Ahmedabad - Sterling - 2009

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I N D E X

Sr. Particulars Page
1 Introduction of Sterling Hospital 2
2 Location and Advantage 3
3 Scope of Services 4
4 General Instructions 5
5 Note 5
6 Registration OPD 6
7 Health Checkup Plans 7
8 Home Health Care 8
9 Registration & Admission IPD 10
10 Bed / Room charges 11
11 Consultant Visit Charges 12
12 Deposits 14
13 Ambulance Services & Charges 15
14 Miscellaneous Services & Charges 15
15 Physiotherapy 16
16 Psychiatry 16
17 Bio-Medical Services 17
18 Ward / ICU Procedures 18
19 Guidelines for Surgery / Procedure Fees 20
20 Grade wise Operation Charges 21
21 Grade wise Operation Theatre Charges 24
22 Operation Theatre Equipment Charges 25
23 Operation Charges General Surgery 26
24 Operation Charges Orthopedic Surgery 34
25 Operation Charges Obstetrics & Gynecology 43
26 Operation Charges ENT 51
27 Operation Charges Ophthalmic Surgery 54
28 Operation Charges - Pediatric Surgery 56
29
Operation Charges - Laparoscopic / Thorocoscopic / Endoscopic
Surgery
59
30 Operation Charges Neuro Surgery 64
31 Operation Charges Plastic Surgery 66
32 Operation Charges Urology 72
33 Operation Charges Vascular Surgery 74
34 Operation Charges Onco Surgery 75
35 Operation Charges Oral & Maxillofacial Surgeries 78
36 Procedure Charges Opthalmology 79
37 Cardiology 80
38 Cardiology Packages 81
39 Cardiac Surgery Packages 83
37 Pulmonology 86
38 Gastro-Enterology 87
39 Nephrology 89
40 Oncology 90
41 Pathology 91
42 Radiology 105

We are pleased to introduce Sterling Hospital, a unit of Sterling Add
Life India Ltd., a 110 bedded multi specialty and tertiary Care
Centre, situated at the most vantage location of Baroda.

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Our world-class technology and unparalleled service have elevated us
to a global platform. Our passion for excellence has worked to our
advantage. In a short span of time, Sterling Hospital has notched up
an impressive string in almost all the specialties including the field
of Cardiology, Cardio thoracic Surgeries, Diabetology & Endocrinology
with foot care clinic, Urology & Nephrology, Renal Transplantation,
Dialysis facilities, Critical care & Pulmonology, Cosmetic & Plastic
Surgeries, Neurology & Neuro Surgeries, Gastroenterology & G I
Surgeries, Laparoscopic surgeries, 24 hrs. Emergencies & Casualty
Dept., Hemato Oncology & Onco Surgeries, Ortho, Joint Replacement,
Spine & Trauma Surgeries, Vascular Surgeries, pediatric surgeries,
Neonatology, High Risk Pregnancy, Ophthalmology, Dentistry, Pathology,
Radiology, Physiotherapy & Occupational therapy, Health Check Ups,
Home Health Care etc.

Being one of the popular hospital of Gujarat bring with it its fair
share of responsibility and to meet it in a better way we have made
special arrangements for patients & their relatives. There is ICU on
Wheels Ambulances to meet any emergencies. We sterling offers 24 hrs.
Cafeteria facilities, In house STD-PCO, Photocopy & Internet
facilities, etc.

Since our inception the team at Sterling Hospitals began a journey of
leading the provision and advancement of tertiary healthcare in
Gujarat and setting standards of care, which define patient benefits.

As we take confident steps to create a new dimension to quality &
affordable healthcare services in this part of Gujarat, on behalf of
our entire team at Sterling Hospitals, we assure you that our energy,
our talent and our resources will be guided towards innovations, which
clinicians aspire to achieve, and services that patients aspire to
receive.
Sterling Hospital has state-of-the art infrastructure and is equipped
to offer healthcare services in specialties, and Super specialties
backed by specialized facilities, value added services and 24 hour
services. The hospital is one place diagnostic and treatment center
with excellent patient-friendly ambience. With medical expertise

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supported by the latest equipments we offer healthcare treatment of
International standards including diagnostics tests at the hospital.
LOCATION:
Sterling Hospital fully equipped with state-Of-the art infrastructure,
suited at the most peaceful and vantage location of Vadodara City.
STERLING ADVANTAGE:
- Comprehensive one stop center
- Consultations of highly qualified and experienced Consultant
doctors from the entire range of medical specialties, Super
specialties with Excellent Nursing care. All this is backed by
innovative management support system
- Health Check Up Programs for conscious individuals
- Pathology, Radiology & CT Scan facilities
- 24 Hour Pharmacy
- 24 Hour services like Accident & Emergency, Ambulance, Poisoning
& other Medico Legal cases.
- 24 Hour ICU ON Wheel fully equipped Ambulance
- Choice of rooms from Suites, AC Special, Semi Special [ AC, Non
AC] & wards for Male & Female.

Only Hospital in Baroda having Burns ICU with Extensive Burns
Management unit.

SPECIALTIES:-
Gen.Medicine Pathology
Gen. Surgery Microbiology
Orthopedic surgery Radiology
E.N.T. Surgery Pediatrics
Skin and V.D. Obst. & Gynecology

SUPER SPECIALTIES:-
Cardiology Critical care
Cardiac Surgery Arthroscopy
Vascular Surgery Joint Replacement Surgery
Neurology Spine Surgery
Plastic and Reconstructive Surgery Endocrinology

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Neurosurgery Hematology
Nephrology Oncology
Urology Onco Surgery
Gastroenterology Neonatology
G.I. Surgery Pulmonology
Laparoscopy

Specialised Facilities: Specialized Clinics: Health Check Ups:
Neonatal I.C.U. Diet Clinic Cardiac
Burns I.C.U. Diabetes care clinic Primary
Medical ICU Physiotherapy clinic Executive
Surgical ICU Adolescence clinic Comprehensive
Cardiac I.C.U. Well Baby clinic Whole Body
Cardiac surgical ICU Menopause Clinic Sterling Gold
Dialysis unit Pain clinic Sterling Platinum
Neuro surgery O.T.
Cardiac O.T Skin Clinic
Joint Replacement O.T. Breast Health Clinic
Ortho.O.T. Sleep Lab
Laproscopic surgery O.T.
Septic O.T.
General O.T.
We aim to bring quality healthcare with human-touch within the reach
of common man. We hope we are delivering what people want everything
under one roof. We assure our efforts would continue to do so.

OTHER GENERAL INSTRUCTIONS

Children below 15 years are not allowed.
Outside eatables, blankets, pillows etc. are not allowed in
hospital premises to avoid infection.
Patients are advised not to keep valuables, jewellery and cash
with them during their stay at the hospital.
Cash may be deposited in the billing department which will be
refunded over the actual billing amount at the time of discharge

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Patient / Relatives are requested not to tip the staff as this is
strictly prohibited.
All the charges mentioned in this schedule of charge are in
Indian Rupees.
Charges are subject to change without prior information.
In case of any dispute, decision taken by hospital authorities
would be considered as final.

NOTES

10% increase in the rates of hospital services will take place
every year unless specified otherwise.

Management reserves all rights.

REGISTRATION

Out Door patients & Indoor Patients at the Hospital are registered
respectively & registration number generates Patient ID. OPD Patient
has OPD ID and Indoor Patient has IPD ID number. This number helps to
site patients medical record at any time & generate computerized bill.

OUT DOOR DEPARTMENT

Out Door Department registers Outdoor Patients. Patients referred to
consultants specialists sub-specialists of different disciplines are
offered Diagnosis Investigations and Treatment & Follow up services.
Timings: The department timings are 9:00 AM to 2:00 PM and 3:00 PM to
7:00 PM except on Public Holidays & Sundays.

Out Patient Fee Schedule:

Cons.
Categ.
Doctor
First
Consultation
Subsequent
Consultation
(up to 60 days)
1
Consultants
200 100
2
Senior Consultant 300
150
3
Super-specialty
Consultant
400
200
4
Full-time Doctors
150 75

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Emergency visit: Double the routine charge

Other Facilities:

a). Diet Counseling. Rs. 100/-
b). Stress Management. Rs. 250/-

HEALTH CHECK-UP PLANS
The Preventive Health Department of Sterling Hospital has Eleven Health
Check-up Plans in place. Designed with inputs from consultant doctors
these plans include consultations from specialists like Physician,
Surgeon, ENT Surgeon, Ophthalmologist, Dietician, Gynecologist and
Stress Consultant besides pathology and radiology findings.

Besides these pre- designed plans we also offer customized plans to
corporate for Pre-employment Check-up, Regular Check-up & Industry
Specific health check- ups.
Our pre-designed plans are:

SR PARTICULARS RATE
1 Cardiac Health Check Up Plan 1200
2 Primary Health Check Up Plan 2200
3 Executive Health Check Up Plan
3200 [M]
4200 [F]
4 Comprehensive Health Check Up Plan
4700 [M]
5400 [F]
5 Whole Body Health Check Up Plan
7100 [M]
8100 [F]
6 Sterling Gold 23000
7 Sterling Platinum 36000
8 Diabetes Care Package Cheeni Kum 5000
9 Diet Clinic Counselling 500

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10 Well Woman 2300
11 Senior Citizen
5100 [M]
6000 [F]

Details in the attached brochure of Health Check up

HOME HEALTH CARE
Charges of Equipment:

Sr. Equipment
Charges Per Day
(subject to minimum
one day charge) Rs.
Deposit
Rs.
Remarks
1. Suction Machine 70 4000
2. Nebuliser 50 2500
3.
Fowler Bed with
Mattress
50 5000
4. Air Bed 70 6000
5. Wheel Chair 10 2000
6 IV Stand 5 400
7 Oxygen Cylinder
Type B Cylinder
Rs. 150 per day
refill & Rs. 10 per
day rental charges
3000
Type D Cylinder
Rs. 200 per day
refill & Rs. 20 per
day rental charges
5000
8 Walker 5
9 Bedpan 5
10 Comod Stand 10
11 Cotton Mattress 20
1000
12 Pulse Oxymeter 250 40000
Transportation
arrangement to
be made by
hospital, it
will be
charged at
actuals as per
distance

Charges for Nursing Care:

Sr. Particular Rate
1 Minor Dressing Charges (without dressing
materials)
150
(with in 20 kms)
2 Injection Charges - IM (without cost of
injectables & disposables)
75
Injection Charges IV 100
3 Viggo Insertion + Cost of Viggo 100

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4 Ryles Tube + Cost of Supplies 150
5 Foyls Catheter 250
6 Enema 200
7 RBS 200
8 K-90 Catheter 100

Charges for Health Care Professionals:

Charges / Duration
Sr. Health Care Professional *8 hrs. 12 hrs. 24 hrs.
1 Medical Officer 1000 2000
2 Nurse 250 400 800
3 Attendants (Ward boy, Aya ben) 150 200 400

* Minimum 8 hours.

To & fro traveling expenses & food for the health care professionals should be
arranged by the client.

Visit Charges for Doctors:

RATE
Sr. Doctor Night Emergency Routine
1 Medical Officer (MBBS) 400 250
2 MD / MS 800 500

Physiotherapist Charges per Visit:

Sr. Duration Rate
1 Up to hr. 100
2 30 45 min. 150
3 1 hour or more 200

REGISTRATION AND ADMISSION FEE

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Indoor Admission Fees: Rs 100/-
Registration Fees for 1
st
New Consultation: Rs 25/-
10% Administrative Service Charge will be levied on all services
except medicines & consumables.
15% charge will be applicable on all services except medicine &
consumables during emergency hours i.e. from 8 pm to 8 am on
working days, holidays & Sundays.

ROOMS

Room Classification & Charges (Billing Class):

The rooms are classified in 4 categories A B C & D & the charges are as
follows:-

BED / ROOM CHARGES

SEMI SPECIAL SPECIAL
SR SERVICES
GENERAL
WARD

GENERAL
WARD
AC
ICU
ICU RECOVERY
(HDU)
OPD
AC NON AC AC NON AC
SUITE
1 BED CHARGES 350 500 2500 1200 0 1100 700 1650 1100 4000
Class Room Type
A Day Care Ward
A General Ward

B Semi Special Room (Non-AC)
B Special Room (Non-AC)
B General Ward AC
B HDU / ICU Recovery

C
AC Semi-Special Room (2
Patients)
C AC Special Room
C
Burns / Medical / Surgical /
Cardiac / Neonatal ICU

D Suite Room

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Note: Food is provided free to all these wards.

Room Particulars
One relative/attendant can stay with the patient except in general ward
& ICU.
Apart from visiting hrs relatives can visit the patient by paying
Rs.20/- at the registration counter for a visitors pass its validity -
2 hours from the time of issuing (not exceeding 2 passes per day).
The room fee includes diet, hospital linen during stay.
ICU charges include administration of Injections, diet, linen during
stay Oral and Endo Tracheal Suction, Cardiac Monitoring Infusion Pump
(up to 2 in No.) & Pulse Oximetry.
The Indoor patients are advised to buy drugs disposables and consumable
items from the Hospital Pharmacy to maintain the quality and standards.
If the patient shifts from room of lesser charge to room of higher
charge after any procedure in the hospital then the final billing will
be as per the fee schedule of the room of higher charge for the
procedures and stay in hospital.
In case patient is shifted to ICU he shall be required to vacate the
room occupied by him or else he / she shall be required to pay the room
fees in addition to the ICU fees.
The discharge time for the patient is 9:00 AM to 12:00 Noon. Discharge
after 02.00 p.m. room charge will be charge.
In case of planned procedure the patient is advised admission at least
one day prior.
Liquors / Smoking are strongly prohibited in rooms as well as hospital
premises.
In case of patient shifting from higher to lower or lower to higher
class of room, the higher room charge will be applied for that
particular day.

INDOOR CONSULTATION / VISIT CHARGES FOR CONSULTANTS

1. WARD VISIT CHARGES

BILLING CLASS
A B C D
Consultant
Category
Firs
t
Follo
w-up
Emerg
-ency
First
Follo
w-up
Emerg
-ency
First
Follo
w-up
Emerg
-ency
First
Follo
w-up
Emerg
-ency
Full Time
Doctors/Con
sultants
150 70 300 200 120 350 250 170 400 300 220 450
Consultants 250 100 400 300 150 500 350 200 550 400 250 600
Senior
Consultants
300 150 450 350 250 550 400 300 600 500 400 700
Super
Specialist
Consultants
400 200 500 450 300 550 500 400 600 600 500 700
Dietitian 75 100 150 200

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Physiotherap
ist
75 100 150 200

2. ICU VISIT CHARGES
BILLING CLASS
A B C D
Consultant
Category
Firs
t
Follo
w-up
Emerg
-ency
First
Follo
w-up
Emerg
-ency
First
Follo
w-up
Emerg
-ency
First
Follo
w-up
Emerg
-ency
Full Time
Doctors
300 150 350 350 200 400 400 250 450 450 300 500
Consultants 400 250 500 500 350 600 550 400 650 600 450 700
Senior
Consultants
450 350 550 550 400 650 600 450 700 700 500 800
Super
Specialist
Consultants
500 400 600 600 450 700 700 500 800 800 600 900
ICU
Consultants
- - - 50 50 50 100 100 100 150 150 150

CROSS REFERENCE VISIT CHARGES FOR SUPER SPECIALIST

BILLING CLASS
A B C D
Consultant Category
First
Follow
-up
First
Follow
-up
First
Follow
-up
First
Follow
-up
Super Specialist
Consultants
800 400 850 500 900 600 1000 700

CONSULTANTS FEES SCHEDULE FOR: ICU VISITS

SR ROUTINE VISIT CHARGES
1 Professional Management Charges 500 /-*

Primary Consultants shall take professional Management Charge @ Rs. 500/-
per day for first 3 days of admission of patient to ICU. This is not
applicable to the patients getting admitted in Hospital other than in ICU.

Routine Visits:
Consultants shall take one or two Daily Routine visits between 7 A.M. and 9
P.M., except in special cases / serious condition.

Emergency Visits:

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Consultant shall attend the patient within one hour if called by House
Officer / other Consultant.

Diabetic Management Charges:
Rs 500/- for first 3 days from admission or reference.

Burns Management Charges:
After discussion with Chief Medical Administrator, Treating Consultant will
be allowed to charge Rs. 500/- per day as Burns Management charges to
major burns patients, till either patient is in ICU or till patient remains
in critical condition.

DEPOSITS

On Admission, patients are required to deposit some amount so as to cover
expenses incurred per day. This will enable the Hospital Administration to
ensure best services and up date the billing department. Deposits are to be
paid at the time of admission or within 24 hours in case of Emergency
admission.

Class of
Accommodation
General
(A)
Semi
Special
non
AC/Special
non AC (B)
Special
AC/ Semi
Special
AC (C)
Suite (D)
Medical Care 10000 12000 15000 20000
Surgical Care 12000 15000 20000 25000
Emergency 15000 15000 20000 25000
ICU CARE WITH
VENTILATOR
CHARGES

20000

30000

35000

40000
ICU CARE WITHOUT
VENTILATOR
CHARGES

15000

25000

25000

30000

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AMBULANCE SERVICES & CHARGES

SR SERVICES RATES
1 AMBULANCE PER KM 6
2 AMBULANCE CHARGES ( IN BARODA) 100
3 BROTHER - MALE NURSE SIMPLE AMBULANCE PER HOUR 100
4 HOUSE OFFICER SIMPLE AMBULANCE PER HOUR 300
5 WAITING CHARGES SIMPLE AMBULANCE PER HALF HOUR 50
6 OXYGEN CHARGES SIMPLE AMBULANCE (OUT STATION) PER KM 2
7 JOURNEY CHARGES - I.C.U ON WHEEL (OUT STATION) PER KM 12
8 AMBULANCE - I.C.U. ON WHEEL (IN BARODA) 300
9 BROTHER - MALE NURSE - I.C.U. ON WHEEL (OUT STATION) PER HOUR 150
10 NURSING STAFF I.C.U. ON WHEELS (IN BARODA) 75
11 ANESTHETIST I.C.U. ON WHEEL (IN BARODA) 400
12 ANESTHETIST I.C.U. ON WHEEL (OUT STATION) PER HOUR 900
13 OXYGEN CHARGES - I.C.U. ON WHEEL (IN BARODA) 50
14 OXYGEN CHARGES - I.C.U. ON WHEEL (OUT STATION) PER KM 2
15 VENTILOR- I.C.U. ON WHEEL (IN BARODA) 750
16 VENTILOR- I.C.U. ON WHEEL (OUT STATION) PER HOUR 1000
17 IABP MACHINE - I.C.U. ON WHEEL (OUT STATION) PER HOUR 1000
18 INFUSION PUMP (PER PIECE) - I.C.U ON WHEEL (OUT STATION) PER 24 HOUR 125
19 WAITING CHARGES - I.C.U. ON WHEEL (OUT STATION) PER HALF HOUR 100

MISCELLANEOUS SERVICES & CHARGES

SR SERVICES RATES

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1 DISABILITY CERTIFICATE OUT OF BARODA DISTRICT 5000
2 DISABILITY CERTIFICATE WITHIN BARODA DISTRICT 3000
3 LOCKER CHARGES 50
4 MLC - ALL OPD (MINOR CASES) 500
5 MLC BROUGHT DEAD PATIENT 1000
6 MLC - OUTSIDE BARODA DISTRICT 2000
7 MLC - WITHIN BARODA DISTRICT 1000
8 ROOM HEATER CHARGES (PER DAY) 250
9 TELEPHONE CHARGES 3

PHYSIOTHERAPY

SR SERVICES
GENERAL
WARD
ICU
ICU
RECOVERY
OPD
AC
NON
AC
AC
NON
AC
SUITE
1
PHYSIOTHERAPY FIRST
CONSULTING
150 150 150 110 150 150 150 150 150
2 PHYSIOTHERAPY ICU 150 150 150 150 150 150 150 150 150
3 PHYSIOTHERAPY IPD 75 150 150 0 150 100 150 100 150
4
PHYSIOTHERAPY ONE
MODALITY
0 0 0 50 0 0 0 0 0
5
PHYSIOTHERAPY MORE THAN
ONE MODALITY
0 0 0 75 0 0 0 0 0

PSYCHIATRY

SR SERVICES
GENERAL
WARD
ICU
ICU
RECOVERY
OPD
AC
NON
AC
AC
NON
AC
SUITE
1
CHEMICAL
HYPNOTISM(EXCL.ANAES.CH)
600 600 600 600 600 600 600 600 600
2 COUNSELING/PSYCOTHERAPY 300 300 300 300 300 300 300 300 300
3
ELECTRO CONVULSIVE
THERAPY(EXCL.ANAES.CH)
500 500 500 500 500 500 500 500 500
4
FAMILY COUNSELLING(PER 15
MIN)
300 300 300 300 300 300 300 300 300

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BIO MEDICAL SERVICES

SR SERVICES RATES
1 AIR FLUIDIZATION BED THERAPY (PER DAY) 2500
2 CARDIAC MONITORING 250
3 LOWER G.I. SCOPE EQUIPMENT 1100
4 HOLTER MONITORING 750
5 IBP OR ETCO2 500
6 INCUBATOR 400
7 INFUSION PUMP CHARGES 250
8 INVASIVE VENTILATOR CHARGES 2000
9 NEBULISER (EACH SESSION) 50
10 NIBP 250
11 NON INVASIVE (VISION) VENTILATOR CHARGES 1750
12 OXYGEN CHARGES (MORE THAN 6 HOURS) 600
13 OXYGEN CHARGES (UP TO 6 HOURS) 300
14 OXYGEN CHARGES (WITH VENTILATOR) 1000
15 PHOTOTHERAPY DOUBLE SURFACE 500
16 PHOTOTHERAPY SINGLE SURFACE 300
17 PULSE OXIMETER 250
18 RADIANT WARMER 400
19 RIPPLE BED CHARGES (AIR BED) 150
20 SYRINGE PUMP 250
21 VENTILATOR CHARGES (STAND BY) 750
22 BIPAP VENTILATOR CHARGES 1500
23 ERCP EQUIPMENT 1500
24 UPPER G.I. SCOPE EQUIPMENT 600
25 VIDEO ENDOSCOE CHARGE 2000
26 ADULT WORMER CHARGES 250
27 PNEUMATIC CUFF PRESSURE DEVICE 300

FOOT-NOTE:

Any additional specific specialized equipment will be charged as per
hospital policy.

WARD/ICU PROCEDURES

SR SERVICES RATE
1 ANTERIOR NASAL PACKING (EPISTAXIS) 750
2 ARTERIAL LINE CANULATION 750

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3 ASCITIC ABDOMINAL TAPPING 1000
4 BACKUP CHARGES 50
5 BIPAP MASK 1000
6 BLOOD OR COMPONENT TRANSFUSION 350
7 BONE MARROW BIOPSY 750
8 BOWEL WASH 250
9 C.V.LINE CANNULATION 600
10 CENTRAL VENOUS CATHETERISATION 700
11 CENTRAL VENOUS LINE CANNULATION 700
12 CATHETERIZATION (URETHRAL) 200
13 COLOSTOMY 500
14 CONSULTING DRASSING FEE MAJOR 100
15 CONSULTING DRASSING FEE MINOR 50
16 CONSULTING DRASSING FEE SUPRAMAJOR 500
17 DEBRIDEMENT AND STITCHING CHARGE MAJOR 100
18 DIRECT LARYNGOSCOPY 500
19 DOUBLE LUMEN INTERNAL JUGULAR CANNULATION 800
20 DRESSING CHARGES MAJOR 100
21 DRESSING CHARGES MINOR 50
22 DRESSING CHARGES SUPRAMAJOR 500
23 ECHO COLOUR DOPPLER 1000
24 ENDOTRACHEAL INTUBATION 400
25 EPIDURAL CATHATERISATION 100
26 EPIDURAL INJECTION 100
27 FIBRO OPTIC FLEXIBLE NASOPHARYNGO - LARYNGOSCOPY 500
28 FOREIGN BODY REMOVAL EYE 1500
29 GASTRIC LAVAGE 250
30 ICD REMOVAL CHARGES 100
31 IM INJECTION 30
32 INFUSION CHARGES 50
33 INTER CASTAL DRAINAGE ICD 2000
34 IV INJECTION 30
35 LOWER G.I. SCOPE EQUIPMENT 1100
36 LUMBER PUNCTURE 500
37 MICROSCOPIC EXAMINATION OF EAR 250
38 MONITOR CHARGES 250
39 NASAL AND SINUS ENDOSCOPY 400
40 NICU MMR 500
41 NICU-BCG 150

WARD/ICU PROCEDURES

SR SERVICES RATE
42 NICU-CHICKENPOX VACCINE 1350
43 NICU-DPT+HIB 550
44 NICU-DPT+HIB+BIP B 700

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45 NICU-DPT+HIP B 250
46 NICU-DT & POLIO 100
47 NICU-DTAP 1200
48 NICU-DTP & POLIO 100
49 NICU-H INFLUENZA-B VACCINE 500
50 NICU-HEPATITIS-A VACCINE 1000
51 NICU-HEPATITIS-B VACCINE 200
52 NICU-MEASLES 100
53 NICU-POLIO 20
54 NICU-TYOHOID VACCINE 300
55 PLASTER REMOVAL CHARGE 200
56 PLEURAL BIOPSY 1200
57 PLEURAL TAPPING 1000
58 PROCEDURE CHARGES 50
59 PROFESSION MANAGEMENT CHARGES 500
60 R T FEEDING PER DAY 50
61 R T INSERTION 200
62 RANDOM BLOOD SUGAR BY GLUCOMETER 50
63 RESUSCITATION MAJOR 1000
64 RESUSCITATION MINOR 500
65 SINGLE DOUBLE FEMORAL LINE CANNULATION 500
66 SINGLE LUMEN INTERNAL JUGULAR CANNULATION 700
67 SPECIAL THERAPEUTIC DRIP 250
68 SUBCUTANEOUS INJECTION 10
69 SUPRAPUBIC CYSTOTOMY 1500
70 SUTURING CHARGES 50
71 TRIPPLE LUMEN INTERNAL JUGULAR CANNULATION 700
72 URINE KETONE WARD/ICU 20
73 URINE SUGAR (STRIP METHOD) 20
74 WAX REMOVAL 100
75 EPIDUREAL STEROID INJECTION 800
76 EPIDUREAL CATHATER PLACEMENT CHARGE 1000

FOOT-NOTES ON EXTRA CHARGES:
Drugs Disposable material Consumables etc will be charged as per the actual
consumption.
10% Backup charges (Trays Instruments etc) shall be levied on procedure charges
(Tray Charges).
The fee for the procedures done on EMERGENCY call shall be 25% more than the
above Routine fees.

OPERATION CHARGES AND GUIDELINES FOR
SURGERY/PROCEDURE FEES
GUIDELINES
The fee for the procedure mentioned indicates Surgeons
professional fee only.

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The professional fee does not include cost of any other
Medicaments consumables room fee etc except mentioned otherwise.
The professional fee of the Surgeon for the same operation varies
as per the rooms.
This variation in no way indicates that the patient in higher room
fee of the hospital is operated with superior skill and that with
less fee with inferior skill, but it suggests that hospital is
giving relief in operative charges for lower billing class.
Surgery Package includes all the expenses for that particular
surgery except consumables and medicines.

High Risk Surgery Fee:
a) The fee shall be 25% extra in case of anaesthesia Risk.
b) The fee shall be 50% extra in case of HbsAg HCV and HIV
Positive cases.

Operation Charge:

a) As per procedure list in Routine hours.
b) Add emergency charges 25% if applicable.
c) Add High Risk Surgery Fee if any.

If patient changes the type of accommodation to higher class then the
charges will be revised as per new class retrospectively except stay
charges. However the patient is shifted to lower class then no changes will
be made. (In deserving cases the treating doctor may reduce the operative
charges appropriately)

Special Notes:
In case of any emergency surgeries, 25% of the surgical charges will
be charged extra.
When patient is required 2
nd
surgery in the same region & from incision
during the first surgery, the 2
nd
one would be charged at 50% of the
surgical charges, but if it is a separate incision surgery then full
charges will be charged for 2
nd
operation.
In case of class up gradation, charges of the higher class would be
levied from 1
st
day of hospitalization irrespective of the date of
surgery.
In case where the assistant surgeon is required, maximum 20% of the
principal surgeons charges can be levied as assistant surgeon
charges.
These charges would not be applicable in case of packages.
Total Operation Charges
=
(a + b + c)

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For the fixation of the grade for new (unlisted) surgeries, CPT codes
will be taken as base and in case of any dispute; Chief Medical
Administrator would be the final authority.
Post surgical 3 days routine visits, including visit on the day of
surgery will be considered as a part of above surgical charges and the
surgeons will not charge the visits for these 3 days. However, any
emergency on request visit will be charged extra for these days. All
the visits from 4
th
day onwards would be levied extra.

GRADE WISE OPERATION CHARGES

GRADE NO. Class-A Class-B Class-C Class-D
1 2000.00 2500.00 3200.00 4000.00
2 3000.00 3900.00 5000.00 6000.00
3 5000.00 6500.00 8000.00 10000.00
4 7000.00 9000.00 11000.00 14000.00
5 10000.00 13000.00 16000.00 20000.00
6 13000.00 17000.00 21000.00 26000.00
7 16000.00 21000.00 25500.00 32000.00
8 20000.00 26000.00 32000.00 40000.00
9 22000.00 28500.00 35000.00 44000.00
10 25000.00 32500.00 39000.00 48000.00

Classification of Accommodation Type

A - GENERAL WARD
B - NON AC WARDS / STEP DOWN / OPD / GENERAL WARD AC
C - A/C WARDS / ICU
D - SUIT WARD

SURGICAL FEES

CLASS OF ROOM A B C D

SEMI SPECIAL
/ SPECIAL -
NON AC/Gen.
Ward AC

SEMI
SPECIAL /
SPECIAL -
AC
SR SERVICES
GENERAL
WARD
ICU RECOVERY ICU
SUITE
1 GRADE - 0 SURGEON FEES MAX UP TO 4000/-, ACCORDING TO BILLING CLASS
2 GRADE - 0 HIGH RISK SURGEON FEES MAX UP TO 5000/-, ACCORDING TO BILLING CLASS
3 GRADE - 0 ANESTHESIA CHARGES
400 OR 25 % OF THE SURGICAL CHARGE WHICHEVER
IS HIGHER
4 GRADE - 0 HIGH RISK ANESTHESIA CHARGES
400 OR 25 % OF THE SURGICAL CHARGE WHICHEVER
IS HIGHER
5 GRADE - 0 ASST SURGEON FESS 20 % OF THE SURGICAL CHARGE
6 GRADE - 0 HIGH RISK ASST SURGEON FEES 20 % OF THE SURGICAL CHARGE

7 GRADE-I SURGEON FEES 2000 2500 3200 4000
8 GRADE-I HIGH RISK SURGEON FEES 2500 3125 4000 5000

Page 20 of 112
9 GRADE-I ANESTHESIA CHARGES 400 650 800 1000
10 GRADE-I HIGH RISK ANESTHESIA CHARGES 500 810 1000 1254
11 GRADE-I ASST SURGEON FEES 400 500 640 800
12 GRADE-I HIGH RISK ASST SURGEON FEES 500 625 800 1000

13 GRADE-II SURGEON FEES 3000 3900 5000 6000
14 GRADE-II HIGH RISK SURGEON FEES 3750 4875 6250 7500
15 GRADE-II ANESTHESIA CHARGES 600 975 1250 1500
16 GRADE-II HIGH RISK ANESTHESIA CHARGES 750 1219 1563 1875
17 GRADE-II ASST SURGEON FEES 600 780 1000 1200
18 GRADE-II HIGH RISK ASST SURGEON FEES 750 975 1250 1500

19 GRADE-III SURGEON FEES 5000 6500 8000 10000
20 GRADE-III HIGH RISK SURGEON FEES 6250 8125 10000 12500
21 GRADE-III ANESTHESIA CHARGES 1000 1625 2000 2500
22 GRADE-III HIGH RISK ANESTHESIA CHARGES 1250 2031 2500 3125
23 GRADE-III ASST SURGEON FEES 1000 1300 1600 2000
24 GRADE-III HIGH RISK ASST SURGEON FEES 1250 1625 2000 2500

25 GRADE-IV SURGEON FEES 7000 9000 11000 14000
26 GRADE-IV HIGH RISK SURGEON FEES 8750 11250 13750 17500
27 GRADE-IV ANESTHESIA CHARGES 1400 2250 2750 3500
28 GRADE-IV HIGH RISK ANESTHESIA CHARGES 1750 2813 3438 4375
29 GRADE-IV ASST SURGEON FEES 1400 1800 2200 2800
30 GRADE-IV HIGH RISK ASST SURGEON FEES 1750 2250 2750 3500

SURGICAL FEES

GENERAL
WARD
SEMI SPECIAL /
SPECIAL - NON
AC
SEMI SPECIAL
/ SPECIAL -
AC SR SERVICES
ICU RECOVERY ICU
SUITE
31 GRADE-V SURGEON FEES 10000 13000 16000 20000
32 GRADE-V HIGH RISK SURGEON FEES 12500 16250 20000 25000
33 GRADE-V ANESTHESIA CHARGES 2000 3250 4000 5000
34 GRADE-V HIGH RISK ANESTHESIA CHARGES 2500 4063 5000 6250
35 GRADE-V ASST SURGEON FEES 2000 2600 3200 4000
36 GRADE-V HIGH RISK ASST SURGEON FEES 2500 3250 4000 5000

37 GRADE-VI SURGEON FEES 13000 17000 21000 26000
38 GRADE-VI HIGH RISK SURGEON FEES 16250 21250 26250 32500
39 GRADE-VI ANESTHESIA CHARGES 2600 4250 5250 6500
40 GRADE-VI HIGH RISK ANESTHESIA CHARGES 3250 5313 6563 8125
41 GRADE-VI ASST SURGEON FEES 2600 3400 4200 5200

Page 21 of 112
42 GRADE-VI HIGH RISK ASST SURGEON FEES 3250 4250 5250 6500

43 GRADE-VII SURGEON FEES 16000 21000 25500 32000
44 GRADE-VII HIGH RISK SURGEON FEES 20000 26250 31875 40000
45 GRADE-VII ANESTHESIA CHARGES 3200 5250 6375 8000
46 GRADE-VII HIGH RISK ANESTHESIA CHARGES 4000 6563 7969 10000
47 GRADE-VII ASST SURGEON FEES 3200 4200 5100 6400
48 GRADE-VII HIGH RISK ASST SURGEON FEES 4000 5250 6375 8000

49 GRADE-VIII SURGEON FEES 20000 26000 32000 40000
50 GRADE-VIII HIGH RISK SURGEON FEES 25000 32500 40000 50000
51 GRADE-VIII ANESTHESIA CHARGES 4000 6500 8000 10000
52 GRADE-VIII HIGH RISK ANESTHESIA CHARGES 5000 8125 10000 12500
53 GRADE-VIII ASST SURGEON FEES 4000 5200 6400 8000
54 GRADE-VIII HIGH RISK ASST SURGEON FEES 5000 6500 8000 10000

55 GRADE-IX SURGEON FEES 22000 28500 35000 44000
56 GRADE-IX HIGH RISK SURGEON FEES 27500 35625 43750 55000
57 GRADE-IX ANESTHESIA CHARGES 4400 7125 8750 11000
58 GRADE-IX HIGH RISK ANESTHESIA CHARGES 5500 8906 10938 13750
59 GRADE-IX ASST SURGEON FEES 4400 5700 7000 8800
60 GRADE-IX HIGH RISK ASST SURGEON FEES 5500 7125 8750 11000

GRADE WISE OPERATION THEATRE CHARGES


SEMI SPECIAL /
SPECIAL
NON AC

SEMI SPECIAL /
SPECIAL
AC

SR SERVICES
GENERAL
WARD
ICU RECOVERY ICU
SUITE
1 GRADE - OPRATION THEATRE CHARGES** 25% ** 28%** 28%** 30%**

** % of operation charge

Note:

For Emergency & high risk, operation theatre charges will vary according to
percentage of operative fees.

