Himcare Scheme General Surgery Package

Specialty code Package Code Package name Package Amount Preauth Required or Not (Y/N) Mandatory investigations for pre-auth Post-Op investigations for claims submission Average length of Stay (Including Days in intensive care units) Govt Reserved Procedure (Y/N) Medical (M) or Surgical (S)
S1 0001 Adventious Burse – Excision 10,000 N     3 N S
S1 0002 Anterior Resection for CA 15,000 N     4 N S
S1 0003 Appendicectomy 10,000 N     2 N S
S1 0004 Appendicular Abscess – Drainage 12,000 N     2 N S
S1 0005 Arteriovenous (AV) Malformation of Soft Tissue Tumour – Excision 15,000 N     3 N S
S1 0006 Bakers Cyst – Excision 6,000 Y Clinical Record   3 N S
S1 0007 Uni Inguinal block dissection 13,000 Y CT Scan   3 N S
S1 0008 Bleeding Ulcer – Gastrectomy & vagotomy 25,000 N     5 N S
S1 0009 Bleeding Ulcer – Partial Gastrectomy 25,000 N     5 N S
S1 0010 Block dissection Cervical Nodes 10,000 N     3 N S
S1 0011 Branchial Fistula 14,000 Y Clinical Record   3 N S
S1 0012 Breast Lump – Excision 6,000 Y Clinical Record   2 N S
S1 0014 Branchial Cyst 10,000 Y Clinical Record   2 N S
S1 0015 Bursa – Excision 2,000 N     2 N S
S1 0016 Bypass – Inoperable Pancreas 15,000 Y Ultrasound/CT Scan   4 N S
S1 0017 Cervial Lymphnodes – Excision 2000 Y CT Scan   1 N S
S1 0018 Colostomy 10,000 Y Clinical Picture   4 N S
S1 0019 Cyst over Scrotum – Excision 2,000 Y Clinical Picture   1 N S
S1 0020 Cystic Mass – Excision 2,000 Y Clinical Picture   1 N S
S1 0022 Dermoid Cyst –  Excision 2,000 Y Clinical Picture   D N S
S1 0023 Drainage of Ischio Rectal Abscess 4,000 N     1 N S
S1 0024 Incision and Drainage of large Abscess 4,000 N     D N S
S1 0025 Drainage of Psoas Abscess 7,500 N     2 N S
S1 0026 Drainage of Subdiaphramatic Abscess 10,000 N     3 N S
S1 0027 Drainage Pericardial Effusion 13,750 N     5 N S
S1 0028 Duodenal Diverticulum 20,000 Y Clinical Record   5 N S
S1 0029 Duodenal Jejunostomy 20,000 Y Clinical Record   5 N S
S1 0030 Duplication of Intestine 18,000 Y Clinical Record   5 N S
S1 0031 Hydrocele + Orchidectomy 8,000 Y Clinical Record   2 N S
S1 0032 Epidedectomy 8,000 Y Clinical Record   3 N S
S1 0033 Epididymal Swelling –Excision 4,000 N     2 N S
S1 0034 Epidymal Cyst 4,000 Y Clinical Record   D N S
S1 0035 Evacuation of Scrotal Hematoma 2,000 N     2 N S
S1 0036 Excision Benign Tumor -Small intestine 15,000 Y Clinical Record   5 N S
S1 0037 Excision Bronchial Sinus 8,000 Y Clinical Record   D N S
S1 0038 Drainage of liver Abscess 8,000 Y Ultrasound   3 N S
S1 0039 Excision Filarial Scrotum 4,000 Y Clinical Picture   3 N S
S1 0040 Excision Mammary Fistula 5,000 Y Clinical Record   2 N S
S1 0041 Excision Meckel’s Diverticulum 15,000 Y Contrast Studies   3 N S
S1 0042 Excision Pilonidal Sinus 8,000 Y Clinical Record   2 N S
S1 0043 Excision Small Intestinal Fistula 15,000 Y Clinical Record   5 N S
S1 0044 Excision of Growth from Tongue only 6,000 Y Clinical Picture   1 N S
S1 0045 Excision of Growth from Tongue with neck node dissection 15,000 Y Clinical Picture   4 N S
