sl.no procedure name approved rates ark code category … · 2020-04-14 · sl.no procedure name...

Sl.No PROCEDURE NAME Approved Rates ARK Code Category

1Operations for Congenital Arteriovenous

Fistula15,000 2B

2 Prophylactic Cryoretinopexy- Closed 2,500 2B.109 2B

3 Enucleation with Implant 11,000 2B.92 2B

4 Ptosis Surgery 10,000 2B.97 2B

5 IRIS Prolapse – Repair 4,000 2B.104 2B

6 Retinal Detachment Surgery 15,000 2B.66 2B

7Socket Reconstruction with amniotic

membrane8,000 2B.68 2B

8 Iridectomy – Surgical 3,000 2B.107 2B

9 Vitrectomy 7,500 2B.61 2B

10 Laser for retinopathy (per sitting) 1,500 2B.76 2B

11 Orbitotomy 10,000 2B.70 2B

12 Squint correction (per muscle) 4,000 2B.93 2B

13 PRP - Retinal Laser including 3 sittings 5,000 2B.77 2B

14 Corneal Grafting 8,500 2B.88 2B

15

Glaucoma Surgery (Trabeculectomy

only) with or without Mitomycin C,

including postoperative medications for

12 weeks (and wherever surgical or laser

procedures required for bleb

augmentation and anterior

chambermaintenance)

