CGHS Rates for Kidney & Ureter Surgery (Nephrectomy, Pyeloplasty)

For Central Government Health Scheme (CGHS) beneficiaries who have been advised to undergo surgery on their kidney or ureter, understanding the approved financial coverage is a primary concern. This guide provides detailed information on the package rates for various urological procedures as defined by the CGHS. These procedures range from kidney removal (nephrectomy) and stone extraction (lithotomy) to complex reconstructive surgeries like pyeloplasty and ureteric reimplantation.

The rate list below specifies the costs for both open and minimally invasive (laparoscopic/endoscopic) surgical approaches. It is important to note that the rates differ based on whether the empanelled hospital holds NABH (National Accreditation Board for Hospitals & Healthcare Providers) accreditation or not. This guide aims to clarify the scope of coverage, explain what is included in the package rates, and provide practical steps for availing these services at a network hospital.

Please use the detailed table of rates as your primary reference for financial information. The accompanying text describes the coverage qualitatively and offers guidance on the process, but does not repeat the specific monetary figures. Always cross-reference the procedure advised by your doctor with the codes and descriptions in the official list to ensure clarity.

CGHS Kidney Surgery Rates (effective 13 October 2025)

Open, laparoscopic and endoscopic approaches to the same procedure carry different rates — confirm which approach your surgeon plans before checking the figure below.

• Partial nephrectomy, open, Non-NABH — Rs 36,550
• Partial nephrectomy, open, NABH — Rs 43,000
• Partial nephrectomy, open, Super Speciality — Rs 49,450
• Partial nephrectomy, laparoscopic/endoscopic, Non-NABH — Rs 45,050
• Partial nephrectomy, laparoscopic/endoscopic, NABH — Rs 53,000
• Partial nephrectomy, laparoscopic/endoscopic, Super Speciality — Rs 60,950
• Simple nephrectomy, open, Non-NABH — Rs 53,550
• Simple nephrectomy, open, NABH — Rs 63,000
• Simple nephrectomy, open, Super Speciality — Rs 72,450
• Laparoscopic nephrectomy, Non-NABH — Rs 53,550
• Laparoscopic nephrectomy, NABH — Rs 63,000
• Laparoscopic nephrectomy, Super Speciality — Rs 72,450
• Nephrolithotomy, laparoscopic/endoscopic, Non-NABH — Rs 45,050
• Nephrolithotomy, laparoscopic/endoscopic, NABH — Rs 53,000
• Nephrolithotomy, laparoscopic/endoscopic, Super Speciality — Rs 60,950
• Pyelolithotomy, open, Non-NABH — Rs 53,550
• Pyelolithotomy, open, NABH — Rs 63,000
• Pyelolithotomy, open, Super Speciality — Rs 72,450
• Pyelolithotomy, laparoscopic/endoscopic, Non-NABH — Rs 45,050
• Pyelolithotomy, laparoscopic/endoscopic, NABH — Rs 53,000
• Pyelolithotomy, laparoscopic/endoscopic, Super Speciality — Rs 60,950
• Laparoscopic pyelolithotomy, Non-NABH — Rs 53,550
• Laparoscopic pyelolithotomy, NABH — Rs 63,000
