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HOSPITAL NAMEKARTHIK MEDICAL CENTRE
DISTRICTSALEM
ADDRESSNO.5/148, CHINNA NACHIYAR SALEM MAIN ROAD, SALEM
HOSPITAL CONTACT NO04283-222309/222310
AVAILABLE SPECIALITIESGENERAL MEDICINE
GENERAL SURGERY
GENITOURINARY SURGERY
MEDICAL GASTROENTEROLOGY
MEDICAL ONCOLOGY
NEUROSURGERY
OBSTETRICS AND GYNAECOLOGY
ORTHOPEDICS (INCLUDING POLYTRAUMA)
PEDIATRICS
PLASTIC SURGERY
REPLACEMENT
SPINE
SURGICAL GASTROENTEROLOGY
SURGICAL ONCOLOGY

Packages Rate
CM0076 : INGUINAL BLOCK DISSECTION ONE SIDE 11948
CM0077 : ABDOMNO PERINEAL RESECTION (APR) + SACRECTOMY 36936
CM0078-A : LAPROSCOPIC APR 41796
CM0078-B : EXTRALEVATOR APR 31266
CM0078-C : TRANS ABDOMINAL 31266
CM0078-D : TRANS ANAL 31266
CM0078-E : INTERSPHINCTERIC RESECTION 31266
CM0078-F : LOW ANTERIOR RESECTION 35316
CM0079 : ABDOMINAL WALL TUMORS RESECTION WITH RECONSTRUCTION 36045
CM0080 : ABDOMINAL WALL TUMORS RESECTION WITHOUT RECONSTRUCTION 25920
CM0081 : BILATERAL PELVIC LYMPH NODE DISSECTION(BPLND) ANY SITE 17820
CM0082-A : RADICAL VAGINECTOMY WITHOUT RECONSTRUCION a) WITH LND 22883
CM0082-B : RADICAL VAGINECTOMY WITHOUT RECONSTRUCION b) WITHout LND 20858
CM0083-A : RADICAL VAGINECTOMY WITH RECONSTRUCION a) WITH LND 33413
CM0083-B : RADICAL VAGINECTOMY WITH RECONSTRUCION b) WITHOUT LND 29363
CM0084-A : RADICAL HYSTERECOMY+BILATERAL PELVIC LYMPH NODE DISSECTION+BILATERAL SALPHINGO OOPHERECTOMY 30173
CM0084-B : OVARIAN TRANSPOSITION 35843
CM0085-A : ANTERIOR EXENTRATION - ANY SITE 46778
CM0085-B : POSTERIOR EXENTRATION- ANY SITE 33818
CM0086 : TOTAL PELVIC EXENTRATION - ANY SITE 57308
CM0087 : EXTRALEVATOR EXENTRATION - ANY SITE 32603
CM0088 : SUPRALEVATOR EXENTRATION - ANY SITE 32603
CM0089 : TOTAL ABDOMINAL HYSTERECTOMY+BILATERAL SALPHINGO OOPHERECTOMY+BILATERAL PELVIC LYMPH NODE DISSECTION+OMENTECTOMY 28107
CM0090-A : RETRO PERITONEAL LYMPH NODE DISSECTION(RPLND) (FOR RESIDUAL DISEASES /STAGING 17213
CM0090-B : RETRO PERITONEAL LYMPH NODE DISSECTION(RPLND) (FOR RESIDUAL DISEASES /WITH VASCULAR RECONSTRUCTION 25515
CM0091-A : OESOPHAGECTOMY WITH TWO FIELD LYMPADENECTOMY 48803
CM0091-B : OESOPHAGECTOMY WITH THREE FIELD LYMPADENECTOMY 58928
CM0092-A : VERMILIONECTOMY WITHOUT WEDGE EXCISION 13568
CM0092-B : VERMILIONECTOMY WITH WEDGE EXCISION 15188
CM0093 : EMASCULATION 20007
CM0094 : PALATECTOMY ANY TYPE 20453
CM0095 : RADICAL TRACHELECTOMY 27743
CM0096 : SUBSTERNAL BYPASS 22073
CM0097 : ABBE OPERATION 15188
CM0098 : CYTOREDUCTIVE SURGERY 18833
CM0099 : VULVECTOMY 12353
CM0100 : BREAST CANCER 0
CM0100-a : BREAST CANCER - combined regimen AC & T 0
CM0100-a-I : BREAST CANCER - Dose Dense AC (Adriamycin/Cyclophosphamide) ; (Day 1: Doxorubicin 60mg/m2 IV, Cyclophosphamide 600mg/m2 IV) ; Repeat cycle - every 14 days for 4 cycles; Followed by Paclitaxel for 4 cycles 3000
CM0100-a-II : BREAST CANCER - Paclitaxel (Preceeded by Dose Dense AC - 4 cycles) ; (Day 1: Paclitaxel 175mg/m2) Repeat cycle - every 14 days for 4 cycles 7000
CM0100-b : BREAST CANCER - TC (Doectaxel & Cyclophosphamide) ; Day 1: Docetaxel 75mg/m2 IV, Cyclophosphamide 600mg/m2 IV ; Repeat cycle - every 21 days for 4 cycles 6000
CM0100-c : BREAST CANCER - CMF (Cyclophosphamide/Methotrexate/Fluorouracil) - (includes day 1 & day 8) ; Days 1-14: Cyclophosphamide 100mg/m2 orally ; Days 1 and 8: Methotrexate 40mg/m2 IV ; Days 1 and 8: 5-fluorouracil 600mg/m2 IV. ; Repeat cycle - every 28 days for 6 cycles 2700
CM0100-d : BREAST CANCER - EC (Epirubicin/Cyclophosphamide) ; Day 1: Epirubicin 100mg/m2 IV ; Day 1: Cyclophosphamide 830mg/m2 IV. ; Repeat cycle - every 21 days for 8 cycles 5100
CM0100-e : BREAST CANCER - FEC + T 0
CM0100-e-I : BREAST CANCER - FEC/CEF followed by T (Fluorouracil/Epirubicin/Cyclophosphamide) - followed by Docetaxel or followed by weekly Paclitaxel) ; Day 1: 5-fluorouracil 500mg/m2 IV ; Day 1: Epirubicin 100mg/m2 IV ; Day 1: Cyclophosphamide 500mg/m2 IV. ; Repeat cycle every 21 days for 3 cycles 5100
CM0100-e-II : BREAST CANCER - Docetaxel - (Preceeded by FEC/CEF ) ; Day 1: Docetaxel 100mg/m2 IV. ; Repeat cycle - every 21 days for 3 cycles 5500
CM0100-e-III : BREAST CANCER - Paclitaxel - weekly - (Preceeded by FEC/CEF ) ; Paclitaxel 100mg/m2 IV ; Repeat cycle - once weekly for 8 weeks 3500
CM0100-f : BREAST CANCER - FAC + T 0
CM0100-f-I : BREAST CANCER - FAC followed by T (Fluorouracil/Adriamycin/Cyclophosphamide) - followed by weekly Paclitaxel ; 5-fluorouracil 500mg/m2 IV Days 1 and 8 OR 1 and 4: ; Day 1: Doxorubicin 50mg/m2 IV ; Day 1: Cyclophosphamide 500mg/m2 IV. ; Repeat cycle - every 21 days for 6 cycles 3200
CM0100-f-II : BREAST CANCER - Paclitaxel - weekly - Preceeded by FAC ; Paclitaxel 80mg/m2 IV ; Repeat Cycle weekly for 12 weeks. 3500
CM0100-g : BREAST CANCER - TAC (Docetaxel/Adriamycin/Cyclophosphamide) ; Day 1: Doxorubicin 60mg/m2 IV ; Day 1: Cyclophosphamide 600mg/m2 IV. ; Day 1: Docetaxel 100mg/m2 IV. ; Repeat cycle every 21 days for 4 cycles, 5600
CM0100-h : BREAST CANCER - AC followed by T + Trastuzumab 0
CM0100-h-I : BREAST CANCER - AC - followed by Paclitaxel + Trastuzumab +/- Pertuzumab ; Day 1: Doxorubicin 60mg/m2 IV ; Day 1: Cyclophosphamide 600mg/m2 IV. ; Repeat cycle - every 21 days for 4 cycle 3000
CM0100-h-II : BREAST CANCER - Paclitaxel (Preceeded by AC) ; (To be choosen along with Trastuzumab package - CM0100-h-III or CM0100-h-IV or CM0100-h-V) ; Paclitaxel 80mg/m2 IV. ; Repeat Cycle weekly for 12 weeks. 3500
CM0100-h-III : BREAST CANCER - Trastuzumab (6mg) ; (to be choosen along with Paclitaxel package CM0100-h-II) ; Day 1: Trastuzumab 6mg/kg IV ; Repeat cycle every 21 days to complete 1 year. ; (to be approved with Paclitaxel Cycle 1, 4, 7, 10 and standalone for the upto 1 year every 21 days) 30500
CM0100-h-IV : BREAST CANCER - Trastuzumab 4mg (Followed by Trastuzumab 2mg subsequent weeks) ; (to be choosen along with Paclitaxel package CM0100-h-II) ; Day 1: Trastuzumab 4mg/kg IV with first dose of paclitaxel. ; (First dose - only to be approved with Paclitaxel Cycle 1. Subsequent cycles - 2mg package only) 30500
CM0100-h-V : BREAST CANCER - Trastuzumab 2mg (Subsequent doses) ; (to be choosen along with Paclitaxel package CM0100-h-II) ; Day 1: Trastuzumab 2mg/kg IV weekly Till one year from Day 1 of AC. ; (to be approved with Paclitaxel Cycles 2 - 12 and standalone for the upto 1 year every week) 11500
CM0100-i : BREAST CANCER - TCH 0
CM0100-i-I : BREAST CANCER - TC (Docetaxel/Carboplatin) ; (To be choosen along with Trastuzumab package - CM0100-i-II or CM0100-i-III or CM0100-i-IV) ; Day 1: Docetaxel 75mg/m2 IV; Carboplatin AUC 6mg per min/mL IV. ; every 21 days for 6 cycles 7100
CM0100-i-II : BREAST CANCER - Trastuzumab (6mg) ; (to be choosen along with TC package CM0100-i-I) ; Trastuzumab 6mg/kg IV ; Repeat cycle every 21 days to complete 1 year. ; (to be approved with TC Cycle 1 to 6 and standalone for the upto 1 year every 21 days (or) after completion of weekly trastuzumab for 18 weeks as standalone for the upto 1 year every 21 days) 30500
CM0100-i-III : BREAST CANCER - Trastuzumab 4mg (First dose - only) - followed by 2mg ; (to be choosen along with TC package CM0100-i-I) ; Day 1: Trastuzumab 4mg/kg IV ; (First dose - only to be approved with TC Cycle 1. Subsequent cycles - 2mg package only) 30500
CM0100-i-IV : BREAST CANCER - Trastuzumab 2mg (Subsequent doses - Weekly) ; Trastuzumab 2mg/kg IV ; (to be approved weekly for 17 weeeks may overlap with TC Cycles 2 - 6. To be followed by Trastuzumab (6mg) package upto 1 year 11500
CM0100-j : BREAST CANCER - AC followed by Docetaxel + Trastuzumab 0
CM0100-j-I : BREAST CANCER - AC - followed by Docetaxel + Trastuzumab ; Day 1: Doxorubicin 60mg/m2 IV; Day 1: Cyclophosphamide 600mg/m2 IV. ; Repeat cycle every 21 days for 4 cycles, 3000
CM0100-j-II : BREAST CANCER - Docetaxel (preceeded by AC) + Trastuzumab ; (To be choosen along with Trastuzumab package - CM0100-j-III or CM0100-j-IV or CM0100-j-V) ; Day 1: Docetaxel 100mg/m2 IV. ; Repeat cycle every 21 days for 4 cycles 5400
CM0100-j-III : BREAST CANCER - Trastuzumab (6mg) ; (to be choosen along with Docetaxel package CM0100-j-II) ; Day 1: Trastuzumab 6mg/kg IV ; Repeat every 21 days till 1 year ; (to be approved with Docetaxel Cycle 1 to 4 and standalone for the upto 1 year every 21 days (or) or from 13 th week after completion of 12 weeks of weekly Trastuzumab - upto 1 year every 21 days) 30500
CM0100-j-IV : BREAST CANCER - Trastuzumab 4mg (First dose - only) - followed by 2mg ; (to be choosen along with Docetaxel package CM0100-j-II) ; Trastuzumab 4mg/kg IV ; (First dose - only to be approved with Docetaxel Cycle 1. Subsequent cycles - 2mg package only) 30500
CM0100-j-V : BREAST CANCER - Trastuzumab 2mg (Subsequent doses) ; Trastuzumab 2mg/kg IV ; (to be approved weekly for 11 weeeks may overlap with Docetaxel Cycles 2 - 4. To be followed by Trastuzumab (6mg) package upto 1 year) 11500
CM0100-k : BREAST CANCER - Docetaxel + Cyclophosphamide + Trastuzumab 0
CM0100-k-I : BREAST CANCER - Docetaxel + Cyclophosphamide - with Trastuzumab ; (To be choosen along with Trastuzumab package - CM0100-k-II or CM0100-k-III or CM0100-k-IV) ; Day 1: Docetaxel 75mg/m2 IV; Cyclophosphamide 600mg/m2 IV. ; Repeat cycle every 21 days for 4 cycles, 5000
CM0100-k-II : BREAST CANCER - Trastuzumab (6mg) ; (to be choosen along with Docetaxel + Cyclophosphamide package CM0100-k-I) ; Day 1: Trastuzumab 6mg/kg IV ; (to be approved with Docetaxel + Cyclophosphamide Cycle 1 to 4 and standalone for the upto 1 year every 21 days (or) after completion of weekly trastuzumab for 12 weeks as standalone for the upto 1 year every 21 days) 30500
CM0100-k-III : BREAST CANCER - Trastuzumab 4mg (First dose - only) - followed by 2mg ; (to be choosen along with Docetaxel + Cyclophosphamide package CM0100-k-I) ; Trastuzumab 4mg/kg IV ; (First dose - only to be approved with Docetaxel + Cyclophosphamide Cycle 1. Subsequent cycles - 2mg package only) 30500
CM0100-k-IV : BREAST CANCER - Trastuzumab 2mg (Subsequent doses) ; Trastuzumab 2mg/kg IV ; (to be approved weekly for 11 weeeks may overlap with Docetaxel + Cyclophosphamide Cycles 2 - 4. To be followed by Trastuzumab (6mg) package upto 1 year) 11500
CM0100-L : BREAST CANCER - Paclitaxel + Trastuzumab 0
CM0100-L-I : BREAST CANCER - Paclitaxel - (with Trastuzumab) ; (To be choosen along with Trastuzumab package - CM0100-L-III or CM0100-L-IV) ; Paclitaxel 80mg/m2 IV. ; Repeat Cycle weekly for 12 weeks. 3000
CM0100-L-II : BREAST CANCER - Trastuzumab (6mg) ; trastuzumab 6mg/kg IV ; Repeat every 21 days ; (to be approved after completion of weekly trastuzumab for 12 weeks as standalone for the upto 1 year every 21 days) 30500
CM0100-L-III : BREAST CANCER - Trastuzumab 4mg (First dose - only) - followed by 2mg ; (to be choosen along with Paclitaxel package CM0100-L-I) ; Trastuzumab 4mg/kg IV with first dose of paclitaxel. ; (First dose - only to be approved with Paclitaxel Cycle 1. Subsequent cycles - 2mg package only) 30500
CM0100-L-IV : BREAST CANCER - Trastuzumab 2mg (Subsequent doses) ; (to be choosen along with Paclitaxel package CM0100-L-I) ; Day 1: Trastuzumab 2mg/kg IV weekly ; (to be approved with Paclitaxel Cycles 2 - 12. May be approved as standalone for the upto 1 year every week or Trastuzumab 6mg Package may be used once every 21 days upto 1 year) 11500
CM0100-M : BREAST CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) ; (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0101 : BLADDER CANCER 0
CM0101-a-I : BLADDER CANCER - DDMVAC ; Day 1: Methotrexate 30mg/m2 IV; Day 2: Vinblastine 3mg/m2 IV, doxorubicin 30mg/m2 IV, cisplatin 70mg/m2 IV; ; Repeat every 2 weeks for 3-4 cycles 3800
CM0101-a-II : BLADDER CANCER - Gemcitabine + cisplatin ; Days 1, 8, and 15: Gemcitabine 1,000mg/m2 IV; Day 2: Cisplatin 70mg/m2. ; Repeat every 4 weeks for 4 cycles. 6400
CM0101-a-III : BLADDER CANCER - Cisplatin + methotrexate + vinblastine (CMV) ; Day 1: Methotrexate 30mg/m2 IV, vinblastine 4mg/m2 IV; Day 2: Cisplatin 100mg/m2 IV, leucovorin 15mg oral or IV every 6 hours for 4 doses; Day 8: Methotrexate 30mg/m2 IV, vinblastine 4mg/m2 IV Day 9: Leucovorin 15mg oral every 6 hours for 4 doses ; Repeat every 3 weeks for 3 cycles. 4800
CM0101-b : BLADDER CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) ; (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0102 : LUNG CANCER 0
CM0102-i : LUNG CANCER - Mesothelioma 0
CM0102-i-a : LUNG CANCER - Mesothelioma - Pemetrexed + cisplatin ; Day 1: Pemetrexed 500mg/m2 IV, cisplatin 75mg/m2 ; Repeat every 21 days up to 12 cycles. 14500
CM0102-i-b : LUNG CANCER - Mesothelioma - Pemetrexed + carboplatin ; Day 1: Pemetrexed 500mg/m2 IV, carboplatin AUC 5mg/min/mL IV. ; Repeat every 21 days for a max of 9 cycles. 16500
CM0102-i-c : LUNG CANCER - Mesothelioma - Cisplatin & Gemcitabine ; Day 1: Cisplatin 80-100mg/m2 IV ; Days 1, 8, and 15: Gemcitabine 1000-1250mg/m2 IV ; Repeat every 21 - 28 days for 6 cycles. 7600
CM0102-i-d : LUNG CANCER - Mesothelioma - Vinorelbine ; Vinorelbine 25-30mg/m2 (max 60mg) IV ; Repeat every week for 12 weeks. 9000
CM0102-i-e : LUNG CANCER - Mesothelioma - Pemetrexed ; Day 1: Pemetrexed 500mg/m2 IV. ; Repeat every 21 days for 4 cycles (If First line) or Repeat every 21 days for 8 cycles (If Second line) 14500
CM0102-i-f : LUNG CANCER - Mesothelioma - Gemcitabine ; Days 1, 8, and 15: Gemcitabine 1250mg/m2 IV. ; Repeat every 28 days for a max of 10 cycles. 7600
CM0102-i-g : LUNG CANCER - Mesothelioma - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) ; (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0102-ii : LUNG CANCER - NSCLC 0
CM0102-ii-a : LUNG CANCER - NSCLC - Cisplatin & Vinorelbine - (i) ; Days 1 and 8: Cisplatin 50mg/m2 IV and Days 1, 8, 15 and 22: Vinorelbine 25mg/m2 IV ; (or) ; Day 1: Cisplatin 100mg/m2 IV and Days 1, 8, 15 and 22: Vinorelbine 30mg/m2 IV. ; Repeat cycle every 4 weeks for 4 cycles. 33600
CM0102-ii-b : LUNG CANCER - NSCLC - Cisplatin & Vinorelbine - (ii) ; Day 1: Cisplatin 75-80mg/m2 ; Days 1 and 8: Vinorelbine 25-30mg/m2. ; Repeat every 3 weeks for 4 cycles 17900
CM0102-ii-c : LUNG CANCER - NSCLC - Cisplatin & Etoposide ; Day 1: Cisplatin 100mg/m2 IV ; Days 1-3: Etoposide 100mg/m2 IV. ; Repeat cycle every 4 weeks for 4 cycles 4900
CM0102-ii-d : LUNG CANCER - NSCLC - Cisplatin & Docetaxel ; Day 1: Docetaxel 75mg/m2 IV, cisplatin 75mg/m2 IV. ; Repeat every 3 weeks for 4 cycles. 6300
CM0102-ii-e : LUNG CANCER - NSCLC - Cisplatin & Gemcitabine ; Day 1: Cisplatin 75mg/m2 IV ; Days 1 and 8: Gemcitabine 1,250mg/m2 IV. ; Repeat every 3 weeks for 4 cycles 6100
CM0102-ii-f : LUNG CANCER - NSCLC - Pemetrexed + cisplatin (for Non Squamous Cell CA) ; Day 1: Cisplatin 75mg/m2 IV, pemetrexed 500mg/m2 IV. ; Repeat every - 21 days for 4 cycles. 14500
CM0102-ii-g : LUNG CANCER - NSCLC - Paclitaxel/Carboplatin ; Day 1: Paclitaxel 200mg/m2 IV, carboplatin AUC 6mg per min/mL IV. ; Repeat cycle every 3 weeks for 4 cycles. 8100
CM0102-ii-h : LUNG CANCER - NSCLC - Cisplatin & Etoposide ; Days 1, 8, 29 and 36: Cisplatin 50mg/m2 IV ; Days 1-5 and 29-33: Etoposide 50mg/m2 IV ; Concurrent thoracic radiotherapy 1.8Gy/day for 5 days/week (total dose, 61Gy). 8500
CM0102-ii-i : LUNG CANCER - NSCLC - Cisplatin & Vinblastine ; Days 1 and 29: Cisplatin 100mg/m2 IV ; Days 1, 8, 15, 22 and 29: Vinblastine 5mg/m2 IV ; concurrent thoracic radiotherapy (total dose, 60Gy). 8200
CM0102-ii-j : LUNG CANCER - NSCLC - Carboplatin + Pemetrexed ; Day 1: Carboplatin AUC 5mg per min/mL IV ; Day 1: Pemetrexed 500 mg/m2 IV ; with concurrent thoracic radiotherapy. ; Repeat every 3 weeks for 4 cycles. 16500
CM0102-ii-k : LUNG CANCER - NSCLC - Cisplatin + Pemetrexed ; Day 1: Cisplatin 75 mg/m2 IV. ; Day 1: Pemetrexed 500 mg/m2 IV ; with concurrent thoracic radiotherapy. ; Repeat every 3 weeks for 3 cycles. 14900
CM0102-ii-l : LUNG CANCER - NSCLC - Paclitaxel + Carboplatin ; Paclitaxel 45mg/m2 IV + carboplatin AUC 2mg per min/mL IV ; with concurrent thoracic radiotherapy (total dose, 60Gy) ; Repeat weekly for 6 weeks 3300
CM0102-ii-m : LUNG CANCER - NSCLC - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0102-iii : LUNG CANCER - SCLC 0
CM0102-iii-a : LUNG CANCER - SCLC - Cisplatin & Etoposide ; Day 1: Cisplatin 60mg/m2 IV, Days 1-3: Etoposide 120mg/m2 IV. ; Repeat cycle every 3 weeks for at least 4 cycles. ;(OR) ; Day 1: Cisplatin 80mg/m2 IV, Days 1-3: Etoposide 100mg/m2 IV. ; Repeat cycle every 4 weeks for 4-6 cycles. 4900
CM0102-iii-b : LUNG CANCER - SCLC - Carboplatin & Etoposide ; Day 1: Carboplatin AUC 5-6mg per min/mL IV ; Days 1-3: Etoposide 100mg/m2 IV. ; Repeat cycle every 21 days or 28 days for 4 - 6 cycles 6500
CM0102-iii-c : LUNG CANCER - SCLC - Cisplatin + Irinotecan ; Day 1: Cisplatin 60mg/m2 IV. ; Days 1, 8, and 15: Irinotecan 60mg/m2 IV. ; Repeat cycle every 4 weeks for 4 cycles. 5800
CM0102-iii-d : LUNG CANCER - SCLC - Cisplatin + Irinotecan ; Day 1 and 8: Cisplatin 30mg/m2 IV, irinotecan 65mg/m2 IV. ; Repeat cycle every 3 weeks for 4-6 cycles. 5700
CM0102-iii-e : LUNG CANCER - SCLC - Carboplatin & Irinotecan ; Day 1: Carboplatin AUC 5mg per min/mL IV ; Days 1, 8, and 15: Irinotecan 50mg/m2 IV. ; Repeat cycle every 4 weeks for 4 cycles 7700
CM0102-iii-f : LUNG CANCER - SCLC - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) ; (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0103-i : ESOPHAGEAL CANCER - Neo Adjuvant 0
CM0103-i-a : ESOPHAGEAL CANCER - Neo Adjuvant - Paclitaxel + Carboplatin ; Day 1: Paclitaxel 50mg/m2 IV + carboplatin AUC 2mg/min/mL IV. ; Repeat weekly for 5 weeks 3300
CM0103-i-b : ESOPHAGEAL CANCER - Neo Adjuvant - Fluorouracil & Cisplatin ; Days 1 and 29: Cisplatin 75-100mg/m2 IV ; Days 1-4 and 29-32: 5-FU 750-1,000mg/m2 IV. 12000
CM0103-i-c : ESOPHAGEAL CANCER - Neo Adjuvant - Fluorouracil & Cisplatin ; Days 1-5: Cisplatin 15mg/m2 IV daily ; Days 1-5 and Days 22-26: 5-FU 800 mg/m2 IV ; Repeat every 21 days for 2 cycles 7100
CM0103-i-d : ESOPHAGEAL CANCER - Neo Adjuvant - Fluorouracil + Oxaliplatin + Leucovorin ; Day 1: Oxaliplatin 85mg/m2, leucovorin 200mg/m2 and 5-FU 400mg/m2 bolus, with 1,600mg/m2 infusion; ; Repeat every 14 days for 6 cycles 4600
CM0103-i-e : ESOPHAGEAL CANCER - Neo Adjuvant - Cisplatin + capecitabine ; Day 1: Cisplatin 30mg/m2 IV ; Days 1-5: Capecitabine 800mg/m2 orally twice daily ; Repeat cycle weekly for 5 weeks 2500
CM0103-i-f : ESOPHAGEAL CANCER - Neo Adjuvant - Fluorouracil & Oxaliplatin ; Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV ; Days 1-33: 5-FU 180mg/m2/day IV 25800
CM0103-i-g : ESOPHAGEAL CANCER - Neo Adjuvant - Oxaliplatin + capecitabine ; Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV ; Days 1-5: Capecitabine 625mg/m2 orally twice daily for 5 weeks. 8900
CM0103-i-h : ESOPHAGEAL CANCER - Neo Adjuvant - Irinotecan & Cisplatin ; Days 1, 8, 22, and 29: Irinotecan 65mg/m2 IV, cisplatin 30mg/m2 IV. 9700
CM0103-i-i : ESOPHAGEAL CANCER - Neo Adjuvant - Fluorouracil & Paclitaxel ; Day 1: Paclitaxel 45mg/m2 IV ; Days 1-5: 5-FU 300mg/m2/day IV infusion. ; Repeat cycle weekly for 5 weeks. 5500
CM0103-i-j : ESOPHAGEAL CANCER - Neo Adjuvant - Paclitaxel + capecitabine ; Day 1: Paclitaxel 45-50mg/m2 IV ; Days 1-5: Capecitabine 625-825mg/m2 orally twice daily. ; Repeat cycle weekly for 5 weeks. 12200
CM0103-i-k : ESOPHAGEAL CANCER - Neo Adjuvant - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0103-ii : ESOPHAGEAL CANCER - Peri-Operative 0
CM0103-ii-a : ESOPHAGEAL CANCER - Peri-Operative - ECF (Epirubicin/Cisplatin/Fluorouracil) ; Day 1: Epirubicin 50mg/m2 IV; cisplatin 60mg/m2 IV ; Days 1-21: 5-FU 200mg/m2 IV continuous infusion once daily; ; Repeat every 21 days for 3 cycles preoperatively and 3 cycles postoperatively 16700
CM0103-ii-b : ESOPHAGEAL CANCER - Peri-Operative - EOF (Epirubicin/Cisplatin/Fluorouracil) ; Day 1: Epirubicin 50mg/m2 IV; oxaliplatin 130mg/m2 IV ; Days 1-21: 5-FU 200mg/m2 IV; ; Repeat every 21 days for 3 cycles preoperatively and 3 cycles postoperatively. 18700
CM0103-ii-c : ESOPHAGEAL CANCER - Peri-Operative - EOC (Epirubicin/Cisplatin/Fluorouracil) ; Day 1: Epirubicin 50mg/m2 IV; oxaliplatin 130mg/m2 IV ; Days 1-21: Capecitabine 625mg/m2 orally twice daily. ; Repeat every 21 days for 3 cycles preoperatively and 3 cycles postoperatively. 7800
CM0103-ii-d : ESOPHAGEAL CANCER - Peri-Operative - Fluorouracil & Cisplatin ; Days 1 and 29: Cisplatin 75-100mg/m2 IV ; Days 1-4 and 29-32: 5-FU 750-1,000mg/m2 IV ; Repeat cycle every 28 days for 2-4 cycles 12000
CM0103-ii-e : ESOPHAGEAL CANCER - Peri-Operative - Fluorouracil & Cisplatin ; Days 1-5: Cisplatin 15mg/m2 IV daily ; Days 1-5: 5-FU 800 mg/m2 IV continuous infusion over 24 hours. ; Cycled every 21 days for 2 cyclesCycled every 21 days for 2 cycles 7100
CM0103-ii-f : ESOPHAGEAL CANCER - Peri-Operative - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0103-iii : ESOPHAGEAL CANCER - Post-Operative 0
CM0103-iii-a : ESOPHAGEAL CANCER - Post-Operative - Fluorouracil + Leucovorin (i) ; Days 1-5: 5-FU 425mg/m2/day IV and leucovorin 20mg/m2/day IV, followed by 4 weeks break and CCRT ; RT Days 1-4 and 23-25: 5-FU 400mg/m2/day IV and leucovorin 20mg/m2/day IV followed by one month Break and ; Days 1-5: 5-FU 425mg/m2/day IV and leucovorin 20mg/m2/day IV followed by one month Break and ; Days 1-5: 5-FU 425mg/m2/day IV and leucovorin 20mg/m2/day IV. 25400
CM0103-iii-b : ESOPHAGEAL CANCER - Post-Operative - Fluorouracil + Leucovorin (ii) ; Days 1, 2, 15, and 16: Leucovorin 200mg/m2 IV, 5-FU 400mg/m2 IV push and 5-FU 600mg/m2 infusion 9000
CM0103-iii-c : ESOPHAGEAL CANCER - Post-Operative - Capecitabine (i) ; Days 1-14: Capecitabine 750-1000mg/m2 orally twice daily; ; Repeat every 28 days; 1 cycle before and 2 cycles after chemoradiation 3100
CM0103-iii-d : ESOPHAGEAL CANCER - Post-Operative - Capecitabine (ii) ; Days 1-5 OR Days 1-7: Capecitabine 625-825mg/m2 orally twice daily, ; once weekly for 5 weeks. 1600
CM0103-iii-e : ESOPHAGEAL CANCER - Post-Operative - FluorouracilDays 1-5 OR Days 1-7: 5-FU 200-250mg/m2 IV continuous infusion over 24 hours daily, ; once weekly for 5 weeks.once weekly for 5 weeks. 6500
CM0103-iii-f : ESOPHAGEAL CANCER - Post-Operative - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0103-iv : ESOPHAGEAL CANCER - Definitive 0
CM0103-iv-a : ESOPHAGEAL CANCER - Definitive - Fluorouracil & Cisplatin (i) ; Days 1 and 29: Cisplatin 75-100mg/m2 IV ; Days 1-4 and 29-32: 5-FU 750-1,000mg/m2 IV 12000
CM0103-iv-b : ESOPHAGEAL CANCER - Definitive - Fluorouracil & Cisplatin (ii) ; Days 1-5: Cisplatin 15mg/m2 IV daily ; Days 1-5: 5-FU 800 mg/m2 IV continuous infusion over 24 hours. ; Cycled every 21 days for 2 cycles 7100
CM0103-iv-c : ESOPHAGEAL CANCER - Definitive - Fluorouracil & Oxaliplatin ; Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV ; Days 1-33: 5-FU 180mg/m2/day continuous IV infusion. 25800
CM0103-iv-d : ESOPHAGEAL CANCER - Definitive - Cisplatin + capecitabine ; Day 1: Cisplatin 30mg/m2 IV ; Days 1-5: Capecitabine 800mg/m2 orally twice daily ; Repeat cycle weekly for 5 weeks 2000
CM0103-iv-e : ESOPHAGEAL CANCER - Definitive - Oxaliplatin + capecitabine ; Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV ; Days 1-5: Capecitabine 625mg/m2 orally twice daily for 5 weeks 8900
CM0103-iv-f : ESOPHAGEAL CANCER - Definitive - Paclitaxel + Carboplatin ; Day 1: Paclitaxel 50mg/m2 IV and carboplatin 2mg/min/mL IV ; Repeat weekly for 5 weeks. 3300
CM0103-iv-g : ESOPHAGEAL CANCER - Definitive - Cisplatin with Docetaxel (i) ; Days 1 and 22: Docetaxel 60mg/m2 IV ; Days 1 and 22: Cisplatin 60-80mg/m2 IV given for 1 cycle 8900
CM0103-iv-h : ESOPHAGEAL CANCER - Definitive - Cisplatin with Docetaxel (ii) ; Day 1: Docetaxel 20-30mg/m2 IV ; Day 1: Cisplatin 20-30mg/m2 IV ; Repeat weekly for 5 weeks 3000