10,000 2B.98 2B

16Intraocular Foreign Body Removal from

Anterior Segment4,000 2B.67 2B

17 Lensectomy /pediatric lens aspiration 9,000 2B.100 2B

18 Surgical Membranectomy 8,000 2B.63 2B

19 Perforating Corneo - Scleral Injury 10,000 2B.85 2B

20Small Tumour of Lid – Excision + Lid

Reconstruction10,000 2B.96 2B

21

Cataract with foldable hydrophobic

acrylic IOL by Phaco emulsification tech

+ Glaucoma

10,500 2B

ANNEXURE 7B

GOVERNMENT ORDER NO. HFW 69 CGE 2018, dated: 15.11.2018

Package rates for Complex secondary Healthcare Treatments

CARDIO VASCULAR SURGERY

OPHTHALMOLOGY

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ANNEXURE 7B



22Cataract with non-foldable IOL using SICS

technique + Glaucoma6,500 2B

23Anterior Chamber Reconstruction

+Perforating corneo - Scleral Injury + IOL11,500 2B

24Photocoagulation for Retinopathy for 3

sittings-Complete package 2000 2B.74 2B

25 Therapeutic Penetrating Keratoplasty 3300 2B.86 2B

26 Lamellar Keratoplasty 3300 2B.87 2B

27 Scleral Patch Graft 8000 2B.89 2B

28Glaucoma Filtering Surgery For

Paediatric Glaucoma8500 2B.101 2B

29Mastoidectomy corticol modified/

radical11,500 2B.126 2B

30 Myringoplasty 7,500 2B.127 2B

31 Ossiculoplasty 9,500 2B.128 2B

32 Stapedectomy 10,000 2B.133 2B

33Ant. Ethmoidal artery ligation - open/

endoscopic11,000 2B.142 2B

34 Antrostomy – Bilateral 8,500 2B.143 2B

35 Antrostomy – Unilateral 6,000 2B.144 2B

36 Cryosurgery 3,000 2B.147 2B

37 Septoplasty + FESS 11,500 2B.148 2B

38 Ethmoidectomy – External 11,500 2B.149 2B

39 Fracture - setting maxilla 8,000 2B.150 2B

40 Endoscopic DCR 7,000 2B.99 2B

41 Septo-rhinoplasty 12,500 2B.119 2B

42 Arytenoidectomy 10,000 2B.138 2B

43 Pharyngeal diverticulum's – Excision 10,000 2B.151 2B

44 Laryngectomy with block dissection 25,000 2B.155 2B

45 Laryngofissure 5,000 2B.120 2B

46 Oro Antral fistula 7,500 2B.123 2B

47 Tonsillectomy + Styloidectomy 10,000 2B.117 2B

48 Uvulophanyngo Plasty 14,000 2B.139 2B

ENT

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ANNEXURE 7B



49 Commondo Operation (glossectomy) 17,500 2B.124 2B

50 Excision of Cystic Hygroma Minor 5,000 2B.152 2B

51 Excision of the Mandible Segmental 7,500 2B.197 2B

52 Hemi-mandibulectomy with graft 15,000 2B.196 2B

53 Labyrinthectomy 20,000 2B.137 2B

54

Excision of Pinna for Growths

(Squamous/Basal) Injuries - Total

Amputation

& Excision of External Auditory Meatus

8,000 2B.122 2B

55 Mastoidectomy with tympanoplasty 16,000 2B

56 Myringoplasty with Ossiculoplasty 13,500 2B

57Excision of Pinna for Growth

(Squamous/Basal/ Injuries) Skin Only2,500 2B

58 Tympanotomy 4,000 2B

59 Aural polypectomy +Tympanoplasty 10,000 2B

60 Nasal polypectomy – Bilateral 9,000 2B

61 Nasal polypectomy – Unilateral 6,000 2B

62 Tonsillectomy + Myrinogotomy 10,000 2B

63 Thyroglossal Fistula/ cyst – Excision 7,000 2B

64 External fixation - Pelvis 15,000 2B.46 2B

65 Limb Lengthening 25,000 2B.37 2B

66Reconstruction of ACL/PCL with implant

and brace30,000 2B.47 2B

67Open Reduction Internal Fixation (Large

Bone)20,000 2B.53 2B

68 Bimalleolar Fracture Fixation 15,000 2B

69Bone Tumour (malignant/ benign)

curettage and bone grafting20,000 2B

70Closed Interlock Nailing + Bone Grafting

– femur19,000 2B

71 Closed Interlocking Intermedullary 17,500 2B

ORTHOPAEDICS

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ANNEXURE 7B



72Closed Reduction and Internal Fixation

with K wire6,000 2B

73Closed Reduction and Percutaneous

Screw Fixation (neck femur)15,000 2B

74Closed Reduction and Percutaneous

Nailing20,000 2B

75 External fixation - Long bone 15,000 2B

76 Fixator with Joint Arthrolysis 20,000 2B

77

Fracture - Hip Internal Fixation

(Intertrochanteric Fracture with

implant) + rehabilitation

17,000 2B

78 Fracture - Humerus Internal Fixation 17,000 2B

79 Open Reduction of CDH 30,000 2B

80Open Reduction with bone grafting of

nonunion20,000 2B

81External fixation - both bones of

forearms25,000 2B

82Fracture intercondylarHumerus +

olecranon osteotomy20,000 2B

83Arthroscopic Meniscus Repair/

Meniscectomy20,000 2B

84Bipolar Hemiarthroplasty (hip &

shoulder)40,000 2B

85 Unipolar Hemiarthroplasty 30,000 2B

86 Elbow replacement 40,000 2B

87 Arthrodesis of Knee (with implant) 40,000 2B

88 Arthrodesis of Wrist (with implant) 30,000 2B

89 Arthrodesis of Ankle (with implant) 30,000 2B

90Maysers muscle pedicle graft for Non-

union fracture neck femur (orthroplasty) 20000 2B.33 2B

91 Facio-Maxillary Injury repairs & fixations 15000 2B.34 2B

92 Anterolateral Clearance For Tuberculosis 18,000 2B.43 2B

93Posterior cruciate ligament (PCL)

