Chief Minister's Comprehensive Health Insurance Scheme

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Packages	Rate
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE)	22680
CM0159 : UPTO-40% MIXED BURNS (WITH SURGERIES)	32400
CM0160 : UPTO-50% WITH SCALDS (CONSERVATIVE)	40338
CM0161 : UPTO-50% MIXED BURNS ( WITH SURGERIES)	49410
CM0162 : UPTO-60% WITH SCALDS (CONSERVATIVE)	60588
CM0163 : UP TO-60% MIXED BURNS (WITH SURGERIES)	65610
CM0164 : ABOVE 60% MIXED BURNS (WITH SURGERIES)	81810
CM0165 : POST BURN CONTRACTURE FOR FUNCTIONAL IMPROVEMENT (INCLUDING SPLINT / PRESSURE GARMENT / PHYSIOTHERAPY) - MILD	17010
CM0166 : POST BURN CONTRACTURE FOR FUNCTIONAL IMPROVEMENT (INCLUDING SPLINT / PRESSURE GARMENT / PHYSIOTHERAPY) - MODERATE	25110
CM0167 : POST BURN CONTRACTURE FOR FUNCTIONAL IMPROVEMENT (INCLUDING SPLINT / PRESSURE GARMENT / PHYSIOTHERAPY) - SEVERE	31590
CM0168 : PTOSIS	19845
CM0169 : CUP AND BAT EARS	19845
CM0170A : FILARIAL LYMPHOEDEMA -NV SHUNT	11259
CM0170B : FILARIAL LYMPHOEDEMA -REDUCTION SURGERY	19845
CM0171 : HEMIFACIAL ATROPHY	28026
CM0172 : HEMIFACIAL MICROSMIA	40176
CM0173 : LEPROSY RECONSTRUCTIVE SURGERY	23409
CM0174 : TUMOR OF MANDIBLE AND MAXILLA	32481
CM0175 : CORRECTIVE SURGERY FOR CONGENITAL DEFORMITY OF HAND (PER HAND)	21546
CM0176 : PRESSURE SORE RECONSTRUCTIVE SURGERY	35559
CM0177 : ABDOMINAL WALL RECONSTRUCTION INCLUDING POST CANCER EXCISION	35478
CM0178 : LID DEFORMITY CORRECTION (FOLLOWING TRAUMA/BURNS/CONGENITAL)	13608
CM0180 : TOTAL ELBOW REPLACEMENT	38070
CM0181 : SHOULDER REPLACEMENT	38880
CM0182 : RADIAL HEAD REPLACEMENT	26730
CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG)	18023
CM0184 : CORRECTION OF NON-UNION FRACTURES - NON-UNION OF FRACTURE OF FEMUR/BOTH BONE OF LEG/ NON-UNION OF OTHER LONG BONES -HUMERUS/ BOTH BONES OF FOREARM WITH OR WITHOUT BONE GRAFTING	18023
CM0185 : SKELETAL SKULL TRACTION	24584
CM0186A : IMPLANT EXIT- K-WIRES /SCREWS/OTHER MINOR IMPLANTS	6278
CM0186B : IMPLANT EXIT- PLATES (SPINE IMPLANTS/OTHER MAJOR IMPLANT)	16605
CM0187 : ARTHRODESIS OF JOINTS -SHOULDER/ HIP / KNEE /ELBOW/ ANKLE / WRIST / HAND / FOOT	21870
CM0192 : ILIZAROV RING FIXATOR APPLICATION-FEMUR - DEFORMITY CORRECTION / LIMB LENGTHENING/TIBIA - DEFORMITY CORRECTION / LIMB LENGTHENING /PLATING/EXTERNAL FIXATOR/K WIRES	32198
CM0193 : SURGERY FOR NEGLECTED CTEV/RECURRENT CTEV-CTEV CORRECTIVE SURGERY /CTEV PONSETTI CORRECTION (FOLLOW UP PROCEDURES)/CTEV ILIZAROV	36248
CM0195 : KNEE LIGAMENT RECONSTRUCTION-ACL RECONSTRUCTION/PCL RECONSTRUCTION/MPFL RECONSTRUCTION	24300
CM0203 : SURGICAL CORRECTION FOR PELVIC BONE FRACTURES	26123
CM0204 : CORRECTION SACRO ILLIAC JOINT / ACETABULAR FRACTURES	23895
CM0205 : TOTAL KNEE REPLACEMENT	65000
CM0206A : TOTAL HIP REPLACEMENT- CEMENTED	60075
CM0206B : TOTAL HIP REPLACEMENT-UNCEMETED	69075
CM0515 : CHRONIC INFLAMMATORY DEMYELINATING POLY NEUROPATHY	11786
CM0516A : HEMORRHAGIC STROKE	24300
CM0516B : ISCHEMIC STROKE	14580
