ehs service contract agreement 2013
TRANSCRIPT
SERVICE CONTRACT AGREEMENT
This Deed of “Service Contract Agreement” (Herein after called as Contract) is made and
executed on this the day of the month of , 2013-14,
Between:
AAROGYASRI HEALTH CARE TRUST(A Trust of Government of Andhra Pradesh), a
Trust incorporated under the Indian Trusts Act, having its office at Trust Head Office, Door
No. 8-2-293/82/a/ahct, Road No.46, Jubilee Hills Hyderabad 500 033, represented by its
CHIEF EXECUTIVE OFFICER namely Sri. K Dhananjaya Reddy, S/o K Reddenna, Age:
49 Years, Occ: Chief Executive Officer, Aarogyasri Health Care Trust, R/o CEO Camp
Office, Jubilee Hills, Hyderabad (Herein after referred to as the “Trust” which expression
shall unless it be repugnant to the context or meaning thereof shall be deemed to mean and
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include its officials, successors in office, deputees, appointees, designees, nominees,
authorized persons and assignees of the FIRST PART).
AND
represented by its Managing Director / Superintendent/ COO/
CEO / Proprietor and having its Registered Office at
(Hereinafter referred to
as “SERVICE PROVIDER” or NWH which expression shall unless it be repugnant to the
context or meaning thereof be deemed to mean and include its officials, successors in office,
nominees and assignees of the OTHER PART).
WHEREAS, the Trust is set up by the Govt. of AP for providing health care services
to families of employees and pensioners of State Govt. under Employees Health Scheme
in State in 23 districts for the surgeries / therapeutic procedures as mentioned in
annexure-C for which purpose Trust has created a network of Service Providers. The
Trust is charitable in nature and is a non- profitable institution under the Government of
AP.
The headlines and the articles/ terms/ contents or covenants contained herein may not
be construed or misinterpreted in the strict legal sense or in any manner which hampers and
obstructs the implementation of the objectives and functioning of the Trust; But, in all
respects the parties hereto shall follow the principles guiding Aarogyasri with its spirit and
objectives and the policy of the Government from time to time in this regard.
WHEREAS
(A) The Service Provider, has applied to the Trust that they have the required
infrastructure, professional skills, personnel and technical resources, to provide the
services on the terms and conditions set forth in this Contract;
(B)The Trust having examined and inspected the Service Provider has agreed to let
the service providers to provide the services based as defined in the General
Conditions attached to this Contract (herein after called the Services)
(C) The Trust for provision of healthcare services to beneficiaries under Employees
Health Scheme (EHS) intends to spend a portion of its receipts to eligible payments
under this contract;
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Now therefore the parties hereto hereby agree as follow;
1. The documents mentioned hereto in GCC, SCC and appendices below shall be deemed to
form an integral part of this Contract and may be read and understood as part and parcel of
this contract Agreement.
(a) The documents as mentioned in General Conditions of Contract;
(b) The documents as mentioned in Special Conditions of Contract;
(c) The Appendices: All that the documents relating to the below Appendices:
Appendix A – Aarogyasri Scheme Manual
Appendix B – List of Empanelled Specialties
Appendix C – Packages and Package prices
Appendix-D – Application submitted by the service providers.
2. The mutual rights and obligations of the Trust and Service Provider shall be as set forth in
the Contract; in particular:
(a) The Service Provider shall carry out the Services in accordance with the provisions
of the Contract; and
(b) The Trust shall make payments to the Service Provider in accordance with the
provisions of the Contract.
3. This Contract Agreement will be in force for a period of one (1) year commencing from
00:00 hours of Dt. / / to 00:00 hours of Dt. / /or until otherwise terminated or till the
time of signing of new contract.
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IN WITNESS WHERE OF, the Parties hereto have caused this Contract to be signed in
their respective names as of the day and year first above written.
For and on Behalf of
Aarogyasri Health Care Trust
By
Authorized Representative
For and on Behalf of
Service Provider/ NWH
By
Authorized Representative [Note: if the Service Provider consists of more than one entity, all of these entities should
appear as signatories, e.g., in the following manner:
For and on Behalf of Each of the Members of the Service Providers
[Member]
By
Authorized Representative
[Member]
By
[Authorized Representative etc.]
Witness:
1. Witness for AHCT
Sign:
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Name & Address:
2. Witness for Service Provider/ NWH:
Sign:
Name & Address:
GENERAL CONDITIONS OF CONTRACT
Article 1 General Provisions
.1 Definitions:
Unless the context otherwise requires, the following terms whenever used in
this Contract have the following meanings:
a) “Applicable Law” means the laws and other instruments having the force
of law in India, and includes the Andhra Pradesh Allopathic Private Medical
Care Establishments (Registration and Regulation) Act, 2002.
b) “Aarogyamithra” means first contact person for Aarogyasri patient at
Network Hospital.
c) “Beneficiaries” as per GOMs 174, dated,01.11.2013
c) “Category” means the group of therapies as mentioned in the scheme.
For example: Polytrauma, Cardiology, General Surgery etc; are categories
under the scheme.
d) “CEO” means Chief Executive Officer of the Trust.
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e) “Confidential Information” means all information (whether in written,
oral, electronic or other format) that has been identified or marked confidential
at the time of disclosure including project data which relates to the technical,
financial and business affairs, customers, Service Providers products,
developments, operations, processes, data, trade secrets, design rights,
knowhow and personnel of each party and its officials which is disclosed to or
otherwise learned by the other party whether a party to this agreement in the
course of or in connection with this Agreement (including without limitation
such information received during negotiations, location visits and meetings in
connection with this Agreement).
f) “Contract” means the Contract signed by the Parties, to which this
General Conditions of Contract (GCC) are attached, along with the
documents as mentioned in GCC, SCC and appendices together with all the
documents listed in Article 1 of such signed Contract.
g) “Conflicting activities” means any activity by the service provider which
contradicts the provisions mentioned in this contract and acting against the
interests of the Trust.
h) “Coverage” shall mean the entitlement by the beneficiary to Health
Services provided under the Scheme, subject to the terms and conditions, of the
Scheme.
i) “Counselling” to offer reasonable advice and guidance to the beneficiary
relating to his/ her treatment by recommending him/ her the best possible
option under the given circumstances, by the NWH.
j) “Consent” should be reasonable, informed and proper consent obtained by
the NWH from the beneficiary relating to the treatment or performance of a
surgery. It can be by the beneficiary or his/ her attendant in a free and fair
manner.
k) “Consultants” are the specialists in different fields of medicine who
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provides expert medical care of services to the patients in a hospital as defined
in AP Gazette rules dated: 05.05.2007 and shall be registered with Andhra
Pradesh Medical Council.
l) “Deliverables” means the Products, infrastructure and Services specifically
developed for ‘Aarogyasri Health Care Trust’ and agreed to be delivered by the
Service Provider in pursuance of the Agreement and includes all the
documents related to the Service, user manuals, technical manuals, design,
methodologies, process and operating manuals, service mechanisms, policies
and guidelines and all their modifications.
m) “Doctor” means Qualified Allopathic doctor recognized by Medical
Council of India and registered with AP Medical Council.
n) “Documents” means original document/s pertaining to treatment of
Aarogyasri beneficiary (Medical records, prescriptions, reports, bills,
registration paper/s, discharge summary, patient data and other supporting
document/s and all other related documents not specified herein.
o) EDC means “Empanelment and Disciplinary Committee”.
p) “Effective Date” means the date on which this Contract comes into force
and effect pursuant to GCC Article 2.1.
q) “Equipment” means all the equipment, both medical and non-medical,
furniture and other materials.
r) “Family” means head of the family, spouse, dependent children and
dependent parents as enumerated as per GOMs 174, dated, 01.11.2013 EHF
schemes respectively.
s) “Financial Year” means the calendar year which begins from 1st of April
and ends on 31st of March of the next consecutive year.
t) “Flagging” Taking cognizance of any complaint / grievance / allegation
against the NWH under the scheme of the Trust by the District Coordinator /
District Manager / Network team leader / Field staff or Doctor of the trust,
based upon the prima facie evidence. The Flag raised is to be determined as pet
Term 13.9 of the Manual.
u) “GCC” means General Conditions of Contract.
v) “Government” m e a n s t h e G o v e r n m e n t of Andhra Pradesh or the Government of India.
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w) “Government Hospital” means Institution/hospital established by State
Government or Central Government.
x) “Empolyee Health Card” means Employee Health Card issued by
Aarogyasri Health Care Trust.
y) “Hospital” means Hospital Registered under Andhra Pradesh Allopathic
Private Medical Care Establishments (Registration and Regulations) Act,
2002, Rules & Regulations 2007 and PNDT Act with minimum 50 beds.
z) “IMA” means Indian Medical Association.
aa) “Infrastructure” means the physical infrastructure facilities available in
the Network Hospital.
bb) “IEC” means Information, Education & Communication.
cc) jj)“IRDA” means Insurance Regulatory and Development
Authority
dd) “Materials” means all documentation in printed or printable
form and all instructional and informational aids in any form
(including audio, video and text) and on any medium, provided
to the Trust under the Contract.
ee) “Member”, in case of Service Provider consists of a joint
venture of more than one entity, means any of these entities and
“Members” means all of these entities;
ff) “Manual” means a manual or manuals prepared by the Trust
consisting of instructions and guidelines to be followed for
the operation of any of its Scheme(s).
gg) “Network Hospital/ NWH” means the hospital empanelled
under Aarogyasri Scheme of Service Provider herein.
hh) “Package” means the package of different components. The
package includes:
• Consultation, medicines, diagnostics, speciality services,
• Implants, grafts, prosthesis,
• Food
• Hospital charges etc.
• Post discharge Follow-up within 10 days after discharge ii) “Package Price” means the price paid for the package to a NWH.
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jj) “Party” means the Trust or the Service Provider, as the case may be and
“Parties” means both of them.
kk) “Pre-Authorization” means a process by which an Insured Person
obtains written approval for certain medical procedures or treatments, from
Trust and is mere approval of eligibility of the case for assistance under
Scheme.
ll) “Personnel” means persons hired by the Service Providers or by any
Subcontractor as employees and assigned to the performance of the Services or
any part thereof; and “Key Personnel” means the Personnel referred to in
Clause GCC 4.2 (a);
mm) “PHC” means Primary Health Centre.
nn) “MEDCO” means Medical Coordinator from the Network Hospital
with minimum MBBS qualification to coordinate with the Trust.
oo) RAS means Rajiv Aarogyasri Scheme
pp) “Reporting” means Formal reporting as the beneficiary.
qq) “SCC” means the Special Conditions of Contract by which the GCC may
be amended or supplemented.
rr) “Service” means the work to be performed by the Service Provider
pursuant to this Contract, as described in Appendix A hereto.
ss) “Service Level” means the level and quality of service and other
performance criteria which will apply to the services as set out in the scheme
of the Trust.
tt) “SLAs” means Service Level Agreements.
uu) “Subcontractor” means any person or entity to whom/which the
Service Providers subcontract any part of the Services in Services in
accordance with the provisions of Clause GCC 3.7; and
vv) “Scheme” means Employee Health Insurance Scheme ( as applicable or
any other Health Care Scheme under the Trust.
ww) “Service Provider” means a hospital, nursing home or such other
medical aid provider empanelled with the Trust and adhering to the
empanelment procedure and guidelines and referred also as NWH.
xx) “Surgery/Surgeries” means cutting, abrading, suturing, laser or
otherwise physically changing body tissues and organs by qualified
allopathic medical 9
doctor who is authorized to do so.
yy) “Trust” means Aarogyasri Health Care Trust of Government of AP.
zz) “Third Party” means any person or entity other than the Government, the
Trust, the Service Providers or a Subcontractor.
ab) “Treatment” means medical/surgical and other modes of management
by qualified allopathic Doctor in the Network hospital.
ac) Therapy/ Therapies: Standard way of medical treatment to the patient
as per the medical protocols of Allopathic Medicine.
ad) “TAT” means Turn Around Time.
ae) “The Scheme” means the description of Services including the disease
and financial coverage, the terms and conditions of services available under
the scheme.
af) “Writing” means either written in indelible ink or electronically through
the appropriate module of the IT application of the Trust.
.2 Relation between the Parties
Nothing contained herein in this contract shall be construed or deemed to
create any association, partnership or joint venture, employer-employee
relationship or principal – agent relationship in any manner whatsoever
between the parties. The Service Provider subject to this Contract shall have
complete charge of personnel and subcontractor, if any, performing the
services and shall be fully responsible for the services performed by them or on
their behalf hereunder. It is the bounden obligation upon the part of the service
provider to protect the interests of the Trust and its objections and to act under
the policies and guidelines of the government from time to time in this regard.
.3 Law Governing Contract and Jurisdiction
This Contract, its meaning and interpretation, and the relation between the
Parties shall be governed by the Applicable Law. The jurisdiction over matters
arising out of or relating to this Contract shall lie at Hyderabad exclusively
under the High Court of Andhra Pradesh in the State of AP.
.4 Language
This Contract has been executed in the language specified in the SCC, which
shall be the binding and controlling language for all matters relating to the
meaning or interpretation of this Contract.
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.5 Headings
The heading shall not limit, alter or affect the meaning of this Contract. The
tables of contents, headings or sub-headings in this Agreement are for
convenience of reference only and shall not be used in, and shall not affect, the
construction or interpretation of this Contract.
.6 Notices
i. Any notice, request or consent required or permitted to be given or made
pursuant to this contract shall be in writing. Any such notice, request or
consent shall be deemed to have been given or made when delivered in person
to an authorized representative of the Party to whom the communication is
addressed, or when sent by registered post, e-mail, or fax to such party at the
address specified in the SCC.
ii. Notice will be deemed to be effective as specified in the SCC.
iii. A party may change its address for notice hereunder by giving the other
party notice of such change pursuant to the provisions listed in the SCC with
respect to Clause GCC 1.6.2.
.7 Location
The service shall be performed at such locations as are specified in Appendix -
A hereto and, where the location of a particular task is not so specified, at such
locations, as the Trust may approve.
.8 Authority of Member in Charge
In case the Service Provider consists of a joint venture of more than one entity,
the Members hereby authorize the entity specified in the SCC to act on their
behalf in exercising all the Service Providers’ rights and obligations towards
the Trust under this Contract, including without limitation the receiving of
instructions and payments from the Trust.
.9 Authorized Representatives
Any action required or permitted to be taken, and any document required or
permitted to be executed, under this Contract by the Trust or the Service
Provider may be taken or executed by the officials specified in the SCC.
.10 Taxes and Duties
Unless otherwise specified in the SCC, the Service Providers, Sub-contractors
and personnel shall clear such taxes, duties, fees and other impositions as may
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be levied under the Applicable Law including the existing service tax laws and
Finance Act. The Trust is subjected for the deduction of TDS as levied by the
Government from time to time as per the applicable law.
.11 Indemnity
Formal legal acceptance of responsibility against damage or loss, as specified
in SCC Clause 1.11
.12 To appoint other Service Provider:
The Trust has the right to appoint other Service Provider/s for implementing
the packages.
Article 2 Commencement, Completion, Modification and Termination of Contract
.1 Effectiveness of Contract
This Contract shall come into force and effect on the date of the Trust’s
notice to the Service Providers instructing the Service Providers to begin
carrying out the services mentioned in SCC.
.2 Termination of Contract for Failure to Become Effective
If this contract has not become effective within such time period after the date
of the Contract signed by the parties as shall be specified in the SCC, either
party may, by not less than one (1) month’s written notice to the other party,
declare this contract to be null and void, and in the event of such a declaration
by either party, neither party shall have any claim against the other party with
respect hereto.
.3 Commencement of Services
The Service Provider shall begin carrying out the Services as shall be
specified in the SCC.
.4 Expiration of Contract
Unless terminated earlier pursuant to Clause GCC 2.9 hereof, this Contract
shall terminate as shall be specified in the SCC.
.5 Entire Agreement
This contract contains all the necessary covenants, stipulations and provisions
mutually agreed by the parties. No agent or representative of either party has
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authority to make, and the parties shall not be bound by or be liable for, any
statement, representation, promise or agreement not set forth herein. This
contract is framed with the mutual assent of both the parties.
.6 Modification
Modification of the terms and conditions of this contract, including any
modification of the Scope of the service, may only be made by written
agreement between the parties. Pursuant to clause GCC 7.2 hereof, however,
each party shall give due consideration to any proposals for modification made
by the other party. Modifications shall be further subject to Conditions
Specified in the SCC.
.7 Force Majeure:
a. Definition
(a) For the purposes of this contract, “Force Majeure” means an event which
is beyond the reasonable control of a party, and which makes a party’s
performance of its obligations hereunder impossible or so impractical as
reasonably to be considered impossible in the circumstances, and includes, but
is not limited to, war, riots, civil disorder, earthquake, fire, explosion, storm,
flood or other adverse weather conditions, strikes, lockouts or other industrial
action (except where such strikes, lockouts or other industrial action are within
the power of the party invoking Force Majeure to prevent), confiscation or any
other action by government agencies.
(b) Force Majeure shall not include (i) any event which is caused by the
negligence or intentional action of a party or such party’s Subcontractors,
agents, representatives or employees, nor (ii) any event which a diligent party
could reasonably have been expected to both (A) take into account at the time
of the conclusion of this contract and (B) avoid or overcome in the carrying out
of its obligations hereunder.
(c) Force Majeure shall not include insufficiency of funds or failure to make
any payment required hereunder.
b. No Breach of Contract
The failure of a party to fulfil any of its obligations hereunder shall not be
considered to be a breach of, or default under, this contract insofar as such
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inability arises from an event of Force Majeure, provided that the party
affected by such an event has taken all reasonable precautions, due care and
reasonable alternative measures, all with the objective of carrying out the terms
and conditions of this contract.
c. Measures to be taken
(a) A Party affected by an event of Force Majeure shall take all reasonable
measures to remove such party’s inability to fulfil its obligations hereunder
with a minimum of delay.
(b) A Party affected by an event of Force Majeure shall notify the other Party
of such event as soon as possible, and in any event not later than fourteen (14)
days following the occurrence of such event, providing evidence of the nature
and cause of such event, and shall similarly given notice of the restoration of
normal conditions as soon as possible.
(c) The Parties shall take all reasonable measures to minimize the
consequences of any event of Force Majeure.
d. Extension of Time
Any period within which a Party shall, pursuant to this Contract, Complete any
Action or task, shall be extended for a period Equal to the time during which
such Party was unable to perform such action as a result of Force Majeure.
e. Payments
During the period of their inability to perform the Services as a result of an
event of Force Majeure, there shall not be any payment.
f. Consultation
Not later than thirty (30) days after the Service Provider as the result of an
event of Force Majeure, has become unable to perform a material portion of
the Services, the Parties shall consult with each other with a view to agreeing
on appropriate measures to be taken in the circumstances.
.8 Suspension
The Trust may, by written notice of suspension to the Service Providers
suspend all payments to the Service Provider as per the procedure laid out in
EDC clause (SCC) i.e., Art 6(1)(2) hereunder if the Service Provider fails to
perform any of its obligations under this Contract, including the carrying out of
the Services, provided that such notice of suspension (i) shall specify the
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nature of the failure, and (ii) shall request the Service Provider to remedy such
failure within a period and in the manner specified in the SCC.
.9 1. Termination
a. By the Trust
The Trust may, by not less than thirty (30) days written notice of termination to
the Service Provider (except in the event listed in paragraph (f) below, for
which there shall be only notice of not less than sixty (60) days) such notice to
be given after the occurrence of any of the events specified in paragraphs (a)
through (f) of this Clause GCC 2.9.1, terminate this Contract
(a) If the Service Provider fails to remedy a failure in the performance of its
obligations hereunder, as specified in a notice of suspension pursuant to Clause
2.8 hereinabove, within thirty (30) days of receipt of such notice of suspension
or within such further period as the Trust may have subsequently approved in
writing.
(b) If the Service Provider becomes insolvent or bankrupt or enter into any
agreements with their creditors for relief of debt or take advantage of any law
for the benefit of debtors or go into liquidation or receivership whether
compulsory or voluntary.
(c) If the Service Provider submits to the Trust a statement which has a
material effect on the rights, obligations or interests of the Trust and which the
Service Provider knows to be false.
(d) If, as the result of Force Majeure, the Service Providers are unable to
perform a material portion of the Services for a period of not less than sixty
(60) days; or
(e) If the Service Providers act to the contrary to the terms and conditions of
this contract.
(f) If the Trust, in its judicious discretion and for any reasons what so ever,
decides to terminate this Contract.
2. By the Service Provider
The Service Provider may, by not less than thirty (30) days written notice to
the Trust such notice to be given after the occurrence of any of the events
specified in paragraphs (a) through (d) of this Clause GCC 2.9.2, terminate this
Contract:
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(a) If the Trust fails to pay any money due to the Service Provider pursuant to
this Contract and not subject to dispute pursuant to Clause GCC 8 hereof
within forty-five (45) days after receiving written notice from the Service
Provider that such payment is overdue;
(b) If the Trust is in material breach of its obligations pursuant to this Contract
and has not remedied the same within forty-five (45) days (or such longer
period as the Service Provider may have subsequently approved in writing)
following the receipt by the Trust of the Service Providers notice specifying
such breach;
(c) If, as the result of Force Majeure, the Service Provider is unable to perform
a material portion of the Service for a period of not less than sixty (60) days; or
(d) If the Trust fails to comply with any final decision reached as a result of
arbitration pursuant to Clause GCC 8 hereof.
(e) If the Service Provider, in its sole discretion and for any reasons what so
ever, decides to terminate this Contract.
3. Cessation of Rights and Obligations
Upon termination of this Contract pursuant to Clauses GCC 2.2 or GCC 2.9
hereof, or upon expiration of this Contract pursuant to Clause GCC 2.4 hereof,
all rights and obligations of the Parties hereunder shall cease, except (i) such
rights and obligations as may have accrued on the date of termination or
expiration, (ii) the obligation of confidentiality set forth in Clause GCC 3.3
hereof, (iii) the Service Provider’s obligation to permit the Trust or its
designated representative for copying and auditing of Aarogyasri accounts and
records set forth in Clause GCC 3.6(ii) hereof, and (iv) any right which a party
may have under the Applicable Law.
4. Cessation of Services
Upon termination of this Contract by notice of either party to the other
pursuant to Clauses GCC 2.9.1 or GCC 2.9.2 hereof, the Service Provider
shall, immediately upon dispatch or receipt of such notice, take all necessary
steps to bring the services to a close in a prompt and orderly manner and shall
make every reasonable effort to keep expenditures for this purpose to a
minimum. With respect to documents prepared by the Service Provider and
equipment and materials furnished by the Trust, the Service Provider shall
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proceed as provided, respectively, by Clauses GCC 3.9 or GCC 3.10 hereof.
5. Payment upon Termination
Upon termination of this Contract pursuant to Clauses GCC 2.9.1 or GCC 2.9.2
hereof, the Trust shall make the following payments to the Service Provider.
(a) Payments pursuant to Clause GCC 6 hereof for services satisfactorily
performed prior to the effective date of termination;
(b) Payments, expenditures pursuant to Clause GCC 6 hereof for expenditures
actually incurred prior to the effective date of termination; and
(c) Except in the case of termination pursuant to paragraphs (a) through (d) of
Clause GCC 2.9.1 hereof, payments of any reasonable cost incident to the
prompt and orderly termination of the Contract.
6. Disputes about Events of Termination
If either party disputes whether an event specified in paragraphs (a) through (e)
of clause GCC 2.9.1 or in clause GCC 2.9.2 hereof has occurred, such party
may, within forty-five (45) days after receipt of notice of termination from the
other party, refer the matter to arbitration pursuant to Clause GCC 8 hereof,
and this contract shall not be terminated on account of such event except in
accordance with the terms of any resulting arbitral award.
Article 3 Obligations of NWH
.1 a. Standard of performance
The Service Provider shall perform the services and carry out their obligations
hereunder with all due diligence, efficiency and economy, in accordance with
generally accepted professional techniques and practices, and shall observe
sound management practices, and employ appropriate advanced technology
and safe and effective equipment, machinery, materials and methods. The
Service Provider shall always act, in respect of any matter relating to this
contract or to the services, as a faithful Service Provider to the Trust and shall
at all times support and safeguard the Trust’s legitimate interests and its
objectives in any dealings with subcontractor or Third parties.
b. Law Governing Services
The Service Provider shall perform the Services in accordance with the
Applicable Law and shall take all practicable steps to ensure that any
subcontractors as well as the personnel of the Service Provider and any
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subcontractors comply with the Applicable Law. The Trust shall notify the
Service Provider in writing of relevant Trust manuals and the Service Provider
shall, after such notification, follow the same.
c. Scope of Services
The Scope of services to be performed by the Service Provider is specified in
the Appendix-A. The Service Provider shall provide the services specified
therein in conformity with the conditions and time Schedule stated therein
Service Level Agreements (SLAs).
.2 Conflict of Interests:
i. Service Provider not to benefit from Commissions, Discounts, etc.
The Payments of the Service Provider pursuant to Clause GCC 6 hereof shall
constitute the Service Provider’s sole payments in connection with this contract
or the services and, subject to Clause GCC 3.2.2 hereof, the Service Provider
shall not accept for their own benefit any trade commission, discount or similar
payment in connection with activities pursuant to this contract or to the
services or in the discharge of their obligation hereunder, and the Service
Provider shall ensure that any subcontractors as well as the personnel and
agents of either of them, similarly shall not receive any such additional
payments.
ii. Procurement Rules of Government
If the Service Provider as part of the services, has the responsibility of advising
the Trust on the procurement of goods, works or services, the Service Provider
shall comply with any applicable procurement guidelines of the Government
and shall at all times exercise such responsibility in the best interest of the
Trust.
iii. Prohibition of Conflicting Activities
The Service Provider shall not engage, and shall cause their Personnel as well
as their Subcontractors and their Personnel not to engage, either directly or
indirectly, in any of the following activities:
(a) During the term of this Contract, any business or professional activities
which would conflict with the activities assigned to them under this Contract;
and
(b) After the termination of this Contract, such other activities as may
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be specified in the SCC.
iv. Fraud and Corrupt Practices
a. The Service Provider and its Personnel shall observe the highest standards of
ethics and shall not have engaged in and shall not hereafter engage in any
corrupt practice, fraudulent practice, coercive practice, undesirable practice,
unwanted/unnecessary surgical interventions / therapies against medical ethics
and standard treatment protocols or restrictive practice (collectively the
“Prohibited Practices”). Not with standing anything to the contrary contained
in this Contract, the Trust shall be entitled to terminate this Contract forthwith
by a communication in writing to the Service Provider, without being liable in
any manner whatsoever to the Service Provider, if it determines that the
Service Provider has, directly or indirectly or through an agent, engaged in any
Prohibited Practices in the Empanelment Process or before or after entering
into of this Contract. In such an event, the Trust shall forfeit and appropriate
genuine pre-estimated damages payable to the Trust towards, inter alia, the
time, cost and effort of the Trust, without prejudice to the Trust’s any other
rights or remedy hereunder or in law.
b. Without prejudice to the rights of the Trust under sub clause (a) above and
the other rights and remedies which the Trust may have under this contract, if
the Service Provider is found by the Trust to have directly or indirectly or
through an agent, engaged or indulged in any Prohibited Practices, during the
Selection Process or before or after the execution of this contract, the Service
Provider shall not be eligible to apply for empanelment during a period of 2
(two) years from the date the Service Provider is found by the Trust to have
directly or indirectly or through an agent, engaged or indulged in any
Prohibited Practices.
c. For the purposes of sub clauses (a) and (b) above, the terms shall have the
meaning specified in SCC.
.3 Confidentiality
The Service Provider, their Subcontractors, agents and the Personnel of either
of them shall not, either during the term or within one (1) year after the
expiration of this Contract, disclose any proprietary or confidential information
relating to the Services, this Contract or the Trust work or operations, without
19
the prior written consent of the Trust. Other conditions are specified in SCC.
.4 Liability of the Service Provider
Subject to additional provisions, if any, set forth in the SCC, the Service
Provider’s liability under this Contract shall be as provided by the Applicable
Law.
.5 Insurance to be taken out by the Service Provider
The Service Provider (i) shall take out and maintain, and shall cause any
subcontractors to take out and maintain, at their (or the subcontractors as the
case may be) own cost but on terms and conditions approved by the Trust,
insurance against the risks and for the coverage, as shall be specified in the
SCC, and (ii) at the Trust request, shall provide evidence to the Trust showing
that such insurance has been taken out and maintained and that the current
premiums there for have been paid.
.6 Accounting, Inspection and Auditing
The Service Provider (i) shall keep accurate and systematic accounts and
records with specific details in respect of the services hereunder, in accordance
with standard accounting principles and in such form and detail as will clearly
identify all relevant time charges and cost. (ii) Shall keep an accurate records
up to date of all patient data and medical records in accordance with standard
medical practices, and (iii) shall permit the Trust or its designated
representative periodically, and up to one (1) year from the expiration or
termination of this contract, to inspect the same and make copies thereof as
well as to have them audited by auditors appointed by the Trust.
.7 Service Provider’s actions requiring Trust’s prior Approval The Service Provider shall obtain the Trust’s prior approval in writing before
taking any of the following actions:
a. Appointing or changing such members of the Personnel which has a bearing
on the empanelment criteria;
b. Entering into a subcontract for the performance of any part of the services, it
being understood (i) that the selection of the Subcontractors and the terms and
conditions of the subcontract shall have been approved in writing by the Trust
prior to the execution of the subcontract, and (ii) that the Service Provider shall
remain fully liable for the performance of the Services by the Subcontractors
20
and its personnel pursuant to this Contract; c. Any other action that may be specified in the SCC.
.8 Reporting Obligations
The Service Providers shall submit to the Trust the reports and documents, in
the form, in the numbers and within the time periods set forth in the relevant
manual of the Trust.
.9 Furnishing of Copies of Medical records/ documents:
All medical records, reports, and other documents prepared by the Service
Provider for the Trust under this contract shall be copied and provided to the
Trust in the capacity of a government agency in order to comply with the
applicable law whenever required. Restriction about the future use of these
documents, if any, shall be specified in the SCC.
.10 Equipment and Materials if any furnished by the Trust
Equipment and materials if any made available to the Service Provider by the
Trust shall be the property of the Trust and shall be marked accordingly. Upon
termination or expiration of this Contract, the Service Provider shall make
available to the Trust an inventory of such equipment and materials and shall
dispose of such equipment and materials in accordance with the Trust’s
instructions. While in possession of such equipment and materials, the Service
Provider unless otherwise instructed by the Trust in writing, shall insure them
at the expense of the Service Provider in an amount equal to their full
replacement value.
.11 Lease Agreement or Change of Management
If the Service Provider sells, transfers, bequeath, mortgages, leases out or in
any manner transfers management/ownership or control of the Service
provider’s hospital or the building in which the services are offered, this
agreement shall remain effective and valid for the full contract term upon the
new owner/management of the Network Hospital taking over and the new
owner/management shall be bound by this contract as if signed by him.
The EDC is the competent authority to verify any matter related to the Service
Provider in the clauses mentioned supra, and to take a decision on
consideration/continuation of the contract agreement with new
management/Service Provider on case to case basis depending upon the
21
circumstances and the situation in the best interests of the Trust and its
objectives. The decision of the EDC is binding upon the parties and the
conditions narrated in the SCC (8.2 clause) are applicable.
The Service Provider shall intimate any such change to the Trust at least 30
days prior to such transfer with a copy of contract or transfer deed.
The new owner/management shall submit revised certificate of registration and
enter into a supplementary agreement / agreement with the Trust on the same
terms and conditions.
