CGHS Rates for Spine & Functional Neurosurgery

Spine and functional neurosurgery are highly specialized fields that address a wide range of complex conditions affecting the brain, spinal cord, and peripheral nerves. These procedures can correct congenital abnormalities, repair traumatic injuries, stabilize the spine, and manage chronic pain or movement disorders.

This page provides a guide to the Central Government Health Scheme (CGHS) approved rates for several key spine and functional neurosurgery procedures. These include treatments for congenital issues like spina bifida (meningomyelocele), nerve injuries such as brachial plexus damage, spinal instability requiring craniovertebral (CV) junction fusion, and vertebral fractures treated with balloon kyphoplasty. It also covers functional procedures like implanting pumps for spasticity and stimulators for movement disorders or chronic pain.

The rate table above details the specific amounts approved by CGHS for each procedure at empanelled healthcare facilities. Rates vary depending on the specific surgery and whether the hospital holds NABH accreditation. This guide will help you understand what is covered, what may be billed separately, and how to navigate the process at a CGHS-empanelled hospital.

CGHS Spine & Functional Neurosurgery Rates (effective 13 October 2025)

• Meningomyelocele Repair, Non-NABH — Rs 53,550
• Meningomyelocele Repair, NABH — Rs 63,000
• Meningomyelocele Repair, Super Speciality — Rs 72,450
• Brachial Plexus Exploration and neurotization, Non-NABH — Rs 53,550
• Brachial Plexus Exploration and neurotization, NABH — Rs 63,000
• Brachial Plexus Exploration and neurotization, Super Speciality — Rs 72,450
• Combined Trans-Oral Surgery & Craniovertebral (CV) Junction Fusion, Non-NABH — Rs 53,550
• Combined Trans-Oral Surgery & Craniovertebral (CV) Junction Fusion, NABH — Rs 63,000
• Combined Trans-Oral Surgery & Craniovertebral (CV) Junction Fusion, Super Speciality — Rs 72,450
• Craniovertebral Junction (CVJ) Fusion procedures, Non-NABH — Rs 64,600
• Craniovertebral Junction (CVJ) Fusion procedures, NABH — Rs 76,000
• Craniovertebral Junction (CVJ) Fusion procedures, Super Speciality — Rs 87,400
• Depressed Fracture Elevation, Non-NABH — Rs 45,050
• Depressed Fracture Elevation, NABH — Rs 53,000
• Depressed Fracture Elevation, Super Speciality — Rs 60,950
• Spasticity Surgery, Non-NABH — Rs 45,050
• Spasticity Surgery, NABH — Rs 53,000
• Spasticity Surgery, Super Speciality — Rs 60,950
• Spinal Bifida Surgery Major, Non-NABH — Rs 53,550
• Spinal Bifida Surgery Major, NABH — Rs 63,000
• Spinal Bifida Surgery Major, Super Speciality — Rs 72,450
• Spinal Bifida Surgery Minor, Non-NABH — Rs 45,050
• Spinal Bifida Surgery Minor, NABH — Rs 53,000
• Spinal Bifida Surgery Minor, Super Speciality — Rs 60,950
• Trans Oral Surgery, Non-NABH — Rs 45,050
• Trans Oral Surgery, NABH — Rs 53,000
• Trans Oral Surgery, Super Speciality — Rs 60,950
• Radiofrequency (RF) lesion for facet joint pain syndrome, Non-NABH — Rs 53,550
• Radiofrequency (RF) lesion for facet joint pain syndrome, NABH — Rs 63,000
• Radiofrequency (RF) lesion for facet joint pain syndrome, Super Speciality — Rs 72,450
• Lateral mass C1-C2 screw fixation, Non-NABH — Rs 64,600
• Lateral mass C1-C2 screw fixation, NABH — Rs 76,000
• Lateral mass C1-C2 screw fixation, Super Speciality — Rs 87,400
• Baclofen pump implantation lesioning for movement disorder including Parkinsonism/Spinal Cord Stimulator Implantation, Non-NABH — Rs 64,600
• Baclofen pump implantation lesioning for movement disorder including Parkinsonism/Spinal Cord Stimulator Implantation, NABH — Rs 76,000
• Baclofen pump implantation lesioning for movement disorder including Parkinsonism/Spinal Cord Stimulator Implantation, Super Speciality — Rs 87,400
• Endoscopic Sympathectomy, Non-NABH — Rs 53,550
• Endoscopic Sympathectomy, NABH — Rs 63,000
• Endoscopic Sympathectomy, Super Speciality — Rs 72,450
• Dorsal column stimulation for backache in failed back syndrome, Non-NABH — Rs 53,550
• Dorsal column stimulation for backache in failed back syndrome, NABH — Rs 63,000
• Dorsal column stimulation for backache in failed back syndrome, Super Speciality — Rs 72,450
• Baclofen pump implantation for spasticity/Intra-thecal Pump Implantation, Non-NABH — Rs 29,750
• Baclofen pump implantation for spasticity/Intra-thecal Pump Implantation, NABH — Rs 35,000
• Baclofen pump implantation for spasticity/Intra-thecal Pump Implantation, Super Speciality — Rs 40,250
• Balloon Kyphoplasty, Non-NABH — Rs 53,550
• Balloon Kyphoplasty, NABH — Rs 63,000
• Balloon Kyphoplasty, Super Speciality — Rs 72,450

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 guide is intended for CGHS beneficiaries who have been advised to undergo specific spine or functional neurosurgery procedures. The rates apply to a defined list of surgeries aimed at treating a variety of neurological and spinal conditions.

