Ayushman Bharat (PM-JAY) Knee Replacement Package Rate
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Medically reviewed by Dr. Nikhil Singh, Anaesthesia, MBBS, MD
Last reviewed: 19 Sept 2026 · How we review health content
Under Ayushman Bharat PM-JAY, total knee replacement is a defined Health Benefit Package. The base procedure rate is stratified by city tier, and the knee implant is mapped as a separate allowance.
PM-JAY Total Knee Replacement Package (HBP 2022)
Base procedure rate by city tier. The implant is reimbursed separately.
- Primary TKR base package, Tier-3 (Z) — Rs 36,400
- Primary TKR base package, Tier-2 (Y) — Rs 41,300
- Primary TKR base package, Tier-1 (X) — Rs 43,600
- Knee implant allowance (per knee, separate) — Rs 55,000
- Revision TKR base package (Tier-3 to Tier-1) — Rs 44,600 - 53,500
Rates shown are as per the Ayushman Bharat PM-JAY Health Benefit Package (HBP) 2022 master, National Health Authority (2022) and are subject to periodic revision. Always verify the latest approved rates on the official source.
How Ayushman Bharat (PM-JAY) Works
Ayushman Bharat PM-JAY provides health cover of Rs 5,00,000 per family per year for secondary and tertiary hospitalisation on a family-floater basis, with no cap on family size, age or gender and pre-existing conditions covered from day one.
Eligible families are identified from the SECC 2011 deprivation and occupational criteria. Treatment is cashless and paperless at empanelled public and private hospitals and is portable across India.
Payment is made against fixed Health Benefit Packages. HBP 2022 introduced tiered pricing by city tier (Tier-1/X, Tier-2/Y, Tier-3/Z), with implants such as stents and joint prostheses reimbursed as separately mapped add-on amounts.
Frequently Asked Questions
Is knee replacement free under Ayushman Bharat?
For eligible beneficiaries it is cashless at empanelled hospitals within the Rs 5 lakh family cover. The package pays the hospital a defined rate (base package plus a Rs 55,000 implant allowance per knee).
Why does the PM-JAY rate differ from the CGHS rate?
PM-JAY and CGHS are different schemes with their own package masters and eligibility. PM-JAY HBP 2022 uses tiered city pricing; CGHS uses its own OM-based rate lists.
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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.
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For eligible beneficiaries it is cashless at empanelled hospitals within the Rs 5 lakh family cover. The package pays the hospital a defined rate (base package plus a Rs 55,000 implant allowance per knee).
PM-JAY and CGHS are different schemes with their own package masters and eligibility. PM-JAY HBP 2022 uses tiered city pricing; CGHS uses its own OM-based rate lists.
Written by Dr. Nikhil Singh · Anaesthesia, MBBS, MD
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Written by Dr. Nikhil Singh
Anaesthesia, MBBS, MD
Last reviewed: 19 September 2026
Medical Disclaimer
The content provided on Zospital 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 on this website. If you think you may have a medical emergency, call your doctor or emergency services immediately.
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