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w.e.f 01.06.2015 Page | 17

JAYABEN MODY HOSPITAL

SCHEDULE OF CHARGES

W.E.F. 1ST JUNE-2015

Following departments are available in the hospital for routine and emergency work.

Surgery & Trauma Centre Intensive Care Unit

Surgical Unit

Ophthalmic Unit

Pediatric Ward & NICU

Maternal & Child Health Unit

Dental Department

ENT Department

Occupational Health Centre

Radiology

Diagnostic Laboratory Unit

Dialysis Unit

Physiotherapy Centre

Orthopedic Unit

SR. NO.PARTICULARSPAGE NO.

1CONSULTATION CHARGE

2VISIT CHARGES

3ACCOMODATION CHARGE (ROOMS CHARGES)

4PROCEDURE CHARGES

5RADIOLOGICAL INVESTIGATION CHARGES

7ANAESTHESIA CHARGES

8OPTHALMOLOGY (EYE) CHARGE

9ENT CHARGES

10OBSTETRICS CHARGES

11GYNAEC OPERATION CHARGE

12GENERAL SURGERY CHARGES

13LAPROSCOPIC SURGERY CHARGE

14ORTHOPAEDIC OPD CHARGES

15ORTHOPAEDIC OPERATION CHARGES

16"C" ARM CHARGES

17ARTHOSCOPY CHARGES

18PHYSIOTHERAPY CHARGES

19LABORATORY INVESTIGATION CHARGE

20DENTAL CHARGES

1CONSULTATION

(a) 1ST CONSULTATIONRs. 100/-

b) SUBSEQUENT CONSULTATIONRs.70/-

(Valid for 1 month)

2SUPER SPECIALIST

a) 1ST CONSULTATIONRs. 200/-

b) SUBSEQUENT CONSULTATIONRs.130/-

(Valid for 1 month)

3EMERGENCY WARD

a) CONSULTATIONRs. 150/-

5FILLING OF FORMS FOR INSURANCERs.50/-

6ISSUE OF CERTIFICATERs.50/-

7DISABILITY CERTIFICATERs.1500/-

8COPY OF INDOOR CASE PAPER / OTHER DOCUMENTRs.50/-

(A) CONSULTANTS /OUT SIDE CONSULTANTS/ PRIVATE CASES

SRNO.TYPE OF CLASSDAYNIGHT

8 PM - 8AM

(1)General Ward5070

(2)Semi -Special 120160

(3)Special Room180250

(4)Special - A.C230300

(5)Deluxe Room350450

(6)Super Deluxe Room600700

(7)ICU / NICU250300

(8)Burns- General120160

(9)Burns- Special210250

(B) DIETICIAN CHARGES

(1) OPD, Gen. Ward, Semi Special, Special Room, Burns GeneralRs. 50/-

(2)Special AC, Delux Room, Super Deluxe Room, ICU/ NICU, Burns SpecialRs. 100/-

ROOM CHARGES (ACCOMMEDATION):SR NO.CategoryCharges per bed

(1)General Ward250


(3)Special Room1100


(5)Deluxe Room1650

(6)I.C.U.1350


(8)NICU1350



Note:

If patient is discharged within 6 hours then half day charges to be recovered, If patient is kept for observation in ICU /NICU up to 2 hours Rs. 500/- to be taken for bed charges.DEPOSIT AMOUNT AT THE TIME OF ADMISSION:SR NO.TYPE OF CLASSAmount

(1)General Ward2000


(3)Special Room5000


(5)Deluxe Room15000


(7)ICU / NICU15000



PROCEDURE CHARGES:

A) Physician

PROCEDURE G.WS.SP.SPECIALDELUXICU/NICUSUP. DELUXE

FNAC300450600750750825

PL TAP200300400500500550

ASCITICTAP200300400500500550

LUMBAR PUNCTURE300450600750750825

BONE MARROW ASPIRATION300450600750750825

BONE MASSOW ASPIRATION WITH BIOPSY400600800100010001100

LIVER ABSC ESS DRINAGE200300400500500550

CENTRAL LINE5007501000125012501400

INTUBATION CHARGES450675900112511251250

LIVER BIOPSY250375500625625700

B) ICU ChargesPROCEDURE / SERVICECHARGES

VENTILATOR CHARGES (Less than 12 Hours)Rs. 1500/-

VENTILATOR CHARGES (12 Hours to 24 Hours)Rs. 2500/-

CARDIAC MONITORRs. 200/- per day

OXYGEN CHARGES (Less than 12 Hours)Rs. 600/-

OXYGEN CHARGES (12 Hours to 24 Hours)Rs. 1000/-

MULTIPERA MONITORRs. 70/- PER HOUR

VENTILATOR CHARGES - C-PAPRs. 25/- PER HOUR

VENTILATOR CHARGES - DRAGGERRs. 50/- PER HOUR

D.C. SHOCKRs. 50/- EVERY SHOCK

PULSE OXYMETERRs. 100/- PER DAY

INFUSION PUMPRs. 100/- PER DAY

PHOTOTHERAPHYRs. 100/- PER DAY

RBS -BY GLUCO METER -PEDIATRICRs. 90/- PER DAY

NEBULIZATIONRs. 20/- PER NEBULIZATION

C) DRESSING CHARGEDRESSING CHARGEOPD , G.W., & SEM. SPEC.SPECIALDELUX/ ICU/ NICUSUP. DELUX

* (MATERIAL COST EXTRA)

