5. Revised Rate List

1 Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) 1 01 PROCEDURES CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees) 001 General 01001001 Consultation by Medical Officer (OPD) 150/- 01001002 Consultation by Specialists (OPD) 200/- 01001003 Visit/ Revisit/ Consultation by Specialists (Indoor) (Maximum two visits per day admissible) 200/- 01001004 Consultation by Super-Specialists (OPD) 250/- 01001005 Visit/ Revisit/ Consultation by Super-Specialists (Indoor) (Maximum two visits per day admissible)

2 250/- 01001006 Pre-operative Anaesthetic Consultation 200/- 01001007 Paramedical Consultation 75/- 01001008 Special Nursing Charge (per shift of 12 hrs.) 150/- 01001009 Aya/ Attendant Charge (per shift of 12 hrs.) 75/- 01001010 Delayed primary suture 1700/- 01001011 Dressings Large 160/- 01001012 Suturing without local anesthesia 400/- 01001013 Suturing of wounds with local anesthesia 500/- 01001014 Debridement of wounds 1200/- 01001015 Removal of Benign Tumor 1100/- 01001016 Aspiration Plural Effusion - Therapeutic 1000/- 01001017 Abdominal Aspiration - Therapeutic 1300/- 01001018 Removal of Superficial 1200/- 01001019 Bone Marrow Aspiration 1500/- 01001020 Joints Aspiration 1500/- 01001021 Strapping 100/- 01001022 Removal of Stitches 60/- 01001023 Venesection 300/- 01001024 Phimosis Under LA 1500/- CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees)

3 01001025 Lumbar puncture 700/- 01001026 Sternal puncture 1500/- 01001027 Injection for Haemorrhoids 1000/- 01001028 Injection for Varicose Veins 1300/- 01001029 Catheterisation 120/- 01001030 Dilatation of Urethra 1100/- 01001031 Incision & Drainage 600/- 01001032 Intercostal Drainage 1500/- 01001033 Peritoneal dialysis 1800/- 01001034 Removal of soft tissue or regional block under general anaesthesia 2400/- 01001035 Dressing Small 100/- 01001036 Secondary suture of wounds 1200/- 002 Skin 01002001 Excision of Moles 600/- 01002002 Excision of Warts 600/- 01002003 Excision of Molluscum contagiosum 600/- 01002004 Excision of Veneral Warts 600/- 01002005 Excision of Corns 550/- 01002006 I/D Injection Keloid of Acne 300/- 01002007 Chemical Cautery (per sittings) 120/- 01002008 Excision of Sebaceous Cysts 1700/- 01002009 Excision of Superficial Liipoma 2400/- 01002010 Excision of Dermoid Cysts 2450/- 003 01003001 Speech therapy per session of 30-40 minutes 200/- 01003002 Removal of foreign body From Nose/ Ear/ Throat (Day care package) 1500/- 01003003 Swallowing Therapy 250/- 01003004 Syringing 300/- 01003005 Polyp removal under LA 800/- 01003006 Peritonsillar abscess drainage under LA 1600/- 01003007 Tinnitus Retraining Therapy 250/- Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No.)

4 796-F (MED) dated 31-01-2011) 2 CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees) 01003008 Myringoplasty 10700/- 01003009 Staepedectomy 12000/- 01003010 Myringotomy with Grommet insertion 6000/- 01003011 Endoscopic Removal of Fish Bone 1000/- 01003012 Tympanotomy 8000/- 01003013 Paracentesis 4300/- 01003014 tympanoplasty 14000/- 01003015 Mastoidectomy 15600/- 01003016 Otoplasty 16500/- 01003017 Labyrinthectomy 15600/- 01003018 Skull Base surgery 50000/- 01003019 Facial Nerve Decompression 20000/- 01003020 Septoplasty 10200/- 01003021 Submucous Resection 10800/- 01003022 Septo-rhinoplasty 15000/- 01003023 Rhinoplasty (non-cosmetic) 12000/- 01003024 Fracture Reduction 9000/- 01003025 Intra Nasal Diathermy 6000/- 01003026 Turbinectomy 9600/- 01003027 Endoscopic DCR 13000/- 01003028 Endoscopic Surgery 15000/- 01003029 Septal Perf.

