HOLY FAMILY HOSPITAL OKHLA ROAD, NEW DELHI

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1 HOLY FAMILY HOSPITAL OKHLA ROAD, NEW DELHI Schedule Schedule of Charges of Charges Effective from 1 April, 1 st April, (Valid upto 31 st March, 2020) Phone Nos: to Phone Nos: to to to Fax No Fax No :

2 INDEX S.No. CHARGING HEAD Page No. 1 General Information 3 In-Patient Schedule of Charges 2 Room / Bed and Board 5 3 CCU/ICU / Ped. ICU / Post Op. ICU and Board 5 4 Oxygen 5 5 Ventilator 5 6 NNU Nursery, Photo Therapy, Incubator, Nursing Care 5 7 Hospital Doctor s Fee :- Visits 6 8 :- Consultation 6 9 Surgery Fee : General Surgery 6 10 Surgery Fee : Laparoscopic General Surgery 9 11 Surgery Fee : Hernia Surgery Surgery Fee : Breast Surgery Surgery Fee : Rectal Surgery Surgery Fee : O.B. & Gynae (Open) & Delivery Fee Surgery Fee : O.B. & Gynae (Laparoscopic) Surgery Fee : O.B. & Gynae (Hysteroscopic) Surgery Fee : Ophthalmology Surgery Fee : Orthopedics Surgery Fee : Neuro Surgery Surgery Fee : E.N.T Surgery Fee : Thoracic Surgery Fee : Vascular Surgery Fee : Urology Surgery Fee : Plastic Surgery Surgery Fee : Pediatric Surgery Surgery Fee : Miscellaneous Nephrology and Renal Transplant Operation Theater Charges Anesthesia Charges Cath Lab Procedures & Cardiac Surgery & Packages Non-Invasive Cardiac Lab-(ECG,Echo,TMT, Holter Moniter) Gastroenterology Neurology Investigations Respiratory Medicine-(Sleep Lab,Spirometer,Video Bronchoscopy) Radiology :BMD, C.T.Scan Radiology : Mammography, Ultrasound Radiology : X-Ray Radiology : MRI Radiology : Miscellaneous 60 2

3 40 Laboratory Spot Investigation Exchange Blood Transfusion Physio-Therapy : IPD Treatment : IPD Plastering Dressing Chemotherapy : IPD Psychotherapy Laser Procedures (Ophthalmology) : IPD & OPD Laser Procedures (Dermatology) Aesthetic Clinic : IPD & OPD Special Investigation (Uroflowmetry) Speech & Hearing Test Instrument & Special Equipments (Cardiac Monitor, DVT Pump) Diet for Attendant Concession (Only SB Bed) Ayurvedic Treatment : IPD & OPD Ambulance Mortuary Miscellaneous Charges 76 Out-Patient Schedule of Charges 60 O.P.D. Consultation (Private OPD) O.P.D. Registration (General OPD) O. B. Registration Charges Chemotherapy : OPD Casualty Dialysis [O.P.D.] O.P.D. Procedures : Urology, ENT, Ophthalmology, & Gynae, Plastering Charges : OPD Skin Procedures : OPD Treatment : OPD Nursing Procedures : OPD Physio-Therapy : OPD 81 Out-Patient : Package charges for Minor O.T. Procedures 71 ENT : Minor O.T. Procedures General Surgery : Minor O.T. Procedures OB./Gyn. : Minor O.T. Procedures Eye (Ophthalmology) : Minor O.T. Procedures Ortho. : Minor O.T. Procedures Plastic Surgery : Minor O.T. Procedures Urology : Minor O.T. Procedures Thoracic : Minor O.T. Procedures Pediatric Surgery : Minor O.T. Procedures Miscellaneous Charges 89 3

4 General Information: 1. Accommodation Categories:- ACCOMMODATION CATEGORIES :- DR = Delux Room PR = Private (Single) Room SPR = Semi Private Room (Two beds in a Room) NSB = Non-Subsidised Bed (Four or five beds in a Room) SB = Subsidised Bed DR, PR, SPR and NSB accommodations will be offered to Credit Facility and Reimbursable cases. SB category is only for non-reimbursable cases. (Pls see point no.7) 2. Room / Bed Charges:- (a) (b) (c) (d) (e) (f) Room charges are for full day on the day of admission irrespective of the time of checking in. If a patient is discharged within 24 hrs of admission, room / bed will be charged for one day only irrespective of calender days. 6 hours and above, upto 24 hours of admission is counted as one day. For stay less than 6 hours Room/bed will be charged for half a day. Check out time is 11:00AM. Room / Bed charges are inclusive of charges for bed, Nursing Care and Diet Services for the patient only. If the patient is NPO, no food will be supplied to the attendant of the patient. Diet for the attendant will be charged separately as per the Schedule of Charges. 3. Surgical & Doctor s visits fee (Hospital Case):- (a) If more than one surgeon performs different procedures at the same time even with single incision, the surgical fee for each surgery will be charged in full separately. (b) If a surgeon performs more than one surgery (as per categorisation in the schedule of charges) at a single opening or incision. The higher one will be charged in full, Ist lesser one will be charged at 50% and the 2nd lesser or more thereafter will be charged at 25%. (c) If a surgeon performs more than one surgery with different incisions, the surgical fee for each procedure will be charged in full. (d) If a single procedure is performed by more than one surgeon, only the single fee as per schedule of charges will be charged. (e) In case of major surgeries carried out in Operation Theater, Surgeon s Post Operative visits will not be charged for next 3 days including day of surgery. This clause is not applicable on minor surgeries and diagnostic procedures. If the surgical fee in Delux Room is Rs.10,000/- or less, will be treated as Minor Surgery. 4. Shifting from one to another accommodation:- (a) (b) In case the patient is shifted from lower to higher category, the charges for surgical procedure/s, doctors visits, any other professional fees, Investigations, Nursing Care and other variable charges (except Bed charges) will be charged as per the higher category from the date of admission. In normal course, shifting from higher category to lower category is not allowed. Contd.. 4

5 5. Any treating consultant / physician can charge only one visit per day irrespective of the number of visits. 6. Private Patients of Visiting Consultants:- The Visits and / or Surgical charges mentioned in this Schedule of Charges and point no. 3 mentioned above will not be applicable to patients admitted by Visiting Consultants as their PRIVATE PATIENT. Visiting Consultants are free to charge a differential fee for their Private Patients, but this will be billed and collected by the hospital on their behalf. 7. Re-imbursable cases not to opt Subsidised Bed (SB) category :- Patients entitled for reimbursement from their employer / Insurance company will be accommodated in Delux Room (DR), Private Room(PR), Semi Private(SPR) or Non Subsidised Bed(NSB) only.as per Hospital policy, Subsidised Beds(SB) will only be allotted to economically Impoverished patients and who are not the beneficiaries of any organizational reimbursement scheme. If a patient opts to occupy a Subsidised Bed (SB), the Final Bill with payment receipt will only be issued. In such cases, Neither printed details of the bill nor Emergency/Essentiality Certificate will be issued. No form for reimbursement will be signed by any doctor or official. 8. ICU/CCU/SEMI ICU/PED. ICU/305 (SPL. NURSERY)/NICU-415/HDU are the common areas. Any patient admitted directly in these areas will decide about the type of accommodation at the time of admission in these areas and charges will be made accordingly irrespective of whether or not theyhave actually utilized such an accommodation for whatever reason. NOTE :The hospital reserves the right to modify the charges mentioned in this Schedule of charges without prior notice whenever it deems necessary. 5

6 S.No. DESCRIPTION 01:01 ROOM / BED AND BOARD CHARGES (in rupees) 001 DELUX ROOM PRIVATE (SINGLE) ROOM SEMI PRIVATE ROOM NON-SUBSIDISED BED SUBSIDISED BED 1300 NOTE: The Room / Bed Charges are inclusive of Nursing Care. 02:01 CCU/ICU/PED ICU/SEMI ICU / POST OP. ICU / INTENSIVE NURSING CARE UNIT / H.D.U. S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/SB 001 ICU / CCU PED. ICU / SPL. NURSERY (305) H.D.U. - (415) SEMI ICU P.OP.ROOM H.D.U. - LABOR ROOM 2800 Note :- ICU / CCU (Intensive / Coronary Care Unit) / Post-op. ICU and Ped. ICU charges include bed Nursing care and monitoring charges for all vital parameters. All other service charges will be as per the category in which the patient is admitted. 03:01 OXYGEN DR/PR/SPR/NSB SB 001 BY HOOD/MASK (PER DAY) BY NASAL CATHETER (PER DAY) BY HOOD/MASK (LESS THAN 6 HOURS) :01 VENTILATOR DR/PR/SPR/NSB SB 001 BI-PAP / C PAP INFANT VENTILATOR VENTILATOR PER DAY :01 NNU (NEO-NATAL UNIT) NURSERY (206) DR/PR/SPR/NSB/SB 001 NEO NATAL UNIT (NNU) - NURSERY : PER DAY 2000 Note:- NNU-Nursery charges are inclusive of charges for bed and Nursing Care for patient (Newborn Baby) only. 05:02 PHOTO THERAPY DR/PR/SPR/NSB SB 001 PHOTO THERAPY : DOUBLE - PER DAY PHOTO THERAPY : SINGLE - PER DAY :03 INCUBATOR / OPEN CARE 001 INCUBATOR / OPEN CARE : PER DAY WARMER CARE : PER DAY :04 NURSING CARE DR PR SPR NSB SB 001 NURSING CARE : PER DAY(Only for newborn babies in Nursery 208) Note :- Nursing care is professional charges for routine nursing care provided by the nurses. 6

7 S.No. DESCRIPTION ACCOMMODATION CATEGORY HOSPITAL DOCTOR S FEE DR PR SPR NSB SB 06:01 VISITS : MEDICAL CARE - PER DAY 001 VISIT : MEDICAL CARE : PER DAY :02 CONSULTATION 001 CONSULTATION (EACH) SURGICAL FEE S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:01 GENERAL SURGERY DR PR SPR NSB SB 001 GES037 ADRENALECTOMY GES001 APPENDICECTOMY GES121 ASPIRATION OF LIVER ABSCESS GES018 ASPIRATION OF SUPERFICIAL COLD ABSCESS GES118 AVULSION OF NAIL OR NAIL REMOVAL GES021 AXILLARY LYMPH NODE BIOPSY GES128 BARIATRIC SURGERY GES097 BIOPSY OF LIVER GES042 BLOCK DISSECTION NECK GES112 CAECOSTOMY GES002 CHOLECYSTECTOMY WITH DUCT EXPLORATION GES122 CHOLECYSTOSTOMY GES013 COLECTOMY WITH ILEOSTOMY GES048 COLOSTOMY GES055 COLOSTOMY / ILEOSTOMY / JEJUNOSTOMY CLOSURE GES136 CONSTRUCTION OF J POUCH AFTER A PREVIOUS TOTAL PROCTO COLECTOMY GES137 CYTO-REDUCTIVE SURGERY WITH TOTAL PERITONECTOMY GES058 DEBRIDEMENT(LARGE) GES098 DEBRIDEMENT(MEDIUM) GES059 DEBRIDEMENT(SMALL) GES087 DELTOID MUSCLE BIOPSY GES053 DIVERTICULECTOMY GES102 DRAINAGE OF ABSCESS - LARGE & DEEP GES123 DRAINAGE OF ABSCESS - MEDIUM GES017 DRAINAGE OF ABSCESS - SMALL GES085 DRAINAGE OF LARGE INTRA ABDOMINAL ABSCESS GES138 ASPIRATION OF LIVER ABSCESS GES132 DRESSING MAJOR GES133 DRESSING MEDIUM

8 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:01 GENERAL SURGERY DR PR SPR NSB SB 030 GES134 DRESSING MINOR GES035 DUODENAL DIVERTICULAM GES022 EXCISION BIOPSY-SUPERFICIAL LUMPS GES099 EXCISION OF CARBUNCLE GES110 EXCISION OF DERMOID CYST GES111 EXCISION OF GLOMUS TUMOR (WITH OR WITHOUT EXCISION OF NAIL) GES139 EXCISION OF HILAR CHAOLANGIO CARCINOMA GES060 EXCISION OF LARGE SUPERFICIAL SOFT TISSUE MASS / TUMOUR GES100 EXCISION OF MEDIUM SUPERFICIAL SOFT TISSUE MASS / TUMOUR GES032 EXCISION OF MESENTERIC CYST GES046 EXCISION OF PILONIDAL SINUS GES056 EXCISION OF SEBACEOUS CYST GES033 EXCISION OF SMALL INTESTINAL FISTULA GES101 EXCISION OF SMALL SUPERFICIAL SOFT TISSUE MASS / TUMOUR GES049 EXCISION OF SUBMANDIBULAR GLAND GES086 EXP.LAP.RESECTION OF LIVER SEG.-EXCISION OF UMBILICAL PORT GES084 EXP.LAPAROTOMY+CHOLEDOCHLITHOTOMY + CHOLEDOCHO DUODENOSTOMY GES003 EXPLORATORY LAPAROTOMY ONLY GES114 EXP. LAPAROTOMY WITH DUODENAL PERFORATION CLOSURE GES115 EXP. LAP. WITH EXCISION / DEBULKING OF INTRA-ABDOMINAL TUMOR MAJOR GES095 FASCIOTOMY LARGE / MULTIPLE GES094 FASCIOTOMY MEDIUM GES124 FASCIOTOMY SMALL GES104 FASCIOTOMY REDO ( LARGE / MULTIPLE) GES103 FASCIOTOMY REDO (MEDIUM) GES125 FASCIOTOMY REDO (SMALL) GES116 FEEDING JEJUNOSTOMY GES140 FREYS PROCEDURE GES004 GASTRECTOMY GES005 GASTRECTOMY WITH VAGOTOMY GES006 GASTROJEJNOSTOMY GES007 GASTROJEJUNOSTOMY WITH VAGOTOMY GES008 GASTROSTOMY GES031 GLAND BIOPSY GES130 HEMATOMA DRAINAGE GES044 HEMI THYROIDECTOMY GES012 HEMICOLECTOMY

9 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:01 GENERAL SURGERY DR PR SPR NSB SB 067 GES109 HEMIGLOSSECTOMY GES120 HEPATICO JEJUNOSTOMY GES069 HIGHLY SELECTIVE VAGOTOMY GES025 ILEOTRANSVERSE COLOSTOMY GES057 INTESTINAL OBSTRUCTION GES024 INTESTINAL PERFORATION GES105 INTESTINAL RESECTION WITH ANASTOMOSIS MULTIPLE GES009 INTESTINAL RESECTION WITH ANASTOMOSIS SINGLE GES070 LAPAROTOMY AND BOWEL RESECTION FOR INTUSSUSCEPTION GES071 LAPAROTOMY AND CLOSURE OF INTESTINAL PERFORATION GES073 LAPAROTOMY AND DIVISION OF INTRA- ABDOMINAL ADHESIONS / BANDS GES072 LAPAROTOMY AND REDUCTION OF INTUSSUSCEPTION GES074 LEFT HEPATECTOMY GES075 LEFT LIVER LOBECTOMY GES047 LIGATION OF VARICOSE VEINS : UNILATERAL GES114 LIVER RESECTION MAJOR / COMPLEX GES113 LUMBAR PUNCTURE IN O.T GES020 LYMPH NODE BIOPSY GES011 LYSIS OF ADHESION WITH BOWEL RESECTION WITH ANASTOMOSIS GES010 LYSIS OF INTESTINAL ADHESION GES142 NECROSECTOMY AND OPEN DRAINAGE OF PANCREATIC ABSCESS GES096 NEEDLE ASPIRATION OF ABSCESS GES143 OESOPHAGEAL DEVASCULARISATION GES039 OESOPHAGO GASTRECTOMY GES054 OMENTECTOMY GES082 OPEN CHOLECYSTECTOMY GES106 OPEN CHOLECYSTECTOMY WITH CBD EXPLORTION GES144 OPEN DRAINAGE OF LIVER ABSCESS GES038 OPERATION FOR PANCREAS GES040 PANCREATICO DUODONECTOMY (WHIPPLE S PROCEDURE) GES083 PARATHYROID ADENOMA WITH HEMI THYROIDECTOMY GES045 PARATHYROIDECTOMY GES041 PAROTIDECTOMY GES027 PARTIAL SUBTOTAL GASTRECTOMY CA./ ULCER

10 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:01 GENERAL SURGERY DR PR SPR NSB SB 101 GES117 PERITONEAL BIOPSY GES145 PERITONEOVENOUS SHUNT GES014 PYLOROMYOTOMY (RAMSTEDT S) GES015 PYLOROPLASTY WITH VAGOTOMY GES077 RADICAL CHOLECYSTECTOMY GES036 RECURRENT INTESTINAL OBSTRUCTION GES088 REMOVAL OF DEEP FOREIGN BODY-LIMBS GES108 REMOVAL OF MESH & TACKERS GES089 REMOVAL OF SUPERFICIAL FOREIGN BODY- LIMBS GES107 REMOVAL OF SUPERFICIAL FOREIGN BODY- LIMBS -MINOR GES029 REPAIR OF COMMON BILE DUCT (C.B.D.) GES146 RESECTION ANASTOMOSIS OESOPHAGUS (IVOR LEWIS) GES078 RESUTURING OF WOUNDS LARGE / MULTIPLE GES050 RESUTURING OF WOUNDS SMALL GES051 SECONDARY SUTURING OF ABDOMINAL WALL GES026 SIGMOID DIVERTICULUM GES016 SPLENECTOMY GES127 STRICTUROPLASTY GES079 SUB-TOTAL COLECTOMY GES126 SUTURING OF WOUNDS / LACERATIONS LARGE / MULTIPLE GES019 SUTURING OF WOUNDS / LACERATIONS SMALL GES147 TOTAL OESOPHAGOGASTRECTOMY WITH COLONIC/JEJUNAL PULL UP GES043 THYROIDECTOMY TOTAL GES030 TOTAL COLECTOMY GES028 TOTAL GASTRECTOMY FOR CA GES148 TOTAL PROCTO COLECTOMY WITH J POUCH GES149 TRISEGMENTECTOMY GES023 TRUCUT NEEDLE BIOPSY GES080 TRUNCAL VAGOTOMY AND GASTRO JEJUNOSTOMY GES081 TRUNCAL VAGOTOMY AND PYLOROPLASTY :02 LAPAROSCOPIC GENERAL SURGERY 001 GES091 DIAGNOSTIC LAPAROSCOPY ONLY GES092 DIAGNOSTIC LAPAROSCOPY WITH BIOPSY GES093 DIAGNOSTIC LAPAROSCOPY WITH MULTIPLE BIOPSIES HES029 LAPARASCOPIC TOTAL EXTRA PERITONEAL MESH - (TEP) - UNILATERAL

11 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:02 LAPAROSCOPIC GENERAL SURGERY DR PR SPR NSB SB 005 LGS001 LAPAROSCOPIC ABDOMINO-PERINEAL RESECTION OF RECTUM LGS002 LAPAROSCOPIC ADHESIOLYSIS LGS003 LAPAROSCOPIC ADRENALECTOMY BILATERAL LGS004 LAPAROSCOPIC ADRENALECTOMY UNILATERAL GES061 LAPAROSCOPIC APPENDICECTOMY GES052 LAPAROSCOPIC CHOLECYSTECTOMY LGS005 LAPAROSCOPIC CHOLEDOCHAL CYST EXCISION LGS006 LAPAROSCOPIC CLOSURE OF BOWEL PERFORATION LGS007 LAPAROSCOPIC COLOSTOMY/ CECOSTOMY LGS008 LAPAROSCOPIC COMPLETE RECTAL PROLAPSE REPAIR GES062 LAPAROSCOPIC DEROOFING OF NON- HYDATID LIVER CYST LGS009 LAPAROSCOPIC DIAPHAGMATIC HERNIA REPAIR LGS010 LAPAROSCOPIC DISTAL RADICAL GASTRECTOMY GES067 LAPAROSCOPIC DRAINAGE OF INTRA- ABDOMINAL COLLECTION GES063 LAPAROSCOPIC DRAINAGE OF LIVER ABCESS GES068 LAPAROSCOPIC DUODENAL PERFORATION CLOSURE HES020 LAPAROSCOPIC EPIGASTRIC HERNIA REPAIR- INLAY MESH HES019 LAPAROSCOPIC EPIGASTRIC HERNIA REPAIR- ONLAY MESH LGS011 LAPAROSCOPIC EXCISION OF HYDATID CYST OF LIVER HES021 LAPAROSCOPIC FUNDOPLICATION(DOR S) HES022 LAPAROSCOPIC FUNDOPLICATION(NISSEN) LGS012 LAPAROSCOPIC GASTRIC BYPASS GES064 LAPAROSCOPIC GASTRIC PERFORATION CLOSURE GES065 LAPAROSCOPIC GASTRO-JEJUNOSTOMY (GJ) LGS013 LAPAROSCOPIC HELLERS OPERATION/ CARDIO MYOTOMY (THROUGH THE CHEST) / ABDOMEN 030 LGS014 LAPAROSCOPIC HEPATICO-JEJUNOSTOMY LGS015 LAPAROSCOPIC HIATUS HERNIA REPAIR THROUGH THE ABDOMEN / CHEST LGS016 LAPAROSCOPIC ILEOSTOMY / JEJUNOSTOMY LGS017 LAPAROSCOPIC INCISIONAL HERNIA REPAIR HES023 LAPAROSCOPIC INGUINAL HERNIORRHAPHY BILATERAL

