13.Revised Rate List

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) 01 – PROCEDURES

CODE 001 01001001

01001002

01001003 01001004

01001005 01001006 01001007 01001008 01001009 01001010 01001011 01001012 01001013 01001014 01001015 01001016 01001017 01001018 01001019 01001020 01001021 01001022 01001023 01001024

NAME OF TREATMENT PROCEDURE General Consultation by Medical Officer (OPD) Consultation by Specialists (OPD) Visit/ Revisit/ Consultation by Specialists (Indoor) (Maximum two visits per day admissible) Consultation by SuperSpecialists (OPD) Visit/ Revisit/ Consultation by Super-Specialists (Indoor) (Maximum two visits per day admissible) Pre-operative Anaesthetic Consultation Paramedical Consultation Special Nursing Charge (per shift of 12 hrs.) Aya/ Attendant Charge (per shift of 12 hrs.) Delayed primary suture Dressings Large Suturing without local anesthesia Suturing of wounds with local anesthesia Debridement of wounds Removal of Benign Tumor Aspiration Plural Effusion Therapeutic Abdominal Aspiration Therapeutic Removal of F.B. Superficial Bone Marrow Aspiration Joints Aspiration Strapping Removal of Stitches Venesection Phimosis Under LA

Maximum Approved Rate (INR) (Rupees)

150/200/-

200/-

CODE 01001025 01001026 01001027 01001028 01001029 01001030 01001031 01001032 01001033

250/-

01001034 01001035

250/-

01001036 002 01002001 01002002

200/75/150/75/1700/160/400/500/1200/1100/1000/-

01002003 01002004 01002005 01002006 01002007 01002008 01002009 01002010 003 01003001

1300/-

01003002

1200/1500/1500/100/60/300/1500/-

01003003 01003004 01003005 01003006 01003007

NAME OF TREATMENT PROCEDURE Lumbar puncture Sternal puncture Injection for Haemorrhoids Injection for Varicose Veins Catheterisation Dilatation of Urethra Incision & Drainage Intercostal Drainage Peritoneal dialysis Removal of soft tissue or regional block under general anaesthesia Dressing Small Secondary suture of wounds Skin Excision of Moles Excision of Warts Excision of Molluscum contagiosum Excision of Veneral Warts Excision of Corns I/D Injection Keloid of Acne Chemical Cautery (per sittings) Excision of Sebaceous Cysts Excision of Superficial Liipoma Excision of Dermoid Cysts E.N.T. Speech therapy per session of 30-40 minutes Removal of foreign body From Nose/ Ear/ Throat (Day care package) Swallowing Therapy Syringing Polyp removal under LA Peritonsillar abscess drainage under LA Tinnitus Retraining Therapy

Maximum Approved Rate (INR) (Rupees) 700/1500/1000/1300/120/1100/600/1500/1800/-

2400/100/1200/600/600/600/600/550/300/120/1700/2400/2450/-

200/-

1500/250/300/800/1600/250/-

1

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01003008 01003009 01003010 01003011 01003012 01003013 01003014 01003015 01003016 01003017 01003018 01003019 01003020 01003021 01003022 01003023 01003024 01003025 01003026 01003027 01003028 01003029 01003030 01003031 01003032 01003033 01003034 01003035 01003036 01003037 01003038 01003039 01003040 01003041 01003042 01003043 01003044 01003045 01003046

NAME OF TREATMENT PROCEDURE Myringoplasty Staepedectomy Myringotomy with Grommet insertion Endoscopic Removal of Fish Bone Tympanotomy Paracentesis Tympanoplasty Mastoidectomy Otoplasty Labyrinthectomy Skull Base surgery Facial Nerve Decompression Septoplasty Submucous Resection Septo-rhinoplasty Rhinoplasty (noncosmetic) Fracture Reduction Intra Nasal Diathermy Turbinectomy Endoscopic DCR Endoscopic Surgery Septal Perf. Repair Antrum Puncture Lateral Rhinotomy Cranio-facial resection Ethamoidectomy Caldwell Luc Surgery Angiofibroma Excision Endoscopic Hypophysectomy Endoscopic Optic Nerve Decompression Decompression of Orbit Ranula Excision Tongue Tie excision Sub Mandibular Duct Lithotomy Adenoidectomy Palatopharyngoplasty Cleft Palate repair Pharyngoplasty Styloidectomy

Maximum Approved Rate (INR) (Rupees) 10700/12000/6000/1000/8000/4300/14000/15600/16500/15600/50000/20000/10200/10800/15000/12000/9000/6000/9600/13000/15000/15000/3000/1350/28000/17600/12000/18000/25000/-

CODE 01003047 01003048 01003049 01003050 01003051 01003052 01003053

9700/8000/15100/16000/18000/11500/-

Tympanomastoidectomy

01003055 01003056 01003057 01003058 01003059 004

Dacunisation Tonsillectomy Adenotonsillectomy Synichiolysis Submucosal Diathermy Nasal Mass ExcisionSimple Nasal Mass ExcisionEndoscopic Removal FESS Anterior Nasal Packing Post Nasal Packing Nasal Bone Reduction Opthalmology

01004001

Cauterisation of ulcer/subconjuctival injection - One eye

01003054

01004002 01004003 01004004 01004005 01004006 01004007 01004008 01004009 01004010 01004011

32000/30000/9600/8100/-

NAME OF TREATMENT PROCEDURE Uvulo-palatoplasty

01004012 01004013 01004014 01004015 01004016 01004017 01004018 01004019 01004020

Cauterisation of ulcer/subconjuctival injection - Both eyes Retrobular Injection - One Eye Retrobular Injection - Both Eyes Syringing of Lacrimal Sac -For one eye Syringing of Lacrimal Sac - For both eyes Paracentesis Foreign body removal Refraction/Fundoscopy Ortho-optic exercises Plepoptic Exercises Chalazion operation -One Eye Chalazion operation Both Eyes Dressing (Eye) Clinical Photography Pterygium Orbitotomy Ptosis correction. Ectropion Correction Xenon Arc Laser

Maximum Approved Rate (INR) (Rupees) 20000/15600/7000/11200/13500/4200/4000/11200/13500/11200/4000/5000/6000/-

200/-

300/200/300/200/300/800/300/90/100/100/800/1000/100/100/2200/9000/6500/3600/700/-

2

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01004021 01004022 01004023 01004024 01004025 01004026 01004027 01004028 01004029 01004030 01004031 01004032 01004033 01004034 01004035

NAME OF TREATMENT PROCEDURE D C R (Dacryo custorhinostomy) ECCE/ICCE Epicanthus correction. Squint Correction (one eye) Squint Correction (both eyes) Keratoplasty Trabeculotomy Iridectomy Goniotomy Scleral Bukling (Retinal Detachment Surgery)

Maximum Approved Rate (INR) (Rupees) 5700/6000/2100/-

01004049

4000/-

01004051

6000/14000/5700/2400/2400/-

01004052

14000/-

Syringing & Probing Vitrectomy Enucleation Eviseration Entropion correction Cataract with IOL(Cost of lens extra)

1100/11000/4000/3800/3000/7500/5700/-

01004038

Fistulectomy Glucoma surgery with Glucoma valves

01004039

Caliculoplasty

3000/-

01004040

Dacryocystectomy Ptosis surgery with LPS resection Ptosis surgery with Sling surgery

3000/-

3000/4000/-

01004045

Ectropion surgery- one lid Ectropion surgery- both lids Cheek rotation flap for lid tumors

01004046

Telecanthus correction

4000/-

01004047

Fracture orbital repair

9000/-

01004048

Lasik

18000/-

01004036 01004037

01004041 01004042 01004043 01004044

CODE

5000/-

7000/7000/-

8000/-

01004050

NAME OF TREATMENT PROCEDURE TTT- Transpupillary thermal therapy PTK- Phototherapeutic keratectomy

Maximum Approved Rate (INR) (Rupees) 4000/9000/-

3000/-

01004053

Iris cyst removal Lid Abscess incision and drainage Orbital Abscess incision and drainage

01004054

Cyclodiathermy

2000/-

01004055

4000/-

01004059

Perforating injury repair Phaco + IOL (inclusive of Foldable & Non-foldable lens) Package YAG Laser Capsulotomy per sitting YAG Laser Iridectomy per sitting Argon Laser Trabeculoplasty (ALT) (per sitting)

01004060

HVF

500/-

01004061

Cryopexy

1200/-

01004062

ICG including Medicine ICG- Double including Medicine

2000/-

01004056 01004057 01004058

01004063 01004064

1000/-

4000/-

14500/600/600/-

1000/-

3600/-

01004065

Electrolysis (Per sitting) Cyclocryo/ Cyclodiathermy

150/500/-

01004066

D.C.T. (OPD)

800/-

01004067

Silicone Oil (1000)

4000/-

01004068

Silicone Oil (C5)

4000/-

01004069

Silicone Oil Removal

3500/-

01004070

Pneumo Retinopexy

2400/-

3

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

01004071

FGE/ FAE

1500/-

01004092

Lensectomy

7500/-

01004072

Indirect Laser

1000/-

01004093

16000/-

01004073

Endo Laser

2400/-

01004094

Orbitotomy (Multiple Wall) ERM (Epi Retinal Membrane)

01004074

SF6 Gas

2400/-

01004095

2400/-

01004075

C3F8 Gas

2400/-

01004096

01004076

2400/-

01004085

PFCL Photodynamic Therapy procedure charges- single eye Photodynamic Therapy procedure charges- both eyes Photodynamic Therapy (single eye) Photodynamic Therapy (both eyes) Intravitreal Avastin (including cost of injectionsingle) Intravitreal Lucentis (excluding cost of injection-single) Intravitreal Macugen (excluding cost of injection-single) Intravitreal injections of antibiotics (cost of medicines extra) Retinal Foreign Body Removal

