> Tariff List – CGHS Charges​
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SR No.Treatment TypeTreatmentCharges
1CheckupOld Case Checkup 290 Rs.(INR)
2CheckupNew Checkup 400 Rs.(INR)
3Diagnostic ServiceIOPA X-ray 125 Rs.(INR)
4ProphylacticFull Mouth Dental Scaling (Acc to the intensity of stains in teeth) 800/ - 1400/- 1600/ - 2100/ - Rs.(INR)
5ProphylacticDental Polishing of Teeth (Full Mouth) 290 Rs.(INR)
6?Dental Insurance PlanMmsdc dental health awareness plan - Single Person 1450 Rs.(INR)
7?Dental Insurance PlanMmsdc dental health awareness plan - Family (2 Adult + 1 Child) 2750 Rs.(INR)
8CheckupHome Dental Visit for Checkup / Follow-up Charges (Within 3 KM) 650 Rs.(INR)
9?CheckupFollow-up Visit 200 Rs.(INR)
10CheckupHome Dental Visit for Checkup / Follow-up Charges (3 - 5 KM) 850 Rs.(INR)
11CheckupHome Dental Visit for Checkup / Follow-up Charges (5 - 8 KM) 1050 Rs.(INR)
12?PaymentBajaj EMI Finserve Processing Fees for Treatment Charges Payment ** 767 Rs.(INR)
13Diagnostic Test (Radiology)Occlusal X-ray (Out-sourced) 700 Rs.(INR)
14Diagnostic Test(Radiology)OPG X-ray 690 Rs.(INR)
15Diagnostic Test(Radiology)PNS view X-ray (Para- Nasal Sinus) 767 Rs.(INR)
16Diagnostic Test(Radiology)TMJ X-ray Open/Close view (Temporomandibular joint) 690 Rs.(INR)
17Diagnostic Test(Radiology)Oral digital Scanning for Clear Aligners 8600 Rs.(INR)
18Diagnostic Test(Radiology)Paranasal Sinus - 3D Image Modalities (Outsourced) 2200 Rs.(INR)
19Diagnostic Test(Radiology)3D TMJ Open-Close bothside (Outsourced) 4500 Rs.(INR)
20Diagnostic Test(Radiology)Both Jaw CBCT - 3D Imaging Modalities (Maxilla and Mandible) (outsourced) 4000 Rs.(INR)
21Diagnostic Test(Radiology)Single Jaw CBCT - 3D Imaging Modalities (Maxilla or Mandible) (outsourced) 2200 Rs.(INR)
22Diagnostic Test(Radiology)Sectional CBCT - 3D Imaging modalities (outsourced) 1800 Rs.(INR)
23Diagnostic Test(Radiology)Extraoral Radiographs - Skullview (outsourced) 700 Rs.(INR)
24Diagnostic Test(Radiology)lateral cephalogram X-ray (Outsourced) 700 Rs.(INR)
SR No.Treatment TypeTreatmentCharges
1CheckupOld Case Checkup290 Rs.(INR)
2CheckupNew Checkup400 Rs.(INR)
3Diagnostic ServiceIOPA X-ray125 Rs.(INR)
4ProphylacticFull Mouth Dental Scaling (Acc to the intensity of stains in teeth)800/- 1400/- 1600/- 2100/- Rs.(INR)
5ProphylacticDental Polishing of Teeth (Full Mouth)290 Rs.(INR)
6Dental Insurance PlanMmsdc dental health awareness plan - Single Person1450 Rs.(INR)
7Dental Insurance PlanMmsdc dental health awareness plan - Family (2 Adult + 1 Child)2750 Rs.(INR)
8CheckupHome Dental Visit for Checkup / Follow-up Charges (Within 3 KM)650 Rs.(INR)
9CheckupFollow-up Visit200 Rs.(INR)
10CheckupHome Dental Visit for Checkup / Follow-up Charges (3 - 5 KM)850 Rs.(INR)
11CheckupHome Dental Visit for Checkup / Follow-up Charges (5 - 8 KM)1050 Rs.(INR)
12PaymentBajaj EMI Finserve Processing Fees for Treatment Charges Payment **767 Rs.(INR)
13Diagnostic Test (Radiology)Occlusal X-ray (Out-sourced)700 Rs.(INR)
14Diagnostic Test (Radiology)OPG X-ray690 Rs.(INR)
15Diagnostic Test (Radiology)PNS view X-ray (Para-Nasal Sinus)767 Rs.(INR)
16Diagnostic Test (Radiology)TMJ X-ray Open/Close view (Temporomandibular joint)690 Rs.(INR)
17Diagnostic Test (Radiology)Oral digital Scanning for Clear Aligners8600 Rs.(INR)
18Diagnostic Test (Radiology)Paranasal Sinus - 3D Image Modalities (Outsourced)2200 Rs.(INR)
