CGHS Breast Surgery Rate List: Mastectomy and Reconstruction

CGHS covers breast surgery, the imaging and biopsy that lead up to it, and post-mastectomy reconstruction.

The Office Memorandum effective 13 October 2025 states that for cancer SURGERIES the existing CGHS rules and rates continue, and revised only chemotherapy, radiotherapy and investigations. Mastectomy itself therefore has no code in the 2025 schedule, so the figures below cover reconstruction, imaging and tumour testing — the parts that were repriced.

CGHS Post-Mastectomy Reconstruction Rates (effective 13 October 2025)

Reconstruction is priced under burns and plastic surgery, which carries three rates — non-NABH, NABH and a higher super-speciality rate. The 2025 OM states that for cancer SURGERIES the existing CGHS rules and rates continue, so mastectomy itself was not repriced. 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.

• Post-mastectomy reconstruction (mammoplasty), Non-NABH — Rs 36,550
• Post-mastectomy reconstruction (mammoplasty), NABH — Rs 43,000
• Post-mastectomy reconstruction (mammoplasty), Super Speciality — Rs 49,450
• Flap reconstructive surgery — head and neck, Non-NABH — Rs 53,550
• Flap reconstructive surgery — head and neck, NABH — Rs 63,000
• Flap reconstructive surgery — head and neck, Super Speciality — Rs 72,450

Breast Imaging, Biopsy and Tumour Testing

The 2025 OM did revise investigations, so the figures below supersede the 2014 list.

• X-ray mammography, unilateral or bilateral, Non-NABH — Rs 1,169
• X-ray mammography, unilateral or bilateral, NABH — Rs 1,375
• MRI mammography, Non-NABH — Rs 4,250
• MRI mammography, NABH — Rs 5,000
• USG breast with relevant lymph nodes, unilateral or bilateral, Non-NABH — Rs 680
• USG breast with relevant lymph nodes, unilateral or bilateral, NABH — Rs 800
• MRI breast, with contrast, Non-NABH — Rs 4,250
• MRI breast, with contrast, NABH — Rs 5,000
• MRI breast, without contrast, Non-NABH — Rs 2,975
• MRI breast, without contrast, NABH — Rs 3,500
• Trucut needle biopsy (excluding the cost of the needle or biopsy gun), Non-NABH — Rs 3,273
• Trucut needle biopsy (excluding the cost of the needle or biopsy gun), NABH — Rs 3,850
• Histopathology examination — paraffin section, Non-NABH — Rs 425
• Histopathology examination — paraffin section, NABH — Rs 500
• ER / PR / HER2-neu with Ki67, Non-NABH — Rs 4,250
• ER / PR / HER2-neu with Ki67, NABH — Rs 5,000
• FISH for HER2-neu, Non-NABH — Rs 8,500
• FISH for HER2-neu, NABH — Rs 10,000

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.

Mastectomy Rates Were Not Revised in 2025

Clause 2(f) of the Office Memorandum effective 13 October 2025 says that for cancer surgeries the existing CGHS rules and rates continue, and that the revised rates apply to chemotherapy, investigations and radiotherapy. Mastectomy accordingly has no code in the 2025 rate table.

The previously notified figures therefore remain in force: a simple mastectomy at Rs 12,650 (non-NABH) and Rs 14,548 (NABH), and a formal or modified radical mastectomy at Rs 28,750 and Rs 33,063. Ask the empanelled hospital which figure is written on your permission letter before surgery, because these are the one part of this page the 2025 memorandum did not reprice.

Chemotherapy and Radiotherapy Are Separate

Breast cancer treatment usually combines surgery with chemotherapy and/or radiotherapy. Those are billed under their own CGHS codes, not the mastectomy package, and the Office Memorandum effective 13 October 2025 did reprice them — see our CGHS cancer treatment rate guide for the current chemotherapy and radiotherapy figures.

How CGHS Package Rates Work

A CGHS "package rate" is an all-inclusive amount covering admission, surgeon and anaesthetist charges, operation theatre, nursing, routine investigations, medicines and accommodation for the standard length of stay.

Under the Office Memorandum effective 13 October 2025, 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 the NABH rate.

The published rate is the semi-private ward figure: a general-ward entitlement is 5% lower and a private-ward entitlement 5% higher. Hospitals in Tier II cities are paid 10% less and in Tier III cities 20% less than in Tier I, with the North-East and the Union Territories of Jammu & Kashmir and Ladakh at Tier II rates.

Referral and Prior Permission

For planned (non-emergency) procedures, a CGHS beneficiary needs a referral from the CGHS wellness centre and prior permission from the competent authority. Emergency treatment at an empanelled hospital is reimbursed up to CGHS rates without prior permission.

• Carry a valid CGHS card and follow your ward entitlement (based on pay/pension)
• Use an empanelled hospital for cashless treatment up to CGHS rates
• Obtain prior permission and referral for planned surgery

Frequently Asked Questions

Does the mastectomy package include chemotherapy?

No. The mastectomy package covers the surgery and standard hospital stay. Chemotherapy cycles and radiotherapy courses are reimbursed under separate CGHS codes.

Is breast reconstruction covered by CGHS?

Yes — post-mastectomy reconstruction (mammoplasty) is priced under burns and plastic surgery at Rs 36,550 (non-NABH), Rs 43,000 (NABH) and Rs 49,450 (super-speciality) under the rates effective 13 October 2025.

Related

• CGHS chemotherapy and radiotherapy rates
• CGHS rate list for common procedures

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.