CM0625-II : AMPUTATIONS - FORE QUARTER / HIND QUARTER WITH OR WITHOUT HEMIPELVECTOMY	32400
CM0661-A-III : SPINAL AVM EMBOLIZATION	39488
CM0661-B-III : SPINAL AVM EMBOLIZATION	47588
CM0662-III : SPINAL DURAL FISTULA EMBOLIZATION	50018
CM0704 : RECONSTRUCTIVE MICRO SURGERY - REPLANTATION OF HAND, FINGER, THUMB, ARM, SCALP ETC	41148
CM0705 : RECONSTRUCTIVE MICRO SURGERY -FREE TISSUE TRANSFER	54999
CM0715 : CLEFT LIP	13041
CM0716 : CLEFT PALATE	16281
CM0717 : SYNDACTYLY OF HAND FOR EACH HAND	21546
CM0718A : MICROTIA/ANOTIA - STAGE 1	20574
CM0718B : MICROTIA/ANOTIA - STAGE 2	14256
CM0719 : TM JOINT ANKYLOSIS	32400
CM0720 : RECONSTRUCTIVE MICRO SURGERY -BRACHIAL PLEXUS SURGERY	20250
CM0721 : RECONSTRUCTIVE BREAST SURGERY FOLLOWING CANCER EXCISION, REDUCTION, AUGMENTATION	32724
CM0722-II : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA	16241
CM0722-III : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA	16241
CM0725-II : SKIN TUMOR/SOFT TISSUE/BONE TUMORS - EXCISION / AMPUTATION/RESECTION WITH RECONSTRUCTION	19967
CM0725-IV : SKIN TUMOR/SOFT TISSUE/BONE TUMORS - EXCISION / AMPUTATION/RESECTION WITH RECONSTRUCTION	19967
CM0730 A-III : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L OPEN	32400
CM0730 B-III : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L LAP	32400
CM0730 C-I : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L OPEN	44550
CM0730 D-I : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L LAP	44550
CM0749A-II : NECK DISSECTION ANY TYPE - WITH WIDE EXCISION (INCLUDING MALIGNANCY)	24584
CM0749B-II : NECK DISSECTION ANY TYPE - WITHOUT WIDE EXCISION (INCLUDING MALIGNANCY)	16484
CM0750-A-II : NECK DISSECTION ANY TYPE - WITHOUT RECONSTRUCTION (INCLUDING MALIGNANCY)	20939
CM0750-B-II : NECK DISSECTION ANY TYPE - WITH RECONSTRUCTION (INCLUDING MALIGNANCY)	28229
CM0759B-i : CRANIOSYNOSTOSIS - STRIP CRANIECTOMY	16200
CM0759B-ii : CRANIOSYNOSTOSIS - ORBITO FACIAL ADVANCEMENT	12150
CM0759B-iii : CRANIOSYNOSTOSIS - PLASTIC SURGICAL CORRECTION	12150
CM0807 : BONE RESECTION / CURRETTAGE/ CEMENTING- ANY CAUSE	24300
CM0812A-i : NERVE RECONSTRUCTION ( WITH NERVE GRAFT )	28350
CM0812A-ii : NERVE REPAIR NEUROLYSIS	16200
CM0812A-iii : NERVE REPAIR NERVE SUTURING	16200
CM0812B-i : PERIPHERAL NERVE REPAIR	16200
CM0812B-ii : PERIPHERAL NERVE RECONSTRUCTION ( WITH NERVE GRAFT )	28350
CM0812B-iii : TENDON REPAIR	8100
CM0812B-iv : TENDON RECONSTRUCTION ( WITH TENDON GRAFT)	16200
CM0813 : VAGINAL ATRESIA - (INCLUDING MC INDO-S REPAIR / PLASTIC SURGICAL REPAIR)	23693
CM0814-II : VASCULAR MALFORMATIONS- (INCLUDING SCLEROTHERAPY/ REDUCTION SURGERY)	21263
CM0815A : RECONSTRUCTIVE UPPER LIMB /HAND/LOWER LIMB/FOOT SURGERY FOLLOWING INFECTION, TRAUMA, BURNS, TUMORS/ MALIGNANCY, DEVELOPMENTAL INCLUDING DIABETIC FOOT - MILD	21101
CM0815B : RECONSTRUCTIVE UPPER LIMB /HAND/LOWER LIMB/FOOT SURGERY FOLLOWING INFECTION, TRAUMA, BURNS, TUMORS/ MALIGNANCY, DEVELOPMENTAL INCLUDING DIABETIC FOOT - MODERATE	27986