19Diagnostic Test (Radiology)3D TMJ Open-Close bothside (Outsourced)4500 Rs.(INR)
20Diagnostic Test (Radiology)Both Jaw CBCT - 3D Imaging Modalities (Maxilla and Mandible) (outsourced)4000 Rs.(INR)
21Diagnostic Test (Radiology)Single Jaw CBCT - 3D Imaging Modalities (Maxilla or Mandible) (outsourced)2200 Rs.(INR)
22Diagnostic Test (Radiology)Sectional CBCT - 3D Imaging modalities (outsourced)1800 Rs.(INR)
23Diagnostic Test (Radiology)Extraoral Radiographs - Skullview (outsourced)700 Rs.(INR)
24Diagnostic Test (Radiology)Lateral cephalogram X-ray (Outsourced)700 Rs.(INR)
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SR No.Treatment TypeTreatmentCharges
1CheckupOld Case Checkup 290 Rs.(INR)
2CheckupNew Checkup 400 Rs.(INR)
3Diagnostic ServiceIOPA X-ray 125 Rs.(INR)
4ProphylacticFull Mouth Dental Scaling (Acc to the intensity of stains in teeth) 800/ - 1400/- 1600/ - 2100/ - Rs.(INR)
5ProphylacticDental Polishing of Teeth (Full Mouth) 290 Rs.(INR)
6?Dental Insurance PlanMmsdc dental health awareness plan - Single Person 1450 Rs.(INR)
7?Dental Insurance PlanMmsdc dental health awareness plan - Family (2 Adult + 1 Child) 2750 Rs.(INR)
8CheckupHome Dental Visit for Checkup / Follow-up Charges (Within 3 KM) 650 Rs.(INR)
9?CheckupFollow-up Visit 200 Rs.(INR)
10CheckupHome Dental Visit for Checkup / Follow-up Charges (3 - 5 KM) 850 Rs.(INR)
11CheckupHome Dental Visit for Checkup / Follow-up Charges (5 - 8 KM) 1050 Rs.(INR)
12?PaymentBajaj EMI Finserve Processing Fees for Treatment Charges Payment ** 767 Rs.(INR)
13Diagnostic Test (Radiology)Occlusal X-ray (Out-sourced) 700 Rs.(INR)
14Diagnostic Test(Radiology)OPG X-ray 690 Rs.(INR)
15Diagnostic Test(Radiology)PNS view X-ray (Para- Nasal Sinus) 767 Rs.(INR)
16Diagnostic Test(Radiology)TMJ X-ray Open/Close view (Temporomandibular joint) 690 Rs.(INR)
17Diagnostic Test(Radiology)Oral digital Scanning for Clear Aligners 8600 Rs.(INR)
18Diagnostic Test(Radiology)Paranasal Sinus - 3D Image Modalities (Outsourced) 2200 Rs.(INR)
19Diagnostic Test(Radiology)3D TMJ Open-Close bothside (Outsourced) 4500 Rs.(INR)
20Diagnostic Test(Radiology)Both Jaw CBCT - 3D Imaging Modalities (Maxilla and Mandible) (outsourced) 4000 Rs.(INR)
21Diagnostic Test(Radiology)Single Jaw CBCT - 3D Imaging Modalities (Maxilla or Mandible) (outsourced) 2200 Rs.(INR)
22Diagnostic Test(Radiology)Sectional CBCT - 3D Imaging modalities (outsourced) 1800 Rs.(INR)
23Diagnostic Test(Radiology)Extraoral Radiographs - Skullview (outsourced) 700 Rs.(INR)
24Diagnostic Test(Radiology)lateral cephalogram X-ray (Outsourced) 700 Rs.(INR)
CGHS-AHMEDABAD RATE updated as on 13 October 2025
Sr. No.CGHS TREATMENT PROCEDURE/INVESTIGATION LIST (AHMEDABAD)Non- NABH/ Non- NABL Rates (₹)NABH/NABL Rates (₹)
1974Code-BP018 | Cleft Lip - Repair2975035000
1975Code-BP019 | Cleft Palate Repair3655043000
1976Code-BP020 | Primary Bone Grafting for Alveolar Cleft in Cleft Lip3655043000
1977Code-BP021 | Secondary Surgery for Cleft Lip Deformity3655043000
1978Code-BP022 | Secondary Surgery for Cleft Palate3655043000
736Code-BT001 | Speech Therapy per session of at least 40 minutes340400
737Code-BT002 | Occupational Therapy per session of at least 40 minutes340400
739Code-BT004 | Special education per session of at least 40 minutes340400
514Code-BY001 | Skin Biopsy10631250
515Code-BY002 | Punch/Wedge biopsy25503000
