File 1685415157

B.P.
Koirala Institute of Health Sciences, Dharan
Hospital Services - Rate List
BPKIHS GENERAL EHS BIMA

SN DEPARTMENT CODE TEST NAME RATE RATE RATE
1 ACADEMIC SEVICES 987 BDS INTERNSHIP LOG BOOK CHARGES 250 0 0
2 ACADEMIC SEVICES 670 BDS LOG BOOK FOR COMMUNITY DENTISTRY 100 0 0
3 ACADEMIC SEVICES 2116 BDS LOG BOOK FOR ORAL ANATOMY AND HISTOLOGY 270 0 0
4 ACADEMIC SEVICES 671 BDS LOG BOOK FOR PERIODONTICS 110 0 0
5 ACADEMIC SEVICES 1450 CERTIFICATE NSG. COMMUNITY HEALTH LOG BOOK 180 0 0
6 ACADEMIC SEVICES 2035 LIBERARY LATE FINE 0 0 0
7 ACADEMIC SEVICES 981 LOG BOOK CURRICULUM MBBS 320 0 0
8 ACADEMIC SEVICES 795 LOG BOOK FOR BDS CURRICULUM 140 0 0
9 ACADEMIC SEVICES 790 LOG BOOK FOR BMIT 60 0 0
10 ACADEMIC SEVICES 1851 LOG BOOK FOR BSC MLT 3RD YEAR 630 0 0
11 ACADEMIC SEVICES 979 LOG BOOK FOR BSC NURSING CURRICULUM 250 0 0
12 ACADEMIC SEVICES 980 LOG BOOK FOR CERTIFICATE NURSING CURRICULUM 190 0 0
13 ACADEMIC SEVICES 1852 LOG BOOK FOR CLINICAL RECORDS GYNCEOLOGY 390 0 0
LOG BOOK FOR CONSERVATIVE DENTISTRY &

14 ACADEMIC SEVICES 673 ENDODONTICS 180 0 0
15 ACADEMIC SEVICES 537 LOG BOOK FOR DENTAL MATERIA 250 0 0
16 ACADEMIC SEVICES 699 LOG BOOK FOR FORENSIC MEDICINE & ODONTOLOGY 630 0 0
17 ACADEMIC SEVICES 793 LOG BOOK FOR MBBS CURRICULUM 320 0 0
18 ACADEMIC SEVICES 672 LOG BOOK FOR ORAL & MAXILLOFACIAL SURGERY 170 0 0
19 ACADEMIC SEVICES 722 LOG BOOK FOR ORAL MEDICINE & RADIOLOGY 390 0 0
20 ACADEMIC SEVICES 674 LOG BOOK FOR ORAL PATHOLOGY & MICROBIOLOGY 170 0 0
21 ACADEMIC SEVICES 723 LOG BOOK FOR PEDODONTICS & PREVENTIVE MEDICINE 110 0 0
22 ACADEMIC SEVICES 671 LOG BOOK FOR PERIODONTICS DEPARTMENT 160 0 0
1
23 ACADEMIC SEVICES 754 LOG BOOK FOR PROSTHODONTICS 260 0 0
24 ACADEMIC SEVICES 670 LOG BOOK FOR PUBLIC HEALTH DENTISTRY 250 0 0
LOG BOOK OF DELIVERY RECORD FOR NURSING

25 ACADEMIC SEVICES 1850 MIDWIFERY 330 0 0
26 ACADEMIC SEVICES 986 LOG BOOK OF ORTHODONTICS 250 0 0
27 ACADEMIC SEVICES 5659 M.SC CURRICULUM 250 0 0
28 ACADEMIC SEVICES 1981 M.SC. NSG. COMMUNITY HEALTH LOG BOOK 250 0 0
29 ACADEMIC SEVICES 663 MBBS LOG BOOK FOR COMMUNITY MEDICINE 330 0 0
30 ACADEMIC SEVICES 664 MBBS LOG BOOK FOR FORENSIC MEDICINE 250 0 0
31 ACADEMIC SEVICES 665 MBBS LOG BOOK FOR GYNACOLOGY 400 0 0
32 ACADEMIC SEVICES 669 MBBS LOG BOOK FOR INTERNSHIP 330 0 0
33 ACADEMIC SEVICES 666 MBBS LOG BOOK FOR LABOR OBS/GYN 330 0 0
34 ACADEMIC SEVICES 662 MBBS LOG BOOK FOR MEDICINE 460 0 0
35 ACADEMIC SEVICES 668 MBBS LOG BOOK FOR PAEDIATRICS 250 0 0
36 ACADEMIC SEVICES 667 MBBS LOG BOOK FOR PHYSIOLOGY 320 0 0
37 ACADEMIC SEVICES 661 MBBS LOG BOOK FOR SURGERY 470 0 0
38 ACADEMIC SEVICES 6100 MSC NURSING CLINICAL POSTIING LOG BOOK 380 0 0
ANAESTHESIOLOGY & CRITICAL

39 CARE 1597 ANAESTHESIA FOR CT SCAN 1250 1880 2000
40 ANAESTHESIOLOGY
CARE
& CRITICAL 1596 ANAESTHESIA FOR MANUPULATION 1250 1690 2000
41 ANAESTHESIOLOGY & CRITICAL 995 CAUDAL 1880 2130 2000

CARE

42 CARE 1654 CVP INSERTION CHARGE IN WARD 1290 1510 2000

43 CARE 1688 EPIDURAL CATHETER INSERTION PER VISIT 0 380 0
44 ANAESTHESIOLOGY
CARE
& CRITICAL 1000 EPIDURAL CATHETER INSERTION WITH 3 WARD VISITS 2610 2950 3000
45 ANAESTHESIOLOGY & CRITICAL 2142 FACET JOINT INJECTION 2370 2950 3000
CARE

46 CARE 993 GLOSSOPHARYNGEAL NERVE BLOCK 630 750 700
2
47 ANAESTHESIOLOGY & CRITICAL 2126 INJ. MORPHINE 10MG/ML 100 0 0

CARE

48 CARE 2127 INJ. PETHEDINE 50MG/ML 110 0 0
ANAESTHESIOLOGY & CRITICAL INTERTICULAR JT. INJECTION/INTERCOSTAL NERVE

49 CARE 997 BLOCK 1290 1510 2000
50 ANAESTHESIOLOGY
CARE
& CRITICAL 991 INTRAORBITAL BLOCK 630 790 700
51 ANAESTHESIOLOGY & CRITICAL 999 LATERAL FEMORAL CUTANEOUS BLOCK 630 750 700
CARE

52 CARE 1002 LOCAL /REGIONAL INFILTRATION 630 750 700
ANAESTHESIOLOGY & CRITICAL LUMBAR SYMPATHETIC BLOCK/ COELIC PLEXUS BLOCK

53 CARE 1208 CHEMICLA RF (RADIOFREQUENCY) 2610 2950 3000
54 ANAESTHESIOLOGY
CARE
& CRITICAL 994 LUMBER/ THORACIC / CERVICAL 1880 2130 2000
55 ANAESTHESIOLOGY & CRITICAL 988 MANDIBULAR BLOCK 1290 1510 2000

CARE

56 CARE 989 MAXILLARY BLOCK 1290 1510 2000

57 CARE 992 MENTAL NERVE BLOCK 630 750 700
58 ANAESTHESIOLOGY
CARE
& CRITICAL 1655 MONITORED ANESTHESIA CARE 0 3750 0

59 2157 MORE THAN 3 WARD VISITS EACH WARD VISIT 0 400 0
CARE

60 CARE 971 PAIN CLINIC OPD CONSULTATION FEE (15 DAYS) 0 500 0
61 ANAESTHESIOLOGY & CRITICAL 1445 PRE ANAESTHESIA CHECK UP (PAC) 120 550 0
CARE

62 CARE 2143 SL JOINT INJECTION 2370 2950 3000

63 CARE 998 STELLATE GANGLION BLOCK 630 1260 850
64 ANAESTHESIOLOGY
CARE
& CRITICAL 990 SUBERAOBITAL / SUPRATROCHCHEAR 630 750 700
65 ANAESTHESIOLOGY & CRITICAL 2122 SYRUP MORPHINE 60 ML 140 0 200

CARE

66 CARE 1679 TAB. MORPHINE 10 MG 10 0 0

67 CARE 1678 TAB. MORPHINE 30 MG 10 0 0
68 ANAESTHESIOLOGY
CARE
& CRITICAL 2123 TAB. MORPHINE PR 30 MG 20 0 0
69 ANATOMY 126 BARR-BODY (HETERROCHROMATIN) EXAMINATION 210 380 0
70 ANATOMY 135 KARYOTYPING (INDIVIDUAL) 3480 5060 0
3
71 ANATOMY 6088 MULTISHOT BAND LIGATOR 4540 4540 0
72 BED CHARGES BED CHARGE 300 500 0
73 BIOCHEMISTRY 336 ABG (ARTERIAL BLOOD GAS) ONE SAMPLE 760 1380 800
74 BIOCHEMISTRY 6078 ACR 880 1590 900
75 BIOCHEMISTRY 1199 ADENOSINE DEAMINASE (ADA) 1000 1500 575
76 BIOCHEMISTRY 576 ALBUMIN 130 240 100
77 BIOCHEMISTRY 341 ALKALINE PHOSPHATASE (ALP) 170 300 123
78 BIOCHEMISTRY 342 ALT (SGPT) 170 300 120
79 BIOCHEMISTRY 333 AMYLASE 230 380 200
80 BIOCHEMISTRY 2253 APO A 800 1460 800
81 BIOCHEMISTRY 2254 APO B 800 1460 800
82 BIOCHEMISTRY 343 AST (SGOT) 170 300 120
83 BIOCHEMISTRY 330 BILE PIGMENT (URINE) 110 200 200
84 BIOCHEMISTRY 642 BILE SALT 110 200 200
85 BIOCHEMISTRY 339 BILIRUBIN (DIRECT) 130 200 100
86 BIOCHEMISTRY 340 BILIRUBIN (TOTAL) 130 200 100
87 BIOCHEMISTRY 1599 BILIRUBIN (TOTAL, DIRECT) 250 400 300
88 BIOCHEMISTRY 2249 C3 600 1050 600
89 BIOCHEMISTRY 2250 C4 600 1050 600
90 BIOCHEMISTRY 321 CALCIUM TOTAL 140 250 200
91 BIOCHEMISTRY 1206 CERULOPLASMIN 930 1680 1000
92 BIOCHEMISTRY 2252 CHOLINESTERASE 500 900 500
93 BIOCHEMISTRY 331 CHYLE 110 200 200
94 BIOCHEMISTRY 324 CREATINE KINASE MB 300 550 330
4
95 BIOCHEMISTRY 323 CREATINE KINASE TOTAL 250 460 215
96 BIOCHEMISTRY 346 CREATININE 120 190 100
97 BIOCHEMISTRY 289 CSF & OTHER BODY FLUID RE/ME 300 550 100
98 BIOCHEMISTRY 1674 D-DIMER 800 1450 400
99 BIOCHEMISTRY 3033 DHEAS. 0 0 0
100 BIOCHEMISTRY 5053 DS DNA 0 0 0
101 BIOCHEMISTRY 720 FASTING BLOOD SUGAR 70 120 100
102 BIOCHEMISTRY 698 GAMMA GT 160 280 105
103 BIOCHEMISTRY 320 GLUCOSE ( GTT) (4 SAMPLES) 280 460 240
104 BIOCHEMISTRY 318 GLUCOSE ( RANDOM ) 70 120 100
105 BIOCHEMISTRY 319 GLUCOSE (GCT ) 70 120 100
106 BIOCHEMISTRY 809 GLYCOSYLATED HAEMOGLOBIN (HBA1C) 850 1400 500
107 BIOCHEMISTRY 6010 IL6 2350 4200 0
108 BIOCHEMISTRY 1195 IONISED CALCIUM 300 500 400
109 BIOCHEMISTRY 807 IRON AND TIBC 800 1400 1100
110 BIOCHEMISTRY 704 LACTATEDEHYDRYGENASE (LDH) 250 450 310
111 BIOCHEMISTRY 347 LIPID PROFILE 1270 2000 600
112 BIOCHEMISTRY 1202 LIPOPROTEIN LP (A) 810 1470 900
113 BIOCHEMISTRY 344 LIVER FUNCTION TEST (LFT) 1000 1600 460
114 BIOCHEMISTRY 806 MICROALBUMIN 700 1200 700
115 BIOCHEMISTRY 1588 NA + K + CA + CL 850 1500 900
116 BIOCHEMISTRY 6009 PCT (PROCALCITONINE) 2500 4550 0
117 BIOCHEMISTRY 322 PHOSPHORUS 150 250 185
118 BIOCHEMISTRY 6064 POTASSIUM (K) 150 0 150
5
119 BIOCHEMISTRY 721 PP BLOOD SUGAR 70 120 100
120 BIOCHEMISTRY 2215 PROTEIN IN SPOT URINE 250 460 300
121 BIOCHEMISTRY 1201 QUANTITATIVE CRP (HS CRP) 800 1400 800
122 BIOCHEMISTRY 1196 SERUM CHOLESTEROL (TOTAL) 250 400 150
123 BIOCHEMISTRY 1204 SERUM COPPER 700 1270 700
124 BIOCHEMISTRY 728 SERUM CREATININE 120 190 100
125 BIOCHEMISTRY 796 SERUM ELECTROLYTES (SODIUM, POTASIUM) 400 700 400
126 BIOCHEMISTRY 6066 SERUM FERRITIN 800 1450 500
127 BIOCHEMISTRY 577 SERUM HDL CHOLESTEROL 400 600 150
128 BIOCHEMISTRY 348 SERUM LDL CHOLESTEROL 450 750 150
129 BIOCHEMISTRY 244 SERUM LIPASE 450 800 332
130 BIOCHEMISTRY 690 SERUM LITHIUM 1000 1500 559
131 BIOCHEMISTRY 2211 SERUM MAGNESIUM 400 700 300
132 BIOCHEMISTRY 350 SERUM TRIGLYCERIDE (TAG) 270 450 150
133 BIOCHEMISTRY 727 SERUM UREA 120 190 90
134 BIOCHEMISTRY 6063 SODIUM (NA) 150 0 150
135 BIOCHEMISTRY 5373 SUCROSE LYSIS TEST 660 1200 700
136 BIOCHEMISTRY 338 TOTAL PROTEIN 130 240 130
137 BIOCHEMISTRY 329 TOTAL PROTEIN IN URINE 250 460 160
138 BIOCHEMISTRY 2251 TRANSFERRIN 1000 1520 1000
139 BIOCHEMISTRY 239 TROPONIN I (QUALITATIVE) 880 1450 715
140 BIOCHEMISTRY 345 UREA 120 190 90
141 BIOCHEMISTRY 328 URIC ACID 150 250 95
142 BIOCHEMISTRY 2255 URINARY PROTEIN CREATININE RATIO 370 600 400
6
143 BIOCHEMISTRY 5545 URINE ALBUMIN / CREATININE RATIO 820 1400 850
144 BIOCHEMISTRY 2212 URINE AMYLASE 230 380 300
145 BIOCHEMISTRY 2214 URINE CALCIUM 150 250 200
146 BIOCHEMISTRY 2216 URINE CREATININE 130 230 200
147 BIOCHEMISTRY 2213 URINE GLUCOSE 100 180 100
148 BIOCHEMISTRY 6080 URINE PHOSPHOROUS 150 250 200
149 BIOCHEMISTRY 6079 URINE URIC ACID 150 250 200
150 CARDIOLOGY 5397 ASD DEVICE CLOSURE 45000 0 45000
151 CARDIOLOGY 1946 BPV/BAV (BALOON VALVOTOMY) 65000 0 72000
152 CARDIOLOGY 1948 CAROTID DOPPLER 1380 2880 1500
153 CARDIOLOGY 1949 CAROTID ENDARTERECTOMY 13800 28750 14000
154 CARDIOLOGY 5331 CINEFLUROSCOPY FOR PROSTHETIC VALVE FUNCTION 1000 0 1000
155 CARDIOLOGY 1950 CORONARY ANGIOGRAPHY (PACKAGE) 13800 26800 12000
CORONARY ANGIOPLASTY + STENTING (STENT EXTRA)

156 CARDIOLOGY 1945 (PACKAGE) 97750 201250 99000
157 CARDIOLOGY 3620 CORONORY ANGIOGRAPHY 0 0 0
DEPOSIT FOR PACEMAKING (TOTAL DEPOSITE WILL BE

158 CARDIOLOGY 826 REIMBURSED AFTER RETURNING THE PACEMAKER) 28750 69000 0
159 CARDIOLOGY 1951 ELECTRO-PHYSIOLOGY STUDY 8050 18400 0
160 CARDIOLOGY 1952 EPICARDIAL PACEMAKER 8050 18400 7000
161 CARDIOLOGY 1953 EPS + RFA 46000 115000 50000
162 CARDIOLOGY 1955 PACEMAKER PROGRAMMING 1000 0 1000
163 CARDIOLOGY 6012 PDA DEVICE 122040 0 0
164 CARDIOLOGY 5396 PDA DEVICE CLOSURE 40000 0 40000
165 CARDIOLOGY 1985 PERICARDIOCENTESIS (PACKAGE) 5750 13800 3500
166 CARDIOLOGY 1957 PERIPHERAL VASCULAR ANGIOGRAPHY WITHOUT DYE 8050 18400 9000
7
167 CARDIOLOGY 1958 PERIPHERAL VASCULAR PROCEDURES 11500 27600 12000
168 CARDIOLOGY 1959 PERMACATH PLACEMENT 5750 13800 6000
PERMANENT PACEMAKER IMPLANTATION (PACEMAKER

169 CARDIOLOGY 1960 GENRATOR EXTRA) (PACKAGE) 45000 0 45000
170 CARDIOLOGY 1961 PTMC 74750 115000 81000
171 CARDIOLOGY 1962 RENAL ANGIOGRAPHY (PACKAGE) 10000 0 8000
172 CARDIOLOGY 1956 RENAL PERIPHERAL ANGIOPLASTY (PACKAGE) 63250 143750 72000
RIGHT HEART CATHETERIZATION (OXIMETRY EXTRA )

173 CARDIOLOGY 1963 WITHOUT CONTRAST (PACKAGE) 11500 27600 12000
174 CARDIOLOGY 2267 TEE 1600 2200 1500
175 CARDIOLOGY 1964 TEMPORARY PACEMAKER IMPLANTATION (PACKAGE) 5750 13800 6000
176 CARDIOLOGY 4766 TILTING TEST 1500 0 2000
177 CARDIOLOGY 4767 TTE + TEE (PACKAGE) 2600 3200 3000
178 CONSERVATIVE
ENDODONTICS
& 1147 ALGINATE IMPRESSION SINGLE 390 660 0
CONSERVATIVE &
179 1539 ALL CERAMIC CROWN (LAB CHARGE EXTRA) 2750 5500 0
ENDODONTICS
CONSERVATIVE &
180 ENDODONTICS 5375 AMALGAM CLASS 2ND + CORE 770 1540 0
181 CONSERVATIVE & 877 AMALGAM RESTORATION (CAPSULE) 660 1210 0

ENDODONTICS
CONSERVATIVE &
182 ENDODONTICS 1122 AMALGAM RESTORATION SILVER ALLOY POWDER 440 880 500
CONSERVATIVE &
183 ENDODONTICS 1165 ANTERIOR + RCT APEXIFICATION 2750 4620 0
184 CONSERVATIVE
ENDODONTICS
& 1136 ANTERIOR RCT 2090 4180 0
185 CONSERVATIVE & 2164 ANTERIOR RCT (WITH 4 X-RAY) 2750 4840 0
ENDODONTICS
CONSERVATIVE &
186 ENDODONTICS 5365 ANTERIOR RCT WITH ROTARY FILES 3300 6050 0
CONSERVATIVE &
187 ENDODONTICS 1145 BLEACHING NON- VITAL 770 1540 0
188 CONSERVATIVE
ENDODONTICS
& 5554 BLEACHING WITH OPALESCENT BOOST (1 SYRINGE) 3410 4950 0
189 CONSERVATIVE & 2166 CALCIUM HYDROCIDE DRESSING 390 550 0

ENDODONTICS
CONSERVATIVE &
190 ENDODONTICS 5552 CANAL CLEANING AND SHAPING WITH IOPAR 1100 2200 0
8
191 CONSERVATIVE & 1538 CAST POST (LAB CHARGE EXTRA) 1380 2530 0
ENDODONTICS
CONSERVATIVE &
192 ENDODONTICS 1544 CERAMIC INLAY (EXCLUDING LAB CHARGES) 2750 5500 0
CONSERVATIVE &
193 ENDODONTICS 1545 CERAMIC ONLAY (EXCLUDING LAB CHARGES) 2750 5500 0
194 CONSERVATIVE
ENDODONTICS
& 880 COMPOMER RESTORATION (DYRACT) 660 1210 0
195 CONSERVATIVE & 1129 COMPOSITE CORE BUILD UP 1870 3520 0

ENDODONTICS
CONSERVATIVE &
196 ENDODONTICS 885 COMPOSITE RESTORATION LIGHT CURE ANTERIOR 1320 2640 0
CONSERVATIVE &
197 ENDODONTICS 886 COMPOSITE RESTORATION LIGHT CURE POSTERIOR 1490 2750 0
198 CONSERVATIVE
ENDODONTICS
& 1130 COMPOSITE
APPLICATION
RESTORATION LIGHT CURE WITH XENO 1430 2750 0
199 CONSERVATIVE & 901 COMPOSITE SPLINT 1540 2750 0

ENDODONTICS
CONSERVATIVE &
200 ENDODONTICS 1128 COMPOSITE VENEER 1490 2750 0
CONSERVATIVE &
201 ENDODONTICS 1151 CROWN CEMENTATION WITH GIC 550 1100 0
202 CONSERVATIVE
ENDODONTICS
& 1152 CROWN
CEMENT
CEMENTATION WITH ZINC PHOSPHATE 390 550 0
CONSERVATIVE &
203 5364 CROWN CUTTING 1930 3300 0
ENDODONTICS
CONSERVATIVE &
204 ENDODONTICS 1145 DESENSITIZING 390 770 0
205 CONSERVATIVE & 5551 EMERGENCY ACCESS 990 1980 0

ENDODONTICS
CONSERVATIVE & FULL METAL AND PORCELAIN FUSED TO METAL CROWN

206 ENDODONTICS 2033 WITH RUBBER BASE IMPRESSION COMPOUND 3030 5500 0
CONSERVATIVE &
207 ENDODONTICS 1157 FULL METAL CROWN (EXCLUDING LAB CHARGE) 1930 3300 0
208 CONSERVATIVE
ENDODONTICS
& 1133 GIC RESTORATION 550 1100 350
209 CONSERVATIVE & 1549 HEMISECTION / BICUSPIDIZATION 1650 3300 0

ENDODONTICS
CONSERVATIVE &
210 ENDODONTICS 1669 IRM RESTORATION 280 550 0
CONSERVATIVE &
211 ENDODONTICS 1154 METAL INLAY (EXCLUDING LAB CHARGE) 1930 3300 0
212 CONSERVATIVE
ENDODONTICS
& 1155 METAL ONLAY (EXCULDING LAB CHARGE) 1930 3300 0
213 CONSERVATIVE & 2167 METAPEX DRESSING 390 550 0

ENDODONTICS
CONSERVATIVE &
214 ENDODONTICS 1134 MICACLE MIX RESTORATION 550 1100 0
9
215 CONSERVATIVE & 5553 OBTURATION WITH IOPAR 990 1980 0

ENDODONTICS
CONSERVATIVE &
216 ENDODONTICS 1550 PERIRADICULAR SURGERY WITH BONE GRAFT 2200 4400 0
CONSERVATIVE &
217 ENDODONTICS 1162 PIT & FISSURE SEALANT 440 720 0
218 CONSERVATIVE
ENDODONTICS
& 1125 POLISHING AMALGAM RESTORATION (OLD) 170 330 0
219 CONSERVATIVE & 1158 PORCELAIN FUSED TO METAL CROWN (EXCLUDING LAB 1930 3300 0
ENDODONTICS CHARGE)
CONSERVATIVE &
220 ENDODONTICS 1143 POST CORE CASTING (LAB CHARGE EXTRA) 1380 2530 0
CONSERVATIVE &
221 ENDODONTICS 1144 POST CORE PRE FEBRICATED (LAB CHARGE EXTRA) 1380 2530 0
222 CONSERVATIVE
ENDODONTICS
& 1166 POSTERIOR + RCT APEXIFICATION 2750 4620 0
223 CONSERVATIVE & 2165 POSTERIOR RCT (WITH 4 X-RAY) 3080 5500 0
ENDODONTICS
CONSERVATIVE &
224 ENDODONTICS 1542 POSTERIOR RCT + SCREW POST 2860 5720 0
CONSERVATIVE &
225 ENDODONTICS 1138 POSTERIOR RCT LOWER 2530 4400 0
226 CONSERVATIVE
ENDODONTICS
& 1137 POSTERIOR RCT UPPER 2530 4400 0
CONSERVATIVE &
227 5367 POSTERIOR RCT WITH ROTARY FILES 3630 6820 0
ENDODONTICS
CONSERVATIVE &
228 ENDODONTICS 1139 RADICULAR SURGERY (ANTERIOR) 1870 3740 0
229 CONSERVATIVE & 1140 RADICULAR SURGERY (POSTERIOR) 2200 4400 0

ENDODONTICS
CONSERVATIVE &
230 ENDODONTICS 1543 RCT WITH ESTHTIC POST INCLUDING CEMENTATION 4400 8250 0
CONSERVATIVE &
231 ENDODONTICS 2169 RE-TREATMENT (RE-RCT) 4000 7000 0
232 CONSERVATIVE
ENDODONTICS
& 1146 RUBBER BASE IMPRESSION SINGLE 1100 2200 0
233 CONSERVATIVE & 1163 RUBBER DAM APPLICATION 280 550 0

ENDODONTICS
CONSERVATIVE &
234 ENDODONTICS 876 SIMPLE GRINDING 280 440 0
CONSERVATIVE &
235 ENDODONTICS 1156 TEMPORARY CROWN COLD CURE 330 550 0
236 CONSERVATIVE
ENDODONTICS
& 1540 TEMPORARY CROWN HEAT CURE 330 550 0
237 CONSERVATIVE & 1135 TEMPORARY RESTORATION WITH ZINC OXIDE EUGENOL 170 280 0
ENDODONTICS
CONSERVATIVE &
238 ENDODONTICS 5374 TRICALCIUM SILICAFE CEMENTS 1870 2750 0
10
239 CONSERVATIVE & 2168 TRIPLE ANTIBIOTIC PASTE DRESSING 280 550 0
ENDODONTICS
CONSERVATIVE &
240 ENDODONTICS 5376 ULTRASONIC RETROPREPARATION 1320 2420 0
CTVS (CARDIOTHORACIC AND

241 VASCULAR SURGERY) 982 12 CHANEL ECG HOLTER 2000 2400 2000
242 CTVS (CARDIOTHORACIC AND

VASCULAR SURGERY) 984 24 HR ABPM 2000 2400 1000
243 CTVS (CARDIOTHORACIC AND 5423 AAA REPAIR (COST OF GRAFT EXTRA) 60000 0 63000
VASCULAR SURGERY)

244 VASCULAR SURGERY) 5515 AORTIC CANNULA 8000 0 0

245 VASCULAR SURGERY) 5478 AORTIC CANNULA STRAIGHT 4000 0 0

VASCULAR SURGERY) 6011 ASD DEVICE 169500 0 0
247 CTVS (CARDIOTHORACIC AND 5408 ASD/PAPVC/PULMONARY VALVOTOMY/BD GLENN 60000 0 63000
VASCULAR SURGERY)

248 VASCULAR SURGERY) 5501 AV FISTULA CREATION LA 8000 16000 8000

249 VASCULAR SURGERY) 6422 AV FISTULA SURGERY (PACKAGE) 10200 16500 12000

VASCULAR SURGERY) 5514 AV FISTULA UNDER REGIONAL BLOCK 12000 24000 12000

251 6021 BIOPROSHTHESIS VALVE 180000 0 0
VASCULAR SURGERY)
CTVS (CARDIOTHORACIC AND BT SHUNT/PA BANDING/ EPICARDIAL PACEMAKER

252 VASCULAR SURGERY) 5421 IMPLANTATION 40000 0 40000
253 CTVS (CARDIOTHORACIC AND 5416 CABG 80000 0 81000

VASCULAR SURGERY)

254 VASCULAR SURGERY) 5418 CABG + MVR/AVR (COST OF VALVE EXTRA) 80000 0 81000
CTVS (CARDIOTHORACIC AND CARDIOPLEGIA CANNULA - ANTEGRADE WITHOUT

255 VASCULAR SURGERY) 5486 VENT 8000 0 0

VASCULAR SURGERY) 5487 CARDIOPLEGIA
VENT (5FR)
CANNULA - ANTEGRADE WITHOUT 8000 0 0
257 CTVS (CARDIOTHORACIC AND 5488 CARDIOPLEGIA CANNULA - ANTEGRADE WITHOUT 8000 0 0
VASCULAR SURGERY) VENT (9FR)

258 VASCULAR SURGERY) 5489 CARDIOPLEGIA CANNULA RETROGRADE 11FR 22000 0 0

259 VASCULAR SURGERY) 5490 CARDIOPLEGIA CANNULA RETROGRADE 13FR 22000 0 0

VASCULAR SURGERY) 5491 CARDIOPLEGIA CANNULA RETROGRADE 14FR 22000 0 0
261 CTVS (CARDIOTHORACIC AND 5485 CARDIOPLEGIA DELIVERY SET 14000 0 0

VASCULAR SURGERY)

262 VASCULAR SURGERY) 1947 CAROTID ANGIOPLASTY (PACKAGE) 46000 115000 50000
11
263 CTVS (CARDIOTHORACIC AND 5420 COA REPAIR 40000 0 40000

VASCULAR SURGERY)

264 VASCULAR SURGERY) 5536 CTVS OT CHARGE WITHOUT CONSUMABLES 60000 0 63000

265 VASCULAR SURGERY) 5484 CUSTOM PACK - ADULT 16000 0 0

VASCULAR SURGERY) 5482 CUSTOM PACK - NEONATE 17000 0 0
267 CTVS (CARDIOTHORACIC AND 5483 CUSTOM PACK - PAEDIATRIC 19000 0 0

VASCULAR SURGERY)

268 VASCULAR SURGERY) 5481 DUAL STAGE VENOUS CANNULA 6500 0 0

269 VASCULAR SURGERY) 274 E.C.G. (GENERAL) 250 350 200

VASCULAR SURGERY) 270 ECHOCARDIOGRAPHY (TTE, GENERAL) 1600 2200 1050
271 CTVS (CARDIOTHORACIC AND 5506 EMBOLECTOMY UNDER GA 30000 55000 30000
VASCULAR SURGERY)

272 VASCULAR SURGERY) 5505 EMBOLECTOMY UNDER LA 20000 38000 20000

273 VASCULAR SURGERY) 6090 ENDOVENOUS LASER ABLATION (EVLA) ONE SIDE 40500 65000 45000

VASCULAR SURGERY) 5497 HEMOCONCENTRATOR WITH HOLDER - ADULT 15000 0 0

275 5498 HEMOCONCENTRATOR WITH HOLDER - PEDIATRIC 15000 0 0
VASCULAR SURGERY)

276 VASCULAR SURGERY) 1954 LEFT HEART CATHETERIZATION (PACKAGE) 11500 27600 12000
277 CTVS (CARDIOTHORACIC AND 5500 LUNG LOBECETOMY / PNEUMONECTOMY 50000 90000 50000
VASCULAR SURGERY)

278 VASCULAR SURGERY) 5512 MECHANICAL HEART VALVE 75000 0 0
CTVS (CARDIOTHORACIC AND MVR/AVR/DVR/VALVE REPAIR (COST OF VALVE AND

279 VASCULAR SURGERY) 5414 RING EXTRA) 80000 0 81000

VASCULAR SURGERY) 5510 OPEN THORACOSTOMY/PC WINDOW 5000 10000 5000
281 CTVS (CARDIOTHORACIC AND 5494 OXYGENATOR - ADULT 36000 0 0

VASCULAR SURGERY)

282 VASCULAR SURGERY) 5496 OXYGENATOR - NEONATE 40000 0 0

283 VASCULAR SURGERY) 5495 OXYGENATOR - PEDIATRIC 36000 0 0

VASCULAR SURGERY) 5419 PDA LIGATION 40000 0 40000
285 CTVS (CARDIOTHORACIC AND 5422 PERICARDECTOMY 60000 0 63000

VASCULAR SURGERY)

286 VASCULAR SURGERY) 5425 PERICARDIOTOMY 30000 0 30000
12
287 CTVS (CARDIOTHORACIC AND 5424 PERIPHERAL VASCULAR SURGERY (COST OF GRAFT 50000 0 50000
VASCULAR SURGERY) EXTRA)

288 VASCULAR SURGERY) 5499 PERMANENT CATHETER INSERTION 6000 12000 9000

289 VASCULAR SURGERY) 5429 RING 70000 0 0

VASCULAR SURGERY) 5427 STERNAL WIRE REMOVAL 12000 0 12000
291 CTVS (CARDIOTHORACIC AND 5493 STRAIGHT CONNECTOR WITH LEUR LOCK 3300 0 0
VASCULAR SURGERY)

292 VASCULAR SURGERY) 4765 STRESS ECHO 2500 3200 2000

293 VASCULAR SURGERY) 5503 TEMPORARY DIALYSIS CATHETER INSERTION 5000 7500 9000

VASCULAR SURGERY) 5426 THORACOTOMY 30000 60000 30000
295 CTVS (CARDIOTHORACIC AND 276 TMT (GENERAL) 2300 2760 1500
VASCULAR SURGERY)

296 VASCULAR SURGERY) 5412 TOF/TAPVC/AS/COMPLEX CONGENITAL 80000 0 81000

297 VASCULAR SURGERY) 5428 VALVE 75000 0 0

VASCULAR SURGERY) 5502 VARICOSE VEIN SURGERY 18000 36000 18000

299 6423 VARICOSE VEIN SURGERY (PACKAGE) 23100 36100 0
VASCULAR SURGERY)

300 VASCULAR SURGERY) 5479 VENOUS CANNULA SINGLE STAGE ANGLED 6000 0 0
301 CTVS (CARDIOTHORACIC AND 5480 VENOUS CANNULA SINGLE STAGE STRAIGHT 6000 0 0
VASCULAR SURGERY)

302 VASCULAR SURGERY) 5410 VSD 70000 0 72000

303 VASCULAR SURGERY) 5492 Y CONNECTOR WITH LUER LOCK 1500 0 0
304 CYTOLOGY 391 BRONCHOSCOPY SPECIMEN ( I.E BRUSH, ASPIRATE, 660 1200 700
WASHING & BRONCHOALVEOLAR LAVAGE)
305 CYTOLOGY 392 EXFOLIATIVE CYTOLOGY 1200 2000 2000
306 CYTOLOGY 229 FNAC 1270 2300 510
307 CYTOLOGY 5550 LIQUID BASE CYTOLOGY 1200 2000 2000
308 CYTOLOGY 393 PAP SMEAR 1000 2000 315
309 CYTOLOGY 2145 SLIDE FOR CONSULTATION (REPORTING ONLY SLIDES 0 600 0
RECEIVED)
310 CYTOLOGY 2218 ULTRASOUND FOR FNAC 660 700 850
13
311 DERMATOLOGY & 478 ACNE SCAR REVISION 1500 3000 0

VENEREOLOGY
DERMATOLOGY &
312 VENEREOLOGY 483 BIOPSY EXCISION 1500 3000 2000
DERMATOLOGY &
313 VENEREOLOGY 583 CHEMICAL CAUTERY (PER SITTING) 500 1100 500
314 DERMATOLOGY
VENEREOLOGY
& 481 CHEMICAL PEELING (3 SITTING) 1500 3000 0
315 DERMATOLOGY & 1589 CO2 LASER SURGERY 1500 3000 0

VENEREOLOGY
DERMATOLOGY &
316 VENEREOLOGY 337 DERMABRASION ( PACKAGE) 1500 3000 0
DERMATOLOGY &
317 VENEREOLOGY 2106 DERMASCOPY (PER SITTING) 130 250 0
318 DERMATOLOGY
VENEREOLOGY
& 6017 DIODE LASER - AMPRIT/ PUBIC (PER SITTING) 3500 5000 0
319 DERMATOLOGY & 6018 DIODE LASER - EXTREMITIES/BLACK (PER SITTING) 5000 8000 0
VENEREOLOGY
DERMATOLOGY &
320 VENEREOLOGY 6016 DIODE LASER - FACE (PER SITTING) 2500 3500 0
DERMATOLOGY &
321 VENEREOLOGY 475 ELECTRO CAUTERY (PER SITTING) 1000 2000 500
322 DERMATOLOGY
VENEREOLOGY
& 381 EPILATION 1500 3000 0
DERMATOLOGY &
323 2105 FOCUSSED PHOTOTHERAPY (15 SITTINGS) 1500 3000 0
VENEREOLOGY
DERMATOLOGY & INRA VENUS PULSE THERAPY 3 DAYS (RS. 50.00 PER
324 VENEREOLOGY 719 DAY) 200 400 0
325 DERMATOLOGY & 2101 INTENSIVE PULSED LIGHT (IPL) (FOR 1ST 3 CM2) 2000 4000 0
VENEREOLOGY
DERMATOLOGY & INTENSIVE PULSED LIGHT (IPL) (FOR ADDITIONAL PER

326 VENEREOLOGY 2102 CM2) 300 600 0
DERMATOLOGY &
327 VENEREOLOGY 335 INTOPHORESIS ( 4 SITTING) 1500 3000 0
328 DERMATOLOGY
VENEREOLOGY
& 486 INTRA LESIONAL (PER SITTING) 500 1100 500
329 DERMATOLOGY & 2103 MICRODERMABRASION (PER SITTING) 600 1100 0

VENEREOLOGY
DERMATOLOGY &
330 VENEREOLOGY 6020 MICRONEEDLING (PER SITTING) 600 1000 0
DERMATOLOGY &
331 VENEREOLOGY 2104 MULTIUTILITY PHOTOTHERAPY (15 SITTINGS) 1500 3000 0
332 DERMATOLOGY
VENEREOLOGY
& 1687 NAIL AVULSION WITH LATERAL MATERECTOMY 1500 3000 2000
333 DERMATOLOGY & 485 NEEDLING (PER SITTING) 500 1100 500
VENEREOLOGY
DERMATOLOGY &
334 VENEREOLOGY 1909 NEURONOX/UNIT 600 1100 0
14
335 DERMATOLOGY & 1594 PARING (2 PER SITTING) 500 1100 500
VENEREOLOGY
DERMATOLOGY &
336 VENEREOLOGY 130 PATCH TESTING 1500 3000 0
DERMATOLOGY &
337 VENEREOLOGY 6019 PRP/PRF INJECTION (PER SITTING) 1000 2000 0
338 DERMATOLOGY
VENEREOLOGY
& 255 PULSE THERAPY (FOR 3 DAYS) 1035 0 200
339 DERMATOLOGY & 561 PUNCH BIOPSY (PER SITTING) 1000 2000 1000
VENEREOLOGY
DERMATOLOGY &
340 VENEREOLOGY 2099 Q-SWITCH ND: YAG LASER (FOR 1ST 3 CM2) 1650 3000 0
DERMATOLOGY &
341 VENEREOLOGY 2100 Q-SWITCH ND: YAG LASER (FOR ADDITIONAL PER CM2) 280 600 0
342 DERMATOLOGY
VENEREOLOGY
& 482 RADIO CAUTARY 1000 2000 1000
343 DERMATOLOGY & 2107 SIF ANALYSIS (PER SITTING) 300 600 0
VENEREOLOGY
DERMATOLOGY &
344 VENEREOLOGY 1592 SMEAR PREPARATION & STAINING 100 200 0
DERMATOLOGY &
345 VENEREOLOGY 315 STERILE DRESSING ( PER SITTING) 100 200 65
346 DERMATOLOGY
VENEREOLOGY
& 317 STITCH REMOVAL ( PER SITTING) 100 200 250
DERMATOLOGY &
347 480 TATTOO REMOVAL 1500 3000 0
VENEREOLOGY
DERMATOLOGY &
348 VENEREOLOGY 1591 VETILIGO SURGERY (PER 10 CM2 AREA) 1500 3000 0
349 DERMATOLOGY & 1590 WHOLE BODY PHOTOTHERAPY (15 SITTING) 1500 3000 0
VENEREOLOGY
350 DIALYSIS 1647 ACUTE HAEMODIALYSIS FOR THREE SESSION 10190 0 0
351 DIALYSIS 1648 MAINTENANCE HAEMODIALYSIS 4 1920 0 0
352 EMERGENCY 6509 EMERGENCY VISITOR CARD DEPOSIT (REFUNDABLE) 500 0 0
353 ENT OTORHINOLARYNGOLOGY 1039 ADENOIDECTOMY GA 15000 22500 16000

& HEAD & NECK SURGERY
ENT OTORHINOLARYNGOLOGY
354 & HEAD & NECK SURGERY 1017 ADENOIDECTOMY LA 6600 15000 7000
355 & HEAD & NECK SURGERY 1214 ADENOTONSILLECTOMY GA 12100 27500 13500
356 ENT OTORHINOLARYNGOLOGY

& HEAD & NECK SURGERY 1213 ADENOTONSILLECTOMY LA 9900 25000 10000
357 ENT OTORHINOLARYNGOLOGY 5475 ADENOTONSILLECTOMY WITH POWERED 16500 30000 18000
& HEAD & NECK SURGERY INSTRUMENTS GA
358 & HEAD & NECK SURGERY 5564 ANKYLOGLOSSIA SURGERY GA 12000 24000 16000
15
359 ENT OTORHINOLARYNGOLOGY 5563 ANKYLOGLOSSIA SURGERY LA 7700 9000 8000

ENT OTORHINOLARYNGOLOGY ANTERIOR NASAL PACKING, PUNCH BIOPSY, CHEMICAL

360 & HEAD & NECK SURGERY 205 CAUTERY, INCISION AND DRAINAGE, STICH REMOVAL, 330 600 400
SUTURI
361 & HEAD & NECK SURGERY 5558 ANTERN LATERAL THIGH FLAP GA 16500 30000 18000

& HEAD & NECK SURGERY 767 ANTRUM WASH 363 600 400
363 ENT OTORHINOLARYNGOLOGY 1216 ATTICOTOMY GA 11000 25000 12000

364 & HEAD & NECK SURGERY 1215 ATTICOTOMY LA 8800 20000 9000
365 & HEAD & NECK SURGERY 1218 AURICAL RECONSTRUCTION GA 15000 27500 16000

& HEAD & NECK SURGERY 1217 AURICAL RECONSTRUCTION LA 8800 20000 9000
367 ENT OTORHINOLARYNGOLOGY 1031 AVULSION OF A.C. POLYP GA 11000 25000 12000
368 & HEAD & NECK SURGERY 1009 AVULSION OF A.C. POLYP LA 7700 15000 8000
369 & HEAD & NECK SURGERY 209 BERA 968 2000 1000

& HEAD & NECK SURGERY 1220 BRANCHIAL CYST, SINUS, FISTULA GA 11000 27000 12000
371 1219 BRANCHIAL CYST, SINUS, FISTULA LA 7700 25000 8000
372 & HEAD & NECK SURGERY 1222 CALLDWELL- LUC OPERATION GA 11000 25000 12000
373 ENT OTORHINOLARYNGOLOGY 1221 CALLDWELL- LUC OPERATION LA 8800 18000 9000
374 & HEAD & NECK SURGERY 530 CALORIE TEST 420 1000 500
375 & HEAD & NECK SURGERY 1224 CANALPLASITY GA 12100 27500 13500

& HEAD & NECK SURGERY 1223 CANALPLASITY LA 8800 20000 9000
377 ENT OTORHINOLARYNGOLOGY 1226 CEREBEROPONTINE ANGLE SURGERY GA 12100 27500 13500
378 & HEAD & NECK SURGERY 1225 CEREBEROPONTINE ANGLE SURGERY LA 11000 20000 12000
379 & HEAD & NECK SURGERY 1228 CLASSIC RADICAL NECK DISSECTION GA 16500 35000 18000

& HEAD & NECK SURGERY 1227 CLASSIC RADICAL NECK DISSECTION LA 12100 27000 13500
381 ENT OTORHINOLARYNGOLOGY 1230 CLEFT LIP/ PLATE REPAIR GA 16500 35000 18000
382 & HEAD & NECK SURGERY 1229 CLEFT LIP/ PLATE REPAIR LA 12100 25000 13500
16
383 ENT OTORHINOLARYNGOLOGY 1233 CLOSER OF OROANTRAL FISTULA GA 12100 27500 13500
384 & HEAD & NECK SURGERY 1231 CLOSER OF OROANTRAL FISTULA LA 8800 15000 9000
385 & HEAD & NECK SURGERY 1236 CLOSERE OF PHARYNGOCUTANEOUS FISTUL GA 9900 22500 10000

& HEAD & NECK SURGERY 1235 CLOSERE OF PHARYNGOCUTANEOUS FISTUL LA 0 15000 0
387 ENT OTORHINOLARYNGOLOGY 1238 COCHLEAR IMPLANTS GA 23100 52000 25000

388 & HEAD & NECK SURGERY 1240 COCHLEOSACCULOTOMY GA 12100 27500 13500
389 & HEAD & NECK SURGERY 1239 COCHLEOSACCULOTOMY LA 11000 20000 12000

& HEAD & NECK SURGERY 1027 COMBINED APPROACH TYMPANOPLASTRY GA 13200 30000 13500
391 ENT OTORHINOLARYNGOLOGY 1005 COMBINED APPROACH TYMPANOPLASTRY LA 11000 25000 12000
392 & HEAD & NECK SURGERY 1242 COMMANDO OPERATION GA 20000 40000 20000
393 & HEAD & NECK SURGERY 1241 COMMANDO OPERATION LA 12100 27000 13500

& HEAD & NECK SURGERY 1244 CORTICAL MASTOIDECTOMY GA 12100 27500 13500
395 1243 CORTICAL MASTOIDECTOMY LA 9900 22000 10000
396 & HEAD & NECK SURGERY 1247 CYST ON/ AROUND PINNA GA 9900 25000 10000
397 ENT OTORHINOLARYNGOLOGY 1245 CYST ON/ AROUND PINNA LA 8800 15000 9000
398 & HEAD & NECK SURGERY 1250 DENKERS OPERATION GA 12000 25000 12000
399 & HEAD & NECK SURGERY 1249 DENKERS OPERATION LA 8800 18000 9000

& HEAD & NECK SURGERY 1252 DIRECT LARYNGOSCOPY/ BRONCHOSCOPY GA 11000 25000 12000
401 ENT OTORHINOLARYNGOLOGY 1251 DIRECT LARYNGOSCOPY/ BRONCHOSCOPY LA 8800 20000 9000
402 & HEAD & NECK SURGERY 1254 DIVERTICULECTOMY GA 11000 25000 12000
403 & HEAD & NECK SURGERY 1253 DIVERTICULECTOMY LA 8800 15000 9000

& HEAD & NECK SURGERY 1256 DIVISION OF STYLOID PROCESS GA 16000 32000 16000
405 ENT OTORHINOLARYNGOLOGY 1255 DIVISION OF STYLOID PROCESS LA 8800 25000 9000
406 & HEAD & NECK SURGERY 1918 DL BIOPSY GA 12100 25000 13500
17
407 ENT OTORHINOLARYNGOLOGY 1917 DL BIOPSY LA 7700 15000 8000

408 & HEAD & NECK SURGERY 5568 DNE GA 2750 5000 3000
409 & HEAD & NECK SURGERY 5567 DNE LA 1100 2000 2000

& HEAD & NECK SURGERY 1258 DOHLMAN OPERATION GA 11000 25000 12000
411 ENT OTORHINOLARYNGOLOGY 1257 DOHLMAN OPERATION LA 8800 15000 9000

412 & HEAD & NECK SURGERY 1041 DRAINAGE OF NECK SPACE ABSCESS GA 11000 25000 12000
413 & HEAD & NECK SURGERY 1019 DRAINAGE OF NECK SPACE ABSCESS LA 8800 15000 9000

& HEAD & NECK SURGERY 426 ELECTRO CAUTERY / CHEMICAL CAUTERY 220 600 500
415 ENT OTORHINOLARYNGOLOGY 1650 ELECTRO NYSTAGANO GRAPHY 847 1500 850
416 & HEAD & NECK SURGERY 1262 ENDOLYMPHATIC SAC DECOMPRESSION GA 12100 27500 13500
417 & HEAD & NECK SURGERY 1261 ENDOLYMPHATIC SAC DECOMPRESSION LA 11000 20000 12000

& HEAD & NECK SURGERY 5476 ENDOSCOPIC DCR GA 16500 30000 18000
419 6070 ENT MINOR OT 3500 6500 2500
420 & HEAD & NECK SURGERY 1264 ENUCLEATION OF CYST GA 11000 25000 12000
421 ENT OTORHINOLARYNGOLOGY 1263 ENUCLEATION OF CYST LA 7700 15000 8000

422 & HEAD & NECK SURGERY 1266 EPITYMPANOTOMY GA 11000 25000 12000
423 & HEAD & NECK SURGERY 1265 EPITYMPANOTOMY LA 8800 21000 9000

& HEAD & NECK SURGERY 1670 ESOPHAGIAL SURGERY GA 20000 35000 20000
425 ENT OTORHINOLARYNGOLOGY 1695 ESOPHAGIAL SURGERY LA 12100 25000 13500

426 & HEAD & NECK SURGERY 1268 ETHMOIDAL VESSEL LIGATION GA 12100 30000 13500
427 & HEAD & NECK SURGERY 1267 ETHMOIDAL VESSEL LIGATION LA 9900 25000 10000

& HEAD & NECK SURGERY 5566 EXAMINATION UNDER MICROSCOPE GA 5500 7000 6000
429 ENT OTORHINOLARYNGOLOGY 5565 EXAMINATION UNDER MICROSCOPE LA 1100 1500 2000
430 & HEAD & NECK SURGERY 1270 EXCISION BIOPSY OF LOCAL MASS GA 9900 25000 10000
18
431 ENT OTORHINOLARYNGOLOGY 1269 EXCISION BIOPSY OF LOCAL MASS LA 5500 15000 6000
432 & HEAD & NECK SURGERY 1272 EXCISION OF ANGIOFIBROMA NASOPHARYNX GA 16500 35000 18000
433 & HEAD & NECK SURGERY 1271 EXCISION OF ANGIOFIBROMA NASOPHARYNX LA 12100 27000 13500

& HEAD & NECK SURGERY 1274 EXCISION OF BLEEDING POLYPUS GA 9900 25000 10000
435 ENT OTORHINOLARYNGOLOGY 1273 EXCISION OF BLEEDING POLYPUS LA 5500 15000 6000
436 & HEAD & NECK SURGERY 1276 EXCISION OF DERMOID CYST GA 9900 25000 10000
437 & HEAD & NECK SURGERY 1275 EXCISION OF DERMOID CYST LA 5500 15000 6000

& HEAD & NECK SURGERY 1278 EXCISION OF RHINOSPORIDIOSIS GA 12500 25000 13500
439 ENT OTORHINOLARYNGOLOGY 1277 EXCISION OF RHINOSPORIDIOSIS LA 7700 18000 8000

440 & HEAD & NECK SURGERY 1280 EXCISION OF SEBACEOUS CYST GA 9900 25000 10000
441 & HEAD & NECK SURGERY 1279 EXCISION OF SEBACEOUS CYST LA 5500 15000 6000

& HEAD & NECK SURGERY 1036 EXCSION
GA
OF FIBROMA/ LIPOMA / PAPILLOMA/ KELOID 9900 25000 10000
ENT OTORHINOLARYNGOLOGY EXCSION OF FIBROMA/ LIPOMA / PAPILLOMA/ KELOID

443 1014 5500 15000 6000
& HEAD & NECK SURGERY LA
444 & HEAD & NECK SURGERY 1284 EXTENDED TOTAL PAROTIDECTOMY GA 18000 36000 18000
445 ENT OTORHINOLARYNGOLOGY 1283 EXTENDED TOTAL PAROTIDECTOMY LA 11000 27000 12000
446 & HEAD & NECK SURGERY 1286 EXTERNAL CARTID ARTERY LIGATION GA 9900 22500 10000
447 & HEAD & NECK SURGERY 1285 EXTERNAL CARTID ARTERY LIGATION LA 7700 15000 8000

& HEAD & NECK SURGERY 1288 EXTERNAL/INTERNAL ETHMOIDECTOMY GA 12100 30000 13500
449 ENT OTORHINOLARYNGOLOGY 1287 EXTERNAL/INTERNAL ETHMOIDECTOMY LA 9900 25000 10000

450 & HEAD & NECK SURGERY 1290 EXTRACRANIAL REPAIR OF CSF RHINORRHOEA GA 13750 30500 14000
451 & HEAD & NECK SURGERY 1289 EXTRACRANIAL REPAIR OF CSF RHINORRHOEA LA 12100 25000 13500

& HEAD & NECK SURGERY 1292 FACIAL NERVE DECOMPRESSION SURGERY GA 15000 27500 16000
453 ENT OTORHINOLARYNGOLOGY 1291 FACIAL NERVE DECOMPRESSION SURGERY LA 12100 25000 13500
454 & HEAD & NECK SURGERY 1294 FACIAL REANIMATION GA 12100 27500 13500
19
455 ENT OTORHINOLARYNGOLOGY 1293 FACIAL REANIMATION LA 11000 20000 12000

456 & HEAD & NECK SURGERY 1296 FACIOMASILLARY FRACTURE REDUCTION GA 12100 30000 13500
457 & HEAD & NECK SURGERY 1295 FACIOMASILLARY FRACTURE REDUCTION LA 12100 18000 13500

& HEAD & NECK SURGERY 1035 FESS GA 15000 30000 16000
459 ENT OTORHINOLARYNGOLOGY 1013 FESS LA 9900 25000 10000

460 & HEAD & NECK SURGERY 5474 FESS WITH NAVIGATION GA 20000 34000 20000
ENT OTORHINOLARYNGOLOGY FESS WITH POWERED INSTRUMENTS (MICRODIBRIDER)

