Digestive system surgical procedures OHIP billing codes


Incision

Code Description Amount Ans Units Assist Units
Z506 Drainage of oral abscess or haematoma $50.90 6 N/A
Z510 Drainage of pharyngeal abscess or haematoma $91.10 6 N/A
Z524 Drainage of haematoma or deep neck abscess (external approach) $271.05 7 6
Z501 Biopsy $35.50 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
Z537 Biopsy - requiring general anaesthetic $97.05 N/A N/A
Z111 Tongue tie, release of - simple $15.35 N/A N/A
Z112 Tongue tie, release of - complex or requiring general anaesthetic $50.90 6 N/A
S031 Palatal fenestration $197.55 6 N/A
Z500 Sialolithotomy $30.65 N/A N/A
Z521 Sialolithotomy - requiring general anaesthesia $103.60 6 6
Z503 Biopsy $35.40 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
S084 Oesophagostomy - Cervical - other than neonatal $212.35 N/A N/A
S085 Oesophagostomy - Cervical - neonatal $304.20 N/A N/A
S082 Oesophagostomy - Intrathoracic oesophageal stent - via laparotomy $410.55 7 N/A
S083 Oesophagostomy - Intrathoracic oesophageal stent - via oesophagoscope (includes Z515) $304.20 6 N/A
S081 Oesophagostomy - Transoesophageal division of oesophageal varices $558.05 N/A N/A
S080 Oesophagostomy - Oesophagealgastric devascularization (including splenectomy and oesophageal division/anastomosis) $898.15 N/A N/A
S116 Gastrotomy - with removal of tumour or foreign body $406.85 7 6
E731 - with suture of bleeding peptic ulcer . . . Add $247.05 N/A N/A
S117 Gastrotomy - Pyloromyotomy (Ramstedt's) $314.80 10 6
S118 Gastrostomy $345.85 7 6
E697 - with repair of MalloryWeiss laceration . . . add $142.40 N/A N/A
E707 - when done with another intraabdominal procedure $70.80 N/A N/A
Z532 Percutaneous endoscopic gastrostomy $172.95 7 6
Z520 Change of gastrostomy tube $0.00 N/A N/A
S149 Enterotomy - Ileostomy $406.85 7 6
S150 Enterotomy - Small intestine including excision of polyps or biopsy $406.85 7 6
S151 Enterotomy - Insertion of feeding enterostomy $356.50 7 6
E737 - when done with another intraabdominal procedure . . . Add $82.35 N/A N/A
S154 Enterotomy - Large intestine including excision of polyps $406.85 7 6
S155 Enterotomy - Colonoscopy with laparotomy $387.40 7 6
S156 Enterotomy - Exteriorization of intestine (Mickulicz) $406.85 6 6
S157 Enterotomy - Colostomy $406.85 7 6
S158 Enterotomy - Cecostomy $387.40 7 6
S160 Enterotomy - Enteroenterostomy $406.85 7 6
E793 - Enterotomy laparoscopic or laparoscopic assisted, to S149 or S157 $0.00 N/A N/A
E714 - repair of enterocutaneous fistula in conjunction with bowel resection . . . Add $82.35 N/A N/A
Z544 Biopsy $34.90 6 N/A
Z545 Thrombosed haemorrhoid(s) $25.25 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
S241 Sphincterotomy(ies) under local anaesthesia $88.20 N/A 6
S243 Sphincterotomy(ies) under general anaesthesia $200.00 6 6
Z554 Biopsy - incisional $102.10 N/A N/A
Z551 Biopsy - needle $87.50 7 N/A
S268 Insertion of implantable pump for continuous liver perfusion $604.95 7 7
S233 Percutaneous trans-hepatic catheter drainage of obstructed bile ducts including daily supervision and including percutaneous cholangiogram and catheterization to duodenum if achieved $394.25 N/A N/A
S234 Replacement of catheter in S233 $64.85 N/A N/A
Z562 Biliary duct calculus manipulation and/or removal via T-tube tract - as sole procedure $116.20 7 N/A
Z542 Biliary duct calculus manipulation and/or removal via T-tube tract - Intubation of bile duct for obstruction $85.25 N/A N/A
S278 Cholecystostomy $408.05 7 7
S276 Choledochotomy (previous cholecystectomy) $610.20 8 7
S280 Transduodenal sphincterotomy and choledochotomy (previous cholecystectomy) $844.65 9 7
S281 Choledochoduodenostomy or choledochoenterostomy or choledochocholechostomy $721.70 9 7
E704 - with choledochoscopy, to S276, S280, S281 or S287 plus E721 . . . Add $46.50 N/A N/A
S282 Cholecystogastrostomy $447.45 7 7
S283 Cholecystoenterostomy $447.45 7 7
E743 - with enteroenterostomy, to S281 or S283 . . . Add $153.05 N/A N/A
S285 Intrahepatic choledochoenterostomy (anastomosis above the common hepatic duct bifurcation) $915.30 12 9
Z762 Biopsy - needle $102.10 N/A N/A
Z577 Biopsy - incisional $122.05 7 N/A
S297 Drainage of acute pancreatitis or abscess or marsupialization of cyst $406.85 7 7
Z563 Needle biopsy of peritoneum $48.00 N/A N/A
Z564 Open lavage of peritoneal cavity for diagnosis without manual exploration of peritoneal cavity $73.60 7 N/A
S312 Laparotomy, with or without biopsy or for Hirschsprung’s disease (except biopsies of stomach, liver, pancreas and multiple paraaortic lymph nodes $330.00 7 6
E745 - insertion of tubes and postoperative continuous peritoneal lavage when combined with any other abdominal procedure . . . Add $94.85 N/A N/A
S321 Laparotomy - for acute trauma $397.15 6 6
E733 - with repair of intestine single . . . Add $142.10 N/A N/A
E734 - multiple and/or with resection . . . Add $211.15 N/A N/A
E735 - with splenectomy (partial or complete) . . . Add $284.75 N/A 4
E736 - with repair of lacerated liver . . . Add $187.90 N/A 4
E739 - with repair of diaphragm . . . Add $122.05 N/A 4
E723 - with repair of lacerated spleen . . . Add $284.80 N/A 4
E693 - with repair of ruptured bladder . . . Add $0.00 N/A 4
E694 - with nephrectomy . . . Add $0.00 N/A 4
S313 Peritoneal abscess - subphrenic $370.95 7 7
S314 Peritoneal abscess - abdominal $264.45 7 6
Z569 Peritoneal abscess - Pelvic abscess, incision and drainage rectal or vaginal approach $122.05 7 N/A
Z594 Peritoneal abscess - Percutaneous abdominal abscess drainage including daily supervision, for one or more abscesses within the same abdominal quadrant or the pelvis $288.30 N/A N/A
E686 - Peritoneal abscess within each other abdominal quadrant, or the pelvis (if the initial abscess was not in the pelvis) . . . add $144.10 N/A N/A
Z595 Peritoneal abscess - Replacement of drainage catheter in abdominal abscess $54.05 N/A N/A
Z574 Peritoneal abscess - Removal of infected sutures from abdominal wall or re-exploration of wound for bleeding - general anaesthetic $94.85 7 6
S311 Peritoneal abscess - Umbilical vein intraabdominal dissection and catheterization $232.50 6 6
S320 Peritoneal abscess - Insertion of antabuse into abdominal wall $58.15 N/A N/A
S203 Insertion of peritoneo-jugular shunt for ascites - primary $281.85 7 7
S209 Insertion of peritoneo-jugular shunt for ascites - revision $208.15 7 7
S310 Insertion of peritoneo-jugular shunt for ascites - Insertion of intraperitoneal chemotherapy port by laparotomy or laparoscopy $215.10 6 6
S315 Insertion of peritoneo-jugular shunt for ascites - Removal of intraperitoneal chemotherapy port by laparotomy or laparoscopy $215.10 6 6