S1 0047 Excision of  Swelling in Hand 2,000 N     D N S
S1 0049 Excision of Neurofibroma 3,000 N     2 N S
S1 0050 Exicision of Sinus and Curettage 5,000 N     2 N S
S1 0051 Fibroadenoma – Bilateral 8,000 Y Clinical Record   2 N S
S1 0052 Fibrodenoma – Unilateral 5,000 Y Clinical Record   2 N S
S1 0053 Fissurectomy 8,000 N     2 N S
S1 0054 Fissurectomy and Haemorrhoidectomy 10,000 N     2 N S
S1 0055 Eversion of Hydrocele Sac – Bilateral 6,000 Y Ultrasound   2 N S
S1 0056 Eversion of Hydrocele Sac – Unilateral 4,000 Y Ultrasound   2 N S
S1 0057 Fissurectomy with Sphincterotomy 15,000 N     2 N S
S1 0058 Foreign Body Removal in Deep Region requiring GA 5,000 N     2 N S
S1 0059 Fundoplication 20,000 Y Clinical Record   3 N S
S1 0060 G J Vagotomy/ Vagotomy + Pyloroplasty 15,000 Y Clinical Record   5 N S
S1 0062 Ganglion -Excision 2,000 N     D N S
S1 0063 Gastrojejunostomy 15,000 Y Contrast Studies   4 N S
S1 0064 Gastrostomy 15,000 Y Contrast Studies   4 N S
S1 0065 Graham’s Operation for duodenal perforation 15,000 N     5 N S
S1 0066 Granuloma – Excision 2,000 N     1 N S
S1 0067 Haemangioma – Excision 8,000 Y Clinical Record   3 N S
S1 0070 Hepatic Resection (lobectomy) 20,000 Y CT Scan   7 N S
S1 0071 Hernia – Epigastric 10,000 Y Clinical Record   2 N S
S1 0072 Hernia – Incisional 10,000 Y Clinical Record   3 N S
S1 0073 Hernia – Repair & release of obstruction 15,000 Y Clinical Record   3 N S
S1 0074 Hernia – Umbilical 10,000 Y Clinical Record   3 N S
S1 0075 Hernia – Femoral 10,000 Y Clinical Record   2 N S
S1 0076 Hernioplasty – Inguinal 10,000 Y Clinical Record   3 N S
S1 0077 Herniorraphy-Inguinal 9,000 Y Clinical Record   2 N S
S1 0078 Hiatus Hernia – abdominal 15,000 Y Clinical Record   5 N S
S1 0079 Hydatid Cyst of Liver 15,000 Y CT Scan   3 N S
S1 0080 Hydrocele – Excision – Unilateral 5,000 Y Clinical Record   2 N S
S1 0081 Hydrocele – Excision – Bilateral 8,000 Y Clinical Record   2 N S
S1 0082 IlieoSigmoidostomy 17,000 Y Contrast Studies   5 N S
S1 0083 Infected Bunion Foot – Excision 4,000 N     1 N S
S1 0084 Inguinal Node (dissection) – Unilateral 3,000 N     2 N S
S1 0085 Intestinal perforation 12,500 N     5 N S
S1 0086 Intestinal Obstruction 12,500 N     5 N S
S1 0087 Intussusception 15,000 N     6 N S
S1 0088 Jejunostomy 10,000 N     5 N S
S1 0089 Gastric Perforation 15,000 N     5 N S
S1 0090 Intestinal Perforation (Resection Anastomosis) 20,000 N     5 N S
S1 0091 Appendicular Perforation 15,000 N     5 N S
S1 0093 Closure of Hollow Viscus Perforation 15,000 N     5 N S
S1 0094 Laryngectomy & Pharyngeal Diverticulum (Throat) 15,000 N     3 N S
S1 0095 Ileostomy 10,000 N     4 N S
S1 0096 Lipoma excision 2,000 N     D N S
S1 0097 Loop Colostomy Sigmoid 12,000 N     4 N S
S1 0098 Mastectomy 12,000 N     2 N S
S1 0099 Mesenteric Cyst – Excision 15,000 Y Clinical Record   3 N S
S1 0100 Mesenteric Caval Anastomosis 15,000 Y Clinical Record   5 N S
S1 0102 Oeshophagoscopy for foreign body removal 5,000 N     D N S
S1 0103 Oesophagectomy 17,500 Y CT Scan   5 N S
S1 0104 Portal Hypertension shunt surgery t 18,000 Y Clinical Record   5 N S
