bhamashah swasthya bima yojana 2017 - rajasthan · bhamashah swasthya bima yojana 2017 . s. no....

S. No. Final Package name Package

type

Package

Rate

Speciality Code Short Name

1 Congenital (Complex) - Pulmonary Atresia with or without VSD /

truncus arteriosis and other anomalies

Tertiary 125000 Cardiology & CTVS 29120001 Congenital (Complex) -

Pulmonary Atresia (For details

see website)

2 Congenital (Complex) - Sennings Tertiary 97000 Cardiology & CTVS 29120002

3 Aorta-Aorta Bypass with graft Tertiary 63000 Cardiology & CTVS 29120003

4 Coil Closure - PDA Coil (one) insertion Tertiary 12000 Cardiology & CTVS 29120004

5 Coronary Balloon Angioplasty Tertiary 28000 Cardiology & CTVS 29120005

6 Cath with Oxymetry Tertiary 6000 Cardiology & CTVS 29120006

7 Cath without Oxymetry Tertiary 5000 Cardiology & CTVS 29120007

8 Aorta-Aorta Bypass without graft Tertiary 31500 Cardiology & CTVS 29120008

9 Additional Stent required Tertiary 25000 Cardiology & CTVS 29120009

10 Refractory Cardiac Failure Tertiary 21000 Cardiology & CTVS 29120010

11 Balloon Atrial Septectomy – BAS Tertiary 14000 Cardiology & CTVS 29120011

12 IVC filter Tertiary 35000 Cardiology & CTVS 29120012

13 Infective Endocarditis Tertiary 25000 Cardiology & CTVS 29120013

14 Pericardial Effusion, Tamponade Tertiary 17500 Cardiology & CTVS 29120014

15 PTCA - one medicated stent Tertiary 54000 Cardiology & CTVS 29120015

16 PTCA - 2 medicated stent Tertiary 78000 Cardiology & CTVS 29120016

17 Balloon Mitral Valvulotomy – BMV Tertiary 31000 Cardiology & CTVS 29120017

18 Coarctation dilatation – BDC Tertiary 26000 Cardiology & CTVS 29120018

19 Balloon Pulmonary Valvulotomy – BPV Tertiary 35000 Cardiology & CTVS 29120019

20 Balloon Aortic Valvulotomy – BAV Tertiary 32000 Cardiology & CTVS 29120020

21 Peripheral Angioplasty with stent (medicated) Tertiary 55000 Cardiology & CTVS 29120021

22 Renal Angioplasty withstent Tertiary 60000 Cardiology & CTVS 29120022

23 Both side renal Angioplasty withstent (medicated) Tertiary 90000 Cardiology & CTVS 29120023

24 Vertebral/carotid Angioplasty with stent - Without device Tertiary 60000 Cardiology & CTVS 29120024

25 Pericardiocentesis Tertiary 8000 Cardiology & CTVS 29120025

26 IVUS Tertiary 30000 Cardiology & CTVS 29120026

27 EP study Tertiary 10000 Cardiology & CTVS 29120027

28 RF Ablation Tertiary 20000 Cardiology & CTVS 29120028

29 Medical treatment of Acute MI with Thrombolysis (with

Strepto/Urokinase)

