schedule of charges 49-50, community centre, east of...

SCHEDULE OF CHARGES –Cardiac Services

National Heart Institute

49-50, Community Centre,

East of Kailash, New Delhi – 110065

Tel : +91-11-4660 6600

IMPORTANT NOTES

1. These tariffs are applicable for Domestic Patients only.

2. Inpatient’s service charges include bed charges, nursing care services charges, Resident Doctor fee, linen and diet charges.

3. Doctors’ visit shall be charged as per applicable rates defined.

4. Inpatient’s service charges is for full day on the day of admission irrespective of time of checking-in, however, for stay less

than 6 hours charges for half day shall be levied.

5. Check out time is 11.00 A.M.

6. For Insurance patients check out time is 5 PM, considering the fact that final approval of bill by TPA offices takes

approximately 3 - 4 hours from the time all documents are mailed from the hospital. Generally TPA offices receive the

documents around and after 1 PM. However, the patient can leave the hospital by 11 AM - general check out time, if he / she

settles the hospital bill by cash and agrees to take the refund from hospital after final approval from TPA is received and bill

settled.

7. The doctor’s visit charges are for routine visits from 6.00 AM to 11.00 PM. In case doctors’ visit is required between 11.00

PM & 6.00 AM, such visit will be treated as an emergency visit and will be charged at applicable rates.

8. The Treating Consultant / Physician can charge maximum two visits per day irrespective of his / her number of visits of the

patient in a day.

9. The Specialized Referral Consultant / Physician can charge one visit per day irrespective of his / her number of visits of the

patient.

10. Free Bed is for EWS category subject to availability.

11. Mode of payment – we accept payment by Cash / Credit Card / Pay Order / Demand Draft.

12. In all Package Cases (Surgical or Other Package Procedures), full estimated amount shall be deposited prior to scheduling of

the procedure. Actual expenses may vary in case of prolonged stay, repeat procedure or unforeseen situation(s) arising due to

patient illness and state of health.

13. An advance payment, as per table below, is mandatory at the time of admission for all types / categories of patients (including

Insurance / TPA patients) and bookings for surgeries. The advance deposited will be adjusted against the final bill at the time

of settlement.

Sl. No Type of Accommodation Amount in IRS

1 Premium Suite 50,000

2 Deluxe Room /Single /ICCU 30,000

3 Double Room 20,000

4 Economy Room 15,000

5 Daycare procedure Total Package Charges

14. Non payable items by payers - TPAs / CGHS / ECHS / ESI will be paid for & settled by the patient directly prior to

proceeding on discharge.

15. Up gradation of patient class / category during hospitalization shall result in corresponding upgradation of all applicable

charges across the entire spectrum of services from the day of admission. Patients of CGHS / ECHS category, Insurance

holder etc. who are willing to upgrade accommodation beyond their entitlement will be charged difference amount across the

entire spectrum of hospital services.

NATIONAL HEART INSTITUE

Schedule of Charges

Index

Sl. No. Description Page No

1 Important Notes (General Provisions)

PART I – Clinical Services

2 Outpatient Services

3 Inpatient Services

4 ICCU Procedure Charges

5 Cardiology Packages / Procedures

6 Cardiothoracic Surgery Packages

7 Vascular Surgery

8 OT and Anaesthesia Charges for General Surgical Procedures

9 Anaesthesiology Services – Peripheral

PART II – Diagnostic Services

10 Non – Invasive Lab

11 Radiology Services

12 Pathology & Biochemistry Investigations

13 Nuclear Medicine

PART III – Ancillary Charge Schedule

14 Dialysis

15 Physiotherapy

16 Dentistry Services

Sl

No

Name of the Procedure Charges in IRS

OUTPATIENT SERVICES

1 REGISTRATION CHARGES 100

2 O.P.D. CONSULTATION Variable 500 - 1000-(Ceiling of Rs.1 000/-

to be maintained)

3 CONSULTATION BY DUTY DOCTOR (by RMO / Sr. Resident) in

OPD 500

4 CONSULTATION WITH ANGlO REVIEW 1000

5(a) DOMICILIARY VISIT OF CARDIOLOGIST (Local) 2500 + cost of travel

DOMICILIARY VISIT OF CARDIOLOGIST (Outstation) 10,000 + cost of travel

b) DOMICILIARY VISIT OF RMO 1500 + cost of travel

c) DOMICILIARY VISIT OF NURSE / TECHNICIAN 800 + cost of travel

6 HEALTH CHECKUP

a)

Type I- Basic Cardiac Checkup

Consultation, General Profile (Haemogram, Blood Grouping, Urine

Analysis - RIM), Cardiopulmonary Profile (X-Ray Chest, ECG & PFT),

Diabetes Profile (Sugar - Fasting, PP I Random), Kidney Profile (Urea,

Creatinine, Uric acid), Lipid Profile (Cholesterol, Triglycerides) , Dental

check up

3500

b)

