CGHS Rates for Gum Surgery, Apicectomy, and Restorative Dentistry

The Central Government Health Scheme (CGHS) provides a framework for its beneficiaries to access a wide range of healthcare services, including specialized dental treatments. This guide focuses on periodontal, endodontic, and restorative dental procedures, which address issues related to the gums, root canals, and tooth structure.

Periodontal treatments, such as flap surgery and gingivoplasty, manage gum diseases. Endodontic surgeries like apicectomy address infections at the root tip that cannot be resolved by a standard root canal treatment. Restorative procedures like crown lengthening and tooth splinting help restore the function and form of teeth. The CGHS has established fixed rates for these procedures to ensure transparency for beneficiaries.

The table of rates details the CGHS-approved amounts for these specific dental procedures. The rates differ based on whether the procedure is performed at an NABH-accredited or a non-NABH accredited hospital. Beneficiaries should use this list as a reference when planning their treatment at a CGHS-empanelled facility.

CGHS Periodontal, Endodontic & Restorative Dentistry Rates (effective 13 October 2025)

Dental codes carry no separate super-speciality rate.

• Gingivoplasty - Per Quadrant, Non-NABH — Rs 850
• Gingivoplasty - Per Quadrant, NABH — Rs 1,000
• Flap Surgery- Per Tooth, Non-NABH — Rs 383
• Flap Surgery- Per Tooth, NABH — Rs 450
• Multiple Extraction and Treatment Procedures for Special Children, Patients with Systemic Diseases, Patient with Special Needs Which Requires Admission and Treatment Under GA, Non-NABH — Rs 5,100
• Multiple Extraction and Treatment Procedures for Special Children, Patients with Systemic Diseases, Patient with Special Needs Which Requires Admission and Treatment Under GA, NABH — Rs 6,000
• Operculectomy- Pericoronal flap excision, Non-NABH — Rs 1,700
• Operculectomy- Pericoronal flap excision, NABH — Rs 2,000
• Alveoloplasty - Per Tooth, Non-NABH — Rs 255
• Alveoloplasty - Per Tooth, NABH — Rs 300
• Alveoloplasty - Per Quadrant, Non-NABH — Rs 1,020
• Alveoloplasty - Per Quadrant, NABH — Rs 1,200
• Excision of hyperplastic tissue - per arch, Non-NABH — Rs 1,020
• Excision of hyperplastic tissue - per arch, NABH — Rs 1,200
• Surgical Augmentation/Alveolectomy per Arch, Non-NABH — Rs 2,975
• Surgical Augmentation/Alveolectomy per Arch, NABH — Rs 3,500
• Bone replacement graft for ridge preservation - per site, Non-NABH — Rs 1,700
• Bone replacement graft for ridge preservation - per site, NABH — Rs 2,000
• Medication -intracanal medicament (only lesion cases), Non-NABH — Rs 425
• Medication -intracanal medicament (only lesion cases), NABH — Rs 500
• Apicectomy-Multiple tooth, Non-NABH — Rs 2,550
• Apicectomy-Multiple tooth, NABH — Rs 3,000
• Root end resection and Retro grade filling, Non-NABH — Rs 2,550
• Root end resection and Retro grade filling, NABH — Rs 3,000
• Surgical - Apicectomy/ Periapical surgery without bone grafting, Non-NABH — Rs 595
• Surgical - Apicectomy/ Periapical surgery without bone grafting, NABH — Rs 700
• Tissue Conditioning, Maxillary/Mandibular, Non-NABH — Rs 255
• Tissue Conditioning, Maxillary/Mandibular, NABH — Rs 300
• Crown lengthening - Per Tooth, Non-NABH — Rs 425
• Crown lengthening - Per Tooth, NABH — Rs 500
• Crown - Removal, Non-NABH — Rs 425
• Crown - Removal, NABH — Rs 500
• Odontoplasty /Enameloplasty, Non-NABH — Rs 425
• Odontoplasty /Enameloplasty, NABH — Rs 500
• Veneer - Ceramic paediatric, Non-NABH — Rs 2,550
• Veneer - Ceramic paediatric, NABH — Rs 3,000
• Occlusion Analysis/Adjustment/Occlusal Equilibration, Non-NABH — Rs 425
• Occlusion Analysis/Adjustment/Occlusal Equilibration, NABH — Rs 500
• Tooth Splinting -General, Non-NABH — Rs 1,275
• Tooth Splinting -General, NABH — Rs 1,500
• Splinting - Periodontally weak teeth, Non-NABH — Rs 1,530
• Splinting - Periodontally weak teeth, NABH — Rs 1,800

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 rate list is for CGHS beneficiaries who have been advised to undergo specific dental surgical and restorative procedures by a qualified dental specialist. It covers a range of treatments for individuals with gum problems, complex root canal issues, and other dental conditions requiring surgical intervention.

