CGHS Rates for Ankle, Shoulder, Elbow, Wrist & Finger Joint Replacement

While hip and knee replacements are common orthopaedic procedures, severe arthritis and joint damage can also affect other parts of the body. For CGHS beneficiaries suffering from debilitating pain in the ankle, shoulder, elbow, wrist, or fingers, total joint replacement surgery can be a necessary intervention to restore function and relieve pain.

This page provides the Central Government Health Scheme (CGHS) approved package rates for these specific joint replacement surgeries. These procedures, known as arthroplasty, involve removing damaged parts of a joint and replacing them with artificial components (a prosthesis).

The rates provided are for the surgical procedure itself and are categorized based on whether the hospital holds NABH accreditation. The cost of the implant is typically separate. Refer to the detailed rate table for specific cost information, as rates vary by procedure and hospital tier.

CGHS Joint Replacement Rates — Ankle, Shoulder, Elbow, Wrist & Finger (effective 13 October 2025)

• Total Ankle Joint Replacement (TAR) - Unilateral, Non-NABH — Rs 1,09,650
• Total Ankle Joint Replacement (TAR) - Unilateral, NABH — Rs 1,29,000
• Total Ankle Joint Replacement (TAR) - Unilateral, Super Speciality — Rs 1,48,350
• Total Shoulder Joint Replacement - Unilateral, Non-NABH — Rs 1,09,650
• Total Shoulder Joint Replacement - Unilateral, NABH — Rs 1,29,000
• Total Shoulder Joint Replacement - Unilateral, Super Speciality — Rs 1,48,350
• Total Elbow Joint Replacement - Unilateral, Non-NABH — Rs 93,500
• Total Elbow Joint Replacement - Unilateral, NABH — Rs 1,10,000
• Total Elbow Joint Replacement - Unilateral, Super Speciality — Rs 1,26,500
• Total Wrist Joint Replacement - Unilateral, Non-NABH — Rs 1,09,650
• Total Wrist Joint Replacement - Unilateral, NABH — Rs 1,29,000
• Total Wrist Joint Replacement - Unilateral, Super Speciality — Rs 1,48,350
• Total Finger Joint Replacement, Non-NABH — Rs 53,550
• Total Finger Joint Replacement, NABH — Rs 63,000
• Total Finger Joint Replacement, Super Speciality — Rs 72,450

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.

Who this covers

This information is for all CGHS beneficiaries and their eligible dependents who have been medically advised by a specialist to undergo joint replacement surgery for a condition that has not responded to conservative treatments like medication and physical therapy.

The specific procedures covered on this page include:

• Total Ankle Joint Replacement (TAR) - Unilateral

• Total Shoulder Joint Replacement - Unilateral

• Total Elbow Joint Replacement - Unilateral

• Total Wrist Joint Replacement - Unilateral

• Total Finger Joint Replacement

These surgeries are typically recommended for patients with advanced conditions such as severe osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis that significantly impair joint movement and cause chronic pain.

What CGHS covers vs. what you pay separately

The CGHS package rate is a comprehensive charge that bundles the costs associated with the surgical procedure. This generally includes the surgeon and anaesthetist fees, operation theatre charges, standard medications and consumables used during the surgery, and the cost of a hospital stay for a duration specified by CGHS norms (e.g., General Ward, Semi-Private, or Private Ward, depending on the beneficiary's entitlement).

A crucial point to understand is that the cost of the artificial joint, or the implant/prosthesis itself, is not included in the surgical package rate. Beneficiaries are required to pay for the implant separately. CGHS has established ceiling prices for various types of implants. If the chosen implant's cost exceeds this ceiling, the patient must cover the difference.

Additionally, some high-cost drugs, specialized investigations, or non-standard consumables may also be billed separately. It is important to request a detailed cost estimate from the hospital's billing department before admission to understand the full financial responsibility.

How to use this at a CGHS-empanelled hospital

To avail the benefits for joint replacement surgery under CGHS, follow these general steps:

1. Obtain a medical opinion and a referral for the specific joint replacement surgery from a government hospital specialist or a CGHS medical officer.

2. Select a CGHS-empanelled private hospital that is equipped to perform the required orthopaedic surgery.

3. Present your CGHS card and the specialist's prescription/referral at the hospital's CGHS desk. The hospital will initiate the process for pre-authorization from CGHS.

4. The hospital will provide a cost estimate, which will show the CGHS package rate for the surgery and the separate cost of the implant and any other non-covered items. Confirm at the counter which rate (NABH or Non-NABH) is applicable to the hospital, as this depends on its accreditation status.

5. Once CGHS grants approval, the surgery can be scheduled. The beneficiary will need to pay for the implant and any other non-admissible expenses directly to the hospital. The hospital will bill CGHS directly for the approved package rate.

Frequently Asked Questions

Are the costs of the artificial joints (implants) included in the CGHS package rates?

No, the package rates listed are for the surgical procedure only. The cost of the prosthesis or implant is billed separately. CGHS has defined ceiling limits for what it will reimburse for an implant, and any cost beyond that limit must be paid by the beneficiary.

The rate for shoulder replacement is 'Unilateral'. What if I need surgery on both shoulders?

The term 'Unilateral' means the rate applies to a single side (one shoulder). If surgery is required on both shoulders, it will be treated as two distinct procedures. Each will require its own referral and pre-authorization from CGHS.

What is the difference between NABH and Non-NABH rates?

NABH (National Accreditation Board for Hospitals & Healthcare Providers) is a quality accreditation. CGHS allows hospitals with this accreditation to charge a higher package rate. The rate applied to your procedure depends on the hospital's accreditation status, not on a choice made by the patient.

Is prior permission required from CGHS for a total elbow replacement?

Yes, all total joint replacement surgeries are classified as major procedures and require prior permission from the relevant CGHS authority before you can undergo the surgery at an empanelled hospital on a cashless basis.

What does the CGHS surgery package typically include?

The package rate generally covers the surgeon's fee, anaesthesia charges, operation theatre costs, room rent for a specified number of days according to your ward entitlement, and routine medical supplies and nursing care during that stay. It does not cover the implant cost or certain high-cost consumables.

Can I choose any type of implant for my ankle replacement?

You and your surgeon will decide on the most suitable implant. However, CGHS reimburses the cost of implants up to a specific ceiling price. If you and your doctor opt for an implant that is more expensive than the CGHS-defined limit, you will be responsible for paying the difference.

Does the package cover physiotherapy after the surgery?

Physiotherapy administered during the inpatient hospital stay is usually part of the package. However, long-term physiotherapy and rehabilitation after discharge from the hospital are typically not included in the surgical package and would be covered under separate CGHS guidelines.

Related

• How to apply for a CGHS card
• CGHS rate list for common procedures
• CGHS vs Ayushman Bharat: what's the difference

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.