CM0103-iv-i : ESOPHAGEAL CANCER - Definitive - Cisplatin with Paclitaxel ; Days 1, 8, 15, and 22: Paclitaxel 60mg/m2 IV ; Day 1: Cisplatin 75mg/m2 IV given for 1 cycle. 13100
CM0103-iv-j : ESOPHAGEAL CANCER - Definitive - Irinotecan & Cisplatin ; Days 1, 8, 22, and 29: Irinotecan 65mg/m2 IV ; Days 1, 8, 22, and 29: Cisplatin 30mg/m2 IV. 9700
CM0103-iv-k : ESOPHAGEAL CANCER - Definitive - Fluorouracil & Paclitaxel ; Day 1: Paclitaxel 45mg/m2 IV ; Days 1-5: 5-FU 300mg/m2/day IV ; Repeat cycle weekly for 5 weeks. 5500
CM0103-iv-l : ESOPHAGEAL CANCER - Definitive - Paclitaxel + capecitabine ; Day 1: Paclitaxel 45-50mg/m2 IV ; Days 1-5: Capecitabine 625-825mg/m2 PO twice daily. ; Repeat cycle weekly for 5 weeks. 12200
CM0103-iv-m : ESOPHAGEAL CANCER - Definitive - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0104 : GASTRIC CANCER 0
CM0104-i : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) 0
CM0104-i-a : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Paclitaxel + Carboplatin ; Day 1: Paclitaxel 50mg/m2 IV, carboplatin AUC 2mg/min/mL IV. ; Repeat cycle weekly for 5 weeks. 3300
CM0104-i-b : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Fluorouracil & Cisplatin (i) ; Days 1 and 29: Cisplatin 75-100mg/m2 IV ; Days 1-4 and 29-32: 5-FU 750-1000mg/m2/day IV 12000
CM0104-i-c : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Fluorouracil & Cisplatin (ii) ; Days 1-5: Cisplatin 15mg/m2 IV once daily, 5-FU 800mg/m2/day IV ; Repeat cycle every 21 days for 2 cycles. 7100
CM0104-i-d : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Fluorouracil & Oxaliplatin (i)Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV ; Days 1-33: 5-FU 180mg/m2/day IV. 25800
CM0104-i-e : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Fluorouracil & Oxaliplatin (ii)Day 1: Oxaliplatin 85mg/m2 and leucovorin 400mg/m2 followed by 5-FU 400mg/m2 bolus, then 800mg/m2 24-hour continuous infusion over days 1 and 2; the first 3 cycles were delivered during radiotherapy (RT), the other 3 after RT; 6 bimonthly (14 days) cycles. 6100
CM0104-i-f : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Cisplatin + capecitabine ; Day 1: Cisplatin 30mg/m2 IV ; Days 1-5: Capecitabine 800mg/m2 orally twice daily. ; Repeat cycle weekly for 5 weeks. 2000
CM0104-i-g : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Oxaliplatin + capecitabine ; Days 1, 15, and 29: Oxaliplatin 85mg/m2 IV ; Days 1-5: Capecitabine 625mg/m2 orally twice daily for 5 weeks 8900
CM0104-i-h : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Fluorouracil & Paclitaxel ; Day 1: Paclitaxel 45-50mg/m2 IV weekly ; Days 1-5: 5-FU 300mg/m2 IV ; Repeat cycle weekly for 5 weeks 5500
CM0104-i-i : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Paclitaxel + capecitabine ; Day 1: Paclitaxel 45-50mg/m2 IV ; Days 1-5: Capecitabine 625-825mg/m2 orally twice daily. ; Repeat cycle weekly for 5 weeks. 3100
CM0104-i-j : GASTRIC CANCER - Preoperative Chemoradiation (esophagogastric junction and gastric cardia) - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0104-ii : GASTRIC CANCER - Perioperative Chemotherapy (including esophagogastric junction) 0
CM0104-ii-a : GASTRIC CANCER - Perioperative Chemotherapy (including esophagogastric junction) - ECF (Epirubicin/Cisplatin/Fluorouracil) ; Day 1: Epirubicin 50mg/m2 IV, cisplatin 60mg/m2 IV ; Days 1-21: 5-FU 200mg/m2/day IV ; Repeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperatively 16700
CM0104-ii-b : GASTRIC CANCER - Perioperative Chemotherapy (including esophagogastric junction) - EOF (Epirubicin/ oxaliplatin /Fluorouracil) ; Day 1: Epirubicin 50mg/m2 IV; oxaliplatin 130mg/m2 IV ; Days 1-21: 5-FU 200mg/m2 IV; ; Repeat every 21 days for 3 cycles preoperatively and 3 cycles postoperatively. 18700
CM0104-ii-c : GASTRIC CANCER - Perioperative Chemotherapy (including esophagogastric junction) - epirubicin + cisplatin + capecitabine ; Day 1: Epirubicin 50mg/m2 IV + cisplatin 60mg/m2 IV ; Days 1-21: Capecitabine 625mg/m2 orally twice daily. ; Repeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperatively. 5900
CM0104-ii-d : GASTRIC CANCER - Perioperative Chemotherapy (including esophagogastric junction) - ECF modification (epirubicin + oxaliplatin + capecitabine) ; Day 1: Epirubicin 50mg/m2 IV + oxaliplatin 130mg/m2 IV ; Days 1-21: Capecitabine 625mg/m2 orally twice daily. ; Repeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperativelyRepeat cycle every 21 days for 3 cycles preoperatively and 3 cycles postoperatively 7800
CM0104-ii-e : GASTRIC CANCER - Perioperative Chemotherapy (including esophagogastric junction) - Fluorouracil & Cisplatin ; Day 1: Cisplatin 75-80mg/m2 IV ; Days 1-5: 5-FU 800mg/m2 IV ; Repeat cycle every 28 days for 2-3 cycles preoperatively and 3-4 cycles postoperatively for a total of 6 cycles. 6900
CM0104-ii-f : GASTRIC CANCER - Perioperative Chemotherapy (including esophagogastric junction) - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0104-iii : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) 0
CM0104-iii-a : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Fluorouracil + Leucovorin (i) ; Cycles 1, 3, and 4 (before and after radiation) Days 1-5: Leucovorin 20mg/m2 IV, 5-FU 425mg/m2/day IV ; Repeat cycle every 28 days. ; Cycle 2 (with radiation) Days 1-4 and 31-33: Leucovorin 20mg/m2 IVP ; Days 1-4: 5-FU 400mg/m2/day IVP. ; Repeat cycle every 35 days 25400
CM0104-iii-b : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Fluorouracil + Leucovorin (ii) ; Days 1, 2, 15, and 16: Leucovorin 400mg/m2 IV, 5-FU 400mg/m2 IV and 5-FU 1200mg/m2 infusion; ; 1 cycle before and 2 cycles after chemoradiation. ; Repeat cycle every 28 daysRepeat cycle every 28 days 14900
CM0104-iii-c : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Capecitabine (i) ; Days 1-14: Capecitabine 750-1000mg/m2 orally twice daily. ; Repeat cycle every 28 days; 1 cycle before and 2 cycles after chemoradiation. 3100
CM0104-iii-d : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Capecitabine (ii) ; Days 1-5 OR Days 1-7: Capecitabine 625-825mg/m2 orally twice daily; weekly for 5 weeks. 1600
CM0104-iii-e : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Fluorouracil ; Days 1-5 OR Days 1-7: 5-FU 200-250mg/m2 IV; ; weekly for 5 weeks. 6500
CM0104-iii-f : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Cisplatin + capecitabine ; Day 1: Cisplatin 60mg/m2 IV. ; Days 1-14: Capecitabine 1000mg/m2 orally twice daily ; Repeat cycle every 21 days for 6 cycles. 4000
CM0104-iii-h : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Oxaliplatin + capecitabine ; Day 1: Oxaliplatin 130mg/m2 IV. ; Days 1-14: Capecitabine 1000mg/m2 orally twice daily ; Repeat cycle every 21 days for 8 cycles.Repeat cycle every 21 days for 8 cycles. 6000
CM0104-iii-i : GASTRIC CANCER - Postoperative Chemoradiation (including esophagogastric junction) - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0105-i : COLORECTAL CARCINOMA 0
CM0105-i-a : COLORECTAL CARCINOMA - FOLFOX (Stage - III) - (Oxaliplatin, Leucovorin, 5-FU) ; Day 1: Oxaliplatin 85mg/m2 IV, leucovorin 400mg/m2 IV , 5-FU 400mg/m2 IV, followed by 5-FU 1,200mg/m2/day IV x 2 days (total 2,400mg/m2) over 46-48-hour continuous infusion. ; Repeat cycle every 2 weeks- upto 12 cycles 8000
CM0105-i-b : COLORECTAL CARCINOMA - CAPEOX (Stage - III) (Oxaliplatin, Capecitabine) ; Day 1: Oxaliplatin 130mg/m2 IV over 2 hours ; Days 1-14: Capecitabine 1,000mg/m2 orally twice daily. ; Repeat cycle every 3 weeks for 6 months 6500
CM0105-i-c : COLORECTAL CARCINOMA - FLOX (Stage - III) (5-FU, leucovorin, oxaliplatin) ; 5-FU 500mg/m2 IV bolus weekly x 6, leucovorin 500mg/m2 IV weekly x 6, each ; oxaliplatin 85mg/m2 IV on weeks 1, 3, and 5 ; 8-week cycle x 3 cycles ; 30000
CM0105-i-d : COLORECTAL CARCINOMA - Capecitabine ; Capecitabine 1,250mg/m2 - BD / TDS D 1-14 ; every 3 weeks * 24 weeks 4300
CM0105-i-e : COLORECTAL CARCINOMA - Fluorouracil + Leucovorin (i) ; Leucovorin 500mg/m2 weekly x 6 weeks, ; 5-FU 500mg/m2 weekly x 6 weeks. ; Repeat cycle every 8 weeks for 4 cycles. 23700
CM0105-i-f : COLORECTAL CARCINOMA - Fluorouracil + Leucovorin (ii)Simplified biweekly infusion. ; Leucovorin 400mg/m2 IV, 5-FU bolus 400mg/m2 and then 1,200mg/m2/day x 2 days (total 2,400mg/m2 over 46-48 hours) ; Repeat cycle every 2 weeks for 6 cycles. 5200
CM0105-i-g : COLORECTAL CARCINOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0105-ii : COLORECTAL CARCINOMA - Concurrent 0
CM0105-ii-a : COLORECTAL CARCINOMA - Concurrent - 5FU - with XRT ; Days 1-5 OR 1-7: 5-FU 225mg/m2 IV ; with External beam radiotherapy 3800
CM0105-ii-b : COLORECTAL CARCINOMA - Concurrent - Fluorouracil + Leucovorin - with XRT ; Days 1-4: 5-FU 400mg/m2 IV + leucovorin 20mg/m2 IV. ; Repeat cycle during weeks 1 and 5 of XRT. 6100
CM0105-ii-c : COLORECTAL CARCINOMA - Concurrent - Capecitabine - with XRT ; Capecitabine Tablet 825mg / m2 twice daily on Days 1-5 ; Repeat cycle weekly for 5 weeks. 1300
CM0105-ii-d : COLORECTAL CARCINOMA - Concurrent - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0106-106 : OSTEOSARCOMA/ BONE TUMORS 0
CM0106-i-a : OSTEOSARCOMA/ BONE TUMORS / Dedifferentiated chondrosarcoma - Cisplatin + doxorubicin ; Days 1-3: Doxorubicin 25mg/m2/day IV, ; Day 1: Cisplatin 100mg/m2 IV ; Repeat cycle every 3 weeks for 6 cycles 5600
CM0106-i-b-1 : OSTEOSARCOMA/ BONE TUMORS / Dedifferentiated chondrosarcoma - MAP (high-dose methotrexate + cisplatin + doxorubicin) - PRE OPERATIVE ; Days 1 and 28: Methotrexate 8g/m2 IV ; Days 7-9 and 34-36: Cisplatin 120mg/m2 by infusion for 72 hours. ; Days 9 and 36: Doxorubicin 60mg/m2 IV 24200
CM0106-i-b-2 : OSTEOSARCOMA/ BONE TUMORS / Dedifferentiated chondrosarcoma - MAP (high-dose methotrexate + cisplatin + doxorubicin) - POST OPERATIVE NECROSIS < 90% ; Days 1, 48, 96, and 144: Doxorubicin 45mg/m2/day for 2 consecutive days ; Days 21, 69, and 117: Methotrexate 8g/m2 IV ; Days 27, 75, and 123: Cisplatin 120mg/m2 by infusion for 72 hours. 40100
CM0106-i-b-3 : OSTEOSARCOMA/ BONE TUMORS / Dedifferentiated chondrosarcoma - MAP (high-dose methotrexate + cisplatin + doxorubicin) - POST OPERATIVE NECROSIS > 90%Postoperative Chemotherapy (Necrosis 59100
CM0106-i-c : Doxorubicin + cisplatin + ifosfamide + high-dose methotrexate (surgery to be done also) 111505
CM0106-i-d : OSTEOSARCOMA/ BONE TUMORS / Dedifferentiated chondrosarcoma - Ifosfamide + cisplatin + epirubicin ; Day 1: Epirubicin 90mg/m2 IV, cisplatin 100mg/m2 IV ; Days 2-4: Ifosfamide 2.0g/m2 with mesna ; Repeat cycle every 21 days. (3 cycles preoperatively and 3 cycles postoperatively). 8300
CM0106-ii : Other bone tumors - Chordroma 0
CM0106-ii-a : Other bone tumors - Chordroma - Imatinib ; Imatinib 800 mg once daily 4500
CM0106-ii-b : Other bone tumors - Chordroma - Imatinib + cisplatin ; Imatinib 400mg OD + cisplatin 25mg/m2 weekly. 4500
CM0106-ii-c : Other bone tumors - Chordroma - Imatinib + sirolimus ; Imatinib 400mg OD + sirolimus 2mg OD 6000
CM0106-ii-d : Other bone tumors - Chordroma - Erlotinib ; Erlotinib 150mg OD 2200
CM0106-ii-e : Other bone tumors - Chordroma - Sunitinib ; Sunitinib 37.5mg OD 28500
CM0106-iii :Other bone tumors - Giant Cell Tumor of Bone 0
CM0106-iii-a :Other bone tumors - Giant Cell Tumor of Bone - Denosumab ; Denosumab 120mg subcutaneous on Week 1,2 and 3 of a 4 week cycle 56000
CM0106-iii-b :Other bone tumors - Giant Cell Tumor of Bone - Interferon alfa ; interferon alfa- 2a thrice weekly 4600
CM0106-iii-c :Other bone tumors - Giant Cell Tumor of Bone - Peginterferon ; Peginterferon alfa-2a 1.0mcg/kg SQ injection weekly. 3500
CM0106-iv : Other bone tumors - Mesenchymal Chordosarcoma 0
CM0106-iv-a : VAC and IE cycles 6420
CM0106-iv-b : Other bone tumors - Mesenchymal Chordosarcoma VAIA ; Day 1: Vincristine 1.5mg/m2 IV ; Days 1-3: Ifosfamide 2,000mg/m2 IV + mesna ; Days 1, 3, and 5: Dactinomycin 0.5mg/m2 IV ; Days 2 and 4: Doxorubicin 30mg/m2 IV. ; Repeat cycle every 3 weeks. 7600
CM0106-v : Other bone tumors - Mesenchymal Chordosarcoma Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0107 : WILMS TUMOR 0
CM0107-a : WILMS TUMOR - Vincristine & Actinomycin D ; Dactinomycin 45mcg/kg - week - 0, 3, 6,9,12,15,18 ; Vincristine 1.5 mg/m2 - week - 1,2,3,4,5,6,7,8,9,10,12,15,18 19400
CM0107-b : WILMS TUMOR - Dactinomycin, Vincristine & Adriamycin ; Dactinomycin 1.35 mg /m2 - week - 0, 6, 12, 18,24 ; Adriyamycin 30-45 mg /m2- week - 3, 9, 15, 21 ; Vincristine 2mg max- week - 1,2,3,4,5,6,7,8,9,10,12,15,18,21,24 23200
CM0107-c : WILMS TUMOR - Adriamycin, Cyclophosphamide, Etoposide, Vincristine ; Cyclophosphamide 440mg/m2/day - week 3, 9, 15, 21 for 5 days, week - 6,12,18,24 for 3 days ; Adriyamycin 30-45mg /m2- week -0, 6, 12, 18,24 ; Vincristine 2mg (max)- week - 1,2,4,5,6,7,8,10,11, 12,13,18,24 ; Etoposide 100mg /m2- week - 3,9,15,21 53700
CM0107-d : WILMS TUMOR - Cyclophosphamide, Etoposide, Carboplatin ; Cyclophosphamide 440mg/m2/day - week 6,15,24 *5 days / week ; Carboplatin 500mg/m2 - week - 0,3,9,12,18,21 *2 days / week ; Etoposide 100mg/m2 - week - 0,3,9,12,18,21 *5 days / week 84500
CM0107-e : WILMS TUMOR - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0108 : HEPATOBLASTOMA- OPERABLEHEPATOBLASTOMA- OPERABLE 0
CM0108-a : HEPATOBLASTOMA- OPERABLE - PLADO - Cisplatin + Doxorubicin ; cisplatin (PLA) (80mg/m2 / iv), doxorubicin (DO) (30 mg/m2 IV ; Every 21 days for 6 cycles 2800
CM0108-b : HEPATOBLASTOMA- OPERABLE - Cisplatin + Vincristine +5FU ; cisplatin (90 mg/m2), vincristine (1.5mg/m2), 5-FU(5-Flurouracil- 600 mg/m2) ; Every 21 days for 6 cycles 2400
CM0108-c : HEPATOBLASTOMA- OPERABLE - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0109 : HEPATOCELLULAR CARCINOMA 0
CM0109-a : HEPATOCELLULAR CARCINOMA - Sorafenib ; Sorafenib 400 mg PO BID 5800
CM0109-b : HEPATOCELLULAR CARCINOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0110A : Neuroblastoma ALL STAGES - VINCRISTINE/CISPLATIN/ETOPOSIDE/CYCLOPHOSPHAMIDE/CARBOPLATIN 8000
CM0110B : Neuroblastoma ALL STAGES - CYCLOPHOSPHAMIDE/ADRIAMYCIN/VINCRISTINE ; D1-D5 - CYCLOPHOSPHAMIDE 300mg/m2 ; ADRIAMYCIN 60mg/m2 ; VINCRISTINE 1.5mg/m2 7100
CM0110C : Neuroblastoma ALL STAGES - Cisplatin & Etoposide ; Days 1-5 : Cisplatin - 20mg/m2 ; Days 1-5 : Etoposide - 70 mg/m2 4900
CM0110D : Neuroblastoma ALL STAGES - Carboplatin & Etoposide ; Days 1-2 : Carboplatin - 500mg/m2 ; Days 1-5: Etoposide 100mg/m2 6500
CM0110E : Neuroblastoma ALL STAGES - For Stage IV Palliative Chemotherapy only 10000
CM0110F : Neuroblastoma ALL STAGES - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0111 : RETINOBLASTOMA 0
CM0111-a : RETINOBLASTOMA - Melphalan - Intra-arterial ; Melphalan - 3-7.5mg - Intra-arterial 9700
CM0111-b : RETINOBLASTOMA - Carboplatin - Intra-arterial ; Carboplatin 15-30 mg - Intra-arterial 8900
CM0111-c : RETINOBLASTOMA - Topotecan - Intra-arterial ; Topotecan 0.15-1.5 mg - Intra-arterial 9900
CM0111-d : RETINOBLASTOMA - Methotrexate - Intra-arterial ; Methotrexate 6-12 mg - Intra-arterial 8600
CM0111-e : RETINOBLASTOMA - Carboplatin - Peri Ocular ; Carboplatin 20mg/m2 - Peri Ocular 1900
CM0111-f : RETINOBLASTOMA - Topotecan - Peri Ocular ; Topotecan 0.09 - 0.27 - Peri Ocular 4300
CM0111-g : RETINOBLASTOMA - Melphalan - Intra-vitreal ; Melphalan 20-30 mcg / 0.1cc - Intra-vitreal 270
CM0111-h : RETINOBLASTOMA - Carboplatin - Intra-vitreal ; Carboplatin 3-6mcg / 0.05cc - Intra-vitreal 1900
CM0111-i : RETINOBLASTOMA - Methotrexate - Intra-vitreal ; Methotrexate 400mcg/0.1cc - Intra-vitreal 1600
CM0111-j : RETINOBLASTOMA - Carboplatin + Etoposide + Vincristine ; Carboplatin 560mg/m2 ; Etoposide 150mg/m2 ; Vincristine 1.5mg/m2 6800
CM0111-k : RETINOBLASTOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0112 : HISTIOCYTOSIS 0
CM0112-a : HISTIOCYTOSIS - Prednisolone and Vinblastine - 1; Prednisolone and Vinblastine - 1 ; Prednisolone - 6 weeks oral ; Vinblastine 1,2,3,4,5,6 6100
CM0112-b : HISTIOCYTOSIS - Prednisolone and Vinblastine - 2; Prednisolone and Vinblastine - 1 ; Prednisolone - 6 weeks oral ; Vinblastine 1,2,3,4,5,6 6800
CM0112-c : HISTIOCYTOSIS - Prednisolone and Vinblastine - continuation; Prednisolone and Vinblastine - continuation after either course 1 or both 1 & 2 ; Prednisolone - 5 days a week oral ; Vinblastine -IV ; repeat every 3 weeks till 1 year 1800
CM0112-d : HISTIOCYTOSIS - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0113 : RHABDOMYOSARCOMA 0
CM0113-a : RHABDOMYOSARCOMA - VAC (Vincristine + Dactinomycin + Cyclophosphamide + Mesna ) ; Day -1 - Vincristine 1.5 mg /m2 IV (2 mg max), Doxorubicin 75 mg /m2 IV , cyclophosphamide 1200 mg /m2 IV + mesna ; Repeat at 21 day intervals for 4-6 cycles 3800
CM0113-b : RHABDOMYOSARCOMA - IVA (Vincristine + Dactinomycin + Ifosfamide + Mesna ) ; Day 1,2 - Ifosfamide IV 3 g/m2 + mesna ; Day 1 - Vincristine IV 1.5 mg/m2 (max 2 mg), Actinomycin-D IV 1.5 mg/m2 (max 2 mg) ; Repeat at 21 day intervals for 6 cycles 5600
CM0113-c : RHABDOMYOSARCOMA - IVAD (Vincristine + Doxorubicin + Ifosfamide + Mesna ) ; Days 1 and 2 - Ifosfamide 3 g/m2 + Mesna, Doxorubicin 30mg/m2 ; Day 1 - vincristine 1.5 mg/m2, Actinomycin-D 1.5 mg/m2 ; Repeat at 21 day intervals for 6 cycles 5500
CM0113-d : RHABDOMYOSARCOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0114 : EWINGS SARCOMA 0
CM0114-i : EWINGS SARCOMA - Induction Treatment I 0
CM0114-i-a : EWINGS SARCOMA - Induction Treatment - VIDE ; Day 1:Vincristine 1.5mg/m2(max 2mg) IV ; Days 1-3:Doxorubicin 20mg/m2 IV, ifosfamide 3g/m2IV, mesna continuous IV, etoposide 150mg/m2 IV ; Repeat cycle every 3 weeks for up to 6 cycles 8300
CM0114-i-b : EWINGS SARCOMA - Induction Treatment - VAC/IE ; 0
CM0114-i-c : EWINGS SARCOMA - Induction Treatment - VAIA - 4 day Regimen ; Day 1:Vincristine 1.5mg/m2IV ; Days 1-3: Ifosfamide 2,000mg/m2 IV + mesna ; Days 1, 3, and 5: Dactinomycin 0.5mg/m2 IV ; Days 2 and 4: Doxorubicin 30mg/m2 IV. ; Repeat cycle every 21 days for 4 cycles, then local therapy, followed by 10 additional cycles of VAIA for High risk and ; 10 additional cycles of VAIA or 10 cycles of VACA for standard-risk patients 7600
CM0114-i-d : EWINGS SARCOMA - Induction Treatment - VAIA - 24 day Regimen ; Days 1, 8, 15, and 22: Vincristine 1.5mg/m2 IV ; Days 1, 2, 22, 23, 43, and 44 : Ifosfamide 3,000mg/m2 IV + mesna ; Days 1, 2, 43, and 44 : Doxorubicin 30mg/m2 IV ; Days 22, 23, and 24: Dactinomycin 0.5mg/m2 IV ; After completion of one 9-week cycle, local therapy followed by 3 additional cycles. 17700
CM0114-ii : EWINGS SARCOMA - Maintenance Treatment 0
CM0114-ii-a : EWINGS SARCOMA - Maintenance Treatment - Etoposide/Ifosfamide ; Days 1-5: Ifosfamide 1,800mg/m2/day IV + mesna ; Days 1-5: Etoposide 100mg/m2/day IV. 8200
CM0114-iii : EWINGS SARCOMA - Maintenance Treatment - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0115 : PALLIATIVE CHEMOTHERAPY (Any Regimen)- Maximum Payable 10000
CM0116 : CERVICAL CANCER 0
CM0116-a : CERVICAL CANCER - CISPLATIN ; Cisplatin 40mg/m2 IV once weekly for up to 6 cycles 1800
CM0116-b : CERVICAL CANCER - Cisplatin & 5FU with RT ; Days 1-5 of radiotherapy: Cisplatin 75mg/m2 IV, 5-FU 4,000mg/m2 IV over 96 hours ; Repeat cycle every 3 weeks for 3 9200
CM0116-c : CERVICAL CANCER - Cisplatin & 5FU ; Days 1 and 29: Cisplatin 50mg/m2 IV ; Days 2-5, and 30-33: 5-FU 1,000mg/m2 IV 8900
CM0116-d : CERVICAL CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0117 : VULVAL CANCER 0
CM0117-a : VULVAL CANCER - Cisplatin ; Day 1 : 40 mg/m 2 IV 1800
CM0117-b : VULVAL CANCER - Cisplatin + 5FU ; Days 1-5 of radiotherapy: Cisplatin 75mg/m2 IV, 5-FU 4,000mg/m2 ; Repeat cycle every 3 weeks - total 3 cycles 4700
CM0117-c : VULVAL CANCER - 5-FU + Mitomycin ; 5-FU + Mitomycin ; Days 1-4 and 29-32: 5-FU 1,000mg/m2/day continuous IV infusion ; Days 1 and 29: Mitomycin 10mg/m2 IV bolus (maximum 20mg per course), 11400
CM0117-d : VULVAL CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0118 : VAGINAL CANCER 0
CM0118-a : VAGINAL CANCER - Cisplatin ; Cisplatin 75mg/m2 ; once weekly for up to 6 doses 1800
CM0118-b : VAGINAL CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0119 : OVARIAN CANCER 0
CM0119-a : OVARIAN CANCER - Paclitaxel + Cisplatin ; Day 1: Paclitaxel 135mg/m2 continuous IV ; Day 2: Cisplatin 75-100mg/m2 ; Day 8: Paclitaxel 60mg/m2 ; Repeat every 3 weeks for 6 cycles. 8800
CM0119-b : OVARIAN CANCER - Paclitaxel + Carboplatin ; Day 1: Paclitaxel 175mg/m2 IV, Carboplatin AUC 5-6 mg/min/mL IV ; Repeat every 3 weeks for 6 cycles 7000
CM0119-c : OVARIAN CANCER - Docetaxel + Carboplatin ; Day 1: Docetaxel 60-75mg/m2 IV, Carboplatin AUC 5-6 mg/min/mL ; Repeat every 3 weeks for 6 cycles 8700
CM0119-d : OVARIAN CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0120 : ENDOMETRIAL CANCER (Palliative Chemotherapy only) 10000
CM0121 : OVARY- GERM CELL TUMOR 0
CM0121-a : OVARY- GERM CELL TUMOR - BEP (Bleomycin + Etoposide + Cisplatin) ; Days 1,8,15 : Bleomycin 30 units/wk IV, Etoposide 100 mg/m 2/day IV ; Days 1-5 : Cisplatin 20 mg/m 2/day IV ; Repeat every 21 days 3-4 cycles 10800
CM0121-b : OVARY- GERM CELL TUMOR - EP ( Etoposide + Carboplatin) ; Day 1 : Carboplatin 400 mg/m 2 IV on days 1-3 ; Repeat every 28 days for three cycles 6500
CM0121-c : OVARY- GERM CELL TUMOR - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0122 : GESTATIONAL TROPHOBLAST DISEASES 0
CM0122-a : GESTATIONAL TROPHOBLAST DISEASES - Methotrexate (5 days regimen) ; Days 1-5: MTX 0.4 mg/kg/day IV or IM for 5 days, not to exceed 25 mg/day ; Repeat cycle every 14 days 2100
CM0122-b : GESTATIONAL TROPHOBLAST DISEASES - Methotrexate (8-day alternating regimen) ; Days 1, 3, 5, and 7 : MTX 1 mg/kg IM, ; Days 2, 4, 6, and 8 : Folinic acid 15 mg ; Repeat cycle every 14 days 2900
CM0122-c : GESTATIONAL TROPHOBLAST DISEASES - Methotrexate + Folinic Acid ; Day 1 : MTX 100 mg/m 2 IVP, then 200 mg/m 2 infusion ; Day 2 : Folinic acid 15 mg IM/PO q12h for 4 doses ; Repeat cycle every 18 days 2000
CM0122-d : GESTATIONAL TROPHOBLAST DISEASES - Methotrexate - Weekly ; MTX 30-50 mg/m 2 IM weekly 1300
CM0122-e : GESTATIONAL TROPHOBLAST DISEASES - Act-D ; Act-D 10-13 mcg/kg or 0.5-mg flat dose IV qd for 5d ; Repeat cycle every 14 days 7800
CM0122-f : GESTATIONAL TROPHOBLAST DISEASES - Actinomycin ; Actinomycin 1.25 mg/m 2 IV ; Repeat every 2 weeks 2200
CM0122-g : GESTATIONAL TROPHOBLAST DISEASES - EMA-CO (complete) ; Day 1 : Act-D - 0.5 mg IV, Etoposide - 100 mg/m2 IV, MTX - 300 mg/m2 IV ; Day 2 : Act-D - 0.5 mg IV, Etoposide - 100 mg/m2 IV, Leucovorin - 15 mg PO/IM q12h 4 doses ; Day 8 : Vincristine - 0.8 mg/m2 IV, Cyclophosphamide - 600 mg/m2 IV ; Repeat cycle every 14 days 6400
CM0122-h : GESTATIONAL TROPHOBLAST DISEASES - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0123 : TESTICULAR CANCER 0
CM0123-a : TESTICULAR CANCER - EP ; Days 1-5: Etoposide 100mg/m2, cisplatin 20mg/m2 ; Repeat cycle every 3 weeks for 4 cycles. 5400
CM0123-b : TESTICULAR CANCER - BEP ; Days 1-5: Cisplatin 20mg/m2, etoposide 100mg/m2 ; Days 1, 8, and 15 OR Days 2, 9, or 16: Bleomycin 30 units IV ; Repeat cycle every 3 weeks for 3 cycles. 10000
CM0123-c : TESTICULAR CANCER - VIP ; Day 1 (before ifosfamide): Mesna 120mg/m2 IV ; Days 1-5: Etoposide 75mg/m2 IV, mesna 1,200mg/m2 IV, ifosfamide 1,200mg/m2 IV + cisplatin 20mg/m2. ; Repeat cycle every 3 weeks for 4 cycles. 6300
CM0123-d : TESTICULAR CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0124 : PROSTATE CANCERPROSTATE CANCER 0
CM0124-a : PROSTATE CANCER - Docetaxel + prednisone ; Day 1: Docetaxel 75mg/m2 IV, prednisone 5mg orally twice daily. ; once every 3 weeks, Repeat for up to 10 cycles if tolerated 3600
