CGHS Rates for Skull Base & Advanced ENT Surgery

Skull base surgery is a highly specialized field that addresses complex tumours and conditions located at the difficult-to-reach area at the base of the brain and skull. These procedures often require a multidisciplinary team of surgeons, including ENT specialists, neurosurgeons, and plastic surgeons. The Central Government Health Scheme (CGHS) provides coverage for several of these advanced procedures for its beneficiaries.

This guide outlines the CGHS-approved package rates for specific skull base and advanced ENT operations, including Cranio-Facial resection, Angiofibroma Excision, Endoscopic Hypophysectomy, and Endoscopic Optic Nerve Decompression. The rates shown in the table above vary depending on whether the procedure is performed at an NABH-accredited hospital or a non-NABH-accredited facility. Understanding this structure helps beneficiaries navigate their treatment process at empanelled hospitals.

CGHS Skull Base & Advanced ENT Surgery Rates (effective 13 October 2025)

ENT codes carry no separate super-speciality rate.

• Skull Base Surgery, Non-NABH — Rs 45,050
• Skull Base Surgery, NABH — Rs 53,000
• Cranio-Facial resection, Non-NABH — Rs 36,550
• Cranio-Facial resection, NABH — Rs 43,000
• Angiofibroma Excision, Non-NABH — Rs 36,550
• Angiofibroma Excision, NABH — Rs 43,000
• Endoscopic Hypophysectomy, Non-NABH — Rs 45,050
• Endoscopic Hypophysectomy, NABH — Rs 53,000
• Endoscopic Optic Nerve Decompression, Non-NABH — Rs 45,050
• Endoscopic Optic Nerve Decompression, NABH — Rs 53,000

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 Page Covers

This information is intended for all CGHS beneficiaries (including pensioners and serving employees) who have been advised to undergo specific advanced ENT or skull base surgical procedures. The rates and guidelines are applicable for patients with conditions that require:

• Skull Base Surgery: A general category for procedures addressing lesions or defects at the base of the skull.

• Cranio-Facial Resection: A major surgery typically for removing tumours that span the facial bones and the skull base.

• Angiofibroma Excision: Surgical removal of a benign, but highly vascular, tumour usually found in the nasopharynx.

• Endoscopic Hypophysectomy: A minimally invasive procedure to remove tumours of the pituitary gland through the nasal cavity.

• Endoscopic Optic Nerve Decompression: A procedure to relieve pressure on the optic nerve, often caused by trauma, inflammation, or tumours, performed through the sinuses.

What CGHS Covers vs. What You Pay Separately

The CGHS package rate is designed to be comprehensive, covering a significant portion of the surgical expenses. This typically includes the surgeon's and anaesthetist's fees, operation theatre charges, standard medications, routine nursing care, and a specified duration of hospital stay (ward/room charges).

However, certain high-cost items are often excluded from the package rate and may require separate payment by the beneficiary. These can include specialized implants, dural grafts, bone substitutes, specific high-cost medications, or advanced consumables required for the surgery. The exact items that fall outside the package can vary. It is important for beneficiaries to have a detailed discussion with the hospital's billing department before the procedure to understand the full cost breakdown and identify any potential out-of-pocket expenses.

How to Use This at a CGHS-Empanelled Hospital

To avail of treatment under CGHS for these specialized surgeries, beneficiaries should follow a standard process:

1. Obtain a valid referral from a CGHS Wellness Centre medical officer or a specialist at a government hospital. The referral must clearly state the diagnosed condition and the recommended surgical procedure.

2. At your chosen CGHS-empanelled hospital, present your CGHS card and the referral letter at the dedicated CGHS counter.

3. The hospital will initiate the process for pre-authorization from CGHS, which is mandatory for major elective surgeries like these. The medical team will confirm the diagnosis and match the required procedure with the appropriate code from the CGHS list.

4. Confirm the applicable rate with the hospital. The rate charged will depend on the hospital's accreditation status (NABH or non-NABH) at the time of the procedure. This is not a choice for the patient but is determined by the hospital's own certification.

5. Before admission, clarify all details regarding what is included in the CGHS package and what items, if any, will be billed separately. Ensure you receive this information in writing if possible.

Frequently Asked Questions

What is skull base surgery?

Skull base surgery refers to a group of highly specialized operations performed to treat tumours and other abnormalities on the underside of the brain, the base of the skull, or the upper vertebrae of the neck. It often involves collaboration between ENT surgeons and neurosurgeons.

Is endoscopic hypophysectomy a major procedure?

Yes, endoscopic hypophysectomy is considered a major and complex surgery. It involves removing a pituitary tumour through the nose and sphenoid sinus, requiring advanced surgical skills and equipment to navigate the delicate area near the brain and major nerves.

What is a cranio-facial resection?

Cranio-facial resection is an extensive surgical procedure to remove tumours that involve both the cranial base (skull) and the facial structures. It is often performed for cancerous growths that have spread across these areas.

Do the CGHS package rates cover implants like dural grafts used in skull base surgery?

The standard CGHS package rate typically does not include the cost of high-value implants or specialized consumables like dural grafts. These items are often billed separately. Beneficiaries should confirm the specifics of what is covered with the hospital's billing department before the surgery.

What is angiofibroma and why is its excision a specialized surgery?

An angiofibroma is a non-cancerous tumour rich in blood vessels, most commonly found in the back of the nasal cavity in adolescent males. Its excision is a specialized procedure because the tumour can bleed profusely during surgery, requiring expert surgical techniques to control blood loss and ensure complete removal.

Do I need a special referral for these advanced surgeries under CGHS?

Yes, for planned major surgeries such as these, you will need a specific referral from a government specialist or a CGHS medical officer. The referral must justify the need for the procedure at an empanelled private hospital.

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.