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وزارة الصحة: قرار وزاري رقم ١٢٦ / ٢٠٢٣ بإصدار لائحة رسوم الخدمات العلاجية

2023/126 126/2023 ٢٠٢٣/١٢٦ ١٢٦/٢٠٢٣

تحميل English

استنادا إلى المرسوم السلطاني رقم ٣٦ / ٢٠١٤ بتحديد اختصاصات وزارة الصحة واعتماد هيكلها التنظيمي،

وإلى لائحة رسوم الخدمات العلاجية الصادرة بالقرار الوزاري رقم ٥٥ / ٢٠٠٩،

وإلى موافقة مجلس الوزراء،

وإلى موافقة وزارة المالية،

وبناء على ما تقتضيه المصلحة العامة.

تقرر

المادة الأولى

يعمل بأحكام لائحة رسوم الخدمات العلاجية، المرفقة.

المادة الثانية

يلغى القرار الوزاري رقم ٥٥ / ٢٠٠٩ المشار إليه، كما يلغى كل ما يخالف اللائحة المرفقة أو يتعارض مع أحكامها.

المادة الثالثة

ينشر هذا القرار في الجريدة الرسمية، ويعمل به اعتبارا من ٣ من سبتمبر ٢٠٢٣م.

صدر في: ١٨ من ذي القعدة ١٤٤٤هـ
الموافق: ٧ من يونيو ٢٠٢٣م

د. هلال بن علي بن هلال السبتي
وزير الصحة 

نشر في عدد الجريدة الرسمية رقم (١٤٩٧) الصادر في ١١ من يونيو ٢٠٢٣م.

لائحة رسوم الخدمات العلاجية

الفصل الأول
تعريفات وأحكام عامة

المادة (١)

في تطبيق أحكام هذه اللائحة يكون للكلمات والعبارات الآتية المعنى المبين قرين كل منها، ما لم يقتض سياق النص معنى آخر:

الوزارة:

وزارة الصحة.

الوزير:

وزير الصحة.

المؤسسات الصحية:

المراكز والمجمعات الصحية والمستشفيات التابعة للوزارة.

الخدمات العلاجية:

كافة الخدمات التي تقدمها المؤسسات الصحية.

الرسوم:

جميع الرسوم الواردة في هذه اللائحة.

المادة (٢)

تلتزم المؤسسات الصحية بتقديم الخدمات العلاجية لكافة المواطنين والمقيمين في سلطنة عمان، وتسهيل إجراءات حصولهم على هذه الخدمات وفقا لأحكام هذه اللائحة.

المادة (٣)

يجب على جميع المؤسسات الصحية اتخاذ كافة الإجراءات اللازمة لضمان تحصيل الرسوم المقررة في هذه اللائحة على نحو لا يحول دون علاج الحالات الطارئة.

المادة (٤)

فيما عدا الإصابات الناتجة عن الحوادث المرورية والحالات التي تشملها تغطية تأمينية، تتمتع الفئات الآتية بالخدمات العلاجية مجانا:

أ – العمانيون.

ب – مواطنو دول مجلس التعاون لدول الخليج العربية المقيمون في سلطنة عمان مدة لا تقل عن (٣) ثلاثة أشهر.

 ج – الأجانب المتزوجون من عمانيات ويشمل ذلك: الزوج، الأبناء المولودين للزوجة العمانية من هذا الزواج.

 د – الأجنبيات المتزوجات من عمانيين.

 هـ – الوالدان الأجنبيان للعماني المقيمان معه في سلطنة عمان.

 و – الوالدان والأبناء الأجانب للزوج أو الزوجة الأجانب ذوي الأصول العمانية المقيمين معه في سلطنة عمان.

 ز – الأجانب العاملون في الحكومة وأسرهم وفقا لعقود خدمتهم.

ح – أعضاء السلك الدبلوماسي الأجانب وأفراد أسرهم وفقا للجداول السنوية الصادرة عن وزارة الخارجية.

المادة (٥)

استثناء من حكم المادة (٤) من هذه اللائحة تقدم مجانا خدمات الرعاية الصحية الأولية، وخدمات الطوارئ والإسعاف، وعلاج الحالات الطارئة الحرجة التي تحتاج إلى الإقامة في المؤسسة الصحية، للفئات الآتية:

أ – مواطني دول مجلس التعاون لدول الخليج العربية المقيمين في سلطنة عمان مدة تقل عن (٣) ثلاثة أشهر.

ب – أعضاء الوفود الزائرة لسلطنة عمان بما في ذلك وفود الأندية الرياضية والثقافية المدعوة عن طريق الجهات الرسمية.

المادة (٦)

يجب على الفئات المنصوص عليها في المادة (٤) من هذه اللائحة تقديم المستندات الآتية عند تلقي الخدمة العلاجية:

 أ – العمانيين: البطاقة الشخصية، أو جواز السفر.

ب – مواطني دول مجلس التعاون لدول الخليج العربية: البطاقة الشخصية أو جواز السفر.

ج – الزوج الأجنبي: محرر مثبت للزواج، ومصادق عليه، أو موثق قانونا.

د – الأجانب الموظفين في الحكومة وأسرهم: بطاقة العلاج المجاني.

هـ – الدبلوماسيين: البطاقة الدبلوماسية.

و – ذوي الأصول العمانية: شهادة إثبات صادرة من وزارة الداخلية.

ز – الوالدين الأجنبيين للعمانيين: بطاقة إقامة.

ح – أعضاء الوفود الزائرة لسلطنة عمان: خطاب من الجهة المستضيفة.

المادة (٧)

تعفى الفئات الآتية من سداد كافة الرسوم:

أ – المرضى المصابون بأحد الأمراض الوبائية أو المعدية التي تهدد الصحة العامة والتي يصدر بها قرار من الوزير، ومخالطوهم، والمشتبه في إصابتهم.

ب – المتبرعون بالدم عند تبرعهم.

ج – المتبرعون بالأعضاء لإحدى الفئات الواردة في المادة (٤) من هذه اللائحة عدا البند (ز).

د – الأشخاص المستفيدون من الضمان الاجتماعي وأسرهم، ويشمل المدرجين على قائمة الانتظار لدى وزارة التنمية الاجتماعية، على أن يتم تقديم بطاقة الضمان الاجتماعي أو رسالة رسمية تفيد أن الحالة مدرجة على قوائم الانتظار للتمتع بميزات الضمان الاجتماعي.

هـ – المحولون من وزارة التنمية الاجتماعية لاستكمال إجراءات الحصول على خدمات الضمان الاجتماعي.

و – اليتامى المسجلون في المؤسسات التابعة لوزارة التنمية الاجتماعية.

ز – الأشخاص العمانيون ذوو الإعاقة المسجلون لدى وزارة التنمية الاجتماعية.

ح – الأطفال العمانيون دون سن الثانية.

ط – الأطفال المستفيدون من برنامج التحصين الموسع.

ي – جميع المستفيدين من حملات التطعيم الوطنية.

ك – العمانيون المستفيدون من برامج الفحص المبكر.

ل – الحوامل العمانيات.

م – العمانيات المستفيدات من خدمات رعاية الأمومة والطفولة، بما فيها برنامج المباعدة بين الولادات.

ن – العمانيون مرضى الغسيل الكلوي المزمن ومرضى السرطان.

س – نزلاء السجون، والمحبوسون احتياطيا.

ع – الفحص الطبي للكشافة والمرشدات.

ف – عمليات الختان للمعتنقين للدين الإسلامي في سلطنة عمان.

المادة (٨)

تعفى الحالات الآتية من سداد رسوم التسجيل والمقابلة:

أ – الطلاب المحولون من المدارس أثناء ساعات الدوام الرسمي للمدرسة.

ب – المرضى العمانيون غير المقتدرين ماديا على سداد الرسوم في الأحوال التي تقدرها المؤسسة الصحية.

ج – المرضى الذين يراجعون المؤسسة الصحية ذاتها في اليوم ذاته بناء على توصية الطبيب المعالج لإعادة المقابلة أو لعلاج المرض ذاته.

المادة (٩)

تعفى الحالات الآتية من سداد رسوم الترقيد:

أ – المصابون أو المشتبه في إصابتهم بأحد الأمراض المعدية أو الوبائية المرقدون في غرف أو أسرة العزل، إلى أن يتم شفاؤهم أو يثبت عدم إصابتهم بأي من هذه الأمراض.

ب – المرقدون في غرف أو أسرة العزل بناء على توصية من الطبيب المعالج واعتماد مدير المؤسسة الصحية.

ج – المرقدون بغرض إجراء عملية جراحية أو تدخل جراحي أو إجراء طبي إذا غادر المريض المؤسسة الصحية دون إجرائها بسبب نقص في الأدوية أو الأجهزة أو الأطباء أو أي سبب آخر يعود للمؤسسة ذاتها.

ولا يشمل ذلك حالة تأجيل العملية أو الإجراء العلاجي بسبب المضاعفات الطبية غير المتوقعة أو التي لا يمكن تفاديها، أو بسبب رفض المريض أو من يرافقه إجراء العملية الجراحية أو التدخل الجراحي أو الإجراء الطبي.

د – المرقدون بطريق الخطأ وفقا لما يقرره رئيس القسم الإكلينيكي في المؤسسة الصحية، وبموافقة مدير المؤسسة الصحية.

المادة (١٠)

استثناء من الرسوم المقررة بموجب هذه اللائحة، يتم تحصيل رسوم الخدمات العلاجية عن الحالات التي تشملها تغطية تأمينية ومنها الحالات المحولة من المؤسسات الصحية الخاصة لإجراء أي من الفحوصات الطبية الإكلينيكية أو المخبرية أو الإشعاعية الموجودة في المؤسسات الصحية، وفقا للأسعار المعتمدة.

المادة (١١)

لا تصرف للمرضى غير المرقدين من الفئات غير المستحقة للخدمات العلاجية المجانية أدوية من صيدليات المؤسسات الصحية إلا بعد تقديم ما يثبت عدم توفر الأدوية الموصوفة لهم في الصيدليات الخاصة.

وفي هذه الحالة، يلتزم هؤلاء المرضى بسداد قيمة الدواء وفقا للقوائم المعتمدة من الوزارة، مضافا إليها (٢٠٪) عشرون بالمائة من قيمة الدواء كرسوم خدمة.

المادة (١٢)

يجوز للمؤسسات الصحية إعارة المرضى المستلزمات الطبية الواردة في القوائم المعتمدة لدى الوزارة مع تحصيل الضمان المالي الذي تحدده الوزارة، على أن يتم رد هذا الضمان عند إعادة الجهاز بحالة سليمة في التاريخ المحدد من الطبيب المعالج بعد خصم قيمة الاستهلاك، شريطة تقديم إيصال الإيداع.

وفي حالة فقدان أو تلف أو تعذر إعادة تلك المستلزمات في الموعد المحدد لذلك، لا يتم رد الضمان المالي.  وتستثنى من تقديم هذا الضمان الفئات الآتية:

أ – الحالات المستفيدة من الضمان الاجتماعي وأسرهم، شريطة تقديم بطاقة الضمان الاجتماعي.

ب – المدرجون في قائمة الانتظار لدى وزارة التنمية الاجتماعية، شريطة تقديم رسالة رسمية تفيد أن الحالة مدرجة على قوائم الانتظار للتمتع بميزات الضمان الاجتماعي.

ج – المحولون من وزارة التنمية الاجتماعية لاستكمال إجراءات الحصول على خدمات الضمان الاجتماعي.

د – اليتامى المسجلون في المؤسسات التابعة لوزارة التنمية الاجتماعية.

هـ – نزلاء السجون والمحبوسون احتياطيا.

الفصل الثاني
الرسوم

أولا: رسوم التسجيل والمقابلة

المادة (١٣)

يجب تسجيل جميع الحالات التي يتم استقبالها في المؤسسات الصحية وإصدار بطاقة صحية لها، وتجدد سنويا عند أول زيارة من كل عام ميلادي.

المادة (١٤)

يتم تحصيل رسوم التسجيل والتجديد والمقابلة وفقا للملحق رقم (١) المرفق بهذه اللائحة.

المادة (١٥)

يجب على جميع الحالات المحولة من مؤسسة صحية إلى مؤسسة صحية أخرى أو من تخصص أو قسم إلى آخر في المؤسسة الصحية ذاتها سداد رسوم المقابلة للتخصص المحول إليه المريض، ويشمل ذلك التحويلات من أقسام الطوارئ.

المادة (١٦)

يلتزم المرضى المرقدون غير المستحقين للخدمات العلاجية المجانية بسداد رسم مقابلة الطبيب للمقابلة الأولى فقط دون المقابلات التالية في حال التحويل إلى تخصص آخر، سواء كان التحويل داخل المؤسسة الصحية المرقد فيها المريض أو في مؤسسة صحية أخرى.

المادة (١٧)

يجب على جميع الحالات المحولة من المؤسسات الصحية الخاصة سداد رسمي التسجيل والمقابلة.

ثانيا: رسوم الترقيد

المادة (١٨)

يتم تحصيل رسوم الترقيد وفقا للملاحق أرقام (٢ ،٣، ٤) المرفقة بهذه اللائحة.

المادة (١٩)

تحسب رسوم الترقيد من تاريخ الترقيد إلى تاريخ الخروج من المؤسسة الصحية، مع عدم حساب يوم الخروج إذا تم قبل الساعة الثانية ظهرا.

ويحسب الترقيد يوما واحدا إذا تم الترقيد والخروج في ذات اليوم.

المادة (٢٠)

استثناء من حكم المادة (١٨) من هذه اللائحة، إذا تم نقل المريض من الجناح العام إلى أجنحة أو غرفة خاصة بناء على توصية إكلينيكية يحصل الرسم في هذه الحالة وفقا لرسم الترقيد في الجناح العام.

المادة (٢١)

يتم تحصيل رسم الترقيد للمريض الذي تقرر المؤسسة الصحية نقله من الغرفة الخاصة إلى الجناح العام وفقا للملاحق أرقام (٢، ٣، ٤) من هذه اللائحة على النحو الآتي:

أ – يتم تحصيل رسم الترقيد للغرفة الخاصة إذا مضى على ترقيد المريض فيها (١٢) اثنتا عشرة ساعة أو أكثر، سواء كان المريض مستحقا أم غير مستحق للخدمات العلاجية المجانية.

ب – يتم تحصيل رسم الترقيد للجناح العام إذا لم يمض على ترقيد المريض في الغرفة الخاصة (١٢) اثنتا عشرة ساعة وذلك للمرضى غير المستحقين للخدمات العلاجية المجانية، ولا يتم تحصيل رسم عن الترقيد في الجناح العام إذا انتهى الترقيد قبل الساعة (١٢) الثانية عشرة ظهرا من اليوم التالي.

وفي جميع الأحوال، يجوز للمؤسسة الصحية نقل المريض المرقد في غرفة خاصة إلى الجناح العام في حالة إذا ما احتاجت المؤسسة إلى استخدام الغرفة الخاصة لأغراض العزل أو أي أسباب أخرى تراها ضرورية.

المادة (٢٢)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية بسداد رسم ترقيد لحالات العناية النهارية وحالات الملاحظة في أقسام الطوارئ إذا تجاوزت مدة الإقامة (٦) ست ساعات، ويكون الرسم على النحو الآتي:

أ – مساويا لرسوم الترقيد في المؤسسة الصحية ذاتها (الجناح العام، غرفة خاصة، جناح خاص) لحالات العناية النهارية.

ب – مساويا لرسم الترقيد في الجناح العام في المؤسسة الصحية ذاتها وحالات الملاحظة في أقسام الطوارئ.

المادة (٢٣)

يلتزم المرضى بسداد دفعة مقدمة من قيمة رسم الترقيد وفقا للملحق رقم (٥) المرفق بهذه اللائحة، وفي حالة استنفاد (٥٠٪) خمسين بالمائة من المبلغ، يلتزم المريض بإيداع مبلغ إضافي يعادل المبلغ المستنفد.

المادة (٢٤)

يلتزم المرضى المرقدون غير المستحقين للخدمات العلاجية المجانية، بالإضافة إلى الدفعة المقدمة من رسوم الترقيد وفقا للملحق رقم (٥) المرفق بهذه اللائحة، بسداد الآتي:

أ – دفعة مقدمة تعادل قيمة تكاليف العملية الجراحية أو التدخل الجراحي أو الإجراء الطبي.

ب – دفعة مقدمة لا تقل عن مبلغ (٢٥٠) مائتين وخمسين ريالا عمانيا للمرقدين لأسباب علاجية أخرى.

وفي جميع الأحوال، تضاف إلى الدفعات المقدمة لرسوم الترقيد وفقا للملحق رقم (٥) المرفق بهذه اللائحة جميع الرسوم الخاصة بالخدمات العلاجية الأخرى التي يحصل عليها المريض خلال فترة ترقيده.

ثالثا: رسوم العمليات والتدخلات الجراحية وجراحة الأسنان والإجراءات الطبية

المادة (٢٥)

تحصل رسوم العمليات والتدخلات الجراحية وجراحة الأسنان والإجراءات الطبية وفقا للملحق رقم (٦) المرفق بهذه اللائحة، مضافا إليها رسوم التخدير الآتية في حال أجريت العملية أو التدخل الجراحي داخل غرفة العمليات:

أ – التخدير العام (General anesthesia): (١٥٪) من قيمة مجموع رسوم العمليات.

ب – التخدير الجزئي (Regional anesthesia): (١٠٪) من قيمة مجموع رسوم العمليات.

ج – التخدير الموضعي (Local anesthesia): (٥٪) من قيمة مجموع رسوم العمليات.

وفي جميع الأحوال، يجب ألا تقل رسوم التخدير عن مبلغ (١٠٠) مائة ريال عماني.

المادة (٢٦)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية الذين تجرى لهم عدة عمليات أو تدخلات جراحية أو إجراء طبي في وقت واحد أو تحت ذات التخدير، بسداد قيمة العملية أو التدخل أو الإجراء ذي السعر الأعلى، و(٥٠٪) خمسين بالمائة من قيمة أي عملية أخرى سواء أكانت العملية في التخصص ذاته أم في تخصص آخر.

المادة (٢٧)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية بسداد قيمة جميع الزرعات والأجهزة التي يتم زراعتها لهم أثناء العملية أو التدخلات الجراحية الأخرى، وذلك وفقا لقيمتها المعتمدة من الوزارة مضافا إليها (٢٠٪) عشرون بالمائة كرسوم خدمة.

رابعا: رسوم تقويم الأسنان

المادة (٢٨)

تحصل رسوم عمليات تقويم الأسنان (Orthodontics) بنظام الحزمة الواحدة وفقا للملحق رقم (٧) المرفق بهذه اللائحة، بالإضافة إلى أي عملية أو إجراء إضافي آخر خارج محتوى الحزمة، وفقا لقيمتها في الملحق رقم (٦) المرفق بهذه اللائحة.

المادة (٢٩)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية الذين تجرى لهم عمليات تقويم الأسنان بسداد دفعة مقدمة تعادل (٥٠٪) خمسين بالمائة من قيمة العملية، و(٥٠٪) خمسين بالمائة عند استكمال نصف العلاج.

خامسا: رسوم الفحوصات المخبرية

المادة (٣٠)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية بسداد رسوم الفحوصات المخبرية، وفقا للملحق رقم (٨) المرفق بهذه اللائحة.

كما يتم تحصيل الرسم في كل مرة يجرى فيها الفحص المخبري في وحدات العناية المركزة أو أقسام الطوارئ أو الأقسام الأخرى.

المادة (٣١)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية بسداد رسوم الفحوصات المخبرية التي ترسل إلى الخارج، وفقا للرسوم المتعاقد عليها لكل فحص مطلوب إجراؤه، مضافا إليها (٢٠٪) عشرون بالمائة رسوم خدمة.

المادة (٣٢)

تلتزم المؤسسات الصحية الخاصة بسداد رسوم الفحوصات المخبرية التي يتطلب إجراؤها في المؤسسات الصحية، وفقا للملحق رقم (٨) المرفق بهذه اللائحة، كما تلتزم بسداد الرسوم لتلك الفحوصات إذا أرسلت للخارج وفقا للرسوم المتعاقد عليها لكل فحص مضافا إليها (٢٠٪) عشرون بالمائة رسوم خدمة.

سادسا: رسوم الفحوصات والتدخلات الإشعاعية

المادة (٣٣)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية بسداد رسوم الفحوصات والتدخلات الإشعاعية، حسب الملحق رقم (٩) المرفق بهذه اللائحة.

سابعا: رسوم خدمات بنك الدم

المادة (٣٤)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية بسداد رسوم خدمات بنوك الدم وفقا للملحق رقم (١٠) المرفق بهذه اللائحة.

وللمرضى غير المستحقين للخدمات العلاجية المجانية الذين يحملون بطاقة متبرع بالدم سارية المفعول الحصول على وحدات الدم ومشتقاته مجانا.

ثامنا: رسوم التأهيل الطبي

المادة (٣٥)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية بسداد رسوم التأهيل الطبي (العلاج الطبيعي، العلاج المهني، علاج اللغة والنطق، الأطراف الصناعية) وفقا للملحق رقم (١١) المرفق بهذه اللائحة.

وفي جميع الأحوال، يتم تحصيل رسم لكل علاج على حدة في حالة إجراء عدة علاجات خلال الجلسة الواحدة.

تاسعا: رسوم الخدمات الإضافية

المادة (٣٦)

يلتزم الحجاج والمعتمرون بسداد رسوم الفحوصات والتطعيم بنظام الحزمة الواحدة، ويتم تحصيل رسوم الحجاج والمعتمرين وفقا للملحق رقم (١٢) المرفق بهذه اللائحة.

وتستثنى الحالات المستفيدة من الضمان الاجتماعي وأسرهم بمن في ذلك المدرجون على قائمة الانتظار لدى وزارة التنمية الاجتماعية من سداد هذه الرسوم، على أن يتم تقديم بطاقة الضمان الاجتماعي أو رسالة رسمية تفيد بأن الحالة مدرجة على قوائم الانتظار.

المادة (٣٧)

يتم تحصيل رسم استخدام سيارة الإسعاف، ورسم مقابل تحنيط جثث الموتى، ورسم مقابل حفظ جثث الموتى من الفئات غير المستحقة للخدمات العلاجية المجانية وفقا للملحق رقم (١٢) المرفق بهذه اللائحة.

المادة (٣٨)

يتم تحصيل رسوم عن التقارير الطبية التي يتم إصدارها بناء على طلب من المرضى والمرتبطة بالخدمات العلاجية والتشخيصية المقدمة لهم وفقا للملحق رقم (١٢) المرفق بهذه اللائحة، وتستثنى من سداد هذه الرسوم الحالات المستفيدة من الضمان الاجتماعي وأسرهم، والمدرجون على قائمة الانتظار لدى وزارة التنمية الاجتماعية.

المادة (٣٩)

يلتزم المرضى غير المستحقين للخدمات العلاجية المجانية عند طلب نتائج الفحوصات الطبية على قرص مدمج بسداد رسوم وفقا للملحق رقم (١٢) المرفق بهذه اللائحة.

الملحق رقم (١)
رسوم التسجيل والتجديد والمقابلة

الخدمة مستحق للعلاج مجانا (ر.ع) غير مستحق للعلاج مجانا (ر.ع)
التسجيل / التجديد سنويا ١ ٥
المقابلة للمرة الواحدة ٢٠٠ بيسة أ. مركز صحي أو مجمع صحي أو مستشفى محلي
العيادة العامة ٥
العيادات التخصصية ١٠
قسم الطوارئ ١٠
ب. مستشفيات الرعاية الصحية الثانوية
العيادات العامة ١٠
العيادات التخصصية ١٥
قسم الطوارئ ٢٠
ج. مستشفيات الرعاية الصحية
العيادات التخصصية ٢٥
قسم الطوارئ ٣٠

الملحق رقم (٢)
رسوم الترقيد في مستشفيات الرعاية الصحية الثالثية

الفئة مستحق للعلاج مجانا (ر.ع) / يوم) غير مستحق للعلاج مجانا (ر.ع / يوم)
جناح كبار الشخصيات / الجناح الذهبي ٣٥
جناح التمريض الخاص / الجناح الفضي / أجنحة خاصة ٣٠ ١٠٠
غرفة خاصة في الجناح العام ٢٠ ٧٠
الجناح العام ٣٠
عناية الاعتماد العالي (High Dependency) ٥٠
وحدة العناية المركزة للكبار والأطفال (ICU/PICU) ٨٠
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية عالية) ٨٠
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية متوسطة) ٥٠
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية منخفضة) ٣٠
وحدة العناية القلبية (CCU) Cardiac Care Unit ٦٠
وحدة العناية القلبية المنخفضة (PCCU) Post Cardiac Care Unit ٤٠
وحدة عناية ما بعد جراحة القلب (PSCC) Post-Surgical Cardiac Care ٨٠
وحدة الحروق (Burn Unit) ٦٠

الملحق رقم (٣)
رسوم الترقيد في مستشفيات الرعاية الصحية الثانوية

الفئة مستحق للعلاج مجانا (ر.ع) / يوم) غير مستحق للعلاج مجانا (ر.ع / يوم)
الجناح الخاص ١٥ ٧٥
غرفة خاصة في الجناح العام ١٥ ٧٠
الجناح العام ٢٠
عناية الاعتماد العالي (High Dependency) ٤٠
وحدة العناية المركزة للكبار والأطفال (ICU/PICU) ٧٠
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية عالية) ٧٠
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية متوسطة) ٤٥
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية منخفضة) ٣٠
وحدة العناية القلبية (CCU) Cardiac Care Unit ٥٠
وحدة العناية القلبية المنخفضة (PCCU) Post Cardiac Care Unit ٣٠
وحدة عناية ما بعد جراحة القلب (PSCC) Post-Surgical Cardiac Care ٧٠
وحدة الحروق (Burn Unit) ٥٠

الملحق رقم (٤)
رسوم الترقيد في مستشفيات الرعاية الصحية الأولية

الفئة مستحق للعلاج مجانا (ر.ع) / يوم) غير مستحق للعلاج مجانا (ر.ع / يوم)
غرفة خاصة ١٠ ٢٠
الجناح العام ١٠
عناية (الاعتماد العالي -High Dependency) ٢٠
وحدة العناية المركزة للكبار والأطفال (ICU/PICU) ٣٥
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية عالية) ٤٠
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية متوسطة) ٣٠
وحدة العناية المركزة بالأطفال الخدج (SCBU) (اعتمادية منخفضة) ٢٠

الملحق رقم (٥)
الدفعات المقدمة من رسوم الترقيد

نوع المستشفى السرير العادي غرفة خاصة جناح تمريض خاص / جناح فضي / جناح خاص جناح كبار الشخصيات / جناح ذهبي
مستحق للعلاج مجانا غير مستحق للعلاج مجانا مستحق للعلاج مجانا غير مستحق للعلاج مجانا مستحق للعلاج مجانا غير مستحق للعلاج مجانا مستحق للعلاج مجانا غير مستحق للعلاج مجانا
مستشفيات الرعاية الصحية الثالثية ٨٠ ١٠٠ ٢٠٠ ١٠٠ ٢٠٠ ١٧٥ غير مستحق
مستشفيات الرعاية الصحية الثانوية ٨٠ ١٠٠ ٢٠٠ ١٧٥ غير مستحق
مستشفيات الرعاية الصحية الأولية ٨٠ ٥٠ ١٠٠

الملحق رقم (٦)
رسوم العمليات والتدخلات الجراحية وجراحة الأسنان والإجراءات الطبية

Specialty
التخصص
Procedure Name
اسم الإجراء
Price (R.O)
القيمة بالريال العماني
General Surgery Breast Biopsy – Percutaneous (e.g. FNA) 50
General Surgery Breast Biopsy – Open 150
General Surgery Breast Abscess Incision & Drainage 200
General Surgery Breast Cyst Aspiration 60
General Surgery Breast Cyst Excision 300
General Surgery Breast Fibroadenoma Excision 300
General Surgery Breast Fat Necrosis Excision 300
General Surgery Breast Fibroadenosis Excision 300
General Surgery Breast Mass Excision 300
General Surgery Breast Lumpectomy/Wide Local Excision 350
General Surgery Breast Lumpectomy Margin Re-excision 200
General Surgery Breast Lumpectomy/Wide Local Excision (with axillary clearance) 550
General Surgery Accessory Nipple Excision 250
General Surgery Breast/Duct/Nipple/ or Areola Lesion Excision (not specified

elsewhere)

300
General Surgery Breast Microdochectomy 300
General Surgery Breast Duct Excision – Total 400
General Surgery Accessory Breast Tissue Excision 800
General Surgery Mastectomy – Subcutaneous 500
General Surgery Mastectomy – Total 600
General Surgery Mastectomy – Total (with axillary clearance) 800
General Surgery Mastectomy (skin-sparing) 1000
General Surgery Mastectomy (nipple-sparing) 1000
General Surgery Mastectomy – Radical 1000
General Surgery Breast Reconstruction – TRAM Flap 1800
General Surgery Breast Reconstruction – Latissimus Dorsi Flap 1800
General Surgery Breast Reconstruction – Free Flap 2800
General Surgery Augmentation Mammoplasty (with prosthetic implant) 800
General Surgery Augmentation Mammoplasty (without prosthetic implant) 600
General Surgery Reduction Mammoplasty 2000
General Surgery Mastopexy 1800
General Surgery Breast Implant Removal 200
General Surgery Nipple-Areola Complex Reconstruction 600
General Surgery Correction of Inverted Nipple 400
General Surgery Thyroid Lobectomy 600
General Surgery Hemithyroidectomy 600
General Surgery Hemithyroidectomy – Endoscopic 800
General Surgery Total Thyroidectomy 800
General Surgery Total Thyroidectomy – Endoscopic 1000
General Surgery Total Thyroidectomy with Central Neck Dissection 1200
General Surgery Total Thyroidectomy with Berry Picking of Nodes 1100
General Surgery Redo Thyroidectomy 800
General Surgery Redo Thyroidectomy with Central Neck Dissection 1200
General Surgery Completion Thyroidectomy 600
General Surgery NOTES Thyroidectomy (natural orifice transluminal endoscopic

surgery)

1000
General Surgery MIVAT Thyroidectomy (minimally invasive video- assisted thyroidectomy) 800
General Surgery Excision of Neck Swelling/Lesion – Anterior/Posterior Triangle 300
General Surgery Thyroid Wound Re-exploration 300
General Surgery Parathyroidectomy for Parathyroid Adenoma 600
General Surgery Minimally Invasive Radio-Guided Parathyroidectomy (MIRGP) 800
General Surgery Parathyroidectomy – Endoscopic 900
General Surgery Total Parathyroidectomy 900
General Surgery Total Parathyroidectomy (with autotransplantation) 1200
General Surgery Parathyroidectomy with Ipsilateral Hemithyroidectomy and

Central Neck Node Dissection (CNND)

1200
General Surgery Parathyroidectomy with Frozen Section and IOPTH Assay 1000
General Surgery Bilateral Neck Exploration (BNE) for Hyperparathyroidism 800
General Surgery Thymectomy with Mediastinal Dissection 1200
General Surgery Thymectomy (cervical approach) 1000
General Surgery Cervical Neurogenic Tumor Excision (e.g. schwannoma,

paraganglioma, pheochromocytoma, neurofibroma)

1500
General Surgery Intra-abdominal Neurogenic Tumor Excision (e.g. schwannoma,

paraganglioma, pheochromocytoma, neurofibroma)

1500
General Surgery Excision of Branchial Cyst 350
General Surgery Excision of Branchial Sinus 350
General Surgery Excision of Branchial Fistula 350
General Surgery Sistrunk Operation – Thyroglossal Cyst 350
General Surgery Sistrunk Operation – Thyroglossal Sinus 350
General Surgery Sistrunk Operation – Thyroglossal Fistula 350
General Surgery Neck Dissection – Radical 900
General Surgery Neck Dissection – Modified Radical 800
General Surgery Neck Dissection – Selective 600
General Surgery Axillary Lymph Node Dissection 700
General Surgery Lymph Node Biopsy (axillary) – Open 200
General Surgery Lymph Node Biopsy (cervical) – Open 250
General Surgery Lymph Node Biopsy (inguinal) – Open 200
General Surgery Lymph Node Biopsy – Needle 50
General Surgery Retroperitoneal Lymph Node Dissection – Laparoscopic 2000
General Surgery Retroperitoneal Lymph Node Dissection – Open 1600
General Surgery Para-aortic Lymph Node Dissection 1500
General Surgery Pelvic Lymph Node Dissection 1500
General Surgery Inguinal Lymph Node Dissection 1000
General Surgery Staging Laparotomy 1500
General Surgery Staging Laparoscopy 1700
General Surgery Adrenalectomy – Open 1200
General Surgery Adrenalectomy – Laparoscopic 1500
General Surgery Adrenalectomy (laparoscopic converted to open surgery) 1500
General Surgery Adrenalectomy – Retroperitoneoscopic 1300
General Surgery Adrenalectomy – Radical with Nephrectomy 2200
General Surgery Inguinal Herniotomy – Unilateral 350
General Surgery Inguinal Herniotomy – Bilateral 550
General Surgery Repair of Uncomplicated Inguinal Hernia – Infant 400
General Surgery Repair of Complicated Inguinal Hernia – Infant 550
General Surgery Repair of Uncomplicated Inguinal Hernia – Other than Infant 450
General Surgery Repair of Complicated Inguinal Hernia – Other than Infant 600
General Surgery Repair of Uncomplicated Inguinal Hernia – Laparoscopic 550
General Surgery Repair of Complicated Inguinal Hernia – Laparoscopic 750
General Surgery Repair of Uncomplicated Incisional/Ventral Hernia (small) 450
General Surgery Repair of Uncomplicated Incisional/Ventral Hernia (large) 650
General Surgery Repair of Uncomplicated Incisional/Ventral Hernia – Laparoscopic 600
General Surgery Repair of Complicated Incisional/Ventral Hernia 700
General Surgery Repair of Complicated Incisional/Ventral Hernia – Laparoscopic 800
General Surgery Repair of Uncomplicated Umbilical Hernia (younger than 5 years) 350
General Surgery Repair of Uncomplicated Umbilical Hernia (5 years or older) 450
General Surgery Repair of Complicated Umbilical Hernia (younger than 5 years) 500
General Surgery Repair of Complicated Umbilical Hernia (5 years or older) 600
General Surgery Repair of Uncomplicated Umbilical Hernia – Laparoscopic 550
General Surgery Repair of Complicated Umbilical Hernia – Laparoscopic 700
General Surgery Repair of Uncomplicated Femoral Hernia 350
General Surgery Repair of Uncomplicated Femoral Hernia – Laparoscopic 450
General Surgery Repair of Complicated Femoral Hernia 500
General Surgery Repair of Complicated Femoral Hernia – Laparoscopic 600
General Surgery Repair of Uncomplicated Lumbar Hernia 550
General Surgery Repair of Complicated Lumbar Hernia 700
General Surgery Repair of Diaphragmatic Hernia (other than hiatal hernia) 2000
General Surgery Repair of Hiatal Hernia 1500
General Surgery Exploratory Laparotomy (without repair) 550
General Surgery Exploratory Laparoscopy (without repair) 700
General Surgery Intra-abdominal Organ/Mass/Lesion Biopsy (not specified

elsewhere) – Open

450
General Surgery Intra-abdominal Organ/Mass/Lesion Biopsy (not specified

elsewhere) – Laparoscopic

600
General Surgery Peritoneal Lavage (continuous irrigation) 400
General Surgery Peritoneal Lavage (operative) 700
General Surgery Intra-abdominal Foreign Body Removal – Open 700
General Surgery Intra-abdominal Foreign Body Removal – Laparoscopic 800
General Surgery Intra-abdominal Bleeding Control – Open 800
General Surgery Intra-abdominal Bleeding Control – Laparoscopic 1000
General Surgery Surgical Drainage of Intra-abdominal Abscess 700
General Surgery Surgical Drainage of Visceral Abscess (not specified elsewhere) 600
General Surgery Surgical Drainage of Intra-abdominal Haematoma 600
General Surgery Intra-abdominal Adhesions Lysis (Adhesiolysis) – Open 600
General Surgery Intra-abdominal Adhesions Lysis (Adhesiolysis) – Laparoscopic 800
General Surgery Intra-abdominal Tumor Cytoreduction/Debulking – Open 1200
General Surgery Intra-abdominal Tumor Cytoreduction/Debulking – Laparoscopic 1400
General Surgery Intra-abdominal Tumor Cytoreduction/Debulking with Intraperitoneal Hyperthermic Chemotherapy – Open 1300
General Surgery Intra-abdominal Tumor Cytoreduction/Debulking with

Intraperitoneal Hyperthermic Chemotherapy – Laparoscopic

1500
General Surgery Intra-abdominal Non-Neurogenic Tumor or Lesion Excision (not

elsewhere specified)

1000
General Surgery Omentum Resection (Omentectomy) 900
General Surgery Mesentery Repair (not elsewhere specified) 1000
General Surgery Mesenteric Cyst/Tumor Resection – Simple or Small Lesion 900
General Surgery Mesenteric Cyst/Tumor Resection – Complex or Large Lesion 1500
General Surgery Celiac Artery Decompression (Resection of Median Arcuate

Ligament)

800
General Surgery Partial Colectomy – Open 1200
General Surgery Right Hemicolectomy – Open 1500
General Surgery Left Hemicolectomy – Open 1500
General Surgery Extended Right Hemicolectomy – Open 1800
General Surgery Extended Left Hemicolectomy – Open 1800
General Surgery Transverse Colectomy – Open 1500
General Surgery Segmoidectomy – Open 1500
General Surgery Anterior Resection of the Rectum – Open 1500
General Surgery Low Anterior Resection of the Rectum – Open 1500
General Surgery Ultra-low Rectal Resection – Open 1600
General Surgery Completion Proctectomy – Open 1500
General Surgery Total Colectomy – Open 2500
General Surgery Pan-proctocolectomy – Open 3000
General Surgery Intersphincteric Abdominoperineal Resection with Pull-Through Coloanal Anastomosis – Open 1800
General Surgery Partial Colectomy – Laparoscopic 1500
General Surgery Right Hemicolectomy – Laparoscopic 1800
General Surgery Left Hemicolectomy – Laparoscopic 1800
General Surgery Extended Right Hemicolectomy – Laparoscopic 2100
General Surgery Extended Left Hemicolectomy – Laparoscopic 2100
General Surgery Transverse Colectomy – Laparoscopic 1800
General Surgery Segmoidectomy – Laparoscopic 1800
General Surgery Anterior Resection of the Rectum – Laparoscopic 1800
General Surgery Lower Anterior Resection of the Rectum – Laparoscopic 1800
General Surgery Ultra-low Rectal Resection – Laparoscopic 1900
General Surgery Completion Proctectomy – Laparoscopic 1800
General Surgery Total Colectomy – Laparoscopic 2800
General Surgery Pan-proctocolectomy – Laparoscopic 3300
General Surgery Intersphincteric Abdominoperineal Resection with Pull-Through

Coloanal Anastomosis – Laparoscopic

2100
General Surgery Ripstein Rectopexy – Open 600
General Surgery Posterior Rectopexy – Open 600
General Surgery Anterior Rectopexy – Open 600
General Surgery Ripstein Rectopexy – Laparoscopic 800
General Surgery Posterior Rectopexy – Laparoscopic 800
General Surgery Anterior Rectopexy – Laparoscopic 800
General Surgery Ileorectal Anastomosis – Open 2500
General Surgery Ileorectal Anastomosis – Laparoscopic 2800
General Surgery Ileocolic Anastomosis – Open 1200
General Surgery Ileocolic Anastomosis – Laparoscopic 1500
General Surgery Ileal Pouch-Anal Anastomosis (single stage operation) – Open 3200
General Surgery Ileal Pouch-Anal Anastomosis (single stage operation) –

Laparoscopic

3500
General Surgery Ileal Pouch-Rectal Anastomosis (single stage operation) – Open 2700
General Surgery Ileal Pouch-Rectal Anastomosis (single stage operation) –

Laparoscopic

3000
General Surgery Ileal Pouch Repair – Minor 900
General Surgery Ileal Pouch Repair – Major 1500
General Surgery Ileostomy Creation – Open 600
General Surgery Ileostomy Creation – Laparoscopic 800
General Surgery Ileostomy Closure – Open 1000
General Surgery Ileostomy Closure – Laparoscopic 1200
General Surgery Colostomy Creation – Open 600
General Surgery Colostomy Creation – Laparoscopic 800
General Surgery Colostomy Closure – Open 1000
General Surgery Colostomy Closure – Laparoscopic 1200
General Surgery Coloplasty (open) 1000 (not including rectal

resection)

General Surgery Coloplasty-Rectal Anastomosis (open) 2000
General Surgery Coloplasty-Anal Anastomosis (open) 2000
General Surgery Coloplasty (laparoscopic) 1200 (not including rectal

resection)

General Surgery Coloplasty-Rectal Anastomosis (laparoscopic) 2300
General Surgery Coloplasty-Anal Anastomosis (laparoscopic) 2300
General Surgery Recto-Vaginal Fistula Repair (trans-rectal approach) 800
General Surgery Recto-Vaginal Fistula Repair (trans-vaginal approach) 700
General Surgery Recto-Vaginal Fistula Repair (combined approach) 1000
General Surgery Colocutaneous Fistula Repair – Open 1200
General Surgery Colocutaneous Fistula Repair – Laparoscopic 1500
General Surgery Enterocutaneous Fistula Repair – Open 1200
General Surgery Enterocutaneous Fistula Repair – Laparoscopic 1500
General Surgery Enteroenteric or Enterocolic Fistula Repair – Open 1400
General Surgery Enteroenteric or Enterocolic Fistula Repair – Laparoscopic 1700
General Surgery Repair of Large Intestine Perforation/Injury – Primary Closure 800
General Surgery Repair of Large Intestine Perforation/Injury – Resection 1200
General Surgery Repair of Small Intestine Perforation/Injury – Primary Closure 1000
General Surgery Repair of Small Intestine Perforation/Injury – Resection 1400
General Surgery Fistula in Ano – Fistulotomy 250
General Surgery Fistula in Ano – Seton Insertion (Loose) 250
General Surgery Fistula in Ano – Seton Insertion (Tight) 250
General Surgery Fistula in Ano – Fistulectomy 300
General Surgery Fistula in Ano – Ligation of Fistula Tract 400
General Surgery Fistula in Ano – Fat Plug Repair of Fistula 400
General Surgery Fistula in Ano – Coring out with Tranrectal Ligation of Internal

