(a) faculty of modern medicine

BANARAS HINDU UNIVERSITY

SIR SUNDERLAL HOSPITAL

FROM PAGE NO. 1 TO 32

LIST OF MAINTENANCE CHARGES LEVIED FOR MEDICAL /

SURGICAL PROCEDURES, INVESTIGATIONS AND LABORATORY TESTS, ETC.

CARRIED OUT IN DIFFERENT DEPARTMENTS / DISCIPLINES OF FACULTIES OF

MODERN MEDICINE & AYURVEDA AND S.S.HOSPITAL, BHU

(Revised w.e.f. 02-07-2019)

(A) FACULTY OF MODERN MEDICINE

(1) ANAESTHESIOLOGY DEPARTMENT

S.No. CODE NO. NAME OF INVESTIGATIONS /

PROCEDURES

CHARGES

1. ANESTH-01 Maintenance Charges (Minor) Rs.100/-

2. ANESTH-02 Maintenance Charges (Major) Rs.500/-

3. ANESTH-03 Fibreoptic Laryngoscopy Rs.100/-

4. ANESTH-04 Blood Gas Analysis/Electrolyte Rs.200/-

5. ANESTH-05 ICU/Post Op. Recovery Charges per day Rs.1200/-

6. ANESTH-06 T3, T4, TSH Rs.400/-

7. ANESTH-07 Maintenance Charges for Renal Transplantation/

Open Heart Surgery

Rs.3,000/-

8. ANESTH-08 Blood Glucose Rs.10/-

9. ANESTH-09 Blood Urea Rs.20/-

10. ANESTH-10 Serum Creatinine Rs.30/-

11. ANESTH-11 Serum Protein & Albumin Rs.30/-

12. ANESTH-12 Conjugated and Unconjugated Bilirubin Rs.30/-

13. ANESTH-13 SGPT Rs.40/-

14. ANESTH-14 Serum Electrolytes Na, K, Cl. Rs.60/-

15. ANESTH-15 Serum Calcium Rs.20/-

16. ANESTH-16 Serum Phosphorus Rs.20/-

17. ANESTH-17 Serum Magnesium Rs.100/-

18. ANESTH-18 Serum Iron Rs.100/-

19. ANESTH-19 CPK Rs.250/-

20. ANESTH-20 CPK-MB Rs.250/-

21. ANESTH-21 Acid Phosphatase Prostatic Fraction Rs.100/-

22. ANESTH-22 Serum Alkaline Phosphatase Rs.30/-

23. ANESTH-23 LDH Rs.100/-

24. ANESTH-24 Special (Gasserian Ganglion block, Percutaneous

Cordotomies)

Rs. 1000/-

25. ANESTH-25 Major ( Coeliac Plexus block, Epidural steriod

Foramin Inj. Facet Joint Inj. Stellate Ganglion

Rhizotomy, Permanent epdidural,

Radiofrequency lesion, Pain procedures under

Image Intensifier)

Rs. 500/-

26. ANESTH-26 Minor (Intra articular Inj., TENS/Acupuncture,

Triger point Inj. Laser Therapy, procedures for

painless labour, Post operative pain relief

procedure.

Rs. 100/-

27. ANESTH-27 Super Major Operations Rs. 1000/-

…

2 S.No. CODE NO. NAME OF INVESTIGATIONS / PROCEDURES CHARGES

28. ANESTH-28 Percutaneous Necleotomy Kit Rs. 30000/- (can be

splited into 3 parts

each Rs. 10000/-)

29. ANESTH-29 R.F. Canula (15 dm 20 gauge) Rs. 2000/- (can be

splited into 2 parts

each Rs. 1000/-)

30. ANESTH-30 O.T. Equipment & Room Maintenance (Minor

Operations performed in Operation Theatres)

Rs. 200/-

Certified that the above-mentioned Maintenance Charges have been taken from the original list duly

approved by the competent authority of the University.

(2) ANATOMY DEPARTMENT (CYTOGENETIC LAB.)

S.No. Proposed Code

No.

Name of Test Proposed

Charges (Rs.)

1 ANTCYT-01 Karyotyping for Chromosomal

Abnormalities Viz all syndromes detectable

at genetic level (Down’s Tumer, Fragile X

etc.)

500/-

2 DNA-based diagnostic techniques for

ANTCYT-02 (a) Duchenne and Becker muscular

dystrophy (DMD/BMD)

2500/-

ANTCYT-03 (b) Prime gene mutation detection for

Developmental delay

500/-

ANTCYT-04 (c) MPZ gene mutation detection for

Muscular dystrophy of unknown origin

500/-

ANTCYT-05 (d) FMR gene mutation detection for

Fragile -X

500/-

2 ANTCYT-06 Amniocentesis Test 2000/-

3 ANTCYT-07 Chorionic Villus sampling (CVS) 2000/-

(3) “BLOOD BANK”

S.No. CODE NO. NAME OF INVESTIGATIONS/

PROCEDURES, ETC.

CHARGES

1. BLDBNK-01 Each single unit of Donor Bleeding (including

charges for Blood Donor Bag + HIV + HBsAg +

VDRL Testing + Grouping & Cross Matching)

Rs. 850/-

2. BLDBNK-02 Fresh Frozen Plasma (FFP) per unit Rs. 400/-

3. BLDBNK-03 Platelet Poor Plasma (PPP) per unit Rs. 400/-

4. BLDBNK-04 Platelet Concentrate or Cryoprecipitate per unit Rs. 400/-

5. BLDBNK-05 Whole unit with full processing charge without

replacement’

Rs. 850/-

6. BLDBNK-06 Disabled 0/-

7. BLDBNK-07 Transfer Bag Charges (Each Bag) Rs. 50/-

…

3 8. BLDBNK-08 Blood Grouping (Per Case) Rs. 20/-

9. BLDBNK-09 Cell Separator Charges Rs. 8000/-

10. BLDBNK-10 HbA1C (Glycoselated Hemoglobin) for Diabetes

Mellitus

Rs. 250/-

11. BLDBNK-11 Thalassaemia Screen for Thalassemia Rs. 700/-



(4) BIO-CHEMISTRY DEPARTMENT : Disabled

As per decision of RFTS Committee in meeting held on 04.02.2015

(5) CARDIOLOGY DEPARTMENT


PROCEDURES

CHARGES

1. CARDIO-01 Computerised Treadmill Rs. 400/-

2. CARDIO-02 Echo Cardiography Rs. 400/-

3. CARDIO-03 Holter Monitoring Test Rs. 600/-

4. CARDIO-04 Vectro Cardiography Rs. 200/-

5. CARDIO-05 E.C.G. Rs. 100/-

6. CARDIO-06 CCU Maintenance Charges Rs. 500/- per day

7. CARDIO-07 Temporary Pacing Rs. 500/-

8. CARDIO-08 Permanent Pacemaker Implantation (for single chamber) Rs. 5,000/-

9. CARDIO-09 Permanent Pacemaker Implantation (for dual chamber) Rs. 5,000/-

10. CARDIO-10 Transoesophageal ECHO

(To be acquired in near future)

Rs. 1,500/-

11. CARDIO-11 Coloured 2D ECHO Colour Doppler (Screening

only)

Rs. 250/-

12. CARDIO-12 Signal Averaged ECG Rs. 600/-

13. CARDIO-13 Coloured 2D ECHO Colour Doppler Rs. 500/-

14. CARDIO-14 Coronary Angiograph Rs. 1000/-

15. CARDIO-15 Angioplasty Rs. 5000/-

16. CARDIO-16 Report of Agniography in C.D. Rs. 100 per case

17. CARDIO-17

Rs. 1000/-

18. CARDIO-18

Rs. 1000/

19. CARDIO-19 Rs. 1000/

20. CARDIO-20 Rs. 1000/

21. CARDIO-21

Rs. 1000/

22. CARDIO-22 Rs. 1000/

23. CARDIO-23 Rs. 3000/-

24. CARDIO-24

Rs. 1000/-

25. CARDIO-25 Rs. 3000/-

26. CARDIO-26

Rs. 5000/-

27. CARDIO-27 Cost of Consumables required in Cardiac Cath Lab. As decided



…

4 (6) CARDIOTHORACIC SURGERY DEPARTMENT


PROCEDURES

CHARGES

1. CDTHSG-01 O.T. Equipment & Room Maintenance Charges

(Minor Operation)

Rs. 100/-

2. CDTHSG-02 OT Equipment and Room Maintenance Charges

(Moderate Operation)

Rs. 500/-

3. CDTHSG-03 OT Equipment and Room Maintenance Charges

(Major Operation)

Rs. 3,000/-

4. CDTHSG-04 Open Heart Surgery Rs. 9,000/-

(Out of Rs. 12,000/-

total charges on

Procedure, Rs.3,000/-

goes to ANESTH-07)

5. CDTHSG-05 2D, 3D Trans Esophageal Echo Cardiography Rs. 1500/-

6. CDTHSG-06 O.T. Equipment & Room Maintenance (Minor


Rs. 200/-

7. CDTHSG-07 Fiberoptic Bronchoscopy & Procedures Rs. 1000/- per case

8. CDTHSG-08 Cost of Consumables required in Cardiac Cath

Lab.

As decided



(7) CLINICAL PATHOLOGY (CENTRE FOR CLINICAL INVESTIGATION)

S.No. Code Praticular Charges (Rs.)

1. CPTHMM-01 Haematological Profile with Histogram

(C.B.C.)