516Code-BY003 | Excision Biopsy of Ulcers42505000
517Code-BY004 | Excision Biopsy of Superficial Lumps78209200
518Code-BY005 | Incision Biopsy of Growths/Ulcers42505000
522Code-BY009 | Muscle Biopsy21252500
523Code-BY010 | Trucut Needle Biopsy- (excluding the cost of Needle/Biopsy Gun if used)32733850
1Code-CN001 | Consultation OPD350350
741Code-DI001 | Intraoral Periapical (IOPA) Radiograph X-ray/RVG(Single Film)170200
742Code-DI002 | Intraoral Occlusal/Bite Wing X-Ray255300
743Code-DI003 | Digital OPG with X ray film/ CD425500
744Code-DI004 | Biopsy of Oral tissue- Soft10201200
745Code-DI005 | Biopsy of Oral tissue - Hard (bone, tooth)17002000
746Code-DP001 | Abscess - Drainage-Dental12751500
747Code-DP002 | Scaling8501000
748Code-DP003 | Curettage and Root Planning - Per Tooth298350
749Code-DP004 | Curettage and Root Planning - Per Arch17002000
750Code-DP005 | Gingivoplasty - Per Quadrant8501000
751Code-DP006 | Gingivectomy - Per Quadrant10201200
752Code-DP007 | Flap Surgery- Per Tooth383450
753Code-DP008 | Flap Surgery- Per Quadrant17002000
754Code-DP009 | Flap Surgery and Bone Graft per quadrant25503000
755Code-DP010 | Extraction - Normal Tooth340400
756Code-DP011 | Complicated Extraction per tooth under LA680800
757Code-DP012 | Extraction Impacted - Soft tissue/ 3rd Molar/wisdom tooth extraction17002000
758Code-DP013 | Multiple Extraction and Treatment Procedures for Special Children, Patients with Systemic Diseases, Patient with Special Needs Which Requires Admission and Treatment Under GA51006000
759Code-DP014 | Extraction - Orthodontic Extraction638750
760Code-DP015 | Operculectomy- Pericoronal flap excision17002000
761Code-DP016 | Extraction Impacted – Bony42505000
762Code-DP017 | Alveoloplasty - Per Tooth255300
763Code-DP018 | Alveoloplasty - Per Quadrant10201200
764Code-DP019 | Frenectomy21252500
765Code-DP020 | Excision of hyperplastic tissue - per arch10201200
766Code-DP021 | Surgical Augmentation/Alveolectomy per Arch29753500
767Code-DP022 | Bone replacement graft for ridge preservation - per site17002000
768Code-DP023 | Minor oral surgery, cyst, granuloma, residual infection, mucocele, epulis under LA17002000
769Code-DP024 | Application of Desensitizing Medicament425500
770Code-DP025 | Fluoride Application for Children8501000
771Code-DP026 | Temporary restoration128150
772Code-DP027 | Glass ionomer Cement Restoration510600
773Code-DP028 | Composite - Occlusal Pit/Class I425500
774Code-DP029 | Composite -Class I with buccal extension/Class II Class III/Class IV/Class VI/Diastema Closure/MOD8501000
775Code-DP030 | RCT-Single Rooted tooth17002000
776Code-DP031 | RCT Multiple root and/ canal tooth25503000
777Code-DP032 | Re-RCT - Anterior21252500
778Code-DP033 | Re-RCT - Posterior25503000
779Code-DP034 | Medication -intracanal medicament (only lesion cases)425500
780Code-DP035 | Apicectomy-Single tooth17002000
781Code-DP036 | Apicectomy-Multiple tooth25503000
782Code-DP037 | Apexification with any bio-compatible material17002000
783Code-DP038 | Root end resection and Retro grade filling25503000
784Code-DP039 | Surgical - Apicectomy/ Periapical surgery without bone grafting595700
785Code-DP040 | Tissue Conditioning, Maxillary/Mandibular255300
786Code-DP041 | Core build-up/ Post and Core - Custom made /Inlay/onlay12751500
787Code-DP042 | Crown lengthening - Per Tooth425500
788Code-DP043 | Crown - PMMA Crown8501000
