CGHS Rates for Oral and Maxillofacial Surgery

Oral and Maxillofacial Surgery (OMS) is a specialized field of dentistry and medicine that addresses conditions affecting the head, neck, face, jaws, and the hard and soft tissues of the mouth. It encompasses a wide range of procedures, from routine extractions to complex reconstructive surgeries.

This guide focuses on a specific set of procedures within OMS, including treatments for salivary gland disorders, removal of jaw cysts, surgical correction of jaw deformities, repair of facial bone fractures, and major jaw resections like mandibulectomy and maxillectomy. These surgeries are often necessary to treat diseases, correct congenital deformities, or repair trauma.

For Central Government Health Scheme (CGHS) beneficiaries, understanding the costs associated with these treatments is crucial. This page details the approved CGHS package rates for various oral and maxillofacial surgeries at empanelled hospitals. The rates vary depending on the specific procedure and the accreditation status of the hospital (NABH or non-NABH).

CGHS Oral & Maxillofacial Surgery Rates (effective 13 October 2025)

Dental codes carry no separate super-speciality rate.

• Removal of - Lateral Exostosis/Torus Mandibularis/Torus Palatines/Surgical reduction of Osseous Tuberosity, Non-NABH — Rs 2,550
• Removal of - Lateral Exostosis/Torus Mandibularis/Torus Palatines/Surgical reduction of Osseous Tuberosity, NABH — Rs 3,000
• Sialolithotomy/Sialodocotomy/ Closure of Salivary Fistula, Non-NABH — Rs 1,700
• Sialolithotomy/Sialodocotomy/ Closure of Salivary Fistula, NABH — Rs 2,000
• Excision of Salivary gland, Non-NABH — Rs 12,750
• Excision of Salivary gland, NABH — Rs 15,000
• Partial Ostectomy / sequestrectomy for removal of non-vital bone, Non-NABH — Rs 1,700
• Partial Ostectomy / sequestrectomy for removal of non-vital bone, NABH — Rs 2,000
• Alveolus – Closed Reduction stabilization of Teeth, Non-NABH — Rs 3,400
• Alveolus – Closed Reduction stabilization of Teeth, NABH — Rs 4,000
• Alveolus – Open Reduction stabilization of Teeth, Non-NABH — Rs 5,100
• Alveolus – Open Reduction stabilization of Teeth, NABH — Rs 6,000
• Oroantral Fistula closure, Non-NABH — Rs 4,250
• Oroantral Fistula closure, NABH — Rs 5,000
• Osseous, Oste periosteal, or Cartilage graft of the Mandible or Maxilla - autogenous or non-autogenous bone graft, Non-NABH — Rs 2,550
• Osseous, Oste periosteal, or Cartilage graft of the Mandible or Maxilla - autogenous or non-autogenous bone graft, NABH — Rs 3,000
• Osteoplasty - for Orthognathic deformities/ Mandibular Rami/ Body of Mandible, Non-NABH — Rs 25,500
• Osteoplasty - for Orthognathic deformities/ Mandibular Rami/ Body of Mandible, NABH — Rs 30,000
• Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under LA, Non-NABH — Rs 5,100
• Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under LA, NABH — Rs 6,000
• Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under GA and admission, Non-NABH — Rs 21,250
• Cyst of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under GA and admission, NABH — Rs 25,000
• Segmental / Hemi Mandibulectomy with graft, Non-NABH — Rs 21,250
• Segmental / Hemi Mandibulectomy with graft, NABH — Rs 25,000
• Segmental /Hemi Mandibulectomy without graft, Non-NABH — Rs 17,000
• Segmental /Hemi Mandibulectomy without graft, NABH — Rs 20,000
• Sub-Total mandibulectomy with graft, Non-NABH — Rs 29,750
• Sub-Total mandibulectomy with graft, NABH — Rs 35,000
• Sub-Total mandibulectomy without graft, Non-NABH — Rs 25,500
• Sub-Total mandibulectomy without graft, NABH — Rs 30,000
• Maxillectomy/Mandibulectomy- Total with graft, Non-NABH — Rs 29,750
• Maxillectomy/Mandibulectomy- Total with graft, NABH — Rs 35,000
• Maxillectomy/Mandibulectomy- Total without graft, Non-NABH — Rs 25,500
• Maxillectomy/Mandibulectomy- Total without graft, NABH — Rs 30,000
• Maxillectomy- partial with graft, Non-NABH — Rs 21,250
• Maxillectomy- partial with graft, NABH — Rs 25,000
• Maxillectomy- partial without graft, Non-NABH — Rs 17,000
• Maxillectomy- partial without graft, NABH — Rs 20,000
• Malar and/or Zygomatic arch - Closed Reduction, Non-NABH — Rs 5,100
• Malar and/or Zygomatic arch - Closed Reduction, NABH — Rs 6,000
• Malar and/or Zygomatic arch - Open Reduction, Non-NABH — Rs 8,500
• Malar and/or Zygomatic arch - Open Reduction, NABH — Rs 10,000
• Distraction osteogenesis of mandible or maxilla under GA, Non-NABH — Rs 25,500
• Distraction osteogenesis of mandible or maxilla under GA, NABH — Rs 30,000
• Facial bones - Complicated Reduction with fixation, Non-NABH — Rs 38,250
• Facial bones - Complicated Reduction with fixation, NABH — Rs 45,000

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 guide is intended for CGHS beneficiaries who have been medically advised to undergo specific oral and maxillofacial surgical procedures. The rates listed apply to a range of treatments, from less invasive interventions to highly complex operations.