150/-

2. CPTHMM-02 Blood for Reticulocyte 150/-

3. CPTHMM-03 Blood for ESR 25/-

4. CPTHMM-04 Para Check (Strip test) 200/-

5. CPTHMM-05 Dengue Test (Strip test) 500/-

6. CPTHMM-06 Prothrombin time with INR 200/-

7. CPTHMM-07 APTT 250/-

8. CPTHMM-08 Factor VIII assay 500/-

9. CPTHMM-09 Factor IX assay 500/-

10. CPTHMM-10 Plasma Fibrinogen 500/-

11. CPTHMM-11 D-dimer 600/-

12. CPTHMM-12 Protein-C 1500/-

13. CPTHMM-13 Protein-S 1500/-

14. CPTHMM-14 Lupus Anticoagulant 500/-

15. CPTHMM-15 Homocystein 1500/-

16. CPTHMM-16 Haptoglobin 1500/-

17. CPTHMM-17 Blood Glucose Fasting 20/-

18. CPTHMM-18 Blood Glucose PP 20/-

19. CPTHMM-19 Blood Glucose Random 20/-

20. CPTHMM-20 Blood Sugar GTT 80/-

21. CPTHMM-21 Blood Sugar GCT 20/-

22. CPTHMM-22 HbA1c 250/-

…

5 23. CPTHMM-23 Seminogram/Semen analysis 50/-

24. CPTHMM-24

CSF Examination for Cell count, Glucose and

Protein 50/-

25. CPTHMM-25 Serous Fluid Routine & Microscopic 50/-

26. CPTHMM-26 Serum Creatinine 40/-

27. CPTHMM-27 Serum Electrolytes (Na, K & Cl) 100/-

28. CPTHMM-28 Blood Urea 30/-

29. CPTHMM-29 RENAL FUNCTION TEST (RFT) 170/-

30. CPTHMM-30 Serum Cystatin C 1500/-

31. CPTHMM-31 Serum SGOT 40/-

32. CPTHMM-32 Serum SGPT 40/-

33. CPTHMM-33 Serum Alkaline Phosphatase 50/-

34. CPTHMM-34 Total Bilirubin (Direct & Indirect) 50/-

35. CPTHMM-35 Serum Protein/Albumin 30/-

36. CPTHMM-36 LIVER FUNCTION TEST (LFT) 200/-

37. CPTHMM-37 Serum Amylase 150/-

38. CPTHMM-38 Fluid Amylase 150/-

39. CPTHMM-39 Serum Lipase 150/-

40. CPTHMM-40 Fluid Lipase 150/-

41. CPTHMM-41 Serum Gama G.T. 100/-

42. CPTHMM-42 Serum LDH 100/-

43. CPTHMM-43 Fluid LDH 100/-

44. CPTHMM-44 Serum CPK 150/-

45. CPTHMM-45 Serum CPK-MB 200/-

46. CPTHMM-46 Serum Cholesterol 40/-

47. CPTHMM-47 Triglyceride 50/-

48. CPTHMM-48 Lipid Profile 300/-

49. CPTHMM-49 Serum Calcium 20/-

50. CPTHMM-50 Serum Phosphorous 20/-

51. CPTHMM-51 Serum Uric Acid 50/-

52. CPTHMM-52 Serum Iron 100/-

53. CPTHMM-53 Serum for TIBC 200/-

54. CPTHMM-54 Serum Ferritin 600/-

55. CPTHMM-55 Serum Iron Profile 900/-

56. CPTHMM-56 Acid Phosphatase Prostatic Fraction 100/-

57. CPTHMM-57 Urine for Routine & Microscopy (10

paramerer) 80/-

58. CPTHMM-58 Urine Creatinine 40/-

59. CPTHMM-59 Urinary Electrolyte Na, K & Cl 100/-

60. CPTHMM-60 Urine Urea 30/-

61. CPTHMM-61 24 Hrs. Urinary Calcium 20/-

62. CPTHMM-62 24 Hrs. Urinary Protein 20/-

63. CPTHMM-63 Urine Phosphorous 20/-

64. CPTHMM-64 Urine Uric Acid 50/-

65. CPTHMM-65 Urine Microalbumin 250/-

66. CPTHMM-66 Stool for Occult Blood 50/-

67. CPTHMM-67 ABG 80/-

68. CPTHMM-68

ABG-plus test (with additional parameter

including lactates 120/- per test

69. CPTHMM-69 Hb electrophoresis 700/-

…

6 70. CPTHMM-70 Typhoid Test (Strip Test) 200/-

71. CPTHMM-71 Chickengunia (Strip Test) 500/-



(8) DENTAL SURGERY DEPARTMENT


PROCEDURES

CHARGES

1. DENTSG-01 O.T. Equipment & Room Maintenance Charges

(Minor Operation)

Rs. 100/-

2. DENTSG-02 O.T. Equipment & Room Maintenance Charges

(Major Operation)

Rs. 500/-

3. DENTSG-03 Crown & Bridge Works

(Including Composite Testoration & Inlays)

Rs. 300/-

4. DENTSG-04 Complete Dentures Rs. 500/-

5. DENTSG-05 Root Canal Treatment Rs. 600/-

6. DENTSG-06 Maxillo-Facial Prosthesis Rs. 500/-

7. DENTSG-07 Dental X-Ray Film & Processing Material (per

film)

Rs. 60/-

8. DENTSG-08 OPG X-Ray / Cephalmetric (per film) Rs.300/-

9. DENTSG-09 Occlusal X-Ray (per film) Rs.100/-

10. DENTSG-10 Fixed Orthodontics Rs.2000/-

11. DENTSG-11 Ceramic Crown Rs. 500/-

12. DENTSG-12 O.T. Equipment & Room Maintenance (Minor


Rs. 200/-

13. DENTSG-13 Histopathology Examination Small Tissue Rs. 200/-

14. DENTSG-14 FNAC Examination Rs.150/-

15. DENTSG-15 Fibre Optic Branchoscopy Rs. 100/-

16. DENTSG-16 Anaesthesia Maintenance Charge Rs. 500/-

17. DENTSG-17 Major Maxillofacial Operation charge Rs. 1000/-

18. DENTSG-18 Implant Surgery per Implant Rs. 500/-

19. DENTSG-19 Metal Crown Rs. 300/-



(9) DERMATOLOGY & VENEREOLOGY DEPARTMENT


PROCEDURES

CHARGES (Rs.)

1- DERVEN-01 Scraping & KOH mount 10/-

2- DERVEN-02 Smear & Staining 10/-

3- DERVEN-03 Hanging Drop preparation 10/-

4- DERVEN-04 Tzanck test 10/-

5- DERVEN-05 Urine for Sugar Protein & Microscopy 30/-

6- DERVEN-06 Blood for TC / DC 20/-

7- DERVEN-07 Blood for Hb% 15/-

8- DERVEN-08 Blood for ESR 10/-

9- DERVEN-09 SGOT 40/-

…

7 10- DERVEN-10 SGPT 40/-

11- DERVEN-11 Culture for fungus 150/-

12- DERVEN-12 Culture for gonococcus 50/-

13- DERVEN-13 Patch Test 200/-

14- DERVEN-14 Chemical Cautery 100/-

15- DERVEN-15 Electro Cautery 200/-

16- DERVEN-16 Intralesional Therapy 100/-

17- DERVEN-17 Iontophoresis 200/-

18- DERVEN-18 Skin biopsy 200/-

19- DERVEN-19 Electrolysis 10/-

20- DERVEN-20 Cryosurgery 10/-

21- DERVEN-21 Punch Grafting/Chemical

peeling/Microdermabrasion

10/-

22- DERVEN-22 Q-Swithched ND-Yag Laser/Intense

Pulsed Light for hair removal

(3 cm x 3 cm per sitting)

PUVA and NBUVB (per 10 sitting)

600/-

23- DERVEN-23 TANEM 1200 per sitting

24- DERVEN-24 PRP (Platelet rich plasma for hair

loss)

2000/- per sitting

25- DERVEN-25 Chemical peeling Laser NDY AG/IPL 500/- per sitting

26- DERVEN-26 Diode Laser 750/-(small area) per

sitting

1000/- (Large area) per

sitting

27- DERVEN-27 Punch Grafting/Blister Grafting 800/- per sitting

28- DERVEN-28 Hair Transplantion 8000/-



(10) ENDORCRINOLOGY DEPARTMENT

Sl. No. Code no. Name of investigations/ procedures Charges 1. ENDCRI-01 Thyroid Hormone

T3, T4, TSH Rs. 400/-

2. ENDCRI-02 TSH Rs. 200/-

3. ENDCRI-03 Gonadal Hormone Test LH, FSH, Testosterone

Rs. 600/-

4 ENDCRI-04 LH, FSH, Prolactin Rs. 600/- 5 ENDCRI-05 Bone Density Measurement by DEXA-Single Site Rs. 500/- 6 ENDCRI-06 Bone Density Measurement by DEXA-Double

Site/whole body Rs. 700/-

7 ENDCRI-07 HbA1c test Rs. 250/- 8 ENDCRI-08 Cortisol Plasma Rs. 400/- 9 ENDCRI-09 Thyroid Anti Microsomal AMA (Anti TPO

Antibody) Rs. 300/-

10 ENDCRI-10 Serum iPTH Rs. 400/- 11 ENDCRI-11 GH Rs. 200/- 12 ENDCRI-12 25 OH Vitamin D Rs. 500/-

13 ENDCRI-13 Insulin Rs. 200/- 14 ENDCRI-14 17 OH Progesterone Rs. 500/-

…

8 15 ENDCRI-15 HDU charges (per day) Rs. 200/- 16 ENDCRI-16 AMH Rs. 700/- 17 ENDCRI-17 LH Rs. 200/- 18 ENDCRI-18 FSH Rs. 200/- 19 ENDCRI-19 Prolactin Rs. 200/- 20 ENDCRI-20 Testosterone Rs. 200/- 21 ENDCRI-21 Anti GAD antibody 65

Rs. 700/-

22 ENDCRI-22 IGFI Rs. 700/-



(11) GENERAL MEDICINE DEPARTMENT


PROCEDURES

CHARGES

1. GENLMD-01 Lumber Puncture Rs. 100/-

2. GENLMD-02 Ascitic Tap Rs. 100/-

3. GENLMD-03 Pericardial Tap Rs. 100/-

4. GENLMD-04 Pleural Tap Rs. 100/-

5. GENLMD-05 Bone Marrow Aspiration Rs. 100/-

6. GENLMD-06 Splenic Aspiration Rs. 100/-

7. GENLMD-07 Tissue Aspiration Rs. 100/-

8. GENLMD-08 Other Minor Surgical procedures Rs. 100/-

9. GENLMD-09 Renal Biopsy Rs. 100/-

10. GENLMD-10 Liver Biopsy Rs. 100/-

11. GENLMD-11 Bone Marrow Biopsy Rs. 100/-

12. GENLMD-12 Pleural Biopsy Rs. 100/-

13. GENLMD-13 ECG Charges Rs. 100/-

14. GENLMD-14

Daily Charges for patients in Intermediate

Care Unit

Rs. 200/-

(per day)

15. GENLMD-15 Acute Care Unit Admission Rs. 500/- per day

per patient



(12) GENERAL SURGERY DEPARTMENT


PROCEDURES

CHARGES

1. GENLSG-01 O.T. Equipment & Room Maintenance

Charges (Minor Operation)

Rs. 100/-

2. GENLSG-02 O.T. Equipment & Room Maintenance

Charges (Major Operation)

Rs. 500/-

3. GENLSG-03 Laparaoscopy Rs. 1000/-

4. GENLSG-04 Endoscopy (Upper GI/Lower

GI/Choledochoscope/ Sigmoidoscope)

Rs. 300/-

5. GENLSG-05 Anal Manometry Rs. 200/-

6. GENLSG-06 IRC Rs. 200/-

7. GENLSG-07 Ultrasound Rs. 200/-

8. GENLSG-08 Supra Major Operation Charge Rs. 1000/-

…

9 9. GENLSG-09 O.T. Equipment & Room Maintenance

(Minor Operations performed in

Operation Theatres)

Rs. 200/-

10. GENLSG-10 RFA for varicose veins Rs. 10000/- per case



(13) GASTROENTEROLOGY DEPARTMENT

Sl. No. Code No. Procedure/ Investigation being performed at

present

Approved

Charges

(Rs.)