01004086

PPV/ Victerectomy

6500/-

01004087

Endo Diathermy

1600/-

01004088

Belt Buckle

3200/-

01004089

IVTCA

800/-

01007003 01007004

01004090

Membrane Peeling

2400/-

01007005

01004091

Anterior Vitrectomy

5000/-

01007006

Reti Blue Corneal Collagen Crosslinking Biopsies including Histopathological report (Package) Biopsy procedure under Local Anaesthesia Biopsy procedure under General Anaesthesia Biopsy procedure under Endoscopy FNAC Strapping (including Bandage & materials) Strapping of Finger Strapping of Toes Strapping of Wrist Strapping of Elbow Strapping of Knee Strapping of Ankle Strapping of Chest Strapping of Shoulder Nasal bone fracture Figure of 8 bandage Colar and cuff sling Ball bandage Physiotheraphy & Traction Ultrasonic therapy (per sitting) S.W. Diathermy (per sitting) Electrical stimulation (therapeutic) (per sitting) Infra red (per sitting) U.V. Therapeutic dose (per sitting) Electric vibrator (per sitting)

01004077

01004078 01004079 01004080

01004081

01004082

01004083

01004084

15000/-

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

005 01005001 01005002

25000/85000/100000/-

6000/-

4000/-

4000/-

2000/4000/-

01005003 01005004 006 01006001 01006002 01006003 01006004 01006005 01006006 01006007 01006008 01006009 01006010 01006011 01006012 007 01007001 01007002

3600/-

15000/-

4000/6000/8000/3500/-

200/200/360/400/400/400/500/450/450/450/450/450/-

70/90/70/90/90/90/-

4

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01007007 01007008 01007009

01007010 01007011 01007012 01007013 01007014

NAME OF TREATMENT PROCEDURE Vibrator belt massage (per sitting) Intra Lumbar Traction (per sitting) Intermittent Cervical traction (per sitting) Combined Lumbar & Cervical traction (per sitting) Wax bath (per sitting) Hot pack (per sitting) Whirl pool bath (per sitting) Obesity Exercises (per sitting)

Maximum Approved Rate (INR) (Rupees)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

90/-

01007030

SWD + IFT

100/-

90/-

01007031

US + IFT

100/-

70/-

01007032

200/-

01007033

US + IFT + Stimulation US + Knee Joint + Spad Fraction

01007034

US + PWB

100/-

01007035

US + SW + Traction

200/-

01007036

US + Tens

100/-

01007037

US + Stimulation

100/-

70/-

01007038

100/-

90/-

01007039

Knee Joints Spad Fraction Electronic Tilt TrainingPer Session

70/50/70/90/60/-

60/-

01007040

01007018

Breathing Exercises & Postural Drainage (per sitting) Cerebral Palsy – Massage (per sitting) Post – polio exercise (per sitting) Basic Gait Training (Per Session)

80/-

01007041

01007019

Traction + IFT

150/-

01007042

01007020

Traction + Stimulation

100/-

01007043

01007021

Traction + SWD

100/-

01007044 008

01007022

Traction + SWD + IFT

200/-

01007023

Traction + US

140/-

01007024

Traction + US + IFT Traction + US + IFT + Exercises Traction + US + IFT + SWD

200/-

01007015 01007016 01007017

01008001

01007025 01007026

260/-

01008002 01008003 01008004 01008005 01008006

260/-

01007027

IFT + PWB

150/-

01008007 01008008

01007028

Exercise- per sitting PWB + Knee Joint Spad Fraction

60/-

01008009

01007029

100/-

100/-

01008010

Interferential Therapy Laser Treatment- Per Session Microwave Diathermy- Per Session Quadriceps Chair Training (Per Session) Tens Dental Extraction of tooth including LA Complicated Ext. per Tooth including LA Flap Operation per Tooth Gingivectomy per tooth Cyst under LA (small) Cyst under LA (large) Impacted Molar including LA Apisectomy including LA Fracture wiring including LA Reduction & immobilisation of fractureMaxilla under LA

100/100/150/150/100/80/-

120/250/500/300/300/500/800/1000/80/-

1400/-

5

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

01008011

01008012

01008013

01008014

01008015

01008016 01008017 01008018 01008019

01008020

01008021 01008022 01008023

01008024 01008025 01008026 01008027 01008028

NAME OF TREATMENT PROCEDURE Reduction & immobilisation of fractureMandible under LA Splints/ Circum mandibular wiring under GA Internal wire fixation/ plate fixation of Maxilla under LA Internal wire fixation/ plate fixation of Maxilla under GA Internal wire fixation/ plate fixation of Mandible under LA/GA Cyst & Tumour of Maxilla/ mandible by enucleation/ excision (package) TM joint ankylosis- under GA (package) Hemi-mandibulectomy with graft (package) Hemi-mandibulectomy without graft (package) Segmentalmandibulectomy with graft (package) Segmentalmandibulectomy without graft (package) Maxillectomy- partial with graft (package) Maxillectomy- partial without graft (package) Maxillo-facial prosthesis (sal/ auricular/ orbital/ facial lost part) (package) Alvelolectomy, Frenectomy per Quadrant Alvelolectomy (minor) Amalgam Filling/tooth (compound) Amalgam Filling/tooth (regular)

Maximum Approved Rate (INR) (Rupees)

6000/-

01008041

NAME OF TREATMENT PROCEDURE De Sensitising per sitting Dento Alveolar Fracture Reduction & Splinting/l.a. Denture Repair (category1) Dialation of Whartons Duct under L.A. Direct/ indirect Pulp Capping Drain. of Dento Alveolar Absce. (ex. Oral) Enucleation of Cyst of Oral Cavity Fibre Post Based Post & Core

2000/-

01008042

Floride Application (per sitting)

400/-

01008043

Extraction of Impacted Tooth By Operation

400/-

3000/-

CODE 01008034 01008035 01008036

2000/01008037 4000/-

6000/-

01008038 01008039 01008040

11000/-

01008033

Apicoectomy Molar Tooth Arch Bar Removal Bite Plate/ Retainers Cast Rpd (per Tooth) Davis Crown/ radicular Screw supported

1500/230/1150/230/950/2000/1900/-

7000/-

01008046

Extraction of MISP Tooth by Operation (Open Meth) GTR (Guided Tissue Regeneration) Gingivectomy per Quadrant

2000/-

01008047

Glass Ionomer Filling

400/-

5000/-

01008048 01008049

Glass Ionomes Filling Interdental Wiring Intra Articular Inj. of Steroids in TMJ

450/1150/-

Jacket Crown Acrylic Minor Dento-alveolar Tracture Reduction & Splinting/la Post Core/ tooth (cast Post) lab Metal Chgs. Extra Post Core/ tooth (pin Retained.comp.core) Post Core/ tooth Screw/pin Retain. amalgm. Preformed Carbonate Jacket Crown

1500/-

4000/-

01008044 01008045

6000/-

4000/01008050 5000/-

01008051

1150/380/-

01008052

450/01008053 380/01008054

01008029 01008030 01008031 01008032

Maximum Approved Rate (INR) (Rupees) 200/-

2250/380/1150/380/-

01008055 01008056

1150/1900/750/-

900/-

950/-

1150/750/-

550/750/-

1900/-

6

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

01008057

Preformed Steel Crown

1150/-

01008058

Pulpotomy Reduction of Dislocation of Tmj (Under LA.) Reimplantation (per Tooth) Removal Partial Denture (1st Tooth) Removable Partial Denture (Additional Tooth) Removable Partial Denture per Tooth (Palatal Bar) Repair of Facial Soft Tissue Laceration Repair of Facial Soft Tissue Laceration (minor) Root Canal Treatment (Upto 4 Sitting) Root Canal Treatment (Extra Sitting) Root Canal Treatment with Filling and Crown (package) (Lab. Charges extra) Scaling per Sitting Sialolithotomy for Small Stones Surgical Extraction or Surgical Removal of Impact (package) Surgical Removal of Benin Reoplasm of Oral (package) Surgical Removal of Soft Tissue Lesion (package) Surgical Removal of Impact Mesiod.tuber (package) ITU/CCU CHARGES (Special Care Cases) ICU/ITU/CCU/NICU/PICU (including:- Oxygen; ECG/SPO2/NIBP/IBP monitoring; 1:2 Nursing ë GNM Nursing; Round the Clock Doctor (Resident on spot); Diet; Syringe Pump)

750/-

01012001 01012002 01012003

NAME OF TREATMENT PROCEDURE Ventilator charge (including accessories) per day Pneupack Ventilator in Nursery (per day) High Definition Unit/ Step Down (including Oxygen) Exchange Transfusion O.T. Charges for Exchange transfusion Oxygen Charges Private/ Semi-private/ General Ward per hour Burn Cases upto 30% Burns 1st Dressing (excluding dressing materials and medicines) upto 30% Burns Subsequent Dressing (excluding dressing materials and medicines) 30% to 50% Burns 1st Dressing (excluding dressing materials and medicines) 30% to 50% Burns Subsequent Dressing (excluding dressing materials and medicines) Extensive Burn above 50% Frist Dressing (excluding dressing materials and medicines) Extensive Burn above 50% Subsequent dressing (excluding dressing materials and medicines) Burn Unit Bed (including Oxygen) Obstetric & Gynaecology Cases Normal delivery or with Episiotomy & P. repair Low Forceps Low midcavity forceps

01012004 01012005

Cesarean Section Cesarean Hysterectomy

CODE

01009002

01008059 01008060 01008061 01008062

01008063 01008064 01008065 01008066 01008067

01008068 01008069 01008070

01008071

01008072 01008073

01008074 009

01009001

01009003 1400/3400/400/-

01009004 01009005

230/-

01009006 010

750/-

01010001 011

1150/750/-

01011001

1150/400/-

01011002

3600/400/-

01011003

115/01011004 1150/01011005 1500/1150/01011006 1150/-

01011007 012

2400/-

Maximum Approved Rate (INR) (Rupees)

1000/800/1500/1200/400/-

60/-

700/-

700/-

700/-

700/-

1500/-

1500/1500/-

12000/12000/14000/20000/22000/-

7

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) Maximum Approved Rate (INR) (Rupees)

