IMA NHB Suggested Package amount for negotiation with Insurance Companies

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1 IMA NHB Suggested Package amount for negotiation with Insurance Companies S.No Name of the Procedure -Treatment System IMA MHB Proposed minimum quotable rate for single room non A/c 1 CABG CARDIOLOGY 2 Angiography(Day Care) CARDIOLOGY 3 Angiography With Angioplasty CARDIOLOGY 4 Valve Replacement* CARDIOLOGY 5 Temporary Pacemaker Implantation CARDIOLOGY 6 Permanent Pacemaker Implantation CARDIOLOGY 7 DVR - Double Valve Replacement (Cardiac Surgery) CARDIOLOGY 8 EPS and RFA CARDIOLOGY 9 Tonsillectomy E.N.T Adenotonsillectomy E.N.T Tympanoplasty E.N.T Mastoidectomy E.N.T 13 Septoplasty E.N.T Nasal Polyps/ Sinusitis (Fess)- Unilateral E.N.T 15 Nasal Polyps/ Sinusitis (Fess)- Bilateral E.N.T 16 Cortical Mastoidectomy With Myringoplasty E.N.T 18 Peritonsilar Abscess Drainage E.N.T Septoplasty + Turbinoplasty / Conchaplasty E.N.T 20 Myringotomy with Grommet insertion E.N.T 17 Meatotomy Urology 21 Haemorrhoidectomy 22 Haemorrhoidectomy + Fissurectomy 23 Fissure Dialatation 24 Fissureectomy 25 Fistula High End 26 Fistula Low End 27 Appendectomy (Lap) 28 Cholesystectomy (Lap)

2 29 Excision Of Pilonoidal Sinus With Flap Cover 30 Excision Of Pilonoidal Sinus With Primary Closure 31 Mastectomy (Simple) 32 Mastectomy (Radical) 33 Thyroidectomy (Total/Subtotal) 34 Inguinal Herniorraphy- Unilateral - Exclucive of Mesh & Tackers 35 Inguinal Hernioplasty- Unilateral - Open (Case to case varies) 36 Inguinal Herniorraphy- Bilateral - Open (Case to case varies) 37 Inguinal Hernioplasty- Bilateral - Open (Case to case varies) 38 Umblical Herniorraphy 39 Umblical Herniorraplasty - Exclusive of Mesh & Tackers 40 Incisional Herniorraphy 41 Incisional Hernioplasty - Open (Exclusive of Mesh & Tackers) 42 Circumcision 43 Perianal Abcess 44 Breast Lumpectomy 45 AV Fistula 46 Hydrocele 47 URS(therapeutic) - Unilateral 48 Right or left Hemi Coloctomy - Exclusive of Stappler 49 Resection and Anastomosis of Small Intestine - Exclusive of Stappler (Case to case varies) 50 ESWL(Extracorporeal shock wave lithotripsy) - Sitting (Case to case varies) 51 Exploratory Laparotomy - Case to case varies 52 ERCP EPT/Stenting/Stone removal 53 Renal Transplant Surgery ( Recipient) 54 VP Shunting NEUROLOGY 55 Normal Delivery 56 Lscs (With Well Baby Care) 57 Lap Hystractomy (Abdominal/Vaginal)- Level 2 58 Instrumental Delivery (Including Well Baby Care) 59 Ovarian Cystectomy 60 Dilatation & Curettage (D&C) 61 Vaginal-Vault Prolapse Repair CTC