Opening

400
General Surgery Wide Excision of Pilonidal Sinus 350
General Surgery Wide Excision of Pilonidal Sinus (with Z Plasty) 400
General Surgery Wide Excision of Pilonidal Sinus (with Lateralization) 400
General Surgery Wide Excision of Pilonidal Sinus (with Rotational Flap) 500
General Surgery Wide Excision of Pilonidal Sinus (with Gluteal Flap) 700
General Surgery Pilonidal Secondary Suturing 200
General Surgery Haemorrhoidectomy (Modified Morgan) 300
General Surgery Haemorrhoidectomy (Ligasure) 350
General Surgery Haemorrhoidectomy (Stapled) 400
General Surgery Haemorrhoid Sclerotherapy 100
General Surgery Haemorrhoid Banding 180
General Surgery Haemorrhoid Banding & Sclerotherapy 220
General Surgery Anal Fissure Repair (Lateral Internal Sphincterotomy) 250
General Surgery Anal Fissure Repair (Fissurectomy) 300
General Surgery Anal Fissure Repair (V-Y Advancement Flap) 350
General Surgery Anoplasty (V-Y Flap) 350
General Surgery Anoplasty (Mucosal Advancement) 350
General Surgery Anoplasty (Skin Advancement) 350
General Surgery Anoplasty (Diamond Flap) 350
General Surgery Anal Cutback 400
General Surgery Anal Transposition 1000
General Surgery Endo-anal Pull-through 1500
General Surgery Anterior Perineal Anorectoplasty 2000
General Surgery Pull-through & Anastomosis – Duhamel procedures 1500
General Surgery Pull-through & Anastomosis – Modified Duhamel procedures 1500
General Surgery Pull-through & Anastomosis – Swenson procedures 1500
General Surgery Pull-through & Anastomosis – Soave procedures 1500
General Surgery Pull-through & Anastomosis – Others 1500
General Surgery Posterior Sagittal Anorectoplasty (PSARP) 2000
General Surgery Repair of Persistent Cloaca 3000
General Surgery Repair of Urogenital Sinus 2000
General Surgery Total Urogenital Mobilization 2000
General Surgery Rectal Prolapse Reduction 50
General Surgery Rectal Prolapse Sclerotherapy 120
General Surgery Rectal Prolapse Repair – Rectopexy 600
General Surgery Rectal Prolapse Repair – Rectopexy & Sigmoid Resection 2100
General Surgery Rectal Prolapse Repair – Sigmoid Resection 1800
General Surgery Rectal Prolapse Repair – Thiersch Operation 300
General Surgery Rectal Prolapse Repair – Delorme Operation 450
General Surgery Rectal Prolapse Repair – Perineal Proctosigmoidectomy 2000
General Surgery Incision & Drainage of Pilonidal Abscess/Cyst 100
General Surgery Incision & Drainage of Anorectal Abscess – Perianal 150
General Surgery Incision & Drainage of Anorectal Abscess – Ischiorectal 250
General Surgery Incision & Drainage of Anorectal Abscess – Intersphincteric 150
General Surgery Incision & Drainage of Anorectal Abscess – Others (deep) 300
General Surgery Incision & Drainage of Anorectal Abscess – Others (superficial) 150
General Surgery Rectal Biopsy (suction) 100
General Surgery Rectal Biopsy 50
General Surgery Anorectal Myomectomy 400
General Surgery Anal Polyp or Benign Tumor Removal 100
General Surgery Anal Injury/Tear Repair – Simple 100
General Surgery Anal Injury/Tear Repair – Complex 300
General Surgery Anal/Rectal Foreign Body Removal – Simple 50
General Surgery Anal/Rectal Foreign Body Removal – Complex 100
General Surgery Fecal Impaction Removal 20
General Surgery Anal Cancer Local Resection 400
General Surgery Transanal Endoscopic Microsurgery for Rectal Polyps 300
General Surgery Transanal Endoscopic Microsurgery for Rectal Adenomas 400
General Surgery Transanal Endoscopic Microsurgery for Rectal Malignancy 600
General Surgery Anal Dilatation (Lord’s Operation) 100
General Surgery Anorectal Examination (under general anesthesia) 100
General Surgery Anal Benign Lesion Removal (not specified elsewhere) 120
General Surgery Anal Sphincteroplasty – Simple 200
General Surgery Anal Sphincteroplasty – Complex 350
General Surgery Sigmoidoscopy – Diagnostic 100
General Surgery Sigmoidoscopy with Biopsy 110
General Surgery Sigmoidoscopy and Foreign Body Removal 150
General Surgery Sigmoidoscopy and Dilatation and/or Intraluminal Stent Insertion 150
General Surgery Sigmoidoscopy and Polyp/Benign Tumor Excision 150
General Surgery Sigmoidoscopy and Control of Bleeding 180
General Surgery Sigmoidoscopy and Lesion Ablation 150
General Surgery Sigmoidoscopy and Submucosal Injection 130
General Surgery Surgical Gastrostomy (e.g. Stamm procedure) 350
General Surgery Gastrostomy Tube Replacement 10
General Surgery Surgical Jejunostomy (e.g. for feeding or decompression) 400
General Surgery Jejunostomy Tube Replacement 15
General Surgery Surgical Closure of Gastrostomy 300
General Surgery Surgical Closure of Jejunostomy 400
General Surgery Liver Resection – Left Hepatectomy 2000
General Surgery Liver Resection – Right Hepatectomy 2200
General Surgery Liver Resection – Extended Right Hepatectomy 2200
General Surgery Liver Resection – Extended Left Hepatectomy 2200
General Surgery Liver Resection – Hepatic Segmentectomy 1800
General Surgery Liver Resection – Sectionectomy 2000
General Surgery Liver Resection – Wedge Hepatectomy 1500
General Surgery Liver Wound Repair – Simple 1000
General Surgery Liver Wound Repair – Complex 1500
General Surgery Liver Wound Re-exploration or Packing Removal 700
General Surgery Liver Biopsy (surgical) 400
General Surgery Liver Cyst/Abscess Marsupialization 500
General Surgery Liver Cyst/Abscess Drainage (surgical) 600
General Surgery Liver Benign Tumor Excision (surgical) 700
General Surgery Cholecystectomy – Laparoscopic 750
General Surgery Cholecystectomy (with bile duct exploration) – Laparoscopic 850
General Surgery Cholecystectomy – Open 900
General Surgery Cholecystectomy (with bile duct exploration) – Open 1000
General Surgery Cholecystectomy (laparoscopic converted to open surgery) 1000
General Surgery Cholecystostomy (surgical) 600
General Surgery Cholecystoenterostomy 900
General Surgery Cholecystoenterostomy (Roux-en-Y) 1000
General Surgery Cholecystoenterostomy – Laparoscopic 1000
General Surgery Choledochojejunostomy 1000
General Surgery Choledochoduodenostomy 1000
General Surgery Cholecystocolostomy (jejunal interposition) 1200
General Surgery Pancreatectomy – Total 4000
General Surgery Pancreatectomy (with islet cell autotransplantation) 3000
General Surgery Pancreatectomy – Distal (without splenectomy) 1500
General Surgery Pancreatectomy – Distal (with splenectomy) 2000
General Surgery Pancreatectomy – Partial 1500
General Surgery Pancreaticoduodenectomy (Whipple procedure) – Conventional 3000
General Surgery Pancreaticoduodenectomy (Whipple procedure) – Pylorus-sparing 2500
General Surgery Pancreatic Cyst-Duodenostomy (Roux-en-Y) 1000
General Surgery Pancreatic Cyst-Gastrostomy (Roux-en-Y) 1000
General Surgery Pancreatic Cyst-Jejunostomy (Roux-en-Y) 1000
General Surgery Pancreatic Cyst-Duodenostomy 900
General Surgery Pancreatic Cyst-Gastrostomy 900
General Surgery Pancreatic Cyst-Jejunostomy 900
General Surgery Pancreaticojejunostomy (Puestow operation) 1500
General Surgery Duodenal Exclusion (Pyloric exclusion) 1000
General Surgery Kasai Portoenterostomy 2000
General Surgery Cholecystoportostomy 1500
General Surgery Cholangiojejunostomy (e.g. Longmire procedure) 2000
General Surgery Hepaticoenterostomy 2000
General Surgery Transduodenal Sphincterotomy 700
General Surgery Transduodenal Sphincteroplasty 700
General Surgery Bile Duct Exploration (surgical) 600
General Surgery Bile Duct/Gall Bladder Biopsy (surgical) 400
General Surgery Bile Duct Tumor Local Excision 800
General Surgery Choledochal Cyst Excision 700
General Surgery Choledochal Cyst Excision (with hepaticoenterostomy) 1500
General Surgery Pancreatic Biopsy (surgical) 400
General Surgery Pancreatic Cyst/Tumor Excision 700
General Surgery Pancreatic Cyst Marsupialization 500
General Surgery Pancreatic Cyst/Pseudocyst Drainage (surgical) 550
General Surgery Pancreatic Abscess Drainage (surgical) 600
General Surgery Pancreatic/Peripancreatic Debridement 1000
General Surgery Spleen Biopsy (surgical) 400
General Surgery Splenectomy – Total 1000
General Surgery Splenectomy – Partial 1000
General Surgery Splenectomy – Laparoscopic 1200
General Surgery Spleen Rupture Repair/Splenorrhaphy – Simple 700
General Surgery Spleen Rupture Repair/Splenorrhaphy – Complex 1200
General Surgery Splenic Cyst/Lesion Excision 700
General Surgery Splenic Haematoma Evacuation (surgical) 700
General Surgery Splenunculus Excision 800
General Surgery Splenic Tissue Re-implantation 2000
General Surgery Esophagostomy – Cervical Approach 300
General Surgery Esophagostomy – Thoracic or Abdominal Approach 400
General Surgery Esophagogastrostomy 700
General Surgery Esophagojejunostomy 800
General Surgery Esophagostomy Closure – Cervical Approach 200
General Surgery Esophagostomy Closure – Thoracic or Abdominal Approach 300
General Surgery Esophagotomy (e.g. for foreign body removal) – Cervical

Approach

300
General Surgery Esophagotomy (e.g. for foreign body removal) – Thoracic Approach 400
General Surgery Esophageal Lesion Excision – Cervical Approach 600
General Surgery Esophageal Lesion Excision – Thoracic or Abdominal Approach 700
General Surgery Esophageal Diverticulum Resection – Cervical Approach 700
General Surgery Esophageal Diverticulum Resection – Thoracic Approach 800
General Surgery Esophageal Fistula Repair – Cervical Approach 1200
General Surgery Esophageal Fistula Repair – Thoracic or Abdominal Approach 1500
General Surgery Esophageal Perforation/Rupture Repair – Cervical Approach 1000
General Surgery Esophageal Perforation/Rupture Repair – Thoracic or Abdominal

Approach

1300
General Surgery Esophagogastric Laceration Repair (e.g. Mallory-Weiss tear) 1000
General Surgery Esophagogastric Devascularization 1000
General Surgery Esophagogastric Devascularization – Sugiura Operation 2500
General Surgery Esophagogastrectomy (not including esophageal reconstruction) 1500 (type of reconstruction, if

any, to be identified separately)

General Surgery Total Esophagectomy (not including esophageal reconstruction) 1500 (type of reconstruction, if

any, to be identified separately)

General Surgery Partial Esophagectomy (not including esophageal reconstruction) 1200 (type of reconstruction, if any, to be identified separately)
General Surgery Esophageal Reconstruction (gastric interposition/gastric pull-up) 1000
General Surgery Esophageal Reconstruction (colonic or jejunal interposition) 2500
General Surgery Esophageal Reconstruction (musculocutaneous flap) 1500
General Surgery Esophageal Reconstruction (free tissue flap) 2500
General Surgery Esophageal Atresia Repair (without tracheoesophageal fistula) 1000
General Surgery Esophageal Atresia Repair (with tracheoesophageal fistula) 1500
General Surgery Esophageal Atresia Repair (long gap) – Foker Procedure 1000
General Surgery Esophageal Atresia Repair (long gap) – Gastric Pull-up 1500
General Surgery Esophageal Atresia Repair (long gap) – Colon Interposition 3000
General Surgery Tracheoesophageal Fistula Repair – Cervical Approach 1200
General Surgery Tracheoesophageal Fistula Repair – Thoracic Approach 1500
General Surgery Esophageal Defect Repair (not specified elsewhere) – Cervical

Approach

1200
General Surgery Esophageal Defect Repair (not specified elsewhere) – Thoracic

Approach

1500
General Surgery Pyloromyotomy (Ramstedt’s operation) 800
General Surgery Pyloroplasty 1000
General Surgery Pyloroplasty (with vagotomy) 1200
General Surgery Fundoplication (e.g. Nissen fundoplication) 900
General Surgery Heller’s Cardiomyotomy 700
General Surgery Truncal Vagotomy 500
General Surgery Selective Vagotomy 450
General Surgery Highly Selective Vagotomy (proximal gastric vagotomy) 450
General Surgery Posterior Truncal Vagotomy & Anterior Seromyotomy 700
General Surgery Gastrojejunostomy (with vagotomy) 1000
General Surgery Gastrojejunostomy 800
General Surgery Gastroduodenostomy 800
General Surgery Gastrojejunostomy or Gastroduodenostomy Revision (including

reconstruction)

1200
General Surgery Total Gastrectomy (with esophagoenterostomy) 1400
General Surgery Total Gastrectomy (with Roux-en-Y reconstruction) 1500
General Surgery Total Gastrectomy (with intestinal pouch formation) 1600
General Surgery Partial Gastrectomy (with esophagogastrostomy) 1400
General Surgery Partial Gastrectomy (with gastroduodenostomy) 1400
General Surgery Partial Gastrectomy (with gastrojejunostomy) 1400
General Surgery Partial Gastrectomy (with Roux-en-Y reconstruction) 1500
General Surgery Partial Gastrectomy (with intestinal pouch formation) 1600
General Surgery Bariatric Surgery – Vertical-banded Gastroplasty 900
General Surgery Bariatric Surgery – Adjustable Gastric Banding 700
General Surgery Bariatric Surgery – Intra-gastric Balloon 400
General Surgery Bariatric Surgery – Intra-gastric Balloon Removal 200
General Surgery Bariatric Surgery – Vertical Sleeve Gastrectomy (non-obese) 1500
General Surgery Bariatric Surgery – Vertical Sleeve Gastrectomy (obese) 1800
General Surgery Bariatric Surgery – Mini Gastric Bypass 1600
General Surgery Bariatric Surgery – Roux-en-Y Gastric Bypass 1600
General Surgery Bariatric Surgery – Single Anastomosis Duodeno-Ileostomy (SADI) 1600
General Surgery Bariatric Surgery – Biliopancreatic Diversion Gastric Bypass 2000
General Surgery Gastrocolic Fistula Closure – Open 1200
General Surgery Gastrocolic Fistula Closure – Laparoscopic 1500
General Surgery Repair of Perforated Gastric Ulcer 1000
General Surgery Repair of Perforated Duodenal Ulcer 1000
General Surgery Local Excision of Benign Gastric Tumor (operative) 900
General Surgery Local Excision of Malignant Gastric Tumor (operative) 1200
General Surgery Excision of Gastric Ulcer (operative) 900
General Surgery Excision of Duodenal Ulcer (operative) 900
General Surgery Repair of Bleeding Gastric Ulcer (operative) 1000
General Surgery Repair of Bleeding Duodenal Ulcer (operative) 1000
General Surgery Gastric Devascularization 1000
General Surgery Gastric Transection 1200
General Surgery Duodenoduodenostomy 800
General Surgery Duodenojejunostomy 800
General Surgery Jejunojejunostomy 800
General Surgery Small Intestine Resection – Open 1200
General Surgery Small Intestine Resection – Laparoscopic 1500
General Surgery Small Intestine Resection (for congenital malformation) – Open 1400
General Surgery Small Intestine Resection (for congenital malformation) –

Laparoscopic

1700
General Surgery Intestinal Malrotation Correction e.g. Ladd procedure (without

midgut volvulus)

800
General Surgery Intestinal Strictureplasty 700
General Surgery Intestinal Strictureplasty (for long or multiple strictures) 1000
General Surgery Excision of Vitello-intestinal (omphalomesenteric duct) Remnant 400
General Surgery Excision of Meckel’s Diverticulum 400
General Surgery Excision of Other Umbilical Lesions (e.g. granuloma, polyp) –

Minor

150
General Surgery Excision of Other Umbilical Lesions (e.g. granuloma, polyp) –

Major

400
General Surgery Umbilical Lesion Cauterization 20
General Surgery Reduction of Intussusception – Manual Reduction 900
General Surgery Reduction of Intussusception – Resection & Anastomosis 1200
General Surgery Reduction of Volvulus (operative) 1500
General Surgery Reduction of Midgut Volvulus (operative) 1800
General Surgery Reduction of Volvulus (endoscopic) 400
General Surgery Reduction of Intussusception (endoscopic) 300
General Surgery Small Intestine Exclusion from the Pelvis 500
General Surgery Excision of Intestinal Benign Tumor (without intestinal resection)

– Open

800
General Surgery Excision of Intestinal Benign Tumor (without intestinal resection)

– Laparoscopic

1200
General Surgery Repair of Exomphalos (omphalocele) – Primary Closure 600
General Surgery Repair of Exomphalos (omphalocele) – Staged Repair 400 (per stage)
General Surgery Gastroschisis Repair – Primary Closure 1000
General Surgery Gastroschisis Repair – Staged Repair 600
General Surgery Gastroschisis Silo Application 150
General Surgery Sacrococcygeal Teratoma Resection – Sacral Approach 1500
General Surgery Sacrococcygeal Teratoma Resection – Abdominal Approach 2000
General Surgery Sacrococcygeal Teratoma Resection – Combined Approach 2500
General Surgery Appendicectomy – Open 500
General Surgery Appendicectomy – Laparoscopic 600
General Surgery Appendicectomy (with peritoneal lavage) 900
General Surgery Appendicectomy (laparoscopic converted open surgery) 800
General Surgery Appendicostomy (Malone Procedure) 400
General Surgery Salivary Gland Needle Biopsy 50
General Surgery Salivary Gland Incisional Biopsy 100
General Surgery Incision & Drainage of Parotid Abscess 250
General Surgery Incision & Drainage of Submandibular Abscess/Cyst/Hematoma 200
General Surgery Incision & Drainage of Submental Abscess/Cyst/Hematoma 200
General Surgery Salivary Gland/Duct Stone Removal – Intraoral (simple) 50
General Surgery Salivary Gland/Duct Stone Removal – Intraoral (complex) 150
General Surgery Salivary Gland/Duct Stone Removal – Extraoral 300
General Surgery Submandibular Gland Excision 400
General Surgery Sublingual Gland Excision 400
General Surgery Parotid Tumor/Lesion Excision (without nerve dissection) 600
General Surgery Parotid Tumor/Lesion Excision (with nerve dissection) 1000
General Surgery Salivary Duct Repair 800
General Surgery Salivary Duct Dilatation/Stenting 50
General Surgery Salivary Duct Diversion 400
General Surgery Salivary Fistula Repair 600
General Surgery Salivary Duct Ligation 250
General Surgery Salivary Gland/Duct Exploration (without intervention) 200
General Surgery Sympathectomy – Cervical 800
General Surgery Sympathectomy – Thoracic 900
General Surgery Sympathectomy – Lumbar 700
General Surgery Sympathectomy – Others 500
General Surgery Marginal Excision of Soft Tissue Tumor – Face/Scalp 700
General Surgery Wide Excision of Soft Tissue Tumor (without graft) – Face/Scalp 900
General Surgery Wide Excision of Soft Tissue Tumor (with graft) – Face/Scalp 1200
General Surgery Radical Excision of Soft Tissue Tumor – Face/Scalp 1800
General Surgery Marginal Excision of Soft Tissue Tumor – Abdominal

Wall/Back/Chest Walls

700
General Surgery Wide Excision of Soft Tissue Tumor (without graft) – Abdominal

Wall/Back/Chest Walls

900
General Surgery Wide Excision of Soft Tissue Tumor (with graft) – Abdominal

Wall/Back/Chest Walls

1200
General Surgery Radical Excision of Soft Tissue Tumor – Abdominal

Wall/Back/Chest Walls

1800
General Surgery Excision of Sebaceous Cyst – Single/Small 100
General Surgery Excision of Sebaceous Cyst – Large or Multiple 200
General Surgery Excision of Lipoma – Single/Small 100
General Surgery Excision of Lipoma – Large or Multiple 200
General Surgery Excision of Dermoid Cyst (skin or subcutaneous tissue) –

Single/Small

150
General Surgery Excision of Dermoid Cyst (skin or subcutaneous tissue) – Large or

Multiple

250
General Surgery Excision of Benign Skin Lesion (not specified elsewhere) –

Single/Small

100
General Surgery Excision of Benign Skin Lesion (not specified elsewhere) – Large

or Multiple

200
General Surgery Excision of Premalignant/Malignant Skin Lesion (not specified

elsewhere) – Single

150
General Surgery Excision of Premalignant/Malignant Skin Lesion (not specified

elsewhere) – Large or Multiple

300
General Surgery Wart Excision – Single 80
General Surgery Wart Excision – Multiple 100
General Surgery Tangential Excision – Small 200
General Surgery Tangential Excision – Large 400
General Surgery Scar Excision – Keloid 150
General Surgery Scar Excision – Hypertrophic Scar 150
General Surgery Scar Excision – Tattoo Scar 150
General Surgery Scar Excision – Others 150
General Surgery Escharotomy 150
General Surgery W-Plasty 150
General Surgery Z-Plasty 150
General Surgery Primary Closure/Suturing of Superficial Skin Wound (<7 cm) –

Scalp, Neck, Trunk, Extremities

20
General Surgery Primary Closure/Suturing of Superficial Skin Wound (7-15 cm) –

Scalp, Neck, Trunk, Extremities

25
General Surgery Primary Closure/Suturing of Superficial Skin Wound (>15 cm) –

Scalp, Neck, Trunk, Extremities

30
General Surgery Primary Closure/Suturing of Superficial Skin Wound (<7 cm) –

Face, Ears, Eyelids, Nose, Lips, External Genitalia

25
General Surgery Primary Closure/Suturing of Superficial Skin Wound (7-15 cm) –

Face, Ears, Eyelids, Nose, Lips, External Genitalia

30
General Surgery Primary Closure/Suturing of Superficial Skin Wound (>15 cm) –

Face, Ears, Eyelids, Nose, Lips, External Genitalia

35
General Surgery Primary Closure/Suturing of Deep Skin Wound (<7 cm) – Scalp,

Neck, Trunk, Extremities

50
General Surgery Primary Closure/Suturing of Deep Skin Wound (7-15 cm) – Scalp,

Neck, Trunk, Extremities

60
General Surgery Primary Closure/Suturing of Deep Skin Wound (>15 cm) – Scalp,

Neck, Trunk, Extremities

70
General Surgery Primary Closure/Suturing of Deep Skin Wound (<7 cm) – Face,

Ears, Eyelids, Nose, Lips, External Genitalia

60
General Surgery Primary Closure/Suturing of Deep Skin Wound (7-15 cm) – Face, Ears, Eyelids, Nose, Lips, External Genitalia 70
General Surgery Primary Closure/Suturing of Deep Skin Wound (>15 cm) – Face,

Ears, Eyelids, Nose, Lips, External Genitalia

80
General Surgery Repair of Wound Dehiscence – Complex 400
General Surgery Repair of Wound Dehiscence – Simple 200
General Surgery Wound Sutures Removal (under general anesthesia) 50
General Surgery Wound Dressing (under general anesthesia) 50
General Surgery Wound Suturing (under general anesthesia) 100
General Surgery Debridement with Skin Graft 400
General Surgery Debridement with Flap Cover 400
General Surgery Debridement – Bone (simple) 50
General Surgery Debridement – Bone (complex or extensive) 150
General Surgery Debridement – Burn (limited) 50
General Surgery Debridement – Burn (extensive) 150
General Surgery Debridement – Subcutaneous Tissue (simple) 30
General Surgery Debridement – Subcutaneous Tissue (complex or extensive) 120
General Surgery Excision of Coccygeal Pressure Ulcer 200
General Surgery Excision of Coccygeal Pressure Ulcer (with flap closure) 500
General Surgery Excision of Sacral Pressure Ulcer 200
General Surgery Excision of Sacral Pressure Ulcer (with flap closure) 500
General Surgery Excision of Ischial Pressure Ulcer 200
General Surgery Excision of Ischial Pressure Ulcer (with flap closure) 500
General Surgery Excision of Trochanteric Pressure Ulcer 200
General Surgery Excision of Trochanteric Pressure Ulcer (with flap closure) 500
General Surgery Delayed Primary Closure/Suturing of Skin Wound (<10 cm) 80
General Surgery Delayed Primary Closure/Suturing of Skin Wound (10-20 cm) 100
General Surgery Delayed Primary Closure/Suturing of Skin Wound (>20 cm) 150
General Surgery Secondary Closure/Suturing of Skin Wound (<10 cm) 120
General Surgery Secondary Closure/Suturing of Skin Wound (10-20 cm) 150
General Surgery Secondary Closure/Suturing of Skin Wound (>20 cm) 200
General Surgery Needle/Punch Biopsy – Skin/Subcutaneous Tissue/Mucous

Membrane

60
General Surgery Incisional/Wedge Biopsy – Skin/Subcutaneous Tissue/Mucous

Membrane

80
General Surgery Excisional Biopsy – Skin/Subcutaneous Tissue/Mucous Membrane 70
General Surgery Other Biopsy – Skin/Subcutaneous Tissue/Mucous Membrane 60
General Surgery Incision & Drainage of Hand Abscess/Haematoma – Simple 150
General Surgery Incision & Drainage of Hand Abscess/Haematoma – Complex 300
General Surgery Incision & Drainage of Soft Tissue Abscess/Haematoma (simple) –

Upper Limb (other than hand)

60
General Surgery Incision & Drainage of Soft Tissue Abscess/Haematoma (deep or

complex) – Upper Limb (other than hand)

200
General Surgery Incision & Drainage of Soft Tissue Abscess/Haematoma – Lower

Limb (superficial or simple)

60
General Surgery Incision & Drainage of Soft Tissue Abscess/Haematoma – Lower

Limb (deep or complicated)

300
General Surgery Incision & Drainage of Wound Hematoma – Small 30
General Surgery Incision & Drainage of Wound Hematoma – Large 50
General Surgery Incision & Drainage of Wound Abscess – Small 40
General Surgery Incision & Drainage of Wound Abscess – Large 70
General Surgery Penetrating Wound Exploration (without repair) – Neck 300
General Surgery Penetrating Wound Exploration (without repair) – Back 300
General Surgery Incision & Drainage of Soft Tissue Abscess/Haematoma –

Abdominal Wall/Chest Wall (superficial or simple)

150
General Surgery Incision & Drainage of Soft Tissue Abscess/Haematoma –

Abdominal Wall/Chest Wall (deep or complex)

300
General Surgery Incision & Drainage of Neck Abscess 200
General Surgery Aspiration of Soft Tissue Abscess/Hematoma/Cyst 20
General Surgery Subungual Hematoma Evacuation 25
General Surgery Subungual Hematoma Pressure Relief (nail trephination) 15
General Surgery Nail Removal – Wedge Resection 50
General Surgery Nail Removal – Avulsion 60
General Surgery Nail Removal – Vandenbos Procedure 80
General Surgery Nail Removal – with Matrixectomy 100
General Surgery Nail Removal – with Distal Phalanx Amputation (Syme’s

procedure)

400
General Surgery Nail Bed Repair/Suturing 100
General Surgery Lymph Node Abscess Drainage – Simple 150
General Surgery Lymph Node Abscess Drainage – Complex 300
General Surgery Sclerotherapy for Lymphatic Malformation/Lymphangioma/Cystic

Hygroma

150
General Surgery Anorectal Manometry 50
General Surgery Myelomeningocele Repair 1200
General Surgery Meningocele Repair 1200
Vascular Surgery Ankle-brachial Index (resting) 20
Vascular Surgery Ankle-brachial Index (resting & post-exercise) 35
Vascular Surgery Exploration of Artery (without repair) – Aorta 1000
Vascular Surgery Exploration of Great Vessel (other than aorta) 1000
Vascular Surgery Exploration of Artery (without repair) – Carotid Artery 800
Vascular Surgery Exploration of Artery (without repair) – Subclavian Artery 800
Vascular Surgery Exploration of Artery (without repair) – Axillary Artery 650
Vascular Surgery Exploration of Artery (without repair) – Brachial Artery 650
Vascular Surgery Exploration of Artery (without repair) – Radial Artery 500
Vascular Surgery Exploration of Artery (without repair) – Ulnar Artery 500
Vascular Surgery Exploration of Artery (without repair) – Abdominal Artery other than Aorta (e.g. renal, celiac, mesenteric) 900
Vascular Surgery Exploration of Artery (without repair) – Iliac Artery 900
Vascular Surgery Exploration of Artery (without repair) – Femoral Artery 600
Vascular Surgery Exploration of Artery (without repair) – Popliteal Artery 500
Vascular Surgery Exploration of Artery/Vein (not specified elsewhere) – Neck 700
Vascular Surgery Exploration of Artery/Vein (not specified elsewhere) – Chest 1000
Vascular Surgery Exploration of Artery/Vein (not specified elsewhere) – Abdomen 800
Vascular Surgery Exploration of Artery/Vein (not specified elsewhere) – Limb 400
Vascular Surgery Ligation of Neck Vein 400
Vascular Surgery Ligation of Neck Artery 500
Vascular Surgery Ligation of Chest Artery 1200
Vascular Surgery Ligation of Chest Vein 1000
Vascular Surgery Ligation of Abdominal/Pelvic Artery 700
Vascular Surgery Ligation of Abdominal/Pelvic Vein 650
Vascular Surgery Ligation/Plication of Inferior Vena Cava (other than post-

traumatic)

800
Vascular Surgery Ligation of Upper Limb Artery or Vein 400
Vascular Surgery Ligation of Lower Limb Artery or Vein 400
Vascular Surgery Embolectomy – Pulmonary Artery 1200
Vascular Surgery Embolectomy – Innominate Artery 1100
Vascular Surgery Embolectomy – Carotid Artery 1000
Vascular Surgery Embolectomy – Subclavian Artery 1000
Vascular Surgery Embolectomy – Axillary Artery 800
Vascular Surgery Embolectomy – Brachial Artery 700
Vascular Surgery Embolectomy – Radial Artery 550
Vascular Surgery Embolectomy – Ulnar Artery 550
Vascular Surgery Embolectomy – Abdominal Artery other than Aorta (e.g. renal, celiac, mesenteric) 1100
Vascular Surgery Embolectomy – Aorta 1300
Vascular Surgery Embolectomy – Iliac Artery 1100
Vascular Surgery Embolectomy – Femoral Artery 800
Vascular Surgery Embolectomy – Popliteal Artery 700
Vascular Surgery Embolectomy – Other Lower Limb Artery 500
Vascular Surgery Thrombectomy – Aorta 1300
Vascular Surgery Thrombectomy – Carotid Artery 1000
Vascular Surgery Thrombectomy – Innominate Artery 1100
Vascular Surgery Thrombectomy – Subclavian Artery 1000
Vascular Surgery Thrombectomy – Axillary Artery 800
Vascular Surgery Thrombectomy – Brachial Artery 700
Vascular Surgery Thrombectomy – Radial Artery 550
Vascular Surgery Thrombectomy – Ulnar Artery 550
Vascular Surgery Thrombectomy – Abdominal Artery other than Aorta (e.g. renal,

celiac, mesenteric)

1100
Vascular Surgery Thrombectomy – Iliac Artery 1100
Vascular Surgery Thrombectomy – Femoral Artery 800
Vascular Surgery Thrombectomy – Popliteal Artery 700
Vascular Surgery Thrombectomy – Other Lower Limb Artery 500
Vascular Surgery Thrombectomy – Arterial or Venous Graft (without graft revision) 700
Vascular Surgery Thrombectomy – Arterial or Venous Graft (with graft revision) 850
Vascular Surgery Thrombectomy – AV Fistula 700
Vascular Surgery Endarterectomy – Pulmonary Artery 1300
Vascular Surgery Endarterectomy – Carotid Artery 1100
Vascular Surgery Endarterectomy – Vertebral Artery 1100
Vascular Surgery Endarterectomy – Innominate Artery 1200
Vascular Surgery Endarterectomy – Subclavian Artery 1100
Vascular Surgery Endarterectomy – Axillary Artery 900
Vascular Surgery Endarterectomy – Brachial Artery 800
Vascular Surgery Endarterectomy – Radial Artery 650
Vascular Surgery Endarterectomy – Ulnar Artery 650
Vascular Surgery Endarterectomy – Aorta 1400
Vascular Surgery Endarterectomy – Abdominal Artery (other than aorta) 1200
Vascular Surgery Endarterectomy – Iliac Artery 1200
Vascular Surgery Endarterectomy – Femoral Artery 900
Vascular Surgery Endarterectomy – Popliteal Artery 800
Vascular Surgery Endarterectomy – Other Lower Limb Artery 600
Vascular Surgery Subclavian-Carotid Transposition 1000
Vascular Surgery Carotid-Subclavian Transposition 1000
Vascular Surgery Vertebral-Carotid Transposition 1100
Vascular Surgery Vertebral-Subclavian Transposition 1100
Vascular Surgery Bypass Grafting (vein graft) – Carotid-subclavian or Subclavian-

carotid

1200
Vascular Surgery Bypass Grafting (vein graft) – Others (involving the carotid artery) 1200
Vascular Surgery Bypass Grafting (vein graft) – Subclavian-subclavian, -brachial, – vertebral, -axillary 1200
Vascular Surgery Bypass Grafting (vein graft) – Axillary-axillary, -brachial 1200
Vascular Surgery Bypass Grafting (vein graft) – Axillary-femoral 1200
Vascular Surgery Bypass Grafting (vein graft) – Brachial-brachial, -ulnar, -radial 1200
Vascular Surgery Bypass Grafting (vein graft) – Aorto-subclavian, -innominate, –

carotid

1500
Vascular Surgery Bypass Grafting (vein graft) – Aorto-celiac, -mesenteric 1300
Vascular Surgery Bypass Grafting (vein graft) – Aorto-renal 1300
Vascular Surgery Bypass Grafting (vein graft) – Aorto-iliac, -femoral 1300
Vascular Surgery Bypass Grafting (vein graft) – Aorto-bifemoral or Aorto bi-iliac 1500
Vascular Surgery Bypass Grafting (vein graft) – Aorto-iliofemoral 1500
Vascular Surgery Bypass Grafting (vein graft) – Aorto-iliofemoral (bilateral) 1600
Vascular Surgery Bypass Grafting (vein graft) – Aortofemoral-popliteal 1500
Vascular Surgery Bypass Grafting (vein graft) – Hepato-renal or Spleno-renal 1300
Vascular Surgery Bypass Grafting (vein graft) – Ilio-iliac or Ilio-femoral 1300
Vascular Surgery Bypass Grafting (vein graft) – Femoral-femoral, -popliteal, -tibial,

-distal

1200
Vascular Surgery Bypass Grafting (vein graft) – Other distal bypass 1000
Vascular Surgery Bypass Grafting (synthetic graft) – Carotid-subclavian or

Subclavian-carotid

1000
Vascular Surgery Bypass Grafting (synthetic graft) – Others (involving the carotid

artery)

1000
Vascular Surgery Bypass Grafting (synthetic graft) – Subclavian-subclavian, – brachial, -vertebral, -axillary 1000
Vascular Surgery Bypass Grafting (synthetic graft) – Axillary-axillary, -femoral 1000
Vascular Surgery Bypass Grafting (synthetic graft) – Axillary-popliteal, -tibial or

Axillary-femoral-femoral

1000
Vascular Surgery Bypass Grafting (synthetic graft) – Aorto-subclavian, -innominate,

-carotid

1300
Vascular Surgery Bypass Grafting (synthetic graft) – Aorto-celiac, -mesenteric, – renal 1100
Vascular Surgery Bypass Grafting (synthetic graft) – Aorto-iliac or Aortobi-iliac 1300
Vascular Surgery Bypass Grafting (synthetic graft) – Aorto-femoral or Aorto-

bifemoral

1300
Vascular Surgery Bypass Grafting (synthetic graft) – Aorto-femoral-popliteal 1300
Vascular Surgery Bypass Grafting (synthetic graft) – Spleno-renal 1100
Vascular Surgery Bypass Grafting (synthetic graft) – Ilio-celiac, -mesenteric, -renal 1100
Vascular Surgery Bypass Grafting (synthetic graft) – Ilio-iliac or Ilio-femoral 1100
Vascular Surgery Bypass Grafting (synthetic graft) – Femoral-femoral, -popliteal, –

tibial, -distal

1000
Vascular Surgery Bypass Grafting (synthetic graft) – Other distal bypass 800
Vascular Surgery Bypass Graft Revision – Lower Limb 1000
Vascular Surgery Injection for Pseudoaneurysm 300
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Ascending Aorta 2000
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Transverse Aortic Arch 2000
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Descending Aorta 2000
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Thoracoabdominal Aorta 2200
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Abdominal Aorta 1500
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Abdominal/Pelvic Artery

(other than aorta)

1300
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Iliac Artery 1300
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Innominate Artery 1300
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Carotid Artery 1200
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Subclavian Artery 1200
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Vertebral Artery 1200
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Axillary Artery 1000
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Brachial Artery 900
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Radial Artery 750
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Ulnar Artery 750
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Femoral Artery 1000
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Popliteal Artery 900
Vascular Surgery Repair of Aneurysm/Pseudoaneurysm – Other Lower Limb Artery 700
Vascular Surgery Portacaval Shunt 1200
Vascular Surgery Renoportal Shunt 1200
Vascular Surgery Mesocaval Shunt 1200
Vascular Surgery Splenorenal Shunt 1200
Vascular Surgery Vein Valvuloplasty 500
Vascular Surgery Vein Valve Transposition 1000
Vascular Surgery Crossover Vein Graft to the Venous System 1000
Vascular Surgery Saphenofemoral Vein Crossover Bypass Grafting 1000
Vascular Surgery Arteriovenous Fistula (AVF) Creation – Radiocephalic 500
Vascular Surgery Arteriovenous Fistula (AVF) Creation – Radiobasilic 500
Vascular Surgery Arteriovenous Fistula (AVF) Creation – Brachiocephalic 500
Vascular Surgery Arteriovenous Fistula (AVF) Creation – Brachiobasilic 500
Vascular Surgery Arteriovenous Fistula (AVF) Creation – Other Forearm Vein

Transposition

500
Vascular Surgery Arteriovenous Fistula (AVF) Creation – Other Sites 500
Vascular Surgery Redo Arteriovenous Fistula (AVF) Creation 650
Vascular Surgery Arteriovenous Graft (AVG) e.g. PTFE graft 400
Vascular Surgery Arteriovenous Fistula (AVF) Closure 400
Vascular Surgery Arteriovenous Fistula (AVF) Thrombectomy 500
Vascular Surgery Arteriovenous Fistula (AVF) Ligation/Banding 400
Vascular Surgery Arteriovenous Fistula (AVF) Complications Repair (e.g. stenosis,

aneurysm)

700
Vascular Surgery Steal Syndrome Repair – Ligation/Banding 400
Vascular Surgery Steal Syndrome Repair – Revascularization 1000
Vascular Surgery Repair of AV Fistula (acquired) – Neck 900
Vascular Surgery Repair of AV Fistula (acquired) – Abdomen/Pelvis 1000
Vascular Surgery Repair of AV Fistula (acquired) – Upper Limb 700
Vascular Surgery Repair of AV Fistula (acquired) – Lower Limb 700
Vascular Surgery Repair of AV Fistula (congenital) – Neck 1200
Vascular Surgery Repair of AV Fistula (congenital) – Abdomen/Pelvis 1300
Vascular Surgery Repair of AV Fistula (congenital) – Upper Limb 1000
Vascular Surgery Repair of AV Fistula (congenital) – Lower Limb 1000
Vascular Surgery Repair of Blood Vessel (without graft) – Carotid Artery 1000
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Carotid Artery 1000
Vascular Surgery Repair of Blood Vessel (with vein graft) – Carotid Artery 1200
Vascular Surgery Repair of Blood Vessel (without graft) – Subclavian Artery 1000
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Subclavian Artery 1000
Vascular Surgery Repair of Blood Vessel (with vein graft) – Subclavian Artery 1200
Vascular Surgery Repair of Blood Vessel (without graft) – Axillary Artery 800
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Axillary Artery 800
Vascular Surgery Repair of Blood Vessel (with vein graft) – Axillary Artery 1000
Vascular Surgery Repair of Blood Vessel (without graft) – Brachial Artery 700
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Brachial Artery 700
Vascular Surgery Repair of Blood Vessel (with vein graft) – Brachial Artery 900
Vascular Surgery Repair of Blood Vessel (without graft) – Radial Artery 550
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Radial Artery 550
Vascular Surgery Repair of Blood Vessel (with vein graft) – Radial Artery 750
Vascular Surgery Repair of Blood Vessel (without graft) – Ulnar Artery 550
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Ulnar Artery 550
Vascular Surgery Repair of Blood Vessel (with vein graft) – Ulnar Artery 750
Vascular Surgery Repair of Blood Vessel (without graft) – Femoral Artery 800
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Femoral Artery 800
Vascular Surgery Repair of Blood Vessel (with vein graft) – Femoral Artery 1000
Vascular Surgery Repair of Blood Vessel (without graft) – Popliteal Artery 700
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Popliteal Artery 700
Vascular Surgery Repair of Blood Vessel (with vein graft) – Popliteal Artery 900
Vascular Surgery Repair of Abdominal Aorta (without graft) 1200
Vascular Surgery Repair of Abdominal Aorta (with synthetic graft) 1200
Vascular Surgery Repair of Abdominal Aorta (with vein graft) 1500
Vascular Surgery Repair of Blood Vessel (without graft) – Abdominal/Pelvic Artery

(other than aorta)

1100
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Abdominal/Pelvic

Artery (other than aorta)

1100
Vascular Surgery Repair of Blood Vessel (with vein graft) – Abdominal/Pelvic Artery (other than aorta) 1300
Vascular Surgery Repair of Inferior Vena Cava (without graft) 1200
Vascular Surgery Repair of Inferior Vena Cava (with synthetic graft) 1200
Vascular Surgery Repair of Inferior Vena Cava (with vein graft) 1500
Vascular Surgery Repair of Blood Vessel (without graft) – Abdominal/Pelvic Vein

(other than inferior vena cava)

1000
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Abdominal/Pelvic

Vein (other than inferior vena cava)

1000
Vascular Surgery Repair of Blood Vessel (with vein graft) – Abdominal/Pelvic Vein

(other than inferior vena cava)

1200
Vascular Surgery Repair of Blood Vessel (without graft) – Neck Vein 800
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Neck Vein 800
Vascular Surgery Repair of Blood Vessel (with vein graft) – Neck Vein 900
Vascular Surgery Repair of Blood Vessel (without graft) – Limb Vein 500
Vascular Surgery Repair of Blood Vessel (with synthetic graft) – Limb Vein 500
Vascular Surgery Repair of Blood Vessel (with vein graft) – Limb Vein 600
Vascular Surgery Repair of Blood Vessel (not specified elsewhere) – Limb 500
Vascular Surgery Repair of Blood Vessel (not specified elsewhere) – Neck 800
Vascular Surgery Repair of Blood Vessel – Abdominal or Chest Walls 650
Vascular Surgery Repair of Thoracic Aorta (without graft) 2000
Vascular Surgery Repair of Thoracic Aorta (with synthetic graft) 2000
Vascular Surgery Repair of Thoracic Aorta (with vein graft) 2200
Vascular Surgery Repair of Superior Vena Cava (without graft) 1800
Vascular Surgery Repair of Superior Vena Cava (with synthetic graft) 1800
Vascular Surgery Repair of Superior Vena Cava (with vein graft) 2000
Vascular Surgery Repair of Pulmonary Artery/Vein (without graft) 1800
Vascular Surgery Repair of Pulmonary Artery/Vein (with synthetic graft) 1800
Vascular Surgery Repair of Pulmonary Artery/Vein (with vein graft) 2000
Vascular Surgery Sclerotherapy for Varicose Veins 150
Vascular Surgery Endovenous Ablation of Varicose Veins (e.g. laser therapy,

radiofrequency ablation)

250
Vascular Surgery Ligation & Division of Long Saphenous Vein 300
Vascular Surgery Ligation & Division of Short Saphenous Vein 300
Vascular Surgery Ligation of Perforator Veins 250
Vascular Surgery Ligation & Excision of Cluster of Varicose Veins 300
Vascular Surgery Ligation & Stripping of Long Saphenous Vein 400
Vascular Surgery Ligation & Stripping of Short Saphenous Vein 400
Vascular Surgery Ligation & Stripping of Long and Short Saphenous Veins 500
Vascular Surgery Ligation & Stripping of Long OR Short Saphenous Vein (with

ulcer excision, skin graft, or communicating veins interruption)

500
Vascular Surgery Phlebectomy of Varicose Veins 300
Vascular Surgery Ligation of Venous Tributaries 250
Vascular Surgery Ligation of Feeder Vessels 250
Vascular Surgery Carotid Body Tumor Excision (without carotid artery excision) 800
Vascular Surgery Carotid Body Tumor Excision (with carotid artery excision) 1200
Medicine & A/E Lumbar Puncture 50
Medicine & A/E Peripheral Nerve Biopsy 200
Medicine & A/E Tensilon Test 35
Medicine & A/E Electroencephalography (EEG) 60
Medicine & A/E Long Term Electroencephalography (EEG) 250
Medicine & A/E Needle Electromyography (Needle EMG) 100
Medicine & A/E Nerve Conduction Studies (NCS) 60
Medicine & A/E NCS + EMG 150
Medicine & A/E Visual Evoked Potential (VEP) 40
Medicine & A/E Somato-Sensory Evoked Potential (SSEP) 40
Medicine & A/E Brainstem Auditory Evoked Potential (BAEP) 40
Medicine & A/E Transcranial Magnetic Stimulation (TMS) 40
Medicine & A/E Electro-convulsive Therapy (ECT) 50
Medicine & A/E Single Fibre EMG 200
Medicine & A/E Intracranial Ultrasound 60
Medicine & A/E Muscle Biopsy – Needle 70
Medicine & A/E Muscle Biopsy – Open 150
Medicine & A/E Botox Injection 100
Medicine & A/E Implantation of Neurostimulator – Cranial 600
Medicine & A/E Implantation of Neurostimulator – Spinal 450
Medicine & A/E Removal of Neurostimulator – Cranial 500
Medicine & A/E Removal of Neurostimulator – Spinal 300
Medicine & A/E Implantation of Neurostimulator – Others 400
Medicine & A/E Removal of Neurostimulator – Others 250
Medicine & A/E IQ Test 15
Medicine & A/E Electrocardiography (ECG) 10
Medicine & A/E 24-hour BP Monitoring 60
Medicine & A/E 24-hour Holter Monitoring 60
Medicine & A/E Transthoracic Echocardiography (TTE) – Adult 70
Medicine & A/E Transthoracic Echocardiography (TTE) – Paediatric 90
Medicine & A/E Transesophageal Echocardiography (TEE) 130
Medicine & A/E Dobutamine Stress Echocardiography (DSE) 120
Medicine & A/E Exercise Stress Echocardiography 100
Medicine & A/E Treadmill Exercise Test 50
Medicine & A/E Tilt-table Test 100
Medicine & A/E Bronchoscopy and Bronchial Washing 100
Medicine & A/E Bronchoscopy and Endobronchial Brushing 110
Medicine & A/E Bronchoscopy and Endobronchial Biopsy 130
Medicine & A/E Bronchoscopy – Diagnostic 100
Medicine & A/E Bronchoscopy for Difficult Intubation 110
Medicine & A/E Bronchoscopy and Foreign Body Removal 120
Medicine & A/E Bronchoscopy and Broncho-Alveolar Lavage 110
Medicine & A/E Bronchoscopy and Transbronchial Lung Biopsy 140
Medicine & A/E Bronchoscopy for Tracheostomy Tube Placement 110
Medicine & A/E Endo-Bronchial Ultrasound (EBUS) 100
Medicine & A/E Endo-Bronchial Ultrasound and Fine Needle Aspiration Cytology

