Cluster - 1 BURNS AND PLASTIC SURGERY

Pre-Operative Speciality Code

Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1 1.1 Burns 20% burns or scalds/burns over face (with or without grafting) Clinical Photograph Clinical Photograph 3 23000 S11 S1112001

2 1.2 Burns Up to 30% (with grafting) Clinical Photograph Clinical Photograph 3 34500 S11 S1112002

3 1.3 Burns upto-40% with Scalds (Conservative/ without grafting) Clinical Photograph Clinical Photograph 3 28750 S11 S1112003

4 1.4 Burns upto-40% Mixed Burns (with grafting) Clinical Photograph Clinical Photograph 3 40250 S11 S1100002

5 1.5 Burns upto-50% with Scalds (Conservative) Clinical Photograph Clinical Photograph 3 28750 S11 S1112004

6 1.6 Burns upto-50% Mixed Burns (with surgery grafting) Clinical Photograph Clinical Photograph 3 46000 S11 S1112005

7 1.7 Burns upto-60% with Scalds (Conservative) Clinical Photograph Clinical Photograph 3 46000 S11

8 1.8 Burns Up to-60% Mixed Burns (with Surgeries) Clinical Photograph Clinical Photograph 3 57500 S11 S1100003

9 1.9 Burns Above 60% Mixed Burns (with Surgeries) Clinical Photograph Clinical Photograph 3 63250 S11 S1100004

Post Burn Contracture surgeries for Functional Improvement(Package including

10 1.10 Burns Clinical Photograph Clinical Photograph 3 28175 S11 S1112006
splints, pressure garments and physiotherapy), Mild

Post Burn Contracture surgeries for Functional Improvement(Package including

11 1.11 Burns Clinical Photograph Clinical Photograph 3 34500 S11 S1112007
splints, pressure garments and physiotherapy), Moderate

Post Burn Contracture surgeries for Functional Improvement(Package including

12 1.12 Burns Clinical Photograph Clinical Photograph 3 40250 S11 S1112008
splints, pressure garments and physiotherapy), Severe

Reconstructive lower limb surgery following infection, Trauma, Tumors / Malignancy,

13 1.13 Plastic Surgery Clinical photograph Clinical photograph 4 48300 S11 S1012001
Developmental including diabetic foot – SEVERE

14 1.14 Plastic Surgery Abdominal wall reconstruction including post cancer excision. Clinical photograph Clinical photograph 4 40250 S11 S1012002

Reconstructive Micro surgery Replantation of hand, finger, thumb, arm, scalp etc
15 1.15 Plastic Surgery Clinical photograph Clinical photograph 4 57500 S11 S1012003
(Per finger 15000)
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

16 1.16 Plastic Surgery Reconstructive Micro surgery B) free tissue transfer Clinical photograph Clinical photograph 4 57500 S11 S1012004

17 1.17 Plastic Surgery Flap surgeries b) myocutaneous flap Clinical photograph Clinical photograph 4 40250 S11 S1012005

18 1.18 Plastic Surgery Flap surgeries c) osteo myocutaneous flap Clinical photograph Clinical photograph 4 40250 S11 S1012006

19 1.19 Plastic Surgery operation for vascularmalformation Clinical photograph Clinical photograph 4 34500 S11 S1012007

20 1.20 Plastic Surgery Ear Reconstruction for Microtia (stage-I) Clinical photograph Clinical photograph 4 28750 S11 S1012008

21 1.21 Plastic Surgery Ear Reconstruction for Microtia (stage-II) Clinical photograph Clinical photograph 4 34500 S11 S1012009

22 1.22 Plastic Surgery Ear Reconstruction for Microtia (stage-III) Clinical photograph Clinical photograph 4 40250 S11 S1012010

23 1.23 PLASTIC REPAIR Corrective Surgery for Congenital deformity of Upper Limb (Per Procedure) Clinical photograph Clinical photograph 4 20000 S11 S1012011

24 1.24 PLASTIC REPAIR Corrective Surgery for Craniosynostosis Clinical photograph Clinical photograph 4 50000 S11 S1012012

Clinical photograph and

Burns/Plastic % Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns) - any % (not diagram with Rule of 9/ L
25 1.25 Clinical photograph 7,000 S11 S1100001
Surgery requiring admission). Needs at least 5-6 dressing & B Chart for extent of
burns

% Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): Upto 40 %; Clinical photograph and
Burns/Plastic Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed diagram with Rule of 9/ L
26 1.26 Clinical photograph 40,250 S11 S1100002
Surgery necessary; Surgical procedures are required for deep burns that are not amenable to & B Chart for extent of
heal with dressings alone. burns

% Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): 40 % - 60 %; Clinical photograph and
Burns/Plastic Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed diagram with Rule of 9/ L
27 1.27 Clinical photograph 57,500 S11 S1100003
Surgery necessary; Surgical procedures are required for deep burns that are not amenable to & B Chart for extent of
heal with dressings alone. burns
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

% Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): > 60 %; Clinical photograph and
Burns/Plastic Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed diagram with Rule of 9/ L
28 1.28 Clinical photograph 63,250 S11 S1100004
Surgery necessary; Surgical procedures are required for deep burns that are not amenable to & B Chart for extent of
heal with dressings alone. burns

Electrical contact burns: Low voltage- without part of limb/limb loss; Includes % TBSA Clinical photograph and
Burns/Plastic skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical diagram with Rule of 9/ L
29 1.29 Clinical photograph 30,000 S11 S1100005
Surgery procedures are required for deep burns that are not amenable to heal with dressings & B Chart for extent of
alone. burns

Electrical contact burns: Low voltage- with part of limb/limb loss; Includes % TBSA Clinical photograph and
Burns/Plastic skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical diagram with Rule of 9/ L
30 1.30 Clinical photograph 40,000 S11 S1100007
Surgery procedures are required for deep burns that are not amenable to heal with dressings & B Chart for extent of
alone. burns

Electrical contact burns: High voltage- without part of limb/limb loss; Includes % TBSA Clinical photograph and
Burns/Plastic skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical diagram with Rule of 9/ L
31 1.31 Clinical photograph 50,000 S11 S1100007
Surgery procedures are required for deep burns that are not amenable to heal with dressings & B Chart for extent of
alone. burns

Electrical contact burns: High voltage- with part of limb/limb loss; Includes % TBSA Clinical photograph and
Burns/Plastic skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical diagram with Rule of 9/ L
32 1.32 Clinical photograph 60,000 S11 S1100008
Surgery procedures are required for deep burns that are not amenable to heal with dressings & B Chart for extent of
alone. burns

Chemical burns: Without significant facial scarring and/or loss of function; Includes % Clinical photograph and
Burns/Plastic TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical diagram with Rule of 9/ L
33 1.33 Clinical photograph 40,000 S11 S1100009
Surgery procedures are required for deep burns that are not amenable to heal with dressings & B Chart for extent of
alone. burns

Chemical burns: With significant facial scarring and/or loss of function; Includes % Clinical photograph and
Burns/Plastic TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical diagram with Rule of 9/ L
34 1.34 Clinical photograph 60,000 S11 S1100010
Surgery procedures are required for deep burns that are not amenable to heal with dressings & B Chart for extent of
alone. burns
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

35 1.35 Plastic Surgery Hemangioma – Sclerotherapy (under GA) Doppler/ MRI Clinical Photo 35,000 S10 S1000003

36 1.36 Plastic Surgery Hemangioma – Debulking/ Excision MRI Clinical Photo 35,000 S10 S1000004

Tissue Expander for disfigurement following burns/ trauma/ congenital deformity

37 1.37 Plastic Surgery Clinical Photo Clinical Photo 50,000 S10 S1000005
(including cost of expander / implant)

38 1.38 Plastic Surgery Scalp avulsion reconstruction Clinical Photo Clinical Photo 50,000 S10 S1000006

39 1.39 Plastic Surgery NPWT (Inpatient only)(Per day Packege Amount) Clinical Photo Clinical Photo 2,000 per day S10 S1000007

40 1.40 Plastic Surgery Pressure Sore – Surgery Clinical Photo Clinical Photo 30,000 S10 S1000008

Burns/Plastic Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum for
41 1.41 Concern Investigation Concern Investigation 1,00,000 S11 U100
Surgery family,Package amount is Negotiable)

Cluster - 2 CARDIOLOGY
Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY
Intervention
42 2.1 CAG (Coronary Angiography) 2D ECHO - 0 4025 S12 S1212001
Cardiology
Intervention
43 2.2 Peripheral/ Renal Angiography 2D ECHO - 0 4025 S12 S1212002
Cardiology
Intervention
44 2.3 Coronary Ballon Angioplasty CAG - 5 24150 S12 S1212003
Cardiology
Intervention
45 2.4 Cath with Oxymetry 2D ECHO - 0 5520 S12 S1212004
Cardiology
Intervention
46 2.5 Cath without Oxymetry 2D ECHO - 0 4428 S12 S1212005
Cardiology
Intervention
47 2.6 Check Angiography 2D ECHO - 0 3335 S12 S1212006
Cardiology
Intervention
48 2.7 Coronary Angiography + Peripheral/ Renal Angiography 2D ECHO - 0 4025 S12 S1212007
Cardiology
2.10 has been
modified tthen 2.8 &
49 2.10 Cardiology Renal/ Carotid /Peripheral Ballon Plasty (Unilateral) PAG - 5 23000 S12 S1212008
2.9 can be included in
Rare case2.10
cover stent
Intervention may be permitted
50 2.11 Aortic Stenting PAG - 5 60000 S12 S1212009
Cardiology after special
permission
Intervention
51 2.12 Ballon Atrial Septectomy – BAS 2D ECHO - 0 16100 S12 S1200001
Cardiology

Intervention Different size and

52 2.13 IVC filter 0 - 0 50000 S12 S1212010
Cardiology types of filter

Intervention Bi-Ventricular Pacing - CRT Report,

53 2.14 Bi Ventricular Pacing - CRT ECG, ECHO, CAG 0 2,90,000 S12 S1212011
Cardiology ECG, ECHO, X-Ray Chest
After special
AICD- Automatic Implantable cardiac
Intervention Permission in very
54 2.15 A AICD - Automatic Implantable Cardiac Defibrillator (with device Single Chamber) ECG, ECHO, CAG Defibrillator (with device) report, ECG, 0 3,10,000 S12 S1212012
Cardiology Rare Case,as life
ECHO,X-Ray Chest
saving
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY
After special
AICD- Automatic Implantable cardiac
Intervention Permission in very
55 2.15 B AICD - Automatic Implantable Cardiac Defibrillator (with device Double Chamber) ECG, ECHO, CAG Defibrillator (with device) report, ECG, 0 4,12,000 S12 S1212013
Cardiology Rare Case,as life
ECHO, X-Ray Chest
saving

After
Combo: AICD+Bi ventricular pacemaker
Intervention specialPermission in
56 2.16 Combo: AICD+Bi ventricular pacemaker (with device) ECG, ECHO (with device) report, ECG, ECHO, X-Ray 0 5,97,000 S12 S1212014
Cardiology very Rare Case,as life
Chest
saving

Intervention
57 2.17 PTCA - one stent (non-medicated) CAG X-Ray 5 62100 S12 S1212015
Cardiology
Intervention
58 2.18 PTCA - 2 stent (non-medicated) CAG X-Ray 5 85100 S12 S1212016
Cardiology
Intervention
59 2.19 Balloon Mitral Valvotomy – BMV 2D ECHO 2D ECHO 0 20000 S12 S1200003
Cardiology
Intervention
60 2.20 Coarctation dilatation – BDC 2D ECHO 2D ECHO, x-RAY 0 16000 S12 S1200012
Cardiology
Intervention
61 2.21 Balloon Pulmonary Valvotomy – BPV 2D ECHO 2D ECHO 0 16,100 S12 S1200004
Cardiology
Intervention
62 2.22 Balloon Aortic Valvotomy – BAV 2D ECHO 2D ECHO 0 16,100 S12 S1200002
Cardiology
Intervention
63 2.23 Peripheral Angioplasty withstent (non-medicated) 2D ECHO , ANGIOGRAM DOPPLER 5 50000 S12 S1212017
Cardiology
Intervention
64 2.24 Renal Angioplasty withstent (non-medicated) ANGIOGRAM DOPPLER , X-RAY 5 55000 S12 S1200008
Cardiology

Intervention
65 2.25 Both side renal Angioplasty withstent (non-medicated) ANGIOGRAM DOPPLER , X-RAY 5 80000 S12 S1212018
Cardiology

Intervention
66 2.26 Vertebral Angioplasty ANGIOGRAM DOPPLER 5 55000 S12 S1200005
Cardiology

Intervention
67 2.27 Temporary Pacemaker implantation CAG , ECG ECHO , X-RAY 0 4600 S12 S1200021
Cardiology

Intervention
68 2.28 Permanent pacemaker implantation (only VVI) including Pacemaker value CAG , ECG ECHO , X-RAY 0 63250 S12 S1212019
Cardiology

Intervention
69 2.29 Pericardiocentesis 2D ECHO 2D ECHO 0 3450 S12 S1200020
Cardiology
Intervention
70 2.30 PDA Device Closure 2D ECHO 2D ECHO 0 50000 S12 S1200016
Cardiology
Intervention
71 2.31 ASD Device Closure 2D ECHO 2D ECHO , X-RAY 0 92000 S12 S1200014
Cardiology
Intervention
72 2.32 VSD Device Closure 2D ECHO 2D ECHO , X-RAY 0 92000 S12 S1200015
Cardiology
Intervention
73 2.33 PDA Coil (one) insertion 2D ECHO 2D ECHO , X-RAY 0 13800 S12 S1200018
Cardiology
Intervention
74 2.34 PDA Multiple coil insertion 2D ECHO 2D ECHO , X-RAY 0 23000 S12 S1200017
Cardiology
Intervention
75 2.35 IVUS angiogram IVUS report 0 4,600 S12 S1212020
Cardiology
Intervention
76 2.36 EP study ECG, 2D Echo Clinical Photograph 0 11,308 S12 S1212021
Cardiology
Intervention
77 2.37 RF Ablation ECG, 2D Echo Clinical Photograph 0 16,100 S12 S1212022
Cardiology
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Intervention
78 2.38 3D Maping + Ablation ECG, 2D Echo Clinical Photograph 0 27313 S12 S1212023
Cardiology

2D ECHO, CPKMB, ECG,

79 2.39 Cardiology Medical treatment of Acute MI with Thrombolysis 2D ECHO, ECG, LAB INVESTIGATION 0 17250 S12 S1200013
TROPONINE-T

80 2.40 Cardiology Thrombolysis for peripheral ischemia ECG, 2D Echo 0 0 11,500 S12 S1200034
Intervention
81 2.41 Rotablation+ PTCA CAG X-Ray 5 34500 S12 S1200031
Cardiology
Intervention
82 2.42 Rotablation+ PTCA+ Stent X-Ray 5 80500 S12 S1200032
Cardiology
Intervention
83 2.43 Coiling (Coil clouser) 2D ECHO 2D ECHO,X-ray 5 20,000 S12 S1212024
Cardiology
Intervention
84 2.44 Post mi vsd closure 2D ECHO,ECG 2D ECHO,X-ray 5 92,000 S12 S1212025
Cardiology
Indication for DES
Intervention 1)Diabetes
85 2.45 PTCA - one stent (medicated) CAG X-ray 5 72,000 S12 S1200024
Cardiology 2)Lesion >18 mm in
length
Indication for DES
Intervention 1)Diabetes
86 2.46 PTCA - 2 stent (medicated) CAG X-ray 5 108,000 S12 S1200025
Cardiology 2)Lesion >18 mm in
length
Intervention
87 2.47 IABP 2D Echo 2D Echo - 15,000 S12 S1212026
Cardiology
2D ECHO,Angiogram
88 2.48 Cardiology PDA stenting 40,000 S12 S1200019
report & stills

89 2.49 Cardiology PTSMA CAG X-Ray 25,000 S12 S1200027

90 2.50 Cardiology Pulmonary artery stenting CAG X-Ray 40,000 S12 S1200028

91 2.51 Cardiology Pulmonary artery stenting (double) CAG X-Ray 65,000 S12 S1200029

92 2.52 Cardiology Right ventricular outflow tract (RVOT) stenting CAG X-Ray 40,000 S12 S1200030

Chest x-Ray/CT Chest x-Ray/CT Scan,Hb,Serum

93 2.53 Cardiology Bronchial artery Embolisation (for Haemoptysis) 25,000 S12 S1200035
Scan,Serum Creatinine,HB Creatinine

94 2.54 Cardiology Percutaneous Transluminal Tricuspid Commissurotormy (PTTC) 2D ECHO 2D ECHO 25,000 S12 S1200036

CT,Serum
CT,Serum Creatinine,PT(Prothrombin
Creatinine,PT(Prothrombi
95 2.55 Cardiology Coiling - Pseudoaneurysms of Abdomen Time),International normalized ratio 55,000 S12 S1200037
n Time),International
(INR)
normalized ratio (INR)

CT,Serum
CT,Serum Creatinine,PT(Prothrombin
Creatinine,PT(Prothrombi
96 2.56 Cardiology Embolization - Arteriovenous Malformation (AVM) in the Limbs Time),International normalized ratio 40,000 S12 S1200038
n Time),International
(INR),HB
normalized ratio (INR)
Catheter directed Thrombolysis for: Deep vein thrombosis (DVT), Mesenteric
97 2.57 Cardiology PT,S.Creatinine ,CT/MRI PT,S.Creatinine 50,000 S12 S1200039
Thrombosis & Peripheral vessels
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

98 2.58 Cardiology Concern Investigation Concern Investigation 1,00,000 S12 U100
family,Package amount is Negotiable)
Cluster - 3 CARDIO THORACIC SURGERY
Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

99 3.1 Cardiac CABG CAG Clinical Photograph 5 78200 S13 S1300001

100 3.2 Cardiac Re DO CABG CAG Clinical Photograph 5 83375 S13 S1312001

101 3.3 Cardiac CABG with IABP 2D ECHO , CAG Clinical Photograph 5 100625 S13 S1312002

102 3.4 Cardiac CABG with Aneurismal repair CAG Clinical Photograph 5 96025 S13 S1312003

103 3.5 Cardiac CABG with MV repair 2D ECHO , CAG Clinical Photograph 5 97750 S13 S1312004

104 3.6 Cardiac CABG with post MI VSD repair 2D ECHO , CAG Clinical Photograph 5 99475 S13 S1312030

105 3.7 Cardiac Open Mitral Valvotomy 2D ECHO 2D ECHO 5 78200 S13 S1300008

106 3.8 Cardiac Open Aortic Valvotomy 2D ECHO 2D ECHO , X-RAY 5 78200 S13 S1312005

107 3.9 Cardiac Open Pulmonary Valvotomy 2D ECHO 2D ECHO 5 80500 S13 S1300010

108 3.10 Cardiac Mitral Valve Repair 2D ECHO 2D ECHO , X-RAY 5 86250 S13 S1300011

109 3.11 Cardiac Tricuspid Valve Repair 2D ECHO 2D ECHO , X-RAY 5 92000 S13 S1300012

110 3.12 Cardiac Mitral Valve Repair + Tricuspid Valve Repair 2D ECHO 2D ECHO , X-RAY 5 119600 S13 S1312006

111 3.13 Cardiac Aortic Valve Repair 2D ECHO 2D ECHO , X-RAY 5 86250 S13 S1300013
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Bioprosthetic Valve in
special case like
112 3.14 Cardiac Mitral Valve Replacement 2D ECHO 2D ECHO , X-RAY 5 120750 ,during pregnency S13 S1312007
,Expecting Woman
,Old Age >70 yrs

Bioprosthetic Valve in
special case like
113 3.15 Cardiac Aortic Valve Replacement 2D ECHO 3D ECHO , X-RAY 5 128800 ,during pregnency S13 S1312008
,Expecting Woman
,Old Age >70 yrs

114 3.16 Cardiac Double Valve Replacement 2D ECHO 5D ECHO , X-RAY 5 152950 S13 S1312009

115 3.17 Cardiac Ross Procedure 2D ECHO 2D ECHO , X-RAY 5 120000 S13 S1300023

116 3.18 Cardiac ASD 2D ECHO 2D ECHO , X-RAY 5 86250 S13 S1300024

117 3.19 Cardiac VSD 2D ECHO 2D ECHO , X-RAY 5 86250 S13 S1300025

118 3.20 Cardiac AVSD/ AV Canal Defect 2D ECHO 2D ECHO , X-RAY 0 90850 S13 S1300026

119 3.21 Cardiac ICR for TOF 2D ECHO 2D ECHO , X-RAY 5 95000 S13 S1300027

120 3.22 Cardiac Pulmonary Valvotomy + RVOT Resection 2D ECHO 2D ECHO, X-RAY, clinical photograph 5 90850 S13 S1300028

121 3.23 Cardiac AP Window 2D ECHO 2D ECHO, X-RAY, clinical photograph 0 57500 S13 S1300029

122 3.24 Cardiac Surgery for HOCM 2D ECHO/TEE 2D ECHO, X-RAY, clinical photograph 0 90850 S13 S1300030

123 3.25 Cardiac Ebsteins 2D ECHO 2D ECHO, X-RAY, clinical photograph 0 90850 S13 S1300031
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

124 3.26 Cardiac Fontan 2D ECHO 2D ECHO, X-RAY, clinical photograph 0 90850 S13 S1300032

125 3.27 Cardiac TAPVC 2D ECHO 2D ECHO , clinical photograph 0 90850 S13 S1300033

126 3.28 Cardiac Pulmonary Atresia with or without VSD 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 97750 S13 S1312010

127 3.29 Cardiac TGA 2D ECHO/Angio 2D ECHO , X-RAY, clinical photograph 0 97750 S13 S1312011

128 3.30 Cardiac Arterial Switch Operation 2D ECHO/Angio 2D ECHO , X-RAY, clinical photograph 0 86250 S13 S1300035

129 3.31 Cardiac ALCAPA - - 0 86250 S13

130 3.32 Cardiac Sennings 2D ECHO/Angio 2D ECHO , X-RAY, clinical photograph 0 74750 S13 S1300037

131 3.33 Cardiac Mustards 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 86250 S13 S1300038

132 3.34 Cardiac Pulmonary Conduit 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 105000 S13 S1312013

133 3.35 Cardiac Truncus Arteriosus Surgery 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 97750 S13 S1300039

134 3.36 Cardiac Root Replacement (Aortic Aneurysm/ Aortic Dissection) / Bental Procedure 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 130000 S13 S1300040

135 3.37 Cardiac Aortic Arch Replacement 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 38065 S13 S1300041

136 3.38 Cardiac Aortic Aneurysm Repair using CPB 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 125000 S13 S1300042

137 3.39 Cardiac Aortic Aneurysm Repair without using CPB 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 65000 S13 S1300043

138 3.40 Cardiac Pulmonary Embolectomy / Endarterectomy ABG, 2D ECHO, X-Ray 2D ECHO , X-RAY, clinical photograph 0 92000 S13 S1312014

139 3.41 Cardiac Surgery for Cardiac Tumour/ LA Myxoma/ RA Myxoma 2D ECHO 2D ECHO , X-RAY, clinical photograph 0 96600 S13 S1300045

140 3.42 Cardiac Closed Mitral Valvotomy 2D ECHO 2D ECHO , X-RAY 0 23000 S13 S1300009

141 3.43 Cardiac PDA Closure 2D ECHO 2D ECHO , X-RAY 5 23000 S13 S1300046
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

142 3.44 Cardiac Coarctation Repair 2D ECHO, CAG Doppler 0 28750 S13 S1300047

143 3.45 Cardiac Coarctation Repair with graft 2D ECHO, CAG Doppler 0 36800 S13 S1300048

144 3.46 Cardiac BT Shunt (inclusives of grafts) 2D ECHO 2D ECHO, x-RAY 0 42000 S13 S1300049

145 3.47 Cardiac Glenn Shunt 2D ECHO 2D ECHO, x-RAY 0 57500 S13 S1300050

146 3.48 Cardiac Central Shunt 2D ECHO 2D ECHO, x-RAY 0 42000 S13 S1300051

147 3.49 Cardiac Aortic arch Anamolies 2D ECHO 2D ECHO, x-RAY 0 57500 S13 S1312016

148 3.50 Cardiac Pericardiectomy 2D ECHO 2D ECHO , X-RAY 0 34500 S13 S1300052

149 3.51 Cardiac Thoracoscopic surgery CT Chest X-Ray 0 40250 S13 S1312017

150 3.52 Cardiac Surgery without CPB CT Chest X-Ray 0 57500 S13 S1312018

151 3.53 Cardiac Surgery with CPB CT Chest X-Ray 0 57500 S13 S1312019

152 3.54 Thoracic Lobectomy CT-Chest , X-RAY Clinical Photograph , X-RAY 0 34500 S13 S1312020

153 3.55 Thoracic Pneumonectomy CT-Chest , X-RAY Clinical Photograph , X-RAY 0 46000 S13 S100219

154 3.56 Thoracic Pleurectomy CT-Chest , X-RAY Clinical Photograph , X-RAY 0 46000 S13 S1312022

155 3.57 Thoracic Decortication CT-Chest , X-RAY Clinical Photograph , X-RAY 0 51750 S13 S1312023

156 3.58 Thoracic Mediastinotomy CT-Chest , X-RAY Clinical Photograph , X-RAY 0 28750 S13 S1312024

157 3.59 Thoracic Pulmonary AV Fistula surgery Biopsy , CT , X-RAY Biopsy , Clinical Photograph , X-RAY 0 23000 S13 S1300053

158 3.60 Thoracic Lung Cyst CT-Chest , X-RAY Clinical Photograph , X-RAY 0 34500 S13 S1300054

159 3.61 Thoracic SOL mediastinum CT-Chest , X-RAY Clinical Photograph , X-RAY 0 51750 S13 S1300055
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

160 3.62 Thoracic Surgical Correction of Bronchopleural Fistula. Biopsy , CT , X-RAY Biopsy , Clinical Photograph , X-RAY 0 34500 S13 S1512026

161 3.63 Thoracic Diaphragmatic Eventeration Barium Study, CT SCAN USG 0 46000 S13 S1300057

BArium Study, X-RAY,

162 3.64 Thoracic Diaphragmatic Hernia BIOPSY, CLINICAL PHOTOGRAPH 0 23000 S13 S1312025
ENDOSCOPY, USG

163 3.65 Thoracic Oesophageal Diverticula /Achalasia Cardia Barium Study, CT SCAN USG 0 23000 S13 S1300058

164 3.66 Thoracic Diaphragmatic Injuries CT-Chest , X-RAY Clinical Photograph , X-RAY 0 23000 S13 S1300059

165 3.67 Thoracic Thoracotomy, Thoraco Abdominal Approach CT-Chest , X-RAY Clinical Photograph , X-RAY 0 34500 S13 S1300060

CT-Chest , post ix- endoscopy or

166 3.68 Thoracic Foreign Body Removal with scope ENDOSCOPY PICTURE 0 11500 S13 S1300061
BRONCHOSCOPY ct chest

CT-Chest , post ix- endoscopy or

167 3.69 Thoracic Bronchial Repair Surgery for Injuries due to FB ENDOSCOPY PICTURE 0 28750 S13 S1300062
BRONCHOSCOPY ct chest

Gastro StudyFollowed by Thoracotomy & Repairs for Oesophageal Injury for post ix- endoscopy or
168 3.70 Thoracic GASTROSCOPY ENDOSCOPY PICTURE 0 16100 S13 S1312026
Corrosive Injuries/FB ct thorax

ENDOSCOPY, X-RAY,
169 3.71 Thoracic Oesophageal tumour removal Biopsy , Clinical Photograph , USG 0 28750 S13 S1312027
BARIUM STUDY

Biopsy , CT , Endoscopy ,
170 3.72 Thoracic Oesophagectomy Biopsy , Clinical Photograph , USG 0 34500 S13 S100103
USG

171 3.73 Thoracic Lung Injury repair CT-Chest , X-RAY Clinical Photograph , X-RAY 0 23000 S13 S1300063

172 3.74 Thoracic Diaphragmatic injury repair CT-Chest , X-RAY Clinical Photograph , X-RAY 0 28750 S13 S1312029

173 3.75 Thoracic Thyomectomy CT-Chest , X-RAY Clinical Photograph , X-RAY 0 28750 S13 S1300064

174 3.76 Cardiac CABG with Post MI Cardiac repair CAG, 2D Echo,ECG 2D Echo, X-ray 5 100000 S13 S1312030

175 3.77 Cardiac Tricuspid valve replacement 2D Echo 2D Echo, X-ray 5 115000 S13 S1312031

176 3.78 Cardiac Root enlargement with/ without graft 2D Echo 2D Echo, X-ray,Clinical Photograph 5 90000 S13 S1312032

177 3.79 Cardiac ICR 2D Echo 2D Echo, X-ray 5 90000 S13 S1312033
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

178 3.80 Cardiac Double Switch Operation 2D ECHO 2D ECHO, X-Ray, Clinical Photograph 120,000 S13 S1300036

179 3.81 Cardiac Pulmonary Valve Replacement 2D ECHO Scar Photo,ECHO 120,000 S13 S1300065

Intercostal Drainage and Management of ICD, Intercostal Block, Antibiotics &

180 3.82 Cardiac Post Op X-ray / CT Scan Post Op X-ray / CT Scan,Scar Photo 10,000 S13 S1300066
Physiotherapy

181 3.83 Cardiac Encysted Empyema/Pleural Effusion - Tubercular Post Op X-ray / CT Scan Post Op X-ray / CT Scan,Scar Photo 10,000 S13 S1300067

First rib Excision by transaxillary approach, Excision of cervical rib / fibrous band /
182 3.84 Cardiac Post Op X-ray / CT Scan Post Op X-ray / CT Scan,Scar Photo 30,000 S13 S1300068
muscle by cervical approach

183 3.85 Cardiac Congenital Cystic Lesions Post Op X-ray / CT Scan Post Op X-ray / CT Scan,Scar Photo 30,000 S13 S1300069

184 3.86 Cardiac Pulmonary Sequestration Resection Post Op X-ray / CT Scan Post Op X-ray / CT Scan,Scar Photo 40,000 S13 S1300070

185 3.87 Cardiac Pulmonary artero venous malformation Post Op X-ray / CT Scan Post Op X-ray / CT Scan,Scar Photo 40,000 S13 S1300071

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

186 3.88 Cardiac Concern Investigation Concern Investigation 1,00,000 S13 U100
family,Package amount is Negotiable)

Cluster - 4 CARDIO VASCULAR SURGERY

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

187 4.1 Vascular Patch Graft Angioplasty Regional angiogram Angiogram report, clinical Photograph 5 18400 S13 S100217

188 4.2 Vascular Femoropopliteal by pass procedure with graft (inclu. Graft) ANGIO Doppler 5 51750 S13 S1312035

189 4.3 Vascular Thromboembolectomy ANGIO Color Doppler 5 20700 S13 S1312036

Angiogram/spiral CT
190 4.4 Vascular Surgery for Arterial Aneursysm -Distal Abdominal Aorta Color Doppler 5 65000 S13 S1312037
Angiogram

Angiogram/spiral CT
191 4.5 Vascular Surgery for Arterial Aneursysm -Upper Abdominal Aorta Color Doppler 5 57500 S13 S1312038
Angiogram

Angiogram/spiral CT
192 4.6 Vascular Surgery for Arterial Aneursysm –Vertebral Color Doppler 5 23000 S13 S1312039
Angiogram

193 4.7 Vascular Intrathoracic Aneurysm (without graft)-Aneurysm not Requiring Bypass Techniques CT-Angio , Cath DOPPLER 5 74750 S13 S1300074

194 4.8 Vascular Intrathoracic Aneurysm (with graft) -Requiring Bypass Techniques CT-Angio , Cath DOPPLER 5 86250 S13 S1300075
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

195 4.9 Vascular Dissecting Aneurysms with CPB (inclu. Graft) CT-Angio , Cath DOPPLER 5 94,300 S13 S1312040

196 4.10 Vascular Dissecting Aneurysms without CPB (incl. graft) CT-Angio , Cath DOPPLER 5 86,250 S13 S1312041

197 4.11 Vascular Vascular Procedure – Major Vessels color Doppler/Angiogram Color Doppler 5 23000 S13 S1312042

198 4.12 Vascular Vascular Procedure – Minor Vessels color Doppler/Angiogram Color Doppler 5 20000 S13 S1312043

Renal arterial
199 4.13 Vascular Surgery for Arterial Aneurysm Renal Artery Clinical Photograph 5 17250 S13 S1300076
Doppler,angiogram

200 4.14 Vascular Surgery for Arterial Aneurysm Carotid Carotid Doppler Clinical Photograph 5 17250 S13 S1312044

201 4.15 Vascular Surgery for Arterial Aneursysm Main Arteries of the Limb Peripheral Doppler Clinical Photograph 5 17250 S13 S1312045

202 4.16 Vascular Operations for Acquired Arteriovenous Fistual regional Angiogram Clinical Photograph 5 11500 S13 S1312046

203 4.17 Vascular Congenital Arterio Venous Fistula regional Angiogram Clinical Photograph 5 17250 S13 S1300077

Renal arterial
204 4.18 Vascular Operations for Stenosis of Renal Arteries Clinical Photograph 5 23000 S13 S1300078
Doppler,angiogram

Angiogram/spiral CT
205 4.19 Vascular Peripheral Embolectomy without graft Color Doppler 5 17,250 S13 S1312047
Angiogram

Angiogram/spiral CT
206 4.20 Vascular Aorto Billiac / Bifemoral bypass with Synthetic Graft Color Doppler 5 86,250 S13 S1312048
Angiogram

Angiogram/spiral CT
207 4.21 Vascular Axillo bifemoral bypass with Synthetic Graft Color Doppler 5 86,250 S13 S1312048
Angiogram

Angiogram/spiral CT
208 4.22 Vascular Femoro Distal Bypass with Vein Graft Color Doppler 5 57500 S13 S1300080
Angiogram

Angiogram/spiral CT
209 4.23 Vascular Femoro Distal Bypass with Synthetic Graft Color Doppler 5 70000 S13 S1300081
Angiogram

Angiogram/spiral CT
210 4.24 Vascular Axillo Brachial Bypass using with Synthetic Graft Color Doppler 5 69000 S13 S1300082
Angiogram

Angiogram/spiral CT
211 4.25 Vascular Brachio - Radial Bypass with Synthetic Graft Color Doppler 5 57500 S13 S1300083
Angiogram

Angiogram/spiral CT
212 4.26 Vascular Excision of Carotid body Tumor with vascular repair Color Doppler 5 34500 S13 S1300084
Angiogram
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Angiogram/spiral CT
213 4.27 Vascular Carotid artery bypass with Synthetic Graft Color Doppler 5 69000 S13 S1300085
Angiogram

Spiral CT Angiogram /MRI

214 4.28 Vascular Excision of Arterio Venous malformation – Large Color Doppler 5 57500 S13 S1300086
Angiogram

Spiral CT Angiogram /MRI

215 4.29 Vascular Excision of Arterio Venous malformation – Small Color Doppler 5 30000 S13 S1300087
Angiogram

216 4.30 Vascular Arterial Embolectomy Angiogram/colour Doppler Color Doppler/SBP/PVR 5 17,250 S13 S100150

217 4.31 Vascular D V T - IVC Filter color Doppler Plain X-ray abdomen 5 28750 S13 S1300088

Angiogram/Spiral CT
218 4.32 Vascular Vascular Tumors Color Doppler 5 46000 S13 S1312050
Angiogram

Angiogram/Spiral CT
219 4.33 Vascular Small Arterial Aneurysms – Repair Color Doppler 5 11500 S13 S1312051
Angiogram

Angiogram/Spiral CT
220 4.34 Vascular Medium size arterial aneurysms – Repair Color Doppler 5 17250 S13 S1312052
Angiogram

Angiogram/Spiral CT
221 4.35 Vascular Medium size arterial aneurysms with synthetic graft Color Doppler 5 34500 S13 S1312053
Angiogram

222 4.36 Vascular Carotid endarterectomy ANGIOGRAM X-RAY/DOPPLER 5 28750 S13 S1300089

223 4.37 Vascular Intrathoracic Aneurysm-Aneurysm not Requiring Bypass Techniques CT Angio, CATH Doppler 44,750 S13 S1300074

224 4.38 Vascular Intrathoracic Aneurysm-Requiring Bypass Techniques CT Angio, CATH Doppler 86,250 S13 S1300075

Angioplasty stills showing Balloon &

225 4.39 Vascular Aortic Angioplasty with two stents / Iliac angioplasty with stent Bilateral PAG 90,000 S13 S1300090
post flow,Scar Photo

Duplex
226 4.40 Vascular Bilateral thrombo embolectomy ultrasound/Angiogram - Scar Photo 30,000 S13 S1300091
pre or intra operative

Angiogram/ Computed
Tomography Angiography
227 4.41 Vascular Aorto-uni-iliac/uni-femoral bypass with synthetic graft Duplex ultrasound,Scar Photo 70,000 S13 S1300092
(3D-CTA)/Magnetic
Resonance Angiography
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

228 4.42 Vascular Concern Investigation Concern Investigation 1,00,000 S13 U100
family,Package amount is Negotiable)
Cluster - 5 GENITO URINARY SURGERY (RENAL)
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical Photograph , USG , X-RAY, urine

229 5.1 Urology Open Pyelolithotomy IVP , KUB , USG 2 15000 S7 S700028
analysis

Clinical Photograph , USG , X-RAY, urine

230 5.2 Urology Open Nephrolithotomy IVP , KUB , USG 2 15000 S7 S700030
analysis

231 5.3 Urology Open Cystolithotomy IVP , KUB , USG Clinical Photograph , USG , X-RAY 2 10000 S7 S700060

Clinical Photograph , USG , voiding

232 5.4 Urology VVF Repair IVP , KUB , USG 3 23000 S7 S712001
cystogram

Clinical Photograph , IVP/DTPA renal

233 5.5 Urology Pyeloplasty IVP , KUB , USG 3 23000 S7 S700016
scan

234 5.6 Urology Cystolithotripsy IVP , KUB , USG Clinical Photograph , X-RAY 2 9775 S7 S700095

IVP , KUB , USG, Spiral CT Clinical Photograph , X-RAY KUB, USG

235 5.7 Urology PCNL (Percutaneous Nephro Lithotomy) 2 23000 S7 S700025
KUB KUB

236 5.8 Urology ESWL (Extra carporial shock-wave lithotripsy) IVP , KUB , USG X-RAY and USG KUB 2 8625 S7 S700026

IVP , KUB , USG, Spiral CT

237 5.9 Urology URSL X-RAY KUB 2 10000 S7 S712002
KUB

238 5.10 Urology Nephrostomy (PCN) IVP , USG Clinical Photograph 0 5750 S7 S712003

239 5.11 Urology DJ stent (One side) IVP , USG X-RAY KUB 0 5750 S7 S712004

RGU & MCU, Uroflometry, Clinical

240 5.12 Urology Urethroplasty for Stricture Diseases-single stage RGU & MCU, Uroflometry 0 25000 S7 S712005
Photograph

RGU & MCU, Uroflometry, Clinical

241 5.13 Urology Urethroplasty for Stricture Diseases-First Stage RGU & MCU, Uroflometry 2 18000 S7 S712005
Photograph
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

RGU & MCU, Uroflometry, Clinical

242 5.14 Urology Urethroplasty for Stricture Diseases-Second Stage RGU & MCU, Uroflometry 3 18000 S7 S712006
Photograph

243 5.15 Urology Hypospadiasis(Adult) USG,Clinical Photograph Clinical Photograph, Uroflowmetry 3 20700 S7 S712007

244 5.16 Urology TURBT Biopsy , CT , USG, ECHO Biopsy , USG KUB 3 28750 S7 S700062

245 5.17 Urology TURP USG, Uroflometry, ECHO Biopsy , USG bladder and prostate 3 24150 S7 S700093

Biopsy , CT KUB , USG,

246 5.18 Urology Simple Nephrectomy Biopsy , Clinical Photograph , USG 3 20700 S7 S700006
Renal Scan

USG, CT, ECHO, Renal

247 5.19 Urology Lap. Nephrectomy Simple Biopsy , Clinical Photograph , USG 3 20700 S7 S700007
Scan

248 5.20 Urology Lap. Nephrectomy Radical CT, KUB , USG, Renal Scan Biopsy , Clinical Photograph , USG 6 25300 S7 S700009

249 5.21 Urology Lap. Partial Nephrectomy CT, USG Biopsy , Clinical Photograph , USG 6 18527 S7 S700011

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S,
250 5.22 RETROGRADE INTRARENAL SURGERY WITH LASER LITHOTRIPSY X RAY KUB, USG KUB 5 30000 S7 S712008
Nephrology PT/ APTT, X RAY KUB, IVP,
USG KUB

CBC, S. CREATININE,
URINE R/M, URINE C/S, X
Urology/
251 5.24 HOLMIUM ENUCLEATION OF PROSTATE RAY KUB, USG KUB, S. USG KUB, UROFLOWMETRY 5 30000 S7 S700094
Nephrology
PSA, UROFLOWMETRY, S.
ELECTROLYTES

CBC, S. CREATININE,
Urology/
252 5.30 CHECK CYSTOSCOPY URINE R/M, USG KUB, - 5 5750 S7 S700067
Nephrology
URINE CYTOLOGY

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S,
253 5.31 CYSTOSCOPY + URINE SAMPLING + B/L RGP - 5 9200 S7 S700057
Nephrology PT/ APTT, X RAY KUB, USG
KUB

CBC, S. CREATININE,
Urology/
254 5.41 COLOSTOMY & SUPRAPUBIC URINARY DIVERSION FOR PELVIC FRACTURE INJURY URINE R/M, USG KUB, - 5 23000 S7 S712009
Nephrology
RGU + MCU
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S,
255 5.45 SURGERY FOR URETHRORECTAL FISTULA MCU 5 28750 S7 S712010
Nephrology USG KUB, RGU + MCU, CT
ABDOMEN

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S,
256 5.46 OPEN SURGERY FOR COLOVESICAL FISTULA MCU 5 34500 S7 S712011
Nephrology USG KUB, RGU + MCU, CT
ABDOMEN

CBC, S. CREATININE,
URINE C/S, X RAY KUB,
Urology/ S. CREATININE, USG KUB, CHEST X RAY,
257 5.54 OPEN NEPHROURETERECTOMY WITH BLADDER CUFF EXCISION USG KUB, CECT 5 34500 S7 S700014
Nephrology CT ABDOMEN
ABDOMEN, LFT, CHEST X
RAY, URINE CYTOLOTY

CBC, S. CREATININE,
URINE C/S, X RAY KUB,
Urology/ S. CREATININE, USG KUB, CHEST X RAY,
258 5.55 LAPAROSCOPIC NEPHROURETERECTOMY WITH BLADDER CUFF EXCISION USG KUB, CECT 5 51750 S7 S700015
Nephrology CT ABDOMEN
ABDOMEN, LFT, CHEST X
RAY, URINE CYTOLOTY

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S, X
259 5.57 OPEN URETEROCALICOSTOMY USG KUB, DIURETIC RENAL SCAN 5 34500 S7 S700020
Nephrology RAY KUB, IVP, USG KUB,
DIURETIC RENAL SCAN

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S, X
260 5.58 LAPAROSCOPIC URETEROCALICOSTOMY USG KUB, DIURETIC RENAL SCAN 5 40250 S7 S700021
Nephrology RAY KUB, IVP, USG KUB,
DIURETIC RENAL SCAN

CBC, S. CREATININE,
URINE R/M, URINE C/S, X
Urology/
261 5.59 OPEN HEMINEPHRECTOMY FOR FUSION ANOMALY RAY KUB, CT IVU, USG USG KUB 5 34500 S7 S712012
Nephrology
KUB, DIURETIC RENAL
SCAN
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

CBC, S. CREATININE,
URINE R/M, URINE C/S, X
Urology/
262 5.60 LAPROSCOPIC HEMINEPHRECTOMY FOR FUSION ANOMALY RAY KUB, CT IVU, USG USG KUB 5 40250 S7 S712013
Nephrology
KUB, DIURETIC RENAL
SCAN

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S, X
263 5.61 OPEN ANATROPHIC NEPHROLITHOTOMY ( For Staghorn Stone) USG KUB, X RAY KUB, S. CREATININE 5 34500 S7 S712014
Nephrology RAY KUB, CT IVU, USG
KUB

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S,
264 5.66 OPEN URETERAL REIMPLANTATION FOR URETEROVAGINAL FISTULA USG KUB, DIURETIC IVP, MCU 5 34500 S7 S700044
Nephrology PT/ APTT, X RAY KUB, IVP,
USG KUB, MCU

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S,
265 5.67 LAPAROSCOPIC URETERAL REIMPLANTATION FOR URETEROVAGINAL FISTULA USG KUB, DIURETIC IVP, MCU 5 46000 S7 S700046
Nephrology PT/ APTT, X RAY KUB, IVP,
USG KUB, MCU

CBC, S. CREATININE,
Urology/
266 5.68 LAPAROSCOPIC VVF REPAIR URINE R/M, URINE C/S, MCU 5 43700 S7 S700085
Nephrology
IVP, USG KUB, MCU

CBC, S. CREATININE,
Urology/
267 5.71 URETEROLYSIS FOR RETROPERITONEAL FIBROSIS URINE R/M, URINE C/S, CT DIURETIC IVP 5 34500 S7 S712015
Nephrology
IVU, USG KUB

CBC, S. CREATININE,
Urology/ URINE CYTOLOGY, URINE
268 5.78 OPEN RADICAL CYSTECTOMY WITH NEOBLADDER USG KUB, CT IVU, POUCHOGRAM 5 80500 S7 S700075
Nephrology C/S,CT ABDOMEN, USG
KUB, CHEST X RAY

CBC, S. CREATININE,
URINE CYTOLOGY, URINE
Urology/ CBC, S. CREATININE, ABG, USG
269 5.80 OPEN RADICAL CYSTECTOMY WITH MAINZ 2 POUCH C/S,CT ABDOMEN, USG 5 57500 S7 S712016
Nephrology ABDOMEN, CT IVU, COLONOSCOPY
KUB, CHEST X RAY,
COLONOSCOPY

CBC, S. CREATININE, MCU,

Urology/ URINE C/S,CT ABDOMEN,
270 5.82 OPEN AUGMENTATION CYSTOPLASTY MCU 5 57500 S7 S700089
Nephrology USG KUB, CHEST X RAY,
URINE AFB, IVP
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

CBC, S. CREATININE,
Urology/ URINE R/M, URINE C/S,
271 5.84 OPEN BLADDER DIVERTICULECTOMY WITH URETERIC REIMPLANTATION MCU, DMSA RENAL SCAN 5 34500 S7 S700091
Nephrology USG KUB, MCU, DMSA
SCAN

USG SCROTUM, DOPPLER

Urology/
272 5.91 OPEN ORCHIECTOMY (SIMPLE / RADICAL) SCROTUM / AFP, LDH, B AFP, LDH, B HCG, CT ABDOMEN 5 17250 S7 S712017
Nephrology
HCG, CT ABDOMEN

Urology/ CT IVU, MCU, URINE FOR

273 5.108 OPEN ILEAL REPLACEMENT FOR URETERIC STRICTURE DIURETIC IVP 5 57500 S7 S712018
Nephrology AFB, USG ABDOMEN

Urology/ CT IVU, MCU, USG

274 5.111 OPEN BOARI FLAP MCU 5 28750 S7 S700052
Nephrology ABDOMEN

CBC, S. CREATININE,
Urology/
275 5.124 OPEN URETEROLYSIS URINE R/M, URINE C/S, CT DIURETIC IVP 5 34500 S7 S712019
Nephrology
IVU, USG KUB

Urology/ CT ABDOMEN,
276 5.126 OPEN COLOVAGINAL FISTULA REPAIR BARIUM ENEMA 5 34500 S7 S712020
Nephrology COLONOSCOPY

CBC, S. CREATININE,
Urology/
277 5.127 URETHROVAGINAL FISTULA REPAIR URINE R/M, URINE C/S, MCU 5 34500 S7 S700087
Nephrology
IVP, USG KUB, MCU

Urology/
278 5.135 RADIOCEPHALIC AV FISTULA FOR HEMODIALYSIS DOPPLER UPPER LIMB DOPPLER UPPER LIMB 5 6440 S7 S712022
Nephrology

Urology/
279 5.136 BRACHIOCEPHALIC AV FISTULA FOR HEMODIALYSIS DOPPLER UPPER LIMB DOPPLER UPPER LIMB 5 8280 S7 S712023
Nephrology

CBC, S.CRETAIN, BL UREA,

Urology/ MAINTENANCE HEMODIALYSIS (MHD) (WITH INJ. ERYTHROPOETINE WITH INJ. IRON) S. Na+ /S.K+, HIV(ELLISA),
280 5.142 - 0 2300 S7 S712024
Nephrology –PER DIALYSIS. HCV (ELLISA), HBS Ag
(ELLISA)

Interventional Permanent tunnelled catheter placement as substitute for AV fistula in long term Colour Doppler/
281 5.143 Clinical Photograph 0 30,000 S7 S712025
Radiology dialysis Peripheral Angiogram
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Interventional Colour Doppler/

282 5.144 Endovascular intervention for salvaging hemodialysis AV fistula Clinical Photograph 0 40,000 S7 S712026
Radiology Peripheral Angiogram

Interventional Colour Doppler/

283 5.145 SPC for atony bladder Clinical Photograph 3 20,000 S7 S712027
Radiology Peripheral Angiogram

284 5.146 Urology Adrenalectomy-unilateral, open clinical notes,CT/MRI/USG Clinical photograph,USG 25,000 S7 S700001

285 5.147 Urology Adrenalectomy-unilateral, Laparoscopic clinical notes,CT/MRI/USG Clinical photograph,USG 30,000 S7 S700002

286 5.148 Urology Adrenalectomy-bilateral, open clinical notes,CT/MRI/USG Clinical photograph,USG 32,000 S7 S700003

287 5.149 Urology Adrenalectomy-biilateral, Laparoscopic clinical notes,CT/MRI/USG Clinical photograph,USG 40,000 S7 S700004

288 5.150 Urology Paraganglioma excision with liver mobilization clinical notes,CT/MRI/USG Clinical photograph,USG 50,000 S7 S700005

289 5.151 Urology Nephrectomy-Radical (Renal tumor) Open USG ,CT / MRI HPEE 25,000 S7 S700008

