone
281 Genitourinary System
S9
Urology
282
283
284
285
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
S9
S9
S9
S9
Corrective Procedures
Bladder Prostate
Corrective Procedures
Corrective Procedures
286 Genitourinary System
S9
Corrective Procedures
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Urology Kidney Stone
Renal Calculi
Renal Calculi
299 Genitourinary System
S9
Urology Testis, Testis And Penis
300
301
302
303
304
305
306
307
308
309
310
311
312
313
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
Renal Calculi
Renal Calculi
Lithotripsy
Lithotripsy
Lithotripsy
Lithotripsy
Urology Testis, Testis And Penis
Urology Corrective Procedures
Transplantation
Urology Corrective Procedures
Urology Corrective Procedures
Transplantation
Urology Testis, Testis And Penis
Urology Testis, Testis And Penis
314 Genitourinary System
S9
Transplantation
287
288
289
290
291
292
293
294
295
296
297
298
Sub
Procedure 100%
Procedures
Category
code
Rates
Code
S9H5 Hypospadius Adult Double Stage - TURBT
S9H5.8
30000
S9H7 Nephrostomy
S9H7.1
10000
Post-Transplant Immunosuppressive Treatment From 7th To
S9H6
S9H6.1
50000
12 Th Month After Transplantation
S9H5 Urethroplasty For Stricture Urethra Double Stage Stage-1
S9H5.2
30000
S9H9 Incontinence Urine (Male)
S9H9.7
20000
S9H5 Urethroplasty For Stricture Urethra Double Stage Stage-2
S9H5.3
30000
S9H5 Hypospadius Adult Single Stage
S9H5.5
40000
Urethroplasty For Stricture Urethra Double Stage
S9H5
S9H5.4
50000
Reconstruction Procedure
S9H7 Renal Cyst Excision
S9H7.8
15000
S9H7 Bilateral Nephroureterectomy
S9H7.7
25000
S9H7 Endoscope Removal Of Stone In Bladder
S9H7.9
10000
S9H7 Anderson Hynes Pyeloplasty
S9H10.2 40000
S9H7 Anatrophic Pyelolithotomy For Staghorn Calculus
S9H10.1 50000
S9H7 Simple Nephrectomy
S9H7.3
40000
S9H7 Nephrectomy Pyonephrosis/XGP
S9H7.2
40000
S9H7 Lap. Nephrectomy Simple
S9H7.4
30000
S9H7 Lap. Partial Nephrectomy
S9H7.6
35000
S9H7 Lap. Nephrectomy Radical
S9H7.5
40000
S9H3 Open Nephrolithotomy
S9H3.2
10000
S9H3 Open Cystolithotomy
S9H3.3
10000
Total Amputation Of Penis(Non- Malignant) Inv - Clinical
S9H2 Photograph Post Procedure Evidence Of Clinical
S9H2.5
25000
Photograph,Biopsy
S9H3 Open Pyelolithotomy
S9H3.1
10000
S9H3 Laparoscopic Pyelolithotomy
S9H3.4
30000
S9H4 ESWL
S9H4.3
20000
S9H4 URSL
S9H4.4
25000
S9H4 Cystolithotripsy
S9H4.1
10000
S9H4 PCNL
S9H4.2
30000
S9H2 Partial Amputation Of Penis(Non- Malignant)
S9H2.4
15000
S9H8 Closure Of Urethral Fistula
S9H8.3
25000
S9H1 A.V. Fistula (Pretransplant Procedure Only)
S9H1.1
10000
S9H8 Vasico Vaginal Fistula
S9H8.1
40000
S9H8 Epispadiasis - Correction
S9H8.2
40000
S9H1 Renal Transplantation Surgery
S9H1.2 140000
S9H2 Torsion Testis
S9H2.2
12000
S9H2 Chordae Correction
S9H2.3
15000
Post-Transplant Immunosuppression Treatment From 1st To
S9H1
S9H1.3
50000
6th Month After Transplantation
Sl. No
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
Category
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Genitourinary System
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Category
Code
Sub Category
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
S9
Urology Testis, Testis And Penis
Bladder Prostate
Bladder Prostate
Urology Corrective Procedures
Bladder Prostate
Bladder Prostate
Bladder Prostate
Bladder Prostate
Urology Corrective Procedures
Corrective Procedures
Lithotripsy
Lithotripsy
Urology Corrective Procedures
Urology Corrective Procedures
Urology Corrective Procedures
Corrective Procedures
S4
Obstetrics
S4
Sub
Category
Code
S9H2
S9H9
S9H9
S9H8
S9H9
S9H9
S9H9
S9H9
S9H8
S9H5
S9H4
S9H4
S9H8
S9H8
S9H8
S9H5
Procedures
Procedure 100%
code
Rates
Orchidopexy Bilateral
Open Prostatectomy
TURP Cyst Lithotripsy
Transurethral Resection Of Prostate (TURP)
Caecocystoplasty
Incontinence Urine (Female)
Diverticulectomy
Total Cystectomy
Ureterocele
Urethroplasty For Stricture Urethra Single Stage
DJ Stent (One Side)
Nephrostomy
Optical Urethrotomy
Ileal Conduit formation
Ureteric Reimplantation
Hypospadius Adult Double Stage - Stage-1
S9H2.1
S9H9.2
S9H9.1
S9H8.9
S9H9.3
S9H9.6
S9H9.5
S9H9.4
S9H8.8
S9H5.1
S9H4.6
S9H4.5
S9H8.4
S9H8.7
S9H8.6
S9H5.6
15000
30000
30000
30000
30000
20000
10000
35000
15000
50000
5000
2000
20000
20000
25000
35000
S4C1
Rupture Uterus
S4C1.2
25000
Gynaecology
S4C2
Slings With Mesh Repair For Prolapse
S4C2.7
40000
S4
Gynaecology
S4C2
LAVH
S4C2.1
30000
S4
Obstetrics
S4C1
Abruptioo Placenta With Coagulation Defect - DIC
S4C1.4
20000
S4
Obstetrics
S4C1
Caesarean Hysterectomy With Bladder Repair
S4C1.1
30000
S4
Gynaecology
S4C2
Laparoscopic Ovarian Drilling
S4C2.12
15000
S4
Gynaecology
S4C2
Laparoscopic Myomectomy
S4C2.13
25000
S4
Gynaecology
S4C2
Laparoscopic Cystectomy
S4C2.10
20000
S4
Gynaecology
S4C2
Laparoscopic Ectopic Resection
S4C2.11
20000
S4
Gynaecology
S4C2
Laparoscopic Adhesolysis
S4C2.16
25000
S4
Gynaecology
S4C2
Vaginal Hysterectomy
S4C2.17
15000
S4
Gynaecology
S4C2
Laparoscopic Recanalisation
S4C2.14
20000
Sl. No
343
344
345
346
347
348
349
350
351
352
353
354
355
Category
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics
Surgery
Infectious Diseases
Infectious Diseases
Infectious Diseases
Interventional Radiology
Category
Code
Sub Category
Sub
Category
Code
Procedures
Procedure 100%
code
Rates
S4
Gynaecology
S4C2
Laparoscopic Sling Operations
S4C2.15
25000
S4
Gynaecology
S4C2
Cystocele ,Rectocele & Perineorraphy
S4C2.4
15000
S4
Gynaecology
S4C2
Pelvic Floor Reconstruction With Mesh
S4C2.5
15000
S4
Gynaecology
S4C2
Vaginal Hysterectomy With Pelvic Floor Repair
S4C2.2
15000
S4
Gynaecology
S4C2
Vaginal Hysterectomy With Mesh Repair
S4C2.3
20000
S4
Gynaecology
S4C2
Vault Prolapse Abdominal Repair
S4C2.8
20000
S4
Gynaecology
S4C2
Vault Prolapse Abdominal Repair With Mesh
S4C2.9
25000
S4
Gynaecology
S4C2
Mc Indo-S Repair For Vaginal Atresia
S4C2.6
30000
S4
Obstetrics
S4C1
Eclampsia With Complication Requiring Ventilatory Support
S4C1.3
20000
Tetanus Severe
Diphtheria Complicated
Cryptococcal Meningitis
Preoperative Portal Vein Embolization For Liver Tumors
Chemo Embolization For Liver Tumors Using Drug And PVA
Or DC Beads
Preoperative Prophylactic Tumor Embolization
Peripheral Stent Graft For Peripheral Aneurysms And AV
Fistulae
Embolization Of Caratico-Cavernous Fistula
Intracranial Arterial And Venous Stenting
Embolization Of AV Malformation Of Brain Per Sitting With
Onyx
Carotid Stenting Single Stent With Protection Device
Balloon Retrograde Transvenous Obliteration Of Bleeding
Gastric Varices ( BRTO)
Subclavian, Iliac, Superficial Femoral Artery Stenting Each
With One Stent
Deep Venous Thrombolysis For DVT With IVC Filter
Tibial Angioplasty In Critical Limb Ischemia
Biliary Drainage Procedures - External Drainage And Stent
Placement - Single Metallic Stent
M5R1.1
M5R1.2
M5R1.3
M15W1.23
20000
25000
20000
100000
M5
M5
M5
M15
Infectious Diseases
Infectious Diseases
Infectious Diseases
Interventional Radiology
M5R1
M5R1
M5R1
M15W1
356 Interventional Radiology
M15
Interventional Radiology
M15W1
357 Interventional Radiology
M15
Interventional Radiology
M15W1
358 Interventional Radiology
M15
Interventional Radiology
M15W1
359 Interventional Radiology
360 Interventional Radiology
M15
M15
Interventional Radiology
Interventional Radiology
M15W1
M15W1
361 Interventional Radiology
M15
Interventional Radiology
M15W1
362 Interventional Radiology
M15
Interventional Radiology
M15W1
363 Interventional Radiology
M15
Interventional Radiology
M15W1
364 Interventional Radiology
M15
Interventional Radiology
M15W1
365 Interventional Radiology
366 Interventional Radiology
M15
M15
Interventional Radiology
Interventional Radiology
M15W1
M15W1
367 Interventional Radiology
M15
Interventional Radiology
M15W1
M15W1.24 100000
M15W1.28 100000
M15W1.32 150000
M15W1.33 150000
M15W1.31 150000
M15W1.29 150000
M15W1.30 150000
M15W1.22 100000
M15W1.7 125000
M15W1.6 125000
M15W1.8 120000
M15W1.15 100000
Sl. No
Category
Category
Code
Sub Category
Sub
Category
Code
Procedures
Mesenteric Artery Angioplasty & Stenting In Acute & Chronic
Mesenteric Ischemia - Single Stent
M15W1 Cortical Venous Sinus Thrombolysis
M15W1 Inferior Vena Cava Stenting Single Stent
Embolization Of AV Malformation Of Peripheral Extremity,
M15W1
Craniofascial And Visceral Per Sitting
M15W1
Procedure 100%
code
Rates
368 Interventional Radiology
M15
Interventional Radiology
369 Interventional Radiology
370 Interventional Radiology
M15
M15
Interventional Radiology
Interventional Radiology
371 Interventional Radiology
M15
Interventional Radiology
372 Interventional Radiology
M15
Interventional Radiology
M15W1 Hepatic Vein Stenting In Budd - Chiari Syndrome Single Stent M15W1.2 125000
373 Interventional Radiology
M15
Interventional Radiology
M15W1
374 Interventional Radiology
M15
Interventional Radiology
M15W1
375 Interventional Radiology
M15
Interventional Radiology
M15W1
376 Interventional Radiology
M15
Interventional Radiology
M15W1
377 Interventional Radiology
M15
Interventional Radiology
M15W1
378 Interventional Radiology
M15
Interventional Radiology
M15W1
379 Interventional Radiology
M15
Interventional Radiology
M15W1
380 Interventional Radiology
M15