DURATION WISE OPERATION THEATRE CHARGES

Page 22 of 112
New O. T. Charges - on hourly base
Particulars Class -
A
Class -
B
Class -
C
Class -
D
Emergency OT 600 700 800 800
Burns OT 700 1000 1200 1200
Septic OT 6 600 700 800 800
OT 5 - GENETRAL 1200 1500 1800 1800
OT 1 - CABG 1500 1800 2200 2200
OT 2 - ORTH/ NEURO 1500 1800 2200 2200
OT 4 - GENERAL 1200 1500 1800 1800
OT 3 - FOR REPLACEMENT 2200 2700 3200 3200

Notes:

The above fee schedule is for one hour of OT use.
After the first hour, use of OT is recorded in terms of units; every unit is
of 30 min duration.
Half hourly charges are also applicable.
Of the above, Grade wise or Duration wise operation theatre charges, whichever
charge is higher will be applicable.

OPERATION THEATRE- EQUIPMENT CHARGES

SR SERVICES RATE
1 AESCULAP CRANIOTOME 2000
2 ANAESTHESIA VENTILATOR 100
3 ARTHROSCOPY 1200
4 CAMERA & TV AND XENON LIGHT SOURCE 500
5 C-ARM (MAJOR) IITV 1000
6 C-ARM (MINOR) IITV 500
7 CYSTOSCOPY/HYSTEROSCOPY 750
8 DERMATOME PNEUMATIC 1250
9 ETCO2 100
10 LAPAROSCOPIC INSTRUMENTS INCLUDING XENON CAMERA AND SCOPE 2000
11 LIPOSUCTION MACHINE 750
12 MESHER (SKIN) 1500
13 MICROSCOPE BHEL 500
14 MICROSCOPE ZEISS / MOLLERWEDEL 2500
15 MICROSURGERY INSTRUMENT 2500
16 MONITORING DURING ANESTHESIA 100
17 RESECTOSCOPE 750
18 URETHROSCOPE/TURP 1000
19 INTRA CORPOREAL LITHOTRIPSY 750
20 FENTANYL CITREATE INJECTION 1 AMP 50
21 ISO FLURANE PER ML 10
22 SERVO FLURANE 1 ML 50

Page 23 of 112
23 DAWNS STG HANDLE 300
24 COMPUTER NAVIGATION FOR HIP/KNEE/TRAUMA/SPINE 5000

Note:

Use of these special equipments will be charged extra over & above the theatre
charges.
Any additional specific specialized equipment will be charged as per
hospital policy.

OPERATION CHARGES: GENERAL SURGERY

Sr Particulars Grade
1 BREAST-ABCESS 0
2 BURNS - DRESSING (MINOR) 0
3 DEBRIDEMENT (MINOR)-EACH 0
4 DORSAL S/H OF PREPUCE 0
5 EAR REPAIR EACH SIDE 0
6 FACE/LIPS-CLW MINOR 0
7 HAND/FOOT PARONYCHIA/PULP SPACE ABCESS 0
8 HAND/FOOT-HAND INJURY MINOR 0
9 HAND/FOOT-HAND/FOOT INGROWING NAIL 0
10 HEAD-EXCISION OF CYSTS/GROWTH 0
11 HEAD-SCALP WOUNDS-MINOR 0
12 INFECTION-CARBUNCLE SMALL 0
13 INFECTION-PUS ASPIRATION SUB CUT 0
14 INFECTIONS-I & D - MEDIUM 0
15 INFECTIONS-I & D SMALL 0
16 INJURY-DEBRIDEMENT MINOR 0
17 INJURY-FOREIGN BODY REMOVAL 0
18 INJURY-SECONDARY STUTURING 0
19 LYMPHATICS/LYMPH NODES-LN BIPOSY 0
20 LYMPHATICS/LYMPH NODES-TB COLD ABCESS 0

Page 24 of 112


21 MOUTH/TONGUE-CANCER TONGUE BIOPSY 0
22 MOUTH/TONGUE-TONGUE TIE 0
23 SKIN-CORN/WARTS 0
24 TUMORS-LIPOMA/SEB.CYST/FIBROMA ETC. 0
25 ULCERS-SCRAPPING/BIOPSY 0
26 URETHRA/PENIS-PARAPHIMOSIS MULTIPLE PUNCTURE 0
27 URETHRA/PENIS-STRICTURE DILATATION 0
28 AMPUTATION - FINGER/TOE 1
29 ANAL CANAL & RECTUM-PROLAPSE RECTUM THIERCH LOCAL 1
30 ANAL CANAL & RECTUM-RECTAL POLYP 1
31 BURNS-STSG MINOR 1
32 DEBRIDEMENT (MAJOR)-EACH 1
33 HAND/FOOT-HAND INJURY MAJOR 1
34 HAND/FOOT-PALMAR ABCESS 1
35 HEAD-SCALP WOUNDS-MAJOR 1
36 INFECTION-CARBUNCLE LARGE 1
37 INFECTIONS-I & D LARGE 1
38 INFECTIONS-I & D - MULTIPLE/SPECIAL 1
39 INJURY-DEBRIDEMENT MAJOR 1
40 INJURY-WOUND MAJOR / DEEP 1
41 INJURY-WOUND REPAIR MULTIPLE SUPERFICIAL 1
42 KIDNEYS AND URETERS-SUPRAPUBIC CYSTOSTOMY 1
43 LYMPHATICS/LYMPH NODES-EXCISION OF LN MASS 1
44 LYMPHATICS/LYMPH NODES-TB COLD ABCESS LARGE 1
45 MOUTYH/TONGUE-SUB MUCOUS SYSTS RANULA 1
46 SALIVARY GLANDS-PAROTID ABCESS 1
47 SKIN-NONSPECIFIC SINUSES 1
48 SKIN-SKIN GRAFTING MINOR 1
49 TESTES & SCROTUM-MULTIPLE SEB.CYST SCROTUM 1
50 TESTES & SCROTUM-TESTES BIOPSY 1
51 THORAX-INTERCOSTAL DRAINAGE 1
52 TRACHEOSTOMY 1
53 UMBILICUS/ABDOMINAL WALL - U.GRANULOMA 1
54 UMBILICUS/ABDOMINAL WALL-UMBILICAL ABSCESS 1

Page 25 of 112


55 URETHRA/PENIS-CIRCUMSCISION 1
56 VEINS-VEIN GRAFT HARVESTING 1
57 ANAL CANAL & RECTUM-ANAL FISSURES-DILATATION 2
58 ANAL CANAL & RECTUM-ANAL FISSURES-SPHINCTEROTOMY 2
59 BURNS-STSG MAJOR 2
60 FACE/LIPS-CLW MAJOR 2
61 HAND/FOOT-TENDON REPAIR SINGLE 2
62 INTESTINES-ADHESINOLYSIS AS AN ADJUNCT TO OTHER PROCEDURE 2
63 PERITONEUM/MESENTERY OMENTUM-INTRAOPERATIVE ENDOSCOPY-ANY TYPE 2
64 PERITONEUM/MESENTERY/OMENTUM-LAPAROTOMY AS BASIC PROCEDURE 2
65 PILONIDAL SINUS MINOR 2
66 UMBILICUS/ABDOMINAL WALL-UMBILICAL SINUS 2
67 URETHRA/PENIS-PARAPHIMOSIS MULTIPLE PUNCTURE + CIRCUMASION 2
68 AMPUTATION FOREARM/TRANSMETATARSAL 3
69 AMPUTATION RAYS 3
70 ANAL CANAL & RECTUM-FISTULA IN ANO LOW 3
71 ANAL CANAL & RECTUM-PILONIDAL SINUS 3
72 ANAL CANAL RECTUM-PILES HAEMORRHOIDECTOMY 3
73 APPENDIX-INTERVAL 3
74 BREAST-AXILLARY CLEARANCE ONLY 3
75 BREAST-GYNAECOMASTIA UNILATERL 3
76 BREAST-LUMPECTOMY/FIBRO ADENOMA 3
77 BREAST-RECURRENT NODULE EXCISION 3
78 GALL BLADDER-CHOLECYSTOSTOMY 3
79 HAND/FOOT-TENDON REPAIR MULTIPLE 3
80 HERNIAS-INGUINAL H.RRAPHY-Unilateral 3
81 HERNIAS-EPIGASTRIC/UMBILICAL 3
82 HERNIAS'-INGUINAL. HERNIO TOMY- Unilateral 3
83 HERNIAS'-PARA UMBILICAL 3
84 INTESTINES-ANASTOMOSIS-COLOSTOMY-ALONE ANY TYPE 3
85 INTESTINES-ANASTOMOSIS-ILEOSTOMY ALONE 3
86 INTESTINES-INTUSSUSCEPTION-REDUCTION ONLY 3
87 INTESTINES-JEJUNOSTOMY 3
88 NECK-BRANCHIAL CYST 3

Page 26 of 112


89 NECK-CYSTIC HYGROMA 3
90 PERITONEUM/MESENTERY OMENTUM-DIAGNOSTIC LAPAROSCOPY 3
91 PERITONEUM/MESENTERY/OMENTUM-EXPLORATORY LAPROTOMY ALONE 3
92 PILONIDAL SINUS MODERATE 3
93 SKIN-SKIN GRAFTING MAJOR 3
94 STOMACH DUODENUM-GASTROSTOMY 3
95 STOMACH DUODENUM-VAGOTOMY TRUNCAL/SELECTIVE 3
96 TESTES & SCROTUM - FOURMIERS 3
97 TESTES & SCROTUM - GANGRENE SCROTUM- SIMPLE 3
98 TESTES & SCROTUM-HYDEOCOELE UNILAT. 3
99 TESTES & SCROTUM-ORCHIDECTOMY UNILAT 3
100 UMBILICUS/ABDOMINAL WALL UMBILECTOMY 3
101 URETHRA/PENIS-OPTICAL VISUAL URETHROTOMY 3
102 VEINS-LIGATION OF PERFORATOR 3
103 VEINS-S.F FLUSH LIGATION 3
104 VEINS-VARICOSE VEIN STRIPPING-UNILATERAL 3
105 AMPUTATION ABOVE ELBOW 4
106 AMPUTATION BELOW KNEE 4
107 AMPUTATION FORE QUARTER 4
108 AMPUTATION - SIMS (SYNES) 4
109 ANAL CANAL & RECTUM-AC INJURY SPHINC REPAIR 4
110 ANAL CANAL & RECTUM-FISTULA IN ANO HIGH 1ST STAGE 4
111 ANAL CANAL & RECTUM-FISTULA IN ANO HIGH 2ND STAGE 4
112 ANAL CANAL & RECTUM-FISTULA IN ANO HIGH INTERMEDIATE STAGE 4
113 ANAL CANAL & RECTUM-MULTIPLE/RECURRENT FISTULA IN ANO 4
114 APPENDIX-ACUTE/LOCAL PERITONOTIS/ABCESS 4
115 BREAST-GYNAECOMASTIA BILATERAL 4
116 BREAST-SEGMENTAL MASTECTOMY 4
117 HERNIA-INGUINAL HERNIOPLASTY (MESH)- Unilateral 4
118 HERNIAS-FEMORAL HERNIA-SIMPLE Unilateral 4
119 HERNIAS-INCISIONAL H.ANATOMICAL REPAIR 4
120 HERNIAS-EPIGASTRIC/UMBILICAL/PARA UMBILICAL WITH MESH 4
121 INTESTINES-ANASTOMOSIS-COLOSTOMY-WITH OTHER PROCEDURE 4
122 INTESTINES-ANASTOMOSIS-ILEOSTOMY - WITH OTHER PROCEDURE 4

Page 27 of 112


123 INTESTINES-RESECTION OF INTESTINES FOR-DIVERTICULI 4
124 INTESTINES-STRICTURO PLASTY SINGLE 4
125 KIDNEYS AND URETERS-BLADDER REPAIR 4
126 KIDNEYS AND URETERS-CYSTO LITHOTOMY 4
127 KIDNEYS AND URETERS-PYONEPHROSIS DRAINAGE OPEN 4
128 KIDNEYS AND URETERS-URETEROLITHOTOMY 4
129 LAPROSCOPIC APPENDIX 4
130 PERITONEUM/MESENTERY OMENTUM-DIAGNOSTIC LAP BIOPSY 4
131 PERITONEUM/MESENTERY OMENTUM-MESENTERIC CYST 4
132 PERITONEUM/MESENTERY OMENTUM-OMENTAL CYST 4
133 PERITONEUM/MESENTERY OMENTUM-PRIMARY PERITONITIS 4
134 PERITONEUM/MESENTERY OMENTUM-RETROPERITONEAL ABSCESS 4
135 PERITONEUM/MESENTERY OMENTUM-RETROPERITONEAL CYST 4
136 PILONIDAL SINUS MILD 4
137 SALIVARY GLANDS-SUPREFICIAL PAROTIDECTOMY 4
138 SALIVARY GLANDS-TOTAL EXCISION OF SUB MANDIBULAR GLAND 4
139 SKIN-MELANOMA LOCAL EXCISION 4
140 SKIN-SQAMOUS CELL CANCER EXCISION 4
141 STOMACH DUODENUM-PYLORIC STENOSIS CONGENITAL 4
142 STOMACH DUODENUM-PYLOROPLASTY 4
143 TESTES & SCROTUM-CANCER 4
144 TESTES & SCROTUM-HYDROCOELE BILATERAL 4
145 TESTES & SCROTUM-ORCHIDECTOMY BILAT 4
146 TESTES & SCROTUM-ORCHIOPEXY UNILATERL 4
147 TESTES & SCROTUM-TORSION TESTES 4
148 TESTES & SCROTUM-VARICOCOELE (BILATERAL) 4
149 TESTES & SCROTUM-VARICOCOELE (UNILATERAL) 4
150 THORAX-RIB EXCISION MULTIPLE 4
151 THORAX-RIB EXCISION SINGLE 4
152 THYROID/PARATHYROID-NODULE EXCISION 4
153 THYROID/PARATHYROID-PARATHYROIDECTOMY 4
154 THYROID/PARATHYROID-THYROGLOSSAL CYST 4
155 THYROID/PARATHYROID-THYROGLOSSAL TRACT EXACSION 4
156 AMPUTATION ABOVE KNEE 5

Page 28 of 112


157 APPENDIX-PERFORATED GANGRENOUS/PERITONITIS 5
158 BREAST-SIMPLE MASTECTOMY 5
159 GALL BLADDER-CBD REPAIR 5
160 GALL BLADDER-CBDUCT EXPLORATION WITH T-TUBE DRAINAGE 5
161 GALL BLADDER-CHOLECYSTECTOMY OPEN 5
162 GALL BLADDER-CHOLECYSTO JEJUNOSTOMY 5
163 GALL BLADDER-TRANSDUODENAL SPHICTEROPLASTY 5
164 HERNIAS-FEMORAL HARNIA-OBSTRUCTED 5
165 INTESTINES-ADHESINOLYSIS-ONLY FOR OBSTRUCTION 5
166 INTESTINES-ANASTOMOSIS-COLOCOLIC ANASTOMOSIS 5
167 INTESTINES-ANASTOMOSIS-COLORECTAL ANASTOMOSIS HIGH 5
168 INTESTINES-ANASTOMOSIS-HARTMANN'S OPERATION 5
169 INTESTINES-ANASTOMOSIS-JEJUNO/ILEO-COLIC ANASTOMOSIS 5
170 INTESTINES-ANASTOMOSIS-SMALLBOWEL ANY TYPE 5
171 INTESTINES-MALROLATION-ANY PROCEDURE 5
172 INTESTINES-PERFORATION CLOSER MULTIPLE 5
173 INTESTINES-PERFORATION CLOSER SINGLE 5
174 INTESTINES-RESECTION OF INTESTINES AND ANASTAMOSIS FOR ADHESIONS 5
175 INTESTINES-RESECTION OF INTESTINES FOR-ANTERIOR RESECTION ONLY 5
176 INTESTINES-RESECTION OF INTESTINES FOR-HEMICOLECTOMY-RIGHT OR LEFT 5
177 INTESTINES-RESECTION OF INTESTINES FOR-INTESTINAL TRAUMA WITH RESECTIONS 5
178 INTESTINES-RESECTION OF INTESTINES FOR-LOWER GL BLEED RESECTION 5
179 INTESTINES-RESECTION OF INTESTINES FOR-MESENTERIC ISCHEMIA 5
180 INTESTINES-RESECTION OF INTESTINES FOR-PERFORATION 5
181 INTESTINES-RESECTION OF INTESTINES FOR-SIGMOID COLECTOMY 5
182 INTESTINES-RESECTION OF INTESTINES FOR-STRICTURES 5
183 INTESTINES-STRICTURO PLASTY MULTIPLE 5
184 MOUTH/TONGE-CANCER EXCISION (LOCAL) 5
185 MOUTH/TONGE-CANCER HEMI GLOSSECTOMY 5
186 NECK-RADICAL NECK DISSECTION UNILATERAL 5
187 NECK-SUPRAHYOID BLOCK DISSECTION 5
188 PANCREAS-ACUTE PANCREATITIS DRAINAGE 5
189 PANCREAS-PSEUDOCYST EXTERNAL DRAINAGE 5
190 PERITONEUM/MESENTERY OMENTUM-EXPLORATORY LAPRARTOMY WITH BIOPSY 5

Page 29 of 112


191 PERITONEUM/MESENTERY OMENTUM-RETROPERITONEAL TUMOR BIOPSY OPEN 5
192 PERITONEUM/MESENTERY OMENTUM-SUBPHRENIC/PELVIC ABSCESS 5
193 PILONIDAL SINUS MAJOR 5
194 SALIVARY GLANDS-TOTAL PAROTIDECTOMY 5
195 SPLEEN-SPLEENECTOMY PLANNED 5
196 STOMACH DUDENUM-VOLVULUS STOMACH EMERGENCY 5
197 STOMACH DUDENUM-VOLVULUS STOMACH PLANNED 5
198 STOMACH DUODENUM -GASTRO JEJUNOSTOMY 5
199 STOMACH DUODENUM-DIEULAFOY'S EROSION 5
200 STOMACH DUODENUM-PEPTIC PERFORATION 5
201 STOMACH DUODENUM-SUPRA SELECTIVE VAGOTOMY 5
202 THORAX-EVENTRATION 5
203 THORAX-RUPTURE DIAPHRAGM 5
204 THYROID/PARATHYROID-HEMI THYROIDECTOMY 5
205 THYROID/PARATHYROIDLOBECTOMY UNILATERAL 5
206 THYROID/PARATHYROID-RADICAL THYROIDECTOMY 5
207 THYROID/PARATHYROID-SUBTOTAL THROIDECTOMY 5
208 UMBILICUS/ABDOMINAL WALL-BURST ABDOMEN 5
209 ADRENAL TUMORS ANY TYPE 6
210 AMPUTATION - HIND QUARTER 6
211 ANAL CANAL & RECTUM-ANAL CANAL CANCER+ING.BLOCK DISSECTION 6
212 ANAL CANAL & RECTUM-PROLAPSE RECTUM OPEN... ANY TYPE (RECTOPEXY) 6
213 BREAST-MRM CANCER 6
214 ESOPHAGUS-ACHALASIA CARDIA 6
215 ESOPHAGUS-MALIGANANCY OF ESOPHAGUS PALLIATIVE EXCISION/BYPASS 6
216 ESOPHAGUS-PERFORATION 6
217 GALL BLADDER HEPATICOJEJUNOSTOMY 6
218 GALL BLADDER-CHOLANGIO CARCINOMA EXCISION 6
219 GALL BLADDER-CHOLECYSTECTOMY LAP 6
220 GALL BLADDER-CHOLEDOCHO DUODENOSTOMY 6
221 GALL BLADDER-CHOLEDOCHO JEJUNOSTOMY 6
222 HERNIA-INGUINAL- LAPROSCOPIC REPAIR (Unilateral) 6
223 HERNIAS-INCISIONAL H. OBSTRUCTED WITH REPAIR 6
224 HERNIAS-INCISIONAL H.MESH REPAIR 6

Page 30 of 112


225 HERNIAS'-LUMBAR/SUBCOSTAL/OTHER HERNIAS 6
226 HERNIAS'-OBSTRUCTED HERNIA 6
227 HERNIAS'-RECURRENT HERNIAS 6
228 INTESTINES-ANASTOMOSIS-COLORECTAL ANASTOMOSIS LOW 6
229 INTESTINES-ANASTOMOSIS-COLOSTOMY CLOSURE WITH ANASTOMOSIS 6
230 INTESTINES-ANASTOMOSIS-ILEOSTOMY CLOSURE WITH ANASTOMOSIS 6
231 INTESTINES-RESECTION OF INTESTINES FOR-TOTAL COLECTOMY 6
232 INTESTINES-VOLVULOUS-ANY 6
233 KIDNEYS AND URETERS-NEPHRECTOMY 6
234 KIDNEYS AND URETERS-OPEN PROSTATECTOMY 6
235 KIDNEYS AND URETERS-PUJ RECONSTRUCTION 6
236 KIDNEYS AND URETERS-PYELOLITHOTOMY 6
237 LIVER-ABCESS OPEN 6
238 LIVER-HYDATID CYST 6
239 LIVER-INJURY 6
240 MESH PLASTY FOR SLIDING HERNIA 6
241 NECK-RND WITH FLAP 6
242 PANEREAS-PSEUDOCYSTS INTERNAL DRAINAGE (ANY TYPE) 6
243 PERITONEUM/MESENTERY OMENTUM-RETROPERITONEAL TUMOR EXCISION 6
244 PILONIDAL SINUS COMPLICATED 6
245 SPLEEN-RUPTURE SPLEEN 6
246 SPLEEN-SPLENORRAPHY 6
247 STOMACH DUDENUM-DOUDENAL INJURIES 6
248 STOMACH DUDENUM-PARTIAL GASTRECTOMY 6
249 STOMACH DUODENUM-BLEEDING ULCER 6
250 THYROID/PARATHYROID-RETRO STERNAL GOITER 6
251 ESOPHAGUS-HIATUS HERNIA 7
252 ESOPHAGUS-MALIGANCY OF ESOPHAGUS CURATIVE EXCISION - TRANSLIATAL 7
253 GALL BLADDER EXCISION+ANASTOMOSIS 7
254 INTESTINES-ANASTOMOSIS-ABDOMINOPERINEAL RESECTION 7
255 LIVER-PORTAL HYPERTENSION PLANNED SHUNT/NON SHUNT 7
256 PANCREAS-ACUTE PANCREATITIS NECROSECTOMY 7
257 PANEREAS-CRONIC PANCREATITIS PUESTOW/DISTAL PANCREATECTOMY 7
258 PANEREAS-PALLIATIVE BYPASS CANCER FOR PANCREAS 7

Page 31 of 112


259 STOMACH DUDENUM-TOTAL GASTRECTOMY 7
260 ESOPHAGUS-MALIGANCY OF ESOPHAGUS CURATIVE EXCISION - IVOR LOUIS 2 STAGE 8
261 HERNIAS'-STRANGULATED HERNIA-RESECTION ANASTOMOSIS+REPAIR 8
262 HERNIAS'-STRANGULATED HERNIA-RESECTION ANASTOMOSIS+REPAIR-ANY TYPE 8
263 TOTAL PROCTOCOLECTOMY 8
264 PORTAL HYPERTENSION - EMERGENCY DEVASCULARISATION 8
265 HEPATIC RESECTION (LOBECTOMY) 8
266 STRANGULATED INCISIONAL HERNIA WITH RESECTION ANASTOMOSIS & REPAIR 8
267 COMPLICATED & LARGE HERNIA WITH RESECTION & ANASTOMOSIS 8
268
ESOPHAGUS-MALIGANCY OF ESOPHAGUS CURATIVE EXCISION - MCKEOWN 3 STAGE
ESOPHAGECTOMY 9
269 LIVER-HEPATIC RESECTION LOBECTOMY 9
270 LIVER-HEPATIC SEGMENTAL RESECTION 9
271 LIVER-PORTAL HYPERTENSION EMERGENCY SURGERY 9
272 PANEREAS-WHIPPLES' RESECTION 9

Page 32 of 112

OPERATION CHARGES: ORTHOPAEDIC SURGERY

Sr. Particulars Grade
1 FOOT - REMOVAL OF IMPLANTS 0
2 FOOT / ANKEE-FIXATION OF PHALANX 0
3 TRACTIONS-SKIN TRACTION 0
4 GENERAL-CTEV CORRECTIVE PLASTER 0
5 ACROMIO CLAVICULAR JOINT FIXN K-WIRE 1
6 ARTHRODESIS - IP JOINT 1
7 FOOT / ANKEE-FIXATION OF MATATARSAL 1
8 FOREARM-REMOVAL OF IMPLANTS NAILS 1
9 GENERAL-GANGLION EXCISION 1
10 GENERAL-HIP SPICA 1
11 GENERAL-JOINT ASPIRATION 1
12 OPEN FRACTURES DEBRIDEMENTGR1 1
13
PLASTERS-MANIPULATION AND APPLICATION OF POP OF MOST CLOSED FRACTURES AND
DISLOCATION 1
14 PLASTERS-SPLINTAGE AND POP OF MOST OF FRACTURES (OPD) 1
15 SHOULDER-SHOULDER MANIPULATION 1
16 TRACTIONS-SKELETAL TRACTION 1
17 WRIST & HAND-DEQERVAIN'S RELEASE 1
18 WRIST & HAND-TRIGGER FINGER / THUMB 1
19 ADDUCTOR TENOTOMY 2
20 ELBOW-FRACTURE RADIAL HEAD EXCISION 2
21 ELBOW-UNICONDYLAR FRACTURE FIXATION 2
23 PSOAS TENOTOMY 2
24 SYNOVIAL BIOPSY 2
25 TIBIA-KNEE MANIPULATION 2
26 TRACTIONS- LATERAL PELVIC TRACTION 2
27 WRIST & HAND-CARPAL TUNNEL SYNDROME 2

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28 ACROMINO CLAVICULAR JOINT EXCISION 3
29 ACROMIO CLAVICULAR JOINT FIXN /CORACO CLAVICULAR 3
30 ARTHRODESIS MP JOINT 3
31 ARTHROSCOPY-DIAGNOSTIC ARTHROSCOPY 3
32 BONE GRAFTING ILIAC CREAST ANT / POST 3
33 BONE MARROW INJn FOR NON UNION 3
34 CDH-ARTHROGRAPHY 3
35 ELBOW-FRACTURE OLECRANON SIMPLE 3
36 ELBOW-FRACTURE RADIAL HEAD FIXATION 3
37 FEMUR-FRACTURE PATELLA FIXATION 3
38 FEMUR-REMOVAL OF IMPLANTS 3
39 FOOT / ANKEE-FIXATION OF LATERAL MALLEOLUS 3
40 FOOT / ANKEE-FIXATION OF MEDICAL MALLEOLUS 3
41 FOREARM-EXTERNAL FIXATION OF FOREARM BONES - SINGLE BONE 3
42 FOREARM-FRACTURE SINGLE BONE - NAILING OPEN 3
43 FOREARM-K WIRE FIXATION OF LOWER END RADIUS 3
44 FOREARM-REMOVAL OF PLATES 3
45 FOREARM-SINGLE BONE NAILING CLOSED 3
46 FRACTURE SCAPHOID 3
47 GENERAL-BONE GRAFTING (DONOR SITE) TIBIA 3
48 GENERAL-CEREBRAL PALSY SOFT TISSUE SURGERY 3
49 GENERAL-POLIO SOFT TISSUE SURGERY 3
50 GENERAL-SEQUESTRECTOMY/DEBRIDMENT 3
51 HIP-HIP ARTHROTOMY 3
52 HUMERUS-PERCUTANEOUS WIRE FIXATION OF SUPRA CONDYLAR 3
53 HUMERUS-REMOVAL OF IMPLANTS NAILS 3
54 HUMERUS-REMOVAL OF IMPLANTS PLATES 3
55 KNEE ARTHROTOMY 3
56 NEEDLE BIOPSY VERTEBRAE 3
58 PATELLA -FRACTURE EXCISION 3
59 PROXIMAL HUMRUS CR + K WIRING 3
60 SPINE INSTRUMENTATION > 4 LEVEL - EACH LEVEL 3
61 TIBIA-ARTHROTOMY OF KNEE 3

Page 34 of 112


62 TIBIA-REMOVAL OF IMPLANTS 3
63 TKRCOLAT LIGAMENT BALANCING 3
64 TRACTIONS-SKULL TRACTION 3
65 TROCANTERIC OSTEOTOMY IN THR 3
66 WRIST & HAND-PERCUTANEOUS K WIRE FIXATION OF SMALL BONES 3
67 WRIST & HAND-WRIST SYNOVECTOMY 3
68 ACROMINO PLASTY 4
69 AMPUTATION-BK/ BE/ 4
70 ARTHRODESIS ANKLE 4
71 ARTHRODESIS ELBOW 4
72 ARTHRODESIS FOOT 4
73 ARTHRODESIS WRIST 4
74 ARTHROSCOPY-CHONDROMALACIA PATELLA 4
75 ARTHROSCOPY-DEBRIDEMENT FOR OA 4
76 ARTHROSCOPY-LOOSE BODY REMOVAL 4
77 ARTHROSCOPY-MENISECTOMY-DOUBLE SAME JOINT 4
78 ARTHROSCOPY-MENISECTOMY-SINGLE 4
79 ARTHROSCOPY-PATELLA-LATERAL RELEASE 4
80 ARTHROSCOPY-PLICA RELEASE 4
81 ARTHROSCOPY-PRIMARY ACL REPAIR 4
82 ARTHROSCOPY-SYNOVECTOMY 4
83 ARTHROSCOPY-TIBIAL SPINE AVULSION 4
84 CANCELLOUS SCREEN FIXATION 4
85 ELBOW-FRACTURE OLECRANON COMMINUTED 4
86 EXCISION OF NON MALIGNENT TUMOUR OF BONE 4
87 FACIOTOMY 4
88 FOOT / ANKEE-BIMALLEOLAR FRACTURE FIXATION 4
89 FOOT / ANKEE-FIXATION OF TARSUS (TALUS) 4
90 FOOT / ANKEE-TENDON REPAIR 4
91 FOOT / ANKEE-TENDON TRANSFER 4
92 FOREARM-EXTERNAL FIXATION OF FOREARM BONES BOTH BONE 4
93 FOREARM-EXTERNAL FIXATION OF LOWER END RADIUS 4
94 FOREARM-FRACTURE BOTH BONES NAILING OPEN 4
95 FOREARM-FRACTURE SINGLE BONE PLATING 4

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96 FOREARM-NAILING OF SEGMENTAL FRACTURE CLOSED 4
97 FOREARM-NAILING OF SEGMENTAL FRACTURE OPEN 4
98 FRACTURE CALCANEUM PLATING 4
99 FRACTURE CLAVICLE 4
100 FRACTURE SCAPULA GLENOID 4
101 GENERAL-CTEV CORRECTIVE SURGERY 4
102 GENERAL-POLIO BONY SURGERY 4
103 HIP-EXCISION ARTHROPLASTY 4
104 HIP-FR. PELVIS EXTERNAL FIXATION 4
105 HUMERUS-CLOSED NAILING 4
106
HUMERUS-PERCUTANEOUS WIRE FIXATION OF SUPRA CONDYLAR / INTERCONDYLAR HUMERUS
- ADULT 4
107 HUMERUS-UNIPLANAR EXTERNAL FIXATION OF HUMERUS 4
108 HUMPECTOMY [SCOLIOCIS] RIB HUMP EXCISION 4
109 ILIZAROV-FRESH FRACTURES-TIBIA/HUMERUS/FOREARM-CLOSE-WITHOUT COMMINUTION 4
110 NON UNION SCAPHOID 4
111 SHOULDER-FIXATION OF SURGICAL NECK HUMERUS KWIRE FIXATION 4
112 TIBIA-HIGH TIBIA OSTEOTOMY 4
113 TIBIA-OPEN REPAIR OF LIGAMENT INJURY OF KNEE 4
114 TIBIA-OPEN SYNOVECTOMY OF KNEE 4
115 TIBIA-UNIPLANAR EXTERNAL FIXATION OF TIBIA 4
116 VERTEBROPLASTY EACH LEVEL 4
117 WRIST & HAND-NERVE REPAIR 4
118 WRIST & HAND-TANDON REPAIR 4
119 WRIST & HAND-TENDON TRANSFER 4
120 WRIST & HAND-WRIST ARTHRODESIS 4
121 AMPUTATION AE/ AK 5
122 ARM & FOREARM EXPLORATION 5
123 ARTHRODESIS KNEE 5
124 ARTHROSCOPY-ARTHROLYSIS 5
125 ARTHROSCOPY-INTRAARTICULAR FRACTURE FIXATION 5
126 ARTHROSCOPY-MENISCUS REPAIR 5
127 ARTHROSCOPY-MENISECTOMY BOTH 5
128 CDH-OPEN REDUCTION 5
129 CERVICAL RIB EXCISION 5