1. Gastro-01 UGI Endoscopy 400/-

2. Gastro-02 Left sided Colonoscopy 400/-

3. Gastro-03 Full length Colonoscopy 700/-

4. Gastro-04 Endoscopy Sclerotherapy binding (upto two

procedure in a year)

600/-

5. Gastro-05 Therapeutic Biliary Duct Endoscopy 1500/-

6. Gastro-06 Sigmoidoscopy 150/-

7. Gastro-07 Therapeutic Endoscopy (Repeated Sessions upto

one year)

1000/-

8. Gastro-08 USG Guided FNAC 200/-

9. Gastro-09 Esophageal Manometry 2500/-

10. Gastro-10 pH Manometry 2500/-

11. Gastro-11 Enterosocpy 3000/-

12. Gastro-12 Endoscopic Ultrasound 2000/-

13. Gastro-13 Charges for maintenance of computerized

equipment for retrieving and analyzing data and

generating reports in relation to Capsule Endoscopy

1500/-

14. Gastro-14 Lab. charges for HBV DNA test 500/-

15. Gastro-15 Anti HEV IgM 300/-

16. Gastro-16 Anti HBe 300/-

17. Gastro-17 Anti HAV IgM 300/-

18. Gastro-18 Anti HBc IgM 300/-

19. Gastro-19 HBs Ag 200/-

20. Gastro-20 HBe Ag 200/-

21. Gastro-21 Anti HCV IgM 200/-

22. Gastro-22 D-Xylose 200/-

23. Gastro-23 Sudan-III 200/-

24. Gastro-24 Alfa Fetoprotein 300/-

25. Gastro-25 ANA (Anti Nuclear Antibody ) 300/-

26. Gastro-26 AMA (Anti Mitochondrial Antibody) 300/-

27. Gastro-27 ASMA (Anti Smooth Muscle Antibody) 300/-

28. Gastro-28 TTG (Tissue Transgulatamase) Antibody 300/-

29. Gastro-29 AGA (Anti Gliadin Antibody) 300/-

30. Gastro-30 Hydated Disease Serology 300/-

31. Gastro-51 Achalasia Dilatation 1500/-

32. Gastro-52 Bile Duct Stent Placement 3500/-

33. Gastro-53 Cyoacrylate gluing 3500/-

34. Gastro-54 Endoscopic sphincterotomy with common bile 3000/-

…

10 duct stone extraction

35. Gastro-55 Endoscopic Band Ligation 1500/-

36. Gastro-56 Endoscopic Cystogrostomy 2500/-

37. Gastro-57 Enteral Stent Placement 4000/-

38. Gastro-58 Feeding Gastrostomy 2500/-

39. Gastro-59 Foreignbody extraction 1500/-

40. Gastro-60 Polypectomy 1500/-

41. Gastro-61 Sphincterotomy 2000/-

42. Gastro-62 Capsule endoscopy (Capsule cost) 25000/-

43. Gastro-63 Kit cost of HBV DNA quantification 2500/- The charges from code No.01 to 30 are 60% departmental share and 51 to 63 are 100% departmental share as these are actual cost accessories and kits.



(14) IMMUNODIAGNOSTIC TRAINING & RESEARCH CENTRE

S.No. CODE NO. NAME OF INVESTIGATIONS / PROCEDURES Charges

1. IDTGRC-01 Rheumatoid Factor Rs. 50/-

2. IDTGRC-02 C-Reactive Proteins Rs. 50/-

3. IDTGRC-03 ASO Test Rs. 50/-

4. IDTGRC-04 Hepatitis-B Surface Antigen (HBsAg) Rs. 50/-

5. IDTGRC-05 Bence Jones Protein in Urine Rs. 50/-

6. IDTGRC-06 L.E. Cell Phenomenon Rs. 50/-

7. IDTGRC-07 RA Titre Rs. 250/-

8. IDTGRC-08 ANA Ab Rs. 300/-

9. IDTGRC-09 CRP Titre Rs. 250/-

10. IDTGRC-10 Collagen disease profile (As package that includes test,

i.e. Rheumatoid Factor, LE Cell Phenomenon, ANA &

Anti DNA Antibody)

Rs. 600/-

11. IDTGRC-11 Serum Immunoglobulin IgG Rs. 200/-

12. IDTGRC-12 Serum IgA Rs. 200/-

13. IDTGRC-13 Serum IgM Rs. 200/-

14. IDTGRC-14 Serum IgE Rs. 250/-

15. IDTGRC-15 Immunophenotyping of Lymphocyte Rs. 800/-

16. IDTGRC-16 HLA B 27 Typing Rs. 900/-

17. IDTGRC-17 DR & DQ Typing by PCR in diagnosis of autoimmune

diseases

Rs. 6,000/-

18. IDTGRC-18 Cross Matching for Renal Transplant Cases Rs. 1000/-

19. IDTGRC-19 Anti Thyroglobulin Antibody Rs. 250/-

20. IDTGRC-20 Anti Thyroidmicorsomal Antibody Rs. 250/-

21. IDTGRC-21 ß2 Glycoprotein Rs. 350/-

22. IDTGRC-22 Kappa Light Chain Test Rs. 300/-

23. IDTGRC-23 Cytokines (interleukin) test Rs. 500/-

24. IDTGRC-24 Anti SSA Ab Rs. 450/-

25. IDTGRC-25 MCD Panel (Anti SSA Ab+ anti SSB Ab+ anti Sm

Ab+ anti RNP Ab+ anti centromere Ab+ anti

Scleroderma-70 Ab-anti Jo-1 Ab)

Rs. 1000/- (for

all test in

combination)

26. IDTGRC-26 Myeloma Profile Rs. 250/-

…

11 27. IDTGRC-27 Anti GBM + MPO Rs. 600/-

28. IDTGRC-28 CSF Elctrophoresis Rs. 250/-

29. IDTGRC-29 ASO Titre Rs. 250/-

30. IDTGRC-30 Auto Immune-hepatitis Profile (anti mitochondrial Ab.

Anti LKM Ab, anti smooth muscle Ab, LCI, SLA.

ANA.)

Rs. 600/-

31. IDTGRC-31 Anti Neutrophil cytoplasmic Ab (ANCA) (C-ANCA or

PANCA)

Rs. 600/-

32. IDTGRC-33 Tumour Markers – Alpha Feto Protein (AFP) Rs. 250/-

33. IDTGRC-34 Prostate Specific Antigen (PSA) Rs. 200/-

34. IDTGRC-35 βHCG Rs. 250/-

35. IDTGRC-36 Carcinoembryonic Antigen (CEA) Rs. 250/-

36. IDTGRC-37 Tumour Markers CA-125 Rs. 350/-

37. IDTGRC-38 Complement Profile : C3 & C4 Rs. 400/-

38. IDTGRC-39 Panel Reactive Antibody Rs. 4000/-

39. IDTGRC-40 Complete HLA typing by molecular method (low

resolution class I & class II)

