Surgical Benefit Schedule (2)
| Health Insurance Coverage | ||
| Description of Surgical Operation Percentage of Maximum Benefits | ||
| Esophagus | Operation for stricture | 37.50% |
| | Use of gastroscope | 12.50% |
| Eye | Removal of foreign body, from Cornea | 2.50% |
| | Detached retina multiple fusions | 100.00% |
| | Cataract, Retinal treatment by laser | 50.00% |
| | Glaucoma | 31.25% |
| | Removal of eyeball, Ocular muscle surgery | 31.25% |
| | Removal of pterygium | 15% |
| | Probing of lacrimal passage | 12.50% |
| | Probing of lacrimal passage with insertion of tube or stent | 15.00% |
| | Nasolacrimal duct surgery | 31.25% |
| | Incision of style or chalazion | 5.00% |
| Fractures | Treatment of Simple Collar bone, shoulder blade, | 15.00% |
| | Coccyx, tarsals, metatarsals or os calcis | 10.00% |
| | Thigh | 37.00% |
| | Upper arm or leg, one bone | 25.00% |
| | Fingers or toes, each or rib | 5.00% |
| | Forearm two bones, knee cap, or pelvis, not requiring traction | 20.00% |
| | Leg, two bones | 30.00% |
| | Jaw, lower Facial bone | 17.50% |
| | Carpals, metacarpals, nose, ribs two or more or sternum | 7.50% |
| | Pelvis, requiring traction | 31.25% |
| | Vertebrae, transverse processes, each | 6.25% |
| | Vertebrae, compression fracture, one or more | 37.50% |
| | Wrist | 11.25% |
| Compound Open | For a compound fracture increase the above benefits 50% for a fracture requiring an oper operation including bone grafting or bone splicing, increase the above benefit 100% except that the maximum benefit shall not exceed | 100.00% |
| Genito-Urinary Tract | Removal of kidney | 75.00% |
| | Fixation of kidney | 75.00% |
| | Removal of tumors or stones in kidney, ureter, or bladder by cutting operation | 62.50% |
| | By cauterization of endoscopic means, ESWL | 20.00% |
| | Stricture of urethra open operation | 30.00% |
| | Intra-urethral cutting operation | 15.00% |
| | Prostrate entire removal by open operation-complete procedure | 75.00% |
| | Partial removal by endoscopic means | 25.00% |
| | By other cutting operation | 50.00% |
| | Orchidectomy or epididymectomy | 25.00% |
| | Hydrocele or varicocele | 12.50% |
| | Circumcision | 12.50% |
| | Hysterectomy, radical for cancer | 75.00% |
| | Abdominal operation for extra-uterine pregnany | 50.00% |
| | Hysterectomy with complete removal of tubes and ovaries, with or without appendectomy | 62.50% |
| | Curettage or cauterization of cervix non-puerperal | 10.00% |
| | Dilations and curettage, non-puerperal | 12.50% |
| | Repair of perineal or vaginal laceration, not immediately post partum, including cystocele and rectocele | 37.50% |
| | Removal of fibroid tumors without abdominal approach, Transvaginal hysterectomy | 20.00% |
| Goitre | Total & subtotal thyroidectomy | 75.00% |
| | Thyroid lobectomy | 37.50% |
| Hernia | Injection treatment, complete course | |
| | Single hernia | 18.75% |
| | Double hernia | 25.00% |
| | Radical operation, including injection treatment for cure of | |
| | Single hernia | 37.50% |
| | Double hernia | 50.00% |
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