3 62 Laproscopic Ovarian Drilling 63 IMRT (Cancer Radiation Therapy) INTENSITY MODULATED RADIATION THERAPY ONCOLOGY 64 VMAT(Cancer Radiation Therapy) Volumetric modulated Arc therapy ONCOLOGY 65 SBRT (Cancer Radiation Therapy) Steriotactic Body Radiation therapy ONCOLOGY 66 SRS Brain (Cancer Radiation Therapy) Stereotactic Radio Surgery ONCOLOGY 67 SRT Brain (Cancer Radiation Therapy) Steriotactic Fractionated Radiation ONCOLOGY 68 3 D CRT (Cancer Radiation Therapy) 3D Conformal radiation therapy ONCOLOGY 69 IGRT (Cancer Radiation Therapy) Image Guided radiation Therapy ONCOLOGY 70 Cataract + Cost Of Lens 7000/- OPHTHALMOLOGY 71 Retinal Detatchment OPHTHALMOLOGY 72 Vitrectomy OPHTHALMOLOGY 73 Vitrectomy With Gas Temponade OPHTHALMOLOGY 74 Vitrectomy With Silicon Temponade OPHTHALMOLOGY 75 Vitrectomy - Membrane Peeling- Endolaser OPHTHALMOLOGY 76 Vitrectomy Sutureless + Membranectomy + Endolaser OPHTHALMOLOGY 77 Vitrectomy - Membrane Peeling - Endolaser - Silicon Oil Or Gas - With Or Without B OPHTHALMOLOGY 78 Total Knee Replacement (Unilateral) - Exclusive of Implant ORTHOPAEDICS imp 79 Total Knee Replacement (Bilateral) - Exclusive of Implant ORTHOPAEDICS 1+imp 80 Hip Replacement (Unilateral) - Exclusive of Implant ORTHOPAEDICS imp 81 Hip Replacement (Bilateral) - Exclusive of Implant ORTHOPAEDICS 1+imp 82 Fracture Neck Femur (Bipolar Arthroplasty/Multiple Screw Fixation ORTHOPAEDICS 83 Therapeutic Arthroscopy ORTHOPAEDICS 84 Arthroscopic Surgery ( Other Than Acl) / Menisectomy ORTHOPAEDICS 85 Acl Reconstruction - Exclusive of Implant ORTHOPAEDICS Laminectomy/Discectomy - Single Level ORTHOPAEDICS 87 Stabilization Of Spinal Column ORTHOPAEDICS imp 88 Carpel Tunnel Release ORTHOPAEDICS 89 Close Reduction of Fracture of Limbs and POP ORTHOPAEDICS 90 Reduction of Compound Fractures - (Case to case varies) ORTHOPAEDICS 91 Close Reduction of Dislocations ORTHOPAEDICS 92 Implant Removal ORTHOPAEDICS 93 MCL Reconstriction/Repair - Exclusive of Implant ORTHOPAEDICS 94 Reduction of Dislocation in GA ORTHOPAEDICS

4 95 DJ Stent Removal 96 Pcnl- Unilateral 97 Pcnl- Bi Lateral - Case to case varies 98 Turp/Laser Holmium 99 Dialysis - Case to case varies 100 Cystoscopy(Therapeutic) 101 Cystoscopy Urs With Dj Stending (Unilateral) 102 Nephrectomy/Nephrolithomy/Pyelolithotomy 103 Orchidectomy 104 Varicose Veins(surgical as well as laser) - Open (Case to case varies) 105 Varicose Veins(surgical as well as laser) - RF Unilateral VASCULAR VASCULAR CTC OPHTHOLMOLOGY S.No Procedure Final Proposed package rates Tamilnadu Eye Hospitals 1 ECCE/SICS 2 ECCE / SICS+IOL 8000 Phaco with 3. Indian Non-aspheric foldable IOL Indian aspheric foldable IOL Imported Non-aspheric Foldable IOL Imported Aspheric Foldable IOL Indian ToriciOL 8. Imported Toric IOL 9. MICS+Indian MIL 10. MICS+Imported IOL Indian Multifocal IOL Imported Multifocal IOL

5 Please Note : Make use of this rate for all insurance companies irrespective of PPN Rates proposed are for single non A/C room for basic hospitals Please add up A/C room charges for A/C room Hospital with better facility can force more having this rate as base rate. Please do not quote less than this rate ****

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