Maximum Approved Rate (INR) (Rupees)

CODE

22000/-

01012029

18000/-

01012030 01012031

16000/-

01012032

NAME OF TREATMENT PROCEDURE Repair of post-coital tear, perineal injury Excision of urethral caruncle Laparoscopy (Gynae) Shirodhkar, Mc. Donalds stich

6100/-

01012033

Laparotomy

20000/-

01012009

NAME OF TREATMENT PROCEDURE Rupture Uterus- closure & repair with Tubal Ligation Perforation of Uterus after D/E Laparotomy & Closure Laparotomy-peritonitis Lavage and Drainage Laparotomy-failed laparoscopy to explore

01012010 01012011

Salphingectomy Salphingo-Oophorectomy

14000/18000/-

01012034

Abdominal Hysterectomy

22000/-

01012012 01012013

18000/15000/-

01012035

Vaginal Hysterectomy

22000/-

01012036

Myomectomy

22000/-

01012014

Ovarean Cystectomy Oopherctomy Broad Ligment Haemotoma Drainage

01012037 01012038

Vaginoplasty Vulvectomy (Simple/Radical)

22000/-

01012015

Exploration of perineal Haematoma & Resuturing of Episiotomy

25000/-

01012039

RVF Repair

25000/-

01012040

Other Major Operations

25000/-

01012041

Manchester Operations

20000/-

01012042

Perineorrhaphy

14700/-

01012043

Colporraphy

14400/-

2500/3300/-

01012044

Modified Gilliam

16900/-

2500/-

01012045

Shirodkar’s Operation

10200/-

3700/-

01012046

Diagnostic Curettage

2700/-

2500/-

01012047

Fractional Curettage

3400/-

4200/12000/-

01012048

D & C and Cervical Biopsy

3400/-

01012049

Polypectomy

3600/-

5900/-

01012050

3600/-

4200/-

01012051

Other-Minor Operation Excision Vaginal Cyst/Burtholin Cyst

CODE 01012006

01012007 01012008

01012016 01012017 01012018

01012019 01012020 01012021 01012022 01012023 01012024 01012025 01012026

01012027 01012028

Exploration of abdominal Haematoma (after laparotomy + LUCS) Internal podalic version and extraction Manual Removal of Placenta 3rd stage Complication MRP for outside delivery etc Examination under anaesthesia Burst-abdomen Repair Gaping Pareneal Wound Secondary Suturing Gaping abdominal wound Secondary Suturing Complete perineal tearrepair Exploration of PPH-tear repair Destructive Operation Suction evacuation vesicular mole, Missed abortion D/E Colpotomy-drainage P/V needling EUA

4200/4000/6100/3700/-

12000/-

12000/-

12000/12000/3700/-

4900/-

3900/-

8

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

01012052

Excision Vaginal Septum

5900/-

01013005

01012053

Laparoscopy Diagnostic

6000/-

01013006

01012054

Laparoscopy Sterilisation

7300/-

01012055

Laparoscopy Operative

12000/-

01012056

Laparoscopy LAVH

25000/-

01013009

01012057

Drilling of Ovary

10800/-

01013010

01012058

Adhesiolysis Management of Ectopic pregnancy

17400/-

01013011

20000/-

01013012

11500/-

01013013

5500/-

01013014

11500/-

01013015

Maximum Approved Rate (INR) (Rupees)

01013018

NAME OF TREATMENT PROCEDURE Aspiration of Liver Abscess Open Drainage of Liver Abscess Drainage of Pelvic Abscess Drainage of Ischiorectal Abscess Drainage of Subdiaphragmatic Abscess Open Drainage of Perinepheric Abscess Drainage of Perigastric Abscess Drainage of Perotid Abscess Drainage of Retropharyngeal Abscess Open Drainage of Psoas Abscess Open Drainage of Perivertebral Abscess Fissurectomy/ Haemorroidectomy/ Correction of Piles Haemorroidectomy/ Correction of Piles with Stapler Gun (cost of Gun extra) Excision of Superficial Neurofibroma

3900/-

01013019

Varicose Veins

25000/-

Abortion- Evacuation

4200/-

01013020

4000/-

01012069

MTP- 1st Trimester

3200/-

014

Excision of Carbuncle Injury Of Superficial Soft Tissues

01012070

MTP - 2nd Trimester

4800/-

01012071 013 01013001 01013002

Extended Hysterectomy General Surgery Drainage of Abscess Dressing under G.A. Aspiration of cold Abscess of Lymphnode Aspiration of Empyema

28000/-

015 01015001 01015002 01015003

Interestical (Implant) Head & Neck Breast Soft Tissue Sarcome

016

GASTROENTROLOGY

01016001

Capsule Endoscopy

01012059 01012060 01012061 01012062 01012063

Hysteroscopy TCRE Hysteroscopy Removal of IUCD Hysteroscopy Removal of Septum

01012064

Hysteroscopy Diagnostic Werthimas Hystrectomy for Cancer cervix

30000/-

01012065

Sterilisation Post Pertum

4700/-

01012066

Sterilisation Intravaginal

6000/-

01012067

Abortion- D & C

01012068

01013003 01013004

CODE

01013007 01013008

7300/01013016

2000/2400/3100/2400/-

01013017

3000/10000/10000/8000/-

14000/14000/12000/8000/8000/8000/10000/-

16000/-

16000/2800/-

9700/9600/12000/-

30000/-

9

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) Maximum Approved Rate (INR) (Rupees)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

18000/-

01016025

Gastrostomy (PEG)

7000/-

30000/-

01016026

Gastrostomy (PEG) (BS)

11000/-

5000/-

01016027

Glue Injection

4500/-

6500/-

01016028

Glue Injection (BS)

7000/-

2200/-

01016029

Hemosta by Glod Probe

7000/-

3000/-

01016030

Hemostatic Clip

7000/-

01016007

NAME OF TREATMENT PROCEDURE Complete Double Baloon Enteroscopy Complete Small Bowel Evaluation Argan Plasma Coa (Major) Argan Plasma Coa (Major) (BS) Argan Plasma Coa (Minor) Argan Plasma Coa (Minor) (BS)

01016008

Band Ligation

3500/-

01016031

Hemostatic Clip (BS)

10000/-

01016009

Band Ligation (BS)

5500/-

01016032

Hepatonorm

700/-

01016010

Biliary Brushing

1000/-

01016033

Injection Hemostasis

4000/-

01016011

Biliary Brushing (BS)

1600/-

01016034

Injection Hemostasis (BS)

6000/-

01016012

Biliary Pancreatic (M)

16000/-

01016035

LGI Manometry

4000/-

01016013

Biliary Pancreatic (M) (BS)

23000/-

01016036

LGI Manometry (BS)

6000/-

01016014

Biliary Pancreatic (P)

13300/-

01016037

UGI Manometry

3200/-

01016015

Biliary Pancreatic (P) (BS)

18000/-

01016038

UGI Manometry (BS)

4500/-

01016016

Cre Ballon Dilatation (BS)

15000/-

01016039

Nasobiliary Drainage

12000/-

01016017

Cre Balloon Dilatation

9000/-

01016040

Nasobiliary Drainage (BS)

18000/-

01016018

Dilatation (Stricture)

3000/-

01016041

3000/-

01016019

Dilatation (Stricture) (BS)

4200/-

01016042

Nasojejunal Tube Plac Nasojejunal Tube Plac (BS)

4200/-

01016020

EMG Charge (Large)

3500/-

01016043

Papilla Cannu Minor

6500/-

01016021

EMG Charge (Small)

1500/-

01016044

Papilla Cannu Minor (BS)

8200/-

01016022

3000/-

01016045

4200/-

01016046

Pappu Stnt Spingt (M) Pappu Stnt Spingt (M) (BS)

12000/-

01016023

Endoscopic Tube Place Endoscopic Tube Place (BS)

17500/-

01016024

Oesophageal Transit

1200/-

01016047

Polypectomy (Colonic)

3200/-

CODE 01016002 01016003 01016004 01016005 01016006

10

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01016048 01016049

NAME OF TREATMENT PROCEDURE Polypectomy (Colonic) (BS)

Maximum Approved Rate (INR) (Rupees) 4800/-

01016050

Polypectomy (Upper GI) Polypectomy (Upper GI) (BS)

4500/-

01016051

Pre Cutting

4500/-

01016052

Pre Cutting (BS)

7500/-

01016053

Pseudocyst Drainage

9000/-

01016054

Pseudocyst Drainage (BS)

16000/-

01016055

Sclerotherapy

3000/-

01016056

Sclerotherapy (BS)

3800/-

01016057

Small Bowel Enteroscp

14000/-

01016058

Sphincterotomy

10500/-

01016059

Sphincterotomy (BS)

16000/-

01016060

Stone Extraction

12000/-

01016061

Stone Extraction (BS)

17000/-

01016062

Gastric Emptying

2500/-

01016063

Mechanical Lithotripsy

25000/-

01016064 017 01017001

ERCP (Stenting) Head & Neck Ear Lobe Repair one side

10000/-

01017002

01017003 01017004 01017005

Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin Only Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin and Cartilage Partial Amputation of Pinna Total Amputation of Pinna

3000/-

600/-

4500/-

6000/6000/7500/-

CODE

01017006 01017007 01017008 01017009 01017010 01017011 01017012

NAME OF TREATMENT PROCEDURE Total Amputation & Excision of External Auditory Meatus Excision of Cystic Hygroma Minor Excision of Cystic Hygroma Major Excision of Cystic Hygroma Extensive Excision of Branchial Cyst Excision of Branchial Sinus Excision of Pharyngeal Diverticulum Mandibulectomy

Maximum Approved Rate (INR) (Rupees)

10250/5500/8000/12300/11000/11000/12200/-

01017013 01017014

Operation for Cervical Rib

25000/30000/-

01017015

Pharyngectomy

35000/-

01017016

Stenosis Excision

17000/-

01017017

Commando Operation Block Dissection of Cervical Lymph Nodes Pharyngectomy & Reconstruction Operation for Carcinoma Lip - Wedge Excision Operation for Carcinoma Lip - Vermilionectomy

