CGHS Hip Replacement Rate List: Total Hip Replacement Package Rates

CGHS reimburses total hip replacement (THR) at a fixed package rate at empanelled hospitals, with the hip prosthesis reimbursed separately against the prosthetics ceiling.

The Office Memorandum effective 13 October 2025 raised the THR package to Rs 1,09,650 at a non-NABH hospital, Rs 1,29,000 at a NABH hospital and Rs 1,48,350 at a super-speciality hospital.

CGHS Total Hip Replacement (THR) Package Rates (effective 13 October 2025)

Rates exclude the hip prosthesis. Implants such as lenses, stents, meshes and valves are reimbursed in addition to the package rate, 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.

• Total Hip Replacement (THR) (excluding the prosthesis), Non-NABH — Rs 1,09,650
• Total Hip Replacement (THR) (excluding the prosthesis), NABH — Rs 1,29,000
• Total Hip Replacement (THR) (excluding the prosthesis), Super Speciality — Rs 1,48,350
• THR revision, Stage I (excluding the prosthesis), Non-NABH — Rs 82,450
• THR revision, Stage I (excluding the prosthesis), NABH — Rs 97,000
• THR revision, Stage I (excluding the prosthesis), Super Speciality — Rs 1,11,550
• THR revision, Stage II (excluding the prosthesis), Non-NABH — Rs 1,09,650
• THR revision, Stage II (excluding the prosthesis), NABH — Rs 1,29,000
• THR revision, Stage II (excluding the prosthesis), Super Speciality — Rs 1,48,350

Partial Hip Replacement and Hip Fracture Fixation

These codes carry no separate super-speciality rate — a super-speciality hospital is billed the NABH figure.

• Hemiarthroplasty of the hip (excluding the prosthesis), Non-NABH — Rs 53,550
• Hemiarthroplasty of the hip (excluding the prosthesis), NABH — Rs 63,000
• Dynamic hip screw (DHS) for fracture neck of femur (excluding implants), Non-NABH — Rs 45,050
• Dynamic hip screw (DHS) for fracture neck of femur (excluding implants), NABH — Rs 53,000
• Proximal femoral nail (PFN) for intertrochanteric fracture (excluding implants), Non-NABH — Rs 45,050
• Proximal femoral nail (PFN) for intertrochanteric fracture (excluding implants), NABH — Rs 53,000
• Multiple pinning for fracture neck of femur (excluding implants), Non-NABH — Rs 45,050
• Multiple pinning for fracture neck of femur (excluding implants), NABH — Rs 53,000
• Pelvi-acetabular fracture, internal fixation (excluding implants), Non-NABH — Rs 53,550
• Pelvi-acetabular fracture, internal fixation (excluding implants), NABH — Rs 63,000

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

What is the CGHS package rate for hip replacement?

Under the rates effective 13 October 2025, total hip replacement is Rs 1,09,650 (non-NABH), Rs 1,29,000 (NABH) and Rs 1,48,350 (super-speciality), with the hip prosthesis reimbursed separately against the prosthetics ceiling.

Is the hip implant covered separately?

Yes, the hip prosthesis is reimbursed against the notified prosthetics ceiling list, over and above the surgery package.

What does CGHS pay for a partial hip replacement after a fracture?

Hemiarthroplasty of the hip is a separate code at Rs 53,550 (non-NABH) and Rs 63,000 (NABH). Fixation options for a fractured neck of femur, such as a dynamic hip screw or a proximal femoral nail, are Rs 45,050 (non-NABH) and Rs 53,000 (NABH), with the implant reimbursed separately.

Related

• Hip replacement cost in India (private hospitals)
• CGHS knee replacement 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.