Rs. 12000/-

36. IDTGRC-41 Anti Sm Ab Rs. 450/-

37. IDTGRC-42 Anti RNP Ab Rs. 450/-

38. IDTGRC-43 Anti Centromere Ab Rs. 450/-

39. IDTGRC-44 Anti Scleroderma ‘70’ Ab Rs. 450/-

40. IDTGRC-45 Anti Jo-1 Ab Rs. 450/-

41. IDTGRC-46 Anti mitochondrial Ab Rs. 450/-

42. IDTGRC-47 Anti smooth muscle Ab Rs. 450/-

43. IDTGRC-48 Anti LKM Ab Rs. 450/-

44. IDTGRC-49 Auto antibodies test (other than above) Rs. 450/-

45. IDTGRC-50 Anti Gliadin IgA Rs. 450/-

46. IDTGRC-51 Anti CCP 2 Ab Rs. 450/-

47. IDTGRC-52 Lambda Light Chain Test Rs. 600/-

48. IDTGRC-53 Serum ceruloplasmius Rs. 600/-

49. IDTGRC-54 ß2 microglobuline Rs. 600/-

50. IDTGRC-55 Immunofluorescent test of renal biopsies Rs. 600/-

51. IDTGRC-56 Skin biopsy Rs. 600/-

52. IDTGRC-57 VMA Rs. 600/-

53. IDTGRC-58 Immunophenotyping of Leukemia Rs. 6000/-

54. IDTGRC-59 ds DNA antibody Rs. 300/-

55. IDTGRC-60 Anti cardiolipin Ab IgG (Anti Phospholipid Ab) Rs. 350/-

56. IDTGRC-61 Anti TTG Ig A Rs. 450/-

57. IDTGRC-62 EBV IgM Rs. 450/-

58. IDTGRC-63 ASCA IgA Rs. 450/-

59. IDTGRC-64 Anti Intrinsic factor Ab Rs. 450/-

60. IDTGRC-66 Anti Parietal cell Ab Rs. 450/-

61. IDTGRC-67 Anti Aspergillous Ab Rs. 450/-

62. IDTGRC-68 Anti HAV IgM Rs. 250/-

63. IDTGRC-69 Anti HEV IgM Rs. 250/-

64. IDTGRC-70 Anti HCV Rs. 250/-

65. IDTGRC-71 Tumour Markers CA-19.9 Rs. 350/-

66. IDTGRC-72 Tumour Markers CA-242 Rs. 350/-

67. IDTGRC-73 Chromogranin Ab Rs. 1400/-

68. IDTGRC-74 Aquaporin-4 Ab Rs. 1400/-

69. IDTGRC-75 Anti Cardiolipin Ab IgM Rs. 350/-

…

12



(15) MICROBIOLOGY DEPARTMENT

S.No. CODE NO. NAME OF INVESTIGATIONS / PROCEDURES CHARGES

1. MICBIO - 01 STAINED SMEAR STUDY GRAM STAINING 30.00

2. MICBIO - 02 STAINED SMEAR STUDY FOR AFB Free

3. MICBIO - 03 STAINED SMEAR STUDY FOR DIPHTHERIA 30.00

4. MICBIO - 04 BLOOD FOR MP 30.00

5. MICBIO - 05 BLOOD FOR MF 30.00

6. MICBIO - 06 BLOOD FOR VDRL 60.00

7. MICBIO - 07 BLOOD FOR ALDEHYDE 30.00

8. MICBIO - 08 STOOL FOR MICROSCOPY (OVA/CYST) 40.00

9. MICBIO - 09 BLOOD FOR WIDAL TEST 70.00

10. MICBIO - 10 DEC PROVOCATION TEST FR MF 50.00

11. MICBIO - 11 CULTURE & SENSIVITY 200.00

12. MICBIO - 12 BLOOD CULTURE 200.00

13. MICBIO - 13 CASONI TEST 50.00

14. MICBIO - 14 TPHA TEST FOR SYPHILIS 80.00

15. MICBIO - 15 BRUCELL AGLUTINATION TEST 70.00

16. MICBIO - 16 PAUL BINNEL TEST 50.00

17. MICBIO - 17 CULTURE FOR Tb. BACILLI Free

18. MICBIO - 18 CULTURE FOR ANAEROBES 200.00

19. MICBIO - 19 CULTURE FOR FUNGUS 200.00

ELISA Based Tests :

20. MICBIO - 20 ELISA-I FOR TOXOPLASMOSIS 350.00

21. MICBIO - 21 ELISA-I FOR RUBELLA 350.00

22. MICBIO - 22 ELISA-I FOR CYSTICERCOSIS 250.00

23. MICBIO - 23 ELSIA-I FOR HERPES SIMPLEX 350.00

24. MICBIO - 24 ELISA-I FOR AMOEBIASIS 250.00

25. MICBIO - 25 ELISA-I FOR LEISHMANIS 250.00

26. MICBIO - 26 ELISA-I FOR CMV 350.00

27. MICBIO - 27 ELISA-I FOR ANTISPERM-ANTIBODY 250.00

28. MICBIO - 28 ……..

29. MICBIO - 29 ……

30. MICBIO - 30 TORCH PANNEL 1000.00

PCR Based Tests :

31. MICBIO - 31 PCR FOR TUBERCULOSIS 1000.00

32. MICBIO - 32 PCR FOR TYPHOID 1000.00

33. MICBIO - 33 TYPHIDOT FOR TYPHOID FEVER 500.00

34. MICBIO- 34 Gomori methenamine Silver (GSM) 100 Sp.

Staining

35. MICBIO- 35 Cryptococcal Ag test 400.00

36. MICBIO- 36 HIV test Free

37. MICBIO- 37 TB/DST test Molecular Free

38. MICBIO- 38 Automated blood culture 650.00

39. MICBIO-39 Modified Acid fast stain 100.00

40. MICBIO-40 Galactomannan assay 500.00

41. MICBIO-41 Mannan assay 300.00

42. MICBIO-42 Leptospirosis Igm ELISA 300.00

…

13 43. MICBIO-43 Chikungunya IgM Free

44. MICBIO-44 JE IgM Free

45. MICBIO-45 Dengue IgM Free

46. MICBIO-46 Measles IgM 300.00

47. MICBIO-47 Measles IgG 300.00

48. MICBIO-48 Stool R/m for Opportunistic Coccidean Parasites 250.00

49. MICBIO-49 Anti Measles antibody titre (with serum and CSF) 1000.00



(16) NEUROLOGY DEPARTMENT


1. NEROMD-01 EEG Rs. 300/-

2. NEROMD-02 Video EEG Rs. 300/-

3. NEROMD-03 NCV Rs. 600/-

4. NEROMD-04 EMG Rs. 600/-

Above charges revised on 07.09.2015- HMC)



(17) NEUROSURGERY DEPARTMENT


1. NEROSG-01 O.T. Equipment & Room Maintenance


Rs. 100/-



Rs. 500/-


Charges (Specialised Surgical Procedure)

Rs. 1,000/-

4. NEROSG-04 C-Arm Fluoroscopy Rs. 250/-

5. NEROSG-05 D.S.A. Rs. 750/-

6. NEROSG-06 Therapuetic Embolization i.e. Aneurysm,

AVMs & Vascular Tumours

Rs. 5000/-



Operation Theatres)

Rs. 200/-

8. NEROSG-08 Maintenance charge for C-Arm Image

Intensifier

Rs. 500/-

9. NEROSG-09 Plasma Sterilizer Rs. 500/-



(18) NEPHROLOGY DEPARTMENT


PROCEDURES

CHARGES

1. NEPHRO-01 Haemodialysis (with providing material

by the Nephrology Department)

Rs. 1,500/-

2. NEPHRO-02 Peritoneal Dialysis (with providing

material by the Nephrology Department)

Rs. 2,500/-

…

14 3. NEPHRO-03 Haemodialysis procedure or peritoneal

dialysis procedure or Renal Biopsy

Procedure (without providing material)

Rs. 450/-

4. NEPHRO-04 OT Equipment and Room Maintenance

Charges for Renal Transplantation

Rs. 3,000/- (Out of

Rs. 10,000/-

collected for the

said Procedure)

5. NEPHRO-05 CRRT Procedure / CAPD Procedure Rs. 500/-

6. NEPHRO-06 12 Hrs. Dialysis Rs.1,000/-

7. NEPHRO-07 24 Hrs. Dialysis Rs.2,000/-

8. NEPHRO-08 Haemodialysis Rs. 1120/- per

pateint

9. NEPHRO-09 Haemodialysis Rs. 280/- per

patient

10. NEPHRO-10 Double Lumen Curved/Straight Catheter

kit (Brand Mahurkar)

2000/-

11. NEPHRO-11 Single Lumen Femoral Catheter

(Medcomp) + Guide wire

(GTI/Needletech)

400/-

12. NEPHRO-12 Single use dialyzer Rs. 1600/-



(19) OBSTRETRICS & GYNAECOLOGY DEPARTMENT


PROCEDURES

CHARGES

1. OBSGYN-01 O.T. Equipment & Room Maintenance

Charges Minor Operation (D&C, MTP,

Vaginal Delivery, Forceps Delivery,

Ventuse Delivery)

Rs. 100/-


Charges Major Operation (Hysterectomy

Abdominal & Vaginal / Laparotomy,

Radical Hysterectomy & other Radical

Surgical Procedures)

Rs. 500/-

3. OBSGYN-03 Ultrasonography (Biophysical Score)

(USG + CTZ)/ Trans Vaginal Sonography

Rs. 200/-

4. OBSGYN-04 Ultrasonography

(Antenatal S.I. Max. 3) Antenatal Cardio

Tocography (SI Max.3)

Rs. 200/-

5. OBSGYN-05 USG guided Amnomicentesis/Chlorion

Villus Sampling

Rs. 200/-

6. OBSGYN-06 USG guided Interventional Procedures Rs. 200/-

7. OBSGYN-07 Hysteroscopic Operative procedures Rs. 500/-

8. OBSGYN-08 Colposcopy and Biopsy Rs. 100/-



Operation Theatres)

Rs. 200/-



…

15 (20) OPHTHALMOLOGY DEPARTMENT


PROCEDURES, ETC.

CHARGES

1. OPHTHL-01 OT Equipment & Room Maintenance


Rs. 100/-

2. OPHTHL-02 OT Equipment & Room Maintenance


Rs. 500/-

3. OPHTHL-03 Laser Procedure (per package) Rs. 500/-

4. OPHTHL-04 Intraocular Lense Implantation (Micro-

Procedure)

Rs. 200/-

5. OPHTHL-05 Ophthascon Ultrasound Rs. 200/-

6. OPHTHL-06 Fluoresce In Angiography (per eye) Rs. 100/-

7. OPHTHL-07 Fundus Photography Rs. 100/-

8. OPHTHL-08 Slit Lamp Photography Rs. 100/-

9. OPHTHL-09 Refraction Charges Rs. 30/-

10. OPHTHL-10 A-Scan Biometry Rs.200/-

11. OPHTHL-11 Automated Perimetry Rs.300/-

12. OPHTHL-12 Phacoemulsification Surgery Rs.1,000/-

13. OPHTHL-13 Vitrectomy Procedure Rs. 1000/- per patient

14. OPHTHL-14 Nd: YAG Laser Rs. 500/- for full

treatment

15. OPHTHL-15 Argon Green Laser 1000/- for full

treatment

16. OPHTHL-16 Digital Fundus Photography 500/- for both eyes

17. OPHTHL-17 O.C.T. Rs. 500/- per patient

18. OPHTHL-18 B-Scan Rs. 200/- per patient

19. OPHTHL-19 O.T. Equipment & Room Maintenance


Operation Theatres)

Rs. 200/-



(21) ORTHOPAEDICS DEPARTMENT

S.No. CODE NO. NAME OF INVESTIGATIONS/ PROCEDURES, ETC. CHARGES

1. ORTHOP-01 OT Equipment & Room Maintenance


Rs. 100/-

2. ORTHOP-02 OT Equipment & Room Maintenance


Rs. 500/-

3. ORTHOP-03 Traumatic (SWD/MWD) (Not in vogue) Rs. 10/-

(old rate)

4. ORTHOP-04 Microwave Diathermy / Shortwave

Diathermy/ Ultrasound Diathermy/ Muscle

Stimulator/ Wax Bath/ Cervical Traction/

Pelvic Traction.

