Preauth Required or Not (Y/N) Amount. S Adventious Burse Excision 10,000 N 3 N S. S Anterior Resection for CA 15,000 N 4 N S
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1 1 General urgery.. 1 General urgery pecialty code Package Code Package name Package Amount Preauth Required or ot (Y/) Mandator y investig ations for pre-auth Post-Op investigat ions for claims submission Average length of tay (Including Days in intensive care units) Govt Reserved Procedur e (Y/) Medical (M) or urgical () Adventious Burse Excision 10, Anterior Resection for CA 15, Appendicectomy 10, Appendicular Abscess Drainage 12, Arteriovenous (AV) Malformation of oft Tissue Tumour - Excision 15, Bakers Cyst Excision 6,000 Y Clinical Uni Inguinal block dissection 13,000 Y CT can Bleeding Ulcer - Gastrectomy & vagotomy Bleeding Ulcer - Partial Gastrectomy 25,000 25,000
2 Block dissection Cervical odes 10, Branchial Fistula 14,000 Y Clinical Breast Lump Excision 6,000 Y Clinical Branchial Cyst 10,000 Y Clinical Bursa Excision 2, Bypass - Inoperable Pancreas 15,000 Y Ultrasou nd/ct can Cervial Lymphnodes Excision 2000 Y CT can Colostomy 10,000 Y Clinical Picture Cyst over crotum Excision 2,000 Y Clinical Picture Cystic Mass Excision 2,000 Y Clinical Picture Dermoid Cyst - Excision 2,000 Y Clinical Picture D Drainage of Ischio Rectal Abscess 4, Incision and Drainage of large 4,000 D
3 Abscess Drainage of Psoas Abscess 7, Drainage of ubdiaphramatic Abscess 10, Drainage Pericardial Effusion 13, Duodenal Diverticulum 20,000 Y Clinical Duodenal Jejunostomy 20,000 Y Clinical Duplication of Intestine 18,000 Y Clinical Hydrocele + Orchidectomy 8,000 Y Clinical Epidedectomy 8,000 Y Clinical Epididymal welling Excision 4, Epidymal Cyst 4,000 Y Clinical D Evacuation of crotal Hematoma 2, Excision Benign Tumor -mall intestine Excision Bronchial inus 8,000 Y Clinical D
4 Drainage of liver Abscess 8,000 Y Ultrasou nd Excision Filarial crotum 4,000 Y Clinical Picture Excision Mammary Fistula 5,000 Y Clinical Excision Meckel's Diverticulum 15,000 Y Contrast tudies Excision Pilonidal inus 8,000 Y Clinical Excision mall Intestinal Fistula Excision of Growth from Tongue only Excision of Growth from Tongue with neck node dissection 6,000 Y Clinical Picture Picture Excision of welling in Hand 2,000 D Excision of eurofibroma 3, Exicision of inus and Curettage 5, Fibroadenoma Bilateral 8,000 Y Clinical
5 Fibrodenoma Unilateral 5,000 Y Clinical Fissurectomy 8, Fissurectomy and Haemorrhoidectomy 10, Eversion of Hydrocele ac Bilateral Eversion of Hydrocele ac Unilateral 6,000 Y Ultrasou nd 4,000 Y Ultrasou nd Fissurectomy with phincterotomy 15, Foreign Body Removal in Deep Region requiring GA 5, Fundoplication 20,000 Y Clinical G J Vagotomy/ Vagotomy + Pyloroplasty Ganglion -Excision 2,000 D Gastrojejunostomy 15,000 Y Contrast tudies Gastrostomy 15,000 Y Contrast tudies Graham's Operation for duodenal 15,000
6 perforation Granuloma Excision 2, Haemangioma Excision 8,000 Y Clinical Hepatic Resection (lobectomy) 20,000 Y CT can Hernia Epigastric 10,000 Y Clinical Hernia Incisional 10,000 Y Clinical Hernia - Repair & release of obstruction Hernia Umbilical 10,000 Y Clinical Hernia Femoral 10,000 Y Clinical Hernioplasty Inguinal 10,000 Y Clinical Herniorraphy-Inguinal 9,000 Y Clinical Hiatus Hernia abdominal Hydatid Cyst of Liver 15,000 Y CT can
7 Hydrocele - Excision Unilateral 5,000 Y Clinical Hydrocele - Excision Bilateral 8,000 Y Clinical Ilieoigmoidostomy 17,000 Y Contrast tudies Infected Bunion Foot Excision 4, Inguinal ode (dissection) - Unilateral 3, Intestinal perforation 12, Intestinal Obstruction 12, Intussusception 15, Jejunostomy 10, Gastric Perforation 15, Intestinal Perforation (Resection Anastomosis) 20, Appendicular Perforation 15, Closure of Hollow Viscus Perforation Laryngectomy & Pharyngeal Diverticulum (Throat) 15,000 15,000
