Sr.No Package no 770 11.2 Throat Sub speciality Procedure name Pre-Operative Investigation Microlaryngeal Surgery including Phonosurgery Post Operative Investigation No of Follow up Package Rates Remarks Speciality Code PMJAY Procedure Code PMJAY Biopsy, CT Scan/ MRI Biopsy 1 11500 S15 S1512001 771 11.3 Throat Excision/ Hypopharynx of Tumors in Pharynx Biopsy, CT Scan/ MRI Clinical Photograph, 1 23000 S15 S1512002 772 11.4 Pancreas Distal Pancreatectomy CT, CA 19-9, PET Scan Clinical Photograph 1 55000 S15 S1512003 773 11.5 Pancreas Enucleation of Cyst CT, CA 19-9 Clinical Photograph 1 35000 S15 S1500030 774 11.6 Pancreas Whipples - any type CT, ERCP, CA 19-9, PET Scan, EUS Clinical Photograph 1 75000 S15 S1512004 775 11.7 Spleen Splenectomy /CT Clinical Photograph 1 30000 S15 S100132 776 11.8 Radical Nephrectomy Biopsy, CT, IVP, KUB, 1 34500 S15 S1512006 777 11.9 778 11.10 779 11.11 780 11.12 781 11.14 782 11.15 783 11.16 784 11.17 Radical Cystectomy Other cystectomies High Orchidectomy Bilateral Orchidectomy Total Penectomy Biopsy, CT, IVP, KUB, Biopsy, CT, IVP, KUB, CT Scan (Abdomen, Pelvis), Biopsy,, CT Scan Thorax Biopsy, Bone Scan, Local X-ray Biopsy, CT Scan (Abdomen, Pelvis),Clinical Photograph Inguinal Block Dissection-one side Biopsy, Clinical phtograph, CT Scan Radical Prostatectomy Partial Penectomy CT, KUB, Bone Scan, Biopsy Biopsy, Clinical Photograph Abdomen Pelvis 785 11.18 Gynaec Radical Hysterectomy Biopsy, CT 786 11.19 Gynaec Surgery for Ca Ovary - early stage Cluster-11 SURGICAL ONCOLOGY CA 125, CEA, Biopsy/ cytology, afp, ßHCG, LDH, X-ray chest, Tumor Marker 1 60000 S15 S1512007 1 40000 S15 S1512008 1 15000 S15 S1512009 1 11500 S15 S1512010 1 25000 S15 S1512011 1 8740 S15 S1512012 1 60000 S15 S1512013 1 15000 S15 S1512014 1 34500 S15 S1512015 1 23000 S15 S1512016
787 11.20 Gynaec Surgery for Ca Ovary - advance stage CA 125, CEA, Biopsy/ cytology, afp, ßHCG, LDH, X-ray chest 788 11.21 Gynaec Vulvectomy Biopsy, Photograph 789 11.22 Breast Mastectomy - any type 790 11.23 Breast Axillary Dissection 791 11.24 Breast Wide excision 792 11.25 Ca.Rectum 793 11.26 Ca. Gall Abdomino Perineal Resection (APR) +Sacrectomy Radical Cholecystectomy 794 11.27 Breast Wide excision + Reconstruction ( Pedicle flap) 795 11.28 Lung Cancer Pneumonectomy 796 11.29 Lung Cancer Lobectomy 797 11.30 Lung Cancer Decortication Photograph, CT, Bone scan Photograph, CT, Bone scan Photograph, CT, Tumor Marker 1 40000 S15 S1512017 1 17250 S15 S1512018 1 25000 S15 S1512019 1 23000 S15 S1500022 1 11500 S15 S1512020 CT/ Barium Meal Follow through Clinical Photograph, 1 50000 S15 S1512021 CT, PET Scan CT/BMFT, Colonoscopy,Biopsy, CEA, PET Scan Photograph, CT Photograph, CT Biopsy, CT, PET scan, CT brain 798 11.31 Lung Cancer Surgical Correction of Bronchopleural Fistula. Biopsy, CT, PET scan (SOS) 799 11.32 Head &Neck Resection of Nasopharyngeal Tumor Biopsy, CT, PET scan, CT brain 800 11.33 Head &Neck Craniofacial resection of any type Biopsy, CT 1 60000 S15 S1500031 Clinical Photograph, 1 25000 S15 S1512022 1 50000 S15 S100219 1 50000 S15 S1312020 1 40000 S15 S1312023 1 35000 S15 S1512026 1 50000 S15 S1500004 1 90000 S15 S1512027 801 11.34 A Head &Neck Composite Resection ANY TYPE Biopsy, CT/MRI 1 41250 S15 S1512028 802 11.34 B Head &Neck PEDICLE FLAP Reconstruction