List of Services Department Wise

D Code Dept name Hiper Link
D01 Pulmonary Medicine Pulmonary Medicine-D1'!Print_Titles

D02 Dermatology Dermat-D2'!Print_Titles
D03 Gastroenterology GastroEnter-D3'!Print_Titles
D04 General medicine General Medicine-D4'!Print_Titles
D05 Neonatology Neonatology-D5'!Print_Titles
D06 Nephrology Nephrology-D6'!Print_Titles
D07 Neurology Neurology-D7'!Print_Titles
D08 Paediatrics Paediatrics-D8'!Print_Titles
D09 Cardiology Cardiology-D9'!Print_Titles
D10 Endocrinology Endocrinology-D10'!Print_Titles
D11 Medical Oncology Medical Oncology-D11'!Print_Titles
D12 PMR PMR-D12'!Print_Titles
D13 Paediatric Nephrology Paediatric Nephrology-D13'!Print_Titles
D14 Palliative Medicine Palliative Medicine -D14'!Print_Titles
D15 Psychiatry Psychiatry-D15'!Print_Titles
D16 Radiation Oncology Radiation Oncology-D16'!Print_Titles
D17 Dental Surgery Dental Surgery-D17'!Print_Titles
D18 Ophthalmology Opthalmology- D18'!Print_Titles
D19 paediatric surgery Paediatric Surgery-D19'!Print_Titles
D20 Surgical Oncology Surgical Oncology-D20'!Print_Titles
D21 Cardio Thoracic Surgery Cardio Thora Surg-D21'!Print_Titles
D22 ENT ENT -D22'!Print_Titles
D23 General Surgery General surgery -D23'!Print_Titles
D24 Gynaecologic Oncology Gyne. Onco-D24'!Print_Titles
D25 Neuro surgery Neuro surg-D25'!Print_Titles
D26 Obstetrics &Gynaecology OBG-D26'!Print_Titles
D27 Orthopaedics Ortho-D27'!Print_Titles
D28 Plastic surgery Plastic surg-D28'!Print_Titles
D29 Genito Urinary Surgery Genito Urin.surg-D29'!Print_Titles
D30 Anesthesiology Anaethes-D30'!Print_Titles
D31 Emergency Medicine Emerg.Medicine D31'!Print_Titles
D32 Medical I C U CCU-D32'!Print_Titles
D33 Radiology Radiology-D33'!Print_Titles
D34 Bio Chemistry Bio-chemistry D34'!Print_Titles
D35 Micro Biology Micro-Biology D35'!Print_Titles
D36 TRANS MED & IMMUNO HAEMATOLOGY Trans & Immu Haema D36'!Print_Titles
D37 UoH
D38 Immunology Immunology-D38'!A1
D39 Physiotherapy Physiother-D39'!A1
D40 Other Depts
Nursing Procedures General Procedures (2)'!A1
Pharmacy Pharmacy!A1
Admin ( ADH) Admin!A1
SJMC SJMC!A1
SJRI SJRI!A1
Page 4 of 368
Schedule of Charges praposal for 2018-19
Pulmonary Medicine
Sum of units Any request
Service Common
Ch Code ChargeDesc ServiceDesc ServCat from Apr-17 to for Rate Remarks
Catagory ward Rate Nov-17 Revision
Printed in SOC's
V. NON-OPERATIVE PROCEDURES *
B. SPECIALISED PROCEDURES
9. PULMONARY MEDICINE
165 Pulmonary Medicine
2809 Bronchial Challenge Test PROCEDURE null 1,000 2
2810 Fiberoptic Bronchoscopy PROCEDURE null 3,000 191
2811 Fiberoptic Bronchoscopy - Repeat within 1 weePROCEDURE null 1,050 6
2812 Biopsy - Fiberoptic Bronchoscopy & Biopsy PROCEDURE null 3,250 47
2818 Spirometry / Routine Spirometry with BronchodPROCEDURE null 300 2,532
2822 Lung Volume PROCEDURE null 1,500 6
2823 DLCO PROCEDURE null 1,500 118
2824 Pleural Aspiration (Therapeutic) PROCEDURE null 300 18
2825 Bronchoscopic endotracheal Intubation PROCEDURE null 1,500 1
2826 Spirometry (Repeat) PROCEDURE null 100 8
2829 Lung Volume + DLCO PROCEDURE null 2,500 6
2830 Pleural Aspiration (Repeat) PROCEDURE null 300 -
2831 Pleurodesis PROCEDURE null 1,000 8
2832 Sleep Study PROCEDURE null 6,000 166
2833 Chemotheraphy PROCEDURE null 500 150
2841 Titration Study PROCEDURE null 2,500 105
2842 Multilple Sleep Latency Test (MSLT) PROCEDURE null 3,000 1
2843 Single Antigen PROCEDURE null 100 -
2844 Five Antigens PROCEDURE null 500 26
2845 30 Antigens PROCEDURE null 2,000 -
2847 Concentration 1:5000 and 1:500 MISC. null 500 -
2848 Concentration 1:50 (0.5cc and 0.6 cc) MISC. null 500 -
2849 concentration 1:50 (0.6cc and 1 cc) MISC. null 500 -
2858 Breath Carbon - Monoxide levels (smoking) PROCEDURE null 50 12
Page 4 of 368
Page 5 of 368
Pulmonary Medicine
Service Common
2859 6 Minute Walk Test PROCEDURE null 250 204
2860 Trans Bronchial Needle Aspiration PROCEDURE null 3,500 7
2861 Trans Bronchial Lung Biopsy PROCEDURE null 3,500 21
2884 Medical Thoracoscopy PROCEDURE null 5,000 17
2992 FeNO PROCEDURE null 500 108
2993 Level 3 Sleep Study PROCEDURE null 2,000 39
2994 USG Chest PROCEDURE null 500 150
2998 Split Sleep Study PROCEDURE null 6,500 19
2999 Autotitration 1 night PROCEDURE null 600 20
3000 Autitrtion 2 nights PROCEDURE null 1,000 8
3571 CPAP per day PROCEDURE null 500 29
3572 Bipap per day PROCEDURE null 500 518
3573 Pleural Biopsy PROCEDURE null 1,000 -
3574 Intercostal/Mallecot Drainage PROCEDURE null 1,000 20
3579 USG Chest (Repeat) MISC. null 250 16
3580 USG Pleural Aspiration MISC. null 750 66
3581 USG Pigtail Insertion MISC. null 1,500 24
3582 USG Lung Biopsy MISC. null 1,500 11
3583 MEP/MIP MISC. null 250 1
3584 TGV MISC. null 1,500 4
3585 Exercise Prescription PROCEDURE null 250 16
3586 Breathing Exercise PROCEDURE null 100 87
3587 Breathing Exercise and Chest PT PROCEDURE null 100 69
3588 Breathing Exercise and Chest PT and Postural DrMISC. null 150 110
3589 Breathing Exercise, Aerobic Training PROCEDURE null 120 32
3590 Breathing Exercise ,Aerobic Training and Resist MISC. null 160 1
3591 Sleep (mask fitting,upper airway excercises) PROCEDURE null 150 14
3592 Pulmonary Rehabilitation for twice a day in a wMISC. null 300 49
3593 Pulmonary Rehabilation Package for 12 visits PROCEDURE null 1,200 7
Page 5 of 368
Page 6 of 368
Pulmonary Medicine
Service Common
3594 Endobronchial Ultra Sound PROCEDURE null 17,500 17
3598 Repeat USG guided BIOPSY PROCEDURE null 300 -
3599 Cardio PulmonaryCardio Pulmonary Excercise TePROCEDURE null 2,500 5
9.1 PULMONARY MEDICINE. OT
177 Pulmonary Surgery
3595 Whole Lung Lavage SURGERY MAJOR 15,000 -
3596 Medical Thoracoscopy in OT SURGERY MAJOR 10,000 3
3597 OT Bronchoscopy SURGERY MAJOR 5,000 6
Not Printed in SOC's confrim to print or not
156 Evening Special Procedures
2809 Bronchial Challenge Test -E PROCEDURE null 1,800 -
2810 Fiberoptic Bronchoscopy -E PROCEDURE null 5,400 -
2811 Fiberoptic Bronchoscopy - repeat within 1 weekPROCEDURE null 2,700 -
2812 Fiberoptic Bronchoscopy and Biopsy -E PROCEDURE null 5,850 -
2818 Routine Spirometry with Bronchodilator/ Spiro PROCEDURE null 450 11
2822 Lung Volume -E PROCEDURE null 2,700 -
2824 Pleural Asp.(Therapeutic) -E PROCEDURE null 900 -
2825 Bronchoscopic Endotracheal Intubation -E PROCEDURE null 2,700 -
2833 Chemotherapy PROCEDURE null 900 -
165 Pulmonary Medicine
2803 Biopsy - Lung PROCEDURE null 270 -
3575 Chemotheraphy PROCEDURE null 320 35
95035 Operation Charges - Pulmonary Medicine MISC. null - -
Signature of HOD Signature of CMS Signature of ADH

Date Date Date
Page 6 of 368
Dermatology
Common ward Sum of units from Any request for

Ch Code ChargeDesc ServiceDesc Service Catagory ServCat Rate Apr-17 to Nov-17 Rate Revision
Printed in SOC's
3. Dermatology 3.1 Acne surgeries
44 Dermatology
755 Acne Scar Revision (per sitMISC. null 1000 15
782 Punch Elevation (per Scar)MISC. null 500 1
792 Microdermabrasion - Mediu MISC. null 750 0
793 Microdermabrasion - LargeMISC. null 1500 0
817 Acne Scar Revision (per sitMISC. null 1500 24
848 Dermaroller PROCEDURE null 1500 11
3. Dermatology 3.10 Laser
44 Dermatology
838 Laser PIXEL Large ( > 5X5 MISC. null 5000 10
857 Ablative Laser Cosmetic InPROCEDURE null 4000 4
858 Ablative Laser Cosmetic IndPROCEDURE null 8000 0
859 Ablative Laser Medical IndPROCEDURE null 3000 6
864 Laser Hair removal - Legs( PROCEDURE null 6000 1
865 Laser Hair removal - Axill PROCEDURE null 4000 5
877 Laser Hair removal - Legs( MISC. null 16000 0
878 Laser Hair removal - Axill MISC. null 10000 6
3. Dermatology 3.10 Molluscum
44 Dermatology
707 Currettage of Molluscum MISC. null 400 65
709 Curettage of Molluscum CMISC. null 1000 39
842 Currettage of Molluscum PROCEDURE null 600 28
3. Dermatology 3.11 Paring charges
44 Dermatology
Page 7 of 368
Dermatology

726 Paring (Small) MISC. null 200 809

814 Paring ( Large) MISC. null 400 25
3. Dermatology 3.12 Peels
44 Dermatology
797 Chemical Peels (NeostrataMISC. null 1500 95
798 Chemical Peels (TC) MISC. null 1500 2
836 Spot Peel MISC. null 1000 2
837 TCA Cross PROCEDURE null 1000 4
853 Chemical Peel (Salicylic AcPROCEDURE null 1500 10
854 Peel Service Charge(Own PPROCEDURE null 1000 0
855 Combination Chemical PeePROCEDURE null 2000 46
879 Chemical Peel - Back PROCEDURE null 3000 0
880 Chemical Peel - Arms PROCEDURE null 2000 0
3. Dermatology 3.13 Phototherapy
44 Dermatology
744 PUVA Therapy MISC. null 150 530
758 Narrow Band UVB (per sittMISC. null 200 4109
826 Hand & Foot PhototherapMISC. null 100 71
827 Hand & Foot PhototherapMISC. null 150 757
3. Dermatology 3.14 PRP
44 Dermatology
839 PRP (Medical indications) PROCEDURE null 500 16
840 PRP (Cosmetic indicationsMISC. null 3000 40
3. Dermatology 3.15 Radiofrequency
44 Dermatology
808 Radiofrequency Ablation -MISC. null 1000 23
809 Radiofrequency Ablation MISC. null 1500 8
Page 8 of 368
Dermatology


3. Dermatology 3.16 UL(Both) (X 3 package)
44 Dermatology
831 Skin Rejuvinaton / Toning MISC. null 1500 0
856 Pixel Laser (< 5x5cm) PROCEDURE null 3000 2
861 Laser Hair removal - UpperPROCEDURE null 2000 41
862 Laser Hair removal - SubmPROCEDURE null 3000 24
863 Laser Hair removal - Full FPROCEDURE null 5000 15
866 Nd-Yag Laser PROCEDURE null 3000 2
867 Pigment and Vascular LasePROCEDURE null 1500 10
868 Pigment and Vascular LasePROCEDURE null 3000 3
874 Laser Hair removal - UpperPROCEDURE null 5000 10
875 Laser Hair removal - Subme MISC. null 8000 1
876 Laser Hair removal - Full FMISC. null 13000 10
3. Dermatology 3.17 Vitiligo Surgeries
44 Dermatology
753 Punch Grafting for Vitilig MISC. null 3000 1
784 Blister Grafting (Large - 4 BMISC. null 3000 5
795 Punch Grafting for Vitiligo MISC. null 1500 0
819 Blister grafting (extra largeMISC. null 5000 3
825 Autologus Melanocyte Tran MISC. null 8000 22
851 Blister Grafting <3 Laser APROCEDURE null 5000 4
852 Blister Grafting>3 Laser AsPROCEDURE null 7000 1
3. Dermatology 3.18 Miscellaneous
44 Dermatology
711 DNCB Test MISC. null 300 0
715 Electrolysis (per sitting) MISC. null 700 5
716 MCR Sandal (1 pair) LRU PMISC. null 240 0
Page 9 of 368
Dermatology

717 MCR Sheet (1) - 8mm LRUMISC. null 65 0

718 MCR Slipper (1 pair) LRU PMISC. null 240 0
719 MCR Sandal (1 pair ) NLRUMISC. null 350 0
720 MCR Sheet (1) 3mm NLRUMISC. null 100 0
721 MCR Sheet (1) 8mm NLRUMISC. null 150 0
722 MCR Slipper (1pair) NLRU MISC. null 300 0
723 Fungal Scraping (KOH) MISC. null 100 3472
725 Lontophoresis (per sitting)MISC. null 200 53
733 Podophyllin for Warts - SmMISC. null 300 20
735 Pus Smear (Gram Stain) MISC. null 100 305
740 Smear for Lepra Bacillus ( MISC. null 100 234
741 Smear for TV/ Monilia MISC. null 100 8
742 Tzank Smear MISC. null 100 630
746 Tattooing (per sitting) MISC. null 420 0
757 Trichogram (Hair test) MISC. null 500 97
759 Skin Lab - Outside Refere MISC. null 500 171
763 Urine Albumin, Sugar, MicMISC. null 150 0
764 Urine Albumin MISC. null 50 2
765 Urine Sugar MISC. null 50 0
774 Botx Injection MISC. null 1000 0
775 Surgical Excision MISC. null 1200 34
779 Incision & Drainage - AbscMISC. null 300 56
781 Nail Biopsy MISC. null 1000 48
785 Dermabrassion (Manual) MISC. null 350 0
790 Ear Lobe Repair - Surgical MISC. null 2000 1
806 KOH Multiple Sites MISC. null 150 69
815 Skin Biopsy MISC. null 700 1070
869 Sclerotherapy PROCEDURE null 500 0
Page 10 of 368
Dermatology

870 Hair Transplantion - Base PROCEDURE null 2000 0

871 Hair Transplantion - Per GrPROCEDURE null 20 0
872 Fillers PROCEDURE null 1000 0
873 Podophyllin Application - PROCEDURE null 500 3
3. Dermatology 3.2 Allergy
44 Dermatology
701 Allergic Prick Test - 0-10 AMISC. null 500 4
702 Allergic Prick Test - 10-20 MISC. null 1000 2
703 Allergic Prick Test - Above MISC. null 2000 11
728 Patch Test for Skin allg.- A MISC. null 150 137
835 Patchtest Indian Standard MISC. null 2000 5
841 Patch Test - Footwear SeriPROCEDURE null 1000 3
3. Dermatology 3.5 Cryotherapy
44 Dermatology
710 Cryotherapy Small (1-3) MISC. null 300 1628
743 Cryotherapy Large (>10) MISC. null 1000 19
812 Cryotherapy Medium (4-1MISC. null 500 187
3. Dermatology 3.6 Dressing
44 Dermatology
786 Dressing Service Charges -MISC. null 150 202
788 Dressing Service Charges -PROCEDURE null 250 15
3. Dermatology 3.7 Electrocautery
44 Dermatology
712 Electro Cautery - Small < 5MISC. null 400 318
713 Electro Cautery Medium (MISC. null 800 80
714 Electro Cautery -Large (10MISC. null 1200 36
843 Electro Cautery - DPN or TaPROCEDURE null 600 57
844 Electro Cautery - DPN or PROCEDURE null 1000 68
Page 11 of 368
Dermatology

845 Electro Cautery - DPN or TPROCEDURE null 1500 140

846 Electro Cautery - DPN or TPROCEDURE null 3000 14
3. Dermatology 3.8 ILS
44 Dermatology
737 Skin Intralesional Injectio MISC. null 300 557
739 Skin Intralesional InjectionMISC. null 500 72
847 Skin Intralesional Injectio PROCEDURE null 300 48
3. Dermatology 3.9 Keloid Surgeries
44 Dermatology
849 Keloid Surgery - Small (up PROCEDURE null 300 16
850 Keloid Surgery - Large PROCEDURE null 600 3
3. Dermotology 3.3 Chemical cautery
44 Dermatology
705 Chemical Cautery MISC. null 300 2
3. Dermotology 3.4 Comedone/MILia extraction
44 Dermatology
777 Comedone Extraction (< 1MISC. null 500 36
778 Comedone Extraction (> 1MISC. null 1000 18
44 Dermatology
704 Chemical Cautery - Small MISC. null 120 0
706 Chemical Cautery - Large MISC. null 240 0
748 Laser Procedure (small) MISC. null 2500 7
749 Laser Procedure - (mediu MISC. null 3700 1
750 Laser Procedure (large) MISC. null 4000 0
754 Punch Grafting for VitiligoMISC. null 3740 0
756 Chemical Cautery for mol MISC. null 120 0
760 Pus Smear (Grams Stain) MISC. null 240 0
Page 12 of 368
Dermatology

761 Smear for Lepra bacillus( MISC. null 300 0

762 Tzanck Smear Outside RefMISC. null 300 1
773 Additional (per punch) MISC. null 120 0
787 Dressing Service Charges MISC. null 150 7
791 Microdermabrasion - SmallMISC. null 440 0
796 Surgical Excision - Large MISC. null 600 -1
799 Laser Hair Removal (upto MISC. null 1050 1
800 Laser Hair Removal (10 to MISC. null 2500 3
801 Laser Hair Removal (30 to MISC. null 3700 6
802 Laser Hair Removal (more MISC. null 4200 0
813 Electrocautery (Extra Larg MISC. null 1200 4
820 Incision & Drainage - AbscMISC. null 240 0
822 Punch Grafting for vitiglo MISC. null 4750 0
824 Autologus Melanocyte TraPROCEDURE null 4400 0
5002 GP Allergic Prick Test - 10 MISC. null 1000 0
701 Allergic Prick Test - 0-10 AMISC. null 540 0
702 Allergic Prick Test - 10-20 MISC. null 1000 0
703 Allergic Prick Test - Above MISC. null 1170 0
705 Chemical Cautery - Medi MISC. null 320 0
710 Cyro Surgery for Warts-Sma MISC. null 300 3
712 Electro Cautery - small -E MISC. null 400 2
713 Electro Cautery medium ( MISC. null 800 0
714 Electro Cautery - large (1 MISC. null 1200 1
715 Electrolysis(per sitting) -E MISC. null 700 0
726 Paring Charges -E MISC. null 200 2
732 Podophyllin for warts - m MISC. null 220 3
733 Podophyllin for warts - larMISC. null 300 0
Page 13 of 368
Dermatology

736 Skin Biopsy (Small) -E MISC. null 180 1

739 Skin Intralesional InjectionMISC. null 500 0
743 Cyro Surgery for Warts aboMISC. null 1000 0
748 Laser Procedure (small)-E MISC. null 4500 0
749 Laser Procedure - mediumMISC. null 6660 0
750 Laser Procedure - large -E MISC. null 7200 0
753 Punch Grafting for Vitilig MISC. null 3000 0
755 Acne Scar Revision - per siMISC. null 1000 0
777 Comedone Extraction (fewMISC. null 500 0
778 Comedone Extraction(ManMISC. null 1000 1
779 I and D (Abscess) (small) - MISC. null 300 0
784 Blister Grafting (Large - 4 BPROCEDURE null 3000 0
793 MICRODERMABRASION per MISC.
si null 1500 0
795 Punch Grafting for Vitiligo MISC. null 1500 0
797 Neostrata Peel -E MISC. null 1500 0
798 Salicylic Acid Peel PROCEDURE null 1500 0
799 Laser Hair Removal upto 1MISC. null 1890 0
800 Laser Hair Removal 10 to 3MISC. null 4500 0
801 Laser Hair Removal 30 to 1MISC. null 4500 0
802 Laser Hair Removal more tMISC. null 7560 0
808 Ellman Radiofrequency AblMISC. null 1000 1
809 Ellman Radiofrequency AbMISC. null 1500 0
810 Ellman Radiofrequency AblMISC. null 2000 0
Page 14 of 368
Dermatology


Date Date Date
Page 15 of 368
Remarks
Page 16 of 368
Remarks
Page 17 of 368
Remarks
Page 18 of 368
Remarks
Page 19 of 368
Remarks
Page 20 of 368
Remarks
Page 21 of 368
Remarks
Page 22 of 368
Remarks
Page 23 of 368
Gastroenterology
Sum of units
Service Common from Apr-17 to Any request for
Ch Code ChargeDesc ServiceDesc ServCat Remarks
Catagory ward Rate Rate Revision
Nov-17
Printed in SOC's
III. LABORATORY INVESTIGATIONS
G. PHARMACOLOGY LAB (COLLEGE)
Gastro
### Enterology
11052 DD - Xylose in Blood MISC. null 100 -
11053 DD - Xylose in Urine MISC. null 80 -
6. GASTROENTEROLOGY
Gastro
### Enterology
1000 Sengstaken Tube IntroductMISC. null 800 -
1001 Abdominal Paracentesis MISC. null 200 34
1002 ERCP Biliary Drainage MISC. null 7,700 187
1003 ERCP Biliary Prosthesis MISC. null 8,800 14
1004 Biopsy - Liver MISC. null 300 1
1008 Colonoscopy MISC. null 3,100 752
1009 Endoscopic Gastrostomy MISC. null 3,900 4
1010 Endoscopic Jejunal Biopsy MISC. null 2,000 -
1011 ERCP + Sphincterotomy MISC. null 4,800 14
1012 ERCP Diagnostic Only MISC. null 4,100 56
1013 Esophageal Dilatation MISC. null 3,000 29
1014 Esophageal Dilatation (RepMISC. null 1,700 18
1015 Esophagogastroduodenosco MISC. null 1,350 3,832
1016 Esophagogastroduodenosco MISC. null 1,000 26
1017 Injection Sclerotherapy (1sMISC. null 2,800 73
1018 Injection Sclerotherapy (S MISC. null 1,400 2
1019 Naso Biliary Drainage MISC. null 5,200 2
1020 Placement Jejunal FeedingMISC. null 2,200 25
1021 Pneumatic Dilatation (per MISC. null 3,300 13
1022 Colonoscopy + PolypectomMISC. null 4,600 11
1023 Foreign Body Removal (endMISC. null 2,200 13
Page 24 of 368
Gastroenterology
Sum of units
Nov-17
1024 Sigmoidoscopic Polypecto MISC. null 1,300 11
1025 Fiberoptic Flexible Sigmoi MISC. null 700 244
1028 Esophageal Variceal Bandi MISC. null 2,800 180
1029 Glue Injection MISC. null 2,800 30
1031 Endoscopic Clip Applicatio MISC. null 2,200 -
1032 Endoscopic Clip ApplicationMISC. null 1,700 1
1033 Esophageal Manometry MISC. null 2,200 26
1034 Rectal Manometry MISC. null 1,500 -
1037 ECG monitoring / Oxygen MISC. null 200 -
1038 24 Hrs pH Monitoring MISC. null 1,700 -
1039 Esophageal Stenting MISC. null 2,800 1
1043 Endoscopic Cystogastrost MISC. null 6,600 5
1044 Pancreatic Duct Stenting* MISC. null 5,500 2
1045 Enteroscopy MISC. null 2,800 18
1046 Duodenal Stricture DilatatiMISC. null 3,600 -
1047 Colonic Stricture DilatationMISC. null 3,600 -
1048 Biliary Stricture Dilatation MISC. null 6,600 -
1049 Biliary Metal Stenting MISC. null 6,600 -
1050 Liver Ultrasound MISC. null 300 28
1051 ERCP Fluoroscopy MISC. null 300 220
1052 Endoscopic Fluoroscopy MISC. null 200 -
1053 EUS - Diagnostic MISC. null 4,400 70
1054 EUS - FNAC MISC. null 6,100 14
1055 EUS-Therapeutic MISC. null 6,600 -
1056 Ascitic Tap Procedure MISC. null 100 11
1057 USG guided Liver Biopsy PROCEDURE null 2,200 13
1058 USG guided Pancreatic NecPROCEDURE null 5,500 15
1059 Argon Plasma Coagulation PROCEDURE null 4,200 20
1100 General Anaesthesia MISC. null 500 142
Gastro
### Enterology
Page 25 of 368
Gastroenterology
Sum of units
Nov-17
1005 Biopsy - Peritonial MISC. null 300 4
1006 Bone Marrow Aspiration MISC. null 400 1
1030 Trans Jugular Liver Biopsy MISC. null 6,200 -
Evening
### Special Procedures
1000 Sengstaken Tube IntroductiMISC. null 1,400 -
1002 Biliary Drainage -E MISC. null 13,900 -
1003 Biliary Prosthesis -E MISC. null 15,800 -
1008 Colonoscopy -E MISC. null 5,600 -
1009 Endoscopic Gastrostomy -EMISC. null 7,000 -
1011 ERCP + Sphincterotomy -E MISC. null 7,920 -
1012 ERCP (Including Radiology)MISC. null 7,400 -
1013 Esophageal Dilatation -E MISC. null 5,400 -
1014 Esophageal Dilatation (RepMISC. null 3,100 -
1015 Esophagogastroduodenoscop MISC. null 2,430 -
1016 G.I.Endoscopy (Repeat withMISC. null 1,800 -
1017 Injection Sclerotherapy - 1sMISC. null 5,000 -
1018 Injection Sclerotherapy - MISC. null 2,500 -
1019 Naso Biliary Drainage -E MISC. null 9,400 -
1020 Placement of Jejunal feedi MISC. null 4,000 -
1021 Pneumatic Dilatation (per sMISC. null 5,900 -
1022 Polypectomy -E MISC. null 8,300 1
1023 Removal of Foreign BodiesMISC. null 4,000 -
1024 Sigmoidoscopic Polypectom MISC. null 2,300 -
1025 Fiberoptic Flexible Sigmoi MISC. null 1,300 -
1028 Esophageal Variceal BandinMISC. null 5,000 -
1029 Glue Injection -E MISC. null 5,000 -
1031 Endoscopic Clip ApplicationMISC. null 4,000 -
1032 Endoscopic Clip applicationMISC. null 3,100 -
1033 Esophageal Manometry -E MISC. null 4,000 -
1034 Rectal Manometry -E MISC. null 2,700 -
1038 24h pH monitoring -E MISC. null 3,100 -
Page 26 of 368
Gastroenterology
Sum of units
Nov-17
1039 Esophageal stenting -E MISC. null 5,000 -
1043 Pancreatic Cysto GastrostoMISC. null 11,900 -
1044 Pancreatic Duct Stenting -EMISC. null 9,900 -
1045 Enteroscopy -E MISC. null 5,000 -
1046 Duodenal Stricture DilatatiMISC. null 5,940 -
1049 Biliary Metal Stenting MISC. null 10,800 -
1053 EUS-Diagnostic MISC. null 7,200 -
1054 EUS - FNAC - E MISC. null 9,900 -
1055 EUS-Therapeutic MISC. null 10,800 -
Grand Total 374,920 6,163

Date Date Date
Page 27 of 368
General Medicine
Service Common ward Sum of units from Any request for

Catagory Rate Apr-17 to Nov-17 Rate Revision
General Medicine
Printed in SOC's
7. GENERAL MEDICINE
General
### Medicine
2801 Abdominal Paracentesis PROCEDURE null 175 14
2802 Biopsy - Liver PROCEDURE null 250 1
2804 Biopsy - Muscle PROCEDURE null 250 -
2805 Biopsy - Peritonial PROCEDURE null 250 -
2806 Biopsy - Pleural PROCEDURE null 400 1
2807 Biopsy - Trephine PROCEDURE null 250 -
2808 Bone Marrow Aspiration PROCEDURE null 350 183
2813 Rigid Bronchoscopy PROCEDURE null 715 1
2814 Fiberoptic Laryngoscopy PROCEDURE null 420 -
2815 Intercostal / Mallecot Drai PROCEDURE null 275 44
2827 Synovial Fluid Aspiration PROCEDURE null 175 -
2828 Intra Articular Injection PROCEDURE null 175 15
2834 Lumbar Puncture PROCEDURE null 175 -
2835 Intrathical Drugs AdministrPROCEDURE null 175 5
2836 Synacthen Test PROCEDURE null 175 -
2837 Gn RH PROCEDURE null 240 -
2838 Cloridine Stimulation PROCEDURE null 240 -
2839 Cpeptide PROCEDURE null 240 -
2840 Insulin PROCEDURE null 475 -
2853 Chemotheraphy - Level B ( MISC. null 600 45
2854 Chemotheraphy - Level C ( MISC. null 950 -
2855 Chemotheraphy-Level D Mo MISC. null 700 -
2857 Chemotheraphy - Level A (SMISC. null 350 80
2862 Chemotherapy Planning Cha MISC. null 365 -
Page 28 of 368
General Medicine
Service Common ward Sum of units from Any request for

2863 Auto HSCT Procedure * MISC. null 250,000 1

2864 Allogenic HSCT Procedure MISC. null 300,000 -
2866 Pleural Aspiration (TherapeMISC. null 300 -
2867 Pleural Aspiration (Repeat)MISC. null 210 1
3576 Aspiration-Pleural Asp (TheMISC. null 300 1
3577 Aspiration-Pleural Asp (Re MISC. null 210 -
General
### Medicine
2849 Concentration 1:50 ( 0.6 ccPROCEDURE null 500 -
2865 Administration of BiologicsMISC. null - -
3578 Administration of BiologicsMISC. null 500 -
Evening
267 Pleural Aspiration(General MISC. null 280 -
2801 Abdominal Paracentesis -EPROCEDURE null 320 -
2802 Biopsy - Liver -E PROCEDURE null 450 -
2805 Biopsy - Peritonial -E PROCEDURE null 450 -
2806 Biopsy - Pleural -E PROCEDURE null 720 -
2807 Biopsy - Trephine -E PROCEDURE null 450 -
2808 Bone Marrow Aspiration -EPROCEDURE null 630 1
2813 Rigid Bronchoscopy -E PROCEDURE null 1,290 -
2834 Lumbar Puncture -E PROCEDURE null 320 -
2835 Intrathical Drugs AdministrPROCEDURE null 320 -
Grand Total 565,620 393

Date Date Date
Page 29 of 368
Neonatology
Common Sum of units from Any request for Rate

Ch Code ChargeDesc ServiceDesc Service Catagory ServCat Remarks
ward Rate Apr-17 to Nov-17 Revision
Neonatology
Printed in SOC's
II. HOSPITALIZATION (Charges per day) :
C. NEONATAL ICU PACKAGE PER DAY
NICU
Neonatal
### - NEON
101 Incub/Open Warmer with Respi MISC. null 1,500 2
102 Observation MISC. null 150 263
106 Incubator / Radiant Warner wiMISC. null 1,500 286
107 Warm Cradle MISC. null 250 817
108 Incubator / Open Warner ( Ope MISC. null 300 4,077
110 Incubator / Open Warmer with MISC. null 3,000 352
A. GENERAL PROCEDURES
8.1. UoH - NEONATAL
Unit
### of Hope Procedures
23600 High Risk Neonatal Follow-up MISC. null 120 -
23601 ROP Screening MISC. null 240 -
23602 OAE (Oto-acoustic emission) MISC. null 175 -
23603 Developmental Evaluation (DAMISC. null 120 -
23604 Parent Education Material MISC. null 55 -
23605 Booklet on Breast Feeding MISC. null 85 -
NICU
Neonatal
### - NEON
91 Phototherapy - Single Surface MISC. null 240 1,080
92 Capillary Bilirubin MISC. null 60 2
93 Capillary PCV MISC. null 120 -
94 Cardiac Monitoring MISC. null 180 905
95 Exchange Transfusion - Partia MISC. null 420 5
Page 30 of 368
Neonatology

96 Saline Transfusion MISC. null 360 -

97 G.R.B.S MISC. null 60 16,720
99 Otoacoustic Emission Test MISC. null 210 -
100 Transctaneous Bilirubin Evalu MISC. null 120 1,215
117 Umbilical Cannulation for Exc MISC. null 210 3
118 High Risk Delivery MISC. null 600 12
119 Surfactant Administration MISC. null 360 1
123 Peritoneal Dialysis (PD) MISC. null 860 8
124 Hearing Screening (OAE) MISC. null 70 4
125 Neonatal Resuscitation at the MISC. null 600 8
131 Giraffee Extream Preterm CarPROCEDURE null 1,430 207
137 Nebulization MISC. null 40 2,822
139 Pulse Oximeter Monitoring (pMISC. null 160 2,633
324 Neonatal Resuscitation at the MISC. null 720 14
325 Bubble CPAP MISC. null 1,430 18
327 Prenatal Counselling MISC. null 180 32
328 Lactation Counselling MISC. null 140 149
329 Blocking of Ventilator for Eve MISC. null 360 1
330 Transport of Neonate within HMISC. null 120 2
331 Transport Of Neonate OutsideMISC. null 600 1
332 Parental Nutrition MISC. null 60 409
333 PICC Lines MISC. null 210 19
15223 High flow nasal Cannula HFNCDIAGNOSTIC null 240 407
15224 Blender DIAGNOSTIC null 120 4
15225 Cental Line Maintenance DIAGNOSTIC null 120 905
15226 Blood Warmer DIAGNOSTIC null 120 46
15227 ROP Screening in NICU DIAGNOSTIC null 180 64
PICU
Neonatal
### - NEON
Page 31 of 368
Neonatology

326 Developmental Screening MISC. null 140 -

18. NEONATOLOGY
Neonatology
###
2256 Biopsy - Liver PROCEDURE null 250 1
2258 Bone Marrow Aspiration PROCEDURE null 350 1
2259 Exchange Transfusion - Partia PROCEDURE null 350 -
2260 Saline Transfusion PROCEDURE null 300 -
2261 Tracheostomy in OPD/Ward PROCEDURE null 420 -
2263 Pleural Aspiration PROCEDURE null 210 -
2264 Subdural / Ventricular Tap PROCEDURE null 600 -
2265 Lumbar Puncture PROCEDURE null 175 6
2266 Nebulization (per hour) inclu PROCEDURE null 50 131
2267 Arterial Line PROCEDURE null 240 1
2268 Venesection / Cut Down / CV PROCEDURE null 240 -
2270 Intraosseus PROCEDURE null 50 -
2271 Developmental Evaluation PROCEDURE null 120 -
2273 Central Venous Line PROCEDURE null 300 28
2275 Parent Education Material PROCEDURE null 55 -
2276 Intercostal Chest Drainage PROCEDURE null 175 -
2281 Booklet on Breast Feeding MISC. null 85 -
2285 CCHD Screening PROCEDURE null 120 774
2286 HFOV (ventilation extra) MISC. null 500 50
2287 Routine Delivery Call MISC. null 300 1,505
2288 Screening Bedside NeurosonoMISC. null - -
2289 Therapeutic Hypothermia MISC. null 500 92
Page 32 of 368
Neonatology

NICU
Neonatal
### - NEON
15229 Breast Pump MISC. null 150 186
Neonatal
### - NEON
104 Cradle with phototheraphy MISC. null 250 9
126 Cryotherapy MISC. null 950 -
127 Phototherapy - Double SurfaceMISC. null 300 557
138 Multisystem Monitoring MISC. null 175 1,503
323 Phototherapy - Tripple SurfaceMISC. null 400 179
Neonatology
###
2255 Peritoneal Dialysis (PD) PROCEDURE null 715 -
2262 Umbilical Cannulation for Exc PROCEDURE null 175 -
2269 High Risk Delivery PROCEDURE null 500 -
2272 Surfactant Administration PROCEDURE null 300 -
2274 Partial Blood Exchange PROCEDURE null 300 -
2290 Umbilical Arterial Line MISC. null 300 69

Date Date Date
Page 33 of 368
Nephrology
Charge Service Common
Ch Code ServiceDesc Catagory ServCat ward Rate from Apr-17 to for Rate Remarks
Desc Nov-17 Revision
Nephrology
Printed in SOC's
11. NEPHROLOGY
Nephrology
###
1407 Cont. Arterio Venous Dialysis (8 Hrs) PROCEDURE null 1,500 -
Nephrology
### Procedure
1401 Abdominal Paracentesis MISC. null 175 33
1404 Catheter Removal MISC. null 70 1,114
1405 Femoral Access MISC. null 300 54
1406 Pem catheter Removal PROCEDURE null 400 1
1413 Biopsy - Kidney (with disposable gun) MISC. null 900 178
1414 IPD Dialysis - Every 48 hrs MISC. null 550 2
1416 Subclavian Access / Internal Jugular Access MISC. null 300 150
1420 Peritoneal Equilibration Test (PET test) MISC. null 1,500 13
1422 CRRT for 24 Hours MISC. null 4,000 5
1423 Plasmapheresis MISC. null 1,450 21
1424 CAPD Training MISC. null 1,200 44
1426 CAPD Cycler (24 hrs) MISC. null 1,200 10
1427 ICU Haemodialysis MISC. null 1,400 1,020
1431 High Flux Dialysis MISC. null 1,450 -
1432 CAPD Transfer Set Change MISC. null 250 48
1433 CAPD Catheter Flushing MISC. null 175 35
1434 Isolate Ultrafiltration MISC. null 600 389
Page 34 of 368
Nephrology
1435 Lumbar Puncture MISC. null 175 -

1436 Pleural Tap MISC. null 175 -
1450 Ultrasound Marking for Renal Biopsy PROCEDURE null 500 2
1451 Lung Ultrasound PROCEDURE null 150 -
1452 USG of Kidneys at Bed Side PROCEDURE null 300 101
1453 Hemoperfusion (ICU setting) PROCEDURE null 300 2
1454 Extra Charges for Hemodialysis beyond 4hrs (perhr) PROCEDURE null 300 -
1455 Extra Charges for Hemodialysis beyond 4hrs (per1hr PROCEDURE null 300 39
1456 Extra Charges for Hemodialysis beyond 4hrs (per1.5 PROCEDURE null 450 5
1483 Haemodialysis - Bicarb(C). MISC. null 1,750 1,942
1485 Heparin Free Dialysis - Bicarb (C) MISC. null 1,900 681
1490 Haemodialysis - Bicarb(C). OP MISC. null 1,750 21,691
1494 SLED - Sustained Low Efficiency Dialysis MISC. null 3,000 399
1495 Nocturnal Dialysis MISC. null 1,300 -
1496 SCUF/ICU MISC. null 1,200 181
1497 Haemodiafiltration MISC. null 4,160 -
1498 Biopsy - Kidney (with reusable bard gun) MISC. null 800 -
1499 Permcath insertion PROCEDURE null 4,000 15
1500 CAPD percutaneous catheter insertion PROCEDURE null 4,000 -
VI. OPERATIVE PROCEDURES *
L. NEPHROLOGY
PAEDIATRIC RENAL TRANSPLANTATION RECEIPIENT
Surgery
### Packages
9270 Paediatric Renal Transplantation IP PACKAGE null 81,000 2
9271 Donor Nephrectomy IP PACKAGE null 37,800 1
9272 Donor Nephrectomy (Laparoscopic) IP PACKAGE null 43,200 -
Page 35 of 368
Nephrology
RENAL TRANSPLANTATION
Nephrology
###
6508 Processing Fee to ZCCK for Cadaver Transplant MISC. null - 10
M. CADAVERIC ORGAN RETRIEVAL
Nephrology
###
9501 Kidney - Single MISC. null 5,500 -
9502 Kidney - Double (Cadaver) MISC. null 7,400 -
9503 Liver MISC. null 7,400 -
9504 Heart MISC. null 7,400 -
11. NEPHROLOGY
Nephrology
### Procedure
1492 CAPD Dressing PROCEDURE null 75 22
Nephrology
###
### Operation Charges MISC. null - -
Nephrology
### Procedure
Evening
1413 Kidney Biopsy -E MISC. null 1,620 -
1491 Heparin Free Dialysis - Bicarb (C) OP -E MISC. null 1,650 -
1495 Nocturnal Dialysis -E MISC. null 2,340 -
Grand Total 239,915 28,294
Page 36 of 368
Nephrology

Date Date Date
Page 37 of 368
Neurology
Service Common Sum of units from Any request for

Ch Code ChargeDesc ServiceDesc ServCat ward Remarks
Neurology
Printed in SOC's
13. NEUROLOGY
Neurology
###
1101 BAER MISC. null 835 -
1102 All Evoked Potential E.E.G MISC. null 1,870 -
1103 ENMG-EMG/NCV/Decrementa MISC. null 3,000 929
1107 E.E.G Routine MISC. null 2,300 1,156
1108 Special Recording EEG MISC. null 600 -
1109 Sphenoidal EEG MISC. null 1,190 -
1110 Somato Sensory Evoked Poten MISC. null 715 3
1111 Visual Evoked Potential EEG MISC. null 1,500 81
1112 Lumbar Puncture MISC. null 1,500 3
1113 Lumbar Puncture W Monomet MISC. null 660 -
1114 Biopsy Muscle MISC. null 2,500 -
1115 Biopsy Nerve MISC. null 2,500 3
1117 Carpal Tunnel Inj Service Ch MISC. null 750 -
1119 F Wave and H Reflex StudiesMISC. null 1,485 -
1121 Electro Retinography MISC. null 1,065 -
1122 Electro Oculography MISC. null 1,065 -
1123 Electro Cochleography MISC. null 715 -
1124 Repetitive Nerve StimulationMISC. null 1,190 13
1125 Electro Myography MISC. null 1,190 20
1126 Evoked Potential Studies in MISC. null 1,190 -
1127 Silent Period MISC. null 1,190 -
1128 Long Loop Reflex Studies MISC. null 1,190 -
1129 Radicular Stimulation StudieMISC. null 1,190 -
Page 38 of 368
Neurology

1130 Intra - operative Nerve StimuMISC. null 1,190 -

1131 E.E.G + Brain Mapping MISC. null 1,190 -
1132 TPA Charges for Acute Strok MISC. null 2,500 -
1134 Vertigo Protocol MISC. null 600 -
1135 Dementia Protocol MISC. null 2,500 -
1136 Stroke Protocol MISC. null 5,000 -
1137 Neuromuscular Disease ProtMISC. null 600 -
1138 Parkinsonism Protocol MISC. null 600 -
1139 Epilepsy Protocol MISC. null 600 -
1140 Cephalalgia protocol MISC. null 600 -
1141 24 Hours Video EEG MISC. null 9,500 -
1142 Short Term Video EEG (1-2 hMISC. null 2,500 3
1143 Short Term Video EEG (2-4 hMISC. null 3,700 2
1144 Long Term Video EEG (aboveMISC. null 4,500 3
1145 Sudural EEG Recording MISC. null 3,565 -
1146 Depth EEG Recording MISC. null 3,565 -
1147 Sterio EEG Recording MISC. null 3,565 -
1148 ECOG (Electro CorticographyMISC. null 3,565 -
1149 Cortical Stimulation MISC. null 3,565 -
1150 Comprehensive Evaluation ofMISC. null 3,000 -
1151 WADA Test MISC. null 2,375 -
1152 Dementia Assessment MISC. null 600 -
1153 EPS Assessment MISC. null 600 -
1154 Neuromuscular Assessment MISC. null 600 -
1155 Botulinum Toxin Inj. Service MISC. null 3,000 -
1156 Botulinum Toxin Inj. Service MISC. null 2,000 -
1157 Stroke Assessment PROCEDURE null 600 -
1158 Cefaly Stimulation Theraphy PROCEDURE null 300 11
Page 39 of 368
Neurology

13. NEUROLOGY
Neurology
###
1160 EDSS Score PROCEDURE null 500 46
1161 Neurology Speciality Clinic SPROCEDURE null 300 32
Neurology
###
1133 Video EEG MISC. null 1,430 -
Evening
1101 BAER -E MISC. null 1,500 -
1102 All Evoked Potential E.E.G -E MISC. null 3,370 -
1103 ENMG-EMG/NCV/Decrementa MISC. null 3,500 -
1107 Routine E.E.G -E MISC. null 3,200 -
1108 Special Recording E.E.G -E MISC. null 1,080 -
1109 Sphenoidal E.E.G -E MISC. null 2,140 -
1110 Somato Sensory Evoked Potent MISC. null 1,290 -
1111 Visual Evoked Potential E.E.GMISC. null 2,700 -
1112 Lumbar Puncture -E MISC. null 320 -
1113 Lumbar Puncture W Monomet MISC. null 1,440 -
1114 Muscle Biopsy -E MISC. null 4,500 -
1115 Nerve Biopsy -E MISC. null 4,500 -
1117 Carpal Tunnel Inj Service ChaMISC. null 1,350 -
1124 Repetitive Nerve StimulationMISC. null 2,140 -
1125 Electro Myography -E MISC. null 2,140 -
1131 E.E.G + Brain Mapping -E MISC. null 2,140 -
1132 TPA Charges for Acute StrokeMISC. null 4,500 -
Page 40 of 368
Neurology


Date Date Date
Page 41 of 368
Paediatrics
Catagory ward Rate Apr-17 to Nov-17 Rate Revision
Paediatrics
Printed in SOC's
F. PAEDIATRIC ICU PACKAGE PER DAY
PICU
Paediatric
### I C U - PICU
165 Paed. ICU Without RespirtatMISC. null 1,800 1,671
166 Paed. ICU with Respirator MISC. null 4,000 630
167 Paediatric ICU with Resp. (1MISC. null 2,000 7
175 Paediatric ICU for Only MonMISC. null 250 60
PICU
Paediatric
### I C U - PICU
168 Arterial Line MISC. null 240 133
169 Venesection / Cut down MISC. null 240 29
170 Forced Alk.Diuresis for Pois MISC. null 360 -
171 Plasma Pheresis MISC. null 420 -
172 GRBS MISC. null 60 8,684
173 Peritoneal Dialysis MISC. null 860 63
174 Intraosseus MISC. null 50 -
15200 ABG GEM Machine ICU MISC. null 500 2,020
15201 Bipap (per hour) MISC. null 40 3,049
15203 Burns pad MISC. null 70 41
15204 Catheterization MISC. null 80 97
15205 Central Venous CannulationMISC. null 360 79
15206 Defibrillator MISC. null 210 4
15207 ECG MISC. null 160 75
15208 Enema MISC. null 60 4
15209 Extubation MISC. null 20 50
Page 42 of 368
Paediatrics
15210 ICD Insertion MISC. null 210 10
15211 ICU Haemodialysis MISC. null 1,680 27
15212 Incision & Drainage MISC. null 140 1
15213 Incubator / Radiant WarmerMISC. null 360 98
15215 Infusion Pump (per day) MISC. null 210 513
15216 Intra Hospital Shift on Port MISC. null 360 -
15217 Non-Invasive Bipap VentilatoMISC. null 540 -
15219 Screening Ultrasound - Ha MISC. null 360 300
15220 Screening ECHO MISC. null 210 183
15221 Servo Duo Filter MISC. null 720 339
15222 USG Guidance for CVC MISC. null 360 9
17. PAEDIATRICS
Paediatrics
###
2201 Abdominal Paracentesis MISC. null 175 -
2208 Exchange Transfusion - PartMISC. null 500 -
2209 Fiberoptic Bronchoscopy MISC. null 1,190 1
2210 Fiberoptic Bronchoscopy - MISC. null 600 -
2211 Fiberoptic Bronchoscopy anMISC. null 1,780 -
2212 Fiberoptic Laryngoscopy MISC. null 420 -
2214 Peritoneal Drainage MISC. null 210 -
2215 Routine Spirometry MISC. null 240 -
2218 Sigmoidoscopy - Flexible Sc MISC. null 350 -
2221 Tracheostomy in OPD/WardMISC. null 420 -
2223 Pleural Aspiration MISC. null 210 -
2224 Subdural / Ventricular Tap MISC. null 600 -
2225 Lumbar Puncture MISC. null 175 12
2226 Nebulization (per hour) inc MISC. null 30 4
Page 43 of 368
Paediatrics
2231 PEFR MISC. null 50 -
2237 Parent Education Material MISC. null 55 65
2302 Paed. Blood Product Transf PROCEDURE null 100 90
2303 Paed. Colonoscopy with/witPROCEDURE null 3,500 -
2304 Paed. Upper Gi endoscopy wPROCEDURE null 1,500 -
2305 Paed. Well Baby Card (ImmuPROCEDURE null 25 1,567
17.1 PAEDIATRIC ONCOLOGY
Paediatrics
###
2277 Chemotherapy Planning Char MISC. null 350 6
2278 Chemotherapy Administratio MISC. null 240 111
2279 Chemotherapy Administratio MISC. null 350 311
2280 Intrathecal Chemotherapy MISC. null 600 207
Paediatric Emergency Medicine
Paediatric
### Emergency Medicine
15300 Aluminium Splint / Inch ITEMS null 60 -
15301 Arterial Line PROCEDURE null 240 -
15302 Bandage -Triangular Banda ITEMS null 20 -
15303 Bedside Ultrasound PROCEDURE null 720 -
15304 Bipap (per hour) PROCEDURE null 40 -
15305 Bladder wash PROCEDURE null 100 -
15306 Bowel Wash PROCEDURE null 100 -
15307 Burns pad PROCEDURE null 70 -
15308 Catheterization PROCEDURE null 80 -
15309 Central Venous CannulationPROCEDURE null 360 -
15310 Closed Reduction Pediatric PROCEDURE null 720 -
15311 Crape Bandage ITEMS null 60 -
15313 Defibrillator PROCEDURE null 210 -
Page 44 of 368
Paediatrics
15314 Dressing - Each Bandage ITEMS null 50 -
15315 Dressing - Pad and BandageITEMS null 70 -
15316 Dressing - Service Charges -PROCEDURE null 110 -
15317 Dressing - Service Charges PROCEDURE null 80 -
15318 Dressing - Service Charges -PROCEDURE null 60 -
15319 Dynaplaster for IV ITEMS null 10 -
15320 ECG PROCEDURE null 160 -
15321 Electrolytes - EMS DIAGNOSTIC null 210 -
15322 Enema PROCEDURE null 60 -
15323 Extubation PROCEDURE null 20 -
15324 GRBS PROCEDURE null 60 -
15325 ICD Insertion PROCEDURE null 210 -
15326 Incision and Drainage PROCEDURE null 140 -
15327 Infusion Pump (per day) MISC. null 210 -
15328 Intervenous Cannulation PROCEDURE null 50 -
15329 Intramuscular Injection MISC. null 20 -
15330 Intubation (Endotracheal) PROCEDURE null 240 -
15331 IV Fusion PROCEDURE null 50 -
15332 Ketostick PROCEDURE null 60 -
15333 Lumbar Puncture PROCEDURE null 210 -
15334 Monitoring PROCEDURE null 140 -
15335 Narcotic Injections PROCEDURE null 20 -
15336 Nasal Packing PROCEDURE null 80 -
15337 Nebulization PROCEDURE null 40 -
15338 Oxygen Inhalation (per hourPROCEDURE null 40 -
15339 Plastering - Major PROCEDURE null 250 -
15340 Plastering - Minor PROCEDURE null 210 -
15341 Pleural Aspiration PROCEDURE null 210 -
15342 POP 10 cm ITEMS null 70 -
15343 POP 15 cm ITEMS null 140 -
Page 45 of 368
Paediatrics
15344 Professional Charge CONSULTATI null 140 -
15345 Removal of Foreign Body PROCEDURE null 140 -
15346 Ryles Tube Introduction PROCEDURE null 20 -
15347 Steam Inhalation PROCEDURE null 40 -
15348 Stomach Wash - Routine PROCEDURE null 70 -
15349 Stomach Wash for Poisonin PROCEDURE null 290 -
15350 Suture Removal in Pediatri PROCEDURE null 50 -
15351 Suturing in OT PROCEDURE null 860 -
15352 Suturing with Suture Set PROCEDURE null 160 -
15353 Thomas Splint ITEMS null 650 -
15354 Tracheostomy Care PROCEDURE null 50 -
15355 Tracheostomy in Pediatric PROCEDURE null 290 -
15356 Triangular Sling PROCEDURE null 70 -
15357 Wall Suction PROCEDURE null 20 -
Peadiatrics
Paediatrics
###
2203 Biopsy - Lung. MISC. null 300 -
2204 Biopsy - Muscle MISC. null 250 -
2205 Biopsy - Peritoneal MISC. null 250 -
2206 Biopsy - Pleural MISC. null 250 -
2213 Intercostal Malecot DrainagMISC. null 175 -
2216 Routine Spirometry with Br MISC. null 240 -
2217 Saline Transfusion MISC. null 300 -
2219 Sigmoidoscopy - Rigid Scop MISC. null 240 -
2220 Sigmoidoscopy - if procedu MISC. null 300 -
2222 Umbilical Cannulation for E MISC. null 175 -
2227 Biopsy Nerve MISC. null 250 -
2229 Venesection / Cut Down / CMISC. null 200 -
Page 46 of 368
Paediatrics
2230 High Risk Delivery MISC. null 500 -
2232 Intraosseus MISC. null 50 9
2233 Developmental Evaluation MISC. null 120 -
2234 Surfactant Administration MISC. null 300 31
2235 Central Venous Line MISC. null 300 10
2236 Partial Blood Exchange MISC. null 300 -
2238 Skin Prick Testing-(0-10 AlleMISC. null 300 -
2239 Skin Prick Testing (10-20 All MISC. null 420 4
2240 Skin Prick Testing (above 20MISC. null 650 -
2282 Rapid Hematocrit MISC. null 120 -
Paediatric
### I C U - PICU
15214 Incubator / Radiant Warner MISC. null 1,500 5
15218 SCD: Sequential CompressioMISC. null 300 67
Evening
2207 Bone Marrow Aspiration -E MISC. null 630 -
2208 Exchange Transfusion (Proc MISC. null 900 -
2214 Peritoneal Drainage -E MISC. null 380 -
2217 Saline Transfusion -E MISC. null 540 -
2221 Tracheostomy -E MISC. null 760 -

Date Date Date
Page 47 of 368
Cardiology
Cardiology
Printed in SOC's
B. CCU PACKAGE PER DAY
CCU
Coronary
### Care Unit - CCU
88 CCU Charges with RespiMISC. null 3,500 12
89 CCU Charges with out RMISC. null 3,000 856
90 CCU Charges with RespiMISC. null 7,000 106
CCU
Coronary
### Care Unit - CCU
72 Venesection / Cut DowMISC. null 240 29
73 E.C.G MISC. null 160 1,552
76 Glucometer Random BlMISC. null 60 2,090
1. Cardiology 1.1 Non-invasive Diagnostics
Cardiology
###
401 Echocardiography - AduMISC. null 1,250 8,927
403 Holter Monitoring - AdMISC. null 1,600 429
405 Transoesophageal EchoMISC. null 1,500 24
408 24hrs Amb.Blood PressMISC. null 1,100 1
410 Dobutamine Stress Ec MISC. null 3,600 16
425 Bedside Screening EchMISC. null 300 145
460 INR (Cardio) MISC. null 300 742
Page 48 of 368
Cardiology
461 NT-Pro BNP MISC. null 1,600 621
498 Troponin-T MISC. null 900 14
499 Contrast ECHO MISC. null 2,000 -
24504 Rotablation MISC. null 15,000 2
Evening
402 Stress Test * -E MISC. null 1,600 -
1. Cardiology 1.2 Invasive procedures
Cardiology
###
409 Foreign Body Removal IP ( PACKAGEnull 3,100 -
475 Pericardial Tapping MISC. null 1,000 4
487 IABP insertion ChargesIP PACKAGEnull 6,000 1
1. Cardiology 1.3 Invasive Diagnostics -Packages
Cardiology
###
406 Coronary Graft Angiog IP PACKAGEnull 12,000 1
411 Coronary Angiography IP PACKAGEnull 9,000 218
412 Diagonostic CatheterizIP PACKAGEnull 6,500 2
413 Electro Physiological S IP PACKAGEnull 10,000 -
417 Carotid Angiogram (paIP PACKAGEnull 10,000 -
419 Right Heart Cath.(Incl IP PACKAGEnull 4,000 3
426 Peripheral Angiogram IP PACKAGEnull 8,000 5
24501 ACT MISC. null 200 559
24502 Fluroscopy MISC. null 200 -
Surgery
### Packages
464 Renal/ Mesenteric / O IP PACKAGEnull 6,000 5
1. Cardiology 1.4. Non-coronary interventions-packages
Cardiology
###
407 Carotid Plasty and StenIP PACKAGEnull 56,000 -
Page 49 of 368
Cardiology
424 Chemoport Implantati IP PACKAGEnull 6,200 -
430 PDA Closure IP PACKAGEnull 10,000 -
431 Septostomy/ Emboliza IP PACKAGEnull 5,000 7
432 Peripheral AngioplastyIP PACKAGEnull 20,000 11
433 Non Coronary Cardiac B IP PACKAGEnull 25,000 -
434 Bronchial Artery EmbolIP PACKAGEnull 10,000 4
435 Peripheral Stenting IP PACKAGEnull 31,200 3
436 Aortic Endovascular InIP PACKAGEnull 37,400 -
438 IVC Filter ImplantationIP PACKAGEnull 8,000 -
439 Re - synchronization T IP PACKAGEnull 37,400 -
446 Peripheral Angioplasty IP PACKAGEnull 10,000 -
448 Balloon Valvulplasty (hIP PACKAGEnull 12,400 -
452 ASD/VSD Closure IP PACKAGEnull 25,000 -
1. Cardiology 1.5. Coronary Interventions-Packages
Cardiology
###
444 Coronary Angioplasty (IP PACKAGEnull 28,000 5
449 Cor.Sep.Emboln.for H IP PACKAGEnull 52,400 -
451 CD Recording Charges MISC. null 500 301
471 Coronary Angioplasty IP PACKAGEnull 50,000 1
472 Coronary Stenting IP PACKAGEnull 55,000 62
473 Direct Stenting (PTCA IP PACKAGEnull 35,000 24
476 Renal Stenting / IVC St IP PACKAGEnull 22,000 -
477 I V C Filter Retrieval MISC. null 6,500 -
23528 IABP Charges per day (MISC. null 1,000 -
1. Cardiology 1.6. Anaesthesia Charges
Cardiology
###
491 Stand by (Monitored AMISC. null 250 -
Page 50 of 368
Cardiology
492 Anaesthesia for Angio MISC. null 900 -
493 Anaesthesia for Non - MISC. null 900 -
494 Anaesthesia for CoronaMISC. null 900 -
500 General Anaesthesia orMISC. null 350 2
1. Cardiology 1.7.Paediatric Cardiology Procedure
Cardiology
###
23499 Paediatric Cardiology CONSULTATnull 400 107
23501 Paediatrics Echocardi MISC. null 2,000 -
23502 Fetal Echocardiogram MISC. null 2,500 3
23503 Transoesophageal Echoc MISC. null 2,500 -
23504 Intra OP/Emergency E MISC. null 3,000 -
23505 Stress Test - Paediatric MISC. null 2,500 -
23507 Cardiac Cath CongenitaMISC. null 8,000 -
23508 PAH Study Cath MISC. null 9,000 -
23509 PDA Coil MISC. null 16,000 -
23510 PDA Device MISC. null 20,000 -
23511 ASD Device MISC. null 20,000 -
23512 VSD Device MISC. null 23,000 -
23513 BAV MISC. null 16,000 -
23514 BPV MISC. null 16,000 -
23515 BMV MISC. null 16,000 -
23516 BTV MISC. null 16,000 -
23517 Coarctation Plasty MISC. null 16,000 -
23518 Branch PA Plasty MISC. null 16,000 -
24500 Paediatrics EchocardioMISC. null 1,200 653
1. Cardiology 1.8. Electro physiology study procedure
Cardiology
###
Page 51 of 368
Cardiology
23521 EP Study (Electrophysi MISC. null 15,000 1
23522 Radiofrequency AblatioMISC. null 20,000 1
23523 Radiofrequency Ablati MISC. null 30,000 -
23524 3D Mapping MISC. null 45,000 -
23525 Renal Denervation MISC. null 40,000 -
1. Cardiology -Pacing
Cardiology
###
421 Pacing - Permanent IP PACKAGEnull 11,200 8
427 Dual Chamber Pacing IP PACKAGEnull 20,000 7
428 AICD IP PACKAGEnull 37,400 -
429 Pacemaker Interrogati MISC. null 700 8
440 ECG with Magnet MISC. null 200 6
470 Pacing - Temporary * MISC. null 1,500 54
489 Biventricular Pace MakIP PACKAGEnull 65,000 -
24503 Temporary Pacemaker MISC. null 1,000 -
1. Cardiology 1.1 Non-invasive Diagnostics
Cardiology
###
23610 File Charges ITEMS null 50 220
Cardiology
###
402 Stress Test / TMT - AduMISC. null 1,400 1,146
497 D-Dimmer MISC. null 600 -
23506 Holter - Paediatric MISC. null 1,200 -
23519 Paed.Pacemaker ImplaMISC. null 10,000 -
23520 Paed.Pacemaker ImplaMISC. null 23,000 -
Page 52 of 368
Cardiology
80009 Special Contrast MISC. null - 328
80011 Cost of Stent MISC. null - -
80020 Extra Hardware MISC. null - 3
Coronary
### Care Unit - CCU
74 Streptokinase Therapy MISC. null 50 48
Evening
401 Echocardiography * -E MISC. null 2,250 -
403 Holter Monitoring ** -MISC. null 2,880 -
405 Transoesophageal EchoMISC. null 2,500 -
425 Bed side Screening EchMISC. null 500 -
435 Peripheral Stenting -E MISC. null 56,200 -
Grand Total 1,261,980 19,397

Date Date Date
Page 53 of 368
Endocrinology
Service Common Sum of units from Any request for Rate
Catagory ward Rate Apr-17 to Nov-17 Revision
Endocrinology
Printed in SOC's
4. Endocrinology
###
General Medicine
2868 PODO I MAT PROCEDURE null 50 25
2869 Sensitometer HCP PROCEDURE null 100 -
2870 ACTH stimulation PROCEDURE null 170 -
2995 Periscope MISC. null 350 39
2996 Biothesimeter MISC. null 55 37
2997 File Charges MISC. null 50 118
4. Endocrinology
###
General Medicine
2819 Cardiac Autonomic PROCEDURE null 300 1
2820 Digital Fundus CameMISC. null 100 -

