VADODARA MUNICIPAL CORPORATION

Rate of Charges for medical re-imbursement

for the Employers, Pensioners, Freedom
fighters & their dependent family member for
the year 2018-19 to 2019-2020

Health Department
Additional Medical Officer of Health Office
Khanderao Market
Vadodara
 VADODARA MUNICIPAL CORPORATION
Additional Medical Officer of Health Office
Health Department

With the objective of providing financial help towards medical

treatment expenses of its employees, pensioners, freedom fighters and
their dependent family members, the General Body of Vadodara
Municipal Corporation (VMC) passed a resolution no.212/1980-81
Dated:-07/07/1980 under the name of Medical Facilities Rules for the
Employees of Vadodara Municipal Corporation (1980) and for the first
time medical bill section was established under health department at
Integrated Health Centre Bawchawad. Super Specialty Hospital, Multi
Specialty Hospital, Dental Hospital, Pathological Laboratory and
Diagnostic Centre were recognized for taking cashless indoor medical
services excluding medicines which are reimbursed separately by the
cell as per resolution no.02/2016-17 Dated:-03-03-2017, and resolution
no.02/2017-18 Dated:-26-03-2018.
As per circular by Commissioner 906/2005-06
Date:05/12/2005 medical cell was established with necessary medical,
account and audit staff at Khanderao market for easy and speedy
disposal of claims under direct control of Medical Officer with overall
supervision of Additional Medical officer of Health.
Today VMC has adopted total re-imbursement policy for all
medical treatment and services to maintain well being of its employees,
pensioners, and their dependent family members and freedom fighters
through urban primary health centre and deputy health officer zone as
per circular No.18/Dated:-21-08-2015. All employees, pensioners, and
their dependent family members and freedom fighters should refer
through urban primary health centre in 60-recognized Super Specialty
Hospital, Multi Specialty Hospital, Dental Hospital, Pathological
Laboratory and Diagnostic Centre as per resolution no.02/2016-17
Dated:-03-03-2017, and resolution no.02/2017-18 Dated:-26-03-2018.
The corporation revises the rate of charges to be reimbursed
once in every two years. As a part of this exercise we are bringing the
new rate of charges for the year 2018 to 2020.

Place: Vadodara Municipal Commissioner

Municipal Corporation
Date: - Vadodara

PAGE-1
 HEALTH DEPARTMENT
(ADDITIONAL MEDICAL OFFICER OF HEALTH OFFICE)
Municipal Commissioner.
Deputy Municipal Commissioner (Health).
Medical Officer of Health.
Additional Medical Officer of Health.
Deputy Health Officer (All Zone).

ZONE WISE URBAN PRIMARY HEALTH CENTRES

 EAST ZONE:-
1. BAPOD URBAN PRIMARY HEALTH CENTRE.
2. JUBILEE BAUG URBAN PRIMARY HEALTH CENTRE.
3. KISHANVADI URBAN PRIMARY HEALTH CENTRE.
4. RAMDEVNAGAR URBAN PRIMARY HEALTH CENTRE.
5. SAWAD URBAN PRIMARY HEALTH CENTRE.
6. SUDAMAPURI URBAN PRIMARY HEALTH CENTRE.
7. WARASIYA URBAN PRIMARY HEALTH CENTRE.

 WEST ZONE:-
8. DIWALIPURA URBAN PRIMARY HEALTH CENTRE.
9. ATLADRA URBAN PRIMARY HEALTH CENTRE.
10.TANDALJA URBAN PRIMARY HEALTH CENTRE.
11.JETALPUR URBAN PRIMARY HEALTH CENTRE.
12.AKOTA URBAN PRIMARY HEALTH CENTRE.
13.SUBHANPURA URBAN PRIMARY HEALTH CENTRE.
14.GORWA (PANCHVATI) URBAN PRIMARY HEALTH CENTRE.
15.GOTRI URBAN PRIMARY HEALTH CENTRE.
16.GOKULNAGAR URBAN PRIMARY HEALTH CENTRE.

PAGE-2
 SOUTH ZONE:-
17.YAMUNAMILL URBAN PRIMARY HEALTH CENTRE.
18.GAJRAWADI URBAN PRIMARY HEALTH CENTRE.
19.KAPURAI URBAN PRIMARY HEALTH CENTRE.
20.DANTESHWAR URBAN PRIMARY HEALTH CENTRE.
21.TARSALI URBAN PRIMARY HEALTH CENTRE.
22.MANEJA URBAN PRIMARY HEALTH CENTRE.
23.MAKARPURA URBAN PRIMARY HEALTH CENTRE.
24.MANJALPUR URBAN PRIMARY HEALTH CENTRE.
25.VADSAR URBAN PRIMARY HEALTH CENTRE.

 NORTH ZONE:-
26. EKTANAGAR URBAN PRIMARY HEALTH CENTRE.

27. NAVAYARD URBAN PRIMARY HEALTH CENTRE.

28. NAVIDHARTI URBAN PRIMARY HEALTH CENTRE.

29. KARELIBAUG URBAN PRIMARY HEALTH CENTRE.

30. CHHANI URBAN PRIMARY HEALTH CENTRE.

31. SIYABAUG URBAN PRIMARY HEALTH CENTRE.

32. NAVAPURA URBAN PRIMARY HEALTH CENTRE.

33. SAMA URBAN PRIMARY HEALTH CENTRE.

34. FATEPURA URBAN PRIMARY HEALTH CENTRE.

 JUBILEE BAUG AND DIWALIPURA PATHOLOGICAL AND

RADIOLOGICAL DIAGNOSTIC CENTRE.

PAGE-3
List of the Recognized Hospital:
 SUPER SPECIALTY HOSPITAL:-
(1) Baroda Heart Institute. (Only For Cath-Lab)
(2) Bankers Heart Institute.(O.P.Road)(Only For Cath-Lab)
(3) Sterling Heart Institute.(Only For Cath-Lab)
(4) HCG Cancer Hospital
(5) Himalaya Cancer Hospital & Research Centre
(6) Naik Super Specialty Hospital
(7) Viroc Super Specialty Orthopedic Hospital
(8) Venus Super Specialty Hospital
(9) Uro-Care Hospital
(10) Swasthya Super Specialty Hospital
(11) Vitas Hospital
(12) Nisarg Orthopedic & Maternity Hospital
(13) Samir Hospital
(14) Mangalam Orthopedic Hospital

 MULTI SPECIALTY HOSPITAL:-

(1) Bankers Heart & Multispecialty Hospital
(2) Rhythm Heart Institute
(3) Shukan Multi Specialty Hospital & Trauma Centre
(4) Satyam Hospital
(5) Medistar Hospital
(6) BAPS Shastriji Maharaj Hospital
(7) Narhari Arogya Kendra, Hospital.
(8) Yogini Vasantidevi Arogya Mandir Hospital.
(9) Swami Premdas Jalaram Hospital.
(10) Chandan Cheritable Trust, General Hospital.
(11) Sanjiv Medical Trust Hospital.
(12) Vijay Vallabh Sarvajanik Hospital
(13) Vallabhacharya Mahaprabhuji Hospital No.2
(14) Solace Hospital
(15) Radha Multi Specialty Hospital
(16) Pushti Multi Specialty Hospital
(17) Sumandeep Hospital
(18) Sangam Critical Care & Trauma Centre
(19) B.M.Parikh Foundation Trust, General Hospital.

PAGE-4
 EYE SUPER SPECIALTY HOSPITAL:-
(1) Vrund Eye Hospital
(2) Drashya Eye Hospital
(3) Sankalp Eye Hospital And Retina Centre
(4) Pandya Eye Hospital

 ENT SUPER SPECIALTY HOSPITAL:-

(1) Baroda ENT Hospital
(2) Dhaval Nursing Home (ENT Hospital)
(3) Bharti ENT Care Hospital

 DENTAL SUPER SPECIALTY HOSPITAL:-

(1) Auroma Dental Clinic
(2) Vraj Dental Clinic
(3) Dina Clinic (Dental Hospital)

 OTHER HOSPITAL:-
(1) Sharda Cheritable Trust, Orthopeadic Hospital.
(2) K.G.Patel Children Hospital.
(3) Navalkishor & Maltidevi Shah Medical & Cheritable Trust,
(4) INDU DEEP Hospital.
(5) Baroda Homeopathic Medical College Hospital.
(6) Government Ayurvedic Hospital.

 DIAGNOSTIC CENTRE:-
(1) Medicare Imaging Centre
(2) Baroda Imaging Centre
(3) Akshar X-Ray And Sonography Clinic
(4) Optimum Diagnostic & Research Private Ltd.

 PATHOLOGICAL LABORATORY:-
(1) Medicare Diagnostic Centre
(2) Pathocare Pathology Laboratory
(3) Ambe’s Advance Clinical Laboratory
(4) Amins Pathology Referral Laboratory
(5) Dr.Purendhares Day & Night Laboratory
(6) Dr.Jhaveri Laboratory
(7) Atmiya Pathology Laboratory
PAGE-5
 INDEX
SR. NO. PARTICULARS PAGE NO.

1 CONSULTATION CHARGES 8

2 INDOOR CHARGES 9

3 VISIT CHARGES 10

4 PROCEDURE CHARGES 11

5 RADIOLOGY (X-RAY SECTION) CHARGES 14

ULTRASOUND & ECHO - CARDIOGRAPHY
6 15
CHARGES
7 C.T.SCAN CHARGES 16

8 M.R.I. CHARGES 18
PATHOLOGICAL SECTION CHARGES
9 20
(LABORATORY INVESTIGATION CHARGES)
10 ANAESTHESIA AND O.T. CHARGES 36
CHEMOTHERAPY AND RADIOTHERAPY
11 37
AND ONCO SURGERY CHARGES
12 CATH-LAB CHARGES 39

13 DENTAL CHARGES 42

14 DERMATOLOGICAL CHARGES 45

15 PSYCHIATRY THERAPY CHARGES 46

16 OPTHALMOLOGY (EYE SECTION) CHARGES 47

17 ENT SECTION CHARGES 50

18 PAEDIATRIC PROCEDURE CHARGES 53

19 PAEDIATRIC SURGERY CHARGES 54

20 OBSTETRICS CHARGES 59

21 GYNAEC OPERATION CHARGES 60

PAGE-6
22 GENERAL SURGERY CHARGES 62

23 GASTRO-ENTEROLOGY SECTION CHARGES 69

24 LAPROSCOPIC SURGERY CHARGES 70

25 ORTHOPAEDIC PROCEDURE CHARGES 71

26 ORTHOPAEDIC SURGERY CHARGES 72

27 IITV CHARGES 80

28 ARTHOSCOPY SURGERY CHARGES 81

29 PHYSIOTHERAPY CHARGES 82

30 UROLOGY SECTION CHARGES 83

PLASTIC SURGERY / FASIOMAXILLARY
31 86
CHARGES
NEURO SURGERY CHARGES /
32 92
PULMOOLOGY CHARGES
THORACIC SURGERY CHARGES /
33 94
PULMONOLOGY CHARGES
30 VASCULAR SURGERY SECTION CHARGE 96

35 TERMS & CONDITION 98

PAGE-7
 (1) CONSULTATION CHARGES

(1) FOR CONSULTATION:-

(A). 1ST CONSULTATION RS.150/-

(B). SUBSEQUENT CONSULTATION RS.100/-
(VALID FOR 1 MONTH)
(APPLICABLE FOR RECOGNIZED HOSPITAL ONLY)

(2) SUPER SPECIALIST:-

(A). 1ST CONSULTATION RS.300/-

(B). SUBSEQUENT CONSULTATION RS.200/-
(VALID FOR 1 MONTH)
(APPLICABLE FOR RECOGNIZED HOSPITAL ONLY)

(3) EMERGENCY WARD ADMISSION:-

(A). CONSULTATION RS.300/-

(4) NURSING CHARGSE: - RS.150/DAY.

PAGE-8
 (2) INDOOR CHARGES

 STAY OF GENERAL WARD:- Rs.300/- PER DAY

 RECOVERY ROOM CHARGES:- Rs.1200/- PER DAY

 I.C.U./I.C.C.U. WARD CHARGES:- Rs.2500/- PER

DAY

 N.I.C.U. / P.I.C.U. CHARGES:- Rs.1200/- PER DAY

Note:-
 DISCHARGE CARD/DISCHARGE CERTIFICATE IN CASE OF INDOOR
TREATMENT AND ALL INVESTIGATION REPORTS (O.P.D.AND INDOOR) ARE
MUST BE ATTACHED IN STAFF TREATMENT BILL FOR RECOGNISED
HOSPITAL AND EMPLOYEES BILLS.

PAGE-9
 (3) VISIT CHARGES

 ONLY HOSPITALS CONSULTANTS GENERAL WARDS

VISIT CHARGE:- Rs.120/-PER VISIT

 SUPER SPECIALIST GENERAL WARD VISIT CHARGES:-

Rs.300/- PER VISIT

 HOSPITAL CONSULTANT RECOVERY ROOM VISIT

CHARGE:- Rs.200/-PER VISIT

 SUPER SPECIALIST RECOVERY ROOM VISIT CHARGE:-

Rs.400/- PER VISIT

 HOSPITALS CONSULTANTS I.C.U./I.C.C.U./N.I.C.U./

P.I.C.U. VISIT CHARGE:-Rs.300/- PER VISIT

 SUPER SPECIALIST I.C.U./I.C.C.U./N.I.C.U./P.I.C.U. VISIT

CHARGE:-Rs.600/- PER VISIT

 STAND BY PEADIATRITION/ANEATHETIST VISIT IN

LSCS:- Rs.600/-

NOTE:-
 ROUTINELY NOT MORE THAN TWO VISITS PER DAY FOR
RECOGNISED HOSPITAL.
 DOCTORS NAME AND THEIR DESIGNATION IS MANDATORY IN
CASE OF SUPER SPECIALIST VISIT CHARGE IN STAFF TREATMENT
BILLS.

PAGE-10
 (4) PROCEDURE CHARGES

SR.NO. PROCEDURE CHARGES

1 AIR BED 120/-

2 ALPHAXEL PUMP 150/-

3 ARTERIAL LINE 1700/-

4 ASICITICS TAPPING 950/-

5 AUTOCLAVE 100/-
6 BIAPAP 1200/-

7 BLOOD TRANSFUSION 250/-

8 BONE MARROW ASPIRATION 850/-

9 BOWEL WASH (PER WASH / DAY) 180/-

10 CARDIO PULMONARY RESUS.(CPR) 840/-

11 CATHERISATION – COMPLICATED 240/-
12 CATHERISATION – SIMPLE FOLY’S 200/-
13 CENTRAL VENOUS PRESSU. LINE SETT. 1050/-
CRITICAL CARE INFUSION (DOPA – MINE,
14 400/-
NITROGLYCERIN, ETC.) (ONE TIME CHARGE)
1100/- PER DIALYSIS
15 DIALYSIS BY ANY METHOD (DISPOSABLE AT PAR
WITH COST(M.R.P.))

16 DLC / TLC 2000/-

17 DRESSING CHARGE WITH MATERIAL-MAJOR 150/-

18 DRESSING CHARGE WITH MATERIAL-MINOR 100/-

DRESSING CHARGE WITH MATERIAL-

19 250/-
SUPRAMAJOR

20 ECG (COMPUTERISED) 180/-

21 ECG (NORMAL) 120/-

22 EMG/EEG 1400/-

23 ENDO TRACHIAL TUBE 350/-

24 ET CO2 140/-

25 F.B. REMUOVAL LENSE 300/-

26 FLOWTRON XL PUMP 500/-
27 INFLUSION (PER PROCEDURE) 50/-

PAGE-11
28 INFUSION/SYRING PUMP 200/-

29 INHALER CHARGE (INHABATION) 50/-

30 INJECTION (I.V./I.M./SUBCUTANIOUS) 30/-

31 INTERTHECAL DRUG ADMINISTRATION 400/-

32 INTRA LESSIONAL INJECTION 700/-
33 INTUBATION 600/-
34 L. P. 450/-
35 MINOR PROCEDURE 600/-
36 MONITOR CHARGE 400/-

37 N.I.B.P. 200/-

38 NCV/BERA AS PER ECHO 1450/-

39 NEBULIZOR 80/-

40 NEO-NETAL RESUSCITAL ON 180/-

41 OXYGEN THERAPY (UP TO 6HOURS) 200/-

PARINEAL WASH WITH DRESSING INCLUDING

42 300/-
MATERIAL PER DAY

43 PERICARDIAL IFFU. TAPPING DIAG OR THERAP 1400/-

44 PERITONEAL DIALYSIS 1200/-
45 PERI TONEAL TAPPING 850/-
46 PERMACATH INSERTION 2000/-
47 PLEURAL TAPPING DIAG 500/-
48 PLEURAL TAPPING THERAP 1200/-
PULMONARY FUNCTION TEST (PFT)
49 500/-
(SPIROMETRY)
50 PULSE OXYMETER/SPO2 200/- PER DAY

51 PULSE WAVE ANALYSIS 1650/-

52 RIPPLE BED 180/-

53 RYLE’S TUBE INSERTION BY CONSULTANT 100/-

54 RYLE’S TUBE PER FEEDING 30/-

55 SLEEP STUDY 6150/-

SLIF THERAPY
56 950/-
(ORAL-SUB LINGUAL IMMUNOTHERAPY)

57 SLIF THERAPY SINGLE CHECK 60/-

58 SOAP WATER ENEMA 70/-

PAGE-12
 59 STRESS TEST (TMT) 1200/-
60 THROMBOLYTIC THERAPY CHARGES 600/-
61 TILT TABLE TEST 3000/-

62 TUBECTOMY NO RE-EMBURSE

63 U.O.P. (URINE OUT PUT) 70/-

64 UROFLOWMETRY 400/-

65 VEINFLOW INSERTION 80/-

66 VASECTOMY NO RE-EMBURSE

67 VENE SECTION 240/-

68 VENE SECTION (EMERGENCY) 350/-
69 VENTILATOR 2750/- PER DAY

1400/-
70 VENTILATOR
(UP TO 12 HOURS)

BLOOD PRODUCT:-
71 CROSS MATCH CHARGES 150/-

72 FORZEN PLAZMA 400/-

73 FRESH FROZEN PLAZMA 400/-

74 P.C.V./WHOLE BLOOD 800/-

75 PLATTLET RICH PLAZMA / CONCENTRATE 1000/-

76 RBC CONCENTRATE / RBC SAGM 800/-

77 SINGLE DONNER PLATTLET 8000/-

PAGE-13
 (5) X – RAY SECTION CHARGES

SR.NO. PROCEDURE CHARGES

1 DIGITAL X – RAY 300/-

2 PORTABLE X-RAY 350/-
250/- + NUMBER OF
3 HYSTERO SALPINGO GRAPHY
PLATES CHARGE
250/- + NUMBER OF
4 MYLEO-GRAPHY
PLATES CHARGE
250/- + NUMBER OF
5 FISTULOGRAPHY
PLATES CHARGE
200/- + NUMBER OF
6 I.V.P./O.C.G.
PLATES CHARGE
250/- + NUMBER OF
7 BARIUM PROCEDURES
PLATES CHARGE
200/- + NUMBER OF
8 LOOPOGRAM STUDY
PLATES CHARGE
9 EMERGENCY X – RAY(DIGITAL X-RAY) 350/-
10 PORTABLE X-RAY (EMERGENCY) 400/-
11 MAMMOGRAPHY 800/-

12 M.C.U.G. 800/-

13 BONE MINERAL DENSITOMETRY (B.M.D.) 1400/-

14 FIBROSCAN 1750/-

15 SCANORGAM 580/-
16 ICUG 1400/-

PAGE-14
 (6) ULTRASOUND &
ECHOCARDIOGRAPHY CHARGES

SR. NO. DESCRIPTION CHARGES

1 ABDOMEN (EXCLUDING PELVIS) 800/-

2 ABDOMEN WITH CHEST FOR PLEURAL EFFUSION 800/-

3 PELVIS/PROSTATE/KIDNEYS/BLADDER/LIVER 800/-
4 ABDOMEN & PELVIS 1000/-

5 OBSTETRICS (ROUTINE) 800/-

DOPPLER ECOCARDIOGRAPHY WITH COLOUR
6 1450/-
FLOW IMAGING
7 PERIPHERAL VASCULAR DUPLEX DOPPLER 1450/- PER REGION
8 CAROTIDS DOPPLER 2400/- BOTH