Type II- Advanced Cardiac Checkup


Analysis - RIM), Cardiopulmonary Profile (X-Ray Chest, ECG, PFT &

Stress Test- TMT), Diabetes Profile (Sugar- Fasting, PP I Random),

Kidney Profile (Urea, Creatinine, Uric acid), Lipid Profile (Cholesterol,

Triglycerides) Dental Check Up

4500

c)

Type III - Comprehensive Cardio-Diabetic Checkup


Analysis- RIM), Cardiopulmonary Profile (X-Ray Chest, Ultrasound

Abdomen, ECG, PFT, Echocardiography, Stress Test & Carotid

Doppler), Diabetes Profile (Sugar - Fasting, PP I Random, Glycosylated

Haemoglobin), Urine for Microalbuminuria, Kidney Profile (Urea,

Creatinine, Uric acid), Extended Lipid Profile (Cholesterol,

Triglycerides, HDL, LDL, VLDL, Apolipo A1 &B,&Lp[a]), Dental

check up

6500

7 PACEMAKER FUNCTION TESTING IN PACEMAKER CLINIC 500

8 ECG 250

9 MINOR SURGERY (Charges for procedure room) 2000 or 50 % of Surgeon fee whichever is

higher (Cost of disposables extra)

10 WHOLE BLOOD SERVICE CHARGE (OPD/IPD) 1800 / 2000

11 DRESSING 350

12

AMBULANCE CHARGES

Up to 5 kms 800

Up to 10 kms 1500

Every kilometer after 10 km 60

Waiting charges (for every 30 mins) or part thereof 100

Doctor accompanying the ambulance (Local) 2000

Doctor accompanying the ambulance (Out Station) 10000

13 DIETETIC CONSULTATION 250

INPATIENT SERVICES

1

IPD CONSULTATION - by Treating Consultant & Referrals ( Max 2 visits a day)

a. Economy Room - Hospital patients 600

- Consultants' patient 1000

b. Double room 1000

c. Single room 1200

d. Deluxe room /ICCU /POR 1500

e. Premium Suite 2000

f. Emergency visit in night time (11 PM to 6 AM) 2000

g. Consultation by Duty Doctor (by RMO /Sr Resident) 500

2

SPECIALIZED CARDIAC SERVICES

a. ICCU's 8000

b. Cubicle in ICCU 9000

Specialized cardiac services do not include

→ Ventilator Charges

→ Consultant's Visit

3

INPATIENT SERVICE CHARGES (ROOM TARIFF)

a. Economy room 3000

b. Double room 4000

c. Single room 7000

d. Deluxe room 9000


4

SLEEP STUDY

a. Single room 11000

b. Deluxe room 12500

5

TITRATION STUDY

a. Single room 11000

b. Deluxe room 12500

Sleep / Titration Study include : Sleep / Titration Study does not include :

a. Consultant visit charges a. Room

rent

b. Equipment charges b. Cost of disposables / consumables

ICCU PROCEDURE CHARGES

1

PERICARDIOCENTESIS (only procedure & necessary disposable charges) Room rent is to be charged

additional


b. Double room 7000

c. Single / Deluxe room 8000

d. Premium Suite 15000

2 CENTRAL LINE INSERTION (including triple lumen charges) 5000

3

INTRA AORTIC BALLOON PUMP (IABP). Bed charges extra.


b. Double room 45000

c. Single room 50000

d. Deluxe room 50000


If IABP is not used

→ Rs 15000 shall be levied as preparatory charges for premium suite.

→ Rs 10000 shall be levied as preparatory charges for deluxe room and single room patients

→ Rs 5000 shall be levied for all other categories of room

4 TEMPORARY PACING (TPI) 10000 + cost of the lead

5

VENTILATOR

a. Full day 2000

b. Half day or part thereof 1000

6

BIPAP 1500

Defibrillator used in wards (Full Day) 2000

Defibrillator used in wards (Half Day) 1000

7 CPR 5000

8 THROMBOLYSIS 5000

9 ELECTIVE CARDIOVERSION 5000

10

CHEST TUBE INSERTION


b. Double room 6000

c. Single room 8000

d. Deluxe room 10000


11 NEBULIZATION 300 + Cost of Drugs

12 INJECTION CHARGES 100 + cost of drug & disposable

13 ENEMA 400

14 CATHETER / RT 400 + cost of catheter / cost of ryles tube

15

ALPHA BED

a. Economy room 400

b. Double room 500

c. Single room 600

d. Deluxe room 800

e. ICCU 1000

f. Premium Suite 2000

Note : Observation in ICCU / Procedure Room, post procedure, will attract ICCU charges.