Tertiary 15000 Cardiology & CTVS 29120029

30 Thrombolysis for peripheral ischemia - STK Tertiary 10000 Cardiology & CTVS 29120030

Bhamashah Swasthya Bima Yojana 2017


type

Package

Rate



31 Rotablation Tertiary 50000 Cardiology & CTVS 29120031

32 Pacemaker Implantation - Permanent (only VVIR) including

Pacemaker value


33 Device Closure - PDA Device Tertiary 30000 Cardiology & CTVS 29120033

34 Device Closure - ASD Device Tertiary 80000 Cardiology & CTVS 29120034

35 Device Closure - VSD Device Tertiary 80000 Cardiology & CTVS 29120035

36 CABG Tertiary 75000 Cardiology & CTVS 29120036

37 CABG Redo - without balloon Tertiary 95000 Cardiology & CTVS 29120037

38 CABG with IABP Tertiary 87500 Cardiology & CTVS 29120038

39 CABG with Aneurysmal repair - without balloon Tertiary 95000 Cardiology & CTVS 29120039

40 CABG with MV repair Tertiary 100000 Cardiology & CTVS 29120040

41 CABG with post MI VSD repair Tertiary 90000 Cardiology & CTVS 29120041

42 Valve Repair - Open Mitral Valvulotomy Tertiary 75000 Cardiology & CTVS 29120042

43 Valve Repair - Open Aortic Valvulotomy Tertiary 75000 Cardiology & CTVS 29120043

44 Valve Repair - Open Pulmonary Valvulotomy Tertiary 68000 Cardiology & CTVS 29120044

45 Valve Repair - Mitral Valve Tertiary 90000 Cardiology & CTVS 29120045

46 Valve Repair - Tricuspid Valve Tertiary 90000 Cardiology & CTVS 29120046

47 Valve Replacement - Mitral Valve Tertiary 112000 Cardiology & CTVS 29120047

48 Valve Replacement - Aortic Valve Tertiary 112000 Cardiology & CTVS 29120048

49 Valve Replacement - Double Valve Tertiary 157000 Cardiology & CTVS 29120049

50 Congenital (Simple) - ASD Tertiary 65000 Cardiology & CTVS 29120050

51 Congenital (Simple) - VSD Tertiary 68000 Cardiology & CTVS 29120051

52 Congenital (Simple) - AVSD/ AV Canal Defect Tertiary 80000 Cardiology & CTVS 29120052

53 Congenital (Simple) - ICR for TOF Tertiary 80000 Cardiology & CTVS 29120053

54 Congenital (Simple) - AP Window Tertiary 60000 Cardiology & CTVS 29120054

55 Congenital (Simple) - Surgery for HOCM Tertiary 75000 Cardiology & CTVS 29120055

56 Congenital (Simple) - Ebstein's Tertiary 75000 Cardiology & CTVS 29120056

57 Congenital (Simple) - Fontan Tertiary 80000 Cardiology & CTVS 29120057

58 Congenital (Complex) - TGA Tertiary 100000 Cardiology & CTVS 29120058

59 Congenital (Complex) - Arterial Switch Operation Tertiary 75000 Cardiology & CTVS 29120059

60 Congenital (Complex) - ALCAPA Tertiary 75000 Cardiology & CTVS 29120060

61 Congenital (Complex) - Mustards Tertiary 75000 Cardiology & CTVS 29120061

62 Congenital (Complex) - Pulmonary Conduit Tertiary 85000 Cardiology & CTVS 29120062

63 Congenital (Complex) - Truncus Arteriosus Surgery Tertiary 75000 Cardiology & CTVS 29120063


type

Package

Rate



64 Congenital (Complex) - Root Replacement (Aortic Aneurysm/

Aortic Dissection) / Bental Procedure


65 Congenital (Complex) - Aortic Arch Replacement Tertiary 65000 Cardiology & CTVS 29120065

66 Congenital (Complex) - Aortic Aneurysm Repair without using CPB Tertiary 50000 Cardiology & CTVS 29120066

67 Pulmonary Embolectomy / Endarterectomy Tertiary 95000 Cardiology & CTVS 29120067

68 Surgery for Cardiac Tumour/ LA Myxoma/ RA Myxoma Tertiary 75000 Cardiology & CTVS 29120068

69 Closed Heart Procedures - Closed Mitral Valvulotomy Tertiary 22000 Cardiology & CTVS 29120069

70 Closed Heart Procedures - PDA Surgery Tertiary 20000 Cardiology & CTVS 29120070

71 Closed Heart Procedures - Coarctation Repair with graft Tertiary 35000 Cardiology & CTVS 29120071

72 Closed Heart Procedures - BT Shunt (inclusives of grafts) Tertiary 40000 Cardiology & CTVS 29120072

73 Closed Heart Procedures - Glenn Shunt Tertiary 60000 Cardiology & CTVS 29120073

74 Closed Heart Procedures - Central Shunt Tertiary 45000 Cardiology & CTVS 29120074

75 Closed Heart Procedures - Aortic arch Anomalies Tertiary 50000 Cardiology & CTVS 29120075

76 Closed Heart Procedures - Pericardiectomy Tertiary 35000 Cardiology & CTVS 29120076

77 Closed Heart Procedures - Thoracoscopic surgery Tertiary 35000 Cardiology & CTVS 29120077

78 Cardiac Injuries - Surgery without CPB Tertiary 35000 Cardiology & CTVS 29120078

79 Cardiac Injuries - Surgery with CPB Tertiary 65000 Cardiology & CTVS 29120079

80 Coil Closure- PDA Multiple coil insertion Tertiary 20000 Cardiology & CTVS 29120080

81 Femoro-Popliteal bypass procedure with graft (inclu. Graft) Tertiary 50000 Cardiology & CTVS 29120081

82 Thromboembolectomy Tertiary 20000 Cardiology & CTVS 29120082

83 Surgery for Arterial Aneurysm -Distal Abdominal Aorta Tertiary 60000 Cardiology & CTVS 29120083

84 Intrathoracic Aneurysm (with graft) -Requiring Bypass Techniques Tertiary 110000 Cardiology & CTVS 29120084

85 Dissecting Aneurysms with CPB (inclu. Graft) Tertiary 120000 Cardiology & CTVS 29120085

86 Dissecting Aneurysms without CPB (incl. graft) Tertiary 75000 Cardiology & CTVS 29120086

87 Vascular Procedure – Major Vessels Tertiary 30000 Cardiology & CTVS 29120087

88 Vascular Procedure – Minor Vessels Tertiary 20000 Cardiology & CTVS 29120088

89 Surgery for Arterial Aneurysm Main Arteries of the Limb Tertiary 15000 Cardiology & CTVS 29120089

90 Congenital Arterio Venous Fistula Tertiary 20000 Cardiology & CTVS 29120090

91 Peripheral Embolectomy without graft Tertiary 20000 Cardiology & CTVS 29120091

92 Aorto Billiac / Bifemoral bypass with Synthetic Graft Tertiary 75000 Cardiology & CTVS 29120092

93 Axillo bifemoral bypass with Synthetic Graft Tertiary 75000 Cardiology & CTVS 29120093


type

Package

Rate



94 Femoro Distal Bypass with Vein Graft Tertiary 50000 Cardiology & CTVS 29120094

95 Femoro Distal Bypass with Synthetic Graft Tertiary 65000 Cardiology & CTVS 29120095

96 Axillo Brachial Bypass using with Synthetic Graft Tertiary 60000 Cardiology & CTVS 29120096

97 Brachio - Radial Bypass with Synthetic Graft Tertiary 60000 Cardiology & CTVS 29120097

98 Carotid artery bypass with Synthetic Graft Tertiary 60000 Cardiology & CTVS 29120098

99 Excision of Arterio Venous malformation – Large Tertiary 50000 Cardiology & CTVS 29120099

100 Excision of Arterio Venous malformation – Small Tertiary 20000 Cardiology & CTVS 29120100

101 DVT - IVC Filter Tertiary 25000 Cardiology & CTVS 29120101

102 Vascular Tumors Tertiary 40000 Cardiology & CTVS 29120102

103 Small Arterial Aneurysms – Repair Tertiary 10000 Cardiology & CTVS 29120103

104 Medium size arterial aneurysms – Repair Tertiary 15000 Cardiology & CTVS 29120104

105 Carotid endarterectomy Tertiary 35000 Cardiology & CTVS 29120105

106 Vertebral/carotid Angioplasty with stent - With distal protection

device


107 Thrombosuction catheter/export catheter Tertiary 20000 Cardiology & CTVS 29120107

108 Primary PTCA with one medicated stent Tertiary 65000 Cardiology & CTVS 29120108

109 Covered stent Tertiary 40000 Cardiology & CTVS 29120109

110 IABP Tertiary 40000 Cardiology & CTVS 29120110

111 Medical treatment of Acute MI with Thrombolysis (with TNK/RPA) Tertiary 30000 Cardiology & CTVS 29120111

112 Fractional Flow Reserve (FFR) Tertiary 30000 Cardiology & CTVS 29120112

113 Closed Heart Procedures - Coarctation Repair Tertiary 37500 Cardiology & CTVS 29120113

114 Excision of Carotid body Tumor with vascular repair Tertiary 45000 Cardiology & CTVS 29120114

115 Congenital (Complex) - TAPVC Tertiary 80000 Cardiology & CTVS 29120115

116 Lobectomy Tertiary 25000 Chest Surgery 29140001

117 Pneumonectomy Tertiary 60000 Chest Surgery 29140002

118 Pleurectomy Tertiary 40000 Chest Surgery 29140003

119 Mediastinotomy Tertiary 25000 Chest Surgery 29140004

120 Pulmonary AV Fistula surgery Tertiary 25000 Chest Surgery 29140005

121 Lung Cyst Tertiary 30000 Chest Surgery 29140006

122 SOL mediastinum Tertiary 45000 Chest Surgery 29140007

123 Surgical Correction of Bronchopleural Fistula Tertiary 35000 Chest Surgery 29140008

124 Diaphragmatic Eventeration Tertiary 40000 Chest Surgery 29140009

125 Diaphragmatic Hernia Tertiary 25000 Chest Surgery 29140010


type

Package

Rate



126 Oesophageal Diverticula /Achalasia Cardia Tertiary 25000 Chest Surgery 29140011

127 Thoracotomy - Thoraco Abdominal Approach Tertiary 35000 Chest Surgery 29140012

128 Bronchial Repair Surgery for Injuries due to FB Tertiary 25000 Chest Surgery 29140013

129 Gastro StudyFollowed by Thoracotomy & Repairs for Oesophageal

Injury for Corrosive Injuries/FB

Tertiary 30000 Chest Surgery 29140014

130 Oesophageal tumour removal Tertiary 25000 Chest Surgery 29140015

131 Chest Injuries - Lung Injury repair Tertiary 20000 Chest Surgery 29140016

132 Chest Injuries - Thymectomy Tertiary 25000 Chest Surgery 29140017

133 Thoracoscopic & Laproscopic surgery of any type Tertiary 25000 Chest Surgery 29140018

134 Foreign Body Removal with scope Tertiary 10000 Chest Surgery 29140019

135 Excision of Pinna for Growths (Squamous/Basal) or Injuries - Total

Amputation & Excision of External Auditory Meatus

Tertiary 8500 ENT 29020001 Total Amputation & Excision

of External Auditory Meatus

(For details see website)

136 Excision of Pinna for Growths (Squamous/Basal) or Injuries -

Total Amputation

Tertiary 5100 ENT 29020002

137 Skull base surgery Tertiary 29000 ENT 29020003

138 Trans Antral - Ethmoidectomy Tertiary 10800 ENT 29020004

139 Microlaryngeal Surgery including Phonosurgery Tertiary 9500 ENT 29020005

140 Excision/ Hypopharynx of Tumors in Pharynx Tertiary 19000 ENT 29020006

141 Thryoplasty Tertiary 12000 ENT 29020007

142 Maxillofacial Surgery Tertiary 13000 ENT 29020008

143 Tracheal Reconstruction Tertiary 15000 ENT 29020009

144 Colonoscopy with Biopsy Tertiary 2000 Gastrology 29190001

145 Sigmoidoscopy with Biopsy Tertiary 2000 Gastrology 29190002

146 Colonoscopy Tertiary 1500 Gastrology 29190003

147 Sigmoidoscopy Tertiary 1500 Gastrology 29190004

148 Palliative endoscopic management of malignancies (Mettalic stent

SEMS)

Tertiary 30000 Gastrology 29190005

149 Hemophilia Tertiary 35000 General Medicine 29100001

150 Snake bite requiring ventilator support Tertiary 35000 General Medicine 29100002

151 Scorpion Sting requiring ventilator support Tertiary 17500 General Medicine 29100003

152 Treatment for Sickle cell anemia Tertiary 1750 General Medicine 29100004


type

Package

Rate



153 Bronchiectasis (patient with repeated hospitalisation >6per year) Tertiary 10000 General Medicine 29100005

154 Interstitial Lung diseases Tertiary 30000 General Medicine 29100006

155 Pneumoconiosis Tertiary 15000 General Medicine 29100007

156 Acute Respiratory Failure (with ventilator support-for minimum

5days)