Date Date Date
Page 54 of 368
Medical Oncology
Catagory Rate Apr-17 to Nov-17 Revision
Printed in SOC's
26. MEDICAL ONCOLOGY
Medical
### Oncology
2875 Chemotheray planning charges (F MISC. null 350 870
2876 Chemotherapy Administration Ch MISC. null 240 729
2877 Chemotherapy Administration Ch MISC. null 350 161
2878 Chemotherapy Admin. charges MISC. null 420 - 1
2879 Chemotherapy Admin. Charges MISC. null 475 1
2882 Infusion Chemo using CADD pum MISC. null 600 -
2883 Infusion Chemo using CADD pum MISC. null - -
2887 Paracentesis - Diagnostic MISC. null 175 -
2888 Paracentesis - Theraputic MISC. null 175 -
2889 Intrathecal Chemotherapy MISC. null 600 7
2990 Pleural Aspiration - Repeat MISC. null 210 -
2991 Pleural Aspiration - Theraputic MISC. null 300 -
3551 Biological Therapy (MonoclonalMISC. null 440 -
3552 Weekly Chemotheraphy ChargeMISC. null 330 -
3553 Weekly Chemotheraphy for any MISC. null 165 -
3554 Miscellaneous Cancer TheraphyMISC. null 770 -
3555 Chemotheraphy Consultation frMISC. null 550 -
3556 Bone Marrow Aspitation MISC. null 350 -
3557 Stem Cell Harvest from Bone MISC. null 4,400 -
3558 Stem Cell Harvest from PeripherMISC. null 3,300 -
3559 Lumbar Puncture MISC. null 175 1
Page 55 of 368
Medical Oncology
3560 Pleurodesis - with betadiene MISC. null 305 -
3561 Central Venous Access MISC. null 330 2
3562 Synovial Fluid Aspiration MISC. null 175 -
3563 Intra Articular Injection MISC. null 175 -
3564 Auto HSCT Procedure MISC. null 250,000 -

Date Date Date
Page 56 of 368
PMR
PMR
Printed in SOC's
8.3. UoH - PHYSICAL MEDICINE & REHABILITATION
Unit
###of Hope Procedures
23675 Dressing Services ChargeMISC. null 60 -
23676 Trigger Point Injection MISC. null 90 -
23677 Aspiration MISC. null 210 -
23678 Catheterization MISC. null 70 -
23679 Incision and Drainage MISC. null 120 -
23680 POP Wedging MISC. null 50 -
23681 POP Application - MinorMISC. null 55 -
23682 POP Application - MajorMISC. null 120 -
23683 Suture Removal MISC. null 40 -
23684 Suturing under LA in OPMISC. null 80 -
23685 Phenol Block Injection MISC. null 175 3
23686 Certificate - Medical MISC. null 120 -
23687 Botulinum Toxin Injecti MISC. null 275 -
23688 Alcohol Injection ProcedMISC. null 220 -
8.4. UoH - OCCUPATIONAL THERAPY
Unit
23725 Assessment MISC. null 120 -
23726 Assessment & Home Pr MISC. null 55 -
23727 Development AssessmenMISC. null 120 -
23728 Basic Stimulation MISC. null 100 -
23729 Assessment and Home PMISC. null 55 -
23730 Early Intervention MISC. null 55 -
23731 Developmental TherapyMISC. null 70 -
23732 Developmental Therapy MISC. null 80 -
Page 57 of 368
PMR
23733 Developmental TherapyMISC. null 80 -
23734 Neurodevelopmental The MISC. null 90 -
23735 Developmental Therapy MISC.
& null 80 -
23736 Peabody DevelopmentalMISC. null 240 -
23737 Sensory Integration Ass MISC. null 240 -
23738 Learning Disability EvaluMISC. null 175 -
23739 Handwriting Evaluation MISC. null 55 -
23740 Sensory Integration The MISC. null 55 -
23741 Sensory Integration & FiMISC. null 120 -
23742 Psychiatry RehabilitationMISC. null 55 -
23743 Life Skill Management MISC. null 55 -
23744 Social Skill Training MISC. null 55 -
23745 Pre-Vocational Training MISC. null 55 -
23747 Basic Stimulation & ExerMISC. null 120 -
23748 Cognitive Special EvaluaMISC. null 120 -
23749 Oromotor Evaluation MISC. null 55 -
23750 Oromotor Function MISC. null 90 -
23751 Pre-Prosthetic Training MISC. null 65 -
23752 Prosthetic Training MISC. null 90 -
23753 Cognitive & Perceptual MISC. null 120 -
23754 Functional Retraining MISC. null 120 -
23755 ADL MISC. null 55 -
23756 Functional Retraining & MISC. null 140 -
23757 Home Modification MISC. null 50 -
23758 Hand Function & FunctioMISC. null 120 -
23759 Functional Retraining & MISC. null 160 -
23760 Adaptive Devices MISC. null 35 -
23761 Ergonomic MISC. null 55 -
23762 Hand Function Special EMISC. null 120 -
Page 58 of 368
PMR
23763 Hand Function MISC. null 55 -
23764 Hand Function & Home MISC. null 120 -
23765 Hand Function ADL MISC. null 120 -
23766 Hand Function Exercise MISC. null 55 -
23767 Exercise MISC. null 55 -
23768 Hand Splinting EvaluatioMISC. null 55 -
23769 Splinting Paediatrics MISC. null 120 -
23770 Splinting Adult (Small) MISC. null 175 -
23771 Splinting Adult (MediumMISC. null 420 -
23772 Splinting Adult (IntermeMISC. null 600 -
23773 Lumbarical Splint (VelcroMISC. null 90 -
23774 Ulnar Drift Splint (VelcroMISC. null 90 -
23775 Gutter Splint MISC. null 120 -
23776 Splint Correction MISC. null 55 -
23777 Splint Material (charges MISC. null 65 -
23778 Splint (Large) MISC. null 1,190 -
23779 Splint (Extra Large) MISC. null 1,780 -
21. PMR - MEDICAL REHABILITATION
Physical
### Medicine & Rehabilitation Procedure
3468 Disability Assessment - MISC. null 1,500 -
21.1 PMR - MEDICAL REHABILITATION
Physical
2370 Dressing Services ChargeMISC. null 60 12
2371 Dressing Services Charg MISC. null 80 6
2372 Dressing Services ChargeMISC. null 110 -
2373 Intra - Articular Injectio MISC. null 175 19
2374 Trigger Point Injection MISC. null 90 -
2375 Aspiration MISC. null 210 -
2376 Catheterization MISC. null 70 -
Page 59 of 368
PMR
2378 POP Wedging MISC. null 50 -
2379 POP Application - MinorMISC. null 55 1
2380 POP Application - MajorMISC. null 120 32
2382 Suturing under LA MISC. null 80 -
2383 Suturing without LA MISC. null 50 -
2384 Phenol Block Injection MISC. null 175 -
2385 Certificate - Medical MISC. null 120 -
3461 Stroke Assessment MISC. null 600 8
3462 Cerebral Palsy AssessmeMISC. null 600 -
3463 Spinal Cord Injury Asse MISC. null 600 2
3464 TBI Assessment MISC. null 600 -
3465 Muscular Dystrophy AssMISC. null 600 -
3466 Spinal Dysraphism Asse MISC. null 600 -
3467 Diabetic Foot AssessmenMISC. null 300 -
3469 Botox Injection 100u MISC. null 1,650 -
3470 Botox Injection 50u MISC. null 850 -
3471 Strapping MISC. null 100 4
3472 Tracheostomy Change MISC. null 400 15
3473 Bladder wash MISC. null 100 -
3474 SPC Change MISC. null 110 5
3475 Callus Removal MISC. null 155 1
3476 Fitness Certificate MISC. null 100 32
3477 Insurance AuthenticatioMISC. null - -
21.2 PMR - Occupational Therapy
Physical
2453 Assesment MISC. null 120 142
2454 Assessment and Home MISC. null 100 45
2455 Development AssesmenMISC. null 150 17
2456 Basic Stimulation MISC. null 120 183
Page 60 of 368
PMR
2457 Assessment and Home PMISC. null 100 2
2458 Early Intervention MISC. null 100 3
2459 Developmental TherapyMISC. null 120 423
2460 Developmental Therapy MISC. null 120 2
2461 Developmental TherapyMISC. null 120 12
2462 Neurodevelopmental The MISC. null 150 8
2463 Developmental Therapy MISC. null 150 1
2464 Peabody DevelopmentalMISC. null 240 -
2465 Sensory Integration Ass MISC. null 240 7
2466 Learning Disability EvaluMISC. null 250 6
2469 Handwritting evaluationMISC. null 150 3
2470 Sensory Intergration Th MISC. null 200 8
2471 Sensory Intergration andMISC. null 120 49
2472 Psychiatry RehabilitationMISC. null 120 15
2473 Life Skill Management MISC. null 55 1
2475 Pre-Vocational Training MISC. null 55 -
2477 Basic Stimulation and ExMISC. null 120 47
2478 Cognitive Special EvaluaMISC. null 120 23
2479 Oromotor Evaluation MISC. null 55 10
2481 Pre Prosthetic Training MISC. null 65 1
2483 Cognitive and PerceptuaMISC. null 120 19
2484 Functional Retraining MISC. null 120 2,010
2486 A.D.L. MISC. null 70 58
2487 Functional Retraining anMISC. null 140 24
2488 Home Modification MISC. null 45 -
2489 Hand functionand FunctiMISC. null 150 35
2490 Functional retraining a MISC. null 160 33
2495 Adaptive Devices MISC. null 50 -
2497 Ergonomic MISC. null 55 -
Page 61 of 368
PMR
2499 Hand Function Special EMISC. null 120 3
3203 Exercise MISC. null 55 47
3204 Hand Splinting EvaluatioMISC. null 55 1
3413 Splinting Paediatrics MISC. null 120 14
3414 Splinting Adult (Small) MISC. null 175 84
3415 Splinting Adult (MediumMISC. null 420 46
3416 Splinting Adult (Large) MISC. null 600 105
3417 Lumbarical Splint (VelcroMISC. null 90 -
3418 Ulnar Drift Splint (VelcrrMISC. null 90 14
3419 Gutter Splint MISC. null 120 38
3420 Splint Correction MISC. null 55 22
3421 Splint Material (charges MISC. null 100 32
3447 Splint (Large) MISC. null 1,500 54
3448 Splint (Extra Large) PROCEDURE null 2,000 18
3507 Wheelchair evaluation PROCEDURE null 120 -
21.3 PMR - Orthotic & Prosthestic
Physical
3207 Milwaukee brace (adult)MISC. null 7,130 -
3208 Milwaukee brace (child)MISC. null 3,565 -
3209 Boston Brace (adult) MISC. null 4,160 -
3210 Boston Brace (Child) MISC. null 3,565 1
3215 Knee Cap( Adult) MISC. null 120 4
3216 PP Ankle foot orthosis witMISC. null 715 -
3217 PP Ankle foot orthosis witMISC. null 600 -
3218 MCR X model (adult) MISC. null 540 4
3219 MCR Y Model MISC. null 350 37
3220 MCR T model MISC. null 420 7
3221 MCR Bata Model MISC. null 540 14
3222 MCR Chappal with back MISC. null 715 113
3223 Moulded Shoe with InsoMISC. null 1,430 1
Page 62 of 368
PMR
3224 MCR Insole (one pair) (aMISC. null 175 -
3231 MCR insole one pair (chiMISC. null 90 5
3232 MCR ladies Velcro DesigMISC. null 505 -
3233 PTB Orthosis (adult) MISC. null 2,375 7
3234 PTB Orthosis (child) MISC. null 1,780 1
3235 Miscellaneous MISC. null - 249
3300 A.E.prosthesis (without MISC. null 10,690 -
3301 A.E.prosthesis (without MISC. null 8,315 -
3306 A.K.Prosthesis without sMISC. null 14,255 -
3307 A.K.Prosthesis without sMISC. null 10,690 -
3316 Arch support (adult) MISC. null 55 -
3317 Arch support (child) MISC. null 45 -
3318 B.E. prosthesis (without MISC. null 9,505 -
3319 B.E. prosthesis (without MISC. null 7,130 -
3320 B.K.belt(adult) MISC. null 265 -
3321 B.K.belt(child) MISC. null 210 -
3349 MCR insole ( one pair ) (MISC. null 175 -
3350 MCR insole ( one pair ) (MISC. null 120 12
3351 Metatarsal bar (adult) MISC. null 90 1
3352 Metatarsal bar (child) MISC. null 45 1
3353 New padding for AK calipMISC. null 350 1
3354 New padding for AK calipMISC. null 240 -
3355 New padding for BK calipMISC. null 120 -
3356 New padding for BK calipMISC. null 120 -
3362 Polyproplene FRO ( adulMISC. null 1,780 -
3363 Polyproplene FRO ( childMISC. null 1,310 -
3366 PTB B.K. prosthesis withMISC. null 11,880 4
3367 PTB B.K. prosthesis withMISC. null 7,720 1
3368 PTB socket (adult) MISC. null 950 1
3369 PTB socket (child) MISC. null 540 -
Page 63 of 368
PMR
3383 Stockinette 1 meter (3", MISC. null 35 31
3384 Symes prosthesis (adult)MISC. null 7,130 -
3385 Symes prosthesis (child)MISC. null 5,345 -
3393 Velcro strap 1 pair MISC. null 55 -
3394 Voluntary openhand witMISC. null 1,065 -
3395 Voluntary openhand with MISC. null 890 -
3396 Voluntary openhook - A MISC. null 1,430 -
3397 Voluntary openhook - ALMISC. null 1,065 -
3400 Gaiter - Extra Small MISC. null 500 2
3402 Through Knee ProsthesisMISC. null 8,315 -
3404 Sach foot MISC. null 1,065 -
3405 Cosmetic glove MISC. null 150 -
3408 Taylor Knight Brace MISC. null 1,065 1
3409 Body shell MISC. null 2,080 -
3410 Lumbo sacral corset MISC. null 950 -
3423 Bilat knee A.F.O. withoutMISC. null 8,315 7
3424 Bilat knee A.F.O. withoutMISC. null 5,940 1
3425 Cervical collar (adult) MISC. null 540 2
3426 Cervical collar (child) MISC. null 300 3
3429 Cockup splint (adult) MISC. null 420 19
3430 Cockup splint (child) MISC. null 300 2
3431 Crutch tip -one pair MISC. null 50 -
3432 Gaiter (lower limb) (adulMISC. null 950 52
3433 Gaiter (lower limb) (chil MISC. null 715 37
3434 Jaipur foot MISC. null 350 -
3435 KAFO (adult) MISC. null 4,160 21
3436 Polypropylene A.F.O. (adMISC. null 835 53
3437 Polypropylene A.F.O. (chiMISC. null 540 84
3438 Gaiter (upper limb) (adulMISC. null 715 30
3439 Gaiter (upper limb) (chilMISC. null 420 1
Page 64 of 368
PMR
3440 Above Knee Socket (adulMISC. null 1,780 -
3441 Above Knee Socket (chil MISC. null 950 -
3449 Elbow Knee Temporary PPROCEDURE null 3,565 5
3450 Above Knee Temporary PPROCEDURE null 4,750 -
3451 Below Knee Suspension PROCEDURE null 2,375 -
3452 Bohler Iron articulated PROCEDURE null 1,250 3
3453 Bohler Iron non-articulaPROCEDURE null 650 16
3454 Thermoplast splint modiMISC. null 55 2
3455 Foot drop splint (adult) PROCEDURE null 835 20
3456 Foot drop splint (child) PROCEDURE null 540 -
3457 Sand Bag 3 kg PROCEDURE null 300 -
3460 Limb Prothesis Fittment MISC. null 600 -
3484 Humeral Sling / Cuff MISC. null 600 7
3485 Shoulder Abduction SpliMISC. null 700 3
3486 Elbow Extension Splint (MISC. null 700 1
3487 Elbow Extension Splint (MISC. null 350 2
3488 Knee Extension Splint - MISC. null 800 3
3489 Knee Extension Splint - CMISC. null 450 4
3503 Hip abduction splint PROCEDURE null 700 1
3504 Charcot Restrain orthotiPROCEDURE null 1,700 -
3505 Pop application-major PROCEDURE null 210 -
3506 Pop application-Minor PROCEDURE null 175 -
21.5 PMR - Medico Social work
Physical
3258 Rehabilitation and Plac MISC. null 600 11
3260 Private Attenders ServiceMISC. null 200 3
3276 Assessment PROCEDURE null 150 -
3277 Health Education( Per SePROCEDURE null 100 -
Page 65 of 368
PMR
3278 Counselling( Per sessionPROCEDURE null 300 -
3279 Follow up & After Care( PROCEDURE null 150 -
3280 Visits( Collateral ContactPROCEDURE null 200 -
3281 Addressing Govt. AdvocaPROCEDURE null 200 -
3282 Group Therapy(per sessiPROCEDURE null 500 -
3283 Psycho Social Interventi PROCEDURE null 250 1
21.6 PMR - Speech and Langauge Section
Physical
3261 Speech and Lanuage As PROCEDURE null 90 78
3262 Dysphagia Assessment PROCEDURE null 90 232
3263 Dysphagia Therapy PROCEDURE null 100 426
3264 Voice Assessment PROCEDURE null 90 -
3265 Voice Therapy PROCEDURE null 100 4
3267 Oromotor Excercises & VPROCEDURE null 150 -
3268 Oromotor Excercises & PROCEDURE null 150 1
3269 Speech and Lanuage Th PROCEDURE null 100 108
3270 Group Speech and Lanu PROCEDURE null 150 -
3271 Computerized Speech a PROCEDURE null 300 -
3272 Speech and Language ThPROCEDURE null 180 -
3273 Speech and Language The PROCEDURE null 400 7
3274 Speech and Language The PROCEDURE null 150 -
3275 Home Based Training Pr PROCEDURE null 120 -
21.7 PMR - Diagnostic Ultrasonography
Physical
3501 Venous Doppler - LowerPROCEDURE null 880 -
3502 Ultrasound of Brain PROCEDURE null 330 -
21.8 PMR - Interventions
Physical
3492 Ultrasound guided nervePROCEDURE null 250 2
3493 Ultrasound guided nervePROCEDURE null 250 -
Page 66 of 368
PMR
3495 Ultrasound guided nervePROCEDURE null 1,800 -
3498 Ultrasound guided AspirPROCEDURE null 300 -
3499 U/s guided Pun. of indwePROCEDURE null 200 -
3500 Ultrasound guided wardPROCEDURE null 150 -
N. PHYSICAL MEDICINE & REHABILITATION
N. PHYSICAL MEDICINE & REHABILITATION
Physical
### Medicine & Rehabilitation
9551 Hallux Valgus -Correctio SURGERY MINOR + 4,000 -
9552 Ingrowing Toe Nail SURGERY MINOR 2,600 -
9553 Posteromedial Soft Tiss SURGERY MAJOR + 8,200 -
9554 Vulpius slide SURGERY MINOR + 2,500 -
9555 Tendoachilles LengtheniSURGERY MINOR + 3,000 1
9556 Stendler's release SURGERY MINOR + 2,100 -
9557 Adductor Tenotomy & OSURGERY MINOR + 2,600 -
9558 Adductor Tenotomy SURGERY MINOR + 2,100 -
9559 Obturator Neurectomy SURGERY MINOR + 2,100 -
9560 Iliposoas Recession SURGERY MAJOR 6,600 -
9561 Soutters Younts ProceduSURGERY MAJOR 4,700 -
9562 Fractional Hamstring Le SURGERY MINOR + 3,000 -
9563 C . P Diplegia CorrectionSURGERY MAJOR + 14,000 -
9567 Debridement - Minor SURGERY MINOR + 2,300 -
9568 Debridement - Major SURGERY MAJOR 4,600 -
9569 Ordinary Plaster Cast ApSURGERY MINOR 1,600 -
9570 Release of Contractures SURGERY MINOR + 4,000 -
9571 Rotation Flap SURGERY MAJOR + 13,000 -
9572 Tenotomies - Minor SURGERY MINOR + 3,900 -
Page 67 of 368
PMR
9574 Suture of Wounds - MinSURGERY MINOR 1,600 -
9575 Suture of Wounds - Maj SURGERY MINOR + 2,100 -
9576 Skin Grafting Small AreaSURGERY MINOR 2,600 -
9577 Skin Grafting- Large Are SURGERY MINOR + 3,000 -
9578 Excision ischeal sore & dSURGERY MINOR + 4,900 -
9579 Exci.ischeal sore&flap clSURGERY MAJOR 8,700 -
9580 Flap - Major SURGERY MAJOR + 13,300 -
9581 Revision Amputation SURGERY MAJOR 5,300 -
9582 Raising of TFL Flap SURGERY MAJOR 6,600 -
9583 TFL Flap closure SURGERY MAJOR 4,600 -
9584 Wilson's procedure SURGERY MAJOR 8,600 -
9585 Yount's procedure SURGERY MINOR + 1,900 -
GENERAL
Physical
18100 Harmonic Scalpel SURGERY MAJOR 2,000 -
18101 Basic Microscope per hoSURGERY MAJOR 400 -
18102 Advanced Microscope peSURGERY MAJOR 800 -
18103 Laparoscope per hour SURGERY MAJOR 700 -
18211 Enseal MISC. null - -
21.3 PMR - Orthotic & Prosthestic
Physical
3510 CIC Training PROCEDURE null 100 22
Physical
9588 Bilateral (50% of Proce.)SURGERY MAJOR - -
9589 Extra hours for Minor suSURGERY MAJOR - -
9590 Extra hours for minor + SURGERY MAJOR - -
9591 Extra hours for major suSURGERY MAJOR - -
Page 68 of 368
PMR
9592 Extra hours for major + SURGERY MAJOR - -
95027 Operation Charges MISC. null - -
Physical
2474 Social Skill Training MISC. null 55 -
2480 Oromotor Function MISC. null 100 6
2500 Hand Function MISC. null 75 51
2599 MMC Counseling PROCEDURE null - -
3200 Hand function and HomMISC. null 120 21
3201 Hand Function ADL MISC. null 120 22
3202 Hand Function Exercise MISC. null 55 24
3213 Knee Cage (adult) MISC. null 835 -
3214 Knee Cage (child) MISC. null 650 -
3254 General Counselling MISC. null 300 60
3255 Family Counselling MISC. null 500 -
3256 Transplant Counselling MISC. null 1,000 1
3257 Education Counselling MISC. null 200 9
3259 Support Group MISC. null 500 1
3266 Digital Manipulation/ RelPROCEDURE null 100 -
3302 A.K.belt (adult) MISC. null 350 5
3303 A.K.belt (child) MISC. null 240 -
3304 A.K.foam traction (adultMISC. null 475 1
3305 A.K.foam traction (child)MISC. null 300 -
3308 Abdominal binder MISC. null 715 -
3309 ALC sach foot (adult) MISC. null 1,485 -
3310 ALC sach foot (child) MISC. null 1,190 -
3313 Alum.axillary crutch (AL MISC. null 890 -
3339 Dynamic wire cockup spliMISC. null 540 -
3346 Knee cap (child) MISC. null 90 -
3359 Philadelphia Alk. Collar MISC. null 1,485 -
Page 69 of 368
PMR
3372 Sand bag 1/2 kg MISC. null 120 -
3374 Sand bag 1 kg MISC. null 175 -
3376 Sand bag 2kg MISC. null 210 -
3386 Thomas splint (adult) MISC. null 540 6
3387 Thomas splint (child) MISC. null 420 -
3407 Dennis brown Shoe (CTEMISC. null 600 -
3427 Cockup splint volar (adulMISC. null 1,190 -
3428 Cockup splint volar (chil MISC. null 890 -

Date Date Date
Page 70 of 368
Paediatric Nephrology
Printed in SOC's
19. PAEDIATRIC NEPHROLOGY
Paediatric
### Nephrology
2243 Biopsy - Kidney (with dis MISC. null 715 50
2244 Femoral Catheter MISC. null 420 14
2245 Internal Jugular Catheter MISC. null 420 3
2246 ICU Haemodialysis MISC. null 1,310 10
2247 Haemodialysis Bicarb MISC. null 1,065 117
2248 Peritoneal Dialysis (PD) MISC. null 475 25
2249 Continuous Ambulatory PMISC. null 3,390 2
2250 Continuous Arterio Venous MISC. null 2,375 1
2251 Peritoneal Equilibration TeMISC. null 1,190 -
2252 Hemoperfusion MISC. null 1,190 -
2253 PD Cycler MISC. null 600 8
2254 Plasmapheresis MISC. null 1,430 9
2283 24hrs Amb.Blood PressureMISC. null 800 21
2284 12hrs Amb.Blood PressureMISC. null 500 1
2291 Biopsy - Kidney (with reu MISC. null 800 7
2295 SLED - 6 hours PROCEDUREnull 1,500 5
2296 SLED - 8 hours PROCEDUREnull 1,700 -
2297 SLED - 12 hours or more PROCEDUREnull 1,900 -
2298 Pediatric OPD hemodialsysPROCEDUREnull 1,200 -
2299 Hemodialysis in ITU PROCEDUREnull 1,300 51
Page 71 of 368
2300 Soft catheter insertion fo PROCEDUREnull 1,000 -
L. NEPHROLOGY
PAEDIATRIC RENAL TRANSPLANTATION RECEIPIENT
Paediatric
### Nephrology
9274 Processing fee to ZCCK to SURGERY MAJOR - -
Surgery
### Packages
9521 Live Donor Liver TransplanMISC. null - -
9522 Deceased Donor Liver TraMISC. null - -
Evening
2247 Haemodialysis Bicarb -E MISC. null 1,920 -
2248 Peritoneal Dialysis (PD) -EMISC. null 860 -

Date Date Date
Page 72 of 368
Palliative Medicine

Palliative Medicine
Printed in SOC's
30. PALLIATIVE MEDICINE
Palliative
### Medicine
3010 IV Fusion PROCEDURE null 150 19
3011 Ascitic Tap PROCEDURE null 300 20
3012 Pleural Tap PROCEDURE null 300 -
3013 Trigger Point Injections in PROCEDURE null 250 1
3014 Stellate Ganglion Blocks PROCEDURE null 500 -
3015 Intercostal Nerve Blocks PROCEDURE null 500 1
3016 Lympha pressure sitting perPROCEDURE null 150 1
3017 Syringe driver/PCA per day PROCEDURE null 400 -
3018 Travel Expense According toPROCEDURE null - -
3019 All Services (Consultation, I PROCEDURE null 350 -
3023 Ketamine/Morphine adminis PROCEDURE null 400 21
3025 Counseling PROCEDURE null 200 60
3026 Lymphapress Package (6 SittPROCEDURE null 500 3
30. PALLIATIVE MEDICINE
Palliative
### Medicine
3024 Inpatient Cross Consultatio PROCEDURE null 50 1
3034 Acupuncture PROCEDURE null 500 -
Page 73 of 368
Palliative Medicine

3035 Caudal Injections PROCEDURE null 1,800 -

3036 Cervical Medial Branch BlocPROCEDURE null 2,000 -
3037 Dry Needling PROCEDURE null 800 -
3038 Ganglion Impar Block PROCEDURE null 1,500 -
3039 Intrathecal Drug Delivery PROCEDURE null 10,000 -
3040 Lumbar medial branch/facetj PROCEDURE null 1,800 -
3041 Neurolytic nerve block PROCEDURE null 5,000 -
3042 Peripheral Joint Injection w PROCEDURE null 600 -
3043 Peripheral Nerve Injection PROCEDURE null 600 -
3044 Pulse Radiofrequency PROCEDURE null 5,500 -
3045 Repeat Pulse radiofrequencPROCEDURE null 2,500 -
3046 Spinal cord stimulation stagPROCEDURE null 10,000 -
3047 Sympathetic Ganglion BlockPROCEDURE null 2,000 -
3048 Therapeutic Epidural PROCEDURE null 1,800 -
3049 Thermal Radiofrequency PROCEDURE null 5,500 -
3050 Transforaminal epidural PROCEDURE null 1,800 -
3051 Ulrasound guidance for dayPROCEDURE null 300 -
Palliative
### Medicine
3021 Administration of Drugs (DaPROCEDURE null 240 -
3022 Administration of Drugs (InpMISC. null 400 1
Page 74 of 368
Palliative Medicine

Date Date Date
Page 75 of 368
Psychiatry
Ch Code ChargeDesc ServiceDesc Service Catagory ServCat ward Remarks
Rate Apr-17 to Nov-17 Revision
Psychiatry
Printed in SOC's
8.10. UoH - SPECIAL EDUCATION
Unit
24097 Play Therapy DemonstPROCEDURE null 100 -
24098 Education Materials ( PROCEDURE null 50 1
24099 Special Education ca PROCEDURE null 100 12
24100 Inpatient Consultatio MISC. null 100 4
24101 Screening & Initial A PROCEDURE null 80 -
24102 Special Education ConPROCEDURE null 100 186
24103 Followup Special EducPROCEDURE null 80 1
24104 Followup Special EducPROCEDURE null 90 -
24105 Comprehensive Cogniti PROCEDURE null 100 59
24106 ADL Training Session PROCEDURE null 100 -
8.8. UoH - CHILD PSYCHIATRY
Unit
24000 Assessment of SpecifiMISC. null 600 -
24001 Assessment of SpecificMISC. null 890 -
24002 Detailed Work- up & CMISC. null 715 -
24003 Detailed Work-up withMISC. null 890 -
24004 Special Assessment wiMISC. null 350 5
24005 Special Assessment wiMISC. null 600 3
24006 Letters to School MISC. null 120 1
Page 76 of 368
Psychiatry
24007 Certificate MISC. null 300 3
24008 Assessment of Intelli MISC. null 715 -
24009 School Visit (TransportMISC. null 1,780 -
24012 Family Therapy (singleMISC. null 475 1
24013 Family Therapy ( 3 sesMISC. null 1,190 -
24014 Psycho Education - OnMISC. null 475 -
24015 Behavioural CounsellinMISC. null 1,190 -
24016 Behavioural CounsellinMISC. null 475 2
24017 Developmental AssessMISC. null 350 -
24018 Developmental AssessMISC. null 600 2
24019 Neuropsychological AMISC. null 3,565 -
24020 Child Psychotherapy -MISC. null 420 -
24022 Mini Assessment of HyMISC. null 1,190 -
24024 Mini Assessment of AuMISC. null 1,190 -
24043 Play Therapy (5 sessioPROCEDURE null 1,000 -
24144 Routine Ambulatory MISC. null 1,800 8
24145 Prolonged Ambulator MISC. null 3,750 -
24. PSYCHIATRY
Psychiatry
###
2505 Counselling (per sessiPROCEDURE null 400 24
2508 E.C.T. MISC. null 660 104
2516 Case File and Detaile PROCEDURE null 720 570
2524 ECT-Anaesthesia in waPROCEDURE null 520 102
2569 Special Assessment usPROCEDURE null 400 1
Page 77 of 368
Psychiatry
24.1 Child psychiatry
Psychiatry
###
2502 Child Assessment of SPROCEDURE null 660 65
2503 Assessment of specificPROCEDURE null 980 99
2550 Detailed Work up PROCEDURE null 790 6
2551 Detailed work up withPROCEDURE null 900 1
2552 Special Assessment (UPROCEDURE null 300 -
2553 Letters to School MISC. null 130 1
2555 Certificates PROCEDURE null 330 222
2556 Assessment of IntelligPROCEDURE null 790 157
2557 School Visit (TransportPROCEDURE null 1,800 -
2561 Family PsychotherapyPROCEDURE null 1,190 13
2563 Behavioural CounsellinPROCEDURE null 1,310 1
2564 Behavioural CounsellinPROCEDURE null 520 2
2567 Developmental AssessPROCEDURE null 390 3
2568 Developmental AssessPROCEDURE null 660 23
2571 Neuropsychological asMISC. null 4,000 -
2572 Child Psychotherapy -MISC. null 460 5
2575 Systematic AssessmenMISC. null 6,530 1
2576 Mini Assesment of AutMISC. null 1,310 5
2599 Play Therapy (5 sessioPROCEDURE null 1,200 -
24.2 clinical Psychology
Psychiatry
###
2507 Diagnostic AssessmenPROCEDURE null 1,430 6
2514 Assessment of Persona PROCEDURE null 1,190 2
Page 78 of 368
Psychiatry
2515 Cognitive Functions(PPROCEDURE null 1,250 -
2517 Neuro Psychological PROCEDURE null 4,750 6
2527 Detailed intake PROCEDURE null 660 3
2528 Assesment of more t PROCEDURE null 1,780 -
2529 Assesment with ClinicaPROCEDURE null 300 7
2577 Assessment of IntelligMISC. null 790 4
2578 Assessment of memorMISC. null 660 -
24.3 Social work
Psychiatry
###
2522 Psychotherapy-MaritalMISC. null 520 6
2579 Rehabilitation CounselMISC. null 1,065 -
2581 Group Therapy (Familie MISC. null 520 4
2582 Assessments using ratinMISC. null 500 1
2583 Letters to NGOs / GOsMISC. null 300 1
2606 Marital & Family TherPROCEDURE null 520 1
2607 Rehabilitation CounselMISC. null 350 -
24.4 Day Care centre
Psychiatry
###
2535 Recovery Oriented SerPROCEDURE null - 370
2536 Recovery Oriented Se PROCEDURE null - 13
2537 Recovery Oriented Se PROCEDURE null 6,000 21
24.5 Eating Disorder Clinic
Psychiatry
###
2538 Eating Disorder Clinic PROCEDURE null 200 -
2539 Eating Disorder Clinic MIXED null 400 -
Page 79 of 368
Psychiatry
2542 Eating Disorder Clinic MIXED null 600 -
2543 Eating Disorder Clinic MIXED null 1,200 -
2544 Eating Disorder Clinic PROCEDURE null 1,400 -
2545 Eating Disorder Clinic MIXED null 1,600 -
24.6 General
Psychiatry
###
2510 Group Therapy (ADS 3PROCEDURE null 1,170 5
2526 Group (per session) PROCEDURE null 220 16
2530 Provision of typed as PROCEDURE null 120 2
2532 Brief Intervention for PROCEDURE null 700 178
2533 Assessment and Counse PROCEDURE null 700 113
2584 Psychoeducation MISC. null 500 221
2586 Individual Therapy: si MISC. null 600 155
2588 Special Consultation wPROCEDURE null 800 -
2591 General Service ChargPROCEDURE null 50 1,726
2592 Multidisciplinary Tea PROCEDURE null 300 186
2594 Readmission and Rea PROCEDURE null 500 9
2595 Reassessment/SecondPROCEDURE null 200 1
2596 Case File PROCEDURE null 350 5
2600 MMC Counseling PROCEDURE null 100 92
Psychiatry
###
2518 Psychotherapy/BehaviPROCEDURE null 3,500 -
Page 80 of 368
Psychiatry
2519 Rehabilitation CounselPROCEDURE null 660 -
2531 Psychotherapy-MaritalPROCEDURE null 4,160 1
2558 Child Psychotherapy (PROCEDURE null 3,920 -
2559 Play Therapy (15 sessiPROCEDURE null 3,565 -
2560 Family therapy -1 sessPROCEDURE null 475 -
2562 Counselling - Mental RPROCEDURE null 475 -
2570 Special Assessment wiMISC. null 500 -
2573 Systematic Clinical As MISC. null 4,750 -
2574 Mini Assessment of HyMISC. null 1,190 -
2580 Collateral Contacts wiMISC. null 600 -
2585 Individual Therapy: 10MISC. null 3,920 -
2587 Psychoeducation MISC. null 475 -
2589 Special Consultation wPROCEDURE null 1,000 1
2593 Cross Consultation fr PROCEDURE null 250 9
Evening
2502 Assessment of SpecifiPROCEDURE null 1,080 -
2503 Assessment of specificPROCEDURE null 1,600 -
2507 Diagnostic AssessmentPROCEDURE null 2,570 -
2508 E.C.T. -E MISC. null 1,080 -
2514 Personality AssessmenPROCEDURE null 2,140 -
2515 Cognitive Functions(PPROCEDURE null 2,140 -
2556 Assessment of IntelligPROCEDURE null 1,400 -
Page 81 of 368
Psychiatry

Date Date Date
Page 82 of 368
Radiation Oncology
Radiation Oncology
Printed in SOC's
29. RADIATION ONCOLOGY
Radiotherapy
### Oncology
23001 2DRT Curative (2DRT-C) - eaPROCEDURE null 5,500 21
23002 2DRT Palliative (2DRT-P) - e PROCEDURE null 5,500 116
23003 3DCRT Curative (3DRT-C) - ePROCEDURE null 11,000 364
23004 3DCRT Palliative (3DRT-P) - PROCEDURE null 11,000 77
23005 IMRT Curative (IMRT-C) eachPROCEDURE null 11,000 308
23006 IMRT Palliative (IMRT-P) - e PROCEDURE null 11,000 9
23007 IGRT Curative (IGRT-C) - eac PROCEDURE null 27,500 9
23008 IGRT Palliative (IGRT-P) - ea PROCEDURE null 22,000 -
23018 Stereotatic Radio Surgery (SMISC. null 99,000 -
23019 Stereotatic Radio Theraphy MISC. null 150,000 -
23020 Stereotatic Body Radio TherMISC. null 150,000 -
23021 Brachytherapy - Gyn - SorboMISC. null 5,500 21
23022 Brachytherapy - Gyn - Intra MISC. null 16,500 22
23023 Brachytherapy - Interstitial alMISC. null 22,000 17
23024 Brachytherapy - IntraluminaMISC. null 5,500 2
23025 2DRT Curative (2DRT-C) - PaMISC. null 44,000 1
23026 2DRT Palliative (2DRT-P) - P MISC. null 22,000 7
23027 3DCRT Curative (3DRT-C) - PMISC. null 77,000 18
23028 3DCRT Palliative (3DRT-P) - MISC. null 33,000 7
Page 83 of 368
Radiation Oncology
23029 IMRT Curative (IMRT-C) - Pa MISC. null 99,000 11
23030 IMRT Palliative (IMRT-P) - P MISC. null 44,000 -
23031 IGRT Curative-(IGRT-C) - PacMISC. null 137,500 -
23032 IGRT Palliative-(IGRT-P) - Pa MISC. null 66,000 -
23033 Volumetric Modulated Arc TPROCEDURE null 150,000 -
23034 Volumetric Modulated Arc Th PROCEDURE null 180,000 3
23035 Total Body Irradiation PROCEDURE null 25,000 -
23036 Hemi-Body Irradiation PROCEDURE null 10,000 -
23037 Extra-Corporeal Irradiation PROCEDURE null 10,000 -
23038 Per Fraction- Electrons ( No PROCEDURE null 2,000 3
23039 Blood Irradiation (Whole Bl PROCEDURE null 800 75
23040 Brachytherapy Surface mouPROCEDURE null 11,000 -
23041 VMAT - each instalment PROCEDURE null 30,000 -
23042 Brachy Therapy Catheter PROCEDURE null 1,000 -
Grand Total 1,495,300 1,091

Date Date Date
Page 84 of 368
Dental Surgery

Printed in SOC's
2. Dental 2.1 Dental surgery
Orthodontics
###
2036 Apexification PROCEDURE null 2,500 -
2037 Splinting Tooth PROCEDURE null 500 -
Dental
### Surgery Procedure
501 Alveolectomy - Simple MISC. null 250 2
502 Alveolectomy (per quadrMISC. null 500 1
503 Alveolectomy Full Jaw - MISC. null 1,800 -
504 Crown and Bridge - AcryMISC. null 800 6
506 Apicectomy - Single Too MISC. null 1,000 8
507 Biopsy under L.A. MISC. null 300 40
508 Extraction - Decidious, MMISC. null 100 288
509 Extraction - Simple MISC. null 300 627
510 Extraction - ComplicatedMISC. null 700 185
511 Extraction - Impactions SMISC. null 1,000 54
512 Extraction - Bony ImpactMISC. null 2,500 30
513 Extraction - Total Extrac MISC. null 2,000 2
516 Filllings - Amalgam - CL IMISC. null 300 196
517 Filllings - Amalgam - CL IMISC. null 400 2
518 Fillings - Glass Inomer I MISC. null 300 417
520 Fillings - Temporary MISC. null 150 133
522 Fillings - Light Cure - C MISC. null 500 115
523 Fillings - Light Cure ComMISC. null 700 76
524 Flap (localised) MISC. null 1,000 5
Page 85 of 368
Dental Surgery

525 Flap (per quadrant) MISC. null 2,000 3

526 Flap with Bone Graft MISC. null 3,000 1
527 Gingivectomy (per quadrMISC. null 1,000 1
528 Gingivoplasty (per quadrMISC. null 1,000 -
535 Intra Oral Space MaintaiMISC. null 500 3
536 IO X - ray - Occlusal MISC. null 150 4
537 IO X - ray - Periapical MISC. null 130 2,625
540 Recementing of Crowns MISC. null 300 41
541 Refacing of Bridge MISC. null 300 -
542 Complete Dentures - UpMISC. null 5,500 10
543 Complete dentures - UpMISC. null 3,000 11
544 Removable Partial DentuMISC. null 200 391
545 Removable Partial Dentur MISC. null 600 132
546 Repair of Dentures (ComMISC. null 500 5
550 Repair of Dentures (SeleMISC. null 300 1
551 Repair of Dentures (SimpMISC. null 300 14
552 Root.can.Treat. Anterior MISC. null 1,800 117
553 Root.can.Treat. PosteriorMISC. null 2,500 491
554 Pulpectomy MISC. null 800 47
555 Scaling - I MISC. null 700 357
556 Scaling - II MISC. null 300 66
558 Nickel Cromium Full Cr MISC. null 1,700 172
560 Ceramic Crown MISC. null 3,500 422
569 Impaction Canine MISC. null 2,000 -
570 Surgical Exposure of TooMISC. null 500 -
571 Obturator Surgical MISC. null 500 6
572 Obturator Interim MISC. null 500 3
Page 86 of 368
Dental Surgery

573 Obturator Definitive MISC. null 1,500 1

574 Cast Post & Core Pin MISC. null 1,000 14
577 Miracle Mix - I MISC. null 300 140
578 Miracle Mix - II MISC. null 400 17
580 Temporary Crown MISC. null 500 4
581 Fillings - Glass Inomer II MISC. null 400 52
620 Repeat Posterior Root C PROCEDURE null 3,000 4
621 Repeat Anterior Root CaPROCEDURE null 2,000 5
622 Fibre Post (each) MISC. null 1,000 7
634 Frenectomy PROCEDURE null 500 2
635 Polishing PROCEDURE null 200 64
636 Suture Removal PROCEDURE null 100 2
2. Dental 2.2 Orthodontics
Orthodontics
###
2001 NAM PROCEDURE null 6,000 -
2002 Feeding Plates PROCEDURE null 2,000 1
2003 Quad Helix PROCEDURE null 5,000 -
2004 TPA PROCEDURE null 5,000 -
2005 Lingual Arch PROCEDURE null 5,000 2
2006 RME PROCEDURE null 7,500 2
2007 Upper Expansion AppliaPROCEDURE null 5,000 5
2008 Upper Z Spring AppliancPROCEDURE null 5,000 -
2009 Oral Screen PROCEDURE null 5,000 -
2010 Space Maintainers - UnilPROCEDURE null 3,000 5
2011 Space - Regainers PROCEDURE null 5,000 -
2012 Coffin Spring Appliance PROCEDURE null 2,500 -
2013 Habit Breaking AppliancPROCEDURE null 2,500 1
Page 87 of 368
Dental Surgery

2014 Habit Breaking AppliancePROCEDURE null 5,000 5

2015 Habit Breaking AppliancPROCEDURE null 5,000 2
2016 Tongue Thrust CorrectioPROCEDURE null 5,000 -
2017 Space Maintainers - Re PROCEDURE null 2,500 1
2018 2 x 4 Appliances PROCEDURE null 12,000 1
2019 Pre - Prosthetic Applian PROCEDURE null 12,000 2
2020 Screw Based AppliancesPROCEDURE null 12,000 -
2021 Buttons / Begg Bracket fPROCEDURE null 1,000 3
2022 II Phase Treatment for Cla
PROCEDURE null 55,000 -
2023 Bracket / Band - First 3 PROCEDURE null 600 4
2024 Activator PROCEDURE null 5,000 -
2025 Activator with Head GeaPROCEDURE null 10,000 10
2026 Twin Block PROCEDURE null 7,500 -
2027 Frankel Appliance PROCEDURE null 7,500 -
2028 Hybrid Appliance 1 with PROCEDURE null 7,500 -
2032 Pit & Fissure Sealant PROCEDURE null 600 11
2033 Stainless Steel Crown PROCEDURE null 500 9
2034 Fluoride Applications PROCEDURE null 500 10
Dental
601 Impressions MISC. null 200 2
618 Orthodontic Checkup forMISC. null 500 -
619 Orthodontic Procedure fMISC. null 1,000 -
689 Orthodontic Treatment -PROCEDURE null 25,000 1
690 Orthodontic Treatment PROCEDURE null 35,000 2
691 Orthodontic Treatment -PROCEDURE null 45,000 2
692 Surgical Cases Package PROCEDURE null 75,000 -
693 Single Toooth Implant PROCEDURE null 20,000 5
Page 88 of 368
Dental Surgery

694 Over Denture - 2 ImplanPROCEDURE null 55,000 -

2. Dental 2.3 Prosthodontics
Dental
623 All Ceramic Crowns-SingPROCEDURE null 8,000 1
624 Ziconia Crowns-Single UPROCEDURE null 10,000 7
625 Cast Partial Dentures PROCEDURE null 12,000 -
626 Acrylic Dentures - ImporPROCEDURE null 8,000 10
627 BPS Dentures/Injection PROCEDURE null 20,000 13
628 Semi Regid Dentures PROCEDURE null 8,000 7
629 Maxillofacial Prosthese PROCEDURE null 1,500 -
630 Maxillofacial Prothesis PROCEDURE null 3,000 -
631 Confirmer - Simple PROCEDURE null 1,000 5
632 Confirmer - ComplicatedPROCEDURE null 1,000 1
633 Night Guard PROCEDURE null 1,500 57
695 Implant Surgical Phase PROCEDURE null 12,000 2
696 Implant Prosthesis Phas PROCEDURE null 10,000 -
2029 Hybrid Denture 8 ImplanMIXED null 200,000 -
2030 Hybrid Denture - Single MIXED null 100,000 2
2031 Over Denture - 4 ImplanMIXED null 100,000 -
2035 Semi rigid Harf Arch - D ITEMS null 4,000 5
Orthodontics
###
607 Functional Appliances PROCEDURE null 5,000 -
608 Fixed Functional Applia PROCEDURE null 7,500 -
Dental
505 .Crown and Bridge - AcryMISC. null 700 -
548 Repair of Dentures (Re -MISC. null 350 -
Page 89 of 368
Dental Surgery

549 Repair of Dentures (Re - MISC. null 350 -

559 Nickel Cromium Full CroMISC. null 1,200 -
561 Ceramic Crown Additiona MISC. null 3,000 -
562 Metal Pontic with CeramMISC. null 1,100 -
579 Recementing of Bridge MISC. null 250 -
582 Upper / Lower Eight ExtrMISC. null 500 2
603 Beggs (Extraction) MISC. null 13,000 -
604 Straight Wire (Non-ExtraMISC. null 17,000 -
605 Straight Wire (ExtractionMISC. null 18,500 -
606 Removable Appliances MISC. null 3,000 -
610 Removable Expansion PlMISC. null 4,000 -
612 Habit Breaking AppliancMISC. null 2,500 -
613 Space Maintainers MISC. null 2,000 -
614 Orthopedic Appliances MISC. null 5,000 -
617 Breakage Repair (Single MISC. null 500 -
637 Retention Plate PROCEDURE null 1,500 -
Evening
501 Alveolectomy - Simple - MISC. null 450 -
502 Alveolectomy per quadraMISC. null 900 -
504 Crown and Bridge-AcryliMISC. null 1,350 -
506 Apicectomy - Single TootMISC. null 1,800 -
507 Biopsy under L.A. -E MISC. null 540 -
508 Extraction - Decidious, mMISC. null 180 -
509 Extraction - Simple -E MISC. null 540 -
510 Extraction - ComplicatedMISC. null 1,260 -
511 Extraction - Impactions SMISC. null 1,800 -
512 Extraction - Bony ImpactMISC. null 2,700 -
Page 90 of 368
Dental Surgery

513 Extraction - Total ExtractMISC. null 3,600 -

516 Filllngs - Amalgam - CL I MISC. null 360 -
517 Filllngs - Amalgam - CL I MISC. null 720 -
518 Fillings - Glass Inomer -EMISC. null 450 -
520 Fillings - Temporary -E MISC. null 180 -
522 Fillings - Light cure - Co MISC. null 910 -
523 Fillings - Light cure compMISC. null 1,260 -
524 Flap - Localised -E MISC. null 1,800 -
525 Flap per quadrant -E MISC. null 1,440 -
527 Gingivectomy per quadraMISC. null 1,080 -
532 Inter maxillary wiring u MISC. null 1,540 -
540 Recementing of Crowns MISC. null 540 -
541 Refacing of Bridge - per MISC. null 450 -
542 Complete Dentures - UpMISC. null 9,900 -
543 Complete dentures - uppMISC. null 4,500 -
544 Removable partial dentur MISC. null 360 -
545 Removable partial dentur MISC. null 1,080 -
546 Repair of Dentures - ComMISC. null 540 -
551 Repair of Dentures - SimMISC. null 360 -
552 Root.can.Treat. Anterior MISC. null 1,800 -
553 Root.can.Treat. PosteriorMISC. null 4,500 -
555 Scaling - I -E MISC. null 1,260 -
556 Scaling - II -E MISC. null 540 -
558 Nickel Cromium full cro MISC. null 2,160 -
560 Ceramic Crown -E MISC. null 6,300 -
Grand Total 1,172,580 7,620
Page 91 of 368
Dental Surgery


Date Date Date
Page 92 of 368
Ophthalmology

Ch Code ChargeDesc ServiceDesc Catagory ServCat ward Rate Remarks
Apr-17 to Nov-17 Rate Revision
Printed in SOC's
8.6. UoH - OPHTHALMOLOGY
Unit
23875 Artificial Eye Ball (Cost) Servic MISC. null 240 -
23876 Contact Lens - Hard Lens (Per LMISC. null 475 -
23877 Contact Lens - RGP Lens (Per LeMISC. null 715 -
23878 Contact Lens - Soft Lens (Per LeMISC. null 715 -
23879 Indirect Ophthalmology MISC. null 90 -
23880 Fundus Examination After DropMISC. null 90 -
23881 Refraction & Prescription of Sp MISC. null 130 2
23882 Sub Conjunctival Injection MISC. null 120 -
23883 Syringing Eye MISC. null 100 -
23884 Slit Lamp Photography MISC. null 55 -
23885 Fundus Photography MISC. null 65 -
23886 Low Vision Test MISC. null 120 -
23887 Hand Magnifier + 6D MISC. null 175 -
23890 Stand Magnifier + 8D MISC. null 255 -
23891 Stand Magnifier +14D MISC. null 255 -
23893 IIIuminated Hand Magnifier MISC. null 300 -
23894 Paper Weight Magnifier MISC. null 600 -
23895 Loupe - 2X MISC. null 1,190 -
23896 Loupe - 3.5X MISC. null 1,540 -
Page 93 of 368
Ophthalmology

23897 Microscopic Glasses MISC. null 350 -

23898 Tonometry with Pachymetry MISC. null 120 -
23899 Glaucoma Work-Up (Package) MISC. null 950 -
23900 OCT (one eye) MISC. null 950 -
23901 Low Vision Test (Major) MISC. null 350 -
23902 ROP Screening MISC. null 240 -
23903 Squint Assessment MISC. null 175 -
23904 VER MISC. null 600 -
15. OPTHALMOLOGY
Opthalmology
### Procedure
1701 Argon Laser Focal MISC. null 600 50
1702 Argon Laser Iridotomy MISC. null 600 -
1703 Argon Laser Photo Coagulation MISC. null 890 139
1704 Argon Laser Photomydriasis * MISC. null 600 1
1705 Argon Laser Suture Lysis MISC. null 600 -
1706 Argon Laser Trabeculoplasty MISC. null 890 -
1707 Artificial Eye Ball (Cost) Servic MISC. null 240 3
1708 Auto Plot Perimetry - AdditionaMISC. null 200 -
1709 Auto Plot Perimetry - For Each MISC. null 300 43
1710 Auto Plot Perimetry - Both EyesMISC. null 600 1,014
1712 Chalazion Removal MISC. null 400 55
1713 Conjunctival Flap MISC. null 200 -
1715 Contact Lens - RGP Lens (Per LeMISC. null 700 -
1716 Contact Lens - Soft Lens (Per LeMISC. null 700 1
1717 Contact Lens - Disposable / CosMISC. null 1,350 -
Page 94 of 368
Ophthalmology

1718 Contact Lens - Fort. DisposablesMISC. null 1,600 -

1719 Indirect Ophthalmology MISC. null 90 -
1720 Contact Lens Testing and Fittin MISC. null 300 -
1721 Fluorescein Angiography MISC. null 1,870 11
1722 Fluorescein Angioscopy MISC. null 400 -
1723 Removal of Foreign Body in OPMISC. null 240 18
1724 Fundus Examination After DropMISC. null 90 81
1726 Hordeolo Internum or Exrernu MISC. null 200 -
1727 Incision for Lacrymal Abcess MISC. null 240 -
1728 Operation of the Lids ExpilationMISC. null 200 -
1732 Photocoagulation (per sitting) MISC. null 600 -
1733 Refraction and Prescription of MISC. null 130 10,407
1735 Sub Conjunctival Injection MISC. null 120 2
1737 Syringing Eye MISC. null 100 165
1738 Tarsorrhapy (each eye) MISC. null 420 1
1739 Ultra Sound A-Scan Biometry MISC. null 350 397
1740 Ultra Sound B-Scan MISC. null 350 220
1741 Ultrasound Combined A and B MISC. null 700 5
1742 Corneo Scleral Suture Removal MISC. null 200 -
1743 Diurnal Variation Test MISC. null 300 1
1744 Contact Lens- Special / Premiu MISC. null 780 -
1745 Polarised Photography MISC. null 120 -
1746 YAG Laser Iridotomy MISC. null 890 2
1747 YAG Laser Capsulotomy MISC. null 890 54
1748 Sub Tenon's Injection MISC. null 240 2
1749 Slit Lamp Photography MISC. null 50 1
1750 Fundus Photography MISC. null 70 23
Page 95 of 368
Ophthalmology

1751 Photography with Floppy MISC. null 180 -

1752 Low Vision Test MISC. null 120 -
1753 Toric Lenses (conventional) MISC. null 1,780 1
1754 Toric Lenses (disposable) MISC. null 3,250 -
1758 Stand Magnifier + 8D MISC. null 260 -
1761 IIIuminated Hand Magnifier MISC. null 300 -
1762 Paper Weight Magnifier MISC. null 600 -
1763 Loupe - 2X MISC. null 1,190 -
1764 Loupe - 3.5X MISC. null 1,500 1
1765 Microscopic Glasses MISC. null 350 -
1766 Tonometry with Pachymetry MISC. null 120 -
1767 Claucoma Work-up (Package) MISC. null 950 -
1768 Glaucoma Work-up with OCT MISC. null 3,100 -
1769 OCT (one eye) MISC. null 950 509
1770 Short wave Automated Perimetr MISC. null 830 -
1772 Low Vision Test (Major) MISC. null 350 -
1773 ROP Screening MISC. null 240 137
1775 Squint Assessment MISC. null 180 -
1776 PDT inclusive of Laser MISC. null 15,450 -
1777 UBM Scan MISC. null 890 -
1778 Abscess Drainage MISC. null 350 -
1780 Glaucoma Package II (with OCT,MISC. null 3,600 -
Page 96 of 368
Ophthalmology

1781 GDX (both eyes) MISC. null 1,200 97

1782 Specular Microscopy MISC. null 600 1
1783 A Scan + Specular M MISC. null 830 2
1784 Tonometry MISC. null 50 3,245
1785 Pachymeter MISC. null 120 130
1786 EEG MISC. null 600 -
1787 VER MISC. null 600 -
1788 Incision & Drainage - Eye PROCEDUREnull 240 -
1789 Corneal Staining / Foreign Bod MISC. null 50 55
1790 Suture Removal Majore PROCEDUREnull 400 -
1792 Corneal Topograghy Each Eye PROCEDUREnull 500 -
1793 Refraction only (ARK) PROCEDUREnull 80 8
1794 Basic work-up procedure (ARK, PROCEDUREnull
P 150 -
1795 IOP only LABORATORnull 50 2
1796 Gonio + IOP + Fundoscopy + PeLABORATORnull 850 5
1797 Gonio + IOP + Fundoscopy + peLABORATORnull 1,600 -
1798 OCT PROCEDUREnull 950 -
1799 OCT (Both eyes) PROCEDUREnull 1,400 3
1800 Follow up OCT (one eye) PROCEDUREnull 500 -
1801 CCT 'K' reading + topography LABORATORnull 1,000 -
1802 Chalazion I+C LABORATORnull 600 -
1803 FB Removal ( Cornea) LABORATORnull 100 -
1804 Eye Irrigation / wash LABORATORnull 50 -
1805 Schirmers LABORATORnull 30 -
1806 Dilatation, IOP, Perimetry / OCTLABORATORnull 1,500 -
F. OPHTHALMOLOGY
Page 97 of 368
Ophthalmology

Anti Glaucoma operation

Opthalmology
###
6811 Trabeculectomy with controlledSURGERY MAJOR 5,000 -
6812 Trabeculotomy Major SURGERY MAJOR 4,000 -
6813 Trab + Trabeculotomy SURGERY MAJOR 5,000 -
6814 Phaco + Trab (combined) SURGERY MAJOR 6,000 -
6881 Cyclocryopexy SURGERY MINOR 2,000 1
6883 Goniotomy SURGERY MAJOR 2,600 -
6884 Peripheral Iridectomy SURGERY MAJOR 2,200 1
6887 Trabeculectomy SURGERY MAJOR 3,000 2
6888 Controlled Trabeculectomy SURGERY MAJOR 3,500 -
6890 Excision of Prolapsed Iris SURGERY MAJOR 2,500 -
6891 Glaucoma Valve Implant SURGERY MAJOR 3,000 -
7030 Bleb revision SURGERY MAJOR 2,000 -
Cornea
Opthalmology
###
6822 Deep Foreign Body Removal SURGERY MINOR 1,800 1
6823 Keratoplasty SURGERY MAJOR 7,000 3
6824 Removal of Superficial Foreign SURGERY MINOR 1,300 1
6827 Corneal Tear Repair-minor SURGERY MAJOR 3,500 9
6828 Corneal Tear Repair-major SURGERY MAJOR 6,800 2
7018 Corneal suturing SURGERY MAJOR 2,200 2
7019 Suture Removal SURGERY MAJOR 500 18
7020 Therapeutic keratoplasty SURGERY MAJOR 3,000 2
7021 Triple procedure (KP+ IOL) SURGERY MAJOR 6,500 -
Extra Ocular Muscles
Opthalmology
###
Page 98 of 368
Ophthalmology

6832 Squint Correction Major SURGERY MAJOR 7,000 -

6951 Chalazion Lacrymal Apparatus SURGERY MINOR 1,800 -
6953 Squint Correction SURGERY MAJOR 3,900 7
7035 Two muscle surgery SURGERY MAJOR 3,000 -
7036 Four muscle surgery SURGERY MAJOR 6,000 -
Eye Ball
Opthalmology
###
6991 Enucleation SURGERY MAJOR 2,200 -
6992 Enucleation with Insertn. SURGERY MAJOR 4,200 -
6993 Eviceration SURGERY MAJOR 2,200 3
6995 Reml.of Intra Ocular F.B. SURGERY MAJOR 4,700 -
Eye Lids
Opthalmology
###
6808 Fornix Reconstruction SURGERY MAJOR 3,000 -
6809 Contracted Socket ReconstructiSURGERY MAJOR 6,500 -
6810 Ptosis Major SURGERY MAJOR 5,500 -
6841 Blepharoplasty (Each Eye) SURGERY MAJOR 3,400 -
6843 Deepening Contracted Socket SURGERY MAJOR 4,300 -
6844 Excision of Tumour & Clos SURGERY MAJOR 2,200 1
6845 Extopian Release & Skin G SURGERY MAJOR 3,300 -
6846 Ptosis Correction SURGERY MAJOR 2,300 -
6848 Reconstn.of Each Eye Lid - Min SURGERY MINOR 3,000 1
6849 Recon.of Each Eye Lid -Major SURGERY MAJOR 4,500 -
6850 Release Synechiae & SSG SURGERY MAJOR 3,300 -
6852 Telecanthus Recon. - Min. SURGERY MAJOR 2,200 -
6853 Telecanthus Recon. - Maj. SURGERY MAJOR 5,600 -
6854 Tumour Exc.with Reconstn. SURGERY MAJOR 4,500 -
Page 99 of 368
Ophthalmology

6861 Lid Abscess SURGERY MINOR 1,500 7

7022 Tarsorrhaphy SURGERY MAJOR 1,000 6
7023 Excision biopsy SURGERY MAJOR 1,000 5
7024 Ectropion/Entropion correctionSURGERY MAJOR 3,000 2
7025 Lid tear repair SURGERY MAJOR 2,500 2
7026 Chalazion (incision & curettageSURGERY MAJOR 100 3
Lacrymal Apparatus
Opthalmology
###
6833 Lacrimal Intubation SURGERY MINOR 2,000 -
6862 Lacrimal Abscess SURGERY MINOR 1,500 -
6971 Canalicule Rhinostomy etc SURGERY MAJOR 5,300 -
6972 DCR SURGERY MAJOR 4,700 -
6973 Dacryocycstectomy SURGERY MINOR 2,000 4
6974 Lacrymal Syringing & Probing SURGERY MINOR 1,500 4
7027 Endoscopy assisted NLD intubaSURGERY MAJOR 7,000 -
7028 Punctal cautery SURGERY MAJOR 500 4
7029 Punctal plugs SURGERY MAJOR 500 -
Lens
Opthalmology
###
6815 Multifocal Implant SURGERY MAJOR 8,000 -
6816 Phakic IOL SURGERY MAJOR 8,000 -
6911 Catract Extraction - LA SURGERY MAJOR 2,600 45
6912 Catract Extraction - GA SURGERY MAJOR 2,800 6
6913 Extracapsular Cat.Ext.-LA SURGERY MAJOR 2,800 -
6914 Extracapsular Cat.Ext.-GA SURGERY MAJOR 3,000 -
6915 Lensectomy -GA SURGERY MAJOR 3,000 1
6916 Small insicion cataract surgery SURGERY MAJOR 4,002 268
Page 100 of 368

Ophthalmology

6918 Secondary Implant SURGERY MAJOR 3,000 7

6919 Phacoemulcilfication SURGERY MAJOR 5,000 125
6920 ECCE with PC IOL SURGERY MAJOR 3,600 17
6921 Triple Procedure(Cataract + TraSURGERY MAJOR 3,500 1
6922 Phacoemulcilfication (Non fold SURGERY MAJOR 4,000 -
7031 IOL explantation SURGERY MAJOR 1,500 2
7032 Scleral fixated IOL SURGERY MAJOR 3,500 -
Operation on Conjunctive
Opthalmology
###
6801 Excision of Cysts/Tumours SURGERY MINOR 1,800 4
6802 Others Peritomy SURGERY MINOR 1,800 3
6803 Pteryigium SURGERY MINOR 1,800 13
6804 Removal of Foreign Body in OT SURGERY MINOR 1,500 1
6805 Conjunctiva 1 Tear SURGERY MINOR 2,000 5
6806 Amniotic Mambrane Overlay SURGERY MINOR 2,000 6
6807 Aminotic Membrane + StemcellSURGERY MAJOR 4,700 -
7016 Pterygium excision with graft SURGERY MAJOR 2,500 3
7017 Symblepheron release SURGERY MAJOR 1,800 -
Orbit & RB
Opthalmology
###
6864 Orbital Abscess SURGERY MAJOR 3,300 -
7012 Extenteration of Orbit SURGERY MAJOR 4,500 -
7013 Orbitotomies SURGERY MAJOR 8,000 1
7014 Recons. of Contracted Soc. SURGERY MAJOR 4,500 -
7015 Optic nerve sheath decompressSURGERY MAJOR 6,000 -
7037 Orbital abscess (minor) SURGERY MAJOR 2,800 -
7038 Orbital implant SURGERY MAJOR 3,000 -
Page 101 of 368