461 & HEAD & NECK SURGERY 5473 GA 18000 32000 18000

& HEAD & NECK SURGERY 1298 FLAP RECONSTRUCTION GA 15000 30000 16000
463 ENT OTORHINOLARYNGOLOGY 1297 FLAP RECONSTRUCTION LA 12020 31050 12000

464 & HEAD & NECK SURGERY 427 FLEXIBLE ENDOSCOPY 770 1400 600
465 & HEAD & NECK SURGERY 1300 FOCAL SUBMUCOSAL DIATHERMY GA 8800 20000 9000

& HEAD & NECK SURGERY 1299 FOCAL SUBMUCOSAL DIATHERMY LA 6600 15000 7000
467 1302 FOREIGN BODY EAR REMOVAL GA 9900 22500 10000
468 & HEAD & NECK SURGERY 1301 FOREIGN BODY EAR REMOVAL LA 6600 15000 7000
469 ENT OTORHINOLARYNGOLOGY 779 FOREIGN BODY REMOVAL ( NOSE/EAR) LA 1000 2000 1000
470 & HEAD & NECK SURGERY 5560 FREE - FIVULA FLAP GA 20000 38000 20000
471 & HEAD & NECK SURGERY 1304 FUNCTIONAL NECK DISSECTION GA 16500 35000 18000

& HEAD & NECK SURGERY 1303 FUNCTIONAL NECK DISSECTION LA 12100 25000 13500
473 ENT OTORHINOLARYNGOLOGY 1030 GROMMET INSERTION GA 9900 22500 10000

474 & HEAD & NECK SURGERY 1008 GROMMET INSERTION LA 6600 15000 7000
475 & HEAD & NECK SURGERY 433 HEARING AID TRIAL 385 700 400

& HEAD & NECK SURGERY 1044 HEMITRYROIDECTOMY GA 15000 32000 16000
477 ENT OTORHINOLARYNGOLOGY 1022 HEMITRYROIDECTOMY LA 11000 25000 12000

478 & HEAD & NECK SURGERY 1306 HORIZONAL PARTIAL LARYNGECTOMY GA 16500 35000 18000
20
479 ENT OTORHINOLARYNGOLOGY 1305 HORIZONAL PARTIAL LARYNGECTOMY LA 12100 25000 13500
480 & HEAD & NECK SURGERY 436 IMMPENDENCE 240 500 300
481 & HEAD & NECK SURGERY 1308 INFRATEMPORAL FOSSA APPROACH GA 16500 35000 18000

& HEAD & NECK SURGERY 1307 INFRATEMPORAL FOSSA APPROACH LA 12100 25000 13500
483 ENT OTORHINOLARYNGOLOGY 1310 INTRANASAL ANTROSTOMY GA 9900 22500 10000

484 & HEAD & NECK SURGERY 1309 INTRANASAL ANTROSTOMY LA 6325 17250 7000
485 & HEAD & NECK SURGERY 1312 INTRATYMPANIC INJECTION GA 9900 22500 10000

& HEAD & NECK SURGERY 1311 INTRATYMPANIC INJECTION LA 3500 7000 5000
487 ENT OTORHINOLARYNGOLOGY 1314 JANSEN - HORGAN OPERATION GA 11000 25000 12000
488 & HEAD & NECK SURGERY 1313 JANSEN - HORGAN OPERATION LA 8800 18000 9000
489 & HEAD & NECK SURGERY 1316 LABYRINTHECTOMY GA 12100 27500 13500

& HEAD & NECK SURGERY 1315 LABYRINTHECTOMY LA 11000 20000 12000
491 1318 LARYNGOTOMY GA 16500 35000 18000
492 & HEAD & NECK SURGERY 1317 LARYNGOTOMY LA 12100 30000 13500
493 ENT OTORHINOLARYNGOLOGY 5556 LASER (TOLS) MAJOR (TRANS ORAL LASER SURGERY) GA 16500 30000 18000
494 & HEAD & NECK SURGERY 5555 LASER LA 5500 11000 6000
495 & HEAD & NECK SURGERY 5572 LASER TONSILLECTOMY GA 16500 30000 18000

& HEAD & NECK SURGERY 1320 LATERAL ORBITOTOMY/CRANIOTOMY GA 13750 30500 14000
497 ENT OTORHINOLARYNGOLOGY 1319 LATERAL ORBITOTOMY/CRANIOTOMY LA 12100 22000 13500

498 & HEAD & NECK SURGERY 1322 LATERAL RHINOTOMY GA 12100 27500 13500
499 & HEAD & NECK SURGERY 1321 LATERAL RHINOTOMY LA 8800 23000 9000

& HEAD & NECK SURGERY 1324 LIP CANCER SURGERY & RECONSTRUCTION GA 16500 35000 18000
501 ENT OTORHINOLARYNGOLOGY 1323 LIP CANCER SURGERY & RECONSTRUCTION LA 13915 28750 14000
502 & HEAD & NECK SURGERY 1326 LOBULOPLASTY GA 9900 22500 10000
21
503 ENT OTORHINOLARYNGOLOGY 1325 LOBULOPLASTY LA 3500 7000 6000

504 & HEAD & NECK SURGERY 1328 LOBULOTOMY GA 9900 22500 10000
505 & HEAD & NECK SURGERY 1327 LOBULOTOMY LA 6600 15000 7000

& HEAD & NECK SURGERY 1330 LYNCH- HOWERTH PROCEDURE GA 12100 30000 13500
507 ENT OTORHINOLARYNGOLOGY 1329 LYNCH- HOWERTH PROCEDURE LA 12100 25000 13500
508 & HEAD & NECK SURGERY 1332 MARSUPIALISATION OF CYST GA 11000 25000 12000
509 & HEAD & NECK SURGERY 1331 MARSUPIALISATION OF CYST LA 7700 15000 8000

& HEAD & NECK SURGERY 1332 MARSUPIALISATION OF CYST GA 11000 22500 12000
511 ENT OTORHINOLARYNGOLOGY 1331 MARSUPIALISATION OF CYST LA 7700 15000 8000

512 & HEAD & NECK SURGERY 1336 MAXILLARY ARTERY LIGATION GA 12100 30000 13500
513 & HEAD & NECK SURGERY 1335 MAXILLARY ARTERY LIGATION LA 9900 20000 10000

& HEAD & NECK SURGERY 5559 MEDIAL SURAL ATERIAL PERFORATOR FLAP GA 13200 24000 13500
515 5383 MICRODEBRIDER CHARGES 3850 0 4000
516 & HEAD & NECK SURGERY 1042 MICROLARYNGEAL SURGERY GA 12100 25000 13500
517 ENT OTORHINOLARYNGOLOGY 1020 MICROLARYNGEAL SURGERY LA 8800 18000 9000

518 & HEAD & NECK SURGERY 1338 MIDFACIAL DEGLOVING APROACH GA 15000 30000 16000
519 & HEAD & NECK SURGERY 1337 MIDFACIAL DEGLOVING APROACH LA 8800 23000 9000

& HEAD & NECK SURGERY 6071 MINOR OT CHARGE ENT 3220 0 2500
521 ENT OTORHINOLARYNGOLOGY 5574 MLS WITH LASER GA 16500 30000 18000
522 & HEAD & NECK SURGERY 1025 MODIFIED RADICAL MASTOIDECTOMY GA 15000 30000 16000
523 & HEAD & NECK SURGERY 1003 MODIFIED RADICAL MASTOIDECTOMY LA 11000 25000 12000

& HEAD & NECK SURGERY 1340 MODIFIED RADICAL NECK DISSECTION GA 16500 35000 18000
525 ENT OTORHINOLARYNGOLOGY 1339 MODIFIED RADICAL NECK DISSECTION LA 12100 27000 13500
526 & HEAD & NECK SURGERY 1342 MODIFIED YONGS OPERATION GA 9900 22500 10000
22
527 ENT OTORHINOLARYNGOLOGY 1341 MODIFIED YONGS OPERATION LA 7700 15000 8000
528 & HEAD & NECK SURGERY 1029 MYRINGOPLASTY GA 12100 27500 13500
529 & HEAD & NECK SURGERY 1923 MYRINGOPLASTY LA 8800 21000 9000

& HEAD & NECK SURGERY 1344 NASAL BONE FRACTURE REDUCTION GA 12000 24000 12000
531 ENT OTORHINOLARYNGOLOGY 1344 NASAL BONE FRACTURE REDUCTION GA 11500 28750 12000
532 & HEAD & NECK SURGERY 1343 NASAL BONE FRACTURE REDUCTION LA 5500 15000 6000
533 & HEAD & NECK SURGERY 1343 NASAL BONE FRACTURE REDUCTION LA 10000 15000 10000

& HEAD & NECK SURGERY 1346 NASOPHARYNGECTOMY GA 16500 35000 18000
535 ENT OTORHINOLARYNGOLOGY 1345 NASOPHARYNGECTOMY LA 12100 27000 13500

536 & HEAD & NECK SURGERY 5562 NAVIGATION ASSISTED ENDOSCOPIC SURGERY GA 27500 42000 30000
537 & HEAD & NECK SURGERY 1304 NECK DISSECTION GA 16000 32000 16000

& HEAD & NECK SURGERY 1303 NECK DISSECTION LA 11000 27000 12000
539 432 OAE 605 1500 0
540 & HEAD & NECK SURGERY 1348 ORAL CANCER SURGERY GA 16500 35000 18000
541 ENT OTORHINOLARYNGOLOGY 1347 ORAL CANCER SURGERY LA 12100 25000 13500
542 & HEAD & NECK SURGERY 1350 OSTEOPLASTIC FRONTAL FLAP OPERATION GA 14300 32500 16000
543 & HEAD & NECK SURGERY 1349 OSTEOPLASTIC FRONTAL FLAP OPERATION LA 12100 25000 13500

& HEAD & NECK SURGERY 1352 PARAPHARYNGEAL SPACE APPROACH GA 16500 35000 18000
545 ENT OTORHINOLARYNGOLOGY 1351 PARAPHARYNGEAL SPACE APPROACH LA 12100 25000 13500
546 & HEAD & NECK SURGERY 1354 PARTIAL / TOTAL MAXILLECTOMY GA 12500 30500 14000
547 & HEAD & NECK SURGERY 1353 PARTIAL / TOTAL MAXILLECTOMY LA 11000 25000 12000

& HEAD & NECK SURGERY 1356 PARTIAL PHARYNGECTOMY GA 16500 35000 18000
549 ENT OTORHINOLARYNGOLOGY 1355 PARTIAL PHARYNGECTOMY LA 12100 27000 13500

550 & HEAD & NECK SURGERY 1358 PATTERSON OPERATION GA 12100 30000 13500
23
551 ENT OTORHINOLARYNGOLOGY 1357 PATTERSON OPERATION LA 9900 18000 10000

552 & HEAD & NECK SURGERY 1360 PETROUS APEX SURGERY (PETROSECTOMY) GA 12100 27500 13500
553 & HEAD & NECK SURGERY 1359 PETROUS APEX SURGERY (PETROSECTOMY) LA 11000 20000 12000

& HEAD & NECK SURGERY 1362 PHARYNGOLARYNGCETOMY GA 20000 40000 20000
555 ENT OTORHINOLARYNGOLOGY 1361 PHARYNGOLARYNGCETOMY LA 13200 25000 13500

556 & HEAD & NECK SURGERY 1364 PHARYNGOTOMY GA 16500 35000 18000
557 & HEAD & NECK SURGERY 1363 PHARYNGOTOMY LA 12100 25000 13500

& HEAD & NECK SURGERY 1366 PINNECTOMY GA 12100 27500 13500
559 ENT OTORHINOLARYNGOLOGY 1365 PINNECTOMY LA 8800 20000 9000

560 & HEAD & NECK SURGERY 1368 POST AURAL ABSCESS DRAINAGE GA 9900 22500 10000
561 & HEAD & NECK SURGERY 1367 POST AURAL ABSCESS DRAINAGE LA 6600 15000 7000

& HEAD & NECK SURGERY 1370 POST FURUNCLE GRANULATION SCOOPING GA 9900 22500 10000
563 1369 POST FURUNCLE GRANULATION SCOOPING LA 6600 15000 7000
564 & HEAD & NECK SURGERY 777 POSTERIOR NASAL PACKING 500 1000 500
565 ENT OTORHINOLARYNGOLOGY 1372 PREAURICULAR SINUS TRACT EXCISION GA 12100 27500 13500
566 & HEAD & NECK SURGERY 1371 PREAURICULAR SINUS TRACT EXCISION LA 8800 17600 9000
567 & HEAD & NECK SURGERY 778 PURE TONE AUDIOMETRY 600 1000 325

& HEAD & NECK SURGERY 5557 RADIAL ARTERY FARE - ARM FLAP GA 15000 30000 16000
569 ENT OTORHINOLARYNGOLOGY 1026 RADICAL MASTOIDECTOMY GA 15000 30000 16000

570 & HEAD & NECK SURGERY 1004 RADICAL MASTOIDECTOMY LA 11000 25000 12000
571 & HEAD & NECK SURGERY 1376 RAGID ESOPHAGOSCOPY GA 11000 22000 12000

& HEAD & NECK SURGERY 1375 RAGID ESOPHAGOSCOPY LA 7700 22000 8000
573 ENT OTORHINOLARYNGOLOGY 1378 REMOVAL OF FOREIGN BODY NOSE GA 9900 22500 10000
574 & HEAD & NECK SURGERY 1377 REMOVAL OF FOREIGN BODY NOSE LA 5500 15000 6000
24
575 ENT OTORHINOLARYNGOLOGY 1380 REMOVAL OF LARYNGOCELE GA 16500 35000 18000

576 & HEAD & NECK SURGERY 1379 REMOVAL OF LARYNGOCELE LA 12100 25000 13500
577 & HEAD & NECK SURGERY 1381 REPAIR OF CUT THROAT INJURIES GA 15000 30000 16000

& HEAD & NECK SURGERY 1381 REPAIR OF CUT THROAT INJURIES LA 11000 25000 12000
579 ENT OTORHINOLARYNGOLOGY 1384 REPAIR OF ORAL/ PHARYNGOCUTANEOUS FIS GA 11000 25000 12000
580 & HEAD & NECK SURGERY 1383 REPAIR OF ORAL/ PHARYNGOCUTANEOUS FIS LA 8800 15000 9000
581 & HEAD & NECK SURGERY 1386 RHINOPLASTY GA 15000 30000 16000

& HEAD & NECK SURGERY 1385 RHINOPLASTY LA 11000 20000 12000
583 ENT OTORHINOLARYNGOLOGY 1033 RHINOSEPTOPLASTY GA 12100 27500 13500

584 & HEAD & NECK SURGERY 1011 RHINOSEPTOPLASTY LA 11000 23000 12000
585 & HEAD & NECK SURGERY 5561 SCAPULA FREE FLAP GA 17600 32000 18000

& HEAD & NECK SURGERY 1388 SECONDARY SUTURE OF WOUND GA 9900 25000 10000
587 1387 SECONDARY SUTURE OF WOUND LA 5500 15000 6000
588 & HEAD & NECK SURGERY 1390 SELECTIVE NECK DISSECTION GA 16500 35000 18000
589 ENT OTORHINOLARYNGOLOGY 1389 SELECTIVE NECK DISSECTION LA 12100 27000 13500
590 & HEAD & NECK SURGERY 1392 SEPTAL PERFORATION CLOSER GA 9900 22500 10000
591 & HEAD & NECK SURGERY 1391 SEPTAL PERFORATION CLOSER LA 6600 15000 7000

& HEAD & NECK SURGERY 1031 SEPTOPLASTY GA 12650 28750 13500
593 ENT OTORHINOLARYNGOLOGY 1010 SEPTOPLASTY LA 8800 15000 9000

594 & HEAD & NECK SURGERY 5569 SEPTOPLASTY WITH FESS GA 18000 36000 18000
595 & HEAD & NECK SURGERY 1394 SISTRUNK OPERATION GA 11000 25000 12000

& HEAD & NECK SURGERY 1393 SISTRUNK OPERATION LA 7700 22000 8000
597 ENT OTORHINOLARYNGOLOGY 1396 SKULL BASE SURGERY GA 16500 35000 18000
598 & HEAD & NECK SURGERY 1395 SKULL BASE SURGERY LA 12100 25000 13500
25
599 ENT OTORHINOLARYNGOLOGY 783 SPECIAL AUDIOMETRY 1000 1500 1000

600 & HEAD & NECK SURGERY 780 SPEECH AUDIOMETRY 380 700 400
601 & HEAD & NECK SURGERY 435 SPEECH THERAPY (1 - 4 SESSION) 847 1500 850

& HEAD & NECK SURGERY 1028 STAPEDECTOMY GA 12100 27500 13500
603 ENT OTORHINOLARYNGOLOGY 1006 STAPEDECTOMY LA 8800 22000 9000

604 & HEAD & NECK SURGERY 1038 SUBMANDIBULAR SALIVARY GLAND EXCISION GA 12000 27000 12000
605 & HEAD & NECK SURGERY 1016 SUBMANDIBULAR SALIVARY GLAND EXCISION LA 9000 23000 9000

& HEAD & NECK SURGERY 1400 SUBMUCOUS RESECTION NASAL SEPTUM GA 12650 25000 13500
607 ENT OTORHINOLARYNGOLOGY 1399 SUBMUCOUS RESECTION NASAL SEPTUM LA 8800 18000 9000
608 & HEAD & NECK SURGERY 1402 SUBTOTAL LARYNGECTOMY GA 16500 35000 18000
609 & HEAD & NECK SURGERY 1401 SUBTOTAL LARYNGECTOMY LA 12100 25000 13500

& HEAD & NECK SURGERY 1404 SUPERFICIAL PAROTIDECTOMY GA 15000 30000 16000
611 1403 SUPERFICIAL PAROTIDECTOMY LA 11000 25000 12000
612 & HEAD & NECK SURGERY 1406 SURGERY FOR LARYNGEAL/ TRACHEAL STEN GA 16500 35000 18000
613 ENT OTORHINOLARYNGOLOGY 1405 SURGERY FOR LARYNGEAL/ TRACHEAL STEN LA 12100 25000 13500
614 & HEAD & NECK SURGERY 1408 SURGERY FOR CHOANAL ATRESIA GA 16500 35000 18000
615 & HEAD & NECK SURGERY 1407 SURGERY FOR CHOANAL ATRESIA LA 12100 25000 13500

& HEAD & NECK SURGERY 1410 SURGICAL DRAINSE SEPTAL ABSCESS GA 9900 22500 10000
617 ENT OTORHINOLARYNGOLOGY 1409 SURGICAL DRAINSE SEPTAL ABSCESS LA 6600 15000 7000
618 & HEAD & NECK SURGERY 1412 SURGICAL DRAINSE SEPTAL HAEMATOMA GA 9900 22500 10000
619 & HEAD & NECK SURGERY 1411 SURGICAL DRAINSE SEPTAL HAEMATOMA LA 6600 15000 7000

& HEAD & NECK SURGERY 771 SYRINGING EAR AND IG PACKING 0 220 300 300
621 ENT OTORHINOLARYNGOLOGY 1924 THYRODECTOMY + NECK DISSECTION GA 15000 30000 16000
622 & HEAD & NECK SURGERY 1925 THYRODECTOMY + NECK DISSECTION LA 12000 24000 12000
26
623 ENT OTORHINOLARYNGOLOGY 1414 THYROPLASTY GA 15000 30500 16000

624 & HEAD & NECK SURGERY 1413 THYROPLASTY LA 10450 25000 12000
625 & HEAD & NECK SURGERY 1040 TONSILLECTOMY GA 15000 27500 16000

& HEAD & NECK SURGERY 1018 TONSILLECTOMY LA 8800 23000 9000
627 ENT OTORHINOLARYNGOLOGY 1418 TOTAL LARYNGECTOMY & GLOSSECTOMY GA 20000 35000 20000
628 & HEAD & NECK SURGERY 1417 TOTAL LARYNGECTOMY & GLOSSECTOMY LA 12100 27000 13500
629 & HEAD & NECK SURGERY 1416 TOTAL LARYNGECTOMY GA 20000 40000 20000

& HEAD & NECK SURGERY 1415 TOTAL LARYNGECTOMY LA 12020 31050 12000
631 ENT OTORHINOLARYNGOLOGY 1354 TOTAL MAXILLECTOMY GA 15000 32000 16000

632 & HEAD & NECK SURGERY 1353 TOTAL MAXILLECTOMY LA 10450 27000 12000
633 & HEAD & NECK SURGERY 1422 TOTAL PAROTIDECTOMY GA 18000 36000 18000

& HEAD & NECK SURGERY 1421 TOTAL PAROTIDECTOMY LA 11000 27000 12000
635 1045 TOTAL/SUBTOTAL THYROIDECTOMY GA 18000 36000 18000
636 & HEAD & NECK SURGERY 1023 TOTAL/SUBTOTAL THYROIDECTOMY LA 8800 27000 9000
637 ENT OTORHINOLARYNGOLOGY 1037 TRACHEOSTOMY & DL BIOPSY GA 12100 25000 13500
638 & HEAD & NECK SURGERY 1015 TRACHEOSTOMY & DL BIOPSY LA 9900 20000 10000
639 & HEAD & NECK SURGERY 1043 TRACHEOSTOMY GA 12100 25000 13500

& HEAD & NECK SURGERY 1021 TRACHEOSTOMY LA 7700 15000 8000
641 ENT OTORHINOLARYNGOLOGY 1424 TRANS- SPHENOIDAL HYPOPHYSECTOMY GA 16000 32500 16000
642 & HEAD & NECK SURGERY 1423 TRANS- SPHENOIDAL HYPOPHYSECTOMY LA 12100 25000 13500
643 & HEAD & NECK SURGERY 1426 TRANSANTRAL VIDIAN NURTECTOMY GA 12100 30000 13500

& HEAD & NECK SURGERY 1425 TRANSANTRAL VIDIAN NURTECTOMY LA 9900 20000 10000
645 ENT OTORHINOLARYNGOLOGY 1428 TREPHINE OF FRONTAL SINUS GA 12100 30000 13500
646 & HEAD & NECK SURGERY 1427 TREPHINE OF FRONTAL SINUS LA 8800 20000 9000
27
647 ENT OTORHINOLARYNGOLOGY 1430 TUMOR RESECTION WITH RECONSTRUCTION NOSE 15000 30000 16000
& HEAD & NECK SURGERY GA
648 & HEAD & NECK SURGERY 1429 TUMOR RESECTION WITH RECONSTRUCTION NOSE LA 9900 25000 10000
649 & HEAD & NECK SURGERY 1034 TURBINECTOMY GA 9900 22500 10000

& HEAD & NECK SURGERY 1012 TURBINECTOMY LA 7700 15000 8000
651 ENT OTORHINOLARYNGOLOGY 1432 TYMPANOPLASTY GA 12100 27500 13500

652 & HEAD & NECK SURGERY 1431 TYMPANOPLASTY LA 9900 25000 10000
653 & HEAD & NECK SURGERY 1434 TYMPANOTOMY GA 9900 22500 10000

& HEAD & NECK SURGERY 1433 TYMPANOTOMY LA 5500 15000 6000
655 ENT OTORHINOLARYNGOLOGY 1436 UVULOPALATO PHARYNGOPLASTY GA 16500 35000 18000

656 & HEAD & NECK SURGERY 1435 UVULOPALATO PHARYNGOPLASTY LA 12100 25000 13500
657 & HEAD & NECK SURGERY 1438 VERTICAL PARTIAL LARYNGECTOMY GA 16500 35000 18000

& HEAD & NECK SURGERY 1437 VERTICAL PARTIAL LARYNGECTOMY LA 12100 25000 13500
659 1440 VESTIMULAR NEURECTOMY GA 12100 27500 13500
660 & HEAD & NECK SURGERY 1439 VESTIMULAR NEURECTOMY LA 11000 20000 12000
661 ENT OTORHINOLARYNGOLOGY 5571 WIDE LOCAL EXAMINATION + NECK DISSECTION + FREE 20000 40250 22500
& HEAD & NECK SURGERY FLAP RECONSTRUCTION GA
662 & HEAD & NECK SURGERY 5570 WIDE LOCAL EXCISION + NECK DISSECTION GA 16500 30000 18000
663 & HEAD & NECK SURGERY 5573 WIDE LOCAL EXCISION WITH LASER GA 16500 30000 18000

& HEAD & NECK SURGERY 1442 YOUNGS OPERATION GA 9900 22500 10000
665 ENT OTORHINOLARYNGOLOGY 1441 YOUNGS OPERATION LA 7700 15000 8000

GASTRO-ENTEROLOGY &
666 HEPATOLOGY 5670 BOUGIE DILATION OF ESOPHOUGUS 2300 4600 3000
GASTRO-ENTEROLOGY &
667 HEPATOLOGY 127 BRONCHOSCOPY (GENERAL) 1150 1730 2000
668 GASTRO-ENTEROLOGY
HEPATOLOGY
& 1631 COLONOSCOPY 4000 7000 5000
669 GASTRO-ENTEROLOGY & 5664 COLONSCOPY WITH SEDATIVE 6900 9200 7000
HEPATOLOGY
GASTRO-ENTEROLOGY &
670 HEPATOLOGY 5669 ENDOSCOPIC HEMOSPRAY 580 920 600
28
671 GASTRO-ENTEROLOGY & 5662 ENDOSCOPIC POLYPECTOMY 1800 3800 2000

HEPATOLOGY
GASTRO-ENTEROLOGY &
672 HEPATOLOGY 5665 ENDOSCOPIC VARICEAL BANDING LIGATION (EVBL) 1800 3800 2000
GASTRO-ENTEROLOGY &
673 HEPATOLOGY 5666 ENDOSCOPY ELECTROCOAGULATION 920 1380 1000
HEPATOLOGY
& 5667 ENDOSCOPY INJECTION THERAPY 920 1380 1000
675 GASTRO-ENTEROLOGY & 125 ENDOSCOPY SERVICES WITH OR WITHOUT BIOPSY 1800 3200 1000
HEPATOLOGY (GENERAL)
GASTRO-ENTEROLOGY &
676 HEPATOLOGY 5663 ENDOSCOPY WITH SEDATIVE 3220 4030 4000
GASTRO-ENTEROLOGY &
677 HEPATOLOGY 5673 ERCP WITHOUT STENT 8000 12000 8000
HEPATOLOGY
& 5671 ESOPHAGEAL DILATION (CRE) 2880 4030 3000
679 GASTRO-ENTEROLOGY & 2041 FLEXIBLE SIGMOIDOSCOPE 1500 2000 2000

HEPATOLOGY
GASTRO-ENTEROLOGY &
680 HEPATOLOGY 5668 HERNOCLAIPPING 920 1380 1000
GASTRO-ENTEROLOGY &
681 HEPATOLOGY 5672 PEG INSERTION 4600 6900 5000
HEPATOLOGY
& 5674 PERCUTAINOUS LIVER BIOPSY 1200 2500 2000
GASTRO-ENTEROLOGY &
683 129 RIGID SIGMOIDOSCOPY (GENERAL) 630 920 700
HEPATOLOGY
GASTRO-ENTEROLOGY &
684 HEPATOLOGY 2027 SPIROMETRY 630 920 550
685 GASTRO-ENTEROLOGY & 5676 TRANSIENT ELASTOGRAPHY 3500 6000 4000

HEPATOLOGY
GASTRO-ENTEROLOGY & TRANSJAGULAR LIVER BIOPSY AND HEPATIC HEAMO

686 HEPATOLOGY 5675 DYNAMCIS 6900 9200 7000
GASTRO-ENTEROLOGY &
687 HEPATOLOGY 6073 UBT 230 290 300
688 HAEMATOLOGY 706 AEC (ABSOLUTE EOSINOPHIL COUNT) 240 440 160
689 HAEMATOLOGY 358 APTT 300 440 290
690 HAEMATOLOGY 325 BENCE JONES PROTEIN 180 330 200
691 HAEMATOLOGY 356 BLEEDING TIME 60 110 35
692 HAEMATOLOGY 359 BLOOD GROUPING ( ABO,RH) 110 120 50
693 HAEMATOLOGY 705 BLOOD GROUPING AND X - MATCHING 150 0 200
694 HAEMATOLOGY 390 BONE MARROW CYTOLOGY WITH IRON STAIN 1400 2250 1700
29
695 HAEMATOLOGY 1766 CBC (RBC/TLC/DLC/PLATELET/PCV/MCV,MCH, MCHC) 300 550 300
696 HAEMATOLOGY 6496 CBC PACKAGE INSURANCE 320 0 0
697 HAEMATOLOGY 355 CLOTTING TIME 60 110 35
698 HAEMATOLOGY 362 COOMB'S TEST : INDIRECT 240 390 300
699 HAEMATOLOGY 361 COOMB'S TEST: DIRECT 360 660 400
700 HAEMATOLOGY 6057 DLC 35 0 35
701 HAEMATOLOGY 369 ESR 80 110 35
702 HAEMATOLOGY 6076 G6PD 290 0 300
703 HAEMATOLOGY 370 HAEMOGLOBIN (HB) 100 170 35
704 HAEMATOLOGY 332 KETONE 120 220 200
705 HAEMATOLOGY 6061 MCH 30 0 30
706 HAEMATOLOGY 6062 MCHC 30 0 30
707 HAEMATOLOGY 6060 MCV 30 0 30
708 HAEMATOLOGY 377 OSMOTIC FRAGILITY 480 880 500
709 HAEMATOLOGY 6059 PCV 50 0 50
710 HAEMATOLOGY 6058 PLATELET 50 0 50
711 HAEMATOLOGY 5368 PREGNANCY TEST-ELISA 180 280 100
712 HAEMATOLOGY 357 PROTHROMBIN TIME 250 440 180
713 HAEMATOLOGY 368 PS FOR CYTOLOGY (PBS) 360 660 425
714 HAEMATOLOGY 6055 RBC 35 0 35
715 HAEMATOLOGY 376 RETICULOCYTE COUNT 300 550 125
716 HAEMATOLOGY 387 SEMEN (SPERM) ANALYSIS 600 770 600
717 HAEMATOLOGY 581 SICKLING TEST 120 220 70
718 HAEMATOLOGY 1686 SPECIFIC GRAVITY/UROBILINOGEN/BILIRUBIN/NITRITE) 120 220 200
30
719 HAEMATOLOGY 6056 TLC 35 0 35
720 HAEMATOLOGY 5372 URINE FOR DYSMORPHIC RBC 120 220 200
721 HAEMATOLOGY 305 URINE RE/ME 110 200 200
BLOCKS AND FNAC SLIDES FOR REFERRAL : RS.2500/-

722 HISTOPATHOLOGY 5363 NEEDS TO BE DEPOSITED. REFUNDED AFTER RETURN OF 3000 0 3000
THE
723 HISTOPATHOLOGY 5370 IHC -<5 PANELS 3500 6000 4000
724 HISTOPATHOLOGY 5371 IHC ->5 PANELS 6500 12000 7000
725 HISTOPATHOLOGY 2204 LARGE SPECIMENS: TURP, ALL ORGANS INCL 2500 4600 3000
726 HISTOPATHOLOGY 2203 MEDIUM SPECIMENS EG: ALL CURRETTAGE, APPENDIX,

TONSILLECTOMY ALL POLY 2000 3600 2000
727 HISTOPATHOLOGY 2149 SLIDE CONSULTATION MORE THAN 2 SLIDES FROM 0 1500 0
OUTSIDE
728 HISTOPATHOLOGY 2147 SLIDES FOR CONSULTATION OUT SIDE BPKIHS 0 800 0
729 HISTOPATHOLOGY 2202 SMALL SPECIMENS EG:INCISIONAL/PUNCH/ENDOS 1000 1900 1000
730 HOSPITAL ADMINISTRATION 6069 ADMINISSION CHARGES 1000 1500 1000
731 HOSPITAL ADMINISTRATION 6490 ADMISSION CHARGES (P) 1000 1000 0
732 HOSPITAL ADMINISTRATION 6007 APPLICATION FORM 1500 0 0
733 HOSPITAL ADMINISTRATION 2246 CAPD FLUID CHARGE PER PACK 501 0 501
CERTIFICATION-HEALTH,ILLNESS,DRIVING,TREATMENT
734 HOSPITAL ADMINISTRATION 100 ISURANCE ETC 700 0 0
735 HOSPITAL ADMINISTRATION 109 COMPREHENSIVE HEALTH CHECK UP 9000 0 0
736 HOSPITAL ADMINISTRATION 6470 CORNEAL SUTURE REMOVAL 70 0 250
737 HOSPITAL ADMINISTRATION 6006 DIETETIC CONSULTANCY CHARGE 100 0 0
738 HOSPITAL ADMINISTRATION 769 DOCTORS ROUND IN PRIVATE WARD 0 350 0
739 HOSPITAL ADMINISTRATION 428 DRESSING IN OPD / WARD 70 150 65
740 HOSPITAL ADMINISTRATION 214 DUBLICATE DEATH CERTIFICATE 600 1150 0
741 HOSPITAL ADMINISTRATION 6223 EXPERIENCE LETTER (FOR SECOND TIME) 500 0 0
742 HOSPITAL ADMINISTRATION 102 GENERAL HEALTH CHECK UP 4500 0 0
31
743 HOSPITAL ADMINISTRATION 952 HEALTH CARD 150 0 0
744 HOSPITAL ADMINISTRATION 6469 I/M INJECTION 50 0 100
745 HOSPITAL ADMINISTRATION 951 IDENTITY CARD 300 0 0
746 HOSPITAL ADMINISTRATION 6074 IMMUNIZATION (EXCEPT GOVERNMENT FREE

IMMUNIZATION PROGRAM) 100 0 100
747 HOSPITAL ADMINISTRATION 107 INSURANCE CLAIM CHARGE IN CASE OF DEATH OF THE 1000 0 0
PATIENT
748 HOSPITAL ADMINISTRATION 106 MLC FROM COURT / DIST.OFF./ANY MLC 1000 0 0
749 HOSPITAL ADMINISTRATION 104 MORTUARY CHARGE / DAY 1500 0 0
750 HOSPITAL ADMINISTRATION 115 OXYGEN GAS CHARGES (PER DAY) 300 300 0
751 HOSPITAL ADMINISTRATION 6053 PHARMACY DEPOSIT 5000 0 0
752 HOSPITAL ADMINISTRATION 103 PHYSICAL EXAM (STAFF/STUDENT & OTHER) 2000 0 0
753 HOSPITAL ADMINISTRATION 105 POLICE CASE / WOUND CERTIFICATE 1000 0 0
754 HOSPITAL ADMINISTRATION 6225 RECOMMENDATION LETTER 500 0 0
755 HOSPITAL ADMINISTRATION 6224 SALARY CERTIFICATE 500 0 0
756 HOSPITAL ADMINISTRATION 120 SEARCH FEE 58 115 0
757 HOSPITAL ADMINISTRATION 434 STITCH REMOVAL IN OPD / WARD 70 150 250
758 HOSPITAL ADMINISTRATION 6489 SURGERY CHARGE 15000 28000 0
759 HOSPITAL ADMINISTRATION 6468 SYRINGING & PROBING (LA) 100 0 100
760 HOSPITAL ADMINISTRATION 116 TRACHESTOMY TUBE 1000 1200 1000
761 HOSPITAL ADMINISTRATION 6077 VACUTAINER 20 20 0
762 HOSPITAL ADMINISTRATION GENERAL BED CHARGE 300 500 300
763 HOSPITAL ADMINISTRATION SEMI GENERAL BED CHARGE 900 1500 900
764 HOSPITAL ADMINISTRATION ICU/CCU/PICU/NICU/DICU/SICU 5000 6500 6000
765 HOSPITAL ADMINISTRATION PAYING WARD AC BED 3500 3500
766 HOSPITAL ADMINISTRATION PAYING WARD NON AC BED 2500 2500
32
767 INTERNAL MEDICINE 6008 DAY CARE ADMISSION (MEDICAL ONCOLOGY 300 0 0
CHEMOTHERAPY)
768 INTERNAL MEDICINE 235 HAEMODIALYSIS PROCEDURE CHARGE 1000 1495 0
769 INTERNAL MEDICINE 6022 HEMODIALYSIS SERVICE CHARGE WITH CONSUMABLES 2500 0 0
770 INTERNAL MEDICINE 406 PERITONEAL DIALYSIS 1500 4600 0
771 INTERNAL MEDICINE 6467 SEROPOSITIVE DIALYSIS CHARGE WITH CONSUMABLES 4000 0 0
772 MICROBIOLOGY 585 AFB C/S 40 0 100
773 MICROBIOLOGY 535 AFB TEST 1 0 0
774 MICROBIOLOGY 2009 ANTI-MEASLES IGM 1 0 0
775 MICROBIOLOGY 2010 ANTI-RUBELLA IGM 1 0 0
AUTOMATED BLOOD CULTURE (BACTEC OR

776 MICROBIOLOGY 5321 BACT/ALERT) 300 500 700
777 MICROBIOLOGY 6082 BACTERIAL C/S 400 400 400
778 MICROBIOLOGY 1681 BILE C/S 420 550 200
779 MICROBIOLOGY 1574 BILE R/E, C/S 420 550 200
780 MICROBIOLOGY 294 BLOOD BONE MARROW C/S 300 500 350
781 MICROBIOLOGY 1573 BODY CAVITY FLUID C/S 300 500 300
782 MICROBIOLOGY 1577 BRONCHOALVEOLAR LAVAGE (BAL) C/S 300 500 300
783 MICROBIOLOGY 1600 CD4 COUNT 120 0 100
784 MICROBIOLOGY 1583 CENTRAL VENOUS LINE (CVL) CATHETER TIP 300 500 300
785 MICROBIOLOGY 2001 COVID-19 PCR TEST 880 0 0
786 MICROBIOLOGY 297 CSF C/S 440 550 200
787 MICROBIOLOGY 1680 CSF FOR INDIA INK 40 110 100
788 MICROBIOLOGY 1210 CULTURE FOR MYCOBACTERIA/MGIT 1 0 0
789 MICROBIOLOGY 309 DAT 1 0 0
790 MICROBIOLOGY 1578 DRAIN FLUID M/E C/S 300 500 300
33
791 MICROBIOLOGY 1585 DRAIN TUBE C/S 300 500 300
792 MICROBIOLOGY 575 ENDOMETRIAL ASPIRATE C/S 300 500 300
793 MICROBIOLOGY 1584 ENDOTRACHEAL TUBE TIP C/S 300 0 300
794 MICROBIOLOGY 574 EYE SAMPLES FOR ACANTHAMOEBA 120 220 200
EYE SAMPLES (CORNEAL SCRAPING, LACRIMAL SAC,

795 MICROBIOLOGY 573 VITREOUS FLUID ETC.) FOR M/E, C/S BACTERIA & 540 770 600
FUNGUS
796 MICROBIOLOGY 298 FUNGAL C/S (ALL SAMPLES) 300 500 300
797 MICROBIOLOGY 1671 GEIMSA STAIN FOR FUNGUS 120 220 200
798 MICROBIOLOGY 301 GIEMSA STAIN & RAPID UREASE TEST FOR H. PYLORI IN 110 220 200
ENDOSCOPY SAMPLES
799 MICROBIOLOGY 571 GIEMSA STAIN ( BONE MARROW. SLIT SMEAR FOR LD 80 170 100
BODY)
800 MICROBIOLOGY 281 GIEMSA STAIN MALARIA AND MICROFILARIA 80 170 100
801 MICROBIOLOGY 280 GRAM STAIN ( ALL SAMPLES ) 60 120 56
802 MICROBIOLOGY 3071 HBV DNA QUANTITATIVE 6960 0 0
803 MICROBIOLOGY 6072 HCV RNA VIRAL LOAD 6960 0 0
804 MICROBIOLOGY 311 HIV 1 0 300
805 MICROBIOLOGY 6081 HIV RNA VIRAL LOAD 1390 0 0
806 MICROBIOLOGY 1582 I/V CATHETER TIP C/S 300 500 300
807 MICROBIOLOGY 689 JE SEROLOGY / MAC/ELISA IGM FOR JE ANTIBODY 1 0 0
808 MICROBIOLOGY 6510 KALA_AZAR PCR 500 0 0
809 MICROBIOLOGY 1593 KOH MOUNT & MICROSCOPY 110 220 200
810 MICROBIOLOGY 283 KOH PREPARATION FOR FUNGUS ( ALL SAMPLES) 60 110 70
811 MICROBIOLOGY 303 MANTOUX ( TUBERCULIN ) TEST 110 220 60
812 MICROBIOLOGY 643 MICROFILARIA 80 170 100
813 MICROBIOLOGY 287 OCCULT BLOOD / STOOL CONCENTRATION 100 170 60
814 MICROBIOLOGY 1682 OTHER ASPIRATES C/S 300 500 300
34
815 MICROBIOLOGY 1580 OTHER ASPIRATES R / E C/S 300 500 300
816 MICROBIOLOGY 1576 P/S FOR MALARIA 90 190 250
817 MICROBIOLOGY 1643 PERCARDIAL FLUID C/S 300 500 300
818 MICROBIOLOGY 1642 PERITONEAL/ASCITIC FLUID C/S 300 500 200
819 MICROBIOLOGY 1641 PLEURAL FLUID C/S 300 500 300
820 MICROBIOLOGY 293 PUS C/S 300 500 200
821 MICROBIOLOGY 373 QBC FOR MAL 220 380 300
822 MICROBIOLOGY 5660 SCRUB TYPHUS RDT 1 0 1300
823 MICROBIOLOGY 292 SEMEN C/S 300 500 300
824 MICROBIOLOGY 1447 SERODIAGNOSTIC TEST FOR DENGUE 1 0 0
825 MICROBIOLOGY 296 SPUTUM C/S 300 500 190
826 MICROBIOLOGY 1640 SPUTUM FOR AURAMINE STAINING 1 0 0
827 MICROBIOLOGY 1639 SPUTUM FOR Z-N STAINING 1 0 0
828 MICROBIOLOGY 288 STOOL C/S 300 500 200
829 MICROBIOLOGY 1683 STOOL FOR FAT GLOBULES 60 110 100
830 MICROBIOLOGY 285 STOOL FOR OVA CYST (INCLUDING CONCENTRATION) 60 110 100
831 MICROBIOLOGY 304 STOOL RE 60 110 100
832 MICROBIOLOGY 641 STOOL REDUCING SUBSTANCES 60 110 100
833 MICROBIOLOGY 1644 SYNOVIAL FLUID C/S 300 500 300
834 MICROBIOLOGY 295 THROAT/VAGINAL/CERVICAL SWAB C/S 300 500 190
835 MICROBIOLOGY 1578 TRACHEAL ASPIRATE C/S 300 500 300
836 MICROBIOLOGY 1586 TUSSUE BIOPSY C/S 300 500 300
837 MICROBIOLOGY 290 URINE C/S 300 500 200
838 MICROBIOLOGY 1645 VENTRICULAR FLUID C/S 300 500 300
35
839 MICROBIOLOGY 1587 WATER BACTERIOLOGY 730 880 800
840 MICROBIOLOGY 479 WET MOUNT FOR MICROSCOPY ( ALL SAMPLES) 60 110 100
841 MICROBIOLOGY 1581 WOUND SWAB C/S 300 500 300
842 MICROBIOLOGY 300 Z-N STAIN FOR PROTOZOAL CYST IN STOOL SAMPLE 60 110 100
843 MICROBIOLOGY 572 Z-N STAINING (TB & LEPROSY) 1 0 0
844 NEUROSURGERY 1704 ABSCESS/CYST EXCISION GA 29000 58000 30000
845 NEUROSURGERY 1715 ALL TUMORS OF SPINE GA 33000 66000 35000
846 NEUROSURGERY 1707 ANEURYSM CLIPPING GA 40000 80000 40000
847 NEUROSURGERY 1721 ANTERIOR CERVICAL DISCECTOMY AND FUSION GA 33000 66000 35000
ANTERIOR/ANTEROLATERAL/
848 NEUROSURGERY 1718 COSTOTRANSVERSECTOMY DECOMPRESSION GA 29000 58000 30000
849 NEUROSURGERY 1710 ARTERIO-VENOUS MALFORMATION GA 36000 72000 36000
850 NEUROSURGERY 1729 BRACHIL PLEXUS REPAIR GA 29000 58000 30000
851 NEUROSURGERY 1759 BURR HOLE BIOPSY 20000 40000 20000
852 NEUROSURGERY 1760 BURR HOLE CYST/ABSCESS ASPIRATION 20000 40000 20000
853 NEUROSURGERY 1772 CALVARIAL BIOPSY 13800 27600 14000
854 NEUROSURGERY 1712 CAROTID ENDARTECTOMY GA 29000 58000 30000
855 NEUROSURGERY 1765 CHANGE OF INFECTED EVD 20000 40000 20000
856 NEUROSURGERY 1762 CHRONIC EPIDURAL HEMATOMA 20000 40000 20000
857 NEUROSURGERY 1739 CHRONIC SUBDURAL UNDER GA GA 25000 50000 25000
858 NEUROSURGERY 1757 CHRONIC SUBDURAL UNDER LOCAL ANESTHESIA 18000 36000 18000
859 NEUROSURGERY 1733 CONTUSECTOMY GA 25000 50000 25000
860 NEUROSURGERY 1741 CONTUSECTOMY GA 25000 50000 25000
861 NEUROSURGERY 1708 CP ANGLE TUMORS GA 40000 80000 40000
862 NEUROSURGERY 1701 CRANIOPLASTY GA 35000 70000 35000
36
863 NEUROSURGERY 1735 DECOMPRESSIVE CRANIOTOMY GA 25000 50000 25000
864 NEUROSURGERY 1734 DEPRESSED FRACTURE WITH DUROPLASTY GA 30000 60000 30000
865 NEUROSURGERY 1711 EC-IC BYPASS GA 33000 66000 35000
866 NEUROSURGERY 1706 ENDOSCOPIC PROCEDURES GA 33000 66000 35000
867 NEUROSURGERY 1731 EPIDURAL HEMATOMA EVACUATION GA 25000 50000 25000
868 NEUROSURGERY 1725 EPIDURAL HEMATOMA/ABSCESS GA 33000 66000 35000
869 NEUROSURGERY 1758 EXTERNAL VENTRICULAR DRAIN 18000 36000 18000
870 NEUROSURGERY 1724 FRACTURE DECOMPRESSION GA 33000 66000 35000
871 NEUROSURGERY 1740 FRACTURE ELEVATION WITH DURAL REPAIR GA 25000 50000 25000
872 NEUROSURGERY 1761 FRACTURE ELEVATION WITHOUT DURAL REPAIR 20000 40000 20000
873 NEUROSURGERY 1744 HALO FIXATION GA 15500 31000 16000
874 NEUROSURGERY 1776 INFECTED SHUNT EXTERIORIZATION 15000 30000 16000
875 NEUROSURGERY 1700 INFRATENTORIAL TUMOR GA 35000 70000 35000
INJECTIONS FOR TORTICOLLIS/WRY NECK/LOCAL

876 NEUROSURGERY 1774 SPASTICITY 15000 30000 16000
877 NEUROSURGERY 1723 INSTRUMENTATION OF THE 35000 70000 35000

SPINE-ANTERIOR/POSTERIOR GA
878 NEUROSURGERY 1743 INTERSPINOUS WIRING GA 22000 44000 22500
879 NEUROSURGERY 1720 INTRADURAL LESIONS GA 35000 70000 35000
880 NEUROSURGERY 1713 INTRAVENTRICULAR LESION EXCISION GA 35000 70000 35000
881 NEUROSURGERY 1716 LAMINECTOMY GA 35000 70000 35000
882 NEUROSURGERY 1717 LAMINOPLASTY GA 35000 70000 35000
883 NEUROSURGERY 1703 LOBECTOMY GA 35000 70000 35000
884 NEUROSURGERY 1727 LUMBER DISCECTOMY GA 35000 70000 35000
885 NEUROSURGERY 1771 LUMBER DRAIN INSERTION 13800 27600 14000
886 NEUROSURGERY 1745 LUMBO-PERITONEAL SHUNT GA 20000 40000 20000
37
887 NEUROSURGERY 1719 LUQUE FIXATION GA 35000 70000 35000
888 NEUROSURGERY 1702 MENINGIOMA EXCISION GA 35000 70000 35000
889 NEUROSURGERY 1768 MUSCLE BIOPSY 13800 27600 14000
890 NEUROSURGERY 1730 NEURAL TUBE DEFECTS-MENINGOCELE,

MENINGOMYELOCELE, SPINAL DYSRAPHISM GA 25000 50000 25000
891 NEUROSURGERY 1722 OCCIPITO-CERVICAL FUSION GA 35000 70000 35000
892 NEUROSURGERY 1709 PEDIATRIC TUMORS GA 38000 76000 40000
893 NEUROSURGERY 1764 PERIPHERAL NERVE SHEATH TUMORS 18000 36000 18000
894 NEUROSURGERY 1705 PITUITARY ADENOMA GA 38000 76000 40000
895 NEUROSURGERY 1777 REMOVAL OF INFECTED FOREIGN BODY 15000 30000 16000
896 NEUROSURGERY 1770 RETAPPING OF CYST/ABSCESS 13800 27600 14000
897 NEUROSURGERY 1742 SINGLE LEVEL LAMINECTOMY GA 25000 50000 25000
898 NEUROSURGERY 1775 SMALL PERIPHERAL LUMPS/TUMORS 15000 30000 16000
899 NEUROSURGERY 1726 SPINAL VASCULAR MALFORMATION GA 35000 70000 35000
900 NEUROSURGERY 1732 SUBDURAL HEMATOMA EVACUATION (ACUTE) GA 25000 50000 25000
901 NEUROSURGERY 1769 SUBGALEAL EXTRABONY/BONY LESION EXCISION 18000 36000 18000
902 NEUROSURGERY 1699 SUPRATENTORIAL TUMOR GA 35000 70000 35000
903 NEUROSURGERY 1767 SURAL NERVE BIOPSY 15000 30000 16000
904 NEUROSURGERY 1773 TARSORAPHY 15000 30000 16000
905 NEUROSURGERY 1728 THORACOSCOPIC SYMPATHECTOMY GA 35000 70000 35000
906 NEUROSURGERY 1755 TRACHESTOMY GA 15500 31000 16000
907 NEUROSURGERY 2257 TRACHESTOMY LA 10000 20000 10000
908 NEUROSURGERY 1714 TRANSPHENOIDAL GA 36000 72000 36000
909 NEUROSURGERY 1738 V. PLEURAL SHUNTING GA 25000 50000 25000
910 NEUROSURGERY 1737 V.A SHUNTING GA 25000 50000 25000
38
911 NEUROSURGERY 1736 V.P SHUNTING GA 25000 50000 25000
912 NEUROSURGERY 1763 VERTEBRAL BONE BIOPSY 18000 36000 18000
913 OBSTETRICS & GYNAECOLOGY 2030 2ND TRIMESTER ABORTION (MEDICAL/ D&E) 4550 9660 5000
914 OBSTETRICS & GYNAECOLOGY 6480 CHECK CURRATAGE 3500 0 4000
915 OBSTETRICS & GYNAECOLOGY 1652 COLPOSCOPY 3040 5520 1225
916 OBSTETRICS & GYNAECOLOGY 1443 COMPREHENSIVE ABORTION CARE 3040 8970 4250
917 OBSTETRICS & GYNAECOLOGY 4836 CPT REPAIR FRESH 3800 8050 4000
918 OBSTETRICS & GYNAECOLOGY 2117 CRYO THERAPY PROCEDURE 3040 6900 1500
919 OBSTETRICS & GYNAECOLOGY 5477 CYSTOSCOPY 6000 16560 6000
920 OBSTETRICS & GYNAECOLOGY 3723 DIAGNOSTIC CYSTOSCOPY 4550 11040 6000
921 OBSTETRICS & GYNAECOLOGY 1651 DIAGNOSTIC HYSTEROSCOPY 4000 7000 4000
922 OBSTETRICS & GYNAECOLOGY 186 DIAGNOSTIC LAPAROSCOPIC & PROCEED - GYNAE / 13800 25880 14000
SURGERY
923 OBSTETRICS & GYNAECOLOGY 6506 DOUBLE VOLUME EXCHANGE TRANSFUSION (DVET) 1200 0 2000
924 OBSTETRICS & GYNAECOLOGY 212 DUPLICATE BIRTH CERTIFICATE 760 1380 0
925 OBSTETRICS & GYNAECOLOGY 6479 EBECC (BIOPSY) 3500 0 4000
926 OBSTETRICS & GYNAECOLOGY 6484 EUA (EXAMINATION UNDER ANAESTHESIA) 6000 0 6000
927 OBSTETRICS & GYNAECOLOGY 2139 FAILD MEDICAL ABORTION (REPEAT MVA) 2530 4600 3000
928 OBSTETRICS & GYNAECOLOGY 1934 FIRST TRIMESTER ABORTION (MEDICAL/MVA/PAC) 1520 5520 4250
929 OBSTETRICS & GYNAECOLOGY 4835 FOLLICULAR MONITORING- PACKAGE 1520 4830 2000
930 OBSTETRICS & GYNAECOLOGY 6003 HYSTEROSCOPY UNDER LOCAL ANAESTHESIA 7200 16800 8000
931 OBSTETRICS & GYNAECOLOGY 6482 I AND D (INSSION AND DRAINAGE) 3500 0 4000
932 OBSTETRICS & GYNAECOLOGY 2154 INTERMEDIATE OT CHARGE (GYNAE) 10000 22000 5000
933 OBSTETRICS & GYNAECOLOGY 5576 IUI DOUBLE 9660 20700 10000
934 OBSTETRICS & GYNAECOLOGY 5575 IUI SINGLE 6900 16560 7000
39
935 OBSTETRICS & GYNAECOLOGY 764 LAPAROSCOPIC SURGERY HYSTRECTOMY 17250 34500 18000
936 OBSTETRICS & GYNAECOLOGY 195 LAPAROSCOPIC TUBALIGATION WITH G.A. (MINOR OT) 1520 5520 2000
937 OBSTETRICS & GYNAECOLOGY 6002 LAPAROSCOPY (MINOR) 18000 36000 18000
938 OBSTETRICS & GYNAECOLOGY 6001 LAPAROSCOPY-MAJOR 21600 43200 22500
939 OBSTETRICS & GYNAECOLOGY 2141 LEEP / CONE BIOPSY 7590 16560 8000
940 OBSTETRICS & GYNAECOLOGY 2155 LSCS 14000 31740 14000
941 OBSTETRICS & GYNAECOLOGY 6508 LUMBAR PUNCTURE 800 0 1000
942 OBSTETRICS & GYNAECOLOGY 6005 MAJOR OT (GYANE ONCO) 20000 40000 20000
943 OBSTETRICS & GYNAECOLOGY 2151 MAJOR OT CHARGE (GYNAE) 18220 34500 20000
944 OBSTETRICS & GYNAECOLOGY 2156 MINOR OT CHARGE (GYNAE) 3500 6900 2500
945 OBSTETRICS & GYNAECOLOGY 6106 MVA 4000 0 4000
946 OBSTETRICS & GYNAECOLOGY 640 NON STRESS TEST (NST) 610 970 700
947 OBSTETRICS & GYNAECOLOGY 4834 NON STRESS TEST (NST)-PACKAGE 760 1380 800
948 OBSTETRICS & GYNAECOLOGY 792 NORMAL DELIVERY WITH BIRTH CERTIFICATE 2500 10000 3000
949 OBSTETRICS & GYNAECOLOGY 1653 OBSTETRIC USG 460 830 500
950 OBSTETRICS & GYNAECOLOGY 6004 OPERATIVE HYSTEROSCOPY SA/GA (MAJOR OT) 18000 36000 18000
951 OBSTETRICS & GYNAECOLOGY 5406 PAEDIATRIC CONSULTATION DURING LSCS 0 2070 0
952 OBSTETRICS & GYNAECOLOGY 6507 PARTIAL VLOUME EXCHANGE TRANSFUSION 800 0 1000
953 OBSTETRICS & GYNAECOLOGY 4794 POLYPECTOMY 3500 0 2000
954 OBSTETRICS & GYNAECOLOGY 6481 RE-SUTURING 3500 0 4000
955 OBSTETRICS & GYNAECOLOGY 6483 SUCTION AND EVACUATION 7000 0 7000
956 OBSTETRICS & GYNAECOLOGY 6038 URODYNAMICS 3000 0 6000
957 OBSTETRICS & GYNAECOLOGY 6037 UROFLOMETRY 500 0 500
VACCUM OR FORCEP DELIVERY WITH BIRTH

