Respiratory surgical procedures OHIP billing codes


Endoscopy

Code Description Amount Ans Units Assist Units
Z296 Fiberoptic endoscopy of upper airway (nose, hypopharynx or larynx) (IOP) - with flexible endoscope if only operative procedure performed $19.20 N/A N/A
Z299 Fiberoptic endoscopy of upper airway (nose, hypopharynx or larynx) (IOP) - with rigid endoscope, for diagnostic evaluation, or to facilitate biopsy or surgical treatment of pathology in the posterior nasal cavity, hypopharynx or larynx $8.55 N/A N/A
Z317 Fiberoptic endoscopy of upper airway (nose, hypopharynx or larynx) (IOP) - Examination under anaesthesia (EUA) of nose including suction cautery for posterior epistaxis unilateral or bilateral $112.05 6 N/A
Z306 Fiberoptic endoscopy of upper airway (nose, hypopharynx or larynx) (IOP) - Excision of middle turbinate concha bullosa unilateral $55.60 7 N/A
Z321 Laryngoscopy - Direct - with or without biopsy $61.30 6 N/A
Z322 Laryngoscopy - Direct - with removal of foreign body $106.45 6 N/A
Z323 Laryngoscopy - Direct - with removal of lesion(s) $226.35 6 N/A
E643 - when using laser with microlaryngoscopy for benign disease, to Z323 . . . Add $121.65 N/A N/A
Z343 Laryngoscopy - Direct - with dilatation of larynx, to include bronchoscopy if necessary $202.35 7 N/A
Z324 Laryngoscopy - Indirect - with biopsy or removal of foreign body $44.70 6 N/A
Z360 Bronchoscopy - Emergency rigid bronchoscopy for obstructed airway $474.65 N/A N/A
Z327 Bronchoscopy - flexible or rigid, with or without bronchial biopsy, suction or injection of contrast material $124.90 6 N/A
E846 - Bronchoscopy rigid bronchoscopy rendered immediately after flexible bronchoscopy, to Z327 . . . Add $95.70 N/A N/A
E632 - Bronchoscopy with removal of foreign body, to Z327. . . Add $68.40 N/A N/A
E633 - Bronchoscopy with dilatation of stricture, to Z327. . . Add $44.55 N/A N/A
E634 - Bronchoscopy with selective endobronchial blocker or catheter insertion, to Z327. . . Add $52.00 N/A N/A
E635 - Bronchoscopy with palliative endobronchial tumour resection including laser or cryotherapy, to Z327. . . Add $67.20 N/A N/A
E636 - Bronchoscopy with bronchoalveolar lavage for diagnosis of malignancy or diagnosis and/or treatment of infection and includes obtaining specimens suitable for differential cellular analysis, to Z327. . . Add $50.00 N/A N/A
E637 - Bronchoscopy with selective brushings of all 18 segmental bronchi for occult carcinoma in situ; specimens labeled as to site, to Z327. . . Add $76.45 N/A N/A
E638 - Bronchoscopy with transbronchial lung biopsy under image intensification only, to Z327 . . . Add $81.90 N/A N/A
E622 - Bronchoscopy any bronchoscopic procedure for patients under 3 years of age, to Z327 . . . Add $79.40 N/A N/A
E677 - Bronchoscopy transbronchial needle aspiration (TBNA) of mediastinal and/or hilar lymph nodes, to Z327 . . . Add $104.00 N/A N/A
E678 - Bronchoscopy TBNA of lung mass, to Z327 . . . Add $104.00 N/A N/A
E838 - Bronchoscopy bronchoscopy in a high risk patient with respiratory failure (i.e. severe hypoxemia or hypercapnia), to Z327 . . . Add $79.40 N/A N/A
Z342 Bronchoscopy - Limited bronchoscopy with placement of endobronchial blocker and/or double lumen tube $112.55 N/A N/A
Z359 Bronchoscopy - Repeat bronchoscopy for tracheobronchial toilet when performed within one week of another bronchoscopic procedure $56.65 6 N/A
G050 Bronchoscopy - Endobronchial ultrasound (EBUS), for guided biopsy of hilar and/or mediastinal lymph nodes $203.05 N/A N/A
E837 - Bronchoscopy additional biopsy(s) performed by EBUS, to a maximum of 3, to G050 . . . Add $50.75 N/A N/A
Z355 Quadroscopy or panendoscopy - with or without biopsy (nasopharyngoscopy, laryngoscopy, bronchoscopy, oesophagoscopy with or without gastroduodenoscopy) using separate instruments in search of malignant disease $321.45 6 N/A
Z329 Mediastinoscopy $380.00 7 6
Z330 Mediastinoscopy - with bronchoscopy $490.00 7 6
Z333 Mediastinoscopy - with transbronchial biopsy under image intensification (including bronchoscopy) $317.20 7 6
Z328 Mediastinoscopy - with mediastinotomy $475.80 7 6
Z348 Mediastinoscopy - with bronchoscopy and mediastinotomy $605.85 7 6
Z347 Anterior mediastinotomy - when sole procedure performed $300.00 6 6
Z335 Thoracoscopy (pleuroscopy) with or without pleural biopsy, suction, etc $228.40 7 N/A

