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| SR No. | Treatment Type | Treatment | Charges |
|---|---|---|---|
| 1 | Checkup | Old Case Checkup | 290 Rs.(INR) |
| 2 | Checkup | New Checkup | 400 Rs.(INR) |
| 3 | Diagnostic Service | IOPA X-ray | 125 Rs.(INR) |
| 4 | Prophylactic | Full Mouth Dental Scaling (Acc to the intensity of stains in teeth) | 800/ - 1400/- 1600/ - 2100/ - Rs.(INR) |
| 5 | Prophylactic | Dental Polishing of Teeth (Full Mouth) | 290 Rs.(INR) |
| 6? | Dental Insurance Plan | Mmsdc dental health awareness plan - Single Person | 1450 Rs.(INR) |
| 7? | Dental Insurance Plan | Mmsdc dental health awareness plan - Family (2 Adult + 1 Child) | 2750 Rs.(INR) |
| 8 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (Within 3 KM) | 650 Rs.(INR) |
| 9? | Checkup | Follow-up Visit | 200 Rs.(INR) |
| 10 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (3 - 5 KM) | 850 Rs.(INR) |
| 11 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (5 - 8 KM) | 1050 Rs.(INR) |
| 12? | Payment | Bajaj EMI Finserve Processing Fees for Treatment Charges Payment ** | 767 Rs.(INR) |
| 13 | Diagnostic Test (Radiology) | Occlusal X-ray (Out-sourced) | 700 Rs.(INR) |
| 14 | Diagnostic Test(Radiology) | OPG X-ray | 690 Rs.(INR) |
| 15 | Diagnostic Test(Radiology) | PNS view X-ray (Para- Nasal Sinus) | 767 Rs.(INR) |
| 16 | Diagnostic Test(Radiology) | TMJ X-ray Open/Close view (Temporomandibular joint) | 690 Rs.(INR) |
| 17 | Diagnostic Test(Radiology) | Oral digital Scanning for Clear Aligners | 8600 Rs.(INR) |
| 18 | Diagnostic Test(Radiology) | Paranasal Sinus - 3D Image Modalities (Outsourced) | 2200 Rs.(INR) |
| 19 | Diagnostic Test(Radiology) | 3D TMJ Open-Close bothside (Outsourced) | 4500 Rs.(INR) |
| 20 | Diagnostic Test(Radiology) | Both Jaw CBCT - 3D Imaging Modalities (Maxilla and Mandible) (outsourced) | 4000 Rs.(INR) |
| 21 | Diagnostic Test(Radiology) | Single Jaw CBCT - 3D Imaging Modalities (Maxilla or Mandible) (outsourced) | 2200 Rs.(INR) |
| 22 | Diagnostic Test(Radiology) | Sectional CBCT - 3D Imaging modalities (outsourced) | 1800 Rs.(INR) |
| 23 | Diagnostic Test(Radiology) | Extraoral Radiographs - Skullview (outsourced) | 700 Rs.(INR) |
| 24 | Diagnostic Test(Radiology) | lateral cephalogram X-ray (Outsourced) | 700 Rs.(INR) |
| SR No. | Treatment Type | Treatment | Charges |
|---|---|---|---|
| 1 | Checkup | Old Case Checkup | 290 Rs.(INR) |
| 2 | Checkup | New Checkup | 400 Rs.(INR) |
| 3 | Diagnostic Service | IOPA X-ray | 125 Rs.(INR) |
| 4 | Prophylactic | Full Mouth Dental Scaling (Acc to the intensity of stains in teeth) | 800/- 1400/- 1600/- 2100/- Rs.(INR) |
| 5 | Prophylactic | Dental Polishing of Teeth (Full Mouth) | 290 Rs.(INR) |
| 6 | Dental Insurance Plan | Mmsdc dental health awareness plan - Single Person | 1450 Rs.(INR) |