Biopsy, CT/MRI 1 13750 S15 S1512028 803 11.35 Head &Neck Neck Dissection - any type CT/ MRI, Biopsy 1 32200 S15 S1512029 804 11.36 Head &Neck Hemiglossectomy 805 11.37 Head &Neck Maxillectomy - any type 806 11.38 Head &Neck Thyroidectomy - any type 807 11.39 Head &Neck Parotidectomy - any type x-ray of maxilla, CT/MRI, 808 11.40 Head &Neck Laryngectomy - any type Clinical Photograph/X- Ray,//CT Clinical Photograph, 1 20700 S15 S1512030, X- 1 25000 S15 S1512031, X- RAY, MRI 1 25000 S15 S1512032 and Clinical Photograph 1 20000 S15 S1512033, X- 1 40000 S15 S1512034
809 11.41 Head &Neck Laryngopharyngo Oesophagectomy 810 11.42 Head &Neck Hemimandibulectomy 811 11.43 Head &Neck Wide excision Any type 812 11.44 Ca. Salivary Gland Submandibular Gland Excision 813 11.45 Ca. Trachea Tracheal Resection 814 11.46 Ca. Trachea 815 11.47 816 11.48 817 11.49 Ca. Parathyroid Ca. Tract Ca. Tract Sternotomy + Superior Mediastinal Dissection, X- 1 70000 S15 S1512035, X- 1 25000 S15 S1512036, X- 1 11500 S15 S1512037, X- RAY, OPG/CT scan 1 18400 S15 S1512038, X- RAY 1 50000 S15 S1500001, X- RAY 1 45000 S15 S1500002 Parathyroidectomy Biopsy, CT, Bronchoscopy Clinical Photograph, 1 20700 S15 S1512039 Small bowel resection Biopsy, CT Clinical Photograph, 1 18400 S15 S1512040 Closure of Ileostomy/ Colostomy 818 11.50 Spleen Radical Splenectomy CT 819 11.51 820 11.52 821 11.53 822 11.55 823 11.56 824 11.57 825 11.58 Resection of Retroperitoneal Tumors Abdominal wall tumor Resection Resection with reconstruction Oesophagectomy - any type Gastrectomy - any type, X- 1 8050 S15 S1512041 RAY, Serum Parathormone Barium meal test, CT abdomen,, CT abdomen,, CT abdomen, Biopsy, CT, Endoscopy,, PET SCAN Biopsy, CT, Endoscopy,, PET SCAN Colectomy - any type Biopsy, CT, Endoscopy, CEA Anterior Resection Biopsy, CT, Endoscopy, CEA 1 30000 S15 S1512042 Biopsy, clinical photograph 1 45000 S15 S1512043 BIOPSY, CLINICAL PHOTOGRAPH BIOPSY, CLINICAL PHOTOGRAPH 1 35000 S15 S1500032 1 20700 S15 S1500033 1 60000 S15 S1512044 1 40000 S15 S1512045 1 40000 S15 S1512046 1 50000 S15 S1512047
826 11.59 827 11.60 828 11.61 Abdominoperinial Resection Biopsy, CT, Endoscopy, CEA Triple Bypass Other GI Bypasses surgery any type (including pancreas) Biopsy, CT, Endoscopy Biopsy, CT, Endoscopy 1 40000 S15 S1512048 1 23000 S15 S1500035 1 25000 S15 S1512049 829 11.62 Gynaec Radical Trachelectomy CT/MRI, Biopsy Clinical Photograph, 1 35000 S15 S1500043 830 11.63 Gynaec Radical vaginectomy CT, Biopsy Clinical Photograph, 1 26450 S15 S1500040 831 11.64 Gynaec Radical vaginectomy + Reconstruction CT, Biopsy Clinical Photograph, 1 45000 S15 S1500041 832 11.65 833 11.66 834 11.67 835 11.68 836 11.69 Chest Radical Hysterectomy +Bilateral Pelvic Lymph Node Dissection (BPLND) + Bilateral Salpingo Ophorectomy (BSO) / Ovarian transposition Pap Smear /, CT Clinical Photograph, 1 45000 S15 S1500037 Anterior Exenteration (Gynaec) Pap Smear /, CT Clinical Photograph, 1 60000 S15 S1512050 Posterior Exenteration (Gynaec) Pap Smear /, CT Clinical Photograph, 1 50000 S15 S1512051 Total Pelvic Exenteration Pap Smear /, CT Clinical Photograph, 1 75000 S15 S1512052 Chest wall resection for SOFT tissue bone tumors Biopsy, CT Chest, Bone Scan Clinical Photograph, 1 9660 S15 S1512053 837 11.70 Chest Chest wall resection + Reconstruction