(FNAC)

170
Medicine & A/E Intercostal Tube Insertion 70
Medicine & A/E Pleural Biopsy – Closed 75
Medicine & A/E Pleural Aspiration/Tap – Diagnostic 50
Medicine & A/E Pleural Aspiration/Tap – Therapeutic 60
Medicine & A/E Medical Thoracoscopy (Pleuroscopy) with Intercostal Tube

Insertion

200
Medicine & A/E Medical Thoracoscopy (Pleuroscopy) with Intercostal Tube Insertion and Pleurodesis 270
Medicine & A/E Medical Thoracoscopy (Pleuroscopy) with Intercostal Tube

Insertion and Pleural Biopsy

270
Medicine & A/E Medical Pleurodesis 100
Medicine & A/E Video Assisted Thoracoscopy (Pleuroscopy) with Intercostal Tube

Insertion

350
Medicine & A/E Video Assisted Thoracoscopy (Pleuroscopy) with Intercostal Tube

Insertion and Pleurodesis

400
Medicine & A/E Video Assisted Thoracoscopy (Pleuroscopy) with Intercostal Tube

Insertion and Pleural Biopsy

450
Medicine & A/E Video Assisted Thoracoscopy (Pleuroscopy) with Intercostal Tube Insertion, Pleural Biopsy, and Lung Biopsy 600
Medicine & A/E 6 Minute Walk Test 15
Medicine & A/E Spirometry 25
Medicine & A/E Spirometry with Reversibility 40
Medicine & A/E Full Pulmonary Function Test 50
Medicine & A/E Methacholine Challenge Test 110
Medicine & A/E Overnight Pulse Oximetry 30
Medicine & A/E Cardiopulmonary Exercise Test 60
Medicine & A/E Level 1 Diagnostic Sleep Study [Polysomnography (PSG)] 270
Medicine & A/E Level 2 Diagnostic Sleep Study [Polysomnography (PSG)] 220
Medicine & A/E Level 3 Sleep Screening (Polygraphy) 120
Medicine & A/E Level 1 Split Night Sleep Study [Polysomnography (PSG)] 300
Medicine & A/E CPAP Titration Study 300
Medicine & A/E BiPAP Titration Study 300
Medicine & A/E CPAP/BiPAP Education 20
Medicine & A/E Mantoux Test 5
Medicine & A/E Reading Mantoux Test 2
Medicine & A/E Nebulized Medication Delivery 5
Medicine & A/E Inhaler Technique 5
Medicine & A/E Esophageal Manometry 50
Medicine & A/E Capsule Endoscopy 350
Medicine & A/E Oesophagogastroduodenoscopy (OGD) – Diagnostic 100
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Biopsy 110
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Foreign Body

Removal

150
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Band Ligation of

Oesophageal and/or Gastric Varices

170
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Sclerotherapy for Oesophageal and/or Gastric Varices 160
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Dilatation of

Stricture/Obstruction

150
Medicine & A/E Oesophagoscopy with Dilatation of Achalasia 180
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Intraluminal

Tube/Stent Insertion

150
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Injecting Submucosal

Substance

150
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Lesion Removal (any

method)

180
Medicine & A/E Oesophagogastroduodenoscopy (OGD) with Control of Bleeding

(any method)

180
Medicine & A/E Gastroesophageal Tube/Stent Removal (endoscopic) 120
Medicine & A/E Percutaneous Endoscopic Gastrostomy (PEG) 170
Medicine & A/E Colonoscopy – Diagnostic 130
Medicine & A/E Colonoscopy with Biopsy 140
Medicine & A/E Colonoscopy with Foreign Body or Lesion Removal (any method) 180
Medicine & A/E Colonoscopy with Injecting Submucosal Substance 150
Medicine & A/E Colonoscopy with Dilatation and/or Intraluminal Tube/Stent

Insertion

170
Medicine & A/E Colonoscopy with Control of Bleeding (any method) 200
Medicine & A/E Endoscopic Ultrasound (EUS) – Diagnostic (Upper GI Tract) 400
Medicine & A/E Endoscopic Ultrasound (EUS) – Diagnostic (Lower GI Tract) 300
Medicine & A/E Endoscopic Ultrasound (EUS) – Interventional 800
Medicine & A/E Endoscopic Ultrasound-Guided Fine Needle Aspiration Biopsy

(EUS-FNA)

600
Medicine & A/E Paracentesis 50
Medicine & A/E 24-hour Oesophageal pH Monitoring 200
Medicine & A/E Nasogastric Tube (NGT) Insertion 5
Medicine & A/E Nasogastric Tube (NGT) Removal 2
Medicine & A/E Gastric Lavage 15
Medicine & A/E Endoscopic Retrograde Cholangiopancreatography (ERCP) –

Diagnostic

800
Medicine & A/E Endoscopic Retrograde Cholangiopancreatography (ERCP) with

Biopsy

850
Medicine & A/E Endoscopic Retrograde Cholangiopancreatography (ERCP) and Foreign Body Removal 850
Medicine & A/E Endoscopic Retrograde Cholangiopancreatography (ERCP) and

Tube/Stent Placement (any site)

900

Medicine & A/E

Endoscopic Retrograde Cholangiopancreatography (ERCP) and Removal/Destruction of Calculi 1000
Medicine & A/E Endoscopic Retrograde Cholangiopancreatography (ERCP) with

Sphincterotomy/Papillotomy

1000
Medicine & A/E Endoscopic Retrograde Cholangiopancreatography (ERCP) and

Balloon Dilatation (any site)

1000
Medicine & A/E Sweat Test 50
Medicine & A/E Skin Prick Test 40
Medicine & A/E Patch Test 50
Medicine & A/E Intradermal Skin Test 10
Medicine & A/E Drug Provocative Challenge Test 100
Medicine & A/E Food Provocative Challenge Test 100
Medicine & A/E Immunotherapy/Desensitization (inpatient) 150
Medicine & A/E Immunotherapy/Desensitization (outpatient) 10 (per session)
Medicine & A/E Tracheostomy – Planned 300
Medicine & A/E Tracheostomy – Emergency 150
Medicine & A/E Tracheostomy – Redo 250
Medicine & A/E Changing Tracheostomy Tube 10
Medicine & A/E Tracheostomy Closure (without plastic repair) 150
Medicine & A/E Tracheostomy Closure (with plastic repair) 300
Medicine & A/E Endotracheal Intubation 50
Medicine & A/E Endotracheal Extubation 10
Medicine & A/E Subcutaneous Injection 2
Medicine & A/E Intramuscular Injection 2
Medicine & A/E Intravenous Injection 3
Medicine & A/E Parenteral Nutrition (PN) Administration – Peripheral Line 20
Medicine & A/E Parenteral Nutrition (PN) Administration – Central Line 20
Medicine & A/E Enteral Nutrition (EN) Administration 15
Medicine & A/E Urinary Catheter Insertion (Foley’s catheter) – Male 10
Medicine & A/E Urinary Catheter Insertion (Foley’s catheter) – Female 7
Medicine & A/E Joint Aspiration and/or Injection 25
Medicine & A/E Ganglion/Bursa Aspiration and/or Injection 25
Medicine & A/E Temporal Artery Biopsy 100
Medicine & A/E Epidural Injection/Analgesia 100
Medicine & A/E Intrathecal Injection 100
Medicine & A/E Venipuncture – Percutaneous 2
Medicine & A/E Venipuncture – Cutdown 25
Medicine & A/E Arterial Line Insertion – Percutaneous 25
Medicine & A/E Arterial Line Insertion – Cutdown 60
Medicine & A/E Arterial Puncture (for arterial blood gas analysis) 10
Medicine & A/E Therapeutic Phlebotomy/Venesection 25
Medicine & A/E Umbilical Vein Catheterization 50
Medicine & A/E Insertion of Non-tunneled Central Venous Line 150
Medicine & A/E Insertion of Peripherally-inserted Central Catheter (PICC) 150
Medicine & A/E Insertion of Tunneled Central Venous Line (e.g. Hickman line,

Permcath, Tesio catheter)

250
Medicine & A/E Insertion of Implantable Port (e.g. Porta Cath) 300
Medicine & A/E Removal of Non-tunneled Central Venous Line 30
Medicine & A/E Removal of Peripherally-inserted Central Catheter (PICC) 30
Medicine & A/E Removal of Tunneled Central Venous Line 80
Medicine & A/E Removal of Implantable Port 100
Medicine & A/E Insertion of Peritoneal Dialysis Catheter (e.g. Tenckhoff cathter) 250
Medicine & A/E Re-insertion of Peritoneal Dialysis Catheter 250
Medicine & A/E Removal of Peritoneal Dialysis Catheter – Pulling out 20
Medicine & A/E Removal of Peritoneal Dialysis Catheter – Surgical 150
Medicine & A/E Peritoneal Dialysis 35
Medicine & A/E Haemodialysis 95
Medicine & A/E Urodynamic Study 50
Medicine & A/E Thyroid FNAC 50
Medicine & A/E Parathyroid FNAC 50
Medicine & A/E Saline Suppression Test 20
Medicine & A/E Oral Glucose Tolerance Test (OGTT) 5
Medicine & A/E Low Dose Dexamethasone Suppression Testing (LDDST) 10
Medicine & A/E Continuous Glucose Monitoring System (CGMS) 15 (not including device cost)
Medicine & A/E Continuous Subcutaneous Insulin Infusion (insulin pump therapy) 15 (not including device cost)
Medicine & A/E Foreign Body Removal from Soft Tissue – Superficial 80
Medicine & A/E Foreign Body Removal from Soft Tissue – Deep (simple) 150
Medicine & A/E Foreign Body Removal from Soft Tissue – Deep (complex) 300
Medicine & A/E Removal of Stuck Finger Ring 45
Medicine & A/E Hyperbaric Oxygen Therapy (for mild diving injury) 150
Medicine & A/E Hyperbaric Oxygen Therapy (for severe diving injury) 220
Medicine & A/E Hyperbaric Oxygen Therapy (for routine case) 110
Medicine & A/E Hyperbaric Oxygen Therapy (for emergency case) 120
Medicine & A/E Bone Marrow Aspiration/Biopsy 80
Medicine & A/E Allogeneic Bone Marrow – Fresh 1114
Medicine & A/E Allogeneic Bone Marrow – Frozen 1114
Medicine & A/E Plasmapheresis 116
Medicine & A/E Blood Transfusion Service (≤ 2 years old) 30
Medicine & A/E Blood Transfusion Service (>2 years old) 15
Medicine & A/E Blood Exchange – Newborn 57
Medicine & A/E Blood Exchange (other than newborn) 57
Medicine & A/E Harvest Allogenic Stem Cells 39
Medicine & A/E Harvest Autologous Stem Cells 40
Medicine & A/E Croypreserve Stem Cells 22
Medicine & A/E Thaw Preserved Stem Cells 14
Medicine & A/E Wash Harvest Stem Cells 6
Medicine & A/E T-cell Depletion of Harvest 39
Medicine & A/E Tumor Cell Deplete of Harvest 36
Medicine & A/E RBC Depletion of Harvest 23
Medicine & A/E Platelets Deplete of Harvest 6
Medicine & A/E Volume Deplete of Harvest 20
Medicine & A/E Bone Marrow Harvest Allogeneic 170
Medicine & A/E Bone Marrow/Stem Cell Transplant Autologous 62
Medicine & A/E Bone Marrow/Stem Cell Transplant Allogeneic 61
Medicine & A/E Lymphocyte Infuse Transplant 47
Nursing Newborn Hearing Screening 25
Nursing Tympanometry 10
Nursing Audiometry 15
Nursing 24 Hours Urine Collection 2
Nursing Cervical Collar 2 (not including collar price)
Nursing Cold Compress/Pack 4
Nursing Collar & Cuff Sling 3
Nursing Colostomy/Ileostomy Bag 5
Nursing Crepe Bandage 2
Nursing Hot Compress/Pack 4
Nursing Tubular Bandage (Tubigrip) 2
Nursing Eye Pad 0
Nursing Assisting the Mother for Breast Feeding 0
Nursing Bed Bath 4
Nursing Blood Collection 2
Nursing Cardiotocography (CTG) 10
Nursing Care of Infested Head 3
Nursing Catheter Removal (other than urinary catheter) 5
Nursing Change of Compress/Pack 0
Nursing Changing Napkin 0
Nursing Changing Position 0
Nursing Changing Tracheostomy Tube 10
Nursing Cup Feeding 0
Nursing Cytotoxic Drug/Chemotherapy Administration – Adult 40
Nursing Cytotoxic Drug/Chemotherapy Administration – Paediatric 40
Nursing Drainage Tube Changing 3
Nursing Drainage Tube Removal 4
Nursing Enema Administration 5
Nursing Enteral Nutrition (EN) Administration 15
Nursing Eye Care 3
Nursing Gastric Lavage 15
Nursing Heparin Lock 3
Nursing Home Care Aerosol Therapy 10
Nursing Home Care of Patients on Invasive Ventilation 15
Nursing Home Care of Patients on Non-invasive Ventilation 15
Nursing Home Care Oxygen Therapy 10
Nursing Home Care SpO2 Monitoring 10
Nursing Instilling Eye Drops 0
Nursing Intramuscular Injection 2
Nursing Intravenous Infusion Therapy (other than chemotherapy) 10
Nursing Intravenous Cannulation 3
Nursing Intravenous Injection 3
Nursing Last Offices (Body Shrouding) 120
Nursing Metal Clips Removal 3
Nursing Milk Preparation 0
Nursing Mouth Care 3
Nursing Nasogastric Tube (NGT) Insertion 5
Nursing Nasogastric Tube (NGT) Removal 2
Nursing Nebulized Medication Delivery 5
Nursing NGT Feeding 0
Nursing Oxygen Therapy Via Mask 3
Nursing Oxygen Therapy Via Nasal Catheter 3
Nursing Parenteral Nutrition (PN) Administration – Central Line 20
Nursing Parenteral Nutrition (PN) Administration – Peripheral Line 20
Nursing Perineal Care 3
Nursing Pre-operative Procedures 0
Nursing Pulse Oxymetry 0
Nursing Random Blood Sugar (RBS) Test 1
Nursing Sitze Bath 3
Nursing Splinter Removal 3
Nursing Steam Inhalation 3
Nursing Sterilizing Feeding Utilities 0
Nursing Stoma Care 3
Nursing Subcutaneous Injection 2
Nursing Suctioning 0
Nursing Suppository Administration 1
Nursing Temporary Mobilization 10
Nursing Tepid Sponge 0
Nursing Tetanus Toxoid (TT) Injection 2
Nursing Tracheostomy Nursing Care 3
Nursing Urinary Catheter Insertion (Urethral Catheterization) – Female 7
Nursing Urinary Catheter Insertion (Urethral Catheterization) – Male 10
Nursing Urinary Catheter Removal 2
Nursing Urinary Condom Application 3
Nursing Urine Collection – Single Sample 1
Nursing Urine Dipstick 1
Nursing Vaccine Administration (other than TT) 2
Nursing Wound Dressing 3
Nursing Wound Sutures Removal 3
Orthopedics Muscle Biopsy – Needle 70
Orthopedics Muscle Biopsy – Open 150
Orthopedics Bone Biopsy (needle) – Superficial Bone 80
Orthopedics Bone Biopsy (needle) – Deep Bone 100
Orthopedics Bone Biopsy (surgical) 250
Orthopedics Foreign Body Removal from Soft Tissue – Superficial 80
Orthopedics Foreign Body Removal from Soft Tissue – Deep (simple) 150
Orthopedics Foreign Body Removal from Soft Tissue – Deep (complex) 300
Orthopedics Penetrating Wound Exploration (without repair) – Extremities 200
Orthopedics Incision & Drainage of Wound Hematoma – Small 30
Orthopedics Incision & Drainage of Wound Hematoma – Large 50
Orthopedics Incision & Drainage of Wound Abscess – Small 40
Orthopedics Incision & Drainage of Wound Abscess – Large 70
Orthopedics Joint Aspiration and/or Injection 25
Orthopedics Ganglion/Bursa Aspiration and/or Injection 25
Orthopedics Incision & Drainage of Bursa 150
Orthopedics Incision of Bone Cortex (e.g. osteomyelitis, bone abscess) – Upper

Limb

350
Orthopedics Incision of Bone Cortex (e.g. osteomyelitis, bone abscess) – Lower

Limb (other than hip)

450
Orthopedics Incision of Bone Cortex (e.g. osteomyelitis, bone abscess) –

Hip/Pelvis

700
Orthopedics Partial Excision of Bone (e.g. sequestrectomy, saucerization,

diaphysectomy) – Upper Limb

450
Orthopedics Partial Excision of Bone (e.g. sequestrectomy, saucerization,

diaphysectomy) – Lower Limb

450
Orthopedics Partial Excision of Bone (e.g. sequestrectomy, saucerization,

diaphysectomy) – Pelvis

700
Orthopedics Partial Excision of Bone (e.g. sequestrectomy, saucerization,

diaphysectomy) – Scapula

600
Orthopedics Partial Excision of Bone (e.g. sequestrectomy, saucerization,

diaphysectomy) – Clavicle

450
Orthopedics Marginal Excision of Soft Tissue Tumor – Upper Limb 700
Orthopedics Wide Excision of Soft Tissue Tumor (without graft) – Upper Limb 900
Orthopedics Wide Excision of Soft Tissue Tumor (with graft) – Upper Limb 1200
Orthopedics Radical Excision of Soft Tissue Tumor – Upper Limb 1800
Orthopedics Marginal Excision of Soft Tissue Tumor – Lower Limb 700
Orthopedics Wide Excision of Soft Tissue Tumor (without graft) – Lower Limb 900
Orthopedics Wide Excision of Soft Tissue Tumor (with graft) – Lower Limb 1200
Orthopedics Radical Excision of Soft Tissue Tumor – Lower Limb 1800
Orthopedics Marginal Excision of Soft Tissue Tumor – Pelvis 700
Orthopedics Wide Excision of Soft Tissue Tumor (without graft) – Pelvis 900
Orthopedics Wide Excision of Soft Tissue Tumor (with graft) – Pelvis 1200
Orthopedics Radical Excision of Soft Tissue Tumor – Pelvis 1800
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (without graft)

– Upper Limb

900
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (with graft) –

Upper Limb

1200
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (without graft)

– Pelvis

1100
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (with graft) –

Pelvis

1500
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (without graft)

– Lower Limb

900
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (with graft) –

Lower Limb

1200
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (without graft)

– Clavicle

900
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (with graft) –

Clavicle

1200

Orthopedics

Excision/Curettage of Bone Cyst or Benign Tumor (without graft)

– Scapula

900
Orthopedics Excision/Curettage of Bone Cyst or Benign Tumor (with graft) –

Scapula

1200
Orthopedics Radical Excision of Bone Tumor – Upper Limb 1800
Orthopedics Radical Excision of Bone Tumor – Pelvis 1800
Orthopedics Radical Excision of Bone Tumor – Lower Limb 1800
Orthopedics Radical Excision of Bone Tumor – Scapula 1800
Orthopedics Radical Excision of Bone Tumor – Clavicle 1800
Orthopedics Arthrotomy (for exploration, drainage, or removal of loose or

foreign body)

900
Orthopedics Arthrotomy and Repair 900
Orthopedics Arthrotomy and Biopsy – Small Joint 500
Orthopedics Arthrotomy and Biopsy – Large Joint 700
Orthopedics Joint Resection (arthrectomy) 900
Orthopedics Capsulotomy – Large Joint or Complex 1000
Orthopedics Capsulotomy – Small Joint or Simple 700
Orthopedics Capsulorrhaphy – Large Joint or Complex 700
Orthopedics Capsulorrhaphy – Small Joint or Simple 500
Orthopedics Bankart Procedure 1400
Orthopedics Bristow Procedure 1100
Orthopedics Boytchev Procedure 1400
Orthopedics Capsulectomy – Large Joint or Complex 1100
Orthopedics Capsulectomy – Small Joint or Simple 700
Orthopedics Capsulodesis 700
Orthopedics Acromioclavicular Joint Repair/Reconstruction 1400
Orthopedics Prophylactic Fixation of Bone 900
Orthopedics Fasciotomy – Upper Limb 500
Orthopedics Fasciotomy – Pelvic Compartment 900
Orthopedics Fasciotomy –Thigh/Knee 700
Orthopedics Iliotibial Fasciotomy (Yount Release) 700
Orthopedics Fasciotomy – Leg 600
Orthopedics Fasciotomy – Foot/Toe 500
Orthopedics Fasciotomy – Endoscopic 700
Orthopedics Fasciectomy – Upper Limb 500
Orthopedics Fasciectomy – Lower Limb 500
Orthopedics Plantar Fascia Release (e.g. Steindler stripping) 500
Orthopedics Fascial Defect Repair 400
Orthopedics Excision of Bursa 500
Orthopedics Excision of Popliteal Cyst (Baker Cyst) 1100
Orthopedics Excision of Ganglion – Knee 1100
Orthopedics Excision of Ganglion (other than knee) 500
Orthopedics Excision of other lesions of Joint Capsule or Tendon Sheath –

Knee

700
Orthopedics Excision of other lesions of Joint Capsule or Tendon Sheath (other

than knee)

500
Orthopedics Excision of other lesions of Joint Capsule or Tendon Sheath (other

than knee) – Radical

700
Orthopedics Bone Cyst Aspiration and/or Injection 120
Orthopedics Muscle Transfer 1000
Orthopedics Muscle Repair (other than rotator cuff) 700
Orthopedics Rotator Cuff Repair 1400
Orthopedics Acromioplasty 1100
Orthopedics Scapulopexy 800
Orthopedics Bone Resection – Coccyx (coccygectomy) 2000
Orthopedics Bone Resection – Humeral Head 700
Orthopedics Bone Resection – Distal Ulna (e.g. Darrach procedure) 500
Orthopedics Bone Resection – Carpal Bone (Carpectomy) 1100
Orthopedics Bone Resection – Radial Head 500
Orthopedics Bone Resection (not specified elsewhere) – Minor 500
Orthopedics Bone Resection (not specified elsewhere) – Major 900
Orthopedics Bone Resection – Calcaneus/Tarsal Bone (e.g. Kidner procedure) 700
Orthopedics Bone Resection – Metatarsal 500
Orthopedics Bone Resection – Phalanx 500
Orthopedics Bone Resection – Sesamoid Bone 500
Orthopedics Bone Resection – Clavicle (partial) 900
Orthopedics Bone Resection – Clavicle (total) 1400
Orthopedics Excision of Osteochondritis Dissecans 900
Orthopedics Drilling of Osteochondritis Dissecans 900
Orthopedics Excision of Myositis Ossificans 1400
Orthopedics Osteochondral Graft (as sole procedure) 1400
Orthopedics Tendon Lengthening 900
Orthopedics Tendon Shortening 900
Orthopedics Tenotomy – Percutaneous 200
Orthopedics Tenotomy – Open 300
Orthopedics Tenodesis 300
Orthopedics DeQuervain Tendon Release 500
Orthopedics Trigger Finger Release 350
Orthopedics Tendon Sheath Incision (not specified elsewhere) 200
Orthopedics Tendon Sheath Repair (not specified elsewhere) 900
Orthopedics Tendon Pulley Reconstruction 900
Orthopedics Tenoplasty 900
Orthopedics Tendon Excision 300
Orthopedics Tendon Excision (with synthetic rod implantation) 900
Orthopedics Flexor Tendon Repair 900
Orthopedics Extensor Tendon Repair 900
Orthopedics Tendon Repair (not specified elsewhere) 900
Orthopedics Boutonniere Deformity Correction 900
Orthopedics Mallet Deformity Correction 900
Orthopedics Tendon Transfer – Single 900
Orthopedics Tendon Transfer – Multiple 1200
Orthopedics Ligament Repair (not specified elsewher) 1800
Orthopedics Collateral Ligament Repair 1800
Orthopedics Cruciate Ligament Repair 1800
Orthopedics Collateral AND Cruciate Ligaments Repair 2800
Orthopedics Arthroscopic Repair of Anterior Cruciate Ligament 1800
Orthopedics Arthroscopic Repair of Posterior Cruciate Ligament 1800
Orthopedics Arthroscopic Repair of Anterior AND Posterior Cruciate

Ligaments

2800
Orthopedics Hemiarthroplasty – Shoulder 1800
Orthopedics Hemiarthroplasty – Hip 1800
Orthopedics Arthroplasty – Shoulder (total) 2800
Orthopedics Revision Arthroplasty – Shoulder 4800
Orthopedics Arthroplasty – Elbow 2800
Orthopedics Revision Arthroplasty – Elbow 4800
Orthopedics Acetabuloplasty 1800
Orthopedics Arthroplasty – Hip (total) 2800
Orthopedics Revision Arthroplasty – Hip 4800
Orthopedics Arthroplasty – Knee (total) 2800
Orthopedics Arthroplasty – Knee (hinge prosthesis) 3800
Orthopedics Arthroplasty – Knee (unicompartmental) 2800
Orthopedics Arthroplasty – Knee (others) 2800
Orthopedics Arthroplasty – Patella 1800
Orthopedics Revision Arthroplasty – Knee 4800
Orthopedics Arthroplasty – Ankle 2800
Orthopedics Revision Arthroplasty – Ankle 4800
Orthopedics Arthroplasty – Foot 2800
Orthopedics Sternocleidomastoid Muscle Release 300
Orthopedics Patellar Retinacular Release and Medial Plication 300
Orthopedics Reconstruction of Dislocating Patella 900
Orthopedics Arthrodesis – Shoulder 900
Orthopedics Arthrodesis – Scapulothoracic 1000
Orthopedics Arthrodesis – Elbow 900
Orthopedics Arthrodesis – Sacroiliac Joint 900
Orthopedics Arthrodesis – Symphysis Pubis 900
Orthopedics Arthrodesis – Hip 1800
Orthopedics Arthrodesis – Knee 1800
Orthopedics Arthrodesis – Ankle 1800
Orthopedics Arthrodesis – Tibiofibular Joint 900
Orthopedics Arthrodesis – Pantalar 1800
Orthopedics Arthrodesis – Triple 2800
Orthopedics Arthrodesis – Subtalar 1800
Orthopedics Arthrodesis – Foot (not specified elsewhere) 900
Orthopedics Arthrodesis – Toe 900
Orthopedics Arthrodesis – Others 900
Orthopedics Closed Reduction of Spontaneous Hip Dislocation (e.g. congenital hip dislocation) 400
Orthopedics Open Reduction of Spontaneous Hip Dislocation (e.g. congenital

hip dislocation)

900
Orthopedics Open Reduction of Spontaneous Hip Dislocation (e.g. congenital

hip dislocation) – with femoral shaft shortening

1800
Orthopedics Closed Reduction of Dislocation – Sternoclavicular Joint 300
Orthopedics Closed Reduction of Dislocation – Acromioclavicular Joint 300
Orthopedics Closed Reduction of Dislocation – Shoulder 300
Orthopedics Closed Reduction of Dislocation – Elbow 300
Orthopedics Closed Reduction of Dislocation – Wrist 300
Orthopedics Closed Reduction of Dislocation – Metacarpophalangeal Joint 300
Orthopedics Closed Reduction of Dislocation – Interphalangeal Joint (finger) 300
Orthopedics Closed Reduction of Dislocation – Hip 300
Orthopedics Closed Reduction of Dislocation – Knee 300
Orthopedics Closed Reduction of Dislocation – Patella 300
Orthopedics Closed Reduction of Dislocation – Ankle/Foot 300
Orthopedics Closed Reduction of Dislocation – Metatarsophalangeal Joint 200
Orthopedics Closed Reduction of Dislocation – Interphalangeal Joint (toe) 200
Orthopedics Open Reduction of Dislocation – Sternoclavicular Joint 900
Orthopedics Open Reduction of Dislocation – Acromioclavicular Joint 900
Orthopedics Open Reduction of Dislocation – Shoulder 900
Orthopedics Open Reduction of Dislocation – Elbow 900
Orthopedics Open Reduction of Dislocation – Wrist 900
Orthopedics Open Reduction of Dislocation – Metacarpophalangeal Joint 900
Orthopedics Open Reduction of Dislocation – Interphalangeal Joint (finger) 900
Orthopedics Open Reduction of Dislocation – Hip 900
Orthopedics Open Reduction of Dislocation – Knee 900
Orthopedics Open Reduction of Dislocation – Knee (with ligamentous repair) 2800
Orthopedics Open Reduction of Dislocation – Patella 1800
Orthopedics Open Reduction of Dislocation – Ankle/Foot 900
Orthopedics Open Reduction of Dislocation – Metatarsophalangeal Joint 450
Orthopedics Open Reduction of Dislocation – Interphalangeal Joint (toe) 450
Orthopedics Bunion (hallux valgus) Correction 900
Orthopedics Centralization of Carpus 900
Orthopedics Radioulnar Synostosis Resection 900
Orthopedics Club Foot (congenital talipes equinovarus) Correction – Ponseti

Method

180
Orthopedics Club Foot (congenital talipes equinovarus) Correction – External Fixator 700
Orthopedics Club Foot (congenital talipes equinovarus) Correction – Soft

Tissue Release

450
Orthopedics Joint Manipulation (other than dislocation) 180
Orthopedics Amputation Stump Secondary Closure or Scar Revision 400
Orthopedics Re-amputation/Revision Amputation 900
Orthopedics Amputation Stump Elongation 900
Orthopedics Cineplasty (connecting prosthesis to amputation stump) 900
Orthopedics Krukenberg Procedure (converting amputation stump to pincer) 900
Orthopedics Forequarter Amputation (interthoracoscapular amputation) 1400
Orthopedics Above Elbow Amputation 900
Orthopedics Below Elbow Amputation 900
Orthopedics Hand Amputation (transmetacarpal amputation) 900
Orthopedics Thumb/Finger Amputation (e.g. ray amputation) 900
Orthopedics Hindquarter Amputation (interpelviabdominal amputation) 1800
Orthopedics Above Knee Amputation 900
Orthopedics Below Knee Amputation 900
Orthopedics Foot Amputation (midtarsal) 900
Orthopedics Foot Amputation (transmetatarsal) 900
Orthopedics Toe Amputation (e.g. ray amputation) 450
Orthopedics Shoulder Disarticulation 900
Orthopedics Wrist Disarticulation 900
Orthopedics Hip Disarticulation 900
Orthopedics Knee Disarticulation 900
Orthopedics Ankle Disarticulation (Syme’s amputation) 900
Orthopedics Arthroscopy – Diagnostic 600
Orthopedics Arthroscopic Capsulorrhaphy 800
Orthopedics Arthroscopic Removal of Loose or Foreign Body 600
Orthopedics Arthroscopic Synovectomy 600
Orthopedics Arthroscopic Drainage & Lavage 600
Orthopedics Arthroscopic Debridement 600
Orthopedics Arthroscopic Lysis of Adhesions 600
Orthopedics Arthroscopic Rotator Cuff Repair 2000
Orthopedics Arthroscopic Repair/Fixation of Fracture or Instability 2000
Orthopedics Arthroscopic Cartilage Repair 1000
Orthopedics Arthroscopic Labral Repair 2000
Orthopedics Arthroscopic Abrasion Arthroplasty 1000
Orthopedics Arthroscopic Restoration of Articular Cartilage (e.g. drilling,

microfracture)

1000
Orthopedics Arthroscopic Osteochondral Allograft (e.g. mosaicplasty) 1500
Orthopedics Arthroscopy Meniscal Transplantation 3000
Orthopedics Arthroscopic Meniscectomy 800
Orthopedics Arthroscopic Meniscus Repair 800
Orthopedics Arthroscopic Ligament Release 600
Orthopedics Arthroscopic Tenodesis 600
Orthopedics Arthroscopic Acetabuloplasty 1000
Orthopedics Arthroscopic Femoroplasty 1000
Orthopedics Osteotomy – Clavicle 1000
Orthopedics Osteotomy – Humerus 1000
Orthopedics Osteotomy – Radius/Ulna 1000
Orthopedics Osteotomy – Radius & Ulna 1000
Orthopedics Osteotomy – Metacarpal/Phalanx 1000
Orthopedics Osteotomy – Pelvic Bone 2000
Orthopedics Osteotomy – Femur (neck) 2000
Orthopedics Osteotomy – Femur (intertrochanteric or subtrochanteric) 2000
Orthopedics Osteotomy – Femur (others) 2000
Orthopedics Osteotomy – for Genu Varus/Valgus 1500
Orthopedics Osteotomy – Tibia 1500
Orthopedics Osteotomy – Fibula 1000
Orthopedics Osteotomy – Tibia & Fibula 2000
Orthopedics Osteotomy – Calcaneus/ Tarsal Bones 1500
Orthopedics Osteotomy – Metatarsal 1500
Orthopedics Osteotomy – Phalanx (toe) 1000
Orthopedics Osteotomy (Multiple) – Humerus 2000
Orthopedics Osteotomy (Multiple) – Radius/Ulna 1500
Orthopedics Osteotomy (Multiple) – Radius & Ulna 1500
Orthopedics Osteotomy (Multiple) – Femur 2000
Orthopedics Osteotomy (Multiple) – Leg 2000
Orthopedics Osteotomy (Multiple) – Metatarsal 1500
Orthopedics Nonunion/Malunion Repair – Clavicle 2000
Orthopedics Nonunion/Malunion Repair – Humerus 2000
Orthopedics Nonunion/Malunion Repair – Radius 2000
Orthopedics Nonunion/Malunion Repair – Ulna 2000
Orthopedics Nonunion/Malunion Repair – Radius & Ulna 2000
Orthopedics Nonunion/Malunion Repair – Carpal Bone 2000
Orthopedics Nonunion/Malunion Repair – Metacarpal/Phalanx 1500
Orthopedics Nonunion/Malunion Repair – Femur 2000
Orthopedics Nonunion/Malunion Repair – Tibia 2000
Orthopedics Nonunion/Malunion Repair – Fibula 1500
Orthopedics Nonunion/Malunion Repair – Tarsal Bone 1500
Orthopedics Nonunion/Malunion Repair – Metatarsal Bone 1500
Orthopedics Epiphyseal/Hemiepiphyseal Arrest 1000
Orthopedics Slipped Femoral Epiphysis – In Situ Fixation 1000
Orthopedics Slipped Femoral Epiphysis – Open Reduction 1000
Orthopedics Femoral Bone Grafting 1000
Orthopedics Skeletal Traction (e.g. Steinmann pin insertion) 180
Orthopedics Skull Tong Application 180
Orthopedics Halo Traction Application 450
Orthopedics Halo/Tong Removal 80
Orthopedics External Fixation System Application (uniplane) 900
Orthopedics External Fixation System Application (multiplane) 1800
Orthopedics External Fixation System Replacement (uniplane) 900
Orthopedics External Fixation System Replacement (multiplane) 1800
Orthopedics External Fixation System Adjustment/Revision 400
Orthopedics External Fixation System Removal 280
Orthopedics Implant Removal – Upper Limb Joint 900
Orthopedics Implant Removal – Hip 900
Orthopedics Implant Removal – Hip (complicated) 1800
Orthopedics Implant Removal – Knee 1400
Orthopedics Implant Removal – Ankle 900
Orthopedics Implant Removal (e.g. fixation wires, plates, screws) – Superficial 280
Orthopedics Implant Removal (e.g. fixation wires, plates, screws) – Deep 450
Orthopedics Cast Application – Body Cast 180
Orthopedics Cast Application – Upper Limb 80
Orthopedics Cast Application – Lower Limb (long leg cast) 120
Orthopedics Cast Application – Lower Limb (short leg cast) 80
Orthopedics Cast Application – Hip Spica 120
Orthopedics Cast Modification/Repair 40
Orthopedics Cast Removal 30
Orthopedics Splint Application – Upper Limb (except fingers) 40
Orthopedics Splint Application – Fingers 25
Orthopedics Splint Application – Lower Limb 40
Orthopedics Splint Removal 8
Orthopedics Strapping/Taping 25
Orthopedics Bone Lengthening – Humerus 1500
Orthopedics Bone Lengthening – Radius/Ulna 1500
Orthopedics Bone Lengthening – Radius & Ulna 1500
Orthopedics Bone Lengthening – Metacarpal/Phalanx 1000
Orthopedics Bone Lengthening – Femur 2000
Orthopedics Bone Lengthening – Tibia/Fibula 2000
Orthopedics Bone Shortening – Humerus 1500
Orthopedics Bone Shortening – Radius/Ulna 1000
Orthopedics Bone Shortening – Radius & Ulna 1500
Orthopedics Bone Shortening – Carpal Bone 1000
Orthopedics Bone Shortening – Femur 1500
Orthopedics Bone Shortening – Tibia/Fibula 1500
Orthopedics Closed Reduction of Fracture – Rib 100
Orthopedics Closed Reduction of Fracture – Sternum 100
Orthopedics Closed Reduction of Fracture – Clavicle 200
Orthopedics Closed Reduction of Fracture – Scapula 200
Orthopedics Closed Reduction of Fracture – Humerus 200
Orthopedics Closed Reduction of Fracture – Humerus (with percutaneous

fixation)

500
Orthopedics Closed Reduction of Fracture – Ulna 300
Orthopedics Closed Reduction of Fracture – Ulna (with percutaneous fixation) 500
Orthopedics Closed Reduction of Fracture – Radius 300
Orthopedics Closed Reduction of Fracture – Radius (with percutaneous fixation) 500
Orthopedics Closed Reduction of Fracture – Radius & Ulna 600
Orthopedics Closed Reduction of Fracture – Radius & Ulna (with percutaneous

fixation)

800
Orthopedics Closed Reduction of Fracture – Carpal Bone 300
Orthopedics Closed Reduction of Fracture – Carpal Bone (with percutaneous

fixation)

500
Orthopedics Closed Reduction of Fracture – Metacarpal Bone 300
Orthopedics Closed Reduction of Fracture – Metacarpal Bone (with

percutaneous fixation)

500
Orthopedics Closed Reduction of Fracture – Phalanx 200
Orthopedics Closed Reduction of Fracture – Phalanx (with percutaneous

fixation)

300
Orthopedics Closed Reduction of Fracture – Pelvic Ring 300
Orthopedics Closed Reduction of Fracture – Pelvic Ring (with percutaneous fixation) 600
Orthopedics Closed Reduction of Fracture – Coccyx 200
Orthopedics Closed Reduction of Fracture – Acetabulum 300
Orthopedics Closed Reduction of Fracture – Acetabulum (with percutaneous

fixation)

600
Orthopedics Closed Reduction of Fracture – Femur 300
Orthopedics Closed Reduction of Fracture – Femur (with percutaneous fixation) 600
Orthopedics Closed Reduction of Fracture – Patella 300
Orthopedics Closed Reduction of Fracture – Patella (with percutaneous

fixation)

600
Orthopedics Closed Reduction of Fracture – Tibia 300
Orthopedics Closed Reduction of Fracture – Tibia (with percutaneous fixation) 600
Orthopedics Closed Reduction of Fracture – Fibula 300
Orthopedics Closed Reduction of Fracture – Tibia & Fibula 600
Orthopedics Closed Reduction of Fracture – Calcaneus/Tarsal Bone 300
Orthopedics Closed Reduction of Fracture – Calcaneus/Tarsal Bone (with

percutaneous fixation)

500
Orthopedics Closed Reduction of Fracture – Metatarsal Bone 300
Orthopedics Closed Reduction of Fracture – Metatarsal Bone (with percutaneous fixation) 500
Orthopedics Closed Reduction of Fracture – Phalanx (toe) 200
Orthopedics Closed Reduction of Fracture – Phalanx (toe) (with percutaneous

fixation)

300
Orthopedics Open Reduction of Fracture (without fixation) – Rib 200
Orthopedics Open Reduction of Fracture (with fixation) – Rib 800
Orthopedics Open Reduction of Fracture – Sternum 800
Orthopedics Open Reduction of Fracture – Clavicle 800
Orthopedics Open Reduction of Fracture – Scapula 1500
Orthopedics Open Reduction of Fracture – Humerus 1500
Orthopedics Open Reduction of Fracture – Ulna 800
Orthopedics Open Reduction of Fracture – Radius 800
Orthopedics Open Reduction of Fracture – Radius & Ulna 1500
Orthopedics Open Reduction of Fracture – Carpal Bone 800
Orthopedics Open Reduction of Fracture – Metacarpal Bone 800
Orthopedics Open Reduction of Fracture – Phalanx (finger) 600
Orthopedics Open Reduction of Fracture – Pelvic Bone 1500
Orthopedics Open Reduction of Fracture – Coccyx 800
Orthopedics Open Reduction of Fracture – Acetabulum 1500
Orthopedics Open Reduction of Fracture – Femur 1500
Orthopedics Open Reduction of Fracture – Patella 1000
Orthopedics Open Reduction of Fracture – Tibia 1500
Orthopedics Open Reduction of Fracture – Fibula 1000
Orthopedics Open Reduction of Fracture – Tibia & Fibula 1500
Orthopedics Open Reduction of Fracture – Calcaneus/Tarsal Bone 1000
Orthopedics Open Reduction of Fracture – Calcaneus/Tarsal Bone (with graft) 1500
Orthopedics Open Reduction of Fracture – Metatarsal Bone 1000
Orthopedics Open Reduction of Fracture – Phalanx (toe) 800
Orthopedics Spine: Posterior Lumbar Interbody Fusion – Single Level 2000
Orthopedics Spine: Posterior Lumbar Interbody Fusion – Double Level 3000
Orthopedics Spine: Posterior Lumbar Interbody Fusion – Multiple Level 4000
Orthopedics Spine: Posterolateral Fusion – Single Level 1500
Orthopedics Spine: Posterolateral Fusion – Double Level 2500
Orthopedics Spine: Posterolateral Fusion – Multiple Level 3500
Orthopedics Spine: Transforaminal Lumbar Interbody Fusion – Single Level 1500
Orthopedics Spine: Transforaminal Lumbar Interbody Fusion – Double Level 2500
Orthopedics Spine: Transforaminal Lumbar Interbody Fusion – Multiple Level 3000
Orthopedics Spine: Anterior Cervical Discectomy and Fusion – Single Level 1500
Orthopedics Spine: Anterior Cervical Discectomy and Fusion – Double Level 2500
Orthopedics Spine: Anterior Cervical Discectomy and Fusion – Multiple Level 3000
Orthopedics Spine: Minimally Invasive Lumbar Discectomy – Single Level 1000
Orthopedics Spine: Minimally Invasive Lumbar Discectomy – Double Level 1500
Orthopedics Spine: Anterior Cervical Corpectomy and Fusion – Single Level 2000
Orthopedics Spine: Anterior Cervical Corpectomy and Fusion – Double Level 3000
Orthopedics Spine: Anterior Thoraco-lumbar Corpectomy and Fusion 3000
Orthopedics Spine: Enbloc Spondylectomy 2500
Orthopedics Spine: Posterior Lumbar Corpectomy and Fusion 2500
Orthopedics Spine: Foraminotomy Discectomy – Single Level 1000
Orthopedics Spine: Foraminotomy Discectomy – Double Level 1500
Orthopedics Spine: Foraminotomy Discectomy – Multiple Level 2500
Orthopedics Spine: Anterior Scoliosis Correction 3000
Orthopedics Spine: Revision of Scoliosis Correction 4000
Orthopedics Spine: Posterior Scoliosis Correction 3000
Orthopedics Spine: Posterior Kyphosis Correction 3000
Orthopedics Spine: Posterior Vertebral Column Resection 3000
Orthopedics Spine: Posterior Ponte Osteotomy 2000
Orthopedics Spine: Posterior Smith-Petersen Osteotomy 2000
Orthopedics Spine: Posterior Pedicle Subtraction Osteotomy 2000
Orthopedics Spine: Posterior Hemivertebrectomy 1500
Orthopedics Spine: Anterior Hemivertebrectomy 1500
Orthopedics Spine: Posterior Cervical Laminectomy/Laminoplasty – Single