CARDIOLOGY PACKAGES / PROCEDURES

1 Angiography (Stay 1 Day) Economy Double Single Deluxe Premium

Suite

(a) Day Care (with investigations from NHI) 13,000

(b) Cardiac Catheterization & Coronary Angiography 14,000 15,000 18,000 20,000 50,000

(c) Renal/ Carotid / Peripheral Angiography 12,000 14,000 16,000 18,000 50,000

(d) Coronary + Renal/ Carotid / Peripheral Angiography 20,000 21,000 22,000 28,000 50,000

(e) Check Shot Angiography (Within 6 months of PTCA / CABG ) 10,000 11,000 12,000 14,000 50,000

The Angiography Package include : The Angiography Package does not include :

a. Room 1 bed charges, a. Test other than routine tests charged extra

b. Consultant's fee, nursing care, diet b. Non-ionic contrast

c. ECG -1 c. CD Charges RS.1,000/- (non refundable)

d. X-ray -1 d. Stay & other charges beyond the package days

e. Routine tests (Haemogram, ST, CT, KFT & RSS) & medicines e. Consultant's fee for non cardiac disciplines

g. Day care packages applicable for Economy bed only f. Visit charges of all Consultants after package days

2 Angioplasty Economy Double Single Deluxe Premium

Suite

a. Elective Angioplasty (stay maximum 3 days) 1,00,000 1,20,000 1,35,000 1,50,000 3,00,000

b. Primary Angioplasty (stay maximum 3 days) 1,30,000 1,40,000 1,60,000 1,80,000 3,50,000

c. Angioplasty Re-stenosis (within 6 months of Index PTCA) - (stay 3

days) 85,000 90,000 95,000 1,10,000 1,50,000

d. Peripheral Angioplasty (stay maximum 2 days) 75,000 85,000 95,000 1,10,000 1,50,000

e. Embolectomy 1,35,000 1,40,000 1,50,000 1,60,000 2,25,000

f. Digital Subtraction Angiography - Peripheral Artery 20,000 25,000 30,000 35,000 50,000

g. Digital Subtraction Angiography - Venogram 20,000 25,000 30,000 35,000 50,000

h. FFR 50,000 55,000 65,000 75,000 1,00,000

The Angioplasty Package Include : The Angioplasty Package does not include :

a. Stay ,Consultant charges, nursing care, diet a. Non-ionic contrast

b. ECG - 2

b.Cost of additional balloon(s)/Guidewires, Blood clot

suction device

c. X-Ray - 1 c. Cost of stent(s)

d. Cost of one balloon, one guide wire and disposables

d. Cost of special drugs viz. Reopro, Integrillin, Aggramed etc.

e. Routine investigations - haemogram, BT, CT, PT, Blood Group and cross match, KFT,

LFT, Lipid profile,Lipid e. Intra Aortic Balloon Pump (IABP)

f. Basic consumables and medicines

f.Tests other than routine basic tests, and those pertaining

to non-cardiac disciplines

g. Femoral Doppler - 1 g. Consultant charges for non-cardiac disciplines

h. Cost of treatment, Consultation, stay and other charges

beyond the package days

i. Cost of blood transfusion, if required.

j. Nephrology & Dialysis services

Note : 1. Failed angioplasty cases followed by emergency surgery are allowed a concession of Rs 20,000 in the package of the surgery.

2. A concession of Rs.5,OOO/- will be given to patients, who undergo angioplasty after an angiography at the NHI in the same admission.

3. 25% additional charges of package will be levied, if patient undergoes second PTCA / High risk case / staged procedure within package time.

3 Electrophysiology Studies Economy Double Single Deluxe Premium

Suite

a) Minor (Stay 1 day) 12,000 15,000 17,000 20,000 35,000

b) Major / Complex (Stay 1 day) 22,000 25,000 30,000 35,000 50,000

c) Radio Frequency ablation (Stay 2 days) 70,000 75,000 85,000 1,00,000 1,50,000

d) Radio Frequency ablation with Carto 1,65,000 1,70,000 1,75,000 1,90,000 3,00,000

Electrophysiology Studies Include :

Electrophysiology Studies do not

include:

a. Hospital stay a. Cost of device (s)

b. Medicines and disposables b. Tests other than routine tests etc

c. Basic blood investigations - haemogram, BT, CT, KFT, Urine - R/M c. Additional stay and other charges beyond the package days.

d. EKG - 2

e. X- Ray Chest - 1

4 Device Implantation Economy Double Single Deluxe Premium

Suite

a) Permanent Pacemaker (Single Chamber) 50,000 60,000 70,000 75,000 1,25,000

b) Permanent Pacemaker (Double Chamber) 60,000 70,000 80,000 90,000 1,50,000

c) ICD / Biventricular Pacing 65,000 70,000 80,000 90,000 1,50,000

d) Septal Ablation 75,000 80,000 85,000 95,000 1,50,000

e) IVC Filter Insertion 35,000 45,000 55,000 65,000 1,00,000

Device Implantation Includes : Device Implantation does not include

a. Hospitalization up to 3 days stay including 1 day in ICCU a. Cost of device (s) / Filter

b. Routine Investigations ( X- Ray- 1 , EKGs- 3,Echo/Doppler -1 for Sl no [d] & [e] and

basic RBS, BT, CT, KFT, Urine - R/M) b. Additional stay and other charges beyond the package days