| 7 | Dental Insurance Plan | Mmsdc dental health awareness plan - Family (2 Adult + 1 Child) | 2750 Rs.(INR) |
| 8 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (Within 3 KM) | 650 Rs.(INR) |
| 9 | Checkup | Follow-up Visit | 200 Rs.(INR) |
| 10 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (3 - 5 KM) | 850 Rs.(INR) |
| 11 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (5 - 8 KM) | 1050 Rs.(INR) |
| 12 | Payment | Bajaj EMI Finserve Processing Fees for Treatment Charges Payment ** | 767 Rs.(INR) |
| 13 | Diagnostic Test (Radiology) | Occlusal X-ray (Out-sourced) | 700 Rs.(INR) |
| 14 | Diagnostic Test (Radiology) | OPG X-ray | 690 Rs.(INR) |
| 15 | Diagnostic Test (Radiology) | PNS view X-ray (Para-Nasal Sinus) | 767 Rs.(INR) |
| 16 | Diagnostic Test (Radiology) | TMJ X-ray Open/Close view (Temporomandibular joint) | 690 Rs.(INR) |
| 17 | Diagnostic Test (Radiology) | Oral digital Scanning for Clear Aligners | 8600 Rs.(INR) |
| 18 | Diagnostic Test (Radiology) | Paranasal Sinus - 3D Image Modalities (Outsourced) | 2200 Rs.(INR) |
| 19 | Diagnostic Test (Radiology) | 3D TMJ Open-Close bothside (Outsourced) | 4500 Rs.(INR) |
| 20 | Diagnostic Test (Radiology) | Both Jaw CBCT - 3D Imaging Modalities (Maxilla and Mandible) (outsourced) | 4000 Rs.(INR) |
| 21 | Diagnostic Test (Radiology) | Single Jaw CBCT - 3D Imaging Modalities (Maxilla or Mandible) (outsourced) | 2200 Rs.(INR) |
| 22 | Diagnostic Test (Radiology) | Sectional CBCT - 3D Imaging modalities (outsourced) | 1800 Rs.(INR) |
| 23 | Diagnostic Test (Radiology) | Extraoral Radiographs - Skullview (outsourced) | 700 Rs.(INR) |
| 24 | Diagnostic Test (Radiology) | Lateral cephalogram X-ray (Outsourced) | 700 Rs.(INR) |
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| SR No. | Treatment Type | Treatment | Charges |
|---|---|---|---|
| 1 | Checkup | Old Case Checkup | 290 Rs.(INR) |
| 2 | Checkup | New Checkup | 400 Rs.(INR) |
| 3 | Diagnostic Service | IOPA X-ray | 125 Rs.(INR) |
| 4 | Prophylactic | Full Mouth Dental Scaling (Acc to the intensity of stains in teeth) | 800/ - 1400/- 1600/ - 2100/ - Rs.(INR) |
| 5 | Prophylactic | Dental Polishing of Teeth (Full Mouth) | 290 Rs.(INR) |
| 6? | Dental Insurance Plan | Mmsdc dental health awareness plan - Single Person | 1450 Rs.(INR) |
| 7? | Dental Insurance Plan | Mmsdc dental health awareness plan - Family (2 Adult + 1 Child) | 2750 Rs.(INR) |
| 8 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (Within 3 KM) | 650 Rs.(INR) |
| 9? | Checkup | Follow-up Visit | 200 Rs.(INR) |
| 10 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (3 - 5 KM) | 850 Rs.(INR) |
| 11 | Checkup | Home Dental Visit for Checkup / Follow-up Charges (5 - 8 KM) | 1050 Rs.(INR) |
| 12? | Payment | Bajaj EMI Finserve Processing Fees for Treatment Charges Payment ** | 767 Rs.(INR) |