Procedures covered include treatments for salivary gland conditions like stone removal (sialolithotomy) or fistula closure, and removal of benign bony growths in the mouth (tori). The list also specifies rates for managing jaw cysts and closing connections between the mouth and sinus (oroantral fistula closure).

For patients requiring more extensive surgery, this guide covers facial trauma repair, such as closed or open reduction of malar and zygomatic (cheekbone) fractures. It also details rates for major reconstructive surgeries, including partial or total removal of the upper jaw (maxillectomy) or lower jaw (mandibulectomy), both with and without bone grafting. Procedures like jaw lengthening (distraction osteogenesis) and corrective jaw surgery (osteoplasty) are also included for eligible beneficiaries.

What CGHS covers vs. what you pay separately

The CGHS package rate for a surgical procedure is intended to be an all-inclusive price. This typically covers the surgeon's fee, anaesthesia charges, operation theatre costs, routine drugs and consumables, and room charges for a specified number of days as per the package.

However, beneficiaries should be aware that the package may not cover all expenses. High-cost consumables and implants are often billed separately. For maxillofacial surgeries, this can include items like titanium plates and screws for fracture fixation, bone graft materials (especially non-autogenous or synthetic types), and special surgical meshes. The cost of these items is usually capped at the MRP, and the beneficiary may be required to pay for them out-of-pocket.

Before proceeding with the surgery, it is important to have a clear conversation with the hospital's CGHS desk or billing department. Request a detailed estimate that explicitly lists what is included in the CGHS package and what will be billed separately. This helps in understanding the total potential cost and avoids financial surprises.

How to use this at a CGHS-empanelled hospital

To utilize CGHS benefits for oral and maxillofacial surgery, you must start with a valid referral. A specialist at a CGHS Wellness Centre or a government hospital must recommend the procedure.

Upon visiting a CGHS-empanelled private hospital, present your CGHS card along with the referral letter and any investigation reports. The hospital's OMS department will evaluate your case and confirm the exact procedure code as per the CGHS list.

The rate that the hospital can charge is determined by its accreditation. Hospitals with NABH (National Accreditation Board for Hospitals & Healthcare Providers) accreditation are eligible for a higher reimbursement rate compared to non-NABH accredited hospitals. This is a fixed rule based on the hospital's status, not a choice available to the patient. You can verify a hospital's accreditation on the NABH website or at the hospital itself.

Confirm the final procedure code and the corresponding package rate at the hospital's CGHS counter before admission. Also, inquire about any anticipated out-of-pocket expenses for implants or other items not covered by the package.

Frequently Asked Questions

What is the difference between a mandibulectomy with a graft and without a graft?

A mandibulectomy is the surgical removal of a portion of the lower jaw (mandible), often for cancer treatment. A procedure 'with graft' means the removed bone is replaced with bone from another part of the body or a synthetic material to reconstruct the jaw. A procedure 'without graft' means the jaw defect is not immediately reconstructed with a bone graft. The choice depends on the clinical situation and reconstructive plan.

Does the CGHS rate for jaw cyst removal differ based on the anaesthesia used?

Yes, the CGHS schedule provides different rates for the removal of a large jaw cyst (more than 4 cm). The rate depends on whether the procedure is performed under Local Anaesthesia (LA) on an outpatient basis or under General Anaesthesia (GA) requiring hospital admission, as the latter is a more resource-intensive procedure.

What is the difference between open and closed reduction for a facial bone fracture?

Closed reduction is the non-surgical realignment of a fractured bone, done by manual manipulation from outside the body. Open reduction is a surgical procedure where an incision is made to directly access and realign the bone fragments, which are then often held in place with plates and screws. The CGHS list specifies separate rates for each method.

What is distraction osteogenesis, and is it covered by CGHS?

Distraction osteogenesis is a surgical technique used to lengthen bone, often applied to the jaw to correct deformities. It involves cutting the bone and then using a special 'distractor' device to slowly separate the segments, allowing new bone to form in the gap. Yes, the CGHS rate list includes a specific code and rate for distraction osteogenesis of the mandible or maxilla under general anaesthesia.

What is a Sialolithotomy?

Sialolithotomy is a surgical procedure to remove a stone (sialolith) from a salivary gland or its duct. These stones can block saliva flow, causing pain and swelling. The procedure aims to remove the blockage and restore normal gland function. This surgery is a covered procedure under CGHS.

How do I know if a hospital has NABH accreditation?

You can verify a hospital's accreditation status by checking the official NABH website or by asking the hospital administration directly. Empanelled hospitals are generally required to display their accreditation status. This is important as it determines the applicable CGHS package rate for your surgery.

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.