Level

2000
Orthopedics Spine: Posterior Cervical Laminectomy/Laminoplasty – Double Level 3000
Orthopedics Spine: Posterior Cervical Laminectomy/Laminoplasty – Multiple

Level

4000
Orthopedics Spine: Laminectomy/Laminoplasty – Single Level 2000
Orthopedics Spine: Laminectomy/Laminoplasty – Double Level 3000
Orthopedics Spine: Laminectomy/Laminoplasty – Multiple Level 4000
Orthopedics Spine: Posterior Short Segment Fixation for Fracture 1000
Orthopedics Spine: Posterior Long Segment Fixation for Fracture 1500
Orthopedics Spine: Removal of Cervical Spine Implant 1000
Orthopedics Spine: Removal of Thoraco-lumbar Spine Implant 1500
Orthopedics Spine: Revision for Lumbar Failure 3000
Orthopedics Spine: Exploration or Re-exploration of Spinal Surgery 1500
Orthopedics Spine: Manipulation of Spine 200
Orthopedics Spine: Insertion of Spinal Fixation Device 1500
Orthopedics Spine: Closed Reduction of Fracture – Vertebral Process 300
Orthopedics Spine: Closed Reduction of Fracture/Dislocation – Vertebral Body 600
Orthopedics Spine: Open Reduction of Fracture/Dislocation – Vertebral Body 1500
Orthopedics Spine: Incision & Drainage of Abscess/Haematoma 1000
Plastic Surgery Cranioplasty – Simple 1200
Plastic Surgery Cranioplasty – Major 1800
Plastic Surgery Cranioplasty – Complex 2000
Plastic Surgery Cranioplasty – Patient-Specific Implant (PSI) 2500
Plastic Surgery Transcranial Monobloc Advancement 4000
Plastic Surgery Transcranial Fronto-orbital Advancement 3000
Plastic Surgery Other Major Craniofacial Procedures 2000
Plastic Surgery Orbital Fracture Repair – Open 1200
Plastic Surgery Orbital Fracture Repair – Closed 800
Plastic Surgery Orbital Box Osteotomy 2000
Plastic Surgery Orbital Dystopia Correction 2000
Plastic Surgery Orbital Reconstruction 1800
Plastic Surgery Orbital Reconstruction – Titanium Mesh 1200
Plastic Surgery Cranial Vault Reconstruction – Simple 1800
Plastic Surgery Cranial Vault Reconstruction – Complex 2500
Plastic Surgery Cranial Vault Reconstruction – Total 3000
Plastic Surgery Cranial Vault Expansion and Reshaping 3000
Plastic Surgery Cranial Vault Remodeling 2500
Plastic Surgery Cranial Reconstruction – Titanium Mesh 1200
Plastic Surgery Cranial Reconstruction with Autologous Bone – Rib 1800
Plastic Surgery Cranial Reconstruction with Autologous Bone – Iliac 1800
Plastic Surgery Transcranial Craniectomy (e.g. for osteomyelitis) 1200
Plastic Surgery Elevation of Depressed Skull Fracture (without cranioplasty) 800
Plastic Surgery Posterior Cranial Decompression 1500
Plastic Surgery Bitemporal Cranial Decompression 1500
Plastic Surgery Facial Nerve Reconstruction 1000
Plastic Surgery Facial Nerve Repair 800
Plastic Surgery Orbital Decompression – Transcranial 850
Plastic Surgery Open Reduction Internal Fixation (ORIF) – Cranial Bones 1200
Plastic Surgery LeFort I Osteotomy 1800
Plastic Surgery LeFort II Osteotomy 1800
Plastic Surgery LeFort III Osteotomy and Advancement – Transcranial 2500
Plastic Surgery LeFort III Osteotomy and Advancement – Extracranial 2000
Plastic Surgery Other Maxillary Osteotomy 800
Plastic Surgery Sagittal Split Osteotomy 1500
Plastic Surgery Subsigmoid Osteotomy 1000
Plastic Surgery Other Mandibular Osteotomy 700
Plastic Surgery Open Reduction Internal Fixation (ORIF) of Maxilla/Zygoma –

Simple

800
Plastic Surgery Open Reduction Internal Fixation (ORIF) of Maxilla/Zygoma –

Complex

1000
Plastic Surgery Open Reduction Internal Fixation (ORIF) of Mandible – Simple 800
Plastic Surgery Open Reduction Internal Fixation (ORIF) of Mandible – Complex 1000
Plastic Surgery Closed Reduction of Maxilla/Zygoma Fracture 400
Plastic Surgery Closed Reduction of Mandibular Fracture 400
Plastic Surgery Eyebrow Reconstruction 500
Plastic Surgery Eyelid Reconstruction – Upper Eyelid 500
Plastic Surgery Eyelid Reconstruction – Lower Eyelid 500
Plastic Surgery Ptosis Correction 700
Plastic Surgery Canthopexy 400
Plastic Surgery Canthoplasty 400
Plastic Surgery Canthal Reinsertion 300
Plastic Surgery Correction of Oriental Eye 500
Plastic Surgery Ectropion Correction 400
Plastic Surgery Entropion Correction 400
Plastic Surgery Bat Ear Correction – Modified Converse Technique 600
Plastic Surgery Bat Ear Correction – Chonget Technique 600
Plastic Surgery Ear Lobe Reconstruction 450
Plastic Surgery Ear Reconstruction – Costochondral Graft (Stage I) 2000
Plastic Surgery Ear Reconstruction – Costochondral Graft (Stage II) 800
Plastic Surgery Ear Reconstruction – Costochondral Graft (Stage III) 500
Plastic Surgery Ear Reconstruction – Silastic Implant 800
Plastic Surgery Ear Reconstruction – Release and Skin Graft 600
Plastic Surgery Ear Reconstruction – Dieffenbach Technique 600
Plastic Surgery Closure of Conchal Perforation 250
Plastic Surgery Closure of Ear Lobe Perforation 250
Plastic Surgery Otoplasty 450
Plastic Surgery Septorhinoplasty (plastic surgery) 1200
Plastic Surgery Excision of Rhinophyma 600
Plastic Surgery Redo Rhinoplasty 1800
Plastic Surgery Corrective Rhinoplasty 1200
Plastic Surgery Reduction Rhinoplasty 800
Plastic Surgery Augmentation Rhinoplasty 1200
Plastic Surgery Cleft Rhinoplasty 1200
Plastic Surgery Cleft Nose – Secondary Correction 800
Plastic Surgery Nasal Tip Correction 600
Plastic Surgery Alar Correction 550
Plastic Surgery Nasal Dorsal Augmentation 800
Plastic Surgery Nose Reconstruction – Total 2000
Plastic Surgery Nose Reconstruction – Others 800
Plastic Surgery Cheek Reconstruction 700
Plastic Surgery Genioplasty 800
Plastic Surgery Facial Reconstructive Surgery (not specified elsewhere) 600
Plastic Surgery Facial Cosmetic Surgery (not specified elsewhere) 600
Plastic Surgery Implant – Nasal Bridge 500
Plastic Surgery Implant – Malar 600
Plastic Surgery Implant – Chin Prosthesis 500
Plastic Surgery Lip Reconstruction – Upper Lip 500
Plastic Surgery Lip Reconstruction – Lower Lip 500
Plastic Surgery Revision Lip 500
Plastic Surgery Lip Adhesion 400
Plastic Surgery Cleft Lip Repair – Millard I Operation 1200
Plastic Surgery Cleft Lip Repair – Millard II Operation 1200
Plastic Surgery Cleft Lip Repair – Bilateral Millard Operation (Single Stage) 1500
Plastic Surgery Cleft Lip Repair – Bilateral Millard Operation (Staged Operation) 1200
Plastic Surgery Cleft Lip Repair – Straight Line Repair 1000
Plastic Surgery Cleft Lip Repair – Modified Manchester Technique 1200
Plastic Surgery Cleft Lip Repair – Deepening of Sulcus 500
Plastic Surgery Cleft Lip Repair – Skoog Technique 1200
Plastic Surgery Cleft Lip Repair – Tennison Technique 1200
Plastic Surgery Cleft Lip Repair with Closed Rhinoplasty 1500
Plastic Surgery Columella Lengthening 500
Plastic Surgery Correction of Whistle Tip Deformity (Central Vermilion Defect) 600
Plastic Surgery Correction of Vermilion Notching 400
Plastic Surgery Palatoplasty 600
Plastic Surgery Palatal Fistula Closure – Local Flap 800
Plastic Surgery Palatal Fistula Closure – Tongue Flap 1200
Plastic Surgery Palate Repair – Dorrance (V-Y Pushback) Operation 1200
Plastic Surgery Palate Repair – Veau-Wardill-Kilner Technique 1200
Plastic Surgery Palate Repair – Langenbeck Technique 1000
Plastic Surgery Palate Repair – Bardach Technique 1200
Plastic Surgery Cleft Palate Repair – Secondary Procedure 500
Plastic Surgery Pharyngoplasty – Inferiorly Based Posterior Pharyngeal Flap 800
Plastic Surgery Pharyngoplasty – Superiorly Based Posterior Pharyngeal Flap 800
Plastic Surgery Pharyngoplasty – Orticochea Technique 800
Plastic Surgery Trachea Reconstruction 1800
Plastic Surgery Chest Wall Reconstruction 800
Plastic Surgery Abdominal Wall Reconstruction 800
Plastic Surgery Abdominoplasty 2000
Plastic Surgery Apronectomy 2200
Plastic Surgery Lipectomy – Abdomen 600
Plastic Surgery Lipectomy – Other than Abdomen 600
Plastic Surgery Liposuction – Small Area 500
Plastic Surgery Liposuction – Large Area 800
Plastic Surgery Breast Reconstruction – TRAM Flap 1800
Plastic Surgery Breast Reconstruction – Latissimus Dorsi Flap 1800
Plastic Surgery Breast Reconstruction – Free Flap 2800
Plastic Surgery Augmentation Mammoplasty (with prosthetic implant) 800
Plastic Surgery Augmentation Mammoplasty (without prosthetic implant) 600
Plastic Surgery Reduction Mammoplasty 2000
Plastic Surgery Mastopexy 1800
Plastic Surgery Nipple-Areola Complex Reconstruction 600
Plastic Surgery Correction of Inverted Nipple 400
Plastic Surgery Breast Implant Removal 200
Plastic Surgery Vaginoplasty 1000
Plastic Surgery Vaginal Reconstruction – Plastic Repair 800
Plastic Surgery Clitoral Reduction 600
Plastic Surgery Clitoral Reduction and Vaginoplasty 1000
Plastic Surgery Hypospadias Repair – Flip Flap Technique 600
Plastic Surgery Hypospadias Repair – Ombredanne Technique 500
Plastic Surgery Hypospadias Repair – Duplay Technique 500
Plastic Surgery Hypospadias Repair – Snodgrass Technique 800
Plastic Surgery Meatal Advancement and Glanduloplasty (MAGPI) 400
Plastic Surgery Urethral Advancement and Glanuloplasty (UAGPI) 400
Plastic Surgery Hypospadias Repair – Single Stage 600
Plastic Surgery Hypospadias Repair – Two Stage 400
Plastic Surgery Closure of Urethro-cutaneous Fistula 400
Plastic Surgery Epispadias Repair 500
Plastic Surgery Meatoplasty – Penile 300
Plastic Surgery Phalloplasty 250
Plastic Surgery Penis Reconstruction 1200
Plastic Surgery Revision Circumcision 200
Plastic Surgery Implant – Testis 300
Plastic Surgery Nail Bed Reconstruction 250
Plastic Surgery Supernumerary Digit Excision 200
Plastic Surgery Syndactyly Release – Unilateral 500
Plastic Surgery Syndactyly Release – Bilateral 850
Plastic Surgery Digit Replantation 1800
Plastic Surgery Major Limb Replantation – Lower Limb 2500
Plastic Surgery Major Limb Replantation – Upper Limb (hand) 2500
Plastic Surgery Major Limb Replantation – Upper Limb (other than hand) 2500
Plastic Surgery Terminalisation of Digit 300
Plastic Surgery Re-amputation/Revision Amputation 500
Plastic Surgery Finger Reconstruction – Simple 400
Plastic Surgery Finger Reconstruction – Complex 800
Plastic Surgery Toe Reconstruction – Simple 300
Plastic Surgery Toe Reconstruction – Complex 800
Plastic Surgery Repair of Congenital Constricting Ring 800
Plastic Surgery Digit Pollicization 1200
Plastic Surgery Toe-to-Hand Transfer (with microvascular anastomosis) – Great

Toe

2000
Plastic Surgery Toe-to-Hand Transfer (with microvascular anastomosis) – other than Great Toe 2000
Plastic Surgery Cleft Hand Reconstruction 800
Plastic Surgery Cleft Foot Reconstruction 800
Plastic Surgery Tissue Expander Insertion 600
Plastic Surgery Tissue Expander Removal (due to infection) 200
Plastic Surgery Tissue Expander Removal and Reconstruction 1100
Plastic Surgery Contracture Release – Simple 250
Plastic Surgery Contracture Release – Complex 600
Plastic Surgery Excision of Haemangioma 300
Plastic Surgery Excision of Mole – Single 150
Plastic Surgery Excision of Mole – Multiple 300
Plastic Surgery Excision of Naevus – Single 150
Plastic Surgery Excision of Naevus – Multiple 300
Plastic Surgery Serial Excision of Naevus – First Stage 150
Plastic Surgery Serial Excision of Naevus – Second Stage 150
Plastic Surgery Serial Excision of Naevus – Third Stage 150
Plastic Surgery Excision of Basal Cell Carcinoma – Single 400
Plastic Surgery Excision of Basal Cell Carcinoma – Multiple 550
Plastic Surgery Excision of Basal Cell Carcinoma – Large 500
Plastic Surgery Excision of Squamous Cell Carcinoma – Single 500
Plastic Surgery Excision of Squamous Cell Carcinoma – Multiple 700
Plastic Surgery Excision of Melanoma 400
Plastic Surgery Excision of Melanoma with Skin Graft 550
Plastic Surgery Excision of Melanoma with Flap Cover 700
Plastic Surgery Tangential Excision – Small 200
Plastic Surgery Tangential Excision – Large 400
Plastic Surgery Scar Excision – Keloid 150
Plastic Surgery Scar Excision – Hypertrophic Scar 150
Plastic Surgery Scar Excision – Tattoo Scar 150
Plastic Surgery Scar Excision – Others 150
Plastic Surgery Escharotomy 150
Plastic Surgery W-Plasty 150
Plastic Surgery Z-Plasty 150
Plastic Surgery Scar Revision – Small 100
Plastic Surgery Scar Revision – Large 200
Plastic Surgery Injection of Hypertrophic Scar 25
Plastic Surgery Dermabrasion – Post-traumatic Scar 250
Plastic Surgery Dermabrasion – Others 200
Plastic Surgery Dermabrasion – Post-acne Scar 400
Plastic Surgery Skin Lesion Cauterization (up to 10 lesions) 50
Plastic Surgery Skin Lesion Cauterization (>10 lesions) 80
Plastic Surgery Skin Scarping/Curettage 50
Plastic Surgery Saucerisation of Bone 200
Plastic Surgery Rhytidectomy (Face-Lift) 1200
Plastic Surgery Mucosal Flap 250
Plastic Surgery Mucosal Advancement 250
Plastic Surgery Flap – Tongue 1200
Plastic Surgery Local Flap 300
Plastic Surgery Abbe Flap 450
Plastic Surgery Estlander Flap 450
Plastic Surgery Gillies Fan Flap 450
Plastic Surgery Flap – Naso-labial 300
Plastic Surgery Kutler Flap 250
Plastic Surgery V-Y Advancement Flap 250
Plastic Surgery V-Y Plasty 250
Plastic Surgery Flap Advancement 250
Plastic Surgery Flap Advancement and Closure 250
Plastic Surgery Transposition Flap 300
Plastic Surgery Limberg Flap 300
Plastic Surgery Z Plasty and Closure – Skin Grafting 300
Plastic Surgery Bilobed Flap 400
Plastic Surgery Rotation Flap 300
Plastic Surgery Glabellar Flap 300
Plastic Surgery Pedicle Flap – Staged Transfer 300
Plastic Surgery Mustard Flap 400
Plastic Surgery Millard Island Flap 400
Plastic Surgery Axial Flap 400
Plastic Surgery Switch Flap 400
Plastic Surgery Flap – Forehead 600
Plastic Surgery Interpolation Flap 500
Plastic Surgery Instep Flap 500
Plastic Surgery Fasciocutaneous Flap 500
Plastic Surgery Flap – Tensor Fascia Lata 500
Plastic Surgery Muscle Flap 500
Plastic Surgery Myocutaneous Flap 800
Plastic Surgery Flap – Gastrocnemius Muscle 800
Plastic Surgery Flap – Gluteus Maximus Muscle 700
Plastic Surgery Flap – Gracilis Muscle 800
Plastic Surgery Flap – Latissimus Dorsi Muscle 1000
Plastic Surgery Flap – Pectoralis Major Muscle 800
Plastic Surgery Flap – Rectus Femoris Muscle 800
Plastic Surgery Flap – Rectus Abdominis Muscle 800
Plastic Surgery Flap – Soleus Muscle 600
Plastic Surgery Flap – Trapezius Muscle 600
Plastic Surgery Flap – Deltopectoral Muscle 800
Plastic Surgery Flap – Acromio-thoracic 800
Plastic Surgery Flap – Flexor Digitorum Brevis 500
Plastic Surgery Flap – Temporalis Muscle 600
Plastic Surgery Flap – Lower Limb (others) 500
Plastic Surgery Flap – Upper limb (others) 500
Plastic Surgery Flap – Trunk (others) 500
Plastic Surgery Flap – Abdominal (others) 500
Plastic Surgery Flap – Abdominal Tube 600
Plastic Surgery Flap – Medial Planter 600
Plastic Surgery Flap – Dorsalis Pedis 600
Plastic Surgery Flap – Dorsalis Pedis (Big Toe Transfer) 650
Plastic Surgery Flap – Dorsalis Pedis (Second Toe Transfer) 650
Plastic Surgery Flap – Dorsalis Pedis (Wrap-Around Toe Transfer) 700
Plastic Surgery Flap – Ulnar Forearm 800
Plastic Surgery Flap – Radial Forearm 800
Plastic Surgery Flap – Radial Forearm (Reversed) 800
Plastic Surgery Flap – Lateral Arm 800
Plastic Surgery Flap – Scapular 800
Plastic Surgery Flap – Deep Circumflex Iliac Artery 800
Plastic Surgery Osteocutaneous Flap 1000
Plastic Surgery Osteomyocutaneous Flap 1000
Plastic Surgery Distant Flap 800
Plastic Surgery Cross Thigh Flap 800
Plastic Surgery Cross Leg Flap 800
Plastic Surgery Cross Finger Flap 600
Plastic Surgery Flap – Groin 800
Plastic Surgery Free Transfer Flap – Fibular 2000
Plastic Surgery Free Transfer Flap 2000
Plastic Surgery Free Transfer Flap – Cutaneous 2000
Plastic Surgery Free Transfer Flap – Myocutaneous 2000
Plastic Surgery Free Transfer Flap – Osteocutaneous 2500
Plastic Surgery Free Transfer Flap – Osteomyocutaneous 2500
Plastic Surgery Flap – Inset 300
Plastic Surgery Flap – Division 150
Plastic Surgery Flap – Partial Division 100
Plastic Surgery Flap – Thinning 250
Plastic Surgery Graft – Punch 150
Plastic Surgery Graft – Thiersch 200
Plastic Surgery Graft – Nerve 800
Plastic Surgery Graft – Nerve (Cable) 800
Plastic Surgery Graft – Bone 800
Plastic Surgery Graft – Bone Vascularized 2000
Plastic Surgery Graft – Cartilage 400
Plastic Surgery Graft – Tendon 400
Plastic Surgery Graft – Vein 600
Plastic Surgery Skin Grafting – Simple 350
Plastic Surgery Skin Grafting – Complex 600
Plastic Surgery Skin Graft – Full-thickness (FTSG) 400
Plastic Surgery Skin Graft – Split-thickness (STSG) 350
Plastic Surgery Graft – Scalp 500
Plastic Surgery Graft – Hair Bearing 400
Plastic Surgery Hair Transplant – Punch 250
Plastic Surgery Hair Transplant 400
Plastic Surgery Microsclerotherapy for Spider Veins (Telangiectasia) 200
Plastic Surgery Botox Injection 100
Plastic Surgery Nerve Repair (with nerve graft) – Single Strand 600
Plastic Surgery Nerve Repair (with nerve graft) – Multiple Strands (cable) 800
Plastic Surgery Nerve Repair (with graft other than nerve) 500
Plastic Surgery Nerve Repair – Sciatic Nerve 700
Plastic Surgery Nerve Repair – Other Peripheral Nerve 500
Plastic Surgery Nerve Repair – Digital Nerve 400
Plastic Surgery Nerve Repair – Nerve Plexus 800
Plastic Surgery Neuroplasty (exploration/neurolysis/decompression) – Nerve

Plexus

500
Plastic Surgery Neuroplasty (microscopic) – Peripheral Nerve 500
Plastic Surgery Nerve Transection/Neurectomy – Small Nerve 300
Plastic Surgery Nerve Transection/Neurectomy – Major Nerve 400
Plastic Surgery Sympathectomy – Others 500
Plastic Surgery Excision of Neuroma – Small Peripheral Nerve 300
Plastic Surgery Excision of Neuroma – Major Peripheral Nerve (other than sciatic

nerve)

500
Plastic Surgery Excision of Neuroma – Sciatic Nerve 600
Plastic Surgery Excision of Other Peripheral Nerve Lesions – Simple 250
Plastic Surgery Excision of Other Peripheral Nerve Lesions – Complex or

Extensive

600
Plastic Surgery Percutaneous Rhizolysis/Rhyzotomy (radiofrequency ablation) 200
Plastic Surgery Facial Laceration Repair – Simple 200
Plastic Surgery Facial Laceration Repair – Complex 400
Plastic Surgery Hand Injury Debridement & Repair (human bite) 400
Plastic Surgery Craniofacial Foreign Body Removal – Simple 400
Plastic Surgery Craniofacial Foreign Body Removal – Complex 1800
Plastic Surgery Incision & Drainage of Facial Abscess – Simple 250
Plastic Surgery Incision & Drainage of Facial Abscess – Complex 400
Plastic Surgery Trigger Finger Release 350
Plastic Surgery Median Nerve Decompression (e.g. carpal tunnel release) 300
Plastic Surgery Ulnar Nerve Decompression 300
Plastic Surgery Tibial Nerve Decompression (e.g. tarsal tunnel release) 300
Plastic Surgery Nerve Decompression (not specified elsewhere) 300
Plastic Surgery Nerve Transposition 350
Plastic Surgery Carpal Tunnel Injection 25
Plastic Surgery Injection of Therapeutic/Diagnostic Substance into Muscle/Tendon 20
Plastic Surgery Foreign Body Removal from Soft Tissue – Superficial 80
Plastic Surgery Foreign Body Removal from Soft Tissue – Deep (simple) 150
Plastic Surgery Foreign Body Removal from Soft Tissue – Deep (complex) 300
Plastic Surgery Excision of Ganglion – Knee 1200
Plastic Surgery Excision of Ganglion (other than knee) 600
Plastic Surgery Nerve Destruction – Chemical 200
Plastic Surgery Nerve Destruction – Chemical (under radiological monitoring) 250
Plastic Surgery Lymphedema Surgery (resection of subcutaneous tissue) 1200
Plastic Surgery Lymphovenous Anastomosis 2000
Plastic Surgery Lymph Node Transfer Surgery 2500
Plastic Surgery Excision of Lymphatic Malformation/Lymphangioma/Cystic Hygroma 1200
Plastic Surgery Excision of Lymphatic Malformation/Lymphangioma/Cystic

Hygroma (with neurovascular dissection)

1800
Plastic Surgery Venous Anastomosis 1500
Urology Kidney Biopsy – Open 360
Urology Kidney Biopsy – Laparoscopic 480
Urology Biopsy of Perinephric Lesion 360
Urology Renal Cyst Marsupialization – Open 520
Urology Renal Cyst Marsupialization – Laparoscopic 640
Urology Incision & Drainage of Perinephric Abcess 640
Urology Drainage of Perinephric Collection 320
Urology Suture Kidney Laceration 800
Urology Closure of Renal Fistula 800
Urology Nephropexy – Open 800
Urology Nephropexy – Laparoscopic 960
Urology Nephrostomy 360
Urology Nephrolithotomy – Open 960
Urology Anatrophic Nephrolithotomy 960
Urology Partial Nephrectomy – Open 1200
Urology Partial Nephrectomy – Laparoscopic 1600
Urology Simple Nephrectomy 1100
Urology Laparoscopic Nephrectomy 1600
Urology Radical Nephrectomy – Open 1300
Urology Radical Nephrectomy – Laparoscopic 1800
Urology Hand Assisted Laparoscopic Nephrectomy 1600
Urology Nephroureterectomy 1200
Urology Nephroureterectomy with Bladder Cuff Excision – Open 1200
Urology Nephroureterectomy with Bladder Cuff Excision – Laparoscopic 2000
Urology Transplant Nephrectomy 1200
Urology Donor Nephrectomy – Open 1120
Urology Donor Nephrectomy – Laparoscopic 1600
Urology Orthotopic Kidney Transplantation 2400
Urology Kidney Transplantation 2400
Urology Extended Pyelolithotomy 1200
Urology Pyelolithotomy – Open 1200
Urology Pyelolithotomy – Laparoscopic 2000
Urology Pyelonephrolithotomy 1200
Urology Pyeloplasty (Anderson-Hynes) 960
Urology Pyeloplasty (Foley’s Y-V) 960
Urology Pyeloplasty (Culp) 960
Urology Pyeloplasty – Laparoscopic 1600
Urology Horseshoe Kidney Isthmus Incision 1200
Urology Pyelostomy 600
Urology Pyeloureterostomy 600
Urology Retroperitoneal Lymph Node Dissection – Laparoscopic 2000
Urology Retroperitoneal Lymph Node Dissection – Open 1600
Urology Nephroscopy 800
Urology Percutaneous Nephrolithotomy (PCNL) – Supine 1200
Urology Percutaneous Nephrolithotomy (PCNL) – Prone 1200
Urology Mini-percutaneous Nephrolithotomy (mini-perc) 1200
Urology Micro-percutaneous Nephrolithotomy (micro-perc) 1200
Urology Retrograde Endopyelotomy 720
Urology Antegrade Endopyelotomy 720
Urology Retrograde Balloon Dilatation of Pelvi-Ureteric Junction (PUJ)

Obstruction

560
Urology Antegrade Balloon Dilatation of Pelvi-Ureteric Junction (PUJ) Obstruction 560
Urology Renal Tumor Ablation – Percutaneous 640
Urology Renal Tumor Ablation – Laparoscopic 1120
Urology Ureterolithotomy – Open 800
Urology Ureterolithotomy – Laparoscopic 1200
Urology Repair of Ureteric Injury 800
Urology Excision of Ureteral Diverticulum 800
Urology Removal of Ligature around Ureter 800
Urology Ureterolysis 1200
Urology Ureterostomy 600
Urology Transuretero-ureterostomy 1200
Urology Uretero-Ureterostomy – Open 1200
Urology Uretero-Ureterostomy – Laparoscopic 1600
Urology Closure of Ureterostomy 560
Urology Repair of Ureteric Fistula 560
Urology Ureterectomy 960
Urology Partial Ureterectomy with End-to-End Anastomosis 960
Urology Ureter Reimplantation 960
Urology Ileal Ureter 1600
Urology Uretero-vesical Reimplantation (Leich-Grigoir) 960
Urology Uretero-vesical Reimplantation (Lead Better-Politano) 960
Urology Uretero-vesical Reimplantation (Cohen’s) 960
Urology Uretero-vesical Reimplantation (Nipple Technique) 960
Urology Uretero-vesical Reimplantation (Boari Flap) 1200
Urology Uretro-vesical Reimplantation with Psoas Hitch 960
Urology Ureterocoele Repair 960
Urology Rigid Ureteroscopy 320
Urology Rigid Ureteroscopy with Biopsy 400
Urology Rigid Ureteroscopy with Foreign Body Removal 400
Urology Rigid Ureteroscopy with Removal of Broken/Migrated Double J-

Stent

400
Urology Rigid Ureteroscopy with Stone Removal by Dormia Basket/Grasping Forceps 600
Urology Rigid Ureteroscopy with Fulguration 400
Urology Flexible Uretero-renoscopy (RIRS) 1440
Urology Flexible Ureteroscopy with Biopsy 800
Urology Flexible Ureteroscopy with Foreign Body Removal 960
Urology Flexible Uretero-renoscopy (RIRS) with Laser Stone

Fragmentation

1600
Urology Flexible Ureteroscopy with Dormia Basketing 960
Urology Flexible Ureteroscopy with Fulguration 960
Urology Ureteric Catheterization 240
Urology Ureteral Dilatation 240
Urology Balloon Dilatation of Ureteric Stricture 240
Urology Dilatation of Uretero-vesical Orifice 240
Urology Dilatation of Uretero-cutaneous Fistula 160
Urology Ureteric Meatotomy 240
Urology Ureteric Meatotomy with Stone Retrieval 320
Urology Intubated Ureterotomy (Davies) 560
Urology Incision of Ureterocele 400
Urology Macroplastique/Collagen Injection around Ureteric Orifice 240
Urology DJ-Stent Insertion – Bilateral 320
Urology DJ-Stent Insertion – Unilateral 240
Urology DJ-Stent Removal – Bilateral 240
Urology DJ-Stent Removal – Unilateral 160
Urology Endoscopy via Ileal Conduit 160
Urology Bladder Biopsy – Open 400
Urology Suprapubic Cystostomy – Open 240
Urology Cystolithotomy 560
Urology Excision of Bladder Lesion 560
Urology Detrusor Myomectomy 800
Urology Bladder Diverticulum Excision 1200
Urology Repair of Bladder Injury 800
Urology Excision of Urachus 800
Urology Repair of Cystocele 560
Urology Partial Cystectomy – Open 800
Urology Partial Cystectomy – Laparoscopic 1200
Urology Laparoscopic Cystectomy 2000
Urology Radical Cystectomy – Open 1600
Urology Radical Cystectomy – Laparoscopic 2400
Urology Robotic Radical Cystectomy 4000
Urology Salvage (Palliative) Cystectomy 1440
Urology Repair of Recto-Vesical Fistula 1440
Urology Repair of Colo-Vesical Fistula 1440
Urology Repair of Ileo-Vesical Fistula 1440
Urology Bladder Neck Repair (Young-Dees) 1440
Urology Bladder Neck Repair (V-Y plasty) 1440
Urology Bladder Neck Reconstruction 1440
Urology Bladder Neck Reconstruction – Kropp Procedure 1440
Urology Bladder Neck Suspension – Open 800
Urology Bladder Neck Suspension – Stamey Procedure 480
Urology Bladder Neck Suspension – Laparoscopic 1200
Urology Repair of Bladder Exstrophy 1440
Urology Calm’s Cystoplasty 1200
Urology Enterocystoplasty 1200
Urology Bladder Augmentation 1200
Urology Augmentation Ileocystoplasty 1200
Urology Augmentation Caecocystoplasty 1200
Urology Augmentation Sigmoidocystoplasty 1200
Urology Mitrofanoff Bladder Augmentation 1200
Urology Laparoscopic Neobladder Construction 1600
Urology Continent Urinary Diversion 1200
Urology Uretero-sigmoidostomy Urinary Diversion 1200
Urology Uretero-cutaneous Urinary Diversion 800
Urology Ileal Conduit Urinary Diversion 1200
Urology Revision of Ileal Conduit 800
Urology Robotic Colposuspension 3200
Urology Colposuspension 560
Urology Burch’s Colposuspension 480
Urology Sling Operation 360
Urology Bladder Neck Incision (BNI) 480
Urology Dilatation of Bladder Neck 200
Urology Vesicostomy 320
Urology Refashioning of Vesicostomy 480
Urology Cystoscopy 160
Urology Check Cystoscopy 160
Urology Flexible Cystoscopy 200
Urology Cystourethroscopy 160
Urology Cystourethroscopy – Examination under Anesthesia (EUA) 160
Urology Suprapubic Cystoscopy 240
Urology Cystoscopy with Bladder Biopsy 240
Urology Cystoscopy with Foreign Body Removal 320
Urology Flexible Cystoscopy with DJ-Stent Removal 200
Urology Cystoscopy with Cauterization of Bladder 240
Urology Cystoscopy with Evacuation of Blood Clot 240
Urology Suprapubic Catheterization 160
Urology Instillation of Alum into Bladder 160
Urology Cystoscopic Botulinum Toxin Injections 240
Urology Endoscopic Bladder Distension 160
Urology Suprapubic Cystostomy – Percutaneous 120
Urology Trans-Urethral Resection (TUR) of Bladder Papilloma 720
Urology Trans-Urethral Resection of Bladder Tumor (TURBT) 960
Urology Endoscopic Fulguration of Bladder Lesion/Bleeder 720
Urology Laser Coagulation of Bladder Tumor/Lesion 960
Urology Macroplastique/Collagen Injection around Bladder Neck 200
Urology Cystolitholapexy 560
Urology Trans-Urethral Resection of Bladder Tumor (TURBT) – Bipolar 960
Urology Urethral Biopsy – Open 160
Urology Excision of Urethral Septum/Valve 160
Urology Fulguration of Urethral Lesion 120
Urology Excision of Urethral Lesion 120
Urology Excision of Urethral Caruncle 120
Urology Excision of Urethral Diverticulum 240
Urology Incision & Drainage of Bulbourethral Gland Abscess 120
Urology Repair of Urethro-Cutaneous Fistula 400
Urology Repair of Ruptured Urethra (with prostate-membranous

anastomosis)

1440
Urology Repair of Ruptured Anterior Urethra 800
Urology Realignment of Ruptured Urethra 560
Urology Suturing of Periurethral Laceration 320
Urology Urethroscopy 120
Urology Urethroscopy with Urethral Biopsy 160
Urology Urethral Dilatation 120
Urology Transurethral Balloon Dilatation of Prostatic Urethra 200
Urology Meatal Dilatation 80
Urology Perineal Urethrostomy 200
Urology Perineal Urethrotomy 200
Urology Urethrotomy 160
Urology Urethral Meatotomy 120
Urology Direct Vision Internal Urethrotomy 320
Urology Otis Urethrotomy 120
Urology Closure of Urethrotomy 160
Urology Urethrotomy and Stone Removal 200
Urology Urethroscopy and Removal of Urethral Stone 240
Urology Removal of Urethral Foreign Body 240
Urology Removal of Retained Urethral Catheter 160
Urology Removal of Urethral Stent 160
Urology Insertion of Urethral Stent 240
Urology Urethroscopy and Fulguration of Urethral Lesion 240
Urology Endoscopic Removal of Urethral Polyp 240
Urology Laser Incision of Urethral Stricture 320
Urology Cauterization of Posterior Urethral Mucosal Fold 320
Urology Fulguration of Posterior Urethral Valve 320
Urology Urethral Sphincterotomy 240
Urology Periurethral Injection for Incontinence 240
Urology Implantation of Artificial Urinary Sphincter (AUS) 1600
Urology Repair of Artificial Urinary Sphincter (AUS) 480
Urology Removal of Artificial Urinary Sphincter (AUS) 320
Urology Urethrectomy 320
Urology Urethral Meatopalsty 240
Urology Glandoplasty 320
Urology Urethroplasty 960
Urology Urethroplasty of Stricture with end-to-end Anastomosis 960
Urology Urethroplasty – Snodgrass Technique 960
Urology Urethroplasty – Modified Snodgrass Technique 960
Urology Urethroplasty – Duckett’s Onlay Technique 960
Urology Urethroplasty – Duckett’s Tube Technique 960
Urology Urethroplasty – Buccal Mucosal Graft 960
Urology Urethroplasty – Mathieu’s Technique 960
Urology Urethroplasty – Thiersch-Duplay Technique 960
Urology Distal Urethral Mobilization (DUM) 640
Urology Prostatic Massage 64
Urology Radical Prostatectomy – Open 1360
Urology Radical Prostatectomy – Laparoscopic 2000
Urology Robotic Radical Prostatectomy 3200
Urology Retropubic (Millin’s) Prostatectomy 960
Urology Perineal Prostatectomy 960
Urology Transvesical Prostatectomy 960
Urology Perineal Radical Prostatectomy 1360
Urology Prostate Biopsy – Fine Needle Aspiration (FNA) 80
Urology Prostate Biopsy – Tru Cut 120
Urology Prostate Biopsy – Trans rectal Ultrasound (TRUS) Guided 160
Urology Prostate Biopsy – Trans urethral 160
Urology Trans-Urethral Incision of the Prostate (TUIP) 320
Urology Transurethral Incision & Drainage of Prostatic Abscess 320
Urology Transurethral De-roofing of Prostatic Abscess 560
Urology Insertion of Prostatic Stent 240
Urology Trans-Urethral Resection of Prostate (TURP) 800
Urology Visual Laser Ablation of the Prostate (VLAP) 800
Urology Contact Laser Ablation of the Prostate (CLAP) 800
Urology Laser Enucleation of the Prostate 1200
Urology Bipolar Trans-Urethral Resection of the Prostate (TURIS) 800
Urology Transurethral Needle Ablation of the Prostate (TUNA) 800
Urology Transurethral Microwave Thermotherapy (TUMT) – Prostate 560
Urology Secondary Look Cystoscopy for Postoperative Bleeding 400
Urology Interstitial Laser Coagulation (ILC) – Prostate 400
Urology Transurethral Cannulation of Ejaculatory Ducts 320
Urology Endoscopic Local Ablation of Prostatic Tumor 400
Urology Cryotherapy for Prostatic Tumor 560
Urology Vasectomy 240
Urology Vaso-Vasostomy 400
Urology Excision of Epididymal Lesion 240
Urology Excision of Epididymal Cyst 240
Urology Epididymectomy 240
Urology Seminal Vesicles Biopsy 240
Urology Incision & Drainage of Seminal Vesicles Abscess 240
Urology Seminal Vesicles Excision 320
Urology Spermatic Cord Cyst Excision 240
Urology High Ligation of Varicocele 280
Urology Inguinal Varicocelectomy 280
Urology Laparoscopic Varicocelectomy 400
Urology Excision of Hydrocele/Hematocele – Tunica Vaginalis 240
Urology Aspiration of Hydrocele 65
Urology Patent Processus Vaginalis (PPV) Ligation 200
Urology Epididymovasostomy 400
Urology Implantation of Testicular Prosthesis 320
Urology Incision & Drainage of Testicular/Scrotal Abscess 120
Urology Incision & Drainage of Scrotal Skin Abscess 80
Urology Scrotal Exploration 120
Urology Scrotal Biopsy 80
Urology Excision of Scrotal Lesion 80
Urology Excision of Scrotal Sinus 120
Urology Debridement of Scrotal Skin 120
Urology Scrotal Skin Grafting 200
Urology Suturing of Scrotal Laceration 80
Urology Evacuation of Scrotal Haematoma 80
Urology Removal of Scrotal Foreign Body 120
Urology Fulguration of Scrotal Lesion 80
Urology Scrotal Reconstruction with Rotational Flap 320
Urology Testicular Biopsy – Open 120
Urology Testicular Biopsy – Fine Needle Aspiration (FNA) 65
Urology Suturing of Testicular Laceration 120
Urology Excision of Testicular Appendix 120
Urology Excision of Hydatid Cyst of Morgagni 120
Urology Hydrocelectomy 200
Urology Orchidopexy – Unilateral 200
Urology Orchidopexy – Bilateral 250
Urology Orchidopexy – First Stage 250
Urology Orchidopexy – First Stage (laparoscopic) 500
Urology Orchidopexy – Second Stage 250
Urology Orchidectomy 200
Urology Subcapsular Orchidectomy 200
Urology Inguinal Orchidectomy 300
Urology Radical Orchidectomy 300
Urology Laparoscopic Orchidectomy 800
Urology Exploration for Testicular Torsion 240
Urology Testicular Detorsion 240
Urology Penile Biopsy 80
Urology Excision of Penile Lesion 80
Urology Fulguration of Penile Lesion 64
Urology Removal of Penile Foreign Body (other than prosthesis) –

Superficial

80
Urology Removal of Penile Foreign Body (other than prosthesis) – Deep 120
Urology Excision of Penile Skin Adhesions 80
Urology Repair of Penile Soft Tissue Injury – Simple 120
Urology Repair of Penile Soft Tissue Injury – Complex 200
Urology Phalloplasty 250
Urology Circumcision 120
Urology Redo Circumcision 80
Urology Penile Skin Grafting 100
Urology Dorsal Slit for Paraphimosis 64
Urology Dorsal Plication of Tunica Albuginea 80
Urology Correction of Penile Chordee 80
Urology Repair of Penile Fracture 200
Urology Correction of Penile Torsion 160
Urology Implantation of Penile Prosthesis 2400
Urology Revision of Penile Prosthesis 650
Urology Removal of Penile Prosthesis 250
Urology Cavernoso-Spongiosal Shunt 250
Urology Cavernoso-Saphenous Shunt 250
Urology Winter’s Shunt (cavernosa-glans penis fistulization) 250
Urology Cavernosal Washout with Intra-cavernosal Injection of Vasoactive Drug 100
Urology Amputation of Penis – Partial 320
Urology Amputation of Penis – Complete 440
Urology Marsupialization of Lymphocele – Laparotomy 480
Urology Marsupialization of Lymphocele – Laparoscopic 800
Urology Internal Iliac Artery (hypogastric artery) Ligation 640
Cardiology Diagnostic Cardiac Catheterization – Adult 600
Cardiology Diagnostic Cardiac Catheterization – Paediatric 1000
Cardiology Percutaneous Transluminal Coronary Angioplasty (PTCA) – One

Artery

1000
Cardiology Percutaneous Transluminal Coronary Angioplasty (PTCA) – Two

Arteries

1200
Cardiology Percutaneous Transluminal Coronary Angioplasty (PTCA) – Three Arteries 1400
Cardiology Interventional Paediatric Cardiac Catheterization – Simple 1400
Cardiology Interventional Paediatric Cardiac Catheterization – Intermediate 1900
Cardiology Interventional Paediatric Cardiac Catheterization – Complex 2500
Cardiology Intra-aortic Balloon Pump Insertion 150
Cardiology Temporary Pacemaker Insertion 150
Cardiology Permanent Pacemaker Implantation – Single Chamber 500
Cardiology Permanent Pacemaker Implantation – Dual Chamber 750
Cardiology Implantation of Implantable Cardioverter Defibrillator (ICD) –