12 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:02 LAPAROSCOPIC GENERAL SURGERY DR PR SPR NSB SB 035 HES024 LAPAROSCOPIC INGUINAL HERNIORRHAPHY UNILATERAL HES025 LAPAROSCOPIC INGUINAL HERNIORRHAPHY WITH MESH BILATERAL HES026 LAPAROSCOPIC INGUINAL HERNIORRHAPHY WITH MESH UNILATERAL LGS018 LAPAROSCOPIC LAR LGS019 LAPAROSCOPIC LIVER RESECTIION HES027 LAPAROSCOPIC LUMBAR HERINA REPAIR LGS020 LAPAROSCOPIC MEDIAN ARCUATE LIGAMENT LGS021 LAPAROSCOPIC NECROSECTOMY LGS022 LAPAROSCOPIC NEPHRECTOMY LGS023 LAPAROSCOPIC OESOPHAGECTOMY LGS024 LAPAROSCOPIC PALLIATIVE GASTRECTOMY LGS025 LAPAROSCOPIC RADICAL CHOLECYSTECTOMY (WITH SEGMENT 4 & 5) LGS026 LAPAROSCOPIC RADICAL PROSTATECTOMY FOR Ca PROSTATE LGS027 LAPAROSCOPIC RESECTION AND ANASTOMOSIS-MULTIPLE LGS028 LAPAROSCOPIC RESECTION AND ANASTOMOSIS-SINGLE LGS029 LAPAROSCOPIC RFTA OF MULTIPLE LESION LGS030 LAPAROSCOPIC RFTA OF SINGLE LESION LGS031 LAPAROSCOPIC RIGHT / LEFT HEMICOLECTOMY / TRANSVERSE COLECTOMY / SIGMOID COLECTOMY 053 LGS032 LAPAROSCOPIC SILS APPENDICECTOMY LGS033 LAPAROSCOPIC SILS CHOLECYSTECTOMY LGS034 LAPAROSCOPIC SILS HERNIA REPAIR LGS035 LAPAROSCOPIC SILS SLEEV GASTRECTOMY LGS036 LAPAROSCOPIC SLEEV GASTRECTOMY LGS037 LAPAROSCOPIC SPLENECTOMY/ SPLENORRHAPHY LGS038 LAPAROSCOPIC SPLENIC ARTERY LIGATION LGS039 LAPAROSCOPIC STRICTUROPLASTY MULTIPLE LGS040 LAPAROSCOPIC STRICTUROPLASTY SINGLE HES028 LAPAROSCOPIC TOTAL EXTRA- (TEP ) BILATERAL GES066 LAPAROSCOPIC TRUNCAL VAGOTOMY AND GASTRO JEJUNOSTOMY LGS041 LAPAROSCOPIC ULTRASOUND HES030 LAPAROSCOPIC UMBILICAL HERNIA REPAIR- ONLAY MESH LGS042 LAPAROSCOPIC WERTHIEMS

13 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:02 LAPAROSCOPIC GENERAL SURGERY DR PR SPR NSB SB 067 URS146 ORCHIDOPEXY LAPROSCOPIC BILATERAL URS147 ORCHIDOPEXY LAPROSCOPIC UNILATERAL LGS043 VATS (VIDEO ASSISTED THORACOSCOPIC SURGERY :03 HERNIA SURGERY 001 HES013 ABDOMINOPLASTY WITH MESH HES008 EPIGASTRIC HERNIA HES009 FEMORAL HERNIA HES010 HIATUS HERNIA HES014 HYDROCELECTOMY : BILATERAL HES006 HYDROCELECTOMY : UNILATERAL HES017 INCISIONAL HERNIA REPAIR WITH ABDOMINOPLASTY HES036 INCISIONAL HERNIA REPAIR WITH MESH HES018 INGUINAL HERNIA - BILATERAL HES001 INGUINAL HERNIA : UNILATERAL HES015 INGUINAL HERNIOPLASTY : BILATERAL HES012 INGUINAL HERNIOPLASTY : UNILATERAL HES002 INGUINAL HERNIA WITH ORCHIDECTOMY HES031 NISSEN FUNDOPLICATION AND HIATUS HERNIA REPAIR HES038 ORCHIDECTOMY : BILATERAL HES037 ORCHIDECTOMY : UNILATERAL HES003 RECURRENT HERNIA (INCISIONAL) BILATERAL HES032 RECURRENT HERNIA (INCISIONAL) UNILATERAL HES033 RECURRENT HERNIA WITH MESH BILATERAL HES034 RECURRENT HERNIA WITH MESH UNILATERAL HES011 STRANGULATED / OBSTRUCTED HERNIA HES005 UMBILICAL HERNIA HES035 UMBILICAL HERNIA REPAIR WITH MESH HES004 VENTRAL HERNIA (INCISIONAL) :04 BREAST SURGERY 001 BRS001 BIOPSY OF BREAST BRS006 EXCISION OF MAMMARY FISTULA BRS002 EXCISION OF SMALL FIBROADENOMA BRS003 I. & D. OF BREAST ABSCESS BRS008 LUMPECTOMY LARGE BRS010 LUMPECTOMY SMALL BRS005 MASTECTOMY RADICAL WITH AUX. LYMPH NODES BRS004 MASTECTOMY SIMPLE

14 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:04 BREAST SURGERY DR PR SPR NSB SB 009 BRS011 RADICAL BLOCK DISSECTION OF BREAST BRS007 SEGMENTAL RESECTION OF BREAST BRS009 WIDE EXCISION BIOPSY OF BREAST :05 RECTAL SURGERY 001 RES007 ABDOMINAL PERINEAL RESECTION FOR CA. RECTUM RES002 ANAL DILATATION RES008 ANTERIOR RESECTION RES009 ANTERIOR RESECTION WITH TOTAL MESORECTAL EXCISION RES013 EXCISION OF SKIN TAG RES001 FISSURECTOMY RES003 FISTULECTOMY RES004 HAEMORRHOIDECTOMY RES005 I. & D. OF ISCHIO-RECTAL ABSCESS RES011 PERIANAL ABSCESS DRAINAGE RES006 RECTAL POLYP EXCISION RES010 STAPLED HAEMORRHOIDECTOMY :06 O.B. & GYNAE - OPEN SURGERY 001 OGS012 ABDOMINAL HYSTERECTOMY OGS016 ANTERIOR & POSTERIOR COLPORRHAPHY OGS060 ANTERIOR COLPORRAPHY OGS063 CAUTERY OF VAGINAL VAULT GRANULOMA OGS088 CERVICAL EXPLORATION WITHOUT BIOPSY OGS089 CERVICAL EXPLORATION WITH BIOPSY OGS033 COMPLETE PERINEAL TEAR REPAIR OGS066 CONE BIOPSY OF CERVIX OGS094 CRYO CAUTERISATION OF CERVIX WITH OR WITHOUT BIOPSY OGS032 CRYOSURGERY OGS008 D. & C. WITH CERVIX BIOPSY OGS049 D. & C. WITH POLYPECTOMY OGS009 DILATATION & CURETTAGE (D.& C.) ONLY OGS007 DILATATION & EVACUATION (D. & E.) ONLY OGS028 DRAINAGE OF ABSCESS BARTHOLINS CYST OGS006 E.U.A. (EXAMINATION UNDER ANEASTHESIA) OGS070 END TO END FALLOPIAN TUBAL RECANALISATION / ANASTOMOSIS UNILATERAL OR BILATERAL 018 OGS025 EXCISION OF LABIAL CYST / BARTHOLINS CYST OGS073 EXCISION OF VAGINAL WALL CYST

15 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:06 O.B. & GYNAE - OPEN SURGERY DR PR SPR NSB SB 020 OGS092 EXP. LAP. WITH REPAIR OF UTERUS PERFORATION OR RUPTURE OGS075 FOREIGN BODY REMOVAL FROM VAGINA OGS040 FOTHERGILS / MANCHESTER OPERATION FOR UTERINE PROLAPSE OGS078 HEMATOCOLPOS DRAINAGE / COLPOTOMY OGS037 HEMATOMA DRAINAGE OGS038 HYMENECTOMY OGS058 HYSTEROTOMY OGS046 I & D OF LABIAL ABCESS UNILATERAL OR BILATERAL OGS061 INTERNAL ILIAC ARTERY LIGATION OGS021 L.S.C.S OGS018 L.S.C.S. WITH HYSTERECTOMY OGS090 LSCS WITH PREVIOUS SCAR OGS017 L.S.C.S. WITH TUBECTOMY OGS048 LAPROTOMY & REPOSITIONING OF UTERUS(HAULTENS TECH.) OGS034 LAPROTOMY FOR ECTOPIC PREGNANCY OGS041 LAPROTOMY FOR TWISTED OVARIAN OGS095 LIGATION OF UTERINE & OVARIAN ARTERIES OGS015 MAC DONALD STITCH / CERVICAL ENCIRCLAGE OGS036 MANUAL REMOVAL OF PLACENTA (BED SIDE) OGS069 MANUAL REMOVAL OF PLACENTA IN OT OGS030 MYOMECTOMY OGS002 NON DESCENT VAGINAL HYSTERECTOMY OGS013 OOPHRECTOMY / SALPINGECTOMY OGS053 OVARIAN CYST ASPIRATION WITH BIOPSY- BILATERAL OGS051 OVARIAN CYST ASPIRATION WITH BIOPSY- UNILATERAL OGS052 OVARIAN CYST ASPIRATION WITHOUT BIOPSY-BILATERAL OGS050 OVARIAN CYST ASPIRATION WITHOUT BIOPSY-UNILATERAL OGS023 OVARIAN CYSTECTOMY OGS010 PANHYSTERECTOMY / TAH WITH BSO OGS059 PURANDARE S SLING OPERATION FOR PROLAPSE OGS067 RADICAL HYSTERECTOMY FOR MALIGNANCY / WERTHEIM S HYSTERECTOMY

16 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:06 O.B. & GYNAE - OPEN SURGERY DR PR SPR NSB SB 051 OGS003 RADICAL VULVECTOMY OGS093 REMOVAL OF MAC DONALD STITCH (IN O.T.) OGS065 REPAIR OF RECTOVAGINAL FISTULA (RVF) OGS019 REPAIR OF VESICO-VAGINAL FISTULA OGS064 REPOSITIONING OF INVERTED UTERUS (UTERINE INVERSION) OGS057 RESUTURING OF ABDOMINAL WOUND MAJOR OGS043 RESUTURING OF ABDOMINAL WOUND MINOR OGS044 RESUTURING OF EPISIOTOMY WOUND OGS014 SALPINGO-OOPHRECTOMY OGS042 SHIRODHKAR SUTURE OGS062 SIMPLE VULVECTOMY OGS055 SUCTION AND EVACUATION OGS087 VAGINAL EXPLORATION WITH REMOVAL OF RING PESSARY OGS011 VAGINAL HYSTERECTOMY WITH VAGINAL AND PELVIC FLOOR REPAIR OGS001 VAGINOPLASTY OGS027 VAULT PROLASE REPAIR - ABDOMINAL COLPOSUSPENSION OGS026 VAULT PROLASE REPAIR - VAGINAL ROUTE OGS091 VAULT BIOPSY OGS045 VULVAL BIOPSY OGS024 WEDGE RESECTION OF OVARY :06A DELIVERY FEE 001 DEL001 NORMAL DELIVERY DEL002 FORCEPS DELIVERY :06B O.B. & GYNAE LAPAROSCOPIC SURGERY 001 OGS031 DIAGNOSTIC LAPAROSCOPY OGS068 DIAGNOSTIC LAPAROSCOPY & HYSTEROSCOPY OGL042 DIAGNOSTIC LAPAROSCOPY & HYSTEROSCOPY WITH D & C OGL001 DIAGNOSTIC LAPAROSCOPY WITH D. & C OGS056 DIAGNOSTIC LAPAROSCOPY WITH TUBAL MILKING (FOR ECTOPIC PREGNANCY) OGL002 LAPAROSCOPIC ABLATION OF ENDOMETRIOTIC SPOT OGL003 LAPAROSCOPIC ABSCESS DRAINAGE OGL004 LAPAROSCOPIC ADENOLYSIS OGS085 LAPAROSCOPIC ADHESIOLYSIS & HYSTEROSCOPY

17 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:06B O.B. & GYNAE LAPAROSCOPIC SURGERY DR PR SPR NSB SB 010 OGL005 LAPAROSCOPIC ASPIRATION OF OOCYTE OGL006 LAPAROSCOPIC ASSISTED VAGINAL HYSTRECTOMY (COMPLICATED) OGL007 LAPAROSCOPIC ASSISTED VAGINAL HYSTRECTOMY (SIMPLE) OGL008 LAPAROSCOPIC ASSISTED VAGINAL HYSTRECTOMY WITH BSO OGL009 LAPAROSCOPIC BURCH OPERATION OGL010 LAPAROSCOPIC COLPOSUSPENSION OGL040 LAPROSCOPIC COMPLICATED ENDOMETRIOTIC CYST REMOVAL OGS020 LAPAROSCOPIC CYST ASPIRATION OGL011 LAPAROSCOPIC END TO END ANASTOMOSIS (TUBAL) OGL012 LAPAROSCOPIC ENDOMETRIOSIS OGL013 LAPAROSCOPIC ENDORMYOMECTOMY (COMPLICATED) OGL014 LAPAROSCOPIC ENDORMYOMECTOMY (SIMPLE) OGL015 LAPAROSCOPIC EXCISION OF ENDOMETRIC LESION / ABLATION OGL016 LAPAROSCOPIC EXCISION OF RUDIMENTARY HORN OGL017 LAPAROSCOPIC EXCISION OF SCAR ENDOMETROSIS OGL018 LAPAROSCOPIC FALLOPOSCOPY OGL019 LAPAROSCOPIC FIMBRIOLYSIS OGL020 LAPAROSCOPIC FIMBRIOPLASTY OGL021 LAPAROSCOPIC LUNA OGL022 LAPAROSCOPIC MOSCOWITZ OGL023 LAPAROSCOPIC MULTIPLE PUNCTURE OGL024 LAPAROSCOPIC MYOMECTOMY OGL025 LAPAROSCOPIC OMENTECTOMY OGL026 LAPAROSCOPIC OOPHRECTOMY OGS081 LAPAROSCOPIC OVARIAN CYSTECTOMY OGL027 LAPAROSCOPIC OVARIOPLASTY OGL041 LAPAROSCOPIC PELVIC LYMPHADENECTOMY OGL028 LAPAROSCOPIC REMOVAL OF IUCD OGL029 LAPAROSCOPIC REPAIR OF NULLI PAROUS PROLAPSE OGL030 LAPAROSCOPIC RETROPERITONEAL NODE DISSECTION OGL039 LAPAROSCOPIC SALPINGECTOMY OGS079 LAPAROSCOPIC SALPINGECTOMY FOR ECTOPIC PREGNANCY OGS076 LAPAROSCOPIC SALPINGO-OOPHORECTOMY OGS077 LAPAROSCOPIC SALPINGOSTOMY FOR ECTOPIC PREGNANCY

18 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:06B O.B. & GYNAE LAPAROSCOPIC SURGERY DR PR SPR NSB SB 044 OGL031 LAPAROSCOPIC SURGERY FOR ECTOPIC PREGNANCY OGL032 LAPAROSCOPIC SUTURING OGL033 LAPAROSCOPIC TVT OGL034 LAPAROSCOPIC UTERINE SUSPENSION (SLING) OGL035 LAPAROSCOPIC VAULT SUSPENSION OGL036 LAPAROSCOPIC VAULT SUSPENSION WITH MESH OGS074 LAPAROSCOPY & HYSTEROSCOPY WITH OVARIAN BIOPSY OGS072 LAPAROSCOPY & HYSTEROSCOPY WITH OVARIAN DRILLING OGS071 LAPAROSCOPY WITH OVARIAN BIOPSY OGL037 TOTAL LAPAROSCOPIC HYSTRECTOMY OGL038 TOTAL LAPAROSCOPIC HYSTRECTOMY WITH BSO :06C O.B. & GYNAE HYSTEROSCOPIC SURGERY 001 OGH001 HYSTEROSCOPIC ABLATION OF ENDOMETRIUM OGH002 HYSTEROSCOPIC CUTTING OF UTERINE SYNECHIAE OGS080 HYSTEROSCOPIC DIVISION OF THICK SYNECHIAE OGS082 HYSTEROSCOPIC DIVISION OF THIN SYNECHIAE OGH003 HYSTEROSCOPIC GUIDED BIOPSY OGH004 HYSTEROSCOPIC MYOMA RESECTION OGS029 HYSTEROSCOPIC POLYPECTOMY OGS083 HYSTEROSCOPIC REMOVAL OF IUCD OGS084 HYSTEROSCOPIC REMOVAL OF RETAINED PRODUCTS OF CONCEPTION OGS086 HYSTEROSCOPIC RESECTION OF UTERINE SEPTUM OGH005 HYSTEROSCOPIC TRANS CERVICAL RESECTION OF ENDOMETRIUM OGH006 HYSTEROSCOPIC TUBAL CANNULATION OGS004 HYSTEROSCOPY DIAGNOSTIC OGS005 HYSTEROSCOPY WITH D. & C :07 OPHTHALMOLOGY SURGERY 001 OPS015 AC WASH OPS047 ANTERIOR SYNECHIOTOMY OPS032 BLEPHAROPLASTY FOR ECTROPION (WITH GRAFTING) OPS030 BLEPHAROPLASTY FOR ECTROPION (WITHOUT GRAFTING)

19 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:07 OPHTHALMOLOGY SURGERY DR PR SPR NSB SB 005 OPS031 BLEPHAROPLASTY FOR ENTROPION (WITHOUT GRAFTING) OPS027 CAPSULOTOMY OPS018 CATARACT EXTRACTION / GLAUCOMA OPS019 CATARACT EXTRACTION WITH I.O.L. IMPLANTATION (LENS COST EXTRA) OPS012 CONJ. TEAR OPS002 CORNEAL GRAFTING OPS025 CRYOPEXY / CYCLOCRYO : BILATERAL OPS024 CRYOPEXY / CYCLOCRYO : UNILATERAL OPS011 CYSTS LID CONJ OPS020 DACROCYSTORHINOSTOMY OPS028 ENDOSCOPIC DACROCYSTORHINOSTOMY OPS029 ENUCLEATION / EVICERATION OF EYES (WITHOUT IMPLANT) OPS033 ENUCLEATION / EVICERATION WITH IMPLANT OPS034 EPICANTHUS + TELECANTHUS CORRECTION OPS035 EPICANTHUS CORRECTION OPS010 EXAMINATION UNDER G.A OPS036 EXENTRATION OF ORBIT + SOCKET REPAIR OPS001 EXTRACTION OF CHALAZION SINGLE OPS052 EXTRACTION OF CHALAZION MULTIPLE OPS042 FOREIGN BODY REMOVAL EYE OPS049 INTRA VITREAL INJECTION ANTIBIOTIC/ STEROIDS OPS046 INTRA VITREAL INJECTION ANTI VEGF OPS022 INTRA-OCULAR FOREIGN BODY REMOVAL OPS014 LID INJURY MAJOR OPS013 LID INJURY MINOR OPS037 LID TUMORS EXCISION AND REPAIR-WITH GRAFTING OPS038 LID TUMORS EXCISON AND REPAIR -WITHOUT GRAFTING OPS005 MAJOR RECONSTRUCTIVE SURGERY OPS051 M.I.C.S. WITH I.O.L. IMPLANTATION (COST OF LENS EXTRA) OPS009 NEEDLING & ASPIRATION OPS023 PERFORATING INJURY REPAIR OPS007 PHACOEMULSIFICATION WITH I.O.L. IMPLANTATION (LENS COST EXTRA) OPS053 PHACOEMULSIFICATION WITH GLUCOMA SURGERY COMBINED OPS044 PROBING & SYRINGING OF NASO-LACRIMAL DUCT OPS039 PTERYGIUM SURGERY WITH GRAFTING

20 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:07 OPHTHALMOLOGY SURGERY DR PR SPR NSB SB 040 OPS040 PTERYGIUM SURGERY WITHOUT GRAFTING OPS026 PTOSIS OPS048 PUPILOPLASTY OPS003 RETINAL DETACHMENT SURGERY OPS021 RETINAL DETACHMENT WITH VITRECTOMY OPS045 SECONDARY I.O.L. IMPLANTATION OPS006 SOCKET RECONSTRUCTION OPS017 SQUINT CORRECTION: MORE THAN 2-MUSCLES / VERTICAL MUSCLES OPS016 SQUINT CORRECTION: UPTO 2-MUSCLES / HORIZONTAL MUSCLES OPS041 TARSORRHPHY PERMANENT OPS050 TARSORRHPHY TEMPORARY OPS043 TRABECULECTOMY OPS008 TUMOR OF IRIS OPS004 VITRECTOMY :08 ORTHOPAEDICS SURGERY AMPUTATION & DISARTICULATION 001 ORL049 AMPUTATION THROUGH LARGE BONES ORL050 AMPUTATION DISARTICULATION THROUGH SMALL BONES / DIGITS / RAYS ORL055 DISARTICULATION KNEE / ANKLE / WRIST / ELBOW ORU003 DISARTICULATION - SHOULDER ORL019 DISARTICULATION THROUGH HIP ORL101 REVISION AMPUTATION / STUMP CLOSURE ARTHROPLASTY 007 ORL011 HEMIARTHROPLASTY WITH OR WITHOUT CEMENTING ORL056 REVISION ARTHROPLASTY - HIP / KNEE ORL012 TOTAL HIP REPLACEMENT ORL028 TOTAL KNEE REPLACEMENT ORU027 TOTAL REPLACEMENT ELBOW / WRIST / ANKLE JOINT ORU008 TOTAL REPLACEMENT - SHOULDER ORU039 RADIAL HEAD REPLACEMENT ORL090 RE-SURFACING OF PATELLA ORU019 PUTTI PLATE RECONSTRUCTION OF SHOULDER / LATERJET PROCEDURE ORL ORL036 ARTHROTOMY AND ABSCESS ARTHROTOMY : HIP / KNEE / ANKLE / SHOULDER / ELBOW / WRIST ARTHROTOMY : OTHER SMALL JOINTS - FINGERS / TOES / HANDS / FEET