5 Miscellaneous Procedures Economy Double Single Deluxe Premium

Suite

a) Aortic / Pulmonary / Mitral Balloon Valvuloplasty 65,000 75,000 80,000 90,000 1,50,000

b) Percutaneous ASD / PDA Closure 65,000 75,000 80,000 90,000 1,50,000

Misc.Procedure includes : Misc.procedure does not include.

a. Two nights hospital stay a. Cost of device and non ionic dye

b. professional fee for Hony.Consultant b. Cost of drugs' not in routine use.

c. Consumables & Diet c. All outsourced tests and investigations.

d. Routine investigations (X- Ray - 1, ECG -1 , Haemogram, BT, CT, PT, Blood group

and cross match, KFT , LFT, Urine - R/M) CARDIOTHORACIC SURGERY PACKAGES (Maximum stay 7 days)

1 Cardiothoracic Surgery Packages (Maximum stay 7 days) Economy Double Single Deluxe Premium

Suite

a) Open Heart / Bypass Surgery 1.90 lacs 2.40 lacs 3.00 lacs 3.50 lacs 5.00 lacs

b) Closed Heart / Thoracic Surgery 1.00 lac 1.25 lacs 1.75 lacs 2.25 lacs 3.00 lacs

c) Double Valve Replacement / Combined procedure eg. CABG + Valve

etc 2.40 lacs 2.90 lacs 3.50 lacs 4.00 lacs 5.5 lacs

d) High risk - Open Heart / Bypass/ Closed heart/ Thoracic Surgery/Valve

Replacement / Redo

An uniform additional charges of Rs 50,000 over and

above the cost of packages as mentioned above at

S.No.1(a),(b),©

e) Bentall Repair with Prosthetic Valve 3.15 Lacs 3.5 lacs 4 lacs 4.6 lacs 6 lacs

f) Bentall Repair with Biological Valve 3.15 Lacs 3.5 lacs 4 lacs 4.6 lacs 6 lacs

g) Co-aractation Dilatation 3.15 Lacs 3.5 lacs 4 lacs 4.6 lacs 6 lacs

h) Co-Aractation Dilatation with stenting 3.15 Lacs 3.5 lacs 4 lacs 4.6 lacs 6 lacs

The surgery package include: The surgery package do not include :

a. OT charges

a. All prosthetic & implants (patch,valve, shunt, graft,

stapler etc)

b. Lab investigations (blood grouping and cross matching, kidney profile, liver profile and routine hematology)

b. Intra Aortic Balloon Pump

c. Two echocardiography both pre and post surgery

c. Management of non cardiac ailment arising either

denovo or as a consequence of heart surgery including investigation and consultant's fee

d. One Doppler (if needed)

d. Drugs like (Teicoplanin, Piperacillin + Tazobactum,

albumin, erythropoietin, <eropenem,etc)

e. Re-opening during the period of package e. Nephrology and dialysis services

f. Diet and physiotherapy f. Stay & other charges beyond the package days.

g. 6 units of whole blood for open heart / bypass surgery and 4 units for other heart

surgery (Blood to be donated patient's relative)

h. Nursing care, medicines and medical consumables, professional fees of the consultants

in cardiothoracic surgery, cardiac anesthesia, cardiology for duration of package.

Vascular Surgery (Professional Fees Only)

