महात्मा फुले जन आरोग्य योजना आजार यादी 2023

Diseases covers under Mahatma Phule Jan Arogya Yojana
महात्मा फुले जन आरोग्य योजना आजार यादी

महात्मा फुले जन आरोग्य – प्रधानमंत्री जन आरोग्य योजना

महात्मा फुले जन आरोग्य योजना आणि आयुष्मान भारत प्रधानमंत्री जन आरोग्य योजना या दोन्ही योजना एकत्र करून त्यात काही सुधारणा केल्या गेल्या आहेत.

या सुधारणा काय केल्या गेल्या आहेत आणि त्यामुळे काय फायदे होणार आहेत याबद्दल अधिक माहिती जाणून घेण्यासाठी इथे क्लिक करा

उपचार यादी – Mahatma Phule Jan Arogya Yojana list of diseases


या सुधारणा केल्यानंतर जे १३५६ उपचार या योजने अंतर्गत पुरवले जाणार आहेत त्याची यादी हि खाली दिलेली आहे.

खालील यादी खूप मोठी असल्याने तुम्ही जो उपचार हवा आहे तो शोधण्यासाठी, त्याचे नाव खालील इनपुट बॉक्स मध्ये टाईप करा:



Sr No Category Name Sub Category Name Name of the procedure
1 Burns Burns Above 60% Mixed Burns( With Surgeries) 10 days
2 Burns Burns Post Burn Contracture Surgeries For Functional Improvement (Package And
Physiotherapy)
Mild Contracture Surgeries For Functional Improvement (including splints, pressure garments And Physiotherapy)
3 Burns Burns Post Burn Contracture Surgeries For Functional Improvement (Package And
Physiotherapy)
Moderate Contracture Surgeries For Functional Improvement (including splints, pressure garments And Physiotherapy)
4 Burns Burns Post Burn Contracture Surgeries For Functional Improvement (Package And
Physiotherapy)
Severe Contracture Surgeries For Functional Improvement (including splints, pressure garments And Physiotherapy)
5 Burns Burns 30 - 40% Mixed Burns( With Surgeries)
6 Burns Burns 40- 60% Mixed Burns( With Surgeries)
7 Burns Burns 45 to 60% ( Conservative) 7 days
8 Burns Burns 10-30% Mixed Burns( With Surgeries)
9 Burns Burns 30 to 45% (Conservative) 7 days
10 Burns Burns Up To - 30% ( Conservative) -5 days 15 to 30% in Adults
5 to 30% in below 12 years patients
11 Cardiac And Cardiothoracic Surgery Vascular Injuries Abdominal Vascular Injuries - Aorta, Iliac Arteries, IVC, Iliac Veins without graft- Payable maximum
upto
12 Cardiac And Cardiothoracic
Surgery
Aortic dissection / aneurysm Intrathoracic Aneurysm-Aneurysm Not Requiring
Bypass (With Graft)
13 Cardiac And Cardiothoracic
Surgery
CVTS Valve Repairs Annulus Aortic Ectasia With Valved Conduits
14 Cardiac And Cardiothoracic
Surgery
Valve Replacement Aortic Valve Replacement (With Mechanical valve)
15 Cardiac And Cardiothoracic
Surgery
CVTS Aorto-Aorto Bypass With Graft
16 Cardiac And Cardiothoracic
Surgery
Vascular Arterial Embolectomy
17 Cardiac And Cardiothoracic
Surgery
Vascular Axillo Bifemoral Bypass With Synthetic Graft
18 Cardiac And Cardiothoracic
Surgery
Vascular Axillo Brachial Bypass Using With Synthetic Graft
19 Cardiac And Cardiothoracic
Surgery
Vascular Brachioradial Bypass With Synthetic Graft
20 Cardiac And Cardiothoracic
Surgery
CAD CABG Off Pump Without IABP
21 Cardiac And Cardiothoracic
Surgery
CAD CABG On Pump Without IABP
22 Cardiac And Cardiothoracic
Surgery
CAD CABG With Aneurysmal Repair
23 Cardiac And Cardiothoracic
Surgery
Vascular Carotid Artery Bypass With Synthetic Graft
24 Cardiac And Cardiothoracic
Surgery
CVTS Carotid Body Tumour Excision
25 Cardiac And Cardiothoracic
Surgery
CVTS Carotid Embolectomy
26 Cardiac And Cardiothoracic
Surgery
Coarctation Of Aorta Repair Coarctation Of Aorta Repair With Graft
27 Cardiac And Cardiothoracic
Surgery
Coarctation Of Aorta Repair Coarctation Of Aorta Repair Without Graft
28 Cardiac And Cardiothoracic
Surgery
CAD CABG Off Pump With IABP
29 Cardiac And Cardiothoracic
Surgery
CAD CABG On Pump With IABP
30 Cardiac And Cardiothoracic
Surgery
CVTS Chest Diaphragmatic Hernia
31 Cardiac And Cardiothoracic
Surgery
CVTS Femoro-Femoral Bypass With Graft
32 Cardiac And Cardiothoracic
Surgery
CVTS Chest Diaphragmatic Eventeration
33 Cardiac And Cardiothoracic
Surgery
Valve Replacement Double Valve Replacement (With mechnical Valve)
34 Cardiac And Cardiothoracic
Surgery
Vascular Excision Of AV Malformation without graft
35 Cardiac And Cardiothoracic
Surgery
Vascular Excision Of AV Malformation Large - with graft
36 Cardiac And Cardiothoracic
Surgery
CVTS Femoro Popliteal Bypass With Graft
37 Cardiac And Cardiothoracic
Surgery
Vascular Femorodistal Bypass With Synthetic Graft
38 Cardiac And Cardiothoracic
Surgery
Vascular Femorodistal Bypass With Vein Graft
39 Cardiac And Cardiothoracic
Surgery
CVTS Ileofemoral Bypass With Graft
40 Cardiac And Cardiothoracic
Surgery
Congenital heart disease Intracardiac Repair Of ASD
41 Cardiac And Cardiothoracic
Surgery
CVTS Intracardiac Repair Of VSD
42 Cardiac And Cardiothoracic
Surgery
CVTS Lungs Lobectomy
43 Cardiac And Cardiothoracic
Surgery
CVTS Lungs Lung Cyst
44 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Major Vascular Injury -In Lower Limbs-Repair
without graft- Payable maximum upto
45 Cardiac And Cardiothoracic
Surgery
Vascular Medium Size Arterial Aneurysms With Synthetic
Graft
46 Cardiac And Cardiothoracic
Surgery
CVTS Valve Repairs Valve Repair With Prosthetic Ring
47 Cardiac And Cardiothoracic
Surgery
CVTS Valve Repairs Valve Repair Without Prosthetic Ring / Supramitral
membrane
48 Cardiac And Cardiothoracic
Surgery
Valve Replacement Mitral Valve Replacement (With mechanical Valve)
49 Cardiac And Cardiothoracic
Surgery
Valve Replacement Mitral Valve Replacement (With biprosthatic Valve)
50 Cardiac And Cardiothoracic
Surgery
CVTS Valve Repairs Open Pulmonary Valvotomy
51 Cardiac And Cardiothoracic
Surgery
Vascular Medium Size Arterial Aneurysms - Repair
52 Cardiac And Cardiothoracic
Surgery
Vascular Peripheral Embolectomy Without Graft
53 Cardiac And Cardiothoracic Surgery Ross Procedure Intracardiac Repair Of Complex Congenital Heart
Diseases
Ross procedure - Intracardiac repair of complex congenital heart diseases With Special Conduits
54 Cardiac And Cardiothoracic Surgery Ross Procedure Intracardiac Repair Of Complex Congenital Heart
Diseases
Ross procedure - Intracardiac repair of complex congenital heart diseases Without Special Conduits
55 Cardiac And Cardiothoracic
Surgery
CVTS Ruptured Sinus Of Valsalva Correction
56 Cardiac And Cardiothoracic
Surgery
CVTS Lungs SOL Mediastinum
57 Cardiac And Cardiothoracic
Surgery
CVTS Surgery For Intracardiac Tumours
58 Cardiac And Cardiothoracic
Surgery
Cardiac Injuries Surgery With CPB
59 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Surgery With Vein Graft
60 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Surgery Without Graft For Arterial Injuries, Venous
Injuries
61 Cardiac And Cardiothoracic
Surgery
Systemic Pulmonary Shunts Systemic Pulmonary Shunts With Graft without
CPB
62 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Thoracic Vascular Injuries - Payable maximum upto
63 Cardiac And Cardiothoracic
Surgery
CVTS Thoracotomy, Thoraco Abdominal Approach
64 Cardiac And Cardiothoracic
Surgery
Surgical Correction Of
Bronchopleural Fistula
Transpleural BPF Closure/Myoplasty/Thoracoplasty
65 Cardiac And Cardiothoracic
Surgery
Valve Replacement Tricuspid Valve Replacement with mechanical valve
66 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Vascular Injuries Repair With Prosthetic Graft
67 Cardiac And Cardiothoracic Surgery Vascular Injuries Vascular Injury In Upper Limbs – Axillary,Branchial,Radial And Ulnar - Repair With
Vein Graft - Payable maximum upto
68 Cardiac And Cardiothoracic
Surgery
CVTS Thyomectomy
69 Cardiac And Cardiothoracic
Surgery
CVTS Pulmonary Valve Replacement - with mechanical
valve
70 Cardiac And Cardiothoracic
Surgery
CVTS Pulmonary arterio venous malformation
71 Cardiac And Cardiothoracic
Surgery
CVTS Surgery for Arterial Aneurysm Renal Artery with
graft / patch
72 Cardiac And Cardiothoracic Surgery CVTS Failed device closure for ASD and/or VSD.
Emergency retrieval of device with defect closure under cardiopulmonary bypass
73 Cardiac And Cardiothoracic
Surgery
CVTS Truncus Arteriosus surgery
74 Cardiac And Cardiothoracic
Surgery
CVTS Surgery for HOCM (Hypertrophic obstructive
cardiomyopathy)
75 Cardiac And Cardiothoracic
Surgery
Congenital heart disease Total correction of tetralogy of fallots (TOF)
76 Cardiac And Cardiothoracic
Surgery
CVTS TAPVC Correction
77 Cardiac And Cardiothoracic
Surgery
CVTS Surgery-PDA
78 Cardiac And Cardiothoracic
Surgery
Cvts Valve Repairs Open Mitral Valvotomy
79 Cardiac And Cardiothoracic
Surgery
Vascular Aorto Billac - Bifemoral Bypass With Synthetic
Graft
80 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Neck Vascular Injury - Carotid Vessels without
graft- Payable maximum upto
81 Cardiac And Cardiothoracic
Surgery
Pericardium Percardectomy without CPB
82 Cardiac And Cardiothoracic
Surgery
Systemic Pulmonary Shunts Systemic Pulmonary Shunts Without Graft without
CPB
83 Cardiac And Cardiothoracic
Surgery
Intracardiac repair - TOF with RVPA Conduit
84 Cardiac And Cardiothoracic Surgery Vascular Injuries Abdominal Vascular Injuries - Aorta, Iliac Arteries, IVC, Iliac Veins with graft - Payable maximum upto
85 Cardiac And Cardiothoracic
Surgery
Valve Replacement Aortic Valve Replacement (With Biprothatic Valve)
86 Cardiac And Cardiothoracic
Surgery
Valve Replacement Double Valve Replacement (With Biprosthatic
Valve)
87 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Major Vascular Injury -In Lower Limbs-Repair
with graft - Payable maximum upto
88 Cardiac And Cardiothoracic
Surgery
Vascular Injuries Neck Vascular Injury - Carotid Vessels with graft -
Payable maximum upto
89 Cardiac And Cardiothoracic
Surgery
CVTS Chest Thoracoplasty
90 Cardiac And Cardiothoracic
Surgery
Pericardium Percardectomy with CPB
91 Cardiac And Cardiothoracic
Surgery
Systemic Pulmonary Shunts Systemic Pulmonary Shunts With Graft with CPB
92 Cardiac And Cardiothoracic
Surgery
Systemic Pulmonary Shunts Systemic Pulmonary Shunts Without Graft with
CPB
93 Cardiac And Cardiothoracic
Surgery
Valve Replacement Tricuspid Valve Replacement with biprosthatic
valve
94 Cardiac And Cardiothoracic
Surgery
CVTS Pulmonary Valve Replacement - with biprosthatic
valve
95 Cardiac And Cardiothoracic
Surgery
CVTS On pump multivessel minimal invasive coronary
artery bypass grafting
96 Cardiac And Cardiothoracic
Surgery
CVTS Minimal invasive atrial/ventricular septal defect
closure
97 Cardiac And Cardiothoracic
Surgery
CVTS Minimal Invasive Aortic/Mitral valve replacement
with mechanical valve
98 Cardiac And Cardiothoracic
Surgery
CVTS Minimal Invasive Aortic/Mitral valve replacement
with bioprosthetic valve
99 Cardiac And Cardiothoracic
Surgery
CVTS Partial Anomalous pulmonary venous
connection/return
100 Cardiac And Cardiothoracic
Surgery
CVTS Minimal invasive valve repair with ring
101 Cardiac And Cardiothoracic
Surgery
Limb Ischaemia ICU Management of Acute Limb Ischaemia 4 days
102 Cardiac And Cardiothoracic
Surgery
Double valve replacement with tricuspid valve
repair - with ring
103 Cardiac And Cardiothoracic
Surgery
Double valve replacement with tricuspid valve
repair - without ring
104 Cardiac And Cardiothoracic
Surgery
Mitral valve replacement with tricuspid valve repair
with ring
105 Cardiac And Cardiothoracic
Surgery
Mitral valve replacement with tricuspid valve repair
without ring
106 Cardiac And Cardiothoracic
Surgery
Emergency IABP insertion
107 Cardiac And Cardiothoracic
Surgery
Carotid to brachial bypass with prosthetic graft
108 Cardiac And Cardiothoracic
Surgery
Aortic debranching surgery with prosthetic graft
109 Cardiac And Cardiothoracic
Surgery
Fontan Procedure
110 Cardiac And Cardiothoracic
Surgery
Open aortic Valvotomy/ Supra / Subvalvular Aortic
stenosis
111 Cardiac And Cardiothoracic Surgery TGA (Transposition of greater arteries) Arterial switch / Senning procedure / Mustard Procedure
112 Cardiac And Cardiothoracic
Surgery
Cardiac And Cardiothoracic Surgery Glenn Shunt (without cardiopulmonary bypass)
113 Cardiac And Cardiothoracic
Surgery
Cardiac And Cardiothoracic Surgery Thoracocentesis
114 Cardiac And Cardiothoracic
Surgery
Cardiac And Cardiothoracic Surgery Thrombendarterectomy
115 Cardiac And Cardiothoracic
Surgery
Cardiac And Cardiothoracic Surgery Encysted Empyema/Pleural Effusion - Tubercular
116 Cardiac And Cardiothoracic
Surgery
Cardiac And Cardiothoracic Surgery Thromboembolectomy usually done as emergency
by ETI)
117 Cardiology Cardiology Balloon Procedures Balloon Atrial Septostomy
118 Cardiology Cardiology VSD Device Closure
119 Cardiology Cardiology Acute MI Requiring IABP Pump - 7 Days
120 Cardiology Cardiology Acute MI With Cardiogenic Shock - 7 Days
121 Cardiology Cardiology ASD Device Closure
122 Cardiology Coarctation Of Aorta Repair /
Aortoplasty
Coarctation Of Aorta Repair With Stent
123 Cardiology Cardiology Complex Arrhythmias - 2 Days
124 Cardiology Angioplasty Coronary Ballon Angioplasty
125 Cardiology Cardiology Coil Closure Multiple Coils (MAPCA - Major
Aortopulmonary Collaterals)
126 Cardiology Cardiology Coil Closure Single Coil (PDA etc)
127 Cardiology Cardiology PDA Stenting
128 Cardiology Cardiology Pericardial Effusion / Tamponade - 4 days
129 Cardiology Angioplasty Peripheral Angioplasty
130 Cardiology Cardiology Pacemaker Implantation Single chember Permanent Pacemaker Implantation
- 5 Days
131 Cardiology Angioplasty PTCA Additional Stent
132 Cardiology Cardiology Pulmonary Embolism - 5 Days
133 Cardiology Cardiology Refractory Cardiac Failure - 5 Days
134 Cardiology Angioplasty Renal Angioplasty
135 Cardiology Cardiology Simple Arrhythmias - 2 Days
136 Cardiology Cardiology Pacemaker Implantation Temporary Pacemaker Implantation - 2 Days
137 Cardiology Angioplasty Vertebral Angioplasty
138 Cardiology Cardiology Pulmonary artery stenting
139 Cardiology Cardiology Pulmonary artery stenting (double)
140 Cardiology Cardiology Right ventricular outflow tract (RVOT) stenting
141 Cardiology Cardiology Percutaneous Transluminal Tricuspid
Commissurotormy (PTTC)
142 Cardiology Cardiology Coronary - Cameral Fistula closure / Pulmonary AV
fistula Closure /PDA Device Closure
143 Cardiology Coarctation Of Aorta Repair /
Aortoplasty
Baloon dilatation of Coarctation of Aorta Without
Stent
144 Cardiology Cardiology Balloon Procedures Percutaneous Balloon Dilatation procedures in
Cardiology
145 Cardiology Device closure of RSOV (Rupture of Sinus of
Valsalva Aneurysm)
146 Cardiology Post MI Ventricular septal Rupture - Device closure
147 Cardiology Alcohol septal ablation for hypertrophic
Obstructive Cardiomyopathy
148 Cardiology Cardiology PTSMA (Percutaneous Transluminal Septal
Myocardial Ablation)
149 Cardiology / Interventional
Radiology
Vascular D V T - IVC Filter
150 Critical Care Critical Care Acute Bronchitis And Pneumonia With Respiratory Failure, Ventilator 8 Days Stay - Rs 6000 per day.
Rs 50000 if completed LOS
151 Critical Care Critical Care Acute Severe Asthma With Acute Respiratory
Failure 10 Days ICU Stay. Rs 45000 if complete stay of 10 days.
152 Critical Care Critical Care ARDS With Ventilatory Care 10 Days Stay. Rs
65000 if LOS complete.