290 5.152 Urology Nephrectomy-Partial or Hemi, Open USG ,CT / MRI HPEE 30,000 S7 S700010

291 5.153 Urology Nephrectomy-Partial or Hemi, Laparoscopic USG ,CT / MRI HPEE 35,000 S7 S700011

292 5.154 Urology Nephro ureterectomy (Benign) Open Renal Scan(DTPA) HPEE 25,000 S7 S700012

293 5.155 Urology Nephro ureterectomy (Benign) Laparoscopic Renal Scan(DTPA) HPEE 30,000 S7 S700013

294 5.156 Urology Endopyelotomy (retrograde with laser/bugbee) USG,X Ray,IVP/CT USG 25,000 S7 S700018

295 5.157 Urology Endopyelotomy (antegrade with laser/bugbee) USG,X Ray,IVP/CT USG 28,000 S7 S700019

296 5.158 Urology Uretero-ureterostomy Open USG,X Ray,IVP/CT USG 25,000 S7 S700022
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

297 5.159 Urology Uretero-ureterostomy Laparoscopic USG,X Ray,IVP/CT USG 35,000 S7 S700023

298 5.160 Urology Pyelolithotomy-Laparoscopic USG,X Ray,IVP/CT USG 30,000 S7 S700029

299 5.161 Urology Perinephric Abscess drainage (percutaneous) USG/CT USG 10,000 S7 S700032

300 5.162 Urology Perinephric Abscess drainage (Open) USG/CT USG 20,000 S7 S700033

301 5.163 Urology Renal Cyst deroofing or marsupialization-Open USG/CT USG 20,000 S7 S700034

302 5.164 Urology Renal Cyst deroofing or marsupialization-Laparoscopic USG/CT USG 30,000 S7 S700035

303 5.165 Urology Ureterolithotomy-Open USG,X Ray,IVP/CT Clinical photograph,USG 20,000 S7 S700037

304 5.166 Urology Ureterolithotomy-Laparoscopic USG,X Ray,IVP/CT Clinical photograph,USG 30,000 S7 S700038

305 5.167 Urology Ureterotomy (Cutaneous) USG,X Ray,IVP/CT Clinical photograph,USG 20,000 S7 S700042

306 5.168 Urology Endoureterotomy (laser/bugbee) USG,X Ray,IVP/CT Clinical photograph,USG 20,000 S7 S700043

USG KUB,CT Urography/

307 5.169 Urology Uretero-vaginal/uterine fistula repair open USG 27,000 S7 S700048
MRI Urography

USG KUB,CT Urography/

308 5.170 Urology Uretero-vaginal/uterine fistula repair Laparoscopic USG 37,000 S7 S700049
MRI Urography

309 5.171 Urology Boari flap for ureteric stricture, Laparoscopic USG,IVP/CT USG 40,000 S7 S700053

Ureterocele incision including cystoscopy, ureteric catheterization, retrograde

310 5.172 Urology USG,IVP/CT USG 15,000 S7 S700058
pyelogram

311 5.173 Urology Urachal Cyst excision -open USG,IVP/CT USG 15,000 S7 S700059

312 5.174 Urology Cystolithotomy-open, including cystoscopy USG,IVP/CT USG 15,000 S7 S700060

313 5.175 Urology Cystolithotripsy/Urethral Stone endoscopic, including cystoscopy USG,IVP/CT USG 15,000 S7 S700061
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

314 5.176 Urology TUR-fulgration (Transurethral fulgration of the Bladder Tumor) USG/CT USG/HPEE 18,000 S7 S700063

CBC, S. Cretanine, Urine-

315 5.177 Urology Bladder Neck incision-endoscopic R/M, USG KUB, Urine CLINICAL NOTES 15,000 S7 S700068
Cytology

Extrophy Bladder repair including osteotomy if needed + epispadias repair + ureteric

316 5.178 Urology Clinical Photo Clinical Photo 50,000 S7 S700069
reimplant

317 5.179 Urology Bladder injury repair (as an independent procedure with or without urethral injury) Clinical Photo Clinical Photo 20,000 S7 S700070

Bladder injury repair with colostomy (as an independent procedure with or without
318 5.180 Urology USG, Clinical Notes Clinical Photo 25,000 S7 S700072
urethral injury)

clinical notes,CT
319 5.181 Urology Partial Cystectomy-open Clinical Photo, HPEE 20,000 S7 S700073
Scan/USG/MRI /MCU

clinical notes,CT
320 5.182 Urology Partial Cystectomy-Laparoscopic Clinical Photo, HPEE 30,000 S7 S700074
Scan/USG/MRI /MCU

clinical notes,CT
321 5.183 Urology Radical cystectomy with continent diversion-open Clinical Photo, HPEE 50,000 S7 S700076
Scan/USG/MRI /MCU

clinical notes,CT
322 5.184 Urology Radical Cystectomy with Ileal Conduit-open Clinical Photo, HPEE 50,000 S7 S700077
Scan/USG/MRI /MCU

clinical notes,CT
323 5.185 Urology Radical Cystectomy with ureterostomy-open Clinical Photo, HPEE 35,000 S7 S700078
Scan/USG/MRI /MCU

clinical notes,CT
324 5.186 Urology Radical Cystectomy with ureterosigmoidostomy-open Clinical Photo, HPEE 35,000 S7 S700079
Scan/USG/MRI /MCU

clinical notes,CT
325 5.187 Urology Other Cystectomies Clinical Photo, HPEE 30,000 S7 S1512008
Scan/USG/MRI /MCU

clinical notes,CT
326 5.188 Urology Suprapubic Cystostomy - Open, as an independent procedure Clinical Photo 10,000 S7 S700081
Scan/USG/MRI

clinical notes,CT
327 5.189 Urology Suprapubic Drainage - Closed/Trocar Clinical Photo 5,000 S7 S700082
Scan/USG/MRI

clinical notes,CT
328 5.190 Urology VVF/Uterovaginal Repair - Transvaginal approach Clinical Photo 25,000 S7 S700083
Scan/USG/MRI /IVP

clinical notes,CT
329 5.191 Urology VVF/Uterovaginal Repair - Abdominal,Open Clinical Photo 25,000 S7 S700084
Scan/USG/MRI /IVP

clinical notes,CT
330 5.192 Urology Hysterectomy as part of VVF/uterovaginal fistula repair (top-up) Clinical Photo 5,000 S7 S700086
Scan/USG/MRI /IVP
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,CT
331 5.193 Urology Urethrovaginal fistula repair Clinical Photo 30,000 S7 S700087
Scan/USG/MRI /IVP

clinical notes,CT
332 5.194 Urology Y V Plasty of Bladder Neck/Bladder Neck Reconstruction Clinical Photo 20,000 S7 S700088
Scan/USG/MRI

clinical notes,CT
333 5.195 Urology Augmentation cystoplasty-open Clinical Photo 30,000 S7 S700089
Scan/USG/MRI

clinical notes,CT
334 5.196 Urology Augmentation cystoplasty-Laparoscopic Clinical Photo 40,000 S7 S700090
Scan/USG/MRI

clinical notes,CT
335 5.197 Urology Open simple prostatetctomy for BPH Clinical Photo 25,000 S7 S700092
Scan/USG/MRI

336 5.198 Urology TURP-Transurethral Resection of the Prostate, BPH, Monopolar/Bipolar/Laser USG, Uroflowmetry HPEE, USG 25,000 S7 S700093

337 5.199 Urology TURP/Laser + Circumcision USG, Uroflowmetry HPEE, USG 30,000 S7 S700095

338 5.200 Urology TURP/Laser + Cystolithotripsy USG, Uroflowmetry HPEE, USG 30,000 S7 S700096

339 5.201 Urology TURP/Laser + Cystolithotomy-open USG, Uroflowmetry HPEE, USG 35,000 S7 S700097

340 5.202 Urology TURP/Laser + Orchidectomy USG, Uroflowmetry HPEE, USG 30,000 S7 S700098

341 5.203 Urology TURP/Laser + TURBT USG, Uroflowmetry HPEE, USG 30,000 S7 S700099

342 5.204 Urology TURP/Laser + URS with stone removal USG, Uroflowmetry HPEE, USG 40,000 S7 S700100

343 5.205 Urology TURP/Laser + VIU (visual internal Ureterotomy) USG, Uroflowmetry HPEE, USG 40,000 S7 S700101

344 5.206 Urology TURP/Laser + Hydrocele surgery USG, Uroflowmetry HPEE, USG 40,000 S7 S700102

345 5.207 Urology TURP/Laser + Hernioplasty USG, Uroflowmetry HPEE, USG 40,000 S7 S700103

346 5.208 Urology TURP/Laser + Urethral dilatation-non endoscopic USG, Uroflowmetry HPEE, USG 40,000 S7 S700104

347 5.209 Urology TURP/Laser + Urethral dilatation-endoscopic USG, Uroflowmetry HPEE, USG 40,000 S7 S700105

348 5.210 Urology Radical prostatectomy - laparoscopic USG HPEE, USG 70,000 S7 S700107
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

349 5.211 Urology Transrectal Ultrasound guided prostate biopsy (minimum 12 core) USG HPEE, USG 10,000 S7 S700108

350 5.212 Urology Reduction of Paraphimosis Clinical Photo Clinical Photo 2,000 S7 S700109

351 5.213 Urology Excision of Urethral Caruncle Clinical Notes Clinical Photo 6,000 S7 S700110

352 5.214 Urology Meatoplasty Clinical Photo Clinical Photo 3,500 S7 S700111

353 5.215 Urology Meatotomy Clinical Photo Clinical Photo 3,500 S7 S700112

354 5.216 Urology Post Urethral Valve fulguration USG, MCU USG 10,000 S7 S700113

clinical notes,RGU/MCU/
355 5.217 Urology Urethroplasty-End to end RGU/MCU 20,000 S7 S700114
Uroflowmetry

clinical notes,RGU/MCU/
356 5.218 Urology Urethroplasty-Transpubic RGU/MCU 30,000 S7 S700117
Uroflowmetry

357 5.219 Urology Perineal Urethrostomy without closure USG, Clinical Notes Clinical Photo 20,000 S7 S700119

358 5.220 Urology Urethrorectal fistula repair Dye Study Clinical Notes 40,000 S7 S700120

359 5.221 Urology Urethral Dilatation-non endocopic as an independent procedure Clinical Notes Clinical Notes 2,000 S7 S700121

360 5.222 Urology Urethral Dilatation-endocopic as an independent procedure Clinical Notes Clinical Notes 5,000 S7 S700122

361 5.223 Urology Internal Ureterotomy including cystoscopy as an independent procedure clinical notes,RGU/MCU Clinical Notes 10,000 S7 S700123

362 5.224 Urology Orchiopexy-without laparoscopy, unilateral USG, Clinical Notes USG 15,000 S7 S700126

363 5.225 Urology Orchiopexy-without laparoscopy, bilateral USG, Clinical Notes USG 15,000 S7 S700127

364 5.226 Urology Orchiopexy-with laparoscopy, unilateral USG, Clinical Notes USG 30,000 S7 S700128

365 5.227 Urology Orchiopexy-with laparoscopy, bilateral USG, Clinical Notes USG 30,000 S7 S700129

366 5.228 Urology Stress incontinence surgery, open Clinical Notes Uroflowmetry 20,000 S7 S700130
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

367 5.229 Urology Stress incontinence surgery, laparoscopic Clinical Notes Uroflowmetry 30,000 S7 S700131

368 5.230 Urology Stress incontinence surgery with slings Clinical Notes Uroflowmetry 35,000 S7 S700132

369 5.231 Urology Partial Penectomy Clinical Notes Clinical Notes 15,000 S7 S1512014

370 5.232 Urology Total Penectomy + Perineal Urethrostomy Clinical Notes Clinical Notes 20,000 S7 S700134

371 5.233 Urology Ilio-Inguinal lymphadenectomy-unilateral USG/FNAC HPEE 15,000 S7 S700135

372 5.234 Urology Ilio-Inguinal lymphadenectomy-bilateral USG/FNAC HPEE 25,000 S7 S700136

CT/MRI/USG pelvis,clinical
373 5.235 Urology Pelvic lymphadenectomy open, after prior cancer surgery HPEE 25,000 S7 S700137
notes

CT/MRI/USG pelvis,clinical
374 5.236 Urology Pelvic lymphadenectomy laparoscopic, after prior cancer surgery HPEE 30,000 S7 S700138
notes

375 5.237 Urology Orchiectomy-simple USG/CT Abdomen pelvis HPEE 10,000 S7 S700140

CT/MRI,USG Abdomen
376 5.238 Urology Retroperitoneal lymph node dissection-Laparoscopic HPEE 35,000 S7 S700143
pelvis,clinical notes

377 5.239 Urology Infertility-Scrotal exploration unilateral Semen Analysis Clinical Notes/HPEE 10,000 S7 S700144

378 5.240 Urology Infertility-Scrotal exploration bilateral Semen Analysis Clinical Notes/HPEE 12,000 S7 S700145

379 5.241 Urology Infertility-Vasoepididymostomy, microsurgical, unilateral USG Vasography 15,000 S7 S700146

380 5.242 Urology Infertility-Vasoepididymostomy, microsurgical, bilateral USG Vasography 20,000 S7 S700147

381 5.243 Urology Varicocele-unilateral-non microsurgical Doppler Doppler 10,000 S7 S700148

382 5.244 Urology Varicocele-unilateral-microsurgical Doppler Doppler 12,000 S7 S700149

383 5.245 Urology Varicocele-bilateral-non microsurgical Doppler Doppler 15,000 S7 S700150

384 5.246 Urology Varicocele-bilateral-microsurgical Doppler Doppler 20,000 S7 S700151

 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

385 5.247 Urology Penile prosthesis insertion, Malleable (Indian implant) Clinincal History implant sticker 30,000 S7 S700152

386 5.248 Urology Priapism-aspiration/shunt Clinical Notes Clinical Notes 15,000 S7 S700153

Neurogenic bladder-Package for evaluation/investigation (catheter + ultrasound +

Clinical assessment and
387 5.249 Urology culture + RGU/ MCU) for 1 month (medicines - antibiotics). Follow up visit once in 3 Clinical Notes 7,500 S7 S700154
investigations
months

Chronic prostatitis-Package for evaluation/investigation (ultrasound + culture + Clinical assessment and

388 5.250 Urology Clinical Notes 2,500 S7 S700155
prostate massage) for 1 month (medicines). Follow up visit once in 3 months investigations

Emergency management of Ureteric stone - Package for evaluation/investigation Clinical assessment and
389 5.251 Urology Clinical Notes 3,500 S7 S700156
(ultrasound + culture) for 3 weeks (medicines). investigations

390 5.252 Urology Emergency management of Hematuria (Package rete per day) Daily Urine- RM Clinical Notes 2,000 Package rete per day S7 S700157

391 5.253 Urology Emergency management of Acute retention of Urine (Package rete per day) Clinincal Notes/USG Clinical Notes 2,000 Package rete per day S7 S700158

Acute management of upper urinary tract trauma – conservative (Package rete per
392 5.254 Urology USG/CT, Clinical History Clinical Notes 2,000 Package rete per day S7 S700159
day)

393 5.255 Urology Urinary tract trauma – open surgery (exploratory) USG/CT, Clinical History Clinical Notes 20,000 S7 S700160

394 5.256 Urology Urinary tract trauma – Laparoscopy surgery USG/CT, Clinical History Clinical Notes 30,000 S7 S700161

395 5.257 Urology Pyeloplasty/pyeloureterostomy/pyelopyelostomy Open USG,X Ray,IVP/CT USG 25,000 S7 S700016

396 5.258 Urology Pyeloplasty/pyeloureterostomy/pyelopyelostomy Laparoscopic USG,X Ray,IVP/CT USG 30,000 S7 S700017

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

397 5.259 Urology Concern Investigation Concern Investigation 1,00,000 S7 U100
family,Package amount is Negotiable)

Cluster - 6 NEUROSURGERY/NEUROLOGY/INTERVENTIONAL NEURORADIOLOGY

Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

398 6.1 Brain Craniotomy and Evacuation of Haematoma –Subdural CT Clinical Photograph 3 57040 S8 S812001
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

399 6.2 Brain Craniotomy and Evacuation of Haematoma – Extradural CT Clinical Photograph 3 51520 S8 S812002

400 6.3 Brain Excision of Brain Tumor Supratentorial- Parasagital CT Clinical Photograph 3 51750 S8 S812003

401 6.4 Brain Excision of Brain Tumor Supratentorial-Basal CT Clinical Photograph 3 51750 S8 S812004

402 6.5 Brain Excision of Brain Tumor - Brainstem CT Clinical Photograph 3 70000 S8 S812005

403 6.6 Brain Excision of Brain Tumor - C P Angle CT Clinical Photograph 3 50000 S8 S812006

404 6.7 Brain Excision of Brain Tumor Supratentorial & others CT Clinical Photograph 3 34500 S8 S800056

405 6.8 Brain Excision of Brain Tumors – Infratentorial MRI Clinical Photograph 3 110000 S8 S812007

Brain / Spinal
406 6.9 Intervention with coiling / embolisation procedures DSA DSA 3 85000 S8 S812008
(Endovascular)

407 6.10 Brain Ventriculoatrial /Ventriculoperitoneal/ Ventriculo-other Shunt CT Clinical Photograph 3 40000 S8 S812009

408 6.11 Brain Twist Drill Craniostomy CT Clinical Photograph 3 18630 S8 S800051

409 6.12 Brain Subdural Tapping CT Clinical Photograph 3 17020 S8 S812010

410 6.13 Brain Abscess Tapping Single CT Clinical Photograph 3 17250 S8 S800057

411 6.14 Brain Abscess Tapping multiple CT Clinical Photograph 3 23920 S8 S800058

412 6.15 Brain Meningo Encephalocele MRI Clinical Photograph 3 34270 S8 S812011

413 6.17 Brain C.S.F. Rhinorrhoea (Transcranial / Transnasal) CT Clinical Photograph 3 75000 S8 S812012

414 6.18 Brain Cranioplasty CT , Clinical Photograph Clinical Photograph 3 27830 S8 S812013

415 6.20 Brain Excision of Brain Abcess CT Clinical Photograph 3 28750 S8 S800059

416 6.21 Brain Aneurysm Clipping MRI Angio / DSA Clinical Photograph , X-RAY 3 34500 S8 S800060
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Brain / Spinal
417 6.22 Carotid angioplasty with stent ANGIOGRAM DOPPLER , X-RAY 3 60000 S8 S812014
(Endovascular)

Brain / Spinal
418 6.23 Carotid angioplasty without stent ANGIOGRAM DOPPLER , X-RAY 3 40000 S8 S812015
(Endovascular)

419 6.24 Brain External Ventricular Drainage (EVD) CT Clinical Photograph 3 28750 S8 S812016

420 6.25 Spinal Spinal Cord Tumours (extramedullary) MRI Biopsy , Clinical Photograph 3 34270 S8 S812017

421 6.26 Spinal Excision of Cervical Inter-Vertebral Discs MRI Clinical Photograph 3 34270 S8 S812018

422 6.27 Spinal Anterior Cervical Spine Surgery with fusion MRI Clinical Photograph 3 34270 S8 S812019

423 6.28 Spinal Anterio Lateral Decompression MRI Clinical Photograph 3 17250 S8 S812020

424 6.29 Spinal Laminectomy-Cervical/dorsal/lumbar MRI Clinical Photograph 3 34270 S8 S812021

425 6.30 Spinal Discectomy-Dorsal MRI Clinical Photograph 3 28520 S8 S812022

426 6.31 Spinal Discectomy-Lumbar MRI Clinical Photograph 3 28520 S8 S812023

427 6.32 Spinal Discectomy + cost of implant MRI Clinical Photograph 3 34270 S8 S812024

428 6.33 Spinal Spinal Intra Medullary Tumours MRI Biopsy , Clinical Photograph , X-RAY 3 68540 S8 S812025

429 6.34 Spinal Spina Bifida Surgery Major MRI Clinical Photograph , X-RAY 3 28750 S8 S812026

430 6.35 Spinal Spina Bifida Surgery Minor MRI Clinical Photograph , X-RAY 3 20700 S8 S812027

431 6.36 Brain / Spinal Stereotaxic Procedures (Framed / Frameless) CT/MRI Clinical Photograph 3 50000 S8 S800065

Brain / Spinal
432 6.37 Vertebral artery Stenting ANGIOGRAM DOPPLER 3 60000 S8 S812028
(Endovascular)

433 6.38 AAD Surgeries Transoral surgery and CV Junction (With Posterior Fixation) MRI , X-Ray Cerical Spine Clinical Photograph 3 125000 S8 S812029

434 6.39 AAD Surgeries Trans oral Surgery CT Biopsy , Clinical Photograph 3 39790 S8 S800071
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

435 6.40 Brain Trans Sphenoidal Surgery CT, MRI Biopsy , Clinical Photograph 3 34040 S8 S812030

436 6.41 Brain RF Lesions for Trigminal Neuralgia MRI Clinical Photograph 3 28750 S8 S800050

437 6.44 Neuro muscular Muscle Biopsy with report EMG, NCV Biopsy 3 17250 S8 S800074

438 6.45 Brain MVD MRI Clinical Photograph 3 45000 S8 S812031

439 6.46 Neuro Surgery Nerve Biopsy with report EMG, NCV Biopsy 3 8625 S8 S812032

440 6.47 Neuro Surgery Nerve Decompression MRI Clinical Photograph 3 17250 S8 S800075

441 6.48 Neuro Surgery Peripheral Nerve Surgery Major EMG, NCV Clinical Photograph 3 34500 S8 S800076

442 6.49 Neuro Surgery Peripheral Nerve Surgery Minor EMG, NCV Clinical Photograph 3 17250 S8 S800077

MRI SPINE +CT SPINE-

443 6.50 C.V.JUNCTION POSTERIOR FIXATION ALONE FLEXION/ EXTENTION/ X RAY SPINE 5 65000 S8 S812033
NEUTRAL

444 6.51 BRAIN SURGERY FOR ORBITAL TUMORS/PROPTOSIS MRI CONTRAST/ CECT CECT+BIOPSY REPORT 5 90000 S8 S812034

445 6.52 BRAIN+SPINE INFRATENTORIAL TUMOR WITH SPINAL EXTENSION MRI CONTRAST/ CECT CECT+BIOPSY REPORT 5 100000 S8 S812035

VASCULAR MALFORMATION SURGERY/Procedure

446 6.53 BRAIN CTA/MRA/DSA CTA+BIOPSY 5 120000 S8 S812036
(SUPRATENTORIAL/INFRATENTORIAL)

MRI BRAIN (1.5/3 TESLA)

447 6.54 BRAIN EPILEPSY SURGERY-GRID INSERTION + LOCALISATION +SURGERY/Procedure CT BRAIN 5 110000 S8 S812037
+VEEG +CT SCAN

MRI BRAIN (1.5/3 TESLA)

448 6.55 BRAIN EPILEPSY SURGERY-LESIONECTOMY CT BRAIN 5 60000 S8 S812038
+EEG

MRI BRAIN (1.5/3 TESLA)

449 6.56 BRAIN EPILEPSY SURGERY- ATL/AH FOR MTS CT BRAIN 5 70000 S8 S812039
+EEG

450 6.57 SKULL BONY TUMOR OF SKULL CECT CT BRAIN +BIOPSY REPORT 5 50000 S8 S812040

451 6.58 BRAIN ENDOSPIC BRAIN SURGERIES (DIAGNOSTIC) MRI BRAIN/CT BRAIN CT BRAIN 5 30000 S8 S812041
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

452 6.59 BRAIN ENDOSPIC BRAIN SURGERIES (THIRD VENTRICULOSTOMY) MRI BRAIN/CT BRAIN CT BRAIN 5 45000 S8 S812042

453 6.60 BRAIN ENDOSPIC BRAIN SURGERY (AQUEDUCTOPLASTY) WITHOUT IMPLANT MRI BRAIN/ CT BRAIN CT BRAIN 5 50000 S8 S812043

454 6.61 BRAIN ENDOSPIC BRAIN SURGERY (AQUEDUCTOPLASTY) WITH IMPLANT MRI BRAIN/ CT BRAIN CT BRAIN 5 60000 S8 S812044

455 6.62 BRAIN ENDOSPIC BRAIN SURGERIES ( TUMOUR/CYST EXISION) MRI BRAIN/CT BRAIN CT BRAIN +BIOPSY 5 60000 S8 S812045

456 6.63 NERVE PAIN MANAGEMENT SURGERY (SYMPETHECTOMY/RHIZOTOMY) RELATED INVESTIGATIONS RELATED INVESTIGATIONS 3 40000 S8 S812046

MRI CV JUNCTION + CT CV
C V JUNCTION DECOMPRESSION (POSTERIOR) (ARNOLD-CHIARY MALFORMATION JUNCTION-
457 6.64 C.V.JUNCTION X RAY SPINE 3 70000 S8 S812047
AND OTHERS) FLEXION/EXTENTION/NEU
TRAL

458 6.65 SKULL BONE FLAP REMOVAL CT BRAIN CT BRAIN 3 35000 S8 S812048

459 6.66 SPINE CORPECTOMY AND FIXATION CERVICAL/DORSAL/LUMBER(SINGLE LEVEL) MRI SPINE X RAY SPINE 5 65000 S8 S812049

460 6.67 SPINE CORPECTOMY AND FIXATION CERVICAL/DORSAL/LUMBER (MULTIPLE LEVEL) MRI SPINE X RAY SPINE 5 80000 S8 S812050

461 6.68 SPINE CERVICAL SPINE STABLISATION ANTERIOR MRI SPINE X RAY SPINE 5 60000 S8 S812051

462 6.69 SPINE CERVICAL SPINE STABLISATION-POSTERIOR MRI SPINE X RAY SPINE 5 60000 S8 S812052

463 6.70 SPINE CERVICAL SPINE STABLISATION-GLOBAL MRI SPINE X RAY SPNE 5 90000 S8 S812053

464 6.71 SPINE DL SPINE STABLISATION-ANTERTIOR MRI SPINE X RAY SPINE 5 60000 S8 S812054

465 6.72 A SPINE DL SPINE STABLISATION-POSTERIOR Level one MRI SPINE X RAY SPINE 5 50000 S8 S812055

466 6.72 B SPINE DL SPINE STABLISATION-POSTERIOR Level two MRI SPINE X RAY SPINE 5 60000 S8 S812055

467 6.73 A SPINE DL SPINE STABLISATION-GLOBAL (Anterior & Posterior combine) MRI SPINE X RAY SPINE 5 90000 S8 S812056

468 6.73 B SPINE DL SPINE STABLISATION-POSTERIOR Level three MRI SPINE X RAY SPINE 5 70000 S8 S812056

469 6.73 C SPINE DL SPINE STABLISATION-POSTERIOR Level four MRI SPINE X RAY SPINE 5 80000 S8 S812056
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

470 6.74 SKULL CRANIOSYNOSTOSIS SURGERY MRI+3D CT BRAIN CT BRAIN 5 100000 S8 S800009

471 6.75 SPINE LAMINOPLASTY CERVICAL/DORSAL/LUMBER MRI SPINE X RAY SPINE 3 50000 S8 S812057

DIAGNOSTIC CEREBRAL/SPINAL ANGIOGRAPHY (DSA-DIGITAL SUBSTRACTION

472 6.76 BRAIN CT BRAIN/MRI SPINE RELATED INVESTIGATIONS 0 12000 S8 S812058
ANGIOGRAPHY)

473 6.77 SPINE ENDOSCOPIC SPINE SURGERY MRI SPINE X RAY SPINE 3 40000 S8 S812059

474 6.78 SPINE THECO-PERITONEAL SHUNT MRI BRAIN/CT BRAIN X RAY SPINE+CSF REPORT 3 30000 S8 S812060

MRI BRAIN/CT BRAIN

475 6.79 BRAIN CRANIO-FACIAL RESECTION CT BRAIN +FACE 5 90000 S8 S200050
+FACE

BRAIN
476 6.80 REVASCULARISATI ST-MCA BYPASS/EC-ICA BYPASS CTA/MRA/DSA CTA 5 95000 S8 S812062
ON

477 6.81 VASCULAR CAROTID LIGATION FOR CCF/GIANT ANEURYSM CTA/MRA/DSA CTA 5 30000 S8 S812063

478 6.82 BRAIN REEXPLORATION FOR DEBRIDEMENT/CSF LEAK/HAEMATOMA CT BRAIN CT BRAIN 3 25000 S8 S812064

CONCERNED
479 6.83 REANIMATION FACIAL NERVE REANIMATION CONCERNED INVESTIGATIONS 5 40000 S8 S812065
INVESTIGATIONS

480 6.84 SPINE TRANSPEDICULAR BIOPSY MRI SPINE CONTRAST X RAY SPINE +BIOPSY REPORT 1 25000 S8 S812066

481 6.85 SPINE VERTEBROPLASTY/KYPHOPLASTY MRI SPINE X RAY SPINE +BIOPSY REPORT 5 50000 S8 S812067

482 6.86 Brain Craniotomy and Evacuation of Haematoma - Intracranial Spontaneous / Traumatic NCCT BRAIN NCCT BRAIN 5 90000 S8 S812068

483 6.87 Brain Decompressive Craniectomy - For Infarct / Lesion with mass effect on brain NCCT BRAIN NCCT BRAIN 5 70000 S8 S812069

MRI/CT BRAIN (WITH

484 6.88 BRAIN SUPRATENTORIAL TUMOUR WITH INFRATENTORIAL TUMOR EXTENSION CECT+BIOPSY REPORT 5 100000 S8 S812070
CONTRAST)
Payment fraction (
MEDICAL 1st week-35%,2nd
485 6.89* CONSERVATIVE MANAGEMENT (ISCHEMIC STROKE) CT brain plain,others MRI brain with angiography 5 week 60000 S8 M112001
NEUROLOGY week-25%,3rd week-
15%,4thfraction
Payment week- (
MEDICAL Repeat CT brain after 24 hours,MRI 1st week-50%,2nd
486 6.90* THROMBOLYSIS WITH ACTILYSE FOR ISCHEMIC STROKE CT brain plain,others 5 week 120000 S8 M112002
NEUROLOGY brain with angiography week-15%,3rd week-
10%,4thfraction
Payment week- (
MEDICAL INTRAPARENCHYMAL /SUBARACHNOID HEMMORRHAGE (CONSERVATIVE Repeat CT brain plain , CT angiography 1st week-35%,2nd
487 6.91* CT brain plain,others 5 week 40000 S8 M112003
NEUROLOGY MANAGEMENT) brain week-25%,3rd week-
15%,4th week-
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Payment fraction (
1st week-35%,2nd
week-25%,3rd week-
MEDICAL
488 6.92* MENINGOENCEPHALITIS, OR/ AND EVD/VP shunt (CONSERVATIVE MANAGEMENT) CT brain plain,CSF ,others MRI brain with contrast 5 week 110000 15%,4th week- S8 M112004
NEUROLOGY
10%,5th week-
10%,F/u-5%) of total
package rate

Payment fraction (
1st week-35%,2nd
Clinical diagnosis by Anyone of the following:repetitive week-25%,3rd week-
MEDICAL
489 6.93* MYASTHENIA CRISIS MANAGEMENT BY PLASMAPHERESIS neurophysician OR nerve stimulation,ACH-R antibody,Anti- 5 week 110000 15%,4th week- S8 M112005
NEUROLOGY
previously diagnosed case MUSK antibody 10%,5th week-
10%,F/u-5%) of total
package rate

Payment fraction (
Clinical diagnosis by Anyone of the following:repetitive
MEDICAL 1st week-50%,2nd
490 6.94* MYASTHENIA CRISIS MANAGEMENT BY IV IMMUNOGLOBINS neurophysician OR nerve stimulation,ACH-R antibody,Anti- 5 week 200000 S8 M112006
NEUROLOGY week-15%,3rd week-
previously diagnosed case MUSK antibody
10%,4th week-

Payment fraction (
1st week-35%,2nd
week-25%,3rd week-
MEDICAL Clinical diagnosis by
491 6.95* Gullian-barre syndrome management by plasmapheresis CSF study, NCV/EMG 5 week 109627 15%,4th week- S8 M112007
NEUROLOGY neurophysician
10%,5th week-
10%,F/u-5%) of total
package rate

Payment fraction (
MEDICAL Clinical diagnosis by 1st week-50%,2nd
492 6.96* Gullian-barre syndrome management by Intravenous immunoglobulin CSF study, NCV/EMG 5 week 200000 S8 M112008
NEUROLOGY neurophysician week-15%,3rd week-
10%,4th week-

493 6.97 Neurology Anterior Encephalocele CT Brain/ MRI Brain CT Brain 50,000 S8 S800001

494 6.98 Neurology Burr hole CT Brain/ MRI Brain CT Brain 7,000 S8 S800002
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

495 6.99 Neurology Burr hole with chronic Sub Dural Haematoma (including pre and post Op. CT) CT Brain/ MRI Brain CT Brain 20,000 S8 S800003

496 6.100 Neurology Carpal Tunnel Release including pre and post Op. MRI MRI, EMG/NCV - 10,000 S8 S800004

X-Ray Cervical Spine/ X-Ray Cervical Spine/ Chest X-Ray, CT

497 6.101 Neurology Cervical Ribs – Bilateral 35,000 S8 S800005
Chest X-Ray, CT Scan Scan

X-Ray Cervical Spine/ X-Ray Cervical Spine/ Chest X-Ray, CT

498 6.102 Neurology Cervical Ribs – Unilateral 20,000 S8 S800006
Chest X-Ray, CT Scan Scan

499 6.103 Neurology Duroplasty - Endogenous CT Brain CT Brain 12,500 S8 S800010

Implant cost will

500 6.104 Neurology Duroplasty - Exogenous(Implant cost is not iclluded in package rate) CT Brain Plain CT Brain 12,500 added seperatly in S8 S800011
this package

501 6.105 Neurology Haematoma (Child subdural) inclusive of General anaesthesia, pre and post Op. CT CT Brain CT Brain 50,000 S8 S800014

502 6.106 Neurology Laminectomy with Fusion and fixation MRI Spine X-Ray Spine. 50,000 S8 S800015

503 6.107 Neurology Laminectomy with Fusion MRI Spine X-Ray Spine. 40,000 S8 S800016

504 6.108 Neurology Local Neurectomy CT/MRI Clinical Photograph 16,000 S8 S800017

505 6.109 Neurology Meningocele – Anterior Brain , Spinal Cord MRI X Ray/ Post OP Operative Site 36,000 S8 S800019

506 6.110 Neurology Meningocele – Lumbar Brain , Spinal Cord MRI X Ray/ Post OP Operative Site 36,000 S8 S800020

507 6.111 Neurology Meningococcal – Occipital Clinical Photo/MRI/CT X Ray/ Post OP Operative Site 50,000 S8 S800021

508 6.112 Neurology Skull Traction MRI Spine X-Ray Spine. 8,000 S8 S800026

509 6.113 Neurology Spine - Canal Stenosis CT/MRI CT 40,000 S8 S800027

510 6.114 Neurology Spine - Extradural Haematoma MRI Spine X-Ray Spine. 30,000 S8 S800032

511 6.115 Neurology Spine - Extradural Haematoma with fixation MRI Spine X-Ray Spine. 40,000 S8 S800033

512 6.116 Neurology Spine - Intradural Haematoma MRI X-Ray Spine. 40,000 S8 S800036
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

513 6.117 Neurology Spine - Intradural Haematoma with fixation MRI Spine X-Ray Spine. 50,000 S8 S800037

514 6.118 Neurology Spine - Intramedullar Tumour CT/MRI HPEE 50,000 S8 S800038

515 6.119 Neurology Spine - Intramedullar Tumour - fixation MRI Spine Biopsy , X-Ray Spin 60,000 S8 S800039

516 6.120 Neurology Brain Biopsy MRI Brain/ CT Brain Biopsy 15,000 S8 S800045

517 6.121 Neurology Cranial Nerve Anastomosis concecrned Investigation concecrned Investigation 32,000 S8 S800046

518 6.122 Neurology Depressed Fracture CT Brain CT Brain 40,000 S8 S800047

519 6.123 Neurology Peripheral Neurectomy (Trigeminal) MRI Biopsy 16,500 S8 S800049

520 6.124 Neurology Additonal clip for Aneurysm Clipping MRI ANGIO/DSA X Ray + Clinical Photo of Operative Site 15,000 S8 S800061

521 6.125 Neurology Cervical Disc Multiple level without Fusion MRI Spine X Ray + Clinical Photo of Operative Site 40,000 S8 S800068

522 6.126 Neurology Foramen Magnum Decompression CT/MRI X-Ray 45,000 S8 S800072

523 6.127 Neurology Arterio venous malformation (AVM) excision (whatever size and location) MRA/DSA Report X-Ray , Clinical Photo of Operative Site 50,000 S8 S800079

HistoPatho Repot + Clinical Photo of

524 6.128 Neurology Scalp Arterio venous malformation (AVM) CT/MRI ANGIO 25,000 S8 S800080
Operative Site

Gamma Knife radiosurgery (GKRS)/ SRS for tumours/ Arteriovenous malformation

525 6.129 Neurology CT/MRI Clinical Photo 75,000 S8 S800083
(AVM)

Interventional Coil embolization for aneurysms (includes cost of first 3 coils + balloon and/ or stent if
526 6.130 DSA/CT/MRI ANGIO CT/MR ANGIO 1,00,000 S9 S900001
Neuroradiology used) 1 to 20 coils may be required as per need.

Interventional
527 6.131 Additional coil for coil embolization for aneurysms DSA/CT/MRI ANGIO CT/MR ANGIO 24,000 S9 S900002
Neuroradiology

Interventional
528 6.132 Dural AVMs/AVFs (per sitting) with glue DSA/CT/MR ANGIO CT/MR ANGIO 70,000 S9 S900003
Neuroradiology

Interventional
529 6.133 Dural AVMs/AVFs (per sitting) with onyx DSA/CT/MR ANGIO CT/MR ANGIO 1,50,000 S9 S900004
Neuroradiology
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Interventional Carotico-cavernous Fistula (CCF) embolization with coils. [includes 5 coils, guide
530 6.134 DSA/CT/MR ANGIO CT/MR ANGIO 1,50,000 S9 S900005
Neuroradiology catheter, micro-catheter, micro-guidewire, general items]

Interventional Carotid-cavernous Fistula (CCF) embolization with balloon (includes one balloon,
531 6.135 DSA/CT/MR ANGIO CT/MR ANGIO 75,000 S9 S900006
Neuroradiology guide catheter, micro-catheter, micro-guidewire, general items)

Interventional
532 6.136 Cerebral & Spinal AVM embolization (per sitting). Using Histoacryl DSA/CT/MR ANGIO CT/MR ANGIO 1,00,000 S9 S900007
Neuroradiology

Interventional
533 6.137 Parent vessel occlusion - Basic CT/MR ANGIO CT/MR ANGIO 30,000 S9 S900008
Neuroradiology

Interventional
534 6.138 Additonal coil for Parent Vessel Occlusion DSA/CT/MR ANGIO CT/MR ANGIO 24,000 S9 S900009
Neuroradiology

Interventional
535 6.139 Additonal balloon for Parent Vessel Occlusion DSA/CT/MR ANGIO CT/MR ANGIO 11,000 S9 S900010
Neuroradiology

Interventional
536 6.140 Balloon test occlusion CT/MR ANGIO CT/MR ANGIO 70,000 S9 S900011
Neuroradiology

Interventional
537 6.141 Intracranial balloon angioplasty with stenting DSA/CT/MR ANGIO CT/MR ANGIO 1,60,000 S9 S900012
Neuroradiology

Interventional
538 6.142 Intracranial thrombolysis / clot retrieval DSA/CT/MR ANGIO CT/MR ANGIO 1,60,000 S9 S900013
Neuroradiology

Interventional
539 6.143 Pre-operative tumour embolization (per session) DSA/CT/MR ANGIO CT/MR ANGIO 40,000 S9 S900014
Neuroradiology

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

540 6.144 Neurology Concern Investigation Concern Investigation 1,00,000 S8 U100
family,Package amount is Negotiable)

Cluster - 7 PAEDIATRIC SURGERY

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Gastro Intestinal X-ray with infant feeding

541 7.1 Oesophageal atresia –1.pure atresia- first stage(‘o’stomy & ‘G’stomy) Clinical Photograph 3 23000 S14 S1412001
Tract tube or Dye study

Gastro Intestinal 2D-ECHO, Dye study,

542 7.2 Oesophageal atresia –2.pure atresia- second stage(oesaphageal replacement) Clinical Photograph 3 70000 S14 S1412002
Tract ultrasound

Gastro Intestinal X-ray with infant feeding

543 7.3 3.tracheo-oesphageal fistula(type c) Clinical Photograph 3 40250 S14 S1412003
Tract tube or Dye study

Gastro Intestinal
544 7.4 4. H- type fistula Dye study, Bronchoscopy Clinical Photograph 0 40000 S14 S1412004
Tract
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Gastro Intestinal
545 7.5 Intestinal Atresias & Obstructions X-RAY /CT Clinical Photograph 3 46000 S14 S1412005
Tract

Gastro Intestinal
546 7.6 Biliary Atresia HIDA scan Clinical Photograph 3 46000 S14 S1412006
Tract

Gastro Intestinal
547 7.7 Choledochal Cyst MRCP or CT scan Clinical Photograph 3 46000 S14 S1412007
Tract

Gastro Intestinal
548 7.8 Diaphragmatic Hernia USG/CT Clinical Photograph 0 40000 S14 S1312025
Tract

Gastro Intestinal Invertogram or clinical

549 7.9 Anorectal Malformation1. Low ARM(male & female) Clinical Photograph 3 18400 S14 S1412008
Tract photograph

Gastro Intestinal Invertogram or clinical

550 7.10 2.Intermediate & High variety a. Stage 1 colostomy Clinical Photograph 3 30000 S14 S1412009
Tract photograph

Gastro Intestinal 2-D ECHO, ULTRASOUND,

551 7.11 b. Stage two PSARP/Abdominoperineal Pull through Clinical Photograph 3 34500 S14 S1412010
Tract Dye Study

Gastro Intestinal
552 7.12 c. Stage three colostomy closure/ Ileostomy closure Clinical photograph Clinical Photograph 3 35000 S14 S1412011
Tract

ANORECTAL MALFORMATION.[Colostomy, iliostomy/ pouchostomy (first stage of

Gastro Intestinal Invertogram or clinical
553 7.13 male/female ARM, cloaca, pouch colon or hirschsprung diease] Clinical Photograph 0 30000 S14 S1412012
Tract photograph,

Gastro Intestinal 2-D ECHO, ULTRASOUND

554 7.14 Second stage- PSARVUP/Abdominoperineal Pull through Definitive surgery Clinical Photograph 0 60000 S14 S1412013
Tract Dye Study

Gastro Intestinal 2-D ECHO, ULTRASOUND

555 7.15 Third stage- Colostomy / ileostomy closure Clinical Photograph 3 34500 S14 S1412014
Tract Dye Study

Gastro Intestinal Clinical Photograph/Histopathological

556 7.16 Hirschsprung's Disease- Single Stage Dye Study/ Rectal Biopsy 3 60000 S14 S1412015
Tract Report

Gastro Intestinal Clinical Photograph/Histopathological

557 7.18 Second stage-Definitive surgery Dye Study/ Rectal Biopsy 3 57500 S14 S1412016
Tract Report

558 7.20 Thoracic Surgeries Empyema Thoracis X-Ray/CT Scan Clinical Photograph 3 40000 S14 S1412017

GENITOURINARY
559 7.21 HYPOSPIDIAS- 1. SINGLE STAGE SURGERY Clinical Photograph Clinical Photograph 3 34500 S14 S1412018
Surgeries

GENITOURINARY
560 7.22 HYPOSPIDIAS- 2.STAGED SURGERIES a) 1st Stage procedure Clinical Photograph Clinical Photograph 3 34500 S14 S1412019
Surgeries

GENITOURINARY
561 7.23 a) 2nd Stage procedure Clinical Photograph Clinical Photograph 3 25300 S14 S1412020
Surgeries

562 7.24 Peadiatric Surgery EXSTROPHY BLADDER TOTAL CORRECTION1) SINGLE STAGE - 8 126500 S14 S1412021

563 7.25 Peadiatric Surgery EXSTROPHY BLADDER 2) FIRST STAGE BLADDER CLOSURE USG/ELECTROLYTES/MCU 8 100625 S14 S1412022
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

564 7.26 Peadiatric Surgery EXSTROPHY BLADDER 3) SECOND STAGE BLADDER NECK RECONSTRUCTION - 8 60000 S14 S1412023

565 7.27 Peadiatric Surgery EXSTROPHY BLADDER 4) PRIMARY OR SECONDARY URETEROSIGMOIDOSTOMY - 8 86250 S14 S1412024

566 7.28 Peadiatric Surgery EPISPADIAS REPAIR 1) CONTINENT USG/MCU 5 40000 S14 S1412025

567 7.29 Peadiatric Surgery EPISPADIAS REPAIR 2) INCONTINENT (EPISPADIAS REPAIR +BNR) USG/MCU 5 51750 S14 S1412026

NEC-operative-
568 7.30 Gastrointestinal 1 Exploratory laparotomy+ repair of perforation X ray , USG same as above Clinical photo, X ray abd 4 48000 S14 S1412027

Clinical photograph, Xray

Single stage PSARP female ( Rectovestibular fistula/ anovestibular fistula/ vestibular
569 7.31 Gastrointestinal lumbosacral spine, USG Clinical photgraph 4 50000 S14 S1412028
anus etc)
KUB, 2d echo, MCU

570 7.32 Gastrointestinal Duodenal atresia- Kimuras duodenoduodenostomy X ray abdomen Clinicl photograph 2 48000 S14 S1412029

571 7.33 Gastrointestinal Pyloric stenoses Ramstedts pyloromyotomy USG abdomen/dye study Clinical photograph 2 26000 S14 S1412030

Upper gi scopy/ Upper GI

572 7.34 Gastrointestinal GERD Fundoplication Clinical photograph 2 35000 S14 S1400016
dye study

MCU, USG KUB, urine

573 7.35 Genitourinary Posterior urethral valve- stabilization + cystoscopy+ puv fulguration & or vesicostomy analysis, Bl urea, ser USG KUB, 4 30000 S14 S1412031
creatinine & S electrolyte

Ct brain/ MRI Brain USG,

574 7.36 Brain Hydrocephalus in children- Ventriculoperitoneal shunt Clinical photograph, CSF report 4 25000 S14 S1412032
Fundus examination

MCU, USG KUB, Renal

575 7.37 Genitourinary Vesicoureteric reflux, megaureter- ureteric reimplantation unilateral/bilateral Clinical photo 4 40000 S14 S1412033
scan
Pediatrician advise for
splenectomy, Vaccinations
576 7.38 Abdomen Splenectomy for Thalessemia Clinical photo 2 35000 S14 S1412034
( pneumococcal),USG
Abdomen

577 7.39 Paediatric surgery Ankyloglossia Major Clinical Photo Clinical Photo 15,000 S14 S1400001

578 7.40 Paediatric surgery Ankyloglossia Minor Clinical Photo Clinical Photo 5,000 S14 S1400002

579 7.41 Paediatric surgery Hernia & Hydrocele USG clinical notes 20,000 S14 S1400003

CECT L-S Region, Clinical

580 7.42 Paediatric surgery Sacrococcygeal Teratoma Clinical Photo 20,000 S14 S1400004
Photo, Sputum AFB

581 7.43 Paediatric surgery Undescended Testis - Bilateral-Palp + Nonpalp USG Clinical Photo 15,000 S14 S1400005
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

582 7.44 Paediatric surgery Undescended Testis - Bilateral Palpable USG Clinical Photo 15,000 S14 S1400006

583 7.45 Paediatric surgery Undescended Testis - Bilateral Non-Palpable USG Clinical Photo 20,000 S14 S1400007

584 7.46 Paediatric surgery Undescended Testis - Reexploration/ Second Stage USG Clinical Photo 20,000 S14 S1400008

585 7.47 Paediatric surgery Undescended Testis - Unilateral-Palpable USG Clinical Photo 15,000 S14 S1400009

Clinical Photo, Distal

586 7.48 Paediatric surgery Ano Rectal Malformation - Redo Pullthrough Clinical Photo 15,000 S14 S1400014
Cologram/ USG Dye Study

Clinical Photo, Distal

587 7.49 Paediatric surgery Ano Rectal Malformation - Transposition Clinical Photo 15,000 S14 S1400015
Cologram/ USG Dye Study

588 7.50 Paediatric surgery Duplication Cyst Excision CECT Abdomen Clinical Photo 20,000 S14 S1400017

Clinical Photo, Operative

589 7.51 Paediatric surgery Fecal Fistula Closure Clinical Photo 25,000 S14 S1400018
Details of Previous Surgery

X-Ray with Infant Feeding

590 7.52 Paediatric surgery Gastrostomy + Esophagoscopy+ Threading Clinical Photo 20,000 S14 S1400019
Tube/ Dye Study

591 7.53 Paediatric surgery GI Tumor Excision CECT, Clinical Photo Clinical Photo 30,000 S14 S1400020

592 7.54 Paediatric surgery Hirschsprung’s Disease - Retal Biopsy-Punch Barium Enema HPEE 10,000 S14 S1400023

593 7.55 Paediatric surgery Hirschsprung’s Disease - Retal Biopsy –Open Barium Enema HPEE 10,000 S14 S1400024

594 7.56 Paediatric surgery Hirschsprung’s Disease - Sphinecterotomy Barium Enema HPEE 15,000 S14 S1400025

595 7.57 Paediatric surgery Intussusception - Non –Operative Reduction in infants USG Abdomen USG 20,000 S14 S1400026

USG Abdomen, Clinical

596 7.58 Paediatric surgery Intussusception – Operative in infants Clinical Photo 25,000 S14 S1400027
Photo

X-Ray Abdomen Standing,

597 7.59 Paediatric surgery Ladds Procedure USG Abdomen/Barium Clinical Photo 30,000 S14 S1400028
MEAL

598 7.60 Paediatric surgery Rectal Polypectomy - Sigmoiescopic (Ga) Sigmoidoscopic Picutre HPEE, Clinical Notes 8,000 S14 S1400029

CECT Abdomen, Clinical

599 7.61 Paediatric surgery Retro-Peritoneal Lymphangioma Excision HPEE, Clinical Notes 25,000 S14 S1400030
Picture
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

600 7.62 Paediatric surgery Congenital Lobar Emphysema CECT, X-Ray Chest X-Ray, Clinical Photo 25,000 S14 S1400032