.12 General Provisions
i. The Service Provider undertakes that it has all the required facilities for
performing the enlisted surgeries/ procedures/ therapies per applicable law,
empanelment guidelines of Trust, and the Trust manual. The service
provider shall continue to all the empanelment criteria as confirmed through
the application of Appendix-D at www.ehf.gov.in during the course of the
contract, failing which the contract shall stand terminated.
ii. The Service Provider shall ensure that the documentation of Aarogyasri
patients is done using standard formats supplied.
iii. The first point of contact for all the patients (both OP & IP) covering under
the scheme shall be the Aarogyamithra positioned at the reception of NWH
except in cases of emergency. Provided that all beneficiaries under this
scheme of the trust covered by this agreement, entering the NWH premises
shall be treated under this scheme
iv. Any payment received from the patient beneficiary shall be refunded to the
patient before their discharge from the hospital and evidence should be
submitted.
v. The Service Provider shall adhere, obey and strictly follow the ‘Eligibility
Criteria for Empanelment of Hospitals’ and undertakes to abide by the
same. The Service Provider warrants that it has all the requirements of
Empanelment i.e., Infrastructure requirements, Equipment requirements,
Manpower requirements, Services requirements etc.
vi. The Service Provider agrees shall possess and submit the declaration of the
22
ownership of the hospital as per registration under (Company/ Trust/
Society), premises and equipment. In case of lease of the hospital premises,
the Provider agrees to submit Registered Lease Deed and its renewal from
time to time.
vii. The NWH shall follow and act within the purview and in accordance with
the AP Allopathic Medical Care Establishments Act; PNDT Act (Wherever
applicable) and as per the Rules of Medical Council of India, GOs and the
applicable law from time to time. The NWH and its personnel shall firmly
follow, abide and stick to the moral and code of Medical Ethics under all
circumstances.
viii. The Service Provider agrees not to sell/ transfer/ lease or otherwise
close down the NWH without prior intimation to the AHCT. In case of any
sale /transfer/lease the NWH shall take steps for de-empanelment of the
NWH from the Aarogyasri Scheme and covenants to provide treatment to
the existing beneficiaries till completion of required treatment and also in
facilitating Follow-up treatment to the eligible Aarogyasri beneficiaries as
per follow-up packages.
ix. The Service Provider undertakes that it shall neither entertain nor submit
the false evidences for diagnosis or treatment or surgery or manipulate any
medical records (fraudulent/ forged documents) or submit false claims. In
the event of any false records or claims being submitted by the NWH, Trust
shall have the liberty to take legal and criminal action against the offenders
including the NWH.
x. Other obligations of NWH are specified in SCC
Article 4 Service Provider’s Infrastructure, Equipment, Personnel and
Subcontractors
.1 General
The Service Provider shall employ and provide such qualified and experienced
Personnel and sub-contractors as are required to carry out the Services.
.2 Description of Personnel
i. The title, agreed job description, minimum qualifications and estimated
period of engagement in the carrying out of the Service are described in
Appendix-A.
23
ii. If required to comply with the provisions of Clause GCC 3.1.1 hereof,
adjustments with respect to the estimated periods of engagement of key
personnel set forth in relevant manual of the Trust, may be made by the
Service Provider by written notice to the Trust, and
iii. Any other such adjustments shall only be made with the Trust written
approval.
.3 Approval of Personnel
The key personnel and subcontractors listed by speciality as well as by name in
the Scrutinized online empanelment application are hereby approved by the
Trust. Any subsequent changes shall be made after approval of the Trust.
.4 Approval of Infrastructure and Equipment
The key infrastructure and equipment listed for speciality services as well as
for general services in the Scrutinized online empanelment application are
hereby approved by the Trust. Any subsequent changes shall be made after
approval of the Trust.
.5 Replacement of Personnel:
i. Except as the Trust may otherwise agree, no changes shall be made in the
Key Personnel i.e., MD/CEO of the hospital, MEDCO. If, for any reason
beyond the reasonable control of the Service Provider it becomes necessary to
replace any of the Personnel, the Service Provider shall forthwith provide as a
replacement to a person of equivalent or better qualifications. The procedure of
change of MD/ CEO prescribed herein shall be followed.
ii. Liability of Service Provider: If the Trust (i) finds that the NWH or any of
the Personnel has committed serious misconduct or ethical wrong or has been
charged with having committed a criminal action and negligence, deficiency of
service, or (ii) has reasonable cause to be dissatisfied with the performance of
any of the personnel, then the Service Provider shall be held liable and are
answerable to Courts, Forums upon their own responsibility.
.6 Coordinator(s):
If required under SCC, the Service Provider shall ensure that at all times
during the Service Provider’s performance of the Services, a coordinator(s),
acceptable to the Trust, shall be coordinating the performance of such Services.
Article 5 Obligations of the Trust:
24
.1 Assistance and Exemptions:
Unless otherwise specified in the SCC, the Trust shall use its best efforts to all
reasonable assistance as may be specified in the SCC.
.2 Access to Software application:
The Trust warrants that the Service Provider shall have, free of charge,
unimpeded access to the relevant module(s) of the software application of
Trust in respect of which access is required for the performance of the
Services.
.3 Changes in the Applicable Law:
If, after the date of this Contract, there is any change in the Applicable Law
with respect to taxes and duties which increases or decreases the cost incurred
by the Service Provider in performing the Services, then the expenses
otherwise payable to the Service Provider under this Contract shall remain the
same and subject to the ceiling amounts specified in Clause GCC 6.1(b).
.4 Services and Facilities of the Trust:
The Trust shall make available to the Service Provider and the Personnel, for
the purpose of any training and free of any charge, the training facilities at the
times and in the manner specified by the Trust.
.5 Payment:
In consideration of the Services Performed by the Service Provider under this
contract, the Trust shall make to the Service Provider such payments and in
such manner as is provided by Clause GCC 6 of this Contract.
.6 Counterpart Coordinator(s):
The Trust has made available to the Service Provider, and free of charge,
counterpart coordinator(s) on behalf of the Trust. The specified counterpart
coordinators are given in SCC.
.7 Other obligations of Trust are specified in SCC
Article 6 Payments to the Service Provider:
.1 Packages
a) The definition of package is specified in SCC
b) Except as may be otherwise agreed under Clause GCC 2.6 payments under
this Contract shall not exceed the ceilings specified in the SCC.
.2 Payments:
25
a) Subject to the ceilings specified in Clause GCC 6.1(b) hereof , the Trust
shall pay to the Service Provider Payments as set forth in Clause GCC 6.2 (b).
(b) Payments shall be determined on the basis of satisfactory performance of
the identified procedures as per standard medical practice after the date
determined in accordance with Clause GCC 2.3 and Clause SCC 2.3 (or such
other date as the parties shall agree in writing) at the rates referred to, and
subject to such additional provisions as are set forth, in the SCC.
.3 Currency of payment:
a) Payments shall be made in Indian Rupees.
.4 Mode of Billing and Payment:
Billings and payments in respect of the services shall be made as follow:
i. As soon as practicable and not later than ninety (90) English calendar days
after the discharge of the patient, during the period of the services, the Service
Provider shall submit a claim to the Trust, accompanied by appropriate
supporting materials, indicating the amounts payable pursuant to Clauses GCC
6.3 and 6.4 for such claim. Each claim shall be settled as specified in SCC.
ii. The Trust shall cause the payment of the Service Provider within seven (7)
working days after the receipt by the Trust of such claim with supporting
documents by way of single payment.
iii. The Services shall be deemed completed and finally accepted by the Trust
and the claim shall be deemed approved by the Trust as satisfactory ninety (90)
English calendar days after receipt of the claim by the Trust unless the Trust
within such ninety (90) days period gives notice to the Service Provider
specifying in detail deficiencies in the services / supporting documents
produced. The Service Provider shall thereupon promptly make any necessary
corrections, and upon completion of such corrections, the foregoing process
shall be repeated. Any amount which the Trust has paid or caused to be paid in
accordance with this clause in excess of the amounts actually payable in
accordance with the provisions of this contract shall be reimbursed by the
Service Provider to the Trust within thirty (30) days after receipt by the Service
Provider of notice thereof. Any such claim by the Trust for reimbursement
must be made within twelve (12) English calendar months after receipt by the
Trust of a claim approved by the Trust in accordance with the above.
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iv. All payments under this contract shall be made to the accounts of the
Service Provider specified in the SCC.
Article 7 Fairness and Good Faith:
.1 Good Faith:
The parties hereby undertake to act in good faith with respect to each other’s
rights under this contract and to adopt all reasonable measures to ensure the
realization of the objectives of this contract.
.2 Operation of the contract:
The parties recognize that it is impractical in this contract to provide for every
contingency which may arise during the life of the contract, and the parties
hereby agree that it is their intention that this contract shall operate fairly and
judiciously (to act skilfully with discretion, wisdom and prudence) as between
them, and without detriment to the interest of either of them, and that, if during
the term of this contract either party believes that this contract is operating
unfairly, the parties will use their best efforts to agree on such action as may be
necessary to remove the cause or causes of such unfairness, but no failure to
agree on any action pursuant to this clause shall give rise to a dispute subject to
arbitration in accordance with clause GCC 8 hereof.
Article 8 Settlement of Disputes:
.1 Amicable Settlement:
The parties shall use their best efforts to settle amicably all disputes or
contentions arising out of or in connection with this contract or the
interpretation thereof.
.2 Dispute Settlement:
i. Any dispute between the parties arising under or related to this SCA that
cannot be settled amicably may be referred to by either party to the Arbitration
in accordance with the provisions of the Arbitration Conciliation Act, 1996 or
other rules as may be mutually agreed.
ii. The parties herein fully understands that the option of approaching the court
of law is only after the exhaustion of remedy through the above Arbitration but
not before it in accordance with the provisions specified in the SCC.
Article 9 Disciplinary Actions:
.1 Any deficiency in service by the empanelled hospitals or non-compliance of
27
the provisions of SCA will be scrutinized by the Empanelment Disciplinary
Committee (EDC) constituted as per the Aarogyasri Health Care Trust
Resolution No. 134/ 2009 comprising of representatives from the Trustshall
make deliberations and suspend/ delist/ stop payments/Seek Bank
Guarantee as Security or take any other appropriate action i.e., imposing of
Exemplary Penalty up to Ten Times against erring NWHs for their acts of
Omissions and Commissions by virtue of Board Resolution No. 234/ 2011,
based on the nature of the complaint against the Service Provider. In addition
to this empanelled hospitals who are resorting to irregularities or misuse
shall be blacklisted and entire amount recovered besides launching
criminal action as per 5 (5.1)(b) of GOMs No. 174, dated 01.11.2013
issued by HM& FW (M2) department. The Service Provider shall abide by
the decisions made by the EDC and Trust as specified in SCC.
Article 10 Scheme .1 i. The scheme that the NWH shall service
a. Employees Health Scheme
ii. The guidelines a n d t h e n o r m s for t h e scheme is available in the
manual on the Trust website as amended from time to time and in the
relevant GOs issued by the Government. See SCC for further d
28
SPECIAL CONDITIONS OF CONTRACT
Article 1 General Provisions:
.4 The language shall be English
.6 The addresses are:
For the Trust:
Aarogyasri Health Care Trust, Door No. 8-2-293/82/a/ahct, Road No: 46, Jubilee Hills, Hyderabad - 500033
Attention:
Telephone No.: 91-040-27654107
Fax : 91-040-27654107
E-mail: [email protected]
For the Service Provider:
Attention:
Telephone No.:
Fax: E-
mail:
Notice will be deemed to be effective as follows:
i. In the case of personal delivery or registered mail, on delivery;
ii. In the case of facsimiles, 02 days (48) hours following confirmed
transmission.
iii. In the case of communication, intimating through Trust portal.
.8 The Service Provider is a single entity.
.9 The Authorized Representatives are:
For the Trust: The District Coordinator, Aarogyasri Health Care Trust
representing CEO, AHCT.
For the Service Provider: The Managing Director/Medical
Superintendant/CEO/COO.
.10 The package price payable by the Trust to the Service Provider shall be
subjected to statutory tax deductions at source (TDS) at applicable rates. The
Trust shall issue a TDS certificate to the Service Provider for all TDS deducted
and Service Provider agrees that such certificate may be issued periodically.
29
The TDS certificate shall be provided by the Trust to the Service Provider
within one month of the expiry of the relevant financial year.
.11 The Service Provider is aware that this Contract has arisen for the purpose of
implementation of the Employee Health Scheme to provide comprehensive
health care to all government employees, pensioners and there dependent family
members as per GOMs 174, dated 01.11.2013 in Districts of Andhra Pradesh
and accordingly the Service Provider shall under no circumstance charge or
seek any payment from the beneficiaries but will look only to for
indemnity, and that too only to the package amount specified in respect of
procedures referred to earlier and agreed to under this Contract. Signature or
the LTI of the patient / Beneficiary will be obtained on the discharge form. The
Service Provider shall be covered by proper indemnity policy including errors,
omission and professional indemnity and agrees to keep such policies in force
during entire tenure of the agreement.
a. Acts of Commissions and Omissions by NWH: The Provider shall be responsible for all commissions and omissions in treating
the patients referred under the Scheme and will also be responsible for all legal
consequences that may arise. Trust shall not be held responsible for the choice
of treatment and outcome of the treatment or quality of the care provided by
the Provider and should any legal complications arise and is called upon to
answer, the provider indemnify to pay all such legal expenses and consequent
compensation, if any.
b. Deficiency in Services: The Service Provider admits and agrees that if any claim arises out of alleged
deficiency in service on their part or on the part of their men or agents, then it
will be the duty of the Service Provider to answer such claim. In the unlikely
event of Trust being proceeded against for such cause of action and any
liability was imposed on them, only by virtue of its relationship with the
Service Provider, then the Service Provider will step in and meet such liability
on their own.
c. Treating Doctor and NWHs responsibility: The mere Preauthorization approval of case by Trust based on the data
30
provided by the Network Hospitals shall not be construed as final medical
opinion with regards to Diagnosis &Treatment of choice. The treating Doctor
& Network hospital shall be solely responsible for the final diagnosis of
disease, choice of treatment employed and outcome on such treatment.
.12 Trust reserves the right to appoint other service provider/s for implementing
the packages envisaged herein and the service provider shall have no objection
for the same.
Article 2 Commencement, Completion, Modification and Termination of Contract:
.1 The effectiveness conditions are the following:
i) The Service Provider shall be empanelled by the Trust
ii) The Service Provider shall have in place all the qualified medical and para-
medical staff.
iii) This contract acts retrospectively w.e.f 05.12.2013 from the
date of launching of the scheme as applicable to the hospitals
as per their respective declaration.
iv) The newly empanelled hospitals will come under the scheme from the
date of the signing of the present service contract agreement.
.2 The time period shall be fifteen (15) days.
.3 The time period shall be zero.
.4 The time period shall be for ONE YEAR subject to the condition that it is
understood and agreed between the parties that the term of this agreement shall
be automatically extended, on the existing terms and conditions, by a period of
3months unless expressly terminated by the Trust through a letter in writing, or
by a new agreement between the parties.
31
.6 (a) Addendum:
The Trust and the Service Provider upon mutual consent shall be entitled to
carry the addendum through separate addition to this SCA with a view to
modify, alter, ratify or add to the existing clauses of this SCA in such manner
and to such extent as they may consider expedient in the interest of and for the
purpose of the Trust.
(b) Circulars/GOs:
The service provider shall earnestly abide and adhere to the circulars,
Guidelines, instructions, notifications of the Trust and GOs issued by the
Government from time to time. The same shall be binding upon the NWH.
(c) Guidelines:
The Service Provider agrees to follow all the guidelines in rendering the
services to EHS patients as part and parcel of this SCA. The Service
Provider also agrees to follow and adhere to the guidelines issued by the Trust
from time to time.
(d) Entering into documentation:
The Service Provider hereby agrees to enter into any Agreement, Contract or
Documentation with AHCT as and when such need arises in the interest of the
Trust and its Scheme.
32
.7 None
.8 Suspension results in stoppage of registration of fresh patients
.9 None
Article 3 Obligations of Network Hospital
.2 (i) “Corrupt Practice” means the offering, giving, receiving or soliciting,
directly or indirectly, of anything of value to influence the actions of any
person connected with the Empanelment Process (for removal of doubt,
offering of employment or employing or engaging in any manner whatsoever,
directly or indirectly, any official of the Trust who is or has been associated in
any manner, directly or indirectly with Empanelment Process or Package Price
fixation process or dealing with matters concerning the contract or
empanelment guidelines before or after the execution thereof, at any time prior
to the expiry of one year from the date such official resigns or retires from or
otherwise ceases to be in the service of the Trust, shall be deemed to constitute
influencing the actions of a person connected with the Empanelment Process);
or engaging in any manner whatsoever, whether during the Selection Process
or after the empanelment or after the execution of the contract, as the case may
be, any person in respect of any matter relating to the Scheme or the
empanelment or the contract, who at any time has been or is a legal, financial
or technical adviser in relation to any matter concerning the Scheme;
(ii) “Fraudulent practice” means a misrepresentation or omission of facts or
suppression of facts or disclosure of incomplete facts, in order to influence the
Empanelment Process;
(iii) “Coercive practice” means impairing or harming, or threatening to impair
or harm, directly or indirectly, any person or property to influence any person’s
participation or action in the Empanelment Process or the exercise of its rights
or performance of its obligations by the Trust under this contract;
33
(iv) “Undesirable practice” means (i) establishing contact with any
person connected with or employed or engaged by the Trust with the
objective of canvassing, lobbying or in any manner influencing or
attempting to influence the Empanelment Process; or (ii) having a Conflict of
Interest; and
(v) “Restrictive practice” means forming a cartel or arriving at any
understanding or arrangement among other Service Providers with the
objective of restricting or manipulating a full and fair Selection in the
Empanelment Process.
(vi) Malpractices/Unethical acts:
The NWH and its personnel shall strictly desist and refrain themselves
from committing the illegal acts of malpractices, unlawful and unethical acts
which are as follows
A) Collection of money from EHS beneficiaries
B) Deficiency of services
C) Engaging middle men
D) Rejection of services to EHS patients
E) Mobilizing EHS patients by fraudulent means to network hospitals
F) Fraudulently luring the patients from other hospitals and shifting them at
their choice of hospitals, through brokers, agents and marketing executives
etc.
G) Payment of commissions or percentage by NWHS to primary health
care`s staff or Trust field staff for gaining undue favours.
H) Unauthorised shifting of EHS patients to other hospitals.
I) Discontinuing the required treatment to EHS beneficiary.
J) Fraudulent and fake pre-authorisations.
K) Fraudulent claims
L) Creating and using bogus and forge documents
M) Referral cases with wrong guidance
N) Misguiding the patients by giving wrong guidance
O) Inhuman behaviour against the Aarogyasri beneficiary
P) Resorting to irregularities or miscues.
34
The NWH shall neither encourage such illegal and unjust activities nor shall act
or commit the same. The Trust on the other hand shall enquire/inspect the same
when it is brought to its notice and initiate disciplinary actions against the NWH
and appropriate action including civil and criminal actions as per law against
the guilty/culprits.
.3 The Service Provider agrees to protect the confidentiality of the patient data
including that of the clinical photographs and take due care to follow the
standard medical practices while obtaining such photographs. Under no
circumstances can the Trust be held responsible for lapse in confidentiality and
protecting the information of the patient in the hospital.
.4 a. Limitation of the Service Provider’s Liability towards the Trust:
(a) Except in case of gross negligence or wilful misconduct on the part of
the Service Provider or on the part of any person or firm acting on behalf of
the Service Provider in carrying out the services, the Service Provider, with
respect to damage caused by the Service Provider to the Trust property
(Kiosks, technical data, documents and infrastructure of the Trust) shall not
be liable to the Trust:
(i) for any indirect or consequential loss or damage; and
(ii) for any direct loss or damage that exceeds (A) the total payments for
fees made or expected to be made to the Service Provider hereunder, or (B)
the proceeds the Service Provider may be entitled to receive from any
insurance maintained by the Service Provider to cover such a liability,
whichever of (A) or (B) is higher.
(iii) This limitation of liability shall not affect the Service Provider’s
liability, if any, for loss to beneficiaries caused by the Service Provider or
any person or firm acting on behalf of the Service Provider in carrying out
the Services.
b. Statute of Limitations: The parties agree and intend that any action in relation to an alleged breach
of this contract shall be commenced within one year to the date of the
breach, without regard to the date the breach is discovered. Any action not
bought within that one year time period shall be barred. However it is
subjected to the decision of the Court of Forum in the above matter.
35
c. Waiver:
The failure of either party to enforce its rights under this contract at any
time for any period shall not be construed as a waiver of such rights.
d. Liability of Claim/ Suit/ Disciplinary actions:
NWH admits and agrees that if any claim, suit or disciplinary actions by
Empanelment and Disciplinary Committee (EDC) arises due to any
commissions or omissions of their employees including MEDCO, Billing
Head, Data Entry Operator or employees outsourced by them, NWH will
be liable for such claim or suit or Disciplinary action.
e. Cyber Crimes:
In case of any detection of cyber crime or other crimes related to the
scheme and trust and the matters connected thereto then either party shall
bring the notice of the same to the other, conduct an enquiry within seven
days and shall register the complaint in the police station within jurisdiction
and pursue the complaint to punish the culprits.
f. Lodging of Police Complaint:
The service Provider shall not entertain or encourage middlemen, brokers
or imposters for processing empanelment, pre-authorization, claim
settlements and disciplinary matters of the Trust or the matters related to
the Trust. In such an event of undue interference by the vested interests the
NWH shall lodge a complaint with the nearest police station under
intimation to the Trust and follow the same scrupulously. The NWH
understands that the workflow process in the Trust operates through
online and there is no scope for influence from any outside elements.
Further the criminal action can be initiated against the erring hospitals, in
case they resort to cheating, fraud, irregularities and misuse of the scheme.
g. Severability:
If any provision to this contract is invalid, unenforceable or prohibited by law.
This agreement shall be considered divisible as to such provision and such
provision shall be inoperative and the remainder of this agreement shall be
valid, binding and of the like effect as though such provision was not included
herein.
36
.5 None
.6 None
.7 None
.8 None
.9 The Service Providers shall not use these documents for purposes unrelated to
this Contract without the prior permission / intimation of the Trust. i.e.,
Conferences, Workshops, Seminars etc. The judiciary and quasi- judicial
authorities within India are exempted under this clause.
.10 None
.11 As per term 11.15 of Aarogyasri Trust at appendix –A as amended from time to time.
.12 i. Obligations of the NWH as per term 11 of Aarogyasri Trust manual
February- 2013 at appendix –A as amended from time to time.
ii. The list of empanelled specialities is at appendix-B for which the NWH
shall render services cashless under the scheme.
Article 4 Service Provider’s Infrastructure, Equipment, Personnel and
Subcontractors:
.6 The person(s) designated as MEDCO shall act as a representative of NWH for
facilitating cashless treatment to all beneficiaries.
MEDCO duties
a. Submitting and answering queries relating to preauthorization
and claims.
b. Settle the grievances of the patients and communicate with the Trust.
c. The detailed duties and responsibilities of MEDCO shall be specified
in scheme manuals at Trust website.
37
Article 5 Obligations of the Trust:
.1 None
.2 None
.3 None
.4 None
.5 None
.6 Counterpart co-ordinators are the Aarogyamithras, Team Leaders, District
Manager and District Coordinator on behalf of the Trust at district level.
Aarogyamithra shall identify beneficiary, follow preauth, monitor cashless
treatment, escort the patient, resolve grievances and communicate with the
NWH on behalf of the Trust.
District Co-ordinator shall monitor the cashless and quality treatment,
organise health camps, inspect Network Hospital, communicate with NWH
and resolve grievances.
.7 i. The provisions and guidelines in implementation manuals shall be
prospective.
ii. The Trust shall adhere to the time lines and SLAs under this agreement.
iii. The Trust shall accept the diagnosis and line of treatment if the choice
of management is being followed as per the standard medical protocols
and duly supported by online evidences as enlisted in the manual.
iv.
Article 6 Payments to the Service Provider
.1 a. Packages
Package definition: As per term 21 of Aarogyasri Trust manual March, 2013
as amended from time to time.
b. Follow Up Packages: As per term 22 of Aarogyasri Trust manual March,
2013 at Appendix –A as amended from time to time.
.1 b See in Annexure - C
.2 b The prices for Employees Health Scheme as per Annexure-C
38
.3 None
.4 a. Claims: The claim process is subject to term 13 of Trust manual March,
2013 as amended time to time.
b. Enhancement of Packages:
Enhancement of package may be considered in certain cases where hospitals
have to attend to associated diseases not packaged under Aarogyasri in the
same patient, extended surgeries in certain situations and extended stay on
account of unrelated complications. The enhancements will be subject to
guidelines at term 23 of Trust manual March, 2013 at Appendix-A as amended
time to time.
.4d The payments shall be made online to the Current Account bearing Name
no.
IFSC code of Bank
Branch .
Article 7 None
Article 8 Settlement of disputes
.1 None
.2 Procedure of Arbitration
1. If any dispute arises between the parties hereto during the subsistence of
this Agreement or thereafter, in connection with the validity,
interpretation, implementation or alleged breach of any provision of this
Agreement then the understated procedure may be followed:
a) At the first instance the parties shall refer such dispute to their
respective CEO/ COO/ MD/ Superintendent/ Chairman/ CMD for resolution.
b) In the event the above authorities of the respective institutions are
unable to resolve the dispute within 30 days of it being referred to them, then
either party may refer the dispute for resolution a committee of arbitration
consisting of three Arbitrators, one to be appointed by NWH, one is Director of
Medical Education, third is CEO of AHCT as Head.
The Arbitration shall be held in Hyderabad, India and the proceedings shall be
in Telugu.
The Arbitrator(s) shall make a reasoned award (the AWARD). Any award
39
made in any arbitration held pursuant to the settlement of disputes shall be
final and binding on the parties as from the date it is made and the Service
Provider and the Trust agree and undertake to carry out such Award without
delay.
The contract and the rights and obligations of the parties shall remain in full
force and effect, pending the Award in any arbitration proceedings hereunder.
The arbitration award shall be subject to the jurisdiction of A.P high court at
Hyderabad. No matter pertaining to claim rejection repudiation or
disciplinary action shall be brought for arbitration.
Article 9 Disciplinary actions As per term 8 of Aarogyasri Trust manual as amended from time to time
40
Term 11: Service Level Agreements (SLAs):
SNo Service Level Agreements (SLA) Time, Term
1
Registration to OP/IP Conversion
24 Hours from the
conclusion of
diagnosis
2 IP to Preauthorization submission 3 Days
3 Updation of Preauthorization pending cases without
invasive diagnostic procedures
6 Hours
4
Updation of Preauthorization pending cases requiring
invasive diagnostic procedures / Special
investigations
3 Days
5 Online on-bed status updation by MEDCO Daily
6 Clinical notes updation in Case sheet (Physical
/Online)
Daily
7
Preauthorization approval to Surgery/ Procedure
done for emergency approvals
6 Hours
8 Online updation of surgery notes 24 Hours
9
Online updation of discharge documents
(Satisfaction acknowledgement, Transport
acknowledgement, Discharge summary)
1 Hour prior to
Discharge
10 Provision of timely & quality food As prescribed
11 Online Updation by MEDCO after registration of
patient for Follow up service
1 Hour
12 Online updation of Follow-up treatment 24 Hours
13 Payment of transportation charges Along with
Discharge
14 Resolution of complaints Logged into MEDCOs Ac 2 Days
15 Time between Preauthorization and Surgery done 15 days
16
Time between initiation of preauthorization by the
Service Provider as per manual and approval by
Trust
6 Hrs
17 Time between proper updation of preauthorization 6 Hrs
41
queries and approval by the Trust
18
Enhancement approvals (provided submission of all
the necessary documents & updating pending
remarks within 48 Hrs if any)
4 days
19
Claim settlements after submission of all the
necessary documents
7 days
20
`
Response to claim queries raised by Trust
90 days subject to
maximum of 60days
after end of financial
year.