S1 0105 Pelvic Abscess – Open Drainage 10,000 N     4 N S
S1 0106 PancreaticoDuodenectomy 25,000 Y CT Scan   6 N S
S1 0107 Distal Pancreatectomy with PancreaticoJejunostomy t 25,000 Y CT Scan   7 N S
S1 0108 Papilloma Rectum – Excision 4,000 N     2 N S
S1 0109 Haemorroidectomy+ Fistulectomy 10,000 Y Clinical Records   2 N S
S1 0110 Growth in the Scalp – Excision 2,000 N     1 N S
S1 0111 Porto Caval Anastomosis 15,000 Y Clinical Records   5 N S
S1 0112 Pyeloroplasty 10,000 Y Clinical Records   4 N S
S1 0113 Radical Mastectomy 12,000 Y Clinical Records   2 N S
S1 0114 Radical Neck Dissection – Excision 15,000 Y Clinical Records   6 N S
S1 0115 Hernia – Spigelian 5,000 Y Clinical Records   3 N S
S1 0116 Rectal Dilation 2,000 N     1 N S
S1 0117 Prolapse of Rectal Mass – Excision 10,000 N     2 N S
S1 0118 Rectopexy 10,000 Y Clinical Records   3 N S
S1 0119 Repair of Common Bile Duct 15,000 N     3 N S
S1 0120 Resection Anastomosis (Large Intestine) 15,000 Y Clinical Records   7 N S
S1 0121 Resection Anastomosis (Small Intestine) 15,000 Y Clinical Records   7 N S
S1 0122 Retroperitoneal Tumor – Excision 20,000 Y CT Scan   5 N S
S1 0123 Haemorroidectomy 5,000 Y Clinical Records   2 N S
S1 0124 Salivary Gland – Excision 10,000 Y Clinical Records   3 N S
S1 0125 Segmental Resection of Breast 10,000 Y Clinical Records   3 N S
S1 0126 Scrotal Swelling (Multiple) – Excision 5,000 N     2 N S
S1 0127 Sigmoid Diverticulum 15,000 Y Contrast Studies   6 N S
S1 0128 Simple closure – Peptic perforation 15,000 N     5 N S
S1 0129 Sinus – Excision 5,000 N     2 N S
S1 0130 Soft Tissue Tumor  – Excision 2,000 N     2 N S
S1 0132 Splenectomy 20,000 N     6 N S
S1 0133 Submandibular Lymph node – Excision 2,000 N     2 N S
S1 0134 Submandibular Mass Excision + Reconstruction 20,000 Y CT Scan    5 N S
S1 0135 Swelling in foot  – Excision 2,000 N     D N S
S1 0137 Coloectomy – Total 20,000 Y CT Scan   6 N S
S1 0138 Pharyngectomy& Reconstruction – Total 20,000 Y CT Scan   6 N S
S1 0139 Tracheal Stenosis (End to end Anastamosis) (Throat) 15,000 Y Clinical Records   6 N S
S1 0140 Tracheoplasty (Throat) 15,000 Y Clinical Records   6 N S
S1 0141 Umbilical Sinus – Excision 5,000 N     2 N S
S1 0142 Varicose Veins – Excision and Ligation 10,000 Y Clinical Records   3 N S
S1 0143 Vasovasostomy 12,000 Y Clinical Records   3 N S
S1 0144 Volvulus of Large Bowel 25,000 N     4 N S
S1 0145 Cleft lip operation 12,000 Y Clinical Picture   2 N S
S1 0146 Cleft palate repair (for each stage) 12,000 Y Clinical Picture   2 N S
S1 0147 Cleft lip & palate operation (for each stage) 15,000 Y Clinical Picture   5 N S
S1 0148 Aneurysm not Requiring Bypass Techniques t 36,000 Y CT Scan     N S
S1 0149 Aneurysm Resection & Grafting 36,000 Y CT Scan     N S
S1 0150 Arterial Embolectomy 10,000 N       N S
S1 0151 Carotid artery aneurysm repair 20,000 Y CT Scan      N S
S1 0152 Carotid Body tumour – Excision 20,000 Y CT Scan     N S
S1 0153 Cholecystectomy & Exploration of CBD 20,000 N     6 N S
S1 0154 Cholecystostomy/Cholecystectomy 10,000 N     6 N S