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130 DEFORMITIES-ANKLE 5
131 DEFORMITIES-ELBOW 5
132 DEFORMITIES-FOOT 5
133 DEFORMITIES-FOREARM 5
134 DEFORMITIES-HUMERUS 5
135 DEFORMITIES-TIBIA 5
136 DEFORMITIES-WRIST 5
137 EXCISION OF HEAD & NECK OF FEMUR 5
138 FEMUR-CLOSED INTERLOCK NAILING OF FEMUR 5
139 FEMUR-OPEN NAILING OF FEMUR 5
140 FEMUR-PLATING OF FEMUR 5
141 FEMUR-QUADRICEPS PLASTY 5
142 FEMUR-RECURRENT DISLOCATION OF PATELLA 5
143 FEMUR-UNIPLANAR EXTERNAL FIXATOR OF FEMUR 5
144 FOOT / ANKEE-ARTHRODESIS BY INTERNAL FIXATION 5
145 FOOT / ANKEE-PILON FRACTURE FIXATION 5
146 FOREARM-FRACTURE BOTH BONES PLATING 5
147 FOREARM-FRACTURE BOTH BONES NAILING CLOSED 5
148 GENERAL-CEREBRAL PALSY BONNY SURGERY 5
149 HIP-HEMI REPLACEMENT ARTHROPLASTY UNCEMENTED 5
150 HIP-INTERTROCHANTERIC 5
151 HIP-INTERTROCHANTERIC FRACTURE NECK OF FEMUR (OSTEOSYNTHESIS) 5
152 HIP-OSTEOTOMY AROUND HIP 5
153 HUMERUS TUBEROCITY OPEN REDUCTION 5
154 HUMERUS-PLATING OF HUMERUS 5
155 ILIZAROV-FRESH FRACTURES-FEMUR-CLOSE-JOINT INVOLVING 5
156 ILIZAROV-FRESH FRACTURES-FEMUR-CLOSE-SEGMENTAL 5
157 ILIZAROV-FRESH FRACTURES-FEMUR-CLOSE-WITH COMMINUTION 5
158 ILIZAROV-FRESH FRACTURES-FEMUR-CLOSE-WITHOUT COMMINUTION 5
159 ILIZAROV-FRESH FRACTURES-FEMUR-OPEN-COMMINUTION WITH BONELOSS <2CM 5
160 ILIZAROV-FRESH FRACTURES-FEMUR-OPEN-WITHOUT COMMINUTION 5
161 ILIZAROV-FRESH FRACTURES-TIBIA/HUMERUS/FOREARM-CLOSE-JOINT INVOLVING 5
162 ILIZAROV-FRESH FRACTURES-TIBIA/HUMERUS/FOREARM-CLOSE-SEGMENTAL 5
163 ILIZAROV-FRESH FRACTURES-TIBIA/HUMERUS/FOREARM-CLOSE-WITH COMMINUTION 5

Page 37 of 112


164 ILIZAROV-FRESH FRACTURES-TIBIA/HUMERUS/FOREARM-OPEN-WITH COMMINUTION 5
165 ILIZAROV-FRESH FRACTURES-TIBIA/HUMERUS/FOREARM-OPEN-WITHOUT COMMUNUTION 5
166 ILIZAROV-NON-UNIONS-ASEPTIC-FEMUR WITHOUT GAP/DEFORMITY 5
167 ILIZAROV-NON-UNIONS-ASEPTIC-TIBIA/HUMERUS/FOERARM WITH DEFORMITY 5
168 ILIZAROV-NON-UNIONS-ASEPTIC-TIBIA/HUMERUS/FOERARM WITH GAP <3CM 5
169 ILIZAROV-NON-UNIONS-ASEPTIC-TIBIA/HUMERUS/FOERARM WITHOUT GAP/DEFORMITY 5
170 ILIZAROV-NON-UNIONS-SEPTIC-TIBIA/HUMERUS/FOREARM WITH GAP <3CM 5
171 ILIZAROV-NON-UNIONS-SEPTIC-TIBIA/HUMERUS/FOREARM WITHOUT GAP/DEFORMITY 5
172 KYPHOPLASTY EACH LEVEL 5
173 LENGTHENING-FEMUR <5CM 5
174 LENGTHENING-TIBIA/HUMERUS FOREARM <5CM 5
175 LENGTHENING-TIBIA/HUMERUS FOREARM 5-10CM 5
176 NON- UNION LONG BONES REFRESHENING & PUTTING OF BONE GRAFTS 5
177 OSTEOTOMIES AROUND HIP WITHOUT LENGTHENING 5
178 PATELLAR RESURFACING 5
179 SHOULDER AMPUTATION 5
180 SHOULDER-FIXATION OF SURGICAL NECK HUMERUS PLATING 5
181 SHOULDER-FRACTURE DISLOCATION & SHOULDER FIXATION 5
182 SHOULDER-RECURRENT DISLOCATION OF SHOULDER 5
183 SHOULDER-SPRENGEL SHOULDER 5
184 SPINE-REMOVAL OF IMPLANTS 5
185 THR/TKR IMPACTION BONE GRAFTING 5
186 TIBIA-CLOSED NAILING OF TIBIA 5
187 TIBIA-PLATING OF TIBIA 5
188 TILL AUX FRACTURE 5
189 TRANS FOREMEN NERVE ROOT BLOCK 5
190 TRANSFORAMINAL BLOCK / INTRADISCAL INJECTION / FACET BLOCK DISCOGRAPHY 5
191 AMPUTATION SHOULDER/ HIP DISARTICULATION 6
192 BUERGER'S DISEASE 6
193 CDH-OPEN REDUCTION & OSTEOTOMY 6
194 DEFORMITIES-FEMUR 6
195 DEFORMITIES-KNEE 6
196 FEMUR-FIXATION IN COMMINUTED LOWER END FEMUR FRACTURES 6
197 FEMUR-INTERCONDYLAR FRACTURE FEMUR 6

Page 38 of 112


198 FEMUR-SEGMENTAL FRACTURE FEMUR 6
199 FRACTURE ACETABULUM/ PELVIC ANT FIXn 6
200 HIP-COMMINUTED SUBTROCHANTERIC FRACTURE / UPPER THIRD FRACTURE 6
201 HIP-EXCISION ANGULATION 6
202 HIP-FR. PELVIS POSTERIOR FIXATION 6
203 HUMERUS- SEGMENTAL FRACTURES 6
204 HUMERUS-PLATING OF SUPRA / INTERCONDYLAR FR. HUMERUS 6
205 ILIZAROV-FRESH FRACTURES-FEMUR-OPEN-COMMINUTION WITH BONELOSS 2-5CM 6
206 ILIZAROV-FRESH FRACTURES-FEMUR-OPEN-WITH COMMINUTION 6
207 ILIZAROV-NON-UNIONS-ASEPTIC-FEMUR WITH DEFORMITY 6
208 ILIZAROV-NON-UNIONS-ASEPTIC-FEMUR WITH GAP <3CM 6
209 ILIZAROV-NON-UNIONS-SEPTIC-FEMUR WITH GAP <3CM 6
210 ILIZAROV-NON-UNIONS-SEPTIC-FEMUR WITHOUT GAP/DEFORMITY 6
211 INFECTED REVISION THR/TKR DEBRIDEMENT AND SPACER 6
212 LENGTHENING-FEMUR 5-10CM 6
213 LENGTHENING-TIBIA/HUMERUS FOREARM >10CM 6
214 OSTEOTOMIES AROUND HIP WITH LENGTHENING 6
215 SHOULDER-HEMIARTHROPLASTY 6
216 SHOULDER-SHOULDER ARTHRODESIS 6
217 TIBIA-INTER CONDYLAR FRACTURE 6
218 TIBIA-SEGMENTAL TIBIA FRACTURE FIXATION 6
219 ANTERIOR APPROACH TO CERVICAL / THORACIC / LUMBER SPINE 7
220 ARTHROSCOPY-ACL RECONSTRUCTION 7
221 ARTHROSCOPY-MOSAICPLASTY 7
222 ARTHROSCOPY-PCL REPAIR/RECONSTRUCTION 7
223 ARTHROSCOPY-PCL/ACL+MCL/LCL 7
224 ARTHROSCOPY-REVISION ACL RECONSTRUCTION 7
225 BIPOLAR HIP ARTHROPLASTY CEMENTED 7
226 ENDOSCOPIC SPINE SURGERY SINGLE LEVEL 7
227 HIP-FRACTURE ACETABULUM FIXATION 7
228 ILIZAROV-FRESH FRACTURES-FEMUR-OPEN-COMMINUTION WITH BONELOSS 5-10CM 7
229 ILIZAROV-NON-UNIONS-ASEPTIC-FEMUR WITH GAP 3-6CM 7
230 ILIZAROV-NON-UNIONS-ASEPTIC-TIBIA/HUMERUS/FOERARM WITH GAP >10CM 7
231 ILIZAROV-NON-UNIONS-ASEPTIC-TIBIA/HUMERUS/FOERARM WITH GAP 3-6CM 7

Page 39 of 112


232 ILIZAROV-NON-UNIONS-SEPTIC-TIBIA/HUMERUS/FOREARM WITH DEFORMITY 7
233 ILIZAROV-NON-UNIONS-SEPTIC-TIBIA/HUMERUS/FOREARM WITH GAP 3-6CM 7
234 KYPHOSIS CORRECTION EACH LEVEL CORRECTION OSTEOTOMY 7
235 MAJOR BONE TUMOR SURGERY 7
236 SPINE-ANTERIOR DECOMPRESSION OF SPINE 7
237 SPINE-ANTEROLATERAL DECOMPRESSION 7
238 SPINE-FORAMINOTOMY 7
239 SPINE-LAMINECTOMY UPTO 3 LEVEL 7
240 SPINE-RECESS DECOMPRESSION / DISC EXCISION 7
241 SPINE-SPINE INSTRUMENTATION STABILISATION 4 LEVELS 7
242 SPINE-SPINE FUSION 7
243 ARTHROSCOPYACL+PCL+MCL/LCL/PLC 8
244 ILIZAROV-FRESH FRACTURES-FEMUR-OPEN-COMMINUTION WITH BONELOSS >10CM 8
245 ILIZAROV-FRESH FRACTURES-TIBA/HUMERUS/FOREARM/-OPEN-WITH NV DEFICIT 8
246 ILIZAROV-NON-UNIONS-SEPTIC-FEMUR WITH DEFORMITY 8
247 ILIZAROV-NON-UNIONS-SEPTIC-FEMUR WITH GAP 3-6CM 8
248 ILIZAROV-NON-UNIONS-SEPTIC-FEMUR WITH GAP 6-10CM 8
249 ILIZAROV-NON-UNIONS-SEPTIC-TIBIA/HUMERUS/FOREARM WITH GAP 6-10CM 8
250 LENGTHENING-FEMUR >10CM 8
251 REVISION SPINE EACH LEVEL 8
252 SPINE - SURFRECTION OSTEOTOMY EACH LEVEL 8
253 CERVICAL DISC REPLACEMENT 9
254 ELBOW-TOTAL ELBOW REPLACEMENT 9
255 HIP-TOTAL HIP REPLACEMENT 9
256 ILIZAROV-FRESH FRACTURES-FEMUR-OPEN-COMMINUTION WITH NV DEFICIT 9
257 ILIZAROV-NON-UNIONS-ASEPTIC-FEMUR WITH GAP >10CM 9
258 ILIZAROV-NON-UNIONS-SEPTIC-FEMUR WITH GAP >10CM 9
259 ILIZAROV-NON-UNIONS-SEPTIC-TIBIA/HUMERUS/FOREARM WITH GAP >10CM 9
260 LUMBER DISC REPLACEMENT 9
261 SHOULDER-SHOULDER REPLACEMENT TOTAL 9
262 TIBIA-TOTAL KNEE REPLACEMENT 9
263 UNICONDYLAR KNEE REPLACEMENT 9
264 RESURFACE ARTHROPLASTY 10
265 REVISION THR 10

Page 40 of 112


266 REVISION TKR 10

OPERATION CHARGES: OBSTERICS & GYNAECOLOGY

1. CAUTERY OF CERVIX, ELECTRO OR THERMAL 0
2. DIAPHRAGM OR CERVICAL CAP FITTING WITH INSTRUCTIONS. 0
3. FITTING AND INSERTION OF PESSARY OR OTHER INTRAVAGIANL SUPPORT DEVICE 0
4.
INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONTANEOUS OR
TRAUMATIC NONOBSTETRICAL VAGINA HEMORRHAGE
0
5.
IRRIGATION OF VAGINA AND/OR APPLICATON OF MEDICAMENT FOR TREATMENT OF
BACTRIAL, PARASITIC OR FUNGOID DISEASE.
0
6. REMOVAL OF CERCLAGE SUTURE UNDER ANESHTESIA (OTHER THAN LOCAL) 0
7. ARTIFICIAL INSEMINATION INTRA-CERVICAL 1
8. BIOPSY OF VAGINAL MUCOSA, SIMPLE 1
9. BIOPSY OF VULVA OR PERINEUM ONE LESION 1
10. BIOPSY OF VULVA OR PERINEUM ;EACH SEPARATE ADDITIONAL LESION 1
11.
DESTRUCTION OF LESION(S), VULVA; SIMPLE (EG, LASER SURGERY,
ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)
1
12.
DESTRUCTION OF VAGINAL LESION(S), SIMPLE (EG, LASER SURGERY,
ELECTROSURGEY, CRYOSURGERY, CHEMOSURGERY)
1
13. DILATION AND CURETTAGE OF CERVICAL STUMP 1
14. DILATION OF CERVICAL CANAL, INSTRUMENTAL 1
15. FETAL CONTRACTION STRESS TEST 1
16. FETAL NON-STRESS TEST 1
17. HYMENOTOMY, SIMPLE INCISION 1
18. INCISION AND DRAINAGE OF BARTHOLIN'S GLAND ABSCESS 1
19. INCISION AND DRAINAGE OF VULVA OR PERINEAL ABSCESS 1
20. INSERTION OF CERVICAL DILATOR (EG, LAMINARIA, PROSTAGLANDIN) 1
21. INSERTION OF INTRAUTERINE DEVICE (IUD) 1
22. MARSUPIALIZATION OF BARTHOLIN'S GLAND CYST 1
23. MARSUPIALIZATION OF BARTHOLIN'S GLAND CYST LYSIS OF LABIAL ADHESIONS 1
24. PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING 1
25. PELVIC EXAMINATION UNDER ANESTHESIA 1
26. REMOVAL OF INTRAUTERINE DEVICE (IUD) 1
27.
BIOPSY, SINGLE OR MULTIPE, OR LOCAL EXCISION OF LESION WITH OR WITHOUT
FULGURATION
2

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28.
CATHETERIZATION AND INTRODUCTION OF SALINE OR CONTRAST MATERIAL FOR
SALINE INFUSION SONOHYTERO- GRAPHY OR HYSTEROSALPINGOGRAPHY
2
29. CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL 2
30. CHROMOTUBATION OF OVIDUCT, INCLUDING MATERIAL 2
31. COLPOTOMY WITH EXPLORATION 2
32. COLPOTOMY WITH EXPLORATION 2
33. DILATION OF VAGINA UNDER ANESTHESIA 2


34. ENDOCERVICAL CURETTAGE ( NOT DONE AS PART OF DILATION AND CURETTAGE) 2
35. EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING PHYSICIAN 2
36. EXCISION OF BARTHOLIN'S GLAND OR CYST 2
37.
FETAL MONITORING DURING LABOR BY CONSULTING PHYSICIAN (I.e. NON-
ATTENDING PHYSICIAN) INTERPRETATION ONLY
2
38. INCISION AND DRAINAGE OF VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM 2
39. POSTPARTUM CARE ONLY 2
40. REMOVAL OF IMPACTED VAGINAL FOREIGN BODY UNDER ANAESTHESIA. 2
41. AMNIOCENTESIS; DIAGNOSTIC 3
42. ANTEPARTUM CARE ONLY; 4-6 VISITS 3
43.
CHORIONIC VILLUS SAMPLING, ANY METHOD (FOR RADIOLOGICAL SUPERVISION AND
INTERPRETATION )
3
44. COLPOTOMY WITH EXPLORATION WITH DRAINAGE OF PELVIC ABSCESS 3
45.
CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION WITH OR WITHOUT
DILATION AND CURETTAGE WITH OR WITHOUT REPAIR ;COLD KNIFE OF LASER
3
46. CORDOCENTESIS (INTRAUTERINE), ANY METHOD 3
47. CURETTAGE, POSTPARTUM 3
48. DELIVERY OF PLACENTA 3
49. DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL) 3
50.
ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERVICAL SAMPLING
(BIOPSY), WITHOUT CERVICAL DILATION ANY METHOD
3
51. EXTERNAL CEPHALIC VERSION, WITH OR WITHOUT TOCOLYSIS 3
52.
FETAL MONITORING DURING LABOR BY CONSULTING PHYSICIAN (I.e. NON-
ATTENDING PHYSICIAN) WITH WRITTEN REPORT; SUPERVISION AND INTERPRETATION
3
53. FETAL SCALP BLOOD SAMPLING 3
54.
INCISION AND DRAINAGE OF VAGINAL HEMATOMA NON-OBSTETRICAL (EG, POST-
TRAUMA, SPONTANEOUS BLEEDING)
3
55. INDUCED ABORTION, BY DILATION AND CURETTAGE 3
56. INDUCED ABORTION, BY DILATION AND EVACUATION 3
57.
INDUCED ABORTION, BY ONE OR MORE INTRA-AMNIOTIC INJECTIONS), INCLUDING
HOSPITAL ADMISSION AND VISITS, DELIVERY OF FETUS AND SECONDARIES;
3

Page 42 of 112
58.
HOSPITAL ADMISSION AND VISITS, DELIVERY OF FETUS AND SECONDARIES; WITH
DILATION AND CURETTAGE AND/OR EVACUATION
3
59.
INDUCED ABORTION, BY ONE OR MORE VAGINAL SUPPOSITORIES (EG,
PROSTAGLANDIN) WITH DILATION AND CURETTAGE AND/OR EVACUATION
3
60.
LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL OR VAGINAL
APPROACH, POSTPARTUM, UNILATERAL OR BILATERAL, DURING SAME
HOSPITALIZATION
3
61.
LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL OR VAGINAL
APPROACH, UNILATERAL OR BILATERAL
3


62. LOOP ELECTRODE EXCISION 3
63.
OCCLUSION OF FALLOPIAN TUBE(S) BY DEVICE (EG, BAND, CLIP, FALOPE RING)
VAGINAL OR SUPRAPUBIC APPROACH
3
64. PLASTIC REPAIR OF INTROITUS 3
65. THERAPEUTIC AMNIOTIC FLUID REDUCTION (INCLUDES ULTRASOUND GUIDANCE) 3
66. TRANSABDOMINAL AMNIOINFUSION, INCLUDING ULTRASOUND GUIDANCE 3
67. TREATMENT OF INCOMPLETE ABORTION, ANY TRIMESTER COMPLETED SURGICALLY 3
68. TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER 3
69. UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM MOLE 3
70. VULVECTOMY SIMPLE; PARTIAL 3
71. ANTEPARTUM CARE ONLY; 7 OR MORE VISITS 4
72. CERCLAGE OF UTERINE CERVIX, NONOBSTETRICAL 4
73.
COLPOPERINEORRHAPHY , SUTURE OF INJURY OF VAGINA AND / OR PERINEUM
[NONOBSTETRICAL]
4
74.
COLPOSCOPY OF THE ENTIRE VAGINA, WITH CERVIXIF IF PRESENT , WITH BIOPSY
(S)
4
75. EXCISION OF VAGINAL SEPTUM 4
76. HYSTEROTOMY 4
77.
PROSTAGLANDIN) WITH OR WITHOUT CERVICAL DILATION (EG, LAMINARIA),
INCLUDING HOSPITAL ADMISSION AND VISITS, DELIVERY OF FETUS AND
SECUNDINES;
4
78.
TRANSCERVICAL INTRODUCTION OF FALLOPIAN TUBE CATHETER FOR DIAGNOSIS
AND/OR RE-ESTABLISHI- NG PATENCY (ANY METHOD), WITH OR WITHOUT HYSTERO-
SALPINGOGRAPHY
4
79. VAGINAL DELIVERY (WITH OR WITHOUT EPISIOTOMY, AND/OR FORCEPS) 4
80.
VAGINAL DELIVERY (WITH OR WITHOUT EPISIOTOMY, AND/OR FORCEPS) INCLUDING
POSTPARTUM CARE
4
81.
ANTERIOR COLOPORRHAPHY, REPAIR OR CYSTOCELE WITH OR WITHOUT REPAIR OF
URETHROCELE
5
82. BIOPSY OF OVARY, UNILATERAL OR BILATERAL 5
83. CERCLAGE OF CERVIX, DURING PREGNANCY; ABDOMINAL 5
84. CLITOROPLASTY FOR INTERSEX STATE 5
85. COLPOCLEISIS ( LE FORT TYPE) 5

Page 43 of 112
86. DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL ABDOMINAL APPROACH 5
87. DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL VAGNAL APPROACH 5
88. ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE 5
89.
EXCISION OF CERVICAL STUMP , VAGINAL APPROACH WITH ANTERIOR AND/OR
POSTERIOR REPAIR
5
90. EXCISION OF CERVICAL STUMP, ABDOMINAL APPROACH 5


91. EXCISION OF CERVICAL STUMP, VAGINAL APPROACH 5
92. HYSTEROTOMY, ABDOMINAL (EG, FOR HYDATIDIFORM MOLE, ABORTION) 5
93. HYSTROSCOPY, DIAGNOSTIC, 5
94.
HOSPITAL ADMISSION AND VISITS, DELIVERY OF FETUS AND SECONDARIES; WITH
HYSTEROTOMY
5
95.
PROSTAGLANDIN) WITH HYSTEROTOMY (FAILED MEDICAL EVACUATION)
5
96.
LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPINGOLYSIS,
OVARIOLYSIS)
5
97. LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) 5
98.
MYOMECTOMY EXCISON OF FIBROID TUMOR(S) OF UTERUS 1 TO 4 INTRAMURAL
MYOMA(S) WITH TOTAL WEIGHT OF 250 GRAMS OR LESS AND/OR REMOVA OF SURFACE
MYOMAS VAGINAL APPROACH
5
99.
MYOMECTOMY EXCISON OF FIBROID TUMOR(S) OF UTERUS 1 TO 4 INTRAMURAL
MYOMA(S) WITH TOTAL WEIGHT OF 250 GRAMS OR LESS AND/OR REMOVA OF SURFACE
MYOMAS ABDOMINAL APPROACH
5
100. OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL 5
101.
PARAVAGINAL DEFECT REPAIR (INCLUDING REPAIR OF CYSTOCELE, STRESS URINARY
INCONTINENCE, AND/OR INCOMPLETE VAGINAL PROLAPSE
5
102. PERINEOPLASTY, REPAIR OF PERINEUM 5
103.
PLASTIC OPERATION ON URETHRAL SPHINCTER , VAGINAL APPROACH [EG , KELLY
URETHRAL PLICATION
5
104. PLASTIC REPAIR OF URETHROCELE 5
105.
POSTERIOR COLPORRHAPHY, REPAIR OF RECTOCELE WITH OR WITHOUT
PERINEORRHAPHY.
5
106.
REMOVAL OR REVISION OF SLING FOR STRESS INCONTINENCE (EG, FASCIA OR
SYNTHTIC)
5
107. ROUTINE OBSTETRIC CARE CESAREAN DELIVERY INCLUDING POSTPARTUM CARE 5
108. ROUTINE OBSTETRIC CARE CESAREAN DELIVERY ONLY; 5
109.
ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, CESAREAN DELIVERY, AND
POSTPARTUM CARE
5
110.
ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY (WITH
OR WITHOUT EPISIOTOMY, AND/OR FORCEPS ) AND POSTPARTUM CARE
5

Page 44 of 112
111.
ROUTINE OBSTETRIC CARE VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESAREAN
DELIVERY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS);
5
112.
ROUTINE OBSTETRIC CARE VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESAREAN
DELIVERY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS); INCLUDING
POSTPARTUM CARE
5
113. SALPINGECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR BILATERAL 5


114. SALPINGO-OOPHORECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR BILATERAL 5
115. THRACHELECTOMY(CERVICECTOMY), AMPUTATION OF CERVIX 5
116.
TOTAL ABDOMINAL HYSTERCTOMY (CORPUS AND CERVIX) WITH OR WITHOUT REMOVAL
OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S)
5
117. TREATMENT OF SEPTIC ABORTIO, COMPELETED SURGICALLY 5
118.
UTERINE SUSPENSION, WITH OR WITHOUT SHORTENING OF ROUND LIGAMENTS, WITH
WITHOUT SHORTENING OF SACROUTERINE LIGAMENTS
5
119. VAGINAL HYSTERCTOMY, FOR UTERUS 250 GRAMS OR LESS 5
120. VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL 5
121. WEDGE RESECTION OR BISECTON OF OVARY, UNILATERAL OR BILATERAL 5
122. CLOSURE OF RECTOVAGINAL FISTULA; ABDOMINAL APPROACH 6
123.
CLOSURE OF RECTOVAGINAL FISTULA; TRANSPERINEAL APPROACH, WITH PERINEAL
BODY RECONSTRUCTION, WITH OR WITHOUT LEVATOR PLICATION
6
124. CLOSURE OF RECTOVAGINAL FISTULA; VAGINAL OR TRANSANAL APPROACH 6
125. CLOSURE OF VESICOVAGINAL FISTULA, VAGINAL APPROACH 6
126.
CLOSURE OF VESICOVAGINAL FISTULA, VAGINAL APPROACH (FOR CONCOMITANT
CYSTOSTOMY)
6
127. COLPORRHAPHY, ABDOMINAL APPROACH 6
128. COMBINED ANTEROPOSTERIOR COLPORRHAPHY 6
129. COMBINED ANTEROPOSTERIOR COLPORRHAPHY WITH ENTEROCELE REPAIR 6
130. CONSTRUCTION OF ARTIFICIAL VAGINA, WITH GRAFT 6
131. CONSTRUCTION OF ARTIFICIAL VAGINA, WITHOUT GRAFT 6
132. DRAINAGE OF OVARIAN ABSCESS; ABDOMINAL APPROACH 6
133. DRAINAGE OF OVARIAN ABSCESS; VAGINAL APPRAOCH, OPEN 6
134.
DRAINAGE, OF PELVIC ABSCESS, TRANSVAGINAL OR TRANSRECTAL APPROACH,
PERCUTANEOUS (EG, OVARIAN PERICOLIC)
6
135. EXCISION OF CERVICAL STUMP ABDOMINAL APPROACH, WITH PELVIC FLOOR REPAIR 6
136.
HYSTEROSCOPY, SURGICAL, WITH DIVISION OR RESECTION OF INTRAUTERINE
SEPTUM (ANY METHOD)
6
137.
HYSTEROSCOPY, SURGICAL, WITH ENDOMETRIAL ABLATION (EG, ENDOMETRIAL
RESECTION, ELECTROSURGICAL ABLATION, THERMOABLATIION)
6
138.
HYSTEROSCOPY, SURGICAL, WITH LYSIS OF INTRAUTERINE ADHESIONS (ANY
METHOD)
6
139. HYSTEROSCOPY, SURGICAL, WITH REMOVAL OF LEIOMYOMATA 6
140. HYSTEROSCOPY, SURGICAL, WITH REMOVALOF IMPACTED FOREIGN BODY 6

Page 45 of 112
141.
LAPAROSCOPY SURGICAL WITH VAGINAL HYSTERECTOMY FOR UTERUS 250 GRAMS OR
LESS
6
142.
LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCISION 1 TO 4 INTRAMURAL MYOMAS
WITH TOTAL WEIGHT OF 250 GRAMS OF LESS AND/OR REMOVAL OF SURFACE MYOMAS
6


143.
LAPAROSCOPY, SURGICAL; WITH FULGURATION OF OVIDUCTS (WITH OR WITHOUT
TRANSECTION)
6
144.
LAPAROSCOPY, SURGICAL; WITH FULGURATION OR EXCISION OF LESIONS OF THE
OVARY, PELVIC VISCERA, OR PERITONEAL SURFACE BY ANY METHOD
6
145.
LAPAROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BY DEVICE (EG, BAND,
CLIP, OR FALLOP RING)
6
146.
LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL OR
TOTAL OOPHORECTOMY AND/OR SALPINGECTOMY)
6
147.
MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 5 OR MORE
INTRAMURAL MYOMAS AND/OR INTRAMURAL WITH TOTAL WEIGHT GREATER THAN 250
GMS ABDOMINAL APPROACH
6
148. OOPHORECTOMY, PARTIAL OR TOTAL, UNILATERAL OR BILATERAL 6
149. PEREYRA PROCEDURE, INCLUDING ANTERIOR COLOPO- RRHAPHY 6
150. REPAIR OF ENTEROCELE, ABDOMINAL APPROACH 6
151. REPAIR OR ENTEROCELE, VAGINAL APPROACH 6
152.
ROUTINE OBSTETRIC CARE INCLUDING CESAREAN DELIVERY ONLY, FOLLOWING
ATTEMPTED VAGINAL DELIVERY AFTER PREVIOUS CESAREAN DELIVERY
6
153.
ROUTINE OBSTETRIC CARE INCLUDING CESAREAN DELIVERY ONLY, FOLLOWING
ATTEMPTED VAGINAL DELIVERY AFTER PREVIOUS CESAREAN DELIVERY INCLUDING
POSTPARTUM CARE
6
154. SACROSPINOUS LIGAMENT FIXATION FOR PROLAPSE OF VAGINA 6
155. SLING OPERATION FOR STRESS INCONTINENCE(EG, FASCIA OR SYNTHETHIC) 6
156. SUBTOTAL OR TOTAL HYSTERECTOMY AFTER CESAREAN DELIVERY 6
157.
SUPRACERVICAL ABDOMINAL HYSTEROPEXY, INCLUDING PARTIAL VAGINECTOMY, WITH
PARA-AORTIC AND PELVIC LYMPH NODE SAMPLING, WITH OR WITHOUT REMOVAL OF
TUBES(S), WITH OR WITHOUT REMOVAL OF OVARY(S)
6
158. SURGICAL TREATMENT OF ECTOPIC PREGNANCY; ABDOMINAL PREGNANCY 6
159. SURGICAL TREATMENT OF ECTOPIC PREGNANCY; CERVICAL, WITH EVACUATION 6
160.
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN, REQUIRING
SALPINGECTOMY AND/OR OOPHORECTOMY; ABDOMINAL OR VAGINAL APPROACH
6
161.
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN, WITHOUT
SALPINGECTOMY AND/OR OOPHORECTOMY.
6
162.
SURGICAL TREATMENT OF ECTOPIC PREGNANCY;INTERSTITIAL, UTERINE PREGNANCY
REQUIRING TOTAL HYSTERECTOMY
6
163.
TOTAL ABDOMINAL HYSTERCTOMY (CORPUS AND CERVIX) WITH OR WITHOUT REMOVAL
OF TUBE(S), WITH COLPO-URETHROCYSTOPEXY (EG, MARSHALL- MARCHETTI KRANTZ,
BURCH)
6
164. TRANSVESICAL AND VAGINAL APPROACH (FOR ABDOMINAL APPROACH) 6

Page 46 of 112
165.
VAGINAL HYSTERCTOMY,FOR UTERUS 250 GRAMS OR LESS WITH REMOVAL OF TUBE(S)
, AND/OR OVARY(S)
6


166.
VAGINAL HYSTERCTOMY,FOR UTERUS 250 GRAMS OR LESS WITH REPAIR OF
ENTEROCELE
6
167. VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS 6
168.
VAGINAL HYSTERECTOMY,FOR UTERUS 250 GRAMS OR LESS RADICAL (SCHAUTA TYPE
OPERATION)
6
169.
VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL, WITH REMOVAL OF
PARAVAGINAL TISSUE (RADICAL VAGINECTOMY)
6
170. VULVECTOMY SIMPLE;COMPLETE 6
171.
CLOSURE OF RECTOVAGINAL FISTULA; ABDOMINAL APPROACH, WITH CONCOMITANT
COLOSTOMY
7
172.
EXCISION OF CERVICAL STUMP, VAGINAL APPROACH ,WITH REPAIR OF ENTEROCELE
(FOR INSERTION OF INTRAUTERINE DEVICE)
7
173. FIMBRIOPLASTY 7
174.
FOR OVARIAN, TUBE OR PRIMARY PERITONEAL MALIGNANCY, WITH PARA-AORTIC
AND PELVIC LYMPH NODE BIOPSIES, PERITONEAL WASHINGS, PERITONEAL
BIOPSIES, DIAGPHRAMATIC ASSESSMENTS, WITH OR WITHOUT SALPINGECTOMY(S)
WITH OR WITHOUT OMENTECTOMY
7
175. HYSTEROPLASTY, REPAIR OR UTERINE ANOMALY (STRAUSSMAN TYPE) 7
176. HYSTERORRHAPHY OF RUPTURED UTERUS 7
177. HYSTERORRHAPHY, REPAIR OR RUPTURED UTERUS (NONOBSTETRICAL) 7
178.
HYSTEROSCOPY, SURGICAL, WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR
POLYPECTOMY, WITH OR WITHOUT D & C
7
179.
LAPAROSCOPIC TREATMENT, OF ECTOPIC PREGNANCY; WITH SALPINGECTOMY AND/OR
OOPHORECTOMY
7
180.
LAPAROSCOPIC TREATMENT, OF ECTOPIC PREGNANCY; WITHOUT SALPINGECTOMY
AND/OR OOPHORECTOMY
7
181. LAPAROSCOPY, SURGICAL, COLPOPEXY ( SUSPENSION OF VAGINAL APEX) 7
182.
LAPAROSCOPY, SURGICAL, MYOMECTOMY, 5 OR MORE INTRAMURAL MYOMAS AND/OR
INTRAMURAL MYOMAS WITH TOTAL WEIGHT GREATER THAN 250 GRAMS
7
183.
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTRECTOMY, FOR UTERUS GREATER THAN
250 GRAMS
7
184.
LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTRECTOMY, FOR UTERUS GREATER THAN
250 GRAMS, WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)
7
185. LAPAROSCOPY, SURGICAL; WITH FIMBRIOPLASTY 7
186. LAPAROSCOPY, SURGICAL; WITH SALPINGOSTOMY (SALPINGONEOSTOMY) 7
187.
ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, CESAREAN DELIVERY, AND
POSTPARTUM CARE, FOLLOWING ATTEMPTED VAGINAL DELIVERY AFTER PREVIOUS
CESAREAN DELIVERY
7
188. SALPINGOSTOMY (SALPINGONEOSTOMY) 7

Page 47 of 112
189.
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY
WITH PARTIAL RESECTION OF UTERUS
7
190. TRACHELORRHAPHY, PLASTIC REPAIR OR UTERINE CERVIX, VAGINAL APPROACH 7