• Laparoscopic pyelolithotomy, Super Speciality — Rs 72,450
• Pyeloplasty for hydronephrosis, open, Non-NABH — Rs 45,050
• Pyeloplasty for hydronephrosis, open, NABH — Rs 53,000
• Pyeloplasty for hydronephrosis, open, Super Speciality — Rs 60,950
• Pyeloplasty for hydronephrosis, laparoscopic/endoscopic, Non-NABH — Rs 53,550
• Pyeloplasty for hydronephrosis, laparoscopic/endoscopic, NABH — Rs 63,000
• Pyeloplasty for hydronephrosis, laparoscopic/endoscopic, Super Speciality — Rs 72,450
• Laparoscopic pyeloplasty, Non-NABH — Rs 53,550
• Laparoscopic pyeloplasty, NABH — Rs 63,000
• Laparoscopic pyeloplasty, Super Speciality — Rs 72,450
• Endopyelotomy for hydronephrosis, antegrade, Non-NABH — Rs 36,550
• Endopyelotomy for hydronephrosis, antegrade, NABH — Rs 43,000
• Endopyelotomy for hydronephrosis, antegrade, Super Speciality — Rs 49,450
• Endopyelotomy for hydronephrosis, retrograde, Non-NABH — Rs 36,550
• Endopyelotomy for hydronephrosis, retrograde, NABH — Rs 43,000
• Endopyelotomy for hydronephrosis, retrograde, Super Speciality — Rs 49,450
• Ureterocalicostomy for hydronephrosis, Non-NABH — Rs 36,550
• Ureterocalicostomy for hydronephrosis, NABH — Rs 43,000
• Ureterocalicostomy for hydronephrosis, Super Speciality — Rs 49,450
• Ileal ureter for hydronephrosis, Non-NABH — Rs 45,050
• Ileal ureter for hydronephrosis, NABH — Rs 53,000
• Ileal ureter for hydronephrosis, Super Speciality — Rs 60,950
• Open drainage of perinephric abscess, Non-NABH — Rs 29,750
• Open drainage of perinephric abscess, NABH — Rs 35,000
• Open drainage of perinephric abscess, Super Speciality — Rs 40,250
• Cavernostomy, Non-NABH — Rs 23,375
• Cavernostomy, NABH — Rs 27,500
• Cavernostomy, Super Speciality — Rs 31,625
• Excision of kidney cyst, open, Non-NABH — Rs 36,550
• Excision of kidney cyst, open, NABH — Rs 43,000
• Excision of kidney cyst, open, Super Speciality — Rs 49,450
• Excision of kidney cyst, laparoscopic/endoscopic, Non-NABH — Rs 45,050
• Excision of kidney cyst, laparoscopic/endoscopic, NABH — Rs 53,000
• Excision of kidney cyst, laparoscopic/endoscopic, Super Speciality — Rs 60,950
• Laparoscopic surgery for renal cyst, Non-NABH — Rs 53,550
• Laparoscopic surgery for renal cyst, NABH — Rs 63,000
• Laparoscopic surgery for renal cyst, Super Speciality — Rs 72,450
• Nephroureterectomy, open, Non-NABH — Rs 45,050
• Nephroureterectomy, open, NABH — Rs 53,000
• Nephroureterectomy, open, Super Speciality — Rs 60,950
• Laparoscopic nephroureterectomy, Non-NABH — Rs 45,050
• Laparoscopic nephroureterectomy, NABH — Rs 53,000
• Laparoscopic nephroureterectomy, Super Speciality — Rs 60,950
• Nephrostomy, open, Non-NABH — Rs 29,750
• Nephrostomy, open, NABH — Rs 35,000
• Nephrostomy, open, Super Speciality — Rs 40,250
• Nephrostomy, laparoscopic/endoscopic, Non-NABH — Rs 29,750
• Nephrostomy, laparoscopic/endoscopic, NABH — Rs 35,000
• Nephrostomy, laparoscopic/endoscopic, Super Speciality — Rs 40,250