S.No. Name of the Procedures

Charges in IRS

Economy Double Single Deluxe Premium

Suite

1 Abdominal aortic aneurysm repair 18000 24000 30000 42000 55000

2 Aorta / Axillo bifemoral bypass 18000 24000 30000 42000 55000

3 Aorta Iliac bypass 15000 20000 25000 35000 45000

4 Axillo Femoral bypass 15000 20000 25000 35000 45000

5 Carotid brachial bypass using synthetic graft 15000 20000 25000 35000 45000

6 Carotid bypass graft 15000 20000 25000 35000 45000

7 Carotid endarterectomy 15000 20000 25000 35000 45000

8 Carotid Sympathectomy 9000 12000 15000 20000 25000

9 Congenital AV Fistula 12000 16000 20000 28000 35000

10 Endarterectomy of any peripheral vessel 12000 16000 20000 28000 35000

11 Excision of Carotid body tumor with use of shunt 15000 20000 25000 35000 45000

12 Excision of Carotid body tumor 12000 16000 20000 28000 35000

13 Excision of cervical rib 15000 20000 25000 35000 45000

14 Excision of varicose veins bilateral 15000 20000 25000 35000 45000

15 Excision of varicose veins unilateral 15000 20000 25000 35000 45000

16 Femoral crossed leg graft 15000 20000 25000 35000 45000

17 Femoral Embolectomy - Bilateral 20000 25000 30000 35000 45000

18 Femoral Embolectomy - Unilateral 15000 20000 25000 35000 45000

19 Femoral popliteal bypass 15000 20000 25000 35000 45000

20 Ligation of Esophageal Varices 15000 20000 25000 35000 45000

21 Lieno-renal, porto-caval or Mesocaval shunt 15000 20000 25000 35000 45000

22 Lumbar Sympathectomy 10000 13000 16000 22000 30000

23 Management of popliteal artery entrapment 10000 13000 16000 22000 30000

24 Peripheral aneurysm 15000 20000 25000 30000 40000

25 Peripheral vascular injury repair 15000 20000 25000 30000 40000

26 Profundoplasty using patch 15000 20000 25000 30000 40000

27 Resection and or grafting for aneurysms (Thoracic) 30000 35000 40000 44000 60000

28 Subclavian Bypass 15000 20000 25000 30000 40000

29 Thrombo endarterectomy aorta 15000 20000 25000 30000 40000

30 Thrombo endarterectomy femoral artery 15000 20000 25000 30000 40000

31 Thrombo endarterectomy iliac artery 15000 20000 25000 30000 40000

32 Thrombo endarterectomy popliteal artery 15000 20000 25000 30000 40000

33 Vascular Repair 1,12,500 1,25,000 1,44,000 1,66,000 225000

34 AV Fistula for Dialysis 10,000 14,000 17,000 22,000 30000

OT & ANAESTHESIA CHARGES FOR GENERAL SURGICAL PROCEDURES

Procedure Charges

a) In OT 50 % of the total surgical fees (including Assts.) OR 5000 per hour ;

which ever is higher

b) In other area (Procedure room / Cath

lab) 25 % of total surgical fees

c) Anaesthetist fee

i) GA - 30 % of the total surgeon fees irrespective of the place of

anaesthesia

ii) Other than GA - Rs 1500 per hour or part thereof.

Cost of Consumables, Drugs etc. (at actual)

NOTE : Observation in ICCU / Procedure Room, post procedure will attract ICCU charges.

Anaesthesiology Services - Peripheral

Tariff for peripheral calls, other than the OT; Anaesthesiology Services -

Sl.No. Procedures Charges in IRS

1 IV Cannula - insertion necessitated by Anaesthetist 1000

2 Anaesthetist visit necessitated for patient on ventilator (Visit

Fee) 1000

3 Extubation by Anaesthetist 2000

4 Putting arterial cannulas by Anaesthetist 1000

5 Anaesthesiology Services for :-

1000

a. Cath Lab Procedure

b. Difficult TE Insertions in Echo Lab

c. Stem Cell Therapy

d. Nuclear Imaging calls

e. CT scan & MRI

f. Bronchoscopy

Note :- The Aanesthetist services should be merit based and the patient condition demanding

the same.

Part -II - DIAGNOSTIC SERVICES

NON-INVASIVE LAB

Sl no Procedures Charges in IRS

1 Plain Cine Fluoroscopy 500

2 Stress Test / Treadmill 2000

3 Dynamic ECG (Holter) / Holter Monitoring 2000

4 ELR (Event Loop Recorder) 11000

5 2-D ECHO 2500

6 TEE Test 4000

7 Carotid Doppler 3000

8 Peripheral Arterial Doppler 3000

9 Peripheral Venous Doppler 3000

10 Renal Doppler 2500

11 Stress ECHO 4000

12 Dobutamine ECHO 4000

13 Ambulatory B.P Monitoring 2500

14 Pulmonary Function Test (PFT) 1500

15 Dyssynchrony Study 3000

16 Pelvic Doppler 2500

17 Portal Doppler 2500

18 Radial Arterial Doppler 2500

19 HUTT (Head Up Tilt Test) 2500

RADIOLOGY SERVICES

X- RAYS

Sl.No Name of the Organ to be imaged Charges in IRS

1 X-Ray- Digitized Views (400 Per View) 400

Note: 1. Additional charges of Rs 100 for bed side services

ULTRA SONOGRAPHIC SCANS

Sl.No Name of the Organ to be imaged Charges in IRS

1 Pelvis/Lower Abdomen/Upper Abdomen 1200

2 Whole Abdomen 1500

3 TVS 1500

4 KUB 1200

5 KUB+PVR 1500

6 Brest/Neck/Scrotum 1700

7 Single Breast/ Pregnancy 1200

8 Foetal Well Being 1500

9 Level 2 Obs 2200

10 Prostate/Uterus 1200

11 Follicular Study 3000

Note : 1. Rs.500 to be charged for bed side service

2. Rs.1000 to be charged extra as emergency charges for service provided b/w 5.00

PM - 8.00 AM and on Sundays and Holidays

CT Scan

Sl

No Name of the organ to be imaged

Charges in IRS

Plain Contrast

1 Head 2000 3000

2 Neck 3500 4500

3 Chest 4000 5200

4 Lower / Upper Abdomen 4000 5500

5 Pelvis Both Hips 4500 NA

6 Whole Abdomen 5000 8000

7 Chest + Abdomen 8000 10500

8 Chest + Neck 7000 9000

9 Chest + Upper Abdomen 6000 9000

10 Face / PNS (Cor & Ax) 3500 4500

11 Head and Orbit 3500 4500

12 Head and Neck 4500 6000

13 Head and PNS 4500 6000

14 SI Joint 3500 4500

15 Face and Neck 4500 6000

16 Orbit 3500 5000

17 HRCT Chest / Mast 4500 6500

18 KUB 4500 6000

19 Chest + Neck + Abdomen 10000 14000

20 Left / Right Knee / Ankle 3500 4500

21 Thigh / Foot / Arm 3500 4500

22 Temporal Bone NA 4500

23 CS / Dorso Lumbar / Lumo Sacral Spine 5500 3000

24 CECT / HRCt Chest NA 8000

25 3D Reconstruction 2500 NA

Note

:

Rs 1000 will be charged extra for emergency reporting between 5 PM to 8 AM and on

Sundays and Holidays

Pathology and Biochemistry Investigations

Sl

no Name of Investigations Charges in IRS

1 ABO Group 160

2 Absolute Basophil Count 120

3 Absolute Eosinophil Count 150

4 Absolute Lymphocyte Count 150

5 Absolute Monocyte Count 150

6 Absolute Neutrophil Count 150

7 AFB Stain 240

8 Albumin, Serum 100

9 Alkaline Phosphatase 150

10 Apolipoproteins A1 & B 650

11 APTT (Partial Thromboplastin Time) 350

12 Arterial Line Tip for Culture & Sensitivity 500

13 Ammonia 950

14 Amylase, Serum 350

15 Anti HCV 1400

16 ASO (Anti Streptolysin - O) 400

17 B.U.N (Blood Urea Nitrogen), Serum 120

18 Bicarbonate, Serum 700

19 Bilirubin, Total 100

20 Bilirubin, Direct 100

21 Bleeding time 150

22 Blood - Culture & Sensitivity 600

23 Blood Gas Analysis 1000

24 Blood Gas Analysis (Includes CaCO3, O & PCO2) 800

25 Blood Grouping and RH Factor 160

26 Blood Grouping For Patients (Infants) Less Than 4

months

160

27 Blood Sugar (Random) 80

28 Blood Sugar 2 Hr. PP 80

29 Blood Sugar Fasting 80

30 Blood sugar - Glucometer 80

31 Body Fluid (Rapid) - Culture & Sensitivity 600

32 Bone Marrow Examination 750

33 Calcium, Serum 140

34 Cardiac profile 1600

35 CBC (Complete Blood Count) 300

36 CBC + PS 500

37 CBC + ESR + PS 550

38 Chikungunya - IgM 1200

39 Chloride, Serum 120

40 Cholesterol 150

41 Clot Retraction time 100

42 Clotting time 150

43 Coagulation Profile 1000

44 Coombs Test Direct 200

45 Coombs Test Indirect 350

46 Creatine Kinase (CPK) 300

47 Creatine Kinase MB 450

48 Creatinine, Serum 120

49 CRP (C - Reactive Protein), 350

50 Culture and Sensitivity (Other Specimen) 600

51 CVP Line Tip for Culture & Sensitivity 500

52 D-Dimer, (Quantitative) 1000

53 Dengue NS 1 Antigen Test 1300

54 Dengue Serology (Ig M & Ig G) 1300

55 Diabetes Profile 800

56 DLC 110

57 Electrolytes (Na, K, CI), Serum 350

58 Electrolytes (Na, K, CI), 24 Hrs Urine 350

59 ESR (Westergren) 100

60 Fecal Occult Blood 100

61 Gamma GT 150

62 Glucose Random 80

63 Glucose Fasting and 2 hrs. P.P. 150

64 Glucose Tolerance Test - (GTT 5 + 2 URINE

specimen)