Tertiary 35000 General Medicine 29100008

157 Lung Abscess - non resolving Tertiary 10500 General Medicine 29100009

158 Pneumothorax (With ICDT) Tertiary 22000 General Medicine 29100010

159 Malignant Pleural effusion (First Time) Tertiary 14000 General Medicine 29100011

160 Massive Hemoptysis Tertiary 35000 General Medicine 29100012

161 Thrombocytopenia-SDP (Per unit) Tertiary 10000 General Medicine 29100013

162 Bone Marrow Biopsy Tertiary 3500 General Medicine 29100014

163 Central Line Insertion (Triple Lumen) Tertiary 3000 General Medicine 29100015

164 Bone Marrow Aspiration Tertiary 2000 General Medicine 29100016

165 Central Line Insertion (Double Lumen) Tertiary 2000 General Medicine 29100017

166 Thrombocytopenia-RDP (Per unit) Tertiary 1500 General Medicine 29100018

167 Acute Respiratory Failure ( with ventilator support upto 4 days) Tertiary 25000 General Medicine 29100019

168 Upper GI endoscopy with biopsy Tertiary 1200 General Surgery 29010001

169 Bypass - Inoperable CA of Pancreas Tertiary 19500 General Surgery 29010002

170 Anterior Resection for CA Rectum Tertiary 15000 General Surgery 29010003

171 Distal Pancreatectomy - with Pancreatico - Jejunostomy Tertiary 17000 General Surgery 29010004

172 Hepatic Left Lobectomy Tertiary 30000 General Surgery 29010005

173 Oesophagectomy Tertiary 30000 General Surgery 29010006

174 Operation for Portal Hypertension Tertiary 30000 General Surgery 29010007

175 Colectomy - Total Tertiary 25000 General Surgery 29010008

176 Aneurysm not Requiring - Bypass Techniques Tertiary 28000 General Surgery 29010009

177 Aneurysm Resection & grafting Tertiary 29000 General Surgery 29010010

178 Aorta-Femoral Bypass Tertiary 25000 General Surgery 29010011

179 Carotid artery Aneurysm Tertiary 28000 General Surgery 29010012

180 Dissecting Aneurysms Tertiary 28000 General Surgery 29010013

181 Distal Abdominal Aorta Tertiary 22500 General Surgery 29010014

182 Lap. Assisted Total - Colectomy Tertiary 25000 General Surgery 29010015

183 Lap. Hepatic resection Tertiary 17300 General Surgery 29010016


type

Package

Rate



184 Repair of Main Arteries of the Limbs Tertiary 28000 General Surgery 29010017

185 Mediastinal Tumour Tertiary 23000 General Surgery 29010018

186 Thymectomy Tertiary 23000 General Surgery 29010019

187 Operations for Acquired - Arteriovenous Fistula Tertiary 19500 General Surgery 29010020

188 Operations for Replacement of Oesophagus by Colon Tertiary 21000 General Surgery 29010021

189 Operations for Stenosis of - Renal Arteries Tertiary 24000 General Surgery 29010022

190 Pericardiostomy Tertiary 25000 General Surgery 29010023

191 Portocaval Anastomosis Tertiary 22000 General Surgery 29010024

192 Renal Artery aneurysm and dissection Tertiary 28000 General Surgery 29010025

193 Surgery for Arterial Aneurysm Vertebral Tertiary 20520 General Surgery 29010026

194 Thoracoscopic Lebectomy Tertiary 19500 General Surgery 29010027

195 Tissue Reconstruction - Flap Leprosy Tertiary 22000 General Surgery 29010028

196 Tendon Transfer-Leprosy Tertiary 25000 General Surgery 29010029

197 Carcinoma Parathyroid - Excision Tertiary 28000 General Surgery 29010030

198 20% burns or scalds/burns over face (with or without grafting) Tertiary 25000 General Surgery 29010031

199 Up to 30% (with grafting) Tertiary 35000 General Surgery 29010032

200 upto 40% Burns (Conservative/ without grafting) Tertiary 30000 General Surgery 29010033

201 upto 40% Mixed Burns (with grafting) Tertiary 30000 General Surgery 29010034

202 upto 50% Burns (Conservative) Tertiary 30000 General Surgery 29010035

203 upto 50% Mixed Burns (with surgery grafting) Tertiary 40000 General Surgery 29010036

204 upto 60% Burns (Conservative) Tertiary 40000 General Surgery 29010037

205 Up to 60% Mixed Burns (with Surgeries) Tertiary 50000 General Surgery 29010038

206 Above 60% Mixed Burns (with Surgeries) Tertiary 55000 General Surgery 29010039

207 Post Burn Contracture surgeries for Functional

Improvement(Package including splints, pressure garments and

physiotherapy)- Mild

Tertiary 20000 General Surgery 29010040 Post Burn Contracture

surgeries - Mild (For details

see website)



physiotherapy)- Moderate


surgeries - Moderate (For

details see website)



physiotherapy)- Severe


surgeries - Severe (For details

see website)