Surgical Collapse

Code Description Amount Ans Units Assist Units
M111 Thoracoplasty - one stage $304.20 10 9
E605 - Thoracoplasty for each additional rib (more than 3) to a maximum of 3 additional . . . Add $55.60 N/A N/A
Z742 Phrenicotomy $106.45 6 6

Repair

Code Description Amount Ans Units Assist Units
M100 Tracheal rupture, transcervical $654.30 10 9
M101 Tracheal-bronchial rupture, transthoracic $868.15 13 9
M109 Chest wall - pleura - closed $0.00 6 N/A
M110 Chest wall - pleura - open $0.00 6 N/A
M116 Chest wall - pleura - fixation for trauma $350.00 7 6
E604 - Chest wall pleura for fixation of each additional rib exceeding four ribs . . . Add $55.60 2 N/A
M117 Chest wall - pleura - Sternal fixation for trauma $251.45 6 6
R352 Chest wall - pleura - Pectus excavatum or carinatum repair (by reconstruction, not implant) $750.00 11 6

Tracheo Bronchial Aspiration

Code Description Amount Ans Units Assist Units
Z344 First procedure $45.95 N/A N/A
Z345 Subsequent procedures performed by same physician $18.60 N/A N/A
Z326 Change of tracheostomy tube $12.50 N/A N/A
Z346 Transtracheal aspiration $22.35 N/A N/A
Z356 Closure of persistent tracheostoma $133.95 6 N/A

Repair (To Include Laryngoscopy)

Code Description Amount Ans Units Assist Units
M090 Laryngoplasty e.g. repair of stenosis and fractures, transections not to be billed with M084 $642.45 7 N/A
M089 Creation of tracheooesophageal fistula $234.60 6 6
Z320 Insertion of voice prosthesis $25.85 N/A N/A
Z303 Removal of laryngeal stent or keel $240.20 6 N/A

Introduction

Code Description Amount Ans Units Assist Units
M080 Teflon augmentation larynx $182.10 7 N/A

Accessory Nasal Sinuses – Endoscopic Approach

Code Description Amount Ans Units Assist Units
Z318 Trephine or endoscopic frontal sinusotomy $133.30 7 N/A
M054 Intranasal maxillary antrostomy – unilateral – by endoscopic or endonasal approach $123.70 10 6
M083 Ethmoidectomy/Antrostomy - Intranasal ethmoidectomy including maxillary antrostomy, with endoscope – unilateral (not eligible for payment with M061 or M054) $350.00 10 N/A
E844 - Ethmoidectomy/Antrostomy bilateral procedure, to M083 . . . add $200.00 N/A N/A
Z350 Ethmoidectomy/Antrostomy - Endoscopic sphenoidotomy unilateral $123.70 10 N/A
E843 - bilateral procedure, to Z350 . . . add $103.05 N/A N/A
E845 - Ethmoidectomy/Antrostomy when performed using a 3D CT/MRI image guided system, to M083 or Z350 . . . Add $140.00 N/A N/A
Z351 Endoscopic Septoplasty $122.40 10 N/A
M086 Transnasal endoscopic repair of CSF rhinorrhea (includes harvesting of graft material) with or without 3D CT/MRI image guided system $822.45 15 N/A
E600 - Laryngoscopy using operating microscope to charges for laryngoscopy . . . add $33.60 N/A N/A