500

65 Glycosylated Haemoglobin 550

66 Globulin, Serum 100

67 Gram's Staining 210

68 Haemogram 300

69 Haemoglobin Estimation 100

70 HDL Cholesterol 150

71 Hepatitis B Surface Antigen 400

72 HIV Test (I and II) 700

73 HCV (Rapid) 1400

74 HIV I & II, HCV, HBsAG (Pre-op) 2000

75 Iron Studies 450

76 Iron Serum 250

77 Ketone Blood 500

78 LDH 290

79 LDL Cholesterol, Serum 200

80 LE Cells 200

81 Lipase, Serum 600

82 Lipid Profile 800

83 Lipid Profile (Extended) 1600

84 Lipoprotein (a) ; Lp (a) 650

85 Liver Function Test Profile 850

86 Magnesium Serum 220

87 Malaria Antigen 500

88 Mantoux / PPD / TuberculinTest 130

89 MCH 80

90 MCHC 80

91 MCV 80

92 Packed Cell Volume (PCV) 100

93 Peripheral Smear Examination 200

94 Peripheral Smear Examination for Abnormal Cells 200

95 Peripheral Smear Examination for Band Cells 200

96 Peripheral Smear Examination for Haemolysis 200

97 Peripheral Smear Examination for Micro Filaria 200

98 Peripheral Smear Examination for Type of Anaemia 200

99 Peripheral Smear for Malarial Parasite 200

100 Peripheral Smear Toxic Granules 200

101 Phosphorus, Serum 120

102 Platelet Count 150

103 Potassium, Serum 120

104 Potassium, Spot Urine 120

105 Protein total Serum (total, alb, glo & ratio) 220

106 Protein,Spot Urine 100

107 Prothrombin Time (with INR) 300

108 Pus – AFB Stain 220

109 Pus – Culture & Sensitivity 500

110 Pus – Gram’s Stain 210

111 Pus – Fungus Examination 200

112 RBC 80

113 Renal Profile (Minor) 850

114 Reticulocyte Count 250

115 Rh Factor 160

116 Rheumatoid Factor (Quantitative), Serum 350

117 SGOT – Aspartate Amino Transferase, Serum 160

118 SGPT – Alanine Amino Transferase, Serum 160

119 Sickle Cell Test 150

120 Sodium, Serum 120

121 Sodium, Spot Urine 150

122 Stool – Culture & Sensitivity 500

123 Stool Analysis 300

124 Stool for Eosinophills 100

125 Stool for Fat Globules 100

126 Stool for Hanging Drop 100

127 Stool for Occult Blood 100

128 Stool for Reducing Substance 75

129 Stool pH 75

130 Stool Routine and Microscopy 100

131 TLC 100

132 TROPONIN - T 900

133 TROPONIN - i 1500

134 Typhidot 420

135 Triglycerides serum 150

136 Total Iron binding capcity 350

137 Total Protien, Serum 120

138 Urea, Serum 120

139 Uric Acid, Serum 120

140 Urine – Culture & Sensitivity 500

141 Urine Analysis 300

142 Urine Dipstix test for Sugar & Protein 100

143 Urine for Bile Pigment &bile salts 100

144 Urine for Microscopic Examination 100

145 Urine Bens Jones proteins 100

146 Urine for Microalbuminuria 450

147 Urine for pH 100

148 Urine for Specific Gravity 100

149 Urine Ketone 100

150 Urine Protiens 210

151 Urine Routine and Microscopy 150

152 Urobilinogen (Qualitative) - 24hrs Urine 100

153 VDRL Serum (RPR) 120

154 Venous Line Tip for Culture & Sensitivity 500

155 VLDL Serum 150

156 Widal Test (Tube Method) 180

157 Widal Test (Slide Method) 180

158 Wound Swab - Culture & Sensitivity 500

159 Wound Swab - Gram's Stain 200

160 Wound Swab - Fungus Examination 200

Nuclear Medicine

S.No. Investigations Charges in IRS

1 Baseline & captopril renal scan 8500

2 Bone marrow scan 4500

3 Bone scan SPECT 5500

4 Captopril renal scan 4500

5 Cardiac resting MUGA 5000

6 Cysternography 4500

7 Dobutamine MUGA 5500

8 DVT(Venography) 5000

9 Gastric emptying time 4500

10 Gastro oesophagial reflux 4000

11 Gated SPECT 12000

12 GHA brain scan 9000

13 GI bleeding detection 5500

14 Hepatobilliary scan (HIDA) 4500

15 Iodine therapy-131(5mci) 10000

16 Liver scan and hepatic blood flow 4500

17 Lung perfusion scan 4500

18 Lung ventilation scan 4500

19 Lymphoscintigraphy 4500

20 Mackels diverticulum scan 4500

21 Mammoscitigraphy 9000

22 Parathyroid scan 9000

23 Phosphorous therapy-32(10mci) 20000

24 Renal DMSA, renal scan 5500

25 Renal DTPA renal scan/GFR 5000

26 Salivary gland scan 4500

27 Samarium therapy 40000

28 SESTA MIBI / thallium tumor 9000

29 SPECT ECD brain scan 12000

30 SPECT HMPAO brain scan 11500

31 SPECT stress thallium 11500

32 SPECT thallium scan with dobutamine 11500

33 Strontium therapy-89(4mci) 85000

34 Testicular perfusion scan 4500

35 Thyroid scan 3300

36 Vesico-ureteric reflux/DRCG 5000

37 Whole body bone scan 5500

38 Whole body SESTA MIBI scan 8500

PART III - ANCILLARY CHARGES SCHEDULE

DIALYSIS

S No Procedures Charges in IRS

Charges Remarks

1 Dialysis 1600

Only cost of Dialysis,

consumables will be

charged extra

2 Dialyzer Kit (Dialyzer and tubing) 800

3 Single Use Dialysis 2400 Dialysis + Consumables

4 IPD Dialysis 4000

Only cost of Dialysis,

consumables will be

charged extra

5 Femoral Kit 2000

6 Femoral Catheterization 1500

7 DL Kit 4000

8 DL Catheterization 2500

9 Plasmapheresis 4000 Consumables will be

charged extra

10 Permcath Insertion 8000

Surgeon Fee only,

O.T charges and

consumables will be

charged extra

11 CAPD Catheter Insertion Open Surgery Technique 10000

Surgeon Fee only,

O.T charges and

consumables will be

charged extra

12 CAPD Catheter Insertion Laproscopic 15000

Surgeon Fee only,

O.T charges and

consumables will be

charged extra

13 SLED 8000

14 CRRT 20000

15 Tapping 2000

Note

: Professional Fee of Doctors' does not include charges for OT, consumables & bed.