CM0124-b : PROSTATE CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0125 : FEBRILE NEUTROPENIA 0
CM0125-a : FEBRILE NEUTROPENIA - First-line monotherapy ; Piperacillin-tazobactam 4.5 g ; Cefepime 2 g ; Meropenem 1 g ; Imipenem-cilastatin 500 mg 13500
CM0125-b : FEBRILE NEUTROPENIA - Second-line dual therapy ; Piperacillin-tazobactam 4.5 g IV plus an aminoglycoside ; Meropenem 1 g IV plus an aminoglycoside ; Imipenem-cilastatin 500 mg IV plus an aminoglycoside 19500
CM0125-c : Other Regimen 10000
CM0126 : THYROID CANCER 0
CM0126-a : THYROID CANCER - sorafenib ; sorafenib 400 mg PO BID 2900
CM0126-b : THYROID CANCER - sunitinib ; sunitinib 50 mg 28500
CM0126-c : THYROID CANCER - pazopanib 9500
CM0126-d : THYROID CANCER - Doxorubicin ; Doxorubicin 60 mg/m2 as monotherapy or in combination with cisplatin 40 mg/m2 4400
CM0126-e : THYROID CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0127 : THYMOMA 0
CM0127-a : THYMOMA - CAP ; Day 1: Cisplatin 50mg/m2 IV, doxorubicin 50mg/m2 IV, cyclophosphamide 500mg/m2 IV. ; Repeat every 21 days for a max of 8 cycles. 4600
CM0127-b : THYMOMA - CAPP ; Day 1: Cyclophosphamide 500mg/m2 IV ; Days 1-3: Cisplatin 30mg/m2 IV ; Days 1-3: Doxorubicin 20mg/m2 ; Days 1-5: Prednisone 100mg. ; Repeat every 3 weeks for 3 cycles. 6800
CM0127-c : THYMOMA - ADOC ; Day 1: Cisplatin 50mg/m2 IV, doxorubicin 40mg/m2 IV ; Day 3: Vincristine 0.6mg/m2 IV ; Day 4: Cyclophosphamide 700mg/m2 IV. ; Repeat every 3 weeks for 5 cycles. 5900
CM0127-d : THYMOMA - PE ; Day 1: Cisplatin 60mg/m2 IV ; Days 1-3: Etoposide 120mg/m2 IV ; Repeat every 3 weeks for a max of 8 cycles. 5100
CM0127-e : THYMOMA - VIP ; Days 1-4: Etoposide 75mg/m2 IV, ifosfamide 1.2g/m2 IV, cisplatin 20mg/m2 IV. ; Repeat every 3 weeks for 4 cycles 7600
CM0127-f : THYMOMA - Carboplatin+paclitaxel ; Day 1: Paclitaxel 225mg/m2 IV, carboplatin AUC = 6 IV ; Repeat every 3 weeks for a max of 6 cycles. 9300
CM0127-g : THYMOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0128 : BRAIN CARCINOMA 0
CM0128-i : BRAIN CARCINOMA - Systemic Therapy for Adult Low-Grade Infiltrative Supratentorial Astrocytoma/Oligodendroglioma 0
CM0128-i-a : BRAIN CARCINOMA - Systemic Therapy for Adult Low-Grade Infiltrative Supratentorial Astrocytoma/Oligodendroglioma - Combination PCV (lomustine + procarbazine + vincristine) ; Day 1: Lomustine 110mg/m2 orally. ; Days 8-21: Procarbazine 60mg/m2 orally once daily. ; Days 8 and 29: Vincristine 1.4mg/m2 (maximum 2mg) IV. ; Repeat every 6 weeks. 3800
CM0128-i-b : BRAIN CARCINOMA - Systemic Therapy for Adult Low-Grade Infiltrative Supratentorial Astrocytoma/Oligodendroglioma - Temozolomide (7 weeks) ; Days 1-49: Temozolomide 75mg/m2 orally. ; Repeat cycle every 11 weeks (7 weeks on/4 weeks off) for 6 cycles. 6500
CM0128-i-c : BRAIN CARCINOMA - Systemic Therapy for Adult Low-Grade Infiltrative Supratentorial Astrocytoma/Oligodendroglioma - Temozolomide monthly 5-day course ; Temozolomide monthly 5-day courses at doses of 180 - 200mg/m2/day 2100
CM0128-i-d : BRAIN CARCINOMA - Systemic Therapy for Adult Low-Grade Infiltrative Supratentorial Astrocytoma/Oligodendroglioma - Temozolomide (3 weeks) ; Days 1-21: Temozolomide 75mg/m2/day orally. ; Repeat cycle every 28 days. 3400
CM0128-ii : BRAIN CARCINOMA - Systemic Therapy for Anaplastic GliomasSystemic Therapy for Anaplastic Gliomas 0
CM0128-ii-a : BRAIN CARCINOMA - Systemic Therapy for Anaplastic Gliomas - Temozolomide monthly 5-day course ; Days 1-5: Temozolomide 200mg/m2/day orally. ; Repeat cycle every 4 weeks until disease progression or for up to 24 cycles. 2100
CM0128-ii-b : BRAIN CARCINOMA - Systemic Therapy for Anaplastic Gliomas - PCV with deferred RT (lomustine + procarbazine + vincristine) ; Day 1: Lomustine 110mg/m2 orally ; Days 8-21: Procarbazine 60mg/m2 orally once daily ; Days 8 and 29: Vincristine 1.4mg/m2 (maximum 2mg) IV. ; Repeat every 6 weeks 3800
CM0128-ii-c : BRAIN CARCINOMA - Systemic Therapy for Anaplastic Gliomas - Concurrent Temozolomide (with RT) - followed by adjuvant temozolomide ; 0
CM0128-ii-d : Adjuvant Temozolomide 2100
CM0128-ii-e : BRAIN CARCINOMA - Systemic Therapy for Anaplastic Gliomas - PCV for 1p19q co-deleted (with Radiotherapy) ; Day 1: Lomustine 110mg/m2 orally ; Days 8-21: Procarbazine 60mg/m2 orally once daily ; Days 8 and 29: Vincristine 1.4mg/m2 (maximum 2mg) IV. ; Repeat every 6 weeks. for 6 cycles 3800
CM0128-iii : BRAIN CARCINOMA - Systemic Therapy for Glioblastoma 0
CM0128-iii-a : BRAIN CARCINOMA - Systemic Therapy for Glioblastoma - Concurrent Temozolomide (with RT) - followed by adjuvant temozolomide ; Daily oral temozolomide (75mg/m2/day, 7 days per week from the first to the last day of radiotherapy) 7200
CM0128-iii-b : BRAIN CARCINOMA - Systemic Therapy for Glioblastoma - Adjuvant Temozolomide (preceeded by Concurrent temozolzmide) ; Days 1-5: Temozolomide 150-200mg/m2/day orally for 5 days. ; Repeat cycle every 28 days for 6 cycles. 2100
CM0128-iii-c : BRAIN CARCINOMA - Systemic Therapy for Glioblastoma - Temozolomide (post RT) ; Days 1-5: Temozolomide 150-200mg/m2/day orally for 5 days. ; Repeat cycle every 28 days 2100
CM0128-iii-d : BRAIN CARCINOMA - Systemic Therapy for Glioblastoma - Temozolomide (200mg) with standard RT ; Days 1-5: Temozolomide 200mg/m2, orally 2100
CM0128-iv : BRAIN CARCINOMA - Systemic Therapy for Adult Medulloblastoma and Supratentorial Primitive Neuroectodermal Tumor (PNET) 0
CM0128-iv-a : BRAIN CARCINOMA - Systemic Therapy for Adult Medulloblastoma and Supratentorial Primitive Neuroectodermal Tumor (PNET) - Vincristine + cisplatin + lomustine ; Day 1: Lomustine 75mg/m2 orally ; Day 2: Cisplatin 75mg/m2 IV ; Days 2, 8 and 15: Vincristine 1.5mg/m2 IV bolus, max 2mg bolus; ; During Cranio-spinal RT 4400
CM0128-iv-b : BRAIN CARCINOMA - Systemic Therapy for Adult Medulloblastoma and Supratentorial Primitive Neuroectodermal Tumor (PNET) - Vincristine + cisplatin + cyclophosphamide ; Day 1: Cisplatin 75mg/m2 IV ; Days 2, 8 and 15: Vincristine 1.5mg/m2 IV bolus, max 2mg bolus ; Days 22, 23: Cyclophosphamide 1,000mg/m2 IV. 5500
CM0128-v : BRAIN CARCINOMA - Primary CNS LymphomaPrimary CNS Lymphoma 0
CM0128-v-a : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose methotrexate combined with the following plus radiation therapyHigh dose methotrexate combined with the following plus radiation therapy 0
CM0128-v-a-1 : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose Methotrexate + Cytarabine ; Day 1: MTX 3.5g/m2 ; Days 2-3: Cytarabine 2g/m2 IV twice a day. 6600
CM0128-v-a-2 : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose Methotrexate + leucovorin + Ifosfamide + mesna ; Day 1: MTX 4gm/m2 IV, ; Days 2-5: leucovorin 20-25mg IV (upto 40mg) ; Days 3-5: Ifosfamide 1.5gm/m2 IV + mesna 400mg IV 9500
CM0128-v-b : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose methotrexate combined with the following plus radiation therapy High dose methotrexate (MTX 2.5-4.0mg/m2) + chemotherapy monoclonal antibody 0
CM0128-v-b-1 : BRAIN CARCINOMA - Primary CNS Lymphoma - Rituximab + MTX + vincristine +procarbazine ; Day 1: Rituximab 500mg/m2 IV ; Day 2: MTX 3.5mg/m2 IV plus vincristine 1.4mg/m2 ; Procarbazine 100mg/m2/day administered for 7 days with odd-numbered cycles 41900
CM0128-v-c : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose methotrexate (MTX 8.0mg/m2) + chemotherapy +/- monoclonal antibody High dose methotrexate (MTX 8.0mg/m2) + chemotherapy monoclonal antibody 0
CM0128-v-c-1 : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose methotrexate Induction ; MTX 8g/m2 IV ; Repeat every 2 weeks until complete response achieved or max of 8 cycles reached. ; 7900
CM0128-v-c-2 : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose methotrexate Consolidation ; MTX 8g/m2 IV administered ; Repeat every 2 weeks for 2 cycles. 7900
CM0128-v-c-3-i : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose methotrexate Maintanance (Cycles 1-4) ; Day 1: MTX 8g/m2 IV, Rituximab 375mg/m2 IV. ; Repeat every 4 weeks for 4 cycles 32400
CM0128-v-c-3-ii : BRAIN CARCINOMA - Primary CNS Lymphoma - High dose methotrexate Maintanance (cycles 5-11) ; MTX 8g/m2 IV administered every 4 weeks for 11 cycles. ; Repeat cycle every 4 weeks for 4 cycles 7900
CM0128-v-d : BRAIN CARCINOMA - Primary CNS Lymphoma - Rituximab + Temozolomide regimen 0
CM0128-v-d-1 : BRAIN CARCINOMA - Primary CNS Lymphoma - Rituximab + Temozolomide regimen - Induction ; Day 1: Rituximab 375mg/m2 IV, followed by ; Days 1-5: Temozolomide 150-200mg/m2 orally daily, after rituximab infusion. ; Repeat cycle every 4 weeks for 4 cycles. 26600
CM0128-v-d-2 : BRAIN CARCINOMA - Primary CNS Lymphoma - Rituximab + Temozolomide regimen - MaintananceDays 1-5: Temozolomide 150-200mg/m2 orally daily. ; Repeat cycle every 4 weeks for 8 cycles. 1600
CM0128-v-e : BRAIN CARCINOMA - Meningioma 0
CM0128-v-e-1 : BRAIN CARCINOMA - Meningioma - Interferon-alfaInterferon-alfa ; alpha-IFN 106 units/m2 SC every other day for 4 weeks. ; Repeat cycle every 4 weeks. ; 6000
CM0128-v-e-2 : BRAIN CARCINOMA - Meningioma -Somatostatin analog ; Sandostatin LAR Depot 10-30mg IM ; Repeat every 4 weeks. ; 5400
CM0128-v-e-3 : BRAIN CARCINOMA - Meningioma - Sunitinib ; Days 1-28: Sunitinib 50mg orally daily. ; Repeat cycle every 42 days. 2900
CM0129 : HEAD AND NECK CANCER 0
CM0129-i : HEAD AND NECK CANCER - Squamous Cell Cancers 0
CM0129-i-a : HEAD AND NECK CANCER - HIgh Dose Cisplatin ; Cisplatin 100mg/m2 IV + concurrent radiotherapy; Repeat cycle every 3 weeks for 3 cycles 2000
CM0129-i-b : HEAD AND NECK CANCER - Carboplatin + infusional 5-FU ; Days 1-4: 5-FU 600mg/m2/day as continuous IV I, carboplatin 70mg/m2/day IV ; Repeat every 3 weeks for 3 cycles (given concurrently with radiotherapy). 4700
CM0129-i-c : HEAD AND NECK CANCER - 5-FU + hydroxyurea ; Day 1: Hydroxyurea 1,000mg orally every 12 hours (11 doses/cycle), 5-FU 800mg/m2/day ; Repeat every other week for 7 cycles. with Concurrent radiotherapy 2300
CM0129-i-d : HEAD AND NECK CANCER - Cisplatin + paclitaxel ; Day 1: Paclitaxel 30mg/m2 IV (every Monday), ; Day 2: Cisplatin 20mg/m2 IV (every Tuesday). ; Repeat cycle every week for 7 cycles, with Concurrent radiotherapy 3400
CM0129-i-e : HEAD AND NECK CANCER - Cisplatin + infusional 5-FU ; Day 1: Cisplatin 60mg/m2 over ; Days 1-5: 5-FU 800mg/m2/day ; Repeat every other week for 7 cycles. with Concurrent radiotherapy 5300
CM0129-i-f : HEAD AND NECK CANCER - Carboplatin + paclitaxel ; Day 1: Paclitaxel 40-45mg/m2, carboplatin 100mg/m2 ; Repeat cycle every week for 8 cycles, with Concurrent radiotherapy 3500
CM0129-i-g : HEAD AND NECK CANCER - Weekly cisplatin ; Cisplatin 40mg/m2 IV per week 1800
CM0129-i-h : HEAD AND NECK CANCER - Cisplatin (For high risk oropharyngeal carcinoma) ; Days 1, 22, and 43: Cisplatin 100mg/m2 IV + radiotherapy. 5300
CM0129-i-i : HEAD AND NECK CANCER - Docetaxel + cisplatin + 5-FU ; Day 1: Docetaxel 75mg/m2 IV, cisplatin 75mg/m2 IV, ; Days 1-5: 5-FU 750mg/m2/day IV. ; Repeat every 3 weeks for up to 4 cycles. 6700
CM0129-i-j : HEAD AND NECK CANCER - Paclitaxel + cisplatin+ infusional 5-FU ; Day 1: Paclitaxel 175mg/m2 ; Day 2: Cisplatin 100mg/m2 ; Day 2-6: 5-FU 500mg/m2/day IV ; Repeat every 3 weeks for 3 cycles. 7900
CM0129-ii : HEAD AND NECK CANCER - Nasopharynx Cancer 0
CM0129-ii-a : Nasopharynx Cancer - Concurrent Cisplatin followed by concurrent Cisplatin +5FUC ; 0
CM0129-ii-a-1 : Nasopharynx Cancer - Concurrent Cisplatin (followed by concurrent Cisplatin +5FU) ; Day 1: Cisplatin 100mg/m2 IV; plus radiotherapy. ; Repeat cycle every 3 weeks for 3 cycles; followed by concurrent Cisplatin +5FU 2000
CM0129-ii-a-2 : Nasopharynx Cancer - concurrent Cisplatin +5FU - Preceeded by (Concurrent Cisplatin 3 cycles) ; Days 1-4: Cisplatin 80mg/m2/day, 5-FU 1,000mg/m2/day IV ; Repeat cycle every 4 weeks for 3 cycles 6700
CM0129-ii-b : Nasopharynx Cancer - Concurrent Carboplatin followed by concurrent Carboplatin +5FU 0
CM0129-ii-b-1 : Nasopharynx Cancer - Concurrent Carboplatin - (followed by concurrent Carboplatin +5FU) ; Day 1: Carboplatin AUC 6mg/min/mL IV. ; Repeat cycle every 3 weeks for 3 cycles; 4300
CM0129-ii-b-2 : Nasopharynx Cancer - concurrent Carboplatin +5FU - Preceeded by (Concurrent Carboplatin ) ; Day 1: Carboplatin AUC 5mg/min/mL IV ; Days 1-4: 5-FU 1,000mg/m2/day IV ; Repeat cycle every 3 weeks for 3 cycles. 13500
CM0129-ii-c : Nasopharynx Cancer - Concurrent Cisplatin ; Cisplatin 40mg/m2 ; Repeat weekly for 7 cycles 1800
CM0129-ii-d : Nasopharynx Cancer - Docetaxel + cisplatin + 5-FU followed by Cisplatin ; 0
CM0129-ii-d-1 : Nasopharynx Cancer - Docetaxel + cisplatin + 5-FU - followed by Cisplatin after 3 cycles ; Day 1: Docetaxel 70mg/m2 IV, cisplatin 75mg/m2 IV ; Days 1-4: 5-FU 1,000mg/m2/day IV ; Repeat every week for 3 cycles 6200
CM0129-ii-d-2 : Nasopharynx Cancer - Cisplatin - weekly - Preceded by 3 cycles of Docetaxel + 5-FU ; Day 1: Cisplatin 100mg/m2; ; Repeat every 3 weeks, Till radiation 2800
CM0129-ii-e : Nasopharynx Cancer - Docetaxel + cisplatin 0
CM0129-ii-e-1 : Nasopharynx Cancer - Docetaxel + cisplatin - followed by Cisplatin after 2 cycles ; Day 1: Docetaxel 75mg/m2 IV + cisplatin 75mg/m2 IV ; Repeat every 3 weeks for two cycles 3900
CM0129-ii-e-2 : Nasopharynx Cancer - Cisplatin - weekly - Preceded by 2 cycles of Docetaxel + cisplatin ; Cisplatin 40mg/m2 IV ; weekly concurrent with radiotherapy. 2300
CM0129-ii-f : Nasopharynx Cancer - Cisplatin + 5-FU ; Day 1: Cisplatin 100mg/m2/day IV. ; Days 1-4: 5-FU 1,000mg/m2/day continuous IV infusion for 4 days. ; Repeat cycle every 3 weeks for a minimum of 6 cycles 5100
CM0129-iii : HEAD AND NECK CANCER (or) Nasopharynx Cancer - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0130 : RENAL CELL CARCINOMARENAL CELL CARCINOMA 0
CM0130-a : Pazopanib 19000
CM0130-b : Sunitinib 29000
CM0130-c : Sorafenib 5800
CM0130-d : Other Regimen 10000
CM0131 : UNKNOWN PRIMARYUNKNOWN PRIMARY 0
CM0131-i : UNKNOWN PRIMARY - Adenocarcinoma 0
CM0131-i-a : UNKNOWN PRIMARY - Adenocarcinoma - Paclitaxel + carboplatin + etoposide ; Day 1: Paclitaxel 200 mg/m 2 IV, carboplatin AUC 6 ; Days 1-10: etoposide 50 mg PO alternating with 100 mg daily ; Repeat every 21days for 2-3 cycles; restage, can be treated upto 8 cycles 8000
CM0131-i-b : UNKNOWN PRIMARY - Adenocarcinoma - Paclitaxel + carboplatin ; Day 1: Paclitaxel 200 mg/m 2, carboplatin AUC 6 ; Repeat cycle every 3 weeks, Maximum 8 cycles 7200
CM0131-i-c : UNKNOWN PRIMARY - Adenocarcinoma - Docetaxel + carboplatin ; Day 1: Docetaxel 65mg/m2 IV, carboplatin AUC 6 ; Repeat cycle every 3 weeks, Maximum 8 cycles. 3800
CM0131-i-d : UNKNOWN PRIMARY - Adenocarcinoma - Gemcitabine + cisplatin ; Day 1: Cisplatin 100mg/m2 IV ; Day 1 and 8: Gemcitabine 1250mg/m2 IV. ; Repeat cycle every 3 weeks for 4 cycles. 5300
CM0131-i-e : UNKNOWN PRIMARY - Adenocarcinoma - Gemcitabine + docetaxel ; Day 1 and 8: Gemcitabine 1000mg/m2 IV over 30 minutes ; Day 8: Docetaxel 75mg/m2 IV ; Repeat cycle every 3 weeks for a maximum of 6 cycles 5800
CM0131-i-f : UNKNOWN PRIMARY - Adenocarcinoma - Gemcitabine + irinotecan ; Days 1 and 8: Irinotecan 100mg/m2 IV, gemcitabine 1000mg/m2 IV. ; Repeat cycle every 3 weeks for 6 cycles.restage every 2-3 cycles 5600
CM0131-ii : UNKNOWN PRIMARY - Squamous cell carcinoma 0
CM0131-ii-a : UNKNOWN PRIMARY - Squamous cell carcinoma - Paclitaxel + cisplatin + 5-FU ; Paclitaxel 175 mg/m 2 IV, ; Day 2: cisplatin 100 mg/m 2 IV, ; Day 5-FU (5-fluorouracil) 500 mg/m 2/day IV ; Repeat every 21d 6200
CM0131-ii-b : UNKNOWN PRIMARY - Squamous cell carcinoma - Docetaxel + cisplatin + 5-FU ; Day 1: Docetaxel 75mg/m2 IV, cisplatin 75mg/m2 IV. ; Days 1-5: 5-FU 750mg/m2/day IV ; Repeat cycle every 3 weeks for 3 cycles. 6800
CM0131-iii : UNKNOWN PRIMARY - Neuroendocrine tumors 0
CM0131-iii-b : UNKNOWN PRIMARY - Neuroendocrine tumors - Etoposide + cisplatin ; Days 1-3: Etoposide 100 mg/m 2 ; Days 2-3: cisplatin 45 mg/m 2 IV ; Repeat every 28 days 5000
CM0131-iv : UNKNOWN PRIMARY - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0132 : CA HEPATO BILIARY /CA COMMON BILE DUCT/CA GALLBLADDER/ CHOLANGIOCARCINOMACA HEPATO BILIARY /CA COMMON BILE DUCT/CA GALLBLADDER/ CHOLANGIOCARCINOMA 0
CM0132-a : CA HEPATO BILIARY /CA COMMON BILE DUCT/CA GALLBLADDER/ CHOLANGIOCARCINOMA - Gemcitabine + cisplatin ; Days 1 and 8: Cisplatin 25mg/m2 IV, gemcitabine 1,000mg/m2 IV ; Repeat every 21 days for 4 cycles, re-evaluate and continue an additional 4 cycles if warranted 3700
CM0132-b : CA HEPATO BILIARY /CA COMMON BILE DUCT/CA GALLBLADDER/ CHOLANGIOCARCINOMA - 5-FU ; 5 - FU IV 4100
CM0132-c : CA HEPATO BILIARY /CA COMMON BILE DUCT/CA GALLBLADDER/ CHOLANGIOCARCINOMA - Capecitabine ; Capecitabine oral ; Repeat every 21 days 3600
CM0132-d : CA HEPATO BILIARY /CA COMMON BILE DUCT/CA GALLBLADDER/ CHOLANGIOCARCINOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0133 : PANCREAS CARCINOMAPANCREAS CARCINOMA - 0
CM0133-i : PANCREAS CARCINOMA - Patients with resectable pancreatic cancer - Locally Advanced ; 0
CM0133-i-a : PANCREAS CARCINOMA - Patients with resectable pancreatic cancer - Locally Advanced Gemcitabine ; Days 1, 8, and 15: Gemcitabine 1,000mg/m2 IV ; Repeat every 4 weeks for six cycles 6600
CM0133-ii : PANCREAS CARCINOMA - Adjuvant chemotherapy and chemoradiation 0
CM0133-ii-a : PANCREAS CARCINOMA - Adjuvant chemotherapy and chemoradiation - 5-FU + Leucovorin ; Days 1-5: Leucovorin 20mg/m2 IV, 5-FU 425mg/m2 IV ; Repeat cycle every 4 weeks 5000
CM0133-ii-b : PANCREAS CARCINOMA - Adjuvant chemotherapy and chemoradiation - Gemcitabine & 5FU ; Prior to chemoradiation: ; Days 1, 8 and 15: Gemcitabine 1,000mg/m2 IV; initiate 1-2 weeks prior to chemoradiation (50.4Gy + 5-FU 250mg/m2/day). ; After chemoradiation: ; Days 1, 8 and 15: Gemcitabine 1,000mg/m2 IV; initiate 3-5 weeks following chemoradiation. ; Repeat cycle every 4 weeks for 3 months. 6700
CM0133-ii-c : PANCREAS CARCINOMA - Adjuvant chemotherapy and chemoradiation - Continuous infusion 5-FU (with Radiation) ; Prior to chemoradiation: ; Days 1-21: 5-FU 250mg/m2/day continuous IV infusion; initiate 1-2 weeks prior to chemoradiation (50.4Gy + 5-FU 250mg/m2/day). ; After chemoradiation: ; Days 1-28: 5-FU 250mg/m2/day continuous IV infusion; initiate 3-5 weeks following chemoradiation. ; Repeat cycle every 6 weeks for 3 months. 20700
CM0133-iii : PANCREAS CARCINOMA - Neoadjuvant therapy - Neoadjuvant therapy 0
CM0133-iii-a : PANCREAS CARCINOMA - Neoadjuvant therapy - CapecitabineCapecitabine ; Capecitabine ; Repeat cycle every 3 weeks for up to 52 weeks. 3600
CM0133-iv : PANCREAS CARCINOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0134 : PERI AMPULLARY CARCINOMA 0
CM0134-a : PERI AMPULLARY CARCINOMA - 5-FU ; Fluorouracil 425 mg/m2 administered on days 1 to 5 and 29-33 5300
CM0134-b : PERI AMPULLARY CARCINOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0135 : NEURO ENDOCRINE CARCINOMA 0
CM0135-a : NEURO ENDOCRINE CARCINOMA - All NECs are covered under Organ Cancers. If uncovered - Unlisted only. 0
CM0135-b : NEURO ENDOCRINE CARCINOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0136 : SARCOMA 0
CM0136-i : SARCOMA - Gastrointestinal Stromal Tumor - GIST 0
CM0136-i-a : SARCOMA - Gastrointestinal Stromal Tumor - GIST - Imatinib ; Imatinib 400mg orally once daily to twice daily 3000
CM0136-ii : SARCOMA - SOFT TISSUE SARCOMA 0
CM0136-ii-a : SARCOMA - SOFT TISSUE SARCOMA - Doxorubicin + dacarbazine (AD) ; Days 1-4: Doxorubicin 60mg/m2 + dacarbazine 750mg/m2 ; Repeat cycle every 3 weeks 11500
CM0136-ii-b : SARCOMA - SOFT TISSUE SARCOMA - Doxorubicin + ifosfamide + mesna ; Days 1 and 2: Doxorubicin 30mg/m2/day IV, ifosfamide 3,750mg/m2/day IV, mesna 750mg/m2 IV ; Repeat cycle every 3 weeks 9200
CM0136-ii-c : SARCOMA - SOFT TISSUE SARCOMA - Mesna + doxorubicin + ifosfamide + dacarbazine (MAID) ; Days 1-3: Doxorubicin 20mg/m2/day, ifosfamide 2,500mg/m2/day, dacarbazine 300mg/m2/day IV ; Days 1-4: Mesna 2,500mg/m2/day IV for 84 to 96 hours. ; Repeat cycle every 3 weeks. 10700
CM0136-ii-d : SARCOMA - SOFT TISSUE SARCOMA - Ifosfamide + epirubicin + mesna ; Days 1 and 2: Epirubicin 60mg/m2/day IV ; Days 1-5: Ifosfamide 1.8g/m2/day IV + mesna. ; Repeat cycle every 3 weeks for 5 cycles. 12800
CM0136-ii-e : SARCOMA - SOFT TISSUE SARCOMA - Gemcitabine + docetaxel ; Days 1 and 8: Gemcitabine 900mg/m2 IV ; Day 8: Docetaxel 100mg/m2 IV. ; Repeat cycle every 3 weeks 5100
CM0136-ii-f : SARCOMA - SOFT TISSUE SARCOMA - Gemcitabine + vinorelbine ; Days 1 and 8: Vinorelbine 25mg/m2 IV, gemcitabine 800mg/m2 IV ; Repeat cycle every 3 weeks 14700
CM0136-ii-g : SARCOMA - SOFT TISSUE SARCOMA - Gemcitabine + dacarbazine ; Day 1: Gemcitabine 1,800mg/m2 IV + dacarbazine 500mg/m2 IV. ; Repeat cycle ever 2 weeks for a total of 12 cycles; 3300
CM0136-ii-h : SARCOMA - SOFT TISSUE SARCOMA - Doxorubicin ; Doxorubicin 60-75mg/m2 IV ; once every 3 weeks 2900
CM0136-ii-i : SARCOMA - SOFT TISSUE SARCOMA - Ifosfamide ; Days 1-3: Ifosfamide 2,000-3,000mg/m2/day IV for 3 to 4 days + mesna ; Repeat every 3 weeks. 10000
CM0136-ii-j : SARCOMA - SOFT TISSUE SARCOMA - Ifosfamide ; Day 1: Ifosfamide 5,000mg/m2 + mesna 5,000mg/m2 IV ; Day 2: mesna 400-600mg/m2 IV ; Ifosfamide, mesna ; Repeat every 3 weeks 1900
CM0136-ii-k : SARCOMA - SOFT TISSUE SARCOMA - Epirubicin ; Epirubicin 160mg/m2 IV ; Repeat every 3 weeks 5900
CM0136-ii-l : SARCOMA - SOFT TISSUE SARCOMA - Gemcitabine ; Days 1 and 8: Gemcitabine 1,200mg/m2 IV ; Repeat cycle every 3 weeks. 3600
CM0136-ii-m : SARCOMA - SOFT TISSUE SARCOMA - Dacarbazine (i) ; Dacarbazine 250mg/m2/day IV for 5 days ; Repeat every 3 weeks. 6200
CM0136-ii-n : SARCOMA - SOFT TISSUE SARCOMA - Dacarbazine (ii) ; Dacarbazine 800-1,000mg/m2 IV ; Repeat every 3 weeks. 2400
CM0136-ii-o : SARCOMA - SOFT TISSUE SARCOMA - Liposomal doxorubicin ; Liposomal doxorubicin 30-50mg/m2 IV ; Repeat every 4 weeks. 7900
CM0136-ii-p : SARCOMA - SOFT TISSUE SARCOMA - Temozolomide ; Temozolomide 200mg/m2 orally twice daily for 5 days, followed by 9 doses of 90mg/m2 orally ; Repeat every 4 weeks 4200
CM0136-iii : SARCOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0137 : PRIMITIVE NEURO ECTODERMAL TUMOR 0
CM0137-a : PRIMITIVE NEURO ECTODERMAL TUMOR - Weekly vincristine ; vincristine 1.5mg/m2 IV, max 2mg ; for 5 to 6 weeks 1700
CM0137-b : PRIMITIVE NEURO ECTODERMAL TUMOR - Vincristine + cisplatin + lomustine ; During craniospinal radiotherapy (RT) ; Day 1: Lomustine 75mg/m2 orally ; Day 2: Cisplatin 75mg/m2 IV ; Days 2, 8 and 15: Vincristine 1.5mg/m2 IV bolus, max 2mg bolus; up to max 8 doses 4400
CM0137-c : PRIMITIVE NEURO ECTODERMAL TUMOR - Vincristine + cisplatin + cyclophosphamide ; Day 1: Cisplatin 75mg/m2 IV ; Days 2, 8 and 15: Vincristine 1.5mg/m2 IV, max 2mg ; Days 22, 23: Cyclophosphamide 1,000mg/m2 IV 7600
CM0137-d : PRIMITIVE NEURO ECTODERMAL TUMOR - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0137-vi : Other Regimen 10000
CM0138 : MELANOMA - No primary regimens only RT. For advanced unresectable and metastatic disease - Pallitive Chemotherapy 10000
CM0139 : ANAL CANAL CANCER 0
CM0139-a : ANAL CANAL CANCER - 5-FU + Mitomycin ; Days 1-4 and 29-32: 5-FU 1,000mg/m2/day IV ; Days 1 and 29: Mitomycin 10mg/m2 IV bolus (maximum 20mg per course), with Concurrent radiotherapy 11400
CM0139-b : ANAL CANAL CANCER - Capecitabine + Mitomycin (i) ; Days 1-5: Capecitabine 825mg/m2 orally twice daily weekly for 6 weeks, ; Days 1 and 29: Mitomycin 10mg/m2 IV bolus, with Concurrent radiotherapy. 8100
CM0139-c : ANAL CANAL CANCER - Capecitabine + Mitomycin (ii) ; Days 1-5: Capecitabine 825mg/m2 orally twice daily weekly for 6 weeks, ; Day 1: Mitomycin 12mg/m2 IV bolus, with Concurrent radiotherapy 6800
