| 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) |
| S4 | 0001 | Hysterectomy ± Salpingo-oophorectomy | 20,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0002 | Abdominal Myomectomy | 16,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0003 | Surgeries for Prolapse – Sling Surgeries | 16,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0004 | Surgeries for Stress Incontinence ‘Burch’ | 35,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0005 | Hysterotomes – 2nd Trimester abortions | 5,000 | Y | Ultrasound | | D | | S |
| S4 | 0006 | Incisional Hernia Repair | 15,000 | Y | Clinical Picture | | 3 | | S |
| S4 | 0007 | Radical Hysterectomy (Wertheims) | 25,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0008 | Laparotomy and proceed for Ovarian Cancers. Omentomy with Bilateral Salpingo-oophorectomy | 25,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0009 | Non descent vaginal hysterectomy | 14,000 | Y | Ultrasound | | 4 | | S |
| S4 | 0010 | Vaginal hysterectomy with anterior and posterior colpoperineorrhaphy | 16,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0011 | Vaginal surgical repair for vesico-vaginal fistula | 20,000 | Y | Cystography | | 5 | | S |
| S4 | 0012 | Sacrocolpopexy | 16,000 | Y | Ultrasound | | 7 | | S |
| S4 | 0013 | Repair for rectovaginal fitulas | 10,000 | Y | Ultrasound | | 3 | | S |
| S4 | 0014 | Vaginoplasty | 10,000 | Y | | | 3 | | S |
| S4 | 0015 | LLETZ | 3000 | Y | Clinical Picture | | 3 | | S |
| S4 | 0016 | Colpotomy | 1,200 | N | | | D | | S |
| S4 | 0017 | Dilation and Evacuation (D&E) | 1,000 | N | | | D | | S |
| S4 | 0018 | Cervical biopsy and Polypectomy | 3,000 | N | | | D | | S |
| S4 | 0019 | Bartholins Cyst Enucleation/ Incision drainage | 3,000 | N | | | D | | S |
| S4 | 0020 | Vulvectomy simple | 15,000 | Y | CT Scan | | 3 | | S |
| S4 | 0021 | Radical Vulvectomy | 20,000 | Y | CT Scan | | 3 | | S |
| S4 | 0022 | Diagnostic laparoscopy | 4,000 | N | Ultrasound | | 3 | | S |
| S4 | 0023 | Laparoscopic hysterectomy (TLH) | 20,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0024 | Laparoscopic myomectomy | 15,000 | Y | Ultrasound | | 3 | | S |
| S4 | 0025 | Laparoscopic cystectomy | 15,000 | Y | Ultrasound | | 5 | | S |
| S4 | 0026 | Laparoscopic ovarotomy | 10,000 | Y | Ultrasound | | 3 | | S |
| S4 | 0027 | Laparoscopic adhesiolysis | 6,000 | Y | Ultrasound | | 1 | | S |
| S4 | 0028 | Laparoscopic tubal surgeries – salpingectomy, salpingotomy | 11,000 | Y | Ultrasound | | 3 | | S |
| S4 | 0029 | Drag hysteroscopy | 6,000 | Y | Ultrasound | | 1 | | S |
| S4 | 0030 | Hysteroscopic myomectomies | 6,000 | Y | Ultrasound | | 1 | | S |
| S4 | 0031 | Hysteroscopic adhesiolysis | 6,000 | Y | Ultrasound | | 1 | | S |
| S4 | 0032 | Hysteroscopic polypectomy | 3,000 | Y | Ultrasound | | 2 | | S |
| S4 | 0033 | Hysteroscopic IUCD removal | 3,000 | Y | Ultrasound | | 1 | | S |
| S4 | 0034 | Caesarian Delivery | 6,500 | N | | | 5 | | S |
| S4 | 0035 | Caesarian hysterectomy | 20,000 | N | | | 5 | | S |
| S4 | 0036 | High risk delivery: Pre-mature delivery | 9,000 | N | | | 3 | | |
| S4 | 0037 | High risk delivery: Expected Gestation at delivery less than 35 weeks | 9,000 | N | | | 3 | | |
| S4 | 0038 | High risk delivery: Mothers with eclampsia or imminent eclampsia | 9,000 | N | | | 3 | | |
| S4 | 0039 | High risk delivery: Obstructed labour | 9,000 | N | | | 3 | | |