191. TRANSPOSITION, OVARY(S) 7
192. TUBOTUBAL ANASTOMOSIS 7
193. TUBOTUBAL IMPLATATION 7
194.
VAGINAL HYSTERCTOMY,FOR UTERUS 250 GRAMS OR LESS WITH COLPO-
URETHROCYSTOPEXY (EG, MARSHALL- KRANTZ TYPE, PEREYRA TYPE WITH OR
WITHOUT ENDOSCOPIC CONTROL
7
195.
VAGINAL HYSTERCTOMY,FOR UTERUS 250 GRAMS OR LESS WITH REMOVAL OF
TUBE(S), AND/OR OVARY(S) WITH REPAIR OF ENTEROCELE
7
196.
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS WITH REMOVAL OF
TUBE(S) , AND/OR OVARY(S)
7
197.
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS WITH REMOVAL OF
TUBE(S) AND/OR OVARY(S) WITH REPAIR OF ENTEROCELE
7
198.
VAGINAL HYSTERECTOMY,FOR UTERUS 250 GRAMS OR LESS WITH TOTAL OR PARTIAL
VAGINECTOMY
7
199.
VAGINAL HYSTERECTOMY,FOR UTERUS GREATER THAN 250 GRAMS WITH REPAIR OF
ENTEROCELE
7
200. VULVECTOMY , RADICAL, PARTIAL 7
201.
VULVECTOMY RADICAL, PARTIAL; WITH UNILATERAL INGUINOFEMORAL
LYMPHADENECTOMY
7
202.
TOTAL ABDOMINAL HYSTERECTOMY , WITH BILATERAL TOTAL PELVIC
LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY), WITH OR
WITHOUT REMOVAL OF TUBE(S) WITH OR WITHOUT REMOAL OF OVARY(S)
8
203.
VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS WITH COLP-
URETHROCYSTOPEXY (MARSHALL-MARCHETTI KRANTZ TYPE, PEREYRA TYPE) WITH OR
WITHOUT ENDOSCOPIC CONTORL
8
204. VAGINECTOMY, COMPLETE REMOVAL OF VAGINAL WALL 8
205.
VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL, WITH REMOVAL OF
PARAVAGINAL TISSUE (RADICAL VAGINECTOMY) WITH BILATERAL TOTAL PELVIC
LYMPHADENECTOMY AND PARA-AORTIC LYMP NODE SAMPLING (BIOPSY)
8
206.
VULVECTOMY RADICAL,PARTIAL; WITH BILATERAL INGUINOFEMORAL
LYMPHADENECTOMY
8
207. VULVECTOMY, RADICAL, COMPLETE 8
208.
VULVECTOMY, RADICAL, COMPLETE WITH UNILATERAL INGUINOFEMORAL
LYMPHADENECTOMY
8
209.
VULVECTOMY, RADICAL, COMPLETE, WITH INGUINOFEMORAL, ILIAC, AND PELVIC
LYMPHADENECTOMY
8
210.
RADICAL TRACHELECTOMY, WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND
PARA-AORTIC LYMPH NODE SAMPLING BIOPSY, WITH OR WITHOUT REMOVAL OF
TUBE(S) WITH OR WITHOUT REMOVAL OF OVARY(S)
9

Page 48 of 112
211.
VULVECTOMY, RADICAL, COMPLETE WITH BILATERAL INGUINOFEMORAL
LYMPHADENECTOMY
9

PROCEDURE CHARGES: E.N.T

1 ANTERIOR NASAL PACKING (EPISTAXIS) 0
2 ANTRAL PUNCTURE AND SINUS WASH (EACH SIDE) 0
3 AUDIOMETRY (PURE TONE) 0
4 BIOPSY FROM ORAL CAVITY / NOSE / EAR (LA) 0
5 CHEMICAL CAUTERY NOSE OR EAR 0
8 ELECTRO CAUTERY / SUBMUCOS NASAL CAUTERY 0
9 F.B. REMOVAL EAR OR NOSE WITHOUT ANAESTHESIA 0
10 FIBRE OPTIC FLEXIBLE NASOPHARYNGO-LARYNGOSCOPY 0
11 MICROSCOPIC EXAMINATION OF EAR 0
12 MYRINGOTOMY (EACH SIDE) 0
13 NASAL AND SINUS ENDOSCOPY 0
14 SUCTION CLEANING / EAR OR NOSE 0
15 WAX REMOVAL 0
16 F.B. REMOVAL FROM NOSE/EAR 1
17 GLAND BIOPSY NECK 1
18 I & D PER TONSILAR / RETROPHARYNEAL ABSCESS 1
19 MYRINGOTOMY WITH VENTILATION TUBE (EXCLUSIVE OF COST OF GROMMET) 1
20 PLANNED TRACHEOSTOMY 1
21 POSTERIOR NASAL PACKING / BALLOON TAMPON 1
22 SEPTAL HAEMATOMA DRAINAGE 1
23 CLOSE REDUCTION - TM JOINT 2
24 EMERGENCY TRACHEOSTOMY / ICU 2
25 EXCISION OF SMALL LESION ORAL CAVITY SMALL TUMOUR SALIVARY CALCULUS 2
26 I & D RETROPHARYNGEAL ABSCESS 2
27 INTRA ORAL EXCISION OF ELONGATED STYLOID 2
28 NASAL BONE FRACTURE REDUCTION 2
29 ABSCESS TONSILLECTOMY 3
30 DIAGNOSTIC RIGID OESOPHAGOSCOPY 3
31 EXCISION MULTIPLE LYMPH NECK NODE ENBLOC (TB LYMPHNODE) 3
32 SEPTOPLASTY (LIMITED) 3
33 TONSIL-ADENOID RESECTION (TAR) 3
34 EMERGENCY BRONCHOSCOPY FOR F.B. REMOVAL 4

Page 49 of 112
35 ENDOSCOPIC DAERYOCYSTORHINOSTOMY 4
36 ENDOSCOPIC SINUS SURGERY (ANTERIOR DISEASE ONLY) 4

PROCEDURE CHARGES: E.N.T

37 ENDOSCOPIC SINUS SURGERY (EXTENSIVE) FEES 4
38 EXCISION OF STYLOID (EXT. APPROACH) 4
39 MICROLARYNGEAL SURGERY (MLS) 4
40 MYRINGOPLASTY 4
41 OESOPHAGOSCOPY FOR F.B. REMOVAL 4
42 PARTIAL MAXILLECTOMY 4
43 SEPTOPLASTY (EXTENDED) 4
44 SEPTORHINOPLASTY PARTIAL 4
45 SUBMANDIBULAR GLAND EXCISION 4
46 FACIAL NERVE DECOMPRESSION 5
47 FUNCTIONAL / MODIFIED NECK DESSECTION 5
48 LATERAL RHONOTOMY FOR BENIGN TUMOUR EXCISION 5
49 SELECTIVE NECK DISSECTION 5
50 STAPEDECTOMY 5
51 THYROIDECTOMY HEMITHYROIDECTOMY 5
52 TYMPANOPLASTY WITH MASTOIDECTOMY 5
53 UVULOPALATO PHARYNGO PLASTY (UPPD) FOR SNORING 5
54 ENDOSCOPIC MAXILLECTOMY FOR INVASIVE FUNGAL SINUSITIES OR INV. PAPPILLOMA 6
55 EXCISION OF NASO-PHARINGES ANGIOFIBROMA - TYPE I&II 6
56 EXCISION OF NPA - TYPE III & IV 6
57 EXTENDED MAXILLECTOMY 6
58 MEDIALISATION THYROPLASTY 6
59 PAROTIDECTOMY SUPERFICIAL 6
60 RADICAL NECK DISSECTION (RND) 6
61 SEPTORHINOPLASTY FULL 6
62 THYROIDECTOMY SUBTOTAL / TOTAL 6
63 TOTAL LARYNGECTOMY 6
64 TOTAL LARYNGECTOMY WITH R.N.D. 6
65 COMPOSITE RESECTION FOR CANCER ORAL CAVITY 7
66 ENDOSCOPIC REPAIR OF CSF RHINOUHOEA 7
67 PARA PHARYNGEAL EXCISION MANDIBULECTOMY 7
68 PAROTIDECTOMY TOTAL 7
69 SPHENOIDECTOMY & TRANS SPHENOID PROCEDURE 7
70 TOTAL MAXILLECTOMY 7

Page 50 of 112

FOOTNOTES:
Drugs Disposable material Consumables etc will be charged as per
actual.
20% Backup charges (Trays Instruments etc) shall be levied on above
charges.
The fee for the procedures done on EMERGENCY call shall be 25% more
than the above Routine fees.

OPERATION CHARGES: OPTHALMIC SURGERY

1. ABSCESS 0

Page 51 of 112
2. CORNEAL FOREIGN BODY REMOVAL 0
3. FLOUROSCEIN STAINING 0
4. INJECTION : INTRA-VITREAL 0
5. INJECTION : PECIBULBAE 0
6. INJECTION : SUBCONJUNCTIVAL 0
7. SUPERFICIAL (INVOLVING CORNEAL SCLERA) 0
8. WARTS 0
9. CAPSULOTOMY 1
10. CHALAZION 1
11. CONJUNCTIVAL CYST 1
12. CRYOPEXY 1
13. EYE BURNS MANAGEMENT SUPERFICIAL (INVOLVING CORNEAL SCLERA) 1
14. DEBRIDENT OF CORNEA/SCLERA DEPOSITS 2
15. EYE BURNS MANAGEMENT - DEEP (IRIS/ACHAMBER ADHENSION) 2
16. LID TEAR : PARTIAL THICKNESS 2
17. PROBING 2
18. PTERYGIUM (WITHOUT GRAFT) 2
19. MULTIPLE 2
20. LID TEAR : FULL THICKNESS 3
21. CORNEO SCLERAL PERFORATION 4
22. CONVENTIONAL ECCE 4
23. ECTROPION 4
24. ENTROPION 4
25. INTRA OCCULAR FOREIGN BODY REMOVAL 4
26. PTOSIS 4
27. ROUTINE CATARACT 4
28. DCR 5
29. ENUCLEATION 5
30. EVISCERATION 5
31. GLAUCOMA 5
32. KERATOPLASTY 5
33. ORBITOTOMY ANTERIOR 5
34. ORBITOTOMY LATERAL 5
35. SQUINT 5
36. IOF + IOL 6

OPERATION CHARGES: OPTHALMIC SURGERY

37. RETINAL DETACHMENT 6
38. VITRECTOMY 6

Page 52 of 112
39. IOF + IOL + VITRECTOMY 7
40. PHACO EMULSIFICATION + IMPLANTATION PMMA 7
41. COMBINED AGS WITH PHACO 8
42. PHACO EMULSIFICATION + IMPLANTATION FOLDABLE 8

Foot Note:
Charges of any surgery done in emergencies will be 25% more than
routine charges.
Charges of difficult & high risk surgery will be 25% more than routine
charges.
Any operative procedure not mentioned in this list will be charged
according to policies of hospital management.
Any material / implant used during surgery will be charged extra.
Any specialized instruments will be charged extra.

PACKAGES OF PHACO FOLDABLE LENS

PARTICULARS
GENERAL
WARD
SPECIAL
NON-AC
SEMI-
SPECIAL
NON-AC
SPECIAL
A/C
SEMI-
SPECIAL
A/C
SUITE
PACKAGE AMOUNT
(RS.)
23,000

28,000 28,000 34,000 34,000 41,000

PACKAGES INCLUDE:
Surgeon charges, operation theater charges, anesthesia charges.
Scan charges.
Nnursing care charges.

PACKAGES EXCLUDE:
Room rent, consultant visits, pharmacy & consumables, implant,
material, lens charges.
Ward facilities including oxygen charges, ventialtor charges, other
bio-medical charges, etc. will charged as per actual.
Special instrument charges.

Note:

In case of emergency / high risk case the hospital will charge extra as
per policy of hospital.

PAEDIATRIC SURGERY
1. ANAL DILATATION 2
2. CIRCUMCISION 2
3. CYSTOSTOSCOPY 2
4. EXCISION OF BCG ADENITIS 2
5. EXTERNAL ANGULAR DERMOID CYST 2
6. INJECTION SCLEROSIS FOR HEMANGIOMA 2
7. LYMPHNODE BIOPSY 2
8. MEATOTOMY / MEATOPLASTY 2
9. PERITONEAL TAP 2
10. RECTAL POLYP 2

Page 53 of 112
11. REPAIR OF URETHROCUTANEOUS FISTULA 2
12. SIGMOIDOSCOPY 2
13. SUPRAPUBIC CYSTOSTOMY 2
14. SYNICHIAE SEPARATION 2
15. TONGUE TIE 2
16. UMBILICAL POLYP 2
17. VENTRICULAR TAP 2
18. CYSTOLITHOTOMY 3
19. CYSTOSCOPIC FULGURATION OF P U VALVE 3
20. HYDROCELE 3
21. INGUNIAL HERNIA REPAIR 3
22. ANEPLASTY 4
23. ANORECTAL MYECTOMIES 4
24. CHANGE OF VENTRICULAR OR PERITONEAL END FOR VP SHUNT 4
25. CHORDEE CORRECTION 4
26. COLOSTOMY CLOSURES 4
27. DIAGNOSTIC LAPROSCOPY 4
28. DISTAL PENILE HYPOSPADIAS REPAIR 4
29. EMERGENCY APPENDICECTOMY 4
30. ESOPHAGO GASTROSCOPY FOR Fb REMOVAL 4
31. EXCISION OVARION & TESTICULAR MALIGNANCIES 4
32. FULLTHICKNESS RECTAL BIOPSY 4
33. GASTROSTOMY IN NEWBORN 4
34. HAEMANGIOMA EXCISION 4
35. ICD INSERTION IN EMERGENCY 4
36. INGUINAL EXPLORATION IN TORSION TESTIS 4
37. INTUSUSCEPTION 4
38. MEEKELS DIVERTICULECTOMY 4
39. MESENTERIC LYMPHNODE BIOPSY 4
40. NON NEONATAL COLOSTOMY 4
41. ORCHIDOPEXY 4
42. OVARIAN CYST REMOVAL 4
43. RAMSTEDS PYLOROMYOTOMY 4
44. REPAIR OF PENILE TORSION 4
45. SURGERY FOR RECTAL PROLAPSE 4
46. TRACHEOSTOMY 4
47. UMBILICAL HERNIA REPAIR 4
48. VESICOSTOMY 4

PAEDIATRIC SURGERY

49. BRANCHIAL CYST EXCISION 5
50. BRONCHOSCOPY FOR FOREIGNBODY REMOVAL 5
51. EXCISION OF CYSTIC HYGROMA 5
52. RHABDOMYOSARCOMA WIDE EXCISION 5
53. SACROCOCCYGEALTERATOMA EXCISION 5
54. SINGLE STAGE HYPOSPADIA REPAIR 5
55. THYROGLOSSAL CYST SISTRUNKS OPERATION 5
56. ANDERSON HAYENS PYELOPLASTY 6
57. CARNIOTOMY FOR CARNIAL HEMATOMAS 6
58. CHOLECYSTECTOMY 6
59. CLITOROPLASTY 6
60. DECORTICATION 6

Page 54 of 112
61. DEPRESSED # SKULL ELEVATION / DUROPLASTY 6
62. DUHAMELS PULLTHRU 6
63. ENCEPHALOCELE REPAIR 6
64. EXCISION OF ABD CYST 6
65. EXOMPHALOS MAJOR 6
66. FULGURATION OF POSTERIOR URETHRAL VALVES 6
67. LAPROTOMY FOR NEONATAL INTESTINAL OBSTRUCTION 6
68. LIPOMENINGOCELE REPAIR 6
69. MENINGOMYELOCELE REPAIR 6
70. MIDPENILE & PROXIMAL PENILE HYPOSPADIAS REPAIR SINGLE STAGE 6
71. NEONATAL COLOSTOMY 6
72. NEPHRECTOMY 6
73. NEPHROLITHOTOMY 6
74. NISSENS FUNDOPLICATION 6
75. PYELOSTOMIES 6
76. SPLENECTOMY 6
77. STEPHEN FOWLER ORCHIOPEXY 6
78. URETERIC REIMPLANTATION 6
79. URETEROSTOMIES 6
80. V.P. SHUNT 6
81. VAGINOPLASTY 6
82. LOBECTOMY 7
83. REPAIR OF DIAPRAGHMATIC HERNIA 7
84. BLADDER AUGMENTATION 8
85. BLADDER NECK RECONSTRUCTION FOR INCONTINENCE 8
86. EPISPADIAS REPAIR 8
87. ESOPHAGEAL REPLACEMENT 8
88. EXCISION OF CHOLEDOCHAL CYST 8
89. EXCISION OF MEDIASTINAL MASS/CYST 8
90. EXCISION OF NEUROBLASTOMA 8
91. EXSTROPHY REPAIR 8
92. HEPATIC RESECTION FOR HEPATOBLASTOMA 8
93. KASAIS PORTOENTEROSTOMY FOR BILIARY ATRESIA 8
94. LADDS PROCEDURE FOR MALROTATION 8
95. MALONES ACE PROCEDURE 8
96. MARTINS PULLTHRU FOR TOTAL COLONONIC AGANGLIONOSIS 8
97. MITROFINOFFS PROCEDURE FOR NEUROGENIC BLADDER 8
98. NEPHRECTOMY FOR WILMS 8

PAEDIATRIC SURGERY

99. PENAS PSARP 8
100. REPAIR FOR DUODENAL ATRESIA 8
101. SEIGURAS DEVASCULARISATION 8
102. TOTAL COLECTOMY 8
103. VAGINAL RECONSTRUCTION FOR VAGINAL ATRESIA 8

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LAPROSCOPIC / THOROCOSCOPIC / ENDOSCOPIC SURGERY

A D R E N A L G L A N D 7
1. ADRENAL TUMOR (UNILATERAL) 8
A N A L C A N A L / R E C T U M
2. PROLAPSE RECTUM 7
A N A S T O M O S I S
3. ILEORECTAL ANASTOMOSIS 7
4. LOW COLO RECTAL ANASTOMOSIS 7
5. BY PASS PROCEDURE ANY TYPE 7
6. ILEO ANAL ANASTOMOSIS WITH / WITHOUT POUCH 7
7. COLO COLIC ANASTOMOSIS 7
8. HIGH COLO RECTAL ANASTOMOSIS 7
A P P E N D I X
9. INTERVAL APPENDICECTOMY 5
10.
APPENDICECTOMY FOR PERFORATED / GANGRENOUS APPENDIX WITH GENERALISED
PERITONITIS / ABSCESS
6
11. APPENDICECTOMY FOR ACUTE APPENDICITIS 6
12. APPENDICECTOMY FOR APPENDICITIS WITH LOCALISED PERITONITIS 6
B L A D D E R
13. PCVL (VESICOLITHOTOMY) 5
14. CYSTOLITHOTRITY FOR SMALL BLADDER STONE (< 2 CM) 5
15. OPTICAL URETHROTOMY (SECOND SITTING) 5
16. TUR BT (< 2 CMS) 6
17. CYSTOLITHOTRITY FOR MULTIPLE BLADDER STONES / LARGE STONE (> 2 CMS) 6
18. LAPAROSCOPIC RADICAL CYSTECTOMY 8
19. BLADDER DIVERTICULECTOMY 8
20. PARTIAL CYSTECTOMY 8

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G A L L B L A D D E R
21. LAPROSCOPIC CHOLECYSTECTOMY / CHOLECYSTOSTOMY 5
22. CHOLECYSTO JEJUNOSTOMY 7
23. CHOLEDOCHO DUODENOSTOMY 7
24. CHOLEDOCHO JEJUNOSTOMY 7
25. CBD REPAIR 7
26. CHOLESYSTECTOMY WITH CBD EXPLORATION 7
27. TRANSDUODENAL SPHINCTEROTOMY / PLASTY 7
28.
CHOLESYSTECTOMY ACUTE / EMPYEMA / GANGRENE / PERI CHOLECYSTIC
ABSCESS
7
G A L L B L A D D E R / B I L E D U C T
29. CHOLANGIO CARCINOMA EXCISION WITH ANASTOMOSIS 8
30. CHOLEDOCHAL CYST EXCISION + ANASTOMOSIS 8
31. HEPATICOJEJUNOSTOMY 8
32. CBD EXPLORATION WITH T TUBE DRAINAGE 8
G Y N A E C
33. LAPROSCOPIC PCOD DRILLING 5
34. LAPROSCOPY FOR OVARIAN CYST 5
35. LAPROSCOPY FOR SIMPLE ADHESIONOLYSIS 5
36. OPERATIVE HYSTEROSCOPY 6
37. TOTAL LAPAROSCOPIC HYSTERECTOMY 7
38. L A V H 7
39. LAPAROSCOPIC MYOMECTOMY 7


G Y N A E C
40. LAPAROSCOPIC ECTOPIC PREGNANCY 7
41. LAPAROSCOPIC Sx FOR SUI 7
42. LAPAROSCOPIC TUBOPLASTY 7
43. WERTHEIM HYSTERECTOMY 8
44. OVARIAN MALIGNANCY 8
45. SURGERY FOR ENDOMETRIAL CANCER 8
H E A D & N E C K
46. RADICAL THYROIDECTOMY 8
47. THYROID / PARA THYROID : RETROSTERNAL GOITRE 8
48. SUB TOTAL THYROIDECTOMY FOR LARGE SIZE GOITRE 8
49. SUB TOTAL THYROIDECTOMY 8
50. PARATHYROIDECTOMY FOR HYPERPLASIA 8
H E R N I A
51. LAPROSCOPIC INGUINAL HERNIA REPAIR UNILATERAL 6
52. LAPROSCOPIC FEMORAL HERNIA REPAIR UNILATERAL 6
53. EPIGASTRIC / UMBILICAL / PARAUMBILICAL HERNIA WITH / WITHOUT MESH REPAIR 6
54. UNCOMPLICATED LUMBER / SUBCOSTAL / HERNIAS 6
55. AVERAGE SIZE INCISIONAL HERNIA WITH MESH REPAIR < 5 CMS DEFECT 6
56. RECURRENT INGUNIAL HERNIA 7
57. OBSTRUCTED FEMORAL HERNIA WITH REPAIR 7
58. COMPLICATED & LARGE HERNIA REPAIR WITHOUT RESECTION OF BOWEL > 5 CMS 7
59. OBSTRUCTED INCISIONAL HERNIA REPAIR WITHOUT RESECTION OF BOWEL 7
60. STRANGULATED HERNIA RESECTION ANASTOMOSIS & REPAIR 8
61. STRANGULATED INCISIONAL HERNIA WITH RESECTION ANASTOMOSIS & REPAIR 8
62. COMPLICATED & LARGE HERNIA WITH RESECTION & ANASTOMOSIS 8
63. OBSTRUCTED INGUINAL HERNIA WITH MESH REPAIR 8
I N T E S T I N A L R E S E C T I O N
64. HARTMANNS OPERATION WITH COLOSTOMY 7

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65. RESECTION ANASTOMOSIS OF SMALL INTESTINE 7
66. INTESTINAL OBSTRUCTION WITH STRUNGULATION 7
I N T E S T I N E S
67. ADHESIONOLYSIS AS AN ADJUNCT TO OTHER PROCEDURE 5
68. STRICUROPLASTY SINGLE 6
69. PERFORATION (SINGLE) CLOSURE 6
70. ADHESIONOLYSIS FOR OBSTRUCTION 6
71. VOLVULUS ANY PROCEDURE WITHOUT RESECTION 6
72. SMALL BOWEL ANASTOMOSIS (ANY TYPE) 6
73. FEEDING JEJUNOSTOMY ONLY 6
74. STRICTUROPLASTY (MULTIPLE) 7
75. HEMICOLECTOMY RIGHT OR LEFT 7
76. SIGMOID COLECTOMY 7
77. MULTIPLE PERFORATION CLOSURE 7
78. INTUSSUSCPTION REDUCTION ONLY 7
79. MALROTATION GUT ANY PROCEDURE WITHOUT RESECTION 7
80. JEJUNO / ILEO COLIC ANASTOMOSIS 7


K I D N E Y
81. LAPAROSCOPIC SIMPLE NEPHRECTOMY 7
82. LAPAROSCOPIC PYELOPLASTY 7
83. LAPAROSCOPIC RENAL CYST DEROOFING 7
84. P C N L (SINGLE TRACT ) PARTIAL STAGHORN 7
85. URETHEROSCOPY MIDDLE 3
rd
7
86. P C N L SINGLE CALCULUS 7
87. P C N L ( DOUBLE TRACT, STAGBORN) COMPLETE 8
88. LAPROSCOPIC RADICAL NEPHRECTOMY 8
89. ENDOPYELOTOMY 8
L I V E R
90. LAPROSCOPIC DRAINAGE ABSCESS 5
91. PORTAL HYPERTENSION - PLANNED SHUNT OPERATION 8
92. PORTAL HYPERTENSION - EMERGENCY DEVASCULARISATION 8
93. HEPATIC RESECTION (LOBECTOMY) 8
94. COMPLICATED INJURIES LIVER & BILIARY TRACT 8
95. LIVER TEAR REPAIR 8
96. HYDATID CYST 8
N E U R O
97. ENDOSCOPIC CSF RHINORRHOEA REPAIR 6
98. KIDNEY 6
99. PYONEPHROSIS DRAINAGE PERCUTANEOUS NEPHROSTOMY 6
100. ENDOSCOPIC SHUNT PLACEMENT 8
O E S O P H A G U S
101. ACHALASIA CARDIA 8
102. OESAPHAGEAL PERFORATION 8
103. HIATUS HERNIA REPAIR 8
104. SURGERY FOR GERD 8
105. OESOPHAGECTOMY FOR LOWER 1/3
rd
CA OESOPHAGUS 9
106. BYPASS FOR OESOPHAGEAL MALIGNANCY 8
107. EXCISION OF BENIGN TUMOUR / LESION OESOPHAGUS 8
P A E D I A T R I C
108. LAPROSCOPIC APPENDICULAR SURGERY 5
109. LAPROSCOPIC PYLOROMYOTOMY 5
110. LAPROSCOPIC L N BIOPSY 6
111. LAPROSCOPIC ORCHIODOPEXY 6
112. LAPROSCOPIC HERNIA REPAIR 6
113. LAPROSCOPIC CHOLANGIOGRAPHY & LIVER BIOPSY 6

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114. LAPROSCOPIC EXCISION OF OVARIAN CYST 6
115. LAPROSCOPIC ADHENOLYSIS 6
116. LAPROSCOPIC V P SHUNT PLACEMENT 6
117. THORACOSCOPIC LUNG PLEURAL BIOPSY 6
118. LAPAROSCOPIC MECKEL DIVERETICULATION 7
119. LAPAROSCOPIC FUNDOPLICATION 8
120. LAPAROSCOPIC PULL THRU 8
121. LAPAROSCOPIC SPLENECTOMY 8
122. THORACOSCOPIC CDH REPAIR 8
123. THORACOSCOPIC DECORTOCATION 8


P A N C R E A S
124. EXTERNAL DRAINAGE PSENDOCYST 6
125. DRAINAGE OF PANCREATIC ABSCESS 7
126. INTERNAL DRAINAGE OF CYST 7
127. TRIPAL BYPASS FOR MALIGNANCY 7
128. WHIPPLES RESECTION 9
129. ACUTE PANCREATITIS - NECROSECTOMY 8
130. CHRONIC PANCREATITS PUESTOW / DISTAL PANCREATCTOMY 8
P E N I S
131. P U VALVEFULGURATION 6
132. OPTICAL URETHROTOMY (FIRST SITTING) 6
133. PELVIC LYMPHADENECTOMY 8
P E R I T O N E U M / M E S E N T A R Y / O M E N T U M
134. SECOND LOOK LAPROSCOPY 5
135. LAPROSCOPY WITH BIOPSY 5
136.
DRAINAGE INTRA PERITONEAL / SUBPHRENIC / PELVIC / RETROPERITONEAL
ABSCESS
6
137. OMENTAL CYST EXCISION 6
138. RETROPERITONEAL TUMOR BIOPSY 6
139. MESENTERIC CYST EXCISION 7
140. DRAINAGE OF PERITONITIS WITH RELATED PROCEDURE 7
141. PRIMARY PERITONITIS 7
142. RETROPERITONEAL TUMOR EXCISION 8
143. RETROPERITONEAL CYST 8
P R O S T A T E
144. TUR P (<30 GM) 5
145. TUR P (30-60 GM) 6
146. RADICAL PROSTATEECTOMY 8
R E S E C T I O N O F I N T E S T I N E S
147. PROCTOCOLECTOMY 8
148. TOTAL COLECTOMY 8
149. ANTERIOR RESECTION (HIGH/ LOW) 8
150. LOWER GI BLEED RESECTION ANY TYPE 8
151. INTESTINAL TRAUMA 8
152. ABDOMINOPERINEAL RESECTION WITH COLOSTOMY 8
153. FECAL FISTULA 8
154. REPAIR RECTO / COLO VAGINAL FISTULA 8
155. REPAIR VESICO VAGINAL FISTULA 8
T E S T I S / S C R O T U M
156. MICROSCOPIC VARICOCOELECTOMY 5
157. ESWL (< 1 CM STONE) WITHOUT STENTING 5
158. ESWL (ANY 2
nd
SITTING) 5
159. VARICOCELE ( UNILATERAL) 5
160. E S W L (1-2 CM STONE) WITHOUT STENTING 6
161. ESWL (1-2 CM STONE) WITH D.J. STENTING 7
162. ESWL ( > 2 CM STONE ) WITH D.J. STENTING 8
S P L E E N
163. SPLENECTOMY FOR LARGE SPLEEN 8
164. SPLENORRAPHY FOR SPLENIC TEAR 8

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165. SPLENECTOMY FOR RUPTURED SPLEEN 8
S T O M A C H
166. GASTROSTOMY 5
S T O M A C H / D U O D E N U M
167. CONGENITAL PYLORIC STENOSIS 6
168. VAGOTOMY TRUNCAL / SELECTIVE 6
169. SUPRA SELECTIVE VAGOTOMY 6
170. PEPTIC PERFORATION 6
171. EXCISION (WEDGE) TUMOR 6
172. GASTRO JEJUNOSTOMY 6
173. PYLOROPLASTY 6
174. VOLVULUS STOMACH (PLANNED) 7
175. TOTAL GASTRECTOMY 8
176. OPERATION FOR BLEEDING ULCER INCLUDING OTHER PROCEDURES 8
177. DUODENAL INJURIES 8
178. EMERGENCY OPERATION FOR VOLVULUS STOMACH 8
179. PROXIMAL PARTIAL GASTRECTOMY 8
180. DISTAL PARTIAL GASTRECTOMY 8
T H O R A C I C
181. EXPLORATORY THORACOSCOPY BASIC PROCEDURE 6
182. THORACOSCOPY WITH BIOPSY 7
183. WEDGE EXCISION LUNG 7
184. RUPTURE DIAPHRAGM 7
185. DECORTICATION OF LUNG 7
186. PNEUMONECTOMY 8
187. LOBECTOMY 8
188. CHEST WALL SARCOMA 8
189. TRANSHIATAL OESOPHAGECTOMY 8
190. TWO / THREE STAGE OESOPHAGECTOMY 8
T H Y R O I D / P A R A T H Y R O I D
191. LOBECTOMY 7
192. HEMITHYROIDECTOMY 7
193. NODULE EXCISION 7
194. PARATHYROID ADENOMA EXCISION 7
U R E T E R
195. URETEROSCOPY (LOWER 3
rd
) 5
196. URETROSCOPY LOWER 3
rd
STONE REMOVAL 6
197. URETRIC REPAIR 6
198. PERCUTANEOUS NEPHROSTOMY 6
199. LAPAROSCOPIC UPPER URETERIC STONE REM. 7
200. URS MIDDLE 3
rd
STONE 7
201. BLADDER 7
202. TUR P > 60 GM 7
203. TUR BT > 2 CM 7
204. LAPAROSCOPIC URETERIC RE IMPLANTATION 8
205. LAPAROSCOPIC ILEAL REPLACEMENT 8
206. URETEROSCOPY UPPER 3
rd
STONE 8
V A S C U L A R
207. LAPAROSCOPIC LUMBER SYMPATHECTOMY 7

OPERATION CHARGES: NEURO SURGERY

1 PERIPHERAL-NERVE BIOPSY 2
2 PERIPHERAL-RELEASE OF MINOR ENTRAPMENT NEUROPATHY 2

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3 SPINE-SKULL TRACTION 3
4 PERIPHERAL-MAJOR ENTRAPMENT NEUROPATHY RELEASE 3
5 SPINE-NEUROTIZATION SINGLE NERVE. 3
6
BRAIN-BURR HOLE/TWIST DRILL HOLE (SINGLE) AND BIOPSY TAPPING / EVACUATION (50%
Extra Each) 4
7 SPINE-LAMINECTOMY FOR EACH 3 ADDITIONAL LEVEL 4
8 SPINE-MICRODISCECTOMY FOR EACH ADDITIONAL LEVEL 4
9
BRAIN-EXCISION/EVACUATION OF SINGLE BRAIN LESION (50% EXTRA FOR EACH ADDITIONAL
LESION). 5
10 VENTRICULOSTOMY / E.V.D. 5
11 BRAIN-ATL WITH AH/CORPUS CALLOSOTOMY/LEISONECTOMY FOR EPILEPSY/ LOBECTOMY 5
12 BRAIN-EXCISION/EVACUATION OF SINGLE BRAIN LESION 5
13 BRAIN-MVD FOR V / VII / IX th CRANIAL NERVE 5
14 BRAIN-V-A/V-P SHUNT 5
15 PERIPHERAL-MAJOR NERVE EXPLORATION AND REPAIR 5
16 SPINE-SINGLE CORPECTOMY AND GRAFT FUSION (50% FOR EACH ADDITIONAL LEVEL) 5
17 SPINE-THECOPERITONEAL SYRINGOPERITONIAL SHUNT 5
18 BRAIN-CRANIOPLASTY / DUROPLASTY 5
19 SPINE-EXCISION OF TUMOR/CYST/ABSCESS 7
20 BRAIN-POSTERIOR FOSSA CRANIOTOMY 7
21 BRAIN-TRANSORAL APPROACH 7
22 BRAIN-TRANSSPHENOIDAL APPROACH 7
23 BRAIN-UNILATERAL CRANIOTOMY 7
24 SPINE-ODONTOID EXCISION 7
25 BRAIN-EXCISION OF INTRAVENTRICULAR/BRAINSTEM LESION 7
26 SPINE-ANTERIOR APPROACH TO SPINE 7
27 SPINE-CV JUNCTION REPAIR 7
28 SPINE-SPINE FIXATION / INSTRUMENTATION 7
29 BRAIN-CLIPPING OF SINGLE INTRACRANIAL ANEURSYSM 7
30 BRAIN-CRANIOSTENOSIS REPAIR 7
31 BRAIN-EXCISION OF INTRACRANIAL AVM 7
32 BRAIN-HEMISPHERECTOMY 7
33 PERIPHERAL-EXPLORATION OF BRACHIAL PLEXUS & REPAIR 7
34 SPINE-LAMINECTOMY UPTO 3 LEVELS 7
35 SPINE-MICRODISCECTOMY (SINGLE LEVEL) 7