Rs. 100/- for each

per set of 6 sittings

for one episode of

treatment for each

procedure

5. ORTHOP-05 Continuous Passive Motion (CPM)-Knee/

Continuous Passive Motion (CPM)-

Shoulder/ Inter ferrential Therapy (IFT)/

Transcutaneous nerve stimulation (TENS)/

Neurodevelopment Therapy (NDT)/

Sensory Integration (SI)

…

16 6. ORTHOP-06 Arthoscopy-Diagnostic Procedure/Major

Orthopedics Operation (nailing, platting,

external fixator, spinal decompression,

wiring etc.)

Rs. 1000/- each

7. ORTHOP-07 OT Equipment & Room Maintenance charges

(Minor Operation performed in Operation

Theatres)

Rs. 200/-

8. ORTHOP-11 Use of C-Arm Image Intensifier Rs. 250/-

9. ORTHOP-12 OT Equipment & Room Maintenance charges

for all Specialized Surgery including

Arthroscopy for Therapeutic Procedure

Rs. 2000/-

Code Nos. ORTHOP-8 to 10 have no existance.



(22) OTORHINOLARYNGOLOGY DEPARTMENT


1. OTRINO-01 Diagnostic procedure under local anaesthesis

eg. Nasal Endoscopy, Otomicroscopy,

Laryngoscopy, Lymphnode Biopsy and

Biopsy to establish Histopathological

Diagnosis

Rs. 100/-

2. OTRINO-02

Code Disable for further use --

3. OTRINO-03 All other surgical procedures Rs. 500/-

4. OTRINO-04 For puretone Audiometry/Free field

Audiometry Rs. 100/-

5. OTRINO-05 Impedance Audiometry & Colorimetry Rs. 100/-

6. OTRINO-06 Brain Stem Evoked Response Audiometry

(BERA) Rs. 500/-

7. OTRINO-07 O.T. Equipment & Room Maintenance


Operation Theatres)

Rs. 200/-



(23) PAEDIATRICS DEPARTMENT


1. PAEDIA-01 Phototherapy (Per Package) Rs. 200/-

2. PAEDIA-02 Peritoneal Dialysis (Per Dialysis) Rs. 750/-

3. PAEDIA-03 Paediatric Intensive Care Unit (PICU) and

Neonantal Intensive Care Unit (NICU)

Rs. 200/-

per day per patient

4. PAEDIA-04

(100% to Deptt.)

Arterial Blood Gas Analysis for PCO2,

PO2 & PH (per test)

Rs. 120/-

5. PAEDIA-05 Nebuliser (Per Package) Rs. 100/-

6. PAEDIA-06 Peritoneal Ped – dialysis procedure Rs. 450/-

7. PAEDIA-07 Phototherapy Rs. 100/-

8. PAEDIA-08 Chest tube drainage Rs. 125/-

9. PAEDIA-09 Exchange Transfusion Rs. 300/-

…

17 10. PAEDIA-10 Bone Marrow aspiration Rs. 100/-

11. PAEDIA-11 Peritoneal Tapping Rs. 100/-

12. PAEDIA-12 Pericardial tapping Rs. 100/-

13. PAEDIA-13 Biopsy (Muscle, Liver, Kidney) Rs.100/-

14. PAEDIA-14 Serum (Fe, TIBC, O.F. Fetal Hb) Rs. 100/-

15. PAEDIA-15 Bed Charges PICU cubical Rs. 200/-

16. PAEDIA-16 Paediatric Intensive Care Unit (PICU) and

Neonantal Intensive Care Unit (NICU) on

Ventilator

Rs. 500/- per day

per patient

17. PAEDIA-17 Bed charges for Pediatric Medicine Ward Rs 50/- per day per

patient

18. PAEDIA-18 Servoguard for Siemens Ventilator

(Model servo 300)

460/- per Pc.

19. PAEDIA-19 Green bacterial filter 260/-per Pc

20. PAEDIA-20 Disposable neonatal respiratory circuit 350/-per Pc.

21. PAEDIA-21 Disposable pediatric respiratory circuit 350/- per Pc.

22. PAEDIA-22 HME filter 150/- per Pc.

23. PAEDIA-23 CPAP Rs. 500/-

24. PAEDIA-23 Day Care Charge for Thalassemia Patient Rs. 100/-

25. PAEDIA-24 Hemoglobinopathies and Sickle cell

disease

Rs.700/-



(24) PAEDIATRIC SURGERY DEPARTMENT


1. PAEDSG-01 OT Equipment & Room Maintenance Charges

(Minor Operation)

Rs. 100/-


(Major Operation)

Rs. 500/-

3. PAEDSG-03 Incubator Charges per day Rs. 50/-

4. PAEDSG-04 Phototherapy Unit Charges Per Package Rs. 100/-

5. PAEDSG-05 Ventilator Charges per day Rs. 100/-

6. PAEDSG-06 Blood Gas Analyser Rs. 100/-

7. PAEDSG-07 Giendoscopy/Cystoscopy/Laparoscopy/

Bronchoscopy

Rs. 300/-

8. PAEDSG-08 Laparoscopic Surgery Rs. 500/-

9. PAEDSG-09

Central AC Maintenance Charges for Paediatric

Surgery Ward

Rs.50/- per day

10. PAEDSG-10

Central AC Maintenance Charges for Neonatal

and Paediatric Surgery ICU

Rs.100/- per day


(Specialised Operation)

Rs. 1000/-

12. PAEDSG-12 Additional OT Equipment & Room Maintenance

Charges for use of Harmonic Knife in any

Surgical Operation

Rs. 2000/-

13. PAEDSG-13 Patients admitted in the Paediatric Surgery

Department in the Special rooms of II Floor

Rs. 1000/- per

day per patient (100% will be

deposited in Hospital

Spl. Fund (Area

wise)

…

18 14. PAEDSG-14 O.T. Equipment & Room Maintenance (Minor


Rs. 200/-



(25) PLASTRIC SURGERY DEPARTMENT


PROCEDURES, ETC.

CHARGES

1. PLSTSG-01 OT Equipment & Room Maintenance Charges (Minor

Operation) Rs. 100/-

2. PLSTSG-02 OT Equipment & Room Maintenance Charges (Major

Operation) Rs. 500/-

3. PLSTSG-03 OT Equipment & Room Maintenance Charges

(Specialised Surgical Procedure) Rs. 1,000/-

4. PLSTSG-04 Bed Maintenance Charges in the Burn Unit having

AC facility, Burn Bath and Physiotherapy facility Rs. 100/-

Per day

5. PLSTSG-05 Intermittent Pneumatic Compression including

methods of Pressotherapy for the Lymphodema

patients

Rs 100/-

Per day

Introduced on 20.01.2012.



(26) PSYCHIATRY DEPARTMENT


PROCEDURES, ETC.

CHARGES

1. PSYCHI-01 E.E.G. Rs. 200/-

2. PSYCHI-02 E.C.T. Rs. 200/-

3. PSYCHI-03 Maintenance Charges for Bio-fee back

Equipment used in Phychotherapy

Rs. 100/-

4. PSYCHI-04 Maintenance Charges for Bio-fee back

Equipment used in Behaviour therapy

Rs. 100/-

5. PSYCHI-05 I. Q. Testing Rs. 100/-

6. PSYCHI-06 Full Cognitive function testing Rs. 200/-

7. PSYCHI-07 Serum Electrolytes Na, K, Cl. Rs. 60/-

8. PSYCHI-08 Serum Lithium & Electrolyte estimation

by automatic Electrolyte Analyzer

Rs. 200/- per sample

9. PSYCHI-09 Sleep Lab. investigation therapy Rs. 1000/- per sleep study

10. PSYCHI-10 Computerized Stress Profile Assessment Rs. 500/- per case

11. PSYCHI-11 E.C.G. Rs. 100/- per case



…

19 (27) PATHOLOGY DEPARTMENT


PROCEDURES, ETC.

CHARGES

1. PATHOG-01 Prothrombin Time Rs. 200/-

2. PATHOG-02 Complete Haemogram Rs. 250/-

3. PATHOG-03 Platelet Profile

BT

Aggregation

PF-3

Clot Retraction

Rs. 250/-

4. PATHOG-04 Bleeding Disorders/Coagulation Disorders Rs. 500/--

5. PATHOG-05 Cytology (Exfoliative cytology &FNAC) Rs. 150/-

6. PATHOG-06 Histo-Pathology Examination: Small

tissue.

Rs. 200/-

7. PATHOG-07 Frozen Section Facility Rs. 200/-

8. PATHOG-08 GBP Rs. 50/-

9. PATHOG-09 GBP + BM Rs. 150/-

10. PATHOG-10 Reticulocyte Count Rs. 100/-

11. PATHOG-11 Osmotic Fragility Rs. 100/-

12. PATHOG-12 G6PD Rs. 100/-

13. PATHOG-13 HbF Rs. 100/-

14. PATHOG-14 Sickling Test Rs. 100/-

15. PATHOG-15 Hb electrophoresis Rs. 250/-

16. PATHOG-16 Rh Antibody Titre Rs. 200/-

17. PATHOG-17 Panel for Breast Carcinoma Rs. 1200/- each

18. PATHOG-18 Individual Marker Rs. 500/- each

New Test added in Department of Pathology under Revolving Fund HAEMATOLOGY

LABORATORY:

1. Extended Coagulation profile : Rs. 1000/-

S.No. Code No. Name of Investigation Approved charges

1. PATHOG-19 Test for Factor XIII Assay Rs. 200/- per test

2. PATHOG-20 Test for Factor VIII Assay Rs. 500/-- per test

3. PATHOG-21 Test for Factor IX Assay Rs. 500/- per test

4. PATHOG-22 Other Factor Assays Rs. 200/- per test

5. PATHOG-23 Plasma Fibrinogen Rs. 500/- per test

Extended test for platelet functions: Platelet Aggregation studies Rs. 1000/-


1. PATHOG-24 ADP

Adreneline R

Collagen

Ristocetin

Rs. 500/- per test

2. PATHOG-25 Von Wille brand Antigen Rs. 500/- per test

3. Tests for Thrombophilia


1. PATHOG-26 D-dimer Rs. 600/-

…

20 2. PATHOG-27 APCR Rs. 1000/-

3. PATHOG-28 Protein-C Rs. 1500/-

4. PATHOG-29 Protein-S Rs. 1500/-

4. Coomb’s test


1. PATHOG-30 Direct Rs. 100/-

2. PATHOG-31 Indirect Rs. 100/-

5. Special Stains on demand (if possible) Rs. 200/-

Histopathology laboratory: Immunohistochemistry

S.No. Code No. Name of Investigation

1. PATHOG-32 Immuno Histo Chemistry (IHC) for each

marker (ER, PR, HER-2)

Rs.600/- for each marker

2. PATHOG-33 Histology: Large tissue or more than one

bottel

Rs. 400/-



(28) RADIOLOGY DEPARTMENT

S.No. CODE NO. NAME OF INVESTIGATIONS/ PROCEDURES,

ETC.

