What is OHIP billing code E519?

E519 is "Excision of additional polyp (10 mm to 19 mm)", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E519 pay?

The current OHIP fee for E519 is $77.50, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill E519 to OHIP?

E519 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E519 claims against the Schedule of Benefits rules before submission.

What codes are related to E519?

Codes related to E519 in the Schedule of Benefits include Z517, Z571, Z518, Z516, E720, E520, E518.

All codes

E519

E519 – Excision of additional polyp (10 mm to 19 mm)

OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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This fee code represents the surgical excision of an additional intestinal polyp with a diameter between 10mm and 19mm. It is an add-on service that must be claimed with one of the primary polyp excision codes (Z571, Z518, Z517, or Z516). The selection of the primary code is based on the size of the largest polyp excised during the procedure.

When to Use

Use E519 when you have already claimed a primary polyp excision code (Z516, Z517, Z518, or Z571) for the largest polyp and need to bill for a second polyp measuring between 10mm and 19mm.
Use E519 in conjunction with a primary code when performing a colonoscopy where multiple polyps are removed, provided the additional polyp meets the 10mm-19mm size threshold.

Common Pitfalls

Claiming more than two total additional polyp codes (E519, E518, E520, or E720) per patient per day, as the Ministry enforces a strict maximum of two additional excisions.
Attempting to bill E519 for polyps smaller than 10mm, which are considered part of the primary procedure and are not eligible for additional fee claims.
Failing to link E519 to a valid primary code (Z516, Z517, Z518, or Z571) on the same claim, which will result in an automatic rejection.

Billing Tips

Ensure the primary code selected (Z516, Z517, Z518, or Z571) corresponds strictly to the size of the largest polyp removed to maintain compliance with the hierarchy of primary codes.
When removing multiple polyps of varying sizes, prioritize claiming the highest-value additional codes (e.g., E520 or E519) within the two-code daily limit to maximize the claim value.

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Provider Fee$77.50

Effective: April 1, 2025

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