21
Final settlement of Claims after discharge
Within 60 days after
final updation from
the hospital
42
List of Specialties Empanelled
S.NO
Code
Specialities
Hospital
Inspection
EDC
S.NO
Code
Specialities
Hospital
Inspection
EDC
1
S1
General Surgery
17
S17
Prostheses
2
S2
ENT
18
M1
Critical care
3
S3
Opthamology
19
M2
General Medicine
4
S4
Gynacology&Obstetrics
20
M3
Infectious Diseases
5
S5
Orthopaedics
21
M4.1
Paediatric Intensive Care
6
S6
Surgical Gastroenterology
22
M4.2
Neonatal Intensive care
7
S7
Cardio Thorasic surgery
23
M4.3
Paediatric General
8
S8
Pediatric Sugery
24
M5
Cardiology
9
S9
Genito Urinary surgery
25
M6
Nephrology
10
S10
Neuro surgery
26
M7
Neurology
11
S11
Surgical Oncology
27
M8
Pulmonology
12
S12
Medical oncology
28
M9
Dermatalogy
13
S13
Radiation Oncology
29
M10
Rheumatology
14
S14
Plastic Surgery
30
M11
Endocrinology
15
S15
Polytrauma
31
M12
Gastroenterology
16
S16
Cochlear Implantation
43
SNO
ICD
Procedure/
Diagnostic
Code
Applicable
specialityProcedure Name
Package Price For
NON-NABH Semi
Private ward
Package Price
For NON-
NABH Private
ward
Package Price
For NABH Semi
Private ward
Package Price
For NABH
Private ward
1 04.06.1 S1 Excision of Ganglion - large 10270 10570 10570 11070
2 04.06.3 S1 Excision of Ganglion - Small 10600 11200 11200 12200
3 04.92 S1 Ganglion Sclerotherapy 2000 2000 2000 2000
4 05.23.2 S1 Laproscopic-Lumbar Sympathectomy 26200 27400 27400 29400
5 06.2.1 S1 Hemithyroidectomy 26200 27400 27400 29400
6 06.2.2 S1 Laproscopic Hemi Thyroidectomy 28940 29540 29540 30540
7 06.4.1 S1 Total Thyroidectomy 31500 33000 33000 35500
8 06.4.2 S1 Laproscopic Total Thyroidectomy 29410 30010 30010 31010
9 06.6 S1 Excision of Lingual Thyroid 30900 31800 31800 33300
10 06.7 S1 Excision of Thyroglossal Cyst Fistula 30900 31800 31800 33300
11 06.8.1 S1 Parathyroidectomy -Non Malignant 31500 33000 33000 35500
12 06.31.1 S1 Resection Enucleation - Thyroid 26800 28600 28600 31600
13 06.31.2 S1 Subtotal Thyroidectomy 28730 29930 29930 31930
14 06.31.3 S1 Laproscopic Sub total Thyroidectomy 28380 28980 28980 29980
15 06.31.4 S1 Laproscopic Thyroid Nodule Excision 28370 28970 28970 29970
16 06.39.1 S1 Isthmectomy 25500 26700 26700 28700
17 06.39.2 S1 Partial Thyroidectomy 25420 26620 26620 28620
18 06.39.3 S1 Laproscopic Isthmectomy 29270 29870 29870 30870
1907.3.1
S1 Bilateral Adrenalectomy in nonmalignant conditions43000 46000 46000 51000
2007.22.1
S1 Unilateral Adrenelectopmy in nonmalignant conditions37110 39210 39210 42710
2117.33.1
S1
Laproscopic Right Hemi Colectomy in non malignant
conditions40300 40600 40600 41100
22 17.35.3 S1 Laproscopic Left Hemicolectomy 32960 34160 34160 36160
23 25.1.1 S1 Excision of large growth from Tongue 20600 21500 21500 23000
LIST PACKAGES FOR EMPLOYEES HEALTH SCHEME
APPENDIX – CPACKAGES AND PACKAGE PRICES
44
24 25.1.2 S1 Excision of Small growth from Tongue 17370 18270 18270 19770
25 25.2.1 S1 Partial Glossectomy 28450 30250 30250 33250
26 26.4 S1 Parotid Duct Repair 28260 30360 30360 33860
27 26.30.2 S1 Excision of Salivary Gland 23370 25470 25470 28970
28 26.30.3 S1 Removal Of Submandibular Salivary Gland 25690 26290 26290 27290
29 26.31 S1 Superficial Parotoidectomy (Non-malignant) 23360 25460 25460 28960
30 27.42.1 S1 Wedge Excision of Lip 15930 17130 17130 19130
3127.42.2
S1 Wedge Excision of Lip&Vermilionectomy(27.43)19230 20730 20730 23230
32 27.43.2 S1 Vermilionectomy 22380 23580 23580 25580
33 27.54.2 S1 ABBE Operation 21800 23600 23600 26600
34 29.2 S1 Excision of Branchial Cyst 25500 27000 27000 29500
35 29.52.1 S1 Excision of Branchial Sinus 24900 25800 25800 27300
36 38.5 S1 Excision and Ligation of Varicose Veins 25630 27130 27130 29630
37 39.1.1 S1 Splenorenal Anastomosis 71500 73000 73000 75500
38 39.1.2 S1 Warren Shunt for Portal Hypertension 70700 71900 71900 73900
39 39.1.3 S1 Portocaval Anastomosis 81810 83610 83610 86610
40 39.8.1 S1 Excision of Carotid Body Tumours 36330 38730 38730 42730
41 39.92 S1 Hemangioma Scleotherapy 9150 9150 9150 9150
42 40.11 S1 Lymph Node Biopsy 8770 8770 8770 8770
43 40.23 S1 Axillary Lymph Node Dissection 28420 29020 29020 30020
44 40.29.1 S1 Excision of Cystic Hygroma -Extensive 24740 26240 26240 28740
45 40.29.2 S1 Excision of Cystic Hygroma -Major 25500 27000 27000 29500
46 40.29.3 S1 Cystic Hygroma Excision - Minor 10900 11800 11800 13300
47 41.5.2 S1 Splenectomy For Hypersplenism 42100 44200 44200 47700
4841.5.3
S1 Laproscopic Splenectomy - For other Indications55600 56200 56200 57200
49 43.1.1 S1 Gastrostomy 21200 22400 22400 24400
50 43.3.1 S1 Pyloromyotomy 32100 34200 34200 37700
5143.5.1
S1
Partial/Subtotal Gastrectomy with anastomosis to
Esophagus for ulcer231100 232300 232300 234300
52 44.02 S1 Highly Selective Vagotomy 27100 29200 29200 32700
53 44.2 S1 Pyloroplasty & Vagotomy 50100 52200 52200 55700
45
54 44.03 S1 Selective Vagotomy drainage 49200 50400 50400 52400
55 44.4 S1 Operation for bleeding peptic ulcer 48900 49800 49800 51300
5644.4.1
S1
Surgical management For Haemorrhage Of The Small
Intestine49800 51600 51600 54600
57 44.39.2 S1 Gastrojejunostomy & Vagotomy 40900 41800 41800 43300
5844.42
S1 Surgical management of Duodenal perforation50110 52210 52210 55710
5944.42.1
S1
Laproscopic Surgical treatment for Duodenal
Perforation48900 49800 49800 51300
60 44.62 S1 Gastrostomy Closure 23800 25600 25600 28600
6145.3.2
S1 Resection & Anastomosis Of Small Intestine(45.9)50100 52200 52200 55700
62 45.31 S1 Surgical treatment for Duodenal Diverticulum 32100 34200 34200 37700
63 45.33.1 S1 Excision of Meckel's Diverticulum 41500 43000 43000 45500
6445.34.1
S1 Surgical treatment for Acute Intestinal obstrucion50100 52200 52200 55700
65 45.62 S1 Duodenectomy 40160 41660 41660 44160
6645.63
S1 Surgical treatment for Duplication Of Intestines50400 52800 52800 56800
67 45.73 S1,S6 Right Hemi Colectomy 40300 40600 40600 41100
68 45.75 S1,S6 Left Hemi Colectomy 40900 41800 41800 43300
69 45.81 S1 Lap roscopic colectomy (Total Colectomy) 61200 62400 62400 64400
70 45.82 S1 Total Colectomy 62100 64200 64200 67700
71 46.1.1 S1 Colostomy 20910 21810 21810 23310
72 46.2.2 S1 Ileostomy 20900 21800 21800 23300
73 46.03 S1 Loop Colostomy Sigmoid 22100 24200 24200 27700
74 46.23 S1 Illieo Sigmoidostomy 50100 52200 52200 55700
75 46.51.2 S1 Ileostomy Closure 25910 26810 26810 28310
76 46.52.2 S1 Colostomy Closure 25900 26800 26800 28300
7746.62
S1
Surgical treatment For Recurrent Intestinal obstruction
(Noble Plication Other)50100 52200 52200 55700
78 46.64 S1 Cecopexy 31800 33600 33600 36600
46
7946.73
S1 Surgical treatment for Acute Intestinal perforation50100 52200 52200 55700
80 46.74 S1 Excision Small Intestinal Fistula 51500 53000 53000 55500
81 46.80.1 S1,S8 Surgical treatment for Intususception 50100 52200 52200 55700
8246.81
S1
Surgical treatment for Mal-Rotation & Volvulus Of The
Midgut50100 52200 52200 55700
8346.82
S1 Surgical treatment for Volvulus of Large bowel50100 52200 52200 55700
84 47.01 S1,S8 Laproscopic Appendicectomy 22120 23320 23320 25320
85 47.09.1 S1 Open Appendicectomy 18680 19880 19880 21880
8647.09.2
S1 Surgical treatment for Appendicular Perforation27680 29480 29480 32480
8747.19
S1
Laproscopic Surgical treatment for Appendicular Mass-
Abscess30900 31800 31800 33300
88 48.3 S1 Excision of Prolapse of Rectal Mass 27190 28690 28690 31190
89 48.9 S1 Anorectoplasty 28150 30250 30250 33750
90 48.35 S1 Excision of Papilloma Rectum 21160 22660 22660 25160
91 48.49 S1 Pull Through Abdominal Resection 52100 54200 54200 57700
92 48.62.1 S1 Anterior Resection of Rectum 52100 54200 54200 57700
93 48.73 S1 Fistulectomy 15600 16200 16200 17200
9448.75.1
S1,S6,S8 Rectopexy Open with Mesh for Rectal Prolapse41800 43600 43600 46600
9548.75.2
S1,S6,S8 Laproscopic Rectopexy With Mesh for Rectal Prolapse51800 53600 53600 56600
9648.75.3
S1,S6,S8 Rectopexy Open without Mesh for Rectal Prolapse31800 33600 33600 36600
97 48.75.5 S1 Laproscopic Rectopexy With Repair 41200 42400 42400 44400
98 49.01 S1 Drainage of Ischio Rectal Abscess 16510 18010 18010 20510
99 49.3 S1 Fissurectomy 15600 16200 16200 17200
100 49.45 S1 Lord's Procedure for Haemorrhoids 10310 10610 10610 11110
101 49.46.1 S1 Haemorroidectomy 22670 24170 24170 26670
102 49.46.2 S1 Haemorroidectomy+ Fistulectomy(49.12) 27640 30040 30040 34040
103 50.29.1 S1 Excision of liver Abscess 32110 34210 34210 37710
47
104 50.29.2 S1,S8 Surgical treatment For Hydatid cyst of Liver 40300 40600 40600 41100
105 51.02 S1 Cholecystostomy 31770 33870 33870 37370
106 51.7 S1 Repair Of CBD 49510 51010 51010 53510
10751.22.1
S1 Cholecystectomy With CBD Exploration (51.41)41800 43600 43600 46600
10851.22.2
S1
Laproscopic Cholecystectomy With CBD Exploration
(51.41)30600 31200 31200 32200
109 51.22.3 S1,S6 Cholecystectomy 25300 25600 25600 26100
110 51.22.4 S1,S6,S8 Laproscopic Cholecystectomy 30300 30600 30600 31100
11151.22.5
S1 Laproscopic Cholecystectomy With Gargrene30600 31200 31200 32200
112 51.22.6 S1 Laproscopic Cholecystectomy For Calculus 30600 31200 31200 32200
11351.22.7
S1 Laproscopic Cholecystectomy With CBD Repair40600 41200 41200 42200
114 52.4.2 S1,S6 Pancreaticocystojejunostomy 51800 53600 53600 56600
115 52.4.4 S1,S6 Pancreaticocystogastrostomy 43430 44930 44930 47430
11653.01
S1 Herinoplasty without Mesh for Direct Inguinal Hernia20900 21800 21800 23300
11753.03
S1 Herinoplasty with Mesh Direct Inguinal Hernia25900 26800 26800 28300
11853.04
S1
Laproscopic Surgical treatment for Unilateral Femoral
Hernia With Mesh30600 31200 31200 32200
11953.9.1
S1 Rare Hernias repair (Spigalion,Obuturator,Sciatic)21500 23000 23000 25500
12053.29.1
S1
Laproscopic Surgical treatment for Unilateral Femoral
Hernia Without Mesh40610 41210 41210 42210
121 53.29.2 S1 Unilateral Femoral Hernia repair 26500 28000 28000 30500
122 53.41 S1 Umbilical Hernia repair with Mesh 31510 33010 33010 35510
12353.42.1
S1
Laproscopic Surgical treatment for - Umbilical Hernia
With Mesh50600 51200 51200 52200
124 53.49.1 S1 Umbilical Hernia repair without Mesh 26510 28010 28010 30510
12553.51.1
S1
Laproscopic Surgical treatment for Incisional Hernia
without Mesh30600 31200 31200 32200
48
126 53.59.1 S1 Epigastric Hernia repair without Mesh 26510 28010 28010 30510
12753.59.2
S1 Ventral And Scar Hernia repair without Mesh31500 33000 33000 35500
12853.62
S1
Laproscopic Surgical treatment for Incisional Hernia
with Mesh40600 41200 41200 42200
12953.63
S1
Laproscopic Surgical treatment for Epigastric Hernia
repair with Mesh50600 51200 51200 52200
130 53.69.1 S1 Epigastric Hernia repair with Mesh 41510 43010 43010 45510
131 53.69.2 S1 Ventral And Scar Hernia repair with Mesh 41510 43010 43010 45510
13253.71.1
S1
Laproscopic Surgical treatment for Hiatus Hernia With
Mesh50600 51200 51200 52200
133 53.72 S1 Hiatus Hernia Repair - Abdominal 49720 51520 51520 54520
134 54.0.1 S1 Drainage of Perigastric Abscess 37230 39330 39330 42830
135 54.0.2 S1 Drainage of Subdiaphragmatic Abscess 31670 34070 34070 38070
136 54.0.3 S1 Open Drainage of Pelvic Abscess 151480 154180 154180 158680
13754.0.4
S1
Laproscopic Surgical treatment for Intra Abdominal
Abscess35600 36200 36200 37200
138 54.3.4 S1 Excision of Umbillical Sinus 18210 19710 19710 22210
139 54.4.1 S1 Excision of Mesenteric Cyst 33660 36060 36060 40060
14054.7.2
S1 Surgical treatment for Minor Abdominal Injuries21490 22690 22690 24690
14154.7.3
S1 Surgical treatment for Major Abdominal Injuries52100 54200 54200 57700
142 54.7.4 S1 Surgical treatment for Burst Abdomen 51500 53000 53000 55500
14354.99.1
S1 Treatment with Self Expanding Metalic Stent (SEMS)21020 21620 21620 22620
144 61.2.1 S1 Surgical treatment for Unilateral Hydrocoele 18420 19920 19920 22420
145 61.2.2 S1 Surgical treatment for Bilateral Hydrocoele 20150 21650 21650 24150
146 61.3.2 S1 Surgical treatment for Fourniers Gangrene 34190 38390 38390 45390
147 61.3.3 S1 Surgical treatment for Filarial Scrotum 27100 29200 29200 32700
148 61.3.4 S1 Excision of multiple Scrotal swellings 9130 9430 9430 9930
149 61.92 S1 Evacuation of Scrotal Hematoma 20660 22760 22760 26260
150 61.99 S1 Excision of multiple Scrotal Cysts 8550 8850 8850 9350
49
151 62.3.1 S1,S9 Orchidectomy -Unilateral 23500 25000 25000 27500
152 62.3.4 S1 Orchidectomy + Herniorraphy(53.00) 31510 33010 33010 35510
153 62.5.1 S1 Orchidopexy with Eversion of Sac 27100 29200 29200 32700
154 63.1.4 S1 Laproscopic Excision of Varicocele Cyst 41200 42400 42400 44400
155 63.2 S1 Excision of Epididymal Cyst 16200 17400 17400 19400
156 63.4 S1 Epididectomy 15900 16800 16800 18300
157 64.0 S1 Circumcision 8510 8810 8810 9310
158 64.91 S1 Dorsal Slit and Reduction of Paraphimosis 9440 10040 10040 11040
15970.73.2
S1,S4,S6 Rectovaginal fistula Management without Colostomy40900 43000 43000 46500
160 76.31.1 S1 Hemimandibulectomy 45780 48780 48780 53780
161 76.31.4 S1,S11 Segmental Mandible Excision 37140 39540 39540 43540
162 77.5 S1 Surgical treatment for Infected Bunion Foot 4800 5100 5100 5600
163 77.91 S1 Excision of Cervical Rib 28380 29880 29880 32380
164 83.95.1 S1 Drainage of Psoas Abscess 19470 21570 21570 25070
165 85.21.1 S1 Excision of Mammary Fistula 16140 18240 18240 21740
166 85.21.2 S1 Wide Excision of Mammary Fistula 14020 15220 15220 17220
167 85.21.3 S1 Excision of Bilateral Fibroadenoma 15600 16200 16200 17200
168 85.21.4 S1 Excision of Unilateral Fibroadenoma 10300 10600 10600 11100
169 85.21.5 S1 Unilateral Lumpectomy 10600 11200 11200 12200
170 85.21.6 S1 Bilateral Lumpectomy 15900 16800 16800 18300
171 85.21.7 S1 Breast Conservation Surgery 16200 17400 17400 19400
172 85.22.2 S1 Segmental Resection of Breast 15770 16670 16670 18170
173 85.41.1 S1 Simple Mastectomy (Non Malignant) 32100 34200 34200 37700
174 85.44 S1 Surgical repair of bilateral Gynaecomastia 12700 13600 13600 15100
175 85.91 S1 I & D of Breast Abscess 9240 9540 9540 10040
176 86.01.1 S1 Drainage of large Abscess 20130 21930 21930 24930
177 86.01.2 S1 Paronychia Drainage 6820 6820 6820 6820
178 86.3.3 S1 Excision of swelling Neck 11440 11740 11740 12240
179 86.3.5 S1 Excision of Granuloma 10510 11110 11110 12110
180 86.3.6 S1 Surgical treatment for Carbuncle back 30490 34690 34690 41690
181 86.3.7 S1 Excision of Sebaceous Cyst 9270 9570 9570 10070
182 86.3.8 S1 Excision of Keloid 28000 30700 30700 35200
50
183 86.3.9 S1 Excision of Pyogenic Granuloma 8310 8910 8910 9910
184 86.3.12 S1 Excision of Large Corn 5720 6020 6020 6520
185 86.3.16 S1 Excision of Large Swelling in Hand 15720 16020 16020 16520
186 86.3.17 S1 Excision of Small Swelling in Hand 11080 11380 11380 11880
187 86.3.18 S1 Excision of Fibro Lipoma 9260 9560 9560 10060
188 86.3.19 S1 Excision of Fibroma 9180 9180 9180 9180
189 86.3.20 S1 Excision of Sinus 18050 19250 19250 21250
190 86.3.21 S1 Excision of Large Dermoid Cyst 11290 12190 12190 13690
191 86.3.22 S1 Excision of Small Dermoid Cyst 7230 7530 7530 8030
192 86.4.4 S1 Wide Local Excision (Non - malignant) 36550 38650 38650 42150
193 86.05 S1 Foreign Body Removal in Deep Region 30720 32820 32820 36320
194 86.6 S1 Skin Grafting 18430 20530 20530 24030
195 86.21.1 S1 Excision of Pilonidal Sinus 19250 21350 21350 24850
196 86.23 S1 Surgical treatment for Ingrowing Nail 6960 7260 7260 7760
197 86.89.1 S1 Surgical treatment for Cut Throat Injury 35380 37480 37480 40980
198 04.42.2 S2 Facial Nerve Decompression 20610 21210 21210 22210
199 09.53 S2 Endoscopic Surgery for Dacrocystitis 10510 11110 11110 12110
200 18.21.1 S2 Surgical treatment for Preauricular sinus 18560 18560 18560 18560
201 18.29 S2 Cryosurgery 11270 11570 11570 12070
20218.39
S2 Partial amputation of Pinna (malignancy perichondritis)19540 21640 21640 25140
203 19.4.1 S2 Myringoplasty 16600 18100 18100 20600
204 19.4.2 S2 Myringoplasty with ossiculoplasty (19.3) 17310 17610 17610 18110
205 19.5 S2 Tympanoplasty 17410 18310 18310 19810
206 19.11 S2 Stapedectomy - Veingraft 18910 19810 19810 21310
207 20.01.1 S2 Myringotomy with grommet for one ear 10310 10610 10610 11110
208 20.01.2 S2 Myrinogotomy with-grommet for both ears 15610 16210 16210 17210
209 20.4 S2 Mastoidectomy 18610 20710 20710 24210
210 20.51 S2 Aural polypectomy 17410 18310 18310 19810
211 20.79.1 S2 Labyrinthectomy 20010 20010 20010 20010
212 21.1 S2 lateral Rhinotomy 15610 16210 16210 17210
213 21.3 S2 Excision of Benign tumours of Nose 17410 19810 19810 23810
214 21.32 S2 Surgery for Angiofibroma 42110 44210 44210 47710
51
215 21.84 S2 Septo rhinoplasty 19110 19710 19710 20710
216 21.88 S2 Youngs operation 14610 15210 15210 16210
217 21.99 S2 Surgical treatment for Choanal atresia 15010 15010 15010 15010
218 22.5 S2 Endoscopic Sinus Surgery 18300 20100 20100 23100
219 22.39 S2,S18 Caldwell-luc(unilateral) 18200 19400 19400 21400
220 22.71 S2 Surgical treatment for Oro antral fistula 15000 15000 15000 15000
221 25.93 S2,S8,S14 Surgical treatment for release of tongue tie 10010 10010 10010 10010
222 26.2 S2 Excision of Benign Parotid gland tumor 20610 21210 21210 22210
223 27.0 S2 Drainage Parapharyngeal abscess 10310 10610 10610 11110
224 27.7 S2 Uvulo ¿ Palato - Pharyngoplasty 26200 27400 27400 29400
22527.49.1
S2 Surgical treatment for Pararetro pharyngeal abscess10010 10010 10010 10010
226 28.3 S2 Adeno tonsillectomy 12010 12010 12010 12010
227 28.6.1 S2 Adenoidectomy Gromet insertion 12110 14210 14210 17710
228 29.39.1 S2 Exision of Tumors In Pharynx 20910 21810 21810 23310
229 29.39.2 S2 Exision of Parapharyngeal Tumour 21510 23010 23010 25510
230 30.3 S2 Laryngectomy in nonmalignant conditions 43000 46000 46000 51000
231 30.22 S2 Phono Surgery For Vocal Cord Paralysis 27410 29810 29810 33810
232 31.62 S2 Laryngo Fissurectomy 27340 29740 29740 33740
233 31.98.1 S2 Microlaryngeal Surgery 19450 20650 20650 22650
23431.98.2
S2 Surgical treatment for Laryngotracheal stenosis20910 21810 21810 23310
235 76.5.1 S2 Bilateral Styloidectomy 15910 16810 16810 18310
236 76.45 S2 Temporal Bone Excision 52110 54210 54210 57710
237 76.79 S2 Exision of Maxilla 39500 42500 42500 47500
238 96.52 S2 Removal of Impacted Ear wax 9710 10310 10310 11310
239 96.53.1 S2 Rhinorrhoea- repair 25610 26210 26210 27210
240 96.53.2 S2 CSF rhinorrhoea - Endoscopic repair 25610 26210 26210 27210
24198.02
S2 Bronchoscopy Foreign Body Removal from Oesophagus10600 11200 11200 12200
242 98.11 S2 Removal of foreign body in Ear 10600 11200 11200 12200
24398.15.2
S2 Bronchoscopy Foreign Body Removal from Bronchous24610 25210 25210 26210
52
24404.42.1
S3,S10 Decompression/Excision Of Optic Nerve Lesions78890 79790 79790 81290
245 08.0 S3 Surgical treatment for Ankyloblepharon 14370 14670 14670 15170
246 08.01 S3 Drainage of Lid Abscess 9760 10660 10660 12160
247 08.2.1 S3 Surgical treatment for disorders of Eyelid 11030 12530 12530 15030
248 08.2.2 S3 Exision of Small tumour of lid 10740 11640 11640 13140
249 08.3 S3 Surgical correction of Ptosis 30600 31200 31200 32200
250 08.4.1 S3 Ectropion correction 17710 20410 20410 24910
251 08.4.2 S3 Entropion correction 15300 15600 15600 16100
252 08.7 S3 Lid Reconstruction surgery 10350 10650 10650 11150
253 08.38 S3 Lagophthalmos correction 13220 13220 13220 13220
254 08.59 S3 Epicanthus repair 7110 7410 7410 7910
255 09.4 S3 Surgery for Congenital dacrocystitis 10760 11660 11660 13160
256 09.21 S3 Dacrocystectomy 8140 8440 8440 8940
257 09.43 S3 Congenital NLD probing 11020 11920 11920 13420
258 09.81 S3 External Dacryocysto rhinostomy 14960 15860 15860 17360
25909.82
S3 Canaliculo/conjuctivo Dacryocysto rhinostomy13430 14030 14030 15030
260 10.6 S3 Fornix forming sutures 11590 12490 12490 13990
261 10.41 S3 Surgical treatment for Symblepharon 4750 5050 5050 5550
262 11.6 S3 Corneal Patch Graft 17720 18020 18020 18520
263 11.31 S3 Pterygium repair 7600 7900 7900 8400
264 11.32 S3 Pterigium + conjunctival autograft 12080 12380 12380 12880
265 11.59.1 S3 Double Z-Plasty 4310 4610 4610 5110
266 11.61 S3 Lamellar Keratoplasty 22790 23090 23090 23590
267 11.63 S3 Penetrating Keratoplasty 18650 19550 19550 21050
268 11.64 S3 Therapeutic Penetrating Keratoplasty 19800 20100 20100 20600
269 11.69 S3 Amniotic Membrane Graft for Cornea 11900 12800 12800 14300
270 12.0 S3 Intraocular foreign body removal 33740 34940 34940 36940
271 12.1 S3 Iridectomy-Iridotomy 7900 8800 8800 10300
27212.4
S3
Surgical treatment for Other disorders of iris and ciliary
body7300 7600 7600 8100
273 12.13 S3 Surgical treatment for Iris prolapse 7300 7600 7600 8100
53
274 12.41 S3 Exision of tumours of iris 21340 21640 21640 22140
275 12.54.1 S3 Glaucoma Surgery 9080 9980 9980 11480
276 12.72 S3 Cyclocryotherapy 12690 13290 13290 14290
27712.79
S3 Glaucoma Filtering Surgery For Paediatric Glaucoma10200 11100 11100 12600
278 12.81.1 S3 Surgical treatment for Scleral wound 11340 12240 12240 13740
27912.81.2
S3 Surgical treatment for Perforating scleral injury23360 25460 25460 28960
280 12.87.1 S3 Scleral Patch Graft 21540 23940 23940 27940
281 12.87.2 S3 Amniotic Membrane Graft for Sclera 18240 20340 20340 23840
282 12.89 S3 Removal of blood clot 7500 7800 7800 8300
283 12.99 S3 Anterior chamber reconstruction 8590 9490 9490 10990
284 13.7 S3 Bandage contact lens with glue application 7090 7990 7990 9490
285 13.41 S3 Cataract surgery phacoemulsification 20000 20000 20000 20000
286 13.42 S3 Lensectomy 12820 13720 13720 15220
287 13.64.1 S3 Posterior capsulotomy/polishing 11690 12590 12590 14090
288 13.64.2 S3 Yag laser capsulotomy 8200 9100 9100 10600
289 13.71.1 S3 Cataract surgery phacoemulsification +IOL 22450 22750 22750 23250
290 13.71.2 S3 Cataract surgery SICS + IOL(ECCE+IOL) 15300 15600 15600 16100
29113.71.3
S3 Paediatric Cataract Surgery (Phacoemulsification IOL)19150 20950 20950 23950
29213.72
S3
Secondary IOL-scleral fixation-sulcus fixation of lens
ACIOL22600 23200 23200 24200
29314.4
S3 Scleral buckle procedure for Retinal detachment30500 32900 32900 36900
294 14.25.1 S3 Photocoagulation for Retinopathy 2010 2010 2010 2010
29514.25.2
S3 Photocoagulation For Retinopathy Of Prematurity10330 10930 10930 11930
296 14.52.1 S3 Cryoretinopexy - closed 13150 14050 14050 15550
297 14.52.2 S3 Cryoretinopexy - open 11890 12190 12190 12690
298 14.72 S3 Vitrectomy - Membrane Peeling- Endolaser 21390 22590 22590 24590
299 14.74.1 S3 Vitrectomy 24230 25430 25430 27430
300 14.74.2 S3 Vitrectomy Plus Silicon Oil Or Gas (14.75) 24830 26330 26330 28830
54
301
14.74.3
S3
Vitrectomy -Membrane peeling - Endolaser _Silicon oil
or Gas - with or without belt bulking
32410 34810 34810 38810
30214.75
S3
Monthly Intravitreal Anti-Vegf For Macular
Degeneration - Per Injection (Maximum - 6)16390 18490 18490 21990
30314.79
S3 Removal Of Silicon Oil Or Gas post Vitrectomy10630 11530 11530 13030
304 15.2.1 S3 Rectus Muscle Surgery(Single) 8530 9130 9130 10130
305 15.2.2 S3 Oblique muscle surgery 8330 8930 8930 9930
306 15.4 S3 Rectus Muscle Surgery(Twohree) 11290 11890 11890 12890
307 16.0 S3 Orbitotomy 27400 27700 27700 28200
30816.3
S3 Evisceration /Enucleation with Orbital implant16110 16710 16710 17710
309 16.5 S3 Exenteration of Orbit 13480 14980 14980 17480
310 16.63 S3 Dermis Fat Graft 24090 25290 25290 27290
311 16.64 S3 Socket Reconstruction 26720 27920 27920 29920
312 16.81 S3 Endoscopic orbital decompression 9050 9050 9050 9050
31316.92
S3 Excision of Benign neoplasm of Eye and Adnexa10020 10320 10320 10820
314 16.99 S3,S10 Surgical Management of Proptosis 60900 61800 61800 63300
315 86.3.11 S3 Dermoid cyst excision 14520 14820 14820 15320
316 38.86 S4 PPH-Conservative Surgical management 33100 35200 35200 38700
317 54.03 S4 Surgical management of pelvic abscess 28260 30360 30360 33860
318 54.51 S4,S6 Laparoscopic Adhesiolysis 31800 33600 33600 36600
319 59.4.3 S4 Purandares Sling operations - Open 26060 26660 26660 27660
320 59.4.4 S4 Laparoscopic Sling Operations 33100 33700 33700 34700
321 65.21 S4 Surgical Management of Ovarian Tumours 33270 34770 34770 37270
322 65.22 S4 Ovarian cystectomy 33270 34770 34770 37270
323 65.23 S4 Laparoscopic Cystectomy 25520 26120 26120 27120
324 65.49 S4 Surgical Management of Tubal Ovarian mass 30010 30610 30610 31610
325 66.62 S4 Laparoscopic Ectopic Resection 22740 23340 23340 24340
326 66.73 S4 Laparoscopic Recanalisation 33630 34530 34530 36030
327 67.5 S4 Encirclage 11290 12190 12190 13690
55
328 67.33 S4 Cryo Surgery 3090 3090 3090 3090
329 67.61 S4 Surgical Management of Cervical Tears 11600 12200 12200 13200
330 68.4 S4 Hysterectomy - abdominal 25420 26920 26920 29420
331 68.5.1 S4 Vaginal Hysterectomy 26200 27400 27400 29400
33268.5.2
S4 Vaginal Hysterectomy With Pelvic Floor Repair(70.79)31800 33600 33600 36600
333 68.21 S4 Hysteroscopic septal resection 17490 17490 17490 17490
334 68.23 S4 Ablation of Endometrium 11280 11580 11580 12080
335 68.29.1 S4 Laparoscopic Myomectomy 30600 31200 31200 32200
336 68.29.2 S4 Hysteroscopic submucus fibroid resection 15300 15600 15600 16100
337 68.29.3 S4 Myomectomy 27620 29420 29420 32420
338 68.29.4 S4 Polypectomy 13080 13980 13980 15480
339 68.51 S4 Laproscopic Vaginal Hysterectomy 30600 31200 31200 32200
340 69.0 S4 D&C (Dilatation & Curettage) 6300 6600 6600 7100
34169.1
S4
Surgical Management of Endometriosis - Excision of
Chocolate Cyst23600 24200 24200 25200
34269.02.1
S4 Incomplete Abortion + inevitable abortion Management9150 9450 9450 9950
343 69.02.2 S4 Surgical Management of Missed abortion 9930 10230 10230 10730
344 69.02.3 S4 Surgical Management of Septic Abortion 11400 12600 12600 14600
34569.09
S4
Surgical Management of Vesicular moles (Benign GTD)
D & C14900 15800 15800 17300
34669.22
S4 Manchesters Operation + Cervical amputation(67.4)25610 26210 26210 27210
347 69.92 S4 Intra Uterine Insemination 10000 10000 10000 10000
34870.5
S4 Repair of Cystocele ,Rectocele &Perineorraphy(71.71)20900 21800 21800 23300
34970.31
S4 Haemato Colpo Surgical management or Hymenectomy15600 16200 16200 17200
350 70.51 S4 Surgical Management of Cystocoele - Repair 14820 15420 15420 16420
351 70.61 S4 Mc Indoe's operation For Vaginal Atresia 42020 45020 45020 50020
352 70.71 S4 Surgical Management of Vaginal Tear 13600 14200 14200 15200
353 70.77.1 S4 Abdominal Repair for Vault Prolapse 36200 37400 37400 39400
56
35470.77.2
S4 Laproscopic Sacrospinocolpopexy for vault prolapse45900 46800 46800 48300
35570.78
S4 Abdominal Repair With Mesh for Vault Prolapse41200 42400 42400 44400
356 71.6 S4 Vulvectomy for tumors 22700 24200 24200 26700
357 71.8 S4 Surgical Treatment for Vulval Heamatoma 14100 14700 14700 15700
35871.23
S4
Surgery for Bartholin cyst(Marsupilasation,cyst
removal)10300 10600 10600 11100
359 72.0 S4 Instrumental Vaginal Delivery 15540 16440 16440 17940
360 73.59.1 S4 Normal Vaginal Delivery 15160 15760 15760 16760
36173.59.2
S4 Normal Vaginal Delivery with Epidural Anesthesia20600 21200 21200 22200
36273.59.3
S4
Normal Vaginal Delivery In Rh-Negative Mother With
Rh-Positive Baby18600 19200 19200 20200
36373.59.4
S4 Normal Vaginal Delivery in Twins(Multiple pregnency)16410 17010 17010 18010
364 73.59.5 S4 Normal Vaginal Delivery HIV +ve Mother 22100 24200 24200 27700
365 74.1.1 S4 Caesarean Section 15610 16510 16510 18010
36674.1.2
S4
Caesarean Section In Rh-Negative Mother With Rh-
Positive Baby17400 18600 18600 20600
36774.1.3
S4 Caesarean Section in Twins(Multiple pregnency)17400 18900 18900 21400
368 74.1.4 S4 Cesarean Section in HIV+ve Mother 21200 22400 22400 24400
369 74.3 S4 Surgical Management of Ectopic pregnancy 21820 22420 22420 23420
37074.91
S4 Caesarean Hysterectomy with Bladder Repair49190 51590 51590 55590
371 74.99.1 S4 Surgery for Rupture Uterus with Tubectomy 33700 34900 34900 36900
37274.99.2
S4
Surgical Management of Abruptio-Placenta with
Coagulation Defects(Dic)27730 28630 28630 30130
373
74.99.3
S4
Obstetric Hysterectomy (Atonic PPH,Traumatic PPH ,
Rupture-Rupture Uterus,Abnormal Placentation)
32300 34400 34400 37900
374 75.0.1 S4 First Trimester Medically Induced Abortion 4350 4650 4650 5150
57
37575.0.2