Ophthalmology

Retina
Opthalmology
###
6817 ROP-LIO SURGERY MINOR 4,500 1
6819 Intra Vitreal (Minor) SURGERY MINOR 1,500 121
6820 Intra Vitreal (Major) SURGERY MINOR 2,000 12
6831 Silicon Oil Removal SURGERY MINOR 1,800 11
6834 Retinal Detachment Surgery SURGERY MAJOR 12,000 1
6835 Vitretctomy SURGERY MAJOR 10,000 27
6836 Endolaser SURGERY MINOR 12,000 -
6935 Vitretctomy (Minor) SURGERY MAJOR 3,300 3
6936 R O P Cyro SURGERY MAJOR 4,500 1
6980 Vitrectomy + Additional ProcedSURGERY MAJOR 14,000 1
6981 Silicon Oil Removal + Cataract SURGERY MAJOR 3,500 2
6982 Laser Indirect OphthalmoscopyMISC. null 1,000 1
6983 Laser Indirect OphthalmoscopyMISC. null 700 3
GENERAL
Opthalmology
###
6856 EUA / Minor SURGERY MINOR 1,600 6
6857 EUA / Major SURGERY MINOR 2,500 1
7092 Extra hours for Minor surgery ( SURGERY MAJOR - -
7093 Extra hours for minor + surgerySURGERY MAJOR - -
7094 Extra hours for major surgery ( SURGERY MAJOR - -
7095 Extra hours for major + surgerySURGERY MAJOR - -
7099 Bilateral (50% of Proce./Surger SURGERY MAJOR - 6
7100 Extra Hours taken for a surgerySURGERY MAJOR - -
18051 Phaco and Microscope per houMISC. null 800 -
18052 Basic Microscope per hour MISC. null 400 -
Page 102 of 368

Ophthalmology

18053 Advanced Microscope per hourMISC. null 800 -

18108 Endolaser MISC. null 1,000 -
18109 Vitrectomy Unit SURGERY MAJOR 800 -
Opthalmology
###
6829 Radial Keratotomy SURGERY MAJOR 14,000 -
6842 Canthoplasty SURGERY MAJOR 2,100 3
6863 Retina Cryo SURGERY MAJOR 2,500 -
7033 AC tap SURGERY MAJOR 750 -
7034 AC wash/reformation SURGERY MAJOR 1,000 -
18050 Harmonic Scalpel MISC. null 2,000 -
18054 Laparoscope per hour MISC. null 700 -
Opthalmology
### Procedure
1791 Schirmer's Test PROCEDUREnull 30 219
Evening
1701 Argon Laser Focal * -E MISC. null 900 -
1702 Argon Laser Iridotomy * -E MISC. null 900 -
1703 Argon Laser Photo CoagulationPMISC. null 1,350 -
1704 Argon Laser Photomydriasis * -MISC. null 900 -
1705 Argon Laser Suture Lysis * -E MISC. null 900 -
1706 Argon Laser Trabeculoplasty * -MISC. null 1,350 -
1707 Artificial Eye Ball (Cost) Servic MISC. null 350 -
1708 Auto Plot Perimetry - AdditionalMISC. null 300 -
1709 Auto Plot Perimetry - For each MISC. null 450 -
1710 Auto Plot Perimetry - Both EyesMISC. null 900 1
Page 103 of 368

Ophthalmology

1712 Chalazion Removal -E MISC. null 600 1

1713 Conjunctival Flap -E MISC. null 330 -
1716 Contact Lens - Soft Lens (Per LeMISC. null 1,050 -
1717 Contact Lens - Disp./Cosmetic (MISC. null 2,050 -
1718 Contact Lens- Fort.Disposables(MISC. null 2,400 -
1720 Contact Lens Testing and Fittin MISC. null 450 -
1721 Fluorescein Angiography *** -EMISC. null 2,820 -
1726 Hordeolo Internum or Exrernum MISC. null 330 -
1727 Incision for Lacrymal Abcess -E MISC. null 350 -
1728 Operation of the Lids ExpilationMISC. null 330 -
1732 Photocoagulation (per sitting) -MISC. null 900 -
1733 Refraction and Prescription of MISC. null 200 8
1735 Sub Conjunctival Injection -E MISC. null 180 -
1738 Tarsorrhapy (each eye) -E MISC. null 630 -
1739 Ultra Sound A-Scan Biometry * MISC. null 540 -
1740 Ultra Sound B-Scan * -E MISC. null 540 -
1741 Ultra Sound Combined A and BMISC. null 1,050 -
1744 Contact Lens- Special (PremiumMISC. null 1,150 -
1746 YAG Laser Iridotomy -E MISC. null 1,350 -
1747 YAG Laser Capsulotomy -E MISC. null 1,350 -
1748 Sub Tenons Injection -E MISC. null 360 -
1766 Tonometry with pachymetry -EMISC. null 180 -
1767 Claucoma work up (Package) -EMISC. null 1,450 -
1768 Glaucoma work up with OCT -EMISC. null 4,650 -
1769 OCT (one eye) -E MISC. null 1,440 -
1781 GDX (Both eyes) - E MISC. null 1,800 -
Page 104 of 368

Ophthalmology

Grand Total 531,497 17,922

Date Date Date
Page 105 of 368

Paediatric Surgery
Paediatric Surgery
Printed in SOC's
20. PAEDIATRIC SURGERY
###
Paediatric Surgery Procedure
2901 Abdominal ParacentesPROCEDURE null 175 -
2910 Central Venous Line PROCEDURE null 300 -
2911 Subdural / VentricularPROCEDURE null 600 -
2914 Intussusception ReducPROCEDURE null 3,000 13
2915 Incubator/Open Warme PROCEDURE null 3,500 36
2919 Dressing Large PROCEDURE null 110 2
2920 Dressing Medium PROCEDURE null 85 17
2921 Dressing Small PROCEDURE null 60 89
2922 Enema PROCEDURE null 60 43
2923 Glucometer Random BPROCEDURE null 60 4
2924 Bladder wash PROCEDURE null 150 1
2925 Bowel Wash PROCEDURE null 250 16
2926 Bladder CatheterizatioPROCEDURE null 120 29
2927 Colostomy Care PROCEDURE null 75 -
2928 wound debridement PROCEDURE null 190 -
2929 Imcision and drainagePROCEDURE null 145 14
2930 Injection, IV & I.M. PROCEDURE null 50 12
2931 Enteral tube change PROCEDURE null 50 1
2932 Steam Inhalation PROCEDURE null 50 1
2933 Nebulisation PROCEDURE null 35 16
Page 106 of 368

Paediatric Surgery
2935 Esophageal foreign boPROCEDURE null 790 5
2936 Intercostal Tube DrainPROCEDURE null 480 -
2937 Prepucial AdhesiolysisPROCEDURE null 385 28
2938 Tracheostomy Tube C PROCEDURE null 385 13
2939 Dressing under sedati PROCEDURE null 600 4
K. PAEDIATRIC SURGERY
CNS
###
Paediatric Surgery
9001 Encephalocele -repair SURGERY MAJOR + 12,600 -
9002 Laminectomy SURGERY MAJOR + 22,000 5
9003 Meningomyelocol andSURGERY MAJOR + 14,000 4
9004 V.P. Shunt SURGERY MAJOR 10,000 10
9005 V.P. Shunt Revision SURGERY MAJOR 5,300 7
9280 V.P.Shunt Exteriorizati SURGERY MINOR 700 -
GIT
###
Paediatric Surgery
9141 Laparotomy (Cyst Exci SURGERY MAJOR 10,000 26
9142 Formation , enteral st SURGERY MAJOR 8,000 9
9143 Heller's CardiomyotomSURGERY MAJOR 10,000 2
9145 Pyloromyotomy SURGERY MAJOR 8,000 1
9146 Ladd?s procedure SURGERY MAJOR 12,000 2
9147 Operations for Intesti SURGERY MAJOR 12,000 1
9148 Meckel's Diverticulec SURGERY MAJOR 9,000 1
9149 Appendectomy SURGERY MAJOR 9,000 2
9153 EUA SURGERY MINOR 2,600 4
9154 Rectal Biopsy SURGERY MINOR + 3,500 4
Page 107 of 368

Paediatric Surgery
9155 Colostomy Closure SURGERY MAJOR 9,000 7
9156 Abdominal pull thoughSURGERY MAJOR + 17,000 11
9157 Anorectal Malformation SURGERY MAJOR 14,000 3
9158 Cloaca (PSARVP) SURGERY MAJOR + 17,000 -
9159 Lap Diagnostic SURGERY MINOR + 10,000 6
9160 Lap Appendectomy SURGERY MINOR + 12,000 21
9161 Lap Splenectomy SURGERY MAJOR + 18,000 -
9162 Lap Cholecystectomy SURGERY MAJOR 14,000 5
9282 Transanal Endorectal SURGERY MAJOR 13,000 7
9283 Secondary suturing SURGERY MINOR 2,000 5
HEPATOBILIARY & PANCREATIC
###
Paediatric Surgery
9201 Hepatic Resections SURGERY MAJOR + 15,000 -
9202 Hepatic Cyst Excision SURGERY MAJOR 10,000 1
9203 Kasai's Portoenterost SURGERY MAJOR + 16,000 2
9204 Excision of CholedochalSURGERY MAJOR + 17,000 3
9205 Cholecystectomy SURGERY MAJOR 9,000 -
9206 Pancreatectomy SURGERY MAJOR + 15,000 -
9208 Pancreatico - Enteric SURGERY MAJOR + 17,500 1
9209 Drainage of Pseudo PaSURGERY MAJOR 8,300 1
9211 Operations for Portal SURGERY MAJOR + 18,000 -
9212 Spelenectomy SURGERY MAJOR 12,000 6
9284 POC,Liver biopsy SURGERY MAJOR 8,000 4
HERNIAS
###
Paediatric Surgery
9231 Herniotomies (UmbilicSURGERY MINOR + 9,000 54
9233 Bilateral Inguinal Her SURGERY MINOR + 11,000 6
Page 108 of 368

Paediatric Surgery
NEONATAL SURGERY
###
Paediatric Surgery
9053 Tracheostomy SURGERY MAJOR 7,000 12
9054 Pure EA ? esophagostoSURGERY MAJOR 14,000 1
9055 TEF/EA - Primary RepaSURGERY MAJOR + 18,000 1
9056 Gastrostomy SURGERY MAJOR 6,300 2
9057 Congenital Diaphragma SURGERY MAJOR + 14,500 2
9060 Duodenal Atresia SURGERY MAJOR + 12,000 -
9061 Neonatal Intestinal ObSURGERY MAJOR + 14,500 -
9062 Colostomy (FormationSURGERY MAJOR 8,000 4
9063 Anoplasty SURGERY MINOR + 5,000 5
9064 Gastroschisis SURGERY MAJOR 12,600 1
9065 Omphalocele - Minor SURGERY MAJOR + 7,600 -
9066 Omphalocele - Major SURGERY MAJOR + 12,300 -
9067 Sacrococcygeal Terat SURGERY MAJOR 15,000 2
PAEDIATRIC GENERAL SURGERY - HEAD & NECK
###
Paediatric Surgery
9101 Excision of Superficial SURGERY MINOR 5,000 39
9102 Excision of Cystic Hy SURGERY MAJOR 9,000 4
9103 Thyroglossal Cyst - ExcSURGERY MAJOR 8,000 3
9104 Excision of Salivary Gl SURGERY MAJOR 10,000 -
9106 Branchial Apparatus ExSURGERY MAJOR 8,000 1
9108 Sternomastoid Releas SURGERY MINOR + 5,300 -
9281 Tongue Tie Release SURGERY MINOR 2,000 6
PAEDIATRIC UROLOGY
###
Paediatric Surgery
9215 Hemodialysis Cathete SURGERY MINOR + 4,000 4
Page 109 of 368

Paediatric Surgery
9219 wound debridement SURGERY MINOR + 2,000 1
9220 Suturing of superficia SURGERY MINOR 1,500 41
9224 Incision and drainage SURGERY MINOR + 2,300 10
9241 Bladder Exstrophy CloSURGERY MAJOR + 11,000 -
9243 Circumscision SURGERY MINOR + 5,000 18
9244 Orchidectomy SURGERY MINOR + 3,300 3
9245 Orchidopexy - UnilaterSURGERY MINOR + 8,000 22
9246 Orchidopexy - BilateraSURGERY MINOR + 11,000 4
9247 Pyeloplasty SURGERY MAJOR 14,000 20
9248 Cystolithotomy SURGERY MAJOR 6,000 -
9249 Cystoscopy SURGERY MINOR 5,000 63
9250 Nephrectomy / NephrSURGERY MAJOR 10,000 3
9251 Pyelollithotomy / NepSURGERY MAJOR + 10,000 1
9252 Surgery for distal hyp SURGERY MINOR + 9,000 17
9253 Urethroplasty for pro SURGERY MAJOR 11,000 6
9255 Transurethral Fulgrati SURGERY MAJOR 6,500 7
9256 Ureterolithotomy SURGERY MAJOR 7,000 1
9257 Unilateral Reimplant oSURGERY MAJOR + 14,000 7
9258 Urinary Diversion Per SURGERY MAJOR + 16,000 -
9259 Urinary Diversion TemSURGERY MAJOR 7,000 4
9260 Urinary Undiversion SURGERY MAJOR + 13,900 1
9261 Closure of urethrocutaSURGERY MINOR + 5,000 10
9262 Feminizing GenitoplasSURGERY MAJOR 12,000 1
9263 Bladder Neck Repair SURGERY MAJOR + 10,300 -
9264 Mitrofanoff ProcedureSURGERY MAJOR 8,000 -
9265 Malones (ACE) SURGERY MAJOR 7,000 -
9266 Epispadias Repair SURGERY MAJOR 11,000 -
Page 110 of 368

Paediatric Surgery
9268 CVAD Insertion - percuSURGERY MINOR + 4,000 25
9269 CVAD Insertion - tunn SURGERY MINOR + 5,000 23
9273 Bilateral Reimplant of SURGERY MAJOR 17,000 5
9275 Repair of US Sinus SURGERY MAJOR + 15,000 1
9276 CAPD Catheter Inserti SURGERY MAJOR 8,000 17
9285 Urethral Calibration SURGERY MINOR 1,300 22
9286 CAPD Catheter RemovSURGERY MINOR 2,000 6
9288 Bladder AugmentationSURGERY MAJOR + 20,000 1
9290 Lap Orchidopexy SURGERY MAJOR 10,000 18
9291 Lap for DSD SURGERY MAJOR 16,000 -
9292 Endourologic proceduSURGERY MINOR 6,000 -
9293 Radical Nephroureter SURGERY MAJOR 14,000 -
9298 Lap Nephrectomy SURGERY MAJOR - -
GENERAL
###
Paediatric Surgery
9294 Percutaneous IntervenSURGERY MAJOR 5,000 6
9295 Muscle Biopsy SURGERY MINOR 2,000 5
9296 Injection sclerotherapSURGERY MINOR 1,500 22
9297 Lithotripsy SURGERY MINOR 1,000 -
18096 Harmonic Scalpel SURGERY MAJOR 2,000 10
THORAX
###
Paediatric Surgery
9121 Bronchoscopic Removal SURGERY MAJOR 7,000 24
9122 Esophagoscopy and DilSURGERY MINOR + 5,000 9
9123 Esophageal Substituti SURGERY MAJOR + 20,000 1
9124 Decortication SURGERY MAJOR + 13,000 2
Page 111 of 368

Paediatric Surgery
9125 Thoracotomy (Biopsy/SURGERY MAJOR 10,000 5
9126 Eventeration of Diaph SURGERY MAJOR + 10,000 2
9127 Lobectomy - PulmonarSURGERY MAJOR + 18,000 1
9129 Thoracic tumor and Cys SURGERY MAJOR 14,000 -
9130 VATS Minor SURGERY MAJOR + 10,000 1
9131 VATS Major SURGERY MAJOR + 12,000 -
###
Paediatric Surgery
9051 Choanal Atresia SURGERY MAJOR 8,000 -
9052 Excision of Cysts &T SURGERY MAJOR 7,300 -
9058 Congenital Lobar EmpSURGERY MAJOR + 16,000 -
9059 Mediastinal Tumours &SURGERY MAJOR + 14,000 -
9107 Thyrodectomy SURGERY MAJOR 12,000 -
9128 Pneumonectomy - Paed SURGERY MAJOR + 11,300 -
9132 VATS Intermediate SURGERY MAJOR + 12,600 -
9150 Hemicolectomy - PaediSURGERY MAJOR 10,000 -
9151 Rectopexy - Pediatric SURGERY MAJOR 6,000 -
9152 Rectal Prolapse (Scler SURGERY MINOR 3,000 -
9207 Sub-Total Pancreatec SURGERY MAJOR + 13,900 -
9210 Splenorrhaphy SURGERY MAJOR 7,000 -
9221 Split Skin Grafting SURGERY MINOR 4,000 -
9232 Congenital Hydrocele SURGERY MINOR + 7,000 -
9254 Composite UrethroplaSURGERY MAJOR 10,000 -
9267 Re-operation for surgeSURGERY MAJOR - -
9272 Posterior Urethral stri SURGERY MAJOR + 20,000 -
9277 Laparascopy - Minor/ SURGERY MAJOR 10,000 -
9278 Laparascopy - Major SURGERY MAJOR + 20,000 -
Page 112 of 368

Paediatric Surgery
9287 Laparoscopic IntermedSURGERY MAJOR + 15,000 -
9392 Extra hours for Minor SURGERY MAJOR - -
9393 Extra hours for minor SURGERY MAJOR - -
9394 Extra hours for major SURGERY MAJOR - -
9399 Bilateral (50% of Proc SURGERY MAJOR - -
9400 Extra Hours taken for SURGERY MAJOR - -
18097 Basic Microscope per SURGERY MAJOR 400 -
18098 Advanced MicroscopeSURGERY MAJOR 800 -
18099 Laparoscope per hourSURGERY MAJOR 700 -
###
Paediatric Surgery Procedure
2902 Biopsy - Liver PROCEDURE null 250 -
2904 Intercostal Tube DrainPROCEDURE null 420 -
2905 Sigmoidoscopy - Flexi PROCEDURE null 350 -
2906 Sigmoidoscopy - Rigid PROCEDURE null 240 -
2907 Sigmoidoscopy - if pr PROCEDURE null 300 -
2908 Tracheostomy in OPD PROCEDURE null 420 -
2909 Umbilical CannulationPROCEDURE null 240 -
2912 Prepucial AdhesiolysisPROCEDURE null 420 -
2913 Esophageal foreign boPROCEDURE null 475 1
2916 Injection sclerotherapPROCEDURE null 1,500 -
2918 USG Guided Pigtail InsPROCEDURE null 5,000 -
###
Evening Special Procedures
2908 Tracheostomy -E PROCEDURE null 760 -
2910 Central Venous Line -EPROCEDURE null 540 -
Page 113 of 368

Paediatric Surgery
2911 Subdural / Ventricular PROCEDURE null 1,080 -
Grand Total 1,347,200 1,135

Date Date Date
Page 114 of 368

Surgical Oncology
Apr-17 to Nov-17 Revision
Surgical Oncology
Printed in SOC's
O. SURGICAL ONCOLOGY
ABDOMINAL ONCOSURGERY: INTERMEDIATE
Surgical
### Oncology
17025 Open Cholecystectomy SURGERY MAJOR 11,000 -
17112 Laparotomy & colostomy SURGERY MAJOR 11,000 1
17113 Cholecystojejunostomy SURGERY MAJOR 11,000 -
17114 Limited bowel resection SURGERY MAJOR 11,000 8
17115 Partial gastrectomy SURGERY MAJOR 11,000 1
17116 Gastrojejunostomy SURGERY MAJOR 11,000 3
17117 Intestinal bypass SURGERY MAJOR 11,000 -
17118 Pelvic lymph node dissectio SURGERY MAJOR 11,000 -
17119 Partial Cystectomy SURGERY MAJOR 11,000 -
17120 Retroperitoneal lymphnode SURGERY MAJOR 11,000 -
17121 Splenectomy SURGERY MAJOR 11,000 -
17623 Omentectomy SURGERY MINOR 11,000 -
ABDOMINAL ONCOSURGERY: MAJOR
Surgical
### Oncology
17122 Transhiatal oesophagectom SURGERY MAJOR 25,000 -
17123 Transhthoracic oesophagec SURGERY MAJOR 25,000 1
17124 Oesophago-gastrectomy SURGERY MAJOR 25,000 -
17125 Distal Radical gastrectomy SURGERY MAJOR 25,000 -
17126 Subtotal Radical gastrectomSURGERY MAJOR 25,000 2
17127 Radical cholecystectomy SURGERY MAJOR 25,000 1
17128 Radical choledochectomy SURGERY MAJOR 25,000 -
17129 Hepaticojejunostomy SURGERY MAJOR 25,000 -
17130 Triple bypass for pancreatic SURGERY MAJOR 25,000 -
Page 115 of 368

Surgical Oncology
17131 Whipple's pancreaticoduod SURGERY MAJOR 25,000 4
17132 Distal pancreaticosplenect SURGERY MAJOR 25,000 -
17133 Wedge liver resections SURGERY MAJOR 25,000 -
17134 Segmental liver resections SURGERY MAJOR 25,000 -
17135 L hemihepatectomy SURGERY MAJOR 25,000 -
17136 R hemihepatectomy SURGERY MAJOR 25,000 -
17137 Extended L hemihepatecto SURGERY MAJOR 25,000 -
17138 Extended R hemihepatecto SURGERY MAJOR 25,000 -
17139 Trisegmentectomy SURGERY MAJOR 25,000 -
17140 Major small bowel resectionSURGERY MAJOR 25,000 -
17141 R radical hemicolectomy SURGERY MAJOR 25,000 7
17142 L radical hemicolectomy SURGERY MAJOR 25,000 -
17143 Radical Transverse colectomSURGERY MAJOR 25,000 -
17144 Radical sigmoid colectomy SURGERY MAJOR 25,000 -
17145 Anterior Resection SURGERY MAJOR 25,000 3
17146 Abdominoperineal resectio SURGERY MAJOR 25,000 3
17147 Total colectomy SURGERY MAJOR 25,000 -
17148 Retroperitoneal tumour res SURGERY MAJOR 25,000 -
17149 Radical Nephrectomy SURGERY MAJOR 25,000 -
17150 Radical cystectomy SURGERY MAJOR 25,000 1
17151 Retroperitoneal lymph nodeSURGERY MAJOR 25,000 -
17152 Ant Pelvic exenteration SURGERY MAJOR 25,000 -
17153 Post Pelvic exenteration SURGERY MAJOR 25,000 1
17154 Total pelvic exenteration SURGERY MAJOR 25,000 -
ABDOMINAL ONCOSURGERY: MINOR
Surgical
### Oncology
17101 Feeding Jejunostomy SURGERY MAJOR 8,000 2
17102 EUA + biopsy anal/rectal ca SURGERY MAJOR 8,000 -
17103 Feeding gastrostomy SURGERY MAJOR 8,000 -
Page 116 of 368

Surgical Oncology
17104 Colostomy SURGERY MAJOR 8,000 2
17105 Ileostomy SURGERY MAJOR 8,000 1
17106 Staging laparotomy SURGERY MAJOR 8,000 7
17107 Colostomy Closure SURGERY MAJOR 8,000 -
17108 Ileostomy closure SURGERY MAJOR 8,000 -
17110 Minor abdominal wall tumou SURGERY MAJOR 8,000 -
17111 Omental biopsy SURGERY MAJOR 8,000 -
17622 Diagnostic laparoscopy SURGERY MINOR 8,000 5
ABDOMINAL ONCOSURGERY: SPECIALISED
Surgical
### Oncology
17026 Colonic Conduit SURGERY MAJOR 19,700 -
17155 Staging laparoscopy SURGERY MINOR 14,000 -
17156 Laparoscopy and biopsy SURGERY MINOR 14,000 1
17157 Lap assisted ostomy in OncoSURGERY MINOR 14,000 -
17158 Laparoscopic stoma reversalSURGERY MINOR 14,000 -
17159 Lap assisted small bowel resSURGERY MINOR 14,000 -
17160 Lap assisted hemicolectomySURGERY MAJOR 32,000 -
17161 Lap assisted anterior resect SURGERY MAJOR 32,000 -
17162 Lap assisted APR SURGERY MAJOR 29,000 -
17163 Lap assisted splenectomy SURGERY MAJOR 29,000 -
17164 Lap Adrenalectomy SURGERY MAJOR 29,000 -
17165 D2 gastrectomy SURGERY MAJOR 29,000 1
17166 Lap assisted gastrectomy SURGERY MAJOR 32,000 -
17167 Lap assisted oesophagecto SURGERY MAJOR 32,000 -
17168 Three field oesophagectom SURGERY MAJOR 29,000 -
17624 Extended radical colectomy SURGERY MAJOR 29,000 -
17625 Multivisceral resections SURGERY MAJOR 32,000 -
17636 Staging Laparoscopy combinSURGERY MAJOR 6,000 1
BREAST ONCOSURGERY: MAJOR
Page 117 of 368

Surgical Oncology
Surgical
### Oncology
17207 Modified radical mastectomSURGERY MAJOR 16,000 8
BREAST ONCOSURGERY: MINOR
Surgical
### Oncology
17201 Excision biopsy breast tumoSURGERY MAJOR 3,300 19
17202 Incision biopsy breast tumo SURGERY MAJOR 3,300 -
17203 Microdochectomy SURGERY MAJOR 3,300 -
17204 Wide excision breast tumouSURGERY MAJOR 10,000 3
17205 Simple Mastectomy SURGERY MAJOR 10,000 2
17206 Axillary Dissection alone fo SURGERY MAJOR 10,000 -
BREAST ONCOSURGERY: SPECIALISED
Surgical
### Oncology
17208 Sentinel node biopsy SURGERY MINOR 12,000 2
17209 BCS (including axillary disse SURGERY MAJOR 18,000 1
17626 Image guided biopsy breast SURGERY MINOR 12,000 -
ENDOCRINE ONCOSURGERY: INTERMEDIATE
Surgical
### Oncology
17503 Hemithyroidectomy SURGERY MAJOR 13,000 5
17504 Simple parathyroidectomy SURGERY MAJOR 13,000 -
17505 Radical orchidectomy SURGERY MAJOR 13,000 -
17506 Oophorectomy for breast caSURGERY MAJOR 13,000 -
ENDOCRINE ONCOSURGERY: MAJOR
Surgical
### Oncology
17507 Total thyroidectomy SURGERY MAJOR 16,000 6
17508 Radical parathyroidectomy SURGERY MAJOR 16,000 -
17510 Adrenalectomy SURGERY MAJOR 16,000 -
17511 Pancreatic islet tumour reseSURGERY MAJOR 16,000 -
ENDOCRINE ONCOSURGERY: MINOR
Surgical
### Oncology
Page 118 of 368

Surgical Oncology
17501 Parathyroid autotransplantaSURGERY MAJOR 3,300 -
17502 Simple Orchidectomy SURGERY MAJOR 3,300 1
ENDOCRINE ONCOSURGERY: SPECIALISED
Surgical
### Oncology
17512 Radical thyroidectomy SURGERY MAJOR 21,000 -
17513 Total thyroidectomy + neck SURGERY MAJOR 21,000 -
17514 Laparoscopic adrenalectom SURGERY MAJOR 21,000 -
17515 Laparoscopic oophorectomySURGERY MAJOR 21,000 -
17516 Miniparathyroidectomy SURGERY MAJOR 10,000 1
LIMB ONCOSURGERY: INTERMEDIATE
Surgical
### Oncology
17307 Wide excision of tumours SURGERY MAJOR 10,000 6
17308 Intermediate amputation - SURGERY MAJOR 10,000 -
17309 Intermediate amputation - fSURGERY MAJOR 10,000 -
LIMB ONCOSURGERY: MAJOR
Surgical
### Oncology
17312 Compartmental excision SURGERY MAJOR 16,000 1
17313 Resection of Large soft tis SURGERY MAJOR 16,000 -
17314 Major amputation - hip disarSURGERY MAJOR 16,000 -
17315 Major amputation - shoulderSURGERY MAJOR 16,000 -
17316 Major amputation - forequaSURGERY MAJOR 16,000 -
17317 Major amputation - hindquaSURGERY MAJOR 16,000 -
17319 Regional reconstruction fol SURGERY MAJOR 19,000 -
LIMB ONCOSURGERY: MINOR
Surgical
### Oncology
17301 Excision biopsy SURGERY MAJOR 3,300 34
17302 Incision biopsy SURGERY MAJOR 3,300 3
Page 119 of 368

Surgical Oncology
17303 Excision of superficial tumo SURGERY MAJOR 3,300 6
17304 Minor amputation - fingers SURGERY MAJOR 3,300 -
17305 Minor amputation - toes SURGERY MAJOR 3,300 -
LIMB ONCOSURGERY: SPECIALISED
Surgical
### Oncology
17320 Limb conservation surgery SURGERY MAJOR 24,000 -
17322 Scapular resection SURGERY MAJOR 23,700 -
17323 Pelvic bone resections SURGERY MAJOR 24,000 -
17324 Hemipelvectomy SURGERY MAJOR 24,000 -
MISCELLANEOUS ONCOSURGERY: INTERMEDIATE
Surgical
### Oncology
17606 Partial penectomy SURGERY MAJOR 10,000 1
17607 Major split skin grafting SURGERY MAJOR 10,000 -
17608 Local flap reconstruction SURGERY MAJOR 10,000 -
17609 Wide excision misc tumoursSURGERY MAJOR 10,000 1
17628 Assisting other department SURGERY MINOR 10,000 -
17639 Venous access device insertSURGERY MAJOR 10,000 -
MISCELLANEOUS ONCOSURGERY: MAJOR
Surgical
### Oncology
17611 Radical penectomy SURGERY MAJOR 16,000 -
17612 Inguinal lymphnode dissect SURGERY MAJOR 16,000 -
17613 Ilioinguinal lymphnode diss SURGERY MAJOR 16,000 1
17614 Major oncoplastic reconstruSURGERY MAJOR 16,000 -
17615 Assisting other department SURGERY MAJOR 16,000 -
17629 Major debridement SURGERY MAJOR 16,000 -
MISCELLANEOUS ONCOSURGERY: MINOR
Surgical
### Oncology
17601 Minor Suturing SURGERY MAJOR 3,300 4
17602 Minor excisions SURGERY MAJOR 3,300 4
Page 120 of 368

Surgical Oncology
17604 Circumcision SURGERY MAJOR 3,300 -
17605 Minor split skin grafting SURGERY MAJOR 3,300 1
17627 Minor debridement SURGERY MINOR 3,300 -
MISCELLANEOUS ONCOSURGERY: SPECIALIZED
Surgical
### Oncology
17616 Chemoport insertion SURGERY MAJOR 12,000 -
17617 Sentinel node excision SURGERY MAJOR 12,000 -
17618 Re-operative procedures - reSURGERY MAJOR 18,000 -
17630 Image guided excisions SURGERY MINOR 12,000 -
17638 Sentinel node excision combSURGERY MAJOR 6,000 -
GENERAL
Surgical
### Oncology
17619 Bilateral (50% of Procedure SURGERY MAJOR - -
17631 Extra hours taken for a Surg SURGERY MAJOR - -
17632 Extra hours for Minor SurgerMISC. null - -
17633 Extra hours for Minor + SurgSURGERY MAJOR - -
17634 Extra hours for Major SurgerSURGERY MAJOR - -
17635 Extra hours for Major + SurgSURGERY MAJOR - -
18085 Basic Microscope per hour SURGERY MAJOR 400 -
18086 Advanced Microscope per hSURGERY MAJOR 800 -
18087 Laproscope per hour SURGERY MAJOR 700 -
THORACIC ONCOSURGERY: INTERMEDIATE
Surgical
### Oncology
17406 Thymectomy SURGERY MAJOR 11,000 -
17407 Minor mediastinal tumour eSURGERY MAJOR 11,000 -
17408 Wedge resection lung SURGERY MAJOR 11,000 -
17409 Re-exploration - Major SURGERY MAJOR 11,000 -
Page 121 of 368

Surgical Oncology
THORACIC ONCOSURGERY: MAJOR
Surgical
### Oncology
17410 Lobectomy SURGERY MAJOR 25,000 -
17411 Pneumonectomy SURGERY MAJOR 25,000 -
17412 Mediastinal tumour resecti SURGERY MAJOR 25,000 -
17413 Thoracotomy & oesophagecSURGERY MAJOR 25,000 -
17414 Major chest wall tumour resSURGERY MAJOR 25,000 -
THORACIC ONCOSURGERY: MINOR
Surgical
### Oncology
17402 Minor chest wall tumour excSURGERY MAJOR 9,000 1
17403 Thoracotomy & biopsy SURGERY MAJOR 9,000 -
17404 Open Lung Biopsy SURGERY MAJOR 9,000 -
17405 Pleurodesis SURGERY MAJOR 9,000 -
THORACIC ONCOSURGERY: SPECIALISED
Surgical
### Oncology
17415 Staging Thoracoscopy SURGERY MINOR 14,000 -
17416 Thoracoscopy & biopsy SURGERY MINOR 14,000 -
17418 Thoracoscopy assisted oes SURGERY MAJOR 29,000 -
17419 Misecellaneous VATS SURGERY MINOR 14,000 -
17637 Staging Thoracoscopy cominSURGERY MAJOR 6,000 -
Surgical
### Oncology
17001 Mucosal biopsy SURGERY MAJOR 3,300 2
17002 H&N cancer EUA SURGERY MAJOR 3,300 1
17003 Cervical LN biopsy SURGERY MAJOR 3,300 9
17004 Excision of skin tumours SURGERY MAJOR 3,300 4
17006 Tracheostomy in OT SURGERY MAJOR 3,300 -
17007 Wide excision - Oral Cancer SURGERY MAJOR 13,000 5
17008 Central Neck Dissection SURGERY MAJOR 13,000 -
Page 122 of 368

Surgical Oncology
17009 Supraomohyoid neck dissectSURGERY MAJOR 13,000 1
17010 Selective neck dissection SURGERY MAJOR 13,000 2
17011 Partial glossectomy SURGERY MAJOR 13,000 1
17012 Hemi glossectomy SURGERY MAJOR 13,000 1
17013 Submandibular gland resectSURGERY MAJOR 13,000 -
17014 Superficial parotidectomy - SURGERY MAJOR 16,000 1
17015 Radical Neck Dissection SURGERY MAJOR 16,000 -
17016 Mandibular resections SURGERY MAJOR 16,000 1
17017 Modified Neck Dissections SURGERY MAJOR 16,000 3
17018 Functional Neck Dissection SURGERY MAJOR 16,000 -
17019 Radical Maxillectomy SURGERY MAJOR 16,000 -
17020 Total Laryngectomy SURGERY MAJOR 16,000 -
17021 Total conservative parotide SURGERY MAJOR 16,000 1
17022 Radical parotidectomy SURGERY MAJOR 16,000 1
17023 Total laryngopharyngeoeso SURGERY MAJOR 21,000 -
17024 Composite H&N resections SURGERY MAJOR 21,000 2
17027 Partial Laryngectomy SURGERY MAJOR 13,000 -
17610 Total penectomy SURGERY MAJOR 16,000 -
17620 Subtotal glossectomy SURGERY MAJOR 16,000 -
17621 Combined oral cancer resectSURGERY MAJOR 29,000 -
Grand Total 2,952,300 202

Date Date Date
Page 123 of 368

Cardio Thoracic Surgery
Printed in SOC's
A. CARDIO THORACIC & VASCULAR SURGERY
A.1 ADULT CARDIAC SURGICAL PACKAGES
Surgery
### Packages
5200 CABG IP PACKAGE MAJOR + 130,000 24
5201 CABG + IABP IP PACKAGE MAJOR + 155,000 -
5202 CABG+LV Aneurysmal ReIP PACKAGE MAJOR + 150,000 -
5203 CABG Emergency salvagIP PACKAGE MAJOR + 150,000 -
5204 CABG + Mitral Valve RepIP PACKAGE MAJOR + 130,000 -
5205 CABG + Mitral Valve RepIP PACKAGE MAJOR + 130,000 -
5206 CABG + Post MI VSD RepIP PACKAGE MAJOR + 130,000 -
5207 Open Mitral Valvotomy IP PACKAGE MAJOR + 100,000 -
5208 Open Aortic Valvotomy IP PACKAGE MAJOR + 100,000 -
5209 Open Pulmonary Valvot IP PACKAGE MAJOR + 100,000 -
5210 Mitral Valve Repair IP PACKAGE MAJOR + 110,000 -
5211 Tricuspid Valve Repair IP PACKAGE MAJOR + 100,000 -
5212 Aortic Valve Repair IP PACKAGE MAJOR + 100,000 -
5213 Mitral Valve Replaceme IP PACKAGE MAJOR + 110,000 6
5214 Aortic Valve Replaceme IP PACKAGE MAJOR + 110,000 3
5215 Tricuspid Valve Replace IP PACKAGE MAJOR + 100,000 -
5216 Aortic+Mitral Valve Rep IP PACKAGE MAJOR + 130,000 5
5217 Aortic+Mitral+Tricuspid IP PACKAGE MAJOR + 100,000 -
5218 Ross Procedure IP PACKAGE MAJOR + 100,000 -
5219 Aortic Root ReplacemenIP PACKAGE MAJOR + 150,000 -
5220 Aneurysm Resection & GIP PACKAGE MAJOR + 150,000 -
Page 124 of 368

5222 Intra Thoracic Aneurys IP PACKAGE MAJOR + 100,000 -
5223 Intra Thoracic Aneurys IP PACKAGE MAJOR + 70,000 -
5224 Dissecting Aneurysm wiIP PACKAGE MAJOR + 100,000 -
5225 Dissecting Aneurysm wiIP PACKAGE MAJOR + 80,000 -
5226 Intra Cardiac Tumour SuIP PACKAGE MAJOR + 100,000 -
5227 Ruptured Sinus of ValsulIP PACKAGE MAJOR + 100,000 -
5228 Pulmonary EmbolectomIP PACKAGE MAJOR + 100,000 -
5229 Cardiac injuries surgery IP PACKAGE MAJOR + 100,000 -
5230 Cardiac injuries withoutIP PACKAGE MAJOR + 50,000 -
A.2 Closed Heart Procedures
Surgery
### Packages
5231 Closed Mitral ValvotomyIP PACKAGE MAJOR + 40,000 -
5232 PDA - Repair IP PACKAGE MAJOR + 36,000 1
5233 Coarctation Repair IP PACKAGE MAJOR + 36,000 -
5235 Pericardiostomy IP PACKAGE MAJOR + 12,000 -
5236 Pericardiectomy IP PACKAGE MAJOR + 60,000 -
A.3 Congenital Open heart procedures
Surgery
### Packages
5246 ASD Closure IP PACKAGE MAJOR + 100,000 1
5247 VSD Closure IP PACKAGE MAJOR + 100,000 2
5248 AVSD/AV Canal Defect RIP PACKAGE MAJOR + 100,000 -
5249 TOF - ICR IP PACKAGE MAJOR + 100,000 -
5250 HOCM Surgery IP PACKAGE MAJOR + 80,000 -
5251 Fontan IP PACKAGE MAJOR + 100,000 -
5252 Ebsteins Repair IP PACKAGE MAJOR + 100,000 -
5253 TAPVC IP PACKAGE MAJOR + 100,000 -
5254 Pulmonary Atresia with IP PACKAGE MAJOR + 100,000 -
Page 125 of 368

5255 TGA - ICR IP PACKAGE MAJOR + 100,000 -
5256 Arterial Switch Surgery IP PACKAGE MAJOR + 100,000 -
5257 Truncus Areriosus SurgeIP PACKAGE MAJOR + 100,000 -
5258 Sennings IP PACKAGE MAJOR + 100,000 -
5259 Mustards IP PACKAGE MAJOR + 100,000 -
5260 Pulmonary Conduit IP PACKAGE MAJOR + 100,000 -
5261 AP Window on CPB IP PACKAGE MAJOR + 100,000 -
5262 ALCAPA IP PACKAGE MAJOR + 100,000 -
5263 Complex TOF/ + special IP PACKAGE MAJOR + 100,000 -
A.4 Pediatric Cardiac Surgery Packages
Surgery
### Packages
5240 B T Shunt IP PACKAGE MAJOR + 36,000 -
5241 Glenn Shunt IP PACKAGE MAJOR + 36,000 -
5242 Central Shunt IP PACKAGE MAJOR + 36,000 -
5243 Aortic Arch anomalies c IP PACKAGE MAJOR + 36,000 -
5244 AP Window without CP IP PACKAGE MAJOR + 36,000 -
5245 PA Banding IP PACKAGE MAJOR + 36,000 -
A.5 Thoracic Surgery Procedures packages
Surgery
### Packages
5264 Segmentectomy IP PACKAGE MAJOR + 60,000 -
5265 Lobectomy IP PACKAGE MAJOR + 80,000 8
5266 Pneumonectomy IP PACKAGE MAJOR + 100,000 2
5267 Pleurectomy IP PACKAGE MAJOR + 60,000 -
5268 Decortication IP PACKAGE MAJOR + 80,000 20
5269 Lung Cyst Excision IP PACKAGE MAJOR + 60,000 1
5270 SOL Mediastinum Excisi IP PACKAGE MAJOR + 60,000 2
5271 Mediastinotomy IP PACKAGE MAJOR + 60,000 -
Page 126 of 368

5272 Pulmonary AV Fistula SuIP PACKAGE MAJOR + 45,000 -
5273 Bronchopleural Fistula cIP PACKAGE MAJOR + 60,000 -
5274 Diaphragmatic eventratiIP PACKAGE MAJOR + 50,000 -
5275 Diaphragmatic Hernia S IP PACKAGE MAJOR + 50,000 -
5276 Oesphageal diverticula/IP PACKAGE MAJOR + 50,000 -
5277 Oesophageal tumour exiIP PACKAGE MAJOR + 45,000 -
5278 Oesophagectomy +/ColoIP PACKAGE MAJOR + 70,000 -
5279 Thymectomy (ThymomaIPe PACKAGE MAJOR + 45,000 2
5280 Thoracoplasty IP PACKAGE MAJOR + 60,000 -
5281 Thoracotomy & Lung injuIP PACKAGE MAJOR + 45,000 -
5282 Foreign body removal b IP PACKAGE MINOR + 30,000 -
5283 Thoracotomy-Bronchial rIP PACKAGE MAJOR + 45,000 1
5284 Diaphragmatic injury repIP PACKAGE MAJOR + 45,000 1
5285 Traumatic/corrosive oesIP PACKAGE MAJOR + 60,000 -
A.6 VASCULAR SURGICAL PROCEDURES PACKAGES
Surgery
### Packages
5286 Fem-pop bypass with GrIP PACKAGE MAJOR + 50,000 -
5287 Thromboembolectomy IP PACKAGE MAJOR + 20,000 -
5288 Distal Abd.Aortic Aneur IP PACKAGE MAJOR + 60,000 -
5289 Proximal Abd.Aortic An IP PACKAGE MAJOR + 60,000 -
5290 Intrathoracic Aneurysm IP PACKAGE MAJOR + 100,000 -
5291 Intrathoracic Aneurysm IP PACKAGE MAJOR + 70,000 -
5292 Dissecting Aneurysm (CPIP PACKAGE MAJOR + 100,000 -
5293 Dissecting Aneurysm (noIP PACKAGE MAJOR + 80,000 -
5294 Surgery Vertebral Arter IP PACKAGE MAJOR + 25,000 -
5295 Vascular Procedure - MaIP PACKAGE MAJOR + 25,000 -
5296 Vascular Procedure - MiIP PACKAGE MAJOR + 15,000 -
Page 127 of 368

5297 Renal Artery Aneurysm IP PACKAGE MAJOR + 20,000 -
5298 Carotid Artery AneurysmIP PACKAGE MAJOR + 20,000 -
5299 Main Limb Arteries Ane IP PACKAGE MAJOR + 20,000 -
5300 Surgery Acquired AV FistIP PACKAGE MAJOR + 20,000 -
5301 Surgery Congenital AV FIIP PACKAGE MAJOR + 20,000 -
5302 Renal Artery Stenoses S IP PACKAGE MAJOR + 25,000 -
5303 Peripheral EmbolectomyIP PACKAGE MINOR + 20,000 -
5304 Aorto Billiac/Bifemoral IP PACKAGE MAJOR + 55,000 -
5305 Axillo Bifemoral Bypass (IP PACKAGE MAJOR + 55,000 -
5306 Femoro Distal Bypass wiIP PACKAGE MAJOR + 55,000 -
5307 Femor Distal bypass withIP PACKAGE MAJOR + 55,000 -
5308 Axillo Brachial bypass + IP PACKAGE MAJOR + 55,000 -
5309 Brachio-Radial bypass + IP PACKAGE MAJOR + 55,000 -
5310 Excision & Repair Carot IP PACKAGE MAJOR + 40,000 -
5311 Carotid Artery bypass + IP PACKAGE MAJOR + 65,000 -
5312 Excision of Large AV MaIP PACKAGE MAJOR + 55,000 -
5313 Excision of Small AV MaIP PACKAGE MAJOR + 35,000 -
5314 DVT - IVC Filter Insertio IP PACKAGE MINOR 20,000 -
5315 Vascular Tumour ExcisioIP PACKAGE MAJOR + 40,000 -
5316 Small Arterial AneurysmIP PACKAGE MAJOR + 20,000 -
5317 Medium sized Arterial IP PACKAGE MAJOR + 55,000 -
5318 Medium sized Art. AneurIP PACKAGE MAJOR + 55,000 -
5319 Carotid Endartectomy IP PACKAGE MAJOR + 55,000 -
5351 Patch Graft Angioplasty IP PACKAGE MAJOR + 20,000 -
A.7 VASCULAR SURGICAL PROCEDURES PACKAGES (NON_PACKAGED
Cardio
### Thoracic Surgery
5320 Removal of FB(Trachea) SURGERY MAJOR 2,100 -
Page 128 of 368

5321 Node Biopsy SURGERY MINOR + 2,000 1
5323 Chest Wall Tumour RemSURGERY MAJOR + 17,000 -
5324 Rib Resection and DrainSURGERY MAJOR 7,000 3
5325 Tracheostomy in OT SURGERY MINOR + 3,000 1
5326 Oesophagoscopy SURGERY MAJOR 1,800 -
5327 Pericardial Tube DrainagSURGERY MAJOR 4,000 1
5328 Mediastinitis SURGERY MAJOR + 11,800 -
5329 Pericardial Tapping in O SURGERY MINOR + 1,300 1
5330 Re-Exploration - Minor SURGERY MAJOR 4,700 4
5331 Pleurodesis SURGERY MAJOR 1,700 -
5332 Ant.Lat.Spinal cord dec SURGERY MAJOR + 22,000 -
5333 Cervical Rib Resection SURGERY MAJOR 7,000 -
5334 Tracheal ReconstructionSURGERY MAJOR 22,000 -
5352 Bronchoscopy Flexible SURGERY MINOR 1,800 -
5353 Bronchoscopy Rigid SURGERY MINOR 1,800 -
5362 Open Lung Biopsy SURGERY MINOR 10,000 6
5363 Open Pleural Biopsy SURGERY MINOR 9,600 -
5364 Scalene Node Biopsy SURGERY MINOR 9,600 -
5365 Mediastinal Node BiopsSURGERY MINOR 9,600 1
5366 Empyema Window Opera SURGERY MINOR 9,600 -
5367 Ultrasound Guided Tub SURGERY MINOR 9,600 -
5368 Single Rib Resection SURGERY MINOR 9,600 -
5369 Chest Wall Biopsy SURGERY MINOR 9,600 -
5370 Sinus Excision Chest WalSURGERY MINOR 9,600 1
5371 Pericardiostomy SURGERY MINOR + 12,000 -
5372 Thoracic A V MalformatiSURGERY MINOR + 12,000 -
5373 Mediastinal Mass (smallSURGERY MINOR + 12,000 -
Page 129 of 368

5374 Thoracotomy and Empym SURGERY MINOR + 12,000 1
5375 Lobectomy SURGERY MAJOR 16,000 -
5376 Pneumonectomy SURGERY MAJOR 16,000 -
5377 Segmectomy SURGERY MAJOR 16,000 1
5378 Resection SURGERY MAJOR 16,000 -
5379 Decortication SURGERY MAJOR 16,000 1
5380 Lung Cyst Removal SURGERY MAJOR 16,000 1
5381 SOL Mediastinal Excisio SURGERY MAJOR 16,000 1
5382 Mediastinotomy SURGERY MAJOR 16,000 -
5383 BPF Repair SURGERY MAJOR 16,000 -
5384 Diaphragmatic Hernia S SURGERY MAJOR 16,000 -
5385 Oesophagectomy ColonSURGERY MAJOR 16,000 -
5386 Thymectomy SURGERY MAJOR 16,000 -
5387 Thoracotomy SURGERY MAJOR 16,000 3
5388 Vascular Procedures (perSURGERY MAJOR 16,000 2
5389 Omental Transfer Chest SURGERY MAJOR 16,000 -
5390 Pulmonary A V Fistula SURGERY MAJOR 25,000 -
5391 Oesophageal Ca SURGERY MAJOR 25,000 -
5392 Oesophageal Ca with ColSURGERY MAJOR 25,000 -
5393 Trachea Bronchial RepaiSURGERY MAJOR 25,000 -
5394 Omental Transfer MediaSURGERY MAJOR 25,000 -
5395 Repeat Lobectomy SURGERY MAJOR + 26,000 -
5396 Repeat Pneumonectom SURGERY MAJOR + 26,000 -
5397 Repeat Segmectomy SURGERY MAJOR + 26,000 -
5398 Repeat Resection SURGERY MAJOR + 26,000 -
5399 Repeat Decortication SURGERY MAJOR + 26,000 -
5400 Repeat Lung Cyst RemovSURGERY MAJOR 26,000 -
Page 130 of 368

5401 Repeat SOL Mediastinal SURGERY MAJOR + 26,000 -
5402 Repeat MediastinotomySURGERY MAJOR + 26,000 -
5403 Repeat BPF Repair SURGERY MAJOR + 26,000 -
5404 Repeat Diaphragmatic HSURGERY MAJOR 26,000 -
5405 Repeat OesophagectomySURGERY MAJOR + 26,000 -
5406 Repeat Thymectomy SURGERY MAJOR + 26,000 -
5407 Repeat Thoracotomy SURGERY MAJOR + 26,000 -
5408 Repeat Vascular ProceduSURGERY MAJOR + 26,000 -
5409 Repeat Omental TransfeSURGERY MAJOR + 26,000 -
A.8 VASCULAR SURGICAL PROCEDURES PACKAGES (NON_PACKAGED BREAKUP OF CHARGES)
Cardio
5335 Diagnostic Thoracoscop SURGERY MINOR + 4,600 -
5336 Lung Biopsy - VATS SURGERY MAJOR + 19,000 -
5337 Partial Pericardiectomy SURGERY MAJOR + 19,000 -
5338 Pleurodesis - VATS SURGERY MAJOR 19,000 -
5339 Hellers OesophagomyotSURGERY MAJOR + 22,000 -
5340 Mediastinal Tumour ResSURGERY MAJOR + 22,000 -
5341 Sympathectomy -VATS SURGERY MAJOR 19,000 -
5344 Mediastinal Biopsy -VATSURGERY MAJOR 7,800 -
A.9 GENERAL
Cardio
5345 Bilateral (50% of ProcedSURGERY MAJOR - -
5346 Extra Hours taken for a SURGERY MAJOR - -
5347 Extra hours for minor suSURGERY MAJOR - -
5348 Extra hours for minor + SURGERY MAJOR - -
5349 Extra hours for major suSURGERY MAJOR - -
Page 131 of 368

### Harmonic Scalpel MISC. null 2,000 1
### Basic Microscope per hoMISC. null 400 -
### Advanced Microscope pMISC. null 800 -
### Laparoscope per hour MISC. null 700 -
### Enseal MISC. null - 7
Cardio
5322 Open Lung Biopsy SURGERY MAJOR 7,300 -
Cardio
### Thoracic & Vascular Surgery - Procedure
2701 Biopsy - Lung PROCEDURE null 310 -
2702 Biopsy - Pleural PROCEDURE null 250 -
2703 Bronchial Challenge TestPROCEDURE null 630 -
2704 Fiberoptic Bronchoscop PROCEDURE null 1,250 -
2705 Fiberoptic BronchoscopyPROCEDURE null 630 -
2706 Fiberoptic BronchoscopyPROCEDURE null 1,780 -
2707 Rigid Bronchoscopy PROCEDURE null 750 -
2708 Intercostal / Malecot DrPROCEDURE null 210 56
Evening
2705 Fiberoptic BronchoscopyPROCEDURE null 1,130 -
2708 Intercostal/Malecot DraPROCEDURE null 380 -
Page 132 of 368


Date Date Date
Page 133 of 368

ENT
ENT
Printed in SOC's
8.7. UoH - ENT : AUDIOLOGY AND SPEECH THERAPY
Unit
23952 Pure Tone Audiometry MISC. null 250 -
23955 Long Term Speech Therap MISC. null 150 -
23956 Group Speech Therapy (pMISC. null 150 -
23957 BOA (Behavioural ObservMISC. null 250 2
23958 OAE (Oto-acoustic emissMISC. null 250 -
23962 Speech Evaluation MISC. null 150 62
23963 Speech Therapy Case ReMISC. null 50 -
23964 Hearing Aid Trial MISC. null 150 -
23965 Speech Assessment ProtMISC. null 500 -
23967 Regular Speech Therapy M ( ISC. null 100 365
23968 Speech (5 sessions) MISC. null 500 -
23970 Home Based Training P MISC. null 150 -
5. ENT
E.N.T
### PROCEDURE
901 Antral Wash under LA - MISC. null 90 -
902 Antral Wash under LA - BMISC. null 150 -
903 Assesment of Hearing foMISC. null 120 5
906 Caloric Test MISC. null 150 -
907 Chemical Cautery of BleeMISC. null 35 -
908 Cortisone Injection to MISC. null 100 -
909 Ear Lobe Repair (Double/MISC. null 800 8
910 ENG MISC. null 350 -
911 Fiberoptic BronchoscopyMISC. null 1,200 -
912 Fiberoptic BronchoscopyMISC. null 600 -
Page 134 of 368

ENT
913 Fiberoptic BronchoscopyMISC. null 1,780 -
914 Rigid Bronchoscopy MISC. null 715 -
915 Fiberoptic LaryngoscopyMISC. null 500 349
918 Incision & Drainage of MISC. null 200 1
919 Impedance Audiometry MISC. null 350 325
920 Long Term Speech Therapy MISC. null 150 88
921 Neuro Otological Test MISC. null 420 -
922 Nose Prick (Boring of NoMISC. null 90 5
923 Pure Tone Audiogram MISC. null 300 1,616
924 Pure Tone Audiogram - RMISC. null 200 14
925 Removal of Foreign BodyMISC. null 80 18
926 Speech Evaluation and TMISC. null 150 335
927 Suction Clearance MISC. null 200 1,484
928 Syringing to Ear MISC. null 100 518
929 Tracheostomy in OPD/ WMISC. null 200 25
930 Vestibular Function TestsMISC. null 350 -
932 Nasal Packing MISC. null 100 73
933 Intra Tympanic Amino GlMISC. null 420 -
934 Injection into Auricle MISC. null 420 -
935 Ear Piercing (per ear) MISC. null 200 15
936 Nasendoscopy Biopsy / CMISC. null 550 -
937 Saline Nasal Wash MISC. null 65 -
938 BAER for Threshold Esti MISC. null 1,200 109
939 BAER for Differential DiaMISC. null 1,200 6
940 BAER - Repeat within 6 MISC. null 500 11
941 Diagnostic Scopy MISC. null 200 133
942 Diagnostic Nasal Endosc MISC. null 400 578
943 Biopsy - Fibreoptic Lary MISC. null 600 1
944 Behavioural Observatio MISC. null 250 1,611
945 Epleys Maneuver/Dix-HalMISC. null 100 295
950 Computerised Speech A MISC. null 300 1
Page 135 of 368

ENT
952 Computerised Electrony MISC. null 300 -
966 Videostroboscopy PROCEDURE null 715 -
967 Laryngeal EMG PROCEDURE null 950 -
968 Faciomaxillary Botox InjePROCEDURE null 1,485 -
969 Transoral VF injection PROCEDURE null 1,485 -
970 Transoral VF AugmentatiPROCEDURE null 2,375 -
971 Tran-cervical Laryngeal I PROCEDURE null 890 -
972 Foreign Body Removal (eMISC. null 420 -
975 Endoscopic Biopsy - Nos MISC. null 550 -
976 Endoscopic Biopsy - Ear MISC. null 550 1
977 Endoscopic Biopsy - OralMISC. null 550 39
978 Endoscopic Biopsy - Orp MISC. null 550 -
979 Endoscopic Biopsy - HypMISC. null 550 -
980 Suturing (Small) MISC. null 300 3
981 Suturing (Large) MISC. null 420 -
982 Rigid Laryngoscopy MISC. null 420 -
983 Otoendoscopy MISC. null 250 23
984 Endoscopice Suction CleMISC. null 300 -
985 Endoscopice Suction CleaMISC. null 300 -
986 High Frequency AudiomeMISC. null 350 21
987 Aided Audiometry MISC. null 150 2
988 Otoacoustic Emission TesMISC. null 400 123
989 Peadiatric Sleep Study(MPROCEDURE null 5,600 -
990 Paediatric Sleep Study(MPROCEDURE null 2,000 -
991 Impedance AudiometeryLABORATORY
( null 200 10
992 Audiology Special Test LABORATORYnull 300 3
993 Audiology - Counselling LABORATORYnull 150 7
994 Evaluation Report PROCEDURE null 100 2
995 Tracheostomy in ICU / WPROCEDURE null 3,500 -
Page 136 of 368

ENT
996 Nasal Endoscopic debri PROCEDURE null 600 -
2101 90 Degree Videolaryngo PROCEDURE null 500 769
2103 Biopsy - Minor PROCEDURE null 250 29
2104 Incision and Drainage - PROCEDURE null 200 4
2105 Incision and Drainage - PROCEDURE null 400 -
5.1 ENT Packages
E.N.T
### PROCEDURE
946 Snoring Evaluation Pack MISC. null 4,160 -
947 Vertigo Protocol MISC. null 3,500 -
948 Imaging Surchage MISC. null 55 2
954 Speech Theraphy using MISC. null 200 1
955 Nasalance (Active Rhin MISC. null 120 1
956 Endoscopy Imaging MISC. null 55 -
957 Endoscopy Imaging withPROCEDURE null 120 -
958 Ear Piercing with Studs MISC. null 350 2
960 Five Antigens MISC. null 120 -
961 30 Antigens MISC. null 475 -
962 Allergic Prick Test (0-10 MISC. null 300 2
963 Allergic Prick Test (10-20MISC. null 420 7
964 Allergic Prick Test (abov MISC. null 650 -
965 VEMP Proceedure MISC. null 350 -
H. ENT
CONSERVATIVE PROCEDURES
E.N.T
###
7793 Endoscopic Nasal SurgerSURGERY MAJOR 5,600 3
7794 Endoscopic Ear Surgery SURGERY MAJOR 9,000 -
7795 FESS-Minor SURGERY MINOR 3,500 68
7796 FESS-Major SURGERY MAJOR 8,000 17
7797 Sphenoid Sinus Surgery SURGERY MAJOR 7,000 -
Page 137 of 368

ENT
7798 DCR Surgery Minor SURGERY MINOR 3,000 4
7799 DCR Surgery-Major SURGERY MAJOR 7,000 -
7800 METP-Type1 SURGERY MINOR 4,000 74
7801 METP-Type2 SURGERY MAJOR 8,000 4
7802 METP-Type3 SURGERY MAJOR 10,000 1
7803 Neck Exploration-Minor SURGERY MINOR 3,300 9
7804 Neck Exploration-Major SURGERY MAJOR 10,000 -
7805 Phono Surgery-Minor SURGERY MINOR 3,000 10
7806 Phono Surgery-Major SURGERY MAJOR 7,600 1
7807 Tracheal Surgery-Minor SURGERY MINOR 3,600 5
7808 Tracheal Surgery-Major SURGERY MAJOR 14,600 -
7809 Digital Imaging SURGERY MAJOR - -
7891 Laryngo - Tracheal InjurySURGERY MAJOR + 10,300 -
7892 Para-pharyngal Benign LeSURGERY MAJOR + 15,300 -
7893 Para Pharyngal Benign LesSURGERY MAJOR + 15,600 -
7894 Thyroplasty MedialisatioSURGERY MAJOR 6,700 -
7895 Vidian Neurectomy - Tra SURGERY MAJOR 6,200 -
7896 Vidian Neurectomy - TranSURGERY MAJOR 6,200 -
7911 Optic Nerve DecompressSURGERY MAJOR + 10,300 -
7912 Cartilage Graft of Ear & SURGERY MINOR 9,000 -
7913 Parotidectomy - SuperficSURGERY MAJOR + 15,300 2
7914 Parotidectomy - Total SURGERY MAJOR + 15,700 -
7915 Intra tympanic GM Inj. SURGERY MINOR 1,700 1
7916 T. Tube insertion SURGERY MINOR + 3,500 3
7917 Tracheal dilatation SURGERY MAJOR 3,300 3
7918 Endoscopic Closure of CSFSURGERY MAJOR + 12,000 1
7919 Endoscopic nasal cauteriSURGERY MINOR + 2,000 1
7920 Mini FESS SURGERY MAJOR 4,500 3
7921 Extended FESS SURGERY MAJOR + 9,000 -
7922 Septal button insertion SURGERY MINOR + 2,000 -
7923 Microdebrider Use SURGERY MAJOR 900 1
Page 138 of 368

ENT
7924 Laser Assited nasal surg SURGERY MINOR 3,000 -
7925 Laser Assited nasal surg SURGERY MAJOR 6,600 -
7926 Laser with FESS-Minor SURGERY MINOR 3,000 -
7927 Laser with FESS-Major SURGERY MAJOR 7,600 -
7928 Laser Assisted Laryngeal SURGERY MINOR 3,200 -
7929 Laser Assisted Laryngeal SURGERY MAJOR 8,600 -
7930 Tracheal Surgery laser AsSURGERY MINOR 3,300 -
7931 Laser assisted Stapedot SURGERY MAJOR 7,800 -
7932 Video Laryngoscopy SURGERY MAJOR 6,000 2
7933 Bronchoscopy-video endSURGERY MINOR 5,000 -
7934 Oesophagoscopy -video SURGERY MINOR 3,300 -
7935 LUAP SURGERY MAJOR 7,000 -
7936 L-Tousillectomy SURGERY MAJOR 5,000 -
7937 Maxillary Sinus TrephinaSURGERY MAJOR 6,000 -
7938 Frontal SinusTrephine SURGERY MAJOR 6,000 -
7940 RF Adenoidectomy SURGERY MAJOR 12,000 -
7943 Hyoid suspension SURGERY MAJOR 9,000 -
7944 Lateral canthotomy SURGERY MINOR 8,000 -
7945 Endoscopic Vidian Neur SURGERY MAJOR 9,000 -
7946 Endoscopic sphenopalatin SURGERY MAJOR 12,000 -
7947 Facial Nerve DecompressSURGERY MAJOR 10,000 -
7948 Endoscopic skull base suSURGERY MINOR 5,000 -
7949 Endoscopic skull base suSURGERY MAJOR 12,000 1
7950 Endoscopic Pituitary exciSURGERY MAJOR 12,000 -
7951 Endoscopic AngiofibromaSURGERY MAJOR 19,000 -
7952 Modified Lothrops proc SURGERY MAJOR 12,000 -
7953 Frontal sinus surgery SURGERY MAJOR 6,000 -
7955 Follow Up Laryngeal Sur SURGERY MINOR 3,000 -
7956 Sialendoscopy (TherapeuSURGERY MAJOR 5,000 -
7957 Sialendoscopy (DiagnostiSURGERY MAJOR 4,000 2
7958 Microflab Laryngeal SurgSURGERY MAJOR 6,600 2
Page 139 of 368