| 13 | Diagnostic Test (Radiology) | Occlusal X-ray (Out-sourced) | 700 Rs.(INR) |
| 14 | Diagnostic Test(Radiology) | OPG X-ray | 690 Rs.(INR) |
| 15 | Diagnostic Test(Radiology) | PNS view X-ray (Para- Nasal Sinus) | 767 Rs.(INR) |
| 16 | Diagnostic Test(Radiology) | TMJ X-ray Open/Close view (Temporomandibular joint) | 690 Rs.(INR) |
| 17 | Diagnostic Test(Radiology) | Oral digital Scanning for Clear Aligners | 8600 Rs.(INR) |
| 18 | Diagnostic Test(Radiology) | Paranasal Sinus - 3D Image Modalities (Outsourced) | 2200 Rs.(INR) |
| 19 | Diagnostic Test(Radiology) | 3D TMJ Open-Close bothside (Outsourced) | 4500 Rs.(INR) |
| 20 | Diagnostic Test(Radiology) | Both Jaw CBCT - 3D Imaging Modalities (Maxilla and Mandible) (outsourced) | 4000 Rs.(INR) |
| 21 | Diagnostic Test(Radiology) | Single Jaw CBCT - 3D Imaging Modalities (Maxilla or Mandible) (outsourced) | 2200 Rs.(INR) |
| 22 | Diagnostic Test(Radiology) | Sectional CBCT - 3D Imaging modalities (outsourced) | 1800 Rs.(INR) |
| 23 | Diagnostic Test(Radiology) | Extraoral Radiographs - Skullview (outsourced) | 700 Rs.(INR) |
| 24 | Diagnostic Test(Radiology) | lateral cephalogram X-ray (Outsourced) | 700 Rs.(INR) |
| Sr. No. | CGHS TREATMENT PROCEDURE/INVESTIGATION LIST (AHMEDABAD) | Non- NABH/ Non- NABL Rates (₹) | NABH/NABL Rates (₹) |
|---|---|---|---|
| 1974 | Code-BP018 | Cleft Lip - Repair | 29750 | 35000 |
| 1975 | Code-BP019 | Cleft Palate Repair | 36550 | 43000 |
| 1976 | Code-BP020 | Primary Bone Grafting for Alveolar Cleft in Cleft Lip | 36550 | 43000 |
| 1977 | Code-BP021 | Secondary Surgery for Cleft Lip Deformity | 36550 | 43000 |
| 1978 | Code-BP022 | Secondary Surgery for Cleft Palate | 36550 | 43000 |
| 736 | Code-BT001 | Speech Therapy per session of at least 40 minutes | 340 | 400 |
| 737 | Code-BT002 | Occupational Therapy per session of at least 40 minutes | 340 | 400 |
| 739 | Code-BT004 | Special education per session of at least 40 minutes | 340 | 400 |
| 514 | Code-BY001 | Skin Biopsy | 1063 | 1250 |
| 515 | Code-BY002 | Punch/Wedge biopsy | 2550 | 3000 |
| 516 | Code-BY003 | Excision Biopsy of Ulcers | 4250 | 5000 |
| 517 | Code-BY004 | Excision Biopsy of Superficial Lumps | 7820 | 9200 |
| 518 | Code-BY005 | Incision Biopsy of Growths/Ulcers | 4250 | 5000 |
| 522 | Code-BY009 | Muscle Biopsy | 2125 | 2500 |
| 523 | Code-BY010 | Trucut Needle Biopsy- (excluding the cost of Needle/Biopsy Gun if used) | 3273 | 3850 |
| 1 | Code-CN001 | Consultation OPD | 350 | 350 |
| 741 | Code-DI001 | Intraoral Periapical (IOPA) Radiograph X-ray/RVG(Single Film) | 170 | 200 |
| 742 | Code-DI002 | Intraoral Occlusal/Bite Wing X-Ray | 255 | 300 |
| 743 | Code-DI003 | Digital OPG with X ray film/ CD | 425 | 500 |
| 744 | Code-DI004 | Biopsy of Oral tissue- Soft | 1020 | 1200 |
| 745 | Code-DI005 | Biopsy of Oral tissue - Hard (bone, tooth) | 1700 | 2000 |