27000/-

01017018 01017019 01017020 01017021

01017022 01017023 01017024 01017025 01017026 01017027 01017028 01017029 01017030 01017031 01017032

Operation for Carcinoma Lip - Wedge Excision and Vermilonectomy Estlander Operation Abbe Operation Cheek Advancement Excision of the Maxilla Excision of the Mandible Segmental Hemimandibulectomy Partial Glossectomy Hemiglossectomy Total Glossectomy Parotidectomy Superficial

20300/40000/10000/10000/-

12000/9700/12000/10200/23300/18100/27200/6100/1350025000/24000/-

11

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) Maximum Approved Rate (INR) (Rupees)

01017033

NAME OF TREATMENT PROCEDURE Parotidectomy Conservative

01017034

Parotidectomy - Radical

22000/-

01017035

Parotidectomy - Total

15000/-

CODE

19700/-

CODE 01018004 01018005 01018006 01018007

01017036

01017037 01017038 01017039 01017040 01017041 01017042 01017043

Repair of Parotid Duct Removal of Submandibular Salivary gland

20400/-

Hemithyroidectomy Partial Thyroidectomy Subtotal Thyroidectomy (Toxic Goitre)

15000/16000/-

01019003

22000/-

01019004

Total Thyroidectomy Resection Enucleation of Adenoma

23000/-

01019005

12500/-

01019006

12600/-

01019007

31400/-

020 01020001

10000/-

01017047

Isthmectomy Total Thyroidectomy and Block Dissection Excision of Lingual Thyroid Excision of Thyroglossal Cyst/Fistula Excision of Parathyroid Adenoma/Carcinoma

01017048

Laryngectomy

37150/-

01017049 01017050 01017051 01017052 01017053 01017054 01017055 01017056 01017057 01017058 018 01018001 01018002 01018003

Laryngo Pharyngectomy Sinus & Fistula repair Lymph Node Excision Hyoid Suspension Genioplasty Direct Laryngoscopy Phonosurgery Fibroptic Laryngoscopy Microlaryngeal Surgery Laryngofissure Head & Neck Cancer Benign Tumour Excisions Temporal Bone resection Radical Neck Dissection

43500/14000/8000/12000/12000/5400/15400/3000/11000/17500/-

01017044 01017045 01017046

25650/15000/25600/-

01018008 019 01019001 01019002

01020002 01020003 01020004 01020005 01020006 01020007 01020008 01020009

01020010

01020011 01020012

11000/27600/28500/-

01020013 01020014

NAME OF TREATMENT PROCEDURE Carotid Body Excision (cost of Graft extra) Total Laryngectomy Flap Reconstructive Surgery Parapharyngeal Tumour Excision Total Thyroidectomy Breast Drainage of Abscess Excision of Lumps Local Mastectomy (Simple) Radical Mastectomy (Formal or Modified) Excision of Mammary Fistula Segmental Resection of Breast Breast Cancer (Tumour excision) Cardio Respiratory Procedures Tracheostomy Thoracotomy (Penetrating Wounds) Intercostal Drainage of empyema Decortication (Pleurectomy) Thoracoplasty Pneumonectomy Lobectomy Segmental Resection Hydatid Cyst- Removal Video-assisted thoracoscopic lung Surgeries Lung volume reduction surgery (Unilateral/ Bilateral) Thoracoscopic Decortication Thoracoscopic Pneumonectomy Thoracoscopic Lobectomy

Maximum Approved Rate (INR) (Rupees) 36000/39050/42800/32000/30000/7000/10000/13500/28000/16000/18300/30000/-

3700/17500/5400/37000/37000/37000/37000/37000/37000/-

37000/-

37000/37000/37000/37000/-

12

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01020015 01020016 01020017

01020018 01020019 01020020 01020021

01020022 01020023 01020024 01020025 01020026 01020027 01020028 01020029

NAME OF TREATMENT PROCEDURE Thoracoscopic Segmental Resection Thoracoscopic Cyst excision Thoracoscopic Sympathectomy Chest Wall Tumor Excision with Reconstruction Repair of Congenital Chest Wall Defermities

Maximum Approved Rate (INR) (Rupees)

01020039

NAME OF TREATMENT PROCEDURE Lung Resection with Dissection of Lymph Node Stations Surgery for Recurrent Pnemothoraxic Surgery for Aspergillosis (Lung Cavities)

37000/-

01020040

Bronchotomy

37000/-

37000/-

01020041

15000/-

Multiple Lobectomy Decortication + Thoracoplasty Decortication + Lung Resection + Thoracoplasty

37000/-

021

Open Lung Biopsy

18000/-

Medicistinoscopy(cervical)

15000/-

Video-assisted thoracoscopy (VATS)

36960/-

Mediostonoscopy Cardiac / Cardio Thoracic Procedures Coronary Bypass Surgery (including Pre-Surgery Profile) Coronary Bypass Surgerypost Angioplasty (including Pre-Surgery Profile) Coronary Balloon Angioplasty (Excluding Cost of Stents) (including Pre-Surgery Profile) (4 days’ package) Balloon angioplasty with Valvotomy (including PreSurgery Profile) Open Heart Procedures (including Pre-Surgery Profile) Total Correction of Tetralogy of Fallot (including Pre-Surgery Profile) RSUV Correction (including Pre-Surgery Profile) TAPVC Correction (including Pre-Surgery Profile) Open ASD VSD (including Pre-Surgery Profile) Open Pulmonary Valvotomy (including PreSurgery Profile) Open Aortic Valvotomy (including Pre-Surgery Profile) Blalock Taussig Operation

Thoracotomy for BPF Surgery for Destroyed Lung Sleeve Resection with Lobectomy Extrapleural Pneumonectomy

37000/37000/37000/-

37000/-

CODE

01020037 01020038

01021001

37000/-

37000/-

01021002

01021003

01021004

37000/37000/-

01021005

37000/01021006

01020030

01020032

Tracheal Stenosis Surgery Repair of Tracheo Innuminete Fistula Tracheal Resection for Tracheal Tumour

37000/-

01020033

Segmentectomy

37000/-

01020034

Wedge Resection Lung Resection with Paratracheal L. Node Resection Lung Resection with Chest Wall Invasion

37000/-

01020031

01020035 01020036

Maximum Approved Rate (INR) (Rupees)

37000/37000/-

37000/37000/-

01021007

01021008 01021009

01021010

01021011 01021012

37000/37000/37000/-

150000/-

150000/-

66000/-

90000/-

150000/-

150000/-

150000/-

150000/150000/-

150000/-

150000/72000/-

13

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

01021013

01021014

01021015

01021016

01021017

01021018

01021019

01021020 01021021 01021022 01021023

01021024

01021025 01021026

01021027 01021028 01021029 01021030

NAME OF TREATMENT PROCEDURE (including Pre-Surgery Profile) Mitral Valvotomy (including Pre-Surgery Profile) Mitral Valve Replacement (Excluding Cost of Valve) (including Pre-Surgery Profile) Aortic Valve Replacement (Excluding Cost of Valve) (including Pre-Surgery Profile) Double Valve Replacement (Excluding Cost of Valves) (including Pre-Surgery Profile) Thoraco-Abdomi Aorta Replacement (including Pre-Surgery Profile) Coarctation-Arota Repair of Block Taussing Shunt (including Pre-Surgery Profile) Patent Ductus Arteriousus (including Pre-Surgery Profile) Mitral Valvotomy (Open) (including Pre-Surgery Profile) Pericardiostomy (including Pre-Surgery Profile) Pericardiectomy (including Pre-Surgery Profile) Pericardio Centesis Permanent Pacemaker Implantation (Excluding Cost of Pacemaker) (4 days’ package) Temporary Pacing Lead Implantation (Including use of Temporary Pacemaker) Embolectomy Aneurysm- Resection & Grafting (cost of Graft extra) Thoracocentesis Thorachostomy Exploratory Thorocotomy

Maximum Approved Rate (INR) (Rupees)

01021031

NAME OF TREATMENT PROCEDURE Unifocalization with Shunt (including Pre-Surgery Profile)

01021032

Removal of Foreign Body from Trachea or Oesophagus

CODE

72000/-

150000/-

150000/-

160000/-

01021033 01021034 01021035 01021036 01021037 01021038 01021039 01021040 01021041

150000/-

96000/-

72000/-

150000/-

01021042 01021043 01021044 01021045 01021046 01021047

01021048

54000/72000/3900/-

01021049 01021050 01021051 01021052

19400/01021053 01021054 01021055 12600/19800/01021056 96000/2000/5400/37000/-

Rib Resection & Drainage Mediastinal Tumour Thymectomy ASD Device Closure (Excluding Cost of Device) PDA Device Closure (Excluding Cost of Device) DSA EP STUDY 3D RF Ablation Mini EP Study Coronary Angiography (1 day’s package) Fonten Gunshot injury Heart transplant Intra coronary stenting Directiol atherectomy Permanent Pacemaker Implantation (DDD) (Pacemaker Cost extra) (4 days’ package) Permanent Pacemaker Implantation (Biventricular) (Pacemaker Cost extra) (4 days’ package) Femoral Poplitial Bypass Iliacfemoral Bypass Aorto Bifemoral Bypass Carotid Subclavian Bypass PA Banding BD Glen Thoracic Aorta/ Arch Replacement (including Pre-Surgery Profile)

Maximum Approved Rate (INR) (Rupees)

150000/-

6000/11500/35000/35000/40000/32000/5400/8400/40000/5000/11700/170000/52000/277000/58000/98000/-

25000/-

30000/75000/75000/75000/75000/55000/55000/-

150000/-

Note:- CABG if done along with other Heart Surgeries like Valve Replacement etc. will attract the same rate as CABG. 022 Oesophagus

14

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

01022001

01022002 01022003 01022004 01022005 01022006 01022007 01022008

01022009

01022010 01022011 01022012 01022013 023 01023001 01023002 01023003 01023004 01023005 01023006 01023007