Destruction

Code Description Amount Ans Units Assist Units
Z548 Cauterization of fissure $34.90 6 N/A
Z549 Fulguration of condylomata - local anaesthetic $30.95 N/A N/A
Z758 Fulguration of condylomata - general anaesthetic $97.65 6 6

Injection

Code Description Amount Ans Units Assist Units
Z575 Haemorrhoid injections (to a maximum of 6 per year) $27.05 N/A N/A
Z576 Injections for anal fissure $35.90 6 N/A

Transplant

Code Description Amount Ans Units Assist Units
S201 Small bowel transplant - donor $964.50 8 6
S202 Small bowel transplant - recipient $2,748.75 30 20
S196 Multivisceral transplant - donor $2,748.75 8 6
S197 Multivisceral transplant - recipient, without evisceration $7,934.35 35 25
E807 - recipient, with evisceration, to S197 . . . add $2,644.75 N/A N/A
S302 Donor pancreas removal $679.50 8 6
S303 Backbench pancreas graft preparation $339.75 N/A N/A
S308 Pancreas transplant $2,378.30 30 20

Appendix

Code Description Amount Ans Units Assist Units
S204 Incision and drainage of abscess $239.20 7 6
S205 Appendectomy $336.60 7 6
S206 Appendectomy - with gross perforation and peritonitis $451.50 7 6

Mesentery

Code Description Amount Ans Units Assist Units
S195 Local excision of lesion $305.05 7 6
S199 Resection of mesentery $325.40 6 6

Meckel's Diverticulum

Code Description Amount Ans Units Assist Units
S194 Meckel’s diverticulum excision $356.50 7 6
S159 Meckel’s diverticulum excision - with small bowel resection $406.85 7 6

Manipulation

Code Description Amount Ans Units Assist Units
Z538 Reduction of prolapse $25.25 6 N/A
Z539 Dilation of gastrostomy, enterostomy, colostomy, etc. $25.25 6 N/A
Z540 Intubation of small intestine (therapeutic or diagnostic) - with or without fluoroscopy $79.80 N/A N/A
E732 - with biopsy . . . Add $29.10 N/A N/A
Z541 Dilation and/or disimpaction or removal of foreign body under general anaesthetic (as sole procedure) $58.15 6 N/A
Z756 Fecal disimpaction no anaesthetic $36.80 N/A N/A
Z550 Dilation of anal sphincter $12.05 6 N/A
S248 Peter Lord procedure $43.60 6 N/A

Colonoscopy

Code Description Amount Ans Units Assist Units
Z497 Confirmatory colonoscopy sigmoid to descending colon $51.95 5 N/A
Z499 Absence of signs or symptoms, family history associated with an increased risk of malignancy (e.g. a first degree relative or at least two second degree relatives with colorectal cancer or a premalignant lesion) – sigmoid to descending colon $51.95 5 N/A
Z492 Five year follow up of normal colonoscopy (Z499), absence of intervening signs or symptoms - sigmoid to descending $51.95 5 N/A
Z493 Ten year follow up of normal colonoscopy (Z497, Z555), absence of intervening signs or symptoms sigmoid to descending $51.95 5 N/A
Z496 Colonoscopy - For diagnosis or ongoing management - Presence of signs or symptoms sigmoid to descending colon $51.95 5 N/A
Z494 Hereditary (e.g. Familial adenomatous Polyposis or Hereditary NonPolyposis Colorectal Cancer) or other bowel disorders (e.g. inflammatory bowel disease) associated with increased risk of malignancy $51.95 5 N/A
Z498 Follow up of abnormal colonoscopy sigmoid to descending colon $51.95 5 N/A
Z495 Follow up of unsatisfactory colonoscopy $51.95 5 N/A
Z491 Follow up of incomplete polyp resection $51.95 5 N/A
Z555 Absence of signs or symptoms or risk factors, 50 years of age or older sigmoid to descending colon $51.95 5 N/A
E797 - Oesophagoscopygastroscopy, with or without duodenoscopy management of uncomplicated upper or lower gastrointestinal bleeding, by any technique (e.g. laser, injection, diathermy, banding etc.) . . . add $46.30 N/A N/A
E747 - Endoscopy of ileostomy or colostomy, or reduction of obstructed Koch ileostomy to cecum . . . Add $31.40 N/A N/A
E740 - to splenic flexure, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $51.95 N/A N/A
E741 - to hepatic flexure, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $31.40 N/A N/A
E705 - into terminal ileum, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $30.50 N/A N/A
E630 - endoscopic placement of stent in colon, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $137.05 N/A N/A
E717 - if biopsy and/or coagulation of angiodysplastic lesion(s) (one or more), to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 or Z580 . . . Add $27.05 N/A N/A
E785 - multiple screening biopsies (> 34 sites) for malignant changes in ulcerative colitis, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $54.25 N/A N/A
E749 - when Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499, Z512, Z555 or Z580 rendered in private office . . . add $22.35 N/A N/A

