Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1 Consultation OPD 2 Consultation- for Inpatients 3 Dressings of wounds 4 Suturing of wounds with local anesthesia 5 Aspiration Plural Effusion - Diagnostic 6 Aspiration Plural Effusion - Therapeutic 7 Abdominal Aspiration - Diagnostic 8 Abdominal Aspiration - Therapeutic 9 Pericardial Aspiration 10 Joints Aspiration 11 Biopsy Skin 12 Removal of Stitches 13 Venesection 14 Phimosis Under LA 15 Sternal puncture 16 Injection for Haemorrhoids 17 Injection for Varicose Veins 18 Catheterisation 19 Dilatation of Urethra 20 Incision & Drainage 21 Intercostal Drainage 22 Peritoneal Dialysis TREATMENT PROCEDURE SKIN 23 Excision of Moles 24 Excision of Warts 25 Excision of Molluscum contagiosum 26 Excision of Veneral Warts 27 Excision of Corns 28 I/D Injection Keloid 29 Chemical Cautery (s) TREATMENT PROCEDURE OPTHALMOLOGY 30 Subconjunctival/subtenon’s injections in one eyes
Non NABH/ Non- NABH/ NABL NABL 135 135 270 270 50 58 108 124 298 343 298 343 345 397 460 529 380 437 317 365 230 265 36 41 112 129 1180 1357 173 199 414 476 350 403 83 95 500 575 420 483 125 144 1319 1517 0 0 345 397 310 357 117 135 160 184 140 161 97 112 110 127 0 69
79
31
Subconjunctival/subtenon’s injections in both eyes
150
173
32 33 34
Pterygium Surgery Conjunctival Peritomy Conjunctival wound repair or exploration following blunt trauma Removal of corneal foreign body Cauterization of ulcer/subconjunctival injection in one eye Cauterization of ulcer/subconjunctival injection in both eyes
86 58 115
99 67 132
115 69
132 79
138
159
35 36 37
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 38 Corneal grafting—Penetrating keratoplasty 39 Corneal grafting—Lamellar keratoplasty 40 Cyanoacrylate /fibrin glue application for corneal perforation 41 Bandage contact lenses for corneal perforation 42 Scleral grafting or conjunctival flap for corneal perforation 43 Keratoconus correction with therapeutic contact lenses 44 UV radiation for cross-linking for keratoconus 45 EDTA for band shaped keratopathy 46 Arcuate keratotomy for astigmatism 47 Re-suturing (Primary suturing) of corneal wound
Non NABH/ Non- NABH/ NABL NABL 5175 5951 4500 5175 690 794 460 2070
529 2381
1080
1242
1800 863 2800 1150
2070 992 3220 1323
48
Penetrating keratoplasty ---- with glaucoma surgery
10930
12570
49 50
Penetrating keratoplasty --- with vitrectomy Penetrating keratoplasty ---- with IOL implantation
10930 12290
12570 14134
51 52 53
15525 10350 15008
17854 11903 17259
14850
17078
55
DALK- Deep anterior lamellar keratoplasty Keratoprosthesis stage I and II DSAEK- Descemet’s stripping automated endothelial keratoplasty ALTK- Automated lamellar therapeutic keratoplasty Probing and Syringing of lacrimal sac- in one eye
69
79
56
Probing and Syringing of lacrimal sac- in both eye
125
144
57 58
Dacryocystorhinostomy—Plain Dacryocystorhinostomy—Plain with intubation and/or with lacrimal implants Dacryocystorhinostomy—conjunctival with implant Caliculoplasty Dacryocystectomy Punctal plugs for dry eyes Refraction Indirect Ophthalmoscopy Orthoptic check-up- with synoptophore Lees’ charting or Hess’ charting Orthoptic exercises Pleoptic exercises Perimetry/field test—Goldman Perimetry/field test— automated
2588 8775
2976 10091
8280
9522
2300 1553 130 40 67 40 100 50 50 130 144
2645 1786 150 46 77 46 115 58 58 150 166
54
59 60 61 62 63 64 65 66 67 68 69 70
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 71 Fluorescein angiography for fundus or iris 72 Ultrasound A- Scan 73 Ultrasound B- Scan 74 Fundus Photo Test 75 Indocyanin green angiography 76 Corneal endothelial cell count with specular microscopy 77 Corneal topography 78 Corneal pachymetry 79 Auto-refraction 80 Macular function tests 81 Potential acuity metry 82 Laser interferometry 83 OCT-Optical coherence tomography 84 HRT- Heidelberg’s retinal tomogram 85 GDX--- Nerve fibre layer analyzer 86 UBM- Ultrasound bio microscopy 87 Non Contact tonometry 88 IOP measurement with schiotz 89 IOP measurement with applation tonometry 90 Three mirror examination for reti 91 90 D lens examination 92 Gonioscopy 93 Chalazion incision and curettage in one eye 94 Chalazion incision and curettage in both eyes 95 Ptosis surgery with fasanella servat procedure 96 Ptosis surgery with LPS resection one lid 97 Ptosis surgery with Sling surgery one lid 98 Ectropion surgery- one lid 99 Ectropion surgery- both lids 100 Epicanthus correction 101 Cantholysis and canthotomy 102 Entropion surgery- one lid 103 Entropion surgery- both lids 104 Tarsorraphy 105 Suturing of lid lacerations 106 Lid retraction repair 107 Concretions removal 108 Bucket handle procedure for lid tumors 109 Cheek rotation flap for lid tumors 110 Orbitotomy 111 Enucleation 112 Enucleation with orbital implants and artificial prosthesis 113 Evisceration
Non NABH/ Non- NABH/ NABL NABL 828 952 777 894 207 238 180 207 900 1035 207 238 298 207 35 44 100 156 1913 150 88 135 50 30 50 58 50 58 400 431 2300 5500 6003 2000 3000 1550 575 1380 2000 650 1150 1700 115 345 6210 7245 2700 3000
343 238 40 51 115 179 2200 173 101 155 58 35 58 67 58 67 460 496 2645 6325 6903 2300 3450 1783 661 1587 2300 748 1323 1955 132 397 7142 8332 3105 3450
3105
3571
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 114 Evisceration with orbital implants and artificial prosthesis 115 Telecanthus correction 116 Orbital decompression 117 Exenteration 118 Exenteration with skin grafting 119 Fracture orbital repair 120 Retinal laser procedures 121 Retinal detachment surgery 122 Retinal detachment surgery with scleral buckling 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155
Buckle removal Silicone oil removal Anterior retinal cryopexy Squint correction for one eye Squint correction for both eyes Trabeculectomy Trabeculotomy Trabeculectomy with Trabeculotomy Trephition Goniotomy Glaucoma surgery with Glaucoma valves Cyclocryotherapy YAG laser iridotomy YAG laser capsulotomy ALT-Argon laser trabeculoplasty PDT-Photodymic therapy TTT- Transpupillary thermal therapy PTK- Phototherapeutic keratectomy Argon/diode laser for retinal detatchment Intralase application for keratoconus EOG- electro-oculogram ERG- Electro-retinogram VEP- visually evoked potential Vitrectomy- pars plana Intravitreal injections- of antibiotics Intravitreal injections- of lucentis excluding cost of drug X- Ray orbit CT-orbit and brain MRI- Orbit and brain Dacryocystography Orbital angio-graphical studies ECCE with IOL SICS with IOL
Non NABH/ Non- NABH/ NABL NABL 5124 5893 4658 5175 5500 6210 9000 1350 10350 12420 1150 2520 1162 4500 6750 6210 6210 9315 2070 345 6210+valve 1035 1350 1093 1346 3105 2700 7500 1035 5175 810 715 720 10350 1035 2700 115 173 3105 340 1500 3450 13500
5357 5951 6325 7142 10350 1553 11903 14283 1323 2898 1336 5175 7763 7142 7142 10712 2381 397 #VALUE! 1190 1553 1257 1548 3571 3105 8625 1190 5951 932 822 828 11903 1190 3105 132 199 3571 391 1725 3968 15525
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 156 Phaco with foldable IOL (silicone and acrylic)/PMMA IOL 157 Pars plana lensectomy with/without IOL 158 Secondary IOL implantation- AC IOL PC IOL or scleral fixated IOL 159 Cataract extraction with IOL with capsular tension rings (Cionni’s ring) 160 Optic nerve sheathotomy 161 Iridodialysis repair or papillary reconstruction 162 Iris cyst removal 163 Lid Abscess incision and Drainage 164 Orbital Abscess incision and Drainage 165 Biopsy 166 Paracentesis 167 Scleral graft for scleral melting or perforation 168 Amniotic membrane grafting 169 Cyclodiathermy 170 Intraocular foreign body removal 171 Electrolysis 172 Perforating injury repair 173 Botulinum injection for blepharospasm or squint
174 175 176 177 178 179 180 181 182 183 184 185 186
TREATMENT PROCEDURE DENTAL PROCEDURES Flap Operation per quadrant Gingivectomy per quadrant Reduction & immobilization of fracture- Maxilla Under LA Reduction & immobilization of fracture-Mandible Under LA splints/Cirucum mandibular wiring under LA splints/Cirucum mandibular wiring under GA Internal wire fixation/plate fixation of Maxilla under LA Internal wire fixation/plate fixation of Maxilla under GA Internal wire fixation/plate fixation of Mandible under LA Internal wire fixation/plate fixation of Mandible under GA Extraction per tooth under LA Complicated Ext. per Tooth under LA Extraction of impacted tooth under LA
Non NABH/ Non- NABH/ NABL NABL 10781 12398 10350 6900
11903 7935
12150
13973
6750 4500 850 1530 2700 414 230 2520 1100 2070 187 230 4050 2500
7763 5175 978 1760 3105 476 265 2898 1265 2381 215 265 4658 2875
0
0
360 234 900
414 269 1035
3500
4025
459 990 3000
528 1139 3450
4000
4600
3500
4025
4250
4888
80 100 160
92 115 184
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 187 Extraction in mentally retarded/patients with systemic diseases/patient with special needs under short term GA 188 Cyst & tumour of Maxilla /mandible by enucleation/ excision/ marsupalisation upto 4 cms under LA 189 Cyst & tumour of Maxilla/mandible by enucleation/ excision/ marsupalisation size more than 4 cms under LA 190 Cyst & tumour of Maxilla/mandible by enucleation/excision/marsupalisation size more than 4 cms under GA 191 TM joint ankylosis- under GA 192 Biopsy Intraoral-Soft tissue 193 Biopsy Intraoral-Bone 194 Hemi-mandibulectomy with graft 195 Hemi-mandibulectomy without graft 196 Segmental-mandibulectomy with graft 197 Segmental-mandibulectomy without graft 198 Maxillectomy- Total with graft 199 Maxillectomy- Total without graft 200 Maxillectomy- partial with graft 201 Maxillectomy- partial without graft 202 Release of fibrous bands & grafting -in (OSMF) treatment under GA 203 Pre-prosthetic surgery- Alveoloplasty 204 Pre-prosthetic surgery - ridge augmentation 205 Root canal Treatment(RCT) Anterior teeth(per tooth) 206 Root canal Treatment(RCT) Posterior teeth (per tooth) 207 Apicoectomy- Single root 208 Apicoectomy-Multiple roots 209 Metal Crown-per unit 210 Metal Crown with Acrylic facing per unit 211 Complete single denture-metal based 212 Complete denture- acrylic based per arch 213 Removable partial denture-Metal based-upto 3 teeth 214 Removable partial denture-Metal based-more than 3 teeth 215 Removable partial denture-Acrylic based-upto 3 teeth 216 Removable partial denture-Acrylic based-more than 3 teeth
Non NABH/ Non- NABH/ NABL NABL 939 1080
244
281
406
467
1000
1150
7500 374 374 18900 18900 3400 990 2500 1950 2700 2500 1500
8625 430 430 21735 21735 3910 1139 2875 2243 3105 2875 1725
500 1200 500
575 1380 575
700
805
500 650 500 700 1500 950 700
575 748 575 805 1725 1093 805
900
1035
500
575
264
304
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 217 Amalgum restoration-per tooth 218 Composite Restoration-per tooth-anterior tooth 219 Glas Ionomer-per tooth 220 Scaling & polishing 221 Removable Orthodontics appliance- per Arch 222 Fixed Orhtodontics-per Arch 223 Space maintainers-Fixed 224 Habit breaking appliances-removable 225 Habit breaking appliances-Fixed 226 Expansion plate 227 Feeding appliance for cleft palate 228 Maxillo-facial prosthesis (sal/auricular/orbital/facial lost part) 229 Functional orthodentic appliances 230 Obturator (Maxillo-facial) 231 Occlusal night guard(splint) TREATMENT PROCEDURE ENT 232 Pure Tone Audiogram 233 Impedence with stepedeal reflex 234 SISI Tone Decay 235 Multiple hearing assessment test to Adults 236 Speech Discrimination Score 237 Speech Assessment 238 Speech therapy per session of 30-40 minutes 239 Cold Calorie Test for Vestibular function 240 Removal of foreign body From Nose 241 Removal of foreign body From Ear 242 Syringing (Ear) 243 Polyp removal under LA 244 Polyp removal under GA 245 Peritonsillar abscess Drainage under LA 246 Myringoplasty 247 Staepedectomy 248 Myringotomy with Grommet insertion 249 Tympanotomy 250 Tympanoplasty 251 Mastoidectomy 252 Otoplasty 253 Labyrinthectomy 254 Skull Base surgery 255 Facial Nerve Decompression 256 Septoplasty 257 Submucous Resection 258 Septo-rhinoplasty 259 Rhinoplasty- Non-cosmetic
Non NABH/ Non- NABH/ NABL NABL 200 230 250 288 200 230 300 345 700 805 1150 1323 500 575 800 920 1500 1725 1000 1150 1500 1725 3500 4025 3000 1350 800 0 172 230 132 115 230 120 131 172 345 207 166 575 850 1449 6900 9200 4600 7763 12420 13455 16100 13800 25000 17250 5750 7314 16100 11500
3450 1553 920 0 198 265 152 132 265 138 151 198 397 238 191 661 978 1666 7935 10580 5290 8927 14283 15473 18515 15870 28750 19838 6613 8411 18515 13225