Interventional Radiology
M15W1
381
382
383
384
Interventional Radiology
Interventional Radiology
Interventional Radiology
Interventional Radiology
M15
M15
M15
M15
Interventional Radiology
Interventional Radiology
Interventional Radiology
Interventional Radiology
M15W1
M15W1
M15W1
M15W1
385 Interventional Radiology
M15
Interventional Radiology
M15W1
386 Interventional Radiology
M15
Interventional Radiology
M15W1
387 Interventional Radiology
M15
Interventional Radiology
388 Interventional Radiology
M15
Interventional Radiology
M15W1 Trans Jugular Intrahepatic Portosystemic Shunt (TIPSS)
M15W1.26 150000
Gastrointestinal Visceral Arterial Embolization In Upper And
M15W1
M15W1.10 100000
Lower Gastrointestinal Bleeding With Microcatheter
389 Medical Oncology
M1
Lymphoma Nhl
M1K9
390 Medical Oncology
391 Medical Oncology
M1
M1
Multiple Myeloma
Multiple Myeloma
M1K10 Vincristin, Adriamycin,Dexamethasone (VAD)
M1K10 Thalidomide+Dexamethasone(Oral)
Renal Artery Embolization With Multiple Coils And
Microcatheter
Acute Stroke Thrombolysis With rTPA
Bronchial Artery Embolization In Hemoptysis Using PVA
And Micro Catheter
Intra-Arterial Thrombolysis For Acute Ischemic Limbs
Uterine Artery Embolization In Severe Menorrhagia
Secondary To PPH, Uterine Fibroids And AVM
Permanent Tunnelled Catheter Placement As Substitute For
AV Fistula In Long Term Dialysis
Endovascular Intervention For Salvaging Hemodialysis AV
Fistula
Central Venous Stenting For Central Venous Occlusion (
Brachiocephalic, Subclavian Vein And Sup Vena Cava) Single
Metallic Stent
Nephrostomy Tube And Nephroureteral Stent Placement
Embolization Of Postoperative And Post Traumatic Bleeding
Radiofrequency Tumor Ablation Therapy
Inferior Vena Cava Filter Placement
Percutaneous Vertebro Plasty/ Cementoplasty (For Each
Level) Post Procedure Evidence Of Clinical Photograph And
Radiographic Image
M15W1.9 110000
M15W1.5 100000
M15W1.1 125000
M15W1.34 90000
M15W1.4 100000
M15W1.3 100000
M15W1.11 60000
M15W1.18 100000
M15W1.17 80000
M15W1.19 40000
M15W1.21 120000
M15W1.20 125000
M15W1.16
M15W1.13
M15W1.12
M15W1.14
60000
100000
120000
100000
M15W1.25 50000
Embolization Of Pulmonary AV Malformation Post Procedure
M15W1.27 100000
Evidence Of Clinical Photograph And Radiographic Image
Cyclophosphamide Adriamycin Vincristin Prdnisone (CHOP)
M1K9.1
3500
M1K10.1
M1K10.2
4000
3000
Sl. No
Category
Category
Code
Sub Category
Sub
Category
Code
Procedures
Procedure 100%
code
Rates
M1K6.2
10000
Bone Tumors/Osteosarcoma
Lymphoma, Hodgkin'S
Cervix
5- Flurouracil-Oxaliplastin Leucovorin (Folfox) (Stage III
Only)
M1K7 Cisplastin/Adriamycin
M1K8 Adriamycin Bleomycin Vinblastin Dacarbazine (ABVD)
M1K13 Cervical Cancer Weekly Cisplastin
M1K7.1
M1K8.1
M1K13.1
20000
4000
2000
M1
Childhood B-Cell Lymphomas
M1K14 Variable Regimen Inv - Hematology - Payable maximum upto
M1K14.1
12000
397 Medical Oncology
M1
Neuroblastoma Stage I –Iii
M1K15
M1K15.1
9000
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
M1
M1
M1
M1
M1
M1
M1
M1
M1
M1
M1
M1
M1
M1
M1
Multiple Myeloma
Wilm'S Tumor
Hepatoblastoma -Operable
Colon Rectum
Breast
Breast
Breast
Breast
Breast
Breast
Small Cell Lung Cancer
Oncologyoesophagus
Stomach
Breast
Urinary Bladder
M1K10
M1K11
M1K12
M1K6
M1K1
M1K1
M1K1
M1K1
M1K1
M1K1
M1K3
M1K4
M1K5
M1K1
M1K2
M1K10.3
M1K11.1
M1K12.1
M1K6.1
M1K1.4
M1K1.5
M1K1.6
M1K1.1
M1K1.2
M1K1.3
M1K3.1
M1K4.1
M1K5.1
M1K1.7
M1K2.1
1500
7000
15000
4000
9500
1500
85
3000
3100
3000
7000
5000
5000
835
2000
413 Medical Oncology
M1
Urinary Bladder
M1K2
M1K2.2
5000
414 Medical Oncology
M1
Retinoblastoma
M1K16
M1K16.1
4000
415 Medical Oncology
M1
Febrile Neutropenia Fn High Risk 2
M1K27
M1K27.2
30000
416 Medical Oncology
417 Medical Oncology
418 Medical Oncology
M1
M1
M1
Vaginal Cancer
Ovary
Rectal Cancer Stage 2 And 3
M1K28
M1K29
M1K25
M1K28.1
M1K29.1
M1K25.1
5000
10500
4000
419 Medical Oncology
M1
Multiple Myeloma
M1K10 Zoledronic Acid Along With Adjuvant Chemotherapy Of AS-I M1K10.4
3000
420 Medical Oncology
M1
Febrile Neutropenia Fn High Risk 2
421 Medical Oncology
M1
422 Medical Oncology
M1
392 Medical Oncology
M1
Colon Rectum
393 Medical Oncology
394 Medical Oncology
395 Medical Oncology
M1
M1
M1
396 Medical Oncology
M1K6
Variable Regimen Inv - X-Ray/CT Scan - Payable maximum
upto/Per month
Melphalan Prednisone Oral
SIOP/NWTS Regimen (Stages I III) - Per month
Cisplastin Adriamycin
Monthly 5-FU
Paclitaxel
Cyclophosphamide / Methotraxate / 5flurouracil (CMF)
Tamoxifen Tabs - Per month
Adriamycin/Cyclophosphamide (Ac)
5- Flurouracil A-C (FAC)
AC (AC Then T)
Cisplastin/Etoposide (IIIB)
Cisplastin- 5FU
5-Fu Leucovorin (MCDONALD Regimen)
Aromatase Inhibitors - Per month
Bladder Cancer Weekly Cisplastin
Methotraxate Vinblastin Adriamycin Cyclophosphamide
(MVAC)
Carbo/Etoposide/Vincristin
2nd Line Iv Antibiotics And Other Supportive
Therapy(Carbapenems, Fourth Generation Cephalosporins,
Piperacillin, Anti-Fungal . Azoles Etc.,)
Cisplastin/5-FU
Carboplastin/ Paclitaxel
Xelox Along With Adjuvant Chemotherapy Of AS-I
1st Line Iv Antibiotics And Other Supportive Therapy ( Third
Generation Cephalosporin, Aminoglycoside Etc.,)
Etoposide - Methotrexate - Actinomycin / Cyclophosphamide
Gestational Trophoblast Ds. High Risk M1K32
Avincristine (EMA-CO)
Gestational Trophoblast Ds. Low Risk
M1K27
M1K31 Actinomycin
M1K27.1
9000
M1K32.1
6000
M1K31.2
3000
Sub
Category
Code
Procedure 100%
code
Rates
Category
Code
Sub Category
423 Medical Oncology
M1
Gestational Trophoblast Ds. Low Risk
M1K31 Weekly Methotrexate
M1K31.1
600
424
425
426
427
428
429
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
M1
M1
M1
M1
M1
M1
Ovary Germ Cell Tumour
Prostate
Testis
Acute Myeloid Leukemia
Acute Myeloid Leukemia
Acute Myeloid Leukemia
M1K30
M1K34
M1K33
M1K20
M1K20
M1K20
M1K30.1
M1K34.1
M1K33.1
M1K20.1
M1K20.2
M1K20.3
8000
3000
8000
60000
40000
3000
430 Medical Oncology
M1
Histocytosis
M1K17 Variable Regimen Inv - CT, Biopsy - Payable maximum upto
M1K17.1
10000
431 Medical Oncology
M1
Rhabdomyosarcoma
M1K18
M1K18.1
9000
432 Medical Oncology
M1
Ewing'S Sarcoma
M1K19
M1K19.1
8000
433 Medical Oncology
M1
Unlisted Regimen
M1K22
M1K22.1
5000
434
435
436
437
438
M1
M1
M1
M1
M1
Terminally Ill
Vulval Cancer
Acute Lymphatic Leukemia
Acute Lymphatic Leukemia
Acute Lymphatic Leukemia
M1K23
M1K24
M1K21
M1K21
M1K21
M1K23.1
M1K24.1
M1K21.3
M1K21.1
M1K21.2
3000
5000
3000
50000
20000
439 Nephrology
M8
Nephrology
M8T2
M8T2.5
15000
440 Nephrology
441 Nephrology
442 Nephrology
M8
M8
M8
Nephrology
Nephrology
Nephrology
M8T2
M8T2
M8T2
M8T2.3
M8T2.2
M8T2.4
15000
20000
35000
443 Nephrology
M8
Nephrology
M8T2
M8T2.6
10000
444 Neurology
445 Neurology
446 Neurology
M9
M9
M9
Neurology
Neurology
Neurology
M9T3
M9T3
M9T3
447 Neurology
M9
Neurology
M9T3
448 Neurology
M9
Neurology
M9T3
449 Neurology
M9
Neurology
M9T3
450 Neurology
M9
Neurology
M9T3
451 Neurology
M9
Neurology
M9T3
Sl. No
Category
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Medical Oncology
Procedures
Bleomycin-Etoposide-Cisplastin (BEP)
Hormonal Therapy - Per month
Bleomycin-Etoposide-Cisplastin (BEP)
Induction Phase - Payable maximum upto
Consolidation Phase - Payable maximum upto
Maintenance Phase - Per month
Vincristin-Actinomycin- Cyclophosphamide (VACTC) Based
Chemo - Per month
Variable Regimen Inv - Hematology, Biopsy - Payable
maximum upto
Palliative Chemotherapy -Unlisted Regimen - Payable
maximum upto per cycle
Palliative And Supportive Therapy - Per month
Cisplastin/5-FU
Maintenance Phase - Per month
Induction 1st And 2 nd Months - Payable maximum upto
Induction 3rd, 4th, 5th months - Payable maximum upto
Chronic Renal Failure (CRF) - 5 Days Stay for Initial
treatment and Dialysis and supportive therapy
Nephrotic Syndrome - 4 Days Stay
Acute Renal Failure-(ARF) -10 Days Stay In MICU
Rapidly Progressive Renal Failure (RPRF)10 Days
Maintenance Haemodialysis For CRF- Dialysis and supportive
therapy (Minimum of 8 dialysis+monthly Dialysis Panel) - Per
Month
Neuromuscular (Myasthenia Gravis)-15 Days Stay
Immunoglobulin Therapy -5 Days Stay
Optic Neuritis - Analysis 3 Days Stay
Neuroinfections - Fungal Meningitis- Min 20 Days - ICU, 40
Days - Ward Stay
Myopathies - Acquired NCS, 15 Days Stay
Neuroinfections - Viral Meningoencephalitis (Including
Herpes Encephalitis) - Min 10 Days - ICU, 7 Days - Ward
Stay
Neuropathies (GBS) - 10 Days – ICU 20 Days - Ward Stay
Neuroinfections - Pyogenic Meningitis -Min 10 Days - ICU, 7
Days - Ward Stay
M9T3.8 15000
M9T3.11 100000
M9T3.10 10000
M9T3.5
40000
M9T3.4
15000
M9T3.7
25000
M9T3.9
35000
M9T3.6
25000
Sl. No
Category
Category
Code
Sub Category
452 Neurology
453 Neurology
M9
M9
Neurology
Neurology
454 Neurology
M9
Neurology
455 Neurology
M9
Neurology
456
457
458
459
460
461
462
463
464
465
466
467
468
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
Epilepsy Surgery
Trigeminal Neuralgia
Trigeminal Neuralgia
Epilepsy Surgery
Epilepsy Surgery
Epilepsy Surgery
Spine
Brain
Brain
Brain
Spine
Brain
Other Surgical Procedures
469 Neurosurgery
S10
Other Surgical Procedures
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
Spinal Surgeries
Other Surgical Procedures
Other Surgical Procedures
Other Surgical Procedures
