ST.

STEPHEN'S HOSPITAL
TIS HAZARI, DELHI - 110 401
SCHEDULE OF CHARGES W.E.F 01-04-2011
INDEX
SL. No. Particulars Page No.
1 O.P.D. SERVICES :
- Registration …………………………………….….. 4
- Clinics ……………………………………………… 4
- Comprehensive Check-up………………….……. 4
2 ADMISSION FEE ................................................................................ 5
3 ACCOMMODATION CHARGES ………………………………………… 5
4 ICU, CCU ……………………………………………………………………. 5
5 CONSULTATION CHARGES ……………………………….……………. 5
6 THERAPEUTIC DIET SERVICES ……………………………………… 5
7 PROCEDURE & DRESSING - Dressing, Injection, etc… ……………. 6
8 LABORATORY SERVICES
- Haematology 7
- Microbiology ................................... 7
- Serology ......................................... 8
- Blood Bank . ................................... 8
- Biochemistry . ................................. 9
- Clinical Pathology ........................... 10
- Histopathology & Cytology ............ 10
- Immuno Assay ............................... 11
9 RADIOLOGY SERVICES
- X-Ray ………………………………... 12
- CT Scan..... …………………….……. 13
- Ultrasound……………………………. 13
- MRI......………………….................... 14
- Interventional Radiology…… ………. 15
10 PHYSIOTHERAPY SERVICES ……………………………………….. 17
11 OCCUPATIONAL SERVICES .......................................................... 18
12 A.L.C. SERVICES .......................................................................... 18
13 CARDIOLOGY SERVICES ………………………................................ 21
14 PACKAGE CHARGES FOR C T S ………………………………………. 22
15 RHEUMATOLOGY SERVICES ……….……………………………… 22
16 ENDOCRINOLOGY SERVICES ………………………………………… 23
17 GASTROENTROLOGY SERVICES ................................................. 23
18 DERMATOLOGY SERVICES .......................................................... 24
19 RESPIRATORY MEDICINE SERVICES ......................................... 25
20 PSYCHIATRIC SERVICES ............................................................... 25
21 NEUROLOGY SERVICES …………………………………………….. 25
22 NEPHROLOGY SERVICES ............................................................. 26
23 PEADIATRIC SERVICES .............................................................. 27
24 OPHTHALMOLOGY SERVICES………………………………………… 27
25 E.N.T. & AUDIOLOGY SERVICES ………………………………....... 28
26 DENTAL SERVICES ………………………………………………….. 29
27 MATERNITY SERVICES ………………………………………………. 30
28 REPRODUCTIVE AND FOETAL MEDICINE UNIT (RFM UNIT) …. 31
29 MINOR OT PROCEDURES ............................................................. 32
30 OPERATION CHARGES ................................................................ 33
31 OXYGEN CHARGES ………………………..…….…………….. 34
32 IN PATIENT PACKAGE CHARGES FOR GENERAL SURGERY ... 35
33 MISCELLANEOUS CHARGES - Certificate Fee ……………………. 36
- Ambulance Services …………….. 36
- Mortuary Services ………………. 36
GENERAL INFORMATIONS:

1. This schedule will apply to all patients including those belonging to the Institutions
who have St. Stephen's Hospital on their panel for treatment of their referred
patients, except for those who are offered CGHS/DGEHS rates.

2. a) For O.P.D. Services there are two categories of charges only i.e. GENERAL and
PRIVATE. For private OPD, the charges @ semi private rates would be applicable.

b) For in-patients, the charges are determined with reference to the type of
accommodation chosen by the patients as given below:

GENERAL, CUBICLE, SEMI-PVT NON A.C., SEMI-PVT A.C., PRIVATE NON A.C.,
PRIVATE A.C., SPECIAL ROOMS and DELUXE.

3. Change of Accommodation:

a) If a higher type of accommodation is desired by a patient during the hospital

stay, i.e. if a general ward patient wishes to be transferred to a private/semi
private ward, he/she will pay general ward charges for all services up to the time of
transfer and private ward charges as per category chosen for all services from the date
of transfer to higher accommodation.

However, in the case of a person operated or who has undergone a delivery who is
subsequently desiring a higher category of accommodation, the operation fees/delivery
charges will be as per the highest category of accommodation availed.

b) If a patient wishes to change to lower accommodation (from private/semi private to

general ward) the decision to transfer will depend on the availability of bed and
evaluation by Medical social worker as to his/her eligibility to go to a subsidized bed. If
transfer is effect, the patient will pay all the charges up to the date of transfer as per
private schedule of charges and at the general ward schedule from the date of transfer.

4. a) ICU/CCU etc. are treatment areas and not the accommodation areas. Any patient
admitted directly in these areas will decide about the type of accommodation at the time

2
 of admission in these areas and charges will be made accordingly irrespective of
whether or not they have actually utilized such an accommodation for whatever reason.

No charges of stay in the treatment areas up to 2 hours.

b) Labour charges will apply fully irrespective of the duration of stay in the Labour

Room.

c) Accommodation Charges:
Duration of stay for 24 hours will be counted as one full day. Upon discharge, the
fractions thereof will be calculated as follows:

i. 4 hours of stay – No charges

ii. 4 hours to 12 hours of stay – Half day charge
iii. More than 12 hours of stay – Full day charge

5. Service Charges: The patient will be charged for all services provided from the time of
admission till the time of discharge.

6. VAT, Service Tax etc. will be applicable wherever it applies.

7. Checkout Time is within 6 hours from the time of billing and if not settled such
bills will be modified accordingly.

8. An attendant is allowed to stay with the patient free of charge in Cubicle/ Semi-
Private/Private Non A.C./Private A.C, Special and Deluxe rooms. No attendant is
permitted to stay with the patient in General Ward.

9. Visitors should strictly observe visiting hours of the hospital.

Dr. Sudhir C. Joseph

DIRECTOR

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 ST STEPHEN'S HOSPITAL, TIS HAZARI, DELHI - 110 401.

SCHEDULE OF CHARGES FOR O.P.D.

New Registration Revisit

I. OPD CONSULTATION

1. Registration - General O.P.D. 80 70

2. Registration - Private O.P.D. 400 350

3. Registration- Private O P D (Evening) 500 450

4. Casualty 150 -

5. Child Health Card 20 -

II. CLINICS

1. Well Baby Clinic-General 80 80

2. All sub-specialties and super- specialty Clinic-General 80 80

NOTE : No Registration fee will be charged for the Cards issued to the New Born Babies

III. ANTI NATAL CLINIC New Registration Revisit

1. Pregnancy Clinic (Per Visit) 500 200

2. High Risk Pregnancy Clinic ( per Visit) 500 250
3. For entire duration of Pregnancy (Unlimited Visit) 1500 -
4. Special Scheme for entire duration of Pregnancy (Unlimited Visit) 3000* -

* Rs.2000/- rebate will be given on delivery in St. Stephen’s Hospital

V. COMPREHENSIVE CHECK-UP:

1. Comprehensive check-up

a) Basic Preventive Health check-up - 850

b) Executive Health check-up - 2000

c) Preventive Heart check-up - 3500

d) Whole Body check-up - 4400

e) Well woman check-up - 2000

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 SCHEDULE OF CHARGES FOR INPATIENTS

General Private
ADMISSION FEE 225 450

ACCOMMODATION CHARGES
(Per day)
SL. No. Category of Accommodation Amount
1 General Ward * (Subsidized Charges) 1100
2 Cubicle 1200
3 Semi Private Non A.C. 1500
4 Semi Private A.C. Room 1750
5 Semi Private A.C. Room (Delux) 2400
6 Non A.C. Single Room 2600
7 A.C. Single Room (Small) 2900
8 A.C. Single Room- Special Room 3500
10 Delux Room 4200
* Note: Deserving patients will be given a subsidy of Rs.350/- to those admitted in General Ward
and Rs.50/- in Cubicle Ward.

I.C.U. & C.C.U. CHARGES

(per day for all Catagories)
SL. No. Amount
1 I C U care 3500
2 High Dependency Unit (Medicine) 1800
3 Post Operative Care 1300
3 Ventilator Charges 3500
4 Monitoring charges in Wards. 425
5 Invasive Ventilation-Bippapp machine 1600

CONSULTATION FEE & VISITING CHARGES

Consultation charge per

Category of Accommodation day
Rs.
1 A.C. Rooms 460
2 Non A.C. Rooms and A.C. Semi Private Rooms 375
3 Semi-Private (non-A.C. Rooms) 300
4 Cubicle 150
NOTE:
1. The charges as noted above will apply when the specialist visit the patients in the ICU/CCU and Nursery.
2. Surgeon's fees include visiting charges for the first seven days starting from and including day of operation.

THERAPEUTIC DIET CHARGES

I. THERAPEUTIC DIET Gen./ Cub. S Pvt. Private

CO01 DIET COUNSELING CHARGES 50 90 125

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 PROCEDURE & DRESSING/ TREATMENT CHARGES

Gen./
I. PROCEDURES& DRESSING/TREATMENT Cub. S .Pvt. Private
ICU05 MONITORING CHARGES IN WARDS 460 460 460
PD01 DRESSING SMALL 70 90 110
PD02 DRESSING LARGE 130 160 250
PD03 SPECIAL DRESSING(PLASTIC SURGERY) 130 160 230
PD04 CHEMOTHERAPY (I V INJECTION) 750 1100 1550
PD05 INJECTION INOCULATION 10 10 10
PD06 15% TO 30% BURNS FIRST DRESSING 130 150 230
PD07 SUBSEQUENT DRESSING (15-30 %) 90 110 170
PD08 30% TO 50% BURNS FIRST DRESSING 220 280 370
PD09 SUBSEQUENT DRESSING (30-50%) 150 200 280
PD10 EXTENSIVE BURN ABOVE 50% 220 280 370
PD11 SUBSEQUENT DRESSING (ABOVE 50%) 150 200 280
PD12 NEBULIZATION THERAPY 50 70 90
PD13 D.C. SHOCK 150 200 230
PD14 RBS (BY GLUCOMETERS) 80 90 110
PD15 BLOOD GAS ANALYSER 300 370 430
PD16 BLOOD GAS ANALYSER WITH ELECTROLYTE 400 450 550
PD17 INFUSION PUMPS 150 220 280
PD18 SYRINGE PUMPS 150 220 280
PD19 SUTURE REMOVAL 50 70 90
PD20 OT DRESSING 130 160 230
PT01 LUMBAR PUNCTURE 310 390 550
PT02 CUT DOWN 190 240 310
PT03 CHEST ASPIRATION 190 240 310
PT04 INTER COSTAL DRAINAGE 500 600 700
PT05 LIVER BIOPSY 310 390 550
PT06 KIDNEY BIOPSY 1150 1750 2300
PT07 LIVER ASPIRATION 300 400 550
PT08 BONE MARROW 300 400 550
PT09 SUBDURAL TAP 300 400 550
PT10 TAP THERAPEUTIC (ASCITIC) 150 220 280
PT11 TAP DIAGNOSTIC (ASCITIC) 150 220 280
PT12 VENTRICULAR TAP 310 390 550
PT13 UMBILICAL CANULATION 150 220 280
PT14 EXCHANGE TRANSFUSION 1500 1800 2300
PT15 BLOOD TRANSFUSION 220 350 460
PT16 PULSE OXIMETER 170 230 290
PT17 IMAGE INTENSIFIER 700 1050 1400
PT18 PLASTER APPLICATION CHARGES 200 280 370
PT19 FLOW RATE (UROLOGY) 330 450 550
PT20 URODYNAMICS 800 1150 1520
PT21 CATHETERISATION 150 220 280
PT23 URINE ALBUMIN 50 70 90
PT24 TRACHEOSTOMY 1300 4150 4600
PT25 INTUBATION 430 580 700
PT26 FLUID/BLOOD WARMER 1050 1400 2100
PT27 BODY WARMER 1050 1400 2100
PT28 OPERATING MICROSCOPE 700 1050 1400
PT29 ARGON COAGULATOR 700 1050 1400
PT30 INVASIVE MONITORING 1050 1400 2100
PT31 HARMONIC SCALPEL 8500 9700 10870

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PT32 ISOFLURIN 450 450 450
PT33 SERVO FLURANE 600 600 600
THERAPEUTIC ARTHOSCOPY- SHAVER CHARGES W/O
PT34 IMPLANT 1000 1200 1500
THERAPEUTIC ARTHOSCOPY- SHAVER CHARGES WITH
PT35 IMPLANT 3000 3200 3500