958 OBSTETRICS & GYNAECOLOGY 703 CERTIFICATE 3000 12000 3000
40
959 OBSTETRICS & GYNAECOLOGY 2136 VIA 150 350 200
960 OPHTHALMOLOGY 543 3 M EXAMINATION (3 MIRROR EXAM) 40 60 100
961 OPHTHALMOLOGY 5393 ANTERIOR SEGMENT OCT TEST SCREENING ONLY 730 1100 1500
962 OPHTHALMOLOGY 5392 ANTERIOR SEGMENT OCT TEST WITH PRINT 2420 2750 3000
963 OPHTHALMOLOGY 437 AUTOMATED PERIMETRY (ONE EYE) 770 1210 800
964 OPHTHALMOLOGY 439 AUTOMATED PERIMETRY (TWO EYE) 1050 1650 2000
965 OPHTHALMOLOGY 805 BIOMETRY WITH PRINTOUT (BOTH EYES) 500 660 500
966 OPHTHALMOLOGY 804 BIOMETRY WITH PRINTOUT (ONE EYE) 390 550 400
967 OPHTHALMOLOGY 203 BIOMETRY WITHOUT PRINTOUT (BOTH EYES) 390 440 400
968 OPHTHALMOLOGY 202 BIOMETRY WITHOUT PRINTOUT (ONE EYE) 280 440 300
969 OPHTHALMOLOGY 6424 BLEPHEROPLASTY 12000 0 16000
970 OPHTHALMOLOGY 6497 CHALZION 2750 0 2800
971 OPHTHALMOLOGY 1900 CORNEAL SUTURE REMOVAL UNDER GA 2200 0 3500
972 OPHTHALMOLOGY 1899 CORNEAL SUTURE REMOVAL UNDER LA 390 660 300
973 OPHTHALMOLOGY 1896 DACROCYSTORHINOSTOMY (DCR) SURGERY 7920 11000 7500
974 OPHTHALMOLOGY 6502 ECTROPION 5500 0 6000
975 OPHTHALMOLOGY 1903 ENEUCLEATION 3850 0 9000
976 OPHTHALMOLOGY 6503 ENTROPION 5500 0 5500
977 OPHTHALMOLOGY 548 ETHI BOND SUTURE 660 770 700
978 OPHTHALMOLOGY 1897 EUA (EXAMINATION UNDR ANAESTHESIA) 2750 0 3000
979 OPHTHALMOLOGY 6504 EVISCERATION 5500 0 5500
980 OPHTHALMOLOGY 1904 EXENTERATION 4400 0 4500
981 OPHTHALMOLOGY 208 F.B. REMOVAL 60 110 100
FLUORESCEIN ANGIOGRAPHY (EXCLUSIVE OF FILM,

982 OPHTHALMOLOGY 545 MEDICINE, FLUORESCEIN, DEVELOPING CHARGE, 1100 1650 2000
BUTTER NEEDLE,
41
983 OPHTHALMOLOGY 1481 FOCAL LASER 770 1100 800
FUNDUS EXAMINATION UNDER MYDRIATICS /

984 OPHTHALMOLOGY 207 DILATATION 30 60 500
985 OPHTHALMOLOGY 450 FUSIONAL EXERCISE ON SYNAPTOPHORE (PER SITTING) 60 90 100
986 OPHTHALMOLOGY 210 GOLDMAN PERIMETRY (ONE EYE) 280 440 300
987 OPHTHALMOLOGY 211 GOLDMAN PERIMETRY (TWO EYES) 330 550 400
988 OPHTHALMOLOGY 546 GONIOSCOPY 60 110 100
989 OPHTHALMOLOGY 444 HESS CHARTING 110 170 0
990 OPHTHALMOLOGY 6500 I & D 2750 0 3000
991 OPHTHALMOLOGY 6498 INCISIONAL BIOPSY 2750 0 3000
992 OPHTHALMOLOGY 6486 INJECTION AVASTIN FIRST DOSE (0.5ML) 7000 0 7000
993 OPHTHALMOLOGY 6487 INJECTION AVASTIN SECOND DOSE (0.05ML) 6000 0 7000
994 OPHTHALMOLOGY 6488 INJECTION AVASTIN THIRD & ABOVE DOSE (0.05ML) 5000 0 5000
INTERMEDIATE (PETRYGIUM, ECTROPION, ENTROPION,

995 OPHTHALMOLOGY 1906 5500 8800 0
EVISCERATION ETC)
996 OPHTHALMOLOGY 6499 INTRA VITREAL INJECTION 1250 0 1250
997 OPHTHALMOLOGY 1908 MAJOR (ORBITOTOMY, LID RECONSTRUCTION, 9900 16500 10000
CONTRACTED SOCKET RECONSTRUCTION ETC)
MINOR (CHALGION, I & D, INCISIONAL BIOPSY,

998 OPHTHALMOLOGY 1905 INTRAVITREAL INJECTION ETC) 2750 3850 3000
999 OPHTHALMOLOGY 451 OPTOMETRIC EVALUATION 80 110 100
1000 OPHTHALMOLOGY 440 OPTOMETRIC EXAMINATION 80 110 100
1001 OPHTHALMOLOGY 452 ORTHOPTICS EVALUATION 80 110 100
1002 OPHTHALMOLOGY 443 ORTHOPTICS EXAMINATION 80 110 100
1003 OPHTHALMOLOGY 547 PAD AND BANDAGE 90 110 100
1004 OPHTHALMOLOGY 215 PATCHING 60 80 100
1005 OPHTHALMOLOGY 1907 PERFORATING INJURY REPAIR & INTRAVITRED 3850 0 8500
INJECTION UNDER GA
1006 OPHTHALMOLOGY 1486 PHACOEMULSIFICATION WITH FOLDABLE IOLS 11550 14300 12000
42
1007 OPHTHALMOLOGY 1487 PHACOEMULSIFICATION WITH FOLDABLE IOLS 7260 11000 8000
1008 OPHTHALMOLOGY 1484 PHACOEMULSIFICATION WITH PMMA IOLS 8800 13200 9000
1009 OPHTHALMOLOGY 1485 PHACOEMULSIFICATION WITH PMMA IOLS 7260 11000 8000
1010 OPHTHALMOLOGY 5395 POSTERIOR SEGMENT OCT TEST SCREENING ONLY 730 1100 1500
1011 OPHTHALMOLOGY 5394 POSTERIOR SEGMENT OCT TEST WITH PRINT 2420 2750 3000
1012 OPHTHALMOLOGY 5707 PRODTHETIC EYE CHARGE 440 660 500
1013 OPHTHALMOLOGY 213 PRP PER SITTING 1100 1320 2000
1014 OPHTHALMOLOGY 6501 PTERIGIUM 5500 0 6000
1015 OPHTHALMOLOGY 1901 PTOSIS SURGERY 7260 11000 8000
1016 OPHTHALMOLOGY 216 REFRACTION 40 80 60
1017 OPHTHALMOLOGY 1927 SCHIRMERS TEST 40 70 100
1018 OPHTHALMOLOGY 1483 SICS / ECCE + PCIOL (IOL NOT SUPPLIED BY THE
HOSPITAL) 6600 8800 7000
1019 OPHTHALMOLOGY 1482 SICS / ECCE + PIOL (PMMA PIOL / AICOL) 7260 9900 8000
1020 OPHTHALMOLOGY 222 SILICON BAND 1980 2200 2000
1021 OPHTHALMOLOGY 221 SILICON TYRE 2970 3300 3000
1022 OPHTHALMOLOGY 1902 SQUINT SURGERY 7260 11000 8000
1023 OPHTHALMOLOGY 224 SUTURE SILK 280 330 300
1024 OPHTHALMOLOGY 1895 SYRINGING AND PROBING (GA) 4400 0 4500
1025 OPHTHALMOLOGY 1898 TRABECULECTOMY 7260 9900 8000
1026 OPHTHALMOLOGY 218 USG WITH PRINTOUT (BOTH EYES) 880 1320 900
1027 OPHTHALMOLOGY 217 USG WITH PRINTOUT (ONE EYE) 440 660 500
1028 OPHTHALMOLOGY 220 USG WITHOUT PRINTOUT (BOTH EYES) 770 1100 800
1029 OPHTHALMOLOGY 219 USG WITHOUT PRINTOUT (ONE EYES) 390 550 400
1030 OPHTHALMOLOGY 225 VR SURGERY 19800 26400 20000
43
1031 OPHTHALMOLOGY 1480 YAG LASE POSTERIOR CAPSULATOMY 550 880 600
1032 OPHTHALMOLOGY 1479 YAG LASER PI (PERIPHERAL IRRIDOTOMY) 830 1100 850
ORAL & MAXILLOFACIAL

1033 SURGERY 5633 ABSCESS DRAINAGE (MINOR) 440 880 1000
1034 ORAL & MAXILLOFACIAL

SURGERY 1509 ADDITIONAL TOOTH (EXT.) 60 110 120
1035 ORAL & MAXILLOFACIAL 1497 ALVEOLOPLASTY 390 770 0

SURGERY

1036 SURGERY 1508 ANTERIOR EXT. 110 500 120

1037 SURGERY 1506 APICOECTOMY 1650 3030 0

SURGERY 5630 ARCH BAR APPLICATION (PER ARCH) 3850 7700 0
1039 ORAL & MAXILLOFACIAL 5642 ARCH BAR REMOVAL (PER ARCH) 280 550 0
SURGERY

1040 SURGERY 5648 BI-JAW OSTEOTOMY GA 20350 50050 22500

1041 SURGERY 1505 BIOPSY 500 990 500

SURGERY 1504 BONE GRAFTING 1650 3300 0

1043 5640 BRIDLE WIRING 220 440 0
SURGERY

1044 SURGERY 2183 CIRCUMMANDIBULAR WIRING GA 13750 27500 14000
1045 ORAL & MAXILLOFACIAL 2182 CLEFT ALVEOLUS GA 7150 27500 8000
SURGERY

1046 SURGERY 2180 CLEFT LIP CLOSURE GA 7150 13750 8000

1047 SURGERY 2181 CLEFT PALATE (COMPLETE) GA 13200 24750 13500

SURGERY 2191 CLOSURE OF O A F 12000 22500 12000
1049 ORAL & MAXILLOFACIAL 2190 CLOSURE OF O A F GA 13750 27500 14000

SURGERY

1050 SURGERY 2191 CLOSURE OF O A F GA 15000 30000 16000

1051 SURGERY 5637 CORONECTOMY 1210 2420 0

SURGERY 2045 CYST ENUCLEATION 13750 26400 14000
1053 ORAL & MAXILLOFACIAL 1521 DRESSING DENTAL 70 130 65

SURGERY

1054 SURGERY 5641 DRY SOCKET PACK 90 220 0
44
1055 ORAL & MAXILLOFACIAL 1493 ENUCLEATION 1320 2640 2000

SURGERY

1056 SURGERY 2176 ENUCLEATION (MULTIPLE CYST) GA 16500 33000 18000

1057 SURGERY 2175 ENUCLEATION (SINGLE CYST) GA 13750 27500 14000

SURGERY 2188 EXCISION SOFT TISSUE TUMOR GA 13750 27500 14000
1059 ORAL & MAXILLOFACIAL 2189 EXCISION SOFT TISSUE TUMOR GA 16500 33000 18000
SURGERY

1060 SURGERY 5657 EXTRACTION OF TEETH - I GA 13750 27500 14000

1061 SURGERY 5658 EXTRACTION OF TEETH - II GA 16500 33000 18000

SURGERY 5656 EXTRACTION THIRD MOLAR - B/L GA 15400 30800 16000
1063 ORAL & MAXILLOFACIAL 5655 EXTRACTION THIRD MOLAR - I GA 13750 27500 14000
SURGERY

1064 SURGERY 6044 FLAP RE-EXPLORATION -I 8000 16000 0

1065 SURGERY 6045 FLAP RE-EXPLORATION-II 13200 26400 0

SURGERY 6043 FREE FLAP RECONSTRUCTION (S TISSUE) 25000 50000 0

1067 6042 FREE FLAP RECONSTRUCTION (SOFT TISSUE) 20000 40000 0
SURGERY

1068 SURGERY 2186 FRONTAL/ ZYGMATIC GA 13750 27500 14000
1069 ORAL & MAXILLOFACIAL 2179 GAP ANTHROPLASTY GA 14300 24750 16000
SURGERY

1070 SURGERY 5645 HAIR TRANSPLANT (PER FOLLICLE) 50 100 0

1071 SURGERY 2178 I.M.F. GA 13200 26400 13500

SURGERY 1495 IMF 4400 8800 0
1073 ORAL & MAXILLOFACIAL 1491 IMPACTION 3RD MOLAR 1540 3080 0
SURGERY

1074 SURGERY 1490 IMPACTION CANINE 1650 3300 0

1075 SURGERY 1510 INCISION & DRAINAGE 1350 2640 2000

SURGERY 5646 INCISION AND DRAINAGE GA 13750 27500 14000
1077 ORAL & MAXILLOFACIAL 2195 INFERIOR ALVELOR NERVE AVULSION GA 13750 27500 14000
SURGERY

1078 SURGERY 2194 LE FORT I OSTEOTOMY GA 13750 27500 14000
45
1079 ORAL & MAXILLOFACIAL 6040 LOCAL FLAP RECONSTRUCTION 5000 10000 0
SURGERY

1080 SURGERY 2198 MANDIBULAR FRACTURE-I GA 13750 27500 14000

1081 SURGERY 2199 MANDIBULAR FRACTURE-II GA 16500 33000 18000

SURGERY 2193 MANDIBULECTOMY GA 16500 33000 18000
1083 ORAL & MAXILLOFACIAL 1494 MARSUPIALIZATION 550 1100 0

SURGERY

1084 SURGERY 2192 MAXILLECTOMY GA 13750 27500 14000

1085 SURGERY 5649 MIDFACE FRACTURE - I GA 15400 30800 16000

SURGERY 5650 MIDFACE FRACTURE - II GA 18150 44000 20000
1087 ORAL & MAXILLOFACIAL 5631 MINOR DRESSING 110 220 65

SURGERY

1088 SURGERY 1498 MINOR SURGERY 550 1100 2500

1089 SURGERY 6039 NECK DISSECTION B/L 20000 36000 0

SURGERY 5651 NECK DISSECTION GA 15400 27500 16000

1091 1492 OPEN EXTRACTION 400 800 670
SURGERY

1092 SURGERY 2044 ORIF- COMPLICATED FRACTURE 16500 33000 18000
1093 ORAL & MAXILLOFACIAL 5644 ORIF MANDIBLE LA 6600 13200 7000
SURGERY

1094 SURGERY 2032 ORIF- MAXILLA & MANDIBLE 15400 27500 16000

1095 SURGERY 2031 ORIF-SIMPLE 13750 24200 14000

SURGERY 5639 ORTHO EXTRACTION 330 660 300
1097 ORAL & MAXILLOFACIAL 2200 PAN-FACIAL FRACTURE-I GA 16500 33000 18000
SURGERY

1098 SURGERY 2201 PAN-FACIAL FRACTURE-I GA 22000 49500 22500

1099 SURGERY 5654 PLATE REMOVAL GA 13750 27500 14000

SURGERY 5643 PLATE REMOVAL LA 1100 2200 2000
1101 ORAL & MAXILLOFACIAL 6041 PMMC FLAP RECONSTRUCTION 10000 14000 0
SURGERY

1102 SURGERY 1507 POSTERIOR EXT. 170 550 120
46
1103 ORAL & MAXILLOFACIAL 2185 REDUCTION OF LE FORT II, III, # GA 13750 27500 14000
SURGERY

1104 SURGERY 2184 REMOVAL OF WIRE GA 5000 10000 5000

1105 SURGERY 2196 REPAIR OF SOFT TISSUE GA 13750 27500 14000

SURGERY 2197 REPAIR OF SOFT TISSUE GA 16500 33000 18000
1107 ORAL & MAXILLOFACIAL 1501 RIBBON GAUGE 110 300 0

SURGERY

1108 SURGERY 2177 RIGID INTERNAL FIXATION GA 13200 24750 13500

1109 SURGERY 5647 SAGITTAL SPLIT OSTEOTOMY GA 13750 27500 14000

SURGERY 1503 SCALING 400 800 400
1111 ORAL & MAXILLOFACIAL 1496 SPLINTING 440 880 500

SURGERY

1112 SURGERY 2187 SUB MANDIBULAR GLAND EXCISION GA 15400 30800 16000

1113 SURGERY 5632 SURGICAL EXPOSURE 1500 3000 2000

SURGERY 5638 TMJ DISLOCATION 550 1100 600

1115 2046 TMJ PROCEDURE 13750 26400 14000
SURGERY

1116 SURGERY 5635 WOUND REPAIR (INTERMEDIATE) 1320 2640 2000
1117 ORAL & MAXILLOFACIAL 5636 WOUND REPAIR (MAJOR) 3300 6600 4000
SURGERY

1118 SURGERY 5634 WOUND REPAIR (MINOR) 660 1320 700

1119 SURGERY 5652 ZYGOMA FRACTURE - I (INDIRECT) GA 13750 27500 0

SURGERY 5653 ZYGOMA FRACTURE - II GA 16500 33000 18000
1121 ORAL MEDICINE & RADIOLOGY 568 CEPHALOGRAM 800 1050 0
1122 ORAL MEDICINE & RADIOLOGY 1933 INTRALESIONAL INJECTIONS 150 250 0
1123 ORAL MEDICINE & RADIOLOGY 566 IOPA / BITEWING RADIOGRAPH 130 220 100
1124 ORAL MEDICINE & RADIOLOGY 6054 LOW LEVEL LASER THERAPY 100 200 0
1125 ORAL MEDICINE & RADIOLOGY 197 OCCLUSAL RADIOGRAPH 250 380 0
1126 ORAL MEDICINE & RADIOLOGY 6014 OPG WITHOUT PRINT 400 0 700
47
1127 ORAL MEDICINE & RADIOLOGY 567 PANORAMIC RADIOGRAPH 800 1050 800
1128 ORAL MEDICINE & RADIOLOGY 1932 PUNCHN BIOPSY 450 700 500
1129 ORAL MEDICINE & RADIOLOGY 570 RVG 280 500 0
1130 ORAL MEDICINE & RADIOLOGY 1931 TMJ VIEWS 550 750 0
1131 ORAL MEDICINE & RADIOLOGY 5605 TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION 500 800 0
(TENS) THERAPY
1132 ORAL PATHOLOGY 2260 BIOPSY LARGE SPECIMEN (ORAL) 2200 4000 3000
1133 ORAL PATHOLOGY 2259 BIOPSY MEDIUM SPECIMEN (ORAL) 1750 3000 2000
1134 ORAL PATHOLOGY 2258 BIOPSY SMALL SPECIMENS [ORAL] 900 1600 900
1135 ORAL PATHOLOGY 6031 BLOCKS FOR REFERRAL/ REDUNDABLE (ORAL) 2500 0 0
1136 ORAL PATHOLOGY 2261 FNAC (ORAL) 1100 2000 2000
1137 ORAL PATHOLOGY 6026 HISTOPATHOLOGY FOR LARGE SPECIMENS (ORAL) 2500 4600 3000
1138 ORAL PATHOLOGY 6027 HISTOPATHOLOGY FOR MEDIUM SPECIMENS (ORAL) 2010 3450 3000
1139 ORAL PATHOLOGY 6028 HISTOPATHOLOGY FOR SMALL SPECIMENS (ORAL) 600 900 2000
1140 ORAL PATHOLOGY 2262 ORAL EXFOLIATIVE CYTOLOGY 900 1600 900
1141 ORAL PATHOLOGY 6030 SLIDES FOR CONSULTATION REPORTING ONLY SLIDES 600 900 0
RECEIVED- 1 SLIDE (ORAL)
1142 ORAL PATHOLOGY 6029 SPECIAL STAIN (ORAL) 600 900 600
1143 ORTHOPAEDICS 6491 ABCESS DRAINAGE IN LIMBS UNDER GA/RA 10000 19000 10000
1144 ORTHOPAEDICS 6232 ABCESS DRAINAGE IN LIMBS UNDER LA 4000 7600 4000
1145 ORTHOPAEDICS 1469 ABOVE ELBOW 20020 30030 22500
1146 ORTHOPAEDICS 1471 ABOVE KNEE 20020 30030 22500
1147 ORTHOPAEDICS 6236 ACDF/ACCF 20000 38000 20000
1148 ORTHOPAEDICS 1839 AMPUTATION/DISARTICULATION

SHOULDER AND HIP
JOINTS BELOW THE 10000 19000 14000
1149 ORTHOPAEDICS 6492 AMPUTATION/DISARTICULATION OF FINGERS/TOES 7500 14000 8000

UNDER GA/RA
AMPUTATION/DISARTICULATION OF FINGERS/TOES
1150 ORTHOPAEDICS 6237 UNDER LA 3500 6600 4000
48
1151 ORTHOPAEDICS 6493 ANKLE FRACTURES FIXATION (DOUBLE BONE) 12000 23000 12000
1152 ORTHOPAEDICS 6455 ANKLE FRACTURES FIXATION (SINGLE BONE) 8000 15000 10000
1153 ORTHOPAEDICS 1832 ANTERIOR SPINAL INSTRUMENTATION 25000 47500 25000
1154 ORTHOPAEDICS 1837 ANTEROLATERAL DECOMPRESSION (ALD) 15000 28500 16000
1155 ORTHOPAEDICS 1778 AO FIXATOR APPLICATION 10000 19000 16000
1156 ORTHOPAEDICS 1054 APPLICATION OF ABOVE ELBOW SLAB/CAST WITH MUA 1000 1900 1000
APPLICATION OF ABOVE ELBOW SLAB/CAST WITHOUT

1157 ORTHOPAEDICS 1052 MUA 700 1350 700
1158 ORTHOPAEDICS 1058 APPLICATION OF ABOVE KNEE SLAB/CAST WITH MUA 1200 2300 2000
1159 ORTHOPAEDICS 1056 APPLICATION OF ABOVE KNEE SLAB/CAST WITHOUT 700 1300 700
MUA
1160 ORTHOPAEDICS 1053 APPLICATION OF BELOW ELBOW SLAB/CAST WITH MUA 800 1500 800
APPLICATION OF BELOW ELBOW SLAB/CAST WITHOUT

1161 ORTHOPAEDICS 1051 MUA 500 1000 500
1162 ORTHOPAEDICS 1057 APPLICATION OF BELOW KNEE SLAB/CAST WITH MUA 1000 1900 1000
APPLICATION OF BELOW KNEE SLAB/CAST WITHOUT

1163 ORTHOPAEDICS 1055 500 1000 500
MUA
1164 ORTHOPAEDICS 6494 ARTHRODESIS OF FINGER AND TOES UNDER GA/RA 7500 14500 8000
1165 ORTHOPAEDICS 6243 ARTHRODESIS OF FINGER AND TOES UNDER LA 3500 7000 4000
ARTHRODESIS OF LARGE JOINTS OF UPPER / LOWER

1166 ORTHOPAEDICS 1829 LIMBS 15000 28500 16000
1167 ORTHOPAEDICS 1809 ARTHROTOMY OF FINGER & TOES UNDER GA/RA 7500 14500 8000
1168 ORTHOPAEDICS 6495 ARTHROTOMY OF FINGER/TOES UNDER LA 3500 7000 4000
1169 ORTHOPAEDICS 6446 ARTHROTOMY OF LARGE JOINT (SHOULDER/HIP/KNEE) 12500 23750 13500
1170 ORTHOPAEDICS 1470 BELOW ELBOW 11550 17325 12000
1171 ORTHOPAEDICS 1472 BELOW KNEE 12320 18480 13500
1172 ORTHOPAEDICS 1836 BIOPSY UNDER IMAGE INTENSIFIER UNDER GA/RA 10000 19000 10000
1173 ORTHOPAEDICS 1657 BONE DENSITOMETER 3000 5500 3000
1174 ORTHOPAEDICS 6441 BONE GRAFTING + FIXATION OF ANY FRACTURE 15000 28500 16000
49
1175 ORTHOPAEDICS 1822 BONE GRAFTING UNDER GA/RA 10000 19000 10000
BONE MARROW INJECTION UNDER IMAGE INTENSIFIER

1176 ORTHOPAEDICS 6426 UNDER GA 7500 14250 8000
BONE MARROW INJECTION UNDER IMAGE INTENSIFIER

1177 ORTHOPAEDICS 1821 UNDER LA 3000 5700 4000
1178 ORTHOPAEDICS 1813 CDH CORRECTION 15000 28500 16000
1179 ORTHOPAEDICS 6242 CLOSED REDUCTION OF SHOULDER/ELBOW/HIP/KNEE 7500 14250 8000

UNDER GA
1180 ORTHOPAEDICS 1790 CLOSED SCREW FIXATION FOR TIBIAL PLATEAU 10000 19000 14000
1181 ORTHOPAEDICS 1938 COCK UP SPLINT DEPOSIT 1705 2555 2000
1182 ORTHOPAEDICS 1965 COCK UP SPLINT FOR 3 MONTH 425 635 500
1183 ORTHOPAEDICS 1972 COCK UP SPLINT FOR 6 MONTH 850 1275 850
1184 ORTHOPAEDICS 6457 CONTRACTURE RELEASE LARGE 15000 28500 16000
1185 ORTHOPAEDICS 6456 CONTRACTURE RELEASE SMALL 10000 19000 10000
1186 ORTHOPAEDICS 1841 CORE BIOPSY UNDER LA 3500 6650 4000
1187 ORTHOPAEDICS 1812 CTEV BONY CORRECTION 15000 28500 16000
1188 ORTHOPAEDICS 1811 CTEV SOFT TISSUE CORRECTION 15000 28500 16000
1189 ORTHOPAEDICS 1843 CURETTAGE & BONE GRAFTING / CEMENTING UPPER 15000 28500 16000
AND OR LOWER LIMB
1190 ORTHOPAEDICS 1810 CURETTAGE AND SEQUESTRECTOMY 10000 19000 14000
1191 ORTHOPAEDICS 1782 DCP/LOCKING PLATE/DHS/DCS/CCS FIXATION 15000 28500 16000
1192 ORTHOPAEDICS 1814 DEFORMITY CORRECTION UPPER/ LOWER LIMB 15000 28500 16000
1193 ORTHOPAEDICS 5432 DEPOSIT CHARGE 55000 82500 0
1194 ORTHOPAEDICS 1845 DIAGNOSTIC ARTHROSCOPY 12500 23750 16000
1195 ORTHOPAEDICS 6238 DISARTICULATION OF SHOULDER/HIP 15000 28500 16000
1196 ORTHOPAEDICS 6435 DRAINAGE OF ACUTE OSTEOMYELITIS UNDER GA/RA 10000 19000 10000
1197 ORTHOPAEDICS 6434 DRESSING-LARGE 500 950 500
1198 ORTHOPAEDICS 6433 DRESSING-SMALL 250 475 250
50
1199 ORTHOPAEDICS 6443 DYNAMIZATION OF NAIL UNDER GA/RA 3500 6500 4000
1200 ORTHOPAEDICS 6442 DYNAMIZATION OF NAIL UNDER LA 500 950 500
1201 ORTHOPAEDICS 1817 EXCISIONAL ARTHROPLASTY 10000 19000 14000
1202 ORTHOPAEDICS 6438 EXCISIONAL BIOPSY UNDER LA 5000 9500 5000
1203 ORTHOPAEDICS 6439 EXCISIONAL BIOPSY UNDER RA/GA 10000 19000 10000
1204 ORTHOPAEDICS 6459 FASCIOTOMY OF HAND/FOOT 7500 14000 8000
1205 ORTHOPAEDICS 6460 FASCIOTOMY OF THIGH/ARM 10000 19000 10000
1206 ORTHOPAEDICS 1942 FINGER SPLINT DEPOSIT 485 725 500
1207 ORTHOPAEDICS 1969 FINGER SPLINT FOR 3 MONTH 120 180 200
1208 ORTHOPAEDICS 1976 FINGER SPLINT FOR 6 MONTH 245 365 300
1209 ORTHOPAEDICS 6458 FIXATION/SURGERY OF CARPAL BONES 15000 28500 16000
1210 ORTHOPAEDICS 1941 FORE ARM BRACE DEPOSIT 2200 3300 3000
1211 ORTHOPAEDICS 1968 FORE ARM BRACE FOR 3 MONTH 550 825 600
1212 ORTHOPAEDICS 1975 FORE ARM BRACE FOR 6 MONTH 1100 1650 2000
1213 ORTHOPAEDICS 6452 FOREIGN BODY REMOVAL UNDER LA 5000 9500 5000
1214 ORTHOPAEDICS 1848 FOREIGN BODY REMOVAL UNDER RA/GA 10000 19000 14000
1215 ORTHOPAEDICS 6454 FRACTURE FIXATION WITH TBW 10000 19000 10000
1216 ORTHOPAEDICS 6244 FREE FLAPS/TISSUE TRANSFER 25000 47500 25000
1217 ORTHOPAEDICS 1807 HEMI REPLECEMENT ARTHROPLASTY 15000 28500 16000
1218 ORTHOPAEDICS 1780 HYBRID ILIZAROV FIXATOR APPLICATION 12500 23750 14000
1219 ORTHOPAEDICS 1779 ILIZAROV FIXATOR APPLICATION 15000 28500 16000
1220 ORTHOPAEDICS 6226 ILIZAROV FIXATOR APPLICATION FOR BONE TRANSPORT 20000 38000 20000
1221 ORTHOPAEDICS 1656 IMAGE INTENSIFIER IN OT 500 1000 500
1222 ORTHOPAEDICS 6453 IMPLANT REMOVAL UNDER LA 3000 5700 3000
51
1223 ORTHOPAEDICS 1849 IMPLANT REMOVALUNDE RA/GA 10000 19000 14000
1224 ORTHOPAEDICS 6436 INCISIONAL BIOPSY UNDER LA 3500 7000 4000
1225 ORTHOPAEDICS 6437 INCISIONAL BIOPSY UNDER RA/GA 7500 14250 8000
1226 ORTHOPAEDICS 6015 INJ. ZOLENDRONIC ACID 500 0 0
1227 ORTHOPAEDICS 1920 INTERCONDYLAR FRACTURE HUMERUS 15000 28500 16000
1228 ORTHOPAEDICS 1801 INTERLOCKING NAILING / PFN 15000 28500 16000
1229 ORTHOPAEDICS 6428 INTERMEDIATE OT IN EMERGENCY 7500 14250 0
1230 ORTHOPAEDICS 1789 K-NAIL FIXATION 10000 19000 14000
1231 ORTHOPAEDICS 1804 K-NAIL FIXATION WITH BONE GRAFTING 15000 28500 16000
1232 ORTHOPAEDICS 2096 KNEE HINGE DEPOSIT 2420 3630 3000
1233 ORTHOPAEDICS 2097 KNEE HINGE FOR 3 MONTH 485 725 500
1234 ORTHOPAEDICS 2098 KNEE HINGE FOR 6 MONTH 970 1455 1000
1235 ORTHOPAEDICS 6227 K-WIRE FIXATION OF BONES UNDER GA 10000 19000 10000
1236 ORTHOPAEDICS 6440 K-WIRE FIXATION OF BONES UNDER LA/RA 7500 14250 8000
1237 ORTHOPAEDICS 1834 LAMINECTOMY/LAMINOTOMY/ 15000 28500 16000

FORAMINOTOMY/DISCECTOMY
1238 ORTHOPAEDICS 1939 LEG BRACE DEPOSIT 7040 10560 8000
1239 ORTHOPAEDICS 1966 LEG BRACE FOR 3 MONTH 1760 2640 2000
1240 ORTHOPAEDICS 1973 LEG BRACE FOR 6 MONTH 3520 5280 4000
1241 ORTHOPAEDICS 6241 LIMB LENGHENING SURGERY 20000 38000 20000
1242 ORTHOPAEDICS 1826 LOCAL FLAP SURGERIES - LARGE 15000 28500 16000
1243 ORTHOPAEDICS 6448 LOCAL FLAP SURGERIES-SMALL 7500 14250 8000
1244 ORTHOPAEDICS 1970 METACARPAL FRACTURE SPLINT FOR 3 MONTH 245 365 300
1245 ORTHOPAEDICS 1943 METACARPAL FRACTURE SPLINT DEPOSIT 970 1455 1000
1246 ORTHOPAEDICS 1977 METACARPAL FRACTURE SPLINT FOR 6 MONTH 485 725 500
52
1247 ORTHOPAEDICS 6427 MINOR OT IN EMERGENCY 3500 6500 0
1248 ORTHOPAEDICS 6429 MINOR OT IN ROT 5000 9500 0
1249 ORTHOPAEDICS 6240 NERVE TRANSPOSITION 10000 19000 10000
1250 ORTHOPAEDICS 1921 OPEN REDUCTION OF SHOULDER/ELBOW/HIP/KNEE 15000 28500 16000
1251 ORTHOPAEDICS 1831 PEDICLE SCREW / LATERAL MASS SCREW FIXATION 15000 28500 16000
1252 ORTHOPAEDICS 2013 PLATING FOR TIBIAL PLATEAU 15000 28500 16000
1253 ORTHOPAEDICS 1059 POP CAST REMOVAL 200 400 1200
1254 ORTHOPAEDICS 6239 REPLANTATION OF FINGER/HAND 30000 57000 30000
1255 ORTHOPAEDICS 1835 SCOLIOSIS CORRECTION 25000 47500 25000
1256 ORTHOPAEDICS 6444 SKIN GRAFTING-LARGE GA 10000 19000 10000
1257 ORTHOPAEDICS 6235 SKIN GRAFTING-SMALL 5000 9500 5000
1258 ORTHOPAEDICS 750 STEROID INJECTION (INTRALESIONAL / INTRA- 100 200 100
ARTICULAR)
1259 ORTHOPAEDICS 6445 SURGERIES OF ACETABULUM AND PELVIS- COMPLEX 20000 38000 20000
1260 ORTHOPAEDICS 1808 SURGERIES OF ACETABULUM AND PELVIS- NORMAL 15000 28500 16000
1261 ORTHOPAEDICS 6432 SUTURING OF WOUNDS-LARGE GA/RA 5000 9500 5000
1262 ORTHOPAEDICS 6431 SUTURING OF WOUNDS-SMALL UNDER LA 1500 2850 2000
1263 ORTHOPAEDICS 1473 SYMES 11000 16500 12000
1264 ORTHOPAEDICS 1816 TENDON TRANSFERS/TENDON REPAIRS/NERVE

REPAIRS/TENDON RECONSTRUCTION 15000 28500 16000
1265 ORTHOPAEDICS 6230 TENS FOR FEMUR 15000 28500 16000
1266 ORTHOPAEDICS 6229 TENS FOR RADIUS/ULNA UNDER GA/RA 7500 14000 8000
1267 ORTHOPAEDICS 1847 THERAPEUTIC ARTHROSCOPY 25000 47500 25000
1268 ORTHOPAEDICS 1940 THIGH BRACE DEPOSIT 8470 12705 9000
1269 ORTHOPAEDICS 1967 THIGH BRACE FOR 3 MONTH 2120 3180 3000
1270 ORTHOPAEDICS 1974 THIGH BRACE FOR 6 MONTH 4235 6350 4500
53
1271 ORTHOPAEDICS 1944 THUMB SPICA SPLINT DEPOSIT 1210 1815 2000
1272 ORTHOPAEDICS 1971 THUMB SPICA SPLINT FOR 3 MONTH 300 450 300
1273 ORTHOPAEDICS 1978 THUMB SPICA SPLINT FOR 6 MONTH 605 905 700
1274 ORTHOPAEDICS 6451 TLIF/PLIF 20000 38000 20000
1275 ORTHOPAEDICS 1819 TOTAL HIP ARTHROPLASTY 30000 57000 30000
1276 ORTHOPAEDICS 1820 TOTAL KNEE ARTHROPLASTY 30000 57000 30000
1277 ORTHOPAEDICS 5431 USAGE CHARGE 11550 17325 0
1278 ORTHOPAEDICS 6447 VASCULAR REPAIR 15000 28500 16000
1279 ORTHOPAEDICS 6449 WOUND DEBRIDEMENT LARGE IN EMERGENCY UNDER 7000 13300 7000
GA/RA
1280 ORTHOPAEDICS 1827 WOUND DEBRIDEMENT SMALL UNDER LA 3500 6650 8000
1281 ORTHOPAEDICS 6461 ZOLEDRONIC ACID INJECTION IN WARD 500 950 500
1282 ORTHOPDONTICS DENTAL 1560 ABSOLUTE ANCHORAGE SYSTEM 3990 7260 0
1283 ORTHOPDONTICS DENTAL 1555 DENTOFACIAL ORTHOPEDIC APPLEANCE 13310 24200 0
1284 ORTHOPDONTICS DENTAL 2170 FIXED 6660 12100 0
1285 ORTHOPDONTICS DENTAL 2171 FIXED 9320 16940 0
1286 ORTHOPDONTICS DENTAL 2052 FIXED EXPANSION APPLIANCE 2660 4360 0
FIXED ORTHODONTIC PROCEDURES_x000D_

1287 ORTHOPDONTICS DENTAL 1565 ( EXTRACTION CASE) 39930 54450 0
1288 ORTHOPDONTICS DENTAL 1564 FIXED ORTHODONTIC PROCEDURES_x000D_

(NON EXTRACTION CASE) 33280 43560 0
1289 ORTHOPDONTICS DENTAL 1563 FIXED ORTHODONTIC PROCEDURES_x000D_ 13310 21780 0

(SINGLE AECH TREATMENT)
1290 ORTHOPDONTICS DENTAL 2172 FIXED ORTHODONTICS T/T (2 X 4) 6660 12100 0
1291 ORTHOPDONTICS DENTAL 2173 FIXED ORTHODONTICS T/T FORCED 6660 12100 0
1292 ORTHOPDONTICS DENTAL 1557 FIXED RETAINER 2000 3630 0
1293 ORTHOPDONTICS DENTAL 2053 IMPLANT ANCHORAGE SYSTEM 13310 21780 0
1294 ORTHOPDONTICS DENTAL 2051 LINGUAL ORTHODONTICS 53240 87120 0
54
1295 ORTHOPDONTICS DENTAL 1562 MINOR SURGICAL ORTHODONTIC PROCEDURES 1600 2900 0
1296 ORTHOPDONTICS DENTAL 2174 ORTHODONTICS EXTRUSION 19970 36300 0
1297 ORTHOPDONTICS DENTAL 1554 REMOVABLE 2660 4240 0
1298 ORTHOPDONTICS DENTAL 1556 REMOVABLE 6660 12100 0
1299 ORTHOPDONTICS DENTAL 1561 REMOVABLE / FIXED APPLIANCE REPAIR PROCEDURS 330 610 0
1300 ORTHOPDONTICS DENTAL 1553 REMOVABLE ORTHODONTIC APPLIANCE 1330 1820 0
VACUUM FORMED INVISIBLE RETAINERS OR OCCLUSAL

1301 ORTHOPDONTICS DENTAL 1558 SPLINT 2000 3630 0
1302 ORTHOSIS 1466 2 POST CERVICAL COLLAR 2575 3860 0
1303 ORTHOSIS 1467 4 POST CERVICAL COLLAR 2475 3710 0
1304 ORTHOSIS 1456 AFO (FOOT DROP SPLINT) (UNILATERAL) 1430 2145 0
1305 ORTHOSIS 1692 ANKLE BRACE 1155 1730 0
1306 ORTHOSIS 1454 ARM BRACE 1455 2180 0
1307 ORTHOSIS 5439 ARTICULATED AFO 7260 10890 0
1308 ORTHOSIS 1474 ASHE BRACE 945 1415 0
1309 ORTHOSIS 1461 BOSTON BRACE 9460 14190 0
1310 ORTHOSIS 1459 CHAIR BACK BRACE 3630 5445 0
1311 ORTHOSIS 5449 CORRECTIVE SPINAL BRACE 23650 35475 0
1312 ORTHOSIS 1465 CTEV SPLINT 1815 2720 0
1313 ORTHOSIS 5447 CUSTOM MADE BODY JACKET ( CHILD ) 11550 17325 0
1314 ORTHOSIS 5448 CUSTOM MADE BODY JACKET (ADULT ) 15125 22685 0
1315 ORTHOSIS 5434 CUSTOM MADE INSOLE (FOOT ORTHOSIS) 3025 4535 0
1316 ORTHOSIS 1468 DENNIS BROWNE SPLINT 1100 1650 0
1317 ORTHOSIS 5438 DYNAMIC AFO 6600 9900 0
1318 ORTHOSIS 5440 DYNAMIC AFO DORSI/ PLANTER FLEXION ASSIT 14520 21780 0
55
1319 ORTHOSIS 1452 DYNAMIC COCK UP SPLINT 1090 1635 0
1320 ORTHOSIS 1478 FLEXOR TENDON REPAIR SPLINT 1400 2100 0
1321 ORTHOSIS 1658 FOOT DROP SPLINT 660 990 0
1322 ORTHOSIS 1455 FORE ARM BRACE 1210 1815 0
1323 ORTHOSIS 5452 FUNCTIONAL FOREARM BRACE 2475 3710 0
1324 ORTHOSIS 5451 FUNCTIONAL HUMERAL BRACE 3025 4535 0
1325 ORTHOSIS 1691 FUNCTIONAL KNEE BRACE 1815 2720 0
1326 ORTHOSIS 5445 FUNCTIONAL THIGH BRACE 4235 6350 0
1327 ORTHOSIS 5430 HALO VEST APPLICATION CHARGE (INTERMEDIATE) 6600 9900 0
1328 ORTHOSIS 5450 HIP ABDUCTION SPLINT WITH JOINT 5750 8625 0
1329 ORTHOSIS 1458 HKAFO (UNILATERAL) 6600 9900 0
1330 ORTHOSIS 1457 KAFO (UNILATERAL) 3630 5445 0
1331 ORTHOSIS 1476 KAFO WITHOUT KNEE JOINT 2200 3300 0
1332 ORTHOSIS 5443 KNEE GAITER ORTHOSIS 5060 7590 0
1333 ORTHOSIS 1460 KNIGHT TAYLOR BRACE 3630 5445 0
1334 ORTHOSIS 1690 LATERAL SHOE RAISE B/L 300 450 0
1335 ORTHOSIS 5435 LEAF SPRING AFO 4840 7260 0
1336 ORTHOSIS 1693 METATARSAL PAD/ BAR 110 165 0
1337 ORTHOSIS 1462 MILWAUKEE BRACE 15290 22935 0
1338 ORTHOSIS 5433 MOLDED FOOT ORTHOSIS 3630 5445 0
1339 ORTHOSIS 5446 MOLDED KAFO WITH HIP, KNEE & ANKLE JOINT 19580 29370 0
1340 ORTHOSIS 5444 MOLDED KAFO WITH KNEE JOINT & ANKLE JOINT 11550 17325 0
1341 ORTHOSIS 5442 MOLDED KNEE ORTHOSIS 6380 9570 0
1342 ORTHOSIS 5441 MOLDED PTB ORTHOSIS WITH SOFT INSERT 7700 11550 0
56
1343 ORTHOSIS 1477 MOULDED LSO - ADULT 2915 4370 0
1344 ORTHOSIS 1912 MOULDED LSO - PAEDIATRIC 3630 5445 0
1345 ORTHOSIS 1910 ORTHOSIS/PROSTHESIS REPAIR CHARGE - MAJOR 725 1085 0
1346 ORTHOSIS 1475 ORTHOSIS/PROSTHESIS REPAIR CHARGE - MINOR 510 765 0
1347 ORTHOSIS 1463 PTB BRACE 1745 2615 0
1348 ORTHOSIS 2042 RIGID FOOT ORTHOSIS 1815 2720 0
1349 ORTHOSIS 1911 SACH FOOT 3105 4655 0
1350 ORTHOSIS 2043 SCOTTIS RITE BRACE (ABDUCTION SPLINT) 3300 4950 0
1351 ORTHOSIS 5436 SOLID AFO 5500 8250 0
1352 ORTHOSIS 5437 SPIRAL AFO 6050 9075 0
1353 ORTHOSIS 1453 STATIC COCK UP SPLINT 825 1235 0
1354 ORTHOSIS 1451 TAYLORS BRACE 2200 3300 0
1355 ORTHOSIS 1464 THIGH BRACE (SARMIENTO) 1745 2615 0
PAEDIATRICS & ADOLESCENT

1356 MEDICINE 1081 ABDOMINAL PARACENTESIS 300 550 300
1357 PAEDIATRICS & ADOLESCENT 1077 BONE MARROW ASPIRATION 240 550 317
MEDICINE

1358 MEDICINE 2121 CHEST TUBE INSERTION & DRAINAGE 610 1100 700

1359 MEDICINE 408 CUT DOWN (VENOUS) 0 610 1100 700
1360 PAEDIATRICS
MEDICINE
& ADOLESCENT 404 EXCHANGE TRANSFUSION 1ST PROCEDURE 1210 3300 2000
1361 PAEDIATRICS & ADOLESCENT 1076 LAMBER PUNCTURE 240 550 300
MEDICINE

1362 MEDICINE 402 LYING-IN CHARGES WITH MOTHER/DAY 300 0 300

1363 MEDICINE 2120 NEBULIZATION 180 0 100
1364 PAEDIATRICS
MEDICINE
& ADOLESCENT 6052 PAEDIATRIC VIDEO EEG 1700 3000 2000
1365 PAEDIATRICS & ADOLESCENT 2119 PHOTOTHERAPY 360 0 200

MEDICINE

1366 MEDICINE 1078 PLEURAL TAP 610 1100 500
57
1367 PAEDIATRICS & ADOLESCENT 1079 RENAL BIOPSY 610 1100 700
MEDICINE

1368 MEDICINE 409 SUB DURAL TAP 610 1100 700

1369 MEDICINE 405 SUBSEQUENT EXCHANGES/DAY 610 2750 700
1370 PATHOLOGY 2118 BLOOD COMPONENT CHARGE 950 0 800
1371 PATHOLOGY 2220 CROSS MATCH GENERAL 120 0 100
1372 PATHOLOGY 5366 HEMOLYTIC PROFILE HAPTOGLOBIN 330 600 400
LEUKEMIA CYCOCHEMISTRY (PACKAGE) SBB / PAS /

1373 PATHOLOGY 2134 MPO 400 800 400
1374 PATHOLOGY 334 PORPHOBILIN 110 330 200
1375 PEDODONTICS & PREVENTIVE 829 ALGINATE IMPRESSION (PER ARCH) 200 400 0
DENTISTRY
PEDODONTICS & PREVENTIVE

1376 DENTISTRY 177 APEXIFICATION 1800 3600 0

1377 DENTISTRY 1664 APICOECTOMY - POSTERIOR 2000 4000 0
1378 PEDODONTICS
DENTISTRY
& PREVENTIVE 5621 BIODENTINE 2000 4000 0

1379 813 BIOPSY 300 600 300
DENTISTRY

1380 DENTISTRY 5626 CHEMOMECHANICAL CARIES REMOVAL PROCEDURE 500 1000 0
1381 PEDODONTICS & PREVENTIVE 163 COMPOMER RESTORATION CLASS II / COMPOSITE 600 1200 600
DENTISTRY RESTORATION CLASS I
PEDODONTICS & PREVENTIVE COMPOSITE CORE BUILD UP / ROOT CANAL TREATED

1382 DENTISTRY 1660 TOOTH 1200 2400 0

1383 DENTISTRY 844 COMPOSITE LAMINATE (PER TOOTH) 1800 3600 0
1384 PEDODONTICS
DENTISTRY
& PREVENTIVE 1659 COMPOSITE RESTORATION - CLASS II 800 1600 350
1385 PEDODONTICS & PREVENTIVE 817 CROWN - STAINLESS STEEL / POLYCARBONATE 1250 2500 0
DENTISTRY

1386 DENTISTRY 693 CYST MARSUPILIZATION / ENUCLEATION 1500 3000 0

1387 DENTISTRY 6032 DRESSING PER VISIT DENTAL (PEDODONTICS) 200 400 0
1388 PEDODONTICS
DENTISTRY
& PREVENTIVE 822 EACH ADDITIONAL EXPANSION SCREW / BAND / COIL
SPRING / WIRE CHANGE 300 600 0
1389 PEDODONTICS & PREVENTIVE 687 EXTRACTION - PERMANENT TEETH 150 300 300
DENTISTRY

1390 DENTISTRY 707 EXTRACTION - SURGICAL / IMPACTION 1000 2000 670
58
1391 PEDODONTICS & PREVENTIVE 172 EXTRACTION (PRIMARY ANTERIOR / ROOT STUMP) 100 200 120
DENTISTRY

1392 DENTISTRY 854 FEEDING APPLIANCE (ACRYLIC) 600 1200 0

1393 DENTISTRY 181 FIXED SPACE MAINTAINER 900 1800 0
1394 PEDODONTICS
DENTISTRY
& PREVENTIVE 562 FLUORIDE APPLICATION (PER VISIT) 80 150 0
1395 PEDODONTICS & PREVENTIVE 5629 FLUORIDE APPLICATION (VARNISH) 150 300 0
DENTISTRY

1396 DENTISTRY 853 FULL METAL CROWN 1000 2000 0

1397 DENTISTRY 161 GIC - CLASS I 180 350 200
1398 PEDODONTICS
DENTISTRY
& PREVENTIVE 1513 GIC - CLASS II 200 400 200
1399 PEDODONTICS & PREVENTIVE 2166 HABIT BREAKING APPLIANCE - FIXED 1500 3000 0
DENTISTRY

1400 DENTISTRY 772 HAND SCALING AND POLISHING - PRIMARY DENTITION 200 400 0

1401 DENTISTRY 6033 HEAT CURING 500 1000 0
1402 PEDODONTICS
DENTISTRY
& PREVENTIVE 5334 HYRAX EXPANSION SCREW 4000 8000 0

1403 833 INCISION AND DRAINAGE 400 800 450
DENTISTRY

1404 DENTISTRY 6034 INTERCEPTIVE ORTHOODNTIC THERAPY (PER ARCH) 5000 10000 0
1405 PEDODONTICS & PREVENTIVE 5625 LASER / CAUTERY PROCEDURE 1000 2000 0
DENTISTRY

1406 DENTISTRY 174 MINOR ORAL SURGICAL PROCEDURE 1000 2000 2500

1407 DENTISTRY 1914 MIRACLE MIX - CORE BUILD UP 500 1000 0
1408 PEDODONTICS
DENTISTRY
& PREVENTIVE 1913 MIRACLE MIX RESTORATION 250 500 300
1409 PEDODONTICS & PREVENTIVE 5620 MTA 1500 3000 0

DENTISTRY

1410 DENTISTRY 5622 NITROUS-OXIDE OXYGEN INHALATION SEDATION 1000 2000 0

1411 DENTISTRY 776 OPERCULECTOMY 200 400 0
1412 PEDODONTICS
DENTISTRY
& PREVENTIVE 856 OTHER PROSTHESIS 1000 2000 0
1413 PEDODONTICS & PREVENTIVE 774 PIT AND FISSURE SEALANT 250 500 0
DENTISTRY

1414 DENTISTRY 6036 PNAM THERAPY 1000 2000 0
59
1415 PEDODONTICS & PREVENTIVE 851 PORCELAIN FUSED TO METAL CROWN 1500 3000 0
DENTISTRY
PEDODONTICS & PREVENTIVE PORCELAIN LAMINATES / TOOTH (EXCLUDING LAB

1416 DENTISTRY 1547 CHARGES) 2500 5000 0

1417 DENTISTRY 848 POST AND CORE 1000 2000 0
1418 PEDODONTICS
DENTISTRY
& PREVENTIVE 2047 PREVENTIVE RESIN RESTORATION 500 1000 0
1419 PEDODONTICS & PREVENTIVE 6035 PREVENTIVE RESIN RESTORATION TYPE III 800 1600 0
DENTISTRY

1420 DENTISTRY 814 PULP CAPPING (WITH DYCAL) 300 600 0

1421 DENTISTRY 2159 PULPECTOMY - POSTERIOR (EXCLUDING METAPEX) 1000 2000 0
1422 PEDODONTICS
DENTISTRY
& PREVENTIVE 176 PULPECTOMY (EXCLUDING METAPEX) 700 1400 0
1423 PEDODONTICS & PREVENTIVE 175 PULPOTOMY 500 1000 0