Spine
Spine
Management Of Aneurysms
Management Of Aneurysms
Brain Tumours
Brain Tumours
Spinal Surgeries
Brain Tumours
Brain Tumours
Brain Tumours
Brain Tumours
Brain Tumours
Brain Tumours
Spinal Surgeries
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Sub
Procedure 100%
Procedures
Category
code
Rates
Code
M9T3 ADEM Or Relapse In Multiple Sclerosis 15 Days Stay
M9T3.12 20000
M9T3 CIDP -10 Days Stay
M9T3.1
8000
Haemorrhagic Stroke/Strokes Management with all necessary
M9T3 investigations including 4- vessel cerebral angio (DSA), &
M9T3.2 25000
Surgery if necessary
Ischemic Strokes-Management with all necessary
M9T3 investigations including 4- vessel cerebral angio (DSA), &
M9T3.3 20000
Surgery if necessary
S10I10 Temporal Lobectomy Plus Depth Electrodes
S10I10.4 140000
S10I11 Radiofrequency Ablation
S10I11.1 30000
S10I11 Micro Vascular Decompression
S10I11.2 60000
S10I10 Temporal Lobectomy
S10I10.1 90000
S10I10 Lesionectomy Type 1
S10I10.2 150000
S10I10 Lesionectomy Type 2
S10I10.3 150000
S10I8 Spinal Fixation Rods And Plates, Artificial Discs
S10I8.4 85000
S10I1 De-Compressive Craniotomy(Non Traumatic)
S10I1.6 50000
S10I1 Endoscopy Procedures
S10I1.5 65000
S10I1 Intra-Cerebral Hematoma Evacuation
S10I1.7 60000
S10I8 Anterior Discectomy & Bone Grafting
S10I8.1 40000
S10I1 Endoscopic Third Ventriculostomy
S10I1.8 30000
S10I6 C.V. Junction Fusion
S10I6.5 20000
Stereotactic Procedures - Post Procedure Evidence Of Clinical
S10I6
S10I6.1 20000
Photograph
S10I5 Spinal Fusion Procedure
S10I5.12 50000
S10I6 Trans Sphenoidal Surgery
S10I6.2 20000
S10I6 Combined Trans Oral Surgery And CV Junction Fusion
S10I6.4 30000
S10I6 Trans Oral Surgery
S10I6.3 25000
S10I8 Discectomy With Implants
S10I8.2 65000
S10I8 Corpectomy For Spinal Fixation
S10I8.3 70000
S10I12 Cost Of Each Coil
S10I12.2 30000
S10I12 Embolization
S10I12.1 50000
S10I2 Aneurysm Clipping
S10I2.12 100000
S10I2 Excision Of Brain Abscess
S10I2.11 60000
S10I5 Surgery On Cord Tumours
S10I5.1 25000
S10I2 External Ventricular Drainage (EVD)
S10I2.13 40000
S10I2 Ventriculoatrial Shunt
S10I2.10 20000
S10I2 C.S.F. Rhinorrhoea
S10I2.7 20000
S10I2 Meningomylocele
S10I2.6 25000
S10I2 Meningocele Excision
S10I2.9 25000
S10I2 Cranioplasty
S10I2.8 30000
S10I5 Anterior Cervical Spine Surgery With Fusion
S10I5.8 45000
Sl. No
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
Category
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Neurosurgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Category
Code
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S10
S3
S3
S3
S3
S3
S3
Sub Category
Spinal Surgeries
Spinal Surgeries
Spinal Surgeries
Spinal Surgeries
Spinal Surgeries
Spinal Surgeries
Spinal Surgeries
Spinal Surgeries
Brain Tumours
Brain Tumours
Brain Tumours
Excision Of Brain Tumours
Brain Tumours
Brain Tumours
Brain
Brain
Brain
Brain
Excision Of Brain Tumours
Excision Of Brain Tumours
Excision Of Brain Tumours
Excision Of Brain Tumours
Excision Of Brain Tumours
Excision Of Brain Tumours
Excision Of Brain Tumours
Excision Of Brain Tumours
Excision Of Brain Tumours
Spinal Surgeries
Soft Tissue And Vascular Injuries
Soft Tissue And Vascular Injuries
Soft Tissue And Vascular Injuries
Spine
Soft Tissue And Vascular Injuries
Soft Tissue And Vascular Injuries
Soft Tissue And Vascular Injuries
Orbit
Squint Correction Surgery
Cornea Sclera
Cornea Sclera
Cornea Sclera
Vitreo
Sub
Category
Code
S10I5
S10I5
S10I5
S10I5
S10I5
S10I5
S10I5
S10I5
S10I2
S10I2
S10I2
S10I3
S10I2
S10I2
S10I1
S10I1
S10I1
S10I1
S10I3
S10I3
S10I3
S10I3
S10I3
S10I3
S10I3
S10I3
S10I3
S10I5
S10I9
S10I9
S10I9
S10I8
S10I9
S10I9
S10I9
S3B7
S3B8
S3B5
S3B5
S3B5
S3B6
Procedures
Anterior Cervical Discectomy
Laminectomy
Anterolateral Decompression
Posterior Cervical Discectomy
Spina Bifida Surgery Major
Spinal Intramedullary Tumours
Excision Of Cervical Intervertebral Discs
Spina Bifida Surgery Minor
Meningoencephalocele
Brain Stem Tumour
Basal Brain Tumour
Other Procedures
C P Angle Tumour
Parasagittal Tumour
Craniotomy And Evacuation Of Hematoma Extradural
Craniotomy And Evacuation Of Hematoma Subdural
Excision Of Lobe (Frontal, Temporal, Cerebellum Etc.)
Evacuation Of Brain Abscess - Burr Hole
Vascular Malformations
Abscess Tapping
Atrial Shunt
Peritoneal Shunt
Ventricular Tapping
Ventriculolateral / Ventriculoperitoneal Shunt
Excision Of Brain Tumours Subtentorial
Subdural Tapping
Twist Drill Craniotomy
Discectomy
Lumbar Sympathectomy
Decompression/Excision Of Optic Nerve Lesions
Peripheral Nerve Injury Repair
Syringomyelia
Repair Of Brachial Plexus Injury
Cervical Sympathectomy
Proptosis
Enuleation With Orbital Implant
Rectus Muscle Surgery Single.
Corneal Patch Graft
Scleral Patch Graft
Penetrating Keratoplasty
Removal Of Silicon Oil Or Gas
Procedure 100%
code
Rates
S10I5.7
S10I5.10
S10I5.9
S10I5.6
S10I5.3
S10I5.2
S10I5.5
S10I5.4
S10I2.5
S10I2.3
S10I2.2
S10I3.1
S10I2.4
S10I2.1
S10I1.2
S10I1.1
S10I1.4
S10I1.3
S10I3.8
S10I3.7
S10I3.10
S10I3.9
S10I3.6
S10I3.3
S10I3.2
S10I3.5
S10I3.4
S10I5.11
S10I9.3
S10I9.4
S10I9.5
S10I8.5
S10I9.1
S10I9.2
S10I9.6
S3B7.4
S3B8.1
S3B5.3
S3B5.4
S3B5.5
S3B6.5
15000
15000
30000
15000
20000
50000
25000
15000
25000
70000
60000
40000
70000
50000
40000
40000
40000
25000
40000
20000
20000
20000
15000
20000
45000
15000
15000
15000
50000
65000
40000
65000
60000
50000
60000
20000
6000
4000
6000
15000
6000
Sl. No
Category
Category
Code
Sub Category
Sub
Procedures
Category
Code
S3B6 Vitrectomy Plus Silicon Oil Or Gas.
S3B11 Photocoagulation For Diabetic Retinopathy Per Sitting
S3B5 Double Z Plasty
Monthly Intravitreal Anti-VEGF For Macular Degeneration S3B6
Per Injection (Maximum – 6)
Vitrectomy - Membrane Peeling Endolaser , Silicon Oil Or
S3B6
Gas
S3B11 Scleral Buckle For Retinal Detachment
S3B5 Amniotic Membrane Graft
S3B6 Vitrectomy
S3B6 Vitrectomy + Membrane Peeling+ Endolaser
S3B10 Photocoagulation For Retinopathy Of Prematurity
S3B9 Lid Reconstruction Surgery
S3B5 Therapeutic Penetrating Keratoplasty
S3B10 Pediatric Cataract Surgery - Phacoemulsification – IOL
S3B10 Glaucoma Filtering Surgery For Paediatric Glaucoma
S3B5 Lamellar Keratoplasty
S3B8 Oblique Muscle
S3B7 Orbitotomy
S3B8 Rectus Muscle Surgery Two/Three
S3B7 Socket Reconstruction
S3B7 Dermis Fat Graft
529 Ophthalmology Surgery
530 Ophthalmology Surgery
531 Ophthalmology Surgery
S3
S3
S3
Vitreo
Retina
Cornea Sclera
532 Ophthalmology Surgery
S3
Vitreo
533 Ophthalmology Surgery
S3
Vitreo
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
S3
S3
S3
S3
S3
S3
S3
S3
S3
S3
S3
S3
S3
S3
S3
Retina
Cornea Sclera
Vitreo
Vitreo
Pediatric Ophthalmic Surgery
Lid Surgery
Cornea Sclera
Pediatric Ophthalmic Surgery
Pediatric Ophthalmic Surgery
Cornea Sclera
Squint Correction Surgery
Orbit
Squint Correction Surgery
Orbit
Orbit
549 Orthopedic Surgery And Procedures
S5
Orthopedics Spine Surgery
S5D4
550 Orthopedic Surgery And Procedures
S5
Orthopedics Bone And Joint Surgery
Procedures
551 Orthopedic Surgery And Procedures
S5
552 Orthopedic Surgery And Procedures
Procedure 100%
code
Rates
S3B6.6
S3B11.2
S3B5.6
20000
1500
4000
S3B6.3
7000
S3B6.4
30000
S3B11.1
S3B5.7
S3B6.1
S3B6.2
S3B10.1
S3B9.1
S3B5.1
S3B10.2
S3B10.3
S3B5.2
S3B8.3
S3B7.3
S3B8.2
S3B7.1
S3B7.2
15000
7000
6000
25000
7500
15000
15000
15000
15000
3000
6000
10000
12000
7000
9000
Spinal Ostectomy And Internal Fixations
S5D2.12
40000
S5D3
Arthroscopy. Operative Meniscectomy
S5D2.6
25000
Orthopedics Bone Tumours
S5D6
Excision Of Bone Tumours. Deep With Re-Construction With
Conventional Prosthesis
S5D6.1
40000
S5
Orthopedics Soft Tissue Surgery
S5D5
Operations For Brachial Plexus & Cervical Rib
S5D2.15
30000
553 Orthopedic Surgery And Procedures
S5
Orthopedics Spine Surgery
S5D4
Costo Transversectomy
S5D2.11
30000
554 Orthopedic Surgery And Procedures
S5
Orthopedics Bone And Joint Surgery
Procedures
S5D3
Soft Tissue Reconstruction Procedures For Joints/Osteotomy
S5D2.9
30000
555 Orthopedic Surgery And Procedures
S5
Orthopedics Spine Surgery
S5D4
Anterolateral Clearance For Tuberculosis
S5D2.10
50000
556 Orthopedic Surgery And Procedures
S5
Orthopedics Soft Tissue Surgery
S5D5
Neurolysis/Nerve Suture
S5D2.14
25000
557 Orthopedic Surgery And Procedures
S5
Orthopedics Fracture Correction
Surgeries
S5D1
Reduction Of Compound Fractures & External Fixation
S5D1.4
15000
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Ophthalmology Surgery
Sl. No
Category
Category
Code
558 Orthopedic Surgery And Procedures
S5
559 Orthopedic Surgery And Procedures
S5
560 Orthopedic Surgery And Procedures
S5
561 Orthopedic Surgery And Procedures
S5
562 Orthopedic Surgery And Procedures
S5
563 Orthopedic Surgery And Procedures
Sub Category
Orthopedics Fracture Correction
Surgeries
Orthopedics Fracture Correction
Surgeries
Orthopedics Fracture Correction
Surgeries
Orthopedics Fracture Correction
Surgeries
Sub
Category
Code
Procedures
Procedure 100%
code
Rates
S5D1
Bone Grafting As Exclusive Procedure
S5D1.1
20000
S5D1
Open Reduction & Internal Fixation Of Fingers & Toes
@Rs5000 Each Up To Maximum Of Rs 15000
S5D1.3
15000
S5D1
Excision Or Other Operations For Scaphoid Fractures
S5D1.2
15000
S5D1
Ilizarov Ring Fixator Application.