ENT
EAR
E.N.T
###
7601 Atticotomy with TympanSURGERY MAJOR 7,700 -
7602 Aural Polypectomy SURGERY MINOR 2,300 1
7603 Cortical Mastoidectomy SURGERY MAJOR 8,500 2
7604 Cortical Mastoidectomy SURGERY MINOR + 6,700 1
7605 Ear Canal Reconstructio SURGERY MINOR 5,700 2
7606 Ear Lobe Repair - One EaSURGERY MINOR 1,700 -
7607 Ear Lobe Repair - Both E SURGERY MINOR 2,500 1
7608 Endolymphatic Sac DecoSURGERY MAJOR + 13,000 -
7609 Facial Nerve DecompressSURGERY MAJOR + 12,000 -
7610 F.B. Removal from the MSURGERY MINOR + 2,000 1
7611 F.B. Removal from the ExSURGERY MINOR 1,600 4
7612 I & D Haematoma Auris SURGERY MINOR + 1,800 -
7613 I & D Mastoid Abscess SURGERY MINOR 6,000 -
7614 Labrinthectomy SURGERY MAJOR + 10,700 -
7615 Mid-Cranial Fossa Appr.tSURGERY MAJOR + 12,600 -
7616 Modified Radical Masto SURGERY MAJOR 8,000 15
7617 Mod.Radical Mastoidec SURGERY MAJOR 9,000 -
7618 Myringotomy with GromSURGERY MINOR + 2,000 3
7619 Myringotomy with Grome SURGERY MINOR 2,500 5
7620 Myringotomy SURGERY MINOR 2,000 -
7621 Post-op. Exam. of Mid-EaSURGERY MINOR + 2,000 -
7622 Pre-Auricular Sinus ExcisSURGERY MINOR + 1,900 6
7623 Pre-Auricular Sinus ExcisSURGERY MINOR + 2,800 -
7624 Radical Mastoidectomy SURGERY MAJOR 10,000 -
7625 Revision Meatoplasty SURGERY MINOR + 3,000 1
7626 Stapedectomy SURGERY MAJOR + 11,000 6
7627 Temporal Bone ResectionSURGERY MAJOR + 15,200 -
7628 Temporal Bone ResectionSURGERY MAJOR + 16,600 -
7629 Trans Labrinthine vestib SURGERY MAJOR 12,900 -
Page 140 of 368

ENT
7630 Tympanoplasty Type I SURGERY MAJOR 7,000 11
7631 Tympanoplasty Type II SURGERY MAJOR 8,000 -
7632 Tympanotomy SURGERY MINOR + 2,500 9
7633 Excis.ofGlom.Jug.Tum.F SURGERY MAJOR + 14,000 -
7634 Excis.ofGlom.Jug.Tum. P SURGERY MAJOR + 14,000 1
7635 Excis.ofGlom.Jugu.Tum I SURGERY MAJOR + 11,700 1
7636 Ex Glom.JugTumLat.TranSURGERY MAJOR + 15,600 -
7637 Myringoplasty (TranscanaSURGERY MAJOR 4,200 -
7638 Biopsy - ENT SURGERY MINOR + 2,000 10
7639 Keratosis obturan removSURGERY MINOR 3,800 3
7640 Trans Labrinthine acoustSURGERY MAJOR 17,200 -
7641 P S C C Occlusion SURGERY MAJOR + 8,300 -
7643 BAHA SURGERY MAJOR + - -
7644 MEIHDS SURGERY MAJOR + - -
7829 Otoendoscopic Surgery (SURGERY MINOR 7,000 -
7830 Otoendoscopic Surgery (SURGERY MAJOR 8,000 -
7831 Otoendoscopic Stapedo SURGERY MAJOR 9,000 -
ENT-COCHLEAR IMPLANT PACKAGE
Surgery
### Packages
7642 Cochlear Implant PackagSURGERY MAJOR - -
LARYNX
E.N.T
###
7771 Laryngectomy with ModifSURGERY MINOR + 16,000 -
7772 Laryngectomy with RadicSURGERY MINOR + 18,000 -
7773 Laryngo Fissure and Pro SURGERY MINOR + 8,700 -
7774 Sub-total Laryngectomy SURGERY MAJOR + 15,000 -
7775 Total Laryngectomy SURGERY MAJOR + 15,000 -
7776 Arytenoidectomy SURGERY MAJOR 5,620 -
7777 Cordectomy via Laryngo SURGERY MAJOR 6,800 -
7778 Dilatation of Larynx SURGERY MINOR + 3,700 -
7779 Direct Laryngoscopy & BSURGERY MINOR + 3,700 25
Page 141 of 368

ENT
7780 Endoscopic Cord LateraliSURGERY MAJOR 6,800 -
7781 Excision of Laryngocole SURGERY MINOR + 9,300 -
7782 Lateral or Extended FronSURGERY MAJOR + 13,700 -
7783 Micro Surgery of Larynx SURGERY MINOR + 7,700 21
7784 Reconstruction Surgery oSURGERY MINOR + 9,300 -
7785 Supraglottic Laryngecto SURGERY MAJOR + 13,700 -
7786 Supraglottic LaryngectomSURGERY MAJOR + 13,700 -
7787 Suspension LaryngoscopiSURGERY MAJOR 4,700 -
7788 Teflon Inj. to Paralysed SURGERY MAJOR 4,700 -
7789 Total Laryngopharyngo ESURGERY MAJOR + 21,300 -
7791 xVertical Laryngectomy wSURGERY MAJOR + 11,300 -
7792 Woodman's Operation SURGERY MAJOR 6,800 -
7832 Injection Hyroplasty SURGERY MINOR + - -
NECK
E.N.T
###
7811 Cricopharyngeal Myoto SURGERY MINOR + 7,200 -
7812 Excision Biopsy of Lymp SURGERY MINOR + 3,000 11
7813 Excision of Branchial CysSURGERY MAJOR 6,300 -
7814 Excision of Branchial FistSURGERY MAJOR 6,300 -
7815 Excision of SubmandibulSURGERY MINOR + 7,600 2
7816 Excision of Thyroglossal SURGERY MINOR + 7,600 5
7817 Excision of Thyroglossal FSURGERY MINOR + 7,600 -
7818 Hemi Thyroidectomy SURGERY MINOR + 8,000 11
7819 I & D of Neck Abscess SURGERY MINOR 7,000 2
7820 I & D of Submandibular SURGERY MINOR 3,100 1
7821 Mod. Neck Dissection SURGERY MINOR 9,700 -
7822 Radical Neck Dissection SURGERY MINOR 8,100 -
7823 Styloid Process Excision SURGERY MINOR 6,300 1
7824 Supra Omohyoid DissectSURGERY MINOR 7,800 -
7825 Thyroidectomy - Total SURGERY MAJOR 11,500 -
7826 Total Thyroidectomy wit SURGERY MINOR 20,000 1
Page 142 of 368

ENT
7827 Wedge Biopsy Neck NodSURGERY MINOR 3,100 -
NOSE
E.N.T
###
7651 Anterior Nasal Packing SURGERY MINOR 1,700 1
7652 Antral wash - One side SURGERY MINOR 1,700 -
7653 Antral wash - Both sides SURGERY MINOR 1,700 -
7654 Intranasal Antrostomy - SURGERY MINOR 1,700 1
7655 Intranasal Antrostomy -BSURGERY MINOR + 2,000 -
7656 Antrochaonal Polypecto SURGERY MAJOR 4,200 -
7657 Antroscopy SURGERY MINOR + 1,900 1
7658 Antroscopy PolypectomySURGERY MAJOR 5,300 -
7659 Arterial Ligation on EpistSURGERY MAJOR + 7,700 -
7660 Biopsy Nose SURGERY MINOR 1,700 9
7661 Caldwell Luc - One Side SURGERY MAJOR 3,300 2
7662 Caldwell Luc - Both SidesSURGERY MAJOR 5,300 -
7663 Canalization of Nose in SURGERY MINOR + 1,900 -
7664 Closure of Oroantral FistSURGERY MAJOR 4,200 -
7665 Cranio Facial Resection SURGERY MAJOR + 16,700 -
7666 Cranio-Facial Resection SURGERY MAJOR + 16,800 -
7668 Endoscopic EthmoidectoSURGERY MAJOR 8,000 -
7669 Endoscopic PolypectomySURGERY MAJOR 6,200 -
7670 Excision of Rhinosclero SURGERY MAJOR 6,300 -
7671 External Fronto EthmoidSURGERY MAJOR 6,600 1
7672 External Fronto EthmoidSURGERY MAJOR 8,800 -
7673 Fracture Nasal Bone RedSURGERY MAJOR 3,300 -
7674 Frontal Trephine SURGERY MAJOR 2,200 -
7675 F.B. Removal from Nose SURGERY MINOR + 2,000 6
7676 Maxillectomy with ExcentSURGERY MAJOR 12,900 -
7677 Maxillectomy with ExtenSURGERY MAJOR + 16,600 -
7678 Maxillectomy - Partial SURGERY MAJOR + 13,000 -
7679 Maxillectomy - Total SURGERY MAJOR + 13,000 -
Page 143 of 368

ENT
7680 Nasal Endoscopic ExaminSURGERY MINOR + 2,000 15
7681 Obliterative Surgery of F SURGERY MAJOR 6,800 -
7682 Oroantral Fistula ClosureSURGERY MAJOR 6,300 -
7683 Post-Nasal & Anter. NasaSURGERY MINOR + 2,000 1
7684 Rhinoplasty with Nasal TSURGERY MAJOR 8,800 -
7685 Septal Abscess or Haem SURGERY MINOR + 1,900 -
7686 Septoplasty SURGERY MAJOR 6,000 36
7687 Sub-mucus Diathermy SURGERY MINOR + 2,000 4
7688 S.M.R. SURGERY MAJOR 6,000 -
7689 Choanal Atresia - TransnasSURGERY MINOR + 7,000 -
7690 Choanal Atresia - TransnaSURGERY MINOR + 7,000 -
7691 Choanal Atresia - TranspalSURGERY MINOR + 7,700 -
7692 Surgery for Choanal AtresSURGERY MINOR + 7,600 -
7693 Transnasal Ethmoidecto SURGERY MINOR + 6,600 1
7694 Turbinectomy SURGERY MINOR + 1,900 6
7695 Young's Operation SURGERY MINOR + 3,700 -
7696 Septo Rhinoplasty SURGERY MINOR + 11,200 -
7697 Facial Translocation SURGERY MAJOR + 16,700 -
7698 Endoscopic D.C.R. SURGERY MAJOR + 8,300 5
7833 Endoscopic Septal SurgeSURGERY MINOR + 7,000 -
7836 Septoplasty/SMR + FESS SURGERY MAJOR 11,800 6
OESOPHAGUS
E.N.T
###
7851 Dilatation of Oesophageal SURGERY MAJOR 2,300 2
7852 Oesophagoscopy Biopsy/SURGERY MAJOR + 5,000 8
7854 Cervical OesophagostomSURGERY MAJOR + 3,200 -
ORAL CAVITY & ORO PHARYNX
E.N.T
###
7731 Biopsy Oral Cavity SURGERY MINOR 1,800 17
7732 Closure of Pharyngeal FisSURGERY MINOR + 8,800 -
7733 Closure of Pharyngeal FisSURGERY MINOR + 7,000 -
Page 144 of 368

ENT
7734 Excision of Benign LesionSURGERY MINOR + 7,100 1
7735 Exci.of Ca.Cheek Pri. LocaSURGERY MINOR + 9,100 -
7736 Excis.of Ca.Cheek with NSURGERY MINOR + 13,300 -
7737 Exci.of Ca.Cheek with N SURGERY MAJOR + 21,300 -
7738 Exci.of Ca.Cheek with NeSURGERY MINOR + 15,100 -
7739 Excision of Growth Epuli SURGERY MINOR + 3,700 -
7740 Exci.of Hypopharyngeal DSURGERY MINOR + 9,300 -
7741 Excision of Ranula SURGERY MINOR + 3,700 1
7742 Excision of Small GrowthSURGERY MINOR + 3,700 -
7743 Hemiglossectomy Transal- SURGERY MINOR + 7,600 -
7744 I & D of Peritonsillar AbsSURGERY MINOR + 1,900 2
7745 Nasopharyngeal Examn. SURGERY MINOR + 1,900 -
7746 Remvl.of Stone from SubSURGERY MAJOR 2,100 1
7747 Tonsillectomy SURGERY MAJOR 4,000 26
7748 Tonsillectomy & Adenio SURGERY MAJOR 5,500 27
7749 Total Glossectomy with SURGERY MINOR + 11,800 -
7750 Tongue Tie Release SURGERY MINOR + 1,900 5
7751 I & D of RetropharyngealSURGERY MINOR + 2,800 2
7828 Electro Coagulation TonsSURGERY MINOR + - -
GENERAL
E.N.T
###
7835 Coblation Assisted SurgeMISC. null 5,000 4
7837 Coblation Instrument chSURGERY MINOR - -
7992 Extra hours for Minor surSURGERY MAJOR - -
7993 Extra hours for minor + sSURGERY MAJOR - -
7994 Extra hours for major surSURGERY MAJOR - -
7995 Extra hours for major + sSURGERY MAJOR - -
7999 Bilateral (50% of Proce./ SURGERY MAJOR - -
8000 Extra Hours taken for a sSURGERY MAJOR - -
18061 Basic Microscope per hoSURGERY MAJOR 330 -
Page 145 of 368

ENT
18062 Advanced Microscope peSURGERY MAJOR 660 -
THROAT- NASO PHARYNX
E.N.T
###
7711 Excision of AngiofibromaSURGERY MINOR + 11,000 -
7715 Adenoidectomy SURGERY MAJOR + 3,000 19
7716 Biopsy Nasopharynx SURGERY MINOR + 2,000 2
7834 Endoscopic Adenoidect SURGERY MAJOR 6,000 -
TRACHEA & BRONCHUS
E.N.T
###
7871 Cervical Tracheal Stenos SURGERY MINOR + 12,800 1
7872 TE Puncture SURGERY MINOR + 5,300 -
7873 TE Puncture with MyotoSURGERY MINOR + 7,100 -
7874 Tracheostomy in OT SURGERY MINOR + 5,000 37
7875 Bronchoscopy for BiopsySURGERY MINOR + 5,600 -
E.N.T
###
7954 Follow Up Laryngeal Sur SURGERY MINOR 2,800 -
E.N.T
### PROCEDURE
904 Audiogram with Special TMISC. null 175 1
905 Audiography / Speech ThMISC. null 35 -
916 Group Speech Therapy ( MISC. null 120 -
917 Hearing Aid Trial MISC. null 55 -
931 Zinc Ionisation - Middle MISC. null 120 -
951 Comprehensive Speech PMISC. null 600 -
953 Speech Assesment ProtoMISC. null 420 -
Page 146 of 368

ENT
959 Single Antigen MISC. null 50 -
Evening
901 Antral Wash under LA - OMISC. null 160 -
902 Antral Wash under LA - BMISC. null 270 -
906 Caloric Test MISC. null 270 -
907 Chemical Cautery of BleeMISC. null 60 -
915 Fiberoptic Laryngoscopy MISC. null 900 -
919 Impedance Audiometry -MISC. null 630 -
920 Long term speech therapy MISC. null 270 -
921 Neuro Otological Test -E MISC. null 760 -
923 Pure Tone Audiogram -E MISC. null 540 -
924 Pure Tone Audiogram - RMISC. null 360 -
925 Removal of Foreign BodyMISC. null 140 -
926 Speech Evaluation and TMISC. null 270 -
927 Suction Clearance -E MISC. null 360 -
928 Syringing to Ear -E MISC. null 180 -
929 Tracheostomy -E MISC. null 360 -
930 Vestibular Function TestsMISC. null 630 -
936 Nasendoscopy Biopsy/cau MISC. null 990 -
938 .BAER for threshold esti MISC. null 2,160 -
939 BAER for differential diagMISC. null 2,160 -
940 BAER repeat within 6 moMISC. null 900 -
941 Diagnostic Scopy MISC. null 360 2
942 Diagnostic Nasal Endosc MISC. null 720 -
Grand Total 1,798,345 9,785
Page 147 of 368

ENT
Date Date Date
Page 148 of 368

General Surgery
General Surgery
Printed in SOC's
10. GENERAL SURGERY
###
General Surgery Procedure
2601 Abdominal ParPROCEDURE MAJOR 175 -
2602 Aspiration Bio PROCEDURE null 175 35
2604 Biopsy - Liver PROCEDURE MAJOR 250 -
2605 Biopsy - MusclPROCEDURE null 350 25
2608 Cryo Surgery f PROCEDURE null 175 1
2610 Ear Lobe RepaiPROCEDURE null 300 -
2611 Ear Lobe RepairPROCEDURE null 240 -
2612 Excision of SmaPROCEDURE null 120 -
2613 Injection Trea PROCEDURE null 120 11
2614 Intra Lesional PROCEDURE null 120 -
2615 Nose Prick (BoPROCEDURE null 120 -
2616 Sengs Taken TuPROCEDURE null 715 6
2617 SigmoidoscopyPROCEDURE null 350 -
2621 Tracheostomy PROCEDURE null 240 8
2622 Band Ligation PROCEDURE null 175 63
2623 Biopsy - RectalPROCEDURE null 175 27
2624 Colostomy Irri PROCEDURE null 175 -
2626 Pleural Tappin PROCEDURE null 175 -
2631 Incision & Dra PROCEDURE null 175 4
2636 Suturing - MinPROCEDURE null 175 6
Page 149 of 368

General Surgery
2637 Suturing - Int PROCEDURE null 240 -
2638 Suturing - Maj PROCEDURE null 475 12
2639 ICD PROCEDURE null 175 1
2643 AV Fistula PROCEDURE null 475 -
2644 Miscellaneous PROCEDURE null 175 -
2648 ICD Removal PROCEDURE null 120 -
2649 SPC Removal PROCEDURE null 120 -
2650 Drain RemovalPROCEDURE null 120 121
2651 Ganglion AspirPROCEDURE null 120 -
2652 Colostomy BagPROCEDURE null 120 70
2653 Bladder wash PROCEDURE null 100 -
2654 Biopsy IntermePROCEDURE null 250 -
2655 Water HoldingPROCEDURE null 175 3
2656 Distal Loop WaPROCEDURE null 175 31
2657 ICD Insertion PROCEDURE null 175 2
2658 Drain InsertionPROCEDURE null 175 3
2659 Seton Change PROCEDURE null 175 -
2661 Debridement PROCEDURE null 175 2
2662 SSG PROCEDURE null 240 -
2664 SPC PROCEDURE null 240 -
2665 Circumcision PROCEDURE null 350 3
2666 Segmental BloPROCEDURE null 475 -
2667 Debridement -PROCEDURE null 475 23
2668 Wrist AV FistulPROCEDURE null 240 1
2677 Crepe BandageMISC. null 50 -
2678 Catheterizatio PROCEDURE null 70 6
2679 Dressing Servi PROCEDURE null 60 266
2685 Dressing Servi PROCEDURE null 80 3
Page 150 of 368

General Surgery
2686 Dressing Servi PROCEDURE null 110 5,562
2687 Minor ProceduPROCEDURE null 55 96
2688 Removal of Fo PROCEDURE null 240 2
2689 Ryles Tube Int MISC. null 20 1
2690 Callus RemovalPROCEDURE null 155 10
2691 Excision Medi PROCEDURE null 350 110
2692 Ingrowing Toe PROCEDURE null 600 48
10.1 STOMA CLINIC PROCEDURE
###
2670 Proctoscopy PROCEDURE null 45 52
2671 SigmodoscopyPROCEDURE null 240 -
2673 Inj Sclerother PROCEDURE null 120 -
2674 Banding of Ha PROCEDURE null 175 -
2676 Hemorrhoid ScPROCEDURE null 240 -
27. SURGICAL ONCOLOGY
###
2680 Chemotheraphy MISC. null 350 -
2681 Chemotheraphy MISC. null 240 1
2682 Chemotheraphy MISC. null 350 4
2683 Chemotheraphy MISC. null 420 -
2684 ChemotherapyMISC. null 475 -
B. GENERAL SURGERY
CATEGORY - A
###
General Surgery
5744 Fistulotomy II SURGERY MINOR + 2,000 6
5900 Mucus cyst excSURGERY MINOR + 2,000 3
5901 oral cancer bi SURGERY MINOR 2,000 -
5902 oral cancer EUSURGERY MINOR 2,000 -
Page 151 of 368

General Surgery
5916 Miscell Pleuro SURGERY MINOR 2,000 -
5923 Suturing MinoSURGERY MINOR 2,000 18
CATEGORY - B
###
General Surgery
5704 Amputation ofSURGERY MINOR + 3,000 96
5731 CryohaemorrhSURGERY MINOR + 3,000 -
5733 Debridement (SURGERY MINOR + 3,000 170
5742 Fissurectomy SURGERY MINOR + 3,000 22
5756 I&D SURGERY MINOR + 3,000 211
5783 Removal of SupSURGERY MINOR + 3,000 4
5819 Circumcision SURGERY MINOR + 3,000 4
5859 Lords dilatatio SURGERY MINOR + 3,000 -
5895 Lymph Node BiSURGERY MAJOR 3,000 14
5920 CAPD SURGERY MINOR + 3,000 13
5921 Excision of smaSURGERY MINOR + 3,000 231
5922 Ear lobe repairSURGERY MINOR + 3,000 -
5924 Split skin graft SURGERY MINOR + 3,000 24
5926 Suturing - ModSURGERY MINOR + 3,000 9
5980 EUA (perianal SURGERY MINOR + 3,000 68
CATEGORY - C
###
General Surgery
5705 Amputation ofSURGERY MAJOR 6,000 -
5706 Amputation Peni SURGERY MAJOR 6,000 -
5710 Appendicecto SURGERY MAJOR 6,000 49
5730 Colostomy- Lo SURGERY MAJOR 6,000 7
5734 Debridement (SURGERY MAJOR 6,000 3
5735 Dodd and Cocke SURGERY MAJOR 6,000 -
5737 Feeding Jejun SURGERY MINOR + 6,000 10
5740 FibroadenomaSURGERY
B MAJOR 6,000 4
Page 152 of 368

General Surgery
5743 Fistulectomy/FSURGERY MINOR + 6,000 36
5747 Gastrostomy SURGERY MAJOR 6,000 -
5749 Gynaecomastia- SURGERY MAJOR 6,000 -
5750 HaemorrhoideSURGERY MINOR + 6,000 34
5755 Hydrocoele OpSURGERY MINOR + 6,000 8
5757 Ileostomy SURGERY MAJOR 6,000 1
5758 Incisional Her SURGERY MAJOR 6,000 3
5761 Inguinal Herni SURGERY MAJOR 6,000 1
5765 Laparotomy SURGERY MAJOR 6,000 141
5781 Pilonidal SinusSURGERY MINOR + 6,000 8
5813 Umbilical & PaSURGERY MAJOR 6,000 3
5815 Varicose Veins SURGERY MAJOR 6,000 9
5816 Varicocoele OpSURGERY MAJOR 6,000 -
5817 Laproscopy (DiSURGERY MAJOR 6,000 20
5851 Amputation abSURGERY MAJOR 6,000 -
5854 Amputation -f SURGERY MINOR + 6,000 15
5868 Hernia epigastrSURGERY MAJOR 6,000 1
5870 Hernia paraumb SURGERY MAJOR 6,000 1
5891 Head/neck -Tr SURGERY MAJOR 6,000 -
5899 Salivary calcul SURGERY MAJOR 6,000 -
5912 Orchidectomy SURGERY MAJOR 6,000 2
5913 Orchidopexy SURGERY MAJOR 6,000 -
5927 Microdochect SURGERY MINOR + 6,000 1
5928 Split skin graf SURGERY MAJOR 6,000 -
5929 A V Fistula* SURGERY MAJOR 6,000 -
5933 Early breast caSURGERY MAJOR 6,000 -
5937 Oral cavity be SURGERY MAJOR 6,000 -
5938 Brachial cyst E SURGERY MAJOR 6,000 -
Page 153 of 368

General Surgery
5939 Soft tissue tumSURGERY MAJOR 6,000 -
5983 Hydrocoele (laSURGERY MAJOR 6,000 5
6078 Wide excision SURGERY MAJOR 6,000 -
6079 Axillary Dissec SURGERY MAJOR 6,000 -
6080 Central Neck DSURGERY MAJOR 6,000 -
6082 Pelvic LymphnoSURGERY MAJOR 6,000 -
6089 Fistula-in-Ano (SURGERY MAJOR 6,000 1
CATEGORY - D
###
General Surgery
5702 Amputation - SURGERY MAJOR 9,000 5
5703 Amputation - SURGERY MAJOR 9,000 21
5707 Amputation Pen SURGERY MAJOR 9,000 -
5721 Supra Omo HyoSURGERY MAJOR 9,000 -
5722 Cholecystecto SURGERY MAJOR 9,000 12
5724 Cholecystojej SURGERY MAJOR 9,000 -
5725 Cholecystosto SURGERY MAJOR 9,000 -
5727 Closure of Col SURGERY MAJOR 9,000 19
5728 Closure of DuoSURGERY MAJOR 9,000 -
5729 Closure of SmaSURGERY MAJOR 9,000 -
5732 Cysto GastrostSURGERY MAJOR 9,000 -
5736 Embolectomy SURGERY MAJOR 9,000 -
5738 Femoral HerniaSURGERY MAJOR 9,000 -
5751 Heller's Opera SURGERY MAJOR 9,000 -
5754 Highly Selecti SURGERY MAJOR 9,000 -
5759 Incisional Her SURGERY MAJOR 9,000 42
5766 Laparotomy wiSURGERY MAJOR 9,000 4
5770 Lumbar SympaSURGERY MAJOR 9,000 -
5771 Meckel's DiverSURGERY MAJOR 9,000 -
Page 154 of 368

General Surgery
5782 Profundo PlastSURGERY MAJOR 9,000 -
5794 Simple MastecSURGERY MAJOR 9,000 3
5796 Small Bowel ReSURGERY MAJOR 9,000 2
5797 Small Bowel StSURGERY MAJOR 9,000 -
5804 Thyroglossal CSURGERY MAJOR 9,000 -
5805 Thyroid Lobec SURGERY MAJOR 9,000 8
5835 Other Lap.ProcSURGERY MAJOR 9,000 -
5839 Thoracoscopy D SURGERY MAJOR 9,000 -
5847 Assisting Othe SURGERY MAJOR 9,000 -
5852 Amputation - sSURGERY MAJOR 9,000 -
5857 Ltd. Resection SURGERY MAJOR 9,000 2
5865 Bowel malrotaSURGERY MAJOR 9,000 -
5866 Bowel adhesiolSURGERY MAJOR 9,000 -
5871 CholedechojejSURGERY MAJOR 9,000 -
5880 Abscess drainaSURGERY MAJOR 9,000 -
5884 Head & neck SURGERY MAJOR 9,000 1
5893 Head/neck -paSURGERY MAJOR 9,000 2
5906 Cysto jejunost SURGERY MAJOR 9,000 -
5907 Vascular arteriSURGERY MAJOR 9,000 -
5930 V . Veins Tren SURGERY MAJOR 9,000 5
5934 Wide excision SURGERY MAJOR 9,000 4
5936 Partial glosse SURGERY MAJOR 9,000 -
5940 Hemiglossect SURGERY MAJOR 9,000 -
5941 Cervical symp SURGERY MAJOR 9,000 -
5950 Parathyroid tr SURGERY MAJOR 9,000 -
5951 Ligation of AV fSURGERY MAJOR 9,000 -
5952 Angiogram SURGERY MAJOR 9,000 -
5981 Stapled HaemoSURGERY MAJOR 9,000 -
5984 Debridement (SURGERY MAJOR 9,000 5
Page 155 of 368

General Surgery
5986 I & D (major) SURGERY MAJOR 9,000 2
5987 Split skin graft SURGERY MAJOR 9,000 1
6069 Paraumbilical SURGERY MAJOR 9,000 47
6075 Radiofrequency SURGERY MAJOR 9,000 9
6076 Portal Vein emSURGERY MAJOR 9,000 -
6083 RetroperitoniaSURGERY MAJOR 9,000 -
6084 SMA thrombecSURGERY MAJOR 9,000 -
6085 Recurrent InguSURGERY MAJOR 9,000 1
CATEGORY - E
###
General Surgery
5708 Anal SphincterSURGERY MAJOR + 14,000 -
5711 Laproscopic A SURGERY MAJOR + 14,000 37
5723 Cholecystectom SURGERY MAJOR + 14,000 5
5726 Choledocho DuSURGERY MAJOR + 14,000 -
5745 Gastrectomy - SPURGERY MAJOR + 14,000 3
5768 Left Hemicole SURGERY MAJOR + 14,000 -
5777 Pancreatic Jej SURGERY MAJOR + 14,000 1
5784 Right Hemicol SURGERY MAJOR + 14,000 6
5791 Splenectomy, ESURGERY MAJOR + 14,000 -
5792 Sigmoid Colec SURGERY MAJOR + 14,000 1
5795 Simple MastectSURGERY MAJOR + 14,000 -
5798 Splenectomy SURGERY MAJOR + 14,000 10
5799 SubmandibularSURGERY MAJOR 14,000 -
5801 Subtotal Thyr SURGERY MAJOR + 14,000 -
5802 Superficial Pa SURGERY MAJOR 14,000 3
5803 Surgery for Hi SURGERY MAJOR + 14,000 -
5810 Transverse Co SURGERY MAJOR + 14,000 -
5812 Truncal Vagot SURGERY MAJOR 14,000 3
Page 156 of 368

General Surgery
5814 Vagotomy and SURGERY MAJOR 14,000 -
5825 Laparoscopic ASURGERY MAJOR + 14,000 1
5833 Lap.DU PerforaSURGERY MAJOR + 14,000 -
5834 Lap.Varicoele lSURGERY MAJOR + 14,000 -
5837 Lap.Cysto Gas SURGERY MAJOR + 14,000 -
5840 Thor.Sympath SURGERY MAJOR + 14,000 -
5841 Thor.MediastinSURGERY MAJOR + 14,000 -
5842 Thor.VagotomySURGERY MAJOR + 14,000 -
5843 Thor.Splanchn SURGERY MAJOR + 14,000 -
5846 Assisting Othe SURGERY MAJOR + 14,000 -
5849 RetroperitoniaSURGERY MAJOR + 14,000 1
5850 Amputation beSURGERY MAJOR 14,000 -
5853 Amputation -hSURGERY MAJOR + 14,000 -
5856 Breast conservSURGERY MAJOR + 14,000 1
5858 Rectopexy SURGERY MAJOR 14,000 1
5862 fundoplicationSURGERY MAJOR + 14,000 -
5881 Packing for traSURGERY MAJOR 14,000 -
5882 Hydatid cyst exSURGERY MAJOR + 14,000 4
5896 Deep lobe paroSURGERY MAJOR + 14,000 -
5898 SMG excision wSURGERY MAJOR + 14,000 -
5905 Pancreatic ne SURGERY MAJOR + 14,000 1
5943 Modified radi SURGERY MAJOR + 14,000 12
5953 ReconstructionSURGERY MAJOR + 14,000 -
5955 Femoro femoral SURGERY MAJOR + 14,000 -
5956 AV fistula at e SURGERY MAJOR + 14,000 -
5957 AV fistula usin SURGERY MAJOR + 14,000 -
5958 AV fistula withSURGERY MAJOR + 14,000 -
5959 Excision of AV SURGERY MAJOR + 14,000 -
5960 Venous throm SURGERY MAJOR + 14,000 1
Page 157 of 368

General Surgery
5962 Valve repair foSURGERY MAJOR + 14,000 -
5965 Varicose veins SURGERY MAJOR + 14,000 1
6070 Chemoport insSURGERY MAJOR + 14,000 -
CATEGORY - F
###
General Surgery
5701 Abdomino PeriSURGERY MAJOR + 18,000 3
5709 Anterior ResecSURGERY MAJOR + 18,000 2
5712 Arterial Graft (SURGERY MAJOR + 18,000 -
5719 Block DissectioSURGERY MAJOR + 18,000 -
5720 Functional NecSURGERY MAJOR + 18,000 -
5739 Femoro Poplitea SURGERY MAJOR + 18,000 -
5752 HemimandibulSURGERY MAJOR + 18,000 -
5763 Laproscopic InSURGERY MAJOR + 18,000 43
5764 Laparoscopic SURGERY MAJOR + 19,000 183
5767 Large Soft Tiss SURGERY MAJOR + 18,000 -
5772 Oesophago GaSURGERY MAJOR + 18,000 -
5773 Thoraco LaproSURGERY MAJOR + 18,000 -
5779 Partial Pancre SURGERY MAJOR + 18,000 1
5780 Pelvic ExentratSURGERY MAJOR + 18,000 -
5786 Segmental Hepa SURGERY MAJOR + 18,000 -
5800 Subtotal Cole SURGERY MAJOR + 18,000 -
5806 Total Colecto SURGERY MAJOR + 18,000 1
5808 Total Parotide SURGERY MAJOR + 18,000 -
5811 Triple ResectioSURGERY MAJOR + 18,000 -
5828 Lap.FundoplicaSURGERY MAJOR + 18,000 -
5829 Lap.Truncal Va SURGERY MAJOR + 18,000 3
5830 Lap.assisted s SURGERY MAJOR + 18,000 -
5831 Lap.assisted C SURGERY MAJOR + 18,000 3
5844 Thor.OesophagSURGERY MAJOR + 18,000 -
Page 158 of 368

General Surgery
5848 Subfascial endSURGERY MAJOR + 18,000 -
5855 Limb conservatSURGERY MAJOR + 18,000 -
5861 colonic transpoSURGERY MAJOR + 18,000 1
5863 Lap- Hellers o SURGERY MAJOR + 18,000 1
5867 Gastric vagotom SURGERY MAJOR + 18,000 -
5872 TransdoudenalSURGERY MAJOR + 18,000 -
5873 Radical chole SURGERY MAJOR + 18,000 -
5874 Radical cholec SURGERY MAJOR + 18,000 -
5875 Hepaticojejun SURGERY MAJOR + 18,000 2
5876 Left lateral s SURGERY MAJOR + 18,000 -
5878 Resectional deSURGERY MAJOR + 18,000 -
5879 Enucleations/ SURGERY MAJOR + 18,000 -
5883 Head/neck- mod SURGERY MAJOR + 18,000 1
5885 Head/neck -coSURGERY MAJOR + 18,000 -
5886 Hd/nk-comp. reSURGERY MAJOR + 18,000 -
5887 Head/neck -coSURGERY MAJOR + 18,000 -
5888 Head/neck- subSURGERY MAJOR + 18,000 -
5889 Head/neck- TotSURGERY MAJOR + 18,000 -
5890 Head/neck- Rad SURGERY MAJOR + 18,000 -
5892 Hd/nk -ThyroidSURGERY MAJOR + 18,000 -
5894 Hd/nk-laryngoSURGERY MAJOR + 18,000 -
5897 Radical paroti SURGERY MAJOR + 18,000 -
5908 Adrenelectom SURGERY MAJOR + 18,000 1
5909 RetroperitoneaSURGERY MAJOR + 18,000 -
5910 Ileo inguinal b SURGERY MAJOR + 18,000 -
5911 TFL flap reconsSURGERY MAJOR + 18,000 -
5918 Relaparotomy(rSURGERY MAJOR + 18,000 1
5942 Veins - valvuloSURGERY MAJOR + 18,000 -
5945 Radical hemic SURGERY MAJOR + 18,000 1
Page 159 of 368

General Surgery
5954 Axillo femoral SURGERY MAJOR + 18,000 -
5961 Peripheral aneSURGERY MAJOR + 18,000 -
5966 Re- resection SURGERY MAJOR + 18,000 -
5967 Sentinel node SURGERY MAJOR + 18,000 -
5968 Total thyroide SURGERY MAJOR + 18,000 17
5969 Axillo bifemoraSURGERY MAJOR + 18,000 -
5970 Carotid artery SURGERY MAJOR + 18,000 -
5971 Axillo - Axillar SURGERY MAJOR + 18,000 -
5972 Valve transfer SURGERY MAJOR + 18,000 -
5973 IVC repair Pri SURGERY MAJOR + 18,000 -
5974 Venous BypassSURGERY MAJOR + 18,000 -
5989 Trifemorall en SURGERY MAJOR + 18,000 -
5990 FemoropopliteSURGERY MAJOR + 18,000 -
5991 Aortic endart SURGERY MAJOR + 18,000 -
5993 Surgery for th SURGERY MAJOR + 18,000 -
5995 Lap hydatid cysSURGERY MAJOR + 18,000 -
5996 Distal sub totaSURGERY MAJOR + 18,000 -
5997 Lap assisted o SURGERY MAJOR + 18,000 -
6071 Compartmental SURGERY MAJOR + 18,000 -
6072 Breast conservSURGERY MAJOR + 18,000 -
6077 Frey's ProceduSURGERY MAJOR + 18,000 -
6086 Laproscopic mSURGERY MAJOR + 18,000 1
6088 Re-operative pSURGERY MAJOR + 18,000 -
6091 Laparoscopic rMISC. null 18,000 14
6092 Laparoscopic reMISC. null 18,000 5
CATEGORY - G
###
General Surgery
5713 Aortic Graft - SSURGERY MAJOR + 23,000 -
Page 160 of 368

General Surgery
5714 Aortic Graft - SURGERY MAJOR + 23,000 -
5716 Aortic BifemorSURGERY MAJOR + 23,000 -
5746 Gastrectomy - SURGERY MAJOR + 23,000 -
5769 Left Hemi-HepSURGERY MAJOR + 23,000 -
5774 IVOR - Lewis SURGERY MAJOR + 23,000 -
5775 Mc KEOWN'S SURGERY MAJOR + 23,000 -
5776 Trans Hiatal E SURGERY MAJOR + 23,000 -
5778 Pancreato DuoSURGERY MAJOR + 23,000 -
5785 Right HemihepSURGERY MAJOR + 23,000 -
5787 Shunt Surgery SURGERY MAJOR + 23,000 -
5788 Porta Caval Sh SURGERY MAJOR + 23,000 -
5789 Proximal SplenSURGERY MAJOR + 23,000 -
5790 Distal Spleno SURGERY MAJOR + 23,000 -
5807 Total ColectomSURGERY MAJOR + 23,000 -
5826 Laparoscopic SURGERY MAJOR + 23,000 9
5827 Lap.AdrenalecSURGERY MAJOR + 23,000 2
5832 Lap.assisted A SURGERY MAJOR + 23,000 -
5838 Lap.assist.Do SURGERY MAJOR + 23,000 -
5845 Thor.OesophagSURGERY MAJOR + 23,000 -
5877 Extended righ SURGERY MAJOR + 23,000 -
5946 Major liver Re SURGERY MAJOR + 23,000 -
5947 Centripetal GaSURGERY MAJOR + 23,000 -
5975 Re- resection SURGERY MAJOR + 23,000 -
5976 Carotid endar SURGERY MAJOR + 23,000 -
5977 Carotid subcla SURGERY MAJOR + 23,000 -
5979 IVC repair GrafSURGERY MAJOR + 23,000 -
5998 Abdominal aortSURGERY MAJOR + 23,000 -
5999 Bypass for viscSURGERY MAJOR + 23,000 -
Page 161 of 368

General Surgery
6000 Radical GastreSURGERY MAJOR + 23,000 -
6073 Laproscopic reSURGERY MAJOR + 23,000 -
6074 Radical Nephr SURGERY MAJOR + 23,000 -
6081 Laproscopic N SURGERY MAJOR 23,000 -
6087 Laproscopic anSURGERY MAJOR + 23,000 -
6090 Single Incisio MISC. null 23,000 1
GENERAL
###
General Surgery
5820 Fluroscopy TimPROCEDURE null 200 -
5821 Fluroscopy Ti PROCEDURE null 300 -
5824 Fluroscopy TimPROCEDURE null 100 -
5919 Extra hours forSURGERY MAJOR - -
6099 Bilateral (50% SURGERY MAJOR - 32
6100 Extra Hours takSURGERY MAJOR - -
6115 Use of GI Stap SURGERY MINOR 200 -
18092 Harmonic ScalSURGERY MAJOR 2,000 318
18093 Basic MicroscoSURGERY MAJOR 400 -
18094 Advanced MicrSURGERY MAJOR 800 -
18095 Laparoscope pSURGERY MAJOR 700 -
18150 Intra operativ MISC. null 1,000 -
18151 CUSA MISC. null 1,000 -
18152 Laser and Cell MISC. null 1,000 -
Page 162 of 368

General Surgery
###
General Surgery
999 Misc. OT ChargMISC. null - 73
5753 Hepatico-JejunSURGERY MAJOR + 18,000 -
5982 Stapled GI an SURGERY MAJOR 9,000 -
95007 Operation ChaMISC. null - -
###
2609 Debridement PROCEDURE MAJOR 175 4
2620 Skin Graft PROCEDURE null 175 1
2635 Skin Grafting - PROCEDURE null 475 -
2672 Banding of Ha PROCEDURE null 175 -
2695 Suture RemovaPROCEDURE null 50 5
2696 Suture RemovaPROCEDURE null 100 -
###
Evening Special Procedures
2608 Cryo Surgery f PROCEDURE null 320 -
2611 Ear Lobe RepairPROCEDURE null 430 -
2612 Excision of SmaPROCEDURE null 220 -
2613 Injection Trea PROCEDURE null 220 -
2614 Intra Lesional PROCEDURE null 220 -
2615 Nose Prick (BoPROCEDURE null 220 -
2616 Sengs taken TuPROCEDURE null 1,290 -
Grand Total 3,850,730 9,125
Page 163 of 368

General Surgery
Date Date Date
Page 164 of 368

Gynaecologic Oncology
Printed in SOC's
28. GYNECOLOGIC ONCOLOGY
Gynecologic
### Oncology Procedures
25000 Aspiration Biopsy MISC. null 175 -
25001 Aspiration Cytology MISC. null 175 1
25002 Aspiration of LympocelMISC. null 175 -
25003 Biopsy - Vaginal MISC. null 175 8
25004 Biopsy - Vulva MISC. null 175 3
25005 Biopsy - cervix MISC. null 175 39
25006 Catheter Removal MISC. null 70 10
25007 Cauterization Cervix MISC. null 175 -
25008 Cervix Cytology (papsmMISC. null 40 78
25009 Chemo-Port Flushing i MISC. null 100 8
25010 Chemo-Port Removal i MISC. null 250 -
25011 Chemotherapy Five DaMISC. null 450 4
25012 Chemotherapy Four DaMISC. null 425 1
25013 Chemotherapy iv PushMISC. null 50 1
25014 Chemotherapy PlanninMISC. null 250 1
25015 Chemotherapy Single PROCEDURE null 350 198
25016 Chemotherapy Single MISC. null 50 22
25017 Chemotherapy Three DMISC. null 400 6
25018 Chemotherapy Two DaMISC. null 375 15
25019 Colposcopy MISC. null 120 13
25020 Colposcopy and Biops MISC. null 175 -
Page 165 of 368

25021 Colposcopy and BiopsyMISC. null 175 -
25022 Colposcopy and BiopsyMISC. null 175 1
25023 Colposcopy and CervixMISC. null 175 5
25024 Colposcopy and Pap S MISC. null 150 178
25025 Colposcopy Vagina MISC. null 120 1
25026 Colposcopy Vagina, Pa MISC. null 150 2
25027 Colposcopy Vagina, PapMISC. null 275 -
25028 Colposcopy Vulva MISC. null 120 -
25029 Colposcopy Vulva, Pap MISC. null 120 1
25030 Colposcopy Vulva, Pap MISC. null 275 -
25031 Colposcopy, Pap Smear,MISC. null 275 -
25032 Colposcopy, Pap Smear,MISC. null 300 1
25033 Colposcopy, Pap SmearMISC. null 275 2
25038 Cryosurgery for Minor MISC. null 65 -
25039 Cryosurgery for Perin MISC. null 175 -
25040 Cryosurgery for VaginaMISC. null 175 -
25041 Cryosurgery for Vulva MISC. null 175 -
25042 Cryosurgery for Cervix MISC. null 175 -
25043 Culdocentesis MISC. null 175 -
25044 Cytology EndometriumMISC. null 50 3
25045 Cytology Vagina MISC. null 50 -
25046 Cytology Vault MISC. null 50 39
25047 Cytology Vulva MISC. null 50 2
Page 166 of 368

25048 Dilation and Curettage MISC. null 475 1
25049 Dilation and Curettage,MISC. null 500 -
25050 Dilation and Curettage,MISC. null 550 -
25052 Drain Removal MISC. null 120 15
25053 Drainage of Pyometra MISC. null 110 -
25054 Drainage of Pyometra MISC. null 130 -
25055 Dressing - Service CharMISC. null 110 1
25056 Dressing - Service Cha MISC. null 80 5
25057 Dressing - Service CharMISC. null 60 10
25058 Endometrial Biopsy MISC. null 120 57
25059 Excision of Cervical Le MISC. null 120 -
25060 Excision of Lymph NodMISC. null 150 1
25061 Excision of Vaginal Les MISC. null 120 -
25062 Excision of Vulval LesioMISC. null 120 -
25063 FNAC Lymph Node MISC. null 150 -
25064 FNAC Parametrium MISC. null 165 -
25065 FNAC Pod Mass MISC. null 165 1
25066 Fractional Curettage MISC. null 540 2
25067 Fractional Curettage anMISC. null 715 1
25068 Fractional Curettage a MISC. null 605 -
25069 HPV DNA Test MISC. null 1,485 1
25071 Lucd/Loop/Copper T/ M MISC. null 40 1
25072 Lletz (charges to be puMISC. null - -
25073 Mirena Coil Insertion MISC. null 600 -
25074 Office Hysteroscopy & MISC. null 1,650 -
Page 167 of 368

25075 Office Hysteroscopy a MISC. null 1,650 -
25076 Office Hysteroscopy DiMISC. null 1,430 -
25077 Paracentesis - Repeat MISC. null 90 7
25078 Paracentesis - Repeat PMISC. null 90 -
25079 Paracentesis Diagnosti MISC. null 175 3
25080 Paracentesis of Lymph MISC. null 175 -
25081 Paracentesis TherapeutMISC. null 220 9
25082 Perineal Care MISC. null 20 -
25083 Peripheral Insertion of MISC. null 300 -
25084 Pleural Diagnostic - PleMISC. null 300 -
25085 Pleural Therapeutic - PMISC. null 330 2
25086 Pleurodesis MISC. null 350 -
25087 Polypectomy Cervix MISC. null 90 5
25088 Polypectomy EndometMISC. null 90 -
25089 Polypectomy Vagina MISC. null 90 -
25090 Polypectomy Vulva MISC. null 90 -
25091 Repair of Superficial MISC. null 475 -
25092 Residual Urine Measu MISC. null 55 3
25093 Secondary suturing MISC. null 175 1
25094 Suture/Staple RemovalMISC. null 40 27
25095 Suturing MISC. null 175 -
25096 Suturing Intermediate MISC. null 240 -
25097 Toluidine Blue Test Vul MISC. null 55 -
25098 Tru Cut Biopsy MISC. null 250 27
25140 Cold coagulator for mi PROCEDURE null 65 -
25141 Cold coagulator for vagPROCEDURE null 175 -
25142 Cold coagulator for cerPROCEDURE null 175 -
Page 168 of 368

P. GYNAECOLOGIC ONCOLOGY
CERVIX LEVEL 1
Gynecologic
### Oncology Surgery
25340 Class 1/Type A Radical SURGERY MAJOR 6,481 -
CERVIX LEVEL 2
Gynecologic
25341 Class II /Type B Radic SURGERY MAJOR + 11,000 -
CERVIX LEVEL 3
Gynecologic
25342 Class II/Type B Radica SURGERY MAJOR + 16,600 1
25343 Class II/Type B Radica SURGERY MAJOR + 16,600 -
25344 Class III /Type C1 Rad SURGERY MAJOR + 16,600 -
25345 Class III/Type C1 Radi SURGERY MAJOR + 16,600 2
25346 Class III /Type C2 Rad SURGERY MAJOR + 16,600 -
25347 Class III/Type C2 Radi SURGERY MAJOR + 16,600 -
25348 Radical Trachelectomy SURGERY MAJOR + 16,600 -
25349 Radical TrachekectomySURGERY MAJOR + 16,600 -
25350 Vaginal Radical Gyster SURGERY MAJOR + 16,600 -
25351 Vaginal Radical Hyster SURGERY MAJOR + 16,600 -
25352 Vaginal Radical Hyste SURGERY MAJOR + 16,600 -
CERVIX LEVEL 4
Gynecologic
25353 Class IV/Type D Radica SURGERY MAJOR + 33,000 -
25354 Class V Radical Hyster SURGERY MAJOR + 33,000 -
25355 Class V Radical Hyste SURGERY MAJOR + 33,000 -
25356 Exenteration-Anterior SURGERY MAJOR + 21,000 -
Page 169 of 368

25357 Exenteration-Posterior SURGERY MAJOR + 21,000 -
25358 Exenteration-Total SURGERY MAJOR + 21,000 -
ENDOMETRIUM / BODY OF UTERUS LEVEL 1
Gynecologic
25262 TAH+BSO SURGERY MAJOR 6,600 16
25263 TAH+BSO+OmentectomSURGERY MAJOR 6,600 1
Gynecologic
25264 PLND+Cytoloy SURGERY MAJOR + 11,000 -
25265 PLND+Omentectomy+Cy SURGERY MAJOR + 11,000 1
25266 TAH+BSO+OmentectomSURGERY MAJOR + 11,000 1
25267 TAH+BSO+PLND+CytoloSURGERY MAJOR + 11,000 -
Gynecologic
25268 Omentectomy+PALND+C SURGERY MAJOR + 16,600 -
25269 TAH+BSO+OmentectomSURGERY MAJOR + 16,600 -
25270 TAH+BSO+PALND+CytolSURGERY MAJOR + 16,600 1
Gynecologic
25271 Omentectomy+RPLND+SURGERY MAJOR + 22,000 -
25272 RPLND+Cytology SURGERY MAJOR + 22,000 1
25273 TAH+BSO+OmentectomSURGERY MAJOR + 22,000 2
25274 TAH+BSO+RPLND+CytoSURGERY MAJOR + 22,000 4
HYSTEROSCOPY
Gynecologic
25392 Hysterescopy (DiagostiSURGERY MAJOR + 1,800 1
25393 Hysteroscopy + Polype SURGERY MAJOR + 3,900 2
Page 170 of 368

25394 Hysteroscopy and CureSURGERY MAJOR + 3,000 4
25395 Hysteroscopy directed SURGERY MAJOR + 3,000 -
25396 Hysteroscopy, EndometSURGERY MAJOR + 3,000 1
LAPAROSCOPY LEVEL 2
Gynecologic
25397 Laparoscopic AdhesiolySURGERY MAJOR + 7,600 1
25398 Laparoscopic Excision oSURGERY MAJOR + 13,000 -
25400 Laparoscopic Ovarian SURGERY MAJOR + 11,000 -
25401 Laparoscopic Salpinge SURGERY MAJOR + 9,000 -
25402 Laparoscopic Salpingo SURGERY MAJOR + 9,000 1
LAPAROSCOPY LEVEL 4
Gynecologic
25407 Laparoscopic Hysterec SURGERY MAJOR + 22,000 -
LAPAROSCOPY LEVEL 5
Gynecologic
25408 Laparosopic Hysterect SURGERY MAJOR + 22,000 -
25409 TLH + BSO + Oment + SURGERY MAJOR + 22,000 -
LAPAROSCOPY LEVEL3
Gynecologic
25403 Laparoscopic Total HysSURGERY MAJOR 12,000 -
25404 Laparoscopic Total Hy SURGERY MAJOR + 12,000 -
25405 Laparoscopic Total HysSURGERY MAJOR + 12,000 -
25406 LAVH+/-BSO/USO SURGERY MAJOR + 12,000 -
LAPRASCOPY LEVEL 1
Gynecologic
25440 Diagnostic laparoscopySURGERY MAJOR 2,600 1
OTHERS
Page 171 of 368

Gynecologic
25410 Intraoperative Consult SURGERY MAJOR + - -
25411 Laparoto,y + Biopsy SURGERY MAJOR + 3,300 1
25412 Laparotomy + Closure SURGERY MAJOR + 4,701 -
25413 Laparotomy + Colosto SURGERY MINOR + 1,800 1
25414 Other Laparotomy + PrSURGERY MAJOR + 18,140 1
25415 Perineal floor repair SURGERY MAJOR 3,700 -
25416 Posterior Colporraphy SURGERY MINOR 1,700 -
25417 Re-Laparotomy (referraSURGERY MAJOR + 15,300 -
25418 Repair of Complete W SURGERY MAJOR 2,000 -
25419 Repair of Superficial SURGERY MINOR 1,800 1
25421 Retroperitoneal LymphSURGERY MAJOR 10,000 -
25422 Retroperitoneal Tumour SURGERY MAJOR + 15,300 -
25423 Sacrocolpopexy with MSURGERY MAJOR 7,000 -
25424 Sacrospinous ColpopexSURGERY MAJOR 3,700 -
25425 Vaginal Hysterectomy SURGERY MAJOR 3,700 5
25426 Vaginal Hysterectomy wSURGERY MAJOR + 10,200 -
OVARY / TUBE LEVEL 1
Gynecologic
25275 Ovarian Cystectomy BilSURGERY MAJOR 4,300 -
25276 Ovarian Cystectomy UniSURGERY MAJOR 4,300 -
25277 Removal of T.O. Mass USURGERY MAJOR 4,300 1
25278 Removal of T.O. Mass BiSURGERY MAJOR 4,300 -
25279 Removal of Adnexa BilaSURGERY MAJOR 4,300 -
25280 Removal of Adnexa UnilSURGERY MAJOR 4,300 3
Gynecologic
Page 172 of 368

25281 Second Look Laparoto SURGERY MAJOR 6,600 -
25282 TAH+BSO+AppendectoSURGERY MAJOR 6,600 -
25283 TAH+BSO+Omentecto SURGERY MAJOR 6,600 3
Gynecologic
25284 Radical Oophrectomy TSURGERY MAJOR + 16,600 -
25285 Staging Laparotomy OvSURGERY MAJOR + 16,600 2
25286 TAH+Omentectomy+ApSURGERY MAJOR + 16,600 -
25290 TAH+Omentectomy+ApSURGERY MAJOR + 16,600 3
25291 TAH + Omentectomy + SURGERY MAJOR + 16,600 -
25292 TAH+Omentectomy+PLSURGERY MAJOR + 16,200 -
25293 TAH+Omentectomy+P SURGERY MAJOR + 16,600 -
25294 TAH+Omentectomy+R SURGERY MAJOR + 16,600 -
25295 TAH+Omentectomy+R SURGERY MAJOR + 16,600 5
25296 TAH+Omentectomy+R SURGERY MAJOR + 16,600 -
Gynecologic
25300 Ovarian Debulking+OmSURGERY MAJOR + 22,000 -
25301 Ovarian Debulking+O SURGERY MAJOR + 22,000 -
Page 173 of 368

25308 Ovarian+Debulking+O SURGERY MAJOR + 21,600 -
25310 Ovarian Debulking+O SURGERY MAJOR + 22,000 1
25315 Secondary CytoreductiSURGERY MAJOR + 22,000 1
Gynecologic
Page 174 of 368

P. GYNAECOLOGIC ONCOLOGY
Gynecologic
25200 Aspiration Biopsy in OTSURGERY MINOR + 1,800 -
25201 Aspiration Biopsy LA SURGERY MINOR 1,600 -
25202 Aspiration Cytology in SURGERY MINOR + 1,800 -
25203 Aspiration Cytology LA SURGERY MINOR 1,600 -
25204 Cone Biopsy in OT SURGERY MINOR + 2,000 3
25205 Cone Biopsy LA SURGERY MINOR + 1,800 -
25206 Cryosurgery for Cervix SURGERY MINOR + 1,800 -
25207 Cryosurgery for Cervix SURGERY MINOR 1,600 -
25208 Cryosurgery for vagina SURGERY MINOR + 1,800 -
25209 Crysurgery for Vagina SURGERY MINOR 1,600 -
25210 Crysurgery for Vulva inSURGERY MINOR + 1,800 -
25211 Cryosurgery for Vulva SURGERY MINOR 1,600 -
25212 Dilatation & Curettage SURGERY MINOR + 1,800 3
25213 Dilatation & Curettage SURGERY MINOR 1,600 1
Page 175 of 368

25214 Drainage of Pyometra SURGERY MINOR + 1,800 -
25215 Drainage of Pyometra SURGERY MINOR 1,600 -
25216 Drainage of Pyometra SURGERY MINOR + 1,800 -
25217 Drainage of Pyometra SURGERY MINOR 1,600 -
25218 Drainage of Vulvar AbsSURGERY MINOR + 1,800 1
25219 Drainage of Vulvar AbsSURGERY MINOR 1,600 -
25220 Drainage of Vulvar CystSURGERY MINOR + 1,800 -
25221 Drainage of Vulvar CystSURGERY MINOR 1,600 -
25222 EUA + Dilatation and C SURGERY MINOR + 1,800 1
25223 EUA + Dilatation and C SURGERY MINOR + 1,800 -
25226 EUA + Biopsy Cervix SURGERY MINOR 1,700 1
25227 EUA + biopsy EndometSURGERY MINOR 1,700 -
25228 EUA + Biopsy Vagina SURGERY MINOR 1,700 -
25229 EUA + Biopsy Vulva SURGERY MINOR 1,700 1
25230 EUA +Colposcopy+ CervSURGERY MINOR + 1,800 -
25231 EUA + Dilatation and C SURGERY MINOR + 1,900 1
25232 EUA + Fractional Urett SURGERY MINOR + 1,800 2
25233 EUA +Fractional + CureSURGERY MINOR + 1,800 -
25234 EUA+Fractional Curett SURGERY MINOR + 1,800 -
25235 EUA + Fractional Curet SURGERY MINOR + 1,800 1
25236 EUA + Fractional Cure SURGERY MINOR + 1,800 -
25237 Evacuation of vesicula SURGERY MINOR + 1,800 -
25238 Examination under AnaSURGERY MINOR 1,700 3
25239 Excision of Cervical LesSURGERY MAJOR 2,800 -
25240 Excision of Cervical LesSURGERY MINOR 1,600 -
Page 176 of 368

25241 Excision of Vaginal Les SURGERY MAJOR 2,800 -
25242 Excision of Vaginal Les SURGERY MINOR 1,600 -
25243 Excision of Vulvar lesioSURGERY MINOR + 1,700 3
25244 Excision of Vulvar lesioSURGERY MINOR 1,600 -
25245 Fractional Curettage SURGERY MINOR + 1,800 -
25246 Fractional Curettage LASURGERY MINOR 1,600 -
25247 Insertion of Peritionea SURGERY MINOR + 1,900 -
25248 Insertion of Peritoneal SURGERY MINOR 1,600 -
25249 Insertion of Chemo-PorSURGERY MINOR + 1,900 -
25250 Insertion of Chemo-PorSURGERY MINOR + 1,800 -
25251 Insertion of Mirena CoiSURGERY MINOR + 1,900 -
25252 Insertion of Mirena CoiSURGERY MINOR 1,600 -
25253 LLETZ SURGERY MINOR + 1,800 -
25254 LLETZ LA SURGERY MINOR 1,600 -
25255 Peripheral Insertion of SURGERY MINOR 1,600 -
25256 Polypectomy Cervix SURGERY MINOR + 1,800 -
25257 Polypectomy Cervix LASURGERY MINOR 1,600 -
25258 Polypectomy EndometSURGERY MINOR + 1,800 -
25259 Polypectomy EndometrSURGERY MINOR 1,600 -
25260 Removal of Superficial SURGERY MAJOR 2,800 -
25261 RemovalOfSuperficialCySURGERY MINOR 1,600 -
GENERAL
Gynecologic
25427 Enseal SURGERY MAJOR - -
25428 Basic Microscope per SURGERY MAJOR - -
25429 Advanced Microscopr pSURGERY MAJOR 400 -
25430 Laproscope per hour SURGERY MAJOR 700 -
Page 177 of 368

25431 Bilatereal (50% of ProcSURGERY MAJOR - 1
25432 Extra hours taken for aSURGERY MAJOR - -
VAGINA LEVEL 3
Gynecologic
25369 TAH+BSO+Omentectomy SURGERY MAJOR + 22,000 -
25370 TAH + BSO + OmentectSURGERY MAJOR 22,000 -
25371 TAH + BSO + OmentectSURGERY MAJOR + 22,000 -
25373 TAH + BSO + Omentecto SURGERY MAJOR 22,000 -
25375 TAH + BSO + PALND + TSURGERY MAJOR + 22,000 -
25376 TAH + BSO + PLND + ToSURGERY MAJOR + 22,000 -
25377 TAH + BSO + RPLND + TSURGERY MAJOR + 22,000 -
25378 Total Vaginectomy SURGERY MAJOR + 22,000 -
25379 Total Vaginectomy + P SURGERY MAJOR + 22,000 -
25380 Total Vaginectomy + P SURGERY MAJOR + 22,000 -
25381 Total Vaginectomy + R SURGERY MAJOR + 22,000 -
VAGINA LEVEL 4
Gynecologic
25382 Total Vaginectomy + SURGERY MAJOR + 22,000 -
Page 178 of 368

VULVA LEVEL 1
Gynecologic
25359 Hemovulvectomy SURGERY MAJOR + 4,300 -
25360 Skinning Vulvectomy SURGERY MAJOR 4,300 1
25361 Vulvectomy Simple SURGERY MAJOR 4,300 -
VULVA LEVEL 2
Gynecologic
25362 Unilateral Extraperion SURGERY MAJOR 6,600 -
25363 Unilateral Inguino-FemSURGERY MAJOR 6,600 -
25364 Vulvectomy Radical SURGERY MAJOR 6,600 2
VULVA LEVEL 3
Gynecologic
25365 Bilateral Extraperiton SURGERY MAJOR + 19,000 -
25366 Bilateral Inguino-FemorSURGERY MAJOR + 19,000 1
25434 Radical wide excision oSURGERY MAJOR 19,000 -
25435 Radical wide excision ofSURGERY MAJOR 19,000 -
VULVA LEVEL 4
Gynecologic
25367 Unilateral Inguino-FemoSURGERY MAJOR + 22,000 -
25436 Radical Vulvectomy + biSURGERY MAJOR 22,000 -
25437 Radical Vulvectomy + uSURGERY MAJOR 22,000 -
VULVA LEVEL 5
Gynecologic
25368 Vulvectomy Radical +BiSURGERY MAJOR 33,000 -
Page 179 of 368

Gynecologic
25433 Dvt Phlebo Press SURGERY MINOR + 50 71

Date Date Date
Page 180 of 368

Neuro surgery
Neuro surgery
Printed in SOC's
G. NEURO SURGERY ICU PACKAGE PER DAY
NeICU
Neuro
### Surgry ICU - NICU
176 NICU without RespiraMISC. null 1,800 84
177 NICU with Respirator MISC. null 4,000 36
178 NICU with Respirator MISC. null 2,000 -
12. NEUROSURGERY
Neuro
1200 Biopsy Nerve MISC. null 550 -
1201 Abscess Tapping MISC. null 835 -
1202 Burrhole CraniostomyMISC. null 715 -
1206 LP drainage and Pres MISC. null 650 -
1210 Skull Traction ApplicaMISC. null 500 -
1211 Scalp Repair MISC. null 350 -
1212 Subdural Tapping MISC. null 1,000 -
1213 Tracheostomy MISC. null 500 -
1214 Twist Drill CraniostomMISC. null 1,870 -
1215 Urokinase Therapy foMISC. null 1,065 -
1216 Ventricular Tap - DiagMISC. null 890 -
1222 Rhizotomy (Single LevMISC. null 600 -
1229 Brain Biopsy / Localis MISC. null 2,500 -
1231 Nerve Block MISC. null 500 -
Page 181 of 368

Neuro surgery
1235 Neurogenic Pain Ma MISC. null 1,500 -
1236 Ventricular Tap - TherMISC. null 1,485 6
1240 C T Guided ProcedureMISC. null 1,000 1
1241 CT Guided Procedure MISC. null 2,000 -
1242 Scalp Abscess/ Scalp lMISC. null 2,080 -
1243 CSF Drainage System MISC. null 700 1
1244 Medi.Documentation-Cl MISC. null 600 1
1245 Diagnostic L P MISC. null 500 -
1249 Hematoma EvacuatioPROCEDUREnull 1,780 -
1250 Head Injury MonitorinPROCEDUREnull 1,500 -
I. NEURO SURGERY
NEURO SURGERY
Neurosurgery
###
8091 Burrhole (Diagnostic)SURGERY MINOR 4,000 -
8092 Burrhole (TherapeuticSURGERY MINOR 6,500 -
8222 Exploratory Burrhole SURGERY MINOR 10,000 -
8229 Intracranial Catheter SURGERY MINOR 8,000 1
BASE OF THE SKULL SURGERY
Neurosurgery
###
8053 Base of skull proceduSURGERY MAJOR 35,000 -
8125 Carotid end arterect SURGERY MAJOR 18,000 -
8126 STMC Anastomosis SURGERY MAJOR 25,000 -
CRANIAL SURGERY - INTERMEDIATE
Neurosurgery
###
8050 Microsurgical Cranial SURGERY MINOR + 17,000 3
8075 Microsurgical Cranial SURGERY MINOR + 16,500 -
Page 182 of 368

