What is OHIP billing code E523?

E523 is "Repair of abdominal defect - same surgeon, to other procedure", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E523 pay?

The current OHIP fee for E523 is $321.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill E523 to OHIP?

E523 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E523 claims against the Schedule of Benefits rules before submission.

All codes

E523

E523 – Repair of abdominal defect - same surgeon, to other procedure

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

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Repair of abdominal defect - same surgeon, to other procedure

When to Use

Use E523 when performing an abdominal wall hernia repair or fascial closure that is incidental to a primary abdominal surgery, such as an exploratory laparotomy or bowel resection.
Apply this code when repairing a distinct abdominal wall defect discovered during a primary procedure that requires separate surgical attention but is not the primary focus of the operative note.

Common Pitfalls

Billing E523 as a standalone procedure will result in automatic rejection, as it is strictly an add-on code requiring a primary surgical procedure code on the same claim.
Attempting to claim E523 for routine closure of an incision site is considered unbundling, as standard closure is included in the global fee of the primary surgical procedure.

Billing Tips

Ensure the operative report explicitly describes the additional work performed on the abdominal defect to justify the add-on fee beyond the primary procedure's global surgical package.

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Provider Fee$321.00

Effective: April 1, 2025

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