CM0139-d : ANAL CANAL CANCER - Cisplatin + 5-FU ; Days 1-5: 5-FU 1,000mg/m2/day IV ; Day 2: Cisplatin 100mg/m2 IV ; Repeat cycle every 4 weeks, with Concurrent radiotherapy 6700
CM0139-e : ANAL CANAL CANCER - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0158 : UPTO-40% WITH SCALDS (CONSERVATIVE) 22680
CM0159 : UPTO-40% MIXED BURNS (WITH SURGERIES) 32400
CM0160 : UPTO-50% WITH SCALDS (CONSERVATIVE) 40338
CM0161 : UPTO-50% MIXED BURNS ( WITH SURGERIES) 49410
CM0162 : UPTO-60% WITH SCALDS (CONSERVATIVE) 60588
CM0163 : UP TO-60% MIXED BURNS (WITH SURGERIES) 65610
CM0164 : ABOVE 60% MIXED BURNS (WITH SURGERIES) 81810
CM0165 : POST BURN CONTRACTURE FOR FUNCTIONAL IMPROVEMENT (INCLUDING SPLINT / PRESSURE GARMENT / PHYSIOTHERAPY) - MILD 17010
CM0166 : POST BURN CONTRACTURE FOR FUNCTIONAL IMPROVEMENT (INCLUDING SPLINT / PRESSURE GARMENT / PHYSIOTHERAPY) - MODERATE 25110
CM0167 : POST BURN CONTRACTURE FOR FUNCTIONAL IMPROVEMENT (INCLUDING SPLINT / PRESSURE GARMENT / PHYSIOTHERAPY) - SEVERE 31590
CM0168 : PTOSIS 19845
CM0169 : CUP AND BAT EARS 19845
CM0170A : FILARIAL LYMPHOEDEMA -NV SHUNT 11259
CM0170B : FILARIAL LYMPHOEDEMA -REDUCTION SURGERY 19845
CM0171 : HEMIFACIAL ATROPHY 28026
CM0172 : HEMIFACIAL MICROSMIA 40176
CM0173 : LEPROSY RECONSTRUCTIVE SURGERY 23409
CM0174 : TUMOR OF MANDIBLE AND MAXILLA 32481
CM0175 : CORRECTIVE SURGERY FOR CONGENITAL DEFORMITY OF HAND (PER HAND) 21546
CM0176 : PRESSURE SORE RECONSTRUCTIVE SURGERY 35559
CM0177 : ABDOMINAL WALL RECONSTRUCTION INCLUDING POST CANCER EXCISION 35478
CM0178 : LID DEFORMITY CORRECTION (FOLLOWING TRAUMA/BURNS/CONGENITAL) 13608
CM0180 : TOTAL ELBOW REPLACEMENT 38070
CM0181 : SHOULDER REPLACEMENT 38880
CM0182 : RADIAL HEAD REPLACEMENT 26730
CM0183 : SURGICAL CORRECTION OF LONGBONE FRACTURE-FRACTURE NECK/ SHAFT OF FEMUR/FRACTURE SHAFT OF OTHER LONG BONES (HUMERUS,BOTH BONES OF FOREARM, BOTH BONES OF LEG) 18023
CM0184 : CORRECTION OF NON-UNION FRACTURES - NON-UNION OF FRACTURE OF FEMUR/BOTH BONE OF LEG/ NON-UNION OF OTHER LONG BONES -HUMERUS/ BOTH BONES OF FOREARM WITH OR WITHOUT BONE GRAFTING 18023
CM0185 : SKELETAL SKULL TRACTION 24584
CM0186A : IMPLANT EXIT- K-WIRES /SCREWS/OTHER MINOR IMPLANTS 6278
CM0186B : IMPLANT EXIT- PLATES (SPINE IMPLANTS/OTHER MAJOR IMPLANT) 16605
CM0187 : ARTHRODESIS OF JOINTS -SHOULDER/ HIP / KNEE /ELBOW/ ANKLE / WRIST / HAND / FOOT 21870
CM0192 : ILIZAROV RING FIXATOR APPLICATION-FEMUR - DEFORMITY CORRECTION / LIMB LENGTHENING/TIBIA - DEFORMITY CORRECTION / LIMB LENGTHENING /PLATING/EXTERNAL FIXATOR/K WIRES 32198
CM0193 : SURGERY FOR NEGLECTED CTEV/RECURRENT CTEV-CTEV CORRECTIVE SURGERY /CTEV PONSETTI CORRECTION (FOLLOW UP PROCEDURES)/CTEV ILIZAROV 36248
CM0195 : KNEE LIGAMENT RECONSTRUCTION-ACL RECONSTRUCTION/PCL RECONSTRUCTION/MPFL RECONSTRUCTION 24300
CM0203 : SURGICAL CORRECTION FOR PELVIC BONE FRACTURES 26123
CM0204 : CORRECTION SACRO ILLIAC JOINT / ACETABULAR FRACTURES 23895
CM0205 : TOTAL KNEE REPLACEMENT 65000
CM0206A : TOTAL HIP REPLACEMENT- CEMENTED 60075
CM0206B : TOTAL HIP REPLACEMENT-UNCEMETED 69075
CM0209 : ACQUIRED HEART DISEASE WITH CONGESTIVE CARDIAC FAILURE 13770
CM0210 : INBORN ERROR OF METABOLISM 32400
CM0211 : HEMOPHAGOCYTIC LYMPHO HISTIOCYTOSIS 24300
CM0212 : HYPOPLASTIC/APLASTIC ANEMIA (FANCONI ANEMIA) 2511
CM0213 : NECROTISING ENTEROCOLITIS - CLINICAL SEPSIS /HYPERBILIRUBINEMIA /NON VENTILATED 20250
CM0214 : VITAMIN D RESISTANT RICKETS 8100
CM0215 : ADRENAL FAILURE INCLUDING PRIMARY ADRENAL FAILURE AND CAH 20250
CM0216 : PRIMARY IMMUNO DEFICIENCY DISORDERS 121500
CM0291 : CRANIOTOMY AND EVACUATION OF HAEMATOMA 47183
CM0292A : EXCISION OF BRAIN TUMORS - [PRIMARY /BENIGN ) ( SUPRATENTORIAL- FRONTAL/PARIETAL/TEMPORAL/SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) 51233
CM0292B : EXCISION OF BRAIN TUMORS - [PRIMARY /BENIGN ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDES SUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR) 55283
CM0293A : EXCISION OF BRAIN TUMORS - [MALIGNANT ) ( SUPRATENTORIAL- FRONTAL/PARIETAL/TEMPORAL/SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) 51233
CM0293B : EXCISION OF BRAIN TUMORS - [MALIGNANT ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDES SUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR) 55283
CM0294A : EXCISION OF BRAIN TUMORS - [SECONDARIES ) ( SUPRATENTORIAL- FRONTAL/PARIETAL/TEMPORAL/SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) 51233
CM0294B : EXCISION OF BRAIN TUMORS - [SECONDARIES ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDES SUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR) 55283
CM0295A : SHUNT SURGERIES-VENTRICULOATRIAL / VENTRICULOPERITONEAL SHUNT/ VENTRICULOPLEURAL SHUNT 21830
CM0295B : LUMBAR PERITONEAL/SYRINGO SUBARACHANOID /CYSTO PERITONEAL 23450
CM0296A : SHUNT SURGERIES-SHUNT DYSFUNTION - SHUNT SURGERIES-VENTRICULOATRIAL / VENTRICULOPERITONEAL SHUNT/ VENTRICULOPLEURAL SHUNT-REVISION 21830
CM0296B : SHUNT SURGERIES-SHUNT DYSFUNTION - SHUNT SURGERIES-VENTRICULOATRIAL / VENTRICULOPERITONEAL SHUNT/ VENTRICULOPLEURAL SHUNT- REPLACEMENT 24260
CM0296C : SHUNT SURGERIES-SHUNT DYSFUNTION - FAILURE/REVISION OF SHUNT ;LUMBAR PERITONEAL/SYRINGO SUBARACHANOID /CYSTO PERITONEAL - REVISION 23450
CM0296D : SHUNT SURGERIES-SHUNT DYSFUNTION - FAILURE/REVISION OF SHUNT ;LUMBAR PERITONEAL/SYRINGO SUBARACHANOID /CYSTO PERITONEAL - REPLACEMENT 25880
CM0297 : SHUNT SURGERIES - VP SHUNT WITH PROGRAMMABLE SHUNT 33170
CM0298 : TWIST DRILL CRANIOSTOMY 16160
CM0299 : SUBDURAL TAPPING 16160
CM0300 : VENTRICULAR TAPPING 16160
CM0301 : BRAIN ABSCESS & OTHER INFECTIVE LESION - BURR HOLE /TAPPING 16161
CM0302 : CRANIOTOMY / EXCISION OF ABSCESS & OTHER INFECTIVE LESION 22075
CM0303 : C.S.F. RHINORRHOEA & ACF REPAIR 43133
CM0304 : CRANIOPLASTY 32603
CM0305 : EXTERNAL VENTRICULAR DRAINAGE (EVD) 22316
CM0306 : EXCISION OF LOBE (FRONTAL, TEMPORAL, PARIETAL , CEREBELLUM ETC) 45563
CM0307 : PARASAGITAL LESION (INCLUDES VENTRICULAR LESIONS & CYSTS ) 43133
CM0308 : BASAL LESION 48803
CM0309 : BRAIN STEM LESION 59333
CM0310 : C P ANGLE LESION 59333
CM0311 : STEREOTACTIC PROCEDURES- SURGICAL PROCEDURE 40298
CM0312 : STEREOTACTIC PROCEDURES- ABLATION 85658
CM0313 : STEREOTACTIC PROCEDURES- BIOPSY 40298
CM0314 : DE-COMPRESSIVE CRANIECTOMY (NON TRAUMATIC / CVA INFARCT) 47183
CM0315 : INTRA-CEREBRAL HEMATOMA EVACUATION 47183
CM0316 : SUBDURAL HEMORRHAGE/ DECOMPRESSION FOR CONTUSION & ICH 47183
CM0317A : DECOMPRESSION - OPTIC NERVE LESION (INCLUDES PROPTOSIS) 53258
CM0317B : EXCISION - OPTIC NERVE LESION (INCLUDES PROPTOSIS) 52448
CM0317C : DECOMPRESSION - ORBITAL TUMOR (INCLUDES PROPTOSIS) 38516
CM0317D : EXCISION - ORBITAL TUMOR (INCLUDES PROPTOSIS) 38516
CM0318 : TEMPORAL LOBECTOMY 35033
CM0319 : LESIONECTOMY 99023
CM0320 : TEMPORAL LOBECTOMY PLUS DEPTH ELECTRODES 39812
CM0321 : MICROVASCULAR DECOMPRESSION FOR TRIGEMINAL NEURALGIA 43781
CM0322 : MENINGO ENCEPHALOCELE /MENINGO MYELOCELE /MENINGOCELE EXCISION/LIPOMENINGOCELE (AT ANY LEVEL REPAIR) 26366
CM0323 : DERMAL SINUS WITH INTRADURAL EXTENSION/TETHERED CORD /RELEASE OF TIGHT FILUM 25556
CM0324 : ARNOLD CHIARI MALFORMATION - FORAMEN MAGNUM DECOMPRESSION 49856
CM0325 : INTRACRANIAL FOREIGN BODY REMOVAL 47183
CM0326A : DEPRESSED FRACTURE ( WITH HEMATOMA) - EXCISION- TRAUMA /OTHER THAN TRAUMA FOR 3 CM SQ 19400
CM0326B : DEPRESSED FRACTURE ( WITH HEMATOMA) - ELEVATION /SCREW & FIXATION -TRAUMA /OTHER THAN TRAUMA FOR 3 CM SQ 26771
CM0326C : DEPRESSED FRACTURE ( WITH HEMATOMA) - BONE FLAP REMOVAL POST CRANIOPLASTY TRAUMA /OTHER THAN TRAUMA 40541
CM0326D : DEPRESSED FRACTURE ( WITH HEMATOMA) - ELEVATION /SCREW & FIXATION -TRAUMA /OTHER THAN TRAUMA FOR MORE THAN 3 CM SQ 34061
CM0326E : DEPRESSED FRACTURE ( WITHOUT HEMATOMA) - EXCISION- TRAUMA /OTHER THAN TRAUMA 15836
CM0326F : DEPRESSED FRACTURE ( WITHOUT HEMATOMA) - ELEVATION /SCREW & FIXATION -TRAUMA /OTHER THAN TRAUMA FOR 3 CM SQ 23531
CM0326G : DEPRESSED FRACTURE ( WITHOUT HEMATOMA) - BONE FLAP REMOVAL POST CRANIOPLASTY TRAUMA /OTHER THAN TRAUMA 30821
CM0326H : DEPRESSED FRACTURE ( WITHOUT HEMATOMA) - ELEVATION /SCREW & FIXATION -TRAUMA /OTHER THAN TRAUMA MORE THAN FOR 3 CM SQ 30821
CM0327A : BONY LESION OF SKULL (PRIMARY BENIGN /MALIGNANT, SECONDARIES) FOR 3 CM SQ 36831
CM0327B : BONY LESION OF SKULL (PRIMARY BENIGN /MALIGNANT, SECONDARIES) FOR MORE THAN 3 CM SQ 38451
CM0328A : SPONTANEOUS ICH - CRANIOTOMY & EVACUATION 48398
CM0328B : SPONTANEOUS ICH - DECOMPRESSIVE CRANIECTOMY 42728
CM0329A : DEEP BRAIN STIMULATION E-COG with Brain mapping (MRI, FMRI with 3D- Mapping) 75128
CM0329B : DEEP BRAIN STIMULATION with E-COG, Brain mapping, intra-operative neuronavigation techniques & I-O CT/ MRI guided Stereotactic Stimulation 95378
CM0330 : INTRATHECAL PUMP IMPLANT 35033
CM0331 : NEURO ENDOSCOPY PROCEDURES-EXCISION OF INTRAVENTRICULAR LESION 47426
CM0332 : NEURO ENDOSCOPY PROCEDURES-EXCISION OF SUPRATENTORIAL LESION 50261
CM0333 : NEURO ENDOSCOPY PROCEDURES-SPINAL ENDOSCOPY FOR DISCECTOMY 32846
CM0334 : NEURO ENDOSCOPY PROCEDURES-ENDOSCOPIC THIRD VENTRICULOSTOMY 38111
CM0335 : CERVICAL / LUMBAR SYMPATHECTOMY 26285
CM0471 : ECLAMPSIA WITH COMPLICATIONS REQUIRING VENTILATORY SUPPORT 22478
CM0472 : ECLAMPSIA WITH COMPLICATIONS & HELLP SYNDROME 18833
CM0473 : ABRUPTIO-PLACENTA WITH OUT COAGULATION DEFECTS (DIC) 15836
CM0474 : ABRUPTIO-PLACENTA WITH COAGULATION DEFECTS (DIC) 20696
CM0477 : SLINGS WITH MESH REPAIR FOR PROLAPSE 14621
CM0478A : VAULT PROLAPSE ABDOMINAL REPAIR WITHOUT MESH 13001
CM0478B : VAULT PROLAPSE ABDOMINAL REPAIR WITH MESH 13811
CM0480 : LAPAROSCOPIC MYOMECTOMY 17051
CM0481 A : RECANALISATION ANY TYPE- open 11786
CM0481 B : RECANALISATION ANY TYPE- lap 15431
CM0482 : STAGING LAPROTOMY FOR OVARIAN AND UTERINE CA 21870
CM0484 : LAPAROSCOPIC SLING OPERATIONS 19076
CM0485A : PPH SURGICAL MANAGEMENT - HYSTERECTOMY 15431
CM0485B : PPH SURGICAL MANAGEMENT -LIGATION/ EMBOLIZATION 13001
CM0501 : ACUTE BRONCHITIS AND PNEUMONIA WITH RESPIRATORY FAILURE 32400
CM0502 : REQUIRING VENTILATORY SUPPORT -OP POISIONING / METABOLIC COMA/SCORPION STING/ SNAKE BITE / BITES & STINGS - MAX 7 DAYS 25200
CM0506 : CORROSIVE OESOPHAGEAL INJURY 22802
CM0507 : ACUTE PANCREATITIS WITH PSEUDOCYST (INFECTED) 24300
CM0508 : CHRONIC PANCREATITIS WITH SEVERE PAIN I) SEMS- SELF EXPANDABLE METALLIC STENT FOR BILIARY OBSTRUCTION (OBSTRUCTIVE JAUNDICE)- MALIGNANT/BENIGN 56984
CM0509 : CHRONIC PANCREATITIS WITH SEVERE PAIN- II) ENDOSCOPIC PANCREATIC SPINCTEROTOMY AND /OR PANCREATIC DUCT STENTING 13568
CM0510 : CHRONIC PANCREATITIS WITH SEVERE PAIN-PANCREATIC DUCT STENTING- PANCRETIC DUCT LEAKS, PSEUDOCYST OF PANCREAS, PANCREATIC STRICTURE, PANCREATIC STONE DISEASE 13568
CM0511 : NON VARICEAL BLEED- HEATER PROBE (UPPER & LOWER GI BLEED) INCLUDES GAVE, ULCER, RADIATION PROCTITIS/COLITIS, POST POLYPECTOMY BLEED, DIEULAFOYS LESION, ANGIODYSPLASIA,MALLORY WEISS TEAR. 13325
CM0547A : RT. HEPATECTOMY. 51435
CM0547B : NON ANATOMICAL RESECTION OF LIVER 32400
CM0548A : LT. HEPATECTOMY 51435
CM0548B : NON ANATOMICAL RESECTION OF LIVER 32400
CM0549 : SPLENORENAL ANASTOMOSIS 48600
CM0550 : SURGERY FOR BLEEDING ULCERS 32400
CM0551 : I STAGE-SUB TOTAL COLECTOMY + ILEOSTOMY 48600
CM0552 : II STAGE - J-POUCH 28350
CM0553 : III STAGE-ILEOSTOMY CLOSURE 17820
CM0554 A : HEPATICO JEJUNOSTOMY - BILIARY STRICTURE 60750
CM0554 B : HEPATICO JEJUNOSTOMY - INJURY / EXTERNAL BILIARY FISTULA MANAGEMENT 36450
CM0555A : BILIARY PANCREATITIS - CBD CALCULI - OTHER STENTS 17820
CM0555B : BILIARY PANCREATITIS - CBD CALCULI - SEMS 28350
CM0556 : REPAIR SURGERY FOR INJURIES DUE TO FB 40500
CM0557A : SURGICAL REMOVAL OF FOREIGN BODY FROM GIT (INVASIVE) 40500
CM0557B : SURGICAL REMOVAL OF FOREIGN BODY FROM GIT (NON INVASIVE ) 16200
CM0558 : GASTRO STUDY FOLLOWED BY THORACOTOMY & SURGICAL MANAGEMENT FOR OESOPHAGEAL INJURY FOR CORROSIVE INJURIES/FB 44955
CM0559 : HAEMANGIOMA SOL LIVER HEPATECTOMY + WEDGE RESECTION 32400
CM0560 : LIENORENAL SHUNT 48600
CM0563A : ANAL SPHINCTER RECONSTRUCTION 28350
CM0563B : LEVATOROPLASTY 32400
CM0564 : GRACILOPLASTY 32400
CM0565 : BILIARY PERITONITIS -EMERGENCY LAPAROTOMY 32400
CM0566 : SPLEEN SPARING DEVASCULARISATION 32400
CM0567 : LIVER SEGMENTECTOMY 36450
CM0568 : PORTOCAVAL ANASTOMOSIS 64800
CM0569 : DEVASCULARISATION WITH OESOPHAGEAL TRANSECTION 64800
CM0570 : WARREN SHUNT 48600
CM0571 : PANCREAS DIVISUM 24300
CM0573 A : CYSTOLITHOTRIPSY 11340
CM0573 B : CYSTOLITHOTRIPSY - LASER LITHOTRIPSY 13770
CM0573 C : RETROGRADE INTRARENAL SURGERY 22680
CM0574 : PERCUTANEOUS NEPHROLITHOTOMY 25110
CM0575 : EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY 16200
CM0576 : URETERO RENOSCOPIC LITHOTRIPSY 17820
CM0577 : SINGLE STAGE URETHROPLASTY FOR STRICTURE URETHRA 37260
CM0578 : BUCCAL MUCOSAL GRAFT- URETHROPLASTY 28350
CM0579 A : DOUBLE STAGE URETHROPLASTY FOR STRICTURE URETHRA - STAGE I 20250
CM0579 B : DOUBLE STAGE URETHROPLASTY FOR STRICTURE URETHRA - STAGE II 28350
CM0580 : DOUBLE STAGE URETHROPLASTY FOR STRICTURE URETHRA - RECONSTRUCTION PROCEDURE 28350
CM0581 : ANATROPHIC PEYLOLITHOTOMY FOR STAGHORN CALCULUS 36450
CM0582 A : RENAL CYST EXCISION - LAP 20250
CM0582 B : RENAL CYST EXCISION - OPEN 20250
CM0583 A : NEPHRECTOMY PYONEPHROSIS/XANTHO GRANULOMATOUS PYELONEPHRITIS - LAP 32400
CM0583 B : NEPHRECTOMY PYONEPHROSIS/XANTHO GRANULOMATOUS PYELONEPHRITIS - OPEN 32400
CM0584 : ENDOSCOPE REMOVAL OF STONE IN BLADDER 11340
CM0585 : URETERIC INJURY REPAIR 24300
CM0586 : BLADDER INJURY REPAIR 24300
CM0587 : URETERIC REIMPLANTATION 32400
CM0588 : VESICO VAGINAL FISTULA 24300
CM0589 : CLOSURE OF URETHRAL FISTULA 17820
CM0590 : OPTICAL URETHROTOMY 20250
CM0591 : PERINEAL URETHROSTOMY 16200
CM0592 : ANDERSON HYNES PYELOPLASTY 28350
CM0593 A : CAECO CYSTOPLASTY / AUGMENTATION - CYSTOPLASTY 25920
CM0593 B : BLADDER NECK INCISION (BNI) 16200
CM0594 : SUPRA PUBLIC CYSTOSTOMY 6480
CM0595 : DIVERTICULECTOMY /PERSISTENT URACHUS 16200
CM0596 : URACHAL SINUS/TUMOR / EXCISION 16200
CM0597 : INCONTINENCE URINE- (MALE)/ (FEMALE-INCLUDING CYSTOSCOPY OTIS URETHROTOMY) 12150
CM0598 : TRANSURETHRAL RESECTION OF PROSTATE (TURP) 21870
CM0599 : TURP WITH CYSTOLITHOTRIPSY 22680
CM0600 : CHORDEE CORECTION 12150
CM0620-I : EXCISION OF TUMOR IN NASOPHARYNX( MALIGNANT) 16929
CM0624-I : WERTHEIMS / RADICAL HYSTERECTOMY 23126
CM0624-II : WERTHEIMS / RADICAL HYSTERECTOMY 23126
CM0625-I : AMPUTATIONS - FORE QUARTER / HIND QUARTER WITH OR WITHOUT HEMIPELVECTOMY 32400
CM0625-II : AMPUTATIONS - FORE QUARTER / HIND QUARTER WITH OR WITHOUT HEMIPELVECTOMY 32400
CM0626 A : DENGUE SHOCK SYNDROME -(ADULT/PAEDIATRICS) 17820
CM0626 B : DENGUE HEMORRHAGIC FEVER -(ADULT/PAEDIATRICS) 14580
CM0628-I : NEPHROSTOMY 6480
CM0628-II : NEPHROSTOMY 6480
CM0629-I : OBSCURE/ NON VARICEAL BLEED- CLIPPING / ARGON PLASMA COAGULATION/ INJECTION/CONSERVATIVE 37382
CM0629-II : OBSCURE/ NON VARICEAL BLEED- CLIPPING / ARGON PLASMA COAGULATION/ INJECTION/CONSERVATIVE 37382
CM0630 A-II : MIXED CONNECTIVE TISSUE DISEASE-(METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE/ PULSE CYCLOPHOSPHAMIDE THERAPY 12960
CM0631A-II : VASCULITIS (PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE/ PULSE CYCLOPHOSPHAMIDE THERAPY ) 9720
CM0631B-II : VASCULITIS (PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE/ PULSE CYCLOPHOSPHAMIDE THERAPY / INTERNAL ORGAN INVOLVEMENT REQUIRING INTRAVENOUS IMMUNOGLOBULIN/ MYCOPHENOLATE MOFETIL INDUCTION/MYCOPHENOLATE MOFETIL MAINTENANCE/ PNEUMOCOCCAL VACCINATION) 162000
CM0632-I : FULL THICKNESS BUCCAL MUCOSAL RESECTION & RECONSTRUCTION 33899
CM0633-I : ORBITAL EXENTERATION/ EVISCERATION WITH IMPLANT 19157
CM0634 A-I : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 1ST TO 6 TH MONTH AFTER TRANSPLANTATION ( LIVER) - Covered Primary package alloted under Corpus fund 0
CM0634 B : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 7 TH TO 12 TH MONTH AFTER TRANSPLANTATION ( LIVER) - Covered Primary package alloted under Corpus fund 0
CM0634 C : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 1ST TO 6 TH MONTH AFTER TRANSPLANTATION ( HEART & LUNG) - Covered Primary package alloted under Corpus fund 0
CM0634 D : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 7 TH TO 12 TH MONTH AFTER TRANSPLANTATION ( HEART & LUNG) Covered Primary package alloted under Corpus fund 0
CM0634 E : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 1ST TO 6 TH MONTH AFTER TRANSPLANTATION ( LUNG) Covered Primary package alloted under Corpus fund 0
CM0634 F : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 7 TH TO 12 TH MONTH AFTER TRANSPLANTATION ( LUNG) Covered Primary package alloted under Corpus fund 0
CM0634 G : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 1ST TO 6 TH MONTH AFTER TRANSPLANTATION ( COCHLEAR) Covered Primary package alloted under Corpus fund 0
CM0634 H : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 7 TH TO 12 TH MONTH AFTER TRANSPLANTATION ( COCHLEAR) Covered Primary package alloted under Corpus fund 0
CM0634 I : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 1ST TO 6 TH MONTH AFTER TRANSPLANTATION ( AUDITORY BRAINSTEM IMPLANTATION) Covered Primary package alloted under Corpus fund 0
CM0634 J : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 7 TH TO 12 TH MONTH AFTER TRANSPLANTATION ( AUDITORY BRAINSTEM IMPLANTATION) Covered Primary package alloted under Corpus fund 0
CM0634 M : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 1ST TO 6 TH MONTH AFTER TRANSPLANTATION ( ALLOGENIC BONE MARROW / STEM CELL TRANSPLANTATION) - Covered Primary package alloted under Corpus fund 0
CM0634 N : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 7 TH TO 12 TH MONTH AFTER TRANSPLANTATION ( ALLOGENIC BONE MARROW / STEM CELL TRANSPLANTATION) - Covered Primary package alloted under Corpus fund 0
CM0634 O : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 1ST TO 6 TH MONTH AFTER TRANSPLANTATION ( AUTOLOGOUS BONE MARROW / STEM CELL TRANSPLANTATION) - Covered Primary package alloted under Corpus fund 0
CM0634 P : POST-TRANSPLANT IMMUNOSUPPRESSIVE TREATMENT FROM 7 TH TO 12 TH MONTH AFTER TRANSPLANTATION ( AUTOLOGOUS BONE MARROW / STEM CELL TRANSPLANTATION) - Covered Primary package alloted under Corpus fund 0
CM0635-I : OPEN PROSTATECTOMY 24300
CM0635-II : OPEN PROSTATECTOMY 24300
CM0636-I : RADICAL PROSTATECTOMY 40500
CM0636-II : RADICAL PROSTATECTOMY 40500
CM0640 : USG GUIDED MAJOR PROCEDURES ( EG. LIVER ABSCESS,POST OP COLLECTIONS)DRAINAGE PIGTAIL INSERTION 7695
CM0641A-I : USG GUIDED MAJOR PROCEDURES (RF ABLATION Solid organs) 23490
CM0641B-I : USG GUIDED MAJOR PROCEDURES (RF ABLATION other organs ) 20250
CM0641C-I : USG GUIDED MAJOR PROCEDURES (ETHANOL ABLATION Solid organs) 17415
CM0641D-I : USG GUIDED MAJOR PROCEDURES (ETHANOL ABLATION other organs) 31590
CM0642 : USG GUIDED MINOR PROCEDURES (FNAC, BIPOSY, SINOGRAPHY,TAPPING) 0
CM0642A-I : USG GUIDED MINOR PROCEDURES (FNAC & BIPOSY) 1215
CM0642B-I : USG GUIDED MINOR PROCEDURES (SINOGRAPHY) 1620
CM0642C-I : USG GUIDED MINOR PROCEDURES (TAPPING) 1215
CM0645-III : GASTROINTESTINAL VISCERAL ARTERIAL EMBOLIZATION IN UPPER AND LOWER GASTROINTESTINAL BLEEDING WITH MICROCATHETER 61763
CM0649-III : PREOPERATIVE PORTAL VEIN EMBOLIZATION FOR LIVER TUMORS 56903
CM0651-II : EMBOLIZATION OF AV MALFORMATION OF BRAIN PER SITTING WITH ONYX 61763
CM0652-III : EMBOLIZATION OF CARATICO-CAVERNOUS FISTULA 75128
CM0654-III : BRAIN AVM EMBOLIZATION 79178
CM0655-III : TUMOR EMBOLIZATION 67838
CM0661-A-II : SPINAL AVM EMBOLIZATION 39488
CM0661-A-III : SPINAL AVM EMBOLIZATION 39488
CM0661-B-II : SPINAL AVM EMBOLIZATION 47588
CM0661-B-III : SPINAL AVM EMBOLIZATION 47588
CM0662-II : SPINAL DURAL FISTULA EMBOLIZATION 50018
CM0662-III : SPINAL DURAL FISTULA EMBOLIZATION 50018
CM0663 : BALLOON RETERO GRADE VARICEAL EMBOLIZATION 45968
CM0664-II : LIVER HEMANGIOMA EMBOLIZATION 65408
CM0665-II : VEIN OF GALEN EMBOLIZATION 53663
CM0666-II : DURAL FISTULA EMBOLIZATION 65813
CM0677-II : INTRACRANIAL VENOUS STENTING 99833
CM0678-II : INTRACRANIAL ARTERIAL STENTING 99833
CM0688-II : DURAL SINUS ANGIOPLASTY AND STENTING 53258
CM0689-I : HEPATIC VEIN ANGIOPLASTY AND STENTING 42728
CM0694-I : BILIARY DRAINAGE PROCEDURES/ERCP - EXTERNAL DRAINAGE AND STENT PLACEMENT - METALLIC BILIARY STENT / POST OP BILIARY STRICTURE/LEAK/CHOLANGITIS/BILIARY PANCREATITIS/CHOLEDOCHAL CYST/BILE DUCT STONES 75695
CM0694-II : BILIARY DRAINAGE PROCEDURES/ERCP - EXTERNAL DRAINAGE AND STENT PLACEMENT - METALLIC BILIARY STENT / POST OP BILIARY STRICTURE/LEAK/CHOLANGITIS/BILIARY PANCREATITIS/CHOLEDOCHAL CYST/BILE DUCT STONES 75695
CM0704 : RECONSTRUCTIVE MICRO SURGERY - REPLANTATION OF HAND, FINGER, THUMB, ARM, SCALP ETC 41148
CM0705 : RECONSTRUCTIVE MICRO SURGERY -FREE TISSUE TRANSFER 54999
CM0706-I : EXCISION OF LINGUAL THYROID 16646
CM0707-I : ACUTE PANCREATITIS - CONSERVATIVE MANAGEMENT / MILD / MODERATE / SEVERE MEDICAL / IMAGE GUIDED DRAINAGE OF PANCREATIC COLLECTIONS 45320
CM0707-II : ACUTE PANCREATITIS - CONSERVATIVE MANAGEMENT / MILD / MODERATE / SEVERE MEDICAL / IMAGE GUIDED DRAINAGE OF PANCREATIC COLLECTIONS 45320
CM0709 A-I : LAP NEPHRECTOMY SIMPLE/HEMI/PARTIAL. 36450
CM0709 A-II : LAP NEPHRECTOMY SIMPLE/HEMI/PARTIAL. 36450
CM0709 A-III : LAP NEPHRECTOMY SIMPLE/HEMI/PARTIAL. 36450
CM0709 B-I : LAP NEPHRECTOMY-RADICAL 36450
CM0709 B-II : LAP NEPHRECTOMY-RADICAL 36450
CM0709 B-III : LAP NEPHRECTOMY-RADICAL 36450
CM0710 A-I : NEPHROURETERECTOMY OPEN 32400
CM0710 A-II : NEPHROURETERECTOMY OPEN 32400
CM0710 B-I : NEPHROURETERECTOMY LAP 32400
CM0710 B-II : NEPHROURETERECTOMY LAP 32400
CM0713-I : TRACHEOSTOMY 4091
CM0714-I : THOROCOSTOMY 35154
CM0715 : CLEFT LIP 13041
CM0716 : CLEFT PALATE 16281
CM0717 : SYNDACTYLY OF HAND FOR EACH HAND 21546
CM0718A : MICROTIA/ANOTIA - STAGE 1 20574
CM0718B : MICROTIA/ANOTIA - STAGE 2 14256
CM0719 : TM JOINT ANKYLOSIS 32400
CM0720 : RECONSTRUCTIVE MICRO SURGERY -BRACHIAL PLEXUS SURGERY 20250
CM0721 : RECONSTRUCTIVE BREAST SURGERY FOLLOWING CANCER EXCISION, REDUCTION, AUGMENTATION 32724
CM0722-II : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA 16241
CM0722-III : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA 16241
CM0723-I : HEAD & NECK CANCER COMPOSITE RESECTION 30254
CM0724-I : HEAD & NECK CANCER COMPOSITE RESECTION WITH RECONSTRUCTION 37949
CM0725-I : SKIN TUMOR/SOFT TISSUE/BONE TUMORS - EXCISION / AMPUTATION/RESECTION WITH RECONSTRUCTION 19967
CM0725-II : SKIN TUMOR/SOFT TISSUE/BONE TUMORS - EXCISION / AMPUTATION/RESECTION WITH RECONSTRUCTION 19967
CM0725-III : SKIN TUMOR/SOFT TISSUE/BONE TUMORS - EXCISION / AMPUTATION/RESECTION WITH RECONSTRUCTION 19967
CM0725-IV : SKIN TUMOR/SOFT TISSUE/BONE TUMORS - EXCISION / AMPUTATION/RESECTION WITH RECONSTRUCTION 19967
CM0729-II : DIAPHRAGMATIC HERNIA 32400
CM0730 A-I : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L OPEN 32400
CM0730 A-II : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L OPEN 32400
CM0730 A-III : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L OPEN 32400
CM0730 B-I : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L LAP 32400
CM0730 B-II : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L LAP 32400
CM0730 B-III : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - U/L LAP 32400
CM0730 C-I : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L OPEN 44550
CM0730 C-II : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L OPEN 44550
CM0730 C-III : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L OPEN 44550
CM0730 D-I : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L LAP 44550
CM0730 D-II : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L LAP 44550
CM0730 D-III : URETERIC REIMPLANTATIONS/MEGA URETER OBSTRUCTIVE /REFLUXING - B/L LAP 44550
CM0731-I : HYPOSPADIAS 24300
CM0731-II : HYPOSPADIAS 24300
CM0732-I : EPISPADIAS 34020