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 260 Fracture Reduction 261 Intra nasal Diathermy 262 Turbinectomy 263 Endoscopic DCR 264 Endoscopic Surgery 265 Septal Perforation Repair 266 Antrum Puncture 267 Lateral Rhinotomy 268 Cranio-facial resection 269 Caldwell Luc Surgery 270 Angiofibroma Excision 271 Endoscopic Hypophysectomy 272 Endoscopic Optic Nerve Decompression 273 Decompression of Orbit 274 Punch/Wedge biopsy 275 Tonsillectomy 276 Uvulo-palatoplasty 277 FESS for antrochoal polyp 278 FESS for ethmoidal polyp 279 Polyp removal ear 280 Polyp removal Nose(Septal polyp) 281 Mastoidectomy plus Ossciculoplasty including TORP or PORP 282 Endolymphatic sac decompression 283 Diagnostic endoscopy under GA 284 Yonges operation for Atrophic rhinitis 285 Vidian neurectomy for vasomotor Rhinitis 286 Nasal Packing-anterior 287 Nasal Packing-posterior 288 Ranula Excision 289 Tongue Tie excision 290 Sub Mandibular Duct Lithotomy 291 Adenoidectomy 292 Palatopharyngoplasty 293 Pharyngoplasty 294 Styloidectomy 295 Direct laryngoscopy including Biopsy under GA 296 297 298 299
300
Oesophagoscopy/foreign body removal from Bronchoscopy with F.B.removal Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE FOR HEAD AND NECK Ear Lobe Repair one side
Non NABH/ Non- NABH/ NABL NABL 4250 4888 1150 1323 5750 6613 11700 13455 13800 15870 13800 15870 950 1093 1000 1150 22950 26393 9563 10997 17000 19550 21500 24725 32775 37691 22950 26393 674 775 5000 5750 15000 17250 5750 6613 5750 6613 748 860 748 860 2415 2777 2875 2300 6900 9315 345 805 6159 1500 269 5640 8165 17193 9200 5000
3306 2645 7935 10712 397 926 7083 1725 309 6486 9390 19772 10580 5750
1800 2438 15000 8500 0
2070 2804 17250 9775 0
500
575
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 301 Excision of Pinna for Growth (Squamous/Basal/ 4000 4600 Injuries) Skin Only 302 Excision of Pinna for Growth (Squamous/Basal/ 3800 4370 Injuries) Skin and Cartilage 303 Partial Amputation of Pinna 4500 5175 304 Total Amputation of Pinna 6200 7130 305 Total Amputation & Excision of External Auditory 1500 1725 Meatus 306 Excision of Cystic Hygroma 5175 5951 307 Excision of Cystic Hygroma Extensive 7452 8570 308 Excision of Branchial Cyst 10350 11903 309 Excision of Branchial Sinus 9315 10712 310 Excision of Pharyngeal Diverticulum 10580 12167 311 Excision of Carotid Body-Tumours 11615 13357 312 Operation for Cervical Rib 12500 14375 313 Block Dissection of Cervical Lymph Nodes 13500 15525 314 Pharyngectomy & Reconstruction 15000 17250 315 Operation for Carcinoma Lip - Wedge-Excision 8050 9258 316
Operation for Carcinoma Lip - Vermilionectomy
5758
6622
317
Operation for Carcinoma Lip - Wedge Excision and Vermilonectomy Estlander Operation Abbe Operation Cheek Advancement Excision of the Maxilla Excision of mandible-segmental Mandibulectomy Partial Glossectomy Hemiglossectomy Total Glossectomy Commondo Operation Parotidectomy - Superficial Parotidectomy - Total Parotidectomy - Radical Repair of Parotid Duct Removal of Submandibular Salivary gland Hemithyroidectomy Partial Thyroidectomy (lobectomy) Subtotal Thyroidectomy Total Thyroidectomy Resection Enucleation of thyroid Adenoma Total Thyroidectomy and Block Dissection Excision of Lingual Thyroid
9292
10686
7475 9800 9775 19320 15525 21000 5520 7000 22885 22000 12075 15000 19550 11500 8625 9500 11500 13053 19000 10580 26450 16882
8596 11270 11241 22218 17854 24150 6348 8050 26318 25300 13886 17250 22483 13225 9919 10925 13225 15011 21850 12167 30418 19414
318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 340 Excision of Thyroglossal Cyst/Fistula 341 Excision of Parathyroid Adenoma/Carcinoma 342 Laryngectomy 343 Laryngo Pharyngectomy 344 Hyoid Suspension 345 Genioplasty 346 Direct Laryngoscopy including biopsy under GA 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369
370 371 372 373 374 375 376 377 378
Phonosurgery Fibroptic examition of Larynx under LA Microlaryngeal Surgery Laryngofissure Tracheal Stenosis Excision Head and neck cancer Excisional Biopsies Benign Tumour Excisions Temporal Bone subtotal resection Modified Radical Neck Dissection Carotid Body Excision Total Laryngectomy Flap Reconstructive Surgery Parapharyngeal Tumour Excision Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE BREAST Drainage of abscess Excision of lumps Local mastectomy-simple Radical mastectomy-formal or modified. Excision of mammary fistula Segmental resection of breast Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE GENERAL SURGERY Injury Of Superficial Soft Tissues Suturing of small wounds Secondary suture of wounds Debridement of wounds Removal Of Foreign Bodies Biopsies Excision of Cervical Lymph Node Excision of Axillary Lymph Node Excision of Inguinal Lymph Node Excision Biopsy of Ulcers
Non NABH/ Non- NABH/ NABL NABL 13225 15209 21275 24466 17825 20499 30000 34500 10350 11903 12000 13800 5175 5951 13800 1649 10350 17250 19780 0 5750 9500 20700 25300 23400 35273 37260 35397 21250 5000 0 6000 6969 12650 28750 15525 16100 25000 5000 0
15870 1896 11903 19838 22747 0 6613 10925 23805 29095 26910 40564 42849 40707 24438 5750 0 6900 8014 14548 33063 17854 18515 28750 5750 0
425 242 290 450 300 0 1725 2277 2277 1470
489 278 334 518 345 0 1984 2619 2619 1691
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 379 Excision Biopsy of Superficial Lumps 3000 3450 380 Incision Biopsy of Growths/Ulcers 1470 1691 381 Trucut Needle Biopsy 1550 1783 382 Percutaneous Kidney Biopsy 1470 1691 383 Marrow Biopsy (Open) 1060 1219 384 Muscle Biopsy 1470 1691 385 Scalene Node Biopsy 1350 1553 386 Excision of Sebaceous Cysts 1118 1286 387 Excision of Superficial Lipoma 1739 2000 388 Excision of Superficial Neurofibroma 2250 2588 389 Excision of Dermoid Cysts 2277 2619 390 Haemorrhoidectomy 2500 2875 391 Stappler haemorrhoidectomy 4025 4629 392 keloid excision 1150 1323 393 Vericose vein surgery;Tendelenburg operation with 7763 8927 suturing or ligation. TREATMENT PROCEDURE OESOPHAGUS 0 0 394 395 396 397 398 399 400 401 402 403 404 405
406 407 408 409 410 411 412 413
Atresia of Oesophagus and Tracheo Oesophageal Fistula Operations for Replacement of Oesophagus by Colon Oesophagectomy for Carcinoma Easophagus Oesophageal Intubation (Mausseau Barbin Tube)
28750
33063
25000
28750
22500 11500
25875 13225
Achalasia Cardia Transthoracic Achalasia Cardia Abdominal Oesophago Gastrectomy for mid 1/3 lesion Heller’s Operation Colon-Inter position or Replacement of Oesophagus Oesophago Gastrectomy – Lower Corringers procedure Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE ABDOMEN / GI SURGERY Gastroscopy Gastric & Duodenal Biopsy (Endoscopic) Pyloromyotomy Gastrostomy Simple Closure of Perforated peptic Ulcer Vagotomy Pyleroplasty / Gastro Jejunostomy Duodenojejunostomy Partial/Subtotal Gastrectomy for Carcinoma
14950 12650 24495 19750 22540
17193 14548 28169 22713 25921
21390
24599
27625 5000 0
31769 5750 0
1553 1755 2800 7763 8798 12420 17055 20700
1786 2018 3220 8927 10118 14283 19613 23805
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 414 Partial/Subtotal Gastrectomy for Ulcer 415 Operation for Bleeding Peptic Ulcer 416 Operation for Gastrojejunal Ulcer 417 Total Gastrectomy for Cancer 418 Highly Selective Vagotomy 419 Selective Vagotomy & Drainage 420 Congenital Diaphragmatic Hernia 421 Hiatus Hernia Repair- Abdominal 422 Hiatus Hernia Repair- Transthoracic 423 Exploratory Laparotomy 424 Epigastric Hernia Repair 425 Umbilical Hernia Repair 426 Ventral /incisional Hernia Repair 427 Inguinal Hernia Herniorraphy 428 Inguinal Hernia - Hernioplasty 429 Femoral Hernia Repair 430 Rare Hernias Repair (Spigalion, Obturator, Lumbar, Sciatic) 431 Splenectomy - For Trauma 432 Splenectomy - For Hypersplenism 433 Splenorenal Anastomosis 434 Portocaval Anastomosis 435 Direct Operation on Oesophagus for Portal Hypertension 436 Mesentericocaval Anastomosis 437 Warren Shunt 438 Pancerato Duodenectomy 439 By Pass Procedure for Inoperable Carcinoma of Pancreas 440 Cystojejunostomy or Cystogastrostomy 441 Cholecystectomy 442 Cholecystectomy & Exploration of CBD 443 Repair of CBD 444 Operation for Hydatid Cyst of Liver 445 Cholecystostomy 446 Hepatic Resections (Lobectomy /Hepatectomy) 447 448 449 450 451 452 453 454
Operation on Adrenal Glands - Bilateral Operation on Adrenal Glands - Unilateral Appendicectomy Appendicular Abscess – Drainage Mesenteric Cyst- Excision Peritonioscopy/Laparoscopy Jejunostomy Ileostomy
Non NABH/ Non- NABH/ NABL NABL 20183 23210 20976 24122 19780 22747 22368 25723 18630 21425 18630 21425 17078 19640 14490 16664 16100 18515 12650 14548 11385 13093 11385 13093 10293 11837 14835 17060 16500 18975 18285 21028 18975 21821 18975 14490 23000 28750 22885
21821 16664 26450 33063 26318
25450 28750 21735 23000
29268 33063 24995 26450
14490 10292 14375 13600 11902 10292 14375
16664 11836 16531 15640 13687 11836 16531
26105 13800 8108 9775 11040 4600 5750 15410
30021 15870 9324 11241 12696 5290 6613 17722
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 455 Resection & Anastomosis of Small Intestine 456 Duodenal Diverticulum 457 Operation for Intestinal Obstruction 458 Operation for Intestinal perforation 459 Benign Tumours of Small Intestine 460 Excision of Small Intestine Fistula 461 Operations for GI Bleed 462 Operations for Haemorrhage of Small Intestines 463 464
465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494
Non NABH/ Non- NABH/ NABL NABL 20700 23805 18400 21160 10350 11903 40000 46000 19550 22483 19550 22483 16000 18400 19550 22483
Operations of the Duplication of the Intestines Operations for Recurrent Intestinal Obstruction (Noble Plication & Other Operations for Adhesions) Ilieosigmoidostomy and related resection Ilieotransverse Colostomy and related resection
17825 23000
20499 26450
16790 16790
19309 19309
Caecostomy Loop Colostomy Transverse Sigmoid Terminal Colostomy Closure of Colostomy Right Hemi-Colectomy Left Hemi-Colectomy Total Colectomy Operations for Volvulus of Large Bowel Operations for Sigmoid Diverticulitis Fissure in Ano with Internal sphinctrectomy with fissurectomy. Fissure in Ano - Fissurectomy Rectal Polyp-Excision Fistula in Ano - High Fistulectomy Fistula in Ano - Low Fistulectomy Prolapse Rectum - Theirch Wiring Prolapse Rectum - Rectopexy Prolapse Rectum - Grahams Operation Operations for Hirschsprungs Disease Excision of Pilonidal Sinus (open) Excision of Pilonidal Sinus with closure Abdomino-Perineal Excision of Rectum Anterior Resection of rectum Pull Through Abdominal Resection Retro Peritoneal Tumor Removal Radio ablation of varicose veins Laser ablation of varicose veins Laproscopic Fundoplication Laproscopic Spleenectomy
3903 11799 17250 17480 13800 13800 17250 24920 18630 13800
4488 13569 19838 20102 15870 15870 19838 28658 21425 15870
5750 5658 16780 9867 10350 5750 18400 14260 11500 11500 18300 19665 17170 18000 1800 17250 19300 25000
6613 6507 19297 11347 11903 6613 21160 16399 13225 13225 21045 22615 19746 20700 2070 19838 22195 28750
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 495 Laproscopic Removal of hydatid cyst 496 Laproscopic treatment of Pseudo Pancreatic cyst 497 498 499 500 501 502 503 504 505 506 507 508 509 510
511 512 513 514 515 516 517 518 519
520 521 522 523 524 525 526 527 528 529 530 531 532
Laproscopic whipples operation Laproscopic GI bypass operation Laproscopic Total Colectomy Laproscopic Hemi Colectomy Laproscopic Anterior Resection Laproscopic Cholecystetomy Laproscopic Appedicectomy Laproscopic Hernia inguinal repair Laproscopic ventral Hernia Repair Laproscopic Paraumblical Hernia Repair Laproscopic Adrenelectomy Laproscopic Nephrectomy Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE ICU/CCU PROCEDURES (SPECIAL CARE CASES) Coronary Care with Cardiac Monitoring (Room Rent extra) Compressed air / piped oxygen /per hour Ventilator charges (Per day) Paediatric care for New born (Per day) Incubator charges (Per day) Neonatal ICU charges (Per day) Resuscitation Exchange Transfusion Pneupack ventilator in Nursery (Per day) TREATMENT PROCEDURE CARDIOVASCULAR AND CARDIAC SURGERY & INVESTIGATIONS ASD Closure VSD with graft TOF/TAPVC/TCPC/REV/RSOV repair B.D.Glenn/Left atrium myxoma Senning/ASO with graft DSO AV Canal repair Fonten Conduit repair CABG CABG + IABP CABG + Valve. CABG without bypass.