9 LIMBS (ARTERIAL) DOPPLER 2400/- BOTH

10 LIMBS (VENOUS) DOPPLER 2400/- BOTH

11 RENAL DOPPLER 1450/-
12 OBSTRETRIC DOPPLER 1450/-
MUSCULOSKELETAL/JOINTS/BREAST/
13 SCROTUM/SOFT TISSUE/ 1000/- PER REGION
NECK/NEONATAL/BRAIN/ORBITS
14 ULTRASOUND GUIDED PROCEDURES 700/-
15 ULTRASOUND SCREENING WITHOUT PLATE 600/-
OBSTRETRIC SONOGRAPHY -1ST TRIMESTER/2ND
16 700/-
TRIMESTER(ROUTINE)
2ND TRMESTER(FETAL ANOMALY)/3RD
17 1200/-
TRIMESTER(BIO PHYSICAL PROFILE)
18 3D/4D ULTRA SOUND OF FETUS 1400/-
OVARIAN FOLLICULAR STUDY(SINGLE CYCLE)
19 700/-
TRANS ABDOMINAL
OVARIAN FOLLICULAR STUDY(SINGLE CYCLE)
20 900/-
TRANS VAGINAL
TRANS – ESOPHAGEAL ECHOCARDIOGRAPHY
21 3000/-
(WITH CD)
22 STRESS ECHO CARDIOGRAPHY (DSE) 3000/-

23 PSEUDO SCAN 800/-

PAGE-15
 (7) C.T.SCAN CHARGES

SR. NO. DESCRIPTION CHARGES

1 ANY 3D CT SCAN-JOINT/SINGLE BONE 3000/-

2 ANY ANGIO/SINGLE REGION 5000/-
3 BONE SCAN 1200/-
4 BRAIN WITH P.N.S. PLAIN 2000/-
5 C.T. GUIDED BIOPSY 2500/-
6 CHEST/ABDOMEN/PELVIS PLAIN 3500/-
7 CHEST/ABDOMEN/PELVIS WITH CONTRAST 5500/-
CT SCAN KNEE/WRIST/ELBOW/CERVICAL
8 3000/-
SPINE/D L SPINE/HIP/TIBIA
DENTAL CT SCAN-BOTH JAW-
9 4000/-
MAXILLA/MANDIBLE
DENTAL CT SCAN-SINGLE JAW-
10 2500/-
MAXILLA/MANDIBLE
11 DTPA SPECT SCAN 3200/-
12 E.E.G. 1100/-
13 FCG/HRV/HFECG/VEC STUDDY 1200/-
14 HEAD PLAIN 2000/-
15 HEAD SCAN WITH CONTRAST 3000/-
16 HIP JOINT & SI JOINT 3300/-
17 HRCT 3000/-
18 HRCT SCAN WITH CONTRAST 4000/-
19 IVP/UROGRAPHY/KUB CONTRAST 5000/-
20 IVP/UROGRAPHY/KUB PLAIN 3500/-
21 LIVER TRIPHASIC STUDY 4500/-
MULTIPLE (DOUBLE STUDY WITH CONTRAST)
22 7000/-
CHEST+ABDOMEN+PELVIS
23 MYELOGRAPHY 4800/-
24 NECK PLAIN 3000/-
25 NECK SCAN WITH CONTRAST 4000/-
26 NECK WITH CHEST 5000/-
27 ORBIT PLAIN 1500/-
28 ORBIT WITH CONTRAST 2000/-

PAGE-16
29 PARANASAL SINUS (LIMITED CORONAL) 2000/-
30 PARANASAL SINUS (P.N.S.) CONTRAST 2500/-
31 PET SCAN 13000/-
32 PULMONARY CT ANGIO 5000/-
33 SPINE UO TO 3 VERTIBRATOR 3000/-
34 THORAX PLAIN 3500/-
35 THORAX SCAN WITH CONTRAST 4000/-
36 VCG/TVCG/SAECG/QTD STUDDY 1200/-
37 VENOGRAPHY 5000/-

PAGE-17
 (8) M.R.I. CHARGES

SR.NO. DESCRIPTION CHARGES

1 ABDOMEN 3500/-
2 ANKLE 4000/-
3 ANY ANGIOGRAPHY OF SINGLE REGION 4300/-
4 BOTH HIPS 4000/-
5 BRACHIAL PLEXUS 3700/-
6 BRAIN ANGIO 4300/-
7 BRAIN SPECTROSCOPY 1200/-
8 BRAIN VENOGRAPHY 4000/-
9 C D SPINE 3600/-
10 CARDIC MR 7500/-
11 CERVICAL SPINE 3600/-
12 CV JUNCTION WITH FLEXION EXTENSION 3600/-
13 ELBOW 4000/-
14 FINGER 4000/-
15 FOOT 4000/-
16 HEAD PLAIN 3000/-
17 HEAD SCAN WITH CONTRAST 5000/-
18 KNEE MRI 4000/-
19 LUMBER SPINE/L S SPINE 3600/-
20 MEDIASTINUM 3500/-
21 MRCP 3600/-
22 MRI ANY CONTRAST 2400/-
23 NECK 3500/-
24 NECK ANGIO 1200/-
25 ONLY WHOLE SPINE SCR 600/-
26 ORBIT 3000/-
27 PARANASAL SINUS (P.N.S.) 3500/-
28 PELVIS 3500/-
29 PELVIS WITH BOTH HIPS 4200/-
30 PITUTARY 3500/-

PAGE-18
31 RENAL ANGIOGRAPHY 5000/-
32 SHOULDER 3500/-
33 SINGLE JOINT 3500/-
34 SINGLE PART OF A LIMB 3500/-
35 STROKE PROTOCOL 4300/-
36 WRIST/HAND 4000/-

PAGE-19
 (9) PATHOLOGY SECTION CHARGES
LABORATORY INVESTIGATIONS
(A) HAMATOLOGY:-

SR.NO. NAME OF TEST CHARGES

1 ABSOLUTE EOSONOPHIL COUNT 60/-

2 ANTINATAL PROFILE 1000/-

3 BAND CELLS 60/-

4 BLOOD GROUP 60/-

5 CBC (PLATELATE INCLUDE) 160/-

6 CBC WITH ESR 190/-

7 CBC WITH ESR WITH INDICES 210/-
8 CBC WITH ESR WITH MP 190/-
9 CBC WITH INDICES 180/-

10 CBC WITH MP 190/-

11 CBC WITH MP WITH INDICES 210/-

12 CBC WITH MP WITH ESR 210/-

13 COOMB’S DIRECT 220/-

14 COOMB’S INDIRECT 270/-

15 DIFFERENCE WBC COUNT (DC) 60/-

16 ESR 60/-

17 FERRITINE 620/-

18 FETAL HB 280/-
19 G6PD 160/-

20 HB A-2 800/-
21 HB ELECTROPHORESIS 800/-

22 HEMOGLOBIN 60/-

23 INDICES 120/-
24 LE CELLS 500/-

25 MALARIA PARASITE / PERPH SMEAR 60/-

26 MICROFILARIA 240/-

27 OSMOTIC FRAGILITY 280/-

PAGE-20
 28 PLATELETS 60/-

29 RBC FOLATE 1400/-

30 RETICULOCYTE 80/-

31 SERUM FOLATE 1000/-

32 SERUM IRON 400/-

33 SICKLING TEST 80/-

34 T.I.B.C. 400/-
35 TOTAL RBC COUNT (TRBC) 60/-

36 TOTAL WBC COUNT (TC) 60/-

(B) COAGULATION:-
37 BLEEDING PROFILE 400/-
38 BLEEDING TIME / CLOTTING TIME 60/- EACH
39 CLOT RETRACTION 60/-
40 FDP(D.CLIMER) 900/-

41 FIBRINOGEN 810/-

42 PARTIAL THROMBOPLATSTIN TIME (APTT) 180/-

43 PROTHROMBIN TIME (PTT) 150/-

44 THROMBIN TIME 600/-

(C)URINE:-
45 24HRS PROTIEN 240/-
24HRS URINE (CALCIUM/PHOSPHARAS/
46 180/-
CREATINEN/URIC ACID)
47 24HRS URINE VMA 840/-
ANY SINGLE CHEMISTRY
48 40/-
(ALBUMIN/SUGAR/ACETONE)
49 B.J.PROTEIN 150/-

50 MICROALBUMINURIA 500/-

51 RENEL STONE/ GALL STONE 550/-

52 URINE AMYLAZE 600/-

53 URINE BILE SALT / PIGMENT 40/- EACH

54 URINE CRT CLEARANCE 480/-

PAGE-21
 55 URINE FOR GONOCOCCI 300/-

56 URINE FOR LEPTOSPIROSIS 1800/-

57 URINE KETONE 30/-

58 URINE PROTEINE CREATININE RATIO 350/-

59 URINE ROUTIN AND MICRO 80/-

60 URINE ROUTINE 60/-

61 URINE ROUTINE WITH BSBP 100/-

62 URINE SUGAR / URINE ALBUMIN 30/- EACH

63 URINE SUGAR BY STRIP 40/-

(D) STOOL:-

64 CONC METHOD 70/-

65 HANGING DROPS 60/-

66 LACTOSE INTOLERANCE 40/-

67 OCCULT BLOOD 60/-

68 SEMEN ANALYSIS 140/-

69 STOOL CULTURE 360/-

70 STOOL ROUTINE 60/-

71 STOOL ROUTINE WITH OCCULT BLOOD 80/-

72 STOOL SUGAR 70/-

(E) SEROLOGY:-

73 AIDS WESTERN BLOT TEST 3600/-

74 AIDS/HIV 360/-

75 AMOEBIC ANTIBODY (IgG-IgM) 300/- EACH

76 ANA 720/-
77 ANA WESTERN BLOT TEST 3500/-

78 ANTI DNA 720/-

79 ANTI MICROSOMAL ANTIBODY 600/-

80 ANTISTREPTOLYSIN O TITRE (ASO) 250/-

81 BRUCELLOSIS 400/-

PAGE-22
 82 C REACTIVE PROTEIN (CRP) 300/-

83 DENGU (IgG-IgM) 500/- EACH

84 DS DNA 720/-

85 H.C.V. 600/-

86 H.PYLORI (IgG-IgM) 600/- EACH

87 HbsAg (AUSTRLIA ANTIGEN) 170/-

88 IMMUNOGLOBULINS TOTAL IGG,IGA,IGM 500/-EACH

89 INFECTIOUS MONON UCLEOSIS 500/-

90 LEPTOSPIROSIS (IGG-IGM) 720/-EACH

91 MALERIAL ANTIGEN TEST 400/-

92 NS-1 ANTIGEN 800/-

93 PREGNANCY TEST (ELISA) 150/-

94 RHEUMATOID ARTHRITIS (RA) 150/-

95 S.C3 LEVEL 900/-

96 TPHA 450/-
97 TROPONIN-T 1000/-
98 VDRL 120/-

99 WIDAL /FEBRILE ANTIGENS SEROLOGY 120/-

(F) MICROBIOLOGY:-

100 ASPIRATION CYTOLOGY WITH PROC. 650/-

101 BLOOD CULTURE & SENSITIVITY 1200/-

102 CYTOLOGY (PAP SMEAR) 350/-

103 FUNGAL BACTEC 1000/-

104 FUNGAL C/S 700/-

105 FUNGAL CULTURE & SENSITIVITY 700/-

106 FUNGAL STAIN 200/-

107 GRAM STAIN 70/-

108 KOH/GONOCOCCI 150/-

109 LEPRA BACILLI 400/-
110 OPTIONAL ANAEROBLE 70/-

111 PUS/SPUTUM/FLUID CULTURE & SENSITIVITY 700/-

PAGE-23
112 ROUTINE AEROBIC C/S 600/-

113 SPUTUM EXAMINATION 150/-

114 URINE CULTURE & SENSITIVITI 400/-

115 Z. N. STAIN/SPUTUM AFB 70/-EACH

(G) BIOCHEMISTRY:-

116 24 Hrs. URINARY PROTIN 120/-

117 ALKALINE PHOSPHATASE 120/-

118 AMYLASE 250/-

119 APOLIPOPROTEINS 800/-

120 BILIRUBIN 120/-

121 CHOLESTREROL 150/-

122 CL - 120/-
123 CPK 250/-

124 CPK- MB 360/-

125 CPK- MM 600/-

126 CPK- MP 850/-

127 CREATININE 120/-

128 ELECTROLYTES 500/-

129 G.T.T. (3 SAMPLE) 250/-

130 G.T.T. (5 SAMPLE) 500/-

131 GAMMA GT (GGT) 150/-

132 HB1AC- GLYCOSYLATED 600/-

133 HCO3 140/-

134 HDL 150/-

135 K+ 120/-

136 LACTIC ACID 600/-

137 LDH 150/-

138 LIPID PROFILE 600/-

139 LIVER FUNCTION TEST (LFT) 600/-
140 MANTOUX TEST (MT TEST) 70/-

141 NA+ 120/-

PAGE-24
 142 OSMOLALITY 900/-

143 PHOSPHOROUS 150/-

144 PROTEIN ELECTROPHORESIS 800/-

145 SERUM ACETONE 80/-

146 SERUM ACID PHOSPHATASE 550/-

147 SERUM AMMONIA 700/-

148 SERUM CALCIUM 170/-

149 SERUM CALCIUM IONIZED 300/-

150 SERUM CHOLINESTERASE 800/-

151 SERUM LIPASE 550/-

152 SERUM LITHIUM 500/-

153 SERUM MAGNESIUM 400/-

154 SGOT 100/-

155 SGPT 120/-

156 SUGAR BY GLUCOSTRIP 60/-

157 SUGAR FBS/PP2BS/RBS 60/-EACH
158 TOTAL PROTEIN 120/-

159 TREIGLYCERIDE 150/-

160 UREA 100/-

161 URIC ACID 120/-

162 YGT (GGTP) 350/-

(H) BODY FLUIDS:-

163 CSF EXAMINATION 300/-

164 FLUID ADA LEVEL 700/-

165 FLUID CYTOLOGY/FLUID ROUTINE 250/-EACH

166 PERICARDIAL FLUID EXMINATION 300/-

167 PERITONEAL FLUID EXMINATION 300/-

168 PLEURAL FLUID EXMINATION 300/-

169 SEMEN WITH FRUCTOSE 150/-

PAGE-25
(I) HORMONES:-

170 CORTISOL 600/-

171 DHEAS 550/-

172 ESTRADIOL 600/-

173 ESTROIL 600/-

174 FREE T3 400/-

175 FREE T4 400/-
176 FSH 400/-

177 LH 400/-

178 PARA THYROID HORMONE 1200/-

179 PROCALCITONE ( QUNTITATIVE) 2100/-

180 PROCALCITONE (QUALITATIVE) 3600/-

181 PROGESTERONE 550/-

182 PROLACTIN 400/-

183 SERUM INSULIN LEVEL 550/-

184 T3 200/-
185 T3T4TSH 600/-
186 T4 200/-

187 TESTOSTERONE 600/-

188 TSH 300/-

189 17-HYDROXY PROGESTERONE 1300/-

(J) TOMOUR MARKERS:-

190 AFP (ALFA FETO PROTEIN) 700/-

191 B.HCG 700/-

192 CA 125 1100/-

193 CA 15.3 950/-

194 CA 19.9 950/-

195 CEA 800/-

196 PSA 600/-

PAGE-26
(K) DRUG ASSAY:-

197 CARBAMEZIPINE 800/-

198 DIGOXIN 650/-
199 PHENYTOIN 800/-

200 THEOPHYLLIN 1100/-

201 TRIXYCLIC ANTIDEPRESSANT 750/-

202 VALPROIC ACID 1000/-

(L) TUBERCULOSIS:-

203 BACTEC CULTURE PUS 1000/-

204 BACTEC CULTURE URINE 1000/-

205 BACTEX CULTURE CSF 1000/-

CULTURE BY BACTEC METHOD
206 1000/-
BACTEC CULTURE SPUTUM
207 T.B. IGA 800/-
208 T.B. IGH 600/-

209 T.B. IGM 800/-

210 T.B.C/S.BACTEX METHOD SECONDARY DRUG 700/-

(M) CYTOLOGY:-

211 BONE MARROW PROCEDURE 500/-

212 BONE MARROW REPORTING 500/-

213 FNAC PROCEDURES AND REPORTING 800/-

214 PAS STAIN 250/-

215 VAGINAL PAP’S SMEAR 300/-

PAGE-27
(N) HISTOPATHOLOGY:-
216 APENDIX 550/-
217 BONE 1100/-

218 BONE MARROW 1000/-

219 BONE MARROW TREPHINE 1200/-

220 BRAIN TUMOR 1200/-

221 BREAST 850/-

222 CT GUIDED/IMPRINT/FNAC CRUSH WITH VISIT 1700/- EACH

223 ENDOMETRIAL BIOPSY 600/-

224 ENT 600/-

225 FROZEN SECTION 1000/-

226 GALL BLADER 950/-

227 INTESTINE 1150/-

228 LIVER 600/-
229 LYMPHNODE 900/-

230 MODIFIED RADICAL MASTECTOMY 1500/-

MULTIPLE MUCOSAL BIOPSIES
231 850/-
(LIKE ESOPHAGUS / COLONOSCOPY)
232 MUSCOSAL 900/-

233 RND 1500/-

234 SKIN 550/-
235 SOFT TISSUE 1200/-

236 TESTICULAR 800/-

237 THYROID 1200/-

238 TUR 1000/-
239 UTERUS & CERVIX 1000/-

240 UTERUS / CERVIX AND ADNEXA 1000/-

PAGE-28
(O) INFERTILITY PROFILE:-

241 ANTI CARDIOLIPIN ANTIBODY 700/-

242 TORCH FULL 4200/-
243 TAXOPLASMOSIS IGG/IGM 500/-EACH

244 RUBELLA IGG/IGM 500/-EACH

245 CYTOMEGALO VIRUS IGG/IGM 550/-EACH

246 HERPEES IGG/IGM 800/-EACH

247 CHLAMYDIA IGG/IGM 800/-EACH

(P) HEPATITIS MARKER:-

248 ANTI HAV (HEPATITIES A) 700/-

249 ANTI HCV ANTIBODY 600/-
250 ANTI HEV 1100/-
251 HBC A.G. (HEP B.E. ANTIGEN)/ANTI HBC TOTAL 550/-EACH

252 HBS A.B. (HEP B SURFACE ANTIBODY) 550/-

(Q) IMMUNO-HISTOCHEMISTRY:-

253 ANAPLASTIC LARGE CELL LYMPHOMA 1000/-

254 CD 34% IN BMT PATIENTS 500/-

255 ER-PR 1000/-

256 HER-2 NEU ONCOPROTEIN 650/-

257 IMMUNOHISTOCHEMISTRY (IHC) 1700/-

258 IMMUNOPHENOTYPING OF ACUTE LEUKEMIA 5600/-

259 PNH TEST 3950/-

PAGE-29
(R) OTHER INVESTIGATION:-

SR. NO. NAME OF TEST CHARGES

260 “V” CHROMOSOME (16 MUTATIONS) 7200/-
261 ABG 850/-

262 ANGIOTENSIN CONVERTING ENZYME (ACE) 1300/-

263 ACETYL CHOLINE RECEPTOR ANTIBODY 2600/-

264 ACTH 1200/-

265 ACUTE LEUKAEMIA PANEL 6000/-

266 ALCOHOL 800/-

267 ALDOSTERONE 1100/-

268 ALPHA FETOPROTEIN 700/-

269 AML PROGNOSTIC PCR PANEL 9000/-

270 AMINO ACID URINE 950/-

271 AMNIOTIC FLUID (AF) 10000/-

272 ANCA 1400/-

273 ANTI CCP 1300/-
274 ANTI DIURETIC HORMONE (ADH) 1400/-

275 ANTI GBM ANTIBODY 1100/-

276 ANTI GLIADIN ANTI BODY (A OR G) 1200/- EACH

277 ANTI MITOCHONDRIAL ANTI BODY 1400/-

278 ANTI MULLERIEN HORMONE 1700/-

279 ANTI OVARIAN ANTIBODY 600/-

280 ANTI SPERM ANTIBODY 600/-
281 ANTI THROMBIN III 1700/-

282 ASCA (IgG-IgA) 1200/- EACH

283 ASPERGILLAS ANTIBODY 1070/-

285 AUTO IMMUNE ENCEPHALITIS PANEL 10000/-

286 AUTO IMMUNE HEPATITIS PANEL 3750/-

287 B2 MICROGLOBULIN 1100/-

288 BCR / ABL (CML, AML, ALL) 5400/-

289 BETA2 GLYCOPROTINE (IgG-IgM) 800/- EACH
290 BUCCAL MUCOSA FOR X-Y STUDY 1400/-

291 C MYC (ALL, NHL) 5400/-

PAGE-30
292 C1Q 1000/-

293 C3 & C4 550/- EACH

294 C3 COMPLEMENT 550/-

295 CARDIOLIPIN (A/G/M) 500/- EACH

296 CATECHOLAMINE – SERUM 3500/-

CATECHOLAMINE – URINE
297 3500/-
(24HRS COLLECTION IN HCL)
298 CD4/CD8 2000/-EACH

299 CEA 1100/-

300 CERULOSPASMIN COPPER OXIDASE 700/-

301 CHIKEN GUNIYA (IgG/IgM) 1700/- EACH

302 CHORION (CVS) 10000/-

303 CHROMOSOME BREAKAGE SYNDROME 10000/-
CHRONIC INFLAMATORY BOWEL DISEASE
304 4700/-
PROFILE
305 CLOSTRIDIUM DIFFICILE ANTIGEN 3750/-