210 Budd chiari syndrome Tertiary 21000 General Surgery 29010043


type

Package

Rate



211 Fulminant Hepatic failure Tertiary 35000 General Surgery 29010044

212 Pancreas - Distal Pancreatectomy Tertiary 31500 General Surgery 29010045

213 Pancreas - Enucleation of Cyst Tertiary 24000 General Surgery 29010046

214 Anorectal - Low Anterior resection OR Sphincter preserving

surgery of any type

Tertiary 14700 General Surgery 29010047

215 Hepatic Right Lobectomy Tertiary 70000 General Surgery 29010048

216 Operation for Lobectomy with volume reduction Tertiary 60000 General Surgery 29010049

217 Anal Fistulactomy - Low Tertiary 8000 General Surgery 29010050

218 Anal Fistulactomy - High Tertiary 12000 General Surgery 29010051

219 Pancreas - Whipples (any type) Tertiary 56000 General Surgery 29010052

220 Renal Transplant Tertiary 175000 General Surgery 29010053

221 Induction Therapy – ALL (per month) Tertiary 60000 Medical Oncology 29160001

222 Maintenance therapy- ALL (per month) Tertiary 5000 Medical Oncology 29160002

223 5-FU + Cisplatin Tertiary 5000 Medical Oncology 29160003

224 Paclitaxel + Carboplatin Tertiary 10000 Medical Oncology 29160004

225 Palliative chemotherapy/ Supportive cherapy Tertiary 5000 Medical Oncology 29160005

226 Azacytidine Tertiary 60000 Medical Oncology 29160006

227 Induction regimen- AML Tertiary 60000 Medical Oncology 29160007

228 Consolidation Regimen -AML Tertiary 40000 Medical Oncology 29160008

229 Decitabine Tertiary 30000 Medical Oncology 29160009

230 Hyper-CVAD regimen (per month) Tertiary 50000 Medical Oncology 29160010

231 Consolidation Therapy- ALL (per month) Tertiary 60000 Medical Oncology 29160011

232 Nilotinib (per month) Tertiary 9000 Medical Oncology 29160012

233 Bevacizumab + Irinotecn Tertiary 90000 Medical Oncology 29160013

234 Carmustine Tertiary 6000 Medical Oncology 29160014

235 Capecitabin+oxaliplatin Tertiary 11000 Medical Oncology 29160015

236 Mitomycin + 5-FU Tertiary 5000 Medical Oncology 29160016

237 Gemcitabine + Oxaliplatin Tertiary 8000 Medical Oncology 29160017

238 Gemcitabine + Capecitabine Tertiary 8000 Medical Oncology 29160018

239 Ifosfamide + Paclitaxel + Cisplatin (ITP) Tertiary 12000 Medical Oncology 29160019

240 Pemetrexed Tertiary 10000 Medical Oncology 29160020

241 Gemcitabine + Docetaxel Tertiary 8000 Medical Oncology 29160021

242 Gemcitabine + Paclitaxel Tertiary 7000 Medical Oncology 29160022


type

Package

Rate



243 Methotrexate + Vinblastine + Doxorubicin + Cisplatin (MVAC) Tertiary 4000 Medical Oncology 29160023

244 Procarbazine + Lomustine + Vincristine (PCV) Tertiary 18000 Medical Oncology 29160024

245 Gemcitabine + Cisplatin Tertiary 7000 Medical Oncology 29160025

246 Everolimus + Octreotide LAR Tertiary 60000 Medical Oncology 29160026

247 Octreotide Tertiary 30000 Medical Oncology 29160027

248 Cisplatin +Paclitaxel Tertiary 6500 Medical Oncology 29160028

249 Bendamustine + Rituximab Tertiary 45000 Medical Oncology 29160029

250 Rituximab Tertiary 40000 Medical Oncology 29160030

251 Lenalidomide Tertiary 10000 Medical Oncology 29160031

252 Chlorambucil + Prednisone (CP) Tertiary 4000 Medical Oncology 29160032

253 Cyclophosphamide + Vincristine +Prednisone (CVP) Tertiary 2700 Medical Oncology 29160033

254 Hydroxyurea Tertiary 1000 Medical Oncology 29160034

255 Oxaliplatin + 5FU+ Leucovorin (FOLFOX) Tertiary 20000 Medical Oncology 29160035

256 Oxaliplatin+Capecitabin Tertiary 11000 Medical Oncology 29160036

257 Epirubicin+ Oxaliplatin + Capecitabine (EOX) Tertiary 11500 Medical Oncology 29160037

258 Epirubicin+ Cisplatin + Capecitabine (ECX) Tertiary 9500 Medical Oncology 29160038

259 Epirubicin+ Oxaliplatin +5FU (EOF) Tertiary 9500 Medical Oncology 29160039

260 Irinotecan + Cisplatin Tertiary 7500 Medical Oncology 29160040

261 Epirubicin+ Cisplatin + 5FU Tertiary 6000 Medical Oncology 29160041

262 Docetaxel+ Cisplatin +5FU (DCF) Tertiary 11500 Medical Oncology 29160042

263 5 FU + Leucovorin Tertiary 4000 Medical Oncology 29160043

264 Sorafenib Tertiary 10000 Medical Oncology 29160044

265 Imatinib 400 mg Tertiary 4000 Medical Oncology 29160045

266 Cladribine Tertiary 90000 Medical Oncology 29160046

267 Methotrexate/ciplatin/5fu Tertiary 2000 Medical Oncology 29160047

268 Capecitabine Tertiary 6000 Medical Oncology 29160048

269 Docetaxel + doxorubicine+cyclophosphamide(TAC) Tertiary 8000 Medical Oncology 29160049

270 Docetaxel+ cyclophosphamide (TC) Tertiary 7000 Medical Oncology 29160050

271 Cyclophosphamide + doxorubicine+5 Fluorouracil(CAF) Tertiary 3500 Medical Oncology 29160051

272 Doxorubicin + Cyclophosphamide (AC) Tertiary 3500 Medical Oncology 29160052

273 Trastazumab Tertiary 48000 Medical Oncology 29160053

274 Everolimus + Exemestane Tertiary 40000 Medical Oncology 29160054

275 Anastrozole Tertiary 1000 Medical Oncology 29160055


type

Package

Rate



276 Tamoxifen Tertiary 600 Medical Oncology 29160056

277 Letrozole Tertiary 500 Medical Oncology 29160057

278 BCNU+Etoposide+Cytarabine+Melphalan (Mini-BEAM) Tertiary 60000 Medical Oncology 29160058

279 Doxorubicin + Bleomycin + Vinblastine + Dacarbazine

(ABVD)/COPP/EBVD

Tertiary 5000 Medical Oncology 29160059

280 Erlotinib Tertiary 8000 Medical Oncology 29160060

281 Geftinib Tertiary 5000 Medical Oncology 29160061

282 Gemcitabine Tertiary 5000 Medical Oncology 29160062

283 Temozolomide + Thalidomide Tertiary 25000 Medical Oncology 29160063

284 Dacarbazine Tertiary 5000 Medical Oncology 29160064

285 Cyclophosphamide + Doxorubicin + Cisplatin (CAP) Tertiary 4000 Medical Oncology 29160065

286 Irinotecan + Oxaliplatin +5FU + Leucovorin (FOLFOXIRI regimen) Tertiary 25000 Medical Oncology 29160066

287 Irinotecan + 5FU + Leucovorin (FOLFIRI regimen) Tertiary 20000 Medical Oncology 29160067

288 Capecitabine + Irinotecan (XELIRI) Tertiary 10000 Medical Oncology 29160068

289 Capecitabine + Paclitaxel (XP) Tertiary 8000 Medical Oncology 29160069

290 Trastazumab + (Paclitaxel/Docetaxel/capecitabine/vinorelbine) Tertiary 52000 Medical Oncology 29160070

291 Capecitabine + Lapatinib Tertiary 40000 Medical Oncology 29160071

292 Fulvestrant Tertiary 25000 Medical Oncology 29160072

293 Paclitaxel 3weekly Tertiary 7000 Medical Oncology 29160073

294 Megestrol Tertiary 2000 Medical Oncology 29160074

295 Melphalan + Prednisone + Lenalidomide (MPL) Tertiary 20000 Medical Oncology 29160075

296 Lenalidomide + Dexamethasone Tertiary 16000 Medical Oncology 29160076

297 Melphalan + Prednisone + Thalidomide (MPT)/MP Tertiary 10000 Medical Oncology 29160077

298 Lenalidomide/thalidomide + Bortezomib + Dexamethasone (RVD) Tertiary 8000 Medical Oncology 29160078

299 Thalidomide + Dexamethasone Tertiary 3000 Medical Oncology 29160079

300 Fludarabine + Cyclophosphamide + Rituximab (FCR)/FR Tertiary 61000 Medical Oncology 29160080

301 Bortezomib Tertiary 5000 Medical Oncology 29160081

302 Etoposide + Ifosfamide (I + E) Tertiary 10000 Medical Oncology 29160082

303 High dose Methotrexate + Leucovorin Tertiary 10000 Medical Oncology 29160083

304 Cisplatin+ Doxorubicin Tertiary 5000 Medical Oncology 29160084

305 Gemcitabine + Liposomal Doxorubicin Tertiary 15000 Medical Oncology 29160085


type

Package

Rate



306 Gemcitabine + Carboplatin Tertiary 10000 Medical Oncology 29160086

307 Bleomycin + Etoposide + Cisplatin (BEP) Tertiary 10000 Medical Oncology 29160087

308 Nab-Paclitaxel + Gemcitabine Tertiary 17000 Medical Oncology 29160088

309 Capecitabine + Erlotinib Tertiary 11000 Medical Oncology 29160089

310 Gemcitabine + Erlotinib Tertiary 11000 Medical Oncology 29160090

311 Gemcitabine + Docetaxel + Capecitabine (GTX) Tertiary 10000 Medical Oncology 29160091

312 High dose Methotrexate Tertiary 10000 Medical Oncology 29160092

313 IT Mtx + Leucovorin + Vincristine + Procarbazine Tertiary 6000 Medical Oncology 29160093

314 Cabazitaxel + Prednisone Tertiary 25000 Medical Oncology 29160094

315 Abiraterone + Prednisone Tertiary 20000 Medical Oncology 29160095

316 Docetaxel + Prednisone Tertiary 7000 Medical Oncology 29160096

317 Everolimus Tertiary 30000 Medical Oncology 29160097

318 Pazopanib Tertiary 24000 Medical Oncology 29160098

319 Cyclophosphamide + Doxorubicin + Vincristine + Prednisone

(CHOP)/GDP/MINE/ICE/DHAP

Tertiary 5000 Medical Oncology 29160099

320 Doxorubicin + Ifosfamide (AI) Tertiary 10000 Medical Oncology 29160100

321 Doxorubicin + Dacarbazine (AD) Tertiary 4000 Medical Oncology 29160101

322 Eltrombopeg 30 tab Tertiary 60000 Medical Oncology 29160102

323 Ruxolitinib 20mg Tertiary 50000 Medical Oncology 29160103

324 Rituximab + CHOP)/CEOP/CVP/GDP/MINE/GEMOX/DHAP/ICE Tertiary 45000 Medical Oncology 29160104

325 Brachytherpay - catheter based Tertiary 35000 Medical Oncology 29160105

326 Dasatinib Tertiary 30000 Medical Oncology 29160106

327 Febrile neutropenia Tertiary 30000 Medical Oncology 29160107

328 Temozolomide - concurrent with RT Tertiary 20000 Medical Oncology 29160108

329 Platin + Nab-Paclitaxel Tertiary 17000 Medical Oncology 29160109

330 Liposomal Doxorubicin Tertiary 13000 Medical Oncology 29160110

331 Pemetrexed + Platin Tertiary 13000 Medical Oncology 29160111

332 VelP/VIP/TIP Tertiary 10000 Medical Oncology 29160112

333 Capecitabine + Vinorelbine (XN) Tertiary 8000 Medical Oncology 29160113

334 Docetaxel Tertiary 7000 Medical Oncology 29160114

335 Single Donor Platelets Tertiary 7000 Medical Oncology 29160115

336 supportive therapy Tertiary 5000 Medical Oncology 29160116

337 Temozolamide adjuvant per cycle Tertiary 5000 Medical Oncology 29160117


type

Package

Rate



338 chemotherapy for pediatric solid Tumors Tertiary 4000 Medical Oncology 29160118