S4 Termination of pregnancies for foetal anamolies + IUD9200 10100 10100 11600
376 75.4 S4 Retained Placenta with Manual Removal 30910 32410 32410 34910
377 75.69 S4 Complete perineal tear repair 19410 20610 20610 22610
37893.9.1
S4
Management of Eclampsia with Complications
Requiring Ventilatory Support41200 42400 42400 44400
37996.49
S4 LNG-IUS (Levonorgestrene Intautrine system)14000 14000 14000 14000
380 97.71.1 S4 Intra abdominal IUCD retrival - Open 21200 22400 22400 24400
381 97.71.2 S4 Intra abdominal IUCD retrival - Lap 25600 26200 26200 27200
382 98.16 S4 Hysteroscopic FB removal 10570 10570 10570 10570
383 99.0.1 S4 Medical Management of PPH 11370 12270 12270 13770
38499.0.2
S4
Medical Management of Haemorragic shock in
pregnancy37900 38800 38800 40300
385 D25 S4 Medical Management of Fibroids 8880 10080 10080 12080
386E28.2
S4 Medical Management of Polycystic Ovarian Syndrome11630 11930 11930 12430
387N73.9
S4 Medical Management of Pelvic Inflammatory Disease8890 10090 10090 12090
388 N80 S4 Medical Management of Endometriosis 8000 8900 8900 10400
389 N93.8 S4 Medical Management of DUB 11230 12430 12430 14430
390O10.1
S4 Heart disease complicating pregnancy Management22100 24200 24200 27700
391 O14.1 S4 Pre- eclampsia / PIH Management 42370 44470 44470 47970
392O14.2
S4 HELLP Syndrome Management in pregnancy22100 24200 24200 27700
393O15.0
S4 Eclampsia Management without ventilator support32400 34800 34800 38800
394 O21 S4 Hyperemisis Gravidarum Management 9170 10070 10070 11570
395O24
S4 Diabetes complicating pregnancy Management22100 24200 24200 27700
396 O26.6 S4 Hepatic Disorder Management in pregnancy 22100 24200 24200 27700
58
397O28.0.A
S4 Moderate Anaemia Management in pregnancy12280 14380 14380 17880
398 O28.0.B S4 Severe Anemia Management in pregnancy 25860 26460 26460 27460
399O36.8
S4 Intra Uterine Growth Retardation Management23000 26000 26000 31000
400 O40 S4 Acute Poly Hydramnios Management 21500 23000 23000 25500
401 O44 S4 Placenta Previa-type III to IV Management 21200 22400 22400 24400
402 04.0 S5 Surgery for Brachial Plexus & Cervical Rib 46270 47770 47770 50270
403 04.3.1 S5 Neurolysis / Nerve Suture 26510 28010 28010 30510
404 04.04 S5 Obturatorneurectomy 20620 21220 21220 22220
405 04.5.1 S5 Nerve Repair With Grafting 43140 44640 44640 47140
406 77.00.1 S5 Sequestrectomy&Saucerizations 40710 43410 43410 47910
407 77.00.2 S5 Sequestrectomy& bone grafting 40880 42680 42680 45680
408 77.1 S5 Excision of Accessory bone 21500 23000 23000 25500
40977.8
S5
Bone tumor surgery reconstruction with internal
fixation(78.59)50430 52830 52830 56830
41077.20.1
S5 Long bone osteotomy with POP application & k-wires31810 33610 33610 36610
411 77.20.2 S5 Long bone osteotomy with internal fixation 31510 33010 33010 35510
412 77.31 S5 Costo Transversectomy(77.39) 41640 43140 43140 45640
413 77.35 S5 Corrective osteotomy Acetabulum 42410 44810 44810 48810
414 77.37 S5 High tibial osteotomy 33410 35810 35810 39810
415 77.39 S5 Anterolateral Clearance For Tuberculosis 61510 63010 63010 65510
41677.60.4
S5
Excision of deep Bone Tumours and Re-Construction
With Conventional Prosthesis52750 55750 55750 60750
417 77.60.5 S5 Bone tumor curettage and bone graft(78.00) 31510 33010 33010 35510
418 77.60.6 S5 Bone tumor curettage 25330 26230 26230 27730
419 77.60.7 S5 Bone curettage and bone cement(84.56) 31510 33010 33010 35510
42077.60.8
S5 Surgical Management of Exostosis of small joints24430 25930 25930 28430
42177.60.9
S5 Surgical Management of Exostosis of long bones28910 29810 29810 31310
422 77.60.10 S5 Excision of Fracture fragment 87010 88510 88510 91010
59
423 77.61 S5 Excision of Scaphoid 23910 24810 24810 26310
424 77.63.1 S5 Excision of Radial head 24510 26010 26010 28510
425 77.63.2 S5 Excision of Lower end Ulna 24510 26010 26010 28510
42677.64
S5 Excision Or Other Operations For Scaphoid Fractures16510 18010 18010 20510
42777.89
S5 Spinal Ostectomy And Internal Fixations(78.59)49430 51230 51230 54230
428 77.96 S5 Excision of Patella 17230 18130 18130 19630
429 78.00.1 S5 Bone Grafting As Exclusive Procedure 20910 21810 21810 23310
430 78.00.2 S5 Phemister grafting 27510 29010 29010 31510
431 78.3 S5 Limb lengthening 43050 45150 45150 48650
432 78.10.1 S5 Neglected CTEV. Jess Fixator 37810 39610 39610 42610
433 78.10.2 S5 Tension band wirings 26210 27410 27410 29410
43478.15
S5
Cancecllous screw/pins fixations for fracture neck of
Femur37100 39200 39200 42700
435 78.41.1 S5 Clavicle surgery 25910 26810 26810 28310
43678.42
S5
Internal fixation lateral epicondyle for non union
Humerus27970 29470 29470 31970
437 78.43 S5 Reconstruction around Radial head 33800 35600 35600 38600
438 78.60.1 S5 Removal of implants plates and nail 16200 17400 17400 19400
439 78.60.2 S5 Removal of implants wires and screws 15610 16210 16210 17210
44078.95
S5
Surgery for Avascular Necrosis Of Femoral Head (Core
Decompression)30800 32300 32300 34800
44179.0.1
S5
Reduction Of Compound Fractures & External
Fixation(78.10)26500 28000 28000 30500
44279.0.2
S5
Closed reduction with percutaneous k-wire
fixation(78.10)16310 16610 16610 17110
44379.0.3
S5
Closed reduction with percutaneous screw
fixation(78.10)17610 18210 18210 19210
44479.3
S5 Open reduction & Internal Fixation Of Fingers & Toes16390 17290 17290 18790
445 79.8 S5 Open reduction of Deep dislocations 32410 34810 34810 38810
446 79.71 S5 Closed reduction of Shoulder dislocation 8100 8400 8400 8900
60
447 79.72 S5 Closed reduction of Elbow dislocation 8400 9000 9000 10000
448 79.73 S5 Closed reduction of Wrist dislocation 8100 8400 8400 8900
44979.74
S5 Closed reduction of fingers small joint dislocation8100 8400 8400 8900
450 79.75 S5 Closed reduction of Hip dislocation 8100 8400 8400 8900
451 79.76 S5 Closed reduction of Knee dislocation 8400 9000 9000 10000
452 79.77 S5 Closed reduction of Ankle dislocation 8400 9000 9000 10000
45379.81.1
S5 Acromioclavicular joint dislocation open reconstruction26680 27580 27580 29080
454 80.1 S5 Arthrotomy and joint lavage 37110 39210 39210 42710
455 80.2 S5 Diagnostic Arthroscopy 24910 25810 25810 27310
456 80.6 S5 Arthroscopy . Operative Meniscectomy 25910 26810 26810 28310
457 80.21 S5 Subacromial decompression 31500 33000 33000 35500
458 80.42 S5 Release of Stiff Elbow 27940 29440 29440 31940
459 80.70.1 S5 Synovectomy 37110 39210 39210 42710
46080.70.2
S5 Surgical management Dequerenstenosynovities6510 6510 6510 6510
46181.00.1
S5 Mossmiami instrumentation for vertebral fractures51880 54880 54880 59880
462 81.1.1 S5 Arthrodesis of foot Small joints 15300 15600 15600 16100
463 81.1.2 S5 Congenital ankle deformity correction 54210 58410 58410 65410
464 81.2.1 S5 Arthrodesis of major joints 30310 30610 30610 31110
46581.04
S5 Scoliosis and kyphosis correction(81.05+33.4)97110 99210 99210 102710
466 81.4 S5 Flexion construction of hip release 41510 43010 43010 45510
467 81.7 S5 Excision arthroplasty(81.8) 31500 33000 33000 35500
468 81.8.2 S5 Shoulder replacement 41200 42400 42400 44400
469 81.11 S5 Ankle arthrodesis 37100 39200 39200 42700
470 81.12 S5 Triple arthrodesis 36800 38600 38600 41600
471 81.18 S5 Subtalar arthrodesis 37410 39810 39810 43810
472 81.21 S5 Arthrodesis of Hip 37100 39200 39200 42700
473 81.22 S5 Arthrodesis of Knee 36800 38600 38600 41600
474 81.23 S5 Arthrodesis of Shoulder 37400 39800 39800 43800
61
475 81.24 S5 Arthrodesis of Elbow 36810 38610 38610 41610
476 81.26 S5 Arthrodesis of hand Small joint(81.27/81.28) 15600 16200 16200 17200
477 81.27 S5 Arthrodesis of Wrist 36800 38600 38600 41600
478 81.43 S5 Release of Stiff knee 36810 38610 38610 41610
479 81.45.1 S5 Anterior cruciate ligamentl reconstruction 26510 28010 28010 30510
480 81.45.2 S5 Posterior cruciate ligament reconstruction 26510 28010 28010 30510
481 81.51.1 S5 Total hip replacement cemented 79510 81010 81010 83510
482 81.51.2 S5 Total hip replacement uncemented 101200 102400 102400 104400
48381.52.1
S5 Bipolar hemiarthroplastyof Hip without cement40400 42800 42800 46800
484 81.52.2 S5 Hemiarthroplasty of Hip uncemented 36200 37400 37400 39400
485 81.52.3 S5 Bipolar hemiarthroplasty of Hip with cement 44400 46800 46800 50800
486 81.52.4 S5 Hemiarthroplasty of Hip cemented 36810 38610 38610 41610
487 81.54 S5 Total knee replacement 106800 108600 108600 111600
48881.82
S5
Reconstruction procedure for recurrent dislocation
shoulder31210 32410 32410 34410
489 81.83 S5 Arthroplasty of Shoulder 42400 44800 44800 48800
490 81.84 S5 Elbow replacement 41500 43000 43000 45500
491 81.96 S5 Joint reconstruction/intraarticular fractures 36800 38600 38600 41600
492 82.11 S5 Trigger Finger release 6510 6510 6510 6510
493 82.35 S5,S14 Dupuytrens contracture release 21200 22400 22400 24400
494 82.56.2 S5 Tendon transfer procedure for claw hand 33810 35610 35610 38610
495 82.99.2 S5 Maxpage release for Volkmann 31510 33010 33010 35510
496 83.3.2 S5 Synovial cyst excision/ganglion/Bakers Cyst 20100 20400 20400 20900
497 83.5 S5 Excision of Retrocalcaneal bursa 15910 16810 16810 18310
498 83.12 S5 Adductor release 15900 16800 16800 18300
499 83.13 S5 Tenotomy 16510 18010 18010 20510
500 83.14.1 S5 Fasciotomy 21500 23000 23000 25500
501 83.14.2 S5 Fasciotomy with skin graft 25910 26810 26810 28310
502 83.63 S5 Rotator cuff repair 31220 32420 32420 34420
503 83.75 S5 Tendon transfer procedure around ankle 34110 36210 36210 39710
504 83.81 S5 Tendon transfer with graft 33200 34400 34400 36400
505 83.84.1 S5 CTEV correction 50910 51810 51810 53310
62
506 83.85 S5 Hamstrings release 16510 18010 18010 20510
507 83.86 S5 Quadricepsplasty 37100 39200 39200 42700
508 83.87 S5 Tricepsplasty 32110 34210 34210 37710
509 83.89 S5 Fasciotomy with skin graft with fixator 42710 45410 45410 49910
510 83.95.2 S5 Drainage of cold abscess 31210 32410 32410 34410
511 83.95.3 S5 Drainage of acute osteomyelitis 29510 31010 31010 33510
512 84.01.1 S5 Fingers amputations 10600 11200 11200 12200
513 84.04 S5 Disarticulation at wrist level 24510 26010 26010 28510
514 84.4 S5 Orif-long bones with locking plates 36210 37410 37410 39410
515 84.05 S5 Below Elbow amputations 24510 26010 26010 28510
516 84.06 S5 Disarticulation at elbow level 25910 26810 26810 28310
517 84.07 S5 Above Elbow amputations 26810 28610 28610 31610
518 84.08.1 S5 Disarticulation at Shoulder level 41510 43010 43010 45510
519 84.09.2 S5 Amputations - Forequarter 39480 41880 41880 45880
520 84.11.1 S5 Disarticulations at small joints Foot 10010 10010 10010 10010
521 84.13 S5 Disarticulation at ankle level 26210 27410 27410 29410
522 84.15 S5 Below Knee amputations 28670 30470 30470 33470
523 84.16 S5 Disarticulations at knee level 27010 27010 27010 27010
524 84.17.1 S5 Above Knee amputations 28800 30600 30600 33600
525 84.18 S5 Disarticulation at Hip level 42110 44210 44210 47710
52684.19.1
S5 Amputations - Hind Quarter And Hemipelvectomy52110 54210 54210 57710
527 84.54 S5 Limb reconstruction system(lrs) 40410 42810 42810 46810
528 84.72.1 S5 Ilizarov Ring Fixator Application 46410 48810 48810 52810
529 84.72.2 S5 Ilizarov fixator with joint arthrolysis 52110 54210 54210 57710
530 86.21.2 S5 Excision of Sinus over Sacrum 16310 16610 16610 17110
53186.89.3
S5
Soft Tissue Reconstruction Procedures For
Joints/Osteotomy31510 33010 33010 35510
532 86.89.4 S5 CDH soft tissue reconstruction 36500 38000 38000 40500
533 93.5 S5 Hip spica 8600 9200 9200 10200
534 93.41 S5 Cervical spine injury(skull traction) treatment 21500 23000 23000 25500
535 93.44 S5 Application of skeletal traction 6300 6600 6600 7100
536 93.46 S5 Application of skin traction 4500 4500 4500 4500
63
537 93.53.1 S5 Application of functional cast brace 2500 2500 2500 2500
538 93.53.2 S5 U-slab application 7100 7700 7700 8700
539 93.53.3 S5 Synthetic cast application above Elbow 5000 5000 5000 5000
540 93.53.4 S5 Synthetic cast application below Elbow 5550 5550 5550 5550
541 93.53.5 S5 Synthetic cast application above Knee 6500 6500 6500 6500
542 93.53.6 S5 Synthetic cast application below Knee 5000 5000 5000 5000
543 93.53.7 S5 Synthetic cast cutting 500 500 500 500
544 93.54.1 S5 POP application above Elbow 4300 4600 4600 5100
545 93.54.2 S5 POP application below Elbow 3300 3600 3600 4100
546 93.54.3 S5 POP application above Knee 5300 5600 5600 6100
547 93.54.4 S5 POP application below Knee 4300 4600 4600 5100
54893.56
S5 Bandages and strapping procedures for fractures6810 7110 7110 7610
549 39.1.4 S6 Surgery For Portal Hypertension Bleed 102100 104200 104200 107700
550 41.5.1 S6 Splenectomy 36500 38000 38000 40500
55141.5.6
S6
Splenectomy + Devascularisation + Spleno Renal
Shunt(39.1)79270 81970 81970 86470
552 41.42 S6 Spleenectomy For Space Occupying Lesion 42290 42590 42590 43090
553 42.7 S6 Open Hellers Myotomy 81200 82400 82400 84400
554 42.7.1 S6 Laproscopic Hellers Myotomy 29620 31120 31120 33620
555
42.11
S6
Surgery For Oesophageal Perforation Stage 1 Cervical
Exclusion And Chest Tube And Feeding Jejunostomy
126800 128600 128600 131600
55642.32.1
S6
Surgery For Oesophageal Perforation Stage 2 Definitive
Surgery102400 104800 104800 108800
557
42.32.2
S6
Surgery For Oesophageal Perforation - Single Staged
Foreign Body, Iatrogenic & Spontaneous
102400 104800 104800 108800
558 42.40.1 S6 Oesophagectomy 91200 92400 92400 94400
559 42.55 S6 Colonic Pull Up 61500 63000 63000 65500
560 43.4 S6 Surgery for Corrosive Injury Stomach 61200 62400 62400 64400
56143.5.2
S6 Partial Gastrectomy with anastomosis to esophagus41200 42400 42400 44400
64
56243.6.1
S6 Partial Gastrectomy with anastomosis to duodenum41200 42400 42400 44400
56343.6.2
S6 Distal Gastrectomy For Gastric Outlet Obstruction41200 42400 42400 44400
56443.7.1
S6
Partial/Subtotal Gastrectomy with anastomosis to
jejunum For Ulcer33190 34390 34390 36390
565 43.9 S6 Total Gastrectomy 41800 43600 43600 46600
566 43.99.1 S6 Oesophago-Gastrectomy 91200 92400 92400 94400
56744
S6 Truncal Vagotomy + Gastro Jejunostomy(44.3)48900 49800 49800 51300
568 44.4.2 S6 Surgery For Bleeding Ulcers 48900 49800 49800 51300
569 44.43 S6 Surgery For Obscure Gi Bleed 72900 73800 73800 75300
57044.63
S6 Gastro Jejuno-Colic Fistula Surgical Management62100 64200 64200 67700
571 44.67 S6 Lap Fundoplications 54300 54600 54600 55100
57245.8
S6 I Stage-Sub Total Colectomy + Ileostomy(46.2)60300 60600 60600 61100
573 45.73.3 S6,S1 Extended Right Hemicolectomy 48300 48600 48600 49100
57445.83
S6 I Stage- Sub Total Colectomy + Ileostomy + J - Pouch96300 96600 96600 97100
575 45.95.1 S6 II Stage-J - Pouch 50300 50600 50600 51100
576 46.51.4 S6 II Stage- Ileostomy Closure 25910 26810 26810 28310
577 46.51.5 S6 III Stage-Ileostomy Closure 26800 28600 28600 31600
578 46.80.2 S6 Surgical management of Volvulus 49200 50400 50400 52400
579 46.80.3 S6 Surgical management of Malrotation 49200 50400 50400 52400
580 48.5 S6,S11 Abdomino Perineal Resection of rectum 53090 55490 55490 59490
581 48.62.2 S6 Hartman.S Procedure With Colostomy 54300 54600 54600 55100
582 48.63.1 S6 Anterior Resection of Large Intestine 40900 41800 41800 43300
583 48.93 S6 Anterior Resection With Ileostomy 60290 60590 60590 61090
584 49.7.1 S6 Anal Sphincter Repair -With Colostomy 35060 36260 36260 38260
585 49.7.2 S6 Anal Sphincter Repair -Without Colostomy 125530 126730 126730 128730
586 50.3.1 S6 Rt.Hepatectomy 86890 87190 87190 87690
587 50.3.2 S6 Lt.Hepatectomy 90300 90600 90600 91100
65
588 50.4 S6 Hepatectomy For Cholangiocarcinoma 151800 153600 153600 156600
589 50.21 S6 Hydatid Cyst-Marsupilisation 40300 40600 40600 41100
59050.22
S6
Haemangioma Sol Liver Hepatectomy + Wedge
Resection90300 90600 90600 91100
59150.26
S6
Hepato Cellular Carcinoma(Advanced) Radio
Frequency Ablation72300 72600 72600 73100
592 50.29.3 S6 Segmentectomy 60300 60600 60600 61100
59351.2
S6 Radical Extended Cholecystectomy For Ca Gall Bladder102400 104800 104800 108800
594 51.6 S6 Cyst Excision+Hepatic Jejunostomy(51.37) 56100 58200 58200 61700
595 51.37 S6 Hepatico Jejunostomy 67570 68170 68170 69170
59651.39
S6 Choledochoduodenostomy Or Choledocho Jejunostomy42100 43600 43600 46100
597 51.41 S6 GB+ Calculi CBD Stones Or Dilated CBD 50300 50600 50600 51100
598 51.98 S6 Benign Biliary Stricture Repair 102100 104200 104200 107700
599 52.3 S6 Enucleation Of Cyst 91500 93000 93000 95500
600 52.4.1 S6,S11 Triple Bypass -Pancreas 61500 63000 63000 65500
60152.4.3
S6 Lateral Pancreaticojejunostomy(Non- Malignant)103000 106000 106000 111000
602 52.4.5 S6 Other Bypasses -Pancreas 40750 42250 42250 44750
603 52.7 S6,S11 Whipples Any Type 102700 105400 105400 109900
604 52.22.1 S6 Laproscopic Pancreatic Necrosectomy 114870 116970 116970 120470
605 52.22.2 S6 Open Pancreatic Necrosectomy 123050 126050 126050 131050
606 52.52.1 S6 Distal Pancreatectomy 121500 123000 123000 125500
607 52.52.2 S6 Distal Pancreatectomy + Splenectomy(41.5) 121500 123000 123000 125500
608 52.59 S6 Central Pancreatectomy 121500 123000 123000 125500
609 53.75 S6 Diaphragmatic Hernia (Gortex Mesh Repair) 49200 50400 50400 52400
61070.73.1
S6,S1,S4 Rectovaginal fistula Management with Colostomy41420 43520 43520 47020
611 00.61 S7 Vertebral Angioplasty 76210 77410 77410 79410
61200.66.1
S7 Coronary Balloon Angioplasty with stent(00.45)40600 41200 41200 42200
613 00.66.2 S7 PTCA 1 Additional Stent (00.46) 9000 9000 9000 9000
66
614 00.66.3 S7 PTCA 2 Additional Stent (00.47) 12000 12000 12000 12000
615 00.66.4 S7 PTCA 3 Additional Stent (00.48) 25000 25000 25000 25000
616 32.2.1 S7 Surgical management of lung cyst 40310 40610 40610 41110
617 32.4.2 S7 Lobectomy 60310 60610 60610 61110
618 32.5.1 S7 Pneumonectomy 60310 60610 60610 61110
619 32.9 S7 Surgical management of Lung Abcess 60910 61810 61810 63310
620 33.32 S7 Surgical management of Empyema Thoracis 53350 54550 54550 56550
62133.98
S7
Surgical management For Bronchial Injuries due to
foreign Body63010 66010 66010 71010
62234.3.1
S7
Surgical management of SolItary fibrous tumor-
Mediastinum60910 61810 61810 63310
62334.3.5
S7 Surgical Management Of Thymoma Mediastinum68000 69500 69500 72000
624 34.51 S7,S11 Decortication of lung 60300 60600 60600 61100
62534.73.1
S7,S11
Surgical management of Bronchopleural Fistula -
Thorocoplasty68740 69940 69940 71940
626 34.73.2 S7 Transpleural Bronchopleural Fistula closure 65610 66210 66210 67210
62734.73.3
S7,S11
Surgical management of Bronchopleural Fistula -
Myoplasty75450 75750 75750 76250
62834.81
S7 Surgical management of Diaphragmatic Eventeration52710 55410 55410 59910
62934.82
S7
Surgical management of Diaphragmatic injuries,
Thoraco Abdominal approach57100 59200 59200 62700
630 35.0 S7 Balloon Valvotomy 26610 27210 27210 28210
631 35.1 S7 Valve repair without Prosthetic Ring 110610 111210 111210 112210
632 35.02 S7 Closed Mitral Valvotomy 40600 41200 41200 42200
633
35.8
S7
Total Correction Of Complex Congenital Heart Disease
With Special Conduits (Xeno Graft)
191510 193010 193010 195510
634
35.11
S7
Ross procedure - Intracardiac repair of complex
congenitalheart diseases without Special Conduits
111920 114320 114320 118320
635 35.12 S7 Mitral valvotomy (Open) 110610 111210 111210 112210
67
636 35.13 S7 Open Pulmonary Valvotomy 79710 82410 82410 86910
637 35.20.1 S7 Valve repair with Prosthetic Ring 140910 141810 141810 143310
638 35.20.2 S7 Double valve replacement (With Valve) 178610 179210 179210 180210
63935.20.3
S7 Double valve replacement With Bio Prosthetic Valve198610 199210 199210 200210
640 35.21 S7 Aortic Valve Replacement (With Valve) 120610 121210 121210 122210
641
35.22.1
S7
Ross procedure - Intracardiac repair of complex
congenital heart diseases with Special Conduits
151510 153010 153010 155510
64235.22.2
S7
Surgical management of Annulus Aortic Ectasia With
Valved Conduits168450 169050 169050 170050
64335.22.3
S7 Arotic Valve Replacement With Bioprosthetic Valve165610 166210 166210 167210
644 35.23 S7 Mitral Valve Replacement (With Valve) 146210 147410 147410 149410
64535.24
S7
Replacement of Mitral valve with Bioprosthetic valve
low Profile160610 161210 161210 162210
646 35.27 S7 Tricuspid valve Replacement (With Valve) 144850 145450 145450 146450
64735.28
S7 Tricuspid valve Replacement with Bio Prosthetic160610 161210 161210 162210
648 35.41 S7 Balloon Atrial Septostomy 33970 34570 34570 35570
649 35.51 S7 ASD Device Closure 80600 81200 81200 82200
650 35.53 S7 VSD Device Closure 80600 81200 81200 82200
651 35.71 S7 Intra Cardiac Repair Of ASD 82110 84210 84210 87710
652 35.72 S7 Intracardiac Repair Of VSD 87110 89210 89210 92710
653 35.81 S7 Total Correction of Tetralogy of Fallot 105780 107280 107280 109780
65435.82
S7 surgical management (Correction) of TAPVC122550 125250 125250 129750
655 35.83.1 S7 Patent Ductus Arterious - Stenting 75600 76200 76200 77200
656 35.83.2 S7 Patent Ductus Arterious - Device Closure 74420 76520 76520 80020
65735.83.3
S7 Patent Ductus Arterious - Single Coil Closure25600 26200 26200 27200
65835.83.4
S7 Patent Ductus Arterious - Multiple Coils Closrue35600 36200 36200 37200
68
659 35.83.5 S7 Surgery for-PDA 41210 42410 42410 44410
660 35.84 S7 TGA - Arterial Switch 151510 153010 153010 155510
661 35.91 S7 TGA - Sennings Procedure 151510 153010 153010 155510
662 36.1.1 S7 Coronary Bypass Surgery 116450 117050 117050 118050
663 36.1.2 S7 Coronary Bypass Surgery-Post Angioplasty 120530 122330 122330 125330
664 36.1.3 S7 CABG With IABP Pump(37.61) 160490 163190 163190 167690
665 36.1.4 S7 CABG With Aneurysmal Repair(39.52) 156960 159660 159660 164160
66636.11
S7
Surgery For Anomalous left coronary artery from the
pulmonary artery (ALCAPA)115990 116590 116590 117590
667 37.0 S7 Pericardiocentesis 16510 18010 18010 20510
668 37.8 S7 Permanent Pacemaker Implantation 77100 79200 79200 82700
669 37.12 S7 Pericardiostomy 26210 27410 27410 29410
67037.23.1
S7
Medical Management Of Valvular Heart Diseases -
Requiring Cardiac Catheterization18560 19460 19460 20960
67137.23.2
S7
Medical Management Of Congenital Heart Diseases -
Requiring Cardiac Catheterization18570 19470 19470 20970
672 37.31 S7 Pericardiectomy 50660 51860 51860 53860
67337.33.1
S7
Surgical Treatment For MVR And Atrial Fibrillation-
Maze Method170610 171210 171210 172210
67437.33.2
S7
Surgical Treatment For MVR And Atrial Fibrillation-
Cryoablation Method119490 120090 120090 121090
67537.33.3
S7
Surgical Treatment For MVR And Atrial Fibrillation-
Hifu Method169710 170310 170310 171310
676 37.34 S7 Surgery For Intracardiac Tumors 102110 104210 104210 107710
677 37.49.1 S7 Surgery for Cardiac injuries Without CPB 72410 74810 74810 78810
678 37.49.2 S7 Surgery for Cardiac injuries With CPB 94370 96770 96770 100770
679 37.78 S7 Temporary Pacemaker Implantation 13610 14210 14210 15210
680 38.0 S7 Peripheral Embolectomy Without Graft 30000 30000 30000 30000
681 38.1 S7 Arterial Embolectomy 30000 30000 30000 30000
682 38.3 S7 Surgical management of Vascular Tumors 40900 41800 41800 43300
683 38.7.1 S7 DVT - Ivc Filter implantation 100600 101200 101200 102200
684 38.12.1 S7 TGA - Carotid Embolectomy 72110 74210 74210 77710
685 38.15 S7 Pulmonary Thrombo Embolectomy 149610 150210 150210 151210
69
686 38.34.1 S7 Coarctation-Arota Repair Without Graft 70600 71200 71200 72200
68738.34.2
S7
Coaractation of Aorta Repair Without Stent+
Aortoplasty(35.11)30990 31590 31590 32590
68838.35
S7
Intrathoracic Aneurysm -Aneurysm Not Requiring
Bypass100610 101210 101210 102210
689 38.40.1 S7 Aneurysm Resection & Grafting 184400 185000 185000 186000
69038.40.2
S7
Medium Size Arterial Aneurysms - Repair With
Synthetic Graft95610 96210 96210 97210
69138.40.3
S7 Excision Of Vascular Tumors With Prosthetic Graft75900 76800 76800 78300
69238.44.1
S7
Coaractation of Aorta Repair With Stent +
Aortoplasty(35.11)80600 81200 81200 82200
693 38.44.2 S7 Coarctation-Arota Repair With Graft 100610 101210 101210 102210
69438.44.3
S7
Thoraco Abdominal Aneurysm Or Dissection Repair
With Graft(38.45)201510 203010 203010 205510
69538.45
S7 Intrathoracic Aneurysm -Requiring Bypass (With Graft)185610 186210 186210 187210
69638.60.1
S7 Excision Of Arterio Venous Malformation - Large90750 91500 91500 92750
69738.60.2
S7 Excision Of Arterio Venous Malformation - Small44600 45200 45200 46200
698 39.0.1 S7 Systemic Pulmonary Shunts With Graft TOF 64810 66010 66010 68010
69939.0.2
S7 Systemic Pulmonary Shunts Without Graft TOF56300 57200 57200 58700
70039.3.1
S7
Surgery for Arterial Injuries, Venous Injuries Without
Graft25310 25610 25610 26110
70139.3.2
S7
Surgical Management of Major Vascular Injury -In
Lower Limbs30300 30600 30600 31100
70239.3.3
S7
Surgical Management of Minor Vascular Injury - Tibial
Vessels In Leg20010 20010 20010 20010
70339.3.4
S7
Surgical Management of Minor Vascular Injury -
Vessels In Foot20010 20010 20010 20010
70
70439.3.5
S7
Surgical Management of Neck Vascular Injury - Carotid
Vessels100310 100610 100610 101110
705
39.3.6
S7
Surgical Management of Abdominal Vascular Injuries -
Aorta, Illac Arteries, Ivc, Iliac Veins
100310 100610 100610 101110
70639.3.7
S7 Surgical Management of Thoracic Vascular Injuries150310 150610 150610 151110
707
39.3.8
S7
Surgical Management Of Abdominal Vascular Injuries -
Aorta, Illac Arteries, Ivc, Iliac Veins Without
Prosthetic Graft
76510 78010 78010 80510
70839.8.2
S7 Excicion Of Carotid Body Tumor With Vascular Repair80600 81200 81200 82200
70939.8.3
S7
Excision Of Carotid Body Tumor With Prosthetics Graft
Repair100600 101200 101200 102200
710 39.22 S7 Carotid Artery Bypass With Synthetic Graft 126110 128210 128210 131710
711 39.23 S7 Aorto-Aorto Bypass With Graft 102710 105410 105410 109910
712 39.25.1 S7 Femoro- Ileal Bypass With Graft 67110 69210 69210 72710
713 39.25.2 S7 Femoro- Ileal Bypass Without Graft 47110 49210 49210 52710
71439.25.3
S7 Aorto Billiac - Bifemoral Bypass With Synthetic Graft128310 131610 131610 137110
715 39.26 S7 Aorto-Aorto Bypass Without Graft 87110 89210 89210 92710
716 39.27.1 S7 A V Fistula surgery (creation) at Wrist 10610 11210 11210 12210
717 39.27.2 S7 A. V Fistula surgery (creation) At Elbow 10610 11210 11210 12210
718 39.29.1 S7 Femoro- Poplitial Bypass With Graft 67110 69210 69210 72710
719 39.29.2 S7 Femoro- Poplitial Bypass Without Graft 47110 49210 49210 52710
720 39.29.3 S7 Femoro-Femoral Bypass With Graft 67110 69210 69210 72710
721 39.29.4 S7 Femoro-Femoral Bypass Without Graft 47110 49210 49210 52710
722 39.29.5 S7 Axillo Bifemoral Bypass With Synthetic Graft 100910 101810 101810 103310
723 39.29.6 S7 Femoro Distal Bypass With Vein Graft 60610 61210 61210 62210
724 39.29.7 S7 Femoro Distal Bypass With Synthetic Graft 80910 81810 81810 83310
72539.29.8
S7 Axillo Brachial Bypass Using With Synthetic Graft71810 73610 73610 76610
71
72639.29.9
S7 Brachio - Radial Bypass With Synthetic Graft59610 60210 60210 61210
727 39.50.2 S7 Renal Angioplasty 60600 61200 61200 62200
728 39.50.3 S7 Peripheral Angioplasty 60610 61210 61210 62210
72939.50.4
S7 Perpheral Angioplasty - Additional Stent(00.46)9000 9000 9000 9000
730 39.52.1 S7 Small Arterial Aneurysms - Repair 20610 21210 21210 22210
731 39.52.2 S7 Medium Size Arterial Aneurysms - Repair 25610 26210 26210 27210
73239.52.3
S7 surgical management of Ruptured Sinus Of Valsalva132700 135400 135400 139900
73339.54
S7 Surgical management of Dissecting Aneurysms180600 181200 181200 182200
734
39.56.1
S7
Surgical Management of Vascular Injury In Upper
Limbs - Axillary,Branchial,Radial And Ulnar -With
Vein Graft
20310 20610 20610 21110
73539.56.2
S7
Surgical Management of Vascular Injury With Vein
Graft30310 30610 30610 31110
73639.57.2
S7
Surgical Management of Vascular Injury With
Prosthetic Graft40900 41800 41800 43300
737
39.57.3
S7
Surgical Management Of Neck Vascular Injury -
Carotid Vessels - With Prosthetic Graft
101210 102410 102410 104410
738
39.57.4
S7
Surgical Management Of Major Vascular Injury -In
Lower Limbs With Prosthetic Graft
71510 73010 73010 75510
739
39.57.5
S7
Surgical Management Of Abdominal Vascular Injuries -
Aorta, Illac Arteries, Ivc, Iliac Veins With Prosthetic