LABORATORY SERVICE CHARGES

I. HAEMATOLOGY General Private.

HM01 Hb (HAEMOGLOBIN) 60 70
HM02 CBC (HB,TC,DC,PLTS,Cell Indi PS) 260 270
HM03 ESR 90 100
HM04 RETICULOCYTE COUNT 175 200
HM05 ABSOLUTE EOSINOPHIL COUNT 100 125
HM06 MP (MALARIA PARASITE SMEAR) 90 100
HM07 MICROFILARIA 100 120
HM08 BT 75 100
HM09 PT/INR 260 275
HM10 APTT 350 370
HM11 COAGULATION WORK UP 3000 3500
HM12 FACTOR ASSAY 1500 1750
HM13 BETHESDA ASSAY 2000 2500
HM14 INHIBITOR SCREENING 1500 1750
HM15 LUPUS ANTICOAGULANT PANEL 1800 2000
HM16 FDP/D-DIMER 850 900
HM17 FIBRINOGEN 225 250
HM18 HAMS TEST 225 250
HM19 H PREPARATION 75 100
HM20 G6 PD SCREENING 350 400
HM21 SICKLE CELL PREPARATION 75 100
HM22 Hb A2 AND Hb F (THAL SCREENING TEST 600 650
HM23 OSMOTIC FRAGILITY TEST 250 300
HM24 BONE MARROW WITH IRON 550 600
HM25 CYTOCHEMISTRY FOR LEUKEMIA 360 440
HM26 LE CELLS 175 200
HM27 RAPID TEST FOR MALARIA 450 500
HM28 TEG – ANALYSIS 1250 1500
HM29 SPLENIC ASPIRATE FOR L.D. BODIES 125 150

II. MICROBIOLOGY General Private.

MB01 GRAMS STAIN 125 150
MB02 AFB STAIN 150 180
MB03 ALBERTS STAIN 125 150
MB08 FUNGAL CULTURE 550 600
MB10 INDIA INK PREPARATION 110 120
MB11 KOH PREPARATION 125 150
MB12 HANGING DROP PREPARATION 100 125
MB22 CULTURE IDENTIFICATION AND SENSITIVITY 520 620
MB05 ANAEROBIC CULTURE 650 700
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MB24 CULTURE- QUANTITATIVE 1000 1200

III. SEROLOGY General Private.

SE01 WIDAL 160 180
SE02 CRP 250 300
SE03 ASO 350 400
SE04 RA FACTOR 250 300
SE06 VDRL./RPR 80 90
SE13 HIV SPOT 300 350
SE14 HIV ELISA 300 350
SE15 HBs Ag SPOT 200 250
SE16 HBs Ag ELISA 300 350
SE17 HCV SPOT 300 350
SE18 HCV ELISA 600 650
SE20 DENGUE IgM – IgG 1000 1200
SE21 CRYPTOCOCCUS 500 650
SE22 TB IgG (ELISA) 350 450
SE23 TB IgM (ELISA) 350 450
SE29 NCC 300 350
SE32 TOXO IgG 300 350
SE33 HEPATITIS C – PCR QUALITATIVE 2700 3000
SE34 HEPATITIS C – PCR QUANTITATIVE 6250 6500
SE35 HEPATITIS B – PCR QUALITATIVE 2500 3000
SE36 HEPATITIS B – PCR QUANTITATIVE 6500 7000
SE37 HUMAN PAPILLOMA VIRUS (HYBRID CAP.) 1300 1500
SE38 HLA B-24- PCR 1300 1500
SE40 DENGUE NS 1 ANTIGEN 1300 1400
SE41 ENTEROCHECK (S. typhi IgM) 300 350
SE42 HEV-IgM 1100 1200
SE43 LEPTOSPIRA-IgM 900 1000
SE44 CHIKUNGUNIA-IgM 650 700

IV. BLOOD BANK General Private.

BB01 ABO Rh [BLOOD GROUP] 175 200
BB02 SUB GROUPS 125 150
BB03 Rho PHENOTYPE 300 350
BB04 DIRECT COOMBS 250 300
BB05 INDIRECT COOMBS (FOR ANTI D) 300 350
BB06 RHO ANTI BODY TITER 650 700
BB07 AUTOANTIBODY 125 150
BB08 COLD AGGLUTININS 300 350
BB09 CROSS MATCH 300 350
BB10 WHOLE BLOOD 850 850
BB11 PACKED CELLS 850 850
BB12 FRESH FROZEN PLASMA (FFP) 850 850
BB13 PLATELETS CONCENTRATE 750 750
BB14 BANK PLASMA 750 750
BB15 VENESECTION - THALASSEMIA 300 300
BB16 PLT APHEREIS 10000 10000
BB17 DONOR SCREENING FOR APHERESIS 500 500
BB18 VENESECTION – TRIPLE BAG 500 500
BB19 CROSS MATCH – FOR THALASEEMIA PATIENTS ONLY 100 100
BB20 ANTIBODY SCREEN- FOR B.T 300 350
BB21 Rh PHENOTYPE 300 350

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V. BIOCHEMISTRY General Private.
BC01 FBS 75 80
BC02 PPBS 75 80
BC03 RBS 75 80
BC04 GCT 75 80
BC05 GTT (GLUCOSE TOLERANCE TEST) 275 330
BC06 GLYCOSYLATED Hb (Hb,A1c) 350 400
BC07 ACETONE 40 50
BC09 BUN (BLOOD UREA NITROGEN) 85 90
BC10 CREATININE 85 90
BC11 URIC ACID 95 100
BC12 SODIUM 120 130
BC13 POTASSIUM 120 130
BC14 CHLORIDE 120 130
BC16 URINE PROTEIN 24 HRS 110 120
BC17 URINE CREATININE 85 90
BC18 CREATININE CLEARANCE 250 300
BC19 UREA CLEARANCE TEST 250 300
BC20 CALCIUM 120 130
BC21 PHOSPHOROUS 120 130
BC22 MAGNESIUM 350 370
BC23 LFT 550 600
BC24 BILIRUBIN 170 180
BC25 SGPT 120 130
BC26 SGOT 120 130
BC27 ALKALINE PHOSPHATASE 120 130
BC30 TOTAL PROTEIN 120 130
BC31 ALBUMIN 100 110
BC33 AMYLASE 300 320
BC34 LIPASE 400 450
BC35 LDH 250 260
BC36 CPK 250 260
BC37 CK MB 310 320
BC38 LIPID PROFILE 700 750
BC40 CHOLESTEROL 100 110
BC41 TRIGLYCERIDES 200 220
BC42 HDL 180 190
BC43 LDL 180 190
BC44 Iron & TIBC 300 320
BC45 KFT 265 280
BC46 URINE AMYLASE 300 320
BC47 URINE CALCIUM 120 130
BC48 URINE CHLORIDE 120 130
BC49 URINE BICARBONATE 200 250
BC50 URINE CREATININE 85 90
BC51 URINE POTASSIUM 120 130
BC52 URINE MAGNISIUM 350 370
BC53 URINE PHOSPHOROUS 120 130
BC54 URINE PROTEIN RANDOM QUANTITATIVE 110 120
BC55 URINE SODIUM 120 130
BC56 URINE HEMOSEDERINE 175 200
BC58 URINARY URIC ACID 24HR 95 100
BC61 A.D.A. 450 460
BC62 RENAL PROFILE (BUN,CR,UA,NA,K) 630 640
BC63 CYSCTATIN-C 900 1000
BC64 QUANTIFERON TB GOLD 2250 2500
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VI. CLINICAL PATHOLOGY General Private.
CP01 STOOL ROUTINE 60 70
CP02 STOOL OCCULT BLOOD 40 50
CP03 STOOL REDUCING SUBSTANCE 40 50
CP04 URINE ROUTINE 60 70
CP05 URINE BILLIRUBIN 40 50
CP06 URINE UROBILINOGEN 40 50
CP07 URINE ACETONE (KETONE) 40 50
CP08 URINE SPECIFIC GRAVITY 40 50
CP09 URINE pH 40 50
CP10 URINE GLUCOSE 40 50
CP11 URINE PROTEIN 40 50
CP12 URINE NITRATE 40 50
CP13 URINE BENCE JONES PROTEIN 125 150
CP14 URINE PREGNANCY TEST 110 120
CP15 BODY FLUIDS EXAM.(CSF,AF,PF,PC) 350 400
CP16 SEMEN ANALYSIS 200 250
CP17 PCT (Post Coital Test) 80 100
CP18 APT TEST 60 70
CP19 ASPIRATE FOR POLYMORPHS 75 100
CP20 STOOL pH 40 50
CP21 STOOL FATGLOBULES 40 50
CP22 URINE OCCULT BLOOD 40 50
CP23 BODY FLUID AMYLASE 350 400
CP24 BODY FLUID LDH 250 270
CP25 BODY FLUID BILIRUBIN 170 180

VII. HISTOPATHOLOGY & CYTOLOGY General Private.

HP01 HISTOPATHOLOGY – SMALL (UPTO 3 CONTAINERS) 600 700
HP25 ADDITIONAL CONTAINER (SMALL BIOPSY) 100 125
HP03 HISTOPATHOLOGY - LARGE 800 900
HP26 ADDITIONAL CONTAINER (LARGE BIOPSY) 200 250
HP04 FNA C 500 600
HP05 PAP SMEAR 350 450
HP06 INTRA OPERATIVE PATHOLOGY (IOP) (UPTO TWO) 900 1000
HP16 ADDITIONAL CONTAINER (IOP) 250 300
HP08 BODY FLUIDS CYTOLOGY (UPTO TWO SITES) 400 500
HP17 ADDITIONAL SITE (BODY FLUIDS) 125 150
HP09 IMMUNO HISTO CHEMISTRY (FIRST) 1250 1500
HP18 ADDITIONAL TEST (IMMUNO HISTOCHEMISTRY) 900 1000
HP11 IMMUNO HISTOCHEMISTRY LCA 1250 1500
HP12 IMMUNO HISTOCHEMISTRY CYTOKERATIN 1250 1500
HP13 IMMUNO HISTOCHEMISTRY ER 1250 1500
HP14 IMMUNO HISTOCHEMISTRY PR 1250 1500
HP15 IMMUNO HISTOCHEMISTRY HER-2 NEU 1250 1500
HP19 IMMUNO HISTOCHEMISTRY VIMENTIN 1250 1500
HP20 DUPLICATE SLIDE CHARGES (PER SLIDE) 20 20
HP21 BLOCK CHARGES (PER BLOCK) 20 20
HP22 CD3 1250 1500
HP23 CD20 1250 1500
HP24 Ki67 1250 1500
HP27 IMMUNOFLUOROSCENCE FOR KIDNY BIOPSY 1500 1800
HP29 ONCOLOGY SPECIMEN 1300 1500
HP28 HUMAN PAPILLOMA VIRU (HYBRID CAP. ASSAY) 1700 2000

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HP30 F N A C SLIDE REVIEW 300 400

VIII. IMMUNO ASSAYS General Private.

IA01 T3 270 300
IA02 FREE T3 270 300
IA03 T4 270 300
IA04 FREE T4 270 300
IA05 TSH 270 300
IA06 LH 420 430
IA07 FSH 420 430
IA08 PROLACTIN 420 430
IA09 ESTRADIOL (E2) 420 430
IA10 PROGESTRONE 420 430
IA11 B-HCG 420 430
IA12 TESTOSTERONE 460 470
IA13 CORTISOL 460 470
IA14 INSULIN 600 630
IA15 C-PEPTIDE 700 750
IA17 ANTI DS DNA 550 600
IA19 ANTI CARDIOLIPIN ANTIBODY IgG- IgM 1000 1100
IA20 PSA 550 600
IA22 AFP 600 630
IA23 CEA 550 600
IA24 CA – 125 800 850
IA25 SERUM FERRITIN 450 500
IA26 VIT B12 750 800
IA27 SERUM FOLATE 750 800
IA28 IgE 400 500
IA29 TFT 1250 1450
IA30 ACTH 900 1000
IA33 OSTEOCALCIN 1250 1500
IA34 INTACT PTH 900 1000
IA38 hGH 500 550
IA39 IGF-1 3000 3050
IA41 ANTI HBc 800 830
IA44 ANTI HBs 800 830
IA45 ANDROSTENEDIONE 1300 1400
IA46 DHEA-SO4 700 750
IA54 THYROGLOBULIN 1200 1300
IA56 ANTI TPO Ab 900 950
IA57 HOMOCYSTEINE 600 650
IA58 URINE CORTISOL 460 470
IA59 ESTRIOL (FE3) 400 420
IA60 ANA PROFILE 1750 2000
IA61 ANA FT 900 1000
IA62 CA-19.9 800 850
IA66 CA 15.3 900 1000
IA67 PROCALCITONIN (PCT) 1800 2000
IA70 EBV IgM 1000 1200
IA71 DERECT RENIN 700 800