01023008 01023009

NAME OF TREATMENT PROCEDURE Atresia of Oesophagus and Tracheo Oesophageal Fistula Operations for Replacement of Oesophagus by Colon Oesophagectomy for Carcinoma Easophagus Oesophageal Intubation (Mausseau Barbin Tube) Achalasia Carida Transthoracic Achalasia Carida Abdominal Oesophago Gastrectomy for mid 1/3 lesion Oesophagus Dilatation of Stricture- per visit Colon-Inter position or Replacement of Oesophagus Oesophago Gastrectomy – Lower Corringers procedure Esophageal Perforation Surgery Installation of Ryles Tube in Ca Esophagus Esophageal Directiculum Surgery Abdomen Gastroscopy Gastric & Duodenal Biopsy (Endoscopic) Pyleromyotomy Gastrostomy Simple Closure of Perforated peptic Ulcer Vagotomy Pyleroplasty / Gastro Jejunostomy Duodenojejunostomy Partial/Subtotal Gastrectomy for Carcinoma Partial/Subtotal Gastrectomy for Ulcer

Maximum Approved Rate (INR) (Rupees)

CODE 01023010

29700/01023011 38000/-

01023012

38000/-

01023013

15500/-

01023014

29700/-

01023015

14600/-

01023016

38000/-

01023017

1500/-

38000/-

01023018 01023019 01023020 01023021

38000/-

01023022

38000/-

01023023

5000/38000/-

01023024 01023025

1300/-

01023026

1700/10000/12000/-

01023027

15000/30000/25000/-

30000/30000/-

01023028 01023029 01023030

01023031 01023032 01023033 01023034

NAME OF TREATMENT PROCEDURE Operation for Bleeding Peptic Ulcer Gastrojejunostomy & Vagotomy Operation for Gastrojejunal Ulcer Total Gastrectomy for Cancer Highly Selective Vagotomy Selective Vagotomy & Drainage Congenital Diaphragmatic Hernia Hiatus Hernia Repair Abdominal Hiatus Hernia Repair Transthoracic Exploratory Laparotomy Epigastric Hernia Repair Umbilical Hernia Repair Ventral and Scar Hernia Repair Inguinal Hernia Herniorraphy- unilateral Inguinal Hernia – Hernioplasty- with meshunilateral Femoral Hernia Repair Rare Hernias - Repair (Spigalion, Obturator, Lumbar, Sciatic) Splenectomy - For Trauma Splenectomy - For Hypersplenism Splenorenal Anastomosis Portocaval Anastomosis Direct Operation on Oesophagus for Portal Hypertension Mesentericocaval Anastomosis Warren Shunt Pancerato Duodenectomy

Maximum Approved Rate (INR) (Rupees) 25000/27000/25000/35000/25000/25000/30000/30000/30000/12900/15000/15000/18000/15000/-

22000/22000/-

25000/25000/25000/40000/40000/-

30000/35000/35000/36000/-

15

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

01023035 01023036 01023037 01023038 01023039 01023040 01023041 01023042 01023043

01023044 01023045 01023046 01023047 01023048 01023049 01023050 01023051 01023052 01023053 01023054 01023055 01023056 01023057 01023058 01023059

NAME OF TREATMENT PROCEDURE By Pass Procedure for Inoperable Carcinoma of Pancreas Cystojejunostomy or Cystogastrostomy Cholecystectomy Cholecystectomy & Exploration of CBD Repair of Common Bile Duct Operation for Hydatid Cyst of Liver Cholecystostomy Hepatic Resections (Lobectomy Hepatectomy) Operation on Adrenal Glands - Bilateral Operation on Adrenal Glands - Unilateral for Tumour Appendicectomy for Acute Appendicitis Appendicectomy for Chronic Appendicitis Appendicular Abscess – Drainage Mesenteric Cyst- Excision Peritonioscopy/ Laparoscopy Jejunostomy Ileostomy Congenital Atresia & Stenosis of Small Intestine Muconium ileus Mal-rotation & Volvulus of the Midgut Resection & Anastomosis of Small Intestine Excision of Meckle’s Deverticulum Duodenal Diverticulum Operation for Intestinal Obstruction Operation for Intestinal perforation

Maximum Approved Rate (INR) (Rupees)

CODE 01023060

30000/01023061 30000/18000/-

01023062

22000/20000/-

01023063

25000/14200/28000/35000/-

20000/20000/18000/12000/18000/5100/18000/18000/25000/20000/-

01023064 01023065 01023066 01023067 01023068 01023069 01023070 01023071 01023072 01023073 01023074 01023075 01023076 01023077 01023078

01023079 20000/01023080 22000/01023081 22000/18000/-

01023082

25000/-

01023083

25000/-

01023084

NAME OF TREATMENT PROCEDURE Benign Tumours of Small Intestine Excision of Small Intestine Fistula Operations for Haemorrhage of the Small Intestines Operations of the Duplication of the Intestines Operations for Recurrent Intestinal Obstruction (Noble Plication & Other Operations for the Adhesions) Ilieosigmoidostomy Ilieotransverse Colostomy Caecostomy Loop Colostomy Transverse Sigmoid Terminal Colostomy Closure of Colostomy Right Hemi-Colectomy Left Hemi-Colectomy Total Colectomy Operations for Volvulus of Large Bowel Operations for Sigmoid Diverticulitis Fissure in Ano - Dilatation Fissure in Ano Fissurectomy Rectal Polyp-Excision Operation of Haemorrhoids -Lords procedure Fistula in Ano - High Fistulectomy Fistula in Ano - Low Fistulectomy Imperforat Anus Colostomy Imperforate Anus - Pull Through Operation Prolapse Rectum Theirch Wiring

Maximum Approved Rate (INR) (Rupees) 25000/25000/-

25000/-

32000/-

28000/22000/22000/10000/20000/24000/24000/24000/24000/39000/25200/22000/6800/16000/8000/-

10000/20000/12000/16000/22000/15000/-

16

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) Maximum Approved Rate (INR) (Rupees)

CODE

10000/-

01024018

22000/-

01024019 01024020

01023092

NAME OF TREATMENT PROCEDURE Prolapse Rectum Rectopexy Prolapse Rectum Grahams Operation Operations for Hirschsprungs Disease Excision of Pilonidal Sinus Abdomino-Perineal Excision of Rectum Anterior Resection of rectum Pull Through Abdominal Resection Operations for Neuroblastoma

01023093

Fistula/ Fistulotomy

12000/-

01023094

Hernioctomy Nephrology / Genitourinary Partial Nephrectomy Nephrolithotomy Pyelolithotomy Operations for Hydronephrosis Open Drainage of Perinephric Abscess Cavernostomy Operations for Cyst of the Kidney Ureterolithotomy Nephroureterectomy Operations for Ureter for Double Ureters Operations for Ureter -for Ectopia of Single Ureter Operations for Vesicoureteric Reflux Ureterostomy - Cutaneous Uretero-Colic anastomosis Formation of an Ileal Conduit Ureteric Catheterisation Dormia Extraction of Calculus

21000/-

CODE 01023085 01023086 01023087 01023088 01023089 01023090 01023091

024 01024001 01024002 01024003 01024004 01024005 01024006 01024007 01024008 01024009 01024010 01024011 01024012 01024013 01024014 01024015 01024016 01024017

22000/12300/26700/26300/-

01024021

01024022 01024023 01024024

22000/01024025 22000/-

25000/25000/25000/-

01024026 01024027 01024028 01024029 01024030 01024031

01024032 25000/15000/20400/25000/20000/20000/-

01024033 01024034 01024035 01024036 01024037

30000/01024038 27000/28000/20000/20000/-

01024039

22000/5000/-

01024041 01024042 01024043

6000/-

01024040

01024044

NAME OF TREATMENT PROCEDURE Biopsy of Bladder (Cystoscopic) Diathermy Destruction of Bladder Neoplasm Litholapexy Operations for Injuries of the Bladder Suprapubic Drainage (Cystostomy/ Vesicostomy) Total Cystectomy Diverticulectomy Open Resection of the Bladder Neck Y-V Plasty of the Bladder Neck Cystoplasty Operations for Extrophy of the Bladder Repair of Ureterocoel Suprapubic Prostatectomy Retropubic Prostatectomy Transurethral Resection of Prostate (TURP)/ TUR Bladder Tumour Intravesical BCG instillation (Cost of BCG extra) Operations for Injury to Urethra Internal urethrotomy Urethral Reconstruction Operation for Congenital Valves of Urethra Operations for Incontinence of Urine Male Operations for Incontinence of Urine Female Reduction of Paraphimosis Circumcision (under General Anaesthesia) Meatotomy Meatoplasty Operations for Hypospadias - Chordee

Maximum Approved Rate (INR) (Rupees) 6000/15000/15000/30000/-

12000/35000/32000/25000/25000/28000/40000/25000/25000/25000/-

25000/-

500/30000/15000/32000/16000/-

25000/-

25000/2450/6000/3500/6800/15000/-

17

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

01024045 01024046 01024047 01024048 01024049 01024050

01024051 01024052 01024053 01024054 01024055 01024056 01024057

01024058 01024059 01024060 01024061 01024062 01024063 01024064 01024065

01024066 01024067 01024068

NAME OF TREATMENT PROCEDURE Correction Operations for Hypospadias - Second Stage or One Stage Repair Operations for Epispadias Partial Amputation of the Penis Total amputation of the Penis Orchidectomy- Simple Orchidectomy- Radical Adreneclectomy Unilateral/Bilateral for Tumour/For Carcinoma Operations for Hydrocele Unilateral Operations for Hydrocele Bilateral Operation for Torsion of Testis Vasovasostomy Operations for Varicocele Block Dissection of Inguinal Nodes - One Side Block Dissection of Inguinal Nodes - Both Sides Excision of Filarial Scrotum Emergency Dialysis Femoral Puncture Emergency Dialysis Subclavian Puncture Fistula/Shunt Dialysis Femoral Catheterisation Bilateral Haemo Dialysis (All Inclusive) Double Lumen Sub Clavian Catheter Continuous Arterio Venus Haemofiltration (CAVH)/ CAVD Subclavian Access Femoral Access