601 7.63 Paediatric surgery Exomphalos/gastroschisis Clinical Photo Clinical Photo 25,000 S14 S1400033

602 7.64 Paediatric surgery Cleft Lip and Palate Surgery (per stage) Clinical Photo Clinical Photo 15,000 S14 S1400034

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

603 7.65 Paediatric surgery Concern Investigation Concern Investigation 1,00,000 S14 U100
family,Package amount is Negotiable)

Cluster- 8 POLY-TRAUMA
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY
Nerve Conduction study,
604 8.1 Polytrauma Nerve and tendon repair &/ Vascular repair Clinical Photograph 3 23000 S6 S600001
CT scan
Nerve Conduction study,
605 8.2 Polytrauma Nerve & Tendon Repair &/ Vascular Repair (Grade-I& II) Clinical Photograph 3 14950 S6 S612001
CT scan
Nerve Conduction study,
606 8.3 Polytrauma Nerve & Tendon Repair &/ Vascular Repair (Grade-III) Clinical Photograph 3 26450 S6 S612002
CT scan
CLINICAL PHOTOGRAPH, X-
607 8.4 Plastic Surgery Flap cover Surgery for wound in compound fracture CLINICAL PHOTOGRAPH 3 23000 S6 S612003
RAY

Other Small bonefractures/K-wiring (To be covered along with other injuries only and
608 8.5 Polytrauma X-RAY X-RAY 3 10000 S6 S612004
not as exclusive procedure)

Surgery for Patella fracture (To be covered along with other injuries only and not as
609 8.6 Polytrauma X-RAY X-RAY 3 15000 S6 S612005
exclusive procedure)

CLINICAL PHOTOGRAPH, X-
610 8.7 Plastic Surgery Facial bone fractures (Facio-Maxillary Injuries) CLINICAL PHOTOGRAPH, X-RAY 3 28750 S6 S612006
RAY

Pelvic Bone
611 8.8 Surgical Correction of Pelvic bone fractures. X-RAY X-RAY 3 40000 S6 S612007
Fractures

JOINT RECONSTRUCTION (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND MRI , CLINICAL
612 8.50 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 74750 S6 S612008
NOT AS EXCLUSIVE PROCEDURE) PHOTOGRAPH, X-RAY

ELLIZAROV FIXATION,/ External Fixation (TO BE COVERED ALONG WITH OTHER CLINICAL PHOTOGRAPH, X-
613 8.51 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 75000 S6 S612009
INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY

OPEN REDUCTION INTERNAL FIXATION- SMALL BONE (TO BE COVERED ALONG WITH CLINICAL PHOTOGRAPH, X-
614 8.52 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 17250 S6 S612010
OTHER INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY

OPEN REDUCTION INTERNAL FIXATION- LARGE BONE (TO BE COVERED ALONG WITH CLINICAL PHOTOGRAPH, X-
615 8.53 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 40250 S6 S612011
OTHER INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

OPEN REDUCTION OF SMALL JOINT(TO BE COVERED ALONG WITH OTHER INJURIES CLINICAL PHOTOGRAPH, X-
616 8.54 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 20000 S6 S612012
ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY

OPEN REDUCTION WITH PHEMISTER GRAFTING (TO BE COVERED ALONG WITH CLINICAL PHOTOGRAPH, X-
617 8.55 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 40000 S6 S612013
OTHER INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY

PERCUTANEOUS- FIXATION OF FRACTURE (TO BE COVERED ALONG WITH OTHER CLINICAL PHOTOGRAPH, X-
618 8.56 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 20000 S6 S612014
INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY

PREPATELLAR BURSA AND REPAIR OF MCL OF KNEE (TO BE COVERED ALONG WITH
MRI, CLINICAL
619 8.57 ORTHO OTHER INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) stage A) Stage 1, B) CLINICAL PHOTOGRAPH, X-RAY 3 57500 S6 S612015
PHOTOGRAPH, X-RAY
Stage 2

RECONSTRUCTION OF ACL/PCL (TO BE COVERED ALONG WITH OTHER INJURIES ONLY MRI, CLINICAL
620 8.58 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 70000 S6 S612016
AND NOT AS EXCLUSIVE PROCEDURE) stage A) Stage 1, B) Stage 2 PHOTOGRAPH, X-RAY

SHOULDER JACKET (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND NOT CLINICAL PHOTOGRAPH, X-
621 8.60 ORTHO CLINICAL PHOTOGRAPH, X-RAY 3 50000 S6 S612017
AS EXCLUSIVE PROCEDURE) RAY

CLINICAL PHOTOGRAPH, X-
RESECTION & ANASTOMOSIS OF INTESTINE (TO BE COVERED ALONG WITH OTHER
622 8.61 SURGERY RAY, USG ABD, CT SCAN CLINICAL PHOTOGRAPH, X-RAY 3 34500 S6 S612018
INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE)
ABD

CLINICAL PHOTOGRAPH, X-
OPERATION FOR INJURY OF BLADDER (TO BE COVERED ALONG WITH OTHER
623 8.62 UROLOGY RAY, USG ABD, CT SCAN CLINICAL PHOTOGRAPH, X-RAY 3 32200 S6 S612019
INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE)
ABD

CLINICAL PHOTOGRAPH, X-
URETHRAL INJURY (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND NOT
624 8.63 UROLOGY RAY, USG ABD, CT SCAN CLINICAL PHOTOGRAPH, X-RAY 3 28750 S6 S612020
AS EXCLUSIVE PROCEDURE)
ABD

CLINICAL PHOTOGRAPH, X-
URETHRAL RECONSTRUCTION (TO BE COVERED ALONG WITH OTHER INJURIES ONLY
625 8.64 UROLOGY RAY, USG ABD, CT SCAN CLINICAL PHOTOGRAPH, X-RAY 3 34500 S6 S612021
AND NOT AS EXCLUSIVE PROCEDURE)
ABD

CLINICAL PHOTOGRAPH, X-
INTESTINAL RESECTION (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND
626 8.66 SURGERY RAY, USG ABD, CT SCAN CLINICAL PHOTOGRAPH, X-RAY 3 40250 S6 S612022
NOT AS EXCLUSIVE PROCEDURE)
ABD

CLINICAL PHOTOGRAPH, X-
SPLENECTOMY (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND NOT AS
627 8.67 SURGERY RAY, USG ABD, CT SCAN CLINICAL PHOTOGRAPH, X-RAY 3 51750 S6 S612023
EXCLUSIVE PROCEDURE)
ABD
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

CLINICAL PHOTOGRAPH, X-
ILIEOSIGMOIDOSTOMY (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND
628 8.70 SURGERY RAY, USG ABD, CT SCAN CLINICAL PHOTOGRAPH, X-RAY 3 28750 S6 S612024
NOT AS EXCLUSIVE PROCEDURE)
ABD

PERFORATING SCLERA-CORNEAL INJURY (TO BE COVERED ALONG WITH OTHER CLINICAL PHOTOGRAPH, X-
629 8.73 OPHTHALMOLOGY CLINICAL PHOTOGRAPH, X-RAY 3 46000 S6 S612025
INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY

DEPRESSED FRACTURE (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND CLINICAL PHOTOGRAPH, X-
630 8.74 NEUROSURGERY CLINICAL PHOTOGRAPH, X-RAY 3 40250 S6 S612026
NOT AS EXCLUSIVE PROCEDURE) RAY, CT SCAN BRAIN

SKULL TRACTION (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND NOT AS CLINICAL PHOTOGRAPH, X-
631 8.76 NEUROSURGERY CLINICAL PHOTOGRAPH, X-RAY 3 12880 S6 S612027
EXCLUSIVE PROCEDURE) RAY, CT SCAN BRAIN

BURR HOLE (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND NOT AS CLINICAL PHOTOGRAPH, X-
632 8.77 NEUROSURGERY CLINICAL PHOTOGRAPH, X-RAY 3 28750 S6 S612028
EXCLUSIVE PROCEDURE) RAY, CT SCAN BRAIN

TEMPORAL BONE RESECTION (TO BE COVERED ALONG WITH OTHER INJURIES ONLY CLINICAL PHOTOGRAPH, X-
633 8.78 NEUROSURGERY CLINICAL PHOTOGRAPH, X-RAY 3 57500 S6 S612029
AND NOT AS EXCLUSIVE PROCEDURE) RAY, CT SCAN BRAIN

SKULL BASE SURGERY (TO BE COVERED ALONG WITH OTHER INJURIES ONLY AND CLINICAL PHOTOGRAPH, X-
634 8.79 NEUROSURGERY CLINICAL PHOTOGRAPH, X-RAY 3 69000 S6 S612030
NOT AS EXCLUSIVE PROCEDURE) RAY, CT SCAN BRAIN

RUPTURE UTERUS, CLOSER AND REPAIR WITH TUBAL LIGATION (TO BE COVERED CLINICAL PHOTOGRAPH, X-
635 8.80 GYNAECOLOGY CLINICAL PHOTOGRAPH, X-RAY 3 40250 S6 S612031
ALONG WITH OTHER INJURIES ONLY AND NOT AS EXCLUSIVE PROCEDURE) RAY,

THORACIC THORACOPLASTY (TO BE COVERED ALONG WITH /Without OTHER INJURIES ONLY CLINICAL PHOTOGRAPH, X-
636 8.84 CLINICAL PHOTOGRAPH, X-RAY 3 34500 S6 S612032
SURGERY AND NOT AS EXCLUSIVE PROCEDURE) RAY, CT SCAN THORAX

Wound management for compound fracture

637 8.85 ORTHO Clinical Photograph, Xray Clinical Photograph, Xray 3 30000 S6 S612033
(Any grade)

EXTERNAL FIXATOR WITH SOFT TISSUE INJURY, SURGICAL MANAGEMENT, STG

638 8.86 ORTHO Clinical Photograph, Xray Clinical Photograph, Xray 3 50000 S6 S612034
COVERING FOR SMALL BONES

EXTERNAL FIXATOR WITH SOFT TISSUE INJURY, SURGICAL MANAGEMENT, STG

639 8.87 ORTHO Clinical Photograph, Xray Clinical Photograph, Xray 3 50000 S6 S612035
COVERING FOR LARGE BONES

640 8.88 SPINE DEFORMITY SURGERY FOR SPINE (KYPHO/SCOLIOSIS) Clinical Photograph, Xray Clinical Photograph, Xray 3 150000 S6 S612036
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Pre-op. Doppler
Post-op. Doppler study,Clinical photo
641 8.89 Polytrauma Plexus injury along with Vascular injury repair/ graft study,Nerve Conduction 60,000 S6 S600002
showing scar
study,CT

PRE OP CLINICAL Post- op. X-ray,Clinical Photograph

642 8.90 Polytrauma Internal fixation with Flap cover Surgery for wound in compound fracture 40,000 S6 S600003
PICTURE,X-RAY/CT showing flap cover

Clinical photograph showing scar,Post-

643 8.91 Polytrauma Head injury requiring Facio-Maxillary Injury repairs & fixations (including implants) X-RAY/CT 35,000 S6 S600004
op. X-ray

Clinical photograph showing scar,Post-

644 8.92 Polytrauma Internal fixation of Pelviacetabular fracture X-RAY/CT 40,000 S6 S600005
op. X-ray

Craniotomy and evacuation of Haematoma – subdural/Extra dural along with fixation Clinical photograph showing scar,Post-
645 8.93 Polytrauma Pre-op. X-ray,CT 60,000 S6 S600006
of fracture of single long bone op. X-ray/CT

Craniotomy and evacuation of Haematoma – subdural/Extra dural along with fixation Clinical photograph showing scar,Post-
646 8.94 Polytrauma Pre-op. X-ray,CT 75,000 S6 S600007
of fracture of 2 or more long bone. op. X-ray/CT

Visceral injury requiring surgical intervention along with fixation of fracture of single Clinical photograph showing scar,Post-
647 8.95 Polytrauma Pre-op. X-ray,CT,USG 30,000 S6 S600008
long bone. op. X-ray

Visceral injury requiring surgical intervention along with fixation of fracture of 2 or Clinical photograph showing scar,Post-
648 8.96 Polytrauma Pre-op. X-ray,CT,USG 45,000 S6 S600009
more long bones. op. X-ray

Pre-op. X-ray of fracture , Clinical photograph showing scar,Post-

649 8.97 Polytrauma Chest injury with one fracture of long bone (with implants) 35,000 S6 S600010
Chest Xray op. X-ray

Pre-op. X-ray of fracture , Clinical photograph showing scar,Post-

650 8.98 Polytrauma Chest injury with fracture of 2 or more long bones 45,000 S6 S600011
Chest Xray op. X-ray

Clinical report,electro- Clinical Photographs with Graft site +

651 8.99 Polytrauma Emergency tendons repair ± Peripheral Nerve repair/ reconstructive surgery 30,000 S6 S600012
diagnostic studies Showing scar,MRI

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

652 8.100 Polytrauma Concern Investigation Concern Investigation 1,00,000 S6 U100
family,Package amount is Negotiable)

Cluster- 9 MEDICAL ONCOLOGY

Pre-operative Post-operative Speciality Code
Sr.No Package No Sub-specialty Procedure name No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation Investigation PMJAY
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Biopsy with
immunohistochemistry,
Mammography, 2D Echo,
Clinical Photograph, Mammography,
653 9.1* Breast Adriamycin/Cyclophosphamide (AC) Chest X-ray, Sonography, 4 to 6 months 4485 M5 M512001
chest X-ray
Bone scan, Blood
Investigations, clinical
Photograph

Biopsy with
immunohistochemistry,
Mammography, 2D Echo,
Clinical Photograph, Mammography,
654 9.2* Breast 5- Fluorouracil A-C (FAC) Chest X-ray, Sonography, 4 to 6 months 4600 M5 M512002
chest X-ray
Bone scan, Blood
Investigations, clinical
Photograph

Biopsy with
immunohistochemistry,
Mammography, 2D Echo,
Clinical Photograph, Mammography,
655 9.3* Breast AC (AC then T) Chest X-ray, Sonography, 4 to 6 months 4600 M5 M512003
chest X-ray
Bone scan, Blood
Investigations, clinical
Photograph

Biopsy with
immunohistochemistry,
Mammography, 2D Echo,
Clinical Photograph, Mammography,
656 9.4* Breast Paclitaxel Chest X-ray, Sonography, 4 motnhs 11500 M5 M512004
chest X-ray
Bone scan, Blood
Investigations, clinical
Photograph

Biopsy with
immunohistochemistry,
Mammography, 2D Echo,
Clinical Photograph, Mammography,
657 9.5* Breast Cyclophosphamide/Methotrexate/5Fluorouracil (CMF) Chest X-ray, Sonography, 4 to 6 months 3450 M5 M512005
chest X-ray
Bone scan, Blood
Investigations, clinical
Photograph

Biopsy with
immunohistochemistry,
Mammography, 2D Echo,
Clinical Photograph, Mammography,
658 9.6# Breast Tamoxifen tabs Chest X-ray, Sonography, 4 to 5 years 109 M5 M512006
chest X-ray
Bone scan, Blood
Investigations, clinical
Photograph
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Biopsy with
immunohistochemistry,
Mammography, 2D Echo,
Clinical Photograph, Mammography,
659 9.7# Breast Aromatase Inhibitors Chest X-ray, Sonography, 2 to 5 years 1150 M5 M512007
chest X-ray
Bone scan, Blood
Investigations, clinical
Photograph
Biopsy with
immunohistochemistry,
HER2 +ve Early After 4 cycles of 9.3 package followed by Taxanes with GCSF, Herceptin with or Mammography, 2D Echo, Clinical Photograph, Mammography, 6 months to 1
660 9.8* 50000 M5 M512008
Breast Cancer without Carboplatin Chest X-ray, Sonography, chest X-ray year
Bone scan, Blood
Investigations, clinical

Biopsy, USG,CT scan/MRI,

Clinical Photograph, USG,CT scan/MRI,
661 9.9* Cervical Cancer Weekly Cisplatin Chest X-ray, clinical 6 to 8 weeks 4025 M5 M512009
Chest X-ray.
Photograph.

Biopsy, USG,CT scan/MRI,

Clinical Photograph, USG,CT scan/MRI,
662 9.10* Vulval Cancer Cisplatin/5-FU Chest X-ray, clinical 9200 M5 M512010
Chest X-ray.
Photograph.

Biopsy, USG,CT scan/MRI,

Clinical Photograph, USG,CT scan/MRI,
663 9.11* Vaginal Cancer Cisplatin/5-FU Chest X-ray, clinical 6 to 8 weeks 9200 M5 M512011
Chest X-ray.
Photograph.

Biopsy with
immunohistochemistry,
Clinical Photograph, Sonography, CT
664 9.12* Ovarian Cancer Carboplatin/Paclitaxel Chest X-ray, USG, CT scan, 4 to 6 months 11500 M5 M512012
scan, CA 125, chest x-ray.
CA 125, Cytology, clinical
Photograph
Biopsy with
immunohistochemistry,
Clinical Photograph, Sonography, CT
665 9.13* Ovarian Cancer Liposomal Doxorubicin & Gemcitabine Chest X-ray, USG, CT scan, 4 to 6 months 13800 M5 M512013
scan, CA 125, chest x-ray.
CA 125, Cytology, clinical
Photograph

Biopsy with
immunohistochemistry,
Ovary Germ cell CT scan, USG, Chest x-ray, Tumor
666 9.14* Bleomycin /Etoposide/ Cisplatin (BEP) CT scan, USG, Chest x-ray, 3 to 4 months 11270 M5 M512014
Tumor markers, Clinical Photograph, 2 D echo.
Tumor markers, Clinical
Photograph, 2 D echo.

Biopsy, CT scan, USC,

Gestational
Chest x-ray, Tumor CT scan, USC, Chest x-ray, Tumor
667 9.15* Trophoblast Ds.- Weekly Methotrexate 3 to 4 months 863 M5 M512015
markers, MRI Brain, markers, MRI, clinical Photograph.
Lowrisk
Clinical Photograph.
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Biopsy, CT scan, USG,

Gestational
Chest x-ray, Tumor CT scan, USC, Chest x-ray, Tumor
668 9.16* Trophoblast Ds.- Actinomycin 3 to 4 months 4370 M5 M512016
markers, MRI, Brain, markers, MRI, clinical Photograph.
Lowrisk
Clinical Photograph.

Biopsy, CT scan, USG,

Gestational
Chest x-ray, Tumor CT scan, USC, Chest x-ray, Tumor
669 9.17* Trophoblast Ds.- Etoposide-Methotrexate-Actinomycin / Cyclophosphamide -Vincristine (EMA-CO) 4 to 6 months 8280 M5 M512017
markers, MRI Brain, markers, MRI, clinical Photograph.
Highrisk
Clinical Photograph.

Biopsy with
immunohistochemistry,
CT scan, USG, Chest x-ray, Tumor
670 9.18* Testicular Cancer Bleomycin-Etoposide-Cisplatin (BEP) CT scan, USG, Chest x-ray, 3 to 4 months 11040 M5 M512018
markers, Clinical Photograph, 2 D echo.
Tumor markers, Clinical
Photograph, 2 D echo.

Biopsy with
immunohistochemistry, CT scan, USG, Chest x-ray, Tumor
671 9.19* Testicular Cancer Taxanes, Ifosphamides, Vinblastine, Gemcitabine, Docetaxol, Platin CT scan, USG, Chest x-ray, markers, MRI Brain, Clinical 3 to 4 months 16100 M5 M512019
Tumor markers, MRI Photograph.
Brain, Clinical Photograph.

Biopsy, CT scan/MRI, USG,

CT scan/MRI, USG, x-ray, Tumor
x-ray, Tumor markers,
672 9.20# Prostate Cancer Hormonal therapy markers, Bone scan, Clinical 1.5 to 2 years 4140 M5 M512020
Bone scan, Clinical
Photograph.
Photograph.

Biopsy, CT scan/MRI, USG,

CT scan/MRI, USG, x-ray, Tumor
x-ray, Tumor markers,
673 9.21* Prostate Cancer Docetaxol + steriods with G-CSF markers, Bone scan, Clinical 1.5 to 2 years 18400 M5 M512021
Bone scan, Clinical
Photograph.
Photograph.

Biopsy, USG,CT scan/MRI,

Clinical Photograph, USG,CT scan/MRI,
674 9.22* Bladder Cancer Weekly Cisplatin Chest X-ray, clinical 4 to 6 weeks 4140 M5 M512022
Chest X-ray.
Photograph.

Biopsy, CT scan/MRI, USG,

CT scan/MRI, USG, x-ray, Urine
675 9.23* Bladder Cancer Methotrexate Vinblastine Adriamycin Cyclophosphamide (MVAC) x-ray, Urine cystology, 4 to 6 months 7130 M5 M512023
cystology, Clinical Photograph.
Clinical Photograph.

Biopsy, CT scan/MRI, USG,

CT scan/MRI, USG, x-ray, Urine
676 9.24* Bladder Cancer Gemcitabine/Carboplatin x-ray, Urine cystology, 4 to 6 months 12880 M5 M512024
cystology, Clinical Photograph.
Clinical Photograph.
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Biopsy with
Lung cancer-Non-
immunohistochemistry, CT scan, USG, x-ray, Sonography, Bone
small cell lung
677 9.25* Platin/Etoposide CT scan, USG, x-ray, scan, MRI Brain PET-CT Scan, Clinical 4 to 6 months 9430 M5 M512025
cancer (NSCLC)
Sonography, Bone scan, Photograph.
and SCLC
MRI Brain PET-CT Scan.

Biopsy with
Lung cancer-Non- immunohistochemistry, CT scan, USG, x-ray, Sonography, Bone
678 9.26* small cell lung Pemetrexed/ Platin Gemcitabine/ Platin Gefitinib CT scan, USG, x-ray, scan, MRI Brain PET-CT Scan, Clinical 4 to 6 months 14950 M5 M512026
cancer (NSCLC) Sonography, Bone scan, Photograph.
MRI Brain PET-CT Scan.

Biopsy, CT scan, USG, x- Biopsy, CT scan, USG, x-ray,

679 9.27* Esophageal Cancer Weekly Cisplatin/ Carboplatin Cisplatin-5FU Epirubicin/ Taxanes ray, Sonography, Sonography, Endoscopy, Clinical 4 to 6 months 8625 M5 M512027
Endoscopy. Photograph.

Biopsy, CT scan, USG, x- Biopsy, CT scan, USG, x-ray,

680 9.28* Gastric Cancer 5-FU -Leucovorin (McDonald Regimen), Epirubicin/Taxanes/Platin ray, Sonography, Sonography, Endoscopy, Clinical 4 to 6 months 17250 M5 M512028
Endoscopy. Photograph.

Biopsy, CT scan/MRI, x- Biopsy, CT scan/MRI, x-ray, Tumor

681 9.29* Colorectal Cancer Monthly 5-FU 4 to 6 months 5750 M5 M512029
ray, Tumor marker-S. CEA marker-S. CEA, Clinical Photograph.

Biopsy, CT scan/MRI, x- Biopsy, CT scan/MRI, x-ray, Tumor

682 9.30* Colorectal Cancer 5-Fluorouracil-Oxaliplatin -Leucovorin (FOLFOX) (Stage III only) 4 to 6 months 13800 M5 M512030
ray, Tumor marker-S. CEA marker-S. CEA, Clinical Photograph.

Biopsy, CT scan/MRI, x- Biopsy, CT scan/MRI, x-ray, Tumor

683 9.31* Colorectal Cancer 5-FU, Irinotican, Leucovorin, (FOLFIRI) Capecitabine, 4 to 6 months 11500 M5 M512031
ray, Tumor marker-S. CEA marker-S. CEA, Clinical Photograph.

Biopsy, CT scan, MRI scan,

Osteosarcoma
684 9.32* Cisplatin/Adriamycin + ifosmide (IAP) x-ray, Bone scan, 2 D X-Ray, Clinical Photograph. 8 to 9 months 13800 M5 M512032
Bone Tumors
Echo.

Biopsy-
immunohistochemistry,
Serum biochemistry, Bone
Lymphoma- Adriamycin/ Bleomycin/Vinblastine/ Dacarbazine (ABVD), Blood investigations & imaging-USG/CT
685 9.33* marrow examination, CT 6 to 8 months 6900 M5 M512033
Hodgkin disease Cyclophosphamide/Vincristine/Prednisolone/Procarbazine (COPP). scan/PET-CT scan, Clinical Photograph
scan, x-ray, Sonography,
PET-CT Scan, 2 D Echo,
PFT.
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Biopsy-,
immunohistochemistry,
Serum biochemistry, Bone
Cyclophosphamide/Adriamycin/Vincristine/Prednisolone (CHOP), Rituximab,
marrow examination, CT Blood investigations & imaging-USG/CT 4 months to 2
686 9.34* Lymphoma-NHL Chlorambucil CVP (Cyclophosphamide/Vincristine,/Prednisolone), Bendamustine 13800 M5 M512034
scan, x-ray, Sonography, scan/PET-CT scan, Clinical Photograph years
Cladribone High dose Methotrexate/VCR/Procarbazine- Cytarabine
PET-CT, CSF cytology, MRI
brain/spine, Viral
markers,2 D Echo.

Hematology, Serum
biochemistry, Serum
Protein electrophoresis
Blood investigations, & Bone marrow
and immunofixatation,
687 9.35* Multiple Myeloma Vincristine, Adriamycin,Dexamethasone(VAD) examination, X-Rays, Clinical 2 to 5 years 5750 M5 M512035
Bone marrow
Photograph
examination, skeletal
survey & MRI Spine, 2 D
Echo.

Hematology, Serum
biochemistry, Serum
Protein electrophoresis
and immunofixatation, Blood investigations, & Bone marrow
688 9.36# Multiple Myeloma Thalidomide+Dexamethasone(Oral) 2 to 5 years 4830 M5 M512036
Bone marrow examination, Clinical Photograph
examination, skeletal
survey & MRI Spine, 2 D
Echo.
Hematology, Serum
biochemistry, Serum
Blood investigations, & Bone marrow
Protein electrophoresis
689 9.37# Multiple Myeloma Melphalan -Prednisone (oral) examination, X-Rays, Clinical 2 to 5 years 2530 M5 M512037
and immunofixatation,
Photograph
Bone marrow
examination,
Hematology,skeletal
Serum
biochemistry, Serum
Blood investigations, & Bone marrow
Protein electrophoresis
690 9.38# Multiple Myeloma Bortezamib, Lenalinomide, Bisphosphonates, Autologus stem cell transplant examination, X-Rays, Clinical 2 to 5 years 13800 M5 M512038
and immunofixatation,
Photograph
Bone marrow
examination, skeletal

USG/CT, biopsy with Imaging USG/CT scan, Clinical

691 9.39* Wilm's Tumor SIOP/NWTS regimen(Stages I - IV) 4 to 6 months 9775 M5 M512039
Immunohistochemistry Photograph

Hepatoblastoma USG/CT, biopsy, Tumor USG/CT, Tumor marker, Clinical

692 9.40* Cisplatin – Adriamycin 4 to 6 months 5175 M5 M512040
Operable marker-AFP, 2D Echo. Photograph.
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Hematology, Serum
biochemistry, CT Scan
whole body Or PET Scan,
Childhood B Cell Tissue biopsy with Bone marrow examination, Imaging- 6 months to 6.5
693 9.41* Variable Regimen - MCP 841/BFM - 90, BFM-NHL, LMB 96, Rasburrycase 16100 M5 M512041
Lymphomas immunochemistry/IPT, Studies, Clinical Photograph years
Bone marrow
examination, CSF
Cytology.

CT, Biopsy-With
Immunohistochemistry, Blood investigations & imaging-
Neuroblastoma (
694 9.42* Variable Regimen Variable regimens, Autologous Stem Cell Blood investigations, USG/CT scan, MIBG scan, Clinical 3 to 6 months 16100 M5 M512042
Stages I-III )
MIBG scan, Bone marrow Photograph
examination.

Biopsy, Blood
investigations, MRI Orbit
Ophthalmologic examination, Imaging- 4 months to 1
695 9.43* Retinoblastoma Carbo/Etoposide/Vincristine, Endoxan/vincristine/doxorubicin-platin/Etoposide & Brain, CSF study, Bone 7130 M5 M512043
Studies, Clinical Photograph year
marrow examination,
Bone scan.

Hematology, Biopsy,
Serum biochemistry, Bone
marrow examination,
Chest X-Ray, skeletal
Variable Regimen- LCH-III, Vinblastine + Prednisolone, 6MP, MTX, Cladribone, Blood investigations and imagine,
696 9.44* Histiocytosis survey, MRI Brain, 6 to 12 months 20700 M5 M512044
Allergenic stem cell transplant. Clinical Photograph
Endocrine evaluation, HAL
typing & matching, serum
cyclosporine level.CSF
Cytology.

Blood investigations,
Biopsy &
Rhabdomyosarco Immunohistochemistry, Physical examination, Imagine MRI/CT
697 9.45* Vincristine-Actinomycin-Cyclophosphamide (VAC) based chemo 8 to 10 months 5750 M5 M512045
ma CT scan/MRI, Bone can, Clinical Photograph
marrow examination,
Bone scan.
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

X-Ray/CT Scan/MRI,
Biopsy &
Physical examination, X-Ray/CT
698 9.46* Ewings sarcoma Variable Regimen- Endoxan/VCR/Doxorubicin-Ifosphamides/Etoposide. Immunohistochemistry, 1 year 16100 M5 M512046
scan/MRI, Clinical Photograph
Bone Scan, Bone marrow
examination, 2D Echo.

Hematology, Bone
marrow examination with
Physical examination, Blood
Acute Myeloid Immunophenotyping,
699 9.47* Induction Phase investigations, Bone marrow 1 month 25300 M5 M512047
Leukemia Conventional Cytogenetics
examination, Clinical Photograph
and FISH studies, MRI
Brain, X-Ray, 2D Echo.

Hematology, Bone
marrow examination with
Physical examination, Blood
Acute Myeloid Immunophenotyping,
700 9.48* Consolidation Phase investigations, Bone marrow 4 months 43700 M5 M512048
Leukemia Conventional Cytogenetics
examination, Clinical Photograph
and FISH studies, MRI
Brain, X-Ray, 2D Echo.

Hematology, Bone
marrow examination with
Acute Physical examination, Blood
Immunophenotyping,
701 9.49* Lymphoblastic Induction phase 1st and 2nd months, MCP 841/BFM 90 protocol, Imatinib investigations, Bone marrow 1 to 2 months 71300 M5 M512049
Cytogenetics and FISH
Leukemia examination, Clinical Photograph
studies, CSF cytology, MRI
Brain, USG/CT scan.

Hematology, Bone
marrow examination with
Acute Immunophenotyping, Physical examination, Blood
3rd, 4th, 5th month-MCP 841/BFM 90 protocol, Imatinib, Allergenic stem cell
702 9.50* Lymphoblastic Cytogenetics and FISH investigations, Bone marrow 3 to 4 months 36800 M5 M512050
transplant
Leukemia studies, CSF cytology, MRI examination, Clinical Photograph
Brain, USG/CT scan, 2D
Echo.

Acute Hematology, Bone Physical examination, Blood

703 9.51* Lymphoblastic Maintenance- MCP 841/BFM 90 protocol, Imatinib marrow examination, FISH investigations, Bone marrow 2 years 4830 M5 M512051
Leukemia study, CSF cytology. examination, Clinical Photograph
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Biopsy. CT, USG, Blood Blood investigations, USG/CT scan,

704 9.52* unlisted regimen Palliative Chemotherapy 7130 M5 M512052
investigations Clinical Photograph

For Terminally ill

705 9.53* Palliative and Supportive Therapy Biopsy , CT , USG Clinical Photograph 4830 M5 M512053
cancer patient

CT scan Abdomen, Pelvis,

Colorectal Cancer Tissue biopsy, USG/CT/biopsy, Biochemical
706 9.54* XELOX along with Adjuvant chemotherapy 6 months 10120 M5 M512054
Stage 2& 3 Photograph, Tummor investigations
marker-S. CEA.

Febrile 1ST Line iv antibiotics And other supportive therapy ( third generation Blood C&S, Urine C&S,
USG/CT/biopsy, Biochemical
707 9.55* Neutropenia- cephalosporin,aminoglycoside, Comnination of Beta Lactum with beta lactamase Chest X-Ray, Tissue 17250 M5 M512055
investigations.
Highrisk-1 inhibitor (Piperacillin-tazobactum), Vancomycin, Anti-Fun gals (azoles), G-CSF etc.,) Biopsy, CT scan.

Febrile Blood C&S, Urine C&S,

2nd line iv antibiotics and other supportive therapy(Carbapenems, Fourth generation USG/CT/biopsy, Blood investigations,
708 9.56* Neutropenia- Chest X-Ray, Tissue 48300 M5 M512056
cephalosporins, Piperacillin, anti-fungal -azoles etc.,) Blood Culture-sensitivity, X-Ray.
Highrisk-2 Biopsy, CT scan.

Serum biochemistry, Bone

Relapsed
Ifosphamides /Platin /Etoposide (ICE), Cytarabine/ Platin/ Steroids (DHAP), marrow examination, CT Blood investigations & imaging-
709 9.57* lymphoma- NHL 4-6 months 36800 M5 M512057
Autologous stem cell Transplant scan, X-ray, Sonography, USG/CT scan/PET-CT scan
and HD
PET-CT scan

Bone Marrow examination

with Immunophe-
notyping, Conventional
710 9.58* APML ATRA, Arsenic trioxide, Daunorubicin, Cytarabine 6 MP, methotrexate Bone marrow exam with RT-PCR study, 2 to 2.5 years 64400 M5 M512058
Cytogenetics and FISH/RT-
PCR studies, MRI Brain, X-
ray, 2 D echo, ECG

Bone Marrow examination

with Immunophe-
notyping, Conventional Physical exam, Blood investigations,
711 9.59* Paediatric AML BFM 93 Cytogenetics and FISH bone marrow exam (if clinically 2-2.5 years 59800 M5 M512059
study, MRI Brain, CSF indicated)
cytology, X-ray, 2 D echo,
ECG

Hematology, Serum
Biochemistry, Bone
marrow examination with
Physical exam, Blood investigations,
712 9.60*A CLL CVP - Cyclophosphamide, Vincristine, Steroids [CLL *] Immunophe-notyping, 5463 M5 M512060
Imaging USG/CT scan
Lymph node biopsy with
IHC, USG/CT scan, 2 D
Echo
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Hematology, Serum
Biochemistry, Bone
marrow examination with
Physical exam, Blood investigations,
713 9.60*B CLL L +P -- Chlorambucil, Steroids [CLL *] Immunophe-notyping, 5463 M5 M512060
Imaging USG/CT scan
Lymph node biopsy with
IHC, USG/CT scan, 2 D
Echo

Hematology, Serum
Biochemistry, Bone
marrow examination with
Physical exam, Blood investigations,
714 9.60*C CLL Fludarabine, Cyclophosphamide, Rituximab (FCR) [CLL *] Immunophe-notyping, 43700 M5 M512060
Imaging USG/CT scan
Lymph node biopsy with
IHC, USG/CT scan, 2 D
Echo

Hematology, Serum
Biochemistry, Bone
marrow examination with
Physical exam, Blood investigations,
715 9.60*D CLL Rituximab [CLL *] Immunophe-notyping, 38237 M5 M512060
Imaging USG/CT scan
Lymph node biopsy with
IHC, USG/CT scan, 2 D
Echo

Hematology, Serum
Biochemistry, Bone
marrow examination with
Physical exam, Blood investigations,
716 9.60*E CLL Bendamustine [CLL *] Immunophe-notyping, 2-3 years 16387 M5 M512060
Imaging USG/CT scan
Lymph node biopsy with
IHC, USG/CT scan, 2 D
Echo

Hematology with serum

biochemistry, Bone Physical exam, Blood investigations,
717 9.61# CML Blastic crisis Imatinib, Nilotinib, Dasatinib Allogeneic stem cell Transplant marrow examination, Bone marrow study, RT- PCR for BCR- 4600 M5 M512061
cytogenetic study, Ph by ABL
FISH or RT-PCR, USG study

Hematology and serum

biochemistry, Bone
Marrow examination, viral
718 9.62A^ Aplastic Anaemia Aplastic Anaemia - ATG + Cyclosporine + Steroid Blood investigations 320000 M5 M512062
markers, IPT for PNH, HLA
typing & matching. S.
Cyclosporine level
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Hematology and serum

biochemistry, Bone
Marrow examination, viral
719 9.62B^ Aplastic Anaemia Allogeneic stem cell Transplant Blood investigations 780000 M5 M512063
markers, IPT for PNH, HLA
typing & matching. S.
Cyclosporine level

Hematology, serum
Myelodysplastic biochemistry, Bone
720 9.63A^ Myelodysplastic syndrome - Lenalinomide Decitabine Blood investigations 200000 M5 M512064
syndrome marrow examination with
cytogenetics, FISH study,

Hematology, serum
Myelodysplastic biochemistry, Bone
721 9.63B^ Allogeneic stem cell Transplant Blood investigations 780000 M5 M512065
syndrome marrow examination with
cytogenetics, FISH study,

Thalassemia/Haem
Thalassemia/Haemoglobinopat hies Sickle cell anaemia - Allogeneic Bone Marrow Blood investigations Hb
722 9.64^ oglobinopathies Blood investigations 780000 M5 M512066
Transplant electrophoresis ,HLA study
Sickle cell anaemia

Hematology, serum
Congenital
biochemistry, Hb
723 9.65^ condition Congenital condition amenable to BMT - Allogeneic stem cell Transplant Blood investigations 780000 M5 M512067
electrophoresis , HLA
amenable to BMT
typing

Hematology, Serum
biochemistry, RI brain &
724 9.66* Medulloblastoma Cisplatin/cyclophosphamide/VCR/Procarbazine, Lomustine spine, Biopsy Physical exam, MRI study 4-6 months 6900 M5 M512068
immunohistochemistry,
CSF cytology

Relapsed
Blood investigations and
725 9.67^ Paediatric Solid Relapsed Paediatric Solid Tumor - Autologus stem cell transplant - Blood investigations and Imaging, 780000 M5 M512069
Imaging,
Tumours

Blood investigations and

726 9.68^A Palliative package Fixation of pathological fracture [Palliative package ^] Blood investigations and Imaging, 31740 M5 M512070
Imaging,

Blood investigations and

727 9.68^B Palliative package Oesophageal Stenting /prosthesis- double [Palliative package ^] Blood investigations and Imaging, 31750 M5 M512070
Imaging,
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Blood investigations and

728 9.68^C Palliative package Oesophageal Stenting/prosthesis- Single [Palliative package ^] Blood investigations and Imaging, 26450 M5 M512070
Imaging,

Blood investigations and

729 9.68^D Palliative package Nerve blockage With Image / Nerve blockage Without Image [Palliative package ^] Blood investigations and Imaging, 10580 M5 M512070
Imaging,

Pain killer / G-CSF/ Drainage – Biliary and urinary / Stenting – Biliary/ Stenting – Blood investigations and
730 9.68^E Palliative package Blood investigations and Imaging, 5290 M5 M512070
urinary / Nutritional supplement [Palliative package ^] Imaging,

CXR , USG ABDOMEN, CT

731 9.69* Anal Cancer MITOMYCIN, 5FU ULTRASOUND 3 to 4 months 4600 M5 M512071
Abdomen

Chest X ray, CT/MRI,

732 9.70* Head & Neck CISPLATIN WEEKLY CT Scan Xrays 5 to 6 weeks 4140 M5 M512072
Biopsy

733 9.71* Head & Neck TPF (DOCETAXEL ,CISPLATIN , 5-FU) X ray, CT, MRI Biopsy CT Scan X-rays 2 to 3 months 16330 M5 M512073

734 9.72# Head & Neck CISPLATIN + MTX X ray, CT, MRI Biopsy CT Scan X-rays 2 to 3 months 4600 M5 M512074

AFP , USG ABDOMEN, CT

735 9.73# HCC SORAFENIB ORAL USG ABDOMEN 4 to 8 months 8280 M5 M512075
Scan, Chest x ray

USG, Biopsy, CT Scan,

736 9.74# RCC SUNITINIB USG ABDOMEN 4 to 8 months 27600 M5 M512076
Chest x ray

MRI Brain, Biopsy with

737 9.75* Brain Tumour Tenozolamide, Procarbazine, CCNU, Vincristine Immunohistochemistry, X- MRI Brain, X-ay 6months 17480 M5 M512077
ray

MRI, CT scan, Biopsy with

Sarcoma- soft
738 9.76* Cisplatin/ Adriamycin/ Ifosphamides Immunohistochemistry, X- MRI, CT scan, X-ray 4 to 6 months 17250 M5 M512078
tissue
ray

CT scan, Biopsy, Tumor

Hepatobilliary CT scan, Tumor markers, X-ray,
739 9.77* Gemcitabine/ Oxaliplatin/ Capecitabine/ 5 FU markers, X-ray, 4 to 6 months 17480 M5 M512079
tumor Sonography
Sonography
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

CT scan, Biopsy, Tumor

CT scan, Tumor markers, X-ray,
740 9.78* Pancreatic cancer Gemcitabine/ Oxaliplatin/ Capecitabine/ 5 FU/Erlotinib markers, X-ray, 4 to 6 months 17480 M5 M512080
Sonography
Sonography

Endometrial CT scan/MRI study, X-ray,

741 9.79* Weekly Platin Paclitaxel/ Carboplatin CT scan, X-ray, Sonography 4 to 6 months 4830 M5 M512081
cancer Biopsy, Sonography

Biopsy report of proven

PET Study (All Cancer for all oncology cluster diagnostic or staging in proven cancer cancer of any past time
742 9.80 Oncology - - 15000 M5 M512082
patient) necessary for pre
authorisation
Cluster-10 RADIATION ONCOLOGY
Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Cobalt 60 external Clinical photograph, rt treatment

743 10.1 Radical treatment Usg/x-ray/ct, biopsy 6 to 7 weeks 23000 M6 M612001
beam radiotherapy charts

Cobalt 60 external Clinical photograph, rt treatment

744 10.2 Palliative treatment Usg/x-ray/ct, biopsy 3 weeks 11500 M6 M612002
beam radiotherapy charts

Cobalt 60 external Clinical photograph, rt treatment

745 10.3 Adjuvent therapy Usg/x-ray/ct, biopsy 4 weeks 23000 M6 M612003
beam radiotherapy charts

Clinical photograph, rt treatment

746 10.4 Linear accelerators Radical treatment with photons (linear accelarator) Usg/x-ray/ct, biopsy 6 to 7 weeks 66700 M6 M612004
charts

Clinical photograph, rt treatment

747 10.5 Linear accelerators Palliative treatment with photons (linear accelarator) Usg/x-ray/ct, biopsy 3 weeks 28750 M6 M612005
charts

Clinical photograph, rt treatment

748 10.6 Linear accelerators Adjuvant treatment with photons/electrons Usg/x-ray/ct, biopsy 4 weeks 51750 M6 M612006
charts

Weekly
Brachytherapy- Clinical photograph, rt treatment
749 10.7 Ii. Hdr per application Usg/x-ray/ct, biopsy application for 2 11500 M6 M612007
intracavitary-ii charts
to 5 weeks
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Brachytherapy- Clinical photograph, rt treatment

750 10.8 Ii. Hdr - one application and multiple dose fractions Usg/x-ray/ct, biopsy 5 days 11500 M6 M612008
interstitial-ii charts

LA with multi leaf USG/ X-ray/ CT/ MRI/

751 10.9 Radical treatment with IMRT USG/ X-ray/ CT/ MRI/ Biopsy 6 to 7 weeks 95450 M6 M612009
collimator Biopsy

LA with multi leaf USG/ X-ray/ CT/ MRI/

752 10.10 Radical treatment with IGRT USG/ X-ray/ CT/ MRI/ Biopsy 6 to 7 weeks 115000 M6 M612010
collimator Biopsy

LA with some USG/ X-ray/ CT/ MRI/

753 10.15 SRS (Stereotactic Radiosurgery) USG/ X-ray/ CT/ MRI/ Biopsy 1 day 143750 M6 M612011
accessories Biopsy

LA with some USG/ X-ray/ CT/ MRI/

754 10.16 SRT (Stereotactic Radiotherapy) USG/ X-ray/ CT/ MRI/ Biopsy 6 weeks 143750 M6 M612012
accessories Biopsy

755 10.17 Brain Tumour Gamma Knife / Cyber Knife CT CT 1 day 115000 M6 M612013

Total Body USG/ X-ray/ CT/ MRI/

756 10.19 Pre Bonemarrow/Stem Cell Transplant USG/ X-ray/ CT/ MRI/ Biopsy 6 to 7 weeks 66700 M6 M612014
Radiation Biopsy

Clinical photograph, rt treatment

757 10.20 Iodine Therapy Radio Iodine Therapy Usg,/x-ray,/ct,/biopsy Per dose 15000 M6 M612015
charts

Daily (5day x
EBRT (External Clinical photograph, rt treatment
758 10.21 SBRT (Sterotactic Beam RT) Usg,/x-ray,/ct,/biopsy week) 6 to 7 130000 M6 M612016
Beam RT) charts
weeks

Daily (5day x
Clinical photograph, rt treatment
759 10.22 EBRT 3DCRT (3 Dimentional Conformal RT) Usg,/x-ray,/ct,/biopsy week) 6 to 7 80000 M6 M612017
charts
weeks
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical photograph, rt treatment Total 5 to 10 Fraction

760 10.23 EBRT Electron Boost Usg,/x-ray,/ct,/biopsy 2 weeks 5000 M6 M612018
charts of 200 Gray each

Clinical photograph, rt treatment

761 10.24 EBRT Electron treatment curative Usg,/x-ray,/ct,/biopsy 6 to 7 weeks 66700 M6 M612019
charts

Clinical photograph, rt treatment

762 10.25 EBRT Rapidarc/VMAT Usg,/x-ray,/ct,/biopsy 6 to 7 weeks 130000 M6 M612020
charts

Clinical photograph, rt treatment 6.5 x 2

763 10.26 Brachytherapy Intraluminal Brachytherapy in addition to EBRT Usg,/x-ray,/ct,/biopsy 2 weeks 11500 M6 M612021
charts up to 55 Gray

Clinical photograph, rt treatment

764 10.27 Brachytherapy CT guided ICR (Intra Cavitory RT)in addition to EBRT Usg,/x-ray,/ct,/biopsy 2 weeks 16500 weekly upto 66 Gray M6 M612022
charts

Clinical photograph, rt treatment 6hourly two fraction

765 10.28 Brachytherapy CT guided Interstitial RT in addition to EBRT Usg,/x-ray,/ct,/biopsy 2 to 3 days 16500 M6 M612023
charts per day for two days

Clinical photograph, rt treatment

766 10.29 Brachytherapy MRI guided ICR in addition to EBRT Usg,/x-ray,/ct,/biopsy 2 weeks 16500 weekly upto 66 Gray M6 M612024
charts

Clinical photograph, rt treatment 6hourly two fraction

767 10.30 Brachytherapy MRI guided Interstial RT in addition to EBRT Usg,/x-ray,/ct,/biopsy 2 to 3 days 16500 M6 M612025
charts per day for two days

Radiation
768 10.31 Respiratory Gating along with Linear Accelerator planning CT, Biopsy Clinical Photo, RT Chart 70,000 M6 M600009
Oncology

Radiation
769 10.32 Tomotherapy(Radical/Adjuvant/Neoadjuvant) Blood test, CT, Biopsy Clinical Photo, RT Chart 75,000 M6 M600011
Oncology

Cluster-11 SURGICAL ONCOLOGY

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

770 11.2 Throat Microlaryngeal Surgery including Phonosurgery Biopsy, CT Scan/ MRI Biopsy 1 11500 S15 S1512001
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

771 11.3 Throat Excision/ Hypopharynx of Tumors in Pharynx Biopsy, CT Scan/ MRI Clinical Photograph, biopsy 1 23000 S15 S1512002

772 11.4 Pancreas Distal Pancreatectomy CT , CA 19-9, PET Scan Clinical Photograph 1 55000 S15 S1512003

773 11.5 Pancreas Enucleation of Cyst CT, CA 19-9 Clinical Photograph 1 35000 S15 S1500030

CT , ERCP, CA 19-9, PET

774 11.6 Pancreas Whipples - any type Clinical Photograph 1 75000 S15 S1512004
Scan, EUS

775 11.7 Spleen Splenectomy USG/CT Clinical Photograph , USG 1 30000 S15 S100132

Genito Urinary Biopsy , CT , IVP , KUB

776 11.8 Radical Nephrectomy Biopsy , Clinical Photograph , USG 1 34500 S15 S1512006
System ,USG

Genito Urinary Biopsy , CT , IVP , KUB

777 11.9 Radical Cystectomy Biopsy , Clinical Photograph , USG 1 60000 S15 S1512007
System ,USG

Genito Urinary Biopsy , CT , IVP , KUB

778 11.10 Other cystectomies Biopsy , Clinical Photograph , USG 1 40000 S15 S1512008
System ,USG

CT Scan (Abdomen,
Genito Urinary
779 11.11 High Orchidectomy Pelvis), Biopsy, USG, CT Biopsy , Clinical Photograph , USG 1 15000 S15 S1512009
System
Scan Thorax

Genito Urinary Biopsy , USG, Bone Scan,

780 11.12 Bilateral Orchidectomy Biopsy , Clinical Photograph , USG 1 11500 S15 S1512010
System Local X-ray

Biopsy, CT Scan
Genito Urinary
781 11.14 Total Penectomy (Abdomen, Pelvis),Clinical Biopsy , Clinical Photograph , USG 1 25000 S15 S1512011
System
Photograph

Genito Urinary Biopsy , Clinical

782 11.15 Inguinal Block Dissection-one side Biopsy , Clinical Photograph , USG 1 8740 S15 S1512012
System phtograph, CT Scan

Genito Urinary CT , KUB , USG, Bone Scan,

783 11.16 Radical Prostatectomy Biopsy , Clinical Photograph , USG 1 60000 S15 S1512013
System Biopsy

Biopsy, Clinical
Genito Urinary
784 11.17 Partial Penectomy Photograph, USG Biopsy , Clinical Photograph , USG 1 15000 S15 S1512014
System
Abdomen Pelvis

785 11.18 Gynaec Radical Hysterectomy Biopsy , CT , USG Biopsy , Clinical Photograph , USG 1 34500 S15 S1512015