Graft
70610 71210 71210 72210
740
39.57.6
S7
Surgical Management Of Vascular Injury In Upper
Limbs - Axillary,Branchial,Radial And Ulnar -With
Prosthetic Graft
70300 70600 70600 71100
72
741
42.9
S7
Gastro Study Followed By Thoracotomy & Repairs For
Oesophageal Injury For Corrosive Injuries/Fb
67110 69210 69210 72710
74242.31
S7
Surgical Management of Oesophageal Diverticula
/Achalasia Cardia52710 55410 55410 59910
74353.8
S7 Surgical Management of Diaphragmatic Hernia61800 63600 63600 66600
744 98.15.1 S7,S8 Bronchoscopic Foreign body removal 20300 20600 20600 21100
745 02.1 S8 Surgical management of Encephalocele 42990 43890 43890 45390
746 05.2 S8 Surgical management of Neuroblastoma 48370 50470 50470 53970
74707.2
S8
Adrenal Gland Surgeries In Paediatric
patients(07.3&07.4)50340 53340 53340 58340
748 16.49.1 S8 Execision of pediatric tumors 53600 57200 57200 63200
74918.21.2
S8
Surgical treatment for Preauricular sinus in pediatric
patient10600 11200 11200 12200
75018.71
S8
Surgical correction of Microtia/Anotia In Paediatric
Patient35840 38840 38840 43840
751 27.43.1 S8 Excision of Retention Cyst Lip 3060 3360 3360 3860
752 27.54.3 S8 Surgical correction of Cleft Lip in children 27110 29210 29210 32710
753 27.62 S8,S14 Surgical correction of Cleft Palate 28010 31010 31010 36010
75427.69
S8,S14 Surgical corection of Velo-Pharyngeal Incompetence38940 42540 42540 48540
75529.52.2
S8
Surgical management of Sinuses & Fistula of the neck
in Paediatric Patient21770 22670 22670 24170
756 32.2 S8 Excision ofThoracoscopic cysts 41500 43000 43000 45500
75732.2.2
S8 Open excision of Lung cyst In Paediatric Patient41200 42400 42400 44400
75834.3.3
S8 Mediastinal Cyst Excision In Paediatric Patients66900 67800 67800 69300
75934.06
S8 Empyema decortication In Paediatric Patients32140 33640 33640 36140
76034.09
S8 Empyema-ICD drainage In Paediatric Patients10900 11800 11800 13300
73
76134.52
S8 Thoracoscopic Decortication In Paediatric Patients49500 51000 51000 53500
762 34.74 S8 Surgical Correction of Thoracic Wall Defects 65910 66810 66810 68310
763 39.99 S8 Excision of Haemangioma 19150 19450 19450 19950
76440.29.4
S8
Surgical management of Lymphangioma In Paediatric
Patients49210 50410 50410 52410
765 41.5.5 S8 Paediatric Splenectomy (Non Traumatic) 44700 47400 47400 51900
76642.12
S8
Surgical management of Oesophageal Atresia In
Paediatric Patients64590 67290 67290 71790
76742.42.4
S8
Surgical Correction of Thoracic Duplications In
Paediatric Patients47250 49950 49950 54450
76842.85
S8
Surgical Correction of Esophageal Obstructions In
Paediatric Patients60000 61500 61500 64000
76942.89
S8
Surgical Correction of Esophageal Substitutions In
Paediatric Patients76170 79170 79170 84170
77043.3.2
S8
Surgical management of - Gastric Outlet Obstructions In
Paediatric Patients31200 32400 32400 34400
77144.66
S8
Surgical management of Gastro Esophageal Reflux In
Paediatric Patients38210 40010 40010 43010
77245.3.3
S8
Surgical Management of Intestinal Atresias &
Obstructions In Paediatric Patients65900 66800 66800 68300
77345.4
S8
Surgical management of Intestinal Polyposis In
Paediatric Patients61500 63000 63000 65500
77445.33.2
S8 Meckel's Diverticulectomy In Paediatric Patients43000 46000 46000 51000
77545.95.2
S8
Stage 2 procedure for Anorectal Malformations In
Paediatric Patients62100 64200 64200 67700
77646.11.1
S8
Stage 1 procedure for Anorectal Malformations In
Paediatric Patients49500 51000 51000 53500
77746.11.2
S8
Stage 1 procedure for Hirschprungs Disease In
Paediatric Patients48600 49200 49200 50200
778 46.32.1 S8 Feeding Jejunostomy In Paediatric Patients 30350 31850 31850 34350
779 46.51.3 S8 Ileostomy closure In Paediatric Patients 26810 28610 28610 31610
74
78046.52.3
S8
Stage 2 procedure for Hirschprungs Disease In
Paediatric Patients73500 75000 75000 77500
781 46.52.4 S8 Colostomy closure In Paediatric Patients 25900 26800 26800 28300
78246.99
S8
Surgical mangement of Acute Intestinal Obstruction In
Paediatric Patients51000 54000 54000 59000
783 48.36 S8 Rectal polypectomy In Paediatric Patients 8300 8600 8600 9100
78448.41.1
S8
Laparoscopic Pull Through For Ano Rectal Anomalies
In Paediatric Patients73800 75600 75600 78600
78548.41.2
S8
Laparoscopic Pull Through Surgeries For Hirschprungs
Disease In Paediatric Patients73500 75000 75000 77500
78649.12
S8
Surgical mangement of Anal Fissure and Fistula In
Paediatric Patients24090 25590 25590 28090
78751.63
S8
Surgical Management of Biliary Atresia & Choledochal
Cyst In Paediatric Patients71860 74260 74260 78260
788 52.9 S8 Pancreatic surgery in Paediatric Patients 76500 78000 78000 80500
78953.0
S8 Unilateral Inguinal Hernia repair In Paediatric Patients55800 56100 56100 56600
79053.1
S8 Bilateral Inguinal Hernia repair In Paediatric Patients20300 20600 20600 21100
791 53.9.2 S8 Lumbar Hernia repair In Paediatric Patients 16800 18600 18600 21600
792 53.21 S8 Femoral Hernia repair In Paediatric Patients 15300 15600 15600 16100
793 53.42.2 S8 Umbilical Hernia repair In Paediatric Patients 20300 20600 20600 21100
794 53.51.2 S8 Incisional Hernia repair In Paediatric Patients 32700 35400 35400 39900
79553.72.1
S8
Open repair of diaphragmatic hernia in Paediatric
patients75630 76530 76530 78030
79654.3.2
S8
Correction of Vitello intestinal duct anomalies in
Paediatric Patients39960 41160 41160 43160
797 54.7 S8,S14 Repair of Abdominal wall defects 76500 78000 78000 80500
79854.9
S8
Surgical management of Abdominal trauma in
Paediatric Patients62400 64800 64800 68800
79954.11
S8
Surgical management of peritonitis in Paediatric
Patients40900 41800 41800 43300
75
80054.99.2
S8
Correction of Duplications of alimentary tract in
Paediatric Patients48660 50160 50160 52660
80155.03.1
S8 Renal calculi-nephrolithotomy in Paediatric Patients34020 35820 35820 38820
802 55.5.1 S8,S9 Simple Nephrectomy 41200 42400 42400 44400
80355.8
S8
Surgical Management of Congenital Hydronephrosis in
Paediatric Patients56200 57700 57700 60200
804 56.2.1 S8,S9 Open ureterolithotomy 30290 31790 31790 34290
805 56.6 S8 Ureterostomy in Paediatric Patients 33860 35360 35360 37860
806 56.74.1 S8,S9 Ureteric Reimplantations 36580 38380 38380 41380
807 56.92 S8,S9 Ureteric Implantation with tailoring 43690 45490 45490 48490
80857.1
S8 Vesical calculi-vesicolithotomy in Paediatric Patients25100 26600 26600 29100
80957.17
S8 Supra pubic drainage- open in Paediatric Patients11200 12400 12400 14400
810 57.21.1 S8,S9 Vesicostomy 27270 28770 28770 31270
811 57.22 S8 Vesicotomy closure in Paediatric Patients 28720 30520 30520 33520
81257.86.1
S8
Stage 1 procedure for Exstrophy Bladder in Paediatric
Patients75320 77420 77420 80920
81357.86.2
S8
Stage 2 procedure for Exstrophy Bladder in Paediatric
Patients71720 73220 73220 75720
814 57.87 S8,S9 Bladder augmentation 49800 51600 51600 54600
81558.4
S8 Repair of Urethral injuries in Paediatric Patients27530 29030 29030 31530
81658.39
S8 Surgical Management of Posterior Urethral Valves32100 34200 34200 37700
817 58.45.1 S8,S9 Single Stage procedure for Hypospadiasis 43900 47800 47800 54300
818 58.45.2 S8,S9 Stage 1 procedure for Hypospadiasis 31460 33560 33560 37060
819 58.45.3 S8,S9 Stage 2 procedure for Hypospadiasis 31670 33470 33470 36470
820 58.45.4 S8,S9 Surgical Correction of Epispadiasis 43660 45460 45460 48460
82161.49
S8
Surgical Correction of Scrotal Transposition In
Paediatric Patients20900 21800 21800 23300
76
82262.5.2
S8
Surgical management of Undescended Testis In
Paediatric Patients25900 26800 26800 28300
82362.5.3
S8 Laparoscopic Orchidopexy In Paediatric Patients27100 29200 29200 32700
824 63.1.1 S8 Laparoscopic Varicocele Ligation 41200 42400 42400 44400
825 63.1.2 S8,S9 Open Varicocele ligation 32710 35410 35410 39910
826 63.1.3 S8 Hydrocele high ligation In Paediatric Patients 15300 15600 15600 16100
827 63.52 S8,S9 Surgical Management for Torsion of Testis 26990 28790 28790 31790
82864.4
S8,S9 Surgical Management of Phimosis and Paraphimosis8600 9200 9200 10200
829 64.5 S8 Intersex-Genitoplasty surgery(70.6) 47480 49580 49580 53080
83076.5.2
S8,S14
Surgical Management of Tempero mandibular Joint
Ankylosis47240 49940 49940 54440
83176.93.2
S8,S14 Management Of Tmj Dysfunction Syndrome (76.94)1090 1090 1090 1090
832 77.8.1 S8 Execision of cogental dermal sinus 30610 31210 31210 32210
83383.79
S8 Surgical Management of Torticollis in Paediatric Patient16070 16670 16670 17670
83486.3.10
S8
Excision of External angular dermoid in Paediatric
Patient8360 8660 8660 9160
83586.3.13
S8
Surgical Management (excision) of Congenital Dermal
Sinus30600 31200 31200 32200
83686.3.15
S8 Excision of Sebacencyst Lipoma in Paediatric Patient6150 6450 6450 6950
837 86.04.1 S8 Excision of hamartoma 20600 21200 21200 22200
838 86.09.1 S8 Execision of cysti lesions of neck 27100 29200 29200 32700
83986.85.1
S8
Surgical correction of Syndactyly of Hand For Each
Hand in Paediatric Patient27110 29210 29210 32710
84086.85.2
S8
Syndactoly correction-multiple correction in Paediatric
Patient29510 31010 31010 33510
841 96.23 S8 Anal Dilatation 5300 5600 5600 6100
842 38.17 S9 Renal angio embolization 36120 37920 37920 40920
77
84339.27.3
S9
A.V. Fistula surgery (creation) [Pre-Transplant
Procedure Only]10900 11800 11800 13300
84439.50.1
S9 Balloon dialatation of transplant Renal Artery stenosis34120 35620 35620 38120
845 39.53.1 S9 AV Fistula 12500 14000 14000 16500
846 40.9.1 S9 Open post transplant lymphocele 30830 32330 32330 34830
847 40.9.2 S9 Laproscopic post transplant lymphocele 32890 34390 34390 36890
84840.24.1
S9
Uni-lateral illioinguinal block dissection in non
malignant conditions31510 33010 33010 35510
84940.24.2
S9
Bi-lateral illioinguinal block dissection in non
malignant conditions34140 35640 35640 38140
85054.0
S9 Surgery for Retroperitoneal Fibrosis Open/Lap40930 42430 42430 44930
851 54.99 S9 Parapelvic Cyst Excision-Open/Lap 33800 35600 35600 38600
852 55.01 S9 Open Nephrolithotomy 25900 27700 27700 30700
853 55.02 S9 Nephrostomy - Renal 13900 14800 14800 16300
854 55.04 S9 Percutaneous Nephrolithotomy 36400 38500 38500 42000
855 55.4.1 S9 Nephrectomy for Pyonephrosis/Xgp 40900 41800 41800 43300
856 55.4.3 S9 Laproscopic Partial Nephrectomy 62410 64810 64810 68810
857 55.5.2 S9 Laproscopic Simple Nephrectomy 52410 54810 54810 58810
858 55.5.3 S9 Laproscopic Radical Nephrectomy 63090 64290 64290 66290
859 55.6 S9 Renal Transplantation Surgery 206000 212000 212000 222000
860 55.7 S9 Nephropexy 37880 39980 39980 43480
86155.7.0
S9
Revascularization procedure for renovascular
hypertension29930 31430 31430 33930
862 55.11.1 S9 Open Pyelolithotomy 22970 24170 24170 26170
863 55.11.2 S9 Laparoscopic Pyelolithotomy 43010 44210 44210 46210
86455.11.3
S9 Anatrophic Peylolithotomy For Staghorn Caliculus51800 53600 53600 56600
865 55.11.4 S9 Partial stag horn caluculi 35270 36770 36770 39270
866 55.11.5 S9 Complete stag horn caluculi 40060 42160 42160 45660
867 55.39 S9 Renal Cyst Excision 24720 26220 26220 28720
868 55.51.1 S9,S11 Radical Nephro-Ureterectomy 52100 54200 54200 57700
78
869 55.51.2 S9 Bilateral Nephroureterectomy 82100 84200 84200 87700
870 55.51.3 S9 Laproscopic unilateral Nephroureterectomy 50900 51800 51800 53300
871 55.51.4 S9 Open unilateral Nephroureterectomy 47410 49810 49810 53810
872 55.51.5 S9 Hemi- Nephroureterectomy 47100 49200 49200 52700
873 55.53 S9 Post transplant graft Nephrectomy 37110 39210 39210 42710
874 55.61 S9 Renal auto transplantation 61500 63000 63000 65500
87555.87.1
S9 Surgical Management of Congenital Hydronephrosis37100 39200 39200 42700
876 55.87.2 S9 Anderson Hynes Pyeloplasty 49500 51000 51000 53500
877 55.87.3 S9 Retrograde Intrarenal Surgery(RIRS) 32480 33380 33380 34880
878 55.92 S9 Laparoscopic deroofing of Renal Cyst 32990 34190 34190 36190
879 56.0 S9 URSL 26200 27400 27400 29400
880 56.2.2 S9 Laparoscopic ureterolithotromy 31510 33010 33010 35510
881 56.4 S9 Surgical corrrection of Ureterocele 24560 25460 25460 26960
88256.41
S9 Excision of Ureterocele with Ureteric Implantation43880 45380 45380 47880
88356.51
S9 Surgical Procedure for Ileal Conduit Formation42180 43680 43680 46180
88456.74.2
S9
Post transplant revision Ureteroneo cystostomy/Pyelo
Ureterostomy39370 41470 41470 44970
885 56.74.3 S9 Ureteric replacement 46380 47880 47880 50380
886 56.75 S9 Uretero ureterostomy 34030 35230 35230 37230
887 56.91 S9 Balloon dilatation of Ureteric stricture 20710 21310 21310 22310
888 57.0 S9 Cystolithotripsy 14200 15400 15400 17400
889 57.01 S9 Endoscope removel of stone in bladder 14910 15810 15810 17310
890 57.6.1 S9 Partial Cystectomy 35350 36850 36850 39350
891 57.7 S9 Total Cystectomy 47130 49230 49230 52730
892 57.19 S9 Open Cystolithotomy 20940 22740 22740 25740
893 57.21.2 S9 Mitrafanoff procedure 48960 51660 51660 56160
89457.49.1
S9 Transurethral resection of bladder tumour (TURBT)39900 40800 40800 42300
79
895
57.49.2
S9
Transurethral resection of bladder tumour (TURBT)
with intravesical Mitomycin instillation
35900 36800 36800 38300
896 57.51 S9 Excision of Urachal cyst 36160 37660 37660 40160
897 57.59 S9 Bladder Diverticulectomy 34000 35800 35800 38800
89857.71.1
S9,S11
Laproscopic radical cystectomy with Ilealconduit
diversion126500 128000 128000 130500
89957.71.3
S9
Laproscopic radical cystectomy with
Ureterosigmoidostomy(57.88)59670 62670 62670 67670
90057.71.4
S9
Open radical cystectomy with Ureterosigmoidostomy
(57.88)48000 51000 51000 56000
90157.71.5
S9
Laproscopic radical cystectomy with Continent Urinary
diversion(56.7)65560 66460 66460 67960
90257.71.6
S9
Open radical cystectomy with Continent Urinary
diversion53000 56000 56000 61000
903 57.84.1 S9 Surgical correction of Vesicovaginal Fistula 45810 47610 47610 50610
904 57.84.2 S9 Transvaginal repair of Vesicovaginal Fistula 37940 40040 40040 43540
90557.84.4
S9
Trans abdominal repair of Vesicovaginal Fistula with
omentoplasty55800 59100 59100 64600
906 57.88 S9 Caecocystoplasty 44840 47840 47840 52840
907 57.91.1 S9 Bladder neck incision 25330 26530 26530 28530
908 57.91.2 S9 Bladder neck reconstruction for Incontinence 62100 64200 64200 67700
909 58.0 S9 Perineal Urethrostomy 33150 34650 34650 37150
910 58.5.1 S9 Optical Urethrotomy 22440 23940 23940 26440
91158.5.2
S9 BMG Urethroplasty for pan Urethral stricture66500 68000 68000 70500
912 58.6 S9 Dilatation for Urethra stenosis 10870 11170 11170 11670
913 58.31 S9 Excision of Urethral Caruncle 16570 17170 17170 18170
914 58.43 S9 Urethral Fistula closure 31500 33000 33000 35500
915 58.45.5 S9 Single stage- Urethroplasty for Stricture 53310 56610 56610 62110
91658.46
S9
Double stage Urethroplasty (Reconstruction Procedure)
for stricture Urethra.40210 42910 42910 47410
917 58.47 S9 Meatoplasty 12580 12880 12880 13380
80
918 58.49 S9 Transpubic Urethroplasty with Omentoplasty 68610 72210 72210 78210
919 58.49.1 S9 Urethroplasty doblestage stage I 40770 42870 42870 46370
920 58.49.2 S9 Urethroplasty doublestage stageII 40200 42900 42900 47400
921 59.02 S9 Nephrolysis/surgery for Chyluria Open/Lap 41810 43610 43610 46610
92259.4.1
S9 Surgical Management of Incontinence Urine (Male)26800 28000 28000 30000
92359.4.2
S9 Surgical Management of Incontinence Urine (Female)22900 23800 23800 25300
92459.5
S9
MMK/birch colpo suspension for stress urinary
Incontinence42100 44200 44200 47700
925 59.8.1 S9 Dj Stent (One Side) 5310 5610 5610 6110
926 59.8.2 S9 CAPD-Tenchkoff catheter insertion 38630 40730 40730 44230
927 59.09 S9 Drainage of Perinephric Abscess 40070 42170 42170 45670
92859.79
S9
Mid urethral sling procedure for stress urinary
incontinence31500 33000 33000 35500
929 60.3 S9 Open Prostatectomy 34510 36010 36010 38510
930 60.5.1 S9 Laproscopic radical Prostratectomy 57110 59210 59210 62710
931 60.5.2 S9 Open radical Prostratectomy 50910 51810 51810 53310
932 60.21 S9 Laser Prostatectomy 41500 43000 43000 45500
933 60.29.1 S9 Transurethral Resection of Prostate (TURP) 31500 33000 33000 35500
93460.29.2
S9
Transurethral Resection of Prostate (TURP) Cyst
Lithotripsy30900 31800 31800 33300
935 60.29.3 S9 Bipolar TURP 41500 43000 43000 45500
936 61.4 S9 Scrotal/Perineal Injuries 29570 31670 31670 35170
937 62.5 S9 Orchidopexy Bilateral 24670 26470 26470 29470
938 63.92 S9 Vasectomy reversal 23910 24810 24810 26310
939 64.3.1 S9,S11 Partial amputation of penis 38170 39670 39670 42170
940 64.41 S9,S8 Surgical Management of Penile Injuries 26200 27400 27400 29400
941 64.42.1 S9 Surgical correction of Chordee 34670 36470 36470 39470
94264.42.2
S9 Surgical Correction of Chordee without Hypospadiasis34430 36530 36530 40030
94364.43
S9
Plaque Excision/Plasty for Penile curvature/Peyronies
disease42100 44200 44200 47700
81
944 64.98 S9 Surgery for Priapism 37100 39200 39200 42700
945 86.75 S9 Difficult vascular access/graft 31500 33000 33000 35500
946 97.64 S9 CAPD-Tenchkoff catheter removal 36040 38140 38140 41640
947 97.64.1 S9 CAPD bags per month 8530 8530 8530 8530
948 97.65 S9 Cystoscopy/ Stent removal 9400 9700 9700 10200
94998.51
S9 Extracorporeal shockwave lithotripsy (ESWL)20600 21200 21200 22200
95099.23.1
S9
Post Renal Transplant Immunosuppressive Treatment
From 1st To 6th Months91670 91670 91670 91670
95199.23.2
S9
Post Renal Transplant Immunosuppressive Treatment
From 7th To 12 Th Month.61200 61200 61200 61200
952 99.28.1 S9 Intravesical BCG Induction therapy 10050 10350 10350 10850
953 99.28.2 S9 Intravesical BCG maintenance 18120 19320 19320 21320
954 01.09.1 S10 Twist Drill Craniostomy 15600 16200 16200 17200
955 01.09.2 S10 Subdural Tapping 19510 19510 19510 19510
956 01.09.3 S10 Ventricular Tapping 15000 15000 15000 15000
95701.13
S10 Burr Hole procedure for evacuation of Brain Abscess32690 32690 32690 32690
958 01.18 S10 Endoscopy Procedures -Brain 79800 81600 81600 84600
95901.24.1
S10 Craniotomy And Evacuation of Subdural Haematoma66000 66000 66000 66000
96001.24.2
S10 Craniotomy And Evacuation of Extradural Haematoma60000 60000 60000 60000
96101.25
S10 De-Compressive Craniectomy (Non Traumatic)80600 81200 81200 82200
962 01.31 S10 Tapping of Brain Abscess 40000 40000 40000 40000
963 01.39 S10 Evacuation of Intra-Cerebral Hematoma 72000 72000 72000 72000
964 01.53.1 S10 Temporal Lobectomy Plus Depth Electrodes 140300 140600 140600 141100
965 01.53.2 S10 Temporal Lobectomy 75600 76200 76200 77200
96601.53.3
S10 Excision of Lobe(frontal,temporal,cerebe llum Etc.)40310 40610 40610 41110
967 01.59.1 S10 Excision of Parasagital Brain tumour 70400 71900 71900 74400
968 01.59.2 S10 Excision of Basal Brain tumour 70300 70600 70600 71100
82
969 01.59.3 S10 Excision of Brain Stem Brain tumour 70920 71820 71820 73320
970 01.59.4 S10 Excision of C P Angle Brain tumour 77720 78020 78020 78520
971 01.59.5 S10 Excision of Other Brain tumours 48560 48860 48860 49360
972 01.59.6 S10 Lesionectomy Type 1 57160 57460 57460 57960
973 01.59.7 S10 Lesionectomy Type 2 57350 57650 57650 58150
974 01.59.8 S10 Excision of Subtentorial Brain Tumours 48550 48850 48850 49350
975 01.59.9 S10 Evacuation of Brain Abscess 60000 60000 60000 60000
976 01.59.10 S10 Surgical Management of Meningomyelocele 40600 41200 41200 42200
977 01.59.11 S10 Intra Ventricular Tumours 60600 61200 61200 62200
978 01.59.12 S10 Meningocele Excision 40300 40600 40600 41100
979 01.59.13 S10 Excision of brain abscess 49250 49550 49550 50050
980 02.0 S10 Cranioplasty 30310 30610 30610 31110
981 02.02 S10 Depressed / Elevated Fracture 30300 30600 30600 31100
982 02.2 S10 Endoscopic Third Ventriculostomy 30900 31800 31800 33300
983 02.05 S10 Cranioplasty With Impants 30300 30600 30600 31100
984 02.06 S10 Cranioplasty With Titanium Mesh 31940 32240 32240 32740
98502.12
S10 Surgical Management of Meningo Encephalocele40600 41200 41200 42200
986 02.31 S10 Surgical Management of C.S.F. Rhinorrhoea 40600 41200 41200 42200
987 02.32 S10 Ventriculo Atrial Shunt 21510 23010 23010 25510
988 02.32.1 S10 Atrial shunt 20010 20010 20010 20010
989 02.34 S10 Ventriculo Peritoneal Shunt 30010 30010 30010 30010
990 02.34.1 S10 Ventriculoatrial / Ventriculoperitonial shunt 20010 20010 20010 20010
991 02.39 S10 External Ventricular Drainage (EVD) 40000 40000 40000 40000
992 03.1 S10 Selective Posterior Rhizotomy 30300 30600 30600 31100
993 03.4.1 S10 Surgery for Cord Tumours 38910 39810 39810 41310
99403.4.2
S10
Surgical Management of Intra Medullary Spinal
Tumours51210 52410 52410 54410
995 03.4.3 S10 Surgical Management of Syringomyelia 60600 61200 61200 62200
996 03.09.1 S10 Laminectomy 27250 27850 27850 28850
997 03.09.2 S10 Laminoplasty With Implants 30780 31380 31380 32380
998 03.39 S10 Endoscopy - Spinal 29910 30810 30810 32310
999 03.52 S10 Meningo Myelocele Spinal Procedure 25600 26200 26200 27200
83
1000 03.59.1 S10 Surgical Management of Spina Bifida Major 35610 36210 36210 37210
1001 03.59.2 S10 Surgical Management of Spina Bifida Minor 30310 30610 30610 31110
1002 03.96 S10 Facet, Nerve Root Blocks 10000 10000 10000 10000
1003
04.02
S10
Radio Surgery For Brain Tumours & Vascular
Malformations/ Trigeminal Neuralgia
25300 25600 25600 26100
100404.2
S10 Radiofrequency Ablation For Trigeminal Neuralgia30600 31200 31200 32200
1005 04.5.2 S10 Surgical treatment for brachial plexus injuries 72900 73800 73800 75300
100604.41
S10 Microvascular Decompression For Trigeminal Neuralgia60310 60610 60610 61110
100704.43
S10,S5 Surgical management Carpal tunnel syndrome10010 10010 10010 10010
1008 04.76.1 S10 Peripheral Nerve Injury Repair 40900 41800 41800 43300
1009 05.22 S10 Cervical Sympathectomy 31210 32410 32410 34410
1010 05.23.1 S10 Lumbar Sympathectomy 31510 33010 33010 35510
1011 07.62 S10 Trans Sphenoidal Surgery 40300 40600 40600 41100
1012 38.12.2 S10 Carotid Endarterectomy 40600 41200 41200 42200
1013 39.28 S10 Intra Cranial Vascular Bypass 100900 101800 101800 103300
1014 39.51 S10 Aneurysm Clipping 110010 110010 110010 110010
1015
39.53.2
S10
Other Vascular Malformations (Other Than AVM) -
Cavernomas, AV Fistulas, Sinus Pericranii
60910 61810 61810 63310
1016 39.72.1 S10 Embolization of Aneurysm 76510 78010 78010 80510
1017 39.72.2 S10 Brain Tumour Embolisation 28300 28600 28600 29100
101839.79.1
S10 Coil Embolization of Aneurysm (each coil cost)35020 35020 35020 35020
101939.79.2
S10 Surgical Management of Vascular Malformations60600 61200 61200 62200
102078.19
S10 Spinal Fixation Rods And Plates, Artificial Discs85610 86210 86210 87210
1021 80.5.1 S10 Anterior Lateral Decompression 31210 32410 32410 34410
1022 80.51.1 S10 Postirior cervical disectomy 27250 27850 27850 28850
84
1023 80.51.2 S10 Excision Of Cervical Inter-Vertebral Discs 31210 32410 32410 34410
1024 80.51.3 S10 Anterior Discectomy & Bone Grafting 41210 42410 42410 44410
1025 80.51.4 S10 Discectomy With Implants 65600 66200 66200 67200
1026 80.51.5 S10 Anterior Cervical Discectomy 27550 28450 28450 29950
1027 80.51.6 S10 Disectomy 26950 27250 27250 27750
1028 80.99 S10 Corpectomy For Spinal Fixation 75610 76210 76210 77210
1029 81.00.2 S10 Spinal Fusion Procedure 50610 51210 51210 52210
1030 81.01.1 S10 Trans Oral Surgery 40310 40610 40610 41110
103181.01.2
S10 Combined Trans-Oral Surgery & Cv Junction Fusion51800 52400 52400 53400
1032 81.01.3 S10 C.V. Junction Fusion 40610 41210 41210 42210
1033 81.02 S10 Anterior Cervical Spine Surgery With Fusion 45610 46210 46210 47210
1034 86.3.14 S10 Excision Of Scalp Lesions 10000 10000 10000 10000
1035 93.59 S10 Stereotactic Procedures 20600 21200 21200 22200
103606.4.3
S11 Thyroidectomy any type in malignant conditions31210 32410 32410 34410
1037 06.8.2 S11 Parathyroidectomy in malignant conditions 36090 37290 37290 39290
103806.31.5
S11
Excision of Solitory Thyroid nodule in malignant
conditions37200 38700 38700 41200
103906.39
S11
Thyroidectomy for solitary nodule in malignant
conditions38840 40340 40340 42840
104007.3.2
S11
Laparoscopic Biilateral adrenalectomy in malignant
conditions41080 41080 41080 41080
104107.22.2
S11 Unilateral Adrenalectomy in malignant conditions67140 68640 68640 71140
104216.51
S11
Maxillectomy + Orbital Exenteration in malignant
conditions55670 57470 57470 60470
1043 16.59 S11 Orbital Exenteration in malignant conditions 44130 46230 46230 49730
104417.33.2
S11
Laproscopic Right Hemicolectomy in malignant
conditions40000 40000 40000 40000
1045 17.35.1 S11 Hartman procedure in malignant conditions 71510 73010 73010 75510
104617.35.2
S11
Laparoscopic Left Hemicolectomy in malignant
conditions39930 39930 39930 39930
85
104718.3
S11 Sleeve Resection of Ear in malignant conditions47320 50320 50320 55320
1048 25.2.2 S11 Hemiglossectomy in malignant conditions 43370 45470 45470 48970
104925.3
S11
Total Glossectomy + Reconstruction in malignant
conditions(25.59)59360 60860 60860 63360
105026.32.1
S11 Parotidectomy any type in malignant conditions26210 27410 27410 29410
105126.32.2
S11
Excision of Submandibular gland in malignant
conditions26910 27810 27810 29310
1052 27.32 S11 Palatectomy any type in malignant conditions 40990 42190 42190 44190
1053
27.49.2
S11
Full Thickness Buccal Mucosal Resection &
Reconstruction in malignant conditions(27.59)
65120 66920 66920 69920
105429.3.1
S11
Excision of Parapharyngeal tumours in malignant
conditions48930 50430 50430 52930
105529.3.2
S11
Resection of Nasopharyngeal Tumor in malignant
conditions79310 82010 82010 86510
105630.4.1
S11 Laryngectomy Any Type in malignant conditions69690 71190 71190 73690
105730.4.2
S11
Laryngopharyngo Oesophagectomy in malignant
conditions99110 101210 101210 104710
105831.5
S11
Tracheal Resection in malignant conditions - CA
Thyroid/CA Trachea67700 69500 69500 72500
1059 32.4.1 S11 Sleeve Resection of Lung Cancer 110110 112210 112210 115710
1060 32.4.3 S11 Lobectomy for Carcinoma Lung 77910 78810 78810 80310
1061 32.5.2 S11 Pneumonectomy for Carcinoma Lung 81190 82090 82090 83590
1062 32.9.0 S11 Icd + pleurodesis 21490 23590 23590 27090
106332.29.1
S11 Solitary Lung Metastatectomy in malignant conditions69970 70870 70870 72370
106432.29.2
S11 Lung Metastatectomy multiple in malignant conditions78910 79810 79810 81310
106534.3.2
S11 Resection of mediastinal tumors in malignant conditions64660 65560 65560 67060
86
106634.3.4
S11
Superior Mediastinal Dissection+Sternotomy in
malignant conditions(77.31)61660 62560 62560 64060
106734.04
S11 Intercostal Drainage(Icd) in malignant conditions3310 3610 3610 4110
106834.4.1
S11
Surgical Resection of Soft tissue /Bone tumors of Chest
wall31200 32400 32400 34400
1069
34.4.2
S11
Surgical Resection and Reconstruction of Soft tissue
/Bone tumors of Chest wall in malignant conditions
71210 72410 72410 74410
1070
34.73.4
S11
Surgical Correction of Bronchopleural Fistula -
Transpleural BPF Closure in malignant conditions
75940 76840 76840 78340
1071 38.07 S11 IVC thrombectomy in malignant conditions 54260 54860 54860 55860
107238.7.2
S11
IVC filters for tumour thrombus in malignant
conditions58470 59070 59070 60070
107339.57.1
S11
Vascular reconstruction with synthetic graft in
malignant conditions71850 72450 72450 73450
107439.58
S11
Vascular reconstruction with auto graft in malignant
conditions77960 80060 80060 83560
1075 39.59 S11 Microvascular reconstruction 49990 54490 54490 61990
107639.97
S11
Vascular isolation and perfusion in malignant
conditions55450 57550 57550 61050
107740.4
S11 Neck Dissection Any Type in malignant conditions34000 35500 35500 38000
1078
40.5
S11
Retro Peritoneal Lymph Node Dissection RPLND As
Part Of Staging in malignant conditions
41800 43600 43600 46600
107940.24
S11
Uni-lateral Inguinal Block Dissection in malignant
conditions65350 66850 66850 69350
108040.24.3
S11
Bi-lateral Ilioinguinal block disection in malignant
conditions38550 40050 40050 42550
1081 40.51 S11 Axillary Dissection in malignant conditions 41320 43420 43420 46920
87
108240.53
S11
Bilateral Pelvic Lymph Node Dissection(Bplnd) in
malignant conditions41810 43610 43610 46610
1083
40.53.1
S11
Bilateral pelvic lymph node dissection(bplnd)(CA.