CM0815C : RECONSTRUCTIVE UPPER LIMB /HAND/LOWER LIMB/FOOT SURGERY FOLLOWING INFECTION, TRAUMA, BURNS, TUMORS/ MALIGNANCY, DEVELOPMENTAL INCLUDING DIABETIC FOOT - SEVERE	31226
CM0816A : FLAP SURGERIES CUTANEOUS- FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT	20250
CM0816B : MYOCUTANEOUS - FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT	28755
CM0816C : OSTEOCUTANEOUS - FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT	36855
CM0816D : MICROSURGICAL FREE FLAP SPLIT THICKNESS GRAFT - FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT	54999
CM0817 : POST BURN HYPERTROPHY SURGERY/SCAR REVISION SURGERY	20169
CM0818 : RECONSTRUCTION USING TISSUE EXPANDER (POST TRAUMATIC/POST BURNS) REQUIRES MULTIPLE SITTINGS	45279
CM0819 : FLAP SURGERIES WITH BONE GRAFTING	21060
CM0820-II : AMPUTATION OF ANY SITE / ANY CAUSE WITHOUT PROSTHESIS (except fingers, toes and small joints)	20250
CM0820-III : AMPUTATION OF ANY SITE / ANY CAUSE WITHOUT PROSTHESIS (fingers, toes and small joints)	8100
CM0821-II : AMPUTATION OF ANY SITE / ANY CAUSE WITH CUSTOM MADE PROSTHESIS (except fingers, toes and small joints)	100000
CM0821-III : AMPUTATION OF ANY SITE / ANY CAUSE WITH CUSTOM MADE PROSTHESIS (fingers, toes and small joints)	50000
CM0823 : OPERATIONS FOR BRACHIAL PLEXUS (multiple sitting - max 3)	24300
CM0829-II : STATUS EPILEPTICUS WITH MECHANICAL VENTILATION -(ADULT/PAEDIATRIC )	32400
CM0837-II : PYOGENIC /TB /VIRAL/ FUNGAL -MENINGITIS/ MENINGOENCEPHALITIS - NON VENTILATED	24300
CM0839-II : NEURO TUBERCULOSIS/NEUROCYSTICERCOSIS/ TUBERCULOMA	9720
CM0857 : SURGERY OF CORD TUMORS - INTRA MEDULLARY TUMORS	47604
CM0858 : SURGERY OF CORD TUMORS -INTRADURAL EXTRAMEDULLARY TUMOR	37074
CM0859 : SURGERY OF CORD TUMORS - EXTRADURAL TUMOR	37074
CM0860 : SPILT CORD MALFORMATIONS - ANY TYPE(INCLUDES SPINA BIFIDA MAJOR/MINOR)	21101
CM0861-I : POSTERIOR DISCECTOMY WITH OR WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY ( FOR CERVICAL COMPRESSIVE MYELOPATHY/ AT ANY LEVELS)	34952
CM0861-II : POSTERIOR DISCECTOMY WITH OR WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY ( FOR CERVICAL COMPRESSIVE MYELOPATHY/ AT ANY LEVELS)	34952
CM0862 : ANTERIOR DISCECTOMY (WITH OR WITHOUT BONE GRAFTING/SPACER/IMPLANT/VETEBROPLASTY ) ANY LEVEL	34952
CM0863 : ANTERIOR CERVICAL SPINE SURGERY WITH FUSION	32441
CM0864 : ANTERIOR LATERAL DECOMPRESSION/STABILSIATION	19481
CM0865-I : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- MICROLUMBAR	28391
CM0865-II : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- MICROLUMBAR	28391
CM0866-I : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- CONVENTIONAL	20291
CM0866-II : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- CONVENTIONAL	20291
CM0867 : SPINAL FUSION PROCEDURE	34466
CM0871 : SYRINGOMYELIA	49208
CM0872 : CORPECTOMY (ANTERIOR /ANTEROLATERAL) AT ALL SPINAL LEVELS	36491
CM0873 : SPINAL FIXATION RODS ,SCREWS,PLATES, ARTIFICIAL DISCS	48641
CM0888-II : GULLAIN BARRE SYNDROME	81000
CM0889-II : OPTIC NEURITIS	8100
CM0891-II : MYASTHENIA GRAVIS	12150