S5D1.5
40000
Orthopedics
S5D2
Amputations - Hind Quarter And Hemipelvectomy
S5D2.3
40000
S5
Orthopedics Bone And Joint Surgery
Procedures
S5D3
Arthrodesis Of - Major Joints
S5D2.4
30000
564 Orthopedic Surgery And Procedures
S5
Orthopedics
S5D2
Amputations - Forequarter
S5D2.2
30000
565 Orthopedic Surgery And Procedures
S5
Orthopedics Fracture Correction
Surgeries
S5D1
CTEV Neglected. JESS Fixator
S5D1.6
30000
566 Orthopedic Surgery And Procedures
S5
Orthopedics
S5D2
Open Reduction Of Dislocations - Deep
S5D2.1
30000
567 Orthopedic Surgery And Procedures
S5
Orthopedics Bone And Joint Surgery
Procedures
S5D3
Arthroscopy - ACL Repair
S5D2.7
30000
568 Orthopedic Surgery And Procedures
S5
Orthopedics Soft Tissue Surgery
S5D5
Nerve Repair With Grafting
S5D2.13
25000
569 Orthopedic Surgery And Procedures
S5
S5D3
Arthroscopy - Diagnostic
S5D2.5
20000
570 Orthopedic Surgery And Procedures
S5
S5D3
Avascular Necrosis Of Femoral Head (Core Decompression)
S5D2.8
15000
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
S8
S8
S8
S8
S8
S8
S8
S8
S8
S8
S8
S8
S8
S8
S8
S8G5
S8G1
S8G5
S8G5
S8G5
S8G5
S8G5
S8G5
S8G5
S8G5
S8G6
S8G6
S8G6
S8G6
S8G6
Intussusception
Anorectal Malformations Stage 1
Paediatric Acute Intestinal Obstruction
Laparoscopic Choleycystectomy
Laparoscopic Appendectomy
Paediatric Splenectomy (Non Traumatic)
Laparoscopic Pull Through Surgeries For HD
Surgeries On Adrenal Gland In Children
Hydatid Cysts In Paediatric Patient
Gastro Esophageal Reflux Correction
Undescended Testis
Scrotal Transposition Repair
Torsion Testis
Laparoscopic Varicocele Ligation
Laparoscopic Orchidopexy
S8G5.8
S8G1.5
S8G5.9
S8G5.11
S8G5.10
S8G5.3
S8G5.2
S8G5.4
S8G5.6
S8G5.5
S8G6.4
S8G6.3
S8G6.5
S8G6.7
S8G6.6
40000
45000
40000
40000
30000
35000
60000
25000
40000
30000
25000
20000
25000
25000
25000
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Orthopedics Bone And Joint Surgery
Procedures
Orthopedics Bone And Joint Surgery
Procedures
Abdomen
Congenital Malformations - Gi Tract
Abdomen
Abdomen
Abdomen
Abdomen
Abdomen
Abdomen
Abdomen
Abdomen
Urogenital
Urogenital
Urogenital
Urogenital
Urogenital
Sl. No
586
587
588
589
590
591
592
Category
Category
Code
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
S8
S8
S8
S8
S8
S8
S8
593 Pediatric Surgery
S8
594 Pediatric Surgery
S8
595 Pediatric Surgery
S8
596 Pediatric Surgery
S8
597 Pediatric Surgery
S8
598 Pediatric Surgery
S8
599 Pediatric Surgery
S8
600
601
602
603
604
605
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
S8
S8
S8
S8
S8
S8
606 Pediatric Surgery
S8
607 Pediatric Surgery
608 Pediatric Surgery
S8
S8
609 Pediatric Surgery
S8
610 Pediatric Surgery
S8
611 Pediatric Surgery
S8
612 Pediatric Surgery
S8
613 Pediatric Surgery
S8
614 Pediatric Surgery
S8
Sub Category
Chest
Abdomen
Abdomen
Urogenital
Urogenital
Chest
Chest
Congenital Malformations
–Urogenital
Chest
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Chest
Head And Neck
Chest
Chest
Head And Neck
Head And Neck
Congenital Malformations
–Urogenital
Head And Neck
Head And Neck
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations - Gi Tract
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Sub
Category
Code
S8G4
S8G5
S8G5
S8G6
S8G6
S8G4
S8G4
Procedures
Procedure 100%
code
Rates
Thoracic Wall Defects- Correction
Gastric Outlet Obstructions
Laparoscopic Pull Through For Ano Rectal Anomalies
Epispadiasis - Correction
Nephrectomy
Thoracoscopic Decortication
Thoracoscopic Cysts Excision
S8G4.7
S8G5.1
S8G5.12
S8G6.2
S8G6.1
S8G4.5
S8G4.4
50000
30000
60000
40000
40000
40000
40000
S8G2
Hemangioma Excision
S8G2.17
25000
S8G4
Thoracic Duplications
S8G4.6
40000
S8G2
Hamartoma Excision
S8G2.16
20000
S8G2
Microtia/ Anotia
S8G2.13
30000
S8G2
Syndactyly Of Hand For Each Hand
S8G2.12
15000
S8G2
Hypospadius Stage 1
S8G2.15
35000
S8G2
TM Joint Ankylosis
S8G2.14
40000
S8G4
S8G3
S8G4
S8G4
S8G3
S8G3
Bronchoscopy Foreign Body Removal
Sinuses & Fistula Of The Neck
Paediatric Esophageal Substitutions
Paediatric Esophageal Obstructions- Surgical Correction
Encephalocele
Neuroblastoma
S8G4.1
S8G3.5
S8G4.3
S8G4.2
S8G3.4
S8G3.1
20000
20000
60000
30000
20000
25000
S8G2
Lymphangioma Excision
S8G2.18
40000
S8G3
S8G3
Cystic Lesions Of The Neck
Congenital Dermal Sinus
S8G3.3
S8G3.2
20000
30000
S8G2
Velo-Pharyngial Incompetence
S8G2.11
15000
S8G2
Ureteric Reimplantations
S8G2.2
65000
S8G2
Extrophy Bladder Stage 1
S8G2.3
65000
S8G1
Hirschsprung Disease Stage 2
S8G1.8
60000
S8G2
Congenital Hydronephrosis
S8G2.1
50000
S8G2
Extrophy Bladder Stage 2
S8G2.4
60000
Sl. No
Category
Category
Code
Sub Category
Sub
Category
Code
Procedures
S8
S8
S8
S8
S8
M6
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations - Gi Tract
Congenital Malformations - Gi Tract
Congenital Malformations
–Urogenital
Congenital Malformations
–Urogenital
Congenital Malformations - Gi Tract
Congenital Malformations - Gi Tract
Congenital Malformations - Gi Tract
Congenital Malformations - Gi Tract
Abdomen
General Paediatrics Renal
S8G1
S8G1
S8G1
S8G1
S8G5
M6S12
629 Pediatrics Medical Management
M6
Gen Paediatrics Cvs
M6S11
630 Pediatrics Medical Management
M6
Gen Paediatrics Cvs
M6S11
631 Pediatrics Medical Management
M6
Gen Paediatrics Cvs
M6S11
632 Pediatrics Medical Management
M6
Gen Paediatrics Cvs
M6S11
633 Pediatrics Medical Management
M6
General Paediatrics Infections
M6S14
634 Pediatrics Medical Management
635 Pediatrics Medical Management
M6
M6
General Paediatrics Infections
General Paediatrics Infections
M6S14
M6S14
636 Pediatrics Medical Management
M6
General Paediatrics Infections
M6S14 Suspected Dengue Shock Syndrome With Thrombocytopenia
637 Pediatrics Medical Management
M6
General Paediatrics Severe Anemia
638 Pediatrics Medical Management
M6
General Paediatrics Severe Anemia
639 Pediatrics Medical Management
M6
General Paediatrics Infections
640 Pediatrics Medical Management
M6
General Paediatrics Severe Anemia
615 Pediatric Surgery
S8
616 Pediatric Surgery
S8
617 Pediatric Surgery
S8
618 Pediatric Surgery
S8
619 Pediatric Surgery
620 Pediatric Surgery
S8
S8
621 Pediatric Surgery
S8
622 Pediatric Surgery
S8
623
624
625
626
627
628
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatric Surgery
Pediatrics Medical Management
Procedure 100%
code
Rates
S8G2
Hypospadius Stage 2
S8G2.7
35000
S8G2
Pediatric Tumours
S8G2.8
50000
S8G2
Posterior Urethral Valves
S8G2.5
30000
S8G2
Hypospadias Single Stage
S8G2.6
40000
S8G1
S8G1
Oesophageal Atresis
Diaphragmatic Hernia
S8G1.1
S8G1.2
60000
60000
S8G2
Cleft Palate
S8G2.10
15000
S8G2
Cleft Lip
S8G2.9
10000
S8G1.3
S8G1.6
S8G1.7
S8G1.4
S8G5.7
M6S12.3
50000
60000
45000
55000
50000
10000
M6S11.2
15000
M6S11.1
20000
M6S11.4
15000
M6S11.3
15000
M6S14.3
20000
M6S14.2
M6S14.5
10000
10000
M6S14.4
20000
M6S13.2
20000
M6S13.1
20000
M6S14.1
35000
M6S13.3
10000
Intestinal Atresias & Obstructions
Anorectal Malformations Stage 2
Hirschsprung Disease Stage 1
Biliary Atresis & Choledocal Cyst
Intestinal Polyposis Surgical Correction
Acute Renal Failure 10 Days Stay
Congenital Heart Disease With Congestive Cardiac Failure - 7
Days
Acute Broncho/ Lobarpneumonia With Pyo Pneumothorax 14
Days
Viral Myocarditis 7 Days Stay
Acquired Heart Disease With Congestive Cardiac Failure- 7
Days Stay
Neuro Tuberculosis With Ventilation- 12 Days Stay - DOTS
Rx Free
Neuro Tuberculosis- 12 Days Stay - DOTS Rx Free
Cerebral Malaria (Falciparum) 7 Days Stay
Haemophilia Including treatment with blood & blood
products, factor concentrate & 7 Days Stay
Thalassemia Major Requiring Chelation Therapy - 7 Days
M6S13
Stay - Payable maximum upto
M6S14 Pyogenic Meningitis With 10 Days Stay
Anaemia Of Unknown Cause treated with Haematinics, Blood
M6S13 Transfusion etc for minimum 5 Days Stay - Payable
maximum upto
M6S13
Sl. No
Category
Category
Code
Sub Category
Sub
Category
Code
Procedures
Acute Broncho/ Lobarpneumonia With Empyema/ Pleural
Effusion
Febrile Seizures (Atypical- Mechanical Ventilated)
Status Epilepticus
Acute Gastro Intestinal Bleed Inv - ABG/Upper GI
Endoscopy, USG Abdomen 10 Days PICU Stay With Post
Treatment Evidence For Clinical Improvement With Lab
Investigations
Intra Cranial Bleed
Infective Endocarditis
Cardiogenic Shock
Meningo- Encephalitis (Ventilated)
Meningo-Encephalitis (Non Ventilated)