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 RADIOLOGY SERVICE CHARGES

Gen./
I. X-RAY Cub. S. Pvt. Private
PORT PORTABLE CHARGES 120 150 200
XR01 FLUROSCOPY CHEST 120 155 200
XR04 ABDOMEN A P OR ERECT 180 220 270
XR05 ABDOMEN FOR LAT. VIEW 180 220 270
XR07 ABDOMEN ERECT & SUPINE 360 430 520
XR08 CHEST P A 180 220 270
XR09 CHEST OBLIQUE OR LATERAL 180 220 270
XR10 CHEST P A & RIGHT OR LEFT LATERAL 360 420 520
XR11 MASTOIDS 180 220 270
XR12 EXTREMITIES,BONES&JOINTS-1 EXPOSURE 180 220 270
XR13 EXTREMITIES,BONES&JOINTS-2 EXPOSURES 250 300 350
XR14 PELVIS 180 220 270
XR15 PARA-NASAL SINUSES 180 220 270
XR16 T M JOINTS ONE EXPOSURE 180 220 270
XR17 T M JOINTS (TWO EXPOSURE) 250 300 350
XR18 K.U.B.(ABDOM. & PELVIS) 2 EXPOSURES 250 300 350
XR19 SKULL A P & LATERAL 360 430 520
XR20 SKULL A P / LAT. 180 220 270
XR21 SKULL LAT OR OBLIQUE OR TOWNES 180 220 270
XR22 SPINE A P & LATERAL (2 EXPOSURES) 250 300 350
XR23 SPINE A P / LAT. (1 EXPOSURE) 180 220 270
XR24 SPINE LEFT OR RIGHT LATERAL 180 220 270
XR25 SPINE LEFT OR RIGHT OBLIQUE 180 220 270
XR26 SPINE BOTH OBLIQUE 250 300 350
XR27 SPINE A P, LATERAL & OBLIQUE 500 600 700
XR28 BARIUM SWALLOW/GASTROGRAFIN 1100 1450 1820
XR29 SINOGRAPHY/SIALOGRAPHY 900 1200 1500
XR30 CYSTOGRAPHY/URETHROGRAPHY 1800 2100 2400
XR31 HYSTERO-SALPINGOGRAPHY 880 1100 1320
XR33 RETROGRADE PYELOGRAPHY 1800 2100 2400
XR35 BARIUM ENEMA 2100 2500 3000
XR36 BARIUM MEAL UPPER OR LOWER 2100 2500 3000
XR38 I V UROGRAPHY 2100 2500 3000
XR42 CEREBRAL/FEMORAL ANGIOGRAPHY 2100 2500 3000
XR43 APICOGRAM (CHEST) 180 220 270
XR44 CHEST DECUBITUS VIEW 180 220 270
XR45 K.U.B.(ABD & PELVIS) 1 FILM 180 220 270
XR46 EXTREMITIES, BONES & JOINTS 2 EXPOSURE 250 300 350
XR48 SPLENO-PORTOGRAPHY 2400 2900 3400
XR49 T-TUBE CHOLANGIOGRAPHY 1450 1820 2200
XR50 INTRA-OPERATIVE CHOLANGIOGRAPHY 1450 1820 2200
XR51 PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY 1200 1500 1800
XR52 BILIARY DRAINAGE UNDER GUIDANCE 2400 2900 3400
XR54 CENTRAL VENOGRAPHY 2100 2500 3000
XR55 BARIUM MEAL FOLLOW THROUGH 2300 2700 3100
XR56 PERCT. TRANSHEPATIC BILIARY DRAINAGE 2600 3100 3600
XR57 MAMMOGRAPHY 900 1200 1500
XR58 SMALL BOWEL ENEMA 2100 2500 3000
XR60 PARA NASAL SINUSES TWO EXPOSURE 250 300 350

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XR61 TM JOINTS TWO EXPOSURES 250 300 350
XR62 EXTREMITIES, BONES, JOINTS 3 EXPOSURES 300 350 400
XR63 MASTOID BI-LATERAL 220 290 340
XR64 SOFT TISSUE NECK LATERAL 200 220 270
XR65 ERCP 800 950 1100
XR66 PERCUTANEOUS NEPHROSTOMY 900 1050 1200
XR67 NASO JEJUNAL TUBE INSERTION FLUROSCOPY 280 380 480
XR68 NASAL BONE LAT. VIEW 200 220 270

Gen./
II. CT SCAN Cub. S. Pvt. Private
CT01 CT HEAD BASIC BRAIN SCAN 1520 1700 1950
CT02 CT PNS,ORBIT,PITUTARY FOSSA,TEMPORAL BONE, 1820 2120 2530
CT03 CT CHEST 2420 3020 3630
CT04 CT UPPER ABDOMEN 2420 3020 3630
CT05 CT LOWER ABDOMEN 2420 3020 3630
CT06 CT SPINE (FOR 3 LEVELS) 1820 2120 2530
CT07 CT LIMBS & JOINTS 1820 2120 2530
CT08 CT NECK 1820 2120 2530
CT09 SPINE ADDITIONAL 1 LEVEL 600 720 850
CT11 CT SCANOGRAM 300 390 480
CT12 CT GUIDED BIOPSY, FNAC, ASPIRATION 1500 1900 2200
CT13 EMERGENCY SCAN CHARGE FOR CT 220 360 500
CT14 CT FOR P.N.S LIMITED CUTS 1220 1520 1820
CT21 CT WHOLE ABDOMEN 4400 5060 5830
CT22 CT HEAD INTRACRANIAL ANGIOGRAPHY 6050 7260 8470
CT23 CT HEAD PERFUSION STUDIES 6050 7260 8470
CT24 LARYNX 1820 2120 2530
CT25 THORAX HRCT 2420 3020 3630
CT26 THORACIC AORTA ANGIOGRAPHY 6050 7260 8470
CT27 CORONARY ANGIOGRAPHY + CA SCORING 6050 7260 8470
CT28 CT BRONCHOSCOPY 3630 4570 5500
CT29 UPPER ABDOMEN SINGLE,DUAL,TRIPHASIC 6050 7260 8470
CT30 SPLENO-PORTAL,MESENTRIC, VENOUS 6050 7260 8470
CT31 UPPER ABDOMEN HEPATIC VOLUME 3020 3960 4840
CT32 UPPER ABDOMEN HEPATIC PERFUSION 2420 3020 3630
CT33 UPPER ABDOMINAL AORTA ANGIOGRAPHY 6050 7260 8470
CT34 UPPER ABDOMEN RENAL ANGIOGRAPHY 6050 7260 8470
CT35 LOWER ABDOMEN + COLONOSCOPY 3630 4570 5500
CT36 CT PERIPHERAL ANGIOGRAPHY 6050 7260 8470
CT37 CT DENTA SCAN (ORTHOPANTOMOGRAM) 1100 1320 1650
CT38 CT BONE MINERAL ANALYSIS 1820 2120 2530
CT39 3-D RECONSTRUCTIONS 600 900 1200
CT40 ANAESTHETIST CHARGES 370 600 600

Gen./
III. ULTRA SOUND Cub. S. Pvt. Private
US01 OBSTETRICS FIRST SCAN 580 760 950
US02 OBSTETRICS FOLLOW UP (2ND VISIT) 460 690 890
US03 OBSTETRICS DOPLER STUDY 800 1275 1760
US04 BIOPHYSICAL PROFILE 650 950 1250
US05 OBSTETRICS DOPLER AND BIOPHYSICAL PROFILE 1250 1750 2150
US06 PELVIC SCAN 580 750 950

13
US07 TRANSVAGINAL SCAN 650 900 1150
US08 FOLLICULAR STUDY Ist SITTING 650 900 1150
US09 FOLLICULAR STUDY SUBSEQUENT SITTING 150 230 300
US10 LEVEL II SCAN FOR FOETAL ANOMALIES 1500 1900 2300
US11 FOETAL ECHO 840 1330 1840
US13 NEONATAL SKULL 500 725 1000
US15 NEONATAL HIP 660 900 1150
US16 ABDOMINAL SCANS 500 725 1000
US17 UPPER ABDOMEN – GENERAL SCAN 550 725 950
US18 LOWER ABDOMEN GENERAL SCAN 550 725 950
US19 WHOLE ABDOMEN GENERAL SCAN 800 1050 1275
US20 KUB GENERAL SCAN 500 725 1000
US21 TRANSRECTAL GENERAL SCAN 750 1100 1460
US22 SMALL PARTS (BREAST,EYE,TESTIS,THYROID, JOINT) 800 1275 1760
US23 VEINS UPPER OR LOWER EXTREMITIES 1200 1925 2640
US24 ARTERIES VASCULAR STUDY 1700 2300 2900
RENAL DOPPLER AND PORTAL VEIN STUDY WITH
US25 ABDOMINAL SCAN 1100 1450 1825
US26 FNAC USG INTERVENTIONS 1000 1250 1500
US27 DIAGNOSTIC PLEURAL ASCETIC TAP 875 1000 1300
US28 LUNG/ LIVER ABSCESS DRAINAGE/ PELVIC ABSCESS 1050 1500 2000
DRAINAGE WITH INDWELLING CATHETERS (Pig Tail) –
US29 Excluding cost of consumables. 1125 1800 2400
US32 TRANSRECTAL BIOPSIES 1800 2500 3300
US33 BIOPSY NEEDLE CHARGES 850 1700 1700
US34 USG CHEST,PVR,MATERNAL KIDNEYS 150 180 220
US35 ECV 230 350 460
US36 RENAL INTERVENTION (PC NEPHROSTOMY) 1800 2500 3300
US41 EMERGENCIES ULTRASOUND 165 165 165
US42 PORTABLE CHARGES 80 80 80
US43 VENOUS DOPPLER STUDY BOTH LIMBS 1850 2950 4050
US44 CAROTID DOPPLER STUDY 1700 2300 2900
US45 ARTERIAL DOPPLER STUDY BOTH LIMBS 1850 2950 4050
US47 SINGLE LOOK USG 200 250 300
US48 USG FOR PVR 200 250 300

IV. MRI Gen./ Cub. S. Pvt. Private

MRI01 MRI BRAIN 5200 5700 6300
MRI02 MRI SPINE 5200 5700 6300
MRI03 MRI ABDOMEN 5200 5700 6300
MRI04 MRI THORAX 5200 5700 6300
MRI05 MRI PELVIS 5200 5700 6300
MRI06 MRI JOINTS 5200 5700 6300
MRI07 MRI EXTREMITIES 5200 5700 6300
MRI08 MRCP 5200 5700 6300
MRI09 MR UROGRAPHY 5200 5700 6300
MRI10 MRI CSF FLOW STUDY 5200 5700 6300
MRI11 MRI ANGIOGRAPHY ONE PART 5200 5700 6300
MRI12 MRI BRAIN+ANGIOGRAPHY(CIRCLE OF WILLIS) 8000 8700 9400
MRI13 MRI BRAIN+ANGIOGRAPHY (NECK+CIRCLE OF WILLIS) 9350 10000 10700
MRI14 MRI ANGIOGRAPHY(NECK+CIRCLE OF WILLIS) 8000 8700 9400
MRI15 MRI MARROW SCREENING 2650 3300 4000
MRI16 MRI SPINE ONE PART + SCREENING WHOLE SPINE 6400 7370 8250
MRI17 MRI PELVIMETRY/PLACENTA LOCALISATION 2000 2600 3300
14
MRI18 MRI ARTHOGRAPHY+1 FILM CONVENTIONAL 6600 7400 8000
MRI19 MRI LUMBER SPINE & SI JOINTS 6600 7400 8000
MRI20 MRI LTD STUDY OF IAM 2000 2600 3300
MRI23 MRI ANAESTHESIA CHARGES 375 600 600
MRI24 MRI BRAIN-PITUITARY FOSSA 5200 5700 6300
MRI25 MRI ORBIT 5200 5700 6300
MRI26 MRI PNS 5200 5700 6300
MRI27 MRI T.M. JOINTS (SPECIFY SIDE) 5200 5700 6300
MRI28 MRI ANGIOGRAPHY-CIRCLE OF WILLIS 5200 5700 6300
MRI29 MRI BRAIN-VENOGRAPHY 5200 5700 6300
MRI30 MRI ANGIOGRAPHY-NECK 5200 5700 6300
MRI31 MRI ANGIOGRAPHY-RENAL ANGIOGRAPHY 5200 5700 6300
MRI32 MRI NASOPHARYNX 5200 5700 6300
MRI33 MRI NECK 5200 5700 6300
MRI34 MRI FISTULOGRAPHY 5200 5700 6300
MRI35 MRI BOTH HIPS-DYNAMIC STUDY 5200 5700 6300
MRI36 MRI EXTREMITY/JOINT- DOUBLE 10100 11400 12600
MRI37 MRI EMERGENCY CHARGES 250 400 500
MRI38 MRI BRAIN SCREENING 1700 2200 2700