CM0893 : CAVERNOUS SINUS THROMBOSIS	20250
CM0894 : RHINOCEREBRAL MUCORMYCOSIS	24300
CM0947 : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES /VERTERBROPLASTY	61358
CM0948 : SPINAL EPIDURAL ABSCESS/HEMATOMA - LAMINECTOMY / EVACUATION	21668
CM0951 A : TRANSVERSE MYELITIS WITH CENTRAL DEMYELINATION	81000
CM0951 B : TRANSVERSE MYELITIS WITHOUT CENTRAL DEMYELINATION	16200
CM0969 : SACROSPINOUS FIXATION (VAGINAL ROUTE)	18671
CM0976A : CT / C-ARM GUIDED DISC OZONE NUCLEOLYSIS (CERVICAL / THORACIC / LUMBAR DISC)	12758
CM0976B : USG GUIDED DISC OZONE NUCLEOLYSIS (CERVICAL / THORACIC / LUMBAR DISC)	7898
CM0978 : C-ARM GUIDED INTRA ARTICULAR INJECTIONS (SHOULDER / ELBOW / WRIST / HIP / KNEE / ANKLE / JOINTS OF FOOT AND HAND	12758
CM0981 : LUDWIGS ANGINA AND OTHER NECK ABSCESS DRAINAGE	9720
CM0985 : CRANIOFACIAL RESECTION	39164
CM0986A : POSTERIOR DECOMPRESSION WITHOUT STABILISATION AT ANY LEVEL (2 -3 levels)	20250
CM0986B : POSTERIOR DECOMPRESSION WITH STABILISATION AT ANY LEVEL (2 -3 levels)	36450
FUP0061A : UP TO-60% MIXED BURNS (WITH SURGERIES) - First Qtr	750
FUP0061B : UP TO-60% MIXED BURNS (WITH SURGERIES) - Next 3 Qtrs	500
FUP0062A : ABOVE 60% MIXED BURNS (WITH SURGERIES) - First Qtr	750
FUP0062B : ABOVE 60% MIXED BURNS (WITH SURGERIES) - Next 3 Qtrs	500
FUP0063A : TOTAL ELBOW REPLACEMENT - First Qtr	500
FUP0063B : TOTAL ELBOW REPLACEMENT - Next 3 Qtrs	500
FUP0065B : TOTAL HIP REPLACEMENT - Next 3 Qtrs	500
FUP0066A : REVISION HIP REPLACEMENT SURGERY (ONLY WITH SPECIFIC APPROVAL) - First Qtr	500
FUP0066B : REVISION HIP REPLACEMENT SURGERY (ONLY WITH SPECIFIC APPROVAL) - Next 3 Qtrs	500
FUP0067A : REVISION KNEE REPLACEMENT SURGERY ( ONLY WITH SPECIFIC APPROVAL) - First Qtr	500
FUP0067B : REVISION KNEE REPLACEMENT SURGERY ( ONLY WITH SPECIFIC APPROVAL) - Next 3 Qtrs	500
FUP0068A : TOTAL KNEE REPLACEMENT - First Qtr	500
FUP0068B : TOTAL KNEE REPLACEMENT - Next 3 Qtrs	500
FUP0088A : CORPECTOMY (ANTERIOR /ANTEROLATERAL) AT ALL SPINAL LEVELS - First Qtr	2000
FUP0088B : CORPECTOMY (ANTERIOR /ANTEROLATERAL) AT ALL SPINAL LEVELS - Next 3 Qtrs	1000
FUP0089A : SPINAL FIXATION RODS ,SCREWS,PLATES, ARTIFICIAL DISCS - First Qtr	2000
FUP0089B : SPINAL FIXATION RODS ,SCREWS,PLATES, ARTIFICIAL DISCS - Next 3 Qtrs	1000
CM0183a : Neck/ Shaft Of Femur ORIF	18023
CM0183b : IM Nailing	12150
CM0183c : Shaft of Other Long Bones (Humerus)	13770
CM0183d : Tibia	12150
CM0183e : Radius, Fibula, Ulna (ORIF)	12150
CM0183f : Clavicle ( CRIF) (Displaced)	6480
CM0183g : Clavicel (ORIF) (Displaced)	9720
CM0183h : Both Bones of Forearm, Both Bones of Leg (Fixation of both bones)	18023
CM0183i : Bimalleolar Fracture	12150
CM0183j : Closed Reduction and Proximal Femoral nailing / Screw Fixation	12150
CM0183k : Closed Reduction and Pinning / Tens Nail	9720
CM0183l : Closed Reduction and Internal Fixation with K wire	4860
CM0183m : Tension Band wiring	9720
CM0184a : Neck/ Shaft Of Femur ORIF	18023
CM0184b : IM Nailing	12150
CM0184c : Shaft of Other Long Bones (Humerus)	13770