Snake Bite Requiring Ventilatory Assistance With 10 Days
PICU Stay
Septic Shock- 10 Days PICU Stay
Poison Ingestion/ Aspiration Requiring Ventilatory Assistance
7 Days PICU Stay
Scorpion Sting With Myocarditis And Cardiogenic Shock
Requiring Ventilatory Assistance 10 Days ICU Stay
Acute Hepatitis With Hepatic Encephalopathy – 10 Days
PICU Stay
Acute Pancreatitis - 10 Days PICU Stay
Diabetic Ketoacidosis - 8 Days PICU Stay
Acute Renal Failure With Dialysis - 10 Days PICU Stay
641 Pediatrics Medical Management
M6
Gen Paediatrics Respiratory
M6S10
642 Pediatrics Medical Management
643 Pediatrics Medical Management
M6
M6
Pediatric Ic Care Cns
Pediatric Ic Care Cns
M6S4
M6S4
644 Pediatrics Medical Management
M6
Pediatric Ic Care Git
M6S5
645
646
647
648
649
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
M6
M6
M6
M6
M6
Pediatric Ic Care Cns
Pediatric Ic Care Cardiovascular
Pediatric Ic Care Cardiovascular
Pediatric Ic Care Cns
Pediatric Ic Care Cns
M6S4
M6S3
M6S3
M6S4
M6S4
650 Pediatrics Medical Management
M6
Pediatric Ic Care Toxicology
M6S9
651 Pediatrics Medical Management
M6
Pediatric Ic Care Infection
M6S8
652 Pediatrics Medical Management
M6
Pediatric Ic Care Toxicology
M6S9
653 Pediatrics Medical Management
M6
Pediatric Ic Care Toxicology
M6S9
654 Pediatrics Medical Management
M6
Pediatric Ic Care Git
M6S5
655 Pediatrics Medical Management
656 Pediatrics Medical Management
657 Pediatrics Medical Management
M6
M6
M6
Pediatric Ic Care Git
Pediatric Ic Care Endocrine
Pediatric Ic Care Renal
M6S5
M6S7
M6S6
658 Pediatrics Medical Management
M6
General Paediatrics Neurology
M6S15 Convulsive Disorders/Status EpileptICUs (Fits) - 7 Days Stay
659 Pediatrics Medical Management
M6
Paediatrics Neonatal
M6S1
660 Pediatrics Medical Management
M6
Paediatrics Neonatal
M6S1
661 Pediatrics Medical Management
M6
Paediatrics Neonatal
M6S1
662 Pediatrics Medical Management
M6
Paediatrics Neonatal
M6S1
663 Pediatrics Medical Management
M6
Paediatrics Neonatal
M6S1
33 To 34 Weeks Preterm Baby Severe Hyaline Membrane
Disease Clinical Sepsis Bubble CPAP Hyperbilirubinemia
33 To 34 Weeks Preterm Baby Severe Hyaline Membrane
Disease With Clinical Sepsis, Mechanical Ventilation
Hyperbilirubinemia
Necrotising Enterocolitis, Clinical Sepsis Non Ventilated
Hyperbilirubinemia
Term Baby, Fulminant Culture Positive Sepsis, Septic Shock,
Ventilated, Hyperbilirubinemia Renal Failure
33 To 34 Weeks Preterm Severe Hyaline Membrane Disease
Culture Positive Sepsis Mechanical Ventilation/ Bubble CPAP
Hyperbilirubinemia.- 6 weeks stay
Procedure 100%
code
Rates
M6S10.1
20000
M6S4.4
M6S4.3
25000
30000
M6S5.1
30000
M6S4.5
M6S3.5
M6S3.4
M6S4.2
M6S4.1
40000
50000
50000
60000
40000
M6S9.1
50000
M6S8.1
50000
M6S9.3
40000
M6S9.2
25000
M6S5.3
50000
M6S5.2
M6S7.1
M6S6.1
50000
30000
40000
M6S15.1
10000
M6S1.11
40000
M6S1.12
60000
M6S1.9
25000
M6S1.10
40000
M6S1.15
60000
Sl. No
Category
Category
Code
Sub Category
664 Pediatrics Medical Management
M6
Paediatrics Neonatal
665 Pediatrics Medical Management
M6
Paediatrics Neonatal
666 Pediatrics Medical Management
M6
Paediatrics Neonatal
667 Pediatrics Medical Management
M6
Paediatrics Neonatal
668 Pediatrics Medical Management
M6
Paediatrics Neonatal
669 Pediatrics Medical Management
M6
Paediatrics Neonatal
670 Pediatrics Medical Management
M6
Paediatrics Neonatal
671 Pediatrics Medical Management
M6
Paediatrics Neonatal
672 Pediatrics Medical Management
M6
Paediatrics Neonatal
673 Pediatrics Medical Management
M6
Paediatrics Neonatal
674 Pediatrics Medical Management
M6
Paediatrics Neonatal
675 Pediatrics Medical Management
M6
Paediatrics Neonatal
676
677
678
679
680
681
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
M6
M6
M6
M6
M6
M6
Pediatric Ic Care Cardiovascular
Pediatric Ic Care Cardiovascular
Pediatric Ic Care Respiratory
Pediatric Ic Care Respiratory
General Paediatrics Neurology
General Paediatrics Neurology
682 Pediatrics Medical Management
M6
Pediatric Ic Care Cardiovascular
683 Pediatrics Medical Management
684 Pediatrics Medical Management
M6
M6
General Paediatrics Neurology
Pediatric Ic Care Respiratory
Sub
Category
Code
Procedures
30 To 32 Weeks Preterm Severe Hyaline Membrane Disease
Clinical/ Culture Positive Sepsis Mechanical Ventilation
Hyperbilirubinemia- 8 weeks stay
35 To 36 Weeks Preterm Mild Hyaline Membrane Disease
M6S1
Culture Positive Sepsis Nonventilated Hyperbilirubinemia
33 To 34 Weeks Preterm Mild Hyaline Membrane Disease
M6S1
Culture Positive Sepsis – Nonventilated Hyperbilirubinemia
<30 Weeks Preterm Severe Hyaline Membrane Disease
Clinical/Culture Positive Sepsis Patent Ductus Arteriosus M6S1
Medical Management Mechanical Ventilation
Hyperbilirubinemia
Term Baby With Persistent Pulmonary Hypertension
M6S1
Ventilation- HFO Hyperbilirubinemia Clinical Sepsis
Term Baby With Culture Positive Sepsis- Non Ventilated
M6S1
Hyperbilirubinemia
30 To 32 Weeks Preterm Severe Hyaline Membrane Disease
M6S1 Clinical Sepsis Patent Ductus Arteriosus - Medical
Management Mechanical Ventilation Hyperbilirubinemia
M6S1 Term Baby Severe Hyperbilirubinemia Clinical Sepsis
Term Baby With Seizures Ventilated Inv - Neurosonogram,
CT-Scan Brain, Ultrasound Abdomen, CSF Analysis , Blood
M6S1 Ammonia , Lactate, Metabolilc Screening-Blood And Urine
ABG , Blood Culture, 10 Days Stay With Post Treatment
Evidence Of Clinical Improvement And Lab Investigations
Term Baby With Severe Perinatal Asphyxia - Non Ventilated
M6S1
Clinical Sepsis Hyperbilirubinemia
Term Baby With Severe Perinatal Asphyxia - Ventilated
M6S1
Clinical Sepsis Hyperbilirubinemia
<30 Weeks Preterm Severe Hyaline Membrane Disease
M6S1 Clinical/ Culture Positive Sepsis Mechanical Ventilation
Hyperbilirubinemia- 10 weeks stay
M6S3 Severe Myocarditis
M6S3 Congenital Heart Disease With Infection (Non Ventilated)
M6S2 ARDS With Multi- Organ Failure
M6S2 ARDS Plus DIC (Blood & Blood Products)
M6S15 Encephalitis / Encephalopathy - 10 Days Stay
M6S15 Stroke Syndrome-14 Days Stay
Congenital Heart Disease With Infection And Cardiogenic
M6S3
Shock (Ventilated)
M6S15 Guillian-Barre Syndrome- 15 Days Stay
M6S2 Severe Bronchiolitis (Non Ventilated)
M6S1
Procedure 100%
code
Rates
M6S1.16
90000
M6S1.13
35000
M6S1.14
45000
M6S1.3
90000
M6S1.4
80000
M6S1.1
25000
M6S1.2
90000
M6S1.7
25000
M6S1.8
25000
M6S1.5
25000
M6S1.6
40000
M6S1.17
90000
M6S3.1 40000
M6S3.2 30000
M6S2.8 100000
M6S2.9 120000
M6S15.3 15000
M6S15.2 20000
M6S3.3
50000
M6S15.4
M6S2.2
60000
15000
Sl. No
Category
Category
Code
Sub Category
685 Pediatrics Medical Management
M6
Pediatric Ic Care Respiratory
686 Pediatrics Medical Management
M6
Paediatrics Neonatal
687
688
689
690
691
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
Pediatrics Medical Management
M6
M6
M6
M6
M6
Pediatric Ic Care Respiratory
Pediatric Ic Care Respiratory
Pediatric Ic Care Respiratory
Pediatric Ic Care Respiratory
Pediatric Ic Care Respiratory
692 Pediatrics Medical Management
M6
General Paediatrics Renal
693 Pediatrics Medical Management
M6
General Paediatrics Renal
694 Pediatrics Medical Management
695 Plastic Surgery
696 Plastic Surgery
M6
S12
S12
General Paediatrics Renal
Plastic Surgery
Plastic Surgery
697 Plastic Surgery
S12
Plastic Surgery
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
S12
S12
S12
S12
S12
S12
S12
S12
S12
S12
S12
S12
S12
S12
S12
S12
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Orthopedic And Facial Trauma
Wound Management For Compound
Fractures
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Plastic Surgery
Sub
Procedures
Category
Code
M6S2 Severe Bronchopneumonia (Non Ventilated)
33 To 34 Weeks Preterm Severe Hyaline Membrane Disease
Clinical/Culture Positive Sepsis Patent Ductus ArteriosusM6S1
Medical Management Mechanical Ventilation
Hyperbilirubinemia
M6S2 Severe Bronchiolitis (Ventilated)
M6S2 Severe Aspiration Pneumonia (Non Ventilated)
M6S2 Severe Aspiration Pneumonia (Ventilated)
M6S2 Severe Bronchopneumonia (Ventilated)
M6S2 Acute Severe Asthma (Ventilated)
Urinary Tract Infection With Complications Like
M6S12
Pyelonephritis And Renal Failure - 10 Days Stay
Steroid Resistant Nephrotic Syndrome Complicated Or
M6S12
Resistant - 2 Weeks Stay
M6S12 Acute Renal Failure With Dialysis - 10 Days Stay.