789Code-DP044 | Crown - All Metal-Nickel Free17002000
790Code-DP045 | Crown - Metal with Ceramic Facing25503000
791Code-DP046 | Crown - Recementation510600
792Code-DP047 | Crown - Removal425500
793Code-DP048 | Odontoplasty /Enameloplasty425500
794Code-DP049 | Pulpectomy (Anterior Tooth)17002000
795Code-DP050 | Pulpectomy (Posterior Tooth)25503000
796Code-DP051 | Pulpotomy8501000
797Code-DP052 | Veneer - Ceramic paediatric25503000
798Code-DP053 | Interceptive Orthodontic Treatment of the Primary Dentition/Transition Dentition59507000
799Code-DP054 | Limited Orthodontic Treatment of the Primary Dentition42505000
800Code-DP055 | Occlusion Analysis/Adjustment/Occlusal Equilibration425500
801Code-DP056 | Tooth Splinting - General12751500
802Code-DP057 | Splinting - Periodontally weak teeth15301800
803Code-DP058 | Night Guard17002000
804Code-DP059 | Bridge/ Fixed Partial denture (per missing/ extracted tooth) metal crown17002000
805Code-DP060 | Bridge/ Fixed Partial denture (per missing/ extracted tooth) metal crown with Ceramic facing25503000
806Code-DP061 | Removable Partial Denture - Flexible Per Arch63757500
807Code-DP062 | Removable Partial Denture - Cast Metal Up to 3 Teeth34004000
808Code-DP063 | Removable Partial Denture - Cast Metal (additional Per tooth)255300
809Code-DP064 | Removable Partial Denture - Acrylic Up to 3 teeth17002000
810Code-DP065 | Removable Partial Denture - Tooth Addition (per tooth)255300
811Code-DP066 | Add Clasp to existing Partial Denture425500
812Code-DP067 | Add Tooth to existing Partial Denture340400
813Code-DP068 | Tooth Supported Overdenture Per Arch63757500
814Code-DP069 | Complete Denture - Per Arch850010000
815Code-DP070 | Removable orthodontic appliance / Post Orthodontic R O A -per arch21252500
816Code-DP071 | Fixed orthodontic per arch1275015000
817Code-DP072 | Space Maintainers - Fixed34004000
818Code-DP073 | Minor Treatment to Control Habits-Removable Appliance Therapy21252500
819Code-DP074 | Minor Treatment to Control Habits-Fixed Appliance Therapy34004000
820Code-DP075 | Functional orthodontic appliance51006000
821Code-DP076 | Feeding appliance for Cleft Palate42505000
822Code-DP077 | Expansion plate55256500
823Code-DP078 | Maxillofacial Prosthesis - Sal/auricular/orbital/Nasal/Palatal/facial lost/ Speech Aid59507000
824Code-DP079 | Obturator Prosthesis - Surgical/Definitive/Modification42505000
825Code-DP080 | Removal of - Lateral Exostosis/Torus Mandibularis/Torus Palatines/Surgical reduction of Osseous Tuberosity25503000
826Code-DP081 | Sialolithotomy/Sialodocotomy/ Closure of Salivary Fistula17002000
827Code-DP082 | Excision of Salivary gland1275015000
828Code-DP083 | Release of fibrous bands & grafting in (OSMF) treatment under GA1700020000
829Code-DP084 | Facial Space Abscess42505000
830Code-DP085 | Partial Ostectomy / sequestrectomy for removal of non-vital bone17002000
831Code-DP086 | Alveolus – Closed Reduction stabilization of Teeth34004000
832Code-DP087 | Alveolus – Open Reduction stabilization of Teeth51006000
833Code-DP088 | Arch bar fixation42505000
834Code-DP089 | Oroantral Fistula closure42505000
835Code-DP090 | Condylar fracture closed reduction51006000
836Code-DP091 | Condylar fracture open reduction1275015000
837Code-DP092 | Maxilla - Closed Reduction51006000
838Code-DP093 | Maxilla - Open Reduction850010000
839Code-DP094 | Mandible - Closed Reduction51006000