The procedures listed include treatments for gum disease like Gingivoplasty and Flap Surgery, root-end surgery such as Apicectomy, and preparatory procedures for restorations like Crown Lengthening. It also includes provisions for splinting periodontally weak teeth and occlusal adjustments.

Notably, this list includes a specific provision for 'Multiple Extraction and Treatment Procedures for Special Children, Patients with Systemic Diseases, Patient with Special Needs Which Requires Admission and Treatment Under GA (General Anesthesia)'. This is intended for beneficiaries whose medical or physical condition makes routine dental treatment in a chair setting difficult.

What CGHS Covers vs. What You Pay Separately

The rates published in the CGHS list represent the package price for the procedure itself. This fee typically includes the surgeon's fees, operation theatre charges, and standard supplies required for the procedure as defined by CGHS.

However, the cost of certain high-value consumables, specific types of bone graft materials (unless specified in the package like 'Bone replacement graft for ridge preservation'), membranes, or specialized medications may not be included in the package rate. These items are often billed separately to the patient at MRP (Maximum Retail Price).

It is important for beneficiaries to have a detailed discussion with the hospital's billing department before the procedure. Request a clear written estimate that distinguishes between the CGHS package rate and any additional costs for non-covered consumables or items you will be required to pay for directly.

How to Use This at a CGHS-Empanelled Hospital

To avail of these rates, you must first obtain a referral for the specific procedure from a CGHS Wellness Centre or a government hospital specialist. Without a valid referral, you may not be able to use the CGHS benefits for treatment at an empanelled private hospital.

When you visit the empanelled hospital, present your CGHS card and the referral letter at the CGHS counter. The hospital staff will verify your eligibility and the recommended procedure.

The applicable rate (NABH or non-NABH) depends on the accreditation status of the hospital where you receive treatment, not your personal choice. Confirm the hospital's current accreditation status. Before undergoing the procedure, double-check the specific procedure code with the billing department to ensure it matches the CGHS list and to avoid any billing discrepancies later.

Frequently Asked Questions

What is flap surgery and why is it performed?

Flap surgery is a periodontal procedure used to treat moderate to advanced gum disease (periodontitis). During the surgery, the gums are temporarily lifted away from the teeth to allow the surgeon to remove tartar and diseased tissue from the root surfaces and surrounding bone. The gums are then stitched back into place. The CGHS rate for this is listed on a 'per tooth' basis.

What is an apicectomy and when is it necessary?

An apicectomy, or root-end surgery, is a procedure performed after a root canal treatment has not fully resolved an infection. It involves removing the tip of the tooth's root (the apex) and any infected tissue, and then placing a filling to seal the root end. It is typically recommended when infection persists at the root tip.

Does the CGHS rate for 'Flap Surgery' cover the entire mouth?

No, the CGHS rate list specifies 'Flap Surgery - Per Tooth'. This means the rate is applicable for each individual tooth that requires the procedure. If you need flap surgery in multiple areas, the total cost will be calculated based on the number of teeth being treated.

Are bone grafts for dental procedures covered by CGHS?

The CGHS list includes a specific item for 'Bone replacement graft for ridge preservation - per site'. If your procedure matches this description, it is covered at the listed rate. For other procedures requiring bone grafts, the grafting material itself might be considered a separate consumable. Always clarify with the hospital whether the cost of the graft material is included in the package or will be an additional expense.

My child has special needs and requires dental work under general anesthesia. Is this covered?

Yes, the CGHS rate list has a specific package for 'Multiple Extraction and Treatment Procedures for Special Children, Patients with Systemic Diseases, Patient with Special Needs Which Requires Admission and Treatment Under GA'. This package is designed to facilitate necessary dental care for patients who cannot be treated in a standard clinical setting.

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.