CM0732-II : EPISPADIAS 34020
CM0733-I : TORSION TESTIS 20250
CM0733-II : TORSION TESTIS 20250
CM0734-I : URETEROCELE SURGERY 24300
CM0734-II : URETEROCELE SURGERY 24300
CM0735 A-I : OPEN CHOLECYSTECTOMY- RADICAL WITH OR WITHOUT CBD EXPLORATION 40500
CM0735 A-II : OPEN CHOLECYSTECTOMY- RADICAL WITH OR WITHOUT CBD EXPLORATION 40500
CM0735 B-I : OPEN CHOLECYSTECTOMY- ANY TYPE/ CBD EXPLORATION 17820
CM0735 B-II : OPEN CHOLECYSTECTOMY- ANY TYPE/ CBD EXPLORATION 17820
CM0736 A-I : LAP CHOLECYSTECTOMY- RADICAL WITH /WITHOUT CBD EXPLORATION 40500
CM0736 A-II : LAP CHOLECYSTECTOMY- RADICAL WITH /WITHOUT CBD EXPLORATION 40500
CM0736 B-I : LAP CHOLECYSTECTOMY- ANY TYPE/ CBD EXPLORATION 17820
CM0736 B-II : LAP CHOLECYSTECTOMY- ANY TYPE/ CBD EXPLORATION 17820
CM0737-I : LAP CHOLECYSTOSTOMY WITH /WITHOUT EXPLORATION CBD 17820
CM0737-II : LAP CHOLECYSTOSTOMY WITH /WITHOUT EXPLORATION CBD 17820
CM0738-I : OPEN CHOLECYSTOSTOMY 16200
CM0738-II : OPEN CHOLECYSTOSTOMY 16200
CM0739-I : GASTRECTOMY ANY TYPE - ANY CAUSE 32279
CM0739-II : GASTRECTOMY ANY TYPE - ANY CAUSE 32279
CM0739-III : GASTRECTOMY ANY TYPE - ANY CAUSE 32279
CM0740-I : GASTRECTOMY ANY TYPE - ANY CAUSE WITH LYMPHADENECTOMY 39569
CM0740-II : GASTRECTOMY ANY TYPE - ANY CAUSE WITH LYMPHADENECTOMY 39569
CM0740-III : GASTRECTOMY ANY TYPE - ANY CAUSE WITH LYMPHADENECTOMY 39569
CM0741-A : PENECTOMY- PARTIAL WITHOUT PERINEAL URETHEROSTOMY -CA 12636
CM0741-B : PENECTOMY- Total WITHOUT PERINEAL URETHEROSTOMY -CA 19724
CM0742A : PENECTOMY- PARTIAL WITH PERINEAL URETHEROSTOMY -CA 23936
CM0742B : PENECTOMY- TOTAL WITH PERINEAL URETHEROSTOMY -CA 32279
CM0743-I : ANTERIOR RESECTION 41189
CM0743-II : ANTERIOR RESECTION 41189
CM0743-III : ANTERIOR RESECTION 41189
CM0744-A-I : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH 19886
CM0744-A-II : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH 19886
CM0744-A-III : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH 19886
CM0744-B-I : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH /ILEOSTOMY 39731
CM0744-B-II : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH /ILEOSTOMY 39731
CM0744-B-III : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH /ILEOSTOMY 39731
CM0744-C-I : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH/ WITH STAPLED ANASTOMOSIS 60386
CM0744-C-II : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH/ WITH STAPLED ANASTOMOSIS 60386
CM0744-C-III : SEGMENTAL RESECTION/WEDGE RESECTION OF STOMACH/ WITH STAPLED ANASTOMOSIS 60386
CM0745-I : ABDOMINOPERINIAL RESECTION 31874
CM0745-II : ABDOMINOPERINIAL RESECTION 31874
CM0745-III : ABDOMINOPERINIAL RESECTION 31874
CM0746A-I : SPLENECTOMY WITHOUT DEVASCULARISATION -TRAUMATIC 28350
CM0746A-II : SPLENECTOMY WITHOUT DEVASCULARISATION -TRAUMATIC 28350
CM0749A-I : NECK DISSECTION ANY TYPE - WITH WIDE EXCISION (INCLUDING MALIGNANCY) 24584
CM0749A-II : NECK DISSECTION ANY TYPE - WITH WIDE EXCISION (INCLUDING MALIGNANCY) 24584
CM0749B-I : NECK DISSECTION ANY TYPE - WITHOUT WIDE EXCISION (INCLUDING MALIGNANCY) 16484
CM0749B-II : NECK DISSECTION ANY TYPE - WITHOUT WIDE EXCISION (INCLUDING MALIGNANCY) 16484
CM0750-A-I : NECK DISSECTION ANY TYPE - WITHOUT RECONSTRUCTION (INCLUDING MALIGNANCY) 20939
CM0750-A-II : NECK DISSECTION ANY TYPE - WITHOUT RECONSTRUCTION (INCLUDING MALIGNANCY) 20939
CM0750-B-I : NECK DISSECTION ANY TYPE - WITH RECONSTRUCTION (INCLUDING MALIGNANCY) 28229
CM0750-B-II : NECK DISSECTION ANY TYPE - WITH RECONSTRUCTION (INCLUDING MALIGNANCY) 28229
CM0751-I : HEMIMANDIBULECTOMY 20372
CM0751-IV : HEMIMANDIBULECTOMY 20372
CM0752-I : MARGINAL MANDIBULECTOMY 18185
CM0752-IV : MARGINAL MANDIBULECTOMY 18185
CM0753-I : SEGMENTAL MANDIBULECTOMY 18185
CM0753-IV : SEGMENTAL MANDIBULECTOMY 18185
CM0754 : LEIOMYOMA EXCISION 9720
CM0755 : MULTI ORGAN RESECTION FOR ANY GI CANCERS 54473
CM0756 : SURGERIES FOR ENTERO CUTANEOUS FISTULA 32400
CM0757 : INCISIONAL HERNIA REPAIR WITHOUT MESH 16200
CM0758 : INCISIONAL HERNIA REPAIR WITH MESH 20250
CM0759A-i : CRANIOSYNOSTOSIS - STRIP CRANIECTOMY 16200
CM0759A-ii : CRANIOSYNOSTOSIS - ORBITO FACIAL ADVANCEMENT 12150
CM0759A-iii : CRANIOSYNOSTOSIS - PLASTIC SURGICAL CORRECTION 12150
CM0759B-i : CRANIOSYNOSTOSIS - STRIP CRANIECTOMY 16200
CM0759B-ii : CRANIOSYNOSTOSIS - ORBITO FACIAL ADVANCEMENT 12150
CM0759B-iii : CRANIOSYNOSTOSIS - PLASTIC SURGICAL CORRECTION 12150
CM0760-I : LIVER ABSCESS - OPEN DRAINAGE 14580
CM0760-II : LIVER ABSCESS - OPEN DRAINAGE 14580
CM0761 : BRAIN - ANY BIOPSY 40476
CM0762 : SPINAL VASCULAR MALFORMATION (CONVENTIONAL/INTERVENTIONAL) 36086
CM0763A-I : RECTAL PROLAPSE - THEIRSCH WIRING 12150
CM0763A-II : RECTAL PROLAPSE - THEIRSCH WIRING 12150
CM0763B-I : RECTAL PROLAPSE - DEBULKING 21060
CM0763B-II : RECTAL PROLAPSE - DEBULKING 21060
CM0763C-I : RECTAL PROLAPSE - LAPAROSCOPIC RECTOPEXY 21060
CM0763C-II : RECTAL PROLAPSE - LAPAROSCOPIC RECTOPEXY 21060
CM0764B : SPLENECTOMY WITH DEVASCULARISATION -TRAUMATIC 30780
CM0764 : GLOSSECTOMY (TOTAL/HEMI/PARTIAL) FOR CANCER 15795
CM0765 : GLOSSECTOMY (TOTAL/HEMI/PARTIAL) WITH RECONSTRUCTION- FOR CANCER 32279
CM0766 : MAXILLECTOMY ANY TYPE -FOR CA 20250
CM0767 : PAROTIDECTOMY ANY TYPE- FOR CA 15795
CM0768 : LARYNGECTOMY ANY TYPE -FOR CA 29363
CM0769-I : LARYNGO PHARYNGO OESOPHAGECTOMY 59940
CM0770 A-I : TOTAL COLECTOMY - OPEN/ LAPROSCOPIC -ANY CAUSE 34020
CM0770 A-II : TOTAL COLECTOMY - OPEN/ LAPROSCOPIC -ANY CAUSE 34020
CM0770 A-III : TOTAL COLECTOMY - OPEN/ LAPROSCOPIC -ANY CAUSE 34020
CM0770 B-I : SUB TOTAL COLECTOMY - OPEN/ LAPROSCOPIC -ANY CAUSE 26730
CM0770 B-II : SUB TOTAL COLECTOMY - OPEN/ LAPROSCOPIC -ANY CAUSE 26730
CM0770 B-III : SUB TOTAL COLECTOMY - OPEN/ LAPROSCOPIC -ANY CAUSE 26730
CM0771-I : WHIPPLES ANY TYPE 66825
CM0771-II : WHIPPLES ANY TYPE 66825
CM0771-III : WHIPPLES ANY TYPE 66825
CM0772A-I : OPEN CYSTECTOMY(/PARTIAL/ COMPLETE) WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 28350
CM0772A-II : OPEN CYSTECTOMY(/PARTIAL/ COMPLETE) WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 28350
CM0772A-III : OPEN CYSTECTOMY(/PARTIAL/ COMPLETE) WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 28350
CM0772B-I : OPEN CYSTECTOMY(RADICAL )WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 36450
CM0772B-II : OPEN CYSTECTOMY(RADICAL )WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 36450
CM0772B-III : OPEN CYSTECTOMY(RADICAL )WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 36450
CM0773 A-I : LAPAROSCOPIC CYSTECTOMY [PARTIAL / COMPLETE] WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 28350
CM0773 A-II : LAPAROSCOPIC CYSTECTOMY [PARTIAL / COMPLETE] WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 28350
CM0773 B-I : LAPAROSCOPIC CYSTECTOMY [RADICAL ]WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 36450
CM0773 B-II : LAPAROSCOPIC CYSTECTOMY [RADICAL ]WITH OR WITHOUT DRAINAGE PROCEDURES - ANY CAUSE 36450
CM0774 : LAPROSCOPIC ASSISTED VAGINAL HYSTERECTOMY 16241
CM0775-I : SALPINGO OOPHORECTOMY U/L OR B/L- FOR CA 20534
CM0775-II : SALPINGO OOPHORECTOMY U/L OR B/L- FOR CA 20534
CM0776-I : MASTECTOMY ANY TYPE 16200
CM0776-II : MASTECTOMY ANY TYPE 16200
CM0777-I : MASTECTOMY ANY TYPE WITH AXILLARY DISSECTION / SENTINAL NODE EXPLORATION 0
CM0777-II : MASTECTOMY ANY TYPE WITH AXILLARY DISSECTION / SENTINAL NODE EXPLORATION 0
CM0777-A-I : MASTECTOMY ANY TYPE WITH AXILLARY DISSECTION 20250
CM0777-A-II : MASTECTOMY ANY TYPE WITH AXILLARY DISSECTION 20250
CM0777-B-I : MASTECTOMY ANY TYPE WITH SENTINAL NODE EXPLORATION 20250
CM0777-B-II : MASTECTOMY ANY TYPE WITH SENTINAL NODE EXPLORATION 20250
CM0778-I : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST (BENIGN /MALIGNANT) 0
CM0778-II : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST (BENIGN /MALIGNANT) 0
CM0778-A-I : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST -BENIGN 3969
CM0778-A-II : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST -BENIGN 3969
CM0778-B-I : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST (MALIGNANT) 5265
CM0778-B-II : WIDE EXICISION/ LUMPECTOMY - TUMORS OF BREAST (MALIGNANT) 5265
CM0785-I : METASTATECTOMY SOLITARY OR MULTIPLE - ANY CAUSE 30254
CM0785-II : METASTATECTOMY SOLITARY OR MULTIPLE - ANY CAUSE 30254
CM0786-A-I : OPERATIONS OF ADRENAL GLAND - U/L( ANY CAUSE) 20210
CM0786-A-II : OPERATIONS OF ADRENAL GLAND - U/L( ANY CAUSE) 20210
CM0786-B-I : OPERATIONS OF ADRENAL GLAND - B/L ( ANY CAUSE) 36572
CM0786-B-II : OPERATIONS OF ADRENAL GLAND - B/L ( ANY CAUSE) 36572
CM0787 : TEMPORAL BONE - EXCISION / RESECTION - ANY TYPE 28350
CM0789-I : STERNOTOMY + MEDIASTINAL DISSECTION - CA / SOL 33656
CM0795-I : PARATHYROIDECTOMY - ANY TYPE 20250
CM0796-I : RESECTION AND ANASTOMOSIS /SEGMENTAL RESECTION - SMALL INTESTINE- ANY CAUSE 32400
CM0796-II : RESECTION AND ANASTOMOSIS /SEGMENTAL RESECTION - SMALL INTESTINE- ANY CAUSE 32400
CM0796-III : RESECTION AND ANASTOMOSIS /SEGMENTAL RESECTION - SMALL INTESTINE- ANY CAUSE 32400
CM0797-I : RESECTION AND ANASTOMOSIS /SEGMENTAL RESECTION - LARGE INTESTINE- ANY CAUSE 36450
CM0797-II : RESECTION AND ANASTOMOSIS /SEGMENTAL RESECTION - LARGE INTESTINE- ANY CAUSE 36450
CM0797-III : RESECTION AND ANASTOMOSIS /SEGMENTAL RESECTION - LARGE INTESTINE- ANY CAUSE 36450
CM0798-I : GASTROSTOMY/FEEDING GASTROSTOMY/PERCUTANEOUS ENDOSCOPIC GASTROSTOMY 16200
CM0798-II : GASTROSTOMY/FEEDING GASTROSTOMY/PERCUTANEOUS ENDOSCOPIC GASTROSTOMY 16200
CM0798-III : GASTROSTOMY/FEEDING GASTROSTOMY/PERCUTANEOUS ENDOSCOPIC GASTROSTOMY 16200
CM0799-I : OESOPHAGOSTOMY 20250
CM0799-II : OESOPHAGOSTOMY 20250
CM0800-I : JEJUNOSTOMY / FEEDING JEJUNOSTOMY 16200
CM0800-II : JEJUNOSTOMY / FEEDING JEJUNOSTOMY 16200
CM0801-I : GASTROJEJUNOSTOMY 20250
CM0801-II : GASTROJEJUNOSTOMY 20250
CM0802-I : ILEOSTOMY 16200
CM0802-II : ILEOSTOMY 16200
CM0803 A-I : ILEOTRANSVERSE COLOSTOMY 20250
CM0803 A-II : ILEOTRANSVERSE COLOSTOMY 20250
CM0803 A-III : ILEOTRANSVERSE COLOSTOMY 20250
CM0803 B-I : COLOSTOMY 16200
CM0803 B-II : COLOSTOMY 16200
CM0803 B-III : COLOSTOMY 16200
CM0804-I : HARTMANNS PROCEDURE WITH COLOSTOMY- ANY CAUSE 36450
CM0804-II : HARTMANNS PROCEDURE WITH COLOSTOMY- ANY CAUSE 36450
CM0805-I : CLOSURE OF GASTROSTOMY/ILEOSTOMY/COLOSTOMY / JEJUNOSTOMY / GASTROJEJUNOSTOMY / ILEOTRANSVERSE COLOSTOMY / OESOPHAGOSTOMY 16200
CM0805-II : CLOSURE OF GASTROSTOMY/ILEOSTOMY/COLOSTOMY / JEJUNOSTOMY / GASTROJEJUNOSTOMY / ILEOTRANSVERSE COLOSTOMY / OESOPHAGOSTOMY 16200
CM0805-III : CLOSURE OF GASTROSTOMY/ILEOSTOMY/COLOSTOMY / JEJUNOSTOMY / GASTROJEJUNOSTOMY / ILEOTRANSVERSE COLOSTOMY / OESOPHAGOSTOMY 16200
CM0806-I : RESECTION OF RETRO PERITONEAL TUMORS 36086
CM0806-II : RESECTION OF RETRO PERITONEAL TUMORS 36086
CM0807 : BONE RESECTION / CURRETTAGE/ CEMENTING- ANY CAUSE 24300
CM0808A : URINARY DIVERSION PROCEDURES ( INCLUDING PERCUTANEOUS / ANTEGRADE/RETROGRADE URETERIC STENTING ) 24300
CM0808B : URINARY DIVERSION PROCEDURES ( NEPHROSTOMY) 6480
CM0809 : SUPRA PUBIC CYSTOSTOMY 6480
CM0810-II : INTERCOSTAL DRAINAGE 3321
CM0811 : CRYOTHERAPY FOR ALL LESIONS 18428
CM0812A-i : NERVE RECONSTRUCTION ( WITH NERVE GRAFT ) 28350
CM0812A-ii : NERVE REPAIR NEUROLYSIS 16200
CM0812A-iii : NERVE REPAIR NERVE SUTURING 16200
CM0812B-i : PERIPHERAL NERVE REPAIR 16200
CM0812B-ii : PERIPHERAL NERVE RECONSTRUCTION ( WITH NERVE GRAFT ) 28350
CM0812B-iii : TENDON REPAIR 8100
CM0812B-iv : TENDON RECONSTRUCTION ( WITH TENDON GRAFT) 16200
CM0812B-v : VASCULAR REPAIR (utilise vascular repair package) 0
CM0812B-vi : VASCULAR RECONSTRUCTION (utilise vascular reconstruction package) 0
CM0813 : VAGINAL ATRESIA - (INCLUDING MC INDO-S REPAIR / PLASTIC SURGICAL REPAIR) 23693
CM0814-II : VASCULAR MALFORMATIONS- (INCLUDING SCLEROTHERAPY/ REDUCTION SURGERY) 21263
CM0815A : RECONSTRUCTIVE UPPER LIMB /HAND/LOWER LIMB/FOOT SURGERY FOLLOWING INFECTION, TRAUMA, BURNS, TUMORS/ MALIGNANCY, DEVELOPMENTAL INCLUDING DIABETIC FOOT - MILD 21101
CM0815B : RECONSTRUCTIVE UPPER LIMB /HAND/LOWER LIMB/FOOT SURGERY FOLLOWING INFECTION, TRAUMA, BURNS, TUMORS/ MALIGNANCY, DEVELOPMENTAL INCLUDING DIABETIC FOOT - MODERATE 27986
CM0815C : RECONSTRUCTIVE UPPER LIMB /HAND/LOWER LIMB/FOOT SURGERY FOLLOWING INFECTION, TRAUMA, BURNS, TUMORS/ MALIGNANCY, DEVELOPMENTAL INCLUDING DIABETIC FOOT - SEVERE 31226
CM0816A : FLAP SURGERIES CUTANEOUS- FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT 20250
CM0816B : MYOCUTANEOUS - FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT 28755
CM0816C : OSTEOCUTANEOUS - FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT 36855
CM0816D : MICROSURGICAL FREE FLAP SPLIT THICKNESS GRAFT - FOR UPPER LIMB/HAND/LOWER LIMB/FOOT /AFTER FRACTURE FIXATION / ELETRICAL BURNS WITH OR WITHOUT VITALS EXPOSED/ ULCER/FOLLOWING TRAUMA/BURNS/ INFECTION/MALIGNANCY /DEVELOPMENTAL INCLUDING DIABETIC FOOT 54999
CM0817 : POST BURN HYPERTROPHY SURGERY/SCAR REVISION SURGERY 20169
CM0818 : RECONSTRUCTION USING TISSUE EXPANDER (POST TRAUMATIC/POST BURNS) REQUIRES MULTIPLE SITTINGS 45279
CM0819 : FLAP SURGERIES WITH BONE GRAFTING 21060
CM0820-I : AMPUTATION OF ANY SITE / ANY CAUSE WITHOUT PROSTHESIS (except fingers, toes and small joints) 20250
CM0820-II : AMPUTATION OF ANY SITE / ANY CAUSE WITHOUT PROSTHESIS (except fingers, toes and small joints) 20250
CM0820-III : AMPUTATION OF ANY SITE / ANY CAUSE WITHOUT PROSTHESIS (fingers, toes and small joints) 8100
CM0821-I : AMPUTATION OF ANY SITE / ANY CAUSE WITH CUSTOM MADE PROSTHESIS (except fingers, toes and small joints) 100000
CM0821-II : AMPUTATION OF ANY SITE / ANY CAUSE WITH CUSTOM MADE PROSTHESIS (except fingers, toes and small joints) 100000
CM0821-III : AMPUTATION OF ANY SITE / ANY CAUSE WITH CUSTOM MADE PROSTHESIS (fingers, toes and small joints) 50000
CM0822 A-I : SOFT TISSUE INJURY - LACERATION (SUTURING) /WOUND DEBRIDEMENT 486
CM0822 A-II : SOFT TISSUE INJURY - LACERATION (SUTURING) /WOUND DEBRIDEMENT 486
CM0822 B-I : SOFT TISSUE INJURY - DEEP WOUND [NERVE/TENDON REPAIR] 4050
CM0822 B-II : SOFT TISSUE INJURY - DEEP WOUND [NERVE/TENDON REPAIR] 4050
CM0823 : OPERATIONS FOR BRACHIAL PLEXUS (multiple sitting - max 3) 24300
CM0825A : POLYTRAUMA/HEAD INJURY MINOR (only lacerations less than 10 cm) 2025
CM0825B : POLYTRAUMA/HEAD INJURY MINOR (deep / pitted wound exposing scalp/ bone requiring debridement and suturing) 5670
CM0826 : POLYTRAUMA/HEAD INJURY MAJOR (with fractures, intracranial bleeding) 20250
CM0827-I : SEVERE MYOCARDITIS/CONGENITAL HEART DISEASE PRESENTING WITH OR WITHOUT / INFECTION / FAILURE / CARDIOGENIC SHOCK / SEPTIC SHOCK / INFECTIVE ENDOCARDITIS/ CYANOTIC SPELL - NON VENTILATED 32400
CM0828-I : SEVERE MYOCARDITIS/CONGENITAL HEART DISEASE PRESENTING WITH OR WITHOUT / INFECTION / FAILURE / CARDIOGENIC SHOCK / SEPTIC SHOCK / INFECTIVE ENDOCARDITIS/ CYANOTIC SPELL - VENTILATED 40500
CM0829-I : STATUS EPILEPTICUS WITH MECHANICAL VENTILATION -(ADULT/PAEDIATRIC ) 32400
CM0830 : DIABETIC KETOACIDOSIS - TYPE I / TYPE II 24300
CM0831-I : CHRONIC RENAL FAILURE WITH HEMODIALYSIS/ERYTHROPOIETIN / IRON 13892
CM0832-I : ACUTE RENAL FAILURE WITHOUT HEMODIALYSIS/ERYTHROPOIETIN / IRON 7857
CM0833-I : ACUTE RENAL FAILURE WITH HEMODIALYSIS/ ERYTHROPOIETIN / IRON 9153
CM0834-I : ACUTE RENAL FAILURE / CRF WITH VENTILATOR CARE 21627
CM0835A-I : ACUTE RENAL FAILURE / CRF - CONTINUOUS RENAL REPLACEMENT THERAPY-SCUF & SLED 46170
CM0835B-I : ACUTE RENAL FAILURE / CRF - CONTINUOUS RENAL REPLACEMENT THERAPY - CVVH/CVVHD 62370
CM0837-I : PYOGENIC /TB /VIRAL/ FUNGAL -MENINGITIS/ MENINGOENCEPHALITIS - NON VENTILATED 24300
CM0838-I : PYOGENIC /TB /VIRAL/ FUNGAL -MENINGITIS/ MENINGOENCEPHALITIS - WITH VENTILATORY SUPPORT 40500
CM0839-I : NEURO TUBERCULOSIS/NEUROCYSTICERCOSIS/ TUBERCULOMA 9720
CM0840 A : IDIPOPATHIC THROMBOCYTOPENIC PURPURA 32400
CM0840 B : TTP 48600
CM0841 A : ANY COAGULATION DISORDERS 40500
CM0841 B : DIC 20250
CM0843A : MULTI SYSTEM ORGAN FAILURE- ARDS WITHOUT DIC(BLOOD PRODUCTS) 66087
CM0843B : MULTI SYSTEM ORGAN FAILURE- ARDS WITH DIC(BLOOD PRODUCTS) 90387
CM0844 : ENTERIC ENCEPHALOPATHY 16378
CM0845 : LEPTOSPIROSIS WITH HEPATIC INVOLVEMENT 16119
CM0846 : SUBMERSION INJURY WITH VENTILATORY SUPPORT 21870
CM0847 : ARDS WITH VENTILATORY SUPPORT 68081
CM0848-I : RESPIRATORY FAILURE OF ANY CAUSE REQUIRING HIGH FREQUENCY VENTILATION 45522
CM0851A-II : CHEST WALL RESECTION WITHOUT RECONSTRUCTION 32279
CM0851B-II : CHEST WALL RESECTION WITH RECONSTRUCTION 42404
CM0854 A-I : ORCHIDECTOMY /HIGH ORCHIDECTOMY U/L 9720
CM0854 A-II : ORCHIDECTOMY /HIGH ORCHIDECTOMY U/L 9720
CM0854 A-III : ORCHIDECTOMY /HIGH ORCHIDECTOMY U/L 9720
CM0855 B-II : ORCHIDECTOMY /HIGH ORCHIDECTOMY B/L 12150
CM0856 : ANEURYSM CLIPPING 78935
CM0857 : SURGERY OF CORD TUMORS - INTRA MEDULLARY TUMORS 47604
CM0858 : SURGERY OF CORD TUMORS -INTRADURAL EXTRAMEDULLARY TUMOR 37074
CM0859 : SURGERY OF CORD TUMORS - EXTRADURAL TUMOR 37074
CM0860 : SPILT CORD MALFORMATIONS - ANY TYPE(INCLUDES SPINA BIFIDA MAJOR/MINOR) 21101
CM0861-I : POSTERIOR DISCECTOMY WITH OR WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY ( FOR CERVICAL COMPRESSIVE MYELOPATHY/ AT ANY LEVELS) 34952
CM0861-II : POSTERIOR DISCECTOMY WITH OR WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY ( FOR CERVICAL COMPRESSIVE MYELOPATHY/ AT ANY LEVELS) 34952
CM0862 : ANTERIOR DISCECTOMY (WITH OR WITHOUT BONE GRAFTING/SPACER/IMPLANT/VETEBROPLASTY ) ANY LEVEL 34952
CM0863 : ANTERIOR CERVICAL SPINE SURGERY WITH FUSION 32441
CM0864 : ANTERIOR LATERAL DECOMPRESSION/STABILSIATION 19481
CM0865-I : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- MICROLUMBAR 28391
CM0865-II : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- MICROLUMBAR 28391
CM0866-I : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- CONVENTIONAL 20291
CM0866-II : LAMINECTOMY AT ANY LEVEL - (INCLUDING LUMBAR LAMINECTOMY FOR LUMBAR CANAL STENOSIS)- CONVENTIONAL 20291
CM0867 : SPINAL FUSION PROCEDURE 34466
CM0868 : TRANS SPHENOIDAL SURGERY (SELLAR/SUPRASELLAR/SKULL BASAL LESION) 64776
CM0869 : TRANS ORAL SURGERY 20428
CM0870 : C.V. JUNCTION FUSION 32198
CM0871 : SYRINGOMYELIA 49208
CM0872 : CORPECTOMY (ANTERIOR /ANTEROLATERAL) AT ALL SPINAL LEVELS 36491
CM0873 : SPINAL FIXATION RODS ,SCREWS,PLATES, ARTIFICIAL DISCS 48641
CM0878-I : PELVIC FLOOR RECONSTRUCTION WITH MESH 24908
CM0878-II : PELVIC FLOOR RECONSTRUCTION WITH MESH 24908
CM0879-I : LAPAROSCOPIC / LAPROTOMY - ECTOPIC RESECTION 17294
CM0879-II : LAPAROSCOPIC / LAPROTOMY - ECTOPIC RESECTION 17294
CM0880 : LAPAROSCOPIC ADHESOLYSIS 16241
CM0881 A-I : THALASSEMIA MAJOR /HAEMOGLOBINOPATHIES/ CHELATION THERAPY 97200
CM0881 B-I : SICKLE CELL ANAEMIA 4050
CM0882-I : INTERSTITAL LUNG DISEASE 23733
CM0883-I : OESOPHAGEAL VARICES /GASTRIC VARICES/PESUDO ANEURYSM - BANDING 8262
CM0884-I : OESOPHAGEAL VARICES /GASTRIC VARICES/PESUDO ANEURYSM - SCLEROTHERAPY 6156
CM0884-II : OESOPHAGEAL VARICES /GASTRIC VARICES/PESUDO ANEURYSM - SCLEROTHERAPY 6156
CM0885-I : OESOPHAGEAL VARICES /GASTRIC VARICES/PESUDO ANEURYSM - DEVASCULARISATION 32400
CM0885-II : OESOPHAGEAL VARICES /GASTRIC VARICES/PESUDO ANEURYSM - DEVASCULARISATION 32400
CM0886-I : OESOPHAGEAL VARICES /GASTRIC VARICES/PESUDO ANEURYSM - GLUE INJECTION 6156
CM0886-II : OESOPHAGEAL VARICES /GASTRIC VARICES/PESUDO ANEURYSM - GLUE INJECTION 6156
CM0887-I : END STAGE RENAL DISEASE 11462
CM0888-I : GULLAIN BARRE SYNDROME 81000
CM0889-I : OPTIC NEURITIS 8100
CM0891-I : MYASTHENIA GRAVIS 12150
CM0892 : MANAGEMENT OF COMA 24365
CM0895 : HYPER OSMOLAR NON-KETOTIC COMA 24300
CM0896 : OPERATION FOR HYDATID CYST OF LIVER 28350
CM0897-I : HEPATO CELLULAR CARCINOMA (ADVANCED) RADIO FREQUENCY ABLATION 24098
CM0898 : COLONIC PULL THOROUGH /COLOPLASTY/ ABDOMINAL RESECTION 40500
CM0899-I : OESOPHAGECTOMY ANY TYPE INCLUDING (TRANS HIATAL / TRANS THORACIC WITH GASTRIC PULL UP) 52650
CM0899-II : OESOPHAGECTOMY ANY TYPE INCLUDING (TRANS HIATAL / TRANS THORACIC WITH GASTRIC PULL UP) 52650
CM0900 : OESOPHAGO- GASTRECTOMY 64800
CM0901 : ACHALASIA CARDIA -SURGICAL CORRECTION 24300
CM0902-I : ACHALASIA CARDIA - LAP SURGICAL CORRECTION ( INCLUDING HELLERS MYOTOMY) 24300
CM0902-II : ACHALASIA CARDIA - LAP SURGICAL CORRECTION ( INCLUDING HELLERS MYOTOMY) 24300
CM0903 : ACHALASIA CARDIA -PNEUMATIC DILATATION 8465
CM0904 : LAP FUNDOPLICATIONS 36450
CM0905-I : CYST EXCISION WITH OR WITHOUT HEPATIC JEJUNOSTOMY/ BILIARY DRAINAGE 36450
CM0905-II : CYST EXCISION WITH OR WITHOUT HEPATIC JEJUNOSTOMY/ BILIARY DRAINAGE 36450
CM0907 : ENUCLEATION OF CYST 32400
CM0908A-I : OTHER BYPASS PANCREAS 32400
CM0908A-II : OTHER BYPASS PANCREAS 32400
CM0908B-I : TRIPLE BYPASS 32400
CM0908B-II : TRIPLE BYPASS 32400
CM0910 : PANCREATIC NECROSECTOMY OPEN 34020
CM0911 : PANCREATIC NECROSECTOMY LAP 34020
CM0913 : SCLEROSING CHOLANGITIS 8100
CM0918 A : URETEROSCOPY AND DJ STENTING U/L 4860
CM0918 B : URETEROSCOPY AND DJ STENTING B/L 7290
CM0919 : URETEROSCOPY AND DJ STENT REMOVAL 2430
CM0920 : TRANSURETHRAL RESECTION OF BLADDER TUMOR /RE-TURBT 24300
CM0921A : EPIGASTRIC HERNIA / ABDOMINAL /UMBILICAL / FEMORAL HERNIA-WITHOUT MESH - OPEN 12150
CM0921B : HIATUS HERNIA REPAIR ABDOMINAL - WITHOUT MESH - OPEN 28350
CM0921C : VENTRAL AND SCAR /SPIGELIAN/OBTURATOR/SCIATIC- WITHOUT MESH - OPEN 12960
CM0921D : EPIGASTRIC HERNIA/UMBILICAL HERNIA - WITH MESH - OPEN 16200
CM0921E : HIATUS HERNIA REPAIR ABDOMINAL - WITH MESH - OPEN 32400
CM0921F : VENTRAL AND SCAR / FEMORAL /SPIGELIAN/OBTURATOR/SCIATIC WITH MESH - OPEN 16200
CM0922A : EPIGASTRIC HERNIA / ABDOMINAL /UMBILICAL / FEMORAL HERNIA-WITHOUT MESH - LAP 12150
CM0922B : HIATUS HERNIA REPAIR ABDOMINAL - WITHOUT MESH - LAP 28350
CM0922C : VENTRAL AND SCAR /SPIGELIAN/OBTURATOR/SCIATIC- WITHOUT MESH - LAP 12960
CM0922D : EPIGASTRIC HERNIA/UMBILICAL HERNIA - WITH MESH - LAP 16200
CM0922E : HIATUS HERNIA REPAIR ABDOMINAL - WITH MESH - LAP 32400
CM0922F : VENTRAL AND SCAR / FEMORAL /SPIGELIAN/OBTURATOR/SCIATIC WITH MESH - LAP 16200
CM0924 : APPENDICULAR PERFORATION 12150
CM0925A : VAGOTOMY ANY TYPE WITHOUT DRAINAGE PROCEDURES 20250
CM0925B : VAGOTOMY ANY TYPE WITH DRAINAGE PROCEDURES 32400
CM0926 : OPERATION FOR BLEEDING PEPTIC ULCER 32400
CM0927 : PYLOROMYOTOMY 17820
CM0928 : OPERATIONS FOR RECURRENT INTESTINAL OBSTRUCTION (NOBLE PLICATION /OTHER) 28350
CM0929 : OPERATION FOR ACUTE INTESTINAL PERFORATION / PERFORATION PERITONITIS (INTESTINAL/GASTRIC/BILIARY)/ DUODENAL PERFORATION 24300
CM0930 : OPERATION FOR ACUTE INTESTINAL OBSTRUCTION (INCLUDING VOLVULUS / MALROTATION/INTUSUSCEPTION) 32400
CM0931-I : INVESTIGATION AND MANAGEMENT CHRONIC HEPATITIS B / C 158697
CM0932-I : CIRRHOSIS OF LIVER WITH COMPLICATIONS 24365
CM0935 : STAY IN GENERAL WARD - OBSERVATION FOR TRAUMA - PER DAY 567
CM0936 A : STAY IN ICU - MILD/MODERATE/SEVERE WITH OR WITHOUT VENTILATION (FOR TRAUMA/POST OP COMPLICATIONS) 0
CM0936 B : STAY IN ICU - MILD WITHOUT VENTILATION (FOR TRAUMA) 810
CM0936 C : STAY IN ICU - MODERATE WITHOUT VENTILATION (FOR TRAUMA) 12150
CM0936 D : STAY IN ICU - MODERATE WITH VENTILATION (FOR TRAUMA) 20250
CM0936 E : STAY IN ICU - SEVERE WITHOUT VENTILATION (FOR TRAUMA / POST OP COMPLICATIONS - Sepsis / coma) 20250
CM0936 F : STAY IN ICU - SEVERE WITH VENTILATION (FOR TRAUMA / POST OP COMPLICATIONS - Sepsis / Coma) 40500
CM0937 A : PYELOLITHOTOMY - OPEN 20250
CM0937 B : PYELOLITHOTOMY - LAP 20250
CM0938 A : NEPHROLITHOTOMY - OPEN 20250
CM0938 B : NEPHROLITHOTOMY - LAP 20250
CM0939 : OPEN CYSTOLITHOTOMY 11340
CM0940 A : URETEROLITHOTOMY - OPEN 16200
CM0940 B : URETEROLITHOTOMY - LAP 16200
CM0941 A : VESICOLITHOTOMY - OPEN 11340
CM0941 B : VESICOLITHOTOMY - LAP 11340
CM0942 : POSTERIOR FOSSA ENDOSCOPIC SURGERY 64800
CM0943 : ENDOSCOPIC RESECTION OF ANTERIOR SKULL BASE LESIONS 40476
CM0947 : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES /VERTERBROPLASTY 61358
CM0948 : SPINAL EPIDURAL ABSCESS/HEMATOMA - LAMINECTOMY / EVACUATION 21668