21 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:08 ORTHOPAEDICS SURGERY DR PR SPR NSB SB ARTHROTOMY AND ABSCESS 018 ORL022 DRAINAGE OF ABSCESS-DEEP : HIP / KNEE / ANKLE / SPINE ORL059 PSOAS / PARA VERTEBRAL ABSCESS ORL100 DRAINAGE OF ABSCESS- SUPERFICIAL ARTHROSCOPIC SURGERY 021 ORU029 ARTHROSCOPIC REPAIR SHOULDER - BANKART S REPAIR/ROTATOR CUFF REPAIR ORU038 ARTHROSCOPIC SURGERY SHOULDER DECOMPRESSION / ACROMIOPLASTY / ARTHROSCOPIC RELEASE 023 ORL023 DIAGNOSTIC ARTHROSCOPY- KNEE / SHOULDER / ANKLE / WRIST ORL058 OPEN / ARTHROSCOPIC ANT. C. LIGAMENT / PCL RECONSTRUCTION ORL024 ARTHROSCOPIC MENISCECTOMY ORL102 MENISCUS REPAIR ORL103 ARTHROSCOPIC SYNOVECTOMY ORL104 OPERATIVE ARTHROSCOPY-LOOSE BODY REMOVAL / ARTHRISCOPIC RELEASE BIOPSIES 029 ORL030 OPEN BIOPSY : BONES ORL038 SYNOVECTOMY : HIP / KNEE / SHOULDER / WRIST ORL039 SYNOVECTOMY : OTHER SMALL JOINTS ORL105 NEEDLE BIOPSY : BONES BONE GRAFTING 033 ORL106 BONE GRAFTING SMALL BONES ORU022 BONE GRAFTING LONG BONES ORL107 ARTIFICIAL BONE GRAFTING CLOSE REDUCTION 036 ORL001 CLOSED REDUCTION FRACTURE : Forearm, Arm, Leg, thigh, Wrist, Ankle ORU005 CLOSED REDUCTION - DISLOCATION : Elbow, Shoulder, Knee, Wrist, Ankle ORU031 MANIPULATION UNDER ANESTHESIA (M.U.A.) ORL108 CLOSED REDUCTION-DISLOCATION : HIP ORL109 CLOSED REDUCTION-FRACTURE & DISLOCATION: Hand, Foot Bone

22 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:08 ORTHOPAEDICS SURGERY DR PR SPR NSB SB DRESSINGS, DEBRIDEMENT AND FASCIOTOMY 041 ORL089 FASCIOTOMY LARGE ORU034 FASCIOTOMY SMALL ORL088 FASCIOTOMY THREE COMPARTMENT LEG ORL006 WOUND DEBRIDEMENT & TOILETTING SMALL ORU016 WOUND DEBRIDEMENT AND TOILETTING LARGE FRACTURES K.WIRE FIXATION 046 ORU006 FIXATION WITH K.WIRE -LONG BONE ORU041 FIXATION WITH K.WIRE- MULTIPLE SMALL BONE ORU042 FIXATION WITH K.WIRE-SMALL BONE PLATING FIXATION 049 ORL017 ACETABULAR RECONSTRUCTION ANTERIOR COLUMN ORL115 ACETABULAR RECONSTRUCTION POSTERIOR COLUMN ORL016 FIXATION WITH PLATING PELVIC BONES ORL027 TIBIAL PLATEAU ELEVATION & FIXATION (I GRAFTING) ORU036 O.R.I.F. WITH PLATING LONG BONE ORU048 O.R.I.F. WITH PLATING SMALL BONE ORU032 O.R.I.F. WITH PLATING - BOTH BONES ORU052 O.R.I.F. WITH PLATING WITH BONE GRAFT LONG BONES ORU004 O.R.I.F. WITH PLATING WITH BONE GRAFT - BOTH BONE ORU049 O.R.I.F. WITH DUAL PLATING LONG BONE NAILING FIXATION 059 ORL005 INTERLOCKING NAILING / PFN ORL092 DYNAMISATION OF I.M. NAIL ORU050 FLEXIBLE INTRA-MEDULLARY / TENS NAILING ORU051 O.R.I.F. WITH INTERLOCKING WITH BONE GRAFT EXTERNAL FIXATION 063 ORL091 ADJUSTMENT OF EXTERNAL FIXATOR ORL009 EXTERNAL FIXATION - LONG BONES ORL094 EXTERNAL FIXATION (ILIAZAROV TECHNIQUE) LONG BONES ORU040 EXTERNAL FIXATOR SMALL BONES ORU053 EXTERNAL FIXATION PELVIS ORL063 FAILED CLUB FOOT FIXATOR CORRECTION

23 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:08 ORTHOPAEDICS SURGERY DR PR SPR NSB SB FIXATION WITH SCREWS 069 ORU045 O.R.I.F. WITH SCREWS ORL078 O.R.I.F. WITH DHS FIXATION WITH TENSION BAND WIRING 071 ORU033 TENSION BAND WIRING ORL082 CIRCLAGE WIRING OTHER FIXATION 073 ORL070 O.R.I.F ANKLE - BIMALLEOLAR FIXATION ORL087 O.R.I.F. ANKLE TRIMALLEOLAR FIXATION ORL031 PATELLECTOMY IMPLANT REMOVAL 076 ORL053 REMOVAL OF IMPLANTS : MAJOR (PLATES, EXTERNAL FIXATOR, NAIL, TENSION BAND WIRE) 077 ORL052 REMOVAL OF IMPLANTS : MINOR : SCREWS ETC ORU054 REMOVAL OF IMPLANTS : K.WIRE ORU055 REMOVAL OF IMPLANT THR / BIPOLAR / TKR OSTEOMYLITIS 080 ORU043 OSTEOMYELITIS - LONG BONES ORU044 OSTEOMYELITIS - SMALL BONES ORL084 SEQUESTRECTOMY - LONG BONES ORL083 SEQUESTRECTOMY - SMALL BONES OSTEOMIES AND ARTHRODESIS 084 ORL043 ARTHRODESIS : ANKLE, KNEE, SHOULDER, ELBOW, WRIST, TRIPLE ORL018 ARTHRODESIS OF HIP ORU024 ARTHRODESIS OF MINOR JOINTS ORL048 OSTEOTOMY : MID FOOT ORU026 OSTEOTOMY AND FIXATION ORL013 OSTEOTOMY AROUND HIP ORL062 PELVIC OSTEOTOMIES ORU056 OSTEOCLASIS AND FIXATION ORU057 EPIPHYSIODESIS TENDON AND NERVE SURGERY 093 ORU012 CARPAL TUNNEL RELEASE / DECOMPRESSION ORL034 MAJOR RECONSTRUCTION : NERVE / TENDONS (MORE THAN 3)

24 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:08 ORTHOPAEDICS SURGERY DR PR SPR NSB SB TENDON AND NERVE SURGERY 095 ORL033 MINOR RECONSTRUCTION : NERVES / TENDONS ORU010 REPAIR OF TENDONS - 3 OR LESS ORU011 REPAIR OF TENDONS -MORE THAN 3 TENDONS ORL047 TENDON ACHILLES / REPAIR & RECONSTRUCTION ORL098 TENDON LENGTHENING / STERNOMASTOID RELEASE ORU015 TENDON TRANSFER & REPAIR ORU001 TENDON TRANSFER MULTIPLE ORU018 PERIPHERAL NERVE TRANSFER / TRANSPOSITION ORL073 PERCUTANEOUS TENOTOMY (3 OR LESS) ORL074 PERCUTANEOUS TENOTOMY (MORE THAN 3) ORL041 CLUB FOOT RELEASE (CTEV) : BILATERAL ORL040 CLUB FOOT RELEASE (CTEV) : UNILATERAL ORU058 PERIPHERAL NERVE EXPLORATION / NEUROLYSIS ORL110 QUADRICEPSPLASTY ORL111 LIGAMENT REPAIR UPTO TWO ORL112 LIGAMENT REPAIR MORE THAN TWO TUMOURS 111 ORL021 MINOR EXCISION OF SWELLING / TUMOR WITH OR WITHOUT BIOPSY ORL020 TUMOR EXCISION & RECONSTRUCTION - LONG BONES ORL113 TUMOR EXCISION & RECONSTRUCTION SMALL BONES ORU037 EXCISION OF BURSAE ORU014 EXCISION OF GANGLION ORL114 EXCISION OF EXOSTOSIS SPINE 117 ORS004 ANTEROLATERAL DECOMPRESSION ORS005 CERVICAL VERTIBRECTOMY ORS001 LAMINECTOMY (LUMBAR / CERVICAL) / DISCECTOMY ORS002 POSTERIOR / ANTERIOR FUSION & INSTRUMENTATION ORS003 POSTERIOR / ANTERIOR FUSION ONLY MISCELLANEOUS 122 ORL054 TARGETTED DELIVERY OF STEROID ORL045 EXCISION : NAIL & NAIL BED

25 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:08 ORTHOPAEDICS SURGERY DR PR SPR NSB SB MISCELLANEOUS 124 ORL046 MINOR PROCEDURES IN FOOT ORL086 SKELETAL TRACTION (IN O.T.) ORL015 C.D.H. (OPEN REDUCTION & FIXATION) ORL014 C.D.H. (CLOSED REDUCTION & HIP SPICA) ORL065 CORE DECOMPRESSION FOR AVN HIP WITH FIBULAR GRAFTING ORL066 CORE DECOMPRESSION FOR AVN HIP WITHOUT FIBULAR GRAFTING ORL051 LIMB LENGTHENING WITH INSTRUMENTATION ORL069 MUSCLE PEDICLE GRAFTING ORU028 DE QUERVAIN RELEASE TRIGGER THUMB / FINGER ORU013 EXCISION HEAD OF RADIUS / LOWER END ULNA :09 NEURO SURGERY 001 NES001 BURR HOLES FOR CH SDH / ABSCESS NES042 CERVICAL TRACTION (IN O.T.) NES029 CORPECTOMY NES005 CRANIOPLASTY NES014 CRANIOTOMY - A.V.MALFORMATION NES013 CRANIOTOMY - ABSCESS / CYSTS NES016 CRANIOTOMY - ACOUSTIC NEUROMA NES015 CRANIOTOMY - ANEURYSM NES017 CRANIOTOMY - BRAIN STEM TUMOR NES032 CRANIOTOMY - CONTUSIONS NES012 CRANIOTOMY - CRANIOPHARYNGIOMA NES008 CRANIOTOMY - EXTRADURAL HEMATOMA NES018 CRANIOTOMY - FOR CSF RHINORRHEA NES006 CRANIOTOMY - INTRACEREBRAL HEMATOMA NES011 CRANIOTOMY - PITUITARY TUMOR NES010 CRANIOTOMY - POST. FOSSA TUMOR NES007 CRANIOTOMY - SUBDURAL HEMATOMA NES041 CRANIOTOMY - TEMPORAL CRANIOTOMY NES009 CRANIOTOMY - VASCULAR TUMOR NES033 CRANIOTOMY FOR DEPRESSED FRACTURE NES052 DE-TEETHERING OF CORD NES034 DECOMPRESSIVE CRANIOTOMY NES023 DISCECTOMY (CERVICAL / DORSAL / MICRO-II LEVELS) NES053 ENDODSCOPIC COLLOID CYST EXCISION NES054 ENDOSCOPIC LUMBAR / CERVICAL DISC (MULTIPLE)

26 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:09 NEURO SURGERY DR PR SPR NSB SB 026 NES055 ENDOSCOPIC LUMBAR / CERVICAL DISC (SINGLE) NES056 ENDOSCOPIC THIRD VENTRICULOSTOMTY NES035 ENDODSCOPIC SURGERY NES046 EXTERNAL VENTRICULAR DRAINAGE (EVD) NES057 FORAMINAL BLOCKS FOR LUMBAR SPINE NES051 FORAMINOTOMY NES022 LAMINECTOMY (LUMBAR) NES058 MENINGOCOEL REPAIR NES059 MENINGO-MYELOCELE REPAIR NES025 MICRODISCECTOMY - MORE THAN II LEVELS NES043 NEUCLEOPLASTY NES028 NEURO-ENDOSCOPIC SKULL BASE SURGERY NES060 OMAYA RESERVOIR INSERTION NES061 OMAYA RESERVOIR TAP NES024 OPERATION FOR CANAL STENOSIS (LUMBAR / CERVICAL) NES036 PERIPHERAL NERVE SURGERY NES062 RF LESSIONING / PRGR FOR TRIMENIAL NEURALGIA NES045 REMOVAL OF V.P.SHUNT NES021 REPAIR OF ENCEPHALOCELE NES019 REPAIR OF MENINGOCELE NES020 REPAIR OF MENINGOMYELOCELE NES004 REVISION OF SHUNT NES003 SHUNT FOR HYDRO CEPHALUS NES037 SPINAL DYSRAPHISM NES038 SPINAL INSTRUMENTATION NES026 SPINAL TUMOR / HEMATOMA / ABSCESS NES047 SUBDURAL TAP NES030 SURGERY FOR CRANIOSYNOSTOSIS NES027 TRANS SPHENOIDAL PITUITARY / SELLAR SURGERY NES044 UNLOCKING OF FACET JOINT NES039 VENTRIC TAP NES002 VENTRICULO AURICULAR SHUNT NES040 VERTEBROPLASTY :10 E.N.T. SURGERY 001 ENS019 ABSCESS TONSILLECTOMY - I. & D ENS045 ADENO-TONSILLECTOMY ENS062 ADENOIDECTOMY ENS064 ANGIOFIBROMA REMOVAL ENS065 ANTRAL POLYPECTOMY ENS046 ANTRAL WASH : UNILATERAL OR BILATERAL ENS056 BIOPSY CHEEK OR TONGUE : U/L OR B/L

27 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:10 E.N.T. SURGERY DR PR SPR NSB SB 008 ENS008 BRONCHOSCOPY WITH OR WITHOUT F.B.REMOVAL / BIOPSY ENS041 CALDWELL LUC : BILATERAL ENS040 CALDWELL LUC : UNILATERAL ENS067 CAUTERY PATCHING EAR ENS063 CHANGE OF TRACHEOSTOMY TUBE ENS068 COCHLEAR IMPLANT ENS089 COMMANDO SURGERY WITH MODIFIED RADICAL NECK DISSECTION ENS042 DIAGNOSTIC NASAL ENDOSCOPY ENS069 ENDOLYMPHATIC SAC DECOMPRESSION ENS086 ENDOSCOPIC CHOANAL ATRESIA REPAIR B/L ENS070 ENDOSCOPIC CSF RHINORRHEA REPAIR ENS013 ENDOSCOPIC DACROCYSTORHINOSTOMY ENS009 ETHMOIDECTOMY (EXTERNAL) ENS085 EXCISION OF PALATIAL GROWTH WITH FLAP REPAIR ENS029 EXCISION THYROGLOSSAL CYST ENS087 EXTENDED TRANS LABYRINTHINE APPROACH ENS025 FACIAL NERVE DECOMPRESSION OR GRAFTING ENS071 FACIAL REANIMATION PROCEDURE - LID LOADING ENS072 FACIAL REANIMATION PROCEDURE - TEMPORALIS TRANSFER ENS073 FESS - LIMITED ENS088 FESS EXTENDED UNILATERAL ENS044 FESS : BILATERAL ENS043 FESS : UNILATERAL ENS012 FOREIGN BODY REMOVAL - EAR / NOSE / THROAT ENS022 FRACTURE NASAL BONES ENS095 GLOSSECTOMY PARTIAL ENS096 GLOSSECTOMY TOTAL ENS097 GVELO-PALATOPHARYNGOPLASTY ENS024 HEMATOMA PINNA : BILATERAL ENS023 HEMATOMA PINNA : UNILATERAL ENS053 I. & D. OF PARA PHARYNGEAL ABSCESS ENS030 I. & D. OF THYROGLOSSAL CYST ENS057 I. & D. QUINCY ENS059 I. & D. TONSILLAR ABSCESS : UNILATERAL OR BILATERAL ENS031 LARYNGECTOMY (TOTAL) ENS017 LARYNGOSCOPY - DIRECT ENS084 LARYNGOSCOPY - FIBER OPTIC

28 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:10 E.N.T. SURGERY DR PR SPR NSB SB 045 ENS060 LATERAL RHINOTOMY ENS055 LYMPH NODE BIOPSY ENS014 MASTOIDECTOMY (MODIFIED) ENS037 MASTOIDECTOMY WITH TYMPANOPLASTY ENS028 MAXILLARY SINUS SURGERY ENS099 MAXILLECTOMY ENS098 MAXILLECTOMY -MEDIAL ENS026 MICRO LARYNGEAL SURGERY ENS006 MICRO LARYNGOSCOPY WITH BIOPSY ENS038 MICROSCOPIC EXAMINATION (E.U.M.) ENS100 MODIFIED ENDOSCOPIC LATHROP PROCEDURE (M.E.L.) ENS034 MYRINGOPLASTY ENS036 MYRINGOTOMY WITH OR WITHOUT GROMMET : BILATERAL ENS035 MYRINGOTOMY WITH OR WITHOUT GROMMET : UNILATERAL ENS048 NASAL CAUTERY IN EPISTAXIS ENS074 NASAL ENDOSCOPIC CAUTERISATION FOR EPISTAXIS ENS090 NASAL ENDOSCOPY WITH BIOPSY ENS091 NASAL PACK REMOVAL (IN O.T.) ENS092 NASAL PACK REMOVAL + CHECK NASAL ENDOSCOPY (IN O.T.) ENS058 NASAL PACKING ANTERIOR (WITH PACK REMOVAL) ENS094 NASAL PACKING POSTERIOR (WITH PACK REMOVAL) ENS027 NASAL PACKING ANTERIOR WITH POSTERIOR (WITH PACK REMOVAL) ENS033 NASAL POLYPECTOMY : BILATERAL ENS032 NASAL POLYPECTOMY : UNILATERAL ENS101 NECK DISSECTION PARTIAL ENS102 NECK DISSECTION TOTAL ENS002 OESOPHAGOSCOPY WITH F.BODY REMOVAL + BIOPSY ENS007 OSSICULOPLASTY / TYMPANOTOMY ENS052 PRE AURICULAR SINUS : BILATERAL ENS051 PRE AURICULAR SINUS : UNILATERAL ENS076 RHINOPLASTY ENS016 S.M.R ENS039 SEPTOPLASTY ENS011 SEPTOPLASTY WITH S.M.D ENS061 SEPTORHINOPLASTY ENS047 SMD ENS050 SPLIT EAR LOBULE : BILATERAL

29 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:10 E.N.T. SURGERY DR PR SPR NSB SB 082 ENS049 SPLIT EAR LOBULE : UNILATERAL ENS015 STAPEDECTOMY ENS021 STYLOIDECTOMY : BILATERAL ENS020 STYLOIDECTOMY : UNILATERAL ENS077 THYROPLASTY ENS078 THYROPLASTY WITH ARYTENOID - ABDUCTION / ADDUCTION ENS005 TONSILLECTOMY ENS018 TRACHEOSTOMY ENS004 TURBINECTOMY : BILATERAL ENS003 TURBINECTOMY : UNILATERAL ENS010 TYMPANOPLASTY ENS103 VESTIBULAR NEURONECTOMY ENS079 VOCAL CORD LATERLIZATION ENS054 YOUNG OPERATION :11 THORACIC SURGERY 001 THS002 BRONCHOSCOPY WITH OR WITHOUT F.B.REMOVAL / BIOPSY THS024 BULLECTOMY THS035 CERVICAL RIB EXCISION BILATERAL THS036 CERVICAL RIB EXCISION UNILATERAL THS008 CHEST ASPIRATION THS031 CLOSURE OF BRONCHO-PLEURAL FISTULA THS014 DECORTICATION THORACOTOMY THS020 DECORTICATION WITH LOBECTOMY THS037 DIAGNOSTIC THORACOSCOPY AND DRAINAGE THS038 EXCISION OF CHEST WALL TUMOR EXCLUDING RIBS THS039 EXCISION OF CHEST WALL TUMOR INCLUDING RIBS THS001 EXPLORATORY THORACOTOMY THS005 HIATUS OR DIAPHRAGMATIC HERNIA THS025 HYDATID CYST THS009 INTERCOSTAL DRAINAGE THS012 LOBECTOMY - WEDGE, SEGMENT / LOBE THS022 MEDIASTINAL LYMPHNODE EXCISION & BIOPSY THS003 MEDIASTINAL TUMOR EXCISION THS010 NEEDLE BIOPSY- PLEURA / LUNG THS007 OESOPHAGOSCOPY WITH F.B.REMOVAL THS011 OPEN BIOPSY - PLEURA / LUNG THS017 PERICARDECTOMY THS018 PERICARDIOSTOMY

30 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:11 THORACIC SURGERY DR PR SPR NSB SB 024 THS028 PLEURAL ASPIRATION THS041 PLEURECTOMY THS027 PLEURODESIS EACH SITTING THS013 PNEUMENECTOMY THS006 RECONSTRUCTION OF PERIPHERAL VASCULAR INJURY THS029 REMOVAL OF FOREIGN BODY (BULLET) CHEST / SHOULDER THS021 RIB RESECTION AND DRAINAGE THS023 SCALENE NODE BIOPSY THS026 SEGMENTAL RESECTION THS004 SURGERY FOR PORTAL HYPERTENSION THS032 THORACOSCOPIC DECORTICATION THS042 THORACOSCOPIC DRAINAGE OF PLEURAL EFFUSION THS043 THORACOSCOPIC PLEURODESIS THS044 THORACOSCOPIC OESOPHEGECTOMY THS033 THORACOTOMY FOR ANTERO-LATERAL DECOMPRESSION THS030 THORACOSCOPY WITH DRAINAGE OF LUNG ABSCESS THS034 THORACOTOMY FOR PENETRATING INJURY CHEST THS019 THORACOTOMY WITH LIGATION OF PDA THS040 THYMECTOMY :12 VASCULAR SURGERY 001 VAS055 A.V. FISTULA (COMPLEX) FOR DIALYSIS VAS054 A.V. FISTULA (PROXIMAL) FOR DIALYSIS VAS007 A.V. FISTULA (DISTAL) FOR DIALYSIS VAS018 ABDOMINAL ANEURYSM VAS013 AORTO-FEMORAL BYPASS VAS012 AV GRAFT FOR VASCULAR ACCESS FOR HAEMODIALYSIS VAS040 AXILLARY-BRACHIAL BYPASS USING SYNTHETIC GRAFT VAS033 BASALIC VEIN TRANSPOSITION VAS037 BRACHIAL ARTERY REPAIR VAS027 BRACHIAL ARTERY REPAIR WITH GRAFT VAS041 CAROTID AXILLARY BYPASS USING SYNTHETIC GRAFT VAS011 CAROTID ENDARTERECTOMY VAS017 CERVICAL RIB EXCISION VAS003 CERVICO THORACIC SYMPATHECTOMY VAS030 CLOSURE OF A.V. FISTULA VAS028 CLOT EVACUATION