| 746 | Code-DP001 | Abscess - Drainage-Dental | 1275 | 1500 |
| 747 | Code-DP002 | Scaling | 850 | 1000 |
| 748 | Code-DP003 | Curettage and Root Planning - Per Tooth | 298 | 350 |
| 749 | Code-DP004 | Curettage and Root Planning - Per Arch | 1700 | 2000 |
| 750 | Code-DP005 | Gingivoplasty - Per Quadrant | 850 | 1000 |
| 751 | Code-DP006 | Gingivectomy - Per Quadrant | 1020 | 1200 |
| 752 | Code-DP007 | Flap Surgery- Per Tooth | 383 | 450 |
| 753 | Code-DP008 | Flap Surgery- Per Quadrant | 1700 | 2000 |
| 754 | Code-DP009 | Flap Surgery and Bone Graft per quadrant | 2550 | 3000 |
| 755 | Code-DP010 | Extraction - Normal Tooth | 340 | 400 |
| 756 | Code-DP011 | Complicated Extraction per tooth under LA | 680 | 800 |
| 757 | Code-DP012 | Extraction Impacted - Soft tissue/ 3rd Molar/wisdom tooth extraction | 1700 | 2000 |
| 758 | Code-DP013 | Multiple Extraction and Treatment Procedures for Special Children, Patients with Systemic Diseases, Patient with Special Needs Which Requires Admission and Treatment Under GA | 5100 | 6000 |
| 759 | Code-DP014 | Extraction - Orthodontic Extraction | 638 | 750 |
| 760 | Code-DP015 | Operculectomy- Pericoronal flap excision | 1700 | 2000 |
| 761 | Code-DP016 | Extraction Impacted – Bony | 4250 | 5000 |
| 762 | Code-DP017 | Alveoloplasty - Per Tooth | 255 | 300 |
| 763 | Code-DP018 | Alveoloplasty - Per Quadrant | 1020 | 1200 |
| 764 | Code-DP019 | Frenectomy | 2125 | 2500 |
| 765 | Code-DP020 | Excision of hyperplastic tissue - per arch | 1020 | 1200 |
| 766 | Code-DP021 | Surgical Augmentation/Alveolectomy per Arch | 2975 | 3500 |
| 767 | Code-DP022 | Bone replacement graft for ridge preservation - per site | 1700 | 2000 |
| 768 | Code-DP023 | Minor oral surgery, cyst, granuloma, residual infection, mucocele, epulis under LA | 1700 | 2000 |
| 769 | Code-DP024 | Application of Desensitizing Medicament | 425 | 500 |
| 770 | Code-DP025 | Fluoride Application for Children | 850 | 1000 |
| 771 | Code-DP026 | Temporary restoration | 128 | 150 |
| 772 | Code-DP027 | Glass ionomer Cement Restoration | 510 | 600 |
| 773 | Code-DP028 | Composite - Occlusal Pit/Class I | 425 | 500 |
| 774 | Code-DP029 | Composite -Class I with buccal extension/Class II Class III/Class IV/Class VI/Diastema Closure/MOD | 850 | 1000 |
| 775 | Code-DP030 | RCT-Single Rooted tooth | 1700 | 2000 |
| 776 | Code-DP031 | RCT Multiple root and/ canal tooth | 2550 | 3000 |
| 777 | Code-DP032 | Re-RCT - Anterior | 2125 | 2500 |
| 778 | Code-DP033 | Re-RCT - Posterior | 2550 | 3000 |
| 779 | Code-DP034 | Medication -intracanal medicament (only lesion cases) | 425 | 500 |
| 780 | Code-DP035 | Apicectomy-Single tooth | 1700 | 2000 |
| 781 | Code-DP036 | Apicectomy-Multiple tooth | 2550 | 3000 |
| 782 | Code-DP037 | Apexification with any bio-compatible material | 1700 | 2000 |