339 Etoposide / Doxorubicin/Cisplatin/Taxane Tertiary 4000 Medical Oncology 29160119

340 Paclitaxel weekly Tertiary 3500 Medical Oncology 29160120

341 DL Scopy/EUA under GA Tertiary 3000 Medical Oncology 29160121

342 Cisplatin /carboplatin weekly Tertiary 2000 Medical Oncology 29160122

343 zoledronic acid Tertiary 1300 Medical Oncology 29160123

344 Chemoport placement - including port cost Tertiary 25000 Medical Oncology 29160124

345 Piccline Tertiary 15000 Medical Oncology 29160125

346 Brachiocephalic AV fistula for Hemodialysis Tertiary 7200 Nephrology 29200001

347 Maintenance Hemodialysis (with Inj. Erythropoitin & IRON) – Per

Dialysis

Tertiary 2000 Nephrology 29200002

348 Maintenance Hemodialysis (without Inj. Erythropoitin & IRON) –

Per Dialysis

Tertiary 1500 Nephrology 29200003

349 Double Lumen HD Catheter Tertiary 3500 Nephrology 29200004

350 Plasma pheresis Tertiary 14000 Nephrology 29200005

351 Stroke (Arterial/Venous) Tertiary 25000 Neurology 29210001

352 CNS Infection - Bacterial/Viral Tertiary 25000 Neurology 29210002

353 CNS Infection - Fungal Tertiary 40000 Neurology 29210003

354 Seizure Disorder / Status Epilepticus Tertiary 15000 Neurology 29210004

355 Neuromuscular disorders Tertiary 20000 Neurology 29210005

356 Anneurysm coiling Tertiary 150000 Neurosurgery 29060001

357 Microdiscectomy Lumbar Tertiary 24000 Neurosurgery 29060002

358 Trans Sphenoidal surgeries Tertiary 24000 Neurosurgery 29060003

359 Anterior Encephalocele Tertiary 28750 Neurosurgery 29060004

360 Burr hole Tertiary 20625 Neurosurgery 29060005

361 Cranioplasty Tertiary 30000 Neurosurgery 29060006

362 Craniostenosis Tertiary 22000 Neurosurgery 29060007

363 Craniotomy and Evacuation of Haematoma - Extradural Tertiary 32000 Neurosurgery 29060008

364 Haematoma Brain (hypertensive) Tertiary 32000 Neurosurgery 29060009

365 Haematoma (Child - irritable subdural) Tertiary 24200 Neurosurgery 29060010

366 Meningocele - Lumbar Tertiary 24750 Neurosurgery 29060011

367 Meningococle - Occipital Tertiary 29000 Neurosurgery 29060012

368 Posterior Fossa Decompression Tertiary 40000 Neurosurgery 29060013

369 Brachial Plexus - Repair Tertiary 70000 Neurosurgery 29060014


type

Package

Rate



370 Spina Bifida Repair/TCS Tertiary 24200 Neurosurgery 29060015

371 Anterio Lateral Decompression of Dorsal spine Tertiary 30000 Neurosurgery 29060016

372 Spinal Tumour/Haematoma/Abscess Tertiary 30000 Neurosurgery 29060017

373 Intracranial Tumours/SOL Tertiary 70000 Neurosurgery 29060018

374 Tumours Meninges Gocussa Tertiary 25000 Neurosurgery 29060019

375 Tumours Meninges Posterior Tertiary 25000 Neurosurgery 29060020

376 Ventricular Puncture Tertiary 9000 Neurosurgery 29060021

377 AAD Surgery - Trans oral Surgery Tertiary 60000 Neurosurgery 29060022

378 Spinal Surgery - RF Lesions for Trigeminal Neuralgia Tertiary 25000 Neurosurgery 29060023

379 Neurosurgery - Nerve Decompression Tertiary 15000 Neurosurgery 29060024

380 Neurosurgery - Peripheral Nerve Surgery Major Tertiary 30000 Neurosurgery 29060025

381 Neurosurgery - Peripheral Nerve Surgery Minor Tertiary 15000 Neurosurgery 29060026

382 Surgery Of Cord Tumours - Discectomy Tertiary 12000 Neurosurgery 29060027

383 Brain Surgery - De-compressive Craniectomy (Non Traumatic) Tertiary 50000 Neurosurgery 29060028

384 Brain Surgery - Endoscopic Third Ventriculostomy Tertiary 24000 Neurosurgery 29060029

385 Spinal Surgery - Syringomyelia Tertiary 42000 Neurosurgery 29060030

386 Soft Tissue and Vascular Surgery - Cervical Sympathectomy Tertiary 35000 Neurosurgery 29060031

387 Soft Tissue and Vascular Surgery - Decompression/Excision of

Optic nerve lesions

Tertiary 45500 Neurosurgery 29060032

388 Soft Tissue and Vascular Surgery - Proptosis Tertiary 42000 Neurosurgery 29060033

389 Epilepsy Surgery - Lesionectomy/Temporal

Lobectomy/Hemispherotomy

Tertiary 105000 Neurosurgery 29060034

390 Epilepsy Surgery - Temporal lobectomy plus Depth Electrodes Tertiary 35000 Neurosurgery 29060035

391 Microvascular Decompression for Trigeminal Neuralgia Tertiary 42000 Neurosurgery 29060036

392 Embolization of Aneurysm Tertiary 32900 Neurosurgery 29060037

393 Meningo encephalocele Tertiary 17500 Neurosurgery 29060038

394 Brain Surgery - Ventriculoatrial / Ventriculoperitoneal Shunt Tertiary 24800 Neurosurgery 29060039

395 Brain Surgery - Abscess Tapping Single Tertiary 15000 Neurosurgery 29060040

396 Brain Surgery - Abscess Tapping multiple Tertiary 20800 Neurosurgery 29060041

397 Brain Surgery - Meningo Encephalocele Tertiary 29800 Neurosurgery 29060042


type

Package

Rate



398 Brain Surgery - Aneurysm Clipping Tertiary 60000 Neurosurgery 29060043

399 Brain Surgery - Carotid angioplasty without stent Tertiary 15000 Neurosurgery 29060044

400 Brain Surgery - External Ventricular Drainage (EVD) Tertiary 25000 Neurosurgery 29060045

401 Spinal Surgery - Excision of Cervical Intervertebral Discs Tertiary 29800 Neurosurgery 29060046

402 Spinal Surgery - Discectomy lumbar Tertiary 24800 Neurosurgery 29060047

403 Spinal Surgery - Spinal Intra Medullary Tumours Tertiary 59600 Neurosurgery 29060048

404 Spinal Surgery - Spina Bifida Surgery Minor Tertiary 18000 Neurosurgery 29060049

405 Spinal Surgery - Stereotaxic Procedures Tertiary 25000 Neurosurgery 29060050

406 Spinal Surgery - Vertebral artery stenting Tertiary 50000 Neurosurgery 29060051

407 Spinal Surgery - Corpectomy and Spinal Fixation Tertiary 44800 Neurosurgery 29060052

408 Spinal Surgery - Spinal Fixation (Rods and Plates) Tertiary 45000 Neurosurgery 29060053

409 Spinal Surgery - MVD Tertiary 35000 Neurosurgery 29060054

410 Endo Vascular Embolization AVM/Fistula Tertiary 150000 Neurosurgery 29060055

411 Percutaneous balloon kyphoplasty Tertiary 100000 Neurosurgery 29060056

412 Endo Vascular Embolization Tumor Tertiary 150000 Neurosurgery 29060057

413 Spine 360 degree Fusion Tertiary 80000 Neurosurgery 29060058

414 Trans Lumbar Inter Body Fusion Tertiary 94000 Neurosurgery 29060059

415 Minimal Invasive Spine Surgery Tertiary 85000 Neurosurgery 29060060

416 Craniotomy and Evacuation of Haematoma-Subdural Tertiary 80000 Neurosurgery 29060061

417 Plasma Pheresis (including cost of filter) Tertiary 60000 Neurosurgery 29060062

418 IV tPA in Acute Stroke Tertiary 60000 Neurosurgery 29060063

419 Percutaneous Vertebroplasty Tertiary 30000 Neurosurgery 29060064

420 Cerebral Angiography Tertiary 15000 Neurosurgery 29060065

421 Conservative Management in Neuro ICU (per day) Tertiary 8000 Neurosurgery 29060066

422 Laminectomy with Fusion - with implant Tertiary 32000 Neurosurgery 29060067

423 Inversion of Uterus Reposition Tertiary 7500 Obstetrics &

Gynecology

29040001

424 Hysterolaproscopy Tertiary 12000 Obstetrics &

