Quick answer. Across 62 comparable procedures, the CGHS Tier I NABH rate was a median 1.27 times the PM-JAY Tier 1 rate. CGHS was higher on 45, lower on 16 and equal on 1. These are what each scheme pays hospitals, from lists dated 2025 and 2022, not what private patients pay.
We matched 82 procedures across the two main government rate lists in India, one by one, and recorded both rates with the page they came from. 53 are exact matches and 29 are close ones. 62 of them are comparable enough to go into the medians, and the method section explains why the other 20 are not. The full dataset is a free CSV download.
This is general information about scheme payments, not medical or financial advice. For how each scheme works, see CGHS explained and PM-JAY explained. More cost pages are under cost guides and schemes and insurance.
Main findings
- Across 62 procedures that match in scope, the CGHS NABH rate for Tier I cities was a median 1.27 times the PM-JAY Tier 1 rate (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- Across the same 62 procedures, the CGHS non-NABH rate for Tier I cities was a median 1.08 times the PM-JAY Tier 1 rate (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- The CGHS Tier I NABH rate was higher than PM-JAY Tier 1 on 45 of 62 comparable procedures, lower on 16 and equal on 1 (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- Half of the 62 comparable procedures had a CGHS-to-PM-JAY ratio between 0.97 and 1.83, and 13 of them had a ratio of 2.00 or more (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- Orthopaedics had the highest median ratio of any specialty, 2.46 across 8 procedures, and cardiology the lowest, 0.96 across 6 (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- Total knee replacement, one knee, is listed at ₹1,52,000 under CGHS (OR089, Tier I NABH) and ₹43,600 under PM-JAY (SB039A, Tier 1), a ratio of 3.49, with the implant separate in both (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- Phaco cataract surgery, per eye, is listed at ₹17,000 under CGHS (OP100, Tier I NABH) and ₹5,700 under PM-JAY (SE020A, Tier 1), a ratio of 2.98, with the lens separate in both (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- Total laparoscopic hysterectomy is listed at ₹63,000 under CGHS (OG046, Tier I NABH) and ₹25,000 under PM-JAY (SO010E, Tier 1), a ratio of 2.52 (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- Laparoscopic gall bladder removal is listed at ₹36,300 under CGHS (AG094, Tier I NABH) and ₹38,900 under PM-JAY (SG039C, Tier 1), a ratio of 0.93 (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- A single chamber pacemaker implantation is listed at ₹35,200 under CGHS (CP006, Tier I NABH) and ₹36,800 under PM-JAY (MC015A, Tier 1), a ratio of 0.96, with the device separate in both (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- The lowest ratio among comparable procedures was the Whipple operation, ₹53,000 under CGHS (AG035, Tier I NABH) and ₹1,50,000 under PM-JAY (SG045A, Tier 1), a ratio of 0.35 (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
- A haemodialysis session is listed at ₹2,500 under CGHS (NU122, sero-negative, Tier I NABH) and ₹1,800 under PM-JAY (MG072D, Tier 1), a ratio of 1.39 (CGHS memorandum of 3 Oct 2025 against PM-JAY HBP 2022, Uttarakhand copy, checked 2 Nov 2026).
How to read this
The ratio is the CGHS Tier I NABH rate divided by the PM-JAY Tier 1 rate. A ratio of 1.50 means the CGHS line is one and a half times the PM-JAY line. A ratio below 1.00 means the PM-JAY line is the higher one. Tier I and Tier 1 both mean the same 8 cities in the 7th Pay Commission X group, so the comparison is between lists for the same kind of city.
- These are scheme payments. Each figure is what that scheme pays an empanelled hospital for its own members. Neither is a price a private patient is charged or can ask for.
- The lists are about three and a half years apart. The CGHS memorandum is dated 3 Oct 2025 and the NHA memorandum on HBP 2022 is dated 6 Apr 2022. We did not adjust either for inflation, so some of the gap may be the date alone.
- The schemes serve different people. CGHS covers central government employees, pensioners and other listed groups. PM-JAY covers eligible families. A higher or lower rate says nothing about the quality of care under either scheme, and neither rate shows what a procedure costs a hospital to deliver.