OPERATION CHARGES: NEURO SURGERY

36 SPINE-REPAIR OF MENINGOCELE 7
37 SPINE - EXCISION OF EXTRADURAL TUMOR/CYST/ABSCESS TUMOR/CYST/ABSCESS 7
38 SPINE-EXCISION OF SINGLE DISC 7

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39 SPINE - EXCISION OF INTRADURAL EXTRAMEDULLARY TUMOR/CYST/ABSCESS 8
40 SPINE - EXCISION OF INTRAMEDULLARY TUMOR/CYST/ABSCESS 9

OPERATION CHARGES: PLASTIC SURGERY

1 BURNS (+BIOLOGICAL DRESSING) SCRAPPING < 8% BSA 0
2 BURNS DRESSING-MINOR < 5% BSA 0
3 BURNS DRESSING-MEDIUM 5-20% BSA 0
4 BURNS-BIOLOGICAL DRESSING APPLICATION < 5% 0
5 BURNS-BIOLOGICAL DRESSING APPLICATION 5-20% 0
6 BURNS-ESCHAROTOMY PER 100% BSA 0
7 EAR REPAIR (SINGLE) 0
8 FLAPS-SKIN-DIVISION & INSET 0
9 FLAPS-SKIN-DELAY 0

Page 62 of 112
10 TRAUMA - DEGLOVING DEBRIDEMENT - HAND / FOOT 2-5% BSA 0
11 TRAUMA - DEGLOVING DEBRIDEMENT - SCALP PART <2 BSA 0
12 TRAUMA DIGIT FRACTURES STRAPPING 0
13 TRAUMA - LACERATIONS Single 0
14 AESTHETIC SURGERY - DERMABRASION (LASER/BURR) SCARS SMALL 1
15 AESTHETIC SURGERY - FACE - CHEMICAL PEEL (PER SITTING) 1
16 BENIGN SWELLING > 5 CMS 1
17 BENIGN SWELLINGS < 5 CMS 1
18 BURNS (+BIOLOGICAL DRESSING) SCRAPPING 8-20% BSA 1
19 BURNS DRESSING-MAJOR 20%-50% BSA 1
20 BURNS DRESSING > 50% BSA EXTENSIVE 1
21 BURNS-BIOLOGICAL DRESSING APPLICATION 20-50% 1
22 FLAP THINING (DEBULKING) 1
23 FLAP (ADJUSTMENT & INSERT) 1
24 FLAPS-SKIN-LOCAL 1
25 FULL THICKNESS SKIN GRAFTS < 2 CMS 1
26 KELOIDS-EXCISION < 2% BSA 1
27 LEUCODERMA < 1% BSA 1
28 NERVE (Digital) REPAIRS Single 1
29 POST BURN RELEASE FINGER/TOE/EAR MINOR 1
30 SCAR REVISION SMALL (<2cm) 1
31 SPLIT THICKNESS SKIN GRAFTS < 1% BSA 1
32 TRAUMA - SINGLE DIGIT AMPUTATION WITH DIRECT CLOSURE 1
33 TRAUMA - DEGLOVING DEBRIDEMENT - ARM / THIGH 5-10% BSA 1
34 TRAUMA - DEGLOVING DEBRIDEMENT FOREARM / LEG 10-15% BSA 1
35 TRAUMA DIGIT FRACTURES K-WIRE 1
36 TRAUMA - LACERATIONS 2-4 1


37 TRAUMA TENDONS SINGLE 1
38 'Z' PLASTY SINGLE 1
39 BENIGN SWELLING MULTIPLE 2
40 BURNS (+BIOLOGICAL DRESSING) SCRAPPING > 20% - 50% BSA 2
41 BURNS-BIOLOGICAL DRESSING APPLICATION > 50% 2
42 CONGENITAL DEFORMITIES - HYPOSPADIAS - TWO STAGE REPAIR - CHORDEE RELEASE 2
43 CONGENITAL EAR DEFORMITIES EAR-MICROTIA-AUTOPLASTY STAGE I 2
44 CONGENITAL DEFORMITIES SYNDACTYLY - SIMPLE (PER WEB) 2
45 FULL THICKNESS SKIN GRAFTS > 2 5 CMS 2
46 GRAFTS OTHER THAN SKIN GRAFTS CARTILAGE / TENDON / NERVE 2

Page 63 of 112
47 KELOIDS-EXCISION 2-5% BSA 2
48 LEUCODERMA 2-4% BSA 2
49 POST BURN RELEASE WITHOUT COVERAGE-WRIST/HAND/FOOT/EAR COMPLETE 2
50 RHINOPHYMA 2
51 SCAR REVISION MEDIUM (2-5cms) 2
52 SMALL TUMOUR EXCISION OVER FACE WITHOUT RECONSTRUCTION 2
53 SPLIT THICKNESS SKIN GRAFTS < 1-2% BSA 2
54 TRAUMA (2-3) DIGIT AMPUTATION WITH DIRECT CLOSURE 2
55 TRAUMA DIGIT FRACTURES CIRCUMFERRENTIL WIRE 2
56 TRAUMA- DIGIT FRACTURES EXTERNAL FIXATOR 2
57 TRAUMA- FRACTURE - NASAL BONE - CLOSE REDUCTION PACKING SPLINTAGE 2
58 AESTHETIC SURGERY - DERMABRASION (LASER/BURR) SCARS BIG 3
59 AESTHETIC SURGERY FAT REDUCTION SURGERIES (PER AREA) - LIPOSUCTION 3
60 AESTHETIC SURGERY - BALDNESS MICRO GRAFT (Per STRIP < 5 Cms) 3
61 AESTHETIC SURGERY - MALE PATTERN BALDNESS SCALP REDUCTION 3
62 AESTHETIC SURGERY RHINOPLASTY TIP 3
63 BURNS (+BIOLOGICAL DRESSING) SCRAPPING > 50% 3
64 BURNS-TANGENTIAL EXCISION & STSG < 5% 3
65 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - CLEFT LIP - INCOMPLETE 3
66 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - PALATAL FISTULA 3
67 CONGENITAL DEFORMITIES - HYPOSPADIAS ONE STAGE REPAIR GLANULAR 3
68 CONGENITAL EAR DEFORMITIES EAR- MICROTIA-AUTOPLASTY STAGE III 3
69 CONGENITAL EAR DEFORMITIES EAR- PROMINENT EARS (PER SIDE) 3
70 CONGENITAL DEFORMITIES SYNDACTYLY - COMPOUND (PER WEB) 3
71 FLAPS-SKIN REGIONAL 3
72 FULL THICKNESS SKIN GRAFTS 5 - 10 CMS 3


73 GRAFTS OTHER THAN SKIN GRAFTS - CRANIAL BONE GRAFT 3
74 GRAFTS OTHER THAN SKIN GRAFTS ILIAC BONE GRAFT 3
75 HEAD & NECK MANDIBLE EXTERNAL FIXATOR 3
76 KELOIDS-EXCISION 5-10% BSA 3
77 MALIGNANCY SKIN TUMORS 3
78 MISCELLANEOUS BOTOX / RESTYLENE PERLANE (PER INJ.) 3
79 MICROVASCULAR SURGERY - NERVE REPAIR (PER NERVE) 3
80 NERVE (Major) REPAIRS Single 3
81
POST BURN RELEASE WITHOUT COVERAGE-MAJOR KNEES / ANKLE / NECK / SHOULDER /
AXILLA
3
82 SCAR REVISION LARGE (>5cms) 3

Page 64 of 112
83 SMALL TUMOUR EXCISION OVER FACE WITH RECONSTRUCTION 3
84 SPLIT THICKNESS SKIN GRAFTS 2-5% BSA 3
86 TRAUMA (>3) DIGIT OR OTHERS AMPUTATION WITH DIRECT CLOSURE 3
87 TRAUMA DIGIT FRACTURES PLATING 3
88 TRAUMA LACERATIONS > 4-Nos 3
89 TRAUMA FRACTURE MANDIBLE IMF 3
90 TRAUMA FRACTURE MANDIBLE O.R. WITH IO WIRE 3
91 TRAUMA- FRACTURAE - MAXILLA - FRONTOMAXILLARY SUSPENSION 3
92 TRAUMA- FRACTURE ZYGOMA CLOSE REDUCTION 3
93 TRAUMA TENDONS MULTIPLE <2 3
94 'W' PLASTY LARGE (<5 Cm) 3
95 'Z' PLASTY MULTIPLE 3
96 AESTHETIC SURGERY - BREAST AUGMENTATION (PER SIDE) 4
97 AESTHETIC SURGERY - BREAST - BREAST LIFT (PER SIDE) 4
98 AESTHETIC SURGERY - DERMABRASION (LASER/BURR) - REGIONAL 4
99 AESTHETIC SURGERY - FACE - CROW'S FEET 4
100 AESTHETIC SURGERY - FACE - FACE LIFT 4
101 AESTHETIC SURGERY FAT REDUCTION SURGERIES (PER AREA) DERMALIPECTOMY 4
102
AESTHETIC SURGERY FAT REDUCTION SURGERIES (PER AREA) - LIPOSUCTION WITH
TUMESCENT TECH.
4
103 AESTHETIC SURGERY FAT REDUCTION SURGERIES (PER AREA) MINIABDOMINOPLASTY 4
104 AESTHETIC SURGERY - BALDNESS MICRO GRAFT (Per STRIP - 5 To 10 Cms) 4
105 AESTHETIC SURGERY - BALDNESS HAIR BEARING FLAPS 4
106 AESTHETIC SURGERY RHINOPLASTY AUGMENTATION 4
107 AESTHETIC SURGERY RHINOPLASTY REDUCTION 4


108 BURNS-TANGENTIAL EXCISION & STSG: 5-10% 4
109 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - CLEFT LIP - WITH A/V VEC. 4
110 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - CLEFT LIP - COMPLETE 4
111 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - PALATE INCOMPLETE 4
112 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - VELOPHARYNGEAL INCOMPETENCE 4
113 CONGENITAL DEFORMITIES - HYPOSPADIAS ONE STAGE REPAIR CORONAL 4
114
CONGENITAL DEFORMITIES - HYPOSPADIAS - TWO STAGE REPAIR - URETHRAL TUBE
RECONSTRUCTION
4
115 CONGENITAL EAR DEFORMITIES EAR- MICROTIA-AUTOPLASTY STAGE II 4
116 CONGENITAL DEFORMITIES VAGINAL RECONSTRUCTION STSG 4
117 EYE-LID RE-CONSTRUCTION 4

Page 65 of 112
118 FACIAL REANIMATION SLING 4
119 FLAPS-COMPOUND MYOCUTANEOUS / FASCIO CUTANEOUS / TENDOCUTANEOUS 4
120 FLAPS-SKIN DISTANT 4
121 LEUCODERMA 4-8% BSA 4
122 MICROVASCULAR SURGERY -MISCELLANEOUS HAIR BEARING FLAPS 4
123 MICROVASCULAR SURGERY VASOPLASTY / TUBOPLASTY (PER SITTING) 4
124 REINSERTION OF FLAP 4
126 TRAUMA FRACTURA BLOW OUT OR BRIT WITH ENTRAPMENT 4
127 TRAUMA- FRACTURE MAXILLA - PLATES & SCREWS 4
128 TRAUMA- FRACTURE - NASAL BONE OPEN REDUCTION & PLATING / WIRE FIXATION 4
129 TRAUMA- FRACTURE ZYGOMA OPEN REDUCTION & FIXATION 4
130 TRAUMA TENDONS MULTIPLE >2 4
131 'W' PLASTY SMALL (>5 Cm) 4
132 AESTHETIC SURGERY - BREAST - REDUCTION (BILATERAL) 5
133 AESTHETIC SURGERY - DERMABRASION (LASER/BURR) - FULL FACE 5
134 AESTHETIC SURGERY - FACE - FACE LIFT WITH DOUBLE CHIN CORRECTION 5
135 AESTHETIC SURGERY - FACE - FORHEAD AND BROW LIFT 5
136 AESTHETIC SURGERY FAT REDUCTION SURGERIES (PER AREA) - COMBINED PROCEDURE 5
137 AESTHETIC SURGERY - BALDNESS MICRO GRAFT (Per STRIP > 10 Cms) 5
138 AESTHETIC SURGERY RHINOPLASTY - SEPTRORHINOPLASTY 5
139 BURNS-TANGENTIAL EXCISION & STSG: 10-20% 5
140 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - ALVEOLAR BONE GRAFTING 5
141 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - NASAL DEFORMITY CORRECTION 5


142 CONGENITAL DEFORMITIES - CLEFT LIP & PALATE - PALATE COMPLETE 5
143 CONGENITAL DEFORMITIES - HYPOSPADIAS ONE STAGE REPAIR PENILE 5
144 CONGENITAL DEFORMITIES - HYPOSPADIAS ONE STAGE REPAIR PENOSCROTAL 5
145 CONGENITAL DEFORMITIES EPISPADIAS 5
146 CONGENITAL DEFORMITIES VAGINAL RECONSTRUCTION FLAPS 5
147 CRANIOFACIAL - MANDIBULAR OSTEOTOMIES - SAGITTAL SPLIT 5
148 CRANIOFACIAL - MANDIBULAR OSTEOTOMIES SEGMENTAL 5
149 CRANIOFACIAL - MAXILLARY OSTEOTOMIES SEGMENTAL 5
150 FACIAL REANIMATION MICRONEURAL 5
151 FLAPS-COMPOUND OSTEOCUTANEOUS / OSTEOMYOCUTANEOUS 5
152 GYNACOMASTIA BILATERAL 5

Page 66 of 112
153 LOCAL MYOCUTANEOUS FLAP 5
154 MICROVASCULAR SURGERY - REVASCULARIZATION ELBOW 5
155 MICROVASCULAR SURGERY - REVASCULARIZATION - VASCULAR REPAIR 5
156 MICROVASCULAR SURGERY - REVASCULARIZATION WRIST / LEG / FOREARM 5
157 TRAUMA FRACTURE - MANDIBLE O.R. WITH AO FIXATOR 5
158 TRAUMA FRACTURE - MANDIBLE O.R. WITH PLATE & SCREWS 5
159 TRAUMA- FRACTURAE - MAXILLA AO FIXATION 5
160 TRAUMA- FRACTURAE- MAXILLA - EXTERNAL FIXATOR 5
161 TRAUMA- FRACTURE - NASAL BONE - FRONTONASO ETHEOID COMPLEX 5
162 CRANIOFACIAL - HYPERTELONISM - ORBITAL (PER EYE) 6
163 CRANIOFACIAL - MAXILLARY OSTEOTOMIES LEFORT I 6
164 MICROVASCULAR SURGERY - REVASCULARIZATION - FINGER / TOE 6
165
MICROVASCULAR SURGERY - REVASCULARIZATION - VASCULAR REPAIR WITH VENUS
GRAFT
6
166 CRANIOFACIAL - ABNORMAL SKULL SHAPES MINOR 7
167 CRANIOFACIAL - MAXILLARY OSTEOTOMIES LEFORT II 7
168 FLAPS-FREE FLAPS - CUTANEOUS / MUSCULOCUTANEOUS / FASCIOCUTANEOUS 7
169
MICROVASCULAR SURGERY - FREE FLAPS - CUTANEOUS / MYOCUTANEOUS /
FASCIOCUTANEOUS
7
170 MICROVASCULAR SURGERY - REPLANTATION - FINGER / TOE 7
171 TRAUMA DIGITAL NERVE REPAIR 7
172 CRANIOFACIAL - ABNORMAL SKULL SHAPES MAJOR 8
173 CRANIOFACIAL - MAXILLARY OSTEOTOMIES - LEFFORT III 8
174 CRANIOFACIAL HYPERTELONISM MIDLINE 8


175 FLAPS-FREE FLAPS OSTEOCUTANEOUS 8
176 GENDER CHANGE 8
177 MICROVASCULAR SURGERY - FREE FLAPS - OSTEOCUTANEOUS 8
178 MICROVASCULAR SURGERY - FREE FLAPS - TOE TRANSFER 8
179 MICROVASCULAR SURGERY - BRACHIAL PLEXUS INJURY REPAIR WITH NERVE GRAFT 8
180 MICROVASCULAR SURGERY - REPLANTATION - ELBOW / ARM 8
181 MICROVASCULAR SURGERY - REPLANTATION PALM 8
182 MICROVASCULAR SURGERY - REPLANTATION - WRIST & FOREARM / LEG 8
183 CRANIOFACIAL - FACIAL BIPARTITION 9
184 FREE FLAP LATISMUS DORSI / MYOCUTANEOUS FLAP FOR ANKLE 9

Page 67 of 112

OPERATION CHARGES: UROLOGY

1 DIAGNOSTIC URETHRO-CYSTOSCOPY 1
2 PROSTATE NEEDLE BIOPSY 1
3 TESTICULAR BIOPSY 1
4 TROCAR CYSTOSTOMY 1
5 URETHRAL DILATIONS 1
6 CIRCUMCISION 2
7 CYSTOSCOPY+URETERIC CATHETERISATION 2
8 DOUBLE "J" STENTING (Primary) 2
9 MEATOPLASTY 2
10 DIAGNOSTIC UTEROSCOPY 3
11 HYDROCELECTOMY ADULT 3
12 HYDROCELECTOMY CONGENITAL 3
13 PER CUTANEOUS NEPHROSTOMY 3
14 VARICOCELECTOMY (Unilateral) 3
15 VISUAL INTERNAL URETHROTOMY 3
16 BILATERAL ORCHIECTOMY For Ca PROSTATE 4
17 CYSTOLITHOTOMY 4
18 FULGURATION OF BLADDER TUMOR/FOLLOW-UP RESECTION 4
19 P.U. VALVE FULGURATION 4

Page 68 of 112
20 PARTIAL CYSTECTOMY 4
21 TORSION TESTIS 4
22 URETEROSCOPY LOWER THIRD (DORMIA) 4
23 URETHROPLASTY - Two Stage (Each) 4
24 CYSTOLITHOTRITY (Mechanical Crushing) 5
25 NEPHROLITHOTOMY 5
26 NEPHROTOMY - ( Open ) 5
27 OPEN PROSTATECTOMY (Millin's) 5
28 ORCHIOPEXY 5
29 PARTIAL AMPUTATION OF PENIS 5
30 PYELOLITHOTOMY 5
31 TUR BLADDER TUMOR < 2 Cms 5
32 URETEROLITHOTOMY 5
33 URETEROSCOPY MIDDLE THIRD 5
34 URETEROSCOPY UPPER THIRD 5
35 VARICOCELECTOMY (Bilateral) 5
36 VASOEPIDIDYMOSTOMY 5

OPERATION CHARGES: UROLOGY

37 VASOVASOPLASTY 5
38 BLADDER DIVERTICULECTOMY 6
39 HYPOSPADIAS REPAIR-Two Stage (each) 6
40 NEPHRECTOMY- (Non-Malignant) 6
41 OPEN PROSTATECTOMY (Radical) 6
42 P.C.N.L (SINGLE) 6
43 PYELOPLASTY 6
44 TUR BLADDER TUMOR > 2 Cms 6
45 TUR PROSTATE (30-50 gms) 6
46 URETERIC RE-IMPLANTATION-Bilateral 6
47 URETERIC RE-IMPLANTATION-Boari Flap 6
48 URETERIC RE-IMPLANTATION-Unilateral 6
49 URETHROPLASTY Single Stage 6
50 VVF REPAIR 6
51 ENDOPYELOTOMY 7
52 HYPOSPADIAS REPAIR-Single Stage 7
53 NEPHRECTOMY- (Malignancy) 7
54 TOTAL CYSTECTOMY 7
55 TUR BLADDER TUMOR > 5 Cms 7

Page 69 of 112
56 TUR PROSTATE (> 50 gms) 7
57 URETHROPLASTY - Transpubic/Flap 7
58 P.C.N.L (COMPLETE STAGHORN - STAGED) 8
59 P.C.N.L (PARTIAL STAGHORN) 8
60 TOTAL AMPUTATION (Without GROIN DISSECTION) 8
61 TOTAL AMPUTATION PENIS (With GROIN DISSECTION) 8

OPERATION CHARGES: VASCULAR SURGERY

1 VARICOSE VEIN SX SCLEROTHERAPHY 0
2 VARICOSE VEIN SX AVULSIONS (ISOLATED PROCEDURE) 2
3 A.V.FISTULA-DISTAL 3
4 A.V.FISTULA-DISTAL-REDO 3
5 VASCULAR PATCH PLACEMENT 3
6 A.V.FISTULA-PROXIMAL 4
7 A.V.FISTULA-PROXIMAL-REDO 4
8 VASCULAR EXPLORATION 4
9 VASCULAR TUMORS EXCISION Minor 4
10 DIALYSIS ACCESS SURGERY (DAS) 5
11 EMBOLECTOMY/ THROMBECTOMY 5
12 VASCULAR INJURY REPAIR (SINGLE) 5
13 VASCULAR TUMORS EXCISION Major 6
14 ENDOVENOUS LASER ABLATION OF VERICOSE VEINS 7
15 FEMORO FEMORAL BYPASS 7
16 FEMORO POPLITEAL BY PASS 7
17 ILIAC/FEMORAL THROMBOENDARTERECTOMY 7
18 PROFUNDOPLASTY 7
19 TOCS RELEASE W/O VASCULAR REPAIR 7
20 VARICOSE VEIN SURGERY 7
21 AXILLO - FEMORAL BYPASS 8
22 CAROTID ENDARTERECTOMY 8
23 CAROTID SUBCLAVIAN BYPASS 8
24 DEEP VENOUS RECONSTRUCTION 8

Page 70 of 112
25 FEMORO DISTAL BYPASS 8
26 TOCS RELEASE WITH VASCULAR REPAIR 8
27 AORTIC ANEURYSM REPAIR 9
28 AORTO FEMORAL BYPASS 9

Page 71 of 112
ONCO SURGERY

Sr Particular Grade
1. DIRECT LARYNGEAL BIOPSY (DLB) 1
2. HOPKINS TELESCOPIC EXAMINATION 1
3. FLEXIBLE LARYNGOSCOPIC EXAMINATION 2
4. SUSPENSION LARYNGOSCOPY 2
5. LUMPECTOMY 3
6. AXILLARY DISSECTION 4
7. DEFUNCTIONING ILESTOMY 4
8. EXTENDED RADICAL TRANSVERSE COLECTOMY 4
9. HIGH INGUINAL ORCHIECTOMY 4
10. LOCAL ROTATION FLAPS 4
11. OPEN BIOPSY OF MEDIASTINAL TUMOUR 4
12. SUPRAHYOID NODE DESECTION (ND) 4
13. COLOSTOMY 5
14. FEEDING JEJUNOSTOMY 5
15. FOREHEAD FLAP 5
16. SUPRA OMOHYOID SISSECTION (SOHND) 5
17. WIDE EXCISION OF LIP 5
18. AMPUTATION ABOVE KNEE (AK) 6
19. AMPUTATION BELOW ELBOW 6
20. AMPUTATION BELOW KNEE (BK) 6
21. AMPUTATION MID ARM 6
22. AMPUTATION SYMES 6
23. BILATERAL SOHND 6
24. BILATERAL SUPRAHYOID ND 6
25. BREAST CONSERVATION SURGERY 6
26. COLOSTOMY CLOSURE 6
27. GASTRO JEJUNOSTOMY 6
28. HEMITHYROIDECTOMY 6
29. MARGINAL MANDIBULECTOMY 6
30. MODIFIED NODE DISSECTION (MND) 6
31. MODIFIED RADICAL MASTECTOMY (MRM) 6
32. PACTORALIS MAJOR MYOCUTANEOUS FLAP 6
33. PARTIAL AMPUTATION OF PENIS 6
34. RADICAL MASTECTOMY (RM) 6
35. RADICAL NECK DISSECTION (RND) 6
36. SCLAP FLAP 6
37. SEGMENTAL MANDIBULECTOMY 6
38. SUPERFICIAL PAROTIDECTOMY 6
39. THORACOTOMY 6
40. VULVECTOMY 6
41. WIDE EXCISION BASE TONGUE 6
42. WIDE EXCISION OF TONGUE (PARTIAL, HEMI, ANTERIOR) 6
43. WIDE EXCISION PRIMARY OF PALATE 6
44. WIDE EXCISION UPPER ALVEOLECTOMY 6
45. ANGLE TO ANGLE MANDIBULECTOMY 7
46. CHOLECYSTO JEJUNOSTOMY (CJ) GJ JJ 7
47. DELTOPECTORAL FLAP 7
48. DISTAL MANDIBULECTOMY 7
49. EXTENDED HEMI MANDIBULECTOMY 7
50. GASTRO JEJUNOSTOMY, JEJUNO JEJUNOSTOMY (JJ) 7
51. HEMI MANDIBULECTOMY 7
52. HIP DISARTICULATION 7
53. MANDIBLE SWING 7
54. MEDIAL MAXILLECTOMY 7
55. RESECTION ANASTOMOSIS 7

ONCO SURGERY

Sr. Particular Grade
56.
SHOULDER DISARTICULATION
7
57. TOTAL AMPUTATION OF PENIS 7
58. TOTAL GLOSSECTOMY 7

Page 72 of 112
59. VULVECTOMY WITH GROIN DISSECTION 7
60. ADRENALECTOMY 8
61. ANTERIOR RESECTION (SIGMOID COLECTOMY) 8
62. BILATERAL MND 8
63. BILATERAL PARTIAL MAXILLECTOMY 8
64. BILATERAL RND 8
65. EXCISION OF PRIMARY + NECK DISSECTION 8
66. EXCISION OF PRIMARY + NECK DISSECTION + MANDIBULECTOMY 8
67. FREE FIBULA 8
68. FREE RECTUS ABDOMINIS 8
69. GASTRIC PULL 8
70. LATISSIMUS DORSI FLAP 8
71. LEFT HEMICOLECTOMY 8
72. LIMB PRESERVATION SURGERY 8
73. LOBECTOMY 8
74. LOWER PARTIAL MAXILLECTOMY 8
75. MEDIASTINAL MASS EXCISION 8
76. MRM /RM WITH SPLIT THICKNESS GRAFT (STG) 8
77. PARTIAL GASTRECTOMY 8
78. PNEUMONECTOMY 8
79. RADIAL FOREARM FREE FLAP 8
80. RADICAL MAXILLECTOMY 8
81. RADICAL TOTAL PAROTIDECTOMY 8
82. RECTUS ABDOMINIS FLAP 8
83. RETROPERITONEAL MASS EXCISION 8
84. RIGHT / EXTENDED RIGHT HEMICOLECTOMY 8
85. SPLENECTOMY 8
86. SUPERIOR MEDIASTINAL DISSECTION 8
87. TOTAL CYSTECTOMY WITH URETERO SIGMOIDOSTOMY 8
88. TOTAL LARYNGECTOMY 8
89. TOTAL LARYNGO PHARYNGO OESOPHAGECTOMY 8
90. TOTAL MAXILLECTOMY 8
91. TOTAL PAROTIDECTOMY NERVE SPARING 8
92.
TRANS ABDOMINAL HYSTERECTOMY (TAH) + BILATERAL SALPINGO OOPHORECTOMY (BSO)
+ OMENTECTOMY
8
93. TRANSVERSE COLECTOMY 8
94. TRAPEZIUS FLAP 8
95. WERTHEIMS 8
96. ABDOMINAL PERINEAL RESECTION (APR) 9
97. ANTERIOR PELVIC EXENTERATION 9
98. BILATERAL ADRENALECTOMY 9
99. BILATERAL TOTAL MAXILLECTOMY 9
100. ESOPHAGUS LEFT THORACO ABDOMINAL 9
101. ESOPHAGUS TRANS HIATAL 9
102. FREE JEJUNUM 9
103. HEPATICO JEJUNOSTOMY 9
104. IVOR LEWIS 9
105. LIVER RESECTION 9
106. LOW ANTERIOR RESECTION 9

ONCO SURGERY

Sr. Particular Grade
107.
ORBITAL EXENTERATION
9
108.
PAROTIDECTOMY WITH RND
9
109.
PARTIAL / NEAR TOTAL LARYNGECTOMY
9
110. PARTIAL NEPHRECTOMY 9
111. PELVIC EXENTERATION 9
112. PENECTOMY WITH BILATERAL GROIN DISSECTION 9

Page 73 of 112
113. POSTERIOR PELVIC EXENTERATION 9
114. RADICAL CHOLECYSTECTOMY 9
115. RADICAL NEPHRECTOMY 9
116. RADICAL PROSTATECTOMY 9
117. RETRO PERITONEAL LYMPH NODE DISSECTION (RPLND) 9
118. THREE STAGE ESOPHAGECTOMY 9
119. TOTAL ANO PROCTO COLECTOMY WITH ILEOSTOMY 9
120. TOTAL CYSTECTOMY WITH ILEAL CONDUIT OR OTHER DIVERSIONS 9
121. TOTAL GASTRECTOMY 9
122. TOTAL LARYNGECTOMY WITH RND 9
123. TOTAL PANCREATECTOMY 9
124. TOTAL THYROIDECTOMY WITH RADICAL NECK DISSECTION (RND) 9
125. WHIPPLES PANCREATICODUODENECTOMY 9
126 FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) 700
127 PUNCH BIOPSY 700
128 NEEDLE BIOPSY 700

ORAL & MAXILLOFACIAL SURGERIES (DENTAL DEPT.)

Sr Particular Grade
1. ALVELOPLASTY 0
2. FRENECTOMY 0
3. TRANSMYLOHYOID INTUBATION 1
4. ORAL IMPLANT 2
5. ORAL TUMOR CURETTAGE 2
6. ORO-ANTRAL FISTULA REPAIR 2
7. TMJ ARTHROCENTESIS 2
8. VESTIBULOPLASTY 2
9. WISDOM TOOTH REMOVAL 2
10. FACIAL BONE IMPLANT 3
11. MASSETRIC HYPERTROPHY CORRECTION 3

Page 74 of 112
12. DISTRACTION OSTEOGENESIS (MANDIBLE) 4
13. MANDIBULAR CYST ENUCLEATION (LARGE) 4
14. MANDIBULAR SWING 4
15. NASAL RECONSTRUCTION (INTERNAL FIXATION) 4
16. ORAL SUBMUCOUS FIBROSIS SURGERY 4
17. ORTHOGNATHIC - V.S.R.O. / INVERTED L 4
18. ORTHOGNATHIC GENOPLASTY 4
19. ORTHOGNATHIC SEGMENTAL 4
20. PREPRESTHETIC SURGERY (MAJOR) 4
21. TMJ RECONSTRUCTION 4
22. TMJ REPLACEMENT 4
23. DISTRACTION OSTEOGENEIS MIDFACE 5
24. ORTHOGNATHIC - B.S.S.R.O. 5
25. ORTHOGNATHIC LEFORT I TYPE 5
26. LEFORT III/IV O.R.I.F. 6
27. MAXILLARY SWING 6
28. ORAL CANCER COMPOSITE RESECTION 6
29. ORBITAL HYPERTELORISM 6
30. ORTHOGNATHIC - LEFORT II/III TYPE 6
31. TOTAL MAXILLECTOMY 6

PROCEDURE CHARGES: OPTHALMOLOGY

1 A - SCAN (EACH EYE) 600
2 APPLANATION TONOMETRY 150
3 AUTOMATED FIELD ANALYSIS 1200
4 B - SCAN (EACH EYE) 900
5 CARBOLIZATION 100
6 CORNEAL / CONJUNCTIVAL FB REMOVAL SUPERFICIAL 300
7 FLUORESCEIN ANGIOGRAPHY 1500
8 FLUORESCEIN ANGIOSCOPY 800
9 GONIOSCOPY 200
10 INTRA VITREAL INJECTION 800
11 RETRO BUBLAR INJECTION 200

Page 75 of 112

CARDIOLOGY

NON-INVASIVE CARDIOLOGY:-

SR SERVICES RATE
1 CONSULTATION CHARGES 400
2 ECHO COLOUR DOPPLER FULL STUDY 1000
3 ECHO COLOUR DOPPLER (BED SIDE) 1800
4 ECHO COLOUR DOPPLER SCREENING 500
5 ECHO COLOUR DOPPLER SCREENING (BED SIDE) 1000
6 ECG CHARGES 150
7 REVIEW CASSETTE CHARGE 150
8 STRESS TEST (TMT) 1000
9 DOBUTAMINE STRESS ECHO (DSE) 3000
10 PERI CARDIAL TAPPING 2500
11 TILT TABLE TEST (HUTT) 1500
12 PACEMAKER CLINIC 2500
13 HOLTER 2500
14 TRANSESOPHAGAEL ECHO (TEE) 2500

Page 76 of 112

CARDIOLOGY PACKAGES


SEMI SPECIAL
/ SPECIAL -
NON AC

SEMI SPECIAL
/ SPECIAL -
AC
SR SERVICES
GENERAL
WARD
ICU RECOVERY ICU
SUITE
1 Coronary Angiography 6000 10000 15000 19000
2
Coronary Angioplasty Single
vessel
[without stent]
55000 75000 90000 110000
3
Coronary Angioplasty Double
vessel
[without stent]
65000 90000 105000 125000
4 Atrial Septal Defect [ ASD ] 35000 40000 60000 70000
5
Ventricular Septal Defect [ VSD
]
35000 40000 60000 70000
6
Persistent Ductus Arteriosus [
PDA]
35000 45000 60000 80000
7 IVC Filter 35000 40000 60000 70000
8
Balloon Mitral Valvuloplasty [
BMV ]
35000 40000 60000 70000
9
Balloon Aortic Valvuloplasty [
BAV ]
35000 40000 60000 70000
10 Peripheral Angiography 8000 11000 13000 20000
11
Peripheral Angioplasty (without
stent)
25000 35000 45000 60000
12
Permanent Pacemaker [Single
Chamber]
25000 32000 50000 60000
13
Permanent Pacemaker [ Dual
Chamber]
35000 40000 60000 70000
14 Temporary Pacemaker 5000 5000 5000 5000

Page 77 of 112
15 Pericardiocentesis 5000 5000 5000 5000
16 IABP Baloon Package* 53000 53000 53000 53000

* IABP Balloon package includes Intra Aortic Balloon & insertion charges, pump
charges is for 3 days only, afterwards Rs. 2500 per day will be charged as Equipment
charges.

The above tariff includes

Room charge for 1 day for Angiography, 2 days for Angioplasty (includes 2 hrs.
of TCU in Angiography & 1 day of ICCU for Angioplasty).
Cardiologists Procedure charges.
Cathlab usage charge.
Diet / Dieticians fee.
Psychological Support / Counselors visit.
Pre Angiography Profile tests (Hb, TC, DC, S.Cr, Bu, HIV, HBs Ag, APTT).
Non Ionic Dye charges.
Cardiologist routine visit fee on a Pkg. day.
Nursing care charge.
ECG charge.
Review cassette charge.
Oxygen charges during package period.