DENTISTRY

1424 DENTISTRY 824 RECEMENTATION OF CROWN 300 600 0

1425 DENTISTRY 2048 REMOVABLE COMPLETE DENTURE 2000 4000 0
1426 PEDODONTICS
DENTISTRY
& PREVENTIVE 1666 REMOVABLE FUNCTIONAL APPLIANCES 7500 15000 0

1427 821 REMOVABLE ORTHODONTIC APPLIANCE 1200 2400 0
DENTISTRY

1428 DENTISTRY 1527 REMOVABLE PARTIAL DENTURE 750 1500 0
1429 PEDODONTICS & PREVENTIVE 835 REMOVABLE SPACE MAINTAINER 500 1000 0
DENTISTRY

1430 DENTISTRY 1528 REPAIR / RELINING OF APPLIANCE 300 600 0

1431 DENTISTRY 152 REPAIR OF SOFT TISSUE INJURY 600 1200 0
1432 PEDODONTICS
DENTISTRY
& PREVENTIVE 1662 REPLANTATION (WITHOUT RCT) 1500 3000 0
1433 PEDODONTICS & PREVENTIVE 5623 RESIN CEMENT 500 1000 0

DENTISTRY
PEDODONTICS & PREVENTIVE ROOT CANAL DRESSING - CALCIUM HYDROXIDE (PER

1434 DENTISTRY 1663 VISIT) 200 400 0

1435 DENTISTRY 1523 ROOT CANAL DRESSING - METAPEX (PER VISIT) 400 800 0
1436 PEDODONTICS
DENTISTRY
& PREVENTIVE 166 ROOT CANAL TREATMENT - ANTERIOR 1250 2500 0
1437 PEDODONTICS & PREVENTIVE 815 ROOT CANAL TREATMENT - POSTERIOR 1500 3000 0
DENTISTRY

1438 DENTISTRY 5628 ROOT CANAL TREATMENT - ROTARY 3000 6000 0
60
1439 PEDODONTICS & PREVENTIVE 828 RUBBER BASE IMPRESSION (PER ARCH) 350 600 0
DENTISTRY

1440 DENTISTRY 2158 RUBBER DAM APPLICATION 200 400 0

1441 DENTISTRY 5624 SILVER DIAMINE FLUORIDE 200 400 0
1442 PEDODONTICS
DENTISTRY
& PREVENTIVE 158 SIMPLE GRINDING / PROXIMAL STRIPPING (PER TOOTH) 100 200 0
1443 PEDODONTICS & PREVENTIVE 192 SPLINTING - COMPOSITE AND WIRE (4 UNIT) 1250 2500 0
DENTISTRY

1444 DENTISTRY 823 SPLINTING - GUNNING SPLINT 1500 3000 0

1445 DENTISTRY 1519 SPLINTING - RIBBOND FIBER (1CM) 1800 3600 0
1446 PEDODONTICS
DENTISTRY
& PREVENTIVE 1916 STRIP CROWN 1750 3500 0
1447 PEDODONTICS & PREVENTIVE 1915 SUTURING (EXCLUDING SUTURE MATERIAL) 250 500 0
DENTISTRY

1448 DENTISTRY 1516 TEMPORARY CROWN 250 500 0

1449 DENTISTRY 162 TEMPORARY RESTORATION 100 200 0
1450 PEDODONTICS
DENTISTRY
& PREVENTIVE 1515 TOOTH PREPARATION 600 1200 0

1451 1518 ULTRASONIC SCALING - PERMANENT DENTITION 400 800 0
DENTISTRY

1452 DENTISTRY 841 ULTRASONIC SCALING - PRIMARY DENTITION 300 600 0
1453 PEDODONTICS & PREVENTIVE 5335 VACUUM FABRICATED SPLINT/ MOUTHGUARD 1500 3000 0
DENTISTRY

1454 DENTISTRY 5627 ZIRCONIA CROWN 3000 6000 0
1455 PERIODONTICS DENTAL 1110 ALVELOPLASTY PER SEGMENT 600 1000 0
1456 PERIODONTICS DENTAL 5607 APICOECTOMY OF ANTERIOR TOOTH WITH RCT 2000 3500 0
1457 PERIODONTICS DENTAL 1107 APICOECTOMY OF ANTERIOR TOOTH WITHOUT RCT 1800 3000 0
1458 PERIODONTICS DENTAL 1108 APICOECTOMY OF POSTERIOR TOOTH WITHOUT RCT 2500 4000 0
1459 PERIODONTICS DENTAL 1536 BIO-OSS PER TOOTH 4000 7000 0
1460 PERIODONTICS DENTAL 5606 BIOPSY (EXCISIONAL) 1000 1500 1000
1461 PERIODONTICS DENTAL 1111 BIOPSY (INCISIONAL) 800 1000 800
1462 PERIODONTICS DENTAL 5326 BONE GRAFT PER TOOTH WITH LOCAL MATERIAL 1100 2000 0
61
1463 PERIODONTICS DENTAL 1668 COMPOSITE SPLINTING PER SEXTANT 1200 2000 0
1464 PERIODONTICS DENTAL 1094 CONNECTIVE TISSUE GRAFT 1650 3000 0
1465 PERIODONTICS DENTAL 5616 CROWN CEMENTATION FOR IMPLANT 250 500 0
1466 PERIODONTICS DENTAL 2049 CROWN LENGTHNING PER TOOTH- ANTERIOR 800 1500 0
1467 PERIODONTICS DENTAL 1105 CUSPAL GRINDING PER TOOTH 60 100 0
1468 PERIODONTICS DENTAL 2034 CYST ENUCLEATION (PERIODONTAL)-ANTERIOR TOOTH 1650 3000 0
1469 PERIODONTICS DENTAL 2050 CYST ENUCLEATION OF POSTERIOR TOOTH 2500 5000 0
1470 PERIODONTICS DENTAL 5619 DENTIUM IMPLANT ABUTMENTWITH PLACEMENT 10000 20000 0
1471 PERIODONTICS DENTAL 1116 DEPIGMENTATION OF GINGIVA PER SEXTANT 600 1000 0
1472 PERIODONTICS DENTAL 1115 DESENSITIZING PER SEGMENT 500 1000 0
1473 PERIODONTICS DENTAL 1113 DESENSITIZING PER TOOTH 250 400 0
1474 PERIODONTICS DENTAL 868 DISTAL WEDGE SURGERY 450 800 0
1475 PERIODONTICS DENTAL 1095 EPITHELIZED SOFT TISSUE GRAFT 1100 2000 0
1476 PERIODONTICS DENTAL 871 FLAP SURGERY FULL MOUTH 5000 10000 0
1477 PERIODONTICS DENTAL 188 FLAP SURGERY PER QUADRANT 1500 2500 0
1478 PERIODONTICS DENTAL 1118 FLAP SURGERY PER SEXTANT 1000 1500 0
1479 PERIODONTICS DENTAL 1114 FLAP SURGERY PER TOOTH 500 800 0
1480 PERIODONTICS DENTAL 1092 FRENECTOMY 600 1000 0
1481 PERIODONTICS DENTAL 865 FULL MOUTH MANUAL SUPRAGINGIVAL SCALING 300 0 0
1482 PERIODONTICS DENTAL 861 FULL MOUTH ULTRASONIC SUBGINGIVAL SCALING 700 1200 0
FULL MOUTH ULTRASONIC SUPRA AND SUBGINGIVAL

1483 PERIODONTICS DENTAL 863 SCALING 900 1600 0
1484 PERIODONTICS DENTAL 859 FULL MOUTH ULTRASONIC SUPRAGINGIVAL SCALING 450 800 0
1485 PERIODONTICS DENTAL 5329 GBR PER IMPLANT 2500 5000 0
1486 PERIODONTICS DENTAL 187 GINGIVECTOMY/ GINGIVOPLASTY PER SEXTANT 1100 2000 0
62
1487 PERIODONTICS DENTAL 5328 GTR AND BONE GRAFT WITH LOCAL MATERIALS 2500 5000 0
1488 PERIODONTICS DENTAL 873 GTR PER TOOTH WITH LOCAL MATERIAL 1700 3000 0
1489 PERIODONTICS DENTAL 5327 GTR WITH BIOGIDE PER TOOTH 5000 8000 0
1490 PERIODONTICS DENTAL 5332 IMPLANT SURGERY 5500 10000 0
1491 PERIODONTICS DENTAL 5322 IMPLANT SURGERY WITH ADIN FIXTURE 16500 30000 0
1492 PERIODONTICS DENTAL 5618 IMPLANT SURGERY WITH DENTIUM FIXURE 15000 30000 0
1493 PERIODONTICS DENTAL 5323 IMPLANT SURGERY WITH XIVE FIXTURE 27500 50000 0
1494 PERIODONTICS DENTAL 1106 INCIAL / OCCLUSAL GRINDING: PER QUADRANT 250 400 0
1495 PERIODONTICS DENTAL 870 INCISION AND DRAINAGE PER AREA 300 500 900
INTER DENTAL PAPILLA RECONSTRUCTION _x000D_

1496 PERIODONTICS DENTAL 1121 ( PER PAPILLA) 600 1000 0
1497 PERIODONTICS DENTAL 6246 LASER DEPIGMENTATION 2500 5000 0
1498 PERIODONTICS DENTAL 6250 LASER EXCISION OF ORAL LESION (LARGE) 1500 3000 0
1499 PERIODONTICS DENTAL 6249 LASER EXCISION OF ORAL LESION (SMALL) 1000 2000 0
1500 PERIODONTICS DENTAL 6247 LASER FRENECTOMY 1500 3000 0
1501 PERIODONTICS DENTAL 6248 LASER OPERCULECTOMY 1500 3000 0
LATERAL / CORONAL POSITIONED AUTOGRAFT PER

1502 PERIODONTICS DENTAL 1093 TOOTH 600 1000 0
1503 PERIODONTICS DENTAL 1533 LIP REPOSITIONING SURGERY 1000 2000 0
1504 PERIODONTICS DENTAL 5608 LOCAL DRUG DELIVERY PER TOOTH 1200 2500 0
1505 PERIODONTICS DENTAL 6245 LOW LEVEL LASER THERAPY (PERIODONTICS) 1500 3000 0
1506 PERIODONTICS DENTAL 864 MANUAL SUPRAGINGIVAL SCALING PER QUADRANT 150 0 0
MANUAL SUPRAGINGIVAL SCALING PER TOOTH-

1507 PERIODONTICS DENTAL 866 ANTERIOR 110 200 0
1508 PERIODONTICS DENTAL 867 MANUAL SUPRAGINGIVAL SCALING PER TOOTH- 180 300 0
POSTERIOR
1509 PERIODONTICS DENTAL 1112 MINOR SURGICAL PROCEDURE 600 1000 0
1510 PERIODONTICS DENTAL 5617 NATURAL TOOTH PONTIC WITH RIBBOND FIBER 2500 5000 0
63
1511 PERIODONTICS DENTAL 151 OPERCULECTOMY 600 1000 0
1512 PERIODONTICS DENTAL 5324 PLACEMENT OF ADIN IMPLANT ABUTMENT 11000 20000 0
1513 PERIODONTICS DENTAL 5325 PLACEMENT OF XIVE IMPLANT ABUTMENT 16500 30000 0
1514 PERIODONTICS DENTAL 5610 PRF PROCEDURE 300 500 0
1515 PERIODONTICS DENTAL 2161 PROPHYJET POLISHING (GEN. STAIN) 600 1000 0
1516 PERIODONTICS DENTAL 2162 PROPHYJET POLISHING (PER SEXTENT) 300 500 0
1517 PERIODONTICS DENTAL 1694 RADISECTION/HEMISECTION WITHOUT RCT 1200 2000 0
1518 PERIODONTICS DENTAL 5613 REPAIR SPLINTING 500 800 0
1519 PERIODONTICS DENTAL 872 RESECTIVE OSSEOUS SURGERY PER SEXTANT 1500 2500 0
1520 PERIODONTICS DENTAL 1098 RIBBOND FIBRE SPLINTING PER SEXTANT 2600 5000 0
1521 PERIODONTICS DENTAL 1120 RIDGE AUGMENTATION WITH GRAFT (LOCAL) PER AREA 2000 4000 0
1522 PERIODONTICS DENTAL 5330 ROOT RESECTION / HEMISECTION WITH RCT 2000 4000 0
1523 PERIODONTICS DENTAL 5611 RVG IMAGING PER PROCEDURE 280 500 0
1524 PERIODONTICS DENTAL 1667 SCALING IN GENERALISED STAINING 900 1800 0
1525 PERIODONTICS DENTAL 869 SCALING, ROOT PLANING & GINGIVAL CURETTAGE PER 300 500 0
TOOTH
1526 PERIODONTICS DENTAL 5609 SOCKET PRESERVATION 500 800 0
1527 PERIODONTICS DENTAL 5614 SPLINTING REMOVAL 500 800 0
1528 PERIODONTICS DENTAL 1096 SPLINTING WITH WIRE 600 1000 0
1529 PERIODONTICS DENTAL 1097 SPLINTING WITH WIRE AND COMPOSITE 1800 3000 0
1530 PERIODONTICS DENTAL 5612 SUBGINGIVAL IRRIGATION PER TOOTH 100 200 0
1531 PERIODONTICS DENTAL 1535 SUPPORTIVE PERIODONTAL THERAPY 500 1000 0
1532 PERIODONTICS DENTAL 1109 SURGICAL

TOOTH
EXPOSURE OF ECTOPICALLY ERUPTING 1000 2000 0
1533 PERIODONTICS DENTAL 1117 SUTURES REMOVAL 100 150 250
1534 PERIODONTICS DENTAL 5615 TEMPORARY PROSTHESIS FOR IMPLANT 500 800 0
64
1535 PERIODONTICS DENTAL 6013 ULTRASONIC DEBRIDEMENT OF WOUND 500 1000 500
1536 PERIODONTICS DENTAL 860 ULTRASONIC SUBGINGIVAL SCALING PER QUADRANT 300 500 0
ULTRASONIC SUPRA & SUBGINGIVAL SCALING PER

1537 PERIODONTICS DENTAL 862 QUADRANT 350 600 0
1538 PERIODONTICS DENTAL 858 ULTRASONIC SUPRAGINGIVAL SCALING PER QUADRANT 250 400 0
1539 PHARMACOLOGY & 1982 CARBMAZEPINE 2090 0 0

THERAPEUTICS
PHARMACOLOGY &
1540 THERAPEUTICS 1983 LAMOTRIGINE 2090 0 3000
PHARMACOLOGY &
1541 THERAPEUTICS 1984 PHENYTOIN 2090 0 3000
1542 PHARMACY CHARGES 6466 PHARMACY CHARGES 6200 6200 0
1543 PHYSIOLOGY 635 AFT 1300 1850 2000
1544 PHYSIOLOGY 131 EEG 1800 2500 1080
1545 PHYSIOLOGY 637 EMG 2000 2600 2000
1546 PHYSIOLOGY 1067 NCV FOR ALL FOUR LIMBS 1400 2000 2000
1547 PHYSIOLOGY 1066 NCV OF ANY TWO LIMBS 1000 1400 1000
1548 PHYSIOLOGY 133 PFT 700 820 700
1549 PHYSIOLOGY 132 PFT BY SPIROMETER 700 820 700
1550 PHYSIOLOGY 638 VEP (EVOKED POTENTIAL VISUAL) 1000 1500 1000
1551 PHYSIOLOGY 639 VER 700 1010 700
1552 PHYSIOTHERAPY 731 CERVICAL & LUMBAR TRACTION (1 DAY) 75 110 100
1553 PHYSIOTHERAPY 4824 COLD LASER 160 240 200
1554 PHYSIOTHERAPY 123 CONTINUOUS PASSIVE MOTION/DAY 60 90 100
1555 PHYSIOTHERAPY 4832 CPM UPPER EXTREMITY 145 215 200
1556 PHYSIOTHERAPY 4820 DIADYNAMIC 135 200 200
1557 PHYSIOTHERAPY 4818 DIPOLE VECTOR IFT 145 215 200
1558 PHYSIOTHERAPY 4827 ESWT MSK 1210 1815 2000
65
1559 PHYSIOTHERAPY 760 EXERCISE/DAY 35 52 100
1560 PHYSIOTHERAPY 4825 HIGH ENERGY LASER 185 270 200
1561 PHYSIOTHERAPY 736 HIP SPICA 750 1500 2550
1562 PHYSIOTHERAPY 747 HOT PACKS/DAY 50 75 100
1563 PHYSIOTHERAPY 753 INFRA RAY/DAY 40 60 100
1564 PHYSIOTHERAPY 518 INTERFERENTIAL THERAPY/DAY 85 125 100
1565 PHYSIOTHERAPY 4817 ISOPLANAR IFT 145 215 200
1566 PHYSIOTHERAPY 4822 KOTZ 135 200 200
1567 PHYSIOTHERAPY 755 LASER THERAPY/DAY 95 140 100
1568 PHYSIOTHERAPY 4831 LEG PRESS 125 185 200
1569 PHYSIOTHERAPY 4826 MAGNETO THERAPY ( FMF) 245 365 300
1570 PHYSIOTHERAPY 122 MAKING WINDOW OR WEDGE IN PLASTER CAST 100 200 100
1571 PHYSIOTHERAPY 154 MICROWAVE DIATHERMY/DAY 85 125 100
1572 PHYSIOTHERAPY 1060 MOBILIZATION LOCALIZED 50 75 100
1573 PHYSIOTHERAPY 1061 MOBILIZATION WHOLE BODY 85 125 100
1574 PHYSIOTHERAPY 645 MUSCLE STIMULATION PER DAY 85 125 100
1575 PHYSIOTHERAPY 1063 PHONOPHORESIS (ULTRA SOUND WITH MEDICATION) 100 150 100
1576 PHYSIOTHERAPY 4830 PRE LOWER EXTREMITY 125 185 200
1577 PHYSIOTHERAPY 4828 PRE UPPER EXTREMITY 125 185 200
PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION

1578 PHYSIOTHERAPY 1062 (PNF) 75 110 100
1579 PHYSIOTHERAPY 4823 RUSSIAN STIMULATION 145 215 200
1580 PHYSIOTHERAPY 516 SHORT WAVE DIATHERAPY (10 DAYS) 730 1095 800
1581 PHYSIOTHERAPY 749 SHORT WAVE DIATHERMY (1 DAY) 100 150 100
1582 PHYSIOTHERAPY 4819 TENS (RANDOM/ ENDORPHIN) 145 215 200
66
1583 PHYSIOTHERAPY 756 TENS/DAY 85 125 100
1584 PHYSIOTHERAPY 4821 ULTRA REIZ 135 200 200
1585 PHYSIOTHERAPY 744 ULTRASOUND 1 DAY (THERAPEUTIC ULTRASOUND) 85 125 100
1586 PHYSIOTHERAPY 759 VACATRON/DAY 70 105 100
1587 PHYSIOTHERAPY 748 WAX BATH/DAY 50 75 100
1588 PROSTHESIS 5468 ABOVE ELBOW PROSTHESIS COSMETIC 24200 36300 0
1589 PROSTHESIS 5469 ABOVE ELBOW PROSTHESIS FUNCTIONAL 30250 45375 0
1590 PROSTHESIS 5461 ABOVE KNEE PROSTHESIS CONVENTIONAL 30250 45375 35000
1591 PROSTHESIS 5584 AK CHILD MODULAR PROSTHESIS 132000 198000 0
1592 PROSTHESIS 5592 AK FAIRING 7150 10725 0
1593 PROSTHESIS 5588 AK SOCKET ADAPTER 13750 20625 0
1594 PROSTHESIS 5577 AK SOCKET LAMINATED 16225 24335 0
1595 PROSTHESIS 5580 AK SOCKET PP MOULDED 13145 19715 0
1596 PROSTHESIS 5472 AK SUSPENSION BELT 7865 11795 8000
1597 PROSTHESIS 5591 AK/BK COSMETIC SOCKS 825 1235 0
1598 PROSTHESIS 5466 BELOW ELBOW PROSTHESIS COSMETIC 14850 22275 0
1599 PROSTHESIS 5467 BELOW ELBOW PROSTHESIS FUNCTIONAL 20350 30525 0
1600 PROSTHESIS 5457 BELOW KNEE PROSTHESIS WITH LAMINATED SOCKET 38500 57750 0
1601 PROSTHESIS 5456 BELOW KNEE PROSTHESIS WITH P.P SOCKET 35200 52800 0
1602 PROSTHESIS 5594 BK COSMETIC COVER 1650 2475 0
1603 PROSTHESIS 5593 BK FAIRING 6490 9735 0
1604 PROSTHESIS 5589 BK SOCKET ADAPTER 10450 15675 0
1605 PROSTHESIS 5578 BK SOCKET LAMINATED 10835 16250 0
1606 PROSTHESIS 5581 BK SOCKET PP MOULDED 8690 13035 0
67
1607 PROSTHESIS 5585 BK SUSPENSION BELT/SLEEVE 6380 9570 0
1608 PROSTHESIS 5587 CONVENTIONAL BELOW KNEE PROSTHESIS 18150 27225 0
1609 PROSTHESIS 5453 CUSTOM MADE PARTIAL FOOT PROSTHESIS 7865 11795 0
1610 PROSTHESIS 1979 DISCHARGE FILE 50 95 100
1611 PROSTHESIS 5590 DOUBLE ENDED ADAPTER 9350 14025 0
1612 PROSTHESIS 5604 HKAFO MOULDED 30250 45375 0
1613 PROSTHESIS 5455 LAMINATED SYMES PROSTHESIS 20900 31350 0
1614 PROSTHESIS 5602 LEATHER KNEE CAP FOR KAFO 605 905 0
1615 PROSTHESIS 5463 MODULAR ABOVE KNEE PROSTHESIS WITH LAMINATED 96800 145200 99000
SOCKET WITH SACH FOOT
MODULAR ABOVE KNEE PROSTHESIS WITH P.P SOCKET

1616 PROSTHESIS 5462 WITH SACH FOOT 90750 136125 99000
1617 PROSTHESIS 5603 MODULAR EXTENSION PROSTHESIS 52800 79200 0
1618 PROSTHESIS 5464 MODULAR

SACH FOOT
HIP DISARTICULATION PROSTHESIS WITH 132000 198000 0
1619 PROSTHESIS 5470 MODULAR ORTHO PROSTHESIS 50600 75900 0
MODULAR THROUGH KNEE PROSTHESIS WITH

1620 PROSTHESIS 5460 LAMINATED SOCKET WITH SACH FOOT 80850 121275 0
1621 PROSTHESIS 5459 MODULAR THROUGH KNEE PROSTHESIS WITH P.P 78650 117975 0
SOCKET SACH FOOT
1622 PROSTHESIS 5454 MOLDED SYMES PROSTHESIS 19360 29040 0
1623 PROSTHESIS 5586 MOLDED TAYLORS BRACE 7260 10890 8000
1624 PROSTHESIS 5595 POLYCENTRIC KNEE JOINT (ORTHOSIS) 3850 5775 0
1625 PROSTHESIS 5583 PU /RANGER/SACH FOOT 6050 9075 0
1626 PROSTHESIS 5598 SHOE RAISE PER INCH 715 1070 0
1627 PROSTHESIS 5465 SILICON HAND PROSTHESIS (WRIST DISARTICULATION) 19250 28875 0
1628 PROSTHESIS 5600 STOCKINETT PER MTR. (60MM/80MM) 165 245 0
1629 PROSTHESIS 5599 STUMP SOCKS (BK) 495 740 0
1630 PROSTHESIS 5601 SUSPENSION BELT (LEATHER)AK/BL PROSTHESIS 495 740 0
68
1631 PROSTHESIS 5596 TES BELT 10450 15675 12000
1632 PROSTHESIS 5458 THROUGH KNEE PROSTHESIS CONVENTIONAL 22000 33000 0
1633 PROSTHESIS 5597 TK FAIRING 7150 10725 0
1634 PROSTHESIS 5579 TK SOCKED LAMINATED 16280 24420 0
1635 PROSTHESIS 5582 TK SOCKET PP MOULDED 11500 17250 0
1636 PROSTHESIS 5471 TRIAL/ GAIT TRAINING / FINAL FINISHING 6050 9075 0
1637 PROSTHODONTICS DENTAL 149 ACRYLIC RPD PER ARCH UPTO 5 TOOTH 580 1060 0
1638 PROSTHODONTICS DENTAL 6105 ACRYLIC SCREW 690 0 0
1639 PROSTHODONTICS DENTAL 5351 ADHESIVE/ SOLVENT 2180 3960 0
1640 PROSTHODONTICS DENTAL 569 AESTHETIC POST & CORE 2180 4000 0
1641 PROSTHODONTICS DENTAL 148 ALGINATE IMPRESSION / ARCH 320 580 0
1642 PROSTHODONTICS DENTAL 594 ALL CERAMIC CROWN / PER UNIT/LAB CHARGE EXTRA 5080 9240 0
ANY OTHER PROTHESIS APART FROM ABOVE

1643 PROSTHODONTICS DENTAL 1091 730 1320 0
MENTIONED
1644 PROSTHODONTICS DENTAL 2108 CAD-CAM ZIRCONIA CROWN (ANTERIOR TEETH) 14520 26400 0
1645 PROSTHODONTICS DENTAL 2109 CAD-CAM ZIRCONIA CROWN (POSTERIOR TEETH) 17420 31680 0
1646 PROSTHODONTICS DENTAL 5336 CAST DENTURE BASE ( CHROME- COBALT) 8710 15840 0
CAST PARTIAL DENTURE BASE (CHOME-COBALT /

1647 PROSTHODONTICS DENTAL 2114 VITALLIUM) 8710 15840 0
1648 PROSTHODONTICS DENTAL 557 COMPLETE DENTURE 2900 13200 0
1649 PROSTHODONTICS DENTAL 6102 COMPOSIT RESTORATION (ANTERIOR) 1520 0 0
1650 PROSTHODONTICS DENTAL 473 COMPOSITE LAMINATES PER TOOTH 650 1190 0
1651 PROSTHODONTICS DENTAL 6103 COMPSIT RESTORATION POSTERIOR 1820 0 0
1652 PROSTHODONTICS DENTAL 6104 COMPSIT VENEER 1820 0 0
1653 PROSTHODONTICS DENTAL 578 CUSTOM FABRICATED / CAST POST & CORE 1160 2110 0
1654 PROSTHODONTICS DENTAL 1089 DEFINITIVE OBTURATOR PROSTHESES ACRYLIC 670 1190 0
69
1655 PROSTHODONTICS DENTAL 1090 DEFINITIVE OBTURATOR PROSTHESES METAL 5080 9320 0
DEFINITIVE OBTURATOR PROSTHESIS CUM PARTIAL

1656 PROSTHODONTICS DENTAL 5348 DENTURE PER ARCH 1160 2110 0
1657 PROSTHODONTICS DENTAL 2110 E-MAX ALL CERAMIC CROWN (ANTERIOR TEETH) 5810 10560 0
1658 PROSTHODONTICS DENTAL 2111 E-MAX ALL CERAMIC CROWN (POSTERIOR TEETH) 7260 13200 0
1659 PROSTHODONTICS DENTAL 646 EYE PROSTHESIS EXTRA OCULAR FACIAL 2900 5280 0
1660 PROSTHODONTICS DENTAL 644 EYE PROSTHESIS INTRA OCULAR 2180 3960 0
1661 PROSTHODONTICS DENTAL 1087 FAULTY BRIDGE REMOVAL 440 790 0
1662 PROSTHODONTICS DENTAL 596 FEEDING APPLIANCE ACRYLIC 510 920 0
1663 PROSTHODONTICS DENTAL 597 FEEDING APPLIANCE METAL 2180 3960 0
1664 PROSTHODONTICS DENTAL 595 FULL METAL CROWN / PER UNIT/ LAB CHARGE EXTRA 1450 2640 0
1665 PROSTHODONTICS DENTAL 2113 FULL METAL RESTORATIONS 1450 2640 0
1666 PROSTHODONTICS DENTAL 1083 FULL MOUTH REHABILITATION INCLUSIVE OF LAB

CHARGES 108900 198000 0
1667 PROSTHODONTICS DENTAL 636 FULL MOUTH REHABILITATION/ LAB CHARGES EXTRA 65340 118800 0
1668 PROSTHODONTICS DENTAL 658 IMMEDIATE DENTURE/COMPLETE U/L 5810 10560 0
1669 PROSTHODONTICS DENTAL 4847 IMPLANT PLACEMENT SURGERY (INCLUDING DENTAL 36300 66000 0
IMPLANT)
IMPLANT PLACEMENT SURGERY (INCLUDING XIVE

1670 PROSTHODONTICS DENTAL 5344 IMPLANT) PER IMPLANT 58080 105600 0
1671 PROSTHODONTICS DENTAL 655 IMPLANT SUPPORTED BRIDGE 36300 66000 0
1672 PROSTHODONTICS DENTAL 6101 IMPLANT SURGERY DENTAL 7590 0 0
1673 PROSTHODONTICS DENTAL 653 IMPLANTS SUPPORTED DENTURE MANDIBULAR 43560 79200 0
1674 PROSTHODONTICS DENTAL 656 IMPLNAT SUPPORTED CROWN/ANTERIOR 29040 52800 0
1675 PROSTHODONTICS DENTAL 1082 LAB CHARGE EXTRA 1450 2640 0
1676 PROSTHODONTICS DENTAL 599 MANDIBULAR GUIDANCE APPLIANCE ACRYLIC 730 1320 0
1677 PROSTHODONTICS DENTAL 5341 MARYLAND FIXED PARTIAL DENTURE (FPD) 2900 5280 0
MAXILLOFACIAL PROSTHESIS (COLD CURE) /

1678 PROSTHODONTICS DENTAL 463 OBTURATION SURGICAL 370 660 0
70
1679 PROSTHODONTICS DENTAL 465 MAXILLOFACIAL PROSTHESIS (HEAT CURE) / SURGICAL 1020 1850 0
OBTURATION
MAXILLOFACIAL PROSTHESIS (NOSE/ EAR/ ORBITAL/

1680 PROSTHODONTICS DENTAL 5350 OTHERS, RTV SILICONE) 14520 26400 0
MULTI UNIT PFM BRIDGE PER UNIT CHARGE /

1681 PROSTHODONTICS DENTAL 1488 INCLUSIVE CEMENTATION LAB CHARGES EXTRA 1450 2640 0
1682 PROSTHODONTICS DENTAL 652 NOSE/EAR PROSTHESIS 3630 6600 0
1683 PROSTHODONTICS DENTAL 1085 OCCLUSAL SPLINT / HEAT CURE RESIN/ VACCUM 880 1580 0
PRESSED
1684 PROSTHODONTICS DENTAL 1084 OCCLUSAL SPLINT / SELF CURE RESIN 730 1320 0
1685 PROSTHODONTICS DENTAL 657 OVER DENTURE PROSTHESIS 5810 10560 0
1686 PROSTHODONTICS DENTAL 598 PALATAL LIFT PROSTHESIS 730 1320 0
1687 PROSTHODONTICS DENTAL 5340 PARTIAL VENEER PORCELAIN FUSED TO METAL (PFM) 1450 2640 0
RESTORATION PER UNIT
1688 PROSTHODONTICS DENTAL 146 POLYCARBONATE CROWN 510 920 0
1689 PROSTHODONTICS DENTAL 593 PORCELAIN FUSED TO METAL CROWN / PER UNIT 2900 5330 0
1690 PROSTHODONTICS DENTAL 2112 PORCELAIN FUSED TO METAL RESTORATIONS 2180 3960 0
1691 PROSTHODONTICS DENTAL 474 PORCELAIN LAMINATES PER TOOTH 2620 4750 0
1692 PROSTHODONTICS DENTAL 533 POST (PREFABTRICATED) CORE COMPOSITE 730 1320 0
1693 PROSTHODONTICS DENTAL 145 POST AND CORE COMPOSITE 730 1320 0
1694 PROSTHODONTICS DENTAL 467 PROVISIONAL RECEMENT 220 400 0
1695 PROSTHODONTICS DENTAL 1086 RE- CEMENTATION 370 660 0
1696 PROSTHODONTICS DENTAL 139 REBASING OF DENTURE PER ARCH 730 1320 0
1697 PROSTHODONTICS DENTAL 147 RECEMENTATION WITH GIC PER UNIT 310 560 0
1698 PROSTHODONTICS DENTAL 138 RELINING BY CHAIR SIDE RELINER (SELF CURE) 370 660 0
1699 PROSTHODONTICS DENTAL 137 RELINING BY HEAT CURE PER ARCH 510 920 0
1700 PROSTHODONTICS DENTAL 141 REPAIR OF DENTURE 370 660 0
1701 PROSTHODONTICS DENTAL 6075 ROOT PLANNING 150 280 0
1702 PROSTHODONTICS DENTAL 5338 RPD ( SELF CURED DENTURE BASE RESIN) 370 660 0
71
1703 PROSTHODONTICS DENTAL 559 RPD EVERY ADDITIONAL TOOTH 70 130 0
1704 PROSTHODONTICS DENTAL 5339 RPD RELINE 290 530 0
1705 PROSTHODONTICS DENTAL 471 RPD REPAIR & ADDITIONAL TOOTH 290 530 0
1706 PROSTHODONTICS DENTAL 5337 RUBBER BASED IMPRESSION PER ARCH 730 1320 0
1707 PROSTHODONTICS DENTAL 136 SINGLE COMPLETE DENTURE 1450 6600 0
1708 PROSTHODONTICS DENTAL 140 SOFT RELINER PER ARCH 510 920 0
1709 PROSTHODONTICS DENTAL 469 STANLESS STEEL CROWN 1090 1980 0
1710 PROSTHODONTICS DENTAL 5345 SUPRASTRUCTURE FOR IMPLANT SUPPORTED

OVERDENTURE PER ARCH 7800 13200 0
1711 PROSTHODONTICS DENTAL 600 SURGICAL TEMPLATE COLD CURE 370 660 0
TEMPORARY CROWN (COLD CURE) _x000D_

1712 PROSTHODONTICS DENTAL 459 ADDITIONAL TOOTH 70 130 0
1713 PROSTHODONTICS DENTAL 461 TEMPORARY CROWN (HEAT CURE) 650 1190 0
1714 PROSTHODONTICS DENTAL 458 TOOTH PREPARATION & TEMPORARY CROWN 1450 2640 0
CEMENTATION (PER UNIT)
1715 PROSTHODONTICS DENTAL 5349 TRISMUS SCREW ( SELF CURED RESIN) 730 1320 0
1716 PROSTHODONTICS DENTAL 4845 VACUUM PROCESSED OCCLUSAL SPLINT 1750 3170 0
1717 PSYCHIATRY 1070 16 - PF TEST 440 600 500
1718 PSYCHIATRY 397 BENDER-GESTALT TEST 330 500 400
1719 PSYCHIATRY 1072 BREATHING EXERCISE (PER SESSION) 330 500 400
1720 PSYCHIATRY 1075 COUNSELLING (PER SESSION) 330 500 400
1721 PSYCHIATRY 2150 DEVELOPMENT SCREENING TEST FOR CHILDREN 280 500 300
1722 PSYCHIATRY 1074 ERP (PER SESSION) 330 500 400
1723 PSYCHIATRY 400 IPDE (F 6 MODULE) 440 600 500
1724 PSYCHIATRY 2028 IPT (INTER PERSONAL THERAPY) 330 500 400
1725 PSYCHIATRY 660 MODIFIED ECT PER CYCLE 440 750 500
1726 PSYCHIATRY 416 PEN (EYSENCK) 440 600 500
72
1727 PSYCHIATRY 420 PTI 440 600 500
1728 PSYCHIATRY 1071 RELAXATION TRAINING (PER SESSION) 330 500 400
1729 PSYCHIATRY 398 RORSCHACH'S TEST 550 700 600
1730 PSYCHIATRY 424 SEGUIN FORM BOARD FOR CHILDREN 170 300 200
1731 PSYCHIATRY 423 SPM / CPM (RAVEN'S) 330 500 400
1732 PSYCHIATRY 1073 SYSTEMATIC DESENSEZATION 330 500 400
1733 PSYCHIATRY 399 TAT / CAT 440 600 500
1734 PSYCHIATRY 425 VINELAND SM SCALE 280 500 300
1735 PSYCHIATRY 422 WAIS / WAPIS 390 600 400
PULMONARY,CRITICAL CARE &

1736 SLEEP MEDICINE 6092 BRONCHOSCOPY WITH BIOPSY/TBNA/TBLB 3450 6000 4000

1737 SLEEP MEDICINE 6091 DIAGNOSTIC BRONCHOSCOPY 2300 4600 2000
1738 PULMONARY,CRITICAL
SLEEP MEDICINE
CARE & 6093 EBUS 25000 35000 25000

1739 6094 INTERVENTIONAL BRONCHOSCOPY 15000 25000 16000
SLEEP MEDICINE

1740 SLEEP MEDICINE 6098 LUNG ULTRASOUND 600 1200 600
1741 PULMONARY,CRITICAL CARE & 6095 PFT 700 1400 700

SLEEP MEDICINE

1742 SLEEP MEDICINE 6097 SLEEP STUDY TYPE 1 5750 10000 6000

1743 SLEEP MEDICINE 6096 SLEEP STUDY TYPE 3 4000 7000 4000
1744 PULMONARY,CRITICAL
SLEEP MEDICINE
CARE & 6099 USG GUIDED BIOPSY 1730 3450 2000
1745 RADIOLOGY 5903 ABDOMINAL CT AORTOGRAPHY 9500 12000 10000
1746 RADIOLOGY 5905 ABDOMINAL CT VENOGRAPHY 9500 12000 10000
1747 RADIOLOGY 5808 BA ENEMA (14X17) 2 FILMS 2150 2700 3000
1748 RADIOLOGY 5807 BA FOLLOW THROUGH (14X17) 2 FILMS 2150 2700 3000
1749 RADIOLOGY 5806 BA MEAL (14X17) 2 FILMS 2150 2700 3000
1750 RADIOLOGY 5805 BA SWALLOW (14X17) 1 FILM 2150 2700 3000
73
1751 RADIOLOGY 5826 BREAST DUCTOGRAPHY (BOTH BREAST) 3500 4500 4000
1752 RADIOLOGY 5825 BREAST DUCTOGRAPHY (SINGLE BREAST) 2150 2700 3000
1753 RADIOLOGY 5898 CAROTID CT ANGIOGRAPHY 9500 12000 10500
1754 RADIOLOGY 5846 COLOR DOPPLER ARTERIAL (BOTH LIMB) 3000 4000 3500
1755 RADIOLOGY 5845 COLOR DOPPLER ARTERIAL (ONE LIMB) 1800 2600 2000
1756 RADIOLOGY 5850 COLOR DOPPLER ARTERIAL + VENOUS (BOTH LIMB) 4500 5500 5000
1757 RADIOLOGY 5849 COLOR DOPPLER ARTERIAL + VENOUS (ONE LIMB) 3000 4000 3000
1758 RADIOLOGY 5851 COLOR DOPPLER CAROTIDS 1500 2200 1500
1759 RADIOLOGY 5852 COLOR DOPPLER RENAL 1500 2200 3500
1760 RADIOLOGY 5848 COLOR DOPPLER VENOUS (BOTH LIMB) 3000 4000 3000
1761 RADIOLOGY 5847 COLOR DOPPLER VENOUS (ONE LIMB) 1800 2600 1800
1762 RADIOLOGY 5853 COLOUR DOPPLER (OTHERS) 1500 2200 950
1763 RADIOLOGY 5880 CT ABDOMEN 7200 9200 5000
1764 RADIOLOGY 5899 CT ANGIOGRAPHY (CEREBRAL + CAROTID) 14500 18000 16000
1765 RADIOLOGY 5904 CT ANGIOGRAPHY (THORACO-ABDOMINAL AORTA) 14500 18000 16000
1766 RADIOLOGY 5916 CT BONE MINERAL STUDY 7200 9200 8000
1767 RADIOLOGY 5888 CT CERVICAL SPINE 5500 7000 7000
1768 RADIOLOGY 5920 CT DENTAL SCAN 6000 7500 6000
1769 RADIOLOGY 5873 CT FACE (ORBIT+PNS+MAXILLA+MANDIBLE) 6500 8000 7000
1770 RADIOLOGY 5893 CT GUIDED INTERVENTION 4500 6000 4500
1771 RADIOLOGY 5861 CT HEAD 3600 4500 3500
1772 RADIOLOGY 5875 CT HEAD + NECK 7000 8500 7000
1773 RADIOLOGY 5867 CT HEAD + ORBIT 5500 7000 7000
1774 RADIOLOGY 5865 CT HEAD + PNS 5500 7000 7000
74
1775 RADIOLOGY 5869 CT HEAD + TEMPORAL BONE 6000 7500 7000
1776 RADIOLOGY 5870 CT JAWS (MAXILLA / MANDIBLE) 4500 6000 4500
1777 RADIOLOGY 5871 CT JAWS/ORAL CAVITY + NECK 6500 8000 7000
1778 RADIOLOGY 5890 CT L-S SPINE 5500 7000 6000
1779 RADIOLOGY 5874 CT NECK 5500 7000 4500
1780 RADIOLOGY 5877 CT NECK + THORAX 9000 11000 9000
1781 RADIOLOGY 5863 CT ORBIT 4000 5000 7000
1782 RADIOLOGY 5866 CT ORBIT + PNS 5500 7000 7000
1783 RADIOLOGY 5883 CT PELVIS + HIP JOINTS 5500 7000 6000
1784 RADIOLOGY 5864 CT PNS 4000 5000 7000
1785 RADIOLOGY 5876 CT PNS + NECK 7000 8500 7000
1786 RADIOLOGY 5906 CT RENAL ARTERIOGRAPHY 9500 12000 10000
1787 RADIOLOGY 5907 CT SPLENOPORTOGRAPHY 9500 12000 10000
1788 RADIOLOGY 5868 CT TEMPORAL BONE 4500 5500 7000
1789 RADIOLOGY 5872 CT TEMPORO-MANDIBULAR JOINT (TMJ) 4000 5000 7000
1790 RADIOLOGY 5889 CT THORACIC SPINE 5500 7000 6000
1791 RADIOLOGY 5879 CT THORAX (NCCT + CECT) 5500 7000 4500
1792 RADIOLOGY 5878 CT THORAX (NCCT) /HRCT CHEST 4500 5500 4500
1793 RADIOLOGY 5881 CT THORAX + ABDOMEN 11000 13000 12000
1794 RADIOLOGY 5919 CT UROGRAPHY (CTU) 7500 9500 7000
1795 RADIOLOGY 5917 CT VIRTUAL BRONCHOSCOPY 7200 9200 8000
1796 RADIOLOGY 5918 CT VIRTUAL COLONOSCOPY 10000 12500 10000
1797 RADIOLOGY 5892 CT WHOLE SPINE 12000 14500 12000
CT: ANY ONE JOINT (SHOULDER OR ELBOW OR WRIST

1798 RADIOLOGY 5885 OR KNEE OR ANKLE) - BILATERAL 6500 8000 7000
75
1799 RADIOLOGY 5884 CT: ANY ONE JOINT (SHOULDER OR ELBOW OR WRIST 5500 7000 6000
OR KNEE OR ANKLE) - UNILATERAL
CT: ANY ONE REGION OF EXTREMITY (ARM OR
1800 RADIOLOGY 5887 FOREARM OR HAND OR THIGH OR LEG OR FOOT) - 6500 8000 7000
BILATERAL
CT: ANY ONE REGION OF EXTREMITY (ARM OR
1801 RADIOLOGY 5886 FOREARM OR HAND OR THIGH OR LEG OR FOOT) - 5500 7000 5500
UNILATERAL
1802 RADIOLOGY 5891 CT: COMBINED TWO SPINAL REGIONS 8500 10000 9000
1803 RADIOLOGY 5813 CYSTOGRAM (14X17) 1 FILM 1800 2350 2000
1804 RADIOLOGY 5810 DISTAL COLONOGRAM (14X17) 2 FILMS 2150 2700 3000
1805 RADIOLOGY 5801 DOUBLE EXPOSURE 10X12 (1 FILM) 430 450 450
1806 RADIOLOGY 5802 DOUBLE EXPOSURE 10X12 (2 FILMS) 480 510 500
1807 RADIOLOGY 5817 FISTULOGRAM / SINOGRAM (14X17) 1 FILM 2000 2600 1170
1808 RADIOLOGY 5809 GASTROGRAPHY (14X17) 1 FILM 2000 2600 2000
1809 RADIOLOGY 5822 HSG (14X17) 2 FILMS 2300 3000 3500
1810 RADIOLOGY 5895 INTRACRANIAL CT ARTERIOGRAPHY 9500 12000 10000
1811 RADIOLOGY 5897 INTRACRANIAL CT ARTERIO-VENOGRAPHY 12000 15500 12000
1812 RADIOLOGY 5894 INTRACRANIAL CT PERFUSION STUDY 7500 9000 8000
1813 RADIOLOGY 5896 INTRACRANIAL CT VENOGRAPHY 9500 12000 10000
1814 RADIOLOGY 5811 IVU (14X17) 2 FILMS 2150 2700 3000
1815 RADIOLOGY 5913 LOWER LIMB CT ARTERIOGRAPHY (BILATERAL) 12000 15500 12000
1816 RADIOLOGY 5912 LOWER LIMB CT ARTERIOGRAPHY (UNILATERAL) 9500 12000 10000
1817 RADIOLOGY 5915 LOWER LIMB CT VENOGRAPHY (BILATERAL) 12000 15500 12000
1818 RADIOLOGY 5914 LOWER LIMB CT VENOGRAPHY (UNILATERAL) 9500 12000 10000
1819 RADIOLOGY 5824 MAMMOGRAPHY (BOTH BREAST) 2400 3250 3000
1820 RADIOLOGY 5823 MAMMOGRAPHY (SINGLE BREAST) 1450 1900 875
1821 RADIOLOGY 5815 MICTURATING CYSTOURETHROGRAM (MCU) - (14X17) 2 2150 2700 2500
FILMS
1822 RADIOLOGY 5804 MULTIPLE EXPSURE 14X17 (1 FILM) 550 560 650
76
1823 RADIOLOGY 5819 MYELOGRAM (14X17) 2 FILMS 2150 2700 2000
1824 RADIOLOGY 5882 NCCT KUB/ NCCT ABDOMEN ONLY 5000 6500 5000
1825 RADIOLOGY 5812 NEPHROSTOGRAM (14X17) 1 FILM 1800 2350 2000
1826 RADIOLOGY 5832 OBSTETRIC DOPPLER STUDY 1800 2600 2000
1827 RADIOLOGY 5901 PULMONARY CT ARTERIOGRAPHY 9500 12000 10000
1828 RADIOLOGY 5862 REPEAT CT HEAD (WITHIN 3 WEEKS) 2400 3300 3500
1829 RADIOLOGY 5814 RETROGRADE URETHROGRAM (RGU) - (14X17) 2 FILMS 2150 2700 2500
1830 RADIOLOGY 5816 RGU + MCU 3500 4500 4000
1831 RADIOLOGY 5821 SIALOGRAM (14X17) 1 FILM 1800 2350 2000
1832 RADIOLOGY 5800 SINGLE EXPOSURE 10X12 (1 FILM) 360 390 400
1833 RADIOLOGY 5855 TARGETTED USG FOR FLUID COLLECTION ONLY 350 550 400
1834 RADIOLOGY 5833 TARGETTED

ONLY
USG FOR PLACENTAL LOCALIZATION/AFI 300 500 300
1835 RADIOLOGY 5902 THORACIC CT AORTOGRAPHY 9500 12000 10000
1836 RADIOLOGY 5803 TRIPLE EXPOSURE 10X12 (2 FILMS) 490 510 550
1837 RADIOLOGY 5818 T-TUBE CHOLANGIOGRAM (14X17) 1 FILM 1800 2350 1250
1838 RADIOLOGY 5837 ULTRASOUND (ABDOMEN + SCROTUM) 1450 2100 2000
1839 RADIOLOGY 5827 ULTRASOUND (ABDOMEN) 800 1150 600
1840 RADIOLOGY 5835 ULTRASOUND (BOTH BREAST) 800 1150 1000
1841 RADIOLOGY 5829 ULTRASOUND (KUB) 800 1150 800
ULTRASOUND (MATERNAL ABDOMEN + OBSTETRIC

1842 RADIOLOGY 5831 SCAN) 1450 2100 2000
1843 RADIOLOGY 5844 ULTRASOUND (NECK) 800 1150 600
1844 RADIOLOGY 5830 ULTRASOUND (OBSTETRIC SCAN) 800 1150 1000
1845 RADIOLOGY 5828 ULTRASOUND (PELVIS ONLY) 700 1050 600
1846 RADIOLOGY 5836 ULTRASOUND (SCROTUM) 700 1050 1000
77
1847 RADIOLOGY 5834 ULTRASOUND (SINGLE BREAST) 700 1050 600
1848 RADIOLOGY 5843 ULTRASOUND (SONOHYSTEROGRAPHY) 2300 3000 3000
ULTRASOUND (TARGETTED USG FOR SINGLE FOCAL

1849 RADIOLOGY 5841 LESION) 800 1150 1000
1850 RADIOLOGY 5838 ULTRASOUND (THORAX) 800 1150 600
1851 RADIOLOGY 5842 ULTRASOUND (TVS/TRUS) 1000 1500 1000
ULTRASOUND (USG-7): USG EVALUATION/SCREENING

1852 RADIOLOGY 5840 FOR RHEUMATOID ARTHRITIS. 1700 2500 2000
ULTRASOUND MSK: ONE LOCATION

1853 RADIOLOGY 5839 (JOINT/TENDON/PERIPHERAL NERVE ETC) 1600 2400 2000
1854 RADIOLOGY 5909 UPPER LIMB CT ARTERIOGRAPHY (BILATERAL) 12000 15500 12000
1855 RADIOLOGY 5908 UPPER LIMB CT ARTERIOGRAPHY (UNILATERAL) 9500 12000 10000
1856 RADIOLOGY 5911 UPPER LIMB CT VENOGRAPHY (BILATERAL) 12000 15500 12000
1857 RADIOLOGY 5910 UPPER LIMB CT VENOGRAPHY (UNILATERAL) 9500 12000 10000
1858 RADIOLOGY 5860 USG ELASTOGRAPHY 2000 3000 2000
1859 RADIOLOGY 5854 USG FOR OVULATION MONITORING 1600 2400 2000
1860 RADIOLOGY 5858 USG GUIDANCE FOR FNAC 1000 1500 1000
1861 RADIOLOGY 5859 USG GUIDED BIOPSY PROCEDURE 2000 3000 2000
USG GUIDED DIAGNOSTIC FLUID TAPPING ONLY

1862 RADIOLOGY 5856 (ASCITES, PLEURAL EFFUSUION, JOINT EFFUSION ETC.) 600 850 600
USG GUIDED DRAINAGE/ INTERVENTIONAL

1863 RADIOLOGY 5857 PROCEDURES/PCN/PTBD ETC. 3200 6400 4000
1864 RADIOLOGY 5820 VENOGRAM (14X17) 2 FILMS 2150 2700 3000
1865 RADIOLOGY 5900 VERTEBROBASILAR CT ARTERIOGRAPHY 9500 12000 10000
1866 SEROLOGY 306 ALDEHYDE TEST 70 130 95
1867 SEROLOGY 1595 ANTI HCV 420 610 500
1868 SEROLOGY 307 ASO ( TITRE ) 300 440 200
1869 SEROLOGY 206 CMV 1 GG 420 550 500
1870 SEROLOGY 223 CMV 1 GM 420 550 500
78
1871 SEROLOGY 308 CRP 160 280 600
1872 SEROLOGY 1447 DENGUE SEROOGY 800 0 800
1873 SEROLOGY 310 HBSAG 130 280 200
1874 SEROLOGY 316 HCV 420 550 265
1875 SEROLOGY 2083 HEPATITIS A (IGM) 420 610 500
1876 SEROLOGY 2084 HEPATITIS E (IGM) 420 610 500
1877 SEROLOGY 2256 HIV (TRI-DOT) 220 280 300
1878 SEROLOGY 2082 LEPTOSPIRA (IGM & IGG) 420 610 500
1879 SEROLOGY 313 RA FACTOR 130 220 100
1880 SEROLOGY 2011 RAPID SYPHILLIUS TEST 220 390 300
1881 SEROLOGY 200 RUBELLA 1 GG 420 550 500
1882 SEROLOGY 204 RUBELLA 1 GM 420 550 500
1883 SEROLOGY 1575 SERODIAGNOSTIC TEST FOR LEPTOSPIROSIS 970 1320 1000
SERODIAGNOSTIC TEST FOR MALARIA OR OPTIMAL TEST