S1 0155 Congential Arteriovenus Fistula (large) 20,000 Y CT Angio     N S
S1 0156 Congential Arteriovenus Fistula (small) 10,000 Y CT Angio     N S
S1 0157 Decortication (Pleurectomy) 20,000 Y CT Angio     N S
S1 0158 Dissecting Aneurysms 36,000 Y CT Angio     N S
S1 0159 Distal Abdominal Aorta repair 36,000 Y CT Angio     N S
S1 0160 Estlander Operation (lip) 7,000 Y Clinical Record   1 N S
S1 0161 Excision and Skin Graft of Venous Ulcer 15,000 Y Clinical Record     N S
S1 0162 Excision of Parathyroid Adenoma/Carcinoma 22,000 Y Clinical Record     N S
S1 0163 Flap Reconstructive Surgery 20,000 Y Clinical Record     N S
S1 0164 Split thickness skin grafts – Small (< 4% TBSA) 5,000 Y Clinical Record   D N S
S1 0165 Split thickness skin grafts – Medium (4 – 8% TBSA) 10,000 Y Clinical Record   D N S
S1 0166 Split thickness skin grafts – Large (> 8% TBSA) 15,000 Y Clinical Record   D N S
S1 0167 Free Grafts – Wolfe Grafts 8,000 Y Clinical Record     N S
S1 0168 Hemi thyroidectomy 10,000 Y Clinical Record     N S
S1 0169 Total thyroidectomy 20,000 Y Clinical Record     N S
S1 0170 Laparoscopic Hernia Repair 18,000 Y Clinical Record   3 N S
S1 0171 Lap. Assisted left Hemi colectomy t 25,000 Y Clinical Record   5 N S
S1 0172 Lap. Assisted Right Hemi colectomy t 25,000 Y Clinical Record   5 N S
S1 0173 Lap. Assisted small bowel resection 15,000 Y Clinical Record   3 N S
S1 0174 Lap. Assisted Total Colectomy 25,000 Y Clinical Record   5 N S
S1 0175 Lap. Cholecystectomy & CBD exploration 20,000 Y Clinical Record   3 N S
S1 0176 Lap. For intestinal obstruction 15,000 Y Clinical Record   5 N S
S1 0177 Lap. Hepatic resection 25,000 Y Clinical Record   5 N S
S1 0178 Lap. Hydatid of liver surgery 25,000 Y CT Scan   5 N S
S1 0180 Laparoscopic Appendicectomy 15,000 N     3 N S
S1 0181 Laparoscopic Cholecystectomy 15,000 Y Ultrasound   5 N S
S1 0182 Laparoscopic cystogastrostomy 20,000 Y Clinical Record   5 N S
S1 0183 Laparoscopic Gastrostomy 12,000 Y Clinical Record   5 N S
S1 0184 Laparoscopic Hiatus Hernia Repair 22,000 Y Clinical Record   5 N S
S1 0185 Laparoscopic Pyloromyotomy 20,000 Y Clinical Record   5 N S
S1 0186 Laparoscopic Rectopexy 15,000 Y Clinical Record   5 N S
S1 0187 Laparoscopic Spleenectomy 20,000 Y Clinical Record   5 N S
S1 0188 Laparoscopic umbilical hernia repair 15,000 Y Clinical Record   5 N S
S1 0189 Laparoscopic ventral hernia repair 20,000 Y Clinical Record   5 N S
S1 0190 Laparotomy-peritonitis lavage and drainage 10,000 Y Clinical Record   5 N S
S1 0191 Ligation of Ankle Perforators 5,000 N     3 N S
S1 0192 Lymphatics Excision of Subcutaneous Tissues In Lymphoedema 10,000 Y Clinical Picture    3 N S
S1 0193 Repair of Main Arteries of the Limbs 25,000 Y Clinical Record   5 N S
S1 0194 Mediastinal Tumour 20,000 N       N S
S1 0195 Oesophagectomy for Carcinoma Oesophagus 25,000 Y CT Scan   7 N S
S1 0196 Operation for Bleeding Peptic Ulcer 15,000 N     5 N S
S1 0197 Operation for Carcinoma Lip – Vermilionectomy 10,000 Y Clinical Record   6 N S