Non NABH/ Non- NABH/ NABL NABL 18000 20700 18000 20700 20000 22000 25000 23000 23000 18975 16200 18000 17500 12580 12000 22000 38000 6000 0
23000 25300 28750 26450 26450 21821 18630 20700 20125 14467 13800 25300 43700 6900 0
675
776
45 531 186 345 391 184 265 575 0
52 611 214 397 450 212 305 661 0
51808 51808 114368 80750 119000 93254 144900 152100 152100 127075 169000 169000 126000
59579 59579 131523 92863 136850 107242 166635 174915 174915 146136 194350 194350 144900
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 533 Ascending aorta replacement 534 DVR 535 MVR/AVR 536 MV repair + AV repair 537 Aorta femoral bypass 538 B.T Shunt/Coaractation 539 P.A.Banding septostomy 540 Pericardectomy 541 CMV/PDA 542 Gunshot injury 543 Heart transplant 544 Balloon coronary angioplasty/PTCA with VCD
Non NABH/ Non- NABH/ NABL NABL 130000 149500 47700 54855 93254 107242 103615 119157 52000 59800 46782 53799 46782 53799 42320 48668 51980 59777 51980 59777 248400 285660 80600 92690
545
Balloon coronary angioplasty/PTCA without VCD
80000
92000
546 547 548 549 550 551 552 553 554 555 556 557 558 559 560
48875 10264 9000 10350 12650 15000 21000 36000 30000 127500 14500 18500 7500 8160 13800
56206 11804 10350 11903 14548 17250 24150 41400 34500 146625 16675 21275 8625 9384 15870
561
Rotablation balloon valvotomy/PTMC CATH Arch Replacement Aortic Dissection Thoraco Abdominal Aneurism Repair Embolectomy Vascular Repair Bentall Repair with Prosthetic Valve Bentall Repair with Biologic Valve Coaractation dilatation Coaractation dilatation with Stenting TPI Single Chamber TPI Dual Chamber Permanent pacemaker implantation- Single Chamber Permanent pacemaker implantation- Dual Chamber
19320
22218
562
Permanent pacemaker implantation Biventricular
31050
35708
563 564 565 566
AICD implantation Single Chamber AICD implantation Dual Chamber Combo device implantation Diagnostic Electrophysiological studies conventional Ambulatory BP monitoring External Loop/event recording RF Ablation conventional RF Ablation Atrial Tachycardia/Carto Endomyocardial biopsy
28750 40000 40000 4550
33063 46000 46000 5233
587 2563 31500 45000 9000
675 2947 36225 51750 10350
567 568 569 570 571
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 572 IABP 573 Intra vascular coils 574 Septostomy- Balloon 575 Septostomy- Blade 576 AVBD/PVBD 577 Digital subtraction angiography-Peripheral artery 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610
611 612
Digital subtraction angiography- venogram C.T Guided biopsy Sinogram Peripheral Angioplasty with VCD Peripheral Angioplasty without VCD Renal Angioplasty IVUS FFR Holter analysis Aortic stent grafting for aortic aneurysm IVC Filter implantation ASD/VSD/PDA device closure ECG HUTT 2 D echocardiography 3 D echocardiography Fetal Echo 2 D TEE 3 D TEE(Transoesophageal echo ) Stress Echo- exercise Stress Echo- pharmacological Stress MPI- exercise Stress MPI - pharmacological Coronary angiography CT coronary angiography Cardiac CT scan Cardiac MRI Stress Cardiac MRI MR angiography. Cardiac PET Pericardiocentesis Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE OBSTETRICS AND GYNAECOLOGY Normal delivery with or without Episiotomy & P. repair vacuum delivery
Non NABH/ Non- NABH/ NABL NABL 7820 8993 41400 47610 16150 18573 19550 22483 48300 55545 11500 13225 11500 1265 863 11500 11500 60350 22500 12750 850 77000 14516 36225 50 2040 1080 1275 1260 1275 1403 1350 2250 1955 2500 11500 6030 2272 2444 3000 5635 1500 3500 20000 4250 0
13225 1455 992 13225 13225 69403 25875 14663 978 88550 16693 41659 58 2346 1242 1466 1449 1466 1613 1553 2588 2248 2875 13225 6935 2613 2811 3450 6480 1725 4025 23000 4888 0
8000
9200
8625
9919
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 613 Forceps Delivery 9200 10580 614 Cesarean Section 14050 16158 615 Cesarean Hysterectomy 18975 21821 616 Rupture Uterus closure & repair with Tubal 17250 19838 Ligation 617 Perforation of Uterus after D/E Laparotomy & 13800 15870 Closure 618 Laparotomy for Ectopic pregnancy 13800 15870 619 Laparotomy-peritonitis Lavage and Drainage 11500 13225 620 Salphingo-Oophorectomy/ Oophorectomy 10000 11500 Laproscopic 621 Ovarian Cystectomy-laparoscopic. 10350 11903 622 Ovarian Cystectomy -laparotomy. 13800 15870 623 Salpingo-Oophorectomy-laparotomy 11520 13248 624 Laproscopic Broad Ligament Hematoma Drainage 6210 7142 with repair 625 Exploration of perineal Haematoma & Repair 8000 9200 626 Exploration of abdominal Haematoma (after 8050 9258 laparotomy + LSCS) 627 Manual Removal of Placenta 3450 3968 628 Examination under anesthesia (EUA) 1000 1150 629 Burst-abdomen Repair 9000 10350 630 Gaping Perineal Wound Secondary Suturing 1656 1904 631 Gaping abdominal wound Secondary Suturing 3450 3968 632 Complete perineal tear-repair 2128 2447 633 Exploration of PPH-tear repair 3500 4025 634 Suction evacuation vesicular mole 5000 5750 635 Suction evacuation Missed abortion/ incomplete 5175 5951 abortion 636 Colpotomy 3450 3968 637 Repair of post-coital tear/ perineal injury 3508 4034 638 Excision of urethral caruncle 3450 3968 639 Shirodhkar/ Mc. Donald’s stitch 2898 3333 640 Abdominal Hysterectomy with or without salpingo17250 19838 oophorectomy 641 Vaginal Hysterectomy (NDVH) 17250 19838 642 Vaginal Hysterectomy with repairs (UV Prolapse) 17250 19838 643 644 645 646 647 648 649
Myomectomy -laparotomy Myomectomy -laparoscopic Vaginoplasty Vulvectomy -Simple Vulvectomy-Radical RVF Repair Manchester Operation
14000 6325 14950 9200 9200 14000 15000
16100 7274 17193 10580 10580 16100 17250
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 650 Shirodkar’s sling Operation or other sling operations for prolapse uterus 651 Laparoscopic sling operations for prolapse uterus
Non NABH/ Non- NABH/ NABL NABL 3450 3968 35000
40250
652 653 654 655 656 657 658
Diagnostic Curettage Cervical Biopsy Polypectomy Other-Minor Operation Endometrial Excision Vaginal Cyst/Bartholin Cyst Excision Vaginal Septum Laparoscopy -Diagnostic with chromopertubation and or adhesiolysis and drilling
2484 1800 1518 2300 3450 4600 4025
2857 2070 1746 2645 3968 5290 4629
659 660 661 662 663
Laparoscopy Sterilization LAVH Balloon Temponade for PPH Total laparoscopic hysterectomy Laparoscopic treatment of Ectopic pregnancysalpingectomy/salpinostomy conservative Conisation of cervix Trachhelectomy of cervix for early CA cervix Hysteroscopic cannulation Laparotomy recannalization of Fallopian tubes(Tubuloplasty) Laparoscopic recannalization of Fallopian tubes(Tubuloplasty) Colposcopy Inversion of Uterus – Vaginal Reposition Inversion of Uterus – Abdominal Reposition Laparoscopic VVF Repair Abdominal VVF Repair Vaginal VVF Repair Interventional Ultrasonography (CVS) Amniocentesis Karyotyping Thermal balloon ablation. Ultrasonographic myolysis Vaginal Myomectomy Intra Uterine Inseminition ICSI Laparotomy abdominal sacro-colpopexy Vaginal Colpopexy Laparoscopic abdominal sacro-colpopexy Laparotomy pelvic Lymphadenectomy Laparoscopic pelvic Lymphadenectomy
3450 55000 2800 25243 8798
3968 63250 3220 29029 10118
4025 5500 2875 22425
4629 6325 3306 25789
55000
63250
958 2500 2500 50000 40000 25200 880 880 800 10350 9264 10000 920 10350 15000 19800 20000 1200 3500
1102 2875 2875 57500 46000 28980 1012 1012 920 11903 10654 11500 1058 11903 17250 22770 23000 1380 4025
664 665 666 667 668 669 670 671 672 673 674 675 676 677 678 679 680 681 682 683 684 685 686 687
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 688 Endometrial aspiration cytology/biopsy 689 Transvaginal sonography (TVS for Follicular monitioring /aspiration) 690 laparoscopic treatment for stress incontinence 691 Transvaginal tapes for Stress incontinence 692 trans-obturator tapes for Stress incontinence 693 Interventional radiographic arterial embolization 694 695 696 697 698 699 700 701 702 703 704 705
706 707 708 709 710 711 712 713 714 715 716
717 718 719 720 721 722 723
Diagnostic cystoscopy Staging laparotomy surgery for CA Ovary Internal Iliac ligation stepwise devascularisation Assisted breech delivery Intra-uterine fetal blood transfusion Hysteroscopy TCRE Hysteroscopy Removal of IUCD Hysteroscopy Removal of Septum Hysteroscopy Diagnostic Radical Hysterectomy for Cancer cervix with pelvic lymphadenectomy Radical Hysterectomy for Cancer endometrium extending to cervix with pelvic and para aortic lymphadenectomy Sterilization Post partum (minilap) Sterilization interval (minilap) Ultrasonography Level II scan/Anomaly Scan Fetal nuchal Translucency Fetal Doppler/Umblical Doppler/Uterine Vessel Doppler MTP- 1st Trimester MTP - 2nd Trimester Quadruple test Biophysical score Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE NEPHROLOGY AND UROLOGY Partial Nephrectomy -open Partial Nephrectomy-laproscopic/endoscopic Nephrolithomy -open Nephrolithomy -laproscopic/endoscopic Pyelolithotomy-open Pyelolithotomy -laproscopic/endoscopic Operations for Hydronephrosis -pyeloplasty open
Non NABH/ Non- NABH/ NABL NABL 513 590 460 529 13500 15000 12000 16200
15525 17250 13800 18630
2875 6325 3393 9200 10925 19148 8500 7500 11000 7500 8500
3306 7274 3902 10580 12564 22020 9775 8625 12650 8625 9775
8500
9775
3750 3750 500 300 850
4313 4313 575 345 978
3000 4370 2000 600 28000 5000 0
3450 5026 2300 690 32200 5750 0
16215 14490 12000 14000 13000 10580 18400
18647 16664 13800 16100 14950 12167 21160