153 Critical Care Critical Care ARDS Plus DIC (Blood & Blood Products) With
Ventilatory Care - 14 Days
154 Critical Care Critical Care ARDS With Multi Organ Failure With Ventilatory
Care 14 Days Stay
155 Critical Care Critical Care COPD Respiratory Failure (Infective Exacerbation) 11 Days Stay with ventilator support. Rs 70000 will be approved if LOS 11 days
156 Critical Care Critical Care OP Poisoning / Other Poisoning Requiring Ventilatory Assistance Clinical Photo - 5 days Stay
157 Critical Care Critical Care Septic Shock(ICU Management) With Ventilatory
Assistance - 7 Days
158 Critical Care Critical Care OP or other Poisoning without Ventilatory
Assistance Clinical Photo 7 days ICU Stay
159 Critical care Critical care Cavernous / Saggital Sinus Thrombosis 10 Days
Stay
160 Critical care Critical care Snake bite with Coagulopathy without Dialysis 7
days
161 Critical care Critical care Snake bite with Coagulopathy with Dialysis 7 days
162 Critical care Critical care Acute liver failure with Coagulopathy - 5 days
163 Dermatology Dermatology Pemphigus / Pemphigoid Tzanck Clinical Protocol
15 Days Stay
164 Dermatology Dermatology Stevens- Johnson Syndrome 5 Days ICU Stay
165 Dermatology Dermatology Toxic Epidermal Necrolysis 7 Days ICU Stay. Rs
30000 if LOS 7 days complete
166 Dermatology Dermatology Psoriatic erythroderma/ Arthropathy 3 days stay
167 Dermatology Dermatology Urticaria and Atopic dermatitis 5days stay
168 Dermatology Dermatology Hidradenitis suppurativa 5 days stay
169 Dermatology Dermatology Leprosy and recurrent lepra reactions 10 days stay
170 Endocrinology Other Endocrinal Disorders Pituitary - Acromegaly (Injections/tablets to be given of 6 months) (three day indoor stay) - Cost of
6 months Medicines
171 Endocrinology Other endocrinal disorders Hypopitutarism (Injections/tablets to be given of 6
months duration) (three day indoor stay)
172 Endocrinology Other Endocrinal Disorders Endogenous Cushings Syndrome (minimum three day stay)(Injections/tablets to be given of 6 months
duration)
173 Endocrinology Other Endocrinal Disorders Turner syndrome/ Prader willi syndrome , three Days indoor Stay (Injections/tablets to be given of 6
months duration)
174 Endocrinology Endocrinology Adrenal Insufficiency - (medicines should be given
for 6 months duration)(3 day indoor stay)
175 Endocrinology Endocrinology Endogenous Hyperthyroidism with or without
Graves opthalmopathy (3 day indoor stay)medicines to given for 6 months
176 Endocrinology Endocrinology Gonadotropin releasing hormone excess state, 3 day indoor stay(medicines to be given for 6 months
duration)
177 Endocrinology Endocrinology Prolactin Excess (Prolactinoma) medicines to be
given for 6 months duration) (3 day indoor stay)
178 Endocrinology Endocrinology PTH deficiency/ PTH resistance/ Vit D resistance
states/Renal rickets (medicines to be given for 6 months duration)(3 day indoor stay)
179 Endocrinology Endocrinology Thyrotoxic crisis - Routine Ward - 1500 ICU (without Ventilator) - 4000
ICU (with Ventilator) - 6000 - 5 Days
180 Endocrinology Endocrinology Somatostatin expressing neuroendocrine lesions (hyperinsulinemic hypoglycemia, tumor induced osteomalacia, thymic, pancreatic, GI- NET)(medicines to be given for 6 months
duration)(3 day indoor stay)
181 Endocrinology Endocrinology Osteoporosis medicines (denosumab/ PTH) to be given for 6 months duration)(2 day indoor stay)
182 ENT ENT Surgery Drainage of Peritonsillor abscess
183 ENT Head And Neck Hemi/Subtotal/ Total thyroidectomy for Benign
Thyroid lesion
184 ENT Head And Neck Partial Glossectomy
185 ENT Head And Neck Removal Of Submandibular Salivary Gland
186 ENT Congenital Malformations Velo-Pharyngial Incompetence
187 ENT ENT Antrostomy - Bilateral
188 ENT ENT Rhinotomy – Lateral
189 ENT ENT Excision of CA cheek/ oral cavity + radial forearm
flap
190 ENT ENT Surgery Rhinocerebral Mucormycosis 10 Days Stay
191 ENT ENT Surgery Fungal Sinusitis Pns 10 Days Stay
192 ENT ENT Surgery Myringoplasty
193 ENT ENT Surgery Myringotomy without grommet insertion
194 ENT ENT Surgery Fracture setting nasal bone with surgical
intervention
195 ENT ENT Surgery Septo-rhinoplasty
196 ENT Throat Adenoidectomy
197 ENT Nose Angiofibroma Nose
198 ENT Hearing Aid Behind The Ear Analogue Hearing Aid
199 ENT Head And Neck Brachial Cyst / Sinus Excision
200 ENT Bronchial Injuries Bronchial Injuries Due To Foreign Body Repair
Surgery
201 ENT ENT Surgery Bronchoscopic Foreign Body Removal
202 ENT Head And Neck Cystic Hygroma Excision
203 ENT Nose Endoscopic DCR
204 ENT Nose Endoscopic Sinus Surgery
205 ENT Nose Excision Of Benign Tumour Nose
206 ENT Head And Neck Excision Of Thyroglossal Cyst Fistula
207 ENT Throat Excision Of Tumours In Pharynx
208 ENT Head And Neck Hemimandibulectomy
209 ENT Ear Labyrinthectomy
210 ENT Throat Laryngo Fissure
211 ENT Throat Microlaryngeal Surgery
212 ENT Head And Neck Parathyroidectomy
213 ENT Head And Neck Parotid Duct Repair
214 ENT Throat Phono Surgery For Vocal Cord Paralysis
215 ENT Nose Modified radical Mastoidectomy / Radical
mastoidectomy
216 ENT Head And Neck Segmental Mandible Excision
217 ENT Ear Stapedectomy + Veingraft
218 ENT Ear Tympanoplasty
219 ENT Throat Uvulo-Palato Pharyngoplasty
220 ENT Throat Tonsillectomy
221 ENT Myringoplasty with Ossiculoplasty
222 ENT ENT Surgery Cochlear Implant surgery for Children below 2
Years
223 ENT ENT Surgery Sailo endoscopy for removal of Salivary gland stone
224 ENT ENT Myringotomy with Grommet - One ear
225 ENT ENT Ossiculoplasty
226 ENT ENT Skull base surgery
227 ENT ENT Antrostomy - Unilateral
228 ENT ENT Septoplasty
229 ENT ENT Fracture - setting nasal bone
230 ENT ENT Turbinectomy Partial - bilateral
231 ENT ENT Turbinectomy Partial - unilateral
232 ENT ENT Radical fronto ethmo sphenodectomy
233 ENT ENT Intranasal Diathermy
234 ENT ENT Ranula excision
235 ENT ENT Nasal polypectomy – Unilateral single or multiple
236 ENT ENT Tympanotomy
237 ENT ENT Youngs operation
238 ENT ENT Arytenoidectomy
239 ENT ENT Choanal atresia
240 ENT ENT Pharyngeal diverticulum's – Excision
241 ENT ENT Laryngophayryngectomy
242 ENT ENT Oro Antral fistula
243 ENT ENT Parapharyngeal / Retropharyngeal Abscess –
Drainage
244 ENT ENT Laryngopharyngectomy with Gastric pull-up/
jejunal graft
245 ENT ENT Intra Nasal Ethmoidectomy
246 ENT ENT Ethmoidectomy – External
247 ENT FESS
248 General Medicine Critical Care Gen Medicine Sickle cell Crisis presenting with Fever, Joint pains, Tachycardia) per day including PCV administration. General ward
1500
ICU - 4000
ICU with NIV - 5000
ICU with invasive ventilator 6000 - 5 days stay
249 General Medicine Critical Care Gen Medicine Cerebral Malaria management with or without
Ventilatory support and treatment - 10 Days
250 General Medicine Critical Care Gen Medicine Metabolic Coma with or without Ventilatory
Support per day - 7 days stay - 6000 per day
251 General Medicine Critical Care Gen Medicine Scorpion Sting Requiring Ventilator Support per
day - 6000 per day - 5 Days
252 General Medicine Critical Care Gen Medicine Snake Bite Requiring Ventilator Support - 10 Days
stay
253 General Medicine Critical Care Gen Medicine TB Meningitis or Tuberculoma 10 days - ICU Stay
254 General Medicine Critical Care Gen Medicine Thrombocytopenia With Bleeding Diathesis 7 days
255 General Medicine General Medicine Rituximab Treatment for Neurological, Rheumatological, Nephrological Haematological and dermatological problems 15 days
256 General Medicine General Medicine Acute inflammatory demyelinating
polyneuropathy
257 General Medicine General Medicine Metabolic encephalopathy/encephalitis due to any
cause
258 General Medicine General Medicine Hyperosmolar Non-Ketotic coma
259 General Medicine General Medicine Acute transverse myelitis
260 General Medicine General Medicine Cerebral sino-venous thrombosis
(any Isolated/Multiple sinovenus thrombosis without involvment of cavernous sinus) Renamed as independent procedure
261 General Medicine / Cardiology Cardiology Thrombolytic Therapy for Acute MI - 5 Days
262 General Medicine / Cardiology Cardiology NSTEMI / Evolved MI - 5 Days stay
263 General Medicine / Cardiology Cardiology Acute LVF (Known IHD / Valvular Heart Disease. -
5 Days
264 General Medicine
/Endocrinology
Diabetes Diabetic Ketoacidosis - per day ICU Stay - 10 Days
265 General Surgery Endocrinology Uncontrolled
Diabetes Mellitus With Infectious Emergencies
Cholecystitis - Abd 10 Days Stay
266 General Surgery Abdomen AppendIcular Perforation
267 General Surgery Head And Neck Cervical Rib Excision
268 General Surgery Abdomen Large Intestine Colostomy Closure for Malignant and Non
malignant conditions
269 General Surgery Abdomen Large Intestine Colostomy for Malignant and Non Malignant
conditions
270 General Surgery Pancreas Cystogastrostomy / Cystojejunostomy
271 General Surgery Abdomen Hernia Epigastric Hernia With Mesh
272 General Surgery Abdomen Hernia Epigastric Hernia Without Mesh
273 General Surgery Abdomen Stomach, Duodenum,
Jejunum
Gastrostomy
274 General Surgery Abdomen Stomach, Duodenum,
Jejunum
Gastrostomy Closure
275 General Surgery Abdomen Hernia Hiatus Hernia Repair Abdominal
276 General Surgery Abdomen Small Intestine Ileostomy
277 General Surgery Abdomen Small Intestine Ileostomy Closure
278 General Surgery Abdomen Small Intestine Intussusception
279 General Surgery Abdomen Lap. Appendectomy
280 General Surgery Gall Bladder Lap.Cholecystectomy
281 General Surgery Abdomen Large Intestine Left Hemi Colectomy
282 General Surgery Abdomen Large Intestine Mal-Rotation & Volvulus Of The Midgut
283 General Surgery Abdomen Small Intestine Operation For Acute Intestinal Obstruction
284 General Surgery Abdomen Small Intestine Operation For Duodinal / Jejunal / Ileal Perforation
285 General Surgery Abdomen Stomach, Duodenum,
Jejunum
Operation For Bleeding Peptic Ulcer
286 General Surgery Abdomen Small Intestine Operation For Haemorrhage Of The Small Intestine
287 General Surgery Abdomen Burst abdomen (Complete Dehiscence) closure
288 General Surgery Abdomen Large Intestine Operation For Volvulus Of Large Bowel
289 General Surgery Abdomen Large Intestine Operation Of The Duplication Of The Intestines
290 General Surgery Abdomen Small Intestine Operations For Recurrent Intestinal Obstruction
(Noble Plication Other)
291 General Surgery Abdomen Stomach, Duodenum,
Jejunum
Partial/Subtotal Gastrectomy For Ulcer
292 General Surgery Abdomen Rectum And Anus Pull Through Abdominal Resection
293 General Surgery Abdomen Stomach, Duodenum,
Jejunum
Pyloromyotomy
294 General Surgery Abdomen Hernia Rare Hernias (Spigalion,Obuturator,Sciatic)
295 General Surgery Gall Bladder Repair Of CBD
296 General Surgery Abdomen Small Intestine Resection & Anastomosis Of Small Intestine
297 General Surgery Head And Neck Thyroid Non
Malignant
Resection Enucleation
298 General Surgery Abdomen Large Intestine Right Hemi Colectomy
299 General Surgery Breast Simple Mastectomy(NM)
300 General Surgery Spleen Splenectomy For Hypersplenism
301 General Surgery Spleen Splenorenal Anastomosis
302 General Surgery Genitourinary Suprapubic Cystostomy
303 General Surgery Abdomen Large Intestine Total Colectomy
304 General Surgery Abdomen Hernia Umbilical Hernia With Mesh
305 General Surgery Abdomen Hernia Umbilical Hernia Without Mesh
306 General Surgery Abdomen Hernia Ventral And Scar Hernia With Mesh
307 General Surgery Abdomen Hernia Ventral and Scar Hernia Without Mesh
308 General Surgery Spleen Warren Shunt
309 General Surgery General Surgery Drainage of Ischio Rectal Abscess with minimum 2
followup dressings
310 General Surgery General Surgery Drainage of Intra abdominal abscess Fr ex - Psoas Abscess, Pelvic abscess, Appendicular abscess etc
with minimum 2 followup dressings
311 General Surgery General Surgery Drainage of liver Abscess
312 General Surgery General Surgery Excision Pilonidal Sinus
313 General Surgery General Surgery Eversion of Hydrocele Sac- unilateral
314 General Surgery General Surgery Haemorroidectomy+ Fistulectomy with or without
sphinctor repair
315 General Surgery General Surgery Varicose Veins - Radiofrequency Ablation /
Excision and Ligation
316 General Surgery General Surgery Anal fissures with or without Sphincterotomy with
anal dilatation
317 General Surgery General Surgery Inguinal Hernia Repair
318 General Surgery General Surgery Surgery on Rectal prolapse
319 General Surgery General Surgery Haemorroidectomy
320 General Surgery General Surgery Scrotal Swelling (Multiple) – Excision
321 General Surgery General Surgery Drainage of perivertebral abscess
322 General Surgery General Surgery Ligation of Ankle Perforators
323 General Surgery General Surgery Benign Retroperitoneal Tumor – Excision
324 General Surgery General Surgery Benign Submandibular Lymph node – Excision
325 General Surgery General Surgery Benign Submandibular Mass Excision +
Reconstruction
326 General Surgery General Surgery Rib Resection & Drainage for empyema in adults
327 General Surgery General Surgery Excision of salivary glands
328 General Surgery Gall Bladder Open Cholecystectomy
329 General Surgery General Surgery Surgery of low fistula in ano
330 General Surgery General Surgery Surgery of high fistula in ano
331 General Surgery Abdomen Mesentric cyst excision
332 General Surgery General Surgery Dermoid Cyst – Excision
333 General Surgery General Surgery Incision and Drainage of large Abscess with
minimum 2 followup dressings
334 General Surgery General Surgery Bakers Cyst – Excision
335 General Surgery General Surgery Hydrocele + Orchidectomy / Epidydectomy
336 General Surgery General Surgery Fibroadenoma - unilateral
337 General Surgery General Surgery Evacuation of Scrotal Hematoma
338 General Surgery General Surgery Excision Benign Tumor -Small intestine
339 General Surgery General Surgery Excision Mammary Fistula
340 General Surgery General Surgery Excision of Neurofibroma
341 General Surgery General Surgery Exicision of Sinus and Curettage
342 General Surgery General Surgery Excision and Skin Graft of Venous or non healing
Ulcer Unilateral,single
343 General Surgery General Surgery Excision and Skin Graft of Venous or non healing
Ulcer Unilateral, multiple
344 General Surgery General Surgery Mesenteric Cyst – Excision
345 General Surgery General Surgery Rectopexy
346 General Surgery General Surgery Resection Anastomosis (Large Intestine)
347 General Surgery General Surgery Umbilical Sinus – Excision
348 General Surgery General Surgery Debridement of Ulcer-Leprosy And 3 follow up
dressing
349 General Surgery General Surgery Free Grafts - Wolfe Grafts
350 General Surgery General Surgery Cervial Lymphnodes / Cervical swelling
351 General Surgery General Surgery Cystic mass – Excision
352 General Surgery General Surgery Ganglion - Excision
353 General Surgery General Surgery Granuloma - Excision
354 General Surgery General Surgery Lipoma in lower limb
355 General Surgery General Surgery Excision Meckel's Diverticulum Isolated
356 General Surgery General Surgery Gastric Perforation Isolated
357 General Surgery General Surgery Cyst over Scrotum – Excision
358 General Surgery General Surgery Epidymal Cyst
359 General Surgery General Surgery Branchial Fistula
360 General Surgery General Surgery Drainage of intraperitoneal Abscess
361 General Surgery General Surgery I and D cold Abscess minimum 2 follow up dressing
362 General Surgery General Surgery Benign Soft Tissue Tumor – Excision
363 General Surgery /
Cardiovascular Surgery
Head And Neck Carotid Body-Tumours Excision
364 Gynaecology And Obstetrics
Surgery
Obstetrics Abruptio Placenta With Coagulation Defect - DIC
365 Gynaecology And Obstetrics
Surgery
Obstetrics Obstetric Hysterectomy /Internal iliac ligation With
or without Bladder Repair
366 Gynaecology And Obstetrics
Surgery
Gynaecology Cystocele,Rectocele & Perineorraphy
367 Gynaecology And Obstetrics
Surgery
Obstetrics Eclampsia With Complication Requiring
Ventilatory Support
368 Gynaecology And Obstetrics
Surgery
Gynaecology Laparoscopic Adhesolysis (G)
369 Gynaecology And Obstetrics
Surgery
Gynaecology Laparoscopic Cystectomy
370 Gynaecology And Obstetrics
Surgery
Gynaecology Surgical management of ruptured ectopic pregnancy
371 Gynaecology And Obstetrics
Surgery
Gynaecology Laparoscopic Myomectomy
372 Gynaecology And Obstetrics
Surgery
Gynaecology Laparoscopic Ovarian Drilling
373 Gynaecology And Obstetrics
Surgery
Gynaecology Laparoscopic Recanalisation
374 Gynaecology And Obstetrics
Surgery
Gynaecology Laparoscopic Sling Operations
375 Gynaecology And Obstetrics
Surgery
Gynaecology LAVH
376 Gynaecology And Obstetrics
Surgery
Gynaecology Mc Indo-S Repair For Vaginal Atresia
377 Gynaecology And Obstetrics
Surgery
Obstetrics Rupture Uterus
378 Gynaecology And Obstetrics
Surgery
Gynaecology Slings With Mesh Repair For Prolapse
379 Gynaecology And Obstetrics
Surgery
Gynaecology Vaginal Hysterectomy
380 Gynaecology And Obstetrics
Surgery
Gynaecology Vaginal Hysterectomy With Pelvic Floor Repair
381 Gynaecology And Obstetrics
Surgery
Gynaecology Vault Prolapse Abdominal / Vaginal Repair With or
without Mesh
382 Gynaecology And Obstetrics
Surgery
Gynaecology Perineal/ Vesico-vaginal/ Recto-vaginal tear repair
383 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery LLETZ (Large Loop Excision of the transformation
zone )
384 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Tuboplasty (G)
385 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Hysteroscopic adhesiolysis
386 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Abdominal Hysterectomy
387 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Repair for rectovaginal fistulas / Vsicovaginal fistula
388 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Hysteroscopic myomectomies
389 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Hysteroscopic polypectomy
390 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Cervical Polypectomy
391 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Cyst-Labial / Bartholin cyst enucleation
392 Gynaecology And Obstetrics
Surgery
Gynaecology And Obstetrics Surgery Bartholins Cyst Incision drainage / Enucleation
393 Haematology Haematology Oral Chelation Therapy for Thalassemia or Thalassemia and Sickle cell combination - Day care blood transfusion (PCV or Whole blood) Leucodepleted or NAT tested or Leucodepletion
filter.