Maximum Approved Rate (INR) (Rupees)

24000/22000/-

CODE 01024069 01024070 01024071 01024072 01024073 01024074

14000/-

01024075 01024076

20000/14000/20000/-

01024077 01024078

30000/8000/-

01024079 01024080 01024081 01024082 01024083

12000/-

01024084

15000/18000/15000/-

01024085 01024086

25000/-

32000/16000/1200/1800/8000/1500/1500/3000/-

17000/1850/1750/-

01024087 01024088 01024089 01024090 01024091 01024092 01024093 01024094 01024095 01024096 01024097 01024098 01024099 01024100 01024101 01024102

NAME OF TREATMENT PROCEDURE Plasma Exchange Donor Nephrectomy Renal Transplantation Ureteric Reimplant Lymphocoel Transplant Nephrectomy Nephrouretectomy Vascular Prosthetic Graft CAPD (insertion & removal) PCNL - Unilateral PCNL – Bilateral/ PCNL-III Palomo’s Unilateral Palomo’s Bilateral Endoscopic Teflon Inject Testicular Biopsy Gil-Verner’s Extended Pyelolithotomy Radical Nephrectomy Complicated Tumour or Adhesions Anderson Hynes Pyeloroplasty Vasico Vaginal Fistula Repair Radical Cystectomy Caeco Cystoplasty Nephrectomy Simple Nephrostomy Ureteric Reimplant Partial Cystectomy Epididymectomy TURP Cystolithotripsy Open Prostatectomy Closure of Urethral Fistula Orchidopexy - Unilateral Orchidopexy - Bilateral Cystolithotomy Suprapubic Endoscopic Removal of Stone in Bladder Resection Bladder Neck Endoscopic

Maximum Approved Rate (INR) (Rupees) 2500/50000/250000/4200/4300/35000/35000/35000/8000/30000/46000/7300/12600/5100/4350/22000/-

50000/25000/30000/44000/26000/25000/22000/25000/28000/12000/30000/28000/28000/15000/20000/15000/18000/18000/-

18

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01024103 01024104 01024105 01024106 01024107 01024108 01024109

01024110 01024111 01024112 01024113 01024114

01024115

01024116 01024117 01024118 01024119 01024120 01024121 01024122 01024123 01024124 01024125 01024126

NAME OF TREATMENT PROCEDURE Ureteroscopic Removalwith LASER Ureteroscopic Removalwithout LASER Urethroplasty 1st Stage Optical Urethrotomy Exploratory Scrototomy Perineal Urethrostomy Dilatation of Stricture Urethra under G.A. Dilatation of Stricture Urethra without Anesthesia Retroperitoneoscopy Nephrectomy Retroperitoneoscopy partial Nephrectomy Retroperitoneoscopic nephrolithotomy Retroperitoneoscopic pyelolithotomy Retroperitoneoscopic operation for Hyderonephrosis Retroperitoneoscopic surgery for Renal cyst Retroperitoneoscopic ureterolithotomy Retroperitoneoscopic Nephroureteroectomy Laproscopy aassisted orchidopexy Laproscopic operation for varicocele Cystoscopic Basketing of Urethra Lithotripsy/ ESWL (Complete) Lithotripsy-1/ SMSL (Day Care) Lithotripsy-2/3/ SMSL (Day Care) Slow Efficiency Dialysis (SLED) Prosthetic Surgery for urinary incontinence

Maximum Approved Rate (INR) (Rupees)

01025011

NAME OF TREATMENT PROCEDURE Hilioum Laser Prostrate surgery/ Optical Internal urethrotomy/ C High Intensity Focus Ultrasound (HIFU) Robotic for Carcinoma CRRT Procedure TURP with LASER Lithoclast (Day Care) Plastic Surgery Primary Suture of Wound Injection of Keloids Ganglion Injection of Keloids Haemangioma Free Grafts - Wolfe Grafts Free Grafts - Theirech Small Area 5% Free Grafts - Large Area 10% Free Grafts - Very Large Area 20% Skin Flaps - Rotation Flaps Skin Flaps Advancement Flaps Skin Flaps - Direct- cross Leg Flaps- Cross Arm Flap Skin Flaps - Cross Finger

01025012

Skin Flaps - Abdominal

35500/-

01025013 01025014

Skin Flaps - Thoracic Skin Flaps - Arm Etc. Subcutaneous Pedicle Flaps Raising Subcutaneous Pedicle Flaps Delay Subcutaneous Pedicle Flaps Transfer Cartilage Grafting Reduction of Facial Fractures of Nose Reduction of Facial Fractures of Maxilla

34400/35500/-

CODE

40000/01024127 18000/14000/18000/10000/15000/4000/-

01024128 01024129 01024130 01024131 025 01025001 01025002

2200/40000/-

01025003 01025004

35000/-

01025005

35000/35000/-

01025006 01025007 01025008

35000/-

35000/35000/35000/22000/20000/12000/30000/18000/23000/4000/-

Maximum Approved Rate (INR) (Rupees)

01025009

01025010

01025015 01025016 01025017 01025018 01025019 01025020

30000/-

150000/11000/32000/16000/3200/2700/6100/18000/18500/30000/32400/28750/31650/-

35500/35500/-

28500/27750/28500/29700/9000/13800/-

40000/-

19

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

01025021

01025022

01025023 01025024 01025025

NAME OF TREATMENT PROCEDURE Reduction of Fractures of Mandible & Maxilla - Eye Let Splinting Reduction of Fractures of Mandible & Maxilla - Cast Netal Splints Reduction of Fractures of Mandible & Maxilla Gumming Splints Internal Wire Fixation of Mandible & Maxilla

Maximum Approved Rate (INR) (Rupees)

27000/-

27000/-

27000/32000/-

01025026

33800/-

01025027

Primary Bone Grafting of Cleft Lip Palate

34550/-

01025028

Secondary Surgery for Cleft Lip Deformity

01025030 01025031

01025032

01025033 01025034 01025035

01025036 01025037

026 01026001

Secondary Surgery for Cleft Palate Reconstruction of Eyelid Defects - Minor Reconstruction of Eyelid Defects - Major Plastic Surgery of Different Regions of the Ear - Minor Plastic Surgery of Different Regions of the Ear - Major Plastic Surgery of the Nose - Minor Plastic Surgery of the Nose - Major Plastic Surgery for Facial Paralysis (Support with Reanimation) Pendulous Breast Mammoplasty Orthopaedic Surgery Procedure Application of P.O.P Casts for Upper & Lower Limbs

01026002

32400/-

7500/-

01026012 01026013

Tension Band Wirings

6000/-

01026014

18000/28000/-

01026016

Bone Grafting Excision of Bone Tumours -Superficial Excision of Bone Tumours -Deep

01026017

Excision of Ganglion

10000/-

01026005 01026006 01026007 01026008 01026009 01026010

32600/01026011 31350/17550/-

NAME OF TREATMENT PROCEDURE Application of Functional Cast Brace Application of Skin Traction Application of Skeletal Tractions Bandage & Strappings for Fractures Aspiration & Intra Articular Injections Application of P.O.P Spices & Jackets Close Reduction of Fractures of Limb & P.O.P Reduction of Compound Fractures Open Reduction & Internal Fixation of Fingurs & Toes Open Reduction of fracture of Long Bones of Upper / Lower Limb Nailing & External Fixation Open Reduction of fracture of Long Bones of Upper / Lower Limb -AO Procedures

01026003 01026004

Cleft Lip - repair. Cleft Palate Repair Severe Degree

01025029

CODE

Maximum Approved Rate (INR) (Rupees)

1650/4450/1150/950/6000/7500/10000/18000/-

28000/-

27000/-

30000/-

10000/-

20000/10000/-

01026015

20000/-

32000/22550/-

01026018

01026019 01026020

7500/-

01026021

Excision or other Operations for Scaphoid Fractures Sequestrectomy & Saucerizations Superficial Sequestrectomy & Saucerizations -Deep Sequestrectomy & Saucerizations Arthrotomy

40000/-

25000/-

20000/30000/-

35000/-

20

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01026022 01026023 01026024

01026025

01026026 01026027 01026028 01026029

01026030

NAME OF TREATMENT PROCEDURE S.P.Nailing for Fracture Neck Femur Multiple Pinning Fracture Neck Femur Nail Plate Fixations for Fracture Neck Femur A.O.Compression Procedures for Fracture Neck Femur Open Reduction of Fracture Neck Femur Muscle Pedicle Graft and Internal Fixations Closed Reduction of Dislocations Open Reduction of Dislocations - Superficial Open Reduction of Dislocations - Deep Open Reduction of Fracture Dislocation & Internal Fixation

Maximum Approved Rate (INR) (Rupees)

CODE

35000/-

01026042

35000/-

01026043

35000/-

01026044

35000/-

01026045

10000/-

Amputations - Below Knee

Rs 25000/-

01026050

Amputations - Below Elbow

25000/-

01026032

32000/35000/-

01026034

Nerve Repair with Grafting Tendon with Transplant or Graft Tendon Lengthening/Tendon Sutures

01026035

Tendon Transfer

35000/-

01026036

Laminectomy, Excision Disc (Prosthesis extra)

01026052

01026039 01026040 01026041

Costo Transversectomy Corrective Ostectomy & Internal Fixation - Minor

25000/40000/32000/-

35000/-

25000/-

01026038

25000/-

30000/-

Neurolysis/Nerve Suture

01026037

30400/-

01026049

20000/-

01026031

Laminectomy, Excision Disc and Tumours (Prosthesis extra) Anterolateral Clearance for tuberculosis Antereolateral Decompression and Spinal Fusion

15000/-

01026048

01026047

01026051

01026033

30000/-

Soft Tissue Operations for Polio (instrumentation extra) Partial Hip Replacement (Cost of Prosthesis extra) Operations for Brachial Plexus & Cervical Rib

01026046 35000/-

NAME OF TREATMENT PROCEDURE Corrective Ostectomy & Internal Fixation - Major Arthrodisis of - Minor Joints Arthrodisis of - Major Joints Soft Tissue Operations for C.T.E.V.