Sigmoidoscopy

Code Description Amount Ans Units Assist Units
Z580 Sigmoidoscopy (using 60 cm. flexible endoscope) $57.70 5 N/A

Gastrectomy

Code Description Amount Ans Units Assist Units
S122 Wedge resection for ulcer $520.00 7 7
E708 - with vagotomy . . . Add $122.05 N/A N/A
E713 - after previous partial gastrectomy . . . Add $137.55 N/A N/A
S123 Partial or subtotal - distal $840.00 8 7
S125 Partial or subtotal - proximal $900.00 8 7
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
E644 - radical mediastinal node dissection following preoperative chemotherapy and/or radiotherapy, to M142, M143, S089 or S090 . . . Add $207.45 N/A N/A
E731 - Gastrotomy with removal of tumour or foreign body with suture of bleeding peptic ulcer . . . Add $247.05 N/A N/A
E708 - Wedge resection for ulcer with vagotomy . . . Add $122.05 N/A N/A
E713 - Wedge resection for ulcer after previous partial gastrectomy . . . Add $137.55 N/A N/A
E709 - Partial or subtotal with cholecystectomy . . . Add $122.05 N/A N/A
E711 - Partial or subtotal after previous gastroenterostomy . . . Add $106.55 N/A N/A
E706 - Partial or subtotal with choledochotomy . . . Add $122.05 N/A N/A
E712 - Partial or subtotal after previous vagotomy and pyloroplasty . . . Add $111.10 N/A N/A
S128 Total gastrectomy - with or without splenectomy $1,235.00 9 7
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
E713 - Wedge resection for ulcer after previous partial gastrectomy . . . Add $137.55 N/A N/A
E709 - Partial or subtotal with cholecystectomy . . . Add $122.05 N/A N/A
E706 - Partial or subtotal with choledochotomy . . . Add $122.05 N/A N/A
S129 Total gastrectomy - with or without splenectomy - laparoscopic or laparoscopic assisted, to S128 . . . Add $910.00 9 7

Dilation Of Oesophagus

Code Description Amount Ans Units Assist Units
Z529 Passive (bougie) - initial session $40.56 N/A N/A
Z530 Passive (bougie) - repeat session (within three months following previous dilation) $27.35 N/A N/A
Z525 Pneumatic - as sole procedure $110.85 N/A N/A
Z523 Pneumatic - with rigid dilators guided over a string or wire $52.90 N/A N/A
Z531 Pneumatic - Repeat dilations during the same admission $26.40 N/A N/A

Suture

Code Description Amount Ans Units Assist Units
S103 Closure of H-type tracheooesophageal fistula by cervical or thoracic approach $923.05 N/A N/A
S104 Repair of oesophageal atresia with or without tracheal fistula $1,153.85 N/A N/A
S138 Closure of gastrostomy or other external fistula of stomach $345.85 7 6
S139 Gastrorrhaphy (for perforated gastric or duodenal ulcer or wound) $503.15 7 6
S140 Closure of gastrocolic fistula $574.40 7 7
S184 Suture of intestine $314.80 7 6
E721 - Pyloroplasty or gastroenterostomy plus vagotomy and cholecystectomy with choledochotomy . . . Add $122.05 N/A N/A
S185 Closure of colostomy or enterostomy with or without resection and/or anastomosis $406.85 7 6
S187 Plication of small intestine for adhesions $528.85 7 6
S229 Suture of rectum, traumaexternal approach $239.20 7 6
S231 Closure of fistula - rectovaginal (any repair) $338.55 7 6
S525 Closure of fistula - rectovesical $446.90 7 6
S343 Secondary closure for evisceration sole operative procedure in abdomen $350.00 7 6
E752 - with repeat surgery on kidney at least 30 days after previous kidney surgery . . . Add $83.25 N/A N/A