- Accreditation is handled differently. The CGHS NABH rate has accreditation built in. PM-JAY Tier 1 does not. NHA’s 2021 guidelines describe indicative, voluntary incentives on top of the base rate, including 15% for full NABH accreditation. If that 15% applied to every row, the median would be 1.10 across 62 procedures. That is our arithmetic, and a state may not pay it.
- Implants are outside these figures. For rows marked separate in both, the ratio compares procedure rates before the implant. PM-JAY prints its implant amount, while CGHS pays at ceiling rates its memorandum does not print, so we cannot compare totals. See our knee replacement, angioplasty and cataract guides for the implant figures we could trace.
We do not read any of this as showing that either scheme pays too much or too little, or as saying anything about what hospitals charge. It shows what two published lists say.
Findings by specialty
Each median uses only the rows comparable in scope, so the count beside it is the sample. Below about 5 rows, treat a median as a rough pointer. The overall median is 1.27 across 62 procedures.
| Specialty | Rows in dataset | Rows in median | Median ratio, CGHS NABH to PM-JAY Tier 1 | Lowest to highest |
|---|---|---|---|---|
| Orthopaedics | 9 | 8 | 2.46 | 1.63 to 3.49 |
| Cardiology | 8 | 6 | 0.96 | 0.55 to 1.99 |
| Cardiac surgery | 6 | 5 | 1.11 | 0.92 to 1.37 |
| Ophthalmology | 9 | 7 | 1.18 | 0.94 to 2.98 |
| General surgery | 10 | 10 | 1.22 | 0.35 to 2.20 |
| Gynaecology and obstetrics | 9 | 7 | 1.72 | 1.12 to 2.52 |
| Urology | 8 | 6 | 1.21 | 0.94 to 2.20 |
| ENT | 9 | 5 | 1.22 | 1.00 to 1.80 |
| Neurosurgery | 8 | 6 | 1.12 | 0.94 to 1.91 |
| Oncology (radiotherapy and isotope) | 3 | 0 | None | Not comparable, see below |
| Dialysis and kidney access | 3 | 2 | 1.13 | 0.87 to 1.39 |
Gynaecology and obstetrics has a median of 1.72 across 7 procedures, partly because PM-JAY lists its six hysterectomy lines at one rate while CGHS pays more for laparoscopic routes. Caesarean section (3.53) and normal delivery (3.50) have higher ratios still, but they are outside the median because the CGHS lines include newborn care. Dialysis has only 2 rows in its median, so its 1.13 is a thin figure.
Oncology has no median. The three radiotherapy and isotope rows below use different units in each list, and cancer surgery and chemotherapy were left out altogether, for reasons given in the method section.
The full table: 82 procedures
Rates are in rupees for a semi-private ward where CGHS applies. Ratios are rounded to two decimals. Rows marked as a close match have a small difference in wording, set out in the CSV. Rows marked “not in medians” still show their ratio, but please do not quote those as like for like.
Orthopaedics
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Total knee replacement, primary, one knee | ₹1,52,000 | ₹43,600 | 3.49 | Separate in both. |
| Total hip replacement (close match) | ₹1,29,000 | ₹73,900 | 1.75 | Separate in both. Not in medians: one CGHS rate maps to several PM-JAY rates. |
| Total elbow replacement | ₹1,10,000 | ₹34,100 | 3.23 | Separate in both. |
| ACL reconstruction | ₹63,000 | ₹38,600 | 1.63 | Separate in both. |
| Proximal femoral nail for intertrochanteric fracture | ₹53,000 | ₹20,200 | 2.62 | Separate in both. |
| Dynamic hip screw for hip fracture (close match) | ₹53,000 | ₹23,000 | 2.30 | Separate in both. |
| Tension band wiring | ₹27,500 | ₹16,300 | 1.69 | Separate in both. |
| Below knee amputation (close match) | ₹43,000 | ₹23,300 | 1.85 | None named in either. |
| Hemiarthroplasty, hip (close match) | ₹63,000 | ₹21,800 | 2.89 | Separate in both. |
Cardiology