CHARGES

1. RADIOG-01 X-Ray Single Exposure Rs. 60/-

2. RADIOG-02 X-Ray Double Exposure Rs. 90/-

3. RADIOG-03 Barium Swallow/Barium Meal Examination

- Routine like Stomach, Duodenum, ICR

Region/ Barium Enema

Rs. 230/-

4. RADIOG-04 I.V.P. Myelography/Angiography Rs. 300/-

5. RADIOG-05 H.S.G./Sinogram/Cystogram/Urethrogram Rs. 200/-

6. RADIOG-06 Ultrasonography Rs. 200/-

7. RADIOG-07 Colour Doppler Rs. 400/-

8. RADIOG-08 CT Scan Head/Neck Out sourced

9. RADIOG-09 CT Scan Body Out sourced

10. RADIOG-10 ERCP Charges for X-Ray Rs. 200/-

11. RADIOG-11 MRI Charges Rs. 2200/-

12. RADIOG-12 MRI Investigation Contrast Dye Charges Rs. 800/-

13. RADIOG-13 Surcharge on X-Ray for Special ward Rs. 20/-

14. RADIOG-14 Mammography Rs. 600/-

15. RADIOG-15 Computed Radiography Single Exposure Rs. 100/-

16. RADIOG-16 Computed Radiography Double Exposure Rs. 150/-

17. RADIOG-17 MR Angio/MRCP/MR Spectroscopy Rs. 2200/- +

Rs. 500/-



…

21 (29) RADIOTHERAPY & RADIATION MEDICINE DEPARTMENT


PROCEDURES, ETC.

CHARGES

1 Code No. Treatment Charges on Telecobalt Unit Rupees

RTTECO-01 a. More than 10 fractions 10,000.00

RTTECO-02 b. Less than or equal to 10 fractions 5,000.00

RTTECO-03 c. Up to or Less than 3 fractions 5,000.00

d. Planning CT Scan Charges to be paid

directly by patient as per prevailing rates.

2 Treatment Charges on Linear Accelerator

a. Conventional Treatment

RTLARA-04 I Radical 20,000.00

RTLAPA-05 II. 4 to 10 fractions 5,000.00

RTLAPA-06 III. Up to 3 fractions 5,000.00

RTLA3D-07 b. 3-D Conformal Radiation therapy including

immobilization, computerized planning,

patient QA and verification.

Planning CT Scan Charges to be paid


20,000.00

RTLAIM-08 c. IMRT Package including immobilization,

computerized planning, patient QA and

verification.



20000.00

RTLABO-09 d. IMRT Boost less than or equal to 10

fractions including immobilization,

computerized planning, patient QA and

verification.



20,000.00

3. Brachytherapy

RTBRIC-10 Intracavitary Brachytherapy per fraction 5,000.00

RTBRIN-11 Interstitial implant 10000.00

4. Chemotherapy

RTCTBO-12 Bolus chemotherapy per day Free

RTCTIN-13 Infusional chemotherapy per day Free

RTBRIC-14 HDR complete treatment Intra Cavitry 10000.00



(30) SURGICAL ONCOLOGY DEPARTMENT


PROCEDURES, ETC.

CHARGES

1. ONCOSG-01 OT Equipment & Room Maintenance


Rs. 100/-

2. ONCOSG-02 OT Equipment & Room Maintenance


Rs. 500/-

3. ONCOSG-03 Endoscopy Rs. 300/-

…

22 4. ONCOSG-04 Laser Procedure Rs. 500/-

5. ONCOSG-05 Laser Rs.3,000/-

6. ONCOSG-06 Ultrasonic Dissector (Harmonic Scalpel) use Rs.3,000/-

7. ONCOSG-07 Mammography Test (in collaboration with

Department of Radio-Diagnosis, IMS, BHU.)

Rs. 1,000/-

8. ONCOSG-08 RFA/RFG 10000/-

Per patient

9. ONCOSG-09 Bronchoscopy Rs. 500/-

10. ONCOSG-10 USG (SonoSite) Rs. 200/-

11. ONCOSG-11 Doppler Rs. 400/-

12. ONCOSG-12 Intraoprative USG/Doppler Rs. 500/-

13. ONCOSG-13 Disabled 0.00#

14. ONCOSG-14 O.T. Equipment & Room Maintenance

(Minor Operations performed in Operation

Theatres)

Rs. 200/-

15. ONCOSG-15 Ligasture Rs. 3000/-

16. ONCOSG-16 Argon Rs. 2000/-

17. ONCOSG-17 Radical Cancer Surgery Rs. 5000/-

ONCOSG-18 Maintenance of HDU beds (9, 10, 11,12 &

20)

Rs. 100/-



(31) TB & CHEST DISEASES DEPARTMENT


PROCEDURES, ETC.

CHARGES (Rs.)

1- TBCHST-01 Pleural aspiration 200/- per patient

2- TBCHST-02 Broncho Pulmonary Procedure 1000/- per patient

3- TBCHST-03 Pulmonary Function Test 300/- per patient

4- TBCHST-04 Nebulizer Therapy 100/- per day

5- TBCHST-05 Pulse Oximetry 100/- per day

6- TBCHST-06 Fiber optic bronchoscopy 1000/-

7- TBCHST-07 USG guided pleural aspiration/biopsy 500/-

8- TBCHST-08 PFT+Diffusion Studies 1000/-

9- TBCHST-09 Polysomnography (for overnight study

i.e. 6 to 10 hrs.)

1500/-

10- TBCHST-10 High Dependency Unit 500/- per day per bed

11- TBCHST-11 12 Channel ECG 100/- per ECG

12- TBCHST-12 BIPAP (Per day) (Ventilator) 300/- per day

13- TBCHST-13 Thoracoscopy 2000/-



…

23 (32) UROLOGY DEPARTMENT


PROCEDURES, ETC.

CHARGES

1. UROLOG-01 OT Equipment & Room Maintenance

Charges

(Minor Operation)

Rs. 100/-

2. UROLOG-02 OT Equipment & Room Maintenance

Charges

(Major Operation)

Rs. 500/-

3. UROLOG-03 Cystoscopy/OLU/Urethroscopy Rs. 300/-

4. UROLOG-04 TURP Rs. 500/-

5. UROLOG-05 A.V. Fistula Rs. 300/-

6. UROLOG-06 Intra-Corporeal- Lithotripsy/Percutanous

Nephrolithotomy

Rs. 1,000/-

7. UROLOG-07 Lithotripsy (ESWL) Rs. 10,000/-

8. UROLOG-08 OT Equipment and Room Maintenance

Charges for Renal Transplantation

Rs. 6,000/-

(out of Rs. 10,000/-

for the entire

procedure)

9. UROLOG-09 ESWL for Residual Calculi Rs. 2000/-

10. UROLOG-10 Laser Lithotripsy Rs. 7500/-

11. UROLOG-11 Green Light Laser Prostatectomy Rs. 50000/-

12. UROLOG-12 RIRS/Holmium Laser

Lithotripsy/Holmium Lasr Stricturotomy

Rs. 10000/- for

each procedure

13. UROLOG-13 O.T. Equipment & Room Maintenance


Operation Theatres)

Rs. 200/-



(33) Charge of CT Scan at 64 Slice CT Scan Centre (PPP Model).

S.No. Proposed

Codes

Name of Investigation Exixting

charges

(Rs.)

