What is OHIP billing code E819?

E819 is "Diagnostic ureteroscopy of second ureter", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E819 pay?

The current OHIP fee for E819 is $54.65, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill E819 to OHIP?

E819 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E819 claims against the Schedule of Benefits rules before submission.

What codes are related to E819?

Codes related to E819 in the Schedule of Benefits include Z628, E822, E760, E761, E820, E823.

All codes

E819

E819 – Diagnostic ureteroscopy of second ureter

OHIP Surgical Assists Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits

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Payable as an add-on to Z628 (Cystoscopy and diagnostic ureteroscopy - above intramural) for the diagnostic ureteroscopy of the second ureter during the same operative session. This fee is added to the fee for the primary procedure, Z628.

When to Use

Use E819 when performing a diagnostic ureteroscopy on the contralateral ureter during the same operative session as the primary diagnostic ureteroscopy billed under Z628.
Use this code specifically when the primary procedure is Z628; it is not applicable for bilateral therapeutic procedures or when using other primary ureteroscopy codes.

Common Pitfalls

Billing E819 without a corresponding Z628 claim will result in an automatic rejection, as it is strictly an add-on code.
Attempting to use E819 for therapeutic interventions (e.g., stone extraction or stent placement) in the second ureter is incorrect; those require their own specific procedural codes.
Claiming E819 alongside Z638 is prohibited by the Schedule of Benefits; ensure your primary procedure selection does not conflict with this exclusion.

Billing Tips

Always ensure the diagnostic nature of the second ureteroscopy is clearly documented in the operative report to support the use of E819 over a therapeutic code.
When applying after-hours premiums like E409 or E410, ensure they are applied to the total procedural fee (Z628 + E819) if the criteria for the premium are met.

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Provider Fee$54.65

Effective: April 1, 2025

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