Gynecology

29040002

425 Hysteroscopic Myomectomy Tertiary 12000 Obstetrics &

Gynecology

29040003

426 Trans Obturator tape surgery for stress incontinence Tertiary 13800 Obstetrics &

Gynecology

29040004

427 Abdominal Sacrocolpopexy Tertiary 15000 Obstetrics &

Gynecology

29040005

428 vault Prolapse - abdominal Colposacropaxy Tertiary 15000 Obstetrics &

Gynecology

29040006

429 Trans vaginal tape surgery for stress inincontinence Tertiary 17250 Obstetrics &

Gynecology

29040007

430 Laproscopic Sacrocolpopexy with mesh Tertiary 18000 Obstetrics &

Gynecology

29040008


type

Package

Rate



431 vault Prolapse - abdominal Laproscopic Tertiary 18000 Obstetrics &

Gynecology

29040009

432 Laproscopc Myomectomy Tertiary 20000 Obstetrics &

Gynecology

29040010

433 Laproscopic Tuboplasty Tertiary 16000 Obstetrics &

Gynecology

29040011

434 Uterine Artery Embolisation (UAE) Tertiary 25000 Obstetrics &

Gynecology

29040012

435 Vaginoplasty Tertiary 25000 Obstetrics &

Gynecology

29040013

436 Bone Tumour- Excision (Long Bone) Tertiary 19500 Orthopedics 29030001

437 Nerve & Tendon Repair + Vascular Repair Tertiary 19500 Orthopedics 29030002

438 Fracture - Acetabulam Tertiary 25000 Orthopedics 29030003

439 Limb Lengthening with Monorail Tertiary 30000 Orthopedics 29030004

440 Ilizarov Fixation Tertiary 21600 Orthopedics 29030005

441 Pelvic Osteotomy Tertiary 22000 Orthopedics 29030006

442 Reconstruction of - ACL/PCL Tertiary 25000 Orthopedics 29030007

443 Accessory bone Excision + Acromion reconstruction Tertiary 22400 Orthopedics 29030008

444 Decompression Stabilization and Laminectomy-Short Segment Tertiary 20000 Orthopedics 29030009

445 Hind Quarter/Forequater Amputation Tertiary 12000 Orthopedics 29030010

446 Bone & Soft Tissue - Hip & Knee Disarticulation Tertiary 19000 Orthopedics 29030011

447 Polytrauma - Perforating Sclera - Corneal Injury (To be covered

along with other injuries only & not as exclusive procedure)

Tertiary 40000 Orthopedics 29030012 Polytrauma - Perforating

Sclera / Corneal Injury along

with other injuries (For details

see website)

448 Polytrauma - Surgery for Patella fracture (To be covered along

with other injuries only)

Tertiary 8000 Orthopedics 29030013

449 Total Hip Replacement (uncemented, U/L) Tertiary 50000 Orthopedics 29030014

450 Decompression Stabilization and Laminectomy-Long Segment Tertiary 50000 Orthopedics 29030015

451 Total Hip Replacement (Cemented, U/L) Tertiary 72000 Orthopedics 29030016

452 Repair of MCL/LCL/MPFL Tertiary 15000 Orthopedics 29030017

453 Shoulder/Hip Hemi Arthroplasty Tertiary 18000 Orthopedics 29030018

454 Amputation-Lower Limb Tertiary 20000 Orthopedics 29030019

455 Bone Tumour- Excision (Small Bone) Tertiary 20000 Orthopedics 29030020

456 Trimalleolar Fracture - Fixation Tertiary 18000 Orthopedics 29030021

457 Ray- Amputation Tertiary 12000 Orthopedics 29030022


type

Package

Rate



458 Implant removal-Major Tertiary 10000 Orthopedics 29030023

459 Exomphalos - Primary/Secondary closure Tertiary 25000 Pediatric Surgery 29220001

460 Anal Dilatation Tertiary 4000 Pediatric Surgery 29220002

461 Posterior sagittal anorectoplasty (PSARP) Tertiary 25000 Pediatric Surgery 29220003

462 Chordee Correction Tertiary 12000 Pediatric Surgery 29220004

463 Oesophageal Atresia with tracheo esophageal fistula Tertiary 25000 Pediatric Surgery 29220005

464 Pyloric Stenosis (Ramstedt - OP) Tertiary 15000 Pediatric Surgery 29220006

465 Urethroplasty Tertiary 25000 Pediatric Surgery 29220007

466 Peadiatric Surgery - Exosotrophy bladder -Primary/Secondary

closure

Tertiary 40000 Pediatric Surgery 29220008

467 EPISPADIAS REPAIR Tertiary 25000 Pediatric Surgery 29220009

468 Peadiatric Surgery - EPISPADIAS REPAIR 2) INCONTINENT

(EPISPADIAS REPAIR +BNR)


469 Plastic Surgery - Flap cover Surgery for wound in compound

fracture


470 Plastic Surgery - Facial bone fractures (Facio-Maxillary Injuries) Tertiary 25000 Pediatric Surgery 29220012

471 GBS for IVIG / vial of 5gm each Tertiary 10000 Pediatric Surgery 29220013

472 Urethral reconstruction in exosotrophy patients Tertiary 10000 Pediatric Surgery 29220014

473 Uretric reimplantation Tertiary 40000 Pediatric Surgery 29220015

474 Bladder neck reconstruction Tertiary 25000 Pediatric Surgery 29220016

475 Exploratory Laparotomy with Resection & Anastamosis of

Intestine


476 Abdomino Perineal pull through Tertiary 25000 Pediatric Surgery 29220018

477 Pull through for Hirschsprung disease Tertiary 33000 Pediatric Surgery 29220019

478 Cystoscopic injection for Vesico ureteric reflux Tertiary 35000 Pediatric Surgery 29220020

479 Oesophageal replacement surgery for pediatric patients Tertiary 25000 Pediatric Surgery 29220021

480 Anoplasty Tertiary 25000 Pediatric Surgery 29220022

481 Sclerosant Injection for cystic hygroma for pediatric patients Tertiary 4000 Pediatric Surgery 29220023

482 Cystolithotomy Tertiary 11250 Pediatric Surgery 29220024


type

Package

Rate



483 Advanced Package for - Neo Natal Care all babies admitted with

complications like Meningitis/Severe respiratory distress

/Shock/Coma/Convulsions or Encephalopathy/Jaundice requiring

exchange transfusion/NEC)

Tertiary 24000 Pediatrics 29080001 Advanced Package for Neo

Natal Care (For details see

website)

484 Neck Dissection - any type Tertiary 25000 Plastic Surgery 29130001

485 Reconstructive lower limb surgery following infection, Trauma,

Tumors / Malignancy, Developmental including diabetic foot –

SEVERE

Tertiary 42000 Plastic Surgery 29130002 Reconstructive lower limb

surgery (For details see

website)

486 Abdominal wall reconstruction including post cancer excision. Tertiary 35000 Plastic Surgery 29130003

487 Reconstructive Micro surgery -Replantation of hand, finger,

thumb, arm, scalp etc

Tertiary 50000 Plastic Surgery 29130004

488 Reconstructive Micro surgery- free tissue transfer Tertiary 50000 Plastic Surgery 29130005

489 Flap surgeries - myocutaneous flap/muscle/fasciocutaneous flap Tertiary 35000 Plastic Surgery 29130006

490 Flap surgeries - osteo myocutaneous flap Tertiary 35000 Plastic Surgery 29130007

491 Operation for vascularmalformation Tertiary 30000 Plastic Surgery 29130008

492 Ear Reconstruction for Microtia (stage-I) Tertiary 35000 Plastic Surgery 29130009

493 Ear Reconstruction for Microtia (stage-II) Tertiary 25000 Plastic Surgery 29130010

494 Ear Reconstruction for Microtia (stage-III) Tertiary 15000 Plastic Surgery 29130011

495 Total Penectomy Tertiary 9600 Plastic Surgery 29130012

496 Partial Penectomy Tertiary 6000 Plastic Surgery 29130013

497 Palatal fistulla Tertiary 9000 Plastic Surgery 29130014

498 30%-60% burns (conservative management) Tertiary 25000 Plastic Surgery 29130015