Maximum Approved Rate (INR) (Rupees)

01026053

01026054 25000/-

01026055 01026056 01026057

40000/-

60000/-

01026058 01026059 01026060

32000/01026061 45000/30000/15000/-

01026062 01026063 01026064

Amputations - Above Knee Amputations - Above Elbow Amputations Forequarter Amputations -Hind Quarter and Hemipelvectomy Disarticulations - Major Disarticulations - Minor Arthrography & Osteomedullography Spinal Ostectomy and Internal Fixations Arthroscopy - Operative Soft Tissue Operation on Knee Myocutaneous and Fasciocutaneous Flat Procedures for Limbs Removal of Nails, Wires & Screw Removal of Plates Total Hip ReplacementUnilateral (Excluding

35000/30000/40000/-

44000/30000/20000/10450/40200/24250/24000/-

24000/10000/15000/60000/-

21

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) Maximum Approved Rate (INR) (Rupees)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

01026083

Above knee full slab

2200/-

01026084

Minerva Jacket

4000/-

01026085

Plaster Jacket

3050/-

01026086

Shoulder spica

3350/-

01026087

Single Hip spica

3100/-

01026088

Double Hip spica

3800/-

01026089

Resection of First Rib

45000/-

01026090

Resection of Cerical Rib

35000/-

01026091

Rib Resection

12500/-

01026092

Ligament Reconstruction

22000/-

027

Neuro-Surgery Craniotomy and Evacuation of Haematoma -Subdural Craniotomy and Evacuation of Haematoma -Extradural Evacuation of Brain Abscess Excision of Lobe (Frontal, Temporal, Cerebelium etc.) Excision of Brain Tumours -Supratentotial Excision of Brain Tumours -Subtentorial

01026071

NAME OF TREATMENT PROCEDURE Implants) Total Finger Joint Replacement-Unilateral (Excluding Implants) Total Knee Joint Replacement-Unilateral (Excluding Implants) Any Other Joint Replacement (e.g. elbow, shoulder, etc.)- Unilateral (Cost of Implants extra) Multiple fractures repair (excluding peripheral limb injuries)-major (above three fractures) (cost of implants extra) Multiple fractures repair (excluding peripheral limb injuries)-medium (above two fractures) (cost of implants extra) Sternal Dehisences Repair Sternal Dehisences Reconstruction

01026072

Fingers (post, slab)

300/-

01026073

300/-

01026076

Fingers full plaster Colles Fracture - Below elbow Colles Fracture - Full plaster Colles fracture Ant. Or post. slab

01026077

Above elbow full plaster

1000/-

01026078

Above Knee post-slab

700/-

01026079

Below Knee full plaster

1000/-

01026080

750/-

01027008

01026081

Below Knee post-slab Tube Plaster (or plaster cylinder)

1450/-

01027009

01026082

Above knee full plaster

2400/-

01027010

CODE

01026065

01026066

01026067

01026068

01026069 01026070

01026074 01026075

23000/-

55000/-

55000/-

100000/-

60000/25000/55000/-

1200/-

01027001

01027002 01027003

2000/1000/-

01027004 01027005 01027006 01027007

01027011

Surgery of Cord Tumours Ventriculoatrial /Ventriculoperitoneal Shunt Excision of Cervical InterVertebral Discs Sympathetectomy Lumbar Sympathetectomy Cervical

70000/-

70000/80000/-

80000/80000/80000/60000/-

40000/50000/18000/18000/-

22

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

01027012 01027013

Twist Drill Craniostomy Subdural Tapping

30000/15000/-

01027041 01027042

01027014

Ventricular Tapping

12000/-

01027043

01027015

15000/-

01027031 01027032

Abscess Tapping Placement of ICP Monitor Urokinase Therepy for ICH Skull Traction Application Lumber Pressure Monitoring Vascular Malformations Peritoneal Shunt Atrial Shunt Meningo Encephalocoel Meningomyelocoel C.S.F. Rhinorrhaea Cranioplasty Posterior Cervical Dissectomy Anterior Cervical Dissectomy Brachial Plexus Exploration Microsuturing Median Nerve Decompression Peripheral Neurectomy (Tirgeminal) Trigeminal Rhiotomy

01027033

Cranial Nerve Astomosis

60000/-

01027034

Meningocoele Excision Peripheral Nerve Surgery – Major Peripheral Nerve Surgery Minor Ventriculo-Atrial Shunt (Exclud. Cost of valve) Nerve Biopsy (Procedure + Investigation) Brain Biopsy (Procedure + Investigation) Anterior Cervical Spine Surgery with fusion

45000/-

01027016 01027017 01027018 01027019 01027020 01027021 01027022 01027023 01027024 01027025 01027026 01027027 01027028 01027029 01027030

15000/15000/3400/10000/100000/15000/15000/52000/42000/55000/55000/50000/-

01027044 01027045

NAME OF TREATMENT PROCEDURE Anterior Lateral Decompression Brain Mapping Cervical or Dorsal Laminectomy Combined Trans-oral Surgery & CV Junction Fusion C.V. Junction Fusion

01027046

Depressed Fracture

40000/-

01027047 01027048

45000/50000/-

01027062

Discectomy Endarterectomy R.F. Lesion for Trigeminal Neuralgia Spasticity Surgery Spinal Fusion Procedure Spinal Intra Medullary Tumours Spinal Bifida Surgery Major Spina/ Bifida Surgery Minor Stereotaxic Proceduresbiopsy/ aspiration Trans Sphenoidal Surgery Trans Oral Surgery Implantation of DBS- one Electrode Implantation of DBS- two Electrodes Endoscopic Adueductoplasty Facial nerve reconstruction Recanelisation of venous sinuses

01027063

Carotid stenting

75000/-

01027064

Cervical disc arthroplasty Lumbar disc arthroplasty

35000/-

CODE

01027049 01027050 01027051 01027052 01027053 01027054

50000/-

01027055 01027056 01027057

40000/-

01027058

45000/35000/-

01027059

50000/-

01027060 01027061

01027035 01027036 01027037 01027038 01027039 01027040

Maximum Approved Rate (INR) (Rupees) 60000/2400/45000/-

110000/80000/-

30000/90000/65000/65000/65000/55000/22000/65000/110000/100000/100000/100000/50000/80000/-

50000/40000/100000/15000/-

01027065

30000/-

01027066

Corpus Callosectomy

60000/-

01027067

Hemishpherectomy

80000/-

18000/60000/-

23

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01027068 01027069 01027070 01027071 01027072 01027073 01027074

01027075 01027076

01027077 01027078 01027079

01027080 01027081

NAME OF TREATMENT PROCEDURE Endoscopic CSF rhinorrhea repair Microsurgical excision of Acoustic tumour Microsurgical excision of meningomas Epilepsy surgery RF lesion for facet pain syndrome Cervical laminoplasty Lateral mass C1-C2 screw fixation Microsurgical decompression for Trigemil nerve Cerebellar stimulation for hemifacial spasm Cerebellar stimulation for other cranial nerve neuralgia IC EC bypass procedures Stereotactic guided craniotomy Baclofen pump implantation lesioning for movement disorder including Parkinsonism

Maximum Approved Rate (INR) (Rupees) 50000/-

18000/-

01027101

12000/-

01027102

01027103

Complex Brain Surgery

130000/-

01027104

Complex Spine Surgery

110000/-

01027105

Dorsal Sympathectomy Neuro rehabilitisationpackage for 25 sittings (bed charges extra) Vascular Surgery

50000/-

60000/-

01027090

60000/-

01027091

80000/-

01027092

40000/40000/-

01027093

60000/-

60000/-

80000/70000/70000/-

01027098

60000/-

Endoscopic discectomy

60000/-

01027088

Aneurysm coiling Endoscopic spil procedure- aneurysm

80000/-

01027089

01027097

01027099

01027087

01027085

01027095

01027096

60000/-

01027084

01027094

80000/-

01027086

01027083

NAME OF TREATMENT PROCEDURE coiling Surgery for grooving skull fractures- aneurysm coiling Carpel Tunnel decompression Clipping of intracranial aneurysm with use of clip Endoscopic aspiration of intracerebellar haematoma Stereotactic Radiosurgery for brain pathology (X knife/ Gamma) Foramen magnum decompression Foramen magnum decompression with syringosubarachnoid shunt Dorsal column stimulation for bachache in failed back syndrome Surgery for recurrent disc prolapse/ epidural fibrosis Surgery for brain stem tumours Decompressive cranectomy for hemishpherical acute subdural Intra arterial thrombolysis with RTPA for ischemic stroket RTPA-acute Stereotactic aspiration of intracerebral haematoma

Programmable shunt Endoscopic sympathectomy External ventricular drainage Image guided surgery Excision of tethored Endoscopic 3rd ventriculostomy Endoscopic cranial surgery/Biopsy/aspiration/ aneurysm coiling

01027082

CODE

Maximum Approved Rate (INR) (Rupees)

40000/-

01027100

80000/40000/90000/-

60000/-

120000/60000/-

60000/-

50000/60000/100000/-

70000/-

100000/50000/-

60000/60000/-

01027106 028

15000/-

80000/-

24

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

01028001

Patch Graft Angioplasty

50000/-

01029001

01028002

Operations for Stenosis of Renal Arteries

50000/-

01029002

01028003 01028004 01028005

Thrombendarterectomy Operations for Acquired Arteriovenous Fistula Congenital Arterio Venous Fistula

80000/-

01029006

NAME OF TREATMENT PROCEDURE Excision of thyroglossal Duct/Cyst Diaphragmatic Hernia Repair (Thoracic or Abdominal Approach) Tracheo Oesophageal Fistula (Correction Surgery) Colon Replacement of Oesophagus Omphalo Mesenteric Cyst Excision Omphalo Mesenteric Duct- Excision

