Digestive system surgical procedures OHIP billing codes

These are the most commonly used Digestive system surgical procedures OHIP billing codes. To find other billing codes search the OHIP fee schedule here .


Incision

Code Description Amount Ans Units Assist Units
Z506 Drainage of oral abscess or haematoma $50.90 6
Z510 Drainage of pharyngeal abscess or haematoma $91.10 6
Z524 Drainage of haematoma or deep neck abscess (external approach) $271.05 7 6
Z501 Biopsy $35.50
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00
Z537 Biopsy - requiring general anaesthetic $97.05
Z111 Tongue tie, release of - simple $15.35
Z112 Tongue tie, release of - complex or requiring general anaesthetic $50.90 6
S031 Palatal fenestration $197.55 6
Z500 Sialolithotomy $30.65
Z521 Sialolithotomy - requiring general anaesthesia $103.60 6 6
Z503 Biopsy $35.40 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00
S084 Oesophagostomy - Cervical - other than neonatal $212.35
S085 Oesophagostomy - Cervical - neonatal $304.20
S082 Oesophagostomy - Intrathoracic oesophageal stent - via laparotomy $410.55 7
S083 Oesophagostomy - Intrathoracic oesophageal stent - via oesophagoscope (includes Z515) $304.20 6
S081 Oesophagostomy - Transoesophageal division of oesophageal varices $558.05
S080 Oesophagostomy - Oesophagealgastric devascularization (including splenectomy and oesophageal division/anastomosis) $898.15
S116 Gastrotomy - with removal of tumour or foreign body $406.85 7 6
E731 - with suture of bleeding peptic ulcer . . . Add $247.05
S117 Gastrotomy - Pyloromyotomy (Ramstedt's) $314.80 10 6
S118 Gastrostomy $345.85 7 6
E697 - with repair of MalloryWeiss laceration . . . add $142.40
E707 - when done with another intraabdominal procedure $70.80
Z532 Percutaneous endoscopic gastrostomy $172.95 7 6
Z520 Change of gastrostomy tube $0.00
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
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
E714 - repair of enterocutaneous fistula in conjunction with bowel resection . . . Add $82.35
Z544 Biopsy $34.90 6
Z545 Thrombosed haemorrhoid(s) $25.25 6
E542 - Abscess or haematoma Local anaesthetic subcutaneous palmar or plantar spaces, when performed outside hospital add $0.00
S241 Sphincterotomy(ies) under local anaesthesia $88.20 6
S243 Sphincterotomy(ies) under general anaesthesia $200.00 6 6
Z554 Biopsy - incisional $102.10
Z551 Biopsy - needle $87.50 7
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
S234 Replacement of catheter in S233 $64.85
Z562 Biliary duct calculus manipulation and/or removal via T-tube tract - as sole procedure $116.20 7
Z542 Biliary duct calculus manipulation and/or removal via T-tube tract - Intubation of bile duct for obstruction $85.25
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
S282 Cholecystogastrostomy $447.45 7 7
S283 Cholecystoenterostomy $447.45 7 7
E743 - with enteroenterostomy, to S281 or S283 . . . Add $153.05
S285 Intrahepatic choledochoenterostomy (anastomosis above the common hepatic duct bifurcation) $915.30 12 9
Z762 Biopsy - needle $102.10
Z577 Biopsy - incisional $122.05 7
S297 Drainage of acute pancreatitis or abscess or marsupialization of cyst $406.85 7 7
Z563 Needle biopsy of peritoneum $48.00
Z564 Open lavage of peritoneal cavity for diagnosis without manual exploration of peritoneal cavity $73.60 7
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
S321 Laparotomy - for acute trauma $397.15 6 6
E733 - with repair of intestine single . . . Add $142.10
E734 - multiple and/or with resection . . . Add $211.15
E735 - with splenectomy (partial or complete) . . . Add $284.75 4
E736 - with repair of lacerated liver . . . Add $187.90 4
E739 - with repair of diaphragm . . . Add $122.05 4
E723 - with repair of lacerated spleen . . . Add $284.80 4
E693 - with repair of ruptured bladder . . . Add $0.00 4
E694 - with nephrectomy . . . Add $0.00 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
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
E686 - Peritoneal abscess within each other abdominal quadrant, or the pelvis (if the initial abscess was not in the pelvis) . . . add $144.10
Z595 Peritoneal abscess - Replacement of drainage catheter in abdominal abscess $54.05
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
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
Z549 Fulguration of condylomata - local anaesthetic $30.95
Z758 Fulguration of condylomata - general anaesthetic $97.65 6 6