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Coronary angioplasty (PTCA) (close match) | ₹83,725 | ₹60,900 | 1.37 | Separate in both. Not in medians: PM-JAY line includes an item the CGHS line does not name. |
| Permanent pacemaker, single chamber | ₹35,200 | ₹36,800 | 0.96 | Separate in both. |
| Permanent pacemaker, dual chamber | ₹47,300 | ₹49,500 | 0.96 | Separate in both. |
| Temporary pacemaker | ₹21,120 | ₹28,800 | 0.73 | None named in either. |
| Peripheral angioplasty (close match) | ₹53,000 | ₹51,800 | 1.02 | Separate in both. |
| Balloon mitral valvotomy | ₹97,000 | ₹53,600 | 1.81 | CGHS line silent. PM-JAY lists it apart. Not in medians: implant treatment differs or is unclear. |
| ASD device closure | ₹1,10,000 | ₹55,400 | 1.99 | Separate in both. |
| Pericardiocentesis | ₹10,000 | ₹18,200 | 0.55 | None named in either. |
Cardiac surgery
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Coronary artery bypass graft (CABG) (close match) | ₹1,80,000 | ₹1,94,900 | 0.92 | None named in either. Not in medians: PM-JAY line includes an item the CGHS line does not name. |
| Aortic valve replacement (close match) | ₹1,80,000 | ₹1,96,400 | 0.92 | Separate in both. |
| Double valve replacement (close match) | ₹2,36,000 | ₹2,34,300 | 1.01 | Separate in both. |
| Pericardiectomy | ₹1,52,000 | ₹1,10,600 | 1.37 | None named in either. |
| Bentall aortic root replacement (close match) | ₹2,74,000 | ₹2,47,500 | 1.11 | Separate in both. |
| Aorto-femoral bypass (close match) | ₹1,29,000 | ₹1,06,500 | 1.21 | Separate in both. |
Ophthalmology
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Cataract, phaco with foldable lens, per eye (close match) | ₹17,000 | ₹5,700 | 2.98 | Separate in both. |
| Cataract, SICS with lens, per eye | ₹13,400 | ₹5,000 | 2.68 | Separate in both. |
| Pterygium with conjunctival graft | ₹13,400 | ₹14,000 | 0.96 | None named in either. |
| Dacryocystorhinostomy, without tube | ₹13,400 | ₹12,000 | 1.12 | None named in either. |
| Trabeculectomy (close match) | ₹20,000 | ₹17,000 | 1.18 | None named in either. Not in medians: PM-JAY line includes an item the CGHS line does not name. |
| Scleral buckling for retinal detachment (close match) | ₹35,000 | ₹29,600 | 1.18 | None named in either. |
| Enucleation, no implant (close match) | ₹13,400 | ₹14,300 | 0.94 | None named in either. |
| Enucleation with implant | ₹20,000 | ₹15,900 | 1.26 | CGHS includes it. PM-JAY lists it apart. Not in medians: implant treatment differs or is unclear. |
| YAG laser capsulotomy | ₹5,000 | ₹2,300 | 2.17 | None named in either. |
General surgery
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Laparoscopic cholecystectomy | ₹36,300 | ₹38,900 | 0.93 | None named in either. |
| Open appendicectomy | ₹20,900 | ₹25,000 | 0.84 | None named in either. |
| Laparoscopic appendicectomy | ₹33,000 | ₹25,000 | 1.32 | None named in either. |
| Inguinal hernia, open, with mesh | ₹35,000 | ₹25,000 | 1.40 | Separate in both. |
| Inguinal hernia, laparoscopic, with mesh | ₹38,500 | ₹25,000 | 1.54 | Separate in both. |
| Umbilical hernia repair | ₹35,000 | ₹31,300 | 1.12 | Separate in both. |
| Haemorrhoidectomy, no stapler | ₹33,000 | ₹15,000 | 2.20 | None named in either. |
| Total thyroidectomy | ₹53,000 | ₹32,900 | 1.61 | None named in either. |
| Whipple pancreaticoduodenectomy | ₹53,000 | ₹1,50,000 | 0.35 | None named in either. |
| Right hemicolectomy, open | ₹35,200 | ₹42,200 | 0.83 | None named in either. |
Gynaecology and obstetrics
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Abdominal hysterectomy | ₹43,000 | ₹25,000 | 1.72 | None named in either. |
| Total laparoscopic hysterectomy | ₹63,000 | ₹25,000 | 2.52 | None named in either. |
| Laparoscopically assisted vaginal hysterectomy | ₹63,000 | ₹25,000 | 2.52 | None named in either. |