V. INTERVENTIONAL RADIOLOGY General Private

INR01 PERIPHERAL ANGIOGRAPHY (DIAGNOSTIC) (ONE LIMB 12200 16300
INR02 PERIPHERAL TRAUMA INTERVENTIONAL 23400 31300
INR03 PERIPHERAL ARTERIAL ANGIOPLASTY WITHOUT STENT RT/LT 23400 31300
INR04 PERIPHERAL ARTERIAL ANGIOPLASTY WITH STENT RT/LT 23400 31300
INR05 ILAIC ANGIOPLASTY/STENTING 26300 35000
INR06 PERIPHERAL ARTERIAL THROMBOLYSIS RT/LT 28900 37500
INR07 PERIPHERAL HEMANGIOMA SCLEROTHERAPY (DIRECT) 1600 2100
PERIPHERAL HEMANGIOMA SCLERO/EMBOLISATION
INR08 (TRANSARTERIAL) 23400 31300
INR09 UTERINE ART EMBOL FOR FIBROIDS-PRE MYOMECTOMY 17800 23800
INR10 UTERINE ARTERY EMBOLIZATION FOR FIBROIDS 17800 23800
INR11 UTERINE ART/PELVIC ANGIO- POST PART HRAGE-OTHERS 15000 20000
INR12 UTERINE ARTERY/PELVIC EMBOLIZATION FOR POST PARTUM 18750 25000
PELVIC CONGESTION SYNDROME (OVARIAN VEIN)
INR13 EMBOLISATION 26300 35000
INR14 FALLOPIAN TUBE CATHETERIZATION ( FOR BLOCKED TUBE 13100 17500
PRE/POST PROCEDURE USG EVALUATION FOR
INR15 FIBROIDS/ADENOMYOSIS/UTERUS/BODY 750 1000
INR16 PUDENDAL ARTERY EVALUATION 13750 18800
INR17 VERICOSEAL EVALUATION 17800 23800
INR18 VERICOSEAL INTERVENTIONAL 23400 31300
INR19 RENAL ARTERY ANGIOGRAPHY 14000 18800
INR20 RENAL ARTERY ANGIOPLASTY 23000 30600
INR21 RENAL ARTERY STENTING 23000 30600
INR22 RENAL ARTERY EMBOLIZATION (ONE SIDE) 10300 13800
INR23 PERCUTANOUS NEPHROSTOMY & DRAINAGE (RT/LT) 10300 13800
INR24 URETRIC STENT (DOUBLE PIGTAIL/J) RT/LT INTERVENT 13100 17500
INR25 FOLLOW UP FOR NEPHROSTOMY DRAINAGE CATHETER 1875 2500
INR26 GUIDED PERIPHERAL INSERTION OF CENTRAL CATH-PICC 4700 5600
INR27 DIALYSIS CATH INSERT IJ,SUBCLAV,FEMORAL-NON TUNNEL 2250 3100
INR28 DIALYSIS CATH INSERT (IJ,FEMORAL)TUNNELLED/ EXCHANGE 4700 6300
INR29 CHEST PORT INSERTION FOR CHEMOTHERAPY 8900 11900
INR30 CENTRAL VENOGRAM/ARM VENOGRAM (DIAGNOSTIC) 4700 5600
15
INR31 CENTRAL VENOGRAM/ARM VENOGRAM INTERVENTIONAL 13100 17500
INR32 MEDIASTINAL SYNDROMES INTERVENTIONAL 15000 20000
INR33 VENOUS SAMPLING (ADRENAL & RENAL VEIN) 9400 12500
INR34 I V C MEMBRANOTOMY AND ANGIOPLASTY/STENTING 23400 31300
INR35 PORTAL VEIN EMBOLISATION 23400 31300
INR36 AORTOGRAM/SPECIFIC SINGLE AORTOGRAM 9400 12500
INR37 AORTIC ANGIOPLASTY/STENTING 32800 43800
INR38 AORTIC STENT GRAFT ENDOLEAK EMBOLIZATION 32800 43800
INR39 ABDOMINAL AORTIC ANEURYSM GRAFT 37500 50000
INR40 BRONCHIAL ARTERY EVALUATION 10300 13800
INR41 BRONCHIAL ARTERY EMBOLIZATION 22500 30000
INR42 INTRA VASCULAR CATHETER/ FOREIGN BODY REMOVAL 4700 5600
INR43 PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAM 6600 8800
INR44 POST PTBD CHECK CHOLANGIOGRAM PRE/INTRA/POST PROCD 2800 3800
INR45 PTBD- POST OPERATIVE/BILIARY LEAK 13100 17500
INR46 PTBD EXTERNAL DRAINAGE(SINGLE) 9400 12500
INR47 PTBD-EXTERNO-INTERNALISATION 13100 17500
INR48 PTBD--INTERNALISATION 7500 10000
INR49 PCN/PTBD WITH STENTING 21600 28800
INR50 TRANSJUGLAR LIVER BIOPSY 7800 11300
INR51 TIPS (TRANS-JUGULAR PORTO-SYSTIMIC SHUNT) INTERVEN 35600 46300
INR52 ARTERIO-PORTOGRAM 16900 22500
INR53 GI BLEED AND ISCHEMIA (TRIPLE VESSEL) EVALUATION 13100 17500
INR54 GI BLEED EMBOLISATION 19700 26300
INR55 GI ISCHEMIA INTERVENTION (ANGIOPLATY/STENTING) 19700 26300
INR56 PARTIAL SPLENIC EMBOLIZATION 32800 43800
INR57 EMPERICAL ANY ARTERY EMBOLISATION 32800 43800
INR58 USG GUIDED ANEURYSM EMBOLISATION 8400 11300
INR59 CHEMOEMBOLIZATION OF HEPATIC TUMOUR/METS 32800 43800
INR60 TRANS ARTERIAL CHEMOTHERAPY INFUSION 26300 35000
INR61 RADIOFREQUENCY ABLATION OF HEPATIC TUMOURS/ METS 26300 35000
INR62 NASO JEJUNAL INTUBATION 3750 5000
INR63 CEREBRAL ANGIOGRAM 15000 20000
INR64 CAROTID ANGIOGRAM 9400 12500
INR65 VESSELS EVAL CEREBRAL+CAROTID+ SUBCLAVIAN+ VERTEBRAL 17800 23800
INR66 SPINAL ANGIOGRAM 18750 25000
INR67 EVALUATION FOR NASAL BLEEDING / NASAL MASS 11250 15000
INR68 EMBOLIZATION FOR NASAL BLEEDING / SINUS MASS 17800 23800
INR69 EMBOL OF EXTERNAL CAROTID ARTERY/SINGLE VESSEL 27200 36300
INR70 EMBOLIZATION OF TUMOURS FED BY BOTH ICA & ECA 53100 70000
INR71 EMBOLIZATION OF TUMOURS FED BY VA OR/AND BA 49700 66300
INR72 GLUE EMBOLIZATION OF TUMOURS 49700 66300
INR73 EMBOLIZATION OF SPINAL TUMOURS 34700 46300
INR74 EMBOLIZATION FOR VERTEBRAL BODY HEMANGIOMA/METS 26300 35000
INR75 VERTEBROPLASTY (VERTERAL BODY/PELVIC BONE 34700 46300
INR76 VENOUS SINUS SAMPLING (PETROSAL SINUS) 34700 46300
INR77 CCF OCCLUSION 56250 75000
INR79 PROXIMAL OCCLUSION OF INTERNAL CAROTID ARTERY 51500 68800
INR80 CEREBRAL AVM EMBOLIZATION (BESIDES VB TERRITORY) 52500 70000
INR81 AVM EMBOLIZATION IN THE VERTEBROBASILAR TERRITORY 52500 70000
INR82 SPINAL AVM EMBOLIZATION/AVF EMBOLIZATION 59000 78800
INR83 COILING OF INTRACRANIAL ANEURYSM 46900 62500
INR84 COILING OF MULTIPLE ANEURYSMS 52500 70000
INR85 GDC COILING OF INTRACRANIAL ANEURYSMS WITH SPASM 56250 75000
16
INR86 COILING OF INTRACRANIAL ANEURYSM ATTEMPTED 28100 37500
INR87 POST SAH INTRACRANIAL ANGIOPLASTY FOR SPASM 52500 70000
INR88 INTRACRANIAL DRUG THERAPY FOR POST SAH VASOSPASAM 32800 43800
INR89 INTRA ARTERIAL THROMBOLYSIS 44400 56800
INR90 MANAGEMENT OF DURAL SINUS THROMBOSIS 52500 70000
INR91 ANGIOGPLASTY FOR CAROTID/VERTEBRAL ARTERY STENOSIS 52500 70000
INR92 STENTING FOR CAROTID/VERTEBRAL ARTERY STENOSIS 40300 53800
INR93 INTRACRANIAL ANGIOPLASTY 52500 70000
INR94 INTRACRANIAL STENTING 52500 70000

Extra Costs: Contrast Charges.

PHYSIOTHERAPY SERVICES

I. PHYSIOTHERAPY SERVICES General Private

PHY01 EXERCISE/HOME PROGRAM 90 130
PHY02 MUSCLE ASSESSMENT 110 190
PHY03 FUNCTIONAL MOBILIZATION 120 190
PHY04 MANUAL THERAPY 120 190
PHY05 GAIT TRAINING 110 190
PHY06 ANC (3 SITTINGS) 150 250
PHY07 POSTNATAL (3 SITTINGS) 150 250
PHY08 EXERCISE/DAY FOR PMR PATIENT 190 325
PHY09 ICU CARE(PHYSIO) 150 150
PHY10 EXERCISE FOR CTS CLOSED HEART (7 DAYS) 1150 1900
PHY11 EXERCISE FOR CTS OPEN HEART (7 DAYS) 1300 2500
PHY12 PULMONARY PHYSIOTHERAPY 120 200
PHY13 SHORT WAVE DIATHERMY 110 190
PHY14 ULTRASOUND 110 190
PHY15 INFRA RED RAYS/ULTRAVIOLET 110 190
PHY16 HYDRO COLLATOR THERAPY 90 130
PHY17 PARAFFIN WAX BATH 90 130
PHY18 INTERFERENTIAL THERAPY 110 190
PHY19 MUSCLE STIMULATION 110 190
PHY20 LUMBER TRACTION 110 190
PHY21 CERVICAL TRACTION 110 190
PHY22 TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION 110 190
PHY23 McKENZIE EXERCISE PROGRAMME 110 190
PHY24 MULLIGAN’S MOBILIZATION 110 190
PHY25 CPM 110 190
PHY26 CRYO THERAPY 110 190
PHY27 TRACTION/S W D 150 250
PHY28 TRACTION U S T 150 250
PHY29 TRACTION/I F T 150 250
PHY30 S W D/U S T 150 250
PHY31 WAX BATH/EXERCISE 150 250
PHY32 HOT PACKS/EXERCISE 150 250
PHY33 C P M/EXERCISE 150 250
PHY34 FUNCTIONAL MOBILIZATION AND CHEST CARE 150 250
17
PHY35 PULMONARY PT (NIGHT) 150 250
PHY36 US & PWB 150 250
PHY37 SWD & IFT 150 250
PHY38 US & IFT 150 250
PHY39 ICT & HP 150 250
PHY40 CPM & HP 150 250
PHY41 PWB & CPM 150 250
PHY42 PT CONSULTATION 120 200
PHY43 PRE-OPERATIVE ASSESSMENT 120 200
PHY44 ANY TWO MODULE TREATMENT PACKAGE (5 Days) 650 1250
PHY45 MANUAL MOBILIZATION + ELECTROTHERAPY (5 Days) 650 1250
PHY46 SPECIAL PHYSIOTHERAPY CARE 180 180
PHY47 NEURO MUSCULAR DYSFUNCTION MANAGEMENT 180 250
PHY48 RENAL TRANSPLANT- RECEIPENT (10 DAYS) 1725 2300
PHY49 RENAL TRANSPLANT – DONOR (5 DAYS) 920 1380
PHY50 ASSESSMENT AND PRESCRIPTION & DOCUMENTATION 120 200
PHY51 HOT PACKS/MOBILISATION 150 250
PHY52 HOT PACKS/IFT 150 250
II. OCCUPATIONAL THERAPY General Private
OCC01 ASSESSMENT 90 180
OCC02 ASSESSMENT & THERAPY 1 HOUR 125 250
OCC03 ASSESSMENT & THERAPY 3 HOURS 200 400
OCC04 ASSESSMENT & THERAPY MORE THAN 3 HRS 250 500
OCC05 ASSESSMENT & THERAPY FOR SMALL PARTS 100 200
OCC06 THERAPY FOR ICU PATIENTS 150 150
OCC07 REHAB. MED. PATIENT’S THERAPY/DAY 180 360