Repair

Code Description Amount Ans Units Assist Units
S161 Oesophageal myotomy, partial (below aortic arch) $584.15 N/A N/A
E758 - with oesophageal hiatus hernia repair . . . Add $217.35 N/A N/A
S100 Total thoracic oesophageal myotomy (as sole procedure) $738.90 N/A N/A
E758 - Oesophageal myotomy, partial (below aortic arch) with oesophageal hiatus hernia repair . . . Add $217.35 N/A N/A
S091 Oesophageal hiatus hernia - abdominal or transthoracic approach with fundal plication $750.00 N/A N/A
S092 Oesophageal hiatus hernia - recurrent $709.85 N/A N/A
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
E744 - Oesophageal hiatus hernia with gastroplasty, to either S091 or S092 . . . Add $115.80 N/A N/A
E742 - Oesophageal hiatus hernia for each additional procedure performed. . . . Add $217.35 N/A N/A
S095 Oesophageal stricture (Thal) may include oesophageal hiatus hernia repair with or without gastroplasty $676.05 N/A N/A
S096 Ruptured oesophagus, suture and drainage $507.00 N/A N/A
S097 Oesophagogastrostomy for bypass (as sole procedure) $608.30 N/A N/A
S098 Oesophageal bypass, abdomen to neck - with stomach $912.60 N/A N/A
S099 Oesophageal bypass, abdomen to neck - with colon or jejunum $1,264.05 N/A N/A
S132 Pyloroplasty $406.85 7 7
S133 Pyloroplasty and vagotomy $528.85 7 7
E731 - Gastrotomy with removal of tumour or foreign body with suture of bleeding peptic ulcer . . . Add $247.05 N/A N/A
S137 Pyloroplasty or gastroenterostomy plus vagotomy and cholecystectomy $678.90 8 7
E731 - Gastrotomy with removal of tumour or foreign body with suture of bleeding peptic ulcer . . . Add $247.05 N/A N/A
E721 - with choledochotomy . . . Add $122.05 N/A N/A
S134 Gastroduodenostomy or gastrojejunostomy $0.00 N/A N/A
E711 - Partial or subtotal after previous gastroenterostomy . . . Add $106.55 N/A N/A
E721 - Pyloroplasty or gastroenterostomy plus vagotomy and cholecystectomy with choledochotomy . . . Add $122.05 N/A N/A
E716 - either of above plus vagotomy . . . Add $147.30 N/A N/A
S181 Revision of ileostomy or colostomy - skin level $131.75 7 6
S182 Revision of ileostomy or colostomy - full thickness $350.65 7 6
S192 Revision of ileostomy or colostomy - Simple revision of continent ileostomy pouch $387.40 7 6
S191 Revision of ileostomy or colostomy - Complete reconstruction of continent ileostomy to include valve repair $951.20 7 6
S193 Revision of ileostomy or colostomy - Revision of standard ileostomy into continent ileostomy pouch $793.50 7 6
S183 Revision of ileostomy or colostomy - Cecopexy or sigmoidopexy (as sole procedure) $314.80 6 6
S223 Anastomosis of rectum $488.20 6 6
S225 Rectal prolapse - excision of mucous membrane $239.20 7 6
S226 Rectal prolapse - perineal repair major $356.50 6 6
S227 Rectal prolapse - abdominal approach $554.10 8 6
S228 Rectal prolapse - insertion of Thiersh wire $190.85 6 6
S253 Low imperforate anus repair $1,224.00 7 7
S260 High imperforate anus repair (supralevator) $1,801.00 7 7
S256 Excision of scar, for stenosis $142.40 6 6
S257 Anoplasty, for stenosis $275.05 6 6
S258 Repair of anal sphincter $275.05 7 6
S259 Repair of anal sphincter and ano-rectal ring $356.50 6 6
S273 Marsupialization and/or decompression of cyst(s) or abscess(es) $434.80 7 7
E715 - more than three cysts or abscess(es) . . . Add $74.90 N/A N/A
S292 Common duct stricture, dissection and/or resection* $203.40 10 7
S293 Common duct stricture, dissection and/or resection* $0.00 12 8
Z596 Extracorporeal shock wave lithotripsy for bile duct calculi $314.20 6 N/A
S305 Pancreatic cyst - gastrostomy $589.95 8 7
S306 Pancreatic cyst - duodenostomy $589.95 8 8
S307 Pancreatic cyst - jejunostomy $589.95 8 8
S304 Pancreatic cyst - Lateral pancreatoduodenostomy or anastomosis of filleted pancreatic duct to intestine (Puestow) $813.60 10 9
S325 Omentopexy - as sole operative procedure $305.05 7 6
S322 Herniotomy - Inguinal and/or femoral - infants $325.00 7 6
S326 Herniotomy - Inguinal and/or femoral - children $275.00 6 6
S323 Herniotomy - Inguinal and/or femoral - adolescents and adults $331.80 7 6
S328 Herniotomy - Unilateral with exploration of other side - infants and children $329.30 7 6
S329 Herniotomy - Strangulated or incarcerated - without resection of bowel $425.00 7 6
S330 Herniotomy - Strangulated or incarcerated - with resection of bowel $660.50 7 6
S332 Herniotomy - Umbilical - adolescent or adult $300.00 6 6
S333 Herniotomy - Umbilical - child (operative) $222.75 6 6
E764 - Herniotomy umbilical hernia repair when done in conjunction with other abdominal surgery, to other surgery . . . Add $96.85 N/A N/A
E756 - Herniotomy with resection of strangulated contents . . . Add $111.45 N/A N/A
E757 - Herniotomy without resection of strangulated contents . . . Add $55.25 N/A N/A
S348 Omphalocele and gastroschisis - Primary or first stage repair $375.80 7 7
E691 - Omphalocele and gastroschisis requiring mobilization of abdominal wall musculature, to S348 . . . Add $100.00 N/A N/A
S349 Omphalocele and gastroschisis - Second or subsequent stage repair $475.80 7 7
S346 Congenital diaphragmatic hernia - Primary or first stage repair $576.90 13 9
S347 Congenital diaphragmatic hernia - Second or subsequent stage repair $366.00 13 9
S340 Congenital diaphragmatic hernia - Ventral post-operative $370.95 7 6
S344 Congenital diaphragmatic hernia - Massive incisional hernia $500.00 7 6
S345 Congenital diaphragmatic hernia - Massive sliding inguinal hernia $400.00 7 6
E725 - recurrent all types, except oesophageal . . . Add $130.00 N/A 4
E726 - repeat recurrent inguinal hernia (more than 2 repairs), to S322, S323, S326, S329 or S330 . . . Add $226.00 N/A 4
S342 Congenital diaphragmatic hernia - Epigastric $239.20 6 6
E727 - hydrocele extra applicable to adults only . . . Add $65.90 N/A N/A