CM0184d : Tibia	12150
CM0184e : Radius, Fibula, Ulna (ORIF)	12150
CM0184f : Clavicle ( CRIF) (Displaced)	6480
CM0184g : Clavicel (ORIF) (Displaced)	9720
CM0184h : Both Bones of Forearm, Both Bones of Leg (Fixation of both bones)	18023
CM0184i : Bimalleolar Fracture	12150
CM0184j : Closed Reduction and Proximal Femoral nailing / Screw Fixation	12150
CM0184k : Closed Reduction and Pinning / Tens Nail	9720
CM0184l : Closed Reduction and Internal Fixation with K wire	4860
CM0184m : Tension Band wiring	9720
CM0186A-i : IMPLANT EXIT- K-WIRES - Single	1215
CM0186A-ii : IMPLANT EXIT- K-WIRES - Multiple	2025
CM0186A-iii : IMPLANT EXIT- SCREWS - single (Open)	3240
CM0186A-iv : IMPLANT EXIT- SCREWS - Multiple (Open)	6075
CM0186A-v : IMPLANT EXIT- SCREWS - single (Closed)	1620
CM0186A-vi : IMPLANT EXIT- SCREWS - Multiple (Closed)	2430
CM0186A-vii : IMPLANT EXIT- OTHER MINOR IMPLANTS (TENS, TBW, etc) - Solitary	4050
CM0186A-viii : IMPLANT EXIT- OTHER MINOR IMPLANTS (Pins / TENS, TBW, etc) - Multiple	6278
CM0186B-i : IMPLANT EXIT- PLATES (Open)	10125
CM0186B-ii : IMPLANT EXIT- Femoral Screws / IM Nails / Rush Nail (Open)	8100
CM0186B-iii : IMPLANT EXIT- SPINE IMPLANTS - upto 2 levels(complete exit) (eg- L2-L3, L3-L4)	14175
CM0186B-iv : IMPLANT EXIT- SPINE IMPLANTS - upto 2 levels(partial exit) (eg- L2-L3, L3-L4)	12150
CM0186B-v : IMPLANT EXIT- SPINE IMPLANTS - > 2 levels(complete exit) (eg- L2-L3, L3-L4, L4-L5)	16605
CM0186B-vi : IMPLANT EXIT- SPINE IMPLANTS - > 2 levels(partial exit) (eg- L2-L3, L3-L4, L4-L5)	14175
CM0186B-vii : IMPLANT EXIT- Bipolar, etc	12150
CM0186B-viii : IMPLANT EXIT - Other Major implants	10125
CM0187a : ARTHRODESIS OF JOINTS - HIP	21870
CM0187b : ARTHRODESIS OF JOINTS - SHOULDER / KNEE	16200
CM0187c : ARTHRODESIS OF JOINTS - ELBOW/ ANKLE / WRIST	12150
CM0187d : ARTHRODESIS OF JOINTS - ANKLE - Triple Arthrodesis	12960
CM0187e : ARTHRODESIS OF JOINTS - HAND / FOOT	8100
CM0192-A : ILIZAROV RING FIXATOR APPLICATION-FEMUR - DEFORMITY CORRECTION / LIMB LENGTHENING	20250
CM0192-B : ILIZAROV RING FIXATOR APPLICATION- TIBIA - DEFORMITY CORRECTION / LIMB LENGTHENING	14580
CM0193-A : SURGERY FOR NEGLECTED CTEV/RECURRENT CTEV/RESISTANT CTEV BY JESS FIXATION	36248
CM0195-A : KNEE LIGAMENT RECONSTRUCTION-ACL RECONSTRUCTION/PCL RECONSTRUCTION	24300
CM0195-B : KNEE LIGAMENT RECONSTRUCTION-MPFL RECONSTRUCTION	20250
CM0204- b : ACETABULAR FRACTURES	23895
CM0204-a : CORRECTION SACRO ILLIAC JOINT	16200
CM0625-II A : AMPUTATIONS - FORE QUARTER	32400
CM0625-II B : AMPUTATIONS - HIND QUARTER / Internal Hemipelvectomy	32400
CM0625-II C : AMPUTATIONS - HIND QUARTER / External Hemipelvectomy	32400
CM0722-II-A : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MAXILLA	8121
CM0722-II-B : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE	8121
CM0722-II-C : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA- INTERDENTAL WIRING	4050
CM0807-a - I : Cementing (only as Addon)	4050
CM0807-a : BONE RESECTION	20250
CM0807-b - I : Cementing (only as Add on)	4050