Package does not include the following. This will be charged extra at actuals:
For All above Packages:
Any other procedure that may require in a particular case e.g. Dialysis,
Sonography & Doppler test etc.
Cost of Medicine & Other consumables [more than package]
Standby charges of surgical team Rs. 3000 to 7000
Any other specialists Consultation fees.
Cross Matching & Screening.
Cost of Reopro/Integrillin/Steptokinase/Urokinase/Low molecular weight
Heparin.
Extra CD Rs. 100/-
Room charge along with Nursing care charge if patient is required to stay for
more than Pkg. period.
Medicated Stent, Balloon
Cost of Stent / Pacemaker / Valve/ Consumables extra as applicable.
IABP, IAB Catheter
Anaesthesia standby chages:-
For Angioplasty:
Room Type: A 800 B 1000 C 1500 D 2000
For Angiography Rs. 500/-
Permanent Pacemaker
Include
5 days stay including stay in ICCU [ 2 days in ICCU and 3 days in respective
ward/room category]
Consumables and Pharmacy drugs up to Rs. 1500

Page 78 of 112
Exclude
Anesthesia Charges
Cost of Pacemaker

Cardiac Surgery Packages

Sr Procedure General
General
AC
Semi
Special
Non-AC
Semi
Special
AC
Special
Non-AC
Special
AC
Suite
1
Coronary Artery
Bypass Surgery
(CABG)
105000 115000 120000 135000 125000 150000 180000
2 MVR [Valve Extra] 100000 105000 110000 125000 120000 150000 175000
3 AVR [Valve Extra] 100000 105000 110000 125000 120000 150000 175000
4 ASD 90000 100000 105000 120000 110000 150000 195000
5 VSD 90000 100000 105000 120000 110000 150000 195000
6 TOF 105000 115000 120000 135000 125000 150000 165000
7
INTRA CARDIAC
REPAIRS FOR
CONGENITAL CARDIAC
DEFECTS
105000 115000 120000 135000 125000 150000 165000
8
INTRA CARDIAC
REPAIRS FOR ACQUIRED
CARDIAC DEFECTS
105000 115000 120000 135000 125000 150000 165000
9
Double Valve
Replacement
[Valve Extra]
110000 115000 120000 135000 125000 160000 190000
10 Pericardiectomy 75000 80000 90000 115000 90000 115000 130000

Cardiac Artery Bypass Graft

Include

Theatre Charge, Surgical Charge, Anesthesia Charges, Physiotherapy, Patients
Diet and Room rent for 10 days [4 days in ICCU/ITU and 6 days in the
respective ward/room].
Pathology Investigation up to Rs. 5000/-, Radiology Investigations up to Rs.
3000/-.
Consumables and Pharmacy drugs up to Rs. 40000/-.

Exclude

Stay beyond permitted in package (After package period all services will be
charged extra).
Cardioplegia Cannula / Grafts / Heart Valves / Patches / Swan-ganz catheter /
Cardiac Output Catheter / Blood component.
Pacemakers

Page 79 of 112
IABP
Consultations by other Specialist other than Surgeon & Cardiologist i.e.
Diabetologist, Neurologist etc.
Re-exploration charges.
Pre & post Operative Echocardiography.

ASD / VSD

Include
Diet and Room rent for 07 days [ 2 days in ICCU/ITU and 5 days in the
respective ward/room]
Exclude

Valve / Graft / Patches / Pacemaker
IABP, IAB Catheter

Valve Replacement

Include

Diet and Room rent for 07 days [ 2 days in ICCU/ITU and 5 days in the
respective ward/room category]
Exclude

Valve / Graft / Patches / Pacemaker
IABP, IAB Catheter

Package does not include the following. This will be charged extra at actuals:
For All above Packages:

Any other procedure that may require in a particular case e.g. Dialysis,
Sonography & Doppler test etc.
Cost of Medicine & Other consumables [more than package]
Room charge along with Nursing care charge if patient is required to stay for
more than Pkg. period.
Cost of Valve/ Consumables extra as applicable.
IABP, IAB Catheter.
Additional Notes

Patient is required to deposit the entire amount as applicable at the
time of admission, with the hospital accounts office.
If the patient is required to transfer to the ITU, CCU or PICU the bed/
room which the patient was occupying prior to the transfer is to be
vacated.

Page 80 of 112
If after admission you wish to move to higher admission class e.g. to
higher class contact the surgeon & the IPD counter. Package charge will
be charged as per the higher admission class with retrospective effect
from your date of admission.
Transfer from higher class to lower class not permitted unless the
desired class is not available at the time of admission.
Patients are strongly advised to buy all medicines from hospital
pharmacy. The hospital will not permit the use of outside medicine &
consumables to prevent the use of fake or spurious drugs which could be
harmful to the patient during surgery.
Every patient admitted for open Heart surgey & Bypass surgery as an
emergency case / high risk case the hospital will charge extra 25% in
addition to the package charge.
If combined Cardiac procedure is done, an extra fee of 25% of package
will be charged over & above the package charges.
o CABG & valve Replacement
o CABG & Carotid Endarcetomy
o Aortic Root Replacement & Re-implantation of Coronary
o Aortic Dissection & Aneurysm

PULMONOLOGY


SEMI SPECIAL
/ SPECIAL -
NON AC

SEMI SPECIAL
/ SPECIAL -
AC
SR SERVICES
GENERAL
WARD
ICU RECOVERY ICU
SUITE
1
FB REMOVAL/CONTROL OF HEAMOPTYSIS/MUCUS PLUG
REMOVAL
5000 6000 7000 8000
2 FIBREOPTIC BRONCHOSCOPY 2250 3000 4000 4500
3 FOB+BAL (BRONCHOALEVOLAR LAVAGE) 2500 3500 4500 5000
4 MASS BIOPSY 500 600 800 1000
5 PERCUTANEOUS LUNG BX 2000 2500 3000 3500
6 PLEURAL ASPIRATION 1500 2000 2500 3000
7 PLEURODESIS 2000 2500 3000 3500
8 SLEEP APNEA STUDY TITRATION - 6500 7500 9500
9 SLEEP APNEA STUDY - 5500 7000 9000
10 THERAPEAUTIC BRONCHOSCOPY - STENT PLACEMENT 7000 7000 7000 7000

Page 81 of 112
11 TRANS BRONCHIAL LUNG BX (TBLB) 3250 4000 5000 6000
12 TRANS-TRACHEAL NODE FNAC (PLUS COST OF NEEDLE) 3000 3500 4000 4500
13 PULMONARY FUNCTION TEST 350 350 350 350

Sleep Apnea Study Package Includes:
One night stay charges
Charges of Doctor Fees, Equipment Charges & Nursing Care Charges
Note:
Above SAS package charges are for OPD Patients only.
In case of emergency/High Risk Case, the hospital will charge extra as per
Policy of Hospital.
In case of emergency/High Risk Case, the consultant visit charge will be extra
as per charge list.

Foot Notes:

Instrument charges rs. 1000/- for Fiber Optic Bronchoscope, videoendoscope
extra.
Emergency charges 25% extra.
High risk & difficult procedure 25% extra.
Implantation &/or material + disposable charges extra.
Procedure not mentioned in the list will be charge as per hospital policy.

GASTRO-ENTEROLOGY


SEMI SPECIAL
/ SPECIAL -
NON AC

SEMI SPECIAL
/ SPECIAL -
AC
SR SERVICES
GENERAL
WARD

ICU RECOVERY ICU
SUITE
1 ACHALASIA CARDIA BALLON DIALATION 4000 5000 6000 7000
2 BALLON DILATION PYLORUS 4000 4500 5000 6000
3 BAND LIGATION 3000 3500 4000 4500
4 BILLIARY STENT PLACEMENT 2500 3000 4000 5000
5 COLONIC SELF EXPANDING STENT 8000 9000 10000 12000
6 COLONOSCOPIC COLONIC DECOMP 3000 4000 5000 6000
7 COLONOSCOPIC POLYPECTOMY 3500 4000 4500 5000
8 COLONOSCOPY 2200 2500 3000 3000
9 DIAGNOSTIC ERCP 3000 3500 4000 4500
10 ENDOSCOPIC BIOPSY 500 500 750 750
11 ENDOSCOPIC FB REMOVAL 2500 3000 3500 4000
12 ENDOSCOPIC INJECTION THERAPY 2500 3000 3500 4000
13 ENDOSCOPIC LITHOTRIPSY 3000 3500 4000 4500
14 ENDOSCOPIC METALIC BILLIARY STENTING 10000 11000 12000 14000
15 ENDOSCOPIC POLYPECTOMY 2500 3000 3500 4000
16
ENDOSCOPIC SELF EXPANDING BILIARY STENT
PLACEMENT
8000 9000 10000 12000

Page 82 of 112
GASTRO-ENTEROLOGY


SEMI SPECIAL
/ SPECIAL -
NON AC

SEMI SPECIAL
/ SPECIAL -
AC
SR SERVICES
GENERAL
WARD

ICU RECOVERY ICU
SUITE
17 ENDOSCOPIC SPHINCTEROTOMY 2500 3000 3500 4500
18 ENDOSCOPIC SPHIRETEROPLASTY 3000 3500 4000 4500
19 ENDOSCOPIC STENT PLACEMENT 3500 4000 5500 6000
20 ENDOSCOPIC STENT REMOVAL 2500 3000 3500 4000
21 ENDOSCOPY GASTROSTOMY 3000 4000 5000 6000
22 ENDOSCOPY NJ TUBE 2000 2500 3000 3500
23 ETHENOL INJECTION 3500 4000 4500 5000
24 GLUE THERAPY 5000 6000 7000 8000
25 LIVER ABSCESS ASPIRATION 2000 2500 3000 3500
26 LIVERBIOPSY 2000 2500 3000 3500
27 OESOPHAGEAL BALLON DIALTION 3000 3500 4000 5000
28 OESOPHAGEAL DILATION 1700 1800 2000 2500
29 OESOPHAGEAL PLASTIC PROSTHESIS 6500 7800 10400 13000
30 OESOPHAGEAL SELF EXPANDING STENT INSERTION 9100 11700 13000 19500
31 PERCUTANEOUS CATHETER PLACEMENT (FOR CYST) 3000 3500 4000 5000
32
PERCUTANEOUS CATHETER PLACEMENT (IN INTRA-
ABDOMINAL ABSCESS)
2500 3000 3500 4000
33 PERCUTANEOUS CATHETER PLACEMENT 1950 2340 3250 4550
34 PYLORIC SELF EXPANDING STENT 8000 9000 10000 12000
35 SANGSTAKEN TUBE / LINTOUS TUBE 2500 3000 3500 4000
36 SCLEROTHERAPY 1500 1800 2000 2200
37 SIGMOIDOSCOPY 1200 1500 1800 2000
38 UPPER GI ENDOSCOPY 1200 1500 1800 2000
39 VARICEAL BANDING 2200 2400 2600 3000
40 PEG TUBE REMOVABLE 750 1000 1250 1500
41 ENDOSCOPY PEG TUBE PLACEMENT 3500 4000 5000 6000
42 ENDOSCOPIC PENCREATATIC STENT PLACEMENT 8000 9000 10000 12000
43 ILEOSCOPY DIAGNOSTIC 1200 1500 1800 2000
44 BILLIARY STENT REMOVAL 2000 2200 2500 2800
45 CAPSULE ENDOSCOPY PACKAGE 41000 48000 56000 65000

NOTES:

Charges of any surgery done in emergencies will be 25% more than routine
charges.
Charges of difficult and high-risk surgery will be 25% more than routine
charges.
Any operative procedure not mentioned in this list will be charged according
to the policy of hospital management.
Any material/implant used during surgery will be charged extra.
Radiology charges wherever applicable will be charged extra.
For different endoscopic procedures, specialized equipment charges will be as
follows :
1. Upper G.I. Fibroptic Endoscope - 600/-

Page 83 of 112
2. Lower G.I. Fibroptic Endoscope - 1100/-
3. EDCP Fibroptic scope - 1500/-
4. Videoendoscope - 2000/-

NEPHROLOGY


SEMI SPECIAL
/ SPECIAL
- NON AC

SEMI SPECIAL
/ SPECIAL -
AC
SR SERVICES
GENERAL
WARD
ICU RECOVERY ICU
SUITE
1 CAPD TRAINING 2000 2500 3000 4000
2 CHARCOAL HEAMO-PERFUSION 3000 4000 4500 6000
3
CONTINUOUS ARTERIVENOUS HAMEO-FILTERATION
(CAVH) FILTER EXTRA
6000 6500 7500 8000
4 FEMORAL DOUBLE LUMEN CATHETER 1000 1200 1500 1800
5 FEMORAL SINGLE LUMEN CATHETER 750 1000 1200 1500
6 HAEMODIALYSIS BI-CARBONATE 1200 1400 1600 1800
7
INTERNAL JUGULAR / SUBCLAVIAN DOUBLE LUMEN
CATHETERISATION
1500 1800 2100 2500
8
INTERNAL JUGULAR / SUBCLAVIAN SINGLE LUMEN
CATHETERISATION
1000 1400 1600 2000
9 KIDNEY BIOPSY 1800 2000 2500 3000
10 P.D.CATHETER REPOSITIONING 500 750 1000 1200
11 PERITONEAL DIALYSIS 1200 1500 1800 2000
12 PERMCATH INSERTION 4000 5000 6000 8000
13 PLASMAPHERESIS (FILTER EXTRA) 4000 4500 5000 6000
14 SLED DIALYSIS 2500 3000 3500 4000
15 SUBCLAVIAN DOUBLE LUMEN CATHETER CHANGING 800 1000 1200 1400
16 TENCKUFF CATHETER 3000 4000 5000 6000
FOOT NOTES:

Charges of any Procedures done in emergencies will be 25% more than the
routine charges.
Gun Charges to be charged Extra (as disposable)
Charges of high-risk procedure will be 25% more than the routine charges.
Any operative procedure not mentioned in this list will be charged according
to the policy of hospital management.

Page 84 of 112
Any material/implant used during the surgery / procedure will be charged
extra.
Nephrologist must enter his Visit Fees in the visit sheet kept in the
Dialysis Room for Chronic Haemodialysis patients. This visit will be
considered over and above routine visit and charged extra according to Room.
Repeated Serological test for HIV and Hbs Ag should be done before starting
Haemodialysis and every 3 months for patients on Chronic Haemodialysis or if
patient has dialysis at other centre.
Rs.10/- will be charged extra per cycle of P. D. Procedure.
Except for HD and PD 10% backup charge will be levied on the above charges.

ONCOLOGY

Planning for the Chemotherapy- performs at the OPD level or at the time of the first
admission:

Plan Duration Rate
CHEMOTHERAPY PLAN 1 CHARGES UP TO 6 MONTHS CHEMOTHERAPY 1200
CHEMOTHERAPY PLAN 2 CHARGES 6 TO 9 MONTHS CHEMOTHERAPY 2000
CHEMOTHERAPY PLAN 3 CHARGES 9 TO 12 MONTHS CHEMOTHERAPY 4000
CHEMOTHERAPY PLAN 4 CHARGES > 1 YEAR CHEMOTHERAPY 6000
CHEMOTHERAPY PLAN 5 CHARGES > 2 YEARS 9000

At the Indoor Level:


SEMI SPECIAL
/ SPECIAL
- NON AC

SEMI SPECIAL
/ SPECIAL -
AC
SR SERVICES
GENERAL
WARD
ICU RECOVERY ICU
SUITE
1 CHEMOTHERAPY CHARGES 1000 1200 1500 2000
2 CHEMOTHERAPY SUBCUTANEOUS INJECTION 200 300 400 500
3 CHEMOTHERAPY IV BOLUS INJECTION 500 600 700 800
4 CHEMOTHERAPY INTRATHECAL INJECTION 750 900 1200 1500
5 CHEMOTHERAPY RESERVIOR METHOD 1500 2000 2500 3000
6 CHEMOTHERAPY WITH PORT ACCESS 1500 2000 2500 3000
7 CHEMOTHERAPY INDUCTION 10000 12000 15000 20000
8 CHEMOTHERAPY CONSOLIDATION 10000 12000 15000 20000
9 IMMUNOTHERAPY 1000 1200 1500 2000
10 IMMUNOGLOBULIN THERAPY 500 700 900 1000
11 IMMUNOSUPPRESSION THERAPY 10000 12000 15000 20000
12 BONE MARROW ASPIRATION PROCEDURE 500 600 700 800
13 BONE MARROW BIOPSY PROCEDURE 1000 1200 1500 1800

Page 85 of 112

PATHOLOGY
Sr. SERVICES RATE
1 5 HT (HYDROXY TRYPTAMINE) 2500.00
2 A.B. EOSINOPHIL COUNT 100.00
3 A.N.A.(BY ELISA METHOD) 400.00
4 A.P.T.T. 200.00
5 ACE LEVEL (ANGIOTENSINE CONVERTING ENZYME) 800.00
6 ACETYLCHOLINE RECEPTOR AB LEVEL 3000.00
7 ACID FAST BACILLI CULTURE(BACTEC SYSTEM) 800.00
8 ACID FAST BACILLI CULTURE(CONVENTIONAL METHOD) 500.00
9 ACID PHOSPHATASE 300.00
10 ACTH STIMULATION TEST (2 SAMPLES) 850.00
11 ACTH STIMULATION TEST (3 SAMPLES) 1100.00
12 ACUTE MYLOID LEUKEMIA CHARACTERIZATION FLOW CYTOMETRY 10000.00
13 ADENOSINE DEAMINASE ACTIVITY (ADA) 400.00
14 AEROBIC CULTURE 1000.00
15 AFB CULTURE (LJ MEDIUM - CONVENTIONAL) 600.00
16 AFB RADIOMETRIC SUSCEPTIBILITY (10 DRUG PANEL) 6500.00
17 AFB RADIOMETRIC SUSCEPTIBILITY (5 DRUG PANEL) 4600.00
18 AFB RADIOMETRIC SUSCEPTIBILITY (SIRE PANEL) 1950.00
19 AFB RADIOMETRIC SUSCEPTIBILITY (SIREP PANEL) 3500.00
20 AFB SENSITIVITY (LJ MEDIUM -10 DRUG PANEL) 3400.00
21 AFP (ALPHA FETO PROTEIN) 500.00
22 ALBERT STAIN 200.00
23 ALBUMIN 100.00
24 ALBUMIN - CREATININE RATIO 350.00
25 ALCOHOL LEVEL (BLOOD) 500.00
26 ALDOSTERON 2500.00
27 ALERGIC BASIC SCREENING PANEL 2000.00
28 ALKALINE PHOSPHATASE(ALKPO4) 110.00
29 ALPHA 1 ANTI TRYPSIN 1750.00
30 ALUMINIUM(SERUM/PLASMA/DIALYSIS FLUID) 1600.00
31 AMINOACID CHROMATOGRAPHY+METABOLIC TESTS 2000.00
32 AMMONIA (NH3) 450.00
33 AMOEBIASIS SEROLOGY 750.00
34 AMYLASE 250.00
35 AMYLASE BODY FLUID 250.00
36 AMYLASE(URINE) 250.00
37 ANA (IFA) PER DILUTION 600.00

Page 86 of 112
38 ANA(BLOT) 3000.00
39 ANAEROBIC CULTURE 700.00
40 ANAEROBIC SENSITIVITY 600.00
41 ANCA (IFA) 2000.00
42 ANTI CARDIOLIPIN IGG (ACA IGG) 900.00
43 ANTI CARDIOLIPIN IGM (ACA IGM) 350.00
44 ANTI CCP IGG ANTIBODIES FOR RA 1500.00
45 ANTI DELTA ANTIBODY (HDV-HEPATITIS DELTA VIRUS) 1500.00
46 ANTI DS DNA (BY IFA) 700.00
47 ANTI GBM ANTIBODY 1250.00
48 ANTI GLIADIN ANTIBODY IGA 1400.00
49 ANTI GLIADIN ANTIBODY IGG 1400.00
50 ANTI H.C.V. (HEPATITIS C VIRUS) - ELISA 900.00
51 ANTI HAV IGM 700.00
52 ANTI HAV IGG 1000.00
53 ANTI HBC (TOTAL) 750.00
54 ANTI HBC LGM (CORE M) 750.00
55 ANTI HBE 700.00
56 ANTI HBS 700.00
57 ANTI MEASLES ANTIBODY (IGG/IGM) 1900.00
58 ANTI MICROSOMAL ANTIBODY 500.00
59 ANTI MITOCHONDRIAL ANTIBODY 1000.00
60 ANTI PARIETAL CELL ANTIBODY 2200.00
61 ANTI PARIETAL CELL ANTIBODY WITH TITRE 3800.00
62 ANTI PHOSPHOLIPID AB IGG 500.00
63 ANTI PHOSPHOLIPID AB IGM 500.00
64 ANTI SMOOTH MUSCLE ANTIBODIES(QUALITATIVE) 4000.00
65 ANTI SPERM ANTIBODY 750.00
66 ANTI THROMBIN III 2000.00
67 ANTI THYROGLOBULIN ANTIBODY 500.00
68 ANTI THYROID ANTIBODIES 700.00
69 ANTINEURONAL ANTIBODY 3300.00
70 APOLIPROTEIN A1 400.00
71 APOLIPROTEIN B 400.00
72 APTT MIXING STUDY 400.00
73 ARSENIC (BLOOD) 2000.00
74 ASCITIC FLUID R & M 300.00
75 ASO TITRE 350.00
76 ASPERGILLUS SEROLOGY 2000.00
77 ASPERGILLUS SPECIFIC IGE 2250.00
78 ASPERGILLUS(GALACTOMANAN) ANTIGEN 2000.00
79 ASPIRATED FLUID R&M 375.00
80 AUTO IMMUNE HEPATITIS PANEL-1 3500.00
81 B-12 LEVEL 600.00
82 B-2 MICROGLOBULIN 1200.00
83 BACTERIAL ANTIGEN DETECTION (6 ANTIGENS) 3500.00
84 BACTERIAL ANTIGEN TEST 1000.00

Page 87 of 112
85 BACTERIAL MENINGITIS MULTIPLEX PCR 1800.00
86 BACTERIAL PNEUMONIA PANEL(PCR) 3400.00
87 BACTIC BODY FLUID CULTURE (ONE VIAL) 750.00
88 BCR-ABL 4100.00
89 BENZODIAZAPINE 500.00
90 BETA HCG 450.00
91 BETA HCG PER DILUTION 600.00
92 BICARBONATE 200.00
93 BILIRUBIN 110.00
94 BIOPSY - TURP 600.00
95 BIOPSY (BY FLOW CYTOMETRY) 8000.00
96 BIOPSY (INTERMEDIATE) 800.00
97 BIOPSY- COLONIC 350.00
98 BIOPSY- ENDOBRONCHIAL 350.00
99 BIOPSY EXTRA LARGE 1500.00
100 BIOPSY- FISTULA-IN-ANO 600.00
101 BIOPSY- HEMORRHOIDS 500.00
102 BIOPSY LARGE (AS PER BITS) 1000.00
103 BIOPSY LIVER 500.00
104 BIOPSY- POLY P 400.00
105 BIOPSY- SIX QUADRANT PROSTATE 1000.00
106 BIOPSY SMALL 600.00
107 BLEEDING TIME (B.T.) 60.00
108 BLOOD CROSS MATCH CHARGES 150.00
109 BLOOD CULTURE (BACTEC) 1000.00
110 BLOOD CULTURE BACKTEC (ONE SET) 1000.00
111 BLOOD CULTURE BACKTEC (TWO SETS) 1500.00
112 BLOOD FOR AMINO ACIDES 3500.00
113 BLOOD FOR FILARIA 150.00
114 BLOOD GAS ANALYSIS(MULTIPLE,EACH) 500.00
115 BLOOD GROUP RH 60.00
116 BLOOD INDICES 100.00
117 BLOOD MERCURY LEVEL 1700.00
118 BLOOD PH (VENOUS/ARTERIAL) 150.00
119 BLOOD UREA 110.00
120 BNP 1200.00
121 BODY FLUID (CELL COUNT ONLY) 100.00
122 BONE MARROW ASPIRATION AND TRIPHINE BIOPSY(OLS) 1500.00
123 BONE MARROW ASPIRIATION 600.00
124 BONE MARROW TRIPHINE BIOPSY 500.00
125 BRONCHIAL BRUSHING FOR CYTOLOGY 500.00
126 BRUCELLOSIS IGG / IGM QUANLITATIVE 2250.00
127 BRUCELLOSIS SEROLOGY (ABORTUS & METITENSIS) 500.00
128 BT & CT 70.00
129 B-TYPE NATRIURETIC PEPTIDE 1200.00
130 BUCCAL SMEARE EXAMINATION 200.00
131 BUFFY COAT SMEAR EXAMINATION 300.00

Page 88 of 112
132 BUN 110.00
133 C M V IGG 400.00
134 C M V IGM 600.00
135 C P K MB 300.00
136 C P K-TOTAL 250.00
137 C R P (C REACTIVE PROTEIN) 250.00
138 CSF ELECTROPHORESIS 900.00
139 CSF IGG 400.00
140 CSF ROUTINE & MICRO 300.00
141 CSF ROUTINE WITH LP 600.00
142 CSF T.P.H.A. 200.00
143 C.P.K MM 550.00
144 C1 ESTERASE INHIBITOR 2000.00
145 C3 COMPLEMENT 450.00
146 C4 COMPLEMENT 700.00
147 CA - 125 800.00
148 CA - 15 - 3 1250.00
149 CA - 19 - 9 1000.00
150 CALCITONIN 1900.00
151 CALCIUM TOTAL 150.00
152 C-ANCA[ELISA] 700.00
153 CARBAMAZEPINE 500.00
154 CATECHOLAMINES (BLOOD) 1500.00
155 CBC 160.00
156 CBC FOR RANBAXI 180.00
157 CBC WITH ESR 180.00
158 CBC+ESR+MP 200.00
159 CBC+MP 180.00
160 CD 4 COUNT ( SRL) 1750.00
161 CD 4 COUNT ( TALS) 1125.00
162 CD MARKER ON BONEMARROW 7000.00
163 CD4 / CD8 COUNT 2200.00
164 CEA 500.00
165 CERULOPLASMIN 1000.00
166 CHIKUNGUNYA IGM (RAPID) 600.00
167 CHIKUNGUNYA IGM&IGG (ELISA) 750.00
168 CHLAMIDIA LGG ANTIBODIES(RANBAXY) 1300.00
169 CHLAMYDIA IGM ANTIBODYS (RANBAXY) 1400.00
170 CHLORIDE 120.00
171 CHOLINESTRASE (SERUM) 300.00
172 CHROMOSOMAL KARYOTYPING 2500.00
173 CHYLOMICRONS 300.00
174 CLOTTING TIME (C.T.) 50.00
175 CMV PCR (QUALITATIVE) 3200.00
176 CMV-PCR (QUANTITATIVE/ VIRAL LOAD) 7000.00
177 COLD AGGLUTINATION 400.00
178 COPPER (BLOOD) 450.00

Page 89 of 112
179 CORTISOL PER SAMPLE 450.00
180 CORTISOL TWO SAMPLE 900.00
181 C-PEPTIDE LEVEL (SPC) 900.00
182 CREATININE (BLOOD) 120.00
183 CREATININE CLEARANCE (24 HRS.) 220.00
184 CREATININE(DRAIN) 100.00
185 CRYOGLOBIN 400.00
186 CRYPTOCOCAL ANTIGEN 1400.00
187 CRYPTOCOCAL LGG 5000.00
188 CRYPTOCOCCAL LATEX AGGLUTINATION (AG DETECTION) 2000.00
189 CSF - JEV RT PCR 1900.00
190 CSF - SERUM IGG RATIO 600.00
191 CSF (MANOMETERY) 350.00
192 CSF HSV 1 & 2 IGG (METRO) 490.00
193 CSF HSV 1 & 2 IGM (METRO) 490.00
194 CSF-HSV-PCR(QUALITATIVE) 3500.00
195 CSF-OLIGOCLONAL BANDS 2850.00
196 CYCLOSPORINE LEVEL 1500.00
197 CYSTICERCUS IGG ANTIBODEIS(SEROM/CSF) AT RANBAXY 1700.00
198 CYSTICERCUS IGG ANTIBODIES 1500.00
199 CYTOCHEMISTRY 600.00
200 CYTOGENETIC 3500.00
201 CYTOLOGICAL EXAMINATION 500.00
202 D-DIMER TEST 800.00
203 DEAFNESS-CONNEXIN 26 MUTATIONS (INDIAN) 6100.00
204 DELTA 508 MUTATION FOR CFTR 2700.00
205 DELTA AMINOLEVULINIC ACID(URINE) 2500.00
206 DENGUE ANTIBODIES IGG (ELISA) 700.00
207 DENGUE IGG+IGM BY ELISA 1200.00
208 DENGUE SEROLOGY (RAPID) 700.00
209 DEXAMETHASONE SUPPRESSION TEST 800.00
210 DHEAS04 400.00
211 DIALYSIS FLUID R & M 300.00
212 DIGOXIN LEVEL 750.00
213 DIHYROTESTOSTERONE (DHT) 2000.00
214 DILUTE RUSSELLS VIPER VENOM TIME (DRVVT) 2500.00
215 DIRECT COOMBS TEST 150.00
216 DMD CARRIER TEST- LINKAGE STUDIES 7500.00
217 DNA DELETION FOR DMD 4500.00
218 DRAIN FLUID R & M 300.00
219 DRUG ALLERGIC TESTING 850.00
220 DRUG TOXIC SCREENING(SERUM/URINE) 2000.00
221 DRUGS OF ABUSE SCRINNING - 9 2200.00
222 DVT DEEP VAIN THROMBOSIS PROFILE 10000.00
223 D-XYLOSE EXCREATION TEST 600.00
224 ESR 60.00
225 E.HISTOLYTICA ANTIBODIES (EIA) 1200.00

Page 90 of 112
226 ECHINOCOCCUS (HYDATID CYST FLUID) 600.00
227 ECHINOCOCCUS IGG (QUANTITATIVE) 1300.00
228 ELECROLYTES(NA+K+CO+HCO3+AGAP) 600.00
229 ENZYME - MPS II - HUNTER SYNDROME 4800.00
230 ENZYME BETA-GALACTOSIDASE-GMI GANGLIOSIDOSIS 2600.00
231 ENZYME-ARYL SULPHATASE A-MLD 2600.00
232 ENZYME-BETA HEXOSAMINIDASE-TAY SACH-SANDHOFF 3700.00
233 EPIDERMAL GROWTH FACTOR RECEPTOR(EGFR) 1800.00
234 EPSTEIN BAR EA-IGG 1500.00
235 EPSTEIN BAR NA - LGG 1500.00
236 EPSTEIN BAR NA - LGM 1450.00
237 EPSTEIN BAR VCA - LGM 1400.00
238 ER /PR/C-ERB B2 3200.00
239 ER/PR 2500.00
240 ERB - B2 BY FISH 13125.00
241 ERYTHROPOIETIN LEVEL (EPO) 1200.00
242 ESTIMATED GFR 150.00
243 ESTRADIOL (E2) 400.00
244 ESTRIOL- E3 (BLOOD) 550.00
245 EXTRA SENSITIVITY 150.00
246 F D P (FIBRINOGEN DEGRADATION PRODUCT) 700.00
247 FNAC PROCEDURE 650.00
248 FNAC REPORTING 500.00
249 F S H 350.00
250 FACTOR - 5 1500.00
251 FACTOR XIII 600.00
252 FACTOR-8 1500.00
253 FASTING BLOOD GLUCOSE 50.00
254 FERRIC CHLORIDE TEST(URINE) 100.00
255 FERRITIN 450.00
256 FERRITIN PER DILUTION 150.00
257 FETAL HB 150.00
258 FIBRINOGEN 500.00
259 FILARIA ANTIGEN 460.00
260 FISH FOR 13Q DEL 4500.00
261 FISH FOR MDS PANEL 6000.00
262
FLOWCYTOMETRY FOR CHRONIC LYMPHOPROLIFERATIVE DISORDERS (CLPD) 9000.00
263 FOLIC ACID (FOLATE) 900.00
264 FOOD AND INHALATION ALLERGIC TEST 1800.00
265 FRACTIONAL SODIUM (NA) EXCRETION 700.00
266 FRAGILE X SCREEN 3100.00
267 FRAGILE X SYNDROME 4700.00
268 FREE LIGHTCHAIN RATION 2800.00
269 FREE PSA 1350.00
270 FREE T3 300.00
271 FREE T4 300.00
272 FREE TESTOSTERONE 850.00

Page 91 of 112
273 FRIEDREICH ATAXIA 5200.00
274 FROZEN SECTION (PROCEDURE) 2500.00
275 FROZEN SECTION (REGISTRATION) 500.00
276 FUNGAL BLOOD CULTURE(BACTEC) 750.00
277 FUNGAL BODY FLUID CULTURE(BACTEC) 750.00
278 FUNGAL CULTURE AND SENSITIVITY 1000.00
279 FUNGAL CULTURE(CONVENTIONAL METHOD) 500.00
280 FUNGAL SMEAR (KOH MOUNT/LPCB) 150.00
281 G 6 P D QUALITATIVE 200.00
282 G 6 P D QUANTITATIVE 400.00
283 G T T 3 SAMPLE 200.00
284 G T T 5 SAMPLE 300.00
285 GAD-65 (GLUTAMIC ACID DECARBOXYLASE) ANTIBODY 4000.00
286 GALACTOSEMIA (BLOOD TRANSFERASE AND EPIMERASE) 3500.00
287 GAMMA GT 150.00
288 GASTRIN LEVEL 2300.00
289 GENE MUTATION TEST FOR ENTIRE SCA PANEL 9000.00
290 GNRH STIMULATION TEST 2750.00
291 GRAM STAIN 120.00
292 GRAM STAIN WITH SCORE 200.00
293 GROWTH HORMONE 600.00
294 H D L CHOLESTEROL 200.00
295 H. PYLORI ANTIBODY 2200.00
296 H.C.V. RNA GENOTYPE WITH LIPA 11500.00
297 HANGING DROP PREPARATION FOR STOOL 200.00
298 HAPTOGLOBIN 1000.00
299 HB A 1C / GLYOCO HB 400.00
300 HB ELECTROPHORESIS 550.00
301 HB TC DC 150.00
302 HB WITH PCV 150.00
303 HBDSAG (DELTA) HEPATITIS DELTA VIRUS ANTIGEN 2400.00
304 HBE AG 700.00
305 HBS AG (RAPID) 250.00
306 HBSAG (ELFA) 500.00
307 HBSAG (ELISA) 350.00
308 HBSAG CONFIRMATORY TEST 650.00
309 HBV DNA (QUALITATIVE) 3750.00
310 HBV DNA QUANTITATIVE 8000.00
311 HBV RT PCR (QUANTITATIVE) 6500.00
312 HCV - RAPID DOT 600.00
313 HCV GENOTYPING 12500.00
314 HCV RNA PCR (QUALITATIVE) 3100.00
315 HCV RNA PCR (QUANTITATIVE) 7500.00
316 HEMOGLOBIN (HB) 60.00
317 HEMOGLOBIN VARIANT ANALYSIS BY HPLC 950.00
318 HEMOGLOBINURIA 200.00
319 HEMOSIDERIN 500.00