5 Repair 15000/- 01003030 Antrum Puncture 3000/- 01003031 Lateral Rhinotomy 1350/- 01003032 Cranio-facial resection 28000/- 01003033 Ethamoidectomy 17600/- 01003034 Caldwell Luc Surgery 12000/- 01003035 Angiofibroma Excision 18000/- 01003036 Endoscopic Hypophysectomy 25000/- 01003037 Endoscopic Optic Nerve Decompression 32000/- 01003038 Decompression of Orbit 30000/- 01003039 Ranula Excision 9600/- 01003040 Tongue Tie excision 8100/- 01003041 Sub Mandibular Duct Lithotomy 9700/- 01003042 Adenoidectomy 8000/- 01003043 Palatopharyngoplasty 15100/- 01003044 Cleft Palate repair 16000/- 01003045 Pharyngoplasty 18000/- 01003046 Styloidectomy 11500/- CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees) 01003047 Uvulo-palatoplasty 20000/- 01003048 Tympanomastoidectomy 15600/- 01003049 Dacunisation 7000/- 01003050 Tonsillectomy 11200/- 01003051 Adenotonsillectomy 13500/- 01003052 Synichiolysis 4200/- 01003053 Submucosal Diathermy 4000/- 01003054 Nasal Mass Excision- Simple 11200/- 01003055 Nasal Mass Excision- Endoscopic Removal 13500/- 01003056 FESS 11200/- 01003057 Anterior Nasal Packing 4000/- 01003058 Post Nasal Packing 5000/- 01003059 Nasal Bone Reduction 6000/- 01003060 Excision of Lesion Base of Tongue- per Oral Approach 6400/- 004 Opthalmology 01004001 Cauterisation of ulcer/subconjuctival injection - One eye 200/- 01004002 Cauterisation of ulcer/subconjuctival injection - Both eyes 300/- 01004003 Retrobular Injection - One Eye 200/- 01004004 Retrobular Injection - Both Eyes 300/- 01004005 Syringing of

6 Lacrimal Sac -For one eye 200/- 01004006 Syringing of Lacrimal Sac - For both eyes 300/- 01004007 Paracentesis 800/- 01004008 Foreign body removal 300/- 01004009 Refraction/Fundoscopy 90/- 01004010 Ortho-optic exercises 100/- 01004011 Plepoptic Exercises 100/- 01004012 Chalazion operation -One Eye 800/- 01004013 Chalazion operation - Both Eyes 1000/- 01004014 Dressing (Eye) 100/- 01004015 Clinical Photography 100/- 01004016 Pterygium 2200/- 01004017 Orbitotomy 9000/- Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) 3 CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees) 01004018 Ptosis correction. 6500/- 01004019 Ectropion Correction 3600/- 01004020 Xenon Arc Laser 700/- 01004021 D C R (Dacryo custo-rhinostomy) 5700/- 01004022 ECCE/ICCE 6000/- 01004023 Epicanthus correction.

7 2100/- 01004024 Squint Correction (one eye) 4000/- 01004025 Squint Correction (both eyes) 6000/- 01004026 Keratoplasty 14000/- 01004027 Trabeculotomy 5700/- 01004028 Iridectomy 2400/- 01004029 Goniotomy 2400/- 01004030 Scleral Bukling (Retinal Detachment Surgery) 14000/- 01004031 Syringing & Probing 1100/- 01004032 Vitrectomy 11000/- 01004033 Enucleation 4000/- 01004034 Eviseration 3800/- 01004035 Entropion correction 3000/- 01004036 Cataract with IOL(Cost of lens extra) 7500/- 01004037 Fistulectomy 5700/- 01004038 Glucoma surgery with Glucoma valves 5000/- 01004039 Caliculoplasty 3000/- 01004040 Dacryocystectomy 3000/- 01004041 Ptosis surgery with LPS resection 7000/- 01004042 Ptosis surgery with Sling surgery 7000/- 01004043 Ectropion surgery- one lid 3000/- 01004044 Ectropion surgery- both lids 4000/- 01004045 Cheek rotation flap for lid tumors 8000/- 01004046 Telecanthus correction 4000/- 01004047 Fracture orbital repair 9000/- CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees)

8 01004048 Lasik 18000/- 01004049 TTT- Transpupillary thermal therapy 4000/- 01004050 PTK- Phototherapeutic keratectomy 9000/- 01004051 Iris cyst removal 1000/- 01004052 Lid Abscess incision and drainage 3000/- 01004053 Orbital Abscess incision and drainage 4000/- 01004054 Cyclodiathermy 2000/- 01004055 Perforating injury repair 4000/- 01004056 Phaco + IOL (inclusive of Foldable & Non-foldable lens) Package 14500/- 01004057 YAG Laser Capsulotomy per sitting 600/- 01004058 YAG Laser Iridectomy per sitting 600/- 01004059 Argon Laser Trabeculoplasty (ALT) (per sitting) 1000/- 01004060 HVF 500/- 01004061 Cryopexy 1200/- 01004062 ICG including Medicine 2000/- 01004063 ICG- Double including Medicine 3600/- 01004064 Electrolysis (Per sitting) 150/- 01004065 Cyclocryo/ Cyclodiathermy 500/- 01004066 (OPD) 800/- 01004067 Silicone Oil (1000) 4000/- 01004068 Silicone Oil (C5) 4000/- 01004069 Silicone Oil Removal 3500/- Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No.)