Single Chamber

500
Cardiology Implantation of Implantable Cardioverter Defibrillator (ICD) –

Dual Chamber

750
Cardiology Implantation of Cardiac Resynchronization Therapy Defibrillator

Device

1500
Cardiology Implantation of Cardiac Resynchronization Therapy Pacemaker

Device

1500
Cardiology Implantation of Loop Recorder 250
Cardiology Pulse Generator Replacement 300
Cardiology Implantable Cardiac Device – Follow Up 50
Cardiology Removal of Implantable Cardiac Device 1500
Cardiology Diagnostic Electrophysiology Study (EPS) – Conventional 500
Cardiology Diagnostic Electrophysiology Study (EPS) – Electroanatomic Mapping 700
Cardiology Cardiac Ablation – Conventional (simple) 1000
Cardiology Cardiac Ablation – Conventional (complex) 1500
Cardiology Cardiac Ablation – Electroanatomic Mapping (simple) 2000
Cardiology Cardiac Ablation – Electroanatomic Mapping (complex) 3000
Cardiology Atrial Septostomy 700
Cardiology Left Atrial Appendage Occlusion 1500
Cardiology Epicardial Ablation 3500
Cardiology Percutaneous Balloon Valvuloplasty – Aortic 1500
Cardiology Percutaneous Balloon Valvuloplasty – Mitral 2000
Cardiology Percutaneous Balloon Valvuloplasty – Pulmonary 1500
Cardiology Percutaneous Balloon Valvuloplasty – Tricuspid 1500
Cardiology Percutaneous Valve Replacement – Aortic 2500
Cardiology Percutaneous Valve Replacement – Mitral 3500
Cardiology Percutaneous Valve Replacement – Pulmonary 2500
Cardiology Percutaneous Valve Replacement – Tricuspid 2500
Cardiothoracic Coronary Artery Bypass Grafting (CABG) – One Graft 3300
Cardiothoracic Coronary Artery Bypass Grafting (CABG) – Two Grafts 3600
Cardiothoracic Coronary Artery Bypass Grafting (CABG) – Three Grafts 3900
Cardiothoracic Coronary Artery Bypass Grafting (CABG) – Four Grafts 4200
Cardiothoracic Coronary Artery Bypass Grafting (CABG) – Five Grafts 4500
Cardiothoracic Coronary Artery Bypass Grafting (CABG) – Six or more grafts 4500
Cardiothoracic Redo Coronary Artery Bypass Grafting (CABG) – One Graft 4500
Cardiothoracic Redo Coronary Artery Bypass Grafting (CABG) – Two Grafts 4800
Cardiothoracic Redo Coronary Artery Bypass Grafting (CABG) – Three Grafts 5100
Cardiothoracic Coronary Artery Bypass Grafting (CABG) – Off-pump 1300
Cardiothoracic Ligation of Coronary Artery Fistula 1600
Cardiothoracic Atrial Septectomy 2200
Cardiothoracic Percutaneous Repair of Atrial Septal Defect (ASD) 1500
Cardiothoracic Surgical Repair of Atrial Septal Defect (ASD) – Ostium Pimum 2700
Cardiothoracic Surgical Repair of Atrial Septal Defect (ASD) – Ostium Secundum 2700
Cardiothoracic Surgical Repair of Atrial Septal Defect (ASD) – Sinus Venosus 2700
Cardiothoracic Atrio-ventricular Canal Repair – Single Patch 4200
Cardiothoracic Atrio-ventricular Canal Repair – Double Patch 4000
Cardiothoracic Repair of Ventricular Aneurysm 3500
Cardiothoracic Percutaneous Repair of Ventricular Septal Defect (VSD) 2500
Cardiothoracic Surgical Repair of Ventricular Septal Defect (VSD) – Single 3500
Cardiothoracic Surgical Repair of Ventricular Septal Defect (VSD) – Multiple 4100
Cardiothoracic Repair of Ventricular Septal Defect (VSD) – Post Myocardial

Infarction

4100
Cardiothoracic Enlargement of Ventricular Septal Defect (VSD) 3500
Cardiothoracic Percutaneous Closure of Patent Ductus Arteriosus (PDA) – any method 1000
Cardiothoracic Surgical Closure of Patent Ductus Arteriosus (PDA) – by ligation 1500
Cardiothoracic Surgical Closure of Patent Ductus Arteriosus (PDA) – by division 1500
Cardiothoracic Pericardial Tapping (Pericardiocentesis) 100
Cardiothoracic Pericardiostomy 600
Cardiothoracic Pericardial Window/Pericardiotomy 600
Cardiothoracic Pericardiectomy 2500
Cardiothoracic Excision of Cardiac Tumor 3500
Cardiothoracic Excision of Pericardial Tumor/Cyst 1500
Cardiothoracic Percutaneous Occlusion of Major Aorto-pulmonary Collateral

Arteries (MAPCAs)

1500
Cardiothoracic Endomyocardial Biopsy 1000
Cardiothoracic Mitral Valve Repair 4200
Cardiothoracic Mitral Valve Replacement – Bioprosthesis 4750
Cardiothoracic Mitral Valve Replacement – Mechanical Prosthesis 4350
Cardiothoracic Redo Mitral Valve Repair 5700
Cardiothoracic Redo Mitral Valve Replacement – Bioprosthesis 6000
Cardiothoracic Redo Mitral Valve Replacement – Mechanical Prosthesis 5600
Cardiothoracic Tricuspid Valve Repair 4200
Cardiothoracic Tricuspid Valve Replacement – Bioprosthesis 4750
Cardiothoracic Tricuspid Valve Replacement – Mechanical Prosthesis 4350
Cardiothoracic Redo Tricuspid Valve Repair 5700
Cardiothoracic Redo Tricuspid Valve Replacement – Bioprosthesis 6000
Cardiothoracic Redo Tricuspid Valve Replacement – Mechanical Prosthesis 5600
Cardiothoracic Aortic Valve Replacement – Bioprosthesis 4750
Cardiothoracic Aortic Valve Replacement – Mechanical Prosthesis 4350
Cardiothoracic Redo Aortic Valve Replacement – Bioprosthesis 6000
Cardiothoracic Redo Aortic Valve Replacement – Mechanical Prosthesis 5600
Cardiothoracic Pulmonary Valve Repair 3600
Cardiothoracic Pulmonary Valve Replacement 4800
Cardiothoracic Redo Pulmonary Valve Repair 4800
Cardiothoracic Redo Pulmonary Valve Replacement 6000
Cardiothoracic Infundibulectomy 2600
Cardiothoracic Aortic Root Replacement 8500
Cardiothoracic Valve-sparing Aortic Root Replacement 7000
Cardiothoracic Repair of Single Atrium 4000
Cardiothoracic Repair of Sinus of Valsalva Aneurysm – Single Patch 3500
Cardiothoracic Repair of Sinus of Valsalva Aneurysm – Double Patch 3500
Cardiothoracic Repair of Anomalous Left Coronary Artery from Pulmonary

Artery Origin (ALCAPA repair) – by Grafting

4700

Cardiothoracic

Repair of Anomalous Left Coronary Artery from Pulmonary

Artery Origin (ALCAPA repair) – by Coronary Artery Translocation

4700
Cardiothoracic Repair of Anomalous Left Coronary Artery from Pulmonary

Artery Origin (ALCAPA repair) – Other Techniques

4700
Cardiothoracic Repair of Transposition of the Great Arteries (Arterial Switch

Operation)

6000
Cardiothoracic Repair of Transposition of the Great Arteries – Senning Operation 6000
Cardiothoracic Repair of Transposition of the Great Arteries – Mustard Operation 6000
Cardiothoracic Réparation à l’Etage Ventriculaire Procedure (REV procedure) 6000
Cardiothoracic Repair of Corrected Transposition of the Great Arteries (CTGA) 6000
Cardiothoracic Total Repair of Tetralogy of Fallot 4700
Cardiothoracic Blalock-Taussig Shunt (pump) 2700
Cardiothoracic Blalock-Taussig Shunt (off pump) 2200
Cardiothoracic Norwood Procedure 6300
Cardiothoracic Damus-Kaye-Stansel Procedure 5000
Cardiothoracic Bidirectional Glenn Shunt – Unilateral 3400
Cardiothoracic Bidirectional Glenn Shunt – Bilateral 4000
Cardiothoracic Hemi-Fontan Procedure 3500
Cardiothoracic Fontan Atriopulmonary Connection 5000
Cardiothoracic Fontan Total Cavopulmonary Connection (TCPC) – Lateral Tunnel

(fenestrated)

5000
Cardiothoracic Fontan Total Cavopulmonary Connection (TCPC) – Lateral Tunnel

(non-fenestrated)

5000
Cardiothoracic Fontan Total Cavopulmonary Connection (TCPC) – External

Conduit (fenestrated)

5000
Cardiothoracic Fontan Total Cavopulmonary Connection (TCPC) – External

Conduit (non-fenestrated)

5000
Cardiothoracic Biventricular Repair of Hypoplastic Left Heart Syndrome (HLHS) 6100
Cardiothoracic Repair of Truncus Arteriosus 5900
Cardiothoracic Repair of Hemitruncus Arteriosus 5900
Cardiothoracic Rastelli Procedure 8000
Cardiothoracic Intracardiac Repair of Double Outlet Right Ventricle (DORV) 4800
Cardiothoracic Repair of Ebstein Anomaly 4700
Cardiothoracic Repair of Aortic Coarctation 1900
Cardiothoracic Repair of Aortopulmonary Window (AP window) 4700
Cardiothoracic Right Ventricle to Pulmonary Artery Conduit (RV-PA

conduit) Placement

5900
Cardiothoracic Left Ventricle to Pulmonary Artery Conduit (LV-PA

conduit) Placement

5900
Cardiothoracic Redo Ventricle to Pulmonary Artery Conduit Placement 7100
Cardiothoracic Atrial Baffle Procedure 4500
Cardiothoracic Right Ventricular Outflow Tract (RVOT) Reconstruction 4700
Cardiothoracic Repair of Total Anomalous Pulmonary Venous Connection (TAPVC) 5300
Cardiothoracic Resection of Subaortic Stenosis 3400
Cardiothoracic Pulmonary Artery Banding 2000
Cardiothoracic Repair of Interrupted Aortic Arch 4000
Cardiothoracic Creation of Central Shunt (aortopulmonary shunt) – Pump 2700
Cardiothoracic Creation of Central Shunt (aortopulmonary shunt) – Off Pump 2200
Cardiothoracic Repair of Vascular Ring 2300
Cardiothoracic Aortic Valve Replacement – Ross Procedure 8100
Cardiothoracic Aortic Valve Replacement – Konno Procedure 5000
Cardiothoracic Supravalvar Aortic Stenosis Repair 3400
Cardiothoracic Supravalvar Mitral Ring Repair 3400
Cardiothoracic Atrial Fenestration 2900
Cardiothoracic Closure of Atrial Fenestration 2900
Cardiothoracic Truncal Valve Repair 4500
Cardiothoracic Truncal Valve Replacement 5000
Cardiothoracic Repair of Partial Anomalous Pulmonary Venous Connection

(PAPVC)

3500
Cardiothoracic Cor Triatriatum Repair 3400
Cardiothoracic Repair of Pulmonary Venous Stenosis 3500
Cardiothoracic Repair of Anomalous Systemic Venous Connections 5300
Cardiothoracic Repair of Systemic Venous Stenosis 3500
Cardiothoracic Repair of Pulmonary Atresia with Ventricular Septal Defect (VSD) 5800
Cardiothoracic Repair of Pulmonary Atresia with Ventricular Septal Defect (VSD)

and Major Aorto-pulmonary Collateral Arteries (MAPCAs)

5250
Cardiothoracic Unifocalization of Major Aorto-pulmonary Collateral Arteries

(MAPCAs)

3000
Cardiothoracic One and One Half Ventricle Repair 5000
Cardiothoracic Repair of Double-Chambered Right Ventricle (DCRV) 3500
Cardiothoracic Simple Pneumonectomy 2800
Cardiothoracic Extrapleural Pneumonectomy 2800
Cardiothoracic Carinal Pneumonectomy 2800
Cardiothoracic Completion Pneumonectomy 2800
Cardiothoracic Lung Lobectomy – Single Lobe 2800
Cardiothoracic Lung Lobectomy – Two Lobes 2800
Cardiothoracic Lung Lobectomy – Sleeve 2800
Cardiothoracic Lung Segmentectomy 2800
Cardiothoracic Lingulectomy 2800
Cardiothoracic Lung Volume Reduction Surgery 2800
Cardiothoracic Bullectomy – Open 2600
Cardiothoracic Bullectomy – Thoracoscopic 2800
Cardiothoracic Lung Wedge Resection – Single 2500
Cardiothoracic Lung Wedge Resection – Multiple 2500
Cardiothoracic Resection of Apical Lung Tumor 2600
Cardiothoracic Lung Biopsy – Thoracoscopic 800
Cardiothoracic Lung Biopsy – Open 1300
Cardiothoracic Pleural Biopsy – Open 1300
Cardiothoracic Drainage of Lung Abscess – Open 1200
Cardiothoracic Drainage of Lung Abscess – Percutaneous 200
Cardiothoracic Excision of Lung Cyst/Lesion 1300
Cardiothoracic Thoracotomy and Chest Exploration 1300
Cardiothoracic Chest Re-exploration 0
Cardiothoracic Thoracotomy and Tumor Biopsy 1300
Cardiothoracic Thoracotomy and Foreign Body Removal 1500
Cardiothoracic Thoracotomy and Control of Haemorrhage 1500
Cardiothoracic Repair of Lung Laceration 1350
Cardiothoracic Thoracotomy with Pleurodesis 1350
Cardiothoracic Pleurectomy (via thoracotomy) 1350
Cardiothoracic Pleurectomy (via thoracoscopy) 2800
Cardiothoracic Pulmonary Decortication (via thoracotomy) – Partial 2500
Cardiothoracic Pulmonary Decortication (via thoracotomy) – Total 2500
Cardiothoracic Pulmonary Decortication (via thoracoscopy) – Partial 3500
Cardiothoracic Pulmonary Decortication (via thoracoscopy) – Total 3500
Cardiothoracic Decortication and Pleurectomy 2500
Cardiothoracic Diagnostic Thoracoscopy 700
Cardiothoracic Diagnostic Thoracoscopy with Biopsy 800
Cardiothoracic Tube Thoracostomy 50
Cardiothoracic Mediastinotomy with Exploration 1200
Cardiothoracic Mediastinotomy and Foreign Body Removal 1200
Cardiothoracic Excision of Mediastinal Cyst/Tumor 2000
Cardiothoracic Mediastinoscopy 750
Cardiothoracic Mediastinoscopy with Biopsy 750
Cardiothoracic Mediastinotomy with Biopsy 1250
Cardiothoracic Drainage of Mediastinal Abscess 1250
Cardiothoracic Bronchial Repair 1550
Cardiothoracic Thoracic Duct Ligation 1300
Cardiothoracic Thymectomy (thoracic approach) 1200
Cardiothoracic Thymectomy with Mediastinal Dissection 1200
Cardiothoracic Thymectomy (cervical approach) 1000
Cardiothoracic Thoracoplasty 2800
Cardiothoracic Diaphragm Plication (diaphragmatic eventration repair) 1300
Cardiothoracic Rib Resection 1250
Cardiothoracic Incision of Bone Cortex (e.g. osteomyelitis, bone abscess) –

Thorax

900
Cardiothoracic Repair of Diaphragmatic Rupture/Tear 1800
Cardiothoracic Repair of Pectus Carinatum 2500
Cardiothoracic Repair of Pectus Excavatum 2500
Cardiothoracic Sternal Wound Debridement 200 (only if originally operated

outside government hospitals)

Cardiothoracic Sternal Resection – Partial 1200
Cardiothoracic Sternal Resection – Radical 1200
Cardiothoracic Sternal Wire/Rod Removal 1200
Cardiothoracic Extracorporeal Membrane Oxygenation (ECMO) – Day 1 1600
Cardiothoracic Extracorporeal Membrane Oxygenation (ECMO) – Subsequent Days 250 per day
Dermatology Patch Test 35
Dermatology Needle/Punch Biopsy – Skin/Subcutaneous Tissue/Mucous

Membrane (without immunofluorescence examination)

60
Dermatology Needle/Punch Biopsy – Skin/Subcutaneous Tissue/Mucous

Membrane (with immunofluorescence examination)

80
Dermatology Incisional/Wedge Biopsy – Skin/Subcutaneous Tissue/Mucous

Membrane

80
Dermatology Excisional Biopsy – Skin/Subcutaneous Tissue/Mucous Membrane 70
Dermatology Other Biopsy – Skin/Subcutaneous Tissue/Mucous Membrane 60
Dermatology Skin Scarping/Curettage 30
Dermatology Nail Biopsy 60
Dermatology Expression of Comedone 25
Dermatology Skin Tag/Papilloma Excision (<10 lesions) 30
Dermatology Skin Tag/Papilloma Excision (10-20 lesions) 50
Dermatology Skin Tag/Papilloma Excision (>20 lesions) 80
Dermatology Intralesional Steroid Administration 15 (per lesion)
Dermatology Dermojet 25
Dermatology Bath PUVA 35
Dermatology Full Body PUVA 30
Dermatology Hand Foot PUVA 20
Dermatology Skin Lesion Cauterization (<5 lesions) 20
Dermatology Skin Lesion Cauterization (5-10 lesions) 30
Dermatology Skin Lesion Cauterization (>10 lesions) 50
Dermatology Perineal Warts Diathermy 30
Dermatology Vulval Wart Removal – Silver Nitrate Stick 30
Dermatology Vulval Wart Removal – Podophyllin Solution 30
Dermatology Cryotherapy with Liquid Nitrogen (up to 5 lesions) 25
Dermatology Cryotherapy with Liquid Nitrogen (>5 lesions) 50
Dermatology Cryotherapy with Nitrous Oxide (up to 5 lesions) 25
Dermatology Cryotherapy with Nitrous Oxide (>5 lesions) 50
Dermatology Laser Procedures with Excimer (up to 3 areas) 10
Dermatology Laser Procedures with Excimer (>3 areas) 20
Dermatology Radiofrequency Ablation for Skin Lesions (up to 5 lesions) 60
Dermatology Radiofrequency Ablation for Skin Lesions (>5 lesions) 80
Dermatology Chemical Peeling (<15cm) 60
Dermatology Chemical Peeling (15-40cm) 80
Dermatology Chemical Peeling (>40cm) 100
Dermatology Non-fractional CO2 Laser Therapy (<15cm) 60
Dermatology Non-fractional CO2 Laser Therapy (15-40cm) 80
Dermatology Non-fractional CO2 Laser Therapy (>40cm) 100
Dermatology Fractional CO2 Laser Therapy (<15cm) 60
Dermatology Fractional CO2 Laser Therapy (15-40cm) 80
Dermatology Fractional CO2 Laser Therapy (>40cm) 100
Dermatology Pulsed Dye Laser (PDL) Therapy (<15cm) 100
Dermatology Pulsed Dye Laser (PDL) Therapy (15-40cm) 150
Dermatology Pulsed Dye Laser (PDL) Therapy (>40cm) 200
Dermatology Wood Lamp Examination 5
Dermatology Slit Smear Examination in Leprosy 20
Dermatology Tzanck Smear 20
Dermatology Smear for Scabies 20
Dermatology Smear for Leishmania Donovani Bodies 20
Dermatology Fungal KOH Examination 20
Dermatology Fungal Culture 20
Dermatology Mixing Drug for Topical Application 5
Obst & Gyne Biopsy of Vulva 50
Obst & Gyne Evacuation of Vulval Haematoma 100
Obst & Gyne Vulval Drain Removal 30
Obst & Gyne Suture of Vulva 150
Obst & Gyne Marsupialization of Bartholin Cyst 100
Obst & Gyne Incision and Drainage of Bartholin’s Abscess 100
Obst & Gyne Partial Vulvectomy 350
Obst & Gyne Simple Vulvectomy 350
Obst & Gyne Radical Vulvectomy 850
Obst & Gyne Excision of Vulval Cyst 100
Obst & Gyne Lysis of Vulval Adhesions 150
Obst & Gyne Enlargement of Introitus 150
Obst & Gyne Amputation of Clitoris 100
Obst & Gyne Vaginoscopy 100
Obst & Gyne Exploration of Vagina (without repair) 50
Obst & Gyne Colposcopy 150
Obst & Gyne Colposcopy with Biopsy 200
Obst & Gyne Vaginal Biopsy 50
Obst & Gyne Examination Under Anaesthesia (EUA) – Female Reproductive

Tract

100
Obst & Gyne Vaginal Pack Insertion 50
Obst & Gyne Vaginal Pack Removal 10
Obst & Gyne Evacuation of Vaginal Haematoma 100
Obst & Gyne Removal of Vaginal Drain 10
Obst & Gyne Excision of Vaginal Cyst/Lesion 150
Obst & Gyne Lysis of Vaginal Adhesions 100
Obst & Gyne Division of Vaginal Septum 300
Obst & Gyne Vaginectomy 850
Obst & Gyne Suture of Vagina 100
Obst & Gyne Vaginal Reconstruction (obstetric) 250
Obst & Gyne Vaginal Reconstruction (non-obstetric) 350
Obst & Gyne Hymenectomy 100
Obst & Gyne Hymenorrhaphy 200
Obst & Gyne Biopsy of Endocervix 50
Obst & Gyne Punch Biopsy of Cervix 50
Obst & Gyne Cervical Biopsy & Cautery 100
Obst & Gyne Conization of Cervix 300
Obst & Gyne Large Loop Excision of the Transformation Zone (LLETZ) 200
Obst & Gyne Cervical Smear 15
Obst & Gyne Exploration of Cervix (without repair) 25
Obst & Gyne Cervical Polypectomy 35
Obst & Gyne Cervical Polypectomy – Hysteroscopic 80
Obst & Gyne Cervical Cautery 25
Obst & Gyne Cryosurgery of Cervix 35
Obst & Gyne Colposcopy Cervical Biopsy & Cold Coagulation 150
Obst & Gyne Dilatation of Cervical Canal 50
Obst & Gyne Amputation of Cervix 150
Obst & Gyne Repair of Cervical Tear 100
Obst & Gyne Cervical Suture Removal 25
Obst & Gyne McDonald’s Cervical Cerclage 150
Obst & Gyne Shirodkar Cervical Cerclage 200
Obst & Gyne Removal of Cervical Cerclage 25
Obst & Gyne Vaginal Pessary Insertion 25
Obst & Gyne Vaginal Pessary Removal 10
Obst & Gyne Diagnostic Hysteroscopy 100
Obst & Gyne Operative Hysteroscopy 200
Obst & Gyne Exploration of Uterus & Vagina (without repair) 100
Obst & Gyne Hysteroscopy with Dilatation and Curettage (D&C) 120
Obst & Gyne Dilatation and Curettage (D&C) – Diagnostic 120
Obst & Gyne Dilatation and Curettage (D&C) – Termination of Pregnancy

(TOP)

120
Obst & Gyne Dilatation and Curettage (D&C) – Miscarriage 120
Obst & Gyne Suction Evacuation of Uterus 160
Obst & Gyne IUCD Insertion 50
Obst & Gyne IUCD Removal 30
Obst & Gyne IUCD Removal – Hysteroscopic 130
Obst & Gyne Removal of Contraceptive Implant 50
Obst & Gyne Laparotomy Excision of Uterine Horn 300
Obst & Gyne Laparoscopic Excision of Uterine Horn 500
Obst & Gyne Hysteroscopic Resection of Uterine Septum 350
Obst & Gyne Hysteroscopic Myomectomy 500
Obst & Gyne Laparotomy Myomectomy 350
Obst & Gyne Laparoscopic Myomectomy 550
Obst & Gyne Hysteroscopic Division of Intrauterine Adhesions 300
Obst & Gyne Laparoscopic Lysis of Abdominal & Pelvic Adhesions 500
Obst & Gyne Endometrial Polypectomy 150
Obst & Gyne Endometrial Polypectomy – Hysteroscopic 300
Obst & Gyne Hysteroscopic Transcervical Resection of Endometrium (TCRE) 350
Obst & Gyne Laparoscopic Cautery of Endometriotic Spots 250
Obst & Gyne Laparoscopic Uterosacral Nerve Ablation (LUNA) 300
Obst & Gyne Endometrial Biopsy 60
Obst & Gyne Laparoscopic Biopsy of Endometriotic Lesion 120
Obst & Gyne Intrauterine Packing 100
Obst & Gyne Suture of Uterine Laceration 250
Obst & Gyne Repair of Ruptured Uterus 300
Obst & Gyne B-Lynch Suture of Uterus 250
Obst & Gyne Hysteroscopic Metroplasty 300
Obst & Gyne Hysterotomy (obstetric) 350
Obst & Gyne Hysterotomy (non-obstetric) 350
Obst & Gyne Vaginal Hysterectomy 450
Obst & Gyne Non Descent Vaginal Hysterectomy 550
Obst & Gyne Vaginal Hysterectomy & Pelvic Floor Repair 650
Obst & Gyne Laparoscopic Assisted Vaginal Hysterectomy 550
Obst & Gyne Subtotal Laparoscopic Hysterectomy 550
Obst & Gyne Total Laparoscopic Hysterectomy (TLH) 650
Obst & Gyne Total Laparoscopic Hysterectomy (TLH) with Bilateral Salpingo-

Oophorectomy (BSO), Omentectomy & Nodal Dissection

1400
Obst & Gyne Subtotal Abdominal Hysterectomy 450
Obst & Gyne Total Abdominal Hysterectomy 450
Obst & Gyne Caesarean Hysterectomy (including the caesarean delivery) 850
Obst & Gyne Obstetric Hysterectomy 850
Obst & Gyne Laparoscopic Radical Hysterectomy 1200
Obst & Gyne Radical Abdominal Hysterectomy 1200
Obst & Gyne Laparotomy Radical Hysterectomy with Bilateral Pelvic Node Dissection 1400
Obst & Gyne Laparotomy Abdominal Hysterectomy with Unilateral Salpingo-

Oopherectomy

550
Obst & Gyne Laparoscopic Hysterectomy with Unilateral Salpingo-

Oopherectomy

700
Obst & Gyne Laparotomy Abdominal Hysterectomy with Bilateral Salpingo-

Oopherectomy

550
Obst & Gyne Laparoscopic Hysterectomy with Bilateral Salpingo-

Oopherectomy

700
Obst & Gyne Laparotomy Abdominal Hysterectomy with Bilateral

Salpingectomy

550
Obst & Gyne Laparoscopic Hysterectomy with Bilateral Salpingectomy 700
Obst & Gyne Laparotomy Ovarian Biopsy 350
Obst & Gyne Laparoscopic Ovarian Biopsy 450
Obst & Gyne Laparoscopic Ovarian Cyst Aspiration 350
Obst & Gyne Laparoscopic Para Ovarian Cyst Aspiration 350
Obst & Gyne Laparotomy Excision of Ovarian Cyst in Pregnancy 550
Obst & Gyne Laparotomy Ovarian Cystectomy in Pregnancy 550
Obst & Gyne Laparoscopic Ovarian Cystectomy in Pregnancy 650
Obst & Gyne Laparoscopic Release of Ovarian Torsion 450
Obst & Gyne Laparotomy Release of Ovarian Torsion 450
Obst & Gyne Laparoscopic Ovarian Cauterization 350
Obst & Gyne Laparotomy Unilateral Salpingo-Oopherectomy 350
Obst & Gyne Laparotomy Bilateral Salpingo-Oopherectomy 350
Obst & Gyne Laparoscopic Unilateral Salpingo-Oopherectomy 450
Obst & Gyne Laparoscopic Bilateral Salpingo-Oopherectomy 450
Obst & Gyne Laparoscopic Ovarian Drilling 350
Obst & Gyne Laparoscopic Excision of Bleeding Corpus Luteal Cyst 350
Obst & Gyne Reconstruction of Ovary 350
Obst & Gyne Repositioning of Ovaries 550
Obst & Gyne Laparoscopic Cytoreduction of Ovarian Tumor 1400
Obst & Gyne Laparotomy Cytoreduction of Ovarian Tumor 1200
Obst & Gyne Laparotomy Excision of Bleeding Corpus Luteal Cyst 400
Obst & Gyne Laparotomy Ovarian Cystectomy 400
Obst & Gyne Laparoscopic Ovarian Cystectomy 450
Obst & Gyne Laparoscopic Ovarian Wedge Resection 400
Obst & Gyne Laparoscopic Salpingo-Oophorectomy (Remaining Tube/Ovary) 400
Obst & Gyne Laparotomy Salpingo-Oophorectomy (Remaining Tube/Ovary) 350
Obst & Gyne Laparotomy Excision of Tubo-Ovarian Mass 450
Obst & Gyne Laparoscopic Excision of Tubo-Ovarian Mass 650
Obst & Gyne Chromo Pertubation Test 120
Obst & Gyne Dilatation of Fallopian Tube 350
Obst & Gyne Removal of Prosthesis from Fallopian Tube 250
Obst & Gyne Fimbrioplasty 500
Obst & Gyne Laparotomy Tubal ligation – Sterilization 300
Obst & Gyne Laparoscopic Tubal Ligation – Sterilization 350
Obst & Gyne Postpartum Tubal Ligation 300
Obst & Gyne Laparotomy Salpingostomy 350
Obst & Gyne Laparoscopic Salpingostomy 450
Obst & Gyne Laparoscopic Haematosalpinx Aspiration 450
Obst & Gyne Laparotomy Salpingectomy – Bilateral 450
Obst & Gyne Laparotomy Salpingectomy – Right Side 450
Obst & Gyne Laparotomy Salpingectomy – Left Side 450
Obst & Gyne Laparoscopic Salpingectomy – Bilateral 650
Obst & Gyne Laparoscopic Salpingectomy – Left Side 650
Obst & Gyne Laparoscopic Salpingectomy – Right Side 650
Obst & Gyne Suturing of Perineal Tear – First Degree 100
Obst & Gyne Suturing of Perineal Tear – Second Degree 150
Obst & Gyne Suturing of Perineal Tear – Third Degree 200
Obst & Gyne Suturing of Perineal Tear – Fourth Degree 360
Obst & Gyne Suturing of Perineal Laceration 100
Obst & Gyne Repair of Obstetrics Laceration of Urethra 200
Obst & Gyne Excision of Urethro-Vaginal Diverticulum 250
Obst & Gyne Repair of Urethro-Vaginal Fistula 450
Obst & Gyne Repair of Uretero-Vaginal Fistula 550
Obst & Gyne Repair of Vesico-Vaginal Fistula – Vaginal Approach 450
Obst & Gyne Repair of Vesico-Vaginal Fistula – Abdominal Approach 500
Obst & Gyne Repair of Vesico-Vaginal Fistula (with omentoplasty) –

Transvesical Approach

600
Obst & Gyne Repair of Vesico-Uterine Fistula 550
Obst & Gyne Repair of Uterine Wound/Scar Dehiscence 400
Obst & Gyne Colposuspension 560
Obst & Gyne Burch’s Colposuspension 480
Obst & Gyne Sling Operation 360
Obst & Gyne Tension-free Vaginal Tape (TVT) 400
Obst & Gyne Tension-free Obturator Tape (TOT) 400
Obst & Gyne Suprapubic Colpo Urethropexy 400
Obst & Gyne Vault Suspension 450
Obst & Gyne Sacral Colpopexy – Vaginal 450
Obst & Gyne Sacral Colpopexy – Abdominal 500
Obst & Gyne Sacrospinous Colpopexy 500
Obst & Gyne Plication of Utero Sacral Ligaments 400
Obst & Gyne Anterior Colporrhaphy 300
Obst & Gyne Repair of Rectocoele 300
Obst & Gyne Repair of Enterocoele 300
Obst & Gyne Posterior Colpoperineorrhaphy 350
Obst & Gyne Repair of Cystocoele and Rectocoele 600
Obst & Gyne Manchester/Fothergill Operation 500
Obst & Gyne Manual Replacement of Uterus 300
Obst & Gyne Hysterosacropexy – Vaginal 400
Obst & Gyne Hysterosacropexy – Abdominal 450
Obst & Gyne Laparotomy Ventrosuspension 400
Obst & Gyne Laparoscopic Ventrosuspension 400
Obst & Gyne Sacral Cervicopexy 400
Obst & Gyne Excision of Uterine Scar Ectopic Pregnancy 650
Obst & Gyne Evacuation of Broad Ligament Haematoma 450
Obst & Gyne Staging Laparotomy for Uterine Cancer 1500
Obst & Gyne Staging Laparoscopy for Uterine Cancer 1500
Obst & Gyne Pelvic Exenteration – Anterior 1800
Obst & Gyne Pelvic Exenteration – Posterior 1800
Obst & Gyne Pelvic Exenteration – Complete 2500
Obst & Gyne Classical Caesarean Section 650
Obst & Gyne Classical Caesarean Section with Bilateral Tubal Ligation (BTL) 700
Obst & Gyne Lower Segment Caesarean Section (LSCS) – Primary 450
Obst & Gyne Lower Segment Caesarean Section (LSCS) – Primary, with

Bilateral Tubal Ligation (BTL)

500
Obst & Gyne Lower Segment Caesarean Section (LSCS) – Repeat 550
Obst & Gyne Lower Segment Caesarean Section (LSCS) – Repeat, with Bilateral

Tubal Ligation (BTL)

600
Obst & Gyne Vaginal Delivery – Birth Before Arrival (BBA) to Hospital 100
Obst & Gyne Spontaneous Vaginal Delivery – Single 400
Obst & Gyne Spontaneous Vaginal Delivery – Twin 550
Obst & Gyne Spontaneous Vaginal Delivery – Preterm 450
Obst & Gyne Spontaneous Vaginal Delivery – Breech 500
Obst & Gyne Assisted Vaginal Delivery with Episiotomy – Vacuum Extraction 550
Obst & Gyne Assisted Vaginal Delivery with Episiotomy – Low Forceps 550
Obst & Gyne Assisted Vaginal Delivery with Episiotomy – Mid Forceps 600
Obst & Gyne Assisted Vaginal Delivery with Episiotomy – Breech 600
Obst & Gyne Assisted Vaginal Delivery without Episiotomy – Low Forceps 450
Obst & Gyne Forceps for After-coming Head 50
Obst & Gyne Internal Podalic Version 50
Obst & Gyne Incision of Cervix to Assist Delivery 150
Obst & Gyne Operation on Fetus to Assist Delivery 150
Obst & Gyne Resuturing of Gaped Episiotomy 100
Obst & Gyne Manual Removal of Placenta (M.R.P) 100
Obst & Gyne Evacuation of Retained Placental Tissue 200
Obst & Gyne Application of Scalp Electrode 50
Obst & Gyne External Cephalic Version 50
Obst & Gyne Amnioreduction 150
Obst & Gyne Amniocentesis 150
Obst & Gyne Cordocentesis 250
Obst & Gyne Chorionic Villus Sampling 250
Obst & Gyne Intrauterine Blood Transfusion – Intraperitoneal 250
Obst & Gyne Intrauterine Blood Transfusion – Intracardiac 300
Obst & Gyne Intrauterine Blood Transfusion – Umbilical Cord 300
Obst & Gyne Fetal Shunt Placement – Ultrasound Guided 300
Obst & Gyne Fetal Paracentesis – Ultrasound Guided 250
Obst & Gyne Fetal Thoracocentesis – Ultrasound Guided 250
Obst & Gyne Fetal Cephalocentesis – Ultrasound Guided 250
Obst & Gyne Fetal Ovarian Cyst Aspiration – Ultrasound Guided 250
Obst & Gyne Fetal Bladder Aspiration – Ultrasound Guided 250
Obst & Gyne Ultrasound Guided Intra-gestational Injection (e.g. methotrexate,

kcl)

300
Obst & Gyne Endoscopic Laser Ablation of Communicating Placental Vessels (twin-to-twin transfusion syndrome) 400
Obst & Gyne Antenatal Scan – Early Pregnancy Scan 25
Obst & Gyne Antenatal Scan – First Trimester Scan 100
Obst & Gyne Antenatal Scan – Growth Scan 30
Obst & Gyne Antenatal Scan – Anomaly Scan 100
Obst & Gyne Antenatal Scan – Fetal Echocardiography 100
Obst & Gyne Follicular Scan 30
Obst & Gyne Gynecological Scan 35
Obst & Gyne Labor Induction – Prostaglandin Tablet 25
Obst & Gyne Labor Induction – Prostaglandin Gel 25
Obst & Gyne Labor Induction – Cervidil (Dinoprostone) 25
Obst & Gyne Labor Induction – Cervical Catheter 40
Obst & Gyne Labor Induction – Artificial Rupture of Membranes (Amniotomy) 25
Obst & Gyne Fetal Contraction Stress Test 50
Obst & Gyne Fetal Non-stress Test 25
Obst & Gyne Fetal Scalp Blood Sampling 50
Obst & Gyne Fetal Umbilical Cord Occlusion 200
ENT Newborn Hearing Screening 25
ENT Tympanometry 10
ENT Audiometry 15
ENT PTA with Speech Audiometry 20
ENT BERA (including ECoG) 50
ENT Tonsillectomy 150
ENT Adenoidectomy 120
ENT Control of Post-tonsillectomy Bleeding 200
ENT Control of Post-adenoidectomy Bleeding 200
ENT Examination under Anesthesia (EUA) – Nasopharynx 50
ENT Examination under Anesthesia (EUA) – Ear 50
ENT Examination under Anesthesia (EUA) – Nose 50
ENT Examination under Microscope (EUM) – Ear Suction Cleaning &

Dewaxing

25
ENT Biopsy – Nasopharynx 100
ENT Biopsy (under anesthesia) – Oral cavity 100
ENT Biopsy – Oral cavity 25
ENT Biopsy – Hypopharynx 150
ENT Biopsy – Larynx 150
ENT Biopsy – Ear 50
ENT Biopsy – Neck 250
ENT Incision & Drainage of Retropharyngeal Abscess – Transoral Approach 200
ENT Incision & Drainage of Retropharyngeal Abscess – External

Approach

400
ENT Incision & Drainage of Parapharyngeal Abscess – Transoral

Approach

200
ENT Incision & Drainage of Parapharyngeal Abscess – External

Approach

400
ENT Incision & Drainage of Nasal Abscess (under anesthesia) 60
ENT Incision & Drainage of Nasal Abscess 30
ENT Incision & Drainage of Septal Abscess (under anesthesia) 60
ENT Incision & Drainage of Septal Abscess 30
ENT Incision & Drainage of Septal Haematoma (under anesthesia) 60
ENT Incision & Drainage of Septal Haematoma 30
ENT Incision & Drainage of Post-aural Abscess (under anesthesia) 100
ENT Incision & Drainage of Post-aural Abscess 50
ENT Incision & Drainage of Pre-auricular Abscess (under anesthesia) 100
ENT Incision & Drainage of Pre-auricular Abscess 50
ENT Incision & Drainage of Pinna Abscess 150
ENT Incision & Drainage of Pinna Haematoma (without quilting) –