CA 125, CEA, Biopsy/

Biopsy , Clinical Photograph , USG,
786 11.19 Gynaec Surgery for Ca Ovary - early stage cytology, aFP, ßHCG, LDH, 1 23000 S15 S1512016
Tumor Marker
X-ray chest
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

CA 125, CEA, Biopsy/

Biopsy , Clinical Photograph , USG,
787 11.20 Gynaec Surgery for Ca Ovary - advance stage cytology, aFP, ßHCG, LDH, 1 40000 S15 S1512017
Tumor Marker
X-ray chest

788 11.21 Gynaec Vulvectomy Biopsy, Photograph Biopsy , Clinical Photograph , USG 1 17250 S15 S1512018

Biopsy, X-rays,
Mammogram,
789 11.22 Breast Mastectomy - any type Biopsy , Clinical Photograph 1 25000 S15 S1512019
Photograph, USG, CT,
Bone scan

Biopsy, X-rays,
Mammogram,
790 11.23 Breast Axillary Dissection Biopsy , Clinical Photograph 1 23000 S15 S1500022
Photograph, USG, CT,
Bone scan

Biopsy, X-rays,
791 11.24 Breast Wide excision Mammogram, Biopsy , Clinical Photograph 1 11500 S15 S1512020
Photograph, USG, CT

CT/ Barium Meal Follow

792 11.25 Ca.Rectum Abdomino Perineal Resection (APR) +Sacrectomy Clinical Photograph, biopsy 1 50000 S15 S1512021
through

793 11.26 Ca. Gall Bladder Radical Cholecystectomy CT , USG, PET Scan Biopsy , Clinical Photograph , USG 1 60000 S15 S1500031

CT/BMFT,
794 11.27 Breast Wide excision + Reconstruction ( Pedicle flap) Colonoscopy,Biopsy, CEA, Clinical Photograph, biopsy 1 25000 S15 S1512022
PET Scan

Biopsy, X-rays,
795 11.28 Lung Cancer Pneumonectomy Mammogram, Biopsy , Clinical Photograph , USG 1 50000 S15 S100219
Photograph, USG, CT

Biopsy, X-rays,
796 11.29 Lung Cancer Lobectomy Mammogram, Biopsy , Clinical Photograph 1 50000 S15 S1312020
Photograph, USG, CT

Biopsy , CT , X-RAY, PET

797 11.30 Lung Cancer Decortication Biopsy , Clinical Photograph , X-RAY 1 40000 S15 S1312023
scan, CT brain

Biopsy , CT , X-RAY, PET

798 11.31 Lung Cancer Surgical Correction of Bronchopleural Fistula. Biopsy , Clinical Photograph , X-RAY 1 35000 S15 S1512026
scan (SOS)

Biopsy , CT , X-RAY, PET

799 11.32 Head &Neck Resection of Nasopharyngeal Tumor Biopsy , Clinical Photograph , X-RAY 1 50000 S15 S1500004
scan, CT brain
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

800 11.33 Head &Neck Craniofacial resection of any type Biopsy , CT , X-RAY Biopsy , Clinical Photograph , X-RAY 1 90000 S15 S1512027

801 11.34 A Head &Neck Composite Resection ANY TYPE Biopsy, CT/MRI Biopsy , Clinical Photograph 1 41250 S15 S1512028

802 11.34 B Head &Neck PEDICLE FLAP Reconstruction Biopsy, CT/MRI Biopsy , Clinical Photograph 1 13750 S15 S1512028

803 11.35 Head &Neck Neck Dissection - any type CT/ MRI, Biopsy Biopsy , Clinical Photograph 1 32200 S15 S1512029

Clinical Photograph/X-
804 11.36 Head &Neck Hemiglossectomy Clinical Photograph, biopsy 1 20700 S15 S1512030
Ray,USG/biopsy/CT

Biopsy , Clinical
805 11.37 Head &Neck Maxillectomy - any type Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 25000 S15 S1512031
CT Scan

Biopsy , Clinical
806 11.38 Head &Neck Thyroidectomy - any type Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 25000 S15 S1512032
MRI

x-ray of maxilla, CT/MRI,

807 11.39 Head &Neck Parotidectomy - any type biopsy and Clinical Photograph 1 20000 S15 S1512033
biopsy

Biopsy , Clinical
808 11.40 Head &Neck Laryngectomy - any type Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 40000 S15 S1512034
CT Scan

Biopsy , Clinical
809 11.41 Head &Neck Laryngopharyngo Oesophagectomy Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 70000 S15 S1512035
CT Scan

Biopsy , Clinical
810 11.42 Head &Neck Hemimandibulectomy Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 25000 S15 S1512036
CT Scan

Biopsy , Clinical
811 11.43 Head &Neck Wide excision Any type Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 11500 S15 S1512037
CT Scan

Biopsy , Clinical
812 11.44 Ca. Salivary Gland Submandibular Gland Excision Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 18400 S15 S1512038
OPG/CT scan
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Biopsy , Clinical
813 11.45 Ca. Trachea Tracheal Resection Biopsy , Clinical Photograph 1 50000 S15 S1500001
Photograph , USG , X-RAY

Biopsy , Clinical
814 11.46 Ca. Trachea Sternotomy + Superior Mediastinal Dissection Biopsy , Clinical Photograph 1 45000 S15 S1500002
Photograph , USG , X-RAY

815 11.47 Ca. Parathyroid Parathyroidectomy Biopsy, CT, Bronchoscopy Clinical Photograph, biopsy 1 20700 S15 S1512039

Ca. Gastro
816 11.48 Small bowel resection Biopsy, CT Clinical Photograph, biopsy 1 18400 S15 S1512040
Intestinal Tract

Biopsy , Clinical
Ca. Gastro
817 11.49 Closure of Ileostomy/ Colostomy Photograph , USG , X-RAY, Biopsy , Clinical Photograph 1 8050 S15 S1512041
Intestinal Tract
Serum Parathormone

818 11.50 Spleen Radical Splenectomy CT , USG Biopsy , Clinical Photograph , USG 1 30000 S15 S1512042

Gastro Intestinal Barium meal test, CT

819 11.51 Resection of Retroperitoneal Tumors Biopsy, clinical photograph 1 45000 S15 S1512043
System abdomen, biopsy

Gastro Intestinal
820 11.52 Abdominal wall tumor Resection USG, CT abdomen, biopsy BIOPSY, CLINICAL PHOTOGRAPH 1 35000 S15 S1500032
System

Gastro Intestinal
821 11.53 Resection with reconstruction USG, CT abdomen, biopsy BIOPSY, CLINICAL PHOTOGRAPH 1 20700 S15 S1500033
System

Gastro Intestinal Biopsy , CT , Endoscopy

822 11.55 Oesophagectomy - any type Biopsy , Clinical Photograph , USG 1 60000 S15 S1512044
System ,USG, PET SCAN

Gastro Intestinal Biopsy , CT , Endoscopy

823 11.56 Gastrectomy - any type Biopsy , Clinical Photograph , USG 1 40000 S15 S1512045
System ,USG, PET SCAN

Gastro Intestinal Biopsy , CT , Endoscopy ,

824 11.57 Colectomy - any type Biopsy , Clinical Photograph , USG 1 40000 S15 S1512046
System USG, CEA

Gastro Intestinal Biopsy , CT , Endoscopy ,

825 11.58 Anterior Resection Biopsy , Clinical Photograph , USG 1 50000 S15 S1512047
System USG, CEA

Gastro Intestinal Biopsy , CT , Endoscopy ,

826 11.59 Abdominoperinial Resection Biopsy , Clinical Photograph , USG 1 40000 S15 S1512048
System USG, CEA
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Gastro Intestinal Biopsy , CT , Endoscopy ,

827 11.60 Triple Bypass Biopsy , Clinical Photograph , USG 1 23000 S15 S1500035
System USG

Gastro Intestinal Biopsy , CT , Endoscopy ,

828 11.61 Other GI Bypasses surgery any type (including pancreas) Biopsy , Clinical Photograph , USG 1 25000 S15 S1512049
System USG

829 11.62 Gynaec Radical Trachelectomy CT/MRI, Biopsy Clinical Photograph, biopsy 1 35000 S15 S1500043

830 11.63 Gynaec Radical vaginectomy CT, Biopsy Clinical Photograph, biopsy 1 26450 S15 S1500040

831 11.64 Gynaec Radical vaginectomy + Reconstruction CT, Biopsy Clinical Photograph, biopsy 1 45000 S15 S1500041

Radical Hysterectomy +Bilateral Pelvic Lymph Node Dissection (BPLND) + Bilateral

832 11.65 Gynaec-Ca.Cervix Pap Smear / biopsy, CT Clinical Photograph, biopsy 1 45000 S15 S1500037
Salpingo Ophorectomy (BSO) / Ovarian transposition

833 11.66 Gynaec-Ca.Cervix Anterior Exenteration (Gynaec) Pap Smear / biopsy, CT Clinical Photograph, biopsy 1 60000 S15 S1512050

834 11.67 Gynaec-Ca.Cervix Posterior Exenteration (Gynaec) Pap Smear / biopsy, CT Clinical Photograph, biopsy 1 50000 S15 S1512051

835 11.68 Gynaec-Ca.Cervix Total Pelvic Exenteration Pap Smear / biopsy, CT Clinical Photograph, biopsy 1 75000 S15 S1512052

Biopsy, CT Chest, Bone

836 11.69 Chest Chest wall resection for SOFT tissue bone tumors Clinical Photograph, biopsy 1 9660 S15 S1512053
Scan

Biopsy, CT Chest, Bone

837 11.70 Chest Chest wall resection + Reconstruction Clinical Photograph, biopsy 1 30000 S15 S1500048
Scan

Bone / soft tissue CT-Local part, CT

838 11.71 Limb salvage surgery for Bone Tumors with modular Prosthesis Clinical Photograph, biopsy 1 75000 S15 S1500045
tumors Chest,MRI, Bone Scan

Bone / soft tissue

839 11.72 Forequarter amputation Biopsy, CT Chest Clinical Photlograph/ X-Ray, biopsy 1 30000 S15 S1512054
tumors

Bone / soft tissue Biopsy, CT/MRI Pelvis, CT

840 11.73 Hemipelvectomy Clinical Photlograph/ X-Ray, biopsy 1 55000 S15 S1500046
tumors Chest, PET scan
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Bone / soft tissue

841 11.74 Bone resection CT/MRI, Biopsy Clinical Photograph/X-ray, biopsy 1 30000 S15 S1512055
tumors

842 11.75 Renal Cell Cancer Partial Nephrectomy CT/Isotope renogram Clinical Photograph, biopsy 1 40000 S15 S1512056

843 11.76 Renal Cell Cancer Nephroureterectomy for Transitional Cell Carcinoma of renal pelvis (one side) CT, Biopsy Clinical Photograph, biopsy 1 46000 S15 S1512057

CT-Chest, CT.Abd+Pelvis,
844 11.77 Testes cancer Retro Peritoneal Lymph Node Dissection(RPLND) (for Residual Disease) Clinical Photograph, biopsy 1 60000 S15 S1512058
Tumor markers, biopsy

CT/MRI, Urinary
845 11.78 Tumours Adrenalectomy Clinical Photograph, biopsy 1 45000 S15 S1512059
hormones

846 11.79 Testes cancer Urinary diversion biopsy, USG Scrotum Clinical Photograph, biopsy 1 40000 S15 S1512060

847 11.80 Testes cancer Retro Peritoneal Lymph Node Dissection RPLND as part of staging CT, biopsy Clinical Photograph, biopsy 1 23000 S15 S1512061

Ca. Urinary
848 11.81 Anterior Exenteration (Urinary Bladder) Cystoscopy, biopsy/CT Clinical Photograph, biopsy 1 60000 S15 S1512062
Bladder

Ca. Urinary
849 11.82 Total Exenteration (Urinary Bladder) Cystoscopy, biopsy/CT Clinical Photograph, biopsy 1 75000 S15 S1512063
Bladder

Ca. Urinary
850 11.83 Bilateral pelvic lymph Node Dissection(BPLND) CT, biopsy Clinical Photograph, biopsy 1 25000 S15 S1500042
Bladder

Thoracic and
851 11.84 Mediastinal tumor resection CT Clinical Photograph, biopsy 1 50000 S15 S1512064
Mediastinum

CT, biopsy, Bone scan/

852 11.85 Lung Lung metastatectomy of any type X-Ray, Biospy 1 35000 S15 S1512065
PET scan

CT/ Bronchoscopy, biopsy,

853 11.86 Lung Sleeve resection of Lung cancer. X-Ray, Biospy 1 90000 S15 S1500027
PET scan

UGI Endoscopy, biopsy /

854 11.87 Esophagus Oesophagectomy with Two field Lymphadenectomy Clinical Photograph, biopsy 1 80000 S15 S1500028
CT
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

UGI Endoscopy, biopsy /

855 11.88 Esophagus Oesophagectomy with Three field Lymphadenectomy Clinical Photograph, biopsy 1 80000 S15 S1500029
CT

856 11.89 Palliative Surgeries Tracheostomy Clinical Photograph Clinical Photograph 1 5520 S15 S1500021

857 11.90 Palliative Surgeries Gastrostomy Clinical Photograph Clinical Photograph 1 15000 S15 S100064

858 11.91 Palliative Surgeries Jejunostomy Clinical Photograph Clinical Photograph 1 15000 S15 S100088

859 11.92 Palliative Surgeries Ileostomy Clinical Photograph Clinical Photograph 1 15000 S15 S100095

860 11.93 Palliative Surgeries Colostomy Clinical Photograph Clinical Photograph 1 15000 S15 S100018

861 11.94 Palliative Surgeries Suprapubic Cystostomy Clinical Photograph Clinical Photograph 1 10000 S15 S1512070

USG, CT SCAN, Clinical

862 11.95 Palliative Surgeries Gastro Jejunostomy Clinical Photograph, biopsy 1 20000 S15 S1512071
Photograph

CT SCAN, USG, Endoscopy,

863 11.96 Palliative Surgeries Ileotransverse BYPASSColostomy Biopsy, Clinical Clinical Photograph, biopsy 1 9890 S15 S1512072
Photograph

CT SCAN, USG, Endoscopy,

864 11.97 Palliative Surgeries Substernal bypass Biopsy, Clinical Clinical Photograph, biopsy 1 35000 S15 S1500003
Photograph

865 11.98 Reconstruction Myocutaneous / cutaneous flap Clinical Photograph Clinical Photograph 1 25000 S15 S1500005

Doppler study, Clinical

866 11.99 Reconstruction Micro vascular reconstruction Clinical Photograph 1 45000 S15 S1500009
Photograph

Soft Tissue and Clinical Photograph,

867 11.100 Wide excision - for soft tissue and bone tumors Clinical Photograph, biopsy 1 12650 S15 S1512073
Bone Tumors biopsy

Soft Tissue and Clinical Photograph,

868 11.101 Wide excision + Reconstruction for soft tissue and bone tumors Clinical Photograph, biopsy 1 25000 S15 S1512074
Bone Tumors biopsy

Soft Tissue and Clinical Photograph,

869 11.102 Amputation for bone / soft tissue tumours (Major / Minor) Clinical Photograph, Biopsy 1 25000 S15 S1512075
Bone Tumors biopsy

Genito Urinary Biopsy, Clinical

870 11.103 Inguinal Block Dissection-both side Biopsy, Clinical Photograph, USG 1 16100 S15 S1512076
System Photograph, CT scan
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

CT/ BMFT, Colonoscopy,

871 11.104 Ano-rectal Low Anterior resection OR Sphincter preserving surgery of any type Biopsy, Clinical Photograph, USG 1 40000 S15 S1512077
Biopsy, CEA

Barium meal test, CT

Gastro Intestinal
872 11.105 Laproscopic resection of any type abdomen, biopsy, Biopsy, Clinical Photograph, USG 1 50000 S15 S1512078
Surgery
Endoscopy, Tumor Marker

CT abdomen, biopsy,
873 11.106 Liver Hepatic surgery of any type Biopsy, Clinical Photograph, USG 1 70000 S15 S1512079
Endoscopy, Tumor Marker

Lung & CT abdomen, biopsy,

874 11.107 Thoracoscopic and Laproscopic surgery of any type Biopsy, Clinical Photograph, USG 1 60000 S15 S1512080
Oesophagus Endoscopy

Genito Urinary CT abdomen, biopsy,

875 11.108 Laproscopic surgery for kidney & supra renal any type Biopsy, Clinical Photograph, USG 1 40000 S15 S1512081
System Endoscopy

876 11.109 Brain Tumour Brain tumours surgery of any type CT/ MRI, Biopsy CT, Photograph 1 55000 S15 S1512082

Gynaec Body of Biopsy, CT scan, USG, CA

877 11.110 TAH + BSO + BLND + O.S. CT, Biopsy, Photograph 1 45000 S15 S1512083
the uterus 125

MRI, Bone scan & PET

878 11.111 Bone & soft tissue Hind Quarter Amputation CT, Biopsy, Photograph 1 40000 S15 S1512084
scan

879 11.112 Bone & soft tissue Hip & Knee Disarticulation MRI Photograph 1 45000 S15 S1512085

Gynaec CIN Early

Biopsy, CT scan, USG, CA
880 11.113 cancer of any Radical Trachelectomy Cone Biopsy, Simple Hysterectomy Biopsy, USG 1 40000 S15 S1512086
125
female organ

All System Pre

881 11.114 malignant and Laser Surgery Any type Usg,/x-ray,/ct,/biopsy clinical photograph 1 15000 S15 S1512087
Malignant Lesion

Usg,/x-ray,/ct,/biopsy
882 11.115 Head & Neck Flap Cutting any type clinical photograph 1 5000 S15 S1512088
previous procedure report
883 11.116 Head & Neck Eyeball enucleation Usg,/x-ray,/ct,/biopsy clinical photograph 3 15000 S15 S1512089

For All Long term

884 11.117 PICC (For cluster 9 user also) Usg,/x-ray,/ct,/biopsy clinical photograph 3 10000 S15 S1512090
Chemotherapy

For All Long term

885 11.118 Port Insertion (For cluster 9 user also) Usg,/x-ray,/ct,/biopsy clinical photograph 3 15000 S15 S1512091
Chemotherapy

886 11.119 Palliative Surgeries ICD Tube Insertion Usg,/x-ray,/ct,/biopsy clinical photograph 0 1500 S15 S1512092
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

887 11.120 Pancreas Wide Excision any type (Surgery other than Whipples) Usg,/x-ray,/ct,/biopsy clinical photograph 3 50000 S15 S1512093

888 11.121 Palliative Surgeries Drain Insertion any type Usg,/x-ray,/ct,/biopsy clinical photograph 0 1500 S15 S1512094

Any Wound Gap Usg,/x-ray,/ct,/biopsy

889 11.122 Resuturing clinical photograph 1 3000 S15 S1512095
Surgery previous procedure report
890 11.123 Larynx Voice prosthesis Biopsy, CECT Invoice of prosthesis, scar photo 30,000 S15 S1500018
Biopsy, Blood Routine
891 11.124 Skin Skin Tumours Wide Excision + Reconstruction clinical photograph 25,000 S15 S1500038
(CBC), CT Scan
Biopsy, Blood Routine
892 11.125 Skin Skin Tumours Amputation clinical photograph 25,000 S15 S1500039
(CBC), CT Scan

893 11.126 Oncosurgery Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per family) Concern Investigation Concern Investigation 1,00,000 S15 U100

Cluster-14 PROCEDURES FOR KNEE & HIP REPLACEMENT

Package Rates Package Rates for

Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up for Private Government Procedure Code PMJAY
Investigation PMJAY
Hospitals Hospitals

Haematology, Serum
Primary Hip replacement
Biochemistry, Viral Clinical Photograph,
894 14.1 Hip Replacement (With Implant) Cemented THR 3 1,00,000 50000 S5 S512001
markers, Clinical X-RAY
(Indian Implant)
Photograph, X-RAY

Haematology, Serum
Primary Hip replacement
Biochemistry, Viral Clinical Photograph,
895 14.2 Hip Replacement (With Implant) Cemented THR 3 1,20,000 70000 S5 S512002
markers, Clinical X-RAY
(Imported Implant)
Photograph, X-RAY

Haematology, Serum
Primary Hip replacement Biochemistry, Viral Clinical Photograph,
896 14.3 Hip Replacement 3 1,20,000 70000 S5 S512003
(With Implant) Uncemented THR (Indian Implant) markers, Clinical X-RAY
Photograph, X-RAY

Haematology, Serum
Primary Hip replacement
Biochemistry, Viral Clinical Photograph,
897 14.4 Hip Replacement (With Implant) Uncemented THR 3 1,30,000 85000 S5 S512004
markers, Clinical X-RAY
(Imported Implant)
Photograph, X-RAY

Haematology, Serum
Revision Hip Replacement Biochemistry, Viral Clinical Photograph,
898 14.5 Hip Replacement 3 3,00,000 2,25,000 S5 S512005
(With Implant) All component Revision markers, Clinical X-RAY
Photograph, X-RAY

Haematology, Serum
Revision Hip Replacement Biochemistry, Viral Clinical Photograph,
899 14.6 Hip Replacement 3 2,00,000 1,30,000 S5 S512006
(With Implant) Acetabular Component with cage markers, Clinical X-RAY
Photograph, X-RAY
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Haematology, Serum
Revision Hip Replacement Biochemistry, Viral Clinical Photograph,
900 14.7 Hip Replacement 3 2,50,000 1,80,000 S5 S512007
(With Implant) Acetabular Component with pelvic Augments markers, Clinical X-RAY
Photograph, X-RAY

Haematology, Serum
Revision Hip Replacement Biochemistry, Viral Clinical Photograph,
901 14.8 Hip Replacement 3 2,00,000 1,40,000 S5 S512008
(With Implant) Stem Replacement markers, Clinical X-RAY
Photograph, X-RAY

Haematology, Serum
Biochemistry, Viral
Primary Knee Replacement markers, Clinical
902 14.9 Knee Replacement (With Implant) Metal Back Photograph, X-RAY, Clinical Photograph, X-RAY 3 1,10,000 65000 S5 S512009
(Indian Implant) Bilateral Lower Limb
Standing ORG/CT
scanogram

Haematology, Serum
Biochemistry, Viral
Primary Knee Replacement markers, Clinical
903 14.10 Knee Replacement (With Implant) Metal Back Photograph, X-RAY, Clinical Photograph, X-RAY 3 1,30,000 75000 S5 S512010
(Imported Implant) Bilateral Lower Limb
Standing ORG/CT
scanogram

Haematology, Serum
Biochemistry, Viral
Primary Knee Replacement markers, Clinical
904 14.11 Knee Replacement (With Implant) All Poly Photograph, X-RAY, Clinical Photograph, X-RAY 3 80000 45000 S5 S512011
(Indian Implant) Bilateral Lower Limb
Standing ORG/CT
scanogram

Haematology, Serum
Biochemistry, Viral
Primary Knee Replacement markers, Clinical
905 14.12 Knee Replacement (With Implant) All Poly Photograph, X-RAY, Clinical Photograph, X-RAY 3 90000 50000 S5 S512012
(Imported Implant) Bilateral Lower Limb
Standing ORG/CT
scanogram

Haematology, Serum
Biochemistry, Viral
markers, Clinical
906 14.13 Knee Replacement Revision Knee Replacement for Long Stem without Augment Photograph, X-RAY, Clinical Photograph, X-RAY 3 2,50,000 1,75,000 S5 S512013
Bilateral Lower Limb
Standing ORG/CT
scanogram

Haematology, Serum
Biochemistry, Viral
markers, Clinical
907 14.14 Knee Replacement Revision Knee Replacement With Augment Support Photograph, X-RAY, Clinical Photograph, X-RAY 3 3,00,000 2,25,000 S5 S512014
Bilateral Lower Limb
Standing ORG/CT
scanogram
Cluster-15 ORGAN TRANSPLANT PACKAGES
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Pre-Operative Speciality Code

Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Blood group, FBS, PPBS,

ELISA
USG ABDOMEN, Urine
R/M and C/S
CBC, RFT, LFT, Uric acid,
PTH, Lipid profile, Iron
Kidney profile, CMV IgG and IgM
908 15.1 Kidney transplantation Laparoscopic Donor nephrectomy RFT 60000 S17 S1712001
transplantation BT, CT, PT, G6PD
2D Echocardiogram
Chest X Ray, ECG, DTPA
Renogram, PAP smear
(female)
CT Angiogram for kidney
vessel

Open Kidney transplantation from living donor Part-1 Investigations

Blood group, HbA1C, FBS, PPBS, ELISA, HCV RNA Qualitative, CMV IgG and IgM
USG Abdomen,
Urine R/M and C/S
iPTH, Vit D, Uric Acid
Kidney
909 15.2 A BT,CT, PT, aPTT, G6PD level 15000 S17 S1712002
transplantation
Chest X Ray, ECG, 2D echocardiogram
Lipid Profile, Anticardiolipin Antibody, Lupus Anticoagulant, C3, C4, ANA, dsDNA,
pANCA, cANCA, USG Doppler Neck vessels
Usg Doppler Iliofemoral Vessels
MCU, Uroflowmetry

Open Kidney transplantation from living donor Part-2 Investigations

Kidney HLA Typing
910 15.2 B 22500 S17 S1712003
transplantation LCM, FCM
Single Antigen Qualitative

Open Kidney transplantation from living donor Part-3 Investigation

Kidney
911 15.2 C Single Antigen Quantitative 22500 S17 S1712004
transplantation

Kidney Open Kidney transplantation from living donor Part-4 Operative Part S. Creatinine, USG kidney graft,
912 15.2 D 240000 S17 S1712005
transplantation Doppler study for graft
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Open Kidney transplantation from deceased donor Part-1 Investigations

Blood group, HbA1C, FBS, PPBS, ELISA, HCV RNA Qualitative, CMV IgG and IgM
USG Abdomen,
Urine R/M and C/S
iPTH, Vit D, Uric Acid
Kidney
913 15.3 A BT, CT, PT, aPTT, G6PD level 18000 S17 S1712006
transplantation
Chest X Ray, ECG, 2D echocardiogram
Lipid Profile, Anticardiolipin Antibody, Lupus Anticoagulant, C3, C4, ANA, dsDNA,
pANCA, cANCA, USG Doppler Neck vessels
Usg Doppler Iliofemoral Vessels
MCU, Uroflowmetry

Open Kidney transplantation from deceased donor Part-2 Investigations

Kidney HLA Typing
914 15.3 B 27000 S17 S1712007
transplantation LCM, FCM
Single Antigen Qualitative

Open Kidney transplantation from deceased donor Part=3 InvestigationSingle Antigen

Kidney
915 15.3 C Quantitative 27000 S17 S1712008
transplantation

Kidney Open Kidney transplantation from deceased donor Part-4 Operative Part S. Creatinine, USG kidney graft,
916 15.3 D 288000 S17 S1712009
transplantation Doppler study for graft

Open dual Kidney transplantation from deceased donor Part-1 Investigations

Blood group ,HbA1C, FBS, PPBS, ELISA, HCV RNA Qualitative, CMV IgG and IgM
USG Abdomen,
Urine R/M and C/S
iPTH, Vit D, Uric Acid
Kidney
917 15.4 A BT,CT, PT,aPTT,. G6PD level 20000 S17 S1712010
transplantation
Chest X Ray, ECG, 2D echocardiogram
Lipid Profile, Anticardiolipin Antibody, Lupus Anticoagulant, C3, C4, ANA, dsDNA,
pANCA, cANCA,USG Doppler Neck vessels
Usg Doppler Iliofemoral Vessels
MCU, Uroflowmetry

Open dual Kidney transplantation from deceased donor Part-2 Investigations

Kidney HLA Typing
918 15.4 B 30000 S17 S1712011
transplantation LCM, FCM
Single Antigen Qualitative
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Kidney Open dual Kidney transplantation from deceased donor Part=3 Investigation
919 15.4 C 30000 S17 S1712012
transplantation Single Antigen Quantitative

Kidney S. Creatinine, USG kidney graft,Doppler

920 15.4 D Open dual Kidney transplantation from deceased donor Part - 4 Operative Part 320000 S17 S1712013
transplantation for both kidney grafts

Kidney USG and Doppler study of

921 15.5 Wound exploration for kidney graft nephrectomy Clinical photo, S. Creatinine 40000 S17 S1712014
transplantation kidney allograft

Robotic kidney transplantation from living donor Part-1 Investigations

Blood group, HbA1C, FBS, PPBS, ELISA, HCV RNA Qualitative, CMV IgG and IgM
USG Abdomen,
Urine R/M and C/S
iPTH, Vit D, Uric Acid
Kidney
922 15.6 A BT, CT, PT, aPTT, G6PD level 22000 S17 S1712015
transplantation
Chest X Ray, ECG, 2D echocardiogram
Lipid Profile, Anticardiolipin Antibody, Lupus Anticoagulant, C3, C4, ANA, dsDNA,
pANCA, cANCA,USG Doppler Neck vessels
Usg Doppler Iliofemoral Vessels
MCU, Uroflowmetry

Robotic kidney transplantation from living donor Part-2 Investigations

Kidney HLA Typing
923 15.6 B 33000 S17 S1712016
transplantation LCM, FCM
Single Antigen Qualitative

Kidney Robotic kidney transplantation from living donor Part-3 Investigation

924 15.6 C 33000 S17 S1712017
transplantation Single Antigen Quantitative

Kidney
925 15.6 D Robotic kidney transplantation from living donor Part - 4 Operative Part S. Creatinine, USG kidney graft 352000 S17 S1712018
transplantation
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Robotic kidney transplantation from deceased donor Part-1 Investigations

Blood group ,HbA1C, FBS, PPBS, ELISA, HCV RNA Qualitative, CMV IgG and IgM
USG Abdomen,
Urine R/M and C/S
iPTH, Vit D, Uric Acid
Kidney
926 15.7 A BT,CT, PT,aPTT,. G6PD level 23000 S17 S1712019
transplantation
Chest X Ray, ECG, 2D echocardiogram
Lipid Profile, Anticardiolipin Antibody, Lupus Anticoagulant, C3, C4, ANA, dsDNA,
pANCA, cANCA,USG Doppler Neck vessels
Usg Doppler Iliofemoral Vessels
MCU, Uroflowmetry

Robotic kidney transplantation from deceased donor Part-2 Investigations

Kidney HLA Typing
927 15.7 B 34500 S17 S1712020
transplantation LCM, FCM
Single Antigen Qualitative

Robotic kidney transplantation from deceased donor Part-3 Investigation

Kidney
928 15.7 C Single Antigen Quantitative 34500 S17 S1712021
transplantation

Kidney
929 15.7 D Robotic kidney transplantation from deceased donor Part - 4 Operative Part S. Creatinine, USG kidney graft 368000 S17 S1712022
transplantation

Robotic dual kidney transplantation from deceased donor Part-1 Investigations

Blood group, HbA1C, FBS, PPBS, ELISA, HCV RNA Qualitative, CMV IgG and IgM
USG Abdomen,
Urine R/M and C/S
iPTH, Vit D, Uric Acid
Kidney
930 15.8 A BT, CT, PT, aPTT, G6PD level 24000 S17 S1712023
transplantation
Chest X Ray, ECG, 2D echocardiogram
Lipid Profile, Anticardiolipin Antibody, Lupus Anticoagulant, C3, C4, ANA, dsDNA,
pANCA, cANCA, USG Doppler Neck vessels
Usg Doppler Iliofemoral Vessels
MCU, Uroflowmetry

Robotic dual kidney transplantation from deceased donor Part-2 Investigations

Kidney HLA Typing
931 15.8 B 36000 S17 S1712024
transplantation LCM, FCM
Single Antigen Qualitative
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Kidney Robotic dual kidney transplantation from deceased donor Part-3 Investigation
932 15.8 C 36000 S17 S1712025
transplantation Single Antigen Quantitative

Kidney Clinical photograph, S. Creatinine, USG

933 15.8 D Robotic dual kidney transplantation from deceased donor Part-4 Operative Part 384000 S17 S1712026
transplantation kidney graft

Single antigen qualitative

Kidney Plasmapheresis for acute B cell rejection Albumin and Rituximab based protocol ( Single antigen qualitative and 49,000* per sittings
934 15.9* and quantitative, Flow 49,000 S17 S1712027
transplantation Rate is per sittings with limit of 4 sittings) quantitative, Flow Cytometry with limit of 4 sittings
Cytometry, Kidney biospy

Single antigen qualitative

Kidney Plasmapheresis for highly sensitized recipient Albumin and Rituximab based protocol Single antigen qualitative and 37,500* per sittings
935 15.10 and quantitative, Flow 37,500 S17 S1712028
transplantation (rate is per sittings with limit of 4 sittings) quantitative, Flow Cytometry with limit of 4 sittings
Cytometry

Monthly investigations and immunosuppression from discharge after kidney

CBC, RFT, RBS, Urine,
Kidney transplant Include Prednisolone ,Tacrolimus 4mg/day, Mycophenolate 360 or 500 mg CBC, RFT, RBS, Urine, Graft Doppler, 10,000* Rate per
936 15.11 Graft Doppler, Tacrolimus 10,000 S17 S1712029
transplantation (4 tables) /day, Valgancyclovir 450 mg OD, Fluconazole 100mg OD, Sepmax OD (Rate Tacrolimus level(monthly) month
level
is per

Monthly investigations and immunosuppression after kidney transplant Include

Kidney
937 15.12 Prednisolone,Tacrolimus 4mg/day,Mycophenolate 360 or 500 mg (4 tables) /day, CBC, RFT, RBS, Urine CBC, RFT, RBS, Urine 5,000 * Rate per month S17 S1712030
transplantation
Sepmax OD (Package Rate per month)

Blood culture, CBC, RFT,

Treatment of Invasive fungal infection after kidney transplant Include Liposomal RBS, XR Chest, CT of organ
Kidney Amphotericin 300MG /day(5mg/kg for 60 kg person) for 30 days and Surgical of invasion (plain) , Urine Blood culture, CBC, RFT, RBS, XR Chest, * Rate per day with
938 15.13 12,000 S17 S1712031
transplantation debridement Hospital stay for 10 days ,ICU stay for 10 d (Rate per day with limit of Routine and culture, CT Thorax limit of 30 days
30 days) Endoscopy for fluid and
reports, BAL charges

Kidney graft biopsy, CBC,

RFT, RBS, XR Chest, CT of
organ of invasion (Plain),
Kidney CMV infection after kidney transplant Include IV gancyclovir 500 mg / Hospital stay CBC, RFT, RBS, XR Chest, Tacrolimus
939 15.14 A Graft Doppler, Tacrolimus 18000 S17 S1712032
transplantation for 14 day, tab.Valgancyclovir 450 mg OD for 3-7 days level, CMV DNA quantity
level, CMV DNA quantity,
BKV DNA quantity, Urine
routine and culture
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Kidney graft biopsy, CBC,

RFT, RBS, XR Chest, CT of
organ of invasion (Plain),
Kidney CMV infection after kidney transplant Include IV gancyclovir 500 mg / Hospital stay CBC, RFT, RBS, XR Chest, Tacrolimus
940 15.14 B Graft Doppler, Tacrolimus 36000 S17 S1712033
transplantation for 14 day, tab.Valgancyclovir 450 mg OD for 8-12 days level, CMV DNA quantity
level, CMV DNA quantity,
BKV DNA quantity, Urine
routine and culture

Kidney graft biopsy, CBC,

RFT, RBS, XR Chest, CT of
organ of invasion (Plain),
Kidney CMV infection after kidney transplant Include IV gancyclovir 500 mg / Hospital stay CBC, RFT, RBS, XR Chest, Tacrolimus
941 15.14 C Graft Doppler, Tacrolimus 60000 S17 S1712034
transplantation for 14 day, tab.Valgancyclovir 450 mg OD for 13 and above Days level, CMV DNA quantity
level, CMV DNA quantity,
BKV DNA quantity, Urine
routine and culture

Single antigen quantity

Kidney graft biopsy , CBC
Single antigen quantity , CBC,
RFT, RBS, XR Chest, CT
RFT, RBS, XR Chest,
Thorax,
Treatment for B cell rejection with Therapeutic Plasma exchange with ALBUMIN +IVIG Tacrolimus level,
Kidney Graft Doppler, Tacrolimus
942 15.15 A 5 gm (4 sessions), Inj Rituximab 200 mg or Inj Boretezomib 2 mg (4 doses) CMV DNA quantity, 67500 S17 S1712035
transplantation level
IV methyl prednisolone, Hospital stay for3-7 days BKV DNA quantity
CMV DNA quantity, BKV
DNA quantity, Urine CS

Single antigen quantity

Kidney graft biopsy , CBC
Single antigen quantity , CBC,
RFT, RBS, XR Chest, CT
RFT, RBS, XR Chest,
Thorax,
Treatment for B cell rejection with Therapeutic Plasma exchange with ALBUMIN +IVIG Tacrolimus level,
Kidney Graft Doppler, Tacrolimus
943 15.15 B 5 gm (4 sessions), Inj Rituximab 200 mg or Inj Boretezomib 2 mg (4 doses) CMV DNA quantity, 135000 S17 S1712036
transplantation level
IV methyl prednisolone, Hospital stay for 8-13 Days BKV DNA quantity
CMV DNA quantity, BKV
DNA quantity, Urine CS

Single antigen quantity

Kidney graft biopsy , CBC
Single antigen quantity , CBC,
RFT, RBS, XR Chest, CT
RFT, RBS, XR Chest,
Thorax,
Treatment for B cell rejection with Therapeutic Plasma exchange with ALBUMIN +IVIG Tacrolimus level,
Kidney Graft Doppler, Tacrolimus
944 15.15 C 5 gm (4 sessions), Inj Rituximab 200 mg or Inj Boretezomib 2 mg (4 doses) CMV DNA quantity, 225000 S17 S1712037
transplantation level
IV methyl prednisolone, Hospital stay for 13 Days abd above BKV DNA quantity
CMV DNA quantity, BKV
DNA quantity, Urine CS
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Single antigen quantity

Kidney graft biopsy, CBC
RFT, RBS, XR Chest, CT CBC,
Thorax, Graft Doppler, RFT, RBS, XR Chest,
Kidney Treatment for T cell rejection with thymoglobulin IV methyl prednisolone, IV
945 15.16 A Tacrolimus level Tacrolimus level, 39000 S17 S1712038
transplantation thymoglobulin 75 mg, Hospital stay for 3-7 days
CMV DNA quantity, BKV CMV DNA quantity, BKV DNA quantity
DNA quantity, Urine CS

Single antigen quantity

Kidney graft biopsy, CBC
RFT, RBS, XR Chest, CT CBC,
Thorax, Graft Doppler, RFT, RBS, XR Chest,
Kidney Treatment for T cell rejection with thymoglobulin IV methyl prednisolone, IV
946 15.16 B Tacrolimus level Tacrolimus level, 78000 S17 S1712039
transplantation thymoglobulin 75 mg, Hospital stay for 8-12 days
CMV DNA quantity, BKV CMV DNA quantity, BKV DNA quantity
DNA quantity, Urine CS

Single antigen quantity

Kidney graft biopsy, CBC
RFT, RBS, XR Chest, CT CBC,
Thorax, Graft Doppler, RFT, RBS, XR Chest,
Kidney Treatment for T cell rejection with thymoglobulin IV methyl prednisolone, IV
947 15.16 C Tacrolimus level Tacrolimus level, 130000 S17 S1712040
transplantation thymoglobulin 75 mg, Hospital stay for 13 and above Days
CMV DNA quantity, BKV CMV DNA quantity, BKV DNA quantity
DNA quantity, Urine CS

Blood culture, CBC, RFT,

RBS
XR Chest, CT Thorax, Graft
Blood culture ,CBC,RFT,RBS
Doppler
Chest Infection after transplant with 10day ICU care with Ventilator, isolation ward XR Chest,
Tacrolimus level, CMV
Kidney for 3-10 days CT Thorax,
948 15.17 A DNA quantity, BKV DNA 75000 S17 S1712041
transplantation Tacrolimus level,
quantity
Urine culture
Urine culture,
Bronchoscopy charges and
reports

Blood culture, CBC, RFT,

RBS
XR Chest, CT Thorax, Graft
Blood culture ,CBC,RFT,RBS
Doppler
Chest Infection after transplant with 10day ICU care with Ventilator, isolation ward XR Chest,
Tacrolimus level, CMV
Kidney for 11-20 days CT Thorax,
949 15.17 B DNA quantity, BKV DNA 112500 S17 S1712042
transplantation Tacrolimus level,
quantity
Urine culture
Urine culture,
Bronchoscopy charges and
reports
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Blood culture, CBC, RFT,

RBS
XR Chest, CT Thorax, Graft
Blood culture ,CBC,RFT,RBS
Doppler
Chest Infection after transplant with 10day ICU care with Ventilator, isolation ward XR Chest,
Tacrolimus level, CMV
Kidney for 21 and above days CT Thorax,
950 15.17 C DNA quantity, BKV DNA 150000 S17 S1712043
transplantation Tacrolimus level,
quantity
Urine culture
Urine culture,
Bronchoscopy charges and
reports

HCVRNA quantity, CBC, HCVRNA quantity, CBC,

Kidney HEPATITIS C VIRUS TREAMENTInclude Sofosbuvir400+ledispasvir90mg OD for 3
951 15.18 RFT, LFT, Tacrolimus level LFT, RFT 10,500 * Rate per month S17 S1712044
transplantation months and HCVRNA quantity ( 3 times)

Kidney Yearly HEPATITIS B VIRUS TREATMENT Include ENTECAVIR 0.5 MG OD for 12 months, HBVDNA quantity, CBC,
952 15.19 HBVDNA quantity, CBC, LFT, RFT 2,200 * Rate per month S17 S1712045
transplantation HBVDNA quantity( 3 time) RFT, LFT, Tacrolimus level

Kidney tacrolimus lvel, CBC, FRT,

953 15.20 Monthly once a day tacrolimus immunosuppression after kidney transplant tacrolimus lvel, CBC, FRT, LFR, RBS 6,800 * Rate per month S17 S1712046
transplantation LFR, RBS

Kidney Sirolimus LEVEL, CBC, LFT,

954 15.21 Monthly sirolimus immunosuppression after kidney transplant Sirolimus LEVEL, CBC, LFT, RFT, RBS 3,680 * Rate per month S17 S1712047
transplantation RFT, RBS

Kidney Everolimus LEVEL, CBC,

955 15.22 Monthly everolimus Immunosuppression after kidney transplant Everolimus LEVEL, CBC, LFT, RFT, RBS 9,000 * Rate per month S17 S1712048
transplantation LFT, RFT, RBS
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Living donor hepatectomy Part-1 Investigations

Blood group CBC, FBS, PPBS, Glycosylated Hemoglobin, Lipid profile, G6PD deficiency,
Uric acid, Serum Ceruloplasmin, 24 hours urinary copper, S. Creatinine, Blood urea,
Liver LFT, aPTT, PT, INR, S. Calcium, S. Magnesium, S. Na, S. K, S. Alpha feto protein, S. CEA,
956 15.23 A 11250 S17 S1712049
transplantation S. CA19-9, Stool for occult blood, Urine R/M, HIV ELISA, HCV ELISA, HBV DNA, Anti-
HBc antibody, CMV IgG and IgM, EBV, TORCH Complex, Varicella zoster IgG and IgM,
X-ray chest, USG abdomen, ECG, Pulmonary function test, 2D echocardiography,
NCCT abdomen

Liver Living donor hepatectomy Part-2 Investigations

957 15.23 B 7500 S17 S1712050
transplantation CT triphasic angiography for celiac axis, CT Volumetry, MR cholengiography

Liver LFT, RFT, Lipid profile, ELISA, CT

958 15.23 C Living donor hepatectomy Part-3 Operative Part 131250 S17 S1712051
transplantation volumetry

Liver transplantation from living donor Part-1 Investigations

Blood group, CBC, S. Creatinine, Blood urea, S. Na+, S. K+, S. Ca++, S. Mg++, FBS,
PPBS, Glycosylated hemoglobin, LFT, Urine R/M, 24 hours urinary proteins, 24 hours
Liver urinary copper, S. Ammonia, Lipid profile, G6PD, D-dimer, S. Fibrinogen, PT, INR, a-
959 15.24 A 8750 S17 S1712052
transplantation PTT, S. Iron, S. Ferritin, S. Transferrin, TIBC, S. Alfa feto protein, S. CEA, S. CA19-9,
Arterial blood gas study, HIV ELISA, HBsAg ELISA, Anti HBs antibody titer, HCV ELISA,
HCV RNA by PCR Assay, HBV DNA by PCR Assay, HEV antibody, TORCH complex, EBV
antibody titers, Varicella Zoster antibody titers, CMV IgG and IgM
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Liver transplantation from living donor Part-2 Investigations

Protein C, Protein S, Antithrombin C, Homocysteine, Homocysteine, ANA, AMA,
ASMA, LKM1, IgG level, USG abdomen, Colour Doppler study for portal vein, X-ray
Liver
960 15.24 B chest, ECG, Triphasic CT abdomen for celiac axis, Pulmonary function tests, 2D 17500 S17 S1712053
transplantation
echocardiography, Dobutamine stress echo., Coronary angiography, Arterial blood
gas analysis, Ascites fluid R/M, Ascites fluid culture, Pleural fluid R/M, TB PCR assay,
Vit D level, Vit. B12 level

Liver
961 15.24 C Liver transplantation from living donor Part -3 Operative Part LFT, S. Creatinine, Clinical photograph 323750 S17 S1712054
transplantation

Liver transplantation from deceased donor Part 1 Investigations

Blood group, CBC, S. Creatinine, Blood urea, S. Na+, S. K+, S. Ca++, S. Mg++, FBS,
PPBS, Glycosylated hemoglobin, LFT, Urine R/M, 24 hours urinary proteins, 24 hours
Liver urinary copper, S. Ammonia, Lipid profile, G6PD, D-dimer, S. Fibrinogen, PT, INR, a-
962 15.25 A 12500 S17 S1712055
transplantation PTT, S. Iron, S. Ferritin, S. Transferrin, TIBC, S. Alfa feto protein, S. CEA, S. CA19-9,
Arterial blood gas study, HIV ELISA, HBsAg ELISA, Anti HBs antibody titer, HCV ELISA,
HCV RNA by PCR Assay, HBV DNA by PCR Assay, HEV antibody, TORCH complex, EBV
antibody titers, Varicella Zoster antibody titers, CMV IgG and IgM

Liver transplantation from deceased donor Part 2 Investigations

Protein C, Protein S, Antithrombin C, Homocysteine, Homocysteine, ANA, AMA,
ASMA, LKM1, IgG level, USG abdomen, Colour Doppler study for portal vein, X-ray
Liver
963 15.25 B chest, ECG, Triphasic CT abdomen for celiac axis, Pulmonary function tests, 2D 25000 S17 S1712056
transplantation
echocardiography, Dobutamine stress echo., Coronary angiography, Arterial blood
gas analysis, Ascites fluid R/M, Ascites fluid culture, Pleural fluid R/M, TB PCR assay,
Vit D level, Vit. B12 level

Liver
964 15.25 C Liver transplantation from deceased donor Part - 3 Operative Part LFT, S. Creatinine 462500 S17 S1712057
transplantation
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Split liver transplantation from deceased donor Part 1 Investigations

Blood group, CBC, S. Creatinine, Blood urea, S. Na+, S. K+, S. Ca++, S. Mg++, FBS,
PPBS, Glycosylated hemoglobin, LFT, Urine R/M, 24 hours urinary proteins, 24 hours
Liver urinary copper, S. Ammonia, Lipid profile, G6PD, D-dimer, S. Fibrinogen, PT, INR, a-
965 15.26 A 12500 S17 S1712058
transplantation PTT, S. Iron, S. Ferritin, S. Transferrin, TIBC, S. Alfa feto protein, S. CEA, S. CA19-9,
Arterial blood gas study, HIV ELISA, HBsAg ELISA, Anti HBs antibody titer, HCV ELISA,
HCV RNA by PCR Assay, HBV DNA by PCR Assay, HEV antibody, TORCH complex, EBV
antibody titers, Varicella Zoster antibody titers, CMV IgG and IgM

Split liver transplantation from deceased donor Part 2 Investigations

Protein C, Protein S, Antithrombin C, Homocysteine, Homocysteine, ANA, AMA,
ASMA, LKM1, IgG level, USG abdomen, Colour Doppler study for portal vein, X-ray
Liver
966 15.26 B chest, ECG, Triphasic CT abdomen for celiac axis, Pulmonary function tests, 2D 25000 S17 S1712059
transplantation
echocardiography, Dobutamine stress echo., Coronary angiography, Arterial blood
gas analysis, Ascites fluid R/M, Ascites fluid culture, Pleural fluid R/M, TB PCR assay,
Vit D level, Vit. B12 level

Liver
967 15.26 C Split liver transplantation from deceased donor Part - 3 Operative Part LFT, S. Creatinine 462500 S17 S1712060
transplantation

Dual lobe liver transplantation: One lobe from one living donor and other lobe from
other living donor (Two donor hepatectomy and one liver recipient surgery) DONOR
Ix Part-1 Investigations
Blood group CBC, FBS, PPBS, Glycosylated Hemoglobin, Lipid profile, G6PD deficiency,
Liver Uric acid, Serum Ceruloplasmin, 24 hours urinary copper, S. Creatinine, Blood urea,
968 15.27 A 30000 S17 S1712061
transplantation LFT, aPTT, PT, INR, S. Calcium, S. Magnesium, S. Na, S. K, S. Alpha feto protein, S. CEA,
S. CA19-9, Stool for occult blood, Urine R/M, HIV ELISA, HCV ELISA, HBV DNA, Anti-
HBc antibody, CMV IgG and IgM, EBV, TORCH Complex, Varicella zoster IgG and IgM,
X-ray chest, USG abdomen, ECG, Pulmonary function test, 2D echocardiography,
NCCT abdomen
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Dual lobe liver transplantation: One lobe from one living donor and other lobe from
Liver other living donor (Two donor hepatectomy and one liver recipient surgery) DONOR
969 15.27 B 30000 S17 S1712062
transplantation Ix Part-2 Investigations
CT triphasic angiography for celiac axis, CT Volumetry, MR cholengiography