394 Haematology Haematology Haemophilia A treatment with , Recombinant or
Plasma derived Factor VIII Day Care procedure
395 Haematology Haematology Anaemia treated with Haematinics, Blood Transfusion etc for per day - Rs 2000 per day -
Length of stay 2 Days
396 Haematology Haematology Thalassemia trasfusion dependant or Thalassemia and Sickle cell combination requiring parental Chelation therapy - Day care blood transfusion (PCV or Whole blood) Leucodepleted or NAT tested or Leucodepletion filter.
397 Haematology Haematology Haemophilia with Inhibitors treatment by Factor VII or FEIBA or Emisuzmad (Hemlibra) for Haemophilia A with inhibitor - Day Care procedure
398 Haematology Haematology Aplastic Anaemia with ATG+Cyclosporin+Eltrombopeg /
Danazol+Cyclosporin+Eltrombopeg - 7 Days
399 Haematology Haematology Immune Thrombocytopenia per month
400 Haematology Haematology Haemophilia A with VWF deficiency - Treatment with factor VIII with VWF - Day care procedure
401 Haematology Haematology Hemophilia B with Plasma derived / Recombinant Factor IX
Day care
402 Haematology Haematology Immune Thrombocytopenia per month with
immunosupressants
403 Haematology Haematology Immune Thrombocytopenia per month with Oral
TPO agonist
404 Haematology Haematology Immune Thrombocytopenia per month with
Injectable TPO agonist
405 Haematology Haematology Autoimmune hemolytic Anaemia with Rituximab
Rs 80000 per month
406 Haematooncology / Medical Oncology Non Hodgkin's Lymphoma and others -CHOEP Cyclophosphamide 750mg/m2 D1 Vincristine 1.4mg/m2 D1 Adriamycin 50 mg/m2 D1 Etoposide 100mg/m2 D1-3
Prednisolone 100 mg D1-5 Every 21days. Total 6 cycles
407 Haematooncology / Medical Oncology AEVD Lymphoma and others
Adriamycin 25mg/m2 Vinblastine 6mg/m2 Dacarbazine 375 mg/m2
Day 1,15
Etoposide 65mg/m2 Day 1-3, 15-17
Every 28 days for 6 cycles
408 Haematooncology / Medical Oncology Multiple Myeloma / Plasma Cytoma Pomalidomide + Dexamethasone Pomalidomide 4 mg
daily Day 1-21 Dexamethasone 40mg Day 1, 8, 15, 22
Every 28 days
409 Haematooncology / Medical Oncology Langerhans Cell Histiocytosis (Histiocytosis
Protocol - Induction)
410 Haematooncology / Medical Oncology Langerhans Cell Histiocytosis (Histiocytosis
Protocol - Maintenance)
411 Infectious diseases Infectious Diseases Diphtheria Complicated 10 days
412 Infectious diseases Infectious Diseases Cryptococcal Meningitis 21 days
413 Infectious diseases Infectious Diseases Tetanus Severe 21 days
414 Interventional Radiology Interventional Radiology Acute Stroke Thrombolysis With rTPA
415 Interventional Radiology Interventional Radiology Balloon Retrograde Transvenous Obliteration Of
Bleeding Gastric Varices ( BRTO)
416 Interventional Radiology Interventional Radiology Biliary Drainage Procedures - External Drainage
And Stent Placement - Single Metallic Stent
417 Interventional Radiology Interventional Radiology Bronchial Artery Embolization In Hemoptysis
Using PVA And Micro Catheter
418 Interventional Radiology Interventional Radiology Carotid Stenting Single Stent With Protection
Device
419 Interventional Radiology Interventional Radiology Central Venous Stenting For Central Venous Occlusion ( Brachiocephalic or Subclavian Vein or Sup Vena Cava or Common Iliac Vein ) Single
Metallic Stent
420 Interventional Radiology Interventional Radiology Chemo Embolization For Liver Tumors or
metastases Using Drug And PVA Or DC Beads
421 Interventional Radiology Interventional Radiology Cortical Venous Sinus Thrombolysis
422 Interventional Radiology Interventional Radiology Deep Venous Thrombolysis For DVT With IVC
Filter
423 Interventional Radiology Interventional Radiology Embolization Of AV Malformation Of Brain Per
Sitting With Onyx
424 Interventional Radiology Interventional Radiology Embolization of AV Malformation Of Peripheral
Extremity or Craniofascial or Visceral Per Sitting
425 Interventional Radiology Interventional Radiology Embolization Of Caratico-Cavernous Fistula
426 Interventional Radiology Interventional Radiology Embolization Of Postoperative or Post Traumatic
Bleeding
427 Interventional Radiology Interventional Radiology Embolization Of Pulmonary AV Malformation Post Procedure Evidence Of Clinical Photograph And
Radiographic Image
428 Interventional Radiology Interventional Radiology Endovascular Intervention For Salvaging
Hemodialysis AV Fistula
429 Interventional Radiology Interventional Radiology Gastrointestinal Visceral Arterial Embolization In
Upper or Lower Gastrointestinal Bleeding With Microcatheter
430 Interventional Radiology Interventional Radiology Hepatic Vein Stenting In Budd - Chiari Syndrome
Single Stent
431 Interventional Radiology Interventional Radiology Inferior Vena Cava Filter Placement
432 Interventional Radiology Interventional Radiology Inferior Vena Cava Stenting Single Stent
433 Interventional Radiology Interventional Radiology Intra-Arterial Thrombolysis For Acute Ischemic
Limbs
434 Interventional Radiology Interventional Radiology Intracranial Arterial And Venous Stenting
435 Interventional Radiology Interventional Radiology Mesenteric Artery Angioplasty & Stenting In
Chronic Mesenteric Ischemia - Single Stent
436 Interventional Radiology Interventional Radiology Nephrostomy Tube And Nephroureteral Stent
Placement
437 Interventional Radiology Interventional Radiology Percutaneous Vertebro Plasty/ Cementoplasty (For Each Level) Post Procedure Evidence Of Clinical
Photograph And Radiographic Image
438 Interventional Radiology Interventional Radiology Peripheral Stent Graft For aorta or Peripheral
Aneurysms And AV Fistulae
439 Interventional Radiology Interventional Radiology Preoperative Portal Vein Embolization For Liver
Tumors
440 Interventional Radiology Interventional Radiology Preoperative Prophylactic Tumor Embolization
441 Interventional Radiology Interventional Radiology Radiofrequency Tumor Ablation Therapy
442 Interventional Radiology Interventional Radiology Renal Artery Embolization With Multiple Coils
And Microcatheter
443 Interventional Radiology Interventional Radiology Subclavian Artery Stenting with stent
444 Interventional Radiology Interventional Radiology Tibial Angioplasty In Critical Limb Ischemia
445 Interventional Radiology Interventional Radiology Trans Jugular Intrahepatic Portosystemic Shunt
(TIPSS)
446 Interventional Radiology Interventional Radiology Uterine Artery Embolization In Severe Menorrhagia Secondary To PPH or Uterine Fibroids or AVM
447 Interventional Radiology Interventional Radiology Intracranial clot retrieval
448 Interventional Radiology Interventional Radiology Central Venous Balloon plasty For Central Venous Occlusion ( Brachiocephalic or Subclavian Vein or Sup Vena Cava or Common Iliac Vein ) Single
Metallic Stent
449 Interventional Radiology Interventional Radiology Catheter directed thrombolysis in acute Mesenteric
arterial or venous Ischemia
450 Interventional Radiology Interventional Radiology Iliac Artery Stenting with stent
451 Interventional Radiology Interventional Radiology Superficial Femoral Artery Stenting With Stent.
452 Interventional Radiology Interventional Radiology Prostate artery embolisation in BPH or Haematuria
453 Interventional Radiology Interventional Radiology Arterial Chemoinfusion in malignant tumours
454 Interventional Radiology Interventional Radiology Microwave ablation for tumor
455 Interventional Radiology Interventional Radiology HIFU (High intensity focus ultrasound) or Cryoablation or IRE (Irreversible Eletroporration)
for tumor
456 Interventional Radiology Interventional Radiology Chemoport or Implantable lines
457 Interventional Radiology Interventional Radiology PICC line insertion for Chemotherapy or longterm
antibiotic infusion
458 Interventional Radiology Interventional Radiology USG or Fluoroscopy or CT guided percutaneous Neoronolysis for reducing pain in Cancer or Non
malignant conditions
459 Interventional Radiology Interventional Radiology Endovenous thermal ablation for one limb in
Vericose veins
460 Interventional Radiology Interventional Radiology Retrieval of foregn body for example IVC Filter or
device or IV line
461 Interventional Radiology / Nephrology Interventional Radiology Permanent Tunnelled Catheter Placement As Substitute For AV Fistula In Long Term Dialysis /
CAPD
462 Maxillo facial Surgery /
Plastic Surgery
Plastic Surgery Benign tumour Of Mandible And Maxilla - Excision
463 Maxillo facial Surgery /
Plastic Surgery
Plastic Surgery Benign tumour of Mandible And Maxilla - Excision
with reconstruction
464 Maxillo facial Surgery / Polytrauma Orthopedic And Facial Trauma Wound Management For Compound
Fractures
Facial Bone Fractures (Closed or Compound) - Single (Faciomaxillary Injuries)
465 Maxillo facial Surgery / Polytrauma Orthopedic And Facial Trauma Wound Management For Compound
Fractures
Facial Bone Fractures (Closed or Compound) - Multiple (Faciomaxillary Injuries)
466 Medical Gastroenterology Gastroenterology Achalasia Cardia - 7 Days Stay for POEM ( Peroral
Endoscopic Myotomy)
467 Medical Gastroenterology Gastroenterology Acute Pancreatitis (Mild) - 1 Week Stay With Post Treatment Evidence Of - Payable maximum upto
468 Medical Gastroenterology Gastroenterology Endoscopic stenting for Benign Biliary Stricture - 3
Days
469 Medical Gastroenterology Gastroenterology Chronic Pancreatitis With Severe Pain - 7 Days
Stay - Payable maximum upto
470 Medical Gastroenterology Gastroenterology Cirrhosis With Hepatic Encephalopathy -11 Days
Stay
471 Medical Gastroenterology Gastroenterology Cirrhosis With Hepato Renal Syndrome - 14 days
Stay
472 Medical Gastroenterology Gastroenterology Corrosive Oesophageal Injury 7 Days Stay
473 Medical Gastroenterology Gastroenterology Managemnt of acute pancreatitis with Acute
Pancreatitis With Pseudocyst / Walled off Necrosis 3 Weeks Stay - Payable maximum upto
474 Medical Gastroenterology Gastroenterology Gastric Varices / Ectopic varices 3 Days Stay
475 Medical Gastroenterology Gastroenterology GAVE (Gastric Antral Vascular Ectasia) - 2 Days
Stay
476 Medical Gastroenterology Gastroenterology Obscure GI Bleed - 1 Week Stay
477 Medical Gastroenterology Gastroenterology Oesophageal Varices, Sclerotherapy- One Day Stay
478 Medical Gastroenterology Gastroenterology Oesophageal Varices, Variceal Banding One Day
Stay
479 Medical Gastroenterology Gastroenterology Acute Pancreatitis (Severe) -2 Weeks Stay - Payable
maximum upto
480 Medical Gastroenterology Gastroenterology Albumin Therapy for Liver Cirrhosis, Nephrotic or
Nephritic Syndrome, Sepsis etc per day - 6000 per day - Length of stay 5 days
481 Medical Gastroenterology Gastroenterology Endoscopic management of Benign Oesphagial
Strictures 3 days
482 Medical Gastroenterology Gastroenterology Endoscopic management of GI Fistule / Perforation
/ Leak 10 stays stay
483 Medical Gastroenterology Gastroenterology Percutaneous endoscopic Gastrostomy - Day Care
484 Medical Gastroenterology Gastroenterology Endoscopic management of Non variceal GI
bleeding - 5 Days
485 Medical Gastroenterology Gastroenterology Endoscopic management of Malignant biliary
obstruction
486 Medical Gastroenterology Gastroenterology Endoscopic management of Malignant enteral or
luminal obstruction
487 Medical Gastroenterology Gastroenterology Steroid refarctory acute severe ulcerative colitis 3
weeks stay
488 Medical Gastroenterology Gastroenterology Achalasia Cardia Balloon Dilatation - Day Care
489 Medical Gastroenterology Gastroenterology ERCP For CBD /PD Stones - Day Care
490 Medical Gastroenterology Gastroenterology ESWL For CBD /PD Stones - Day Care
491 Medical Gastroenterology Gastroenterology Gastric / Colonic Polypectomy- Day Care
492 Medical Gastroenterology Gastroenterology Glue Insertion For Fundal Varices- Day Care
493 Medical Gastroenterology Gastroenterology Rectal Banding- Day Care
494 Medical Gastroenterology Gastroenterology Immunomodulatory refractory IBD (Inflammatory Bowel Disease) requiring Biologic Drug Therapy
(14 days stay)
495 Medical Gastroenterology Gastroenterology Endoscopic Management of Refractory Variceal
bleed - 5 days
496 Medical Gastroenterology Gastroenterology Endoscopic resection of Early GI Luminal
Malignant/ Premalignant lesions - 5 days
497 Medical Gastroenterology Gastroenterology Endoscopic Ultrasound guided coiling of Gatric
Varices - 3 days
498 Medical Gastroenterology Gastroenterology Endoscopic management of refractoty Non variceal GI bleeding with OTSC Placement- 5 Days
499 Medical Gastroenterology Gastroenterology Endoscopic bilary drainage in recurrent / refractory
benign biliary obstruction - 3 days
500 Medical Gastroenterology Gastroenterology Stricturising Crohn's Disease - 7 days
501 Medical Gastroenterology /
Surgical Gastroenterology
Gastroenterology Fistulising Crohn's disease - 5 Days
502 Medical Oncology/
Haematooncology
5- Flurouracil-Oxaliplastin Leucovorin (Folfox) - 2
weeks cycle
503 Medical Oncology/
Haematooncology
Cisplatin plus Adriamycin/Cisplatin plus
Ifosfamide/Ifosmide plus Adriamycin
504 Medical Oncology/
Haematooncology
Gestational Trophoblast Ds. High
Risk
Etoposide - Methotrexate - Actinomycin /
Cyclophosphamide vincristine (EMA-CO)
505 Medical Oncology/
Haematooncology
Methotraxate Vinblastin Adriamycin
Cyclophosphamide (MVAC)
506 Medical Oncology/
Haematooncology
Wilm'S Tumor SIOP/NWTS Regimen (Stages I III) - Per month
507 Medical Oncology/ Haematooncology Supportive Care Palliative And Supportive Therapy - Per month (Analgesics, Antibiotices, Nutrional supplements,
vitamins etc)
508 Medical Oncology/
Haematooncology
VIE (Vincristin, Ifosphamide,Etoposide) Inv -
Hematology, Biopsy - Payable maximum upto
509 Medical Oncology/
Haematooncology
Neuroblastoma Stage I –Iii Variable Regimen Inv - X-Ray/CT Scan - Payable
maximum upto/Per month
510 Medical Oncology/
Haematooncology
Medical Oncology Radioiodine ablation therapy for cancer thyroid
511 Medical Oncology/
Haematooncology
5- Flurouracil A-C (FAC)
512 Medical Oncology/
Haematooncology
Gestational Trophoblast Ds. Low
Risk
Actinomycin (Unlisted)
513 Medical Oncology/
Haematooncology
Adriamycin Bleomycin Vinblastin Dacarbazine
(ABVD) 2 weekly
514 Medical Oncology/
Haematooncology
Adriamycin/Cyclophosphamide (Ac) protocol 2
weekly or 3 weekly
515 Medical Oncology/
Haematooncology
Hormonal Treatment - Per month
(Letrozole/Tamoxifen)
516 Medical Oncology/
Haematooncology
Weekly Cisplastin
517 Medical Oncology/
Haematooncology
Bleomycin-Etoposide-Cisplastin (BEP) / VIP
Protocol - 3 weekly
518 Medical Oncology/
Haematooncology
Carboplastin/ Paclitaxel 3weekly
519 Medical Oncology/
Haematooncology
Cisplastin- 5FU
520 Medical Oncology/
Haematooncology
Cisplastin and Etoposide or Carboplatin and
etoposide
521 Medical Oncology/
Haematooncology
5-FU 2 weekly/Capacitabine 3 weekly
522 Medical Oncology/
Haematooncology
Anticancer therapy - Unlisted
Regimen
Chemotherapy -Unlisted Regimen - Payable
maximum upto per cycle
523 Medical Oncology/
Haematooncology
Vincristin-Actinomycin- Cyclophosphamide (VAC)
Based Chemo - Per Cycle
524 Medical Oncology/
Haematooncology
CAPOX
525 Medical Oncology/
Haematooncology
Medical Oncology Gemcitabine + cisplatin 21 days or Gemcitabin +
Carboplatin 21 days
526 Medical Oncology/
Haematooncology
Medical Oncology Temozolamide 28 days cycle
527 Medical Oncology/
Haematooncology
Paclitaxel/Docitaxel two or Three weekly
528 Medical Oncology/
Haematooncology
Palbociclib 21 days out of 28 day cycle
529 Medical Oncology/
Haematooncology
Pazopanib 30 days cycle
530 Medical Oncology/
Haematooncology
Regorafenib 21 days out of 28 day cycle
531 Medical Oncology/ Haematooncology Docetaxel + Cyclophosphamide Docetaxel
75mg/m2 D1 Cyclophosphamide 600 mg/m2 D1 every 21 days
532 Medical Oncology/ Haematooncology Fulvestrant Fulvestrant 500 mg D1
D15 D28 then every 28 days
533 Medical Oncology/
Haematooncology
Lapatinib plus Capecitabine
534 Medical Oncology/ Haematooncology Cisplatin + Irinotecan Cisplatin 60mg/m2 D1 Irinotecan 60 mg/m2 D1 D8 D15 every 28 days
535 Medical Oncology/ Haematooncology Lipodox + Carboplatin Lipopdox 30 mg/m2 D1
Carboplatin AUC 5-6 D1 every 28 days