Neuro surgery
8098 Surface tumors SURGERY MINOR + 12,000 3
8099 Extradural/ Bony dec SURGERY MINOR + 10,000 2
8101 Re-exploration ( Sam SURGERY MINOR + 8,000 4
CRANIAL SURGERY - SPECIALISED
Neurosurgery
###
8052 Head Injury (ComplexSURGERY MAJOR 25,000 14
8112 Percutaenous VertebrSURGERY MAJOR 7,600 1
8115 Head Injury - IntermeSURGERY MAJOR 11,000 1
8116 Head Injury - Major SURGERY MAJOR 20,000 5
8120 Endoscopic Surgery (DSURGERY MINOR + 11,000 1
8121 Endoscopic Surgery ( SURGERY MAJOR 15,000 -
8156 Head injury - duropl SURGERY MAJOR + 15,000 -
8237 Head Injury with Ha SURGERY MAJOR 35,000 7
CRANIAL SURGERY- MAJOR
Neurosurgery
###
8077 Deep brain tumor-Co SURGERY MAJOR 21,000 18
8078 Brain Tumors (endoscSURGERY MAJOR 25,000 1
8103 Sub-occipital craniec SURGERY MAJOR 13,000 2
8104 Haematoma evaculatSURGERY MAJOR 13,000 3
8157 Deep brain tumor- min SURGERY MAJOR + 18,000 3
8216 Complex Cranial (micrSURGERY MAJOR 33,000 10
CRANIAL SURGERY- MINOR
Neurosurgery
###
8062 Crainotomy/MIS(UndeSURGERY MINOR 15,000 1
8095 Scalp rotation flap SURGERY MINOR + 5,500 4
8100 Cranioplasty SURGERY MINOR + 7,500 3
8204 Mini Craniotomy SURGERY MINOR 16,000 4
Page 183 of 368

Neuro surgery
8219 Cranial ReconstructioSURGERY MINOR 16,000 3
8236 Cranioplasty (complexSURGERY MAJOR 9,500 13
OTHER NEUROSURGERIES
Neurosurgery
###
8149 Minimal invasive pro SURGERY MAJOR 13,000 2
8150 Transoral surgery SURGERY MAJOR + 16,000 -
8152 Total Vertebroplasty SURGERY MAJOR + 20,000 -
8155 Nerve Entrapment relSURGERY MINOR + 7,600 -
8158 Vertebroplasty(SingleSURGERY MINOR 2,600 1
8159 Peripheral nerve surgSURGERY MINOR + 12,000 -
8164 Intra-op doppler SURGERY MINOR 2,200 -
8191 Spinal extra dural tu SURGERY MAJOR 12,500 2
8198 Cranio Cervical (soft SURGERY MINOR 10,000 1
8200 CSF diversion proced SURGERY MINOR 17,000 2
8206 Surgery for Epilepsy - SURGERY MAJOR 4,300 -
8207 Surgery for Epilepsy dSURGERY MAJOR 8,700 -
8210 Cranial synangosis / SURGERY MAJOR 14,000 -
8212 Microsurgical cranial SURGERY MAJOR 28,000 19
8213 Microsurgical spinal SURGERY MAJOR 30,000 32
8214 Cranial Surgery for st SURGERY MAJOR 25,000 17
8215 Endoscopic ventricul SURGERY MAJOR 21,000 -
8225 DSA Guided InterventiSURGERY MINOR 14,000 -
8226 DSA Guided InterventSURGERY MAJOR 16,000 1
8227 Surgery for Neuro DevSURGERY MINOR 20,000 -
8232 Epilepsy Surgery (imaSURGERY MAJOR 20,000 -
Page 184 of 368

Neuro surgery
8233 Epilepsy Surgery withSURGERY MAJOR 30,000 -
8234 Hemispheretomy SURGERY MINOR 20,000 -
8235 Lobectomy SURGERY MINOR 10,000 -
8240 Decompressive CraniaSURGERY MAJOR 20,000 5
8241 Peripheral Nerve Sur SURGERY MAJOR 15,000 -
PROCEDURES DONE UNDER L.A
Neurosurgery
###
8058 Crainotomy/MIS SURGERY MINOR 16,000 -
8059 Biopsy - NeurosurgerySURGERY MINOR 4,500 1
8060 Stereotactic ProcedurSURGERY MINOR 20,000 -
8063 Stereotactic ProcedurSURGERY MINOR 14,000 -
8083 External Venticular D SURGERY MINOR 5,500 1
8084 Urokinase Instillation SURGERY MINOR 6,000 -
8085 Stereotactic LocaliserSURGERY MINOR 9,000 -
8086 Nerve Block (Simple) SURGERY MINOR 3,000 -
8087 Twist Drill SURGERY MINOR 3,000 -
8088 Neurolysis SURGERY MINOR 6,500 3
8165 Vertebroplasty ( each SURGERY MINOR 2,500 -
8166 Rhizotomy ( each leveSURGERY MINOR 2,000 1
8167 Epidural Procedure SURGERY MINOR 2,000 -
8168 Nerve Block SURGERY MINOR 1,800 -
8170 Wound repair SURGERY MINOR 1,800 3
8172 Ventricular drianage SURGERY MINOR 2,000 -
8173 Percutaneous Image gSURGERY MINOR + 4,000 -
8174 Haematoma DrainageSURGERY MINOR + 8,000 -
8176 Scalp Tumor - Small SURGERY MINOR + 4,500 -
8178 Cerebral angiography(SURGERY MINOR + 4,200 -
Page 185 of 368

Neuro surgery
8179 4 vessel Angio SURGERY MINOR + 7,500 -
8180 Implants SURGERY MAJOR - -
8192 Percutaenous VertebrSURGERY MINOR + 6,000 -
8193 Trefine Craniotomy SURGERY MAJOR 7,000 -
8194 Minimal invasive pro SURGERY MAJOR 12,000 -
8199 Monitoring during anaSURGERY MAJOR 200 -
8203 Mini Craniotomy undeSURGERY MINOR 18,000 -
8223 Exploratory Burrhole SURGERY MAJOR 8,000 -
8228 Surgery for Neuro DevSURGERY MINOR 15,000 -
8230 Intracranial Catheter SURGERY MINOR 6,000 -
8231 ICP Monitoring SURGERY MINOR 4,000 -
8242 Scalp Tumor - Large SURGERY MAJOR 9,000 2
8243 Incission & Drainage SURGERY MAJOR 1,000 -
GENERAL
Neurosurgery
###
8184 Bilateral (50% of ProcSURGERY MAJOR - 1
8185 Extra Hours taken for SURGERY MAJOR - -
8186 Extra hours for MinorSURGERY MAJOR - -
8187 Extra hours for minor SURGERY MAJOR - -
18008 Microscope ( 0 to 2 HSURGERY MAJOR 1,000 -
18009 Microscope ( 2 to 3 HSURGERY MAJOR 1,500 2
18010 Microscope ( 3 to 5 HSURGERY MAJOR 2,000 1
18011 Microscope (more thaSURGERY MAJOR 3,000 -
18073 Basic Microscope perMISC. null 400 -
18074 Advanced MicroscopeMISC. null 800 -
Page 186 of 368

Neuro surgery
SHUNTS
Neurosurgery
###
8054 Shunt assisted with g SURGERY MINOR 15,000 4
8127 Ventriculo peritoneal SURGERY MINOR + 8,000 3
8128 Lumbo- Peritoneal SURGERY MINOR + 10,000 1
8130 Revision SURGERY MINOR 5,000 3
8238 Microsurgical InfratenSURGERY MAJOR 18,000 -
8239 Newer device/ ImporSURGERY MAJOR 20,000 -
SPINAL SURGERY - INTERMEDIATE
Neurosurgery
###
8079 Micro Surgical Spinal SURGERY MINOR + 16,500 3
8138 Instrumentation ( SimSURGERY MINOR + 10,000 1
8139 Re-exploration(same SURGERY MINOR + 9,000 1
8140 Spinal Dysraphism SURGERY MINOR + 12,500 1
8220 Microlumbar Disectom SURGERY MINOR + 10,000 1
8221 Microsurgical LamineSURGERY MINOR 13,500 -
SPINAL SURGERY - MAJOR
Neurosurgery
###
8056 Microsurgical Disc Su SURGERY MAJOR 12,000 2
8061 Micro lumbar Disect SURGERY MAJOR 22,500 15
8081 Complex spinal surgeSURGERY MAJOR 18,000 24
8144 Instrumentation ( Co SURGERY MAJOR 13,000 22
8161 Instrumentation withSURGERY MAJOR + 17,000 30
8201 Spinal fusion SURGERY MINOR 22,000 9
8217 Complex Spinal FusioSURGERY MAJOR 26,000 12
SPINAL SURGERY - MINOR
Page 187 of 368

Neuro surgery
Neurosurgery
###
8134 Explantation SURGERY MINOR 5,500 2
8143 Micro lumbar DisectoSURGERY MAJOR 9,000 4
8147 Laminectomy Simple SURGERY MAJOR 8,300 -
Neurosurgery
#N/A
#N/A
#N/A
Neurosurgery
###
8055 Instrumentation (ImaSURGERY MAJOR 18,000 -
8057 Spinal Fenestration SURGERY MINOR + 9,000 -
8080 Percutaneous Spinal SURGERY MINOR + 15,000 -
8082 Endoscopic DiscectomSURGERY MAJOR 16,000 -
8118 Optic Nerve DecomprSURGERY MAJOR 11,600 -
8202 Spinal stabilization SURGERY MINOR + 26,200 -
8205 Cranial Procedure SURGERY MAJOR 30,000 -
8218 Complex Spinal withoSURGERY MINOR 18,000 -
8224 DSA Guided InterventiSURGERY MINOR 12,000 -
18072 Harmonic Scalpel MISC. null 2,000 -
18075 Laparoscope per hourMISC. null 700 -
Neuro
1205 Intrathecal MedicatioMISC. null 715 1
1225 Cerebral Flow MonitorMISC. null 1,190 -
1226 Cerebral Flow MonitorMISC. null 1,780 -
1230 Discography MISC. null 1,190 -
Page 188 of 368

Neuro surgery
1232 Epidural Block / Proc MISC. null 1,190 8
1239 Embolic Detection / MISC. null 5,940 -
1246 Repeat Same AdmissiMISC. null 600 -
1247 Repeat Same AdmissiMISC. null 890 -
Evening
1201 Abscess tapping -E MISC. null 1,500 -
1202 Burrhole CraniostomyMISC. null 1,290 -
1211 Scalp Repair -E MISC. null 715 -
1212 Subdural Tapping -E MISC. null 1,800 -
1214 Twist Drill CraniostomMISC. null 3,370 -
1215 Urokinase Therapy forMISC. null 1,920 -
1216 Ventricular Tap - DiagMISC. null 1,600 -
1222 Rhizotomy (Single LeveMISC. null 1,080 -

Date Date Date
Page 189 of 368

Obstetrics &Gynaecology
Servic
e Common ward Sum of units from Any request for Rate
Ch Code ChargeDesc ServiceDesc Catag ServCat Remarks
ory
Printed in SOC's
14. OBSTETRICS & GYNAECOLOGY
Obsteric
### & Gynaecology Procedure
1501 Antenatal Cards MISC. null 20 2,098
1502 Antinatal Urine Tescting for Revi MISC. null 30 2,075
1505 Biopsy Cervix MISC. null 175 3
1506 Cauterization Cervix MISC. null 175 1
1507 Cervix Cytology (Papsmear) - Se MISC. null 40 1,436
1508 Cervix Mucus Study MISC. null 55 -
1510 Colposcopy MISC. null 120 2
1511 Colposcopy and Cervix Biopsy MISC. null 175 4
1512 Colposcopy and Pap Smear MISC. null 150 -
1514 Cryosurgery for Cervix MISC. null 175 -
1517 Dilation and Evacuation MISC. null 475 172
1518 Endometrial Biopsy MISC. null 120 149
1519 Encirclage MISC. null 300 2
1520 Family Welfare - OM Kit MISC. null 20 -
1522 Foetal Monitoring - NST MISC. null 250 205
1523 Intrapartum Fetal Monitoring MISC. null 350 -
1527 Hysterosalpingogram MISC. null 175 2
1528 Incision & Drainage MISC. null 240 1
1531 Loop Removal MISC. null 40 -
1534 Perineal Care MISC. null 20 5,496
1535 Polypectomy Cervix MISC. null 300 1
1536 Secondary Suturing (OPD / War MISC. null 175 -
Page 190 of 368

Servic
ory
1537 Suture Removal MISC. null 40 16

1539 Use of Doppler - Check.FHS MISC. null 90 -
1541 Vaginal Cytology - Hormonal MISC. null 50 1
1543 Monitoring of High Risk PregnanMISC. null 350 1
1544 IV Tocolysis MISC. null 120 -
1545 Serial NST for High Risk Pregna MISC. null 600 1,994
1547 HPV DNA Test MISC. null 1,485 -
1561 Biopsy - Vaginal MISC. null 175 -
1562 Biopsy - Vulval MISC. null 175 -
1567 Endometrial Polypectomy MISC. null 155 -
1568 Excision of Vulval Lesions MISC. null 120 -
1569 Excision of Vaginal Lesions MISC. null 120 6
1570 Fractional Curettage MISC. null 540 -
1575 Repair of Superficial Dehiscenc MISC. null 475 2
1577 Suturing - Intermediate (OPD / MISC. null 240 -
1581 Family Welfare & Lactation CounMISC. null 120 989
1585 Miscellaneous ( Family Welfare MISC. null - 10
1586 Mirena Coil Insertion MISC. null 600 20
1588 Abd. Ultrasound - Repeat(Withi MISC. null 280 -
1589 Obstetric Ultrasound-Anomaly MISC. null 550 -
1590 Obstetric Biophysical Profile MISC. null 830 -
1591 Abdominal Ultrasound MISC. null 550 -
1592 Transvaginal Ultrasound Single MISC. null 110 -
1593 AFI / HR (Single Parameter/pres MISC. null 110 5
1594 Pelvic Ultrasound (Trans-vaginal MISC. null 440 -
1595 Pelvic Ultrasound (Trans-abdomiMISC. null 440 -
1596 Serial Scan Follicular Monitorin MISC. null 750 -
Page 191 of 368

Servic
ory
1597 Additional Scan for Follicular M MISC. null 170 -

14.1 OBG DELIVERY CHARGES
Obsteric
1602 Axis Traction Forceps MISC. null 3,000 -
1603 Breech Delivery MISC. null 3,000 -
1604 Breech Extraction MISC. null 3,000 1
1608 Low Mid-cavity Forceps Delivery MISC. null 3,000 11
1609 Normal Delivery MISC. null 2,000 106
1610 Normal Delivery with EpisiotomyMISC. null 2,000 945
1611 Outlet Forceps Delivery MISC. null 3,000 14
1612 Twin Delivery MISC. null 3,000 3
1613 Vaccum Extraction Delivery MISC. null 3,000 1
1614 Induction / Acceleration with R MISC. null 3,000 18
1615 Induction / Acceleration with Fo MISC. null 3,000 9
1617 Induction/ Twin Delivery MISC. null 1,800 -
1618 Forceps / Vaccum Extraction Del MISC. null 1,800 -
D. GYNAECOLOGY
D. GYNAECOLOGY
Obstetrics
### & Gynaecol
6601 Abdominal Hysterectomy RGERY MAJOR 8,000 33
6602 Abdominal Myomectomy RGERY MAJOR + 7,600 11
6604 Abdominal Sacro Colpopoexy RGERY MINOR + 9,000 1
6605 Cervical Biopsy & Biopsies from RGERY MINOR + 1,800 1
6606 Dilatation & Curettage RGERY MINOR + 1,800 2
6607 Dilatation & Evacuation - in O.T. RGERY MINOR + 1,900 6
6609 Hysteroscopy (Diagnostic) RGERY MINOR + 1,900 42
6610 Infertility - Laparoscopy RGERY MAJOR 4,700 -
Page 192 of 368

Servic
ory
6611 Laparotomy RGERY MAJOR + 5,300 36

6612 Laproscopy (Diagnostic) - Pelvic RGERY MAJOR 2,600 14
6613 Infertility- Laparoscopy with c RGERY MAJOR 2,700 4
6614 Ovarian Cystectomy RGERY MAJOR 4,600 20
6615 Antero Colporraphy RGERY MAJOR 3,600 2
6616 Polypectomy RGERY MINOR + 1,800 2
6617 Removal of T.O. Mass RGERY MAJOR + 5,600 -
6618 Sling Operation RGERY MAJOR + 7,000 -
6620 Tuboplasty RGERY MAJOR + 8,000 2
6621 Tumour Removal Superficial CystRGERY MAJOR 3,000 -
6622 Vaginal Hysterectomy RGERY MAJOR 8,000 15
6624 Vagino Plasty RGERY MAJOR + 10,000 2
6627 V.V.F/R.V.F. Repair RGERY MAJOR + 5,700 -
6628 Laparoscopic aasi.Vaginal Hypt RGERY MAJOR + 12,000 13
6629 Laparoscopic Myomectomy RGERY MAJOR + 13,700 -
6630 Laparoscopic Ovarian Cystecto RGERY MAJOR + 11,800 39
6631 Laparascopic Adhesiolysis RGERY MAJOR 8,200 -
6632 Laparoscopic Salpingect. SalpingRGERY MAJOR + 10,000 7
6633 Hysteroscopic Adhesiolysis RGERY MAJOR 4,600 -
6634 Hysteroscopic Myomectomy RGERY MAJOR + 5,900 -
6635 Hysteroscopic Polypectomy RGERY MAJOR 4,200 3
6636 Hysteroscopy directed Biopsies RGERY MAJOR 3,600 -
6637 Hysteroscopic Endometrial AblaRGERY MAJOR + 5,300 -
6638 Laproscopic Salpingostomy RGERY MAJOR + 10,000 1
6639 Laproscopic Gonadectomy RGERY MAJOR + 13,600 -
6640 Laproscopic treatment of endomRGERY MAJOR + 13,600 -
6641 Laproscopic Ovarian drilling RGERY MAJOR + 4,700 -
6642 Perineal floor repair RGERY MAJOR 5,700 1
Page 193 of 368

Servic
ory
6643 Sacrospinous Colpopeny RGERY MAJOR 5,700 -

6644 Resuturing RGERY MAJOR 2,200 5
6645 Examination under AnaesthesiaRGERY MINOR 1,700 12
6646 EUA + Fractional curetage RGERY MINOR + 1,900 -
6647 EUA + polypectomy + D & C RGERY MINOR + 2,000 1
6648 EUA + D & C RGERY MINOR + 1,800 12
6649 Cone Biopsy RGERY MINOR + 2,200 4
6650 Excisions of Vaginal lesions RGERY MAJOR 3,000 2
6651 Excisions of Vulval lesions RGERY MINOR + 1,800 6
6654 Suturing Intermediate RGERY MINOR + 2,000 4
6656 Laparotomy & Biopsy RGERY MAJOR 6,700 3
6659 Re-Laparotomy (referrals from oRGERY MAJOR + 11,000 1
6660 Adnexal mass unilateral RGERY MAJOR 4,600 -
6661 Adnexal mass bilateral RGERY MAJOR 6,600 -
6687 Laparoscopic salpingo oophere RGERY MAJOR + 10,000 1
6688 EUA + Colposcopy + Cervical bioRGERY MINOR + 2,000 -
6690 Evacuation of vesicular mole RGERY MINOR + 1,900 2
6693 Diagnostic hystero laparoscopy RGERY MAJOR + 6,000 -
6695 Vaginal Hysterectomy with PelvicRGERY MAJOR + 10,000 4
6710 Sacrocolpopexy with Mesh repaRGERY MAJOR 9,000 -
6723 TAH+BSO RGERY MAJOR + 8,000 75
6724 TAH+USO RGERY MAJOR + 7,500 6
6725 Vaginal hysterectomy+USO RGERY MAJOR + 8,500 -
6729 Posterior Colporraphy RGERY MINOR 1,800 1
6731 Partial Omentectomy RGERY MAJOR 3,000 -
6735 TAH + BSO + Appendicectomy RGERY MAJOR 12,600 1
6736 Cervical Biopsy & Biopsies from RGERY MAJOR 1,800 -
6740 Total Laproscopic Hystrectomy RGERY MAJOR 13,000 6
Page 194 of 368

Servic
ory
GENERAL
Obstetrics
### & Gynaecol
6700 Extra Hours taken for a surgery RGERY MAJOR + - -
18064 Harmonic Scalpel RGERY MAJOR 2,000 66
18067 Laparoscope per hour RGERY MAJOR 700 -
E. OBSTETRICS
E. OBSTETRICS
Obstetrics
### & Gynaecol
6701 Caesarean Hysterectomy RGERY MAJOR + 9,000 1
6702 Caesarean Section RGERY MAJOR + 6,000 783
6703 Cervical Encirlage RGERY MAJOR 1,800 13
6705 Leprotomy for Ectopic CestationRGERY MAJOR + 5,700 27
6706 Manual Removal of Placenta RGERY MAJOR + 2,600 2
6743 Internal Podalic Version & BreecRGERY MAJOR - -
GENERAL
Obstetrics
### & Gynaecol
6792 Extra hours for Minor surgery (ARGERY MAJOR - -
6793 Extra hours for minor + surgery RGERY MAJOR - -
6794 Extra hours for major surgery (CRGERY MAJOR - -
6795 Extra hours for major + surgery RGERY MAJOR - -
6799 Bilateral (50% of Proce./SurgeryRGERY MAJOR - -
6800 Extra Hours taken for a surgery RGERY MAJOR - -
14. OBSTETRICS & GYNAECOLOGY
Page 195 of 368

Servic
ory
Obsteric
1599 Bougie Induction EDURE null 400 13
1600 Baby Care EDURE null 50 -
1601 Accelerated Labour EDURE null 300 45
1606 Induced Labour EDURE null 400 456
Obstetrics
### & Gynaecol
6603 Abdominal Radical HysterectomRGERY MAJOR + 11,600 -
6608 Fractional Curettage RGERY MINOR + 1,902 -
6626 Vulvectomy Simple RGERY MAJOR 4,300 -
6652 Repair of Superficial Wound De RGERY MINOR + 1,800 -
6653 Suturing Minor RGERY MINOR 1,700 -
6657 Laparotomy & Partial omentect RGERY MAJOR 5,602 -
6658 Other Laparotomy + ProceduresRGERY MAJOR + 19,600 -
6662 Laparotomy & colostomy RGERY MAJOR 6,802 -
6663 Class I Radical Hysterectomy RGERY MAJOR + 5,002 -
6664 Class II Radical Hysterectomy + RGERY MAJOR + 11,000 -
6665 Class II Radical Hysterectomy + RGERY MAJOR + 16,000 -
6677 Pelvic Lymphnode Dissection RGERY MAJOR + 11,000 -
6678 Simple vulvectomy + Groin disseRGERY MAJOR + 19,600 -
6682 Total abdominal hysterectomy RGERY MAJOR + 11,000 -
6683 Total abdominal hysterectomy RGERY MAJOR + 17,000 -
6684 Abdominal hysterectomy+parti RGERY MAJOR + 11,800 -
6685 Abdominal hysterectomy+parti RGERY MAJOR + 17,000 -
6689 Laparoscopic excision of T.O maRGERY MAJOR + 13,700 -
6691 Operative Laparoscopy RGERY MAJOR + 18,000 -
6692 Operative Hysteroscopy RGERY MAJOR + 10,000 -
6694 Vaginal surgery RGERY MAJOR + 17,000 -
6699 Bilateral (50% of Proce./SurgeryRGERY MAJOR - -
Page 196 of 368

Servic
ory
6721 Ovarian tumour debulking + o RGERY MAJOR + 13,000 -

6726 Abd.Hysterectomy+Omentecto RGERY MAJOR + 12,600 -
6730 Total Vaginectomy RGERY MAJOR 9,000 -
6732 Appendicetomy RGERY MAJOR 6,000 -
6733 Laparotomy + Appendecetomy RGERY MAJOR 5,002 -
6734 Laparotomy+Biopsy+Appendic RGERY MAJOR 5,000 -
18065 Basic Microscope per hour RGERY MAJOR 400 -
18066 Advanced Microscope per hour RGERY MAJOR 800 -
18068 Harmonic Scalpel RGERY MAJOR 2,000 -
18069 Microscope per hour RGERY MAJOR 400 -
18070 Neurosurgical Microscope per hRGERY MAJOR 800 -
18071 Laparoscope per hour RGERY MAJOR 700 -
Obsteric
1503 Aspiration Biopsy MISC. null 175 1
1504 Aspiration for Postcoital Test MISC. null 55 1
1509 Chromotubation - Direct MISC. null 240 1
1515 Cryo Surgery for Minor Procedu MISC. null 65 -
1516 Culdocentesis MISC. null 175 -
1521 Foetal Monitoring - CST MISC. null 175 -
1532 Management of Post Partum MISC. null 300 -
1533 Non Stress Test (NST) MISC. null 250 4,580
1542 Laminaria Tent Insertion MISC. null 55 1
1546 LLETZ MISC. null - -
1563 Chemotherapy Planning ChargesMISC. null 350 -
1564 Chemotherapy Administration C MISC. null 420 -
Page 197 of 368

Servic
ory
1571 Paracentesis - Abdominal MISC. null 175 -

1572 Paracentesis - Repeat AbdominaMISC. null 90 -
1573 Paracentesis - Pleural MISC. null 300 -
1574 Paracentesis - Repeat Pleural MISC. null 90 -
1576 Suturing - Minor (OPD /Ward) MISC. null 175 -
1579 Aspiration of Lympocele MISC. null 175 -
1582 Chemotherapy Administration ChMISC. null 240 1
1583 Chemotherapy Administration ChMISC. null 350 -
1584 Chemotherapy administration c MISC. null 475 -
1605 Destructive Operation on Dead MISC. null 1,700 6
1607 Keillands Forceps Delivery MISC. null 1,800 -
1616 Induction / Acceleration c vaccu MISC. null 835 -
1619 Etonox Analgesia for Pain MISC. null 800 7
1620 Artificial Rupture in Membrane MISC. null 250 45
Evening
1505 Biopsy Cervix -E MISC. null 320 -
1506 Cauterization Cervix -E MISC. null 320 -
1507 Cervix Cytology (Papsmear) -E MISC. null 70 5
1510 Colposcopy -E MISC. null 220 -
1511 Colposcopy and Cervix Biopsy -E MISC. null 320 -
1512 Colposcopy and Pap Smear -E MISC. null 370 -
1514 Cryosurgery for Cervix -E MISC. null 320 -
1517 Dilation and Evacuation -E MISC. null 860 -
1518 Endometrial Biopsy -E MISC. null 860 -
1522 Foetal Monitoring - N S T -E MISC. null 450 -
1527 Hysterosalpingogram -E MISC. null 320 -
1528 I and D -E MISC. null 430 -
1536 Secondary Suturing -E MISC. null 320 -
Page 198 of 368

Servic
ory
1541 Vaginal Cytology-Hormonal -E MISC. null 90 -

1602 Axis Traction Forceps EDURE null 5,400 -
1603 Breech Delivery EDURE null 5,400 -
1604 Breech Extraction EDURE null 5,400 -
1605 Destructive Operation on Dead EDURE null 4,000 -
1608 Low Mid-cavity Forceps DeliveryEDURE null 4,200 -
1609 Normal Delivery EDURE null 4,700 -
1610 Normal Delivery With EpisiotomEDURE null 4,700 -
1611 Outlet Forceps Delivery EDURE null 4,200 -
1612 Twin Delivery EDURE null 4,200 -
1613 Vaccum Extraction Delivery EDURE null 4,200 -
1614 Induction / Acceleration with R MISC. null 4,700 2
1615 Induction / Acceleration with R EDURE null 4,200 -
1617 Induction/Twin Delivery EDURE null 4,200 -
1618 Forceps/Vaccum extraction DeliEDURE null 4,200 -
Grand Total 850,885 22,604

Date Date Date
Page 199 of 368

Orthopaedics
Servi
ce Common Sum of units from Any request for
Ch Code ChargeDesc ServiceDesc CataServCat ward Rate Remarks
gory
Orthopaedics
Printed in SOC's
8.2. UoH - ORTHOPAEDICS
Unit
23625 Aspiration MISC.null 210 -
23626 Crepe Bandage Service Charges MISC.null 50 -
23627 Strapping (Chest) MISC.null 50 -
23628 Dressing Service Charges - Small MISC.null 60 2
23629 Dressing Service Charges - Medium MISC.null 80 12
23630 Dressing Service Charges - Large MISC.null 110 2
23631 Incision & Drainage MISC.null 120 -
23632 Minor Procedure - In Minor OT MISC.null 175 -
23633 Mantoux Test MISC.null 10 -
23634 Plastering / Cast Application - Major MISC.null 210 13
23635 Plastering / Cast Application - Minor MISC.null 175 40
23636 Removal of Foreign Body MISC.null 120 -
23637 Suture Removal (Dressing Charges Extra) MISC.null 40 -
23638 Suturing under LA in OPD / Ward MISC.null 80 -
23639 Suturing without LA in OPD / Ward MISC.null 50 -
23640 Ponsetti Tenotomy Procedure MISC.null 275 7
16. ORTHOPAEDICS
Orthopaedics
### Procedure
1901 Aspiration MISC.null 210 12
1902 Aspiration of Joint (in minor O.T.) MISC.null 300 3
1903 Biopsy - Muscle MISC.null 250 -
Page 200 of 368

Orthopaedics
Servi
gory
1904 Bone Marrow Aspiration MISC.null 350 -

1905 Closed Redn.of Fract.and dislocation-Chi MISC.null 350 -
1906 Closed Reduction of Fract.and dislocationMISC.null 600 -
1907 FCB MISC.null 175 -
1908 Intra Articular Injection MISC.null 175 11
1909 Major Wound Dressing-Exclusive of MaterMISC.null 120 107
1910 Manipulation MISC.null 275 -
1911 Suturing - Minor (OPD / Ward) MISC.null 175 -
1912 Post Op.Immobiln.of frac.without manipuMISC.null 175 -
1913 Skeletal Traction MISC.null 300 34
1914 Skin Traction / Thomas Splint MISC.null 175 194
1915 Trigger Point Injection in OPD/ward MISC.null 90 30
1916 Strapping MISC.null 90 16
G. ORTHOPAEDICS
Elbow INTERMEDIATE B1
Orthopaedics
###
7277 Below elbow amputation SURGEMINOR 7,000 -
7278 ORIF Radial neck/ head SURGEMINOR 5,600 3
7374 Intramedullary Nailing (Single Bone) SURGEMAJOR 6,000 1
7380 Excision Head of Radius SURGEMINOR 6,600 1
7381 Exploration/Arthrotomy SURGEMINOR 6,600 -
7386 Synovectomy - Elbow SURGEMAJOR 7,000 -
7388 Tennis Elbow Operation SURGEMINOR 6,600 -
Elbow INTERMEDIATE B2
Orthopaedics
###
7375 Intramedullary Nailing (Both Bones) SURGEMAJOR 9,000 1
7377 External Fixation for Open Fractures SURGEMAJOR 8,000 1
Page 201 of 368

Orthopaedics
Servi
gory
7378 Condylar Fracture Fixation SURGEMAJOR 9,000 4

7379 Excision Arthoplasty SURGEMAJOR 9,600 -
7382 French Osteotomy SURGEMAJOR 9,600 -
7383 Lateral Condylefixation SURGEMAJOR 8,000 1
7384 Single Bone Fracture - ORIF with Bone GrSURGEMAJOR 7,600 3
7385 Supracondylar Fracture Fixation SURGEMAJOR 9,600 3
7390 Ulnar Nerve Transposition SURGEMINOR 7,600 -
Elbow MAJOR C1
Orthopaedics
###
7279 Ender's nailing humerus SURGEMAJOR 9,000 1
7371 Arthodesis - Elbow SURGEMAJOR 13,600 -
7373 Monteggia Fracture ORIF/Galezzi with ORSURGEMAJOR 9,000 -
7519 ORIF supracondylar fractures SURGEMAJOR 9,600 2
Elbow MAJOR C2
Orthopaedics
###
7372 Fracture - Both Bones ORIF with Bone GraSURGEMAJOR 13,000 1
7376 Non-Union of Forearm Fracture SURGEMAJOR 13,000 -
7387 Tension Band Wiring SURGEMAJOR 8,000 6
7520 Interposition of arthroplasty SURGEMAJOR 11,600 -
7521 Open reduction of neglected dislocation SURGEMAJOR 11,600 -
7522 Malunited fracture dislocation SURGEMAJOR 10,000 -
Elbow SPECIALISED D1
Orthopaedics
###
7551 Complex fracture both bones ORIF SURGEMAJOR 15,000 -
7552 Locked Compression Plating-(Forearm) SURGEMAJOR 13,000 -
Elbow SPECIALISED D2
Orthopaedics
###
7281 ORIF supracondylar + intercondylar fract SURGEMAJOR 20,000 1
Page 202 of 368

Orthopaedics
Servi
gory
7389 Total Joint Replacement - Elbow SURGEMAJOR 25,000 -

7523 Arthroscopy elbow(Procedure Includes BiSURGEMAJOR 20,000 -
FOOT & ANKLE MINOR A1
Orthopaedics
###
7103 Club Foot (CTEV) Manipulation SURGEMINOR 1,500 -
7106 Ingrowing Toe Nail SURGEMINOR 2,000 -
7132 Stendler's release SURGEMINOR 3,200 -
FOOT & ANKLE MINOR A2
Orthopaedics
###
7101 Calcaneal Osteotomy SURGEMINOR 5,800 -
7102 Ray Amputation SURGEMINOR 3,800 -
7104 Correction of Hammer Toes SURGEMINOR 4,600 -
7107 Kwiring of Fractures/Dislocation SURGEMINOR 5,000 14
7122 Tendoachilles Lengthening SURGEMINOR 3,800 1
7478 Calcanial Spur Excision SURGEMINOR 4,600 -
FOOT & ANKLE INTERMEDIATE B1
Orthopaedics
###
7105 Hallux Valgus - Correction SURGEMAJOR 7,000 1
7109 Subtalar Fusion (grice green) SURGEMINOR 6,600 -
7116 Arthrotomy/Exploration - Foot & Ankle SURGEMAJOR 7,000 1
7123 Tension Band Wiring/Screw Fixation (singSURGEMAJOR 6,000 -
7126 Unimalliolus Fracture - Ankle SURGEMINOR 5,000 6
7130 Lisfranks Amputation SURGEMINOR 5,600 -
7131 ORIF Jones fracture SURGEMAJOR 5,500 -
7137 Excision of Acessary navicular bone SURGEMAJOR 6,000 -
7138 Metatarsal osteotomy SURGEMAJOR 6,000 -
7139 Kwiring of Fractures/Dislocation - MultiplSURGEMAJOR 5,000 4
7140 Hallux Varus - Correction SURGEMAJOR 6,000 -
Page 203 of 368

Orthopaedics
Servi
gory
FOOT & ANKLE INTERMEDIATE B2

Orthopaedics
###
7110 Talectomy SURGEMAJOR 8,000 -
7118 Repair of Tendoachilles SURGEMAJOR 7,000 4
7119 Synovectomy - Foot & Ankle SURGEMAJOR 8,000 -
7125 Non-Union Medial Malleolus Fracture SURGEMINOR 7,000 -
7481 Core Decompression Head of Femur SURGEMINOR 7,000 1
FOOT & ANKLE MAJOR C1
Orthopaedics
###
7108 Posteromedial Soft Tissue Release for CT SURGEMAJOR 8,000 -
7111 Triple Fusion SURGEMAJOR 10,600 -
7113 Blair's Fusion SURGEMAJOR 10,600 -
7114 Arthrodesis - Foot & Ankle SURGEMAJOR 10,600 -
7121 Bimalleolar Fracture ORIF SURGEMAJOR 8,000 18
7124 Trimalleolar Fracture ORIF SURGEMAJOR 9,000 1
7128 Repair of Neg TA Rupture SURGEMAJOR 9,000 4
7129 ORIF Talus Fractures SURGEMAJOR 9,000 -
7133 Arth Ankle using char cam SURGEMAJOR 10,600 -
7134 Tenden trans for ft drop SURGEMAJOR 10,600 -
7135 Symes amputation SURGEMAJOR 9,000 -
7136 Open Reduction & Internal fixation of Fr SURGEMAJOR 9,000 3
7490 Cong.Vertical Talus Surg. Correction SURGEMAJOR 10,600 1
7491 ORIF -Lisfranc injury SURGEMAJOR 9,600 -
7570 Osteotomy at Midtarsal Joint SURGEMAJOR 9,600 1
FOOT & ANKLE MAJOR C2
Orthopaedics
###
7112 Pantalar Arthrodesis SURGEMAJOR 10,000 1
7127 CTEV corr using JESS ext SURGEMAJOR 13,000 -
Page 204 of 368

Orthopaedics
Servi
gory
7206 Fracture dislocation ankle SURGEMAJOR 10,000 -

18002 Supramalleolar Osteotomy SURGEMAJOR 10,000 -
FORE ARM INTERMEDIATE B1
Orthopaedics
###
7351 Single Bone Fracture - ORIF SURGEMAJOR 7,000 28
FORE ARM MAJOR C1
Orthopaedics
###
7352 Both Bones Fracture - ORIF SURGEMAJOR 10,600 17
7518 Fasciotomy - Major SURGEMAJOR 10,600 -
HIP INTERMEDIATE B1
Orthopaedics
###
7171 Adductor Tenotomy & Obturator Neurec SURGEMAJOR 9,000 -
7189 Adductor Tenotomy SURGEMINOR 5,000 -
7190 Iliopsoas Recession SURGEMAJOR 8,700 -
7193 Sout.&Youxt Opr.for polio SURGEMINOR 6,600 -
HIP INTERMEDIATE B2
Orthopaedics
###
7142 Core decompression of femoral head SURGEMAJOR 8,000 9
7173 Arthrotomy/Exploration - Hip SURGEMAJOR 9,600 -
7177 Excision Arthroplasty (Grindle Stone) SURGEMAJOR 9,000 -
7187 Pelvis - Sacroiliac Fusion SURGEMAJOR 9,600 -
HIP MAJOR C1
Orthopaedics
###
7172 Arthrodesis - Hip SURGEMAJOR 12,000 -
7174 Asnis Fixation SURGEMAJOR 11,000 -
7181 Osteotomies Around the Hip SURGEMAJOR 12,000 -
7182 VDO SURGEMAJOR 11,000 -
7183 Slipped Femoral Epiphysis Operation SURGEMAJOR 12,500 1
Page 205 of 368

Orthopaedics
Servi
gory
7184 Austine Moore Pinning SURGEMAJOR 8,000 -

7191 Open Reduction for Dislocation of Hip SURGEMAJOR 10,600 2
7192 Non-Union Femoral Neck Fracture SURGEMAJOR 12,000 -
7196 Enders Nailing - Hip SURGEMAJOR 10,600 1
7496 Fracture dislocation of femoral head SURGEMAJOR 10,600 -
HIP MAJOR C2
Orthopaedics
###
7145 Gamma Nailing SURGEMAJOR 13,000 -
7175 Congential Dislocation Hip/Stabilization SURGEMAJOR 14,600 1
7176 Dynamic Hip Fixation - Richard's SURGEMAJOR 12,000 3
7497 ORIF pubicsymphysis SURGEMAJOR 12,000 -
7498 External Fixation for pelvic Fractures SURGEMAJOR 12,000 -
7499 Sacroiliac joint ORIF SURGEMAJOR 11,000 -
7500 Myositis resection SURGEMAJOR 12,000 -
7534 Core decompression and fibular grafting SURGEMAJOR 11,000 3
HIP MINOR A2
Orthopaedics
###
7185 Closed Reduction of Hip Dislocation SURGEMAJOR 2,750 2
HIP SPECIALISED D2
Orthopaedics
###
7143 Recon. Nailing of femur SURGEMAJOR 21,000 15
7194 Open Reduction & Internal fixation of Fr SURGEMAJOR 24,000 -
7195 Total Hip Replacement SURGEMAJOR 26,000 15
7501 Complex acetabular fracture ORIF SURGEMAJOR 28,000 -
7535 Hip Arthroscopy(Procedure Includes Bio SURGEMAJOR 20,000 -
7536 Modular Bipolar Arthoplasty SURGEMAJOR 18,000 14
7537 Surface Replacment SURGEMAJOR 25,000 -
7569 Open Reduction Congenital Dislocation HiSURGEMAJOR 20,000 -
Page 206 of 368

Orthopaedics
Servi
gory
HIP SPECIALISED D3
Orthopaedics
###
7538 Revision THR (Total Hip Replacement) SURGEMAJOR 28,000 -
7539 Revision of failed Hemi arthroplasty or a SURGEMAJOR 24,000 -
HIP Specialized D1
Orthopaedics
###
7144 Prox. Femoral nailing SURGEMAJOR 15,000 37
7178 Hemi Arthroplasty with Bone Cement (T SURGEMAJOR 15,000 2
7179 Hemi Arthroplasty without Bone CementSURGEMAJOR 15,000 15
7180 Hind Quarter Amputation SURGEMAJOR 20,000 -
KNEE INTERMEDIATE B1
Orthopaedics
###
7163 Collateral ligament repair SURGEMINOR 6,000 -
7252 Arthrotomy/Exploration - Knee SURGEMINOR 8,000 8
7254 Hamstring Release SURGEMAJOR 8,000 1
KNEE INTERMEDIATE B2
Orthopaedics
###
7255 High Tibial Osteotomy SURGEMAJOR 11,000 -
7256 Menisectomy SURGEMAJOR 9,600 1
7257 Patellectomy or Fixation SURGEMAJOR 9,600 -
7258 Quadriceps Plasty SURGEMAJOR 13,000 2
7261 Stapling SURGEMAJOR 11,000 1
7262 Synovectomy & Joint Debridement SURGEMAJOR 10,000 -
7272 Lateral release for Patellas SURGEMAJOR 9,000 -
7273 Car. screw fix of Femoral SURGEMAJOR 10,000 -
7487 Mekay's Osteotomy SURGEMAJOR 13,600 -
KNEE MAJOR C1
Orthopaedics
###
Page 207 of 368

Orthopaedics
Servi
gory
7164 ORIF Avulsion fracture ACL SURGEMAJOR 12,000 -

7165 ORIF Avulsion fracture PCL SURGEMAJOR 12,000 5
7166 Femoral Unicondyle SURGEMAJOR 9,000 3
7251 Arthrodesis - Knee SURGEMAJOR 12,000 -
7253 Condylar Plate Fixation SURGEMAJOR 11,000 -
7264 Patella - TBW SURGEMAJOR 9,000 13
7265 Diagnostic Arthroscopy - Knee SURGEMINOR 10,000 19
7274 Disc. Menisci excision SURGEMAJOR 13,600 -
7276 Osteo Chord. Dessi.Knee Excision & Cur SURGEMAJOR 13,600 -
7486 High Tibial Osteotomy withh Fixation SURGEMAJOR 11,000 1
KNEE MAJOR C2
Orthopaedics
###
7169 Femoral Bicondyle SURGEMAJOR 11,000 -
7170 Arthroscopic meniscal repair SURGEMAJOR 12,000 8
7260 Rotary Instability SURGEMAJOR 14,600 -
7266 Arthroscopy & Proceedure - Knee SURGEMAJOR 13,600 8
7267 Arthroscopic Lavage SURGEMAJOR 11,000 3
7269 Arthrodesis of Knee using Ilizarov SURGEMAJOR 15,000 -
7270 Femural Condylar Fra ORIF SURGEMAJOR 13,600 1
7271 Operation for Con dis Pat SURGEMAJOR 15,000 -
7275 Arthoscopic Menisectomy SURGEMAJOR 12,000 1
7510 Patellar tendon reconstruction SURGEMAJOR 11,000 -
7541 Percutaneous fracture patella fixation SURGEMAJOR 10,000 -
7563 Microfracture SURGEMAJOR 11,600 -
18003 Realignment of quadriceps SURGEMAJOR 11,600 -
18004 Multiplanar Deformity SURGEMAJOR 11,600 -
KNEE SPECIALISED D1
Orthopaedics
###
Page 208 of 368

Orthopaedics
Servi
gory
7197 PCL Reconstruction SURGEMAJOR 20,000 -

7198 Femoral Bondylar with supracondylar fraSURGEMAJOR 17,000 1
7202 Knee instability reconstruction procedureSURGEMAJOR 17,000 2
7203 Postero Lateral corner reconstruction SURGEMAJOR 17,000 -
7268 ACL Reconstruction SURGEMAJOR 17,000 2
KNEE SPECIALISED D2
Orthopaedics
###
7199 Arthroscopic ACL reconstruction SURGEMAJOR 18,000 20
7200 Arthroscopic PCL reconstruction SURGEMAJOR 17,000 -
7201 Arthroscopic stabilization of fractures SURGEMAJOR 17,000 1
7204 Arthroscopy Major SURGEMAJOR 18,000 9
7263 Total Joint Replacement - Knee SURGEMAJOR 22,000 18
7564 Mosaicplasty SURGEMAJOR 15,000 -
7565 OATS SURGEMAJOR 15,000 1
7566 Arthroscopy MPFL repair - Knee SURGEMAJOR 14,000 2
7571 Arthroscopy meniscal repair - Knee SURGEMAJOR 18,000 7
7572 PLC reconstruction SURGEMAJOR 16,000 -
KNEE SPECIALISED D3
Orthopaedics
###
7542 Revision Total Knee Replacement SURGEMAJOR 30,000 -
7543 Revision Arthoscopy ACL Reconstruction SURGEMAJOR 26,000 -
7544 Revision Arthoscopy PCL Reconstruction SURGEMAJOR 26,000 -
7545 Single Stage ACL PCL Reconstruction SURGEMAJOR 25,000 -
7573 Augmented Arthoscopy ACL ReconstructiSURGEMAJOR 25,000 -
LEG INTERMEDIATE B1
Orthopaedics
###
7146 Fibular plating SURGEMINOR 5,000 2
7233 Fibulectomy SURGEMINOR 6,600 -
Page 209 of 368

Orthopaedics
Servi
gory
7485 Fibular Grafting (SHIFT) SURGEMINOR 5,000 1

LEG INTERMEDIATE B2
Orthopaedics
###
7221 Below Knee Amputation SURGEMAJOR 8,000 -
7224 Intra Medullary Nailing (`K' or `V' Nail) SURGEMAJOR 9,600 16
7226 Postero Lateral Grafting SURGEMAJOR 10,000 -
7227 Compartmental Release SURGEMINOR 8,000 -
7502 Percutaneous intercondylar fixation SURGEMINOR 8,000 -
LEG MAJOR C1
Orthopaedics
###
7147 Tibial condylar unicondyle SURGEMAJOR 7,000 9
7148 Hungtington procedure SURGEMAJOR 9,000 -
7222 Compression Plating of Tibia (DCP/MullerSURGEMAJOR 12,000 1
7225 External Fixation for Tibial Fracture SURGEMAJOR 9,000 6
7228 ORIF for Tibial Condylar Fracture SURGEMAJOR 10,000 9
7229 Non-Union Tibia SURGEMAJOR 12,000 -
7231 Clo nailing for Tibial fr SURGEMAJOR 10,600 4
7235 Enders Nailing - Leg SURGEMAJOR 9,000 -
LEG MAJOR C2
Orthopaedics
###
7149 Tibial condylar Bicondylar SURGEMAJOR 11,000 3
7223 Congenital Pseudaorthrosis Tibia SURGEMAJOR 13,000 -
7232 ORIF Tibial fr. using Ili SURGEMAJOR 15,000 -
7503 Exchange nailing SURGEMAJOR 11,000 1
LEG SPECIALIZED D1
Orthopaedics
###
7150 Tibial condylar Comminuted SURGEMAJOR 16,000 1
7230 Non-Union Tibia Fracture using Ilizarov SURGEMAJOR 19,000 -
Page 210 of 368

Orthopaedics
Servi
gory
7234 Inter locking nailing - Leg SURGEMAJOR 14,000 32

7504 Congenital Pseudaorthrosis+fibular graft SURGEMAJOR 19,000 -
7505 Congenital Pseudaorthrosis + Iiizarov SURGEMAJOR 19,000 -
7506 Tibia-multiple osteotomies + IF SURGEMAJOR 18,000 -
7507 MIPPO SURGEMAJOR 16,000 1
7540 Locked Compression Plating (Leg) SURGEMAJOR 15,000 -
LEG SPECIALIZED D2
Orthopaedics
###
7562 Polar Fracture with Tibial Shaft Fracture] SURGEMAJOR 22,000 -
MISCELLANEOUS INTERMEDIATE B1
Orthopaedics
###
7307 Amputations - intermediate SURGEMINOR 5,600 -
7308 Biopsy - intermediate SURGEMINOR 5,600 4
7309 Bone Graft - intermediate SURGEMINOR 5,600 1
7310 Osteotomy - intermediate SURGEMINOR 5,600 -
7311 Closed Reduction of Fracture/DislocationsSURGEMINOR 5,600 6
7312 Debridement - intermediate SURGEMINOR 5,600 3
7313 Wound Closure - intermediate SURGEMINOR 5,000 -
7314 Curratage of bone tumor - intermediate SURGEMINOR 5,600 -
7315 Internal fixation of fracture - intermediat SURGEMINOR 5,600 19
7316 External fixation - intermediate SURGEMINOR 5,600 1
7317 Excision of tumor - intermediate SURGEMINOR 5,600 4
7318 Nerve repair - intermediate SURGEMINOR 5,600 -
7319 Tendon Repair - intermediate SURGEMINOR 5,600 1
7320 Release of contracture - intermediate SURGEMINOR 5,600 -
7337 Removal Implants - intermediate SURGEMINOR 5,600 14
7458 Ordinary Plating of Fractures SURGEMINOR 6,600 -
7459 Osteomyelitis Acute Drainage SURGEMINOR 3,800 1
Page 211 of 368

Orthopaedics
Servi
gory
7466 Rib Resection SURGEMINOR 5,600 -

MISCELLANEOUS MAJOR C1
Orthopaedics
###
7338 Wound closure - major SURGEMAJOR 7,000 -
7339 Osteotomy - major SURGEMAJOR 9,000 -
7340 Currattage of bone tumor - major SURGEMAJOR 9,000 -
7341 Internal fixation of fracture - major SURGEMAJOR 9,000 1
7342 External fixation - major SURGEMAJOR 9,000 1
7343 Excision of tumor - major SURGEMAJOR 9,000 -
7344 Nerve repair - major SURGEMAJOR 9,000 -
7345 Tendon Repair - major SURGEMAJOR 9,000 -
7346 Release of contracture - major SURGEMAJOR 9,000 -
7432 Amputations - Major SURGEMAJOR 10,600 -
7435 Biopsy - Major SURGEMAJOR 7,000 -
7436 Bone Block Surgery SURGEMINOR 10,000 -
7438 Bone Graft -Major SURGEMAJOR 9,000 -
7440 Closed Reduction of Fracture/DislocationSURGEMAJOR 8,000 -
7447 Debridement - Major SURGEMAJOR 9,000 1
7460 Osteomyelitis Chronic Medium Curttage SURGEMINOR 8,600 -
7465 Removal Implants - Major SURGEMAJOR 9,000 3
7467 Rotation Flap SURGEMAJOR 10,600 -
7470 Skin Graft - Major SURGEMINOR 9,000 -
7473 Tendon Transfer - Major SURGEMAJOR 10,600 -
MISCELLANEOUS MINOR A1
Orthopaedics
###
7287 Osteotomy - minor SURGEMINOR 2,000 3
7288 Curratage of bone tumor - minor SURGEMINOR 2,000 -
7289 Internal fixation of fracture - minor SURGEMINOR 2,000 28
Page 212 of 368

Orthopaedics
Servi
gory
7290 External fixation of fracture - minor SURGEMINOR 2,000 19

7296 Excision of tumor minor SURGEMINOR 2,000 2
7300 Nerve repair - minor SURGEMINOR 2,000 -
7306 Release of contracture - minor SURGEMINOR 2,000 6
7431 Amputations - Minor SURGEMINOR 3,200 9
7433 Application of Special Plasters/MJHSBS/SSURGEMINOR 2,000 2
7434 Biopsy - Minor SURGEMINOR 2,000 11
7437 Bone Graft - Minor SURGEMINOR 3,200 2
7439 Closed Reduction of Fracture/DislocationSURGEMINOR 3,200 14
7442 Compression Bandage (Robert Tones) SURGEMINOR 2,000 -
7446 Debridement - Minor SURGEMINOR 2,000 74
7448 Electrical Stimulation of Fractures SURGEMINOR 2,000 -
7453 Intra Articular Injection in OT SURGEMINOR 2,000 2
7454 Joint Aspiration SURGEMINOR 2,000 -
7456 Non-Operative Mgmt.of Fracture (BalanceSURGEMINOR 2,000 -
7457 Ordinary Plaster Cast Application SURGEMINOR 2,000 1
7462 PTB Plaster Application SURGEMINOR 2,000 -
7464 Removal Implants - Minor SURGEMINOR 3,000 83
7468 Skeletal Traction in OT SURGEMINOR 3,200 -
7469 Skin graft - Minor SURGEMINOR 3,200 -
7471 Skin Traction SURGEMINOR 2,000 -
7472 Tendon Repair - Minor SURGEMINOR 3,200 3
7475 Trigger Point Injection in OT SURGEMINOR 2,000 -
7477 Wound Closure - Minor SURGEMINOR 2,000 1
7479 Skull Traction SURGEMINOR 3,700 -
7576 Dynamisation SURGEMINOR 2,000 9
MISCELLANEOUS MINOR A2
Orthopaedics
###
Page 213 of 368

Orthopaedics
Servi
gory
7441 Cold abcess Drainage SURGEMINOR 3,600 -

7474 Tenotomies - Major SURGEMINOR 7,300 -
ORTHOPAEDIC PROCEDURE IN EMERGENCY
Orthopaedics
###
7577 Closed reduction + cast application SURGEMAJOR 5,000 -
7578 Closed reduction + slab application SURGEMAJOR 5,000 -
7579 Traction application- Skin or skeletal SURGEMAJOR 6,000 -
7580 Splinting (Long bone fracture,Short bone SURGEMAJOR 5,000 -
GENERAL
Orthopaedics
###
7391 Fluroscopy Time (0-10 Minutes) PROCEnull 200 710
7392 Fluroscopy Time (10-15 Minutes) PROCEnull 300 6
7393 Fluroscopy Time (15-20 Minutes) PROCEnull 300 -
7394 Fluroscopy Time (20-30 Minutes) PROCEnull 600 -
7395 Fluroscopy Time (Every Adnl.5mts) PROCEnull 100 -
7591 Extra hours for Minor surgery (A) SURGEMAJOR - -
7592 Extra hours for minor + surgery (B) SURGEMAJOR - -
7593 Extra hours for major surgery (C) SURGEMAJOR - -
7594 Extra hours for major + surgery (D) SURGEMAJOR - -
7598 Bilateral (50% of Proce./Surgery) SURGEMAJOR - 19
7599 Extra Hours taken for a surgery SURGEMAJOR - -
18076 Harmonic Scalpel SURGEMAJOR 2,000 -
18077 Basic Microscope per hour SURGEMAJOR 1,500 -
18078 Advanced Microscope per hour SURGEMAJOR 2,000 -
18079 Laparoscope per hour SURGEMAJOR 600 -
18206 Enseal MISC.null - -
SHOULDER & ARM INTERMEDIATE B1
Orthopaedics
###
Page 214 of 368

Orthopaedics
Servi
gory
7322 Arthrotomy/Exploration - Shoulder & ar SURGEMAJOR 10,000 -

SHOULDER & ARM INTERMEDIATE B2
Orthopaedics
###
7239 Fixation of clavicle fracture SURGEMAJOR 9,000 2
7240 Above elbow amputation SURGEMAJOR 7,000 -
7241 Proximal humerus fracture CR & Kwiring( SURGEMAJOR 7,000 2
7326 Supraspinatus Tendinitis & Subacrominal SURGEMAJOR 9,600 -
7330 Intramedullary Nailing Humerus SURGEMAJOR 9,600 2
SHOULDER & ARM MAJOR C1
Orthopaedics
###
7242 Arthroscopy & lavage - Shoulder & Arm SURGEMAJOR 9,600 2
7325 Recurrent Dislocation SURGEMAJOR 12,000 3
7329 Compression Plating of Humerus SURGEMAJOR 11,000 5
7331 Non-Union Fracture of Humerus SURGEMAJOR 11,000 3
7333 External Fixation for Open Fractures of SURGEMINOR 7,000 2
7335 Diagnostic Arthroscopy- Shoulder & Arm SURGEMAJOR 10,600 3
SHOULDER & ARM MAJOR C2
Orthopaedics
###
7243 Interlocking nailing of humerus SURGEMAJOR 10,000 1
7244 Arthroscopic frozen shoulder release SURGEMAJOR 11,600 -
7321 Arthodesis - Shoulder SURGEMAJOR 14,600 -
7323 Forequarter Amputation SURGEMAJOR 18,800 -
7324 Proximal Humerus Fracture ORIF SURGEMAJOR 11,000 16
7328 Acromioclavicular joint Fixation + ligamenSURGEMAJOR 11,600 -
7336 Arthroscopy & procedure - Shoulder & A SURGEMAJOR 17,000 2
SHOULDER & ARM MINOR A2
Orthopaedics
###
7332 Closed Reduction of Humerus Fractures SURGEMINOR 3,000 2
Page 215 of 368

Orthopaedics
Servi
gory
7480 Acromion Excision SURGEMINOR 6,000 -

18005 MUA SURGEMAJOR 3,000 1
SHOULDER & ARM SPECIALISED D1
Orthopaedics
###
7246 Arthroscopy & procedure - Major - Shou SURGEMAJOR 17,000 -
7247 Arthroscopic rotator cuff repair SURGEMAJOR 17,000 13
7249 Arthroscopic subacromal decompressionSURGEMAJOR 16,000 2
7334 Ilizarov Fix.for Non union Humerus Fr. SURGEMAJOR 20,000 -
7516 Expandable nail - Shoulder & Arm SURGEMAJOR 17,000 -
7549 Locked compression Plating(Shoulder & SURGEMAJOR 14,000 -
SHOULDER & ARM SPECIALISED D2
Orthopaedics
###
7245 Hemireplacement of shoulder SURGEMAJOR 22,000 1
7248 Arthroscopic stabilization of shoulder instSURGEMAJOR 19,000 4
7250 Arthroscopic shoulder arthrodesis SURGEMAJOR 19,000 -
7327 Total Joint Replacement - Shoulder & Ar SURGEMAJOR 25,000 -
7513 Open reduction of dislocation of shouldeSURGEMAJOR 12,000 1
7514 OR + IF fracture scapula SURGEMAJOR 18,000 -
7515 OR + IF fracture glenoid SURGEMAJOR 18,000 -
7517 Neers capsular shift SURGEMAJOR 19,000 -
7567 Arthoscopy biceps tenodesis SURGEMAJOR 19,000 -
7568 Arthoscopic repair of AC joint instability SURGEMAJOR 19,000 -
SPECIALISED D2
Orthopaedics
###
7452 Ilizarov Instrumentation & Corticotomy f SURGEMAJOR 20,000 -
SPECIALISED D3
Orthopaedics
###
7581 Combined Complex Procedure SURGEMAJOR 25,000 1
Page 216 of 368

Orthopaedics
Servi
gory
SPINE INTERMEDIATE B2
Orthopaedics
###
7209 Biopsy - Open SURGEMINOR 5,000 -
SPINE MAJOR C1
Orthopaedics
###
7293 Cervical Rib Excision SURGEMAJOR 10,000 -
7295 Costo Transversecomy SURGEMAJOR 15,000 -
7301 Posterior Spinal Fusion SURGEMAJOR 15,000 -
SPINE MAJOR C2
Orthopaedics
###
7210 Laminoplasty SURGEMAJOR 11,000 -
7298 Laminectomy - Single SURGEMAJOR 13,000 -
7299 Laminectomy & Disectomy SURGEMAJOR 15,000 -
SPINE MINOR A1
Orthopaedics
###
7304 Epidural Steroid Injection SURGEMINOR 1,800 1
SPINE MINOR A2
Orthopaedics
###
7208 Closed Biopsy SURGEMINOR 3,000 1
SPINE SPECIALIZED D1
Orthopaedics
###
7211 Laminectomy - multiple SURGEMAJOR 16,000 -
7212 Disectomy - multiple SURGEMAJOR 15,000 -
7213 Fenestration Disectomy SURGEMAJOR 15,000 -
7214 Pedicular fixation simple SURGEMAJOR 16,000 87
7292 Anterolateral Decompression SURGEMAJOR 19,000 -
Orthopaedics
###
Page 217 of 368

Orthopaedics
Servi
gory
7215 Surgical correction of kyphosis SURGEMAJOR 25,000 -

7216 Microdisectomy SURGEMAJOR 20,000 -
7218 PLIF SURGEMAJOR 18,000 -
7219 ALIF SURGEMAJOR 20,000 -
7220 Pedicular fixation with fusion SURGEMAJOR 18,000 1
7238 MISS SURGEMAJOR 20,000 -
7291 Anterior Spinal Fusion with Decompressi SURGEMAJOR 24,000 -
7294 Correction Spinal Osteotomy & Fusion SURGEMAJOR 25,000 -
7297 Instrumentation & Spinal Fusion for ScoliSURGEMAJOR 30,000 -
7302 Spinal Fracture Reduction with Fixation SURGEMAJOR 20,000 -
7303 Decom.&Fusion for spondyl SURGEMAJOR 20,000 -
7305 Recurrent Disc/Failed back syndrome SURGEMAJOR 21,000 -
7512 Anterior Decompression & instrumentati SURGEMAJOR 22,000 2
7546 Precutaneous spinal procedure SURGEMAJOR 18,000 -
7547 Complex spinal surgery SURGEMAJOR 20,000 -
7548 Vertebroplasty SURGEMAJOR 19,000 -
Orthopaedics
###
7560 Anterior and Posterior Spinal Surgery SURGEMAJOR 26,000 -
7561 Grade III/ IV Listhesis Surgery SURGEMAJOR 26,000 -
18000 Posterolateral Decompression InstrumentSURGEMAJOR 28,000 -
18001 Anterolateral Decompression InstrumentSURGEMAJOR 26,000 -
THIGH INTERMEDIATE B1
Orthopaedics
###
7158 Exostoics Excision SURGEMINOR 6,000 -
7159 A/C Osto. Femor Decomp. SURGEMINOR 6,000 -
THIGH INTERMEDIATE B2
Orthopaedics
###
Page 218 of 368

Orthopaedics
Servi
gory
7151 Above Knee Amputation SURGEMAJOR 8,000 -

THIGH MAJOR C1
Orthopaedics
###
7152 Compression Plating of Femur (DCP/MullSURGEMAJOR 11,000 1
7153 Intra Medullary Nailing -`K' Nail SURGEMAJOR 10,000 2
7154 External Fixation for Femus Fractures SURGEMAJOR 9,000 1
7162 Enders Nailing - Thigh SURGEMAJOR 9,000 1
THIGH MAJOR C2
Orthopaedics
###
7155 Non-Union Femur SURGEMAJOR 13,000 -
7492 DCP and bone grafting SURGEMAJOR 14,000 -
7493 Int. locking nailing +bone grafting SURGEMAJOR 15,000 -
THIGH SPECIALIZED D1
Orthopaedics
###
7156 Non-Union Femur using Ilyzarov SURGEMAJOR 20,000 -
7157 Int. locking nailing Femo SURGEMAJOR 14,000 18
7160 Iliza.fix.for op.Fem. Fr. SURGEMAJOR 19,000 -
7161 Comp.dis. for Non le. Fe. SURGEMAJOR 20,000 -
7533 Locked Plating - Thigh SURGEMAJOR 16,000 2
THIGH SPECIALIZED D2
Orthopaedics
###
7141 Supracondylar nailing SURGEMAJOR 18,000 2
7494 Exchange nailing + bone grafting SURGEMAJOR 18,000 1
TOTAL HIP REPLACEMENT - PACKAGE
Surgery
### Packages
7600 Total Hip Replacement - Package IP PA null 70,000 -
TOTAL KNEE REPLACEMENT - PACKAGE
Orthopaedics
###
Page 219 of 368