306 CMV-PCR (QUALITATIVE) 4200/-

307 CMV-PCR (QUANTITATIVE) 6200/-

308 CORTISOL - SERUM (AM OR PM) 400/- EACH

CORTISOL – URINE
309 550/-
(24HRS COLLECTION IN GLACIAL ACID)
310 C-PEPTIDE 800/-

311 C-PSA (COMPLEX PSA) 7200/-

312 CYTOGENETICS 1550/-

313 D. DIMER 1200/-

314 DNA ISOLATION AND STORAGE 2000/-

315 DOUBLE MARKER (FREE BCG, PAPPA) 1700/-

316 DRUG ALLERGY 2400/-

317 DRUGS OF ABUSE (8 DRUGS) 5400/-

318 DRVVT 2750/-

319 ENDOMYCIAL ANTIBODIES (A/G/M) 1200/- EACH

320 ENTEROCHECK TEST 550/-

321 EPSTEINBARR VIRUS 1200/- EACH
322 ERYTHRO POIETIN EPO LEVEL 1300/-

323 FACTOR ( V,VI,VII,VIII,IX,X ) 1700/- EACH

324 FETAL BLOOD SAMPLE FOR KARYOTYPING 6000/-

PAGE-31
325 FILARIAL ANTIBODY (IgG-IgM) 800/- EACH

326 FISH FOR CLL PANEL 9000/-

327 FOLIC ACID 600/-

328 FOOD ALLERGY (NON VEG. ONLY) 1900/-

329 FOOD ALLERGY (VEG. ONLY) 3000/-

330 FRAGILE “X” SYNDROME 4800/-

331 FRAGILE X SYNDROME 6000/-

332 FREE LIGHT CHAIN ASSAY (FLC) 4000/-

333 GAD ANTIBODY 1400/-

334 GASTRINE 1100/-

335 GENETIC STUDY OF COUPLE WITH POC 10800/-

336 HAPATOGLOBIN 900/-

337 HBeAB 850/-

338 HBS ANTIBODY (QUANTITATIVE) 600/-

339 HBV DNA –PCR (QUALITATIVE) 3500/-

340 HBV DNA –PCR (QUANTITATIVE) 4400/-
341 HCV PCR (QUALITATIVE) 3500/-

342 HCV PCR (QUANTITATIVE) 5500/-

343 HCV RNA GENOTYPING 3500/-

344 HBeAG 800/-

345 HEMOFILIYA 3600/-

347 HEP-B CORE (IgG/IgM) 550/- EACH

348 HEP-E ANTIGEN OR ANTIBODY 550/- EACH

349 HERPEES ZOASTER (IgG/IgM) 700/-EACH

350 HEV (E VIRUS) IgG/IgM 700/- EACH

HIGH RESOLUTION
351 8400/-
CHROMOSOME STUDY (COUPLE)
352 HIGH RESOLUTION CHROMOSOME STUDY 5400/-

353 HIV PCR (QUANTITATIVE) (VIRAL LOAD) 4700/-

354 HIV PCR (QUALITATIVE) 4200/-

355 HLA B27 1900/-

356 HLD/B27 3100/-

357 HOMOCYSTEINE LEVEL 1400/-

358 HSV I OR II (IGG OR IgM) 550/- EACH

359 HSV PCR (QUALITATIVE) 3500/-

PAGE-32
360 HSV PCR (QUANTITATIVE) 4400/-

361 HUMAN GROWTH HORMONE 650/-

362 IgE 600/-

363 IgF 2300/-

364 IgG/IgM/IgA 400/-EACH

365 IGG4 5060/-

366 IGL LEVEL 950/-

IMMUNO ELECTROPHOROSIS
367 7000/-
(IMMUNOFIXATION)
IMMUNO THERAPY (VACCINE)
368 2750/-
4 VIALS INJECTABLES
369 IMMUNO THERAPY (VACCINE) 4 VIALS ORAL 4200/-

370 INFLUENZA (A & B) (THROAT / NASAL SWAB) 1700/-

371 INHALANT ALLERGY WITH CONTACT ALLERGY 1700/-

372 INHIBIN-A 1400/-
373 INSULIN LIKE GROWTH FACTOR(IGF1) 2200/-

374 INTRINSTIC FACTOR 1700/-

375 JAPANESE ENCYPHALITIS (IgG/IgM) 700/- EACH

376 JO 1 1100/-
377 LACTATE 950/-

378 LECTASH PAYRUVATE 1700/-

380 LEPROSY (IgG/IgM) 1200/- EACH

381 LUPUS ANTI COAGULANT (A) 800/-

LYMPHOCYTE CULTURE
382 4200/-
FOR KARYOTYPING (SINGLE)
LYMPHOCYTE CULTURE
383 5400/-
FOR KARYOTYPING (COUPLE)
384 MEASALS (IgG/IgM) 550/- EACH
385 MUMPS (IgG/IgM) 550/- EACH

386 MYOGLOBIN 1200/-

NEURONAL AUTOIMMUNE ANTIBODIES BY
387 3600/-
IMMUNOBLOT
388 NSE 74 (LUNG CANCER) 1700/-

389 PAPILLOMA VIRUS – PCR 6000/-

390 PAPPA (FOR EARLY DOWN’S SYNDROME) 1100/-

391 PATERNITY TESTING (3 PERSON) 18000/-

392 PF/PV ANTIBODY 400/-EACH

393 PRENATAL CHROMO (13, 18, 21, X & Y) 8400/-

PAGE-33
394 PRENATAL THALASSAEMINA 11000/-

395 PRO BNP 2800/-

396 PRODUCTS OF CONCEPTION 5400/-

397 PROTEIN (C OR S) 1700/- EACH

398 QUADRIPLE TEST 1600/-

399 RABBIES ANTIBODY (IgG/IgM) 950/- EACH

400 S LEAD LEVEL 1900/-

401 SERUM CEPHALOPLASMIN 1100/-

402 SHBG 1700/-

403 SICKLE CELL ANEMIA 2750/-

404 SSA/SSB/SCL 70/SMOOTH MUSCLE AB 1100/- EACH

405 STONE ANALYSIS 700/-

406 TACROLIMMUS 2750/-

407 TB A/G/M (ALL THREE) 1400/-

408 TB A/G/M/G COMPLEX 550/- EACH

409 TB INTERFERONE/TB GOLD 1700/-
410 TB PCR – (QUANTITATIVE) (GENXPERT) 1700/-
TB PCR – REAL TIME (QUANTITATIVE)
411 2150/-
(GENXPERT)
412 TESTOSTERONE 500/-

413 TESTOSTERONE – FREE 900/-

414 TETANUS ANTIBODY (IgG/IgM) 950/- EACH

THYROID ANTIBODIES
415 700/- EACH
(MICROSOMAL / THYROGLOBULIN)
416 THYROID BINDING GLOBULINE 800/-

417 THYROID RECEPTOR AB 1400/-

418 TORCH-10 (WITH CHLAMYDIA & VDRL) 2900/-
419 TORCH-8 (WITH VDRL) 1900/-

420 TPO (THYROID PEROXIDASE) 800/-

421 TRANSFERRING 1100/-

422 TRIPLE TEST (AFP,BCG,E3) WITH GRAPHICS 1700/-

423 TRISOMY 12 (CLL) 4800/-

424 TRISOMY 21 (PRE NATAL SAMPLE – AF/CVS) 6000/-

425 TRISOMY 8 4800/-

426 TTGA (TISSUE TRANS GLUTAMASE) 1000/-

PAGE-34
427 TYPHIDOT (lgG/lgM) 800/- EACH

428 URINARY COPPER (ATOMIC ABSORPTION) 1900/-

429 URINARY NA+ 300/-

URINE KETO STEROID –
430 1200/-
24HRS COLLECTION IN HCL
VEG WITH NON VEG WITH INHALANT WITH
431 6000/-
DRUGS
432 VEG. PROFILE (VEG.FOOD + INHALANT) 3500/-

433 VERICELLA AB (IgG/IgM) 700/- EACH

434 VITAMIN-B1/B6 1400/- EACH

435 VITAMIN-B12 900/-

436 VITAMIN-C (ASCORBIC ACID) 1400/-

437 VITAMIN-E 1400/-

438 VITAMIN-K 1400/-

439 VITAMIN-D3 (1,25 OR 25 HYDROXY) 1100/- EACH
440 VMA – 24HRS COLLECTION IN HCL 1200/-

441 ZINC 1400/-

PAGE-35
 (10) ANESTHESIA AND O.T. CHARGES

SR.NO. DESCRIPTION CHARGES

1 LOCAL ANESTHESIA 350/-

25% OF OPERATION
2 GENERAL ANESTHESIA
CHARGE
20% OF OPERATION
3 OPERATION THEATRE CHARGES
CHARGES
20% OF OPERATION
4 LABOUR ROOM CHARGE
CHARGES
AT PAR WITH
5 SUTURE MATERIAL CHARGES
COST(M.R.P.)
20% OF OPERATION
6 ANY SPECIALIZED INSTRUMENT CHARGE
CHARGES
EMERGENCY/HIGH RISK/COMPLICATED ADD 25% OF
7
OPERATION CHARGE OPERATION CHARGES
BUCKLING IMPLANT LIKE SILICON SPONGE, AT PAR WITH
8
BAND, TIRE ETC. CHARGES COST(M.R.P.)
AT PAR WITH
9 DRUG USED IN RETINAL SURGERY CHARGE
COST(M.R.P.)
SPEED BAND FOR BINDING, SELEROTHERAPY AT PAR WITH
10
NEEDLES, CYNOACRYLATE GLUE ETC. CHARGES COST(M.R.P.)
AT PAR WITH
11 COST OF DISPOSABLE
COST(M.R.P.)
ANY MATERIAL USED IN ORTHOPAEDIC AT PAR WITH
12
DEPARTMENT COST(M.R.P.)

PAGE-36
 (11) CHEMOTHERAPY AND
RADIOTHERAPY AND ONCO SURGERY
CHARGES

SR. NO. DESCRIPTION CHARGES

1 CANECR BREAST 12600/-

2 CANECR HEAD & NECK 25200/-

3 CANCER ESOPHAGUS 36000/-

4 CANCER OVARY, UTERUS CERVIX 25200/-

5 CANCER LUNG 44400/-

6 CANCER LARYNX 26400/-

7 CANCER BLADDER 36000/-

8 CANCER PENIS+BILATERAL GROIN 26400/-

9 CANCER COLON 20400/-

10 CANCER RECTUM 27600/-

11 CANCER STOMACH 27600/-

12 CANCER GALL BLADDER 44400/-

13 CANCER THYROID 20400/-

14 HEPATOMALIVER 72000/-
15 SOFT TISSUE SARCOMA 18000/-

16 SKIN MELIGNANCY 18000/-

17 CANCER PANCREAS 7200/-

18 MULTIPLE LID TUMER BOTH EYE 6000/-

20 MALIGNAT UTERUS CYST/ OVERAIN CYST 16800/-

MALIGNAT CERVICAL CYST
21 16800/-
(WERTHEIM’S CYST)
22 CHEMOTHERAPY PLANNING 1800/-
23 CHEMOTHERAPY ADMINISTRATION 1200/-

NOTE:- CHEMOTHERAPY RELATED DRUGS MUST BE SUPPLIED BY

RECOGNISED HOSPITAL IN STAFF TREATMENT BILL.

PAGE-37
RADIOTHERAPY CHARGES:-

SR. NO. PROCEDURE CHARGES

1 3-D CONFORMAL RADIOTHERAPY PACKAGE 33600/-

2 BRACHYTHERAPY WITH G.A. 1700/-

3 BRACHYTHERAPY WITHOUT G.A. 1000/-

4 CT SCAN PLANNING 6600/-

CT SCAN PLANNING WITH SPECIAL ORFIT
5 7300/-
CAST
INTENSITY MODULARTED RADIOTHERAPY
6 46800/-
PACKAGE
7 RAPID ARC/VMAT RADIOTHERAPY 40000/-

8 REIRRADIATION 3350/-

9 RETREATMENT 3350/-
10 RT CURATIVE 5300/-
11 RT PALLIATIVE 3350/-

12 RT SINGLE FRACTION 1300/-

13 RT WITH CAST WITH STIMULATOR 5300/-
RT WITH SIMULATOR WITH SPECIAL ORFIT
14 6600/-
CAST
15 RT WITH SPECIAL ORFIT CAST 6600/-

16 RT WITH STIMULATOR 5300/-

17 RT WITH TPS PLANNING 5300/-

RT WITH TPS PLANNING WITH SPECIAL ORFIT
18 16500/-
CAST
19 SRS 66000/-

20 SRT 79000/-
TELETHERAPY WITH CURATIVE WITH 2D WITH
21 46800/-
ST PACKAGE

PAGE-38
 (12) CATH-LAB CHARGES

SR. NO. NAME OF CARDIAC PROCEDURE CHARGES

1 CORONARY ANGIOGRAPHY 7800/-
PERIPHERAL ANGIOGRAPHY / RENAL
2 9000/-
ANGIOGRAPHY
CORONARY ANGIOGRAPHY +
3 12600/-
PERIPHERAL/RENAL ANGIOGRAPHY / CAROTID
4 CORONARY BALLOON ANGIOPLASTY ONLY 54000/-

CORONARY ANGIOPLASTY 60000/-

7260/- (LOCAL TAXES
A -1) BARE METAL STENT (BMS)STAINLESS STEEL
APPLICABLE)
5 DRUG ELUTING STENTS (DES) INCLUDING
METALLIC DES AND BIORESORBLE 29600/- (LOCAL TAXES
VASCULAR SCAFFOLD APPLICABLE)
(BVS)/BIODEGRADABLE STENTS
PERIPHERAL/RENAL ANGIOPLASTY 54000/-
6
COST OF STENT 35000/-
CAROTID ANGIOPLASTY- (UNILATERAL) 48000/-
7
COST OF STENT 45000/-
CAROTID ANGIOPLASTY – (BILATERAL) 72000/-
8
COST OF FILTER 65000/-

AORTIC STENTING 42000/-

9
COST OF STENT 45000/-

ASD (ATRIAL SEPTAL DEFECT) CLOSURE 36000/-

10
COST OF ASD DEVICE 80000/-

VSD (VENTRICULAR SEPTAL DEFECT) CLOSURE 36000/-

11
COST OF VSD DEVICE 80000/-

PDA (PATENT DUCTUS ARTERIOUS) CLOSURE 36000/-

12
COST OF PDA DEVICE 50000/-

13 BALLOON MITRAL VALVOPLASTY (BMV) 54000/-

14 BALLOON AORTIC VALVOPLASTY (BAV) 54000/-

15 BALLOON PULMONARY VALVOPLASTY (BPV) 54000/-

BALLOON DILATATION COARCT 54000/-

16
COST OF STENT 40000/-

17 TEMPORARY PACEMAKER (TPI) 6000/-

PAGE-39
 PERMANENT PACEMAKER (PPI) 24000/-

COST OF PACE MAKER

18
A) SINGLE CHAMBER (DI/DR) 95000/-

B) DOUBLE CHAMBER (DI/DR) 200000/-

19 CARDIAC CATHLAB WITH OXYMETRY 9600/-

20 CARDIAC CATHLAB WITHOUT OXYMETRY 9000/-

21 EP STUDY DIAGNOSTIC 24000/-

22 EP STUDY THERAPEUTIC 36000/-

23 CHECK CORONARY ANGIOGRAPHY 6000/-

IVC FILTER 24000/-

24
COST OF FILTER 45000/-

BI VENTRICULAR PACEMAKER (CRT) 60000/-

25
COST OF PACE MAKER (CRT) 275000/-
AICD (AUTOMATIC IMPLANTABLE CARDIAC
60000/-
26 DEFIBRILATER)
COST OF IMPLANT 275000/-
COMBO (AICD WITH VENTRICULAR
84000/-
27 PACEMAKER - CRT)
COST OF IMPLANT 650000/-
CORONARY ARTERY BYPASS GRAFT SURGERY
28 138000/-
(NON-BEATING)(WITHOUT IABP)
29 IABP 60000/-

30 RE-DO CORONARY ARTERY BYPASS SURGERY 168000/-

31 ASD SURGERY (ATRIAL SEPTAL DEFECT) 132000/-

32 VSD SURGERY (VENTRICULAR SEPTAL DEFECT) 132000/-
PDA LIGATION SURGERY (PATENT DUCTUS
33 48000/-
ARTERIOSUS)
MVR (MITRAL VALVE REPLACEMENT) 132000/-

34 COST OF METALIC VALVE 45000/-

COST OF BIO PROSTATIC VALVE 75000/-

AVR (AORTIC VALVE REPLACEMENT) 132000/-

35 COST OF METALIC VALVE 45000/-

COST OF BIO PROSTATIC VALVE 75000/-

DVR ( DOUBLE VALVE REPLACEMENT) 156000/-
36 COST OF METALIC VALVE 45000/-

COST OF BIO PROSTATIC VALVE 75000/-

37 TOF (TETRALOGY OF FALLOT)/ CHD 144000/-

PAGE-40
38 RE-EXPLORE 12000/-

39 RE-SUTURING 12000/-

40 EMBOLECTOMY 42000/-

41 AORTA FEMORAL BYPASS SURGERY 108000/-

42 AORTA BI FEMORAL BYPASS SURGERY 168000/-

B T SHUNT- (BLALICK TAUSSING SHUNT) WITH
43 78000/-
CONDUIT
44 PERICARDIACTOMY 54000/-

45 THORACOTOMY (COARCTATION OF AORTA) 108000/-

46 BENTAL SURGERY 300000/-

THORACOTOMY (CMV, PERICARDIAL WINDOW
47 54000/-
ETC.)
CABG + MVR (COST OF VALVE/ RING EXTRA) 156000/-
48 COST OF METALIC VALVE 45000/-

COST OF BIO PROSTATIC VALVE 75000/-

RSOV REPAIR (RUPTURE SINUS OF VALSALVA) 156000/-

COST OF METALIC VALVE 45000/-

49
COST OF BIO PROSTATIC VALVE 75000/-

COST OF CONDUIT 100000/-

PERMANENT PACEMAKER INSERTION
50 42000/-
(EPICARDIAL) (COST OF PACEMAKER EXTRA)
51 HOLTER 2400/-
52 CARDIAC STRESS PERFUSION 12870/-
53 SLEEP STUDY 6150/-

54 THROMBOSUCTION 42000/-

PAGE-41
 (13) DENTAL CHARGES

SR. NO. PROCEDURE CHARGES

1 X-RAY FOR ONE TOOTH (IOPA) 90/-

2 OCCUSAL X-RAY 200/-

3 O.P.G. 700/-
4 ABSECESS DRAINAGE 120/-

5 ACRIPOD DENTURE 10200/-

6 AFEXIFICATION PER TOOTH 1100/-

7 ALVELOPLASTY 120/- PER ARCH

8 ALVEOLECTOMY FOR SEGMENT 350/-

9 APICOECOTOMY PER TOOTH 1800/-
10 ARTHROCASTESIS 1200/-

11 BLEACHING 1200/- PER SITTING

12 BONE GRAFTING 2400/-

13 CEMENT FILLING 60/-
14 CERAMIC BRACKETS 21600/-

15 COMPLETE ACRYLIC DENTURE 2400/- TO 6000/-

16 CROWN CEMENTATION 250/-

17 CURETTEGE WITH ROOT PLANNING 450/-

18 CYST ERADICATION 600/-

19 CYST REMOVAL 1100/-

20 DEGRANULATION- LASER (PER QUANRANT) 250/-

21 DENTURE REFILLING 400/-

22 DENTURE REPAIR 250/-

23 DEPIGMENTATION (PER QUADRANT) 180/-

24 DEPIGMENTATION- LASER (PER QUADRANT) 250/-

25 DISIMPACTION 600/-

26 DRESSING WITH MATERIAL 60/-

27 EXTRACTION FRO ONE TOOTH- SIMPLE 100/-

28 EXTRACTION FRO ONE TOOTH- SURGICAL 500/-

29 FLAP SURGERY (FULL MOUTH) 1200/-

30 FLAP SURGERY (PER QUANRANT) 300/-

PAGE-42
 FLAP SURGERY WITH BONE GRAFT
31 1200/-
(PER QUADRANT)
32 FLAP SURGERY WITH BONE GRAFT (FULL MOUTH) 4800/-
FLAP SURGERY WITH BONE GRAFT AND GTR
33 2400/-
(PER QUANRANT)
34 FRENECTOMY 600/-