Dual lobe liver transplantation: One lobe from one living donor and other lobe from
other living donor (Two donor hepatectomy and one liver recipient surgery)
Receipient Ix
Part-3 Investigations
Blood group, CBC, S. Creatinine, Blood urea, S. Na+, S. K+, S. Ca++, S. Mg++, FBS,
Liver
970 15.27 C PPBS, Glycosylated hemoglobin, LFT, Urine R/M, 24 hours urinary proteins, 24 hours 30000 S17 S1712063
transplantation
urinary copper, S. Ammonia, Lipid profile, G6PD, D-dimer, S. Fibrinogen, PT, INR, a-
PTT, S. Iron, S. Ferritin, S. Transferrin, TIBC, S. Alfa feto protein, S. CEA, S. CA19-9,
Arterial blood gas study, HIV ELISA, HBsAg ELISA, Anti HBs antibody titer, HCV ELISA,
HCV RNA by PCR Assay, HBV DNA by PCR Assay, HEV antibody, TORCH complex, EBV
antibody titers, Varicella Zoster antibody titers, CMV IgG and IgM

Dual lobe liver transplantation: One lobe from one living donor and other lobe from
other living donor (Two donor hepatectomy and one liver recipient surgery)
Receipient Ix Part-4 Investigations
Protein C, Protein S, Antithrombin C, Homocysteine, Homocysteine, ANA, AMA,
Liver LFT, RFT, Lipid profile, ELISA, CT
971 15.27 D ASMA, LKM1, IgG level, USG abdomen, Colour Doppler study for portal vein, X-ray 30000 S17 S1712064
transplantation volumetry of both donors
chest, ECG, Triphasic CT abdomen for celiac axis, Pulmonary function tests, 2D
echocardiography, Dobutamine stress echo., Coronary angiography, Arterial blood
gas analysis, Ascites fluid R/M, Ascites fluid culture, Pleural fluid R/M, TB PCR assay,
Vit D level, Vit. B12 level

Dual lobe liver transplantation: One lobe from one living donor and other lobe from
Liver
972 15.27 E other living donor (Two donor hepatectomy and one liver recipient surgery) 1080000 S17 S1712065
transplantation
Receipient Ix Part-5 Operativr Part for both Donor and recippient

Liver
973 15.28 Emergency Exploratory laparotomy for liver donor ABG, USG abdomen USG abdomen 20000 S17 S1712066
transplantation
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Liver
974 15.29 Emergency Exploratory laparotomy for liver recipient ABG, USG abdomen USG abdomen 50000 S17 S1712067
transplantation

Liver
975 15.30 Post liver transplant Percutaneous Endoscopy guided gastrostomy (PEG) LFT, CBC Photograph 8000 S17 S1712068
transplantation

Liver
976 15.31 Post liver transplant incisional hernia repair (Prosthetic mesh) CT abdomen Clinical photograph, LFT 40000 for 7 days admission S17 S1712069
transplantation

Liver LFT, CECT, HRCT thorax,

977 15.32 Liver resection for HCC in Child-A cirrhosis LFT, CECT, Alfa fetoprotein 1,25,000 S17 S1712070
transplantation Alfa fetoprotein

Liver LFT, CECT, HRCT thorax,

978 15.33 Radiofrequency ablation (RFA) for HCC for Child-A, B and C cirrhosis LFT, CECT, Alfa fetoprotein 25,000 * Per session S17 S1712071
transplantation Alfa fetoprotein

LFT, S. Creatinine, PT, INR,

Liver X-ray abdomen, Doppler portal vein, S.
979 15.34 Trans-jugular Intrahepatic Porto-Systemic Shunt procedure (TIPS) CBC, S. Ammonia, Doppler 1,50,000 S17 S1712072
transplantation Creatinine
portal vein, USG abdomen

(Including Procedure
Liver
980 15.35 Trans-jugular liver allograft biopsy CBC, PT, LFT, S. Creatinine, X-ray chest, biopsy report 8000 and histopathology S17 S1712073
transplantation
charge)

(Including Procedure
Liver
981 15.36 Percutaneous liver allograft biopsy CBC, PT, LFT, S. Creatinine, X-ray chest, biopsy report 5000 and histopathology S17 S1712074
transplantation
charge)

Liver LFT, MRCP, USG abdomen,

982 15.37 Post liver transplant percutaneous transhepatic biliary drainage (PTBD) X-ray abdomen, USG abdomen, LFT 15000 S17 S1712075
transplantation CBC, PT

Liver LFT, MRCP, USG abdomen, (2 weeks of

983 15.38 Post liver transplant roux en Y jejunojejunostomy and choledochojejunostomy X-ray abdomen, USG abdomen, LFT 50000 S17 S1712076
transplantation CBC, PT hospitalization)
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Liver LFT, MRCP, USG abdomen,

984 15.39 Post liver transplant ERCP X-ray abdomen, USG abdomen, LFT 10000 S17 S1712077
transplantation CBC, PT

Liver LFT, MRCP, USG abdomen,

985 15.40 Post liver transplant ERCP with stenting X-ray abdomen, USG abdomen, LFT 18000 S17 S1712078
transplantation CBC, PT

Monthly investigations and immunosuppression from day of discharge to 3 months

CBC, RFT, Na, K, LFT, RBS,
Liver after liver transplant Include Prednisolone, Tacrolimus 4mg/day, Mycophenolate
986 15.41 A Tacrolimus level, USG liver CBC, RFT, LFT, RBS, Tacrolimus level 41580 S17 S1712079
transplantation upto 2 g /day, Valgancyclovir 450 mg ,Fluconazole 100mg/day, Septran 1 tablet once
allograft
a day For First Month

Monthly investigations and immunosuppression from day of discharge to 3 months

CBC, RFT, Na, K, LFT, RBS,
Liver after liver transplant Include Prednisolone, Tacrolimus 4mg/day, Mycophenolate
987 15.41 B Tacrolimus level, USG liver CBC, RFT, LFT, RBS, Tacrolimus level 13860 S17 S1712080
transplantation upto 2 g /day, Valgancyclovir 450 mg ,Fluconazole 100mg/day, Septran 1 tablet once
allograft
a day For Second Month

Monthly investigations and immunosuppression from day of discharge to 3 months

CBC, RFT, Na, K, LFT, RBS,
Liver after liver transplant Include Prednisolone, Tacrolimus 4mg/day, Mycophenolate
988 15.41 C Tacrolimus level, USG liver CBC, RFT, LFT, RBS, Tacrolimus level 13860 S17 S1712081
transplantation upto 2 g /day, Valgancyclovir 450 mg ,Fluconazole 100mg/day, Septran 1 tablet once
allograft
a day For Third Month

Monthly investigations and immunosuppression from 4-12 months after liver

Liver
989 15.42 transplant Include Prednisolone ,Tacrolimus 4mg/day, Mycophenolate upto 2 g / day CBC, RFT, RBS, LFT CBC, RFT, RBS, LFT 4,200 *Rate per month S17 S1712082
transplantation
, Fluconazole 100mg/day, Septran 1 tablet once a day,

Monthly investigations and immunosuppression (with everolimus)from 4-12 months

Liver after liver transplant Include Prednisolone Tacrolimus 2 mg/day +Everolimus 1
990 15.43 CBC, RFT, RBS, LFT CBC, RFT, RBS, LFT 7800 *Rate per month S17 S1712083
transplantation mg/day, Mycophenolate upto 2 g /day Fluconazole 100mg/day, Septran 1 tablet once
a day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Maintainence immunosuppresants and investigations after 12 months of liver

Liver
991 15.44 transplant(Calcineurin based ) Include Prednisolone, Tacrolimus 2mg/day CBC, RFT, RBS, LFT CBC, RFT, RBS, LFT 3,500 *Rate per month S17 S1712084
transplantation
Mycophenolate upto 2 g /day

Maintainence immunosuppresants and investigations and for 12 months after liver

Liver
992 15.45 transplant (Calcineurin and mTOR based ) Include Prednisolone Tacrolimus 2 mg/day CBC, RFT, RBS, LFT CBC, RFT, RBS, LFT 8,000 *Rate per month S17 S1712085
transplantation
Everolimus 1 mg/day, Mycophenolate upto 2 g/day

Fluid KOH preperation and

Invasive fungal infection after liver transplant Include Liposomal Amphotericin 5-10
Liver culture, CBC, RFT, LFT, Blood culture, CBC, RFT, LFT, RBS, XR
993 15.46 mg/kg/day for 30 days and Surgical debridement, ICU stay for 10 days Hospital stay 3,75,000 S17 S1712086
transplantation RBS, XR Chest, CT of organ Chest, CT Thorax
for 21 days With Liposomal Amphotericin 300 mg/day
of invasion, Endoscopy

CBC,RFT, LFT, RBS, X-ray

Chest, CT Thorax, Graft
Liver CMV infection after liver transplant Include IV gancyclovir 500 mg / Hospital stay for Doppler, Tacrolimus level, CBC, RFT, LFT, RBS, XR Chest,
994 15.47 A 19800 S17 S1712087
transplantation 14 day, tab.Valgancyclovir 450 mg OD for 3-7 days CMV DNA quality and Tacrolimus level, CMV DNA quantity
quantity, Urine RM and
Culture

CBC,RFT, LFT, RBS, X-ray

Chest, CT Thorax, Graft
Liver CMV infection after liver transplant Include IV gancyclovir 500 mg / Hospital stay for Doppler, Tacrolimus level, CBC, RFT, LFT, RBS, XR Chest,
995 15.47 B 39600 S17 S1712088
transplantation 14 day, tab.Valgancyclovir 450 mg OD for 8-12 days CMV DNA quality and Tacrolimus level, CMV DNA quantity
quantity, Urine RM and
Culture

CBC,RFT, LFT, RBS, X-ray

Chest, CT Thorax, Graft
Liver CMV infection after liver transplant Include IV gancyclovir 500 mg / Hospital stay for Doppler, Tacrolimus level, CBC, RFT, LFT, RBS, XR Chest,
996 15.47 C 66000 S17 S1712089
transplantation 14 day, tab.Valgancyclovir 450 mg OD for 13 and above Days CMV DNA quality and Tacrolimus level, CMV DNA quantity
quantity, Urine RM and
Culture

Liver graft biopsy, CBC,

LFT, RFT, RBS, XR Chest,
Liver CBC, RFT, RBS, XR Chest, Tacrolimus
997 15.48 A Treatment for T cell rejection IV methyl prednisolone IV, Hospital stay for 3-7 days Graft Doppler, Tacrolimus 9000 S17 S1712090
transplantation level, CMV DNA quantity
level, CMV DNA quality
and quantity
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Liver graft biopsy, CBC,

LFT, RFT, RBS, XR Chest,
Liver CBC, RFT, RBS, XR Chest, Tacrolimus
998 15.48 B Treatment for T cell rejection IV methyl prednisolone IV, Hospital stay for 8-12 days Graft Doppler, Tacrolimus 18000 S17 S1712091
transplantation level, CMV DNA quantity
level, CMV DNA quality
and quantity

Liver graft biopsy, CBC,

LFT, RFT, RBS, XR Chest,
Liver Treatment for T cell rejection IV methyl prednisolone IV, Hospital stay for 13 and CBC, RFT, RBS, XR Chest, Tacrolimus
999 15.48 C Graft Doppler, Tacrolimus 30000 S17 S1712092
transplantation above days level, CMV DNA quantity
level, CMV DNA quality
and quantity

Livergraft biopsy , CBC,

Treatment for T cell rejection with thymoglobulin IV methyl prednisolone ,IV
Liver RFT, LFT, RBS, XR Chest, CBC, RFT, RBS, XR Chest, Tacrolimus
1000 15.49 A thymoglobulin 75 mg , Hospital stay for 15 d,Valgancyclovir 450 mg/day Fluconazole 80000 S17 S1712093
transplantation Graft Doppler, Tacrolimus level, CMV DNA quantity
100 mg/day for First month
level, CMV DNA quantity

Livergraft biopsy , CBC,

Treatment for T cell rejection with thymoglobulin IV methyl prednisolone ,IV
Liver RFT, LFT, RBS, XR Chest, CBC, RFT, RBS, XR Chest, Tacrolimus
1001 15.49 B thymoglobulin 75 mg , Hospital stay for 15 d,Valgancyclovir 450 mg/day Fluconazole 60000 S17 S1712094
transplantation Graft Doppler, Tacrolimus level, CMV DNA quantity
100 mg/day for second month
level, CMV DNA quantity

Livergraft biopsy , CBC,

Treatment for T cell rejection with thymoglobulin IV methyl prednisolone ,IV
Liver RFT, LFT, RBS, XR Chest, CBC, RFT, RBS, XR Chest, Tacrolimus
1002 15.49 C thymoglobulin 75 mg , Hospital stay for 15 d,Valgancyclovir 450 mg/day Fluconazole 60000 S17 S1712095
transplantation Graft Doppler, Tacrolimus level, CMV DNA quantity
100 mg/day for 3rd month
level, CMV DNA quantity

Blood culture , CBC , RFT,

LFT, RBS, XR Chest, CT
Thorax, Graft Doppler,
Liver Chest Infection after transplant with 10day ICU care Include ICU stay , ICU ventilator , Blood culture , CBC, RFT, LFT, RBS, XR
1003 15.50 A Tacrolimus level, CMV 75000 S17 S1712096
transplantation ICU medicine , isolation ward for 1 to 3 day Chest, CT Thorax, Tacrolimus level
DNA quantity,
bronchoscopy charges and
reports
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Blood culture , CBC , RFT,

LFT, RBS, XR Chest, CT
Thorax, Graft Doppler,
Liver Chest Infection after transplant with 10day ICU care Include ICU stay , ICU ventilator , Blood culture , CBC, RFT, LFT, RBS, XR
1004 15.50 B Tacrolimus level, CMV 112500 S17 S1712097
transplantation ICU medicine , isolation ward for 3 to 7 day Chest, CT Thorax, Tacrolimus level
DNA quantity,
bronchoscopy charges and
reports

Blood culture , CBC , RFT,

LFT, RBS, XR Chest, CT
Thorax, Graft Doppler,
Liver Chest Infection after transplant with 10day ICU care Include ICU stay , ICU ventilator , Blood culture , CBC, RFT, LFT, RBS, XR
1005 15.50 C Tacrolimus level, CMV 150000 S17 S1712098
transplantation ICU medicine , isolation ward for 10 day or above Chest, CT Thorax, Tacrolimus level
DNA quantity,
bronchoscopy charges and
reports

Liver Post-liver transplant Hepatitis C infectionIncludes sofosbuvir 400 mg/ day + LFT, RFT, CBC, RBS, HCV LFT, RFT, CBC, RBS, HCV ELISA, HCV
1006 15.51 30,000 *Rate per month S17 S1712099
Transplantation daclatasavir 60 mg/day + ribavirin 1000 mg/day ELISA, HCV RNA quantity RNA quantity

Liver LFT, RFT, CBC, RBS, HBV LFT, RFT, CBC, RBS, HBV ELISA, HBV
1007 15.52 Post-liver transplant Hepatitis B infection Includes entecavir 0.5 mg /day 4,000 *Rate per month S17 S1712100
Transplantation ELISA, HBV DNA quantity DNA quantity

Liver Post-liver transplant Hepatitis B infection (entecavir resistant)Includes tenofovir 300 LFT, RFT, CBC, RBS, HBV LFT, RFT, CBC, RBS, HBV ELISA, HBV
1008 15.53 4,700 *Rate per month S17 S1712101
Transplantation mg /day ELISA, HBV DNA quantity DNA quantity

Pancreas transplant Part-1 Investigations

Blood group, CBC, RFT, LFT, Thyroid Function Test, Calcium, S. Phosphorus, S. Vit D, S.
Uric Acid, Blood Sugar FaSTING, PPBS, HIV ELISA, HCV ELISA, HBSAgelisa, HCV RNA
Pancreas quantitative, CMV IgG and IgM, Urine Routine and Micro, Urine Culture, USG
1009 15.54 A 10000 S17 S1712102
transplantation Abdomen, Chest XR, ECG, Lipid Profile, Anticardiolipid Ab, Lupus Anticoagulant, C3,
C4, P-ANCA, C-ANCA, ANA, DSDNA, PT INR, APTT, Pulmonary Function Test, ABG,
Doppler of Neck Vessels, Doppler of Iliofemoral Vessels, Uroflometry, MCU,
Urodynamic study
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Pancreas transplant Part-2 Investigations

Pancreas HLA Typing
1010 15.54 B 40000 S17 S1712103
transplantation LCM, FCM
Single Antigen Qualitative

Pancreas transplant Part-3 Investigation

Pancreas Single Antigen Quantitative, S. Amylase, S. lipase, C-Peptide, GAD Antibody, Plain CT
1011 15.54 C 30000 S17 S1712104
transplantation of Abdomen

Clinical photograph, blood sugar,

Pancreas
1012 15.54 D Pancreas transplant Part - 4 Operative Part Doppler study for pancreas and kidney 420000 S17 S1712105
transplantation
graft, C-peptide

Pancreas
1013 15.55 Exploratory laparotomy after pancreas transplant for abdominal wash ABG, USG abdomen USG abdomen 20000 S17 S1712106
transplantation

Pancreas
1014 15.56 Exploratory laparotomy after pancreas transplant for pancreatectomy ABG, USG abdomen USG abdomen 50000 S17 S1712107
transplantation

Cluster - 16 ORTORINOLARYNGOLOGY
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes and

1015 16.1 ENT Aural polypectomy 4,000 S2 S200001
autoscopy examination

CT temporal bone,CECT/
1016 16.2 ENT Labyrinthectomy HPEE 20,000 S2 S200002
MRI

1017 16.3 ENT Mastoidectomy X RAY,CT/MRI Clinical photo showing scar 12,500 S2 S200003

PTA , X-Ray
1018 16.4 ENT Mastoidectomy corticol modified/ radical Clinical photo showing scar 11,500 S2 S200004
Mastoids,clinical notes

clinical notes and

POST OP. SCOP
1019 16.5 ENT Mastoidectomy with tympanoplasty autoscopy 16,000 S2 S200005
Y PICTURE
examination/CTSCAN/MRI

1020 16.6 ENT Myringoplasty PTA and IA PTA and IA 7,500 S2 S200006
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

PTA and IA,Endoscopy

1021 16.7 ENT Myringoplasty with Ossiculoplasty clinical notes 13,500 S2 S200007
Picture,clinical notes

Operative notes with steps of

1022 16.8 ENT Myringotomy – Bilateral clinical notes 6,000 S2 S200008
surgery,clinical notes

Operative notes with steps of

1023 16.9 ENT Myringotomy – Unilateral clinical notes surgery,clinical notes,Endoscopy 3,500 S2 S200009
Picture

1024 16.10 ENT Myringotomy with Grommet - One ear PTA and IA Otoscopic findings 6,500 S2 S200010

1025 16.11 ENT Myrinogotomy with Grommet - Both ear PTA and IA Otoscopic findings 8,500 S2 S200011
1026 16.12 ENT Ossiculoplasty PTA and IA Otoscopic findings 9,500 S2 S200012
1027 16.13 ENT Partial amputation – Pinna PTA and IA Post op audiogram 4,000 S2 S200013

Excision of Pinna for Growths (Squamous/Basal) Injuries - Total Amputation & CT/FNAC/HPE/CLINICAL HPE/POST OP.
1028 16.14 ENT 8,000 S2 S200014
Excision of External Auditory Meatus PHOTO CLINICAL PHOTO

1029 16.15 ENT Excision of Pinna for Growths (Squamous/Basal) Injuries Total Amputation CT clinical notes,Histopathological report 6,500 S2 S200015

1030 16.16 ENT Stapedectomy PTA and IA Post op audiogram 10,000 S2 S200016

clinical notes,Clinical photo showing

1031 16.17 ENT Tympanoplasty PTA and IA,clinical notes 9,000 S2 S200017
scar

1032 16.18 ENT Vidian neurectomy – Micro clinical notes clinical notes 9,000 S2 S200018

1033 16.19 ENT Ear lobe repair - single (daycare) CLINICAL PHOTO POST.OP CLINICAL PHOTO 1,500 S2 S200019

1034 16.20 ENT Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin and Cartilage CLINICAL PHOTO POST.OP CLINICAL PHOTO 4,000 S2 S200020
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1035 16.21 ENT Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin Only CLINICAL PHOTO POST.OP CLINICAL PHOTO 2,500 S2 S200021

1036 16.22 ENT Pharyngectomy and reconstruction CT/MRI clinical notes 15,000 S2 S200022

1037 16.23 ENT Skull base surgery CT/MRI POST OPCLINICIAL PHOTO 37,000 S2 S200023

1038 16.24 ENT Total Amputation & Excision of External Auditory Meatus CLINICAL PHOTO POST.OP CLINICAL PHOTO 7,500 S2 S200024

1039 16.25 ENT Tympanotomy CLINICAL PHOTO POST.OP CLINICAL PHOTO 4,000 S2 S200025

1040 16.26 ENT Removal of foreign body from ear clinical notes clinical notes 3,000 S2 S200026

1041 16.27 ENT Aural polypectomy +Tympanoplasty PTA and IA clinical notes 10,000 S2 S200027

1042 16.28 ENT Ant. Ethmoidal artery ligation - open/ endoscopic CT/MRI POST.OP CLINICAL PHOTO 11,000 S2 S200028

clinical notes,CT/MRI,X-
1043 16.29 ENT Antrostomy – Bilateral clinical notes,X Ray 8,500 S2 S200029
Ray

1044 16.30 ENT Antrostomy – Unilateral X RAY PNS CLINICAL NOTES 6,000 S2 S200030

1045 16.31 ENT Cryosurgery CLINICAL NOTES CLINICAL NOTES 3,000 S2 S200031

1046 16.32 ENT CSF Rhinorrhoea – Repair CT/MRI Clinical Photograph 14,000 S2 S200032

1047 16.33 ENT Septoplasty + FESS X RAY PNS/CT PNS CLINICAL PHOTO/HPE 11,500 S2 S200033

1048 16.34 ENT Ethmoidectomy – External X RAY PNS/CT PNS HPEE 11,500 S2 S200034

X RAY/CT/MRI/CLINIAL
1049 16.35 ENT Fracture reduction nose with septal correction clinical notes,X Ray 8,000 S2 S200035
NOTES

1050 16.36 ENT Fracture - setting maxilla X RAY PNS/CT PNS clinical notes,X Ray 8,000 S2 S200036
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1051 16.37 ENT Fracture - setting nasal bone X RAY PNS/CT PNS clinical notes,X Ray 5,000 S2 S200037

1052 16.38 ENT Functional Endoscopic Sinus (FESS) X RAY PNS/CT PNS clinical notes 11,000 S2 S200038

1053 16.39 ENT Intra Nasal Ethmoidectomy X RAY PNS/CT PNS clinical notes 5,000 S2 S200039

1054 16.40 ENT Rhinotomy – Lateral X RAY PNS/CT PNS clinical notes 7,500 S2 S200040

1055 16.41 ENT Nasal polypectomy – Bilateral X RAY PNS/CT PNS HPEE 9,000 S2 S200041

1056 16.42 ENT Nasal polypectomy – Unilateral X RAY PNS/CT PNS HPEE 6,000 S2 S200042

1057 16.43 ENT Turbinectomy Partial – Bilateral X RAY PNS/CT PNS clinical notes 3,000 S2 S200043

1058 16.44 ENT Turbinectomy Partial – Unilateral X RAY PNS/CT PNS clinical notes 2,000 S2 S200044

1059 16.45 ENT Radical fronto ethmo sphenodectomy clinical notes,CT/MRI HPEE 18,000 S2 S200045

1060 16.46 ENT Rhinoplasty CLINICAL PHOTO POST OP CLINICAL PHOTO 15,000 S2 S200046

X RAY PNS/NASAL
1061 16.47 ENT Septoplasty clinical notes 5,000 S2 S200047
ENDOSCOPY

1062 16.48 ENT Youngs operation NASAL ENDOSCOPY clinical notes 3,000 S2 S200048

1063 16.49 ENT Angiofibrom Excision CT PNS HPE 18,000 S2 S200049

1064 16.50 ENT Cranio-facial resection CT PNS CLINICAL PHOTO 22,500 S2 S200050

X RAY PNS/SCOPY
1065 16.51 ENT Endoscopic DCR ENDOSCOPY PICTURE 7,000 S2 S200051
EXAMINATION

1066 16.52 ENT Endoscopic Hypophysectomy CT/MRI HPEE 21,000 S2 S200052

1067 16.53 ENT Intranasal Diathermy X RAY PNS clinical notes 3,000 S2 S200053

1068 16.54 ENT Rhinosporidiosis CT PNS ,HPE HPEE 5,000 S2 S200054

1069 16.55 ENT Septo-rhinoplasty CLINICAL PHOTO/CT PNS clinical notes 12,500 S2 S200055

1070 16.56 ENT Adeno Tonsillectomy X RAY NASOPHARYNX HPEE 8,000 S2 S200056

1071 16.57 ENT Adenoidectomy X RAY NASOPHARYNX HPEE 5,000 S2 S200057

 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1072 16.58 ENT Arytenoidectomy CT clinical notes 10,000 S2 S200058

CT PNS/NASAL
1073 16.59 ENT Choanal atresia clinical notes 12,500 S2 S200059
ENDOSCOPY

1074 16.60 ENT Tonsillectomy + Myrinogotomy PTA/IA HPEE 10,000 S2 S200060

1075 16.61 ENT Pharyngeal diverticulum's – Excision CT/BARIUM STUDY HPEE 10,000 S2 S200061

1076 16.62 ENT Laryngectomy with block dissection CT/MRI HPEE 25,000 S2 S200062

1077 16.63 ENT Laryngofissure clinical notes clinical notes 5,000 S2 S200063

1078 16.64 ENT Laryngophayryngectomy clinical notes,CT/MRI HPEE 20,000 S2 S200064

1079 16.65 ENT Maxilla – Excision clinical notes,CT/MRI HPEE 12,500 S2 S200065

1080 16.66 ENT Oro Antral fistula CT/MRI CLINICAL NOTES 7,500 S2 S200066

1081 16.67 ENT Parapharyngeal – Exploration CT/MRI clinical notes 12,500 S2 S200067

1082 16.68 ENT Parapharyngeal Abscess – Drainage CT/MRI clinical notes 12,500 S2 S200068

1083 16.69 ENT Peritonsillor abscess under LA clinical notes Clinical NOTES 2,500 S2 S200069

1084 16.70 ENT Pharyngoplasty CT/MRI clinical notes 10,000 S2 S200070

1085 16.71 ENT Retro pharyngeal abscess – Drainage CLINICAL NOTES, X RAY/CT clinical notes 5,000 S2 S200071

1086 16.72 ENT Tonsillectomy + Styloidectomy X RAY ,CLINICAL NOTES CLINICAL NOTES 10,000 S2 S200072

1087 16.73 ENT Thyroglossal Fistula/ cyst – Excision USG/ X-RAY clinical notes 7,000 S2 S200073

1088 16.74 ENT Tonsillectomy – (Uni/ Bilateral) CLINICAL NOTES HPEE 7,500 S2 S200074

1089 16.75 ENT Total Parotidectomy USG,FNAC,CT/MRI HPEE 18,000 S2 S200075

1090 16.76 ENT Superficial Parotidectomy USG,FNAC,CT/MRI HPEE 12,000 S2 S200076

1091 16.77 ENT Uvulophanyngo Plasty clinical notes clinical notes 14,000 S2 S200077

HPEE,CLINICAL PHOTO
1092 16.78 ENT Commondo Operation (glossectomy) CT /MRI ,BIOPSY 17,500 S2 S200078
SHOWING SCAR

1093 16.79 ENT Excision of Branchial Cyst CT/USG CLINICAL NOTES 7,000 S2 S200079

1094 16.80 ENT Excision of Branchial Sinus CT/USG CLINICAL NOTES 7,000 S2 S200080
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1095 16.81 ENT Excision of Cystic Hygroma Major/ Extensive CLINICAL PHOTO/FNAC/CT HPEE 10,000 S2 S200081

1096 16.82 ENT Excision of Cystic Hygroma Minor CLINICAL PHOTO/FNAC/CT HPEE 5,000 S2 S200082

CLINICAL NOTES /X RAY

1097 16.83 ENT Excision of the Mandible Segmental CLINICAL PHOTO 7,500 S2 S200083
OPG.

1098 16.84 ENT Hemi-mandibulectomy with graft X RAY,BIOPSY/CT CLINICAL PHOTO 15,000 S2 S200084

1099 16.85 ENT Hemiglossectomy CLINICAL NOTES/BIOPSY CLINICAL PHOTO 6,000 S2 S200085

1100 16.86 ENT Palatopharyngoplasty CLINICAL NOTES CLINICAL NOTES 10,000 S2 S200086

1101 16.87 ENT Partial Glossectomy CLINICAL NOTES/BIOPSY CLINICAL PHOTO 5,000 S2 S200087

CLINICAL NOTE,CLINICAL
1102 16.88 ENT Ranula excision CLINICAL PHOTO 5,000 S2 S200088
PHOTO

1103 16.89 ENT Removal of Submandibular Salivary gland USG/FNAC HPEE 5,000 S2 S200089

1104 16.90 ENT Total Glossectomy CLINICAL NOTES/BIOPSY CLINICAL PHOTO 15,000 S2 S200090

1105 16.91 ENT Total Laryngectomy + Neck dissection BIOPSY,CT/MRI HPEE 25,000 S2 S200091

CLINICAL NOTES/BIOPSY/
1106 16.92 ENT Laryngopharyngectomy with Gastric pull-up/ jejunal graft HPEE 30,000 S2 S200092
CT/MRI

1107 16.93 ENT Excision of CA cheek/ oral cavity + radial forearm flap BIOPSY,CT/MRI HPEE 30,000 S2 S200093

1108 16.94 ENT Excision of growth Jaw + free fibular flap reconstruction BIOPSY,CT/MRI HPEE 30,000 S2 S200094

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

1109 16.95 ENT Concern Investigation Concern Investigation 1,00,000 S2 U100
family,Package amount is Negotiable)

Cluster - 17 OBSTETRICS AND GYNAECOLOGY

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

USG, PRE OP, MINOR

1110 17.1 Obs & Gyac Hysterectomy ± Salpingo-oophorectomy HPEE 20,000 S4 S400001
PROFILE , HPEE OF D & C

1111 17.2 Obs & Gyac Abdominal Myomectomy USG, Preop Minor Profile HPEE 16,000 S4 S400002
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

USG, Clinical History Preop

1112 17.3 Obs & Gyac Surgeries for Prolapse - Sling Surgeries USG 16,000 S4 S400003
minor profile

USG ( PVR) Clinical

1113 17.4 Obs & Gyac Surgeries for Stress Incontinence 'Burch' History, Preop Minor 35,000 S4 S400004
Profile

USG, Indication for 2nd

1114 17.5 Obs & Gyac Hysterotomes - 2nd Trimester abortions USG 5,000 S4 S400005
trimester termination

1115 17.6 Obs & Gyac Incisional Hernia Repair Clinical History Notes, USG Mesh Sticker Stapler ( If Used) 15,000 S4 S400006

USG, CT SCAN, Preop

1116 17.7 Obs & Gyac Radical Hysterectomy (Wertheims) HPEE 20,000 S4 S400007
Major Profile HPEE Report

USG, CT Scan, Tumer

Laparotomy and proceed for Ovarian Cancers. Omentomy with Bilateral Salpingo- Marker ( CA125), HPEE,
1117 17.8 Obs & Gyac HPEE 20,000 S4 S400008
oophorectomy Preop Major Profile, X-Ray
Chest

USG/CT Scan, Clinical

1118 17.9 Obs & Gyac Non descent vaginal hysterectomy HPEE Report Minor Profile 14,000 S4 S400009
History Notes, HPEE Preop

USG, Clinical History

1119 17.10 Obs & Gyac Vaginal hysterectomy with anterior and posterior colpoperineorrhaphy Notes, HPEE Report Preop HPEE Report 16,000 S4 S400010
Minor Profile

Clinical History Notes, RFT,

1120 17.11 Obs & Gyac Vaginal surgical repair for vesico-vaginal fistula CT IVP ( KUB ), Preop Clinical Examination 10,000 S4 S400011
Minor Profile

USG, Preop.minor Profile,

1121 17.12 Obs & Gyac Sacrocolpopexy Clinical Examination 16,000 S4 S400012
Clinical History Notes

CT, Barium Encma, Preop

1122 17.13 Obs & Gyac Repair for rectovaginal fitulas Clinical Examination 10,000 S4 S400013
Minor Profile

USG, Clinical Historm,

1123 17.14 Obs & Gyac Vaginoplasty Clinical Examination 10,000 S4 S400014
Preop Minor Profile

1124 17.15 Obs & Gyac LLETZ Colposcopy, Biopsy HPEE Report 15,000 S4 S400015
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical Hiatory, USG

1125 17.16 Obs & Gyac Colpotomy HPEE Report 1,200 S4 S400016
Preop, Minor Profile

USG, Clinical History,

1126 17.17 Obs & Gyac Dilation and Evacuation (D&E) NO 5,000 S4 S400017
Preop Minor Profile

USG, Clinical History,

1127 17.18 Obs & Gyac Cervical biopsy and Polypectomy HPEE 3,000 S4 S400018
Minor Profile
Clinical History Notes
1128 17.19 Obs & Gyac Bartholins Cyst Enucleation/ Incision drainage HPEE 3,000 S4 S400019
Preop Minor Profile
HPEE, Clinical History
1129 17.20 Obs & Gyac Vulvectomy simple HPEE 17,250 S4 S400020
Preop Minor History
HPEE, CT, Clinical History
1130 17.21 Obs & Gyac Radical Vulvectomy HPEE 17,250 S4 S400021
Preop Major Profile
Clinical History Preop
1131 17.22 Obs & Gyac Diagnostic laparoscopy CD, HPEE Report 11,000 S4 S400022
Minor Profile
USG / Ct, Clinical History,
1132 17.23 Obs & Gyac Laparoscopic hysterectomy (TLH) HPEE / CD 20,000 S4 S400023
Minor Preofile, HPEE

USG / Ct, Clinical History,

1133 17.24 Obs & Gyac Laparoscopic myomectomy HPEE / CD 15,000 S4 S400024
Minor Preofile, HPEE

USG / Ct, Clinical History,

1134 17.25 Obs & Gyac Laparoscopic cystectomy Minor Preofile, HPEE ( CA - HPEE / CD 15,000 S4 S400025
125 )

USG / CT, Clinical History,

1135 17.26 Obs & Gyac Laparoscopic ovarotomy HPEE / CD 10,000 S4 S400026
Minor Profile CA - 125

USG / CT, Clinical History,

1136 17.27 Obs & Gyac Laparoscopic adhesiolysis NO / CD 6,000 S4 S400027
Minor Profile

USG / Clinical History

1137 17.28 Obs & Gyac Laparoscopic tubal surgeries - salpingectomy, salpingotomy HPEE / CD 11,000 S4 S400028
Preop Minor Profile

USG, Clinical History,

1138 17.29 Obs & Gyac Drag hysteroscopy CD 6,000 S4 S400029
Preop Minor Profile

USG, Clinical History,

1139 17.30 Obs & Gyac Hysteroscopic myomectomies CD , HPEE 6,000 S4 S400030
Preop Minor Profile

USG, Clinical History,

1140 17.31 Obs & Gyac Hysteroscopic adhesiolysis CD 6,000 S4 S400031
Preop Minor Profile

USG, Clinical History,

1141 17.32 Obs & Gyac Hysteroscopic polypectomy CD , HPEE 3,000 S4 S400032
Preop Minor Profile
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

USG, Clinical History,

1142 17.33 Obs & Gyac Hysteroscopic IUCD removal CD 3,000 S4 S400033
Preop Minor Profile

1143 17.34 Obs & Gyac Caesarian Delivery ANH Preop Minor Profile Birth Registration Form 9,000 S4 S400034

1144 17.35 Obs & Gyac Caesarian hysterectomy ANH Preop, Indicator HPEE 16,000 S4 S400035

ANC Profile, Clinical

Clinical History Notes in Details with
1145 17.36 Obs & Gyac High risk delivery: Pre-mature delivery History Notes, USG Preop, 9,000 S4 S400036
Tratment Given
Major Profile

ANC Profile, Clinical

Clinical History Notes in Details with
1146 17.37 Obs & Gyac High risk delivery: Expected Gestation at delivery less than 35 weeks History Notes, USG Preop, 9,000 S4 S400037
Tratment Given
Major Profile

ANC Profile, Clinical

Clinical History Notes in Details with
1147 17.38 Obs & Gyac High risk delivery: Mothers with eclampsia or imminent eclampsia History Notes, USG Preop, 9,000 S4 S400038
Tratment Given
Major Profile

ANC Profile, Clinical

Clinical History Notes in Details with
1148 17.39 Obs & Gyac High risk delivery: Obstructed labour History Notes, USG Preop, 9,000 S4 S400039
Tratment Given
Major Profile

ANC Profile, Clinical

High risk delivery: Major Fetal malformation requiring intervention immediately after Clinical History Notes in Details with
1149 17.40 Obs & Gyac History Notes, USG Preop, 9,000 S4 S400040
birth Tratment Given
Major Profile

ANC Profile, Clinical

Clinical History Notes in Details with
1150 17.41 Obs & Gyac High risk delivery: Mothers with severe anaemia (<7 g/dL) History Notes, USG Preop, 9,000 S4 S400041
Tratment Given
Major Profile

High risk delivery: Other maternal and fetal conditions as per guidelines-Such as Rh ANC Profile, Clinical
Clinical History Notes in Details with
1151 17.42 Obs & Gyac haemolytic disease, uncontrolled diabetes, severe growth retardation etc that qualify History Notes, USG Preop, 9,000 S4 S400042
Tratment Given
for high risk delivery etc. Major Profile

Clinical Notes, USG, Preop

1152 17.43 Obs & Gyac Manual removal of placenta HPEE 5,000 S4 S400043
Minor Profile

USG, Clinical History Preop

1153 17.44 Obs & Gyac Laparotomy for ruptured ectopic HPEE 10,000 S4 S400044
Minor
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

USG, Clinical History Preop

1154 17.45 Obs & Gyac MTP > 12 weeks NO 6,500 S4 S400045
Minor, Consort Form

USG, Clinical History Preop

1155 17.46 Obs & Gyac MTP upto 12 weeks NO 5,000 S4 S400046
Minor, Consort Form

USG, Clinical History,

1156 17.47 Obs & Gyac MTP upto 8 weeks Preop Minor Profile, NO 3,500 S4 S400047
Consort Form

USG, Clinical History,

1157 17.48 Obs & Gyac McDonald's stitch Preop Minor Profile, NO 4,000 S4 S400048
Consort Form

USG, Clinical History,

1158 17.49 Obs & Gyac Shirodkar's stitch Preop Minor Profile, NO 4,000 S4 S400049
Consort Form

HSG, USG, Clinical History

1159 17.50 Obs & Gyac Tuboplasty NO 10,000 S4 S400050
Preop Minor Profile

USG, Minor Profile Clinical

1160 17.51 Obs & Gyac Laparotomy for broad ligament haematoma NO 16,000 S4 S400051
History

Clinical History, USGPreop

1161 17.52 Obs & Gyac Trans-vaginal tape/ Trans-obturator tape TVT / TUT Tape Sticker 5,000 S4 S400052
Minor

USG, HSG, Clinical History,

1162 17.53 Obs & Gyac Abdominal Perineal neo construction Cx + Uteria + Vagina USG 20,000 S4 S400053
Preop Minor

USG / CT, Clinical History,

1163 17.54 Obs & Gyac Ablation of Endometriotic Spot + Adhenolysis CD (if Laproscopy) 10,000 S4 S400054
Preop Minor Profile

USG / CT, Clinical History,

1164 17.55 Obs & Gyac Ablation of Endometriotic Spot +Salpingostomy CD (if Laproscopy) 10,000 S4 S400055
Preop Minor Profile

USG / CT, Clinical History,

1165 17.56 Obs & Gyac Adhenolysis + Hernia - Ventral - Lipectomy/Incision CD (if Laproscopy) 16,000 S4 S400056
Preop Minor Profile

USG / CT, Clinical History,

1166 17.57 Obs & Gyac Adhenolysis+ Ovarian Cystectomy CD (if Laproscopy) 10,000 S4 S400057
Preop Minor Profile

USG / CT, Clinical History,

1167 17.58 Obs & Gyac Adhenolysis+ Salpingostomy CD (if Laproscopy) 10,000 S4 S400058
Preop Minor Profile

USG / CT, Clinical History,

1168 17.59 Obs & Gyac Broad Ligment Haemotoma drainage CD (if Laproscopy) 10,000 S4 S400059
Preop Minor Profile
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical History, Minor

1169 17.60 Obs & Gyac Brust abdomen repair Clincial Notes 14,000 S4 S400060
Profile

Pap Smcar, Colposcopy

1170 17.61 Obs & Gyac Cone Biopsy Cervix HPEE 1,000 S4 S400061
Minor Profile

Preop Minor, Clinical

1171 17.62 Obs & Gyac Conventional Tubectomy HPEE 4,000 S4 S400062
Notes

Clinical History Notes

1172 17.63 Obs & Gyac Cyst -Vaginal Enucleation HPEE 3,000 S4 S400063
Preop Minor / USG

Clinical History Notes

1173 17.64 Obs & Gyac Cyst-Labial HPEE 3,000 S4 S400064
Preop Minor / USG

Clinical History Notes

1174 17.65 Obs & Gyac Cystocele - Anterior repair HPEE 12,000 S4 S400065
Preop Minor / USG

Clinical History Notes

1175 17.66 Obs & Gyac Cystocele - Anterior Repair + Perineal Tear Repair HPEE 13,000 S4 S400066
Preop Minor / USG

Clinical History Notes

1176 17.67 Obs & Gyac D&C (Dilatation &curretage) + Electro Cauterisation Cryo Surgery Preop Minor / USG + Pap HPEE 4,000 S4 S400067
Smcar

Clinical History USG, Preop

1177 17.68 Obs & Gyac D&C (Dilatation&curretage) HPEE 3,000 S4 S400068
Minor

Clinical History USG, Preop

1178 17.69 Obs & Gyac Diagnostic laparoscopy & hysteroscopy for infertility CD , HPEE 5,000 S4 S400069
Minor

1179 17.70 Obs & Gyac Electro Cauterisation Cryo Surgery Pap Smcar, Clinical History NO 4,000 S4 S400070

USG / CT, Clinical History

1180 17.71 Obs & Gyac Exploration of abdominal haematoma (after laparotomy + LSCS) NO 14,000 S4 S400071
Preop Minor Profile

Preop Minor Profile USG,

1181 17.72 Obs & Gyac Fractional Curretage HPEE 4,000 S4 S400072
Clinical History

Preop Minor Profile,

1182 17.73 Obs & Gyac Gaping Perineal wound secondary suturing/ episiotomy Clinical History Notes, NO 2,500 S4 S400073
Clinical Site photo

1183 17.74 Obs & Gyac HaematoColpo/Excision - Vaginal Septum USG / CT, Clinical History HPEE 5,000 S4 S400074
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical History, USG

1184 17.75 Obs & Gyac Hymenectomy& Repair of Hymen Clinical Site Photo, Preop HPEE 7,000 S4 S400075
Minor Profile

1185 17.76 Obs & Gyac Amniocentesis AN Profile USG Triple 5,000 S4 S400076

1186 17.77 Obs & Gyac Chorionic villus sampling Electrophoresi 5,000 S4 S400077

1187 17.78 Obs & Gyac Cordocentesis 5,000 S4 S400078

1188 17.79 Obs & Gyac Intrauterine transfusions Clinical Treatment Notes, USG Plates 10,000 S4 S400079

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

1189 17.80 Obs & Gyac Concern Investigation Concern Investigation 1,00,000 S4 U100
family,Package amount is Negotiable)

Cluster - 18 OPTHALMOLOGY
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

History of Previous
1190 18.1 Opthelmology Buckel Removal Operation/ Discharge Clinical Photo 5,000 S3 S300001
Summary (RD)

1191 18.2 Opthelmology Canaliculo Dacryocysto Rhinostomy Dacryocysto Graphy Clinical Photo 10,000 S3 S300002

1192 18.3 Opthelmology Capsulotomy (YAG) B-scan/clinical photo _ 1,500 S3 S300003

1193 18.4 Opthelmology Corneal Grafting clinical photo clinical photo 8,500 S3 S300004

1194 18.5 Opthelmology Prophylactic Cryoretinopexy- Closed retinal photo retinal photo 2,500 S3 S300005

1195 18.6 Opthelmology Cyclocryotherapy/Cyclophotocoagulation retinal photo retinal photo 3,000 S3 S300006

1196 18.7 Opthelmology Pterygium + ConjunctivalAutograft clinical photo Clinical Photo 9,000 S3 S300007

1197 18.8 Opthelmology Dacryocystectomy with implants Dacryocysto Graphy Clinical Photo,sticker of implant 10,000 S3 S300008

1198 18.9 Opthelmology Enucleation B-scan/clinical photo clinical photo 6,000 S3 S300009

1199 18.10 Opthelmology Enucleation with Implant B-scan/clinical photo Clinical Photo,sticker of implant 11,000 S3 S300010

1200 18.11 Opthelmology Exenteration MRI X RAY 15,000 S3 S300011

Glaucoma Surgery (Trabeculectomy only) with or without Mitomycin C, including Visual field
1201 18.12 Opthelmology postoperative medications for 12 weeks (and wherever surgical or laser procedures report/tonometry/retinal clinical photo 10,000 S3 S300012
required for bleb augmentation and anterior chamber maintenance) photo

1202 18.13 Opthelmology Intraocular Foreign Body Removal from Anterior Segment B-scan/clinical photo clinical photo 4,000 S3 S300013
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1203 18.14 Opthelmology Intraocular Foreign Body Removal from Posterior Segment B-scan/clinical photo B-scan/clinical photo 20,000 S3 S300014

1204 18.15 Opthelmology Lensectomy /pediatric lens aspiration B-scan/clinical photo B-scan/clinical photo 9,000 S3 S300015

1205 18.16 Opthelmology Limbal Dermoid Removal clinical photo clinical photo 4,000 S3 S300016

1206 18.17 Opthelmology Surgical Membranectomy B-scan/clinical photo clinical photo 8,000 S3 S300017

1207 18.18 Opthelmology Perforating Corneo - Scleral Injury clinical photo clinical photo 10,000 S3 S300018

1208 18.19 Opthelmology Ptosis Surgery clinical photo clinical photo 10,000 S3 S300019

1209 18.20 Opthelmology IRIS Prolapse – Repair clinical photo clinical photo 4,000 S3 S300020

1210 18.21 Opthelmology Retinal Detachment Surgery retinal photo retinal photo 15,000 S3 S300021

1211 18.22 Opthelmology Small Tumour of Lid – Excision + Lid Reconstruction clinical photo clinical photo 10,000 S3 S300022

1212 18.23 Opthelmology Socket Reconstruction with amniotic membrane clinical photo clinical photo 8,000 S3 S300023

1213 18.24 Opthelmology Iridectomy – Laser clinical photo clinical photo 2,000 S3 S300024

1214 18.25 Opthelmology Iridectomy – Surgical clinical photo clinical photo 3,000 S3 S300025

1215 18.26 Opthelmology Iris cyst removal B-scan/clinical Notes clinical photo 2,500 S3 S300026

1216 18.27 Opthelmology Vitrectomy retinal photo retinal photo/CLINICAL PHOTO 7,500 S3 S300027

1217 18.28 Opthelmology Vitrectomy + Retinal Detachment surgery (pre-auth required) retinal photo retinal photo/CLINICAL PHOTO 17,500 S3 S300028

1218 18.29 Opthelmology Cataract with foldable hydrophobic acrylic IOL by Phaco emulsification tech A-Scan implant sticker,clinical photo 7,500 S3 S300029

1219 18.30 Opthelmology Cataract with non-foldable IOL using SICS technique A-Scan implant sticker,clinical photo 5,000 S3 S300030

Cataract with foldable hydrophobic acrylic IOL by Phaco emulsification tech + A-Scan,field of
1220 18.31 Opthelmology implant sticker,clinical photo 10,500 S3 S300031
Glaucoma vision,tonometry
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

A-Scan,field of
1221 18.32 Opthelmology Cataract with non-foldable IOL using SICS technique + Glaucoma implant sticker,clinical photo 6,500 S3 S300032
vision,tonometry

1222 18.33 Opthelmology Conjunctival tumour excision + AMG clinical photo clinical photo 5,000 S3 S300033

1223 18.34 Opthelmology Entropion correction clinical photo clinical photo 4,000 S3 S300034

1224 18.35 Opthelmology Ectropion correction clinical photo clinical photo 5,000 S3 S300035

1225 18.36 Opthelmology Evisceration clinical photo/B -scan clinical photo 3,500 S3 S300036

1226 18.37 Opthelmology Laser for retinopathy (per sitting) retinal photo retinal photo 1,500 S3 S300037

1227 18.38 Opthelmology Lid tear clinical photo clinical photo 5,000 S3 S300038

1228 18.39 Opthelmology Orbitotomy B-Scan/MRI clinical photo 10,000 S3 S300039

1229 18.40 Opthelmology Squint correction (per muscle) clinical photo clinical photo 4,000 S3 S300040

1230 18.41 Opthelmology Anterior Chamber Reconstruction +Perforating corneo - Scleral Injury + IOL A-Scan,clinical photo clinical photo,IOL Sticker 11,500 S3 S300041

1231 18.42 Opthelmology PRP - Retinal Laser including 3 sittings retinal photo retinal photo 5,000 S3 S300042

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

1232 18.43 Opthelmology Concern Investigation Concern Investigation 1,00,000 S3 U100
family,Package amount is Negotiable)

Cluster - 19 GENERAL SURGERY

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1233 19.1 General Surgery Adventious Burse – Excision USG/MRI 10,000 S1 S100001

USG/Colonoscopy/CT/Bio
1234 19.2 General Surgery Anterior Resection for CA HPE 15,000 S1 S100002
psy

1235 19.3 General Surgery Appendicectomy Clinical notes + USG HPE 10,000 S1 S100003

1236 19.4 General Surgery Appendicular Abscess – Drainage USG/CT HPE/USG 12,000 S1 S100004

1237 19.5 General Surgery Arteriovenous (AV) Malformation of Soft Tissue Tumour - Excision USG/Color droppler HPE/USG 15,000 S1 S100005
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1238 19.6 General Surgery Bakers Cyst – Excision Clinical report/USG HPE/USG 6,000 S1 S100006

1239 19.7 General Surgery Bilateral Inguinal block dissection USG/CT/FNAC HPE 25,000 S1 S100007

1240 19.8 General Surgery Bleeding Ulcer - Gastrectomy & vagotomy USG/CT/HPE/OGD USG/HPE 25,000 S1 S100008

1241 19.9 General Surgery Bleeding Ulcer - Partial Gastrectomy USG/CT USG 25,000 S1 S100009