CM0952 : SURGERY/CHEMOTHERAPY/RADIOTHERAPY FOR ALL LEUKEMIAS 0
CM0952A : All Leukemia ( Chemotheraphy) 0
CM0952A-I : Chronic Myeloid Leukemia (CML) 0
CM0952A-I-i-a : Imatinib 1525
CM0952A-I-i-b : Nilotinib 17800
CM0952A-I-ii : Blast phase-Lymphoid ALL Type Induction + TKI 0
CM0952A-I-ii-a : Induction 12840
CM0952A-I-ii-b : Imatinib 1525
CM0952A-I-ii-c : Nilotinib 17800
CM0952A-I-iii : Blast phase-myeloid AML Type Induction + TKI 0
CM0952A-I-iii-a : Daunorubicin (90mg/m2)+ Cytarabine 12320
CM0952A-I-iii-b : Daunorubicin + Cytarabine + Cladribine 10365
CM0952A-I-iii-c : Daunorubicin + Cytarabine (High Dose) 16725
CM0952A-I-iii-d : Daunorubicin (90mg) + Cytarabine 12320
CM0952A-I-iii-e : Idarubicin + Cytarabine (High Dose) 29600
CM0952A-I-iii-f : Idarubicin + Cytarabine 23240
CM0952A-I-iii-g : mitoxantrone + Cytarabine 10820
CM0952A-I-iii-h : Imatinib 1525
CM0952A-I-iii-i : Nilotinib 17800
CM0952A-I-iii-ii : Other Regimen 10000
CM0952A-I-iii-iii : Other Regimen 10000
CM0952A-II : Acute Myeloid Leukemia (AML) 0
CM0952A-II-a : Daunorubicin + Cytarabine 1 12320
CM0952A-II-b : Idarubicin + Cytarabine 23240
CM0952A-II-c : Daunorubicin + Cytarabine 2 10365
CM0952A-II-d : Daunorubicin + Cytarabine (High Dose) 16725
CM0952A-II-e : Idarubicin + Cytarabine (High Dose) 29600
CM0952A-II-f : Daunorubicin (90mg) + Cytarabine 12320
CM0952A-II-g : idarubicin + Cytarabine 23240
CM0952A-II-h : mitoxantrone + Cytarabine 10280
CM0952A-II-i : Cytarabine 6800
CM0952A-II-j : Decitabine 25000
CM0952A-II-k : azacytidine 77500
CM0952A-II-l : Hydroxyurea 1600
CM0952A-II-m : Cytarabine - High Dose 9720
CM0952A-II-n : Cladribine + Cytarabine + Idarubicin + Gcsf 85150
CM0952A-II-o : Cladribine + Cytarabine + Mitoxantrone + Gcsf 40690
CM0952A-II-p : Fludarabine + Cytarabine + Idarubicin + Gcsf 66710
CM0952A-II-q : Etoposide +Cytarabine+Mitoxantrone 13260
CM0952A-II-r : Cytarabine SC 2800
CM0952A-II-s : azacytidine 77500
CM0952A-II-t : Decitabine 25500
CM0952A-II-u : Other Regimen 10000
CM0952A-III : Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL / SLL) 0
CM0952A-III-a-i : Rituximab + chlorambucil Cycle 1 1084
CM0952A-III-a-ii : Rituximab + chlorambucil Cycle 3 25584
CM0952A-III-a-iii : Rituximab + chlorambucil Cycle 4-8 32984
CM0952A-III-a-iv : Maintanance - Rituximab 25500
CM0952A-III-b : Rituximab Day 1, 8, 15, and 22: 100500
CM0952A-III-c : Chlorambucil 2344
CM0952A-III-d-i : Bendamustine + Rituximab (Cycle -1) 36500
CM0952A-III-d-ii : Bendamustine + Rituximab (Cycles 2-6) 37900
CM0952A-III-d-iii : Bendamustine (70mg) (Cycle -1) 12500
CM0952A-III-d-iv : Bendamustine (90 mg) (Cycles 2-6) 6500
CM0952A-III-e : Fludarabine + cyclophosphamide + rituximab (FCR) 31898
CM0952A-III-f : Fludarabine + rituximab (FR) 67930
CM0952A-III-g : Alemtuzumab + rituximab 108950
CM0952A-III-h : Alemtuzumab without rituximab 11450
CM0952A-III-i : High-dose methylprednisolone + rituximab 103955
CM0952A-III-j : High-dose methylprednisolone 6455
CM0952A-III-k : Other Regimen 10000
CM0952A-IV : Acute Lymphoblastic Leukemia (ALL) 0
CM0952A-IV-i : Ph(+) AYA (Age 15-39 years) 0
CM0952A-IV-i-a-1 : Childrens Oncology Group (COG) AALL-0031 INDUCTION PHASE 13340
CM0952A-IV-i-a-2 : Childrens Oncology Group (COG) AALL-0031 CONSOLIDATION PHASE - BLOCK 1 17095
CM0952A-IV-i-a-3 : Childrens Oncology Group (COG) AALL-0031 CONSOLIDATION PHASE - BLOCK 2 19175
CM0952A-IV-i-a-4 : Childrens Oncology Group (COG) AALL-0031 REINDUCTION 25291
CM0952A-IV-i-a-5 : Childrens Oncology Group (COG) AALL-0031 INTENSIFICATION 41425
CM0952A-IV-i-a-6 : Childrens Oncology Group (COG) AALL-0031 MAINTENANCE Cycles 1-4 (8 weeks) 35621
CM0952A-IV-i-a-7 : Childrens Oncology Group (COG) AALL-0031 MAINTENANCE Cycles 5-12 (8 weeks) 12836
CM0952A-IV-i-b-1 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 1 and 3) 59429
CM0952A-IV-i-b-2 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 2 and 4) 62380
CM0952A-IV-i-b-3 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 5 & 7) 11469
CM0952A-IV-i-b-4 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 6 & 8) 13420
CM0952A-IV-i-b-5 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) Induction II 15133
CM0952A-IV-i-b-6 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) Induction III 5535
CM0952A-IV-i-b-7 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) Maintenance 9923
CM0952A-IV-i-c-1 : Multiagent Chemotherapy + TKIs INDUCTION PHASE 15133
CM0952A-IV-i-c-2 : Multiagent Chemotherapy + TKIs CONSOLIDATION I 8460
CM0952A-IV-i-c-3 : Multiagent Chemotherapy + TKIs CONSOLIDATION II 3700
CM0952A-IV-i-c-4 : Multiagent Chemotherapy + TKIs MAINTENANCE 3410
CM0952A-IV-i-c-5 : Imatinib 1525
CM0952A-IV-i-c-6 : Nilotinib 17800
CM0952A-IV-i-d : Other Regimen 10000
CM0952A-IV-ii : Ph(+) AYA (Age > 40 years) 0
CM0952A-IV-ii-a-1 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 1 and 3) 59429
CM0952A-IV-ii-a-2 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 2 and 4) 62380
CM0952A-IV-ii-a-3 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 5 & 7) 11469
CM0952A-IV-ii-a-4 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 6 & 8) 13420
CM0952A-IV-ii-a-5 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) Induction II 15133
CM0952A-IV-ii-a-6 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) Induction III 5535
CM0952A-IV-ii-a-7 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) Maintenance 9923
CM0952A-IV-ii-b-1 : Multiagent Chemotherapy + TKIs INDUCTION PHASE 15573
CM0952A-IV-ii-b-2 : Multiagent Chemotherapy + TKIs CONSOLIDATION I 12110
CM0952A-IV-ii-b-3 : Multiagent Chemotherapy + TKIs CONSOLIDATION II 3200
CM0952A-IV-ii-b-4 : Multiagent Chemotherapy + TKIs MAINTENANCE 6410
CM0952A-IV-ii-b-5 : Imatinib 1525
CM0952A-IV-ii-b-6 : Nilotinib 17800
CM0952A-IV-ii-c : Corticosteroids + TKIs 9035
CM0952A-IV-ii-d : Other Regimen 10000
CM0952A-IV-iii : Ph(-) AYA (Age 15-39 years) 0
CM0952A-IV-iii-a-1 : GRAALL-2003 INDUCTION 15678
CM0952A-IV-iii-a-2 : GRAALL-2003 SALVAGE 28760
CM0952A-IV-iii-a-3 : GRAALL-2003 CONSOLIDATION 30779
CM0952A-IV-iii-a-4 : GRAALL-2003 Late intensification between consolidation blocks 6 and 7 (for patients in complete remission [CR] after the first induction course) 15495
CM0952A-IV-iii-a-5 : GRAALL-2003 Late intensification between consolidation blocks 6 and 7 (for patients in CR after salvage course) 27210
CM0952A-IV-iii-a-6 : GRAALL-2003 Maintenance 56898
CM0952A-IV-iii-b : CNS Therapy-Treatment of patients with initial CNS involvement: 21155
CM0952A-IV-iii-v : CCG-1961 18310
CM0952A-IV-iii-vi : Other Regimen 10000
CM0952A-IV-iv : Ph(-) AYA (Age > 40 years) 0
CM0952A-IV-iv-a-1 : CALGB 8811 (Larson Regimen) INDUCTION 18038
CM0952A-IV-iv-a-2 : CALGB 8811 (Larson Regimen) CONSOLIDATION 16685
CM0952A-IV-iv-b-1 : Hyper-CVAD with or without Rituximab CYCLE 1,3,5,7 60970
CM0952A-IV-iv-b-2 : Hyper-CVAD with or without Rituximab CYCLE 2,4,6,8 56820
CM0952A-IV-iii-c : Other Regimen 10000
CM0952-ii : Surgery for All Leukemias - Utilise Surgical Oncology Package if unavailable maximum payable 40500
CM0953A : All Lymphoma Chemotheraphy 0
CM0953A-I : Hodgkins Lymphoma 0
CM0953A-I-a : ABVD 4480
CM0953A-I-b : Escalated BEACOPP 7119
CM0953A-I-c : ABVD + Rituximab (cyled every 4 weeks) 28480
CM0953A-I-d-i : ABVD + Rituximab (1 cycle - weekly rituximab 4 doses) followed by ABVD 102480
CM0953A-I-d-ii : ABVD 4480
CM0953A-I-e-i : CHOP + Rituximab 26818
CM0953A-I-e-ii : CHOP 2818
CM0953A-I-f-i : CVP +/- Rituximab 25768
CM0953A-I-f-ii : CVP 1768
CM0953A-I-g : Rituximab 25500
CM0953A-I-h : Other Regimen 10000
CM0953A-II-a : Bortezomib + dexamethasone 68038
CM0953A-II-b : Cyclophosphamide + doxorubicin + vincristine + prednisone + rituximab 26818
CM0953A-II-c : Rituximab 25500
CM0953A-II-d : Rituximab + cyclophosphamide + prednisone 25738
CM0953A-II-e : Rituximab + cyclophosphamide + dexamethasone 25520
CM0953A-II-f-i : Thalidomide with or without rituximab (Weeks 1 and 2) 2540
CM0953A-II-f-ii : Thalidomide with or without rituximab (Weeks 3-50) 6000
CM0953A-II-f-iii : Thalidomide with or without rituximab (Weeks 50-52) 6000
CM0953A-II-f-iv : Thalidomide with or without rituximab Weeks 2-5 and 13-16 24000
CM0953A-II-g-i : Bendamustine with or without rituximab 36500
CM0953A-II-g-ii : Bendamustine - rituximab 12500
CM0953A-II-h-i : Cladribine with or without rituximab 32250
CM0953A-II-h-ii : Cladribine - rituximab 8250
CM0953A-II-i : Bendamustine 12500
CM0953A-II-j : Chlorambucil 1126
CM0953A-II-k : Fludarabine 12030
CM0953A-II-l : Fludarabine + cyclophosphamide + rituximab (FCR) 32398
CM0953A-II-m : Alemtuzumab 2650
CM0953A-II-n : Other Regimen 10000
CM0953A-III : NON HODGKINS LYMPHOMA 0
CM0953A-III-i : BURKITT LYMPHOMA 0
CM0953A-III-i-a -1 : CALGB 10002 Cycle 1: 8967
CM0953A-III-i-a-2 : CALGB 10002 Cycles 2 (beginning Day 8), 4, and 6: 66113
CM0953A-III-i-a-3 : CALGB 10002 Cycles 3, 5, and 7: 33108
CM0953A-III-i-a-4 : CALGB 10002 Cycles 4, and 6: 36413
CM0953A-III-i-b : CODOX-M (original or modified) (cyclophosphamide + doxorubicin + vincristine with intrathecal MTX + cytarabine, followed by systemic MTX and cytarabine) with or without Rituximab 46780
CM0953A-III-i-c-1 : Dose-adjusted EPOCH (etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin) + intrathecal MTX + rituximab (Cycles 1 & 2) 32972
CM0953A-III-i-c-2 : Dose-adjusted EPOCH (etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin) + intrathecal MTX + rituximab (Cycles 3-6) 32572
CM0953A-III-i-d-1 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 1 and 3) 59429
CM0953A-III-i-d-2 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 2 and 4) 61880
CM0953A-III-i-d-3 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 5 & 7) 10969
CM0953A-III-i-d-4 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 6 & 8) 12920
CM0953A-III-i-e-1 : CODOX-M alternated with IVAC (CODOX-M) CODOX-M (original or modified) (cyclophosphamide + doxorubicin + vincristine, plus intrathecal MTX + cytarabine, followed by systemic MTX) alternating with IVAC (ifosfamide + cytarabine + etoposide) and intrathecal MTX with or without Rituximab 46780
CM0953A-III-i-e-2 : CODOX-M alternated with IVAC (IVAC) CODOX-M (original or modified) (cyclophosphamide + doxorubicin + vincristine, plus intrathecal MTX + cytarabine, followed by systemic MTX) alternating with IVAC (ifosfamide + cytarabine + etoposide) and intrathecal MTX with or without Rituximab 42847
CM0953A-III-i-f : RICE (rituximab + ifosfamide + carboplatin + etoposide) 32994
CM0953A-III-i-g : RIVAC (rituximab + ifosfamide + cytarabine + etoposide) 43894
CM0953A-III-i-h : RGDP (rituximab + gemcitabine + dexamethasone + cisplatin) 32255
CM0953A-III-i-i : HDAC + Rituximab 27800
CM0953A-III-i-ii : Other Regimen 10000
CM0953A-III-ii : NON HODGKIN LYMPHOMA -- ADULT T-CELL LEUKEMIA / LYMPHOMA 0
CM0953A-III-ii-a-1 : Zidovudine + alpha-interferon (induction) 4580
CM0953A-III-ii-a-2 : Zidovudine + alpha-interferon (Maintenance Therapy) 2100
CM0953A-III-ii-b : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) 2818
CM0953A-III-ii-c : CHOEP 8640
CM0953A-III-ii-d : Dose-adjusted EPOCH(etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin) 6892
CM0953A-III-ii-e : Other Regimen 10000
CM0953A-III-iii : DIFFUSE LARGE B CELL LYMPHOMA 0
CM0953A-III-iii-a : CDE (cyclophosphamide + doxorubicin + etoposide) + rituximab 2500
CM0953A-III-iii-b-1 : CODOX-M alternated with IVAC (CODOX-M) CODOX-M/IVAC (modified) (cyclophosphamide + vincristine + doxorubicin + high-dose methotrexate alternating with ifosfamide + etoposide + high-dose cytarabine) 46780
CM0953A-III-iii-b-2 : CODOX-M alternated with IVAC (IVAC) CODOX-M/IVAC (modified) (cyclophosphamide + vincristine + doxorubicin + high-dose methotrexate alternating with ifosfamide + etoposide + high-dose cytarabine) 42847
CM0953A-III-iii-c-1 : Dose-adjusted EPOCH (etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin) + intrathecal MTX + rituximab (Cycles 1&2) 32972
CM0953A-III-iii-c-2 : Dose-adjusted EPOCH (etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin) + intrathecal MTX + rituximab (Cycles 3-6) 32572
CM0953A-III-iii-d-1 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 1 and 3) 59429
CM0953A-III-iii-d-2 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 2 and 4) 61880
CM0953A-III-iii-d-3 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 5 & 7) 10969
CM0953A-III-iii-d-4 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 6 & 8) 12920
CM0953A-III-iii-e-1 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) Rituximab 26818
CM0953A-III-iii-e-2 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) 2818
CM0953A-III-iii-f : Other Regimen 10000
CM0953A-III-iv : AIDS-Related B-Cell Lymphomas 0
CM0953A-III-iv-a : CDE (cyclophosphamide + doxorubicin + etoposide) + rituximab 2500
CM0953A-III-iv-b-1 : CODOX-M alternated with IVAC (CODOX-M) CODOX-M/IVAC (modified) (cyclophosphamide + vincristine + doxorubicin + high-dose methotrexate alternating with ifosfamide + etoposide + high-dose cytarabine) 46780
CM0953A-III-iv-b-2 : CODOX-M alternated with IVAC (IVAC) CODOX-M/IVAC (modified) (cyclophosphamide + vincristine + doxorubicin + high-dose methotrexate alternating with ifosfamide + etoposide + high-dose cytarabine) 42847
CM0953A-III-iv-c-1 : Dose-adjusted EPOCH (etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin) + intrathecal MTX + rituximab (Cycles 1&2) 32972
CM0953A-III-iv-c-2 : Dose-adjusted EPOCH (etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin) + intrathecal MTX + rituximab (Cycles 3-6) 32572
CM0953A-III-iv-d-1 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 1 and 3) 59429
CM0953A-III-iv-d-2 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 2 and 4) 61880
CM0953A-III-iv-d-3 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 5 & 7) 10969
CM0953A-III-iv-d-4 : HyperCVAD (cyclophosphamide + vincristine + doxorubicin + dexamethasone alternating with high-dose methotrexate and cytarabine) (Cycles 6 & 8) 12920
CM0953A-III-iv-e-1 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) with or without Rituximab 26818
CM0953A-III-iv-e-2 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) 2818
CM0953A-III-iv-f : Other Regimen 10000
CM0953A-III-v : Primary Cutaneous Marginal Zone or Follicle Center Lymphoma 0
CM0953A-III-v-a-1 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) with or without Rituximab 26818
CM0953A-III-v-a-2 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) 2818
CM0953A-III-v-b : Rituximab 25500
CM0953A-III-v-c : Other Regimen 10000
CM0953A-III-vi : Follicular Lymphoma (Grade 1-2) 0
CM0953A-III-vi-a-1 : Bendamustine with or without rituximab 36500
CM0953A-III-vi-a-2 : Bendamustine (-) rituximab 12500
CM0953A-III-vi-b-1 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) with or without Rituximab 26818
CM0953A-III-vi-b-2 : Cyclophosphamide + Doxorubicin + Vincristine + Prednisone (CHOP) 2818
CM0953A-III-vi-c : Cyclophosphamide + Vincristine + Prednisone + Rituximab (RCVP) 25768
CM0953A-III-vi-d : Rituximab 25500
CM0953A-III-vi-e : Lenalidomide + Rituximab 4940
CM0953A-III-vi-f : Other Regimen 10000
CM0953A-III-vii : Extranodal NK/T-Cell Lymphoma 0
CM0953A-III-vii-a : SMILE 27483
CM0953A-III-vii-b : DeVIC +RT 9163
CM0953A-III-vii-c : VIPID 6619
CM0953A-III-vii-d : Other Regimen 10000
CM0953-ii : Surgery for All Lymphomas - Utilise Surgical Oncology Package if unavailable maximum payable 40500
CM0954 : Myelodysplastic Syndromes Treatment Regimens 0
CM0954-i : Symptomatic Anemia With del(5q) with or without Other Cytogenetic Abnormalities 0
CM0954-i-a : Lenalidomide 2575
CM0954-ii : Symptomatic Anemia Without del(5q) and Serum Erythropoietin =500mU/mL 0
CM0954-ii-a-1 : rHu-Epo with or without G-CSF 26080
CM0954-ii-a-2 : rHu-Epo (-) G-CSF 25750
CM0954-ii-b-1 : Darbepoetin alfa with or without G-CSF 9330
CM0954-ii-b-2 : Darbepoetin alfa (-) G-CSF 9000
CM0954-iii : Symptomatic Anemia Without del(5q), Serum Erythropoietin >500mU/mL, Unlikely to Respond to IST 0
CM0954-iii-a-1 : Decitabine (15mg/m2) 15500
CM0954-iii-a-2 : Decitabine (20mg/m2) 16500
CM0954-iii-b : Lenalidomide 2575
CM0955 : Multiple Myeloma 0
CM0955-a : Lenalidomide (28 days) + Dexamethasone 6817
CM0955-b : Lenalidomide (21 days) + Dexamethasone 5004
CM0955-c : Lenalidomide 2575
CM0955-d : Bendamustine + Lenalidomide + Dexamethasone 13639
CM0955-e : Bendamustine 22000
CM0955-f : Cyclophosphamide + Lenalidomide + Dexamethasone 5136
CM0955-g : Dexamethasone + Cyclophosphamide + Etoposide + Cisplatin (DCEP) 5764
CM0955-h : Dexamethasone + Thalidomide + Cisplatin + Doxorubicin + Cyclophosphamide + Etoposide (DT-PACE) 7724
CM0955-i : High-dose Cyclophosphamide 5140
CM0955-j : VAD / VAMP 6104
CM0955-k : Melphalan 3900
CM0955-l : Melphalan + Prednisolone 1137
CM0955-m : Thalidomide + Dexamethasone 2376
CM0955-n : Melphalan / Prednisolone/Thalidomide(MPT) 2257
CM0956 : ALL LYMPHOMA SALVAGE CHEMO (Package 953 to be utilised) 0
CM0957 : CHILDHOOD B CELL LYMPHOMA VARIABLE REGIMEN (Package 953 to be utilised) 0
CM0959 : CYSTIC FIBROSIS 29646
CM0960 : SEPTIC SHOCK (ICU MANAGEMENT) 34871
CM0962-I : NEPHROTIC SYNDROME 13037
CM0963-I : NEPHROTIC SYNDROME WITH COMPLICATIONS 21056
CM0964-I : ACUTE DISSEMINATED ENCEPHALOMYELITIS 40500
CM0967-I : TOXIC/DRUG INDUCED LIVER INJURY 21708
CM0968 : MALIGNANT ASCITES 4577
CM0969 : SACROSPINOUS FIXATION (VAGINAL ROUTE) 18671
CM0970 : SLEEVE RESECTION CA EAR 15795
CM0971 : SLEEVE RESECTION CA LUNG 19602
CM0973 : ENDOSCOPIC PARATHYROIDECTOMY 24300
CM0976A : CT / C-ARM GUIDED DISC OZONE NUCLEOLYSIS (CERVICAL / THORACIC / LUMBAR DISC) 12758
CM0976B : USG GUIDED DISC OZONE NUCLEOLYSIS (CERVICAL / THORACIC / LUMBAR DISC) 7898
CM0978 : C-ARM GUIDED INTRA ARTICULAR INJECTIONS (SHOULDER / ELBOW / WRIST / HIP / KNEE / ANKLE / JOINTS OF FOOT AND HAND 12758
CM0979-I : CHEMO EMBOLIZATION FOR LIVER TUMORS USING DRUG AND PVA OR DC BEADS 57308
CM0980-I : TRANS JUGULAR INTRAHEPATIC PORTO SYSTEMIC SHUNT (TIPSS) 106313
CM0981 : LUDWIGS ANGINA AND OTHER NECK ABSCESS DRAINAGE 9720
CM0982 : OP /ANY POISIONING - CONSERVATIVE MANAGEMENT OR WITHOUT VENTILATORY SUPPORT (ONLY WITH FIR ) 14580
CM0983 : MAXILLECTOMY WITH ORBITAL EXENTERATION 27824
CM0984 : MAXILLECTOMY WITH SKULL BASE RESECTION 30578
CM0985 : CRANIOFACIAL RESECTION 39164
CM0986A : POSTERIOR DECOMPRESSION WITHOUT STABILISATION AT ANY LEVEL (2 -3 levels) 20250
CM0986B : POSTERIOR DECOMPRESSION WITH STABILISATION AT ANY LEVEL (2 -3 levels) 36450
CM0987 : ACUTE SEVERE ASTHMA WITH VENTILATION 41472
CM0988 : CRITICAL CARE ICU MANAGEMENT ( RESPIRATORY DISTRESS/ METABOLIC COMA/MULTIORGAN DYSFUNCTION/SEPTIC SHOCK/OTHERS WITH VENTILATION 25200
CM0989A : CRITICAL CARE ICU MANAGEMENT -CRITICAL LIMB ISCHEMIA (heparinisation) 16200
CM0989B : CRITICAL CARE ICU MANAGEMENT -CRITICAL LIMB ISCHEMIA (SK) 20250
CM0989C : CRITICAL CARE ICU MANAGEMENT -CRITICAL LIMB ISCHEMIA (rTPA) 60750
FUP0001A : CORONARY BALLOON ANGIOPLASTY (PPCI) - First Qtr 1500
FUP0001B : CORONARY BALLOON ANGIOPLASTY (PPCI) - Next 3 Qtrs 1000
FUP0002A : PTCA WITH STENT - First Qtr 1500
FUP0002B : PTCA WITH STENT - Next 3 Qtrs 1000
FUP0004A : ASD DEVICE CLOSURE - First Qtr 1500
FUP0004B : ASD DEVICE CLOSURE - Next 3 Qtrs 1000
FUP0005A : VSD DEVICE CLOSURE - First Qtr 1500
FUP0005B : VSD DEVICE CLOSURE - Next 3 Qtrs 1000
FUP0006A : PDA STENTING - First Qtr 1500
FUP0006B : PDA STENTING - Next 3 Qtrs 1000
FUP0007A : DEVICE CLOSURE - First Qtr 1500
FUP0007B : DEVICE CLOSURE - Next 3 Qtrs 1000
FUP0008A : SINGLE COIL - First Qtr 1500
FUP0008B : SINGLE COIL - Next 3 Qtrs 1000
FUP0009A : MULTIPLE COILS - First Qtr 1500
FUP0009B : MULTIPLE COILS - Next 3 Qtrs 1000
FUP0010A : BALLOON VALVOTOMY(ALL VALVE) - First Qtr 1300
FUP0010B : BALLOON VALVOTOMY(ALL VALVE) - Next 3 Qtrs 750
FUP0011A : PERMANENT PACEMAKER IMPLANTATION (SINGLE / DUAL CHAMBER) - First Qtr 500
FUP0011B : PERMANENT PACEMAKER IMPLANTATION (SINGLE / DUAL CHAMBER) - Next 3 Qtrs 500
FUP0012A : TEMPORARY PACEMAKER IMPLANTATION - First Qtr 500
FUP0012B : TEMPORARY PACEMAKER IMPLANTATION - Next 3 Qtrs 500
FUP0013A : COARCTATION OF AORTA - WITH STENT - First Qtr 3000
FUP0013B : COARCTATION OF AORTA - WITH STENT - Next 3 Qtrs 1500
FUP0014A : COARCTATION OF AORTA - WITHOUT STENT - First Qtr 3000
FUP0014B : COARCTATION OF AORTA - WITHOUT STENT - Next 3 Qtrs 1500
FUP0016A : CORONARY BYPASS SURGERY - First Qtr 3000
FUP0016B : CORONARY BYPASS SURGERY - Next 3 Qtrs 1500
FUP0017A : CORONARY BYPASS SURGERY-POST ANGIOPLASTY - First Qtr 3000
FUP0017B : CORONARY BYPASS SURGERY-POST ANGIOPLASTY - Next 3 Qtrs 1500
FUP0018A : CABG WITH IABP PUMP - First Qtr 3000
FUP0018B : CABG WITH IABP PUMP - Next 3 Qtrs 1500
FUP0019A : CORONARY BYPASS SURGERY OFF PUMP WITH IABP - First Qtr 3000
FUP0019B : CORONARY BYPASS SURGERY OFF PUMP WITH IABP - Next 3 Qtrs 1500
FUP0020A : CABG OF PUMP WITHOUT IABP - First Qtr 3000
FUP0020B : CABG OF PUMP WITHOUT IABP - Next 3 Qtrs 1500
FUP0021A : CABG WITH ANEURYSMAL REPAIR - First Qtr 1300
FUP0021B : CABG WITH ANEURYSMAL REPAIR - Next 3 Qtrs 750
FUP0022A : CABG WITH VENTRICULAR RUPTURE REPAIR - First Qtr 1300
FUP0022B : CABG WITH VENTRICULAR RUPTURE REPAIR - Next 3 Qtrs 750
FUP0023A : CABG WITH VALVE REPLACEMENT WITH MECHANICAL VALVE - First Qtr 3000
FUP0023B : CABG WITH VALVE REPLACEMENT WITH MECHANICAL VALVE - Next 3 Qtrs 1500
FUP0024A : CABG WITH VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - First Qtr 3000
FUP0024B : CABG WITH VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - Next 3 Qtrs 1500
FUP0025A : SINGLE VALVE REPLACEMENT WITH MECHANICAL VALVE - First Qtr 3000
FUP0025B : SINGLE VALVE REPLACEMENT WITH MECHANICAL VALVE - Next 3 Qtrs 1500
FUP0026A : SINGLE VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - First Qtr 3000
FUP0026B : SINGLE VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - Next 3 Qtrs 1500
FUP0027A : DOUBLE VALVE REPLACEMENT WITH MECHANICAL VALVE - First Qtr 3000
FUP0027B : DOUBLE VALVE REPLACEMENT WITH MECHANICAL VALVE - Next 3 Qtrs 1500
FUP0028A : DOUBLE VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - First Qtr 3000
FUP0028B : DOUBLE VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - Next 3 Qtrs 1500
FUP0029A : TRIPLE VALVE REPLACEMENT WITH MECHANICAL VALVE - First Qtr 3000
FUP0029B : TRIPLE VALVE REPLACEMENT WITH MECHANICAL VALVE - Next 3 Qtrs 1500
FUP0030A : TRIPLE VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - First Qtr 3000
FUP0030B : TRIPLE VALVE REPLACEMENT WITH BIOPROSTHETIC VALVE - Next 3 Qtrs 1500
FUP0031A : COARCTATION-AORTA REPAIR WITH GRAFT - First Qtr 3000
FUP0031B : COARCTATION-AORTA REPAIR WITH GRAFT - Next 3 Qtrs 1500
FUP0032A : ANEURYSM RESECTION & GRAFTING - First Qtr 3000
FUP0032B : ANEURYSM RESECTION & GRAFTING - Next 3 Qtrs 1500
FUP0033A : INTRATHORACIC ANEURYSM -REQUIRING BYPASS (WITH GRAFT) - First Qtr 3000
FUP0033B : INTRATHORACIC ANEURYSM -REQUIRING BYPASS (WITH GRAFT) - Next 3 Qtrs 1500
FUP0034A : ANNULUS AORTIC ECTASIA WITH VALVED CONDUITS - First Qtr 1300
FUP0034B : ANNULUS AORTIC ECTASIA WITH VALVED CONDUITS - Next 3 Qtrs 750
FUP0035A : ARTERIAL SWITCH - First Qtr 1300
FUP0035B : ARTERIAL SWITCH - Next 3 Qtrs 750
FUP0036A : SENNINGS PROCEDURE - First Qtr 1300
FUP0036B : SENNINGS PROCEDURE - Next 3 Qtrs 750
FUP0037A : TOTAL CORRECTION OF TETRALOGY OF FALLOT - ANY TYPE - First Qtr 1300
FUP0037B : TOTAL CORRECTION OF TETRALOGY OF FALLOT - ANY TYPE - Next 3 Qtrs 750
FUP0038A : WITH SPECIAL CONDUITS - First Qtr 1300
FUP0038B : WITH SPECIAL CONDUITS - Next 3 Qtrs 750
FUP0039A : WITH PROSTHETIC RING - First Qtr 3000
FUP0039B : WITH PROSTHETIC RING - Next 3 Qtrs 1500
FUP0043A : PRIMARY ANGIOPLASTY FOR ACUTE MI +DRUG ELUTING STENT - First Qtr 1500