35 FULL CAST CROWN- CHROME – COBALT (BRIDGE) 850/-

36 FULL CAST CROWN- GOLD 600/-

37 FULL CAST CROWN- PORCELINE/CERAMIC 1800/-

38 FULL CAST CROWN- ZIRCONIUM METAL 4200/-

39 FULL MOUTH SCALING & POLISHING 400/-

40 GINGIVECTOMY- FULL MOUTH 3600/-

41 GINGIVECTOMY- PER SEGMENT 950/-

42 GLASS JONOMER FILLING- CROWN BUILD UP 950/-

43 GLASS JONOMER FILLING- ONE 400/-
44 HEMISECTION 600/-

45 I&D 350/-
46 IMPACTED MOLAR- DISTO ANGULAR & VERTICAL 1000/-

47 IMPACTED MOLAR- HORIZONTAL 1400/-

48 IMPACTED MOLAR- MESIO 1000/-

49 IMPLANT 5400/-

50 IMPLANT PLACEMENT WITHOUT PROSTHESIS 5400/-

51 IMPLANT WITH PROSTHESIS 9000/-

52 INLAY- CHROME – COBALT 700/-
53 INLAY- GOLD 500/-

54 JACKET CROWN ACRYLIC 350/-

55 LIGHT CURED COMPOSITE 800/-
56 LINGUAL BRACKETS 30000/-

57 LUCTION 6600/-

58 METAL BRACKETS 10800/-

MUCOGINGIVAL SURGERY WITH SOFT TISSUE
59 1800/-
GRAFT
MUCOGINGIVAL SURGERY WITHOUT SOFT TISSUE
60 1200/-
GRAFT
61 MYOFUNCTIONAL APPLIANCE 2400/-

62 NIGHT GUARD 1200/-

63 OPERCULECTOMY 250/-

PAGE-43
64 OPERCULECTOMY- LASER 600/-

65 ORTHO DENTIST TREATMENT(AMERICAN) 26400/-

66 ORTHO DENTIST TREATMENT(INDIAN) 16800/-

67 PERICORONAL FLAP 300/-

68 POLYP EXCISION 200/-

69 POST AND CARE- FIBRE 900/-

70 POST AND CORE 350/-

71 PRP PROCEDURE 4550/-

72 REMOVABLE APPLIANCE 1200/-

REMOVABLE PARTIAL DENTURE-
73 60/-
ONE ADDITIONAL
74 REMOVABLE PARTIAL DENTURE- ACRYLIC 350/-
75 RIDGE AUGMERNTATION 2400/-

76 ROOT CANAL TREATMENT-ANTERIOR 1000/-

77 ROOT CANAL TREATMENT-POSTERIOR 1200/-

78 ROOT RESECTION 600/-
SCALLING AND ROOT PLANNING UNDER L.A.
79 60/-
(PER QUANRANT)
SCALLING AND ROOT PLANNING UNDER L.A.
80 300/-
(FULL MOUTH)
81 SILVER FILLING- ONE SURFACE 350/-

82 SILVER FILLING- TWO SURFACE 500/-

83 SPACE MAINTAINER 600/-

84 TMJ SPLINT 1200/-

85 VESTI BULOPASTY 1200/-

PAGE-44
 (14) DERMATOLOGICAL CHARGES

SR.NO. DERMATOLOGICAL THERAPY CHARGES

1 ACNE SURGERY (COMIDOEXTRACTION) 120/- PER SITE

2 ANATALOGUS MINI – PUNCH GRAFTING 300/-

3 CARBOLIZATION (PER APPLICATION) 60/-

CHEMICAL PEELS (GLYCOLIC ACID)
4 600/-
TRICHLOR (ACUTIC ACID) GATA
5 COMEDONE EXTRACTION 180/-

6 CRYO THERAPY 400/- PER LESION

7 ELECTRO CAUTERISATION (PER SITE) 120/-

8 ELECTROLYSIS 950/- PER SITTING

9 EXCISIONAL SURGERY (MOLES ETC.) 400/- PER LESION
10 INTRADERMAL INJECTION ADMINISTRATION 60/- EACH

11 INTRADERMAL INJECTION WITH DERMOJET 60/- EACH

12 KOH SMEAR 180/-

13 MELLUSUM CONTAGIOSUM EXTRACTION 70/- EACH

14 NAIL AVULALSION 600/-
15 P U VA THERAPY 60/- PER SITTING

16 PARRING 180/-
17 PATCH TESTING 60/- EACH

18 PHOTOCHEMOTHERAPHY 120/- PER SITTING

19 PODOPHYLIN CHARGES 60/- EACH

20 PRICK TEST 180/- PER PRICK

21 SKIN BIOPSY 240/-
22 SMEAR FOR AFB 180/-

23 SMEAR FOR GONOCOCCI 180/-

24 TZANCK TEST 180/-

25 WOODS LAMP EXAMINATION 120/-

PAGE-45
 (15) PSYCHIATRIC THERAPY CHARGES

SR.NO. PARTICULARS CHARGES

1 BEHAVIOUR THERAPY (INDIVIDUAL) 280/-

CEREBRAL STIMULATION (NON CONVULSIVE
2 400/-
CURRENT THERAPY)
3 COGNITIVE (PER PERSION) 60/-

4 CRISIS INTERVENTION 400/-

5 ECTUNDER ANAESTHESIA 800/-

6 FREASSOCIATIONS ABREACTIONS 280/-

7 HYPNOTISM 600/-
8 MATERIAL PSYCHOTHERAPY (COUPLE) 400/-

9 PENTOTHAL ABREACTION / CO2 ABREACTION 400/-

10 PSYCHOTHERAPY / COUNSELLING (INDIVIDUAL) 280/-
11 S.I. 240/-

12 SPEECH THERAPY (PER PERSION) 90/-

PAGE-46
 (16) OPTHALMOLOGY (EYE SECTION)
CHARGES

SR. NO. DESCRIPTION CHARGES

1 A SCAN 250/-
2 ANTERIOR CHAMBER WASH 600/-

3 AUTOMATED FIELDS 700/-

4 B SCAN 800/-

5 BELT BUCKLING WITH PARS PLANA VITRECTOMY 17500/-

6 BLOW OUT FRACTURE 12000/-

7 CATARACT 800/-

8 CATARACT BY (IOL) METHOD 2000/-

9 CATARACT WITH GLAUCOMA 2000/-

10 CONJUCTIVAL NEOPLASIA/DERMOIDS 4000/-

11 CORNEAL TOPOGRAPHY 900/-

12 CRYO RETIONOPEXY 1800/-

13 CRYOPEXY 2500/-

14 DACRYOCYSTCTOMY 2700/-

15 DACRYOCYSTORHINOSTOMY (DCR) 2300/-

16 DEEP SUBTENON INJECTION 350/-
17 DEMIS FAT GRAFTING 10000/-

18 ECTROPION/ENTROPION (WITH GRAFT) 7000/-

19 ECTROPION/ENTROPION (WITHOUT GRAFT) 600/-

20 ENDOSCOPIC ENDONASAL DCR 11000/-

21 ENUCLEATION/EVISCERATION 1000/-
22 ESOTROPIA (LATERAL RECTUS PARESIS) 11000/-

23 EXENTERATION 10000/-

24 EYE BURNS (MAJOR) 1000/-

25 EYE BURNS (MINOR) 600/-

26 FLUID GAS EXCHANGE 4800/-

27 FLURECEIN ANGIOGRAPHY 1200/-

28 FLURESCEIN ANGIOSCOPY 750/-

29 FUNDUS FLURESCEIN ANGIOGRAPHY 2300/-

PAGE-47
30 GLAUCOMA 1200/-

31 GONIOSCOPY 250/-

32 HEIDELBERG RETINAL TOMOGRAPHY (HRT) 2000/-

HIGH COMPOUND MYOPIC ASTIGMATISM WITH
33 11600/-
AMBLYOPIER (LASIK SURGERY)
34 INDECTOMY 650/-

35 INTRAVITREAL INJECTION 3500/-

36 IOFB REMOVAL (ANT SEG.) 6500/-

37 KERATOPLASTY 2500/-
LASER FOR SPECT (CONSIDER PATHOLOGICAL
38 20000/-
CONDITION)
39 LENSECTOMY 1200/-

40 LID – CYST 800/-

41 LID INJURY (MAJOR) 7000/-

42 LID INJURY (MINOR) 600/-
43 LID MARGIN MMG (MUCUS MEMBRANE GRAFT) 8500/-

44 MASCULAR HOLE SURGERY 3500/-

45 MMC AUGMENTED TRAB 6500/-

46 MEMBRANE PEELING 1100/-

NUCLEUS DROP/IOL REMOVAL WITH
47 16200/-
VITRECTOMY
48 OCULAR COHERENSE TOMOGRAPHY (OCT) 2000/-

49 OPTIC DISC PHOTOGRAPHY 300/-

50 ORBITOTOMIES 16000/-

51 ORTHOPTIC EXERCISES 700/-

52 ORTHOPTICS / SITTING 100/-

53 PACHYMETRY 700/-

54 PARS PLANA LENSECTOMY 14000/-

55 PENETRATING INJURY REPAIR 8000/-

56 PERFORATING INJURY 1000/-

57 PHACO (USING FOLDABLE LENSE) 11200/-

58 PHACO EMULSIFICATION 9200/-

59 PLEOPTICS / SITTING 100/-
60 PROBING 500/-

61 PTERYGIUM 1000/-

62 PTERYGIUM WITH GRAPHT 7000/-

PAGE-48
 63 PTOSIS 1200/-

64 REDIAL OPTIC NEUROTOMY FOR CRYO 18000/-

65 RETINAL DETACHMENT BUCKLING 3000/-

66 RETINAL DETACHMENT SURGERY 13000/-

67 SICS(SMALL INSITION CATARACT SURGERY) 4000/-

68 SILICON OIL REMOVAL 2500/-

69 SKIN/BUCCAL MUCOUS GRAFT 8000/-

70 SNIP PROCEDURE 600/-

71 SOCKET RECONSTRUCTION 10000/-

72 SQUINT – ONE MUSCLE 3500/-

73 STYE. CHALZION / ELECTROLYSIS 500/-

74 TARSORRHAPHY 2600/-

75 TOPOGRAPHY 2000/-
TRABENLOTOMY/TRABENLECTOMY WITH
76 6500/-
MYTOMYCINE
77 VISUAL EVOKED POTENTIAL (VEP) 1450/-
78 VITRECOTOMY 3800/-
79 VITRECTOMY 14000/-

80 VITRECTOMY CUTTER 7000/-

81 VITRECTOMY FRAGMATOME 2300/-

82 VITRECTOMY LASER 2300/-

83 VITRECTOMY PFCL 2300/-

84 VITRECTOMY SILICON 2300/-

85 YAG CAPSULOTOMY 2000/-

86 YAG IRIDOTOMY 2000/-

87 YAG LASER 3000/-

88 LASER TREATMENT (PATHOLOGICAL CONDITION) 20000/-

LENS CHARGES:-

SR. NO. TYPES OF LENSE COST OF LENSE

89 RIGID LENSE 1000/-

90 PHACO-INDO AMERICAN LENS 5000/-

91 PHACO-AMERICAN FOLDABLE LENS 7000/-

PAGE-49
 (17) ENT SECTION CHARGES

SR. NO. DESCRIPTION CHARGES

1 ADENOIDECTOMY 1800/-/-
2 ANTRAL PUNCTURE- BILATERAL 400/-

3 ANTRAL PUNCTURE- UNILATERAL 350/-

4 ASPIRATION FLUID MIDDLE EAR 950/- EACH

5 AUDIOMETERY/PTA TEST 500/-

6 BERA 1200/-
7 BPPV MANOUVRE 1200/-

8 CALD-WELL LUC 3200/-

9 CALORIMETRY (CCT) 600/-

10 COLD CAUTRY 400/-

11 CSF RAINORIA REPAIR (CSF RHINORRHOEA) 22500/-

12 EAR LOBE RAP AIR- BILATERAL 400/-
13 EAR LOBE RAP AIR- UNILATERAL 300/-
14 EAR REPAIR- BILATERAL 650/-

15 EAR REPAIR- UNILATERAL 500/-

16 ELECTRO NYSTAGMOGRAPHY 2400/-

17 ETAMOIDECTOMY – EXTARNAL NASAL 3000/-

18 ETAMOIDECTOMY-INTRA NASAL 3000/-

19 EXCISION OF SMALL TUMOR 1700/-

20 EXCISION STYLOID- BILATERAL 2400/-

22 EXCISION STYLOID- UNILATERAL 1800/-

23 F.BODY REMOVAL EAR/NOSE 600/-

24 FESS 3850/-
25 FIBREOPTIC FLEXIBLE ENDOSCOPY 1700/-

26 FRACTURE NASAL BONE REDUCTION 1550/-

27 GLAND BIOPSY 1550/-

28 GLOSSECTOMY 13000/-

29 GROMMET INSERTION 2400/- EACH

30 HEMIGLOSSECTOMY 3600/-
31 I & D– DEEP NECK ABSCESS 7200/-

PAGE-50
32 I & D– MASTOID ABSCESS 2600/-

33 I & D– NECK ABSCESS 2400/-

34 I & D– PERI TONSILLAR/QUINSY 3600/-

35 I & D– SEPTAL HEMATOMA 4800/-

36 INTRA ORAL/NASAL INJECTION 350/-

37 INTRA NASAL ANTROSTOMY 500/-

38 INTRA TYMPANIC MEDICATION 1400/- PER SIDE

39 LARYNGECTOMY 7200/-

40 LARYNGOSCOPY 7200/-

42 MASTOID SURGERY 6000/-

43 MAXILLECTOMY 6000/-

44 MICROLARYNGEAL SURGERY (MLS) 4200/-

45 MYERIGOTOMY 720/-
46 MYRINGOPLASTY 6000/-

47 NASOPHARYNGOSCOPY 1700/-
48 OSSIENIOPLASTY 2400/-
49 PATCH PLASTY 1900/- EACH

50 PERIAURICULAR SINUS 1800/-

51 POLYPECTOMY-BILATERAL 3000/-

52 POLYPECTOMY-UNILATERAL 2400/-
53 RANULA 1200/-

54 REDICAL NECK DISSECTION (RND) 7200/-

55 RETROPHARYNGEAL ABSCESS 1200/-

56 SEPTOPLASTY 3200/-

57 SINOSCOPY 800/-
58 SMR CALDWELL LUC 3000/-

59 STAPEDECTOMY 2750/-

60 STYLODECTOMY- BILATERAL 4000/-

61 STYLODECTOMY- UNILATERAL 2000/-

62 SUB MUCUSFIBROSIS/SMF SURGERY 13000/-

63 SUBMANDIBULAR SALIVARY GLAND EXCISION 2600/-

64 SUBMUCUS RESECTION (SMR) 3000/-
65 SUCTION CLEARING EAR 180/- PER EAR

66 TERBINATE CAUTERIZATION 1800/-

PAGE-51
67 THYROID- HEMI 4550/-

68 THYROID- SIMPLE GOITER 3800/-

69 THYROID- TOTAL 4300/-

70 TINTANOGRAM 400/-

71 TONGUE- PARTIAL GLOSSECTOMY 3000/-

72 TONGUE- SUB LINGNAL DERMAID RENULA 2150/-

73 TONGUE- TIE RELEASE 600/-

74 TONGUE- TOTAL GLOSSECTOMY WITH RNO 5500/-

75 TONGUE- TOTAL GLOSSECTOMY 4800/-

76 TONSILECTOMY 3250/-

77 TRACHEOSTOMY 3000/-

78 TURBINECTOMY 3200/-

79 TYMPHANOPLASTY 6000/-
80 VISIAN NEURECTOMY 2750/-

81 VNC 2000/-
82 WAX REMOVAL 180/- PER EAR
83 YOUNGS OPERATION 3600/- PER SIDE

84 HEARING AID (MAXIMUM 2) 25000/- PER EAR

PAGE-52
 (18) PAEDIATRIC PROCEDURE CHARGES

SR. NO. DESCRIPTION CHARGES

1 APNEA MONITOR 60/-

2 BLOOD EXCHANGE 3600/-

3 BLOOD TRANSFUSION PER UNIT 250/-

4 CAPNOGRAPH 350/-

5 C-PAP MONITOR 60/-

6 HEATER/COOLER 60/-

7 INFUSION 100/-

8 INJECTION-IM/IV 30/-

9 INTRA OSSEOUS INFUSION 120/-

10 IPPR(FOR 12HRS) 300/-

11 MINOR PROCEDURE 800/-

12 OPEN CARE WARMER 400/-

13 OXYGEN MONITOR 60/-

14 PAEDICTRIC INCUBATOR 400/-
15 PERICARDIAL TAPPING 600/-

16 PERITONEAL DIALYSIS (FIRST) 2600/-

17 PHOTOTHERAPY- DOUBLE SURFACE 1200/-

18 PHOTOTHERAPY- SINGLE SURFACE 600/-

19 TUBE FEEDING 120/- PER DAY

20 VENTRICULAR TAPPING 350/-

PAGE-53
 (19) PAEDIATRIC SURGERY CHARGES

GROUP-A (MINOR-I):-

SR.NO. DESCRIPTION CHARGES

1 ABSCESS SMALL 700/-

2 ANAL DILATATION 700/-

3 BENIGH LESION DERMOID (LIPOMA ETC.) L.A. 700/-
4 CATHETERISATION IN OT 700/-

5 CLW 1ST SUTURING 700/-

DILATATION OF URETHRA / MEATAL
6 700/-
CALIBERATION
7 DRESSING UNDER GENERAL ANSTHESIA (DUGA) 700/-
8 KENACORT INJ. 700/-
9 MEAGOTOMY CLW 700/-

10 MEATOTOMY 700/-
11 PLEURAL TAPPING 700/-
12 SIGMOIDOSCOPY 700/-

13 TONGUE TIE RELEASE 700/-

14 VARIOUS MINOR OPERATION- UNDER G.A. 700/-

15 VARIOUS MINOR OPERATION- UNDER L.A. 700/-

GROUP-B (MINOR-II):-

SR.NO. DESCRIPTION CHARGES

16 AMPUTATION FINGER EACH 2400/-

17 CIRCUMCISSION 2400/-

18 CYSTOSCOPY 2400/-

19 EMPYEMA DRAINAGE (ICD) 2400/-

20 EXCISION HEAMENGIOMA SMALL 2400/-

21 F.B. REMOVAL EXTREMITY 2400/-

22 ISCHIORECTAL ABSCESS 2400/-

23 LABIAL SYNECHIE 2400/-

24 MAJOR WOUND REPAIR / CLW-2 2400/-

PAGE-54
 25 PERICARDIAL TAPPING 2400/-

26 PILONIDAL SINUS 2400/-

SIMPLE RESECTION NECK AXILLARY AND
27 2400/-
INDUINAL GLANDS (BIOPSY)
28 SKIN GRAFTING SMALL 2400/-
29 SUPRAPUBIC CYSTOLITHOTOMY 2400/-

30 THIERSCH OPERATION FOR PROLAPSED RECTUM 2400/-

31 UMBILICAL HERNIA 2400/-

32 UMBILICAL POLYPECTOMY 2400/-

33 VENTRICULAR TAPPING 2400/-

GROUP-C (INTERMEDIATE):-

SR.NO. DESCRIPTION CHARGES

34 ANOPLASTY 4200/-
35 APPENDICECTOMY 4200/-
36 BLADDER STONE 4200/-

37 BRANCHIAL CYST - SINUS 4200/-

38 BRONCHOSCOPY 4200/-

39 BURST ABDOMEN RESUTURING 4200/-

40 COLOSTOMY 4200/-
41 CYSTIC HYGROMA LARGE 4200/-
CYSTOSCOPY & PROCEDURE / STENT REMOVAL
42 4200/-
(URETRIC CATH)
43 DIAGNOSTIC LAPROSCOPY 4200/-
44 ESOPHAGOSCOPY 4200/-
45 GASTROSTOMY 4200/-

46 HYPOSPADIAS FISTULA 4200/-

47 INGUINAL HERNIA / HYDROCPLE 4200/-

48 INTRAPERITONEAL / THORACIC BIOPSY 4200/-

49 LARGE SKIN GRAFTING 4200/-

50 LIVER ABCESS ASPIRATION 4200/-

51 LIVER BIOPSY 4200/-

52 NERVE ANDTENDON REPAIR EACH 4200/-

53 ORCHIECTOMY FOR TORSION 4200/-

PAGE-55
 54 ORCHIOPEXY 4200/-

55 ORCHIOPEXY FOR TORSION 4200/-

56 PYELORIC STENOSIS 4200/-

57 RADICLE RESECTION OF NECK GLANDS 4200/-

58 RECTAL POLYPECTOMY 4200/-

59 RESUTURING BURST ABA. 4200/-

60 SCROTAL ORCHIOPEXY 4200/-

61 V.P. SHUNT REVISION (ONE END) 4200/-

GROUP-D (MAJOR-I):-

SR.NO. DESCRIPTION CHARGES

62 ABOVE KELBOW) 6000/-

63 AMPUTATIONS LIMBS BELOW KNEE 6000/-

64 BRANCHIAL SINUS / FISTULA 6000/-
65 CHOLECYSTECTOMY 6000/-

66 CHORDEE CORRECTION 6000/-

67 CRANIOTOMY 6000/-

68 EXCISION HAEMANGIOMA LARGE 6000/-

69 EXPL. LAPROTOMY 6000/-

70 HYDROCEPHALUS V.P. SHUNT 6000/-

INGUINAL OR UMBILICAL HERNIA IN INFANT
71 6000/-
[<1 YEAR]
INTESTINAL OBSTRUCTION : ADHESINOLYSIS,
72 6000/-
BAND RELEASE, PERITONITIS ETC.
73 INTRA PERITONEAL ABCESS DRAINAGE 6000/-