| S4 | 0040 | High risk delivery: Major Fetal malformation requiring intervention immediately after birth | 9,000 | N | | | 3 | | |
| S4 | 0041 | High risk delivery: Mothers with severe anaemia (<7 g/dL) | 9,000 | N | | | 3 | | |
| S4 | 0042 | High risk delivery: Other maternal and fetal conditions as per guidelines-Such as Rh haemolytic disease, uncontrolled diabetes, severe growth retardation etc that qualify for high risk delivery etc. | 9,000 | N | | | 3 | | |
| S4 | 0043 | Manual removal of placenta | 5,000 | N | | | 2 | | S |
| S4 | 0044 | Laparotomy for ruptured ectopic | 10,000 | N | | | 5 | | S |
| S4 | 0045 | MTP > 12 weeks | 6,500 | N | | | 1 | | S |
| S4 | 0046 | MTP upto 12 weeks | 5,000 | N | | | 1 | | S |
| S4 | 0047 | MTP upto 8 weeks | 3,500 | N | | | 1 | | S |
| S4 | 0048 | McDonald’s stitch | 4,000 | N | | | D | | S |
| S4 | 0049 | Shirodkar’s stitch | 4,000 | N | | | D | | S |
| S4 | 0050 | Tuboplasty | 10,000 | N | | | 5 | | S |
| S4 | 0051 | Laparotomy for broad ligament haematoma | 16,000 | Y | Ultrasound | | 3 | | S |
| S4 | 0052 | Trans-vaginal tape/ Trans-obturator tape | 5,000 | Y | Ultrasound | | D | | S |
| S4 | 0053 | Abdominal Perineal neo construction Cx + Uteria + Vagina | 20,000 | Y | CT Scan | | | | S |
| S4 | 0054 | Ablation of Endometriotic Spot + Adhenolysis | 10,000 | Y | Ultrasound | | | | S |
| S4 | 0055 | Ablation of Endometriotic Spot +Salpingostomy | 10,000 | Y | Ultrasound | | | | S |
| S4 | 0056 | Adhenolysis + Hernia – Ventral – Lipectomy/Incision | 16,000 | Y | Ultrasound | | | | S |
| S4 | 0057 | Adhenolysis+ Ovarian Cystectomy | 10,000 | Y | Ultrasound | | | | S |
| S4 | 0058 | Adhenolysis+ Salpingostomy | 10,000 | Y | Ultrasound | | | | S |
| S4 | 0059 | Broad Ligment Haemotoma drainage | 10,000 | Y | Ultrasound | | | | S |
| S4 | 0060 | Brust abdomen repair | 14,000 | N | | | | | S |
| S4 | 0061 | Cone Biopsy Cervix | 1,000 | N | | | | | S |
| S4 | 0062 | Conventional Tubectomy | 1,000 | N | | | | | S |
| S4 | 0063 | Cyst -Vaginal Enucleation | 1,000 | N | | | | | S |
| S4 | 0064 | Cyst-Labial | 1,000 | N | | | | | S |
| S4 | 0065 | Cystocele – Anterior repair | 1,000 | N | | | | | S |
| S4 | 0066 | Cystocele – Anterior Repair + Perineal Tear Repair | 13,000 | Y | Cystography | | | | S |
| S4 | 0067 | D&C (Dilatation &curretage) + Electro Cauterisation Cryo Surgery | 1,500 | N | | | | | S |
| S4 | 0068 | D&C (Dilatation&curretage) | 1,000 | N | | | | | S |
| S4 | 0069 | Diagnostic laparoscopy & hysteroscopy for infertility | 5,000 | N | | | | | S |
| S4 | 0070 | Electro Cauterisation Cryo Surgery | 1,500 | N | | | | | S |
| S4 | 0071 | Exploration of abdominal haematoma (after laparotomy + LSCS) | 14,000 | N | | | | | S |
| S4 | 0072 | Fractional Curretage | 1,000 | N | | | | | S |
| S4 | 0073 | Gaping Perineal wound secondary suturing/ episiotomy | 2,500 | N | | | | | S |
| S4 | 0074 | HaematoColpo/Excision – Vaginal Septum | 5,000 | N | | | | | S |
| S4 | 0075 | Hymenectomy& Repair of Hymen | 1,000 | N | | | | | S |
| S4 | 0076 | Amniocentesis | 5,000 | Y | Clinical investigations | | D | | S |
| S4 | 0077 | Chorionic villus sampling | 5,000 | Y | Clinical investigations | | D | | S |
| S4 | 0078 | Cordocentesis | 5,000 | Y | Clinical investigations | | D | | S |
| S4 | 0079 | Intrauterine transfusions | 10,000 | Y | Clinical investigations | | D | | S |