URINARY BLADDER)
41810 43610 43610 46610
1084
40.59.1
S11
Retro Peritoneal Lymph Node Dissection(Rplnd) (For
Residual Disease) in malignant conditions
403570 405670 405670 409170
108540.59.2
S11 Popliteal lymphadenectomy in malignant conditions30900 31800 31800 33300
1086 41.5.7 S11 Splenectomy in malignant conditions 43710 44610 44610 46110
108742.40.2
S11 Oesophagectomy Any Type in malignant conditions79810 81610 81610 84610
108842.42.1
S11 Transhiatal oesophagectomy in malignant conditions82110 84210 84210 87710
1089
42.42.2
S11
Oesophagectomy With Two Field Lymphadenectomy in
malignant conditions(40.59)
118810 120610 120610 123610
1090
42.42.3
S11
Oesophagectomy With Three Field Lymphadenectomy
in malignant conditions(40.59)
121510 123010 123010 125510
109142.65
S11 Substernal Gastric Bypass in malignant conditions51880 53980 53980 57480
1092 43.1.2 S11 Gastrostomy in malignant conditions 20000 20000 20000 20000
1093
43.7.3
S11
Laparoscopic mobilization of stomach with distal
gastrectomy with billroth i/ii anastomosis in malignant
conditions
101810 103610 103610 106610
1094
43.7.4
S11
Thoracoscopic Mobilization of Oesophagus +
Laparoscopic Mobilization of stomach + Gastric Pull-up
in malignant conditions
120600 121200 121200 122200
109543.89
S11 Gastrectomy Any Type in malignant conditions51200 52400 52400 54400
1096 44.39.1 S11 Gastro Jejunostomy in malignant conditions 50910 51810 51810 53310
88
109745.3.1
S11 Small Bowel Resection in malignant conditions49200 50400 50400 52400
1098 45.7 S11 Colectomy Any Type in malignant conditions 54100 56200 56200 59700
109945.93
S11 Ileotransverse Colostomy in malignant conditions60910 61810 61810 63310
1100 46.1.2 S11 Colostomy in malignant conditions 21210 22410 22410 24410
1101 46.2.1 S11 Ileostomy in malignant conditions 33210 33810 33810 34810
1102 46.32.2 S11 Jejunostomy in malignant conditions 31850 31850 31850 31850
1103
46.41
S11
Laparoscopic anterior/low resection with stapplers with
diversion covering ileostomy in malignant conditions
100000 100000 100000 100000
1104 46.51.1 S11 Ileostomy Closure in malignant conditions 25900 26800 26800 28300
1105 46.52.1 S11 Colostomy Closure in malignant conditions 25900 26800 26800 28300
110648.51
S11
Laparoscopic abdominoperineal resection in malignant
conditions100000 100000 100000 100000
110748.52
S11
Abdomino Perineal Resection (Apr) + Sacrectomy in
malignant conditions(77.99)61510 63010 63010 65510
110848.63.2
S11 Anterior Resection of rectum in malignant conditions51510 53010 53010 55510
110948.64
S11 Posterior Exenteration for Carcinoma Rectum61510 63010 63010 65510
1110 48.69 S11 Total Exenteration for Carcinoma Rectum 100110 102210 102210 105710
1111 50.2 S11 Hepatectomies in malignant conditions 101500 103000 103000 105500
111251.22
S11 Radical Cholecystectomy in malignant conditions79870 81670 81670 84670
111352.52
S11 Distal Pancreatectomy in malignant conditions101810 103610 103610 106610
111452.96
S11 Other Bypasses-Pancreas in malignant conditions52320 54120 54120 57120
111554.1
S11 Inoperable Laparotomy in malignant conditions37770 39270 39270 41770
111654.3.1
S11
Abdominal Wall Tumor Resection in malignant
conditions54290 56090 56090 59090
89
111754.3.3
S11
Resection With Reconstruction of Abdominal wall
Tumors in malignant conditions61110 63210 63210 66710
111854.4
S11
Resection Of Retroperitoneal Tumors in malignant
conditions61500 63000 63000 65500
111954.21
S11 Diagnostic Laparoscopy in malignant conditions22750 23350 23350 24350
1120 55.4.2 S11 Open Partial Nephrectomy 42110 44210 44210 47710
112155.5
S11
Laproscopic radical nephrectomy in malignant
conditions100000 100000 100000 100000
1122 55.5.4 S11 Radical Nephrectomy 52110 54210 54210 57710
1123
55.51.6
S11
Nephroureterectomy For Transitional Cell Carcinoma
Of Renal Pelvis in malignant conditions
66500 68000 68000 70500
112456.5
S11 Urinary Diversion in malignant conditions(56.6/56.7)64750 66250 66250 68750
1125 57.6.2 S11 Other Cystectomies in malignant conditions 89150 90650 90650 93150
1126 57.18 S11 Suprapubic cystostomy 18490 19990 19990 22490
112757.71.2
S11 Open radical cystectomy with Ilealconduit diversion102110 104210 104210 107710
1128 57.79.2 S11 Anterior Exenteration (CA. Urinary Bladder) 61500 63000 63000 65500
1129 57.79.3 S11 Total Exenteration (CA. Urinary Bladder) 76800 78600 78600 81600
113060.5.3
S11 Radical Prostatectomy in malignant conditions89050 91450 91450 95450
1131 60.29.4 S11 Channel TURP 41170 42970 42970 45970
1132 61.3.1 S11 Scrotectomy in malignant conditions 41740 45040 45040 50540
1133 62.3.3 S11 High Orchidectomy 22900 23800 23800 25300
1134 62.4 S11 Bilateral Orchidectomy 25150 26950 26950 29950
1135 64.3 S11 Emasculation in malignant conditions 41770 42970 42970 44970
1136 64.3.2 S11,S9 Total Penectomy 38780 40880 40880 44380
1137 65.0 S11 Surgery For Carcinoma Ovary Early Stage 33860 35960 35960 39460
113865.2.1
S11
Excision of Complex ovarian mass in malignant
conditions53080 56080 56080 61080
1139 65.2.2 S11 Ovarian cystectomy in malignant conditions 53030 56030 56030 61030
90
114065.4
S11
Unilateral Salpingo Oophorectomy in malignant
conditions31500 33000 33000 35500
114165.6
S11 Surgery For Carcinoma Ovary Advance Stage54110 56210 56210 59710
114265.6.1
S11
Bilateral Salpingo Oophorectomy in malignant
conditions30900 31800 31800 33300
114367.4
S11 Radical Trachelectomy in malignant conditions52370 54170 54170 57170
1144 68.6 S11 Radical Hysterectomy in malignant conditions 59570 63470 63470 69970
114568.8.1
S11
Laparoscopic pelvic exenteration in malignant
conditions120010 120010 120010 120010
1146 68.8.2 S11 Anterior Exenteration - Carcinoma Cervix 86840 88940 88940 92440
1147 68.8.3 S11 Posterior Exenteration - Carcinoma Cervix 67100 69200 69200 72700
114868.8.4
S11 Total Pelvic Exenteration - Carcinoma Cervix100100 102200 102200 105700
114968.8.5
S11 Supra Levator Exenteration - Carcinoma Cervix92100 94200 94200 97700
1150
68.41.1
S11
Laparoscopic extraFACIAL hysterectomy + multiple
biopsies + omentectomy in malignant conditions
47550 47850 47850 48350
1151
68.41.2
S11
Laparoscopic ExtraFACIAL Hysterectomy with
Bilateral pelvic node dissection in malignant conditions
48270 49470 49470 51470
1152 68.49 S11 Hysterectomy in malignant conditions 34000 35500 35500 38000
1153
68.69.1
S11
Total Abdominal Hysterectomy(Tah) + Bilateral
Salpingo Ophorectomy (Bso) + Bilateral Pelvic Lymph
Node Dissection (Bplnd) + Omentectomy in malignant
conditions
64240 66340 66340 69840
1154
68.69.2
S11
Radical Hysterectomy +Bilateral Pelvic Lymph Node
Dissection (Bplnd) + Bilateral Salpingo Ophorectomy
(Bso) / Ovarian Transposition in malignant conditions
52110 54210 54210 57710
91
115568.69.3
S11
Laparoscopic wertheim hysterectomy in malignant
conditions56220 59220 59220 64220
1156 70.4.1 S11 Radical Vaginectomy in malignant conditions 55260 57360 57360 60860
115770.4.2
S11 Radical Vaginectomy + Reconstruction(70.62)62650 64750 64750 68250
1158 71.5 S11 Vulvectomy in malignant conditions 47370 48870 48870 51370
115976.4
S11 Cranio Facial Resection in malignant conditions93110 95210 95210 98710
116076.5.3
S11
Resection of Lateral Temporal Bone in malignant
conditions49450 51250 51250 54250
116176.5.4
S11
Subtotal Resection of Temporal Bone in malignant
conditions73480 74980 74980 77480
116276.5.5
S11
Total Resection of Temporal Bone in malignant
conditions79510 81010 81010 83510
1163 76.31 S11 Hemimandibulectomy in malignant conditions 39270 40770 40770 43270
116476.31.3
S11 Marginal Mandibulectomy in malignant conditions48020 51920 51920 58420
116576.39
S11 Maxillectomy Any Type in malignant conditions32880 34980 34980 38480
116676.65.1
S11
Maxillectomy + Infratemporal Fossa Clearance in
malignant conditions67480 69280 69280 72280
1167 77.60.1 S11 Bone Resection in malignant conditions 44170 45370 45370 47370
116877.60.2
S11
Scalp tumour with calvarial resection in malignant
conditions62760 64860 64860 68360
116977.60.3
S11
Bone and Soft TissueTumors Amputation in malignant
conditions(83.49)29800 31300 31300 33800
1170
77.60.11
S11
Surgery (removal) for Bone/Soft tissue tumors-Without
Prosthesis in malignant conditions(83.49)
51280 53380 53380 56880
1171
77.60.12
S11
Surgery (removal) for Bone / Soft tissue tumors-With
Custom Made Prosthesis in malignant
conditions(83.49+84.40)
87610 89710 89710 93210
92
1172
77.60.13
S11
Surgery (removal) for Bone / Soft tissue tumors-With
Modular Prosthesis in malignant
conditions(83.49+84.40)
99510 101010 101010 103510
117377.81
S11 Shoulder Girdle Resection in malignant conditions56300 57500 57500 59500
1174 77.99 S11 Sacral Resection in malignant conditions 61510 63010 63010 65510
1175 83.49.1 S11 Soft tissue and bone tumour wide exision 16800 18600 18600 21600
117683.49.2
S11
Soft tissue And Bone tumors wide excision
reconstruction26800 28600 28600 31600
1177 83.49.3 S11 Head and Neck - Wide Excision 41080 42580 42580 45080
117884.09.1
S11 Forequarter Amputation in malignant conditions79140 80040 80040 81540
1179 84.19.2 S11 Hemipelvectomy in malignant conditions 80090 81290 81290 83290
118084.19.3
S11 Internal Hemipelvectomy in malignant conditions80850 82050 82050 84050
118184.56
S11 Curettage & Bone Cement in malignant conditions52630 54130 54130 56630
118285.4
S11 Mastectomy Any Type in malignant conditions30900 31800 31800 33300
1183 85.7.1 S11 Breast Reconstruction Surgery 43330 44830 44830 47330
1184 85.21 S11 Lumpectomy 3390 3690 3690 4190
118585.22.1
S11 Wide Excision - Breast in malignant conditions6060 6960 6960 8460
118686.4.1
S11 Skin Tumors Wide Excision in malignant conditions36550 38650 38650 42150
118786.4.2
S11
Skin Tumors wide Excision + Reconstruction in
malignant conditions(86.6/86.7)41800 43600 43600 46600
1188 86.4.3 S11 Wide local excision in malignant conditions 64610 65810 65810 67810
1189 86.4.5 S11 Wide local excision + reconstruction 67010 70610 70610 76610
119086.9
S11 Skin Tumors amputation in malignant conditions26190 27990 27990 30990
119186.63
S11
Reconstructon with Myocutaneous / Cutaneous Flap in
malignant conditions39280 42880 42880 48880
93
119286.89
S11
Composite Resection & Reconstruction - Head & Neck
in malignant conditions68960 72860 72860 79360
119399.85
S11
Isolated limb perfusion-hyperthermia in malignant
conditions62140 63340 63340 65340
1194 99.24 S12 Prostate Cancer with Hormonal Therapy 3720 3720 3720 3720
119599.25.1
S12
Chemotherapy for Breast Cancer with Adriamycin /
Cyclophosphamide (Ac)4210 4810 4810 5810
119699.25.2
S12
Chemotherapy for Bladder Cancer with Weekly
Cisplatin.2010 2010 2010 2010
1197
99.25.3
S12
Chemotherapy for Bladder Cancer with Methotrexate
Vinblastine Adriamycin Cyclophosphamide (Mvac)
6010 6010 6010 6010
119899.25.4
S12
Chemotherapy for Breast Cancer with 5- Fluorouracil A-
C (Fac)4210 4810 4810 5810
119999.25.5
S12
Chemotherapy for Non SMAL cell Lung Cancer with
Cisplatin/Etoposide (Iiib)7910 8810 8810 10310
120099.25.6
S12
Chemotherapy for Non SMAL cell Lung Cancer with
Erlotinib15010 15010 15010 15010
120199.25.7
S12
Chemotherapy for Non SMAL cell Lung Cancer with
GEFITINIB7080 7080 7080 7080
120299.25.8
S12
Chemotherapy for Non SMAL cell Lung Cancer with
Paclitaxel /Carboplatin10310 10610 10610 11110
120399.25.9
S12
Chemotherapy for Non SMAL cell Lung Cancer with
PEM + Cisplatin20310 20610 20610 21110
120499.25.10
S12
Chemotherapy for Oesophageal Cancer with
Cisplatin/5fu7410 8310 8310 9810
120599.25.11
S12
Chemotherapy for Gastric Cancer with 5-Fu Leucovorin
(Mcdonald Regimen)5610 6210 6210 7210
120699.25.12
S12 Chemotherapy for Vulval Cancer with Cisplatin/5-Fu5910 6810 6810 8310
1207 99.25.13 S12 Chemotherapy for Gastric Cancer with EOX 15610 16210 16210 17210
120899.25.14
S12
Chemotherapy for Gastric Cancer with
Gemcitabine+Oxaliplatin16310 16610 16610 17110
94
120999.25.15
S12
Chemotherapy for Gastric Cancer with Gemcitabine /
Cisplatin12610 13210 13210 14210
1210 99.25.16 S12 Ac (Ac Then T) 4510 5410 5410 6910
121199.25.17
S12 Chemotherapy for Gastric Cancer with Imatinib(CML)5640 5640 5640 5640
1212 99.25.18 S12 Chemotherapy for Gastric Cancer with Dcf 18310 18610 18610 19110
121399.25.19
S12 Chemotherapy for Colorectal Cancer with Monthly 5-Fu6410 7610 7610 9610
1214
99.25.20
S12
Chemotherapy for Colorectal Cancer with 5-
Fluorouracil-Oxaliplatin Leucovorin (Folfox) (Stage III)
Only
12410 13310 13310 14810
121599.25.21
S12
Chemotherapy for Colorectal Cancer with Capecitabine
+ bevacizumab (metastatic)8320 8920 8920 9920
1216
99.25.22
S12
Chemotherapy for Colorectal Cancer with Capecitabine
+ Oxalipantia (adjuvant) and metastatic
12610 13210 13210 14210
121799.25.23
S12 Chemotherapy for Vaginal Cancer with Cisplatin/5-Fu6900 7800 7800 9300
121899.25.24
S12 Chemotherapy for Colorectal Cancer with Capacitabine7310 7610 7610 8110
121999.25.25
S12
Chemotherapy for Bone Tumors with
Cisplatin/Adriamycin7610 8210 8210 9210
1220
99.25.26
S12
Chemotherapy for Bone Tumors - Hodgkin Lymphoma
disease with Adriamycin Bleomycin Vinblastine
Dacarbazine (Abvd)
5610 6210 6210 7210
1221
99.25.27
S12
Chemotherapy for Non Hodgkin Lymphoma with
Cyclophosphamide Adriamycin Vincristine Prednisone
(Chop)
5110 5710 5710 6710
122299.25.28
S12 Chemotherapy for Breast Cancer with Paclitaxel47410 48010 48010 49010
122399.25.29
S12
Chemotherapy for Non Hodgkin Lymphoma with R -
chop45310 45610 45610 46110
95
1224
99.25.30
S12
Chemotherapy for Multiple Myeloma with Vincristine,
Adriamycin,Dexamethasone(Vad)
4610 5210 5210 6210
122599.25.31
S12
Chemotherapy for Multiple Myeloma with
Thalidomide+Dexamethasone(Oral)5010 5010 5010 5010
122699.25.32
S12
Chemotherapy for Multiple Myeloma with Melphalan
Prednisone (Oral)4800 5100 5100 5600
122799.25.33
S12
Chemotherapy for Wilms Tumor with Siopwts
Regimen(Stages I-III)7310 7610 7610 8110
122899.25.34
S12
Chemotherapy for Ovarian cancer with Carboplatin /
Paclitaxel11310 11610 11610 12110
122999.25.35
S12
Chemotherapy for Hepatoblastoma operable with
Cisplatin -Adriamycin5310 5610 5610 6110
123099.25.36
S12
Chemotherapy for Childhood B cell Lymphoma with
variable regimen22110 24210 24210 27710
123199.25.37
S12
Chemotherapy for Neuroblastoma (Stages I-III ) with
Variable Regimen11510 13010 13010 15510
123299.25.38
S12
Chemotherapy for Neuroblastoma (Stages I-III ) PCV
(medulloblastoma)5610 6210 6210 7210
123399.25.39
S12
Chemotherapy for Retinoblastoma with
Carbo/Etoposide/Vincristine5610 6210 6210 7210
1234
99.25.40
S12
Chemotherapy for Breast Cancer with
Cyclophosphamide/ Methotrexate / 5fluorouracil (Cmf)
2010 2010 2010 2010
123599.25.41
S12 Chemotherapy for Histiocytosis with Variable Regimen5310 5610 5610 6110
1236
99.25.42
S12
Chemotherapy for Rhabdomyosarcoma with Vincristine-
Actinomycin-Cyclophosphamide(Vactc) Based Chemo
9600 10200 10200 11200
123799.25.43
S12
Chemotherapy for Ewings Sarcoma with Variable
Regimen5310 5610 5610 6110
123899.25.44
S12
Chemotherapy for Acute Myeloid Leukemia with
Induction Phase69010 78010 78010 93010
96
1239
99.25.45
S12
Chemotherapy for Ovarian cancer with Germ Cell
Tumor Bleomycin-Etoposide-Cisplatin (Bep)
8610 9210 9210 10210
124099.25.46
S12
Chemotherapy for Acute Myeloid Leukemia with
Consolidation Phase66310 72610 72610 83110
124199.25.47
S12
Chemotherapy for Acute Myeloid Leukemia with
Maintenance phase3000 3000 3000 3000
1242
99.25.48
S12
Chemotherapy for Acute Lymphoblastic Leukemia with
Induction 1st And 2nd Months
109000 118000 118000 133000
124399.25.49
S12
Chemotherapy for Acute Lymphoblastic Leukemia with
Induction 3rd, 4th, 5th11480 12380 12380 13880
124499.25.50
S12
Chemotherapy for Acute Lymphoblastic Leukemia with
Induction Maintenance12310 12610 12610 13110
1245 99.25.51 S12 Palliative Chemotherapy for unlisted Regimen 5310 5610 5610 6110
124699.25.52
S12 Chemotherapy for Breast Cancer with Tamoxifen Tabs505 505 505 505
124799.25.53
S12
Palliative And Supportive Therapy for terminally ill
cancer patient3610 4210 4210 5210
1248
99.25.54
S12
Chemotherapy for Acute Myeloid Leukemia with Xelox
Along With Adjuvant Chemotherapy Of As-I
12010 12010 12010 12010
1249
99.25.55
S12
Chemotherapy for Multiple myeloma with Zoledronic
Acid Along With Adjuvant Chemotherapy Of As-I
3310 3610 3610 4110
125099.25.56
S12
Chemotherapy for low risk Gestational trophoblast DS
with Weekly Methotrexate2310 2610 2610 3110
125199.25.57
S12
Chemotherapy for Multiple myeloma with Lenalidomide
dexa10010 10010 10010 10010
125299.25.58
S12
Chemotherapy for Multiple myeloma with
MPT(myeloma)5370 5370 5370 5370
125399.25.59
S12
Chemotherapy for Multiple myeloma with Imatinib
(GSIT)7010 7010 7010 7010
97
1254
99.25.60
S12
Chemotherapy for Febrile Neutropenia with 1st Line Iv
Antibiotics And Other Supportive Therapy ( Third
Generation Cephalosporin, Aminoglycoside Etc.,)
5310 5610 5610 6110
1255
99.25.61
S12
Chemotherapy for Febrile Neutropenia with 2nd Line Iv
Antibiotics And Other Supportive
Therapy(Carbapenems, Fourth Generation
Cephalosporins, Piperacillin, Anti-Fungal . Azoles Etc.,)
44210 48410 48410 55410
125699.25.62
S12
Chemotherapy for Chronic lymphoid leukemia with
Benadamustine16310 16610 16610 17110
125799.25.63
S12
Chemotherapy for Chronic lymphoid leukemia with
Chilorambucil3010 3010 3010 3010
125899.25.64
S12
Chemotherapy for Breast Cancer with Aromatase
Inhibitors1210 1210 1210 1210
125999.25.65
S12 Chemotherapy for Chronic lymphoid leukemia with IA10610 11210 11210 12210
126099.25.66
S12
Chemotherapy for Chronic lymphoid leukemia with
Imatinib(CML)7010 7010 7010 7010
126199.25.67
S12
Chemotherapy for low risk Gestational trophoblast DS
with Actinomycin5310 5610 5610 6110
126299.25.68
S12
Chemotherapy for Chronic lymphoid leukemia with
Sunitinib15010 15010 15010 15010
126399.25.69
S12 Chemotherapy With Temozolamide(brain tumours)10010 10010 10010 10010
126499.25.70
S12 Chemotherapy With Benadamustin -RITUXIMAB60010 60010 60010 60010
1265 99.25.71 S12 Chemotherapy With TIP(GCT 2nd line) 20010 20010 20010 20010
126699.25.72
S12 Chemotherapy for Breast Cancer with Docetaxel10310 10610 10610 11110
126799.25.73
S12
Chemotherapy for Cervical Cancer with Weekly
Cisplatin2010 2010 2010 2010
98
1268
99.25.78
S12
Chemotherapy for high risk Gestational trophoblast DS
with Etoposide-Methotrexate -Actinomycin /
Cyclophosphamide Vincristine (Ema-Co)
7610 8210 8210 9210
126999.25.83
S12
Chemotherapy for Testicular Cancer with Bleomycin
with Etoposide-Cisplatin (Bep)8610 9210 9210 10210
127099.25.84
S12
Chemotherapy Chemotherapy for Hepatoblastoma
operable with Sorafenib10010 10010 10010 10010
1271 99.25.85 S12 Chemotherapy with Capeiri(metastatic) 54550 55150 55150 56150
127299.25.86
S12 Chemotherapy with Capeox(adjuvant) and metastatic 7790 8390 8390 9390
127392.20.1
S13 Brachytherapy Intracavitary I. Ldr Per Application6760 7660 7660 9160
127492.20.2
S13 Brachytherapy Intracavitary II. Hdr Per Application3560 3860 3860 4360
127592.23.1
S13
Radical Treatment with Cobalt 60 External Beam
Radiotherapy26000 26000 26000 26000
127692.23.2
S13
Palliative Treatment with Cobalt 60 External Beam
Radiotherapy13300 13600 13600 14100
127792.23.3
S13
Adjuvant Treatment with Cobalt 60 External Beam
Radiotherapy15000 15000 15000 15000
127892.24.1
S13
Radical Treatment With Photons External Beam
Radiotherapy (on Linear Accelerator)65000 65000 65000 65000
127992.24.2
S13
Palliative Treatment With Photons External Beam
Radiotherapy (on Linear Accelerator)30500 35000 35000 42500
1280
92.24.3
S13
Adjuvant Treatment With Photons/Electrons /
(92.25)External Beam Radiotherapy (on Linear
Accelerator)
45000 45000 45000 45000
128192.27.1
S13 Brachytherapy Interstitial I. Ldr Per Application17540 18740 18740 20740
128292.27.2
S13
Brachytherapy Interstitial II. Hdr One Application And
Multiple Dose Fractions25900 26800 26800 28300
99
1283
92.29.1
S13
Specialized Radiation therapy- IMRT (Intensity
modulated radiotherapy) Upto 40 Fractions IMRT In 8
Weeks
115700 115700 115700 115700
1284
92.29.2
S13
Specialized Radiation therapy - 3DCRT(3-D
conformational radiotherapy)Upto 30 Fractions 3DCRT
In 6 Weeks
95000 95000 95000 95000
128592.29.3
S13
Specialized Radiation therapy - SRS/SRT Upto 30
Fractions In SRS/SRT 6 Weeks95000 95000 95000 95000
1286 01.24.3 S14 Skull base surgery 102400 104800 104800 108800
1287 02.01 S14 Surgical correction for Craniosynostosis 92070 96270 96270 103270
128804.3.2
S14
Surgical Correction of Nerve and Tendon Repair +
Vascular Repair (82.4+39.3)49790 52790 52790 57790
1289 04.76.2 S14 Sequalae of brachial plexus injuries 42680 44780 44780 48280
129004.76.3
S14 Conservative treatment for brachial plexus injuries10910 11810 11810 13310
129108.23
S14 Corrective surgery for Hyperchalonism elecanthes55440 58140 58140 62640
1292
08.52
S14
Tarsorrhaphy surgery to prevent exposure keratitis to
prevent loss or impairment of vision especially in facial
burns
10910 11810 11810 13310
1293 18.6 S14 Ear reconstruction 44890 47890 47890 52890
129418.71.1
S14 Reconstruction or prosthetic appliance for absent ear33020 36020 36020 41020
129518.79
S14 Surgical Correction of anamolies of Ear (cup & bat ears)28600 32200 32200 38200
1296 21.7.1 S14 Nose fractures with implants 47400 49800 49800 53800
1297 21.8 S14 Nose deformities with functional disturbances 61810 63610 63610 66610
1298 25.2.3 S14 Macroglossia Correction 47400 49800 49800 53800
1299 25.59 S14 Micrognathia - pierre robbinsequalae 68310 71610 71610 77110
1300 27.5 S14 Tessier¿s cleft 54800 58100 58100 63600
1301 27.53 S14 Palatal fistula Repair 43110 46410 46410 51910
1302 27.54.1 S14 Surgical Management Of Cleft Lip 30330 32730 32730 36730
1303 27.54.4 S14 Cleft lip nasal deformity correction 76710 78510 78510 81510
100
1304 27.63 S14 Secondary correction of cleft lip/palate 61810 63610 63610 66610
130539.7
S14 Surgical correction for Vascular malformations35960 38960 38960 43960
1306 58.45.6 S14 Hypospadias cripples 42680 45680 45680 50680
1307 58.45.7 S14 Epispadias / exstrophy 21990 22890 22890 24390
1308 63.8 S14 Vasovasalanastamosis 63000 66000 66000 71000