1242 19.10 General Surgery Block dissection Cervical Nodes CT scan/USG,FNAC HPE 10,000 S1 S100010

1243 19.11 General Surgery Branchial Fistula USG/CT HPE 14,000 S1 S100011

1244 19.12 General Surgery Breast Lump - Left – Excision USG/CT/FNAC HPE 6,500 S1 S100012

1245 19.13 General Surgery Breast Lump - Right – Excision USG/CT/FNAC HPE 6,500 S1 S100013

1246 19.14 General Surgery Branchial Cyst USG/CT HPE 10,000 S1 S100014

1247 19.15 General Surgery Bursa – Excision USG/Clinical Note HPE 4,000 S1 S100015

CT/MRI,USG,Tumor
1248 19.16 General Surgery Bypass - Inoperable Pancreas HPE/USG 15,000 S1 S100016
Marker

1249 19.17 General Surgery Cervial Lymphnodes – Excision USG/FNAC HPE/USG 2,000 S1 S100017

1250 19.18 General Surgery Colostomy USG/CT/Xray/Loopogram HPE/USG,Clinical Photograph 10,000 S1 S100018

1251 19.19 General Surgery Cyst over Scrotum – Excision clinical notes/USG 2,000 S1 S100019

1252 19.20 General Surgery Cystic Mass – Excision clinical notes/USG 2,000 S1 S100020

1253 19.21 General Surgery Dermoid Cyst - Large – Excision USG/FNAC 4,000 S1 S100021

1254 19.22 General Surgery Dermoid Cyst - Small – Excision USG/FNAC 2,000 S1 S100022
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1255 19.23 General Surgery Drainage of Ischio Rectal Abscess clinical notes/USG 4,000 S1 S100023

1256 19.24 General Surgery Incision and Drainage of large Abscess clinical notes 4,000 S1 S100024

1257 19.25 General Surgery Drainage of Psoas Abscess USG/CT,clinical notes 7,500 S1 S100025

1258 19.26 General Surgery Drainage of Subdiaphramatic Abscess USG/CT,clinical notes 10,000 S1 S100026

1259 19.27 General Surgery Drainage Pericardial Effusion USG/CT,Echo 13,750 S1 S100027

1260 19.28 General Surgery Duodenal Diverticulum USG/CT/UGI 20,000 S1 S100028

1261 19.29 General Surgery Duodenal Jejunostomy USG/CT 20,000 S1 S100029

1262 19.30 General Surgery Duplication of Intestine Clinical report,CT HPE 18,000 S1 S100030

1263 19.31 General Surgery Hydrocele + Orchidectomy Clinical report,USG HPE 8,000 S1 S100031

1264 19.32 General Surgery Epidedectomy Clinical report,USG 8,000 S1 S100032

1265 19.33 General Surgery Epididymal Swelling –Excision USG/FNAC 6,000 S1 S100033

1266 19.34 General Surgery Epidymal Cyst Clinical report,USG 4,000 S1 S100034

1267 19.35 General Surgery Evacuation of Scrotal Hematoma Clinical report,USG 5,000 S1 S100035

1268 19.36 General Surgery Excision Benign Tumor -Small intestine USG/CT HPE 15,000 S1 S100036

Clinical
1269 19.37 General Surgery Excision Bronchial Sinus HPE 8,000 S1 S100037
report,Broncoscopy/HRCT

1270 19.38 General Surgery Drainage of liver Abscess Clinical report,USG USG 8,000 S1 S100038

1271 19.39 General Surgery Excision Filarial Scrotum Clinical report,USG,PS 5,000 S1 S100039

Clinical
1272 19.40 General Surgery Excision Mammary Fistula HPE 5,000 S1 S100040
report,mammogram

1273 19.41 General Surgery Excision Meckel's Diverticulum USG/CT HPE 15,000 S1 S100041

1274 19.42 General Surgery Excision Pilonidal Sinus clinical notes 8,000 S1 S100042

1275 19.43 General Surgery Excision Small Intestinal Fistula USG/CT HPE 15,000 S1 S100043

1276 19.44 General Surgery Excision of Growth from Tongue only Biopsy,Clinical Note HPE 6,000 S1 S100044

1277 19.45 General Surgery Excision of Growth from Tongue with neck node dissection Biopsy,CT HPE 15,000 S1 S100045

1278 19.46 General Surgery Excision of Swelling in Right Cervical Region clinical notes 5,000 S1 S100046

1279 19.47 General Surgery Excision of Large Swelling in Hand clinical notes 3,000 S1 S100047

1280 19.48 General Surgery Excision of Small Swelling in Hand clinical notes 1,500 S1 S100048

1281 19.49 General Surgery Excision of Neurofibroma clinical notes HPE 3,000 S1 S100049
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1282 19.50 General Surgery Exicision of Sinus and Curettage clinical notes 5,000 S1 S100050

1283 19.51 General Surgery Fibroadenoma – Bilateral clinical notes HPE 8,000 S1 S100051

1284 19.52 General Surgery Fibrodenoma – Unilateral clinical notes HPE 7,000 S1 S100052

1285 19.53 General Surgery Fissurectomy clinical notes 8,000 S1 S100053

1286 19.54 General Surgery Fissurectomy and Haemorrhoidectomy clinical notes 12,000 S1 S100054

1287 19.55 General Surgery Eversion of Hydrocele Sac – Bilateral clinical notes 10,000 S1 S100055

1288 19.56 General Surgery Eversion of Hydrocele Sac – Unilateral clinical notes 5,000 S1 S100056

1289 19.57 General Surgery Fissurectomy with Sphincterotomy clinical notes Photograph of removed part of body 15,000 S1 S100057

1290 19.58 General Surgery Foreign Body Removal in Deep Region requiring GA Pre-op. X-ray 5,000 S1 S100058

1291 19.59 General Surgery Fundoplication Clinical report,OGD/CT USG 20,000 S1 S100059

1292 19.60 General Surgery G J Vagotomy/ Vagotomy + Pyloroplasty Clinical report HPE 15,000 S1 S100060

1293 19.61 General Surgery Ganglion - large – Excision Clinical report 3,000 S1 S100061

1294 19.62 General Surgery Ganglion - Small – Excision clinical notes 2,000 S1 S100062

1295 19.63 General Surgery Gastrojejunostomy Clinical notes + USG Clinical Photograph 15,000 S1 S100063

1296 19.64 General Surgery Gastrostomy Clinical notes + USG Clinical Photograph 15,000 S1 S100064

1297 19.65 General Surgery Graham's Operation for duodenal perforation X-ray abdomen/USG 15,000 S1 S100065

1298 19.66 General Surgery Granuloma – Excision Clinical report 2,000 S1 S100066

1299 19.67 General Surgery Haemangioma – Excision (large) Doppler 10,000 S1 S100067

1300 19.68 General Surgery Haemangioma – Excision (small) Doppler 5,000 S1 S100068

1301 19.69 General Surgery Haemorrhage of Small Intestine clinical notes 15,000 S1 S100069

1302 19.70 General Surgery Hepatic Resection (lobectomy) Clinical report,USG/CT HPE 20,000 S1 S100070

1303 19.71 General Surgery Hernia – Epigastric Clinical report USG,Mesh Sticker 11,000 S1 S100071

1304 19.72 General Surgery Hernia – Incisional Clinical report 15,000 S1 S100072

1305 19.73 General Surgery Hernia - Repair & release of obstruction Clinical report,X-ray 15,000 S1 S100073

1306 19.74 General Surgery Hernia – Umbilical Clinical report USG/CT 11,000 S1 S100074

1307 19.75 General Surgery Hernia – Femoral Clinical report/USG Mesh Sticker 10,000 S1 S100075

1308 19.76 General Surgery Hernioplasty – Inguinal Clinical report/USG Mesh Sticker 10,000 S1 S100076

1309 19.77 General Surgery Herniorraphy Clinical report 9,000 S1 S100077

 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1310 19.78 General Surgery Hiatus Hernia – abdominal Clinical report,USG/OGD 15,000 S1 S100078

1311 19.79 General Surgery Hydatid Cyst of Liver Clinical report/USG HPE 12,500 S1 S100079

1312 19.80 General Surgery Hydrocele - Excision – Unilateral clinical notes 5,000 S1 S100080

1313 19.81 General Surgery Hydrocele - Excision – Bilateral Clinical report 10,000 S1 S100081

1314 19.82 General Surgery IlieoSigmoidostomy clinical notes 17,000 S1 S100082

1315 19.83 General Surgery Infected Bunion Foot – Excision clinical notes 4,000 S1 S100083

1316 19.84 General Surgery Inguinal Node (dissection) - Unilateral Clinical notes + USG HPE 10,000 S1 S100084

1317 19.85 General Surgery Intestinal perforation Clinical report,X-ray 12,500 S1 S100085

1318 19.86 General Surgery Intestinal Obstruction Clinical report,X-ray 12,500 S1 S100086

1319 19.87 General Surgery Intussusception Clinical report,X-ray 15,000 S1 S100087

1320 19.88 General Surgery Jejunostomy X-RAY/USG Clinical Photo 10,000 S1 S100088

1321 19.89 General Surgery Gastric Perforation Clinical report,X-ray/USG 15,000 S1 S100089

1322 19.90 General Surgery Intestinal Perforation (Resection Anastomosis) Clinical report,X-ray/USG 20,000 S1 S100090

1323 19.91 General Surgery Appendicular Perforation X-RAY/USG HPE 15,000 S1 S100091

1324 19.92 General Surgery Burst Abdomen Obstruction Clinical report 15,000 S1 S100092

1325 19.93 General Surgery Closure of Hollow Viscus Perforation Clinical notes + USG 15,000 S1 S100093

1326 19.94 General Surgery Laryngectomy & Pharyngeal Diverticulum (Throat) Clinical report,CT HPE 15,000 S1 S100094

1327 19.95 General Surgery Ileostomy clinical notes Clinical Photo 10,000 S1 S100095

1328 19.96 General Surgery Lipoma excision clinical notes 2,500 S1 S100096

1329 19.97 General Surgery Loop Colostomy Sigmoid clinical notes 12,000 S1 S100097
clinical
1330 19.98 General Surgery Mastectomy HPE 12,000 S1 S100098
notes,Mammogram
1331 19.99 General Surgery Mesenteric Cyst – Excision USG/ CT HPE 16,000 S1 S100099

1332 19.100 General Surgery Mesenteric Caval Anastomosis USG/ CT 15,000 S1 S100100

1333 19.101 General Surgery Microlaryngoscopic Surgery Clinical Note 15,000 S1 S100101

1334 19.102 General Surgery Oeshophagoscopy for foreign body removal Clinical Note Photo of removed foreign body 7,500 S1 S100102

1335 19.103 General Surgery Oesophagectomy CT HPE 17,500 S1 S100103

1336 19.104 General Surgery Portal Hypertension shunt surgery USG 18,000 S1 S100104

1337 19.105 General Surgery Pelvic Abscess - Open Drainage Clinical Note 10,000 S1 S100105

1338 19.106 General Surgery PancreaticoDuodenectomy CT HPE 25,000 S1 S100106

1339 19.107 General Surgery Distal Pancreatectomy with PancreaticoJejunostomy CT HPE 25,000 S1 S100107
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1340 19.108 General Surgery Papilloma Rectum – Excision clinical notes HPE 4,000 S1 S100108

1341 19.109 General Surgery Haemorroidectomy+ Fistulectomy clinical notes 10,000 S1 S100109

1342 19.110 General Surgery Growth in the Scalp – Excision clinical notes 4,000 S1 S100110

1343 19.111 General Surgery Porto Caval Anastomosis USG 15,000 S1 S100111

1344 19.112 General Surgery Pyeloroplasty USG 10,000 S1 S100112

1345 19.113 General Surgery Radical Mastectomy Mammogram,USG/X-ray HPE 10,000 S1 S100113

1346 19.114 General Surgery Radical Neck Dissection – Excision CT,Biopasy HPE 15,000 S1 S100114

1347 19.115 General Surgery Hernia – Spigelian USG 5,000 S1 S100115

1348 19.116 General Surgery Rectal Dilation clinical notes 2,000 S1 S100116

1349 19.117 General Surgery Prolapse of Rectal Mass – Excision clinical notes 10,000 S1 S100117

1350 19.118 General Surgery Rectopexy clinical notes 10,000 S1 S100118

1351 19.119 General Surgery Repair of Common Bile Duct USG 15,000 S1 S100119

1352 19.120 General Surgery Resection Anastomosis (Large Intestine) clinical notes 15,000 S1 S100120

1353 19.121 General Surgery Resection Anastomosis (Small Intestine) clinical notes 15,000 S1 S100121

1354 19.122 General Surgery Retroperitoneal Tumor – Excision USG/CT HPE 20,000 S1 S100122

1355 19.123 General Surgery Haemorroidectomy Clinical Notes 5,000 S1 S100123

1356 19.124 General Surgery Salivary Gland – Excision FNAC HPE 10,000 S1 S100124

1357 19.125 General Surgery Segmental Resection of Breast clinical notes 10,000 S1 S100125

1358 19.126 General Surgery Scrotal Swelling (Multiple) – Excision clinical notes,USG 5,000 S1 S100126

1359 19.127 General Surgery Sigmoid Diverticulum USG/ X-RAY 15,000 S1 S100127

1360 19.128 General Surgery Simple closure - Peptic perforation Clinical Note,X-ray 15,000 S1 S100128

1361 19.129 General Surgery Sinus – Excision clinical notes 5,000 S1 S100129

1362 19.130 General Surgery Soft Tissue Tumor (small) – Excision clinical notes HPE 5,000 S1 S100130

1363 19.131 General Surgery Soft Tissue Tumor (large) – Excision clinical notes,USG HPE 10,000 S1 S100131

1364 19.132 General Surgery Splenectomy clinical notes,USG HPE 25,000 S1 S100132

1365 19.133 General Surgery Submandibular Lymph node – Excision clinical notes,FNAC 5,000 S1 S100133

1366 19.134 General Surgery Submandibular Mass Excision + Reconstruction clinical notes,CT/FNAC HPE 20,000 S1 S100134

1367 19.135 General Surgery Swelling in foot (small) – Excision clinical notes 1,500 S1 S100135

1368 19.136 General Surgery Swelling in foot (large) – Excision clinical notes 3,500 S1 S100136

1369 19.137 General Surgery Coloectomy – Total USG/Colonoscopy HPE 20,000 S1 S100137
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1370 19.138 General Surgery Pharyngectomy& Reconstruction – Total CT/MRI HPE 20,000 S1 S100138

1371 19.139 General Surgery Tracheal Stenosis (End to end Anastamosis) (Throat) CT/MRI,Laryngoscopy 15,000 S1 S100139

1372 19.140 General Surgery Tracheoplasty (Throat) CT/USG 15,000 S1 S100140

1373 19.141 General Surgery Umbilical Sinus – Excision clinical notes 5,000 S1 S100141

1374 19.142 General Surgery Varicose Veins - Excision and Ligation Clinical notes,Doppler 10,000 S1 S100142

1375 19.143 General Surgery Vasovasostomy Clinical Note/USG 12,000 S1 S100143

1376 19.144 General Surgery Volvlous of Large Bowel Clinical Note/X-ray 25,000 S1 S100144

1377 19.145 General Surgery Cleft lip operation PRE OP CLINICAL PICTURE Clinical photograph 12,000 S1 S100145

1378 19.146 General Surgery Cleft palate repair (for each stage) PRE OP CLINICAL PICTURE Clinical photograph 12,000 S1 S100146

1379 19.147 General Surgery Cleft lip & palate operation (for each stage) PRE OP CLINICAL PICTURE Clinical photograph 15,000 S1 S100147

1380 19.148 General Surgery Aneurysm not Requiring Bypass Techniques t CT Angio CT Angio,Doppler 36,000 S1 S100148

1381 19.149 General Surgery Aneurysm Resection & Grafting CT Angio 36,000 S1 S100149

1382 19.150 General Surgery Arterial Embolectomy CT Angio/Color Doppler Doppler 17,250 S1 S100150

1383 19.151 General Surgery Carotid artery aneurysm repair Angiogram Color Doppler 17,250 S1 S100151

1384 19.152 General Surgery Carotid Body tumour - Excision Angiogram Color Doppler 20,000 S1 S100152

1385 19.153 General Surgery Cholecystectomy & Exploration of CBD USG/CT HPE 22,000 S1 S100153

1386 19.154 General Surgery Cholecystostomy USG/CT HPE 10,000 S1 S100154

1387 19.155 General Surgery Congential Arteriovenus Fistula (large) CT Angio/ Doppler 20,000 S1 S100155

1388 19.156 General Surgery Congential Arteriovenus Fistula (small) CT Angio/ Doppler 10,000 S1 S100156

1389 19.157 General Surgery Decortication (Pleurectomy) HRCT X-ray 20,000 S1 S100157

1390 19.158 General Surgery Dissecting Aneurysms CT Angio/ Cath Doppler 36,000 S1 S100158

1391 19.159 General Surgery Distal Abdominal Aorta repair Angiogram Color Doppler 36,000 S1 S100159

1392 19.160 General Surgery Estlander Operation (lip) Clinical Note 7,000 S1 S100160

1393 19.161 General Surgery Excision and Skin Graft of Venous Ulcer Clinical Note 15,000 S1 S100161

1394 19.162 General Surgery Excision of Parathyroid Adenoma/Carcinoma Biopsy,CT,Bronchoscopy Biopsy,Clinical Photograph 20,700 S1 S100162

1395 19.163 General Surgery Flap Reconstructive Surgery clinical notes 20,000 S1 S100163

1396 19.164 General Surgery Split thickness skin grafts – Small (< 4% TBSA) clinical notes Clinical Photograph 5,000 S1 S100164

1397 19.165 General Surgery Split thickness skin grafts – Medium (4 - 8% TBSA) clinical notes Clinical Photograph 10,000 S1 S100165

1398 19.166 General Surgery Split thickness skin grafts – Large (> 8% TBSA) clinical notes Clinical Photograph 15,000 S1 S100166

1399 19.167 General Surgery Free Grafts - Wolfe Grafts clinical notes Clinical Photograph 10,000 S1 S100167
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1400 19.168 General Surgery Hemi thyroidectomy USG/FNAC/TFT HPE 10,000 S1 S100168

1401 19.169 General Surgery Total thyroidectomy USG/FNAC/TFT HPE 20,000 S1 S100169

1402 19.170 General Surgery Laparoscopic Hernia Repair clinical notes Mesh Sticker 18,000 S1 S100170

1403 19.171 General Surgery Lap. Assisted left Hemi colectomy t USG HPE 25,000 S1 S100171

1404 19.172 General Surgery Lap. Assisted Right Hemi colectomy t USG HPE 25,000 S1 S100172

1405 19.173 General Surgery Lap. Assisted small bowel resection USG/CT HPE 15,000 S1 S100173

1406 19.174 General Surgery Lap. Assisted Total Colectomy USG/CT HPE 25,000 S1 S100174

1407 19.175 General Surgery Lap. Cholecystectomy & CBD exploration USG HPE 20,000 S1 S100175

1408 19.176 General Surgery Lap. For intestinal obstruction USG/CT,X-ray 15,000 S1 S100176

1409 19.177 General Surgery Lap. Hepatic resection USG/CT HPE 25,000 S1 S100177

1410 19.178 General Surgery Lap. Hydatid of liver surgery USG/CT HPE 20,000 S1 S100178

1411 19.179 General Surgery Laparoscopic Adhesinolysis Clinical notes + USG 15,000 S1 S100179

1412 19.180 General Surgery Laparoscopic Appendicectomy Clinical notes + USG HPE 18,000 S1 S100180

1413 19.181 General Surgery Laparoscopic Cholecystectomy USG HPE 15,000 S1 S100181

1414 19.182 General Surgery Laparoscopic cystogastrostomy USG 20,000 S1 S100182

1415 19.183 General Surgery Laparoscopic Gastrostomy USG/CT,Clinical note 12,000 S1 S100183

1416 19.184 General Surgery Laparoscopic Hiatus Hernia Repair OGD/USG 22,000 S1 S100184

1417 19.185 General Surgery Laparoscopic Pyloromyotomy OGD/USG 20,000 S1 S100185

1418 19.186 General Surgery Laparoscopic Rectopexy Clinical notes + USG 15,000 S1 S100186

1419 19.187 General Surgery Laparoscopic Spleenectomy Clinical notes + USG HPE 16,500 S1 S100187

1420 19.188 General Surgery Laparoscopic umbilical hernia repair Clinical notes + USG 15,000 S1 S100188

1421 19.189 General Surgery Laparoscopic ventral hernia repair Clinical notes + USG Mesh Sticker 20,000 S1 S100189

1422 19.190 General Surgery Laparotomy-peritonitis lavage and drainage Clinical notes + USG 10,000 S1 S100190

1423 19.191 General Surgery Ligation of Ankle Perforators Doppler 5,000 S1 S100191

1424 19.192 General Surgery Lymphatics Excision of Subcutaneous Tissues In Lymphoedema clinical notes,USG pelvis 10,000 S1 S100192

1425 19.193 General Surgery Repair of Main Arteries of the Limbs Clinical notes,Doppler 25,000 S1 S100193

1426 19.194 General Surgery Mediastinal Tumour CT Biopsy,Clinical photo showing scar 20,000 S1 S100194

1427 19.195 General Surgery Oesophagectomy for Carcinoma Oesophagus USG/CT,Biopsy HPE 25,000 S1 S100195

1428 19.196 General Surgery Operation for Bleeding Peptic Ulcer Clinical notes,OGD 15,000 S1 S100196

1429 19.197 General Surgery Operation for Carcinoma Lip – Vermilionectomy Clinical notes HPE 10,000 S1 S100197
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1430 19.198 General Surgery Operation for Carcinoma Lip - Wedge Excision and Vermilionectomy Clinical notes HPE 12,000 S1 S100198

1431 19.199 General Surgery Operation for Carcinoma Lip - Wedge-Excision Clinical notes HPE 10,000 S1 S100199

1432 19.200 General Surgery Appendicectomy - Appendicular Abscess – Drainage USG HPE 12,000 S1 S100200

1433 19.201 General Surgery Caecostomy Clinical notes + USG 10,000 S1 S100201

1434 19.202 General Surgery Closure of Colostomy Clinical notes 5,000 S1 S100202

1435 19.203 General Surgery Coccygeal Teratoma Excision USG/CT HPE 15,000 S1 S100203

1436 19.204 General Surgery Congenital Atresia & Stenosis of Small Intestine USG/CT 20,000 S1 S100204

1437 19.205 General Surgery CystoJejunostomy/or Cystogastrostomy clinical notes 20,000 S1 S100205

1438 19.206 General Surgery Drainage of perivertebral abscess Clinical notes + USG 10,000 S1 S100206

clinical notes,OGD/CHEST
1439 19.207 General Surgery Hernia -hiatus-Transthoracic 25,000 S1 S100207
X- ray

1440 19.208 General Surgery Intercostal drainage X-ray X-ray 2,000 S1 S100208

1441 19.209 General Surgery Operation for carcinoma lip- cheek advancement clinical notes HPE 12,000 S1 S100209

1442 19.210 General Surgery Thymectomy CT scan HPE 20,000 S1 S100210

1443 19.211 General Surgery Operation of Choledochal Cyst USG 15,000 S1 S100211
clinical
1444 19.212 General Surgery Operations for Acquired Arteriovenous Fistula 15,000 S1 S100212
notes,Doppler/Angio
1445 19.213 General Surgery Operations for Replacement of Oesophagus by Colon clinical notes,OGD 25,000 S1 S100213

1446 19.214 General Surgery Hemodialysis per sitting RFT Serum Creatinine 2,300 S1 S100214

1447 19.215 General Surgery Parapharyngeal Tumour Excision USG,CT/FNAC HPE 20,000 S1 S100215

1448 19.216 General Surgery Partial/Subtotal Gastrectomy for Carcinoma OGD/CT HPE 22,000 S1 S100216

1449 19.217 General Surgery Patch Graft Angioplasty Angiography 20,000 S1 S100217

1450 19.218 General Surgery Pericardiostomy Clinical note,X-ray 30,000 S1 S100218

1451 19.219 General Surgery Pneumonectomy CT/Xray Clinical photo showing scar,X-ray 25,000 S1 S100219

1452 19.220 General Surgery Removal of Foreign Body from Trachea or Oesophagus clinical notes Photograph of removed foreign body 5,000 S1 S100220

1453 19.221 General Surgery Removal Tumours of Chest Wall USG/CT HPE 20,000 S1 S100221

1454 19.222 General Surgery Procedures Requiring Bypass Techniques Doopler/Angio 35,000 S1 S100222

1455 19.223 General Surgery Resection Enucleation of Adenoma (lung) HRCT HPE 10,000 S1 S100223

1456 19.224 General Surgery Rib Resection & Drainage X-ray/USG X-ray 10,000 S1 S100224

1457 19.225 General Surgery Skin Flaps - Rotation Flaps clinical notes 6,200 S1 S100225
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

1458 19.226 General Surgery Splenectomy - For Trauma CT Angio Report HPE 20,000 S1 S100226

1459 19.227 General Surgery Surgery for Arterial Aneurism Spleen Artery Doopler/Angio 20,000 S1 S100227

1460 19.228 General Surgery Surgery for Arterial Aneurism –Vertebral Doopler/MR Angio 25,000 S1 S100228

1461 19.229 General Surgery Sympathetectomy – Cervical clinical notes 5,000 S1 S100229

1462 19.230 General Surgery Temporal Bone resection clinical notes 15,000 S1 S100230

1463 19.231 General Surgery Thorachostomy X-ray,clinical notes 10,000 S1 S100231

1464 19.232 General Surgery Thoracocentesis X-ray 1,500 S1 S100232

1465 19.233 General Surgery Thoracoplasty X-ray 20,000 S1 S100233

1466 19.234 General Surgery Thoracoscopic Decortication CT X-ray 25,000 S1 S100234

1467 19.235 General Surgery Thoracoscopic Hydatid Cyst excision CT X-ray 20,000 S1 S100235

1468 19.236 General Surgery Thoracoscopic Lobectomy CT X-ray 25,000 S1 S100236

1469 19.237 General Surgery Thoracoscopic Pneumonectomy CT X-ray 30,000 S1 S100237

1470 19.238 General Surgery Thoracoscopic Segmental Resection CT X-ray 25,000 S1 S100238

1471 19.239 General Surgery Thoracoscopic Sympathectomy CT X-ray 15,000 S1 S100239

1472 19.240 General Surgery Thrombendarterectomy CT/Angio 15,000 S1 S100240

1473 19.241 General Surgery Thorax (penetrating wounds) clinical notes,CT/X-ray X-ray 12,500 S1 S100241

1474 19.242 General Surgery Total Thyroidectomy and Block Dissection USG HPE 20,000 S1 S100242

1475 19.243 General Surgery Trendelenburg Operation Doppler 10,000 S1 S100243

1476 19.244 General Surgery Debridement of Ulcer-Leprosy clinical notes 5,000 S1 S100244

1477 19.245 General Surgery Tissue Reconstruction Flap Leprosy clinical notes 25,000 S1 S100245

1478 19.246 General Surgery Tendon Transfer-Leprosy clinical notes 25,000 S1 S100246

1479 19.247 General Surgery Adhenolysis + Appendicectomy USG HPE 20,000 S1 S100247

1480 19.248 General Surgery Hernia - Repair & release of obstruction+ Hernioplasty clinical notes 20,000 S1 S100248

1481 19.249 General Surgery Aspiration of cold Abscess of Lymphnode clinical notes HPE/Cytology 3,000 S1 S100249

1482 19.250 General Surgery Aspiration of Empyema X-ray Fluid-RM/CS 2,000 S1 S100250

clinical note,Serum
1483 19.251 General Surgery AV Shunt for dialysis Doppler 6,000 S1 S100251
Creatinine

clinical notes,Serum
1484 19.252 General Surgery Peritoneal dialysis per sitting Serum Creatinine 2,300 S1 S100252
Creatinine

1485 19.253 General Surgery Vasectomy clinical notes clinical notes 2,500 S1 S100253
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

1486 19.254 General Surgery Concern Investigation Concern Investigation 1,00,000 S1 U100
family,Package amount is Negotiable)

Cluster - 20 ORAL AND MAXILLO FACIAL SURGERY

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Oral and
1487 20.1 Maxillofacial Fixation of fracture of jaw with closed reduction (1 jaw) using wires - under LA OPG/CT Scan Clinical Photo 5,000 S16 S1600001
Surgery

Oral and
Fixation of fracture of jaw with open reduction (1 jaw) and fixing of plates/ wire –
1488 20.2 Maxillofacial OPG/CT Scan Clinical Photo 12,000 S16 S1600002
under GA
Surgery
Oral and
1489 20.3 Maxillofacial Sequestrectomy OPG/CT Scan Clinical Photo 1,500 S16 S1600003
Surgery
Oral and
1490 20.4 Maxillofacial TM joint ankylosis of both jaws - under GA OPG/CT Scan Clinical Photo 15,000 S16 S1600004
Surgery
Oral and
1491 20.5 Maxillofacial Release of fibrous bands & grafting -in (OSMF) treatment under GA Clinical Photo Clinical Photo 3,000 S16 S1600005
Surgery
Oral and
1492 20.6 Maxillofacial Extraction of impacted tooth under LA X-Ray Clinical Photo 500 S16 S1600006
Surgery
Oral and
Cyst & tumour of Maxilla/mandible by enucleation/excision/marsupialization under
1493 20.7 Maxillofacial OPG/CT Scan/X-Ray Clinical Photo 2,500 S16 S1600007
LA
Surgery
Oral and
1494 20.8 Maxillofacial Mandible Tumour Resection and reconstruction/Cancer surgery OPG/CT Scan Clinical Photo 6,000 S16 S1600008
Surgery
Oral and
1495 20.9 Maxillofacial Cleft lip and palate surgery (each stage) Clinical Photo Clinical Photo 15,000 S16 S1600009
Surgery
Oral and
Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per
1496 20.10 Maxillofacial Concern Investigation Concern Investigation 1,00,000 S16 U100
family,Package amount is Negotiable)
Surgery
Cluster - 21 GENERAL MEDICINE
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Government Reserve
1497 21.1 A General Medicine Acute gastroenteritis with moderate dehydration (admission type: Routine ward ) Clinical Notes clinical notes 1800 (Package Amount per M1 M100001
day)

Government Reserve
21.1 B General Medicine Acute gastroenteritis with moderate dehydration (admission type: HDU ) Clinical Notes clinical notes 2700 (Package Amount per M1 M100001
day)

Government Reserve
Acute gastroenteritis with moderate dehydration (admission type: ICU ,without
21.1 C General Medicine Clinical Notes clinical notes 3600 (Package Amount per M1 M100001
ventilator)
day)
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Government Reserve
Acute gastroenteritis with moderate dehydration (admission type: ICU (with
21.1 D General Medicine Clinical Notes clinical notes 4,500 (Package Amount per M1 M100001
ventilator )
day)

Government Reserve
X-Ray abd.Standing /USG
1498 21.2 A General Medicine Recurrent vomiting with dehydration (admission type: Routine ward ) clinical notes 1800 (Package Amount per M1 M100002
Abd.Pelvis,clinical notes
day)

Government Reserve
X-Ray abd.Standing /USG
21.2 B General Medicine Recurrent vomiting with dehydration(admission type: HDU ) clinical notes 2700 (Package Amount per M1 M100002
Abd.Pelvis,clinical notes
day)

Government Reserve
X-Ray abd.Standing /USG
21.2 C General Medicine Recurrent vomiting with dehydration(admission type: ICU ,without ventilator) clinical notes 3600 (Package Amount per M1 M100002
Abd.Pelvis,clinical notes
day)

Government Reserve
X-Ray abd.Standing /USG
21.2 D General Medicine Recurrent vomiting with dehydration(admission type: ICU (with ventilator ) clinical notes 4,500 (Package Amount per M1 M100002
Abd.Pelvis,clinical notes
day)

Government Reserve
1499 21.3 A General Medicine Dysentery (admission type: Routine ward ) Clinical Notes clinical notes 1800 (Package Amount per M1 M100003
day)

Government Reserve
21.3 B General Medicine Dysentery(admission type: HDU ) Clinical Notes clinical notes 2700 (Package Amount per M1 M100003
day)

Government Reserve
21.3 C General Medicine Dysentery(admission type: ICU ,without ventilator) Clinical Notes clinical notes 3600 (Package Amount per M1 M100003
day)

Government Reserve
21.3 D General Medicine Dysentery(admission type: ICU (with ventilator ) Clinical Notes clinical notes 4,500 (Package Amount per M1 M100003
day)

Package Amount per

1500 21.4 A General Medicine Renal colic (admission type: Routine ward ) X-Ray/USG clinical notes 1800 M1 M100004
day

Package Amount per

21.4 B General Medicine Renal colic(admission type: HDU ) X-Ray/USG clinical notes 2700 M1 M100004
day

Package Amount per

21.4 C General Medicine Renal colic(admission type: ICU ,without ventilator) X-Ray/USG clinical notes 3600 M1 M100004
day

Package Amount per

21.4 D General Medicine Renal colic(admission type: ICU (with ventilator ) X-Ray/USG clinical notes 4,500 M1 M100004
day

Package Amount per

1501 21.5 A General Medicine Acute bronchitis (admission type: Routine ward ) Chest X-Ray clinical notes 1800 M1 M100005
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.5 B General Medicine Acute bronchitis(admission type: HDU ) Chest X-Ray clinical notes 2700 M1 M100005
day

Package Amount per

21.5 C General Medicine Acute bronchitis(admission type: ICU ,without ventilator) Chest X-Ray clinical notes 3600 M1 M100005
day

Package Amount per

21.5 D General Medicine Acute bronchitis(admission type: ICU (with ventilator ) Chest X-Ray clinical notes 4,500 M1 M100005
day

Package Amount per

1502 21.6 A General Medicine Pneumothroax (admission type: Routine ward ) Chest X-Ray clinical notes 1800 M1 M100006
day

Package Amount per

21.6 B General Medicine Pneumothroax(admission type: HDU ) Chest X-Ray clinical notes 2700 M1 M100006
day

Package Amount per

21.6 C General Medicine Pneumothroax(admission type: ICU ,without ventilator) Chest X-Ray clinical notes 3600 M1 M100006
day

Package Amount per

21.6 D General Medicine Pneumothroax(admission type: ICU (with ventilator ) Chest X-Ray clinical notes 4,500 M1 M100006
day

Package Amount per

1503 21.7 A General Medicine Accelerated hypertension (admission type: Routine ward ) clinical notes,ECG clinical notes 1800 M1 M100007
day

Package Amount per

21.7 B General Medicine Accelerated hypertension(admission type: HDU ) clinical notes,ECG clinical notes 2700 M1 M100007
day

Package Amount per

21.7 C General Medicine Accelerated hypertension(admission type: ICU ,without ventilator) clinical notes,ECG clinical notes 3600 M1 M100007
day

Package Amount per

21.7 D General Medicine Accelerated hypertension(admission type: ICU (with ventilator ) clinical notes,ECG clinical notes 4,500 M1 M100007
day

Chest X-Ray, 2 D Echo, Package Amount per

1504 21.8 A General Medicine Congestive heart failure (admission type: Routine ward ) clinical notes 1800 M1 M100008
ECG day

Chest X-Ray, 2 D Echo, Package Amount per

21.8 B General Medicine Congestive heart failure(admission type: HDU ) clinical notes 2700 M1 M100008
ECG day

Chest X-Ray, 2 D Echo, Package Amount per

21.8 C General Medicine Congestive heart failure(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100008
ECG day

Chest X-Ray, 2 D Echo, Package Amount per

21.8 D General Medicine Congestive heart failure(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100008
ECG day

Package Amount per

1505 21.9 A General Medicine Severe anemia (admission type: Routine ward ) HB clinical notes 1800 M1 M100009
day

Package Amount per

21.9 B General Medicine Severe anemia(admission type: HDU ) HB clinical notes 2700 M1 M100009
day

Package Amount per

21.9 C General Medicine Severe anemia(admission type: ICU ,without ventilator) HB clinical notes 3600 M1 M100009
day

Package Amount per

21.9 D General Medicine Severe anemia(admission type: ICU (with ventilator ) HB clinical notes 4,500 M1 M100009
day

FBS, PP2BS,HBA1C, Urine Package Amount per

1506 21.10 A General Medicine Diabetic ketoacidosis (admission type: Routine ward ) clinical notes 1800 M1 M100010
Ketons day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

FBS, PP2BS,HBA1C, Urine Package Amount per

21.10 B General Medicine Diabetic ketoacidosis(admission type: HDU ) clinical notes 2700 M1 M100010
Ketons day

FBS, PP2BS,HBA1C, Urine Package Amount per

21.10 C General Medicine Diabetic ketoacidosis(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100010
Ketons day

FBS, PP2BS,HBA1C, Urine Package Amount per

21.10 D General Medicine Diabetic ketoacidosis(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100010
Ketons day

Package Amount per

1507 21.11 A General Medicine Acute febrile illness (admission type: Routine ward ) Fever Profile clinical notes 1800 M1 M100011
day

Package Amount per

21.11 B General Medicine Acute febrile illness(admission type: HDU ) Fever Profile clinical notes 2700 M1 M100011
day

Package Amount per

21.11 C General Medicine Acute febrile illness(admission type: ICU ,without ventilator) Fever Profile clinical notes 3600 M1 M100011
day

Package Amount per

21.11 D General Medicine Acute febrile illness(admission type: ICU (with ventilator ) Fever Profile clinical notes 4,500 M1 M100011
day

Package Amount per

1508 21.12 A General Medicine Acutre excaberation of COPD (admission type: Routine ward ) Chest X-Ray clinical notes 1800 M1 M100012
day

Package Amount per

21.12 B General Medicine Acutre excaberation of COPD(admission type: HDU ) Chest X-Ray clinical notes 2700 M1 M100012
day

Package Amount per

21.12 C General Medicine Acutre excaberation of COPD(admission type: ICU ,without ventilator) Chest X-Ray clinical notes 3600 M1 M100012
day

Package Amount per

21.12 D General Medicine Acutre excaberation of COPD(admission type: ICU (with ventilator ) Chest X-Ray clinical notes 4,500 M1 M100012
day

USG KUB, Urine routine Package Amount per

1509 21.13 A General Medicine UTI (admission type: Routine ward ) clinical notes 1800 M1 M100013
Micro day

USG KUB, Urine routine Package Amount per

21.13 B General Medicine UTI(admission type: HDU ) clinical notes 2700 M1 M100013
Micro day

USG KUB, Urine routine Package Amount per

21.13 C General Medicine UTI(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100013
Micro day

USG KUB, Urine routine Package Amount per

21.13 D General Medicine UTI(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100013
Micro day

Package Amount per

1510 21.14 A General Medicine Malaria (admission type: Routine ward ) PSMP clinical notes 1800 M1 M100014
day

Package Amount per

21.14 B General Medicine Malaria(admission type: HDU ) PSMP clinical notes 2700 M1 M100014
day

Package Amount per

21.14 C General Medicine Malaria(admission type: ICU ,without ventilator) PSMP clinical notes 3600 M1 M100014
day

Package Amount per

21.14 D General Medicine Malaria(admission type: ICU (with ventilator ) PSMP clinical notes 4,500 M1 M100014
day

Package Amount per

1511 21.15 A General Medicine Dengue fever (admission type: Routine ward ) NS, Antigen clinical notes 1800 M1 M100015
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.15 B General Medicine Dengue fever(admission type: HDU ) NS, Antigen clinical notes 2700 M1 M100015
day

Package Amount per

21.15 C General Medicine Dengue fever(admission type: ICU ,without ventilator) NS, Antigen clinical notes 3600 M1 M100015
day

Package Amount per

21.15 D General Medicine Dengue fever(admission type: ICU (with ventilator ) NS, Antigen clinical notes 4,500 M1 M100015
day

Package Amount per

1512 21.16 A General Medicine Chikungunya fever (admission type: Routine ward ) Clinical History clinical notes 1800 M1 M100016
day

Package Amount per

21.16 B General Medicine Chikungunya fever(admission type: HDU ) Clinical History clinical notes 2700 M1 M100016
day

Package Amount per

21.16 C General Medicine Chikungunya fever(admission type: ICU ,without ventilator) Clinical History clinical notes 3600 M1 M100016
day

Package Amount per

21.16 D General Medicine Chikungunya fever(admission type: ICU (with ventilator ) Clinical History clinical notes 4,500 M1 M100016
day

Package Amount per

1513 21.17 A General Medicine Leptospirosis (admission type: Routine ward ) Clinical History clinical notes 1800 M1 M100017
day

Package Amount per

21.17 B General Medicine Leptospirosis(admission type: HDU ) Clinical History clinical notes 2700 M1 M100017
day

Package Amount per

21.17 C General Medicine Leptospirosis(admission type: ICU ,without ventilator) Clinical History clinical notes 3600 M1 M100017
day

Package Amount per

21.17 D General Medicine Leptospirosis(admission type: ICU (with ventilator ) Clinical History clinical notes 4,500 M1 M100017
day

Package Amount per

1514 21.18 A General Medicine Enteric fever (admission type: Routine ward ) CBC, S. Widal clinical notes 1800 M1 M100018
day

Package Amount per

21.18 B General Medicine Enteric fever(admission type: HDU ) CBC, S. Widal clinical notes 2700 M1 M100018
day

Package Amount per

21.18 C General Medicine Enteric fever(admission type: ICU ,without ventilator) CBC, S. Widal clinical notes 3600 M1 M100018
day

Package Amount per

21.18 D General Medicine Enteric fever(admission type: ICU (with ventilator ) CBC, S. Widal clinical notes 4,500 M1 M100018
day

Package Amount per

1515 21.19 A General Medicine Pneumonia (admission type: Routine ward ) CBC, X-Ray Chest clinical notes 1800 M1 M100019
day

Package Amount per

21.19 B General Medicine Pneumonia(admission type: HDU ) CBC, X-Ray Chest clinical notes 2700 M1 M100019
day

Package Amount per

21.19 C General Medicine Pneumonia(admission type: ICU ,without ventilator) CBC, X-Ray Chest clinical notes 3600 M1 M100019
day

Package Amount per

21.19 D General Medicine Pneumonia(admission type: ICU (with ventilator ) CBC, X-Ray Chest clinical notes 4,500 M1 M100019
day

Package Amount per

1516 21.20 A General Medicine Acute excaberation of ILD (admission type: Routine ward ) Chest X-Ray clinical notes 1800 M1 M100020
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.20 B General Medicine Acute excaberation of ILD(admission type: HDU ) Chest X-Ray clinical notes 2700 M1 M100020
day

Package Amount per

21.20 C General Medicine Acute excaberation of ILD(admission type: ICU ,without ventilator) Chest X-Ray clinical notes 3600 M1 M100020
day

Package Amount per

21.20 D General Medicine Acute excaberation of ILD(admission type: ICU (with ventilator ) Chest X-Ray clinical notes 4,500 M1 M100020
day

USG, Chest X-Ray, X-ray Package Amount per

1517 21.21 A General Medicine Liver abscess (admission type: Routine ward ) clinical notes 1800 M1 M100021
Abd day

USG, Chest X-Ray, X-ray Package Amount per

21.21 B General Medicine Liver abscess(admission type: HDU ) clinical notes 2700 M1 M100021
Abd day

USG, Chest X-Ray, X-ray Package Amount per

21.21 C General Medicine Liver abscess(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100021
Abd day

USG, Chest X-Ray, X-ray Package Amount per

21.21 D General Medicine Liver abscess(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100021
Abd day

USG ABD, Hepatits Package Amount per

1518 21.22 A General Medicine Acute viral hepatitis (admission type: Routine ward ) clinical notes 1800 M1 M100022
Marker, HBSAG,NTHCV day

USG ABD, Hepatits Package Amount per

21.22 B General Medicine Acute viral hepatitis(admission type: HDU ) clinical notes 2700 M1 M100022
Marker, HBSAG,NTHCV day

USG ABD, Hepatits Package Amount per

21.22 C General Medicine Acute viral hepatitis(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100022
Marker, HBSAG,NTHCV day

USG ABD, Hepatits Package Amount per

21.22 D General Medicine Acute viral hepatitis(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100022
Marker, HBSAG,NTHCV day

Package Amount per

1519 21.23 A General Medicine Snake bite (admission type: Routine ward ) BT,CT,PT,APTT clinical notes 1800 M1 M100023
day

Package Amount per

21.23 B General Medicine Snake bite(admission type: HDU ) BT,CT,PT,APTT clinical notes 2700 M1 M100023
day

Package Amount per

21.23 C General Medicine Snake bite(admission type: ICU ,without ventilator) BT,CT,PT,APTT clinical notes 3600 M1 M100023
day

Package Amount per

21.23 D General Medicine Snake bite(admission type: ICU (with ventilator ) BT,CT,PT,APTT clinical notes 4,500 M1 M100023
day

Package Amount per

1520 21.24 A General Medicine Acute organophosphorus poisoning (admission type: Routine ward ) Anti Choline esterase clinical notes 1800 M1 M100024
day

Package Amount per

21.24 B General Medicine Acute organophosphorus poisoning(admission type: HDU ) Anti Choline esterase clinical notes 2700 M1 M100024
day

Package Amount per

21.24 C General Medicine Acute organophosphorus poisoning(admission type: ICU ,without ventilator) Anti Choline esterase clinical notes 3600 M1 M100024
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.24 D General Medicine Acute organophosphorus poisoning(admission type: ICU (with ventilator ) Anti Choline esterase clinical notes 4,500 M1 M100024
day

Package Amount per

1521 21.25 A General Medicine Other poisoning (admission type: Routine ward ) Clinical Notes clinical notes 1800 M1 M100025
day

Package Amount per

21.25 B General Medicine Other poisoning(admission type: HDU ) Clinical Notes clinical notes 2700 M1 M100025
day

Package Amount per

21.25 C General Medicine Other poisoning(admission type: ICU ,without ventilator) Clinical Notes clinical notes 3600 M1 M100025
day

Package Amount per

21.25 D General Medicine Other poisoning(admission type: ICU (with ventilator ) Clinical Notes clinical notes 4,500 M1 M100025
day

Package Amount per

1522 21.26 A General Medicine Pyrexia of unknown origin (admission type: Routine ward ) Fever Profile clinical notes 1800 M1 M100026
day

Package Amount per

21.26 B General Medicine Pyrexia of unknown origin(admission type: HDU ) Fever Profile clinical notes 2700 M1 M100026
day

Package Amount per

21.26 C General Medicine Pyrexia of unknown origin(admission type: ICU ,without ventilator) Fever Profile clinical notes 3600 M1 M100026
day

Package Amount per

21.26 D General Medicine Pyrexia of unknown origin(admission type: ICU (with ventilator ) Fever Profile clinical notes 4,500 M1 M100026
day

Chest X-Ray, Package Amount per

1523 21.27 A General Medicine Pericardial/ Pleural tuberculosis (admission type: Routine ward ) clinical notes 1800 M1 M100027
PL.TAPPING,AFB day

Chest X-Ray, Package Amount per

21.27 B General Medicine Pericardial/ Pleural tuberculosis(admission type: HDU ) clinical notes 2700 M1 M100027
PL.TAPPING,AFB day

Chest X-Ray, Package Amount per

21.27 C General Medicine Pericardial/ Pleural tuberculosis(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100027
PL.TAPPING,AFB day

Chest X-Ray, Package Amount per

21.27 D General Medicine Pericardial/ Pleural tuberculosis(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100027
PL.TAPPING,AFB day

Clinical History/Concern Package Amount per

1524 21.28 A General Medicine Systematic lupus erythematosus (admission type: Routine ward ) clinical notes 1800 M1 M100028
Investigation day

Clinical History/Concern Package Amount per

21.28 B General Medicine Systematic lupus erythematosus(admission type: HDU ) clinical notes 2700 M1 M100028
Investigation day

Clinical History/Concern Package Amount per

21.28 C General Medicine Systematic lupus erythematosus(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100028
Investigation day

Clinical History/Concern Package Amount per

21.28 D General Medicine Systematic lupus erythematosus(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100028
Investigation day

Clinical History/Concern Package Amount per

1525 21.29 A General Medicine Vasculitis (admission type: Routine ward ) clinical notes 1800 M1 M100029
Investigation day

Clinical History/Concern Package Amount per

21.29 B General Medicine Vasculitis(admission type: HDU ) clinical notes 2700 M1 M100029
Investigation day

Clinical History/Concern Package Amount per

21.29 C General Medicine Vasculitis(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100029
Investigation day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical History/Concern Package Amount per

21.29 D General Medicine Vasculitis(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100029
Investigation day

Package Amount per

1526 21.30 A General Medicine Seizures (admission type: Routine ward ) Clinical History clinical notes 1800 M1 M100030
day

Package Amount per

21.30 B General Medicine Seizures(admission type: HDU ) Clinical History clinical notes 2700 M1 M100030
day

Package Amount per

21.30 C General Medicine Seizures(admission type: ICU ,without ventilator) Clinical History clinical notes 3600 M1 M100030
day

Package Amount per

21.30 D General Medicine Seizures(admission type: ICU (with ventilator ) Clinical History clinical notes 4,500 M1 M100030
day

Package Amount per

1527 21.31 A General Medicine Bacterial/ fungal endocarditis (admission type: Routine ward ) 2 D Echo clinical notes 1800 M1 M100031
day

Package Amount per

21.31 B General Medicine Bacterial/ fungal endocarditis(admission type: HDU ) 2 D Echo clinical notes 2700 M1 M100031
day

Package Amount per

21.31 C General Medicine Bacterial/ fungal endocarditis(admission type: ICU ,without ventilator) 2 D Echo clinical notes 3600 M1 M100031
day

Package Amount per

21.31 D General Medicine Bacterial/ fungal endocarditis(admission type: ICU (with ventilator ) 2 D Echo clinical notes 4,500 M1 M100031
day

Package Amount per

1528 21.32 A General Medicine Acute inflammatory demyelinating polyneuropathy (admission type: Routine ward ) EMG,NCV,CSF,MRI clinical notes 1800 M1 M100032
day

Package Amount per

21.32 B General Medicine Acute inflammatory demyelinating polyneuropathy(admission type: HDU ) EMG,NCV,CSF,MRI clinical notes 2700 M1 M100032
day

Acute inflammatory demyelinating polyneuropathy(admission type: ICU ,without Package Amount per
21.32 C General Medicine EMG,NCV,CSF,MRI clinical notes 3600 M1 M100032
ventilator) day