Under Anesthesia

100
ENT Incision & Drainage of Pinna Haematoma (without quilting) 50
ENT Incision & Drainage of Pinna Haematoma (with quilting) – Under Anesthesia 150
ENT Incision & Drainage of Pinna Haematoma (with quilting) 75
ENT Incision & Drainage of Submandibular Abscess/Cyst/Hematoma 200
ENT Incision & Drainage of Parotid Abscess 250
ENT Incision & Drainage of Neck Abscess 200
ENT Excision of Sinus/Fistula – Pre auricular 250
ENT Excision of Sinus/Fistula – Post auricular 400
ENT Excision of Accessory Auricle 100
ENT Excision of Sinus/Fistula – Neck 400
ENT Excision of Neck Swelling/Lesion – Anterior/Posterior Triangle 300
ENT Nasal Polypectomy 150
ENT Excision of Antrochoanal Polyp 300
ENT Submandibular Gland Excision 400
ENT Closure of Oroantral Fistula 300
ENT Foreign Body Removal (under anesthesia) – Nose 100
ENT Foreign Body Removal (under anesthesia) – Oropharynx 100
ENT Foreign Body Removal (under anesthesia) – Oral Cavity 100
ENT Foreign Body Removal – Nose 50
ENT Foreign Body Removal – Oropharynx 50
ENT Foreign Body Removal – Oral Cavity 50
ENT Hypopharyngoscopy 100
ENT Hypopharyngoscopy & Foreign Body Removal 150
ENT Micro Laryngoscopy (suspension laryngoscopy) 200
ENT Micro Laryngoscopy (suspension laryngoscopy) with Biopsy 300
ENT Direct Laryngoscopy and Foreign Body Removal 250
ENT Direct Laryngoscopy 100
ENT Airway Assessment (Nasopharyngolaryngobronchoscopy) 300
ENT Rigid Bronchoscopy and Foreign Body Removal 300
ENT Rigid Bronchoscopy 200
ENT Fiberoptic Laryngoscopy (under anesthesia) 100
ENT Fiberoptic Laryngoscopy 25
ENT Pan-Endoscopy 400
ENT Hemilaryngectomy 750
ENT Total Laryngectomy 1040
ENT Neck Dissection – Radical 900
ENT Neck Dissection – Modified Radical 800
ENT Neck Dissection – Selective 600
ENT Repair of Trachea 700
ENT Uvulopalatopharyngoplasty (UPPP) 750
ENT Ear Piercing 15 (per ear)
ENT Dewaxing of Ear 15 (per ear)
ENT Dewaxing of Ear (under anesthesia) 50
ENT Foreign Body Removal – Ear 15 (per ear)
ENT Foreign Body Removal – Ear (under anesthesia) 50
ENT Aural Polypectomy 100
ENT Surgery for External Auditory Canal Atresia 1000
ENT Myringotomy 75 (per ear)
ENT Myringotomy and Grommet Insertion 100
ENT Grommet Removal (under anesthesia) 50
ENT Grommet Removal 25
ENT Exploratory Tympanotomy 150
ENT Tympanoplasty 300
ENT Tympanoplasty with Ossiculoplasty 450
ENT Cortical Mastoidectomy 350
ENT Radical Mastoidectomy 500
ENT Modified Radical Mastoidectomy 600
ENT Retromastoid Approach and Excision of Acoustic Schwannoma 1500
ENT Mastoid Exploration 550
ENT Suction Clearance of Mastoid Cavity 40
ENT Stapedectomy 500
ENT Cochlear Implantation 750
ENT Nasal Endoscopy (under anesthesia) 50
ENT Nasal Endoscopy 25
ENT Repair of Nasal Laceration 100
ENT Septoplasty 250
ENT Submucus Diathermy (SMD) of Turbinates 100
ENT Rhinolith Removal 150
ENT Surgical Closure of Anterior Nares (Young’s operation) 250
ENT Post Nasal Packing 100
ENT Post Nasal Pack Removal (under anesthesia) 50
ENT Post Nasal Pack Removal 25
ENT Nasal Fracture Reduction – Open 300
ENT Nasal Fracture Reduction – Closed (under anesthesia) 100
ENT Nasal Fracture Reduction – Closed 50
ENT Functional Endoscopic Sinus Surgery (FESS) – Simple 350
ENT Functional Endoscopic Sinus Surgery (FESS) – Complex 600
ENT Maxillectomy – Partial 500
ENT Maxillectomy – Infrastructure 500
ENT Maxillectomy – Total without Orbital Exenteration 750
ENT Maxillectomy – Total with Orbital Exenteration 1000
ENT Medial Maxillectomy – Open 750
ENT Medial Maxillectomy – Endoscopic 600
ENT Tracheostomy – Planned 300
ENT Parotidectomy – Partial 600
ENT Parotidectomy – Superficial 600
ENT Parotidectomy – Total 700
ENT Parotidectomy – Extended 1000
ENT Partial Glossectomy 500
ENT Partial Glossectomy with Neck Dissection 1000
ENT Total Glossectomy 600
ENT Total Glossectomy with Neck Dissection 1200
ENT Tracheal Dilatation 300
ENT Otoplasty 450
ENT Septorhinoplasty 750
ENT Mandibulectomy – Marginal 400
ENT Mandibulectomy – Segmental 400
ENT Ear Repair – Ear lobe 50
ENT Ear Repair – Pinna 100
ENT Reopening of Choanal Atresia 500
ENT Debridement of Maxillary & Ethmoid Sinuses 400
ENT Debridement of All Sinuses 600
ENT Extensive Debridement of Paranasal Sinuses & Skull Base 600
ENT Endoscopic Repair of CSF Leak 650
ENT Sistrunk Operation – Thyroglossal Cyst 350
ENT Sistrunk Operation – Thyroglossal Sinus 350
ENT Sistrunk Operation – Thyroglossal Fistula 350
ENT Biopsy – Nasopharynx 100
ENT Biopsy (under anesthesia) – Oral cavity 100
ENT Biopsy – Oral cavity 25
ENT Biopsy – Hypopharynx 150
ENT Biopsy – Larynx 150
ENT Biopsy – Ear 50
ENT Biopsy – Neck 250
ENT Closure of Tracheocutaneous Fistula 300
ENT Neck Trauma Exploration 500
ENT Neck Wound Re-exploration 300
ENT Post Aural Wound Re-exploration 100
ENT Excision of Hypopharyngeal Lesion – Open 500
ENT Excision of Hypopharyngeal Lesion – Endoscopic 300
ENT Excision of Oropharyngeal Lesion – Open 500
ENT Excision of Oropharyngeal Lesion – Endoscopic 200
ENT Excision of Laryngeal Lesion – Open 500
ENT Excision of Laryngeal Lesion – Endoscopic 300
ENT Excision of Nasopharyngeal Lesion – Open 500
ENT Excision of Nasopharyngeal Lesion – Endoscopic 300
ENT Excision of Tracheal Lesion – Open 550
ENT Excision of Tracheal Lesion – Endoscopic 500
ENT Excision of Oral Cavity Lesion – Open 500
ENT Excision of Oral Cavity Lesion – Endoscopic 300
ENT Pharyngotomy 500
ENT Pharyngectomy 500
ENT Debridement of Neck 300
ENT Debridement of Ear 75
ENT Radiofrequency (RF) – Palate 100
ENT Radiofrequency (RF) – Base of Tongue 150
ENT Radiofrequency (RF) – Turbinates 100
ENT Endoscopic Control for Epistaxis (under anesthesia) 200
ENT Endoscopic Control for Epistaxis 10
ENT Sialoendoscopy 500
ENT Sialoendoscopy (combined approach) 600
ENT Tracheal Resection and Anastomosis 1000
ENT Laryngeal Expansion 1000
ENT Total Laryngopharyngectomy with Esophageal Repair 2000
ENT Cricotracheal Resection 1000
ENT Hyoid Suspension 500
ENT Posterior Cricoid Split with Cartilage Interpositioning 700
ENT Anterior Cricoid Split with Cartilage Expansion 700
ENT OSA Surgery (multilevel) 1000
ENT Sphenopalatine Artery Ligation 300
ENT Maxillary Artery Ligation 400
ENT Anterior Ethmoidal Artery Ligation – Endoscopic 300
ENT Anterior Ethmoidal Artery Ligation – External 400
ENT Nasopharyngeal Angiofibroma Excision 1000
ENT Optic Nerve Decompression 750
ENT Orbital Decompression – Transantral 500
ENT Facial Nerve Decompression 750
ENT Endoscopic Dacryocystorhinostomy (DCR) 500
ENT External Carotid Artery Ligation 500
ENT Reconstruction with Split Thickness Skin Graft – Head & Neck 150
ENT Reconstruction with Local Flap – Head & Neck 250
ENT Reconstruction with Regional Flap – Head & Neck 450
ENT Marginal Excision of Soft Tissue Tumor – Neck 700
ENT Wide Excision of Soft Tissue Tumor (without graft) – Neck 900
ENT Wide Excision of Soft Tissue Tumor (with graft) – Neck 1200
ENT Radical Excision of Soft Tissue Tumor – Neck 1800
Ophthalmology Applanation Tonometry 10
Ophthalmology Non-contact Tonometry 10
Ophthalmology Schiotz Tonometry 10
Ophthalmology A-scan Ultrasound 25
Ophthalmology B-scan Ultrasound 25
Ophthalmology Ophthalmic Ultrasound 25
Ophthalmology Diplopia Charting 10
Ophthalmology Exophthalmometry (e.g. Hertel) 10
Ophthalmology Hess Screening 10
Ophthalmology Humphrey Visual Field Analysis 20
Ophthalmology Intraocular Lens (IOL) Power Calculation 20
Ophthalmology Keratometry 10
Ophthalmology Gonioscopy 20
Ophthalmology Lensometry 20
Ophthalmology Eye Examination Under General Anesthesia 150
Ophthalmology Eye Care 5
Ophthalmology Eye Washing 5
Ophthalmology Biopsy – Eyelid 70
Ophthalmology Biopsy – Conjunctiva 60
Ophthalmology Biopsy – Lacrimal Sac/Gland 150
Ophthalmology Biopsy – Other Orbital Content 150
Ophthalmology Biopsy – Cornea 50
Ophthalmology Biopsy – Orbital Tumor 150
Ophthalmology Orbital Contents Fine Needle Aspiration 50
Ophthalmology Ectropion Correction 400
Ophthalmology Entropion Correction 400
Ophthalmology Ptosis Correction 700
Ophthalmology Chalazion Incision & Curettage 50
Ophthalmology Chalazion Incision & Curettage with Granuloma Excision 75
Ophthalmology Eyelid Abscess Drainage 75
Ophthalmology Repair of Partial Thickness Eyelid Tear 100
Ophthalmology Repair of Full Thickness Eyelid Tear 250
Ophthalmology Canthopexy 400
Ophthalmology Canthoplasty 400
Ophthalmology Tarsorrhaphy 120
Ophthalmology Release of Tarsorrhaphy 25
Ophthalmology Trichiasis Epilation 20
Ophthalmology Trichiasis Laser Ablation 50
Ophthalmology Trichiasis Electrolysis 50
Ophthalmology Stye (Hordeolum) Incision & Drainage 50
Ophthalmology Eyelid Growth Excision – Minor 150
Ophthalmology Eyelid Growth Excision – Major 350
Ophthalmology Eyelid Foreign Body Removal 50
Ophthalmology Nasolacrimal Duct Probing & Syringing 100
Ophthalmology Nasolacrimal Duct Dilatation 75
Ophthalmology Lacrimal Punctum Dilatation 25
Ophthalmology Lacrimal Punctum Operation (others) 150
Ophthalmology Lacrimal Canaliculi Probing & Syringing 75
Ophthalmology Lacrimal Sac/Gland Incision & Drainage 80
Ophthalmology Dacryocystectomy (DCT) 400
Ophthalmology Dacryoadenectomy 450
Ophthalmology Excision of Lacrimal Gland Tumor/Lesion 850
Ophthalmology Lacrimal Duct/Canaliculi Repair 250
Ophthalmology Removal of Lacrimal Passages Foreign Body or Dacryolith 150
Ophthalmology Dacryocystorhinostomy (DCR) 450
Ophthalmology Conjunctivorhinostomy 500
Ophthalmology Evisceration of Ocular Contents (with implant) 350
Ophthalmology Evisceration of Ocular Contents (without implant) 300
Ophthalmology Enucleation of Eye (without implant) 400
Ophthalmology Enucleation of Eye (with implant) 450
Ophthalmology Exenteration of Orbit 650
Ophthalmology Exenteration of Orbit (with flap) 800
Ophthalmology Orbital Implant Insertion 350
Ophthalmology Orbital Implant Modification 150
Ophthalmology Orbital Implant Removal 250
Ophthalmology Ocular Prosthesis (artificial eye) Impression & Custom Preparation 550
Ophthalmology Ocular Prosthesis (artificial eye) Placement/Fitting 20
Ophthalmology Ocular Prosthesis (artificial eye) Review/Care 20
Ophthalmology Orbital Abscess Drainage 300
Ophthalmology Orbital Decompression – Transcranial 850
Ophthalmology Orbital Decompression – Orbitotomy 750
Ophthalmology Orbit Exploration – Transcranial 950
Ophthalmology Orbit Exploration – Orbitotomy 650
Ophthalmology Orbital Tumor Excision – Transcranial 1000
Ophthalmology Orbital Tumor Excision – Orbitotomy 800
Ophthalmology Orbital Foreign Body Removal – Transcranial 800
Ophthalmology Orbital Foreign Body Removal – Orbitotomy 550
Ophthalmology Squint Surgery for Esotropia 400
Ophthalmology Squint Surgery for Esotropia + Oblique Muscle 500
Ophthalmology Squint Surgery for Exotropia 400
Ophthalmology Squint Surgery for Exotropia + Oblique Muscle 500
Ophthalmology Squint Surgery for Vertical Deviation 450
Ophthalmology Squint Surgery – Others 400
Ophthalmology Other Surgery on Extraocular Muscle – Simple 350
Ophthalmology Other Surgery on Extraocular Muscle – Complex 450
Ophthalmology Chemodenervation of Extraocular Muscle (e.g. botulinum toxin) 100
Ophthalmology Conjunctival Concretion Removal 25
Ophthalmology Conjunctival Granuloma Excision 100
Ophthalmology Conjunctival Growth Excision – Minor 100
Ophthalmology Conjunctival Growth Excision – Major 250
Ophthalmology Conjunctival Naevus Excision 100
Ophthalmology Incision/Destruction of Other Conjunctival Lesion 50
Ophthalmology Pterygium Excision 150
Ophthalmology Pterygium Excision with Rotational Autograft 250
Ophthalmology Pterygium Excision with Free Autograft 350
Ophthalmology Amniotic Membrane Graft for Conjunctiva 350
Ophthalmology Patch Graft (eye) 550
Ophthalmology Conjunctival Tear Repair 150
Ophthalmology Conjunctival Resuturing 100
Ophthalmology Conjunctival Suture Removal 25
Ophthalmology Conjunctival Foreign Body Removal 25
Ophthalmology Subconjunctival Injection 20
Ophthalmology Excision of Scleral Lesion 250
Ophthalmology Release of Synechiae – Incisional 250
Ophthalmology Release of Synechiae – Laser 200
Ophthalmology Scleral Flap Resuturing 200
Ophthalmology Scleral Suture Removal 25
Ophthalmology Scleral Tear Repair 300
Ophthalmology Subtenon Injection 30
Ophthalmology Retrobulbar Injection 50
Ophthalmology Corneal Lesion Excision/Destruction 250
Ophthalmology Corneal Scrapping 50
Ophthalmology Corneal Tear Repair 300
Ophthalmology Corneal Suturing 300
Ophthalmology Corneal and Scleral Tear Repair 450
Ophthalmology Corneal Foreign Body Removal 35
Ophthalmology Penetrating Keratoplasty Suture Removal 50
Ophthalmology Corneal/Corneoscleral Suture Removal 25
Ophthalmology Corneal Collagen Cross Linking 300
Ophthalmology Therapeutic Keratoplasty 550
Ophthalmology Penetrating Keratoplasty 650
Ophthalmology Deep Lamellar Endothelial Keratoplasty (DLEK) 650
Ophthalmology Deep Lamellar Keratoplasty 650
Ophthalmology Descemet Membrane Endothelial Keratoplasty (DMEK) 650
Ophthalmology Descemet Stripping Automated Endothelial Keratoplasty(DSAEK) 650
Ophthalmology Non-penetrating Deep Sclerectomy 450
Ophthalmology Non-penetrating Deep Sclerectomy with Collagen Implantation 500
Ophthalmology Non-penetrating Deep Sclerectomy with Mitomycin-C 500
Ophthalmology Excimer Laser (eye) 600
Ophthalmology Phackic Intraocular Lens (IOL) 450
Ophthalmology Intra-corneal Ring Segments Insertion 400
Ophthalmology Peripheral Iridotomy (PI) – Incisional 250
Ophthalmology Peripheral Iridotomy (PI) – Laser 200
Ophthalmology Iridectomy – Incisional 250
Ophthalmology Iridectomy – Laser 200
Ophthalmology Argon Laser Trabeculoplasty (ALT) 200
Ophthalmology Trabeculectomy 550
Ophthalmology Trabeculotomy/Goniotomy 450
Ophthalmology Trabeculotomy + Trabeculectomy 650
Ophthalmology Bleb Revision 300
Ophthalmology Aqueous Shunt Revision 300
Ophthalmology Cyclocryopexy 300
Ophthalmology Cyclophotocoagulation 300
Ophthalmology Trans-scleral Cyclophotocoagulation 350
Ophthalmology Other Operation of Iris/Ciliary Body (e.g. foreign body removal,

lesion excision, repair)

350
Ophthalmology Glaucoma Valve Implant Surgery 650
Ophthalmology Glaucoma Valve Implant Surgery with Vitrectomy 750
Ophthalmology Removal of Implanted Material (other than IOL) – Anterior Segment 350
Ophthalmology Removal of Implanted Material (other than IOL) – Posterior

Segment

350
Ophthalmology Argon Laser – Suture Lysis 75
Ophthalmology Anterior Vitrectomy 350
Ophthalmology Vitrectomy 850
Ophthalmology Vitrectomy – Retained Lens Matter 950
Ophthalmology Vitrectomy – Retained Intraocular Foreign Body 950
Ophthalmology Vitrectomy + AC IOL 1000
Ophthalmology Vitrectomy + PC IOL 1000
Ophthalmology Vitrectomy + Scleral Fixation IOL 1250
Ophthalmology Vitrectomy – Diabetic 1250
Ophthalmology Vitrectomy – Endophthalmitis 750
Ophthalmology Vitrectomy – Trauma 1100
Ophthalmology Vitrectomy – Vitreous Hemorrhage 1100
Ophthalmology YAG Laser – Posterior Capsulotomy 200
Ophthalmology YAG Laser – Anterior Capsulotomy 200
Ophthalmology YAG Laser – Membranotomy 200
Ophthalmology YAG Laser – Vitreolysis 200
Ophthalmology Intravitreal Injection 150
Ophthalmology Silicon Oil removal 300
Ophthalmology Anterior Chamber Reformation 100
Ophthalmology Anterior Chamber Paracentesis – Diagnostic 75
Ophthalmology Anterior Chamber Paracentesis – Therapeutic 75
Ophthalmology Anterior Chamber Foreign Body Removal 350
Ophthalmology Intracapsular Cataract Extraction (ICCE) 400
Ophthalmology Extracapsular Cataract Extraction (ECCE) 400
Ophthalmology ICCE + AC IOL 450
Ophthalmology ICCE + Scleral Fixation 500
Ophthalmology ECCE + AC IOL 450
Ophthalmology ECCE + PC IOL 450
Ophthalmology ECCE + PC IOL + Peripheral Iridotomy (PI) 500
Ophthalmology ECCE + PC IOL + Pterygium Excision 550
Ophthalmology ECCE + PC IOL + Trabeculectomy 700
Ophthalmology ECCE + Scleral Fixation IOL 500
Ophthalmology ECCE + Trabeculectomy 750
Ophthalmology ECCE + Vitrectomy + Scleral Fixation PC IOL 750
Ophthalmology ECCE + Vitrectomy + PC IOL 550
Ophthalmology ECCE + Vitrectomy + PC IOL + PI 550
Ophthalmology ECCE + Vitrectomy + AC IOL + PI 550
Ophthalmology Penetrating Keratoplasty (PKP) + ECCE + PC IOL 1000
Ophthalmology Penetrating Keratoplasty (PKP) + ECCE + Vitrectomy + PC IOL 1200
Ophthalmology Penetrating Keratoplasty (PKP) + ECCE + Vitrectomy + PC IOL +

PI

1200
Ophthalmology Penetrating Keratoplasty (PKP) + ECCE + Vitrectomy + AC IOL

+ PI

1200
Ophthalmology Penetrating Keratoplasty (PKP) + Secondary AC IOL 1000
Ophthalmology Secondary AC IOL 300
Ophthalmology Secondary PC IOL 300
Ophthalmology Secondary Scleral Fixation PC IOL 350
Ophthalmology Small Incision Cataract Surgery (SICS) 400
Ophthalmology SICS + AC IOL 450
Ophthalmology SICS + PC IOL 450
Ophthalmology SICS + AC IOL + PI 500
Ophthalmology SICS + PC IOL + Trabeculectomy 750
Ophthalmology SICS + Trabeculectomy 650
Ophthalmology Lens Matter Aspiration 300
Ophthalmology Phacoaspiration 400
Ophthalmology Phacoaspiration + AC IOL 500
Ophthalmology Phacoaspiration + PC IOL 500
Ophthalmology Phacoaspiration + AC IOL + PI 500
Ophthalmology Phacoaspiration + Scleral Fixation 600
Ophthalmology Phacoaspiration + Vitrectomy + PC IOL 550
Ophthalmology Phacoaspiration + Vitrectomy + AC IOL + PI 600
Ophthalmology Phacoaspiration + Vitrectomy + PC IOL + PI 600
Ophthalmology Phacoemulsification 450
Ophthalmology Phacoemulsification + AC IOL 500
Ophthalmology Phacoemulsification + PC IOL 500
Ophthalmology Phacoemulsification + PC IOL + Trabeculectomy 800
Ophthalmology Phacoemulsification + Scleral Fixation IOL 650
Ophthalmology Phacoemulsification + Vitrectomy + PC IOL 700
Ophthalmology Phacoemulsification + Vitrectomy + AC IOL + PI 650
Ophthalmology Phacoemulsification + Vitrectomy + PC IOL + PI 650
Ophthalmology Phacoemulsification + PC IOL + Pterygium Excision 600
Ophthalmology Argon Laser – Fill-in PRP 250
Ophthalmology Argon Laser – Macular Grid 250
Ophthalmology Argon Laser – PRP 200
Ophthalmology Argon Laser – Focal 200
Ophthalmology Barricade Laser (eye) 200
Ophthalmology Focal Macular Grid 250
Ophthalmology Modified Macular Grid 250
Ophthalmology Focal Retinal Photocoagulation 200
Ophthalmology Laser with Indirect Ophthalmoscope (LIO) 250
Ophthalmology Laser with Indirect Ophthalmoscope (LIO)/Cryopexy for Retinal

Breaks

250
Ophthalmology Membranectomy – Anterior 300
Ophthalmology Membranectomy – Posterior 400
Ophthalmology Pneumoretinopexy 400
Ophthalmology Fundus Fluorescein Angiography (FFA) 150
Ophthalmology Retinal Detachment Repair (e.g. cryotherapy, photocoagulation, pneumatic retinopexy) 900
Ophthalmology Retinal Detachment Repair (by scleral buckling or vitrectomy) 1000
Ophthalmology Retinal Detachment Repair – Complicated 700
Ophthalmology Retinopathy of Prematurity (ROP) Surgery 700
Neurosurgery Twist Drill for Placement of External Ventricular Drain (EVD) or

Intracerebral Pressure (ICP) Monitoring Device

300
Neurosurgery Burr Hole for Placement of External Ventricular Drain (EVD) or

Intracerebral Pressure (ICP) Monitoring Device

300
Neurosurgery Burr Hole for Change of External Ventricular Drain (EVD) or

Intracerebral Pressure (ICP) Monitoring Device

200
Neurosurgery Burr Hole for Drainage of Chronic Subdural Hematoma (SDH) 650
Neurosurgery Navigation Guided Aspiration of Intracranial Abscess 800
Neurosurgery Craniotomy/Craniectomy for Subdural Hematoma 800
Neurosurgery Craniotomy/Craniectomy for Intracerebral Hematoma 850
Neurosurgery Craniotomy/Craniectomy for Cerebral Contusion 800
Neurosurgery Craniotomy/Craniectomy for Intracranial Abscess 950
Neurosurgery Craniotomy/Craniectomy for Arachnoid Cyst/Epidermal Cyst 1000
Neurosurgery Craniotomy/Craniectomy for Navigation Guided Biopsy or Tumor

Excision

1100
Neurosurgery Endoscopy for Cranial/Spinal Diagnostic Purposes (Exploratory

Neuroendoscopy)

700
Neurosurgery Endoscopy for Intracranial Biopsy 720
Neurosurgery Endoscopy for Evacuation of Intracranial Hematoma 750
Neurosurgery Endoscopy for Other Intracranial Therapeutic Purposes (e.g. ETV,

Evacuation)

750
Neurosurgery Shunt – Cysto-subarachnoid 600
Neurosurgery Shunt – Bilateral Ventriculo-peritoneal (VP) 700
Neurosurgery Shunt – Ventriculo-atrial (VA) 600
Neurosurgery Shunt – Ventriculo- jugular (VJ) 600
Neurosurgery Shunt – Cysto- peritoneal 520
Neurosurgery Shunt – Combined Cerebral Shunts 700
Neurosurgery Shunt – Unilateral Revision/Conversion/Change of Ventriculo- peritoneal (VP) 520
Neurosurgery Shunt – CSF Shunt Removal (without replacement) 250
Neurosurgery Shunt – Placement of Cerebral Shunt Reservoir 400
Neurosurgery Shunt – Shunt Removal and Placement of External Ventricular

Drain (EVD)

355
Neurosurgery Craniotomy/Craniectomy for Skull Vault Tumors (without

Cranioplasty)

1200
Neurosurgery Craniotomy/Craniectomy for Skull Vault Tumors (with

Cranioplasty)

1400
Neurosurgery Craniotomy/Craniectomy for Skull Base Tumors 2000
Neurosurgery Craniotomy/Craniectomy for Extended Skull Base Tumors/Lesions 2000
Neurosurgery Craniotomy/Craniectomy for Posterior Fossa Tumors 1500
Neurosurgery Craniotomy/Craniectomy for Meningiomas (including duroplasty) 1400
Neurosurgery Craniotomy/Craniectomy for Gliomas 1200
Neurosurgery Craniotomy/Craniectomy for Cerebellopontine Angle Lesions 2000
Neurosurgery Craniotomy/Craniectomy for Intraventricular Tumors 1700
Neurosurgery Craniotomy/Craniectomy: Epilepsy – Lesionectomy (without

electrocorticography)

1500
Neurosurgery Craniotomy/Craniectomy: Epilepsy – Lesionectomy (with electrocorticography) 1700
Neurosurgery Craniotomy/Craniectomy: Epilepsy – Temporal Lobectomy with

Amygdalo-Hippocampectomy

1800
Neurosurgery Craniotomy/Craniectomy: Epilepsy – Corpus Callosotomy 1500
Neurosurgery Craniotomy/Craniectomy: Epilepsy – Functional Hemispherotomy 2000
Neurosurgery Repair of CSF Dural Fistula – Spinal 900
Neurosurgery Endoscopic Repair of CSF Dural Fistula 800
Neurosurgery Transoral/Transnasal/Transethmoidal Excision of Tumors

(microscope-assisted)

1600
Neurosurgery Craniotomy/Craniectomy for Dural Arteriovenous Fistula/

Cavernomas/Haemangioblastoma/Other Vascular Lesions

1500
Neurosurgery Craniotomy/Craniectomy for Arteriovenous Malformations 1500
Neurosurgery Craniotomy/Craniectomy for Extracranial-Intracranial (EC-IC)

Bypass

1600
Neurosurgery Decompression for Trauma/Tumor/Stroke 1000
Neurosurgery Foramen Magnum Decompression 1000
Neurosurgery Craniotomy/Craniectomy for Microvascular Decompression 1500
Neurosurgery Occpitocervical Decompression and Fixation 1500
Neurosurgery Spine: Laminectomy/Laminoplasty for Extradural Tumors/Lesions

– Cervical or Thoracic

1200
Neurosurgery Spine: Laminectomy/Laminoplasty for Extradural Tumors/Lesions

– Lumbar or Sacral

1100
Neurosurgery Spine: Laminectomy/Laminoplasty for Spinal Intradural

(extramedullary) Tumors/Lesions – Cervical or Thoracic

1300
Neurosurgery Spine: Laminectomy/Laminoplasty for Spinal Intradural

(extramedullary) Tumors/Lesions – Lumbar or Sacral

1200
Neurosurgery Spine: Laminectomy/Laminoplasty for Spinal Intradural

(intramedullary) Tumors/Lesions

1500
Neurosurgery Posterior Spinal Decompression 1200
Neurosurgery Anterior Spinal Decompression 1500
Neurosurgery Combined Anterior/Posterior Spinal Decompression 1800
Neurosurgery Minimally Invasive Spinal Decompression 1000
Neurosurgery Disc Arthroplasty/Disc Replacement 1800
Neurosurgery Percutaneous Rhizolysis/Rhyzotomy (radiofrequency ablation) 200
OMF & Dentistry LeFort I Osteotomy 1800
OMF & Dentistry LeFort II Osteotomy 1800
OMF & Dentistry Other Maxillary Osteotomy 800
OMF & Dentistry Sagittal Split Osteotomy 1500
OMF & Dentistry Subsigmoid Osteotomy 1000
OMF & Dentistry Other Mandibular Osteotomy 700
OMF & Dentistry Open Reduction Internal Fixation (ORIF) of Maxilla/Zygoma –

Simple

800
OMF & Dentistry Open Reduction Internal Fixation (ORIF) of Maxilla/Zygoma –

Complex

1000
OMF & Dentistry Open Reduction Internal Fixation (ORIF) of Mandible – Simple 800
OMF & Dentistry Open Reduction Internal Fixation (ORIF) of Mandible – Complex 1000
OMF & Dentistry Closed Reduction of Maxilla/Zygoma Fracture 400
OMF & Dentistry Closed Reduction of Mandibular Fracture 400
OMF & Dentistry Reconstruction of Mandible 1000
OMF & Dentistry Reconstruction of Maxilla/Zygoma 1000
OMF & Dentistry Reduction of Temporomandibular Joint (TMJ) Dislocation –

Closed

45
OMF & Dentistry Reduction of Temporomandibular Joint (TMJ) Dislocation –

Closed (with fixation)

300
OMF & Dentistry Reduction of Temporomandibular Joint (TMJ) Dislocation – Open 800
OMF & Dentistry Temporomandibular Joint (TMJ) Arthrocentesis – Unilateral 30
OMF & Dentistry Temporomandibular Joint (TMJ) Arthrocentesis – Bilateral 50
OMF & Dentistry Injection of Therapeutic Substance into Temporomandibular Joint

(TMJ)

30
OMF & Dentistry Temporomandibular Joint (TMJ) Arthroscopy – Diagnostic 600
OMF & Dentistry Temporomandibular Joint (TMJ) Repair – Arthroscopic 900
OMF & Dentistry Temporomandibular Joint (TMJ) Repair – Open 800
OMF & Dentistry Temporomandibular Joint (TMJ) Replacement 1800
OMF & Dentistry Excision of Maxillary or Mandibular Cyst 300
OMF & Dentistry Excision of Maxillary or Mandibular Tumor (benign) 400
OMF & Dentistry Excision of Maxillary or Mandibular Tumor (malignant) 800
OMF & Dentistry Biopsy – Lip 40
OMF & Dentistry Closure of Oroantral Fistula 300
OMF & Dentistry Closure of Oronasal Fistula 300
OMF & Dentistry Closure of Orocutaneous Fistula 300
OMF & Dentistry Palatal Obturator 200
OMF & Dentistry Removal of Dentoalveolar Foreign Body 100
OMF & Dentistry Incision & Drainage of Masticator Space Abscess/Hematoma –

Transoral Approach

200
OMF & Dentistry Incision & Drainage of Masticator Space Abscess/Hematoma –

Extraoral Approach

400
OMF & Dentistry Incision & Drainage of Oral Cavity Abscess/Hematoma – Simple 50
OMF & Dentistry Incision & Drainage of Oral Cavity Abscess/Hematoma –

Complex

100
OMF & Dentistry Incision & Drainage of Palate/Uvula Abscess/Hematoma 50
OMF & Dentistry Incision & Drainage of Dentoalveolar Abscess/Hematoma 50
OMF & Dentistry Incision & Drainage of Sublingual Abscess/Hematoma 200
OMF & Dentistry Incision & Drainage of Submandibular Abscess/Cyst/Hematoma 200
OMF & Dentistry Suturing/Closure of Tongue Laceration – Simple 30
OMF & Dentistry Suturing/Closure of Tongue Laceration – Complex 100
OMF & Dentistry Suturing/Closure of Mouth Laceration – Simple 30
OMF & Dentistry Suturing/Closure of Mouth Laceration – Complex 100
OMF & Dentistry Excision of Tongue Lesion – Simple 50
OMF & Dentistry Excision of Tongue Lesion – Complex 400
OMF & Dentistry Excision of Mouth Lesion (except tongue) – Simple 50
OMF & Dentistry Excision of Mouth Lesion (except tongue) – Complex 400
OMF & Dentistry Excision of Mouth Floor Lesions (e.g. ranula/mucocele/sublingual

cyst)

450
OMF & Dentistry Marsupialization of Mouth Floor Lesions (e.g.

ranula/mucocele/sublingual cyst)

450
OMF & Dentistry Excision of Lingual Tonsil 200
OMF & Dentistry Frenectomy/Frenotomy 50
OMF & Dentistry Glossoplasty (e.g. tongue flap, fascial sling, fusion to lip, etc.) 300
OMF & Dentistry Excision of Palate/Uvula Lesion – Simple 50
OMF & Dentistry Excision of Palate/Uvula Lesion – Complex 400
OMF & Dentistry Excision of Uvula (Uvulectomy) 250
OMF & Dentistry Palate Resection 400
OMF & Dentistry Radiofrequency (RF) Ablation of Oral Cavity Lesion 100
OMF & Dentistry Excision of Palate/Uvula Lesion – Simple 50
OMF & Dentistry Excision of Palate/Uvula Lesion – Complex 400
OMF & Dentistry Vestibuloplasty 250
OMF & Dentistry Alveoloplasty/Alveolectomy (without tooth extraction) 50 per quadrant
OMF & Dentistry Alveoloplasty/Alveolectomy (in conjunction with tooth extraction) 150 per quadrant
OMF & Dentistry Alveolar Bone Graft 150 per quadrant
OMF & Dentistry Excision of Dentoalveolar Lesion – Minor 100 per quadrant
OMF & Dentistry Excision of Dentoalveolar Lesion – Major 250 per quadrant
OMF & Dentistry Gingival Graft 150 per quadrant
OMF & Dentistry Periodontal Flap Surgery 150 per quadrant
OMF & Dentistry Gingivectomy 50 per quadrant
OMF & Dentistry Gingivoplasty 70 per quadrant
OMF & Dentistry Periodontal Guided Bone/Tissue Regeneration 150 per site
OMF & Dentistry Dental Examination (without treatment) 15
OMF & Dentistry Dental DMF Charting (oral epidemiology assessment) 15
OMF & Dentistry Collection of Oral Sample (e.g. pus swab, saliva) for Lab Testing 20
OMF & Dentistry Other Special Dental Diagnostic Test (e.g. pulp vitality test) 25
OMF & Dentistry Oral Tissue Exploration (without treatment) 30
OMF & Dentistry Wound Cleaning & Dressing – Intraoral 10
OMF & Dentistry Surgical Dressing – Intraoral 35
OMF & Dentistry Removal of Intraoral Sutures 15
OMF & Dentistry Control of Oral Bleeding (any method) 90
OMF & Dentistry Control of Postoperative Oral Bleeding (any method) 103
OMF & Dentistry Dental Crown Lengthening 50 per tooth
OMF & Dentistry Interdental Wiring (other than fracture fixation) 280
OMF & Dentistry Placement of Intermaxillary Fixation (IMF) 280
OMF & Dentistry Removal of Intermaxillary Fixation (IMF) 100
OMF & Dentistry Removal of External Maxillofacial Fixation 100
OMF & Dentistry Removal of Internal Maxillofacial Fixation 210
OMF & Dentistry Removal of Interdental Fixation (any type) 100
OMF & Dentistry Removal of Dental/Maxillary Prosthesis (not specified elsewhere) 25
OMF & Dentistry Repair/Adjustment of Dental/Maxillary Prosthesis (not specified

elsewhere)

35
OMF & Dentistry Dental Splintting – Extracoronal 170 per arch
OMF & Dentistry Dental Splintting – Intracoronal 170 per arch
OMF & Dentistry Dental Scaling – Ultrasonic Instrument 20 per arch
OMF & Dentistry Dental Scaling – Hand-held Instrument 25 per arch
OMF & Dentistry Dental Scaling & Polishing 30 full mouth
OMF & Dentistry Dental Root Planing 40 full mouth
OMF & Dentistry Dental Scaling & Root Planing 50 per quadrant
OMF & Dentistry Dental Bleaching – External 70 per tooth
OMF & Dentistry Dental Bleaching – Internal 50 per tooth
OMF & Dentistry Dental Extraction 20 per tooth
OMF & Dentistry Dental Extraction (under general anesthesia) 25 per tooth
OMF & Dentistry Surgical Dental Extraction 80 per tooth
OMF & Dentistry Removal of Impacted Tooth (extraction) 120 per tooth
OMF & Dentistry Removal of Impacted Tooth (surgical removal) 130 per tooth
OMF & Dentistry Surgical Exposure of Tooth 110 per tooth
OMF & Dentistry Tooth Re-implantation 230 per tooth
OMF & Dentistry Temporary Dental Filling 20 per tooth
OMF & Dentistry Dental Filling – Amalgam (one surface) 25 per tooth
OMF & Dentistry Dental Filling – Amalgam (two surfaces) 40 per tooth
OMF & Dentistry Dental Filling – Amalgam (three or more surfaces) 45 per tooth
OMF & Dentistry Dental Filling – Composite Resin (one surface) 40 per tooth
OMF & Dentistry Dental Filling – Composite Resin (two surfaces) 45 per tooth
OMF & Dentistry Dental Filling – Composite Resin (three or more surfaces) 50 per tooth
OMF & Dentistry Dental Filling – Glass Ionomer 15 per tooth
OMF & Dentistry Dental Filling (under general anesthesia) 35 per tooth
OMF & Dentistry Tooth Restoration by Inlay/Onlay – Porcelain/Ceramic 235 per tooth
OMF & Dentistry Tooth Restoration by Inlay/Onlay – Gold 315 per tooth
OMF & Dentistry Atraumatic Restorative Treatment (ART) 35 per tooth
OMF & Dentistry Placement of Dental Implant (single or two-stage procedure) 630 per unit
OMF & Dentistry Placement of Dental Implant Abutment 170 per unit
OMF & Dentistry Placement of Cement Retained Implant Crown 315 per unit
OMF & Dentistry Placement of Screw Retained Implant Crown 315 per unit
OMF & Dentistry Placement of Pin Retained Dental Restoration 315 per unit
OMF & Dentistry Post and Core Retained Crown Fitted 125 per tooth
OMF & Dentistry Placement of Temporary Dental Crown 45 per tooth
OMF & Dentistry Dental Crown Preparation (include impression taking and

temporary crown)

260 per tooth
OMF & Dentistry Dental Crown Cementation 315 per tooth (including crown

cost)

OMF & Dentistry Dental Bridge Preparation (include impression taking and

temporary crown)

280 per unit
OMF & Dentistry Dental Bridge Cementation 390 per unit (including bridge

cost)

OMF & Dentistry Dental Maryland Bridge Cementation 340 per unit (including bridge

cost)

OMF & Dentistry Dental Crown Repair 240 per unit (include crown

removal)

OMF & Dentistry Dental Bridge Repair 240 per unit (include bridge

removal)

OMF & Dentistry Dental Restoration Repair (others) 90 per unit
OMF & Dentistry Dental Crown/Bridge Re-cementation 45 per unit
OMF & Dentistry Dental Crown Adjustment 50 per unit
OMF & Dentistry Dental Bridge Adjustment 50 per unit
OMF & Dentistry Dental Implant Removal 70 per unit
OMF & Dentistry Dental Filling Removal 65 per tooth
OMF & Dentistry Dental Crown Removal 40 per unit
OMF & Dentistry Dental Bridge Removal 40 per unit
OMF & Dentistry Dental Veneer Preparation (include trimming, impression taking, and temporary veneer if needed) 165 per tooth
OMF & Dentistry Dental Veneer Cementation (porcelain) 270 per tooth (including veneer

cost)

OMF & Dentistry Dental Veneer Cementation (other than porcelain) 155 per tooth (including veneer

cost)

OMF & Dentistry Impression Taking – Restorative 65 per arch
OMF & Dentistry Complete Denture – Conventional (upper) 330 per arch (including denture

cost)

OMF & Dentistry Complete Denture – Conventional (lower) 330 per arch (including denture cost)
OMF & Dentistry Complete Denture – Immediate (upper) 365 per arch (including denture

cost)

OMF & Dentistry Complete Denture – Immediate (lower) 365 per arch (including denture

cost)

OMF & Dentistry Partial Denture – Upper 75 per arch (including denture cost)
OMF & Dentistry Partial Denture – Lower 75 per arch (including denture

cost)

OMF & Dentistry Replacing Denture Missing/Broken Tooth 40 per tooth
OMF & Dentistry Adding Tooth to Denture 40 per tooth
OMF & Dentistry Reline of Denture 90 per arch
OMF & Dentistry Repair of Denture 125 per arch
OMF & Dentistry Rebase of Denture 350 per arch
OMF & Dentistry Apicoectomy 90 per tooth
OMF & Dentistry Pulpotomy 25 per tooth
OMF & Dentistry Pulp Capping (direct or indirect) 25 per tooth
OMF & Dentistry Dental Irrigation (with or without dressing) 50 per tooth
OMF & Dentistry Root Canal Treatment (RCT) – Complete One Canal 150 per tooth
OMF & Dentistry Root Canal Treatment (RCT) – Complete Two Canals 200 per tooth
OMF & Dentistry Root Canal Treatment (RCT) – Complete Three Canals 250 per tooth
OMF & Dentistry Dental Prophylaxis – Fissure Sealant Placement 5 per tooth
OMF & Dentistry Dental Prophylaxis – Topical Fluoride Application 10 per arch
OMF & Dentistry Dental Prophylaxis – Others 10 per quadrant
OMF & Dentistry Oral Health Education 0
OMF & Dentistry Dental X-ray (upper occlusal) 10 per image (5 for each

additional image)

OMF & Dentistry Dental X-ray (lower occlusal) 10 per image (5 for each

additional image)

OMF & Dentistry Dental X-ray (right bite-wing) 10 per image (5 for each

additional image)

OMF & Dentistry Dental X-ray (left bite-wing) 10 per image (5 for each additional image)
OMF & Dentistry Dental X-ray (periapical ) 5 per image
Anaesthesia General Anaesthesia 15% of total cost of performed

operations

Anaesthesia General Anaesthesia with Regional Block 15% of total cost of performed

operations

Anaesthesia General Anaesthesia with Local Infiltration 15% of total cost of performed

operations

Anaesthesia Total Intravenous Anaesthesia (TIVA) 15% of total cost of performed

operations

Anaesthesia Regional Block 10% of total cost of performed operations
Anaesthesia Monitored Anaesthesia Care (MAC) 5% of total cost of performed

operations

Anaesthesia Sedation 5% of total cost of performed operations
Anaesthesia Spinal Anaesthesia Subcategory of Regional Block
Anaesthesia Epidural Anaesthesia – Lumbar Subcategory of Regional Block
Anaesthesia Epidural Anaesthesia – Thoracic Subcategory of Regional Block
Anaesthesia Epidural Anaesthesia – Cervical Subcategory of Regional Block
Anaesthesia Epidural Anaesthesia – Continuous Subcategory of Regional Block
Anaesthesia Combined Spinal/Epidural (CSE) Subcategory of Regional Block
Anaesthesia Bier’s Block (I.V Regional) Subcategory of Regional Block
Anaesthesia Brachial Plexus Block – Infraclavicular Subcategory of Regional Block
Anaesthesia Brachial Plexus Block – Supraclavicular Subcategory of Regional Block
Anaesthesia Brachial Plexus Block – Interscalene Subcategory of Regional Block
Anaesthesia Brachial Plexus Block – Continuous Subcategory of Regional Block
Anaesthesia Brachial Plexus Block – Axillary Subcategory of Regional Block
Anaesthesia Wrist Block Subcategory of Regional Block
Anaesthesia Cervical Plexus Block Subcategory of Regional Block
Anaesthesia Paravertebral Block Subcategory of Regional Block
Anaesthesia Intercostal Block Subcategory of Regional Block
Anaesthesia Interpleural Block Subcategory of Regional Block
Anaesthesia Transversus Abdominis Plane (TAP) Block Subcategory of Regional Block
Anaesthesia Iliohypogastric Block Subcategory of Regional Block
Anaesthesia Ilioinguinal Block Subcategory of Regional Block
Anaesthesia Caudal Block Subcategory of Regional Block
Anaesthesia Saddle Block Subcategory of Regional Block
Anaesthesia Sciatic Block Subcategory of Regional Block
Anaesthesia Femoral Block Subcategory of Regional Block
Anaesthesia Popliteal Block Subcategory of Regional Block
Anaesthesia Ankle Block Subcategory of Regional Block
Anaesthesia Penile Block Subcategory of Regional Block
Anaesthesia Peribulbar Block Subcategory of Regional Block
Anaesthesia Retrobulbar Block Subcategory of Regional Block
Anaesthesia Subtenon Block Subcategory of Regional Block
Anaesthesia Retrobulbar + Facial Block Subcategory of Regional Block
Pain Management Minor (I) Intervention – e.g. lumbar epidural steroid injections,

nerve blocks/infiltrations, ozone therapy

100
Pain Management Minor (II) Intervention – e.g. trans-foraminal epidural steroid injections, CT guided injections, PRP injections 150

Pain Management

Minor (III) Intervention – e.g. cervical epidural injections, multiple sites trans-foraminal epidural injections, facet joint diagnostic

blocks, laser discectomy, CT guided radiofrequency ablation

200
Pain Management Major (I) Intervention – e.g. dorsal root ganglion radiofrequency ablation, facet joint radiofrequency ablation of medial branch, sacroiliac joint interventions, ozone discectomy 250
Pain Management Major (II) Intervention – e.g. radiofrequency ablation of trigeminal neuralgia/stellate ganglion/lumbar plexus, multiple sites radiofrequency ablation of dorsal root ganglion or facet joint of medial branch, radiofrequency ablation/chemolysis of lumbar

sympathetic ganglion

450
Pain Management Major (III-A) Intervention – e.g. kyphoplasty/vertebroplasty, laser ablation of osteoma 2000
Pain Management Major (III-B) Intervention – e.g. spinal cord stimulator implantation, intrathecal pump implantation 1000

الملحق رقم (٧)
رسوم عمليات تقويم الأسنان

No.
مسلسل
Procedure Name
اسم الإجراء
Price (R.O)
القيمة بالريال العماني
A Orthodontics – Extraction/Non-extraction Orthodontics with a

Fixed Appliance

2500 (full package including materials and

devices)

1 Orthodontics – Consultation Subcategory
2 Orthodontics – Impression Taking Subcategory
3 Orthodontics – Face Bow Registration Subcategory
4 Orthodontics – Intra-oral Radiographs Subcategory
5 Orthodontics – Extra-oral Radiographs Subcategory
6 Orthodontics – Photos Taking Subcategory
7 Orthodontics – Treatment Plan/Discussion Subcategory
8 Orthodontics – Oral Hygiene Instructions Subcategory
9 Orthodontics – Prophylactic Treatment Subcategory
10 Orthodontics – Review of Development of Teeth

Occlusion/Eruption

Subcategory
11 Orthodontics – Review of Skeletal Growth Subcategory
12 Orthodontics – Referral to Health Centre Subcategory
13 Orthodontics – Referral to Specialist Clinic Subcategory
14 Orthodontics – Separators Placement Subcategory
15 Orthodontics – Band Selection/Cementation Subcategory
16 Orthodontics – Fixed Appliance Bond-up (upper arch) Subcategory
17 Orthodontics – Fixed Appliance Bond-up (lower arch) Subcategory
18 Orthodontics – Fixed Appliance Bond-up (upper & lower arches) Subcategory
19 Orthodontics – Fixed Appliance Review Subcategory
20 Orthodontics – TAD Insertion Subcategory
21 Orthodontics – TAD Review Subcategory
22 Orthodontics – TAD Removal Subcategory
23 Orthodontics – Fixed Appliance Reposition of Brackets/Bands Subcategory
24 Orthodontics – Tooth Recontouring/Interproximal Reduction Subcategory
25 Orthodontics – Fixed Appliance De-bond (upper arch) Subcategory
26 Orthodontics – Fixed Appliance De-bond (lower arch) Subcategory
27 Orthodontics – Fixed Appliance De-bond (upper & lower arches) Subcategory
28 Orthodontics – Fixed Appliance Complete Subcategory
29 Orthodontics – Holding Arch Cementation Subcategory
30 Orthodontics – Holding Arch Review Subcategory
31 Orthodontics – Holding Arch Repair Subcategory
32 Orthodontics – Holding Arch Removal Subcategory
33 Orthodontics – Headgear Fitting Subcategory
34 Orthodontics – Headgear Review Subcategory
35 Orthodontics – Headgear Completed Subcategory
36 Orthodontics – Reverse Headgear Fitting Subcategory
37 Orthodontics – Reverse Headgear Review Subcategory
38 Orthodontics – Reverse Headgear Completed Subcategory
39 Orthodontics – Removable Appliance Delivery Subcategory
40 Orthodontics – Removable Appliance Review Subcategory
41 Orthodontics – Removable Appliance Repair Subcategory
42 Orthodontics – Removable Appliance Completed Subcategory
43 Orthodontics – Exposure of Impacted Tooth Subcategory
44 Orthodontics – Bonding of Attachment/Chain Subcategory
45 Orthodontics – Suture Removal Subcategory
46 Orthodontics – Retainers (removable) Delivery Subcategory
47 Orthodontics – Retainers (removable) Review Subcategory
48 Orthodontics – Retainers (removable) Repair Subcategory
49 Orthodontics – Retainers (fixed) Fitting Subcategory
50 Orthodontics – Retainers (fixed) Review Subcategory
51 Orthodontics – Retainers (fixed) Repair Subcategory
52 Orthodontics – Post-operative Instructions Subcategory
53 Orthodontics – Pre-surgical Examination/Assessment Subcategory
54 Orthodontics – Post-surgical Review Subcategory
55 Orthodontics – Treatment Complete/Patient Discharge Subcategory
56 Orthodontics – Treatment Discontinue due to Non-compliance Subcategory
57 Orthodontics – Treatment Discontinue on Patient Request Subcategory
58 Orthodontics – Others Subcategory
B Orthodontics – Orthognathic Line of Treatment 3500 (full package including materials and

devices)