31 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:12 VASCULAR SURGERY DR PR SPR NSB SB 017 VAS036 EMBOLECTOMY VAS010 ENDARTERECTOMY OF PERIPHERAL VESSELS VAS016 EXCISION OF A.V. MALFORMATION VAS019 EXCISION OF HAEMANGIOMA - MAJOR VAS020 EXCISION OF HAEMANGIOMA - MEDIUM VAS021 EXCISION OF HAEMANGIOMA - MINOR VAS042 EXPLORATION & REPAIR OF AXILLARY ARTERY VAS043 EXPLORATION & REPAIR OF CAROTID ARTERIAL INJURY VAS044 EXPLORATION & REPAIR OF CAROTID ARTERIAL INJURY USING VEIN PATCH VAS045 EXPLORATION & REPAIR OF FEMORAL ARTERY VAS066 EXPLORATION & REPAIR OF TIBIAL ARTERY VAS046 EXTRA-ANATOMICAL AXILLO-FEMORAL BYPASS USING GRAFT VAS009 FEMORAL EMBOLECTOMY : BILATERAL VAS008 FEMORAL EMBOLECTOMY : UNILATERAL VAS022 FEMORO-FEMORAL CROSS OVER GRAFT VAS014 FEMORO-POPLITEAL BYPASS VAS023 FEMORO-POPLITEAL BYPASS WITH VEIN / GRAFT VAS006 HEPATIC RESECTION (LOBECTOMY) VAS047 ILEO-FEMORAL BYPASS USING SYNTHETIC GRAFT VAS026 ILLIAC ARTERY ANEURYSM VAS062 LASER VARICOSE VEINS BOTH LEG VAS063 LASER VARICOSE VEINS ONE LEG VAS056 LIGATION OF VEINS OF AVF VAS031 LIGATION OF FEMORAL S.F. JUNCTION VAS032 LIGATION OF SAPHENOUS POPLITEAL JUNCTION VAS057 LOCAL TRANSPOSITION OF VEINS VAS002 LUMBAR SYMPATHECTOMY : UNILATERAL VAS059 MULTIPLE AVULSIONS OF VARICOSE VEIN VAS015 PERIPHERAL ANEURYSM REPAIR VAS048 POPLITEAL TO ANTERIOR / POSTERIOR TIBIAL BYPASS VAS049 RE-EXPLORATION FOR BLEEDING AT VASCULAR-ANASTOMATIC SITE VAS050 REMOVAL OF INFECTED GRAFT VAS051 REPAIR OF PERIPHERAL VASCULAR INJURY VAS058 SCLEROTHERAPY OF VARICOSE VEINS VAS060 STRIPPING LSV VAS061 STRIPPING SSV

32 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:12 VASCULAR SURGERY DR PR SPR NSB SB 053 VAS052 SUBCLAVIAN-BRACHIAL BYPASS VAS065 TEMPORAL ARTERY BIOPSY VAS001 THROMBO ENDARTERECTOMY AORTA VAS068 THROMBOLECTOMY VAS034 THROMBOLETOMY WITH DACRON PATCH ARTERIOPLASTY VAS064 THROMBOLYSIS VAS039 VARICOSE VEINS BOTH LEG VAS024 VARICOSE VEINS ONE LEG VAS035 VEIN PATCHPLASTY VAS053 VENOUS ANEURYSM LIGATION VAS025 VENOUS RECONSTRUCTION :13 UROLOGY SURGERY 001 URS123 ADRENELECTOMY OPEN URS035 AMPUTATION OF PENIS - PARTIAL URS034 AMPUTATION OF PENIS - TOTAL URS029 AUGMENTATION CYSTOPLASTY URS053 BASKETING URS010 BLADDER NECK INCISION (B.N.I.) URS056 BLADDER NECK RECONSTRUCTION URS102 BUCCAL MUCOSAL GRAFT ( BILATERAL OR UNILATERAL) URETHROPLASTY OR SUBSTITUTION URETHROPLASTY 009 URS122 CHORDEE WITHOUT HYPOSPADIAS URS066 CIRCUMCISION URS030 CLOSURE OF URETHRAL FISTULA URS008 COMBINATION OF T.U.R.P. + STONE OR TUMOR URS067 COMBINATION OF T.U.R.P. + B.N.I URS132 CYSTOLITHOTOMY URS009 CYSTOLITHOTRIPSY / CYSTOLITHALOPEXY URS095 CYSTOSCOPY + CLOT EVACUATION WITH FULGRATION URS004 CYSTOSCOPY (DIAGNOSTIC) URS068 CYSTOSCOPY WITH BIOPSY URS005 CYSTOSCOPY WITH BLADDER BIOSPY OR R.G.P URS069 CYSTOSTOMY (SUPRAPUBIC) URS051 D.J.STENTING : BILATERAL URS070 D.J.STENTING : UNILATERAL URS093 D.J.STENTING WITH URETERIC CATHETERISATION URS092 DEROOFING OF PROSTATIC ABSCESS URS073 ENDOPYELOTOMY - PCN OR URS

33 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:13 UROLOGY SURGERY DR PR SPR NSB SB 026 URS002 ENDOSCOPIC CORRECTION OF REFLUX : UNILATERAL OR BILATERAL URS074 ENDOSCOPIC DILATATION OF URETERAL STRICTURE URS141 ENDOSCOPIC INCISION OF URETEROCELE URS003 ENDOSCOPIC REMOVAL OF URETHRAL STONE URS012 ENDOSCOPIC VENTRO-SUSPENSION FOR STRESS / TVT / TOT URS064 EPIDIDYMAL CYST URS075 EPIDYDMECTOMY - BILATERAL URS076 EPIDYDMECTOMY - UNILATERAL URS098 EXCISION OF GROWTH PENIS URS037 EXPLORATORY SCROTOTOMY / SCROTAL EXPLORATION URS015 EXTROPHY / EPISPADIAS REPAIR URS071 FRENULOPLASTY URS100 HYPOSPADIAS REPAIR 1ST STAGE URS101 HYPOSPADIAS REPAIR 2ND STAGE URS105 HYPOSPADIAS REPAIR SINGLE STAGE URS119 ILEO INGUINAL LYMPHADENECTOMY BILATERAL URS125 ILEO INGUINAL LYMPHADENECTOMY UNILATERAL URS133 INTRAVESICAL INJECTION OF BOTULINUM TOXIN FOR O.A.B. (OVER ACTIVE BLADDER) URS113 ISTHAMECTOMY WITH NEPHROPEXY URS062 LAPAROSCOPIC ADRENALECTOMY URS115 LAPAROSCOPIC ASSISTED PCNL URS061 LAPAROSCOPIC RADICAL NEPHRECTOMY URS060 LAPAROSCOPIC SIMPLE NEPHRECTOMY URS055 LAPAROSCOPIC URETEROLITHOTOMY URS137 LASER PROSTATECTOMY URS157 MEATAL DILATATION URS057 MEATOPLASTY URS063 MEATOTOMY URS094 NEEDLE ASPIRATION OF PROSTATE URS091 NEEDLE BIOPSY OF PROSTATE URS072 NEPHRECTOMY URS020 NEPHRECTOMY (RADICAL) URS142 NEPHRECTOMY (RADICAL) WITH IVC THROMBECTOMY URS018 NEPHRECTOMY (SIMPLE OR PARTIAL) URS045 NEPHRECTOMY RENAL TUMOR URS019 NEPHROLITHOTOMY (ANATROPHIC) URS114 NEPHROPEXY FOR PTOTIC KIDNEY

34 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:13 UROLOGY SURGERY DR PR SPR NSB SB 063 URS023 NEPHROSTOMY - OPEN URS024 NEPHROSTOMY - PERCUTANEOUS (P.C.N.) URS021 NEPHROURETERECTOMY URS040 OPERATION FOR DOUBLE URETER URS041 OPERATION FOR ECTOPIC URETER URS046 OPERATION FOR INJURY OF BLADDER URS110 OPERATION FOR MEGA URETER URS011 OPTICAL INTERNAL URETHROTOMY URS143 ORCHIDECTOMY : RADICAL / HIGH / INGUINAL UNILATERAL OR BILATERAL URS144 ORCHIDECTOMY - BILATERAL URS145 ORCHIDECTOMY - UNILATERAL URS017 ORCHIOPEXY OR ORCHIDOPEXY : BILATERAL URS016 ORCHIOPEXY OR ORCHIDOPEXY : UNILATERAL URS027 PARTIAL CYSTECTOMY URS090 PCNL UNILATERAL - MULTIPLE PUNCTURE URS121 PCNL BILATERAL URS047 PCNL UNILATERAL URS148 PENILE IMPLANT 3 PIECE SYSTEM URS149 PENILE IMPLANT SEMIRIGID 2 PIECE SYSTEM URS131 PERCUTANEOUS CYSTOLITHOTRIPSY (PCLT) URS033 PERINEAL URETHROSTOMY URS118 PERINEPHRIC ABSCESS DRAINAGE OPEN URS117 PERINEPHRIC ABSCESS DRAINAGE PERCUTANEOUS URS078 PROSTATIC BIOPSY URS079 PYELOLITHOTOMY URS150 PYELOLITHOTOMY LAPROSCOPIC URS022 PYELOPLASTY WITH OR WITHOUT R.G.P URS106 RADICAL CYSTECTOMY WITH NEOBLADDER URS058 RADICAL CYSTOPROSTATECTOMY URS059 RADICAL RETROPUBIC PROSTATECTOMY URS080 RADICAL / TOTAL CYSTECTOMY WITH URINARY DIVERSION URS081 RECTO-URETHERAL FISTULA - POST SAGGITAL REPAIR URS120 RELOOK PCNL URS052 REMOVAL OF D.J.STENT U/L OR B/L URS044 REPAIR OF URETHRAL INJURY URS112 RGP WITH SCLERO THERAPY FOR CHYLURIA URS111 RPLND (RETRO- PERITONEAL LYMPHNODE DISSECTION) URS096 SEPARATION AND DISSECTION OF BLADDER

35 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:13 UROLOGY SURGERY DR PR SPR NSB SB 101 URS082 SUPRAPUBIC DRAINAGE (CLOSED) URS084 SUPRAPUBIC DRAINAGE (OPEN) URS085 SUPRAPUBIC PROSTATECTOMY URS108 SURGERY FOR PEYRONIS DISEASE URS109 SURGERY FOR PRIAPISM URS107 SURGERY FOR RECTOURETHRAL FISTULA URS116 T U R E D (TRANS URETHRAL RESECTION OF EJACULATING DUCT) URS007 T.U.R. - BLADDER TUMOR URS001 T.U.R. - POSTERIOR URETHRAL VALVES URS006 T.U.R. - PROSTATE URS097 T.U.R. - PROSTATE WITH T.U.E.V.P URS086 TESTICULAR BIOPSY URS151 TORSION TESTIS URS128 TRANS URETERO URETEROSTOMY URS087 TRANS URETHRAL ELECTRO VAPOUIZATION OF PROSTATE URS152 TRANSPLANT NEPHRECTOMY URS026 TROCAR CYSTOSTOMY URS065 URETERIC CATHETERISATION - UNILATERAL OR BILATERAL URS129 URETERO URETEROSTOMY URS025 URETEROINTESTINAL DIVERSION / RE- IMPLANTATION OF URETER / PSOAS HITCH URS088 URETEROLITHOTOMY URS153 URETEROLITHOTOMY LAPAROSCOPIC URS130 URETEROLYSIS FOR RETROPERITONEAL FIBROSIS URS014 URETERONEOCYSTOSTOMY : BILATERAL URS013 URETERONEOCYSTOSTOMY : UNILATERAL URS127 URETERONEOCYSTOSTOMY WITH BOARI FLAP URS126 URETEROPLASTY WITH ILEAL REPOSITION URS050 URETEROSCOPIC LITHOTRIPSY URS049 URETEROSCOPIC STONE REMOVAL URS089 URETEROSCOPIC URETEROTOMY URS048 URETEROSCOPY : DIAGNOSTIC URS154 URETHRAL CARBUNCULE EXCISION URS054 URETHRAL DILATATION URS140 URETHROPLASTY END TO END URS155 URETHROPLASTY ONE STAGE URS103 URETHROPLASTY FOR POSTERIOR URETHRAL DISTRACTION DEFECT (PUDD) URS031 URETHROPLASTY TWO STAGED - 1ST STAGE URS032 URETHROPLASTY TWO STAGED - 2ND STAGE

36 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:13 UROLOGY SURGERY DR PR SPR NSB SB 139 URS043 V.V.FISTULA REPAIR / URETERO-VAGINAL FISTULA REPAIR URS099 VARICOCELECTOMY BILATERAL URS124 VARICOCELECTOMY LAPAROSCOPIC URS156 VARICOCELECTOMY OPEN MICROSURGICAL BILATERAL URS104 VARICOCELECTOMY OPEN MICROSURGICAL UNILATERAL URS036 VARICOCELECTOMY UNILATERAL URS039 VASO-EPIDIDYMAL ANASTOMOSIS URS038 VASOVASAL ANASTOMOSIS URS042 Y.V.PLASTY OF BLADDER NECK :14 PLASTIC SURGERY 001 PLS048 ABDOMINOPLASTY PLS028 ABDOMINOPLASTY WITH LIPOSUCTION (COSMETIC) PLS068 BAT EAR BILATERAL PLS033 BLEPHEROPLASTY FOUR LIDS PLS032 BLEPHEROPLASTY TWO LIDS PLS040 BREAST AUGMENTATION (IMPLANT) : BILATERAL PLS039 BREAST AUGMENTATION (IMPLANT) : UNILATERAL PLS041 BREAST AUGMENTATION BY FLAP PLS070 BREAST REDUCTION : BILATERAL PLS069 BREAST REDUCTION : UNILATERAL PLS023 CHEMICAL PEELING PLS010 CLEFT LIP CASE RHINOPLASTY PLS009 CLEFT LIP NOSTRIL PLS002 CLEFT LIP / PALATE : BILATERAL PLS001 CLEFT LIP / PALATE : UNILATERAL PLS005 CLEFT PALATE & LIP : BILATERAL PLS004 CLEFT PALATE & LIP : UNILATERAL PLS008 CLEFT PALATE FISTULA WITH FLAP PLS006 CLEFT PALATE WITH PHARYNGOPLASTY PLS007 CLEFT PALATE-FISTULA SIMPLE PLS021 COMPLICATED SCAR FACE / MULTIPLE SCARS PLS125 CONTRACTURE RELEASE ONLY (ONE FINGER) PLS085 CONTRACTURE RELEASE WITH FLAP & SKINGRAFT PLS084 CONTRACTURE RELEASE WITH SKIN GRAFT MORE FINGERS PLS083 CONTRACTURE RELEASE WITH SKIN GRAFT ONE FINGER PLS103 CYST OR GANGLION MULTIPLE

37 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:14 PLASTIC SURGERY DR PR SPR NSB SB 027 PLS134 WOUND DEBRIDEMENT LARGE PLS135 WOUND DEBRIDEMENT MEDIUM PLS136 WOUND DEBRIDEMENT SMALL PLS022 DERMABRASION FACE PLS098 DETACHMENT OF FLAP PLS122 DISTRACTION OSTEOGENESIS MANDIBLE OR MAXILLA PLS124 DIVISION OF FLAP PLS057 DRESSING - MAJOR PLS114 DRESSING - MEDIUM PLS058 DRESSING - MINOR PLS065 EAR LOBULE KELOID : BILATERAL PLS064 EAR LOBULE KELOID : UNILATERAL PLS101 EXCISION OF CYST - MULTIPLE PLS100 EXCISION OF CYST - SINGLE PLS113 EXCISION OF MOLE - FACE PLS123 EXPLANTATION OF BREAST IMPLANT PLS071 EXTRA DIGIT EXCISION PLS034 EYE LIDS - PTOSIS : UNILATERAL PLS036 EYE LIDS : PARTIAL EXCISION & REPAIR WITH SKIN GRAFT & FLAP PLS038 EYE LIDS FOLD RECONSTRUCTION PLS037 EYE LIDS TUMOR EXCISION & REPAIR WITH SKIN GRAFT & FLAP PLS035 EYE LIDS- PTOSIS : BILATERAL PLS031 FACE LIFT WITH OR WITHOUT NECK LIFT (COSMETIC) PLS056 FACE MOLE OR CYST EXCISION - MULTIPLE PLS049 FASCIO CUTANEOUS FLAP REPAIR - LARGE PLS050 FASCIO CUTANEOUS FLAP REPAIR - MEDIUM PLS051 FASCIO CUTANEOUS FLAP REPAIR - SMALL PLS054 FASCIO CUTANEOUS FLAP WITH SKIN GRAFT - LARGE PLS053 FASCIO CUTANEOUS FLAP WITH SKIN GRAFT - MEDIUM PLS052 FASCIO CUTANEOUS FLAP WITH SKIN GRAFT - SMALL PLS025 FAT OR FULL THICKNESS GRAFT - LARGE PLS024 FAT OR FULL THICKNESS GRAFT - SMALL PLS089 FRACTURE FLOOR OF ORBIT PLS080 FRACTURE MANDIBLE + MAXILLA + ORBIT + NOSE PLS079 FRACTURE MANDIBLE OR MAXILLA A.O PLS117 FRENULOPLASTY PLS128 GYNAECOMASTIA BILATERAL PLS129 GYNAECOMASTIA UNILATERAL

38 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:14 PLASTIC SURGERY DR PR SPR NSB SB 065 PLS073 HAND - TENDON REPAIR (MAGNIFICATION) MULTIPLE PLS072 HAND - TENDON WITH NERVE REPAIR (MAGNIFICATION) PLS016 HYPOSPADIAS - CHORDEE CORRECTIONS PLS015 HYPOSPADIAS - MEATOTOMY PLS017 HYPOSPADIAS - URETHRA RECONSTRUCTION PLS115 INTRAVELAR VELOPLASTY PLS105 JOINT REPLACEMENT (MINOR) PLS130 KELOID LARGE (ELSEWHERE) PLS116 LARGE SCAR EXCISION PLS027 LIPOSUCTION - LARGE AREA PLS026 LIPOSUCTION - SMALL AREA PLS093 LOCAL FLAP - LARGE PLS092 LOCAL FLAP - MEDIUM PLS091 LOCAL FLAP - MINOR PLS090 LOCAL FLAP / CROSS FINGER FLAP PLS131 LYMPHEDEMA SURGERY PLS077 MALAR FRACTURE - CLOSED PLS078 MALAR FRACTURE - MINI INTERNAL FIXATION PLS097 MANDIBLE WIRING PLS132 MELANOCYTE GRAFTING LARGE PLS133 MELANOCYTE GRAFTING SMALL PLS014 MINOR CORRECTION ON CLEFT LIP PLS075 NASAL FRACTURE - CLOSED PLS076 NASAL FRACTURE WITH COMPOUND WOUND PLS106 NERVE GRAFT (UNDER MAGNIFICATION) PLS107 NERVE REPAIR (MULTIPLE) PLS108 NERVE REPAIR (SINGLE) PLS109 NERVE REPLANTATION (UNDER MAGNIFICATION) PLS013 NOSE TIP RHINOPLASTY PLS047 PHARYNGOPLASTY PLS030 PREAURICULAR SINUS : BILATERAL PLS029 PREAURICULAR SINUS : UNILATERAL PLS110 RADIAL CLUB HAND CORRECTION PLS074 RECONSTRUCTION OF EAR DEFORMITY STAGE-I PLS120 RECONSTRUCTION OF EAR DEFORMITY STAGE-II PLS121 RECONSTRUCTION OF EAR DEFORMITY STAGE-III PLS087 RELEASE OF TONGUE TIE PLS088 RELEASE OF TONGUE TIE - Z PLASTY REPAIR

39 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:14 PLASTIC SURGERY DR PR SPR NSB SB 103 PLS094 REPAIR OF FRACTURE ZYGOMA PLS119 REPAIR OF LIP BILATERAL PLS118 REPAIR OF LIP UNILATERAL PLS096 REPAIR OF MORE THAN ONE FINGER PLS095 REPAIR OF ONE FINGER PLS099 REPAIR OF PINNA PLS011 RHINOPLASTY (COSMETIC) PLS003 SECONDARY DEFORMITY - CLEFT LIP / PALATE / NOSE PLS012 SEPTO-RHINOPLASTY PLS020 SIMPLE SCAR EXCISION PLS018 SIMPLE Z PLASTY ANYWHERE PLS061 SKIN GRAFTING - LARGE / EXTENSIVE PLS060 SKIN GRAFTING - MEDIUM PLS059 SKIN GRAFTING - SMALL PLS102 SMALL NAEVUS - SINGLE PLS063 SPLIT EAR LOBULES : BILATERAL PLS062 SPLIT EAR LOBULES : UNILATERAL PLS067 SYNDACTYLE FINGERS : MORE THAN ONE WEB PLS066 SYNDACTYLE FINGERS : ONE WEB PLS082 T.M. JOINT ANKYLOSIS WITH RIB GRAFT PLS081 T.M. JOINT ANKYLOSIS / CONDYLECTOMY : UNILATERAL PLS111 TENDON TRANSFER (MULTIPLE) PLS112 TENDON TRANSFER (SINGLE) PLS042 TISSUE EXPANDER (INSERTION) PLS055 VAGINOPLASTY WITH SKIN GRAFT AND FLAP PLS086 VAS RECANALISATION (MAGNIFICATION) PLS045 WOUND REPAIR - FACE / HAND / LIMBS LARGE / MULTIPLE PLS044 WOUND REPAIR - FACE / HAND / LIMBS - MEDIUM PLS043 WOUND REPAIR - FACE / HAND / LIMBS - SMALL PLS019 Z PLASTY - SCAR EXCISION WITH OR WITHOUT SKINGRAFT :15 PEDIATRIC SURGERY 001 PES002 ABDOMINOPERINEAL PULL THROUGH / PSARP PES028 ANAL DILATATION PES029 ANORECTAL MYOMECTOMY PES030 APPENDECTOMY PES031 AXILLARY LYMPH NODE BIOPSY PES007 BILIARY ATRESIA / CHOLEDOCHAL CYST PES032 BRONCHOSCOPY DIAGNOSTIC / FB / BIOPSY