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 724 Operations for Hydronephrosis -pyeloplasty 19000 21850 Lap/endoscopic 725 Operations for Hydronephrosis Endoplyelotomy 20000 23000 antegrade 726 Operations for Hydronephrosis Endoplyelotomy 20000 23000 retrograde 727 Operations for Hydronephrosis -ureterocalicostomy 18000 20700 728 729 730
18000 8000 5750
20700 9200 6613
731 732 733
Operations for Hydronephrosis-Ileal ureter Open Drainage of Perinephric Abscess Percutaneous Drainage of Perinephric Abscess Ultrasound guided Cavernostomy Operations for Cyst of the Kidney -open Operations for Cyst of the Kidney -Lap/endoscopic
9775 11960 14030
11241 13754 16135
734 735 736 737 738 739
Ureterolithotomy -open Ureterolithotomy-Lap/Endoscopic Nephroureterectomy open Nephroureterectomy -Lap/Endoscopic Operations for Ureter for -Double Ureters Operations for Ureter -for Ectopia of Single Ureter
13248 10000 16100 16100 19000 18000
15235 11500 18515 18515 21850 20700
740 741
Operations for Vesico- ureteric Reflux -Open Operations for Vesico- ureteric RefluxLap/Endoscopic Operations for Vesico- ureteric Reflux/ Urinary incontinence with bulking agents Ureterostomy - Cutaneous Uretero-Colic anastomosis Formation of an Ileal Conduit Ureteric Catheterisation Biopsy of Bladder (Cystoscopic) Cysto-Litholapaxy Operations for Injuries of the Bladder Suprapubic Drainage (Cystostomy/vesicostomy)
18000 18000
20700 20700
20700
23805
12000 16000 15525 690 2070 10925 10000 6000
13800 18400 17854 794 2381 12564 11500 6900
Simple Cystectomy Diverticulectomy -open Diverticulectomy- Lap/Endoscopic Diverticulectomy -Endoscopic incision of neck Augmentation Cystoplasty Operations for Extrophy of the Bladder- Single stage repair
17250 16000 18400 1725 6670 22300
19838 18400 21160 1984 7671 25645
742 743 744 745 746 747 748 749 750 751 752 753 754 755 756
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 757 Operations for Extrophy of the Bladder- Multistage 20815 23937 repair 758 Operations for Extrophy of the Bladder- simple 22500 25875 cystectomy with urinary diversion 759 Repair of Ureterocoel -Open 13800 15870 760 Repair of Ureterocoel -Lap/Endoscopic 14375 16531 761 Repair of Ureterocoel -Endoscopic incision 13000 14950 762 Open Suprapubic Prostatectomy 20700 23805 763 Open Retropubic Prostatectomy 20125 23144 764 Transurethral Resection of Prostate (TURP) 18630 21425 765 Urethroscopy/ Cystopanendoscopy 4600 5290 766 Internal urethrotomy -optical 5750 6613 767 Internal urethrotomy -Core through urethroplasty 11040 12696 768
Urethral Reconstruction -End to end ansatamosis
3450
3968
769
19550
22483
770 771 772
Urethral Reconstruction - substitution urethroplasty (Transpubic urethroplasty Abdomino Perineal urethroplasty Posterior Urethral Valve fulguration. Operations for Incontinence of Urine - Male -Open
14000 11270 17250
16100 12961 19838
773
Operations for Incontinence of Urine - Male -Sling
18400
21160
774
19435
22350
17250
19838
18400
21160
19435
22350
778 779 780 781 782
Operations for Incontinence of Urine - MaleBulking agent Operations for Incontinence of Urine - Female Open Operations for Incontinence of Urine - FemaleSling Operations for Incontinence of Urine - FemaleBulking agent Reduction of Paraphimosis Circumcision Meatotomy Meatoplasty Operations for Hypospadias + Chordee Correction
1725 3000 2346 3220 35000
1984 3450 2698 3703 40250
783 784
Operations for Hypospadias - Second Stage Operations for Hypospadias - One Stage Repair
15000 9200
17250 10580
785 786 787 788
Operations for Crippled Hypospadias Operations for Epispadias _primary repair Operations for Epispadias-crippled epispadias Partial Amputation of the Penis
11500 12593 11385 10764
13225 14482 13093 12379
775 776 777
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 789 Total amputation of the Penis 12000 13800 790 Orchidectomy-Simple 9775 11241 791 Orchidectomy -Radical 12075 13886 792 Post Radical Orchidectomy retroperitoneal lymph 14000 16100 node dissection. 793 Epididymectomy 8000 9200 794 Adreneclectomy Unilateral/Bilateral for 25300 29095 Tumour/For Carcinoma- Open 795 Adreneclectomy Unilateral/Bilateral for 14375 16531 Tumour/For Carcinoma -Lap/Endoscopic 796 Operations for Hydrocele - Unilateral 5865 6745 797 Operations for Hydrocele - Bilateral 8556 9839 798 Operation for Torsion of Testis 11500 13225 799 Micro-surgical Vasovasostomy /Vaso epidedymal 11040 12696 ansatamosis. 800 Operations for Varicocele Unilateral-Microsurgical 7705 8861 9200
10580
802
Operations for Varicocele Palomo’s Unilateral Lap Operations for Varicocele Bilateral --Microsurgical
12650
14548
803
Operations for Varicocele Bilateral – Lap/ Palomo
14950
17193
804
Block Dissection of ilio-inguinal Nodes - One Side (For Ca-Penis) Block Dissection of ilio-inguinal Nodes - Both Sides (For Ca-Penis) Excision of Filarial Scrotum Kidney Transplantation (related) Kidney Transplantation (Spousal/ unrelated) ABO incompatible Transplantation Swap Transplantation Kidney Transplant Graft Nephrectomy Donor Nephrectomy (open) Donor Nephrectomy (Laproscopic) Cadaver Transplantation Kidney Transplant with Native Kidney Nephrectomy (Related)/ Unilateral Kidney Transplant with Native Kidney Nephrectomy (Related)/ Bilateral Kidney Transplant with Native Kidney Nephrectomy (Spousal/ Unrelated) Unilateral Kidney Transplant with Native Kidney Nephrectomy (Spousal/ Unrelated) Bilateral
6325
7274
23000
26450
11500 3500 143000 467500 382500 53550 28750 46000 83300 28000
13225 4025 164450 537625 439875 61583 33063 52900 95795 32200
85000
97750
85000
97750
85000
97750
801
805 806 807 808 809 810 811 812 813 814 815 816 817 818
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 819 Post-Transplant Collection drainage for 6800 7820 Lymphocele (open) 820 Post-Transplant Collection drainage for 6375 7331 Lymphocele (percutaneous) 821 Post-Transplant Collection drainage for 7650 8798 Lymphocele (Laproscopic) 822 Arteriovenous Fistula for Haemodialysis 2300 2645 823 Arteriovenous Shunt for Haemodialysis 3500 4025 824 Jugular Catheterization for Haemodialysis 1500 1725 825 Subclavian Catheterization for Haemodialysis 2250 2588 826 One sided (single Lumen) Femoral Catheterization 1000 1150 for Haemodialysis 827 Bilateral (single Lumen) Femoral Catheterization 1500 1725 for Haemodialysis 828 Double Lumen Femoral Catheterization for 1850 2128 Haemodialysis 829 Permcath Insertion 2800 3220 830 Arterio venous Prosthetic Graft 1850 2128 831 Single lumen Jugular Catheterization 1500 1725 832 Single lumen Subclavian Catheterization 1700 1955 833 Plasma Exchange/ Plasma phresis 1725 1984 834 Open method CAPD catheter insertion 3150 3623 835 Schlendinger method CAPD catheter insertion 3500 4025 836 837 838 839 840 841 842 843 844 845 846 847 848 849 850 851 852 853 854
Sustained low efficiency hemodialysis Continuous Veno venous/Arteriovenous Hemofilteration Hemodialysis for Sero negative cases Hemodialysis for Sero Positive cases Acute Peritoneal Dialysis Fistologram for Arteriovenous Fistula Ultrasound guided kidney Biopsy Fistula stenosis dilation Slow continuous Ultrafilteration PCNL - Unilateral PCNL - Bilateral Endoscopic Bulking agent Inject Testicular Biopsy Radical Nephrectomy -Open Radical Nephrectomy -Lap/Endoscopic Radical Nephrectomy plus IV thrombus Radical Nephrectomy plus IV thrombus plus cardiac bypass. Vesico Vaginal Fistula Repair (Open) Vesico Vaginal Fistula Repair (Laproscopic)
1250 2025
1438 2329
1260 1650 1450 2500 850 3000 2500 20000 25000 4500 1955 17250 20700 23000 23000
1449 1898 1668 2875 978 3450 2875 23000 28750 5175 2248 19838 23805 26450 26450
16000 22000
18400 25300
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 855 Radical Cystectomy -Ileal conduit 17000 19550 856 Radical Cystectomy - continent diversion. 15000 17250 857 Radical Cystectomy – Neo bladder 18500 21275 858 Nephrectomy Simple -Open 10074 11585 859 Nephrectomy Simple-lap/Endoscopic 12500 14375 860 Nephrostomy -Open 10000 11500 861 Nephrostomy -Lap/Endoscopic 10704 12310 862 Ureteric Re- implant for Megaureter/Vesicoureteric 10494 12068 reflex/ uterocele (open) 863
Ureteric Re -implant for Megaureter/Vesicoureteric reflex/ uterocele (Laproscopic)
10494
12068
864 865 866 867 868 869 870 871 872 873 874
Partial Cystectomy TURP & TUR Bladder Tumour TURP with Cystolithotripsy Closure of Urethral Fistula Orchidopexy - Unilateral -Open Orchidopexy - Unilateral- Lap/Endoscopic Orchidopexy - Bilateral -Open Orchidopexy - Bilateral -Lap/Endoscopic Cystolithotomy -Suprapubic Endoscopic Removal of Stone in Bladder Resection Bladder Neck Endoscopic /Bladder neck incision/transurethral incision on prostrate Ureteroscopic Surgery Urethroplasty 1st Stage Scrotal Exploration Perineal Urethrostomy Dilatation of Stricture Urethra under G.A. Dilatation of Stricture Urethra under LA Laproscopic Nephrectomy Laproscopic partial Nephrectomy Laproscopic pyelolithotomy Laproscopic Pyeloplasty Laproscopic surgery for Renal cyst Laproscopic ureterolithotomy Laproscopic Nephro ureterotectomy Lithotripsy Extra corporeal shock wave. Uroflow Study (Uroflometry) Urodynamic Study (Cystometry) Cystoscopy with Retrograde Catheter -Unilateral /RGP Cystoscopy with Retrograde Catheter - Bilateral /RGP
13800 17250 17000 11000 9867 12334 12282 14500 9775 3450 10925
15870 19838 19550 12650 11347 14184 14124 16675 11241 3968 12564
10350 10925 8556 4715 2000 1725 33350 10000 12650 9775 9775 11500 13225 17100 450 480 2803