Endoscopy

Code Description Amount Ans Units Assist Units
Z515 Oesophagoscopy, with or without biopsy(ies) $68.25 4 N/A
Z399 Oesophagoscopygastroscopy, with or without duodenoscopy - elective $92.50 4 N/A
Z400 Oesophagoscopygastroscopy, with or without duodenoscopy - for active bleeding $125.10 4 N/A
E696 - Oesophagoscopygastroscopy, with or without duodenoscopy with dilatation of oesophagus . . . add $30.65 N/A N/A
E702 - Oesophagoscopygastroscopy, with or without duodenoscopy with multiple (3 or more) biopsies of specific lesion . . . add $15.10 N/A N/A
E690 - Oesophagoscopygastroscopy, with or without duodenoscopy with removal of foreign body(ies) . . . add $43.85 N/A N/A
E795 - Oesophagoscopygastroscopy, with or without duodenoscopy with brushing of oesophagus, stomach, and/or duodenum . . . add $46.30 N/A N/A
E770 - Oesophagoscopygastroscopy, with or without duodenoscopy with duodenoscopy and drainage of bile after I.V. CCK stimulation . . . add $23.10 N/A N/A
E692 - Oesophagoscopygastroscopy, with or without duodenoscopy with laser debulking . . . add $69.70 N/A N/A
E698 - Oesophagoscopygastroscopy, with or without duodenoscopy with pneumatic or balloon dilation . . . add $69.70 N/A N/A
E703 - Oesophagoscopygastroscopy, with or without duodenoscopy with snare polypectomy first polyp (> 1 cm) . . . Add $50.50 N/A N/A
E799 - Oesophagoscopygastroscopy, with or without duodenoscopy each additional polyp, by snare polypectomy (> 1 cm) (to a maximum of 2) . . . add $25.25 N/A N/A
E695 - Oesophagoscopygastroscopy, with or without duodenoscopy laser palliation of oesophageal tumour, extensive, complete obstruction . . . add $0.00 N/A N/A
E797 - Oesophagoscopygastroscopy, with or without duodenoscopy management of uncomplicated upper or lower gastrointestinal bleeding, by any technique (e.g. laser, injection, diathermy, banding etc.) . . . add $46.30 N/A N/A
E798 - Oesophagoscopygastroscopy, with or without duodenoscopy management of complicated upper gastrointestinal bleeding by any technique in haemodynamically unstable patients with active bleeding during endoscopy . . . add $69.70 N/A N/A
E629 - Oesophagoscopygastroscopy, with or without duodenoscopy endoscopic placement of stent in duodenum . . . add $137.05 N/A N/A
Z527 Gastroscopy - may include biopsies, photography and removal of polyps less than or equal to 1 cm $82.90 4 N/A
Z547 Gastroscopy - with removal of foreign body $99.75 4 N/A
Z528 Gastroscopy - subsequent (within three months following previous gastroscopy) $67.85 N/A N/A
E674 - Gastroscopy with snare polypectomy 1st polyp > 1 cm (maximum 1) . . . add $142.40 N/A N/A
E675 - Gastroscopy with snare polypectomy each additional polyp > 1 cm (maximum 2) . . . add $73.50 N/A N/A
Z560 Duodenoscopy (not to be claimed if Z399 and/or Z400 performed on same patient within 3 months) $92.10 4 N/A
Z749 Subsequent procedure (within three months following previous endoscopic procedure) $72.55 4 N/A
E629 - Oesophagoscopygastroscopy, with or without duodenoscopy endoscopic placement of stent in duodenum . . . add $137.05 N/A N/A
Z584 Small bowel push enteroscopy $185.15 N/A N/A
Z512 Endoscopy of ileostomy or colostomy, or reduction of obstructed Koch ileostomy $36.80 4 N/A
E747 - to cecum . . . Add $31.40 N/A N/A
Z514 Endoscopy of ileostomy or colostomy, or reduction of obstructed Koch ileostomy - with biopsy $44.55 4 N/A
Z535 Sigmoidoscopy with or without anoscopy - with rigid scope $36.80 4 N/A
Z536 Sigmoidoscopy with or without anoscopy - with biopsy(ies) $44.55 4 N/A
Z592 Sigmoidoscopy with or without anoscopy - with decompression of volvulus $49.40 4 N/A
E797 - Oesophagoscopygastroscopy, with or without duodenoscopy management of uncomplicated upper or lower gastrointestinal bleeding, by any technique (e.g. laser, injection, diathermy, banding etc.) . . . add $46.30 N/A N/A
E746 - Sigmoidoscopy with or without anoscopy when Z535, Z536 or Z592 performed outside hospital . . . Add $5.85 N/A N/A
E641 - Sigmoidoscopy with or without anoscopy endoscopic placement of stent in rectum . . . Add $137.05 N/A N/A
Z543 Anoscopy (proctoscopy) $8.70 N/A N/A
Z561 Endoscopic retrograde cholangiopancreatography (ERCP) - with cannulation of common bile duct and/or pancreatic duct $213.15 6 N/A
Z558 Endoscopic retrograde cholangiopancreatography (ERCP) - including sphincterotomy and may include removal of one or more bile duct stones $300.25 6 N/A
Z760 Endoscopic retrograde cholangiopancreatography (ERCP) - through gastrojejunostomy following previous Billroth II $251.85 6 N/A
E702 - Oesophagoscopygastroscopy, with or without duodenoscopy with multiple (3 or more) biopsies of specific lesion . . . add $15.10 N/A N/A
E666 - Endoscopic retrograde cholangiopancreatography (ERCP) with biliary tract manometry . . . add $52.30 N/A N/A
E662 - Endoscopic retrograde cholangiopancreatography (ERCP) with intraductal cytology brushing or intraductal biopsy . . . add $49.75 N/A N/A
E668 - Endoscopic retrograde cholangiopancreatography (ERCP) with cannulation of minor papilla . . . add $93.80 N/A N/A
E680 - Endoscopic retrograde cholangiopancreatography (ERCP) with insertion of first endobiliary prosthesis and/or pancreatic stent (maximum 1) . . . add $82.35 N/A N/A
E681 - Endoscopic retrograde cholangiopancreatography (ERCP) with insertion of each additional endobiliary prosthesis and/or pancreatic stent (maximum 3) . . . add $43.60 N/A N/A
E669 - Endoscopic retrograde cholangiopancreatography (ERCP) with oesophagoscopygastroscopy and may include duodenoscopy . . . add $102.75 N/A N/A
Z593 Nasobiliary catheter insertion $55.25 N/A N/A
Z552 Peritoneoscopy, culdoscopy or laparoscopy - without biopsy $131.45 6 6
Z553 Peritoneoscopy, culdoscopy or laparoscopy - with biopsy and/or lysis of adhesions and/or removal of foreign body and/or cautery of endometrial implants $173.25 6 6
E857 - if a D&C is required for abnormal uterine bleeding and rendered with tubal occlusion or with diagnostic laparoscopy, to other procedure . . . Add $78.45 N/A N/A
E855 - Laparoscopy with dye injection . . . Add $25.85 N/A N/A