1 Orthodontics – Consultation Subcategory
2 Orthodontics – Impression Taking Subcategory
3 Orthodontics – Face Bow Registration Subcategory
4 Orthodontics – Intra-oral Radiographs Subcategory
5 Orthodontics – Extra-oral Radiographs Subcategory
6 Orthodontics – Photos Taking Subcategory
7 Orthodontics – Treatment Plan/Discussion Subcategory
8 Orthodontics – Oral Hygiene Instructions Subcategory
9 Orthodontics – Prophylactic Treatment Subcategory
10 Orthodontics – Review of Development of Teeth Occlusion/Eruption Subcategory
11 Orthodontics – Review of Skeletal Growth Subcategory
12 Orthodontics – Referral to Health Centre Subcategory
13 Orthodontics – Referral to Specialist Clinic Subcategory
14 Orthodontics – Separators Placement Subcategory
15 Orthodontics – Band Selection/Cementation Subcategory
16 Orthodontics – Fixed Appliance Bond-up (upper arch) Subcategory
17 Orthodontics – Fixed Appliance Bond-up (lower arch) Subcategory
18 Orthodontics – Fixed Appliance Bond-up (upper & lower arches) Subcategory
19 Orthodontics – Fixed Appliance Review Subcategory
20 Orthodontics – TAD Insertion Subcategory
21 Orthodontics – TAD Review Subcategory
22 Orthodontics – TAD Removal Subcategory
23 Orthodontics – Fixed Appliance Reposition of Brackets/Bands Subcategory
24 Orthodontics – Tooth Recontouring/Interproximal Reduction Subcategory
25 Orthodontics – Fixed Appliance De-bond (upper arch) Subcategory
26 Orthodontics – Fixed Appliance De-bond (lower arch) Subcategory
27 Orthodontics – Fixed Appliance De-bond (upper & lower arches) Subcategory
28 Orthodontics – Fixed Appliance Complete Subcategory
29 Orthodontics – Holding Arch Cementation Subcategory
30 Orthodontics – Holding Arch Review Subcategory
31 Orthodontics – Holding Arch Repair Subcategory
32 Orthodontics – Holding Arch Removal Subcategory
33 Orthodontics – Headgear Fitting Subcategory
34 Orthodontics – Headgear Review Subcategory
35 Orthodontics – Headgear Completed Subcategory
36 Orthodontics – Reverse Headgear Fitting Subcategory
37 Orthodontics – Reverse Headgear Review Subcategory
38 Orthodontics – Reverse Headgear Completed Subcategory
39 Orthodontics – Removable Appliance Delivery Subcategory
40 Orthodontics – Removable Appliance Review Subcategory
41 Orthodontics – Removable Appliance Repair Subcategory
42 Orthodontics – Removable Appliance Completed Subcategory
43 Orthodontics – Exposure of Impacted Tooth Subcategory
44 Orthodontics – Bonding of Attachment/Chain Subcategory
45 Orthodontics – Suture Removal Subcategory
46 Orthodontics – Retainers (removable) Delivery Subcategory
47 Orthodontics – Retainers (removable) Review Subcategory
48 Orthodontics – Retainers (removable) Repair Subcategory
49 Orthodontics – Retainers (fixed) Fitting Subcategory
50 Orthodontics – Retainers (fixed) Review Subcategory
51 Orthodontics – Retainers (fixed) Repair Subcategory
52 Orthodontics – Post-operative Instructions Subcategory
53 Orthodontics – Pre-surgical Examination/Assessment Subcategory
54 Orthodontics – Post-surgical Review Subcategory
55 Orthodontics – Treatment Complete/Patient Discharge Subcategory
56 Orthodontics – Treatment Discontinue due to Non-compliance Subcategory
57 Orthodontics – Treatment Discontinue on Patient Request Subcategory
58 Orthodontics – Others Subcategory
C Orthodontics – Expansion 800 (full package including materials and

devices)

1 Orthodontics – Fixed Expansion Devise Cementation Subcategory
2 Orthodontics – Fixed Expansion Devise Review Subcategory
3 Orthodontics – Fixed Expansion Devise Repair Subcategory
4 Orthodontics – Fixed Expansion Devise Removal Subcategory
D Orthodontics – Functional Appliance Therapy 700 (full package including materials and

devices)

1 Orthodontics – Functional Appliance (fixed) Delivery Subcategory
2 Orthodontics – Functional Appliance (fixed) Review Subcategory
3 Orthodontics – Functional Appliance (fixed) Repair Subcategory
4 Orthodontics – Functional Appliance (fixed) Completed Subcategory
5 Orthodontics – Functional Appliance (removable) Delivery Subcategory
6 Orthodontics – Functional Appliance (removable) Review Subcategory
7 Orthodontics – Functional Appliance (removable) Repair Subcategory
8 Orthodontics – Functional Appliance (removable) Completed Subcategory
E Orthodontics – Removable Appliance 500 (full package including materials and

devices)

1 Orthodontics – Removable Appliance Delivery Subcategory
2 Orthodontics – Removable Appliance Review Subcategory
3 Orthodontics – Removable Appliance Repair Subcategory
4 Orthodontics – Removable Appliance Completed Subcategory
F Orthodontics – Habit Breaking Appliance 600 (full package including materials and

devices)

1 Orthodontics – Habit Deterrent Cementation Subcategory
2 Orthodontics – Habit Deterrent Review Subcategory
3 Orthodontics – Habit Deterrent Repair Subcategory
4 Orthodontics – Habit Deterrent Removal Subcategory
G Orthodontics – Clear Retainer (U/L) 100 (full package including materials and

devices)

H Orthodontics – Bonded Retainer (U/L) 200 (full package including materials and

devices)

I Orthodontics – Hawley Retainer (U/L) 160 (full package including materials and

devices)

J Orthodontics – Naso-alveolar Moulding 500 (full package including materials and

devices)

1 Orthodontics – Nasal Hook Construction Subcategory
2 Orthodontics – Nasal Hook Delivery Subcategory
3 Orthodontics – Nasal Hook Review Subcategory
4 Orthodontics – Nasal Hook Repair Subcategory
5 Orthodontics – Nasal Hook Retention Subcategory
6 Orthodontics – Nasal Hook Completed Subcategory
7 Orthodontics – Lip Strapping Fitting Subcategory
8 Orthodontics – Lip Strapping Review Subcategory
9 Orthodontics – Lip Strapping Retention Subcategory
10 Orthodontics – Lip Strapping Completed Subcategory
11 Orthodontics – PNAM Plate Construction Subcategory
12 Orthodontics – PNAM Plate Delivery Subcategory
13 Orthodontics – PNAM Plate Review Subcategory
14 Orthodontics – PNAM Plate Retention Subcategory
15 Orthodontics – PNAM Plate Completed Subcategory
16 Orthodontics – Pre Lip Repair Review Subcategory
17 Orthodontics – Post Lip Repair Review Subcategory
18 Orthodontics – Pre Palate Repair Review Subcategory
19 Orthodontics – Post Palate Repair Review Subcategory
20 Orthodontics – Pre Alveolar Bone Graft Review Subcategory
21 Orthodontics – Post Alveolar Bone Graft Review Subcategory

الملحق رقم (٨)
رسوم الفحوصات المختبرية

NO.
مسلسل
Test Name
اسم الفحص
Price
القيمة بالريال العماني
Cost for Private Institutions

القيمة بالريال العماني للمؤسسات الصحية الخاصة

SECTION I: Biochemistry
A. Core Biochemistry Tests
1 Ammonia 5 8
2 Amylase 2 3
3 AST 2 3
4 ALT 2 3
5 Alkaline phosphatase 2 3
6 Alpha.1.antitrypsin (A1AT) 10 16
7 Albumin 2 3
8 Bicarbonate 2 3
9 Bilirubin (total) 2 3
10 Bilirubin (direct) 2 3
11 Calcium 2 3
12 C-reactive protein 6 10
13 Cholesterol, total 2 3
14 Cholesterol, HDL 2 3
15 Chloride 2 3
16 Creatinine 2 3
17 Caeruloplasmin 5 8
18 Complement 3 (C3) 5 8
19 Complement 4 (C4) 5 8
20 Glucose 2 3
21 Gamma glutamyltransferase (GGT) 2 3
22 Gases in Arterial (Venous or Capillary)

Blood

5 8
23 Glycatedhaemoglobin (HBA1c) 5 8
24 Haptoglobin 5 8
25 Immunoglobulin A (IGA) 5 8
26 Immunoglobulin E (IGE) 5 8
27 Immunoglobulin G (IGG) 5 8
28 Immunoglobulin M (IGM) 5 8
29 Iron 2 3
30 Lactate 5 8
31 Lactate dehydrogenase (LDH) 5 8
32 Magnesium 2 3
33 Microalbumin 5 8
34 Myoglobin 5 8
35 Osmolality 5 8
36 Potassium 2 3
37 Phosphate 2 3
38 Protein, urine CSF 3 4
39 Sodium 2 3
40 Transferrin 8 13
41 Troponin 5 8
42 Total protein 2 3
43 Triglycerides 2 3
44 Urea 2 3
45 Uric Acid 2 3
B. Immunoassay Tests
1 17.alphahydroxy progesterone 5 8
2 Adrenocorticotrophic hormone (ACTH) 10 16
3 Alphafeto protein (AFP) 5 8
4 Aldosterone 5 8
5 Antiglutamate D carboxylase 6 10
6 Anti islet cell antibodies 7 11
7 Ant tissue transglutaminase IgA 5 8
8 Anti-thyroglobulin 9 14
9 Anti thyroid peroxidase 5 8
10 Anti-mullerian hormone (AMH) 15 24
11 BNP,NTpro (NT.pro.B.type.natriuretic

peptide)

7 11
12 Beta.2.microglobulin (B2M) 4 6
13 Beta. Human Chorionic Gonadotrophin

(B.HCG)

5 8
14 Cancer antigen 125 (CA125) 6 10
15 Cancer antigen 15.3 (CA15.3) 6 10
16 Cancer antigen (CA19.9) 6 10
17 Carcinoembryonic antigen (CEA) 6 10
18 Chromogranin 8 13
19 C-peptide 6 10
20 Cortisol 7 11
21 Dehydroepiandrosterone (DHEA) 5 8
22 Estradiol 5 8
23 Ferritin 3 5
24 Folate 6 10
25 Follicle Stimulating Hormone (FSH) 6 10
26 Free triiodothyronine (FT3) 6 10
27 Free tetraiodothyronine (FT4) 6 10
28 Growth hormone (GH( 6 10
29 Insulin 5 8
30 Insulin-like growth factor-1 (IGF1) 6 10
31 Luteinizing Hormone (LH) 5 8
32 Progesterone 5 8
33 Prolactin 5 8
34 Prostate-specific antigen, total (PSA, total) 5 8
35 Parathyroid hormone (PTH) 4 6
36 Renin 6 10
37 Testosterone 5 8
38 Thyroid stimulating hormone (TSH) 5 8
39 Thyroid stimulating hormone, cord blood

(TSH cord blood)

5 8
40 TSH Receptor Antibody 15 24
41 Thyroglobulin 8 13
42 Metanephrine and normetanephrine 8 13
43 Vitamin B12 6 10
44 Vitamin D.25 hydroxy (D3) 10 16
C. Drugs
1 Amikacin 8 13
2 Carbamazipine 7 11
3 Cyclosporin 10 16
4 Digoxin 9 14
5 Gentamicin 8 13
6 Lithium 9 14
7 Methotrexate 7 11
8 Paracetamol 6 10
9 Phenobarbital 10 16
10 Phenytoin 8 13
11 Salicylate 5 8
12 Sirolimus 15 24
13 Tacrolimus 8 13
14 Theophyline 15 24
15 Valproate 7 11
16 Vancomycin 8 13
D. Others
1 Cryoglobulin 6 10
2 Chromatography, serum or urine 10 16
3 Immunofixation, serum or urine 14 22
4 Protein electrophoresis, serum or urine 6 10
5 Porphyrin screen 32 51
6 Reducing substance, urine or stool 3 5
7 Stone analysis 5 8
8 Conductivity (Macroduct & Sweat chloride) 20 32
9 Conductivity (Nanoduct & Sweat chloride) 25 40
10 Urea breath test 12 19
E. Profile/Panel/Dynamic Tests
1 Aldosterone & Renin Ratio in

Serum/Plasma, Panel

10 16
2 Amylase/Creatinine Clearance Ratio in

Urine & Serum, Panel

6 10
3 Anti Tissue transglutaminase Ab panel in

Serum

7 11
4 Bone Profile 8 13
5 C- Peptide & Glucose in Serum/Plasma, Panel 7 11.2
6 CSF Chemistry Group Panel 4 6
7 Calcium Creatinine Ratio in Urine, Panel 4 6
8 Calcium Panel, adjusted for albumin 4 6
9 Complement C3 & C4 in Serum/Plasma,

Panel

10 16
10 Creatinine Clearance corrected Panel

(Paediatric)

4 6
11 Creatinine Clearance, Panel 4 6
12 Dynamic: OGTT (100 g) Panel for

Acromegaly

15 24
13 Dynamic: OGTT (75 g) Panel for

Acromegaly

15 24
14 Dynamic: OGTT (75 g) Panel for DM (glucose at 0 & 120 min) and glucose

powder

5 8
15 Dynamic: OGTT (75 g) Panel for DM;

paediatric (glucose at 0 & 120 min) and glucose powder

5 8
16 Dynamic: GnRH Stimulation Test (for adults) Tests 30 (FSH & LH 4 times at 0, 30,

60, 90 & 120 min; & basal levels of prolactin & testosterone); GnRh injection: RO 36.500

65 91
17 Dynamic: GnRH Stimulation Test (for paediatric) Tests cost: RO 30.0 (FSH & LH 4 times at 0, 30, 60, 90 & 120 min; & basal levels of prolactin & testosterone); GnRh

injection: RO 36.500

65 91
18 Dynamic: GH Stimulation Glucagon Test Tests 65 (GH & glucose 7 times at 0, 30, 60,

90, 120, 150 & 180 min; & cortisol 3 times

at 0, 30 & 60 min); Glucagon injection: RO

5.000

68 95
19 Dynamic: Insulin tolerance Test Tests 57,000 (GH & glucose 6 times at 0, 30, 60,

90, 120, and at hypoglycaemia & cortisol 5

times at 0, 30, 60 & 90 min & and at hypoglycaemia); Insulin injection: RO 1.100

55 77
20 Dynamic: Synacthen (1 mg) stimulation test for cortisol state (Cortisol at 0, 30, & 60

following synacthen injection), Synacthen injection: RO 12.000

25 40
21 Dynamic: Synacthen (250 µg) stimulation test for cortisol state Tests 18.000(Cortisol at 0, 30, & 60 following synacthen injection);

Synacthen injection: RO 3.000

25 40
22 Dynamic: Synacthen (250 µg) stimulation test for CAH Tests 9.0 (17.hydroxyprogesterone at 0, 30, & 60 following synacthen injection); Synacthen

injection: RO 3.000

17 27
23 Dynamic: Dexamethasone suppression test (overnight; 1 mg) (One cortisol test following mid night dexamethasone tablet 1

mg)

7 11
24 Dynamic: Dexamethasone suppression test (low dose; 2 mg/day) (one cortisol test

following 2 days dexamethasone tablet 2 mg/day)

7 11
25 Dynamic: Dexamethasone suppression test (high dose; 8 mg/day) (one cortisol test following 2 days dexamethasone tablet 8

mg/day)

7 11
26 Electrolytes in 24 Hour Urine, Panel

(Sodium & potassium in 24hr urine specimen)

6 10
27 Electrolytes in Urine, Panel (Sodium & potassium in 24hr urine specimen) 6 10
28 Folate& Vitamin B12 Panel (Folate &

vitamin B12)

10 16
29 Infertility Screen, Panel (FSH, LH &

prolactin panel)

15 24
30 Insulin Panel (Insulin & glucose) 8 13
31 Iron Profile, Panel (iron, transferrin) 8 13
32 Immunoglobulins (Immunoglobulin A,

Immunoglobulin G, Immunoglobulin M)

10 16
33 Lipid Profile, Panel (total cholesterol, HDL

cholesterol, LDL cholesterol, non-HDL cholesterol, triglycerides)

8 13
34 Liver Function Test (Bilirubin, ALT,

alkaline phosphatase, albumin, total protein)

8 13
35 Liver Function Tests (G), Extended Panel

(Bilirubin, ALT, alkaline phosphatase, albumin, total protein, AST,GGT)

8 13
36 Magnesium Fractional Excretion in Urine,

Panel (Magnesium & creatinine, both in urine and serum)

6 10
37 Metanephrine and Normetanephrine Panel in

Plasma (Metanephrine & normetanephrine)

8 13
38 Microalbumin/Creatinine panel in random

Urine (Microalbumin and creatinine in urine)

6 10
39 Phosphate Study in Random Urine, Panel

(Phosphate & creatinine, both in urine and serum)

6 10
40 Porphyrin Screen Panel (PBG &Uroporphyrin) in Random Urine (PBG &

Uroporphyrin, both in urine)

32 51
41 Protein Creatinine ratio in Urine, Panel

(Microalbumin and creatinine in urine)

5 8
42 Protein electrophoresis in Serum, Panel (albumin, total protein and electrophoresis in

serum)

8 13
43 Protein electrophoresis in Urine, Panel (total protein and electrophoresis in urine) 8 13
44 Sodium fractional excretion in Urine & Serum, Panel (Sodium &creatinine, both in

urine and serum)

5 8
45 Sweat Test Group, Panel (Macroduct) 20 32
46 Sweat Test Group, Panel (Nanoduct) 25 40
47 Thyroid Cancer Profile in Serum/Plasma, Panel (Thyroglobulin, anti thyroglobulin

antibodies & TSH)

20 32
48 Thyroid Function Test in Serum/Plasma, Panel (FT4 & TSH) 8 13
49 Urea & Electrolytes in 24h Urine, Panel

(Sodium, potassium & urea in 24 hr urine specimen)

5 8
50 Urea and Electrolytes and GFR, Panel (Sodium, potassium, bicarbonate, chloride,

creatinine, urea, eGFR)

8 13
51 Urea and Electrolytes, Panel (Sodium,

potassium, bicarbonate, chloride, creatinine, urea)

8 13
SECTION II: HAEMATOLOGY & BLOOD TRANSFUSION
A. Blood Transfusion Tests
1 Blood group 4 6
2 ICT antibody screen 4 6
3 ICT antibody screen additional IV & V 7 11
4 Cross match (without blood Unit Cost) 9 14
5 Antibody identification 36 58
6 Direct Coombs Test (DCT), polyvalent 4 6
7 Transfusion reaction (Pre/Post test) 20 32
8 Mono specific test / DCPV 7 11
9 Antigen typing 21 34
10 Antibody titre (ID Gel) 12 19
11 Acid elution (ID Gel) 47 75
12 Indirect Coombs test (ICT) antibody screen

(Immuco)

4 6
13 Donor Regrouping (Immuco) 3 5
14 Cross match (Immuco) 8 13
15 Antibody identification (Imucore) 37 59
16 DCT, polyvalent (Imucore) 4 6
17 Transfusion reaction (Pre/Post test) 12 19
18 Antigen typing 20 32
19 Antibody titre 20 32
B. Haematology
1 Complete blood count (CBC) 4 6
2 Blood Film 4 6
3 Bone marrow film 20 32
4 Erythrocyte sedimentation rate (ESR) 3 5
5 Reticulocyte count 3 5
6 Iron stain 3 5
7 CD61 immune platelet 24 38
8 Malaria screen 4 6
9 Parasite density count 3 5
10 PNH (Paroxysmal nocturnal

haemoglobinuria) Serological screen

5 8
11 Microfilariasis 4 6
12 Glucose-6-phosphate dehydrogenase (G6PD) 5 8
13 Haemoglobinopathy, HPLC 5 8
14 Haemoglobinopathy Electrophopresis (Acid & Alkaline) 5 8
15 Haemoglobin S 5 8
16 Hemoglobin H inclusion 5 8
17 Sickling 2 3
C. Immunophenotyping
1 Immunophenotyping-Acute Leukemic Panel 75 105
2 Immunophenotyping – Lymphoproliferative

Disorder

65 91
3 Lymphocytes Subset Analysis, Panel 21 34
4 T-Lymphocytes Subset Analysis, Panel 12 19
5 Platelet Disorder, Panel 17 27
6 Neutrophil Function Test (DHR) 21 34
7 PNH Panel 45 72
8 Leucocytes Adhesion Deficiency (LAD) 30 48
D. Coagulation
1 Prothrombin Time (PT) 3 5
2 Activated Partial Thromboplastin Time

(APTT)

3 5
3 Fibrinogen 3 5
4 Thrombin time 3 5
5 International Normalized Ratio (INR) 3 5
6 D-Dimer 7 11
7 Correction studies PT (Innovin) 3 5
8 Correction studies PTT (Pathromtin) 3 5
9 Lupus screen (screening) 12 19
10 Lupus screen (Confirmatory) 6 10
11 Factor VIII Bethesada assay 6 10
12 Factor IX Bethesada assay 8 13
13 Collagen binding 17 27
14 Heparin-induced thrombocytopenia screen

(HIT screen)

29 46
15 Factor II 6 10
16 Factor V 6 10
17 Factor VII 6 10
18 Factor VIII 6 10
19 Factor IX 6 10
20 Factor X 6 10
21 Factor, XI 6 10
22 Factor XII 6 10
23 Factor XIII 8 13
24 Von Willibald Antigen VWAg 10 16
25 Ristocetin co-factor 5 8
26 Beta 2 glycoprotein 1 (B2 GP1) 3 5
27 Anticardiolipin 3 5
28 LMW (low molecular weight) Heparin assay 14 22
29 PFA 100 (platelet Function Assay) screen 30 48
30 Platelet aggregation study 65 91
31 Protein C 15 24
32 Protein S 10 16
33 APCR (Protein C Global) 5 8
34 A2III (Anti thrombin IIIA) 5 8
35 A2 Anti Plasmin 11 15
E. Profile Tests
1 Coagulation Profile 12 19
2 Antiphospholipid Antibody Screen in Serum, Panel 6 10
3 Lupus Anticoagulant Screen, Panel 18 29
4 Extrinsic Pathway Screen, Panel 24 38
5 Intrinsic Pathway Screen, Panel 24 38
6 Thrombophilia Screening, Panel 35 56
7 Von Willebrand Screen, Panel 32 51
SECTION III. MICROBIOLOGY
A. Culture
1 Culture: Stool 8 13
2 Culture: Urine 7 11
3 Culture: Genitourinary 8 13
4 Culture: Respiratory 7 11
5 Culture: Fluid 8 13
6 Culture: CSF 8 13
7 Culture: Blood 12 19
8 Culture: Wound & miscellaneous 8 13
B. Infection Control
1 Infection control; ICACIN 8 13
2 Infection control; MRSAC 8 13
3 Infection control; ICCRESP 8 13
4 Infection control; ICCREU 8 13
5 Infection control; ICCREW 8 13
6 Infection control; ICVRE 8 13
C. Microscopy Tests
1 Direct smear (Gram Smear) 2 3
2 AFB stain 4 6
3 CSF microscopy 4 6
4 Stool microscopy 3 5
5 Urine microscopy 3 5
D. Molecular Bacteriology
1 MTB; Molecular TB 40 64
2 MRSA PCR 30 48
E. Miscellaneous Bacteriology
1 Clostridium difficile Antigen test in stool 5 8
2 Rota virus Antigen in stool 5 8
3 Bacterial antigen screen in CSF 12 19
4 Urine analysis (dipstick test) 2 3
5 Stool occult blood 2 3
6 Legionella Pneumophila Antigen in Urine 7 11
7 Pregnancy test 3 5
8 Semen analysis 8 13
F. Serology
1 Anti HAV IgM antibody 5 8
2 Anti HAV IgG antibody 5 8
3 Anti HCV antibody 5 8
4 Anti HB core total 5 8
5 Anti HB core IgM 5 8
6 Anti HB surface antibody 5 8
7 Anti HBe antibody 5 8
8 HB Surface Ag 5 8
9 HBe Ag 5 8
10 HBs Ag Neutralisation test 9 14
11 Hepatitis B Profile 30 48
12 Hepatitis B screening panel 15 24
13 HSV 1 & 2 IgG 5 8
14 HSV 1 & 2 IgM 5 8
15 Rubella IgG 5 8
16 Rubella IgM 5 8
17 Toxoplasma IgG 5 8
18 Toxoplasma IgM 5 8
19 CMV IgG 5 8
20 CMV IgM 5 8
21 EBNA IgG 5 8
22 EBV IgG 5 8
23 EBV IgM 5 8
24 HIV screening serology 6 10
25 Measles IgG 5 8
26 PVB19 IgG 5 8
27 PVB19 IgM 5 8
28 Varicella zoster IgG 5 8
29 Chlamydia pneumophiIa IgA 5 8
30 Chlamydia pneumophila IgG 5 8
31 Chlamydia pneumophila IgM 5 8
32 Mycoplasma pneumoniae IgA 5 8
33 Mycoplasma pneumoniae IgG 5 8
34 Mycoplasma pneumoniae IgM 5 8
35 Brucella serology (Br. Mellitensis & Br.

Abortus)

6 10
36 Antistreptolysin O 3 5
37 Syphilis screening (SEIA) test 5 8
38 VDRL (RPR) 5 8
39 TPHA 5 8
40 “Syphilis profile” VDRL& TPHA (Both

tests); ELISA

10 16
41 Amoebiasis antibody 5 8
42 Echinococcus antibody 5 8
43 Leishmaniasis antibody 5 8
44 Schistosomiasis antibody 5 8
45 Cryptococcus Antigen test 5 8
G. Immunology Tests
1 Antinuclear antibody (ANA) 5 8
2 Anti dsDNA Antibody 8 13
3 Auto antibody profile 5 8
4 Extractable nuclear antigen (screening &

confirmatory)

10 16
5 LKM/SM/Mitochondrial antibodies 8 13
6 Rheumatoid Factor 3 4
7 Anti CCP Antibody 8 13
8 ANCA 1.pANCA and 2. Canca 10 16
H. Referral Tests
1. Tests currently referred to SQUH:
1.1 Adenovirus 40 64
1.2 Anti Bacterial 10 16
1.3 Aspergillus Antibody 5 8
1.4 CSF Multiplex 40 64
1.5 Enterovirus PCR 35 56
1.6 Parvovirus19 PCR 40 64
1.7 Pneumocystis jervocii (PCJ) or PCP PCR 40 64
1.8 Pneumococcal Antigen 12 19
1.9 Varicella Zoster Virus (VZV) PCR 40 64
2. Serology Tests (Referral)
2.1 Anti Liver Antibody Profile 11 18
2.2 Borrelia Burgdorferi Antibody 5 8
2.3 Crimean Congo Haemorrhagic Fever

(CCHF) IgM

5 8
2.4 Coxiella (phase 1 & phase 2) 5 8
2.5 Dengue Antibody 8 13
2.6 Galactomanan test (Aspergillus Antigen) 12 19
2.7 Hepatitis D 5 8
2.8 Hepatitis E 5 8
2.9 Mumps IgM 5 8
2.10 Measles IgM 5 8
2.11 Parvo B19 IgM 5 8
2.12 Varicella Zoster Virus (VZV) IgM 5 8
2.13 West Nile Virus IgM 5 8
2.14 West Nile Virus IgM 5 8
2.15 West Nile Virus IgM 20 32
SECTION IV: HISTOPATHOLOGY/ CYTOPATHOLOGY
A. Histopathology
Note: 15 R.O will be added for each immunohistochemistry marker applied for a case. The markers are mentioned in

abbreviations or words under immunohistochemistry title of each report e.g. CK= 15 RO, LCA= 15 RO, Vimentin= 15 RO.

1. Very small specimen/biopsy (HISTVS)
Lab Products of conception 15 24
Lab Appendix 15 24
Lab Gall Bladder 15 24
Lab Oral/Mouth biopsy 15 24
Lab Nasal polyps 15 24
Lab Anal fistula 15 24
Lab Anal fissure 15 24
Lab Pilonidal sinus 15 24
Lab Endometrial curettage 15 24
Lab Fallopian tubes 15 24
Lab Fibroepithelial polyp 15 24
Lab Other specimens up to 1 cm in size (check

gross description)

15 24
Lab Any other tissue with upto 3 HE slides 15 24
2. Small specimen/biopsy (HISTS)
Lab Laryngeal biopsy 20 32
Lab Lung biopsy 20 32
Lab Pleural biopsy 20 32
Lab Oesophageal biopsy 20 32
Lab Gastric biopsy 20 32
Lab Duodenal/jejunal/ileal biopsy 20 32
Lab Colonic/rectal/ anorectal biopsy 20 32
Lab ERCP / ampullary biopsy 20 32
Lab Peritoneal biopsy 20 32
Lab Skin biopsy 20 32
Lab Nail 20 32
Lab Soft tissue biopsy 20 32
Lab Bone biopsy 20 32
Lab Bone Marrow trephine biopsy (benign) 20 32
Lab Stereotactic brain biopsy 20 32
Lab Conjunctival/ corneal biopsy 20 32
Lab Pelvi-ureteric junction 20 32
Lab Other tissues up to 3 cm 20 32
Lab Any other tissue with upto 6 HE slides 20 32
3. Medium specimen/biopsy (HISTM)
Lab Kidney biopsy 25 40
Lab Liver biopsy 20 32
Lab Small Uterus 20 32
Lab Breast lumps 20 32
Lab Breast cores biopsy 20 32
Lab Lymph nodes benign 20 32
Lab Thyroid gland 20 32
Lab Kidney 20 32
Lab Ovarian cyst 20 32
Lab Adrenalectomy 20 32
Lab Prostatic trucut biopsy, TURP biopsy 20 32
Lab Urinary bladder TURBT 20 32
Lab Partial hepatectomy 20 32
Lab Spleen 20 32
Lab Partial gastrectomy e.g. Sleeve 20 32
Lab Other tissues up to 10 cm in size (check

gross description)

20 32
Lab Any other tissue with upto 10 HE slides 20 32
Lab Slides for review 20 32
4. Large specimen/biopsy (HISTL)
Lab Large uterus (total hysterectomy) 30 48
Lab Lung (lobectomy) 30 48
Lab Muscle biopsy 30 48
Lab Liver resections / partial hepatectomy 30 48
Lab Urinary bladder (cystectomy) 30 48
Lab Total nephrectomy (tumour) 30 48
Lab Segmentectomy of breast 30 48
Lab Oesophagus (oesophagectomy) 30 48
Lab Stomach (gastrectomy) 30 48
Lab Colon (colectomy for Hirschsprung’s or

diverticular disease)

30 48
Lab Other tissues up to 15 cm in size (check

gross descript.)

30 48
Lab Any other tissue with 20 HE slides 30 48
5. Very Large specimen/biopsy (HISTV)
Lab Breast (mastectomy) 34 54
Lab Pancreas/duodenum (Whipple surgery) 34 54
Lab Colon (A-P resection or resection for

malignancy)

34 54
Lab Lung (plumonectomy) 34 54
Lab Lymph node(s) for malignancy 34 54
Lab Other tissues >15 cm in size (check gross description) 34 54
Lab Any other tissue with > 20 HE slides 34 54
6. Immunohistochemistry
Immunohistochemistry staining using antibodies are of key value in histopathology particularly in oncology. There are nearly 120 IHC available currently in practice. These tests are usually added according to the initial result of the biopsy that involve all organs and all types of specimens mentioned before (1-5). For pricing purposes, it is recommended to add a cost of 15 R.O. for each immunohistochemistry marker applied for a case. The markers are mentioned in abbreviations or words under

immunohistochemistry title of each report e.g. CK= 15 RO, LCA= 15 RO, Vimentin= 15 RO, ….,and so on.

B. CYTOPATHOLOGY
I. Gynae Cytology
Lab Thin-prep 18 29
Lab Conventional 15 24
Lab Conventional – Two slides 18 29
II. Non-Gynae Cytology
Lab Pre-made slides (1-4 slides) 15 24
Lab Pre-made slides (>4 slides) 18 29
Lab Slides prepared at Royal Hospital Lab (1-4 slides) 13 21
Lab Slides prepared at Royal Hospital Lab (>4

slides)

18 29
SECTION V: CYTOGENETIC & GENETICS
Genetic (cytogenetic & molecular) Tests
Lab NGC ALL Panel (Molecular Genetics) 117 164
Lab NGC AML Panel (Molecular Genetics) 117 164
Lab NGC Aneuploidy testing by QF-PCR in AF–

Pre-natal

38 53
Lab NGC Beckwith Weidemann Syndrome MS-MLPA 68 95
Lab NGC CGH Microarray 240 336
Lab NGC Chromosomal Analysis (PBL) 35 49
Lab NGC Chromosome Analysis (OncoHaem) 40 56
Lab NGC FISH for Cri du Chat Syndrome 59.7 84
Lab NGC FISH for Di George Syndrome 59 83
Lab NGC FISH for Kallman Syndrome 59 83
Lab NGC FISH for Prader Willi/Angelman

Syndrome

59 83
Lab NGC FISH for SRY gene 59 83
Lab NGC FISH for Steroid Sulphatase

Deficiency

59 83
Lab NGC ABL1 Kinase Domain Mutation Status 59 83
Lab NGC BCR-ABL1 (Molecular Genetics) 55 77
Lab NGC FISH for Williams Beuren Syndrome 59 83
Lab NGC FISH for Wolf Hirschhorn Syndrome

(4p-)

59 83
Lab NGC Fanconi Anaemia – Mitomycin Breakage studies 40 56
Lab NGC Genetic markers for Breast Cancer–

BRCA1&2; NGS

114 160
Lab NGC Genetic markers for Breast Cancer –

BRCA1 ;MLPA

72 101
Lab NGC Genetic markers for Breast Cancer –

BRCA2 ;MLPA

75 105
Lab NGC Genetic markers for Breast Cancer –

BRCA1 or BRCA2 ; Known mutation screening

30 48
Lab NGC DNA Extraction & Storage 20 32
Lab NGC Genetic Testing for

Haemoglobinopathies

70 98
Lab NGC Genetic Testing for Huntington

Disease

30 48
Lab NGC MEN 1 Mutation Screening 30 48
Lab NGC MEN 1 Full gene Sanger Sequencing 80 112
Lab NGC MEN 1 known mutation screening 30 48
Lab NGC MEN 1 + MEN 2 NGS 228 319
Lab NGC MEN 2 Mutation Screening 30 42
Lab NGC MEN 2 Full gene Sanger Sequencing 71 99
Lab NGC MEN 2 known mutation screening 30 48
Lab NGC Pheochromocytoma and

paraganglioma. NGS

228 319
Lab NGC Pheochromocytoma and

paraganglioma. Known mutation screening

30 48
Lab NGC Hereditary Cancer Syndrome. NGS 228 319
Lab NGC Hereditary Cancer Syndrome. Known

mutation screening

30 48
Lab NGC Colorectal cancer. NGS 228 365
Lab NGC Colorectal cancer. Known mutation

screening

30 48
Lab NGC Postnatal Aneuploidy testing by QF-

PCR

50 80
Lab NGC RAG1 Gene Testing; Full gene

sequencing

50 80
Lab NGC RAG2 Gene Testing; Full gene sequencing 50 80
Lab NGC RAG 1 or RAG2 Gene Testing;

Known mutation screening

30 48
Lab NGC SRY by PCR 30 48
Lab NGC BCR-ABL1 (major) quantification

(Molecular Genetics)

152 243
Lab NGC BCR-ABL1(Qualitative) (Molecular

Genetics)

40 64
Lab NGC CALR exon 9 (Molecular Genetics) 51 81.6
Lab NGC CBFB-MYH11 (Molecular Genetics) 40 64
Lab NGC Full Gene Sequencing-CFTR test for

cystic fibrosis- Full gene

76 106
Lab NGC CFTR Exon11, Exon12 – “Hot spot mutations” test for cystic fibrosis- Known

gene for carriers

30 48
Lab NGC ETV6-RUNX1(TEL-AML)

(Molecular Genetics)

40 64
Lab NGC FLT3-ITD (Molecular Genetics) 54 76
Lab NGC Factor II-Prothrombin (G20210A)

(Molecular Gen.)

20 32
Lab NGC Factor V Leiden (G1691A) (Molecular

Genetics)

20 32
Lab NGC FISH AML (20q)D205108 105 147
Lab NGC FISH AML BCR/ABL1 t(9;22) 105 147
Lab NGC FISH AML CBFB inv(16)/t(16;16) 94 132
Lab NGC FISH AML CSF1R (5q) 94 132
Lab NGC FISH AML D7S522/CEP (7q) 94 132
Lab NGC FISH AML EGR1 (5q) 94 132
Lab NGC FISH AML MLL (11q23) 94 132
Lab NGC FISH AML PML/RARA t(15;17) 94 132
Lab NGC FISH AML RPN1/MECOM

inv(3)/t(3;3)

94 132
Lab NGC FISH AML RUNX1/RUNX1T1

t(8;21)

94 132
Lab NGC FISH All BCR/ABL1 t(9;22) 94 132
Lab NGC FISH All CDKN2A (9p21) 94 132
Lab NGC FISH All ETV6/RUNX1 t12;21) 94 132
Lab NGC FISH All IGH/MYC/CEP8 t(8;14) +8 94 132
Lab NGC FISH All MLL (11q23) 94 132
Lab NGC FISH All MYB (6Q23) 94 132
Lab NGC FISH All TCF3/PBX1 t(1;19) 94 132
Lab NGC FISH All TRA/D (14q11) 94 132
Lab NGC FISH CLL (13q34)D135319 94 132
Lab NGC FISH CLL ATM(11q22.3) 94 132
Lab NGC FISH CLL CCND1/IGH t(11;14) 94 132
Lab NGC FISH CLL MYB(6q23) 94 132
Lab NGC FISH CLL TP53(17p13.1) 94 132
Lab NGC FISH CML 4q12 94 132
Lab NGC FISH CML BCR-ABL1 t(9;22) 94 132
Lab NGC FISH LYMPHOMA BCL6(3q27) 94 132
Lab NGC FISH LYMPHOMA IGH/BCL2

t(14;18)

94 132
Lab NGC FISH LYMPHOMA ALK(2p23) 94 132
Lab NGC FISH LYMPHOMA CCND1/IGH

t(11;14)

94 132
Lab NGC FISH LYMPHOMA MYC/IGH t(8;14) 94 132
Lab NGC FISH MDS (20q)D205108 94 132
Lab NGC FISH MDS (3q)RPN1/MECOM 94 132
Lab NGC FISH MDS del(5q)/-5 94 132
Lab NGC FISH MM (13q)D135319 94 132
Lab NGC FISH MM IGH/CCND1 94 132
Lab NGC FISH MM IGH/FGFR3 t(4;14) 94 132
Lab NGC FISH MM IGH/MAF t(14;16) 94 132
Lab NGC FISH MM TP53/CEP17 94 132
Lab NGC Jak2 exon 12 (Molecular Genetics) 54 76
Lab NGC Jak2(V617F) (Molecular Genetics) 50 70
Lab NGC MLL-AF4 (Molecular Genetics) 54 76
Lab NGC MPL (Molecular Genetics) 54 76
Lab NGC MPN Panel (Molecular Genetic) 162 227
Lab NGC NPM1 (Molecular Genetics) 54 76
Lab NGC PML-RARA (Molecular Genetics) 40 56
Lab NGC RUNX1-RNX1T1(AML-ETO)

(Molecular Genetics)

54 76
Lab NGC TCF3-PBX1(E2A-PBX1) (Molecular

Genetics)

54 76
Lab NGC Thrombophilia (Molecular Genetics) 50 70
Lab NGC Genetic testing of Nephrotic syndrome

(NPHS1 and NPHS2 genes)

127 178
Lab NGC Genetic markers for cardio genetics –

For 5 cardio genes using 16 capillary analysis

255 357
Lab NGC Genetic Markers for Hereditary Cancer Syndrome 226 316
Note: There are other genetic tests that are under final development or validation, the prices of which will be added when finally approved and become available for service.
1. Virology
CPHL Chikungunya virus Real Time PCR 85 119
CPHL CCHFV IgM antibodies by ELISA 10 11
CPHL CCHFV detection by real time PCR 85 119
CPHL CMV IgM antibodies by ELISA 5 8
CPHL CMV IgG antibodies by ELISA 5 8
CPHL CMV viral load by real time RT-PCR 80 112
CPHL DV nonstructural protein 1 (NS1) by ELISA 10 16
CPHL DVf IgM antibodies by ELISA 10 16
CPHL DVf IgG antibodies by ELISA 10 16
CPHL Dengue Virus rRT-PCR 85 119
CPHL Epstein Barr Virus (EBV) 5 8
CPHL EBV IgG by ELISA 5 8
CPHL EBV Viral Capsid Antigen(VCA) by ELISA 5 8
CPHL Epstein Barr virus qPCR 80 112
CPHL Viral Gastroenteritis rPCR 100 140
CPHL Rotavirus Antigen detection by ELISA 5 8
CPHL Rotavirus genotyping by RT-PCR 80 112
CPHL HSV 1 IgM antibodies by ELISA 5 8
CPHL HSV 1 IgG antibodies by ELISA 5 8
CPHL HSV 2 IgM antibodies by ELISA 5 8
CPHL HSV 2 IgG antibodies by ELISA 5 8
CPHL Herpes Simplex virus 1/2 qPCR 80 112
CPHL HAV IgM 5 8
CPHL HAV total Antibodies 5 8
CPHL HBV surface antigen (HBsAg) by ELISA 5 8
CPHL HBV viral load by real time RT-PCR 80 112
CPHL HBV core total Antibodies by ELISA 5 8
CPHL HBV core IgM Antibodies by ELISA 5 8
CPHL HBV core Antigen 5 8
CPHL HBV envelope Antigen by ELISA 5 8
CPHL HBV envelope Antibody by ELISA 5 8
CPHL HBV surface antibodies (anti-HBs) by

ELISA

5 8
CPHL HCV Abs by ELISA 5 8
CPHL HCV viral load by real time RT-PCR 80 112
CPHL HCV genotyping 50 70
CPHL HDV Antibodies by ELISA 5 8
CPHL HEV Antigen/Antibodies by ELISA 5 8
CPHL HIV screening by ELISA 5 8
CPHL HIV confirmation by Western Blot 20 32
CPHL HIV-1 viral load by real time RT-PCR 80 112
CPHL HIV Resistance Testing 275 385
CPHL Screening of MERs-CoV by real time PCR 85 119
CPHL Screening of Influenza by real time PCR 80 112
CPHL Screening of Respiratory Viral Panel by

Real Time PCR

100 140
CPHL MV IgM antibodies by ELISA 5 8
CPHL MV IgG antibodies by ELISA 5 8
CPHL IgG antibodies Avidity by ELISA 5 8
CPHL Measles virus rRT-PCR 80 112
CPHL Measles genotyping 120 168
CPHL Measles virus isolation 100 140
CPHL Mumps IgM antibodies by ELISA 5 8
CPHL Mumps IgG antibodies by ELISA 5 8
CPHL Mumps virus PCR 80 112
CPHL Rubella IgM antibodies by ELISA 5 8
CPHL RV IgG antibodies by ELISA 5 8
CPHL Rubella virus rRT-PCR 80 112
CPHL RV genotyping 120 168
CPHL RV Isolation 100 140
CPHL Acute flaccid paralysis (AFP) isolation 100 140
CPHL Enterovirus typing 100 140
CPHL Polio virus ITD rPCR 100 140
CPHL Vaccine-derived polioviruses (VDPV) screen

by real time PCR

80 112
CPHL VZV IgM antibodies by ELISA 5 8
CPHL VZV IgG antibodies by ELISA 5 8
CPHL Hanta Pulmonary virus Real Time PCR 85 119
CPHL Japanese Encephalitis Real Time PCR 85 119
CPHL Nipah Virus rRT PCR 85 119
CPHL Real Time PCR to detect highly pathogenic micro organisms 85 119
CPHL Real Time PCR to detect newly

introduced/emerging micro organisms

80 112
CPHL ELISA to detect antibodies against highly

pathogenic micro organisms

15 24
CPHL ELISA to detect newly introduced/emerging

micro organisms

10 16
CPHL Parvo B19 IgM and IgG antibodies by

ELISA

5 8
CPHL RVF IgM antibodies by ELISA 10 16
CPHL RVF detection by real time PCR 85 119
CPHL WNV IgM antibodies by ELISA 10 14
CPHL West Nile virus Real Time PCR 85 119
CPHL Mycoplasma Real Time PCR 80 112
2. Tuberculosis
CPHL AFB Microscopy by ZN stain 4 6
CPHL AFB Microscopy by Auramine stain 4 6
CPHL Direct detection of DNA MTBC (GeneXpert

MTB/RIF Assay)