Orthopaedics
Servi
gory
7205 Unicondylar knee replacement SURGEMAJOR 24,000 -

Surgery
### Packages
7280 Total Knee Replacement IP PA null 65,000 -
WRIST INTERMEDIATE B1
Orthopaedics
###
7283 Lunate excision & procedure SURGEMINOR 5,600 -
7284 Metacarpel fixation SURGEMINOR 5,600 1
7402 Bennet's Fracutre Fixation SURGEMINOR 6,600 -
7407 Synovectomy/Arthrotomy/Exploration SURGEMAJOR 9,000 -
7409 Barton's Fracture ORIF SURGEMAJOR 5,600 3
7412 Ganglion Excision SURGEMINOR 4,600 -
WRIST INTERMEDIATE B2
Orthopaedics
###
7285 Phalangeal fracture fixation - Major SURGEMINOR 6,000 -
7401 Arthodesis - Wrist SURGEMAJOR 9,600 -
7410 ORIF Scaphoid Fracture SURGEMAJOR 9,600 -
7524 Closed reduc+percut pinning dis rad & ulnSURGEMAJOR 7,000 1
7525 Mallet finger SURGEMINOR 7,000 -
WRIST MAJOR C1
Orthopaedics
###
7286 Carpal bone fracture dislocated (ORIF/ CRSURGEMAJOR 9,000 -
7403 Carpal Tunnel Decompression SURGEMINOR 5,000 11
7411 Non-Union Scaphoid SURGEMAJOR 10,600 -
7526 Malunited distal radius -osteotomy & pr SURGEMAJOR 9,000 1
7527 Radial shortening for keinbocks SURGEMAJOR 9,000 -
WRIST MAJOR C2
Orthopaedics
###
7406 Proximal Row Carpectomy SURGEMAJOR 12,000 -
Page 220 of 368

Orthopaedics
Servi
gory
18006 Open TFCC repair SURGEMAJOR 12,000 1

18007 Ligamento taxis SURGEMAJOR 12,000 -
WRIST MINOR A2
Orthopaedics
###
7282 Phalangeal fracture fixation - Minor SURGEMINOR 3,600 -
7404 De Quervains Disease Decompression SURGEMINOR 4,600 3
7405 Excision of Lower End of Ulna SURGEMINOR 4,600 -
WRIST SPECIALISED D2
Orthopaedics
###
7553 Arthrodesis - Wrist SURGEMAJOR 11,000 -
7554 Arthroscopy SURGEMAJOR 13,000 -
7574 Arthroscopy & TFCC repair - Wrist(Proce SURGEMAJOR 13,000 -
7575 Arthoscopy assisted distal radial & carpalSURGEMAJOR 13,000 -
Q. UNIT OF HOPE (UoH)
ELBOW & FOREARM
Unit
###Of Hope Surgery
24260 UoH - Arthrotomy and Lavage (elbow joinSURGEMAJOR 2,700 -
24261 UoH - Centralization of Ulna/Radius SURGEMAJOR - -
24262 UoH - Compartment Syndrome(fasciotomSURGEMAJOR 4,700 -
24263 UoH - Cutis Interposition Arthroplasty SURGEMAJOR 4,700 -
24264 UoH - Deformity Correction/Radial Club SURGEMAJOR 6,700 -
24265 UoH - Elbow Dislocation (open reductionSURGEMAJOR 4,700 -
24266 UoH - Fractional Release/Muscle Slides ( SURGEMAJOR 4,700 -
24267 UoH - IIizarov/small Bone Fixator (forear SURGEMAJOR 7,300 -
24268 UoH - Nancy Nail/Rush Pin Fixation (fore SURGEMAJOR 4,700 1
24269 UoH - Surgical Fusion (elbow) SURGEMAJOR 4,700 -
24270 UoH - Surgical Procedures for Volkmann' SURGEMAJOR 5,300 -
24271 UoH - Tendon/Muscle Transfers (forearmSURGEMAJOR 4,700 -
Page 221 of 368

Orthopaedics
Servi
gory
FEMUR
Unit
###Of Hope Surgery
24201 UoH - Femur Shortening/Osteotomy and SURGE P MAJOR 6,700 2
24202 UoH -IIIizarov/LRS/TSF Frame Femur SURGEMAJOR 8,700 -
24203 UoH - Telescoping Nail/FDNail - Femur SURGEMAJOR 6,700 1
24204 UoH - TEN's/Enders Nailing Femur SURGEMAJOR 6,700 2
24205 UoH - Valgus/Varus Derotation OsetetomSURGEMAJOR 6,700 -
FOOT & ANKLE
Unit
###Of Hope Surgery
24175 UoH - Abductor Hallucis Release in CTEV SURGEMAJOR 1,700 -
24176 UoH - Amputation Metatarsal Single Ray SURGEMAJOR 2,800 -
24177 UoH - Amputation's - Foot and Ankle SURGEMAJOR 3,800 -
24178 UoH - Arthrodesis Subtalar Joint SURGEMAJOR 3,800 -
24179 UoH - Arthrotomy and Lavage Ankle JointSURGEMAJOR 2,800 -
24180 UoH - Corrective Osteotomy of MetatarsaSURGEMAJOR 3,800 1
24181 UoH - CTEV Steindler's Release SURGEMAJOR 1,700 -
24182 UoH - Curly Toes Correction SURGEMAJOR 1,700 2
24183 UoH - Evan's Calcaneal Oseteotomy SURGEMAJOR 2,800 -
24184 UoH - Excision of Accessory Bones SURGEMAJOR 2,800 -
24185 UoH - Excision of Talus (CTEV/MMC) SURGEMAJOR 3,800 -
24186 UoH - Fusions Around Ankle and Foot JoiSURGEMAJOR 5,300 -
24187 UoH - Great Toe Deformity Correction SURGEMAJOR 3,800 -
24188 UoH - HOKE TA Lengthening SURGEMAJOR 1,700 1
24189 UoH - llizarov Correction in Club Foot SURGEMAJOR 8,700 -
24190 UoH - KKR Procedure for Vertical Talus CoSURGEMAJOR 6,700 -
24191 UoH - K-wire Fixation of Fractures in Chil SURGEMAJOR 2,800 1
24192 UoH - Manipulation CTEV + Cast SURGEMAJOR 1,700 -
24193 UoH - Percutaneous Supramalleolar Ose SURGEMAJOR 4,700 1
Page 222 of 368

Orthopaedics
Servi
gory
24194 UoH - Ponsetti Tenotomy SURGEMAJOR 1,700 1

24195 UoH - Soft Tissue Release in Club Foot SURGEMAJOR 4,700 -
24196 UoH - Synovial Excision - Foot & Ankle SURGEMAJOR 3,800 -
24197 UoH - Tarsal Osteotomies SURGEMAJOR 3,600 -
24198 UoH - Tendon Recession in MMC SURGEMAJOR 1,700 -
24199 UoH - Tendon Transfer - Foot & Ankle SURGEMAJOR 3,600 4
24200 UoH - "Z" Lengthening of TA SURGEMAJOR 2,800 1
HIP
Unit
###Of Hope Surgery
24206 UoH - Adductor Tenotomy SURGEMAJOR 1,700 2
24207 UoH - Arthrotomy and Lavage - Hip SURGEMAJOR 4,700 2
24208 UoH - Closed Reduction + Adductor TenoSURGEMAJOR 4,700 -
24209 UoH - Closed Reduction Hip + Hip Spica SURGEMAJOR 2,700 -
24210 UoH - DDH - Open Reduction and Capsul SURGEMAJOR 7,300 1
24211 UoH - DDH Open Reduction + Femoral Sho SURGEMAJOR 8,200 2
24212 UoH - DEGA Osteotomy SURGEMAJOR 4,700 -
24213 UoH - DHS/Angled Blade Plate - PaediatriSURGEMAJOR 4,700 -
24214 UoH - Fascia/muscle Release in Polio SURGEMAJOR 2,700 -
24215 UoH - Femoral Head Excision in PSO SURGEMAJOR 4,700 -
24216 UoH - Fracture Non Union Fixation - Fem SURGEMAJOR 6,700 -
24217 UoH - Pauwells Oseteotomy SURGEMAJOR 6,700 -
24218 UoH - Pelvic/Hip/Femur Osteotomies SURGEMAJOR 6,700 2
24219 UoH - Pelvic Support Oseteotomy SURGEMAJOR 8,200 -
24220 UoH - Percutaneous Insitu Fixation in SCFSURGEMAJOR 6,700 1
24221 UoH - Psoas Release at Brim SURGEMAJOR 2,700 5
24222 UoH - Screw Fixation Head and Neck FemSURGEMAJOR 6,700 1
24223 UoH - Surgical Fusion Hip Joint SURGEMAJOR 6,700 -
24224 UoH - Trochanteric Apo-physiodesis SURGEMAJOR 4,700 -
Page 223 of 368

Orthopaedics
Servi
gory
KNEE JOINT & LEG

Unit
###Of Hope Surgery
24225 UoH - '8' Plate Fixation around Knee & AnSURGEMAJOR 4,700 5
24226 UoH - Arthorotomy and Lavage Knee SURGEMAJOR 2,700 -
24227 UoH - Baumann's Gastroc Release SURGEMAJOR 1,700 7
24228 UoH - Bone Grafting (postero lateral) - Ti SURGEMAJOR 4,700 -
24229 UoH - Compartment Syndrome - FasciotoSURGEMAJOR 4,700 -
24230 UoH - Congenital Pseudaorthrosis + FibulaSURGEMAJOR 7,300 -
24231 UoH - Congenital Pseudaorthrosis +IIizar SURGEMAJOR 7,300 -
24232 UoH - Distalisation of Tibial Tuberosity SURGEMAJOR 4,700 -
24233 UoH - Femoral Epiphysiodesis SURGEMAJOR 2,700 3
24234 UoH - Femoral Osteotomies SURGEMAJOR 6,700 1
24235 UoH - Fractional Hamstring Release SURGEMAJOR 1,700 3
24236 UoH - Fulkerson's Osteotomy SURGEMAJOR 4,700 -
24237 UoH - IIizaroav/TSF/LRS - Tibia SURGEMAJOR 7,300 3
24238 UoH - Judets Quadriceps Plasty with FemSURGEMAJOR 7,300 -
24239 UoH - Muscle/Tendon Transfers around hiSURGEMAJOR 5,300 1
24240 UoH - Osteotomy and Plate/K-wire fixation SURGEMAJOR 6,700 1
24241 UoH - Pan Genu Epiphysiodesis SURGEMAJOR 4,700 2
24242 UoH - Percutaneous Quadriceps RecessioSURGEMAJOR 1,700 -
24243 UoH - Physeal Arrest Surgeries SURGEMAJOR 4,700 -
24244 UoH - Proximalm/Distal Realignment SurgSURGEMAJOR 4,700 -
24245 UoH - Surgical Fusion of Knee SURGEMAJOR 6,700 -
24246 UoH - Telescoping Nail/FDNail - Tibia SURGEMAJOR 6,700 -
24247 UoH - Tibial Epiphysiodesis SURGEMAJOR 2,700 1
24248 UoH - Tibial Shortening and Plating SURGEMAJOR 6,700 -
24249 UoH - Tibia-multilple Osteotomies + IM NSURGEMAJOR 7,300 -
24250 UoH - V-Y Quadriceps Plasty SURGEMAJOR 4,700 1
Page 224 of 368

Orthopaedics
Servi
gory
24251 UoH -Arthrotomy and Lavage Shoulder SURGEMAJOR 2,700 -

24252 UoH - Deformity Correction and Osteoto SURGEMAJOR 5,300 -
24253 UoH - Fractional Lengthenins Muscle in SURGEMAJOR 4,700 -
24254 UoH - IM Nail/Plating/K-wire Fixation H SURGEMAJOR 4,700 1
24255 UoH - LRS/IIizarov Fixator - Humerus SURGEMAJOR 6,700 -
24256 UoH - Malunited Supracondylar Fracture SURGEMAJOR 4,700 -
24257 UoH - Scalpa Mobilization in Sprengel Sh SURGEMAJOR 5,300 -
24258 UoH - Surgical Fusion - Shoulder SURGEMAJOR 4,700 -
24259 UoH - Unipolar/Bipolar Release in TorticolSURGEMAJOR 4,700 1
GENERAL
Unit
###Of Hope Surgery
24277 UoH - Arthrogram Joints SURGEMAJOR 1,700 1
24278 UoH - Bone Grafting and Curettage in B SURGEMAJOR 4,700 -
24279 UoH - Closed Reduction and Cast ApplicaSURGEMAJOR 1,700 -
24280 UoH - Decompression of Bone in Acute SURGEMAJOR 2,800 -
24281 UoH -Exostocis Excision SURGEMAJOR 3,700 2
24282 UoH - Joint Debridement and Synovecto SURGEMAJOR 3,700 2
24283 UoH - Non-Union Fracture Fixation SURGEMAJOR 6,700 1
24284 UoH - Percutaneous Tenotomies SURGEMAJOR 1,700 1
WRIST
Unit
###Of Hope Surgery
24272 UoH - Carpal Bone Excision SURGEMAJOR 4,700 -
24273 UoH - External Fixator/Small Fragment FixSURGEMAJOR 6,700 -
24274 UoH - Surgical Fusion (wrist) SURGEMAJOR 6,700 -
24275 UoH - Tendon Transfers(hand) SURGEMAJOR 4,700 -
24276 UoH - Wrist Deformity in CP/AMC CorrectSURGEMAJOR 4,700 -
Page 225 of 368

Orthopaedics
Servi
gory
16. ORTHOPAEDICS
Orthopaedics
### Procedure
1919 Slab Application Procedure PROCEnull 150 9
1920 Pelvic / Cervical Traction PROCEnull 50 73
Orthopaedics
###
7120 Total Joint Replacement- Foot & Ankle SURGEMAJOR 25,000 -
7186 Jewett Nailing SURGEMAJOR 11,000 -
7188 SP Nailing & Plating SURGEMAJOR 13,000 -
7207 Pilon fracture fixation SURGEMAJOR 17,000 -
7217 Disc replacement - Leg SURGEMAJOR 25,000 -
7236 Hartshill rectangle fixation with fusion SURGEMAJOR 20,000 -
7237 Harrington instrumentation with fusion SURGEMAJOR 20,000 -
7259 Recurrent Dislocation of Patella SURGEMAJOR 11,000 -
7495 Expandable nail - Thigh SURGEMAJOR 20,000 -
7508 Expandable nail - Leg SURGEMAJOR 18,000 -
7509 Percutaneous unicondylar femoral fixatioSURGEMAJOR 8,000 -
7530 Neglected TA Repair SURGEMAJOR 16,000 -
7531 Ankle Arthroscopy(Procedure Includes B SURGEMAJOR 14,000 -
7532 Ankle Fractures ORIF with Ligament RepaSURGEMAJOR 14,000 -
95015 Operation Charges MISC.null - -
Orthopaedics
### Procedure
1917 Ilizarov External Fixator MISC.null 2,155 -
Evening
1905 Closed Redn.of Fract.and dislocation-Chi MISC.null 630 -
1906 Closed Reduction of Fract.and dislocationMISC.null 1,080 -
1908 Intra Articular Injection -E MISC.null 320 -
1910 Manipulation -E MISC.null 500 -
Page 226 of 368

Orthopaedics
Servi
gory
1911 Minor Suturing under L.A. - E MISC.null 320 -

1913 Skeletal Traction -E MISC.null 540 -
1915 Trigger Point Injection -E MISC.null 160 -
Grand Total 5,309,080 2,388

Date Date Date
Page 227 of 368

Plastic Surgery
Ch Code ChargeDesc ServiceDesc CatagorervCat ward Remarks
Rate Apr-17 to Nov-17 Rate Revision
y
Plastic Surgery
Printed in SOC's
23. PLASTIC SURGERY
Plastic
2313 Dressing - Service Charges (Small) MISC. null 70 3,427
2314 Dressing - Service Charges (Medium) MISC. null 150 2,098
2315 Dressing - Service Charges (Large) MISC. null 200 528
2316 Burns pad MISC. null 60 5,693
2317 Suturing Minor MISC. null 1,000 1
2318 Suturing Major MISC. null 2,000 -
2320 POP Applications MISC. null 120 16
2321 Arch Bar Removal (per Arch) MISC. null 120 40
2322 Body Piercing MISC. null 240 -
2323 Intra Lesional Injection MISC. null 150 96
2324 Incision and Drainage MISC. null 120 1
2325 Splinting MISC. null 100 7
2326 Debridement MISC. null 175 -
2327 Cross finger flap MISC. null 600 -
2328 V-Y Flap MISC. null 2,000 -
2329 Flap Division MISC. null 240 -
2330 Removal of Foreign Body in OPD/ward MISC. null 240 -
2331 Closed reduction and splinting MISC. null 120 -
2332 Split skin graft (small) MISC. null 1,000 -
2333 Split skin graft (medium) MISC. null 2,000 -
2335 Delay of Flaps (minor) MISC. null 175 -
Page 228 of 368

Plastic Surgery
y
2336 Delay of Flaps (major) MISC. null 350 -
2339 Tendon repair (minor) MISC. null 1,000 -
2340 Tendon repair (major) MISC. null 2,000 -
2341 Fasciotomy (minor) MISC. null 120 -
2342 Fasciotomy (major) OPD/Ward MISC. null 600 -
2343 Botox injection MISC. null 600 -
2345 Medical Documentation - Clinical Photograp MISC. null 175 -
2349 Ear Piercing (per ear) MISC. null 120 -
2350 Insurance authentification MISC. null 500 -
2351 Medical / Leave Certificate MISC. null 240 2
2352 Disability assessment MISC. null 475 1
2353 Nerve Biopsy PROCEDUnull 2,600 -
2354 Artery Biopsy PROCEDUnull 2,600 -
2358 Ear Lobe Repair Biilateral MISC. null 3,000 -
2359 Ear Lobe Repair Unilateral PROCEDUnull 2,000 -
2361 Muscle Biopsy PROCEDUnull 2,000 1
2362 Revision Amputation Finger Multiple MISC. null 7,000 -
2363 Revision Amputation Finger Single PROCEDUnull 2,500 -
2364 Sutur Removal Large (OPD) PROCEDUnull 100 5
2365 Sutur Removal Medium (OPD) PROCEDUnull 80 583
2366 Sutur Removal Small (OPD) PROCEDUnull 50 8
J. PLASTIC SURGERY
AESTHETIC SURGERY
Plastic
### Surgery
### liposuction Minor SURGERYMAJO 4,000 -
### Liposuction - Moderate SURGERYMAJO 6,000 2
Page 229 of 368

Plastic Surgery
y
### Liposuction- Major SURGERYMAJOR 13,000 -
### Liposuction- Extensive SURGERYMAJOR 20,000 -
### Brow lift Minor SURGERYMAJO 9,600 -
### Brow lift -Major SURGERYMAJO 16,000 -
### Blepharoplasty Minor SURGERYMINO 5,600 -
### Blepharoplasty - Major SURGERYMINOR 12,000 -
### Blepharoplasty Minor (Bilateral) SURGERYMAJO 16,000 -
### Face lift Minor SURGERYMINOR 12,000 1
### Face lift Major SURGERYMAJOR 20,000 -
### Abdominoplasty Minor SURGERYMINOR 12,000 -
### Abdominoplasty Major SURGERYMAJOR 20,000 1
### Abdominoplasty Extensive SURGERYMAJOR 26,000 -
### Body contouring Minor SURGERYMINOR 12,000 -
### Body contouring - Major SURGERYMAJOR 20,000 -
### Body contouring extensive SURGERYMAJOR 32,000 -
### Dermabrasion Minor SURGERYMAJO 4,000 1
### Dermabrasion -Major SURGERYMAJO 7,000 -
### Dermabrasion Extensive SURGERYMAJO 16,000 -
### Alopecia reduction Minor SURGERYMINO 5,600 -
### Alopecia reduction- Moderate SURGERYMINOR 12,000 -
### Alopecia reduction - Major SURGERYMAJO 20,000 -
### Hair Transplant Minor SURGERYMINO 5,600 1
### Hair Transplant - Moderate SURGERYMINOR 12,000 -
### Hair Transplant Major SURGERYMAJOR 26,000 -
BRACHIAL PLEXUS
Plastic
### Surgery
### Brachial Plexu surgery Minor SURGERYMAJOR 17,000 -
Page 230 of 368

Plastic Surgery
y
### Reconstruction Major SURGERYMAJO 24,000 -
### Reconstruction Extensive SURGERYMAJO 30,000 -
### Brachial plexus - ancillary procedures SURGERYMAJO 8,000 -
BREAST
Plastic
### Surgery
### Gynaecomastia exision unilateral- Minor SURGERYMINO 5,600 1
### Gynaecomastia exision unilateral- Major SURGERYMAJO 16,000 1
### Gynaecomastia excision Bilateral-Minor SURGERYMINOR 15,000 2
### Gynaecomastia excision Bilateral-Major SURGERYMAJO 20,000 4
BREAST RECONSTRUCTION
Plastic
### Surgery
### Breast Reconstruction-Minor SURGERYMINOR 15,000 -
### Breast Reconstruction-Major SURGERYMAJO 29,000 -
### Reduction mammoplasty Unilateral-Minor SURGERYMINOR 7,600 -
### Reduction mammoplasty Unilateral-ModeratSURGERYMAJO 14,000 -
### Reduction mammoplasty Unilateral-Major SURGERYMAJO 20,000 -
### Reduction mammoplasty bilateral minor SURGERYMINOR 13,000 -
### Reduction mammoplasty bilateral moderate SURGERYMAJO 30,000 1
### Reduction mammoplasty bilateral major SURGERYMAJO 35,000 -
### Augmentation mammoplasty unilateral - MinSURGERYMINOR 7,600 -
### Augmentation mammoplasty unilateral - MoSURGERYMAJO 14,000 -
### Augmentation mammoplasty unilateral - MajSURGERYMAJO 20,000 -
### Augmentation mammoplasty bilateral-minorSURGERYMINOR 10,000 -
### Augmentation mammoplasty bilateral-moderSURGERYMAJO 20,000 -
### Augmentation mammoplasty bilateral-majorSURGERYMAJO 24,000 -
### Nipple reconstruction unilateral-minor SURGERYMINO 5,600 -
### Nipple reconstruction unilateral-major SURGERYMAJO 11,000 -
Page 231 of 368

Plastic Surgery
y
### Nipple reconstruction Bilateral -minor SURGERYMINOR 10,000 -
### Nipple reconstruction Bilateral -major SURGERYMAJO 20,000 -
### Implant removal-minor SURGERYMINO 4,600 -
### Implant removal-major SURGERYMAJO 15,600 -
CLEFT LIP, PALATE AND CRANIOFACIAL CLEFTS
Plastic
### Surgery
### Suture removalin OT - Minor SURGERYMINO 1,600 2
### Unilateral cleft lip-Minor SURGERYMINO 7,600 1
### Unilateral cleft lip-Moderate SURGERYMINOR 12,000 1
### Unilateral cleft lip-complex SURGERYMAJO 20,000 -
### Unilateral cleft lip and nose SURGERYMAJO 24,000 -
### Bilateral cleft lip-Minor SURGERYMINO 7,600 -
### Bilateral cleft lip -Moderate SURGERYMAJO 16,000 -
### Bilateral cleft lip -Complex SURGERYMAJO 24,000 1
### Cleft palate repair-Minor SURGERYMINO 7,600 3
### Cleft palate repair-Major SURGERYMINOR 12,000 3
### Cleft palate repair-Complex SURGERYMAJO 20,000 -
### Cleft palate repair and flap SURGERYMAJO 24,000 -
### Lip and palate in one SURGERYMAJO 20,000 -
### Secondary lip correction Minor SURGERYMINO 7,600 1
### Secondary lip correction Major SURGERYMAJO 16,000 2
### Secondary lip correction Complex SURGERYMAJO 24,000 -
### Secondary correction lip and nose SURGERYMAJOR 7,600 -
### Sphincter pharyngoplasty SURGERYMAJO 9,600 -
### Pharyngeal flap SURGERYMINOR 12,000 -
### VPI correction complex SURGERYMAJO 24,000 -
### Alveolar bone graft-Minor SURGERYMINO 8,600 -
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Plastic Surgery
y
### Alveolar bone graft-Major SURGERYMAJO 16,000 -
### Facial cleft Minor SURGERYMAJO 9,600 -
### Facial cleft Major SURGERYMAJO 16,000 -
### Facial cleft complex SURGERYMAJO 24,000 -
CONGENITAL HAND DEFORMITY
Plastic
### Surgery
### Congenital hand deformity Minor SURGERYMINO 4,600 -
### Congenital hand deformity Moderate SURGERYMINOR 8,600 3
### Congenital hand deformity Major SURGERYMAJO 13,000 -
### Hand Infection minor SURGERYMINO 1,800 -
### Hand Infection moderate SURGERYMINOR 4,600 -
### Hand Infection Major SURGERYMAJO 8,000 -
### Hand Infection Complex SURGERYMAJO 15,000 -
CONTRACTURES
Plastic
### Surgery
### Contracture release+SSG-minor SURGERYMINOR 4,000 7
### Contracture release+SSG-moderate SURGERYMINOR 6,000 6
### Contracture release+SSG-Major SURGERYMAJO 8,000 4
### Contracture release+SSG-extensive SURGERYMAJOR 17,000 -
### Contracture + flap SURGERYMINO 6,600 2
### contracture+ flap moderate SURGERYMINOR 9,600 2
### contracture+ flap major SURGERYMAJO 18,000 -
CRANIOFACIAL SURGERY
Plastic
### Surgery
### Strip craniectomy SURGERYMINOR 8,600 -
### Facial contouring- Minor SURGERYMINO 7,600 -
### Facial contouring Moderate SURGERYMAJO 16,000 3
Page 233 of 368

Plastic Surgery
y
### Facial contouring Complex SURGERYMAJOR 26,000 -
### Bone graft Minor SURGERYMINO 7,600 -
### Bone graft- moderate SURGERYMINOR 12,000 -
### Bone graft - major SURGERYMAJO 20,000 -
### Bone graft - extensive SURGERYMAJOR 32,000 -
### Orbital reconstruction-Minor SURGERYMINO 9,000 1
### Orbital reconstruction-Major SURGERYMAJO 20,000 1
### Skull base reconstruction -Minor SURGERYMINOR 9,600 -
### Skull base reconstruction -Major SURGERYMAJO 16,000 -
### Skull base reconstruction Complex SURGERYMAJO 24,000 -
### Cranioplasty-Minor SURGERYMINO 7,600 -
### Cranioplasty-Moderate SURGERYMAJO 16,000 -
### Cranioplasty-Major SURGERYMAJO 20,000 -
### Frontal advancement SURGERYMAJO 20,000 -
### Hypertelorism:Extra cranial correction SURGERYMAJOR 26,000 -
### Hypertelorism:Intra cranial correction SURGERYMAJOR 32,000 -
### Mono block advancement SURGERYMAJOR 32,000 -
### Facial bipartition SURGERYMAJOR 39,000 -
### Segmental osteotomy Single SURGERYMINOR 9,600 -
### Segmental osteotomy Multiple SURGERYMAJO 16,000 -
### Le fort I advancement SURGERYMINOR 12,000 -
### Le fort II , III advancement SURGERYMAJO 24,000 -
### Sagittal Split Mandible Unilateral SURGERYMINOR 9,600 -
### Sagittal Split Mandible - Bilateral SURGERYMAJOR 22,000 -
### Bi- jaw surgery Total SURGERYMAJOR 32,000 -
### TMJ ankylosis -Unilateral SURGERYMINOR 9,600 -
### TMJ Ankylosis - Unilateral (complex) SURGERYMINOR 16,000 1
Page 234 of 368

Plastic Surgery
y
### TMJ ankylosis -Bilateral SURGERYMAJO 20,000 -
### TMJ Ankylosis - Bilateral (complex) SURGERYMAJO 24,000 -
### Genioplasty Simple SURGERYMINOR 9,600 -
### Genioplasty Complex SURGERYMAJO 16,000 -
### Facial assymetry Correction Major SURGERYMAJOR 39,000 -
### Facial assymetry Correction Complex SURGERYMAJOR 48,000 -
### Total Craniofacial Correction SURGERYMAJOR 60,000 -
### Avfistula creation minor SURGERYMINO 5,000 36
### Avfistula creation major SURGERYMAJO 8,000 2
### Rexploration for AVF SURGERYMINO 2,000 -
### secondary correction of nose moderate SURGERYMINOR 12,000 -
### secondary correction of nose major SURGERYMAJO 16,000 -
DIVISION AND INSET
Plastic
### Surgery
### Division and inset-Minor SURGERYMINO 2,000 25
### Division and inset-Major SURGERYMAJO 6,600 4
### Flaps Delay -Minor SURGERYMINO 2,000 23
### Flaps Delay -Major SURGERYMAJO 5,000 2
EAR RECONSTRUCTION
Plastic
### Surgery
### EAR RECONSTRUCTION-Minor SURGERYMINO 5,000 -
### EAR RECONSTRUCTION-Moderate SURGERYMINOR 9,600 5
### EAR RECONSTRUCTION-Major SURGERYMAJO 14,000 1
### EAR RECONSTRUCTION-Complex SURGERYMAJOR 26,000 -
### EAR RECONSTRUCTION-Single Stage SURGERYMAJOR 35,000 -
### Ear Lobe Repair Biilateral SURGERYMAJO 3,000 2
### Ear Lobe Repair Unilateral SURGERYMINO 2,000 1
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Plastic Surgery
y
EXCISION AND RESURFACING
Plastic
### Surgery
### Excision And Resurfacing-Minor SURGERYMINO 3,000 5
### Excision And Resurfacing-Moderate SURGERYMINOR 6,300 10
### Excision And Resurfacing-Major SURGERYMAJO 13,000 10
### Excision And Resurfacing-Complex SURGERYMAJOR 26,000 -
### Flap Reelevation- Minor SURGERYMINO 2,000 -
### Flap Reelevation- Major SURGERYMAJO 5,000 -
### Flap Thinning -Minor SURGERYMINO 3,000 2
### Flap Thinning -Major SURGERYMAJO 10,000 2
EXCISIONS
Plastic
### Surgery
### Excisions-Minor SURGERYMINO 2,600 50
### Excisions-Moderate SURGERYMINOR 6,000 32
### Excsions-Major SURGERYMAJOR 12,000 3
EYES
Plastic
### Surgery
### Eyelid Repair (Minor) SURGERYMINOR 4,600 1
### Eyelid Repair (major) SURGERYMAJO 10,000 -
### Ectropion Release (Re-Surfacing each eye) SURGERYMAJO 9,600 -
### Canthoplasty (Minor) SURGERYMINOR 6,000 -
### Canthoplasty (Major) SURGERYMAJO 14,000 -
### Canthoplasty (Complex) SURGERYMAJOR 22,000 -
### Eyebrow Reconstruction (Minor) SURGERYMINO 7,600 -
### Eyebrow Reconstruction (Major) SURGERYMAJO 12,000 -
### Eyelid Reconstruction (Minor) SURGERYMAJO 6,000 -
### Eyelid Reconstruction (Moderate) SURGERYMAJO 10,000 -
Page 236 of 368

Plastic Surgery
y
### Eyelid Reconstruction (Major) SURGERYMAJOR 16,600 -
### Total eyelid reconstruction SURGERYMAJOR 22,000 -
### Ptosis Correction (Minor) SURGERYMAJO 10,000 -
### Ptosis Correction (Major) SURGERYMAJO 14,000 -
### Deepening of contracted eye socket (Minor) SURGERYMAJO 10,000 1
### Deepening of contracted eye socket (Major) SURGERYMAJOR 15,000 -
FACE
Plastic
### Surgery
### Facial Laceration (Minor) SURGERYMINO 4,000 64
### Facial Laceration (Major) SURGERYMINO 10,000 36
### Facial Laceration (Complex) SURGERYMAJO 14,000 3
FLAPS
Plastic
### Surgery
### Flaps -Minor SURGERYMINO 4,000 37
### Flaps-Moderate SURGERYMINOR 10,000 25
### Flaps-Major SURGERYMAJO 15,000 17
### Flaps-Complex SURGERYMAJOR 31,000 1
GENITALIA RECONSTRUCTION
Plastic
### Surgery
### Hypospadias correction -Minor (each stage) SURGERYMINOR 7,600 -
### Hypospadias correction Major (single stage) SURGERYMAJO 15,000 -
### Fistula correction Multiple (Minor) SURGERYMAJO 14,000 -
### Fistula correction - Single (Minor) SURGERYMINO 4,600 -
### Genitalia reconstruction (Minor) SURGERYMINO 4,600 -
### Genitalia reconstruction (Mod) SURGERYMINOR 8,000 1
### Genitalia reconstruction (Major) SURGERYMAJO 26,000 -
HAND RESURFACING
Page 237 of 368

Plastic Surgery
y
Plastic
### Surgery
### Hand Resurfacing-Minor SURGERYMINOR 6,000 1
### Hand Resurfacing-Moderate SURGERYMINOR 10,000 4
### Hand Resurfacing-Major SURGERYMAJO 20,000 2
### Hand Resurfacing-Complex SURGERYMAJOR 33,000 1
### Joint reconstruction-Minor SURGERYMINO 2,800 1
### Joint reconstruction-Moderate SURGERYMINOR 7,000 1
### Joint reconstruction-Major SURGERYMAJO 14,000 -
### Joint reconstruction-Complex SURGERYMAJOR 26,000 -
### Finger Reconstruction-Minor SURGERYMINO 5,000 115
### Finger Reconstruction-Moderate SURGERYMINOR 10,000 36
### Finger Reconstruction-major SURGERYMAJO 11,000 4
### Finger Reconstruction-Complex SURGERYMAJO 15,000 1
### Fracture fixation-Minor SURGERYMINO 4,000 24
### Fracture fixation-Moderate SURGERYMINOR 10,000 10
### Fracture fixation-Major SURGERYMAJO 15,000 2
### Tendon repair-Minor SURGERYMINO 4,600 12
### Tendon repair-Moderate SURGERYMINOR 8,000 15
### Tendon repair-Major SURGERYMAJO 11,000 8
### Wrist Injury-Minor SURGERYMINO 10,000 10
### Wrist Injury-Moderate SURGERYMINOR 15,000 3
### Wrist Injury-Major SURGERYMAJO 21,000 6
### Wrist Injury-Complex SURGERYMAJO 26,000 -
### Carpal Tunnel Release Open SURGERYMINO 7,000 1
LIP
Plastic
### Surgery
### Injury (Minor) SURGERYMINO 4,600 2
Page 238 of 368

Plastic Surgery
y
### Injury (Major) SURGERYMINOR 10,000 -
### Lip reconstruction (Minor) SURGERYMINOR 10,000 2
### Lip reconstruction (Major) SURGERYMAJO 16,000 -
### Lip reconstruction (Complex) SURGERYMAJOR 22,000 -
### microstomia minor SURGERYMINO 4,600 -
### Microstomia-Major SURGERYMAJOR 14,000 -
### Macrostomia correction SURGERYMAJOR 14,000 1
LYMPHEDEMA SURGERY
Plastic
### Surgery
### lymphedema excision SURGERYMAJO 11,000 -
### Microlymphatic surgery SURGERYMAJOR 26,000 -
MAXILLO FACIAL INJURIES
Plastic
### Surgery
### elevation -nasal bone minor SURGERYMAJOR 4,000 3
### elevation -nasal bone major SURGERYMAJOR 8,000 1
### zygoma elevation SURGERYMAJOR 4,000 1
### dental impressions under GA SURGERYMAJO 2,000 -
### cap splint application SURGERYMINOR 3,000 1
### ach bar fixation-segmental SURGERYMINO 2,600 -
### arch bar fixation-complete SURGERYMAJO 3,800 2
### arch bar removal SURGERYMINO 1,800 -
### miniplate removal minor SURGERYMAJOR 4,200 1
### miniplate removal major SURGERYMAJOR 11,000 1
### maxillo facial fracture fixation-minor SURGERYMAJOR 6,000 5
### maxillo facial fracture fixation-moderate SURGERYMAJOR 10,000 9
### maxillo facial fracture fixation-major SURGERYMAJOR 15,000 17
### maxillo facial fracture fixation-extensive SURGERYMAJOR 24,000 -
Page 239 of 368

Plastic Surgery
y
### pan facial fracture fixation-minor SURGERYMAJOR 13,000 -
### pan facial fracture fixation moderate SURGERYMAJOR 20,000 -
### pan facial fracture fixation major SURGERYMAJOR 38,000 -
MICRO SURGERY
Plastic
### Surgery
### Microvascular flap transfer Limited SURGERYMAJOR 17,000 3
### Microvascular flap transfer Moderater SURGERYMAJOR 29,000 6
### Microvascular flap transfer complex SURGERYMAJOR 41,000 -
### Replant Minor SURGERYMAJOR 15,000 3
### replant Major SURGERYMINO 22,000 1
### Replant Complex SURGERYMAJO 37,000 -
### Revascularisation Minor SURGERYMINO 5,000 4
### Revascularisation Limited SURGERYMINOR 10,000 3
### Revascularisation Major SURGERYMAJO 20,000 2
### Revascularisation Complex SURGERYMAJOR 34,000 -
### Nerve Reconstruction Minor SURGERYMAJOR 6,000 2
### Nerve Reconstruction Major SURGERYMAJOR 11,000 3
### Nerve Reconstruction Complex SURGERYMAJOR 22,000 -
### Reexploration - Minor SURGERYMINO 1,800 -
### Reexploration - Major SURGERYMAJO 7,600 -
### Microvascular Flap Transfer Minor SURGERYMAJO 15,000 5
MISCELLANEOUS
Plastic
### Surgery
### Intraleisonal steroid (Minor) SURGERYMINO 1,800 -
### Body piercing (minor) SURGERYMINO 3,000 -
### Body piercing (mod) SURGERYMINOR 4,600 -
### Body piercing (complex) SURGERYMINOR 11,000 -
Page 240 of 368

Plastic Surgery
y
### Nerve biospy minor SURGERYMINO 2,600 8
### Nerve biospy moderate SURGERYMINOR 4,000 1
### Nerve biospy major SURGERYMAJO 6,600 -
### Scelerotherapy SURGERYMINO 2,600 -
NOSE
Plastic
### Surgery
### Suturing (Minor) SURGERYMINO 4,600 28
### Suturing (Major) SURGERYMINO 7,600 4
### Suturing (Complex) SURGERYMAJO 13,000 -
### Reduction Rhinoplasty (Minor) SURGERYMAJO 12,000 1
### Reduction Rhinoplasty (Major) SURGERYMAJOR 22,000 -
### Partial Nasal Reconstruction (Minor) SURGERYMINO 9,600 -
### Partial Nasal Reconstruction (Moderate) SURGERYMAJO 14,000 1
### Partial Nasal Reconstruction (Major) SURGERYMAJOR 22,000 -
### Augumentation with graft (Minor) SURGERYMAJOR 14,000 1
### Augumentation with graft (Major) SURGERYMAJOR 20,000 -
### Augumentation with graft (Complex) SURGERYMAJOR 30,000 -
### Alar Correction (Minor) SURGERYMINOR 10,000 -
### Alar Correction (Major) SURGERYMAJO 16,000 -
### septorhinoplasty SURGERYMINOR 10,000 -
### septorhinoplasty plus ccg SURGERYMAJO 24,000 -
### Single Stage total nasal reconstruction SURGERYMAJOR 33,000 -
### Nasal Reconstruction washioflap SURGERYMAJOR 31,000 -
GENERAL
Plastic
### Surgery
### Basic Microscope per hour MISC. null 400 23
### Advanced Microscope per hour MISC. null 800 9
Page 241 of 368

Plastic Surgery
y
### Artery Biopsy SURGERYMINO 2,600 3
### Muscle Biopsy SURGERYMAJO 2,000 9
### Carpal Tunnel Release Minor SURGERYMAJO 4,000 1
### Carpal Tunnel Release Major SURGERYMAJO 8,000 -
### Tissue Biopsy SURGERYMAJO 2,700 4
### Collagen application minor SURGERYMINO 5,000 1
### Collagen application moderate SURGERYMINOR 10,000 -
### Collagen application major SURGERYMAJO 15,000 1
SCAR REVISION
Plastic
### Surgery
### Scar Revision Minor SURGERYMINO 4,000 2
### Scar Revision Moderate SURGERYMINOR 10,000 4
### Scar Revision Major SURGERYMAJO 14,000 2
### Scar Revision Complex SURGERYMAJOR 26,000 -
### Geometric broken line excision-Minor SURGERYMINOR 6,600 -
### GBLE _ complex SURGERYMINOR 13,000 -
WOUNDS AND BURNS
Plastic
### Surgery
### Minor Suturing SURGERYMINO 2,000 50
### moderate suturing SURGERYMINOR 3,000 24
### Major Suturing SURGERYMINOR 4,600 4
### Extensive Suturing SURGERYMAJO 10,000 -
### Suture removal in OT-Minor SURGERYMINO 1,600 4
### Suture removal in OT - Moderate SURGERYMINO 2,600 -
### Dressing-minor SURGERYMINO 1,600 44
### Dressing moderate SURGERYMINO 3,000 10
### Dressing Major SURGERYMINOR 4,800 16
Page 242 of 368

Plastic Surgery
y
### Debridement-minor SURGERYMINO 2,000 49
### Debridement-moderate SURGERYMINOR 4,000 33
### Debridement-Major SURGERYMINOR 8,000 13
### Debridement-extensive SURGERYMAJO 10,000 1
### SSG small area SURGERYMINO 2,000 45
### SSG-limited area SURGERYMAJO 4,000 19
### SSG-moderate SURGERYMINOR 6,000 36
### SSG-Major SURGERYMAJO 10,000 20
### SSG-extensive SURGERYMAJOR 13,000 2
### Homograft harvest-minor SURGERYMINO 1,800 -
### Homograft harvest-moderate SURGERYMINOR 2,800 -
### Homograft harvest-Major SURGERYMINOR 4,600 -
### Tangential Excision- minor SURGERYMINOR 8,000 3
### TE-moderate SURGERYMAJO 12,000 8
### TE-Major SURGERYMAJO 16,000 11
### TE-extensive SURGERYMAJOR 28,000 3
### Limb Amputation-minor SURGERYMINO 4,600 8
### Limb Amputation-Major SURGERYMINOR 10,000 5
### Limb Amputation SURGERYMAJO 12,000 -
### Limb Amputation-Multiple SURGERYMAJOR 18,000 -
### Fasciotomy - Minor SURGERYMINO 1,800 5
### Fasciotomy - Major SURGERYMAJO 5,000 1
### implant removal - Minor SURGERYMINO 3,000 -
### implant removal - Moderate SURGERYMINOR 4,600 -
### implant removal - Major SURGERYMAJO 8,000 -
### Flap Thinning Moderate SURGERYMINOR 6,000 1
### Microstomia Moderate SURGERYMINOR 8,000 -
Page 243 of 368

Plastic Surgery
y
23. PLASTIC SURGERY
Plastic
2310 VAC Dressing with Wall Suction PROCEDUnull 500 29
2311 VAC Dressing with Vac Machine PROCEDUnull 100 15
Plastic
### Surgery
### Harmonic Scalpel MISC. null 2,000 -
### Laparoscope per hour MISC. null 700 -
### Enseal MISC. null - -
### eyelets & IMF SURGERYMINO 2,800 2
### Tendon harvest (Minor) SURGERYMINO 2,000 -
### Tendon harvest (Major) SURGERYMINO 4,600 -
### TE Harvest (Minor) SURGERYMINO 4,600 -
### TE Harvest (Major) SURGERYMINO 7,000 -
### Bilateral (50% of Proce/Surg) SURGERYMINO - -
### Extra Hours taken for a surgery SURGERYMINO - -
### Extra hours for Minor surgery (A) SURGERYMINO - -
### Extra hours for minor + surgery (B) SURGERYMINO - -
### Extra hours for major surgery (C) SURGERYMINO - -
### Extra hours for major + surgery (D) SURGERYMINO - -
### Revision Amputation Multiple Fingers SURGERYMINO 8,000 -
### Revision Amputation Single Finger SURGERYMINO 4,000 -
### Tissue Expansion Surgery Stage 1 Minor SURGERYMAJO 4,000 1
### Tissue Expansion Surgery Stage 2 Minor SURGERYMAJO 10,000 1
### Tissue Expansion Surgery Stage 1 Major SURGERYMAJO 10,000 -
Page 244 of 368

Plastic Surgery
y
### Tissue Expansion Surgery Stage 2 Major SURGERYMAJO 14,000 -
Plastic
2319 Suture Removal MISC. null 40 332
2334 Split skin graft (big) MISC. null 600 -
2337 Revision amputation (minor) MISC. null 240 -
2338 Revision amputation (major) MISC. null 600 -
2344 Skeleton traction/Zimmer traction MISC. null 175 -
2346 Suture Removal - Minor MISC. null 60 4
2347 Suture Removal - Moderate MISC. null 80 8
2348 Suture Removal - Major MISC. null 100 -
2355 Carpal Tunnel Release Endoscopic PROCEDUnull 12,000 -
2356 Carpal Tunnel Release Open MISC. null 7,000 -
2357 Eamination Under Anaesthesia MISC. null 2,000 -
Evening
2313 Dressing - Service Charges (Small) -E MISC. null 130 2
2314 Dressing - Service Charges (Medium) -E MISC. null 270 1
2315 Dressing - Service Charges (Large) -E MISC. null 360 -
2316 Burns Pad - E MISC. null 110 -
2317 Suturing Minor - E MISC. null 320 -
2318 Suturing Major - E MISC. null 860 -
2320 POP Applications -E MISC. null 240 -
2321 Arch Bar Removal (per Arch) -E MISC. null 220 -
2322 Body Piercing -E MISC. null 430 -
2323 Intra Lesional Injection -E MISC. null 270 1
2324 Incision and Drainage -E MISC. null 220 -
2325 Splinting -E MISC. null 180 -
Page 245 of 368

Plastic Surgery
y
2326 Debridement -E MISC. null 320 -
2327 Cross finger flap -E MISC. null 1,080 -
2328 V-Y Flap -E MISC. null 3,600 -
2329 Flap Division -E MISC. null 430 -
2330 Removal of Foreign Body in OPD/Ward -E MISC. null 430 -
2331 Closed reduction and splinting -E MISC. null 220 -
2332 Split skin graft (small) -E MISC. null 1,800 -
2333 Split skin graft (medium) -E MISC. null 3,600 -
2335 Delay of Flaps (minor) -E MISC. null 320 -
2336 Delay of Flaps (major) -E MISC. null 630 -
2339 Tendon repair (minor) -E MISC. null 1,800 -
2340 Tendon repair (major) -E MISC. null 3,600 -
2341 Fasciotomy (minor) -E MISC. null 220 -
2342 Fasciotomy (major) -E MISC. null 1,080 -
2343 Botox injection -E MISC. null 1,080 -
2347 Suture Removal - Moderate -E MISC. null 220 -
2349 Ear Piercing (per ear) -E MISC. null 220 -
Grand Total 4,437,245 14,216

Date Date Date
Page 246 of 368

Genito Urinary Surgery


Printed in SOC's
25. UROLOGY
Urology
### Procedure
1301 Aspiration Biopsy MISC. null 175 4
1302 Biofeed Back (2 Sessions of 10 mi MISC. null 300 -
1303 Biopsy MISC. null 250 -
1304 CMG, UPP, EMG and P.F. Study MISC. null 1,300 -
1305 Cavernosometry and CavernosogrMISC. null 1,190 -
1306 Cystometrography (CMG) with P.F.MISC. null 1,300 58
1307 Cystometrography - Repeat (withi MISC. null 700 -
1308 Intracavernosal Injection of PapavMISC. null 250 5
1309 P.F. Study MISC. null 440 -
1310 PCN MISC. null 660 5
1311 Prostatic Needle Biopsy MISC. null 440 71
1312 Residue MISC. null 150 2,263
1314 Trocar Suprapubic Cystostomy MISC. null 825 29
1315 Trus MISC. null 400 69
1316 UPP MISC. null 175 1
1317 Upper Tract Study MISC. null 240 -
1318 Catheter Calibration MISC. null 55 168
1319 Urethral Dilation MISC. null 300 67
1320 Urethral Dilation - Repeat MISC. null 150 6
1321 Urinary Flow Rate MISC. null 150 2,431
Page 247 of 368


1322 Video UDE (including Video CassetMISC. null 3,000 -

1323 Miscellaneous - Urology Special P MISC. null 165 -
1324 Uroflowmetric Analysis MISC. null 250 2
1351 LITHOTRIPSY - A (< 1cm) MISC. null 10,000 113
1352 LITHOTRIPSY - B (1-2cms) MISC. null 12,000 12
1353 LITHOTRIPSY - C (2-3cms) MISC. null 13,100 -
1354 LITHOTRIPSY - D (Additional Sittin MISC. null 3,600 -
1355 LITHOTRIPSY - E (Completion LithoMISC. null 2,400 37
1356 LITHOTRIPSY - F (Attempted) MISC. null 600 -
1361 Erectiledysfunction evaluation (C MISC. null - -
1362 Erectiledysfunction evaluation (NoMISC. null - -
1363 Provocative testing (PIPE test) MISC. null 120 -
6209 Fluroscopy (0-10 mis) MISC. null 260 356
C. GENITO URINARY SURGERY
CATEGORY - A
Urology
###
21001 Biopsy - Urology SURGERY MINOR 2,200 10
21002 Dorsal slit SURGERY MINOR 2,200 -
21003 Circumcision SURGERY MINOR 2,200 61
21004 Cystoscopy/ Stent removal SURGERY MINOR 2,200 138
21005 Utrethral Dilatation SURGERY MINOR 2,200 5
CATEGORY - B
Urology
###
21006 Cystoscopy + Biopsy SURGERY MINOR 3,300 9
21007 Cystoscopy + Clot evacuation SURGERY MINOR 3,300 6
Page 248 of 368


21008 Cystoscopy + Fulgration SURGERY MINOR 3,300 -

21009 Cystoscopy + RGP SURGERY MINOR 3,300 8
21010 Cystoscopy + Stenting (unilateral) SURGERY MINOR 3,300 83
21011 Intraop-Consultation SURGERY MINOR 3,300 5
21013 SPC - trocar/open SURGERY MINOR 3,300 6
21014 Fistula Repair SURGERY MINOR 3,300 3
21015 Frenuloplasty SURGERY MINOR 3,300 3
CATEGORY - C
Urology
###
21016 Hydrocelectomy SURGERY MINOR + 5,060 4
21017 Simple Orchidectomy SURGERY MINOR + 5,060 21
21018 Cystolithotomy / Cystolithotripsy SURGERY MINOR + 5,060 19
21019 Diagonstic URS SURGERY MINOR + 5,060 138
21020 Meatoplasty SURGERY MINOR + 5,060 -
21021 Cystoscopy + Bilateral Stenting SURGERY MINOR + 5,060 61
21022 Testicular Biopsy SURGERY MINOR + 5,060 -
21023 VIU SURGERY MINOR + 5,060 41
21139 Relook URS SURGERY MAJOR 5,060 49
CATEGORY - D
Urology
###
21024 Varicocele Ligation -Unilateral SURGERY MINOR + 7,300 1
21025 Amputation of Penis - Partial SURGERY MINOR + 7,300 2
21026 BNI SURGERY MINOR + 7,300 3
21027 Endoscopic Removal of F.B. SURGERY MINOR + 7,300 -
21028 Open Nephrostomy SURGERY MINOR + 7,300 6
21029 URS-Simple SURGERY MINOR + 7,300 45
Page 249 of 368


21030 Laser VIU SURGERY MINOR + 7,300 -

21031 Shunt for Priapism SURGERY MINOR + 7,300 1
21032 Endo incision of Uereterocele SURGERY MINOR + 7,300 1
21033 Endoscopic realignment SURGERY MINOR + 7,300 -
21034 I&D/ Debridement SURGERY MINOR + 7,300 9
21035 AVF Construction SURGERY MINOR + 7,300 7
21036 High Orchidectomy SURGERY MINOR + 7,300 2
21131 Laser CLT SURGERY MAJOR 7,300 -
21132 Relook PSNL SURGERY MAJOR 7,300 2
CATEGORY - E
Urology
###
21038 Chordee correction SURGERY MAJOR 9,500 -
21039 Orchidopexy for testicular torsion SURGERY MAJOR 9,500 2
21040 Orchidopexy - Unilateral SURGERY MAJOR 9,500 1
21041 Perinephric Abscess Drainage SURGERY MAJOR 9,500 -
21042 Urethroplasty Stage-1 SURGERY MAJOR 9,500 3
21043 URS+Stenting/Ureterolithotomy SURGERY MAJOR 9,500 18
21044 TUIP/BNR SURGERY MAJOR 9,500 -
21045 Varicocele Ligation Bilateral SURGERY MAJOR 9,500 6
21046 Orchidectomy for Prostate CancerSURGERY MAJOR 9,500 6
21047 Perineal Urethrostomy SURGERY MAJOR 9,500 -
21048 Urology Assistance in Surgery SURGERY MAJOR 9,500 -
21049 Urethral Sling for SUI SURGERY MAJOR 9,500 -
21050 TVT/TOT SURGERY MAJOR 9,500 1
21051 Bladder repair SURGERY MAJOR 9,500 3
21052 Fracture Penis repair SURGERY MAJOR 9,500 -
Page 250 of 368


21053 Burch Colpo suspension SURGERY MAJOR 9,500 -

21127 CAPD Catheter Insertion SURGERY MINOR 9,500 2
21133 Diagonstic LAP SURGERY MAJOR 9,500 -
CATEGORY - F
Urology
###
21054 Amputation of Penis - Total SURGERY MAJOR 13,200 -
21055 Bladder Diverticulectomy SURGERY MAJOR 13,200 2
21056 Vaso-epididymal anastamosis SURGERY MAJOR 13,200 -
21057 Uretero Ureterostomy SURGERY MAJOR 13,200 -
21058 Bladder neck plasty SURGERY MAJOR 13,200 -
21059 Epispadias Repair SURGERY MAJOR 13,200 -
21060 Exploration for Renal Trauma SURGERY MAJOR 13,200 -
21061 Hypospadias-Single Stage repair SURGERY MAJOR 13,200 1
21062 Simple Nephrectomy SURGERY MAJOR 13,200 7
21063 Partial Cystectomy SURGERY MAJOR 13,200 1
21064 Pyelo lithotomy SURGERY MAJOR 13,200 6
21065 TURP/TURBT SURGERY MAJOR 13,200 95
21066 Ureteric Reimplantation SURGERY MAJOR 13,200 -
21067 Prosthesis Implantation SURGERY MAJOR 13,200 -
21068 URS-Flexible SURGERY MAJOR 13,200 -
21069 URS-Bilateral SURGERY MAJOR 13,200 1
21070 Surgery for Pyeronies disease SURGERY MAJOR 13,200 -
21071 Vasectomy reversal SURGERY MAJOR 13,200 -
21072 URS-Laser Lithotripsy SURGERY MAJOR 13,200 -
21134 Graft Nephrectomy SURGERY MAJOR 13,200 1
CATEGORY - G
Page 251 of 368


Urology
###
21074 Boari Flap Implantation SURGERY MAJOR 17,600 -
21075 Inguinal Block Dissection SURGERY MAJOR 17,600 -
21076 Augmentation Cystoplasty SURGERY MAJOR 17,600 -
21077 Nephrolithotomy/ PCNL SURGERY MAJOR 17,600 37
21078 Open Prostatectomy SURGERY MAJOR 17,600 -
21079 Pyeloplasty SURGERY MAJOR 17,600 5
21080 TURP- Large gland /Tumor SURGERY MAJOR 17,600 -
21081 Simple Nephro Ureterectomy SURGERY MAJOR 17,600 1
21082 Radical Nephrectomy SURGERY MAJOR 17,600 7
21083 Partial Nephrectomy for renal tumSURGERY MAJOR 17,600 2
21084 TURP + Additional Procedures SURGERY MAJOR 17,600 1
21085 BMG Urethroplasty SURGERY MAJOR 17,600 4
21086 Progressive Perineal Uretrhoplast SURGERY MAJOR 17,600 3
21087 RIRS SURGERY MAJOR 17,600 3
21088 Ureterolysis + omental wrapping SURGERY MAJOR 17,600 -
21089 Lap Varicocele ligation SURGERY MAJOR 17,600 -
21090 Lap Orchideopexy SURGERY MAJOR 17,600 -
21091 Lap Ureterolithotomy SURGERY MAJOR 17,600 1
21092 Lap Simple Nephrectomy SURGERY MAJOR 17,600 5
21093 Lap Pelvic Lympnode disection SURGERY MAJOR 17,600 -
21094 VVF Repair SURGERY MAJOR 17,600 -
21130 Open Donor Nephrectomy SURGERY MAJOR 17,600 -
CATEGORY - H
Urology
###
21095 Radical Nepho Ureterectomy SURGERY MAJOR 22,000 -
Page 252 of 368


21096 Ureteral Replacement SURGERY MAJOR 22,000 -

21097 Radical Prostatectomy SURGERY MAJOR 22,000 1
21098 Adrenalectomy HOLEP/ Laser ProsSURGERY MAJOR 22,000 1
21100 Lap Radical Nephrectomy SURGERY MAJOR 22,000 -
21101 Lap Partial Nephrectomy SURGERY MAJOR 22,000 -
21102 Lap Ureteric reimplantation SURGERY MAJOR 22,000 -
21103 Lap Pyloplasty SURGERY MAJOR 22,000 5
21104 Lap VVF repair SURGERY MAJOR 22,000 -
21105 Lap Ureterolysis SURGERY MAJOR 22,000 -
21106 Lap Uretero Ureterostomy SURGERY MAJOR 22,000 -
21107 Lap Pylolithotomy SURGERY MAJOR 22,000 -
21128 Lap Donor Nephrectomy SURGERY MAJOR 22,000 -
21135 Ileal Conduit SURGERY MAJOR 22,000 1
CATEGORY - I
Urology
###
21108 Radical Cystectomy + lieal conduitSURGERY MAJOR + 30,000 -
21109 Radical Cystectomy + Neo BladderSURGERY MAJOR + 30,000 -
21110 Auto Tranplantaion of Kidney SURGERY MAJOR + 30,000 -
21111 Complex VVF Repair SURGERY MAJOR + 30,000 -
21112 RPLND SURGERY MAJOR + 30,000 -
21113 Lap Radical Prostatectomy SURGERY MAJOR + 30,000 -
21114 Lap Nephro Uretertectomy SURGERY MAJOR + 30,000 -
21115 Lap Adrenalectomy SURGERY MAJOR + 30,000 1
21123 Laparoscopic Radical Cystectomy SURGERY MAJOR 30,000 -
21129 Renal Transplant Recipient SURGERY MAJOR 30,000 -
GENERAL
Page 253 of 368


Urology
###
18104 Harmonic Scalpel SURGERY MAJOR 2,000 15
18105 Basic Microscope per hour SURGERY MAJOR 400 -
18106 Advanced Microscope per hour SURGERY MAJOR 800 -
21116 Bilateral(50% of Procedure/SurgerSURGERY MAJOR + - -
21117 Extra hours taken for a Surgery# SURGERY MAJOR - -
21118 Extra hours for Minor Surgery (A)#SURGERY MAJOR - -
21119 Extra hours for Minor + Surgery (BSURGERY MAJOR - -
21120 Extra hours for Major Surgery (C)#SURGERY MAJOR - -
21121 Extra hours for Major + Surgery (DSURGERY MAJOR - -
21122 Bilateral (50% fo Proce/Surgery) SURGERY MAJOR + - -
21124 Fluroscopy Time (15-20 Minutes) SURGERY MAJOR 500 -
21125 Fluroscopy Time (20-30 Minutes) SURGERY MAJOR 800 -
21126 Fluroscopy Time (Every Adnl.5mtsSURGERY MAJOR 100 -
21136 Flexible URS SURGERY MAJOR 2,000 -
21137 Laser Equipment SURGERY MAJOR 5,000 -
21138 Fluroscopy Time (10-15 Minutes) SURGERY MAJOR 5,000 -
L. NEPHROLOGY
RENAL TRANSPLANTATION
Surgery
### Packages
6502 Donor Nephrectomy ( OPEN) IP PACKAGnull 60,000 7
6503 Donor Nephrectomy ( LaproscopicIP PACKAGnull 81,000 1
6507 Renal Transplantation IP PACKAGnull 75,600 9
Page 254 of 368


#N/A
#N/A
#N/A
Urology
###
Evening
214 Catherterization(urology) -E MISC. null 130 -
1302 Biofeed Back (2 Sessions of 10 minMISC. null 540 -
1303 Biopsy -E MISC. null 450 -
1304 CMG, UPP, EMG and P.F. Study -E MISC. null 2,340 -
1305 Cavernosometry and CavernosogrMISC. null 2,140 -
1306 Cystometrography (CMG) with P.F.MISC. null 2,340 -
1307 Cystometrography - Repeat (withi MISC. null 1,260 -
1309 P.F. Study -E MISC. null 790 -
1310 PCN -E MISC. null 1,190 -
1312 Residue -E MISC. null 270 8
1315 Trus -E MISC. null 720 -
1316 UPP -E MISC. null 320 -
1317 Upper Tract Study -E MISC. null 430 -
1319 Urethral Dilation -E MISC. null 540 -
1320 Urethral Dilation - Repeat -E MISC. null 270 -
1322 Video UDE (including Video CassetMISC. null 5,400 -
1355 LITHOTRIPSY - E ( Completion LithoMISC. null 3,960 1
Grand Total 1,937,875 6,721
Page 255 of 368



Date Date Date
Page 256 of 368

Anesthesiology

Ch Code ChargeDesc ServiceDesc CatagoryServCat ward Rate Remarks
Anesthesiology
Printed in SOC's
31. ANAESTHESIOLOGY
Anesthesiology
###
3001 Arterial Line PROCEDUREnull 240 -
3002 Central Venous Cannulation PROCEDUREnull 300 -
3003 Endotracheal intubation PROCEDUREnull 200 -
3004 Lumbar Puncture PROCEDUREnull 175 -
3005 Ryles tube PROCEDUREnull 20 10
3006 Glucometer Random Blood Sugar PROCEDUREnull 60 -
3007 Pre Anaesthesia/Post Anaesthesia .chec PROCEDUREnull - 2,891
3008 Therapeutic epidural steroid injection MISC. null - -
3020 I STAT-ABG MISC. null 385 23
73004 Inj. Sod/Thiopenthol 250 MISC. null 44 242
73010 Injection Prostigmine MISC. null 4 17,206
73011 Injection Scoline 100mg MISC. null 5 71
73012 Injection Xylocaine 2% MISC. null 1 15,838
73013 Injection Xylocaine (Adr MISC. null 1 9,164
73014 Injection Xylocaine 5% MISC. null 1 2
73021 Inj. Sensorcaine 0.5% ml MISC. null 4 8,385
73027 Injection Atropine MISC. null 4 12
73030 Injection Pethedine MISC. null 45 79
73031 Injection Morphine MISC. null 22 630
73032 Injection Xylocard 2% MISC. null 1 5
73033 Injection Fortwin MISC. null 6 374
73045 Injection Mephantine MISC. null 18 -
73048 Injection Atracrium/Trac. MISC. null 119 14,434
Page 257 of 368