Reconstruction

Code Description Amount Ans Units Assist Units
S049 Plastic repair of duct $202.25 7 6
Z511 Dilation and/or probing of duct $43.15 6 N/A
S057 Submandibular duct relocation $360.75 7 6
S013 Cleft lip - unilateral $363.30 8 6
E501 - with nasal cartilage realignment . . . Add $304.30 N/A N/A
S014 Cleft lip - Reconstruction with lip switch flap $444.40 8 6
S015 Cleft lip - Complex reconstruction or revision of previous repair and excision $0.00 N/A N/A
E800 - Radial or linear probe through endoscope to endoscopy fee . . . Add $101.50 N/A N/A
E801 - Radial or linear probe through endoscope including biliary and/or pancreatic examination, to endoscopy fee . . . Add $152.30 N/A N/A

Excision

Code Description Amount Ans Units Assist Units
Z502 Lesion - less than 2 cms $71.00 6 6
S003 Lesion - 2 to 4 cms, inclusive $354.50 6 6
S006 Lesion - over 4 cms $431.15 7 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
S004 Ranula $165.80 6 6
S005 Composite resection of lesion of oral cavity and/or oropharynx with partial resection of mandible $0.00 N/A N/A
S007 Extended composite resection of lesion of oral cavity and oropharynx with partial resection of mandible and resection of maxilla $1,059.45 12 10
S050 Cryotherapy for treatment of premalignant or malignant lesions of oral cavity or sinuses $148.60 6 N/A
S018 Glossectomy - partial $197.45 8 6
S020 Glossoplasty $197.45 6 6
S023 Extraction of tooth (complete care) - single $24.90 6 N/A
E700 - each additional tooth . . . Add $13.40 N/A N/A
S028 Dentigerous cyst $98.80 6 6
S900 Basic units for anaesthesia with any unlisted dental surgical procedure performed by dental or oral surgeon $0.00 8 N/A
S021 Repair of extensive laceration $0.00 N/A 6
S034 Cleft palate repair $369.25 8 6
S035 Removal of sutures under general anaesthesia $41.25 6 N/A
S032 Bone graft to palate $335.65 8 6
S042 Submandibular gland or sublingual gland $391.05 7 6
S043 Parotid gland - total (with preservation of facial nerve) $885.75 10 6
S044 Parotid gland - total (without preservation of facial nerve) $593.00 10 6
S045 Parotid gland - subtotal (with preservation of facial nerve) $752.10 10 6
S047 Parotid gland - repeat subtotal (with preservation of facial nerve) $774.50 10 6
Z522 Parotid gland - Excision small tumour $51.25 7 6
S011 Wedge resection of lip - vermilion $98.45 6 6
S010 Wedge resection of lip - with plastic repair $275.00 N/A N/A
Z504 Wedge resection of lip - Excision of lesion $61.15 6 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
S012 Wedge resection of lip - Lip shave vermilionectomy $225.00 6 6
S087 Intrathoracic diverticulum $507.00 N/A N/A
S086 Cricopharyngeal myotomy, open approach $300.00 N/A N/A
Z505 Cricopharyngeal myotomy, when rendered by endoscopy, or in association with a urgical procedure during the same anaesthetic $37.20 6 6
S088 Cricopharyngeal diverticulum $390.05 N/A N/A
S089 Partial oesophageal resection and reconstruction (including intestinal transposition) $1,081.55 17 N/A
S090 Total thoracic oesophageal resection $1,465.35 13 N/A
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
E644 - radical mediastinal node dissection following preoperative chemotherapy and/or radiotherapy, to M142, M143, S089 or S090 . . . Add $207.45 N/A N/A
E730 - with reconstruction . . . add $678.85 N/A N/A
Z526 Biopsy - incisional - by gastrostomy $73.60 N/A N/A
Z533 Biopsy - incisional - by intubation $36.80 N/A N/A
S162 Local excision of lesion of intestine $528.85 7 6
Z750 Resection of exteriorized intestine $82.35 7 6
S164 Resection with anastomosis - Small intestine - duodenum $746.10 7 6
S165 Resection with anastomosis - Small intestine - other $687.55 7 6
S166 Resection with anastomosis - Small and large intestine terminal ileum, cecum and ascending colon (right hemicolectomy) $799.55 7 7
S167 Resection with anastomosis - Large intestine any portion $0.00 N/A N/A
E796 - with mobilization of splenic flexure, to S167 . . . Add $102.40 N/A N/A
S169 Resection with anastomosis - Total colectomy with ileorectal anastomosis $1,242.90 9 9
S172 Resection with anastomosis - Total colectomy with mucosal proctectomy with ileal pouch, ileoanal anastomosis and loop ileostomy $0.00 N/A N/A
S171 Resection with anastomosis - Left hemicolectomy with anterior resection or proctosigmoidectomy (anastomosis below peritoneal reflection & mobilization of splenic flexure) $1,082.95 8 7
E808 - Resection with anastomosis neorectal pouch formation, to S169 or S171 . . . Add $150.00 N/A N/A
S168 Ileostomy - subtotal colectomy $1,057.70 7 7
S170 Ileostomy - plus total colectomy plus abdominoperineal resection $1,790.60 10 9
S173 Ileostomy - Two-surgeon team - abdominal $1,632.80 10 9
S174 Ileostomy - Two-surgeon team - perineal $481.00 N/A N/A
E738 - Ileostomy with continent ileostomy, to either S168, S169, S170, S173 or S174 . . . Add $387.40 N/A N/A
