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Cross-Border Care · Funding
Cross-Border & NIPHS reimbursement guide
How much you can claim back for common day-case procedures
If you live in the Republic of Ireland and have planned day-case treatment in Northern Ireland, you may be able to claim money back from the HSE. This page explains the HSE’s reimbursement guide in plain English and lists the most common day-case procedures and their estimated repayment amounts.
What is this guide?
The HSE uses Diagnosis-Related Group (DRG) codes to work out how much it repays patients who travel abroad for planned treatment. The same figures apply across two schemes.
Two schemes, one set of pricesThe Cross-Border Directive (CBD) and the Northern Ireland Planned Healthcare Scheme (NIPHS) both use these DRG-based amounts to calculate your repayment.
What a DRG code meansEach procedure is grouped under a DRG code with a set day-case reimbursement price — it’s how the HSE standardises what it will repay.
You pay, then claim backYou pay for your treatment, then apply to the HSE for reimbursement up to the relevant amount below. Our Cross-Border team helps you complete and submit the claim.
Eye procedures at a glance
As an ophthalmology centre of excellence, these are the day-case figures most relevant to our patients.
Cataract (lens) procedures
€1,171
day-case reimbursement
DRG C16Z
Glaucoma & complex cataract
€863
day-case reimbursement
DRG C15B
Retinal procedures
€910
day-case reimbursement
DRG C03B
Pre- and post-operative consultations
€194 each
Search the guide
| Procedure | Day-case reimbursement |
|---|---|
| Cataract (lens) proceduresPhacoemulsification / extraction of the lens, capsulotomyEye · DRG C16Z | €1,171 |
| Glaucoma & complex cataractAqueous shunt, goniotomy, iridotomy, trabeculectomy / trabeculoplastyEye · DRG C15B | €863 |
| Retinal proceduresRetinal injections, vitrectomy (pars plana), scleral bucklingEye · DRG C03B | €910 |
| Pre-operative consultationSpecialist eye consultation before surgeryEye | €194 |
| Post-operative consultationFollow-up eye consultation after surgeryEye | €194 |
| Carpal tunnel releaseOpen or endoscopic carpal tunnel releaseOrthopaedic · DRG B05Z | €1,375 |
| Inflammatory MSK disordersInjections for rheumatoid / juvenile arthritis, SLEJoint Injections · DRG I66B | €2,125 |
| Non-surgical spinal disordersSpinal injections — sciatica, stenosis, disc disordersJoint Injections · DRG I68B | €895 |
| Other musculotendinous disordersJoint pain / stiffness, myalgia, fibromyalgiaJoint Injections · DRG I71B | €514 |
| Specific musculotendinous disordersTrigger finger, ganglion, bursitis, tendinitis, epicondylitisJoint Injections · DRG I72B | €389 |
| Skin biopsy — non-malignancyBiopsy alone for non-malignant skin conditionsSkin · DRG J67B | €668 |
| Skin biopsy — malignancyBiopsy alone for malignant skin conditionsSkin · DRG J69B | €604 |
| Excision of skin lesions — all sitesExcision of skin lesion (malignant & non-malignant)Skin · DRG J11B | €829 |
| CircumcisionMale circumcisionUrology · DRG M05Z | €3,033 |
| VasectomyMale sterilisationUrology · DRG M63Z | €3,895 |
No procedures match your search. Try a different term, or check the full HSE price lists below.
Important to know
Before you rely on these figures
- These are reimbursement estimates set by the HSE, not Solasta’s prices. You pay the clinic for your treatment, then claim back up to the relevant amount.
- This page lists day-case procedures only. Some treatments are also carried out as inpatient stays in Ireland — if that applies to you, check the full HSE price lists for the inpatient figure.
- The amount you receive is the lower of what you paid or the HSE rate — it won’t exceed your actual cost.
- Amounts are taken from the HSE “CBD / NIPHS Most Common Procedures DRG Guide” and may change. Always confirm the current figure and the full price lists with the HSE: hse.ie — NI Planned Healthcare Scheme.
- Your eligibility, referral and prior-authorisation requirements are set by the HSE. See our Cross Border Patients page for the full process.
We'll help you claim it back
Our Cross-Border Healthcare Team guides you through eligibility, referral and the HSE reimbursement claim — every step of the way.
Cross-border patients Contact the teamFigures sourced from the HSE “CBD / NIPHS Most Common Procedures DRG Guide” (day-case prices). This page is for general information only and is not financial or medical advice. Reimbursement eligibility and amounts are determined by the HSE and may change — please confirm current details with the HSE before making decisions.