CGHS Cataract Surgery Rate List: Phaco and IOL Package Rates

CGHS covers cataract surgery at a fixed package rate. Under the rates effective 13 October 2025, the package EXCLUDES the cost of the intraocular lens (IOL) — CGHS reimburses the IOL separately against its own notified ceiling rate.

CGHS Cataract Surgery Package Rates (effective 13 October 2025)

Rates exclude the cost of the intraocular lens (IOL), which CGHS reimburses separately against its own ceiling. Super-speciality hospitals are billed at the NABH rate for these procedures.

• Phaco with foldable IOL / PMMA IOL / MICS, per eye (excluding lens), Non-NABH — Rs 14,450
• Phaco with foldable IOL / PMMA IOL / MICS, per eye (excluding lens), NABH — Rs 17,000
• Small Incision Cataract Surgery (SICS) with IOL, per eye (excluding lens), Non-NABH — Rs 11,390
• Small Incision Cataract Surgery (SICS) with IOL, per eye (excluding lens), NABH — Rs 13,400
• Extracapsular cataract extraction (ECCE) with IOL, per eye (excluding lens), Non-NABH — Rs 11,390
• Extracapsular cataract extraction (ECCE) with IOL, per eye (excluding lens), NABH — Rs 13,400

Rates shown are as per the CGHS approved package rates (Office Memorandum F.No.5-16/CGHS(HQ)/HEC/2024(PartI) dated 03.10.2025, effective 2025-10-13) (2025 (effective 13.10.2025)) and are subject to periodic revision. Always verify the latest approved rates on the official source.

How CGHS Package Rates Work

A CGHS "package rate" is an all-inclusive amount covering admission, surgeon and anaesthetist charges, operation theatre, nursing, routine investigations, medicines and accommodation for the standard length of stay.

High-value implants such as knee and hip prostheses, coronary stents, meshes, spinal cages and heart valves are not part of the package and are reimbursed separately against notified implant ceiling rates.

Under the Office Memorandum effective 13 October 2025, a non-NABH hospital is paid 15% below the NABH rate, and for the specialities the memorandum names, a super-speciality hospital is paid 15% above the NABH rate.

The published rate is the semi-private ward figure: a general-ward entitlement is 5% lower and a private-ward entitlement 5% higher. Hospitals in Tier II cities are paid 10% less and in Tier III cities 20% less than Tier I. Consultations, investigations, radiotherapy, day-care and minor procedures are the same for every ward entitlement.

Referral and Prior Permission

For planned (non-emergency) major procedures, a CGHS beneficiary needs a referral from the CGHS wellness centre and prior permission from the competent authority. Emergency treatment at an empanelled hospital is reimbursed up to CGHS rates without prior permission.

• Carry a valid CGHS card and follow your ward entitlement (based on pay/pension)
• Use an empanelled hospital for cashless treatment up to CGHS rates
• Obtain prior permission and referral for planned surgery

Frequently Asked Questions

Does CGHS cover cataract surgery?

Yes. Phacoemulsification with a foldable IOL is covered at Rs 14,450 (non-NABH) / Rs 17,000 (NABH) under the rates effective 13 October 2025. The package EXCLUDES the cost of the IOL, which CGHS reimburses separately against its own ceiling.

Are premium (multifocal/toric) lenses covered by CGHS?

The package covers a standard IOL. Premium lenses cost more than the package and are generally not reimbursed beyond the package amount.

Related

• Cataract surgery cost in India (private hospitals)
• Cataract: causes, symptoms and treatment

Medical Disclaimer

The information provided in this article is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.