E718 - Ileostomy bowel resection following previous resection with anastomosis, or following S217, S213, S214 or S215 . . . Add $142.40 N/A N/A
S188 Ileostomy - Bowel resection without anastomosis (colostomy and mucous fistula) $544.35 6 6
S189 Ileostomy -Intestinal bypass for morbid obesity $951.20 10 7
S213 Proctectomy - Anterior resection or proctosigmoidectomy (anastomosis below peritoneal reflection) $1,100.00 8 8
E808 - Resection with anastomosis neorectal pouch formation, to S169 or S171 . . . Add $150.00 N/A N/A
S214 Proctectomy - Abdominoperineal resection or pull through $1,300.00 10 8
S215 Two surgeon team - abdominal surgeon $1,009.85 10 8
S216 Two surgeon team - perineal surgeon $459.05 N/A N/A
S217 Hartmann procedure $890.00 9 8
S218 Colon reconstruction following Hartmann procedure $1,030.00 8 8
E796 - Resection with anastomosis Large intestine any portion with mobilization of splenic flexure, to S167 . . . Add $102.40 N/A N/A
Z752 Biopsy of rectosigmoid or above for Hirschsprung’s disease $82.35 6 6
E710 - each additional biopsy . . . Add $45.55 N/A N/A
S222 Presacral or transsacral proctotomy and excision of lesion $350.65 7 6
Z753 Polyps or tumours of rectum or sigmoid * - electrocoagulation base under 2 cm $24.25 7 N/A
Z754 Polyps or tumours of rectum or sigmoid * - excision base under 2 cm $82.35 6 6
Z784 Polyps or tumours of rectum or sigmoid * - excision and suture base 2 to 5 cm, inclusive $213.50 6 6
Z785 Polyps or tumours of rectum or sigmoid * - excision and suture base over 5 cm $329.65 7 6
Z755 Polyps or tumours of rectum or sigmoid * - electrocoagulation base 2 to 5 cm, inclusive $142.40 6 6
Z761 Polyps or tumours of rectum or sigmoid * - electrocoagulation base over 5 cm $219.90 7 6
E688 - Polyps or tumours of rectum or sigmoid * with laser debulking . . . Add $69.80 N/A N/A
S247 Haemorrhoidectomy, with or without sigmoidoscopy or repair of fissure(s) and/or sphincterotomy and/or anal dilation $260.15 6 6
Z565 Complete haemorrhoidectomy using cryotherapy and/or Barron ligation(s) including rectal dilation $99.60 6 N/A
Z546 Barron ligation(s) (not to exceed 6 in any one year) $39.10 N/A N/A
Z566 Barron ligation(s) plus cryotherapy (not to exceed 6 in any one year) $39.10 N/A N/A
S249 Local excision for malignancy $153.05 7 6
Z757 Excision of benign anal lesion(s) $47.15 6 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A
S251 Fistulainano $213.15 6 6
S269 Hepatectomy - local excision of lesion (less than 5 cm) $350.65 7 7
S275 Hepatectomy - partial lobectomy (excision greater than 5 cm) $585.05 8 8
S270 Hepatectomy - Formal anatomical resection - one or two liver segments $1,184.60 12 12
S267 Hepatectomy - Formal anatomical resection - three or four liver segments $1,652.15 12 12
S271 Hepatectomy - Formal anatomical resection - five or more liver segments $1,784.60 12 12
S272 Hepatectomy - Laparotomy, cholangiogram and biopsy (neonatal jaundice) $387.40 7 6
E765 - Liver transplant with reconstruction or repair of the hepatic artery (i.e. reanastomosis or conduit), to liver transplant fee . . . Add $300.45 N/A N/A
S274 Liver transplant - Deceased donor, liver removal . . . Add $964.50 8 6
S294 Liver transplant - Deceased donor, liver transplant . . . Add $2,748.75 30 20
S295 Liver transplant - Repeat liver transplant . . . Add $3,776.20 40 30
S265 Liver transplant - Living donor, hepatectomy . . . Add $4,760.60 35 20
S266 Liver transplant - Living donor, orthotopic liver transplant . . . Add $5,289.55 35 25
S287 Cholecystectomy $478.00 7 7
E721 - Pyloroplasty or gastroenterostomy plus vagotomy and cholecystectomy with choledochotomy . . . Add $122.05 N/A N/A
E722 - with transduodenal sphincterotomy . . . Add $162.70 N/A N/A
E728 - with truncal or selective vagotomy . . . Add $167.65 N/A N/A
E729 - with highly selective vagotomy . . . Add $284.75 N/A N/A
E794 - with intraoperative cholangiogram, to S287 . . . Add $35.85 N/A N/A
S298 Pancreatectomy - Complete with splenectomy $1,270.20 13 9
S300 Pancreatectomy - “Whipple type” procedure $1,785.45 13 9
S301 Pancreatectomy - Local complete excision of tumour or lesion $508.55 8 8
S309 Pancreatectomy - Distal body, tail with splenectomy with or without anastomosis $986.05 11 9
S299 Pancreatectomy - Distal body, tail with preservation of spleen, with or without anastomosis $1,250.00 11 9
E709 - Partial or subtotal with cholecystectomy . . . Add $122.05 N/A N/A
S316 Excision of full thickness abdominal wall tumour and primary closure $0.00 7 N/A
S317 Umbilectomy - plastic $111.45 7 6
S318 Panniculectomy, including any necessary diastasis repair $500.00 6 6
E748 - Panniculectomy with repair of umbilical hernia, to S318 . . . Add $122.05 N/A N/A
E809 - Panniculectomy excision of pannus that extends beyond the mid thigh, to S318 . . . Add $250.00 N/A N/A
S319 Panniculectomy - Mesenteric cyst $335.15 6 6