1. CTSCAN-01 Head (Plain) 1150/-

2. CTSCAN-02 Head (Plain & Contract) 1150/-

3. CTSCAN-03 Brain-repeat within 7 days 500/-

4. CTSCAN-04 Facial Structures 1500/-

5. CTSCAN-05 Dentascan 1800/-

6. CTSCAN-06 PNS/Orbits 1400/-

7. CTSCAN-07 Nech/Larynx 2000/-

8. CTSCAN-08 Pitutary region/Temporal bone 1400/-

9. CTSCAN-09 Thorax (Chest) 2000/-

10. CTSCAN-10 Abdomen (Upper) 2000/-

11. CTSCAN-11 Abdomen (Lower) 2000/-

12. CTSCAN-12 Pelvis 2000/-

13. CTSCAN-13 Musculoskeletal 2000/-

14. CTSCAN-14 Joint (any one) 2000/-

15. CTSCAN-15 Spine (one region) 2000/-

…

24 16. CTSCAN-16 CT/Angiograpy 2500/-

17. CTSCAN-17 Virtual endoscopy 2000/-

18. CTSCAN-18 Perfusion Study 2800/-

19. CTSCAN-19 RT Planning/Color coding 1000/-

20. CTSCAN-20 Cardiac C.T. Scanning 6000/-

21. CTSCAN-21 Interventional procedures – Diagnostic 1200/-

22. CTSCAN-22 Interventional procedures –Therapeutic 1200/-

23. CTSCAN-23 Consumable Kit for Cardiac CT Scanning 3500/-

24. CTSCAN-24 Whole Abdomen 2500/-

25. CTSCAN-25 Head (Plain) Non Ionic Contrast 0

26. CTSCAN-26 Head (Plain & Contract) Non Ionic Contrast 350/-

27. CTSCAN-27 Brain-repeat within 7 days Non Ionic Contrast 350/-

28. CTSCAN-28 Facial Structures Non Ionic Contrast 500/-

29. CTSCAN-29 Dentascan Non Ionic Contrast 500/-

30. CTSCAN-30 PNS/Orbits Non Ionic Contrast 500/-

31. CTSCAN-31 Nech/Larynx Non Ionic Contrast 500/-

32. CTSCAN-32 Pitutary region/Temporal bone Non Ionic Contrast 350/-

33. CTSCAN-33 Thorax (Chest) Non Ionic Contrast 700/-

34. CTSCAN-34 Abdomen (Upper) Non Ionic Contrast 700/-

35. CTSCAN-35 Abdomen (Lower) Non Ionic Contrast 700/-

36. CTSCAN-36 Pelvis Non Ionic Contrast 500/-

37. CTSCAN-37 Musculoskeletal Non Ionic Contrast 350/-

38. CTSCAN-38 Joint (any one) Non Ionic Contrast 500/-

39. CTSCAN-39 Spine (one region) Non Ionic Contrast 1000/-

40. CTSCAN-40 CT/Angiograpy Non Ionic Contrast 1000/-

41. CTSCAN-41 Virtual endoscopy Non Ionic Contrast 1000/-

42. CTSCAN-42 Perfusion Study Non Ionic Contrast 1000/-

43. CTSCAN-43 RT Planning/Color coding Non Ionic Contrast 0

44. CTSCAN-44 Cardiac C.T. Scanning Non Ionic Contrast 3500/-

45. CTSCAN-45 Interventional procedures – Diagnostic Non Ionic Contrast 0

46. CTSCAN-46 Interventional procedures –Therapeutic Non Ionic Contrast 0

47. CTSCAN-47 Consumable Kit for Cardiac CT Scanning Non Ionic

Contrast

0

48. CTSCAN-48 Whole Abdomen Non Ionic Contrast 1000/-

…

25

(B) FACULTY OF AYURVEDA

(33) BASIC PRINCIPLES (SHARIR KRIYA UNIT) DEPARTMENT - DISABLED

As per decision of RFTS Committee in meeting held on 04.02.2015

(34) CLINICAL PATHOLOGY (FACULTY OF AYURVEDA)


PROCEDURES, ETC.

CHARGES

1. 1 CPTHAY-01 Hemoglobin % ***Rs/ 50/-

2. CPTHAY-03 Blood for ESR *Rs. 25/-

3. CPTHAY-04 Blood for GBP Rs. 50/-

4. CPTHAY-06 Blood for Reticulocyte Rs. 15/-

5. CPTHAY-08 Urine for Suga/, Acetone & Microscopy/Urine

for Urobilinogen, Bile Salts, Bile Pigments,

Ketone Bodies & Other.

Rs. 50/-

6. CPTHAY-09 Blood Glucose Random Rs. 20/-

7. CPTHAY-10 24 Hrs. Urinary Calcium /Protein Rs. 20/-

8. CPTHAY-11 Stool for Occult Blood Rs. 50/-

9. CPTHAY-12 Blood Glucose Fasting Rs. 20/- each

10. CPTHAY-13 Blood Glucose PP Rs. 20/-

11. CPTHAY-14 Blood Urea Rs. 30/-

12. CPTHAY-15 Serum Calcium Rs. 20/-

13. CPTHAY-16 Serum Phosphorous Rs. 20/-

14. CPTHAY-17 Seminogram Rs. 20/-

15. CPTHAY-18 Serum Cholesterol Rs. 40/-

16. CPTHAY-19 Serum Uric Acid Rs. 50/-

17. CPTHAY-20 Serum Creatinine Rs. 40/-

18. CPTHAY-21 Serum Amylase Rs. 40/-

19. CPTHAY-22 Serum Alkaline Phosphatase Rs. 50/-

20. CPTHAY-23 Conjugated & Unconjugated Bilirubin Rs. 50/-

21. CPTHAY-24 CSF Examination for Cell Count &

Biochemical

Rs. 50/-

22. CPTHAY-25 Serous Fluid Routine & Microscopic Rs. 20/-

23. CPTHAY-26 Serum Electrolytes Na, K, C1 Rs.100/-

24. CPTHAY-27 Serum Protein & Albumin Rs. 30/-

25. CPTHAY-28 Serum albumin Rs. 30/-

26. CPTHAY-29 Gama G.T. Rs. 100/-

27. CPTHAY-30 SGOT Rs. 40/-

28. CPTHAY-31 SGPT Rs. 40/-

29. CPTHAY-32 Acid Phosphatase Prostatic Fraction Rs. 100/-

30. CPTHAY-33 Serum Iron Rs. 100/-

31. CPTHAY-34 Serum for TIBC Rs. 200/-

32. CPTHAY-35 Haematological Profile with Histogram (CBC) *Rs. 150/-

33. CPTHAY-36 LDH Rs. 100/-

34. CPTHAY-37 CPK Rs. 150/-

35. CPTHAY-38 CPK-MB Rs. 200/-

36. CPTHAY-39 Liver Functions Test Rs. 200/-

…

26 37. CPTHAY-40 Lipid Profile Rs. 300/-

38. CPTHAY-41 Blood for MP Rs. 10/-

39. CPTHAY-42 Blood for MF Rs. 10/-

40. CPTHAY-43 Stool for Microscopy (Ova and Cyst) Rs. 10/-

41. CPTHAY-44 E.C.G. Rs. 30/-

42. CPTHAY-45 HBs Ag Rs. 50/-

43. CPTHAY-46 R A Factor Rs. 50/-

44. CPTHAY-47 ASO Titre Rs. 50/-

45. CPTHAY-48 CRP Rs. 50/-

46. CPTHAY-49 Paracheck (Combo for PV & PF) Rs. 200/-

47. CPTHAY-50 BT/CT **Rs. 20/- per case

48. CPTHAY-51 Un conjugated Bilirubin ***Rs. 50/-

49. CPTHAY-52 Renal Function Test (RFT) ***Rs 170/-



(35) KAYACHIKITSA (PANCHKAMA THERAPY UNIT) DEPARTMENT


PROCEDURES, ETC.

CHARGES

(Rs.)

1. KYCHAY-01 Full Panch Karma Treatment for 15 days 1000/-

2. KYCHAY-02 Pind Sweda for 7 days full therapy 1000/-

3. KYCHAY-03 Nadi Sweda for 7 days full therapy 250/-

4. KYCHAY-04 Medicated Steam Bath for 7 days full therapy 250/-

5. KYCHAY-05 Dry Heat Bath for 7 days full therapy 500/-

6. KYCHAY-06 Shirodhara for 7 days full therapy 500/-

7. KYCHAY-07 Vasti for 8 days full therapy 500/-

8. KYCHAY-08 Vamana /Virechan for15 days full therapy 500/-

9. KYCHAY-09 Awagahan for 7 days full therapy 1000/-

10. KYCHAY-10 Nasya karma for 7 days 250/-

11. KYCHAY-11 ECG 100/- per event

12. KYCHAY-12 Computerized Spirometry 300/- per event

13. KYCHAY-13 Sattvapariksha (Objecitve scale + GSR + AVRT)/

Sattvavajaya (Ayurvedic Psychotherapy) 25/- per event

14. KYCHAY-14 Jalaukavacharan 100/-

15. KYCHAY-15 Agni Karma 100/-



(36) KAYACHIKITSA (PANCHKAMA THERAPY UNIT) DEPARTMENT

(Outsourced through M/s Keral Ayurveda Ltd.)

Coeds and charges of Panchakarma for Kerala Ayurveda Ltd. SSH, B.H.U. Unit for one day:

S.No. Codes Name of Therapy

Approved rates

(Rs.)

1 KCHKAL01B1 Sync abhyangam (two therapist) 650.00

2 KCHKAL02B1 Najvara kizhi 650.00

…

27 S.No. Codes Name of Therapy Approved rates

(Rs.)

3 KCHKAL03B1 Pizhichil 650.00

4 KCHKAL04B1 Ksheera Vasthi 650.00

5 KCHKAL05B1 Choornaswedan 650.00

6 KCHKAL06B1 Patrapotal aswedan 650.00

7 KCHKAL07B1 Takradhara 650.00

8 KCHKAL08B1 Ksheerdhara 650.00

9 KCHKAL09B1 Udwarthnam 650.00

10 KCHKAL10B1 Dhanyamla dhara 650.00

11 KCHKAL11B1 Shirodhara 650.00

12 KCHKAL12B1 Shirovasthi 650.00

13 KCHKAL13B1 Kati vasthi 475.00

14 KCHKAL14B1 abhyangam (single therapist) 475.00

15 KCHKAL15B1 Raktamokshana 475.00

16 KCHKAL16B1 Avgaha swedam 475.00

17 KCHKAL17B1 Sneha vasthi 475.00

18 KCHKAL18B1 Mathra vasthy 475.00

19 KCHKAL19B1 Uttara vasthy 475.00

20 KCHKAL20B1 Upnaham 300.00

21 KCHKAL21B1 Lepam 300.00

22 KCHKAL22B1 Ksheeradhomam 300.00

23 KCHKAL23B1 Snehapanam 300.00

24 KCHKAL24B1 Tharpanam 300.00

25 KCHKAL25B1 Herbal steam bath 300.00

26 KCHKAL26B1 Virechanam 175.00

27 KCHKAL27B1 Nasyam 175.00

28 KCHKAL28B1 Pachu 175.00

29 KCHKAL29B1 Kshalanam 175.00

30 KCHKAL30B1 Vamanam 850.00

31 KCHKAL31B1 Kashaya vasthi 850.00

32 KCHKAL32B1 Vaitharana Vasthi 850.00

Medicine cost extra.

Coeds and charges of Panchakarma for Kerala Ayurveda Ltd. SSH, B.H.U. Unit for seven

days.

S.No. Codes Name of Therapy

Approved rates

(Rs.)

1. KCHKAL01B7 Sync abhyangam (two therapist) 4525.00

2. KCHKAL02B7 Najvara kizhi 4525.00

3. KCHKAL03B7 Pizhichil 4525.00

4. KCHKAL04B7 Ksheera Vasthi 4525.00

5. KCHKAL05B7 Choornaswedan 4525.00

6. KCHKAL06B7 Patrapotal aswedan 4525.00

7. KCHKAL07B7 Takradhara 4525.00

8. KCHKAL08B7 Ksheerdhara 4525.00

…

28

S.No. Codes Name of Therapy Approved rates

(Rs.)