III. ARTIFICIAL LIMB CENTRE General Private

ALC001 SYM S SIZE I 4000 4500
ALC002 SYM S SIZE II 5000 5500
ALC003 SYM S SIZE III 5500 6000
ALC004 PTB PROTHESIS SIZE I 6000 6500
ALC005 PTB PROTHESIS SIZE II 6200 8000
ALC006 PTB PROTHESIS SIZE III 11000 13800
ALC007 ABOVE KNEE PROTHESIS SIZE I 7500 8200
ALC008 ABOVE KNEE PROTHESIS SIZE II 8500 9200
ALC009 ABOVE KNEE PROTHESIS SIZE III 16500 19500
ALC010 COSMETIC HAND SIZE I 2000 2500
ALC011 COSMETIC HAND SIZE II 2500 2900
ALC012 COSMETIC HAND SIZE III 3200 3800
ALC013 BELOW ELBOW & MECH. HAND SIZE I 4500 5000
ALC014 BELOW ELBOW & MECH. HAND SIZE II 6000 6700
ALC015 BELOW ELBOW & MECH. HAND SIZE III 8500 9500
ALC016 AE PROTHESIS MECH. HAND SIZE I 6000 7000
ALC017 AE PROTHESIS MECH. HAND SIZE II 7500 8000
ALC018 AE PROTHESIS MECH. HAND SIZE III 8800 9500
ALC019 EXTENSION PROTHESIS SIZE I 4500 5500
ALC020 EXTENSION PROTHESIS SIZE II7500 7500 8200
ALC021 EXTENSION PROTHESIS SIZE III 10500 12300
ALC022 CHOPART PROTHESIS SIZE I 3800 4500
ALC023 CHOPART PROTHESIS SIZE II 4500 5000
ALC024 CHOPART PROTHESIS SIZE III 5200 5700
18
ALC025 FINGER SPLINT SIZE I 250 350
ALC026 FINGER SPLINT SIZE II 300 400
ALC027 FINGER SPLINT SIZE III 350 450
ALC028 LONG OPPONENS SIZE I 500 550
ALC029 LONG OPPONENS SIZE II 550 650
ALC030 LONG OPPONENS SIZE III 700 800
ALC031 SHORT OPPONENS SIZE I 500 550
ALC032 SHORT OPPONENS SIZE II 550 650
ALC033 SHORT OPPONENS SIZE III 700 800
ALC034 STATIC COCK UP SPLINT SIZE I 650 750
ALC035 STATIC COCK UP SPLINT SIZE II 750 850
ALC036 STATIC COCK UP SPLINT SIZE III 900 950
ALC037 DYNAMIC COCK UP SPLINT SIZE I 650 750
ALC038 DYNAMIC COCK UP SPLINT SIZE II 750 850
ALC039 DYNAMIC COCK UP SPLINT SIZE III 900 950
ALC040 TURN BUCKLE COCK UP SPLINT SIZE I 950 1050
ALC041 TURN BUCKLE COCK UP SPLINT SIZE II 1050 1150
ALC042 TURN BUCKLE COCK UP SPLINT SIZE III 1200 1350
ALC043 E ARM BRACE SIZE I 1250 1400
ALC044 E ARM BRACE SIZE II 1400 1550
ALC045 E ARM BRACE SIZE III 1800 2050
ALC046 ELBOW BRACE WITH ELBIT SIZE I 1800 2050
ALC047 ELBOW BRACE WITH ELBIT SIZE II 2100 2400
ALC048 ELBOW BRACE WITH ELBIT SIZE III 2800 3500
ALC049 SHOULDER CAPSULE BRACE SIZE I 1800 2000
ALC050 SHOULDER CAPSULE BRACE SIZE II 2100 2400
ALC051 SHOULDER CAPSULE BRACE SIZE III 2800 3200
ALC052 SHOULDER ABDUCTION SPLINT SIZE I 1800 2000
ALC053 SHOULDER ABDUCTION SPLINT SIZE II 2300 2500
ALC054 SHOULDER ABDUCTION SPLINT SIZE III 2600 2900
ALC055 TLSO (TAYLOR S BRACE) SIZE I 1100 1400
ALC056 TLSO (TAYLOR S BRACE) SIZE II 1500 1900
ALC057 TLSO (TAYLOR S BRACE) SIZE III 1800 2100
ALC058 TLSO (MOULDED SPL. JACKET) SIZE I 2600 3000
ALC059 TLSO (MOULDED SPL. JACKET) SIZE II 3000 3600
ALC060 TLSO (MOULDED SPL. JACKET) SIZE III 4200 4500
ALC061 LS FRAME SIZE I 1100 1300
ALC062 LS FRAME SIZE II 1500 1800
ALC063 LS FRAME SIZE III 1800 2100
ALC064 LS BELT SIZE II 550 650
ALC065 LS BELT SIZE III 750 850
ALC066 KT BRACE SIZE II 1800 2100
ALC067 KT BRACE SIZE III 2300 2500
ALC068 ASH BRACE SIZE I 900 1100
ALC069 ASH BRACE SIZE II 1400 1500
ALC070 ASH BRACE SIZE III 1700 2000
ALC071 SOMI BRACE SIZE II 1900 2100
ALC072 SOMI BRACE SIZE III 2300 2500
ALC073 TWO POST MOULDED COLLER SIZE I 1500 1800
ALC074 TWO POST MOULDED COLLER SIZE II 1800 2200
ALC075 TWO POST MOULDED COLLER SIZE III 2500 2800
ALC076 FOUR POST COLLER SIZE I 1400 1650
ALC077 FOUR POST COLLER SIZE II 1800 2350

19
ALC078 FOUR POST COLLER SIZE III 2500 2800
ALC079 SOFT COLLER SIZE I 400 450
ALC080 SOFT COLLER SIZE II 450 500
ALC081 SOFT COLLER SIZE III 550 650
ALC082 LS MOULDED SIZE I 2100 2500
ALC083 LS MOULDED SIZE II 2500 2800
ALC084 LS MOULDED SIZE III 3200 3500
ALC085 AFO SIZE I 850 950
ALC086 AFO SIZE II 1050 1200
ALC087 AFO SIZE III 1400 1500
ALC088 KAFOAK PVC SPLINT SIZE I 1500 1800
ALC089 KAFO WITHOUT JOINT SIZE I 1600 1900
ALC090 KAFO U/L JOINT SIZE I 3200 3500
ALC091 KAFO U/L JOINT SIZE II 3500 4000
ALC092 KAFO U/L JOINT SIZE III 4200 4500
ALC093 HKAFO U/L JOINT SIZE I 3500 4000
ALC094 HKAFO U/L JOINT SIZE II 4200 4500
ALC095 HKAFO U/L JOINT SIZE III 4800 5200
ALC096 HKAFO B/L JOINT SIZE I 7000 7500
ALC097 HKAFO B/L JOINT SIZE II 7700 8200
ALC098 HKAFO B/L JOINT SIZE III 9500 10500
ALC099 KNEE BRACE WITH JOINT SIZE I 2300 2800
ALC100 KNEE BRACE WITH JOINT SIZE II 3000 3500
ALC101 KNEE BRACE WITH JOINT SIZE III 3500 4000
ALC102 KNEE BRACE WITHOUT JOINT SIZE I 1500 1900
ALC103 KNEE BRACE WITHOUT JOINT SIZE II 2000 2300
ALC104 KNEE BRACE WITHOUT JOINT SIZE III 2500 2800
ALC105 AFO WITH HINGE SIZE I 1050 1200
ALC106 AFO WITH HINGE SIZE II 1400 1500
ALC107 AFO WITH HINGE SIZE III 1700 1900
ALC108 CDH SIZE I 1600 1900
ALC110 KAFO WITH PLASTIC THIGH SIZE I 3800 4000
ALC111 KAFO WITH PLASTIC THIGH SIZE II 4000 4500
ALC112 KAFO WITH PLASTIC THIGH SIZE III 4800 5200
ALC113 GAITERS B/L SIZE I 1000 1200
ALC114 GAITERS B/L SIZE II 1400 1600
ALC115 GAITERS B/L SIZE III 1800 2100
ALC116 MERMAID SPLINT B/L SIZE I 1500 1800
ALC117 MERMAID SPLINT B/L SIZE II 1800 2100
ALC118 FRO SIZE I 2000 2200
ALC119 FRO SIZE II 2500 2800
ALC120 FRO SIZE III 3000 3500
ALC121 PTB BRACE SIZE I 2200 2500
ALC122 PTB BRACE SIZE II 2600 3000
ALC123 PTB BRACE SIZE III 3200 3500
ALC124 AK CAST BRACE U/L SIZE I 3600 4200
ALC125 AK CAST BRACE U/L SIZE II 4200 4500
ALC126 AK CAST BRACE U/L SIZE III 4500 5000
ALC127 ARCH SUPPORT SIZE I 250 300
ALC128 ARCH SUPPORT SIZE II 300 400
ALC129 ARCH SUPPORT SIZE III 400 450
ALC130 HEEL PAD SIZE I 300 350
ALC131 HEEL PAD SIZE II 350 375

20
ALC132 HEEL PAD SIZE III 375 400
ALC133 CRUTCH ELBOW ADJUSTABLE (AL) SIZE I 500 500
ALC134 CRUTCH ELBOW ADJUSTABLE (AL) SIZE II 550 550
ALC135 CRUTCH AXILLA ADJUSTABLE (AL) EXTRA SMALL 400 400
ALC136 CRUTCH AXILLA ADJUSTABLE (AL) SMALL 450 450
ALC137 CRUTCH AXILLA ADJUSTABLE (AL) MEDIU 500 500
ALC138 CRUTCH AXILLA ADJUSTABLE (AL) LARGE 550 550
ALC139 WALK STICK 350 350
ALC140 WHEEL CHAIR FOLDING STANDARD ADULT 7500 7500
ALC141 TRICYCLE CONVENTIONAL 5500 5500
ALC142 CANE WALKING TETRAPOD SIZE I 550 550
ALC143 CANE WALKING TETRAPOD SIZE II 600 600
ALC144 WHEEL CHAIR FOLDING CHILD SIZE 6200 6200
ALC145 WALKER 1800 1800
ALC146 REPAIR CHARGE 250 250

CARDIOLOGY SERVICE CHARGES

I. CARDIOLOGY PROCEDURE Gen./ Cub. S. Pvt. Private

CPR01 TEMPORARY PACEMAKER IMPLANTATION 2500 3800 6300
CPR02 PERMANENT PACEMAKER IMPLANTATION SINGLE CHAMBER 10500 13800 17250
CPR03 PERMANENT PACEMAKER IMPLANTATION DUEL CHAMBER 13800 17250 20700
CPR04 PERMANENT PACEMAKER IMPLANTATION TRIPLE CHAMBER 23000 35000 46000
CPR05 PERI-CARDIAL TAPPING 1900 3150 5100
CPR07 NON IONIC DYE PER VIAL 2500 2500 2500
CPR09 INVASIVE PRESSURE MONITORING 2500 3800 5000
CPR11 PERICARDIACTOMY 57500 70000 80000

II. ECG Gen./Cub. S. Pvt. Private

ECG E.C.G. 130 150 200

III. CARDIOLOGY INVESTIGATION Gen./Cub. S. Pvt. Private

ACT ACT TEST 350 430 500
ECHO ECHO DOPPLER 1250 1750 2200
EVR EVENT RECORDING (PER DAY) 380 600 850
HOLT HOLTER CHARGES (PER DAY) 1900 2230 2500
STEC STRESS ECHO 1500 2000 2500
TEE TRANS ESOPHAGEAL ECHO 2100 2450 2800
TMT STRESS TEST(TMT TREAD MILL TEST) 1150 1700 2200

PACKAGE CHARGES FOR CARDIOLOGY PROCEDURES

No. of
Code Service Name Gen./Cub. S. Pvt. Private days

I. CATH-LAB PROCEDURES:
ABMV
ANGIOPLASTY/BALOON MITRAL VALVOTOMY 30000 40000 50000 02

ACC CARDIAC CATHETERISATION 7000 9000 11000 01

ACAG CORONARY/RENAL ANGIOGRAPHY 9000 11000 13000 01

21
ACAWS CORONARY/RENAL ANGIOPLASTY 76500 85000 100000 02

ACPA CORONORY PERIPHERAL ANGIOGRAPHY 9000 11000 13000 01

ADSA CERIBRAL ANGIOGRAPHY 9000 11000 13000 01

AEPS ELECTRO PHYSIOLOGY STUDY 9000 10000 11000 01

APA PERIPHERAL ANGIOPLASTY 75000 85000 95000 02

ARFA RADIO FREQUENCY ABLATION 30000 40000 50000 01

ARHS RIGHT HEART STUDY 7000 9000 11000 01

A3DM 3D MAPPING 45000 55000 65000 01

Extra Cost:
1. Stent
a) Drug Eluting Stent
b) Mounted Stent .
2. Pharmacy
3. Non- Ionic Dye
4. Extended Stay
Note:
a. Any Cardiology procedure done in emergency shall be charged as per higher category, ie minimum
Semi- Private Category will be charged.
b. When two or more procedures are performed 50% of the minor procedure will be charged extra.

PACKAGE CHARGES FOR C T S

S Pvt. S Pvt. Pvt. Non PVT No. of
Code Service Name General Non AC AC AC AC (S) days

II. CARDIO-THORACIC SURGERIES

AVSD ASD/VSD/OHS 100000 120000 138000 148000 170000 10

AOHS AVR/MVR/CABG 120000 140000 161000 170000 195000 10

AOHSE AVR/MVR/CABG EMERGENCY 130000 150000 172500 182500 210000 10

Note:
a. Package is for 10 days.
b. Valve will be charged extra.
c. Extended stay will be charged extra for all services.
d. IABP charges and permanent pace maker implant shall be charged extra.
e. Patient to pay an advance at the time of admission equivalent to the approximate amount of bill.