Biopsy, CT Chest, Bone Scan Clinical Photograph, 1 30000 S15 S1500048 838 11.71 Limb salvage surgery for Bone Tumors with modular Prosthesis CT-Local part, CT Chest,MRI, Bone Scan Clinical Photograph, 1 75000 S15 S1500045 839 11.72 Forequarter amputation Biopsy, CT Chest Clinical Photlograph/ X-Ray, 1 30000 S15 S1512054 840 11.73 Hemipelvectomy Biopsy, CT/MRI Pelvis, CT Chest, PET scan Clinical Photlograph/ X-Ray, 1 55000 S15 S1500046 841 11.74 842 11.75 843 11.76 Renal Cell Cancer Renal Cell Cancer Bone resection CT/MRI, Biopsy Clinical Photograph/X-ray, 1 30000 S15 S1512055 Partial Nephrectomy CT/Isotope renogram Clinical Photograph, 1 40000 S15 S1512056 Nephroureterectomy for Transitional Cell Carcinoma of renal pelvis (one side) CT, Biopsy Clinical Photograph, 1 46000 S15 S1512057
844 11.77 Testes cancer Retro Peritoneal Lymph Node Dissection(RPLND) (for Residual Disease) CT-Chest, CT.Abd+Pelvis, Tumor markers, Clinical Photograph, 1 60000 S15 S1512058 845 11.78 Tumours Adrenalectomy CT/MRI, hormones Clinical Photograph, 1 45000 S15 S1512059 846 11.79 Testes cancer diversion Scrotum Clinical Photograph, 1 40000 S15 S1512060 847 11.80 Testes cancer Retro Peritoneal Lymph Node Dissection RPLND as part of staging CT, Clinical Photograph, 1 23000 S15 S1512061 848 11.81 Ca. Anterior Exenteration ( ) Cystoscopy, /CT Clinical Photograph, 1 60000 S15 S1512062 849 11.82 Ca. Total Exenteration ( ) Cystoscopy, /CT Clinical Photograph, 1 75000 S15 S1512063 850 11.83 Ca. Bilateral pelvic lymph Node Dissection(BPLND) CT, Clinical Photograph, 1 25000 S15 S1500042 851 11.84 Thoracic and Mediastinum Mediastinal tumor resection CT Clinical Photograph, 1 50000 S15 S1512064 852 11.85 Lung Lung metastatectomy of any type CT,, Bone scan/ PET scan X-Ray, Biospy 1 35000 S15 S1512065 853 11.86 Lung Sleeve resection of Lung cancer. CT/ Bronchoscopy,, PET scan X-Ray, Biospy 1 90000 S15 S1500027 854 11.87 Esophagus 855 11.88 Esophagus 856 11.89 857 11.90 858 11.91 859 11.92 860 11.93 861 11.94 862 11.95 863 11.96 864 11.97 865 11.98 Reconstructio n Oesophagectomy with Two field Lymphadenectomy Oesophagectomy with Three field Lymphadenectomy UGI Endoscopy, / CT Clinical Photograph, 1 80000 S15 S1500028 UGI Endoscopy, / CT Clinical Photograph, 1 80000 S15 S1500029 Tracheostomy Clinical Photograph Clinical Photograph 1 5520 S15 S1500021 stomy Clinical Photograph Clinical Photograph 1 15000 S15 S100064 Jejunostomy Clinical Photograph Clinical Photograph 1 15000 S15 S100088 Ileostomy Clinical Photograph Clinical Photograph 1 15000 S15 S100095 Colostomy Clinical Photograph Clinical Photograph 1 15000 S15 S100018 Suprapubic Cystostomy Clinical Photograph Clinical Photograph 1 10000 S15 S1512070 Jejunostomy, CT SCAN, Clinical Photograph Clinical Photograph, 1 20000 S15 S1512071 Ileotransverse BYPASSColostomy Substernal bypass CT SCAN, Endoscopy, Biopsy, Clinical Photograph CT SCAN, Endoscopy, Biopsy, Clinical Photograph Clinical Photograph, 1 9890 S15 S1512072 Clinical Photograph, 1 35000 S15 S1500003 Myocutaneous / cutaneous flap Clinical Photograph Clinical Photograph 1 25000 S15 S1500005