499 30%-60% burns (surgical management) Tertiary 30000 Plastic Surgery 29130016

500 Reconstructive surgery follwing facio maxillary trauma, fracture

mandible, maxilla

Tertiary 20000 Plastic Surgery 29130017

501 Gynecomastia Tertiary 15000 Plastic Surgery 29130018

502 Vaginal Reconstruction Tertiary 20000 Plastic Surgery 29130019

503 TM Joint ankylosis - bilateral Tertiary 18000 Plastic Surgery 29130020

504 Scalp Avulsion with reconstruction Tertiary 25000 Plastic Surgery 29130021

505 Skin Malignancies with Reconstruction Tertiary 20000 Plastic Surgery 29130022

506 Cleft lip and Palate Tertiary 10500 Plastic Surgery 29130023


type

Package

Rate



507 Syndactyly-single Tertiary 10000 Plastic Surgery 29130024

508 Plexiform Neurofibromatosis Tertiary 15000 Plastic Surgery 29130025

509 Fingertip injuries with reconstruction Tertiary 12000 Plastic Surgery 29130026

510 Radical treatment - Cobalt 60 external beam radiotherapy Tertiary 20000 Radiation Oncology 29180001

511 Palliative treatment - Cobalt 60 external beam radiotherapy Tertiary 10000 Radiation Oncology 29180002

512 Adjuvant therapy - Cobalt 60 external beam radiotherapy Tertiary 18000 Radiation Oncology 29180003

513 Radical treatment with photons/electrons - Linear Accelarator

(With orphit) / 3d CRT

Tertiary 34000 Radiation Oncology 29180004

514 Palliative treatment with photons - Linear Accelarator Tertiary 15000 Radiation Oncology 29180005

515 Adjuvant treatment with photons/electrons - Linear Accelerator /

3 CDRT (3D Simulation with Orphit)


516 Hdr per application - Brachytherapy-intracavitary (upto 2 fraction) Tertiary 4000 Radiation Oncology 29180007

517 Hdr - one application and multiple dose fractions Brachytherapy-

interstitial


518 Radical treatment with IMRT - LA with multi leaf collimator Tertiary 90000 Radiation Oncology 29180009

519 Radical treatment with IGRT - LA with multi leaf collimator Tertiary 110000 Radiation Oncology 29180010

520 SRS (Stereotactic Radiosurgery) - LA with some accessories Tertiary 90000 Radiation Oncology 29180011

521 SRT (Stereotactic Radiotherapy) - LA with some accessories Tertiary 75000 Radiation Oncology 29180012

522 Gamma Knife / Cyber Knife - For Brain Tumor Tertiary 100000 Radiation Oncology 29180013

523 Total Body Radiation - For Pre Bone Marrow/Stem Cell Transplant Tertiary 25000 Radiation Oncology 29180014

524 Hdr application - Brachytherapy-intracavitary- more than 2

fractions


525 Brachytherapy Tertiary 6000 Radiation Oncology 29180016

526 Whipple's PD Tertiary 80000 Surgical Oncology 29170001

527 Major Hepatic Resection (Rt/Lt/Multiple Segment) Tertiary 75000 Surgical Oncology 29170002

528 Staging Lap. Tertiary 10000 Surgical Oncology 29170003

529 Genitourinary System - Radical Cystectomy Tertiary 48000 Surgical Oncology 29170004


type

Package

Rate



530 Adenoma Excision Tertiary 12000 Surgical Oncology 29170005

531 Excision Cartoid Body - tumour Tertiary 15600 Surgical Oncology 29170006

532 Subtotal - Gastrectomy for ulcer Tertiary 18000 Surgical Oncology 29170007

533 Genitourinary System - Other cystectomies Tertiary 30000 Surgical Oncology 29170008

534 Genitourinary System - High Orchidectomy Tertiary 10000 Surgical Oncology 29170009

535 Genitourinary System - Emasculation Tertiary 10000 Surgical Oncology 29170010

536 Genitourinary System - Inguinal Block Dissection (one side) Tertiary 12000 Surgical Oncology 29170011

537 Genitourinary System - Radical Prostatectomy Tertiary 25000 Surgical Oncology 29170012

538 Gynaecology - Radical Hysterectomy Tertiary 30000 Surgical Oncology 29170013

539 Gynaecology - Surgery for Ca Ovary Tertiary 30000 Surgical Oncology 29170014

540 Breast Cancer - MRM/ BCS Tertiary 25000 Surgical Oncology 29170015

541 Breast Cancer - Axillary Dissection Tertiary 13500 Surgical Oncology 29170016

542 Breast Cancer - Wide excision Tertiary 4500 Surgical Oncology 29170017

543 Breast Cancer - Wide excision + Reconstruction Tertiary 20000 Surgical Oncology 29170018

544 Lung Cancer - Lobectomy Tertiary 24000 Surgical Oncology 29170019

545 Lung Cancer - Decortication Tertiary 22000 Surgical Oncology 29170020

546 Lung Cancer - Surgical Correction of Bronchopleural Fistula. Tertiary 16400 Surgical Oncology 29170021

547 Head & Neck Cancer - Resection of Nasopharyngeal Tumor Tertiary 18000 Surgical Oncology 29170022

548 Head & Neck Cancer - Craniofacial resection of any type Tertiary 25000 Surgical Oncology 29170023

549 Head & Neck Cancer - Composite Resection & Reconstruction of

any type

Tertiary 32000 Surgical Oncology 29170024

550 Head & Neck Cancer - Thyroidectomy (any type) Tertiary 30000 Surgical Oncology 29170025

551 Head & Neck Cancer - Parotidectomy (any type) Tertiary 22000 Surgical Oncology 29170026

552 Head & Neck Cancer - Laryngopharyngo Oesophagectomy Tertiary 25000 Surgical Oncology 29170027

553 Head & Neck Cancer - Wide excision Tertiary 10000 Surgical Oncology 29170028

554 Salivary Gland Cancer - Submandibular Gland Excision Tertiary 16000 Surgical Oncology 29170029

555 Trachea Cancer - Tracheal Resection Tertiary 18000 Surgical Oncology 29170030

556 Trachea Cancer - Sternotomy + Superior Mediastinal Dissection Tertiary 25000 Surgical Oncology 29170031

557 GI Tract Cancer - Small bowel resection Tertiary 20000 Surgical Oncology 29170032

558 GI Tract Cancer - Closure of Ileostomy/ Colostomy Tertiary 14000 Surgical Oncology 29170033

559 Rectal Cancer - Abdomino Perineal Resection (APR) + Sacrectomy Tertiary 25000 Surgical Oncology 29170034

560 Gall Bladder - Radical Cholecystectomy Tertiary 36000 Surgical Oncology 29170035


type

Package

Rate



561 Spleen - Radical Splenectomy Tertiary 26000 Surgical Oncology 29170036

562 GI System - Resection with Reanastomosis Tertiary 27000 Surgical Oncology 29170037

563 GI System - Oesophagectomy (any type) Tertiary 48000 Surgical Oncology 29170038

564 GI System - Gastrectomy for cancer Tertiary 32000 Surgical Oncology 29170039

565 GI System - Colectomy for cancer Tertiary 30000 Surgical Oncology 29170040

566 GI System - Anterior Resection Tertiary 40000 Surgical Oncology 29170041

567 GI System - Abdominoperinial Resection Tertiary 35000 Surgical Oncology 29170042

568 GI System - Triple Bypass Tertiary 32000 Surgical Oncology 29170043

569 GI System - Pancreatic cancer bypass surgery other than triple

bypass


570 Gynaecology - Radical Trachelectomy Tertiary 25000 Surgical Oncology 29170045

571 Gynaecology - Radical vaginectomy Tertiary 23000 Surgical Oncology 29170046

572 Gynaecology - Radical vaginectomy + Reconstruction Tertiary 28000 Surgical Oncology 29170047

573 Gynaecology - Anterior Exenteration Tertiary 30000 Surgical Oncology 29170048

574 Gynaecology - Posterior Exenteration Tertiary 30000 Surgical Oncology 29170049

575 Gynaecology - Pelvic Exenteration Surgery Tertiary 46800 Surgical Oncology 29170050

576 Gynaecology - Radical Trachelectomy Cone Biopsy, Simple

Hysterectomy


577 Chest- Chest wall resection for SOFT tissue bone tumors Tertiary 8400 Surgical Oncology 29170052

578 Chest - Chest wall resection + Reconstruction Tertiary 9600 Surgical Oncology 29170053

579 Bone / soft tissue tumors - Limb salvage surgery for Bone Tumors

with modular Prosthesis


580 Bone / soft tissue tumors - Hemipelvectomy Tertiary 28000 Surgical Oncology 29170055

581 RCC surgery- radical nephrectomy Tertiary 35000 Surgical Oncology 29170056

582 Renal Cell Cancer - Nephroureterectomy for Transitional Cell

Carcinoma of renal pelvis (one side)