Injection

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

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
S302 Donor pancreas removal $679.50 8 6
S303 Backbench pancreas graft preparation $339.75
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
Z538 Reduction of prolapse $25.25 6
Z539 Dilation of gastrostomy, enterostomy, colostomy, etc. $25.25 6
Z540 Intubation of small intestine (therapeutic or diagnostic) - with or without fluoroscopy $79.80
E732 - with biopsy . . . Add $29.10
Z541 Dilation and/or disimpaction or removal of foreign body under general anaesthetic (as sole procedure) $58.15 6
Z756 Fecal disimpaction no anaesthetic $36.80
Z550 Dilation of anal sphincter $12.05 6
S248 Peter Lord procedure $43.60 6

Colonoscopy

Code Description Amount Ans Units
Z497 Confirmatory colonoscopy sigmoid to descending colon $51.95 5
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
Z492 Five year follow up of normal colonoscopy (Z499), absence of intervening signs or symptoms - sigmoid to descending $51.95 5
Z493 Ten year follow up of normal colonoscopy (Z497, Z555), absence of intervening signs or symptoms sigmoid to descending $51.95 5
Z496 Colonoscopy - For diagnosis or ongoing management - Presence of signs or symptoms sigmoid to descending colon $51.95 5
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
Z498 Follow up of abnormal colonoscopy sigmoid to descending colon $51.95 5
Z495 Follow up of unsatisfactory colonoscopy $51.95 5
Z491 Follow up of incomplete polyp resection $51.95 5
Z555 Absence of signs or symptoms or risk factors, 50 years of age or older sigmoid to descending colon $51.95 5
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
E747 - Endoscopy of ileostomy or colostomy, or reduction of obstructed Koch ileostomy to cecum . . . Add $31.40
E740 - to splenic flexure, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $51.95
E741 - to hepatic flexure, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $31.40
E705 - into terminal ileum, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $30.50
E630 - endoscopic placement of stent in colon, to Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 . . . Add $137.05
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
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
E749 - when Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499, Z512, Z555 or Z580 rendered in private office . . . add $22.35

Sigmoidoscopy

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

Gastrectomy

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

Dilation Of Oesophagus

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

Suture

Code Description Amount Ans Units Assist Units
S103 Closure of H-type tracheooesophageal fistula by cervical or thoracic approach $923.05
S104 Repair of oesophageal atresia with or without tracheal fistula $1,153.85
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
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

Repair

Code Description Amount Ans Units Assist Units
S161 Oesophageal myotomy, partial (below aortic arch) $584.15
E758 - with oesophageal hiatus hernia repair . . . Add $217.35
S100 Total thoracic oesophageal myotomy (as sole procedure) $738.90
E758 - Oesophageal myotomy, partial (below aortic arch) with oesophageal hiatus hernia repair . . . Add $217.35
S091 Oesophageal hiatus hernia - abdominal or transthoracic approach with fundal plication $750.00
S092 Oesophageal hiatus hernia - recurrent $709.85
E847 - Chest wall tumour with reconstruction of diaphragm requiring repair with mesh or equivalent synthetic material to M105 . . . Add $75.00
E744 - Oesophageal hiatus hernia with gastroplasty, to either S091 or S092 . . . Add $115.80
E742 - Oesophageal hiatus hernia for each additional procedure performed. . . . Add $217.35
S095 Oesophageal stricture (Thal) may include oesophageal hiatus hernia repair with or without gastroplasty $676.05
S096 Ruptured oesophagus, suture and drainage $507.00
S097 Oesophagogastrostomy for bypass (as sole procedure) $608.30
S098 Oesophageal bypass, abdomen to neck - with stomach $912.60
S099 Oesophageal bypass, abdomen to neck - with colon or jejunum $1,264.05
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
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
E721 - with choledochotomy . . . Add $122.05
S134 Gastroduodenostomy or gastrojejunostomy $0.00
E711 - Partial or subtotal after previous gastroenterostomy . . . Add $106.55
E721 - Pyloroplasty or gastroenterostomy plus vagotomy and cholecystectomy with choledochotomy . . . Add $122.05
E716 - either of above plus vagotomy . . . Add $147.30
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
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
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
E756 - Herniotomy with resection of strangulated contents . . . Add $111.45
E757 - Herniotomy without resection of strangulated contents . . . Add $55.25
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
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 4
E726 - repeat recurrent inguinal hernia (more than 2 repairs), to S322, S323, S326, S329 or S330 . . . Add $226.00 4
S342 Congenital diaphragmatic hernia - Epigastric $239.20 6 6
E727 - hydrocele extra applicable to adults only . . . Add $65.90