11903 12564 9839 5422 2300 1984 38353 11500 14548 11241 11241 13225 15209 19665 518 552 3223
4675
5376
875 876 877 878 879 880 881 882 883 884 885 886 887 888 889 890 891 892
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 893 Cystoscopy with Bladder Biopsy (Cold Cup Biopsy) 894 Voiding-cysto-urethrogram and retrograde urethrogram (Nephrostogram) 895 Radical prostatectomy-Open 896 Radical prostatectomy-Laproscopic 897 Radical prostatectomy- Robotic (Robotic Partial Nephrectomy) 898 Hollmium YAG Prostate Surgery 899 Hollmium YAG OIU 900 Hollmium YAG Core Through 901 Hollmium YAG Stone Lithotripsy 902 Green Light laser for prostate 903 RIRS/ Flexible Ureteroscopy 904 Microscopic VEA/ Vaso-Vasostomy (for Infertility) 905 Cystoscopic Botulinum Toxin Injection ( Over active bladder/ Neurogenic bladder) 906 Peyronie’s disease – Plaque excision with grafting
Non NABH/ Non- NABH/ NABL NABL 3381 3888 414
476
17825 20125 20125
20499 23144 23144
58000 4600 17250 10200 17250 6800 13500
66700 5290 19838 11730 19838 7820 15525
6800
7820
3400
3910
907
High Intensity Focus Ultrasound (HIFU) (Robotic) for Carcinoma prostrate and renal cell carcinoma
4600
5290
908 909 910 911 912
Prosthetic surgery for urinary incontinence TRUS guided prostate biopsy Ultra sound guided PCN Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE NEUROSURGERY Craniotomy and Evacuation of Haematoma Subdural Craniotomy and Evacuation of Haematoma Extradural Evacuation /Excision of Brain Abscess by craniotomy Excision of Lobe (Frontal Temporal Cerebellum etc.) Excision of Brain Tumours -Supratentorial Excision of Brain Tumours -Infratentorial Surgery of spinal Cord Tumours Ventriculoatrial /Ventriculoperitoneal Shunt Twist Drill Craniostomy Subdural Tapping Ventricular Tapping
2300 575 720 15000 6800 0
2645 661 828 17250 7820 0
50715
58322
50000
57500
40000
46000
41000
47150
39123 45000 45000 22500 4250 2456 2967
44991 51750 51750 25875 4888 2824 3412
913 914 915 916 917 918 919 920 921 922 923
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 924 Abscess Tapping 925 Placement of ICP Monitor 926 Skull Traction Application 927 Lumber Pressure Monitoring 928 Vascular Malformations 929 Meningo Encephalocoele excision and repair 930 Meningomyelocoel Repair 931 C.S.F. Rhinorrhaea Repair 932 Cranioplasty 933 Anterior Cervical Dissectomy 934 Brachial Plexus Exploration and neurotization 935 Median Nerve Decompression 936 Peripheral Nerve Surgery – Major 937 Peripheral Nerve Surgery Minor 938 Ventriculo-Atrial Shunt 939 Nerve Biopsy 940 Brain Biopsy 941 Anterior Cervical Spine Surgery with fusion 942 Anterio Lateral Decompression of spine 943 Brain Mapping 944 Cervical or Dorsal or Lumbar Laminectomy 945 Combined Trans-oral Surgery & CV Junction Fusion 946 C.V. Junction Fusion procedures 947 Depressed Fracture Elevation 948 Lumbar Discectomy 949 Endarterectomy (Carotid) 950 R.F. Lesion for Trigeminal Neuralgia 951 Spasticity Surgery 952 Spinal Fusion Procedure 953 Spinal Intra Medullary Tumours 954 Spinal Bifida Surgery Major 955 Spinal Bifida Surgery Minor 956 Stereotaxic Procedures- biopsy/aspiration of cyst 957 958 959 960 961 962 963 964 965 966
Trans Sphenoidal Surgery Trans Oral Surgery Implantation of DBS -One electrode Implantation of DBS -two electrodes Endoscopic aqueductoplasty Facial nerve reconstruction Carotid stenting Cervical disc arthroplasty Lumbar disc arthroplasty Corpus callostomy for Epilepsy
Non NABH/ Non- NABH/ NABL NABL 2875 3306 2875 3306 2300 2645 3825 4399 22000 25300 13500 15525 24995 28744 28750 33063 24150 27773 16600 19090 15525 17854 12600 14490 17250 19838 8280 9522 11615 13357 6900 7935 5808 6679 32200 37030 28750 33063 837 963 23000 26450 34500 39675 30000 25000 27600 18000 11500 39675 30000 34500 18975 15000 23000
34500 28750 31740 20700 13225 45626 34500 39675 21821 17250 26450
30000 30000 34500 40250 15000 30000 42263 27600 13800 35000
34500 34500 39675 46288 17250 34500 48602 31740 15870 40250
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 967 Hemishpherotomy for Epilepsy 32200 37030 968 Endoscopic CSF rhinorrhea repair 30000 34500 969 Burr hole evacuation of chronic subdural 24150 27773 haematoma 970 Epilepsy surgery 36225 41659 971 RF lesion for facet joint pain syndrome 17250 19838 972 Cervical laminoplasty 32000 36800 973 Lateral mass C1-C2 screw fixation 23000 26450 974 Microsurgical decompression for Trigeminal nerve 38000 43700 975
Microsurgical decompression for hemifacial spasm
4646
5343
976 977 978 979 980 981 982 983 984 985 986 987 988 989 990
IC EC bypass procedures Image guided craniotomy Baclofen pump implantation Programmable VP shunt Endoscopic sympathectomy Lumber puncture External ventricular drainage (EVD) Endoscopic 3rd ventriculostomy Endoscopic cranial surgery/Biopsy/aspiration Endoscopic discectomy (Lumbar, Cervical) Aneurysm coiling (Endovascular) Surgery for skull fractures Carpel Tunnel decompression Clipping of intracranial aneurysm Surgery for intracranial Arteriovenous malformarions(AVM) Foramen magnum decompression for Chari Malformation Dorsal column stimulation for backache in failed back syndrome Surgery for recurrent disc prolapse/epidural fibrosis
32000 28980 39000 25000 17107 207 4600 36000 28382 32059 34400 40000 15000 24150 40000
36800 33327 44850 28750 19673 238 5290 41400 32639 36868 39560 46000 17250 27773 46000
1100
1265
25875
29756
32200
37030
Surgery for brain stem tumours Decompressive craniotomy for hemishpherical acute subdural haematoma/brain swelling/large infarct Intra-arterial thrombolysis with TPA (for ischemic stroke ) Steriotactic aspiration of intracerebral haematoma
43988 40000
50586 46000
4600
5290
32545
37427
Endoscopic aspiration of intracerebellar haematoma
40000
46000
991 992 993 994 995
996 997 998
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 999 Steriotactic Radiosurgery for brain pathology(X knife/Gamma ) - ONE session 1000 Steriotactic Radiosurgery for brain pathology(X knife / Gamma knife -Two or more sessions
Non NABH/ Non- NABH/ NABL NABL 27560 31694 57500
66125
1001
Chemotheraphy wafers for malignant brain tumors
13005
14956
1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013
22000 17330 24000 20000 35000 45000 40000 38500 25000 40000 40000 31500
25300 19930 27600 23000 40250 51750 46000 44275 28750 46000 46000 36225
42500 17000 0
48875 19550 0
14400 17250
16560 19838
1018
Battery Placement for DBS Baclofen pump implantation for spasticity Peripheral Nerve tumor surgery Surgery Intra Cranial Meningioma Surgery for Intracranial Schwannoma Surgery for Gliomas Surgery for Orbital tumors Surgery for Cranial (Skull) tumors Surgery for Scalp AVM’s Kyphoplasty Balloon Kyphoplasty Lesioning procedures for Parkinson’s disease, Dystonia etc. Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE PAEDIATRIC SURGERY Excision of thyroglossal Duct/Cyst Diaphragmatic Hernia Repair (Thoracic or Abdominal Approach) Tracheo Oesophageal Fistula (Correction Surgery)
23000
26450
1019 1020 1021 1022 1023 1024 1025 1026 1027 1028 1029 1030 1031 1032 1033 1034
Colon Replacement of Oesophagus Omphalo Mesenteric Cyst Excision Omphalo Mesenteric Duct- Excision Meckels Diverticulectomy Omphalocele 1st Stage (Hernia Repair) Omphalocele 2nd Stge (Hernia Repair) Gastrochisis Repair Inguinal Herniotomy Congenital Hydrocele Hydrocele of Cord Torsion Testis Operation Congenital Pyloric Stenosis- operation Duodenal- Atresia Operation Pancreatic Ring Operation Meconium Ileus Operation Malrotation of Intestines Operation
23000 17250 15525 3347 15525 17250 16100 12558 12000 12000 15000 13938 14000 22425 14500 13000
26450 19838 17854 3849 17854 19838 18515 14442 13800 13800 17250 16029 16100 25789 16675 14950
1014 1015
1016 1017
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 1035 Rectal Biopsy (Megacolon) 9736 11196 1036 Colostomy Transverse 15000 17250 1037 Colostomy Left Iliac 15000 17250 1038 Abdominal Perineal Pull Through (Hirschaprugis 19000 21850 Disease) 1039 Imperforate Anus Low Anomaly -Cut Back 10235 11770 Operation 1040 Imperforate Anus Low Anomaly - Perineal 12000 13800 Anoplasty 1041 Imperforate Anus High Anomaly -Sacroabdomino 12500 14375 Perineal Pull Through 1042 Imperforate Anus High Anomaly - Closure of 8625 9919 Colostomy 1043 Intususception Operation 20700 23805 1044 Choledochoduodenostomy for Atresia of Extra 15000 17250 Hepatic Billiary Duct 1045 Operation of Choledochal Cyst 16000 18400 1046 Nephrectomy for -Pyonephrosis 17000 19550 1047 Nephrectomy for - Hydronephrosis 15000 17250 1048 Nephrectomy for -Wilms Tumour 60000 69000 1049 Paraortic Lymphadenoctomy with Nephrectomy for 20000 23000 Wilms Tumour 1050 Sacro-Coccygeal Teratoma Excision 14000 16100 1051 Neuroblastoma Debulking 16000 18400 1052 Neuroblastoma Total Excision 20700 23805 1053 Rhabdomyosarcoma wide Excision 15000 17250 1054 Congenital Atresia & Stenosis of Small Intestine 19000 21850 1055 1056 1057 1058 1059
16000 15000 12000 27000 11050 0
18400 17250 13800 31050 12708 0
1060 1061 1062 1063 1064 1065 1066
Muconium ileus Mal-rotation & Volvulus of the Midgut Excision of Meckle’s Deverticulum Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE BURNS AND PLASTIC SURGERY Primary Suturing of Wound Injection of Keloids - Ganglion Injection of Keloids - Haemangioma Free Grafts - Wolfe Grafts Free Grafts - Theirech- Small Area 5% Free Grafts - Large Area 10% Free Grafts - Very Large Area 20% and above.