583 Testes cancer - Retro Peritoneal Lymph Node Dissection(RPLND)

for Residual Disease


584 Testes cancer - Urinary diversion Tertiary 18000 Surgical Oncology 29170059

585 Urinary Bladder Cancer - Anterior Exenteration Tertiary 22000 Surgical Oncology 29170060

586 Urinary Bladder Cancer - Total Exenteration Tertiary 38800 Surgical Oncology 29170061

587 Thoracic and Mediastinum Cancer - Mediastinal tumor resection Tertiary 24000 Surgical Oncology 29170062

588 Lung Cancer - Lung metastatectomy of any type Tertiary 18000 Surgical Oncology 29170063


type

Package

Rate



589 Lung Cancer - Sleeve resection of Lung cancer. Tertiary 20000 Surgical Oncology 29170064

590 Oesophagus Cancer - Oesophagectomy with Three field

Lymphadenectomy


591 Palliative Surgeries - Ileotransverse Bypass Colostomy Tertiary 8600 Surgical Oncology 29170066

592 Palliative Surgeries - Substernal bypass Tertiary 17500 Surgical Oncology 29170067

593 Reconstruction - Micro vascular reconstruction Tertiary 18000 Surgical Oncology 29170068

594 Soft Tissue and Bone Tumors - Wide excision Tertiary 15000 Surgical Oncology 29170069

595 Soft Tissue and Bone Tumors - Amputation (Major / Minor) Tertiary 9000 Surgical Oncology 29170070

596 Genitourinary System - Inguinal Block Dissection (both side) Tertiary 14000 Surgical Oncology 29170071

597 Parathyroid Cancer - Parathyroidectomy Tertiary 18000 Surgical Oncology 29170072

598 Palliative Surgeries - Tracheostomy Tertiary 4800 Surgical Oncology 29170073

599 Palliative Surgeries - Gastrostomy Tertiary 8000 Surgical Oncology 29170074

600 GI System - Resection of Retroperitoneal Tumors Tertiary 37500 Surgical Oncology 29170075

601 Partial Cystectomy Tertiary 24000 Urology 29050001

602 Nephro Uretrectomy Tertiary 20000 Urology 29050002

603 PCNL (Percutaneous nephro lithotomy) - Biilateral Tertiary 30000 Urology 29050003

604 Nephrectomy for Renal tumor / Radical Nephrectomy Tertiary 30000 Urology 29050004

605 Retroperitoneal Fibrosis - Renal Tertiary 26250 Urology 29050005

606 URS Extraction of Stone Ureter - Bilateral Tertiary 25000 Urology 29050006

607 Open Nephrolithotomy Tertiary 10000 Urology 29050007

608 Pyeloplasty Tertiary 25000 Urology 29050008

609 PCNL (Percutaneous Nephro Lithotomy)-Unilateral Tertiary 24000 Urology 29050009

610 ESWL (Extra carporial shock wave lithotripsy) for upto 1 cm stone

(upto 2 sittings)

Tertiary 15000 Urology 29050010

611 DJ stent (One side) Tertiary 6000 Urology 29050011

612 Urethroplasty for Stricture Diseases-End to end Tertiary 18000 Urology 29050012

613 Urethroplasty for Stricture Diseases-Johanson stage 1/2 Tertiary 24000 Urology 29050013

614 Urethroplasty for Stricture Diseases-BMG onlay Tertiary 37500 Urology 29050014

615 TURBT Tertiary 23000 Urology 29050015

616 Simple Nephrectomy Tertiary 25000 Urology 29050016

617 Lap. Nephrectomy Simple Tertiary 32000 Urology 29050017

618 Lap. Nephrectomy Radical Tertiary 32000 Urology 29050018

619 Lap. Partial Nephrectomy Tertiary 32000 Urology 29050019


type

Package

Rate



620 Retrograde Intrarenal Surgry with Laser Lithotripsy Tertiary 50000 Urology 29050020

621 Surgery for Uretrorectal Fistula Tertiary 25000 Urology 29050021

622 Open surgery for Colovesical Fistula Tertiary 30000 Urology 29050022

623 Open Nephroureterectomy with bladder cuff excision Tertiary 35000 Urology 29050023

624 Laproscopic Nephroureterectomy with bladder cuff excision Tertiary 45000 Urology 29050024

625 Open Ureterocalicostomy Tertiary 30000 Urology 29050025

626 Laproscopic Ureterocalicostomy Tertiary 40000 Urology 29050026

627 Laproscopic Heminephrectomy for Fusion Anomaly Tertiary 35000 Urology 29050027

628 Open ureteral reimplantation- Unilateral Tertiary 30000 Urology 29050028

629 Laproscopic Ureteal Reimplantation Tertiary 40000 Urology 29050029

630 Ureterolysis for Retroperitoneal Fibrosis Tertiary 30000 Urology 29050030

631 Open Augmentation Cystoplasty Tertiary 50000 Urology 29050031

632 Open Bladder Diverticulectomy with Ureteric Reimplantation Tertiary 30000 Urology 29050032

633 Open orchidectomy (Simple/Radical) Tertiary 15000 Urology 29050033

634 Open ileal replacement for ureteric stricture Tertiary 50000 Urology 29050034

635 Open boari flap Tertiary 35000 Urology 29050035

636 Open ureterolysis Tertiary 30000 Urology 29050036

637 Open colovaginal fistula repair Tertiary 30000 Urology 29050037

638 Adrenalectomy Tertiary 35000 Urology 29050038

639 Lap. Pyeloplasty Tertiary 35000 Urology 29050039

640 Radical Prostatectomy-Lap Tertiary 86000 Urology 29050040

641 Radical Cystectomy with neo Bladder Tertiary 150000 Urology 29050041

642 Radical Prostatectomy Tertiary 48000 Urology 29050042

643 Radical Cystectomy with Ileal conduit/Ureterosigmoidostomy Tertiary 100000 Urology 29050043

644 PCNL (Percutaneous nephro lithotomy) - Unilateral

Complex/Redo/Staghorn


645 VVF Repair/urithrovaginal fistula repair/Female Urethral

Diverticulectomy


646 Open ureteral reimplantation -Bilateral/Ureteral tailoring/redo Tertiary 35000 Urology 29050046

647 Hypospadias-Redo/Proximal/ Complex/ Epispadias Tertiary 30000 Urology 29050047


type

Package

Rate



648 Partial Nephrectomy Tertiary 30000 Urology 29050048

649 TVT/TOT (Stress Urinary incontinence) Tertiary 25600 Urology 29050049

650 AV Fistula-Brachiocephalic Tertiary 25000 Urology 29050050

651 ESWL (Extra carporial shock wave lithotripsy) for more than1 cm

stone (upto 2 sittings)


652 Perineal Urethrostomy Tertiary 25000 Urology 29050052

653 cutaneous Vesicostomy/Ureterostomy Tertiary 20000 Urology 29050053

654 Total Penectomy with groin dissection Tertiary 25000 Urology 29050054

655 Repair of Fracture penis/Priaprism Tertiary 25000 Urology 29050055

656 Drainage of Perinepheric Abscess - Exploration and Drainage Tertiary 20000 Urology 29050056

657 Vaso Vasostomy/ Vaso Epididymal Anastomosis Tertiary 20000 Urology 29050057

658 Partial Penectomy with groin dissection Tertiary 16000 Urology 29050058

659 Bilateral PCN Tertiary 15000 Urology 29050059

660 Hypospadias-Fistula Closure Tertiary 12000 Urology 29050060

661 DJ Stent (both side) Tertiary 10000 Urology 29050061

662 BNI/TUIP Tertiary 15000 Urology 29050062

663 PCCL (Bladder stone) Tertiary 15000 Urology 290500631. Hospitalization period of patient will be as per procedure/package.

2. Pre-authorization for packages/procedures related to Dialysis/Chemotherapy / Radiotherapy / Thalassemia will not be

required again and again subsequently by the hospital as per schedule once uploaded in the system. First TID, which got pre-

bhamashah swasthya bima yojana 2017 - rajasthan · bhamashah swasthya bima yojana 2017 . s. no....

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