1884 SEROLOGY 692 (MORPON LAB) 420 630 500
1885 SEROLOGY 2085 SYPHILIS RAPID TEST 150 280 200
1886 SEROLOGY 198 TOXOPLASMA 1 GG 490 630 500
1887 SEROLOGY 199 TOXOPLASMA 1 GM 420 550 500
1888 SEROLOGY 314 VDRL/RPR ( QUALITATIVE & QUANTITATIVE) 170 280 95
1889 SEROLOGY 119 WIDAL TEST 180 280 100
1890 SPECIAL BIOCHEMISTRY 6474 ACTH 2200 3300 3000
1891 SPECIAL BIOCHEMISTRY 243 AFP(ALPHA FETO PROTEIN) 725 1180 900
1892 SPECIAL BIOCHEMISTRY 6478 ALDOSTERONE 2200 3300 3000
1893 SPECIAL BIOCHEMISTRY 5385 AMH 1000 1820 1000
1894 SPECIAL BIOCHEMISTRY 299 ANTI CARDIOLIPIN IGA 1050 1910 2000
79
1895 SPECIAL BIOCHEMISTRY 6089 ANTI CYCLIC CITRULLINATED PEPTIDE(ANTI-CCP) 2000 3640 1050
1896 SPECIAL BIOCHEMISTRY 284 ANTI DS DNA 1100 2000 525
1897 SPECIAL BIOCHEMISTRY 279 ANTI SMOOTH MUSCLE ANTIBODY 870 1590 900
1898 SPECIAL BIOCHEMISTRY 4655 ANTI TPO 750 1370 1650
1899 SPECIAL BIOCHEMISTRY 278 ANTINEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) 760 1390 800
1900 SPECIAL BIOCHEMISTRY 277 ANTINUCLEAR ANTIBODY (ANA) 1100 2000 525
1901 SPECIAL BIOCHEMISTRY 282 ANTINUCLEAR ANTIGEN SCL - 70 930 1690 1000
1902 SPECIAL BIOCHEMISTRY 803 BHCG 760 1380 800
1903 SPECIAL BIOCHEMISTRY 801 CA125 900 1640 1055
1904 SPECIAL BIOCHEMISTRY 2056 CA15-3 810 1470 1025
1905 SPECIAL BIOCHEMISTRY 2057 CA19-9 810 1470 1067
1906 SPECIAL BIOCHEMISTRY 2058 CEA 900 1640 730
1907 SPECIAL BIOCHEMISTRY 2059 CORTISOL 760 1380 990
1908 SPECIAL BIOCHEMISTRY 6473 DHEA-S 2000 3000 2000
1909 SPECIAL BIOCHEMISTRY 6477 DIRECT RENIN 2500 3500 3000
1910 SPECIAL BIOCHEMISTRY 2075 ESTRADIOL 770 1390 500
1911 SPECIAL BIOCHEMISTRY 969 FSH 700 1270 500
1912 SPECIAL BIOCHEMISTRY 6476 GASTRIN-17 2200 3300 3000
1913 SPECIAL BIOCHEMISTRY 6475 INSULIN (S) 1200 2000 2000
1914 SPECIAL BIOCHEMISTRY 968 LH 700 1270 650
1915 SPECIAL BIOCHEMISTRY 1207 LH, PROLACTIN, FSH (COMBINED) 2000 3200 2000
1916 SPECIAL BIOCHEMISTRY 5283 NT PRO BNP 2000 3640 2000
1917 SPECIAL BIOCHEMISTRY 2074 PROGESTERONE 850 1550 650
1918 SPECIAL BIOCHEMISTRY 970 PROLACTIN 700 1270 550
80
1919 SPECIAL BIOCHEMISTRY 2077 PSA 600 1090 800
1920 SPECIAL BIOCHEMISTRY 3028 PTH (PARATHARMONE) 1000 1820 500
1921 SPECIAL BIOCHEMISTRY 1200 SERUM ELECTOPHORESIS 800 1460 800
1922 SPECIAL BIOCHEMISTRY 250 TESTOSTERONE 770 1220 650
1923 SPECIAL BIOCHEMISTRY 2069 TFT (ACTIVE) 900 1640 900
1924 SPECIAL BIOCHEMISTRY 6471 THYROGLOBULIN (TG) 1000 1800 1000
1925 SPECIAL BIOCHEMISTRY 6472 THYROGLOBULIN ANTOBODY (TGA) 1500 2500 2640
1926 SPECIAL BIOCHEMISTRY 2066 TSH 350 630 308
1927 SPECIAL BIOCHEMISTRY 2291 VITAMIN B12 900 1640 1000
1928 SPECIAL BIOCHEMISTRY 5284 VITAMIN D 1200 2180 1500
1929 SPECIAL BIOCHEMISTRY 1203 VMA 1500 2730 2000
1930 SURGERY 6185 ABDOMINAL MASS GA 20000 40000 20000
1931 SURGERY 6295 ABDOMINOPERINEAL RESECTION (APR) 35000 65000 35000
1932 SURGERY 6279 ABSCESS DRAINAGE (BIG & MULTIPLE) GA 18000 36000 18000
1933 SURGERY 6152 ABSCESS DRAINAGE (BIG & MULTIPLE) GA 13000 26000 14000
1934 SURGERY 6278 ABSCESS DRAINAGE (LARGE) GA 15000 30000 16000
1935 SURGERY 6135 ABSCESS DRAINAGE (LARGE) GA 10000 20000 10000
1936 SURGERY 6276 ABSCESS DRAINAGE (SMALL) LA 3500 6500 4000
1937 SURGERY 6125 ABSCESS DRAINAGE (SMALL) LA 1500 3000 2000
1938 SURGERY 6345 ALVEOLAR BORE GRAFTING GA 20000 38000 20000
1939 SURGERY 6207 ANORECTAL MALFORMATIONS ANOPLASTY GA 20000 40000 20000
1940 SURGERY 6187 ANORECTAL MALFORMATIONS COLOSTOMY GA 20000 40000 20000
1941 SURGERY 6200 ANTERIOR SAGITAL ANORECTOPLASTY (ASARP) GA 25000 48000 25000
1942 SURGERY 6117 ANTIGRADE / RETROGRADE PYELOGRAPHY LA 7000 10000 7000
81
1943 SURGERY 6153 APPENDECTOMY GA 18000 36000 18000
1944 SURGERY 6259 BAND LIGATION / CRYOSURGERY LA 3500 6500 4000
1945 SURGERY 6325 BELOW/ABOVE KNEE AMPUTATION 15000 30000 16000
1946 SURGERY 6204 BILIARY ATRESIA LAPAROTOMY GA 35000 70000 35000
1947 SURGERY 6201 BOWEL ATRESIA LAPAROTOMY GA 30000 60000 30000
1948 SURGERY 6362 BRACHIAL PLEXUS SURGERY GA 20000 38000 20000
1949 SURGERY 6160 BRANCHIAL CYST EXCISION GA 15000 30000 16000
1950 SURGERY 6363 BREAST AUGMENTATION GA 20000 38000 20000
1951 SURGERY 6365 BREAST RECONSTRUCTION GA 20000 38000 20000
1952 SURGERY 6364 BREAST REDUCTION GA 20000 38000 20000
1953 SURGERY 6505 BURN DRESSING 1000 1500 1000
1954 SURGERY 6327 CAPD CATHETER IMPLANTATION GA 15000 30000 16000
1955 SURGERY 6156 CAPD CATHETER IMPLANTATION GA 15000 30000 16000
1956 SURGERY 6326 CAPD CATHETER IMPLANTATION LA 8000 16000 8000
1957 SURGERY 6311 CBD EXPLORATION (OPEN) 18000 36000 18000
1958 SURGERY 6312 CBD EXPLORATION LAPAROSCOPIC 20000 38000 20000
1959 SURGERY 6138 CHEST TUBE INSERTION LA 3500 6500 4000
1960 SURGERY 6277 CHET TUBE INSERTION LA 3500 6500 4000
1961 SURGERY 6290 CHOLEDOCHAL CYST EXCISION 22000 44000 22500
1962 SURGERY 6196 CHOLEDOCHAL CYST GA 25000 48000 25000
1963 SURGERY 6208 CHOLEDOCHODUODENOSTOMY GA 30000 60000 30000
1964 SURGERY 6198 CHOLEDOCHOLITHOTOMY GA 25000 48000 25000
1965 SURGERY 6400 CIRCUMCISION (UNDER ANAESTHESIA) 15000 28000 16000
1966 SURGERY 6157 CIRCUMCISION GA 13000 26000 14000
82
1967 SURGERY 6269 CIRCUMCISION LA 8000 15000 8000
1968 SURGERY 6139 CIRCUMCISION LA 9600 19200 10000
1969 SURGERY 6186 CLEFT LIP AND PALATE GA 20000 40000 20000
1970 SURGERY 6343 CLEFT LIP REPAIR GA 20000 38000 20000
1971 SURGERY 6197 COHEN'S REIMPLANTATION GA 21600 43200 22500
1972 SURGERY 6158 COLOSTOMY CLOSURE GA 20000 40000 20000
1973 SURGERY 6159 COLOSTOMY/ILEOSTOMY GA 15000 30000 16000
1974 SURGERY 6308 COLOSTOMY/JEJUNOSTOMY 15000 30000 16000
1975 SURGERY 6331 COMPLEX INCISIONAL HERNIA REPAIR 20000 38000 20000
1976 SURGERY 6355 CONTRACTURE RELEASE GA/S 20000 38000 20000
1977 SURGERY 6356 CRANIOSYNOSTOSIS GA 20000 38000 20000
1978 SURGERY 6161 CRANIOSYNOSTOSIS GA 15000 30000 16000
1979 SURGERY 6264 CYST EXCISION 3500 6500 4000
1980 SURGERY 6131 CYST LA 3500 6800 4000
1981 SURGERY 6163 CYSTECTOMY GA 15000 30000 16000
1982 SURGERY 6164 CYSTIC HYGROMA GA 15000 30000 16000
1983 SURGERY 6165 CYSTOLITHOTOMY GA 15000 30000 16000
1984 SURGERY 6118 CYSTOSCOPY + PROCEED 8000 14000 8000
1985 SURGERY 6213 CYSTOSCOPY LA 7000 10000 7000
1986 SURGERY 6140 DEBRIDEMENT GA 9600 19200 10000
1987 SURGERY 6280 DEBRIDEMENT/ NECTROSING FASCITIS GA 15000 30000 16000
1988 SURGERY 6141 DIAGNOSTIC CYSTOSCOPY GA 9600 19200 10000
1989 SURGERY 6284 DIAGNOSTIC LAPAROSCOPY & PROCEED 20000 38000 20000
1990 SURGERY 6167 DIAGNOSTIC LAPAROSCOPY & PROCEED GA 20000 40000 20000
83
1991 SURGERY 6114 DJ STENT PLACEMENT LA 7000 12000 7000
1992 SURGERY 6142 DJ STENT REMOVAL GA 9600 19200 10000
1993 SURGERY 6113 DJ STENT REMOVAL LA 4000 7000 4000
1994 SURGERY 6354 EAR RECONSTRUCTION GA 20000 38000 20000
1995 SURGERY 6339 ECTOPION RELEASE LA 3500 6500 4000
1996 SURGERY 6116 ENDODILATATION LA 7000 10000 7000
1997 SURGERY 6218 ENTEROCUTANEOUS FISTULA SURGERY 20000 38000 20000
1998 SURGERY 6168 EXPLORATORY LAPAROTOMY + PROCEED GA 25000 50000 25000
1999 SURGERY 6281 EXPLORATORY LAPAROTOMY AND PROCEED 20000 38000 20000
2000 SURGERY 6348 FACIAL FRACTURES PLATING GA 20000 38000 20000
2001 SURGERY 6220 FALLOPIAN TUBE RECANALIZATION GA/S 20000 38000 20000
2002 SURGERY 6303 FEEDING JEJUNOSTOMY 15000 30000 16000
2003 SURGERY 6169 FEEDING JEJUNOSTOMY GA 15000 30000 16000
2004 SURGERY 6253 FIBROADENOMA EXCISION GA 15000 30000 16000
2005 SURGERY 6273 FIBROADENOMA EXCISION LA 8000 15000 8000
2006 SURGERY 6155 FIBROADENOMA GA 15000 30000 16000
2007 SURGERY 6137 FIBROADENOMA LA 8000 16000 8000
2008 SURGERY 6219 FISTULA/HAEMORRHOIDECTOMY GA 15000 30000 16000
2009 SURGERY 6375 FISTULOTOMY 15000 3000 16000
2010 SURGERY 6351 FREE FLAPS GA 20000 38000 20000
2011 SURGERY 6357 FRONTAL BAR ADVANCEMENT GA 20000 38000 20000
2012 SURGERY 6292 GASTROJEJUNOSTOMY 20000 38000 20000
2013 SURGERY 6205 GASTROSCHISIS CLOSURE GA 25000 48000 25000
2014 SURGERY 6256 GYNAECOMASTIA GA 20000 38000 20000
84
2015 SURGERY 6255 GYNAECOMASTIA SURGERY LA 8000 15000 8000
2016 SURGERY 6358 HAIR TRANSPLANT LA 20000 38000 20000
2017 SURGERY 6209 HEMICOLECTOMY 20000 38000 20000
2018 SURGERY 6291 HEPATICOJEJUNOSTOMY 25000 48000 25000
2019 SURGERY 6266 HERNIORRAPHY LA 8000 15000 8000
2020 SURGERY 6147 HERNIOTOMY GA 15000 30000 16000
2021 SURGERY 6170 HYDATID CYST GA 20000 38000 20000
2022 SURGERY 6305 HYDATID CYST SURGERY (LAPAROSCOPIC) 25000 48000 25000
2023 SURGERY 6304 HYDATID CYST SURGERY (OPEN) 20000 38000 20000
2024 SURGERY 6425 HYDROCELE SURGERY GA 15000 30000 16000
2025 SURGERY 6265 HYDROCELE SURGERY LA 8000 15000 8000
2026 SURGERY 6402 HYPOSPADIAS 20000 38000 20000
2027 SURGERY 6352 HYPOSPADIAS GA 20000 38000 20000
2028 SURGERY 6199 HYPOSPADIAS, URETHROPLASTY GA 25000 50000 25000
2029 SURGERY 6330 INCISIONAL HERNIA REPAIR 15000 30000 16000
2030 SURGERY 6261 INGROWING TOE NAIL LA 3500 6500 4000
2031 SURGERY 6132 INGROWING TOE NAIL LA 3500 6800 4000
2032 SURGERY 6251 INTERMEDIATE OT (SURGERY) 8000 16000 8000
2033 SURGERY 6377 IPOM 18000 36000 18000
2034 SURGERY 6126 LABIAL SYNECHIA RELEASE LA 2900 5800 3000
2035 SURGERY 6171 LAMINECTOMY GA 15800 31600 16000
2036 SURGERY 6299 LAPAROSCOPIC HEMICOLECTOMY 25000 48000 25000
2037 SURGERY 6334 LAPAROSCOPIC INGUINAL HERNIA REPAIR 18500 36000 20000
2038 SURGERY 6286 LAPAROSCOPIC BIOPSY 15000 30000 16000
85
2039 SURGERY 6110 LAPAROSCOPIC NEPHROURETERECTOMY WITH 20000 38000 20000

BLADDER CUFF EXCISION
2040 SURGERY 6111 LAPAROSCOPIC PROSTATECTOMY 20000 40000 20000
2041 SURGERY 6109 LAPAROSCOPIC RADICAL NEPHRECTOMY 20000 38000 20000
2042 SURGERY 6112 LAPAROSCOPIC RENAL CYST DEROOFING 18000 35000 18000
2043 SURGERY 6108 LAPAROSCOPIC SIMPLE NEPHRECTOMY 18000 38000 18000
2044 SURGERY 6319 LAPAROSCOPIC SPLENECTOMY 20000 48000 20000
2045 SURGERY 6297 LAPAROSCOPIC TOTAL COLECTOMY 30000 58000 30000
2046 SURGERY 6283 LAPAROSCOPY APPENDECTOMY 18500 36000 20000
2047 SURGERY 6288 LAPAROSCOPY CHOLECYSTECTOMY 18500 36000 20000
2048 SURGERY 6107 LAPROSCOPIC ADERENALECTOMY 20000 38000 20000
2049 SURGERY 6271 LATERAL SPHINCTEROTOMY 15000 30000 16000
2050 SURGERY 6349 LEFORTE OSTEOTOMY GA 20000 38000 20000
2051 SURGERY 6270 LIPOMA EXCISION LA 8000 15000 8000
2052 SURGERY 6148 LIPOMA GA 13800 27600 14000
2053 SURGERY 6172 LN. BIOPSY GA 12000 24000 12000
2054 SURGERY 6257 LN. BIOPSY LA 3500 6500 4000
2055 SURGERY 6143 LN. BIOPSY LA 9600 19200 10000
2056 SURGERY 6341 LOCAL FLAP COVER LA 3500 6500 4000
2057 SURGERY 6296 LOW ANTERIOR RESECTION (LAR) 30000 58000 30000
2058 SURGERY 6315 MAJOR LIVER RESECTION 35000 65000 35000
2059 SURGERY 6317 MAJOR OPEN PANCREATIC SURGERY 30000 58000 30000
2060 SURGERY 6346 MAJOR RHINOPLASTY GA 20000 38000 20000
2061 SURGERY 6329 MELANOMA GA 15000 30000 16000
2062 SURGERY 6173 MENINGO MYELOCELE EXCISION GA 15800 31600 16000
86
2063 SURGERY 6401 MEONEATOMY/NEATOPLASTY 15000 28000 16000
2064 SURGERY 6174 MESENTRIC CYST/OMENTAL CYST GA 15000 30000 16000
2065 SURGERY 6254 MICRODOCHECTOMY / MAJOR DUCT EXCISION GA 15000 30000 16000
2066 SURGERY 6272 MICRODOCHECTOMY LA 8000 15000 8000
2067 SURGERY 6134 MICRODOCHECTOMY LA 8000 16000 8000
2068 SURGERY 6216 MINOR OT (SURGERY) 3500 6500 2500
2069 SURGERY 6347 MINOR RHINOPLASTY LA 3500 6500 4000
2070 SURGERY 6215 NEPHRECTOMY GA 20000 40000 20000
2071 SURGERY 6175 NEPHROLITHOTOMY GA 20000 40000 20000
2072 SURGERY 6176 NEPHROSTOMY GA 15000 30000 16000
2073 SURGERY 6359 NERVE REPAIRS RA/L 20000 38000 20000
2074 SURGERY 6189 NEUROGENIC BLADDER RECONSTRUCTION GA 25000 50000 25000
2075 SURGERY 6332 OBSTRUCTED HERNIA REPAIR 18000 36000 18000
2076 SURGERY 6307 OESOPHAGECTOMY 30000 58000 30000
2077 SURGERY 6124 OIU(SECOND/THIRD STAGE) 10000 18000 10000
2078 SURGERY 6184 OMPHALOCELE REPAIR GA 20000 40000 20000
2079 SURGERY 6404 OPEN ADERENALECTOMY FUNCTIONAL 25000 48000 25000
2080 SURGERY 6405 OPEN ADERENALECTOMY NON-FUNCTIONAL 20000 38000 20000
2081 SURGERY 6385 OPEN ANATROPHIC NEPHROLITHOTOMY 20000 38000 20000
2082 SURGERY 6282 OPEN APPENDECTOMY 15000 30000 16000
2083 SURGERY 6390 OPEN BOARI'S FLAP 25000 48000 25000
2084 SURGERY 6289 OPEN CHOLECYSTECTOMY 15000 30000 16000
2085 SURGERY 6177 OPEN CHOLECYSTECTOMY GA 18000 36000 18000
2086 SURGERY 6391 OPEN CYSTOLITHOTOMY 15000 28000 16000
87
2087 SURGERY 6333 OPEN INGUINAL HERNIA REPAIR 15000 30000 16000
OPEN NEPHROURETERECTOMY WITH BLADDER CUFF

2088 SURGERY 6382 EXCISION 20000 38000 20000
2089 SURGERY 6384 OPEN OPEN PYELOLITHOTOMY 17000 32000 18000
2090 SURGERY 6392 OPEN PARTIAL CYSTECTOMY 20000 38000 20000
2091 SURGERY 6403 OPEN PROSTETECTOMY 20000 38000 20000
2092 SURGERY 6386 OPEN PYELOPLASTY 17000 32000 18000
OPEN RADICAL CYSTECTOMY WITH

2093 SURGERY 6393 LYMPHADENECTOMY 30000 58000 30000
2094 SURGERY 6381 OPEN RADICAL NEPHRECTOMY 20000 38000 20000
2095 SURGERY 6383 OPEN RENAL CYST DEROOFING 17000 32000 18000
2096 SURGERY 6380 OPEN SIMPLE NEPHRECTOMY 17000 32000 18000
2097 SURGERY 6318 OPEN SPLENECTOMY 15000 30000 16000
2098 SURGERY 6387 OPEN URETEROLITHOTOMY 15000 28000 16000
2099 SURGERY 6389 OPEN URETERO-NEOSYSTOSTOMY 20000 38000 20000
2100 SURGERY 6388 OPEN URETERO-URETEROSTOMY 20000 38000 20000
2101 SURGERY 6413 OPTICAL INTERNAL URETHROTOMY (OIU) 18000 36000 18000
2102 SURGERY 6267 ORCHIDECTOMY LA 8000 15000 8000
2103 SURGERY 6190 ORCHIDOPEXY GA 17000 34000 18000
2104 SURGERY 6301 OTHER LAPAROSCOPIC LARGE BOWEL SURGERY 30000 58000 30000
2105 SURGERY 6211 OTHER LAPAROSCOPIC PROCEDURES 20000 38000 20000
2106 SURGERY 6300 OTHER LARGE BOWEL SURGERY 20000 38000 20000
2107 SURGERY 6310 OTHER MAJOR BILIARY SURGERY 25000 48000 25000
2108 SURGERY 6314 OTHER MAJOR LIVER SURGERY 30000 58000 30000
2109 SURGERY 6344 PALATE REPAIR GA 20000 38000 20000
PANCREATICODUODENECTOMY (WHIPPLES
2110 SURGERY 6316 PROCEDURE) 30000 58000 30000
88
2111 SURGERY 6421 PARATHYROIDECTOMY 18000 34000 18000
2112 SURGERY 6337 PAROTIDECTOMY GA 15000 30000 16000
2113 SURGERY 6397 PARTIAL PENECTOMY 15000 28000 16000
2114 SURGERY 6120 PCNL (SECOND/THIRD STAGE) 10000 18000 10000
2115 SURGERY 6406 PERCUTANEOUS NEPHROLITHOTOMY (PCNL) 25000 48000 25000
2116 SURGERY 6115 PERCUTANEOUS NEPHROSTOMY (PCN) LA 7000 12000 7000
2117 SURGERY 6376 PERFORATION PERITONITIS 18000 36000 18000
2118 SURGERY 6374 PERIANAL ABSCESS DRAINAGE 15000 30000 16000
2119 SURGERY 6399 PERINEAL URETHROSTOMY 15000 28000 16000
2120 SURGERY 6323 PERIPHERAL TUMOR/HEMANGIOMA EXCISION GA 20000 38000 20000
2121 SURGERY 6322 PERIPHERAL TUMOR/HEMANGIOMA EXCISION LA 8000 16000 8000
2122 SURGERY 6415 PERURETHRAL CYSTOLITHOTRIPSY (PUCL) 18000 36000 18000
2123 SURGERY 6373 PILONIDAL SINUS EXCISION 15000 30000 16000
POSTERIOR SAGITTAL ANORECTOPLASY FOR ANO

2124 SURGERY 6202 RECTAL MALFORMATION GA 30000 50000 30000
2125 SURGERY 6414 POSTERIOR URETHRAL VALVE FULGRATION (PUVF) 18000 36000 18000
2126 SURGERY 6188 POSTERIOR URETHRAL VALVE FULGRATION GA 18600 37200 20000
2127 SURGERY 6127 PREPUTIAL ADHESIOLYSIS LA 2900 5800 3000
2128 SURGERY 6260 PROSTATE BIOPSY (TRUCUT) LA 3500 6500 4000
2129 SURGERY 6210 PSEUDOCYST OF PANCREAS SURGERY (LAPAROSCOPIC) 25000 48000 25000
2130 SURGERY 6306 PSEUDOCYST OF PANCREAS SURGERY (OPEN) 20000 38000 20000
2131 SURGERY 6178 PYELOLITHOTOMY GA 18000 36000 18000
2132 SURGERY 6191 PYELOPLASTY GA 18600 37200 20000
2133 SURGERY 6420 RADICAL DUCT EXCISION 15000 28000 16000
2134 SURGERY 6221 RADICAL PROSTETECTOMY WITH LYMPHADENECTOMY 25000 48000 25000
89
2135 SURGERY 6192 RAMSTEDTS PYLOROMYOTOMY GA 20000 40000 20000
2136 SURGERY 6179 RANULA EXCISION GA 15000 30000 16000
2137 SURGERY 6214 RECTAL BIOPSY GA 9600 19200 10000
2138 SURGERY 6180 RECTAL POLYPECTOMY GA 13000 26000 14000
2139 SURGERY 6350 REGIONAL FLAP COVER GA/S 20000 38000 20000
2140 SURGERY 6361 REPLANTATIONS GA/S 20000 38000 20000
RESECTION ANASTOMOSIS (SMALL BOWEL / LARGE

2141 SURGERY 6181 BOWEL) GA 25000 50000 25000
2142 SURGERY 6313 RETROPERITONEAL TUMOR EXCISION 22000 40000 22500
2143 SURGERY 6360 REVASUCULARIZATION GA/S 20000 38000 20000
2144 SURGERY 6379 REXPLORATION OT CHARGE 5000 7000 5000
2145 SURGERY 6149 RIGHT HEMICOLECTOMY GA 15000 30000 16000
2146 SURGERY 6336 SKIN GRAFTING - LARGE AREA GA 18000 36000 18000
2147 SURGERY 6335 SKIN GRAFTING - SMALL AREA GA 15000 30000 16000
2148 SURGERY 6151 SKIN GRAFTING - SMALL AREA GA 15600 31200 16000
2149 SURGERY 6193 SKIN GRAFTING (LARGE AREA) GA/S 18600 37200 20000
2150 SURGERY 6268 SKIN GRAFTING LA 8000 15000 8000
2151 SURGERY 6418 SLNB BREAST 3500 6500 4000
2152 SURGERY 6309 SMALL BOWEL RESECTION AND ANASTOMOSIS 20000 38000 20000
2153 SURGERY 6123 SPCL(SECOND/THIRD STAGE) 10000 18000 10000
2154 SURGERY 6194 SPLENECTOMY GA 20000 38000 20000
2155 SURGERY 6340 SPLIT EAR LA 3500 6500 4000
2156 SURGERY 6285 STAGING LAPAROSCOPY 18000 36000 18000
2157 SURGERY 6287 STOMA CLOSURE 15000 30000 16000
2158 SURGERY 6372 SUBCLAVIAN CATHETERIZATION FOR HAEMODIALYSIS 3500 6500 4000
90
2159 SURGERY 6294 SUBTOTAL GASTRECTOMY 25000 48000 25000
2160 SURGERY 6368 SUCTION DRAIN 1000 1800 1000
2161 SURGERY 6412 SUPRAPUBIC CYTOLITHOTRIPSY (SPCL) 18000 36000 18000
2162 SURGERY 6217 SUTURING GA 15000 30000 16000
2163 SURGERY 6144 SUTURING GA 9600 19200 10000
2164 SURGERY 6275 SUTURING LA 1500 3000 2000
2165 SURGERY 6128 SUTURING LA 2000 2500 2000
2166 SURGERY 6378 TAR 20000 40000 20000
2167 SURGERY 6195 THRORACTOMY PAEDIATRIC GA 30000 50000 30000
2168 SURGERY 6162 THYROGOSSAL CYST SISTRUNK GA 15000 30000 16000
2169 SURGERY 6370 THYROIDECTOMY (RADICAL/MODIFIED RADICAL) GA 18000 36000 18000
2170 SURGERY 6212 THYROIDECTOMY (SELECTIVE NECK DISSECTION) GA 18000 36000 18000
THYROIDECTOMY (TOTAL / SUBTOTAL / NEAR TOTAL )

2171 SURGERY 6369 15000 30000 16000
GA
2172 SURGERY 6342 TISSUE EXPANDER INSERTION GA/L 8000 16000 8000
2173 SURGERY 6324 TOES/FINGER AMPUTATION LA 8000 16000 8000
2174 SURGERY 6136 TONGUE TIE RELEASE GA 10000 15000 10000
2175 SURGERY 6166 TORTICOLLIS GA 15000 30000 16000
2176 SURGERY 6298 TOTAL COLECTOMY 25000 48000 25000
2177 SURGERY 6293 TOTAL GASTRECTOMY 30000 58000 30000
2178 SURGERY 6252 TOTAL MASTECTOMY 18000 36000 18000
2179 SURGERY 6398 TOTAL PENECTOMY WITH LYMPHADENECTOMY 25000 48000 25000
2180 SURGERY 6203 TRACHEO-ESOPHAGEAL ATRESIA REPAIR GA 35000 60000 35000
2181 SURGERY 6206 TRANS ANAL SOAVE PULL THROUGH GA 30000 60000 30000
2182 SURGERY 6182 TRANSPUBIC URETHROPLASTY GA 15000 30000 16000
91
2183 SURGERY 6411 TRANURETHRAL RESECTION OF BLADDER TUMOUR 25000 48000 25000
(TURBT) - BIPOLAR
TRANURETHRAL RESECTION OF BLADDER TUMOUR

2184 SURGERY 6410 (TURBT) - MONOPOLAR 20000 38000 20000
TRANURETHRAL RESECTION OF THE PROSTATE (TURP) -

2185 SURGERY 6409 BIPOLAR 25000 48000 25000
2186 SURGERY 6408 TRANURETHRAL

MONOPOLAR
RESECTION OF THE PROSTATE (TURP) - 20000 38000 20000
2187 SURGERY 6183 TRUCUT BIOPSY GA 15000 30000 16000
2188 SURGERY 6258 TRUCUT BIOPSY LA 3500 6500 4000
2189 SURGERY 6302 TUBE GASTROSTOMY 15000 30000 16000
2190 SURGERY 6121 TURBT (SECOND/THIRD STAGE) 10000 18000 10000
2191 SURGERY 6119 TURP (SECOND/THIRD STAGE) 10000 18000 10000
2192 SURGERY 6130 UMBILICAL GRANULOMA/POLYP EXCISION 3400 6800 4000
2193 SURGERY 6154 UMBILICAL HERNIA REPAIR 15000 30000 16000
2194 SURGERY 6407 URETERORENOSCOPIC LITHOTRIPSY (URSL) 25000 48000 25000
2195 SURGERY 6145 URETHRAL DILATATION GA 8000 16000 8000
2196 SURGERY 6263 URETHRAL DILATATION LA 3500 6500 4000
2197 SURGERY 6129 URETHRAL DILATATION LA 2900 5800 3000
2198 SURGERY 6394 URETHROPLASTY - 1 - END TO END 20000 38000 20000
2199 SURGERY 6395 URETHROPLASTY - 2 - AUGMENTATION 25000 48000 25000
2200 SURGERY 6396 URETHROPLASTY - 3 - PFUDD 30000 58000 30000
2201 SURGERY 6371 UROFLOWMETRY TEST 3500 6500 4000
2202 SURGERY 6122 URSL (SECOND/THIRD STAGE) 10000 18000 10000
2203 SURGERY 6366 USG GUIDED ASPIRATION OF BREAST 800 1500 1000
2204 SURGERY 6367 USG GUIDED BIOPSY OF BREAST 3500 7000 4000
2205 SURGERY 763 V P SHUNT GA 13800 27600 14000
2206 SURGERY 6150 V P SHUNT GA 13800 27600 14000
92
2207 SURGERY 6353 VAGINOPLASTY GA/S 20000 38000 20000
2208 SURGERY 6274 VARICOCELE EXCISION LA 8000 15000 8000
2209 SURGERY 6328 VARICOSE VEINS SURGERY 15000 30000 16000
2210 SURGERY 6338 VAS RECANALIZATION LA 3500 6500 4000
2211 SURGERY 6321 VASCUALR INJURY REPAIR GA 15000 30000 16000
2212 SURGERY 6320 VASCUALR INJURY REPAIR LA 8000 16000 8000
2213 SURGERY 6133 VENESECTION 3500 6800 4000
2214 SURGERY 6262 WEDGE BIOPSY LA 3500 6500 4000
2215 SURGERY 6417 WLE + ALND BREAST 22000 34000 22500
2216 SURGERY 6419 WLE + SNLB BREAST 20000 38000 20000
2217 SURGERY 6416 WLE BREAST 18000 34000 18000
93
BPKIHS
SN DEPARTMENT TEST NAME CATEGORY
CODE
1 ACADEMIC SEVICES OTHER CHARGES 987


39 CARE PAIN CLINIC SERVICES 1597


41 PAIN CLINIC SERVICES 995
CARE
CARE
43 ANAESTHESIOLOGY & CRITICAL PAIN CLINIC SERVICES 1688

CARE


CARE

CARE
CARE
CARE
CARE

CARE

CARE
CARE


CARE

CARE

CARE

CARE

CARE


CARE
CARE

CARE
69 ANATOMY ANATOMY CHARGES 126

72 BED CHARGES BED CHARGES
73 BIOCHEMISTRY HOSPITAL SERVICE CHARGES 3033
74 BIOCHEMISTRY HOSPITAL SERVICE CHARGES 5053
75 BIOCHEMISTRY PATHOLOGY 336



150 CARDIOLOGY HOSPITAL SERVICE CHARGES 3620
151 CARDIOLOGY INVASIVE PROCEDURE 5397

174 CARDIOLOGY NON INVASIVE PROCEDURE 2267
177 CARDIOLOGY cardiology device 6012
178 CONSERVATIVE & CONSERVATIVE & 1147

ENDODONTICS ENDODONTICS CHARGES
CONSERVATIVE & CONSERVATIVE &
179 ENDODONTICS 1539
ENDODONTICS CHARGES
180 5375

182 CONSERVATIVE &

CONSERVATIVE &
1122
ENDODONTICS CHARGES
ENDODONTICS CHARGES
185 2164
186 5365
187 CONSERVATIVE &

CONSERVATIVE &
1145
ENDODONTICS CHARGES
189 ENDODONTICS ENDODONTICS CHARGES 2166
190 CONSERVATIVE &

CONSERVATIVE &
5552
191 CONSERVATIVE &

CONSERVATIVE &
1538
192 1544
193 1545
194 880

196 885

198 1130
199 ENDODONTICS 901
ENDODONTICS CHARGES


ENDODONTICS CHARGES
204 1145

206 CONSERVATIVE &

CONSERVATIVE &
2033
ENDODONTICS CHARGES
ENDODONTICS CHARGES
209 1549
210 1669
211 CONSERVATIVE &

CONSERVATIVE &
1154
ENDODONTICS CHARGES
214 CONSERVATIVE &

CONSERVATIVE &
1134
215 CONSERVATIVE &

CONSERVATIVE &
5553
216 1550
217 1162
218 1125

220 1143

222 1166
ENDODONTICS CHARGES


ENDODONTICS CHARGES
228 1139

230 CONSERVATIVE &

CONSERVATIVE &
1543
ENDODONTICS CHARGES
ENDODONTICS CHARGES
233 1163
234 876
235 CONSERVATIVE &

CONSERVATIVE &
1156
ENDODONTICS CHARGES
238 CONSERVATIVE &

CONSERVATIVE &
5374
239 CONSERVATIVE &

CONSERVATIVE &
2168
240 5376
241 CR GENERAL X-RAYS CR GENERAL X-RAY 5808

268 CTVS CTVS CHARGES 5423

291 CTVS INVASIVE PROCEDURE 1954
292 CTVS INVASIVE PROCEDURE 5503
293 CTVS MATERIALS/CONSUMABLES 5515

CHARGES
MATERIALS/CONSUMABLES
294 CTVS 5478
CHARGES
295 CTVS 5501
CHARGES
296 CTVS CHARGES 6021

CHARGES

CHARGES
299 CTVS 5488
CHARGES
300 CTVS 5489
CHARGES

CHARGES
302 CTVS 5491
CHARGES
303 CTVS 5485
CHARGES
304 CTVS 5484
CHARGES
305 CTVS 5482
CHARGES
306 CTVS 5483
CHARGES
307 CTVS 5481
CHARGES
308 CTVS 5497
CHARGES
310 CTVS 5512
CHARGES
311 CTVS 5494
CHARGES
312 CTVS 5496
CHARGES
313 CTVS 5495
CHARGES
314 CTVS 5429
CHARGES
316 CTVS 5428
CHARGES

CHARGES
318 CTVS 5480
CHARGES
319 CTVS 5492
CHARGES
320 CTVS OPERATION CHARGES 6090
321 CTVS PACKAGE SERVICES 6422
322 CTVS PACKAGE SERVICES 6423

323 VASCULAR SURGERY) INVASIVE PROCEDURE 1947

324 NON INVASIVE PROCEDURE 982
VASCULAR SURGERY)
325 CTVS (CARDIOTHORACIC AND NON INVASIVE PROCEDURE 984

VASCULAR SURGERY)
326 CTVS (CARDIOTHORACIC AND NON INVASIVE PROCEDURE 274

VASCULAR SURGERY)
327 VASCULAR SURGERY) NON INVASIVE PROCEDURE 270

328 VASCULAR SURGERY) NON INVASIVE PROCEDURE 4765

329 NON INVASIVE PROCEDURE 276
VASCULAR SURGERY)
330 cardiology device 6011
VASCULAR SURGERY)
331 CYTOLOGY PATHOLOGY 391

DERMATOLOGY &
338 DERMATOLOGY CHARGES 478
VENEREOLOGY
DERMATOLOGY &
339 VENEREOLOGY DERMATOLOGY CHARGES 483
DERMATOLOGY &
VENEREOLOGY
341 DERMATOLOGY & DERMATOLOGY CHARGES 481

VENEREOLOGY
DERMATOLOGY &
VENEREOLOGY
DERMATOLOGY &
DERMATOLOGY &

VENEREOLOGY

VENEREOLOGY
DERMATOLOGY &
DERMATOLOGY &
VENEREOLOGY

VENEREOLOGY

VENEREOLOGY
DERMATOLOGY &
DERMATOLOGY &
DERMATOLOGY &
VENEREOLOGY
DERMATOLOGY &
VENEREOLOGY

VENEREOLOGY
DERMATOLOGY &
DERMATOLOGY &

VENEREOLOGY

VENEREOLOGY
DERMATOLOGY &
VENEREOLOGY
DERMATOLOGY &
VENEREOLOGY
DERMATOLOGY &
VENEREOLOGY
DERMATOLOGY &
DERMATOLOGY &
VENEREOLOGY

VENEREOLOGY
DERMATOLOGY &
VENEREOLOGY
DERMATOLOGY &
DERMATOLOGY &

VENEREOLOGY

VENEREOLOGY
DERMATOLOGY & GENERAL/GI SURGERY
371 VENEREOLOGY 255
CHARGES
DERMATOLOGY &
372 PROCEDURES CHARGES 6017
VENEREOLOGY
373 DERMATOLOGY & PROCEDURES CHARGES 6018

VENEREOLOGY
374 DERMATOLOGY & PROCEDURES CHARGES 6016

VENEREOLOGY
DERMATOLOGY &
375 VENEREOLOGY PROCEDURES CHARGES 6020
DERMATOLOGY &
376 VENEREOLOGY PROCEDURES CHARGES 6019
377 DIALYSIS DIALYSIS CHARGES 1647
378 DIALYSIS DIALYSIS CHARGES 1648
379 EMERGENCY HOSPITAL SERVICE CHARGES 6509
380 & HEAD & NECK SURGERY EAR SURGERY CHARGES 1216
382 ENT OTORHINOLARYNGOLOGY EAR SURGERY CHARGES 1218


384 EAR SURGERY CHARGES 1224

















441 ENT OTORHINOLARYNGOLOGY NOSE SURGERY CHARGES 1031


443 & HEAD & NECK SURGERY NOSE SURGERY CHARGES 1222
444 NOSE SURGERY CHARGES 1221




























527 ENT OTORHINOLARYNGOLOGY OPERATION CHARGES 5564

528 OPERATION CHARGES 5563
531 & HEAD & NECK SURGERY OPERATION CHARGES 5567













ENT OTORHINOLARYNGOLOGY PHARYNX, LARYNX &

568 & HEAD & NECK SURGERY 1039
ESOPHAGUS OT CHARGES
569 1017
& HEAD & NECK SURGERY ESOPHAGUS OT CHARGES
570 1214

PHARYNX, LARYNX &
1213
573 & HEAD & NECK SURGERY ESOPHAGUS OT CHARGES 1220

PHARYNX, LARYNX &
1219

PHARYNX, LARYNX &
1228
576 1227
577 1230
578 1229

580 1235
581 ENT OTORHINOLARYNGOLOGY PHARYNX, LARYNX & 1242

582 1241


588 1255


PHARYNX, LARYNX &
1917
593 1041
594 1019

PHARYNX, LARYNX &
1264

PHARYNX, LARYNX &
1695

PHARYNX, LARYNX &
1272
600 1271
601 1284
602 1283

604 1285

606 1303


612 1307


PHARYNX, LARYNX &
1317
617 1332
618 1331

PHARYNX, LARYNX &
1332

PHARYNX, LARYNX &
1020

PHARYNX, LARYNX &
1340
624 1339
625 1346
626 1345

628 1347

630 1351


636 1363


PHARYNX, LARYNX &
1375
641 1384
642 1383

PHARYNX, LARYNX &
1390

PHARYNX, LARYNX &
1393

PHARYNX, LARYNX &
1038
648 1016
649 1402
650 1401

652 1403

654 1405


660 1018


PHARYNX, LARYNX &
1417
665 1045
666 1023

PHARYNX, LARYNX &
1037

PHARYNX, LARYNX &
1021

PHARYNX, LARYNX &
1436
672 1435
673 1438
674 1437
675 & HEAD & NECK SURGERY PROCEDURES CHARGES 205
677 ENT OTORHINOLARYNGOLOGY PROCEDURES CHARGES 530



684 SPEECH AND HEARING UNIT 209
685 ENT OTORHINOLARYNGOLOGY SPEECH AND HEARING UNIT 1650


687 & HEAD & NECK SURGERY SPEECH AND HEARING UNIT 436

GASTRO-ENTEROLOGY &
693 HEPATOLOGY ENDOSCOPY 5670
694 GASTRO-ENTEROLOGY & ENDOSCOPY 127

HEPATOLOGY

HEPATOLOGY
GASTRO-ENTEROLOGY &
696 ENDOSCOPY 5664
HEPATOLOGY
GASTRO-ENTEROLOGY &
697 ENDOSCOPY 5669
HEPATOLOGY
GASTRO-ENTEROLOGY &
698 ENDOSCOPY 5662
HEPATOLOGY
GASTRO-ENTEROLOGY &
GASTRO-ENTEROLOGY &
700 ENDOSCOPY 5666
HEPATOLOGY

HEPATOLOGY
GASTRO-ENTEROLOGY &
702 ENDOSCOPY 125
HEPATOLOGY
GASTRO-ENTEROLOGY &
GASTRO-ENTEROLOGY &

HEPATOLOGY

HEPATOLOGY
GASTRO-ENTEROLOGY &
GASTRO-ENTEROLOGY &
708 ENDOSCOPY 5672
HEPATOLOGY

HEPATOLOGY

HEPATOLOGY
GASTRO-ENTEROLOGY &
GASTRO-ENTEROLOGY &
GASTRO-ENTEROLOGY &
713 ENDOSCOPY 5675
HEPATOLOGY
GASTRO-ENTEROLOGY &
714 ENDOSCOPY 6073
HEPATOLOGY
715 HAEMATOLOGY HOSPITAL SERVICE CHARGES 6496
716 HAEMATOLOGY PATHOLOGY 706


749 HISTOPATHOLOGY PATHOLOGY 5363
757 HOSPITAL ADMINISTRATION BED CHARGES 6069
758 HOSPITAL ADMINISTRATION HOSPITAL SERVICE CHARGES 6490

782 HOSPITAL ADMINISTRATION OTHER CHARGES 6007
789 INTERNAL MEDICINE DIALYSIS CHARGES 235

793 INTERNAL MEDICINE HOSPITAL SERVICE CHARGES 6008
794 MICROBIOLOGY HOSPITAL SERVICE CHARGES 6510
795 MICROBIOLOGY PATHOLOGY 585



865 MICROBIOLOGY RADIOLOGY 1578
866 NEUROSURGERY NEURO SURGERY CHARGE 1704


935 OBSTETRICS & GYNAECOLOGY OBST/GYNAE CHARGES 2030


972 OBSTETRICS & GYNAECOLOGY OPERATION CHARGES 186
978 OBSTETRICS & GYNAECOLOGY PROCEDURES CHARGES 6480
982 OPHTHALMOLOGY OPHTHALMOLOGY CHARGES 543


1029 OPHTHALMOLOGY OT PROCEDURES 5393


5633
SURGERY SURGERY CHARGES
ORAL & MAXILLOFACIAL ORAL & MAXILLOFACIAL
1056 1509
1057 1497
1058 1508
1059 SURGERY SURGERY CHARGES 1506

1060 5630
1061 ORAL & MAXILLOFACIAL ORAL & MAXILLOFACIAL 5642

1062 5648
1063 SURGERY 1505
SURGERY CHARGES


1067 SURGERY 2182
SURGERY CHARGES
1068 2180


2191
1071 SURGERY 2190
SURGERY CHARGES
1072 SURGERY 2191
SURGERY CHARGES
1073 5637
1074 2045

1521
1076 SURGERY 5641
SURGERY CHARGES

2176

2175
1080 2188
1081 2189
1082 5657

1084 5656

1086 6044
1087 SURGERY 6045
SURGERY CHARGES


1091 SURGERY 2179
SURGERY CHARGES
1092 5645


1495
1095 SURGERY 1491
SURGERY CHARGES
1096 SURGERY 1490
SURGERY CHARGES
1097 1510
1098 5646

2195
1100 SURGERY 2194
SURGERY CHARGES

2198

2199
1104 2193
1105 1494
1106 2192

1108 5650

1110 1498
1111 SURGERY 6039
SURGERY CHARGES


1115 SURGERY 2044
SURGERY CHARGES
1116 2032


5639
1119 SURGERY 2200
SURGERY CHARGES
1120 SURGERY 2201
SURGERY CHARGES
1121 5654
1122 5643

6041
1124 SURGERY 1507
SURGERY CHARGES

2184

2196
1128 2197
1129 1501
1130 2177

1132 1503

1134 2187
1135 SURGERY 5632
SURGERY CHARGES


1139 SURGERY 5636
SURGERY CHARGES
1140 5634


5653
DENTAL RADIOLOGY
1143 ORAL MEDICINE & RADIOLOGY 568
CHARGES
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
1149 ORAL MEDICINE & RADIOLOGY CHARGES 567
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
CHARGES
DENTAL RADIOLOGY
CHARGES
1154 ORAL PATHOLOGY 6026
SURGERY CHARGES
1155 ORAL PATHOLOGY SURGERY CHARGES 6028

1156 ORAL PATHOLOGY 2262
SURGERY CHARGES
1157 ORAL PATHOLOGY ORAL PATHOLOGY CHARGE 2260
1165 ORTHOPAEDICS ORTHOPAEDICS OPERATION 6491

CHARGES
ORTHOPAEDICS OPERATION
1166 ORTHOPAEDICS 6232
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
1173 ORTHOPAEDICS CHARGES 1832
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES

CHARGES

CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES

CHARGES

CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES

CHARGES

CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES

CHARGES

CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
1272 ORTHOPAEDICS ORTHOSIS CHARGES 1938

OTHERS PROCEDURES
CHARGES
1299 ORTHOPAEDICS PROSTHESIS CHARGES 1469
ORTHODONTICS DENTAL
1304 ORTHOPDONTICS DENTAL CHARGES 1560
1305 ORTHOPDONTICS DENTAL ORTHODONTICS DENTAL 1555

CHARGES

CHARGES
ORTHODONTICS DENTAL
1307 ORTHOPDONTICS DENTAL 2171
CHARGES
ORTHODONTICS DENTAL
CHARGES

CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
CHARGES
ORTHODONTICS DENTAL
1324 ORTHOSIS ORTHOSIS CHARGES 1466


1377 ORTHOSIS PROSTHESIS CHARGES 1911
1378 PAEDIATRICS & ADOLESCENT INTERMEDIATE CARE 1081

MEDICINE NURSERY
PAEDIATRICS & ADOLESCENT INTERMEDIATE CARE
1379 MEDICINE 1077
NURSERY
1380 2121
MEDICINE NURSERY
1381 PAEDIATRICS & ADOLESCENT INTERMEDIATE CARE 408

MEDICINE NURSERY
1382 PAEDIATRICS & ADOLESCENT

INTERMEDIATE CARE
404
MEDICINE NURSERY
1383 MEDICINE 1076
NURSERY
1384 MEDICINE 402
NURSERY
1385 2120
MEDICINE NURSERY
1386 6052
MEDICINE NURSERY

INTERMEDIATE CARE
2119
MEDICINE NURSERY
1388 MEDICINE 1078
NURSERY
1389 MEDICINE NURSERY 1079

INTERMEDIATE CARE
409
MEDICINE NURSERY

INTERMEDIATE CARE
405
MEDICINE NURSERY
1392 PATHOLOGY PATHOLOGY 2118
1397 PEDODONTICS & PREVENTIVE PEDODONTICS & 829

DENTISTRY PREVENTIVE DENTISTRY
PEDODONTICS & PREVENTIVE PEDODONTICS &
1398 177
1399 DENTISTRY 1664
PREVENTIVE DENTISTRY
1400 DENTISTRY PREVENTIVE DENTISTRY 5621


1403 DENTISTRY 163
1404 1660

1406 PEDODONTICS & PREVENTIVE

PEDODONTICS &
1659
1407 DENTISTRY 817
1408 DENTISTRY 693
1409 6032
1410 822

PEDODONTICS &
172
1412 DENTISTRY 687

PEDODONTICS &
854

PEDODONTICS &
181
1416 562
1417 5629
1418 853

1420 1513

1422 772
1423 DENTISTRY 6033


1427 DENTISTRY 5625
1428 174


PEDODONTICS &
1913
1431 DENTISTRY 5620
1432 DENTISTRY 5622
1433 776
1434 856

PEDODONTICS &
774
1436 DENTISTRY 6036

PEDODONTICS &
1547

PEDODONTICS &
848
1440 2047
1441 6035
1442 814

1444 2159

1446 824
1447 DENTISTRY 2048


1451 DENTISTRY 835
1452 1528


PEDODONTICS &
1662
1455 DENTISTRY 5623
1456 DENTISTRY 1663
1457 1523
1458 166

PEDODONTICS &
815
1460 DENTISTRY 5628

PEDODONTICS &
2158

PEDODONTICS &
5624
1464 158
1465 192
1466 823

1468 1916

1470 1516
1471 DENTISTRY 162


1475 DENTISTRY 5335
1476 5627
1477 PERIODONTICS DENTAL NON INVASIVE PROCEDURE 6013
PERIODONTICS DENTAL
1478 PERIODONTICS DENTAL 1110
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
1485 PERIODONTICS DENTAL CHARGES 5326
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
PERIODONTICS DENTAL
CHARGES
1493 PERIODONTICS DENTAL PERIODONTICS DENTAL 5619

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL

CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
PERIODONTICS DENTAL
CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL

CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
PERIODONTICS DENTAL
CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL

CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES

CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PERIODONTICS DENTAL
CHARGES
PHARMACOLOGY &
1561 PHARMACOLOGY 1982
THERAPEUTICS
PHARMACOLOGY &
1562 PHARMACOLOGY 1983
THERAPEUTICS
PHARMACOLOGY &
1563 THERAPEUTICS PHARMACOLOGY 1984
1564 PHARMACY CHARGES Pharmacy Charges 6466
1565 PHYSIOLOGY PHYSIOLOGY CHARGES 635
1574 PHYSIOTHERAPY 736
CHARGES
1575 PHYSIOTHERAPY 122
CHARGES
1576 PHYSIOTHERAPY PHSIOTHERAPY CHARGES 731


1610 PROSTHESIS 1979
CHARGES
1611 PROSTHESIS ORTHOSIS CHARGES 5585
1622 PROSTHESIS PROSTHESIS CHARGES 5468


CAD-CAM & METAL-CERAMIC

1659 PROSTHODONTICS DENTAL CHARGES 2108

1660 PROSTHODONTICS DENTAL 2109
CHARGES
1661 PROSTHODONTICS DENTAL CAD-CAM & METAL-CERAMIC 2114

CHARGES
CHARGES
CHARGES
1665 PROSTHODONTICS DENTAL CAD-CAM & METAL-CERAMIC 2112

CHARGES
1666 PROSTHODONTICS DENTAL PROSTHODONTICS DENTAL 149

CHARGES
PROSTHODONTICS DENTAL
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES

CHARGES

CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES

CHARGES

CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES
CHARGES

CHARGES
CHARGES
CHARGES

CHARGES

CHARGES
1739 PSYCHIATRY PSYCHIATRY CHARGES 1070

PULMONARY,CRITICAL CARE & Pulmonary, Critical Care and

1758 6092
SLEEP MEDICINE Sleep Medicine
1759 SLEEP MEDICINE 6091
Sleep Medicine
1760 SLEEP MEDICINE Sleep Medicine 6093
1761 PULMONARY,CRITICAL CARE & Pulmonary, Critical Care and 6094


1763 SLEEP MEDICINE 6095
Sleep Medicine
1764 6097

1766 PULMONARY,CRITICAL CARE &

Pulmonary, Critical Care and
6099
1767 RADIOLOGY CT SCAN 5880


CT SCAN(ADVANCE
1800 RADIOLOGY 5903
PROCEDURES)
CT SCAN(ADVANCE
1801 RADIOLOGY 5905
PROCEDURES)
CT SCAN(ADVANCE
1802 RADIOLOGY 5898
PROCEDURES)
CT SCAN(ADVANCE
1803 RADIOLOGY PROCEDURES) 5899
CT SCAN(ADVANCE
1804 RADIOLOGY 5904
PROCEDURES)
1805 RADIOLOGY CT SCAN(ADVANCE 5916

PROCEDURES)
CT SCAN(ADVANCE
1806 RADIOLOGY 5920
PROCEDURES)
CT SCAN(ADVANCE
1807 RADIOLOGY 5906
PROCEDURES)
CT SCAN(ADVANCE

PROCEDURES)

PROCEDURES)
CT SCAN(ADVANCE
1811 RADIOLOGY 5918
PROCEDURES)
CT SCAN(ADVANCE
1812 RADIOLOGY 5897
PROCEDURES)

PROCEDURES)
CT SCAN(ADVANCE
1814 RADIOLOGY 5894
PROCEDURES)
CT SCAN(ADVANCE
1815 RADIOLOGY 5896
PROCEDURES)
CT SCAN(ADVANCE
1816 RADIOLOGY 5913
PROCEDURES)
CT SCAN(ADVANCE
1817 RADIOLOGY 5912
PROCEDURES)
CT SCAN(ADVANCE
1818 RADIOLOGY 5915
PROCEDURES)
CT SCAN(ADVANCE
1819 RADIOLOGY 5914
PROCEDURES)
CT SCAN(ADVANCE
1820 RADIOLOGY 5901
PROCEDURES)
CT SCAN(ADVANCE
CT SCAN(ADVANCE
1822 RADIOLOGY 5909
PROCEDURES)
CT SCAN(ADVANCE
1823 RADIOLOGY 5908
PROCEDURES)
CT SCAN(ADVANCE
1824 RADIOLOGY 5911
PROCEDURES)
CT SCAN(ADVANCE
1825 RADIOLOGY 5910
PROCEDURES)
CT SCAN(ADVANCE
1826 RADIOLOGY 5900
PROCEDURES)
1827 SEROLOGY PATHOLOGY 1447
1828 SEROLOGY PATHOLOGY 316
1829 SEROLOGY SEROLOGY 306

