CGHS Eye Surgery Rate List: Glaucoma, Retina (Vitrectomy), Squint and Pterygium

Cataract is not the only eye surgery CGHS covers — glaucoma, retinal (vitrectomy), squint and pterygium procedures all have notified package rates at empanelled hospitals.

The rates below are from the Delhi/NCR rate list; your CGHS city list may differ slightly.

CGHS Glaucoma Surgery Rates

• Trabeculectomy, Non-NABH — Rs 6,900
• Trabeculectomy, NABH — Rs 7,935
• Trabeculectomy with Trabeculotomy, Non-NABH — Rs 10,350
• Trabeculectomy with Trabeculotomy, NABH — Rs 11,903
• Glaucoma valve / Ahmed valve (implant, reimbursed separately) — Rs 12,750 (Non-NABH) / Rs 15,000 (NABH)

Retina, Squint and Pterygium Rates

• Vitrectomy (pars plana), Non-NABH — Rs 11,500
• Vitrectomy (pars plana), NABH — Rs 13,225
• Squint correction — one eye, Non-NABH / NABH — Rs 5,000 / Rs 5,750
• Squint correction — both eyes, Non-NABH / NABH — Rs 7,500 / Rs 8,625
• Pterygium surgery, Non-NABH / NABH — Rs 5,500 / Rs 6,325

Rates shown are as per the CGHS approved package rates, Delhi & NCR 2014 rate list (updated 25.05.2021) (2014, periodically revised) 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.

Rates for NABH-accredited hospitals are set higher (generally 15%) than the non-NABH rate. The same procedure code can show different figures across city rate lists and revision dates, so always check the list for your CGHS city.

Referral and Prior Permission

For planned (non-emergency) 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

Is the glaucoma valve included in the CGHS package rate?

No. The Ahmed/glaucoma valve is an implant reimbursed separately against its notified ceiling (Rs 12,750 non-NABH / Rs 15,000 NABH on the Delhi/NCR list), in addition to the surgery package.

Does CGHS cover retinal detachment surgery?

Yes, vitreoretinal procedures such as pars plana vitrectomy have notified CGHS package rates (Rs 11,500 non-NABH on the Delhi/NCR list). Confirm the exact code with the empanelled hospital.

Related

• CGHS cataract surgery rate list
• CGHS rate list for common procedures

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.