FUP0043B : PRIMARY ANGIOPLASTY FOR ACUTE MI +DRUG ELUTING STENT - Next 3 Qtrs 1000
FUP0045A : AMPUTATION OF ANY SITE / ANY CAUSE WITH CUSTOM MADE PROSTHESIS - First Qtr 600
FUP0045B : AMPUTATION OF ANY SITE / ANY CAUSE WITH CUSTOM MADE PROSTHESIS - Next 3 Qtrs 500
FUP0046A : OESOPHAGECTOMY WITH TWO FIELD LYMPADENECTOMY / THREE FIELD LYMPADENECTOMY - First Qtr 400
FUP0046B : OESOPHAGECTOMY WITH TWO FIELD LYMPADENECTOMY / THREE FIELD LYMPADENECTOMY - Next 3 Qtrs 400
FUP0047A : ALL - First Qtr 1000
FUP0047B : ALL - Next 3 Qtrs 750
FUP0048A : CML - First Qtr 1000
FUP0048B : CML - Next 3 Qtrs 750
FUP0049A : CLL - First Qtr 1000
FUP0049B : CLL - Next 3 Qtrs 750
FUP0050A : MYELODYSPLASTIC SYNDROME - First Qtr 1000
FUP0050B : MYELODYSPLASTIC SYNDROME - Next 3 Qtrs 750
FUP0051A : LYMPHOMA HODGKIN DISEASE - First Qtr 1000
FUP0051B : LYMPHOMA HODGKIN DISEASE - Next 3 Qtrs 750
FUP0052A : LYMPHOMA NON HODGKINS DISEASES - First Qtr 1000
FUP0052B : LYMPHOMA NON HODGKINS DISEASES - Next 3 Qtrs 750
FUP0053A : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE ADJUVANT PACKAGE 28-33 FRACTIONS(INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - First Qtr 2000
FUP0053B : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE ADJUVANT PACKAGE 28-33 FRACTIONS(INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - Next 3 Qtrs 1000
FUP0054A : SPECIALIZED RADIATION THERAPY 3D CRT- RADICAL PACKAGE 34-37 FRACTIONS - First Qtr 2000
FUP0054B : SPECIALIZED RADIATION THERAPY 3D CRT- RADICAL PACKAGE 34-37 FRACTIONS - Next 3 Qtrs 1000
FUP0055A : SPECIALIZED RADIATION THERAPY - IMRT ADJUVANT PACKAGE 28-33 FRACTIONS (INCLUDES AQUAPLAST MOULD,PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) - First Qtr 2000
FUP0055B : SPECIALIZED RADIATION THERAPY - IMRT ADJUVANT PACKAGE 28-33 FRACTIONS (INCLUDES AQUAPLAST MOULD,PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) - Next 3 Qtrs 1000
FUP0056A : SPECIALIZED RADIATION THERAPY - IMRT - RADICAL PACKAGE 34-40 FRACTIONS - First Qtr 2000
FUP0056B : SPECIALIZED RADIATION THERAPY - IMRT - RADICAL PACKAGE 34-40 FRACTIONS - Next 3 Qtrs 1000
FUP0057A : SPECIALIZED RADIATION THERAPY - IMRT WITH IGRT - First Qtr 2000
FUP0057B : SPECIALIZED RADIATION THERAPY - IMRT WITH IGRT - Next 3 Qtrs 1000
FUP0058A : SPECIALIZED RADIATION THERAPY - RAPID ARC THERAPY - First Qtr 2000
FUP0058B : SPECIALIZED RADIATION THERAPY - RAPID ARC THERAPY - Next 3 Qtrs 1000
FUP0059A : TOTAL BODY RADIATION - First Qtr 2000
FUP0059B : TOTAL BODY RADIATION - Next 3 Qtrs 1000
FUP0060A : UPTO-60% WITH SCALDS (CONSERVATIVE) - First Qtr 750
FUP0060B : UPTO-60% WITH SCALDS (CONSERVATIVE) - Next 3 Qtrs 500
FUP0061A : UP TO-60% MIXED BURNS (WITH SURGERIES) - First Qtr 750
FUP0061B : UP TO-60% MIXED BURNS (WITH SURGERIES) - Next 3 Qtrs 500
FUP0062A : ABOVE 60% MIXED BURNS (WITH SURGERIES) - First Qtr 750
FUP0062B : ABOVE 60% MIXED BURNS (WITH SURGERIES) - Next 3 Qtrs 500
FUP0063A : TOTAL ELBOW REPLACEMENT - First Qtr 500
FUP0063B : TOTAL ELBOW REPLACEMENT - Next 3 Qtrs 500
FUP0064A : SHOULDER REPLACEMENT - First Qtr 500
FUP0064B : SHOULDER REPLACEMENT - Next 3 Qtrs 500
FUP0065A : TOTAL HIP REPLACEMENT - First Qtr 500
FUP0065B : TOTAL HIP REPLACEMENT - Next 3 Qtrs 500
FUP0066A : REVISION HIP REPLACEMENT SURGERY (ONLY WITH SPECIFIC APPROVAL) - First Qtr 500
FUP0066B : REVISION HIP REPLACEMENT SURGERY (ONLY WITH SPECIFIC APPROVAL) - Next 3 Qtrs 500
FUP0067A : REVISION KNEE REPLACEMENT SURGERY ( ONLY WITH SPECIFIC APPROVAL) - First Qtr 500
FUP0067B : REVISION KNEE REPLACEMENT SURGERY ( ONLY WITH SPECIFIC APPROVAL) - Next 3 Qtrs 500
FUP0068A : TOTAL KNEE REPLACEMENT - First Qtr 500
FUP0068B : TOTAL KNEE REPLACEMENT - Next 3 Qtrs 500
FUP0069A : INBORN ERROR OF METABOLISM - First Qtr 3000
FUP0069B : INBORN ERROR OF METABOLISM - Next 3 Qtrs 1500
FUP0070A : PRIMARY IMMUNO DEFICIENCY DISORDERS - First Qtr 1500
FUP0070B : PRIMARY IMMUNO DEFICIENCY DISORDERS - Next 3 Qtrs 1000
FUP0071A : HYPOPLASTIC/APLASTIC ANEMIA (FANCONI ANEMIA) - First Qtr 900
FUP0071B : HYPOPLASTIC/APLASTIC ANEMIA (FANCONI ANEMIA) - Next 3 Qtrs 500
FUP0072A : PRETERM BABY RDS WITH OR WITHOUT SURFACTANT WITH MECHANICAL VENTILATION/CPAP - First Qtr 1250
FUP0072B : PRETERM BABY RDS WITH OR WITHOUT SURFACTANT WITH MECHANICAL VENTILATION/CPAP - Next 3 Qtrs 750
FUP0073A : TERM BABY-CONGENITAL HEART DISEASE / CONGESTIVE CARDIAC FAILURE/ WITH VENTILATION - First Qtr 1250
FUP0073B : TERM BABY-CONGENITAL HEART DISEASE / CONGESTIVE CARDIAC FAILURE/ WITH VENTILATION - Next 3 Qtrs 750
FUP0074A : TERM BABY - CONGENITAL HEART DISEASE / CONGESTIVE CARDIAC FAILURE/ WITHOUT VENTILATION - First Qtr 1250
FUP0074B : TERM BABY - CONGENITAL HEART DISEASE / CONGESTIVE CARDIAC FAILURE/ WITHOUT VENTILATION - Next 3 Qtrs 750
FUP0075A : ECMO-EXTRACORPOREAL MEMBRANE OXYGENATION - First Qtr 3000
FUP0075B : ECMO-EXTRACORPOREAL MEMBRANE OXYGENATION - Next 3 Qtrs 1500
FUP0076A : MULTI SYSTEM ORGAN FAILURE- WITH OR WITHOUT /ARDS/DIC(BLOOD PRODUCTS) - First Qtr 1800
FUP0076B : MULTI SYSTEM ORGAN FAILURE- WITH OR WITHOUT /ARDS/DIC(BLOOD PRODUCTS) - Next 3 Qtrs 1000
FUP0077A : MULTI SYSTEM ORGAN FAILURE- WITH OR WITHOUT /ARDS/DIC(BLOOD PRODUCTS) - First Qtr 1800
FUP0077B : MULTI SYSTEM ORGAN FAILURE- WITH OR WITHOUT /ARDS/DIC(BLOOD PRODUCTS) - Next 3 Qtrs 1000
FUP0078A : TUMORS (NEONATES/PAEDIATRIC) - First Qtr 500
FUP0078B : TUMORS (NEONATES/PAEDIATRIC) - Next 3 Qtrs 500
FUP0079A : CONGENITAL LUNG LESIONS (CLE, CCAM) - First Qtr 2000
FUP0079B : CONGENITAL LUNG LESIONS (CLE, CCAM) - Next 3 Qtrs 1000
FUP0080A : EXCISION OF BRAIN TUMORS - [PRIMARY /BENIGN ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDESSUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR/ SUPRATENTORIAL- FRONTAL/TEMPORAL /PARIETAL SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) - First Qtr 2000
FUP0080B : EXCISION OF BRAIN TUMORS - [PRIMARY /BENIGN ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDESSUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR/ SUPRATENTORIAL- FRONTAL/TEMPORAL /PARIETAL SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) - Next 3 Qtrs 1000
FUP0081A : EXCISION OF BRAIN TUMORS - [MALIGNANT ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDESSUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR/ SUPRATENTORIAL- FRONTAL/TEMPORAL /PARIETAL SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) - First Qtr 2000
FUP0081B : EXCISION OF BRAIN TUMORS - [MALIGNANT ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDESSUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR/ SUPRATENTORIAL- FRONTAL/TEMPORAL /PARIETAL SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) - Next 3 Qtrs 1000
FUP0082A : EXCISION OF BRAIN TUMORS - [SECONDARIES ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDESSUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR/ SUPRATENTORIAL- FRONTAL/TEMPORAL /PARIETAL SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) - First Qtr 2000
FUP0082B : EXCISION OF BRAIN TUMORS - [SECONDARIES ) (BOTH INTRA AXIAL AND EXTRA AXIAL -INCLUDESSUBTENTORIAL- CP ANGLE BRAINSTEM/CEREBELLAR/ SUPRATENTORIAL- FRONTAL/TEMPORAL /PARIETAL SELLAR/SUPRASELLAR/CRANIOPHARYNGIOMA) - Next 3 Qtrs 1000
FUP0083A : ANEURYSM CLIPPING - First Qtr 2000
FUP0083B : ANEURYSM CLIPPING - Next 3 Qtrs 1000
FUP0084A : STEREOTACTIC PROCEDURES- SURGICAL PROCEDURE - First Qtr 2000
FUP0084B : STEREOTACTIC PROCEDURES- SURGICAL PROCEDURE - Next 3 Qtrs 1000
FUP0085A : TRANS SPHENOIDAL SURGERY (SELLAR/SUPRASELLAR/SKULL BASAL LESION) - First Qtr 2000
FUP0085B : TRANS SPHENOIDAL SURGERY (SELLAR/SUPRASELLAR/SKULL BASAL LESION) - Next 3 Qtrs 1000
FUP0086A : TRANS ORAL SURGERY - First Qtr 2000
FUP0086B : TRANS ORAL SURGERY - Next 3 Qtrs 1000
FUP0087A : PROSTHETIC VALVE THROMBOSIS- THROMBOLYSIS - First Qtr 1500
FUP0087B : PROSTHETIC VALVE THROMBOSIS- THROMBOLYSIS - Next 3 Qtrs 1000
FUP0088A : CORPECTOMY (ANTERIOR /ANTEROLATERAL) AT ALL SPINAL LEVELS - First Qtr 2000
FUP0088B : CORPECTOMY (ANTERIOR /ANTEROLATERAL) AT ALL SPINAL LEVELS - Next 3 Qtrs 1000
FUP0089A : SPINAL FIXATION RODS ,SCREWS,PLATES, ARTIFICIAL DISCS - First Qtr 2000
FUP0089B : SPINAL FIXATION RODS ,SCREWS,PLATES, ARTIFICIAL DISCS - Next 3 Qtrs 1000
FUP0090A : EMBOLISATION OF ANEURYSM/ ANEURYSM COILING BALLOON ASSISTED - First Qtr 2500
FUP0090B : EMBOLISATION OF ANEURYSM/ ANEURYSM COILING BALLOON ASSISTED - Next 3 Qtrs 1500
FUP0091A : DEEP BRAIN STIMULATION - First Qtr 3000
FUP0091B : DEEP BRAIN STIMULATION - Next 3 Qtrs 1500
FUP0092A : D V T - IVC FILTER - First Qtr 3500
FUP0092B : D V T - IVC FILTER - Next 3 Qtrs 1500
FUP0093A : AORTO-BIILIAC-BIFEOMRAL BYPASS WITH VEIN / SYNTHETIC GRAFT - First Qtr 3500
FUP0093B : AORTO-BIILIAC-BIFEOMRAL BYPASS WITH VEIN / SYNTHETIC GRAFT - Next 3 Qtrs 1500
FUP0094A : AXILLO BIFEMORAL BYPASS WITH SYNTHETIC GRAFT - First Qtr 3500
FUP0094B : AXILLO BIFEMORAL BYPASS WITH SYNTHETIC GRAFT - Next 3 Qtrs 1500
FUP0095A : CAROTID ARTERY BYPASS WITH SYNTHETIC GRAFT - First Qtr 3500
FUP0095B : CAROTID ARTERY BYPASS WITH SYNTHETIC GRAFT - Next 3 Qtrs 1500
FUP0096A : NECK VASCULAR INJURY - CAROTID VESSELS - First Qtr 3500
FUP0096B : NECK VASCULAR INJURY - CAROTID VESSELS - Next 3 Qtrs 1500
FUP0097A : ABDOMINAL VASCULAR INJURIES - AORTA, ILLAC ARTERIES, IVC, ILIAC VEINS - First Qtr 3500
FUP0097B : ABDOMINAL VASCULAR INJURIES - AORTA, ILLAC ARTERIES, IVC, ILIAC VEINS - Next 3 Qtrs 1500
FUP0098A : THORACIC VASCULAR INJURIES - First Qtr 3500
FUP0098B : THORACIC VASCULAR INJURIES - Next 3 Qtrs 1500
FUP0101A : PPH SURGICAL MANAGEMENT - HYSTERECTOMY/LIGATION/ EMBOLIZATION - First Qtr 1000
FUP0101B : PPH SURGICAL MANAGEMENT - HYSTERECTOMY/LIGATION/ EMBOLIZATION - Next 3 Qtrs 500
FUP0102A : PPH SURGICAL MANAGEMENT - HYSTERECTOMY/LIGATION/ EMBOLIZATION - First Qtr 2500
FUP0102B : PPH SURGICAL MANAGEMENT - HYSTERECTOMY/LIGATION/ EMBOLIZATION - Next 3 Qtrs 1000
FUP0103A : THALASSEMIA MAJOR/HAEMOGLOBINOPATHIES/ CHELATION THERAPY/SICKLE CELL ANAEMIA - First Qtr 2500
FUP0103B : THALASSEMIA MAJOR/HAEMOGLOBINOPATHIES/ CHELATION THERAPY/SICKLE CELL ANAEMIA - Next 3 Qtrs 2500
FUP0105A : ACUTE RESPIRATORY FAILURE (WITH VENTILATOR - FOR MINIMUM 5 DAYS ) - First Qtr 2500
FUP0105B : ACUTE RESPIRATORY FAILURE (WITH VENTILATOR - FOR MINIMUM 5 DAYS ) - Next 3 Qtrs 1000
FUP0106A : ACUTE PANCREATITIS - CONSERVATIVE MANAGEMENT / MILD / MODERATE / SEVERE MEDICAL / IMAGE GUIDED DRAINAGE OF PANCREATIC COLLECTIONS - First Qtr 2500
FUP0106B : ACUTE PANCREATITIS - CONSERVATIVE MANAGEMENT / MILD / MODERATE / SEVERE MEDICAL / IMAGE GUIDED DRAINAGE OF PANCREATIC COLLECTIONS - Next 3 Qtrs 1500
FUP0107A : ACUTE MI REQUIRING IABP PUMP - First Qtr 4000
FUP0107B : ACUTE MI REQUIRING IABP PUMP - Next 3 Qtrs 2000
FUP0108A : IMMUNOGLOBULIN THERAPY - HEREDITARY MOTOR SENSORY NEUROPATHIES/HEREDITARY SENSORY AND AUTONOMIC NEUROPATHY/PLEXOPATHY (LUMBOSACRAL/ BRACHIAL)/PERIPHERAL NEUROPATHY (WITH NERVE BIOPSY) (HANSEN, NUTRITIONAL, TOXIC, INFECTIVE, IMMUNE)/CARPAL TUNNEL SYNDROME/ACUTE ENTRAPMENT/ COMPRESSIVE NEUROPATHY / GBS/DOG BITE CATEGORY III/OTHERS - First Qtr 4000
FUP0108B : IMMUNOGLOBULIN THERAPY - HEREDITARY MOTOR SENSORY NEUROPATHIES/HEREDITARY SENSORY AND AUTONOMIC NEUROPATHY/PLEXOPATHY (LUMBOSACRAL/ BRACHIAL)/PERIPHERAL NEUROPATHY (WITH NERVE BIOPSY) (HANSEN, NUTRITIONAL, TOXIC, INFECTIVE, IMMUNE)/CARPAL TUNNEL SYNDROME/ACUTE ENTRAPMENT/ COMPRESSIVE NEUROPATHY / GBS/DOG BITE CATEGORY III/OTHERS - Next 3 Qtrs 2000
FUP0109A : GROWTH HORMONE FOR HYPOPITUTARISM - First Qtr 3500
FUP0109B : GROWTH HORMONE FOR HYPOPITUTARISM - Next 3 Qtrs 1500
FUP0110A : LIVER TRANSPLANTATION - First Qtr 45000
FUP0110B : LIVER TRANSPLANTATION - Next 3 Qtrs 35000
FUP0111A : RT. HEPATECTOMY/NON ANATOMICAL RESECTION OF LIVER - First Qtr 2200
FUP0111B : RT. HEPATECTOMY/NON ANATOMICAL RESECTION OF LIVER - Next 3 Qtrs 1200
FUP0112A : LT. HEPATECTOMY/NON ANATOMICAL RESECTION OF LIVER - First Qtr 2200
FUP0112B : LT. HEPATECTOMY/NON ANATOMICAL RESECTION OF LIVER - Next 3 Qtrs 1200
FUP0113A : PORTOCAVAL ANASTOMOSIS - First Qtr 4000
FUP0113B : PORTOCAVAL ANASTOMOSIS - Next 3 Qtrs 2000
FUP0114A : SLEEVE GASTRECTOMY FOR MORBID OBESITY - First Qtr 2500
FUP0114B : SLEEVE GASTRECTOMY FOR MORBID OBESITY - Next 3 Qtrs 1500
FUP0115A : ROUXEN Y GASTRIC BYPASS FOR MORBID OBESITY - First Qtr 2500
FUP0115B : ROUXEN Y GASTRIC BYPASS FOR MORBID OBESITY - Next 3 Qtrs 1500
FUP0116A : DEVASCULARISATION WITH OESOPHAGEAL TRANSECTION - First Qtr 5000
FUP0116B : DEVASCULARISATION WITH OESOPHAGEAL TRANSECTION - Next 3 Qtrs 1500
FUP0118A : THORACO ABDOMINAL ANEURYSM REPAIR WITH RENO / MESENTRIC REVASCULARISATION - First Qtr 2200
FUP0118B : THORACO ABDOMINAL ANEURYSM REPAIR WITH RENO / MESENTRIC REVASCULARISATION - Next 3 Qtrs 1000
FUP0119A : RENAL TRANSPLANTATION SURGERY INCLUDES --POST RENAL TRANSPLANT REJECTION A.STEROID RESISTANT B.STEROID SENSITIVE/ POST RENAL TRANSPLANT INFECTION - LIFE TREATENING TREATMENT FOR FUNGAL INFECTIONS ( LIPOSOMAL AMP -B OR EICHNOCANDINS) , - First Qtr 40000
FUP0119B : RENAL TRANSPLANTATION SURGERY INCLUDES --POST RENAL TRANSPLANT REJECTION A.STEROID RESISTANT B.STEROID SENSITIVE/ POST RENAL TRANSPLANT INFECTION - LIFE TREATENING TREATMENT FOR FUNGAL INFECTIONS ( LIPOSOMAL AMP -B OR EICHNOCANDINS) , - Next 3 Qtrs 33300
FUP0120A : INVESTIGATION AND MANAGEMENT CHRONIC HEPATITIS B / C - First Qtr 1500
FUP0120B : INVESTIGATION AND MANAGEMENT CHRONIC HEPATITIS B / C - Next 3 Qtrs 1500
FUP0121A : INFERIOR VENA CAVA STENTING SINGLE STENT - First Qtr 2000
FUP0121B : INFERIOR VENA CAVA STENTING SINGLE STENT - Next 3 Qtrs 1000
FUP0122A : ACUTE STROKE THROMBOLYSIS (R TPA ) - First Qtr 2000
FUP0122B : ACUTE STROKE THROMBOLYSIS (R TPA ) - Next 3 Qtrs 1000
FUP0123A : RENAL ARTERY EMBOLIZATION WITH MULTIPLE COILS AND MICRO CATHETER - First Qtr 2500
FUP0123B : RENAL ARTERY EMBOLIZATION WITH MULTIPLE COILS AND MICRO CATHETER - Next 3 Qtrs 1000
FUP0124A : CORTICAL VENOUS SINUS THROMBOLYSIS - First Qtr 2500
FUP0124B : CORTICAL VENOUS SINUS THROMBOLYSIS - Next 3 Qtrs 1000
FUP0125A : INFERIOR VENA CAVA FILTER PLACEMENT - First Qtr 3000
FUP0125B : INFERIOR VENA CAVA FILTER PLACEMENT - Next 3 Qtrs 1500
FUP0126A : SUBCLAVIAN, ILIAC, SUPERFICIAL FEMORAL ARTERY STENTING EACH WITH ONE STENT - First Qtr 2500
FUP0126B : SUBCLAVIAN, ILIAC, SUPERFICIAL FEMORAL ARTERY STENTING EACH WITH ONE STENT - Next 3 Qtrs 1200
FUP0127A : TIBIAL ANGIOPLASTY IN CRITICAL LIMB ISCHEMIA - First Qtr 2500
FUP0127B : TIBIAL ANGIOPLASTY IN CRITICAL LIMB ISCHEMIA - Next 3 Qtrs 1200
FUP0128A : MESENTERIC ARTERY ANGIOPLASTY & STENTING IN ACUTE & CHRONIC MESENTERIC ISCHEMIA - SINGLE STENT - First Qtr 2500
FUP0128B : MESENTERIC ARTERY ANGIOPLASTY & STENTING IN ACUTE & CHRONIC MESENTERIC ISCHEMIA - SINGLE STENT - Next 3 Qtrs 1200
FUP0129A : BILIARY DRAINAGE PROCEDURES/ERCP - EXTERNAL DRAINAGE AND STENT PLACEMENT - METALLIC BILIARY STENT / POST OP BILIARY STRICTURE/LEAK/CHOLANGITIS/BILIARY PANCREATITIS/CHOLEDOCHAL CYST/BILE DUCT STONES - First Qtr 2000
FUP0129B : BILIARY DRAINAGE PROCEDURES/ERCP - EXTERNAL DRAINAGE AND STENT PLACEMENT - METALLIC BILIARY STENT / POST OP BILIARY STRICTURE/LEAK/CHOLANGITIS/BILIARY PANCREATITIS/CHOLEDOCHAL CYST/BILE DUCT STONES - Next 3 Qtrs 1000
FUP0130A : INTRA-ARTERIAL THROMBOLYSIS FOR ACUTE ISCHEMIC LIMBS - First Qtr 2000
FUP0130B : INTRA-ARTERIAL THROMBOLYSIS FOR ACUTE ISCHEMIC LIMBS - Next 3 Qtrs 1000
FUP0131A : CENTRAL VENOUS STENTING FOR CENTRAL VENOUS OCCLUSION (BRACHIOCEPHALIC, SUBCLAVIAN VEIN AND SUP VENA CAVA) SINGLE METALLIC STENT - First Qtr 2500
FUP0131B : CENTRAL VENOUS STENTING FOR CENTRAL VENOUS OCCLUSION (BRACHIOCEPHALIC, SUBCLAVIAN VEIN AND SUP VENA CAVA) SINGLE METALLIC STENT - Next 3 Qtrs 1200
FUP0132A : ENDOVASCULAR INTERVENTION FOR SALVAGING HEMODIALYSIS AV FISTULA - First Qtr 2000
FUP0132B : ENDOVASCULAR INTERVENTION FOR SALVAGING HEMODIALYSIS AV FISTULA - Next 3 Qtrs 1000
FUP0133A : BALLOON RETROGRADE TRANSVENOUS OBLITERATION OF BLEEDING GASTRIC VARICES (BRTO) - First Qtr 3500
FUP0133B : BALLOON RETROGRADE TRANSVENOUS OBLITERATION OF BLEEDING GASTRIC VARICES (BRTO) - Next 3 Qtrs 1500
FUP0134A : PREOPERATIVE PORTAL VEIN EMBOLIZATION FOR LIVER TUMORS - First Qtr 2000
FUP0134B : PREOPERATIVE PORTAL VEIN EMBOLIZATION FOR LIVER TUMORS - Next 3 Qtrs 1000
FUP0135A : CHEMO EMBOLIZATION FOR LIVER TUMORS USING DRUG AND PVA OR DC BEADS - First Qtr 2000
FUP0135B : CHEMO EMBOLIZATION FOR LIVER TUMORS USING DRUG AND PVA OR DC BEADS - Next 3 Qtrs 1000
FUP0136A : TRANS JUGULAR INTRAHEPATIC PORTO SYSTEMIC SHUNT (TIPSS) - First Qtr 3500
FUP0136B : TRANS JUGULAR INTRAHEPATIC PORTO SYSTEMIC SHUNT (TIPSS) - Next 3 Qtrs 1500
FUP0137A : EMBOLIZATION OF PULMONARY AV MALFORMATION - First Qtr 2500
FUP0137B : EMBOLIZATION OF PULMONARY AV MALFORMATION - Next 3 Qtrs 1000
FUP0138A : PREOPERATIVE PROPHYLACTIC TUMOR EMBOLISATION - First Qtr 2000
FUP0138B : PREOPERATIVE PROPHYLACTIC TUMOR EMBOLISATION - Next 3 Qtrs 1000
FUP0139A : EMBOLIZATION OF AV MALFORMATION OF BRAIN PER SITTING WITH ONYX - First Qtr 6000
FUP0139B : EMBOLIZATION OF AV MALFORMATION OF BRAIN PER SITTING WITH ONYX - Next 3 Qtrs 1000
FUP0140A : CAROTID STENTING SINGLE STENT WITH EMBOLIC PROTECTION DEVICE - First Qtr 2000
FUP0140B : CAROTID STENTING SINGLE STENT WITH EMBOLIC PROTECTION DEVICE - Next 3 Qtrs 1000
FUP0141A : INTRACRANIAL VENOUS STENTING - First Qtr 6000
FUP0141B : INTRACRANIAL VENOUS STENTING - Next 3 Qtrs 1000
FUP0142A : INTRACRANIAL ARTERIAL STENTING - First Qtr 6000
FUP0142B : INTRACRANIAL ARTERIAL STENTING - Next 3 Qtrs 1000
FUP0143A : PERIPHERAL STENT GRAFT FOR PERIPHERAL ANEURYSMS AND AV FISTULA - First Qtr 2500
FUP0143B : PERIPHERAL STENT GRAFT FOR PERIPHERAL ANEURYSMS AND AV FISTULA - Next 3 Qtrs 1200
FUP0144A : EMBOLIZATION OF CARATICO-CAVERNOUS FISTULA - First Qtr 6000
FUP0144B : EMBOLIZATION OF CARATICO-CAVERNOUS FISTULA - Next 3 Qtrs 1000
FUP0145A : PLAIN SIMPLE COILING OF ANEURYSM - First Qtr 2500
FUP0145B : PLAIN SIMPLE COILING OF ANEURYSM - Next 3 Qtrs 1500
FUP0146A : ILIAC / IVC STENTING / HIGH END VASCULAR REVASCULARISATION PROCEDURE - First Qtr 2500
FUP0146B : ILIAC / IVC STENTING / HIGH END VASCULAR REVASCULARISATION PROCEDURE - Next 3 Qtrs 1200
FUP0147A : VENOUS / POLY TETRA FLUORO ETHYLENE PATCH ANGIOPLASTY - First Qtr 2500
FUP0147B : VENOUS / POLY TETRA FLUORO ETHYLENE PATCH ANGIOPLASTY - Next 3 Qtrs 1200
FUP0148A : HEPATIC VEIN ANGIOPLASTY AND STENTING - First Qtr 3000
FUP0148B : HEPATIC VEIN ANGIOPLASTY AND STENTING - Next 3 Qtrs 1500
FUP0149A : MINIMAL ACCESS SURGERY- VALVE REPLACEMENT - First Qtr 3500
FUP0149B : MINIMAL ACCESS SURGERY- VALVE REPLACEMENT - Next 3 Qtrs 2500
FUP0150A : MINIMAL ACCESS SURGERY- CABG - First Qtr 2000
FUP0150B : MINIMAL ACCESS SURGERY- CABG - Next 3 Qtrs 1000
FUP0151A : MULTI ORGAN RESECTION FOR ANY GI CANCERS - First Qtr 1500
FUP0151B : MULTI ORGAN RESECTION FOR ANY GI CANCERS - Next 3 Qtrs 1000
FUP0152A : VISCERAL ARTERY ANEURSYM REPAIR / RENAL ARTERY ANEURYSM REPAIR - First Qtr 2500
FUP0152B : VISCERAL ARTERY ANEURSYM REPAIR / RENAL ARTERY ANEURYSM REPAIR - Next 3 Qtrs 1500
FUP0153A : HYBRID / OPEN INCLUDING COVERED STENT PLACEMENT - UNILATERAL - First Qtr 2500
FUP0153B : HYBRID / OPEN INCLUDING COVERED STENT PLACEMENT - UNILATERAL - Next 3 Qtrs 1200
FUP0154A : HYBRID / OPEN INCLUDING COVERED STENT PLACEMENT - BILATERAL - First Qtr 2000
FUP0154B : HYBRID / OPEN INCLUDING COVERED STENT PLACEMENT - BILATERAL - Next 3 Qtrs 2000
CM0100-N : BREAST CANCER - TAMOXIFEN 100
CM0100-O : BREAST CANCER - AROMATASE INHIBITORS 1000
CM0100-P : BREAST CANCER - Zoledronic Acid for skeletal metastasis 2700
CM0124-c : PROSTATE CANCER - Zoledronic Acid for skeletal metastasis 2700
CM0955-O : Multiple Myeloma - Zoledronic Acid 2700
CM0100-a-III : BREAST CANCER - Paclitaxel (Preceeded by Dose Dense AC - 4 cycles) ; (Day 1: Paclitaxel 175mg/m2) Repeat cycle - every 21 days for 4 cycles 7000
CM0100-a-IV : BREAST CANCER - Paclitaxel (Preceeded by Dose Dense AC - 4 cycles) ; (Day 1: Paclitaxel 80mg/m2) Repeat cycle - weekly for 12 cycles 3500
CM0101-a-IV : BLADDER CANCER - Radiosensitizing - Cisplatinc + 5-FU ; Days 1, 2, 3, 15, 16, and 17: IV hydration at a rate of 500mL/hour; followed by 5-FU 400mg/m2 IV push; followed by cisplatin 15mg/m2 IV over 1 hour as induction and consolidation therapy 9800
CM0101-a-V : BLADDER CANCER -Radiosensitizing - Cisplatin + paclitaxel ; Days 1, 8, and 15: Paclitaxel 50mg/m2 ; Day 1-3, 8-10, 15-17: Cisplatin 15mg/m2; followed by twice-daily radiotherapy for 8 days 18400
CM0101-a-VI : BLADDER CANCER -Radiosensitizing - 5-FU + mitomycin32 ; Day 1 of radiotherapy: Mitomycin 12mg/m2 IV bolus, plus ; Week 1 (fractions 1-5) and Week 4 (fractions 16-20) of radiotherapy: 5-FU 500mg/m2 continuous IV infusion (10 days total) 15100
CM0101-c : BLADDER CANCER - Concurrent Cisplatin; Cisplatin 40mg/m2 IV once weekly for up to 5 cycles 1800
CM0103 : OESOPHAGEAL CANCER 0
CM0103-v: ESOPHAGEAL CANCER - Concurrent Cisplatin; Cisplatin 40mg/m2 IV once weekly for up to 5 cycles 1800
CM0105 : COLORECTAL CANCER 0
CM0106 : OSTEOSARCOMA/ BONE TUMORS 0
CM0106-vi : Other bone tumors - Mesenchymal Chordosarcoma VIDE (vincristine + ifosfamide + doxorubicin + etoposide) ; Day 1: Vincristine 1.4mg/m2 (max 2mg), ; Days 1-3: Doxorubicin 20mg/m2 IV + ifosfamide 3mg/m2 IV + mesna 3g/m2 + etoposide 150mg/m2 IV. ; Repeat cycle every 3 weeks for up to 6 cycles. 9200
CM0110 : Neuroblastoma ALL STAGES 0
CM0114-i-b-1 : EWINGS SARCOMA - Induction Treatment - VAC/IE - VAC ; Day 1: Vincristine 2mg/m2 (max 2mg) IV, doxorubicin 75mg/m2 IV bolus, cyclophosphamide 1,200mg/m2 IV, mesna. ; Dactinomycin 1.25mg/m2 IV can be substituted for doxorubicin when a total doxorubicin dose of 375mg/m2 is reached. 4600
CM0114-i-b-2 : EWINGS SARCOMA - Induction Treatment - VAC/IE - IE ; IE cycles ; Days 1-5: Ifosfamide 1,800mg/m2 IV + mesna + etoposide 100mg/m2 IV. ; Repeat each cycle every 3 weeks for 17 cycles. 6000
CM0114-i-e : EWINGS SARCOMA - Induction Treatment - VACA ; Day 1: Vincristine 1.5mg/m2 IV + cyclophosphamide 1,200mg/m2 IV + mesna ; Days 1, 3, and 5: Dactinomycin 0.5mg/m2 IV ; Days 2 and 4: Doxorubicin 30mg/m2 IV. ; Repeat cycle every 21 days for 10 cycles. 4600
CM0117-e : VULVAL CANCER - Cisplatin + 5FU ; Days 1 and 29: Cisplatin 50mg/m2 IV ; Days 2-5, and 30-33: 5-FU 1,000mg/m2 IV 11100
CM0128-ii-c-1 : BRAIN CARCINOMA - Systemic Therapy for Anaplastic Gliomas - Concurrent Temozolomide (with RT) - followed by adjuvant temozolomide ; Daily oral temozolomide (75mg/m2/day, 7 days per week from the first to the last day of radiotherapy) 7200
CM0128-ii-c-2 : BRAIN CARCINOMA - Systemic Therapy for Anaplastic Gliomas - adjuvant temozolomide - preceeded by Concurrent Temozolomide (with RT) ; Temozolomide 150-200mg/m2/day for 5 days. ; Repeat cycle every 28 days for 6 cycles 2100
CM0130 I a : RENAL CELL CARCINOMARENAL CELL CARCINOMA - First-line Therapy for Patients with Predominantly Clear Cell Histology - Pazopanib ; Pazopanib 800mg orally once daily 19250
CM0130 I b : RENAL CELL CARCINOMARENAL CELL CARCINOMA - First-line Therapy for Patients with Predominantly Clear Cell Histology - Sunitinib ; Sunitinib 50mg orally daily for 4 weeks, followed by 2 weeks off. 29250
CM0130 I c : RENAL CELL CARCINOMARENAL CELL CARCINOMA - First-line Therapy for Patients with Predominantly Clear Cell Histology - Bevacizumab + IFN-alpha ; Bevacizumab 10mg/kg IV every 2 weeks + IFN-alpha. 66750
CM0130 I d : RENAL CELL CARCINOMARENAL CELL CARCINOMA - First-line Therapy for Patients with Predominantly Clear Cell Histology - Sorafenib ; Sorafenib 400mg orally twice daily 3650
CM0130 II a : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Subsequent Therapy for Patients with Predominantly Clear Cell Carcinoma - Everolimus ; Everolimus 10mg orally once daily 37250
