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