CGHS Rates for Spine Surgery: Discectomy, Fusion, Scoliosis

Spine surgery encompasses a variety of procedures aimed at correcting structural problems in the spinal column, relieving pressure on nerves, or stabilizing vertebrae. For beneficiaries of the Central Government Health Scheme (CGHS), understanding the approved rates for these complex operations is crucial for planning treatment at an empanelled healthcare facility. This guide outlines the specific CGHS package rates for several major spine surgeries.

The procedures covered here include Discectomy (both standard and microdiscectomy), Spinal Fixation for different sections of the spine, Spinal Fusion surgery for varying numbers of vertebral levels, Scoliosis Surgery for deformity correction, Vertebroplasty for fracture repair, and Spinal Osteotomy. The rates are defined by the CGHS and differ based on whether the procedure is performed at a hospital with NABH (National Accreditation Board for Hospitals & Healthcare Providers) accreditation or a non-NABH facility. This page serves as a reference for patients to understand the scope of coverage for their prescribed spinal procedure.

CGHS Spine Surgery Rates — Additional Procedures (effective 13 October 2025)

These orthopaedic codes carry no separate super-speciality rate.

• Discectomy/ Micro Discectomy, Non-NABH — Rs 69,700
• Discectomy/ Micro Discectomy, NABH — Rs 82,000
• Spinal Fixation Cervical/dorsolumbar/ lumbosacral, Non-NABH — Rs 1,29,200
• Spinal Fixation Cervical/dorsolumbar/ lumbosacral, NABH — Rs 1,52,000
• Fusion Surgery Cervical/ Lumbar Spine up to 2 Level, Non-NABH — Rs 53,550
• Fusion Surgery Cervical/ Lumbar Spine up to 2 Level, NABH — Rs 63,000
• Spinal Fusion Surgery Cervical/ Lumbar Spine -More than 2 Level, Non-NABH — Rs 69,700
• Spinal Fusion Surgery Cervical/ Lumbar Spine -More than 2 Level, NABH — Rs 82,000
• Scoliosis Surgery/ Deformity Correction of Spine, Non-NABH — Rs 82,450
• Scoliosis Surgery/ Deformity Correction of Spine, NABH — Rs 97,000
• Vertebroplasty, Non-NABH — Rs 64,600
• Vertebroplasty, NABH — Rs 76,000
• Spinal Osteotomy, Non-NABH — Rs 45,050
• Spinal Osteotomy, 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 covers

This information is for all CGHS beneficiaries, including current central government employees, pensioners, and their eligible dependents, who have been medically advised to undergo specific spine surgery. A formal referral from a government or CGHS medical specialist is a prerequisite for availing these benefits at an empanelled hospital.

The procedures detailed in the rate table on this page are:

• Discectomy / Micro Discectomy: Removal of a herniated disc.

• Spinal Fixation: Stabilization of the cervical, dorsolumbar, or lumbosacral spine, often using instrumentation.

• Fusion Surgery: Fusing two or more vertebrae in the cervical or lumbar spine. Rates are specified for procedures involving up to 2 levels and for those involving more than 2 levels.

• Scoliosis Surgery / Deformity Correction: Surgical correction of an abnormal curvature of the spine.

• Vertebroplasty: A procedure to stabilize compression fractures in the vertebra.

• Spinal Osteotomy: A procedure where bone is cut to realign a part of the spine.

What CGHS covers vs. what you pay separately

The CGHS package rates listed in the table are designed to cover the primary costs associated with the surgical procedure itself. This typically includes the surgeon's fee, anaesthetist's fee, operation theatre charges, standard medications, and a specified duration of inpatient room stay as per the beneficiary's entitlement.

However, it is important to note that the cost of high-value implants and certain specialized consumables may not be fully included in the package rate. For many spine surgeries, items such as pedicle screws, rods, interbody cages, plates, and bone graft substitutes are billed separately. The reimbursement for these items is often capped at specific ceiling rates set by the CGHS.

Patients are strongly advised to have a detailed discussion with the hospital's billing or CGHS department before admission. This will help clarify the total estimated cost, including the portion covered by the CGHS package and any additional out-of-pocket expenses for implants or other non-covered items.

How to use this at a CGHS-empanelled hospital

To avail the benefits for spine surgery under CGHS, follow these steps:

1. Obtain a valid referral from a government hospital specialist or a designated CGHS medical officer. The referral must clearly state the diagnosis and the specific surgical procedure required.

2. Select a hospital from the list of facilities empanelled under CGHS for neurosurgery or orthopaedic spine surgery. The rates applicable (NABH or non-NABH) are determined by the hospital's current accreditation status, which can be verified at the facility.

3. Upon arrival at the hospital, proceed to the CGHS help desk. Present your CGHS card, the referral letter, and any other required documents.

4. Before the hospital initiates the pre-authorization process, confirm that the procedure code and description they are using match exactly with the one prescribed by your doctor and listed in the CGHS rate list. This alignment is critical to ensure smooth processing of the cashless facility and to avoid any billing disputes later.

Frequently Asked Questions

What is the difference between a discectomy and a microdiscectomy?

A discectomy is the surgical removal of herniated disc material that is pressing on a nerve or the spinal cord. A microdiscectomy is a minimally invasive version of this surgery performed using a surgical microscope and a smaller incision. Both fall under the same CGHS procedure code.

Are spine implants like screws and rods included in the CGHS package rate?

The CGHS package rate generally covers the surgical procedure, but high-cost implants like screws, rods, and cages used in spinal fixation and fusion are often billed separately. CGHS has set ceiling prices for these implants, and any amount exceeding that may be an out-of-pocket expense. Always clarify implant costs with the hospital beforehand.

Does the CGHS rate for spinal fusion change based on the complexity?

Yes, the CGHS rate list differentiates based on the number of spinal levels being fused. There are separate package rates for 'Spinal Fusion Surgery up to 2 Level' and 'Spinal Fusion Surgery - More than 2 Level' for both the cervical and lumbar spine.

What is vertebroplasty and is it covered by CGHS?

Vertebroplasty is a procedure to treat painful vertebral compression fractures, often due to osteoporosis. It involves injecting medical-grade bone cement into the fractured vertebra to stabilize it. This procedure is listed with a specific package rate under CGHS.

How do I determine if a hospital will use the NABH or non-NABH rate?

The applicable rate depends on the hospital's accreditation status, not your choice. If a hospital is accredited by the National Accreditation Board for Hospitals & Healthcare Providers (NABH), it is permitted to charge the higher NABH rate. You can confirm a hospital's accreditation status at their reception or on the official CGHS website.

Is surgery for scoliosis covered under CGHS?

Yes, surgical treatment for scoliosis, referred to as 'Scoliosis Surgery/ Deformity Correction of Spine' in the CGHS list, is a covered procedure with a dedicated package rate. This is a complex surgery to correct and stabilize an abnormal curvature of the spine.

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.