9 796-F (MED) dated 31-01-2011) 4 CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees) 01004070 Pneumo Retinopexy 2400/- 01004071 FGE/ FAE 1500/- 01004072 Indirect Laser 1000/- 01004073 Endo Laser 2400/- 01004074 SF6 Gas 2400/- 01004075 C3F8 Gas 2400/- 01004076 PFCL 2400/- 01004077 Photodynamic Therapy procedure charges- single eye 15000/- 01004078 Photodynamic Therapy procedure charges- both eyes 25000/- 01004079 Photodynamic Therapy (single eye) 85000/- 01004080 Photodynamic Therapy (both eyes) 100000/- 01004081 Intravitreal Avastin (including cost of injection-single) 6000/- 01004082 Intravitreal Lucentis (excluding cost of injection-single) 4000/- 01004083 Intravitreal Macugen (excluding cost of injection-single) 4000/- 01004084 Intravitreal injections of antibiotics (cost of medicines extra) 2000/- 01004085 Retinal Foreign Body Removal 4000/- 01004086 PPV/ Victerectomy 6500/- 01004087 Endo Diathermy 1600/- 01004088 Belt Buckle 3200/- 01004089 IVTCA 800/- 01004090 Membrane Peeling 2400/- CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees) 01004091 Anterior Vitrectomy 5000/- 01004092 Lensectomy 7500/- 01004093 Orbitotomy (Multiple Wall) 16000/- 01004094 ERM (Epi Retinal Membrane) 3600/- 01004095 Reti Blue 2400/- 01004096 Corneal Collagen Cross-linking 15000/- 005 Biopsies including Histopathological report (Package) 01005001 Biopsy procedure under Local Anaesthesia 4000/- 01005002 Biopsy procedure under General Anaesthesia 6000/- 01005003 Biopsy procedure under Endoscopy 8000/- 01005004 FNAC 3500/- 006 Strapping (including Bandage & materials)

10 01006001 Strapping of Finger 200/- 01006002 Strapping of Toes 200/- 01006003 Strapping of Wrist 360/- 01006004 Strapping of Elbow 400/- 01006005 Strapping of Knee 400/- 01006006 Strapping of Ankle 400/- 01006007 Strapping of Chest 500/- 01006008 Strapping of Shoulder 450/- 01006009 Nasal bone fracture 450/- 01006010 Figure of 8 bandage 450/- 01006011 Colar and cuff sling 450/- 01006012 Ball bandage 450/- 007 Physiotheraphy & Traction 01007001 Ultrasonic therapy (per sitting) 70/- 01007002 Diathermy (per sitting) 90/- 01007003 Electrical stimulation (therapeutic) (per sitting) 70/- 01007004 Infra red (per sitting) 90/- 01007005 Therapeutic dose (per sitting) 90/- Annexure-I Revised Rate List under the West Bengal Health Scheme, 2008 (Notification No. 796-F (MED) dated 31-01-2011) 5 CODE NAME OF TREATMENT PROCEDURE Maximum Approved Rate (INR) (Rupees) 01007006 Electric vibrator (per sitting) 90/- 01007007 Vibrator belt massage (per sitting) 90/- 01007008 Intra Lumbar Traction (per sitting) 90/- 01007009 Intermittent Cervical traction (per sitting) 70/- 01007010 Combined Lumbar & Cervical traction (per sitting) 70/- 01007011 Wax bath (per sitting) 50/- 01007012 Hot pack (per sitting) 70/- 01007013 Whirl pool bath (per sitting) 90/- 01007014 Obesity Exercises (per sitting) 60/- 01007015 Breathing Exercises & Postural Drainage (per sitting) 70/- 01007016 Cerebral Palsy Massage (per sitting) 90/- 01007017 Post polio exercise (per sitting) 60/- 01007018 Basic Gait Training (Per Session)