8 Ileostomy 10, Lipoma excision 2,000 D Loop Colostomy igmoid 12, Mastectomy 12, Mesenteric Cyst Excision Mesenteric Caval Anastomosis Oeshophagoscopy for foreign body removal 5,000 D Oesophagectomy 17,500 Y CT can Portal Hypertension shunt surgery t 18,000 Y Clinical Pelvic Abscess - Open Drainage 10, PancreaticoDuodenectomy 25,000 Y CT can Distal Pancreatectomy with PancreaticoJejunostomy t 25,000 Y CT can Papilloma Rectum Excision 4, Haemorroidectomy+ Fistulectomy 10,000 Y Clinical s Growth in the calp Excision 2,000 1
9 Porto Caval Anastomosis s Pyeloroplasty 10,000 Y Clinical s Radical Mastectomy 12,000 Y Clinical s Radical eck Dissection Excision s Hernia pigelian 5,000 Y Clinical s Rectal Dilation 2, Prolapse of Rectal Mass Excision 10, Rectopexy 10,000 Y Clinical s Repair of Common Bile Duct 15, Resection Anastomosis (Large Intestine) Resection Anastomosis (mall Intestine) s s Retroperitoneal Tumor Excision 20,000 Y CT can Haemorroidectomy 5,000 Y Clinical
10 s alivary Gland Excision 10,000 Y Clinical s egmental Resection of Breast 10,000 Y Clinical s crotal welling (Multiple) Excision 5, igmoid Diverticulum 15,000 Y Contrast tudies imple closure - Peptic perforation 15, inus Excision 5, oft Tissue Tumor Excision 2, plenectomy 20, ubmandibular Lymph node Excision ubmandibular Mass Excision + Reconstruction 2,000 20,000 Y CT can welling in foot Excision 2,000 D Coloectomy Total 20,000 Y CT can Pharyngectomy& Reconstruction Total 20,000 Y CT can 6
11 Tracheal tenosis (End to end Anastamosis) (Throat) s Tracheoplasty (Throat) s Umbilical inus Excision 5, Varicose Veins - Excision and Ligation 10,000 Y Clinical s Vasovasostomy 12,000 Y Clinical s Volvulus of Large Bowel 25, Cleft lip operation 12,000 Y Clinical Picture Cleft palate repair (for each stage) Cleft lip & palate operation (for each stage) 12,000 Y Clinical Picture Picture Aneurysm not Requiring Bypass Techniques t 36,000 Y CT can Aneurysm Resection & Grafting 36,000 Y CT can Arterial Embolectomy 10, Carotid artery aneurysm repair 20,000 Y CT can Carotid Body tumour - Excision 20,000 Y CT can
12 Cholecystectomy & Exploration of CBD 20, Cholecystostomy/Cholecystectomy 10, Congential Arteriovenus Fistula (large) Congential Arteriovenus Fistula (small) 20,000 Y CT Angio 10,000 Y CT Angio Decortication (Pleurectomy) 20,000 Y CT Angio Dissecting Aneurysms 36,000 Y CT Angio Distal Abdominal Aorta repair 36,000 Y CT Angio Estlander Operation (lip) 7,000 Y Clinical Excision and kin Graft of Venous Ulcer Excision of Parathyroid Adenoma/Carcinoma 22,000 Y Clinical Flap Reconstructive urgery 20,000 Y Clinical plit thickness skin grafts mall (< 4% TBA) plit thickness skin grafts Medium (4-8% TBA) 5,000 Y Clinical 10,000 Y Clinical D D
13 plit thickness skin grafts Large (> 8% TBA) D Free Grafts - Wolfe Grafts 8,000 Y Clinical Hemi thyroidectomy 10,000 Y Clinical Total thyroidectomy 20,000 Y Clinical Laparoscopic Hernia Repair 18,000 Y Clinical Lap. Assisted left Hemi colectomy t Lap. Assisted Right Hemi colectomy t Lap. Assisted small bowel resection 25,000 Y Clinical 25,000 Y Clinical Lap. Assisted Total Colectomy 25,000 Y Clinical Lap. Cholecystectomy & CBD exploration 20,000 Y Clinical Lap. For intestinal obstruction Lap. Hepatic resection 25,000 Y Clinical
14 Lap. Hydatid of liver surgery 25,000 Y CT can Laparoscopic Appendicectomy 15, Laparoscopic Cholecystectomy 15,000 Y Ultrasou nd Laparoscopic cystogastrostomy 20,000 Y Clinical Laparoscopic Gastrostomy 12,000 Y Clinical Laparoscopic Hiatus Hernia Repair 22,000 Y Clinical Laparoscopic Pyloromyotomy 20,000 Y Clinical Laparoscopic Rectopexy Laparoscopic pleenectomy 20,000 Y Clinical Laparoscopic umbilical hernia repair Laparoscopic ventral hernia repair 20,000 Y Clinical Laparotomy-peritonitis lavage and 10,000 Y Clinical