CM0807-b : BONE Curettage	12150
CM0820-II-A : Amputation of AK / BK	24300
CM0820-II-B : Amputation of AE / BE	20250
CM0820-II-C : Amputation of Fore-Foot	12150
CM0820-II-E : Amputation of Toes	5670
CM0820-II-F : Amputation of Fingers	8100
CM0820-II-G : Trans Meta-Tarsal Amputation	12150
CM0820-III-a : Amputation of great toe	5670
CM0820-III-b : Amputation toe- single	4050
CM0820-III-c : Amputation toe- Multiple	5670
CM0820-III-d : Amputation of Finger - single	5670
CM0820-III-e : Amputation of Finger - Multiple	8100
CM0820-III-f : Transmetatarsal Amputation	8100
CM0861-II-A : POSTERIOR DISCECTOMY WITH SPACER/IMPLANT/VERTEBROPLASTY (open)	34830
CM0861-II-B : POSTERIOR DISCECTOMY WITH BONE GRAFT	26730
CM0861-II-C : POSTERIOR DISCECTOMY WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY	20250
CM0715A : CLEFT LIP - Unilateral	8100
CM0715B : CLEFT LIP - Bilateral	13041
CM0718A-II : MICROTIA/ANOTIA - STAGE 1	8100
CM0718A-IV : MICROTIA/ANOTIA - STAGE 1 (with artificial Implant)	20574
CM0158- a : Medical management only (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) upto	4050
CM0158- b : 10 to 20% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application	8100
CM0158- c : 20 to 30% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application	15390
CM0158- d : 30 to 40% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application including ICU stay	22680
CM0158- e : upto 10% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application including ICU stay	5670
CM0159 - b : 20 to 30% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG	24300
CM0159- a : UPTO 20% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG	16200
CM0159- c : 30 to 40% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG including ICU stay	32400
CM0160A : 40 TO 50% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application	40338
CM0161A : 40 to 50% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG	49410
CM0162A : 50 TO 60% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application including ICU stay	60588
CM0163- a : 50 TO 60% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG including ICU stay	65610
CM0164-a : ABOVE 60% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG including ICU stay	81000
CM0165a : Fingers	3240
CM0165b : Neck - MILD (LESS THAN 1/3RD) - Flexion and extension videos to be uploaded	12150
CM0165c : Others (elbow, thigh, etc)	8100
CM0165d : Pressure Garments and Physiotherapy (2 weeks) - only as an addon	4860
CM0166a : Fingers	4860
CM0166b : Neck - MODERATE (1/3RD TO 2/3RD) - Flexion and extension videos to be uploaded	20250
CM0166c : Others (elbow, thigh, etc)	12150
CM0166d : Pressure Garments and Physiotherapy (2 weeks) - only as an addon	4860
CM0167a : Fingers	6480
CM0167b : Neck - SEVERE (> 2/3RD) - Flexion and extension videos to be uploaded	26730
CM0167c : Others (elbow, thigh, etc)	16200
CM0167d : Pressure Garments and Physiotherapy (2 weeks) - only as an addon	4860