| 783 | Code-DP038 | Root end resection and Retro grade filling | 2550 | 3000 |
| 784 | Code-DP039 | Surgical - Apicectomy/ Periapical surgery without bone grafting | 595 | 700 |
| 785 | Code-DP040 | Tissue Conditioning, Maxillary/Mandibular | 255 | 300 |
| 786 | Code-DP041 | Core build-up/ Post and Core - Custom made /Inlay/onlay | 1275 | 1500 |
| 787 | Code-DP042 | Crown lengthening - Per Tooth | 425 | 500 |
| 788 | Code-DP043 | Crown - PMMA Crown | 850 | 1000 |
| 789 | Code-DP044 | Crown - All Metal-Nickel Free | 1700 | 2000 |
| 790 | Code-DP045 | Crown - Metal with Ceramic Facing | 2550 | 3000 |
| 791 | Code-DP046 | Crown - Recementation | 510 | 600 |
| 792 | Code-DP047 | Crown - Removal | 425 | 500 |
| 793 | Code-DP048 | Odontoplasty /Enameloplasty | 425 | 500 |
| 794 | Code-DP049 | Pulpectomy (Anterior Tooth) | 1700 | 2000 |
| 795 | Code-DP050 | Pulpectomy (Posterior Tooth) | 2550 | 3000 |
| 796 | Code-DP051 | Pulpotomy | 850 | 1000 |
| 797 | Code-DP052 | Veneer - Ceramic paediatric | 2550 | 3000 |
| 798 | Code-DP053 | Interceptive Orthodontic Treatment of the Primary Dentition/Transition Dentition | 5950 | 7000 |
| 799 | Code-DP054 | Limited Orthodontic Treatment of the Primary Dentition | 4250 | 5000 |
| 800 | Code-DP055 | Occlusion Analysis/Adjustment/Occlusal Equilibration | 425 | 500 |
| 801 | Code-DP056 | Tooth Splinting - General | 1275 | 1500 |
| 802 | Code-DP057 | Splinting - Periodontally weak teeth | 1530 | 1800 |
| 803 | Code-DP058 | Night Guard | 1700 | 2000 |
| 804 | Code-DP059 | Bridge/ Fixed Partial denture (per missing/ extracted tooth) metal crown | 1700 | 2000 |
| 805 | Code-DP060 | Bridge/ Fixed Partial denture (per missing/ extracted tooth) metal crown with Ceramic facing | 2550 | 3000 |
| 806 | Code-DP061 | Removable Partial Denture - Flexible Per Arch | 6375 | 7500 |
| 807 | Code-DP062 | Removable Partial Denture - Cast Metal Up to 3 Teeth | 3400 | 4000 |
| 808 | Code-DP063 | Removable Partial Denture - Cast Metal (additional Per tooth) | 255 | 300 |
| 809 | Code-DP064 | Removable Partial Denture - Acrylic Up to 3 teeth | 1700 | 2000 |
| 810 | Code-DP065 | Removable Partial Denture - Tooth Addition (per tooth) | 255 | 300 |
| 811 | Code-DP066 | Add Clasp to existing Partial Denture | 425 | 500 |
| 812 | Code-DP067 | Add Tooth to existing Partial Denture | 340 | 400 |
| 813 | Code-DP068 | Tooth Supported Overdenture Per Arch | 6375 | 7500 |
| 814 | Code-DP069 | Complete Denture - Per Arch | 8500 | 10000 |
| 815 | Code-DP070 | Removable orthodontic appliance / Post Orthodontic R O A -per arch | 2125 | 2500 |
| 816 | Code-DP071 | Fixed orthodontic per arch | 12750 | 15000 |
| 817 | Code-DP072 | Space Maintainers - Fixed | 3400 | 4000 |
| 818 | Code-DP073 | Minor Treatment to Control Habits-Removable Appliance Therapy | 2125 | 2500 |