Paracentesis

Code Description Amount Ans Units Assist Units
Z590 Aspiration - for diagnostic sample $31.30 N/A N/A
Z591 Aspiration - with therapeutic drainage with or without diagnostic sample $57.55 N/A N/A
E724 - Aspiration administration of chemotherapy or sclerosing agent . . . add $23.25 N/A N/A
Z763 Aspiration - Paracentesis with lavage for diagnosis $38.70 N/A N/A
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00 N/A N/A

Other

Code Description Amount Ans Units Assist Units
S030 Closure of fistula - anterior alveolar $197.45 6 6
S033 Closure of fistula - palate $281.95 8 6
S036 Uvulopalatopharyngoplasty (includes tonsillectomy) $239.75 6 N/A
S069 Pharyngoplasty $360.45 8 8
S002 Excision of parapharyngeal space lesions (with mobilization of parotid gland) $907.05 8 6
S067 Partial pharyngectomy transthyroid or lateral $1,017.20 11 8
S068 Pharyngolaryngectomy $1,155.45 14 8
E882 - Laryngectomy total with thyroid lobectomy, to M081 . . . Add $177.40 N/A N/A
E883 - Laryngectomy total with thyroid lobectomy, must include excision of isthmus and pyramidal tract, to M081 . . . Add $266.60 N/A N/A
E884 - Laryngectomy total with total thyroidectomy, to M081 . . . Add $374.00 N/A N/A
S058 Branchial - cleft lesion $306.85 7 6
S059 Branchial - repeat procedure $435.30 6 6
S061 Thyroglossal duct remnant $340.15 7 6
S062 Thyroglossal duct remnant - repeat procedure $410.40 6 6
S063 Tonsillectomy and may include adenoidectomy $178.35 N/A N/A
S065 Adenoidectomy $101.25 N/A N/A
E839 - Nasal polyp single with flexible endoscope, to Z304 . . . Add $19.20 N/A N/A
S066 Secondary suture or cauterization following tonsillectomy and/or adenoidectomy - when haemorrhage occurs after initial procedure $121.05 6 N/A
S024 Excision of torus palatinus $197.45 6 6
S236 Linear or radial echo-endoscope - excluding biliary or pancreatic examination (scope also used for therapeutic procedures) $203.05 6 N/A
S237 Linear or radial echo-endoscope - including biliary and/or pancreatic examination (scope also used for therapeutic procedures) $253.80 6 N/A
E802 - Linear or radial echoendoscope biopsy or fine needle aspiration, to a maximum of 3, per lesion . . . Add $50.75 N/A N/A
E803 - Linear or radial echoendoscope dilation of stricture . . . Add $30.65 N/A N/A
E804 - Linear or radial echoendoscope injection of one or more of any of the following metastases, nodes, masses, or celiac plexus . . . Add $145.05 N/A N/A
E805 - Linear or radial echoendoscope drainage of pseudocyst (including stent insertion if performed) . . . Add $203.05 N/A N/A
S073 Cervical approach $0.00 7 6
S074 Thoracic approach $0.00 13 10
S075 Abdominal approach $0.00 8 7
S131 Vagotomy - truncal or selective $375.80 7 7
S124 Vagotomy - highly selective (as sole procedure without pyloroplasty or gastroenterostomy) $503.10 7 7
S121 Transabdominal vagotomy after previous vagotomy $416.50 8 7
S120 Gastric bypass with Roux-en-Y anastomosis, for morbid obesity $1,350.00 10 7
S115 Reversal of previous vertical banded gastroplasty $820.00 10 7
S114 Sleeve gastrectomy $820.00 10 7
S113 Removal of gastric band $300.00 10 7
Z513 Hydrostatic Pneumatic dilatation of colon stricture(s) through colonoscope $107.50 N/A N/A
Z570 Fulguration of first polyp through colonoscope $49.80 N/A N/A
E719 - each additional polyp (maximum of 4) . . . Add $24.25 N/A N/A
Z571 Excision of first polyp greater than or equal to 3mm through colonoscope $150.15 4 N/A
E720 - each additional polyp greater than or equal to 3mm (maximum of 2) . . . Add $77.50 N/A N/A
Z764 Excision of obstructive tumour or stricture through colonoscopy - less than 2 cm $63.80 N/A N/A
Z765 Excision of obstructive tumour or stricture through colonoscopy - 2 cm or greater $131.75 N/A N/A
E687 - Excision of obstructive tumour or stricture through colonoscopy with laser debulking . . . Add $69.80 N/A N/A
E685 - Excision of obstructive tumour or stricture through colonoscopy total excision of very large sessile polyp (> 3 cm) through colonoscope, and may include fulguration, each . . . Add $227.65 N/A N/A
S175 Intestinal obstruction (mechanical) - One stage - without resection $620.00 7 6
S176 Intestinal obstruction (mechanical) - One stage - with entero-enterostomy $748.00 7 6
S177 Intestinal obstruction (mechanical) - One stage - with resection $900.00 7 6
S180 Intestinal obstruction (mechanical) - One stage - with enterotomy $672.00 7 6
S178 Intestinal obstruction (mechanical) - Intestinal atresia (newborn) $682.90 7 6
S179 Intestinal obstruction (mechanical) - Meconium ileus $682.90 7 6
S291 Choledochectomy for tumour* $406.85 8 8