9. KCHKAL09B7 Udwarthnam 4525.00

10. KCHKAL10B7 Dhanyamla dhara 4525.00

11. KCHKAL11B7 Shirodhara 4525.00

12. KCHKAL12B7 Shirovasthi 4525.00

13. KCHKAL13B7 Kati vasthi 3325.00

14. KCHKAL14B7 abhyangam (single therapist) 3325.00

15. KCHKAL15B7 Raktamokshana 3325.00

16. KCHKAL16B7 Avgaha swedam 3325.00

17. KCHKAL17B7 Sneha vasthi 3325.00

18. KCHKAL18B7 Mathra vasthy 3325.00

19. KCHKAL19B7 Uttara vasthy 3325.00

20. KCHKAL20B7 Upnaham 2050.00

21. KCHKAL21B7 Lepam 2050.00

22. KCHKAL22B7 Ksheeradhomam 2050.00

23. KCHKAL23B7 Snehapanam 2050.00

24. KCHKAL24B7 Tharpanam 2050.00

25. KCHKAL25B7 Herbal steam bath 2050.00

26. KCHKAL26B7 Virechanam 1200.00

27. KCHKAL27B7 Nasyam 1200.00

28. KCHKAL28B7 Pachu 1200.00

29. KCHKAL29B7 Kshalanam 1200.00

30. KCHKAL30B7 Vamanam 5688.00

31. KCHKAL31B7 Kashaya vasthi 5688.00

32. KCHKAL32B7 Vaitharana Vasthi 5688.00

Note : Medicine Cost Extra

(37) PRASUTITANTRA DEPARTMENT (KAUMARBHRITYA)


PROCEDURES, ETC.

CHARGES

1. PSKBAY-01 Phototherapy (per package) Rs. 100/-

2. PSKBAY-02 Nursery Care including incubator Care

Charges (per day)

Rs. 100/-

3. PSKBAY-03 Nebuliser (per package) Rs. 100/-



(38) SHALYA TANTRA DEPARTMENT


PROCEDURES, ETC.

CHARGES

1. SLSKAY-01 OT Equipment & Room Maintenance

Charges for Minor Operation

Rs. 100/-

…

29 2. SLSKAY-02 OT Equipment & Room Maintenance

Charges for Major Operation

Rs. 500/-

3. SLSKAY-03 Kshar Sutra (Each) Rs. 100/-

4. SLSKAY-04 Agni Karma Rs. 100/- per sitting

5. SLSKAY-05 Jalaukavacharan Rs. 100/- per sitting

6. SLSKAY-06 O.T. Equipment & Room Maintenance


Operation Theatres)

Rs. 200/-

7. SLSKAY-07 a Anal Manometery (16 Channel) 400/- (including all

accessories &

disposable)

8. SLSKAY-08 a Bio-feed Back (10 seating) 3000/- (including

all accessories &

disposables)

9. SLSKAY-09 a Video Colonoscopy 500/-

10. SLSKAY-10 a Sigmoidoscopy 100/-

11. SLSKAY-11 a 3D T.R.U.S. (Trans Rectal

Ultrasonography)

800/- (including all

accessories &

disposables)

12. SLSKAY-12a Cyctoscopy 500/-

13. SLSKAY-13 a Vranoupachar 20/-

14. SLSKAY-14 a Major Surgical Procedure 1000/-

15. SLSKAY-15 Urodynamic 500/-

16. SLSKAY-16 Uroflowmetry 100/-



(39) SHALAKYA TANTRA DEPARTMENT (EYE & ENT SECTION)


PROCEDURES, ETC.

CHARGES

1. SLSHAY-01 OT Equipment & Room Maintenance

charges for Minor Operation, Biometri &

Perimetri

Rs. 100/-

2. SLSHAY-02 OT Equipment & Room Maintenance

charges for Major Operation

Rs. 500/-

3. SLSHAY-03 Refraction charges Rs. 30/-

4. SLSHAY-04 Intraocular Lens Implantation

(Microprocedure)

Rs. 200/-

5. SLSHAY-05 O.T. Equipment & Room Maintenance


Operation Theatres)

Rs. 200/-



…

30 (40) SHALAKYA TANTRA DEPARTMENT (SANGYAHARAN) (Codes SLSGAY)

DISABLED VIDE HMC MEETING HELD ON 17.12.2013

(41) SHALYA TANTRA DEPARTMENT (RADILOGY SECTION

* Introduction of Computrized X-Ray procedures approved in HMC meeting held on

15.04.2015.

S.No. CODE NO. NAME OF PROCEDURES CHARGES (Rs.)

1. SLRDAY-01 X-Ray chest PA/AP Lat. 100/-

2. SLRDAY-02 X-Ray Vertebrae (spines) AP & Lat. 150/-

3. SLRDAY-03 Barium Swallow/Barium Meal Examination - Routine

like Stomach, Duodenum, ICR Region/Barium Enema

230/-

4. SLRDAY-04 I.V.P. Myelography / Angiography 300/-

5. SLRDAY-05 H.S.G./Sinogram/Cystogram/ Urethrogram 200/-

6. SLRDAY-06 Ultrasonograpy (USG) 200/-

7. SLRDAY-07 X-Ray Bones AP/PA & Lat. 150/-

8. SLRDAY-08 X-Ray Joint (single) AP & Lat. 150/-

9. SLRDAY-09 X-Ray Joint (Bilateral) AP & Lat. 300/-

10. SLRDAY-10 X-Ray Skull AP/PA/lat. 100/-

11. SLRDAY-11 X-Ray PNS 100/-

12. SLRDAY-12 X-Ray RGU 200/-

1. SLRDAY-13 X-Ray RGU & MCU 400/-



(42) DEPARTMENT OF SANGYAHARAN (Introduced on 20.01.2012)

S.No. Code No. Name of Investigation Charges

1. SGHNAY-01 Agni Karma Rs. 100/- per sitting

2. SGHNAY-02 Jalaukavacharan Rs. 100/- per sitting

3. SGHNAY-03 HDU-Sangyaharan-PFT Rs. 200/-

4. SGHNAY-04 Sangyaharan Serum Electrolyte Rs. 100/-

5. SGHNAY-05 Sangyaharan E.C.G. with interpretation Rs. 100/-

6. SGHGAY-06 Maintenance charges (Minor) Rs. 100/-

7. SGHGAY-07 Maintenance charges (Major) Rs. 500/-

8. SGHGAY-08 Diagnostic Fibreoptic Laryngoscopy Rs. 200/-



(43) DEPARTMENT OF KAUMARBHRITYA/BALROGA*

S.No. CODE NO. NAME OF INVESTIGATIONS/ PROCEDURES, ETC. Approved Charges

1. KBBRAY-01 Phototherapy Rs. 100/- per day

2. KBBRAY-02 NICU (Neonantal Intensive Care Unit) Rs. 100/- per day

…

31 3. KBBRAY-03 Nebuliser Rs. 100/- per

package

4. KBBRAY-04 Bahya Snehan [External Unction] Rs. 500/-

5. KBBRAY-05 Ekanga Snehana [Localized Unction] Rs. 500/-

6. KBBRAY-06 Sarvanga Snehana [Generalized Unction] Rs. 500/-

7. KBBRAY-07 Nadi Swedana [Pipe/Tube Sudation] Rs. 250/-

8. KBBRAY-08 Shashtishali/Patra Pinda/Baluka Swedana

[Sudation by Specific Rice with

decoction/Leaves/Sand]

Rs. 500/-

9. KBBRAY-09 Avagahanga Swedana [Sudation of Children

with specific decoction in tub]

Rs. 1000/-

10. KBBRAY-10 Anuvasan/Niruha Basti Rs. 500/-

11. KBBRAY-11 Shiro-Basti for 15 days Rs. 500/-

12. KBBRAY-12 Kati/Janu etc Basti for 15 days Rs. 250/-

13. KBBRAY-13 Shirodhara for 15 days Rs. 500/-

14. KBBRAY-15 NICU (Neonantal Intensive Care Unit on

Ventilator)

Rs. 500/- per day



(44) “DHARMSHALA & VISHRAM KUTEER”


PROCEDURES, ETC.

CHARGES

1. DHRMSH- 01 Room Rent per day per room Rs. 50/-

2. Vishram Kuteer Room Rent per day per room Rs. 100/-

3. Deluxe Room

Vishram Kuteer

Room Rent per day per room Rs. 500/-

4 DHRMSH- 02* Advance (Security money) for rooms of

Dharmashala & Vishram Kuteer (Normal

Room) and Vishram Kuteer Delux Room

Rs. 200/-, Rs. 500/-

& Rs. 2500/-

respectively



(45) SPECIAL WARD

S.No. CODE NO. PARTICULARS CHARGES

1. SPLWDA- 01 Room Rent charge per day (AC Rooms) Rs. 1500/-

2. SPLWDB- 02 Room Rent charge per day (Non AC Rooms) Rs. 800/

3. SURCHG- 03 Surcharge on Spl. Ward Room Rent Rs. 5% of Total

4. - Room Rent charge per day (Deluxe Room) Rs. 3500/-



…

32

(46) “MISCELANEOUS”


PROCEDURES, ETC.

CHARGES

1. BRTHCF- 01 Birth Certificate Rs. 20/-

2. DETHCF- 02 Death Certificate Rs.50/-

3. LICCRF- 03 LIC Certificate Charge Rs. 100/-

4. GATPAS- 04 Gate Pass Rs. 50/-

5. MEDICF-05 Medical Certificate Rs. 20/-

6. DURECP-06 For issue of Duplicate Receipt (AR-1) Rs. 50/-

7. CCASSH-01

Upto 8 Km. radius of the University campus. Rs. 1500/-

Beyond 8 Km radius of the University Campus. Rs. 24/- per Km.

Upto 300/- (maximum). Rs. 20000/-

(47) “ADMISSION”


PROCEDURES, ETC.

CHARGES

1. ADMSON- 01 Admission Charge per patient Rs. 50/-

(48) “OPD SLIP”


PROCEDURES, ETC.

CHARGES

1. OPDSLP- 01 OPD SLIP Rs. 20/-

(49) DOCTOR’S LOUNGE


PROCEDURES, ETC.

CHARGES

1. DLONGE- 01 Shushrut Sabhagar (Doctors’ Lounge) Rs. 2000/-



(50) ASHRAY

S.No. CODE NO. Perticular CHARGES

1. ASHRAY- 01 Maintenance of ‘Ashray’ Rs. 20/- per day per

patient

(51) CRECHE-01

1. CRECHE-01 Maintenance of Chreche Rs. 1000/- per child

per month



(a) faculty of modern medicine

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