| 819 | Code-DP074 | Minor Treatment to Control Habits-Fixed Appliance Therapy | 3400 | 4000 |
| 820 | Code-DP075 | Functional orthodontic appliance | 5100 | 6000 |
| 821 | Code-DP076 | Feeding appliance for Cleft Palate | 4250 | 5000 |
| 822 | Code-DP077 | Expansion plate | 5525 | 6500 |
| 823 | Code-DP078 | Maxillofacial Prosthesis - Sal/auricular/orbital/Nasal/Palatal/facial lost/ Speech Aid | 5950 | 7000 |
| 824 | Code-DP079 | Obturator Prosthesis - Surgical/Definitive/Modification | 4250 | 5000 |
| 825 | Code-DP080 | Removal of - Lateral Exostosis/Torus Mandibularis/Torus Palatines/Surgical reduction of Osseous Tuberosity | 2550 | 3000 |
| 826 | Code-DP081 | Sialolithotomy/Sialodocotomy/ Closure of Salivary Fistula | 1700 | 2000 |
| 827 | Code-DP082 | Excision of Salivary gland | 12750 | 15000 |
| 828 | Code-DP083 | Release of fibrous bands & grafting in (OSMF) treatment under GA | 17000 | 20000 |
| 829 | Code-DP084 | Facial Space Abscess | 4250 | 5000 |
| 830 | Code-DP085 | Partial Ostectomy / sequestrectomy for removal of non-vital bone | 1700 | 2000 |
| 831 | Code-DP086 | Alveolus – Closed Reduction stabilization of Teeth | 3400 | 4000 |
| 832 | Code-DP087 | Alveolus – Open Reduction stabilization of Teeth | 5100 | 6000 |
| 833 | Code-DP088 | Arch bar fixation | 4250 | 5000 |
| 834 | Code-DP089 | Oroantral Fistula closure | 4250 | 5000 |
| 835 | Code-DP090 | Condylar fracture closed reduction | 5100 | 6000 |
| 836 | Code-DP091 | Condylar fracture open reduction | 12750 | 15000 |
| 837 | Code-DP092 | Maxilla - Closed Reduction | 5100 | 6000 |
| 838 | Code-DP093 | Maxilla - Open Reduction | 8500 | 10000 |
| 839 | Code-DP094 | Mandible - Closed Reduction | 5100 | 6000 |
| 840 | Code-DP095 | Mandible – Open Reduction | 8500 | 10000 |
| 841 | Code-DP096 | Cyst of Maxilla/mandible by enucleation/excision/marsupialization upto 4 cms under LA | 4250 | 5000 |
| 842 | Code-DP097 | Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under LA | 5100 | 6000 |
| 843 | Code-DP098 | Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under GA and admission | 21250 | 25000 |
| 844 | Code-DP099 | Temporomandibular(TM) joint ankylosis- under GA/Open /Closed Reduction | 17000 | 20000 |
| 845 | Code-DP100 | Segmental / Hemi Mandibulectomy with graft | 21250 | 25000 |
| 846 | Code-DP101 | Segmental /Hemi Mandibulectomy without graft | 17000 | 20000 |
| 847 | Code-DP102 | Sub-Total mandibulectomy with graft | 29750 | 35000 |
| 848 | Code-DP103 | Sub-Total mandibulectomy without graft | 25500 | 30000 |
| 849 | Code-DP104 | Maxillectomy/Mandibulectomy- Total with graft | 29750 | 35000 |
| 850 | Code-DP105 | Maxillectomy/Mandibulectomy- Total without graft | 25500 | 30000 |
| 851 | Code-DP106 | Maxillectomy- partial with graft | 21250 | 25000 |
| 852 | Code-DP107 | Maxillectomy- partial without graft | 17000 | 20000 |