42500/-

01029007

Meckels Diverticulectomy

50000/-

01029008

CODE

50000/01029003 50000/01029004 27700/01029005

01028009

Surgery for Arterial Aneursysm -Vertebral Surgery for Arterial Aneursysm Carotid Surgery for Arterial Aneursysm Main Arteries of the Limb Dissecting Aneurysms + Implant

150000/-

01028010

Stripping of Short or Long Sephenous Veins

30000/-

01028006 01028007

01028008

01028011 01028012

Ligation of Ankle Perforators Excision and Skin Graft of Venous Ulcer

17400/15500/-

Maximum Approved Rate (INR) (Rupees) 30000/-

35000/-

40000/40000/30000/30000/30000/-

01029009

Omphalocele 1st Stage (Hernia Repair) Omphalocele 2nd Stge (Hernia Repair)

01029010

Gastrochisis Repair

24000/-

01029011

Inguinal Herniotomy

24000/-

01029012 01029013

Congenital Hydrocele Hydrocele of Cord

24000/22000/-

01029014

25000/-

28000/30000/-

01028013

Venous Thromoectomy

22100/-

01028014

Lymphatics Excision of Subcutaneous Tissues In Lymphoedema

30000/-

01029016 01029017 01029018

30000/-

01029019

16800/-

01029020

Torsion Testis Operation Congenital Pyloric Stenosis- operation Duodenal- Atresia Operation Pancreatic Ring Operation Meconium Ileus Operation Malrotation of Intestines Operation Rectal Biopsy (Megacolon)

40200/-

01029021

Colostomy Transverse

28000/-

40200/-

01029022

Colostomy Left Iliac Abdominal Perineal Pull Through (Hirschaprugis Disease) Imperforate Anus Low

28000/-

01028015

01028018

Trendelenburg Operations Vascular Procedure – Minor Surgery for Arterial Aneursysm Spleen Artery Surgery for Arterial Aneursysm Renal Artery

029

Paediatric Surgery

01028016 01028017

01029015

01029023 01029024

27000/35000/45000/30000/32000/25000/-

35000/22000/-

25

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) Maximum Approved Rate (INR) (Rupees)

CODE

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

01029041 01029042

Peripheral Long Line LP

800/300/-

01029043

Peritoneal Tapping

500/-

25000/-

01029044

800/-

21000/35000/-

01029045

Chest Drainage General Nursery Care (including Nursing Care etc.)

01029027 01029028

NAME OF TREATMENT PROCEDURE Anomaly -Cut Back Operation Imperforate Anus Low Anomaly - Perineal Anoplasty Inperforate Anus High Anomaly -Sacroabdomino Perineal Pull Through Inperforate Anus High Anomaly - Closure of Colostomy Intususception Operation

01029029

Choledochoduodenostom y for Atresia of Extra Hepatic Billiary Duct

35000/-

01029030

Operation of Choledochal Cyst

35000/-

01029031

Nephrectomy for Pyonephrosis

35000/-

01029032

Nephrectomy for Hydronephrosis

CODE

01029025

01029026

01029033

01029034

01029035

Nephrectomy for -Wilms Tumour Paraortic Lymphadenoctomy with Nephrectomy for Wilms Tumour Sacro- Coccygeal Teratoma Excision

28000/-

01029046

01029047 01029048

030 01030001

35000/-

01030002 01030003

35000/-

01030004

01030005

01029037 01029038

01029039

Neuroblastoma Debulking Neuroblastoma Total Excision Rhabdomyosarcoma wide Excision Colon Transplant/ Conduit Management following Acid Structure Oesophagus

01030006 30000/32000/-

01030008

36000/-

01030009

40000/-

01030010

65000/-

01030011 01030012

01029040

Umbilical Line

400/-

600/1600/-

6600/18000/21000/25000/-

24000/-

40000/-

01030007 01029036

Phototherapy per day Neonate Rooming in with mother per day (inclusive of Nursing care) SNCU (Sick New Born Care Unit) Laproscopic/ Endoscopic Operations In Gen. Surgery / Gastrohepatic / NephroDiagnostic Laproscopy Laproscopic Pyloromyotomy Laproscopic Gastrostomy Laproscopic Closure of Perforated peptic ulcer Laproscopic Vagotomy Pyleroplasty/ gastro jejunostomy

600/-

500/01030013

Laproscopic umbilical hernia repair Laproscopic ventral hernia repair Laproscopic cystogastrostomy Lap. Cholecystectomy & CBD exploration Lap. Hydatid of liver surgery

Lap. Hepatic resection Lap. Assisted small bowel resection Lap. For intestinal obstruction

20000/25000/30000/26000/28000/-

28000/30000/30000/-

26

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

CODE 01030014 01030015 01030016 01030017 01030018

01030019 01030020 01030021 01030022 01030023 01030024

01030025

NAME OF TREATMENT PROCEDURE Lap. For intestinal perforation Lap. Assisted Right Hemicolectomy Lap. Assisted left Hemicolectomy Lap. Assisted Total Colectomy Laproscopic Rectopexy Lap. Asisted Abdominoperineal Resection of rectum Lap. Assisted anterior resection Laproscopic Cholecystectomy Laproscopic Appendicectomy Laaproscopic Hernia Repair Laproscopic Hiatus Hernia Repair

Maximum Approved Rate (INR) (Rupees)

CODE

28000/-

01030038

NAME OF TREATMENT PROCEDURE

Maximum Approved Rate (INR) (Rupees)

37000/-

01030040

32000/-

01030041

Nephrolithotomy Operations for HydronephrosisPyeloplasty Operations for HydronephrosisEndopyelotomy antegrade Operations for Cyst of the Kidney

01030042

URSL

25000/-

01030043

50000/-

01030044

Nephroureterectomy Operations for Vesicoureteric Reflux

40000/-

01030045

Diverticulectomy

22000/-

01030046

35000/-

01030048

Repair of Ureterocoel Operations for Varicocele Palomo’s- Unilateral Operations for Varicocele Palomo’s- Bilateral

30000/-

32000/-

01030039

32000/-

35000/-

35000/-

35000/40000/-

37000/37000/25000/21000/21000/30000/-

01030047

20000/-

Laproscopic Adhesiolysis Laproscopic Adrenalectomy Laproscopic Thyroidectomy Laproscopic Spleenectomy Laproscopic Colectomy

Rs 18000/-

01030049

Nephrostomy

16000/-

32000/-

01030050

Orchidopexy- Unilateral

25000/-

32000/-

01030051

Orchidopexy- Bilateral

30000/-

32000/35000/-

01030052

Prostratectomy

45000/-

40000/-

01030053

Laparoscopic Uro stone

30000/-

01030054

01030036 01030037

Incisional Hernioplasty Radiotherapy & Chemotherapy (packages) Nuclear MedicinesRadio Isotope Therapy 131- Iodine Therapy < 15mCi 131- Iodine Therapy 15-50 mCi 131- Iodine Therapy 51100 mCi

35000/-

01030035

Laproscopic Nephrectomy Inguinal Hernia (Laproscopic) Laproscopic Pyelolithotomy Ureterolithotomy Lap Ovarian Cystectomy Laparoscopic Hysterectomy

01030026 01030027 01030028 01030029 01030030 01030031 01030032 01030033 01030034

20000/30000/22000/22000/-

031

25000/-

01031001

Laparoscopic Ectopic

22000/-

01031002

Foreign body removal

4000/-

01031003

5200/16900/16900/-

27

Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011)

01031006

NAME OF TREATMENT PROCEDURE 131- Iodine Therapy > 100mCi Strontium therapy for metastatic bone pain palliation Samarium-153 therapy for metastatic bone pain palliation

032

Cobalt 60 Therapy

01032001

Radical Therapy Adjustment TherapyImmobilisation technique Palliative Therapy (less than 10 fractions) Palliative Therapy (10-25 fractions) Palliative Therapy (single fraction)

CODE 01031004

01031005

01032002 01032003 01032004 01032005 033 01033001 01033002 01033003 01033004 01033005

Linear Accelerators 3-D Planning (L. Acc. or Cobalt-60) 2-D Planning (L. Acc. or Cobalt-60) Intensity Modulated Radio Therapy (IMRT) Image Guided Radio Therapy (IGRT)

Maximum Approved Rate (INR) (Rupees)

CODE

19500/-

01033013

7200/-

70000/16000/15000/25000/5000/-

5000/105000/150000/-

65000/-

01033007

3D-CRT with IGRT

75000/-

01033008

4D-CRT with IGRT Stereotactic Radio Surgery (SRS) Stereotactic Radio Therapy (SRT)

90000/-

01033011 01033012

Rapid Arc with IMRT rate Palliative Radiation Therapy upto 15 fractions

Pre-radiation profile

034

01034004

Brachy Therapy Intra Cavitary Brachytherapy- 1st insertion Intra Cavitary/ Intra Luminal Brachytherapy2nd and subsequent insertion Interstitial Brachy Therapy- 1st insertion Interstitial Brachy Therapy- 2nd insertion

035

Chemotherapy

01035001

Neoadjuvant

1000/-

01035002

Adjuvant

1000/-

01035003

1000/20000/-

01035005

Infusional Chemotherapy Chemotherapy wafers for malignant brain tumours Multiple drug therapy per day

01035006

Targeted therapy

1000/-

01035007

Chemoport facility

1000/-

01033016

01033017 01033018

6000/-

01033006

01033010

01033020

01033014

01034001

IGRT Single Fraction 3D-CRT (Confirmal Radio Therapy)

01033009

01033019

NAME OF TREATMENT PROCEDURE Palliative Radiation Therapy upto 25 fractions Palliative Radiation single fraction Conventional Radiation Therapy with CT Conventional Radiation Therapy CBCT SRS/ SRT Neuro interventional charge/ case Electron Beam (>10 Fractions) Electron Beam (