866 11.99 867 11.100 868 11.101 869 11.102 870 11.103 Reconstructio n Soft Tissue and Bone Tumors Soft Tissue and Bone Tumors Soft Tissue and Bone Tumors 871 11.104 Ano-rectal 872 11.105 Surgery Micro vascular reconstruction Doppler study, Clinical Photograph Clinical Photograph 1 45000 S15 S1500009 Wide excision - for soft tissue and bone tumors Wide excision + Reconstruction for soft tissue and bone tumors Amputation for bone / soft tissue tumours (Major / Minor) Inguinal Block Dissection-both side Low Anterior resection OR Sphincter preserving surgery of any type Laproscopic resection of any type 873 11.106 Liver Hepatic surgery of any type 874 11.107 875 11.108 Lung & Oesophagus Thoracoscopic and Laproscopic surgery of any type Laproscopic surgery for kidney & supra renal any type Clinical Photograph, Clinical Photograph, 1 12650 S15 S1512073 Clinical Photograph, Clinical Photograph, 1 25000 S15 S1512074 Clinical Photograph, Clinical Photograph, Biopsy 1 25000 S15 S1512075 CT scan CT/ BMFT, Colonoscopy, Biopsy, CEA Barium meal test, CT abdomen,, Endoscopy, Tumor Marker CT abdomen,, Endoscopy, Tumor Marker CT abdomen,, Endoscopy CT abdomen,, Endoscopy 1 16100 S15 S1512076 1 40000 S15 S1512077 1 50000 S15 S1512078 1 70000 S15 S1512079 1 60000 S15 S1512080 1 40000 S15 S1512081 876 11.109 Brain Tumour Brain tumours surgery of any type CT/ MRI, Biopsy CT, Photograph 1 55000 S15 S1512082 877 11.110 878 11.111 879 11.112 880 11.113 Gynaec Body of the uterus Bone & soft tissue Bone & soft tissue Gynaec CIN Early cancer of any female organ TAH + BSO + BLND + O.S. Biopsy, CT scan, CA 125 CT, Biopsy, Photograph 1 45000 S15 S1512083 Hind Quarter Amputation MRI, Bone scan & PET scan CT, Biopsy, Photograph 1 40000 S15 S1512084 Hip & Knee Disarticulation MRI Photograph 1 45000 S15 S1512085 Radical Trachelectomy Cone Biopsy, Simple Hysterectomy Biopsy, CT scan, CA 125 Biopsy 1 40000 S15 S1512086 881 11.114 All Pre malignant and Malignant Lesion Laser Surgery Any type Usg,/x-ray,/ct,/ clinical photograph 1 15000 S15 S1512087
882 11.115 Head & Neck Flap Cutting any type Usg,/x-ray,/ct,/ previous procedure report clinical photograph 1 5000 S15 S1512088 883 11.116 Head & Neck Eyeball enucleation Usg,/x-ray,/ct,/ clinical photograph 3 15000 S15 S1512089 884 11.117 For All Long term Chemotherap PICC (For cluster 9 user also) Usg,/x-ray,/ct,/ clinical photograph 3 10000 S15 S1512090 y 885 11.118 For All Long term Chemotherap Port Insertion (For cluster 9 user also) Usg,/x-ray,/ct,/ clinical photograph 3 15000 S15 S1512091 y 886 11.119 ICD Tube Insertion Usg,/x-ray,/ct,/ clinical photograph 0 1500 S15 S1512092 887 11.120 Pancreas Wide Excision any type (Surgery other than Whipples) Usg,/x-ray,/ct,/ clinical photograph 3 50000 S15 S1512093 888 11.121 Drain Insertion any type Usg,/x-ray,/ct,/ clinical photograph 0 1500 S15 S1512094 889 11.122 Any Wound Gap Surgery Resuturing Usg,/x-ray,/ct,/ previous procedure report 890 11.123 Larynx Voice prosthesis Biopsy, CECT clinical photograph 1 3000 S15 S1512095 Invoice of prosthesis, scar photo 30,000 S15 S1500018 891 11.124 Skin Skin Tumours Wide Excision + Reconstruction Biopsy, Blood Routine (CBC), CT Scan clinical photograph 25,000 S15 S1500038 892 11.125 Skin Skin Tumours Amputation Biopsy, Blood Routine (CBC), CT Scan clinical photograph 25,000 S15 S1500039 893 11.126 Oncosurgery Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per family) Concern Investigation Concern Investigation 1,00,000 S15 U100