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E545
E545 – Vasectomy - when performed outside hospital
OHIP Surgical Assists Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on premium payable with S626 (uni- or bilateral vasectomy by any technique) when the vasectomy is performed outside of a hospital. The Schedule lists this as 'add 11.55'.
When to Use
- Use E545 exclusively as an add-on to S626 when the vasectomy procedure is performed in a physician's office or clinic setting rather than a hospital operating room.
- Apply this code when the procedure is performed under local anesthesia in an office environment to compensate for the overhead costs associated with non-hospital surgical delivery.
Common Pitfalls
- Billing E545 without an accompanying S626 will result in an automatic rejection as it is a mandatory premium add-on.
- Attempting to bill E545 for procedures performed within a hospital or ambulatory surgical center is an audit risk, as the code specifically mandates an 'outside hospital' location.
Billing Tips
- Ensure the location indicator on your claim reflects the office setting to justify the E545 premium alongside the S626 base fee.
Provider Fee$13.75
Effective: April 1, 2026
Category
U. Male Genital Surgical Procedures
Subcategory
MALE GENITAL SURGICAL PROCEDURES
Service Type
Premium
Code Classes
Other Premiums (including After Hours Procedure Premiums)
Sex Restriction
Male
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