15 drainage Ligation of Ankle Perforators 5, Lymphatics Excision of ubcutaneous Tissues In Lymphoedema Repair of Main Arteries of the Limbs 10,000 Y Clinical Picture 25,000 Y Clinical Mediastinal Tumour 20, Oesophagectomy for Carcinoma Oesophagus Operation for Bleeding Peptic Ulcer 25,000 Y CT can 7 15, Operation for Carcinoma Lip Vermilionectomy Operation for Carcinoma Lip - Wedge Excision and Vermilionectomy Operation for Carcinoma Lip - Wedge-Excision 10,000 Y Clinical 12,000 Y Clinical 10,000 Y Clinical Appendicectomy - Appendicular Abscess Drainage 12, Caecostomy 10,000 Y Clinical
16 Closure of Colostomy 5,000 Y Clinical Coccygeal Teratoma Excision 20,000 Y CT can Congenital Atresia & tenosis of mall Intestine 20,000 Y Barium tudy CystoJejunostomy/or Cystogastrostomy 20,000 Y Clinical Drainage of perivertebral abscess 10, Hernia -hiatus-transthoracic 20,000 Y Clinical Intercostal drainage 2, Operation for carcinoma lip- cheek advancement 12,000 Y Clinical Thymectomy 20,000 Y Clinical Operation of Choledochal Cyst Operations for Acquired Arteriovenous Fistula Operations for Replacement of Oesophagus by Colon 25,000 Y Clinical Hemodialysis per sitting 2,000 D
17 Parapharyngeal Tumour Excision 20,000 Y CT can Partial/ubtotal Gastrectomy for Carcinoma 22,000 Y CT can Patch Graft Angioplasty 20,000 Y CT Angio Pericardiostomy 30, Pneumonectomy 25, Removal of Foreign Body from Trachea or Oesophagus 5, Removal Tumours of Chest Wall 20,000 Y CT can+ Clinical Photo Resection Enucleation of Adenoma (lung) 10, Rib Resection & Drainage 10, kin Flaps - Rotation Flaps 6, plenectomy - For Trauma 20, urgery for Arterial Aneurism pleen Artery urgery for Arterial Aneurism Vertebral 20,000 25, ympathetectomy Cervical 5,000
18 Temporal Bone resection 15, Thoracocentesis 1,500 Y Clinical Thoracoplasty 20,000 Y Clinical Thoracoscopic Decortication 25,000 Y Clinical Thoracoscopic Hydatid Cyst excision 20,000 Y Clinical Thoracoscopic Lobectomy 25,000 Y Clinical Thoracoscopic Pneumonectomy 30,000 Y Clinical Thoracoscopic egmental Resection 25,000 Y Clinical Thoracoscopic ympathectomy Thrombendarterectomy 15, Thorax (penetrating wounds) 12, Total Thyroidectomy and Block Dissection 20,000 Y Clinical Trendelenburg Operation 10,000
19 Debridement of Ulcer-Leprosy 5,000 Y Clinical Tissue Reconstruction Flap Leprosy 25,000 Y Clinical Tendon Transfer-Leprosy 25,000 Y Clinical Hernia - Repair & release of obstruction+ Hernioplasty Aspiration of cold Abscess of Lymphnode 15,000 1, Aspiration of Empyema 2, AV hunt for dialysis 6, Peritoneal dialysis per sitting 2, Vasectomy 2, Abdomino perineal resection Caecopexy Carbuncle back Colocystoplasty Y Pyelogra phy Diverticulectomy Dorsal slit and reduction of 1500
20 paraphimosis Drainage of peripherally gastric absces Duodenectomy Y Clinical Dupcrytren (duputryen contracture?) Y Clinical Facial erve decompression Y Clinical Fibroma -Excision Fistula repair Fulguration Hemi glossectomy Hemi thyroplasty Anorectoplasty Laryngo Fissure (Throat) Y Clinical Photogra ph +Investi gations Laryngopharyngectomy (Throat) Orchidopexy 6000
21 ebaceous cyst- excision uperficial parotidectomy Thyroplasty Warren shunt Y CT Angio Abbe Operation 7500 Y Clinical Photogra ph+ Investig ations Aorta-Femoral bypass Y CT Angio Diagnostic laproscopy DREIG UDER GA Examination under anesthesia Excision of corns Excision of moles Excision of molluscumcontagiosum Excision of superficial neurofibroma Excision of thyroglossal cyst/fistula Femoropopliteal by pass procedure Y CT Angio
22 Haemorrhoid- injection Isthmectomy Laproscopic Adrenalectomy Laproscopic donor ephrectomy Laproscopic Pyelolithotomy Laproscopic ureterolithotomy Drainage of perinephric abscess Excision I/d injection keloid (per site) Incision and drainage of abscess Operation for stenosis of renal arteries Partial pericardectomy Phimosis under LA Renal artery aneurysm and disection urgery for arterial aneursysm renal artery uturing of wounds withlocal anesthesia Y CT Angio 200
23 Temporary Pacemaker implantation 10000
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