Anesthesiology

73055 Inj.Sensorcaine(Heavy)4ml MISC. null 28 41

73066 Inj. Ephedrine Hcl./ml MISC. null 20 -
73083 Injection Bupivocane MISC. null 11 2,225
73084 Inj.Fenstrong/Fentanyl MISC. null 43 30,887
73089 Injection Tramadol MISC. null 13 1,016
73105 Inj. Succinyl Choline MISC. null 41 101
73106 Inj. Fulsed 5ml MISC. null 26 23
73109 Inj. Fortwin (50mg) MISC. null 6 241
73115 Inj. Vecuronium Bromede MISC. null 78 3,351
73121 Injection Propafol 20ml MISC. null 168 33
73122 Injection Propafol 50ml MISC. null 388 118
73237 Rocronium MISC. null 304 418
73238 Inj.Kenadion MISC. null 12 1,026
75001 Injection Pethadine 50 mg MISC. null 45 4,553
75008 Inj.Ketamin 1cc MISC. null 22 294
R. ANAESTHESIOLOGY
R. ANAESTHESIOLOGY
Anesthesiology
###
3027 Anaesthesia for ECT MISC. null 300 -
3028 Anaesthesia for Cardioversion MISC. null 300 1
3029 Anaesthesia for Cath Lab MISC. null 300 -
3030 Labour Analgesia MISC. null 2,000 1
3031 LP Out side OT MISC. null 300 -
9401 Epidural Injection SURGERY MINOR 300 80
9402 Pain Clinic SURGERY MINOR 100 1
9404 Extra Hours taken for a surgery SURGERY MINOR - -
9406 Nerve Block(minor) SURGERY MINOR 500 1
9407 Nerve block (major) SURGERY MINOR 700 -
Page 258 of 368

Anesthesiology

9408 Local Anaesthesia SURGERY MINOR 100 -

9409 Post-op Epidural Analgesia (Package) for SURGERY MINOR 1,100 84
9410 Post-op Epidural Analgesia (Package) for SURGERY MINOR 1,700 48
9411 Chemical Sympathectomies SURGERY MINOR 1,000 -
9416 Specialised Anaesthesia Care SURGERY MINOR 200 8
9417 Anaesthesia for Endoscopy PROCEDUREnull 300 -
9418 Anaesthesia for CT Scan PROCEDUREnull 300 -
9419 Anaesthesia for Radiotherapy PROCEDUREnull 600 -
R. ANAESTHESIOLOGY
R. ANAESTHESIOLOGY
Anesthesiology
###
73297 Injection Etomidate MISC. null 520 11
Anesthesiology
###
3024 Anaesthesia for Endoscopy MISC. null 300 -
7301 Posterior Spinal Fusion MISC. null 5,385 -
7304 Epidural Steroid Injectio MISC. null 850 -
9405 GRBS done in O T SURGERY MINOR 100 48
73001 Injection Flaxidil / Gall MISC. null 7 4
73002 Inj.Intraval Sodium (.5gm MISC. null 41 -
73005 Injection Ketamin (10mg) MISC. null 39 70
73006 Injection Ketamin (50mg) MISC. null 101 43
73007 Injection Marcaine MISC. null - -
73008 Injection Marcaine (20ml MISC. null - -
73009 Injection Pavulon MISC. null 18 -
73015 Betadine MISC. null - -
73016 Savalon MISC. null - -
73017 Iodine MISC. null - -
Page 259 of 368

Anesthesiology

73018 Injection Buprenorphine MISC. null 14 4

73019 Injection Lignocaine MISC. null - 30
73020 Injection Gelamine MISC. null 5 -
73022 Injection Sonide 50mg MISC. null 297 -
73023 Injection Vasopressin MISC. null 130 -
73024 Methyline blue MISC. null - 4
73025 Xylocaine jelly MISC. null 27 -
73026 Glycine solution MISC. null 20 205
73028 Injection Calmpose MISC. null 12 -
73029 Injection Adrenaline MISC. null 7 -
73034 Injection Xylocaine Visc. MISC. null - 10
73035 Injection Isorpin MISC. null 6 -
73036 Injection Gerican MISC. null 1 -
73037 Injection Phenargan 50mg MISC. null 5 -
73038 Injection S.T.D MISC. null 52 -
73039 Injection Isorpin (Import MISC. null 10 -
73040 Injection Lignox 2% MISC. null 1 -
73041 Sodium chloride MISC. null - -
73042 Occulose 2% MISC. null 107 -
73043 Injection Glycopyrrolate MISC. null 10 -
73044 Injection Mephantine 30mg MISC. null 6 -
73046 Normal Saline MISC. null 22 -
73047 Injection Cardioplegia MISC. null 269 -
73049 Spirit MISC. null 3 -
73050 Injection Lignocaine 2% MISC. null 5 151
73051 Injection Metoprolol MISC. null 14 -
73052 Injection Gentamycin MISC. null 7 -
73053 Injection Norcuron MISC. null 113 -
73054 H2 O2 (Hydrogen peroxide) MISC. null - -
Page 260 of 368

Anesthesiology

73056 Hibiscrub/Surgiscrub MISC. null 1 -

73057 Injection Diazepam MISC. null 13 -
73058 Injection Methergine MISC. null 21 -
73059 Micro Shield Solution 500 MISC. null 585 -
73060 Injection Perinorm MISC. null 6 -
73061 Injection Efcorlin MISC. null 44 -
73062 Injection Calcium glucon. MISC. null 11 -
73063 Injection Deriphyllin MISC. null 4 -
73064 Injection Papavarine MISC. null 8 -
73065 Injection Dopamine MISC. null 30 -
73067 Injection Nefidine MISC. null 8 -
73070 Dacron Vascular Prosthesis MISC. null - -
73085 Injection Forane 100ml MISC. null 1,945 -
73086 Inj. Xylocaine with Adre. MISC. null 18 35
73088 Injection Voveran MISC. null 7 -
73090 Injection Esmeron/Rocuron MISC. null 6 -
73091 Injection Esmeron/Rocuron MISC. null 60 -
73092 Injection Heparine 5000ml MISC. null 35 2
73104 Injection Pancuronium MISC. null 18 1
73107 Inj. Tidigesic MISC. null 15 -
73108 Inj. Nitro Glycerin MISC. null 99 6
73110 Inj. Isoprenaline MISC. null 3 14
73111 Inj. Insulin (Plain) MISC. null 141 -
73116 Inj. Propofol 10ml MISC. null 105 264
73118 Xylocaine Spray 10% P.Puf MISC. null 3 -
73119 Injection Emeset 4mg MISC. null 34 -
73120 Injection Emeset 8mg MISC. null 49 -
73126 Irrigation Saline 500ml MISC. null 12 -
73127 Tincture Benzoin MISC. null - -
Page 261 of 368

Anesthesiology

73128 Injection Dicloran MISC. null 4 -

73129 Injection Ondasteron 2ml MISC. null 8 5
73130 Injection Ondasteron 4ml MISC. null 14 -
73131 Injection Lasix MISC. null 3 -
73132 Injection Tramadal MISC. null 13 3,137
73133 Injection Hylase MISC. null 52 -
75002 Inj.Morphine MISC. null 13 2,343
75003 Injection S.T.D. MISC. null 90 -
75004 Inj.Atropine 100 ml. MISC. null 60 -
75005 Inj.Atropine 500 ml. MISC. null 300 -
75006 Inj.Vasopressin MISC. null 115 -
75007 Inj.Ketorol MISC. null 10 -
75009 Gog Keyyalase MISC. null - -
75010 Inj.Fortwin (50mg) MISC. null 5 29
75011 Injection Norcuron MISC. null 90 -
75051 Inj. Fragmin 1/2ml /5000U MISC. null 205 9
75052 Inj. Fragmin 1ml /10,000U MISC. null 410 -
75053 Inj. Fragmin 1ml / 7,500U MISC. null 486 -
95002 Anesthesia Charge MISC. null - -
95025 Anaesthesia Charges MISC. null - -
Grand Total 26,623 120,342

Date Date Date
Page 262 of 368

Emergency Medicine

Row Labels ChargeDe ServiceDesc ServiceCatagory

ServCat Sum of Common Sum of Apr-17 to Nov-17
Emergency Medicine
Printed in SOC's
D. EMERGENCY ICU PACKAGE PER DAY
EICU
Emergency
### I C U - EICU
121 Emergency ICU Charges with RespiraMISC. null 7,000 771
122 EICU Charges without Respirator MISC. null 3,000 490
373 EICU Charges with Respirator (less t MISC. null 3,500 6
H. EMERGENCY MEDICINE
H. EMERGENCY MEDICINE
Emergency
### Medicine
### Blood Gas - Total ABG- EMS MISC. null 350 3,817
### Biochem - EMS PROCEDURnull 400 11,568
### Creatinine - EMS PROCEDURnull 100 6
### NT-proBNP MISC. null 1,620 -
6. GENERAL PROCEDURES - EMERGENCY MEDICINE / EICU
Emergency
### Medicine
3174 IV Fusion MISC. null 50 87
### Electrolytes - EMS MISC. null 210 1
### Malarial Parasites Smear (MP) - EMSMISC. null 190 -
EICU
Emergency
### Medicine
3101 Arterial Line PROCEDURnull 240 22
Page 263 of 368

Emergency Medicine

3104 Stomach Wash for Poison PROCEDURnull 290 -

3106 Defibrillator PROCEDURnull 210 5
3107 Monitoring PROCEDURnull 140 1,978
3109 Oxygen Inhalation (per hour) PROCEDURnull 40 185
3110 Infusion Pump (per day) PROCEDURnull 210 63
3112 Pleural Aspiration PROCEDURnull 210 18
3114 Catheterization PROCEDURnull 80 381
3117 Dressing - Pad and Bandage PROCEDURnull 70 93
3118 Dressing - Each Bandage PROCEDURnull 50 250
3120 GRBS MISC. null 60 6,146
3121 Incision and Drainage PROCEDURnull 140 8
3125 POP 10 cm PROCEDURnull 70 111
3126 POP 15 cm PROCEDURnull 140 1
3127 Plastering - Major PROCEDURnull 250 -
3128 Plastering - Minor PROCEDURnull 210 104
3129 Removal of Foreign Body PROCEDURnull 140 55
3130 ECG MISC. null 160 4,997
3131 Ryles Tube Introduction PROCEDURnull 20 121
3133 Suture Removal in EMS PROCEDURnull 50 -
3138 Lumbar Puncture PROCEDURnull 210 5
3139 ICD Insertion PROCEDURnull 210 27
3140 Nasal Packing PROCEDURnull 80 3
3141 Suturing with Plastic Suture Set PROCEDURnull 230 220
3142 Suturing with Suture Set PROCEDURnull 160 4
3144 Sengstaken Tube Introduction PROCEDURnull 860 -
3145 Epidural Steroid Injection PROCEDURnull 1,070 1
3146 Intervenous Cannulation PROCEDURnull 50 18,455
3147 Intramuscular Injection PROCEDURnull 20 626
Page 264 of 368

Emergency Medicine

3148 Emergency OT Suturing PROCEDURnull 860 -

3149 Narcotic Injections PROCEDURnull 20 145
3150 Closed Reduction Adults PROCEDURnull 720 79
3151 Professional Charge PROCEDURnull 140 11,868
3152 Central Venous Cannulation PROCEDURnull 360 57
3153 Enema PROCEDURnull 60 65
3154 Ketostick PROCEDURnull 60 170
3155 Nebulization PROCEDURnull 40 715
3156 Triangular Sling PROCEDURnull 70 192
3157 Thomas Splint PROCEDURnull 650 39
3158 Bladder wash PROCEDURnull 100 13
3159 Burns pad PROCEDURnull 70 169
3160 Bedside Ultrasound PROCEDURnull 720 -
3161 Bipap (per hour) MISC. null 40 236
3162 Deo Guard MISC. null 720 6
3163 Extubation MISC. null 20 7
3164 Portable Ventilator (per hour) MISC. null 120 -
3165 SCD: Sequential Compression Devic MISC. null 360 377
3166 SCD: Sequential Compression DeviceMISC. null 570 23
3167 Stomach Wash - Routine MISC. null 70 14
3168 Strip (Pregnancy Test) MISC. null 160 35
3169 Bowel Wash MISC. null 100 -
3170 Dressing - Service Charges - Large MISC. null 110 7
3171 Dressing - Service Charges - MediumMISC. null 80 4
3172 Dressing - Service Charges - Small MISC. null 60 21
3173 Intubation (Endotracheal) MISC. null 240 94
3175 Tracheostomy in OPD / Ward MISC. null 290 9
3176 Tracheostomy Care MISC. null 50 16
Page 265 of 368

Emergency Medicine

3177 CVP Monitoring PROCEDURnull 140 -

3178 Steam Inhalation PROCEDURnull 40 -
3179 Wall Suction PROCEDURnull 20 -
3180 Stoma Care Routine DIAGNOSTInull 60 -
3181 ETCO2 monitering MISC. null 50 127
3182 Transcutaneous pacing MISC. null 175 -
3183 Ultrasound Guided Procedure PROCEDURnull 700 -
### Troponin-I (EMS) PROCEDURnull 720 2,560
### Prothrombin Time (PT) - EMS MISC. null 200 106
### Hemat - EMS MISC. null 140 3,954
### Aluminium Splint / Inch PROCEDURnull 60 20
### Crape Bandage PROCEDURnull 60 -
EICU
Emergency
### Medicine
### ABG - Emergency Medicine DIAGNOSTInull 300 2,920
Emergency
### Medicine
### nTproBNP MISC. null 1,620 324
Emergency
### I C U - EICU
38 Bed Charges Emergency ITU MISC. null 900 374
39 Professional & Treatment Charges(E MISC. null 350 381
40 Visiting Fee (EITU) MISC. null 250 375
Page 266 of 368

Emergency Medicine


Date Date Date
Page 267 of 368

Critical care unit

Ch Code ChargeDesc ServiceDesc Catagory ServCat Remarks
Critical care unit

Printed in SOC's
E. ICU PACKAGE PER DAY
MICU
Intensive
### Care Unit - ICU
128 ICU Charges with Resp
MISC. null 3,500 65
129 ICU Charges without MISC. null 3,000 2,667
130 ICU Charges with ResMISC. null 7,000 3,837
MICU
Intensive
### Care Unit - ICU
112 Venesection / Cut D MISC. null 240 741
116 Glucometer Random MISC. null 60 35
140 Insulin protocol PROCEDUREnull 1,200 211
141 Admission screening PROCEDUREnull 600 4
334 Screening ECHO PROCEDUREnull 210 1,375
335 Lung Ultrasound PROCEDUREnull 360 1,371
336 Marking For Tapping PROCEDUREnull 360 16
337 USG Guidance for CVPROCEDUREnull 360 166
341 Screening Ultrasoun PROCEDUREnull 360 106
342 ABG GEM Machine I PROCEDUREnull 500 14,133
343 SCD:Sequential CompPROCEDUREnull 360 883
344 SCD:Sequential CompPROCEDUREnull 570 92
Page 268 of 368

Critical care unit

Ch Code ChargeDesc ServiceDesc Catagory ServCat Remarks
345 ICU Bronchoscopy PROCEDUREnull 360 26

346 Intra Hospital Shift PROCEDUREnull 360 398
347 Pericardial Tap Ultr PROCEDUREnull 360 1
348 Pacemaker Insertion PROCEDUREnull 360 6
349 ICU Percutaneous Tr PROCEDUREnull 1,430 15
MICU
Intensive
### Care Unit - ICU
3187 ETCO2 Monitoring (Co PROCEDUREnull 500 23
3188 ETCO2 Monitoring (InPROCEDUREnull 150 189
3189 Isolation PrecautionsROOM/Lodgnull 500 40
3190 Isolation with positi ROOM/Lodgnull 300 28
3191 Isolation with negati ROOM/Lodgnull 500 13
Intensive
### Care Unit - ICU
113 Forced Alk. Diuresis MISC. null 300 -
114 Plasma Pheresis MISC. null 350 13

Date Date Date
Page 269 of 368

Radiology

Ch Code ChargeDesc ServiceDesc CatagoryervCat ward Rate Remarks
Radiology
Printed in SOC's
IV. RADIOLOGY INVESTIGATIONS
A. PLAIN X-RAY
A. PLAIN X-RAY
Radiology
###
12001 X-ray Abdomen (KUB) - Adult DIAGNOSTIC null 220 3,212
12002 X-ray Abdomen (KUB) - Child below 10 DIAGNOSTIC null 170 506
12003 X-ray Acromioclavicular Joint DIAGNOSTIC null 170 21
12004 X-ray Ankle Joint (AP & Lat) DIAGNOSTIC null 170 2,171
12005 X-ray Apicogram DIAGNOSTIC null 170 4
12006 X-ray Calcaneum DIAGNOSTIC null 170 446
12008 X-ray Chest X-ray - Adult DIAGNOSTIC null 200 33,704
12010 X-ray Chest X-ray - Child below 10 Year DIAGNOSTIC null 140 3,111
12011 X-ray Clavicle (1 exposure) DIAGNOSTIC null 170 249
12012 X-ray Cervical Spine (1 exposure 8x10) DIAGNOSTIC null 170 151
12013 X-ray Elbow Joint (AP & Lat) DIAGNOSTIC null 170 1,051
12014 X-ray Femur (AP & Lat) DIAGNOSTIC null 220 1,184
12015 X-ray Femur - Child below 10 Years DIAGNOSTIC null 170 79
12016 X-ray Fingers (2 exposures) DIAGNOSTIC null 170 238
12017 Fluroscopy DIAGNOSTIC null 130 20
12018 X-ray Foot AP & Oblique DIAGNOSTIC null 170 2,397
12019 X-ray Forearm (AP & Lat) DIAGNOSTIC null 170 994
12020 X-ray Hand (AP & Lat) DIAGNOSTIC null 170 1,747
12021 X-ray Hip (1 exposure) DIAGNOSTIC null 170 532
12022 X-ray Humerus DIAGNOSTIC null 200 489
12025 X-ray Knee (AP & Lat) DIAGNOSTIC null 170 6,515
12026 X-ray Leg (AP & Lat) DIAGNOSTIC null 220 1,712
12028 X-ray Lumbo Sacral (1 exposure) DIAGNOSTIC null 200 182
Page 270 of 368

Radiology

12029 X-ray Mandible (per exposure) DIAGNOSTIC null 170 40

12030 X-ray Optic Foramen DIAGNOSTIC null 170 1
12031 X-ray Pelvis (1 exposure) DIAGNOSTIC null 200 2,961
12039 X-ray Ribs (AP) DIAGNOSTIC null 200 -
12040 X-ray Sacroiliac Joints (both) DIAGNOSTIC null 170 154
12041 X-ray Scapula (1 exposure) DIAGNOSTIC null 170 47
12042 X-ray Shoulders Joint (1 exposure) DIAGNOSTIC null 170 1,978
12043 X-ray Skull per exposure (Skull Ap, P.A.ODIAGNOSTIC null 170 571
12044 X-ray Sternum (1 exposure) DIAGNOSTIC null 170 11
12045 X-ray Thoracic Lumbar Spine (2 exposuDIAGNOSTIC null 350 651
12047 X-ray Toes (2 exposures) DIAGNOSTIC null 170 123
12048 X-ray Thoracic Spine (1 exposure 15x12DIAGNOSTIC null 200 1
12049 X-ray Thoracic Lumbar Spine (1 exposuDIAGNOSTIC null 220 197
12050 X-ray Wrist (AP & Lat) DIAGNOSTIC null 170 1,746
12051 X-ray Cervical Spine (2 exposures) DIAGNOSTIC null 300 1,824
12052 X-ray Lumbosacral Spine (2 exposures) DIAGNOSTIC null 320 4,753
12053 X-ray Thoracic Spine (2 exposures) DIAGNOSTIC null 340 483
12062 Cystogram including Flouro Charges( 2 DIAGNOSTIC null 530 8
12063 X-ray Leg (AP & Lat) - Child below 12 Y DIAGNOSTIC null 200 130
12064 X-ray Lumbosacral Spine - Child (2 exp DIAGNOSTIC null 300 40
12065 X-ray Lumbosacral Spine AP with PelvisDIAGNOSTIC null 220 260
12067 X-ray PNS DIAGNOSTIC null 170 366
12068 X-ray Neck Soft Tissue - Lateral Exposu DIAGNOSTIC null 170 516
12069 X-ray Knee Skyline Exposure (L/R) DIAGNOSTIC null 170 1,768
12070 X-ray Age Estimation MISC. null 240 -
12071 X-ray Infantogram DIAGNOSTIC null 200 15
12274 X-ray Full Spine Full Limb View DIAGNOSTIC null 670 123
12507 Film Charges X Ray 10 X 8 (1 Film) MISC. null 20 13,535
12508 Film Charges X Ray 17x14 (1 Film) MISC. null 70 55
Page 271 of 368

Radiology

12509 CD Coping for X-rays MISC. null 20 32

B. SPECIAL INVESTIGATIONS
B. SPECIAL INVESTIGATIONS
Radiology
###
12056 Cavitogram (2 exposures) DIAGNOSTIC null 750 -
12057 Orbital Venogram DIAGNOSTIC null 400 -
12058 Distal Colonogram/ Loopogram(2 exposDIAGNOSTIC null 750 7
12206 Barium Enema ( 4 exposures) DIAGNOSTIC null 1,200 5
12207 Barium Meal Follow Through (6 exposuDIAGNOSTIC null 1,330 7
12208 Barium Meal - Upper GI Tract (3exposuDIAGNOSTIC null 670 2
12209 Barium Screening Enema DIAGNOSTIC null 400 -
12210 Barium Swallow Screening DIAGNOSTIC null 260 13
12211 Barium Swallow (2 exposures) DIAGNOSTIC null 530 62
12214 Cine Film per frame DIAGNOSTIC null 950 -
12215 Cystourethrogram (3 exposures) DIAGNOSTIC null 800 35
12219 Fluroscopy for major procedure (eg.PCN
DIAGNOSTIC null 300 -
12222 Hysterosalphinogram (2 exposures) DIAGNOSTIC null 950 128
12224 IVP for BPH 9 (4 exposures) DIAGNOSTIC null 800 -
12225 IVP (6 exposures) DIAGNOSTIC null 1,220 12
12227 Myelogram (4 exposures) DIAGNOSTIC null 1,300 -
12229 Nephrostogram (2 exposures) DIAGNOSTIC null 850 2
12230 Operative Cholangiogram ( 2 exposuresDIAGNOSTIC null 800 -
12235 PTC (6 exposures) DIAGNOSTIC null 1,350 3
12237 RGP (2 exposures) DIAGNOSTIC null 370 -
12240 Sialogram (2 exposures) DIAGNOSTIC null 800 1
12241 Sinogram and Fistulogram (2 exposuresDIAGNOSTIC null 740 4
12242 Small Bowel Enema - Contrast Study DIAGNOSTIC null 1,350 -
12243 Spleno Venogram (4 exposures) DIAGNOSTIC null 1,470 -
12244 T - Tube Cholangiogram (2 exposures) DIAGNOSTIC null 450 4
Page 272 of 368

Radiology

12247 RGU (1 Exposure) DIAGNOSTIC null 370 19

12249 Dacryocystogram (2 exposures) DIAGNOSTIC null 450 -
12252 X ray Charges-Portable (extra) DIAGNOSTIC null 150 12,009
12267 Retrograde Urethrography (RGU + MCUDIAGNOSTIC null 850 122
12270 Venogram (Descending) DIAGNOSTIC null 1,330 4
12271 Venogram (Ascending + Descending) DIAGNOSTIC null 2,400 -
12277 Peripherial Angiogram DIAGNOSTIC null 8,000 4
12278 Transarterial chemoembolization (TALEDIAGNOSTIC null 18,000 -
12279 Peripherial Angioplasty DIAGNOSTIC null 20,000 -
12280 Bronchial Artery Embolization DIAGNOSTIC null 10,000 7
12281 IVC Filter Placement DIAGNOSTIC null 8,000 -
12282 Peripherial Vein Thrombolisis DIAGNOSTIC null 30,000 1
12283 IVC Filter Retrieval DIAGNOSTIC null 6,500 -
12284 Peripheral Stenting DIAGNOSTIC null 22,000 -
12285 Varicose veins Laser Ablation DIAGNOSTIC null 10,000 11
12286 Varicose veins RF Ablation DIAGNOSTIC null 20,000 -
12287 Permanent Catheter Insertion DIAGNOSTIC null 15,000 -
12288 Hemo dialysis Fistula Revision DIAGNOSTIC null 20,000 -
12289 P.T.B.D DIAGNOSTIC null 4,880 5
12290 Biliary Stenting DIAGNOSTIC null 10,000 2
12291 RF Ablation of Tumors DIAGNOSTIC null 60,000 -
12292 Visceral Embolization DIAGNOSTIC null 25,000 1
12312 Cavernosography DIAGNOSTIC null 400 -
12451 Spleno Venogram using C-Arm DIAGNOSTIC null 2,100 -
12455 Paediatric Surgery MCU ( 2 exposures )DIAGNOSTIC null 430 13
12456 Paediatric Surgery Dye Study ( 1 exposuDIAGNOSTIC null 260 218
C. COLOUR DOPPLER SONOGRAPHY
C. COLOUR DOPPLER SONOGRAPHY
Color
###Doppler Sonography
Page 273 of 368

Radiology

12304 Carotids and Vertebrals Doppler MISC. null 900 299

12305 Portal Venous System Doppler MISC. null 900 89
12306 Obstetrics / Pelvis Doppler MISC. null 900 427
12307 Renal Transplant Doppler MISC. null 900 50
12309 Penile Doppler Studies MISC. null 900 16
12425 A V Fistula Duplex Scan MISC. null 600 20
12454 Perforator Marking MISC. null 300 18
12461 Arterial Doppler-Single Extremity MISC. null 1,000 278
12462 Arterial Doppler-Both Extremities MISC. null 2,000 125
12463 Arterial Doppler-Additional Limb MISC. null 970 4
12464 Venous Doppler - Single Extremity MISC. null 970 988
12465 Venous Doppler - Both Extremities MISC. null 1,940 540
12466 Venous Doppler - Additional Limb MISC. null 970 3
12467 Venous Doppler - Varicose Veins - Sing MISC. null 1,000 108
12468 Venous Doppler - Varicose Veins - BothMISC. null 2,000 190
12469 Renal Doppler MISC. null 1,000 152
12470 Scrotal Doppler MISC. null 600 304
12471 Mesenteric Doppler MISC. null 600 6
12510 Twin OB Doppler MISC. null 1,100 18
12511 Neck Vein Doppler MISC. null 450 28
12512 AV Fistula Patency Doppler MISC. null 450 29
12513 AV Fistula Creation Doppler MISC. null 1,000 34
12514 Iliac Vessel Doppler (Bilateral) MISC. null 1,100 20
12515 Pelvic Doppler MISC. null 550 6
12516 Temporal Artery Doppler MISC. null 550 13
12517 Obstetric Anomaly Scan with Uterine AMISC. null 1,000 90
12523 Review Doppler MISC. null 200 16
12524 Repeat Doppler Scan MISC. null 500 4
12525 Uterine artery doppler MISC. null 300 283
Page 274 of 368

Radiology

D. ULTRA SOUND IMAGING

D. ULTRA SOUND IMAGING
Ultra
###Sound Imaging
12055 Catheter Drainage of Fluid Collections MISC. null 1,100 59
12060 AFI/HR ( Single Parameter) MISC. null 120 831
12401 Abdominal Ultrasound DIAGNOSTIC null 600 16,349
12402 Abdominal Ultrasound - Repeat within MISC. null 300 74
12403 Ultrasound Guided Marking MISC. null 240 218
12404 Breast Ultrasound MISC. null 600 415
12405 Chest Scan MISC. null 280 231
12406 Ultrasound - Extremities MISC. null 330 877
12407 Obstetric Ultrasound MISC. null 600 1,969
12409 Pelvic Ultrasound,Transvaginal and Tr MISC. null 480 174
12410 Renal Transplant Scan MISC. null 360 79
12411 Renal Ultrasound - Repeat within 10 d MISC. null 200 29
12412 Renal Ultrasound MISC. null 430 3,075
12413 Scrotal Ultrasound MISC. null 600 498
12414 Serial Scan Follicular Monitoring for T MISC. null 830 254
12415 Additional Scan for Follicular Monitori MISC. null 200 60
12417 Thyroid Ultrasound MISC. null 600 281
12418 Transvaginal Ultrasound MISC. null 480 -
12421 Ultra Sound of Small Parts/Transectal MISC. null 600 275
12422 Ultrasound of Brain MISC. null 360 271
12423 Ultrasound of Brain - Repeat within 10 MISC. null 180 3
12424 Extra Charges for Portable Ultrasound MISC. null 130 872
12426 Review of Untrasound Scan DIAGNOSTIC null 120 866
12427 Peadiatric Renal Scan DIAGNOSTIC null 600 54
12428 Aspiration of Fluid Collection DIAGNOSTIC null 600 118
12429 Cather Drainage of Fluid Collections R DIAGNOSTIC null 800 -
Page 275 of 368

Radiology

12452 Neck Ultrasound MISC. null 600 716

12453 Ultrasound Guided Biopsy MISC. null 360 291
12458 Obstetric Biophysical Profile MISC. null 900 96
12459 Pelvic Ultrasound MISC. null 430 3,038
12504 Anomaly scan MISC. null 1,000 443
12505 Obstretic Ultrasound-Twin Gestation MISC. null 970 32
12506 Pelvic Ultrasound - Repeat within 10 d MISC. null 240 5
12518 Hepatobiliary Scan MISC. null 400 508
12519 Nuchal Translucency (NT) Scan MISC. null 700 783
12520 Musculoskeletal Scan MISC. null 660 167
12521 Nerve Scan - Single Side MISC. null 550 18
12522 Twin Anomaly Scan MISC. null 1,800 5
E. MAMMOGRAPHY
E. MAMMOGRAPHY
Mammography
###
12501 Mammography (Single Side 2 exposures MISC. null 730 61
12502 Mammography (Both Sides 2 exposuresMISC. null 1,450 193
12503 Mammography (for each additional ex MISC. null 240 -
F. CT SCAN
F. CT SCAN
CT###
& MRI
90001 CT Brain Plain DIAGNOSTIC null 3,000 1,909
90005 CT Paranasal Sinus DIAGNOSTIC null 2,450 393
90006 CT Neck DIAGNOSTIC null 4,100 201
90007 CT Orbit DIAGNOSTIC null 3,050 25
90008 CT Lumbar Spine DIAGNOSTIC null 3,850 21
90009 CT Cervical Spine DIAGNOSTIC null 4,100 57
90010 CT Dorsal Spine DIAGNOSTIC null 4,100 8
90011 CT Thorax DIAGNOSTIC null 4,500 813
Page 276 of 368

Radiology

90012 CT Abdomen / Pelvis DIAGNOSTIC null 4,700 1,568

90014 CT TM Joints DIAGNOSTIC null 3,050 3
90015 CT Extermities DIAGNOSTIC null 4,200 242
90017 CT Guided Biopsy DIAGNOSTIC null 2,450 63
90023 CT Brain Cisternography DIAGNOSTIC null 3,850 1
90025 CT Brain and Orbits / Facial Bone DIAGNOSTIC null 4,200 265
90033 HR CT Thorax DIAGNOSTIC null 4,500 292
90034 HR CT Temoral Bone DIAGNOSTIC null 4,300 106
90036 CT Angio Abdomen / Renal / PeripheraDIAGNOSTIC null 4,300 220
90037 CT Angio Cranial DIAGNOSTIC null 3,100 76
90038 CT Stereotactic Procedure DIAGNOSTIC null 4,850 -
90039 CT Brain Biopsy DIAGNOSTIC null 2,550 -
90041 CT Skull Base (PNS,Orbit,Brain CON) DIAGNOSTIC null 4,300 4
90042 CT Skull Base (PNS,Orbit,Brain CON) - DIAGNOSTIC null 1,850 -
90046 CT Limited Study DIAGNOSTIC null 1,850 55
90047 CT Cardiac / Coranary CT Angio DIAGNOSTIC null 5,550 5
90048 Cardiac Calcium Scoring Screening DIAGNOSTIC null 4,300 -
90050 CT Special Technique DIAGNOSTIC null 1,250 -
90051 Virtual Endoscopy DIAGNOSTIC null 6,150 -
90068 Film Charges for CT/MRI 17x14 (1 Film)MISC. null 250 372
90069 CT for Tracheal Stenosis MISC. null 2,450 -
90070 Complimentary CT / MRI MISC. null 850 480
90071 Cochlear Impalant Package (CT and MRMISC. null 24,650 -
90072 CT for CSF Rhinnohrea MISC. null 2,450 -
90073 CD Copying MISC. null 350 24
90100 General Anaesthesia - CT MISC. null 650 -
90164 CT Scan Reporting charges ( Outside S MISC. null 250 -
90181 CT Paediatric - One region MISC. null 2,450 390
90182 CT Urography / CT KUB MISC. null 3,450 1,442
Page 277 of 368

Radiology

90189 10ml Non INOC Contrast MISC. null 400 59

G 1. EMERGENCY MEDICINE PACKAGE
G 1. EMERGENCY MEDICINE PACKAGE
CT###
& MRI
90184 CT Brain & Cervical Spine Package MISC. null 4,950 450
90185 CT Thorax+Abdomen & Pelvis Pacakge M i ISC. null 8,800 47
G. MRI SCAN
G. MRI SCAN
CT###
& MRI
90052 MRI Breast DIAGNOSTIC null 7,400 6
90053 MRI Cartigram DIAGNOSTIC null 3,700 -
90054 MRI Cardiac / Coronary MISC. null 6,800 -
90055 MRI DTI and Fibre Tracking MISC. null 2,450 -
90056 MRI Foetus MISC. null 6,150 -
90058 MRI Special Technique/10 ml MR ContrMISC. null 1,850 525
90059 MRI One Sequence MISC. null 1,850 662
90060 MRI One Region MISC. null 6,550 -
90062 MRI Brain Perfussion MISC. null 3,100 -
90063 MRI Spectroscopy MISC. null 3,100 5
90064 MRI Functional (BOLD) MISC. null 3,100 -
90065 MRA (Peripheral / Renal inclusive of CoMISC. null 8,000 4
90066 MRI Sella with Contrast MISC. null 8,000 29
90067 MRA (Intra or Extra Cranial) MISC. null 7,400 404
90078 MRI Brain and Perfusion MISC. null 9,600 -
90081 MRI Brain and Functional MRI MISC. null 9,600 -
90101 MRI Brain / Neck MISC. null 6,700 688
90102 MRI Lumbar Spine MISC. null 6,700 170
90103 MRI PNS MISC. null 6,700 2
90104 MRI Skull Base MISC. null 6,700 -
Page 278 of 368

Radiology

90105 MRI Orbits MISC. null 6,700 5

90106 MRI Abdomen MISC. null 7,350 19
90107 MRI Chest MISC. null 7,350 4
90108 MRI Muscular Skeletal Joint MISC. null 7,350 349
90109 MRI Internal Auditory Canal / TemporaMISC. null 6,700 11
90110 MRI Pelvis MISC. null 7,350 102
90111 MRI Dorsal Spine MISC. null 6,700 18
90124 MRI Cervical Spine MISC. null 6,700 85
90126 MRI MRCP MISC. null 3,700 21
90159 20ml Non INOC Contrast MISC. null 800 90
90160 50ml Non INOC Contrast MISC. null 1,450 401
90161 100ml Non INOC Contrast MISC. null 2,400 1,902
90165 MRI Scan Reporting Charges ( outside MISC. null 400 -
90172 MRI Brain Limited Study MISC. null 4,200 2,442
90173 MRI Spine (Cervical /Lumbar) Limited MISC. null 4,200 191
90174 MRI Whole Spine Screening MISC. null 6,350 1,072
90175 MRI Brachial/Lumbar Plexus MISC. null 6,700 16
90177 MR Urography MISC. null 3,800 48
90178 MRV + Brain Screening MISC. null 5,700 120
90179 MRI Spine one region + Rest ScreeningMISC. null 8,000 163
90180 MRI Paediatric - one region/ finger MISC. null 3,800 392
90186 Film Charges for CT/MRI 17 x 14 (2-3 fiMISC. null 550 579
90187 MRI Joint with Arthrogram MISC. null 10,100 -
90188 Post MRI Arthrogram MISC. null 2,750 -
90190 MRI Whole Spine with Contrast MISC. null 10,450 60
90191 MRA Extra Cranial + Brain Screening MISC. null 5,700 7
90192 MRA Intra Cranial + Brain Screening MISC. null 5,700 52
Radiology
###
Page 279 of 368

Radiology

12059 PTBD with stent DIAGNOSTIC null 4,880 -

12066 KUB DIAGNOSTIC null 180 737
12201 Angiogram 4 Vessel (20 exposures) DIAGNOSTIC null 5,590 -
12202 Angioplasty (6 exposures) DIAGNOSTIC null 7,000 1
12204 Aortogram (6 exposures) DIAGNOSTIC null 3,500 -
12213 Cerebral Angiogram (6 exposures) DIAGNOSTIC null 3,500 -
12218 Femoral Angiogram (8 exposures) DIAGNOSTIC null 3,500 -
12232 Peripherial Arteriogram (8 exposures) DIAGNOSTIC null 3,500 -
12236 Renal Donar DIAGNOSTIC null 3,500 -
12238 Selective Angiogram DIAGNOSTIC null 3,500 -
12239 Selective Emlolisation DIAGNOSTIC null 3,500 -
12246 Venogram (4 exposures) DIAGNOSTIC null 1,100 1
Grand Total 830,100 165,225

Date Date Date
Page 280 of 368

Bio-Chemistry

Ch Code ChargeDesc ServiceDesc Catagory ServCat ward Rate Apr-17 to Nov-17 Remarks
Rate Revision
Bio-Chemistry
Printed in SOC's
C. BIOCHEMISTRY LAB
C1. Biochemistry: Blood Tests
Clinical
### Biochemistry hosiptal
10552 Serum Alkaline Phosphatase (ALP) MISC. null 200 2,327
10553 Serum Amylase MISC. null 300 1,958
10559 Bilirubin -Total, Direct & Indirect MISC. null 140 10,857
10562 Arterial Blood Gas (ABG) MISC. null 350 5,214
10564 Serum Calcium MISC. null 150 16,926
10568 Serum Cholesterol MISC. null 150 1,069
10569 Serum Cholesterol - HDL MISC. null 200 68
10570 Serum Cholesterol - LDL MISC. null 270 663
10574 Serum CK- MB MISC. null 350 143
10575 Serum Creatinine MISC. null 100 83,193
10579 Serum Creatine Phosphokinase (CPK) MISC. null 350 1,606
10584 Serum Gamma Glutamyl Transferase (GMISC. null 200 178
10585 OGCT - 50gms, after 1 hr MISC. null 90 81
10586 OGTT 75 gm Glucose - Twice(FBS, 2hrs)MISC. null 150 1,453
10587 Glycated Haemoglobin (HbA1c) MISC. null 500 14,957
10590 Serum Lactate Dehydrogenase MISC. null 300 3,999
10591 Serum Lithium MISC. null 300 161
10593 Serum Magnesium MISC. null 200 8,142
10594 Serum Phosphorus MISC. null 200 11,258
10596 PP Glucose with 75g Glucose MISC. null 90 24
10597 Serum Total Protein & Albumin MISC. null 300 5,324
10602 Serum Sodium MISC. null 100 12,481
10604 Fasting Glucose (FBS) MISC. null 60 20,993
Page 281 of 368

Bio-Chemistry

Rate Revision
10607 Serum Triglycerides MISC. null 200 394

10608 Serum Urea MISC. null 100 29,275
10611 Serum Uric Acid MISC. null 160 7,962
10612 Serum Potassium MISC. null 100 23,713
10614 Serum Aspartate Transaminase (SGOT) MISC. null 200 5,740
10615 Serum Alanine Transaminase (SGPT) MISC. null 200 8,286
10621 Serum Ferritin MISC. null 500 3,535
10622 Serum Carbamazepine MISC. null 600 91
10623 Serum Phenobarbital MISC. null 600 88
10626 Serum Ionised Calcium DIAGNOSTICnull 350 525
10627 Serum Valproic Acid MISC. null 600 356
10628 Serum Phenytoin MISC. null 600 216
10629 Plasma Bicarbonate MISC. null 350 1,958
10632 Serum Lipase MISC. null 300 2,077
10635 Plasma Ammonia MISC. null 350 1,145
10643 Serum Anti - TPO MISC. null 750 1,694
10647 Serum Total Testosterone MISC. null 400 670
10650 Plasma Lactate MISC. null 350 78
10662 Serum Estradiol - E2 MISC. null 700 140
10666 Serum Folic Acid MISC. null 1,000 238
10700 Serum C-Reactive Protein (CRP) MISC. null 350 7,004
10735 Serum Osmolality MISC. null 350 510
10881 OGTT 75 gm Glucose load (FBS 1hr,2hr,MISC. null 300 42
10883 Serum Free T3 (FT3) MISC. null 300 830
10884 Random Glucose (RBS) MISC. null 60 20,264
10885 Post Prandial Glucose (PPBS) MISC. null 60 11,695
10886 Serum Cortisol (4-6 PM) MISC. null 600 47
10887 Plasma Insulin MISC. null 500 72
10902 Serum Cortisol (7-9 AM) MISC. null 600 2,670
Page 282 of 368

Bio-Chemistry

Rate Revision
10903 Serum FSH MISC. null 400 371

10906 Serum LH MISC. null 400 257
10908 Serum Prolactin MISC. null 400 548
10912 Serum TSH MISC. null 250 30,230
10913 Serum Total T3 MISC. null 250 385
10914 Serum Total T4 MISC. null 250 862
10915 Serum Beta HCG MISC. null 1,000 1,106
10922 Serum Free T4 (FT4) MISC. null 300 6,357
10931 Serum Troponin I MISC. null 500 3,811
10933 Plasma Insulin Fasting MISC. null 500 204
10934 Serum Vitamin B12 MISC. null 600 11,140
10941 Plasma Vitamin D (25-OH D2 & D3) MISC. null 1,200 12,589
10942 Plasma Parathormone (PTH) MISC. null 600 1,919
10986 Blood Alcohol MISC. null 200 1,165
11100 Serum Cortisol - Random MISC. null 600 1,840
11123 Serum Thyroglobulin LABORATORYnull 1,300 55
11124 Serum Anti Thyroglobulin LABORATORYnull 1,000 28
11125 Serum Growth Hormone (GH) LABORATORYnull 800 57
11129 Serum AMH (Anti-Mullerian Hormone) LABORATORYnull 1,600 44
11130 Serum Anti - CCP LABORATORYnull 1,000 440
11132 Serum Angiotensin Converting Enzyme LABORATORYnull 850 204
11153 Serum Erythropoietin LABORATORYnull 1,200 93
11155 OGTT - 75 Gms, FBS,1hr,2hr LABORATORYnull 240 166
11157 Post Glucose (75gms) -60 mins Growt LABORATORYnull 850 24
11158 Serum Cortisol 60 mins - ACTH Stimula LABORATORYnull 600 94
11159 Serum Cortisol -Dexa Suppressed LABORATORYnull 600 75
11160 Serum GH - 0,60,90 mins Clonidine sti LABORATORYnull 2,400 13
C2. Biochemistry: Tumour Markers
Clinical
Page 283 of 368

Bio-Chemistry

Rate Revision
10701 Serum Alpha Feto Protein (AFP) MISC. null 600 670
10702 Serum Total Prostate Specific Antigen ( MISC. null 600 654
10730 Serum Carcinoembryonic Antigen (CEA)MISC. null 700 539
10734 Serum Carbohydrate Antigen 125 (CA12MISC. null 600 688
C3. Biochemistry: Body Fluid Tests
Clinical
10616 CSF - Glucose MISC. null 100 37
10617 CSF - Protein MISC. null 150 35
10618 CSF - Chloride MISC. null 100 25
10954 Ascitic Fluid - ADA MISC. null 700 469
10956 Pleural Fluid - ADA MISC. null 700 307
10957 Pleural Fluid Amylase MISC. null 300 44
10958 Pleural Fluid LDH MISC. null 300 35
10960 Pericardial Fluid - ADA MISC. null 700 9
10963 Dialysis Fluid Creatinine MISC. null 100 102
10964 Dialysis Fluid Urea MISC. null 100 63
10965 C.S.F - ADA MISC. null 700 399
11138 Dialysis Fluid Glucose LABORATORYnull 100 31
C4. Biochemistry: Urine Tests
Clinical
10555 Urine Amylase Random MISC. null 300 2
10576 Urine Creatinine Random MISC. null 125 271
10578 Creatinine Clearance - Urine MISC. null 210 126
10583 Urine Chloride Random MISC. null 100 53
10598 Protein Total - 24 hrs Urine MISC. null 200 498
10599 Protein/Creatinine Ratio MISC. null 300 3,571
10603 Urine Sodium Random MISC. null 100 463
10624 Magnesium - 24 hrs Urine MISC. null 250 9
10625 Microalbumin in urine MISC. null 300 829
Page 284 of 368

Bio-Chemistry

Rate Revision
10750 Urine Osmolality MISC. null 350 483

10882 Urine Protein Random MISC. null 150 61
10944 Calcium-Random Urine MISC. null 150 214
10945 Phosphorus - 24 hrs Urine MISC. null 250 15
10946 Urine Phosphorus Random MISC. null 200 22
10947 Uric Acid - 24 hrs Urine MISC. null 200 13
10948 Urine Uric Acid Random MISC. null 160 7
10949 Urine Magnesium Random MISC. null 200 5
10950 Sodium - 24 hrs Urine MISC. null 150 12
10951 Potassium - 24 hrs Urine MISC. null 150 13
10952 Urine Potassium Random MISC. null 100 141
10966 Creatinine - 24 hrs Urine MISC. null 150 190
10967 Amylase - 24 hrs Urine MISC. null 350 -
10968 Calcium - 24 hrs Urine MISC. null 200 92
11151 Cortisol - 24Hrs Urine LABORATORYnull 700 16
11154 Urea - Random Urine LABORATORYnull 100 4
C5. Biochemistry: Panels
Clinical
10123 Serum Iron-Panel MISC. null 200 5,231
10556 AST and ALT MISC. null 350 7,334
10557 AST/ALT/Alkaline Phosphatase MISC. null 550 828
10565 Calcium,phosphorus and Uric Acid- Se MISC. null 450 1,367
10566 Serum Calcium, Phosphorus, ALP & Al MISC. null 750 196
10567 Calcium/Phosphorus/Uric Acid-Urine MISC. null 300 21
10573 Lipid Profile MISC. null 800 13,597
10580 CSF - Sugar, Protein and Chloride MISC. null 350 717
10582 Electrolytes MISC. null 300 76,218
10592 Liver Function Tests MISC. null 1,000 31,824
10601 RBS, BU, Creatinine and Electrolytes MISC. null 500 1,019
Page 285 of 368

Bio-Chemistry

Rate Revision
10605 Serum - Fasting Glucose, Creatinine & EMISC. null 450 523
10606 Serum - Fasting Glucose, Urea & ElectroMISC. null 400 15
10609 Urea & Creatinine MISC. null 150 16,295
10633 Amylase + Lipase MISC. null 550 1,990
10648 TSH, FT4, Anti - TPO MISC. null 1,200 1,399
10907 FSH,LH & PROLACTIN MISC. null 1,100 674
10909 T3, T4 ESTIMATION MISC. null 500 51
10910 T3, T4 & TSH MISC. null 700 1,996
10911 T3, T4, TSH, FSH, LH & PROLACTIN MISC. null 1,800 288
10936 FT3, FT4, TSH (PROFILE) MISC. null 900 609
10953 Ascitic Fluid - Panel (Glucose, Protein, MISC. null 600 556
10955 Pleural Fluid - Panel (Glucose, Protein, MISC. null 400 342
10959 Pericardial Fluid - Panel (Glucose, Prot MISC. null 600 7
10961 Synovial Fluid - Panel (Glucose, Protein MISC. null 400 27
10962 Dialysis Fluid Panel (Glucose, Sodium, MISC. null 400 52
10970 FBS,BU,Creatinine and Electrolytes MISC. null 500 364
10971 PPBS,BU,Creatinine and Electrolytes MISC. null 500 112
11142 Anemia Profile LABORATORYnull 2,000 136
11143 Extended Anemia Profile LABORATORYnull 2,500 6
11144 Renal Profile LABORATORYnull 750 226
11145 Diabetic Profile LABORATORYnull 600 293
11146 Extended Diabetic Profile LABORATORYnull 1,400 4
11147 Fertility Profile - 1 - FSH, LH, Prolactin LABORATORYnull 1,450 80
11148 Fertility Profile - 2 - FSH, LH, Prolactin LABORATORYnull 1,750 13
11149 FSH, LH, PRL, TSH, FT4, Cortisol LABORATORYnull 2,000 9
11156 Serum - FSH, LH, Total Testosterone LABORATORYnull 1,100 17
11240 Serum - TSH, FT4,TG, Anti-TG LABORATORYnull 2,700 14
C6. Biochemistry: Tests Done in College
Clinical
Page 286 of 368

Bio-Chemistry

Rate Revision
10705 Chromatography for Amino Acids- Urin MISC. null 550 4

10710 Whole Blood Methaemoglobin MISC. null 250 11
10711 Urine Mucopolysaccharides MISC. null 250 5
10713 Urine Myoglobin MISC. null 110 49
10714 Screening for IEM (PKU, Cystine, HomocMISC. null 200 3
10716 Serum Ceruloplasmin MISC. null 625 123
10718 Serum Electrophoresis MISC. null 700 420
10719 Stool fat MISC. null 150 32
10720 Urine 5 Hydroxy Indoles (5 - HI) MISC. null 270 8
10724 Urine VMA MISC. null 1,450 95
10727 Urine Galactose MISC. null 120 20
10746 Chromatography for Sugar - Urine MISC. null 500 10
10749 Chromatography for Amino Acids - Ser MISC. null 500 1
10755 Urine pH MISC. null 100 4
10756 Gall Stone Analysis MISC. null 300 -
10873 Serum Homocysteine MISC. null 1,350 435
10969 Salivary Calculi Analysis MISC. null 300 -
11122 Urinary Metanephrine LABORATORYnull 1,800 72
11131 Serum Free Light Chains LABORATORYnull 3,000 62
11133 Serum Soluble Transferrin Receptor ( sTLABORATORYnull 500 2
Clinical
10081 Diabetes Mellitus MISC. null 950 -
10082 Hypertension MISC. null 760 -
10083 Renal Profile MISC. null 1,080 4
10413 R.A. Test (Quantitative) MISC. null 330 1
10512 Tissue Polypeptide Specific Antigen(TPSMISC. null 1,000 -
10560 Blood Gas - HCO3 MISC. null 200 1
10561 Blood Gas - PH MISC. null 200 -
Page 287 of 368

Bio-Chemistry

Rate Revision
10571 Cholinesterase-Pseudocholinesterase MISC. null 500 -

10572 Disposable Syringes and Needles for IP MISC. null 50 2
10640 ABG + Electrolytes MISC. null 400 1
10649 Urolith Chemistry - Semi Quantitative MISC. null 400 -
10667 Growth Hormone MISC. null 500 1
10871 Tumour Marker 19.9 MISC. null 525 -
10874 nTSH+n170HP+nTGalactose MISC. null 690 1
10875 nTSH MISC. null 270 -
10876 n17OHP MISC. null 270 -
10877 n Galactose MISC. null 290 -
10888 Protein & Albumin (other body fluids) MISC. null 75 -
10923 Urinary Metanephrines MISC. null 1,000 2
10972 hsCRP MISC. null 15 -
11120 Cortisol - Random Urine DIAGNOSTICnull 600 4
11121 Urine Stone Analysis LABORATORYnull 850 -
11126 Serum PAPP-A (Pregnancy Associated PLABORATORYnull 1,200 -
11127 Serum Free Beta HCG LABORATORYnull 1,200 1
11128 Serum Unconjugated Estriol (UE 3) LABORATORYnull 1,000 -
11134 n17- OHP LABORATORYnull 500 -
11135 nG6PD LABORATORYnull 500 -
11136 nPKU LABORATORYnull 500 -
11137 nTotal Galactose LABORATORYnull 500 -
11139 Neonatal Screening LABORATORYnull 1,600 1
11140 Double Marker LABORATORYnull 1,800 -
11141 Triple Marker LABORATORYnull 2,200 -
11150 Hormone Replacement Therapy ProfileLABORATORYnull - -
11152 Urine Free Light Chain LABORATORYnull 3,000 -
Grand Total 119,395 585,509
Page 288 of 368

Bio-Chemistry

Rate Revision

Date Date Date
Page 289 of 368

Micro-Biology

Micro-Biology
Printed in SOC's
A. CLINICAL PATHOLOGY LAB
A5. Clinical Pathology: Urine & Faeces Analysis
Urine
###Analysis
10201 Bence Jones Protein MISC. null 70 76
10203 Demonstration of Hemosiderin iMISC. null 70 9
10204 Urine Chemical (Albumin / GlucoMISC. null 70 3,571
10205 Urine Microscopy MISC. null 70 7,057
10208 Urine Routine Chemical and MicMISC. null 140 40,295
10984 Urine Haemoglobin MISC. null 70 6
Faeces
###
10252 Faeces for Occult Blood MISC. null 70 1,730
10253 Faeces Routine and Micro MISC. null 70 1,895
D. MICROBIOLOGY LAB
D1. Microbiology: Routine Tests
Microbiology
### Test
10401 Mycobacterial Culture and IdentiMISC. null 740 501
10402 AFB Smear MISC. null 130 2,354
10403 Albert Stain (Klebs-Loeffler Bacil MISC. null 210 33
10404 TPHA Test for Syphilis MISC. null 370 237
10405 Anti-streptolysin O (ASO) MISC. null 370 306
10407 Brucella Agglutination Test MISC. null 370 200
10408 C-Reactive Protein (CRP) MISC. null 210 388
10409 Fungal Culture MISC. null 470 639
Page 290 of 368

Micro-Biology

10410 Grams Stain MISC. null 120 662

10411 Paul Bunnel Test MISC. null 210 55
10414 R.A.Test (Qualitative) MISC. null 210 2,294
10416 VDRL (STS) MISC. null 130 3,533
10417 Weil Felix Test MISC. null 180 2,885
10418 Widal Test MISC. null 180 3,039
10419 Cryptococcal Ag Latex AgglutinatMISC. null 1,160 286
10423 Protozoal Stain (Stool) MISC. null 210 19
10424 Staining for Pneumocystis CariniiMISC. null 210 95
10425 Anaerobic Culture MISC. null 1,390 91
10426 ELISA for Human Immunodeficien MISC. null 420 5,256
10427 Hepatitis B Surface Antigen ( HBsMISC. null 320 5,099
10428 ELISA for Toxoplasma IgM AntiboMISC. null 530 15
10429 ELISA for Rubella IgM AntibodiesMISC. null 530 16
10430 ELISA for Cytomegalovirus (CMV)MISC. null 530 80
10431 ELISA for TORCH IgM AntibodiesMISC. null 1,580 95
10432 Serum Complement C3 Level MISC. null 530 904
10433 ELISA for Antibodies to HepatitisMISC. null 680 1,299
10436 Hanging Drop MISC. null 110 35
10437 Rapid HIV MISC. null 530 11,204
10438 India Ink + Gram`s Stain MISC. null 210 67
10440 ELISA for Hepatitis A virus (HAV) MISC. null 420 136
10442 Water Analysis MISC. null 1,260 9
10444 Elisa for Leptospira IgM AntibodiMISC. null 530 949
10446 Automated Blood and Body FluidMISC. null 740 12,767
10448 Rapid HBs Ag MISC. null 370 10,664
Page 291 of 368

Micro-Biology

10449 Febrile agglutination package SeMISC. null 790 1

10450 Surveillance of Operation TheatrMISC. null 900 -
10451 Settle Plates MISC. null 350 -
10456 ELISA for Acute Hepatitis MarkerMISC. null 2,310 426
10460 Aerobic Culture and Sensitivity MISC. null 580 29,373
10462 Calcoflour White Stain + KOH MISC. null 210 252
10463 Mycobacterial culture and sty toMISC. null 3,990 59
10464 Flurochrome Staining for AFB MISC. null 230 26
10465 Rapid Test for Detection of Rota MISC. null 320 1
10466 HIV DNA PCR (Qualitative) MISC. null 530 1
10467 HIV Viral Load (Quantitative) MISC. null 4,390 157
10468 HIV Genotyping RT only MISC. null 2,940 -
10469 HIV Genotyping PR only MISC. null 2,940 -
10470 HIV Genotyping RT and PR MISC. null 5,040 -
10548 Automated ID & Sensitivity for MISC. null 740 3
10549 RNTCP Sputum AFB Smear MISC. null 1 -
10550 Genexpert - TB MISC. null 2,080 223
11101 Mycobaterial culture and sty to MISC. null 4,520 18
11102 ELISA for Aspergillus Galactoma MISC. null 1,580 337
11107 Mycobacterial culture and sty toLABORATOnull 2,100 11
11108 Surveillance of Burns Ward (1 R DIAGNOSTnull 600 -
11109 Air sampling DIAGNOSTnull 250 -
11110 CSF bacterial antigen detection DIAGNOSTnull 530 -
11112 HCV Quantitative Viral Load MISC. null 5,440 17
11113 Hydatid Cyst - Wet Mount DIAGNOSTnull 110 1
11114 Mycobacterial culture urine samDIAGNOSTnull 110 20
Page 292 of 368

Micro-Biology

11115 Mycobacterial culture urine samDIAGNOSTnull 110 19

11200 Allergy panel for Asthma & RhiniPROCEDU null 6,500 17
11201 Allergy panel for Aspergillus spe PROCEDU null 1,750 27
11202 Allergy panel for Molds PROCEDU null 1,750 2
11203 Allergy panel for Non-veg food +PROCEDU null 2,200 24
11204 Allergy panel for Veg food + HouPROCEDU null 3,100 23
11205 Allergy panel for ENT allergies PROCEDU null 2,250 9
11206 Specific IgE for Bermuda grass PROCEDU null 700 16
11207 Specific IgE for Johnson grass (J PROCEDU null 700 4
11208 Specific IgE for Grey alder PROCEDU null 700 -
11209 Specific IgE for Eucalyptus (gum PROCEDU null 700 2
11210 Specific IgE for Elm PROCEDU null 700 -
11211 Specific IgE for Mesquite PROCEDU null 700 -
11212 Specific IgE for Common ragweePROCEDU null 700 1
11213 Specific IgE for Mugwort PROCEDU null 700 -
11214 Specific IgE for Goosefoot PROCEDU null 700 -
11215 Specific IgE for Common pigweePROCEDU null 700 -
11216 Specific IgE for Dog dander PROCEDU null 700 -
11217 Specific IgE for Cat dander PROCEDU null 700 -
11218 Specific IgE for House dust mite PROCEDU null 700 25
11219 Specific IgE for Cockroach PROCEDU null 700 1
11220 Specific IgE for Mould mix (PeniciPROCEDU null 700 -
11221 Specific IgE for Aspergillus fumigPROCEDU null 700 28
11222 Specific IgE for Aspergillus flavusPROCEDU null 700 2
11223 Specific IgE for Aspergillus niger PROCEDU null 700 1
11224 Specific IgE for Aspergillus terre PROCEDU null 700 3
Page 293 of 368

Micro-Biology

11225 Specific IgE for Penicillium nota PROCEDU null 700 -

11226 Specific IgE for Alternaria altern PROCEDU null 700 -
11227 Specific IgE for Cladosporium h PROCEDU null 700 1
11228 Specific IgE for Egg (whole) PROCEDU null 700 5
11229 Specific IgE for Fish (cod) PROCEDU null 700 5
11230 Specific IgE for Shrimp PROCEDU null 700 4
11231 Specific IgE for Animal mix (cat, PROCEDU null 700 1
11232 Specific IgE for Milk PROCEDU null 700 -
11233 Specific IgE for Wheat PROCEDU null 700 1
11234 Specific IgE for Peanut PROCEDU null 700 -
11235 Specific IgE for Red kidney bean PROCEDU null 700 -
11236 Specific IgE for Soyabean PROCEDU null 700 -
11237 Specific IgE for Chick pea PROCEDU null 700 -
11238 Specific IgE for Lemon/Citrus PROCEDU null 700 -
11239 Specific IgE for Banana PROCEDU null 700 -
11241 Toxoplasma IgM LABORATOnull 600 -
11242 Rubella IgM LABORATOnull 600 -
11243 Cytomegalovirus IgM LABORATOnull 600 -
11244 TORCH IgM LABORATOnull 2,000 -
11245 Toxoplasma IgG LABORATOnull 500 -
11247 Cytomegalovirus IgG LABORATOnull 500 -
11248 TORCH IgG LABORATOnull 1,500 -
11249 Hepatitis A virus IgM LABORATOnull 600 -
11251 Post MRSA Follow up (3 Sets) LABORATOnull 600 -
11252 Hepatitis B e Antibody (anti HBe)LABORATOnull 630 -
11253 IgM Antibody to Hepatitis B CoreLABORATOnull 650 -
Page 294 of 368

Micro-Biology

11254 Antibodies to Hepatitis B surfaceLABORATOnull 650 -

11257 Survelliance of ICU (5 Beds) LABORATOnull 900 -
11258 Total serum IgE LABORATOnull 600 -
11259 Sterile liquid/Disinfectant Testin LABORATOnull 250 -
11260 Biological Indicator Testing LABORATOnull 50 -
11261 Hepatitis B e Antigen (HBeAg) LABORATOnull 630 -
11262 Hepatitis B Markers Profile (HB LABORATOnull 1,575 -
Elisa
###Laboratory
10504 Toxoplasma IgG Ab LABORATOnull 370 6
10505 Rubella IgG Ab MISC. null 370 14
10506 Cytomegalovirus IgG Ab MISC. null 370 57
10507 Herpes Simplex II IgG Ab MISC. null 370 85
10508 Toxoplasma, Rubella, CytomegaloMISC. null 1,260 27
10509 Serum Complement C4 MISC. null 420 889
10510 HCV Antibodies MISC. null 580 4,617
10513 Hepatitis `E`IgM Abs MISC. null 580 133
10515 Western blot for HIV - 1/2 MISC. null 1,840 25
10516 Pneumococal Antigen in C.S.F MISC. null 420 6
10517 Haemophilus influenzae b AntigeMISC. null 420 3
10518 Group B Streptococuss Anti.DeteMISC. null 420 -
10519 Meningococcal Antigen DetectioMISC. null 420 4
10520 Esch Coli KI Antigen in CSF MISC. null 420 -
10522 Dengue IgM Ab MISC. null 260 5,674
10523 ELISA for HSV - I IgG MISC. null 370 81
10524 Malaria serology MISC. null 290 41
10526 Nuguents score for bacterial vagMISC. null 160 -
Page 295 of 368

Micro-Biology

10528 Serum Ig E Antibodies levels MISC. null 530 175

10529 RO water analysis MISC. null 300 -
10532 Chickungunya IgM Rapid Test MISC. null 530 352
10533 HSV-II IgM MISC. null 370 64
10534 Dengue IgG Ab MISC. null 260 391
10537 Automated anaerobic culture MISC. null 680 55
10538 Automated fungal culture MISC. null 630 103
10539 I line TB drug sensitivity by prob MISC. null 3,150 -
10540 II line TB drug sensitivity by pro MISC. null 3,150 -
10541 Dengue NS1 antigen MISC. null 260 6,619
10542 Dengue combined package(NS1+MISC. null 950 379
10543 Wet Mount MISC. null 110 170
10544 Elisa for Hepatitus-D Virus Antib MISC. null 320 4
10697 ELFA for PROCALCITONIN MISC. null 1,250 947
D2. Microbiology: Tests Done Outside
Elisa
###Laboratory
10696 H1N1 Real Time RTPCR MISC. null 2,800 35
Urine
###Analysis
10202 Bile Salt and Bile Pigment MISC. null 35 169
10211 Urine, Albumin, Sugar, Micro MISC. null 70 263
10212 Urobilinogen MISC. null 40 2
10213 Urine Dipstick Analysis (Urology MISC. null 30 -
10988 Urine Calcium Random DIAGNOSTnull 150 -
Microbiology
### Test
10420 Serum Gentamicin MISC. null 195 -
Page 296 of 368