S1 0198 Operation for Carcinoma Lip – Wedge Excision and Vermilionectomy 12,000 Y Clinical Record   6 N S
S1 0199 Operation for Carcinoma Lip – Wedge-Excision 10,000 Y Clinical Record   6 N S
S1 0200 Appendicectomy – Appendicular Abscess – Drainage 12,000 N     5 N S
S1 0201 Caecostomy 10,000 Y Clinical Record     N S
S1 0202 Closure of Colostomy 5,000 Y Clinical Record     N S
S1 0203 Coccygeal Teratoma Excision 20,000 Y CT Scan     N S
S1 0204 Congenital Atresia & Stenosis of Small Intestine 20,000 Y Barium Study     N S
S1 0205 CystoJejunostomy/or Cystogastrostomy 20,000 Y Clinical Record     N S
S1 0206 Drainage of perivertebral abscess 10,000 N       N S
S1 0207 Hernia -hiatus-Transthoracic 20,000 Y Clinical Record   5 N S
S1 0208 Intercostal drainage 2,000 N       N S
S1 0209 Operation for carcinoma lip- cheek advancement 12,000 Y Clinical Record   5 N S
S1 0210 Thymectomy 20,000 Y Clinical Record     N S
S1 0211 Operation of Choledochal Cyst 15,000 Y Clinical Record   5 N S
S1 0212 Operations for Acquired Arteriovenous Fistula 15,000 Y Clinical Record     N S
S1 0213 Operations for Replacement of Oesophagus by Colon 25,000 Y Clinical Record   7 N S
S1 0214 Hemodialysis per sitting 2,000 N     D N S
S1 0215 Parapharyngeal Tumour Excision 20,000 Y CT Scan     N S
S1 0216 Partial/Subtotal Gastrectomy for Carcinoma 22,000 Y CT Scan     N S
S1 0217 Patch Graft Angioplasty 20,000 Y  CT Angio     N S
S1 0218 Pericardiostomy 30,000 N       N S
S1 0219 Pneumonectomy 25,000 N       N S
S1 0220 Removal of Foreign Body from Trachea or Oesophagus 5,000 N       N S
S1 0221 Removal Tumours of Chest Wall 20,000 Y CT Scan+ Clinical Photo     N S
S1 0223 Resection Enucleation of Adenoma (lung) 10,000 N       N S
S1 0224 Rib Resection & Drainage 10,000 N       N S
S1 0225 Skin Flaps – Rotation Flaps 6,200 N       N S
S1 0226 Splenectomy – For Trauma 20,000 N       N S
S1 0227 Surgery for Arterial Aneurism Spleen Artery 20,000 N       N S
S1 0228 Surgery for Arterial Aneurism –Vertebral 25,000 N       N S
S1 0229 Sympathetectomy – Cervical 5,000 N       N S
S1 0230 Temporal Bone resection 15,000 N       N S
S1 0232 Thoracocentesis 1,500 Y Clinical Record     N S
S1 0233 Thoracoplasty 20,000 Y Clinical Record     N S
S1 0234 Thoracoscopic Decortication 25,000 Y Clinical Record     N S
S1 0235 Thoracoscopic Hydatid Cyst excision 20,000 Y Clinical Record     N S
S1 0236 Thoracoscopic Lobectomy 25,000 Y Clinical Record     N S
S1 0237 Thoracoscopic Pneumonectomy 30,000 Y Clinical Record     N S
S1 0238 Thoracoscopic Segmental Resection 25,000 Y Clinical Record     N S
S1 0239 Thoracoscopic Sympathectomy 15,000 Y Clinical Record     N S
S1 0240 Thrombendarterectomy 15,000 N       N S
S1 0241 Thorax (penetrating wounds) 12,500 N       N S
S1 0242 Total Thyroidectomy and Block Dissection 20,000 Y Clinical Record     N S
S1 0243 Trendelenburg Operation 10,000 N       N S
S1 0244 Debridement of Ulcer-Leprosy 5,000 Y Clinical Record     N S
S1 0245 Tissue Reconstruction Flap Leprosy 25,000 Y Clinical Record     N S
S1 0246 Tendon Transfer-Leprosy 25,000 Y Clinical Record     N S
