CGHS Hernia Repair Rate List: Open and Laparoscopic Package Rates

CGHS reimburses inguinal hernia repair at fixed package rates that depend on the technique (open herniorrhaphy, mesh hernioplasty, or laparoscopic repair).

CGHS Inguinal Hernia Repair Package Rates

• Open herniorrhaphy, Non-NABH — Rs 14,835
• Open herniorrhaphy, NABH — Rs 17,060
• Open hernioplasty (mesh), Non-NABH — Rs 16,500
• Open hernioplasty (mesh), NABH — Rs 18,975
• Laparoscopic inguinal hernia repair, Non-NABH — Rs 18,000
• Laparoscopic inguinal hernia repair, NABH — Rs 20,700

Rates shown are as per the CGHS approved package rates (Office Memorandum No. S.11045/36/2012-CGHS (HEC) dated 01.10.2014, as updated by city rate lists) (2014, periodically revised) and are subject to periodic revision. Always verify the latest approved rates on the official source.

City and Revision Differences

Some city rate lists updated after 2014 show higher hernia figures, so the exact amount depends on your CGHS city list and its revision date.

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 and spinal cages are not part of the package and are reimbursed separately against notified implant ceiling rates.

Rates for NABH-accredited hospitals are set 15% higher than the non-NABH rate. The same procedure code can show slightly 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) 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

What is the CGHS rate for hernia surgery?

Open mesh hernioplasty is about Rs 16,500 (non-NABH) and laparoscopic repair about Rs 18,000 (non-NABH), with NABH rates 15% higher. Figures vary by city list.

Related

• CGHS gallbladder (cholecystectomy) rate list

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.