536 Medical Oncology/ Haematooncology Lipodox
Lipodox 40 mg/m2 IV every 28 days
537 Medical Oncology/ Haematooncology Gemcitabine + Paclitaxel Gemcitabine 1000mg/m2 D1 D8 D15
Paclitaxel 100 mg/m2 D1 D8 D15 every 28
days
538 Medical Oncology/ Haematooncology Paclitaxel + Ifosfamide + Cisplatin Paclitaxel 240 mg/m2 D1 Ifosfamide 1500mg/m2 D2-D5 Mesna 300 mg/m2 0h 4h 8h D2-D5 Cisplatin 25mg/m2 D2-
D5 every 21 days
539 Medical Oncology/ Haematooncology Etoposide + Methotrexate + Dactinomycin + Cisplatin
Etoposide 100mg/m2 IV D1 D2 D8 Dactinomycin 0.5 mg IV push D1 D2 Methotrexate 300 mg
/m2 D1
Leucovorin 15 mg PO every 12 hrs for 4 doses Cisplatin 75mg/m2 D8 every 2 weeks
540 Medical Oncology/ Haematooncology Vincristine + Topotecan
+ Cyclophosphamide + Irinotecan + Temozolamide Vincristine 1.5mg/m2( day 1) Topotecan 1.5mg/m2 (day 1-5) Cyclophosphamide 250mg/m2 (days 1-5) Given every 3 weeks Irinotecan 10-50 mg/sqM days 1-5 and days 8-12 Temozolamide 100mg/m2 days 1-5 of each cycle every 3 weeks
541 Medical Oncology/ Haematooncology Methotrexate + Doxorubicin + Cisplatin for Relapsed Osteogenic Sarcoma Cisplatin 120mg/sq.m Doxorubicin 75mg/m2 Methotrexate 8-12 gram/m2
Each cycle for 5 weeks
542 Medical Oncology/ Haematooncology Dacarbazine + Cisplatin Dacarbazine 250mg/m2 D1-D5
Cisplatin 75 mg/m2
Every 21 days
543 Medical Oncology/ Haematooncology Capecitabine + Mitomycin C Capecitabine 825mg/m2 PO twice daily till completion of RT
Mitomycin 10mg/2 D1
544 Medical Oncology/ Haematooncology 5FU + Leucovorin + Irinotecan 5 FU 1200mg/m2 D1 D2
Leucovorin 400mg/m2 D1
Irinotecan 180mg/m2 85 mg/m2 D1 every 14 days
545 Medical Oncology/ Haematooncology Gemcitabine + Nanopaclitaxel Gemcitabine 1000mg/m2 D1 D8
Albumin bound Paclitaxel 125mg/m2 D1 D8
every 21 days
546 Medical Oncology/ Haematooncology Capecitabine + Gemcitabine Gemcitabine 1000mg/m2 D1 D8 D15
Capecitabine 830mg/m2 twice daily D1-D21
every 28 days
547 Medical Oncology/ Haematooncology Oxaliplatin + Gemcitabine Gemcitabine 1000 mg/m2 D1
Oxaliplatin 100 mg/m2 D1 every 14 days
548 Medical Oncology/ Haematooncology Cisplatin + Adriamycin + Cyclophosphamide Cisplatin 50 mg/m2 D1 Doxorubicin 50 mg/m2 D1
Cyclophosphamide 500 mg/m2 D1 every 21 days
549 Medical Oncology/ Haematooncology Cisplatin
Cisplatin 100mg/m2 every 21 days
550 Medical Oncology/ Haematooncology Cabozantinib 60 mg od x 1 month
every 4 weeks
551 Medical Oncology/ Haematooncology LHRH Agonist Leuprolide 22.5 ug
every 3 months
552 Medical Oncology/ Haematooncology Mitoxantrone + Prednisolone Mitoxantrone 12mg/m2 every 3 weeks
Prednsiolone 10 mg daily
553 Medical Oncology/ Haematooncology Vincristine + Carboplatin Vincristine 1.5mg/m2 (day 1, 8 and 15 for first 4 cycles and then only day 1 from cycle 5 to 17) Carboplatin 550mg/m2 every 3 weeks (all cycles)
554 Medical Oncology/
Haematooncology
Vinblastin Vinblastine 6 mg/m2 every week
555 Medical Oncology/
Haematooncology
PACKER
556 Medical Oncology/ Haematooncology Cisplatin + Cyclophosphamide + Vincristine Cyclophosphamide 1000mg/m2 (2 days every cycles) Vincristine 1.5mg/m2 (days 1 and 8) Cisplatin 100mg/m2 (1 day per cycle)
Cycles given every 3 weekly
557 Medical Oncology/
Haematooncology
Pediatric - Germ Cell Tumor / JEB
558 Medical Oncology/ Haematooncology Topotecan
Topotecan 1.5 mg/m2 D1-D5 every 21 days
559 Medical Oncology/ Haematooncology Vinorelbine + Carboplatin Vinorelbine 25mg/m2 D1 D8
CarboplatinAUC 5-6 D1
every 21 days
560 Medical Oncology/ Haematooncology Vinorelbine + Cisplatin Vinorelbine 25mg/m2 D1 D8
Cisplatin 75mg/m2 D1 every 21 days
561 Medical Oncology/ Haematooncology Denosumab Denosumab 120 mg s/c D1, 8, 15
then every 28 days
562 Medical Oncology/ Haematooncology Cyclophosphamide + Doxorubicin + Etoposide + Vincristine + Dactinomycin Vincristine 1.5 mg/m2 Dactinomycin 45 microgram/kg Adriamyicn 60mg/m2 Cyclophosphamide Etoposide
Weekly chemotherapy - varying hybrid regimen
563 Medical Oncology/ Haematooncology DCF protocol (Docetaxel + Cisplatin/Carboplatin + 5 Flurouracil) 2 or 3 weekly cycle
564 Medical Oncology/ Haematooncology FOLFIRINOX protocol (5 Flurouracil + Leucovorin + Irinotecan + Oxaliplatin) 2weekly
cycle
565 Medical Oncology/
Haematooncology
Lenvatinib 30 days
566 Medical Oncology/
Haematooncology
Paclitaxel + Trastuzumab weekly protocol
567 Medical Oncology/
Haematooncology
Trastuzumab 3 weekly protocol
568 Medical Oncology/
Haematooncology
Sorafenib 30 days
569 Medical Oncology/
Haematooncology
Abiraterone 30 days
570 Medical Oncology/
Haematooncology
Ibrutinib 30 days
571 Medical Oncology/
Haematooncology
Temozolomide Plus Capcitabine 28 Cycles or
Temozolomide plus Cisplatin 21 cycle)
572 Medical Oncology/
Haematooncology
FLOT protocol (Docetaxel + Oxaliplatin + 5
Flurouracil) 2 weekly cycle
573 Medical Oncology/
Haematooncology
Gemcitabine + Docetaxel (3 weekly protocol)
574 Medical Oncology/
Haematooncology
Bevacizumab 2weekly or 3weekly protocol
575 Mental Health Packages Mental Disorders Packages F20-F29
Schizophrenia, schizotypal and delusional disorders
- Rs. 2000 per day - Length of stay 10 days
576 Mental Health Packages Mental Disorders Packages F30-F39
Mood (affective) disorders - Rs. 2000 per day - Length of stay 10 days
577 Mental Health Packages Mental Disorders Packages Pre- Electro Convulsive Therapy - Rs 3000 per sitting
(ECT)
Transcranial Magnetic
Stimulation (TMS)Package. Three sittings. Rs 10000 if three sittings
578 Mental Health Packages Mental Disorders Packages Electro Convulsive Therapy (ECT) per setting
579 Mental Health Packages Mental Disorders Packages Substance use disorder - 30 days stay - Rs 1000 per
day
580 Mental Health Packages Mental Disorders Packages Psychotherapy / Counseling session (Per session)
581 Neonatal and Pediatric Medical Management Neonatal <32 Weeks Preterm Hyaline Membrane Disease Clinical/Culture Positive Sepsis Patent Ductus Arteriosus - Medical Management Mechanical Ventilation per day - Rs
6000 - 15 Days
582 Neonatal and Pediatric Medical Management Neonatal 32 To 36 Weeks Preterm Hyaline Membrane Disease
Clinical/ Culture Positive Sepsis Mechanical Ventilation - Rs 6000 per day - 2 Weeks
583 Neonatal and Pediatric Medical Management Neonatal 32-36 Weeks Preterm Hyaline Membrane Disease Clinical Sepsis Patent Ductus Arteriosus - Medical Management Mechanical Ventilation per day - Rs
6000- 14 Days
584 Neonatal and Pediatric Medical Management Neonatal <32 Weeks Preterm Severe Hyaline Membrane Disease Clinical/ Culture Positive Sepsis Mechanical Ventilation per day - Rs 6000 - 3
Weeks
585 Neonatal and Pediatric Medical Management Neonatal 32 To 36 Weeks Preterm Baby Hyaline Membrane Disease Clinical / Culture Positive Sepsis Bubble CPAP per day - Rs 5000 - 2 Weeks
586 Neonatal and Pediatric Medical Management Neonatal 33 To 34 Weeks Preterm Severe Hyaline Membrane Disease Clinical/Culture Positive Sepsis Patent Ductus Arteriosus- Medical Management Mechanical Ventilation
Hyperbilirubinemia 15 days
587 Neonatal and Pediatric Medical Management Neonatal 35 To 36 Weeks Preterm Hyaline Membrane Disease Culture Positive Sepsis Nonventilated
Hyperbilirubinemia 10 days
588 Neonatal and Pediatric
Medical Management
General Pediatrics CVTS Acquired Heart Disease With Congestive Cardiac
Failure- 7 Days Stay
589 Neonatal and Pediatric Medical Management Gen Pediatrics Respiratory Acute Broncho/ Lobarpneumonia With Empyema/ Pleural Effusion per day - Rs 4000 per day - 10
Days
590 Neonatal and Pediatric Medical Management Pediatric ICU Care GIT Acute Gastro Intestinal Bleed Inv - ABG/Upper GI Endoscopy, USG Abdomen PICU Stay With Post Treatment Evidence For Clinical Improvement With Lab Investigations per day - Rs 4000 per day - 7
Days
591 Neonatal and Pediatric
Medical Management
Pediatric ICU Care GIT Acute Hepatitis With Hepatic Encephalopathy – Rs
4000 per day - 14 Days
592 Neonatal and Pediatric
Medical Management
Pediatric ICU Care GIT Acute Pancreatitis - Rs 4000 per day PICU Stay -
12 Days. Rs 50000 for complete LOS of 12 days
593 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Respiratory Acute Severe Asthma with CPAP or high flow
canula per day - Rs 4000 - 10 Days
594 Neonatal and Pediatric Medical Management Pediatric ICU Care Respiratory ARDS Plus DIC (Blood & Blood Products) per day with invasive ventilator or BIPAP - Rs 6000 - 14
days stay
595 Neonatal and Pediatric Medical Management Pediatric ICU Care Respiratory ARDS With Multi- Organ Failure per day with invasive ventilator or BIPAP - Rs 6000 per day -15
Days
596 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Cardiovascular Cardiogenic Shock or severe myocarditis per day
PICU stay - Rs 5000 - 10 Days
597 Neonatal and Pediatric
Medical Management
General Pediatrics Infections Cerebral Malaria (Falciparum) 7 Days Stay
598 Neonatal and Pediatric
Medical Management
General Pediatrics CVTS Congenital Heart Disease With Congestive Cardiac
Failure - 7 Days
599 Neonatal and Pediatric
Medical Management
Pediatric Cardiovascular Congenital Heart Disease With Infection (Non
Ventilated) ICU Stay 7 days
600 Neonatal and Pediatric Medical Management Pediatric ICU Care Cardiovascular Congenital Heart Disease With Infection And
Cardiogenic Shock (Ventilated) per day - Rs 6000 - 10 Days
601 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Endocrine Diabetic Ketoacidosis - per day PICU Stay - 7 Days
602 Neonatal and Pediatric
Medical Management
General Pediatrics Neurology Encephalitis / Encephalopathy - per Day Stay - Rs
1500 - 14 Days
603 Neonatal and Pediatric
Medical Management
Pediatric ICU Care CNS Febrile Seizures (Atypical- Mechanical Ventilated)
per day - Rs 6000 - 7 Days
604 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Cardiovascular Infective Endocarditis per day - Rs 4000 - 15 Days
605 Neonatal and Pediatric
Medical Management
Pediatric ICU Care CNS Intra Cranial Bleed without ventilator per day - Rs
4000 - 10 Days
606 Neonatal and Pediatric
Medical Management
Pediatric ICU Care CNS Meningo- Encephalitis (Ventilated) per day - Rs
6000 - 15 Days
607 Neonatal and Pediatric
Medical Management
Pediatric ICU Care CNS Meningo-Encephalitis (Non Ventilated) - Rs 4000 -
14 Days
608 Neonatal and Pediatric
Medical Management
General Pediatrics Infections Neuro Tuberculosis- 10 Days Stay - DOTS Rx Free
without ventilator - Rs 1500 per day
609 Neonatal and Pediatric
Medical Management
General Pediatrics Infections Neuro Tuberculosis With Ventilation- per day Stay -
DOTS Rx Free - Rs 6000 - 10 Days
610 Neonatal and Pediatric Medical Management Pediatric ICU Care Toxicology Poison Ingestion/ Aspiration Requiring Ventilatory Assistance per day PICU Stay - Rs 6000 - 10 Days
611 Neonatal and Pediatric
Medical Management
Neonatal Necrotising Enterocolitis, Clinical Sepsis Non
Ventilated per day - Rs 4000 - 14 Days
612 Neonatal and Pediatric
Medical Management
General Pediatrics Infections Pyogenic Meningitis per Day ICU Stay - 10 Days
Rs 4000 per day
613 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Infection Septic Shock- per Day PICU ventilated - Rs 6000 -
10 Days
614 Neonatal and Pediatric
Medical Management
Pediatric Respiratory Severe Aspiration Pneumonia (Non Ventilated)
ICU Stay per day - Rs 4000 - 7 Days
615 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Respiratory Severe Aspiration Pneumonia (Ventilated) per day -
Rs 6000 - 10 Days
616 Neonatal and Pediatric
Medical Management
Pediatric Respiratory Severe Bronchiolitis (Non Ventilated) per day High
Flow Nasal Canula - Rs 4000 - 7 Days
617 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Respiratory Severe Bronchiolitis (Ventilated) per day - Rs 6000
- 10 Days
618 Neonatal and Pediatric
Medical Management
Pediatric Respiratory Severe Bronchopneumonia (Non Ventilated) per
day - Rs 4000 - 7 Days
619 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Respiratory Severe Bronchopneumonia (Ventilated) per day -
Rs 6000 - Length of stay 10 days
620 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Cardiovascular Severe Myocarditis - 10 Days
621 Neonatal and Pediatric
Medical Management
Pediatric ICU Care Toxicology Snake Bite Requiring Ventilatory Assistance With
10 Days PICU Stay
622 Neonatal and Pediatric
Medical Management
Pediatric ICU Care CNS Status Epilepticus per day PICU stay - Rs 4000 - 7
Days. Rs 30000 if complete 7 days stay
623 Neonatal and Pediatric
Medical Management
General Pediatrics Renal Steroid Resistant Nephrotic Syndrome Complicated
- per day - Rs 2500 - 14 Days
624 Neonatal and Pediatric
Medical Management
General Pediatrics Neurology Stroke Syndrome-per day - Rs 2000 - 10 Days
625 Neonatal and Pediatric
Medical Management
General Pediatrics Infections Suspected Dengue Shock Syndrome With
Thrombocytopenia - 7 Days
626 Neonatal and Pediatric Medical Management Neonatal Term Baby Severe Hyperbilirubinemia Clinical or Culture positive Sepsis per day - Rs 4000 - 7 Days
627 Neonatal and Pediatric Medical Management Neonatal Term Baby With clinical/ Culture Positive Sepsis- Non Ventilated per day - Rs 4000 - 7 Days
628 Neonatal and Pediatric Medical Management Neonatal Term Baby With Severe Perinatal Asphyxia - Ventilated Clinical Sepsis per day - Rs 6000 - 10
Days
629 Neonatal and Pediatric Medical Management Neonatal Term Baby With Severe Perinatal Asphyxia - Non Ventilated Clinical Sepsis Hyperbilirubinemia 7
days - Rs 4000 per day
630 Neonatal and Pediatric Medical Management Neonatal Term Baby, Fulminant Culture Positive Sepsis,
Septic Shock, Ventilated, Rs 6000 per day - 14 Days
631 Neonatal and Pediatric Medical Management General Pediatrics Renal Urinary Tract Infection With Complications Like Pyelonephritis And Renal Failure - 10 Days Stay
632 Neonatal and Pediatric
Medical Management
General Pediatrics CVTS Viral Myocarditis 7 Days Stay
633 Neonatal and Pediatric Medical Management Neonatal 33 To 34 Weeks Preterm Mild Hyaline Membrane Disease Culture Positive Sepsis – Nonventilated Hyperbilirubinemia - Rs 4000 per day 14 days
634 Neonatal and Pediatric
Medical Management
General Pediatrics CVTS Acute Broncho/ Lobarpneumonia With Pyo
Pneumothorax 14 Days
635 Neonatal and Pediatric
Medical Management
Neonatal Pre term - Necrotising Enterocolitis, Clinical Sepsis
Ventilated - Rs 6000 - 14 Days
636 Neonatal and Pediatric Medical Management Neonatal Term Baby With Persistent Pulmonary Hypertension Ventilation- HFO Clinical Sepsis - Rs
6000 per day - 14 Days
637 Neonatal and Pediatric
Medical Management
Neonatal Term Baby With Seizures per day - Rs 2500 - 21 Days
638 Neonatal and Pediatric Medical Management Neonatal <32 Weeks Preterm Hyaline Membrane Disease Clinical/Culture Positive Sepsis Patent Ductus Arteriosus - Medical Management without Mechanical Ventilation / Bubble CPAP per day - Rs 6000 - 7 Days
639 Neonatal and Pediatric Medical Management Neonatal 32 To 36 Weeks Preterm Hyaline Membrane Disease Clinical/ Culture Positive Sepsis without Mechanical Ventilation or CPAP per day - Rs 4000 - 10 Days
640 Neonatal and Pediatric
Medical Management
Pediatric ICU Care CNS Intra Cranial Bleed with ventilator per day - Rs
4000 - 14 Days
641 Neonatal and Pediatric
Medical Management
Pediatrics Rickettsial fever 7 days stay
642 Neonatal and Pediatric
Medical Management
Neonatal Term baby hyperbilirubinemia non septic more
than 15 mg% per day - Rs 1500 - 5 Days
643 Neonatal and Pediatric Medical Management Neonatal Term baby Meconium Aspiration Syndrome bubble CPAP/ Mechanical Ventilation - Rs 6000 - 10 Days
644 Neonatal and Pediatric
Medical Management
Neonatal endocrine congenital hypothyroidism for new born - 10 Days
645 Neonatal and Pediatric
Medical Management
pediatrics endocrine short stature with growth hormone deficiency - 14
Days
646 Neonatal and Pediatric
Medical Management
pediatrics endocrine Congenital adrenal hyperplasia with failure to thrive
- 10 Days
647 Neonatal and Pediatric Medical Management Neonatal and Paediatrics Idiopathic Thrombocytopenic Purpura per day - Rs 4000 per day ICU stay - 7 Days. (IVIG and other Injections). Cost up to Rs 80000
648 Neonatal and Pediatric Medical Management /
Nephrology
