| E.N.T. | | | | | | |
| 1 | Tonsillectomy/Adenoidectomy | 1.5 | 40,000.00 | 100% | 15,000.00 | 65,000.00 | 50,000.00 |
| 2 | Tympanoplasty | 1.5 | 45,000.00 | 100% | 18,000.00 | 75,000.00 | 60,000.00 |
| 3 | Cochlear Implant - Unilateral | 2 | 8,00,000.00 | 40% | 6,00,000.00 | 12,00,000.00 | 9,00,000.00 |
| GENERAL & LAP. SURGERY | | | | | | |
| 4 | Haemorrhoidectomy / Fistulectomy | 1.5 | 48,000.00 | 40% | 18,000.00 | 1,00,000.00 | 65,000.00 |
| 5 | Appendectomy - Lap. | 1.5 | 48,000.00 | 40% | 20,000.00 | 1,50,000.00 | 70,000.00 |
| 6 | Cholecystectomy - Lap. | 1.5 | 48,000.00 | 40% | 25,000.00 | 1,50,000.00 | 70,000.00 |
| 7 | Hernioplasty - Lap. - Unilateral - Inguinal / Femoral / Umblical / Incisional | 1.5 | 48,000.00 | 40% | 22,000.00 | 1,80,000.00 | 80,000.00 |
| OBSTETRICS & GYNE | | | | | | |
| 8 | Normal Delivery | 1.5 | 60,000.00 | 40% | 10,000.00 | 1,50,000.00 | 90,000.00 |
| 9 | Lower Segment Cesarean Section (LSCS) | 2 | 80,000.00 | 40% | 18,000.00 | 1,80,000.00 | 1,20,000.00 |
| 10 | Laparoscopic Assisted Vaginal Hysterectomy (LAVH) | 2 | 1,20,000.00 | 40% | 35,000.00 | 2,00,000.00 | 1,70,000.00 |
| 11 | Total Abdominal Hysterectomy (TAH) - Lap. | 2 | 1,20,000.00 | 40% | 40,000.00 | 2,00,000.00 | 1,40,000.00 |
| 12 | Ovarian Cystectomy - Lap. | 1.5 | 60,000.00 | 40% | 30,000.00 | 1,05,000.00 | 70,000.00 |
| 13 | Dilatation & Curettage (D&C) - Day Care | 0 | 30,000.00 | 40% | 5,000.00 | 25,000.00 | 15,000.00 |
| 14 | Cystoscopy - Day Care | 0 | 25,000.00 | 40% | 8,000.00 | 27,500.00 | 18,500.00 |
| 15 | Myomectomy - Lap. | 2 | 1,00,000.00 | 40% | 32,000.00 | 1,20,000.00 | 75,000.00 |
| ORTHOPAEDICS | | | | | | |
| 16 | Total Knee Replacement- Unilateral - With Implant | 3 | 2,00,000.00 | 40% | 1,50,000.00 | 4,50,000.00 | 3,00,000.00 |
| 17 | Hip Replacement - Unilateral | 3 | 2,00,000.00 | 40% | 1,40,000.00 | 4,20,000.00 | 2,80,000.00 |
| 18 | ACL Reconstruction/Repair | 1.5 | 1,30,000.00 | 40% | 80,000.00 | 2,20,000.00 | 1,60,000.00 |
| UROLOGY AND NEPHROLOGY | | | | | | |
| 19 | RIRS | 1.5 | 95,000.00 | 40% | 60,000.00 | 1,80,000.00 | 1,20,000.00 |
| 20 | PCNL - Unilateral | 1.5 | 80,000.00 | 40% | 50,000.00 | 1,50,000.00 | 1,00,000.00 |
| 21 | Circumcision (Day-Care) | 0 | 20,000.00 | 40% | 8,000.00 | 30,000.00 | 22,000.00 |
| 22 | Prostate Removal- TURP | 1.5 | 80,000.00 | 40% | 45,000.00 | 1,30,000.00 | 90,000.00 |
| 23 | Dialysis (All inclusive, Day Care) | 0 | 2,800.00 | 40% | 2,500.00 | 5,000.00 | 4,000.00 |
| 24 | DJ Stent Removal (Day Care) | 0 | 7,500.00 | 40% | 5,000.00 | 1,80,000.00 | 12,000.00 |
| VASCULAR SURGERY | | | | | | |
| 25 | Vericose Veins - Unilateral | 1.5 | 70,000.00 | 40% | 35,000.00 | 1,00,000.00 | 70,000.00 |
| 26 | AV fistula ( Day Care) | 0 | 35,000.00 | 40% | 25,000.00 | 65,000.00 | 48,000.00 |
| Cosmetic/Plastic Surgery | | | | | | |
| 27 | Bariatric Surgery | 2 | 2,80,000.00 | 40% | 2,00,000.00 | 5,00,000.00 | 3,80,000.00 |
| 28 | Liposuction - Per Body Area | 1.5 | 1,35,000.00 | 40% | Not covered | 1,50,000.00 | 1,00,000.00 |
| 29 | Breast Implant - Bilateral with Implant | 1.5 | 1,40,000.00 | 40% | Not covered | 2,50,000.00 | 1,80,000.00 |
| 30 | Lipoma Removal - Per Lipoma | 1 | 5,500.00 | 40% | 8,000.00 | 25,000.00 | 18,000.00 |
| 31 | Gynaecomestia | 1 | 45,000.00 | 40% | 40,000.00 | 1,20,000.00 | 90,000.00 |
| Oncology | | | | | | |
| 32 | Chemotherapy - Per Chemo - Day Care - Medicine Extra On Actuals | 0 | 18,000.00 | 40% | 40,000.00 | 1,00,000.00 | 70,000.00 |
| 33 | Breast Cancer Surgery - Unilateral | 1.5 | 1,80,000.00 | 40% | 50,000.00 | 4,00,000.00 | 3,00,000.00 |
| 34 | Commando Surgery with Reconstruction - Including ICU Stay | 3 | 4,10,000.00 | | Not covered | 6,00,000.00 | 5,00,000.00 |