300 989 1035 1553 6728 7200 9315
345 1137 1190 1786 7737 8280 10712
1067 1068
Skin Flaps - Rotation Flaps Skin Flaps - Advancement Flaps
8073 11250
9284 12938
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1069 Skin Flaps - Direct- cross Leg Flaps- Cross Arm Flap 1070 Skin Flaps - Cross Finger 1071 Skin Flaps - Abdominal 1072 Skin Flaps - Thoracic 1073 Skin Flaps - Arm Etc. 1074 Subcutaneous Pedicle Flaps Raising 1075 Subcutaneous Pedicle Flaps Delay 1076 Subcutaneous Pedicle Flaps Transfer 1077 Cartilage Grafting 1078 Reduction of Facial Fractures of Nose 1079 Reduction of Facial Fractures of Maxilla 1080 Reduction of Fractures of Mandible & Maxilla Eye Let Splinting 1081 Reduction of Fractures of Mandible & Maxilla Cast Netal Splints 1082 Reduction of Fractures of Mandible & Maxilla Gumming Splints 1083 Internal Wire Fixation of Mandible & Maxilla 1084 Cleft Lip - repair. 1085 Cleft Palate Repair 1086 Primary Bone Grafting for alveolar cleft in Cleft Lip 1087 Secondary Surgery for Cleft Lip Deformity 1088 Secondary Surgery for Cleft Palate 1089 Reconstruction of Eyelid Defects - Minor 1090 Reconstruction of Eyelid Defects - Major 1091 Plastic Surgery of Different Regions of the Ear Minor 1092 Plastic Surgery of Different Regions of the Ear Major 1093 Plastic Surgery of the Nose - Minor 1094 Plastic Surgery of the Nose - Major 1095 Plastic Surgery for Facial Paralysis (Support with Reanimation) 1096 Pendulous Breast - Mammoplasty 1097 Underdeveloped Breast Mammoplasty 1098 After Mastectomy (Reconstruction)Mammoplasty 1099 1100 1101 1102 1103 1104
Syndactyly Repair Dermabrasion Face upto 30% Burns 1st Dressing upto 30% Burns Subsequent Dressing 30% to 50% Burns 1st Dressing 30% to 50% Burns Subsequent Dressing
Non NABH/ Non- NABH/ NABL NABL 11250 12938 11250 8415 8415 9900 6210 5950 5950 8625 1380 8000 7475
12938 9677 9677 11385 7142 6843 6843 9919 1587 9200 8596
6900
7935
7500
8625
11500 11500 12650 11500
13225 13225 14548 13225
10000 12650 6325 8500 8050
11500 14548 7274 9775 9258
10350
11903
8050 9500 16100
9258 10925 18515
13000 12000 12000
14950 13800 13800
12750 13225 152 124 193 152
14663 15209 175 143 222 175
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1105 Extensive Burn -above 50% Frist Dressing 1106 Extensive Burn -above 50% Subsequent dressing TREATMENT PROCEDURE ORTHOPEDICS 1107 1108 1109 1110 1111 1112 1113 1114 1115 1116 1117 1118 1119 1120 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 1135 1136
Non NABH/ Non- NABH/ NABL NABL 276 317 193 222 0
0
255 259 259 978 994 400 173 575 173 718 800 1265 1158 2415 2185 1955 2243 2760 179 180 230 262 345 345 460 518 518 255 400 633
293 298 298 1125 1143 460 199 661 199 826 920 1455 1332 2777 2513 2248 2579 3174 206 207 265 301 397 397 529 596 596 293 460 728
1137 1138 1139 1140 1141 1142 1143
Plaster Work Fingers (post slab) Fingers full plaster Colles Fracture - Below elbow Colles Fracture - Full plaster Colles fracture Ant. Or post. slab Above elbow full plaster Above Knee post-slab Below Knee full plaster Below Knee post-slab Tube Plaster (or plaster cylinder) Above knee full plaster Above knee full slab Minerva Jacket Plaster Jacket Shoulder spica Single Hip spica Double Hip spica Strapping of Finger Strapping of Toes Strapping of Wrist Strapping of Elbow Strapping of Knee Strapping of Ankle Strapping of Chest Strapping of Shoulder Figure of 8 bandage Collar and cuff sling Ball bandage Application of P.O.P Casts for Upper & Lower Limbs Application of Functiol Cast Brace Application of Skin Traction Application of Skeletal Tractions Bandage & Strappings for Fractures Aspiration & Intra Articular Injections Application of P.O.P Spices & Jackets Close Reduction of Fractures of Limb & P.O.P
1350 621 949 552 575 2473 2600
1553 714 1091 635 661 2844 2990
1144
Reduction of Compound Fractures
2760
3174
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 1145 Open Reduction & Internal Fixation of Fingurs & 5175 5951 Toes 1146 Open Reduction offracture of Long Bones of Upper 8050 9258 / Lower Limb -iling & Exterl Fixation 1147 Open Reduction of fracture of Long Bones of 9660 11109 Upper / Lower Limb -AO Procedures 1148 Tension Band Wirings 5658 6507 1149 Bone Grafting 6601 7591 1150 Excision of Bone Tumours 6900 7935 1151 Excision or other Operations for Scaphoid 7188 8266 Fractures 1152 Sequestrectomy & Saucerisation 6900 7935 1153 Sequestrectomy & Saucerizations -Arthrotomy 9971 11467 1154 Multiple Pinning Fracture Neck Femur 11500 13225 1155 Plate Fixations for Fracture Neck Femur 13500 15525 1156 A.O.Compression Procedures for Fracture Neck 16560 19044 Femur 1157 Open Reduction of Fracture Neck Femur Muscle 19500 22425 Pedicle Graft and Internal Fixations 1158 Close Reduction of Dislocations 3174 3650 1159 Open Reduction of Dislocations 3439 3955 1160 Open Reduction of Fracture Dislocation & Internal 13500 15525 Fixation 1161 Neurolysis/Nerve repair 13800 15870 1162 Nerve Repair with Grafting 16675 19176 1163 Tendon with Transplant or Graft 10350 11903 1164 Tendon Lengthening/Tendon repair 8050 9258 1165 Tendon Transfer 3105 3571 1166 Laminectomy Excision Disc and Tumours 4830 5555 1167 Spil Ostectomy and Internal Fixations 21735 24995 1168 Anterolateral decompression for tuberculosis/ 3450 3968 Costo-Transversectomy 1169 Antereolateral Decompression and Spil Fusion 17415 20027 1170 Corrective Ostectomy & Internal Fixation - short 13600 15640 bones 1171 Corrective Ostectomy & Internal Fixation - long 11040 12696 bones 1172 Arthrodesis of - Minor Joints 10350 11903 1173 Arthrodesis of - Major Joints 10000 11500 1174 Soft Tissue Operations for C.T.E.V. 8050 9258 1175 Soft Tissue Operations for Polio 6900 7935 1176 Hemiarthroplasty- Hip 20000 23000 1177 Hemiarthroplasty- Shoulder 20000 23000 1178 Operations for Brachial Plexus & Cervical Rib 24150 27773 1179 Amputations - Below Knee 6900 7935
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1180 Amputations - Below Elbow 1181 Amputations - Above Knee 1182 Amputations - Above Elbow 1183 Amputations - Forequarter 1184 Amputations -Hind Quarter and Hemipelvectomy 1185 1186 1187 1188 1189 1190 1191 1192 1193 1194 1195 1196 1197 1198 1199 1200 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1220 1221 1222
Disarticulations - Major joint Disarticulations - Minor joint Arthrography Arthroscopy - Diagnostic Arthroscopy-therapeutic: without implant Arthroscopy-therapeutic: with implant Soft Tissue Operation on JOINTS -SMALL Soft Tissue Operation on JOINTS -LARGE Myocutaneous and Fasciocutaneous Flap Procedures for Limbs Removal of Wires & Screw Removal of Plates Total Hip Replacement Total Ankle Joint Replacement Total Knee Joint Replacement Total Shoulder Joint Replacement Total Elbow Joint Replacement Total Wrist Joint Replacement Total finger joint replacement Tubular external fixator Ilizarov's external fixator Pelvi-acetebular fracture -Internal fixation Meniscectomy Meniscus Repair ACL Reconstruction PCL Reconstruction Knee Collateral Ligament Reconstruction Bencarf Repair Shoulder RC Repair Biceps tenodesis Distal biceps tendon repair Arthrolysis of knee Capsulotomy of Shoulder Conservative Pop Application for CTEV per sitting Total Hip Replacement Revision Stage-I Total Hip Replacement Revision Stage-II Total Knee Replacement Revision Stage-I Total Knee Replacement Revision Stage-II
Non NABH/ Non- NABH/ NABL NABL 6843 7869 8050 9258 6843 7869 13225 15209 18400 21160 20700 12650 9200 8568 10000 17250 6900 13500 18630
23805 14548 10580 9853 11500 19838 7935 15525 21425
1760 4140 71100 90000 110000 120000 100000 90000 20000 4600 7763 8625 12000 10000 8500 13500 12500 13200 1500 14000 10380 12500 14220 1200 1200 17000 50000 35000 35000
2024 4761 81765 103500 126500 138000 115000 103500 23000 5290 8927 9919 13800 11500 9775 15525 14375 15180 1725 16100 11937 14375 16353 1380 1380 19550 57500 40250 40250
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 1223 Illizarov/ external fixation for limb lengthening/ 12500 14375 deformity correction 1224 Discectomy/ Micro Discectomy 12500 14375 1225 Laminectomy 4646 5343 1226 Spinal Fixation Cervical/dorsolumbar/ lumbosacral 16000 18400 1227
22000
25300
1228 1229
Fusion Surgery Cervical/ Lumbar Spine upto 2 Level More than 2 Level Scoliosis Surgery/ Deformity Correction of Spine
12000 25000
13800 28750
1230 1231 1232 1233 1234 1235 1236
Vertebroplasty Spinal Injections DHS for Fracture Neck Femur Proximal Femoral Nail (PFN for IT Fracture) Spinal Osteotomy Illizarov’s / External Fixation for Trauma Soft Tissue Operations for Polio/ Cerebral Palsy
10800 450 15000 14000 1434 13000 10557
12420 518 17250 16100 1649 14950 12141
1237 1238 1239
Mini Fixator for Hand/Foot Other Major Surgery Other Minor Surgery TREATMENT PROCEDURE PHYSIOTHERAPY Ultrasonic therapy S.W. Diathermy Electrical stimulation (therapeutic) Muscle testing and diagnostic Infra red U.V. Therapeutic dose Intermittent Lumbar Traction Intermittent Cervical traction Wax bath Hot pack Breathing Exercises & Postural Drainage Cerebral Palsy – exercise Post – polio exercise NUCLEAR MEDICINE / RADIOTHERAPY AND CHEMOTHERAPY
9000 38250 11883 0
10350 43988 13665 0
Cobalt 60 therapy Radical therapy Palliative therapy Linear accelerator Radical therapy
63750 61583 24438 29750 58650
1240 1241 1242 1243 1244 1245 1246 1247 1248 1249 1250 1251 1252
1253 1254 1255 1256 1257
78 78 78 71 78 58 78 75 75 78 50 50 50 0
90 90 90 82 90 67 90 86 86 90 58 58 58 0
73313 70820 28104 34213 67448
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1258 Palliative therapy 1259 3 D Planning 1260 2 D Planing 1261 IMRT(Intensity Modulated radiotherapy) 1262 SRT (Stereotactic radiotherapy) 1263 SRS(Stereotactic radio surgery) 1264 IGRT(Image guided radiotherapy) 1265 Respiratory Gating-alongwith Linear accelerator planning 1266 Electron beam with Linear accelerator 1267 Tomotherapy NUCLEAR MEDICINE / BRACHYTHERAPYHIGH DOSE RADIATION
Non NABH/ Non- NABH/ NABL NABL 30792 35411 4399 5059 4399 5059 90790 104409 54896 63130 80546 92628 147016 169068 110000 126500 67473 71460 0
77594 82179 0
1268 1269 1270 1271 1272
Intracavitory Interstitial Intraluminal Surface mould GLIADAL WAFER NUCLEAR MEDICINE / CHEMOTHARAPY
11730 52785 9775 4644 84510 0
13490 60703 11241 5341 97187 0
1273 1274 1275 1276 1277 1278 1279 1280
863 863 920 552 897 920 920 920
992 992 1058 635 1032 1058 1058 1058
1281
Neoadjuvant Adjuvant Concurrent-chemoadiation Single drug Multiple drugs Targeted therapy Chemoport facility PICC line (peripherally inserted Central canulisation) LIST OF PROCEDURES/ TESTS IN GASTROENTEROLOGY / ENDOSCOPIC PROCEDURES Upper G.I. Endoscopy + Lower G.I. Endoscopy
1553
1786
1282 1283 1284 1285 1286 1287 1288 1289 1290 1291
Diagnostic endoscopy Endoscopic biopsy Endoscopic mucosal resection Oesophageal stricture dilatation Balloon dilatation of achalasia cardia Foreign body removal Oesophageal stenting Band ligation of oesophageal varices Sclerotherapy of oesophageal varices Glue injection of varices
250 345 1500 1725 2875 1725 2700 2250 2250 2500
288 397 1725 1984 3306 1984 3105 2588 2588 2875
0
0
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1292 Argon plasma coagulation 1293 Pyloric balloon dilatation 1294 Enteranal stenting 1295 Duodenal stricture dilation 1296 Single balloon enterocopy 1297 Double balloon enteroscopy 1298 Capsule endoscopy 1299 Piles banding 1300 Colonic stricture dilatation 1301 Hot biopsy forceps procedures 1302 Colonic stenting 1303 Junction biopsy 1304 Conjugal microscopy 1305 Endoscopic sphincterotomy 1306 CBD stone extraction 1307 CBD stricture dilatation 1308 Biliary stenting (plastic and metallic) 1309 Mechanical lithotripsy of CBD stones 1310 Pancreatic sphincterotomy 1311 Pancreatic stricture dilatation 1312 Pancreatic stone extraction 1313 Mechanical lithotripsy of pancreatic stones 1314 Endoscopic cysto gastrostomy 1315 Balloon dilatation of papilla 1316 Ultrasound guided FNAC 1317 Ultrasound guided abscess Drainage 1318 PTBD 1319 Diagnostic angiography 1320 Vascular embolization 1321 TIPS 1322 IVC graphy + hepatic veinography 1323 Muscular stenting 1324 BRTO 1325 Portal haemodymic studies 1326 Manometry and PH metry 1327 Oesophageal PH metry 1328 Oesophageal manometry 1329 Small bowel manometry 1330 Anorectal manometry 1331 Colonic manometry 1332 Biliary manometry 1333 Sengstaken blackenesse tube tempode 1334 Lintas machles tube tempode 1335 Fecal fat test/ fecal chymotrypsin/ fecal elastase
Non NABH/ Non- NABH/ NABL NABL 3623 4166 2415 2777 3500 4025 990 1139 3600 4140 3500 4025 4455 5123 1099 1264 2737 3148 2700 3105 2500 2875 2000 2300 3600 4140 2415 2777 2415 2777 6500 7475 4347 4999 7200 8280 6375 7331 5750 6613 10098 11613 11385 13093 7245 8332 6210 7142 575 661 720 828 1150 1323 2000 2300 13590 15629 5400 6210 30791 35410 87975 101171 51750 59513 1913 2200 1612 1854 4500 5175 4500 5175 6120 7038 6120 7038 6885 7918 6885 7918 2588 2976 2588 2976 350 403
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1336 Breath tests 1337 Extra corporeal shortwave lithotripsy 1338 Liver biopsy NAME OF INVESTIGATION / DENTAL 1339 Dental IOPA X-ray 1340 Occlusal X-ray 1341 OPG X-ray NAME OF INVESTIGATION / PULMONARY
Non NABH/ Non- NABH/ NABL NABL 300 345 37260 42849 1242 1428 0 0 50 58 70 81 176 202 0 0
1342
Lung Ventilation & Perfusion Scan (V/Q Scan)
3240
3726
1343
Lung Perfusion Scan NAME OF INVESTIGATION / OSTEOLOGY
1800 0
2070 0
1344 1345
Whole Body Bone Scan with SPECT. Three phase whole body Bone Scan NAME OF INVESTIGATION / NEUROSCIENCES Brain Perfusion SPECT Scan with Technetium 99m radiopharmaceuticals. Radionuclide Cisternography for CSF leak NAME OF INVESTIGATION / GASTRO AND HEPATOBILIARY Gastro esophageal Reflux Study (G.E.R. Study)
3079 3079 0
3541 3541 0
8798
10118
3366 0
3871 0
1760
2024
Gastro intestinal Bleed (GloB.) Study with Technetium 99m labeled RBCs. Hepatobiliary Scintigraphy. Meckel's Scan Hepatosplenic scintigraphy with Technetium-99m radiopharmaceuticals Gastric emptying NAME OF INVESTIGATION / GENITOURINARY Renal Cortical Scintigraphy with Technetium 99m D.M.S.A. Dynamic Renography. Dynamic Renography with Diuretic. Dynamic Renography with Captopril Testicular Scan NAME OF INVESTIGATION / ENDOCRINOLOGY Thyroid Uptake measurements with 131-Iodine.