Accessory Nasal Sinuses External Or Endonasal Approach

Code Description Amount Ans Units Assist Units
Z319 Antrum or sinus lavage - Antral puncture and/or lavage - unilateral or bilateral $43.15 6 N/A
M055 Maxillary - Caldwell-Luc (includes intranasal antrostomy) - unilateral $247.35 10 6
M056 Maxillectomy - partial or complete $971.75 10 7
E947 - with orbital exenteration, to M056 . . . add $306.85 N/A N/A
M058 Maxillectomy -Radical frontal sinusectomy for tumour, radical exenteration of disease with drill out for access, or ostium revision $460.20 10 N/A
M063 Coronal and/or osteoplastic procedure for frontal sinusectomy, reconstruction or obliteration -v unilateral or bilateral $716.25 10 7
M059 External frontal-ethmoidal sinusectomy and/or reconstruction - unilateral $460.20 10 6
M023 External or transantral ethmoidectomy - unilateral (to include Caldwell-Luc with transantral approach) $360.45 10 6
M061 Sphenoid - Transseptal sphenoidectomy for tumour or radical exenteration of disease $355.65 10 N/A
M064 External transethmoidal sphenoid sinusectomy $612.65 10 7
M067 Closure of antral fistula - under general anaesthetic (to include Caldwell-Luc if necessary) $345.15 7 N/A

Treatment Of Epistaxis (Nasal Haemorrhage)

Code Description Amount Ans Units Assist Units
Z314 Cauterization - unilateral $11.50 6 N/A
Z315 Anterior packing - unilateral $15.35 6 N/A
Z316 Posterior packing - unilateral or bilateral $35.50 6 N/A
E839 - Nasal polyp single with flexible endoscope, to Z304 . . . Add $19.20 N/A N/A
M027 Ligation of external carotid artery - unilateral $297.25 6 6
R788 Ligation of internal maxillary artery - unilateral $408.10 10 7
R789 Ligation of anterior ethmoidal artery - unilateral $299.85 7 6
Z313 Endoscopic transnasal ligation of the sphenopalatine artery for posterior epistaxis - unilateral $123.70 N/A N/A

Reconstruction

Code Description Amount Ans Units Assist Units
M012 Septoplasty $293.95 10 N/A
M013 Partial septorhinoplasty (excluding osteotomies) $526.00 10 N/A
M014 Septorhinoplasty $541.65 10 6
E841 - with autologous bone or cartilage graft from site(s) other than nose, to a maximum of two, to M014 . . . Add $226.80 N/A N/A
E842 - with nonautologous graft or implant, to M014 . . . Add $58.60 N/A N/A
E642 - if performed by external approach using transverse columellar and rim incisions with elevation of nasal tip skin flap, to M012, M013 or M014 . . . Add $119.20 N/A N/A
E840 - with repair of septal perforation, to M012, M013 or M014 . . . Add $119.20 N/A N/A
R319 Graft to nose - autologous, bone or cartilage (without septorhinoplasty) $360.45 7 6
R320 nonautologous or prosthetic implant (without septorhinoplasty) $232.00 7 6
M015 Septodermoplasty (to include fascial and other grafts) $306.85 7 N/A
M016 Repair of septal perforation $358.70 7 N/A
E642 - if performed by external approach using transverse columellar and rim incisions with elevation of nasal tip skin flap, to M012, M013 or M014 . . . Add $119.20 N/A N/A
M017 Packing for localization of cerebrospinal rhinorrhea $39.60 6 N/A
E603 - with fluorescein injection, to M017. . . add $50.90 N/A N/A
M033 Closure or opening of nostril for atrophic rhinitis $254.15 7 N/A
M018 Endonasal augmentation for atrophic rhinitis - unilateral (including obtaining graft or preparing implant) $308.65 7 N/A
M020 Repair of choanal atresia - unilateral or bilateral $360.45 6 6
M021 Puncture and insertion of tube for choanal atresia - unilateral or bilateral $123.70 6 N/A
M028 Dilation of choanal atresia - unilateral or bilateral $73.80 6 N/A
M030 Rhinoplasty for reconstruction of cleft lip - nasal deformity - complex, to include necessary grafts and septoplasty $1,082.30 7 6
M032 Rhinoplasty for reconstruction of cleft lip - nasal deformity - tip and septum to include total take down of cleft lip $432.45 6 N/A
M031 Rhinoplasty for reconstruction of cleft lip - nasal deformity - tip and septum reconstruction to include minor lip repair (Minor revision, Z-plasty) $254.15 7 N/A
E642 - if performed by external approach using transverse columellar and rim incisions with elevation of nasal tip skin flap, to M012, M013 or M014 . . . Add $119.20 N/A N/A