| Caesarean section (close match) | ₹53,000 | ₹15,000 | 3.53 | None named in either. Not in medians: CGHS line includes an item the PM-JAY line does not name. |
| Normal delivery (close match) | ₹35,000 | ₹10,000 | 3.50 | None named in either. Not in medians: CGHS line includes an item the PM-JAY line does not name. |
| Dilatation and curettage (close match) | ₹13,400 | ₹6,300 | 2.13 | None named in either. |
| Abdominal myomectomy | ₹35,000 | ₹31,300 | 1.12 | None named in either. |
| Vesicovaginal fistula repair, vaginal route | ₹63,000 | ₹50,000 | 1.26 | None named in either. |
| Rectovaginal fistula repair | ₹43,000 | ₹31,300 | 1.37 | None named in either. |
Urology
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| TURP for enlarged prostate | ₹63,000 | ₹46,500 | 1.35 | None named in either. |
| PCNL, one side | ₹53,000 | ₹56,300 | 0.94 | None named in either. |
| Simple open nephrectomy (close match) | ₹63,000 | ₹49,300 | 1.28 | None named in either. |
| Open pyeloplasty | ₹53,000 | ₹46,500 | 1.14 | None named in either. |
| Retrograde intrarenal surgery (close match) | ₹63,000 | ₹45,600 | 1.38 | None named in either. Not in medians: PM-JAY line includes an item the CGHS line does not name. |
| Shock wave lithotripsy (ESWL) (close match) | ₹43,000 | ₹25,000 | 1.72 | CGHS names none. PM-JAY lists it apart. Not in medians: implant treatment differs or is unclear. |
| Hydrocele operation, one side | ₹27,500 | ₹12,500 | 2.20 | None named in either. |
| Urethroplasty, end to end | ₹43,000 | ₹44,900 | 0.96 | None named in either. |
ENT
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Tympanoplasty | ₹35,000 | ₹19,200 | 1.82 | None named in either. Not in medians: PM-JAY rate depends on anaesthesia. |
| Septoplasty | ₹27,500 | ₹17,400 | 1.58 | None named in either. Not in medians: PM-JAY rate depends on anaesthesia. |
| Tracheostomy | ₹13,400 | ₹35,000 | 0.38 | None named in either. Not in medians: PM-JAY rate depends on anaesthesia. |
| Tonsillectomy | ₹27,500 | ₹15,300 | 1.80 | None named in either. |
| Adenoidectomy | ₹20,000 | ₹11,800 | 1.69 | None named in either. |
| Stapedectomy | ₹27,500 | ₹21,600 | 1.27 | None named in either. Not in medians: PM-JAY rate depends on anaesthesia. |
| Mastoidectomy (close match) | ₹35,000 | ₹35,000 | 1.00 | None named in either. |
| Superficial parotidectomy | ₹35,000 | ₹29,800 | 1.17 | None named in either. |
| Total parotidectomy | ₹43,000 | ₹35,300 | 1.22 | None named in either. |
Neurosurgery
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Aneurysm clipping (close match) | ₹82,000 | ₹1,03,200 | 0.79 | Separate in both. Not in medians: PM-JAY line includes an item the CGHS line does not name. |
| Endoscopic third ventriculostomy | ₹53,000 | ₹55,000 | 0.96 | None named in either. |
| Foramen magnum decompression for Chiari malformation | ₹1,29,000 | ₹1,12,500 | 1.15 | None named in either. |
| Carpal tunnel release | ₹43,000 | ₹22,500 | 1.91 | None named in either. |
| Burr hole for chronic subdural haematoma | ₹63,000 | ₹37,500 | 1.68 | None named in either. |
| Brain abscess excision by craniotomy | ₹82,000 | ₹74,900 | 1.09 | None named in either. |
| Excision of brain AVM | ₹97,000 | ₹1,03,200 | 0.94 | None named in either. |
| Ventriculoperitoneal shunt (close match) | ₹53,000 | ₹50,700 | 1.05 | CGHS line silent. PM-JAY lists none. Not in medians: implant treatment differs or is unclear. |
Oncology (radiotherapy and isotope)
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| 3D conformal radiotherapy, radical course (close match) | ₹50,000 | ₹52,000 | 0.96 | None named in either. Not in medians: units differ. |
| IMRT radiotherapy, radical course (close match) | ₹1,50,000 | ₹91,000 | 1.65 | None named in either. Not in medians: units differ. |