CM0168a : PTOSIS Single	12150
CM0168b : PTOSIS Bilateral	19845
CM0175a : Polydactyly - Simple	4050
CM0175b : Polydactyly - Bone and neurovascular bundle	8100
CM0175c : Simple syndactyly (per finger)	4860
CM0175d : Complex syndactyly (per finger)	8100
CM0175e : Radial clubhand	12150
CM0175f : Ulnar clubhand	12150
CM0175g : Macrodactyly	14175
CM0175h : Others minor (will be paid as per procedure) Upto	8100
CM0175i : Others major (will be paid as per procedure) Upto	21546
CM0176a : PRESSURE SORE RECONSTRUCTIVE SURGERY - SSG - per 10 sq CM (upto)	9720
CM0176b : PRESSURE SORE RECONSTRUCTIVE SURGERY - Single Rotation FLAP - per 10 sq CM (upto) - per 10 sq CM (upto)	12150
CM0176c : PRESSURE SORE RECONSTRUCTIVE SURGERY - Bilateral FLAP - per 10 sq CM (upto)	16200
CM0176d : PRESSURE SORE RECONSTRUCTIVE SURGERY - Musculocutaneous flap - per 10 sq CM (upto)	24300
CM0176e : PRESSURE SORE RECONSTRUCTIVE SURGERY - Fasciocutaneous flap - per 10 sq CM (upto)	20250
CM0176f : PRESSURE SORE RECONSTRUCTIVE SURGERY - Tensor fascia lata flap - per 10 sq CM (upto)	35559
CM0176g : others (payable based on the procedure carried out) (upto)	35559
CM0177a : single closure	16200
CM0177b : Fascia Lata Graft	28350
CM0177c : Mesh Closure	20250
CM0177d : Local Flaps	16200
CM0177e : Myocutaneous Transposition	28350
CM0177f : TRAM	35559
CM0178a : Unilateral	8100
CM0178b : Bilateral	12960
CM0716A : CLEFT PALATE - Partial	12150
CM0716B : CLEFT PALATE - Complete	16281
CM0716C : CLEFT PALATE - Sub mucous (before 1.5 years of age)	16281
CM0717A : Simple syndactyly (Per finger)	4860
CM0717B : Complex Syndactyly (Per finger)	8100
CM0717C : Simple syndactyly (Per finger)	12150
CM0717D : Complex Syndactyly (Per hand)	21546
CM0718A-I : MICROTIA/ANOTIA - STAGE 1	20574
CM0718A-III : MICROTIA/ANOTIA - STAGE 1 (with cartilage autograft)	12150
CM0722-III-A : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MAXILLA	8121
CM0722-III-B : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE	8121
CM0722-III-C : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA- INTERDENTAL WIRING / Archbar	4050
CM0814-II-a : VASCULAR MALFORMATIONS- Sclerotherapy	10530
CM0814-II-b : VASCULAR MALFORMATIONS- Sclerotherapy and Excision	21263
CM0816A-i : FLAP SURGERIES CUTANEOUS- UPPER LIMB	16200
CM0816A-ii : FLAP SURGERIES CUTANEOUS- LOWER LIMB	9720
CM0861-I-A : POSTERIOR DISCECTOMY WITH SPACER/IMPLANT/VERTEBROPLASTY (open)	34830
CM0861-I-B : POSTERIOR DISCECTOMY WITH BONE GRAFT	26730
CM0861-I-C : POSTERIOR DISCECTOMY WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY	20250
CM0862A : ANTERIOR DISCECTOMY WITHOUT IMPLANTS	24300
CM0862B : ANTERIOR DISCECTOMY WITH IMPLANTS	34952
CM0947 A : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES ( MORE THAN 4 LEVELS)	60750
CM0947 B : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES LESS THAN 4 LEVELS)	40500
CM0947C : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES WITH VERTERBROPLASTY	36450

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