General Pediatrics Renal Acute Renal Failure without dialysis Rs 1500 per day - Length of stay 10 days
649 Neonatal and Pediatric Medical Management /
Nephrology
Pediatric ICU Care Renal Acute Renal Failure With Dialysis Haemodialysis or Peritoneal Dialysis - Rs 4000 per Day PICU Stay
- 14 Days
650 Nephrology Nephrology Pyelonephritis 10 Days Stay
651 Nephrology Nephrology A V Fistula At Elbow or Wrist - Day Care
652 Nephrology Nephrology Acute Renal Failure-(ARF) -10 Days Stay in ICU or
General ward
653 Nephrology Nephrology Chronic Renal Failure (CRF) - 10 Days Stay for Initial treatment and Dialysis and supportive therapy
654 Nephrology Nephrology Maintenance Haemodialysis For CRF- Dialysis and supportive therapy (12 dialysis per 28 days or as per advice of Nephrologist)- Package includes per dialysis cost including return fare, which includes administartion of ESA and iron. One Preauth of 42
days - Rs 1500 Per Dialysis
655 Nephrology Nephrology Nephrotic Syndrome - 4 Days Stay (Except
Diabetic Nephropathy)
656 Nephrology Nephrology Rapidly Progressive Renal Failure (RPRF)10 Days
657 Nephrology Nephrology Post-Transplant Immunosuppression Treatment After Transplantation for first 6 months of a year.To be continued as per advice of Nephrologist
for further period
658 Nephrology Nephrology Post-Transplant Immunosuppression Treatment After Transplantation for second 6 months of a year.To be continued as per advice of Nephrologist
for further period
659 Nephrology Nephrology Resistant Nephritic Syndrome - 5 days stay
660 Nephrology Nephrology Plasmapheresis - 7 Days
661 Nephrology Nephrology CAPD (Contineous Ambulatory Peritoneal
Dialysis) One preauth of 30 days
662 Nephrology / Medical
Gastroenterology
Nephrology CRRT (Contineous Renal Replacement Therapy)
3days stay for ALF and others
663 Neurology Neurology Myopathies - Acquired NCS, 15 Days Stay
664 Neurology Neurology ADEM or NMO Spectrum disorders or Transverse
Myelitis or relapse in Multiple Sclerosis 10 Days Stay
665 Neurology Neurology CIDP -10 Days Stay
666 Neurology Epilepsy Convulsive Disorders/Status EpileptICUs (Fits) - 7
Days Stay
667 Neurology Neurology Neuroinfections - Fungal Meningitis- 10 Days -
ICU stay
668 Neurology Neurology Neuroinfections - Pyogenic Meningitis - 7 Days -
ICU
669 Neurology Neurology Neuroinfections - Viral Meningoencephalitis
(Including Herpes Encephalitis) - 7 Days - ICU
670 Neurology Neurology Neuromuscular (Myasthenia Gravis or LEMS) -10
Days Stay
671 Neurology Neurology Management of Guillian-Barre Syndrome 15 Days
Stay
672 Neurology Neurology Managemnt of optic Neuritis - 5 Days Stay
673 Neurology Neurology Haemorrhagic Stroke/Strokes Management with all necessary investigations 15 days stay without
surgery
674 Neurology Neurology Ischemic Strokes-Management with all necessary investigations without Thrombolysis 7 days stay
675 Neurology Neurology Plasma Exchange for GBS/Myesthenic Crisis/NMOSD/MS Relapse/Refractory Optic Neuritis/HUSTTP/RPRF/ Tranverse Myelitis/
Autoimmune Encephelitis / ALF /ACLF 14 days
676 Neurology Neurology Ischemic Strokes presenting in Window period - Management with all necessary investigations and Thrombolysis (With Tenecteplase or Alteplase) 7
days stay
677 Neurology / Nephrology Neurology Immunoglobulin Therapy -5 Days Stay as per indications of Concerned specialist
678 Neurology / Paediatrics Neurology ACTH Therapy for Epileptic Encephalopathy
679 Neurosurgery Spinal Surgeries Anterior Cervical Spine Surgery With Fusion - Cost
per level per fusion
680 Neurosurgery Spine Anterior Discectomy & Bone Grafting
681 Neurosurgery Brain Tumours Brain Stem Tumour
682 Neurosurgery Brain Tumours C P Angle Tumour
683 Neurosurgery Other Surgical Procedures CV Junction Fusion
684 Neurosurgery Spine Corpectomy For Spinal Fixation per level
685 Neurosurgery Management Of Aneurysms Cost Of Each Coil
Coil Embolization
686 Neurosurgery Brain Craniotomy And Evacuation Of Hematoma
Extradural
687 Neurosurgery Brain Craniotomy And Evacuation Of Hematoma
Subdural
688 Neurosurgery Brain De-Compressive Craniotomy(Non Traumatic)
689 Neurosurgery Spine Discectomy With Implants Lumbar / Thoracic per
level
690 Neurosurgery Management Of Aneurysms Embolization (Non coil)
691 Neurosurgery Brain Endoscopic Third Ventriculostomy
692 Neurosurgery Brain Endoscopy Procedures Brain / Spine
693 Neurosurgery Brain Tumours Excision Of Brain Abscess
694 Neurosurgery Excision Of Brain Tumours Other Procedures
695 Neurosurgery Excision Of Brain Tumours cerebellar tumours
696 Neurosurgery Brain Excision Of Lobe (Frontal, Temporal, Cerebellum
Etc.)
697 Neurosurgery Brain Tumours External Ventricular Drainage (EVD)
698 Neurosurgery Brain Intra-Cerebral Hematoma Evacuation
699 Neurosurgery Epilepsy Surgery Lesionectomy Type 1
700 Neurosurgery Epilepsy Surgery Lesionectomy Type 2
701 Neurosurgery Trigeminal Neuralgia Micro Vascular Decompression
702 Neurosurgery Neurosurgical Trauma Consertative Neurosurgical Trauma Consertative Management Stay General Ward @Rs.1500/ Day - 7 days
703 Neurosurgery Neurosurgical Trauma Consertative Neurosurgical Trauma Consertative Management Stay In Neuro ICU without ventilator
@Rs.4000/Day - 7 days
704 Neurosurgery Neurosurgical Trauma Neurosurgical Trauma Surgical Treatment (Up To)
705 Neurosurgery Brain Tumours Parasagittal Tumour
706 Neurosurgery Excision Of Brain Tumours Thecoperitoneal Shunt
707 Neurosurgery Soft Tissue And Vascular Injuries Proptosis
708 Neurosurgery Trigeminal Neuralgia Radiofrequency Ablation
709 Neurosurgery Spine Spinal Fixation Rods /Plates
710 Neurosurgery Spinal Surgeries Spinal Fusion Procedure
711 Neurosurgery Excision Of Brain Tumours Subdural Tapping
712 Neurosurgery Spine Syringomyelia
713 Neurosurgery Epilepsy Surgery Temporal Lobectomy
714 Neurosurgery Epilepsy Surgery Temporal Lobectomy Plus Depth Electrodes
715 Neurosurgery Other Surgical Procedures Trans Oral Surgery
716 Neurosurgery Other Surgical Procedures Trans Sphenoidal Surgery
717 Neurosurgery Excision Of Brain Tumours Twist Drill Craniotomy
718 Neurosurgery Excision Of Brain Tumours Vascular Malformations
719 Neurosurgery Excision Of Brain Tumours Ventricular Tapping
720 Neurosurgery Brain Tumours Ventriculoatrial Shunt
721 Neurosurgery Excision Of Brain Tumours Ventriculoperitoneal / Ventriculo pleural Shunt
722 Neurosurgery Neurosurgical Trauma Depressed Fracture of Skull
723 Neurosurgery Spinal Surgeries Spine - Extradural Tumour with fixation
724 Neurosurgery Spinal Surgeries Spine - Extradural Haematoma
725 Neurosurgery Spinal Surgeries Spine - Intradural Haematoma
726 Neurosurgery Spinal Surgeries Excision of Benign Orbital Tumour
727 Neurosurgery Neurosurgical Trauma Consertative Neurosurgical Trauma Consertative Management Stay ICU with ventilator - 6000 per day - 7 days stay
728 Neurosurgery Other Surgical Procedures Stereotactic assisted brain tumor surgeries -
729 Neurosurgery Spinal Surgeries Tethered cord syndrome with anomalies of
bone, dura and spinal cord
730 Neurosurgery Spinal Surgeries Decompression or fixation for CV Junction
anomalies
731 Neurosurgery Brain surgeries Brain abscess aspiration under GA
732 Neurosurgery Brain Surgeries Intracranial pressure probe insertion for moderate to severe brain injuries or
Haemorrhage
733 Neurosurgery Brain Surgeries Surgical procedure of Aneurysm clipping
734 Neurosurgery Brain Tumours Cranioplasty using artificial implant
735 Neurosurgery Spinal Surgeries Endoscopic Discectomy
736 Neurosurgery Spinal Surgeries Laminectomy (Cervical / Thoracic / Lumbar)
737 Neurosurgery Brain Tumours Surgical repair of Meningoencephalocele
738 Neurosurgery Spinal Surgeries Surgery for Spinal Tumours Intramedullary /
Extramedullary / Bone
739 Neurosurgery Spine surgeries Transtoracic Anterolateral decompression with
fusion
740 Neurosurgery Brain surgeries Skull base tumors excision
741 Neurosurgery Brain surgeries Surgery for CSF Rhinorroea / Otorrhoea -
Open / Endoscopic
742 Neurosurgery Neurosurgery Duroplasty
743 Neurosurgery Neurosurgery Intracerebral Hematoma
744 Neurosurgery Neurosurgery Spine - Extradural Haematoma with Implant
745 Neurosurgery Neurosurgery Foramen Magnum Decompression
746 Neurosurgery Neurosurgery Carpal Tunnel Release including pre and post Op.
MRI
747 Neurosurgery Neuroendoscopy EATV (Extra Axial Third Ventriculostomy)
748 Neurosurgery Neurovascular Surgeries Encephaloduroangiomyo synangiosis (EDAMS)
749 Neurosurgery Neurovascular Bypass Surgeries Neurovascular Bypass Surgeries
750 Neurosurgery / CVTS Neurovascular Surgeries Carotid End arterectomy
751 Neurosurgery / Paediatric
Surgery
Brain Tumours Meningocele / Meningomyelocele Excision
752 Neurosurgery / Plastic Surgery Soft Tissue And Vascular Injuries Peripheral Nerve Injury Repair
753 Neurosurgery / Plastic Surgery Soft Tissue And Vascular Injuries Repair Of Brachial Plexus Injury
754 Oncohematology / Medical Oncology Febrile Neutropenia Fn High Risk 2 1st Line Iv Antibiotics And Other Supportive Therapy ( Third Generation Cephalosporin,
Aminoglycoside Etc.,)- 5 days stay
755 Oncohematology / Medical Oncology Febrile Neutropenia Fn High Risk 2 2nd Line Iv Antibiotics And Other Supportive Therapy(Carbapenems, Fourth Generation Cephalosporins, Piperacillin, Anti-Fungal . Azoles
Etc.,)
756 Oncohematology / Medical Oncology Burkitt Lumphoma and others - Codox - M -
IVAC / Acute Lymphoblastic Leukemia - GMALL or BFM or Hyper CVAD
757 Oncohematology / Medical Oncology Follicular Lymphoma/Non Hodgkin's Lumphoma/CLL/SLL and others - Lenalidomide + Rituximab Rituximab 375mg/m2 Day 1 Lenlidomide 25 mg D1-
28, for 8 cycles
758 Oncohematology / Medical Oncology Low grade lymphomas /NHL (Low grades) and others - Rituximab
Rituximab 375mg/m2 per week for 6 weeks
759 Oncohematology / Medical Oncology Follicular Lymphoma - Fludarabine + Cyclophosphamide Fludarabine 25mg/m2 D1-3 Cyclophosphamide 250 mg/m2 D1-3 every 28 days for 6 cycles
760 Oncohematology / Medical Oncology Follicular Lymphoma/CLL/NHL and others - Rituximab + Fludarabine
+ Cyclophosphamide Rituximab 375mg/m2 on day 1
Fludarabine 25mg/m2 D1 - 3 Cyclophosphamide 250 mg/m2 D1 - 3
Every 28 days for 6 cycles
761 Oncohematology / Medical Oncology NK/T Cell Lymphoma/NHL and others - SMILE
Methotrexate 2gm/m2 D1 Ifosfamide 1500mg/m2 D2-4 Etoposide 100mg/m2 D2-4
L-asparginase 6000U/m2 D8,10,12,14,16,18,20 Dexamethasone 40mg D1-4 every 28 days
762 Oncohematology / Medical Oncology GELOX NHL and others Gemcitabine 1000mg/m2 D1 and D8 Oxaliplatin 130mg/m2 D1
L- asparginase 6000 U/m2 D1-7 Repeat every 21 days
763 Oncohematology / Medical Oncology ICE - NHL and others Ifosfamide 1.5 mg/m2 D1-3
Carboplatin AUC5 D2 Etoposide 100mg/m2 D1-3
Every 3 weeks
764 Oncohematology / Medical Oncology MINE - NHL and others
Ifosfamide 4 gm/m2 over 3days (D1-3) Mitoxantrone 8mg/m2 Etoposide 65mg/m2 D1- 3
Every 3 weeks
765 Oncohematology / Medical Oncology PTCL - GDP, NHL and others Gemcitabine 1000mg/m2 D1 and D8 Dexamethasone 40mg D1-4 Cisplatin 75mg/m2 D1 or Cacrboplatin AUC-5 Every 3 weeks
766 Oncohematology / Medical Oncology DHAP - NHL and others Dexamethasone 40mg D1-4
Cisplatin 100mg/m2 or Carboplatin AUC-5D1 Cytarabine 2 gm/m2 BD D2
Repeat every 21 days
767 Oncohematology / Medical Oncology Arsenic trioxide ATRA - Daunomycin or Idarubcin
Cytarabine - multiagent - vary in each protocol
- AML M3/APML/Promyelocytic
768 Oncohematology / Medical Oncology Arsenic trioxide ATRA Daunomycin or Idarubcin
Cytarabine - multiagent - vary on protocol -
AML M3/APML/Promyelocytic
769 Oncohematology / Medical Oncology ATO 0.15 mg / kg day 1- Day 5, day 8-12, day
15-
19, day 22-26 every 56 days for 4 cycles
ATRA 45 mg / M2 day 1- Day 14 and Day 29-
43
every 56 days for 4 cycles - AML M3/APML/Promyelocytic
770 Oncohematology / Medical Oncology ATO 0.15 mg / kg day 1- 45 or 60 ATRA 45 mg / M2 - day
1-45 or 60 - AML M3/APML/Promyelocytic
771 Oncohematology / Medical
Oncology
ICICLE BFM KLALL MCP:841 - ALL
772 Oncohematology / Medical Oncology Dasatinib + chemo (to be used only with ALL therapy)
To be used with Philadelphia Chromosome/PH
Positive ALL
773 Oncohematology / Medical Oncology Imatinib + chemo ((to be used only with ALL therapy) - To be used with Philadelphia Chromosome/PH Positive ALL
774 Oncohematology / Medical Oncology Cytrabine 3 gram/m2 twice a day
Days 1, 3 and 5 - AML Consolidation phase
775 Oncohematology / Medical Oncology Cytrabine 200mg/m2/day days 1- 10 and
Daunorubicin 50 mg/m2 days 1, 3 and 5
Etposide 100mg/m2 days 1-5 - AML
776 Oncohematology / Medical Oncology Cytrabine 100-
200mg/m2/day days 1-7 and Daunorubicin 50mg/m2 days 1, 3 and
5 - AML Induction
777 Oncohematology / Medical Oncology LMB 89 - 96 -
Consolidation (second month) - ALL/NHL and others
778 Oncohematology / Medical Oncology LMB 89 - 96 - Induction - COPADAM ( first
month) - ALL/NHL and others
779 Oncohematology / Medical Oncology LMB 89 - 96 -
Maintenance - ALL/NHL and others
780 Oncohematology / Medical
Oncology
MCP - 842 - ALL and others
781 Oncohematology/ Medical
Oncology
Acute Lymphatic Leukemia Maintenance Phase - Per month
782 Oncohematology/ Medical
Oncology
Multiple Myeloma Melphalan+Thalidomide+Prednisone Oral
783 Oncohematology/ Medical
Oncology
Multiple Myeloma Bortezomib+Lenoladomide+Dexamethasone/Cyclop
hosphamide+Bortezomib+Dexamethasone
784 Oncohematology/ Medical
Oncology
Histocytosis Variable Regimen
785 Oncohematology/ Medical
Oncology
Childhood B-Cell Lymphomas Variable Regimen
786 Oncohematology/ Medical
Oncology
Haematooncology Imatinib(Per month)
787 Oncohematology/ Medical
Oncology
Acute Myeloid Leukemia Consolidation Phase up to 4 Cycles - Payable
maximum upto for each cycle
788 Oncohematology/ Medical Oncology Non Hodgkin Lymphoma Cyclophosphamide Adriamycin Vincristin Prednisolone (CHOP)+Rituximab/ Bendamustine+Rituximab/R-CVP/ Chlorambicil+Rituximab/ Fludarabine+Rituximab/R- GDP/Ibrutinib/Ibrutinib+rituximab/Acalabrutinib
789 Oncohematology/ Medical
Oncology
Acute Lymphatic Leukemia Induction 1st And 2 nd Months - Payable maximum
upto
790 Oncohematology/ Medical Oncology Acute Lymphatic Leukemia Consolidation Chemotherapy / Intensive
Chemotherapy upto 4 Cycles - Payable maximum upto for each cycle
791 Oncohematology/ Medical
Oncology
Acute Myeloid Leukemia Induction Phase - Payable maximum upto
792 Oncohematology/ Medical
Oncology
Multiple Myeloma Thalidomide+Dexamethasone(Oral) /Lenalidomide
793 Oncohematology/ Medical
Oncology
Multiple Myeloma/ Bone Metastasis Zoledronic Acid/Pamindronic acid Along With any
chemotherapy regime
794 Oncohematology/ Medical Oncology De-Angelis/MTR (methotrexate, dexamethasone, procarbazine, vincristine, intrathecal MTX, CYTARABINE) - NHL
/Primary CNS Lymphoma
795 Oncohematology/ Medical Oncology Multiple Myeloma Carfinzomib +Pomalidomide+Dexamethasone / Carfinzomib
+Thalidomide+Dexamethasone/Carfinzomib
+Lenalidomide+Dexamethasone
796 Oncohematology/ Medical
Oncology
Haematooncology Dasatinib per month
797 Oncohematology/ Medical
Oncology
Haematooncology Nilotinib(Per month)
798 Oncohematology/ Medical
Oncology
Haematooncology Bosutinib (Per Month)
799 Oncohematology/ Medical
Oncology
Haematooncology CLL and other lymphomas- Acalbrutinib - per
month
800 Oncohematology/ Medical
Oncology
Haematooncology Inj Crinzalizumab for Sickle cell anemia - per month
801 Oncohematology/ Medical
Oncology
Haematooncology Primary Myelofibrosis and Other MPN -
Ruxolitinib - per month
802 Oncosurgery / Neurosurgery Soft Tissue and Vascular Injuries Decompression/Excision Of Optic Nerve Lesions
803 Ophthalmology Surgery Cornea Sclera Amniotic Membrane Graft - Grade 3 Pterigium
804 Ophthalmology Surgery Cornea Sclera Corneal Patch Graft
805 Ophthalmology Surgery Orbit Dermis Fat Graft
806 Ophthalmology Surgery Orbit Enucleation With Orbital Implant
807 Ophthalmology Surgery Pediatric Ophthalmic Surgery Glaucoma Filtering Surgery For Paediatric
Glaucoma
808 Ophthalmology Surgery Cornea Sclera Lamellar Keratoplasty
809 Ophthalmology Surgery Lid Surgery Lid Reconstruction Surgery
810 Ophthalmology Surgery Vitreo Monthly Intravitreal Anti-VEGF For Macular
Degeneration - Per Injection (Maximum – 6)