1309 64.44.1 S14 Penis reconstruction - pedicled 76510 78010 78010 80510
1310 64.44.2 S14 Penis reconstruction - micro vascular 126210 127410 127410 129410
1311 66.79 S14,S4 Tuboplasty/Open Tubal Recanalisation 30120 30720 30720 31720
1312 70.62 S14 Reconstructive procedures for vaginal atresia 40450 43450 43450 48450
131376.6.1
S14 Functional corrective surgery for sequel of facial injuries48710 49010 49010 49510
1314 76.6.2 S14 Orthognathic surgeries involving facial bones 82710 85410 85410 89910
131576.7.2
S14 Panfacial fractures combination with polytrauma456820 460120 460120 465620
1316 76.9 S14 Frontonasoethmoid fractures with implants 36240 38040 38040 41040
131776.41
S14
Surgical Correction of lid retraction with Tumour of
Mandible And Maxilla62450 66050 66050 72050
1318 76.41.1 S14 Corrcetion of lid retraction 27710 30410 30410 34910
1319 76.71.1 S14,S18 Zygoma/orbital fractures 76870 79270 79270 83270
1320 76.71.2 S14 Zygoma/ Orbital Fractures 80850 83250 83250 87250
1321 76.73.1 S14 Maxilla fractures lefort II 74420 76820 76820 80820
1322 76.73.3 S14,S18 Surgical Correction Of Fracture Lefort III 53490 55890 55890 59890
1323 76.73.5 S14 Maxilla fractures lefort III 76900 79300 79300 83300
132476.75.1
S14
Facial bone fractures - mandible fracture single with
implants53610 57210 57210 63210
132576.75.3
S14
Facial bone fractures - mandible fracture multiple with
implants76520 78020 78020 80520
1326 76.91 S14 Alveolar bone grafting with bone graft 32720 35120 35120 39120
1327 77.98 S14 Polydactyly Repair 31940 34640 34640 39140
1328 78.41.2 S14 Calvarial reconstruction 77710 80410 80410 84910
1329 82.1 S14 Treatment for trisser fingerenosynovitis(82.2) 32030 35330 35330 40830
101
1330
82.6.1
S14
Aplasia / hypoplasia / post traumatic loss of thumb for
reconstruction - conventional surgery
66540 69540 69540 74540
133182.6.2
S14
Aplasia / hypoplasia / post traumatic loss of thumb for
reconstruction - microsurgery86750 87950 87950 89950
133282.8
S14 Surgical Correction of Leprosy Reconstructive Surgery23520 25620 25620 29120
133382.48
S14
Surgical correction for Congenital Deformity of Hand
(Per Hand)26520 29520 29520 34520
1334 82.56.1 S14,S5 Tendon transfer procedure for wrist drop 34420 36820 36820 40820
1335 82.82 S14 Cleft hand / foot Correction 55530 58830 58830 64330
1336 82.84 S14 Mallet finger Surgery 29680 32680 32680 37680
1337 82.89 S14 Boutonnierie¿s deformity Repair 38900 42800 42800 49300
1338 82.99.1 S14 Finger tip injuries Repair 20430 20730 20730 21230
1339 83.0 S14 Compressive neuropathies 32793 34893 34893 38393
1340 83.3.1 S14 Treatment for supparativechondritis 33300 36600 36600 42100
1341 83.8 S14 Post cabg(sternal dehiscence/osdo Repair 44660 48560 48560 55060
1342 83.77 S14 Free functional muscle transfer 78220 79720 79720 82220
134383.84.2
S14
Corrective surgery for congenital deformities of foot
(per foot)53000 56000 56000 61000
1344 83.91.1 S14 Post Burn Contracture Surgeries - Mild 43070 47570 47570 55070
1345 83.91.2 S14 Post Burn Contracture Surgeries - Moderate 45090 49590 49590 57090
1346 83.91.3 S14 Post Burn Contracture Surgeries - Severe 51610 55210 55210 61210
134783.99.1
S14
Mgt of electrical burns with vital expossed with
flapcover59910 69810 69810 86310
134884.0
S14
Amputation of hand / fore arm / arm / foot / leg / thigh
with skin cover (84.1)41630 45230 45230 51230
1349 84.01.2 S14 Amputation of digit with skin cover(84.11) 26210 27410 27410 29410
1350 84.08.2 S14 Disarticulation through shoulder 39210 41910 41910 46410
1351 84.17.2 S14 Disarticulation through thigh 43300 46600 46600 52100
135284.22.1
S14
Reimplantation / revascularization - multiple digits per
finger86030 88130 88130 91630
102
135384.22.2
S14 Reimplantation / revascularization - single digit86620 89320 89320 93820
1354 84.23 S14 Reimplantation / revascularization - wrist 86620 89320 89320 93820
1355 84.25 S14 Toe transfer 87070 88570 88570 91070
1356 85.3.1 S14 Breast reduction for gynacomastia-male 40040 42440 42440 46440
1357 85.3.2 S14 Breast reduction for gigantomachia female 52310 54710 54710 58710
135885.7.2
S14
Post mastectomy breast reconstruction with flap and
tissue expandor87650 89450 89450 92450
1359 85.87 S14 Nipple areola reconstruction 41820 45420 45420 51420
136086.04
S14 Reduction Surgery For Filarial Lymphoedema44120 48620 48620 56120
136186.6.1
S14 Any raw area which needs skin grafting - mild<5%35910 39210 39210 44710
136286.6.2
S14
Any raw area which needs skin grafting - moderate 5-
10%40260 43860 43860 49860
136386.6.3
S14 Any raw area which needs skin grafting - major - >10 %54990 60090 60090 68590
136486.22.1
S14
Debridement and primary closure for avulsion
injuries(86.59)58300 61600 61600 67100
136586.22.2
S14
Debridement and skin grafting for avulsion
injuries(86.63)77110 79210 79210 82710
1366 86.28.1 S14 Surgical Management of 40% mixed burns 78510 92010 92010 114510
1367 86.28.2 S14 Surgical Management of 50% mixed burns 133260 151260 151260 181260
1368 86.28.3 S14 Surgical Management of 60% mixed burns 156040 178540 178540 216040
136986.28.4
S14 Surgical Management of above 60% mixed burns154080 176580 176580 214080
137086.59
S14
Eyelid injuries / avulsions - major (more than 25%
either in thickness or length)62110 64210 64210 67710
137186.59.1
S14
Nose injuries / avulsions- primary closure/ skin
graft(86.6)42100 44200 44200 47700
137286.59.2
S14
Ear injuries / avulsions - primary closure/ skin
graft(86.6)42110 44210 44210 47710
103
137386.59.3
S14
Lip injuries / avulsions - primary closure/ skin
graft(86.6)42110 44210 44210 47710
137486.63.1
S14 Sub mucosal fibrosis - surgical management with grafts62410 64810 64810 68810
1375
86.63.2
S14
Extensive degloving injuries / lacerations of the face in
rta / animal bites with exposure of vital structures
77410 79810 79810 83810
137686.70.1
S14
Surgical management for keloid & hypertrophic scar
requiring flap cover28020 30720 30720 35220
1377 86.70.2 S14 Pedicle flap 72260 74360 74360 77860
137886.70.3
S14 Sub mucosal fibrosis - surgical management with flap51720 55020 55020 60520
1379
86.73.1
S14
Flap cover for trauma of the hand / forearm / arm / foot /
leg / thigh etc., with exposure of the underlying vital
structures like tendons, nerves, vessels, bone, with or
without any fracture - flap division
62030 65030 65030 70030
138086.73.2
S14
Crush injury hand involving loss of skin and vital parts
requiring flap cover51640 54340 54340 58840
1381
86.74.1
S14
Flap cover for trauma of the hand / forearm / arm / foot /
leg / thigh etc., with exposure of the underlying vital
structures like tendons, nerves, vessels, bone, with or
without any fracture- flap insert
61810 63610 63610 66610
1382
86.74.2
S14
Micro vascular reconstruction flap (post burns, post
neoplastic, trauma, post traumatic, congenital)
92430 94530 94530 98030
1383 86.74.3 S14 Nose injuries / avulsions -flap cover 36150 38550 38550 42550
1384 86.74.4 S14 Ear injuries / avulsions - flap cover 38070 40770 40770 45270
1385 86.74.5 S14 Lip injuries / avulsions - flap cover 35990 38690 38690 43190
138686.74.6
S14 Scar revision procedures involving natural orifices31290 34590 34590 40090
104
138786.81.1
S14 Reconstructive surgery for facial palsy -micro vascular81460 82360 82360 83860
1388 86.81.2 S14 Surgical Correction of Hemifacial Atrophy 92230 96130 96130 102630
138986.81.3
S14 Reconstructive surgery for facial palsy -conventional82310 85010 85010 89510
1390 86.81.4 S14 Surgical Correction of hemifacial microsomia 84010 87010 87010 92010
1391
86.84
S14
Post traumatic squeal like contractures, severe
hypertrophy, unstable scars, non-healing ulcers etc.,
42070 45370 45370 50870
139286.85
S14
Surgical Management of Syndactyly of Hand For Each
Hand36650 40550 40550 47050
1393 86.93 S14 Tissue expansion -for functional purpose 48150 51150 51150 56150
1394 96.5.1 S14 Conservative management of 40% burns 69000 78000 78000 93000
1395 96.5.2 S14 Conservative management of 50% burns 692310 710310 710310 740310
1396 96.59.5 S14 Conservative management of 60% burns 213510 227010 227010 249510
1397
99.1
S14
Injection treatment - each sitting for
keloid,haemangioma, lymphangioma and vascular
malformations
22100 24200 24200 27700
139805.9
S15 Surgical Treatment (Up To) for Neuro Surgical Trauma151510 153010 153010 155510
1399 31.1 S15,S11 Tracheostomy 6230 6230 6230 6230
1400 34.32 S15 Thoracostomy 11120 11720 11720 12720
1401 34.71 S15 Surgical Treatment for Chest injuries 30610 32410 32410 35410
1402 54.7.1 S15 Surgical Management for Abdominal Injuries 257100 259200 259200 262700
1403 76.7.1 S15 Surgical treatement of fascial bone fracture 16500 18000 18000 20500
1404
78.10.3
S15
Surgical management with K-Wiring for Small bone
fractures (To Be Covered Along With Other Injuries
Only And Not As Exclusive Procedure)
5000 5000 5000 5000
1405
78.16
S15
Surgical Management of Patella Fracture (To Be
Covered Along With Other Injuries Only And Not As
Exclusive Procedure)
5000 5000 5000 5000
105
140678.59
S15 Surgical Correction Of Pelvic Bone Fractures.36700 38500 38500 41500
1407 79.0 S15 Surgical Correction Of Longbone Fracture 31510 33010 33010 35510
140879.6.1
S15
Surgical Management of Grade I&II Compound
Fractures16500 18000 18000 20500
140979.6.2
S15 Surgical Management of Grade III Compound Fractures27810 29610 29610 32610
141079.6.3
S15
Surgical Management of wound In Compound Fracture
with Flap cover(86.7)26610 27210 27210 28210
1411 83.6 S15 Management of Soft Tissue Injury 6810 7110 7110 7610
1412 84.11.2 S15 Toes Amputation 10600 11200 11200 12200
1413 84.91.1 S15 Amputation surgery 10600 11200 11200 12200
141493.9.2
S15
Intesive care management for Chest injuries in RICU
Rs. 4000/- per day35010 35010 35010 35010
141596.7.1
S15
Intesive care managementof Neuro Surgical Trauma in
Neuro Icu @Rs.4000/Day48000 48000 48000 48000
141696.7.2
S15
Intesive care management for Abdominal Injuries In
Surgical [email protected]/Day31010 34010 34010 39010
141796.59.1
S15
Medical management of Neurosurgical troma in general
ward @900/- day12300 13800 13800 16300
141896.59.2
S15
Conservative management of chest injuries in general
ward @900/- day5410 5410 5410 5410
141996.59.3
S15
Conservative management of Abdominal surgical in
general ward Major @900/- day6000 6600 6600 7600
142020.95
S16 Behind Ear Analogue Hearing Aid for Hearing impaired11830 13630 13630 16630
142120.96
S16 Cochlear Implant Surgery for children below 2 years523300 526600 526600 532100
1422
95.49.3
S16
Post Switch On Mapping/Initiation Of AVT And
Training Of Child And Mother - Second Installment
24200 28400 28400 35400
106
1423
95.49.4
S16
Post Switch On Mapping/Initiation Of AVT And
Training Of Child And Mother - Third Installment
24230 28430 28430 35430
1424
95.49.5
S16
Post Switch On Mapping/Initiation Of AVT And
Training Of Child And Mother - Fourth Installment
24230 28430 28430 35430
142595.49.7
S16 Initial mapping switch on for auditory verbal therapy61730 73430 73430 92930
1426
95.49.8
S16
Post switchon mapping /initiation of avt and Training of
child and mother - first installement
24230 28430 28430 35430
142784.40.1
S17
SYMES Prostheses - High Density Ppolyethylene
(HDP) / Polypropylene (PP)1000 1000 1000 1000
1428 84.40.2 S17 SYMES Prostheses - Fibre 1200 1200 1200 1200
1429 84.40.3 S17 SYMES Prostheses - Modular 1800 2100 2100 2600
143084.41.1
S17
Upper Limb - High Density Ppolyethylene (HDP) /
Polypropylene (PP)1800 2100 2100 2600
1431 84.41.2 S17 Upper Limb - Fibre 2100 2400 2400 2900
1432 84.41.3 S17 Upper Limb - Modular 3900 4500 4500 5500
143384.43.1
S17
Whole Upper Limb - High Density Ppolyethylene
(HDP) / Polypropylene (PP)1000 1000 1000 1000
1434 84.43.2 S17 Whole Upper Limb - Fibre 1200 1200 1200 1200
1435 84.43.3 S17 Whole Upper Limb - Modular 1400 1700 1700 2200
143684.44.1
S17
Above Elbow - High Density Ppolyethylene (HDP) /
Polypropylene (PP)1800 2100 2100 2600
1437 84.44.2 S17 Above Elbow - Fibre 2300 2600 2600 3100
1438 84.44.3 S17 Above Elbow - Modular 4900 5800 5800 7300
143984.45.1
S17
Above Knee - High Density Ppolyethylene (HDP) /
Polypropylene (PP)1800 2100 2100 2600
1440 84.45.2 S17 Above Knee - Fibre 2100 2400 2400 2900
1441 84.45.3 S17 Above Knee - Modular 4100 4700 4700 5700
1442 84.45.4 S17 Above Knee - Partial Foot Prostheses 500 500 500 500
107
1443
84.46.1
S17
Below Knee/ Petellar Tendon Bearing - High Density
Ppolyethylene (HDP) / Polypropylene (PP)
1200 1200 1200 1200
1444 84.46.2 S17 Below Knee/Petellar Tendon Bearing - Fibre 1800 2100 2100 2600
144584.46.3
S17 Below Knee/Petellar Tendon Bearing - Modular3600 4200 4200 5200
144684.47.1
S17
Through Knee - High Density Ppolyethylene (HDP) /
Polypropylene (PP)1800 2100 2100 2600
1447 84.47.2 S17 Through Knee - Fibre 2100 2400 2400 2900
1448 84.47.3 S17 Through Knee - Modular 4100 4700 4700 5700
1449 84.47.4 S17 HIP Disarticulation prostheses-HDP/PP 2800 3100 3100 3600
1450 84.47.5 S17 HIP Disarticulation prostheses- fibre 3600 4200 4200 5200
1451 84.47.6 S17 HIP Disarticulation prostheses- Modular 6900 7800 7800 9300
145221.7.2
S18
Surgical Management of Naso Ethmoidal Floor Fracture
- G.A19540 20740 20740 22740
1453 21.82 S18 Surgical Closure Oro-Nasal Fistula 7460 7460 7460 7460
145422.31.1
S18 Sinus Lift Procedure Without Grafting (22.39)17140 17140 17140 17140
145522.31.2
S18 Sinus Lift Procedure With Grafting (22.39/76.91)18730 18730 18730 18730
1456 23.01 S18 Simple Extraction Of Tooth 300 300 300 300
145723.2.1
S18 Application Of Pit & Fissure Sealants (Pedo)580 580 580 580
1458 23.2.2 S18 Amalgam Restoration Per Tooth 340 340 340 340
1459 23.2.3 S18 Temporary Filling Per Tooth 250 250 250 250
1460 23.2.4 S18 Tooth Coloured Restoration Per Tooth 460 460 460 460
146123.3.1
S18 Fabrication & Cementation Of Inlay & Onlay-Ceramic2630 2630 2630 2630
146223.3.2
S18 Fabrication & Cementation Of Inlay & Onlay-Metal1660 1660 1660 1660
1463 23.4.1 S18 Flouride Gel Application (Pedo) 1410 1410 1410 1410
1464 23.4.2 S18 Treatment Under Conscious Sedation 830 830 830 830
108
146523.4.3
S18 Vital Bleaching Procedure For 8 Upper Teeth1100 1100 1100 1100
146623.4.4
S18 Restoration With Composite Veneers (Pertooth)610 610 610 610
146723.4.5
S18
Preparation & Cementation Of Anterior All Ceramic
Laminates3220 3220 3220 3220
1468 23.4.6 S18 Atraumatic Restorative Treatment 770 770 770 770
1469 23.4.7 S18 Pulpotomy & Pulpectomy With Ssc 900 900 900 900
1470 23.5 S18 Management Of Avulsed Tooth 930 930 930 930
147123.6.1
S18 Surgical Placement Of Dental Implants Under L.A11230 11230 11230 11230
1472 23.6.2 S18 Treatment with Micro Implants (Each) 600 600 600 600
147323.6.3
S18 Surgical Placement Of Eye Prosthesis With Implants40450 40450 40450 40450
147423.6.4
S18 Surgical Placement Of Nose Prosthesis With Implants36040 36040 36040 36040
147523.6.5
S18 Surgical Placement Of Zygomatic Implants Under G.A130470 131370 131370 132870
1476 23.7.1 S18 Root Canal Treatment - Deciduous Tooth 890 890 890 890
1477 23.7.2 S18 Anterior Root Canal Treatment 2000 2000 2000 2000
1478 23.7.3 S18 Apicoectomy 2000 2000 2000 2000
147923.7.4
S18 Root Canal Treatment With Hemisection Of Root4010 4010 4010 4010
1480 23.7.5 S18 Posterior Root Canal Treatment 2000 2000 2000 2000
1481 23.7.6 S18 Apicoectomy With Grafting (76.91) 2220 2220 2220 2220
1482 23.11 S18 Root Resection 1930 1930 1930 1930
148323.19.1
S18 Extraction Of III Molar / Impacted Toot Under L.A2000 2000 2000 2000
1484 23.19.2 S18 Surgical Extraction Of Tooth 1490 1490 1490 1490
148523.19.3
S18 Extraction Of Deep Bony Impacted Tooth Under G.A.10000 10000 10000 10000
148623.41.1
S18 Preparation And Cementation Of Acrylic Crown420 420 420 420
109
148723.41.2
S18
Fabrication & Cementation Of Metal Ceramic Crown
(Per Unit)1350 1350 1350 1350
148823.41.3
S18
Preparation & Cementattion Of Anterior All Ceramic
Crown3060 3060 3060 3060
148923.41.4
S18 Placement Of Stainless Steel Crown (Per Tooth)690 690 690 690
149023.41.5
S18
Fibre Post & Core Restoration With Anterior All
Ceramic Crown (23.4)3550 3550 3550 3550
149123.41.6
S18
Fibre Post & Core Restoration With Metal Ceramic
Crown (23.4)2270 2270 2270 2270
149223.41.7
S18
Metal Post & Core Restoration With Metal Ceramic
Crown (23.4)2290 2290 2290 2290
149323.42.1
S18 Placement Of Fixed Habit Breaking Appliances2060 2060 2060 2060
1494 23.42.2 S18 Tretament With Expansion Plate 1640 1640 1640 1640
149523.43.1
S18
Fabrication & Insertion Of Removable Habit Breaking
Appliance1520 1520 1520 1520
149623.43.2
S18
Fabrication & Insertion Of Removable Appliance
(Upper / Lower )1580 1580 1580 1580
149723.43.3
S18
Fabrication & Insertion Of Removable Functional
Appliance2850 2850 2850 2850
149823.43.4
S18
Fabrication & Insertion Of Removable Partial Denture-
Single Tooth550 550 550 550
149923.43.5
S18
Fabrication & Insertion Of Removable Retainers-Each
Arch690 690 690 690
150023.43.6
S18
Fabrication & Insertion Of Fixed Space Maintainers /
Space Retainer1280 1280 1280 1280
150123.43.7
S18
Fabrication & Insertion Of Removable Space
Maintainers (Pedo)1000 1000 1000 1000
1502 23.43.8 S18 Treatment With Inclined Plane 890 890 890 890
150323.43.9
S18 Fabrication Of Occlusal Night Guard (Hard Or Soft)1000 1000 1000 1000
1504 24.1 S18 Operculectomy 440 440 440 440
110
1505 24.2.1 S18 Sub Gingival Curretage Per Quadrant 830 830 830 830
1506 24.2.2 S18 Gingivectomy (Per Quadrant) 1170 1170 1170 1170
1507 24.2.3 S18 Gingivectomy-Single Tooth 620 620 620 620
1508 24.2.4 S18 Flap Surgery - Single Tooth 740 740 740 740
1509 24.2.5 S18 Crown Lengthening Procedure (24.6) 950 950 950 950
1510 24.2.6 S18 Root Coverage Procedure (Per Tooth) 1640 1640 1640 1640
1511 24.3.1 S18 Osseous Surgery 3470 3470 3470 3470
1512 24.3.2 S18 Flap Surgery (Per Quadrant) 1720 1720 1720 1720
151324.3.3
S18 Flap Surgery With Bone Grafting (Per Quadrant)2080 2080 2080 2080
1514 24.3.4 S18 Free Gingival Graft-Gum Surgery 2250 2250 2250 2250
1515 24.3.5 S18 Gingival De Pigmentation Procedure 1530 1530 1530 1530
1516 24.3.6 S18 Local Drug Delivery -Periodontal Treatments 1010 1010 1010 1010
151724.4.1
S18
Pre Prosthetic Surgery - Ridge Augmentation(Full
mouth)20860 20860 20860 20860
151824.4.2
S18 Resection And Reconstruction (Tumor) (76.46)21460 22060 22060 23060
151924.4.3
S18 Surgical Managemant Of Cyst(<2.5 cm) Under L.A.1720 1720 1720 1720
1520 24.4.4 S18 Excision Of Growth Under L.A. 3330 3330 3330 3330
152124.4.5
S18 Surgical Managemant Of Cyst(> 2.5 cm) Under G.A.10680 10680 10680 10680
1522 24.4.6 S18 Excision Of Growth Under G.A. 14840 14840 14840 14840
152324.4.7
S18 Excision Of Precancerous Lesions Under L.A6240 6240 6240 6240
152424.4.8
S18 Excision Of Precancerous Lesions Under G.A10470 10470 10470 10470
152524.4.9
S18
Excision Of Precancerous Lesions With Grafting
(76.91)13230 13230 13230 13230
1526 24.4.10 S18 Surgical Excision With Grafting (76.91) 22120 23320 23320 25320
1527 24.4.11 S18 Enucleation Of Cyst/ Tumor 10480 10480 10480 10480
1528 24.5.1 S18 Alveoloplasty (Quadrant) 690 690 690 690
111
152924.7.1
S18
Rapid Maxillary Expansion With Hyrax Screwifr Palatal
Expanders4720 4720 4720 4720
153024.7.2
S18 Treatment With Temporary Anchorage Devices1930 1930 1930 1930
1531 24.7.3 S18 Treatment With Fixed Functional Appliances 3580 3580 3580 3580
153224.7.4
S18 Fixed Orthodontics Treatment-Ceramic Braces5140 5140 5140 5140
1533 24.7.5 S18 Fixed Orthodontics Treatment-Metal Braces 10680 10680 10680 10680
1534 24.7.6 S18 Treatment With Fixed Retainers 1020 1020 1020 1020
153524.7.7
S18
Fabrication Of Acrylic Splinting Arch ( In Auto
Polymerizing Acrylic)1050 1050 1050 1050
153624.7.8
S18 Fabrication & Insertion Of Feeding Plate (Acrylic)920 920 920 920
153724.7.9
S18 Fabrication & Insertion Of Obturator -Acrylic850 850 850 850
153824.7.10
S18
Fabrication & Insertion Of Obturator & Speech Bulb-
Acrylic1990 1990 1990 1990
1539 24.9 S18 Relining / Rebasing of Complete Denture 930 930 930 930
1540 24.91.1 S18 Vestibuloplasty - Maxilla / Mandible- G.A. 26050 27850 27850 30850
1541 24.91.2 S18 Vestibuloplasty - Maxilla / Mandible- L.A 13220 13220 13220 13220
1542 24.91.3 S18 Sulcus Extention Procedure 2340 2340 2340 2340
1543 24.99.1 S18 Surgical Placement Of Nose Prosthesis 2040 2040 2040 2040
1544 24.99.2 S18 Surgical Placement Of Ear Prosthesis 2180 2180 2180 2180
1545 25.92 S18 Frenectomy 660 660 660 660
1546 26.29.1 S18 Surgical Removal Of Sialolith -L.A. 25000 25000 25000 25000
1547 26.29.2 S18 Surgical Removal Of Sialolith -G.A. 35910 36810 36810 38310
154827.1
S18 Incision & Drainage of Simple Abscess (per Tooth)660 660 660 660
154927.2
S18 Incision & Drainage of Facial Abscess Under G.A8310 8610 8610 9110
155027.3
S18 Incision & Drainage of Facial Abscess Under L.A3500 3500 3500 3500
112
155176.01
S18
Sequestrectomy & Saucerization Of Osteomyelitis Of
Maxilla & Mandible30000 30000 30000 30000
1552 76.31.2 S18 Marginal Mandibulectomy- Osteomyelitis 21180 21480 21480 21980
1553 76.31.5 S18 Coronoidectomy 11990 12290 12290 12790
1554 76.64.1 S18 Segmental Osteotomy Mandible 13880 13880 13880 13880
1555 76.64.2 S18 Vertical Sub Sigmoid Osteotomy 7470 7470 7470 7470
155676.64.3
S18 Bilateral Sagittal Split Osteotomy Of Mandible (BSSO)30070 30970 30970 32470
155776.65
S18
Anterior Segmental Osteotomy - Maxilla / Mandible
(ASO)24690 26490 26490 29490
1558 76.65.2 S18 Segmental Osteotomy Maxilla 13700 13700 13700 13700
155976.73.2
S18
Surgical Management Of Combined Fracture Of
Mandible & Maxilla (76.74/76.75/76.76)33370 34870 34870 37370
1560 76.74.1 S18,S14 Surgical Correction Of Fracture Lefort II 40370 42770 42770 46770
156176.74.2
S18
Open Reduction & Internal Fixation Of Jaw Fractures
Under G.A. (76.76)12810 13110 13110 13610
156276.75.2
S18
Closed Reduction & Immobilisation Of Mandibular
Fracture Under L.A.1880 1880 1880 1880
156376.75.4
S18,S14 Surgical Correction Of Fracture Lefort I -G.A. (76.76)39340 40840 40840 43340
156476.93.1
S18
Surgical Management Of TMJ Dislocation (G.A.)