840Code-DP095 | Mandible – Open Reduction850010000
841Code-DP096 | Cyst of Maxilla/mandible by enucleation/excision/marsupialization upto 4 cms under LA42505000
842Code-DP097 | Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under LA51006000
843Code-DP098 | Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under GA and admission2125025000
844Code-DP099 | Temporomandibular(TM) joint ankylosis- under GA/Open /Closed Reduction1700020000
845Code-DP100 | Segmental / Hemi Mandibulectomy with graft2125025000
846Code-DP101 | Segmental /Hemi Mandibulectomy without graft1700020000
847Code-DP102 | Sub-Total mandibulectomy with graft2975035000
848Code-DP103 | Sub-Total mandibulectomy without graft2550030000
849Code-DP104 | Maxillectomy/Mandibulectomy- Total with graft2975035000
850Code-DP105 | Maxillectomy/Mandibulectomy- Total without graft2550030000
851Code-DP106 | Maxillectomy- partial with graft2125025000
852Code-DP107 | Maxillectomy- partial without graft1700020000
853Code-DP108 | Malar and/or Zygomatic arch - Closed Reduction51006000
854Code-DP109 | Malar and/or Zygomatic arch - Open Reduction850010000
855Code-DP110 | Distraction osteogenesis of mandible or maxilla under GA2550030000
856Code-DP111 | Facial bones - Complicated Reduction with fixation3825045000
1098Code-EP047 | Tongue Tie excision72258500
1125Code-EP074 | Parotidectomy - Superficial2975035000
1126Code-EP075 | Parotidectomy - Total3655043000
1127Code-EP076 | Repair of Parotid Duct2337527500
1128Code-EP077 | Removal of Submandibular Salivary gland2337527500
1164Code-GP001 | Dressings of wounds255300
1169Code-GP006 | Removal of Sutures (All)170200
1173Code-GP010 | Incision & Drainage under local Anaesthesia (Large)19552300
1175Code-GP012 | Drainage of abscess with anaesthesia1139013400
1176Code-GP013 | Excision of lumps under anaesthesia1139013400
1271Code-GS003 | Suturing of small wounds11691375
1272Code-GS004 | Secondary suture of wounds37404400
1273Code-GS005 | Debridement of wounds - Small14031650
1277Code-GS009 | Excision of Cervical Lymph Node under Local Anaesthesia26353100
1278Code-GS010 | Excision of Axillary Lymph Node under General Anaesthesia72258500
1279Code-GS011 | Excision of Inguinal Lymph Node under Local Anaesthesia25503000
1280Code-GS012 | Excision of Sebaceous Cysts42505000
1281Code-GS013 | Excision of Superficial Lipoma42505000
1864Code-OR035 | Bandage & Strappings for Fractures17002000
1865Code-OR036 | Aspiration & Intra Articular Injections42505000
1872Code-OR043 | Bone Grafting2337527500
1914Code-OR085 | Removal of Wires & Screw1139013400
1915Code-OR086 | Removal of Plates2337527500
374Code-RI036 | X Ray Mastoids: Towne view, oblique views (3 films)425500
377Code-RI039 | X Ray Temporomandibular (TM) Joints (one film)213250
379Code-RI041 | X Ray Skull AP & Lateral (2 films)/ Extra oral radiographs - All skull views, TMJ, Lateral oblique [Dental]340400
381Code-RI043 | X Ray Paranasal sinuses (PNS) view (1 film)170200
393Code-RI055 | X ray Arthrography17002000
394Code-RI056 | Ortho Scanogram14371690
395Code-RI057 | Cephalography298350
420Code-RI082 | CT Scan of Para Nasal Sinuses (CT PNS)- Without Contrast19552300
421Code-RI083 | CT Scan of Para Nasal Sinuses (CT PNS)- With Contrast28053300
424Code-RI086 | CT Scan / Cone Beam CT (CBCT) Dental12751500
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