| Iodine-131 therapy, about 100 mCi (close match) | ₹14,320 | ₹26,400 | 0.54 | None named in either. Not in medians: units differ. |
Dialysis and kidney access
| Procedure | CGHS NABH Tier I | PM-JAY Tier 1 | Ratio | Implant note |
|---|---|---|---|---|
| Haemodialysis, one session (close match) | ₹2,500 | ₹1,800 | 1.39 | None named in either. |
| AV fistula for dialysis | ₹20,000 | ₹23,000 | 0.87 | None named in either. |
| Tunnelled dialysis catheter (permcath) (close match) | ₹8,500 | ₹37,500 | 0.23 | CGHS excludes it. PM-JAY lists none. Not in medians: implant treatment differs or is unclear. |
Method and limitations
The two lists
CGHS. Office memorandum F.No.5-16/CGHS(HQ)/HEC/2024(PartI), dated 3 Oct 2025 and effective 13 Oct 2025. Annexure I gives non-NABH, NABH and super speciality rates for semi-private wards. We read the copy on the Raman Research Institute site. All CGHS rates in the dataset are from Part A, the Tier I list. Tier II and Tier III rates are 10% and 20% lower by rule.
PM-JAY. HBP 2022, circulated by NHA memorandum S12015/008/2022/NHA(HPQA) of 6 Apr 2022. We could not reach it from NHA: on 2 Nov 2026, nha.gov.in returned a web app shell in place of the PDF and pmjay.gov.in did not connect. So every PM-JAY figure comes from copies on two state agency sites, Uttarakhand and Haryana. The memorandum lets states modify rates, and the Haryana letter of 5 Jun 2024 accepts HBP 2022 with 114 packages kept for government hospitals. We did not map that list, and rates or eligibility in your state may differ.
Where the two state copies disagree
The copies do not always match. On 16 of the 82 rows, the Tier 1 figure differs, mostly in cardiology and ophthalmology. On 20 rows at least one tier differs, as for PTCA, where Uttarakhand prints ₹60,900 and Haryana ₹52,800. We use Uttarakhand as the main source for two reasons. Its tiers run in order, Tier 1 at or above Tier 2 at or above Tier 3, on all 82 rows, while the Haryana copy has Tier 2 above Tier 1 on 20. It is also the copy our existing cost guides use. That is a judgement, and we cannot say which copy reflects what any state pays today. The CSV records all three Haryana tiers and a yes or no column for Tier 1 agreement.
- Using Haryana Tier 1 figures in place of Uttarakhand, the overall median is 1.36 across 62 procedures.
- Using only rows where the two copies agree on Tier 1, the median is 1.37 across 49 procedures.
How matches were chosen
We parsed all three PDFs with a script, which gave about 1,900 lines in each list, then read each list by specialty and paired common procedures where both lists name the same operation. Each pair was decided by reading both lines, and every rate and code was checked against its source page. This is a chosen sample of 82 rows, not a random one, so the medians describe these rows and not the whole of either list. Rows were picked for how common and how clearly matched they are. We saw both rates while choosing, so we set a fixed rule for the medians, below.
- Exact. Both lines name the same operation, route and side, and neither names a variant or extra item that changes the work.
- Close. The same operation, with a small difference: one line also covers a variant, names a site differently, or leaves something unstated. The note in the CSV says what.
A row goes into the medians unless one of these applies. 20 rows are out for these reasons:
- One CGHS rate maps to several PM-JAY rates: 1 row.
- PM-JAY line includes an item the CGHS line does not name: 5 rows.
- Implant treatment differs or is unclear: 5 rows.
- CGHS line includes an item the PM-JAY line does not name: 2 rows.
- PM-JAY rate depends on anaesthesia: 4 rows.
- Units differ: 3 rows.