40 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:15 PEDIATRIC SURGERY DR PR SPR NSB SB 008 PES033 CATHETERISATION AND MCU PES034 CENTRAL VENOUS LINE IN NEONATE PES035 CERVICAL LYMPH NODE BIOPSY PES036 CHEST ASPIRATION PES037 CHEST TUBE INSERTION PES011 CHEST TUBE MANIPULATION PES112 CIRCUMCISION NEONATAL PES005 COLOSTOMY / ILEOSTOMY CLOSURE PES013 COLOSTOMY / ILEOSTOMY / JEJUNOSTOMY PES039 COMPLETE DECORICATION - OPEN / THORACOSCOPIC PES010 CYSTIC HYGROMA - MAJOR PES092 CYSTIC HYGROMA MINOR EXCISION / SCLEROTHERAPY PES009 CYSTOGASTROSTOMY PES040 DIAGNOSTIC LAPROSCOPY PES041 DIAPHRAGMATIC HERNIA / EVENTRATION PES042 DRAINAGE OF DEEP / LARGE ABCESS PES043 DRAINAGE OF SMALL ABCESS PES097 DRESSING SMALL PES044 DRESSING LARGE PES113 EMPYEMA THORACOCENTESIS PES046 ESOPHAGOSCOPY / FB PES045 ESPOHAGEAL DILATATION PES047 EXCISION BIOPSY SUP. LUMP / SEB CYST PES048 EXCISION BRANCHIAL SINUS / FISTULA PES095 EXCISION OF EXTRA DIGIT - (IN NEONATE CASES) PES096 EXCISION OF RETRO-PERITONEAL TUMOR PES049 EXCISION THYROGLOSSAL CYST / FISTULA PES050 EXPLORATORY LAPROTOMY PES103 EXPLORATORY LAPROTOMY WITH MULTIPLE BIOPSIES PES051 FUNDOPLICATION PES052 GASTROSCHISIS PES038 GASTROSTOMY PES054 HYDROCOELE BILATERAL PES055 HYDROCOELE UNILATERAL PES056 INGUINAL HERNIA IN NEONATE BILATERAL PES057 INGUINAL HERNIA IN NEONATE UNILATERAL PES058 INGUINAL HERNIA REPAIR BILATERAL PES059 INGUINAL HERNIA REPAIR UNILATERAL PES114 INSTILLATION OF INTRACAVITATORY MEDICATION PES060 INTESTINAL FISTULA

41 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:15 PEDIATRIC SURGERY DR PR SPR NSB SB 048 PES004 INTESTINAL OBSTRUCTION PES061 INTUSSUSCEPTION AND RESECTON ANASTMOSIS PES062 INTUSSUSCEPTION REDUCTION (XRAY OR OPERATIVE) PES091 KIDNEY BIOPSY PES063 LAPAROSCOPIC APPENDICECTOMY PES108 LAPAROSCOPIC HERNIOTOMY PES105 LAPAROSCOPIC ORCHIDOPEXY BILATERAL PES104 LAPAROSCOPIC ORCHIDOPEXY UNILATERAL PES064 LIVER ABCESS ASPIRATION PES065 LIVER ABCESS ASPIRATION MULTIPLE PES066 LIVER BIOPSY CLOSED PES067 LOBECTOMY PES068 LYSIS OF INTESTINAL ADHESIONS PES069 MALROTATION INTESTINE PES070 MESENTERIC CYST / DUPLICATION PES072 MULTIPLE POLYPS PES074 NEONATAL INTESTINAL OBSTRUCTION / ATRESIA PES076 OMPHALOCOELE MAJOR / GASTROSCHISIS PES077 OMPHALOCOELE MINOR PES075 OBSTRUCTED / STRANGULATED HERNIA PES008 OESOPHAGOSTOMY PES078 ORCHIDOPEXY BILAT PES015 ORCHIDOPEXY UNILAT PES100 PARAVERTIBRAL ABCESS PES106 PERCUTANEOUS PIGTAIL CATHETER INSERTION PES109 PERFORATION PERITONITIS PES016 PARTIAL DECORTICATION / RIB RESECTION PES001 PERINEAL ANOPLASTY PES017 PERITONEAL ASPIRATION PES012 PERITONEAL DRAINAGE PES006 PNEUMONECTOMY PES018 PULL THROUGH FOR HIRSCHPRUNG S PES019 PYELOPLASTY PES020 PYLORMYOTOMY PES079 RADIAL ARTERY CATH PES080 RECTAL POLYP PES081 RECTAL SUCTION BIOPSY / OPEN BIOPSY PES014 RECURRENT INTESTINAL OBSTRUCTION PES107 REMOVAL OF TUBE / CATHETER

42 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:15 PEDIATRIC SURGERY DR PR SPR NSB SB 087 PES022 RESECTION AND ANASTMOSIS INTESTINE PES071 RESECTION ANASTMOSIS - MULTIPLE PES101 RETRO PERITONEAL ABSCESS / HAEMATOMA PES115 RETRO PERITONEAL / RETRO PERITONEOSCOPY PROCEDURE PES102 SCLEROTHERAPY RECTAL PROLAPSE / HAEMANGIOMA PES023 SIGMOIDOSCOPY PES098 SOFT TISSUE TUMOR (LARGE) PES099 SOFT TISSUE TUMOR (SMALL) PES024 SPLEENECTOMY PES025 SUTURING MULTIPLE WOUND PES026 SUTURING OF WOUND PES027 TONGUE TIE EXCISION PES003 TRACHEOESOPHAGEAL FISTULA (T.O.F.) PES082 UMBILICAL / EPIGASTRIC HERNIA PES083 UMBILICAL CATH ARTERIAL PES084 UMBILICAL CATH VENOUS PES085 UMBILICAL GRANULOMA PES086 URACHUS EXCISION PES087 V Y PLASTY TONGUE TIE PES110 VARICOCOELE BILATERAL PES088 VARICOCOELE UNILATERAL PES089 VENESECTION / CENTRAL LINE PES090 VITELLINE DUCT EXCISION :16 MISCELLANEOUS SURGERY 001 MSS001 PERITONEOSCOPY BIOPSY MSS002 SIGMOIDOSCOPY MSS003 ECT MSS004 EPIDURAL INJECTION NEPHROLOGY 07:17A NEPHROLOGY SURGICAL PROCEDURES 002 VAS012 AV GRAFT FOR VASCULAR ACCESS FOR HAEMODIALYSIS URS134 CAPD CATHETER PLACEMENT URS135 CAPD / PERMACATH CATHETER REMOVAL URS136 CHRONIC HEMODIALYSIS CATHETER (PERMCATH) PLACEMENT DIALYSIS (IN PATIENT) 07:17B HAEMODIALYSIS [PACKAGE] 001 DIA011 HAEMODIALYSIS [IN DEPTT.] DIA012 HAEMODIALYSIS (ICU-BEDSIDE)

43 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 07:17B HAEMODIALYSIS [PACKAGE] DR PR SPR NSB SB 003 DIA014 EMERGENCY HAEMODIALYSIS DIA013 SLED (Sustained Low Efficiency Dialysis) UPTO 8hrs DIA017 SLED (Sustained Low Efficiency Dialysis) More than 8 Hrs. upto 12 Hrs Note : Haemodialysis includes all consumables and professional charges but it does not include cost of Dialyser (Artificial Kidney & Tubbings), any Investigation charges and other medication. 07:17C OTHER PROCEDURES 001 DIA010 CAPD TRAINING CHARGES (FOR COMPLETE TRAINING) DIA009 FEMORAL CATHETERISATION DIA007 FISTULA DRESSING DIA006 HAEMODIALYSIS CATHETER DRESSING TRE075 KIDNEY BIOPSY (LAB. CHARGES EXTRA) DIA016 PERITONEAL CATHETER INSERTION TRE023 PERITONEAL DIALYSIS TRE024 SUBCLAVIAN / JUGULAR CANNULATION OR CATHETERISATION DIA008 U.SOUND / ECHO GUIDANCE CHARGES FOR JUGULAR CANNULATION / CATHETERISATION 010 DIA019 IMMUNO THERAPY (TRANSPLANT) DIA020 CADAVERIC TRANSPLANT WORK-UP DIA021 CRRT INITIATION (CONTINUOUS RENAL REPLACEMENT THERAPY) [FOR 1ST 24HRS.] [KIT / CONSUMABLE EXTRA] 013 DIA022 CRRT MAINTAINENCE CHARGES PER DAY, AFTER 24 HRS. OF INITIATION} [KIT / CONSUMABLE EXTRA] RENAL TRANSPLANT 07:18 RENAL TRANSPLANT SPR 001 PACKAGE FOR RENAL TRANSPLANT Package includes :- 1. Duration of package :- For Recipient : 10 days (Pre-stay 2days + Post.op stay 8days) For Donor : 6 days (Pre-stay 1day + Post.op stay 5days) 2. Visit s Charges : Surgeon s & Nephrologist s visit charges upto above mentioned stay. 3. Surgical Fee, O.T. Charges, Anaesthesia Charges, disposables used in O.T. and ward and physio-therapy (within above mentioned stay). 43

44 4. Investigation as per KINDNEY TRANSPLANT investigation protocol (with-in above mentioned stay) Package excludes :- 1. All Drugs/Medicines (Injectables or Oral) used in O.T. during the surgery, CCU/ICU and, Ward are as per actuals. 2. Any other investigation beyond above mentioned period of stay. 3. All treatment, Medication, Room/Bed or ICU charges, visits of surgeon and Nephrologist beyond the stay mentioned above. 4. Any other incidental procedure other than the main planned package procedure. 5. Consultation charges other than Nephrologist 6. Investigation sent to outside laboratory centres. Note :- 1. The Recipient & Donor both will be admiitted as Semi Pvt. Room category. 2. Patient (Recipient) and donor may opt for higher accommodation. In that case, the difference of room/bed charges will be charged extra. 3. After surgery, in case patient requires to shift out in the room, the recipient will be shifted out to Single Room or as higher opted by the patient. The donor will be shifted out to Semi Pvt. Room or as higher opted by them. OPERATION THEATER (O.T.) CHARGES 08:01 OGT001 The charges for Operation Theater for Delivery cases will be 30% of the Delivery fee. 09:01 ROO002 The charges for Operation Theater for surgeries will be 30% of the Surgeon s fee. ANAESTHESIA S.No. CODE DESCRIPTION DR/PR/SPR/NSB/SB 10:01 ANAESTHESIA 001 ANC001 General/Spinal/Epidural Anaesthesia / Brachial or Regional Blocks 30% of the Surgeon s Fee 002 ANC003 Local Anaesthesia with stand by. 15% of the Surgeon s Fee 003 ANC002 Local Anaesthesia 10% of the Surgeon s Fee 004 ANC005 Anaesthesia outside Operating Room As per above whichever is applicable S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY Other specific type of Anaesthesia Charges DR PR SPR NSB SB 10:02 ANC004 Obst. (Epidural) Anesthesia Upto 1 Hour :03 ANC022 TOP-UP of Epidural Anesthesia (Each Time)

45 CATHLAB. (CARDIOLOGY) PROCEDURES S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY DR PR SPR NSB SB 11:01 ANGIOGRAPHY PACKAGES 01. CAD001 CORONARY ANGIOGRAPHY (Stay 1day) CAD007 PERIPHERAL ANGIOGRAPHY (Stay 1day) CAD009 RENAL ANGIOGRAPHY (Stay 1day) CAD010 CHECK ANGIOGRAPHY (Stay 1day) ANGIOPLASTY PACKAGES 05. CAD002 CORONARY ANGIOPLASTY (Stay 2days) CAD006 PERIPHERAL ANGIOPLASTY (Stay 2days) CAD011 RENAL ANGIOPLASTY (Stay 2days) CAD034 CAROTID ANGIOPLASTY (Stay 2days) PACEMAKER IMPLANTATION PACKAGES 09. CAD012 PACEMAKER IMPLANTATION-SINGLE CHAMBER (Stay 3days) CAD013 PACEMAKER IMPLANTATION-DOUBLE CHAMBER (Stay 3days) CAD014 PACEMAKER / LEAD REPLACEMENT (Stay 3days) CAD031 PACEMAKER EXPLANTATION (Stay 3days) OTHER PACKAGES 13. CAD018 COIL/PARTICLE EMBOLIZATION (Stay 1day) CAD003 EP STUDY (Stay 1day) CAD029 FFR FRACTIONAL FLOW RESERVE (Stay 1day) CAD021 IVC FILTER IMPLANTATION (Stay 1day) CAD016 BALLOON VALVULOPLASTY / BMV/BPV- BALLOON (Stay 2days) CAD015 ASD / VSD DEVICE CLOSURE (Stay 2days) CAD017 BIVENTRICULAR DEVICE/COMBO (Stay 3days) CAD019 ICD/AICD SINGLE CHAMBER (Stay 3days) CAD020 ICD/AICD DOUBLE CHAMBER (Stay 3days) CAD022 RF ABLATION 3D MAPPING (Stay 3days) CAD004 RF ABLATION (Stay 3days) CAD005 EPS + RFA (Stay 3days) NOTE :- In case patient is admitted directly in ICU/CCU, treated and discharged from ICU/CCU only (not stayed or shifted to wards) shall be levied as per minimum Semi-Pvt. Room. (Inclusions and exclusions of packages are on next page) 45

46 Inclusions of Packages. 1. Stay as mentioned above, Professional fee of Cardiologist during the package duration and Cath lab charges. 2. Pre-operative Investigations (RBS, Urea, Createnine, CBC, BT, Sodium, potassium, Hbs Ag(spot), HIV(spot), HCV(spot), PT, APTT, Platelet Count, Blood grouping & typing, X-Ray Chest, ECG (Quantity one of each investigation is covered in package). Exclusions of Packages. 1. Any other investigation other than listed above in inclusions 2. All treatment, all post op. investigations, Medication, Room/Bed charges and visits of Cardiologist beyond stay mentioned in the package charges. 3. Any other incidental procedure other than the main planned package procedure. 4. Consultation charges other than Cardiologist. 5. Cost of Stent/s, Balloons, Guidewire, Pace Maker,Lead & other accessories used in cathlab. (In case of Pacemaker Replacement, cost of lead and accessories will be charged, If replaced). 6. Cost of Devices, Coil / Particles, Filter Wire, Special wires like Pressure Wire-FFR, OCT, Rotablation, Rotablation Burr. 7. All Drugs/Medicines (Injectables or Oral), Contrast, disposables used in cathlab, CCU/ICU and, Ward are as per actuals. 8. IABP (in case used). 9. Angiography CD ************************ Non-package Cathlab Procedures S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 11:02 Non-package Cathlab Procedures DR PR SPR NSB SB 26. CAD023 INTRA AORTIC BALLOON PUMP (IABP) IMPLANTATION CAD024 FOREIGN BODY REMOVAL CAD025 FLUROSCOPY CAD026 TEMPORARY PACEMAKER IMPLANTATION CAD027 PERICARDIOCENTASIS CAD028 ELECTIVE CARDIOVERSION CAD033 EXTRA CORPOREAL MEMBRANE OXYGINATION (ECMO) INITIATION Note :- 1. IABP:- Cost of IABP Balloon and procedure will be charged extra whenever it will be done. It is not inclusive in any of the cathlab packages or Surgery package. 2. The above charges will includes Professional fee and Cath lab Charges only. 3. Cost of Ballon and all other disposables and medicinces will be extra. ************************ 46

47 S.No. CODE DESCRIPTION ACCOMMODATION CATEGORY 11:03 OTHER CHARGES DR PR SPR NSB SB 01. CAD030 INTRA AORTIC BALLOON PUMP (IABP) PER DAY* SCL070 ANGIOGRAPHY CD MSS013 INTEROGATION / REPROGRAMMING OF AICD/PACEMAKER CPP001 ECMO (PER DAY)** Note :- 1. *IABP routine charges (per day) will be levied from next day of IABP implantation. 2. **For ECMO, no charge till 5days from initiation. Above charges will be levied from 6th day. CARDIAC SURGERY PACKAGES 11:04 CARDIAC SURGERY PACKAGES 01. CDS003 OPEN HEART/ BYPASS SURGERIES/CABG CDS004 CLOSED HEART SURGERIES CDS005 SINGLE VALVE REPLACEMENT CDS006 DOUBLE VALVE REPLCEMENT CDS007 CABG + VALVE REPLACEMENT SURGERY CDS008 BENTALL REPAIR WITH PROSTHETIC VALVE CDS009 BENTALL REPAIR WITH BIOLOGICAL VALVE CDS010 ASD/VSD SURGERY Package includes :- 01. Maximum stay of 8 days. 02. Period of 8 days will be effective from one day prior to the date of surgery. 03. Routine Blood Tests (RBS, Urea, Createnine, CBC, BT, Sodium, Potassium, Hbs Ag(spot), HIV(spot), HCV(spot), PT, APTT, Platelet Count,LFT), X-Ray Chest and ECG. 04. Two Echocardiography both pre and post surgery. 05. One doppler (if needed) 06. Drugs, Medical Consumables, Professional fee of the Cardio-thoracic Surgeon, Cardiac Anesthesia, Cardiologist for the duration of package. 07. Nursing Care, Diet (patient only) and Physiotherapy. 08. Six Units of Whole Blood for Open Heart Surgery and 4 Units for other Heart Surgeries. (Blood to be donated by patient s relatives). Package does NOT include :- 01. All charges beyond package of 8 days will be charged as per hospital Schedule of Charges. 02. Consultation charges other than Cardiologist. 03. Cost of SwanGanz catheter/cco (if used) shall be charged extra. 04. Nephrology and dialysis services. 05. Additional investigations and Echo etc. 06. Cost of Valve, Vascular Graft, Aortic Graft, PTFE Patch, Visipaque Dye etc. 07. High cost drugs like Inj. Solumedrol, Morotrol, Meronem, Milron, Targocid, Primacore, Albumin, Clexane, Fibrin Glue, Trasylol, Injectable Anti-platelets, Thromolytic agents etc. 47

48 08. IABP Procedure charges (in case used) and cost of Balloon. 09. Blood transfusion services for Special Blood Products on cell separator. 10. Rs. 5,000/- for Leukocyte Filter (in case used) 11. For High Risk Cases :- Rs.40,000/- will be an additional charge, over and above the cost of packages. NON-PACKAGE CARDIAC SURGERIES / PROCEDURES 11:05 OTHER NON-PACKAGE CARDIAC SURGERIES ACCOMMODATION CATEGORY S.No. CODE DESCRIPTION DR PR SPR NSB SB 01. CDS011 STERNOTOMY PLS PLS127 STERNAL DEBRIDEMENT AND MUSCLE FLAP ROTATION STERNAL RESECTION AND RECONSTRUC- TION Note :- Above mentioned charges are only professional fee of the surgeon. All other charges will be levied as per General S.O.C ************************ NON-INVASIVE CARDIAC LAB S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/GOPD CASUALTY 12:01 ECG (ELECTRO CARDIOGRAM) 001 ECG (ELECTRO CARDIOGRAM) (EACH) :02 ECHOCARDIOGRAPHY / CAROTID DOPPLER 001 ARTERY DOPPLER - LOWER LIMB ARTERY DOPPLER - UPPER LIMB DOBUTAMINE STRESS ECHO DOPPLER STUDY ECHOCARDIOGRAPHY ECHOCARDIOGRAPHY - PEADIATRICS PORTABLE CHARGES FOR ECHOCARDIOGRAPY/DOP- PLER SCREENING ECHO* STRESS ECHO VENOUS DOPPLER - LOWER LIMB VENOUS DOPPLER - UPPER LIMB NOTE : *No report of Screening will be issued to the patients, only noting in file to be made. 48

49 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ 12:03 T.M.T. (TREAD MILL TEST) SB/GOPD CASUALTY 001 TREAD MILL TEST (EACH) :04 HOLTER MONITOR 001 HOLTER MONITORING EXTENDED HOLTER MONITORING ************************ ENDOSCOPIC PROCEDURES (FLAT RATES) 13:01 UPPER GI ENDOSCOPY GASTROENTEROLOGY 001 ACHALASIA DILATATION ARGON PLASMA COAGULATION UPPER GI DILATATION ENDO THERAPY FOR BLEEDING UPPER GI ENDOSCOPIC NASO-JEJUNAL FEEDING TUBE INSERTION ENDOSCOPIC PLACEMENT OF RYLES TUBE ENDOSCOPY UPPER G.I EPT - STONE EXTRACTION EST-ENDOSCOPIC SCLEROTHERAPY EVL-ENDOSCOPIC VARICES LIGATION FOREIGN BODY REMOVAL H. PYLORI TEST OESOPHAGEAL ACHALASIA OESOPHAGEAL METAL STENT PLACEMENT PAPILLOTOMY WITH STONE EXTRACTION PEG REMOVAL PERCUTANEOUS ENDOSCOPIC GASTROTOMY - PEG SENGASTAKEN TUBE PLACEMENT SIDE VIEWING ENDOSCOPY UPPER GI WITH POLYPECTOMY :02 LOWER GI ENDOSCOPY 001 ARGON PLASMA COAGULATION LOWER GI COLONOSCOPY COLONOSCOPY 2 WITH COLONOSOPIC SCLEROTHERAPY COLONOSCOPY I COLONOSCOPY WITH POLYPECTOMY METAL STENT PLACEMENT (LOWER GI) (COST OF STENT EXTRA)