1851 SPECIAL BIOCHEMISTRY PATHOLOGY 243
1852 SPECIAL BIOCHEMISTRY PATHOLOGY 1207
1853 SPECIAL BIOCHEMISTRY special biochemisry 6474

1891 SURGERY GENERAL SURGERY CHARGE 6295






PAEDIATRIC SURGERY
2036 SURGERY 6505
CHARGES
PAEDIATRIC SURGERY
2037 SURGERY CHARGES 763
PEDIATRIC SURGERY
2038 SURGERY 6185
CHARGES
PEDIATRIC SURGERY
2039 SURGERY 6152
CHARGES
PEDIATRIC SURGERY
2040 SURGERY 6135
CHARGES
PEDIATRIC SURGERY
2041 SURGERY 6125
CHARGES
PEDIATRIC SURGERY
2042 SURGERY 6207
CHARGES
PEDIATRIC SURGERY
PEDIATRIC SURGERY
2044 SURGERY 6200
CHARGES
2045 SURGERY PEDIATRIC SURGERY 6153

CHARGES
PEDIATRIC SURGERY
2046 SURGERY 6204
CHARGES
PEDIATRIC SURGERY
2047 SURGERY 6201
CHARGES
PEDIATRIC SURGERY

CHARGES

CHARGES
PEDIATRIC SURGERY
2051 SURGERY 6196
CHARGES
PEDIATRIC SURGERY
2052 SURGERY 6208
CHARGES

CHARGES
PEDIATRIC SURGERY
2054 SURGERY 6157
CHARGES
PEDIATRIC SURGERY
2055 SURGERY 6139
CHARGES
PEDIATRIC SURGERY
2056 SURGERY 6186
CHARGES
PEDIATRIC SURGERY
2057 SURGERY 6197
CHARGES
PEDIATRIC SURGERY
2058 SURGERY 6158
CHARGES
PEDIATRIC SURGERY
2059 SURGERY 6159
CHARGES
PEDIATRIC SURGERY
2060 SURGERY 6161
CHARGES
PEDIATRIC SURGERY
PEDIATRIC SURGERY
2062 SURGERY 6163
CHARGES
PEDIATRIC SURGERY
2063 SURGERY 6164
CHARGES
PEDIATRIC SURGERY
2064 SURGERY 6165
CHARGES
PEDIATRIC SURGERY
2065 SURGERY 6140
CHARGES
PEDIATRIC SURGERY
2066 SURGERY 6141
CHARGES
PEDIATRIC SURGERY
PEDIATRIC SURGERY
2068 SURGERY 6142
CHARGES

CHARGES
PEDIATRIC SURGERY
2070 SURGERY 6169
CHARGES
PEDIATRIC SURGERY
2071 SURGERY 6155
CHARGES
PEDIATRIC SURGERY

CHARGES

CHARGES
PEDIATRIC SURGERY
2075 SURGERY 6170
CHARGES
PEDIATRIC SURGERY
2076 SURGERY 6199
CHARGES

CHARGES
PEDIATRIC SURGERY
2078 SURGERY 6126
CHARGES
PEDIATRIC SURGERY
2079 SURGERY 6171
CHARGES
PEDIATRIC SURGERY
2080 SURGERY 6148
CHARGES
PEDIATRIC SURGERY
2081 SURGERY 6172
CHARGES
PEDIATRIC SURGERY
2082 SURGERY 6143
CHARGES
PEDIATRIC SURGERY
2083 SURGERY 6173
CHARGES
PEDIATRIC SURGERY
2084 SURGERY 6174
CHARGES
PEDIATRIC SURGERY
PEDIATRIC SURGERY
2086 SURGERY 6215
CHARGES
PEDIATRIC SURGERY
2087 SURGERY 6175
CHARGES
PEDIATRIC SURGERY
2088 SURGERY 6176
CHARGES
PEDIATRIC SURGERY
2089 SURGERY 6189
CHARGES
PEDIATRIC SURGERY
2090 SURGERY 6184
CHARGES
PEDIATRIC SURGERY
PEDIATRIC SURGERY
2092 SURGERY 6190
CHARGES

CHARGES
PEDIATRIC SURGERY
2094 SURGERY 6188
CHARGES
PEDIATRIC SURGERY
2095 SURGERY 6127
CHARGES
PEDIATRIC SURGERY

CHARGES

CHARGES
PEDIATRIC SURGERY
2099 SURGERY 6179
CHARGES
PEDIATRIC SURGERY
2100 SURGERY 6214
CHARGES

CHARGES
PEDIATRIC SURGERY
2102 SURGERY 6181
CHARGES
PEDIATRIC SURGERY
2103 SURGERY 6149
CHARGES
PEDIATRIC SURGERY
2104 SURGERY 6193
CHARGES
PEDIATRIC SURGERY
2105 SURGERY 6151
CHARGES
PEDIATRIC SURGERY
2106 SURGERY 6194
CHARGES
PEDIATRIC SURGERY
2107 SURGERY 6144
CHARGES
PEDIATRIC SURGERY
2108 SURGERY 6128
CHARGES
PEDIATRIC SURGERY
PEDIATRIC SURGERY
2110 SURGERY 6162
CHARGES
PEDIATRIC SURGERY
2111 SURGERY 6136
CHARGES
PEDIATRIC SURGERY
2112 SURGERY 6166
CHARGES
PEDIATRIC SURGERY
2113 SURGERY 6203
CHARGES
PEDIATRIC SURGERY
2114 SURGERY 6206
CHARGES
PEDIATRIC SURGERY
PEDIATRIC SURGERY
2116 SURGERY 6183
CHARGES

CHARGES
PEDIATRIC SURGERY
2118 SURGERY 6154
CHARGES
PEDIATRIC SURGERY
2119 SURGERY 6145
CHARGES
PEDIATRIC SURGERY

CHARGES

CHARGES
UROLOGY SURGERY
2123 SURGERY 6117
CHARGES
UROLOGY SURGERY
2124 SURGERY 6400
CHARGES
2125 SURGERY UROLOGY SURGERY 6118

CHARGES
UROLOGY SURGERY
2126 SURGERY 6213
CHARGES
UROLOGY SURGERY
2127 SURGERY 6114
CHARGES
UROLOGY SURGERY
2128 SURGERY 6113
CHARGES
UROLOGY SURGERY
2129 SURGERY 6116
CHARGES
UROLOGY SURGERY
2130 SURGERY 6402
CHARGES
UROLOGY SURGERY
2131 SURGERY 6110
CHARGES
UROLOGY SURGERY
2132 SURGERY 6111
CHARGES
UROLOGY SURGERY
UROLOGY SURGERY
2134 SURGERY 6112
CHARGES
UROLOGY SURGERY
2135 SURGERY 6108
CHARGES
UROLOGY SURGERY
2136 SURGERY 6107
CHARGES
UROLOGY SURGERY
2137 SURGERY 6401
CHARGES
UROLOGY SURGERY
2138 SURGERY 6124
CHARGES
UROLOGY SURGERY
UROLOGY SURGERY
2140 SURGERY 6405
CHARGES

CHARGES
UROLOGY SURGERY
2142 SURGERY 6390
CHARGES
UROLOGY SURGERY
2143 SURGERY 6391
CHARGES
UROLOGY SURGERY

CHARGES

CHARGES
UROLOGY SURGERY
2147 SURGERY 6403
CHARGES
UROLOGY SURGERY
2148 SURGERY 6386
CHARGES

CHARGES
UROLOGY SURGERY
2150 SURGERY 6381
CHARGES
UROLOGY SURGERY
2151 SURGERY 6383
CHARGES
UROLOGY SURGERY
2152 SURGERY 6380
CHARGES
UROLOGY SURGERY
2153 SURGERY 6389
CHARGES
UROLOGY SURGERY
2154 SURGERY 6388
CHARGES
UROLOGY SURGERY
2155 SURGERY 6387
CHARGES
UROLOGY SURGERY
2156 SURGERY 6413
CHARGES
UROLOGY SURGERY
UROLOGY SURGERY
2158 SURGERY 6120
CHARGES
UROLOGY SURGERY
2159 SURGERY 6406
CHARGES
UROLOGY SURGERY
2160 SURGERY 6115
CHARGES
UROLOGY SURGERY
2161 SURGERY 6399
CHARGES
UROLOGY SURGERY
2162 SURGERY 6415
CHARGES
UROLOGY SURGERY
UROLOGY SURGERY
2164 SURGERY 6221
CHARGES

CHARGES
UROLOGY SURGERY
2166 SURGERY 6412
CHARGES
UROLOGY SURGERY
2167 SURGERY 6398
CHARGES
UROLOGY SURGERY

CHARGES

CHARGES
UROLOGY SURGERY
2171 SURGERY 6408
CHARGES
UROLOGY SURGERY
2172 SURGERY 6121
CHARGES

CHARGES
UROLOGY SURGERY
2174 SURGERY 6407
CHARGES
UROLOGY SURGERY
2175 SURGERY 6394
CHARGES
UROLOGY SURGERY
2176 SURGERY 6395
CHARGES
UROLOGY SURGERY
2177 SURGERY 6396
CHARGES
UROLOGY SURGERY
2178 SURGERY 6122
CHARGES
2179 ULTRA SOUND ULTRASOUND 5846



GENERAL EHS BIMA
TEST NAME
RATE RATE RATE
BDS INTERNSHIP LOG BOOK CHARGES 250 0 0
BDS LOG BOOK FOR COMMUNITY DENTISTRY 100 0 0
BDS LOG BOOK FOR ORAL ANATOMY AND HISTOLOGY 270 0 0
BDS LOG BOOK FOR PERIODONTICS 110 0 0
CERTIFICATE NSG. COMMUNITY HEALTH LOG BOOK 180 0 0
LIBERARY LATE FINE 0 0 0
LOG BOOK CURRICULUM MBBS 320 0 0
LOG BOOK FOR BDS CURRICULUM 140 0 0
LOG BOOK FOR BMIT 60 0 0
LOG BOOK FOR BSC MLT 3RD YEAR 630 0 0
LOG BOOK FOR BSC NURSING CURRICULUM 250 0 0
LOG BOOK FOR CERTIFICATE NURSING CURRICULUM 190 0 0
LOG BOOK FOR CLINICAL RECORDS GYNCEOLOGY 390 0 0
LOG BOOK FOR CONSERVATIVE DENTISTRY & ENDODONTICS 180 0 0
LOG BOOK FOR DENTAL MATERIA 250 0 0
LOG BOOK FOR FORENSIC MEDICINE & ODONTOLOGY 630 0 0
LOG BOOK FOR MBBS CURRICULUM 320 0 0
LOG BOOK FOR ORAL & MAXILLOFACIAL SURGERY 170 0 0
LOG BOOK FOR ORAL MEDICINE & RADIOLOGY 390 0 0
LOG BOOK FOR ORAL PATHOLOGY & MICROBIOLOGY 170 0 0
LOG BOOK FOR PEDODONTICS & PREVENTIVE MEDICINE 110 0 0
LOG BOOK FOR PERIODONTICS DEPARTMENT 160 0 0
LOG BOOK FOR PROSTHODONTICS 260 0 0

LOG BOOK FOR PUBLIC HEALTH DENTISTRY 250 0 0
LOG BOOK OF DELIVERY RECORD FOR NURSING MIDWIFERY 330 0 0
LOG BOOK OF ORTHODONTICS 250 0 0
M.SC CURRICULUM 250 0 0
M.SC. NSG. COMMUNITY HEALTH LOG BOOK 250 0 0
MBBS LOG BOOK FOR COMMUNITY MEDICINE 330 0 0
MBBS LOG BOOK FOR FORENSIC MEDICINE 250 0 0
MBBS LOG BOOK FOR GYNACOLOGY 400 0 0
MBBS LOG BOOK FOR INTERNSHIP 330 0 0
MBBS LOG BOOK FOR LABOR OBS/GYN 330 0 0
MBBS LOG BOOK FOR MEDICINE 460 0 0
MBBS LOG BOOK FOR PAEDIATRICS 250 0 0
MBBS LOG BOOK FOR PHYSIOLOGY 320 0 0
MBBS LOG BOOK FOR SURGERY 470 0 0
MSC NURSING CLINICAL POSTIING LOG BOOK 380 0 0
ANAESTHESIA FOR CT SCAN 1250 1880 2000
ANAESTHESIA FOR MANUPULATION 1250 1690 2000
CAUDAL 1880 2130 2000
CVP INSERTION CHARGE IN WARD 1290 1510 2000
EPIDURAL CATHETER INSERTION PER VISIT 0 380 0
EPIDURAL CATHETER INSERTION WITH 3 WARD VISITS 2610 2950 3000
FACET JOINT INJECTION 2370 2950 3000
GLOSSOPHARYNGEAL NERVE BLOCK 630 750 700
INJ. MORPHINE 10MG/ML 100 0 0

INJ. PETHEDINE 50MG/ML 110 0 0
INTERTICULAR JT. INJECTION/INTERCOSTAL NERVE BLOCK 1290 1510 2000
INTRAORBITAL BLOCK 630 790 700
LATERAL FEMORAL CUTANEOUS BLOCK 630 750 700
LOCAL /REGIONAL INFILTRATION 630 750 700
LUMBAR SYMPATHETIC BLOCK/ COELIC PLEXUS BLOCK CHEMICLA RF 2610 2950 3000
(RADIOFREQUENCY)
LUMBER/ THORACIC / CERVICAL 1880 2130 2000
MANDIBULAR BLOCK 1290 1510 2000
MAXILLARY BLOCK 1290 1510 2000
MENTAL NERVE BLOCK 630 750 700
MONITORED ANESTHESIA CARE 0 3750 0
MORE THAN 3 WARD VISITS EACH WARD VISIT 0 400 0
PAIN CLINIC OPD CONSULTATION FEE (15 DAYS) 0 500 0
PRE ANAESTHESIA CHECK UP (PAC) 120 550 0
SL JOINT INJECTION 2370 2950 3000
STELLATE GANGLION BLOCK 630 1260 850
SUBERAOBITAL / SUPRATROCHCHEAR 630 750 700
SYRUP MORPHINE 60 ML 140 0 200
TAB. MORPHINE 10 MG 10 0 0
TAB. MORPHINE 30 MG 10 0 0
TAB. MORPHINE PR 30 MG 20 0 0
BARR-BODY (HETERROCHROMATIN) EXAMINATION 210 380 0
KARYOTYPING (INDIVIDUAL) 3480 5060 0
MULTISHOT BAND LIGATOR 4540 4540 0

BED CHARGE 300 500 0
DHEAS. 0 0 0
DS DNA 0 0 0
ABG (ARTERIAL BLOOD GAS) ONE SAMPLE 760 1380 800
ACR 880 1590 900
ADENOSINE DEAMINASE (ADA) 1000 1500 575
ALBUMIN 130 240 100
ALKALINE PHOSPHATASE (ALP) 170 300 123
ALT (SGPT) 170 300 120
AMYLASE 230 380 200
APO A 800 1460 800
APO B 800 1460 800
AST (SGOT) 170 300 120
BILE PIGMENT (URINE) 110 200 200
BILE SALT 110 200 200
BILIRUBIN (DIRECT) 130 200 100
BILIRUBIN (TOTAL) 130 200 100
BILIRUBIN (TOTAL, DIRECT) 250 400 300
C3 600 1050 600
C4 600 1050 600
CALCIUM TOTAL 140 250 200
CERULOPLASMIN 930 1680 1000
CHOLINESTERASE 500 900 500
CHYLE 110 200 200

CREATINE KINASE MB 300 550 330
CREATINE KINASE TOTAL 250 460 215
CREATININE 120 190 100
CSF & OTHER BODY FLUID RE/ME 300 550 100
D-DIMER 800 1450 400
FASTING BLOOD SUGAR 70 120 100
GAMMA GT 160 280 105
GLUCOSE ( GTT) (4 SAMPLES) 280 460 240
GLUCOSE ( RANDOM ) 70 120 100
GLUCOSE (GCT ) 70 120 100
GLYCOSYLATED HAEMOGLOBIN (HBA1C) 850 1400 500
IL6 2350 4200 0
IONISED CALCIUM 300 500 400
IRON AND TIBC 800 1400 1100
LACTATEDEHYDRYGENASE (LDH) 250 450 310
LIPID PROFILE 1270 2000 600
LIPOPROTEIN LP (A) 810 1470 900
LIVER FUNCTION TEST (LFT) 1000 1600 460
MICROALBUMIN 700 1200 700
NA + K + CA + CL 850 1500 900
PCT (PROCALCITONINE) 2500 4550 0
PHOSPHORUS 150 250 185
POTASSIUM (K) 150 0 150
PP BLOOD SUGAR 70 120 100

PROTEIN IN SPOT URINE 250 460 300
QUANTITATIVE CRP (HS CRP) 800 1400 800
SERUM CHOLESTEROL (TOTAL) 250 400 150
SERUM COPPER 700 1270 700
SERUM CREATININE 120 190 100
SERUM ELECTROLYTES (SODIUM, POTASIUM) 400 700 400
SERUM FERRITIN 800 1450 500
SERUM HDL CHOLESTEROL 400 600 150
SERUM LDL CHOLESTEROL 450 750 150
SERUM LIPASE 450 800 332
SERUM LITHIUM 1000 1500 559
SERUM MAGNESIUM 400 700 300
SERUM TRIGLYCERIDE (TAG) 270 450 150
SERUM UREA 120 190 90
SODIUM (NA) 150 0 150
SUCROSE LYSIS TEST 660 1200 700
TOTAL PROTEIN 130 240 130
TOTAL PROTEIN IN URINE 250 460 160
TRANSFERRIN 1000 1520 1000
TROPONIN I (QUALITATIVE) 880 1450 715
UREA 120 190 90
URIC ACID 150 250 95
URINARY PROTEIN CREATININE RATIO 370 600 400
URINE ALBUMIN / CREATININE RATIO 820 1400 850

URINE AMYLASE 230 380 300
URINE CALCIUM 150 250 200
URINE CREATININE 130 230 200
URINE GLUCOSE 100 180 100
URINE PHOSPHOROUS 150 250 200
URINE URIC ACID 150 250 200
CORONORY ANGIOGRAPHY 0 0 0
ASD DEVICE CLOSURE 45000 0 45000
BPV/BAV (BALOON VALVOTOMY) 65000 0 72000
CAROTID DOPPLER 1380 2880 1500
CAROTID ENDARTERECTOMY 13800 28750 14000
CINEFLUROSCOPY FOR PROSTHETIC VALVE FUNCTION 1000 0 1000
CORONARY ANGIOGRAPHY (PACKAGE) 13800 26800 12000
CORONARY ANGIOPLASTY + STENTING (STENT EXTRA) (PACKAGE) 97750 201250 99000
DEPOSIT FOR PACEMAKING (TOTAL DEPOSITE WILL BE REIMBURSED

28750 69000 0
AFTER RETURNING THE PACEMAKER)
ELECTRO-PHYSIOLOGY STUDY 8050 18400 0
EPICARDIAL PACEMAKER 8050 18400 7000
EPS + RFA 46000 115000 50000
PACEMAKER PROGRAMMING 1000 0 1000
PDA DEVICE CLOSURE 40000 0 40000
PERICARDIOCENTESIS (PACKAGE) 5750 13800 3500
PERIPHERAL VASCULAR ANGIOGRAPHY WITHOUT DYE 8050 18400 9000
PERIPHERAL VASCULAR PROCEDURES 11500 27600 12000
PERMACATH PLACEMENT 5750 13800 6000

PERMANENT PACEMAKER IMPLANTATION (PACEMAKER GENRATOR
45000 0 45000
EXTRA) (PACKAGE)
PTMC 74750 115000 81000
RENAL ANGIOGRAPHY (PACKAGE) 10000 0 8000
RENAL PERIPHERAL ANGIOPLASTY (PACKAGE) 63250 143750 72000
RIGHT HEART CATHETERIZATION (OXIMETRY EXTRA ) WITHOUT

11500 27600 12000
CONTRAST (PACKAGE)
TEMPORARY PACEMAKER IMPLANTATION (PACKAGE) 5750 13800 6000
TEE 1600 2200 1500
TILTING TEST 1500 0 2000
TTE + TEE (PACKAGE) 2600 3200 3000
PDA DEVICE 122040 0 0
ALGINATE IMPRESSION SINGLE 390 660 0
ALL CERAMIC CROWN (LAB CHARGE EXTRA) 2750 5500 0
AMALGAM CLASS 2ND + CORE 770 1540 0
AMALGAM RESTORATION (CAPSULE) 660 1210 0
AMALGAM RESTORATION SILVER ALLOY POWDER 440 880 500
ANTERIOR + RCT APEXIFICATION 2750 4620 0
ANTERIOR RCT 2090 4180 0
ANTERIOR RCT (WITH 4 X-RAY) 2750 4840 0
ANTERIOR RCT WITH ROTARY FILES 3300 6050 0
BLEACHING NON- VITAL 770 1540 0
BLEACHING WITH OPALESCENT BOOST (1 SYRINGE) 3410 4950 0
CALCIUM HYDROCIDE DRESSING 390 550 0
CANAL CLEANING AND SHAPING WITH IOPAR 1100 2200 0
CAST POST (LAB CHARGE EXTRA) 1380 2530 0

CERAMIC INLAY (EXCLUDING LAB CHARGES) 2750 5500 0
CERAMIC ONLAY (EXCLUDING LAB CHARGES) 2750 5500 0
COMPOMER RESTORATION (DYRACT) 660 1210 0
COMPOSITE CORE BUILD UP 1870 3520 0
COMPOSITE RESTORATION LIGHT CURE ANTERIOR 1320 2640 0
COMPOSITE RESTORATION LIGHT CURE POSTERIOR 1490 2750 0
COMPOSITE RESTORATION LIGHT CURE WITH XENO APPLICATION 1430 2750 0
COMPOSITE SPLINT 1540 2750 0
COMPOSITE VENEER 1490 2750 0
CROWN CEMENTATION WITH GIC 550 1100 0
CROWN CEMENTATION WITH ZINC PHOSPHATE CEMENT 390 550 0
CROWN CUTTING 1930 3300 0
DESENSITIZING 390 770 0
EMERGENCY ACCESS 990 1980 0
FULL METAL AND PORCELAIN FUSED TO METAL CROWN WITH RUBBER

3030 5500 0
BASE IMPRESSION COMPOUND
FULL METAL CROWN (EXCLUDING LAB CHARGE) 1930 3300 0
GIC RESTORATION 550 1100 350
HEMISECTION / BICUSPIDIZATION 1650 3300 0
IRM RESTORATION 280 550 0
METAL INLAY (EXCLUDING LAB CHARGE) 1930 3300 0
METAL ONLAY (EXCULDING LAB CHARGE) 1930 3300 0
METAPEX DRESSING 390 550 0
MICACLE MIX RESTORATION 550 1100 0
OBTURATION WITH IOPAR 990 1980 0

PERIRADICULAR SURGERY WITH BONE GRAFT 2200 4400 0
PIT & FISSURE SEALANT 440 720 0
POLISHING AMALGAM RESTORATION (OLD) 170 330 0
PORCELAIN FUSED TO METAL CROWN (EXCLUDING LAB CHARGE) 1930 3300 0
POST CORE CASTING (LAB CHARGE EXTRA) 1380 2530 0
POST CORE PRE FEBRICATED (LAB CHARGE EXTRA) 1380 2530 0
POSTERIOR + RCT APEXIFICATION 2750 4620 0
POSTERIOR RCT (WITH 4 X-RAY) 3080 5500 0
POSTERIOR RCT + SCREW POST 2860 5720 0
POSTERIOR RCT LOWER 2530 4400 0
POSTERIOR RCT UPPER 2530 4400 0
POSTERIOR RCT WITH ROTARY FILES 3630 6820 0
RADICULAR SURGERY (ANTERIOR) 1870 3740 0
RADICULAR SURGERY (POSTERIOR) 2200 4400 0
RCT WITH ESTHTIC POST INCLUDING CEMENTATION 4400 8250 0
RE-TREATMENT (RE-RCT) 4000 7000 0
RUBBER BASE IMPRESSION SINGLE 1100 2200 0
RUBBER DAM APPLICATION 280 550 0
SIMPLE GRINDING 280 440 0
TEMPORARY CROWN COLD CURE 330 550 0
TEMPORARY CROWN HEAT CURE 330 550 0
TEMPORARY RESTORATION WITH ZINC OXIDE EUGENOL 170 280 0
TRICALCIUM SILICAFE CEMENTS 1870 2750 0
TRIPLE ANTIBIOTIC PASTE DRESSING 280 550 0

ULTRASONIC RETROPREPARATION 1320 2420 0
BA ENEMA (14X17) 2 FILMS 2150 2700 3000
BA FOLLOW THROUGH (14X17) 2 FILMS 2150 2700 3000
BA MEAL (14X17) 2 FILMS 2150 2700 3000
BA SWALLOW (14X17) 1 FILM 2150 2700 3000
BREAST DUCTOGRAPHY (BOTH BREAST) 3500 4500 4000
BREAST DUCTOGRAPHY (SINGLE BREAST) 2150 2700 3000
CYSTOGRAM (14X17) 1 FILM 1800 2350 2000
DISTAL COLONOGRAM (14X17) 2 FILMS 2150 2700 3000
DOUBLE EXPOSURE 10X12 (1 FILM) 430 450 450
DOUBLE EXPOSURE 10X12 (2 FILMS) 480 510 500
FISTULOGRAM / SINOGRAM (14X17) 1 FILM 2000 2600 1170
GASTROGRAPHY (14X17) 1 FILM 2000 2600 2000
HSG (14X17) 2 FILMS 2300 3000 3500
IVU (14X17) 2 FILMS 2150 2700 3000
MAMMOGRAPHY (BOTH BREAST) 2400 3250 3000
MAMMOGRAPHY (SINGLE BREAST) 1450 1900 875
MICTURATING CYSTOURETHROGRAM (MCU) - (14X17) 2 FILMS 2150 2700 2500
MULTIPLE EXPSURE 14X17 (1 FILM) 550 560 650
MYELOGRAM (14X17) 2 FILMS 2150 2700 2000
NEPHROSTOGRAM (14X17) 1 FILM 1800 2350 2000
RETROGRADE URETHROGRAM (RGU) - (14X17) 2 FILMS 2150 2700 2500
RGU + MCU 3500 4500 4000
SIALOGRAM (14X17) 1 FILM 1800 2350 2000

SINGLE EXPOSURE 10X12 (1 FILM) 360 390 400
T-TUBE CHOLANGIOGRAM (14X17) 1 FILM 1800 2350 1250
TRIPLE EXPOSURE 10X12 (2 FILMS) 490 510 550
VENOGRAM (14X17) 2 FILMS 2150 2700 3000
AAA REPAIR (COST OF GRAFT EXTRA) 60000 0 63000
ASD/PAPVC/PULMONARY VALVOTOMY/BD GLENN 60000 0 63000
AV FISTULA UNDER REGIONAL BLOCK 12000 24000 12000
BT SHUNT/PA BANDING/ EPICARDIAL PACEMAKER IMPLANTATION 40000 0 40000
CABG 80000 0 81000
CABG + MVR/AVR (COST OF VALVE EXTRA) 80000 0 81000
COA REPAIR 40000 0 40000
CTVS OT CHARGE WITHOUT CONSUMABLES 60000 0 63000
EMBOLECTOMY UNDER GA 30000 55000 30000
EMBOLECTOMY UNDER LA 20000 38000 20000
LUNG LOBECETOMY / PNEUMONECTOMY 50000 90000 50000
MVR/AVR/DVR/VALVE REPAIR (COST OF VALVE AND RING EXTRA) 80000 0 81000
OPEN THORACOSTOMY/PC WINDOW 5000 10000 5000
PDA LIGATION 40000 0 40000
PERICARDECTOMY 60000 0 63000
PERICARDIOTOMY 30000 0 30000
PERIPHERAL VASCULAR SURGERY (COST OF GRAFT EXTRA) 50000 0 50000
PERMANENT CATHETER INSERTION 6000 12000 9000
STERNAL WIRE REMOVAL 12000 0 12000
THORACOTOMY 30000 60000 30000

TOF/TAPVC/AS/COMPLEX CONGENITAL 80000 0 81000
VARICOSE VEIN SURGERY 18000 36000 18000
VSD 70000 0 72000
LEFT HEART CATHETERIZATION (PACKAGE) 11500 27600 12000
TEMPORARY DIALYSIS CATHETER INSERTION 5000 7500 9000
AORTIC CANNULA 8000 0 0
AORTIC CANNULA STRAIGHT 4000 0 0
AV FISTULA CREATION LA 8000 16000 8000
BIOPROSHTHESIS VALVE 180000 0 0
CARDIOPLEGIA CANNULA - ANTEGRADE WITHOUT VENT 8000 0 0
CARDIOPLEGIA CANNULA - ANTEGRADE WITHOUT VENT (5FR) 8000 0 0
CARDIOPLEGIA CANNULA - ANTEGRADE WITHOUT VENT (9FR) 8000 0 0
CARDIOPLEGIA CANNULA RETROGRADE 11FR 22000 0 0
CARDIOPLEGIA DELIVERY SET 14000 0 0
CUSTOM PACK - ADULT 16000 0 0
CUSTOM PACK - NEONATE 17000 0 0
CUSTOM PACK - PAEDIATRIC 19000 0 0
DUAL STAGE VENOUS CANNULA 6500 0 0
HEMOCONCENTRATOR WITH HOLDER - ADULT 15000 0 0
HEMOCONCENTRATOR WITH HOLDER - PEDIATRIC 15000 0 0
MECHANICAL HEART VALVE 75000 0 0
OXYGENATOR - ADULT 36000 0 0

OXYGENATOR - NEONATE 40000 0 0
OXYGENATOR - PEDIATRIC 36000 0 0
RING 70000 0 0
STRAIGHT CONNECTOR WITH LEUR LOCK 3300 0 0
VALVE 75000 0 0
VENOUS CANNULA SINGLE STAGE ANGLED 6000 0 0
VENOUS CANNULA SINGLE STAGE STRAIGHT 6000 0 0
Y CONNECTOR WITH LUER LOCK 1500 0 0
ENDOVENOUS LASER ABLATION (EVLA) ONE SIDE 40500 65000 45000
AV FISTULA SURGERY (PACKAGE) 10200 16500 12000
VARICOSE VEIN SURGERY (PACKAGE) 23100 36100 0
CAROTID ANGIOPLASTY (PACKAGE) 46000 115000 50000
12 CHANEL ECG HOLTER 2000 2400 2000
24 HR ABPM 2000 2400 1000
E.C.G. (GENERAL) 250 350 200
ECHOCARDIOGRAPHY (TTE, GENERAL) 1600 2200 1050
STRESS ECHO 2500 3200 2000
TMT (GENERAL) 2300 2760 1500
ASD DEVICE 169500 0 0
BRONCHOSCOPY SPECIMEN ( I.E BRUSH, ASPIRATE, WASHING &

660 1200 700
BRONCHOALVEOLAR LAVAGE)
EXFOLIATIVE CYTOLOGY 1200 2000 2000
FNAC 1270 2300 510
LIQUID BASE CYTOLOGY 1200 2000 2000
PAP SMEAR 1000 2000 315

SLIDE FOR CONSULTATION (REPORTING ONLY SLIDES RECEIVED) 0 600 0
ULTRASOUND FOR FNAC 660 700 850
ACNE SCAR REVISION 1500 3000 0
BIOPSY EXCISION 1500 3000 2000
CHEMICAL CAUTERY (PER SITTING) 500 1100 500
CHEMICAL PEELING (3 SITTING) 1500 3000 0
CO2 LASER SURGERY 1500 3000 0
DERMABRASION ( PACKAGE) 1500 3000 0
DERMASCOPY (PER SITTING) 130 250 0
ELECTRO CAUTERY (PER SITTING) 1000 2000 500
EPILATION 1500 3000 0
FOCUSSED PHOTOTHERAPY (15 SITTINGS) 1500 3000 0
INRA VENUS PULSE THERAPY 3 DAYS (RS. 50.00 PER DAY) 200 400 0
INTENSIVE PULSED LIGHT (IPL) (FOR 1ST 3 CM2) 2000 4000 0
INTENSIVE PULSED LIGHT (IPL) (FOR ADDITIONAL PER CM2) 300 600 0
INTOPHORESIS ( 4 SITTING) 1500 3000 0
INTRA LESIONAL (PER SITTING) 500 1100 500
MICRODERMABRASION (PER SITTING) 600 1100 0
MULTIUTILITY PHOTOTHERAPY (15 SITTINGS) 1500 3000 0
NAIL AVULSION WITH LATERAL MATERECTOMY 1500 3000 2000
NEEDLING (PER SITTING) 500 1100 500
NEURONOX/UNIT 600 1100 0
PARING (2 PER SITTING) 500 1100 500
PATCH TESTING 1500 3000 0

PUNCH BIOPSY (PER SITTING) 1000 2000 1000
Q-SWITCH ND: YAG LASER (FOR 1ST 3 CM2) 1650 3000 0
Q-SWITCH ND: YAG LASER (FOR ADDITIONAL PER CM2) 280 600 0
RADIO CAUTARY 1000 2000 1000
SIF ANALYSIS (PER SITTING) 300 600 0
SMEAR PREPARATION & STAINING 100 200 0
STERILE DRESSING ( PER SITTING) 100 200 65
STITCH REMOVAL ( PER SITTING) 100 200 250
TATTOO REMOVAL 1500 3000 0
VETILIGO SURGERY (PER 10 CM2 AREA) 1500 3000 0
WHOLE BODY PHOTOTHERAPY (15 SITTING) 1500 3000 0
PULSE THERAPY (FOR 3 DAYS) 1035 0 200
DIODE LASER - AMPRIT/ PUBIC (PER SITTING) 3500 5000 0
DIODE LASER - EXTREMITIES/BLACK (PER SITTING) 5000 8000 0
DIODE LASER - FACE (PER SITTING) 2500 3500 0
MICRONEEDLING (PER SITTING) 600 1000 0
PRP/PRF INJECTION (PER SITTING) 1000 2000 0
ACUTE HAEMODIALYSIS FOR THREE SESSION 10190 0 0
MAINTENANCE HAEMODIALYSIS 4 1920 0 0
EMERGENCY VISITOR CARD DEPOSIT (REFUNDABLE) 500 0 0
ATTICOTOMY GA 11000 25000 12000
ATTICOTOMY LA 8800 20000 9000
AURICAL RECONSTRUCTION GA 15000 27500 16000
AURICAL RECONSTRUCTION LA 8800 20000 9000

CANALPLASITY GA 12100 27500 13500
CANALPLASITY LA 8800 20000 9000
CEREBEROPONTINE ANGLE SURGERY GA 12100 27500 13500
CEREBEROPONTINE ANGLE SURGERY LA 11000 20000 12000
COCHLEAR IMPLANTS GA 23100 52000 25000
COCHLEOSACCULOTOMY GA 12100 27500 13500
COCHLEOSACCULOTOMY LA 11000 20000 12000
COMBINED APPROACH TYMPANOPLASTRY GA 13200 30000 13500
COMBINED APPROACH TYMPANOPLASTRY LA 11000 25000 12000
CORTICAL MASTOIDECTOMY GA 12100 27500 13500
CORTICAL MASTOIDECTOMY LA 9900 22000 10000
CYST ON/ AROUND PINNA GA 9900 25000 10000
CYST ON/ AROUND PINNA LA 8800 15000 9000
ENDOLYMPHATIC SAC DECOMPRESSION GA 12100 27500 13500
ENDOLYMPHATIC SAC DECOMPRESSION LA 11000 20000 12000
EPITYMPANOTOMY GA 11000 25000 12000
EPITYMPANOTOMY LA 8800 21000 9000
FACIAL NERVE DECOMPRESSION SURGERY GA 15000 27500 16000
FACIAL NERVE DECOMPRESSION SURGERY LA 12100 25000 13500
FACIAL REANIMATION GA 12100 27500 13500
FACIAL REANIMATION LA 11000 20000 12000
FOREIGN BODY EAR REMOVAL GA 9900 22500 10000
FOREIGN BODY EAR REMOVAL LA 6600 15000 7000
GROMMET INSERTION GA 9900 22500 10000

GROMMET INSERTION LA 6600 15000 7000
INTRATYMPANIC INJECTION GA 9900 22500 10000
INTRATYMPANIC INJECTION LA 3500 7000 5000
LABYRINTHECTOMY GA 12100 27500 13500
LABYRINTHECTOMY LA 11000 20000 12000
LOBULOPLASTY GA 9900 22500 10000
LOBULOPLASTY LA 3500 7000 6000
LOBULOTOMY GA 9900 22500 10000
LOBULOTOMY LA 6600 15000 7000
MODIFIED RADICAL MASTOIDECTOMY GA 15000 30000 16000
MODIFIED RADICAL MASTOIDECTOMY LA 11000 25000 12000
MYRINGOPLASTY GA 12100 27500 13500
MYRINGOPLASTY LA 8800 21000 9000
PETROUS APEX SURGERY (PETROSECTOMY) GA 12100 27500 13500
PETROUS APEX SURGERY (PETROSECTOMY) LA 11000 20000 12000
PINNECTOMY GA 12100 27500 13500
PINNECTOMY LA 8800 20000 9000
POST AURAL ABSCESS DRAINAGE GA 9900 22500 10000
POST AURAL ABSCESS DRAINAGE LA 6600 15000 7000
POST FURUNCLE GRANULATION SCOOPING GA 9900 22500 10000
POST FURUNCLE GRANULATION SCOOPING LA 6600 15000 7000
PREAURICULAR SINUS TRACT EXCISION GA 12100 27500 13500
PREAURICULAR SINUS TRACT EXCISION LA 8800 17600 9000
RADICAL MASTOIDECTOMY GA 15000 30000 16000

RADICAL MASTOIDECTOMY LA 11000 25000 12000
STAPEDECTOMY GA 12100 27500 13500
STAPEDECTOMY LA 8800 22000 9000
TYMPANOPLASTY GA 12100 27500 13500
TYMPANOPLASTY LA 9900 25000 10000
TYMPANOTOMY GA 9900 22500 10000
TYMPANOTOMY LA 5500 15000 6000
VESTIMULAR NEURECTOMY GA 12100 27500 13500
VESTIMULAR NEURECTOMY LA 11000 20000 12000
AVULSION OF A.C. POLYP GA 11000 25000 12000
AVULSION OF A.C. POLYP LA 7700 15000 8000
CALLDWELL- LUC OPERATION GA 11000 25000 12000
CALLDWELL- LUC OPERATION LA 8800 18000 9000
CLOSER OF OROANTRAL FISTULA GA 12100 27500 13500
CLOSER OF OROANTRAL FISTULA LA 8800 15000 9000
DENKERS OPERATION GA 12000 25000 12000
DENKERS OPERATION LA 8800 18000 9000
ETHMOIDAL VESSEL LIGATION GA 12100 30000 13500
ETHMOIDAL VESSEL LIGATION LA 9900 25000 10000
EXTERNAL/INTERNAL ETHMOIDECTOMY GA 12100 30000 13500
EXTERNAL/INTERNAL ETHMOIDECTOMY LA 9900 25000 10000
EXTRACRANIAL REPAIR OF CSF RHINORRHOEA GA 13750 30500 14000
EXTRACRANIAL REPAIR OF CSF RHINORRHOEA LA 12100 25000 13500
FACIOMASILLARY FRACTURE REDUCTION GA 12100 30000 13500

FACIOMASILLARY FRACTURE REDUCTION LA 12100 18000 13500
FESS GA 15000 30000 16000
FESS LA 9900 25000 10000
FESS WITH NAVIGATION GA 20000 34000 20000
FESS WITH POWERED INSTRUMENTS (MICRODIBRIDER) GA 18000 32000 18000
FLAP RECONSTRUCTION GA 15000 30000 16000
FLAP RECONSTRUCTION LA 12020 31050 12000
FOCAL SUBMUCOSAL DIATHERMY GA 8800 20000 9000
FOCAL SUBMUCOSAL DIATHERMY LA 6600 15000 7000
INTRANASAL ANTROSTOMY GA 9900 22500 10000
INTRANASAL ANTROSTOMY LA 6325 17250 7000
JANSEN - HORGAN OPERATION GA 11000 25000 12000
JANSEN - HORGAN OPERATION LA 8800 18000 9000
LATERAL ORBITOTOMY/CRANIOTOMY GA 13750 30500 14000
LATERAL ORBITOTOMY/CRANIOTOMY LA 12100 22000 13500
LATERAL RHINOTOMY GA 12100 27500 13500
LATERAL RHINOTOMY LA 8800 23000 9000
LYNCH- HOWERTH PROCEDURE GA 12100 30000 13500
LYNCH- HOWERTH PROCEDURE LA 12100 25000 13500
MAXILLARY ARTERY LIGATION GA 12100 30000 13500
MAXILLARY ARTERY LIGATION LA 9900 20000 10000
MIDFACIAL DEGLOVING APROACH GA 15000 30000 16000
MIDFACIAL DEGLOVING APROACH LA 8800 23000 9000
MODIFIED YONGS OPERATION GA 9900 22500 10000

MODIFIED YONGS OPERATION LA 7700 15000 8000
NASAL BONE FRACTURE REDUCTION GA 12000 24000 12000
NASAL BONE FRACTURE REDUCTION GA 11500 28750 12000
NASAL BONE FRACTURE REDUCTION LA 5500 15000 6000
NASAL BONE FRACTURE REDUCTION LA 10000 15000 10000
NECK DISSECTION GA 16000 32000 16000
NECK DISSECTION LA 11000 27000 12000
OSTEOPLASTIC FRONTAL FLAP OPERATION GA 14300 32500 16000
OSTEOPLASTIC FRONTAL FLAP OPERATION LA 12100 25000 13500
PARTIAL / TOTAL MAXILLECTOMY GA 12500 30500 14000
PARTIAL / TOTAL MAXILLECTOMY LA 11000 25000 12000
PATTERSON OPERATION GA 12100 30000 13500
PATTERSON OPERATION LA 9900 18000 10000
REMOVAL OF FOREIGN BODY NOSE GA 9900 22500 10000
REMOVAL OF FOREIGN BODY NOSE LA 5500 15000 6000
RHINOPLASTY GA 15000 30000 16000
RHINOPLASTY LA 11000 20000 12000
RHINOSEPTOPLASTY GA 12100 27500 13500
RHINOSEPTOPLASTY LA 11000 23000 12000
SEPTAL PERFORATION CLOSER GA 9900 22500 10000
SEPTAL PERFORATION CLOSER LA 6600 15000 7000
SEPTOPLASTY GA 12650 28750 13500
SEPTOPLASTY LA 8800 15000 9000
SUBMUCOUS RESECTION NASAL SEPTUM GA 12650 25000 13500

SUBMUCOUS RESECTION NASAL SEPTUM LA 8800 18000 9000
SURGICAL DRAINSE SEPTAL ABSCESS GA 9900 22500 10000
SURGICAL DRAINSE SEPTAL ABSCESS LA 6600 15000 7000
SURGICAL DRAINSE SEPTAL HAEMATOMA GA 9900 22500 10000
SURGICAL DRAINSE SEPTAL HAEMATOMA LA 6600 15000 7000
THYRODECTOMY + NECK DISSECTION GA 15000 30000 16000
THYRODECTOMY + NECK DISSECTION LA 12000 24000 12000
TOTAL LARYNGECTOMY GA 20000 40000 20000
TOTAL LARYNGECTOMY LA 12020 31050 12000
TOTAL MAXILLECTOMY GA 15000 32000 16000
TOTAL MAXILLECTOMY LA 10450 27000 12000
TRANS- SPHENOIDAL HYPOPHYSECTOMY GA 16000 32500 16000
TRANS- SPHENOIDAL HYPOPHYSECTOMY LA 12100 25000 13500
TRANSANTRAL VIDIAN NURTECTOMY GA 12100 30000 13500
TRANSANTRAL VIDIAN NURTECTOMY LA 9900 20000 10000
TREPHINE OF FRONTAL SINUS GA 12100 30000 13500
TREPHINE OF FRONTAL SINUS LA 8800 20000 9000
TUMOR RESECTION WITH RECONSTRUCTION NOSE GA 15000 30000 16000
TUMOR RESECTION WITH RECONSTRUCTION NOSE LA 9900 25000 10000
TURBINECTOMY GA 9900 22500 10000
TURBINECTOMY LA 7700 15000 8000
YOUNGS OPERATION GA 9900 22500 10000
YOUNGS OPERATION LA 7700 15000 8000
ANKYLOGLOSSIA SURGERY GA 12000 24000 16000

ANKYLOGLOSSIA SURGERY LA 7700 9000 8000
ANTERN LATERAL THIGH FLAP GA 16500 30000 18000
DNE GA 2750 5000 3000
DNE LA 1100 2000 2000
ENDOSCOPIC DCR GA 16500 30000 18000
ENT MINOR OT 3500 6500 2500
EXAMINATION UNDER MICROSCOPE GA 5500 7000 6000
EXAMINATION UNDER MICROSCOPE LA 1100 1500 2000
EXCISION BIOPSY OF LOCAL MASS GA 9900 25000 10000
EXCISION BIOPSY OF LOCAL MASS LA 5500 15000 6000
EXCISION OF BLEEDING POLYPUS GA 9900 25000 10000
EXCISION OF BLEEDING POLYPUS LA 5500 15000 6000
EXCISION OF DERMOID CYST GA 9900 25000 10000
EXCISION OF DERMOID CYST LA 5500 15000 6000
EXCISION OF RHINOSPORIDIOSIS GA 12500 25000 13500
EXCISION OF RHINOSPORIDIOSIS LA 7700 18000 8000
EXCISION OF SEBACEOUS CYST GA 9900 25000 10000
EXCISION OF SEBACEOUS CYST LA 5500 15000 6000
EXCSION OF FIBROMA/ LIPOMA / PAPILLOMA/ KELOID GA 9900 25000 10000
EXCSION OF FIBROMA/ LIPOMA / PAPILLOMA/ KELOID LA 5500 15000 6000
FREE - FIVULA FLAP GA 20000 38000 20000
LASER (TOLS) MAJOR (TRANS ORAL LASER SURGERY) GA 16500 30000 18000
LASER LA 5500 11000 6000
LASER TONSILLECTOMY GA 16500 30000 18000

MEDIAL SURAL ATERIAL PERFORATOR FLAP GA 13200 24000 13500
MINOR OT CHARGE ENT 3220 0 2500
MLS WITH LASER GA 16500 30000 18000
NAVIGATION ASSISTED ENDOSCOPIC SURGERY GA 27500 42000 30000
RADIAL ARTERY FARE - ARM FLAP GA 15000 30000 16000
REPAIR OF CUT THROAT INJURIES GA 15000 30000 16000
REPAIR OF CUT THROAT INJURIES LA 11000 25000 12000
SCAPULA FREE FLAP GA 17600 32000 18000
SECONDARY SUTURE OF WOUND GA 9900 25000 10000
SECONDARY SUTURE OF WOUND LA 5500 15000 6000
SEPTOPLASTY WITH FESS GA 18000 36000 18000
SKULL BASE SURGERY GA 16500 35000 18000
SKULL BASE SURGERY LA 12100 25000 13500
WIDE LOCAL EXAMINATION + NECK DISSECTION + FREE FLAP 20000 40250 22500
RECONSTRUCTION GA
WIDE LOCAL EXCISION + NECK DISSECTION GA 16500 30000 18000
WIDE LOCAL EXCISION WITH LASER GA 16500 30000 18000
ADENOIDECTOMY GA 15000 22500 16000
ADENOIDECTOMY LA 6600 15000 7000
ADENOTONSILLECTOMY GA 12100 27500 13500
ADENOTONSILLECTOMY LA 9900 25000 10000
ADENOTONSILLECTOMY WITH POWERED INSTRUMENTS GA 16500 30000 18000
BRANCHIAL CYST, SINUS, FISTULA GA 11000 27000 12000
BRANCHIAL CYST, SINUS, FISTULA LA 7700 25000 8000
CLASSIC RADICAL NECK DISSECTION GA 16500 35000 18000

CLASSIC RADICAL NECK DISSECTION LA 12100 27000 13500
CLEFT LIP/ PLATE REPAIR GA 16500 35000 18000
CLEFT LIP/ PLATE REPAIR LA 12100 25000 13500
CLOSERE OF PHARYNGOCUTANEOUS FISTUL GA 9900 22500 10000
CLOSERE OF PHARYNGOCUTANEOUS FISTUL LA 0 15000 0
COMMANDO OPERATION GA 20000 40000 20000
COMMANDO OPERATION LA 12100 27000 13500
DIRECT LARYNGOSCOPY/ BRONCHOSCOPY GA 11000 25000 12000
DIRECT LARYNGOSCOPY/ BRONCHOSCOPY LA 8800 20000 9000
DIVERTICULECTOMY GA 11000 25000 12000
DIVERTICULECTOMY LA 8800 15000 9000
DIVISION OF STYLOID PROCESS GA 16000 32000 16000
DIVISION OF STYLOID PROCESS LA 8800 25000 9000
DL BIOPSY GA 12100 25000 13500
DL BIOPSY LA 7700 15000 8000
DOHLMAN OPERATION GA 11000 25000 12000
DOHLMAN OPERATION LA 8800 15000 9000
DRAINAGE OF NECK SPACE ABSCESS GA 11000 25000 12000
DRAINAGE OF NECK SPACE ABSCESS LA 8800 15000 9000
ENUCLEATION OF CYST GA 11000 25000 12000
ENUCLEATION OF CYST LA 7700 15000 8000
ESOPHAGIAL SURGERY GA 20000 35000 20000
ESOPHAGIAL SURGERY LA 12100 25000 13500
EXCISION OF ANGIOFIBROMA NASOPHARYNX GA 16500 35000 18000

EXCISION OF ANGIOFIBROMA NASOPHARYNX LA 12100 27000 13500
EXTENDED TOTAL PAROTIDECTOMY GA 18000 36000 18000
EXTENDED TOTAL PAROTIDECTOMY LA 11000 27000 12000
EXTERNAL CARTID ARTERY LIGATION GA 9900 22500 10000
EXTERNAL CARTID ARTERY LIGATION LA 7700 15000 8000
FUNCTIONAL NECK DISSECTION GA 16500 35000 18000
FUNCTIONAL NECK DISSECTION LA 12100 25000 13500
HEMITRYROIDECTOMY GA 15000 32000 16000
HEMITRYROIDECTOMY LA 11000 25000 12000
HORIZONAL PARTIAL LARYNGECTOMY GA 16500 35000 18000
HORIZONAL PARTIAL LARYNGECTOMY LA 12100 25000 13500
INFRATEMPORAL FOSSA APPROACH GA 16500 35000 18000
INFRATEMPORAL FOSSA APPROACH LA 12100 25000 13500
LARYNGOTOMY GA 16500 35000 18000
LARYNGOTOMY LA 12100 30000 13500
LIP CANCER SURGERY & RECONSTRUCTION GA 16500 35000 18000
LIP CANCER SURGERY & RECONSTRUCTION LA 13915 28750 14000
MARSUPIALISATION OF CYST GA 11000 25000 12000
MARSUPIALISATION OF CYST LA 7700 15000 8000
MARSUPIALISATION OF CYST GA 11000 22500 12000
MARSUPIALISATION OF CYST LA 7700 15000 8000
MICROLARYNGEAL SURGERY GA 12100 25000 13500
MICROLARYNGEAL SURGERY LA 8800 18000 9000
MODIFIED RADICAL NECK DISSECTION GA 16500 35000 18000

MODIFIED RADICAL NECK DISSECTION LA 12100 27000 13500
NASOPHARYNGECTOMY GA 16500 35000 18000
NASOPHARYNGECTOMY LA 12100 27000 13500
ORAL CANCER SURGERY GA 16500 35000 18000
ORAL CANCER SURGERY LA 12100 25000 13500
PARAPHARYNGEAL SPACE APPROACH GA 16500 35000 18000
PARAPHARYNGEAL SPACE APPROACH LA 12100 25000 13500
PARTIAL PHARYNGECTOMY GA 16500 35000 18000
PARTIAL PHARYNGECTOMY LA 12100 27000 13500
PHARYNGOLARYNGCETOMY GA 20000 40000 20000
PHARYNGOLARYNGCETOMY LA 13200 25000 13500
PHARYNGOTOMY GA 16500 35000 18000
PHARYNGOTOMY LA 12100 25000 13500
RAGID ESOPHAGOSCOPY GA 11000 22000 12000
RAGID ESOPHAGOSCOPY LA 7700 22000 8000
REMOVAL OF LARYNGOCELE GA 16500 35000 18000
REMOVAL OF LARYNGOCELE LA 12100 25000 13500
REPAIR OF ORAL/ PHARYNGOCUTANEOUS FIS GA 11000 25000 12000
REPAIR OF ORAL/ PHARYNGOCUTANEOUS FIS LA 8800 15000 9000
SELECTIVE NECK DISSECTION GA 16500 35000 18000
SELECTIVE NECK DISSECTION LA 12100 27000 13500
SISTRUNK OPERATION GA 11000 25000 12000
SISTRUNK OPERATION LA 7700 22000 8000
SUBMANDIBULAR SALIVARY GLAND EXCISION GA 12000 27000 12000

SUBMANDIBULAR SALIVARY GLAND EXCISION LA 9000 23000 9000
SUBTOTAL LARYNGECTOMY GA 16500 35000 18000
SUBTOTAL LARYNGECTOMY LA 12100 25000 13500
SUPERFICIAL PAROTIDECTOMY GA 15000 30000 16000
SUPERFICIAL PAROTIDECTOMY LA 11000 25000 12000
SURGERY FOR LARYNGEAL/ TRACHEAL STEN GA 16500 35000 18000
SURGERY FOR LARYNGEAL/ TRACHEAL STEN LA 12100 25000 13500
SURGERY FOR CHOANAL ATRESIA GA 16500 35000 18000
SURGERY FOR CHOANAL ATRESIA LA 12100 25000 13500
THYROPLASTY GA 15000 30500 16000
THYROPLASTY LA 10450 25000 12000
TONSILLECTOMY GA 15000 27500 16000
TONSILLECTOMY LA 8800 23000 9000
TOTAL LARYNGECTOMY & GLOSSECTOMY GA 20000 35000 20000
TOTAL LARYNGECTOMY & GLOSSECTOMY LA 12100 27000 13500
TOTAL PAROTIDECTOMY GA 18000 36000 18000
TOTAL PAROTIDECTOMY LA 11000 27000 12000
TOTAL/SUBTOTAL THYROIDECTOMY GA 18000 36000 18000
TOTAL/SUBTOTAL THYROIDECTOMY LA 8800 27000 9000
TRACHEOSTOMY & DL BIOPSY GA 12100 25000 13500
TRACHEOSTOMY & DL BIOPSY LA 9900 20000 10000
TRACHEOSTOMY GA 12100 25000 13500
TRACHEOSTOMY LA 7700 15000 8000
UVULOPALATO PHARYNGOPLASTY GA 16500 35000 18000