S12M1 Cleft Lip
S12M1 Cleft Palate
Corrective Surgery For Congenital Deformity Of Hand (Per
S12M1
Hand)
S12M1 Corrective Surgery For Craniosynostosis
S12M1 Vaginal Atresia
S12M1 Vascular Malformations
S12M1 Reduction Surgery For Filarial Lymphedema
S12M1 Hemifacial Atrophy
S12M1 Cup And Bat Ears
S12M1 Flap Cover For Electrical Burns With Vitals Exposed
S12M1 Tumour Of Mandible And Maxilla
S12M1 Microtia/Anotia
S12M1 TM Joint Ankylosis
S12M1 Velo-Pharyngial Incompetence
S12M1 Syndactyly Of Hand For Each Hand
S12M1 Nerve And Tendon Repair + Vascular Repair
S12M1 Ptosis
S12M1 Hemifacial Microsmia
S12M1 Leprosy Reconstructive Surgery
714 Poly Trauma
S14
S14O10 Grade I& II
715 Poly Trauma
S14
Chest Consertative Treatment
S14O4
716 Poly Trauma
S14
Orthpedic Trauma
S14O1
Chest Injuries Conservative Stay In General Ward
@Rs.500/Day
Amputation Surgery
Procedure 100%
code
Rates
M6S2.3
15000
M6S1.18
70000
M6S2.1
M6S2.6
M6S2.7
M6S2.4
M6S2.5
20000
20000
25000
30000
35000
M6S12.2
15000
M6S12.1
25000
M6S12.4
S12M1.1
S12M1.2
20000
10000
15000
S12M1.14 15000
S12M1.15
S12M1.12
S12M1.13
S12M1.18
S12M1.19
S12M1.16
S12M1.17
S12M1.11
S12M1.5
S12M1.6
S12M1.3
S12M1.4
S12M1.9
S12M1.10
S12M1.7
S12M1.8
50000
25000
25000
20000
30000
20000
50000
40000
30000
40000
15000
15000
30000
25000
50000
20000
S14O10.1
10000
S14O4.1
3000
S14O1.2
5000
Sl. No
Category
Category
Code
Sub Category
Sub
Category
Code
717 Poly Trauma
S14
Orthpedic Trauma
S14O1
718 Poly Trauma
S14
S14O1
719 Poly Trauma
S14
720 Poly Trauma
721 Poly Trauma
722 Poly Trauma
S14
S14
S14
723 Poly Trauma
S14
724 Poly Trauma
S14
725 Poly Trauma
S14
726 Poly Trauma
S14
727 Poly Trauma
S14
728 Poly Trauma
S14
Orthpedic Trauma
Orthopedic And Facial Trauma
Wound Management For Compound
Fractures
Emergency Room Procedures
Polytrauma Abdomen
Emergency Room Procedures
Orthopedic And Facial Trauma
Wound Management For Compound
Fractures
Orthopedic And Facial Trauma
Wound Management For Compound
Fractures
Orthopedic And Facial Trauma
Wound Management For Compound
Fractures
Orthopedic And Facial Trauma
Wound Management For Compound
Fractures
Orthopedic And Facial Trauma
Wound Management For Compound
Fractures
Abdomen Consertative Treatment
729 Poly Trauma
S14
Neurosurgical Trauma Consertative
S14O2
730 Poly Trauma
S14
Neurosurgical Trauma Consertative
S14O2
731 Poly Trauma
S14
Abdomen Consertative Treatment
S14O6
732 Poly Trauma
733 Poly Trauma
734 Poly Trauma
S14
S14
S14
735 Prostheses
S15
736 Prostheses
S15
737 Prostheses
S15
Chest Consertative Treatment
Neurosurgical Trauma
Polytrauma Chest
Prosthesis Hip Disarticulation
Prosthesis
Prosthesis Hip Disarticulation
Prosthesis
Prosthesis Hip Disarticulation
Prosthesis
Procedures
Open Reduction And Internal Fixation Of Long Bone
Fractures
Soft Tissue Injury
Procedure 100%
code
Rates
S14O1.1
15000
S14O1.3
5000
S14O11 Grade -III
S14O11.1
20000
S14O8
S14O7
S14O8
S14O8.2
S14O7.1
S14O8.1
3000
75000
3000
S14O11 Facial Bone Fractures (Faciomaxillary Injuries)
S14O11.5
15000
S14O11 Surgical Correction Of Pelvic Bone Fractures.
S14O11.6
20000
S14O11.4
5000
S14O11.2
20000
S14O11.3
5000
S14O6.2
7000
S14O2.1
6000
S14O2.2
28000
S14O6.1
3000
S14O4
S14O3
S14O5
Abdominal Injuries Stay In Surgical [email protected]/Day
Neurosurgical Trauma Consertative Management Stay In
General Ward @Rs.500/ Day
Neurosurgical Trauma Consertative Management Stay In
Neuro [email protected]/Day
Abdominal Injuries Conservative Stay In General Ward
@Rs.500/Day
Chest Injuries Stay In Respiratory ICU/[email protected]/Day
Neurosurgical Trauma Surgical Treatment (Up To)
Polytrauma Chest Surgical Treatment
S14O4.2
S14O3.1
S14O5.1
20000
150000
50000
S15P6
Hip Disarticulation Prosthesis Fibre
S15P6.2
3000
S15P6
Hip Disarticulation Prosthesis Modular
S15P6.3
6000
S15P6
Hip Disarticulation Prosthesis HDP/PP
S15P6.1
2500
S14O11
Thoracostomy
Abdominal Injuries Surgical Treatment
Tracheostomy
Small Bone Fractures K-Wiring (To Be Covered With Other
Injuries Only And Not As Exclusive Procedure)
S14O11 Flap Cover Surgery For Wound In Compound Fracture
S14O11
S14O6
Surgery For Patella Fracture (To Be Covered With Other
Injuries Only And Not As Exclusive Procedure)
Sl. No
Category
Category
Code
Sub Category
S15
S15
M10
M10
M10
Prosthesis Above Knee(Ak)
Prostheses
Prosthesis Above Knee(Ak)
Prostheses
Prosthesis Through Knee Prostheses
Prosthesis Below Knee(Bk/Ptb)
Prosthesis Below Knee(Bk/Ptb)
Prosthesis Lower Limb Symes
Prostheses
Prosthesis Lower Limb Symes
Prostheses
Prosthesis Lower Limb Symes
Prostheses
Prosthesis Upper Limb Above Elbow
Prosthesis Below Knee(Bk/Ptb)
Prosthesis Through Knee Prostheses
Prosthesis Above Knee(Ak)
Prostheses
Prosthesis Through Knee Prostheses
Prosthesis Upper Limb Above Elbow
Prosthesis Upper Limb Above Elbow
Prosthesis Upper Limb Whole Upper
Limb
Prosthesis Upper Limb Whole Upper
Limb
Prosthesis Upper Limb Whole Upper
Limb
Prosthesis Upper Limb Above Elbow
Prosthesis Hip Disarticulation
Prosthesis
Prosthesis Upper Limb Above Elbow
Prosthesis Upper Limb Above Elbow
Pulmonology
Pulmonology
Pulmonology
763 Pulmonology
M10
Pulmonology
764 Pulmonology
765 Pulmonology
766 Pulmonology
M10
M10
M10
Pulmonology
Pulmonology
Pulmonology
738 Prostheses
S15
739 Prostheses
S15
740 Prostheses
741 Prostheses
742 Prostheses
S15
S15
S15
743 Prostheses
S15
744 Prostheses
S15
745 Prostheses
S15
746 Prostheses
747 Prostheses
748 Prostheses
S15
S15
S15
749 Prostheses
S15
750 Prostheses
751 Prostheses
752 Prostheses
S15
S15
S15
753 Prostheses
S15
754 Prostheses
S15
755 Prostheses
S15
756 Prostheses
S15
757 Prostheses
S15
758
759
760
761
762
Prostheses
Prostheses
Pulmonology
Pulmonology
Pulmonology
Sub
Category
Code
Procedures
Procedure 100%
code
Rates
S15P5
Above Knee(AK) Prostheses Fibre
S15P5.2
1800
S15P5
Above Knee(AK) Prostheses Modular
S15P5.3
3500
S15P4
S15P3
S15P3
Through Knee Prostheses HDP/PP
Below Knee(BK/PTB) Prostheses HDP/PP
Below Knee(BK/PTB) Prostheses Fibre
S15P4.1
S15P3.1
S15P3.2
1500
1200
1500
S15P2
Lower Limb Symes Prostheses Modular
S15P2.3
1500
S15P2
Lower Limb Symes Prostheses HDP/PP
S15P2.1
1000
S15P2
Lower Limb Symes Prostheses Fibre
S15P2.2
1200
S15P7
S15P3
S15P4
Above Elbow Prosthesis Modular
Below Knee(BK/PTB) Prostheses Modular
Through Knee Prostheses Fibre
S15P7.3
S15P3.3
S15P4.2
4000
3000
1800
S15P5
Above Knee(AK) Prostheses HDP/PP
S15P5.1
1500
S15P4
S15P7
S15P7
Through Knee Prostheses Modular
Above Elbow Prosthesis Modular
Above Elbow Prosthesis Fibre
S15P4.3
S15P7.6
S15P7.5
3500
4000
2000
S15P8
Whole Upper Limb Prosthesis Fibre
S15P8.2
1200
S15P8
Whole Upper Limb Prosthesis HDP/PP
S15P8.1
1000
S15P8
Whole Upper Limb Prosthesis Modular
S15P8.3
1500
S15P7
Above Elbow Prosthesis HDP/PP
S15P7.1
1500
S15P6
Hip Disarticulation Partial Foot Prostheses
S15P6.4
500
S15P7
S15P7
M10T4
M10T4
M10T4
Above Elbow Prosthesis Fibre
Above Elbow Prosthesis HDP/PP
Acute Respiratory Failure (With Ventilator) 10 Days Stay
Interstitial Lung Diseases- 10 Days Stay
Bronchiectasis Requiring Hospitalisation - 10 Days Stay
S15P7.2
S15P7.4
M10T4.6
M10T4.3
M10T4.8
2000
1500
50000
30000
20000
M10T4 Lung Abscess, Non Resolving - Ct Scan Chest,10 Days Stay
M10T4.1
15000
M10T4 Pneumothorax (Large/Recurrent) HRCT-10 Days Stay
M10T4 Acute Respiratory Failure (Without Ventilator) 10 Days Stay
M10T4 Pneumoconiosis - 10 Days Stay
M10T4.2
M10T4.5
M10T4.4
35000
25000
25000
Sl. No
Category
Category
Code
Sub Category
Cobalt 60 External Beam
Radiotherapy
Cobalt 60 External Beam
Radiotherapy
Brachytherapy Intracavity
Brachytherapy Interstitial
Brachytherapy Intracavity
External Beam Radiotherapy (On
Linear Acclerator)
External Beam Radiotherapy (On
Linear Acclerator)
External Beam Radiotherapy (On
Linear Acclerator)
Cobalt 60 External Beam
Radiotherapy
Specialized Radiation Therapy 3dcrt(3-D Conformational
Radiotherapy)
Specialized Radiation Therapy - Imrt
(Intensity Modulated Radiotherapy)
Specialized Radiation Therapy Srs/Srt
Specialized Radiation Therapy - Imrt
With Igrt
Specialized Radiation Therapy Rapid