Acute inflammatory demyelinating polyneuropathy(admission type: ICU (with Package Amount per
21.32 D General Medicine EMG,NCV,CSF,MRI clinical notes 4,500 M1 M100032
ventilator ) day

Package Amount per

1529 21.33 A General Medicine Lung abscess/ Empyema (admission type: Routine ward ) Chest X-Ray, CT Thorax clinical notes 1800 M1 M100033
day

Package Amount per

21.33 B General Medicine Lung abscess/ Empyema(admission type: HDU ) Chest X-Ray, CT Thorax clinical notes 2700 M1 M100033
day

Package Amount per

21.33 C General Medicine Lung abscess/ Empyema(admission type: ICU ,without ventilator) Chest X-Ray, CT Thorax clinical notes 3600 M1 M100033
day

Package Amount per

21.33 D General Medicine Lung abscess/ Empyema(admission type: ICU (with ventilator ) Chest X-Ray, CT Thorax clinical notes 4,500 M1 M100033
day

Package Amount per

1530 21.34 A General Medicine Acute and chronic meningitis (admission type: Routine ward ) CSF,MRI Brain clinical notes 1800 M1 M100034
day

Package Amount per

21.34 B General Medicine Acute and chronic meningitis(admission type: HDU ) CSF,MRI Brain clinical notes 2700 M1 M100034
day

Package Amount per

21.34 C General Medicine Acute and chronic meningitis(admission type: ICU ,without ventilator) CSF,MRI Brain clinical notes 3600 M1 M100034
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.34 D General Medicine Acute and chronic meningitis(admission type: ICU (with ventilator ) CSF,MRI Brain clinical notes 4,500 M1 M100034
day

Package Amount per

1531 21.35 A General Medicine Viral encephalitis (admission type: Routine ward ) CSF, MRI clinical notes 1800 M1 M100035
day

Package Amount per

21.35 B General Medicine Viral encephalitis(admission type: HDU ) CSF, MRI clinical notes 2700 M1 M100035
day

Package Amount per

21.35 C General Medicine Viral encephalitis(admission type: ICU ,without ventilator) CSF, MRI clinical notes 3600 M1 M100035
day

Package Amount per

21.35 D General Medicine Viral encephalitis(admission type: ICU (with ventilator ) CSF, MRI clinical notes 4,500 M1 M100035
day

Package Amount per

1532 21.36 A General Medicine Persistent/ Chronic diarrohea (admission type: Routine ward ) Concern Investigation clinical notes 1800 M1 M100036
day

Package Amount per

21.36 B General Medicine Persistent/ Chronic diarrohea(admission type: HDU ) Concern Investigation clinical notes 2700 M1 M100036
day

Package Amount per

21.36 C General Medicine Persistent/ Chronic diarrohea(admission type: ICU ,without ventilator) Concern Investigation clinical notes 3600 M1 M100036
day

Package Amount per

21.36 D General Medicine Persistent/ Chronic diarrohea(admission type: ICU (with ventilator ) Concern Investigation clinical notes 4,500 M1 M100036
day

Package Amount per

1533 21.37 A General Medicine Acute and chronic pancreatitis (admission type: Routine ward ) USG ABD, CT clinical notes 1800 M1 M100037
day

Package Amount per

21.37 B General Medicine Acute and chronic pancreatitis(admission type: HDU ) USG ABD, CT clinical notes 2700 M1 M100037
day

Package Amount per

21.37 C General Medicine Acute and chronic pancreatitis(admission type: ICU ,without ventilator) USG ABD, CT clinical notes 3600 M1 M100037
day

Package Amount per

21.37 D General Medicine Acute and chronic pancreatitis(admission type: ICU (with ventilator ) USG ABD, CT clinical notes 4,500 M1 M100037
day

Package Amount per

1534 21.38 A General Medicine Visceral leishmaniasis (admission type: Routine ward ) IGM,Ab clinical notes 1800 M1 M100038
day

Package Amount per

21.38 B General Medicine Visceral leishmaniasis(admission type: HDU ) IGM,Ab clinical notes 2700 M1 M100038
day

Package Amount per

21.38 C General Medicine Visceral leishmaniasis(admission type: ICU ,without ventilator) IGM,Ab clinical notes 3600 M1 M100038
day

Package Amount per

21.38 D General Medicine Visceral leishmaniasis(admission type: ICU (with ventilator ) IGM,Ab clinical notes 4,500 M1 M100038
day

Package Amount per

1535 21.39 A General Medicine HIV with complications (admission type: Routine ward ) HIV clinical notes 1800 M1 M100039
day

Package Amount per

21.39 B General Medicine HIV with complications(admission type: HDU ) HIV clinical notes 2700 M1 M100039
day

Package Amount per

21.39 C General Medicine HIV with complications(admission type: ICU ,without ventilator) HIV clinical notes 3600 M1 M100039
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.39 D General Medicine HIV with complications(admission type: ICU (with ventilator ) HIV clinical notes 4,500 M1 M100039
day

Package Amount per

1536 21.40 A General Medicine Neuromuscular disorders (admission type: Routine ward ) EMG,NCV,MRI clinical notes 1800 M1 M100040
day

Package Amount per

21.40 B General Medicine Neuromuscular disorders(admission type: HDU ) EMG,NCV,MRI clinical notes 2700 M1 M100040
day

Package Amount per

21.40 C General Medicine Neuromuscular disorders(admission type: ICU ,without ventilator) EMG,NCV,MRI clinical notes 3600 M1 M100040
day

Package Amount per

21.40 D General Medicine Neuromuscular disorders(admission type: ICU (with ventilator ) EMG,NCV,MRI clinical notes 4,500 M1 M100040
day

Package Amount per

1537 21.41 A General Medicine Metabolic encephalopathy (admission type: Routine ward ) RFT,LFT,Uric acid, CBC clinical notes 1800 M1 M100041
day

Package Amount per

21.41 B General Medicine Metabolic encephalopathy(admission type: HDU ) RFT,LFT,Uric acid, CBC clinical notes 2700 M1 M100041
day

Package Amount per

21.41 C General Medicine Metabolic encephalopathy(admission type: ICU ,without ventilator) RFT,LFT,Uric acid, CBC clinical notes 3600 M1 M100041
day

Package Amount per

21.41 D General Medicine Metabolic encephalopathy(admission type: ICU (with ventilator ) RFT,LFT,Uric acid, CBC clinical notes 4,500 M1 M100041
day

Sicklmg test, Electro Package Amount per

1538 21.42 A General Medicine Sickle cell Anemia (admission type: Routine ward ) clinical notes 1800 M1 M100042
phoresis day

Sicklmg test, Electro Package Amount per

21.42 B General Medicine Sickle cell Anemia(admission type: HDU ) clinical notes 2700 M1 M100042
phoresis day

Sicklmg test, Electro Package Amount per

21.42 C General Medicine Sickle cell Anemia(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100042
phoresis day

Sicklmg test, Electro Package Amount per

21.42 D General Medicine Sickle cell Anemia(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100042
phoresis day

Package Amount per

1539 21.43 A General Medicine Poisonings with unstable vitals (admission type: Routine ward ) Gastic Levage clinical notes 1800 M1 M100043
day

Package Amount per

21.43 B General Medicine Poisonings with unstable vitals(admission type: HDU ) Gastic Levage clinical notes 2700 M1 M100043
day

Package Amount per

21.43 C General Medicine Poisonings with unstable vitals(admission type: ICU ,without ventilator) Gastic Levage clinical notes 3600 M1 M100043
day

Package Amount per

21.43 D General Medicine Poisonings with unstable vitals(admission type: ICU (with ventilator ) Gastic Levage clinical notes 4,500 M1 M100043
day

Package Amount per

1540 21.44 A General Medicine Type 1/2 respiratory failure (admission type: Routine ward ) ABG Analysis clinical notes 1800 M1 M100044
day

Package Amount per

21.44 B General Medicine Type 1/2 respiratory failure(admission type: HDU ) ABG Analysis clinical notes 2700 M1 M100044
day

Package Amount per

21.44 C General Medicine Type 1/2 respiratory failure(admission type: ICU ,without ventilator) ABG Analysis clinical notes 3600 M1 M100044
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.44 D General Medicine Type 1/2 respiratory failure(admission type: ICU (with ventilator ) ABG Analysis clinical notes 4,500 M1 M100044
day

Package Amount per

1541 21.45 A General Medicine Acute asthmatic attack (admission type: Routine ward ) Clinical History clinical notes 1800 M1 M100045
day

Package Amount per

21.445 B General Medicine Acute asthmatic attack(admission type: HDU ) Clinical History clinical notes 2700 M1 M100045
day

Package Amount per

21.45 C General Medicine Acute asthmatic attack(admission type: ICU ,without ventilator) Clinical History clinical notes 3600 M1 M100045
day

Package Amount per

21.45 D General Medicine Acute asthmatic attack(admission type: ICU (with ventilator ) Clinical History clinical notes 4,500 M1 M100045
day

Package Amount per

1542 21.46 A General Medicine Acutre excaberation of ILD(admission type: Routine ward ) Chesr X-Ray(PA) clinical notes 1800 M1 M100020
day

Package Amount per

21.46 B General Medicine Acutre excaberation of ILD(admission type: HDU ) Chesr X-Ray(PA) clinical notes 2700 M1 M100020
day

Package Amount per

21.46 C General Medicine Acutre excaberation of ILD(admission type: ICU ,without ventilator) Chesr X-Ray(PA) clinical notes 3600 M1 M100020
day

Package Amount per

21.46 D General Medicine Acutre excaberation of ILD(admission type: ICU (with ventilator ) Chesr X-Ray(PA) clinical notes 4,500 M1 M100020
day

Package Amount per

1543 21.47 A General Medicine Severe pneumonia (admission type: Routine ward ) Chesr X-Ray(PA) clinical notes 1800 M1 M100047
day

Package Amount per

21.47 B General Medicine Severe pneumonia(admission type: HDU ) Chesr X-Ray(PA) clinical notes 2700 M1 M100047
day

Package Amount per

21.47 C General Medicine Severe pneumonia(admission type: ICU ,without ventilator) Chesr X-Ray(PA) clinical notes 3600 M1 M100047
day

Package Amount per

21.47 D General Medicine Severe pneumonia(admission type: ICU (with ventilator ) Chesr X-Ray(PA) clinical notes 4,500 M1 M100047
day

Package Amount per

1544 21.48 A General Medicine Acute gastroenteritis with severe dehydration (admission type: Routine ward ) Stool Culture clinical notes 1800 M1 M100048
day

Package Amount per

21.48 B General Medicine Acute gastroenteritis with severe dehydration(admission type: HDU ) Stool Culture clinical notes 2700 M1 M100048
day

Acute gastroenteritis with severe dehydration(admission type: ICU ,without Package Amount per
21.48 C General Medicine Stool Culture clinical notes 3600 M1 M100048
ventilator) day

Package Amount per

21.48 D General Medicine Acute gastroenteritis with severe dehydration(admission type: ICU (with ventilator ) Stool Culture clinical notes 4,500 M1 M100048
day

Package Amount per

1545 21.49 A General Medicine Hypertensive emergencies (admission type: Routine ward ) ECG, 2D Echo clinical notes 1800 M1 M100049
day

Package Amount per

21.49 B General Medicine Hypertensive emergencies(admission type: HDU ) ECG, 2D Echo clinical notes 2700 M1 M100049
day

Package Amount per

21.49 C General Medicine Hypertensive emergencies(admission type: ICU ,without ventilator) ECG, 2D Echo clinical notes 3600 M1 M100049
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.49 D General Medicine Hypertensive emergencies(admission type: ICU (with ventilator ) ECG, 2D Echo clinical notes 4,500 M1 M100049
day

Package Amount per

1546 21.50 A General Medicine Dengue hemorrhagic fever/Dengue shock syndrome (admission type: Routine ward ) Dengue NS1, IGM clinical notes 1800 M1 M100050
day

Package Amount per

21.50 B General Medicine Dengue hemorrhagic fever/Dengue shock syndrome(admission type: HDU ) Dengue NS1, IGM clinical notes 2700 M1 M100050
day

Dengue hemorrhagic fever/Dengue shock syndrome(admission type: ICU ,without Package Amount per
21.50 C General Medicine Dengue NS1, IGM clinical notes 3600 M1 M100050
ventilator) day

Dengue hemorrhagic fever/Dengue shock syndrome(admission type: ICU (with Package Amount per
21.50 D General Medicine Dengue NS1, IGM clinical notes 4,500 M1 M100050
ventilator ) day

Package Amount per

1547 21.51 A General Medicine Complicated malaria (admission type: Routine ward ) CBC, RFT,LFT clinical notes 1800 M1 M100051
day

Package Amount per

21.51 B General Medicine Complicated malaria(admission type: HDU ) CBC, RFT,LFT clinical notes 2700 M1 M100051
day

Package Amount per

21.51 C General Medicine Complicated malaria(admission type: ICU ,without ventilator) CBC, RFT,LFT clinical notes 3600 M1 M100051
day

Complicated malaria(admission type: ICU ,without ventilator)(admission type: ICU Package Amount per
21.51 D General Medicine CBC, RFT,LFT clinical notes 4,500 M1 M100051
(with ventilator ) day

Package Amount per

1548 21.52 A General Medicine Heat stroke (admission type: Routine ward ) CPK Total clinical notes 1800 M1 M100052
day

Package Amount per

21.52 B General Medicine Heat stroke(admission type: HDU ) CPK Total clinical notes 2700 M1 M100052
day

Package Amount per

21.52 C General Medicine Heat stroke(admission type: ICU ,without ventilator) CPK Total clinical notes 3600 M1 M100052
day

Package Amount per

21.52 D General Medicine Heat stroke(admission type: ICU (with ventilator ) CPK Total clinical notes 4,500 M1 M100052
day

Package Amount per

1549 21.53 A General Medicine Hyperosmolar Non-Ketotic coma (admission type: Routine ward ) ABGA,RBS clinical notes 1800 M1 M100053
day

Package Amount per

21.53 B General Medicine Hyperosmolar Non-Ketotic coma(admission type: HDU ) ABGA,RBS clinical notes 2700 M1 M100053
day

Package Amount per

21.53 C General Medicine Hyperosmolar Non-Ketotic coma(admission type: ICU ,without ventilator) ABGA,RBS clinical notes 3600 M1 M100053
day

Package Amount per

21.53 D General Medicine Hyperosmolar Non-Ketotic coma(admission type: ICU (with ventilator ) ABGA,RBS clinical notes 4,500 M1 M100053
day

Package Amount per

1550 21.54 A General Medicine Severe sepsis/Septic shock (admission type: Routine ward ) Blood Culture clinical notes 1800 M1 M100055
day

Package Amount per

21.54 B General Medicine Severe sepsis/Septic shock(admission type: HDU ) Blood Culture clinical notes 2700 M1 M100055
day

Package Amount per

21.54 C General Medicine Severe sepsis/Septic shock(admission type: ICU ,without ventilator) Blood Culture clinical notes 3600 M1 M100055
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.54 D General Medicine Severe sepsis/Septic shock(admission type: ICU (with ventilator ) Blood Culture clinical notes 4,500 M1 M100055
day

Package Amount per

1551 21.55 A General Medicine Upper GI bleeding (conservative) (admission type: Routine ward ) Clinical History clinical notes 1800 M1 M100056
day

Package Amount per

21.55 B General Medicine Upper GI bleeding (conservative)(admission type: HDU ) Clinical History clinical notes 2700 M1 M100056
day

Package Amount per

21.55 C General Medicine Upper GI bleeding (conservative)(admission type: ICU ,without ventilator) Clinical History clinical notes 3600 M1 M100056
day

Package Amount per

21.55 D General Medicine Upper GI bleeding (conservative)(admission type: ICU (with ventilator ) Clinical History clinical notes 4,500 M1 M100056
day

Package Amount per

1552 21.56 A General Medicine Upper GI bleeding (endoscopic) (admission type: Routine ward ) Scopy clinical notes 1800 M1 M100057
day

Package Amount per

21.56 B General Medicine Upper GI bleeding (endoscopic) Scopy clinical notes 2700 M1 M100057
day

Package Amount per

21.56 C General Medicine Upper GI bleeding (endoscopic)(admission type: ICU ,without ventilator) Scopy clinical notes 3600 M1 M100057
day

Package Amount per

21.56 D General Medicine Upper GI bleeding (endoscopic)(admission type: ICU (with ventilator ) Scopy clinical notes 4,500 M1 M100057
day

Colonoscopy, USG Abd/ Package Amount per

1553 21.57 A General Medicine Lower GI hemorrhage (admission type: Routine ward ) clinical notes 1800 M1 M100058
CT day

Colonoscopy, USG Abd/ Package Amount per

21.57 B General Medicine Lower GI hemorrhage(admission type: HDU ) clinical notes 2700 M1 M100058
CT day

Colonoscopy, USG Abd/ Package Amount per

21.57 C General Medicine Lower GI hemorrhage(admission type: ICU ,without ventilator) clinical notes 3600 M1 M100058
CT day

Colonoscopy, USG Abd/ Package Amount per

21.57 D General Medicine Lower GI hemorrhage(admission type: ICU (with ventilator ) clinical notes 4,500 M1 M100058
CT day

Immune mediated CNS disorders such as autoimmune encephalitis (admission type: Package Amount per
1554 21.58 A General Medicine CSF,MRI clinical notes 1800 M1 M100059
Routine ward ) day

Immune mediated CNS disorders such as autoimmune encephalitis(admission type: Package Amount per
21.58 B General Medicine CSF,MRI clinical notes 2700 M1 M100059
HDU ) day

Immune mediated CNS disorders such as autoimmune encephalitis(admission type: Package Amount per
21.58 C General Medicine CSF,MRI clinical notes 3600 M1 M100059
ICU ,without ventilator) day

Immune mediated CNS disorders such as autoimmune encephalitis(admission type: Package Amount per
21.58 D General Medicine CSF,MRI clinical notes 4,500 M1 M100059
ICU (with ventilator ) day

Package Amount per

1555 21.59 A General Medicine Acute transverse myelitis (admission type: Routine ward ) MRI.CSF clinical notes 1800 M1 M100060
day

Package Amount per

21.59 B General Medicine Acute transverse myelitis(admission type: HDU ) MRI.CSF clinical notes 2700 M1 M100060
day

Package Amount per

21.59 C General Medicine Acute transverse myelitis(admission type: ICU ,without ventilator) MRI.CSF clinical notes 3600 M1 M100060
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.59 D General Medicine Acute transverse myelitis(admission type: ICU (with ventilator ) MRI.CSF clinical notes 4,500 M1 M100060
day

Package Amount per

1556 21.60 A General Medicine Hydrocephalus (admission type: Routine ward ) CT clinical notes 1800 M1 M100062
day

Package Amount per

21.60 B General Medicine Hydrocephalus(admission type: HDU ) CT clinical notes 2700 M1 M100062
day

Package Amount per

21.60 C General Medicine Hydrocephalus(admission type: ICU ,without ventilator) CT clinical notes 3600 M1 M100062
day

Package Amount per

21.60 D General Medicine Hydrocephalus(admission type: ICU (with ventilator ) CT clinical notes 4,500 M1 M100062
day

Package Amount per

1557 21.61 A General Medicine Cerebral sino-venous thrombosis (admission type: Routine ward ) MR Veno clinical notes 1800 M1 M100063
day

Package Amount per

21.61 B General Medicine Cerebral sino-venous thrombosis(admission type: HDU ) MR Veno clinical notes 2700 M1 M100063
day

Package Amount per

21.61 C General Medicine Cerebral sino-venous thrombosis(admission type: ICU ,without ventilator) MR Veno clinical notes 3600 M1 M100063
day

Package Amount per

21.61 D General Medicine Cerebral sino-venous thrombosis(admission type: ICU (with ventilator ) MR Veno clinical notes 4,500 M1 M100063
day

AKI/ renal failure(dialysis payable separately as an add on package for ) (admission Package Amount per
1558 21.62 A General Medicine RFT, USG clinical notes 1800 M1 M100064
type: Routine ward ) day

AKI/ renal failure(dialysis payable separately as an add on package for )(admission Package Amount per
21.62 B General Medicine RFT, USG clinical notes 2700 M1 M100064
type: HDU ) day

AKI/ renal failure(dialysis payable separately as an add on package for )(admission Package Amount per
21.62 C General Medicine RFT, USG clinical notes 3600 M1 M100064
type: ICU ,without ventilator) day

AKI/ renal failure(dialysis payable separately as an add on package for )(admission Package Amount per
21.62 D General Medicine RFT, USG clinical notes 4,500 M1 M100064
type: ICU (with ventilator ) day

Package Amount per

1559 21.63 A General Medicine Status epilepticus (admission type: Routine ward ) MRI,CSF clinical notes 1800 M1 M100065
day

Package Amount per

21.63 B General Medicine Status epilepticus(admission type: HDU ) MRI,CSF clinical notes 2700 M1 M100065
day

Package Amount per

21.63 C General Medicine Status epilepticus(admission type: ICU ,without ventilator) MRI,CSF clinical notes 3600 M1 M100065
day

Package Amount per

21.63 D General Medicine Status epilepticus(admission type: ICU (with ventilator ) MRI,CSF clinical notes 4,500 M1 M100065
day

Package Amount per

1560 21.64 A General Medicine Status asthmaticus (admission type: Routine ward ) Clinical History clinical notes 1800 M1 M100066
day

Package Amount per

21.64 B General Medicine Status asthmaticus(admission type: HDU ) Clinical History clinical notes 2700 M1 M100066
day

Package Amount per

21.64 C General Medicine Status asthmaticus(admission type: ICU ,without ventilator) Clinical History clinical notes 3600 M1 M100066
day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Package Amount per

21.64 D General Medicine Status asthmaticus(admission type: ICU (with ventilator ) Clinical History clinical notes 4,500 M1 M100066
day

Respiratory failure due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, Package Amount per
1561 21.65 A General Medicine Concern Investigation clinical notes 1800 M1 M100067
poisoning, head injury etc.) (admission type: Routine ward ) day

Respiratory failure due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, Package Amount per
21.65 B General Medicine Concern Investigation clinical notes 2700 M1 M100067
poisoning, head injury etc.)(admission type: HDU ) day

Respiratory failure due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, Package Amount per
21.65 C General Medicine Concern Investigation clinical notes 3600 M1 M100067
poisoning, head injury etc.)(admission type: ICU ,without ventilator) day

Respiratory failure due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, Package Amount per
21.65 D General Medicine Concern Investigation clinical notes 4,500 M1 M100067
poisoning, head injury etc.)(admission type: ICU (with ventilator ) day
Blood and blood component transfusion (admission for a diagnostic procedure
leading to treatment requiring admission, e.g. bone marrow and bone biopsy, Package Amount per
1562 21.66 General Medicine Concern Investigation clinical notes 2,000 M1 M100068
endoscopy, liver biopsy, bronchoscopy, CT/MRI under GA, broncho-alveolar lavage, day
lumbar puncture, muscle biopsy, pleural aspiration, ascitic tapping etc.)
1563 21.67 General Medicine Plasmapheresis - per session Concern Investigation clinical notes 2,000 M1 M100069

1564 21.68 General Medicine Haemodialysis/Peritoneal Dialysis - per session Concern Investigation clinical notes 2,300 M1 M100070

High end radiological diagnostic (CT, MRI, Imaging including nuclear imaging) - can capped @ Rs 5000 per
1565 21.69 General Medicine clinical notes clinical notes 5,000 M1 M100071
only be clubbed with medical package. Rs 5000 per annum limit to a family annum for a family

High end histopathology (Biopsies) and advanced serology investigations - can only be capped @ Rs 5000 per
1566 21.70 General Medicine clinical notes clinical notes 5,000 M1 M100072
clubbed with medical package. Rs 5000 per annum limit to a family annum for a family

60000 ( 1st week-50%,2nd

(Payment fraction week-15%,3rd week-
1567 21.71 General Medicine CONSERVATIVE MANAGEMENT (ISCHEMIC STROKE) CT brain plain,others MRI brain with angiography ( 1st week- 10%,4th week- M1 M112001
35%,2nd week- 10%,5th week-
25%,3rd week- 10%,F/u-5%) of total

120000
(Payment fraction
( 1st week- ( 1st week-50%,2nd
50%,2nd week- week-15%,3rd week-
Repeat CT brain after 24 hours,MRI 15%,3rd week- 10%,4th week-
1568 21.72 General Medicine THROMBOLYSIS WITH ACTILYSE FOR ISCHEMIC STROKE CT brain plain,others M1 M112002
brain with angiography 10%,4th week- 10%,5th week-
10%,5th week- 10%,F/u-5%) of total
10%,F/u-5%) of package rate)
total package
rate)

40000 ( 1st week-50%,2nd

(Payment fraction week-15%,3rd week-
INTRAPARENCHYMAL /SUBARACHNOID HEMMORRHAGE (CONSERVATIVE Repeat CT brain plain , CT angiography
1569 21.73 General Medicine CT brain plain,others ( 1st week- 10%,4th week- M1 M112003
MANAGEMENT) brain
35%,2nd week- 10%,5th week-
25%,3rd week- 10%,F/u-5%) of total
110000 ( 1st week-50%,2nd
(Payment fraction week-15%,3rd week-
1570 21.74 General Medicine MENINGOENCEPHALITIS, OR/ AND EVD/VP shunt (CONSERVATIVE MANAGEMENT) CT brain plain,CSF ,others MRI brain with contrast ( 1st week- 10%,4th week- M1 M112004
35%,2nd week- 10%,5th week-
25%,3rd week- 10%,F/u-5%) of total
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY
110000
( 1st week-50%,2nd
(Payment fraction
week-15%,3rd week-
Clinical diagnosis by Anyone of the following:repetitive ( 1st week-
10%,4th week-
1571 21.75 General Medicine MYASTHENIA CRISIS MANAGEMENT BY PLASMAPHERESIS neurophysician OR nerve stimulation,ACH-R antibody,Anti- 35%,2nd week- M1 M112005
10%,5th week-
previously diagnosed case MUSK antibody 25%,3rd week-
10%,F/u-5%) of total
15%,4th week-
package rate)
10%,5th week-
200000
(Payment fraction ( 1st week-50%,2nd
( 1st week- week-15%,3rd week-
Clinical diagnosis by Anyone of the following:repetitive
50%,2nd week- 10%,4th week-
1572 21.76 General Medicine MYASTHENIA CRISIS MANAGEMENT BY IV IMMUNOGLOBINS neurophysician OR nerve stimulation,ACH-R antibody,Anti- M1 M112006
15%,3rd week- 10%,5th week-
previously diagnosed case MUSK antibody
10%,4th week- 10%,F/u-5%) of total
10%,5th week- package rate)
10%,F/u-5%)
109627 of ( 1st week-50%,2nd
(Payment fraction week-15%,3rd week-
Clinical diagnosis by
1573 21.77 General Medicine Gullian-barre syndrome management by plasmapheresis CSF study, NCV/EMG ( 1st week- 10%,4th week- M1 M112007
neurophysician
35%,2nd week- 10%,5th week-
25%,3rd week- 10%,F/u-5%) of total
( 1st week-50%,2nd
week-15%,3rd week-
Clinical diagnosis by
1574 21.78 General Medicine Gullian-barre syndrome management by Intravenous immunoglobulin CSF study, NCV/EMG 200000 10%,4th week- M1 M112008
neurophysician
10%,5th week-
10%,F/u-5%) of total
Cluster - 22 MENTAL DISORDER PACKAGES
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Government
Clinical assessment and Clinical assessment& Report/ Mental
1575 22.1 Mental Disorder Organic, including symptomatic, mental disorders (Admision Type -routine ward) 1,500 Reserve,Package M8 M800001
investigations Status Examination
amount is per Day

Government
Mental and Behavioural disorders due to psychoactive substance use (Admision Type - Clinical assessment and Clinical assessment& Report/ Mental
1576 22.2 Mental Disorder 1,500 Reserve,Package M8 M800002
routine ward) investigations Status Examination
amount is per Day

Government
Clinical assessment and Clinical assessment& Report/ Mental
1577 22.3 Mental Disorder Schizophrenia, schizotypal and delusional disorders (Admision Type -routine ward) 1,500 Reserve,Package M8 M800003
investigations Status Examination
amount is per Day

Clinical assessment& Report/ Mental Government

Clinical assessment and
1578 22.4 Mental Disorder Mood (affective) disorders (Admision Type -routine ward) Status Examination/Related 1,500 Reserve,Package M8 M800004
investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental

Clinical assessment and
1579 22.5 Mental Disorder Neurotic, stress-related and somatoform disorders (Admision Type -routine ward) Status Examination/Related 1,500 M8 M800005
investigations
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical assessment& Report/ Mental Government

Behavioural syndromes associated with physiological disturbances and physical Clinical assessment and
1580 22.6 Mental Disorder Status Examination/Related 1,500 Reserve,Package M8 M800006
factors (Admision Type -routine ward) investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental Government

Clinical assessment and
1581 22.7 Mental Disorder Mental retardation (Admision Type -routine ward) Status Examination/Related 1,500 Reserve,Package M8 M800007
investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental Government

Clinical assessment and
1582 22.8 Mental Disorder Organic, including symptomatic, mental disorders (Admision Type -HDU) Status Examination/Related 2,500 Reserve,Package M8 M800008
investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental Government

Mental and Behavioural disorders due to psychoactive substance use (Admision Type - Clinical assessment and
1583 22.9 Mental Disorder Status Examination/Related 2,500 Reserve,Package M8 M800009
HDU) investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental Government

Clinical assessment and
1584 22.10 Mental Disorder Schizophrenia, schizotypal and delusional disorders (Admision Type -HDU) Status Examination/Related 2,500 Reserve,Package M8 M800010
investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental Government

Clinical assessment and
1585 22.11 Mental Disorder Mood (affective) disorders (Admision Type -HDU) Status Examination/Related 2,500 Reserve,Package M8 M800011
investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental Government

Clinical assessment and
1586 22.12 Mental Disorder Neurotic, stress-related and somatoform disorders (Admision Type -HDU) Status Examination/Related 2,500 Reserve,Package M8 M800012
investigations
Investigations amount is per Day

Clinical assessment& Report/ Mental Government

Behavioural syndromes associated with physiological disturbances and physical Clinical assessment and
1587 22.13 Mental Disorder Status Examination/Related 2,500 Reserve,Package M8 M800013
factors (Admision Type -HDU) investigations
Investigations amount is per Day
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical assessment& Report/ Mental Government

Clinical assessment and
1588 22.14 Mental Disorder Mental Retardation (Admision Type -HDU) Status Examination/Related 2,500 Reserve,Package M8 M800014
investigations
Investigations amount is per Day

Pre- Electro Convulsive Therapy (ECT) and Pre- Transcranial Magnetic Stimulation
(TMS) Package (Cognitive Tests, Complete Haemogram, Liver Function Test, Renal Clinical assessment& Report/ Mental
Clinical assessment and
1589 22.15 Mental Disorder Function Test, Serum Electrolytes, Electro Cardiogram (ECG), CT/MRI Brain, Status Examination/Related 10,000 Government Reserve M8 M800015
investigations
Electroencephalogram, Thyroid Function Test, VDRL, HIV Test, Vitamin B12 levels, Investigations
Folate levels, Lipid Profile, Homocysteine levels)

Clinical assessment& Report/ Mental

Clinical assessment and
1590 22.16 Mental Disorder Electro Convulsive Therapy (ECT) - per session Status Examination/Related 3,000 Government Reserve M8 M800016
investigations
Investigations

Clinical assessment& Report/ Mental

Clinical assessment and
1591 22.17 Mental Disorder Transcranial Magnetic Stimulation (TMS) - per session Status Examination/Related 1,000 Government Reserve M8 M800017
investigations
Investigations

Cluster - 23 EMERGENCY ROOM PACKAGES (Care Requiring Less Than 12 hrs Stay )
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Emergency Room
1592 23.1 Emergency with stable cardiopulmonary status X Ray,ECG with report X Ray,ECG with report 1,000 M7 M700001
Packages

Emergency Room Emergency consultation: acute colic, high fever, cut, stitches, soft tissue injury, FB
1593 23.2 Blood test clinical notes 1,000 M7 M700002
Packages removal

Single bone fracture plaster, nebulization for asthmatic attack, moderate

Emergency Room
1594 23.3 dehydration, hypoglycaemia in a diabetic, Dengue without complication, Syncope, Blood test clinical notes 1,000 M7 M700003
Packages
Food poisoning etc

Emergency Room
1595 23.4 Animal bites (Payment after completion of 5th dose) clinical notes Antirabies register/Stock register 1,700 M7 M700004
Packages

Cluster - 24 PEAEDIATRIC MEDICAL MANAGEMENT

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1596 24.1 A Pediatric Medicine Diarrhoea (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200001
Investigations

clinical notes,Concern
24.1 B Pediatric Medicine Diarrhoea (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200001
Investigations

clinical notes,Concern
24.1 C Pediatric Medicine Diarrhoea (admission type: ICU without ventilator) clinical notes,Concern Investigations 3,600 M2 M200001
Investigations

clinical notes,Concern
24.1 D Pediatric Medicine Diarrhoea (admission type: ICU (with ventilator)) clinical notes,Concern Investigations 4,500 M2 M200001
Investigations

clinical notes,Concern
1597 24.2 A Pediatric Medicine Acute dysentery (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200002
Investigations

clinical notes,Concern
24.2 B Pediatric Medicine Acute dysentery(admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200002
Investigations

clinical notes,Concern
24.2 C Pediatric Medicine Acute dysentery (admission type: ICU (without ventilator)) clinical notes,Concern Investigations 3,600 M2 M200002
Investigations

clinical notes,Concern
24.2 D Pediatric Medicine Acute dysentery (admission type: ICU (with ventilator)) clinical notes,Concern Investigations 4,500 M2 M200002
Investigations

clinical notes,Concern
1598 24.3 A Pediatric Medicine Pneumonia (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100019
Investigations

clinical notes,Concern
24.3 B Pediatric Medicine Pneumonia (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100019
Investigations

clinical notes,Concern
24.3 C Pediatric Medicine Pneumonia (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100019
Investigations

clinical notes,Concern
24.3 D Pediatric Medicine Pneumonia (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100019
Investigations

clinical notes,Concern
1599 24.4 A Pediatric Medicine Urinary tract infection (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200004
Investigations

clinical notes,Concern
24.4 B Pediatric Medicine Urinary tract infection (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200004
Investigations

clinical notes,Concern
24.4 C Pediatric Medicine Urinary tract infection (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200004
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.4 D Pediatric Medicine Urinary tract infection (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200004
Investigations

clinical notes,Concern
1600 24.5 A Pediatric Medicine Acute Exacerbation of asthma (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200005
Investigations

clinical notes,Concern
24.5 B Pediatric Medicine Acute Exacerbation of asthma (admission type:HDU) clinical notes,Concern Investigations 2,700 M2 M200005
Investigations

clinical notes,Concern
24.5 C Pediatric Medicine Acute Exacerbation of asthma (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200005
Investigations

clinical notes,Concern
24.5 D Pediatric Medicine Acute Exacerbation of asthma (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200005
Investigations

clinical notes,Concern
1601 24.6 A Pediatric Medicine Acute glomerulonephritis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200006
Investigations

clinical notes,Concern
24.6 B Pediatric Medicine Acute glomerulonephritis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200006
Investigations

clinical notes,Concern
24.6 C Pediatric Medicine Acute glomerulonephritis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200006
Investigations

clinical notes,Concern
24.6 D Pediatric Medicine Acute glomerulonephritis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200006
Investigations

clinical notes,Concern
1602 24.7 A Pediatric Medicine Acute urticaria/ Anaphylaxis acute asthma (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200007
Investigations

clinical notes,Concern
24.7 B Pediatric Medicine Acute urticaria/ Anaphylaxis acute asthma (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200007
Investigations

clinical notes,Concern
24.7 C Pediatric Medicine Acute urticaria/ Anaphylaxis acute asthma (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200007
Investigations

clinical notes,Concern
24.7 D Pediatric Medicine Acute urticaria/ Anaphylaxis acute asthma (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200007
Investigations

clinical notes,Concern
1603 24.8 A Pediatric Medicine Poisonings with normal vital signs (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200008
Investigations

clinical notes,Concern
24.8 B Pediatric Medicine Poisonings with normal vital signs (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200008
Investigations

clinical notes,Concern
24.8 C Pediatric Medicine Poisonings with normal vital signs (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200008
Investigations

clinical notes,Concern
24.8 D Pediatric Medicine Poisonings with normal vital signs (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200008
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1604 24.9 A Pediatric Medicine Febrile seizures/other seizures (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200009
Investigations

clinical notes,Concern
24.9 B Pediatric Medicine Febrile seizures/other seizures (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200009
Investigations

clinical notes,Concern
24.9 C Pediatric Medicine Febrile seizures/other seizures (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200009
Investigations

clinical notes,Concern
24.9 D Pediatric Medicine Febrile seizures/other seizures (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200009
Investigations

clinical notes,Concern
1605 24.10 A Pediatric Medicine Epileptic encephalopathy (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200010
Investigations

clinical notes,Concern
24.10 B Pediatric Medicine Epileptic encephalopathy (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200010
Investigations

clinical notes,Concern
24.10 C Pediatric Medicine Epileptic encephalopathy (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200010
Investigations

clinical notes,Concern
24.10 D Pediatric Medicine Epileptic encephalopathy (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200010
Investigations

clinical notes,Concern
1606 24.11 A Pediatric Medicine Optic neuritis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200011
Investigations

clinical notes,Concern
24.11 B Pediatric Medicine Optic neuritis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200011
Investigations

clinical notes,Concern
24.11 C Pediatric Medicine Optic neuritis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200011
Investigations

clinical notes,Concern
24.11 D Pediatric Medicine Optic neuritis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200011
Investigations

clinical notes,Concern
1607 24.12 A Pediatric Medicine Aseptic meningitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200012
Investigations

clinical notes,Concern
24.12 B Pediatric Medicine Aseptic meningitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200012
Investigations

clinical notes,Concern
24.12 C Pediatric Medicine Aseptic meningitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200012
Investigations

clinical notes,Concern
24.12 D Pediatric Medicine Aseptic meningitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200012
Investigations

clinical notes,Concern
1608 24.13 A Pediatric Medicine Trauma (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200013
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.13 B Pediatric Medicine Trauma (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200013
Investigations

clinical notes,Concern
24.13 C Pediatric Medicine Trauma (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200013
Investigations

clinical notes,Concern
24.13 D Pediatric Medicine Trauma (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200013
Investigations

clinical notes,Concern
1609 24.14 A Pediatric Medicine Pyrexia of unexplained origin (admission type:Routine ward) clinical notes,Concern Investigations 1,800 M2 M200014
Investigations

clinical notes,Concern
24.14 B Pediatric Medicine Pyrexia of unexplained origin (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200014
Investigations

clinical notes,Concern
24.14 C Pediatric Medicine Pyrexia of unexplained origin (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200014
Investigations

clinical notes,Concern
24.14 D Pediatric Medicine Pyrexia of unexplained origin (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200014
Investigations

clinical notes,Concern
1610 24.15 A Pediatric Medicine Chronic cough (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200015
Investigations

clinical notes,Concern
24.15 B Pediatric Medicine Chronic cough (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200015
Investigations

clinical notes,Concern
24.15 C Pediatric Medicine Chronic cough (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200015
Investigations

clinical notes,Concern
24.15 D Pediatric Medicine Chronic cough (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200015
Investigations

clinical notes,Concern
1611 24.16 A Pediatric Medicine Wheezing (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200016
Investigations

clinical notes,Concern
24.16 B Pediatric Medicine Wheezing (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200016
Investigations

clinical notes,Concern
24.16 C Pediatric Medicine Wheezing (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200016
Investigations

clinical notes,Concern
24.16 D Pediatric Medicine Wheezing (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200016
Investigations

clinical notes,Concern
1612 24.17 A Pediatric Medicine Unexplained seizures (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200017
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.17 B Pediatric Medicine Unexplained seizures (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200017
Investigations

clinical notes,Concern
24.17 C Pediatric Medicine Unexplained seizures (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200017
Investigations

clinical notes,Concern
24.17 D Pediatric Medicine Unexplained seizures (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200017
Investigations

Global developmental delay/ Intellectual disability of unknown etiology (admission clinical notes,Concern
1613 24.18 A Pediatric Medicine clinical notes,Concern Investigations 1,800 M2 M200018
type: Routine ward) Investigations

Global developmental delay/ Intellectual disability of unknown etiology (admission clinical notes,Concern
24.18 B Pediatric Medicine clinical notes,Concern Investigations 2,700 M2 M200018
type: HDU) Investigations

Global developmental delay/ Intellectual disability of unknown etiology (admission clinical notes,Concern
24.18 C Pediatric Medicine clinical notes,Concern Investigations 3,600 M2 M200018
type: ICU, without ventilator Investigations

Global developmental delay/ Intellectual disability of unknown etiology (admission clinical notes,Concern
24.18 D Pediatric Medicine clinical notes,Concern Investigations 4,500 M2 M200018
type: ICU, with ventilator) Investigations

clinical notes,Concern
1614 24.19 A Pediatric Medicine Dysmorphic children (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200019
Investigations

clinical notes,Concern
24.19 B Pediatric Medicine Dysmorphic children (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200019
Investigations

clinical notes,Concern
24.19 C Pediatric Medicine Dysmorphic children (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200019
Investigations

clinical notes,Concern
24.19 D Pediatric Medicine Dysmorphic children (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200019
Investigations

clinical notes,Concern
1615 24.20 A Pediatric Medicine Rickets (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200020
Investigations

clinical notes,Concern
24.20 B Pediatric Medicine Rickets (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200020
Investigations

clinical notes,Concern
24.20 C Pediatric Medicine Rickets (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200020
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.20 D Pediatric Medicine Rickets (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200020
Investigations

clinical notes,Concern
1616 24.21 A Pediatric Medicine Unexplained severe anemia (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200021
Investigations

clinical notes,Concern
24.21 B Pediatric Medicine Unexplained severe anemia (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200021
Investigations

clinical notes,Concern
24.21 C Pediatric Medicine Unexplained severe anemia (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200021
Investigations

clinical notes,Concern
24.21 D Pediatric Medicine Unexplained severe anemia (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200021
Investigations

clinical notes,Concern
1617 24.22 A Pediatric Medicine Short stature (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200022
Investigations

clinical notes,Concern
24.22 B Pediatric Medicine Short stature (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200022
Investigations

clinical notes,Concern
24.22 C Pediatric Medicine Short stature (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200022
Investigations

clinical notes,Concern
24.22 D Pediatric Medicine Short stature (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200022
Investigations

clinical notes,Concern
1618 24.23 A Pediatric Medicine Musculoskeletal problems (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200023
Investigations

clinical notes,Concern
24.23 B Pediatric Medicine Musculoskeletal problems (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200023
Investigations

clinical notes,Concern
24.23 C Pediatric Medicine Musculoskeletal problems (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200023
Investigations

clinical notes,Concern
24.23 D Pediatric Medicine Musculoskeletal problems (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200023
Investigations

clinical notes,Concern
1619 24.24 A Pediatric Medicine Developmental and behavioral disorders (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200024
Investigations

clinical notes,Concern
24.24 B Pediatric Medicine Developmental and behavioral disorders (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200024
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.24 C Pediatric Medicine Developmental and behavioral disorders (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200024
Investigations

clinical notes,Concern
24.24 D Pediatric Medicine Developmental and behavioral disorders (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200024
Investigations

clinical notes,Concern
1620 24.25 A Pediatric Medicine Diabetic ketoacidosis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100010
Investigations

clinical notes,Concern
24.25 B Pediatric Medicine Diabetic ketoacidosis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100010
Investigations

clinical notes,Concern
24.25 C Pediatric Medicine Diabetic ketoacidosis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100010
Investigations

clinical notes,Concern
24.25 D Pediatric Medicine Diabetic ketoacidosis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100010
Investigations

clinical notes,Concern
1621 24.26 A Pediatric Medicine Nephrotic syndrome with peritonitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200026
Investigations

clinical notes,Concern
24.26 B Pediatric Medicine Nephrotic syndrome with peritonitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200026
Investigations

clinical notes,Concern
24.26 C Pediatric Medicine Nephrotic syndrome with peritonitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200026
Investigations

clinical notes,Concern
24.26 D Pediatric Medicine Nephrotic syndrome with peritonitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200026
Investigations

clinical notes,Concern
1622 24.27 A Pediatric Medicine Pyogenic meningitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200027
Investigations

clinical notes,Concern
24.27 B Pediatric Medicine Pyogenic meningitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200027
Investigations

clinical notes,Concern
24.27 C Pediatric Medicine Pyogenic meningitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200027
Investigations

clinical notes,Concern
24.27 D Pediatric Medicine Pyogenic meningitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200027
Investigations

clinical notes,Concern
1623 24.28 A Pediatric Medicine Persistent/ Chronic diarrhea (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200028
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.28 B Pediatric Medicine Persistent/ Chronic diarrhea (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200028
Investigations

clinical notes,Concern
24.28 C Pediatric Medicine Persistent/ Chronic diarrhea (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200028
Investigations

clinical notes,Concern
24.28 D Pediatric Medicine Persistent/ Chronic diarrhea (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200028
Investigations

clinical notes,Concern
1624 24.29 A Pediatric Medicine Acute severe malnutrition (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200029
Investigations

clinical notes,Concern
24.29 B Pediatric Medicine Acute severe malnutrition (admission type: HDU) clinical notes,Concern Investigations 27,000 M2 M200029
Investigations

clinical notes,Concern
24.29 C Pediatric Medicine Acute severe malnutrition (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200029
Investigations

clinical notes,Concern
24.29 D Pediatric Medicine Acute severe malnutrition (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200029
Investigations

clinical notes,Concern
1625 24.30 A Pediatric Medicine Dengue (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200030
Investigations

clinical notes,Concern
24.30 B Pediatric Medicine Dengue (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200030
Investigations

clinical notes,Concern
24.30 C Pediatric Medicine Dengue (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200030
Investigations

clinical notes,Concern
24.30 D Pediatric Medicine Dengue (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200030
Investigations

clinical notes,Concern
1626 24.31 A Pediatric Medicine Enteric fever (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100018
Investigations

clinical notes,Concern
24.31 B Pediatric Medicine Enteric fever (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100018
Investigations

clinical notes,Concern
24.31 C Pediatric Medicine Enteric fever (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100018
Investigations

clinical notes,Concern
24.31 D Pediatric Medicine Enteric fever (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100018
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1627 24.32 A Pediatric Medicine Chikungunya (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200032
Investigations

clinical notes,Concern
24.32 B Pediatric Medicine Chikungunya (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200032
Investigations

clinical notes,Concern
24.32 C Pediatric Medicine Chikungunya (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200032
Investigations

clinical notes,Concern
24.32 D Pediatric Medicine Chikungunya (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200032
Investigations

clinical notes,Concern
1628 24.33 A Pediatric Medicine Acute hepatitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200033
Investigations

clinical notes,Concern
24.33 B Pediatric Medicine Acute hepatitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200033
Investigations

clinical notes,Concern
24.33 C Pediatric Medicine Acute hepatitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200033
Investigations

clinical notes,Concern
24.33 D Pediatric Medicine Acute hepatitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200033
Investigations

clinical notes,Concern
1629 24.34 A Pediatric Medicine Kala azar (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200034
Investigations

clinical notes,Concern
24.34 B Pediatric Medicine Kala azar (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200034
Investigations

clinical notes,Concern
24.34 C Pediatric Medicine Kala azar (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200034
Investigations

clinical notes,Concern
24.34 D Pediatric Medicine Kala azar (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200034
Investigations

clinical notes,Concern
1630 24.35 A Pediatric Medicine Tuberculosis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200035
Investigations

clinical notes,Concern
24.35 B Pediatric Medicine Tuberculosis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200035
Investigations

clinical notes,Concern
24.35 C Pediatric Medicine Tuberculosis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200035
Investigations

clinical notes,Concern
24.35 D Pediatric Medicine Tuberculosis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200035
Investigations

clinical notes,Concern
1631 24.36 A Pediatric Medicine HIV with complications (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100039
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.36 B Pediatric Medicine HIV with complications (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100039
Investigations

clinical notes,Concern
24.36 C Pediatric Medicine HIV with complications (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100039
Investigations

clinical notes,Concern
24.36 D Pediatric Medicine HIV with complications (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100039
Investigations

clinical notes,Concern
1632 24.37 A Pediatric Medicine Infantile cholestasis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200037
Investigations

clinical notes,Concern
24.37 B Pediatric Medicine Infantile cholestasis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200037
Investigations

clinical notes,Concern
24.37 C Pediatric Medicine Infantile cholestasis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200037
Investigations

clinical notes,Concern
24.37 D Pediatric Medicine Infantile cholestasis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200037
Investigations

clinical notes,Concern
1633 24.38 A Pediatric Medicine Haemolytic uremic syndrome (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200038
Investigations

clinical notes,Concern
24.38 B Pediatric Medicine Haemolytic uremic syndrome (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200038
Investigations

clinical notes,Concern
24.38 C Pediatric Medicine Haemolytic uremic syndrome (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200038
Investigations

clinical notes,Concern
24.38 D Pediatric Medicine Haemolytic uremic syndrome (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200038
Investigations

clinical notes,Concern
1634 24.39 A Pediatric Medicine ITP (admission type: Routine down) clinical notes,Concern Investigations 1,800 M2 M200039
Investigations

clinical notes,Concern
24.39 B Pediatric Medicine ITP (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200039
Investigations

clinical notes,Concern
24.39 C Pediatric Medicine ITP (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200039
Investigations

clinical notes,Concern
24.39 D Pediatric Medicine ITP (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200039
Investigations

clinical notes,Concern
1635 24.40 A Pediatric Medicine Juvenile myasthenia (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200040
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.40 B Pediatric Medicine Juvenile myasthenia (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200040
Investigations

clinical notes,Concern
24.40 C Pediatric Medicine Juvenile myasthenia (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200040
Investigations

clinical notes,Concern
24.40 D Pediatric Medicine Juvenile myasthenia (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200040
Investigations

clinical notes,Concern
1636 24.41 A Pediatric Medicine Kawasaki Disease (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200041
Investigations

clinical notes,Concern
24.41 B Pediatric Medicine Kawasaki Disease (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200041
Investigations

clinical notes,Concern
24.41 C Pediatric Medicine Kawasaki Disease (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200041
Investigations

clinical notes,Concern
24.41 D Pediatric Medicine Kawasaki Disease (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200041
Investigations

clinical notes,Concern
1637 24.42 A Pediatric Medicine Persistent pneumonia (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200042
Investigations

clinical notes,Concern
24.42 B Pediatric Medicine Persistent pneumonia (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200042
Investigations

clinical notes,Concern
24.42 C Pediatric Medicine Persistent pneumonia (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200042
Investigations

clinical notes,Concern
24.42 D Pediatric Medicine Persistent pneumonia (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200042
Investigations

clinical notes,Concern
1638 24.43 A Pediatric Medicine Empyema (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200043
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.43 B Pediatric Medicine Empyema (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200043
Investigations

clinical notes,Concern
24.43 C Pediatric Medicine Empyema (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200043
Investigations

clinical notes,Concern
24.43 D Pediatric Medicine Empyema (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200043
Investigations

clinical notes,Concern
1639 24.44 A Pediatric Medicine Immune haemolytic anemia (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200044
Investigations

clinical notes,Concern
24.44 B Pediatric Medicine Immune haemolytic anemia (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200044
Investigations

clinical notes,Concern
24.44 C Pediatric Medicine Immune haemolytic anemia (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200044
Investigations

clinical notes,Concern
24.44 D Pediatric Medicine Immune haemolytic anemia (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200044
Investigations

clinical notes,Concern
1640 24.45 A Pediatric Medicine Cyanotic spells (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200045
Investigations

clinical notes,Concern
24.45 B Pediatric Medicine Cyanotic spells (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200045
Investigations

clinical notes,Concern
24.45 C Pediatric Medicine Cyanotic spells (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200045
Investigations

clinical notes,Concern
24.45 D Pediatric Medicine Cyanotic spells (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200045
Investigations

clinical notes,Concern
1641 24.46 A Pediatric Medicine Rheumatic fever (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200046
Investigations

clinical notes,Concern
24.46 B Pediatric Medicine Rheumatic fever (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200046
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.46 C Pediatric Medicine Rheumatic fever (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200046
Investigations

clinical notes,Concern
24.46 D Pediatric Medicine Rheumatic fever (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200046
Investigations

clinical notes,Concern
1642 24.47 A Pediatric Medicine Rheumatoid arthritis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200047
Investigations

clinical notes,Concern
24.47 B Pediatric Medicine Rheumatoid arthritis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200047
Investigations

clinical notes,Concern
24.47 C Pediatric Medicine Rheumatoid arthritis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200047
Investigations

clinical notes,Concern
24.47 D Pediatric Medicine Rheumatoid arthritis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200047
Investigations

clinical notes,Concern
1643 24.48 A Pediatric Medicine Encephalitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200048
Investigations

clinical notes,Concern
24.48 B Pediatric Medicine Encephalitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200048
Investigations

clinical notes,Concern
24.48 C Pediatric Medicine Encephalitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200048
Investigations

clinical notes,Concern
24.48 D Pediatric Medicine Encephalitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200048
Investigations

clinical notes,Concern
1644 24.49 A Pediatric Medicine Chronic meningitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200049
Investigations

clinical notes,Concern
24.49 B Pediatric Medicine Chronic meningitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200049
Investigations

clinical notes,Concern
24.49 C Pediatric Medicine Chronic meningitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200049
Investigations

clinical notes,Concern
24.49 D Pediatric Medicine Chronic meningitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200049
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Intracranial ring enhancing lesion with complication (neurocysticercosis, clinical notes,Concern