| 853 | Code-DP108 | Malar and/or Zygomatic arch - Closed Reduction | 5100 | 6000 |
| 854 | Code-DP109 | Malar and/or Zygomatic arch - Open Reduction | 8500 | 10000 |
| 855 | Code-DP110 | Distraction osteogenesis of mandible or maxilla under GA | 25500 | 30000 |
| 856 | Code-DP111 | Facial bones - Complicated Reduction with fixation | 38250 | 45000 |
| 1098 | Code-EP047 | Tongue Tie excision | 7225 | 8500 |
| 1125 | Code-EP074 | Parotidectomy - Superficial | 29750 | 35000 |
| 1126 | Code-EP075 | Parotidectomy - Total | 36550 | 43000 |
| 1127 | Code-EP076 | Repair of Parotid Duct | 23375 | 27500 |
| 1128 | Code-EP077 | Removal of Submandibular Salivary gland | 23375 | 27500 |
| 1164 | Code-GP001 | Dressings of wounds | 255 | 300 |
| 1169 | Code-GP006 | Removal of Sutures (All) | 170 | 200 |
| 1173 | Code-GP010 | Incision & Drainage under local Anaesthesia (Large) | 1955 | 2300 |
| 1175 | Code-GP012 | Drainage of abscess with anaesthesia | 11390 | 13400 |
| 1176 | Code-GP013 | Excision of lumps under anaesthesia | 11390 | 13400 |
| 1271 | Code-GS003 | Suturing of small wounds | 1169 | 1375 |
| 1272 | Code-GS004 | Secondary suture of wounds | 3740 | 4400 |
| 1273 | Code-GS005 | Debridement of wounds - Small | 1403 | 1650 |
| 1277 | Code-GS009 | Excision of Cervical Lymph Node under Local Anaesthesia | 2635 | 3100 |
| 1278 | Code-GS010 | Excision of Axillary Lymph Node under General Anaesthesia | 7225 | 8500 |
| 1279 | Code-GS011 | Excision of Inguinal Lymph Node under Local Anaesthesia | 2550 | 3000 |
| 1280 | Code-GS012 | Excision of Sebaceous Cysts | 4250 | 5000 |
| 1281 | Code-GS013 | Excision of Superficial Lipoma | 4250 | 5000 |
| 1864 | Code-OR035 | Bandage & Strappings for Fractures | 1700 | 2000 |
| 1865 | Code-OR036 | Aspiration & Intra Articular Injections | 4250 | 5000 |
| 1872 | Code-OR043 | Bone Grafting | 23375 | 27500 |
| 1914 | Code-OR085 | Removal of Wires & Screw | 11390 | 13400 |
| 1915 | Code-OR086 | Removal of Plates | 23375 | 27500 |
| 374 | Code-RI036 | X Ray Mastoids: Towne view, oblique views (3 films) | 425 | 500 |
| 377 | Code-RI039 | X Ray Temporomandibular (TM) Joints (one film) | 213 | 250 |
| 379 | Code-RI041 | X Ray Skull AP & Lateral (2 films)/ Extra oral radiographs - All skull views, TMJ, Lateral oblique [Dental] | 340 | 400 |
| 381 | Code-RI043 | X Ray Paranasal sinuses (PNS) view (1 film) | 170 | 200 |
| 393 | Code-RI055 | X ray Arthrography | 1700 | 2000 |
| 394 | Code-RI056 | Ortho Scanogram | 1437 | 1690 |
| 395 | Code-RI057 | Cephalography | 298 | 350 |
| 420 | Code-RI082 | CT Scan of Para Nasal Sinuses (CT PNS)- Without Contrast | 1955 | 2300 |
| 421 | Code-RI083 | CT Scan of Para Nasal Sinuses (CT PNS)- With Contrast | 2805 | 3300 |
| 424 | Code-RI086 | CT Scan / Cone Beam CT (CBCT) Dental | 1275 | 1500 |