Implants count as the same treatment when both lists take them apart from the procedure rate, or when neither names one. CGHS takes them apart either in the line itself or under the general rule in Annexure II, paragraph 4. PM-JAY prints an amount that NHA says its system adds to the procedure price. We did not adjust any excluded row to bring it back in. With all 82 rows, comparable or not, the median would be 1.28. With exact matches only it is 1.32 across 47 procedures, and with close matches only 1.21 across 15.
What we left out
- Cancer surgery. The CGHS memorandum says existing rules and rates continue for cancer surgeries, and it does not print them. The Whipple and hemicolectomy rows are general surgery lines that can also be used for cancer, so those two carry that caveat.
- Chemotherapy. CGHS pays a procedural charge with medicines on top, while PM-JAY oncology lines are regimen rates. The two are not the same thing.
- Revision joint replacement. CGHS lists two stages and PM-JAY one line, so we could not pair them.
- Grouped heart surgery for children. PM-JAY prices by category of defect and CGHS by operation.
- Tests, ICU days, medical management and transplants. These are priced in units or bundles that do not line up across the lists.
Other limits
- PM-JAY Tier 1 is not a fixed multiple of its base rate. In the Uttarakhand copy it is 1.25 times the national reference price for some packages, such as hysterectomy, and 1.5 times for others, such as TURP. That choice alone moves a ratio.
- Package terms differ. CGHS packages allow up to 12 days for super speciality care, 7 for other major surgery, and 3 for laparoscopic surgery and elective angioplasty. NHA says PM-JAY packages include medicines and tests up to 15 days after discharge. We have not priced those differences.
- CGHS rates change by ward: 5% less for general ward and 5% more for private ward entitlement. The dataset uses the semi-private rate.
- Each median treats every row equally. Neither list gives the number of cases, so nothing is weighted by how often a procedure is done.
- Names in the CSV are as printed, including source spellings such as “Bental”, with dashes changed to hyphens and line wrap removed. Page numbers are PDF pages, as a viewer counts them. Rates were read from the PDFs on 2 Nov 2026.
How to cite this dataset
Suggested wording: Best Doctors and Clinics, “CGHS vs PM-JAY package rates”, 82-procedure dataset, checked 2 Nov 2026, bestdoctorsandclinics.in/cghs-vs-pm-jay-rates-india/.
A one-line version for a news report: “Across 62 comparable procedures, the CGHS Tier I NABH rate was a median 1.27 times the PM-JAY Tier 1 rate, according to a Best Doctors and Clinics comparison of the CGHS list of 3 Oct 2025 and state agency copies of PM-JAY HBP 2022.” Please keep the sample size and say that these are scheme payments, not patient prices. If you find an error, tell us through the contact page.
Download the data
Download the CSV (UTF-8, 82 rows, one header row). It adds what the table above leaves out: exact names and codes in both lists, CGHS non-NABH and super speciality rates, PM-JAY Tier 2 and Tier 3, Haryana figures, implant wording, match confidence, scope notes, page numbers, source links and the checked date.
Common questions
Do these rates tell me what I will pay?
No. They are what each scheme pays empanelled hospitals for its members. A private patient is charged the hospital’s own price, so ask the hospital for a written estimate.
Does a higher CGHS rate mean CGHS care is better?
These lists do not measure quality. The rates come from separate schemes and separate years, and differ for reasons this data cannot separate.
Why are some ratios below 1?
On 16 of 62 comparable procedures, the PM-JAY line is higher than the CGHS NABH line. PM-JAY changed many packages for HBP 2022, some up and some down, and CGHS set its own list later. We have not tried to explain any single row.
Which PM-JAY figure applies in my state?
Ask your State Health Agency or the hospital’s Ayushman desk. States can modify rates, and the two copies we read differ on some rows.
Sources
- CGHS office memorandum F.No.5-16/CGHS(HQ)/HEC/2024(PartI), 3 Oct 2025, copy on the Raman Research Institute site, checked 2 Nov 2026.
- PM-JAY HBP 2022 list with NHA memorandum of 6 Apr 2022, Uttarakhand State Health Agency copy, checked 2 Nov 2026.
- PM-JAY HBP 2022 list with Haryana letter of 5 Jun 2024, Haryana copy, checked 2 Nov 2026.
- NHA Health Benefit Package 2.2 user guidelines, November 2021, copy hosted by Business Standard, checked 2 Nov 2026.