Question 1

Does the CGHS rate for Mitral valve Replacement(MVR)/ Aortic valve Replacement (AVR)/ Tricuspid Valve Replacement (TVR) / Pulmonary valve replacement (PVR) apply to private patients?

Accepted Answer

No. CGHS reference rates apply only to CGHS beneficiaries — central government employees, pensioners, and their dependents with a valid CGHS card. Private, self-paying patients are charged the hospital's regular rate, which is typically higher.

Question 2

What if the hospital charges more than the CGHS rate?

Accepted Answer

Empanelled hospitals agree in writing to accept CGHS rates for beneficiaries — the Ministry of Health & Family Welfare's Office Memorandum of 3 October 2025 states the revised rates apply to “all healthcare services availed at CGHS-empanelled Healthcare Organisations”. If you are overcharged as a beneficiary, raise it with the hospital billing desk first, then with your CGHS wellness centre. The Supreme Court in 2024 directed the central government to standardise hospital charges — until that takes effect, the CGHS rate is your enforceable reference.

Question 3

What do X, Y, and Z city tiers mean?

Accepted Answer

CGHS classifies cities by cost-of-living tier. Tier X covers metros (Delhi, Mumbai, Bengaluru, Chennai, Hyderabad, Kolkata, Ahmedabad and NCR towns). Tier Y covers other large cities (Pune, Jaipur, Lucknow, Bhopal, Chandigarh, Patna, Nagpur etc.). Tier Z covers all remaining CGHS cities. Tier Y rates are roughly 10% lower than X; Tier Z is roughly 20% lower.

Question 4

Why are NABH, Non-NABH and Super Speciality rates different?

Accepted Answer

CGHS uses NABH-accredited hospitals — which meet nationally verified quality standards — as the reference rate. Non-NABH (and Non-NABL) hospitals are paid 15% less than NABH; super-speciality hospitals, which provide tertiary procedures like cardiac surgery, transplants and advanced oncology, are paid 15% more than NABH. So for the same procedure, Non-NABH is the lowest and Super Speciality the highest. Each hospital's accreditation is shown on its detail page.

Question 5

How do ward entitlements (General, Semi-private, Private) affect the rate?

Accepted Answer

The rate above assumes a Semi-private ward. Ward entitlement only changes the price for procedures that require hospital admission — for those, General Ward is about 5% less and Private Ward about 5% more than Semi-private. Consultations, investigations, day-care and other procedures not requiring admission are the same in every ward. Your ward entitlement is set by your pay level at retirement (or current pay, for serving employees).

Question 6

When was this rate last revised?

Accepted Answer

These are the rates from the CGHS revision effective 13 October 2025, notified on 3 October 2025 by the Ministry of Health & Family Welfare. Check the official notification on cghs.mohfw.gov.in for any subsequent amendments.

City tier	Non-NABH−15%	NABHbase	Super+15%
XMetro
YCity
ZDistrict

Mitral valve Replacement(MVR)/ Aortic valve Replacement (AVR)/ Tricuspid Valve Replacement (TVR) / Pulmonary valve replacement (PVR)

What should this cost?

All 9 CGHS rates

Next up in Cardiothoracic & Cardiac Surgery

Find a CGHS hospitals for Mitral valve Replacement(MVR)/ Aortic valve Replacement (AVR)/ Tricuspid Valve Replacement (TVR) / Pulmonary valve replacement (PVR)

Frequently asked

What should this cost?

All 9 CGHS rates

Next up in Cardiothoracic & Cardiac Surgery

Find a CGHS hospitals for Mitral valve Replacement(MVR)/ Aortic valve Replacement (AVR)/ Tricuspid Valve Replacement (TVR) / Pulmonary valve replacement (PVR)

Frequently asked

01Does the CGHS rate for Mitral valve Replacement(MVR)/ Aortic valve Replacement (AVR)/ Tricuspid Valve Replacement (TVR) / Pulmonary valve replacement (PVR) apply to private patients?

02What if the hospital charges more than the CGHS rate?

03What do X, Y, and Z city tiers mean?

04Why are NABH, Non-NABH and Super Speciality rates different?

05How do ward entitlements (General, Semi-private, Private) affect the rate?

06When was this rate last revised?