3079
3541
2200 1760 1683
2530 2024 1935
1200 0
1380 0
3079
3541
3079 3079 1960 1319 0
3541 3541 2254 1517 0
1500
1725
1346 1347
1348 1349 1350 1351 1352 1353
1354 1355 1356 1357 1358
1359
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 1360 Thyroid Scan with Technetium 99m Pertechnetate. 1319 1517 1361 1362 1363
Lodine-131 Whole Body Scan. Whole Body Scan with M.I.B.G. Parathyroid Scan NAME OF INVESTIGATION / RADIO-ISOTOPE THERAPY 131-lodine Therapy 131-lodine Therapy <15mCi 131-lodine Therapy 15-50mCi 131-lodine Therapy 51-100mCi 131-lodine Therapy >100mCi Phosphorus-32 therapy for metastatic bone pain palliation Samarium-153 therapy for metastatic bone pain palliation Radiosynovectomy with Yttrium NAME OF INVESTIGATION / CARDIOLOGY
2640 15836 4399 0
3036 18211 5059 0
1530 3854 4956 12000 15000 5000
1760 4432 5699 13800 17250 5750
9405
10816
19125 0
21994 0
1372
Stress thallium / Myocardial Perfusion Scintigraphy
8505
9781
1373
Rest thallium / Myocardial Perfusion Scintigraphy
7200
8280
1374 1375 1376 1377
Venography TMT TEE Lymph angiography NAME OF INVESTIGATION / TUMOUR IMAGING Scintimammography. Indium lableled octeriotide Scan. NAME OF INVESTIGATION / PET SCAN FDG Whole body PET / CT Scan Brain I Heart FDG PET / CTScan, Gallium-68 Peptide PET / CT imaging for Neuroendocrine Tumor LABORATORY MEDICINE / CLINICAL PATHOLOGY Urine routine- pH, Specific gravity, sugar, protein and microscopy Urine-Microalbumin Stool routine Stool occult blood Post coital smear examination Semen analysis
2970 489 440 1452 0
3416 562 506 1670 0
4320 65982 0 18475 13197 13500
4968 75879 0 21246 15177 15525
1364 1365 1366 1367 1368 1369 1370 1371
1378 1379 1380 1381 1382
1383 1384 1385 1386 1387 1388
0
0
33
38
70 33 24 30 35
81 38 28 35 40
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL LABORATORY MEDICINE / HAEMATOLOGY 0 0 1389 1390 1391 1392 1393
16 28 28 25 30
18 32 32 29 35
122
140
43 43 43 13 39 37 35 50 64 225
49 49 49 15 45 43 40 58 74 259
396
455
1406
Bone Marrow Smear Examination and cytochemistry Activated partial ThromboplastinTime (APTT)
92
106
1407 1408
Rapid test for malaria(card test) WBC cytochemistry for leukemia -Complete panel
40 99
46 114
1409
Bleeding Disorder panel- PT, APTT, Thrombin Time Fibrinogen, D-Dimer/ FDP Factor Assays-Factor VIII Factor Assays-Factor IX Platelet Function test Tests for hypercoagulable states- Protein C, Protein S, Antithrombin Tests for lupus anticoagulant Tests for Antiphospholipid antibody IgG, IgM ( for cardiolipin and B2 Glycoprotein 1) Thalassemia studies (Red Cell indices and Hb HPLC) Tests for Sickling / Hb HPLC) LABORATORY MEDICINE / BLOOD BANK
360
414
648 612 50 360
745 704 58 414
150 450
173 518
504
580
69 0
79 0
Blood Group & RH Type
28
32
1394
1395 1396 1397 1398 1399 1400 1401 1402 1403 1404 1405
1410 1411 1412 1413 1414 1415 1416 1417
1418
Haemoglobin (Hb) Total Leucocytic Count (TLC) Differential Leucocytic Count (DLC) E.S.R. Total Red Cell count with MCV,MCH,MCHC,DRW Complete Haemogram/CBC, Hb,RBC count and indices, TLC, DLC, Platelet, ESR, Peripheral smear examination Platelet count Reticulocyte count Absolute Eosinophil count Packed Cell Volume (PCV) Peripheral Smear Examination Smear for Malaria parasite Bleeding Time Osmotic fragility Test Bone Marrow Smear Examination Bone Marrow Smear Examination with iron stain
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL 1419 Cross match 50 58 1420 Coomb’s Test Direct 85 98 1421 Coomb’s Test Indirect 100 115 1422 3 cell panel- antibody screening for pregnant 153 176 female 1423 11 cells panel for antibody identification 153 176 1424 HBs Ag 102 117 1425 HCV 128 147 1426 HIV I and II 150 173 1427 VDRL 43 49 1428 RH Antibody titer 80 92 1429 Platelet Concentrate 56 64 1430 Random Donor Platelet(RDP) 128 147 1431 Single Donor Platelet (SDP- Aphresis) 150 173 LABORATORY MEDICINE / 0 0 HISTOPATHOLOGY 1432 Routine-H & E 85 98 1433 special stain 65 75 1434 Immunohistochemistry(IHC) 675 776 1435 Frozen section 702 807 1436 Paraffin section 309 355 LABORATORY MEDICINE / CYTOLOGY 0 0 1437 Pap Smear 136 156 1438 Body fluid for Malignant cells 150 173 1439 FNAC 200 230 NAME OF INVESTIGATION / FLOW 0 0 CYTOMETRY 1440 Leukemia panel /Lymphoma panel 1382 1589 1441 PNH Panel-CD55,CD59 1000 1150 LABORATORY MEDICINE / CYTOGENETIC 0 0 STUDIES 1442 Karyotyping 1539 1770 1443 FISH 500 575 LABORATORY MEDICINE / BIO-CHEMISTRY 0 0 1444 1445 1446 1447 1448 1449 1450 1451 1452 1453
Blood Glucose Random 24 hrs urine for Proteins,Sodium, creatinine Blood Urea Nitrogen Serum Creatinine Urine Bile Pigment and Salt Urine Urobilinogen Urine Ketones Urine Occult Blood Urine total proteins Rheumatoid Factor test
22 50 49 50 25 20 30 32 18 90
25 58 56 58 29 23 35 37 21 104
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1454 Bence Jones protein 1455 Serum Uric Acid 1456 Serum Bilirubin total & direct 1457 Serum Iron 1458 C.R.P. 1459 C.R.P Quantitative 1460 Body fluid (CSF/Ascitic Fluid etc.)Sugar, Protein etc. 1461 Albumin. 1462 Creatinine clearance. 1463 Serum Cholesterol 1464 Total Iron Binding Capacity 1465 Glucose (Fasting & PP) 1466 Serum Calcium –Total 1467 Serum Calcium –Ionic 1468 Serum Phosphorus 1469 Total Protein Alb/Glo Ratio 1470 IgG. 1471 IgM. 1472 IgA. 1473 ANA. 1474 Ds DNA. 1475 S.G.P.T. 1476 S.G.O.T. 1477 Serum amylase 1478 Serum Lipase 1479 Serum Lactate 1480 Serum Magnesium 1481 Serum Sodium 1482 Serum Potassium 1483 Serum Ammonia 1484 Anemia Profile 1485 Serum Testosterone 1486 Imprint Smear From Endoscopy 1487 Triglyceride 1488 Glucose Tolerance Test (GTT) 1489 Triple Marker. 1490 C.P.K. 1491 Foetal Haemoglobin (HbF) 1492 Prothrombin Time (P.T.) 1493 L.D.H. 1494 Alkaline Phosphatase 1495 Acid Phosphatase 1496 CK MB 1497 CK MB Mass
Non NABH/ Non- NABH/ NABL NABL 42 48 50 58 80 92 85 98 90 104 144 166 81 93 18 80 56 80 42 54 40 56 50 225 225 225 200 327 50 50 105 130 72 100 50 50 100 204 150 240 75 85 765 90 85 101 100 54 70 171 140
21 92 64 92 48 62 46 64 58 259 259 259 230 376 58 58 121 150 83 115 58 58 115 235 173 276 86 98 880 104 98 116 115 62 81 197 161
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1498 Troponin I 1499 Troponin T 1500 Glucose Phosphate Dehydrogenase (G, 6PD) 1501 Lithium. 1502 Dilantin (phenytoin). 1503 Carbamazepine. 1504 Valproic acid. 1505 Feritin. 1506 Blood gas analysis 1507 Blood gas analysis with electrolytes 1508 Urine pregnancy test 1509 Tests for Antiphospholipid antibodies syndrome. 1510 1511 1512 1513 1514
1515 1516 1517 1518 1519 1520
1521 1522 1523 1524 1525 1526 1527 1528 1529 1530 1531 1532 1533 1534 1535 1536 1537
Hb A1 C Hb Electrophoresis/ Hb HPLC Kidney Function Test. Liver Function Test. Lipid Profile.( Total cholesterol,LDL,HDL,treigylcerides) Nutritional Markers Serum Iron Total Iron Binding Capacity Serum Ferritin Vitamin B12 assay. Folic Acid assay. Extended Lipid Profile.( Total cholesterol,LDL,HDL,treigylcerides,Apo A1,Apo B,Lp(a) ) Apo A1. Apo B. Lp (a). CD 3,4 and 8 counts CD 3,4 and 8 percentage LDL. Homocysteine. HB Electrophoresis. Serum Electrophoresis. Fibrinogen. Chloride. Magnesium. GGTP. Lipase. Fructosamine. β2 microglobulin Catecholamines.
Non NABH/ Non- NABH/ NABL NABL 100 115 540 621 100 115 119 137 360 414 400 460 270 311 250 288 400 460 414 476 59 68 280 322 130 100 203 213 183
150 115 233 245 210
0 85 85 100 225 298 536
0 98 98 115 259 343 616
180 179 401 495 672 56 360 396 220 165 56 135 81 215 180 85 945
207 206 461 569 773 64 414 455 253 190 64 155 93 247 207 98 1087
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1538 Creatinine clearance. NAME OF INVESTIGATION / TUMOUR MARKERS 1539 PSA- Total. 1540 PSA- Free. 1541 AFP. 1542 HCG. 1543 CA. 125. 1544 CA 19,9. 1545 CA 15.3. 1546 Vinyl Mandelic Acid 1547 Calcitonin 1548 Carcioembryonic antigen(CEA) OTHERS 1549 Immunofluorescence 1550 Direct(Skin and kidney Disease) 1551 Indirect (antids DNA Anti Smith ANCA) 1552 VitD3 assay 1553 Serum Protein electrophoresis with immunofixationelectrophoresis (IFE) 1554 BETA-2 Microglobulin assay 1555 Anti cycliocitrullinated peptide (Anti CCP) 1556 Anti tissuetransglutaminase antibody 1557 Serum Erythropoetin 1558 ACTH HARMONES 1559 T3, T4, TSH 1560 T3 1561 T4 1562 TSH 1563 LH 1564 FSH 1565 Prolactin 1566 Cortisol 1567 PTH(Paratharmone) 1568 C-Peptide. 1569 Insulin. 1570 Progesterone. 1571 17-DH Progesterone. 1572 DHEAS. 1573 Androstendione. 1574 Growth Hormone. 1575 TPO. 1576 Throglobulin. 1577 Hydatic Serology.