50 S.No. DESCRIPTION ACCOMMODATION CATEGORY 13:02 LOWER GI ENDOSCOPY DR/PR/SPR/NSB/POPD/ CASUALTY SB/GOPD 007 SIGMOIDOSCOPY THERAPY FOR BLEEDING LOWER GI VIDEO PROCTOSCOPY :03 ERCP 001 BRUSHING & BIOSPY ERCP - ENDOSCOPY ERCP-METAL STENT PLACEMENT (COST OF STENT EXTRA) MECHANICAL LITHOTRIPSY PANCREATIC STENTING PANCREATIC STONE REMOVAL PLASTIC STENT DEPLOYMENT PLASTIC STENT REMOVAL STENT REMOVAL & CBD CLEARANCE THERAPEUTIC ERCP :04 OTHERS 001 DIAGNOSTIC ABDOMINAL PARACENTESIS LARGE VOLUME PARACENTESIS LIVER BIOPSY ANESTHESIA FOR ENDOSCOPY - FLAT RATE NOTE : (1). 25% of the above procedures fee will be levied as G.E.Room and Equipment charges. (2). All diagnostic Medication, Radiology and laboratory will be charged extra. (3). Any Drug like antibiotics, contrast & Consumables etc will charged extra. ************************ NEUROLOGY 14:01 NEUROLOGICAL INVESTIGATIONS 001 BAEP -BRAINSTEM AUDITORY EVOKED POTENTIALS* E.E.G. (IN DEPTT.) E.E.G. PORTABLE EMG ALL FOUR LIMBS* EMG BOTH LOWER LIMBS* EMG BOTH UPPER LIMBS* FACIAL NERVE NCV FACIAL NERVE NCV, EMG & BLINK* NCV & EMG ALL FOUR LIMBS* NCV & EMG BOTH LOWER LIMBS* NCV & EMG BOTH UPPER LIMBS* NCV ALL FOUR LIMBS

51 S.No. DESCRIPTION ACCOMMODATION CATEGORY 14:01 NEUROLOGICAL INVESTIGATIONS DR/PR/SPR/NSB/POPD/ CASUALTY SB/GOPD 013 NCV BOTH LOWER LIMBS NCV BOTH UPPER LIMBS RNS STUDIES SSEP ALL FOUR LIMBS* SSEP BOTH LOWER LIMBS* SSEP BOTH UPPER LIMBS* VEP* (VISUAL EVOKED POTENTIAL*) * Cost of EMG Needle will be extra (As per Market price) ************************ RESPIRATORY MEDICINE 15:01 SLEEP LAB 001 POLYSOMNOGRAPHY CPAP TITRATION STUDY SPLIT NIGHT STUDY :02 SPIROMETRY 001 P.F.T. (PULMONARY FUNCTION TEST) P.F.T. DLCO :03 VIDEO BRONCHOSCOPY 001 VIDEO BRONCHOSCOPY VIDEO BRONCHOSCOPY WITH BIOPSY OR TBNA VIDEO BRONCHOSCOPY WITH BIOPSY AND TBNA FOREIGN BODY REMOVAL GLUE APPLICATION (Cost of Glue Extra) APC STENT PLACEMENT (Cost of Stent Extra) DIAGNOSTIC THORACOSCOPY THORACOSCOPY WITH PLEURAL BIOPSY THORACOSCOPY & PLEURODESIS ************************ 51

52 RADIOLOGY S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/ 16:01 BMD CASUALTY GOPD 001 BMD PELVIS (BOTH HIPS) BMD - SINGLE HIP BMD - WHOLE BODY BMD -SPINE BMD -SPINE + PELVIS BMD -SPINE + SINGLE HIP :02 C.T. SCAN 001 3D ANGIO-ABDOMINAL ANGIO-CEREBRAL ANGIO-RENAL ANGIO-PERIPHERAL ANGIO-ABDOMEN AORTA ANGIO-WHOLE ABDOMEN (DUAL PHASE LIVER) C4 TO C7-4 VERTEBRAE EVERY ADDITIONAL VERTEBRA EXTRA FOR EMERGENCY CASES [**] EXTRA FOR M.L.C. CASES EXTREMITIES FACE- CT GUIDANCE BIOPSY (LAB. & DISPOSABLES EXTRA)-CT GUIDED ASPIRATION (LAB. & DISPOSABLES EXTRA)-CT GUIDED F.N.A.C. (LAB. & DISPOSABLES EXTRA) HEAD - PLAIN HEAD - PLAIN + CONTRAST (CONTRAST CHARGE EXT.) HEAD NCCT HEAD NECT HEAD & NECK/FACE-CT HRCT THORAX FULL KUB-PLAIN : CT KUB PLAIN + CONTRAST L3 TO S1-4 VERTEBRAE

53 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/ 16:02 C.T. SCAN CASUALTY GOPD 026 LARYNX LIVER TRIPPLE PHASE LOWER ABDOMEN - CT LOWER THORAX + UPPER ABDOMEN-CT LOWER THORAX/CHEST MISCELLANEOUS [ANKLE/HIP/WRIST ETC.] NECK - CT ORBIT PITUITARY GLAND PNS : AXIAL + CORONAL + SAGITAL PNS FULL PULMONARY ANGIOGRAPHY TEMPORAL BONE [IAM] THORAX/CHEST -CT UPPER ABDOMEN - CT UPPER THORAX VIRTUAL COLONOSCOPY WHOLE ABDOMEN PLAIN + CONTRAST CT WHOLE SPINE NOTE : [**] Emergency charges is extra for scans done between 7:00 pm to 8:00 am or on Sundays & holidays. 16:03 MAMMOGRAPHY 001 MAMMOGRAPHY [BILATERAL] MAMMOGRAPHY [ONE SIDE] :04 ULTRA SOUND 001 ABDOMINAL - SINGLE ORGAN B.P.P. ONLY B.P.P. ONLY (TWIN PREG.) BREAST -U/S CHEST -U/S DOPPLER ONLY DOPPLER ONLY (TWIN PREG.) EMERGENCY (ON CALL) CHARGE [**] EYES -U/S FOLLICULAR/OVALUTION STUDIES GALL BLADDER

54 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/ 16:04 ULTRA SOUND CASUALTY GOPD 012 GUIDED ASPIRATION -U/S GUIDED ASPIRATION IN O.T. -U/S GUIDED BIOPSY -U/S GUIDED MULTI ORGAN ASPIRATION -U/S JOINTS U/S KIDNEY -U/S KUB -U/S LIVER -U/S LOWER ABDOMEN -U/S NEONATAL HEAD -U/S OBS + NT/NB -U/S OBS LEVEL II - 3D/4D (U/S) OBS LEVEL II - 3D/4D (U/S) (TWIN PREG.) OBS WITH DOPPLER OBS WITH DOPPLER (TWIN PREG.) OBS. + B.P.P OBS. + B.P.P. (TWIN PREG.) OBS. + B.P.P. + DOPPLER OBS. + B.P.P. + DOPPLER (TWIN PREG.) OBS. + DOPPLER + SCAR THICKNESS OBS. U/S OBS. ULTRASOUND EACH (TWIN PREG.) PELVIS -U/S PELVIS -U/S PORTABLE CHARGES (ULTRASOUND) POST VOID RESIDU (PVR) RENAL DOPPLER -U/S SCAR THICKNESS SCROTUM / TESTIS SCROTUM / TESTIS DOPPLER SOFT TISSUE SONOGRAPHY SPLEEN -U/S THYROID-U/S TRANSRECTAL TRANSRECTAL BIOPSY (Procedure & Lab. Charges are extra) UPPER ABDOMEN + BPP + DOPPLER UPPER ABDOMEN + PLEURAL SPACE -U/S UPPER ABDOMEN -U/S

55 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/ 16:04 ULTRA SOUND CASUALTY GOPD 050 UPPER ABDOMEN DOPPLER -U/S WHOLE ABDOMEN + DOPPLER -U/S WHOLE ABDOMEN -U/S WHOLE ABDOMEN + BPP + DOPPLER -U/S WHOLE ABDOMEN + OBS. (ABOVE 10 WEEKS) WHOLE ABDOMEN + OBS. (UPTO 10 WEEKS) FOETAL ECHO PENILE DOPPLER DOPPLER STUDY (USG) VENOUS DOPPLER PER LOWER LIMB VENOUS DOPPLER PER UPPER LIMB ARTERY DOPPLER PER LOWER LIMB ARTERY DOPPLER PER UPPER LIMB ARTERY + VENOUS DOPPLER-PER LOWER LIMB ARTERY + VENOUS DOPPLER-PER UPPER LIMB VENOUS DOPPLER BOTH LOWER LIMBS VENOUS DOPPLER BOTH UPPER LIMBS ARTERY DOPPLER BOTH LOWER LIMBS ARTERY DOPPLER BOTH UPPER LIMBS ARTERY + VENOUS DOPPLER-BOTH LOWER LIMB ARTERY + VENOUS DOPPLER-BOTH UPPER LIMB NOTE : [**] Emergency charges is extra for scans done between 7:00 pm to 8:00 am or on Sundays & holidays. 16:05 XRAY 001 ABDOMEN ERECT & SUPINE ADDITIONAL VIEWS FOR ANY REGION ANKLE (BORDEN S VIEW) ANKLE AP & LAT ANKLE AP BOTH ANKLE LAT AXIAL ANKLE LATERAL BOTH APICOGRAM ARM (HUMERUS) AP & LAT BA. ENEMA BA. ENEMA (DOUBLE CONTRAST) BA. MEAL FOLLOW THROUGH

56 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/ 16:05 XRAY CASUALTY GOPD 013 BA. MEAL U.G.I.T BA. SWALLOW /OESOPHAGOGRAPHY CERVICAL SPINE EXTENSION/FLEXION CERVICAL SPINE/NECK AP LATERAL CHEST (SINGLE VIEW) CHEST (2 VIEWS) COCCYX AP LATERAL COLOGRAM WITH BARIUM OR GASTROGRAFFIN DEPTT. SCREENING / FLUROSCOPY DORSO-LUMBAR SPINE AP+LATERAL ELBOW AP & LAT FEMUR AP & LAT FISTULOGRAM/SINOGRAM FOOT AP & OBLIQUE FOOT AP LATERAL BOTH FOREARM AP&LAT GASTROGRAFFIN SWALLOW GASTROGRAFFIN FOLLOW THROUGH HAND (FINGERS) AP + OBLIQUE HANDS AP BOTH HIP AP HIP AP&LAT HIP LATERAL HSG INTUSSUSCEPTION (X-RAY CHARGES) IVP IVP + MCU KNEE AP LATERAL AXIAL BOTH KNEE AP & LAT KNEE AP & LAT AXIAL KNEE AP BOTH KNEE AP LATERAL BOTH KUB/ABDOMEN (SINGLE VIEW) -XRAY LEG AP & LAT LS SPINE AP LATERAL LS SPINE EXTENSION/FLEXION LS SPINE LATERAL MANDIBLE AP MANDIBLE 3 VIEWS (AP + BOTH OBLIQUE)

57 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/ 16:05 XRAY CASUALTY GOPD 052 MANDIBLE BOTH OBLIQUE MASTOIDS (TOWNS + 2 LATERAL OBLIQUE) 3 VIEWS MCU NASAL BONE NASOPHARAYNX/ ADENOIDS NEPHROSTOGRAM OESOPHAGEAL DILATATION UNDER FLUROSCOPY PELVIS AP PER ORBITAL VIEW / IAM PNS PORTABLE ABDOMEN PER EXPOSER PORTABLE ABDOMEN ERECT/SUPINE PORTABLE CHEST PORTABLE EXTREMITIES PER EXPOSER PORTABLE SKULL PER EXPOSER PORTABLE SPINE PER EXPOSER PORTABLE X-RAY (PER EXPOSER) RADIOLOGY CHARGES FOR INTUSSUSCEPTION RGP -RETROGRADE PYELOGRAM RGU + M.C.U RGU/ASCENDING URETHROGRAM SACRO - COCCYX AP LATERAL SCANOGRAM (FULL LEG / SPINE) SCAPULA AP SCAPULA AP LATERAL SCREENING (ABOVE 15 MTS.) SCREENING (UPTO 15 MTS.) SCREENING FOR ERCP / EPT SHOULDER AP SHOULDER AXIAL SI JOINT PA + BOTH OBL SI JOINT PA/SACRO ILIAC JOINT SIALOGRAPHY SKULL : ANY SINGLE VIEW SKULL AP & LATERAL SPINE (2 VIEWS) SPINE (SINGLE VIEW)

58 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB/POPD/ SB/ 16:05 XRAY CASUALTY GOPD 089 STYLOID PROCESS (SINGLE VIEW) THIGH / FEMUR AP TM JOINTS (BILATERAL) TTC VENOGRAPHY/PHLEBOGRAPHY (1 SIDE) VENOGRAPHY/PHLEBOGRAPHY (BILATERAL) WRIST AP & LAT WRIST AP BOTH XRAY PER EXPOSER WRIST AP & LAT + OBLIQUE (SCAPHOID) COST OF DYE / CONTRAST EXTRA WHEREVER APPLICABLE. 16:06 MRI S.No. DESCRIPTION ALL CATEGORIES OF IPD & OPD BRAIN & FACE 001 BRAIN BRAIN & SPECTROSCOPY BRAIN + CSF STUDIES BRAIN + CV JUNCTION SCREENING BRAIN + FMRI (ONE ACTIVITY) [BOLD/ASL] BRAIN + ORBIT BRAIN + PERFUSION (CONTRAST EXTRA) BRAIN + SEIZURE PROTOCOL BRAIN + SELLA BRAIN + TRACTOGRAPHY BRAIN ANGIOGRAPHY BRAIN MRI + MRA BRAIN BRAIN MRI + MRA BRAIN & NECK BRAIN WITH IAM BRAIN WITH PNS CISTERNOGRAPHY CONTRAST EXTENDED STUDY FACE FACE + NECK IAM/TEMPORAL BONE MRA ABDOMINAL AORTA MRA ARCH OF AORTA

59 S.No. DESCRIPTION ALL CATEGORIES OF IPD & OPD BRAIN & FACE 024 MRA BRAIN + MRA NECK MRA + MRV BRAIN MRA + MRV NECK MRI + MRV BRAIN MRI + MRV NECK MR VENOGRAPHY MYELOGRAPHY (WITHOUT CONTRAST) NECK NECK ANGIOGRAPHY NECK/FACE MR FOR C.A.-MRI (Incl. CT Correlation) ORBIT PERFUSION IMAGING FOR STROKE (INCLUDES CONTRAST) WITHIN A WEEK OF 5800 INITIAL STUDY 036 PNS SCREENING BRAIN SELLA / PITUITARY SELLA DYNAMIC STUDY (INCLUDES CONTRAST) SPECTROSCOPY TM JOINTS 8400 SPINE 042 3D MRI BRACHIAL PLEXUS CERVICAL SPINE CERVICAL SPINE (FLEXION+EXTENSION) [DYNAMIC CERVICAL SPINE] CERVICAL SPINE WITH BRACHIAL PLEXUS CERVICAL SPINE WITH CVJ SCREENING CERVICAL SPINE WITH SCREENING WHOLE SPINE CV JUNCTION DORSAL SPINE DORSAL SPINE WITH SCREENING WHOLE SPINE L.S. SPINE L.S. SPINE WITH S.I. JOINTS SCREENING L.S. SPINE WITH SCREENING WHOLE SPINE S.I. JOINTS

60 S.No. DESCRIPTION ALL CATEGORIES OF IPD & OPD SPINE 056 SCREENING WHOLE SPINE WHOLE SPINE JOINTS AND EXTREMITIES 058 ANKLE BILATERAL ANKLES BILATERAL KNEES BILATERAL SHOULDERS BOTH FEET BOTH HANDS CARTILAGE MAPPING (INCLUDES JOINT) ELBOW FOOT FOREARM HAND/ FINGER HIPS HIPS BOTH JOINT (PER JOINT) JOINT SCREENING FOR EFFUSION KNEE LEG MR ARTHROGRAPHY (INCLUDES CONTRAST) SHOULDER THIGH / FEMUR WRIST 5250 BODY MR 079 CARDIAC STERNUM / STERNOCLAVICULAR JOINT THORAX BREAST FETAL MRI LOWER ABDOMEN/PELVIS LOWER ABDOMEN & PELVIS MR ENTEROCLYSIS MR SINOGRAM / FISTULOGRAM 5800 MRI OF OTHER PARTS 088 MR UROGRAM MR UROGRAM WITH LOWER ABDOMEN/KUB

61 S.No. DESCRIPTION ALL CATEGORIES OF IPD & OPD MRI OF OTHER PARTS 090 MRCP MRCP WITH UPPER ABDOMEN MRI KUB MULTIPARAMETRIC PROSTATE PERIPHERAL ANGIOGRAPHY MRI (NON- CONTRAST) PER LIMB RENAL ANGIOGRAPHY TRIPLE PHASE LIVER (INCLUDES CONTRAST) UPPER ABDOMEN WHOLE ABDOMEN WHOLE BODY SCREENING FOR METS 4200 Please Note: Contrast will be Charged Extra wherever required. 16:07 OTHER CHARGES 101 ANAESTHESIA CHARGES EMERGENCY CHARGES* :08 MISCELLANEOUS CHARGES 001 DUPLICATE DVD FOR MRI DUPLICATE X-RAY /ULTRA SOUND/C.T./MRI FILM : PER FILM 125 NOTE : [*] Emergency charges is extra for scans done between 5:00 pm to 8:00 am or on Sundays & holidays. 61

62 LABORATORY S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:01 GROUP : CLINICAL CHEMISTRY & HORMONES DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 001 RBS - RANDOM BLOOD SUGAR UREA CREATININE CALCIUM PHOSPORUS (INORGANIC PHOS.) AMYLASE GTT-GLUCOSE TOLERANCE TEST URIC ACID-SERUM FDP (FIBRIN/FIBRINOGEN DEGRADATION PRODUCT) FLUID ALBUMIN CALCIUM/CREATININE RATIO- URINE FASTING PROTEIN/CREATININE RATIO -URINE FASTING GCT - GLUCOSE CHALLENGE TEST PPS- AFTER GLUCOSE TOTAL/SERUM PROTEIN(TP,ALB,GLOB,A/G) PT (PRO TIME) BILIRUBIN ( DIRECT,INDIRECT,TOTAL) ALKALINE P TASE-ALP SGPT/ALT SGOT /AST LFT-LIVER FUNCTION TEST APTT SODIUM (NA+) ONLY POTASSIUM (K+) ONLY SODIUM & POTASSIUM CHLORIDE (CL-) BICARBONATE (HCO3-) ABG - ARTILLARY BLOOD GAS CHOLESTEROL TOTAL-SERUM HDL CHOLESTROL - DIRECT TRIGLYCERIDES LIPID PROFILE CPK CPK (MB) CHOLESTEROL - FLUID LDH FLUID ELECTROLYTES SERUM

63 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:01 GROUP : CLINICAL CHEMISTRY & HORMONES DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 038 LIPASE-SERUM GAMMA GT / GGT/ GGTP LDH-SERUM SERUM PROTEIN ELECTROPHORESIS MAGNESIUM -SERUM SODIUM-URINE RANDOM SPECIMEN AMYLASE-URINE D-DIMER TEST FT 3 -FREE T FT 4 -FREE T TSH FT3, FT4 & TSH (TOGETHER) FT3 & FT4 (TOGETHER) CORTISOL -SERUM PROLACTIN -SERUM FSH LH PSA - PROSTATE SPECIFIC ANTIGEN FERRITIN FBS - FASTING BLOOD SUGAR PPS (POST PRANDIAL SUGAR) SBR - BILIRUBIN TOTAL (MICRO METHOD) ADA CALCIUM - MICRO METHOD PPS AFTER BREAKFAST PPS AFTER LUNCH PPS AFTER DINNER URINE FOR CREATININE NEONATAL TSH SCREEN (NEO TSH) SERUM ALBUMIN CORD BLOOD PROLACTINE CBG - CAPILLARY BLOOD GAS CORD BLOOD PH FOR FETAL WELL BEING CRP HCG WITH LIPIDS ALPHA FETO PROTEIN BHCG (TUMOR MARKER) E3-ESTRIOL VITAMIN B

64 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:01 GROUP : CLINICAL CHEMISTRY & HORMONES DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 077 FOLATE FOLATE & VITAMIN B CA TRIPLE TEST FLUID FOR PH VITAMIN D-25 HYDROXY MODIFIED G..T.T. (GYNAE) MICROALBUMIN INSULIN (FASTING) INSULIN (PP) INSULIN (RANDOM) TROPONIN I (TROP. I) NT-proBNP GDM SCREENING LACTATE IMMUNOGLOBULIN IGE (TOTAL) PTH INTACT GFR (GLOMERULAR FILTRATION RATE) :02 GROUP : CYTOPATHOLOGY 001 PAPANICULA SMEAR FLUIDS FOR MALIGNANT CYTOLOGY CSF FOR MALIGNANT CYTOLOGY FNAC FNAC- CT/US GUIDED TBNA (TRANS BRONCHIAL NEEDLE ASPIRATION) :03 GROUP : HEMATOLOGY 001 HB (HEMOGLOBIN) TLC (WBC COUNT) MALARIAL PARASITES (MP) PERIPHERAL SMEAR RBC COUNT HEMATOCRIT (HCT/PCV) CBC (COMPLETE BLOOD COUNT) TLC & DLC RED CELL INDICES ESR

