CGHS Tonsillectomy Rate: Tonsil Surgery Package Rate

CGHS reimburses tonsillectomy (tonsil removal) at a fixed package rate at empanelled hospitals. The Office Memorandum effective 13 October 2025 sets it at Rs 23,375 for a non-NABH hospital and Rs 27,500 for a NABH hospital.

CGHS Tonsillectomy and Adenoid Surgery Rates (effective 13 October 2025)

ENT procedure codes carry no separate super-speciality rate. The OM sets the non-NABH rate 15% below the NABH rate for the same code. The OM sets these rates for the semi-private ward: a general-ward entitlement is 5% lower and a private-ward entitlement 5% higher. Tier II cities are 10% lower and Tier III cities 20% lower than Tier I.

• Tonsillectomy, Non-NABH — Rs 23,375
• Tonsillectomy, NABH — Rs 27,500
• Adenoidectomy, Non-NABH — Rs 17,000
• Adenoidectomy, NABH — Rs 20,000
• Peritonsillar abscess (quinsy) drainage under local anaesthesia, Non-NABH — Rs 7,225
• Peritonsillar abscess (quinsy) drainage under local anaesthesia, NABH — Rs 8,500
• Uvulo-palatoplasty, Non-NABH — Rs 29,750
• Uvulo-palatoplasty, NABH — Rs 35,000
• Palatopharyngoplasty, Non-NABH — Rs 29,750
• Palatopharyngoplasty, NABH — Rs 35,000

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.

How CGHS Package Rates Work

A CGHS package rate is all-inclusive of admission, surgeon and anaesthetist charges, operation theatre, nursing, routine investigations, medicines and accommodation for the standard length of stay. A non-NABH hospital is paid 15% below the NABH rate, and for the specialities the memorandum names, a super-speciality hospital is paid 15% above it.

The figures on this page come from the Office Memorandum effective 13 October 2025. The published rate is the semi-private ward figure: a general-ward entitlement is 5% lower and a private-ward entitlement 5% higher, and hospitals in Tier II and Tier III cities are paid 10% and 20% less than in Tier I.

Referral and Prior Permission

Planned major procedures need a referral from the CGHS wellness centre and prior permission. Emergency treatment at an empanelled hospital is reimbursed up to CGHS rates without prior permission.

Frequently Asked Questions

What is the CGHS rate for tonsil surgery?

Rs 23,375 at a non-NABH hospital and Rs 27,500 at a NABH hospital, under the rates effective 13 October 2025. ENT codes carry no separate super-speciality rate.

Are the adenoids removed under the same code?

No. Adenoidectomy is a separate code at Rs 17,000 (non-NABH) and Rs 20,000 (NABH). If both are done in one session, the higher-priced procedure is paid in full and the second at 50% of its package rate.

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.