Reconstruction17,700 2B.48 2B

94 Blunt injury abdomen 10,000 2B.54 2B

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ANNEXURE 7B



95Internal fixation of Pelviacetabular

fracture40,000 2B.40 2B

96 Pyelolithotomy-Laparoscopic 30,000 2B.181 2B

97 Perinephric Abscess drainage (Open) 20,000 2B.191 2B

98 Urachal Cyst excision -open 15,000 2B.113 2B

99 Excision of Urethral Caruncle 6,000 2B.112 2B

100Orchiopexy-without laparoscopy,

bilateral15,000 2B

101Ilio-Inguinal lymphadenectomy-

unilateral15,000 2B

102 Ilio-Inguinal lymphadenectomy-bilateral 25,000 2B

103 Operation for Double Ureter 15,750 2B.110 2B

104 Pyelolithotomy 13,500 2B.111 2B

105

Vaginal hysterectomy with anterior and

posterior

colpoperineorrhaphy

16,000 2B.17 2B

106 Repair for rectovaginal fitulas 10,000 2B.22 2B

107 Vulvectomy simple 15,000 2b.24 2B

108 Laparoscopic hysterectomy (TLH) 20,000 2B.16 2B

109 Laparoscopic myomectomy 15,000 2B.20 2B

110 Laparoscopic adhesiolysis 6,000 2B.56 2B

111 Laparotomy for ruptured ectopic 10,000 2B.19 2B

112 Shirodkar's stitch 4,000 2B.25 2B

113 Tuboplasty 10,000 2B.23 2B

114 Surgeries for Prolapse - Sling Surgeries 16,000 2B.21 2B

115 Diagnostic laparoscopy 11,000 2B.184 2B

116 Laparoscopic cystectomy 15,000 2B.18 2B

117 McDonald's stitch 4,000 2B

118Adhenolysis + Hernia - Ventral -

Lipectomy/Incision16,000 2B

119 Adhenolysis+ Ovarian Cystectomy 10,000 2B

POLYTRAUMA

UROLOGY

OBSTETRICS & GYNAECOLOGY

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ANNEXURE 7B



120 Adhenolysis+ Salpingostomy 10,000 2B

121 Brust abdomen repair 14,000 2B

122 Cystocele - Anterior repair 12,000 2B

123Diagnostic laparoscopy & hysteroscopy

for infertility5,000 2B

124Exploration of abdominal haematoma

(after laparotomy + LSCS)14,000 2B

125 Chorionic villus sampling 5,000 2B

126 Lap. Salphingo-oophorectomy 10,000 2B.14 2B

127Lap. Assisted Vaginal Hysterectomy

(LAVH)11,500 2B.15 2B

128Arteriovenous (AV) Malformation of Soft

Tissue Tumour - Excision15,000 2B.171 2B

129 Branchial Fistula 14,000 2b.232 2B

130 Drainage of Subdiaphramatic Abscess 10,000 2B.156 2B

131 Drainage Pericardial Effusion 13,750 2B.209 2B

132 Duodenal Diverticulum 20,000 2B.210 2B

133 Duodenal Jejunostomy 20,000 2B.237 2B

134 Duplication of Intestine 18,000 2B.157 2B

135 Excision Benign Tumor -Small intestine 15,000 2B.211 2B

136 Excision Meckel's Diverticulum 15,000 2B.213 2B

137 Excision Small Intestinal Fistula 15,000 2B.214 2B

138 Excision of Growth from Tongue only 6,000 2B.238 2B

139Excision of Swelling in Right Cervical

Region5,000 2B.239 2B

140 Fibroadenoma – Bilateral 8,000 2B.194 2B

141 Gastrojejunostomy 15,000 2B.241 2B

142 Hydatid Cyst of Liver 12,500 2B.243 2B

143 IlieoSigmoidostomy 17,000 2B.217 2B

144 Intestinal Obstruction 15,000 2B.58 2B

145 Jejunostomy 10,000 2B.241 2B

146 Gastric Perforation 15,000 2B.201 2B

GENERAL SURGERY

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ANNEXURE 7B



147Intestinal Perforation (Resection

Anastomosis)20,000 2B.218 2B

148 Appendicular Perforation 15,000 2B.200 2B

149

Laryngectomy & Pharyngeal

Diverticulum

(Throat)