74 INTUSUSCEPTION REDUCTION 6000/-

75 LAPROSCOPY ORCHIOPEXY 6000/-

MECKEL'S DIVERTICULAM WITH OBSTN /
76 6000/-
GANGRENE
77 MECKEL'S DIVERTICULECTOMY 6000/-

78 MENINGOCELE RESECTION 6000/-

79 MESENTRIC CYST 6000/-

80 OBSTRUCTED HERNIA 6000/-

81 OMPHALOCAELE 6000/-

82 ORCHIOPEXY FOR HIGH 6000/-

PAGE-56
 83 PERFORATED APPENDIX 6000/-

84 PERINEPHRIC ABCESS 6000/-

85 STING PROCEDURE 6000/-

86 STRANULATED INGUINUL OR UMBLICAL HERNIA 6000/-

87 SURGERY FOR TORTICOLLIS 6000/-

88 THYROGLOSSAL CYST 6000/-

89 URACHAL CYST EXCERSION 6000/-

90 URETEROSTOMY / PYELOSTOMY 6000/-

91 VESICOSTOMY 6000/-

GROUP-E (MAJOR-II):-

SR.NO. DESCRIPTION CHARGES

92 CBD STONES 7200/-

93 CHOLECYSTECTOMY 7200/-
94 COLOSTOMY CLOSURE 7200/-

95 DUPLICATION CYST. 7200/-

96 HYPOSPADIUS : DISTAL : MAGPI,FLIPFLAP, 7200/-

97 INTAOP CHOLANGIOGRAPHY WITH LIVER BIOPSY 7200/-

98 INTESINAL RESCTION 7200/-

99 INTUSUSCEPTION WITH R & A 7200/-

100 LAPROSCOPY & PROCEDURE 7200/-

101 NEPHRECTOMY 7200/-

102 NEW BORN COLOSTOMY 7200/-

NEW BORN OBSTRUCTION / NEW BORN
103 7200/-
LAPROTOMY
104 ORCHIOPEXY [STEPHEN FOWLER] 7200/-
PYELOLITHOTOMY-NEPHROLL-THOTOMY
105 7200/-
URETEROLITHOTOMY
106 RESECTION & ANASTAMOSIS 7200/-
107 SNODGRASS 7200/-

108 SPLENECTOMY 7200/-

109 SURGERY ON BILIARY TRACT. 7200/-

110 URETHROPLASTY, 2ND STAGE HYPOSPADIUS 7200/-

PAGE-57
GROUP-F (SUPRAMAJOR):-
SR.NO. DESCRIPTION CHARGES

111 CONGENTIAL DIAPHRAGMATIC HERNIA 12000/-

112 ENCEPHALOCELE 12000/-

113 FUNDOPLICATION 12000/-

114 LAPROSCOPIC APPENDIX 12000/-

115 LAPROSCOPIC CHOLECYSTECTOMY 12000/-

116 LAPROSCOPIC OVERIANCYSTECTOMY 12000/-

117 LARGE EXOMPHALOS 12000/-

118 LIPOMENIGOCELE REPAIR 12000/-

119 MEDIASTINAL CYSTS & TUMORS 12000/-

120 PSARP 12000/-

121 PULL THRU FOR HIRSCHSPRUNG'S DISEASE 12000/-

122 PYELOPLASTY FOR PUJ 12000/-

R & A FOR INTESTINAL ATRESIA, MECONIUM
123 12000/-
ILEUS, MALROTATION ETC
124 RETROPERINEAL CYSTS 12000/-

125 THORACIC OPERATION T.O. FISTULA 12000/-

GROUP-G (SUPRAMAJOR):-
SR.NO. DESCRIPTION CHARGES

126 CHOLEDOCAL CYST EXCISION 12000/-

127 CYSTCHYROMA LARGE 12000/-

128 ECOTPIC VESICAC OPERATION 12000/-

INTRA PERITONEAL RETEROPERI-TONEAL
129 12000/-
MILLGNANT TURMOURES
130 LAP.FUNDOPLICATION 12000/-

131 LUNG LOBECTOMY 12000/-

NEONATAL THORACOTOMY AND
132 12000/-
LOBECTOMY
NEPHRECTGOMY FOR WILMS
133 12000/-
TUMOR/MULTICYSTIC KIDNEY
PORTOENTEROSTOMY FOR BILARY ARTESIA
134 12000/-
(KASAI'S OPERATION)
135 URETERIC REIMPLANTATION FOR VVR 12000/-

136 VATS DECORTICATION 12000/-

137 VATS LUNG ABSCESS 12000/-

PAGE-58
 (20) OBESTETRICS CHARGES
SR.NO. DESCRIPTION CHARGES

1 ABORTION- MISSED 1450/-

2 ABORTION-SPONTENEOUS 1000/-

3 AFTER INDUCTION OF LABOUR- EPISIOTOMY 2300/-

4 AFTER INDUCTION OF LABOUR- FORCEPS 3000/-

5 AFTER INDUCTION OF LABOUR- NORMAL 2150/-
AFTER INDUCTION OF LABOUR- VACUUM
6 3000/-
EXTRACTION
7 BREECH DELIVERY WITH EPISIOTOMY 3000/-
DELIVERY- ACCIDENTAL HAEMORRHAGE
8 3250/-
(PROCEDURE CHARGE EXTRA)
9 DELIVERY- HIGH RISK PREGNANCY 3000/-
10 DELIVERY- NORMAL 1800/-
11 DELIVERY- TWINS (PROCEDURE CHARGE EXTRA) 3000/-

12 DELIVERY WITH EPISIOTOMY OR P. T. 2400/-

13 ECLAMPSIA MANAGEMENT 3600/-
14 I.U.I. 600/-
15 INVERSION OF UTERUS CORRECTION UNDER GA 3600/-

16 MANAGEMENT OF PPH/EX TEAR 1200/-

17 MANUAL REMOVAL OF PLACENTA 3600/-

SECOND TRIMESTER TERMINATION OF
18 3250/- EACH
PREGNANCY- INTRA/EXTRA AMNIOTIE
TRIAL OF LABOUR
19 1100/-
(OBSERVATION OF COMPLICATE CASES)
20 VESCICULAR MOLE- MORE THAN 16 WEEKS SIZE 3600/-

21 VESCICULAR MOLE- UP TO 16 WEEKS SIZE 3200/-

I.V.F. PACKAGE:-

22 IVF EMBRYO TRANSFER PACKAGE 20600/- PER CYCLE

23 IVF OOCYTE RETRIEVAL PACKAGE 18500/- PER CYCLE
IVF OOCYTE RETRIEVAL AND EMBRYO
24 39300/- PER CYCLE
DEVELOPMENT PACKAGE
25 SPERM FREEZING CHARGE 2100/-

26 FETAL REDUCTION 11000/-

PAGE-59
 (21) GYNEAC OPERATION CHARGES

SR.NO. DESCRIPTION CHARGES

1 ABDOMINAL HYSTRECTOMY 8000/-

2 ABDOMINAL HYSTRECTOMY WITH HIGH RISK 9000/-

ABDOMINAL HYSTRECTOMY WITH CYST
3 ADHESIONS FIBROID, OVARIOS CYST 9600/-
APPENDICECTOMY
4 ANTERIO- PASTERIOR REPAIR (A.P.REPAIR) 4200/-

5 ARTIFICIAL INSEMINATION 300/-

6 BARTHOLIN ABSCES (I & D) 950/-

7 BARTHOLIN CYST EXCISION 1800/-

CAESEREAN SECTION (LSCS)- CS WITH
8 7200/-
HYSTERCTOMY
9 CAESEREAN SECTION (LSCS)- LSCS IN HIGH RISK 7200/-
10 CAESEREAN SECTION (LSCS)- PLANNED 5400/-

11 CAESEREAN SECTION (LSCS)- REPEAT 6000/-

12 CAUTERIZATION OF VAGINAL VAULT 400/-
13 CERVICAL BIOPSY 950/-

14 CERVICAL ENCIRENLERGE (BEFOR DELIVERY) 850/-

15 CERVICAL ERESION ELECTRO- CRYO 400/-

16 CERVICAL ERESION ELECTRO-CAUTERY 300/-

17 CHRONIC WITH ADHESIONS 6000/-

18 DIAGNOSTIC HYSTEROSCOPY 3000/-

19 DIAGNOSTIC LAPAROSCOPY 2400/-

20 DILATATION & CURETTAGE (D&C) 1200/-

21 DILATATION & EVAEUATION (D&E) 1200/-

22 ECTOPIC PREGNANCY- ACUTE WITH SHOCK 6000/-

23 ENDOMETRIAL BIOPSY 950/-

24 EUA 400/-

25 EXCISION VAGINAL CONDYLOMA 11250/-

26 EXPLORATARY LAPAROTOMY 4800/-

27 FOTHERGILL’S REPAIR 6000/-

28 HYMENECTOMY 700/-

PAGE-60
 HYMENECTOMY WITH DRAINAGE OF
29 1200/-
HEMATOCOPUS
30 HYSTEROTOMY 4200/-
LAPAROTOMY WITH MYONECTOMY/
31 6000/-
ADHESION/STERILITY/PELVIS ABSCESS
32 LAPROSCOPIC HYSTERECTOMY 9000/-

33 LAPROSCOPY HYSTERECTOMY 7800/-

34 M.T.P.- UP TO 8 WEEKS 1200/-

35 M.T.P.- HIGH RISK 1800/-

36 M.T.P.- MORE THAN 8 WEEKS 1400/-

37 MANAGEMENT OF DIC 6000/-

38 MYMECTOMY 9300/-

39 OVERAIN CYST REMOVAL 3600/-

40 PAP SMEAR 180/-

41 PERINEAL TEAR REPAIR 1200/-
42 POLYPECTOMY 700/-

43 PRINEORRAPTY WITH PRP VAGINA 13000/-

44 REMOVAL OF MISPLACED IUCD 600/-

45 RESUTURING 1200/-
46 RUPTURE UTRUS REPAIR 8400/-

47 SHIRODKER'S STITCH 1800/-

48 THERMAL BALLOON ABLATION 7800/-

49 TRANSOBTURATOR (TOT) (FOR SUI) 9300/-

50 TUBECTOMY FREE
51 V.V.F. REPAIR- COMPLICATED 8400/-

52 V.V.F. REPAIR- RVF 8400/-

53 V.V.F. REPAIR- SIMPLE 6000/-
54 VAGINAL HYSTERECTOMY WITH A.P.REPAIR 9600/-

55 VAGINAL HYSTERECTOMY WITH HIGH RISK 9600/-

56 VAULT PROLAPSE REPAIR 2400/-

57 VENTRAL SUSPENSION 4800/-

58 VULVAL BIOPSY 500/-

59 VULVECTOMY- REDICAL 19500/-

60 VULVECTOMY- SIMPLE 7800/-

PAGE-61
 (22) GENERAL SURGERY CHARGES

SR. NO. DESCRIPTION CHARGES

1 ABDOMINO PERINEAL EXCISION OF RECTUM 9600/-

2 ABSCESS - MULTIPLE/ CARBUNCLE 1000/-

3 ABSCESS SMALL 600/-

4 ABSCESS BIG- INCISION & DRAINAGE (I&D) 1000/-

5 ABSCESS COLD- ASPIRATION 600/-

6 ABSCESS LIVER- ASPIRATION 1200/-

7 ABSCESS LIVER- OPEN DRAINAGE 2050/-

8 ADENOMA EXCISION 4300/-

9 ADHESINOLYSIS 4800/-
10 AMPUTATION- FINGER OR TOE 1900/-

11 AMPUTATION- HIND/FOR QUARTER LIMB 3850/-

12 AMPUTATION- PENIS (PARTIAL) 2400/-
13 AMPUTATION- PENIS (TOTAL WITH BLOCK) 2900/-

14 AMPUTATION- PENIS (TOTAL WITH DISSECTION) 4200/-

15 AMPUTATION- SYME’S /TRANSEMETARSAL 1700/-
AMPUTATION- THROUGH THE LIMB,ABOVE
16 3000/-
KNEE,BELOW KNEE,
17 ANAL STERCHING CLORDS 1000/-

18 ANOPLASTY 1800/-
19 APPENDICETOMY 4200/-

20 APPENDICETOMY- ACUTE 4400/-

21 APPENDICETOMY- BY LAPAROTOMY 5000/-

22 APPENDICETOMY- ELECTIVE (INTERVAL) 3600/-

23 APPENDICETOMY- INCIDENTAL 1000/-

APPENDICETOMY- WITH MECKLE’S
24 6600/-
DIVERTICULECTOMY
25 AVTERIAR RESECTION OF RECTO SGMOID 7200/-
26 BAKER CYST 2000/-

27 BIOPSY- EXCISION (UNSPECIFIED) 720/-

28 BIOPSY- LIVER 1100/-
29 BIOPSY- LYMPH NODE 1000/-

30 BIOPSY- PUNCH 600/-

PAGE-62
31 BIOPSY- WEDGE 850/-

32 BRANCHIAL CYST/FISTULA 2100/-

33 BY PASS ANASTOMOSIS 5400/-

34 CERVICAL 4800/-

35 CERVICAL RIB EXCISION 4600/-

36 CHOLECYSIOSTOMY 4800/-

37 CHOLECYSTECTOMY 5300/-
38 CHOLECYSTECTOMY WITH CBDEXPLORTION 6700/-

39 CHOLECYSTECTOMY WITH SPHINETEROPLASTY 6700/-

40 CHOLECYSTOJEJONSTOMY 8400/-

41 CHOLEDOCHO DUODENOSTOMY 8400/-

42 COLOSTOMY 3800/-

43 COLOSTOMY CLOSURE 4550/-

44 CRYO- HAEMAMGIOMA 1100/-

45 CRYO- HAEMMERHOIDETOMY 3000/-

46 CYSTIC HYGROMA 2100/-
47 CYSTO LITHOTOMY 4800/-

48 CYSTOSCOPY 2400/-

49 CYSTOSEOPY WITH BIOPSY 3600/-

50 CYSTOSEOPY WITH URETERIC CATHETERISATION 3600/-

51 DERMOID 1000/-

52 EXASTA OF BANE 1550/-

53 EXCISION- BIG LIPOMA 1000/-

54 EXCISION- FIBROMA 700/-

55 EXCISION- INFECTED SEBACVEOUS CYST 650/-

56 EXCISION- LYMPHNODE MASS 1450/-

57 EXCISION OF BAND 4800/-

58 EXCISION- SEBACEOUS CYST 600/-

59 EXCISION- SMALL LIPOMA 700/-

60 EXPLORATORY 5000/-

61 FERMORAL HERNIA (REPAIR) 3100/-

62 FIRST RIB EXCISION 5500/-
63 FISSURECTOMY FISSURE IN ANO 1600/-

64 FISTULECTOMY- HIGH IN ANO 3500/-

PAGE-63
65 FISTULECTOMY- INTERMEDIATE IN ANO 2650/-

66 FISTULECTOMY- LOW FISTULA IN ANO 1900/-

67 FRIBROADENOMA OF BREAST- BILATERAL 2600/-

68 FRIBROADENOMA OF BREAST- MULTIPLE 2000/-

69 FRIBROADENOMA OF BREAST- SINGLE 1400/-

70 GANGLION 850/-

71 GASTEROJEJUNOSTOMY (G. J.) 4800/-

72 GASTEROJEJUNOSTOMY UNDER WITH VOGOTOMY 5000/-

73 GASTEROSTOMY 5400/-

74 GYNAECOMASTIA- BILATERAL 3100/-

75 GYNAECOMASTIA- UNILATERAL 2400/-

76 HAEMOROIDECTOMY 2300/-

77 HAEMOROIDECTOMY- STAPLER 8500/-

78 HEIRSCH’S WIRING 2000/-

79 HELLER’S CARDIOMYOTOMY 4800/-

80 HEMICOLECTOMY 7800/-
81 HERNIA REPAIR- EPIGASTRIC 3500/-

82 HERNIA REPAIR- HERNIOPLASTY (MESH REPAIR) 4800/-

83 HERNIA REPAIR- INGUINAL HENIOTOMY 2500/-

84 HERNIA REPAIR- INGUINAL HERNIA 2500/-

HERNIA REPAIR- INGURINAL HERNIORRHAPHY
85 4300/-
FOR UNCOMPLICATED (BILATERAL)
HERNIA REPAIR- INGURINAL HERNIORRHAPHY
86 3100/-
FOR UNCOMPLICATED (UNILATERAL)
87 HERNIA REPAIR- OBSTERETCTED HERNIA 5000/-

88 HERNIA REPAIR- RECURRENT HERNIA 5400/-

89 HERNIA REPAIR- STRANGULATED HERNIA 5400/-
90 HIATUS HERNIA- ELLI’S REPAIR 3400/-

91 HIATUS HERNIA- NISSEN FUNDOPLICATION 4700/-

92 HYDROCOELE- INCISION EVERSION (BILATERAL) 2500/-

93 HYDROCOELE- INCISION EVERSION (UNILATERAL) 1900/-

94 INCISIONAL HERNIA- ANATOMICAL REPAIR 4200/-

95 INCISIONAL HERNIA- MAINGOT’S KEEL REPAIR 4550/-

96 INCISIONAL HERNIA- MESH REPAIR 5800/-

97 INCISIONAL HERNIA- T L SCAR HERNIA 4200/-

PAGE-64
 INTRA ABDOMINAL/PELVIC
98 2400/-
EXTRA PERITONEAL DRAINAGE
99 INTRA PERITONEAL DRAINAGE 2400/-

100 INTUSUCCEPTION- REDUCTION/COEOPEXY 4800/-

101 ISTHMECTOMY 2000/-

102 LAHONT’S OPERATION SUSPENSION 4300/-

103 LAPAROTOMY 4800/-

104 LOBECTOMY 5400/-

105 LUMBAR 4000/-

106 LYMPHNODES- BLOCK DISSECTIUS 2400/-

107 LYMPHNODES- MAN EXCISION 2000/-

108 MASTECTOMY- PATEY’S 4800/-

109 MASTECTOMY- RADICAL 5400/-

110 MASTECTOMY- SEGMENTAL 2000/-

111 MASTECTOMY- SIMPLE 4000/-

112 MASTECTOMY- TYLECTOMY LUMP EXCISION 2150/-
113 MECKEL’S DIVERTICULETOMY 5300/-
114 MENINAGOCELE EXCISION 4450/-

115 MESSENTERIC/OTHER CYST 6600/-

116 NEPHRECTOMY- RADICAL 12600/-

117 NEPHRECTOMY- SIMPLE 12000/-

118 NEPHREOSTOMY 4800/-

119 NEPHRO LITHOROMY 11000/-

120 NEPHRO URETERECTOMY 12600/-

121 NEPHROLITHOTOMY 12600/-

122 NEPRECTOMY (ABDOMEN) 8400/-

123 NOTARAS SPHINCTREPLASTY 1100/-

124 ONLY THREHDLENBERG’S OPERATION 2800/-

125 ORCHIDECTOMY- BILATARAL 3100/-

126 ORCHIDECTOMY- SUBCAPSULAR 3100/-

127 ORCHIDECTOMY- UNILATERAL 2750/-

128 ORCHIOPEXY 4000/-

129 ORCHIOPEXY- FOR TORSION 4800/-

130 ORCHIOPEXY- UNDESCESNEDE TESTIS 4800/-

131 OSTEOMYELITIS SCRAPPING 1100/-

PAGE-65
132 PALOMO’S OPERATION 2500/-

133 PANTIAL/TOTAL GASTRECTOMY 8900/-

134 PERINEPHRIC ABSCESS 5400/-

135 PERITONEAL TOILET 4600/-

136 PILONCLAL SINUS 1900/-

137 PRE SACRAL DERMID EXCISION 3200/-

138 PROSTATE (SIMPLE) 7000/-

139 PROSTATECTOMY (SIMPLE) 7800/-

140 PROSTOTRIC BIOPSY 4000/-

141 PSEUDOCYST GASTEROSTOMY 6000/-

142 PYELO LITHOTOMY 11000/-

143 RAMSTEDT’S OPERATION 3100/-

144 RECTUM PROLAPSE 4700/-

145 REIPSTEIN’S SACRAL 1200/-

146 REIPSTEIN’S SACRAL- SUSPENSION 3350/-

147 RESCTION ANASTANOROUS SMALL BOWEL 5500/-
148 RETROGRODE 3100/-

149 RETROPERITONEAL TUMOR 5400/-

150 RODENT ULCER 2300/-

151 SALIVERY GLANDS WITH TROCHAR 1550/-

152 SAUCERISING 1450/-

153 SIGMOIDECTOMY 6000/-

154 SIGMOIDOSCOPY 700/-

155 SIMES EXPLORETIN AND EXCISION 1600/-

156 SPLEENCTOMY 6000/-

157 SPLEENCTOMY- ELECTIVE 5000/-

158 SPLEENCTOMY- EMERGENCY 6200/-

159 SPLEENCTOMY- THORACO ABDOMINAL 6600/-

160 STRIPPING WITH SUBFACIAL LIGATION 3600/-

161 SUBMANDIBULAR SALIVARY- GLAND EXCISION 2900/-

162 SUPERFICIAL CONSERATIVE PAROTIDECTOMY 5000/-

163 SUPRAPUBIC CYSTOSTOMY 3100/-
164 SUTRNING PERFORATION 3850/-

165 SUTURING- INTERMEDIATE CLW 1000/-

PAGE-66
166 SUTURING- MAJOR CLW 1450/-

167 SUTURING- MINOR CLW 500/-

168 SUTURING- NERVE REPAIR 1450/-

169 SUTURING- SECONDARY SUTURING 1200/-

170 SUTURING- TERDAN REPAIR 1300/-

171 SYMPATHECTOMY 6200/-

172 TESTIES- BIOPSY (BILATERAL) 1200/-

173 TESTIES- EPIDIDYMAL NODULE 1200/-

174 TESTIES- ESPERMATOCOELE 1200/-

175 THORACOTOMY- THYROID EXCISION 4200/-

176 THYROGLOSSAL CYST/TRACT 3000/-

177 THYROIDECTOMY- HEMI 5500/-

178 THYROIDECTOMY- NEAR TOTAL 5600/-

179 THYROIDECTOMY- PARTIAL 4800/-

180 THYROIDECTOMY- SUBTOTAL 5400/-

181 THYROIDECTOMY- WITH RND 7200/-
182 TOTAL COSEVOTINE PAROTIDECTOMY 5400/-

183 TOTAL PAROTIDECTOMY 4900/-

184 UMBLICAL HERNIA- HEMIOTOMY (INFANTITE) 2400/-

185 UMBLICAL HERNIA- MAYO’S REPAIR 3100/-

186 UMBLICAL HERNIA- MESH REPAIR 4800/-

187 UMBLICAL SPESIS- DRAINAGE 1100/-

188 UMBLICAL SPESIS- OMPHLECTOMY 2900/-
UNDERWATERSEAL DRAINAGE
189 3000/-
(INTER COSTAL) WITH RIB RESECTION
190 URETERO LITHOROMY WITH NEPHROLITHOTOMY 13800/-