811 Ophthalmology Surgery Orbit Orbitotomy
812 Ophthalmology Surgery Retina Photocoagulation For Diabetic Retinopathy Per
Sitting
813 Ophthalmology Surgery Vitreo Removal Of Silicon Oil Or Gas
814 Ophthalmology Surgery Retina Scleral Buckle For Retinal Detachment
815 Ophthalmology Surgery Cornea Sclera Scleral Patch Graft
816 Ophthalmology Surgery Squint Correction Surgery Rectus Muscle Surgery Single.
817 Ophthalmology Surgery Orbit Socket Reconstruction
818 Ophthalmology Surgery Cornea Sclera Therapeutic / Optical Penetrating Keratoplasty
819 Ophthalmology Surgery Squint Correction Surgery Rectus Muscle Surgery Two/Three
820 Ophthalmology Surgery Vitreo Vitrectomy
821 Ophthalmology Surgery Vitreo Vitrectomy - Membrane Peeling Endolaser , Silicon
Oil Or Gas
822 Ophthalmology Surgery Vitreo Vitrectomy + Membrane Peeling+ Endolaser
823 Ophthalmology Surgery Vitreo Vitrectomy Plus Silicon Oil Or Gas.
824 Ophthalmology Surgery Opthalmology Surgery Pterygium + Conjunctival Autograft
825 Ophthalmology Surgery Opthalmology Surgery Dacryocystectomy
826 Ophthalmology Surgery Opthalmology Surgery Perforating Corneo - Scleral Injury
827 Ophthalmology Surgery Opthalmology Surgery Anterior Chamber Reconstruction +Perforating
corneo - Scleral Injury + IOL
828 Ophthalmology Surgery Opthalmology Surgery Photocoagulation for Retinopathy of
Prematurity
829 Ophthalmology Surgery Pediatric Ophthalmic Surgery Pediatric Cataract Surgery - Phacoemulsification –
IOL
830 Ophthalmology Surgery Squint Correction Surgery Rectus Muscle Surgery Two/Three Plus Oblique
831 Ophthalmology Surgery Vitreo Vitrectomy - Endolaser , Silicon Oil Or Gas
832 Ophthalmology Surgery Opthalmology Surgery DCR (Dacryocysto Rhinostomy) with implant
833 Ophthalmology Surgery Opthalmology Surgery Surgical Excision of Chalazion - Per Chalazion
834 Ophthalmology Surgery Opthalmology Surgery Intravitreal Anti-VEGF For ROP
835 Ophthalmology Surgery Ophthalmology Surgery Buckle Removal
836 Ophthalmology Surgery Ophthalmology Surgery Canaliculo Dacryocysto Rhinostomy
837 Ophthalmology Surgery Ophthalmology Surgery Prophylactic Cryoretinopexy- Closed
838 Ophthalmology Surgery Ophthalmology Surgery Cyclocryotherapy
839 Ophthalmology Surgery Ophthalmology Surgery Cyclophotocoagulation
840 Ophthalmology Surgery Ophthalmology Surgery Glaucoma Surgery (Trabeculectomy only) with or without Mitomycin C, including postoperative medications for 12 weeks (and wherever surgical or laser procedures required for bleb augmentation and anterior chamber maintenance)
841 Ophthalmology Surgery Ophthalmology Surgery Limbal Dermoid Removal
842 Ophthalmology Surgery Ophthalmology Surgery IRIS Prolapse – Repair
843 Ophthalmology Surgery Ophthalmology Surgery Iridectomy- laser
844 Ophthalmology Surgery Ophthalmology Surgery Iridectomy- surgical
845 Ophthalmology Surgery Ophthalmology Surgery Conjunctival tumour excision + AMG
846 Ophthalmology Surgery Ophthalmology Surgery Entropion correction
847 Ophthalmology Surgery Ophthalmology Surgery Ectropion correction
848 Ophthalmology Surgery Ophthalmology Surgery Evisceration
849 Orthopaedics / Polytrauma Post Management of traumatically amputed limb
850 Orthopaedics / Polytrauma Degloving injuries of extremities
851 Orthopaedics / Polytrauma Whole blood or PCV in trauma
852 Orthopaedics / Polytrauma Traumatic internal de-arrangement of knee
853 Orthopaedics / Polytrauma POP cast immobilization of undisplaced fracture
without Anaesthesia
854 Orthopaedics / Polytrauma Stabilization before amputation above knee or
above elbow
855 Orthopedic Surgery And
Procedures
Orthopaedics Amputation - Above/Below Elbow
856 Orthopedic Surgery And Procedures Orthopaedics Accessory bone – Excision (limbs) – congenital Accessory digits sometime can be removed (pre-
auth)
857 Orthopedic Surgery And
Procedures
Orthopaedics Hand/Foot Amputation ( partial)
858 Orthopedic Surgery And
Procedures
Orthopaedics Amputation - Wrist
859 Orthopedic Surgery And
Procedures
Orthopaedics Amputation – Below Knee
860 Orthopedic Surgery And
Procedures
Orthopaedics Amputation – Above Knee
861 Orthopedic Surgery And
Procedures
Orthopaedics Hand/Foot Amputation (whole)
862 Orthopedic Surgery And
Procedures
Orthopaedics Close Reduction of fractures under Anaesthesia -
Short bones
863 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Excision Arthoplasty of femur head
864 Orthopedic Surgery And
Procedures
Orthopaedics Closed reduction of dislocation
(hip/elbow/knee/Shoulder)
865 Orthopedic Surgery And
Procedures
Orthopaedics Closed Interlocking Intramedullary (Matches with
Close reduction and percuteneous nailing)
866 Orthopedic Surgery And
Procedures
Orthopaedics Closed Reduction and Internal Fixation with Kwire
867 Orthopedic Surgery And
Procedures
Orthopaedics Closed Reduction and Percutaneous Pinning /
Screw fixation
868 Orthopedic Surgery And
Procedures
Orthopaedics Closed Reduction and Percutaneous Nailing
869 Orthopedic Surgery And
Procedures
Orthopaedics Correction of club foot per cast
870 Orthopedic Surgery And
Procedures
Orthopaedics Primary Hip Replacement (with implant) cemented
THR (Imported implant)
871 Orthopedic Surgery And
Procedures
Orthopaedics External fixation - Long bone/pelvis
872 Orthopedic Surgery And
Procedures
Orthopaedics External fixation - Small bone
873 Orthopedic Surgery And
Procedures
Orthopaedics Limb Lengthening
874 Orthopedic Surgery And
Procedures
Orthopaedics Tendon Repair (Multiple)
875 Orthopedic Surgery And
Procedures
Orthopaedics Open Reduction Internal Fixation (Small Bones) -
Calcaneum / Talus and others
876 Orthopedic Surgery And
Procedures
Orthopaedics Open Reduction of CDH
877 Orthopedic Surgery And
Procedures
Orthopaedics Open Reduction of Small Joint
878 Orthopedic Surgery And
Procedures
Orthopaedics Primary Hip Replacement (with implant)
uncemented THR (Imported implant)
879 Orthopedic Surgery And
Procedures
Orthopaedics Total Hip Replacement hybrid (procedure cost +
Imported implant)
880 Orthopedic Surgery And
Procedures
Orthopaedics Primary knee replacement (with implant) metal
back (imported implant)
881 Orthopedic Surgery And
Procedures
Orthopaedics Primary Hip Replacement (with implant) cemented
THR (Indian implant)
882 Orthopedic Surgery And
Procedures
Orthopaedics Primary knee replacement (with implant) All poly
(indian implant)
883 Orthopedic Surgery And
Procedures
Orthopaedics Primary Hip Replacement (with implant)
uncemented THR (Indian implant)
884 Orthopedic Surgery And
Procedures
Orthopaedics Primary knee replacement (with implant) All poly
(imported implant)
885 Orthopedic Surgery And
Procedures
Orthopaedics Total Hip Replacement hybrid (procedure cost +
Indian implant)
886 Orthopedic Surgery And
Procedures
Orthopaedics Primary knee replacement (with implant) metal
back (indian implant)
887 Orthopedic Surgery And
Procedures
Orthopedics Amputations - Forequarter
888 Orthopedic Surgery And
Procedures
Orthopedics Amputations - Hind Quarter And Hemipelvectomy
889 Orthopedic Surgery And
Procedures
Orthopedics Spine Surgery Anterolateral Clearance For Tuberculosis
890 Orthopedic Surgery And
Procedures
Orthopedics Bone And Joint
Surgery Procedures
Arthrodesis of - Major Joints
891 Orthopedic Surgery And
Procedures
Orthopedics Bone And Joint
Surgery Procedures
Arthroscopy - ACL / PCL Repair
892 Orthopedic Surgery And
Procedures
Orthopedics Bone And Joint
Surgery Procedures
Arthroscopy. Operative Meniscectomy
893 Orthopedic Surgery And
Procedures
Orthopedics Bone And Joint
Surgery Procedures
Avascular Necrosis Of Femoral Head (Core
Decompression)
894 Orthopedic Surgery And
Procedures
Orthopedics Fracture Correction
Surgeries
Bone Grafting as exclusive procedure
895 Orthopedic Surgery And
Procedures
CTEV CTEV Neglected. JESS Fixator
896 Orthopedic Surgery And
Procedures
Orthopedics Bone Tumours Excision Of Bone Tumours. Deep With Re-
Construction With Conventional Prosthesis
897 Orthopedic Surgery And
Procedures
Orthopedics Fracture Correction
Surgeries
Excision or other operations For Scaphoid Fractures
898 Orthopedic Surgery And
Procedures
Orthopedics Fracture Correction
Surgeries
Ilizarov Ring Fixator Application.
899 Orthopedic Surgery And
Procedures
Orthopedics Soft Tissue Surgery Neurolysis/Nerve Suture
900 Orthopedic Surgery And Procedures Orthopedics Fracture Correction Surgeries Open Reduction & Internal Fixation of Fingers &
Toes @Rs 6000 Each Up To Maximum Of Rs 15000
901 Orthopedic Surgery And
Procedures
Orthopedics Open Reduction of Dislocations -
Shoulder/Elbow/Hip/Knee/Ankle
902 Orthopedic Surgery And
Procedures
Orthopedics Fracture Correction
Surgeries
Reduction of Compound Fractures & External
Fixation
903 Orthopedic Surgery And
Procedures
Orthopedics Bone And Joint
Surgery Procedures
Soft Tissue Reconstruction Procedures For Joints
or osteotomy
904 Orthopedic Surgery And
Procedures
Orthopedics Spine Surgery Spinal Ostectomy And Internal Fixations
905 Orthopedic Surgery And
Procedures
Orthopedics Scoliosis (Rs. 90000) + special spinal brace (Rs.
10000)
906 Orthopedic Surgery And
Procedures
Orthopedic Trauma Open Reduction And Internal Fixation Of Long
Bone Fractures
907 Orthopedic Surgery And
Procedures
Orthopaedics Close Reduction of fractures under Anaesthesia -
long bones
908 Orthopedic Surgery And
Procedures
Orthopaedics Hemiarthroplasty (Bipolar)
909 Orthopedic Surgery And
Procedures
Orthopaedics Tendon Repair (Single)
910 Orthopedic Surgery And
Procedures
Ortopaedics Removal of implants with screws
911 Orthopedic Surgery And
Procedures
Ortopaedics Arthoscopy - 2 ligaments repair or reconstruction of
knee joint
912 Orthopedic Surgery And
Procedures
Ortopaedics High Tibial Osteotomy with miniscus and root repair
913 Orthopedic Surgery And
Procedures
Ortopaedics Latarjet procedure for recurrent dislocation of
shoulder
914 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Foot Amputation (partial)
915 Orthopedic Surgery And Procedures Orthopedic Surgery And Procedures AC joint reconstruction/ Stabilization/ Acromionplasty
Nonoperative management is recommended for Rockwood type I and II injuries, whereas surgical reconstruction is recommended for type IV and VI separations. The management for type III and V injuries is more controversial and is determined on a case-by-case basis (pre-auth)
916 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Osteochondroma excision/ Excision of Exostosis
917 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Arthorotomy of any joint
918 Orthopedic Surgery And Procedures Orthopedic Surgery And Procedures Bone Tumour Excision (malignant/ benign) + Joint replacement
(depending upon type of joint and implant)
919 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Duputryen’s Contracture release + rehabilitation
920 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Fasciotomy
921 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Excision of Bursa
922 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Sequestrectomy of Long Bones + anti-biotics +
dressing
923 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Application of P.O.P. casts for Upper & Lower
Limbs
924 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Clavicle fracture management - conservative
(daycare)
925 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Tendon Grafting (isolated grafting)
926 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Pelvic Osteotomy with fixation with plaster.
927 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Skeletal tractions with pins Isolated
928 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures skin traction isolated
929 Orthopedic Surgery And
Procedures
Orthopedic Surgery And Procedures Application of P.O.P. Spikas & Jackets
930 Paediatric Surgery / General
Surgery
Abdomen Surgery for Peritonitis in Children
931 Pediatric Surgery Pediatric Surgery Inguinal Hernia & Hydrocele
932 Pediatric Surgery Pediatric Surgery Hirschsprung’s Disease -Biopsy
933 Pediatric Surgery Congenital Malformations - GI Tract Anorectal Malformations Stage 1
934 Pediatric Surgery Congenital Malformations - GI Tract Anorectal Malformations Stage 2 Open or
Laparosopic
935 Pediatric Surgery Chest Bronchoscopy Foreign Body Removal
936 Pediatric Surgery Head And Neck Congenital Dermal Sinus
937 Pediatric Surgery Congenital Malformations Congenital Hydronephrosis
938 Pediatric Surgery Congenital Malformations - GI Tract Diaphragmatic Hernia
939 Pediatric Surgery Head And Neck Cystic Lesions Of The Neck
940 Pediatric Surgery Congenital Malformations
–Urogenital
Extrophy Bladder Stage 1
941 Pediatric Surgery Congenital Malformations
–Urogenital
Extrophy Bladder Stage 2
942 Pediatric Surgery Abdomen Gastric Outlet Obstructions
943 Pediatric Surgery Congenital Malformations
–Urogenital
Hamartoma Excision
944 Pediatric Surgery Congenital Malformations
–Urogenital
Hemangioma Excision
945 Pediatric Surgery Congenital Malformations - GI Tract Hirschsprung Disease Stage 1
946 Pediatric Surgery Congenital Malformations - GI Tract Hirschsprung Disease Stage 2 Open or Lap
947 Pediatric Surgery Congenital Malformations
–Urogenital
Hypospadias Single Stage
948 Pediatric Surgery Congenital Malformations
–Urogenital
Hypospadius Stage 1
949 Pediatric Surgery Congenital Malformations
–Urogenital
Hypospadius Stage 2
950 Pediatric Surgery Congenital Malformations - GI Tract Intestinal Atresias & Obstructions
951 Pediatric Surgery Abdomen Intussusception
952 Pediatric Surgery Abdomen Laparoscopic Choleycystectomy
953 Pediatric Surgery Congenital Malformations
–Urogenital
Lymphangioma Excision
954 Pediatric Surgery Urogenital Nephrectomy
955 Pediatric Surgery Congenital Malformations - GI Tract Oesophageal Atresia
956 Pediatric Surgery Abdomen Paediatric Acute Intestinal Obstruction
957 Pediatric Surgery Chest Paediatric Esophageal Obstructions- Surgical
Correction
958 Pediatric Surgery Chest Paediatric Esophageal Substitutions
959 Pediatric Surgery Abdomen Paediatric Splenectomy (Non Traumatic)
960 Pediatric Surgery Congenital Malformations Pediatric Tumours
961 Pediatric Surgery Congenital Malformations
–Urogenital
Posterior Urethral Valves
962 Pediatric Surgery Urogenital Scrotal Transposition Repair
963 Pediatric Surgery Head And Neck Sinuses & Fistula Of The Neck
964 Pediatric Surgery Congenital Malformations - Gi Tract Biliary Atresia & Choledocal Cyst
965 Pediatric Surgery Urogenital Torsion Testis
966 Pediatric Surgery Congenital Malformations
–Urogenital
Ureteric Reimplantations
967 Pediatric Surgery Pediatric Surgery Bladdder Augmentation
968 Pediatric Surgery Abdomen Benign Abdominal Cysts In Paediatric Patient
969 Pediatric Surgery Chest Surgery on Thoracic cyst - Open or Thoracoscopic
970 Pediatric Surgery Chest Decortication Open or Thoracoscopic
971 Pediatric Surgery Congenital Malformations - GI Tract Colostomy closure for ARM or Hirsphsprung's
disease / Stage 3
972 Pediatric Surgery Congenital Malformations
–Urogenital
Hypospadius Fistula
973 Pediatric Surgery Urogenital Orchidopexy - Stage 1 - Open / Lap
974 Pediatric Surgery Urogenital Orchidopexy - Stage 2 - Open / Lap
975 Pediatric Surgery Congenital Malformations
–Urogenital
Urinary Diversion (Vasicostomy / Ureterostomy)
976 Pediatric Surgery Pediatric Surgery Urinary Undiversion
977 Pediatric Surgery Pediatric Surgery Exomphalos/gastroschisis
978 Pediatrics Medical
Management
Pediatrics Medical Management Juvenile myasthenia gravis - per day
979 Pediatrics Medical
Management
Pediatrics Medical Management Acute glomerulonephritis - 2000 per day - 5 days
980 Pediatrics Medical
Management
Pediatrics Medical Management Infantile cholestasis - per day
981 Pediatrics Medical
Management
Pediatrics Medical Management Immune haemolytic anemia per day
982 Pediatrics Medical
Management
Pediatrics Medical Management Rheumatoid arthritis - Rs 2000 per day - 5 days
983 Pediatrics Medical
Management
Pediatrics Medical Management Refractory seizures - Rs 2000 per day
984 Plastic Surgery Plastic Surgery Corrective Surgery For Congenital Deformity of
Hand and foot (Per Hand)
985 Plastic Surgery Plastic Surgery Corrective surgery for craniosynostosis
986 Plastic Surgery Plastic Surgery Flap Cover For Electrical Burns With Vitals
Exposed for each flap
987 Plastic Surgery Plastic Surgery Hemifacial Microsmia
988 Plastic Surgery Plastic Surgery Leprosy Reconstructive Surgery for each procedure
989 Plastic Surgery Plastic Surgery Microtia/Anotia for each stage
990 Plastic Surgery Vascular Injuries Tendon/Vascular/ nerve Injury Repair - In forearm/leg/foot or hand - Payable maximum upto
for each procedure
991 Plastic Surgery Plastic Surgery Nerve And Tendon Repair + Vascular Repair for
each limb
992 Plastic Surgery Plastic Surgery Reduction Surgery For Filarial Lymphedema
993 Plastic Surgery Plastic Surgery Syndactyly Of Hand For Each finger
994 Plastic Surgery Plastic Surgery TM Joint Ankylosis
995 Plastic Surgery Plastic Surgery Vaginal Atresia
996 Plastic Surgery Plastic Surgery Vascular Malformations - Minor up to 5 Cms
997 Plastic Surgery Plastic Surgery Diabetic Foot – Surgery
998 Plastic Surgery Plastic Surgery Vascular Malformations - Major more than 5 Cms
999 Plastic Surgery Plastic Surgery Non healing wound - Diabetic foot dail dressing with skin grafting including antidiabetics
1000 Plastic Surgery Plastic Surgery Hemangioma – Sclerotherapy (under GA)
1001 Plastic Surgery Plastic Surgery Ear Pinna Reconstruction with costal cartilage/ Prosthesis
(including the cost of prosthesis /implants).