- MINOR50657590

- MAJOR80100120140

- SUPERMAJOR200250300350

Parineal wash with dressing

Including material per day200250300350

RADIOLOGICAL INVESTIGATION CHARGES:OPD , G.W., & SEM. SPEC.SPECIALDELUX/ ICU/ NICUSUP. DELUX

1(A)Digital X RAY180225250300

2(B) PORTABLE X-RAY220250300300

3(C) HYSTERO S. GRAPHY: Number of Plates + Rs.250/- (Procedure Charge)

4(D) MYLEO-GRAPHY: Number of Plates + Rs.300/- (Procedure Charge)

5(E) FISTULOGRAPHY: Number of Plates + Rs.300/- (Procedure Charge)

6(F) I.V.P.: Number of Plates + Rs.250/- (Procedure Charge)

7(G) BARIUM PROCEDURES: Number of Plates + Rs.250/- (Procedure Charge)

MATERIAL USED E.G. CONTRAST MEDIA, BARIUM, SYRING ETC. WILL CHARGED EXTRA.

ANAESTHESIA CHARGE EXTRA

ANESTHESIA CHARGES

STANDBY PHYSICIAN CHARGES

ASSISTANT CHARGES

--------------------------------------------------------------------------------------------------------

OPD , G.W., & SEM. SPEC.SPECIALDELUX/ ICU/ NICU/S.D.

1Minimum Anesthesia Charges Rs. 300/- Rs. 300/-

2 ANESTHETIST CHARGES 25% of Operation Charges

3Standby Physician / Paediatrician /

Anesthetist charge in O. T.200250300

4Standby Paediatrician / Physician /

Anesthetist charge in Labour Room200250300

5ASSISTANT SURGEON (whenever required)

6FIRST ASSISTANT - 25% OF OPERATION CHARGE

7SECOND ASSISTANT - 15% OF OPERATION CHARGE

Note:Helothane Isoprealine & suture material used in O.T. to be charged.EYE CHARGES

CHARGES FOR EYE CATARACT SURGERY -PHACO (INDIAN FOLDABLE)

GENARAL SEMI. SP. SP.ROOMSP.ACDEL./SD

REGISTRATION200200300300300

WARD CHARGE - 1 DAY1253756758251050

DOCTOR CHARGE50120180230350

NURSING CHARGE75205245245250

OPERATION CHARGE32004000460046004600

O.T. CHARGE16002000230023002300

LENS {INDIAN}15001500150015001500

MEDICINE & MAT500700700700700

A - SCAN150150200200200

TOTAL74009250107001090011250

CHARGES FOR EYE CATARACT SURGERY -PHACO (FOREIGN FOLD)

