CGHS Knee Arthroscopy and ACL Reconstruction Rate List

CGHS reimburses knee arthroscopy and ligament procedures such as ACL reconstruction at fixed package rates. Arthroscopy implants are reimbursed separately. Under the Office Memorandum effective 13 October 2025, ACL reconstruction is Rs 53,550 at a non-NABH hospital and Rs 63,000 at a NABH hospital.

CGHS Knee Arthroscopy and Ligament Surgery Rates (effective 13 October 2025)

Orthopaedic arthroscopy codes carry no separate super-speciality rate. Arthroscopy implants are reimbursed separately. 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.

• Diagnostic arthroscopy, Non-NABH — Rs 29,750
• Diagnostic arthroscopy, NABH — Rs 35,000
• Therapeutic arthroscopy without implant, Non-NABH — Rs 36,550
• Therapeutic arthroscopy without implant, NABH — Rs 43,000
• Therapeutic arthroscopy with implant (excluding the implant), Non-NABH — Rs 45,050
• Therapeutic arthroscopy with implant (excluding the implant), NABH — Rs 53,000
• Meniscectomy, Non-NABH — Rs 45,050
• Meniscectomy, NABH — Rs 53,000
• Meniscus repair (excluding implants), Non-NABH — Rs 53,550
• Meniscus repair (excluding implants), NABH — Rs 63,000
• Arthrolysis of the knee, Non-NABH — Rs 45,050
• Arthrolysis of the knee, NABH — Rs 53,000

Ligament Reconstruction

• Anterior cruciate ligament (ACL) reconstruction (excluding implants), Non-NABH — Rs 53,550
• Anterior cruciate ligament (ACL) reconstruction (excluding implants), NABH — Rs 63,000
• Posterior cruciate ligament (PCL) reconstruction (excluding implants), Non-NABH — Rs 64,600
• Posterior cruciate ligament (PCL) reconstruction (excluding implants), NABH — Rs 76,000
• Knee collateral ligament reconstruction (excluding implants), Non-NABH — Rs 64,600
• Knee collateral ligament reconstruction (excluding implants), NABH — Rs 76,000

Knee Imaging Before Surgery

• MRI knee, single joint, without contrast, Non-NABH — Rs 2,550
• MRI knee, single joint, without contrast, NABH — Rs 3,000
• MRI knee, single joint, with contrast, Non-NABH — Rs 4,888
• MRI knee, single joint, with contrast, NABH — Rs 5,750
• X-ray of bones and joints, AP and lateral (two films), Non-NABH — Rs 323
• X-ray of bones and joints, AP and lateral (two films), NABH — Rs 380

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 length of 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 ACL reconstruction?

Rs 53,550 at a non-NABH hospital and Rs 63,000 at a NABH hospital, under the rates effective 13 October 2025, excluding implants. PCL and collateral ligament reconstruction are higher at Rs 64,600 and Rs 76,000.

What does CGHS pay for a knee arthroscopy?

Diagnostic arthroscopy is Rs 29,750 (non-NABH) and Rs 35,000 (NABH). Therapeutic arthroscopy is Rs 36,550 and Rs 43,000 without an implant, and Rs 45,050 and Rs 53,000 with one, with the implant reimbursed separately.

Related

• CGHS knee replacement rate list
• Understanding knee osteoarthritis

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.