65 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:03 GROUP : HEMATOLOGY DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 011 MCH MCHC DLC CBC & MP (TOGETHER) CBC & PS (TOGETHER) GASTRIC LAVAGE FOR PMNS MCV RETIC COUNT EOSINOPHIL COUNT CLOT RETRACTION BT BLEEDING TIME SICKLE CELL PREP PLATELET COUNT RBC FRAGILITY FILARIAL PREP BONE MARROW EXAMINATION FALCIPARUM & PLASMODIUM VIVAX TEST (F&V) BONE MARROW IRON STAINING KALA - AZAR DETECT BONE MARRROW (ASPIRATION AND EXAMINATION) FILARIAL ANTIGEN CBC & MP WITH F&V :04 GROUP : SPECIAL HEMATOLOGY 001 GLYCOSYLATED HB/HB 1AC FETAL HB G6 PD (CONFIRMATORY) HB ELECTROPHORESIS G6 PD SCREENING (SCREENING + CONFIRMATORY) SERUM IRON SERUM IRON & TIBC :05 GROUP : HISTOPATHOLOGY 001 FROZEN SECTION WITH BIOPSY SPECIMEN TISSUE FOR GROSS/DOCUMENTATION ONLY SLIDE FOR HISTOPATHOLOGY BLOCK FOR HISTOPATHOLOGY

66 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:05 GROUP : HISTOPATHOLOGY DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 005 TISSUE -SMALL FOR HISTOPATHOLOGY TISSUE - MEDIUM FOR HISTOPATHOLOGY TISSUE - LARGE FOR HISTOPATHOLOGY SMALL BIOPSY (SPECIAL STAIN) RADICAL SPECIMEN IHC MARKER (SINGLE) ER/PR/HER-2-NEU :06 GROUP : MICROBIOLOGY 001 CULTURE - BLOOD-ROUTINE CULTURE- BLOOD -RAPID STOOL FOR CHOLERA (HANGING DROP) GRAMS STAIN FUNGUS PREP. -KOH PREP TRICHOMONAS (VAGINAL SWAB,WET PREP) DIPHTHERIA SMEAR RAPID UREASE TEST NIGROSIN PREPRATION FOR CRYPTOCOCCUS FUNGUS CULTURE WET SMEAR FOR TROPHOZOITES CULTURE & SENSITIVITY - CSF CULTURE & SENSITIVITY - EAR SWAB CULTURE & SENSITIVITY - HVS CULTURE & SENSITIVITY - MISC CULTURE & SENSITIVITY - PUS CULTURE & SENSITIVITY - SPUTUM CULTURE & SENSITIVITY - STOOL CULTURE & SENSITIVITY - THROAT SWAB CULTURE & SENSITIVITY - URINE AFB CULTURE - SPUTUM (MYCOBACTERIUM) AFB CULTURE - URINE (MYCOBACTERIUM) AFB CULTURE - PUS (MYCOBACTERIUM) AFB CULTURE - FLUIDS (MYCOBACTERIUM) AFB CULTURE - MISC (MYCOBACTERIUM) MTB/MOTT IDENTIFICATION SMEAR FOR FUNGUS AFB - SPUTUM (SAMPLE I) AFB - SPUTUM (SAMPLE II) AFB - SPUTUM(SAMPLE III )

67 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:06 GROUP : MICROBIOLOGY DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 031 AFB - URINE (SAMPLE I) AFB - URINE (SAMPLE II) AFB - URINE (SAMPLE III) AFB - SMEAR MISC SPECIMEN URETHERAL SMEAR G.C CULTURE OTHERS RAPID CRYPTOSPORIDIUM - ZN STAIN SMEAR FOR PNEUMOCYSTIC CARINI :07 GROUP : MISCELLANEOUS LAB INVESTIGATION 001 FLUID - ROUTINE EXAMINATION CSF- (SPINAL FLUID) - ROUTINE SEMEN ANALYSIS PCT (POST COITAL TEST) C.S.F. ROUTINE WITH SMEAR FOR CRYPTOCOCCUS GA FOR OCCULT BLOOD FLUID FOR CRYSTALS FLUID FOR SUGAR :08 GROUP : PARASITOLOGY 001 STOOL ROUTINE EXAMINATION STOOL OCCULT BLOOD STOOL FOR PH STOOL REDUCING SUBSTANCES STOOL FOR WBC/HPF STOOL/PUS AMOEBA ROTAVIRUS :09 GROUP : SEROLOGY 001 RPR (VDRL) WIDAL HBS AG ELISA HBS AG SPOT ASO (ASLO) TEST ANF/ ANA CRP (LATEX) PREGNANCY TEST UPT (SPOT) [PREGNANCY TEST (SPOT)]

68 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:09 GROUP : SEROLOGY DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 010 HIV ELISA HIV SPOT TORCH TEST (IGM) TOXOPLASMA (IGM) RUBELLA (IGM) CYTOMEGALOVIRUS (CMV) (IGM) HERPES - II (IGM) HCV ELISA HCV SPOT HEPATITIS - A (HAV) HEPATITIS - E (HEV) DS DNA (DOUBLE STRANDED DNA) TORCH TEST (IGG) TOXOPLASMA (IGG) RUBELLA (IGG) CYTOMEGALOVIRUS (CMV) (IGG) HERPES - II (IGG) BACTERIAL ANTIGEN (5 TESTS) DENGUE ANTIGEN DENGUE IGG ANTIBODY DENGUE IGM ANTIBODY CHIKUNGUNYA HCG (MATERNAL) RA FACTOR ANTI CCP TTG PRO-CALCITONIN INFLUENZA A & B RAPID SREENING TEST BLOOD CULTURE + TYPHI DOT IGM RAPID BLOOD CULTURE + TYPHI DOT IGM WIDAL TEST + TYPHI DOT IGM VIRAL TRANSPORT MEDIUM (VTM) TUBES ENA PROFILE / ANA PROFILE QUALITATIVE :10 GROUP : URINALYSIS 001 URINE ROUTINE EXAMINATION ALBUMIN AND SUGAR ACETONE URINE FOR HEMOGLOBIN

69 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:10 GROUP : URINALYSIS DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 005 URINE FOR MYOGLOBIN URINE FOR SP. GRAVITY URINE FOR PH URINE FOR CHYLE APT TEST URINE FOR ALBUMIN URINE FOR SUGAR URINE FOR PORPHOBILINOGEN BILE PIGMENT UROBILINOGEN BENCE JONES PROTEIN HR. URINARY PROTEIN (QUANTITATIVE) URINE OCCULT BLOOD URINE FOR REDUCING SUBSTANCES HR. URINARY URIC ACID HR. URINARY CALCIUM HR. URINARY SODIUM HR. URINARY POTASSIUM HR. URINARY PHOSPHORUS CREATININE CLEARANCE URINE FOR CRENATED RBC HR. URINARY CREATININE URINE FOR HEMOSIDERIN :11 BLOOD BANK 001 CROSS MATCHING GROUPING & TYPING WHOLE BLOOD/RED CELLS :HOSPITAL- PROCESSING OTHER BLOOD BANKS : BLOOD ISSUE FFP - HOSPITAL - PROCESSING RAPID DONOR TESTING PLATELET CONCEN(RD) HOSPITAL : PROCESSING DU FACTOR DIRECT COOMBS INDIRECT COOMBS RH ANTIBODY TITRE REPLACEMENT FFP REPLACEMENT PLATELET CONCENTRA

70 S.No. DESCRIPTION ACCOMMODATION CATEGORY 17:11 BLOOD BANK DR/PR/SPR/NSB/ POPD/CASUALTY SB/GOPD 014 REPLACEMENT WHOLE BLOOD COLD AGGLUTININS VENESECTION PROCEDURE PLATELET APHERESIS TRANSFER BAGS NOTE : Investigations done at outside Lab centers, will be charged as per the rate-list of concerned center SPOT INVESTIGATIONS 18:01 SPOT INVESTIGATIONS 001 ABG (ARTILLARY BLOOD GAS) (ICU BED SIDE) MONTOUX TEST RBS DONE WITH GLUCOMETER URINE FOR ACETONE URINE FOR SUGAR / ALBUMIN EXCHANGE BLOOD TRANSFUSION 19:01 EXCHANGE BLOOD TRANSFUSION (FLAT RATE) 001 EXCHANGE BLOOD TRANSFUSION (FLAT RATE) EACH TIME 002 EXCHANGE PLASMA TRANSFUSION (FLAT RATE) EACH TIME PHYSIO - THERAPY(IPD) :01 RATES OF PHYSICAL THERAPY TREATMENT DR/PR/SPR/NSB SB 001 ANTE-NATAL EXERCISES PER SITTING ANTENATAL EXERCISE - PACKAGE BREATHING EXERCISE CERVICAL TRACTION CHEST PHYSIO-THERAPY (SINGLE) COLD PACK (MULTIPLE) COLD PACK (SINGLE) COMPRESSION THERAPY (MULTIPLE) COMPRESSION THERAPY (SINGLE) CONSULTATION (PHYSIOTHERAPY) CONTRAST BATH (MULTIPLE) CONTRAST BATH (SINGLE) CPM - CONTINUOUS PASSIVE MOVEMENT (SINGLE AREA)

71 S.No. DESCRIPTION ACCOMMODATION CATEGORY 20:01 RATES OF PHYSICAL THERAPY TREATMENT DR/PR/SPR/NSB SB 014 CPM - CONTINUOUS PASSIVE MOVEMENT (TWO AREAS) ELECTRICAL MUSCLE TESTING (MULTIPLE) ELECTRICAL MUSCLE TESTING (SINGLE) EMG BIO-FEEDBACK (SINGLE) EMG BIO-FEEDBACK (MULTIPLE) EXERCISE : TEACHING ONLY MULTIPLE EXERCISE/EXERCISE WITH ADL TRAINING EXERCISE SIMPLE EXERCISE SPECIAL EXERCISES - MOBILIZATION (SINGLE) EXERCISES REHABILITATION GAIT TRAINING INFRA RED RAY THERAPY (MULTIPLE) INFRA RED RAY THERAPY (SINGLE) INFRA RED SAUNA INTERFERENTIAL THERAPY (SINGLE AREA) INTERFERENTIAL THERAPY (MORE THAN TWO AREAS) INTERFERENTIAL THERAPY (TWO AREAS) LASER -INFRA RED : POINT (MULTIPLE AREA) LASER -INFRA RED : POINT (SINGLE AREA) LASER -INFRA RED : SCAN (MULTIPLE AREA) LASER -INFRA RED : SCAN (SINGLE AREA) LONG WAVE DIATHERMY (MORE THAN TWO AREAS) LONG WAVE DIATHERMY (SINGLE AREA) LONG WAVE DIATHERMY (TWO AREAS) LUMBAR TRACTION MANUAL MUSCLE TESTING (MULTIPLE) MANUAL MUSCLE TESTING (SINGLE) MICROWAVE DIATHERMY (SINGLE AREA) MICROWAVE DIATHERMY (TWO AREAS) NEONATAL EXERCISE NEURO-DEVELOPMENTAL THERAPY NUGABEST POST NATAL EXERCISES (ALL SESSIONS) (MULTIPLE) POST OP. CHEST PHYSIO-THERAPY PULSED S.W.D. (SINGLE AREA)

72 S.No. DESCRIPTION ACCOMMODATION CATEGORY 20:01 RATES OF PHYSICAL THERAPY TREATMENT DR/PR/SPR/NSB SB 050 PULSED S.W.D. (TWO AREAS) SHORT WAVE DIATHERMY (TWO AREAS) SHORT WAVE DIATHERMY (SINGLE AREA) STEAM PACKS(MULTIPLE) STEAM PACKS(SINGLE) STIMULATION (NEURO-MUSCULAR ) SINGLE STIMULATION (NEURO-MUSCULAR) MULTIPLE SUSPENSION THERAPY TENS (MULTIPLE) TENS (SINGLE) TILT TABLE THERAPY ULTRA SONIC THERAPY (SINGLE AREA) ULTRA SONIC THERAPY (MORE THAN TWO AREAS) ULTRA SONIC THERAPY (TWO AREAS) WAX BATH (MORE THAN TWO AREAS) WAX BATH (SINGLE AREA) WAX BATH (TWO AREAS) TREATMENT IPD 21:01 TREATMENT IPD 001 ANAL DILATATION ASCITIC FLUID ASPIRATION / PARACENTESIS BIOPSY OF BONE BIOPSY OF LIVER BIOPSY OF MUSCLE BIOPSY OF SKIN BONE MARROW ASPIRATION / STERNAL PUNCTURE CAVAFIX INTRODUCTION CENTRAL VENOUS PRESSURE LINE [CETROFIX] INSERTION CUT DOWN / VENESECTION ENDOTRACHEAL INTUBATION INCIDENTAL ABORTION IN WARD INCISION & DRAINAGE OF ABSCESS INJECTION FOR PILES (SCLEROTHERAPY) INTER COSTAL (TUBE) DRAINAGE LUMBAR PUNCTURE KNEE ASPIRATION

73 S.No. DESCRIPTION ACCOMMODATION CATEGORY 21:01 TREATMENT IPD DR/PR/SPR/NSB SB 018 MINOR SURGICAL PROCEDURE IN WARD MINOR SUTURING NASAL PACKING + PACK REMOVAL NON STRESS MONITORING [PER TWO HOURS] NON STRESS TEST [NST] (PER 20 MINUTES) PLEURAL FLUID ASPIRATION / THORACENTESIS REFRACTION ************************ 22:01 SPECIAL NURSING PROCEDURES 001 SKIN / PELVIC TRACTION APPLICATION :02 SPECIAL NURSING PROCEDURE 001 SALSOL NEBULISATION NORMAL SALINE NEBULISATION LACTODEX MILK PER DAY :03 PLASTERING 001 PLASTERING : BODY CAST PLASTERING : CTEV UNILATERAL PLASTERING : CTEV BILATERAL PLASTERING : HIP PLASTERING : ROUTINE (REPAIR) PLASTERING : ABOVE ELBOW PLASTERING : BELOW ELBOW PLASTERING : ABOVE KNEE PLASTERING : BELOW KNEE PLASTERING : DEFORMITY CORRECTION SMALL PLASTERING : DEFORMITY CORRECTION LARGE Note : Material cost will be extra 23:01 DRESSING 001 DRESSING MINOR DRESSING MEDIUM DRESSING MAJOR Note : Material cost will be extra 73

74 S.No. DESCRIPTION ACCOMMODATION CATEGORY DR/PR/SPR/NSB SB SPECIAL PROCEDURES 24:01 CHEMOTHERAPY 001 CHEMOTHERAPY ONE DAY CYCLE CHEMOTHERAPY TWO DAYS CYCLE CHEMOTHERAPY THREE DAYS CYCLE CHEMOTHERAPY FOUR DAYS CYCLE CHEMOTHERAPY FIVE DAYS CYCLE :01 PSYCHOTHERAPY 001 PSYCHOTHERAPY SHORT SESSION PSYCHOTHERAPY FULL SESSION :01 LASER PROCEDURES(OPHTHALMOLOGY) ALL CATEGORIES OF IPD & OPD 001 AUTOPERIMETRY (FIELDS) COLOUR PHOTOS FUNDUS FLURESIEN ANGIOGRAPHY [SUPPLIES EXTRA] LASER PERIPHERAL IRIDECTOMY LASER PHOTOCOAGULATION PER SITTING LASER PHOTOCOAGULATION - LATTICE & HOLES LASER PHOTOCOAGULATION - R. O. P O C T YAG CAPSULOTOMY :01 LASER PROCEDURES (DERMATOLOGY) DR/PR/SPR/NSB SB (AESTHETIC CLINIC) 001 FRAXEL (FOR ACNE SCARS) LASER HAIR REMOVAL CHIN (PER SESSION) LASER HAIR REMOVAL FACE (PER SESSION) LASER HAIR REMOVAL - NECK (PER SESSION) LASER HAIR REMOVAL SIDE LOCK (PER SESSION) LASER HAIR REMOVAL UPPER LIP (PER SESSION) LASER RE-SURFACING LASER TATTO REMOVAL SMALL LASER TATTO REMOVAL MEDIUM LASER TATTO REMOVAL LARGE LASER TATTO REMOVAL EXTENSIVE

75 S.No. DESCRIPTION ACCOMMODATION CATEGORY 28:01 SPECIAL INVESTIGATIONS DR/PR/SPR/NSB SB 001 URO-FLOWMETRY :01 SPEECH & HEARING TEST 001 AC BERA ASSR BC BERA COCHLEAR IMPLANT COUNSELING DIAGNOSTIC OAE-TEOAE/DPOAE ECOCH G IMPEDANCE TYMPANOMETRY AUDIOMETRY PTA/BOA/FFT SCREENING OAE ABLB/SISI/TD SPEECH THERAPY (CONSULTATION-EACH SESSION) :01 INSTRUMENTS AND SPECIAL EQUIPMENTS 001 CARDIAC MONITOR : PER DAY (When monitored in ward/isolation) DVT PUMP :01 DIET FOR ATTENDANT 001 AERATED COLD DRINKS : 500 ML. BOTTLE BOTTLED DRINKING WATER (1 LITER) TEA ONE CUP COFFEE ONE CUP TEA WITH SNACKS COFFEE & SNACKS FROOTI (200 ML) PACKED JUICES (200 ML) SANDWICHES : VEG (4 SLICES) BREAKFAST [NON-VEGETARIAN] ONLY BREAKFAST [VEGETARIAN] ONLY LUNCH [NON-VEGETARIAN] ONLY LUNCH [VEGETARIAN] ONLY DINNER [NON-VEGETARIAN] ONLY DINNER [VEGETARIAN] ONLY FULL MEALS FOR ATTENDANT [NON-VEGETARIAN] : PER DAY FULL MEALS FOR ATTENDANT [VEGETARIAN] : PER DAY MILK : PER GLASS

76 S.No. DESCRIPTION ACCOMMODATION CATEGORY 32:01 CONCESSION (ONLY FOR SB CASES) SB 001 CONCESSION ON ROOM / BED CONCESSION ON ICU / CCU CONCESSION ON POST OP. ROOM CONCESSION ON SEMI ICU CONCESSION ON HDU (415) CONCESSION ON PED. ICU / SPL. NURSERY (305) CONCESSION ON NNU - NURSERY (206) CONCESSION ON HDU LABOR ROOM 1100 AYURVEDIC TREATMENT 33:01 AYURVEDIC TREATMENT DR/PR/SPR/NSB/ POPD SB/GOPD 001 Avagaha Sweda (Per Sitting) Ekanga Taila Dhara (Per Sitting) Kati Basti (Per Sitting) Ksheera Dhara (Per Sitting) Matra Basti (Per Sitting) Nadi Sweda-Full Body (Per Sitting) Nadi Sweda-One Limb (Per Sitting) Nadi Sweda-Two Limbs (Per Sitting) Nasya Karma (Per Sitting) Netra Tarpan (Per Sitting) Patra Pinda Sweda-Full Body (Per Sitting) Patra Pinda Sweda-One Limb (Per Sitting) Patra Pinda Sweda-Two Limbs (Per Sitting) Sarvang Abhyanga-Adult (Per Sitting) Sarvang Abhyanga-Child (Per Sitting) Sarvanga Bashpa Sweda (Per Sitting) Shashtik Shali Pinda Sweda-Adult (Per Sitting) Shashtik Shali Pinda Sweda-Child (Per Sitting) Shirobasti (7 Days) Taila Dhara (7 Days) Takra Dhara (Per Sitting) Twarita Basti (Per Sitting) Uttara Basti (Per Sitting) Vamana Karma (12 Days) Virechan Karma (12 Days) Yoga Basti[5A+3N] Kala Basti [10A+6N] 16-Days Karma Basti [18A+12N] 30-Days

77 S.No. DESCRIPTION ACCOMMODATION CATEGORY 33:01 AYURVEDIC TREATMENT DR/PR/SPR/NSB/ POPD SB/GOPD 029 Snehadhara Sweda+Yoga Basti 14+8 Days Udwartanam (Per Sitting) Cost of Patrapinda Bundle [Each] S.No. DESCRIPTION ALL CATEGORIES OF IPD & OPD 34:01 AMBULANCE 001 UPTO 5 KM (To & Fro) MORE THAN 5KM AND UPTO 10 KM (To & Fro) BEYOND 10 KM PER KM (To & Fro) 30 Note : ************************ AMBULANCE (1). Holy Family Hospital s ambulance is meant for the use of the hospital s own patients referred for scanning or transfer to another hospital only. (2). All distance will be on to and fro basis. (3). Waiting charges Rs.150/- per hour. Initial half an hour waiting is free. (4). During the night (in between 6.00PM to 8.00AM) - Rs.150/- per hour will be extra. (5). Ambulance will not be provided to discharged patients. (6) Ambulance will not be used for transporting the dead body. (7) The ambulance will be available for use only within the city limits of Delhi and New Delhi. (8) The ambulance will not be available on Sundays and holidays. ************************ 35:01 MORTUARY MORTUARY 1. Any inpatient who has expired in Hospital Rs.500/- per day. 2. Dead Bodies brought from outside Rs. 1500/- per day. ************************ 36:01 MISCELLANEOUS CHARGES 001 DUPLICATE COPY OF THE BILL COMPLITION OF RE-IMBURSEMENT FORM 30 77

78 O.P.D. O.P.D. S.No. DESCRIPTION 37:01 O.P.D.(PRIVATE) CONSULTATION (EACH TIME) PRIVATE O.P.D. 001 CONSULTATION [EACH] CONSULTATION [EACH] : HOMEOPATHIC CLINIC :01 O.P.D.[GENERAL] REGISTRATION (EACH TIME) GENERAL O.P.D. 001 NEW REGISTRATION - PER CLINIC RE-VISIT REGISTRATION - PER CLINIC NEW REGISTRATION - O.B. & WELL BABY CLINIC RE-VISIT REGISTRATION - O.B. & WELL BABY CLINIC CASUALTY VISIT [EACH TIME] 400 BOOK CHARGES 006 ISSUE OF CONTINUATION OPD BOOK(On old book completely full) ISSUE OF DUPLICATE OPD BOOK 50 39:01 O.B. REGISTRATION CHARGES (NON REFUNDABLE NON ADJUSTABLE) S.No. DESCRIPTION DR PR SPR NSB SB 001 O.B. REGISTRATION FOR PR & SPR CATEGORY THROUGH POPD O.B. REGISTRATION FOR NSB & SB CATEGORY THROUGH GOPD OPD PROCEDURES 40:01 CHEMOTHERAPY CHARGES (In OPD-Casualty Room) POPD/ Casualty/ GOPD 001 CHEMOTHERAPY- BED & NURSING CHEMOTHERAPY- GENERAL SUPPLIES CHEMOTHERAPY-THERAPY CHARGES :01 GROUP : DIALYSIS ALL CATEGORIES OF OPD 001 DIALYSIS (PER HAEMODIALYSIS) Package Charges(Artificial Kidney Extra) EXTENDED DIALYSIS (8 HOURS DIALYSIS) Package Charges for JUGULAR CATHETERISATION SUBCLAVIAN CATHETERISATION Package Charges FEMORAL CATHETERISATION - Package Charges KIDNEY BIOPSY (LAB CHARGES EXTRA) HAEMODIALYSIS CATHETER DRESSING FISTULA DRESSING