GENARAL SEMI. SP. SP.ROOMSP.ACDEL./SD

REGISTRATION200200300300300

WARD CHARGE - 1 DAY1253756758251050

DOCTOR CHARGE50 180230350

NURSING CHARGE75205245245250

OPERATION CHARGE52007500100001000010000

O.T. CHARGE26003750500050005000

LENS {INDIAN}

MEDICINE & MAT600800800800800

A - SCAN150150200200200

TOTAL900012980174001760017950

ENT CHARGES:NO.NAME OF THE OPERATIONGENERALSEMI. SPSP. ROOMDEL./SD

1WAX REMOVAL100150200220

2SUCTION CLEANING EAR / NOSE200300400440

3MICROSCOPIC EXAMINATION (EAR)200300400440

4FOREIGN BODY REMOVAL EAR / NOSE50075010001100

5INTRA NASAL / INTRAORAL INJECTION100150200220

6PURE TONE AUDIOMETRY150225300330

7ANTERIOR NASAL PACKING150225300330

8CALOROC TEST100150200220

9ANTRAL PUNCTURE400600800880

10SUBMUCUS DIATHERMY NOSE50075010001100

11HEAT CAUTERY NOSE50075010001100

12REMOVAL OF F.B. NOSE UNDER G.A.1000150020002200

13POSTERLOR NASAL PACKING250375500550

14BIOPSY ORAL CAVITY / NOSE350525700770

15I & D PERITONSILER ABSCESS1000150020002200

16NECK ABSCESS - SUPERFICIAL400600800880

17SEPTAL HEAMATOMA - IND1000150020002200

18MASTOID ABSCESS IND1000150020002200

19EAR LOBE REPAIR400600800880

20TCA CAUTERY EAR100150200220

21MYRINGOTOMY SIMPLE750112515001650

22EAR POLYPECTOMY750112515001650

23F.B. REMOVAL EAR / GA750112515001650

24TONSILECTOMY WITH ADENOIDS2000300040004400

25IND RETROPHARYNEAL ABSCESS1000150020002200

26DIRECT LARYNGOSCOPY1500225030003300

27PLANNED TRACHEOSTOMY1500225030003300

28INTRANASAL ANTROSTOMY750115015001650

29REDUCTION OF FRACTUR NASAL BONE1500225030003300

30F.B. REMOVAL EAR (MIDDLE)750115015001650

31EXCISION SMALL BENINGNLESSION50075010001100

32NECK GLAND BIOPSY50075010001100

33SALIVARY DUCTSTONE REMOVAL (FROM ORAL CAVITY)750112515001650

34EXCISION OF STYLOID2000300040004400

35SUBMANDIBULAR SALIVARY GLAND EXCISION2000300040004400

NO.NAME OF THE OPERATIONGENERALSEMI. SPSP. ROOMDEL./SD

36RENULA EXCISION2500375050005500

37MLS3000450060006600

38S.M.R. / SEPTO / PLASTIY2000300040004400

39CALDEWAL LUC OPERATION1500225030003300

40FOREIGN BODY REMOVAL2000300040004400

LARYNX

TRACHEA

BRONCHUS

OESO PHAGUS

41EXCISION OF THYROGLOSAL CYST.2500375050005500

42EXCISION OF LARGE SWELLING NECK CYST.2500375050005500

43MYRINGOPLASTY2500375050005500

44SIMPLE CORTICAL MASTOIDECTOMY3000450060006600

45TYMPANOPLASTY MASTOIDECTOMY3000450060006600

46NASAL POLYPECTOMY UNILATERAL2500375050005500

47NASAL POLYPECTOMY 3000450060006600

Gynecology Charges:S NONAME OF OPERATIONGENSEMISPECIALSUPER DELUXE/ DELUXE

1D & C1200140016002100

2D & E1400160018002400

3CERVICAL CAUTERISATION80090010001300

4POLYPECTOMY1200140016002100

5ABDOMINAL TL1000150020002600

6CERVICAL BIOPSY750100012001500

7VAGINAL / VULVAL BIOPSY750100012001500

8DIAGNOSYIC LAPROSCOPY3000400050006500

9LAP TL2500300035004550

10OPERATIVE LAPROSCOPY5000600070009100

11LSCS5000600070009100

12OVARION CYST ( UNILATERAL ) 3500400045005850

13LSCS + TL65007500850011000

14OLD PERINEAL REPAIR1500200025003250

15SLING OPRERATION2500350045005850

16LAPROTOMY FOR ECTOPIC5500600070009100

17DRAINAGE OF PELVIC ABSLESS1000120015002000

18MANUAL REMOVAL OF PLACENTA800100014001800

19ABDOMINAL HYSTERECTOMY5000600075009750

20TOTAL ABDOMINAL HYSTERECTOMY60007000850011000

21VAGINAL HYSTERECTOMY60007000800010400

22CYSTOCOEL REPAIR1000140018002400

23RECTOCOEL REPAIR1000140018002400

24LAPRPOSCOPIC ECTOPIC4000500060007800

Obstetrics Charges:S NONAME OF OPERATIONGENSEMISPECIALSUPER DELUXE/ DELUXE

1NORMAL DELIVERY1500170020002600

2NORMAL DELIVERY WITH EPISIOTOMY2000250030003900

3PREMATURE DELIVERY1000120015002000

4BREECH DELIVERY1700190022002900

5BREECH DELIVER WITH EPOISIOTOMY2200250030003900

6TWIN DELIVERY2000250030003900

7TWIN DELIVERY WITH EPISIOTOMY2500320039005000

8FORCEPS DELIVERY2500300035004550

9VACCUM DELIVERY2500300035004550

10PERINEAL TEAR

REPAIR

1. DEGREE60080012001600

2. DEGREE70090013001700

3. DEGREE900110015002000

11INDUCTION OF LABOUR MONITORING700100013001700

12MONITORING OF HIGH RISK PREGNANCY700100013001700

13MISSED ABORTION1400160016002100

14COMPLETE PERINEAL TEAR2000220024003200

15SHIRODHKAR STITCH1200150018002400

GENERAL SURGERY CHARGES:NONAME OF OPERATIONGENERALSEMISPECSUPER DELUXE/ DELUXE

1EXCISION OF SWELLING L/A (DAYS CASE)1500

2DEBRIDEMENT SUTURING OF WOUND L/A1500

3URETHRAL DILATATIONINDOOR800100015002000

OPD1000

4RECONSTRUCTIVE SURGERY L/A(2500-3000)

5ICD INSERTIONELECTIVE700100015002000

EMERGENCY1500200025003250

6EXCISION BREAST LUMP1500200025003250

7BURNS DRESSING

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