CGHS Heart Valve Replacement Rate: Package Rates

CGHS reimburses heart valve replacement at a fixed package rate. The valve (implant) itself is reimbursed separately, over and above the surgery package.

Under the Office Memorandum effective 13 October 2025, single valve replacement is Rs 1,53,000 at a non-NABH hospital, Rs 1,80,000 at a NABH hospital and Rs 2,07,000 at a super-speciality hospital.

CGHS Heart Valve Replacement Package Rates (effective 13 October 2025)

Rates cover the procedure only — the valve is reimbursed separately against CGHS ceiling rates. The OM sets these rates for the semi-private ward: a general-ward entitlement is 5% lower and a private-ward entitlement 5% higher. Tier II cities are 10% lower and Tier III cities 20% lower than Tier I.

• Single valve replacement — mitral (MVR), aortic (AVR), tricuspid (TVR) or pulmonary (PVR), excluding the valve, Non-NABH — Rs 1,53,000
• Single valve replacement — mitral (MVR), aortic (AVR), tricuspid (TVR) or pulmonary (PVR), excluding the valve, NABH — Rs 1,80,000
• Single valve replacement — mitral (MVR), aortic (AVR), tricuspid (TVR) or pulmonary (PVR), excluding the valve, Super Speciality — Rs 2,07,000
• Double valve replacement (DVR), excluding the valves, Non-NABH — Rs 2,00,600
• Double valve replacement (DVR), excluding the valves, NABH — Rs 2,36,000
• Double valve replacement (DVR), excluding the valves, Super Speciality — Rs 2,71,400
• Valve repair — mitral, aortic, tricuspid or pulmonary, Non-NABH — Rs 1,53,000
• Valve repair — mitral, aortic, tricuspid or pulmonary, NABH — Rs 1,80,000
• Valve repair — mitral, aortic, tricuspid or pulmonary, Super Speciality — Rs 2,07,000
• Bentall repair with a prosthetic valve, excluding the valve, Non-NABH — Rs 2,32,900
• Bentall repair with a prosthetic valve, excluding the valve, NABH — Rs 2,74,000
• Bentall repair with a prosthetic valve, excluding the valve, Super Speciality — Rs 3,15,100
• Bentall repair with a biologic valve, excluding the valve, Non-NABH — Rs 2,00,600
• Bentall repair with a biologic valve, excluding the valve, NABH — Rs 2,36,000
• Bentall repair with a biologic valve, excluding the valve, Super Speciality — Rs 2,71,400
• Transcatheter aortic valve implantation (TAVI / TAVR) — procedure cost only, needs approval of the Director, CGHS, Non-NABH — Rs 85,000
• Transcatheter aortic valve implantation (TAVI / TAVR) — procedure cost only, needs approval of the Director, CGHS, NABH — Rs 1,00,000
• Transcatheter aortic valve implantation (TAVI / TAVR) — procedure cost only, needs approval of the Director, CGHS, Super Speciality — Rs 1,15,000
• Balloon mitral valvotomy / percutaneous transvenous mitral commissurotomy (PTMC), Non-NABH — Rs 82,450
• Balloon mitral valvotomy / percutaneous transvenous mitral commissurotomy (PTMC), NABH — Rs 97,000
• Balloon mitral valvotomy / percutaneous transvenous mitral commissurotomy (PTMC), Super Speciality — Rs 1,11,550
• Aortic or pulmonary valve balloon dilatation (AVBD / PVBD), Non-NABH — Rs 52,734
• Aortic or pulmonary valve balloon dilatation (AVBD / PVBD), NABH — Rs 62,040
• Aortic or pulmonary valve balloon dilatation (AVBD / PVBD), Super Speciality — Rs 71,346

Valve Implant Cost and Pre-Surgery Tests

The TAVI valve is the one valve the OM prices explicitly; surgical valves are reimbursed against separate CGHS ceiling rates.

• TAVI / TAVR implant — cost of the implant only, all hospital categories — Rs 12,84,000
• 2D echocardiography, Non-NABH — Rs 1,254
• 2D echocardiography, NABH — Rs 1,475
• 2D transoesophageal echocardiography (TEE), Non-NABH — Rs 1,403
• 2D transoesophageal echocardiography (TEE), NABH — Rs 1,650

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 all-inclusive of admission, surgeon and anaesthetist charges, operation theatre, nursing, routine investigations, medicines and accommodation for the standard stay. 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 it.

The figures on this page come from the Office Memorandum effective 13 October 2025. The published rate is the semi-private ward figure: a general-ward entitlement is 5% lower and a private-ward entitlement 5% higher, and hospitals in Tier II and Tier III cities are paid 10% and 20% less than in Tier I.

Referral and Prior Permission

Planned major procedures need a referral from the CGHS wellness centre and prior permission. Emergency treatment at an empanelled hospital is reimbursed up to CGHS rates without prior permission.

Frequently Asked Questions

What is the CGHS rate for valve replacement?

Under the rates effective 13 October 2025, replacement of a single valve (mitral, aortic, tricuspid or pulmonary) is Rs 1,53,000 (non-NABH), Rs 1,80,000 (NABH) and Rs 2,07,000 (super-speciality). Double valve replacement is Rs 2,00,600, Rs 2,36,000 and Rs 2,71,400. The valve itself is reimbursed separately.

Does CGHS cover TAVI?

Yes, with the approval of the Director, CGHS in consultation with the Special Technical Committee. The procedure is Rs 85,000 (non-NABH), Rs 1,00,000 (NABH) and Rs 1,15,000 (super-speciality), and the TAVI valve is listed separately at Rs 12,84,000, the same figure for every hospital category.

Related

• CGHS CABG (bypass) rate list
• What is coronary artery disease?

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.