45 72
CPHL Mycobacteria Culture 15 24
CPHL Identification and confirmation of MTB by

conventional methods

15 24
CPHL Identification and confirmation of MTB by

line probe assay

50 80
CPHL Identification of Non-Tuberculosis Mycobacteria (NTM) by line probe assay 75 105
CPHL Susceptibility testing of MTBC 100 140
CPHL Susceptibility testing of MTBC by MGIT

only

50 80
CPHL Susceptibility testing of MTBC by line probe

assay only

50 80
CPHL Susceptibility testing of MTBC for second

line drugs

100 140
CPHL Quantiferon test (IGRA) 20 32
3. Bacteriology
CPHL Acinetobacter spp. identification & AMST 10 16
CPHL Bacteroides identification 10 16
CPHL Body Fluids Culture for bacteria 10 16
CPHL Bordetella pertussis culture & identification 10 16
CPHL Brucella spp. ID by serotyping 15 24
CPHL Campylobacter spp. identification 10 16
CPHL Clostridium spp. culture & identification 10 16
CPHL Corynebacterium spp. identification 10 16
CPHL CRE confirmation by Modified Hodge Test

& Metallo Beta-Lactamase E-Test

20 32
CPHL CSF Culture for bacteria 10 16
CPHL E. coli serotyping 15 24
CPHL E. coli 0157 serotyping 10 16
CPHL Enterococcus identification & AMST 10 16
CPHL EPEC Screening 10 16
CPHL ESBL screening & AMST 10 16
CPHL Fungal identification 10 16
CPHL H. Influenzae ID, AMST & Serotyping 15 24
CPHL Legionella spp. culture & identification & serotyping 20 32
CPHL MRSA screening & AMST 10 16
CPHL Neisseria gonorrhae Identification & AMST 10 16
CPHL Neisseria meningitidis ID & AMST 15 24
CPHL Neisseria meningitidis Serotyping 10 16
CPHL Parasite identification by microscopy 2 3.2
CPHL Pseudomonas Identification & AMST 10 16
CPHL Salmonella spp. ID, AMST & Serotyping 15 24
CPHL Shigella Isolate ID, AMST & Serotyping 15 24
CPHL Stool Culture for Bacteria 10 16
CPHL Strep. pneumoniae ID & AMST 15 24
CPHL Strep. pneumoniae Latex serotyping 10 16
CPHL V. cholera ID, serotyping & AMST 20 32
CPHL General Bacterial culture, ID & AMST 15 24
CPHL Culture, ID & AMST of Highly pathogenic

bacteria

20 32
CPHL Identification of unknown bacteria 5 8
CPHL AMST of unknown bacteria 5 8
CPHL Identificationof micro-organisms by

MALDI-TOF

5 8
CPHL Yeast identification and AMST 10 16
CPHL MDRO confirmation 10 16
4. Molecular (PCR & Genotyping)
CPHL 16S rRNA gene Sequencing (Bacterial) 100 140
CPHL Atypical pneumonia bacterial panel DNA 100 140
CPHL Bacterial Genotyping by PFGE 50 80
CPHL Bordetella DNA panel 100 160
CPHL Brucella spp. DNA 80 128
CPHL Chlamydia pneumoniae DNA 80 128
CPHL Coxiella burnettii DNA 80 128
CPHL Legionella sp. DNA 80 128
CPHL Legionella sp. DNA in Environment Water 80 128
CPHL Leptospira spp. DNA 80 128
CPHL Mycoplasma pneumoniae DNA 80 128
CPHL Neisseria meningitidis DNA 80 128
CPHL Neisseria meningitidis serotype DNA 80 128
CPHL Plasmodium spp. DNA panel 100 160
CPHL Salmonella spp. DNA 80 128
CPHL Streptococcus pneumoniae DNA 80 128
CPHL Streptococcus pneumoniae molecular serotyping 100 160
CPHL Molecular serogrouping of bactrial pathogen 100 160
CPHL Rickettsia DNA 80 128
CPHL CRE molecular typing 75 120
CPHL SHIGA toxin PCR 50 80
CPHL H. influenzae DNA 80 128
CPHL Dermatophyte DNA 80 128
CPHL Tropical pathogen molecular panel 100 160
CPHL Direct detection of bacterial pathogens by

(GeneXpert)

45 72
CPHL Bacterial DNA detection by multiplex PCR 100 140
CPHL Yersinia pestis DNA 80 112
5. Serology
CPHL Bordetella pertussis Ab (IgG) 5 8
CPHL Brucella Ab (IgG) 10 16
CPHL Brucella Ab (IgM) 10 16
CPHL Chlamydia pneumoniae (IgM) 5 8
CPHL Cl. difficile Toxin A/B detection 5 8
CPHL Coxella burnetii phase I IgG Ab 5 8
CPHL Coxella burnetii phase II IgM Ab 5 8
CPHL Echinococcosis IHA 5 8
CPHL H. pylori Ab (IgG) 5 8
CPHL H. pylori Antigen 5 8
CPHL Total bacterial Ab (IgG + IgM) by ELISA 5 8
CPHL Bacterial Ab (IgG ) by ELISA 5 8
CPHL Bacterial Ab (IgM ) by ELISA 5 8
CPHL Legionella pneumophila Ab (IgM) 5 8
CPHL Legionella pneumophila Ab (IgG) 5 8
CPHL Leishmania total Ab (IgG+IgM) 5 8
CPHL Leptospira Ab (IgM) 5 8
CPHL Mycoplasma pneumoniae Ab (IgM) 5 8
CPHL RPR (VDRL) 3 5
CPHL Schistosomiasis IHA 5 8
CPHL Schistosomiasis ELISA 5 8
CPHL Toxoplasma Ab (IgG) 5 8
CPHL Toxoplasma Ab (IgM) 5 8
CPHL Listeria monocytogenes serotyping 5 8
CPHL Yersenia entercolitica serotyping 5 8
CPHL Lyme disease Ab (IgM) 5 8
CPHL Cryptococcus Ag detection 5 8
CPHL CNS pathogen Ag detection 5 8
CPHL TPHA 5 8
6. Food & Water
CPHL Food poisoning microbial testing 10 16
CPHL Water microbial testing 10 16
CPHL Water coliform testing 10 16
CPHL Total colony count 15 24
CPHL Detection of bacterial toxins 5 8
7. Chemistry/Biochemistry
CPHL Vitamin A (Serum Retinol) and Vitamin E

(a-Tocopherol)

50 80
CPHL Vitamin D (25-hydroxyvitamin D2 and D3) 40 64
CPHL Iodine 2 3
CPHL Na/K 4 6
CPHL Iodine in salt 2 3
CPHL Iron in flour 2 3
CPHL Melamine 5 8
CPHL Mycotoxins 30 48
CPHL Drinking Water routine Chemical Tests 10 16
CPHL Water Alkalinity 2 3
CPHL Ammonia in water 2 3
CPHL Calcium in water 2 3
CPHL Chloride in water 2 3
CPHL Conductivity in water 2 3
CPHL Copper in water by atomic absorption 3 5
CPHL Fluoride in water 2 3
CPHL Iron in water by atomic absorption 3 5
CPHL Lead in water by atomic absorption 3 5
CPHL Magnesium in water 2 3
CPHL Nitrate in water 2 3
CPHL Nitrite in water 2 3
CPHL pH in water 2 3
CPHL Residual chlorine in water 2 3
CPHL Total dissolved solids in water 2 3
CPHL Total hardness in water 2 3
CPHL Zinc in water by atomic absorption 3 5
CPHL Swimming pool water Tests 10 16
8. Environmental/Toxicology/Malaria
CPHL Dailysis Water routine Chemical Tests 30 48
CPHL Aluminum (Al) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Arsenic (As) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Barium (Ba) by Inductively coupled plasma mass spectrometry 4 6
CPHL Bismuth (Bi) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Boron (B) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Bromine (Br) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Beryllium (Be) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Copper (Cu) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Cadmium (Cd) by Inductively coupled plasma mass spectrometry 4 6
CPHL Chromium (Cr) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Cobalt (Co) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Calcium (Ca) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Gold (Au) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Iodine (I) by Inductively coupled plasma mass spectrometry 4 6
CPHL Indium (In) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Iron (Fe) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Lithium (Li) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Lead (Pb) by Inductively coupled plasma mass spectrometry 4 6
CPHL Mercury (Mg) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Manganese (Mn) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Magnesium (Mg) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Nickel (Ni) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Phosphorus (P) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Palladium (Pd) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Potassium (K) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Platinum (Pt) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Rubidium (Rb) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Strontium (Sr) by Inductively coupled

plasma mass spectrometry

4 6
CPHL Selenium (Se) by Inductively coupled plasma mass spectrometry 4 6
CPHL Silicon (Si) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Silver (Ag) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Sodium (Na) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Sulfur (S) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Thallium (Ti) by Inductively coupled plasma mass spectrometry 4
CPHL Tin (Sn) by Inductively coupled plasma mass

spectrometry

4 6
CPHL Uranium (U) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Vanadium (V) by Inductively coupled plasma mass spectrometry 4 6
CPHL Zinc (Zn) by Inductively coupled plasma

mass spectrometry

4 6
CPHL Malarial Parasite 5 8

الملحق رقم (٩)
رسوم الفحوصات والتدخلات الإشعاعية

No.
مسلسل
Procedure Name
اسم الإجراء
Price (R.O)
القيمة بالريال العماني
1 Abdomen X-Ray 10
2 Abdomen & Pelvis X-Ray 10
3 Acetabulum X-Ray 10
4 Acromio-Clavicular Joint X-Ray 10
5 Ankle Joint X-Ray 10
6 Arm (Humerus) X-Ray 10
7 Arm with Shoulder X-Ray 10
8 Calcaneum (Heel) X-Ray 10
9 Cervical Spine X-Ray 12
10 Cervico-Dorsal Spine X-Ray 12
11 Chest & Abdomen X-Ray (for infants) 10
12 Chest X-Ray 10
13 Chest X-Ray (lateral view only) 10
14 Chest & Abdomen X-Ray 14
15 Clavicle X-Ray 10
16 Coccyx X-Ray 10
17 Cranium (Skull) X-ray 10
18 Dorsal Spine X-Ray 12
19 Dorso-Lumbar Spine X-Ray 12
20 Elbow Joint X-Ray 10
21 Facial X-Ray 10
22 Femur with Hip X-Ray 10
23 Femur with Knee X-Ray 10
24 Femur X-Ray 10
25 Fingers X-Ray 10
26 Foot X-Ray 10
27 Forearm (Radius & Ulna) X-Ray 10
28 Forearm with Elbow X-Ray 10
29 Forearm with Wrist X-Ray 10
30 Full Lower Limb X-Ray (for child) 10
31 Full Upper Limb X-Ray (for child) 10
32 Hand X-Ray 10
33 Hip Joint X-Ray 10
34 Humerus X-Ray 10
35 Infantogram X-Ray 10
36 Internal Auditory Meati X-Ray 10
37 Knee Joint X-Ray 10
38 Leg (Tibia & Fibula) X-Ray 10
39 Lumbar Spine X-Ray 12
40 Lumbo-Sacral Spine X-Ray 12
41 Mandible X-RAY 10
42 Mastoids X-Ray 10
43 Mobile X-Ray 10
44 Orbits X-Ray 10
45 Os calcis X-Ray 10
46 Patella X-Ray 10
47 Pelvis & Hips X-Ray 10
48 Pelvis X-Ray 10
49 Ribs X-Ray 10
50 Sacro-iliac Joints X-Ray 10
51 Sacrum & Coccyx X-Ray 10
52 Sacrum X-Ray 10
53 Scapula X-Ray 10
54 Shoulder Joint X-Ray 10
55 Skeletal Survey X-Ray 50
56 Skull (other areas) X-Ray 10
57 Soft Tissue Neck X-Ray 10
58 Sterno-Clavicular Joints X-Ray 10
59 Sternum X-Ray 10
60 Styloid Process X-Ray 10
61 Temporo-Mandibular Joints X-Ray 10
62 Thoracic Inlet X-Ray 10
63 Thoracic Outlet X-Ray 10
64 Thumb X-Ray 10
65 Tibia & Fibula X-Ray 10
66 Tibia with Ankle X-Ray 10
67 Tibia with Knee X-Ray 10
68 Toes X-Ray 10
69 Whole Spine X-Ray 25
70 Wrist Joint X-Ray 10
71 Nasal Bone X-Ray 10
72 TMJ X-Ray – Lateral View (open and closed mouth) 14
73 TMJ X-Ray – PA View (open and closed mouth) 14
74 Post-Nasal Space X-Ray 10
75 Paranasal Sinuses X-Ray 14
76 PNS Tomogram View 50
77 Orthopantomogram (OPG) 15
78 Cephalogram (AP view) 15
79 Cephalogram (Lateral view) 15
80 Cephalogram (PA view) 15
81 Dacryocystogram 50
82 Mammogram 60
83 Ductogram (Galactogram) 60
84 Hysterosalpingogram (HSG) 60
85 Arthrogram Knee SP 60
86 Arthrogram Shoulder SP 60
87 Arthrogram Wrist SP 60
88 Arthrogram Ankle SP 60
89 Arthrogram Elbow SP 60
90 Myelogram – Cervical 100
91 Myelogram – Dorsal 100
92 Myelogram – Lumbar 100
93 Myelogram – Whole Spine 150
94 Parotid Sialogram 50
95 Submandibular Sialogram 50
96 Sialography 50
97 Nephrostogram 40
98 Micturating Cystourethrogram (MCUG) 50
99 Antegrade Pyelogram 50
100 Retrograde Pyelogram 60
101 Intravenous Urogram 50
102 Cystogram 50
103 Retrograde Urethrogram 60
104 Vasogram 60
105 Loopogram 50
106 Herniogram 60
107 Defecogram (proctogram ) 60
108 Fistulogram 50
109 Sinogram 50
110 Venogram – Left Upper Limb 100
111 Venogram – Right Lower Limb 100
112 Venogram – Right Upper Limb 100
113 Venogram – Left Lower Limb 100
114 AVG Graftogram 60
115 AVF Fistulogram 60
116 Lymphangiogram 80
117 Aortic Angiogram 250
118 Aortic Arch Angiogram 250
119 Pulmonary Angiogram 250
120 Carotid Angiogram 200
121 Upper Limb Angiogram 180
122 Lower Limb Angiogram 180
123 Portal Venogram 180
124 Hepatic Angiogram 180
125 Abdominal Angiogram 180
126 Cholangiogram 80
127 Postoperative (T-tube) Cholangiogram 80
128 Percutaneous Transhepatic Cholangiogram 160
129 Mesenteric Angiogram 180
130 Renal Angiogram 180
131 Spinal Angiogram 500
132 Cerebral Angiogram 500
133 Aortic Doppler 65
134 Carotid Doppler US 40
135 Arterial Doppler – Lower Limb 45
136 Arterial Doppler – Upper Limb 45
137 Peripheral Doppler (both limbs) US 65
138 Testicular Doppler 40
139 Portal Vein Doppler 65
140 Renal Artery Doppler 65
141 Venous Doppler – Lower Limb 45
142 Venous Doppler – Upper Limb 45
143 OT Check X-ray 10
144 OT Contrast Studies 50
145 OT C-arm Fluoroscopy 50
146 Fluoroscopy General (Screening) 50
147 Barium Enema 60
148 Barium Enema Double Contrast 60
149 Barium Meal – UGI 50
150 Barium Meal Double Contrast 50
151 Barium Meal Follow Through 50
152 Barium Meal Follow Through (excluding esophagus and stomach) 50
153 Barium Meal for Esophagus, Stomach & Duodenum 50
154 Barium Swallow 50
155 Modified Barium Study 40
156 Water Soluble Contrast Enema 60
157 Water Soluble Contrast Meal 50
158 Small Bowel Enema 100
159 Air-Enema 80
160 Air-Enema (intussusception) 120
161 Head US 25
162 Orbits US 25
163 Eye U/S 25
164 Neck US 25
165 Parathyroid US 25
166 Thyroid US 25
167 Chest US 25
168 Breast US 25
169 Abdomen US 25
170 Upper Abdomen US 25
171 Kidneys U/S 25
172 K.U.B and Prostate US 30
173 K.U.B US 25
174 Pelvis – General US 25
175 Pelvis – Obstetric US 30
176 Anomaly Scan Confirmation by Radiology 60
177 Scrotum US 25
178 Testes (undescended) US 25
179 Urethra US 25
180 Shoulder US 25
181 Hip Joint US 25
182 Knee US 25
183 Limbs US 30
184 Soft Tissue US 25
185 Foreign Body Localization US 20
186 General Brain (Head) CT 100
187 Head CT 100
188 Pituitary CT 100
189 Pituitary Fossa CT 100
190 Maxillo-Facial CT 100
191 Mandible CT 100
192 Internal Auditory Meati (IAM) CT 100
193 Orbits CT 100
194 Petrous Bone (IAM) CT 100
195 Nasopharynx CT 100
196 Paranasal Sinuses CT 100
197 Sinuses/Oropharynx/Soft Tissue CT 100
198 Parotid Glands CT 100
199 Larynx CT 100
200 Neck CT 100
201 Neck + Chest + Abdomen CT 140
202 Neck + Chest + Abdomen + Pelvis CT 170
203 Chest CT 100
204 Chest (High Resolution) CT 110
205 Chest + Abdomen CT 120
206 Chest + Abdomen + Pelvis CT 150
207 Abdomen CT 100
208 Liver CT 100
209 Renal CT 100
210 Abdomen + Pelvis CT 120
211 Adrenal Glands CT 100
212 Kidneys + Ureters + Bladder (KUB) CT 100
213 Pelvis CT 100
214 Cervical Spine CT 100
215 Cervico-Dorsal Spine CT 100
262 TMJ MRI 120
263 Paranasal Sinuses (PNS) MRI 120
264 Neck Soft Tissue MRI 120
265 Chest MRI 120
266 Lungs MRI 120
267 Mediastinum MRI 120
268 Cardiac MRI 120
269 Breast MRI 120
270 Abdomen MRI 120
271 Abdomen + Pelvis MRI 150
272 Abdomen + Pelvis MRI (angiography/venography) 150
273 Liver MRI 120
274 Pancreas MRI 120
275 Magnetic Resonance CholangioPancreatography (MRCP) MRI 120
276 Renal MRI 120
277 Adrenals MRI 120
278 Pelvis MRI 120
279 Scrotum MRI 120
280 Cervical Spine MRI 120
281 Cervico-Thoracic MRI 120
282 Thoracic Spine MRI 120
283 Thoraco-Lumbar Spine MRI 120
284 Lumbar Spine MRI 120
285 Lumbo-Sacral Spine MRI 120
286 Sacrum MRI 120
287 Sacro-iliac Joint MRI 120
288 Total Spine MRI 150
289 Brachial Plexus MRI 120
290 Shoulder MRI 120
291 Arthrogram Shoulder MRI 150
292 Humerus MRI 120
293 Elbow Joint MRI 120
294 Arthrogram Elbow MRI 150
295 Forearm MRI 120
296 Wrist Joint MRI 120
297 Arthrogram Wrist MRI 150
298 Wrist and Hand MRI 120
299 Hand MRI 120
300 Hip MRI 120
301 Arthrogram Hip MRI 150
302 Femur MRI 120
303 Thigh MRI 120
304 Knee Joint MRI 120
305 Arthrogram Knee MRI 150
306 Leg MRI 120
307 Ankle Joint MRI 120
308 Arthrogram Ankle MRI 150
309 Ankle & Foot MRI 120
310 Calcaneus MRI 120
311 Foot MRI 120
312 Angiography/Venography MRI (lower limbs) 150
313 Angiography/Venography MRI (others) 120
314 Magnetic Resonance Arteriogram (MRA) 250
315 Whole Body (Mets) MRI 300
316 Myelogram MRI 150
317 Ultrasound Guided FNA 50
318 Ultrasound Guided Aspiration 70
319 Ultrasound Guided Biopsy 80
320 Ultrasound Guided Drainage 100
321 Fluoroscopy Guided Drainage 100
322 CT Guided Aspiration 120
323 CT Guided Biopsy 130
324 CT Guided Drainage 180
325 Embolization – Uterine Artery 400
326 Embolization – Bronchial Artery 400
327 Embolization – Varicocele 400
328 Embolization – Upper GI Bleeding 400
329 Embolization – Lower GI Bleeding 400
330 Embolization – Blood Vessel (not specified elsewhere) 400
331 Embolization – Head & Neck (not specified elsewhere) 500
332 Embolization – Intracranial Tumor 800
333 Embolization – Spinal Tumor 800
334 Embolization – Intracranial AVM 1500
335 Embolization – Spinal AVM 1500
336 Intracranial Aneurysm Coiling (conventional) 1000
337 Intracranial Aneurysm Coiling (balloon-assisted) 1200
338 Intracranial Aneurysm Coiling (stent-assisted) 1300
339 Intracranial Aneurysm Coiling (flow-diverter placement) 1500
340 Mechanical Thrombectomy 1000
341 Catheter Directed Thrombolysis 400
342 Trans-arterial Chemoembolization 400
343 Percutaneous Ethanol Injection 400
344 Intra-arterial Vasospasm Treatment 800
345 Balloon Occlusion Test 800
346 Sclerotherapy of Craniofacial Venolymphatic Malformation (fruoroscpy- guided) 800
347 Percutaneous Placement of Intravascular Filter/Device 500
348 Percutaneous Repositioning of Intravascular Filter/Device 400
349 Percutaneous Removal of Intravascular Filter/Device or Foreign Body 400
350 Percutaneous Transluminal Angioplasty (PTA) – Thoracic Aorta 1200
351 Percutaneous Transluminal Angioplasty (PTA) – Abdominal Aorta 1200
352 Percutaneous Transluminal Angioplasty (PTA) – Pulmonary Artery 1200
353 Percutaneous Transluminal Angioplasty (PTA) – Innominate Artery 1000
354 Percutaneous Transluminal Angioplasty (PTA) – Carotid Artery 1000
355 Percutaneous Transluminal Angioplasty (PTA) – Vertebral Artery 1000
356 Percutaneous Transluminal Angioplasty (PTA) – Subclavian Artery 800
357 Percutaneous Transluminal Angioplasty (PTA) – Axillary Artery 600
358 Percutaneous Transluminal Angioplasty (PTA) – Brachial Artery 600
359 Percutaneous Transluminal Angioplasty (PTA) – Radial/Ulnar Artery 500
360 Percutaneous Transluminal Angioplasty (PTA) – Renal Artery 800
361 Percutaneous Transluminal Angioplasty (PTA) – Iliac Artery 800
362 Percutaneous Transluminal Angioplasty (PTA) – Abdominal or Pelvic Artery

(not specified elsewhere)

800
363 Percutaneous Transluminal Angioplasty (PTA) – Femoral Artery 800
364 Percutaneous Transluminal Angioplasty (PTA) – Popliteal Artery 600
365 Percutaneous Transluminal Angioplasty (PTA) – Upper or Lower Limb Artery (not specified elsewhere) 600
366 Percutaneous Transluminal Angioplasty (PTA) – Central Vein 1000
367 Percutaneous Transluminal Angioplasty (PTA) – Vein (other than central

vein)

600
368 Endovascular Repair of Thoracic Aorta (e.g. aneurysm, pseudoaneurysm,

dissection)

1500
369 Endovascular Repair of Abdominal Aorta (e.g. aneurysm, pseudoaneurysm,

dissection)

1500
370 Endovascular Repair of Superior or Inferior Vena Cava 1500
371 Endovascular Repair of Central Blood Vessel (not specified elsewhere) 1500
372 Endovascular Repair of Peripheral Artery (not specified elsewhere) 1000
373 Endovascular Repair of Peripheral Vein (not specified elsewhere) 800
374 Endoscopic Retrograde Cholangiopancreatography (ERCP) – Diagnostic 800
375 Endoscopic Retrograde Cholangiopancreatography (ERCP) with Biopsy 850
376 Endoscopic Retrograde Cholangiopancreatography (ERCP) and Foreign Body

Removal

850
377 Endoscopic Retrograde Cholangiopancreatography (ERCP) and Tube/Stent Placement (any site) 900
378 Endoscopic Retrograde Cholangiopancreatography (ERCP) and Balloon

Dilatation (any site)

1000
379 Endoscopic Retrograde Cholangiopancreatography (ERCP) and

Removal/Destruction of Calculi

1000
380 Endoscopic Retrograde Cholangiopancreatography (ERCP) with

Sphincterotomy/Papillotomy

1000
381 Percutaneous Trans-hepatic Cholangiography (PTC) and Biliary Drainage 700
382 Percutaneous Trans-hepatic Cholangiography (PTC) and Biliary Stenting 700
383 Percutaneous Trans-hepatic Cholangiography (PTC) and Calculus Extraction 750
384 Percutaneous Cholecystostomy 600
385 Percutaneous Biliary Drainage Catheter Exchange 750
386 Peritoneovenous Shunt Placement (e.g. LeVeen shunt, Denver shunt) 750
387 Peritoneovenous Shunt Removal 400
388 Transjugular Intrahepatic Portosystemic Shunt (TIPS) 800
389 Percutaneous Catheterization of Portal Venous System 750
390 Percutaneous Radiological Gastrostomy (PRG) 250
391 Percutaneous Gastrojejunostomy 250
392 Percutaneous Nephrostomy 350
393 Percutaneous Nephrostomy Tube Exchange 400
394 Percutaneous Ureteric Stent Placement 300
395 Percutaneous Ureteric Stricture Dilatation 260
396 Insertion of Non-tunneled Central Venous Line 150
397 Insertion of Peripherally-inserted Central Catheter (PICC) 150
398 Insertion of Tunneled Central Venous Line (e.g. Hickman line, Permcath,

Tesio catheter)

250
399 Insertion of Implantable Port (e.g. Porta Cath) 300
400 Insertion of Peritoneal Dialysis Catheter (e.g. Tenckhoff cathter) 250
401 Re-insertion of Peritoneal Dialysis Catheter 250
402 Adrenal Venous Sampling (radiologically-guided) 150
403 Bone Densitometry 50
404 Bone Scan 90
405 Bone Marrow Scintigram 100
406 Brain PET Scan 600
407 Parathyroid Scan 200
408 Thyroid Scan 100
409 MUGA Scan 150
410 Cardiac Perfusion Scan 200
411 Thallium Viability Scan 800
412 LymphoScintigraphy 100
413 Octreotide Scan 800
414 Gallium-67 Scan 500
415 Renal Scan (DMSA) 100
416 Captopril Renogram 200
417 Diuretic Renogram 200
418 Iodine 131 (MIBG) 220
419 Iodine 131 Ablation & Therapeutic 300
420 Iodine 131 Diagnostic CA Thyroid 200
421 Iodine 131 Therapy for Hyperthyroidism 200
422 Leukoscan 450
423 Whole Body FDG PET/CT Scan 850
424 Lung V/Q Scan 200
425 Lung Perfusion Scan 100
426 Lung Ventilation Scan 100
427 Gastric Emptying Scan (DTPA-Tc99m) 100
428 Milk Scan 65
429 Hepatobiliary Scan (HIDA scan) 150
430 Meckel’s Diverticulum Scan 100
431 GI Bleeding Scan (RBC scan) 150
432 Testicular Scan 100
433 Simple Conventional Fraction /3D 40
434 IMRT 65
435 VMAT 60
436 SRT 80
437 SRS 300
438 Portal Imaging 20
439 CBCT 40
440 Exact Tract 20
441 Physics Simple Planning 100
442 IMRT, VMAT, SRS Planning 200
443 Simulation Immobilization Orfit 100
444 CT-Simulation 100
445 2D Radiation Therapy 20

الملحق رقم (١٠)
رسوم خدمات بنك الدم

No.
مسلسل
Procedure Name
اسم الإجراء
Price (R.O)
القيمة بالريال العماني
1 Apheresis Platelets Irradiated – 5 Day Expiry 118
2 Platelet Apheresis – 5 Day Expiry 116
3 Platelet – Buffy Coat 18
4 Platelet Plasma Reduced 18
5 Platelet Rich Plasma 18
6 Platelets 5 Day Storage Irradiated 20
7 Apheresis Red Blood Cells AS-1 (unit 1) 116
8 Apheresis Red Blood Cells SAGM 116
9 Red Blood Cells CPD 64
10 Red Blood Cells CPDA-1 64
11 Plasma Reduced Red Cells in CPDA1 64
12 Red Cells in SAGM Solution 65
13 Red Blood Cells CPDA-1 Irradiated 67
14 Red Blood Cells SAGM Irradiated 65
15 Red Blood Cells CPDA-1 Leukocytes Reduced 65
16 Red Blood Cells SAGM Leucocytes Reduced 65
17 Red Blood Cells CPDA-1 Irradiated Leukocytes Reduced 68
18 Red Blood Cells SAGM Irradiated Leucocytes Reduced 68
19 Autologous Packed Red Cells 100
20 Cryoprecipitated AHF 18
21 Cryosupernatant Plasma 18
22 Fresh Frozen Plasma 18
23 Fresh Frozen Plasma – Apheresis 116
24 Buffy Coat (WBC Concentrate) 30
25 Frozen Blood Preparation 37
26 Frozen Blood Thaw 28
27 Frozen Blood Freeze/Thaw 37
28 Blood Product Irradiation 4
29 Volume Reduction of Blood Product 11
30 Pooling Blood Platelets 10
31 Split Blood Product 8
32 Rh/Kell phenotyping 4
33 Antigen Typing – K 10
34 Antigen Typing – Fy 10
35 Antigen Typing – Jk 10
36 Antigen Typing – Kp 10
37 Antigen Typing – S 10
38 Antigen Typing – MN 10
39 Antigen Typing – Lu 10
40 Antigen Typing – Le 10
41 Antigen Typing – P1 10
42 Adsorption Study 20

الملحق رقم (١١)
رسوم العلاج التأهيلي

No.
مسلسل
Procedure Name
اسم الإجراء
Price (R.O)
القيمة بالريال العماني
1 Active Exercises 10
2 Aids for Severely Handicapped 0
3 Initial Physiotherapy Assessment & Diagnosis 10
4 Attending Round/Meetings 5
5 Breathing Re-training 10
6 Cardiac-Rehabilitation 10
7 Combined Physiotherapy (e.g. Electrotherapy, Wax, etc.) 12
8 Activities of Daily Living (ADL) Training 10
9 Dry Needling Technique 10
10 Endurance Exercises 10
11 Strengthening Exercises 10
12 Exercises for Neurological Disabilities (e.g. rigidity, spasticity, paralysis) 10
13 Family Education and Home Program 10
14 Faradic Stimulation 10
15 Fitting or Adjustment of Walking Aids 5
16 Follow Up – Rehabilitation 8
17 Gait Re-education/Training 10
18 Group Exercises 10
19 Contrast Bath 10
20 Interferential Therapy (IFT) 10
21 Infrared Therapy 10
22 Laser Therapy 10
23 Soft Tissue Mobilisation (Massage) 10
24 Pre/Post Mastectomy Exercises 10
25 Peripheral Mobilization 10
26 Spinal Mobilization 10
27 Modification (other than environmental) 0
28 Neuromuscular Re-education 10
29 Unspecified Physiotherapy 5
30 Passive Exercises 10
31 Patient Education 10
32 Play Therapy 10
33 Reassessment – Rehabilitation 8
34 Relaxation Exercises 10
35 Resistive Exercises 10
36 Postnatal Exercises 10
37 Sensory Motor Exercises 10
38 Short wave Diathermy (SWD) 10
39 Taping Technique 10
40 Transcutaneous Electrical Nerve Stimulation (TENS) 10
41 Traction – Rehabilitation 10
42 Antenatal Exercises 10
43 Training in Joint Movement 10
44 Training with Walking Aids 10
45 Coordination Exercises 10
46 Ultrasound (US) 10
47 Wax Therapy 10
48 Active Assisted Exercises 10
49 Active Cycle of Breathing (thoracic expansion, breathing control, forced

expiratory technique)

5
50 Activities of Daily Living Assessment 8
51 Acupressure/Trigger Point Release 10
52 Airway Suctioning (open-closed ) 8
53 Assessment of Walking Aids 5
54 Autogenic Drainage 10
55 Back & Other Joint Supports 8
56 Balance Exercises 8
57 Bandaging – Rehabilitation 5
58 Bed Mobility Activities 5
59 Bobath Technique 10
60 Chiropractic Technique 10
61 Circulatory Exercises 5
62 Combined Electrotherapy 10
63 Compression Pump Machine 10
64 Cough Assist Device 10
65 Coughing 5
66 Cryotherapy (Ice) 10
67 Discharge Planning 5
68 Early Intervention Postnatal Exercises 8
69 EMG Bio-feedback 10
70 Environmental Modification 10
71 Facial Muscles Exercises 10
72 Functional Electrical Stimulation 10
73 Falls Prevention Education 5
74 Gait Analysis 8
75 High Frequency Chest Wall Oscillation / Vest Machine 10
76 Hot Packs – Rehabilitation 10
77 Huffing 5
78 Hydrotherapy 10
79 Maitland Technique 10
80 Manual Assistive Cough 8
81 Manual Handling 10
82 Manual Hyperinflation / Bagging 5
83 Manual Traction 10
84 Medicine Balls 5
85 Mirror Therapy 10
86 Mulligan Technique 10
87 Myofascial release 10
88 Neurodevelopment Exercises 10
89 Neurodynamics 10
90 Orthosis/Prosthesis Orientation 10
91 Oscillating Positive Expiratory Pressure Mask 8
92 Osteopath Technique 10
93 Pelvic Floor Exercises 8
94 Phonophoresis 10
95 Positioning 5
96 Post-Operative Chest Physiotherapy 10
97 Postural Assessment 8
98 Postural Education/Advice 5
99 Postural Correction 5
100 Postural Drainage (gravity-assisted technique) 10
101 Proprioception Training 8
102 Proprioceptive Neuromuscular Facilitation(PNF) 10
103 Shockwave Therapy 10
104 Stairs Exercises 8
105 Static/Wheel chair activities 8
106 Static Quads Exercises 10
107 Stretching Exercises 10
108 Thoracic Mobility e.g. AROM,PROM 8
109 Vacuum Machine 10
110 Vestibular Exercises 8
111 Pre-Operative Chest Physiotherapy 10
112 Provide Limb Supports 5
113 Pulleys 8
114 Quadriceps Bench 8
115 Robotic Assisted Therapy/Lokomat Therapy 10
116 Social Counseling of Patient/Family 5
117 Spider Cage 10
118 Static Cycle Machines 10
119 Swiss Balls 5
120 Therasuit 10
121 Tracheal Stimulation 5
122 Training of Caregivers 8
123 Treadmill 10
124 Use of Assistive Devices (crutches, frames, Rolletors, etc.) 8
125 Training in Device Use (e.g. PEP, acapella, flutter, incentive spirometer,

etc.)

8
126 Use of Theraband, Putty, etc. 8
127 Vibration/Percussion/Shaking 5
128 Wobble Boards 8
129 Above Elbow Prosthesis (A.E.P ) 300
130 Ankle Foot Orthosis Night Splint 25
131 Ankle Foot Orthosis Poly P 60
132 Ankle Foot Orthosis 50
133 Ankle Foot Orthosis – outside iron inside T strap 50
134 Ankle Foot Orthosis – steel 50
135 Above Knee Prosthesis (AK) 600
136 Below Elbow Prosthesis 150
137 Below Knee Prosthesis (BK) 300
138 Back Splints 25
139 Bilateral Twisters 4
140 Congenital Talipes Equinovarus Splint 8
141 Cervical Collar 10
142 Cock-up Splint 8
143 Corrective Knee Splint 20
144 Corrective Night Splint (loyds) 20
145 Corrective Night Splint (mermaid) 20
146 Corrective Brace – Upper Limb 20
147 Corrective Walking Brace for Genu Valgum 30
148 Corrective Walking Brace for Genu Varum 30
149 Custom Sandals 50
150 Dynamic Wrist Hand Orthosis (all 5 fingers) 10
151 Dynamic Wrist Hand Orthosis (without thumb spring) 8
152 Dynamic Knuckle Bender Splint 8
153 Dynamic Splint (capners splint) 8
154 Dynamic Splint (toe raising strap) 4
155 Extension Prosthesis 300
156 Femoral Fracture Brace 30
157 Forearm Fracture Brace 30
158 Hip Knee Ankle Foot Orthosis 350
159 Hip Spica / Hip Abduction Splint 30
160 Humerus Fracture Brace 30
161 Hyper Extension Brace 50
162 Knee Ankle Foot Orthosis 300
163 Knee Brace 50
164 Mallet Splint 4
165 Night Splint for Ankle 25
166 Night Splint for Elbow (elbow gutter) 20
167 Night Splint for Hand 6
212 Knee Ankle Foot Orthoses (K.A.F.O) Night Splint 25
213 Supra Malleolar Orthosis (U.C.A.L.) 10
214 Dynamic Ankle Foot Orthosis Poly P 80
215 Elbow Fracture Brace 25
216 Shoulder Fracture Brace 30
217 Shoulder Abduction Brace 60
218 Prosthetic Knee Joint 100
219 Prosthetic SACH Foot 20
220 Change Socket 30
221 Prosthetic Cosmetic Foam 25
222 Upper Limb Cosmetic Glove 40
223 Congenital Dislocation of the Hip (CDH) Orthosis (ready made) 15
224 Esophageal Speech Training 10
225 Expressive Language Development Skills (Semantics) 10
226 Expressive Language Development Skills Morphology/Syntax 10
227 Other Training for Deaf Person 10
228 Reading Activities 10
229 Receptive Language Development Skills (Semantics) 10
230 Receptive Language Development Skills Morphology/Syntax 10
231 Speech and Language Evaluation 10
232 Speech Therapy 10
233 Speech Defect Training 10
234 Speech Therapy – Unspecified 10
235 Speech Training 10
236 Stuttering Therapy – Awareness of Speech Production 10
237 Stuttering Therapy – Relax Body and Speech Musculature 10
238 Traditional Articulation Therapy 10
239 Vocalization Exercise 10
240 Vocalization Counselling 10
241 Vocalization Re-education 10
242 Vocalization Training and Rehabilitation 10
243 Voice Therapy – Awareness of Voice and Abusive Vocal Behaviors 10
244 Voice Therapy – Use Appropriate Volume, Nasa Resonance and/or

Optimum Pitch

10
245 Voice Therapy – Use Relaxation Techniques 10
246 Dysphagia Diagnosis – Fiberoptic Endoscopic Evaluation of Swallowing (FEES) 35
247 Dysphagia Diagnosis – Modified Barium Swallow (MBS) 30
248 Dysphagia Diagnosis – Pharyngeal Manometry 30
249 Dysphagia Diagnosis – Surface EMG 30
250 Dysphagia Diagnosis – Breathing-Swallowing Discoordination Test 30
251 Dysphagia Diagnosis – Ultrasound 30
252 Dysphagia Diagnosis – Others 10
253 Dysphagia Treatment – Neuromuscular Training 10
254 Dysphagia Treatment – Sensory-motor Training 10
255 Dysphagia Treatment – Electromagnetic Intervention 10
256 Dysphagia Treatment – Others 10
168 Pelvis Sling 25
169 Repair (orthosis brace) 10
170 SOMI Brace 50
171 Shoe Modification (Meta Tarsal Pad) 4
172 Shoe Modification (soft pads) 5
173 Shoe modification (lateral wedges) 4
174 Shoe Modification (heel rise) 4
175 Shoe Modification (longitudinal arch support) 4
176 Shoe Modification (Meta Tarsal bar, heel raise) 6
177 Shoe Modification (M.T. bar) 4
178 Shoe Modification (medial wedges) 4
179 Shoe Modification (anterior elongation) 5
180 Shoe Modification (arch support + medial wedges) 5
181 Shoe Modification (shoe raise) 5
182 Shoe Modification (soft heel and sole pad) 6
183 Shoe Modification (toe filler) 6
184 Shoulder Prosthesis 350
185 Spinal Brace for Scoliosis 50
186 Static Wrist Hand Orthosis 6
187 Symes Prosthesis (through ankle prosthesis) 200
188 Thoracic Lumbar Sacral Orthosis (TLSO) 30
189 Taylor Brace 35
190 Through Knee Prosthesis 500
191 Tibial Fracture Brace 50
192 Weight Relieving Ankle Foot Orthosis 50
193 Weight Relieving Knee Ankle Foot Orthosis 200
194 Shoe Modification (lateral sole patch) 4
195 Shoe Modification (medial sole patch) 4
196 Shoe Modification (lateral sole patch + medial border) 5
197 Soft Insole 8
198 Hard Insole 6
199 Congenital Talipes Equinovarus (C.T.E.V) Shoes 40
200 Ankle Foot Orthosis (ready made) 20
201 Hallux Valgus Splint 5
202 Air Cast Walker 40
203 Cervical Orthosis 6
204 Partial Foot Prosthesis 15
205 Stump Shrinker (Above Knee) 8
206 Stump Shrinker (Below Knee) 5
207 Prosthetic Knee Sleeve 15
208 Perlon Cosmetic Stockinette 2
209 Stump Socks Wool 5
210 Stump Socks Terry 2
211 Shoe Modification 5
257 Tracheostomy Care – Rehabilitation 10
258 Speech Valve Fitting 10
259 Gross Motor Training 10
260 Preparatory Exercise for Occupational Therapy 10
261 Hand Writing Evaluation 10
262 Sensory Integration 10
263 Ergonomics 15
264 Fine Motor Exercises 10
265 Splinting (occupational therapy) 15
266 Oral- Motor Rehabilitation 15
267 Cognitive Rehabilitation (e.g. memory, attention, perception activities) 15
268 Sensory Reeducation/ Desensitization Technique 15
269 Functional Mobility Training 10
270 Reevaluation (occupational therapy) 10
271 Pre-Vocational/Vocational Training 15
272 Fall Prevention Training 10
273 Pre-School & School Activity Training 10
274 Individual Counseling (occupational therapy) 10
275 Patient/Family Education (occupational therapy) 10
276 Therapeutic Arts & Crafts 15
277 Functional Performance Maintenance 10
278 Occupational Discharge Planning 10
279 Other Occupational Therapy Interventions 10
280 Energy Conservation Techniques 10
281 Home Program (occupational therapy) 10
282 Optimizing Leisure Pursuit 10
283 Proprioceptive Neuromuscular Facilitation (PNF)/Neuro-Developmental

Treatment (NDT)

10
284 Visual Perceptual Therapy 10
285 Return-to-Work Evaluation 15
286 Edema Control 10
287 Assessment (occupational therapy) 10
288 Developmental Therapy 10
289 Home Visit (occupational therapy) 15
290 Group Therapy (occupational therapy) 10
291 Therapeutic Horticulture 10
292 Sleep Management 10
293 Scar Management 10
294 Positioning/Transferring Techniques 10
295 Wheelchair/Seating Training 10
296 Pressure Garment 15
297 Sensory Modulation 15
298 Assistive Devices/Adaptation (occupational therapy) 15
299 Masticatory Exercises 10
300 Breathing/Respiration Exercises 10
301 Chest Physiotherapy 10
302 Communication Training for Deaf Person (e.g. lip reading, finger reading) 10

الملحق رقم (١٢)
رسوم الخدمات الإضافية

الخدمة مستحق للعلاج مجانا (ر.ع) غير مستحق للعلاج مجانا (ر.ع)
رسوم للحجاج والمعتمرين ٢ ١٠
توفير قرص مدمج لنتائج الفحوصات الطبية ٥ لكل قرص مدمج لنتائج الفحوصات في وحدات العناية المركزية وأقسام الطوارئ
التقارير الطبية ٣ للتقارير الورقية للعمانيين ومواطني دول مجلس التعاون الخليجي ١٥ للتقارير الورقية ١٨ للتقارير على قرص مدمج
٥ للتقارير الورقية لبقية الفئات المستحقة للعلاج المجاني
١٠٠ بيسة عند طلب إضافة ورقة من أوراق التقرير الطبي
استخدام سيارة إسعاف بدون تغطية طبية ٥٠ إذا كانت المسافة لا تتجاوز بين نقطة انطلاق السيارة ونقطة الوصول (٢٠٠) كيلومتر
١٠٠ إذا كانت المسافة بين نقطة انطلاق السيارة ونقطة الوصول تزيد على (٢٠٠) كيلومتر
استخدام سيارة إسعاف مع تغطية طبية ١٠٠ إذا كانت المسافة لا تتجاوز بين نقطة انطلاق السيارة ونقطة الوصول (٢٠٠) كيلومتر
١٥٠ إذا كانت المسافة بين نقطة انطلاق السيارة ونقطة الوصول تزيد على (٢٠٠) كيلومتر
تحنيط جثة ١٢٠
حفظ جثة ١٠ عن كل يوم من اليوم السادس إلى اليوم العاشر
٢٠ عن كل يوم ما بعد اليوم العاشر