Micro-Biology

10421 Serum Amikacin MISC. null 195 -

10422 Serum Penicillin MISC. null 195 1
10434 ELISA for Hepatitis B e Antigen MISC. null 600 187
10435 ELISA for IgM Antibody to HepatiMISC. null 650 62
10443 Leptospira Dark Field Examinati MISC. null 100 1
10445 Elisa for anticysticercal antibody MISC. null 300 2
10447 Mycoplasma culture MISC. null 200 -
10452 ELISA for Hepatitis B ?e? Antibo MISC. null 600 126
10457 Immunoglobulins IGA orIGM or MISC. null 400 -
10458 Immunoglobulins IGA,IGM and I MISC. null 900 1
10697 ELISA for PROCALCITONIN DIAGNOSTnull 1,300 -
Elisa
###Laboratory
10501 Antimycobacterial Antibody MISC. null 400 -
10503 Serological Diagnosis of Invasiv MISC. null 300 -
10511 Hepatitis Markers Profile(HbsAg,MISC. null 1,500 169
10514 Chlamydia Antigen MISC. null 280 -
10521 Typhi dot MISC. null 250 3
10525 Assay for tuberculosis (Fast plaq MISC. null 525 -
10527 Yeast susceptbility to FluconazolMISC. null 125 -
10536 Typhidot IgG Ab MISC. null 150 1
10545 Skelletal TB MISC. null 450 -
10546 Skelletal TB Sensitivity MISC. null 1,550 -
Grand Total 151,386 173,941
Page 297 of 368

Micro-Biology


Date Date Date
Page 298 of 368

TRANS MED & IMMUNO HAEMATOLOGY


Printed in SOC's
A. CLINICAL PATHOLOGY LAB
A1. Clinical Pathology: Haematology Routine Tests
Haematology
### Routine Test
10001 Absolute Eosinophil Count (AEC) MISC. null 90 414
10002 Red cell Indices(MCV,MCH,MCHC MISC. null 125 177
10004 Clot Retraction Time (Mac Farland MISC. null 70 2
10005 Complete Blood Count MISC. null 180 57,329
10006 Complete Haemogram with ESR MISC. null 320 17,809
10007 Erythrocyte Sedimentation Rate (ESMISC. null 80 9,706
10010 Haemoglobin % (HB) MISC. null 90 28,467
10012 HB, TC, DC MISC. null 130 15,575
10013 Leucocyte Count (TC) MISC. null 90 3,131
10015 Malarial Parasites Smear (MP) & Q MISC. null 160 13,972
10016 Microfilaria Smear (MF) & QBC MISC. null 160 105
10018 Packed Cell Volume (PCV) MISC. null 90 24,124
10019 Peripheral Smear (PS) & CBC MISC. null 280 11,405
10020 Platelet Count MISC. null 110 35,257
10025 Reticulocyte Count and Reticulocyt MISC. null 140 3,102
10032 NBT Test MISC. null 150 32
10039 Smear Slide to Outside MISC. null 100 -
10046 PT and APTT MISC. null 400 7,399
10092 Mixing Studies for PT / APTT MISC. null 800 2
10094 HLA B27 LABORATOnull 1,000 1
10095 Flow for Platelet function disordersLABORATOnull 3,000 1
10096 Reticulocyte hemoglobin LABORATOnull 120 1
10097 Immature platelet fraction(IPF) LABORATOnull 110 5
10098 Absolute neutrophil count (ANC) LABORATOnull 110 1
Page 299 of 368


10099 Absolute Lymphocyte count (ALC) LABORATOnull 110 4

Haematology
### Special Test
10104 Bone Marrow Smear MISC. null 450 795
10107 Cryoglobulin - Qualitative MISC. null 80 39
10117 LE cells MISC. null 130 1
10118 Leucocyte Alkaline Phosphatase (LAMISC. null 250 4
10122 Plasma Haemoglobin MISC. null 90 2
A2. Clinical Pathology: Coagulation Tests
Haematology
### Routine Test
10003 Bleeding Time (BT) MISC. null 70 295
10023 Prothrombin Time (PT) MISC. null 150 18,891
10026 Screening test for inhibitors MISC. null 800 5
10030 Fibrinogen Assay MISC. null 400 224
10091 Von Willebrand Factor Antigen AssaMISC. null 1,100 53
10101 Activated Partial Thromboplastin ( MISC. null 250 8,675
10982 Von Willebrand RICOF Activity MISC. null 3,000 18
Haematology
### Special Test
10105 Complete Coagulation Work up MISC. null 2,300 214
10109 Factor Assay MISC. null 900 303
10110 Test for Factor XIII ( Urea Solubility MISC. null 110 4
10112 D-Dimer MISC. null 1,000 510
10127 Thrombin Time MISC. null 250 83
10129 MPV MISC. null 110 3
10132 Inhibitor Studies in Bethesda Units MISC. null 2,400 115
10133 Anticardiolipin Antibody (ELISA) MISC. null 800 10
10134 Lupus Anticoagulant (Coagulation teMISC. null 1,000 7
10135 Anti Phospholipid Antibody (ELISA MISC. null 1,750 608
10137 Protein C MISC. null 2,400 109
10138 Protein S MISC. null 2,400 113
A3. Clinical Pathology: Hemolytic Work-up
Page 300 of 368


Haematology
### Routine Test
10029 Acid Elution Test ( K B test) MISC. null 100 8
10031 G6PD Assay MISC. null 650 112
10045 G6PD Dye Test MISC. null 100 104
Haematology
### Special Test
10114 Ham s Test (Acidified Serum Test) MISC. null 110 3
10119 Osmotic Fragility Test MISC. null 250 57
10124 Sickle Cell Preparation MISC. null 60 45
10125 Sucrose Lysis Test MISC. null 110 1
10141 HB HPLC MISC. null 900 298
A4. Clinical Pathology: Flowcytometry
Haematology
### Routine Test
10987 Flow for PNH MISC. null 4,500 164
Haematology
### Special Test
10145 Flowcytometry for Leukaemia/Ly MISC. null 6,500 174
10149 CD34 Counts MISC. null 2,300 5
10679 CD4 /CD8 - Counts MISC. null 1,250 371
10980 Flow Panel for Primary ImmunodeficMISC. null 3,000 41
10981 Flow for CD 19/20 MISC. null 1,500 183
10985 CD41 For Glanzmanns ThrombastheMISC. null 1,500 23
A6. Clinical Pathology: Miscellaneous tests
Miscellaneous
### Test
10301 Fern Pattern Only MISC. null 70 225
10304 Semen Analysis MISC. null 250 428
10306 Sputum for Eosinophilia MISC. null 80 156
10308 Strip (Pregnancy Test) MISC. null 150 1,536
A7. Clinical Pathology: Body Fluids
Body
### Fluids
10352 TC and DC MISC. null 150 2,290
A8. Clinical Pathology: Molecular Testing
Page 301 of 368


Haematology
### Routine Test
10150 Molecular - BCR ABL(RT-PCR) LABORATOnull 5,500 23
B. BLOOD BANK
B1. Blood Bank : Serology
Haematology
### Routine Test
10093 Antibody identification panel LABORATOnull 750 1
Blood
### Bank
10048 Leucocyte Removal Filtration for ReMISC. null 875 158
10051 Leucocyte Removal Filtration for Pl LABORATOnull 900 3
10052 Wafer LABORATOnull 110 121
10801 ABO Antibody Titre MISC. null 150 -
10804 Cold Agglutinin Titre MISC. null 100 19
10805 Coombs Test - Direct (DCT) MISC. null 200 2,515
10806 Coombs Test - Indirect (ICT) MISC. null 250 386
10809 Crossmatch Charges - Routine MISC. null 1 11,525
10810 Donor Screening (HB, Group and TyMISC. null 100 314
10812 Rapid Screening - HIV,HCV,HBsAg a MISC. null 1,000 2
10816 RhD - Antibody Titre MISC. null 450 16
10817 Professional Charge B MISC. null 200 6,948
10821 RBC Antibody Screening MISC. null 400 9
10851 Fresh Blood Donor Screening ChargMISC. null 750 199
10865 Single Blood bag MISC. null 110 34
10866 Donor Unit Sub Group MISC. null 50 -
10867 Incompatible Crossmatch MISC. null 50 533
10937 Stem Cell Pheresis MISC. null 17,550 1
11103 ABO Blood Grouping & Rho Typing MISC. null 250 14,312
11104 Crossmatch Charges (with AntibodyMISC. null 350 -
11105 DCT - Monospecific MISC. null 300 7
B2. Thalassaemia & Haemophilia Patients
Blood
### Bank
Page 302 of 368


10900 Thalassaemia / Haemophilia PackagMISC. null 1 868

11106 Thalassaemia / Haemophilia PackageMISC. null 250 360
B3. Blood Bank : Blood Products
Blood
### Bank
10819 Platelet Pheresis Single Unit MISC. null 11,000 154
10852 Whole Blood MISC. null 1,280 210
10853 Cryoprecipitate DIAGNOSTnull 400 536
10856 Packed Cells MISC. null 1,248 7,516
10857 Platelet Concentrate MISC. null 632 7,887
10858 Fresh Frozen Plasma MISC. null 632 3,010
D. MICROBIOLOGY LAB
D1. Microbiology: Routine Tests
Blood
### Bank
10049 MRSA screen LABORATOnull 200 -
10050 MDRO screen (Surface SWAB+RectalLABORATOnull 600 -
B. BLOOD BANK
B3. Blood Bank : Blood Products
Blood
### Bank
11161 Whole Blood LABORATOnull 1,279 -
11162 Packed Cells LABORATOnull 1,247 -
11163 Fresh Frozen Plasma LABORATOnull 631 -
Haematology
### Routine Test
10011 Haemoglobin % (HB) Packed Cell V MISC. null 55 86
10021 Platelet Count,Reticulocyte Count MISC. null 150 11
10024 Red Cell Count (RBC) MISC. null 55 54
10028 M C V MISC. null 55 239
10033 Immuno Chemistry panel MISC. null 1,650 -
10038 Peripheral Smear with I:T Ratio MISC. null 130 1
Page 303 of 368


10040 BoneMarrow slide to Outside MISC. null 80 198

10041 Peripheral smear for second opinioMISC. null 125 -
10044 TC, DC, PCV MISC. null 100 2
10047 Outside Bone marrow aspiration MISC. null 375 -
10088 Hepatitis Panel MISC. null 1,225 -
10089 Collagen Vascular work-up MISC. null 1,425 -
10090 Bone Marrow slide for Second OpinMISC. null 150 2
10128 RDW MISC. null 55 3
10151 Molecular- JAK2 LABORATOnull 4,000 36
10973 PCT Major MISC. null 800 -
10974 PCT Minor MISC. null 500 -
Haematology
### Special Test
10102 Alkaline Denaturation - Quantitativ MISC. null 120 2
10106 Complete Hemolytic Work up with H MISC. null 1,200 -
10142 Molecular Testing ? FISH (done in MISC. null 3,150 -
10143 Chromosome Analysis for Cancer MISC. null 2,100 -
10144 AMLI/ETO t (8:21) MISC. null 3,700 -
10146 Imatinib drug resistance mutation AMISC. null 5,250 -
10147 2.FIPILI-PDGF Ra RPTCR Assay MISC. null 4,200 3
10148 JAK 2 Mutation analysis PCR Assay MISC. null 3,400 -
Miscellaneous
### Test
10305 Sigmoidoscopy Specimen for MicroMISC. null 35 -
10307 Vaginal Swab for T.V. and Monilia MISC. null 40 1
Blood
### Bank
10820 Platelet Pheresis Divided Unit MISC. null 5,500 2
10938 Bank Plasma MISC. null 400 2
Page 304 of 368



Date Date Date
Page 305 of 368

Immunology
Immunology
Printed in SOC's
8. IMMUNOLOGY
General
### Medicine
2880 Musculoskeletal USG PROCEDUREnull 750 1
2881 Related ultra sound (MPROCEDUREnull 1,000 2
8. IMMUNOLOGY
General
### Medicine
2885 Nail Fold Capillaroscop PROCEDUREnull 750 1
Grand Total 2,500 4

Date Date Date
Page 306 of 368

Physiotherapy
Sum of units
Service Common Any request for
Ch Code ChargeDesc ServiceDesc Catagory ServCat ward Rate from Apr-17 to Remarks
Rate Revision
Nov-17
Physiotherapy
Printed in SOC's
8.5. UoH - PHYSIOTHERAPY
Unit
23800 Manual Therapy MISC. null 90 -
23801 Taping MISC. null 65 -
23802 Traction MISC. null 90 -
23803 TNS and Wax MISC. null 90 -
23804 Combination Therapy MISC. null 120 15
23805 TNS and Traction MISC. null 90 -
23806 TNS and Exercise MISC. null 90 -
23807 IFT & Traction MISC. null 90 -
23808 IFT & Exercise MISC. null 90 -
23809 IFT & TENS MISC. null 90 -
23810 SWD & TENS MISC. null 90 -
23811 IFT & Moist Heat MISC. null 90 -
23812 Ultrasound & Moist Heat MISC. null 90 -
23813 Cerebal Palsy Assessment MISC. null 65 -
23814 Cerebal Palsy Training MISC. null 65 -
23815 SWD & Ultrasound MISC. null 90 -
23816 Electrical Stimulation & Exerci MISC. null 90 -
23817 Chest Physiotherapy in ICU MISC. null 120 -
23818 Exercise or Postural Drainage MISC. null 65 -
23819 Exercise Therapy MISC. null 65 -
23820 Electrical Stimulation ( < 2gro MISC. null 65 -
23821 General Exercises for PsychiatrMISC. null 65 -
23822 Hand Mobilization MISC. null 65 -
Page 307 of 368

Physiotherapy
Sum of units
Rate Revision
Nov-17
23823 Higher Function Assessment MISC. null 65 -
23824 Home Treatment Programme MISC. null 65 -
23825 Hot Pack (Moist Heat) MISC. null 65 -
23826 Infra Red Rays MISC. null 65 -
23827 Incontinence Stimulation(InfraMISC. null 65 -
23828 Ionization MISC. null 65 -
23829 Spasticity Reduction MISC. null 90 -
23830 Microwave & Exercises MISC. null 90 -
23831 Microwave & Traction MISC. null 90 -
23832 Muscle Assessment MISC. null 90 -
23833 SWD & I FT MISC. null 90 -
23834 Pulmonary Rehab (Pre Vocation MISC. null 90 -
23835 Prosthetic Check Out MISC. null 65 -
23837 Shortwave Diathermy MISC. null 65 -
23838 Shortwave & Exercises MISC. null 90 -
23839 Taping & Exercise MISC. null 90 -
23840 TENS MISC. null 65 -
23841 Traction CT or PT MISC. null 65 -
23842 Ultrasonic & Exercises MISC. null 90 -
23843 Ultrasonic & Traction MISC. null 90 -
23844 Ultrasonic Therapy (per area) MISC. null 65 -
23845 Wax and Shortwave MISC. null 90 -
23846 Wax Therapy (< 2areas) MISC. null 65 -
23847 Wax Therapy & Exercises MISC. null 90 -
23848 Whirlpool MISC. null 65 -
23849 TENS & Ultrasound MISC. null 90 -
23850 Interferential Therapy MISC. null 65 -
23851 Continuous Passive Mobilisati MISC. null 65 -
Page 308 of 368

Physiotherapy
Sum of units
Rate Revision
Nov-17
23852 Continuous Passive Mobilisati MISC. null 90 -
23853 IFT & Ultrasound MISC. null 90 -
23854 Wax Therapy & Ultrasound MISC. null 90 -
23855 Moist Heat & Exercises MISC. null 90 -
23856 Exercise A (less than 30 MinutMISC. null 65 -
23857 Exercise B ( 30 - 60 minutes) oMISC. null 120 3
23858 Exercise C (more than 60 minuMISC. null 120 -
23859 Tilt Table MISC. null 65 -
23860 Developmental Therapy MISC. null 70 -
23861 SWD & Traction MISC. null 90 -
23862 CPM & Wax MISC. null 90 -
23863 Wax & IFT MISC. null 90 -
23864 Electrical Stimulation - Major MISC. null 90 -
23865 Wax therapy - Major- > 2 area MISC. null 90 -
22. PHYSIOTHERAPY
Physiotheraphy
###
3478 Single Therapy (per session) PROCEDURnull 100 17,905
3479 Two Therapies ( per session) PROCEDURnull 150 7,888
3480 Three Therapies ( per session)PROCEDURnull 200 3,369
3481 Four Therapies (per session) PROCEDURnull 250 577
3482 Five Therapies (per session) PROCEDURnull 300 85
3483 Long Duration Therapy ( per seMISC. null 160 1,312
3490 CPM PROCEDURnull 150 76
3491 CPM+Exercises PROCEDURnull 225 173
Page 309 of 368

Physiotherapy
Sum of units
Rate Revision
Nov-17

Date Date Date
Page 310 of 368

Nursing Procedures
Service
Ch Code ChargeDesc ServiceDesc Catagory
Printed in SOC's
A: BED CHARGES & ADMINISTRATIVE CHARGES
Administration
129 General Procedure
31 Room Heater Charges MISC.
131 ADMINISTRATIVE CHARGES
21 Admission & Discharge Documentation MISC.
35 Insurance Documentation MISC.
15015 Insurance Documentation - OP MISC.
General Procedures
Printed in SOC's
A: BED CHARGES & ADMINISTRATIVE CHARGES
Administration
34 Thalassemia care MISC.
J.Tele Phone Charges
Non Revenue
127 Telephone charges
200 Telephone (charges vary depending on actuals calls MISC.
8.9. UoH - MEDICO SOCIAL WORK
173 Unit of Hope Procedures
24025 Correspondence MISC.
24026 Guidance & Counselling MISC.
24027 Vocational Counselling MISC.
24028 Health Education (groups) MISC.
24029 Health information (individual) MISC.
24030 Pre-vocational Assessment MISC.
24031 Home Evaluation / Home visit MISC.
24032 Work Environment Evaluation MISC.
24033 Assessment of Socio-economic Status MISC.
24035 Group Therapy / Counselling MISC.
24036 Rehabilitation Counselling MISC.
24037 Individual Therapy MISC.
24038 Family Counseling MISC.
24039 Financial Assistance/ Fund Raising MISC.
24040 Assessment of Needs MISC.
24041 Community Participation MISC.
24042 Letter to Organizations/ Referral Letter MISC.
24304 Networking with NGOs / GOs / Work place / Schools MISC.
EICU
60002 Dynaplaster for IV MISC.
ITU
111 Post Operative - POST OP
151 Arterial Line MISC.
152 Venesection / Cut Down / CVC MISC.
153 Intubation (Endotracheal) MISC.
154 Stomach Wash for Poisoning MISC.
158 Defibrillator MISC.
159 Monitoring (per day) MISC.
156 G.R.B.S MISC.
157 CVP Monitoring MISC.
160 Oximeter MISC.
161 Oxygen charges for respirator(per hour) MISC.
162 Oxygen Inhalation (per hour) MISC.
163 Respirator (per day) MISC.
164 Infusion Pump (per day) MISC.
MICU
372 Servo Duo Guard Filter MISC.
3184 Bedside EEG DIAGNOSTIC
3185 Proning PROCEDURE
OPD/Ward Procedures
10 Miscellaneous MISC.
201 Arterial Line MISC.
202 Atropine Anitode Therapy (excluding drugs) MISC.
203 Aspiration MISC.
204 Crape Bandage Service Charges MISC.
205 Electroplast Service Charges MISC.
206 Strapping (Chest) MISC.
207 Bandage -Triangular Bandage MISC.
208 Biopsy - Cervical MISC.
209 Lymph Node Biopsy MISC.
210 Biopsy - Transbronchial Lung MISC.
211 Bladder wash MISC.
212 Bowel Wash MISC.
213 Cathererization MISC.
214 Catherterization(urology) MISC.
215 Colostomy Care MISC.
216 CVP Monitoring MISC.
217 Debridment MISC.
218 Defibrillator MISC.
219 Douche MISC.
220 Drainage (Tubing & Bottling) MISC.
221 Dressing - Pad & Bandage MISC.
222 Dressing - Each Bandage MISC.
223 Dressing - Each Pad MISC.
224 Dressing - Salvon Bath & Dressing MISC.
225 Dressing - Service Charges - Small MISC.
226 Dressing - Service Charges - Medium MISC.
227 Dressing - Service Charges - Large MISC.
228 Enema MISC.
229 Forced Alk.Diuresis for Barbit Poisoning MISC.
230 Fistula Care (each visit) MISC.
231 Ear Hole Suturing with LA MISC.
232 G.R.B.S MISC.
233 Incision & Drainage MISC.
234 Infra Red Lamp Application(10 Minutes) MISC.
235 Disposible Needle # MISC.
236 Disposable Needle & Syringe # MISC.
237 Service Charges - Injection IM / SC MISC.
238 Injection Service Charges - Intra Cardiac MISC.
239 Injection Service Charges - Intravenous MISC.
240 Parental Chemotherapy Charges MISC.
241 SC - Kenacort MISC.
243 Intra Articular Pressure Monitoring MISC.
245 Invasive BP Monitoring MISC.
246 IV Fusion MISC.
247 Leather Heel - Large MISC.
248 Leather Heel - Small MISC.
249 Liver Puncture MISC.
250 Lumbar Puncture MISC.
252 Nebuliser- Machine (per use) MISC.
253 Monitoring MISC.
254 Nebuliser - Pipeline MISC.
255 Nebuliser for Children in OPD MISC.
256 Minor Procedure - In Minor OT MISC.
257 Mantux Test MISC.
258 Pulse Oximeter Monitoring (per day) MISC.
260 Oxygen Charges For Respirator (Per Hour) MISC.
261 Pericardial Tap MISC.
262 Peritoneal Drainage MISC.
263 Plasma Pheresis MISC.
264 Plaster Of Paris - Local 10 cms MISC.
265 Plaster of Paris - Local 15 cms MISC.
266 Pleural Aspiration MISC.
267 Pleural Aspiration (General Medicine) MISC.
268 Pocket Droppler (first use) MISC.
269 Pocket Doppler (more than 1 use) MISC.
270 Plastering / Cast Application - Major MISC.
271 Plastering / Cast Application - Minor MISC.
272 Removal of Foreign Body in OPD/ward MISC.
273 Respirator (per day) MISC.
274 E.C.G MISC.
275 Ryles Tube Introduction MISC.
276 Sitz Bath MISC.
277 Infusion Pump (per day) MISC.
278 Steam Inhalation MISC.
279 Stoma Clinic - Irrigation of Stoma (first) MISC.
280 Stoma Clinic - Irrigation of Stoma (subsequent) MISC.
281 Stoma Clinic - OP Consultation MISC.
282 Stoma Clinic - Pre Op Assessment MISC.
283 Stoma Clinic - Post Op 1st Visit MISC.
284 Stomach Wash - Poisoning MISC.
285 Stomach Wash - Routine MISC.
286 Streptokinase Therapy (excluding drugs) MISC.
287 Sub-Clavian Puncture MISC.
288 Suture Removal (Dressing Charges Extra) MISC.
289 Suturing under LA in OPD / Ward MISC.
290 Suturing without LA in OPD / Ward MISC.
291 Tracheostomy Care MISC.
292 Varicose Veins Injection MISC.
293 Venesection / Cut Down / CVC MISC.
294 Wall Suction MISC.
295 Phototherapy - Single Surface (per day) MISC.
296 Incubator / Open Air Care MISC.
297 Peritoneal Wash MISC.
298 Catheter Care MISC.
299 Hepatitis B - Adult MISC.
300 Hepatitis B - Child MISC.
301 Water Mattress MISC.
304 Disposable Syringe - 2CC # MISC.
311 Vacuette Coagulation MISC.
312 Vacuette EDTA MISC.
313 Vacuette ESR MISC.
314 Vacutte Serum 4ml MISC.
315 Vacuette Needle 22G MISC.
316 Vacuette Needle 21G MISC.
317 Vacuette Lithium 4ml MISC.
318 Disposable - Dress Tray Wrapper MISC.
319 Disposable Surgical Pack Wrapper MISC.
350 Sterile Gloves MISC.
370 Elastic Adhesive Bandage per 10cm (10/8 cm) MISC.
371 Culture Tube MISC.
60038 Uristix MISC.
UoH General
23532 G.R.B.S. MISC.
23533 Incision & Drainage MISC.
23534 Service Charges - Injection IM/SC MISC.
23535 Injection Service Charges - Intravenous MISC.
23537 Nebuliser for Children in OPD MISC.
23538 Mantoux Test MISC.
23539 Plaster Of Paris - Local 10 cms MISC.
23540 Plaster of Paris - Local 15cms MISC.
23541 Plastering/Cast application - Major MISC.
23542 Plastering / Cast Application - Minor MISC.
23543 ECG MISC.
23544 Suture Removal (Dressing Charges Extra) MISC.
23545 Suturing under LA in OPD / Ward MISC.
23546 Suturing without LA in OPD / Ward MISC.
23547 Tracheostomy Care MISC.
23548 Wall Suction MISC.
23552 Disposable - Dress Tray Wrapper MISC.
23553 Sterile Gloves MISC.
23554 IV Infusion / Line MISC.
23555 Intraosseous Line MISC.
23556 Pulse Oxymetry MISC.
23557 Disposable Needle # MISC.
23558 Disposable Needle & Syringe # MISC.
23560 Enema MISC.
23561 Catheterization MISC.
23562 Ryles Tube Introduction MISC.
23563 Steam Inhalation MISC.
24142 General Consultation - UoH (Within 30 days) MISC.
24143 General Consultation - UoH (Revisit after 30 days) MISC.
24150 Debridement MISC.
24151 Dressing - Pad & Bandage MISC.
24152 Dressing - Each Bandage MISC.
24153 Dressing - Each Pad MISC.
24154 Dressing - Savlon Bath & Dressing MISC.
24155 Dressing - Service Charges - Small MISC.
24156 Dressing - Service Charges - Medium MISC.
OPD/Ward Procedures
394 Sponge Bath NURSING
395 Back Care / Mouth Care NURSING
399 Pre-Operative Skin Preparation PROCEDURE
60012 Sterile Water 500ml ITEMS
111 Post Operative - POST OP
189 Non-Invasive Bipap Ventilator - Package (per day) MISC.
33 Warm Cradle MISC.
251 Lumber Puncture (General Medicine) MISC.
310 Culture Tube# MISC.
320 SCD: Sequential Compression Device Knee Length MISC.
321 SCD: Sequential Compression Device Thigh Length MISC.
19000 P & L Package MISC.
251 Lumber Puncture(General Medicine) -E MISC.
1533 N S T -E MISC.
2319 Suture Removal -E MISC.
163 Round Off
50005 Round Off MISC.
23502 Revisit after 30 days MISC.
999 Round Off
50005 Round Off MISC.
aposal for 2018-19
Common from
ServCat ward Apr-17 for Rate Remarks
Rate to Nov-17 Revision
null 200 127
null 125 39,924

null 500 4,109
null 100 3
null 250 -
null 2 7
null 60 -
null 60 -
null 60 -
null 550 -
null 60 -
null 55 -
null 220 -
null 70 -
null 60 -
null 110 -
null 110 -
null 60 -
null 110 -
null 60 -
null 60 -
null 220 -
null 60 -
null 220 -
null 10 18,391
null 240 23
null 240 8
null 240 6
null 290 37
null 210 17
null 140 14,933
null 60 32,539
null 140 34
null 160 3,160
null 110 233
null 40 101,876
null 570 19
null 210 2,852
null 720 564

null 300 33
null 300 -
null - 8,243
null 240 -
null 360 -
null 210 3
null 60 63
null 60 3
null 60 -
null 20 1
null 300 -
null 300 98
null 860 -
null 100 117
null 100 729
null 80 1,931
null 80 144
null 100 434
null 140 59
null 210 11
null 210 4
null 40 -
null 40 668
null 70 38
null 50 31
null 20 619
null 100 19
null 60 6,379
null 80 5,179
null 110 1,598
null 60 3,681
null 360 -
null 50 -
null 100 -
null 60 204,664
null 140 95
null 40 48
null - 41
null - 437
null 20 41,398
null 70 15
null 20 175,087
null 140 -
null 60 -
null 210 -
null 240 648
null 250 2
null 50 21,414
null 70 -
null 60 4
null 210 -
null 210 308
null 40 22,040
null 140 2,323
null 40 13,046
null 40 91
null 210 14
null 10 483
null 160 2,254
null 40 107,308
null 110 -
null 210 2
null 250 3
null 420 -
null 70 11
null 140 5
null 210 65
null 210 -
null 140 50
null 210 -
null 250 12
null 210 1,048
null 290 15
null 570 -
null 160 28,473
null 20 788
null 50 1,760
null 210 2,695
null 40 10,821
null 70 3
null 40 -
null 20 -
null 50 -
null 50 1
null 290 2
null 70 41
null 60 1
null 210 -
null 50 332
null 100 54
null 60 -
null 50 2,529
null 140 -
null 240 313
null 20 3,073
null 240 2,155
null 360 529
null 360 -
null 20 6,735
null - -
null - -
null 60 3,837
null - 13
null - 102
null - 8
null - 1
null - -
null 10 1
null 10 3
null 10 2
null 10 3
null 10 4
null 10 2
null 10 -
null 10 16,540
null 10 617
null 80 2
null 20 -
null 10 162
null 10 2,430
null 60 -
null 120 -
null 20 -
null 20 1
null 200 -
null 30 3
null 10 -
null 55 -
null 120 -
null 210 -
null 175 1
null 160 -
null 40 12
null 80 -
null 50 -
null 40 -
null 10 -
null - -
null - -
null - -
null 10 -
null 65 -
null 40 1
null 35 -
null 120 -
null - -
null - -
null 30 -
null 50 -
null 70 -
null 20 -
null 30 -
null 100 761
null 100 1,207
null 175 6
null 70 1
null 50 -
null 20 -
null 80 5
null 60 -
null 80 -
null 50 10,813
null 50 11,204
null 100 2,963
null 26 110
null 450 63
null 250 664

null 220 3
null - 208
null 300 9
null 475 4
null - 468
null 380 -
null 450 11
null 70 -
null - -
null 100 -
null - 10,455
Schedule of Charges praposa
Pharmacy
Charge
Ch Code ServiceDesc
Desc
OT - Materials
Printed in SOC's
OPD/Ward Procedures
134 O.T .Materials
72051 Dynaplaster
73250 Sheath Arterial 6 Fr 11Cm [.038" ] Ref 504-606 X C
31. ANAESTHESIOLOGY
134 O.T .Materials
73101 Injection Isoflurine
73102 Micro Shield - 4
73112 Micro Shield PVP-S
73114 Micro Shield PVP-P
134 O.T .Materials
60026 Materials
70004 Bandage
70010 Burns pad
70061 Skin Graft Blade
71426 Liga Clips (Medium)
71427 Liga Clips- 300
71429 Ethicon Endopath (EMS)
71431 Horizon LIga Clips
71432 Ethicon Liga Clips
71571 Mini Screw 1.5 mm
71572 Mini Screw 2 mm
71576 DCP Screws 4.5 mm x 1
71585 Mini Plate "T" Shape
71586 Mini Plate Oribtal 4 holes
71588 Mini Plate Orbital 4 holes
71589 Mini Plate Y - Shape
71590 Mini Plate 3 holes
71599 Disp. Valleylab Pad
71600 Mini Plate L Shape 20 holes
71611 Square Nail 2mm
71612 Square Nail 2.5mm
71614 Square Nail 3.5 mm
71641 Can Screw 16 mm 1" x 1"
71642 Can Screw 2" x 2
71643 Can Screw 16 mm 3" x 3
71644 Can Screw 16 mm 4" x 4
71645 Cortical Screw 16, 18, 20 mm
71646 Can Washer
71648 Teflon Piston
71663 DCP Plate 12 holes
71674 Semi Tubular Plate 6 holes
71721 Gigly Saw Wire
71731 K-Wire
71739 SS Wire
71849 Miscellaneous - O.T
71850 Materials (O.T)
72020 Teflon Sheet
72024 Arch Bar
72034 Disposable Trochar
72036 Liga Clips (Small)
72059 Proximate Strip 104K
72075 Proximate Strip 101K
72080 Teflon Felt
72092 Proximate Skin Staple Pin
72093 Proximate Stapler TLH 30
72123 Disposable Head Cap
72124 Disposable Face Mask
72129 Ordinary Sponge
72136 Teflon Pleget
72140 Disposable Phaco Knife
72141 Disposable Syringes 1cc
72146 Disposable Electrods
72147 Disposable Sponges
72148 Gynae Sponge
72149 Blue Line Sponge
72157 Bard Mesh 2 x 4
72161 Disposable Needle
72162 Disposable Blade
73068 Bard Vascular Graft
73069 Aortic Dacron Graft
73070 Dacron Vascular Prothesis
73071 Dacron Graft
73072 Dacron Graft (Old)
73073 PTFE Vascular Graft 8x50
73074 Gortex Vascular Graft
73075 Impra Vascular Graft
73076 Peel away sheath 09/04110
73077 Oxygen filter
73078 I.A. Baloon Catheter
73079 I.A.B.P Service charge
73080 Dextrostix
73081 FEP Graft
73082 Stretch Vascular Graft
73087 Sterile Absolute Alchol
73093 Germi Clean
73103 St.Thomas Solution
73113 Cardioplegic Solution
73117 Chlorhoxidene
73123 Distilled Water
73124 Micro Shield Scrub
73125 Distilled Water 10ml
73127 Tincture Benzoin
73204 Disposable Cap & Mask
73210 Disposable Suction Tube
73211 Disposable Cautry Plate
73213 Proximate Stapler TLC 75
73214 Ethicon Endo Liga Clip
73218 Ethicon Liga Clip ERCA
73219 Cautery Pad
73220 Disposable Cautry Lead
73221 Mopping Pad (25cmx30cm) 6 ply X-ray thread
73222 Mopping Pad (30cmx40cm) 8 ply X-ray thread
73223 Bipolar Cautery Lead/Pencil E0509 Handswitching Re
73224 Monopolar Cautery Lead/Pencil E 2100 Handswitching
73225 Cautery Pad / Dispersive Pad E7507 Electrode Valle
73226 Cautery Pad / Dispersive Pad E 7506 Electrode Vall
73227 Cautery Pad 3M/ Cautery Plate 9165 3M Universal Sp
73228 Suction Tube
73229 Wiek Skin Stapler
73230 Lotus Skin Stapler
73231 Cautery Cleaner
73232 Cap And Mask
73233 Tubings Signature Disposable
73234 Total Plus Vitrectomy Pak
73235 Reusable LMA
73239 Surgical Flexible Stone Grasping Forceps 3F*Blue N
73240 Adult Patient Breathing Circuit- Disposable
73241 Lead Round Type 130-150-300 Laproscopy
73242 Monopolar Lead Laproscopy
73243 Catheter Vericose Vein Vnus Closure Fast 100Cm
73244 Pump Tubings For Arthroscope Pump Ar-6415
73245 Sheath Arterial 7 Fr 11Cm
73246 Probe Lithoclast 1.0Mm X 605Mm 3Fr El-045 Uro
73247 Probe Lithoclast 1.0Mm X 570Mm 3Fr El-220 Uro
73248 Probe Ultrasound 3.8 X 403Mm 11.4Fr Fr-083 Uro
73252 Arthroscopic Synovator Shaver Blade Smith And Neph
73253 Arthroscopic Vulvan Saphire 90 Degree Smith And Ne
73254 Arthrocare Vulcan Probes
73255 Amo Phaco Machine Cassette
73256 Phaco Knives Crescent
73257 Phaco Knives Keratome
73258 Phaco Knives Side Port
73259 Full Pack Of Phaco Knives
73260 Embolectomy Catheter
73261 Ligamax 5Mm (15 Pins)
73262 Secure Strap (25 Pins)
73263 Linear Staplertlh 30
73264 Linear Staplertlh 60
73265 Linear Stapler Tlh90
73266 Linear Cutter Tlc 55 (Johnson And Johnson)
73267 Linear Cutter Tlc75
73268 Linear Cutter Tlc 100
73269 Advant 55Mm Stapler Handle
73270 Protack 5Mm (30 Pins)
73271 Craniotome Cutter
73272 Dermatome Blades
73273 Coblater Wands
73274 Gel Port
73275 Cathter Urethral 5Fr Ct Ucut
73276 Balloon Dilation Set Urethral Cat Set Aubs-5-4
73277 Guide Wire Terimo Straight 0.32
73278 Guide Wire Terimo Straight 0.35
73279 Vitrectomy Accessories
73280 Pediatric Return Electrode
73281 Neonatal Return Electrode
73282 ALCON PHACO CASSETTE
73283 Warming Blanket - Pediatric SW2009
73284 AMPLATZ Renal Dilator
73285 Injection Mistatron
73286 Optiflow Patient Tubing (Single Use)
73287 Optiflow Patient Tubing (Multi Use)
73288 Pediatric High Flow Nasal Cannula (Single Use)
73289 Pediatric High Flow Nasal Cannula (Multi Use)
73290 HFNC Machine (per hour)
73291 Koles Chamber
73292 Cannulas
73293 Neuro Diffusor
73294 Injection Sevoflurane
73295 White Plaster
721573 Bard Mesh 10 x 14
Not Printed in book OT Materials
134 O.T .Materials
73296 Inj. Vitamin K
73298 Multi Functional Electro Pad
73299 Polyhesive Return Electrode
73300 EBUS TBNA needle
73301 Disposable Gloves
73302 Medgyn Endo Sampler II
73303 Medgyn Pipette IV 3.1mm O.D
73304 Gauze Pack
73305 Dressing Pad
73306 Cotton Balls Pack
73307 Eye pad
Ward Consumption
Printed in SOC's
OPD/Ward Procedures
125 Pharmacy Materials
302 Vaccuete Tube
303 Needle
of Charges praposal for 2018-19
Common Sum of units from Apr-17 Any request for Rate
Service Catagory ServCat ward Rate to Nov-17 Revision
MISC. null 10 2580

MISC. null 1060 9
MISC. null 11 32001

MISC. null 1 712912
MISC. null 1 712021
MISC. null 1 10451
MISC. null 0 3
MISC. null 3 3942
MISC. null 35 5539
MISC. null 225 232
MISC. null 210 0
MISC. null 320 0
MISC. null 601 0
MISC. null 27 0
MISC. null 31 0
MISC. null 58 6
MISC. null 52 0
MISC. null 54 0
MISC. null 60 0
MISC. null 66 0
MISC. null 77 0
MISC. null 77 0
MISC. null 77 0
MISC. null 77 0
MISC. null 250 0
MISC. null 177 0
MISC. null 122 0
MISC. null 275 0
MISC. null 122 2
MISC. null 146 1
MISC. null 158 0
MISC. null 176 0
MISC. null 110 0
MISC. null 332 0
MISC. null 283 0
MISC. null 300 0
MISC. null 50 0
MISC. null 4780 0
MISC. null 112 0
MISC. null 173 0
MISC. null 72 0
MISC. null 72 1
MISC. null 72 0
MISC. null 98 0
MISC. null 79 0
MISC. null 143 5
MISC. null 157 0
MISC. null 157 0
MISC. null 178 1
MISC. null 177 31
MISC. null 20 1
MISC. null 17 0
MISC. null 1036 0
MISC. null 1036 0
MISC. null 537 0
MISC. null 730 1
MISC. null 993 3
MISC. null 686 0
MISC. null 1036 0
MISC. null 158 0
MISC. null 115 2
MISC. null 1003 0
MISC. null 435 0
MISC. null 518 0
MISC. null 274 23
MISC. null 98 236
MISC. null 93 40
MISC. null 537 0
MISC. null 759 0
MISC. null 472 2
MISC. null 515 0
MISC. null 572 0
MISC. null 650 0
MISC. null 80 7799
MISC. null 0 1386
MISC. null 62 0
MISC. null 165 30
MISC. null 1500 0
MISC. null 300 0
MISC. null 21 0
MISC. null 23 0
MISC. null 24 0
MISC. null 14 0
MISC. null 850 0
MISC. null 825 0
MISC. null 975 0
MISC. null 7 0
MISC. null 5 0
MISC. null 10 17279
MISC. null 200 0
MISC. null 166 0
MISC. null 5 0
MISC. null 3 0
MISC. null 4 0
MISC. null 6 0
MISC. null 12 0
MISC. null 24 0
MISC. null 56 5
MISC. null 26 167
MISC. null 18 40
MISC. null 962 0
MISC. null 2 1
MISC. null 250 0
MISC. null 2915 0
MISC. null 3000 0
MISC. null 15000 0
MISC. null 1500 0
MISC. null 450 0
MISC. null 594 0
MISC. null 1 0
MISC. null 1000 0
MISC. null 1075 0
MISC. null 100 0
MISC. null 28160 0
MISC. null 1200 0
MISC. null 15 0
MISC. null 3955 0
MISC. null 19775 0
MISC. null 0 0
MISC. null 1 0
MISC. null 265 6
MISC. null 269 0
MISC. null 1 0
MISC. null 16 0
MISC. null 1 0
MISC. null 4 0
MISC. null 0 0
MISC. null 50 1
MISC. null 30 1
MISC. null 85 15
MISC. null 1 0
MISC. null 250 0
MISC. null 520 0
MISC. null 100 4
MISC. null 50 2
MISC. null 30 9110
MISC. null 25 13285
MISC. null 148 1856
MISC. null 377 4119
MISC. null 132 55
MISC. null 153 3689
MISC. null 156 2
MISC. null 68 898
MISC. null 29 9642
MISC. null 24 1926
MISC. null 33 718
MISC. null 50 7864
MISC. null 1143 0
MISC. null 5000 1
MISC. null 250 261
MISC. null 550 1
MISC. null 1250 8
MISC. null 337 15
MISC. null 325 10
MISC. null 10078 0
MISC. null 643 0
MISC. null 321 0
MISC. null 390 0
MISC. null 390 0
MISC. null 4227 0
MISC. null 610 0
MISC. null 610 0
MISC. null 1966 0
MISC. null 6339 1
MISC. null 7020 0
MISC. null 1387 296
MISC. null 195 14
MISC. null 195 92
MISC. null 195 101
MISC. null 520 286
MISC. null 2252 0
MISC. null 1925 0
MISC. null 1763 0
MISC. null 2373 0
MISC. null 2839 0
MISC. null 3395 0
MISC. null 2963 0
MISC. null 3537 0
MISC. null 4111 0
MISC. null 468 0
MISC. null 1004 0
MISC. null 484 1
MISC. null 853 0
MISC. null 12203 0
MISC. null 3016 0
MISC. null 325 0
MISC. null 4618 2
MISC. null 553 0
MISC. null 553 0
MISC. null 5000 21
MISC. null 720 261
MISC. null 360 49
MISC. null 2250 0
MISC. null 1100 90
MEDICINES null 5000 0
MISC. null 50 6725
PROCEDURE null 200 0
MISC. null 800 0
MISC. null 3600 0
MISC. null 30 465
MISC. null 10 79
MISC. null 990 0
MISC. null 2640 0
MISC. null 4289 0
MISC. null 17 182

ITEMS null 1500 7
MISC. null 570 3
ITEMS null 13000 0
MISC. null 10 14999
ITEMS null 320 0
ITEMS null 160 11
ITEMS null 20 7435
ITEMS null 20 2789
ITEMS null 20 1530
ITEMS null 20 74
MISC. null 14 190732
MISC. null 11 116290
Remarks
Schedule of Charges praposal for 2
Admin
Ch Code ChargeDesc ServiceDesc Service Catagory
Linen Department
Printed in SOC's
OPD/Ward Procedures
176 LINEN CHARGES
74000 Printed Sheet MISC.
74009 Pajama (A) MISC.
74010 Pajama (S) MISC.
74060 Wrappers Medium (CSSD) MISC.
74061 Wrappers Small (CSSD) MISC.
176 LINEN CHARGES
74001 Blue Sheet MISC.
74002 Bed Sheet White MISC.
74003 A/C Sheet MISC.
74004 Draw Sheet MISC.
74005 Printed Pillow Case MISC.
74006 Blue Pillow Case MISC.
74007 White Pillow Case MISC.
74008 Mother Gown MISC.
74011 Shirt (A) MISC.
74012 Shirt (S) MISC.
74013 Turkey Towel MISC.
74014 Doctors Gown MISC.
74015 Bath Towel MISC.
74016 Patient Gown MISC.
74017 N N Blue Gown MISC.
74018 Trolley Sheet (OPD) MISC.
74019 N N W Gown MISC.
74020 Pink Gown MISC.
74021 K-Gown MISC.
74022 Blue Screen MISC.
74023 Bed Spread MISC.
74024 Lunge MISC.
74025 X-Ray Gown MISC.
74026 Sling MISC.
74027 Green Big Sheet (OT) MISC.
74028 Green Double Sheet (OT) MISC.
74029 Green Half Sheet (OT) MISC.
74030 Green Trolley Sheet (OT) MISC.
74031 Green Big Towel (OT) MISC.
74032 Green Small Mayo (OT) MISC.
74033 Green Big Mayo (OT) MISC.
74034 Green OP Gown (OT) MISC.
74035 Green Ortho Gown (OT) MISC.
74036 Green CCU Gown (OT) MISC.
74037 Legging (OT) MISC.
74038 Green Pant (OT) MISC.
74039 Green Shirt (OT) MISC.
74040 Gown (Cath Lab) MISC.
74041 White Gown (OT) MISC.
74042 White Pant (OT) MISC.
74043 White Shirt (OT) MISC.
74044 Green Turkey Towel (OT) MISC.
74045 Grren L.P.Hole Towel (OT) MISC.
74046 Blue Pant (OT) MISC.
74047 Blue Shirt (OT) MISC.
74048 Urology Hole Towel (OT) MISC.
74049 Wrappers Big (OT) MISC.
74050 Hole Towel (Cath Lab) MISC.
74051 Big Sheet ( Cath Lab) MISC.
74052 Trolley Sheet (Cath Lab) MISC.
74053 Big Towel (Cath Lab) MISC.
74054 Socking Towel (Cath Lab) MISC.
74055 Angio Cover (Cath Lab) MISC.
74056 Trolley Sheet (CSSD) MISC.
74057 Red Gown (CSSD) MISC.
74058 White Towel (CSSD) MISC.
74059 Gown White (CSSD) MISC.
74062 Annexe Sheet MISC.
74063 Annexe Pillow Case MISC.
74064 Sponge Bag (Annexe) MISC.
MRD
Printed in SOC's
C. OTHER PROCEDURES / SERVICES
4. CERTIFICATES
15001 Billing Details MISC.
135 CERTIFICATES
15002 Birth Certificate MISC.
15003 Physical Fitness Certificate MISC.
15004 Duplicate Certificates MISC.
15005 Special Documentation charges (admitted ) MISC.
15006 Special Documentation charges (Nonadmitted ) MISC.
15007 Other Certificates MISC.
15008 Medical Certificate for Visa MISC.
15011 Wound Certificate (Patients Copy) MISC.
15014 Additional Certificate for VISA MISC.
15016 Duplicate Death Certificate MISC.
15017 Correction Charges MISC.
15026 Duplicate IP Bill-Detail MISC.
15027 Duplicate Summary Bill / Pharmacy Details MISC.
15028 Duplicate OP Bills MISC.
15032 OP Folders -Neurology MISC.
15033 Alcohol Certificate MISC.
15034 Copies of Case Sheet Per Record - Service Charges MISC.
15035 Copies of MLC Extract MISC.
15036 Disability Certificate MISC.
15037 Duplicate Birth Certificate MISC.
15038 LIC and Other Certificates per form MISC.
15039 OP Treatment Certificate MISC.
MSW councelling
Printed in SOC's
21.4 PMR - Community Rehabilitation work
60 Community Rehabilitation work
3225 3Health education MISC.
3226 Pre-vocational Assessment MISC.
3227 Home evaluation MISC.
3228 3Work environment evaluation MISC.
3229 Assessment MISC.
3230 Referral letter MISC.
21.5 PMR - Medico Social work
21 Medico Social Work
3250 Correspondence MISC.
3251 Guidance and Counselling MISC.
3252 Vocational Counselling MISC.
3253 Health Education MISC.
2. COMMUNITY HEALTH SERVICES
30 Community Health
4100 SCHS-HOME MISC.
4101 Rural Geriatic MISC.
4102 Mugalur - MCH MISC.
4103 Service Charge (Community Health) MISC.
5. MEDICO SOCIAL WORK
21 Medico Social Work
15040 Grief Counselling PROCEDURE
15041 Cadaver Counselling PROCEDURE
15042 Transplant Counselling PROCEDURE
15043 Transplant Work (Full Package) PROCEDURE
15044 Adoption Counselling PROCEDURE
15045 Infertility Counselling PROCEDURE
15046 Marital Counselling PROCEDURE
15047 Family Therapy PROCEDURE
15048 Socio Demographic Economic Assesment PROCEDURE
15049 Psycho Social Intervation- PROCEDURE
15050 Crisis Intervention PROCEDURE
15051 Letter of Recommendation/Correspondence to N PROCEDURE
15052 Fund raising Letter PROCEDURE
15053 Vocational Counselling / Job Placement PROCEDURE
15054 Complete Rehabilitation & Placement Service PROCEDURE
15055 Support Group monthly ( PMR, Nephro, Burns, Pa PROCEDURE
15056 Visits (collateral contact) PROCEDURE
15057 Counselling on effective Parenting PROCEDURE
15058 Teen Counselling PROCEDURE
15060 Counselling (per session general) PROCEDURE
15061 Legal Certificate PROCEDURE
15062 Rehabilltation PROCEDURE
15063 Rheumatology Counseling MISC.
15064 ID Clinic MISC.
s praposal for 2018-19
ServCat ward Remarks
null 250 136

null 180 107
null 100 0
null 160 103
null 70 0
null 250 2
null 200 335
null 250 0
null 140 11
null 50 0
null 50 0
null 50 0
null 400 0
null 260 128
null 100 0
null 80 0
null 320 0
null 50 0
null 195 0
null 250 0
null 240 0
null 240 0
null 180 0
null 240 0
null 250 0
null 200 0
null 150 0
null 230 0
null 70 3
null 180 0
null 300 0
null 150 0
null 200 0
null 90 0
null 100 0
null 200 0
null 310 0
null 310 0
null 400 0
null 110 0
null 230 0
null 200 0
null 400 0
null 230 0
null 145 0
null 200 0
null 70 0
null 120 0
null 120 0
null 180 0
null 300 0
null 200 0
null 400 0
null 190 0
null 200 0
null 100 0
null 35 0
null 165 0
null 140 0
null 380 0
null 60 0
null 250 0
null 202 0
null 50 0
null 25 0
null 50 12694
null 100 1891

null 100 41
null 50 0
null 225 0
null 125 0
null 75 45
null 2,700 748
null 400 41
null 700 461
null 100 1
null 50 0
null 50 66
null 30 400
null 10 1415
null 100 267
null 100 0
null 100 0
null 100 0
null 200 3
null 200 24
null 100 120
null 50 0
null 50 2
null 50 0
null 90 0
null 65 0
null 55 120
null 50 0
null 50 25
null 50 59
null 50 1
null 50 16
null 560 0
null 130 0
null 120 0
null 90 0
null 300 0
null 300 10
null 300 4
null 1,000 4
null 500 0
null 500 0
null 500 1
null 500 0
null 100 112
null 200 37
null 300 0
null 100 6
null 200 12
null 200 1
null 600 0
null 500 0
null 200 0
null 500 0
null 300 0
null 300 1
null 300 0
null 1,000 0
null 500 0
null 200 0
Schedule of Charges praposal for
Admin
Ch Code ChargeDesc ServiceDesc Service Catagory
Bio-Chemistry
Printed in SOC's
F. CYTOGENETICS TESTS (COLLEGE)
F. CYTOGENETICS TESTS (COLLEGE)
39 Bio Chemistry - College
10707 Registration / Referral (Cytogenetics) MISC.
10743 Karyotyping and Genetic Counselling MISC.
10744 Genetic Counselling MISC.
10745 Millipore Water (per litre) MISC.
10758 Karyotyping * - Family Member MISC.
10759 Follow-up within a year MISC.
10773 Cancer Cytogenetics MISC.
10774 Repeat Karyotyping* - Cancer Follow-up MISC.
10781 Chromosome Breakage Studies MISC.
10782 Molecular Cytogenetics-F.I.S.H.Single Probe MISC.
10783 Molecular Cytogenetics-F.I.S.H.Double Probe MISC.
11255 Cancer Cytogenetics + FISH (Single Probe) LABORATORY
C. BIOCHEMISTRY LAB
C6. Biochemistry: Tests Done in College
77 Other Investigation - Bio Chem - College
11164 Blood Lead (Pb) level DIAGNOSTIC
39 Bio Chemistry - College
10746 Urine Sugar Chromatography LABORATORY
10761 Urine Osteomark MISC.
76 Electrophoresis of -BioChem College
10722 Electropheresis - Urine MISC.
77 Other Investigation - Bio Chem - College
10752 Blood Lead MISC.
10756 Gallstone Analysis MISC.
FORENSIC MEDICINE
Printed in SOC's
3. FORENSIC MEDICINE
136 Forensic Medicine
15012 MLC-packing MISC.
15013 Packing-MLC Unclaimed/Unknown MISC.
Mortury
Printed in SOC's
3. FORENSIC MEDICINE
137 Mortuary Charges
15000 Mortuary Charges In-Patients (Per day) MISC.
15021 Mortuary Charges for outsiders(per day) MISC.
15029 MLC brought dead by police/others (per day) MISC.
15030 Unclaimed/Unknown bodies brought by police -irres MISC.
162 Anatomy SJMC
15023 Dressing MISC.
15024 Embalming MISC.
15025 Cold Storage MISC.
Printed in SOC's
E. HISTOPATHOLOGY LAB (COLLEGE)
E. HISTOPATHOLOGY LAB (COLLEGE)
82 Histopathology Test
11005 FNAC MISC.
11008 Frozen Section including Paraffin Section MISC.
11009 Immunofluoroscence Studies Skin MISC.
11011 ANA by IF method MISC.
11013 DS - DNA by IF Method MISC.
11014 ANCA MISC.
11015 Immunoline MISC.
11016 Immunohistochemistry Panel - General MISC.
11256 Immunohistochemistry Soft Tissue MISC.
110017 Pap Smear MISC.
110018 Biopsy Parafin Method Small(<3cm.and/or1-2 bottle MISC.
110019 Biopsy Parafin Method Large(10 to 15cm.and/or 5-7b MISC.
110020 Biopsy Parafin Method ExtraLarge(>15cm/or >7 bottl MISC.
110021 Cell block and Cytology for Body fluids and for ma MISC.
110023 Liver Mosaic 2 (ANA,AMA,Anti LKM,ASMA) MISC.
110024 Biopsy Parafin Method Medium (3 - 10cm/or 3-4 bott MISC.
110025 Cell block & Cytology for body fluids & for malign MISC.
110027 FNAC - CT / MRI Guided MISC.
110028 Immunohistochemistry Breast MISC.
110029 Immunohistochemistry Lymphomas Panel MISC.
110030 Dermatology Mosaic MISC.
110031 Muscle Enzyme Histochemistry MISC.
110032 Liver Profile DIAGNOSTIC
110033 PLA 2R MISC.
110034 Immunofluoroscence Studies KIDNEY DIAGNOSTIC
84 Drug of Abuse Testing Service - Pharmacology College
10765 Marijuana (THC) Urine Test MISC.
10766 Benzodiazepine Urine Test MISC.
10767 Morphine Urine Test MISC.
10768 Phencyclidine Urine Test MISC.
10769 Methamphetamine Urine Test MISC.
10770 Cocaine Urine Test MISC.
10771 Amphetamine Urine Test MISC.
10776 Multiple Six Drug Test MISC.
s praposal for 2018-19
Common ward Sum of units from Any request for Rate Remarks
ServCat Rate Apr-17 to Nov-17 Revision
null 100 3
null 3000 4
null 550 -
null 500 -
null 1800 -
null 300 -
null 3000 -
null 1800 -
null 3000 2
null 3600 -
null 4500 -
null 5000 -
null 600 -
null 400 -
null 400 -
null 650 1
null 890 -
null 300 -
null 1000 358

null 1 25
null 1000 119
null 1200 345
null 100 274
null 1 81
null 1000 75
null 4500 58
null 1000 -
null 350 1,393

null 950 163
null 2000 383
null 500 2,738
null 700 136
null 900 358
null 1940 841
null 2700 164
null 3300 -
null 350 2,413
null 500 6,860
null 900 235
null 1100 37
null 375 504
null 1200 61
null 700 624
null 450 70
null 450 1
null 3800 56
null 4200 51
null 3000 44
null 1400 -
null 1500 13
null 3500 13
null 2000 -
null 320 134
null 320 57
null 320 83
null 320 71
null 320 73
null 320 86
null 320 82
null 1520 1
Schedule of Charges praposal
Admin
Charge
Ch Code ServiceDesc
Desc
Nutrition
Printed in SOC's
H. BONE MARROW DENSITOMETRY (BMD)
93 Bone Marrow Densitometry (BMD)
90166 BMD Single Region
90167 BMD Spine
90168 BMD Hip Joints
90169 BMD Femur
90170 BMD Forearm
90171 BMD Whole body
1. NUTRITION SERVICES
29 Nutrition
197 Nutrition Service Consult-Package (3 visits)
198 Nutrition Cross Consultation IP
4001 Bio-electrical Impedence
4002 Basel Metabolic Rate
4004 Sleep Study - Basic
4005 Sleep Study - Advanced
4006 Exercise Testing
4007 Complete Diet and Physic Activity Assessment - Spe
4022 Consultation
1.1 SPECIAL PROCEDURE DONE IN COLLEGE
29 Nutrition
4008 Risk Reduction and Weight Management Package
4009 Screening Sessions for lifestyle management progr
1.2 Life Style Management Programme
29 Nutrition
4010 Lifestyle management programme (10 sessions packag
4011 BMD Spine
4012 BMD Femur
4013 BMD Forearm
4014 Tissue quantification
4015 Fat Analysis
4016 AP Vertebral Assessments
4017 Lateral Vertebral Assessments
4018 Lateral Spine
1.3 Tests Done in Physiology SJMC
29 Nutrition
4003 Autonomic Nervous System Testing
4019 Head Up Tilt Test
4020 Muscle Function Test
4021 Passive Muscle Exercise Per day
SJRI
Printed in SOC's
178 Test Done -SJRI
11689 Next Generation Sequencing Genetic Testing
178 Test Done -SJRI
11250 CMV (Cytomegalovirus) PCR Quantitative
e of Charges praposal for 2018-19
Common Sum of units from Apr-17 Any request for Rate
Service Catagory ServCat ward Rate to Nov-17 Revision
MISC. null 1650 0

MISC. null 1750 0
MISC. null 1650 0
MISC. null 1750 0
MISC. null 1750 0
MISC. null 4200 0
CONSULTATION null 270 0



MISC. null 860 19
MISC. null 1720 0
MISC. null 1720 1
MISC. null 1500 3
MISC. null 550 0
MISC. null 1540 0
MISC. null 330 0
LABORATORY null 22000 3
LABORATORY null 8000 3

Remarks
Dept Code SJRI
Nature1 - multiple -
Dept name Status

Nutrition
Printed in SOC's
SJRI
Printed in SOC's
Total Result
SOC1 SOC2 SOC3

H. BONE MARROW DENSITOMETRY (
1. NUTRITION SERVICES
1.1 SPECIAL PROCEDURE DONE IN CO
1.2 Life Style Management Programm

1.3 Tests Done in Physiology SJMC
d in SOC's confrim to print or not

(empty)
(empty)
(empty)
chrg_Cd ChargeDesc ServiceCode ServiceDesServiceCat
OMETRY (BMD)
BONE MARROW DENSITOMETRY (BMD)
93 Bone Marrow Densitometry (BMD)
90166 BMD SingleMISC.
90167 BMD SpineMISC.
90168 BMD Hip JoMISC.
90169 BMD FemuMISC.
90170 BMD Fore MISC.
90171 BMD Whole MISC.
NUTRITION SERVICES
29 Nutrition
197 Nutrition SCONSULTA
198 Nutrition CCONSULTA
4001 Bio-electr PROCEDUR
4002 Basel MetaPROCEDUR
4004 Sleep StudyPROCEDUR
4005 Sleep StudPROCEDUR
4006 Exercise TePROCEDUR
4007 Complete DPROCEDUR
4022 Consultati CONSULTA
SPECIAL PROCEDURE DONE IN COLLEGE
29 Nutrition
4008 Risk ReducPROCEDUR
4009 Screening PROCEDUR
Life Style Management Programme
29 Nutrition
4010 Lifestyle PROCEDUR
4011 BMD SpinePROCEDUR
4012 BMD FemuPROCEDUR
4013 BMD Fore MISC.
4014 Tissue quanPROCEDUR
4015 Fat AnalysiPROCEDUR
4016 AP VertebrMISC.
4017 Lateral Ve MISC.
4018 Lateral Spi MISC.
Tests Done in Physiology SJMC
29 Nutrition
4003 AutonomicPROCEDUR
4019 Head Up TilMISC.
4020 Muscle FunMISC.
4021 Passive MuMISC.
PAEDIATRIC NEPHROLOGY
178 Test Done -SJRI
11689 Next GenerLABORATO
178 Test Done -SJRI

11250 CMV (Cytom
LABORATO
Data
ServCat Sum - Commonward Rate Sum - Apr-17 to Nov-17
null 1650 0
null 1750 0
null 1650 0
null 1750 0
null 1750 0
null 4200 0
null 270 0
null 50 1609
null 140 1
null 400 0
null 1190 0
null 3560 0
null 1190 0
null 120 0
null 200 0
null 3240 0
null 220 0
null 8640 0
null 1500 334
null 1500 165
null 860 19
null 3070 116
null 4260 2
null 1720 0
null 1720 1
null 1500 3
null 1540 7
null 550 0
null 1540 0
null 330 0
null 22000 3
null 8000 3
82060 2263

List of Services Department Wise

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D Code Dept name Hiper Link

D01 Pulmonary Medicine Pulmonary Medicine-D1'!Print_Titles

Signature of HOD Signature of CMS Signature of ADH

Common ward Sum of units from Any request for

Common ward Sum of units from Any request for

726 Paring (Small) MISC. null 200 809

Common ward Sum of units from Any request for

821 Radiofrequency Ablation -MISC. null 3000 0

Common ward Sum of units from Any request for

717 MCR Sheet (1) - 8mm LRUMISC. null 65 0

Common ward Sum of units from Any request for

870 Hair Transplantion - Base PROCEDURE null 2000 0

Common ward Sum of units from Any request for

845 Electro Cautery - DPN or TPROCEDURE null 1500 140

Common ward Sum of units from Any request for

761 Smear for Lepra bacillus( MISC. null 300 0

Common ward Sum of units from Any request for

736 Skin Biopsy (Small) -E MISC. null 180 1

Common ward Sum of units from Any request for

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Service Common ward Sum of units from Any request for

Service Common ward Sum of units from Any request for

2863 Auto HSCT Procedure * MISC. null 250,000 1

Signature of HOD Signature of CMS Signature of ADH

Common Sum of units from Any request for Rate

Common Sum of units from Any request for Rate

96 Saline Transfusion MISC. null 360 -

Common Sum of units from Any request for Rate

326 Developmental Screening MISC. null 140 -

Common Sum of units from Any request for Rate

Signature of HOD Signature of CMS Signature of ADH

1435 Lumbar Puncture MISC. null 175 -

Signature of HOD Signature of CMS Signature of ADH

Service Common Sum of units from Any request for

Service Common Sum of units from Any request for

1130 Intra - operative Nerve StimuMISC. null 1,190 -

Service Common Sum of units from Any request for

Service Common Sum of units from Any request for

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Service Common Sum of units from Any request for

Service Common Sum of units from Any request for

3035 Caudal Injections PROCEDURE null 1,800 -

Signature of HOD Signature of CMS Signature of ADH

Service Common Sum of units from Any request for

Date Date Date

Signature of HOD Signature of CMS Signature of ADH

Signature of HOD Signature of CMS Signature of ADH

Service Common Sum of units from Any request for

Service Common Sum of units from Any request for

525 Flap (per quadrant) MISC. null 2,000 3

Service Common Sum of units from Any request for

573 Obturator Definitive MISC. null 1,500 1

Service Common Sum of units from Any request for

2014 Habit Breaking AppliancePROCEDURE null 5,000 5

Service Common Sum of units from Any request for