1002 Plastic Surgery Plastic Surgery Tissue Expander for disfigurement following burns/
trauma/congenital deformity (including cost of expander / implant)
1003 Plastic Surgery Plastic Surgery Pressure Sore – Surgery for Malignant and Non
malignant conditions
1004 Plastic Surgery/ Paediatric
Surgery
Plastic Surgery Cleft Lip
1005 Plastic Surgery/ Paediatric
Surgery
Plastic Surgery Cleft Palate
1006 Poly Trauma Poly Trauma Plexus injury along with Vascular injury repair with
Graft
1007 Polytrauma Abdomen Conservative Treatment Abdominal Injuries Conservative Stay In General
Ward @Rs.1500 - 2 Day stay
1008 Polytrauma Abdomen Conservative Treatment Abdominal Injuries Stay In Surgical
[email protected]/Day- 5 days stay
1009 Polytrauma Polytrauma Abdomen Abdominal Injuries Surgical Treatment
1010 Polytrauma Orthopedic Trauma Amputation Surgery finger and toes(Per finger per
toe)
1011 Polytrauma Chest Conservative Treatment Chest Injuries Conservative Stay In General Ward
@Rs.1500/Day - 5 days stay
1012 Polytrauma Chest Conservative Treatment Chest Injuries Stay In Respiratory
ICU/[email protected]/Day - 5 days stay
1013 Polytrauma Orthopedic and Facial Trauma Wound Management For Compound
Fractures
Flap Cover Surgery For Wound In Compound Fracture
1014 Polytrauma Polytrauma Chest Polytrauma Chest Surgical Treatment
1015 Polytrauma Orthopedic and Facial Trauma Wound Management For Compound
Fractures
Surgery For Patella Fracture (Fixation / Excision)
1016 Polytrauma Orthopedic and Pelvic trauma Surgical Correction of Pelvic Bone Fractures.
1017 Polytrauma Emergency Room Procedures Thoracostomy
1018 Polytrauma Orthopedic Trauma Multiple CLWs or incised wounds or crush injuries or Soft Tissue Injury for Debridement & Closure - 3
days stay
1019 Polytrauma Emergency Room Procedures Tracheostomy for polytrauma and non polytrauma
other causes.
1020 Polytrauma / Burns Trauma associated with less than 10-15 % BURNS
(CONSERVATIVE MANAGEMENT)
1021 Polytrauma / Burns Trauma associated with less than 10 % BURNS
(CONSERVATIVE MANAGEMENT)
1022 Polytrauma / Ophthalmology Corneal tear operative management
1023 Polytrauma / Ophthalmology Scleral tear
1024 Polytrauma / Ophthalmology Corneoscleral tear
1025 Polytrauma / Ophthalmology Corneoscleral tear with Intraoccular foreign body
1026 Polytrauma / Ophthalmology Lid tear
1027 Polytrauma / Ophthalmology Black eye with haemorrhage (day care basis)
1028 Polytrauma / Ophthalmology Hyphaema (Blood in eye) Non-surgical
Management
1029 Polytrauma / Ophthalmology Hyphaema (Blood in eye) Surgical Management
1030 Polytrauma / Ophthalmology Vitreous haemorrhage Conservative
1031 Polytrauma / Ophthalmology Vitreous haemorrhage Surgical Management
1032 Polytrauma / Ophthalmology Traumatic glaucoma with angle recession
1033 Polytrauma / Ophthalmology Traumatic glaucoma without angle recession
1034 Polytrauma / Ophthalmology Corneal Foreign Body
1035 Polytrauma / Orthopedics Stabilization of patient with Long Bone Fractures before internal fixation
1036 Prosthesis and Orthosis Prosthesis Upper Limb Above Elbow Above Elbow Prosthesis Modular
1037 Prosthesis and Orthosis Prosthesis Above Knee(Ak)
Prostheses
Above Knee(AK) Prostheses Modular
1038 Prosthesis and Orthosis Prosthesis Below Knee(Bk/Ptb) Below Knee(BK/PTB) Prostheses Modular
1039 Prosthesis and Orthosis Prosthesis Through Knee Prostheses Through Knee Prostheses Modular
1040 Prosthesis and Orthosis Prosthesis and Orthosis Rehabilitative management of lower limb deformity & weakness - Calipers HKFO/ KFO/ FO
1041 Prosthesis and Orthosis Prosthesis and Orthosis Rehabilitative management of spine deformity -
Milwaukee Brace Plastic Model
1042 Prosthesis and Orthosis Prosthesis and Orthosis Wrist Disarticulation Prosthesis
1043 Pulmonology Pulmonology Lower Respiratory Tract Infection 13 Days General ward Stay. Rs 20000 if complete 13 days stay.
1044 Pulmonology Pulmonology Acute Respiratory Failure (Without Ventilator)
4000 per day ICU stay - 5 Days
1045 Pulmonology Pulmonology Bronchiectasis Requiring Hospitalisation - 7 Days
Stay
1046 Pulmonology Pulmonology Interstitial Lung Diseases - 7 Days Stay
1047 Pulmonology Pulmonology Lung Abscess, Non Resolving - Ct Scan Chest, per
day - Rs 2500 - 10 Days stay
1048 Pulmonology Pulmonology Pneumoconiosis - per day Stay - Rs 2500 - 10 Days
stay
1049 Pulmonology Pulmonology Pneumothorax (Large/Recurrent) HRCT-10 Days
Stay
1050 Pulmonology Pulmonology Acute Respiratory Failure (With NIV Ventilator)
per day - Rs 5000 - 7 Days
1051 Pulmonology Pulmonology Acute Respiratory Failure (ICU stay With Invasive Ventilator) per day - Rs 6000 - 7 Days stay
1052 Pulmonology Pulmonology Treatment of Pleural diseases requiring
Thoracoscopy 3 days stay
1053 Pulmonology Pulmonology Treatment of mediastinal/lymphadenopathy requiring EBUS(Endobronchial ultrasound)
with 3 days stay
1054 Radiation Oncology Specialized Radiation Therapy - 3DCRT (3-D Conformal Radiotherapy) 3DCRT-Up upto 30 Fractions In 6 Weeks (Preferably Right breast Cancer Cervix, Endometrium, Rectum, Whole Brain Radiotherapy (WBRT), Stomach, Gastrointestinal Tract (GIT), Early stage glottic (Stage I, II), Testis, Lymphoma, Retroperitonium, Ovarian ablation, Benign Tumors, Palliative treatment, Extremity tumors)
1055 Radiation Oncology Specialized Radiation Therapy - IMRT (Intensity Modulated Radiotherapy) IMRT-Up To 35 Fractions In 8 Weeks - Preferably Pre/Post op head and neck cancer, Cancer Esophagus, Anaplastic Thyroid, Brain, Pituatary, Left Breast, Anal Canal, Lung, Pleura, Urinary bladder.
1056 Radiation Oncology Brachytherapy Interstitial B) Interstitial II. HDR One Application And Multiple Dose Fractions. Non OBGY Malignancie
1057 Radiation Oncology Brachytherapy Intracavitary A) Intracavitary II. HDR Per Application
1058 Radiation Oncology External Beam Radiotherapy (On
Linear Acclerator)
Palliative Treatment With Photons
1059 Radiation Oncology Cobalt 60 External Beam
Radiotherapy
Palliative Treatment with Cobalt 60
1060 Radiation Oncology Cobalt 60 External Beam
Radiotherapy
Radical Treatment with Cobalt 60
1061 Radiation Oncology Specialized Radiation Therapy -
SRS/SRT
SRS/SRT upto 5 fractions
1062 Radiation Oncology Specialized Radiation Therapy Rapid Arc Therapy RapidArc/ VMAT/ ART/ Tomotherapy with IGRT Up To 30 Fractions in 6 Weeks - Preferably Radical head and neck cancer, Cancer of liver, Hepatobiliary tract, Pancreas, Prostate, Heart,
Pericardium, Great vessels
1063 Radiation Oncology External Beam Radiotherapy (On
Linear Acclerator)
Radical Treatment With Photons and Electrons
1064 Radiation Oncology Cobalt 60 External Beam
Radiotherapy
Adjuvant Treatment with Cobalt 60
1065 Radiation Oncology Brachytherapy Intraluminal Brachytherapy per fraction
1066 Radiation Oncology Brachytherapy Surface mould Brachytherapy for skin tumors and
vaginal tumors
1067 Radiation Oncology Brachytherapy Interstitial plus Intracavitory per fraction - For
OBGY Malignancies
1068 Rheumatology Rheumatology MCTD Mixed Connective Tissue Disorder 7 Days
Stay
1069 Rheumatology Rheumatology Scleroderma 7 Days Stay
1070 Rheumatology Rheumatology SLE (Systemic Lupus Erythematosis) 10 Days Stay
1071 Rheumatology Rheumatology SLE With Sepsis 4 Weeks Stay
1072 Rheumatology Rheumatology Vasculitis 6 Days Stay. Rs 10000 if LOS 6 Days.
1073 Rheumatology Rheumatology Rheumatoid Arthritis with ILD/ Vasculitis 7 days
stay
1074 Rheumatology Rheumatology Polymyocitis / Dermatomyocitis 7 days stay
1075 Rheumatology Rheumatology Antiphospholipid Antibody syndrome 7 days
1076 Rheumatology Rheumatology Spondyloarthropathy 5 days stay
1077 Rheumatology Rheumatology Spondyloarthropathy with Biologic therapy - One
day
1078 Rheumatology Rheumatology SLE AIHA / SLE Thrombocytopenia - 10 days stay
1079 Rheumatology /
Endocrinology
Rheumatology Osteoporosis - Zoledronic acid injection - One day
stay
1080 Surgical Gastro Enterology Large Intestine Abdomino Perineal Resection(Non- Malignant)
1081 Surgical Gastro Enterology Large Intestine Anterior Resection - Rectum and Anus/Large
Intestine Open / Laparoscopic
1082 Surgical Gastro Enterology Large Intestine Anterior Resection With Ileostomy Open /
Laparoscopic
1083 Surgical Gastro Enterology Gall Bladder Choledochoduodenostomy Or Choledocho Jejunostomy
Or
Hepaticojejunostomy
1084 Surgical Gastro Enterology Liver Cyst Excision + Hepatic Jejunostomy
1085 Surgical Gastro Enterology Large Intestine Extended Right Hemicolectomy
1086 Surgical Gastro Enterology Large Intestine Hartman.S Procedure With Colostomy (for
Obstruction)
1087 Surgical Gastro Enterology Liver Hydatid Cyst- Excision or Pericystectomy Open /
Laparoscopic
1088 Surgical Gastro Enterology Ulcerative Colitis Ii Stage Procedure I Stage- Sub Total Colectomy + Ileostomy + J -
Pouch
1089 Surgical Gastro Enterology Ulcerative Colitis Iii Stage Procedure I Stage-Sub Total Colectomy + Ileostomy
1090 Surgical Gastro Enterology Ulcerative Colitis Ii Stage Procedure II Stage- Ileostomy
1091 Surgical Gastro Enterology Ulcerative Colitis Iii Stage Procedure II Stage-J - IPAA with Ileostomy
1092 Surgical Gastro Enterology Ulcerative Colitis Iii Stage Procedure Ileostomy Closure
1093 Surgical Gastro Enterology Gall Bladder GB+ Calculi CBD Stones Or Dilated CBD
1094 Surgical Gastro Enterology Oesophagus Lap Fundoplications
1095 Surgical Gastro Enterology Oesophagus Lap Heller’s Myotomy
1096 Surgical Gastro Enterology Pancreas Lap- Pancreatic Necrosectomy
1097 Surgical Gastro Enterology Pancreas Lateral Pancreaticojejunostomy(Non-
Malignant)/FREYS PROCEDURE
1098 Surgical Gastro Enterology Large Intestine Left Hemicolectomy Open
1099 Surgical Gastro Enterology Oesophagus Oesophagectomy
1100 Surgical Gastro Enterology Oesophagus Oesophago-Gastrectomy
1101 Surgical Gastro Enterology Gall Bladder Cholecystectomy & Exploration CBD
1102 Surgical Gastro Enterology Pancreas Pancreatic Necrosectomy (Open)
1103 Surgical Gastro Enterology Stomach Partial Gastrectomy
1104 Surgical Gastro Enterology Large Intestine Right Hemicolectomy
1105 Surgical Gastro Enterology Spleen Spleenectomy For Space Occupying Lesion/Portal
Hypertension/ Hypersplenism etc
1106 Surgical Gastro Enterology Stomach Surgery For Corrosive Injury Stomach/Esophagus
1107 Surgical Gastro Enterology Stomach Total Gastrectomy
1108 Surgical Gastro Enterology Small Intestine Volvulus
1109 Surgical Gastro Enterology Pancreas Whipples Any Type
1110 Surgical Gastro Enterology Surgical Gastro Enterology Oesophageal Diverticula /Achlasia Cardia
1111 Surgical Gastro Enterology Liver Rt/Lt Hepatectomy
1112 Surgical Gastro Enterology Stomach Distal Gastrectomy or Gastrojejunostomy For
Gastric Outlet Obstruction
1113 Surgical Gastro Enterology Left Hemicolectomy Laparoscopic
1114 Surgical Gastro Enterology Liver Shunt/Devascularization Surgery for PHT
1115 Surgical Gastro Enterology Small Intestine Bariatric Procedures
1116 Surgical Gastro Enterology /
General Surgery
Small Intestine Lap Adhesiolysis
1117 Surgical Gastroenterology Oesophagus Injuries Gastro Study Followed By Thoracotomy And Repairs For Oesophageal Injury For Corrosive
Injuries/FB
1118 Surgical Oncology Ca Abdominal Wall Tumour Abdominal Wall Tumour Resection
1119 Surgical Oncology Ca GIT Abdomino Perineal Resection (Apr) + Sacrectomy
1120 Surgical Oncology Ca GIT Abdominoperineal Resection
1121 Surgical Oncology Soft Tissue/ Bone Tumours Amputation for soft tissue/Bone Tumours
1122 Surgical Oncology Urinary Bladder/ Ca - Cervix/Rectum Anterior/Posterior Exenteration
1123 Surgical Oncology Ca GIT Anterior Resection
1124 Surgical Oncology Breast Axillary Dissection
1125 Surgical Oncology Adrenal Gland Adrenalectomy
1126 Surgical Oncology Gynecology Bilateral Pelvic Lymph Node Dissection(BPLND)
1127 Surgical Oncology Urinary Bladder Bilateral Pelvic Lymph Node Dissection(BPLND)
for CA Urinary Bladder
1128 Surgical Oncology Limb Salvage Surgery Bone Resection
1129 Surgical Oncology Breast Breast Reconstruction
1130 Surgical Oncology Soft Tissue/ Bone Tumours. Chest
Wall
Chest Wall Resection
1131 Surgical Oncology Breast Chest Wall Resection
1132 Surgical Oncology Soft Tissue/ Bone Tumours. Chest
Wall
Chest Wall Resection + Reconstruction
1133 Surgical Oncology Ca GIT Closure Of Ileostomy
1134 Surgical Oncology Ca GIT Colectomy Any Type
1135 Surgical Oncology Head And Neck Composite Resection & Reconstruction
1136 Surgical Oncology Ca - Eye/ Maxilla /Para Nasal Sinus Cranio Facial Resection
1137 Surgical Oncology Limb Salvage Surgery Curettage & Bone Cement
1138 Surgical Oncology Bone tumours Forequarter Amputation
1139 Surgical Oncology Oral Cavity Full Thickness Buccal Mucosal Resection &
Reconstruction
1140 Surgical Oncology Ca GIT Gastrectomy Any Type
1141 Surgical Oncology Palliative Surgeries Gastro Jejunostomy
1142 Surgical Oncology Palliative Surgeries Gastrostomy
1143 Surgical Oncology Ca Liver Haemangioma SOL Liver Hepatectomy + Wedge
Resection
1144 Surgical Oncology Head And Neck Hemiglossectomy
1145 Surgical Oncology Head And Neck Hemimandibulectomy
1146 Surgical Oncology Bone tumours External Hemipelvectomy
1147 Surgical Oncology Palliative Surgeries Ileostomy
1148 Surgical Oncology Palliative Surgeries Ileotransverse Colostomy
1149 Surgical Oncology Palliative Surgeries Intercostal Drainage(ICD)
1150 Surgical Oncology Limb Salvage Surgery Internal Hemipelvectomy
1151 Surgical Oncology Head And Neck Laryngo Pharyngo Oesophagectomy
1152 Surgical Oncology Ca Ear Lateral Temporal Bone Resection
1153 Surgical Oncology Limb Salvage Surgery Limb Salvage Surgery With Custom Made
Prosthesis
1154 Surgical Oncology Limb Salvage Surgery Limb Salvage Surgery With Modular Prosthesis
1155 Surgical Oncology Limb Salvage Surgery Limb Salvage Surgery Without Prosthesis
1156 Surgical Oncology Breast Lumpectomy Breast
1157 Surgical Oncology Ca Lung Lung Cancer Lobectomy
1158 Surgical Oncology Ca Lung Lung Cancer Pnumenectomy
1159 Surgical Oncology Ca Lung Lung Metastatectomy. Multiple
1160 Surgical Oncology Ca Lung Lung Metastatectomy. Solitary
1161 Surgical Oncology Oral Cavity Marginal Mandibulectomy
1162 Surgical Oncology Ca - Eye/ Maxilla /Para Nasal Sinus Maxillectomy + Infratemporal Fossa Clearance
1163 Surgical Oncology Ca - Eye/ Maxilla /Para Nasal Sinus Maxillectomy + Orbital Exenteration
1164 Surgical Oncology Head And Neck Maxillectomy Any Type
1165 Surgical Oncology Thorax, Mediastinum Mediastinal Tumour Resection
