CGHS Knee Replacement Rate List: Package Rates and Implant Ceiling

Total knee replacement (TKR) is one of the most searched procedures among CGHS beneficiaries, and the scheme reimburses it at a fixed package rate at empanelled hospitals.

The package covers the surgery and hospital stay; the knee implant itself is reimbursed separately against a notified ceiling.

CGHS Knee Replacement Package Rates (effective 13 October 2025)

Rates exclude the knee implant and bone cement. CGHS notifies implant CEILING rates in separate office memoranda, so confirm the current implant ceiling for your city — it is not part of this rate list.

• Total Knee Joint Replacement (TKR), unilateral (excluding implant), Non-NABH — Rs 1,29,200
• Total Knee Joint Replacement (TKR), unilateral (excluding implant), NABH — Rs 1,52,000
• Total Knee Joint Replacement (TKR), unilateral (excluding implant), Super Speciality — Rs 1,74,800
• TKR revision, Stage I (excluding implant), Non-NABH — Rs 82,450
• TKR revision, Stage I (excluding implant), NABH — Rs 97,000
• TKR revision, Stage I (excluding implant), Super Speciality — Rs 1,11,550
• TKR revision, Stage II (excluding implant), Non-NABH — Rs 1,09,650
• TKR revision, Stage II (excluding implant), NABH — Rs 1,29,000
• TKR revision, Stage II (excluding implant), Super Speciality — Rs 1,48,350

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.

Bilateral Knee Replacement

CGHS rate lists do not carry a separate "bilateral" knee line. A both-knee surgery is generally billed as the package rate plus a second knee-implant ceiling, subject to the hospital and approving authority.

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

Does CGHS cover the knee implant cost?

Yes. The implant is reimbursed separately from the surgery package, up to the ceiling CGHS notifies for implants. Those ceilings are issued in their own office memoranda and are not part of this rate list, so confirm the current implant ceiling for your city before surgery.

What is the CGHS rate for knee replacement?

Under the rates effective 13 October 2025 the unilateral TKR package is Rs 1,29,200 (non-NABH) and Rs 1,52,000 (NABH), with the implant reimbursed separately. Figures vary slightly by city list and are revised periodically.

Is prior permission needed for knee replacement under CGHS?

Yes, planned knee replacement needs a referral from the CGHS wellness centre and prior permission. Emergencies are handled without prior permission.

Related

• Knee replacement cost in India (private hospitals)
• Understanding knee osteoarthritis
• Ayushman Bharat (PM-JAY) knee replacement package

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.