UVULOPALATO PHARYNGOPLASTY LA 12100 25000 13500
VERTICAL PARTIAL LARYNGECTOMY GA 16500 35000 18000
VERTICAL PARTIAL LARYNGECTOMY LA 12100 25000 13500
ANTERIOR NASAL PACKING, PUNCH BIOPSY, CHEMICAL CAUTERY,

INCISION AND DRAINAGE, STICH REMOVAL, SUTURI 330 600 400
ANTRUM WASH 363 600 400
CALORIE TEST 420 1000 500
ELECTRO CAUTERY / CHEMICAL CAUTERY 220 600 500
FLEXIBLE ENDOSCOPY 770 1400 600
FOREIGN BODY REMOVAL ( NOSE/EAR) LA 1000 2000 1000
MICRODEBRIDER CHARGES 3850 0 4000
POSTERIOR NASAL PACKING 500 1000 500
SYRINGING EAR AND IG PACKING 0 220 300 300
BERA 968 2000 1000
ELECTRO NYSTAGANO GRAPHY 847 1500 850
HEARING AID TRIAL 385 700 400
IMMPENDENCE 240 500 300
OAE 605 1500 0
PURE TONE AUDIOMETRY 600 1000 325
SPECIAL AUDIOMETRY 1000 1500 1000
SPEECH AUDIOMETRY 380 700 400
SPEECH THERAPY (1 - 4 SESSION) 847 1500 850
BOUGIE DILATION OF ESOPHOUGUS 2300 4600 3000
BRONCHOSCOPY (GENERAL) 1150 1730 2000
COLONOSCOPY 4000 7000 5000

COLONSCOPY WITH SEDATIVE 6900 9200 7000
ENDOSCOPIC HEMOSPRAY 580 920 600
ENDOSCOPIC POLYPECTOMY 1800 3800 2000
ENDOSCOPIC VARICEAL BANDING LIGATION (EVBL) 1800 3800 2000
ENDOSCOPY ELECTROCOAGULATION 920 1380 1000
ENDOSCOPY INJECTION THERAPY 920 1380 1000
ENDOSCOPY SERVICES WITH OR WITHOUT BIOPSY (GENERAL) 1800 3200 1000
ENDOSCOPY WITH SEDATIVE 3220 4030 4000
ERCP WITHOUT STENT 8000 12000 8000
ESOPHAGEAL DILATION (CRE) 2880 4030 3000
FLEXIBLE SIGMOIDOSCOPE 1500 2000 2000
HERNOCLAIPPING 920 1380 1000
PEG INSERTION 4600 6900 5000
PERCUTAINOUS LIVER BIOPSY 1200 2500 2000
RIGID SIGMOIDOSCOPY (GENERAL) 630 920 700
SPIROMETRY 630 920 550
TRANSIENT ELASTOGRAPHY 3500 6000 4000
TRANSJAGULAR LIVER BIOPSY AND HEPATIC HEAMO DYNAMCIS 6900 9200 7000
UBT 230 290 300
CBC PACKAGE INSURANCE 320 0 0
AEC (ABSOLUTE EOSINOPHIL COUNT) 240 440 160
APTT 300 440 290
BENCE JONES PROTEIN 180 330 200
BLEEDING TIME 60 110 35

BLOOD GROUPING ( ABO,RH) 110 120 50
BLOOD GROUPING AND X - MATCHING 150 0 200
BONE MARROW CYTOLOGY WITH IRON STAIN 1400 2250 1700
CBC (RBC/TLC/DLC/PLATELET/PCV/MCV,MCH, MCHC) 300 550 300
CLOTTING TIME 60 110 35
COOMB'S TEST : INDIRECT 240 390 300
COOMB'S TEST: DIRECT 360 660 400
DLC 35 0 35
ESR 80 110 35
G6PD 290 0 300
HAEMOGLOBIN (HB) 100 170 35
KETONE 120 220 200
MCH 30 0 30
MCHC 30 0 30
MCV 30 0 30
OSMOTIC FRAGILITY 480 880 500
PCV 50 0 50
PLATELET 50 0 50
PREGNANCY TEST-ELISA 180 280 100
PROTHROMBIN TIME 250 440 180
PS FOR CYTOLOGY (PBS) 360 660 425
RBC 35 0 35
RETICULOCYTE COUNT 300 550 125
SEMEN (SPERM) ANALYSIS 600 770 600

SICKLING TEST 120 220 70
SPECIFIC GRAVITY/UROBILINOGEN/BILIRUBIN/NITRITE) 120 220 200
TLC 35 0 35
URINE FOR DYSMORPHIC RBC 120 220 200
URINE RE/ME 110 200 200
BLOCKS AND FNAC SLIDES FOR REFERRAL : RS.2500/- NEEDS TO BE 3000 0 3000
DEPOSITED. REFUNDED AFTER RETURN OF THE
IHC -<5 PANELS 3500 6000 4000
IHC ->5 PANELS 6500 12000 7000
LARGE SPECIMENS: TURP, ALL ORGANS INCL 2500 4600 3000
MEDIUM SPECIMENS EG: ALL CURRETTAGE, APPENDIX, 2000 3600 2000

TONSILLECTOMY ALL POLY
SLIDE CONSULTATION MORE THAN 2 SLIDES FROM OUTSIDE 0 1500 0
SLIDES FOR CONSULTATION OUT SIDE BPKIHS 0 800 0
SMALL SPECIMENS EG:INCISIONAL/PUNCH/ENDOS 1000 1900 1000
ADMINISSION CHARGES 1000 1500 1000
ADMISSION CHARGES (P) 1000 1000 0
CAPD FLUID CHARGE PER PACK 501 0 501
CERTIFICATION-HEALTH,ILLNESS,DRIVING,TREATMENT ISURANCE ETC 700 0 0
COMPREHENSIVE HEALTH CHECK UP 9000 0 0
CORNEAL SUTURE REMOVAL 70 0 250
DIETETIC CONSULTANCY CHARGE 100 0 0
DOCTORS ROUND IN PRIVATE WARD 0 350 0
DRESSING IN OPD / WARD 70 150 65
DUBLICATE DEATH CERTIFICATE 600 1150 0
GENERAL HEALTH CHECK UP 4500 0 0

I/M INJECTION 50 0 100
IMMUNIZATION (EXCEPT GOVERNMENT FREE IMMUNIZATION

100 0 100
PROGRAM)
INSURANCE CLAIM CHARGE IN CASE OF DEATH OF THE PATIENT 1000 0 0
MLC FROM COURT / DIST.OFF./ANY MLC 1000 0 0
MORTUARY CHARGE / DAY 1500 0 0
OXYGEN GAS CHARGES (PER DAY) 300 300 0
PHYSICAL EXAM (STAFF/STUDENT & OTHER) 2000 0 0
POLICE CASE / WOUND CERTIFICATE 1000 0 0
SEARCH FEE 58 115 0
STITCH REMOVAL IN OPD / WARD 70 150 250
SURGERY CHARGE 15000 28000 0
SYRINGING & PROBING (LA) 100 0 100
TRACHESTOMY TUBE 1000 1200 1000
VACUTAINER 20 20 0
APPLICATION FORM 1500 0 0
EXPERIENCE LETTER (FOR SECOND TIME) 500 0 0
HEALTH CARD 150 0 0
IDENTITY CARD 300 0 0
PHARMACY DEPOSIT 5000 0 0
RECOMMENDATION LETTER 500 0 0
SALARY CERTIFICATE 500 0 0
HAEMODIALYSIS PROCEDURE CHARGE 1000 1495 0
HEMODIALYSIS SERVICE CHARGE WITH CONSUMABLES 2500 0 0
PERITONEAL DIALYSIS 1500 4600 0

SEROPOSITIVE DIALYSIS CHARGE WITH CONSUMABLES 4000 0 0
DAY CARE ADMISSION (MEDICAL ONCOLOGY CHEMOTHERAPY) 300 0 0
KALA_AZAR PCR 500 0 0
AFB C/S 40 0 100
AFB TEST 1 0 0
ANTI-MEASLES IGM 1 0 0
ANTI-RUBELLA IGM 1 0 0
AUTOMATED BLOOD CULTURE (BACTEC OR BACT/ALERT) 300 500 700
BACTERIAL C/S 400 400 400
BILE C/S 420 550 200
BILE R/E, C/S 420 550 200
BLOOD BONE MARROW C/S 300 500 350
BODY CAVITY FLUID C/S 300 500 300
BRONCHOALVEOLAR LAVAGE (BAL) C/S 300 500 300
CD4 COUNT 120 0 100
CENTRAL VENOUS LINE (CVL) CATHETER TIP 300 500 300
COVID-19 PCR TEST 880 0 0
CSF C/S 440 550 200
CSF FOR INDIA INK 40 110 100
CULTURE FOR MYCOBACTERIA/MGIT 1 0 0
DAT 1 0 0
DRAIN FLUID M/E C/S 300 500 300
DRAIN TUBE C/S 300 500 300
ENDOMETRIAL ASPIRATE C/S 300 500 300

ENDOTRACHEAL TUBE TIP C/S 300 0 300
EYE SAMPLES FOR ACANTHAMOEBA 120 220 200
EYE SAMPLES (CORNEAL SCRAPING, LACRIMAL SAC, VITREOUS FLUID

540 770 600
ETC.) FOR M/E, C/S BACTERIA & FUNGUS
FUNGAL C/S (ALL SAMPLES) 300 500 300
GEIMSA STAIN FOR FUNGUS 120 220 200
GIEMSA STAIN & RAPID UREASE TEST FOR H. PYLORI IN ENDOSCOPY 110 220 200
SAMPLES
GIEMSA STAIN ( BONE MARROW. SLIT SMEAR FOR LD BODY) 80 170 100
GIEMSA STAIN MALARIA AND MICROFILARIA 80 170 100
GRAM STAIN ( ALL SAMPLES ) 60 120 56
HBV DNA QUANTITATIVE 6960 0 0
HCV RNA VIRAL LOAD 6960 0 0
HIV 1 0 300
HIV RNA VIRAL LOAD 1390 0 0
I/V CATHETER TIP C/S 300 500 300
JE SEROLOGY / MAC/ELISA IGM FOR JE ANTIBODY 1 0 0
KOH MOUNT & MICROSCOPY 110 220 200
KOH PREPARATION FOR FUNGUS ( ALL SAMPLES) 60 110 70
MANTOUX ( TUBERCULIN ) TEST 110 220 60
MICROFILARIA 80 170 100
OCCULT BLOOD / STOOL CONCENTRATION 100 170 60
OTHER ASPIRATES C/S 300 500 300
OTHER ASPIRATES R / E C/S 300 500 300
P/S FOR MALARIA 90 190 250
PERCARDIAL FLUID C/S 300 500 300

PERITONEAL/ASCITIC FLUID C/S 300 500 200
PLEURAL FLUID C/S 300 500 300
PUS C/S 300 500 200
QBC FOR MAL 220 380 300
SCRUB TYPHUS RDT 1 0 1300
SEMEN C/S 300 500 300
SERODIAGNOSTIC TEST FOR DENGUE 1 0 0
SPUTUM C/S 300 500 190
SPUTUM FOR AURAMINE STAINING 1 0 0
SPUTUM FOR Z-N STAINING 1 0 0
STOOL C/S 300 500 200
STOOL FOR FAT GLOBULES 60 110 100
STOOL FOR OVA CYST (INCLUDING CONCENTRATION) 60 110 100
STOOL RE 60 110 100
STOOL REDUCING SUBSTANCES 60 110 100
SYNOVIAL FLUID C/S 300 500 300
THROAT/VAGINAL/CERVICAL SWAB C/S 300 500 190
TUSSUE BIOPSY C/S 300 500 300
URINE C/S 300 500 200
VENTRICULAR FLUID C/S 300 500 300
WATER BACTERIOLOGY 730 880 800
WET MOUNT FOR MICROSCOPY ( ALL SAMPLES) 60 110 100
WOUND SWAB C/S 300 500 300
Z-N STAIN FOR PROTOZOAL CYST IN STOOL SAMPLE 60 110 100

Z-N STAINING (TB & LEPROSY) 1 0 0
TRACHEAL ASPIRATE C/S 300 500 300
ABSCESS/CYST EXCISION GA 29000 58000 30000
ALL TUMORS OF SPINE GA 33000 66000 35000
ANEURYSM CLIPPING GA 40000 80000 40000
ANTERIOR CERVICAL DISCECTOMY AND FUSION GA 33000 66000 35000
ANTERIOR/ANTEROLATERAL/COSTOTRANSVERSECTOMY
29000 58000 30000
DECOMPRESSION GA
ARTERIO-VENOUS MALFORMATION GA 36000 72000 36000
BRACHIL PLEXUS REPAIR GA 29000 58000 30000
BURR HOLE BIOPSY 20000 40000 20000
BURR HOLE CYST/ABSCESS ASPIRATION 20000 40000 20000
CALVARIAL BIOPSY 13800 27600 14000
CAROTID ENDARTECTOMY GA 29000 58000 30000
CHANGE OF INFECTED EVD 20000 40000 20000
CHRONIC EPIDURAL HEMATOMA 20000 40000 20000
CHRONIC SUBDURAL UNDER GA GA 25000 50000 25000
CHRONIC SUBDURAL UNDER LOCAL ANESTHESIA 18000 36000 18000
CONTUSECTOMY GA 25000 50000 25000
CONTUSECTOMY GA 25000 50000 25000
CP ANGLE TUMORS GA 40000 80000 40000
CRANIOPLASTY GA 35000 70000 35000
DECOMPRESSIVE CRANIOTOMY GA 25000 50000 25000
DEPRESSED FRACTURE WITH DUROPLASTY GA 30000 60000 30000
EC-IC BYPASS GA 33000 66000 35000

ENDOSCOPIC PROCEDURES GA 33000 66000 35000
EPIDURAL HEMATOMA EVACUATION GA 25000 50000 25000
EPIDURAL HEMATOMA/ABSCESS GA 33000 66000 35000
EXTERNAL VENTRICULAR DRAIN 18000 36000 18000
FRACTURE DECOMPRESSION GA 33000 66000 35000
FRACTURE ELEVATION WITH DURAL REPAIR GA 25000 50000 25000
FRACTURE ELEVATION WITHOUT DURAL REPAIR 20000 40000 20000
HALO FIXATION GA 15500 31000 16000
INFECTED SHUNT EXTERIORIZATION 15000 30000 16000
INFRATENTORIAL TUMOR GA 35000 70000 35000
INJECTIONS FOR TORTICOLLIS/WRY NECK/LOCAL SPASTICITY 15000 30000 16000
INSTRUMENTATION OF THE SPINE-ANTERIOR/POSTERIOR GA 35000 70000 35000
INTERSPINOUS WIRING GA 22000 44000 22500
INTRADURAL LESIONS GA 35000 70000 35000
INTRAVENTRICULAR LESION EXCISION GA 35000 70000 35000
LAMINECTOMY GA 35000 70000 35000
LAMINOPLASTY GA 35000 70000 35000
LOBECTOMY GA 35000 70000 35000
LUMBER DISCECTOMY GA 35000 70000 35000
LUMBER DRAIN INSERTION 13800 27600 14000
LUMBO-PERITONEAL SHUNT GA 20000 40000 20000
LUQUE FIXATION GA 35000 70000 35000
MENINGIOMA EXCISION GA 35000 70000 35000
MUSCLE BIOPSY 13800 27600 14000

NEURAL TUBE DEFECTS-MENINGOCELE, MENINGOMYELOCELE, SPINAL
25000 50000 25000
DYSRAPHISM GA
OCCIPITO-CERVICAL FUSION GA 35000 70000 35000
PEDIATRIC TUMORS GA 38000 76000 40000
PERIPHERAL NERVE SHEATH TUMORS 18000 36000 18000
PITUITARY ADENOMA GA 38000 76000 40000
REMOVAL OF INFECTED FOREIGN BODY 15000 30000 16000
RETAPPING OF CYST/ABSCESS 13800 27600 14000
SINGLE LEVEL LAMINECTOMY GA 25000 50000 25000
SMALL PERIPHERAL LUMPS/TUMORS 15000 30000 16000
SPINAL VASCULAR MALFORMATION GA 35000 70000 35000
SUBDURAL HEMATOMA EVACUATION (ACUTE) GA 25000 50000 25000
SUBGALEAL EXTRABONY/BONY LESION EXCISION 18000 36000 18000
SUPRATENTORIAL TUMOR GA 35000 70000 35000
SURAL NERVE BIOPSY 15000 30000 16000
TARSORAPHY 15000 30000 16000
THORACOSCOPIC SYMPATHECTOMY GA 35000 70000 35000
TRACHESTOMY GA 15500 31000 16000
TRACHESTOMY LA 10000 20000 10000
TRANSPHENOIDAL GA 36000 72000 36000
V. PLEURAL SHUNTING GA 25000 50000 25000
V.A SHUNTING GA 25000 50000 25000
V.P SHUNTING GA 25000 50000 25000
VERTEBRAL BONE BIOPSY 18000 36000 18000
2ND TRIMESTER ABORTION (MEDICAL/ D&E) 4550 9660 5000

COLPOSCOPY 3040 5520 1225
COMPREHENSIVE ABORTION CARE 3040 8970 4250
CPT REPAIR FRESH 3800 8050 4000
CRYO THERAPY PROCEDURE 3040 6900 1500
CYSTOSCOPY 6000 16560 6000
DIAGNOSTIC CYSTOSCOPY 4550 11040 6000
DIAGNOSTIC HYSTEROSCOPY 4000 7000 4000
DOUBLE VOLUME EXCHANGE TRANSFUSION (DVET) 1200 0 2000
DUPLICATE BIRTH CERTIFICATE 760 1380 0
FAILD MEDICAL ABORTION (REPEAT MVA) 2530 4600 3000
FIRST TRIMESTER ABORTION (MEDICAL/MVA/PAC) 1520 5520 4250
FOLLICULAR MONITORING- PACKAGE 1520 4830 2000
HYSTEROSCOPY UNDER LOCAL ANAESTHESIA 7200 16800 8000
INTERMEDIATE OT CHARGE (GYNAE) 10000 22000 5000
IUI DOUBLE 9660 20700 10000
IUI SINGLE 6900 16560 7000
LAPAROSCOPIC TUBALIGATION WITH G.A. (MINOR OT) 1520 5520 2000
LAPAROSCOPY (MINOR) 18000 36000 18000
LAPAROSCOPY-MAJOR 21600 43200 22500
LEEP / CONE BIOPSY 7590 16560 8000
LSCS 14000 31740 14000
LUMBAR PUNCTURE 800 0 1000
MAJOR OT (GYANE ONCO) 20000 40000 20000
MAJOR OT CHARGE (GYNAE) 18220 34500 20000

MINOR OT CHARGE (GYNAE) 3500 6900 2500
NON STRESS TEST (NST) 610 970 700
NON STRESS TEST (NST)-PACKAGE 760 1380 800
NORMAL DELIVERY WITH BIRTH CERTIFICATE 2500 10000 3000
OBSTETRIC USG 460 830 500
OPERATIVE HYSTEROSCOPY SA/GA (MAJOR OT) 18000 36000 18000
PAEDIATRIC CONSULTATION DURING LSCS 0 2070 0
PARTIAL VLOUME EXCHANGE TRANSFUSION 800 0 1000
URODYNAMICS 3000 0 6000
UROFLOMETRY 500 0 500
VACCUM OR FORCEP DELIVERY WITH BIRTH CERTIFICATE 3000 12000 3000
VIA 150 350 200
DIAGNOSTIC LAPAROSCOPIC & PROCEED - GYNAE / SURGERY 13800 25880 14000
EUA (EXAMINATION UNDER ANAESTHESIA) 6000 0 6000
LAPAROSCOPIC SURGERY HYSTRECTOMY 17250 34500 18000
MVA 4000 0 4000
POLYPECTOMY 3500 0 2000
SUCTION AND EVACUATION 7000 0 7000
CHECK CURRATAGE 3500 0 4000
EBECC (BIOPSY) 3500 0 4000
I AND D (INSSION AND DRAINAGE) 3500 0 4000
RE-SUTURING 3500 0 4000
3 M EXAMINATION (3 MIRROR EXAM) 40 60 100
AUTOMATED PERIMETRY (ONE EYE) 770 1210 800

AUTOMATED PERIMETRY (TWO EYE) 1050 1650 2000
BIOMETRY WITH PRINTOUT (BOTH EYES) 500 660 500
BIOMETRY WITH PRINTOUT (ONE EYE) 390 550 400
BIOMETRY WITHOUT PRINTOUT (BOTH EYES) 390 440 400
BIOMETRY WITHOUT PRINTOUT (ONE EYE) 280 440 300
BLEPHEROPLASTY 12000 0 16000
CHALZION 2750 0 2800
ECTROPION 5500 0 6000
ENTROPION 5500 0 5500
ETHI BOND SUTURE 660 770 700
EVISCERATION 5500 0 5500
F.B. REMOVAL 60 110 100
FLUORESCEIN ANGIOGRAPHY (EXCLUSIVE OF FILM, MEDICINE,

1100 1650 2000
FLUORESCEIN, DEVELOPING CHARGE, BUTTER NEEDLE,
FOCAL LASER 770 1100 800
FUNDUS EXAMINATION UNDER MYDRIATICS / DILATATION 30 60 500
FUSIONAL EXERCISE ON SYNAPTOPHORE (PER SITTING) 60 90 100
GOLDMAN PERIMETRY (ONE EYE) 280 440 300
GOLDMAN PERIMETRY (TWO EYES) 330 550 400
GONIOSCOPY 60 110 100
HESS CHARTING 110 170 0
I&D 2750 0 3000
INCISIONAL BIOPSY 2750 0 3000
INJECTION AVASTIN FIRST DOSE (0.5ML) 7000 0 7000
INJECTION AVASTIN SECOND DOSE (0.05ML) 6000 0 7000

INJECTION AVASTIN THIRD & ABOVE DOSE (0.05ML) 5000 0 5000
INTRA VITREAL INJECTION 1250 0 1250
OPTOMETRIC EVALUATION 80 110 100
OPTOMETRIC EXAMINATION 80 110 100
ORTHOPTICS EVALUATION 80 110 100
ORTHOPTICS EXAMINATION 80 110 100
PAD AND BANDAGE 90 110 100
PATCHING 60 80 100
PRP PER SITTING 1100 1320 2000
PTERIGIUM 5500 0 6000
REFRACTION 40 80 60
SILICON BAND 1980 2200 2000
SILICON TYRE 2970 3300 3000
SUTURE SILK 280 330 300
USG WITH PRINTOUT (BOTH EYES) 880 1320 900
USG WITH PRINTOUT (ONE EYE) 440 660 500
USG WITHOUT PRINTOUT (BOTH EYES) 770 1100 800
USG WITHOUT PRINTOUT (ONE EYES) 390 550 400
VR SURGERY 19800 26400 20000
YAG LASE POSTERIOR CAPSULATOMY 550 880 600
YAG LASER PI (PERIPHERAL IRRIDOTOMY) 830 1100 850
ANTERIOR SEGMENT OCT TEST SCREENING ONLY 730 1100 1500
ANTERIOR SEGMENT OCT TEST WITH PRINT 2420 2750 3000
CORNEAL SUTURE REMOVAL UNDER GA 2200 0 3500

CORNEAL SUTURE REMOVAL UNDER LA 390 660 300
DACROCYSTORHINOSTOMY (DCR) SURGERY 7920 11000 7500
ENEUCLEATION 3850 0 9000
EUA (EXAMINATION UNDR ANAESTHESIA) 2750 0 3000
EXENTERATION 4400 0 4500
INTERMEDIATE (PETRYGIUM, ECTROPION, ENTROPION, EVISCERATION 5500 8800 0

ETC)
MAJOR (ORBITOTOMY, LID RECONSTRUCTION, CONTRACTED SOCKET
9900 16500 10000
RECONSTRUCTION ETC)
MINOR (CHALGION, I & D, INCISIONAL BIOPSY, INTRAVITREAL
2750 3850 3000
INJECTION ETC)
PERFORATING INJURY REPAIR & INTRAVITRED INJECTION UNDER GA 3850 0 8500
PHACOEMULSIFICATION WITH FOLDABLE IOLS 11550 14300 12000
PHACOEMULSIFICATION WITH FOLDABLE IOLS 7260 11000 8000
PHACOEMULSIFICATION WITH PMMA IOLS 8800 13200 9000
PHACOEMULSIFICATION WITH PMMA IOLS 7260 11000 8000
POSTERIOR SEGMENT OCT TEST SCREENING ONLY 730 1100 1500
POSTERIOR SEGMENT OCT TEST WITH PRINT 2420 2750 3000
PRODTHETIC EYE CHARGE 440 660 500
PTOSIS SURGERY 7260 11000 8000
SCHIRMERS TEST 40 70 100
SICS / ECCE + PCIOL (IOL NOT SUPPLIED BY THE HOSPITAL) 6600 8800 7000
SICS / ECCE + PIOL (PMMA PIOL / AICOL) 7260 9900 8000
SQUINT SURGERY 7260 11000 8000
SYRINGING AND PROBING (GA) 4400 0 4500
TRABECULECTOMY 7260 9900 8000
ABSCESS DRAINAGE (MINOR) 440 880 1000

ADDITIONAL TOOTH (EXT.) 60 110 120
ALVEOLOPLASTY 390 770 0
ANTERIOR EXT. 110 500 120
APICOECTOMY 1650 3030 0
ARCH BAR APPLICATION (PER ARCH) 3850 7700 0
ARCH BAR REMOVAL (PER ARCH) 280 550 0
BI-JAW OSTEOTOMY GA 20350 50050 22500
BIOPSY 500 990 500
BONE GRAFTING 1650 3300 0
BRIDLE WIRING 220 440 0
CIRCUMMANDIBULAR WIRING GA 13750 27500 14000
CLEFT ALVEOLUS GA 7150 27500 8000
CLEFT LIP CLOSURE GA 7150 13750 8000
CLEFT PALATE (COMPLETE) GA 13200 24750 13500
CLOSURE OF O A F 12000 22500 12000
CLOSURE OF O A F GA 13750 27500 14000
CLOSURE OF O A F GA 15000 30000 16000
CORONECTOMY 1210 2420 0
CYST ENUCLEATION 13750 26400 14000
DRESSING DENTAL 70 130 65
DRY SOCKET PACK 90 220 0
ENUCLEATION 1320 2640 2000
ENUCLEATION (MULTIPLE CYST) GA 16500 33000 18000
ENUCLEATION (SINGLE CYST) GA 13750 27500 14000

EXCISION SOFT TISSUE TUMOR GA 13750 27500 14000
EXCISION SOFT TISSUE TUMOR GA 16500 33000 18000
EXTRACTION OF TEETH - I GA 13750 27500 14000
EXTRACTION OF TEETH - II GA 16500 33000 18000
EXTRACTION THIRD MOLAR - B/L GA 15400 30800 16000
EXTRACTION THIRD MOLAR - I GA 13750 27500 14000
FLAP RE-EXPLORATION -I 8000 16000 0
FLAP RE-EXPLORATION-II 13200 26400 0
FREE FLAP RECONSTRUCTION (S TISSUE) 25000 50000 0
FREE FLAP RECONSTRUCTION (SOFT TISSUE) 20000 40000 0
FRONTAL/ ZYGMATIC GA 13750 27500 14000
GAP ANTHROPLASTY GA 14300 24750 16000
HAIR TRANSPLANT (PER FOLLICLE) 50 100 0
I.M.F. GA 13200 26400 13500
IMF 4400 8800 0
IMPACTION 3RD MOLAR 1540 3080 0
IMPACTION CANINE 1650 3300 0
INCISION & DRAINAGE 1350 2640 2000
INCISION AND DRAINAGE GA 13750 27500 14000
INFERIOR ALVELOR NERVE AVULSION GA 13750 27500 14000
LE FORT I OSTEOTOMY GA 13750 27500 14000
LOCAL FLAP RECONSTRUCTION 5000 10000 0
MANDIBULAR FRACTURE-I GA 13750 27500 14000
MANDIBULAR FRACTURE-II GA 16500 33000 18000

MANDIBULECTOMY GA 16500 33000 18000
MARSUPIALIZATION 550 1100 0
MAXILLECTOMY GA 13750 27500 14000
MIDFACE FRACTURE - I GA 15400 30800 16000
MIDFACE FRACTURE - II GA 18150 44000 20000
MINOR DRESSING 110 220 65
MINOR SURGERY 550 1100 2500
NECK DISSECTION B/L 20000 36000 0
NECK DISSECTION GA 15400 27500 16000
OPEN EXTRACTION 400 800 670
ORIF MANDIBLE LA 6600 13200 7000
ORIF- COMPLICATED FRACTURE 16500 33000 18000
ORIF- MAXILLA & MANDIBLE 15400 27500 16000
ORIF-SIMPLE 13750 24200 14000
ORTHO EXTRACTION 330 660 300
PAN-FACIAL FRACTURE-I GA 16500 33000 18000
PAN-FACIAL FRACTURE-I GA 22000 49500 22500
PLATE REMOVAL GA 13750 27500 14000
PLATE REMOVAL LA 1100 2200 2000
PMMC FLAP RECONSTRUCTION 10000 14000 0
POSTERIOR EXT. 170 550 120
REDUCTION OF LE FORT II, III, # GA 13750 27500 14000
REMOVAL OF WIRE GA 5000 10000 5000
REPAIR OF SOFT TISSUE GA 13750 27500 14000

REPAIR OF SOFT TISSUE GA 16500 33000 18000
RIBBON GAUGE 110 300 0
RIGID INTERNAL FIXATION GA 13200 24750 13500
SAGITTAL SPLIT OSTEOTOMY GA 13750 27500 14000
SCALING 400 800 400
SPLINTING 440 880 500
SUB MANDIBULAR GLAND EXCISION GA 15400 30800 16000
SURGICAL EXPOSURE 1500 3000 2000
TMJ DISLOCATION 550 1100 600
TMJ PROCEDURE 13750 26400 14000
WOUND REPAIR (INTERMEDIATE) 1320 2640 2000
WOUND REPAIR (MAJOR) 3300 6600 4000
WOUND REPAIR (MINOR) 660 1320 700
ZYGOMA FRACTURE - I (INDIRECT) GA 13750 27500 0
ZYGOMA FRACTURE - II GA 16500 33000 18000
CEPHALOGRAM 800 1050 0
INTRALESIONAL INJECTIONS 150 250 0
IOPA / BITEWING RADIOGRAPH 130 220 100
LOW LEVEL LASER THERAPY 100 200 0
OCCLUSAL RADIOGRAPH 250 380 0
OPG WITHOUT PRINT 400 0 700
PANORAMIC RADIOGRAPH 800 1050 800
PUNCHN BIOPSY 450 700 500
RVG 280 500 0

TMJ VIEWS 550 750 0
TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) THERAPY 500 800 0
HISTOPATHOLOGY FOR LARGE SPECIMENS (ORAL) 2500 4600 3000
HISTOPATHOLOGY FOR SMALL SPECIMENS (ORAL) 600 900 2000
ORAL EXFOLIATIVE CYTOLOGY 900 1600 900
BIOPSY LARGE SPECIMEN (ORAL) 2200 4000 3000
BIOPSY MEDIUM SPECIMEN (ORAL) 1750 3000 2000
BIOPSY SMALL SPECIMENS [ORAL] 900 1600 900
BLOCKS FOR REFERRAL/ REDUNDABLE (ORAL) 2500 0 0
FNAC (ORAL) 1100 2000 2000
HISTOPATHOLOGY FOR MEDIUM SPECIMENS (ORAL) 2010 3450 3000
SLIDES FOR CONSULTATION REPORTING ONLY SLIDES RECEIVED- 1

600 900 0
SLIDE (ORAL)
SPECIAL STAIN (ORAL) 600 900 600
ABCESS DRAINAGE IN LIMBS UNDER GA/RA 10000 19000 10000
ABCESS DRAINAGE IN LIMBS UNDER LA 4000 7600 4000
ACDF/ACCF 20000 38000 20000
AMPUTATION/DISARTICULATION JOINTS BELOW THE SHOULDER AND

10000 19000 14000
HIP
AMPUTATION/DISARTICULATION OF FINGERS/TOES UNDER GA/RA 7500 14000 8000
AMPUTATION/DISARTICULATION OF FINGERS/TOES UNDER LA 3500 6600 4000
ANKLE FRACTURES FIXATION (DOUBLE BONE) 12000 23000 12000
ANKLE FRACTURES FIXATION (SINGLE BONE) 8000 15000 10000
ANTERIOR SPINAL INSTRUMENTATION 25000 47500 25000
ANTEROLATERAL DECOMPRESSION (ALD) 15000 28500 16000
AO FIXATOR APPLICATION 10000 19000 16000

APPLICATION OF ABOVE ELBOW SLAB/CAST WITH MUA 1000 1900 1000
APPLICATION OF ABOVE ELBOW SLAB/CAST WITHOUT MUA 700 1350 700
APPLICATION OF ABOVE KNEE SLAB/CAST WITH MUA 1200 2300 2000
APPLICATION OF ABOVE KNEE SLAB/CAST WITHOUT MUA 700 1300 700
APPLICATION OF BELOW ELBOW SLAB/CAST WITH MUA 800 1500 800
APPLICATION OF BELOW ELBOW SLAB/CAST WITHOUT MUA 500 1000 500
APPLICATION OF BELOW KNEE SLAB/CAST WITH MUA 1000 1900 1000
APPLICATION OF BELOW KNEE SLAB/CAST WITHOUT MUA 500 1000 500
ARTHRODESIS OF FINGER AND TOES UNDER GA/RA 7500 14500 8000
ARTHRODESIS OF FINGER AND TOES UNDER LA 3500 7000 4000
ARTHRODESIS OF LARGE JOINTS OF UPPER / LOWER LIMBS 15000 28500 16000
ARTHROTOMY OF FINGER & TOES UNDER GA/RA 7500 14500 8000
ARTHROTOMY OF FINGER/TOES UNDER LA 3500 7000 4000
ARTHROTOMY OF LARGE JOINT (SHOULDER/HIP/KNEE) 12500 23750 13500
BIOPSY UNDER IMAGE INTENSIFIER UNDER GA/RA 10000 19000 10000
BONE DENSITOMETER 3000 5500 3000
BONE GRAFTING + FIXATION OF ANY FRACTURE 15000 28500 16000
BONE GRAFTING UNDER GA/RA 10000 19000 10000
BONE MARROW INJECTION UNDER IMAGE INTENSIFIER UNDER GA 7500 14250 8000
BONE MARROW INJECTION UNDER IMAGE INTENSIFIER UNDER LA 3000 5700 4000
CDH CORRECTION 15000 28500 16000
CLOSED REDUCTION OF SHOULDER/ELBOW/HIP/KNEE UNDER GA 7500 14250 8000
CLOSED SCREW FIXATION FOR TIBIAL PLATEAU 10000 19000 14000
CONTRACTURE RELEASE LARGE 15000 28500 16000

CONTRACTURE RELEASE SMALL 10000 19000 10000
CORE BIOPSY UNDER LA 3500 6650 4000
CTEV BONY CORRECTION 15000 28500 16000
CTEV SOFT TISSUE CORRECTION 15000 28500 16000
CURETTAGE & BONE GRAFTING / CEMENTING UPPER AND OR LOWER

15000 28500 16000
LIMB
CURETTAGE AND SEQUESTRECTOMY 10000 19000 14000
DCP/LOCKING PLATE/DHS/DCS/CCS FIXATION 15000 28500 16000
DEFORMITY CORRECTION UPPER/ LOWER LIMB 15000 28500 16000
DIAGNOSTIC ARTHROSCOPY 12500 23750 16000
DISARTICULATION OF SHOULDER/HIP 15000 28500 16000
DRAINAGE OF ACUTE OSTEOMYELITIS UNDER GA/RA 10000 19000 10000
DRESSING-LARGE 500 950 500
DRESSING-SMALL 250 475 250
DYNAMIZATION OF NAIL UNDER GA/RA 3500 6500 4000
DYNAMIZATION OF NAIL UNDER LA 500 950 500
EXCISIONAL ARTHROPLASTY 10000 19000 14000
EXCISIONAL BIOPSY UNDER LA 5000 9500 5000
EXCISIONAL BIOPSY UNDER RA/GA 10000 19000 10000
FASCIOTOMY OF HAND/FOOT 7500 14000 8000
FASCIOTOMY OF THIGH/ARM 10000 19000 10000
FIXATION/SURGERY OF CARPAL BONES 15000 28500 16000
FOREIGN BODY REMOVAL UNDER LA 5000 9500 5000
FOREIGN BODY REMOVAL UNDER RA/GA 10000 19000 14000
FRACTURE FIXATION WITH TBW 10000 19000 10000

FREE FLAPS/TISSUE TRANSFER 25000 47500 25000
HEMI REPLECEMENT ARTHROPLASTY 15000 28500 16000
HYBRID ILIZAROV FIXATOR APPLICATION 12500 23750 14000
ILIZAROV FIXATOR APPLICATION 15000 28500 16000
ILIZAROV FIXATOR APPLICATION FOR BONE TRANSPORT 20000 38000 20000
IMAGE INTENSIFIER IN OT 500 1000 500
IMPLANT REMOVAL UNDER LA 3000 5700 3000
IMPLANT REMOVALUNDE RA/GA 10000 19000 14000
INCISIONAL BIOPSY UNDER LA 3500 7000 4000
INCISIONAL BIOPSY UNDER RA/GA 7500 14250 8000
INTERCONDYLAR FRACTURE HUMERUS 15000 28500 16000
INTERLOCKING NAILING / PFN 15000 28500 16000
INTERMEDIATE OT IN EMERGENCY 7500 14250 0
K-NAIL FIXATION 10000 19000 14000
K-NAIL FIXATION WITH BONE GRAFTING 15000 28500 16000
K-WIRE FIXATION OF BONES UNDER GA 10000 19000 10000
K-WIRE FIXATION OF BONES UNDER LA/RA 7500 14250 8000
LAMINECTOMY/LAMINOTOMY/ FORAMINOTOMY/DISCECTOMY 15000 28500 16000
LIMB LENGHENING SURGERY 20000 38000 20000
LOCAL FLAP SURGERIES - LARGE 15000 28500 16000
LOCAL FLAP SURGERIES-SMALL 7500 14250 8000
MINOR OT IN EMERGENCY 3500 6500 0
MINOR OT IN ROT 5000 9500 0
NERVE TRANSPOSITION 10000 19000 10000

OPEN REDUCTION OF SHOULDER/ELBOW/HIP/KNEE 15000 28500 16000
PEDICLE SCREW / LATERAL MASS SCREW FIXATION 15000 28500 16000
PLATING FOR TIBIAL PLATEAU 15000 28500 16000
POP CAST REMOVAL 200 400 1200
REPLANTATION OF FINGER/HAND 30000 57000 30000
SCOLIOSIS CORRECTION 25000 47500 25000
SKIN GRAFTING-LARGE GA 10000 19000 10000
SKIN GRAFTING-SMALL 5000 9500 5000
STEROID INJECTION (INTRALESIONAL / INTRA-ARTICULAR) 100 200 100
SURGERIES OF ACETABULUM AND PELVIS- COMPLEX 20000 38000 20000
SURGERIES OF ACETABULUM AND PELVIS- NORMAL 15000 28500 16000
SUTURING OF WOUNDS-LARGE GA/RA 5000 9500 5000
SUTURING OF WOUNDS-SMALL UNDER LA 1500 2850 2000
TENDON TRANSFERS/TENDON REPAIRS/NERVE REPAIRS/TENDON 15000 28500 16000

RECONSTRUCTION
TENS FOR FEMUR 15000 28500 16000
TENS FOR RADIUS/ULNA UNDER GA/RA 7500 14000 8000
THERAPEUTIC ARTHROSCOPY 25000 47500 25000
TLIF/PLIF 20000 38000 20000
TOTAL HIP ARTHROPLASTY 30000 57000 30000
TOTAL KNEE ARTHROPLASTY 30000 57000 30000
VASCULAR REPAIR 15000 28500 16000
WOUND DEBRIDEMENT LARGE IN EMERGENCY UNDER GA/RA 7000 13300 7000
WOUND DEBRIDEMENT SMALL UNDER LA 3500 6650 8000
ZOLEDRONIC ACID INJECTION IN WARD 500 950 500

COCK UP SPLINT DEPOSIT 1705 2555 2000
COCK UP SPLINT FOR 3 MONTH 425 635 500
COCK UP SPLINT FOR 6 MONTH 850 1275 850
DEPOSIT CHARGE 55000 82500 0
FINGER SPLINT DEPOSIT 485 725 500
FINGER SPLINT FOR 3 MONTH 120 180 200
FINGER SPLINT FOR 6 MONTH 245 365 300
FORE ARM BRACE DEPOSIT 2200 3300 3000
FORE ARM BRACE FOR 3 MONTH 550 825 600
FORE ARM BRACE FOR 6 MONTH 1100 1650 2000
KNEE HINGE DEPOSIT 2420 3630 3000
KNEE HINGE FOR 3 MONTH 485 725 500
KNEE HINGE FOR 6 MONTH 970 1455 1000
LEG BRACE DEPOSIT 7040 10560 8000
LEG BRACE FOR 3 MONTH 1760 2640 2000
LEG BRACE FOR 6 MONTH 3520 5280 4000
METACARPAL FRACTURE SPLINT FOR 3 MONTH 245 365 300
METACARPAL FRACTURE SPLINT DEPOSIT 970 1455 1000
METACARPAL FRACTURE SPLINT FOR 6 MONTH 485 725 500
THIGH BRACE DEPOSIT 8470 12705 9000
THIGH BRACE FOR 3 MONTH 2120 3180 3000
THIGH BRACE FOR 6 MONTH 4235 6350 4500
THUMB SPICA SPLINT DEPOSIT 1210 1815 2000
THUMB SPICA SPLINT FOR 3 MONTH 300 450 300

THUMB SPICA SPLINT FOR 6 MONTH 605 905 700
USAGE CHARGE 11550 17325 0
INJ. ZOLENDRONIC ACID 500 0 0
ABOVE ELBOW 20020 30030 22500
ABOVE KNEE 20020 30030 22500
BELOW ELBOW 11550 17325 12000
BELOW KNEE 12320 18480 13500
SYMES 11000 16500 12000
ABSOLUTE ANCHORAGE SYSTEM 3990 7260 0
DENTOFACIAL ORTHOPEDIC APPLEANCE 13310 24200 0
FIXED 6660 12100 0
FIXED 9320 16940 0
FIXED EXPANSION APPLIANCE 2660 4360 0
FIXED ORTHODONTIC PROCEDURES_x000D_ 39930 54450 0

( EXTRACTION CASE)
33280 43560 0
(NON EXTRACTION CASE)
13310 21780 0
(SINGLE AECH TREATMENT)
FIXED ORTHODONTICS T/T (2 X 4) 6660 12100 0
FIXED ORTHODONTICS T/T FORCED 6660 12100 0
FIXED RETAINER 2000 3630 0
IMPLANT ANCHORAGE SYSTEM 13310 21780 0
LINGUAL ORTHODONTICS 53240 87120 0
MINOR SURGICAL ORTHODONTIC PROCEDURES 1600 2900 0
ORTHODONTICS EXTRUSION 19970 36300 0
REMOVABLE 2660 4240 0

REMOVABLE 6660 12100 0
REMOVABLE / FIXED APPLIANCE REPAIR PROCEDURS 330 610 0
REMOVABLE ORTHODONTIC APPLIANCE 1330 1820 0
VACUUM FORMED INVISIBLE RETAINERS OR OCCLUSAL SPLINT 2000 3630 0
2 POST CERVICAL COLLAR 2575 3860 0
4 POST CERVICAL COLLAR 2475 3710 0
AFO (FOOT DROP SPLINT) (UNILATERAL) 1430 2145 0
ANKLE BRACE 1155 1730 0
ARM BRACE 1455 2180 0
ARTICULATED AFO 7260 10890 0
ASHE BRACE 945 1415 0
BOSTON BRACE 9460 14190 0
CHAIR BACK BRACE 3630 5445 0
CORRECTIVE SPINAL BRACE 23650 35475 0
CTEV SPLINT 1815 2720 0
CUSTOM MADE BODY JACKET ( CHILD ) 11550 17325 0
CUSTOM MADE BODY JACKET (ADULT ) 15125 22685 0
CUSTOM MADE INSOLE (FOOT ORTHOSIS) 3025 4535 0
DENNIS BROWNE SPLINT 1100 1650 0
DYNAMIC AFO 6600 9900 0
DYNAMIC AFO DORSI/ PLANTER FLEXION ASSIT 14520 21780 0
DYNAMIC COCK UP SPLINT 1090 1635 0
FLEXOR TENDON REPAIR SPLINT 1400 2100 0
FOOT DROP SPLINT 660 990 0

FORE ARM BRACE 1210 1815 0
FUNCTIONAL FOREARM BRACE 2475 3710 0
FUNCTIONAL HUMERAL BRACE 3025 4535 0
FUNCTIONAL KNEE BRACE 1815 2720 0
FUNCTIONAL THIGH BRACE 4235 6350 0
HALO VEST APPLICATION CHARGE (INTERMEDIATE) 6600 9900 0
HIP ABDUCTION SPLINT WITH JOINT 5750 8625 0
HKAFO (UNILATERAL) 6600 9900 0
KAFO (UNILATERAL) 3630 5445 0
KAFO WITHOUT KNEE JOINT 2200 3300 0
KNEE GAITER ORTHOSIS 5060 7590 0
KNIGHT TAYLOR BRACE 3630 5445 0
LATERAL SHOE RAISE B/L 300 450 0
LEAF SPRING AFO 4840 7260 0
METATARSAL PAD/ BAR 110 165 0
MILWAUKEE BRACE 15290 22935 0
MOLDED FOOT ORTHOSIS 3630 5445 0
MOLDED KAFO WITH HIP, KNEE & ANKLE JOINT 19580 29370 0
MOLDED KAFO WITH KNEE JOINT & ANKLE JOINT 11550 17325 0
MOLDED KNEE ORTHOSIS 6380 9570 0
MOLDED PTB ORTHOSIS WITH SOFT INSERT 7700 11550 0
MOULDED LSO - ADULT 2915 4370 0
MOULDED LSO - PAEDIATRIC 3630 5445 0
ORTHOSIS/PROSTHESIS REPAIR CHARGE - MAJOR 725 1085 0

ORTHOSIS/PROSTHESIS REPAIR CHARGE - MINOR 510 765 0
PTB BRACE 1745 2615 0
RIGID FOOT ORTHOSIS 1815 2720 0
SCOTTIS RITE BRACE (ABDUCTION SPLINT) 3300 4950 0
SOLID AFO 5500 8250 0
SPIRAL AFO 6050 9075 0
STATIC COCK UP SPLINT 825 1235 0
TAYLORS BRACE 2200 3300 0
THIGH BRACE (SARMIENTO) 1745 2615 0
SACH FOOT 3105 4655 0
ABDOMINAL PARACENTESIS 300 550 300
BONE MARROW ASPIRATION 240 550 317
CHEST TUBE INSERTION & DRAINAGE 610 1100 700
CUT DOWN (VENOUS) 0 610 1100 700
EXCHANGE TRANSFUSION 1ST PROCEDURE 1210 3300 2000
LAMBER PUNCTURE 240 550 300
LYING-IN CHARGES WITH MOTHER/DAY 300 0 300
NEBULIZATION 180 0 100
PAEDIATRIC VIDEO EEG 1700 3000 2000
PHOTOTHERAPY 360 0 200
PLEURAL TAP 610 1100 500
RENAL BIOPSY 610 1100 700
SUB DURAL TAP 610 1100 700
SUBSEQUENT EXCHANGES/DAY 610 2750 700

BLOOD COMPONENT CHARGE 950 0 800
CROSS MATCH GENERAL 120 0 100
HEMOLYTIC PROFILE HAPTOGLOBIN 330 600 400
LEUKEMIA CYCOCHEMISTRY (PACKAGE) SBB / PAS / MPO 400 800 400
PORPHOBILIN 110 330 200
ALGINATE IMPRESSION (PER ARCH) 200 400 0
APEXIFICATION 1800 3600 0
APICOECTOMY - POSTERIOR 2000 4000 0
BIODENTINE 2000 4000 0
BIOPSY 300 600 300
CHEMOMECHANICAL CARIES REMOVAL PROCEDURE 500 1000 0
COMPOMER RESTORATION CLASS II / COMPOSITE RESTORATION CLASS

600 1200 600
I
COMPOSITE CORE BUILD UP / ROOT CANAL TREATED TOOTH 1200 2400 0
COMPOSITE LAMINATE (PER TOOTH) 1800 3600 0
COMPOSITE RESTORATION - CLASS II 800 1600 350
CROWN - STAINLESS STEEL / POLYCARBONATE 1250 2500 0
CYST MARSUPILIZATION / ENUCLEATION 1500 3000 0
DRESSING PER VISIT DENTAL (PEDODONTICS) 200 400 0
EACH ADDITIONAL EXPANSION SCREW / BAND / COIL SPRING / WIRE

300 600 0
CHANGE
EXTRACTION (PRIMARY ANTERIOR / ROOT STUMP) 100 200 120
EXTRACTION - PERMANENT TEETH 150 300 300
EXTRACTION - SURGICAL / IMPACTION 1000 2000 670
FEEDING APPLIANCE (ACRYLIC) 600 1200 0
FIXED SPACE MAINTAINER 900 1800 0

FLUORIDE APPLICATION (PER VISIT) 80 150 0
FLUORIDE APPLICATION (VARNISH) 150 300 0
FULL METAL CROWN 1000 2000 0
GIC - CLASS I 180 350 200
GIC - CLASS II 200 400 200
HABIT BREAKING APPLIANCE - FIXED 1500 3000 0
HAND SCALING AND POLISHING - PRIMARY DENTITION 200 400 0
HEAT CURING 500 1000 0
HYRAX EXPANSION SCREW 4000 8000 0
INCISION AND DRAINAGE 400 800 450
INTERCEPTIVE ORTHOODNTIC THERAPY (PER ARCH) 5000 10000 0
LASER / CAUTERY PROCEDURE 1000 2000 0
MINOR ORAL SURGICAL PROCEDURE 1000 2000 2500
MIRACLE MIX - CORE BUILD UP 500 1000 0
MIRACLE MIX RESTORATION 250 500 300
MTA 1500 3000 0
NITROUS-OXIDE OXYGEN INHALATION SEDATION 1000 2000 0
OPERCULECTOMY 200 400 0
OTHER PROSTHESIS 1000 2000 0
PIT AND FISSURE SEALANT 250 500 0
PNAM THERAPY 1000 2000 0
PORCELAIN FUSED TO METAL CROWN 1500 3000 0
PORCELAIN LAMINATES / TOOTH (EXCLUDING LAB CHARGES) 2500 5000 0
POST AND CORE 1000 2000 0

PREVENTIVE RESIN RESTORATION 500 1000 0
PREVENTIVE RESIN RESTORATION TYPE III 800 1600 0
PULP CAPPING (WITH DYCAL) 300 600 0
PULPECTOMY (EXCLUDING METAPEX) 700 1400 0
PULPECTOMY - POSTERIOR (EXCLUDING METAPEX) 1000 2000 0
PULPOTOMY 500 1000 0
RECEMENTATION OF CROWN 300 600 0
REMOVABLE COMPLETE DENTURE 2000 4000 0
REMOVABLE FUNCTIONAL APPLIANCES 7500 15000 0
REMOVABLE ORTHODONTIC APPLIANCE 1200 2400 0
REMOVABLE PARTIAL DENTURE 750 1500 0
REMOVABLE SPACE MAINTAINER 500 1000 0
REPAIR / RELINING OF APPLIANCE 300 600 0
REPAIR OF SOFT TISSUE INJURY 600 1200 0
REPLANTATION (WITHOUT RCT) 1500 3000 0
RESIN CEMENT 500 1000 0
ROOT CANAL DRESSING - CALCIUM HYDROXIDE (PER VISIT) 200 400 0
ROOT CANAL DRESSING - METAPEX (PER VISIT) 400 800 0
ROOT CANAL TREATMENT - ANTERIOR 1250 2500 0
ROOT CANAL TREATMENT - POSTERIOR 1500 3000 0
ROOT CANAL TREATMENT - ROTARY 3000 6000 0
RUBBER BASE IMPRESSION (PER ARCH) 350 600 0
RUBBER DAM APPLICATION 200 400 0
SILVER DIAMINE FLUORIDE 200 400 0

SIMPLE GRINDING / PROXIMAL STRIPPING (PER TOOTH) 100 200 0
SPLINTING - COMPOSITE AND WIRE (4 UNIT) 1250 2500 0
SPLINTING - GUNNING SPLINT 1500 3000 0
SPLINTING - RIBBOND FIBER (1CM) 1800 3600 0
STRIP CROWN 1750 3500 0
SUTURING (EXCLUDING SUTURE MATERIAL) 250 500 0
TEMPORARY CROWN 250 500 0
TEMPORARY RESTORATION 100 200 0
TOOTH PREPARATION 600 1200 0
ULTRASONIC SCALING - PERMANENT DENTITION 400 800 0
ULTRASONIC SCALING - PRIMARY DENTITION 300 600 0
VACUUM FABRICATED SPLINT/ MOUTHGUARD 1500 3000 0
ZIRCONIA CROWN 3000 6000 0
ULTRASONIC DEBRIDEMENT OF WOUND 500 1000 500
ALVELOPLASTY PER SEGMENT 600 1000 0
APICOECTOMY OF ANTERIOR TOOTH WITH RCT 2000 3500 0
APICOECTOMY OF ANTERIOR TOOTH WITHOUT RCT 1800 3000 0
APICOECTOMY OF POSTERIOR TOOTH WITHOUT RCT 2500 4000 0
BIO-OSS PER TOOTH 4000 7000 0
BIOPSY (EXCISIONAL) 1000 1500 1000
BIOPSY (INCISIONAL) 800 1000 800
BONE GRAFT PER TOOTH WITH LOCAL MATERIAL 1100 2000 0
COMPOSITE SPLINTING PER SEXTANT 1200 2000 0
CONNECTIVE TISSUE GRAFT 1650 3000 0