15,000 2B.154 2B

150 Ileostomy 10,000 2B.206 2B

151 Loop Colostomy Sigmoid 12,000 2B.207 2B

152 Mastectomy 12,000 2B.231 2B

153 Mesenteric Cyst – Excision 16,000 2B.244 2B

154 Mesenteric Caval Anastomosis 15,000 2B.158 2B

155 Microlaryngoscopic Surgery 15,000 2B.153 2B

156Oeshophagoscopy for foreign body

removal7,500 2B.245 2B

157 Pelvic Abscess - Open Drainage 10,000 2B.221 2B

158Distal Pancreatectomy with

PancreaticoJejunostomy t25,000 2B.172 2B

159 Porto Caval Anastomosis 15,000 2B.264 2B

160 Repair of Common Bile Duct 15,000 2B.222 2B

161 Sigmoid Diverticulum 15,000 2B.173 2B

162 Coloectomy – Total 20,000 2B.203 2B

163 Vasovasostomy 12,000 2B.247 2B

164 Cleft lip operation 12,000 2B.261 2B

165 Cholecystectomy & Exploration of CBD 22,000 2B.205 2B

166Split thickness skin grafts – Small (< 4%

TBSA)5,000 2B.293 2B

167Split thickness skin grafts – Large (> 8%

TBSA)15,000 2B.294 2B

168 Lap. For intestinal obstruction 15,000 2B.224 2B

169 Lap. Hepatic resection 25,000 2B.225 2B

170 Lap. Hydatid of liver surgery 20,000 2B.174 2B

171 Laparoscopic Appendicectomy 18,000 2B.176 2B

172 Laparoscopic Cholecystectomy 15,000 2B.204 2B

173 Laparoscopic cystogastrostomy 20,000 2B.178 2B

174 Laparoscopic Gastrostomy 12,000 2B.180 2B

175 Laparoscopic Hiatus Hernia Repair 22,000 2B.169 2B

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ANNEXURE 7B



176 Laparoscopic Pyloromyotomy 20,000 2B.182 2B

177 Laparoscopic Rectopexy 15,000 2B.195 2B

178 Laparoscopic Spleenectomy 16,500 2B.183 2B

179 Laparoscopic umbilical hernia repair 15,000 2B.185 2B

180 Laparoscopic ventral hernia repair 20,000 2B.198 2B

181Laparotomy-peritonitis lavage and

drainage10,000 2B.187 2B

182

Lymphatics Excision of Subcutaneous

Tissues

In Lymphoedema

10,000 2B.189 2B

183 Coccygeal Teratoma Excision 15,000 2B.190 2B

184 Drainage of perivertebral abscess 10,000 2b.226 2B

185

Removal of Foreign Body from Trachea

or

Oesophagus

5,000 2B.257 2B

186Resection Enucleation of Adenoma

(lung)10,000 2B.250 2B

187 Rib Resection & Drainage 10,000 2B.251 2B

188 Trendelenburg Operation 10,000 2B.193 2B

189 Tissue Reconstruction Flap Leprosy 25,000 2B.252 2B

190 Tendon Transfer-Leprosy 25,000 2B.253 2B

191 Bleeding Ulcer - Partial Gastrectomy 25,000 2B.208 2B

192 Block dissection Cervical Nodes 10,000 2B

193 Excision Bronchial Sinus 8,000 2B

194 Fissurectomy with Sphincterotomy 15,000 2B

195Foreign Body Removal in Deep Region

requiring GA5,000 2B

196Graham's Operation for duodenal

perforation15,000 2B

197 Hernia - Repair & release of obstruction 15,000 2B

198 Haemorroidectomy+ Fistulectomy 10,000 2B

199 Salivary Gland – Excision 10,000 2B

200 Cleft lip & palate operation15,000 (for each

stage)2B

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ANNEXURE 7B



201 Hemi thyroidectomy 10,000 2B

202 Laparoscopic Hernia Repair 18,000 2B

203 Lap. Cholecystectomy & CBD exploration 20,000 2B

204 Operation for Bleeding Peptic Ulcer 15,000 2B

205 Thymectomy 20,000 2B

206 Operation of Choledochal Cyst 15,000 2B

207 Splenectomy - For Trauma 20,000 2B

208 Thoracocentesis 1,500 2B

209

Endoscopic Retrograde Cholangio

Pancreatography (Endoscopic

Retrograde Cholangio Pancreatography

(ERCP) with Interventions

4,000 2B.60 2B

210 Laproscopic Adrenalectomy 30,000 2B.175 2B

211 Gastro jejuno Colic Fistula 12,500 2B.215 2B

212 Thymectomy 23,000 2B.249 2B

213

Endoscopic Retrograde Cholangio

Pancreatography (ERCP) (Endoscopic

Retrograde Cholangio –

Pancreatography)

2250 2B.308 2B

214Upper GI Therapeutic(including

Varicose Intervention)2,000 2B.59 2B

215 Micro discectomy – Lumbar 40,000 2B.50 2B

216 Muscle Biopsy with report 7,000 2B.297 2B

217 Laminectomy with Fusion and fixation 50,000 2B.51 2B

218Lumbar Disc including pre and post Op.

MRI30,000 2B

219Spine - Decompression & Fusion with

fixation50,000 2B

220

Post Burn Contracture surgeries for

Functional Improvement involving only

skin (Package including splints,pressure

garment and physiotherapy- Moderate

30000 2B.296 2B

Burns Management

NEUROSURGERY

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ANNEXURE 7B



221

Fixation of fracture of jaw with open

reduction (1 jaw)

and fixing of plates/ wire – under GA

12,000 2B.3 2B

222 Sequestrectomy 1,500 2B.1 2B

223

Mandible Tumour Resection and

reconstruction/Cancer

surgery

6,000 2B.5 2B

224TM joint ankylosis of both jaws - under

GA15,000 2B

225

Release of fibrous bands & grafting -in

(OSMF)

treatment under GA

3,000 2B

226 Drainage of parotid abscess 7000 2B.2 2B

227 Diabetic ketoacidosis

Rs 2,000 per day (pre-authorization

needs to be sought to continue package

beyond 5 and 10 day intervals)

Note:

If shifted to HDU/ ICU, suitable rates

would need to be applied and pre-

authorization be sought.