191 URETERO LITHOTOMY 7800/-

192 URETERO LITHOTOMY WITH PYLOLITHOTOMY 13800/-

193 URETHRAL DELATATION 1000/-

194 VARICOCOELECTOMY 1800/-

195 VASOPLASTY 2400/-

196 VERICOSE VEIN STRIPPING 4100/-
197 VESICOVAGINAL FISTULA 6600/-

PAGE-67
MISCELLANEOUS OPERATION (NOT INCLUDED IN LIST):-

198 MINOR UP TO 30 MINUTES 1200/-

199 MINOR UP TO 50 MINUTES 2400/-

200 MEDIUMS UP TO 100 MINUTES 3000/-

201 MAJOR UP TO 150 MINUTES 4200/-

202 MAJOR UP TO 200 MINUTES 5400/-

203 MAJOR MORE THAN 200 MINUTES 6000/-

NOTE:- PLEASE MENTION TIME INTERWAL FOR SURGERY, IF NOT

MENTION IN ABOVE LIST.

PAGE-68
 (23) GASTRO-ENTEROLOGY CHARGES

SR. NO. DESCRIPTION CHARGES

1 ABSCESS DRAINAGE 3000/-

2 ACHALASIA DILATATION 8400/-

3 ANORECTAL MENOMETRY 2750/-

4 COLONIC DECOMPRESSION 5500/-

5 COLONOSCOPY 3600/-
CYNOACRYLATE GLUE
6 8400/-
(COST OF GLUE AT PAR COST (M.R.P.))
ENDOSCOPIC BANDING
7 4200/-
(COST OF BAND & BAND SET EXTRA)
8 ENDOSCOPIC BIOPSY 3000/-

9 ENDOSCOPIC GASTROSTOMY (PEG) 4800/-

ENDOSCOPIC RETROGRADE CHOLANGIO
10 9600/-
PANCREATOGRAPHY (ERCP)
11 ENTERIC DILATATION 7000/-
12 ESOPHAEGEAL / ANTRAL / COLONIC / STENTING 7000/-

13 ESOPHAGEAL BALLOON DILATATION 3800/-

14 ESOPHAGEAL DILATION 3800/-

15 EST ENDOSCOPIC 2750/-

16 FOREGIGN BODY REMOVAL 4800/-

17 GENFEAST 250/-
18 LIVER BIOPSY 2500/-
19 NASO JOJENAL TUBE 4200/-

20 PERCUTANEOUS CATHETER PLACEMENT 3800/-

PLUS PROCEDURE CHARGES
21 SPHINCHETCTOMY, STONE EXTRACTION 2750/-
STENTPLACEMENT ETC.
22 POLYPECTOMY (LOWER G. I.) 4800/-

23 POLYPECTOMY (UPPER G. I.) 4800/-

24 PYLORIC DILATATION 7000/-

SANGSTAKEN/LINTON TUBE PLACEMENT
25 4800/-
(COST OF TUBE AT PAR COST)
26 SELEROTHERAPY 4200/-

27 SIGMODOSCOPY (FLEXIBLE) 3600/-

28 UPPER ENDOSCOPY 3600/-

PAGE-69
 (24) LAPROSCOPIC SURGERY CHARGES

SR. NO. SURGERY CHARGES

1 ADHESINOLYSIS 9600/-
2 APPENDICETOMY 10800/-
3 CHOLOCYSTECTOMY 12000/-

4 DIAGNOSTIC LAPAROSCOPY 8400/-

5 ECTOPIC 19200/-

6 ENDOMETRIOSIS 19200/-

7 GASTROJEJUNOSTOMY 9000/-

8 HEMICOLECTOMY 17400/-
9 HERNIA 10200/-

10 INTRA PERITONEAL TUMOUR 4200/-

11 LIVER ABSCESS 5400/-
12 MYOMECTOMY 16800/-

13 NEPHERECTOMY 11800/-

14 OVARIAN CYST 9400/-

15 PERFORATION 7550/-
16 PYELOPLASTY 7550/-

17 SACROPEXY 19200/-
18 VAGOTOMY 9000/-

19 VENTRAL HERNIA 9000/-

20 WERTHEIMS 31200/-

PAGE-70
 (25) ORTHOPAEDIC PROCEDURE
CHARGES

SR.NO. PROCEDURE CHARGES

1 ABOVE ELBOW POP 400/-

2 ABOVE KNEE / PTB 700/-

3 B.K.WALKING CAST 700/-

4 BELOW ELBOW POP 400/-

5 BELOW KNEE POP 500/-

6 C.T.E.V. CORRECTIVE P.O.P. CAST 1200/-

7 CHEST / BACK STRAPPING 500/-

8 COCK-UP SLAB 500/-

9 CPM 200/- PER DAY

10 CYLINDER POP 700/-
11 DRESSING CHARGES WITH MATERIAL 150/-
12 GARER’S STRAPPING 200/-

13 HAND DEQUERVAINAS RELEASE 850/-

14 HAND SURGERY EXTRA ARTICULAR 950/-

15 HAND TRIGGER THUMB RELEASE 950/-

16 HIP SPICA 1800/-

17 INTRA ARTICULAR INJECTION 400/-

18 LOCAL H.C. 300/-

19 LOCAL INFILTRATION 200/-

20 PATELLAR TENDON BEARING CAST 1400/-

21 PLASTER REMOVAL 200/-

22 SCAPHOID P.O.P. 700/-

23 SLAB APPLICATION 300/-

24 STRAPPING FINGER / TOE 200/-

25 SUTURE REMOVAL 200/-

26 THUMB SPICA CAST 700/-

27 UNAR SLEEVE 700/-

PAGE-71
 (26) ORTHOPAEDIC SURGERY CHARGES

SR. NO. DESCRIPTION CHARGES

ACROMIO CLAVICULAR JOINT DISRUPTION-
1 800/-
CLOSED
2 ACROMIO CLAVICULAR JOINT DISRUPTION- OPEN 2400/-

3 AMPUTATION- DIGITAL 1400/-

4 AMPUTATION- FINGER 1600/-

5 AMPUTATION- HIND QUARTER/FORE QUARTER 5400/-
6 AMPUTATION- LOWER LIMB 3800/-

7 AMPUTATION- METATARSAL 3000/-

8 AMPUTATION- SHOULDER 12000/-

9 AMPUTATION- SYMES 2750/-

10 AMPUTATION- TOES 1550/-
11 AMPUTATION- UPPER LIMB 3600/-
12 ANKLE- BIMALLEOLAR FIXATION 9000/-

13 ANKLE- FIXATION OF SINGLE MALLEOLUS 6600/-

14 ANKLE- PILON FRACTURE 14400/-

15 ANKLE- TRIMALLEOLAR FIXATION 13200/-

16 ARTHRODESIS- ANKLE 6000/-

17 ARTHRODESIS- ELBOW 3000/-

18 ARTHRODESIS- HIP 7200/-

19 ARTHRODESIS- KNEE 6000/-

20 ARTHRODESIS- SHOULDER 14400/-

21 ARTHRODESIS- WRIST 3600/-

22 ARTHROLYSIS 8400/-

23 ARTHROLYSIS- ELBOW 4200/-

24 ARTHROTOMY 4800/-
25 BICONDYLAR 10200/-

26 BONE/SOFT TISSUE BIOPSY 1100/-

27 CALCANEUM- C.C.SCREW 7000/-
28 CALCANEUM- CLOSED 1300/-

29 CALCANEUM- EXT FIXATOR 8400/-

PAGE-72
30 CALCANEUM- HIBRID FIXATOR 9600/-

31 CALCANEUM- OPEN 2900/-

32 CALCANEUM- PLATTING 8400/-

33 CERVICAL RIB 4000/-

34 CERVICAL SPINE RIB EXICISION– TRANSAXILLARY 16800/-

CERVICAL SPINE RIB EXICISION–
35 15600/-
SUPRACLAVICULAR
36 CERVICAL SPINE SURGERY EXTRA CHARGES 2000/-

37 CTEV- EXTERNAL FIXATURE 3000/-

38 CTEV- PLASTER 550/-

39 CTEV- RELEASE 3000/-

40 DEBRIDEMENT 3000/-
41 DECOMPRESSION+FRACTURE STABILIZATION 25200/-

42 DEFORMITY CORRECTION- UPPER LIMB 5500/-

43 DHS/ENDER 7800/-
44 DISC EXCISION- BONE GRAFTS 16800/-
45 DISC EXCISION- INSTRUMENTATION 25200/-
DISC EXICISION (MULTIPLE LEVEL)-
46 15600/-
CONVENTIONAL
47 DISC EXICISION (MULTIPLE LEVEL)- ENDOSCOPIC 16200/-

48 DISC EXICISION (SINGLE LEVEL)- CONVENTIONAL 16800/-

49 DISC EXICISION (SINGLE LEVEL)- ENDOSCOPIC 18000/-

50 ELBOW DISLOCATION- CLOSED 1100/-

51 ELBOW DISLOCATION- FRESH OPEN 3600/-
52 ELBOW DISLOCATION- OLD OPEN 3600/-

53 ENDER NAILING 4000/-

54 EPIDURAL STEROID INJECTION 1300/-
55 EXTERNAL FIXATOR 8400/-

56 EXTERNAL FIXATOR HUMERUS 3400/-

57 EXTERNAL FIXATOR RADIUM & ULNA 2750/-

58 FEMUR CLOSE NAILING ENDERS 6600/-

59 FEMUR IM NAILING OPEN 6600/-

60 FEROMENOCTOMY 3600/-
FOOT INJURIES- A.TARSAL TUNIEL SYNDROM
61 3000/-
RELEASE
62 FOOT INJURIES- CLOSED 800/-

PAGE-73
63 FOOT INJURIES- OPEN COMPLEX 3000/-

64 FOOT INJURIES- OPEN MODERATE 2400/-

65 FOOT INJURIES- OPEN SIMPLE 1900/-

FOOT METATARSAL FRACTURE- EXTERNAL
66 4800/-
FIXATOR
FOOT METATARSAL FRACTURE- IM NAILING
67 3600/-
(SINGLE)
68 FOOT METATARSAL FRACTURE- PLATTING 6000/-
FRACRURE LOWER END RADIUS- OSTEOTONIES
69 4800/-
AROUND WRIST
70 FRACRURE LOWER END RADIUS- SCAPHOID 6000/-

71 FRACTURE EPICONDYLAR HUMERUS- CLOSED 600/-

72 FRACTURE EPICONDYLAR HUMERUS- OPEN 2600/-

73 FRACTURE BOTH BONES- CLOSED 2750/-
74 FRACTURE BOTH BONES- OPEN PLATTING 5000/-

75 FRACTURE BOTH BONES- OPEN WIRE 5500/-

76 FRACTURE CLAVICLE- CLOSED 400/-

77 FRACTURE CLAVICLE- OPEN 2400/-

78 FRACTURE CLAVICLE- I/M NAILING 4000/-

79 FRACTURE CLAVICLE- PLATING 6600/-

80 FRACTURE COLLES- CLOSED 1700/-

81 FRACTURE COLLES- OPEN 2400/-

FRACTURE COLLES- PER CUTANEOUS K WIRE
82 2400/-
FIXATION
83 FRACTURE GALLEAZI- CLOSED 1100/-
84 FRACTURE GALLEAZI- OPEN I.M. WIRING 3000/-

85 FRACTURE GALLEAZI– PLATTING 3600/-

86 FRACTURE HEAD RADIUS- CLOSED 600/-

87 FRACTURE HEAD RADIUS- OPEN 2150/-

88 FRACTURE INTER CONDYLAR HUMERUS- OPEN 4200/-

89 FRACTURE MONTEGGIA- CLOSED 950/-

FRACTURE MONTEGGIA- I.M. WIRING
90 3000/-
OPEN/CLOSED
91 FRACTURE MONTEGGIA- OPEN PLATE 3600/-

92 FRACTURE PATELLA- CLOSED 800/-

93 FRACTURE PATELLA- EXCISION 3000/-

94 FRACTURE PATELLA- OPEN REDUCTION 4200/-

PAGE-74
95 FRACTURE PELVIS- CLOSED 550/-

96 FRACTURE POTTS- CLOSED 1400/-

97 FRACTURE POTTS- OPEN 7800/-

98 FRACTURE SHAFT HUMERUS- CLOSED 600/-

99 FRACTURE SHAFT HUMERUS- OPEN PLATING 4400/-

100 FRACTURE SHAFT HUMERUS- WIRING 4800/-

101 FRACTURE SUPRA CONDYLAR- HUMERUS CLOSED 700/-

102 FRACTURE SUPRA CONDYLAR HUMERUS- OPEN 3000/-

103 FRACTURE SUPRA CONDYLAR-CLOSED WIRING 1900/-

104 FRACTURE TIBIA- CLOSED 1400/-

105 FRACTURE TIBIA- OPEN (I.M. NAILING) 6000/-

106 FRACTURE TIBIA- OPEN (PLATING) 7800/-

107 FRATURE OLECRANON ULNA- CLOSED 600/-

108 FRATURE OLECRANON ULNA- OPEN 2600/-

109 GANGLION EXICISION 2600/-

110 H. T. O. 3800/-
HAND INJURIES- CARPAL TUNNEL SYNDROME
111 1100/-
(C.T.S.)
112 HAND INJURIES- CLOSED 600/-

113 HAND INJURIES- DE QUERVAINS RELEASE 800/-

114 HAND INJURIES- GANGLION 900/-

115 HAND INJURIES- OPEN COMPLEX 2000/-

116 HAND INJURIES- OPEN MODERATE 1800/-

117 HAND INJURIES- OPEN SIMPLE 1400/-

118 HAND INJURIES- TRIGGER THUMP RELEASE 800/-
HEMIREPLACMENT ARTHROPLASTY
119 9600/-
-UNCEMENTED
120 HEMIREPLACMENT ARTHROPLASTY- BIPOLAR 12600/-

121 HEMIREPLACMENT ARTHROPLASTY- CEMENTED 12000/-

122 HIGH TIBIAL OSTEOTOMY 10200/-

123 HIP ACETABULUM FRACTURE- CLOSED 1400/-

124 HIP ACETABULUM FRACTURE- OPEN 8400/-

125 HIP DISLOCATION- CLOSED REDUCTION 1400/-

126 HIP DISLOCATION- OPEN REDUCTION 9600/-
HIP DISLOCATION WITH FEMORAL HEAD
127 12000/-
FRACTURES

PAGE-75
128 HIP FRACTURE GIRDLE STONE 4800/-

129 HIP FRACTURE NECK AMPUTATION 8400/-

130 HIP FRACTURE NECK BIPOLAR 11400/-

131 HIP FRACTURE NECK PINING 6000/-

132 HIP OSTEOTOMY 6000/-

133 ILLIZARV FIXATURE- FEMUR 6000/-

134 ILLIZARV FIXATURE- HUMERUS 5500/-

135 ILLIZARV FIXATURE- LOWER LIMB 6000/-

136 ILLIZARV FIXATURE- RADIUS 5500/-

137 ILLIZARV FIXATURE- TIBIA 5500/-

INTER TROCHANTRIC FRACTURES
138 13200/-
-OSTEOSYNTHESIS-DHS
INTER TROCHANTRIC FRACTURES
139 11400/-
-ENDERS NAILING
INTER TROCHANTRIC FRACTURES
140 13200/-
-PROXYMAL FEMORAL PLATES
141 INTER TROCHANTRIC FRACTURES- PFN 13200/-
INTERLOCKING NAIL FEMUR NECK
142 9000/-
SUBTROCHANTER
143 INTERLOCKING NAIL TIBIA 7800/-
INTERNAL FIXATOR -COMPLICATED DOUBLE
144 21600/-
WALL WITH DOUBLE APPROACH
INTERNAL FIXATOR -COMPLICATED DOUBLE
145 16800/-
WALL WITH SINGLE APPROACH
146 INTERNAL FIXATOR- SIMPLE SINGLE WALL 12000/-
147 INTRA DISCAL INJECTION 4200/-

148 JACKET SPINAL 1800/-

149 JOINT ASPIRATION 950/-
JOINT REPLACEMENT
150 30000/-
TOTAL JOINT REPLACEMENT
JOINT REPLACEMENT
151 30000/-
HIP/KNEE/SHOULDER/ELBOW
152 KNEE ARTHROTOMY 4800/-

153 KNEE DISLOCATION- CLOSED 3000/-

154 KNEE DISLOCATION- OPEN 8400/-

155 KNEE SYNOVECTOMY(OPEN) 7000/-

156 KNEE-INTER CONDYLAR FRACTURE TIBIA 8400/-

157 KNEE-INTERCODYLAR FEMUR 8400/-

158 KNEE-SUPRA CONDYLAR FEMUR 8400/-

PAGE-76
 LUMBER SPINE- LEMINECTOMY (SINGLE LEVEL)
159 15600/-
(ADD EACH LEVEL-4200/-) -CONVENTIONAL
LUMBER SPINE- LEMINECTOMY (SINGLE LEVEL)
160 19200/-
(ADD EACH LEVEL 5800/-) -ENDOSCOPIC
161 NERVE REPAIR DIGITAL 3500/-

162 NERVE REPAIR PERIPHERAL 3500/-

163 OSTEOMYLITUS 2150/-

164 PATELLA INTERNAL FIXATION 7000/-

165 POLIO SOFT TISSUE 2750/-

166 POLIO SOFT TISSUE WITH BONY 3800/-

167 QUADRICEPSPLASTY 10200/-

168 MINIMUM Rs.550/-

RE-ADJUSTMENT
MAXIMUM Rs.2200/-

169 ROTATOR CUFF DEBRIDEMENT 7800/-

ROTATOR CUFF LESIONS- ACROMIOPLASTY AND
170 9600/-
ACUTE JOINT EXICISION
171 ROTATOR CUFF REPAIR 12000/-
172 SEGMENTAL FRACTURE FEMUR OPEN PLATTING 7200/-
173 SEGMENTAL FRACTURE TIBIA OPEN PLATTING 7800/-