Excision

Code Description Amount Ans Units Assist Units
Z304 Nasal polyp - single $21.00 N/A N/A
E839 - with flexible endoscope, to Z304 . . . Add $19.20 N/A N/A
Z305 Nasal polyp - multiple or involving general anaesthetic unilateral $55.60 7 N/A
Z308 Choanal polypectomy - unilateral $55.60 7 N/A
Z309 Biopsy - single $18.30 N/A N/A
E839 - Nasal polyp single with flexible endoscope, to Z304 . . . Add $19.20 N/A N/A
Z310 Biopsy - multiple or involving general anaesthetic $50.90 6 N/A
Z311 Removal of foreign body - local anaesthetic $10.55 N/A N/A
E839 - Nasal polyp single with flexible endoscope, to Z304 . . . Add $19.20 N/A N/A
Z312 Removal of foreign body - general anaesthetic $50.90 6 N/A
M010 Removal of foreign body - Excision of intranasal lesions by lateral rhinotomy approach $493.90 7 6
M011 Removal of foreign body - Excision of other intranasal lesions $0.00 N/A N/A
M081 Laryngectomy - total $838.90 13 6
E882 - with thyroid lobectomy, to M081 . . . Add $177.40 N/A N/A
E883 - with thyroid lobectomy, must include excision of isthmus and pyramidal tract, to M081 . . . Add $266.60 N/A N/A
E884 - with total thyroidectomy, to M081 . . . Add $374.00 N/A N/A
M082 Laryngectomy - Laryngofissure $444.80 8 6
M084 Laryngectomy - segmental, including reconstruction $888.85 9 6
M085 Laryngectomy - Arytenoidectomy or arytenoidopexy or lateralization procedure $395.05 8 6
M099 Segmental resection of cervical trachea $918.60 10 9
E631 - with resection of cricoid . . . Add $314.20 N/A N/A
M103 Segmental resection of trachea with either sternotomy or thoracotomy $1,294.20 13 9
M104 Carinal resection (without pulmonary resection) $825.40 15 11
M105 Chest wall tumour, resection of 2 or 3 ribs or cartilages $650.00 13 9
E847 - Chest wall tumour with reconstruction of diaphragm requiring repair with mesh or equivalent synthetic material to M105 . . . Add $75.00 N/A N/A
E640 - Chest wall reconstruction after chest wall resection where a significant defect (minimum 5 cm in diameter) remains requiring repair with synthetic material . . . Add $179.55 N/A N/A
E601 - Chest wall reconstruction for each additional rib (more than 3) to a maximum of 3 additional . . . Add $57.50 N/A N/A
E602 - Chest wall reconstruction with sternal resection . . . Add $177.95 N/A N/A
M107 Chest wall reconstruction - Total sternectomy $812.25 13 9
N284 Chest wall reconstruction - Excision of first rib and/or cervical rib to include scalenotomy when required $408.00 6 6
M106 Chest wall reconstruction - Mediastinal tumour $1,004.00 13 9
E847 - Chest wall tumour with reconstruction of diaphragm requiring repair with mesh or equivalent synthetic material to M105 . . . Add $75.00 N/A N/A
M108 Chest wall reconstruction - Ligation of thoracic duct as sole procedure $410.45 6 6
Z338 Biopsy of pleura or lung - with limited thoracotomy $202.80 13 9
M138 Hilar lymph node or lung biopsy with full thoracotomy $534.10 13 9
M142 Pneumonectomy, may include radical mediastinal node dissection, sampling or pericardial resection requiring repair $1,400.00 14 10
E609 - Closure of bronchopleural fistula (transthoracic or transsternal) with intercostal muscle bundle, pericardium, Azygos vein, or pericardial fat pad, to M130 . . . add $121.70 N/A N/A
M143 Lobectomy, may include radical mediastinal node dissection or sampling $1,285.00 13 10
E644 - radical mediastinal node dissection following preoperative chemotherapy and/or radiotherapy, to M142, M143, S089 or S090 . . . Add $207.45 N/A N/A
M144 Segmental resection, including segmental bronchus and artery $1,285.00 13 10
M145 Wedge resection of lung $818.45 13 10
M151 Bullectomy for major bullous disease $725.00 13 10
M149 Pleurectomy, and/or apical bullectomy for pneumothorax $525.00 13 10
E612 - total extrapleural pneumonectomy . . . Add $338.35 N/A N/A
E613 - sleeve pneumonectomy . . . Add $248.40 N/A N/A
E614 - omental graft . . . Add $162.45 N/A N/A
E615 - intrapericardial dissection . . . Add $120.80 N/A N/A
E611 - with resection of diaphragm and direct suture closure . . . add $145.00 N/A N/A
E849 - with resection of diaphragm and reconstruction requiring repair with mesh or equivalent synthetic material . . . Add $220.00 N/A N/A
E848 - with reconstruction of pericardium requiring repair with synthetic graft material . . . Add $80.00 N/A N/A
E616 - bilobectomy on right side . . . Add $142.10 N/A N/A
E617 - with pleural tent . . . add $78.80 N/A N/A
E618 - with decortication of remaining lobe(s) . . . Add $121.85 N/A N/A
E619 - sleeve lobectomy . . . add $162.45 N/A N/A
E620 - with wedge bronchoplasty . . . add $78.80 N/A N/A
E621 - with diagnostic wedge resection . . . add $45.85 N/A N/A
E624 - with completion pneumonectomy for positive resection margin . . . Add $111.20 N/A N/A
E625 - with sleeve resection of pulmonary artery . . . Add $142.20 N/A N/A
E608 - each additional wedge resection of lung (to a maximum of 3) . . . add $75.00 N/A N/A
E607 - reoperation more than 30 days subsequent to previous excision, to appropriate excision fee . . . Add $152.30 N/A N/A