CM0130 II b : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Subsequent Therapy for Patients with Predominantly Clear Cell Carcinoma - Pazopanib ; Pazopanib 800mg orally once daily 19250
CM0130 II c : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Subsequent Therapy for Patients with Predominantly Clear Cell Carcinoma - Sorafenib ; Sorafenib 400mg orally twice daily 3650
CM0130 II d : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Subsequent Therapy for Patients with Predominantly Clear Cell Carcinoma - Sunitinib ; Sunitinib 50mg orally daily for 4 weeks, followed by 2 weeks off. 29250
CM0130 II e : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Subsequent Therapy for Patients with Predominantly Clear Cell Carcinoma - Bevacizumab ; Bevacizumab 10mg/kg IV every 2 weeks. 66250
CM0130 III a : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Systemic Therapy for Patients with Non-Clear Cell Histology - Sunitinib ; Sunitinib 50mg orally daily for 4 weeks, followed by 2 weeks off. 29250
CM0130 III b : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Systemic Therapy for Patients with Non-Clear Cell Histology - Bevacizumab ; Bevacizumab 10mg/kg IV every 2 weeks. 66250
CM0130 III c : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Systemic Therapy for Patients with Non-Clear Cell Histology - Everolimus ; Everolimus 10mg orally once daily 37250
CM0130 III d : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Systemic Therapy for Patients with Non-Clear Cell Histology - Erlotinib ; Erlotinib 150mg orally once daily 3400
CM0130 III e : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Systemic Therapy for Patients with Non-Clear Cell Histology - Pazopanib ; Pazopanib 800mg orally once daily 19250
CM0130 III f : RENAL CELL CARCINOMARENAL CELL CARCINOMA - Systemic Therapy for Patients with Non-Clear Cell Histology - Sorafenib ; Sorafenib 400mg orally twice daily 3650
CM0130 IV: RENAL CELL CARCINOMARENAL CELL CARCINOMA - Other Regimen (May be chosen for any other internationally approved Curative regimen with submission of substantiating Documents) 10000
CM0131-i-g : UNKNOWN PRIMARY - Adenocarcinoma - mFOLFOX ; Day 1: Oxaliplatin 85mg/m2 IV over 2 hours + leucovorin 400mg/m2 IV over 2 hours + 5-FU 400mg/m2 IV bolus then ; Days 1 and 2: 5-FU 1200mg/m2 (total 2400mg/m2 over 46-48 hours) IV continuous infusion. ; Repeat cycle every 2 weeks for 24 cycles 8000
CM0131-i-h : UNKNOWN PRIMARY - Adenocarcinoma - CapeOX ; Day 1: Oxaliplatin 130mg/m2 IV over 2 hours ; Day 1-14: Capecitabine 850-1000mg/m2 orally twice daily. ; Repeat cycle every 3 weeks for 16 cycles. 6500
CM0131-i-i : UNKNOWN PRIMARY - Adenocarcinoma - Irinotecan + carboplatin ; Day 1: Carboplatin AUC 5mg per min/mL IV ; Days 1, 8, and 15: Irinotecan 60mg/m2 IV. ; Repeat cycle every 4 weeks for up to 6 cycles 7700
CM0131-ii-c : UNKNOWN PRIMARY - Squamous cell carcinoma -Paclitaxel + carboplatin ; Day 1: Carboplatin AUC 6mg per min/mL IV over 30 minutes + paclitaxel 200mg/m2 IV over 3 hours. ; Repeat cycle every 3 weeks for 8 cycles in responding patients and for 6 cycles maximum in patients with stable disease 7200
CM0131-ii-d : UNKNOWN PRIMARY - Squamous cell carcinoma -Cisplatin + gemcitabine ; Day 1: Cisplatin 100mg/m2 IV ; Day 1 and 8: Gemcitabine 1250mg/m2 IV. ; Repeat every 3 weeks for 4 cycles. 5250
CM0131-ii-e : UNKNOWN PRIMARY - Squamous cell carcinoma -mFOLFOX ; Day 1: Oxaliplatin 85mg/m2 IV over 2 hours + leucovorin 400mg/m2 IV over 2 hours + 5-FU 400mg/m2 IV bolus then ; Days 1 and 2: 5-FU 1200mg/m2 (total 2400mg/m2 over 46-48 hours) IV continuous infusion. ; Repeat cycle every 2 weeks for 24 cycles. 8000
CM0131-ii-f : UNKNOWN PRIMARY - Squamous cell carcinoma -Paclitaxel + cisplatin ; Day 1: Paclitaxel 175mg/m2 IV + cisplatin 60mg/m2 IV. ; Repeat cycle every 3 weeks. 6450
CM0131-ii-g : UNKNOWN PRIMARY - Squamous cell carcinoma -Docetaxel + carboplatin ; Day 1: Docetaxel 75mg/m2 IV over 30 minutes + carboplatin AUC 5mg per min/mL IV over 30 minutes. ; Repeat cycle every 3 weeks for 8 cycles 8700
CM0131-ii-h : UNKNOWN PRIMARY - Squamous cell carcinoma -Docetaxel + cisplatin ; Day 1: Docetaxel 60mg/m2 IV + cisplatin 80mg/m2 IV. ; Repeat cycle every 3 weeks for 2 cycles and an additional 4 cycles until disease progression is demonstrated 5040
CM0131-ii-i : UNKNOWN PRIMARY - Squamous cell carcinoma -Docetaxel + cisplatin ; Day 1: Docetaxel 75mg/m2 IV + cisplatin 75mg/m2 IV. ; Repeat cycle every 3 weeks for up to 6 cycles. 3820
CM0131-ii-j : UNKNOWN PRIMARY - Squamous cell carcinoma -Cisplatin + fluorouracil ; Days 1-5: Cisplatin 20mg/m2 IV ; Days 1-5: Fluorouracil 700mg/m2/day IV via continuous infusion over 24 hours. ; Repeat cycle every 4 weeks for 3 cycles. 7050
CM0694-II-d : ERCP and Stent (plastic) 20250
CM0694-II-e : ERCP and Stent (SEMS) 44550
CM0694-II-f : POST OP BILIARY STRICTURE 28350
CM0707-I-A : ACUTE MILD PANCREATITIS - CONSERVATIVE MANAGEMENT 24300
CM0707-I-B : ACUTE MODERATE PANCREATITIS - CONSERVATIVE MANAGEMENT 32400
CM0707-I-C : ACUTE SEVERE PANCREATITIS - CONSERVATIVE MANAGEMENT 45320
CM0630 B -II-c : MIXED CONNECTIVE TISSUE DISEASE - WITH GANGRENE ON IV PROSTACYCLIN 5670
CM0630 B -II-d : MIXED CONNECTIVE TISSUE DISEASE - PNEUMOCOCCAL VACCINATION 4050
CM0631A-II -a : VASCULITIS - PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE 2430
CM0631A-II -b : VASCULITIS - PULSE CYCLOPHOSPHAMIDE THERAPY 2430
CM0630 A-I-a-ii : MIXED CONNECTIVE TISSUE DISEASE- PULSE CYCLOPHOSPHAMIDE THERAPY 2430
CM0630 A-I-b-ii :MIXED CONNECTIVE TISSUE DISEASE-METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE 2430
CM0630 B -II-a : MYCOPHENOLATE MOFETIL INDUCTION 4860
CM0630 B -II-b : MYCOPHENOLATE MOFETIL MAINTENANCE 2430
CM0630 B -II-e : MIXED CONNECTIVE TISSUE DISEASE-(METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE/ PULSE CYCLOPHOSPHAMIDE THERAPY/ MYCOPHENOLATE MOFETIL INDUCTION/MYCOPHENOLATE MOFETIL MAINTENANCE/ WITH GANGRENE ON IV PROSTACYCLIN/ PNEUMOCOCCAL VACCIN 24300
CM0631A-II-c : VASCULITIS (PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE/ PULSE CYCLOPHOSPHAMIDE THERAPY )(including Diagnostic evaluation - 1st time) 9720
CM0707-II-A : ACUTE MILD PANCREATITIS - CONSERVATIVE MANAGEMENT 24300
CM0707-II-B : ACUTE MODERATE PANCREATITIS - CONSERVATIVE MANAGEMENT 32400
CM0707-II-C : ACUTE SEVERE PANCREATITIS - CONSERVATIVE MANAGEMENT 45320
CM0881 A-I-a : THALASSEMIA MAJOR (upto) 5670
CM0931-I-B : MANAGEMENT CHRONIC HEPATITIS B / C - ENTECAVIR 1 MG 30 TABS 1800
CM0931-I-C : MANAGEMENT CHRONIC HEPATITIS B / C - ENTECAVIR 0.5MG 30 TABS 3500
CM0931-I-F : MANAGEMENT CHRONIC HEPATITIS B / C - SOFOSBUVIR 400 MG 28 TABS 2000
CM0931-I-H : MANAGEMENT CHRONIC HEPATITIS B / C - SOFOSBUVIR 400 MG 28 TABS + VELPATASVIR 100 28 TABS 6000
CM0931-II-B : MANAGEMENT CHRONIC HEPATITIS B / C - ENTECAVIR 1 MG 30 TABS 4500
CM0931-II-D : MANAGEMENT CHRONIC HEPATITIS B / C - TELBUVUDINE 600MG 30 TABS 16000
CM0931-II-F : MANAGEMENT CHRONIC HEPATITIS B / C - SOFOSBUVIR 400 MG 28 TABS 11000
CM0931-I-ii : INVESTIGATION OF CHRONIC HEPATITIS B / C (VIRAL LOAD) 10000
CM0931-II-I : MANAGEMENT CHRONIC HEPATITIS B / C - SOFOSBUVIR 400 MG 28 TABS + LEDIPASVIR 90 28 TABS 15000
CM0931-II-i i: INVESTIGATION OF CHRONIC HEPATITIS B / C (VIRAL LOAD) 10000
CM0931-I-J : MANAGEMENT CHRONIC HEPATITIS B / C INTERFERON WILL BE APPROVED BASED ON DOSAGE) 1000
CM0879-I-a :LAPAROSCOPIC - ECTOPIC RESECTION 17294
CM0629-II-a : OBSCURE BLEED - Conservative management including Capsule endoscopy 24300
CM0629-II-b : OBSCURE BLEED - Conservative 8100
CM0629-II-c : NON VARICEAL BLEED - CLIPPING 24300
CM0629-II-d : NON VARICEAL BLEED - ARGON PLASMA COAGULATION 37382
CM0629-II-e : NON VARICEAL BLEED - CONSERVATIVE 8100
CM0774 A : LAPROSCOPIC ASSISTED VAGINAL HYSTERECTOMY 16241
CM0820-I-A : Amputation of AK / BK 24300
CM0820-I-B : Amputation of AE / BE 20250
CM0820-I-C : Amputation of Fore-Foot 12150
CM0820-I-E : Amputation of Toes 5670
CM0820-I-F : Amputation of Fingers 8100
CM0820-I-G : Trans Meta-Tarsal Amputation 12150
CM0879-I-b :LAPROTOMY - ECTOPIC RESECTION 9720
CM0898 A : COLONIC PULL THROW 40500
CM0898 B : COLOPLASTY 24300
CM0898 C : ABDOMINAL RESECTION 32400
CM0905-IA : CYST EXCISION WITH HEPATIC JEJUNOSTOMY/ BILIARY DRAINAGE 36450
CM0905-IB : CYST EXCISION WITHOUT HEPATIC JEJUNOSTOMY/ BILIARY DRAINAGE 28350
CM0774 B : LAPROSCOPIC ASSISTED VAGINAL HYSTERECTOMY 16241
CM0952A-I-iii-j : Chronic Myeloid Leukemia (CML) - Other Regimen 10000
CM0952A-II-z : Acute Myeloid Leukemia (AML) - Other Regimen 10000
CM0183a : Neck/ Shaft Of Femur ORIF 18023
CM0183b : IM Nailing 12150
CM0183c : Shaft of Other Long Bones (Humerus) 13770
CM0183d : Tibia 12150
CM0183e : Radius, Fibula, Ulna (ORIF) 12150
CM0183f : Clavicle ( CRIF) (Displaced) 6480
CM0183g : Clavicel (ORIF) (Displaced) 9720
CM0183h : Both Bones of Forearm, Both Bones of Leg (Fixation of both bones) 18023
CM0183i : Bimalleolar Fracture 12150
CM0183j : Closed Reduction and Proximal Femoral nailing / Screw Fixation 12150
CM0183k : Closed Reduction and Pinning / Tens Nail 9720
CM0183l : Closed Reduction and Internal Fixation with K wire 4860
CM0183m : Tension Band wiring 9720
CM0184a : Neck/ Shaft Of Femur ORIF 18023
CM0184b : IM Nailing 12150
CM0184c : Shaft of Other Long Bones (Humerus) 13770
CM0184d : Tibia 12150
CM0184e : Radius, Fibula, Ulna (ORIF) 12150
CM0184f : Clavicle ( CRIF) (Displaced) 6480
CM0184g : Clavicel (ORIF) (Displaced) 9720
CM0184h : Both Bones of Forearm, Both Bones of Leg (Fixation of both bones) 18023
CM0184i : Bimalleolar Fracture 12150
CM0184j : Closed Reduction and Proximal Femoral nailing / Screw Fixation 12150
CM0184k : Closed Reduction and Pinning / Tens Nail 9720
CM0184l : Closed Reduction and Internal Fixation with K wire 4860
CM0184m : Tension Band wiring 9720
CM0186A-i : IMPLANT EXIT- K-WIRES - Single 1215
CM0186A-ii : IMPLANT EXIT- K-WIRES - Multiple 2025
CM0186A-iii : IMPLANT EXIT- SCREWS - single (Open) 3240
CM0186A-iv : IMPLANT EXIT- SCREWS - Multiple (Open) 6075
CM0186A-v : IMPLANT EXIT- SCREWS - single (Closed) 1620
CM0186A-vi : IMPLANT EXIT- SCREWS - Multiple (Closed) 2430
CM0186A-vii : IMPLANT EXIT- OTHER MINOR IMPLANTS (TENS, TBW, etc) - Solitary 4050
CM0186A-viii : IMPLANT EXIT- OTHER MINOR IMPLANTS (Pins / TENS, TBW, etc) - Multiple 6278
CM0186B-i : IMPLANT EXIT- PLATES (Open) 10125
CM0186B-ii : IMPLANT EXIT- Femoral Screws / IM Nails / Rush Nail (Open) 8100
CM0186B-iii : IMPLANT EXIT- SPINE IMPLANTS - upto 2 levels(complete exit) (eg- L2-L3, L3-L4) 14175
CM0186B-iv : IMPLANT EXIT- SPINE IMPLANTS - upto 2 levels(partial exit) (eg- L2-L3, L3-L4) 12150
CM0186B-v : IMPLANT EXIT- SPINE IMPLANTS - > 2 levels(complete exit) (eg- L2-L3, L3-L4, L4-L5) 16605
CM0186B-vi : IMPLANT EXIT- SPINE IMPLANTS - > 2 levels(partial exit) (eg- L2-L3, L3-L4, L4-L5) 14175
CM0186B-vii : IMPLANT EXIT- Bipolar, etc 12150
CM0186B-viii : IMPLANT EXIT - Other Major implants 10125
CM0187a : ARTHRODESIS OF JOINTS - HIP 21870
CM0187b : ARTHRODESIS OF JOINTS - SHOULDER / KNEE 16200
CM0187c : ARTHRODESIS OF JOINTS - ELBOW/ ANKLE / WRIST 12150
CM0187d : ARTHRODESIS OF JOINTS - ANKLE - Triple Arthrodesis 12960
CM0187e : ARTHRODESIS OF JOINTS - HAND / FOOT 8100
CM0192-A : ILIZAROV RING FIXATOR APPLICATION-FEMUR - DEFORMITY CORRECTION / LIMB LENGTHENING 20250
CM0192-B : ILIZAROV RING FIXATOR APPLICATION- TIBIA - DEFORMITY CORRECTION / LIMB LENGTHENING 14580
CM0192-C : PLATING/EXTERNAL FIXATOR/K WIRES - to choose either CM0183 /CM0184 / CM0191 / CM0202 0
CM0193-A : SURGERY FOR NEGLECTED CTEV/RECURRENT CTEV/RESISTANT CTEV BY JESS FIXATION 36248
CM0195-A : KNEE LIGAMENT RECONSTRUCTION-ACL RECONSTRUCTION/PCL RECONSTRUCTION 24300
CM0195-B : KNEE LIGAMENT RECONSTRUCTION-MPFL RECONSTRUCTION 20250
CM0204- b : ACETABULAR FRACTURES 23895
CM0204-a : CORRECTION SACRO ILLIAC JOINT 16200
CM0625-II A : AMPUTATIONS - FORE QUARTER 32400
CM0625-II B : AMPUTATIONS - HIND QUARTER / Internal Hemipelvectomy 32400
CM0625-II C : AMPUTATIONS - HIND QUARTER / External Hemipelvectomy 32400
CM0722-II-A : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MAXILLA 8121
CM0722-II-B : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE 8121
CM0722-II-C : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA- INTERDENTAL WIRING 4050
CM0807-a - I : Cementing (only as Addon) 4050
CM0807-a : BONE RESECTION 20250
CM0807-b - I : Cementing (only as Add on) 4050
CM0807-b : BONE Curettage 12150
CM0820-II-A : Amputation of AK / BK 24300
CM0820-II-B : Amputation of AE / BE 20250
CM0820-II-C : Amputation of Fore-Foot 12150
CM0820-II-E : Amputation of Toes 5670
CM0820-II-F : Amputation of Fingers 8100
CM0820-II-G : Trans Meta-Tarsal Amputation 12150
CM0820-III-a : Amputation of great toe 5670
CM0820-III-b : Amputation toe- single 4050
CM0820-III-c : Amputation toe- Multiple 5670
CM0820-III-d : Amputation of Finger - single 5670
CM0820-III-e : Amputation of Finger - Multiple 8100
CM0820-III-f : Transmetatarsal Amputation 8100
CM0861-II-A : POSTERIOR DISCECTOMY WITH SPACER/IMPLANT/VERTEBROPLASTY (open) 34830
CM0861-II-B : POSTERIOR DISCECTOMY WITH BONE GRAFT 26730
CM0861-II-C : POSTERIOR DISCECTOMY WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY 20250
CM0212-A : HYPOPLASTIC ANEMIA 2511
CM0212-B : APLASTIC ANEMIA 2511
CM0212-C : FANCONI ANEMIA 2511
CM0213-A : NECROTISING ENTEROCOLITIS - NON VENTILATED 16200
CM0213-B : CLINICAL SEPSIS /HYPERBILIRUBINEMIA - choose appropriate neonatal package 0
CM0715A : CLEFT LIP - Unilateral 8100
CM0715B : CLEFT LIP - Bilateral 13041
CM0718A-II : MICROTIA/ANOTIA - STAGE 1 8100
CM0718A-IV : MICROTIA/ANOTIA - STAGE 1 (with artificial Implant) 20574
CM0158- a : Medical management only (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) upto 4050
CM0158- b : 10 to 20% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application 8100
CM0158- c : 20 to 30% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application 15390
CM0158- d : 30 to 40% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application including ICU stay 22680
CM0158- e : upto 10% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application including ICU stay 5670
CM0159 - b : 20 to 30% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG 24300
CM0159- a : UPTO 20% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG 16200
CM0159- c : 30 to 40% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG including ICU stay 32400
CM0160A : 40 TO 50% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application 40338
CM0161A : 40 to 50% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG 49410
CM0162A : 50 TO 60% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application including ICU stay 60588
CM0163- a : 50 TO 60% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG including ICU stay 65610
CM0164-a : ABOVE 60% burns (approval will be based on the area of burns as per clinical Photograph, Diagrammatic representation may be accepted for private parts) Medical management + collagen application + Surgical Treatment SSG including ICU stay 81000
CM0165a : Fingers 3240
CM0165b : Neck - MILD (LESS THAN 1/3RD) - Flexion and extension videos to be uploaded 12150
CM0165c : Others (elbow, thigh, etc) 8100
CM0165d : Pressure Garments and Physiotherapy (2 weeks) - only as an addon 4860
CM0166a : Fingers 4860
CM0166b : Neck - MODERATE (1/3RD TO 2/3RD) - Flexion and extension videos to be uploaded 20250
CM0166c : Others (elbow, thigh, etc) 12150
CM0166d : Pressure Garments and Physiotherapy (2 weeks) - only as an addon 4860
CM0167a : Fingers 6480
CM0167b : Neck - SEVERE (> 2/3RD) - Flexion and extension videos to be uploaded 26730
CM0167c : Others (elbow, thigh, etc) 16200
CM0167d : Pressure Garments and Physiotherapy (2 weeks) - only as an addon 4860
CM0168a : PTOSIS Single 12150
CM0168b : PTOSIS Bilateral 19845
CM0175a : Polydactyly - Simple 4050
CM0175b : Polydactyly - Bone and neurovascular bundle 8100
CM0175c : Simple syndactyly (per finger) 4860
CM0175d : Complex syndactyly (per finger) 8100
CM0175e : Radial clubhand 12150
CM0175f : Ulnar clubhand 12150
CM0175g : Macrodactyly 14175
CM0175h : Others minor (will be paid as per procedure) Upto 8100
CM0175i : Others major (will be paid as per procedure) Upto 21546
CM0176a : PRESSURE SORE RECONSTRUCTIVE SURGERY - SSG - per 10 sq CM (upto) 9720
CM0176b : PRESSURE SORE RECONSTRUCTIVE SURGERY - Single Rotation FLAP - per 10 sq CM (upto) - per 10 sq CM (upto) 12150
CM0176c : PRESSURE SORE RECONSTRUCTIVE SURGERY - Bilateral FLAP - per 10 sq CM (upto) 16200
CM0176d : PRESSURE SORE RECONSTRUCTIVE SURGERY - Musculocutaneous flap - per 10 sq CM (upto) 24300
CM0176e : PRESSURE SORE RECONSTRUCTIVE SURGERY - Fasciocutaneous flap - per 10 sq CM (upto) 20250
CM0176f : PRESSURE SORE RECONSTRUCTIVE SURGERY - Tensor fascia lata flap - per 10 sq CM (upto) 35559
CM0176g : others (payable based on the procedure carried out) (upto) 35559
CM0177a : single closure 16200
CM0177b : Fascia Lata Graft 28350
CM0177c : Mesh Closure 20250
CM0177d : Local Flaps 16200
CM0177e : Myocutaneous Transposition 28350
CM0177f : TRAM 35559
CM0178a : Unilateral 8100
CM0178b : Bilateral 12960
CM0716A : CLEFT PALATE - Partial 12150
CM0716B : CLEFT PALATE - Complete 16281
CM0716C : CLEFT PALATE - Sub mucous (before 1.5 years of age) 16281
CM0717A : Simple syndactyly (Per finger) 4860
CM0717B : Complex Syndactyly (Per finger) 8100
CM0717C : Simple syndactyly (Per finger) 12150
CM0717D : Complex Syndactyly (Per hand) 21546
CM0718A-I : MICROTIA/ANOTIA - STAGE 1 20574
CM0718A-III : MICROTIA/ANOTIA - STAGE 1 (with cartilage autograft) 12150
CM0722-III-A : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MAXILLA 8121
CM0722-III-B : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE 8121
CM0722-III-C : RECONSTRUCTIVE SURGERY FOLLWING FACIO MAXILLARY TRAUMA, FRACTURE MANDIBLE, MAXILLA- INTERDENTAL WIRING / Archbar 4050
CM0814 : VASCULAR MALFORMATIONS- (INCLUDING SCLEROTHERAPY/ REDUCTION SURGERY) 0
CM0814-II-a : VASCULAR MALFORMATIONS- Sclerotherapy 10530
CM0814-II-b : VASCULAR MALFORMATIONS- Sclerotherapy and Excision 21263
CM0816A-i : FLAP SURGERIES CUTANEOUS- UPPER LIMB 16200
CM0816A-ii : FLAP SURGERIES CUTANEOUS- LOWER LIMB 9720
CM0861-I-A : POSTERIOR DISCECTOMY WITH SPACER/IMPLANT/VERTEBROPLASTY (open) 34830
CM0861-I-B : POSTERIOR DISCECTOMY WITH BONE GRAFT 26730
CM0861-I-C : POSTERIOR DISCECTOMY WITHOUT BONE GRAFT/SPACER/IMPLANT/VERTEBROPLASTY 20250
CM0862A : ANTERIOR DISCECTOMY WITHOUT IMPLANTS 24300
CM0862B : ANTERIOR DISCECTOMY WITH IMPLANTS 34952
CM0947 A : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES ( MORE THAN 4 LEVELS) 60750
CM0947 B : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES LESS THAN 4 LEVELS) 40500
CM0947C : SPINAL DEFORMITY STABILISATION/CORRECTION PROCEDURES WITH VERTERBROPLASTY 36450
CM0629-I-a : OBSCURE BLEED - Conservative management including Capsule endoscopy 24300
CM0629-I-b : OBSCURE BLEED - Conservative 8100
CM0629-I-c : NON VARICEAL BLEED - CLIPPING 24300
CM0629-I-d : NON VARICEAL BLEED - ARGON PLASMA COAGULATION 37382
CM0629-I-e : NON VARICEAL BLEED - CONSERVATIVE 8100
CM0694-I-a : BILIARY DRAINAGE PROCEDURES - T- Tube 16200
CM0694-I-b : BILIARY DRAINAGE PROCEDURES - Choledocojejunostomy 28350
CM0694-I-c : BILIARY DRAINAGE PROCEDURES - Hepaticojejunostomy 36450
CM0694-I-d : ERCP and Stent (plastic) 20250
CM0694-I-e : ERCP and Stent (SEMS) 44550
CM0694-I-f : POST OP BILIARY STRICTURE 28350
CM0905-IBI : CYST EXCISION WITHOUT HEPATIC JEJUNOSTOMY/ BILIARY DRAINAGE 28350
CM0905-IIA : CYST EXCISION WITH HEPATIC JEJUNOSTOMY/ BILIARY DRAINAGE 36450
CM0775-I-a : SALPINGO OOPHORECTOMY B/L- FOR CA 20534
CM0775-I-b : SALPINGO OOPHORECTOMY U/L FOR CA 14580
CM0625-I A : AMPUTATIONS - FORE QUARTER 32400
CM0625-I B : AMPUTATIONS - HIND QUARTER / Internal Hemipelvectomy 32400
CM0625-I C : AMPUTATIONS - HIND QUARTER / External Hemipelvectomy 32400
CM0765A : GLOSSECTOMY (HEMI/PARTIAL) WITH RECONSTRUCTION- FOR CANCER 24300
CM0765B : GLOSSECTOMY (TOTAL) WITH RECONSTRUCTION- FOR CANCER 32279
CM1038 : Drainage of Subdiaphramatic Abscess 8100
CM1046 : Excision Benign Tumor -Small intestine 12150
CM1067 : IlieoSigmoidostomy 13770
CM1076 : Repair of Common Bile Duct 12150
CM1083 : Pharyngectomy& Reconstruction - Total 16200
CM1084 : Tracheoplasty (Throat) 12150
CM1088 : Estlander Operation (lip) 5670
CM1093 : Operation for carcinoma lip- cheek advancement 9720
CM1096 : Resection Enucleation of Adenoma (lung) 8100
CM1099 : Thoracoplasty 16200
CM1100 : Thoracoscopic Segmental Resection 20250
CM1101 : Thoracoscopic Sympathectomy 12150
CM1191 : Abdominal Perineal neo construction Cx + Uteria + Vagina 16200
CM1198 : Brust abdomen repair 11340
CM1212 : Intrauterine transfusions 8100
CM1220 : Fixator with Joint Arthrolysis 16200
CM1223 : Pelvic Osteotomy with fixation with plaster 24300
CM1231 : Endopyelotomy (retrograde with laser/bugbee) 20250
CM1232 : Endopyelotomy (antegrade with laser/bugbee) 22680
CM1233 : Ureterocalycostomy Open 20250
CM1234 : Ureterocalycostomy Laparoscopic 24300
CM1235 : Uretero-ureterostomy Open 20250
CM1236 : Uretero-ureterostomy Laparoscopic 28350
CM1252 : Holmium Laser Prostatectomy 32400
CM1276 : Duroplasty - Endogenous 10125
CM1277 : Duroplasty - Exogenous 32603
CM1279 : Micro discectomy - Cervical 32400
CM1283 : Cranial Nerve Anastomosis 25920
CM1286 : Additonal clip for Aneurysm Clipping 12150
CM1288 : Superficial Temporal Artery (STA): middle cerebral artery (MCA) or (other EC - IC) Bypass procedure 48600
CM1323 : Microvascular reconstruction 36450
CM1325 : Axillary dissection 12150
CM1326 : Enucleation of pancreatic neoplasm 20250
CM1362 : Blood and blood component transfusion (admission for a diagnostic procedure leading to treatment requiring admission, e.g. bone marrow and bone biopsy, endoscopy, liver biopsy, bronchoscopy, CT/MRI under GA, broncho-alveolar lavage, lumbar punctu 0
CM1413 : Blood and blood component transfusion up to a limit of 2 days(admission for a diagnostic procedure leading to treatment requiring admission, e.g. bone marrow and bone biopsy, endoscopy, liver biopsy, bronchoscopy, CT/MRI under GA, broncho-alveola 0
CM1419 A : Acute lymphoblastic leukemia: Supportive care/ rehabilitation - Blood & Blood Product transfusions / granulocyte colony-stimulating factor (G-CSF) / Granulocyte-macrophage colony-stimulating factor (GM-CSF) / TPN 20000
CM1420 A : Acute myeloid leukemia: Supportive care/ rehabilitation - Blood & Blood Product transfusions / granulocyte colony-stimulating factor (G-CSF) / Granulocyte-macrophage 30000
CM1421 A : Hodgkin Lymphoma (Favorable group): Supportive care/ rehabilitation - Blood & Blood Product transfusions / granulocyte colony-stimulating factor (G-CSF) / Granulocyte-macrophage colony-stimulating factor (GM-CSF) / TPN 15000
CM1422 A : Hodgkin Lymphoma (unfavorable group): Supportive care/ rehabilitation - Blood & Blood Product transfusions / granulocyte colony-stimulating factor (G-CSF) / Granulocyte-macrophage colony-stimulating factor (GM-CSF) / TPN 25000
CM1423 A : Non-Hodgkin Lymphoma: Supportive care/ rehabilitation - Blood & Blood Product transfusions / granulocyte colony-stimulating factor (G-CSF) / Granulocyte-macrophage colony-stimulating factor (GM-CSF) / TPN 50000
CM1429 A : Chronic Myeloid Leukemia : supportive care/ rehabilitation - Blood & Blood Product transfusions / granulocyte colony-stimulating factor (G-CSF) / Granulocyte-macrophage colony-stimulating factor (GM-CSF) / TPN 20000
CM1430 A : Terminally Ill - Pain management (Opioid therapy / Neural Blocks / epidural or Intrathecal infusions / Antero-lateral spinal cordotomy (tractotomy) by RFA) / TPN - Per month 3000