Non NABH/ Non- NABH/ NABL NABL 108 124 0 0 281 375 293 260 352 554 536 315 450 306 0 150 425 425 550 270
323 431 337 299 405 637 616 362 518 352 0 173 489 489 633 311
90 450 425 425 450 0 181 64 64 90 150 150 150 226 450 297 135 225 396 396 553 306 300 298 318
104 518 489 489 518 0 208 74 74 104 173 173 173 260 518 342 155 259 455 455 636 352 345 343 366
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1578 Anti Sperm Antibodies. 1579 Qualitative. 1580 Quantitative. 1581 Qualitative. 1582 HPV serology 1583 Rota Virus serology 1584 PCR for TB 1585 PCR for HIV 1586 Chlamydae antigen 1587 chlamydae antibody 1588 Brucella serology 1589 Influenza A serology USG, X-RAY , CT, MRI, BONE DENSITOMETRY 1590 USG for Obstetrics - Anomalies scan 1591 Abdomen USG 1592 Pelvic USG ( prostate, gynae, infertility etc) 1593 Small parts USG ( scrotum, thyroid , parathyroid etc) 1594 Neonatal head (Tranfontanellar) 1595 Neonatal spine 1596 Contrast enhanced USG 1597 USG Breast 1598 USG Hystero-Salpaingography (HSG) 1599 Carotid Doppler 1600 Arterial Colour Doppler 1601 Venous Colour Doppler 1602 Colour Doppler, renal arteries/any other organ 1603 USG guided intervention- FNAC 1604 USG guided intervention - biopsy 1605 USG guided intervention - nephrostomy X-Ray 1606 Abdomen AP Supine or Erect (One film) 1607 Abdomen Lateral view (one film) 1608 Chest PA view (one film) 1609 Chest Lateral (one film) 1610 Mastoids: Towne view, oblique views (3 films) 1611 Extremities, bones & Joints AP & Lateral views (Two films) 1612 Pelvis A.P (one film) 1613 T. M. Joints (one film) 1614 Abdomen & Pelvis for K. U. B. 1615 Skull A. P. & Lateral (2 films) 1616 Spine A. P. & Lateral (2 films) 1617 PNS view (1 film)
Non NABH/ Non- NABH/ NABL NABL 345 397 1800 2070 1350 1553 1522 1750 218 251 130 150 829 953 540 621 765 880 238 274 208 239 849 976 0 0 323 323 255 349
371 371 293 401
425 450 810 349 255 850 706 706 750 490 700 744 0 128 128 60 60 225 230
489 518 932 401 293 978 812 812 863 564 805 856 0 147 147 69 69 259 265
110 110 128 250 225 110
127 127 147 288 259 127
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST X RAY CONTRAST STUDIES 1618 Barium Swallow 1619 Barium Upper GI study 1620 Barium Upper GI study (Double contrast) 1621 Barium Meal follow through 1622 Barium Enema (Single contrast/double contrast)
Non NABH/ Non- NABH/ NABL NABL 510 720 935 842 765
587 828 1075 968 880
918 2250
1056 2588
638
734
1626
Small bowel enteroclysis ERCP (Endoscopic Retrograde Cholangio – Pancreatography) General :Fistulography /Sinography/Sialography/Dacrocystography/ TTube cholangiogram/Nephrostogram Percutaneous transhepatic cholangiography (PTC)
1296
1490
1627 1628 1629 1630 1631 1632 1633 1634
Intravenous Pyelography (IVP) Micturating Cystourethrography (MCU) Retrograde Urethrography (RGU) Contrast Hystero-Salpingography (HSG) X ray - Arthrography Cephalography Myelography Diagnostic Digital Subtraction Angiography (DSA)
1071 680 680 1020 630 135 2475 1749
1232 782 782 1173 725 155 2846 2011
315 2500
362 2875
893 1215
1027 1397
1700
1955
1642
C. T. Chest - without contrast (for lungs) C. T. Scan Lower Abdomen(incl. Pelvis) With Contrast C. T. Scan Lower Abdomen( Incl. Pelvis) Without Contrast C. T. Scan Whole Abdomen Without Contrast
2720
3128
1643 1644 1645 1646 1647 1648 1649
C. T. Scan Whole Abdomen With Contrast Triple Phase CT abdomen CT angiography abdomen/ Chest CT Enteroclysis C. T. Scan Neck – Without Contrast C. T. Scan Neck – With Contrast C. T. Scan Orbits - Without Contrast
4050 5100 4050 5400 1500 1870 1190
4658 5865 4658 6210 1725 2151 1369
1623 1624 1625
1635 1636 1637 1638 1639 1640 1641
MAMMOGRAPHY X-ray Mammography MRI Mammography CT CT Head-Without Contrast CT Head- with Contrast (+/- CT angiography)
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1650 C. T. Scan Orbits - With Contrast 1651 C. T. Scan of Para Nasal Sinuses- Without Contrast 1652 C. T. Scan of Para Nasal Sinuses - With Contrast
Non NABH/ Non- NABH/ NABL NABL 1615 1857 900 1035 1600
1840
1488
1711
893 1148 1700 2253
1027 1320 1955 2591
1200 1200 1305
1380 1380 1501
1661 1662 1663 1664 1665
C. T. Spine (Cervical, Dorsal, Lumbar, Sacral)–without contrast CT Temporal bone – without contrast CT - Dental C. T. Scan Limbs -Without Contrast C. T. Scan Limbs -With Contrast including CT angiography C.T. Guided intervention –FNAC C.T. Guided Trucut Biopsy C. T. Guided intervention -percutaneous catheter drainage / tube placement MRI MRI Head – Without Contrast MRI Head – With Contrast MRI Orbits – Without Contrast MRI Orbits – With Contrast MRI Nasopharynx and PNS – Without Contrast
1998 2848 1445 3825 2205
2298 3275 1662 4399 2536
1666 1667 1668 1669 1670 1671 1672 1673 1674 1675 1676 1677 1678 1679 1680 1681 1682 1683 1684 1685 1686 1687
MRI Nasopharynx and PNS – With Contrast MR for Salivary Glands with Sialography MRI Neck - Without Contrast MRI Neck- with contrast MRI Shoulder – Without contrast MRI Shoulder – With conntrast MRI shoulder both Joints - Without contrast MRI Shoulder both joints – With contrast MRI Wrist Single joint - Without contrast MRI Wrist Single joint - With contrast MRI Wrist both joints - Without contrast MRI Wrist Both joints - With contrast MRI knee Single joint - Without contrast MRI knee Single joint - With contrast MRI knee both joints - Without contrast MRI knee both joints - With contrast MRI Ankle Single joint - Without contrast MRI Ankle single joint - With contrast MRI Ankle both joints - With contrast MRI Ankle both joints - Without contrast MRI Hip - With contrast MRI Hip – without contrast
4250 3000 2700 4500 2550 2500 2700 4250 2125 4000 2125 4500 2125 4500 2125 4500 2125 4500 4500 2550 2250 2125
4888 3450 3105 5175 2933 2875 3105 4888 2444 4600 2444 5175 2444 5175 2444 5175 2444 5175 5175 2933 2588 2444
1653 1654 1655 1656 1657 1658 1659 1660
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1688 MRI Pelvis – Without Contrast 1689 MRI Pelvis – with contrast 1690 MRI Extremities - With contrast 1691 MRI Extremities - Without contrast 1692 MRI Temporomandibular – B/L - With contrast
Non NABH/ Non- NABH/ NABL NABL 2125 2444 4500 5175 4500 5175 2125 2444 3825 4399
1693
MRI Temporomandibular – B/L - Without contrast
2125
2444
1694 1695
MR Temporal Bone/ Inner ear with contrast MR Temporal Bone/ Inner ear without contrast
3825 2500
4399 2875
1696 1697 1698 1699 1700 1701 1702 1703
MRI Abdomen – Without Contrast MRI Abdomen – With Contrast MRI Breast - With Contrast MRI Breast - Without Contrast MRI Spine Screening - Without Contrast MRI Chest – Without Contrast MRI Chest – With Contrast MRI Cervical/Cervico Dorsal Spine – Without Contrast MRI Cervical/ Cervico Dorsal Spine – With Contrast MRI Dorsal/ Dorso Lumbar Spine - Without Contrast MRI Dorsal/ Dorso Lumbar Spine – With Contrast
2125 4500 3825 2125 900 2125 4000 2125
2444 5175 4399 2444 1035 2444 4600 2444
3825
4399
2125
2444
3825
4399
MRI Lumbar/ Lumbo-Sacral Spine – Without Contrast MRI Lumbar/ Lumbo-Sacral Spine – With Contrast
2125
2444
4500
5175
Whole body MRI (For oncological workup) MR cholecysto-pancreatography. MRI Angiography - with contrast MR Enteroclysis BONE DENSITOMETRY (DEXA SCAN) Dexa Scan Bone Densitometry - Two sites Dexa Scan Bone Densitometry - Three sites (Spine, Hip & extremity) Dexa Scan Bone Densitometry Whole body NEUROLOGICAL INVESTIGATIONS AND PROCEDURES EEG/Video EEG EMG (Electro myography) Nerve condition velocity (at least 2 limbs)
5100 4950 5000 2125 0 1350 1955
5865 5693 5750 2444 0 1553 2248
2205 0
2536 0
298 638 638
343 734 734
1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715
1716 1717 1718
Sr. No. CGHS TREATMENT PROCEDURE/INVESTIGATION LIST 1719 Decremental response (before and after neo stigmine) 1720 Incremental response 1721 SSEP (Somato sensory evoked potentials) 1722 Poly somnography 1723 Brachial plexus study 1724 Muscle biopsy 1725 ACHR anti body titre 1726 Anti MUSK body titre 1727 Serum COPPER 1728 Serum ceruloplasmin 1729 Urinary copper 1730 Serum homocystine 1731 Serum valproate level 1732 Serum phenol barbitone level 1733 Coagulation profile 1734 Protein C, S anti thrombine – III 1735 Serum lactate level CSF 1736 Basic studies including cell count, protein, sugar, gram stain, India Ink preparation and smear for AFP 1737 Special studies 1738 PCR for tuberculosis/ Herpes simplex 1739 Bacterial culture and sensitivity 1740 Mycobacterial culture and sensitivity 1741 Fungal culture 1742 Malignant cells 1743 Anti measles antibody titre (with serum antibody titre) 1744 Viral culture 1745 Antibody titre (Herpes simplex, cytomegalo virus, flavivirus, zoster varicella virus) 1746 Oligoclonal band 1747 Myelin Basic protein 1748 Lactate 1749 Crypto coccal antigen TESTS IN GASTRO-ENTEROLOGY 1750 D-xylase test 1751 Fecal fat test/ fecal chymotrypsin/ fecal elastase 1752 1753 1754 1755
Breath tests H pylori serology for ciliac disease HBV genotyping HCV genotyping
Non NABH/ Non- NABH/ NABL NABL 595 684 595 638 638 638 383 1663 2106 450 405 450 405 315 332 553 2160 450
684 734 734 734 440 1912 2422 518 466 518 466 362 382 636 2484 518
240
276
275 1080 200 180 128 64 801
316 1242 230 207 147 74 921
255 689
293 792
1080 1684 298 1024
1242 1937 343 1178
765 765
880 880
1170 500 2500 4388
1346 575 2875 5046
Sr. No. CGHS TREATMENT Non NABH/ Non- NABH/ NABL PROCEDURE/INVESTIGATION LIST NABL TESTS IN ENDOCRINOLOGY ( IN ADDITION TO THOSE INCLUDED UNDER HARMONES) 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780
Urinary VMA Urinary metanephrine/Normetanephrine Urinary free catecholamine Serum catecholamine Serum aldosterone 24 Hr urinary aldosterone Plasma renin activity Serum aldosterone/renin ratio Osmolality urine Osmolality serum Urinary sodium Urinary Chloride Urinary potassium Urinary calcium Thyroid binding globulin 24 hr. urinary free cotisole Islet cell antebody GAD antibody Insulin associated antibody IGF-1 IGF-BP3 Sex hormone binding globulin USG guided FNAC thyroid gland E2 Thyro globulin antibody
1350 1024 1521 3060 1013 828 900 1080 128 128 80 43 80 80 459 200 675 1200 404 1350 1485 1200 383 208 587
1553 1178 1749 3519 1165 952 1035 1242 147 147 92 49 92 92 528 230 776 1380 465 1553 1708 1380 440 239 675