S1 0248 Hernia – Repair & release of obstruction+ Hernioplasty 15,000 N       N S
S1 0249 Aspiration of cold Abscess of Lymphnode 1,000 N       N S
S1 0250 Aspiration of Empyema 2,000 N       N S
S1 0251 AV Shunt for dialysis 6,000 N       N S
S1 0252 Peritoneal dialysis per sitting 2,500 N       N S
S1 0253 Vasectomy 2,000 N       N S
S1 0254 Abdomino perineal resection 17500 N       N S
S1 0255 Caecopexy 13000 N       N S
S1 0256 Carbuncle back 2000 N       N S
S1 0259 Colocystoplasty 15000 Y Pyelography     N S
S1 0260 Diverticulectomy  15000 N       N S
S1 0261 Dorsal slit and reduction of paraphimosis 1500 N       N S
S1 0262 Drainage of peripherally gastric absces 8000 N       N S
S1 0263 Duodenectomy 20000 Y Clinical Record     N S
S1 0264 Dupcrytren (duputryen contracture?) 10000 Y Clinical Record     N S
S1 0265 Facial Nerve decompression 15000 Y Clinical Record     N S
S1 0267 Fibroma -Excision 2000 N       N S
S1 0268 Fistula repair 5000 N       N S
S1 0269 Fulguration 2000 N       N S
S1 0274 Hemi glossectomy 10000 N       N S
S1 0275 Hemi thyroplasty 12000 N       N S
S1 0280 Anorectoplasty 14000 N       N S
S1 0282 Laryngo Fissure (Throat) 12500 Y Clinical Photograph +Investigations     N S
S1 0283 Laryngopharyngectomy (Throat) 12000 N       N S
S1 0286 Orchidopexy  6000 N       N S
S1 0290 Sebaceous cyst- excision 1200 N       N S
S1 0291 Superficial parotidectomy 10000 N       N S
S1 0293 Thyroplasty 11000 N       N S
S1 0294 Warren shunt 15000 Y CT Angio     N S
S1 0295 Abbe Operation 7500 Y Clinical Photograph+ Investigations     N S
S1 0296 Aorta-Femoral bypass 25000 Y CT Angio     N S
S1 0297 Diagnostic laproscopy 4000 N       N S
S1 0298 DRESSING UNDER GA 1500 N       N S
S1 0299 Examination under anesthesia 1500 N       N S
S1 0300 Excision of corns 250 N       N S
S1 0301 Excision of moles 300 N       N S
S1 0302 Excision of molluscumcontagiosum 350 N       N S
S1 0304 Excision of superficial neurofibroma 300 N       N S
S1 0305 Excision of thyroglossal cyst/fistula 7000 N       N S
S1 0306 Femoropopliteal by pass procedure 23500 Y CT Angio     N S
S1 0310 Haemorrhoid- injection 500 N       N S
S1 0314 Isthmectomy 7000 N       N S
S1 0315 Laproscopic Adrenalectomy 12000 N       N S
S1 0317 Laproscopic donor Nephrectomy 15000 N       N S
S1 0318 Laproscopic Pyelolithotomy 15000 N       N S
S1 0320 Laproscopic ureterolithotomy 14000 N       N S
S1 0321 Drainage of perinephric abscess 8500 N       N S
S1 0323 Excision I/d injection keloid (per site) 250 N       N S
S1 0324 Incision and drainage of abscess 750 N       N S
S1 0326 Operation for stenosis of renal arteries 24000 N       N S
S1 0327 Partial pericardectomy 14500 N       N S
S1 0329 Phimosis under LA 1000 N       N S
S1 0330 Renal artery aneurysm and disection 28000 N       N S
S1 0333 Surgery for arterial aneursysm renal  artery 15000 Y CT Angio     N S
S1 0334 Suturing of wounds withlocal anesthesia 200 N       N S
S1 0336 Temporary Pacemaker implantation 10000 N       N S

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