Page 92 of 112
320 HEPATITIS C IGG ANTIBODY 1000.00
321 HER-2NEU IMMUNOHISTO 1750.00
322 HERPES ANTIBODY (I &II) BOTH IGG & IGM (TAL) 875.00
323 HERPES SIMPLEX VIRUS I&II PCR (RELIANCE LIFE SCI.) 3000.00
324 HERPES ZOSTER VIRUS(HZV)IGG 1500.00
325 HERPES ZOSTER VIRUS(HZV)IGM 1500.00
326 HEV IGG ANTIBODIES 1100.00
327 HEV IGM (HEPATITIS E VIRUS IGM ANTIBODY) 900.00
328 HIGH SENSITIVITY CRP 300.00
329 HISTO SLIDE REVIEW 400.00
330 HISTOPATH +IGG +IGA+IGM+C3 ON TISSUE 2600.00
331 HISTOPATHOLOGY REFERAL BIOPSY 2000.00
332 HIV / HBSAG(RAPID) 300.00
333 HIV (ELISA) 450.00
334 HIV + HBSAG (ELISA) 550.00
335 HIV HBSAG(ELFA) 500.00
336 HIV I & II TEST (RAPID) 300.00
337 HIV I AND II (ELFA) 300.00
338 HIV MONITOR (CD4,CD8,VIRAL LOAD) 5000.00
339 HIV MULTIDRUG RESISTANCE TESTING 22000.00
340 HIV PCR(QUALITATIVE) 2100.00
341 HIV VIRAL LOAD(QUANTITATIVE) 5200.00
342 HLA B-27 1750.00
343 HLA B27 (PCR) 3000.00
344 HLA TYPING (CLASS I) 5000.00
345 HOME VISIT CHARGES FOR BLOOD CLOOECTION 30.00
346 HOMOCYSTEIN 900.00
347 HSV I & II IGG 400.00
348 HSV I IGM 300.00
349 HSV II IGM 300.00
350 HSV TYPE - 1 PCR (QUALITATIVE) 3000.00
351 HSV TYPE-2 PCR (QUALITATIVE) 3000.00
352 HYLURONIC ACID (SERUM-PLASMA) 1000.00
353 I.G.F.B.P.-3 2600.00
354 I.G.F.-I 2750.00
355 IBD SCREENING 3500.00
356 IDENTIFICATION AND EXTENDED SENSITIVITY (CONVENTIONAL) 250.00
357
IDENTIFICATION AND EXTENDING SENSITIVITY WITH MIC (ON AUTOMATED
SYSTEM) PER ORGANISM 700.00
358 IGG4 6500.00
359 IHC (OLS) 2500.00
360 IMMUNO ELECTROPHORESIS 5300.00
361 IMMUNOGLOBULIN IGA 400.00
362 IMMUNOGLOBULIN IGE 500.00
363 IMMUNOGLOBULIN IGG 500.00
364 IMMUNOGLOBULIN IGM 500.00
365 IMMUNOPHENOTYPING 7000.00

Page 93 of 112
366 INDIA INK PREPARATION(CRYPTOCOCCUS NEOFORMANS) 150.00
367 INDIRECT COOMBS TEST 250.00
368 INDIRECT COOMBS TEST WITH TITRE 500.00
369 INFECTIOUS MONONUCLEOSIS 400.00
370 INSULIN 600.00
371 INTERCOSTAL DRAIN FLUID R & M 300.00
372 IONISED CALCIUM 250.00
373 IRON (FE) 250.00
374 JACOB-CRUZEFELT VIRUS- BY PCR 20000.00
375 JAK-2 MUTATION 6125.00
376 JAPANESE ENCEPHALITIS (BY PCR) 3000.00
377 L D H 200.00
378 L D L CHOLESTEROL 200.00
379 L E CELLS 200.00
380 L H 350.00
381 LA - MIXING STUDIES 800.00
382 LACTATE 400.00
383 LAMBDA-KAPPA 6000.00
384 LAP SCORE 1500.00
385 LEAD (BLOOD) 1400.00
386 LEAD (URINE) 1400.00
387 LEAKEMIA / LYMPHOMA EVALUTION PANEL - 1 6000.00
388 LEGIONELLA COMPLEMENT FIXATION TEST 1500.00
389 LEPTO SPIRA SEROLOGY 800.00
390 LEPTOSPIRA IGG 1200.00
391 LEPTOSPIRA IGM 1200.00
392 LEUCOCYTE ENZYME ASSAY(GOUCHERS DISEASE) 2000.00
393 LIGIONELLA ANTIBODY 4500.00
394 LIPASE 400.00
395 LIPASE BODY FLUID 400.00
396 LIPID PROFILE 400.00
397 LIPOPROTEIN LP (A) 900.00
398 LITHIUM (LI) 200.00
399 LIVER ABSCESS ASPIRATE EXAMINATION 150.00
400 LIVER COPPER CONCENTRATION 3000.00
401 LIVER COPPER CONCENTRATION - RANBAXY 18000.00
402 LIVER FUNCTION TEST 600.00
403 LIVER KIDNEY ANTIBODY 1500.00
404 LKM ANTIBODIES 1250.00
405 LUPUS ANTICOAGULANT(LA) 1000.00
406 LUPUS CONFIRMATION 1500.00
407 LYMPHOCYTES CROSS MATCHING 1000.00
408 LYMPHOMA - LEUKEMIA WORKUP - HISTOLOGY 2500.00
409 LYMPHOMA EVALUATION WITH HISTOPATHOLOGY 6000.00
410 MAGNESIUM (MG.) 250.00
411 MALARIAL AG - (PF+PV) 300.00
412 MALARIAL PARASITES(P.S.FOR MP) 100.00

Page 94 of 112
413 MANTOUX TEST (M.T.) 70.00
414 MARIJUANA 500.00
415 MCHC 75.00
416 MCV 75.00
417 MEASLES (RUBEOLA) - IGM ANTIBODIES 1000.00
418 MEASLES(RUBEOLA) - IGG ANTIBODIES 900.00
419 MERCURY (SERUM - PLASMA) 2000.00
420 METH HAEMOGLOBIN 600.00
421 METHOTRAXATE LEVEL 1200.00
422 MICROLBUMINUREA 350.00
423 MITOCHONDRIAL PACKAGE 11000.00
424 MORPHINS 500.00
425 MUMPS IGG (CSF) 900.00
426 MUMPS IGG (SERUM) 1600.00
427 MUMPS IGM (CSF) 1000.00
428 MUMPS IGM (SERUM) 2800.00
429 MYCOPLASMA ANTIBODY LGG 1650.00
430 MYCOPLASMA ANTIBODY LGM 1700.00
431 MYCOPLASMA COMPLEMENT FIXATION TEST 1500.00
432 MYCOPLASMA PNEUMONIAE DNA PCR 3500.00
433 MYOGLOBIN (SERUM/URINE) 600.00
434 NA+K 220.00
435 NEISSERIA GONORRHOEAE CULTURE 700.00
436 NICOTIN LEVEL 990.00
437 OCCULT BLOOD 70.00
438 OSMOLALITY SERUM 500.00
439 OSMOLALITY URINE 500.00
440 OSMOTIC FRAGILITY (RBC HRAGILITY) 600.00
441 P S A 450.00
442 P.P. BLOOD GLUCOSE 50.00
443 P53 IMMUNOHISTO 1800.00
444 P-ANCA (BY ELISA METHOD) 700.00
445 PAP SMEAR CYTOLOGY 350.00
446 PARA THYROID HORMONE (PTH) INTACT 1500.00
447 PARVO VIRUS B-19 IGG ANTIBODY 2300.00
448 PARVO VIRUS B-19 IGM ANTIBODY 2000.00
449 PCP STAIN 1200.00
450 PCV (HEAMATOCRIT) 100.00
451 PERIPHERAL SMEAR STUDY 100.00
452 PERITONEAL FLUID R & M 300.00
453 PGBS 50.00
454 PHENOBARBITAL LEVEL 750.00
455 PHENYTOIN LEVEL / DILANTIN 500.00
456 PHOSPHOROUS 150.00
457 PLASMA HAEMOGLOBIN 250.00
458 PLASMA RENIN ACTIVITY 4000.00
459 PLATELET COUNT 100.00

Page 95 of 112
460 PLEURAL FLUID R & M 300.00
461 PNEUMOSLIDE PANEL 2200.00
462 PNH (SPECIFIC IMMONOLOGICAL TEST) 950.00
463 PNH BY FLOW CYTOMETRY 2500.00
464 PNH SCREEN (SUCROSELYSIS + ACID HEM TEST 750.00
465 PORPHOBILINOGEN QUANTITATIVE 1650.00
466 POST BREAKFAST 2HRS BLOOD SUGAR (PB2BS) 50.00
467 POST DINNER 2HRS BLOOD SUGAR 50.00
468 POTASSIUM (K) 120.00
469 PRADER WILLI SYNDROME(FISH) 4500.00
470 PREDINNER BLOOD SUGER 50.00
471 PREGNANCY TEST 100.00
472 PRO-CALCITONIN 2250.00
473 PROGSTERONE 400.00
474 PROLACTIN 400.00
475 PROTEIN C 2200.00
476 PROTEIN ELECTROPHORESIS 550.00
477 PROTHROMBIN TIME 150.00
478 PT CORRECTION STUDY 500.00
479 PYRUVATE 800.00
480 R.A. TEST (QUALITATIVE) 200.00
481 R.A. TEST (QUANTITATIVE) 280.00
482 RABIES ANTIBODIES 1600.00
483 RANDOM BLOOD SUGAR 50.00
484 RBC COUNT 100.00
485 RBC MORPHOLOGY (URINE) 50.00
486 RENAL BIOPSY 2500.00
487 RETICULOCYTE COUNT 150.00
488 RUBELLA IGG 400.00
489 RUBELLA IGM 450.00
490 S G O T 110.00
491 S G P T 110.00
492 S.DIAZEPAM 450.00
493 SERUM/PLASMA PROTEIN 130.00
494 SECOND OPINION AT WELLSPRING FOR DR.JAYA DESHPANDE 1000.00
495 SEMEN ANALYSIS 150.00
496 SERUM ACETONE 90.00
497 SERUM TRANSFERRIN 1200.00
498 SERUM ZINC 1300.00
499 SHBG-SEX HORMONE BINDING GLOBULIN,SERUM 1300.00
500 SICKLING TEST 100.00
501 SMEAR FOR ACTINOMYCOSIS 150.00
502 SODIUM (NA) 120.00
503 SPECAIL STAIN AT WELLSPRING 1875.00
504 SPECIAL STAIN SUDAN BLACK/PAS 250.00
505 SPINAL MUSCULAR ATROPHY (SM) 3800.00
506 SPUTUM FOR EOSINOPHILIA 50.00

Page 96 of 112
507 SPUTUM ROUTINE MICROSCOPIC EXAMINATION 250.00
508 STONE ANALYSIS (CALCULUS) 500.00
509 STOOL FOR CLOSTRIDIUM DIFFICILE TOXIN 2200.00
510 STOOL FOR HANGING DROP PREPERATION 150.00
511 STOOL R & M 100.00
512 SUCROSE HEMOLYSIS 600.00
513 SULF HAEMOGLOBIN 600.00
514 SYNOVIAL FLUID R & M 350.00
515 T I B C (TOTAL IORN BINDING CAPASITY) 250.00
516 T P H A 500.00
517 T S H 210.00
518 T3, T4 TSH (IMMULITE) 500.00
519 TB ANTIGEN DETECTION 300.00
520 TB GOLD 2500.00
521 TB IGA 400.00
522 TB IGG 400.00
523 TB IGM 400.00
524 TB PCR 2000.00
525 TC DC 100.00
526 TC DC & MP 120.00
527 TC DC, MP BY QBC 200.00
528 TESTOSTERONE (TOTAL) 1050.00
529 THEOPHYLLINE LEVEL 1400.00
530 THROMBIN TIME 500.00
531 THROMBOPHILIA MUTATION ANALYSIS 7000.00
532 THYROGLOBULIN 1150.00
533 THYROID MICROSOMAL ANTIBODY 500.00
534 TISSUE TRANSGLUTAMINASE ANTIBODY (TTG) 900.00
535 TORCH (IGG) 1300.00
536 TORCH (IGM) 1300.00
537 TORCH COMPLEX (IGG & IGM) 2200.00
538 TOTAL CHOLESTROL 130.00
539 TOTAL COUNT 70.00
540 TOTAL T3 (T3) 200.00
541 TOTAL T4 (T4) 200.00
542 TOXOPLASMA IGG 400.00
543 TOXOPLASMA IGM 600.00
544 TRIGLYCERIDE (TG) 150.00
545 TROPONIN - I 900.00
546 TYPHI DOT 450.00
547 TZANK TEST 150.00
548 UNSATURATED IRON BINDING CAPACITY 450.00
549 URIC ACID 110.00
550 URINARY - CATECHOLAMINES (24 HRS.) 3600.00
551 URINARY 5-H1AA 2100.00
552 URINARY CALCIUM (SPOT) 200.00
553 URINARY CALCIUM(24 HRS) 200.00

Page 97 of 112
554 URINARY CALCIUM/CREATININE RATIO 250.00
555 URINARY CHLORIDES(24 HRS) 200.00
556 URINARY COPPER [24 HRS] 1500.00
557 URINARY FREE CORTISOL (24 HRS.) 300.00
558 URINARY MAGNESIUM (24 HRS.) 300.00
559 URINARY OXALATE (24 HRS.) 1500.00
560 URINARY PHOSPHORUS(24 HRS) 200.00
561 URINARY POTASSIUM(24 HRS) 200.00
562 URINARY SODIUM(24 HRS) 200.00
563 URINARY SPECIFIC GRAVITY 24HR 150.00
564 URINARY UREA NITROGEN(24 HRS) 150.00
565 URINARY UREA(24 HR) 150.00
566 URINE ACETONE (KETONE) 20.00
567 URINE ALBUMIN 70.00
568 URINE AMINOACID QUAL 2000.00
569 URINE B.J. PROTEIN (BENSE-JONSE PROTIEN) 100.00
570 URINE BENCE JONES BY ELECTROPHROESIS 900.00
571 URINE BS/BP 25.00
572 URINE CHLORIDE(SPOT SAMPLE) 150.00
573 URINE CHYLE 250.00
574 URINE CREATININE (SPOT/24HR) 200.00
575 URINE ELECTROPHORESIS 550.00
576 URINE FOR EOSINOPHILS 75.00
577 URINE FOR FAT GLOBULES 20.00
578 URINE FOR LEPTOSPIROSIS BY DARK FIELD MICROSCOPY 650.00
579 URINE FOR METABOLIC SCREENING BY GCMS 5000.00
580 URINE FOR PHASE CONTRAST MICROSCOPY 200.00
581 URINE FOR PORPHOBILINOGEN 125.00
582 URINE FOR PROTEIN(24 HRS) 150.00
583 URINE FOR URIC ACID (24 HRS.) 200.00
584 URINE METANEPHRINE 920.00
585 URINE PH 25.00
586 URINE POTASSIUM(SPOT SAMPLE) 150.00
587 URINE PROTEIN (SPOT SAMPLE) 25.00
588 URINE R & M 70.00
589 URINE SODIUM(SPOT SAMPLE) 170.00
590 URINE SPECIFIC GRAVITY 20.00
591 URINE SUGAR 20.00
592 URINE UREA (SPOT SAMPLE) 140.00
593 URINE UREA NITROGEN (SPOT SAMPLE) 100.00
594 URINE URIC ACID (SPOT SAMPLE) 100.00
595 URINE UROBILINOGEN 20.00
596 URINERY MAGNESIUM ( SPOT) 300.00
597 V M A (VANALINE MENDALIC ACID) 900.00
598 VALPROIC ACID 600.00
599 VANCOMYCIN 2100.00
600 VARICELLA ZOSTER SEROLOGY 1700.00

Page 98 of 112
601 VARICELLA ZOSTER VIRUS (VZV) - IGG 1500.00
602 VARICELLA ZOSTER VIRUS (VZV) - IGM 1500.00
603 VASOPRESSIN 3000.00
604 VDRL (RPR) + MODIFIED TPHA 200.00
605 VERICELLA-ZOSTER VIRUS(VZV) BY RAPID PCR 19500.00
606 VERY LONG CHAIN FATTY ACID(VLCFA) 5000.00
607 VITAMIN D (1.25 DIHYDROXYCHOLECALCIFEROL 1600.00
608 VITAMIN D3 3100.00
609 WATER CULTURE (QUALITATIVE) 150.00
610 WATER DEPRIVATION TEST 2200.00
611 WESTERN BLOT (HIV) 2300.00
612 WHOLE BLOOD CHARGES 450.00
613 WIDAL TEST 150.00
614 YEAST AST ONLY 500.00
615 YEAST ID AND AFST - MINI API 1000.00
616 YEAST ID ONLY 500.00
617 YEAST IDENTIFICATION 750.00
618 Z.N STAIN 100.00
619 Z.N STAIN (CONCENTRATION METHOD) 200.00
620 Z.N STAIN (MODIFIED) 200.00

EXPLANATORY NOTES:

These charges are subject to change without any intimation

The routine working hours for the Pathology Department is 8 A.M. To 8.P.M

Depending upon the emergency at times the treating Doctor demands for
results of pathological Investigations on STAT/ Emergency basis. In such
case the charges would be as follows
STAT Charges = Routine + 50% Extra
Priority (Emergency charges) = Routine + 25% Extra
If the pathology tests are carried out between 8 P.M. & 8 A.M on working
days or on Sundays /Holidays then the charges would be Routine + 25% Extra

Page 99 of 112

RADIOLOGY

SR. SERVICES RATES
1 ASCENDING URETHROGRAPHY ( 2 FILM ) 600.00
2 ASCENDING URETHROGRAPHY ( 3 FILM ) 850.00
3 BARIUM ENEMA STUDY ( FILM 3) 850.00
4 BARIUM ENEMA STUDY (FILM 2) 600.00
5 BARIUM FOLLOW THROUGH (5 FILM) 1,350.00
6 BARIUM FOLLOW THROUGH (FILM 4) 1,100.00
7 BARIUM FOLLOW THROUGH ( FILM 3 ) 850.00
8 BARIUM MEAL STUDY( FILM 3) 850.00
9 BARIUM MEAL & FOLLOW THROUGH ( FILM 6) 1,600.00
10 BARIUM MEAL & FOLLOW THROUGH ( FILM 7 ) 1,850.00
11 BARIUM MEAL (4 FILMS) 1,100.00
12 BARIUM MEAL FOLLOW THROUGH ( FILM 2 ) 600.00
13 BARIUM MEAL FOLLOW THROUGH (FILM 8 ) 2,100.00
14 BARIUM MEAL FOLLOW UP ( FILM 7) 1,850.00
15 BARIUM MEAL FOR ILEOCEAL REGION ( FILM 4) 1,100.00
16 BARIUM STUDIES (FILM 5) 1,350.00
17 BARIUM STUDIES (FILM 6) 1,600.00
18 BARIUM SWALLOW STUDY (2 FILMS) 500.00
19 BARIUM SWALLOW STUDY - (FILM-2) 600.00
20 BARIUM SWALLOW STUDY ( FILM 3) 850.00
21 C - ARM For Procedures 1,000.00
22 C - Arm Screening Only 400.00
23 C. T. ANGIOGRAPHY 5,000.00
24 CHEST PA 200.00
25 CONTRAST STUDY (FILMS 2) 600.00
26 CT - AMBULANCE FOR CT PATIENT 50.00
27 CT - BRAIN - IONIC CONTRAST (EMERGENCY) 2,700.00
28 CT - BRAIN + LTD ORBIT 2,200.00
29 CT - BRAIN PLAIN (EMERGENCY) 2,100.00
30 CT - CHEST AND UPPER ABDOMEN - CONTRAST 5,000.00
31 CT CISTERNOGRAPHY 2,500.00
32 CT - DENTAL CT 2,000.00
33 CT - GUIDGNCE FOR FNAC - (DR. CHARGES EXTRA) 1,000.00
34 CT - HEAD WITH CONTRAST (NON IONIC) 1,800.00
35 CT - SPINE (3 VERTEBRA AND 2 DISC SPACES - PLAIN 3,000.00
36 CT - TEMPORAL BONE HRCT 2,000.00
37 CT SCAN - ABDOMEN & PELVIS ( I.V. CONTRAST) 4,500.00
38 CT SCAN - ABDOMEN & PELVIS-PLAIN 4,000.00
39 CT SCAN - ANGIOGRAPHY OF ABDOMINAL AORTA 5,000.00
40 CT SCAN - ANGIOGRAPHY OF ARCH OF AORTA 5,000.00
41 CT SCAN - ANGIOGRAPHY OF BRAIN 5,000.00
42 CT SCAN - ANGIOGRAPHY OF CAROTID ARTERIES 5,000.00
43 CT SCAN - ANGIOGRAPHY OF FEMORO-POPLITEAL-ARTERIES 5,000.00
44 CT SCAN - ANGIOGRAPHY OF ILIAC ARTERIES 5,000.00
45 CT SCAN - ANGIOGRAPHY OF RENAL ARTERIES 5,000.00
46 CT SCAN - ANY JOINT - CONTRAST 3,000.00
47 CT SCAN - ANY ONE JOINT- PLAIN 2,500.00
48 CT SCAN - BRAIN + LTD IAM 2,200.00

Page 100 of 112
RADIOLOGY

SR. SERVICES RATES
49 CT SCAN - BRAIN + LTD - PITUTARY 2,200.00
50 CT SCAN - CHEST CONTRAST 3,600.00
51 CT SCAN - FACE - PLAIN (AXIAL ONLY) 2,500.00
52 CT SCAN - FNAC - With CT SCAN Of Same Region 2,000.00
53 CT SCAN - GUIDED BIOPSY 3,500.00
54 CT SCAN - GUIDED PROCEDURE 2,000.00
55 CT SCAN - HEAD - CONTRAST (IONIC) 2,100.00
56 CT SCAN - HEAD PLAIN 1,500.00
57 CT SCAN - LEG / THIGH / ARM - CONTRAST 3,000.00
58 CT SCAN - LEG / THIGH / ARM - PLAIN 2,500.00
59 CT SCAN - LIVER - TRIPHASIC STUDY 3,500.00
60 CT SCAN - NECK WITH NON IONIC (CONTRAST) 3,500.00
61 CT SCAN - OF CERVICAL SPINE 2,200.00
62 CT SCAN - OF PNS & FACE 2,500.00
63 CT SCAN - PELVIS CONTRAST 3,600.00
64 CT SCAN - PELVIS PLAIN 3,000.00
65 CT SCAN - SACRUM AND COCCYX 2,500.00
66 CT SCAN - SPINE PLAIN 2,200.00
67 CT SCAN - SPINE(3 VERTEBRAE & DISC SPACES)-CONTR. 3,000.00
68 CT SCAN - THORAX + HRCT 3,500.00
69 CT SCAN - UPPER ABDOMEN (NON IONIC CONTRAST ) 3,600.00
70 CT SCAN - UPPER ABDOMEN-PLAIN 3,000.00
71 CT SCAN : ANESTHESIST 500.00
72 CT SCAN : ANY 3D STUDY - ( Additional ) 500.00
73 CT SCAN : EXTRA CUTS 500.00
74 CT SCAN : EXTRA CUTS (MARKING) 1,000.00
75 CT SCAN : PRONE EXTRA CUTS 1,000.00
76 CT SCAN CHEST PLAIN 3,000.00
77 CT SCAN H.R.C.T- LUNGS 3,000.00
78 CT SCAN OF ORBITS (CORONAL AND AXIAL) PLAIN 2,500.00
79 CT SCAN OF P.N.S. (AXIAL & CORONAL) - PLAIN 3,000.00
80 CT SCAN OF P.N.S. (AXIAL & CORONAL) -CONTRAST 3,000.00
81 CT SCAN SMALL PART (CONTRAST) 3,000.00
82 CT SCAN SMALL PART (PLAIN) 2,200.00
83 DOPPLER - BILATERAL RENAL VENOUS DOPPLER STUDY 2,200.00
84 DOPPLER - BILATERAL RENAL VENOUS DOPPLER STUDY(BED SIDE) 3,300.00
85 DOPPLER- BILATERAL CAROTID DOPPLER STUDY 1,600.00
86 DOPPLER- CAROTID ARTERIAL DOPPLER STUDY ( BED SIDE) 2,400.00
87 DOPPLER LEFT FOREARM VENOUS/ARTERIAL STUDY 900.00
88 DOPPLER-ABDOMEN VENOUS DOPPLER 1,000.00
89 DOPPLER-AROTIC DOPPLER 1,000.00
90 DOPPLER-AROTIC DOPPLER(BED SIDE) 1,500.00
91 DOPPLER-BILATERAL RENAL ARTERIAL DOPPLER STUDY 2,200.00
92 DOPPLER-BILATERAL RENAL ARTERIAL DOPPLER STUDY(BED SIDE) 3,300.00
93 DOPPLER-BOTH LOWER LIMB ARTERIAL DOPPLER STUDY 2,400.00
94 DOPPLER-BOTH LOWER LIMB ARTERIAL DOPPLER STUDY(BED SIDE) 3,600.00
95 DOPPLER-BOTH LOWER LIMB VENOUS DOPPLER STUDY 2,400.00
96 DOPPLER-BOTH LOWER LIMB VENOUS DOPPLER STUDY(BED SIDE) 3,600.00
97 DOPPLER-BOTH UPPER LIMB ARTERIAL / VENOUS DOPPLER STUDY 2,400.00

Page 101 of 112
RADIOLOGY

SR. SERVICES RATES
98 DOPPLER-BOTH UPPER LIMB ARTERIAL / VENOUS DOPPLER STUDY(BED SIDE) 3,600.00
99 DOPPLER-LEFT LOWER LIMB ARTERIAL DOPPLER STUDY 1,200.00
100 DOPPLER-LEFT LOWER LIMB ARTERIAL DOPPLER STUDY (BED SIDE) 1,800.00
101 DOPPLER-LEFT LOWER LIMB VENOUS DOPPLER STUDY 1,200.00
102 DOPPLER-LEFT LOWER LIMB VENOUS DOPPLER STUDY(BED SIDE) 1,800.00
103 DOPPLER-LEFT UPPER LIMB ARTERIAL DOPPLER STUDY 1,200.00
104 DOPPLER-LEFT UPPER LIMB VENOUS DOPPLER STUDY 1,200.00
105 DOPPLER-OBSTETRIC DOPPLER STUDY 1,000.00
106 DOPPLER-OBSTETRIC DOPPLER STUDY(BED SIDE) 1,500.00
107 DOPPLER-PORTAL DOPPLER STUDY(BED SIDE) 1,500.00
108 DOPPLER-RIGHT LOWER LIMB ARTERIAL DOPPLER STUDY 1,200.00
109 DOPPLER-RIGHT LOWER LIMB ARTERIAL DOPPLER STUDY(BED SIDE) 1,800.00
110 DOPPLER-RIGHT LOWER LIMB VENOUS DOPPLER STUDY 1,200.00
111 DOPPLER-RIGHT LOWER LIMB VENOUS DOPPLER STUDY(BED SIDE) 1,800.00
112 DOPPLER-RIGHT UPPER LIMB ARTERIAL DOPPLER STUDY 1,200.00
113 DOPPLER-RIGHT UPPER LIMB ARTERIAL DOPPLER STUDY(BED SIDE) 1,800.00
114 DOPPLER-RIGHT UPPER LIMB VENOUS DOPPLER STUDY 1,200.00
115 DOPPLER-TESTICULAR DOPPLER STUDY 1,000.00
116 DOPPLER-TESTICULAR DOPPLER STUDY(BED SIDE) 1,500.00
117 DOPPLIER-PORTAL DOPPLER STUDY 1,000.00
118 DYE-STUDY FOR JEJUNUM (PORTABLE) 1,100.00
119 FISTULOGRAM (FILM 3) 850.00
120 H. S. GRAPHY ( TWO - FILMS ) 600.00
121 H.S. Graphy 180.00
122 I I TV Procedure - Procedure charge + three film 850.00
123 I V PYELOGRAM ( FILM 6 ) 1,600.00
126 I.C.U.G (FILM 3) 850.00
127 I.C.U.G (FILM 4) 1,100.00
128 I.C.U.G. 600.00
129 I.I.T.V. SCREENING ONLY 100.00
130 I.I.T.V. SCREENING FOR TUBE POSITIONING 250.00
131 I.V UROGRAPHY ( FILM 7 ) 1,850.00
132 I.V. UROGRAPHY ( FILM 6) 1,600.00
133 I.V. UROGRAPHY (4 FILMS) 1,100.00
134 I.V.PYELOGRAM ( FILM 8) 2,100.00
135 I.V.PYELOGRAM (FILM 4) 1,100.00
136 I.V.PYELOGRAM (FILM 2) 600.00
137 II TV PROCEDURES ( FILM 1 ) 250.00
138 II TV PROCEDURES ( FILM 6) 1,600.00
139 II TV PROCEDURES ( FILM -3 ) 850.00
142 II TV PROCEDURES (FILM 2) 600.00
143 INJECTING URETHROGRAPHY (FILM 3) 850.00
144 INTRA-OPERATIVE CHOLANGIOGRAM (PORTABLE - 2 FILMS) 800.00
145 IVP (FILM 3) 850.00
146 M.C.U.G (FILM 3) 850.00

Page 102 of 112
RADIOLOGY

SR. SERVICES RATES
147 M.C.U.G. (FILM 4) 1,100.00
148
MAMMOGRAPHY - ONE SIDE [2 Plates Small Size] 700.00
149 MAMMOGRAPHY (BOTH SIDE) 1,200.00
150
MAMMOGRAPHY - ONE SIDE [2 Plates Large Size] 900.00
151
MAMMOGRAPHY - BOTH SIDE [2 Plates Small Size] 1400.00
152
MAMMOGRAPHY - BOTH SIDE [2 Plates Large Size] 1800.00
153
EXTRA PLATES 1 LARGE MAMMOGRAPHY 450.00
154
EXTRA PLATES 1 SMALL MAMMOGRAPHY 350.00
155
EMERGENCY MAMMOGRAPHY CHARGES 600.00
156 REPORTING CHARGES 500.00
157 SINOGRAM CONTRAST STUDY 850.00
158 Therapeutic & Interventional Procedure Charge 700.00
159 USG ABDOMEN & KUB 800.00
160 USG ABDOMEN & KUB BED SIDE 1,200.00
161 USG ABDOMEN (BED SIDE) 1,200.00
162 USG ABDOMEN AND PELVIS SCREENING 550.00
163 USG ABDOMEN SCREENING 550.00
164 USG CHEST 600.00
165 USG CHEST (BED SIDE) 1,200.00
166 USG CHEST (BED SIDE) 1,200.00
167 USG EYES 800.00
168 USG EYES(BED SIDE) 1,200.00
169 USG GUIDED PLEURAL TAPPING ( BED SIDE) 1,500.00
170 USG GUIDED PROCEDURES 1,000.00
171 USG GUIDED PROCEDURES (DIAGNOSTIC) 600.00
172 USG Intracavitary (Prostate, Pelvis) 800.00
173 USG KUB 600.00
174 USG KUB (BED SIDE) 1,200.00
175 USG KUB SCREENING 550.00
176 USG MUSCULO- SKELETAL 800.00
177 USG MUSCULO- SKELETAL(BED SIDE) 1,200.00
178 USG Neonatal Brain 800.00
179 USG Neonatal Brain(BED SIDE) 1,200.00
180 USG OBSTETRIC I/II Trimester 600.00
181 USG OBSTETRIC I/II Trimester(Bed side) 1,200.00
182 USG OBSTETRIC III Trimester 800.00
183 USG OBSTETRIC III Trimester(BED SIDE) 1,200.00
184 USG OBSTETRIC SCREENING 550.00
185 USG OF SMALL PART 800.00
186 USG OF SMALL PART(BED SIDE) 1,200.00
187 USG PELVIS 600.00
188 USG PELVIS ( TVS) 800.00
189 USG PELVIS (BED SIDE) 1,200.00
190 USG PELVIS SCREENING 550.00
191 USG RENAL BIOPSY 1,200.00
192 USG THYROID 800.00
193 USG UPPER ABDOMEN 600.00
194 USG UPPER ABDOMEN SCREENING 550.00
195 USG WHOLE ABDOMEN 900.00

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RADIOLOGY

SR. SERVICES RATES
196 USG-FOLLICULAR STUDY-TRANS ABDOMINAL 600.00
197 USG-FOLLICULAR STUDY-TRANS VAGINAL 800.00
198 WATER SOLUBEL CONTRAST SWALLOW STUDY (FILM 2) 600.00
199 WATER SOLUBLE CONTRAST DUODENOGRAPHY ( FILM 4) 1,100.00
200 WATER SOLUBLE CONTRAST FOLLOW THROUGH STUDY 1,000.00
201 WATER SOLUBLE CONTRAST SWALLOW STUDY ( 6FILM) 1,600.00
202 WATER SOLUBLE CONTRAST SWALLOW STUDY [3 FILMS] 850.00
203 X-RAY ABDOMEN ( STANDING ) (BED SIDE) 400.00
204 X-RAY ABDOMEN (supine ) 200.00
205 X-RAY ABDOMEN (SUPINE) (BED SIDE) 400.00
206 X-RAY ABDOMEN ERECT 200.00
207 X-RAY ABDOMEN FOR F.B (BED SIDE) 400.00
208 X-RAY ABDOMEN FOR K.U.B. (BED SIDE) 400.00
209 X-RAY ABDOMEN LAT (SIDE SHOOT) (BED SIDE) 400.00
210 X-RAY ABDOMEN SITTING 200.00
211 X-RAY ABDOMEN SITTING AP VIEW (BED SIDE) 400.00
212 X-RAY ABDOMEN STANDING 200.00
213 X-RAY ABDOMEN SUPINE 200.00
214 X-RAY ABDOMEN SUPINE & ABDOMEN ERECT ( FILM 2) 400.00
215 X-RAY ABDOMEN UPPER & LOWER UPRIGHT(2 FILMS) 400.00
216 X-RAY ABDOMEN UPRIGHT 200.00
217 X-RAY ADNOID LAT 200.00
218 X-RAY AP BOTH KNEE STANDING / LEFT KNEE LAT 400.00
219 X-RAY ARMS AP / LAT 400.00
220 X-RAY BASE OF SKULL 200.00
221 X-RAY BOTH FOREARM AP /LAT 400.00
222 X-RAY BOTH ANKLE AP 200.00
223 X-RAY BOTH ANKLE AP / LAT 400.00
224 X-RAY BOTH CALCANEUM AXIAL 200.00
225 X-RAY BOTH CALCANEUM LAT 200.00
226 X-RAY BOTH ELBOW JOINT AP 200.00
227 X-RAY BOTH ELBOW JOINT AP / Lateral 400.00
228 X-RAY BOTH FEET AP 200.00
229 X-RAY BOTH FEMUR AP 200.00
230 X-RAY BOTH FEMUR AP (BED SIDE) 800.00
231 X-RAY BOTH FEMUR WITH KNEE AP / LAT 400.00
232 X-RAY BOTH FOOT AP 200.00
233 X-RAY BOTH FOOT AP / OBLI 400.00
234 X-RAY BOTH FOREARM WITH WRIST AP / LAT 400.00
235 X-RAY BOTH HAND AP/OBL 400.00
236 X-RAY BOTH HAND AP/OBL 400.00
237 X-RAY BOTH HAND WITH WRIST PA 200.00
238 X-RAY BOTH HEEL LAT (BED SIDE) 400.00
239 X-RAY BOTH HEELS LAT 200.00
240 X-RAY BOTH HIP AP & FROG LEG LAT 400.00
241 X-RAY BOTH HIP AP & FROG VIEWS 400.00
242 X-RAY BOTH HIP FROG VIEW 200.00
243 X-RAY BOTH HIP JOINTS - AP & FROGS VIEWS 400.00
244 X-RAY BOTH HIP JONT AP/LAT 400.00