Ureter Surgery

• Ureterolithotomy, laparoscopic/endoscopic, Non-NABH — Rs 45,050
• Ureterolithotomy, laparoscopic/endoscopic, NABH — Rs 53,000
• Ureterolithotomy, laparoscopic/endoscopic, Super Speciality — Rs 60,950
• Laparoscopic ureterolithotomy, Non-NABH — Rs 53,550
• Laparoscopic ureterolithotomy, NABH — Rs 63,000
• Laparoscopic ureterolithotomy, Super Speciality — Rs 72,450
• Surgery for double ureters, Non-NABH — Rs 45,050
• Surgery for double ureters, NABH — Rs 53,000
• Surgery for double ureters, Super Speciality — Rs 60,950
• Surgery for ectopia of single ureter, Non-NABH — Rs 36,550
• Surgery for ectopia of single ureter, NABH — Rs 43,000
• Surgery for ectopia of single ureter, Super Speciality — Rs 49,450
• Surgery for vesicoureteral reflux (VUR), open, Non-NABH — Rs 36,550
• Surgery for vesicoureteral reflux (VUR), open, NABH — Rs 43,000
• Surgery for vesicoureteral reflux (VUR), open, Super Speciality — Rs 49,450
• Surgery for vesicoureteral reflux (VUR), laparoscopic/endoscopic, Non-NABH — Rs 45,050
• Surgery for vesicoureteral reflux (VUR), laparoscopic/endoscopic, NABH — Rs 53,000
• Surgery for vesicoureteral reflux (VUR), laparoscopic/endoscopic, Super Speciality — Rs 60,950
• Surgery for VUR / urinary incontinence with bulking agents, Non-NABH — Rs 36,550
• Surgery for VUR / urinary incontinence with bulking agents, NABH — Rs 43,000
• Surgery for VUR / urinary incontinence with bulking agents, Super Speciality — Rs 49,450
• Cutaneous ureterostomy, Non-NABH — Rs 29,750
• Cutaneous ureterostomy, NABH — Rs 35,000
• Cutaneous ureterostomy, Super Speciality — Rs 40,250
• Uretero-colic anastomosis, Non-NABH — Rs 36,550
• Uretero-colic anastomosis, NABH — Rs 43,000
• Uretero-colic anastomosis, Super Speciality — Rs 49,450
• Formation of an ileal conduit, Non-NABH — Rs 45,050
• Formation of an ileal conduit, NABH — Rs 53,000
• Formation of an ileal conduit, Super Speciality — Rs 60,950
• Repair of ureterocele, open, Non-NABH — Rs 36,550
• Repair of ureterocele, open, NABH — Rs 43,000
• Repair of ureterocele, open, Super Speciality — Rs 49,450
• Repair of ureterocele, laparoscopic/endoscopic, Non-NABH — Rs 36,550
• Repair of ureterocele, laparoscopic/endoscopic, NABH — Rs 43,000
• Repair of ureterocele, laparoscopic/endoscopic, Super Speciality — Rs 49,450
• Repair of ureterocele, endoscopic incision, Non-NABH — Rs 29,750
• Repair of ureterocele, endoscopic incision, NABH — Rs 35,000
• Repair of ureterocele, endoscopic incision, Super Speciality — Rs 40,250
• Ureteric reimplant for megaureter / VUR / ureterocele, open, Non-NABH — Rs 36,550
• Ureteric reimplant for megaureter / VUR / ureterocele, open, NABH — Rs 43,000
• Ureteric reimplant for megaureter / VUR / ureterocele, open, Super Speciality — Rs 49,450
• Ureteric reimplant for megaureter / VUR / ureterocele, laparoscopic, Non-NABH — Rs 36,550
• Ureteric reimplant for megaureter / VUR / ureterocele, laparoscopic, NABH — Rs 43,000
• Ureteric reimplant for megaureter / VUR / ureterocele, laparoscopic, Super Speciality — Rs 49,450

Diagnostic & Minor Interventional Urology Procedures

These carry no separate super-speciality rate — they are billed at the NABH rate at every hospital tier.

• Urodynamic study (cystometry), Non-NABH — Rs 2,550
• Urodynamic study (cystometry), NABH — Rs 3,000
• Voiding cysto-urethrogram / retrograde urethrogram (nephrostogram), Non-NABH — Rs 7,225
• Voiding cysto-urethrogram / retrograde urethrogram (nephrostogram), NABH — Rs 8,500
• Fistulogram for arteriovenous fistula, Non-NABH — Rs 7,820
• Fistulogram for arteriovenous fistula, NABH — Rs 9,200
• Percutaneous, ultrasound-guided drainage of perinephric abscess, Non-NABH — Rs 11,390
• Percutaneous, ultrasound-guided drainage of perinephric abscess, NABH — Rs 13,400

Post-Transplant Complications

• Drainage of post-transplant lymphocele, open, Non-NABH — Rs 7,820
• Drainage of post-transplant lymphocele, open, NABH — Rs 9,200
• Drainage of post-transplant lymphocele, open, Super Speciality — Rs 10,580
• Drainage of post-transplant lymphocele, percutaneous, Non-NABH — Rs 11,390
• Drainage of post-transplant lymphocele, percutaneous, NABH — Rs 13,400
• Drainage of post-transplant lymphocele, percutaneous, Super Speciality — Rs 15,410
• Drainage of post-transplant lymphocele, laparoscopic, Non-NABH — Rs 17,000
• Drainage of post-transplant lymphocele, laparoscopic, NABH — Rs 20,000
• Drainage of post-transplant lymphocele, laparoscopic, Super Speciality — Rs 23,000

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.

Who This Covers

This schedule of rates is applicable to all CGHS beneficiaries who require surgical intervention for conditions affecting the kidneys and ureters. The list is comprehensive and covers a variety of medical situations, including:

Patients diagnosed with kidney stones who need surgical removal (Nephrolithotomy, Pyelolithotomy, Ureterolithotomy).

Individuals with hydronephrosis (swelling of the kidney due to urine backup) requiring corrective surgery like Pyeloplasty or Endopyelotomy.

Patients needing partial or complete removal of a kidney (Partial Nephrectomy, Simple Nephrectomy) due to disease, trauma, or cancer.

Those with kidney cysts or abscesses that require surgical excision or drainage.