Physiotherapy Services

Sl

No Procedures Charges in IRS

1 Short Wave Diathermy 250

2 Ultrasonic 200

3 Wax Bath 200- (Each Joint)

4 I.F.T 200

5 TENS 200

6 Muscle Simulator 350

7 Cervical Traction 250

8 Lumbar Traction 250

9

Laser :-

a) Each Pont 300

b) Scanning 500

10

Exercise :-

a) Short Case 300

b) Exercise Therapy for Half an Hour 400

c) Exercise Therapy for 45 minutes 450

11 Demonstration and Advice 200

12 Cryotherapy / Hot Pack 250

13 Electro Diagnosis 250

14 M.M.T / Evaluation 250

15 6 MWT 250

16 Pre Natal & Post Natal Exercise 250

17 Gait Training 300

18 Hemiplegia 500

19 Paraplegia 450

20 Quadriplegia 500

21 DVT Pump 250 per day rent

22 Vibrator 100

23 PEP Device 200

24 Inspiratory Muscle Device 250

25 Chest P.T 300

26 Pediatric Chest P.T 250

27 Postural Drainage 600

28 Cardiac Rehabilitation 600

29 Respiratory Rehabilitation 600

30 Orthopedic Rehabilitation 600

31 Neurolgy Rehabilitation 600

32 Mucus Extractor / Cough Assist :- 500

a) With Vibrator 600

b) With Chest P.T 800

c) With Postural Drainage 1000

33 Single Joint Treatment (One modality + Exercise) 300

34 Single Joint Treatment (Two modality + Exercise) 350

35 Double Joint Treatment (Two modality + Exercise) 400

36 Multiple Joint Treatment 500

37 I.P.D :-

a) Economy Room 250

b) Double Room 300

c) Single Room 350

d) Deluxe Room 400

e) Premium Suite 500

f) ICCUs

i) NonVentilated 400

ii) Ventilated 500

38 Soft Tissue Manipulation 100

39 Limb PT 400

40 Infra Red Lamp 200

41 Tapping per inch 50

42 Peak Flow Meter 100

43 TENS / IFT + Cold / Hot Pack 300

44 Assessments 200

45 Home Programme / Exercise Charts 200

46 Nebulization Charges (OPD only) 200

Dentistry Services

Sl No Procedures Charges in IRS

1 Consultation 500

2 Specialist Consultation 750

3 X- Ray 150

With Report 200

4 RCT Anterior 2500

5 RCT Posterior 3000

6 Re RCT Anterior 3500

7 Re RCT Posterior 4000

8 Single Sitting RCT 4000

9

Composite Tooth Coloured Filling

a. Grade I 800

b. Grade II 1200

c. Grade III 1500

d. Grade IV 2000

10 Diastema Closure 2500

11

GIC Filling

a. Small 800

b. Large 1000

12 Pit GIC Filling 500

13

Post and Core

a. Fibre 1000

b. Custom 1200

14 Temporary Filing and Dycal 500 per tooth

15

Complete Dentures

a. Acrylic 18000

b. Lucitone 22000

c. Flexible 20000

16

Removal of Partial Dentures

a. Lucitone 2500 + 300 per tooth

b. Acrylic 1500 + 300 per tooth

17

Dental Repair

a. Per Joint 500

b. Additional 500

18 Polishing / Cleaning of Dentures 800

19 Rebasing / Relining 4000

20

Scaling and Polishing

a. Full Mouth 1200

b. Subsequent Visits 300

21 Scaling and Polishing for heavy calculus 2500

22

Currettage & Deep Cleaning

a. Per tooth 200

b. Per quandrant 1000

23

Splinting of teeth

a. For 3 teeth 4000

b. Every extra tooth 500

24 Bleacing full mouth 6000

25

Veneers

a. Composite 3500

b. Ceramic 10000 / 12000 /15000

26 Bleaching Trays 1500

27 Bleaching non vital tooth 1000

a. Follow up Visit 800

28 Fluoride Application 1000 per arch

29 Nights Guards 5000

30 Pulpectomy 2000

31 Pulpotomy 1500

32 Stainless Steel Crown 2500

33 Space Maintainer 2500

34 Pit and Fissure Sealents 1500 per tooth

35 Tooth Jewellery 2000 + Jewellery Charge

36

Extraction

a. Grade I 500

b. Grade II 1000

c. Grade III 1500

37

Impaction

a. Grade I 2000

b. Grade II 2500

38

Pedo Extraction

a. Grade I 800

b. Grade II 1000

39

Crowns

a. Full Metal 3000 per unit

b. PFM I 3500 per unit

c. PFM II 5000 per unit

d. Full ceramic 10,000 per unit

schedule of charges 49-50, community centre, east of...

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