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RADIOLOGY

SR. SERVICES RATES
245 X-RAY BOTH HIP WITH FEMUR AP 200.00
246 X-RAY BOTH HIP WITH FEMUR AP (BED SIDE) 400.00
247 X-RAY BOTH HIP WITH FEMUR AP/LAT 400.00
248 X-RAY BOTH HIPS AP 200.00
249 X-RAY BOTH KNEE AP 200.00
250 X-RAY BOTH KNEE AP (BED SIDE) 400.00
251 X-RAY BOTH KNEE AP (STANDING)/ Lateral 400.00
252 X-RAY BOTH KNEE JOINTAP/LATERAL 400.00
253 X-RAY BOTH KNEE LAT 200.00
254 X-RAY BOTH KNEE WITH T.F 200.00
255 X-RAY BOTH KNEES AP 200.00
256 X-RAY BOTH MASTOIDS 800.00
257 X-RAY BOTH MASTOIDS SCHLLERS VIEW 400.00
258 X-RAY BOTH S. I. JOINT PRONE 200.00
259 X-RAY BOTH SHOULDER AP 400.00
260 X-RAY BOTH SHOULDER JOINT AP 200.00
261 X-RAY BOTH WRIST JOINT AP 200.00
262 X-RAY BOTH WRIST JOINT AP / LAT 400.00
263 X-RAY BOTH WRIST JOINT AP/LAT 400.00
264 X-RAY BOTH WRIST LAT 200.00
265 X-RAY C SPINE AP (BED SIDE) 400.00
266 X-RAY C SPINE LAT (BED SIDE) 400.00
267 X-RAY C.SPINE AP& LAT.(FLEXION,EXTENSION,NEUTRAL) 600.00
268 X-RAY C.SPINE SIDE SHOOT 200.00
269 X-RAY CERVICAL DORSAL SPINE AP / LAT VIEW 400.00
270 X-RAY CERVICAL SPINE LATERAL EXTENSION 200.00
271 X-RAY CERVICAL SPINE AP / Lateral 400.00
272 X-RAY CERVICAL SPINE EXTENSION & FLEXION 400.00
273 X-RAY CERVICAL SPINE EXTENSION & FLEXION (BED SIDE) 800.00
274 X-RAY CERVICAL SPINE- FLEXION & EXTENSION VIEWS 400.00
275 X-RAY CERVICAL SPINE FLEXION (BED SIDE) 400.00
276 X-RAY CERVICAL SPINE LATERAL 200.00
277 X-RAY CERVICAL SPINE LATERAL (SIDE SHOOT) 200.00
278 X-RAY CERVICAL SPINE LATERAL EXTENSION (BED SIDE) 400.00
279 X-RAY CERVICAL SPINE LATERAL FLEXION 200.00
280 X-RAY CERVICAL SPINE OPEN MOUTH 200.00
281 X-RAY CERVICAL SPINE OPEN MOUTH AP /LAT 400.00
282 X-RAY CERVICAL SPINE SIDE SHOOT LAT (BED SIDE) 400.00
283 X-RAY CHEST FOR RIBS AP 200.00
284 X-RAY CHEST & ABDOMEN AP 200.00
285 X-RAY CHEST AP / LAT 400.00
286 X-RAY CHEST AP SITTING 400.00
287 X-RAY CHEST AP STANDING 200.00
288 X-RAY CHEST AP STANDING VIEW (BED SIDE) 400.00
289 X-RAY CHEST AP SUPINE 200.00
290 X-RAY CHEST AP UPRIGHT (BED SIDE) 400.00
291 X-RAY CHEST LATERAL (BED SIDE) 400.00
292 X-RAY CHEST LEFT LATERAL 200.00
293 X-RAY CHEST PA SITTING 200.00

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RADIOLOGY

SR. SERVICES RATES
294 X-RAY CHEST PA SITTING (BED SIDE) 400.00
295 X-RAY CHEST RIGHT LATERAL 200.00
296 X-RAY CHEST SITTING AP VIEW (BED SIDE) 400.00
297 X-RAY CHEST SUPINE AP VIEW (BED SIDE) 400.00
298 X-RAY CHEST UPRIGHT AP VIEW 200.00
299 X-RAY CHEST UPRIGHT AP VIEW (BED SIDE) 400.00
300 X-RAY CHEST WITH ABDOMEN - STANDING AP VIEW 400.00
301 X-RAY COCCYX AP /LAT 400.00
302 X-RAY COCCYX LATERAL 200.00
303 X-RAY COCCYX LATERAL (BED SIDE) 400.00
304 X-RAY C-V JUNCTION AP (TRANSORAL) 200.00
305 X-RAY D. L. SPINE LATERAL (BED SIDE) 400.00
306 X-RAY D.L. SPINE AP & LATERAL VIEWS (FILM 2 ) 400.00
307 X-RAY D.L.SPINE AP/LAT AP- RT & LT LAT BENDING 600.00
308 X-RAY D.L.SPINE AP/LAT VIEW 400.00
309 X-RAY D.L.SPINE LAT (BED SIDE) 400.00
310 X-RAY D/L SPINE AP (BED SIDE) 400.00
311 X-RAY D-L SPINE - LATERAL 200.00
312 X-RAY D-L SPINE AP 200.00
313 X-RAY D-L SPINE LAT 200.00
314 X-RAY DORSAL SPINE AP (BED SIDE) 400.00
315 X-RAY DORSAL SPINE AP/LAT 400.00
316 X-RAY DORSAL SPINE LATERAL (BED SIDE) 400.00
317 X-RAY DORSAL SPINE LATERAL VIEW 200.00
318 X-RAY ELBOW FOREARM WITH WRIST AP/LAT 200.00
319 X-RAY ELBOW WITH HUMERUS - AP & LATERAL 200.00
320 X-RAY FEMUR AP / LATERAL 400.00
321 X-RAY FOOT & ANKLE JOINT AP / LAT 400.00
322 X-RAY FOR ADENOIDS 200.00
323 X-RAY FOR LEFT LOWER RIBS 200.00
324 X-RAY FOR NASAL BONES 200.00
325 X-RAY HAND AP / OBLQ (BED SIDE) 400.00
326 X-RAY HIP - FROGS VIEW 200.00
327 X-RAY HIP JOINT AP (BED SIDE) 400.00
328 X-RAY INTERNAL AUDITORY MEATUS 200.00
329 X-RAY INTERNAL AUDITORY MEATUS (BED SIDE) 400.00
330 X-RAY K.U.B. & URETHRAL REGIONS- AP VIEWS (BED SIDE) 400.00
331 X-RAY KNEE WITH LEG AP/LAT 200.00
332 X-RAY KNEE WITH TIBIA AP/LAT (BED SIDE) 400.00
333 X-RAY KUB REGION - AP VIEW 200.00
334 X-RAY L . S. SPINE OBL (BED SIDE) 800.00
335 X-RAY L S SPINE - AP & LAT VIEW 400.00
336 X-RAY L S SPINE AP WITH KUB 200.00
337 X-RAY L S. SPINE AP (BED SIDE) 400.00
338 X-RAY L.S.SPINE AP 200.00
339 X-RAY L.S.SPINE AP/ LATERAL 400.00
340 X-RAY L.S.SPINE AP/LAT IN FLEXION & EXTENSION 600.00
341 X-RAY L.S.SPINE PA/LAT 400.00
342 X-RAY LEFT THUMB AP / LAT 200.00

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RADIOLOGY

SR. SERVICES RATES
343 X-RAY LEFT ACETABULUM /INTERNAL & EXTERNAL OBLI 400.00
344 X-RAY LEFT ACETABULUM AP EXT. OBLIQUE (BED SIDE) 400.00
345 X-RAY LEFT ANKLE AP / LAT (BED SIDE) 400.00
346 X-RAY LEFT ANKLE AP / LAT / OBLQUE VIEW 200.00
347 X-RAY LEFT ANKLE AP / LAT VIEW 200.00
348 X-RAY LEFT ANKLE AP/LAT (BED SIDE) 400.00
349 X-RAY LEFT ANKLE JOINT AP / LAT 200.00
350 X-RAY LEFT ANKLE LAT / AXIALI 200.00
351 X-RAY LEFT ANKLE WITH TIBIA AP/LAT 200.00
352 X-RAY LEFT ARMS AP / LAT (BED SIDE) 400.00
353 X-RAY LEFT ARMS AP/LAT 200.00
354 X-RAY LEFT CALCANEUM LAT / AXIAL VIEW 200.00
355 X-RAY LEFT CLAVICLE AP 200.00
356 X-RAY LEFT ELBOW & HUMAERUS AP/LAT VIEW 200.00
357 X-RAY LEFT ELBOW AP / LAT VIEW (BED SIDE) 400.00
358 X-RAY LEFT ELBOW JOINT AP / Lateral 200.00
359 X-RAY LEFT ELBOW LAT 200.00
360 X-RAY LEFT ELBOW LAT. (BED SIDE) 400.00
361 X-RAY LEFT FEMUR AP 200.00
362 X-RAY LEFT FEMUR AP (BED SIDE) 400.00
363 X-RAY LEFT FEMUR AP/LAT 400.00
364 X-RAY LEFT FEMUR LATERAL 200.00
365 X-RAY LEFT FEMUR WITH HIP AP /LAT 400.00
366 X-RAY LEFT FEMUR WITH KNEE AP / LAT 200.00
367 X-RAY LEFT FEMUR WITH KNEE AP / LAT (BED SIDE) 400.00
368 X-RAY LEFT FOOT AP 200.00
369 X-RAY LEFT FOOT AP / LAT 200.00
370 X-RAY LEFT FOOT AP / LAT (BED SIDE) 400.00
371 X-RAY LEFT FOOT AP / LAT/ OBL 200.00
372 X-RAY LEFT FOOT AP / OBLIQUE 200.00
373 X-RAY LEFT FOOT AP / OBLIQUE (BED SIDE) 400.00
374 X-RAY LEFT FOOT AP / OBLIQUE VIEW 200.00
375 X-RAY LEFT FOOT WITH ANKLE JOINT AP / LAT 200.00
376 X-RAY LEFT FOREARM AP / LAT (BED SIDE) 400.00
377 X-RAY LEFT FOREARM AP / OBLI 200.00
378 X-RAY LEFT FOREARM WITH WRIST AP / LATERAL 200.00
379 X-RAY LEFT FOREARM WITH WRIST AP / LATERAL (BED SIDE) 400.00
380 X-RAY LEFT HAND AP / OBLIQUE 200.00
381 X-RAY LEFT HAND AP / LAT 200.00
382 X-RAY LEFT HAND AP / OBLIQUE 200.00
383 X-RAY LEFT HAND AP / OBLIQUE (BED SIDE) 400.00
384 X-RAY LEFT HAND RIGHT & LEFT OBLI 200.00
385 X-RAY LEFT HAND WITH WRIST & ELBOW FOR ADGE 200.00
386 X-RAY LEFT HAND WITH WRIST AP / LAT 200.00
387 X-RAY LEFT HAND WITH WRIST AP/LAT/OBLIQUE 200.00
388 X-RAY LEFT HAND WITH WRIST WITH ELBOW AP 200.00
389 X-RAY LEFT HIP - LATERAL VIEW 200.00
390 X-RAY LEFT HIP - ABDUCTION / ADDUCTION 400.00
391 X-RAY LEFT HIP AP 200.00

Page 107 of 112
RADIOLOGY

SR. SERVICES RATES
392 X-RAY LEFT HIP AP (BED SIDE) 400.00
393 X-RAY LEFT HIP AP / FROG VIEW 400.00
394 X-RAY LEFT HIP JOINT AP / LAT 400.00
395 X-RAY LEFT HIP JOINT WITH FEMUR (BED SIDE) 400.00
396 X-RAY LEFT HIP JOINT WITH FEMUR AP 200.00
397 X-RAY LEFT HIP JOINT WITH FEMUR AP / LAT 400.00
398 X-RAY LEFT HIP LAT (BED SIDE) 400.00
399 X-RAY LEFT HIP WITH FEMUR AP 200.00
400 X-RAY LEFT HIP WITH FEMUR AP & LAT 400.00
401 X-RAY LEFT HIP WITH FEMUR AP / LAT 200.00
402 X-RAY LEFT HUMENUS AP (BED SIDE) 400.00
403 X-RAY LEFT HUMERUS AP 200.00
404 X-RAY LEFT HUMERUS AP & LATERAL VIEWS 200.00
405 X-RAY LEFT HUMERUS AP / LAT 400.00
406 X-RAY LEFT HUMERUS WITH ELBOW AP / LAT (BED SIDE) 400.00
407 X-RAY LEFT KEEN AP / LAT VIEW (BED SIDE) 400.00
408 X-RAY LEFT KNEE AP 200.00
409 X-RAY LEFT KNEE AP (BED SIDE) 400.00
410 X-RAY LEFT KNEE AP / LAT (BED SIDE) 400.00
411 X-RAY LEFT KNEE AP / Lateral 200.00
412 X-RAY LEFT KNEE AP/ LAT / OBL 200.00
413 X-RAY LEFT KNEE AP/LAT SIDE SHOOT (BED SIDE) 800.00
414 X-RAY LEFT KNEE AP/LAT VIEW (BED SIDE) 400.00
415 X-RAY LEFT KNEE INT.OBL & EXT.OBL 200.00
416 X-RAY LEFT KNEE INTERCONDLOR 200.00
417 X-RAY LEFT KNEE JOINT (BED SIDE) 400.00
418 X-RAY LEFT KNEE LAT 200.00
419 X-RAY LEFT KNEE LAT (BED SIDE) 400.00
420 X-RAY LEFT KNEE SKYLINE 200.00
421 X-RAY LEFT KNEE WITH FEMUR AP/LAT 200.00
422 X-RAY LEFT KNEE WITH LEG AP / LAT VIEW (BED SIDE) 400.00
423 X-RAY LEFT KNEE WITH LEG AP/LAT 200.00
424 X-RAY LEFT LATERAL CHEST SITTING (BED SIDE) 400.00
425 X-RAY LEFT LEG AP / LAT 200.00
426 X-RAY LEFT LEG AP / LAT (BED SIDE) 400.00
427 X-RAY LEFT LEG AP/LAT/OBLIQUES 400.00
428 X-RAY LEFT LEG WITH ANKEL JOINT (BED SIDE) 400.00
429 X-RAY LEFT LEG WITH ANKLE JOINT AP & LATERAL VIEW 200.00
430 X-RAY LEFT LEG WITH ANKLE JOINT AP/LATERAL 200.00
431 X-RAY LEFT MANDIBLE (oblq) 200.00
432 X-RAY LEFT MANDIBLE LAT (BED SIDE) 400.00
433 X-RAY LEFT RING & MIDDLE FINGER AP/LAT/OBLIQUE 200.00
434 X-RAY LEFT RING FINGER AP / LAT 200.00
435 X-RAY LEFT SACRO-ILIAC JOINT 200.00
436 X-RAY LEFT SACRO-ILIAC JOINT (BED SIDE) 400.00
437 X-RAY LEFT SHOULDER AXIL VIEW (BED SIDE) 400.00
438 X-RAY LEFT SHOULDER AXIAL 200.00
439 X-RAY LEFT SHOULDER JOINT AP 200.00
440 X-RAY LEFT SHOULDER JOINT AP (BED SIDE) 400.00

Page 108 of 112
RADIOLOGY

SR. SERVICES RATES
441 X-RAY LEFT SHOULDER JOINT AP / LAT 400.00
442 X-RAY LEFT SHOULDER JOINT AP / OBLIQUE 400.00
443 X-RAY LEFT SHOULDER WITH HUMRUS AP & LAT 200.00
444 X-RAY LEFT SUBMANDIBULER REGION 200.00
445 X-RAY LEFT T. M. JOINT (OPEN & CLOSE MOUTH) 400.00
446 X-RAY LEFT THUMB AP / LAT 200.00
447 X-RAY LEFT THUMB LAT / OBLI (BED SIDE) 400.00
448 X-RAY LEFT TIBIA / FIBULA AP / LAT 200.00
449 X-RAY LEFT T-M JOINT 800.00
450 X-RAY LEFT TM JOINT (BED SIDE) 400.00
451 X-RAY LEFT WRIST AP, LATERAL & SCAPHOID VIEW 200.00
452 X-RAY LEFT WRIST AP/ LAT VIEW (BED SIDE) 400.00
453 X-RAY LEFT WRIST JOINT AP / LAT/OBLI 200.00
454 X-RAY LEFT WRIST JOINT AP /LAT 200.00
455 X-RAY LEFT WRIST LAT 200.00
456 X-RAY LEFT WRIST WITH FINGER 200.00
457 X-RAY LEFT WRIST WITH HAND (BED SIDE) 400.00
458 X-RAY LEFTSHOULDER AP VIEW 200.00
459 X-RAY LOWER ABDOMEN 200.00
460 X-RAY LOWER CHEST 200.00
461 X-RAY LOWER CHEST & UPPER ABDOMEN SUPINE AP (BED SIDE) 400.00
462 X-RAY LUMBAR SPINE - AP VIEW 200.00
463 X-RAY LUMBAR SPINE AP/LAT 400.00
464 X-RAY LUMBAR SPINE LATERAL VIEW 200.00
465 X-RAY LUMBER SPINE LATERAL (BED SIDE) 400.00
466 X-RAY LUMBO SACRAL SPINE LATERAL 200.00
467 X-RAY LUMBO-SACRAL SPINE - AP VIEW 200.00
468 X-RAY LUMBO-SACRAL SPINE AP & LAT. VIEWS 400.00
469 X-RAY MANDIBLE AP / LAT 400.00
470 X-RAY MANDIBLE - LEFT LATERAL 200.00
471 X-RAY MANDIBLE AP 200.00
472 X-RAY MANDIBLE AP / OBL 400.00
473 X-RAY MANDIBLE AP VIEW (BED SIDE) 400.00
474 X-RAY MANDIBLE OBL (BED SIDE) 400.00
475 X-RAY MASTOID - SCHULLERS VIEW 200.00
476 X-RAY MASTOIDS SCHILLERS VIEW (BED SIDE) 400.00
477 X-RAY MAXILL PA 200.00
478 X-RAY MERCHANT VIEW 200.00
479 X-RAY NASAL BONE ( LATERAL ) 200.00
480 X-RAY NASAL BONE (BED SIDE) 400.00
481 X-RAY NASOPHARYNX (BED SIDE) 400.00
482 X-RAY NASOPHARYNX LAT 200.00
483 X-RAY NECK - SOFT TISSUE 200.00
484 X-RAY NECK AP / LAT (BED SIDE) 800.00
485 X-RAY NECK LATERAL 200.00
486 X-RAY OF RIGHT LITTLE FINGER - AP, LAT. & OBLIQUE 200.00
487 X-RAY ORBIT AP 200.00
488 X-RAY ORBIT PA 200.00
489 X-RAY P.N.S. SUPINE 200.00

Page 109 of 112
RADIOLOGY

SR. SERVICES RATES
490 X-RAY PARANASAL SINUSES - WATERS VIEW (BED SIDE) 400.00
491 X-RAY PARANASAL SINUSES - WATERS VIEW 200.00
492 X-RAY PATELLA - SKYLINE VIEW 200.00
493 X-RAY PATELLA SKYLINE VIEW 200.00
494 X-RAY PELVIS - AP VIEW (BED SIDE) 400.00
495 X-RAY PELVIS BOTH HIP AP 200.00
496 X-RAY PELVIS FROG VIEW 200.00
497 X-RAY PELVIS WITH BOTH HIPS (BED SIDE) 400.00
498 X-RAY PNS 200.00
499 X-RAY RIGHT ANKLE JOINT AP/ OBL/LAT 200.00
500 X-RAY RIGHT FEMUR AP 200.00
501 X-RAY RIGHT HAND - AP & OBLIQUE VIEWS 200.00
502 X-RAY RIGHT KNEE WITH FEMAR AP (BED SIDE) 400.00
503 X-RAY RIGHT & LEFT ANKLES AP/LAT 400.00
504 X-RAY RIGHT & LEFT HIP JOINT LAT 400.00
505 X-RAY RIGHT & LEFT SHOULDER JOINT AP 400.00
506 X-RAY RIGHT ACETABULUM - INTERNAL & EXTERNAL OBLI 400.00
507 X-RAY RIGHT ANKLE JOINT AP & LATERAL VIEW 200.00
508 X-RAY RIGHT ANKLE AP / LAT 200.00
509 X-RAY RIGHT ANKLE AP /LAT/OBL 200.00
510 X-RAY RIGHT ANKLE AP /OBL 200.00
511 X-RAY RIGHT ANKLE AP/ LAT VIEW 200.00
512 X-RAY RIGHT ANKLE AP/ LAT (BED SIDE) 400.00
513 X-RAY RIGHT ANKLE AP/LAT 800.00
514 X-RAY RIGHT ANKLE AP/LAT & AXIL 200.00
515 X-RAY RIGHT ANKLE WITH TIBIA AP/LAT 200.00
516 X-RAY RIGHT ARM AP 200.00
517 X-RAY RIGHT ARM WITH SHOULDER AP / LAT 200.00
518 X-RAY RIGHT ARMS AP / LAT 200.00
519 X-RAY RIGHT ARMS AP /LAT (BED SIDE) 400.00
520 X-RAY RIGHT BIG TOE AP / LAT 200.00
521 X-RAY RIGHT CALCANEUM LAT 200.00
522 X-RAY RIGHT CHEST LATERAL 200.00
523 X-RAY RIGHT CLAVICLE AP 200.00
524 X-RAY RIGHT ELBOW AP / LAT (BED SIDE) 400.00
525 X-RAY RIGHT ELBOW JOINT AP / Lateral 200.00
526 X-RAY RIGHT ELBOW LAT SHOOT THROUGH 200.00
527 X-RAY RIGHT ELBOW WITH FOREARM AP/LAT 200.00
528 X-RAY RIGHT ELBOW WITH FOREARM AP/LAT (BED SIDE) 400.00
529 X-RAY RIGHT FEMER WITH HIP AP (BED SIDE) 400.00
530 X-RAY RIGHT FEMUR AP 200.00
531 X-RAY RIGHT FEMUR AP (BED SIDE) 400.00
532 X-RAY RIGHT FEMUR AP / LAT (BED SIDE) 400.00
533 X-RAY RIGHT FEMUR AP /LAT 200.00
534 X-RAY RIGHT FEMUR AP/Lateral 200.00
535 X-RAY RIGHT FEMUR WITH KNEE (BED SIDE) 400.00
536 X-RAY RIGHT FEMUR WITH KNEE AP/ LAT (BED SIDE) 400.00
537 X-RAY RIGHT FEMUR WITH KNEE JT AP/LAT 200.00
538 X-RAY RIGHT FOOT AP / LAT 200.00

Page 110 of 112
RADIOLOGY

SR. SERVICES RATES
539 X-RAY RIGHT FOOT AP / OBLIQUE (BED SIDE) 400.00
540 X-RAY RIGHT FOOT AP /OBLIQUE/ LAT 200.00
541 X-RAY RIGHT FOOT AP/ OBLIQUE VIEW 200.00
542 X-RAY RIGHT FOOT AP/OBLI 200.00
543 X-RAY RIGHT FOREAM AP/LAT (BED SIDE) 400.00
544 X-RAY RIGHT FOREARM AP (BED SIDE) 400.00
545 X-RAY RIGHT FOREARM WITH WRIST AP / LATERAL 200.00
546 X-RAY RIGHT FOREARM WITH WRIST AP/LAT (BED SIDE) 400.00
547 X-RAY RIGHT FROGS VIEW AP 200.00
548 X-RAY RIGHT HAND AP / OBL 200.00
549 X-RAY RIGHT HAND AP/LATERAL 200.00
550 X-RAY RIGHT HAND OBL / LAT 200.00
551 X-RAY RIGHT HAND WITH FOREARM AP, LAT & OBLIQUE 200.00
552 X-RAY RIGHT HAND WITH WRIST AP/LAT 200.00
553 X-RAY RIGHT HIP - ABDUCTION / ADDUCTION 400.00
554 X-RAY RIGHT HIP FROG S LEG LATERAL 200.00
555 X-RAY RIGHT HIP AP 200.00
556 X-RAY RIGHT HIP AP (BED SIDE) 400.00
557 X-RAY RIGHT HIP INTERNAL / EXTERNAL OBLIQUE 400.00
558 X-RAY RIGHT HIP INTERNAL / EXTERNAL OBLIQUE (BED SIDE) 800.00
559 X-RAY RIGHT HIP JIONT WITH FEMUR (BED SIDE) 400.00
560 X-RAY RIGHT HIP JOINT AP / LAT 400.00
561 X-RAY RIGHT HIP JOINT AP/ FROG VIEW (BED SIDE) 400.00
562 X-RAY RIGHT HIP JOINT LAT 200.00
563 X-RAY RIGHT HIP JOINT OBLI (BED SIDE) 400.00
564 X-RAY RIGHT HIP JOINT WITH FEMUR AP 200.00
565 X-RAY RIGHT HIP STANDING AP / LAT 400.00
566 X-RAY RIGHT HIP WITH FEMUR AP / LAT 200.00
567 X-RAY RIGHT HIP WITH FEMUR AP / LAT 400.00
568 X-RAY RIGHT HUMERUS AP 200.00
569 X-RAY RIGHT HUMERUS AP (BED SIDE) 400.00
570 X-RAY RIGHT HUMERUS AP / LATERAL (BED SIDE) 400.00
571 X-RAY RIGHT HUMERUS AP/LAT 200.00
572 X-RAY RIGHT HUMERUS AP/LAT/OBL (BED SIDE) 400.00
573 X-RAY RIGHT HUMERUS WITH ELBOW - AP & LATERAL VIEW (BED SIDE) 400.00
574 X-RAY RIGHT ILIAC BONE OBLIQUE (BED SIDE) 400.00
575 X-RAY RIGHT KNEE AP 200.00
576 X-RAY RIGHT KNEE AP (BED SIDE) 400.00
577 X-RAY RIGHT KNEE AP / Lateral 200.00
578 X-RAY RIGHT KNEE AP / LATERAL (BED SIDE) 400.00
579 X-RAY RIGHT KNEE AP /LAT IN SIDE SHOOT VIEW (BED SIDE) 800.00
580 X-RAY RIGHT KNEE AP/LATERAL (BED SIDE) 400.00
581 X-RAY RIGHT KNEE JOINT - AP & LATERAL 200.00
582 X-RAY RIGHT KNEE LAT 200.00
583 X-RAY RIGHT KNEE LAT (BED SIDE) 400.00
584 X-RAY RIGHT KNEE WITH FEMUR AP 200.00
585 X-RAY RIGHT KNEE WITH FEMUR AP / LAT (BED SIDE) 400.00
586 X-RAY RIGHT KNEE WITH FEMUR AP/LAT 200.00
587 X-RAY RIGHT KNEE WITH LEG AP / LAT (BED SIDE) 400.00

Page 111 of 112
RADIOLOGY

SR. SERVICES RATES
588 X-RAY RIGHT KNEE WITH LEG AP/LAT 200.00
589 X-RAY RIGHT LEG (BED SIDE) 400.00
590 X-RAY RIGHT LEG AP 200.00
591 X-RAY RIGHT LEG AP / LAT 200.00
592 X-RAY RIGHT LEG AP / LAT (BED SIDE) 400.00
593 X-RAY RIGHT LEG OBLIQUES VIEW 200.00
594 X-RAY RIGHT LEG WITH ANKEL JOINT (BED SIDE) 400.00
595 X-RAY RIGHT LEG WITH ANKLE AP & LAT 200.00
596 X-RAY RIGHT LEG WITH KNEE AP/LAT 200.00
597 X-RAY RIGHT LITTLE FINGER 200.00
598 X-RAY RIGHT MANDIBLE (oblq) 200.00
599 X-RAY RIGHT MANDIBLE AP / LAT 400.00
600 X-RAY RIGHT MANDIBLE LAT (BED SIDE) 400.00
601 X-RAY RIGHT MASTOIDS 200.00
602 X-RAY RIGHT MIDDLE FINGER - AP & OBLIQUE 200.00
603 X-RAY RIGHT MIDDLE FINGER AP /LAT 200.00
604 X-RAY RIGHT ORBIT 200.00
605 X-RAY RIGHT RING FINGERS AP/ LAT / OBL 200.00
606 X-RAY RIGHT SACRO-ILIAC JOINT 200.00
607 X-RAY RIGHT SACRO-ILIAC JOINT (BED SIDE) 400.00
608 X-RAY RIGHT SCAPPULLA AP (BED SIDE) 400.00
609 X-RAY RIGHT SCAPULA - AP & LATERAL VIEWS 400.00
610 X-RAY RIGHT SHOULDER - AP & AXIAL VIEWS 400.00
611 X-RAY RIGHT SHOULDER AP / OBLIQUE 400.00
612 X-RAY RIGHT SHOULDER AP / LAT 400.00
613 X-RAY RIGHT SHOULDER JOINT AP 200.00
614 X-RAY RIGHT SHOULDER JOINT AP (BED SIDE) 400.00
615 X-RAY RIGHT SHOULDER JOINT LAT (BED SIDE) 400.00
616 X-RAY RIGHT SHOULDER WITH C. SPINE AP VIEW 200.00
617 X-RAY RIGHT SHOULDER WITH HUMERUS AP/LAT 400.00
618 X-RAY RIGHT SHOULDER WITH SCEPULA AP VIEW (BED SIDE) 400.00
619 X-RAY RIGHT SHOULDER-HUMERUS AP (BED SIDE) 400.00
620 X-RAY RIGHT T. M. JOINT (BED SIDE) 400.00
621 X-RAY RIGHT T. M. JOINT (OPEN & CLOSE MOUTH) 400.00
622 X-RAY RIGHT THUMB AP / LAT / OBLIQUE VIEWS 200.00
623 X-RAY RIGHT THUMB AP / OBLI 200.00
624 X-RAY RIGHT TIBIA AP 200.00
625 X-RAY RIGHT TIBIA FIBULA AP /LAT (BED SIDE) 400.00
626 X-RAY RIGHT TIBIA FIBULA AP/LAT 200.00
627 X-RAY RIGHT TIBIA LAT/OBLI 200.00
628 X-RAY RIGHT T-M JOINT 200.00
629 X-RAY RIGHT TOE AP\LAT 200.00
630 X-RAY RIGHT WRIST (SCAPHOID VIEW) 200.00
631 X-RAY RIGHT WRIST AP & LATERAL VIEWS 200.00
632 X-RAY RIGHT WRIST AP / LAT / OBLI 200.00
633 X-RAY RIGHT WRIST AP /OBLI/SCAPHOID VIEW 200.00
634 X-RAY RIGHT WRIST JOINT 200.00
635 X-RAY RIGHT WRIST JOINT AP / LATERAL 400.00
636 X-RAY RIGHT WRIST PA / LAT 200.00

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RADIOLOGY

SR. SERVICES RATES
637 X-RAY RIGHT WRIST WITH FOREARM - AP & LATERAL 200.00
638 X-RAY RIGHT WRIST WITH FOREARM AP & INT.EXT.OBLI 200.00
639 X-RAY RIGHTARMS AP (BED SIDE) 400.00
640 X-RAY RIGTH T-M JOINT (BED SIDE) 400.00
641 X-RAY RT KNEE WITH LEG (BED SIDE) 400.00
642 X-RAY RT KNEE WITH FEMUR 200.00
643 X-RAY SACRO-ILIAC JOINT - PRONE VIEW 200.00
644 X-RAY SKULL - SUB-MENTO-VERTICAL VIEW 200.00
645 X-RAY SKULL AP 200.00
646 X-RAY SKULL AP (BED SIDE) 400.00
647 X-RAY SKULL AP / Lateral 400.00
648 X-RAY SKULL BASAL VIEW 200.00
649 X-RAY SKULL BASAL VIEW (BED SIDE) 400.00
650 X-RAY SKULL FOR PITUITARY FOSSA 200.00
651 X-RAY SKULL FOR PITUITARY FOSSA (BED SIDE) 400.00
652 X-RAY SKULL LAT (BED SIDE) 400.00
653 X-RAY SKULL LATERAL 200.00
654 X-RAY SKULL TOWNS VIEW 200.00
655 X-RAY SKULL TOWNS VIEW (BED SIDE) 400.00
656 X-RAY STARNUM LAT (BED SIDE) 400.00
657 X-RAY STERNUM LATERAL 200.00
658 X-RAY STERNUM LATERAL & OBLIQUE VIEWS 200.00
659 X-RAY STYLO MUSTOID PROCESS LATERAL 200.00
660 X-RAY T.M.JOINT 200.00
661 X-RAY THORACIC SPINE LATERAL 200.00
662 X-RAY THORACIC SPINE AP 200.00
663 X-RAY THORACIC SPINE AP / LATERAL 400.00
664 X-RAY UPRIGHT AP VIEW EXPIRATORY 200.00
665 X-RAY WRIST JOINT AP / LATERAL (BED SIDE) 400.00
666 X-RAY WRIST JOINT WITH HAND (BED SIDE) 400.00
667 X-RAY ZYGOMATIC ARCH 200.00

EXPLANATORY NOTES:

Routine fee as above between - 8:00 AM To 8:00 PM.
Emergency Fee between - 8:00 PM To 8:00 AM / Holidays / STAT - 50% extra
for all Radiological Investigations.
No Ultra-Sonography will be done as Preliminary Procedures.
Consumables & Anaesthetist charges Extra.
Sonography Screening - Only Rs.50/- (less than Routine Charges).

***************************

Ahmedabad - Sterling - 2009

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