RHEUMATOLOGY SERVICE CHARGES

I. RHEUMATOLOGY General Private

RHEU01 SOFT TISSUE(TENNIS ELBOW, TENDINITIS, BURSITS) 70 230

RHEU02 SMALL/MEDIUM JOINTS (MCP/PIP, WRIST, ELBOW, ANKLE) 80 280

RHEU03 LARGE JOINTS(KNEE, SHOULDER WITH ASPIRATION ON JOINT) 130 350

22
 ENDOCRINOLOGY SERVICE CHARGES

I.
ENDOCRINOLOGY General Private

END01 SCREENING DOPPLER (DIABETIC) 450 700

END02 BIOTHESIOMETER 230 350

END03 TOTAL DIABETIC FOOT STUDY 600 900

GASTROENTEROLOGY SERVICE CHARGES

Gen./
I. GASTROENTEROLOGY Cub. S. Pvt. Private
GENT10 EMERGENCY ENDOSCOPY CHARGES 920 1380 1700
GENT11 ESOPHAGEAL DILATION 2300 2900 3700
GENT12 GASTRIC STRICTURE DILATION 2300 2900 3700
GENT13 ESOPHAGEAL VARICEAL GLUE INJECTION 2900 4100 4600
GENT14 TUMOR ABLATION BY ALCOHOL INJECTION 1700 2300 3500
GENT15 PLACEMENT OF FEEDING TUBES WITH ENDOSCOPY 2400 3250 4100
GENT16 FOREIGN BODY REMOVAL 2100 2900 4100
GENT17 INJECTION BLEEDING ULCER 2000 2900 3500
GENT18 SPHINCTEROTOMY 2300 3500 4100
GENT19 STONE EXTRACTION 2300 2900 4100
GENT20 STENTING 1150 1750 2300
GENT21 NASOBILARY DRAINAGE 1150 1750 2300
GENT22 ESOPHAGEAL PROSTHESIS INSERTION 3450 5200 6900
GENT23 GASTRIC POLYPECTOMY 2900 4100 5200
GENT24 GASTRIC VARICES GLUE INJECTION 2900 4100 5200
GENT25 COLONOSCOPIC POLYPECTOMY 2900 4100 5200
GENT26 DECOMPRESSION OF COLON 1700 2300 3500
GENT27 ENDOSCOPIC MUCOSAL RESECTION 3300 4900 6600
GENT28 TUMOR ABLATION BY ELECTROCAUTERY/LA 3500 4600 5750
GENT29 VARICEAL LIGATION BY ENDOSCOPY 2300 3450 4600
GENT30 COLONIC STRICTURE DILATION 2300 4100 5200
GENT31 ENDOSCOPIC FISTULA CLOSURE 2300 3450 4600
GENT32 PRECUTANEAS ENDOSCOPIC GASTROSTOMY 4600 7500 9200
GENT33 DRAINAGE OF PSEUDOCYST 4600 7500 9200
GENT34 ACHALASIA DIALATION 4600 7500 9200
GENT35 COLONOSCOPY 2900 3700 4800
GENT36 LEFT SIDE COLONOSCOPY 1700 2000 2300
GENT37 EVL SET 4000 4100 4100
GENT39 EVL SET(VIEW MAX) 1700 1700 1700
GENT40 BILARY DIALATATION 8000 10600 13250
GENT42 INTRA OPERATIVE ENDOSCOPIC 5300 6600 8100
GENT43 METALIC STENT INSERTION IN CBD 3500 5200 5750
Gen./
II. GASTROENTEROLOGY INVESTIGATION Cub. S. Pvt. Private
GENT01 UPPER G.I. ENDOSCOPY 1700 2300 2700
GENT03 ESOPHAGEAL SCLERO THERAPY:
st
a. VARICES - 1 SITTING 2500 3300 4100

23
GENT04 ESOPHAGEAL SCLERO THERAPY:
b. VARICES SUBSEQUENT SITTING 1750 2650 3350
GENT05 SIGMOIDOSCOPY (RIGID) 1600 1950 2300
GENT06 SIGMOIDOSCOPY (FLEXIBLE) 1600 1950 2300
GENT07 ESOPHAGOSCOPY 700 950 1150
GENT08 BIOPSY CHARGES FOR GASTRO PROCEDURE 600 700 800
GENT09 ERCP (EXCLUDING STENT) 5300 6600 8000
GENT41 VARICEAL INJECTION 1150 1750 2100
GENT44 ENDOSCOPIC BRUSH CYTOLOGY 600 700 800
GENT45 CBD STENT REMOVAL 3500 4600 5800
GENT46 SIDE VIEWING DUODENOSCOPY 2700 2900 3500
GENT47 MECHANICAL LITHOTRIPSY 8100 9200 11500

DERMATOLOGY SERVICE CHARGES

I. SKIN PROCEDURE General Private

SKN01 SKIN BIOPSY 550 1100
SKN02 EXCISION – MOLES 170 340
SKN03 EXCISION – WARTS 170 340
SKN04 EXCISION - SAB CYST 170 340
SKN05 CAUTERIZATION & SCRAPING – WARTS 170 340
SKN06 CAUTERIZATION SCRAPING MOLLUS CUM CONTRA- SINGLE 200 400
SKN07 CAUTERIZATION & SCRAPING VENERAL WARTS 170 340
SKN08 CAUTERIZATION & SCRAPING CORNS 170 340
SKN09 CHEMICAL PEELING- GLYCOLIC PEEL 620 1240
SKN11 INTRALESIONAL INJECTIONS- SINGLE LESION 300 600
SKN13 CAUTERIZATION SCRAPING MOLLUS CUM CONTRA- DOUBLE 360 720
SKN14 CHEMICAL PEELING- ACNE PEEL 720 1440
SKN15 CHEMICAL PEELING- LACTIC PEEL 720 1440
SKN16 CRYO SURGERY- SINGLE LESION 320 640
SKN17 CRYO SURGERY- DOUBLE LESION 550 1100
SKN18 CRYO SURGERY- MULTIPLE LESION 720 1440
SKN19 MILIA EXTRACTION 360 720
SKN20 ELECTRIC CAUTERIZATION (WARTS,SKIN)- SINGLE LESION 170 340
SKN21 ELECTRIC CAUTERIZATION (WARTS,SKIN)- DOUBLE LESION 320 640
SKN22 ELECTRIC CAUTERIZATION (WARTS,SKIN)- MULTI LESIONS 800 1600
SKN23 DERMAROLLER FOR ACNE SCAR 3000 6000
SKN24 TCA APPLICATION- SINGLE LESION 80 160
SKN25 TCA APPLICATION- DOUBLE LESIONS 130 260
SKN26 TCA APPLICATION- MULTIPLE LESIONS 180 360
SKN27 COSMO PEEL FOR HYPER PIGMENTATION 1200 2400
SKN28 NEORONOX INJECTION (PER UNIT) 100 200
SKN29 NBUVB COMB THERAPY FOR SCALP PSORIASIS- PER SITTING 100 200

24
 RESPIRATORY MEDICINE SERVICE CHARGES

I. RESPIRATORY LAB Gen./Cub. S. Pvt. Private

RES01 BRONCHOSCOPY 5000 6000 7000
RES02 PULMONARY FUNCTION TESTING (PRE &POST
NEBULISATION) 650 950 1300
RES05 PLEURODESIS 2000 2250 2900
RES06 PLEURAL TAP 600 1000 1100
RES07 SMOKING CESSATION CLINIC 200 250 300
RES08 BRONCHOSCOPY WITH BIOPSY 6000 7000 8000
RES09 SLEEP STUDY 8500 10000 11500
RES11 PERCUTANEOUS PLEURAL BIOPSY 800 1150 1600
RES12 BRONCHOSCOPIC GLUE INJECTION 0.50ML 6750 8000 9250
RES13 BRONCHOSCOPIC GLUE INJECTION 1 ML 7250 8500 9750

PSYCHIATRY SERVICE CHARGES

I. PSYCHOLOGY SERVICES General Private

PSY01 COUNSELING PSYCHOTERAPY 200 400
PSY02 PLAY THERAPY 150 300
PSY03 RELAXATION TRAINING 200 400
PSY04 ASSESSMENT OF CHILDHOOD DISORDERS 300 600
PSY05 ASSESSMENT OF DEVELOPMENT AND SOCIAL QUOTIENT 500 1100
PSY06 IQ TEST 500 1000
PSY07 THEMATIC APPERCEPTION TEST 500 1000
PSY08 RORSCHACH TEST 500 1000
PSY09 BEHAVIOUR THERAPY OR PSYCHOTHERAPY ( 6 SESSION) 1200 2000
PSY10 NEUROPSYCHOLOGICAL BATTERY 1400 2500
PSY11 PERSONALITY TEST 800 1500
PSY12 COMPLETE PSYCHODIAGNOSTIC TEST 1200 2500
PSY13 MEMORY TEST 900 1400
PSY14 RELAXATION TRAINING ( 6 SESSION) 900 1500

NEUROLOGY SERVICE CHARGES

I. NEUROPHYSIOLOGY SERVICES Gen. / Cub. S. Pvt. Private

NEPHY01 E.E.G 750 1000 1200
NEPHY02 NERVE CONDUCTION STUDY 1200 1600 1900
NEPHY03 NERVE CONDUCTION STUDY AND EMG 2500 2900 3500
NEPHY04 VISUAL EVOKED RESPONSE 1200 1600 1900
NEPHY05 BRAINSTEM AUDITORY EVOKED RESPONSE 1200 1600 1900
NEPHY06 SOMATOSENSORY EVOKED RESPONSE 1200 1600 1900

25
NEPHY07 DECREMENTAL RESPONSE 1200 1600 1900
NEPHY08 E.M.G 1400 1800 2200
NEPHY09 OVERNIGHT POLYSOMNOGRAPHY 3500 4600 4600
NEPHY10 MULTIPLE SLEEP LATENCY TEST (MSLT) 2300 3750 3750
NEPHY11 CPAP TITRATION STUDY 1750 3200 3200
NEPHY12 SHORT TIME VIDIO EEG 1400 1700 2000
NEPHY13 LONG TIME VIDIO EEG 4000 5500 6000
NEPHY14 BRACHIAL PLEXUS STUDY 1300 1600 1900
NEPHY15 FACIAL N.C. STUDY 1200 1600 1900

NEPHROLOGY SERVICE CHARGES

I. NEPHROLOGY CHARGES Gen./ Cub. S. Pvt. Private

DIA01 PERITONEAL DIALYSIS 1650 2100 2500
DIA02 HAEMODIALYSIS 1650 2100 2500
DIA03 FEMORAL CATHETERISATION 1200 1400 1600
DIA04 SUB CLAVIAN CATHETERISATION 1500 1700 1900
DIA05 VASCULAR ACCESS 1500 1700 1900
DIA06 KIDNEY BIOPSY 1500 1700 2300
DIA07 ADD CHG FOR BEDSIDE HEMODIALYSIS 350 350 350

Note:
I. Haemodialysis includes all consumables and professional charges but it does not include dialyser charges.
II. Charges for procedures to be done in O T.
1. A V Shunt Category – II
2. A V Fistula Category – II
3. CAPD placement Category – IB

PACKAGE CHARGES FOR NEPHROLOGY

Pvt.
S Pvt. S Pvt. Non PVT No. of
Code Service Name General Non AC AC AC AC (S) days
RENAL TRANSPLANTATION
RENAL TRANSPLANTATION
ARTD DONOR 50000 70000 70000 70000 70000 12
RENAL TRANSPLANTATION
ARTR RECIPIENT 200000 330000 330000 330000 330000 12
Note:
a. The package is for 12 days and starts one day before the operation. Any extra stay and services beyond
the package will be charged.
b. Package includes the charges for surgery and stay in the hospital for the donor.
c. Donor opting for the special accommodation than allowed in the package shall be charged for the
difference in accommodation.
d. Pharmacy to be charged extra.

26
 PEADIATRIC SERVICE CHARGES

I. PEADIATRICS SERVICE CHARGES Gen./ Cub. S. Pvt. Private

PAED01 PEADIATRIC CARE FOR NEW BORN (7 to12 days) 350 550 850
PAED02 GENERAL NURSERY CARE PER DAY 350 700 1050
PAED03 PREMATURE BABY CARE PER DAY 350 450 575
PAED04 INCUBATOR/OPEN CARE SYSTEM PER DAY 550 650 700
PAED05 INTENSIVE CARE PER DAY 700 700 700
PAED06 PHOTOTHERAPY 250 325 460
PAED07 RESUSCITATION 350 700 1050
PAED08 RESUSCITATION WITH INCUBATION(BY SP) 700 1050 1400
PAED09 EXCHANGE TRANSFUSION 1300 1725 2100
PAED10 OT CHARGES FOR EXCHANGE TRANSFUSION 100 150 200
PAED13 MULTICHANNEL MONITOR 460 650 775
PAED14 INFUSION PUMPS & SYRINGE PUMPS 160 260 360
PAED15 NON INVASIVE/ BP MONITOR 160 260 360
PAED16 APNOEA MONITOR 160 260 360
PAED18 ROP SCREENING CHARGES 300 400 500
PAED19 MILK 40 50 60

OPTHALMOLOGY SERVICE CHARGES

I. OPTHALMOLOGY SERVICE CHARGES General Private

BUT1 BUTOX INJECTION PER UNIT 325 325
OPTHA01 SAC SYRINGING 80 160
OPTHA02 REFRACTION 80 160
OPTHA03 FUNDUS EXAMINATION(DIRECT OPTHALMOS 80 160
OPTHA04 FUNDUS EXAMINATION (INDIRECT OPTHAL 80 160
OPTHA08 GLAUCOMA INVESTIGATION – GONIOSCOPY 80 160
OPTHA09 ORTHOPTIC EXERCISES 200 400
OPTHA10 FIELD CHARTING WITH FIELD MACHINE B 650 900
OPTHA11 INCISION OF ABSCESS 200 400
OPTHA12 CORNEAL F.B REMOVAL 200 400
OPTHA13 CHALOZION EXCISION 250 500
OPTHA14 WART EXCISION 250 500
OPTHA15 APPLICATION OF THE LIMBAL RING 250 500
OPTHA16 CONJUNCTIVAL RESUTURING 250 500
OPTHA17 ELECTROLYTIC EPLATION 250 500
OPTHA18 A SCAN BIOMETRY 250 500
OPTHA19 ROP SCREENING CHARGES 250 500
OPTHA20 FLUROSCENE ANGIOGRAPHY(LASER THERAPY) 1400 1900
OPTHA21 ARGON LASER PHOTOCOAGULATION 2300 2900
OPTHA22 YAG LASER CAPSULOTOMY 1500 1900
OPTHA23 YAG LASER IRODOTOMY 2300 2700
OPTHA24 CORNEA PROCESSING CHARGES PER CORNE * 2200 2200
OPTHA26 LASIK LASER TREATMENT BOTH EYES 24000 24000
OPTHA27 COSTOMUVE LASIK LASER BOTH EYES 29000 29000
OPTHA28 FIELD CHARTING WITH FIELD MACHINE ONE EYE 350 550
OPTHA30 LASIK LASER TREATMENT ONE EYE 14000 14000