(76.94)15310 15610 15610 16110
1565 78.3.1 S18 Distraction Osteogenesis- Mandible- G.A. 37400 38600 38600 40600
1566 78.3.2 S18 Distraction Osteogenesis- Maxilla- G.A. 37590 38790 38790 40790
1567 78.3.3 S18 Alveolar Distraction L.A. 5140 5140 5140 5140
156881.2
S18 Surgical Management Of TMJ Ankylosis (G.A.)17920 19420 19420 21920
156986.3.1
S18
Radio Frequency & Thermo Coagulaton For Treatment
Of Trigeminal Neuralgia15630 15630 15630 15630
1570 86.3.2 S18 Cryosurgery In Dental Procedures 10830 10830 10830 10830
1571 86.3.4 S18 Laser Treatment For Precancerous Lesions 1070 1070 1070 1070
1572 93.23.1 S18 Chin Cup Thepary 4370 4370 4370 4370
1573 93.23.2 S18 Head Gear Therapy 4150 4150 4150 4150
113
1574 93.23.3 S18 Face Mask Therapy 3450 3450 3450 3450
157593.55.1
S18
Intermaxillary Fixation(IMF) For Alveolar Fractures
Under L.A.4180 4180 4180 4180
1576 93.55.2 S18 Splinting Of Teeth Under L.A(24.7) 950 950 950 950
1577 95.34 S18 Surgical Placement Of Eye Prosthesis 2490 2490 2490 2490
157896.54.1
S18 Oral Prophylaxis - Extrinsic Stains (Upper/ Lower)430 430 430 430
1579 96.54.2 S18 Oral Prophylaxis - Calculi (Upper/ Lower) 560 560 560 560
158099.97.1
S18 Fabrication & Insertion Of Complete Denture (U & L)5670 5670 5670 5670
158199.97.2
S18
Fabrication & Insertion Of Complete Denture (Upper /
Lower)3180 3180 3180 3180
158299.97.3
S18 Fabrication & Insertion of Soft Liner Denture7480 7480 7480 7480
1583
99.97.4
S18
Fabrication & Insertion Of Cast Partial Dentures
Framework With Precission Attachments
9800 9800 9800 9800
158499.97.5
S18 Fabrication Of Over Dentures Without Attachments6030 6030 6030 6030
158599.97.6
S18
Fabrication Of Over Dentures -Implant Supported (2
units)26380 26380 26380 26380
158699.97.7
S18 Fabrication Of Over Dentures With Attachments11200 11200 11200 11200
158799.97.8
S18
Fabrication & Insertion Of Cast Partial Dentures
Framework Per Unit4830 4830 4830 4830
1588G50.0
S18 Medical Management Of Trigeminal Neuralgia8000 8000 8000 8000
1589 K12.3 S18 Medical Management of Oral Ulcers 5000 5000 5000 5000
1590K13.5.A
S18 Hesters Opener Procedure - Management of OSMF25000 25000 25000 25000
1591K13.5.B
S18
Combination Of Intralesional Injection For Oral
Submucous Fibrosis3000 3000 3000 3000
1592 K13.5.C S18 Medical Management of OSMF 3000 3000 3000 3000
114
1593 K13.21.A S18 Medical Management of Leukoplakia 3000 3000 3000 3000
1594
K13.21.B
S18
Medical Management of Premalignant Lesions And
Conditions (Antioxidant Therapy) ( K13.29/K13.5)
5000 5000 5000 5000
1595 K73.9.B S18 Chronic hepatitis, unspecified 15020 17120 17120 20620
1596 L43 S18 Medical Management Of Lichen Planus 1110 1110 1110 1110
1597M26.69
S18
Mdical Management Of TMJ Dysfunction Syndrome
(76.94)5000 5000 5000 5000
1598M79.1
S18
Medical Management Of Myo FACIAL Pain
Dysfunction Syndrome (MPDS)5000 5000 5000 5000
1599J20.0
M1
Medical Management of Acute Bronchitis with
Pneumonia and Respiratory Failure61500 63000 63000 65500
1600J44.0
M1
Medical Management of COPD with Respiratory
Failure (Infective Exacerbation)81800 83600 83600 86600
1601J46
M1
Medical Management of Acute Severe Asthma With
Acute Respiratory Failure51800 53600 53600 56600
1602 J80.A M1 Medical Management of ARDS 102100 104200 104200 107700
1603J80.B
M1,M4
Medical Management of ARDS with Multi Organ
failure (R65.1)115000 115000 115000 115000
1604J80.C
M1,M4
Medical Management of ARDS with DIC (Blood &
Blood Products) (D65)143010 146010 146010 151010
1605 R57.2 M1,M4 Intensive care management of Septic Shock 62990 65990 65990 70990
1606T63
M1
Medical Management of Poisioning Requiring
Ventilatory Assistance51510 53010 53010 55510
1607A01.A
M2,M4
Medical Management of Typhoid And Paratyphoid
Fevers21800 23600 23600 26600
1608A09.9
M2 Medical Management of Acute Gastroenteritis15900 16800 16800 18300
1609 A17.0 M2 Medical Management of Tb Meningitis 32400 34800 34800 38800
1610 A90 M2 Medical Management of Dengue Fever 26500 28000 28000 30500
1611A91
M2 Medical Management of Dengue Haemorrhagic Fever36800 38600 38600 41600
1612 B50 M2 Medical Management of Falciparum Malaria 11510 13010 13010 15510
115
1613 B50.0 M2 Medical Management of Cerebral Malaria 27110 29210 29210 32710
1614 B51 M2 Medical Management of Vivax Malaria 11510 13010 13010 15510
1615D46
M2 Medical Management of Myelodysplastic Syndromes33000 36000 36000 41000
1616D56.1
M2,M4
Medical Management of Chelation Therapy For
Thalassemia Major16200 17400 17400 19400
1617 D61.0 M2 Medical Management of Pancytopenia 31500 33000 33000 35500
1618D64.9.B
M2
Medical Management of Anaemias (Less Than 7 Gms)/
Heart Failure31200 32400 32400 34400
1619D66
M2 Medical Management of Hemophilia (D67/D68.0)61500 63000 63000 65500
1620D69.5
M2
Medical Management of Thrombocytopenia With
Bleeding Diathesis32100 34200 34200 37700
1621D69.9
M2 Medical Management of Other Coagulation Disorders45200 46400 46400 48400
1622 G72.3 M2 Medical Management of Periodic Paralysis 16190 17390 17390 19390
1623G93.4
M2 Medical Management of Metabolic Encephalopathy36800 38600 38600 41600
1624I00.1
M2,M5 Medical Management of Acute Rheumatic Fever17110 19210 19210 22710
1625I13.9
M2,M4 Medical Management of Hypertensive Emergencies21800 23600 23600 26600
1626R40.2
M2
Medical Management of Metabolic Coma Requiring
Ventilatory Support37400 39800 39800 43800
1627T63.0
M2,M4
Medical Management of Snake Bite Requiring
Ventilator Support63010 66010 66010 71010
1628T63.2.A
M2
Medical Management of Scorpion Sting Requiring
Ventilator Support28010 31010 31010 36010
1629 A35 M3 Medical Management of Severe Tetanus 29480 30980 30980 33480
1630A36.A
M3 Medical Management of Complicated Diphtheria28900 31000 31000 34500
1631B45.1
M3 Medical Management of Cryptococcal Meningitis31900 34000 34000 37500
116
1632A01.B
M4
Medical Management of Enteric Fever Complicated in
Paediatric patient12230 13730 13730 16230
1633A09.0.B
M4
Medical Management of Acute gastritis in Paediatric
patient9830 11330 11330 13830
1634A15
M4
Medical Management of Pulmonary koch's with
complications in Paediatric patient11500 13000 13000 15500
1635A17.A
M4
Medical Management of Neuro Tuberculosis in
Paediatric patient17400 19800 19800 23800
1636
A17.B
M4
Medical Management of Neuro Tuberculosis With
Ventilation in Paediatric patient
26800 28600 28600 31600
1637A33
M4 Medical Management of Tetanus in Paediatric patient16550 19550 19550 24550
1638A36.B
M4 Medical Management of Diphtheria in Paediatric patient18600 22200 22200 28200
1639A99
M4
Medical Management of Viral haemmaragic fever with
complicatons in Paediatric patient27110 29210 29210 32710
1640B19
M4
Medical Management of Viral hepatitis in Paediatric
patient13000 16000 16000 21000
1641D59.1
M4
Medical Management of Auto immune hemolytic
anemia in Paediatric patient17710 20410 20410 24910
1642D64.9.A
M4
Medical Management of Anemia Of Unknown Cause in
Paediatric patient11500 13000 13000 15500
1643
D68.0
M4
Medical Management of Haemophillia Including Von
Willibrands disease in Paediatric patients
22100 24200 24200 27700
1644D69.0
M4
Medical Management of Henoch - schonlein purpura in
Paediatric patient17380 20380 20380 25380
1645
D69.3
M4
Medical Management of Idiopathic thrombocytopenic
purpura in Paediatric patient
28600 32200 32200 38200
1646E10.1
M4
Medical Management of Diabetic Ketoacidosis in
Paediatric patient30000 30000 30000 30000
117
1647E55.0
M4 Medical Management of Rickets in Paediatric patient9200 10400 10400 12400
1648
G04.2.A
M4
Medical Management of Meningo- Encephalitis in
Paediatric patients (Non Ventilated)
40000 40000 40000 40000
1649
G04.2.B
M4
Medical Management of Meningo- Encephalitis in
Paediatric patients (Ventilated)
60000 60000 60000 60000
1650G05
M4
Medical Management of Encephalitis / Encephalopathy
in Paediatric patient28300 31600 31600 37100
1651 G41 M4 Medical Management of Status Epilepticus 23030 24530 24530 27030
1652
G41.9
M4
Medical Management of Convulsive Disorders/Status
Epilepticus (Fits)in Paediatric patient
11800 13600 13600 16600
1653G46
M4
Medical Management of Stroke Syndrome in Paediatric
patient24200 28400 28400 35400
1654G71.0
M4
Medical Management of Muscular dystrophy in
Paediatric patient18000 21000 21000 26000
1655G81.0
M4
Medical Management of Acute flaccid paralysis in
Paediatric patient37400 39800 39800 43800
1656I05
M4
Medical Management of Rheumatic heart disease in
Paediatric patient17100 19200 19200 22700
1657I33.0
M4,M5 Medical Management of Infective Endocarditis29200 33400 33400 40400
1658I40
M4
Medical Management of Severe Myocarditis in
Paediatric patient40010 40010 40010 40010
1659I41.1
M4
Medical Management of Viral Myocarditis in Paediatric
patient22100 24200 24200 27700
1660I50.9.D
M4 Acquired heart disease with congestive cardiac failure17100 19200 19200 22700
1661I62.9
M4
Medical Management of Intra Cranial Bleed in
Paediatric patient50000 50000 50000 50000
118
1662J05.0
M4 Medical Management of Croup in Paediatric patient11500 13000 13000 15500
1663J06.0
M4
Medical Management of Acute pharyngo tonsillitis in
Paediatric patient6200 7400 7400 9400
1664
J18.0.A
M4
Medical Management of Acute Broncho Lobar
pneumonia With Empyema/ Pleural Effusion in
Paediatric patients(J18.1/J43/J90)
29200 33400 33400 40400
1665
J18.0.B
M4
Medical Management of Acute Broncho Lobar
pneumonia With Pyo Pneumothorax in Paediatric
patient(J18.1/J86/J93)
24200 28400 28400 35400
1666
K72.0.A
M4
Medical Management of Acute Hepatitis With Hepatic
Encephalopathy in Paediatric patient
50000 50000 50000 50000
1667K76.6
M4
Medical Management of Portal hypertension in
Paediatric patient18300 21600 21600 27100
1668K85.A
M4,M12 Medical management of Acute Pancreatitis (Mild)52110 54210 54210 57710
1669K92.2.A
M4
Medical Management of Acute Gastro Intestinal Bleed
in Paediatric patients25000 25000 25000 25000
1670M05
M4,M9,M1
0
Medical Management of Rheumatoid Arthritis
Requiring Hospitalisation33010 36010 36010 41010
1671N00.1
M4
Medical Management of Acute glomerulonephritis in
Paediatric patient11800 13600 13600 16600
1672
N04.A
M4
Medical Management of Steroid Resistant Nephrotic
Syndrome Complicated Or Resistant in Paediatric
patients
29200 33400 33400 40400
1673
N04.B
M4
Medical Management of Nephrotic syndrome-non
steriod resistant in Paediatric patient
18300 21600 21600 27100
1674N17.9.A
M4
Medical Management of Acute Renal Failure in
Paediatric patient20000.13 20000.13 20000.13 20000.13
1675N17.9.D
M4
Medical Management of Acute Renal Failure With
Dialysis in Paediatric patients43000 46000 46000 51000
119
1676N25.8
M4,M6 Medical Management of Renal Tubular Acidosis19920 21120 21120 23120
1677N39.0.A
M4,M6 Medical Management of UTI (Urinary Tract Infection)18710 20510 20510 23510
1678
N39.0.B
M4
Medical Management of Urinary Tract Infection With
Complications Like Pyelonephritis And Renal Failure in
Paediatric patient(N13.6/N17.9)
16570 18970 18970 22970
1679
P00.1.A
M4
Newborn (suspected to be) affected by maternal renal
and urinary tract diseasesNewborn (suspected to be)
affected by maternal conditions classifiable to N00-N39
19060 22060 22060 27060
1680
P22.0.A
M4
Medical Management of Severe Hyaline Membrane
disease with clinically evident septicemia ,
Hyperbilirubinemia in 30 To 34 Weeks Preterm baby
not requiring ventilatory support. (A41.9+P59.9)
51910 51910 51910 51910
1681
P22.0.B
M4
Medical Management of severe Hyaline Membrane
Disease, Culture Positive Sepsis,Perinatal asphyxia,
Hyper bilirubinemia in above 34 Weeks Preterm baby
not requiring ventilatory support. (A41.9+P59.9)
35000 35000 35000 35000
1682
P22.0.C
M4
Medical Management of severe Hyaline Membrane
Disease, Culture Positive Sepsis,Perinatal asphyxia,
Hyper bilirubinemia in above 34 Weeks Preterm baby
requiring ventilatory support. (A41.9+P59.9+P21.9)
50000 50000 50000 50000
120
1683
P22.0.D
M4
Medical Management of Patent Ductus Arteriosus/
Severe Hyaline Membrane disease with clinically
evident septicemia, Hyperbilirubinemia requiring
ventilatory support in 30 To 34 Weeks Preterm baby.
(A41.9+P59.9+Q25.0)
60000 60000 60000 60000
1684
P22.0.E
M4
Medical management of pre-term Baby of <30 weeks
severe Hyline Membrance Disease septi cemia culture
positive,Hyperbili rubinemia patient Ductus Arteriosus
requiring Mechanical Ventilation.
199960 199960 199960 199960
1685
P22.9.A
M4
Medical Management of Severe respiratory distress in
paediatric patient not requiring ventilatory support
51910 51910 51910 51910
1686
P22.9.B
M4
Medical Management of Severe respiratory distress in
paediatric patient requiring ventilatory support.
20000 20000 20000 20000
1687Q21
M4
Medical Management of Cyanotic heart disease in
Paediatric patient12100 14200 14200 17700
1688
Q24.9.A
M4
Medical Management of Congenital Heart Disease
With Congestive Cardiac Failure in Paediatric patients
17100 19200 19200 22700
1689
Q24.9.B
M4
Medical Management of Congenital Heart Disease
With Infection (Non Ventilated) in Paediatric patient
25000 25000 25000 25000
1690
Q24.9.C
M4
Medical Management of Congenital Heart Disease
With Infection And Cardiogenic Shock (Ventilated) in
Paediatric patients
50000 50000 50000 50000
1691
R56.0
M4
Medical Management of Febrile Seizures (Atypical-
Mechanical Ventilated) in Paediatric patients
25000 25000 25000 25000
1692R57.0.A
M4
Medical Management of Cardiogenic Shock in
Paediatric patients50000 50000 50000 50000
121
1693
T63.2.B
M4
Medical Management of Scorpion Sting With
Myocarditis And Cardiogenic Shock Requiring
Ventilatory Assistance in Paediatric patients
40000 40000 40000 40000
1694
T65.9
M4
Medical Management of Poison Ingestion/ Aspiration
Requiring Ventilatory Assistance in Paediatric patients
40000 40000 40000 40000
1695I10.A
M5
Medical Management of Accelerated Systemic
Hypertension2890 2890 2890 2890
1696I20.8
M5 Medical Management of CAD - Chronic Stable Angina8300 8600 8600 9100
1697I21.9.A
M5 Management Of Acute MI without Angiogram10600 11200 11200 12200
1698 I21.9.B M5 Management Of Acute MI With Angiogram 30600 31200 31200 32200
1699I21.9.C
M5
Medical Management of Acute MI-AHF-Not Requiring
Ventilator25900 26800 26800 28300
1700
I21.9.D
M5
Medical Management of CAD-Acute MI With
Pulmonary Edema – Requiring Ventilator
35900 36800 36800 38300
1701I21.9.E
M5
Medical Management of Acute MI With Cardiogenic
Shock30600 31200 31200 32200
1702I21.9.F
M5
Medical Management of Acute MI Requiring IABP
Pump55900 56800 56800 58300
1703I26
M5 Medical Management of Pulmonary Embolism35600 36200 36200 37200
1704I30
M5
Medical Management Of Pericardial Effusion-Without
Aspiration5300 5600 5600 6100
1705I31.3
M5
Medical Management of Pericardial Effusion,
Tamponade without Aspiration16600 17200 17200 18200
1706I49.9.A
M5 Medical Management of Complex Arrhythmias140600 141200 141200 142200
1707 I49.9.B M5 Ablation Therapy for Simple Arrythmias 91600 92200 92200 93200
122
1708I49.9.C
M5 Medical Management Of Simple Arrhythmias8300 8600 8600 9100
1709I50.0.A
M5,M4
CHF-Acute Decompensation-Medical Management
Without Ventilator10300 10600 10600 11100
1710I50.0.B
M5
CHF-Acute Decompensation-Medical Management
With Ventilator20600 21200 21200 22200
1711I50.9.A
M5 Medical Management of Chronic Heart Failure5000 5000 5000 5000
1712I50.9.B
M5 Medical Management of Refractory Cardiac Failure40600 41200 41200 42200
1713 I71.0.A M5 Medical Management Of Aortic Dissection 15600 16200 16200 17200
1714I80.2
M5,M2 Medical Management of Deep Vein Thrombosis26810 28610 28610 31610
1715I82.9
M5 Medical Management Of Vascular Embolisation15600 16200 16200 17200
1716 M31.4 M5 Medical Management Of Aortoarteritis 15000 15000 15000 15000
1717R57.0.B
M5
Medical Management Cardiogenic Shock (Non AMI)
With Out Angiogram15900 16800 16800 18300
1718R57.0.C
M5
Medical Management Cardiogenic Shock (Non AMI)
With Angiogram20900 21800 21800 23300
1719A41.9
M6 Medical Management of Post Transplant Sepsis38860 40960 40960 44460
1720 K65.9 M6 CAPD Peritonitis 49790 51590 51590 54590
1721N00
M6 Medical Management of Acute Glomerulo Nephritis27520 29020 29020 31520
1722N04.C
M6 Medical Management of Nephrotic Syndrome18390 19890 19890 22390
1723N17.9.B
M6
Medical Management of Rapidly Progressive Renal
Failure33170 35570 35570 39570
1724N17.A
M6 Medical Management of AKI Without Dialysis22410 24810 24810 28810
1725N18.5
M6
Medical Management of CKD Stage-V With
Complications32080 33280 33280 35280
123
1726 N18.6.A M6 Maintanence of CKD with Haemodialysis 12500 12500 12500 12500
172799.14.1
M7 management with immuno globulin therapy - IV75540 76140 76140 77140
1728B69.0
M7
Medical Management of Epilepsy - Idiopathic
Neurocysticercosis Tuberculoma16890 18090 18090 20090
1729 E83.0 M7,M4 Medical Management of Wilson'S Disease 16630 18130 18130 20630
1730 F03 M7,M13 Medical Management of Dementia 12950 12950 12950 12950
1731G00.9
M7,M4
Medical Management of Neuroinfections -Pyogenic
Meningitis(Bacterial)30390 32790 32790 36790
1732G02.1
M7
Medical Management of Neuroinfections -Fungal
Meningitis56440 58540 58540 62040
1733 G04.0 M7 Medical Management of ADEM 21510 23010 23010 25510
1734
G05.1
M7
Medical Management of Neuroinfections -Viral
Meningoencephalitis (Including Herpes Encephalitis)
39630 41730 41730 45230
1735 G20 M7 Medical Management of Parkinsonism 13700 15200 15200 17700
1736 G43 M7 Medical Management of Migraine 4810 4810 4810 4810
1737G61.0
M7,M4 Medical Management of Guillian-Barre Syndrome84500 89000 89000 96500
1738
G61.8
M7
Medical Management of Chronic Inflammatory
Demyelinating Polyneuropathy(CIDP)
17040 19740 19740 24240
1739G70.0
M7
Medical Management of Neuromuscular disorders
(Myasthenia Gravis)23470 25570 25570 29070
1740G71.2
M7 Medical Management of Myopathies – Heriditary10830 10830 10830 10830
1741G72
M7 Medical Management of Acquired Myopathies21570 23670 23670 27170
1742 H46 M7 Medical Management of Optic Neuritis 12100 13300 13300 15300
1743I60
M7
Medical Management of Hemorrhagic
Stroke/Strokes(I61/I62/I63/I64)32230 33430 33430 35430
1744 I63 M7 Medical Management of Ischemic Strokes 21520 23020 23020 25520
124
1745A18.4
M8 Medical Management of Cold Abscess Chest Wall14010 15510 15510 18010
1746 B44 M8 Medical Management of Aspergilloma 26360 27860 27860 30360
1747B44.0
M8
Medical Management of A.B.P.A (Alergic Broncho
Pulmonary Aspergillosis)42110 44210 44210 47710
1748 D86 M8,M10 Medical Management of Sarcoidosis 18010 21010 21010 26010
1749 E84 M8 Medical Management of Cystic Fibrosis 21800 23600 23600 26600
1750I77.8
M8 Medical Management of Pulmonary Vasculitis22100 24200 24200 27700
1751 J18.9 M8 Medical Management of Pneumonias 33000 36000 36000 41000
1752J43
M8
Medical Management of Emphysema Without
Respirative Failure17100 19200 19200 22700
1753J44.1
M8 Medical Management of COPD Acute Exacerbation16500 18000 18000 20500
1754J44.8
M8 Medical Management of Chronic Persistent Asthama16200 17400 17400 19400
1755J45
M8
Medical Management of Bronchial Asthma (Acute and
Chronic Severe)16800 18600 18600 21600
1756J47
M8
Medical Management of Bronchiectasis with Repeated
Hospitalisation>6per Year33000 36000 36000 41000
1757 J64 M8 Medical Management of Pneumoconiosis 37400 39800 39800 43800
1758J68
M8 Medical Management of Inhalational Lung Injuries21500 23000 23000 25500
1759J84.9
M8 Medical Management of Interstitial Lung Diseases32100 34200 34200 37700
1760J85
M8 Medical Management of Lung Abscess ,Non Resolving38000 41000 41000 46000
1761 J86 M8 Medical Management of Empyema 33000 36000 36000 41000
1762 J90 M8 Medical Management of Pleural Effusion 32110 34210 34210 37710
1763J93
M8 Medical Management of Pneumothorax Recurrent33010 36010 36010 41010
1764J93.9
M8
Medical Management of Pneumothorax
(Large/Recurrent)33300 36600 36600 42100
125
1765J96.9.A
M8
Medical Management of Acute Respiratory Failure
(Without Ventilator)26500 28000 28000 30500
1766J96.9.B
M8
Medical Management of Acute Respiratory Failure
(With Ventilator)53000 56000 56000 61000
1767R04.2
M8 Medical Management of Haemoptysis For Evaluation32700 35400 35400 39900
1768A30
M9
Medical Management of Leprosy Reactions &
Deformities (Type I & Type Ii)23000 26000 26000 31000
1769 A55 M9 Medical Management of Chlamydial Tests 31190 35090 35090 41590
1770B02.2
M9
Medical Management of Herpes Zoster Post Herpetic
Neuralgia14520 16320 16320 19320
1771B07
M9 Medical Management of Electro/Cryocautery For Warts9410 10610 10610 12610
1772C43
M9
Medical Management of Cutaneous Malignancies -
Malignant Melanoma15480 17580 17580 21080
1773
C44
M9
Medical Management of Cutaneous Malignancies (Sq.
Cell Ca ,Bcc, Lymphomas )
15480 17580 17580 21080
1774 L10 M9 Medical management of Pemphigus 30770 33770 33770 38770
1775L12
M9
Medical Management of Bullous Disorders
(Pemphigoid/Pemphigois)25900 28000 28000 31500
1776L23
M9
Medical Management of Acute Contact Allergic
Dermatitis16510 18010 18010 20510
1777 L40 M9 Medical Management of Pustular Psoriasis 29210 33410 33410 40410
1778L50.0
M9 Medical Management of Adverse Drug Reactions14940 15540 15540 16540
1779 L50.9 M9 Medical Management of Acute Urticaria 20620 21820 21820 23820
1780L51
M9 Medical Management of Erythema Multiforme10150 11650 11650 14150
1781L51.1
M9 Medical management of Stevens- Johnson Syndrome23760 25860 25860 29360
1782L51.2
M9 Medical management of Toxic Epidermal Necrolysis42310 46810 46810 54310
126
1783 L53.9 M9 Medical Management of Erythroderma 22100 24200 24200 27700
1784L80
M9
Medical Management of Vitiligo Medical (OP
Management)15300 15600 15600 16100
1785L95
M9,M10 Medical Management of Cutaneous Vasculitis22110 24210 24210 27710
1786 M33.9 M9 Medical Management of Dermatomyositis 21810 23610 23610 26610
1787M34
M9
Medical Management of Connective Tissue Disorders -
Systemic Sclerosis22100 24200 24200 27700
1788M60
M9
Medical Management of Connective Tissue Disorders -
Dermatomyositis / Polymyositis23230 26230 26230 31230
1789D68.8
M10
Medical Management of Anti Phospho Lipid Antibody
Syndrome With Ischemia52110 54210 54210 57710
1790I77.9
M10
Medical Management of Vasculitis Including
Undifferentiated32110 34210 34210 37710
1791L93
M10 Medical Management of Severe Lupus Erythamatosis52110 54210 54210 57710
1792 L94.0 M10 Medical management of Scleroderma 32110 34210 34210 37710
1793M07
M10 Medical Management of Severe Psoriatic Arthritis22110 24210 24210 27710
1794M08.0
M10 Medical Management of Juvenile Idiorpathic Arthritis23010 26010 26010 31010
1795M08.2
M10
Medical Management of Juvenile Idiorpathic Arthritis
with systemic onset32110 34210 34210 37710
1796 M10 M10 Medical Management of Gout 11510 13010 13010 15510
1797M12.8
M10 Medical Management of Infection Related Arthrites11170 12670 12670 15170
1798M13.9
M10
Medical Management of Undifferentiated Inflammatory
Arthritis32110 34210 34210 37710
1799M32
M10
Medical Management of SLE (Systemic Lupus
Erythematosis)27760 29860 29860 33360
1800M32.1
M10
Medical management of SLE (Systemic Lupus
Erythematosis) with sepsis73360 75460 75460 78960
127
1801M35.0
M10 Medical management of Primary Sjogren'S Syndrome22110 24210 24210 27710
1802M35.1
M10
Medical Management of MCTD (Mixed Connective
Tissue Disorder)27410 29810 29810 33810
1803M35.8
M10
Medical Management of Undifferentiated Connective
Tissue Disorder22390 24490 24490 27990
1804M48.9
M10 Medical Management of Severe Spondylo Arthropathies26860 28960 28960 32460
1805M60.9.A
M10 Medical Management of Inflamatory Myositis31510 33010 33010 35510
1806M60.9.B
M10
Medical Management of Severe Myositis Requiring
IVIG31510 33010 33010 35510
1807M80.9
M10
Medical Management of Osteoporosis With Recent
Painful Yertebral Fracture15910 17710 17710 20710
1808 M83 M10 Medical Management of Osteomalacia 15050 17150 17150 20650
1809B46.1
M11 Medical management of Rhinocerebral Mucormycosis54620 57620 57620 62620
1810 E05.0 M11 Medical Management of Grave'S Disease 11560 13060 13060 15560
1811E11.2
M11
Medical management of Pyelonephritis in uncontrolled
Diabetes melitus23620 25720 25720 29220
1812E11.5
M11
Medical management of Cavernous Sinus Thrombosis
in uncontrolled Diabetes melitus44020 47020 47020 52020
1813 E22.0 M11 Hormonal therapy for Pituitary - Acromegaly 20540 22640 22640 26140
1814E23.0
M11
Initial evaluation and management of Hypopituitarism
without growth harmone17180 19280 19280 22780
1815E23.1
M11
Hypopiturasim Initial Evaluation And Management
With Growth Hormone28400 30800 30800 34800
1816E23.2
M11
Hypopiturasim Maintanance Phase Monthly Package
For Growth Hormone13560 13560 13560 13560
1817 E24.9 M11 Medical Management of Cushings Syndrome 32100 34200 34200 37700
1818 E30.1 M11 Medical Management of Precocious Puberty 16810 18610 18610 21610
1819J22
M11
Medical management of Lower Respiratoy Tract
Infection25400 27800 27800 31800
128
1820 J32.9 M11 Medical management of Fungal Sinusitis 43950 46950 46950 51950
1821 K81 M11 Medical management of Cholecystitis 32710 35710 35710 40710
1822 M82.1 M11 Medical Management of Osteoporosis 11990 12890 12890 14390
1823Q96
M11
Hormonal therapy for Delayed Puberty Hypogonadism-
Turners Syndrome16310 18110 18110 21110
1824Q98.4
M11
Hormonal therapy for Delayed Puberty Hypogonadism -
Kleinfelter Syndrome16310 18110 18110 21110
1825A04.9
M12
Medical Management of Other Bacterial Intestinal
Infections19250 21350 21350 24850
1826A08.4
M12
Medical Management of Viral And Other Specified
Intestinal Infections18650 20150 20150 22650
1827A09.0.A
M12
Medical Management of Infective Proctitis entero
Colitis18060 18960 18960 20460
1828A18.3
M12 Medical Management of Abdominal Tuberculosis23010 26010 26010 31010
1829C24
M12
Medical Management - SEMS (Stent) For Paliation Of
Advanced Biliary Malignancy52570 53470 53470 54970
1830
C25
M12
Medical Management- SEMS (Stent) For Paliation Of
Advanced Pancreatic Malignancy
48870 49770 49770 51270
1831C26.9
M12
Medical Management - SEMS (Stent) For Paliation Of
Advanced GI Malignancy34820 35720 35720 37220
1832I82.0
M12 Medical Management of Budd-Chiari Syndrome37840 41440 41440 47440
1833 I84 M12 Medical Management of Haemorrhoids 11040 11940 11940 13440
1834I85
M12
Medical Management of Oesophageal Varices with
Sclerotherapy10710 11310 11310 12310
1835I85.1
M12
Medical Management of Oesophageal Varices using
Variceal Banding12500 12800 12800 13300
1836 I86.4 M12 Medical management of Gastric Varices 15500 16100 16100 17100
1837 J95.0 M12 Medical management of Oesophageal Fistula 30900 31800 31800 33300
1838K20
M12
Medical Management of Infective Oesophagitis
(Candida Viralbacterial)14200 16300 16300 19800
129
1839K21
M12
Medical Management ofGastro Esophageal Reflux
Disease8030 8630 8630 9630
1840 K22.0 M12 Medical management of Achalasia Cardia 14800 16300 16300 18800
1841K22.1
M12 Medical management of Corrosive Oesophageal Injury23420 25520 25520 29020
1842K22.2
M12
Conservative management of Oesophageal Foreign
Body8530 9130 9130 10130
1843K22.3.A
M12 Conservative management of Oesophageal Perforation51210 52410 52410 54410
1844
K22.3.B
M12
Medical Management of Oesophageal Perforation,
Conservative Management With Stent
35070 36270 36270 38270
1845 K22.6 M12 Medical Management of Mallory Weiss Tear 10900 11800 11800 13300
1846 K26 M12 Medical Management of Duodenal Ulcer 12440 13640 13640 15640
1847 K28 M12 Medical Management of Gastric Ulcer 12510 13110 13110 14110
1848 K29.0 M12 Medical Management of Erosive Gastritis 11540 12440 12440 13940
1849K31.1
M12 Medical Management of Gastric Outlet Obstruction13210 13810 13810 14810
1850 K31.7 M12 Medical Management of Gastric Polyp 12280 13480 13480 15480
1851K31.8
M12
Medical management of GAVE(Gastric Antral Vascular
Ectasia)20910 21810 21810 23310
1852 K50 M12 Medical Management of Crohn'S Disease 43530 44730 44730 46730
1853 K51 M12 Medical Management of Ulcerative Colitis 26270 27170 27170 28670
1854K55.9
M12 Medical Management of Ischaemic Bowel Disease29600 30500 30500 32000
1855 K60.2 M12 Medical Management of Fissure 5600 6200 6200 7200
1856K62
M12
Medical Management of Rectal Polyp ¿ Medical
Management7940 8840 8840 10340
1857 K62.3 M12 Medical Management of Colorectal Polyps 10910 11810 11810 13310
1858K62.6
M12
Medical Management of Solitary Rectal Ulcer
Syndrome10840 11440 11440 12440
1859 K62.7 M12 Medical Management of Radiation Proctitis 10790 11390 11390 12390
130
1860K72
M12
Conservative management of Cirrhosis with Hepatic
Encephalopathy41200 42400 42400 44400
1861 K72.0.B M12 Medical Management of Acute Liver Failure 51010 52510 52510 55010
1862
K73.9
M12
Medical Management of Chronic Hepatitis (Viral ,
Alchohol, NASH, Drug, auto Immune, metabolic)
23560 25060 25060 27560
1863
K74.6.A
M12
Medical Management of Cirrhosis Decompensated
Including SBP, Portal HTN, Bleed
38380 39880 39880 42380
1864K74.6.B
M12 Medical Management of Compensated Cirrhosis25670 28070 28070 32070
1865K75
M12
Medical Management of Liver Abscess (Amoebic,
Pyogenic & Misc. Infections)31210 32410 32410 34410
1866K75.9
M12
Medical Management of Acute Hepatitis (Viral,
Alcohol, Drugs, Misc. Infections)15900 16800 16800 18300
1867K76.7
M12
Medical management of Cirrhosis with Hepato Renal
Syndrome41200 42400 42400 44400
1868
K80
M12
Medical Management of Gall Stone Diseases(Biliary
Colic, cholangitis, cholecystitis)
23640 23940 23940 24440
1869K83.0
M12 Medical management of Sclerosing Cholangitis76510 78010 78010 80510
1870 K83.1 M12 Medical Management of Billiary Stricture 14560 16060 16060 18560
1871K85.B
M12 Medical management of Acute Pancreatitis (Severe)152110 154210 154210 157710
1872K86.1
M12
Conservative management of Chronic Pancreatitis with
Severe Pain31210 32410 32410 34410
1873K86.3.A
M12
Conservative management of Acute Pancreatitis With
Pseudocyst (Infected)31510 33010 33010 35510
1874K86.3.B
M12
Medical Management of Chronic Pancreatitis With
Pseudocyst Infected31210 32410 32410 34410
1875K90
M12 Medical Management of Malabsorption Syndrome33460 36460 36460 41460
131
1876K90.3
M12
Medical Management of Chronic Pancreatitics With
Maldigestion11210 12410 12410 14410
1877 K91.8 M12 Medical management of Post op stent 48340 49840 49840 52340
1878 K91.9 M12 Medical management of Post op leaks 48820 50320 50320 52820
1879 K92.0 M12 Medical Management of Upper GI Bleed 46100 48200 48200 51700
1880 K92.1 M12 Medical Management of Lower GI Bleed 47480 49580 49580 53080
1881K92.2.B
M12 Conservative management of Obscure GI Bleed50910 51810 51810 53310
1882
R18
M12
Medical Management of Ascities Of Any Etiology
(Tubercolor, Melignant, Pancreatic, Biliary)
16210 17410 17410 19410
1883 F20 M13 Medical Management of Schizophrenia 32910 37110 37110 44110
1884F23
M13 Medical Management of Acute Psychotic Episode28010 31010 31010 36010
1885F31
M13
Medical Management of Bipolar Affective Disorder (A.
Type-1)35010 39510 39510 47010
132
APPENDIX – D: FILLED UP APPLICATION FOR EMPANELMENT SUBMITTED BY THE SERVICE PROVIDER.
Now therefore, each party acknowledges that it has read this Service Contract
Agreement, understands and agrees to be bound by its clauses/ articles/ terms and further
agrees that it is the complete and exclusive statement of the SCA between the parties.
Place: Service Provider Dated:
AHCT
--------------- x----------------
133