1645 24.50 A Pediatric Medicine clinical notes,Concern Investigations 1,800 M2 M200050
tuberculoma) (admission type: Routine ward) Investigations

Intracranial ring enhancing lesion with complication (neurocysticercosis, clinical notes,Concern

24.50 B Pediatric Medicine clinical notes,Concern Investigations 2,700 M2 M200050
tuberculoma) (admission type: HDU) Investigations

Intracranial ring enhancing lesion with complication (neurocysticercosis, clinical notes,Concern

24.50 C Pediatric Medicine clinical notes,Concern Investigations 3,600 M2 M200050
tuberculoma) (admission type: ICU, without ventilator) Investigations

Intracranial ring enhancing lesion with complication (neurocysticercosis, clinical notes,Concern

24.50 D Pediatric Medicine clinical notes,Concern Investigations 4,500 M2 M200050
tuberculoma) (admission type: ICU, with ventilator) Investigations

clinical notes,Concern
1646 24.51 A Pediatric Medicine Refractory seizures (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200051
Investigations

clinical notes,Concern
24.51 B Pediatric Medicine Refractory seizures (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200051
Investigations

clinical notes,Concern
24.51 C Pediatric Medicine Refractory seizures (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200051
Investigations

clinical notes,Concern
24.51 D Pediatric Medicine Refractory seizures (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200051
Investigations

clinical notes,Concern
1647 24.52 A Pediatric Medicine Floppy infant (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200052
Investigations

clinical notes,Concern
24.52 B Pediatric Medicine Floppy infant (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200052
Investigations

clinical notes,Concern
24.52 C Pediatric Medicine Floppy infant (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200052
Investigations

clinical notes,Concern
24.52 D Pediatric Medicine Floppy infant (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200052
Investigations

clinical notes,Concern
1648 24.53 A Pediatric Medicine Acute neuroregression (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200053
Investigations

clinical notes,Concern
24.53 B Pediatric Medicine Acute neuroregression (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200053
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.53 C Pediatric Medicine Acute neuroregression (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200053
Investigations

clinical notes,Concern
24.53 D Pediatric Medicine Acute neuroregression (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200053
Investigations

clinical notes,Concern
1649 24.54 A Pediatric Medicine Neuromuscular disorders (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100040
Investigations

clinical notes,Concern
24.54 B Pediatric Medicine Neuromuscular disorders (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100040
Investigations

clinical notes,Concern
24.54 C Pediatric Medicine Neuromuscular disorders (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100040
Investigations

clinical notes,Concern
24.54 D Pediatric Medicine Neuromuscular disorders (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100040
Investigations

clinical notes,Concern
1650 24.55 A Pediatric Medicine Opsoclonus myoclonus syndrome (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200055
Investigations

clinical notes,Concern
24.55 B Pediatric Medicine Opsoclonus myoclonus syndrome (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200055
Investigations

clinical notes,Concern
24.55 C Pediatric Medicine Opsoclonus myoclonus syndrome (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200055
Investigations

clinical notes,Concern
24.55 D Pediatric Medicine Opsoclonus myoclonus syndrome (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200055
Investigations

clinical notes,Concern
1651 24.56 A Pediatric Medicine Acute ataxia (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200056
Investigations

clinical notes,Concern
24.56 B Pediatric Medicine Acute ataxia (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200056
Investigations

clinical notes,Concern
24.56 C Pediatric Medicine Acute ataxia (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200056
Investigations

clinical notes,Concern
24.56 D Pediatric Medicine Acute ataxia (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200056
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1652 24.57 A Pediatric Medicine Steven Johnson syndrome (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200057
Investigations

clinical notes,Concern
24.57 B Pediatric Medicine Steven Johnson syndrome (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200057
Investigations

clinical notes,Concern
24.57 C Pediatric Medicine Steven Johnson syndrome (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200057
Investigations

clinical notes,Concern
24.57 D Pediatric Medicine Steven Johnson syndrome (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200057
Investigations

clinical notes,Concern
1653 24.58 A Pediatric Medicine Metabolic encephalopathy (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100041
Investigations

clinical notes,Concern
24.58 B Pediatric Medicine Metabolic encephalopathy (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100041
Investigations

clinical notes,Concern
24.58 C Pediatric Medicine Metabolic encephalopathy (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100041
Investigations

clinical notes,Concern
24.58 D Pediatric Medicine Metabolic encephalopathy (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100041
Investigations

clinical notes,Concern
1654 24.59 A Pediatric Medicine Ketogenic diet initiation in refractory epilepsy (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200059
Investigations

clinical notes,Concern
24.59 B Pediatric Medicine Ketogenic diet initiation in refractory epilepsy (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200059
Investigations

Ketogenic diet initiation in refractory epilepsy (admission type: ICU, without clinical notes,Concern
24.59 C Pediatric Medicine clinical notes,Concern Investigations 3,600 M2 M200059
ventilator) Investigations

clinical notes,Concern
24.59 D Pediatric Medicine Ketogenic diet initiation in refractory epilepsy (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200059
Investigations

clinical notes,Concern
1655 24.60 A Pediatric Medicine Inborn errors of metabolism (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200060
Investigations

clinical notes,Concern
24.60 B Pediatric Medicine Inborn errors of metabolism (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200060
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.60 C Pediatric Medicine Inborn errors of metabolism (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200060
Investigations

clinical notes,Concern
24.60 D Pediatric Medicine Inborn errors of metabolism (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200060
Investigations

clinical notes,Concern
1656 24.61 A Pediatric Medicine Wilson’s disease (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200061
Investigations

clinical notes,Concern
24.61 B Pediatric Medicine Wilson’s disease (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200061
Investigations

clinical notes,Concern
24.61 C Pediatric Medicine Wilson’s disease (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200061
Investigations

clinical notes,Concern
24.61 D Pediatric Medicine Wilson’s disease (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200061
Investigations

clinical notes,Concern
1657 24.62 A Pediatric Medicine Celiac disease (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200062
Investigations

clinical notes,Concern
24.62 B Pediatric Medicine Celiac disease (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200062
Investigations

clinical notes,Concern
24.62 C Pediatric Medicine Celiac disease (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200062
Investigations

clinical notes,Concern
24.62 D Pediatric Medicine Celiac disease (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200062
Investigations

clinical notes,Concern
1658 24.63 A Pediatric Medicine Unexplained jaundice (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200063
Investigations

clinical notes,Concern
24.63 B Pediatric Medicine Unexplained jaundice (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200063
Investigations

clinical notes,Concern
24.63 C Pediatric Medicine Unexplained jaundice (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200063
Investigations

clinical notes,Concern
24.63 D Pediatric Medicine Unexplained jaundice (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200063
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1659 24.64 A Pediatric Medicine Unexplained hepatosplenomegaly (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200064
Investigations

clinical notes,Concern
24.64 B Pediatric Medicine Unexplained hepatosplenomegaly (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200064
Investigations

clinical notes,Concern
24.64 C Pediatric Medicine Unexplained hepatosplenomegaly (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200064
Investigations

clinical notes,Concern
24.64 D Pediatric Medicine Unexplained hepatosplenomegaly (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200064
Investigations

clinical notes,Concern
1660 24.65 A Pediatric Medicine Severe pneumonia (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100047
Investigations

clinical notes,Concern
24.65 B Pediatric Medicine Severe pneumonia (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100047
Investigations

clinical notes,Concern
24.65 C Pediatric Medicine Severe pneumonia (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100047
Investigations

clinical notes,Concern
24.65 D Pediatric Medicine Severe pneumonia (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100047
Investigations

clinical notes,Concern
1661 24.66 A Pediatric Medicine Severe exacerbation of asthma (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200066
Investigations

clinical notes,Concern
24.66 B Pediatric Medicine Severe exacerbation of asthma (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200066
Investigations

clinical notes,Concern
24.66 C Pediatric Medicine Severe exacerbation of asthma (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200066
Investigations

clinical notes,Concern
24.66 D Pediatric Medicine Severe exacerbation of asthma (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200066
Investigations

clinical notes,Concern
1662 24.67 A Pediatric Medicine Acute kidney injury (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200067
Investigations

clinical notes,Concern
24.67 B Pediatric Medicine Acute kidney injury (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200067
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.67 C Pediatric Medicine Acute kidney injury (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200067
Investigations

clinical notes,Concern
24.67 D Pediatric Medicine Acute kidney injury (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200067
Investigations

clinical notes,Concern
1663 24.68 A Pediatric Medicine Poisonings (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200068
Investigations

clinical notes,Concern
24.68 B Pediatric Medicine Poisonings (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200068
Investigations

clinical notes,Concern
24.68 C Pediatric Medicine Poisonings (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200068
Investigations

clinical notes,Concern
24.68 D Pediatric Medicine Poisonings (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200068
Investigations

clinical notes,Concern
1664 24.69 A Pediatric Medicine Serious trauma with unstable vitals (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200069
Investigations

clinical notes,Concern
24.69 B Pediatric Medicine Serious trauma with unstable vitals (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200069
Investigations

clinical notes,Concern
24.69 C Pediatric Medicine Serious trauma with unstable vitals (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200069
Investigations

clinical notes,Concern
24.69 D Pediatric Medicine Serious trauma with unstable vitals (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200069
Investigations

clinical notes,Concern
1665 24.70 A Pediatric Medicine Upper GI hemorrhage (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200070
Investigations

clinical notes,Concern
24.70 B Pediatric Medicine Upper GI hemorrhage (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200070
Investigations

clinical notes,Concern
24.70 C Pediatric Medicine Upper GI hemorrhage (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200070
Investigations

clinical notes,Concern
24.70 D Pediatric Medicine Upper GI hemorrhage (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200070
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1666 24.71 A Pediatric Medicine Lower GI hemorrhage (admission type: Routine ward ) clinical notes,Concern Investigations 1,800 M2 M100058
Investigations

clinical notes,Concern
24.71 B Pediatric Medicine Lower GI hemorrhage (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100058
Investigations

clinical notes,Concern
24.71 C Pediatric Medicine Lower GI hemorrhage (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100058
Investigations

clinical notes,Concern
24.71 D Pediatric Medicine Lower GI hemorrhage (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100058
Investigations

clinical notes,Concern
1667 24.72 A Pediatric Medicine Acute abdomen (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200072
Investigations

clinical notes,Concern
24.72 B Pediatric Medicine Acute abdomen (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200072
Investigations

clinical notes,Concern
24.72 C Pediatric Medicine Acute abdomen (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200072
Investigations

clinical notes,Concern
24.72 D Pediatric Medicine Acute abdomen (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200072
Investigations

clinical notes,Concern
1668 24.73 A Pediatric Medicine Liver abscess (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100021
Investigations

clinical notes,Concern
24.73 B Pediatric Medicine Liver abscess (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100021
Investigations

clinical notes,Concern
24.73 C Pediatric Medicine Liver abscess (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100021
Investigations

clinical notes,Concern
24.73 D Pediatric Medicine Liver abscess (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100021
Investigations

clinical notes,Concern
1669 24.74 A Pediatric Medicine Complicated malaria (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100051
Investigations

clinical notes,Concern
24.74 B Pediatric Medicine Complicated malaria (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100051
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.74 C Pediatric Medicine Complicated malaria (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100051
Investigations

clinical notes,Concern
24.74 D Pediatric Medicine Complicated malaria (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100051
Investigations

clinical notes,Concern
1670 24.75 A Pediatric Medicine Severe dengue with shock (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200075
Investigations

clinical notes,Concern
24.75 B Pediatric Medicine Severe dengue with shock (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200075
Investigations

clinical notes,Concern
24.75 C Pediatric Medicine Severe dengue with shock (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200075
Investigations

clinical notes,Concern
24.75 D Pediatric Medicine Severe dengue with shock (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200075
Investigations

clinical notes,Concern
1671 24.76 A Pediatric Medicine Congestive cardiac failure (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200076
Investigations

clinical notes,Concern
24.76 B Pediatric Medicine Congestive cardiac failure (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200076
Investigations

clinical notes,Concern
24.76 C Pediatric Medicine Congestive cardiac failure (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200076
Investigations

clinical notes,Concern
24.76 D Pediatric Medicine Congestive cardiac failure (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200076
Investigations

clinical notes,Concern
1672 24.77 A Pediatric Medicine Brain abscess (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200077
Investigations

clinical notes,Concern
24.77 B Pediatric Medicine Brain abscess (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200077
Investigations

clinical notes,Concern
24.77 C Pediatric Medicine Brain abscess (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200077
Investigations

clinical notes,Concern
24.77 D Pediatric Medicine Brain abscess (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200077
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1673 24.78 A Pediatric Medicine Acute encephalitic syndrome (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200078
Investigations

clinical notes,Concern
24.78 B Pediatric Medicine Acute encephalitic syndrome (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200078
Investigations

clinical notes,Concern
24.78 C Pediatric Medicine Acute encephalitic syndrome (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200078
Investigations

clinical notes,Concern
24.78 D Pediatric Medicine Acute encephalitic syndrome (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200078
Investigations

clinical notes,Concern
1674 24.79 A Pediatric Medicine Acute demyelinating myelopathy, (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200079
Investigations

clinical notes,Concern
24.79 B Pediatric Medicine Acute demyelinating myelopathy, (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200079
Investigations

clinical notes,Concern
24.79 C Pediatric Medicine Acute demyelinating myelopathy, (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200079
Investigations

clinical notes,Concern
24.79 D Pediatric Medicine Acute demyelinating myelopathy, (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200079
Investigations

Immune mediated CNS disorders such as autoimmune encephalitis (admission type: clinical notes,Concern
1675 24.80 A Pediatric Medicine clinical notes,Concern Investigations 1,800 M2 M100059
Routine ward) Investigations

Immune mediated CNS disorders such as autoimmune encephalitis (admission type: clinical notes,Concern
24.80 B Pediatric Medicine clinical notes,Concern Investigations 2,700 M2 M100059
HDU) Investigations

Immune mediated CNS disorders such as autoimmune encephalitis (admission type: clinical notes,Concern
24.80 C Pediatric Medicine clinical notes,Concern Investigations 3,600 M2 M100059
ICU, without ventilator) Investigations

Immune mediated CNS disorders such as autoimmune encephalitis (admission type: clinical notes,Concern
24.80 D Pediatric Medicine clinical notes,Concern Investigations 4,500 M2 M100059
ICU, with ventilator) Investigations

clinical notes,Concern
1676 24.81 A Pediatric Medicine Acute transverse myelitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100060
Investigations

clinical notes,Concern
24.81 B Pediatric Medicine Acute transverse myelitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100060
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.81 C Pediatric Medicine Acute transverse myelitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100060
Investigations

clinical notes,Concern
24.81 D Pediatric Medicine Acute transverse myelitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100060
Investigations

clinical notes,Concern
1677 24.82 A Pediatric Medicine Guillain Barre Syndrome (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200082
Investigations

clinical notes,Concern
24.82 B Pediatric Medicine Guillain Barre Syndrome (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200082
Investigations

clinical notes,Concern
24.82 C Pediatric Medicine Guillain Barre Syndrome (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200082
Investigations

clinical notes,Concern
24.82 D Pediatric Medicine Guillain Barre Syndrome (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200082
Investigations

clinical notes,Concern
1678 24.83 A Pediatric Medicine Hydrocephalus (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100062
Investigations

clinical notes,Concern
24.83 B Pediatric Medicine Hydrocephalus (admission type:HDU) clinical notes,Concern Investigations 2,700 M2 M100062
Investigations

clinical notes,Concern
24.83 C Pediatric Medicine Hydrocephalus (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100062
Investigations

clinical notes,Concern
24.83 D Pediatric Medicine Hydrocephalus (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100062
Investigations

clinical notes,Concern
1679 24.84 A Pediatric Medicine Intracranial space occupying lesion (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200084
Investigations

clinical notes,Concern
24.84 B Pediatric Medicine Intracranial space occupying lesion (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200084
Investigations

clinical notes,Concern
24.84 C Pediatric Medicine Intracranial space occupying lesion (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200084
Investigations

clinical notes,Concern
24.84 D Pediatric Medicine Intracranial space occupying lesion (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200084
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1680 24.85 A Pediatric Medicine Cerebral malaria (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200085
Investigations

clinical notes,Concern
24.85 B Pediatric Medicine Cerebral malaria (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200085
Investigations

clinical notes,Concern
24.85 C Pediatric Medicine Cerebral malaria (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200085
Investigations

clinical notes,Concern
24.85 D Pediatric Medicine Cerebral malaria (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200085
Investigations

clinical notes,Concern
1681 24.86 A Pediatric Medicine Acute ischemic stroke (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200086
Investigations

clinical notes,Concern
24.86 B Pediatric Medicine Acute ischemic stroke (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200086
Investigations

clinical notes,Concern
24.86 C Pediatric Medicine Acute ischemic stroke (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200086
Investigations

clinical notes,Concern
24.86 D Pediatric Medicine Acute ischemic stroke (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200086
Investigations

clinical notes,Concern
1682 24.87 A Pediatric Medicine Cerebral sino-venous thrombosis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100063
Investigations

clinical notes,Concern
24.87 B Pediatric Medicine Cerebral sino-venous thrombosis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100063
Investigations

clinical notes,Concern
24.87 C Pediatric Medicine Cerebral sino-venous thrombosis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100063
Investigations

clinical notes,Concern
24.87 D Pediatric Medicine Cerebral sino-venous thrombosis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100063
Investigations

Respiratory failure due to any causes (pneumonia, asthma, foreign body, poisoning, clinical notes,Concern
1683 24.88 A Pediatric Medicine clinical notes,Concern Investigations 1,800 M2 M200088
head injury etc.) (admission type: Routine ward) Investigations

Respiratory failure due to any causes (pneumonia, asthma, foreign body, poisoning, clinical notes,Concern
24.88 B Pediatric Medicine clinical notes,Concern Investigations 2,700 M2 M200088
head injury etc.) (admission type: HDU) Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Respiratory failure due to any causes (pneumonia, asthma, foreign body, poisoning, clinical notes,Concern
24.88 C Pediatric Medicine clinical notes,Concern Investigations 3,600 M2 M200088
head injury etc.) (admission type: ICU, without ventilator) Investigations

Respiratory failure due to any causes (pneumonia, asthma, foreign body, poisoning, clinical notes,Concern
24.88 D Pediatric Medicine clinical notes,Concern Investigations 4,500 M2 M200088
head injury etc.) (admission type: ICU, with ventilator) Investigations

clinical notes,Concern
1684 24.89 A Pediatric Medicine Acute transverse myelitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M100060
Investigations

clinical notes,Concern
24.89 B Pediatric Medicine Acute transverse myelitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M100060
Investigations

clinical notes,Concern
24.89 C Pediatric Medicine Acute transverse myelitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M100060
Investigations

clinical notes,Concern
24.89 D Pediatric Medicine Acute transverse myelitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M100060
Investigations

clinical notes,Concern
1685 24.90 A Pediatric Medicine Acute encephalitis –infectious/immune-mediated (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200090
Investigations

clinical notes,Concern
24.90 B Pediatric Medicine Acute encephalitis –infectious/immune-mediated (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200090
Investigations

Acute encephalitis –infectious/immune-mediated (admission type: ICU, without clinical notes,Concern

24.90 C Pediatric Medicine clinical notes,Concern Investigations 3,600 M2 M200090
ventilator) Investigations

Acute encephalitis –infectious/immune-mediated (admission type: ICU, with clinical notes,Concern

24.90 D Pediatric Medicine clinical notes,Concern Investigations 4,500 M2 M200090
ventilator) Investigations

clinical notes,Concern
1686 24.91 A Pediatric Medicine Convulsive & non convulsive status epilepticus (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200091
Investigations

clinical notes,Concern
24.91 B Pediatric Medicine Convulsive & non convulsive status epilepticus (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200091
Investigations

Convulsive & non convulsive status epilepticus (admission type: ICU, without clinical notes,Concern
24.91 C Pediatric Medicine clinical notes,Concern Investigations 3,600 M2 M200091
ventilator) Investigations

clinical notes,Concern
24.91 D Pediatric Medicine Convulsive & non convulsive status epilepticus (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200091
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1687 24.92 A Pediatric Medicine Cerebral herniation (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200092
Investigations

clinical notes,Concern
24.92 B Pediatric Medicine Cerebral herniation (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200092
Investigations

clinical notes,Concern
24.92 C Pediatric Medicine Cerebral herniation (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200092
Investigations

clinical notes,Concern
24.92 D Pediatric Medicine Cerebral herniation (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200092
Investigations

clinical notes,Concern
1688 24.93 A Pediatric Medicine Intracranial hemorrhage (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200093
Investigations

clinical notes,Concern
24.93 B Pediatric Medicine Intracranial hemorrhage (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200093
Investigations

clinical notes,Concern
24.93 C Pediatric Medicine Intracranial hemorrhage (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200093
Investigations

clinical notes,Concern
24.93 D Pediatric Medicine Intracranial hemorrhage (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200093
Investigations

clinical notes,Concern
1689 24.94 A Pediatric Medicine Hepatic encephalopathy (admission type: Rourine ward) clinical notes,Concern Investigations 1,800 M2 M200094
Investigations

clinical notes,Concern
24.94 B Pediatric Medicine Hepatic encephalopathy (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200094
Investigations

clinical notes,Concern
24.94 C Pediatric Medicine Hepatic encephalopathy (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200094
Investigations

clinical notes,Concern
24.94 D Pediatric Medicine Hepatic encephalopathy (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200094
Investigations

clinical notes,Concern
1690 24.95 A Pediatric Medicine Complicated bacterial meningitis (admission type: Routine ward) clinical notes,Concern Investigations 1,800 M2 M200095
Investigations

clinical notes,Concern
24.95 B Pediatric Medicine Complicated bacterial meningitis (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200095
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
24.95 C Pediatric Medicine Complicated bacterial meningitis (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200095
Investigations

clinical notes,Concern
24.95 D Pediatric Medicine Complicated bacterial meningitis (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200095
Investigations

clinical notes,Concern
1691 24.96 A Pediatric Medicine Raised intracranial pressure (admission type: routine ward) clinical notes,Concern Investigations 1,800 M2 M200096
Investigations

clinical notes,Concern
24.96 B Pediatric Medicine Raised intracranial pressure (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200096
Investigations

clinical notes,Concern
24.96 C Pediatric Medicine Raised intracranial pressure (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200096
Investigations

clinical notes,Concern
24.96 D Pediatric Medicine Raised intracranial pressure (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200096
Investigations

clinical notes,Concern
1692 24.97 A Pediatric Medicine Hypertensive encephalopathy (admission type: Routind) clinical notes,Concern Investigations 1,800 M2 M200097
Investigations

clinical notes,Concern
24.97 B Pediatric Medicine Hypertensive encephalopathy (admission type: HDU) clinical notes,Concern Investigations 2,700 M2 M200097
Investigations

clinical notes,Concern
24.97 C Pediatric Medicine Hypertensive encephalopathy (admission type: ICU, without ventilator) clinical notes,Concern Investigations 3,600 M2 M200097
Investigations

clinical notes,Concern
24.97 D Pediatric Medicine Hypertensive encephalopathy (admission type: ICU, with ventilator) clinical notes,Concern Investigations 4,500 M2 M200097
Investigations

clinical notes,Concern
1693 24.98 Pediatric Medicine CRRT (per session) clinical notes,Concern Investigations 8,000 M2 M200098
Investigations
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Blood and blood component transfusion up to a limit of 2 days(admission for a

diagnostic procedure leading to treatment requiring admission, e.g. bone marrow and
clinical notes,Concern
1694 24.99 Pediatric Medicine bone biopsy, endoscopy, liver biopsy, bronchoscopy, CT/MRI under GA, broncho- clinical notes,Concern Investigations 1,500 Package rate per Day M2 M200099
Investigations
alveolar lavage, lumbar puncture, muscle biopsy, FNAC, pleural aspiration, ascitic
tapping, neostigmine challenge test etc.)Package rate per Day

Blood and blood component transfusion for indications like clinical notes,Concern
1695 24.100 Pediatric Medicine clinical notes,Concern Investigations 1,500 Package rate per Day M2 M200100
Thalassemia/Hemoglobinopathies - upto a limit of 2 days,Package rate per Day Investigations

High end radiological diagnostic (CT, MRI, Imaging including nuclear imaging) - can clinical notes,Concern capped @ Rs 5000 per
1696 24.101 Pediatric Medicine clinical notes,Concern Investigations 5,000 M2 M200101
only be clubbed with medical package. Investigations annum for a family

High end histopathology (Biopsies) and advanced serology investigations - can only be clinical notes,Concern capped @ Rs 5000 per
1697 24.102 Pediatric Medicine clinical notes,Concern Investigations 5,000 M2 M200102
clubbed with medical package. Investigations annum for a family

Cluster - 25 NEO-NATAL PACKAGES

Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Basic neonatal care package (Rs. 500 per day, maximum 1500): Babies that can be
managed by side of mother in postnatal ward without requiring admission in
SNCU/NICU: Blood sugar,Blood
• Any newborn needing feeding support group,Complete blood
Capped Amount is
1698 25.1 Neonatal • Babies requiring closer monitoring or short-term care for conditions like: count,Coombs test,others clinical notes,Concern Investigaions 500 M3 M300001
1500 for this Package
o Birth asphyxia (need for positive pressure ventilation; no HIE) as required,Concern
o Moderate jaundice requiring phototherapy Investigaions
o Large for dates (>97 percentile) Babies
o Small for gestational age (less than 3rd centile) (Package rate is per day)
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Blood sugar (Package rate

is per day)
Special Neonatal Care Package (Rs. 3000 per day, maximum of 18000 - pre-auth after
Complete Blood Picture
4 days): Babies that required admission to SNCU or NICU:
Blood group
Babies admitted for short term care for conditions like:
Bilirubin
• Mild Respiratory Distress/tachypnea
Coombs Test
• Mild encephalopathy
Chest X ray Capped Amount is
• Severe jaundice requiring intensive phototherapy
1699 25.2 Neonatal CRP clinical notes,Concern Investigaions 3,000 18000 for this M3 M300002
• Haemorrhagic disease of newborn
Micro ESR Package
• Unwell baby requiring monitoring
Blood Culture
• Some dehydration
Electrolytes
• Hypoglycaemia
Renal function tests
Mother's stay and food in the hospital for breastfeeding, family centred care and
Coagulation profile
(Kangaroo Mother Care) KMC is mandatory and included in the package rate
Others as required

Intensive Neonatal Care Package (Rs. 5000 per day, maximum of Rs. 50,000 – pre-
auth is needed after 5 days) (Package rate is per day)
Babies with birthweight 1500-1799 g
or
Babies of any birthweight and at least one of the following conditions:
• Need for mechanical ventilation for less than 24 hours or non-invasive respiratory
support (CPAP, HFFNC)
Capped Amount is
• Sepsis / pneumonia without complications
1700 25.3 Neonatal Concern Investigaions clinical notes,Concern Investigaions 5,000 50000 for this M3 M300003
• Hyperbilirubinemia requiring exchange transfusion
Package
• Seizures
• Major congenital malformations (pre-surgical stabilization, not requiring
ventilation)
• Cholestasis significant enough requiring work up and in-hospital management
• Congestive heart failure or shock
Mother's stay and food in the hospital for breastfeeding, family centred care and
(Kangaroo Mother Care) KMC is mandatory and included in the package rate
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Advanced Neonatal Care Package (Rs. 6000 per day, maximum of Rs. 75,000 – pre-
auth is needed after 7 days) (Package rate is per day)
Babies with birthweight of 1200-1499 g
or
Babies of any birthweight with at least one of the following conditions:
• Any condition requiring invasive ventilation longer than 24 hours
• Hypoxic Ischemic encephalopathy requiring Therapeutic Hypothermia Capped Amount is
1701 25.4 Neonatal • Cardiac rhythm disorders needing intervention (the cost of cardiac surgery or Concern Investigaions clinical notes,Concern Investigaions 6,000 75000 for this M3 M300004
implant will be covered under cardiac surgery packages) Package
• Sepsis with complications such as meningitis or bone and joint infection, DIC or
shock
• Renal failure requiring dialysis
• Inborn errors of metabolism
Mother's stay and food in the hospital for breastfeeding, family centred care and
(Kangaroo Mother Care) KMC is mandatory and included in the package rate

Critical Care Neonatal Package (Rs. 7000 per day, maximum of Rs. 1,20,000 – pre-
auth after 10 days) (Package rate is per day)
Babies with birthweight of <1200 g
or
Babies of any birthweight with at least one of the following conditions:
Capped Amount is
• Severe Respiratory Failure requiring High Frequency Ventilation or inhaled Nitric
1702 25.5 Neonatal Concern Investigaions clinical notes,Concern Investigaions 7,000 120000 for this M3 M300005
Oxide (iNO)
Package
• Multisystem failure requiring multiple organ support including mechanical
ventilation and multiple inotropes
• Critical congenital heart disease
Mother's stay and food in the hospital for breastfeeding, family centred care and
(Kangaroo Mother Care) KMC is mandatory and included in the package rate

Chronic Care Package (Rs. 3000 per day, maximum of Rs. 30,000): If the baby requires
Capped Amount is
stay beyond the upper limit of usual stay in Package no 0004 or 0005 for conditions clinical notes,Concern
1703 25.6 Neonatal clinical notes,Concern Investigaions 3,000 30000 for this M3 M300006
like severe BPD requiring respiratory support, severe NEC requiring prolonged TPN Investigaions
Package
support (Package rate is per day)

clinical notes,Concern
1704 25.7 Neonatal High Risk Newborn Post Discharge Care Package (Protocol Driven) clinical notes,Concern Investigaions 2,400 M3 M300007
Investigaions

Laser Therapy for Retinopathy of Prematurity (Irrespective of no. of eyes affected) - clinical notes,Concern
1705 25.8 Neonatal clinical notes,Concern Investigaions 1,500 M3 M300008
per session Investigaions
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

clinical notes,Concern
1706 25.9 Neonatal Advanced Surgery for Retinopathy of Prematurity clinical notes,Concern Investigaions 15,000 M3 M300009
Investigaions

Ventriculoperitoneal Shunt Surgery (VP) or Omaya Reservoir or External Drainage for clinical notes,Concern
1707 25.10 Neonatal clinical notes,Concern Investigaions 5,000 M3 M300010
Hydrocephalus Investigaions

Cluster - 26 ORTHOPEDICS
Pre-Operative Speciality Code
Sr.No Package no Sub speciality Procedure name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

AC joint reconstruction/ Stabilization/ Acromionplasty (Nonoperative management is

recommended for Rockwood type I and II injuries, whereas surgical reconstruction is X Ray of Affected Limb,
1708 26.1 Orthopeidc X Ray of Affected Limb 25,000 S5 S500001
recommended for type IV and VI separations. The management for type III and V MIR of Shoulder
injuries is more controversial and is determined on a case-by-case basis)

Accessory bone – Excision (limbs) – congenital, Accessory digits sometime can be

1709 26.2 Orthopeidc X Ray of Affected Limb X Ray of Affected Limb 6,000 S5 S500002
removed

X Ray of Affected Limb,

1710 26.3 Orthopeidc Amputation - Below Elbow X Ray of Affected Limb 15,000 S5 S500003
clinical picture

X Ray of Affected Limb,

1711 26.4 Orthopeidc Amputation - Above Elbow X Ray of Affected Limb 15,000 S5 S500004
clinical picture

X Ray of Affected Limb,

1712 26.5 Orthopeidc Amputation – one or more fingers X Ray of Affected Limb 6,000 S5 S500005
clinical picture

X Ray of Affected Limb,

1713 26.6 Orthopeidc Amputation – Wrist X Ray of Affected Limb 15,000 S5 S500006
clinical picture

X Ray of Affected Limb,

1714 26.7 Orthopeidc Amputation - one or more toes/ digits X Ray of Affected Limb 6,000 S5 S500007
clinical picture

X Ray of Affected Limb,

1715 26.8 Orthopeidc Amputation – Below Knee X Ray of Affected Limb 15,000 S5 S500008
clinical picture

X Ray of Affected Limb,

1716 26.9 Orthopeidc Amputation – Above Knee X Ray of Affected Limb 18,000 S5 S500009
clinical picture

X Ray of Affected Limb,

1717 26.10 Orthopeidc Foot & Hand Amputation (whole/ partial) X Ray of Affected Limb 15,000 S5 S500010
clinical picture

Clinical and radiological

1718 26.11 Orthopeidc Disarticulation (hind & for quarter) Clinical and radiological investigation 25,000 S5 S500011
investigation

Clinical and radiological

1719 26.12 Orthopeidc Anterior Spine Fixation Clinical and radiological investigation 35,000 S5 S500012
investigation

Clinical and radiological

1720 26.13 Orthopeidc Posterior Spine Fixation Clinical and radiological investigation 20,000 S5 S500013
investigation
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical and radiological

1721 26.14 Orthopeidc Osteochondroma excision/ Excision of Exostosis Clinical and radiological investigation 10,000 S5 S500014
investigation

Clinical and radiological

1722 26.15 Orthopeidc Excision Arthoplasty Clinical and radiological investigation 15,000 S5 S500015
investigation

X-Ray/USG/ MRI of
1723 26.16 Orthopeidc Arthorotomy of any joint affected joints and clinical Clinical and radiological investigation 15,000 S5 S500016
photo , CBC

Clinical and radiological

1724 26.17 Orthopeidc Arthrodesis Ankle Triple Clinical and radiological investigation 15,000 S5 S500017
investigation

X-Ray, MRI of affected

1725 26.18 Orthopeidc Excision Arthoplasty of Femur head Post-Operative X-Ray 22,500 S5 S500018
joints , CBC, ESR, CRP

Clinical and radiological

1726 26.19 Orthopeidc Bimalleolar Fracture Fixation Clinical and radiological investigation 15,000 S5 S500019
investigation

Clinical and radiological

1727 26.20 Orthopeidc Bone Tumour Excision + reconstruction using implant (malignant/ benign) Clinical and radiological investigation 50,000 S5 S500020
investigation

Clinical and radiological

1728 26.21 Orthopeidc Bone Tumour (malignant/ benign) curettage and bone grafting Clinical and radiological investigation 20,000 S5 S500021
investigation

Bone Tumour Excision (malignant/ benign) + Joint replacement (depending upon Clinical and radiological
1729 26.22 Orthopeidc Clinical and radiological investigation 1,50,000 S5 S500022
type of joint and implant) investigation

1730 26.23 Orthopeidc Clavicle fracture management - conservative (daycare) X- Ray of affected sights X- Ray of limb treated. 3,000 S5 S500023

Clinical and radiological

1731 26.24 Orthopeidc Close Fixation - Hand Bones X- Ray of limb treated. 4,000 S5 S500024
investigation

X Ray of Affected Limb,

1732 26.25 Orthopeidc Close Fixation - Foot Bones X- Ray of limb treated. 4,000 S5 S500025
clinical picture

X Ray of Affected Limb,

1733 26.26 Orthopeidc Close Reduction - Small Joints X- Ray of limb treated. 4,000 S5 S500026
clinical picture

X Ray of Affected Limb,

1734 26.27 Orthopeidc Closed Interlock Nailing + Bone Grafting – femur X- Ray of limb treated. 19,000 S5 S500027
clinical picture

X Ray of Affected Limb,

1735 26.28 Orthopeidc Closed Interlocking Intermedullary X- Ray of limb treated. 17,500 S5 S500028
clinical picture
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

X Ray of Affected Limb,

1736 26.29 Orthopeidc Closed Interlocking Tibia + Orif of Fracture Fixation X- Ray of limb treated. 25,000 S5 S500029
clinical picture

X Ray of Affected Limb,

1737 26.30 Orthopeidc Closed Reduction and Internal Fixation with K wire X- Ray of limb treated. 6,000 S5 S500030
clinical picture

X Ray of Affected Limb,

1738 26.31 Orthopeidc Closed Reduction and Percutaneous Screw Fixation (neck femur) X- Ray of limb treated. 15,000 S5 S500031
clinical picture

X Ray of Affected Limb,

1739 26.32 Orthopeidc Closed Reduction and Percutaneous Pinning X- Ray of limb treated. 15,000 S5 S500032
clinical picture

X Ray of Affected Limb,

1740 26.33 Orthopeidc Closed Reduction and Percutaneous Nailing X- Ray of limb treated. 20,000 S5 S500033
clinical picture

X Ray of Affected Limb,

1741 26.34 Orthopeidc Closed Reduction of the Hip (including hip Spika) X- Ray of limb treated. 7,000 S5 S500034
clinical picture

Debridement & Closure of Major injuries - contused lacerated wounds (anti-biotic + X Ray of Affected Limb,
1742 26.35 Orthopeidc X- Ray of limb treated. 7,000 S5 S500035
dressing) - minimum of 3 sessions clinical picture

X Ray of Affected Limb,

1743 26.36 Orthopeidc Debridement & Closure of Minor injuries X- Ray of limb treated. 3,000 S5 S500036
clinical picture

X Ray of Affected Limb,

1744 26.37 Orthopeidc Closed reduction of dislocation (Knee/ Hip) X- Ray of limb treated. 6,000 S5 S500037
clinical picture

X Ray of Affected Limb,

1745 26.38 Orthopeidc Closed reduction of dislocation (Shoulder/ Elbow) X- Ray of limb treated. 5,000 S5 S500038
clinical picture

1746 26.39 Orthopeidc Duputryen’s Contracture release + rehabilitation USG of Affected Hand clinical picture + USG 10,000 S5 S500039

1747 26.40 Orthopeidc Exploration and Ulnar nerve Repair X-Ray, UGS, RMG & NCV Post of USG 10,000 S5 S500040

X Ray of Affected Limb,

1748 26.41 Orthopeidc External fixation - Long bone Post of X -Ray 15,000 S5 S500041
clinical picture

X Ray of Affected Limb,

1749 26.42 Orthopeidc External fixation - Small bone Post of X -Ray 10,000 S5 S500042
clinical picture

X Ray of Affected Limb,

1750 26.43 Orthopeidc External fixation - Pelvis Post of X -Ray 15,000 S5 S500043
clinical picture

X Ray of Affected Limb,

1751 26.44 Orthopeidc Fasciotomy Post of X -Ray 7,000 S5 S500044
clinical picture

X Ray of Affected Limb,

1752 26.45 Orthopeidc Fixator with Joint Arthrolysis Post of X -Ray 20,000 S5 S500045
clinical picture

X Ray of Affected Limb,

1753 26.46 Orthopeidc Fracture - Acetabulum Post of X -Ray 30,000 S5 S500046
clinical picture

X Ray of Affected Limb,

1754 26.47 Orthopeidc Fracture - Fibula Internal Fixation Post of X -Ray 10,000 S5 S500047
clinical picture
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Fracture - Hip Internal Fixation (Intertrochanteric Fracture with implant) + X Ray of Affected Limb,
1755 26.48 Orthopeidc Post of X -Ray 17,000 S5 S500048
rehabilitation clinical picture

X Ray of Affected Limb,

1756 26.49 Orthopeidc Fracture - Humerus Internal Fixation Post of X -Ray 17,000 S5 S500049
clinical picture

X Ray of Affected Limb,

1757 26.50 Orthopeidc Fracture - Olecranon of Ulna Post of X -Ray 10,000 S5 S500050
clinical picture

X Ray of Affected Limb,

1758 26.51 Orthopeidc Fracture - Radius Internal Fixation Post of X -Ray 10,000 S5 S500051
clinical picture

X Ray of Affected Limb,

1759 26.52 Orthopeidc Fracture - TIBIA Internal Fixation plating Post of X -Ray 17,000 S5 S500052
clinical picture

X Ray of Affected Limb,

1760 26.53 Orthopeidc Fracture - Ulna Internal Fixation Post of X -Ray 10,000 S5 S500053
clinical picture

X Ray of Affected Limb,

1761 26.54 Orthopeidc Head Radius – Excision Post of X -Ray 8,000 S5 S500054
clinical picture

X Ray of Affected Limb,

1762 26.55 Orthopeidc High Tibial Osteotomy Post of X -Ray 17,000 S5 S500055
clinical picture
X Ray of Affected Limb,
1763 26.56 Orthopeidc Closed reduction + Hip Spica Post of X -Ray 7,000 S5 S500056
clinical picture
X Ray of Affected Limb,
1764 26.57 Orthopeidc Internal Fixation Lateral Epicondyle Post of X -Ray 10,000 S5 S500057
clinical picture
X Ray of Affected Limb,
1765 26.58 Orthopeidc Internal Fixation of other Small Bones (metatarsals) Post of X -Ray 10,000 S5 S500058
clinical picture
X Ray of Affected Limb,
1766 26.59 Orthopeidc Limb Lengthening Post of X -Ray 25,000 S5 S500059
clinical picture
X Ray of Affected Limb,
1767 26.60 Orthopeidc Llizarov Fixation Post of X -Ray 10,000 S5 S500060
clinical picture
Clinical + Electro
1768 26.61 Orthopeidc Multiple Tendon Repair Clinical photographs showing scar 20,000 S5 S500061
Diagnostic study

Clinical + Electro Clinical photographs showing scar +

1769 26.62 Orthopeidc Nerve Repair Surgery 15,000 S5 S500062
Diagnostic study Electro Dignostic study

Clinical + Electro Clinical photographs showing scar +

1770 26.63 Orthopeidc Nerve Transposition/Release/ Neurolysis 8,000 S5 S500063
Diagnostic study Electro Dignostic study

X Ray of Affected Limb,

1771 26.64 Orthopeidc Open Reduction Internal Fixation (2 Small Bones) Post of X -Ray 10,000 S5 S500064
clinical picture

X Ray of Affected Limb,

1772 26.65 Orthopeidc Open Reduction Internal Fixation (Large Bone) Post of X -Ray 20,000 S5 S500065
clinical picture

X Ray of Affected Limb,

1773 26.66 Orthopeidc Open Reduction of CDH Post of X -Ray 30,000 S5 S500066
clinical picture

X Ray of Affected Limb,

1774 26.67 Orthopeidc Open Reduction of Small Joint Post of X -Ray 15,000 S5 S500067
clinical picture
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

X Ray of Affected Limb,

1775 26.68 Orthopeidc Open Reduction with bone grafting of nonunion Post of X -Ray 20,000 S5 S500068
clinical picture

X Ray of Affected Limb,

1776 26.69 Orthopeidc Osteotomy -Small Bone Post of X -Ray 17,000 S5 S500069
clinical picture

X Ray of Affected Limb,

1777 26.70 Orthopeidc Osteotomy -Long Bone Post of X -Ray 30,000 S5 S500070
clinical picture

X Ray of Affected Limb,

1778 26.71 Orthopeidc Patellectomy Post of X -Ray 8,000 S5 S500071
clinical picture

X Ray of Affected Limb,

1779 26.72 Orthopeidc Pelvic Osteotomy with fixation with plaster Post of X -Ray, Clinical photo 30,000 S5 S500072
clinical picture

X Ray of Affected Limb,

1780 26.73 Orthopeidc Percutaneous - Fixation of Fracture Post of X -Ray 7,000 S5 S500073
clinical picture

X Ray of Affected Limb,

1781 26.74 Orthopeidc Excision of Bursa Radiology Investigation 3,000 S5 S500074
clinical picture

Clinical and radiological

1782 26.75 Orthopeidc Reconstruction of ACL/PCL with implant and brace Clinical and radiological investigation 30,000 S5 S500075
investigation

Clinical and radiological

1783 26.76 Orthopeidc Sequestrectomy of Long Bones + anti-biotics + dressing Clinical and radiological investigation 25,000 S5 S500076
investigation

X Ray of Affected Limb,

1784 26.77 Orthopeidc Tendo Achilles Tenotomy Clinical and radiological investigation 5,000 S5 S500077
clinical picture

Clinical and radiological

1785 26.78 Orthopeidc Tendon Grafting Clinical and radiological investigation 15,000 S5 S500078
investigation

Clinical and radiological

1786 26.79 Orthopeidc Tendon Release/ Tenotomy Clinical and radiological investigation 5,000 S5 S500079
investigation

Clinical and radiological

1787 26.80 Orthopeidc Tenolysis Clinical and radiological investigation 5,000 S5 S500080
investigation

Clinical and radiological

1788 26.81 Orthopeidc Tension Band Wiring Patella Clinical and radiological investigation 15,000 S5 S500081
investigation

Clinical and radiological

1789 26.82 Orthopeidc Application of P.O.P. casts for Upper & Lower Limbs Clinical and radiological investigation 3,000 S5 S500082
investigation

Clinical and radiological

1790 26.83 Orthopeidc Application of P.O.P. Spikas& Jackets Clinical and radiological investigation 3,500 S5 S500083
investigation

Clinical and radiological

1791 26.84 Orthopeidc Application of Skeletal Tractions with pin Clinical and radiological investigation 3,000 S5 S500084
investigation

Clinical and radiological

1792 26.85 Orthopeidc Application of Skin Traction Clinical and radiological investigation 1,000 S5 S500085
investigation
 Pre-Operative Speciality Code
Sr.No Package No Sub Speciality Procedure Name Post Operative Investigation No of Follow up Package Rates Remarks Procedure Code PMJAY
Investigation PMJAY

Clinical and radiological

1793 26.86 Orthopeidc Head radius - Excision + Fracture - Ulna Internal Fixation Clinical and radiological investigation 20,000 S5 S500086
investigation

Clinical and radiological

1794 26.87 Orthopeidc External fixation - both bones of forearms Clinical and radiological investigation 25,000 S5 S500087
investigation

Clinical and radiological

1795 26.88 Orthopeidc Fracture intercondylarHumerus + olecranon osteotomy Clinical and radiological investigation 20,000 S5 S500088
investigation

Clinical and radiological

1796 26.89 Orthopeidc Correction of club foot per cast Clinical and radiological investigation 15,000 S5 S500089
investigation

Clinical and radiological

1797 26.90 Orthopeidc Arthroscopic Meniscus Repair/ Meniscectomy Clinical and radiological investigation 20,000 S5 S500090
investigation

Clinical and radiological

1798 26.91 Orthopeidc Bipolar Hemiarthroplasty (hip & shoulder) Clinical and radiological investigation 40,000 S5 S500094
investigation

Clinical and radiological

1799 26.92 Orthopeidc Unipolar Hemiarthroplasty Clinical and radiological investigation 30,000 S5 S500095
investigation

Clinical and radiological

1800 26.93 Orthopeidc Elbow replacement Clinical and radiological investigation 40,000 S5 S500097
investigation

Clinical and radiological

1801 26.94 Orthopeidc Arthrodesis of shoulder Clinical and radiological investigation 40,000 S5 S500098
investigation

Clinical and radiological

1802 26.95 Orthopeidc Arthrodesis of Knee (with implant) Clinical and radiological investigation 40,000 S5 S500099
investigation

Clinical and radiological

1803 26.96 Orthopeidc Arthrodesis of Wrist (with implant) Clinical and radiological investigation 30,000 S5 S500100
investigation

Clinical and radiological

1804 26.97 Orthopeidc Arthrodesis of Ankle (with implant) Clinical and radiological investigation 30,000 S5 S500101
investigation

Unspecified Surgical Package (Amount Capped @ 1,00,000rs per anum per

1805 26.98 Orthopeidc Concern Investigation Concern Investigation 1,00,000 S5 U100
family,Package amount is Negotiable)