27
OPTHA31 COSTOMUVE LASIK LASER ONE EYE 17000 17000
OPTHA32 IOL ORDINARY 900 900
OPTHA33 IOL INDIAN FOLDABLE 2000 2000
OPTHA34 HYDROPHOBIC FOLDABLE IOL 5000 5000
OPTHA36 HYDROPHILIC ACRYLIC LENS 5800 5800
OPTHA37 ASPHERIC LENS 8000 8000
OPTHA38 LASIK WORK UP 1000 1000

PACKAGE CHARGES FOR OPHTHALMOLOGY

No.
of
Code Service Name Gen./Cub. S Pvt. Private days

CATARACT WITH IOL IMPLANTATION

ACTIO
CATARACT WITH IOL IMPLANTATION (WITHOUT IOL) 8500 9375 10800 01
Note:
IOL Charges will be extra as follows:

Ordinary IOL - Rs.900/-

Indian Foldable Lens - Rs.2000
Hydrophobic Foldable Lens - Rs.5000
Hydrophilic Acrylic Lens - Rs.5800/-
Aspheric Lens - Rs.8000/-

ENT AUDIOLOGY SERVICE CHARGES

I. ENT & AUDIOLOGY General Private

ENT01 PURE TONE AUDIOGRAM 230 460
ENT02 SISI, TONE DECAY & DIFFERENCE LIMEA 180 350
ENT03 MULTIPLE HEARING ASSESSMENT TEST/AD 400 800
ENT04 HEARING AID SELECTION 180 350
ENT05 SPEECH DISCRIMINATION SCORE 100 210
ENT06 SPEECH ASSESSMENT 130 280
ENT07 SPEECH THERAPY PER SESSION 30-40 Min. 200 300
ENT08 DELAYED SPEECH: AUDIOMETRY & SPEECH & BEHAVIOUR 380 660
ENT09 COLD CARORIC TEST FOR VESTIBULAR FUNCTION 230 460
ENT10 SPECIAL TEST 180 350
ENT11 TYMPANOMETRY 150 300
ENT12 TYMPANOMETRY & STAPE DIAL REFLEX 200 400
ENT13 SPECIAL TEST ARLT, DE, CAY 180 350
ENT14 TYMPANOMETRY STAPE DIAL REFLEX, ARL 460 920
ENT15 HEARING TEST FOR NEW BORN BABIES(OA) 150 200
ENT16 MYRINGO PLASTY 2000 4000
ENT17 MYRINGOTOMY 300 660
ENT18 MYRINGOTOMY WITH GROMMET 800 1100
ENT19 EXAMINATION UNDER MICROSCOPE 180 300
ENT20 BIOPSY (ENT) 270 400
ENT21 FIBRO OPTIC LARYNGOSCOPY 880 1150
ENT22 DIAGNOSTIC NASAL ENDOSCOPY 530 1000
ENT23 ENDOSCOPY SUCTION CLEANING 350 460
ENT24 BRONCHOSCOPY 3450 4000
ENT25 LARYNGOSCOPY (FLEXIBLE) 700 1400
ENT26 BRONCHOSCOPY WITH BIOPSY 4600 5750

28
 DENTAL SERVICE CHARGES

I. DENTAL General Private

DENT01 AMALGAM ONE SURFACE(FILLING PER TOOTH) 380 520
DENT02 AMALGAM TWO SURFACE(FILLING PER TOOTH) 530 700
DENT04 COMPOSITE FILLING-LIGHT CURE 700 950
DENT06 GLASS IONOMER 430 580
DENT07 RCT ANTERIORS(ENDONTICS) 1800 2200
DENT08 RCT POSTERIORS(ENDODONTICS) 2150 3000
DENT09 PULPOTOMY (ENDODONTICS) 530 700
DENT10 APICAL CURETTAGE (ENDODONTICS) 1500 2000
DENT11 ORATEKE AND LUCITONE-COMPLETE DENTURES 7000 10000
DENT12 ACRYLIC & PREMA DENTURES-COMPLETE DENTURES 6000 8000
DENT13 RELINING COMPLETE DENTURES (PROSTHETICS) 1000 1500
DENT14 DENTURE REPAIR (PROSTHETICS) 330 500
DENT15 SINGLE TOOTH PARTIAL DENTURES(ACRYLIC) 850 1150
DENT16 EACH ADDITIONAL TOOTH-PARTIAL DENTURE 270 400
Charges will be determined by
DENT17 CAST PARTIAL DENTURE Doctor
DENT18 JACKET CROWN (ACRYLIC PER UNIT) 1500 2000
DENT19 CROWN(CHROME COBALT PER UNIT)WITHOUT FACING 1600 3000
DENT20 CROWN(CHROME COBALT PER UNIT)ACRYLIC FACING 1900 2400
CROWN(CHROME COBALT PER UNIT) PORCELAIN
DENT21 FACING 2300 3200
DENT22 DOWEL CROWN(ACRYLIC PER UNIT) 1700 2400
DENT23 POST AND CORE 3200 5200
DENT24 OBTURATOR FOR CLEFT PALATE 3200 5200
DENT25 COST OF APPLIANCES(ORTHODONTICS) 3500 5000
DENT26 COST OF EACH VISIT FOR ADJUSTMENT(ORTHODONT) 350 550
Charges will be determined by
DENT27 EACH BREAKAGE/LOSS(ORTHODONTICS) Doctor
DENT28 ACTIVATOR/BIONATOR (ORTHODONTICS) 9000 12500
DENT29 EXPANSION PLATE 7600 11500
DENT30 COST OF APPLIANCE (FIXED, ORTHODONTICS) 15000 20000
DENT31 COST OF EACH VISIT FOR ADJUSTMENT (FIXED ORTH.) 850 1600
Charges will be determined by
DENT32 EACH BREAKAGE/LOSS OF BAND(FIXED ORTHODONTICS) Doctor
DENT33 EXTRA ORAL APPLIANCE HEAD GEAR(KLOEN’S TYPE) 1500 2000
DENT34 SCALING AND POLISHING OR TEETH (I) 700 800
DENT35 SCALING AND POLISHING OF TEETH (II) 850 1000
DENT36 SCALING AND POLISHING OF TEETH (III 1050 1300
DENT39 GINGIVECTOMY – PER QUADRANT 800 1100
DENT40 PERIO – CORONOTOMY (PER TOOTH) 200 250
DENT41 FRENECTOMY 650 800
Charges will be determined by
DENT42 FLOURIDE APPLICATION (PEDODONTICS) Doctor
DENT43 SPACE MAINTAINER FUNCTIONAL(PER UNIT 330 500
DENT44 SPACE MAINTAINER NON FUNCTIONAL 450 580
DENT45 EXTRACTION PER TOOTH 250 350
DENT46 EXTRACTION ALL TEETH IN A JAW 1500 2300
DENT47 DISIMPACTION 2000 3000
DENT49 TOOTH REPLANTATION 1200 1800
DENT50 ALVEOLECTOMY 550 650
DENT52 ABCESS INCISION(PER TOOTH) 150 200

29
DENT53 GROWTH REMOVAL 550 700
DENT54 BIOPSY 550 650
DENT57 FLAP OPERATION 1200 1800
DENT58 FIXATION OF FRACTURED JAW – I.M.F 5000 10000
DENT59 IMPRESSIONS FOR STUDY MODELS 280 330
DENT60 COST OF APPLIANCE (FIXED, ORTHODONTICS SINGLE) 7500 10000
DENT61 COST OF EACH VISIT FOR ADJUSTMENT SINGLE 430 800
DENT62 COST OF APPLIANCE (FIXED, ORTHODONTICS SEGM.) 3500 5000
DENT63 DENTAL X-RAY 150 200
DENT64 ORATEKE AND LUCITONE DENTURE ONE JAW 3500 5100
DENT65 ACRYLIC & PREMA DENTURES ONE JAW 3000 3800
DENT67 RCT (PREMOLARS) 1800 2300
DENT68 EXTRACTION OF RCT TOOTH 1500 2000
DENT69 BLEACHING OF SINGLE TEETH 1500 2000
DENT70 BLEACHING OF ALL TEETH 4500 6000

MATERNITY SERVICE CHARGES

I. MATERNITY CHARGES Gen./Cub. S. Pvt. Private

MAT01 COLPOSCOPY 500 850 950
MAT04 END. ASPIRATION 230 380 500
MAT05 CERVICAL CAUTERISATION (ELECTRICAL) 330 580 760
MAT06 Cx PUNCH BIOPSY 160 320 380
MAT07 VAGINAL VULVAL/PUNCH BIOPSY 160 320 380
MAT11 CARDIO TOCOGRAPH(CTG) 300 580 860
MAT13 CRYO CAUTERY Cx 500 950 1250
MAT15 VASECTOMY 1900 1900 1900
MAT16 CHEMOTHERAPY 750 1100 1550
MAT19 AFI 160 300 350
MAT20 AFI + NST 600 1050 1150
MAT23 UNBOOKED DELIVERY CASES (EXTRA CHARGES) 1150 2300 3000
IVF51 EPIDURAL ANALGESIA CHARGES 950 1275 1900
MAT25 MONITORING CHARGE IN LABOUR WARD 160 200 230
MAT26 ECLAMPSIA PATIENTS CHARGES 460 460 460
MAT27 SPECIAL LABOUR ROOM CHARGES 800 800 800
IVF02 ECV 230 350 460
IVF16 NST 500 780 1000
IVF17 BIOPHYSICAL PROFILE 650 950 1250
MAT28 PAINLESS DELIVERY CHARGES 2600 2900 3200

II. DELIVERY CHARGES

Code Service Name General Cubicle S Pvt. Pvt. Non AC PVT AC

MAT30 NORMAL DELIVERY 2750 4850 7150 7600 8600
MAT31 FORCEPS DELIVERY 4200 6900 9000 9800 11300
MAT32 BREECH DELIVERY 4600 7500 9700 10500 12000
MAT33 TWINS DELIVERY 5400 8000 10500 10800 13100

30
III. LABOUR ROOM CHARGES
Code Service Name General Cubicle S Pvt. Pvt. Non AC PVT AC
MAT34 NORMAL DELIVERY 1000 1600 2350 2500 2900
MAT35 FORCEPS DELIVERY 1100 1800 2500 2800 3000
MAT36 BREECH DELIVERY 1100 1800 2500 2800 3000
MAT37 TWINS DELIVERY 1200 1900 2650 3000 3200

REPRODUCTIVE AND FOETAL MEDICINE UNIT

I. REPRODUCTIVE AND FOETAL MEDICINE UNIT (RFMU) Gen./Cub. S. Pvt. Private

IVF01 CYST ASPIRATION – TAS 750 1150 1550
IVF03 CVS(CHORIONIC VILLUS SAMPLING) 2200 3150 4000
IVF04 AMNIOCENTESIS 750 1150 1550
IVF05 CORDOCENTESIS 2200 3150 4000
IVF06 FOETOSCOPY 2200 3150 4000
IVF07 FOLLICULAR STUDY I SITTING 650 900 1150
IVF08 FOLLICULAR STUDY SUBSEQUENT SITTING 150 230 300
IVF09 MALE INFERTILITY SCAN 800 1280 1800
IVF10 SEMEN ANALYSIS 200 250 330
IVF11 IUI (INTRA UTERINE INSEMINATION) 1900 3800 5100
IVF14 PELVIC SCAN 580 750 950
IVF15 FOETAL SCAN ROUTINE 520 750 980
IVF18 FOETAL DOPPLER 840 1330 1840
IVF19 FOETAL ECHO 840 1330 1840
IVF20 OBSTETRIC DOPLER & BIOPHYSICAL PROFILE 1250 1750 2150
IVF21 LEVEL II SCAN FOR FOETAL ANOMALIES 1500 1900 2300
IVF22 Cx SCORE 130 250 380
IVF23 FOETAL BIOPSY 2150 2750 4000
IVF24 FOETAL DOPPLER & FOETAL ECHO 1200 1700 2000
IVF25 FOETAL SCAN ROUTINE & FOETAL ECHO 1250 1750 2200
IVF26 FOETAL SCAN ROUTINE & FOETAL DOPPLER 1250 1750 2200
IVF27 FOETAL SCAN ROUTINE & BIOPHYSICAL SCORE 1250 1750 2200
IVF28 CYST ASPITATION – TVS 2200 3150 4000
IVF29 SPERM FUNCTION 320 630 950
IVF30 FOETAL INTERVENTIONAL 2500 3450 4000
IVF31 ADDITIONAL TVS 130 200 250
IVF32 FOETAL SCAN ROUTINE + DOPPLER + ECHO 1250 1750 2200
IVF33 SONO HYSTEROSALPINGOGRAM 750 950 1150
IVF34 SPERM WASH 320 630 950
st
IVF36 1 INSTALLMENT AT THE TIME OF REGISTRATION 5000 10000 10000
nd
IVF35 2 INSTALLMENT AT THE TIME OF OOCYTE RETRIEVAL 55000 60000 60000
IVF37 SPERM FREEZING-INITIAL CHARGE 1280 1500 1500
IVF38 OOCYTE/EMBRYO FREEZING – INITIAL CHARGE 11500 13800 13800
IVF39 OOCYTE/EMBRYO FREEZING EVERY SIX MONTHS 3500 3500 3500
IVF40 PESA/TESA/MESA ETC 1750 3450 3450
IVF41 EMBRYO THAWING AND TRANSFER 17250 17250 17250
IVF44 AFI 160 300 350
IVF45 AFI + NST 600 1050 1150
IVF46 ECV 230 350 460
IVF47 NST 500 780 1000