1166 Surgical Oncology Reconstruction Micro Vascular Reconstruction (Free flap)
1167 Surgical Oncology Breast Mastectomy Any Type
1168 Surgical Oncology Reconstruction Myocutaneous / Cutaneous Flap
1169 Surgical Oncology Head And Neck Neck Dissection Any Type
1170 Surgical Oncology Oesophagus Oesophagectomy With Three Field
Lymphadenectomy
1171 Surgical Oncology Oesophagus Oesophagectomy With Two Field
Lymphadenectomy
1172 Surgical Oncology Ca - Eye/ Maxilla /Para Nasal Sinus Orbital Exenteration
1173 Surgical Oncology Ca - Soft Palate Palatectomy Any Type
1174 Surgical Oncology Ca Parathyroid Parathyroidectomy
1175 Surgical Oncology Genitourinary Partial Nephrectomy
1176 Surgical Oncology Ca Gall Bladder Radical / Revision Cholecystectomy
1177 Surgical Oncology Nasopharynx Resection Of Nasopharyngeal Tumour
1178 Surgical Oncology Ca Retroperitoneal Tumors Resection Of Retroperitoneal Tumours
1179 Surgical Oncology Ca Abdominal Wall Tumour Resection With Reconstruction of Abdominal Wall
Tumour
1180 Surgical Oncology Testis Cancer Retro Peritoneal Lymph Node Dissection Rplnd As
Part Of Staging
1181 Surgical Oncology Testis Cancer Retro Peritoneal Lymph Node Dissection(RPLND)
(For Residual Disease)
1182 Surgical Oncology Gynecology Salpino Oophorectomy
1183 Surgical Oncology Oral Cavity Segmental Mandibulectomy
1184 Surgical Oncology Ca Liver Segmentectomy
1185 Surgical Oncology Limb Salvage Surgery Shoulder Girdle Resection
1186 Surgical Oncology Skin Tumours Skin Tumours Amputation
1187 Surgical Oncology Skin Tumours Skin Tumours Wide Excision
1188 Surgical Oncology Skin Tumours Skin Tumours Wide Excision + Reconstruction
1189 Surgical Oncology Ca Lung Sleeve Resection Of Lung Cancer
1190 Surgical Oncology Ca GIT Small Bowel Resection
1191 Surgical Oncology Ca Spleen Splenectomy
1192 Surgical Oncology Surgical Oncology Submandibular Gland Excision
1193 Surgical Oncology Ca Ear Subtotal Temporal Bone Resection
1194 Surgical Oncology Gynecology Surgery For Ca Ovary - Omentectomy, Bilateral
Salping oophorectomy
1195 Surgical Oncology Head And Neck Thyroidectomy Any Type
1196 Surgical Oncology Ca Endometrium Total Abdominal Hysterectomy(TAH) + Bilateral Salpingo Ophorectomy (BSO) + Bilateral Pelvic Lymph Node Dissection (BPLND) + Omentectomy
1197 Surgical Oncology Ca Rectum Total Exenteration
1198 Surgical Oncology Urinary Bladder Total Exenteration
1199 Surgical Oncology Oral Cavity Total Glossectomy + Reconstruction
1200 Surgical Oncology Head And Neck Laryngectomy Any Type
1201 Surgical Oncology Ca GIT Oesophagectomy Any Type
1202 Surgical Oncology Ca Cervix Total Pelvic Exenteration
1203 Surgical Oncology Genitourinary Total Penectomy
1204 Surgical Oncology Ca Ear Total Temporal Bone Resection
1205 Surgical Oncology Testis Cancer Urinary Diversion
1206 Surgical Oncology Ca GIT Whipples Any Type
1207 Surgical Oncology Soft Tissue/ Bone Tumours Wide Excision + Reconstruction soft tissue/Bone
Tumours
1208 Surgical Oncology Soft Tissue/ Bone Tumours Wide Excision for tumour
1209 Surgical Oncology Breast Wide Excision of Breast for Tumour
1210 Surgical Oncology Soft Tissue/ Bone Tumours Wide Excision soft tissue/Bone Tumours
1211 Surgical Oncology Surgical Oncology Oesophageal stenting including stent cost
1212 Surgical Oncology Surgical Oncology Enucleation of pancreatic neoplasm(Other than
Neck of Pancreas)
1213 Surgical Oncology General Surgery Malignant Soft Tissue Tumor – Excision
1214 Surgical Oncology Gynecology Radical Vaginectomy and /or Reconstruction
1215 Surgical Oncology Ca Trachea Tracheal Resection with or without carinal resection
1216 Surgical Oncology Palliative Surgeries Tracheostomy for all malignancies
1217 Surgical Oncology Gynecology Vulvectomy with reconstruction
1218 Surgical Oncology Haemostatic surgery in advanced cancer patient
or Haemostatic Radiotherapy
1219 Surgical Oncology Head And Neck Wide Excision of Tumor
1220 Surgical Oncology Gynec Oncosurgery Wertheim's Hysterectomy
1221 Surgical Oncology Oesophageal or Tracheal stenting Tracheal stenting
1222 Surgical Oncology GIT Malignancy Intersphinctoric Resection Open/ Laparoscopic
1223 Surgical Oncology Hepatoblastoma Hepatoblastoma - Excision
1224 Surgical Oncology Wilm's Tumour Wilm's tumour surgery
1225 Surgical Oncology Muscle tumours Leiomyoma Excision
1226 Surgical Oncology OBGY Radical Trachelectomy
1227 Surgical Oncology Bone tumours Sacral tumor Excision
1228 Surgical Oncology Regional flap Fasciocutaneous flap
1229 Surgical Oncology Spinal Surgeries Vertebral tumor excision and reconstruction
1230 Surgical Oncology Surgical Oncology Excision of Growth from Tongue
1231 Surgical Oncology Surgical Oncology Voice prosthesis (US FDA /CE approved)
1232 Surgical Oncology Surgical Oncology Estlander Operation (lip)
1233 Surgical Oncology Skull base surgery Orbital decompression
1234 Surgical Oncology Skull base surgery Clival tumor excision
1235 Surgical Oncology Skull base surgery Subtotal petrosectomy
1236 Surgical Oncology Skull base surgery Skull base surgery Fisch / Translabyrynthine /
Transcochlear approach
1237 Surgical Oncology / Cardiac And Cardiothoracic Surgery CVTS Lungs Pneumonectomy
1238 Surgical Oncology / Cardiac And Cardiothoracic Surgery CVTS Lungs Pleurectomy Decortication
1239 Surgical Oncology / ENT Head And Neck Parotidectomy Any Type
1240 Surgical Oncology / ENT ENT Total Phryngectomy
1241 Surgical Oncology / ENT ENT Tracheal stenosis (End to end anastamosis)
1242 Surgical Oncology / ENT ENT Central airway tumor debulking
1243 Surgical Oncology / ENT ENT Mediastinal tumour or Lymphadenectomy
1244 Surgical Oncology / ENT Lip Wedge excision and Vermilionectomy
1245 Surgical Oncology / ENT Lip Cheek advancement
1246 Surgical Oncology / ENT Lip Excision of tumor of oral cavity or paranasal sinus or Laryngopharynx without reconstruction
1247 Surgical Oncology / ENT Lip Excision of tumor of oral cavity or paranasal sinus
or Laryngopharynx with reconstruction
1248 Surgical Oncology / ENT ENT Open laryngeal framework surgery or Thyroplasty
1249 Surgical Oncology / ENT ENT Selective pharyngeal diverticulum excision
1250 Surgical Oncology / ENT Skull base surgery Maxillary swing
1251 Surgical Oncology / ENT Throat Parapharyngeal Tumour Excision
1252 Surgical Oncology / ENT
Surgery
ENT Surgery Facial Nerve Decompression
1253 Surgical Oncology / ENT
Surgery
Head And Neck Wedge Excision
1254 Surgical Oncology / ENT
Surgery
ENT Excision of Pinna for Growths (Squamous/Basal) /
Injuries - Total amputation
1255 Surgical Oncology / ENT
Surgery
ENT Endoscopic Hypophysectomy
1256 Surgical Oncology / General
surgery
Palliative Surgeries Jejunostomy
1257 Surgical Oncology / General
surgery
Anorectal Excision of rectal polyp
1258 surgical Oncology / General
Surgery
General Surgery Scalp tumour Excision with skull bone excision
1259 Surgical Oncology / Pediatric
Surgery
Head And Neck Neuroblastoma
1260 Surgical Oncology / Surgical
Gastro Enterology
Oesophagus Colonic Pull Up /
Gastric Pull Up
1261 Surgical Oncology / Surgical
Gastro Enterology
Pancreas Distal Pancreatectomy
1262 Surgical Oncology / Surgical
Gastro Enterology
Pancreas Distal Pancreatectomy + Splenectomy
1263 Surgical Oncology / Surgical
Gastro Enterology
Ca GIT Tripple Bypass
1264 Surgical Oncology / Surgical
Gastro Enterology
Ca GIT Other Bypasses-Pancreas and others
1265 Surgical Oncology / Urology Genitourinary Bilateral Orchidectomy
1266 Surgical Oncology / Urology Genitourinary Emasculation
1267 Surgical Oncology / Urology Genitourinary High Orchidectomy
1268 Surgical Oncology / Urology Genitourinary Inguinal Block Dissection One Side
1269 Surgical Oncology / Urology Genitourinary Nephroureterectomy For Transitional Cell
Carcinima Of Renal Pelvis Open / Lap
1270 Surgical Oncology / Urology Genitourinary Other Cystectomies
1271 Surgical Oncology / Urology Genitourinary Radical Nephrectomy
1272 Surgical Oncology / Urology Genitourinary Radical Prostatectomy
1273 Surgical Oncology / Urology Genitourinary Penile preserving Surgery (WLE, Glansectomy,
Laser)
1274 Surgical Oncology / Urology Genitourinary Radical Cystectomy
1275 Surgical Oncology / Urology Urology Ureteric End to end anastamosis
1276 Surgical Oncology / Urology Urology Radical Urethrectomy
1277 Surgical Oncology / Urology Urology Germ cell tumor excision
1278 Surgical Oncology / Urology Urology Partial Cystectomy
1279 Surgical Oncology / Urology Urology Corrective Procedures Distal ureterectomy with Reimplantation
1280 Urology Urology Laparaoscopic Anderson Hynes Pyeloplasty
1281 Urology Urology Open Prostatectomy (Millin's )
1282 Urology Urology Laparoscopic Ureterolithotomy
1283 Urology Urology Surgery for correction of ureteric stricture (Ureteric
Reimplantation) Unilateral
1284 Urology Urology Ultrasound guided Perinephric Abscess drainage
1285 Urology Urology Varicocele-unilateral
1286 Urology Urology Varicocele-bilateral
1287 Urology Urology Kidney Stone Open Anderson Hynes Pyeloplasty
1288 Urology Urology, Testis And Penis Chordee Correction (Plication)
1289 Urology Urology Corrective Procedures Closure Of Urethral Fistula
1290 Urology Lithotripsy DJ Stent (One Side)
1291 Urology Urology Endoscope Removal Of Stone In Bladder
1292 Urology Lithotripsy ESWL
1293 Urology Corrective Procedures Hypospadius Double Stage - Stage-1
1294 Urology Corrective Procedures Hypospadius Double Stage - Stage-2
1295 Urology Corrective Procedures Hypospadius Single Stage
1296 Urology Urology Corrective Procedures Ileal Conduit formation
1297 Urology Urology Lap. Nephrectomy Radical
1298 Urology Urology Lap. Partial Nephrectomy
1299 Urology Renal Calculi Laparoscopic Pyelolithotomy
1300 Urology Urology Nephrostomy
1301 Urology Adrenal Gland Open Adrenalectomy
1302 Urology Renal Calculi Open Nephrolithotomy
1303 Urology Urology Corrective Procedures Optical Urethrotomy
1304 Urology Urology, Testis And Penis Orchidopexy Bilateral
1305 Urology Urology Corrective Procedures Perineal Urethrostomy
1306 Urology Urology Laparoscopic Renal Cyst Excision
1307 Urology Transplantation Renal Transplantation Surgery Including cost of 4,50,000
1. Renal transpalntation - 150000
2. AV fistula - 20000
3. Doner's Nephrectomy - 50000
4. Recipient Investigations such as Blood investigations, HLA typing, CT Scan, Miturating Cystourethrogram, Retrograde Urethrogram etc - 45000
5. Donor’s Investigations Blood investigations, HLA typing, CT Angiography - 45000
6. Dialysis after Renal transplant (12 weeks) if needed as per Nephrologist’s remarks - 40000
7. Immunosupression therapy for every year as per advice of Nephrologist - 100000
Initially preauth of Rs 3,10,000 aprroved. Other Preauths of AV Fistula, Dialysis and Immunosupression therapy will be approved separately.
1308 Urology Urology Nephrectomy Pyonephrosis/XGP
1309 Urology Urology, Testis And Penis Torsion Testis
1310 Urology Bladder Prostate Total Cystectomy / Radical cystectomy
1311 Urology Urology Corrective Procedures Transurethral Resection Of Prostate (TURP) /
Bladder neck incision
1312 Urology Urology Corrective Procedures Endoscopic Ureterocele incision
1313 Urology Corrective Procedures Urethroplasty For Stricture Urethra Double Stage
Stage-1
1314 Urology Corrective Procedures Urethroplasty For Stricture Urethra Double Stage
Stage-2
1315 Urology Corrective Procedures Urethroplasty For Stricture Urethra Single Stage
1316 Urology Lithotripsy URSL
1317 Urology Urology Corrective Procedures Vasico Vaginal Fistula
1318 Urology Corrective Procedures Hypospadius Adult Double Stage - TURBT
1319 Urology Urology Kidney Stone Open Pyelolithotomy
1320 Urology Lithotripsy Open removal of bladder stone
1321 Urology Urology Corrective Procedures Epispadiasis - Correction - Stage 1
1322 Urology Bladder Prostate Open Prostatectomy (Freyer's )
1323 Urology Urology, Testis And Penis Laparoscopic Orchidopexy Bilateral
1324 Urology Lithotripsy PCNL or RIRS or Push back PCNL for upper
ureretic calculus less than 1 cm
1325 Urology Urology Open simple Nephrectomy
1326 Urology Urology, Testis And Penis Chordae Correction (Patch)
1327 Urology Urology DJ Stent removal Unilateral / Bilateral
1328 Urology Urology Corrective Procedures Epispadiasis - Correction - Stage 2
1329 Urology Urology Open Nephrectomy Radical
1330 Urology Urology Open Partial Nephrectomy
1331 Urology Lithotripsy PCNL or RIRS or Push back PCNL for upper
ureretic calculus more than 1 cm
1332 Urology Urology Laparoscopic simple Nephrectomy
1333 Urology Urology Open Ureterolithotomy
1334 Urology Urology (Genitourinary System) Augmentation cystoplasty
1335 Urology Urology (Genitourinary System) Meatoplasty
1336 Urology Urology (Genitourinary System) Meatotomy
1337 Urology Urology (Genitourinary System) Endopyelotomy (anterograde with laser/bugbee)
1338 Urology Urology (Genitourinary System) Uretero-ureterostomy Open
1339 Urology Urology (Genitourinary System) Ureterotomy (Cutaneous)
1340 Urology Urology (Genitourinary System) Uretero-vaginal/uterine fistula repair Open
1341 Urology Urology (Genitourinary System) Urethral Dilatation- as an independent procedure
1342 Urology Urology (Genitourinary System) Surgery for Bladder injury repair with or without urethral injury (as an independent procedure)
1343 Urology Urology (Genitourinary System) Suprapubic Drainage - Closed/Trocar
1344 Urology Urology (Genitourinary System) Urethrovaginal fistula repair (independent
procedure)
1345 Urology Urology (Genitourinary System) Reduction of Paraphimosis
1346 Urology Urology (Genitourinary System) Excision of Urethral Caruncle
1347 Urology Urology (Genitourinary System) Emergency management of Acute retention of Urine
1348 Urology Urology (Genitourinary System) Partial Cysteectomy / Urachal Cyst excision -open
1349 Urology Urology (Genitourinary System) Ureterocalycostomy Open
1350 Urology Urology (Genitourinary System) Endoureterotomy (laser/bugbee)
1351 Urology Urology (Genitourinary System) Intravesical BCG/Mitomycin 6 induction cycles
(weekly for 6 weeks-total cost of 6 cycles)
1352 Urology Urology (Genitourinary System) Bladder Neck incision-endoscopic
1353 Urology Urology (Genitourinary System) Bladder Neck Reconstruction
1354 Urology Urology (Genitourinary System) Urinary tract trauma Repair Open/Laparoscopy
1355 Urology Urology (Genitourinary System) Post Urethral Valve fulguration
1356 Urology Urology (Genitourinary System) Internal Ureterotomy including cystoscopy as an
independent procedure

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