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Primary Knee Replacement System :
Components Feature/Material Of The Knee Implant Units (In Number) Max Prices Allowed (excl. GST)
Femoral component by whatsoever name/specification Titanium Alloy (all variants) coated 1 51,563/-
Oxidized Zirconium (Oxzr) alloy (all variants) 1 51,563/-
Hi - Flex 1 34,420/-
Cobalt chromium (CoCr) alloy (all variants) & other than above mentioned 1 32,064/-
Tibial component or Tibial tray by whatsoever name/specification Titanium Alloy (& all variants) coated 1 32,317/-
Oxidized Zirconium (Oxzr) alloy 1 32,317/-
Cobalt chromium (CoCr) alloy & other than above mentioned 1 22,614/-
Articulating surface or insert by whatsoever name/specification Any Material 1 12,711/-
Patella by whatsoever name/specification Any Material 1 5,444
Component having Tibial tray and insert combined as single unit by whatsoever name/specification Polyethylene or crosslinked polyethylene or highly crosslinked polyethylene or any other material 1 17,250/-
Component having Tibial tray and insert combined as single unit by whatsoever name called Tibial: Metallic Insert: Polyethylene or Cross linked polyethylene Or highly cross-linked Polyethylene or any other material 1 35,333/-
Revision Knee Replacement System :
Components Feature/Material Of The Knee Implant Units (In Number) Max Prices Allowed (excl. GST)
Femoral Component by whatsoever name/specification Any Material 1 83,547/-
Tibial Component or Tibial tray by whatsoever name/specification Any Material 1 41,554/-
Articulating surface or Insert by whatsoever name/specification Any Material 1 21,123/-
Patella by whatsoever name/specification Any Material 1 5,444/-