31
 IVF48 BIOPHYSICAL SCORE 650 950 1250
IVF50 PAINLESS DELIVERY CHARGES 2600 2900 3200
IVF51 EPIDURAL ANALGESIA CHARGES 950 1275 1900
IVF52 SPERM FREEZING EVERY SIX MONTHS 350 580 580
MAT03 END. BIOPSY 580 750 950
st
IVF53 LOW COST IVF-ICSI 1 INSTALMENT 5000 10000 10000
nd
IVF54 LOW COST IVF-ICSI 2 INSTALMENT 30000 30000 30000
MAT08 OBSTETRIC ULTRASOUND I VISIT 580 760 950
MAT09 OBSTETRIC ULTRASOUND FOLLOW UP 460 690 890
MAT10 GYNAE ULTRASOUND (PELVIC SCAN) 580 750 950
MAT12 HSG(HYSTEROSALINOGRAM) 1150 1280 1400
MAT14 HYDROTUBATION (3 SITTINGS) 500 950 1300
MAT17 TRANSVAGINAL SCAN 650 900 1150
MAT18 HEGAR’S TEST 460 700 920
MAT21 FOETAL THERAPY 2500 3900 4750
MAT22 SINGLE LOOK ULTRASOUND 200 250 300
IVF55 IUD INSERTION 130 200 250
IVF56 PROCEDURE CHARGES FOR MINOR SURGERIES (I B) 2100 3000 3000
IVF57 PROCEDURE CHARGES FOR MINOR SURGERIES (I A) 1400 2800 2800

PACKAGE CHARGES FOR OBS & GYNAE

No.
S Pvt. Pvt. of
Non S Pvt. Non PVT da
Code Service Name General Cubicle AC AC AC AC (S) ys
I. LAPAROSCOPIC SURGERIES IN OBS & GYNAE DEPARTMENT:
LAPAROSCOPIC OVARIAN
ALOC CYSTECTOMY 14700 19600 26000 27900 31700 38000 03
LAPAROSCOPIC OVARIOTOMY
ALOO OOPHRECTOMY 14700 19600 26000 27900 31700 38000 03
LAPAROSCOPICALLY
ALAVH ASST.VAGINAL HYSTERECTOMY 19600 24200 32200 35700 39100 46000 05

AEA ENDOMETRIAL ABLATION 10500 12700 15600 15600 19600 23000 02

Note:
a. Pharmacy to be charged extra.
b. Any Lab test done will be charged extra.
c. Any service provided beyond the package days will be extra.

MINOR OT PROCEDURE CHARGES

I. MINOR OT PROCEDURES General Private

MOT001 I&D 520 690
MOT002 SUTURING 380 540
MOT003 INTERCOSTAL DRAINAGE 1000 1250
MOT004 CHEST TUBE INSERTION 1000 1250
MOT005 NASAL PACKING 600 840
MOT006 REMOVAL OF FOREIGN BODY-NASAL/EAR 300 500
MOT040 REMOVAL OF FOREIGN BODY- HAND/ FOOT 450 600
MOT007 BIOPSY 370 540
MOT008 URETHRAL DILATATION 340 520
MOT009 CYSTOSCOPY 830 920
MOT010 DJ STENT REMOVAL 1380 1840

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MOT011 CIRCUMCISION 1380 1840
MOT012 SUPRA-PUBIC CYSTOSTOMY 1380 1840
MOT013 CLOSED REDUCTION IN DISLOCATION ELB. 830 920
MOT014 CLOSED REDUCTION + POP LEG 1380 1840
MOT015 CLOSED REDUCTION + POP H 830 920
MOT016 TRACHEOSTOMY 1380 1840
MOT017 K WIRE FIXATION 350 500
MOT018 NAIL REMOVAL 1380 1840
MOT019 EAR LOBE REPAIR 830 920
MOT020 EXCISION OF CYST 400 550
MOT021 POP CHARGES 250 350
MOT022 SUTURE REMOVAL 200 250
MOT023 BLADDER IRRIGATION 310 380
MOT024 B C G INSTALLATION 260 380
MOT025 DORSAL SLIT 1380 1840
MOT026 KNEE ASPIRATION 600 950
MOT027 MINOR AMPUTATION 300 380
MOT028 CARDIAC MONITORING 480 480
MOT029 OXYGEN THERAPY (per hour) 80 110
MOT030 ARTERIAL BLOOD GAS 400 450
MOT031 MORTURY SHEETS 90 90
MOT032 AIRWAY 80 80
MOT033 SPC 1150 1150
MOT034 SKIN BIOPSY 250 450
MOT035 RANDOM BLOOD SUGAR 80 100
MOT036 ECG 130 150
MOT037 BLOOD KETONE 180 200
MOT038 CASUALTY MINOR PROCEDURE A 110 180
MOT039 CASUALTY MINOR PROCEDURE B 350 600
MOT041 N/G TUBE INSERTION 50 100

OPERATION CHARGES

Non AC
I. OPERATION CHARGES General Cubicle S. Pvt. Pvt. Pvt. AC
OPER1 OPERATION CATEGORY 1 210 380 800 900 1050
OPER1A OPERATION CATEGORY 1A 240 440 870 1000 1240
OPER1B OPERATION CATEGORY 1B 550 950 1320 1530 1850
OPER2 OPERATION CATEGORY 2 1100 2200 4400 4700 5900
OPER3A OPERATION CATEGORY 3A 1380 2500 5100 6000 8400
OPER3B OPERATION CATEGORY 3B 1500 3000 6500 7800 10000
OPER4A OPERATION CATEGORY 4A 2450 3900 9100 10500 13000
OPER4B OPERATION CATEGORY 4B 3000 5350 11300 13200 18900
OPER5 OPERATION CATEGORY 5 4000 5700 12600 14500 20800
OPER6 OPERATION CATEGORY 6 5300 6600 15400 18800 23100
OPER7 LAPAROSCOPY CHARGES 3700 4500 6400 7100 8900

II. THEATRE/LABOUR ROOM CHARGES General Cubicle S. Pvt. Pvt. Pvt. AC

OT1 OT CATEGORY 1 180 350 530 630 800
OT1A OT CATEGORY 1A 220 400 610 730 900
OT1B OT CATEGORY 1B 500 720 890 1000 1220
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OT2 OT CATEGORY 2 800 1300 3000 3300 3800
OT3A OT CATEGORY 3A 1150 1700 3600 4100 4600
OT3B OT CATEGORY 3B 1150 2200 4200 4600 6000
OT4A OT CATEGORY 4A 1400 2300 5900 6800 7600
OT4B OT CATEGORY 4B 2000 3600 7600 8800 12200
OT5 OT CATEGORY 5 2600 3800 8000 9400 12700
OT6 OT CATEGORY 6 3130 4400 10000 11900 13800
OTC001 THEATRE ADDITIONAL CHARGES 300 420 540 600 660
Note: For Emergency Surgery the next higher category rate will be charged from category 3A onwaeds.

III. ANAESTHESIA CHARGES General Cubicle S. Pvt. Pvt. Pvt. AC

ANA1 ANAESTHESIA CATEGORY 1 110 190 280 330 400
ANA1A ANAESTHESIA CATEGORY 1A 130 210 330 380 450
ANA1B ANAESTHESIA CATEGORY 1B 250 390 460 520 660
ANA2 ANAESTHESIA CATEGORY 2 400 700 1500 1650 1900
ANA3A ANAESTHESIA CATEGORY 3A 575 850 1850 2100 2350
ANA3B ANAESTHESIA CATEGORY 3B 575 1150 2100 2350 3050
ANA4A ANAESTHESIA CATEGORY 4A 700 1200 2900 3450 3900
ANA4B ANAESTHESIA CATEGORY 4B 1000 1700 3700 4500 6200
ANA5 ANAESTHESIA CATEGORY 5 1300 1900 4000 4900 6700
ANA6 ANAESTHESIA CATEGORY 6 1500 2100 4700 6000 7000
ANA07 IV SEDATION 480 540 700 850 970

IV PAIN CLINIC General Cubicle S. Pvt. Pvt. Pvt. AC

ANA08 NERVE BLOCKS FOR CHRONIC PAIN 1150 1150 1725 1725 1725
ANA16 COELIAC PLEXUS BLOCK 1725 1725 2300 2300 2300
ANA17 SCAR/LOCAL INFILTRATION 850 850 1150 1150 1150
ANA18 FLUROSCOPY 300 300 575 575 575
Extra Charges:
a) Pharmacy
b) Disposables

OXYGEN CHARGES

I. OXYGEN General Private

OXY01 OXYGEN CHARGES PER HOUR ADULT 90 120
OXY02 OXYGEN CHARGES PER HOUR PAED. 70 120
OXY03 OXYGEN CHARGES PER DAY PAED. 660 1380
OXY04 OXYGEN CHARGES PER DAY ADULT 860 1380
OXY05 OXYGEN CHARGES PER HR. IN ICU ADULT 90 90
OXY06 OXYGEN CHARGES PER DAY ICU 860 860
OXY07 OXYGEN CHARGES PER HR IN ICU PAED 70 70
OXY08 OXYGEN CHARGES PER DAY IN ICU PAED 700 700
NOTE: 1) These rates apply for supply of Oxygen whether piped or cylinder.
2) In the Operation Theater and ICU charges at the above rates will for apply for the entire
period for which oxygen is supplied
Note:
1. Charges for Multiple Operation:

When 2 or more operations are performed in one sitting by the same surgeon, the following

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 shall be the basis of the charges:

1. Operation Fee: Full fee for the main operation plus 50% of the fee for Other operation.

2. OT Room Charges /
Anaesthesia Charges: Full charges in respect of the main operation up to 1 hour and thereafter
extra charges according to the duration.

2. Package Charge for Anaesthesia (Gases and Drugs):

Up to half an hour
Rs.630/-
Half an hour to one and half hour
Rs.1050/-
Each subsequent hour
Rs.400/-

General Semi Pvt. Private

Anaesthesia for Minor Procedures 575 575 575

Spinal 430 700 920

Epidural/Brachial Block 530 800 1100

Combined Spinal/Epidural CSE 700 1150 1500

Any other block 375 570 630

Labour Analgesia 950 1250 1900

3. PAC Charges 200 300 460

PACKAGE CHARGES FOR GENERAL SURGERY

Pvt.
S Pvt. S Pvt. Non PVT No. of
Code Service Name General Cubicle Non AC AC AC AC (S) days
GENERAL/UROLOGY/PAEDIATRIC SURGERY:

ALC LAPAROSCOPIC
CHOLECYSTECTOMY 19000 25100 33600 38600 43400 49800 04

APCNB P C N L BILATERAL 26000 36500 45900 52600 55700 65200 08

APCNL P.C.N.L. 21100 29700 37000 42900 46800 55100 06

ATURP TRANSURETHRA RESECTION OF

PROSTATE (T.U.R.P) 17100 21500 31000 36100 40100 47500 06

AURSD URS + DJ STENTING 18100 23800 32000 37000 41200 47500 03

AURSB URS + DJ STENTING BILATERAL 23500 31100 39200 45500 48300 56600 03

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APSB HERNIOTOMY BILATERAL 10000 14100 18500 21000 22500 25000 01

APSBO ORCHIOPEXY BILATERAL 11000 15000 19000 22000 23000 26000 01

HERNIOTOMY- UNILATERAL 6500 10500 14700 16900 18100 21400 01

ORCHIDOPEXY- UNILATERAL 7500 11500 15700 17900 19100 22400 01

CIRCUMCESION 5500 9000 12500 14000 15000 18000 01

RE-LOOK SURGERY FOR

ARKS KIDNEY STONE 7300 10000 12500 14500 15100 17800 --

Note:
a. Pharmacy to be charged extra.
b. Any Service provided beyond the package days shall be charged extra.
c. The package starts one day before the operation/procedure.

MISCELLANEOUS CHARGES

I. CERTIFICATE FEE:
1. Fitness Certificate 120
2. Other Certificates 120
3. Birth time certificate - up to 5 Yrs 120
- 5 - 10 Yrs 150
- above 10 Yrs 180
4. Correction of letters 60

II. Room Booking charges - Rs.400/-

III. Ambulance charges:

Rs.15/- per km. subject to a minimum of - Rs.300/- up to 11 km.

Waiting charges after 1/2 an hour will be - Rs.100/- per hour

If a Doctor or a Nurse accompanies the patient at the patient’s request, additional charge - Rs.500/-

During the NIGHT: from 8 p.m. to 6 a.m. extra charge - Rs.250/-

Ambulance will not be used for transporting the dead body.

IV. Mortuary charges:

Any inpatient who has expired in Hospital - Rs.300/- per day.

Dead Bodies brought from outside - Rs.1500/- per day.

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