Ax Therapy
Sub
Category
Code
767 Radiation Oncology
M2
768 Radiation Oncology
M2
769 Radiation Oncology
770 Radiation Oncology
771 Radiation Oncology
M2
M2
M2
772 Radiation Oncology
M2
773 Radiation Oncology
M2
774 Radiation Oncology
M2
775 Radiation Oncology
M2
776 Radiation Oncology
M2
777 Radiation Oncology
M2
778 Radiation Oncology
M2
779 Radiation Oncology
M2
780 Radiation Oncology
M2
781 Radiation Oncology
M2
Brachytherapy Interstitial
M2L4
782
783
784
785
786
787
788
789
790
791
792
793
794
M12
M12
M12
M12
M12
M12
S6
S6
S6
S6
S6
S6
S6
Rheumatology
Rheumatology
Rheumatology
Rheumatology
Rheumatology
Rheumatology
Small Intestine
Stomach
Stomach
Small Intestine
Liver
Liver
Liver
M12T6
M12T6
M12T6
M12T6
M12T6
M12T6
S6E6
S6E5
S6E5
S6E6
S6E2
S6E2
S6E2
Rheumatology
Rheumatology
Rheumatology
Rheumatology
Rheumatology
Rheumatology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Procedures
Procedure 100%
code
Rates
M2L1
Palliative Treatment
M2L1.2
10000
M2L1
Radical Treatment
M2L1.1
20000
M2L3
M2L4
M2L3
A) Intracavitary II. HDR Per Application
B) Interstitial I. LDR Per Application
A) Intracavitary I. LDR Per Application
M2L3.2
M2L4.1
M2L3.1
2500
15000
4500
M2L2
Palliative Treatment With Photons
M2L2.2
20000
M2L2
Adjuvant Treatment With Photons/Electrons
M2L2.3
35000
M2L2
Radical Treatment With Photons
M2L2.1
50000
M2L1
Adjuvant Treatment
M2L1.3
15000
M2L6
3DCRT-Up To 30 Fractions In 6 Weeks
M2L6.1
75000
M2L5
IMRT-Up To 40 Fractions In 8 Weeks
M2L5.1
100000
M2L7
SRS/SRT-Up To 30 Fractions In 6 Weeks
M2L7.1
75000
M2L9
IMRT+IGRT-Up To 40 Fractions In 8 Weeks
M2L9.1
150000
M2L8
Rapid Ax Therapy-Up To 40 Fractions In 8 Weeks
M2L8.1
150000
M2L4.2
25000
M12T6.4
M12T6.6
M12T6.1
M12T6.3
M12T6.5
M12T6.2
S6E6.2
S6E5.2
S6E5.5
S6E6.1
S6E2.6
S6E2.5
S6E2.7
15000
15000
50000
15000
10000
15000
35000
40000
50000
35000
30000
75000
45000
B) Interstitial II. HDR One Application And Multiple Dose
Fractions
Primary Sjogren's Syndrome 7 Days Stay
SLE (Systemic Lupus Erythematosis) 10 Days Stay
SLE With Sepsis 4 Weeks Stay
MCTD Mixed Connective Tissue Disorder 7 Days Stay
Vasculitis 10 Days Stay
Scleroderma 7 Days Stay
Malrotation
Total Gastrectomy
Surgery For Corrosive Injury Stomach
Volvulus
Hydatid Cyst-Marsupilisation
Haemangioma SOL Liver Hepatectomy + Wedge Resection
Cyst Excision + Hepatic Jejunostomy
Sl. No
795
796
797
798
799
Category
Category
Code
Sub Category
Sub
Category
Code
S6E11
S6E11
S6E8
S6E8
S6E9
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
S6
S6
S6
S6
S6
Gall Bladder
Gall Bladder
Ulcerative Colitis Iii Stage Procedure
Ulcerative Colitis Iii Stage Procedure
Ulcerative Colitis Ii Stage Procedure
800 Surgical Gastro Enterology
S6
Liver
S6E2
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
829
830
831
832
833
834
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
S6
Ulcerative Colitis Ii Stage Procedure
Gall Bladder
Pancreas
Pancreas
Pancreas
Pseudocyst
Pseudocyst
Spleen
Spleen
Spleen
Pancreas
Pancreas
Pancreas
Oesophagus
Pancreas
Pancreas
Oesophagus
Oesophagus
Oesophagus
Oesophagus
Emergency
Liver
Emergency
Emergency
Pancreas
Pancreas
Liver
Liver
Large Intestine
Large Intestine
Large Intestine
Large Intestine
Large Intestine
Ulcerative Colitis Iii Stage Procedure
S6E9
S6E11
S6E3
S6E3
S6E3
S6E14
S6E14
S6E12
S6E12
S6E12
S6E3
S6E3
S6E3
S6E4
S6E3
S6E3
S6E4
S6E4
S6E4
S6E4
S6E1
S6E2
S6E1
S6E1
S6E3
S6E3
S6E2
S6E2
S6E7
S6E7
S6E7
S6E7
S6E7
S6E8
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Procedures
Hepatico Jejunostomy
GB+ Calculi CBD Stones Or Dilated CBD
III Stage-Ileostomy Closure
II Stage-J - Pouch
I Stage- Sub Total Colectomy + Ileostomy + J - Pouch
Hepato Cellular Carcinoma(Advanced) Radio Frequency
Ablation
II Stage- Ileostomy
Choledochoduodenostomy Or Choledocho Jejunostomy
Distal Pancreatectomy + Splenectomy
Pancreatic Necrosectomy (Open)
Central Pancreatectomy
Cysto Gastrostomy
Cysto Jejunostomy
Splenectomy + Devascularisation + Spleno Renal Shunt
Splenectomy
Spleenectomy For Space Occupying Lesion
Lateral Pancreaticojejunostomy(Non- Malignant)
Lap- Pancreatic Necrosectomy
Other Bypasses
Colonic Pull Up
Whipples Any Type
Triple Bypass
Lap Heller’s Myotomy
Lap Fundoplications
Oesophagectomy
Oesophago-Gastrectomy
Diaphragmatic Hernia (Gortex Mesh Repair)
Rt Hepatectomy
Surgery For Bleeding Ulcers
Surgery For Obscure GI Bleed
Distal Pancreatectomy
Enucleation Of Cyst
Lt Hepatectomy
Segmentectomy
Extended Right Hemicolectomy
Anterior Resection
Right Hemicolectomy
Left Hemicolectomy
Hartman.S Procedure With Colostomy
I Stage-Sub Total Colectomy + Ileostomy
Procedure 100%
code
Rates
S6E11.2
S6E11.1
S6E8.3
S6E8.2
S6E9.1
45000
25000
20000
30000
80000
S6E2.4
60000
S6E9.2
S6E11.3
S6E3.9
S6E3.8
S6E3.10
S6E14.2
S6E14.1
S6E12.2
S6E12.1
S6E12.3
S6E3.7
S6E3.6
S6E3.5
S6E4.1
S6E3.3
S6E3.4
S6E4.4
S6E4.5
S6E4.2
S6E4.3
S6E1.3
S6E2.1
S6E1.1
S6E1.2
S6E3.1
S6E3.2
S6E2.2
S6E2.3
S6E7.3
S6E7.4
S6E7.1
S6E7.2
S6E7.7
S6E8.1
20000
35000
100000
100000
100000
40000
40000
60000
35000
35000
100000
100000
25000
30000
75000
25000
30000
45000
60000
75000
40000
75000
40000
60000
100000
75000
75000
50000
35000
40000
30000
30000
45000
50000
S6
S6
S6
S6
S6
S6
S11
S11
S11
S11
S11
S11
S11
S11
Large Intestine
Large Intestine
Stomach
Stomach
Stomach
Small Intestine
Breast
Breast
Skin Tumours
Breast
Breast
Ca Git
Genitourinary
Genitourinary
Sub
Category
Code
S6E7
S6E7
S6E5
S6E5
S6E5
S6E6
S11J32
S11J32
S11J33
S11J32
S11J32
S11J10
S11J23
S11J23
849 Surgical Oncology
S11
Genitourinary
S11J23
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
Genitourinary
Genitourinary
Genitourinary
Genitourinary
Genitourinary
Limb Salvage Surgery
Limb Salvage Surgery
Limb Salvage Surgery
Limb Salvage Surgery
Limb Salvage Surgery
Genitourinary
Limb Salvage Surgery
Limb Salvage Surgery
Thorax, Mediastinum
Lung
Urinary Bladder
S11J23
S11J23
S11J23
S11J23
S11J23
S11J22
S11J22
S11J22
S11J22
S11J22
S11J23
S11J22
S11J22
S11J26
S11J27
S11J25
866 Surgical Oncology
S11
Urinary Bladder
S11J25
867
868
869
870
871
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
S11
S11
S11
S11
S11
Esophagus
Esophagus
Lung
Lung
Genitourinary
S11J28
S11J28
S11J27
S11J27
S11J23
872 Surgical Oncology
S11
Testis Cancer
S11J24
Sl. No
835
836
837
838
839
840
841
842
843
844
845
846
847
848
Category
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Gastro Enterology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Category
Code
Sub Category
Procedures
Anterior Resection With Ileostomy
Abdomino Perineal Resection(Non- Malignant)
Truncal Vagotomy + Gastro Jejunostomy
Distal Gastrectomy For Gastric Outlet Obstruction
Partial Gastrectomy
Lap Adhesiolysis
Mastectomy Any Type
Chest Wall Resection
Skin Tumours Wide Excision
Lumpectomy Breast
Breast Reconstruction
Small Bowel Resection
Emasculation
Radical Cystectomy
Nephroureterectomy For Transitional Cell Carcinima Of Renal
Pelvis
Radical Nephrectomy
Partial Penectomy
Inguinal Block Dissection One Side
Other Cystectomies
Total Penectomy
Internal Hemipelvectomy
Curettage & Bone Cement
Forequarter Amputation
Hemipelvectomy
Sacral Resection
Partial Nephrectomy
Bone Resection
Shoulder Girdle Resection
Mediastinal Tumour Resection
Lung Metastatectomy. Solitary
Total Exenteration
Bilateral Pelvic Lymph Node Dissection(BPLND) for CA
Urinary Bladder
Oesophagectomy With Two Field Lymphadenectomy
Oesophagectomy With Three Field Lymphadenectomy
Lung Metastatectomy. Multiple
Sleeve Resection Of Lung Cancer
Bilateral Orchidectomy
Retro Peritoneal Lymph Node Dissection(RPLND) (For
Residual Disease)
Procedure 100%
code
Rates
S6E7.5
S6E7.6
S6E5.3
S6E5.4
S6E5.1
S6E6.3
S11J32.1
S11J32.6
S11J33.1
S11J32.4
S11J32.5
S11J10.1
S11J23.4
S11J23.5
50000
50000
40000
40000
40000
40000
25000
20000
10000
3000
25000
40000
30000
60000
S11J23.2
50000
S11J23.3
S11J23.8
S11J23.9
S11J23.6
S11J23.7
S11J22.6
S11J22.7
S11J22.4
S11J22.5
S11J22.10
S11J23.1
S11J22.8
S11J22.9
S11J26.1
S11J27.1
S11J25.2
40000
15000
15000
40000
25000
65000
30000
40000
55000
60000
55000
30000
40000
50000
50000