Incision

Code Description Amount Ans Units Assist Units
Z301 Drainage of abscess or haematoma $55.60 6 N/A
Z741 Tracheotomy $273.15 6 6
E639 - with anterior cricoid split . . . Add $78.50 N/A N/A
Z738 Insertion of Montgomery “T” Tube or similar laryngeal or tracheal stent $216.10 8 6
Z325 Emergency tracheotomy $474.65 10 10
E623 - Excision repeat operation after 30 days . . . Add $415.15 N/A N/A
Z353 Incisional biopsy of chest wall tumour $110.90 7 6
Z354 Excisional biopsy of rib for tumour $142.20 7 6
Z357 Thoracic window creation $228.25 7 6
Z358 Thoracic window closure $111.20 6 6
Z340 Biopsy of lung, needle $137.85 7 N/A
Z336 Biopsy of pleura, needle including diagnostic aspiration $59.15 6 N/A
Z341 Closed drainage effusion or pneumothorax $69.80 6 N/A
Z337 Rib resection for drainage $133.10 7 6
M133 Thoracotomy for removal of foreign body $390.65 13 9
M137 Thoracotomy with or without biopsy $390.65 13 9
M134 Thoracotomy for post-operative haemorrhage or empyema $390.65 13 9
M132 Thoracotomy with repair of ruptured diaphragm $507.45 13 9
M130 Closure of broncho-pleural fistula (transthoracic or trans-sternal) $584.75 13 9
E609 - with intercostal muscle bundle, pericardium, Azygos vein, or pericardial fat pad, to M130 . . . add $121.70 N/A N/A
E610 - Closure of bronchopleural fistula (transthoracic or transsternal) with myovascular flap (pectoralis major, latissimus dorsi, rectus abdominus) . . . add $263.80 N/A N/A
M135 Major decortication of lung for empyema or tumour $800.00 15 11
Z339 Intercostal drainage with insufflation of sclerosing agent under general anaesthesia $182.90 6 6
Z361 Chronic indwelling pleural catheter for palliative management of malignant pleural effusion - Insertion of indwelling catheter $200.00 N/A N/A
Z362 Chronic indwelling pleural catheter for palliative management of malignant pleural effusion - Removal of indwelling catheter $200.00 N/A N/A

Introduction Thoracentesis

Code Description Amount Ans Units Assist Units
Z331 Aspiration for diagnostic sample $32.45 N/A N/A
Z332 Aspiration with therapeutic drainage with or without diagnostic sample $59.15 6 N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z349 Intrapleural administration of chemotherapy or sclerosing agent - by any method $23.25 N/A N/A
Z334 Total unilateral lung lavage with or without bronchoscopy using Double Lumen Tube and single lung anaesthesia $304.60 13 N/A

Other

Code Description Amount Ans Units Assist Units
Z298 Nasopharynx (including oropharynx, oral cavity and hypopharynx) EUGA of nasopharynx for malignant disease including biopsies (not eligible for payment if rendered in conjunction with tonsillectomy and adenoidectomy or quadroscopy) $41.25 6 N/A
R181 Excision of nasopharyngeal or oropharyngeal lesion - With palatal split $508.20 7 6
R182 Excision of nasopharyngeal or oropharyngeal lesion - With mandibulotomy, glossotomy and/or palatal split $1,216.80 10 7
Z297 Excision of nasopharyngeal or oropharyngeal lesion - Insertion of prosthesis for nasal septal perforation $18.30 N/A N/A
M155 Lung transplant (one lung) $2,054.25 40 18
M156 Repeat lung transplant (one lung) $2,670.55 40 24
M157 Donor Heart Lung removal $906.45 8 8