79 S.No. DESCRIPTION ALL CATEGORIES OF OPD 41:01 GROUP : DIALYSIS 009 US/ECHO GUIDANCE CHARGES FOR JUGULAR/ SUBCLAVIAN CANNULATION OR CATHETERISATION PERITONEAL DIALYSIS KTP FOLLOW-UP (NEPHROLOGY) [FOR 1 YEAR) Note : Haemodialysis includes all consumables and professional charges but it does not include cost of Dialyser (Artificial Kidney), any Investigation charges and other medication. 42:01 O.P.D. Procedures UROLOGY POPD/ Casualty G.O.P.D. 001 BLADDER IRRIGATION CATHETERIZATION PLAIN (Disposables Extra) CHANGE OF SUPRA PUBIC CATHETER PARAPHIMOSIS REDUCTION BCG INSTILLATION IN BLADDER :02 O.P.D. Procedures ENT 001 SYRINGING ENT :03 O.P.D. Procedures OPHTHALMOLOGY 001 ORTHOPTIC WORK UP(SINGLE VISIT) SQUINT WORK UP REFRACTION CONVERGENCE EXERCISE (15 DAYS COURSE) :04 O.P.D. Procedures GYNAE 001 LOCALISATION OF FOETAL HEART BY USG IN LABOR ROOM PAP SMEAR TAKING INTRA UTERINE CONTRACEPTIVE DEVICE (IUCD) REMOVAL (COPPER T ETC.) MAC DONALD STITCH REMOVAL :01 PLASTERING CHARGES 001 PLASTERING : BODY CAST PLASTERING : CTEV UNILATERAL PLASTERING : CTEV BILATERAL PLASTERING : HIP PLASTERING : ROUTINE (REPAIR) PLASTERING : ABOVE ELBOW PLASTERING : BELOW ELBOW PLASTERING : ABOVE KNEE PLASTERING : BELOW KNEE

80 S.No. DESCRIPTION POPD/ Casualty G.O.P.D. 43:01 PLASTERING CHARGES 010 PLASTERING : DEFORMITY CORRECTION SMALL PLASTERING : DEFORMITY CORRECTION LARGE Note : Material cost will be extra 44:01 SKIN PROCEDURES 001 BIOPSY OF SKIN (LAB CHARGES EXTRA) BOTOX INJECTION (PER UNIT) CHEMICAL CAUTERY CORN REMOVAL (PER CORN) IN OPD CORN REMOVAL (PER CORN) MINOR O.T CRYO SURGERY (SINGLE LESION) CRYO SURGERY (TWO LESaION) CRYO SURGERY (MULTIPLE LESION) FILLER INJECTION (COST OF FILLER EXTRA) INTRA LESIONAL INJECTION REMOVAL OF BLACKHEADS REMOVAL OF MOLUSEUM SCRAPING PATCH TESTING - UPTO 4 ANTIGENS PATCH TESTING - ABOVE 4 ANTIGENS RF CAUTERY WOODS LAMP EXAMINATION :01 TREATMENT & PROCEDURES OPD 001 LUMBAR PUNCTURE BONE MARROW ASPIRATION/STERNAL PUNCTURE CUT DOWN/VENESECTION CENTRAL VENOUS PRESSURE LINE (CETROFIX) INSERTION I&D - INCISION & DRAINAGE OF ABSCESS ENDOTRACHEAL INTUBATION MINOR SURGICAL PROCEDURE CAVAFIX INTRODUCTION PLEURAL FLUID ASPIRATION(TAPING)/ THORACENTESIS ASCITIC FLUID ASPIRATION/PARACENTESIS

81 S.No. DESCRIPTION POPD/ Casualty G.O.P.D. 45:01 TREATMENT & PROCEDURES OPD 011 INTER COSTAL (TUBE) DRAINAGE [COST OF CHEST TUBE EXTRA] INTRA ARTICULAR INJECTION (OPD) SINGLE JOINT BIOPSY OF BONE BIOPSY OF LIVER (LAB CHARGES EXT.) BIOPSY OF MUSCLE (LAB CHARGES EXT.) BLADDER WASH CHANGE OF TRACHEOSTOMY TUBE CHANGE OF COLOSTOMY BAG CHEST STRAPPING CLOSED REDUCTION MINOR (IN OPD/ CASUALTY) COPPER SULPHATE CAUTERY DEBRIDEMENT OF THE WOUND DRESSING - MINOR DRESSING MEDIUM DRESSING MAJOR DRESSING PLASTIC SURGERY (LARGE) DRESSING PLASTIC SURGERY (MEDIUM) DRESSING PLASTIC SURGERY (SMALL) EAR PIERCING : BILATERAL EXCISION OF TOE NAIL (IN OPD/CASUALTY) EYE SYRINGING & NEEDLING D.C. (ELECTRIC) SHOCK IN CASUALTY FOLEYS CATHETERISATION FOREIGN BODY (MINOR) REMOVAL (IN CASUALTY) GASTRIC LAVAGE / STOMACH WASH HYDRO CORTIZONE INJ I.V.SERVICE CHARGES (COST OF I.V. EXTRA) INCIDENTAL ABORTION INJ. GIVING CHARGES JAW MANNUAL REDUCTION K-WIRE RAMOVAL (IN OPD) KNEE ASPIRATION MANIPULATION MINOR MANNUAL EVACUATION MONTOUX TEST NASAL PACKING (IN CASUALTY)

82 S.No. DESCRIPTION POPD/ Casualty G.O.P.D. 45:01 TREATMENT & PROCEDURES OPD 047 NEEDLE ASPIRATION (IN OPD) OF MINOR ABSCESS NON STRESS MONITORING (PER TWO HOURS) NST -NON STRESS TEST (PER 20 MINUTES) PROSTATE BIOPSY (Lab Charges is extra) PULLED ELBOW SIMPLE MANIPULATION SODIUM NITRATE CAUTERY SPO2 MONITORING SPOT RBS STRAPPING SUPRA PUBIC CATHETERISATION SUTURING UP TO 5 STITCHES SUTURING ABOVE 5 STICHES EACH STITCH SYRINGING OR NEEDLING EYE (IN CASUALTY) TEMPORARY PACING URINE FOR SUGAR/ALBUMIN - TREATMENT :01 GROUP : NURSING PROCEDURES 001 STEAM INHALATION NEBULIZATION SKIN/PELVIC TRACTION APPLICATION PHYSIO - THERAPY (O.P.D.) 47:01 RATES OF PHYSICAL THERAPY TREATMENT 001 ANTE-NATAL EXERCISES PER SITTING ANTENATAL EXERCISE - PACKAGE BREATHING EXERCISE CERVICAL TRACTION CHEST PHYSIO-THERAPY (SINGLE) COLD PACK (MULTIPLE) COLD PACK (SINGLE) COMPRESSION THERAPY (MULTIPLE) COMPRESSION THERAPY (SINGLE) CONSULTATION (PHYSIOTHERAPY) CONTRAST BATH (MULTIPLE) CONTRAST BATH (SINGLE) CPM - CONTINUOUS PASSIVE MOVEMENT (SINGLE AREA) CPM - CONTINUOUS PASSIVE MOVEMENT (TWO AREAS)

83 S.No. DESCRIPTION OPD CATEGORY 47:01 RATES OF PHYSICAL THERAPY TREATMENT POPD/ Casualty G.O.P.D. 015 ELECTRICAL MUSCLE TESTING (MULTIPLE) ELECTRICAL MUSCLE TESTING (SINGLE) EMG BIO-FEEDBACK (SINGLE) EMG BIO-FEEDBACK (MULTIPLE) EXERCISE : TEACHING ONLY EXERCISE SIMPLE EXERCISE SPECIAL EXERCISES - MOBILIZATION (SINGLE) EXERCISES REHABILITATION MULTIPLE EXERCISE/EXERCISE WITH ADL TRAINING GAIT TRAINING INFRA RED RAY THERAPY (MULTIPLE) INFRA RED RAY THERAPY (SINGLE) INFRA RED SAUNA INTERFERENTIAL THERAPY (SINGLE AREA) INTERFERENTIAL THERAPY (MORE THAN TWO AREAS) INTERFERENTIAL THERAPY (TWO AREAS) LASER -INFRA RED : POINT (MULTIPLE AREA) LASER -INFRA RED : POINT (SINGLE AREA) LASER -INFRA RED : SCAN (MULTIPLE AREA) LASER -INFRA RED : SCAN (SINGLE AREA) LONG WAVE DIATHERMY (MORE THAN TWO AREAS) LONG WAVE DIATHERMY (SINGLE AREA) LONG WAVE DIATHERMY (TWO AREAS) LUMBAR TRACTION MANUAL MUSCLE TESTING (MULTIPLE) MANUAL MUSCLE TESTING (SINGLE) MICROWAVE DIATHERMY (SINGLE AREA) MICROWAVE DIATHERMY (TWO AREAS) NEONATAL EXERCISE NEURO-DEVELOPMENTAL THERAPY NUGABEST PACKAGE FOR CHRONIC CASES (ADULT) PER MONTH (20 SESSIONS) PACKAGE FOR ELECTROMODALITY + JOINT MOBILIZATION EXERCISE (10 SESSIONS)

84 S.No. DESCRIPTION OPD CATEGORY 47:01 RATES OF PHYSICAL THERAPY TREATMENT POPD/ Casualty G.O.P.D. PACKAGE FOR JOINT MOBILISATION WITH 049 ONE HOT/ELECTRO-THERAPY MODALITY ( SESSIONS) 050 PACKAGE FOR PEDIATRIC CASES PER MONTH (20 SESSIONS) POST NATAL EXERCISES (ALL SESSIONS) (MULTIPLE) POST OP. CHEST PHYSIO-THERAPY PULSED S.W.D. (SINGLE AREA) PULSED S.W.D. (TWO AREAS) SHORT WAVE DIATHERMY(TWO AREAS) SHORT WAVE DIATHERMY (SINGLE AREA) STEAM PACKS(MULTIPLE) STEAM PACKS(SINGLE) STIMULATION (NEURO-MUSCULAR ) SINGLE STIMULATION (NEURO-MUSCULAR) MULTIPLE SUSPENSION THERAPY TENS (MULTIPLE) TENS (SINGLE) TILT TABLE THERAPY ULTRA SONIC THERAPY (SINGLE AREA) ULTRA SONIC THERAPY (MORE THAN TWO AREAS) ULTRA SONIC THERAPY (TWO AREAS) WAX BATH (MORE THAN TWO AREAS) WAX BATH (SINGLE AREA) WAX BATH (TWO AREAS) EXERCISE + WALKING HP + EXERCISE IFT + HP + EXERCISE IFT + HP + MOBILISATION EXERCISE IFT + SWD +EXERCISE (MULTIPLE) IFT + SWD +EXERCISE (SINGLE) IFT + US + HP + EXERCISE IFT + US2 + HP + EXERCISE IFT +US + HP + MOBILISATION EXERCISE IFT2 + SW2 + EXERCISE SWD + MOBILISATION EXERCISE SWD + US + EXERCISE

85 S.No. DESCRIPTION OPD CATEGORY 47:01 RATES OF PHYSICAL THERAPY TREATMENT POPD/ Casualty G.O.P.D. 083 SWD + US + MOBILISATION EXERCISE SWD + US2 + CTR + EXERCISE WAX + MOBILISATION EXERCISE NOTE : For OPD patients, if more than one modality of physiotherapy will be performed in single sitting, the charges of higher modality will be charged in full and rest of the modalities will be charged half. ************************ PACKAGE CHARGES FOR MINOR O.T. PROCEDURES 48:01 ENT : MINOR O.T. PROCEDURES 1 ANT. NASAL PACK ANTRAL WASH : U/L OR B/L BIOPSY OF CHEEK OR TONGUE : U/L OR B/L CAUTERY OF NASAL BLEEDERS WITH PACKING CAUTERY PATCHING EAR CHANGE OF TRACHEOSTOMY TUBE DIAGNOSTIC NASAL ENDOSCOPY EUM -EXAMINATION UNDER MICROSCOPE EXCISION OF TONGUE TIE FOREIGN BODY REMOVAL-(NOSE/EAR) FOREIGN BODY THROAT(FISH BONE) LARYNGOSCOPY FIBER OPTIC MYRINGOTOMY FOR ASOM NASAL BIOPSY NASAL PACK REMOVAL SPLIT EAR LOBULE BILATERAL SPLIT EAR LOBULE UNILATERAL :02 GENERAL SURGERY : MINOR O.T. PROCEDURES 1 ASPIRATION OF SUPERFICIAL COLD ABSCESS AVULSION OF TOE NAIL B/L AVULSION OF TOE NAIL U/L BIOPSY OF BREAST DEBRIDEMENT SMALL DRAINAGE OF SMALL ABSCESS EXCISION BIOPSY SMALL EXCISION OF SEBACEOUS CYST EXCISION OF SMALL SUPERFICIAL SOFT TISSUE MASS/TUMOUR

86 S.No. DESCRIPTION OPD CATEGORY 48:02 GENERAL SURGERY : MINOR O.T. PROCEDURES POPD/ Casualty G.O.P.D. 10 GLAND BIOPSY I & D OF BREAST ABSCESS LYMPH NODE BIOPSY NEEDLE ASPIRATION OF ABSCESS REMOVAL OF SUPERFICIAL FOREIGN BODY LIMBS MINOR RESUTURING OF SMALL ABDOMINAL WOUND SCLEROTHERAPY : (INJ. FOR PILES) Note : Charges for Lab will be extra wherever is applicable. 48:03 OB./ GYN : Minor O.T. PROCEDURES 1 CERVICAL BIOPSY COLPOSCOPY DIAGNOSTIC COLPOSCOPY WITH PUNCH BIOPSY COLPOSCOPY WITH PUNCH BIOPSY WITH CRYO CAUTERY CRYO-CAUTERY D. & C. OR D.& E ENDOCERVICAL CURRETTINGS ENDOMETRIAL ASPIRATION ENDOMETRIAL BIOSPY ENDOMETRIAL BRUSH CYTOLOGY HPV-DNA COLLECTION CHARGES (Charges for Kit & Lab Extra) HYDRO TUBATION : PER SITTING (MED. COST EXT.) INCIDENTAL DELIVERY INCLUDING SUTURING POLYP REMOVAL RESUTURING OF EPISIOTOMY RESUTURING OF SMALL ABDOMINAL WOUNDS SUTURING OF SMALL TEARS OVER PERINIUM, VAGINA AND LABIA Note : Charges for Lab will be extra wherever is applicable. 48:04 OPHTHALMOLOGY : MINOR O.T. PROCEDURES 1 CHALAZION SINGLE EYE LID CHALAZION BOTH EYE LID OR MULTIPLE DRAINAGE OF LID ABSCESS FOREIGN BODY REMOVAL SYRINGING

87 S.No. DESCRIPTION OPD CATEGORY 48:05 ORTHO : Minor O.T. POPD/ Casualty G.O.P.D. 1 CLOSED REDUCTION MANIPULATION : LOWER EXTREMITY* CLOSED REDUCTION MANIPULATION : UPPER EXTREMITY* DRESSING : MAJOR (IN MINOR O.T.) * DRESSING : MINOR (IN MINOR O.T.) * DYNAMISATION OF I.M.NAIL EXCISION OF GANGLION / SOFT TISSUE MASS EXCISION OF TOE/FINGER NAIL INTRA ARTICULAR INJECTION/ASPIRATION (IN MINOR O.T.) SINGLE JOINT** PELVIC EXTERNAL FIXATOR*** REMOVAL OF WIRE AND MINOR IMPLANTS TENDO-ACHILLIS TENOTOMY B/L TENDO-ACHILLIS TENOTOMY U/L Note : 1. * Cost of P.O.P. and other materials will be extra wherever is applicable. 2. ** Cost of Injectable extra 3. *** Charges for Implant will be extra. 4. Cost of Medicine and injections will be extra wherever will be used. 48:06 PLASTIC SURGERY : MINOR O.T. PROCEDURES 1 ARCH BAR REMOVAL EXCISION OF CYST MULTIPLE EXCISION OF CYST SINGLE EXCISION OF KELOID SMALL EXCISION OF MOLE-FACE FACIOCUTANEOUS FLAP REPAIR - SMALL FULL THICKNESS GRAFT SMALL HAIR TRANSPLANT : LARGE AREA (1000 Grafts) HAIR TRANSPLANT : MEDIUM AREA (Upto 500 Grafts) HAIR TRANSPLANT : SMALL AREA (<100 Grafts) LOCAL FLAP MINOR MINOR AMPUTATION TOE, DIGIT ETC MINOR IMPLANT REMOVAL WIRE ETC REPAIR OF ONE FINGER REPAIR OF PINNA SIMPLE SCAR EXCISION SIMPLE Z PLASTY SKIN GRAFTING SMALL

88 S.No. DESCRIPTION OPD CATEGORY 48:06 PLASTIC SURGERY : MINOR O.T. PROCEDURES POPD/ Casualty G.O.P.D. 19 SMALL NEVUS SPLIT EAR LOBULE BILATERAL SPLIT EAR LOBULE UNILATERAL WOUND REPAIR SMALL Note : Charges for Lab will be extra wherever is applicable. 48:07 UROLOGY : MINOR O.T. PROCEDURES 1 BIOSPY GROWTH ON PENIS OR SCROTUM CIRCUMCISION DORSAL SLIT MEATOTOMY ORCHIDECTOMY B/L OR U/L PROSTATIC BIOPSY * TESTICULAR BIOPSY TROCAR SPC** URETHRAL DILATATION Note : * Charges for TRU-CUT BIOPSY GUN will be Extra. **Charges for SUPRA-CATH will be extra. Charges for Lab will be extra wherever is applicable. 48:08 THORACIC SURGERY : Minor O.T. 1 CHEST ASPIRATION BRONCHOSCOPY WITH OR WITHOUT F.B.RE- MOVAL Note : 1. Charges for Lab. will be extra wherever is applicable. 2. Cost of CHEST TUBE is extra. PEDIATRIC SURGERY : Minor O.T. 48:09A PEDIATRIC SURGERY : GENERAL SURGERY 1 ASPIRATION OF SUPERFICIAL COLD ABSCESS AVULSION OF TOE NAIL B/L AVULSION OF TOE NAIL U/L CATHETERISATION & MCU DEBRIDEMENT SMALL DRAINAGE OF SMALL ABSCESS DRAINAGE OF ABSCESS DRESSING : MAJOR DRESSING : MINOR EXCISION OF SEBACEOUS CYST EXCISION OF SMALL SUPERFICIAL SOFT TISSUE MASS/TUMOUR

89 S.No. DESCRIPTION OPD CATEGORY 48:09A PEDIATRIC SURGERY : GENERAL SURGERY POPD/ Casualty G.O.P.D. 12 GLAND BIOPSY I & D OF BREAST ABSCESS LABIAL ADHESIONS LYMPH NODE BIOPSY NEEDLE ASPIRATION OF ABSCESS PREPUTIAL DILATATION REMOVAL OF SUPERFICIAL FOREIGN BODY LIMBS MINOR RESUTURING OF SMALL ABDOMINAL WOUND UMBILICAL GRANULOMA UMBILICAL POLYP WOUND REPAIR Note : Charges for Lab will be extra wherever is applicable. 48:09B PEDIATRIC SURGERY : ENT 1 EXCISION OF TONGUE TIE SPLIT EAR LOBULE UNILATERAL :09C PEDIATRIC SURGERY : PLASTIC 1 EXCISION OF CYST MULTIPLE EXCISION OF CYST SINGLE LOCAL FLAP MINOR MINOR AMPUTATION TOE, DIGIT ETC SIMPLE Z PLASTY SMALL NEVUS :09D PEDIATRIC SURGERY : UROLOGY 1 BIOSPY GROWTH ON PENIS OR SCROTUM CIRCUMCISION* DORSAL SLIT TROCAR SPC** URETHRAL DILATATION Note : 1. * Charges for Plastic Bell will be extra. 2. ** Charges for Supra Cath will be extra 89

90 S.No. DESCRIPTION OPD CATEGORY 48:09E PEDIATRIC SURGERY : THORACIC POPD/ Casualty G.O.P.D. 1 CHEST ASPIRATION DIAGNOSTIC CHEST ASPIRATION THERAPUTIC Note : 1. Charges for Lab. will be extra wherever is applicable. 2. Cost of CHEST TUBE is extra. 48:10 MINOR O.T. PROCEDURE CHARGES : PRIVATE PATIENTS 1 The doctor is free to charge a differential fee for their Pvt. Patients. 2 Charges for the O.T and Local Anesthesia will be 25% of the surgical fee. 3 The disposables will be charged on actual. 4 Lab. Charges will be extra wherever applicable. ******************* MISCELLANEOUS CHARGES 49:01 GROUP : DUPLICATE PRINTING 001 DUPLICATE RECEIPTS PRINT 10 NOTE : The hospital reserves the right to modify the above mentioned charges without prior notice whenever it deems necessary. 90

91 HOLY FAMILY HOSPITAL Okhla Road, New Delhi , Tel : Fax: Website : 91

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