75000
S11J25.3
20000
S11J28.1
S11J28.2
S11J27.2
S11J27.3
S11J23.12
90000
100000
60000
90000
10000
S11J24.1
60000
Sl. No
Category
Category
Code
Sub Category
873 Surgical Oncology
874 Surgical Oncology
S11
S11
Genitourinary
Genitourinary
875 Surgical Oncology
S11
Testis Cancer
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
Urinary Bladder
Testis Cancer
Testis Cancer
Limb Salvage Surgery
Ca Git
Ca Git
Ca Git
Ca Git
Ca Spleen
Ca Retroperitoneal Tumors
Ca Git
Ca Gall Bladder
Ca Git
Ca Rectum
Ca Git
Ca Git
Ca Git
Ca Git
Ca Rectum
Ca Git
Ca Cervix
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Head And Neck
Oral Cavity
Oral Cavity
Bronchoplural Fistula
908 Surgical Oncology
S11
Bronchoplural Fistula
909 Surgical Oncology
910 Surgical Oncology
911 Surgical Oncology
S11
S11
S11
Palliative Surgeries
Head And Neck
Oral Cavity
Sub
Procedures
Category
Code
S11J23 Radical Prostatectomy
S11J23 High Orchidectomy
Retro Peritoneal Lymph Node Dissection Rplnd As Part Of
S11J24
Staging
S11J25 Anterior Exenteration
S11J24 Adrenalectomy
S11J24 Urinary Diversion
S11J22 Limb Salvage Surgery With Modular Prosthesis
S11J12 Whipples Any Type
S11J12 Tripple Bypass
S11J12 Anterior Resection
S11J12 Abdominoperineal Resection
S11J14 Splenectomy
S11J15 Resection Of Retroperitoneal Tumours
S11J12 Other Bypasses-Pancreas
S11J13 Radical Cholecystectomy
S11J10 Abdomino Perineal Resection (Apr) + Sacrectomy
S11J11 Posterior Exenteration
S11J10 Closure Of Ileostomy
S11J10 Closure Of Colostomy
S11J12 Gastrectomy Any Type
S11J12 Colectomy Any Type
S11J11 Total Exenteration
S11J12 Oesophagectomy Any Type
S11J18 Supra Levator Exenteration
S11J1 Hemiglossectomy
S11J1 Maxillectomy Any Type
S11J1 Wide Excision for tumour
S11J1 Neck Dissection Any Type
S11J1 Laryngectomy Any Type
S11J1 Laryngo Pharyngo Oesophagectomy
S11J1 Thyroidectomy Any Type
S11J1 Parotidectomy Any Type
S11J37 Marginal Mandibulectomy
S11J37 Segmental Mandibulectomy
S11J36 Surgical Correction Of Bronchoplural Fistula. Myoplasty
Surgical Correction Of Bronchoplural Fistula Trans Plural
S11J36
BPF Closure
S11J29 Tracheostomy
S11J1 Composite Resection & Reconstruction
S11J37 Total Glossectomy + Reconstruction
Procedure 100%
code
Rates
S11J23.10 60000
S11J23.11 15000
S11J24.4
20000
S11J25.1
S11J24.2
S11J24.3
S11J22.3
S11J12.6
S11J12.7
S11J12.4
S11J12.5
S11J14.1
S11J15.1
S11J12.8
S11J13.1
S11J10.4
S11J11.1
S11J10.2
S11J10.3
S11J12.2
S11J12.3
S11J11.2
S11J12.1
S11J18.5
S11J1.4
S11J1.5
S11J1.2
S11J1.3
S11J1.8
S11J1.9
S11J1.6
S11J1.7
S11J37.1
S11J37.2
S11J36.2
60000
45000
40000
75000
75000
25000
40000
40000
35000
45000
25000
60000
50000
50000
20000
20000
40000
40000
75000
60000
70000
15000
25000
25000
25000
40000
75000
20000
20000
25000
25000
50000
S11J36.3
50000
S11J29.1
S11J1.1
S11J37.3
5000
60000
40000
Sl. No
912
913
914
915
916
917
918
919
920
921
922
923
924
925
926
927
928
929
930
931
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
Category
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
Category
Code
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
S11
Sub Category
Oral Cavity
Ca.Ear
Surgical Oncology
Ca.Ear
Ca.Ear
Ca Trachea
Ca Parathyroid
Ca.Thyroid
Ca Trachea
Ca.Eye/ Maxilla /Para Nasal Sinus
Ca.Eye/ Maxilla /Para Nasal Sinus
Head And Neck
Ca.Eye/ Maxilla /Para Nasal Sinus
Ca.Soft Palate
Ca.Ear
Ca.Eye/ Maxilla /Para Nasal Sinus
Nasopharynx
Bronchoplural Fistula
Reconstruction
Gynecology
Palliative Surgeries
Reconstruction
Gynecology
Gynecology
Gynecology
Gynecology
Palliative Surgeries
Palliative Surgeries
Palliative Surgeries
Palliative Surgeries
Palliative Surgeries
Palliative Surgeries
Palliative Surgeries
Palliative Surgeries
Soft Tissue /Bone Tumours
Soft Tissue /Bone Tumours
Skin Tumours
Skin Tumours
Lung
Lung
Soft Tissue /Bone Tumours
Sub
Category
Code
S11J37
S11J5
S11J6
S11J5
S11J5
S11J8
S11J9
S11J7
S11J8
S11J2
S11J2
S11J1
S11J2
S11J4
S11J5
S11J2
S11J3
S11J36
S11J30
S11J31
S11J29
S11J30
S11J31
S11J31
S11J31
S11J31
S11J29
S11J29
S11J29
S11J29
S11J29
S11J29
S11J29
S11J29
S11J34
S11J34
S11J33
S11J33
S11J27
S11J27
S11J34
Procedures
Full Thickness Buccal Mucosal Resection & Reconstruction
Total Temporal Bone Resection
Submandibular Gland Excision
Lateral Temporal Bone Resection
Subtotal Temporal Bone Resection
Tracheal Resection
Parathyroidectomy
Tracheal Resection
Sternotomy + Superior Mediastinal Dissection
Maxillectomy + Orbital Exenteration
Maxillectomy + Infratemporal Fossa Clearance
Hemimandibulectomy
Orbital Exenteration
Palatectomy Any Type
Sleeve Resection
Cranio Facial Resection
Resection Of Nasopharyngeal Tumour
Surgical Correction Of Bronchoplural Fistula Thoracoplasty
Micro Vascular Reconstruction
Hysterectomy for Tumour
Ileotransverse Colostomy
Myocutaneous / Cutaneous Flap
Surgery For Ca Ovary Advance Stage
Vulvectomy
Radical Hysterectomy for Tumour
Surgery For Ca Ovary Early Stage
Jejunostomy
Ileostomy
Substernal Bypass
Gastrostomy
Intercostal Drainage(ICD)
Gastro Jejunostomy
Colostomy
Suprapubic Cystostomy
Wide Excision soft tissue/Bone Tumours
Wide Excision + Reconstruction soft tissue/Bone Tumours
Skin Tumours Wide Excision + Reconstruction
Skin Tumours Amputation
Lung Cancer Lobectomy
Lung Cancer Decortication
Amputation for soft tissue/Bone Tumours
Procedure 100%
code
Rates
S11J37.4
S11J5.4
S11J6.1
S11J5.2
S11J5.3
S11J8.2
S11J9.2
S11J7.1
S11J8.1
S11J2.2
S11J2.3
S11J1.10
S11J2.1
S11J4.1
S11J5.1
S11J2.4
S11J3.1
S11J36.1
S11J30.2
S11J31.1
S11J29.10
S11J30.1
S11J31.4
S11J31.5
S11J31.2
S11J31.3
S11J29.4
S11J29.5
S11J29.2
S11J29.3
S11J29.8
S11J29.9
S11J29.6
S11J29.7
S11J34.1
S11J34.2
S11J33.2
S11J33.3
S11J27.5
S11J27.6
S11J34.3
50000
60000
20000
30000
50000
40000
30000
52000
45000
35000
40000
25000
25000
30000
25000
70000
50000
50000
45000
25000
50000
25000
40000
15000
30000
25000
20000
20000
35000
20000
3000
35000
20000
10000
15000
25000
20000
20000
50000
50000
20000
Sl. No
953
954
955
956
Category
Category
Code
Sub Category
Sub
Category
Code
S11J27
S11J32
S11J32
S11J31
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
S11
S11
S11
S11
Lung
Breast
Breast
Gynecology
957 Surgical Oncology
S11
Ca Endometrium
S11J19
958
959
960
961
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
S11
S11
S11
S11
S11J18
S11J18
S11J22
S11J22
962 Surgical Oncology
S11
963 Surgical Oncology
S11
Surgical Oncology
Surgical Oncology
Surgical Oncology
Surgical Oncology
S11
S11
S11
S11
Ca Cervix
Ca Cervix
Limb Salvage Surgery
Limb Salvage Surgery
Soft Tissue /Bone Tumours. Chest
Wall
Soft Tissue /Bone Tumours. Chest
Wall
Gynec
Gynec
Ca Abdominal Wall Tumour
Ca Abdominal Wall Tumour
968 Surgical Oncology
S11
Ca Cervix
S11J18
969 Surgical Oncology
970 Surgical Oncology
971 Surgical Oncology
S11
S11
S11
Ca Cervix
Gynec
Gynec
S11J18
S11J17
S11J17
964
965
966
967
Procedures marked in Orange color are reserved for Government hospitals
Procedures
Lung Cancer Pnumenectomy
Axillary Dissection
Wide Excision of Breast for Tumour
Salpino Oophorectomy
Total Abdominal Hysterectomy(TAH) + Bilateral Salpingo
Ophorectomy (BSO) + Bilateral Pelvic Lymph Node
Dissection (BPLND) + Omentectomy
Posterior Exenteration
Total Pelvic Exenteration
Limb Salvage Surgery Without Prosthesis
Limb Salvage Surgery With Custom Made Prosthesis
Procedure 100%
code
Rates
S11J27.4
S11J32.2
S11J32.3
S11J31.6
50000
15000
5000
25000
S11J19.1
35000
S11J18.3
S11J18.4
S11J22.1
S11J22.2
50000
75000
40000
50000
S11J20 Chest Wall Resection
S11J20.1
20000
S11J20 Chest Wall Resection + Reconstruction
S11J20.2
30000
S11J17
S11J17
S11J16
S11J16
S11J17.1
S11J17.2
S11J16.1
S11J16.2
25000
40000
35000
45000
S11J18.1
45000
S11J18.2
S11J17.3
S11J17.4
60000
40000
45000
Bilateral Pelvic Lymph Node Dissection(BPLND)
Radical Trachelectomy
Abdominal Wall Tumour Resection
Resection With Reconstruction of Abdominal Wall Tumour
Radical Hysterectomy +Bilateral Pelvic Lymph Node
Dissection (BPLND) + Bilateral Salpingo Ophorectomy (BSO)
/ Ovarian Transposition
Anterior Exenteration
Radical Vaginectomy
Radical Vaginectomy + Reconstruction