The procedures covered on this page include:

• Meningomyelocele & Spinal Bifida Repair (Major/Minor): Surgical correction for congenital defects where the spinal cord does not form properly.

• Craniovertebral (CV) Junction Fusion & Trans-Oral Surgery: Procedures to stabilize the critical junction between the skull and the upper spine.

• Brachial Plexus Exploration and Neurotization: Surgery to repair nerves that control the arm and hand, often following a traumatic injury.

• Spasticity & Movement Disorder Surgery: Includes procedures like Baclofen pump implantation to control muscle stiffness and spinal cord stimulator implantation for conditions like Parkinsonism or chronic pain.

• Balloon Kyphoplasty: A minimally invasive procedure to treat painful compression fractures of the vertebrae.

• Other Procedures: Such as Depressed Fracture Elevation, Radiofrequency (RF) lesioning for facet joint pain, and Endoscopic Sympathectomy.

What CGHS Covers vs. What You Pay Separately

Understanding the components of the CGHS package rate is essential for managing your healthcare expenses. The approved package rate for a specific neurosurgical procedure typically includes the cost of the surgery itself, the surgeon's and anaesthetist's fees, operation theatre charges, and the hospital stay corresponding to the beneficiary's ward entitlement (General, Semi-Private, or Private).

However, it is important to note that the cost of many high-value implants and specialized consumables is often excluded from the package rate. For the procedures listed, this can include items like spinal screws, plates, or rods used in fusion surgeries, intracorporeal balloons for kyphoplasty, Baclofen pumps, and spinal cord stimulators or dorsal column stimulators.

These items are generally billed separately from the procedure package. Under CGHS norms, empanelled hospitals charge for these implants and consumables at the Maximum Retail Price (MRP). Before undergoing surgery, it is advisable to have a detailed discussion with the hospital's billing department to get an estimate of the costs for any items not included in the package rate.

How to Use This at a CGHS-Empanelled Hospital

To utilize your CGHS benefits for any of these neurosurgical procedures, you must follow a set process. The first step is to obtain a formal referral or 'advice' for the specific surgery from a specialist at a government hospital or a CGHS wellness centre.

Once you have the referral, you can approach a CGHS-empanelled private hospital that is equipped to perform the required procedure. At the hospital, present your CGHS card along with the specialist's referral letter to the admissions or CGHS desk.

It is very important to confirm the exact procedure name and code with the hospital billing department before your admission. Ensure it matches the official CGHS list to avoid any confusion or billing issues after the surgery is completed.

Finally, remember that CGHS provides two tiers of rates: one for NABH-accredited hospitals and another for non-NABH-accredited hospitals. The rate that applies to your procedure is determined by the accreditation status of the hospital you choose, not by any other factor.

Frequently Asked Questions

What is the difference between 'Spinal Bifida Surgery Major' and 'Minor' on the CGHS rate list?

The classification of a spinal bifida surgery as 'major' or 'minor' depends on the complexity and extent of the surgical repair needed. A minor procedure might involve closing a small skin defect, while a major repair could involve complex reconstruction of neural and soft tissues. The treating surgeon and the hospital will determine the appropriate classification based on the patient's specific condition.

Are implants like screws for CVJ fusion covered in the package rate?

Typically, the cost of implants is not included in the CGHS package rate for fusion surgeries. Items like pedicle screws, rods, plates, and cages used to stabilize the spine are billed separately. Beneficiaries will have to pay for these items at MRP, in addition to the package rate.

My father needs Balloon Kyphoplasty for a spinal fracture. Is this covered?

Yes, Balloon Kyphoplasty is included in the CGHS list of approved procedures. It is a minimally invasive surgery used to treat painful vertebral compression fractures, often caused by osteoporosis. The procedure involves inflating a balloon in the vertebra to restore its height and then injecting bone cement to stabilize it.

What is a Baclofen pump implantation used for?

Baclofen pump implantation is a procedure for managing severe spasticity (muscle stiffness and spasms) that does not respond to oral medication. A small pump is surgically placed under the skin of the abdomen to deliver Baclofen directly to the spinal fluid. While the surgical procedure is covered under a package rate, the pump itself is usually a high-cost item billed separately.

How do I get approval for Brachial Plexus Exploration surgery under CGHS?

First, you need a referral from a specialist at a government hospital or CGHS wellness centre recommending the surgery. With this advice and your CGHS card, you can approach any CGHS-empanelled hospital that has the neurosurgical capability for this procedure. Confirm the procedure details and billing with the hospital's CGHS desk before admission.

What does 'Radiofrequency (RF) lesion for facet joint pain syndrome' mean?

This is a minimally invasive pain management procedure. It is used to treat chronic back or neck pain originating from the facet joints of the spine. The procedure uses radiofrequency energy to heat and disable the small nerves that send pain signals from the joint to the brain, providing pain relief. It is covered under a specific CGHS code.

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.