2B.289 2B

228 Nephrotic syndrome with peritonitis




Note:




2B.273 2B

229 Infantile cholestasis




Note:




2B.287 2B

ORAL AND MAXILLOFACIAL SURGERY

PEDIATRICS MEDICAL CARE PACKAGES

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ANNEXURE 7B



230

Intracranial ring enhancing lesion with

complication

(neurocysticercosis, tuberculoma)




Note:




2B.283 2B

231 Congestive cardiac failure

Rs 4,000 per day (advised to take pre-

authorization beyond 1 day - up to a

limit of 5 days)

Note:

If shifted to routine ward/ ICU, suitable

rates would need to be applied and pre-


Extend stay beyond 5 and 10 days as

required with pre- authorization

2B.279 2B

232 Poisonings with normal vital signs

Rs 2000 per day (up to a limit of 1 day

after which pre- authorization needs to

be sought up to a limit of 5 days)

2B

233 Empyema




Note:




2B

234

Blood and blood component transfusion

(admissionfor a diagnostic procedure

leading to treatment requiring

admission, e.g. bone marrow and bone

biopsy, endoscopy, liver biopsy,

bronchoscopy, CT/MRI under GA,

broncho-alveolar lavage, lumbar

puncture, muscle biopsy, FNAC, pleural

aspiration,

ascitic tapping, neostigmine challenge

test etc.)

Rs 1,500 per day (upto a limit of 2 days)

- needs mandatory pre-authorization2B

NEO-NATAL PACKAGES

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ANNEXURE 7B



235Advanced Surgery for Retinopathy of

Prematurity15,000 2B.73 2B

236

Basic neonatal care package (Co-

bedded with mother)

(The mother must be kept in the

hospital until the baby is discharged.

She is provided a bed and food)

Rs.500 per day (maximum Rs.1500) 2B

237

Special Neonatal Care Package

(Babies that required admission to

SNCU or NICU

Rs. 3000/day (maximum of

Rs18,000)2B

238 Intensive Neonatal Care Package

Rs. 5,000/day (Maximum of Rs.

50,000) Pre-authorization is needed

after 5 days

2B

239Gastrostomy + Esophagoscopy+

Threading20,000 2B.216 2B

240Undescended Testis - Unilateral-

Palpable15,000 3A.235 2B

241 Congestive heart failureRs 2000 per day (Admission beyond

1 day requires pre-authorization)2B.292 2B

242 Diabetic ketoacidosisRs 2000 per day (Admission beyond

1 day requires pre-authorization)2B.289 2B

243 Upper GI bleeding (endoscopic)



limit of 10 days and also beyond to

continue package)

Note:



authorization be sought

If only in general ward then Rs.2000

2B.272 2B

PEDIATRIC SURGERY

MEDICAL PACKAGES

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ANNEXURE 7B



244 Guillian Barre Syndrome




continue package)

Note:





2B.282 2B

245 Lung abscess/ EmpyemaRs 2,000 per day (pre-authorization



2B

246Acute gastroenteritis with severe

dehydration




continue package)

Note:





2B

247Total Thyroidectomy with central

compartment LN dissection20,000 2B

248F00-F09

Organic, including symptomatic,

mental disorders

Rs. 2500 per day (up to a limit of

10 days after which pre-

authorization needs to be sought

up to a limit of 10 days)

2B

249F40-F48

Neurotic, stress-related and

somatoform disorders





2B

ONCOLOGY

MENTAL DISORDERS PACKAGES

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ANNEXURE 7B



250

F50-F59

Behavioural syndromes

associated with physiological

disturbances and physical

factors





2B

251F 70 – 79

Mental Retardation





2B

252

Pre- Electro Convulsive Therapy (ECT)

and Pre- rTranscranial Magnetic

Stimulation (TMS)Package *

Rs. 10,000 /- 2B

253 Electro Convulsive Therapy (ECT) Rs. 3000/- per session 2B

254Transcranial Magnetic Stimulation

(TMS)Rs. 1000/- per session 2B

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sl.no procedure name approved rates ark code category … · 2020-04-14 · sl.no procedure name...

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