Patients, often children, with Vesicoureteral Reflux (VUR) or other congenital anomalies like double ureters or ureteroceles that necessitate surgical correction, such as ureteric reimplantation.

Individuals requiring urinary diversion procedures like the formation of an ileal conduit or a cutaneous ureterostomy.

Beneficiaries who need diagnostic procedures like a Urodynamic Study or a Voiding Cysto-urethrogram to evaluate urinary system function.

What CGHS Covers vs. What You Pay Separately

The CGHS package rate is designed to be inclusive of many costs associated with a surgical procedure. This typically covers the surgeon's fee, anaesthetist's fee, operation theatre charges, and room rent according to the beneficiary's ward entitlement. Routine drugs and consumables used during the surgery and hospital stay are also generally part of the package.

However, beneficiaries should be aware that certain high-cost items may not be included in the package rate and could be billed separately. These often include specialized implants, such as ureteric stents, bulking agents for incontinence, or specific grafts. The cost of some high-end medications or specialized disposables might also be an additional expense.

It is crucial to have a detailed discussion with the hospital's CGHS desk or billing department before the procedure. Request a clear breakdown of what is covered under the CGHS package and what potential out-of-pocket expenses you might incur for implants, consumables, or other items.

How to Use This at a CGHS-Empanelled Hospital

To avail the benefits for kidney or ureter surgery at a CGHS-empanelled hospital, follow these steps:

1. Obtain a Referral: First, you must be advised for the specific procedure by a government specialist or a medical officer at a CGHS Wellness Centre. For planned surgeries, a referral letter is mandatory.

2. Visit the Empanelled Hospital: Choose a hospital from the list of CGHS empanelled healthcare organizations. Carry your CGHS card, the doctor's prescription, and the referral letter.

3. Confirm the Procedure Code and Rate: At the hospital's CGHS or TPA desk, show them the prescribed surgery. Match the procedure name with the exact description and code in the CGHS rate list. This step is vital to prevent any confusion regarding billing and coverage.

4. Understand the Applicable Rate: The CGHS provides two sets of rates: one for NABH-accredited hospitals and another for non-NABH accredited hospitals. The rate that applies is determined by the hospital's accreditation status, not your preference. The hospital is obligated to charge the correct rate based on its certification.

5. Get Pre-Authorization: The hospital will process the paperwork for pre-authorization from CGHS for cashless treatment. Once approved, you can proceed with the surgery. For emergency procedures, the process may be initiated post-admission.

Frequently Asked Questions

Do CGHS rates for nephrectomy cover both open and laparoscopic methods?

Yes, the CGHS rate list provides separate, specific package rates for both open nephrectomy and laparoscopic nephrectomy. You can find distinct rates for each surgical approach in the official schedule.

What is pyeloplasty, and is it covered by CGHS?

Pyeloplasty is a surgical procedure to correct a blockage or narrowing of the ureter where it leaves the kidney (a condition called ureteropelvic junction obstruction, which causes hydronephrosis). Yes, CGHS covers pyeloplasty, with separate rates listed for open, laparoscopic, and endoscopic techniques.

Are diagnostic procedures like a Urodynamic Study included in the CGHS list?

Yes, the CGHS rate list includes package rates for diagnostic procedures as well. Urodynamic Study (Cystometry) and Voiding Cysto-urethrogram (VCUG) are both listed with their own approved rates.

Does the CGHS package rate include the cost of a ureteric stent if required during surgery?

The CGHS package rate covers the main surgical procedure. The cost of specific implants or high-value consumables, such as a ureteric stent, may be billed separately. You must confirm with the hospital's billing department beforehand what is included and what will be an additional cost.

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

The rate for a procedure is higher at hospitals accredited by the National Accreditation Board for Hospitals & Healthcare Providers (NABH), reflecting certain quality standards. The rate you are charged depends entirely on the accreditation status of the hospital where you receive treatment.

What should I do if a hospital refuses to honour the CGHS rate?

Empanelled hospitals are obligated to follow the official CGHS rates. If you encounter a discrepancy or a refusal to comply, you should not pay the excess amount and should report the incident to the Additional Director of your CGHS city, providing all relevant documentation.

Is surgery for Vesicoureteral Reflux (VUR) covered for children under CGHS?

Yes, the CGHS rate list includes several procedures for treating Vesicoureteral Reflux (VUR). This includes rates for open and laparoscopic surgery, as well as for treatment using injectable bulking agents. These rates apply to all eligible beneficiaries, including children.

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.