174 SHAFT FRACTURE- ENDER NAILING 9000/-

175 SHAFT FRACTURE- EXT FIXATOR 9000/-

176 SHAFT FRACTURE- INT FIXATION 9000/-

177 SHAFT FRACTURE- INTERLOCK NAILING 12000/-

178 SHAFT FRACTURE- PLATING 12000/-

179 SHOULDER ARTHTOTOMY 4550/-
180 SHOULDER DISCLOCATION- CLOSED 900/-

181 SHOULDER FRACTURE DISLOCATION 5750/-

182 SHOULDER ONLY FRACTURE- CLOSE REDUCTION 800/-

183 SHOULDER ONLY FRACTURE- OPEN 3700/-

184 SHOULDER- ONLY STRAPPING 550/-

185 SHOULDER- PER CUTANEOUS K WIRE FIXATION 3350/-

186 SHOULDER RECURRENT DISLOCATION 4200/-

187 SKIN GRAFTING 3000/-

188 SKULL TRACTION 1400/-

189 SOFT TISSUE SURGERY FOR RHEUMATOID 2750/-

190 SOFT TISSUE WITH BONY SURGERY RHEUMATOID 4200/-

PAGE-77
191 SPINE ALD- OPEN 8400/-

192 SPINE DISC LAMINECTOMY WITH FUSION 12000/-

193 SPINE DISC- OPEN LAMINECTOMY 9000/-

194 SPINE DISC REMOVAL 9000/-

SPINE DISC REMOVAL WITH FUSION ONE LEVEL
195 10800/-
(EACH LEVEL : RS. 500/-) (CONVENTIONAL)
SPINE DISC REMOVAL WITH FUSION ONE LEVEL
196 16800/-
(EACH LEVEL : RS. 500/-) (ENDOSCOPIC)
197 SPINE DISC THORACTOMY 9600/-
198 SPINE FRACTURE- CLOSED 800/-
SPINE FRACTURE STABILISATION
199 16800/-
-ANTERIOR INSTRUMENTATION
SPINE FRACTURE STABILISATION
200 13200/-
-POSTERIOR INSTRUMENTATION
201 SPINE FRACTURE STABILISATION- COMBINED 25200/-

202 SPINE FRACTURE- STABILIZATION 9000/-

203 SPINE FUSION- ANTERIOR/POSTERIOR 8400/-
204 SUBTROCN FRACTURE 6600/-
205 SYNOVECTOMY ANKLE/KNEE 3800/-

206 TENDON TRANSFER/REPAIR 2750/-

THORACIC SPINE DECOMPRESSION-
207 19200/-
ANTERIOR WITH THORACOTOMY
208 THORACIC SPINE DECOMPRESSION- ENDOSCOPIC 19200/-
THORACIC SPINE DECOMPRESSION-
209 15600/-
ANTEROLATERAL
210 TRIPLE ARTRODESIS 4200/-
TUMOR SURGERY- CURETTGE WITH BONE
211 3000/-
GRAFTING
212 TUMOR SURGERY- EXOTOSIS EXCISION 2400/-
213 TUMOR SURGERY- RADICAL SURGERY 6000/-

214 UNICONDYLAR WITH PLATTING 8400/-

UPPER END TIBIA FRACTURES
215 7000/-
-EXTERNAL FIXATOR
UPPER END TIBIA FRACTURES-
216 6000/-
INTERNAL FIXATION WITH C.C.SCREW
217 VERTEBRO PLASTY 8400/-

PAGE-78
ADDITIONAL CHARGES:-

218 BONE GRAFTING 3900/-

219 SKIN TRACTION 600/-

220 SKELETAL TRACTION 900/-

221 PELVIS TRACTION/LUMBER 700/-

222 SHOULDER MANIPULATION 950/-

MISCELLANEOUS OPERATION (NOT INCLUDED IN LIST):-

223 MINOR UP TO 30 MINUTES 3000/-

224 MINOR UP TO 50 MINUTES 4200/-

225 MEDIUMS UP TO 100 MINUTES 6000/-

226 MAJOR UP TO 150 MINUTES 7800/-

227 MAJOR UP TO 200 MINUTES 9600/-
228 MAJOR MORE THAN 200 MINUTES 10800/-

NOTE:-
 PLEASE MENTION TIME INTERWAL FOR SURGERY, IF NOT
MENTION IN ABOVE LIST.
 ANY IMPLANT, CERVICAL COLLAR, CERVICAL BELT,
LEBUSECRAL BELT, TEILORS BRESS, BRESS, CELIPARS,
KAKHGHODI, DIFFERENCE DESIGN BONE, BONE PAIR,
ARTIFICIAL ORGAN ETC. WERE RE-EMBURS AT PAR WITH
COST (M.R.P.).
 RECOGNISED HOSPITAL ANY IMPLANT CHARGES INCLUDED
IN STAFF TREATMENT BILL.

PAGE-79
 (27) IITV CHARGES

(A) SUPRA MAJOR OPERATION:-

1. INTERLOCKING FEMUR. 1550/-

2. INTERLOCKING TIBIA. 1550/-
3. PLATING SPINE (PEDICAL SCREW FIXATION) 1550/-

(B) MAJOR OPERATION:-

1. FRACTURE NECK FEMUR. 1550/-

(C) INTERMEDIATE OPERATION:-

1. INTERMEDIATE FRACTUREES FEMUR– TIBIA 950/-
2. CLOSE NAILING LONG BONES (WITHOUT LOCKING) 950/-

(D) MINOR OPERATION:-

1. MINOR PROCEDURE (WITH ONE X-RAY PALTE) 300/-

* X – RAY PLATE TAKEN ON “C” ARM RS.300/- PER PLATE

PAGE-80
(28) ARTHROSCOPIC SURGERY CHARGES

SR.NO. DECRIPTION CHARGES

1 ARTHROLYSIS / ADHESIONLYSIS 10800/-

2 ARTHROSCOPIC SURGERY FOR OSTEOARTHROSIS 9600/-

3 ARTHROSCOPY- ELBOW 12000/-

4 ARTHROSCOPY- KNEE 12000/-

5 ARTHROSCOPY- SHOULDER 12000/-

6 CHONDROMALACIA OF PATELLA 5400/-

7 DIAGNOSTIC ARTHROSCOPY 4200/-

8 INTRA-ARTICULAR FRACTURE OF FEMUR / TIBIA 10800/-

9 LIGAMENTOUS SURGERY ACL 10800/-
10 LIGAMENTOUS SURGERY PCL 14400/-

11 MENESECTOMY- DOUBLE (SAME JOINT) 14400/-

12 MENESECTOMY- SINGLE 7000/-

13 MOSAICPLASTY 18000/-
14 RECURRENT DISLOCATION OF PATELLA 8400/-
15 RELEASING OF PLICA 5400/-

16 REMOVAL OF LOOZ BODY 5400/-

17 SEPTIC ARTHRITIS 8750/-

18 SLIPA REPAIR 15600/-

19 SUBACROMIAL DECOMPRESSION 9600/-

20 SYNEVECTOMY 7550/-

PAGE-81
 (29) PHYSIOTHERAPY CHARGES
SR. NO. DESCRIPTION CHARGE

1 CERABRAL PALS & OTHER 100/-

2 CERVICAL/LUMBER TRACTION 50/-

3 ELECTRICAL MUSCLE STIMULATION 50/-

4 EXERCISE THERAPY– SIMPLE 50/-

5 EXERCISE THERAPY- WITH EQUIPMENT 60/-

6 FRACTURE LOWER LIMB 50/-

7 FRACTURE UPPER LIMB 50/-

8 HEMIPLEGIA 100/-

9 INFRA RED THERAPY 40/-

10 INTER FERENTIAL 60/-

11 PARAFFIN WAX THERAPY 50/-

12 PARAPLEGIA 100/-

13 POLIO PARALYSIS 100/-

14 QUADRIPLEGIA 100/-

15 S W DIATHERAPY 50/-

16 S W DIATHERAPY (BED SIDE) 60/-

17 TENS THERAPY 50/-

18 ULTRA VIOLET RADIATION 40/-

19 ULTRASOUND THERAPY 50/-

20 VIBRATOR 50/-

21 WALKER WITH WHEEL (PER DAY) 20/-

22 LASER THERAPY 300/-

23 OTHER (NOT MENTION IN LIST) 50/-

FOR PAEDIATRIC:-

SR.NO. PROCEDURE CHARGES

24 PHYSIOTHERPY 50/-

25 PLAY THERAPY 50/-

26 SPEECH THERAPY 50/-

27 BEHAVIOUR THERAPY 50/-

28 OCCUPATIONAL THERAPY 50/-

PAGE-82
 (30) UROLOGY SECTION CHARGES

SR. NO. PROCEDURES CHARGES

1 AMPUTATION OF PENIS- PARTIAL 5400/-

2 AMPUTATION OF PENIS- TOTAL 8400/-
3 BLADDER DIVERTICULACTOMY 18600/-

4 CIRCUMCISION WITH REDUCTION OF PARAPHIN 1100/-

5 CIRCUMCISSION 3000/-

6 COMPLETE URODYNAMICS 3250/-

7 CYSTECTOMY- PARTIAL 13800/-

8 CYSTECTOMY- RADICAL 27600/-

9 CYSTECTOMY- TOTAL 27600/-

10 CYSTO LITHOLAPAXY (DORMIA BASKETING) 4800/-

11 CYSTOLITHOTOMY 3600/-
12 CYSTOMETRY (CYSTOMETROGRAM) 1650/-

13 CYSTOSCOPY 2400/-
CYSTOSCOPY WITH TUR PROSTATE
14 15600/-
(LESS THAN 25GMS)
CYSTOSCOPY WITH TUR PROSTATE
15 18000/-
(MORE THAN 25GMS)
16 CYSTOSCOPY WITH BIOPSY 2400/-
17 CYSTOSCOPY WITH BLADDER NECK INCISION 5400/-
18 CYSTOSCOPY WITH BLOOD TUMAR (<2CM) 10800/-

19 CYSTOSCOPY WITH BLOOD TUMAR (>2CM) 10800/-

20 CYSTOSCOPY WITH DORMIA 5400/-

21 CYSTOSCOPY WITH FULGURATION OF BT 5400/-

22 CYSTOSCOPY WITH LITHOTRIPSY (<1.5CM STONE) 7200/-

23 CYSTOSCOPY WITH LITHOTRIPSY (>1.5CM STONE) 8400/-

24 CYSTOSCOPY WITH URETERIC CATHARISATION 2400/-

25 CYSTOSCOPY WITH V. I. U. 1ST SITTING 3600/-

26 CYSTOSCOPY WITH V. I. U. –SUBSEQUENT SITTINGS 2400/-

27 CYSTOSTOMY- OPEN 3200/-

28 CYSTOSTOMY- TROCAR 1700/-

29 DIAGNOSTIC URETHRO CYSTOSCOPY 2600/-

PAGE-83
30 DIVERTICULECTOMY 6600/-

31 DJ PLACEMENT 3600/-

32 ENDOPYELOTOMY 24000/-

33 ESWL (PROFESSIONAL CHARGE ONLY) 7800/-

34 HYDROCELE- BILATERAL 2400/-

35 HYDROCELE- UNILATERAL 2150/-

36 HYPOSPADIAS REPAIR- SINGLE STAGE 12000/-

37 HYPOSPADIAS REPAIR- TWO STAGE 9600/- EACH STAGE

38 MEATOPLASTY 2400/-

39 MEATOTOMY 1400/-

40 NEPHRECTOMY- RADICAL 10800/-

41 NEPHRECTOMY- SIMPLE 10200/-

42 NEPHRIC SURGERY PERINEPHRIC ABSCESS 4800/-

43 NEPHROLITHOTOMY/MINIPERC 10800/-
NEPHROSTOMY PERCWANEOUS + ITV OR
44 5400/-
ULTRASOUND EQUIPMENT CHARGES
45 OPEN PROSTATECTOMY- MILLINS/FREYERS 16800/-
46 OPEN PROSTATECTOMY- RADICAL 27600/-

47 OPTICAL URETHROTOMY- COMPLICATED 8400/-

48 OPTICAL URETHROTOMY- SIMPLE 6600/-

49 ORCHIDECTOMY- RADICAL 3600/-

50 ORCHIDECTOMY- ROUTINE 3600/-

51 ORCHIDECTOMY- SUBCAPSU 3000/-

52 ORCHIOPAXY- BILATERAL 4200/-

53 ORCHIOPAXY- UNILATERAL 3600/-

54 P.U.VALVE FULGURATION 13200/-

55 PCN 6600/-
56 PCNL- MULTIPLE 18000/-

57 PCNL- PARTIAL STAGHON 13200/-

58 PCNL- SINGLE STONE 10800/-

59 PEOSTATIC ABSCESS DRAINAGE 3600/-

60 PROSTATE NEEDLE BIOPSY- DIGITAL 2300/-

61 PRESSURE FLOWMETRY 1850/-

62 PROSTATE NEEDLE BIOPSY- TRUS GUIDED 4200/-

63 PROSTATE/RENAL BIOPSY 1700/-

PAGE-84
64 PYELOLITHOTOMY 10800/-

65 PYELOPLASTY 9600/-

66 REDUCTION OF PARAPHINOSIS ONLY 600/-

AT PAR WITH IKDRC
67 RENAL TRANSPLANT
CHARGES
68 RENAL TRANSPLANT- CADAVER 240000/-

69 RGP 3800/-

70 RIGISCAN 4700/-

71 RIRS 6120/-

72 S/P PUNCTURE CYSTOSTOMY 1900/-

73 SLING OPERATION FOR STRESS INCONTINANCE 5400/-

74 TESTICULAR BIOPSY 1400/-

75 TORSION TASTIES REPAIR 10800/-

76 URETERIC CATHETERIZATION 3800/-

77 URETERIC REIMPLANTATION- BILATERAL 13800/-

78 URETERIC REIMPLANTATION- UNILETERAL 10800/-
79 URETEROSCOPY- LOWER 9000/-
80 URETEROSCOPY- UPPER 10800/-

81 URETHRAL DILATATION 1000/-

82 URETHRAL PRESSURE PROFILOMETRY 1100/-

83 URETHORPLASTY- SINGLE STAGE 10800/-

84 URETHORPLASTY- TWO STAGE 9600/- EACH STAGE

85 URETHROPLASTY BUCCAL MUCOSA 15000/-

86 URETROLITHOTOMY 6000/-
87 VIDEO URODYNAMICS 4850/-

88 V.V.F REPAIR- COMPLEX 10200/-

89 V.V.F REPAIR- SIMPLE 8400/-

90 VARICOCELECTOMY- BILATERAL 8400/-

91 VARICOCELECTOMY- UNILATERAL 6600/-

92 VASOEPIDIDYMOSTOMY 9000/-
93 VASOPLASTY 7200/-

PAGE-85
 (31) PLASTIC SURGERY CHARGES
(A) PLASTIC SURGERY:-

SR. NO. DESCRIPTION CHARGES

TRAUMA & RELATED WROK (FACE, HEAD & NECK)

LACERATION S MULTIPLE (BOTH 1 & 2 DOES NOT
1 3000/-
INCLUDE ANY BONY WORK.)
2 LACERATIONS SMALL 1400/-

3 MANDIBEL OPEN REDUCTION & SIMPLE WIRING 4800/-

4 MANDIBLE A/O FIXATION 8400/-

5 MANDIBLE I/M WIRING 3600/-

6 MANDIBLE PLATES & SCREW 6600/-

7 MAXILLA F. M. SUSPENSION 4800/-

8 MAXILLA PLATES AND SCREWS 6600/-

9 NASAL BONE 3000/-

10 NASAL BONE REQUIRING INTERNAL FIXATION. 4800/-

NASO-ETHOMOID FRONTAL BONE
11 6600/-
INVOLVEMENT.
12 T. M. ANKYLOSIS 6600/-

13 ZYGOMA CLOSED REDUCTION GILLES APPROACH 2750/-

14 ZYGOMA OPEN REDUCTION 4800/-

EXTREMITIES
15 AMPUTATION OF DIGIT (CHARGES PER DIGIT) 650/-

16 DEGLOVING INJURY SCALP 5400/-

17 DEGLOVING INJURY FOR WARM/ARM 3600/-

18 DEGLOVING INJURY HAND/FOOT 3600/-

19 DEGLOVING INJURY LEG/THIGH 3600/-

20 DEGLOVING INJURY SCORTUM/PENIS 3600/-

21 DIGITAL BONE- K WIRE 2150/-

22 DIGITAL BONE- PLATES AND SCREW 3500/-

23 LACERATION MULTIPLE 2750/-
LACERATION MULTIPLE (BOTH 13 & 14 DO NOT
24 3350/-
INCLUDE ANY BONE OR TENDON WORK)
25 LACERATION SINGLE 900/-
NERVE REPAIR (PER NERVE)
26 1800/-
DIGITAL(MICROSURGICAL)

PAGE-86
27 NERVE REPAIR (PER NERVE) OTHERS 2750/-

28 TENDON REPAIR (CHARGES PER TENDON) 1400/-

MANAGEMENT OF BURNS AND POST BURN DEFORMITIES
(NOTE: EXTRA CHARGES – SURGICAL CASE OF BURN AS PER CONSULTANT)
29 BURNS ESCAROTOMY AREA 500/-

30 BURNS EXCISION (PER BSA %) 800/-

31 BURNS FASCIOTOMY AREA 800/-

32 BURNS MAJOR DRESSING 1150/-

33 BURNS MAJOR DRESSING UNDER G/A 2400/-
34 BURNS MINOR DRESSING 250/-

35 BURNS PBC RELEASE ANILLA/GROIN 4200/-

36 BURNS PBC RELEASE DIGIT 1700/-

37 BURNS PBC RELEASE ELBOW/KNEE 2750/-

38 BURNS SCRAPPING (PER BSA %) 500/-

39 BURNS STSG (PER BSA %) 800/-

COSMETIC AND RECONSTRUCTIVE SURGERY

40 AUGMENTATION 4550/-
41 BALEPHAROPLASTY PER LID 3600/-
42 BREAST AUGMENTATION 4800/- PER SIDE

43 BREAST RECONSTRUCTION 6000/- PER SIDE

44 BREAST REDUCTION 6000/- PER SIDE

45 CHANGE OF GENDER 27600/-

46 CLEFT – PAL–TE – COM–LETE 6000/-

47 CLEFT – PAL–TE – INC–MPLETE 4800/-

48 CLEFT LIP- COM–LETE 4200/-

49 CLEFT LIP– INCOMPLETE 3600/-

50 DEBRIDUMENT UNDER G.A. 1400/-

51 DEBRIDUMENT UNDER L.A. 800/-
DERM (BOTH 1 & 2 DOES NOT INCLUDE ANY BONY
52 5600/-
WORK.)ABRASION FULL FACE
53 DERMABRASION LESS THAN FULL FACE 3600/-

54 DERMOLIPERCTOMY PER REGION 6000/-

55 EAR RECONSTRUCTION 3600/- PER STAGE

56 EAR REPAIR FOR WIDE HOLES 1100/- PER SIDE

57 EPISPADIAS 10800/-

PAGE-87
58 EXCISION OF BENIGN LESIONS MULTIPLE 4200/-

59 EXCISION OF BENIGN LESIONS SINGLE 2400/-

60 FACE LIFT 12000/-

61 FACE LIFT DOUBLE CHAIN CORRECTION 4200/-

62 FACE LIFT FORE HEAD LIFT 4800/-

63 FLAPS (COMPOUND) FASCIO- CUTANEOUS 4200/-

64 FLAPS (COMPOUND) MYO – CUT–NEOUS 5500/-

65 FLAPS (COMPOUND) OSTEO-YO FASCIO-CUT 6200/-

66 FLAPS DELAY PROCEDURE 800/-

67 FLAPS OF SKIN ONLY DISTANT 6200/-

68 FLAPS OF SKIN ONLY LOCAL 1800/-

69 FLAPS OF SKIN ONLY REGIONAL 2750/-

70 FULL THICKNESS SKIN GRAFTING (< 2 CM) 4200/-

71 FULL THICKNESS SKIN GRAFTING (> 2 CM) 6000/-

72 HAEMANGIOMA- LARGE (> 5M) 6000/-

73 HAEMANGIOMA- SMALL(< 5M) 4000/-
74 HAIR BEARING FLAPS (PER FLAP) 5600/-

75 HAIR TRANSPLANTATION PER STAGE 3600/-

76 HYPOSPADIES CURONAL 4200/-

77 HYPOSPADIES PANOSCROLAL 6000/-

78 HYPOSPADIES PENILE 5150/-

79 KELOID – I/L–INJECTION 450/-

80 KELOID EXCISION MAJOR 6000/-

81 KELOID EXCISION MINOR 2400/-

82 LEUCODERMA MAJOR 6000/-

83 LEUCODERMA MINOR 2750/-

84 MAJOR MALIGNANCY EXCISION 6000/-

85 MAXILLA (BONY WORK) HEAD & NECK 6000/-

86 MAXILLA- MAJOR 5400/-

87 MAXILLA- MINOR 2400/-

88 MI ABDOMINOPLASTY 6600/-
89 NODE DISSECTION FUNCTIONAL 5400/-
NODE DISSECTION MODIFIED RADICAL FAT
90 4000/-
REDUCTION SURGERY
91 NODE DISSECTION RADICAL 4800/-