CROWN CEMENTATION FOR IMPLANT 250 500 0
CROWN LENGTHNING PER TOOTH- ANTERIOR 800 1500 0
CUSPAL GRINDING PER TOOTH 60 100 0
CYST ENUCLEATION (PERIODONTAL)-ANTERIOR TOOTH 1650 3000 0
CYST ENUCLEATION OF POSTERIOR TOOTH 2500 5000 0
DENTIUM IMPLANT ABUTMENTWITH PLACEMENT 10000 20000 0
DEPIGMENTATION OF GINGIVA PER SEXTANT 600 1000 0
DESENSITIZING PER SEGMENT 500 1000 0
DESENSITIZING PER TOOTH 250 400 0
DISTAL WEDGE SURGERY 450 800 0
EPITHELIZED SOFT TISSUE GRAFT 1100 2000 0
FLAP SURGERY FULL MOUTH 5000 10000 0
FLAP SURGERY PER QUADRANT 1500 2500 0
FLAP SURGERY PER SEXTANT 1000 1500 0
FLAP SURGERY PER TOOTH 500 800 0
FRENECTOMY 600 1000 0
FULL MOUTH MANUAL SUPRAGINGIVAL SCALING 300 0 0
FULL MOUTH ULTRASONIC SUBGINGIVAL SCALING 700 1200 0
FULL MOUTH ULTRASONIC SUPRA AND SUBGINGIVAL SCALING 900 1600 0
FULL MOUTH ULTRASONIC SUPRAGINGIVAL SCALING 450 800 0
GBR PER IMPLANT 2500 5000 0
GINGIVECTOMY/ GINGIVOPLASTY PER SEXTANT 1100 2000 0
GTR AND BONE GRAFT WITH LOCAL MATERIALS 2500 5000 0
GTR PER TOOTH WITH LOCAL MATERIAL 1700 3000 0

GTR WITH BIOGIDE PER TOOTH 5000 8000 0
IMPLANT SURGERY 5500 10000 0
IMPLANT SURGERY WITH ADIN FIXTURE 16500 30000 0
IMPLANT SURGERY WITH DENTIUM FIXURE 15000 30000 0
IMPLANT SURGERY WITH XIVE FIXTURE 27500 50000 0
INCIAL / OCCLUSAL GRINDING: PER QUADRANT 250 400 0
INCISION AND DRAINAGE PER AREA 300 500 900
INTER DENTAL PAPILLA RECONSTRUCTION _x000D_

600 1000 0
( PER PAPILLA)
LASER DEPIGMENTATION 2500 5000 0
LASER EXCISION OF ORAL LESION (LARGE) 1500 3000 0
LASER EXCISION OF ORAL LESION (SMALL) 1000 2000 0
LASER FRENECTOMY 1500 3000 0
LASER OPERCULECTOMY 1500 3000 0
LATERAL / CORONAL POSITIONED AUTOGRAFT PER TOOTH 600 1000 0
LIP REPOSITIONING SURGERY 1000 2000 0
LOCAL DRUG DELIVERY PER TOOTH 1200 2500 0
LOW LEVEL LASER THERAPY (PERIODONTICS) 1500 3000 0
MANUAL SUPRAGINGIVAL SCALING PER QUADRANT 150 0 0
MANUAL SUPRAGINGIVAL SCALING PER TOOTH- ANTERIOR 110 200 0
MANUAL SUPRAGINGIVAL SCALING PER TOOTH- POSTERIOR 180 300 0
MINOR SURGICAL PROCEDURE 600 1000 0
NATURAL TOOTH PONTIC WITH RIBBOND FIBER 2500 5000 0
OPERCULECTOMY 600 1000 0
PLACEMENT OF ADIN IMPLANT ABUTMENT 11000 20000 0

PLACEMENT OF XIVE IMPLANT ABUTMENT 16500 30000 0
PRF PROCEDURE 300 500 0
PROPHYJET POLISHING (GEN. STAIN) 600 1000 0
PROPHYJET POLISHING (PER SEXTENT) 300 500 0
RADISECTION/HEMISECTION WITHOUT RCT 1200 2000 0
REPAIR SPLINTING 500 800 0
RESECTIVE OSSEOUS SURGERY PER SEXTANT 1500 2500 0
RIBBOND FIBRE SPLINTING PER SEXTANT 2600 5000 0
RIDGE AUGMENTATION WITH GRAFT (LOCAL) PER AREA 2000 4000 0
ROOT RESECTION / HEMISECTION WITH RCT 2000 4000 0
RVG IMAGING PER PROCEDURE 280 500 0
SCALING IN GENERALISED STAINING 900 1800 0
SCALING, ROOT PLANING & GINGIVAL CURETTAGE PER TOOTH 300 500 0
SOCKET PRESERVATION 500 800 0
SPLINTING REMOVAL 500 800 0
SPLINTING WITH WIRE 600 1000 0
SPLINTING WITH WIRE AND COMPOSITE 1800 3000 0
SUBGINGIVAL IRRIGATION PER TOOTH 100 200 0
SUPPORTIVE PERIODONTAL THERAPY 500 1000 0
SURGICAL EXPOSURE OF ECTOPICALLY ERUPTING TOOTH 1000 2000 0
SUTURES REMOVAL 100 150 250
TEMPORARY PROSTHESIS FOR IMPLANT 500 800 0
ULTRASONIC SUBGINGIVAL SCALING PER QUADRANT 300 500 0
ULTRASONIC SUPRA & SUBGINGIVAL SCALING PER QUADRANT 350 600 0

ULTRASONIC SUPRAGINGIVAL SCALING PER QUADRANT 250 400 0
CARBMAZEPINE 2090 0 0
LAMOTRIGINE 2090 0 3000
PHENYTOIN 2090 0 3000
PHARMACY CHARGES 6200 6200 0
AFT 1300 1850 2000
EEG 1800 2500 1080
EMG 2000 2600 2000
NCV FOR ALL FOUR LIMBS 1400 2000 2000
NCV OF ANY TWO LIMBS 1000 1400 1000
PFT 700 820 700
PFT BY SPIROMETER 700 820 700
VEP (EVOKED POTENTIAL VISUAL) 1000 1500 1000
VER 700 1010 700
HIP SPICA 750 1500 2550
MAKING WINDOW OR WEDGE IN PLASTER CAST 100 200 100
CERVICAL & LUMBAR TRACTION (1 DAY) 75 110 100
COLD LASER 160 240 200
CONTINUOUS PASSIVE MOTION/DAY 60 90 100
CPM UPPER EXTREMITY 145 215 200
DIADYNAMIC 135 200 200
DIPOLE VECTOR IFT 145 215 200
ESWT MSK 1210 1815 2000
EXERCISE/DAY 35 52 100
HIGH ENERGY LASER 185 270 200
HOT PACKS/DAY 50 75 100
INFRA RAY/DAY 40 60 100
INTERFERENTIAL THERAPY/DAY 85 125 100
ISOPLANAR IFT 145 215 200
KOTZ 135 200 200
LASER THERAPY/DAY 95 140 100
LEG PRESS 125 185 200
MAGNETO THERAPY ( FMF) 245 365 300
MICROWAVE DIATHERMY/DAY 85 125 100
MOBILIZATION LOCALIZED 50 75 100
MOBILIZATION WHOLE BODY 85 125 100
MUSCLE STIMULATION PER DAY 85 125 100
PHONOPHORESIS (ULTRA SOUND WITH MEDICATION) 100 150 100
PRE LOWER EXTREMITY 125 185 200
PRE UPPER EXTREMITY 125 185 200
PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF) 75 110 100
RUSSIAN STIMULATION 145 215 200
SHORT WAVE DIATHERAPY (10 DAYS) 730 1095 800
SHORT WAVE DIATHERMY (1 DAY) 100 150 100
TENS (RANDOM/ ENDORPHIN) 145 215 200
TENS/DAY 85 125 100
ULTRA REIZ 135 200 200
ULTRASOUND 1 DAY (THERAPEUTIC ULTRASOUND) 85 125 100

VACATRON/DAY 70 105 100
WAX BATH/DAY 50 75 100
DISCHARGE FILE 50 95 100
BK SUSPENSION BELT/SLEEVE 6380 9570 0
HKAFO MOULDED 30250 45375 0
LEATHER KNEE CAP FOR KAFO 605 905 0
MODULAR EXTENSION PROSTHESIS 52800 79200 0
MOLDED TAYLORS BRACE 7260 10890 8000
POLYCENTRIC KNEE JOINT (ORTHOSIS) 3850 5775 0
SHOE RAISE PER INCH 715 1070 0
STOCKINETT PER MTR. (60MM/80MM) 165 245 0
SUSPENSION BELT (LEATHER)AK/BL PROSTHESIS 495 740 0
TES BELT 10450 15675 12000
TRIAL/ GAIT TRAINING / FINAL FINISHING 6050 9075 0
ABOVE ELBOW PROSTHESIS COSMETIC 24200 36300 0
ABOVE ELBOW PROSTHESIS FUNCTIONAL 30250 45375 0
ABOVE KNEE PROSTHESIS CONVENTIONAL 30250 45375 35000
AK CHILD MODULAR PROSTHESIS 132000 198000 0
AK FAIRING 7150 10725 0
AK SOCKET ADAPTER 13750 20625 0
AK SOCKET LAMINATED 16225 24335 0
AK SOCKET PP MOULDED 13145 19715 0
AK SUSPENSION BELT 7865 11795 8000
AK/BK COSMETIC SOCKS 825 1235 0

BELOW ELBOW PROSTHESIS COSMETIC 14850 22275 0
BELOW ELBOW PROSTHESIS FUNCTIONAL 20350 30525 0
BELOW KNEE PROSTHESIS WITH LAMINATED SOCKET 38500 57750 0
BELOW KNEE PROSTHESIS WITH P.P SOCKET 35200 52800 0
BK COSMETIC COVER 1650 2475 0
BK FAIRING 6490 9735 0
BK SOCKET ADAPTER 10450 15675 0
BK SOCKET LAMINATED 10835 16250 0
BK SOCKET PP MOULDED 8690 13035 0
CONVENTIONAL BELOW KNEE PROSTHESIS 18150 27225 0
CUSTOM MADE PARTIAL FOOT PROSTHESIS 7865 11795 0
DOUBLE ENDED ADAPTER 9350 14025 0
LAMINATED SYMES PROSTHESIS 20900 31350 0
MODULAR ABOVE KNEE PROSTHESIS WITH LAMINATED SOCKET WITH 96800 145200 99000
SACH FOOT
MODULAR ABOVE KNEE PROSTHESIS WITH P.P SOCKET WITH SACH
90750 136125 99000
FOOT
MODULAR HIP DISARTICULATION PROSTHESIS WITH SACH FOOT 132000 198000 0
MODULAR ORTHO PROSTHESIS 50600 75900 0
MODULAR THROUGH KNEE PROSTHESIS WITH LAMINATED SOCKET

80850 121275 0
WITH SACH FOOT
MODULAR THROUGH KNEE PROSTHESIS WITH P.P SOCKET SACH FOOT 78650 117975 0
MOLDED SYMES PROSTHESIS 19360 29040 0
PU /RANGER/SACH FOOT 6050 9075 0
SILICON HAND PROSTHESIS (WRIST DISARTICULATION) 19250 28875 0
STUMP SOCKS (BK) 495 740 0
THROUGH KNEE PROSTHESIS CONVENTIONAL 22000 33000 0

TK FAIRING 7150 10725 0
TK SOCKED LAMINATED 16280 24420 0
TK SOCKET PP MOULDED 11500 17250 0
CAD-CAM ZIRCONIA CROWN (ANTERIOR TEETH) 14520 26400 0
CAD-CAM ZIRCONIA CROWN (POSTERIOR TEETH) 17420 31680 0
CAST PARTIAL DENTURE BASE (CHOME-COBALT / VITALLIUM) 8710 15840 0
E-MAX ALL CERAMIC CROWN (ANTERIOR TEETH) 5810 10560 0
E-MAX ALL CERAMIC CROWN (POSTERIOR TEETH) 7260 13200 0
FULL METAL RESTORATIONS 1450 2640 0
PORCELAIN FUSED TO METAL RESTORATIONS 2180 3960 0
ACRYLIC RPD PER ARCH UPTO 5 TOOTH 580 1060 0
ACRYLIC SCREW 690 0 0
ADHESIVE/ SOLVENT 2180 3960 0
AESTHETIC POST & CORE 2180 4000 0
ALGINATE IMPRESSION / ARCH 320 580 0
ALL CERAMIC CROWN / PER UNIT/LAB CHARGE EXTRA 5080 9240 0
ANY OTHER PROTHESIS APART FROM ABOVE MENTIONED 730 1320 0
CAST DENTURE BASE ( CHROME- COBALT) 8710 15840 0
COMPLETE DENTURE 2900 13200 0
COMPOSIT RESTORATION (ANTERIOR) 1520 0 0
COMPOSITE LAMINATES PER TOOTH 650 1190 0
COMPSIT RESTORATION POSTERIOR 1820 0 0
COMPSIT VENEER 1820 0 0
CUSTOM FABRICATED / CAST POST & CORE 1160 2110 0

DEFINITIVE OBTURATOR PROSTHESES ACRYLIC 670 1190 0
DEFINITIVE OBTURATOR PROSTHESES METAL 5080 9320 0
DEFINITIVE OBTURATOR PROSTHESIS CUM PARTIAL DENTURE PER

1160 2110 0
ARCH
EYE PROSTHESIS EXTRA OCULAR FACIAL 2900 5280 0
EYE PROSTHESIS INTRA OCULAR 2180 3960 0
FAULTY BRIDGE REMOVAL 440 790 0
FEEDING APPLIANCE ACRYLIC 510 920 0
FEEDING APPLIANCE METAL 2180 3960 0
FULL METAL CROWN / PER UNIT/ LAB CHARGE EXTRA 1450 2640 0
FULL MOUTH REHABILITATION INCLUSIVE OF LAB CHARGES 108900 198000 0
FULL MOUTH REHABILITATION/ LAB CHARGES EXTRA 65340 118800 0
IMMEDIATE DENTURE/COMPLETE U/L 5810 10560 0
IMPLANT PLACEMENT SURGERY (INCLUDING DENTAL IMPLANT) 36300 66000 0
IMPLANT PLACEMENT SURGERY (INCLUDING XIVE IMPLANT) PER 58080 105600 0

IMPLANT
IMPLANT SUPPORTED BRIDGE 36300 66000 0
IMPLANT SURGERY DENTAL 7590 0 0
IMPLANTS SUPPORTED DENTURE MANDIBULAR 43560 79200 0
IMPLNAT SUPPORTED CROWN/ANTERIOR 29040 52800 0
LAB CHARGE EXTRA 1450 2640 0
MANDIBULAR GUIDANCE APPLIANCE ACRYLIC 730 1320 0
MARYLAND FIXED PARTIAL DENTURE (FPD) 2900 5280 0
MAXILLOFACIAL PROSTHESIS (COLD CURE) / OBTURATION SURGICAL 370 660 0
MAXILLOFACIAL PROSTHESIS (HEAT CURE) / SURGICAL OBTURATION 1020 1850 0
MAXILLOFACIAL PROSTHESIS (NOSE/ EAR/ ORBITAL/ OTHERS, RTV

14520 26400 0
SILICONE)
MULTI UNIT PFM BRIDGE PER UNIT CHARGE / INCLUSIVE
1450 2640 0
CEMENTATION LAB CHARGES EXTRA
NOSE/EAR PROSTHESIS 3630 6600 0
OCCLUSAL SPLINT / HEAT CURE RESIN/ VACCUM PRESSED 880 1580 0
OCCLUSAL SPLINT / SELF CURE RESIN 730 1320 0
OVER DENTURE PROSTHESIS 5810 10560 0
PALATAL LIFT PROSTHESIS 730 1320 0
PARTIAL VENEER PORCELAIN FUSED TO METAL (PFM) RESTORATION

1450 2640 0
PER UNIT
POLYCARBONATE CROWN 510 920 0
PORCELAIN FUSED TO METAL CROWN / PER UNIT 2900 5330 0
PORCELAIN LAMINATES PER TOOTH 2620 4750 0
POST (PREFABTRICATED) CORE COMPOSITE 730 1320 0
POST AND CORE COMPOSITE 730 1320 0
PROVISIONAL RECEMENT 220 400 0
RE- CEMENTATION 370 660 0
REBASING OF DENTURE PER ARCH 730 1320 0
RECEMENTATION WITH GIC PER UNIT 310 560 0
RELINING BY CHAIR SIDE RELINER (SELF CURE) 370 660 0
RELINING BY HEAT CURE PER ARCH 510 920 0
REPAIR OF DENTURE 370 660 0
ROOT PLANNING 150 280 0
RPD ( SELF CURED DENTURE BASE RESIN) 370 660 0
RPD EVERY ADDITIONAL TOOTH 70 130 0
RPD RELINE 290 530 0
RPD REPAIR & ADDITIONAL TOOTH 290 530 0

RUBBER BASED IMPRESSION PER ARCH 730 1320 0
SINGLE COMPLETE DENTURE 1450 6600 0
SOFT RELINER PER ARCH 510 920 0
STANLESS STEEL CROWN 1090 1980 0
SUPRASTRUCTURE FOR IMPLANT SUPPORTED OVERDENTURE PER

7800 13200 0
ARCH
SURGICAL TEMPLATE COLD CURE 370 660 0
TEMPORARY CROWN (COLD CURE) _x000D_

70 130 0
ADDITIONAL TOOTH
TEMPORARY CROWN (HEAT CURE) 650 1190 0
TOOTH PREPARATION & TEMPORARY CROWN CEMENTATION (PER

UNIT) 1450 2640 0
TRISMUS SCREW ( SELF CURED RESIN) 730 1320 0
VACUUM PROCESSED OCCLUSAL SPLINT 1750 3170 0
16 - PF TEST 440 600 500
BENDER-GESTALT TEST 330 500 400
BREATHING EXERCISE (PER SESSION) 330 500 400
COUNSELLING (PER SESSION) 330 500 400
DEVELOPMENT SCREENING TEST FOR CHILDREN 280 500 300
ERP (PER SESSION) 330 500 400
IPDE (F 6 MODULE) 440 600 500
IPT (INTER PERSONAL THERAPY) 330 500 400
MODIFIED ECT PER CYCLE 440 750 500
PEN (EYSENCK) 440 600 500
PTI 440 600 500
RELAXATION TRAINING (PER SESSION) 330 500 400
RORSCHACH'S TEST 550 700 600

SEGUIN FORM BOARD FOR CHILDREN 170 300 200
SPM / CPM (RAVEN'S) 330 500 400
SYSTEMATIC DESENSEZATION 330 500 400
TAT / CAT 440 600 500
VINELAND SM SCALE 280 500 300
WAIS / WAPIS 390 600 400
BRONCHOSCOPY WITH BIOPSY/TBNA/TBLB 3450 6000 4000
DIAGNOSTIC BRONCHOSCOPY 2300 4600 2000
EBUS 25000 35000 25000
INTERVENTIONAL BRONCHOSCOPY 15000 25000 16000
LUNG ULTRASOUND 600 1200 600
PFT 700 1400 700
SLEEP STUDY TYPE 1 5750 10000 6000
SLEEP STUDY TYPE 3 4000 7000 4000
USG GUIDED BIOPSY 1730 3450 2000
CT ABDOMEN 7200 9200 5000
CT CERVICAL SPINE 5500 7000 7000
CT FACE (ORBIT+PNS+MAXILLA+MANDIBLE) 6500 8000 7000
CT GUIDED INTERVENTION 4500 6000 4500
CT HEAD 3600 4500 3500
CT HEAD + NECK 7000 8500 7000
CT HEAD + ORBIT 5500 7000 7000
CT HEAD + PNS 5500 7000 7000
CT HEAD + TEMPORAL BONE 6000 7500 7000

CT JAWS (MAXILLA / MANDIBLE) 4500 6000 4500
CT JAWS/ORAL CAVITY + NECK 6500 8000 7000
CT L-S SPINE 5500 7000 6000
CT NECK 5500 7000 4500
CT NECK + THORAX 9000 11000 9000
CT ORBIT 4000 5000 7000
CT ORBIT + PNS 5500 7000 7000
CT PELVIS + HIP JOINTS 5500 7000 6000
CT PNS 4000 5000 7000
CT PNS + NECK 7000 8500 7000
CT TEMPORAL BONE 4500 5500 7000
CT TEMPORO-MANDIBULAR JOINT (TMJ) 4000 5000 7000
CT THORACIC SPINE 5500 7000 6000
CT THORAX (NCCT + CECT) 5500 7000 4500
CT THORAX (NCCT) /HRCT CHEST 4500 5500 4500
CT THORAX + ABDOMEN 11000 13000 12000
CT WHOLE SPINE 12000 14500 12000
CT: ANY ONE JOINT (SHOULDER OR ELBOW OR WRIST OR KNEE OR

6500 8000 7000
ANKLE) - BILATERAL
CT: ANY ONE JOINT (SHOULDER OR ELBOW OR WRIST OR KNEE OR
5500 7000 6000
ANKLE) - UNILATERAL
CT: ANY ONE REGION OF EXTREMITY (ARM OR FOREARM OR HAND OR
6500 8000 7000
THIGH OR LEG OR FOOT) - BILATERAL
CT: ANY ONE REGION OF EXTREMITY (ARM OR FOREARM OR HAND OR
5500 7000 5500
THIGH OR LEG OR FOOT) - UNILATERAL
CT: COMBINED TWO SPINAL REGIONS 8500 10000 9000
NCCT KUB/ NCCT ABDOMEN ONLY 5000 6500 5000
REPEAT CT HEAD (WITHIN 3 WEEKS) 2400 3300 3500

ABDOMINAL CT AORTOGRAPHY 9500 12000 10000
ABDOMINAL CT VENOGRAPHY 9500 12000 10000
CAROTID CT ANGIOGRAPHY 9500 12000 10500
CT ANGIOGRAPHY (CEREBRAL + CAROTID) 14500 18000 16000
CT ANGIOGRAPHY (THORACO-ABDOMINAL AORTA) 14500 18000 16000
CT BONE MINERAL STUDY 7200 9200 8000
CT DENTAL SCAN 6000 7500 6000
CT RENAL ARTERIOGRAPHY 9500 12000 10000
CT SPLENOPORTOGRAPHY 9500 12000 10000
CT UROGRAPHY (CTU) 7500 9500 7000
CT VIRTUAL BRONCHOSCOPY 7200 9200 8000
CT VIRTUAL COLONOSCOPY 10000 12500 10000
INTRACRANIAL CT ARTERIO-VENOGRAPHY 12000 15500 12000
INTRACRANIAL CT ARTERIOGRAPHY 9500 12000 10000
INTRACRANIAL CT PERFUSION STUDY 7500 9000 8000
INTRACRANIAL CT VENOGRAPHY 9500 12000 10000
LOWER LIMB CT ARTERIOGRAPHY (BILATERAL) 12000 15500 12000
LOWER LIMB CT ARTERIOGRAPHY (UNILATERAL) 9500 12000 10000
LOWER LIMB CT VENOGRAPHY (BILATERAL) 12000 15500 12000
LOWER LIMB CT VENOGRAPHY (UNILATERAL) 9500 12000 10000
PULMONARY CT ARTERIOGRAPHY 9500 12000 10000
THORACIC CT AORTOGRAPHY 9500 12000 10000
UPPER LIMB CT ARTERIOGRAPHY (BILATERAL) 12000 15500 12000
UPPER LIMB CT ARTERIOGRAPHY (UNILATERAL) 9500 12000 10000

UPPER LIMB CT VENOGRAPHY (BILATERAL) 12000 15500 12000
UPPER LIMB CT VENOGRAPHY (UNILATERAL) 9500 12000 10000
VERTEBROBASILAR CT ARTERIOGRAPHY 9500 12000 10000
DENGUE SEROOGY 800 0 800
HCV 420 550 265
ALDEHYDE TEST 70 130 95
ANTI HCV 420 610 500
ASO ( TITRE ) 300 440 200
CMV 1 GG 420 550 500
CMV 1 GM 420 550 500
CRP 160 280 600
HBSAG 130 280 200
HEPATITIS A (IGM) 420 610 500
HEPATITIS E (IGM) 420 610 500
HIV (TRI-DOT) 220 280 300
LEPTOSPIRA (IGM & IGG) 420 610 500
RA FACTOR 130 220 100
RAPID SYPHILLIUS TEST 220 390 300
RUBELLA 1 GG 420 550 500
RUBELLA 1 GM 420 550 500
SERODIAGNOSTIC TEST FOR LEPTOSPIROSIS 970 1320 1000
SERODIAGNOSTIC TEST FOR MALARIA OR OPTIMAL TEST (MORPON

LAB) 420 630 500
SYPHILIS RAPID TEST 150 280 200
TOXOPLASMA 1 GG 490 630 500

TOXOPLASMA 1 GM 420 550 500
VDRL/RPR ( QUALITATIVE & QUANTITATIVE) 170 280 95
WIDAL TEST 180 280 100
AFP(ALPHA FETO PROTEIN) 725 1180 900
LH, PROLACTIN, FSH (COMBINED) 2000 3200 2000
ACTH 2200 3300 3000
ALDOSTERONE 2200 3300 3000
AMH 1000 1820 1000
ANTI CARDIOLIPIN IGA 1050 1910 2000
ANTI CYCLIC CITRULLINATED PEPTIDE(ANTI-CCP) 2000 3640 1050
ANTI DS DNA 1100 2000 525
ANTI SMOOTH MUSCLE ANTIBODY 870 1590 900
ANTI TPO 750 1370 1650
ANTINEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) 760 1390 800
ANTINUCLEAR ANTIBODY (ANA) 1100 2000 525
ANTINUCLEAR ANTIGEN SCL - 70 930 1690 1000
BHCG 760 1380 800
CA125 900 1640 1055
CA15-3 810 1470 1025
CA19-9 810 1470 1067
CEA 900 1640 730
CORTISOL 760 1380 990
DHEA-S 2000 3000 2000
DIRECT RENIN 2500 3500 3000

ESTRADIOL 770 1390 500
FSH 700 1270 500
GASTRIN-17 2200 3300 3000
INSULIN (S) 1200 2000 2000
LH 700 1270 650
NT PRO BNP 2000 3640 2000
PROGESTERONE 850 1550 650
PROLACTIN 700 1270 550
PSA 600 1090 800
PTH (PARATHARMONE) 1000 1820 500
SERUM ELECTOPHORESIS 800 1460 800
TESTOSTERONE 770 1220 650
TFT (ACTIVE) 900 1640 900
THYROGLOBULIN (TG) 1000 1800 1000
THYROGLOBULIN ANTOBODY (TGA) 1500 2500 2640
TSH 350 630 308
VITAMIN B12 900 1640 1000
VITAMIN D 1200 2180 1500
VMA 1500 2730 2000
ABDOMINOPERINEAL RESECTION (APR) 35000 65000 35000
ABSCESS DRAINAGE (BIG & MULTIPLE) GA 18000 36000 18000
ABSCESS DRAINAGE (LARGE) GA 15000 30000 16000
ABSCESS DRAINAGE (SMALL) LA 3500 6500 4000
ALVEOLAR BORE GRAFTING GA 20000 38000 20000

BAND LIGATION / CRYOSURGERY LA 3500 6500 4000
BELOW/ABOVE KNEE AMPUTATION 15000 30000 16000
BRACHIAL PLEXUS SURGERY GA 20000 38000 20000
BREAST AUGMENTATION GA 20000 38000 20000
BREAST RECONSTRUCTION GA 20000 38000 20000
BREAST REDUCTION GA 20000 38000 20000
CAPD CATHETER IMPLANTATION GA 15000 30000 16000
CAPD CATHETER IMPLANTATION LA 8000 16000 8000
CBD EXPLORATION (OPEN) 18000 36000 18000
CBD EXPLORATION LAPAROSCOPIC 20000 38000 20000
CHET TUBE INSERTION LA 3500 6500 4000
CHOLEDOCHAL CYST EXCISION 22000 44000 22500
CIRCUMCISION LA 8000 15000 8000
CLEFT LIP REPAIR GA 20000 38000 20000
COLOSTOMY/JEJUNOSTOMY 15000 30000 16000
COMPLEX INCISIONAL HERNIA REPAIR 20000 38000 20000
CONTRACTURE RELEASE GA/S 20000 38000 20000
CRANIOSYNOSTOSIS GA 20000 38000 20000
CYST EXCISION 3500 6500 4000
DEBRIDEMENT/ NECTROSING FASCITIS GA 15000 30000 16000
DIAGNOSTIC LAPAROSCOPY & PROCEED 20000 38000 20000
EAR RECONSTRUCTION GA 20000 38000 20000
ECTOPION RELEASE LA 3500 6500 4000
ENTEROCUTANEOUS FISTULA SURGERY 20000 38000 20000

EXPLORATORY LAPAROTOMY AND PROCEED 20000 38000 20000
FACIAL FRACTURES PLATING GA 20000 38000 20000
FALLOPIAN TUBE RECANALIZATION GA/S 20000 38000 20000
FEEDING JEJUNOSTOMY 15000 30000 16000
FIBROADENOMA EXCISION GA 15000 30000 16000
FIBROADENOMA EXCISION LA 8000 15000 8000
FISTULA/HAEMORRHOIDECTOMY GA 15000 30000 16000
FISTULOTOMY 15000 3000 16000
FREE FLAPS GA 20000 38000 20000
FRONTAL BAR ADVANCEMENT GA 20000 38000 20000
GASTROJEJUNOSTOMY 20000 38000 20000
GYNAECOMASTIA GA 20000 38000 20000
GYNAECOMASTIA SURGERY LA 8000 15000 8000
HAIR TRANSPLANT LA 20000 38000 20000
HEMICOLECTOMY 20000 38000 20000
HEPATICOJEJUNOSTOMY 25000 48000 25000
HERNIORRAPHY LA 8000 15000 8000
HYDATID CYST SURGERY (LAPAROSCOPIC) 25000 48000 25000
HYDATID CYST SURGERY (OPEN) 20000 38000 20000
HYDROCELE SURGERY GA 15000 30000 16000
HYDROCELE SURGERY LA 8000 15000 8000
HYPOSPADIAS GA 20000 38000 20000
INCISIONAL HERNIA REPAIR 15000 30000 16000
INGROWING TOE NAIL LA 3500 6500 4000

INTERMEDIATE OT (SURGERY) 8000 16000 8000
IPOM 18000 36000 18000
LAPAROSCOPIC HEMICOLECTOMY 25000 48000 25000
LAPAROSCOPIC INGUINAL HERNIA REPAIR 18500 36000 20000
LAPAROSCOPIC BIOPSY 15000 30000 16000
LAPAROSCOPIC SPLENECTOMY 20000 48000 20000
LAPAROSCOPIC TOTAL COLECTOMY 30000 58000 30000
LAPAROSCOPY APPENDECTOMY 18500 36000 20000
LAPAROSCOPY CHOLECYSTECTOMY 18500 36000 20000
LATERAL SPHINCTEROTOMY 15000 30000 16000
LEFORTE OSTEOTOMY GA 20000 38000 20000
LIPOMA EXCISION LA 8000 15000 8000
LN. BIOPSY LA 3500 6500 4000
LOCAL FLAP COVER LA 3500 6500 4000
LOW ANTERIOR RESECTION (LAR) 30000 58000 30000
MAJOR LIVER RESECTION 35000 65000 35000
MAJOR OPEN PANCREATIC SURGERY 30000 58000 30000
MAJOR RHINOPLASTY GA 20000 38000 20000
MELANOMA GA 15000 30000 16000
MICRODOCHECTOMY / MAJOR DUCT EXCISION GA 15000 30000 16000
MICRODOCHECTOMY LA 8000 15000 8000
MINOR OT (SURGERY) 3500 6500 2500
MINOR RHINOPLASTY LA 3500 6500 4000
NERVE REPAIRS RA/L 20000 38000 20000

OBSTRUCTED HERNIA REPAIR 18000 36000 18000
OESOPHAGECTOMY 30000 58000 30000
OPEN APPENDECTOMY 15000 30000 16000
OPEN CHOLECYSTECTOMY 15000 30000 16000
OPEN INGUINAL HERNIA REPAIR 15000 30000 16000
OPEN SPLENECTOMY 15000 30000 16000
ORCHIDECTOMY LA 8000 15000 8000
OTHER LAPAROSCOPIC LARGE BOWEL SURGERY 30000 58000 30000
OTHER LAPAROSCOPIC PROCEDURES 20000 38000 20000
OTHER LARGE BOWEL SURGERY 20000 38000 20000
OTHER MAJOR BILIARY SURGERY 25000 48000 25000
OTHER MAJOR LIVER SURGERY 30000 58000 30000
PALATE REPAIR GA 20000 38000 20000
PANCREATICODUODENECTOMY (WHIPPLES PROCEDURE) 30000 58000 30000
PARATHYROIDECTOMY 18000 34000 18000
PAROTIDECTOMY GA 15000 30000 16000
PERFORATION PERITONITIS 18000 36000 18000
PERIANAL ABSCESS DRAINAGE 15000 30000 16000
PERIPHERAL TUMOR/HEMANGIOMA EXCISION GA 20000 38000 20000
PERIPHERAL TUMOR/HEMANGIOMA EXCISION LA 8000 16000 8000
PILONIDAL SINUS EXCISION 15000 30000 16000
PROSTATE BIOPSY (TRUCUT) LA 3500 6500 4000
PSEUDOCYST OF PANCREAS SURGERY (LAPAROSCOPIC) 25000 48000 25000
PSEUDOCYST OF PANCREAS SURGERY (OPEN) 20000 38000 20000

RADICAL DUCT EXCISION 15000 28000 16000
REGIONAL FLAP COVER GA/S 20000 38000 20000
REPLANTATIONS GA/S 20000 38000 20000
RETROPERITONEAL TUMOR EXCISION 22000 40000 22500
REVASUCULARIZATION GA/S 20000 38000 20000
REXPLORATION OT CHARGE 5000 7000 5000
SKIN GRAFTING - LARGE AREA GA 18000 36000 18000
SKIN GRAFTING - SMALL AREA GA 15000 30000 16000
SKIN GRAFTING LA 8000 15000 8000
SLNB BREAST 3500 6500 4000
SMALL BOWEL RESECTION AND ANASTOMOSIS 20000 38000 20000
SPLIT EAR LA 3500 6500 4000
STAGING LAPAROSCOPY 18000 36000 18000
STOMA CLOSURE 15000 30000 16000
SUBCLAVIAN CATHETERIZATION FOR HAEMODIALYSIS 3500 6500 4000
SUBTOTAL GASTRECTOMY 25000 48000 25000
SUCTION DRAIN 1000 1800 1000
SUTURING GA 15000 30000 16000
SUTURING LA 1500 3000 2000
TAR 20000 40000 20000
THYROIDECTOMY (RADICAL/MODIFIED RADICAL) GA 18000 36000 18000
THYROIDECTOMY (SELECTIVE NECK DISSECTION) GA 18000 36000 18000
THYROIDECTOMY (TOTAL / SUBTOTAL / NEAR TOTAL ) GA 15000 30000 16000
TISSUE EXPANDER INSERTION GA/L 8000 16000 8000

TOES/FINGER AMPUTATION LA 8000 16000 8000
TOTAL COLECTOMY 25000 48000 25000
TOTAL GASTRECTOMY 30000 58000 30000
TOTAL MASTECTOMY 18000 36000 18000
TRUCUT BIOPSY LA 3500 6500 4000
TUBE GASTROSTOMY 15000 30000 16000
URETHRAL DILATATION LA 3500 6500 4000
UROFLOWMETRY TEST 3500 6500 4000
USG GUIDED ASPIRATION OF BREAST 800 1500 1000
USG GUIDED BIOPSY OF BREAST 3500 7000 4000
VAGINOPLASTY GA/S 20000 38000 20000
VARICOCELE EXCISION LA 8000 15000 8000
VARICOSE VEINS SURGERY 15000 30000 16000
VAS RECANALIZATION LA 3500 6500 4000
VASCUALR INJURY REPAIR GA 15000 30000 16000
VASCUALR INJURY REPAIR LA 8000 16000 8000
WEDGE BIOPSY LA 3500 6500 4000
WLE + ALND BREAST 22000 34000 22500
WLE + SNLB BREAST 20000 38000 20000
WLE BREAST 18000 34000 18000
BURN DRESSING 1000 1500 1000
V P SHUNT GA 13800 27600 14000
ABDOMINAL MASS GA 20000 40000 20000
ABSCESS DRAINAGE (BIG & MULTIPLE) GA 13000 26000 14000

ABSCESS DRAINAGE (LARGE) GA 10000 20000 10000
ABSCESS DRAINAGE (SMALL) LA 1500 3000 2000
ANORECTAL MALFORMATIONS ANOPLASTY GA 20000 40000 20000
ANORECTAL MALFORMATIONS COLOSTOMY GA 20000 40000 20000
ANTERIOR SAGITAL ANORECTOPLASTY (ASARP) GA 25000 48000 25000
APPENDECTOMY GA 18000 36000 18000
BILIARY ATRESIA LAPAROTOMY GA 35000 70000 35000
BOWEL ATRESIA LAPAROTOMY GA 30000 60000 30000
BRANCHIAL CYST EXCISION GA 15000 30000 16000
CAPD CATHETER IMPLANTATION GA 15000 30000 16000
CHEST TUBE INSERTION LA 3500 6500 4000
CHOLEDOCHAL CYST GA 25000 48000 25000
CHOLEDOCHODUODENOSTOMY GA 30000 60000 30000
CHOLEDOCHOLITHOTOMY GA 25000 48000 25000
CIRCUMCISION GA 13000 26000 14000
CIRCUMCISION LA 9600 19200 10000
CLEFT LIP AND PALATE GA 20000 40000 20000
COHEN'S REIMPLANTATION GA 21600 43200 22500
COLOSTOMY CLOSURE GA 20000 40000 20000
COLOSTOMY/ILEOSTOMY GA 15000 30000 16000
CRANIOSYNOSTOSIS GA 15000 30000 16000
CYST LA 3500 6800 4000
CYSTECTOMY GA 15000 30000 16000
CYSTIC HYGROMA GA 15000 30000 16000

CYSTOLITHOTOMY GA 15000 30000 16000
DEBRIDEMENT GA 9600 19200 10000
DIAGNOSTIC CYSTOSCOPY GA 9600 19200 10000
DIAGNOSTIC LAPAROSCOPY & PROCEED GA 20000 40000 20000
DJ STENT REMOVAL GA 9600 19200 10000
EXPLORATORY LAPAROTOMY + PROCEED GA 25000 50000 25000
FEEDING JEJUNOSTOMY GA 15000 30000 16000
FIBROADENOMA GA 15000 30000 16000
FIBROADENOMA LA 8000 16000 8000
GASTROSCHISIS CLOSURE GA 25000 48000 25000
HERNIOTOMY GA 15000 30000 16000
HYDATID CYST GA 20000 38000 20000
HYPOSPADIAS, URETHROPLASTY GA 25000 50000 25000
INGROWING TOE NAIL LA 3500 6800 4000
LABIAL SYNECHIA RELEASE LA 2900 5800 3000
LAMINECTOMY GA 15800 31600 16000
LIPOMA GA 13800 27600 14000
LN. BIOPSY GA 12000 24000 12000
LN. BIOPSY LA 9600 19200 10000
MENINGO MYELOCELE EXCISION GA 15800 31600 16000
MESENTRIC CYST/OMENTAL CYST GA 15000 30000 16000
MICRODOCHECTOMY LA 8000 16000 8000
NEPHRECTOMY GA 20000 40000 20000
NEPHROLITHOTOMY GA 20000 40000 20000

NEPHROSTOMY GA 15000 30000 16000
NEUROGENIC BLADDER RECONSTRUCTION GA 25000 50000 25000
OMPHALOCELE REPAIR GA 20000 40000 20000
OPEN CHOLECYSTECTOMY GA 18000 36000 18000
ORCHIDOPEXY GA 17000 34000 18000
POSTERIOR SAGITTAL ANORECTOPLASY FOR ANO RECTAL 30000 50000 30000

MALFORMATION GA
POSTERIOR URETHRAL VALVE FULGRATION GA 18600 37200 20000
PREPUTIAL ADHESIOLYSIS LA 2900 5800 3000
PYELOLITHOTOMY GA 18000 36000 18000
PYELOPLASTY GA 18600 37200 20000
RAMSTEDTS PYLOROMYOTOMY GA 20000 40000 20000
RANULA EXCISION GA 15000 30000 16000
RECTAL BIOPSY GA 9600 19200 10000
RECTAL POLYPECTOMY GA 13000 26000 14000
RESECTION ANASTOMOSIS (SMALL BOWEL / LARGE BOWEL) GA 25000 50000 25000
RIGHT HEMICOLECTOMY GA 15000 30000 16000
SKIN GRAFTING (LARGE AREA) GA/S 18600 37200 20000
SKIN GRAFTING - SMALL AREA GA 15600 31200 16000
SPLENECTOMY GA 20000 38000 20000
SUTURING GA 9600 19200 10000
SUTURING LA 2000 2500 2000
THRORACTOMY PAEDIATRIC GA 30000 50000 30000
THYROGOSSAL CYST SISTRUNK GA 15000 30000 16000
TONGUE TIE RELEASE GA 10000 15000 10000

TORTICOLLIS GA 15000 30000 16000
TRACHEO-ESOPHAGEAL ATRESIA REPAIR GA 35000 60000 35000
TRANS ANAL SOAVE PULL THROUGH GA 30000 60000 30000
TRANSPUBIC URETHROPLASTY GA 15000 30000 16000
TRUCUT BIOPSY GA 15000 30000 16000
UMBILICAL GRANULOMA/POLYP EXCISION 3400 6800 4000
UMBILICAL HERNIA REPAIR 15000 30000 16000
URETHRAL DILATATION GA 8000 16000 8000
URETHRAL DILATATION LA 2900 5800 3000
V P SHUNT GA 13800 27600 14000
VENESECTION 3500 6800 4000
ANTIGRADE / RETROGRADE PYELOGRAPHY LA 7000 10000 7000
CIRCUMCISION (UNDER ANAESTHESIA) 15000 28000 16000
CYSTOSCOPY + PROCEED 8000 14000 8000
CYSTOSCOPY LA 7000 10000 7000
DJ STENT PLACEMENT LA 7000 12000 7000
DJ STENT REMOVAL LA 4000 7000 4000
ENDODILATATION LA 7000 10000 7000
HYPOSPADIAS 20000 38000 20000
LAPAROSCOPIC NEPHROURETERECTOMY WITH BLADDER CUFF

20000 38000 20000
EXCISION
LAPAROSCOPIC PROSTATECTOMY 20000 40000 20000
LAPAROSCOPIC RADICAL NEPHRECTOMY 20000 38000 20000
LAPAROSCOPIC RENAL CYST DEROOFING 18000 35000 18000
LAPAROSCOPIC SIMPLE NEPHRECTOMY 18000 38000 18000

LAPROSCOPIC ADERENALECTOMY 20000 38000 20000
MEONEATOMY/NEATOPLASTY 15000 28000 16000
OIU(SECOND/THIRD STAGE) 10000 18000 10000
OPEN ADERENALECTOMY FUNCTIONAL 25000 48000 25000
OPEN ADERENALECTOMY NON-FUNCTIONAL 20000 38000 20000
OPEN ANATROPHIC NEPHROLITHOTOMY 20000 38000 20000
OPEN BOARI'S FLAP 25000 48000 25000
OPEN CYSTOLITHOTOMY 15000 28000 16000
OPEN NEPHROURETERECTOMY WITH BLADDER CUFF EXCISION 20000 38000 20000
OPEN OPEN PYELOLITHOTOMY 17000 32000 18000
OPEN PARTIAL CYSTECTOMY 20000 38000 20000
OPEN PROSTETECTOMY 20000 38000 20000
OPEN PYELOPLASTY 17000 32000 18000
OPEN RADICAL CYSTECTOMY WITH LYMPHADENECTOMY 30000 58000 30000
OPEN RADICAL NEPHRECTOMY 20000 38000 20000
OPEN RENAL CYST DEROOFING 17000 32000 18000
OPEN SIMPLE NEPHRECTOMY 17000 32000 18000
OPEN URETERO-NEOSYSTOSTOMY 20000 38000 20000
OPEN URETERO-URETEROSTOMY 20000 38000 20000
OPEN URETEROLITHOTOMY 15000 28000 16000
OPTICAL INTERNAL URETHROTOMY (OIU) 18000 36000 18000
PARTIAL PENECTOMY 15000 28000 16000
PCNL (SECOND/THIRD STAGE) 10000 18000 10000
PERCUTANEOUS NEPHROLITHOTOMY (PCNL) 25000 48000 25000

PERCUTANEOUS NEPHROSTOMY (PCN) LA 7000 12000 7000
PERINEAL URETHROSTOMY 15000 28000 16000
PERURETHRAL CYSTOLITHOTRIPSY (PUCL) 18000 36000 18000
POSTERIOR URETHRAL VALVE FULGRATION (PUVF) 18000 36000 18000
RADICAL PROSTETECTOMY WITH LYMPHADENECTOMY 25000 48000 25000
SPCL(SECOND/THIRD STAGE) 10000 18000 10000
SUPRAPUBIC CYTOLITHOTRIPSY (SPCL) 18000 36000 18000
TOTAL PENECTOMY WITH LYMPHADENECTOMY 25000 48000 25000
TRANURETHRAL RESECTION OF BLADDER TUMOUR (TURBT) - BIPOLAR 25000 48000 25000
TRANURETHRAL RESECTION OF BLADDER TUMOUR (TURBT) - 20000 38000 20000

MONOPOLAR
TRANURETHRAL RESECTION OF THE PROSTATE (TURP) - BIPOLAR 25000 48000 25000
TRANURETHRAL RESECTION OF THE PROSTATE (TURP) - MONOPOLAR 20000 38000 20000
TURBT (SECOND/THIRD STAGE) 10000 18000 10000
TURP (SECOND/THIRD STAGE) 10000 18000 10000
URETERORENOSCOPIC LITHOTRIPSY (URSL) 25000 48000 25000
URETHROPLASTY - 1 - END TO END 20000 38000 20000
URETHROPLASTY - 2 - AUGMENTATION 25000 48000 25000
URETHROPLASTY - 3 - PFUDD 30000 58000 30000
URSL (SECOND/THIRD STAGE) 10000 18000 10000
COLOR DOPPLER ARTERIAL (BOTH LIMB) 3000 4000 3500
COLOR DOPPLER ARTERIAL (ONE LIMB) 1800 2600 2000
COLOR DOPPLER ARTERIAL + VENOUS (BOTH LIMB) 4500 5500 5000
COLOR DOPPLER ARTERIAL + VENOUS (ONE LIMB) 3000 4000 3000
COLOR DOPPLER CAROTIDS 1500 2200 1500

COLOR DOPPLER RENAL 1500 2200 3500
COLOR DOPPLER VENOUS (BOTH LIMB) 3000 4000 3000
COLOR DOPPLER VENOUS (ONE LIMB) 1800 2600 1800
COLOUR DOPPLER (OTHERS) 1500 2200 950
OBSTETRIC DOPPLER STUDY 1800 2600 2000
TARGETTED USG FOR FLUID COLLECTION ONLY 350 550 400
TARGETTED USG FOR PLACENTAL LOCALIZATION/AFI ONLY 300 500 300
ULTRASOUND (ABDOMEN + SCROTUM) 1450 2100 2000
ULTRASOUND (ABDOMEN) 800 1150 600
ULTRASOUND (BOTH BREAST) 800 1150 1000
ULTRASOUND (KUB) 800 1150 800
ULTRASOUND (MATERNAL ABDOMEN + OBSTETRIC SCAN) 1450 2100 2000
ULTRASOUND (NECK) 800 1150 600
ULTRASOUND (OBSTETRIC SCAN) 800 1150 1000
ULTRASOUND (PELVIS ONLY) 700 1050 600
ULTRASOUND (SCROTUM) 700 1050 1000
ULTRASOUND (SINGLE BREAST) 700 1050 600
ULTRASOUND (SONOHYSTEROGRAPHY) 2300 3000 3000
ULTRASOUND (TARGETTED USG FOR SINGLE FOCAL LESION) 800 1150 1000
ULTRASOUND (THORAX) 800 1150 600
ULTRASOUND (TVS/TRUS) 1000 1500 1000
ULTRASOUND (USG-7): USG EVALUATION/SCREENING FOR

RHEUMATOID ARTHRITIS. 1700 2500 2000
ULTRASOUND MSK: ONE LOCATION (JOINT/TENDON/PERIPHERAL

1600 2400 2000
NERVE ETC)
USG ELASTOGRAPHY 2000 3000 2000

USG FOR OVULATION MONITORING 1600 2400 2000
USG GUIDANCE FOR FNAC 1000 1500 1000
USG GUIDED BIOPSY PROCEDURE 2000 3000 2000
USG GUIDED DIAGNOSTIC FLUID TAPPING ONLY (ASCITES, PLEURAL

EFFUSUION, JOINT EFFUSION ETC.) 600 850 600
USG GUIDED DRAINAGE/ INTERVENTIONAL PROCEDURES/PCN/PTBD

3200 6400 4000
ETC.

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Koirala Institute of Health Sciences, Dharan

Hospital Services - Rate List

BPKIHS GENERAL EHS BIMA

1 ACADEMIC SEVICES 987 BDS INTERNSHIP LOG BOOK CHARGES 250 0 0

4 ACADEMIC SEVICES 671 BDS LOG BOOK FOR PERIODONTICS 110 0 0

6 ACADEMIC SEVICES 2035 LIBERARY LATE FINE 0 0 0

7 ACADEMIC SEVICES 981 LOG BOOK CURRICULUM MBBS 320 0 0

8 ACADEMIC SEVICES 795 LOG BOOK FOR BDS CURRICULUM 140 0 0

9 ACADEMIC SEVICES 790 LOG BOOK FOR BMIT 60 0 0

LOG BOOK FOR CONSERVATIVE DENTISTRY &

15 ACADEMIC SEVICES 537 LOG BOOK FOR DENTAL MATERIA 250 0 0

17 ACADEMIC SEVICES 793 LOG BOOK FOR MBBS CURRICULUM 320 0 0

22 ACADEMIC SEVICES 671 LOG BOOK FOR PERIODONTICS DEPARTMENT 160 0 0

23 ACADEMIC SEVICES 754 LOG BOOK FOR PROSTHODONTICS 260 0 0

LOG BOOK OF DELIVERY RECORD FOR NURSING

26 ACADEMIC SEVICES 986 LOG BOOK OF ORTHODONTICS 250 0 0

27 ACADEMIC SEVICES 5659 M.SC CURRICULUM 250 0 0

31 ACADEMIC SEVICES 665 MBBS LOG BOOK FOR GYNACOLOGY 400 0 0

32 ACADEMIC SEVICES 669 MBBS LOG BOOK FOR INTERNSHIP 330 0 0

34 ACADEMIC SEVICES 662 MBBS LOG BOOK FOR MEDICINE 460 0 0

35 ACADEMIC SEVICES 668 MBBS LOG BOOK FOR PAEDIATRICS 250 0 0

36 ACADEMIC SEVICES 667 MBBS LOG BOOK FOR PHYSIOLOGY 320 0 0

37 ACADEMIC SEVICES 661 MBBS LOG BOOK FOR SURGERY 470 0 0

ANAESTHESIOLOGY & CRITICAL

41 ANAESTHESIOLOGY & CRITICAL 995 CAUDAL 1880 2130 2000

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

47 ANAESTHESIOLOGY & CRITICAL 2126 INJ. MORPHINE 10MG/ML 100 0 0

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL INTERTICULAR JT. INJECTION/INTERCOSTAL NERVE

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL LUMBAR SYMPATHETIC BLOCK/ COELIC PLEXUS BLOCK

55 ANAESTHESIOLOGY & CRITICAL 988 MANDIBULAR BLOCK 1290 1510 2000

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

65 ANAESTHESIOLOGY & CRITICAL 2122 SYRUP MORPHINE 60 ML 140 0 200

ANAESTHESIOLOGY & CRITICAL

ANAESTHESIOLOGY & CRITICAL

69 ANATOMY 126 BARR-BODY (HETERROCHROMATIN) EXAMINATION 210 380 0

70 ANATOMY 135 KARYOTYPING (INDIVIDUAL) 3480 5060 0

71 ANATOMY 6088 MULTISHOT BAND LIGATOR 4540 4540 0

72 BED CHARGES BED CHARGE 300 500 0

74 BIOCHEMISTRY 6078 ACR 880 1590 900

75 BIOCHEMISTRY 1199 ADENOSINE DEAMINASE (ADA) 1000 1500 575

76 BIOCHEMISTRY 576 ALBUMIN 130 240 100

77 BIOCHEMISTRY 341 ALKALINE PHOSPHATASE (ALP) 170 300 123

78 BIOCHEMISTRY 342 ALT (SGPT) 170 300 120

79 BIOCHEMISTRY 333 AMYLASE 230 380 200

80 BIOCHEMISTRY 2253 APO A 800 1460 800

81 BIOCHEMISTRY 2254 APO B 800 1460 800

82 BIOCHEMISTRY 343 AST (SGOT) 170 300 120

83 BIOCHEMISTRY 330 BILE PIGMENT (URINE) 110 200 200

84 BIOCHEMISTRY 642 BILE SALT 110 200 200

85 BIOCHEMISTRY 339 BILIRUBIN (DIRECT) 130 200 100

86 BIOCHEMISTRY 340 BILIRUBIN (TOTAL) 130 200 100

87 BIOCHEMISTRY 1599 BILIRUBIN (TOTAL, DIRECT) 250 400 300