Endoscopy

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

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
S057 Submandibular duct relocation $360.75 7 6
S013 Cleft lip - unilateral $363.30 8 6
E501 - with nasal cartilage realignment . . . Add $304.30
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
E800 - Radial or linear probe through endoscope to endoscopy fee . . . Add $101.50
E801 - Radial or linear probe through endoscope including biliary and/or pancreatic examination, to endoscopy fee . . . Add $152.30

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
S004 Ranula $165.80 6 6
S005 Composite resection of lesion of oral cavity and/or oropharynx with partial resection of mandible $0.00
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
S018 Glossectomy - partial $197.45 8 6
S020 Glossoplasty $197.45 6 6
S023 Extraction of tooth (complete care) - single $24.90 6
E700 - each additional tooth . . . Add $13.40
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
S021 Repair of extensive laceration $0.00 6
S034 Cleft palate repair $369.25 8 6
S035 Removal of sutures under general anaesthesia $41.25 6
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
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
S012 Wedge resection of lip - Lip shave vermilionectomy $225.00 6 6
S087 Intrathoracic diverticulum $507.00
S086 Cricopharyngeal myotomy, open approach $300.00
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
S089 Partial oesophageal resection and reconstruction (including intestinal transposition) $1,081.55 17
S090 Total thoracic oesophageal resection $1,465.35 13
E847 - Chest wall tumour with reconstruction of diaphragm requiring repair with mesh or equivalent synthetic material to M105 . . . Add $75.00
E644 - radical mediastinal node dissection following preoperative chemotherapy and/or radiotherapy, to M142, M143, S089 or S090 . . . Add $207.45
E730 - with reconstruction . . . add $678.85
Z526 Biopsy - incisional - by gastrostomy $73.60
Z533 Biopsy - incisional - by intubation $36.80
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
E796 - with mobilization of splenic flexure, to S167 . . . Add $102.40
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
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
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
E738 - Ileostomy with continent ileostomy, to either S168, S169, S170, S173 or S174 . . . Add $387.40
E718 - Ileostomy bowel resection following previous resection with anastomosis, or following S217, S213, S214 or S215 . . . Add $142.40
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
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
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
Z752 Biopsy of rectosigmoid or above for Hirschsprung’s disease $82.35 6 6
E710 - each additional biopsy . . . Add $45.55
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
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
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
Z546 Barron ligation(s) (not to exceed 6 in any one year) $39.10
Z566 Barron ligation(s) plus cryotherapy (not to exceed 6 in any one year) $39.10
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
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
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
E722 - with transduodenal sphincterotomy . . . Add $162.70
E728 - with truncal or selective vagotomy . . . Add $167.65
E729 - with highly selective vagotomy . . . Add $284.75
E794 - with intraoperative cholangiogram, to S287 . . . Add $35.85
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
S316 Excision of full thickness abdominal wall tumour and primary closure $0.00 7
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
E809 - Panniculectomy excision of pannus that extends beyond the mid thigh, to S318 . . . Add $250.00
S319 Panniculectomy - Mesenteric cyst $335.15 6 6

Paracentesis

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

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
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
E883 - Laryngectomy total with thyroid lobectomy, must include excision of isthmus and pyramidal tract, to M081 . . . Add $266.60
E884 - Laryngectomy total with total thyroidectomy, to M081 . . . Add $374.00
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
S065 Adenoidectomy $101.25
E839 - Nasal polyp single with flexible endoscope, to Z304 . . . Add $19.20
S066 Secondary suture or cauterization following tonsillectomy and/or adenoidectomy - when haemorrhage occurs after initial procedure $121.05 6
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
S237 Linear or radial echo-endoscope - including biliary and/or pancreatic examination (scope also used for therapeutic procedures) $253.80 6
E802 - Linear or radial echoendoscope biopsy or fine needle aspiration, to a maximum of 3, per lesion . . . Add $50.75
E803 - Linear or radial echoendoscope dilation of stricture . . . Add $30.65
E804 - Linear or radial echoendoscope injection of one or more of any of the following metastases, nodes, masses, or celiac plexus . . . Add $145.05
E805 - Linear or radial echoendoscope drainage of pseudocyst (including stent insertion if performed) . . . Add $203.05
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
Z570 Fulguration of first polyp through colonoscope $49.80
E719 - each additional polyp (maximum of 4) . . . Add $24.25
Z571 Excision of first polyp greater than or equal to 3mm through colonoscope $150.15 4
E720 - each additional polyp greater than or equal to 3mm (maximum of 2) . . . Add $77.50
Z764 Excision of obstructive tumour or stricture through colonoscopy - less than 2 cm $63.80
Z765 Excision of obstructive tumour or stricture through colonoscopy - 2 cm or greater $131.75
E687 - Excision of obstructive tumour or stricture through colonoscopy with laser debulking . . . Add $69.80
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
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