PAGE-88
 92 NODE DISSECTION REGIONAL 3600/-
OTOPLASTY FOR MICROTIA & OTHER
93 12000/-
CONGENITAL (PER STAGE)
PALATAL FISTULA SECONDARY SURGERY FOR
94 4000/-
CLEFT LIP AND NOSE
95 PROMINENT EARS (PER EAR) 3600/-

96 RECONSTRUCTION OF EYE LID 7200/-

97 RECONSTRUCTION OF EYEBROW 7200/-

98 RECONSTRUCTION OF ORBITAL FLOOR 12000/-

99 REVISION ONLY 3200/-

100 RHINOPHYMA 4800/-

RHINOPLASTY AUGMENLATION (EXCLUDING
101 5400/-
MATERIAL)
102 RHINOPLASTY SWPTORHINOPLAST 7200/-

103 SCAR REVISION FACE-LARGE 4800/-

104 SCAR REVISION FACE-MEDIUM 3600/-
105 SCAR REVISION FACE-MULTIPLE 5400/-
106 SCAR REVISION FACE-SMALL 2150/-

107 SPLIT SKIN GRAFTING (PER BSA %) 700/-

108 SUCTION ASSISTED LIPOPLASTY (PER REGION) 6000/-

109 VAGINAL AGENESIS 12000/-

110 VALOPHARYEGEAL INCOMPLETE 6000/-

111 W’ PLA’TY 2400/-

112 Z’ PLA’TY MULTIPLE 3600/-

113 Z’ PLA’TY SINGLE 1700/-

(B) MICRO SURGERY:-

SR. NO. DESCRIPTION CHARGES

114 CRAXIIO FACIAL SURGERY 24000/-

115 FREE FLAP (COMPOUND) 13800/-

116 FREE FLAP (SKIN ONLY) 10800/-

117 FREE TOE TRANSFER 13800/-

118 MICRO SURGICAL NERVE REPAIR 4200/-

119 MICROSCOPIC TUBOPLASTY 6600/-

120 MICROSCOPIC VASOPLASTY 6600/-

PAGE-89
 121 MICROSURGICAL NERVE GRAFT 6600/-

122 REPLANTATION OF PALM / HAND / WRIST 16800/-

123 REPLANTATION PER DIGIT 12000/-

124 REVASCULARISATION (PER AREA) 10800/-

(C)CRANIFASIO MAXILLARY SURGERY CHARGES:-

SR. NO. DESCRIPTION CHARGES

125 CARDIO FACIALS SURGERY (> 5 HRS) 19200/-

126 CARDIO FACIALS SURGERY (< 5 HRS) 13800/-

MAXILLAC / MANDIBLE RIGID FIXATION
127 (CONGENITAL / ACQUIRED DEFORMITY 9600/-
CORRECTION)
ORBITAL RECONSTRUCTION
128 8400/-
(WITH BONE GRAFT OR IMPLANT) MAJOR
ORBITAL RECONSTRUCTION
129 6600/-
(WITHOUT BONE GRAFT) MINOR
PANFASCIAL RIGID FIXATION
130 (MAXILLAC, MANDIBLE & ZYGOMA 13800/-
RECONSTRUCTION LIVE SURGERY
RECONSTRUCTION OF SCALP & CALVAVIA
131 6600/-
(CORRECTION OF CONGENITAL DEFORMITY)
RECONSTRUCTION OF SCALP AND CALVEVIA
132 12000/-
WITH BONE GRAFT
RECONSTRUCTION OF SCALP AND CALVEVIA
133 13800/-
WITH BONE GRAFT AND LOCAL FLAP

(D) FACIOMAXILLARY SURGERY CHARGES:-

SR. NO. DESCRIPTION CHARGES

134 CLOSURE OF ORO ANTRAL FISTULA 1400/-

ENUCLEATION OF CYST OR GRANULOMA-
135 550/-
(2CM OR LESS)
ENUCLEATION OF CYST OR GRANULOMA-
136 650/-
(MORE THAN 2 CM)
ENUCLEATION OF CYST OR GRANULOMA-
137 1400/-
LARGE CYST
EXCISION OF ORAL TUMOR OR GROWTH INTRA
138 550/-
ORALLY- (2CM OR LESS)
EXCISION OF ORAL TUMOR OR GROWTH INTRA
139 650/-
ORALLY- (MORE THAN 2 CM)
EXCISION OF ORAL TUMOR OR GROWTH INTRA
140 800/-
ORALLY- ENBLOCK RESECTION
141 EXCISION OF SUBMANDIBULAR SALIVARY GLAND 1700/-

142 IMPACTED CAINE 800/-

PAGE-90
143 IMPACTED SUPERNUMERARY OR ANY OTHER 800/-

144 IMPACTED THIRD MOLARS- DISTO ANGULAR 650/-

145 IMPACTED THIRD MOLARS- MESIO ANGULAR 650/-

146 IMPACTED THIRD MOLARS- SOFT TISSUE 300/-

147 IMPACTED THIRD MOLARS- VERTICAL 650/-

INCISION & DRAINAGE EXTRA ORALLY
148 650/-
UNDER L. A.
INCISION & DRAINAGE OF LUDWIG’S AN’INA &
149 SIMILAR SERVERE INFECTION AD ITS 150/-
MANAGEMENT
INFECTION OF TISSUE SOACES AROUND
150 MANDIBLE, MAXILLA AND NECK INCISION & 300/-
DRAINAGE INTRA ORALLY UNDER L. A.
OSTEOMYLITIES OF THE JAWAS-
151 900/-
SEQUESTRECTOMY
152 OSTEOMYLITIES OF THE JAWAS- CURETTAGE 550/-

153 THIRD MOLAR IN ABNORMAL PLACE 900/-

154 TOOTH BELOW CEMENTO ENEMAL JUNCTION 800/-

PAGE-91
(32) NEURO SURGERY SECTION CHARGES
SR.NO. DESCRIPTION CHARGES
ALCHOHOL / GLYCEROL INCETION FOR IRIGATAL
1 7200/-
NEURNALGLA
2 CARPAL TUNNEL DECOMPRESSION 6000/-
SCALP WOUND DEBRIDMENT EXCISION &
3 4200/-
SEUTURING- MAJOR
SCALP WOUND DEBRIDMENT EXCISION &
4 2400/-
SEUTURING- MINOR

INTERMEDIATE

5 BURRHOLES BIOPSY 9000/-

6 BURRHOLES FOR CHR. SUBDURAL HEMATOMA 9000/-

7 EMERGENCY VENTIRIC DRAINAGE 9000/-

8 IMPLANTATION OF OMMAYA RESERVOIRS 9000/-

9 THEROPENITONEAL SHUNT 9000/-

10 V.A.SHUNT 3600/-
11 V.P.SHUNT 7200/-

MAJOR

12 ACF REPAIR (UNILATERAL) 13800/-

ANTERIOR CERVICAL DISC. EXCISION AND/OR
13 13800/-
FUSION (CLOWARDS OPERATION)
14 CARNIOTOMY FOR POSTERIOR FUSSA TUMOR 13800/-

15 CARNIOTOMY FOR SUPRATEOTOIALTUMOR 13800/-

CERVICAL LAMINECTOMY FOR EXTRADURAL
16 13800/-
S.O.L.
17 CERVICAL LAMINECTOMY FOR STENOSIS 12000/-
COMPOUND FRACTURE OF SKULL BRAIN
18 13800/-
LACERATIONS
19 CRANIOPLASTY 16800/-
CRANIOTOMY FOR ACUTE SUBDURAL
20 13800/-
HEMATOMA
21 CRANIOTOMY FOR INTRACELEBRAL HEMATOMA 16800/-

22 DURAPLASTY 6000/-

23 ENCEPHALOCOELE 13800/-

24 FOR EXTRADURAL HAMATOMA 13800/-

25 FOR EXTRADURAL S.O.L. 12000/-
LUMBER DISC (PROLAPSE) EXCISION WITH
26 13800/-
DECOMPRESSION

PAGE-92
27 LUMBER LAMINECOTMY FOR CANAL STENOSIS 13800/-

28 MENINGU MYPLOCOEIE 13800/-

29 MICRODISCECTOMY FOR PROLAPSE 12000/-

PERIPHERAL NERVE INJURY EXPLORATION AND
30 13800/-
GRAFTING
31 SCAPLE AVM (CIRSOLD ANEURIAM) 13800/-
THORACIC LAMINECTOMY FOR EXTRADURAL
32 13800/-
S.O.L.
33 THORACIC LAMINECTOMY FOR STENOSIS 13800/-

COMPLEX
34 AVM EXCISION (INTRACRAIAL) 13800/
C V JUNCTION ANOMALLY DECOMPRESSION AND
35 13800/
/OR FUSION
36 INTRACRANIAL ANEURYSMA CLIPPING 13800/
INTRADURAL S.O.L. ( INTRAMEDURAL SOL)
37 13800/
AVM –CERV–CAL
INTRADURAL S.O.L. ( INTRAMEDURAL SOL)
38 13800/
AVM- LUMBER
INTRADURAL S.O.L. ( INTRAMEDURAL SOL)
39 13800/
AVM –THORACIC
40 POSTERIOR FOSSA MVD, V,VIII,IX 13800/
RIGHT RETROMASTOID SUBOCEIPITAL
41 13800/-
CRAMIOTOMY
SKULL BONE ANTI. FORSA AND MIDDLE FORSA
42 13800/
TUMOR
SYRINOMYELIA DECOMPRESSION AND/OR
43 13800/
SHUNT
TRANS ORAL EXCISION OF DEMS AND CLIVAL
44 13800/
TUMORS
45 TRANSPHONOIDAL PITUITARY SURGERY 13800/

PAGE-93
 (33) THORACIC SURGERY SECTION
CHARGES
SR. NO. DESCRIPTION CHARGES

1 ACHALASIA CARDIA 3400/-

2 B. T. SHANT 9000/-

3 BRONCHOSCOPY 2000/-
4 CERVICAL RIB 4550/-
5 CLOSED MITRAL VALVOTOMY 19200/-

6 DECORTICATION 10800/-
7 DIAPHARGMATIC HERNIA (ACQUIRED / ADULT) 10800/-
8 DIAPHARGMATIC HERNIA (PEDIATRICS) 8400/-
ENDOBRONCHIAL ULTRASOUND
9 20000/-
BRONCHOSCOPY
10 EXCISION OF CEHSTWALL SECONDARIES 10800/-

11 EXPLORATORY THORACTOMY 4800/-

12 FFOB + BRONCHIAL LAVAGE 2750/-

13 FFOB + BRONCHIOALVEOLAR LAVAGE 3600/-

14 FFOB + TRANSBRONCHIAL LUNG BIOPSY 3600/-

15 FFOB + TRANSBRONCHIAL MASS BIOPSY 3600/-
FFOB + TRANSBRONCHIAL MASS BIOPSY +
16 3600/-
BRONBCHIAL LAVAGE
17 FLEXIBLE+FIBEROPTIC BRONCHOSCOPY (FFOB) 2750/-

18 GASTEROSTOMY IN NEW BORN 3600/-

19 HAEWANGIOMA 2400/-

20 ICDT 2000/-
21 IVER - LWE–S 9600/-

22 LAPAROTOMY & THORACTOMY FOR TRAUMA 9600/-

23 LOBECTOMY / BILOBECTOMY 9600/-

24 LUNG MASS BIOPSY 2750/-
OESOPHAGEAL STRICTURE DILATATION PER
25 1200/-
SITTING
26 OESOPHAGOSCOPY 2000/-

27 OPEN LUNG BIOPSY 3350/-

28 OPEN PERICARDIAL DRAINAGE 3350/-

PAGE-94
29 PDA 13800/-

30 PERICARDIEACTOMY 12000/-

31 PLEURAL ASPIRATION 650/-

32 PLEURAL BIOPSY 1550/-

33 PLEURECTOMY 3350/-

34 PNEMONECTOMY 13800/-

35 PORTAL HYPE TENSION SURGERY 10800/-

36 RECONSTRUCTION OESOPHAGUS 10800/-

37 REMOVAL OF FOREIGN BODY 5400/-

38 RIB RESECTION & OPEN DRAINAGE (ONE) 4200/-

SARGSTATEN TUBE INTRODUCTION AND
39 2000/-
MANAGEMENT (TUBE COST EXTRA)
40 SCALENE NODE BIOPSY 1900/-

41 SUB-STERNAL BYPASS 6600/-

42 SYMPATHECTOMY LUMBAR / CERVICAL 6000/-

43 T.O.FISTULA 6350/-
44 THORACOPLASTY 9000/-
45 THYMACTOMY 7550/-

46 TOTAL OESOPHARGECTOMY 10800/-

47 TRANS HIATAL OESOPHAGECTOMY 8400/-

48 TUBE THORACOSTOMY 2000/-

49 VERICOSE VAIN 10800/-

50 WIDE EXCISION / MASTECTOMY 4800/-

PAGE-95
 (34) VASCULAR SURGERY SECTION
CHARGES

SR.NO. NAME OF OPERATION CHARGES

1 ABDOMINAL AORTIC AN. 16800/-

2 AORTO FEMORAL BY PASS- BILATERAL 19200/-

3 AORTO FEMORAL BY PASS- UNILATERAL 13200/-

4 AORTO RENAL BY PASS 15600/-

5 AXILLO - BRA–HIAL BY PASS 13200/-

6 AXILO FEMORAL 13200/-

7 CAROTID - SUB–LAVIAN 13200/-

8 CAROTID ENDARTERECTOMY 18000/-

DESCENDING THORACIC AORTO – FEMORAL BY
9 19000/-
PASS
10 DIALYSIS FISTULA 8400/-

11 DSA/USG GUIDED RF ABLATION 60000/-

12 EMBOCTOMY/THROMBECTOMY 13200/-
ENDOVENOUS LASER ABLATION OF VERICOSE
13 50000/-
VEINS
14 FEMORAL - POLYTEAL – ABOVE KNEE 11800/-
15 FEMORO 13200/-
16 FEMORO - DISTAL (IN SITU) 15600/-

17 ILEO FEMORAL 13200/-

18 ILIAC 12000/-

19 IVC FILTER PLACEMENT 10800/-

20 LYMPHOMA SURGERY 7200/-

21 PERIPHERAL ARTERIAL- MAJOR 12000/-

22 PERIPHERAL ARTERIAL- MINOR 9000/-

23 PORATAL HYPERTENSION SURGERY 16800/-

24 PROFUNDOPLASTY 9000/-

25 REGIONAL THROMBOLYSIS- 12 HRS 6000/-

26 REGIONAL THROMBOLYSIS- 24 HRS 7200/-

27 REGIONAL THROMBOLYSIS- 6 HRS 4800/-
REPAIR OF VASCULAR MALFORMATIONS-
28 5400/-
AV FISTULAE

PAGE-96
 REPAIR OF VASCULAR MALFORMATIONS-
29 5400/-
HAEMANGIOMA
30 SYMPATHECTOMY 4200/-

31 SYSTEMIC THROMBOLYSIS 2750/-

32 THORACIC AORTIC AN. 25200/-

33 THORACIC OUTLET SYNDRUME SK 7200/-

34 THORACOABDOMINAL 25200/-

35 VASCULAR TUMORS 9000/-

36 VENEOUS RECONSTRUCTION SURGERY 12000/-

37 VERICOSE DOPPLER 1000/-

38 VERICOSE VEIN SECREROTHERAPY 2000/-

39 VERICOSE VEIN SURGERY- ICPV LIGATION 6600/-

40 VERICOSE VEIN SURGERY- LSV STRIP 6000/-

41 VSCULAR TRAUMA 12600/-

PAGE-97
  TERMS & CONDITIONS 

(1) THIS PRICE LIST IS MADE ONLY FOR THE PURPOSE OF RE-EMBURSMENT.
(2) THIS PRICE LIST IS MADE FOR THE RE-EMBURSEMENT OF ALL STAFF
TREATMENT BILLS OF RECOGNISED HOSPITALS, ALL EMPLOYEES AND
PENSIONERS MEDICAL BILLS.
(3) RECOGNISED HOSPITALS CAN ONLY CHARGE THE GENERAL WARD
CHARGES OF THIS PRICE LIST IN ALL STAFF TREATMENT BILLS. IN CASE
OF ICU/ICCU/NICU/PICU/RR/SPECIAL/SEMI SPECIAL/DELUS ETC.
RECOGNISED HOSPITAL TAKE ONLY STAY AND VISIT DIFFERENCE
CHARGES. HOSPITAL SHOULD NOT TAKE ANY OTHERS DIFFERENCE
CHARGES TO EMPLOYEES AND PENSIONERS.
(4) THE CHARGES OTHER THAN THIS PRICE LIST WILL BE RE-EMBURSED
ON THE BASIS OF VADODARA MUNICIPAL CORPORATION RECOGNISED
HOSPITALS PRICE LIST/CHARGES. THE CHARGES NOT MENTION IN VMC
RECOGNISED HOPSITALS PRICE LIST, WILL BE RE-EMBURSED ON THE
BASIS OF CHARGES APROVED BY GOVT.OF INDIA OR GOVT.OF GUJARAT.
(5) THE CHARGES NOT GIVEN (PARA 4) WILL BE RE-EMBERSED AFTER
TAKING OPINION FROM ADDITIONAL MEDICAL OFFICER OF HEALTH
OR MEDICAL OFFICER OF HEALTH V.M.C.
(6) ALL SURGICAL ITEMS WILL BE RE-EMBURSED FOR ALL TYPES OF
SURGERY (ONLY INDOOR PERIOD).
(7) IN CASE OF ON DUTY ACCIDENTS, AFTER TAKING OPINION OF
ADDITIONAL MEDICAL OFFICER OF HEALTH OR MEDICAL OFFICER OF
HEALTH V.M.C. THE WHOLE AMOUNT WILL BE PAID INSTEAD OF RE-
EMBURSEMENT AFTER APPROVAL FROM MUNICIPAL COMMISIONEER.
(8) TONIC (VITAMINS, CALCIUM, IRON, MINERALS, ENZYMES,
NUTRACEUTICAL ETC.) AND COSMETICS WILL NOT RE-EMBURSED IN
ANY CASE.
(9) ANTI TB MEDICINES WILL NOT BE RE-EMBURSE. IT MUST BE TAKEN
FROM URBAN PRIMARY HELATH CENTRES.
(10) ORIGINAL PRESCRIPTION SHOULD VALID FOR 3-MONTHS ONLY,
AND ONLY 1-MONTH MEDICINES WILL BE RE-EMBURSED IN ADVANCE.

PAGE-98
(11) THE CHARGES FOR ANY IMPLANT/CHEMO DRUGS/I.O.L. (LENS)
WILL BE PAID AFTER ITS CONFERMATION AND SUBMISSION LIKE
IMPLANT STICKERS/ BOXES/I.O.L. ID CARD/CHEMOTHERAPY INJECTION
BOXES ETC.
(12) COSMETIC PURPOSE OPERATION/PROCEDURE MUST NOT BE
ALLOWED IN STAFF TREATMENT BILL FOR ALL RECOGNISED
HOSPITALS, ALL EMPLOYEES AND PENSIONERS MEDICAL BILLS.
(13) THOSE EMPLOYEES/PENSSIONERS DOES NOT HAVING MEDICAL
CARD (TAKING MEDICAL ALLOWANCE IN CASH) MUST NOT RE-
EMBURSED O.P.D. TREATMENT, ANY O.P.D. INVESTIGATION, DAY CARE
TREATMENT AND DENTAL TREATMENT ETC.ONLY INDOOR TREATMENT
BILLS WILL BE RE-EMBURSED.
(14) EMPLOYEES/PENSSIONERS SHOULD CLAIM MEDICAL BILL ONLY
EITHER FROM VADODARA MUNICIPAL CORPORATION OR MEDICLAIM.
THEY SHOULD NOT CLAIM MEDICAL BILL FROM BOTH SIDES.
(15) THIS PRICE LIST IS APPLICABLE FROM 01/04/2018 TO
31/03/2020 ONLY.

V.M.C. PRICE LIST PAGE NO: 1 TO 99 APPROVED.

MUNICIPAL COMMISSIONAR
MUNICIPAL CORPORATION
VADODARA

 THE END 
PAGE-99