What is OHIP billing code S011?

S011 is "Wedge resection of lip - vermilion", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S011 pay?

The current OHIP fee for S011 is $98.45, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill S011 to OHIP?

S011 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S011 claims against the Schedule of Benefits rules before submission.

All codes

S011

S011 – Wedge resection of lip - vermilion

OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Performs a wedge resection of the lip vermilion. The fee for the surgical procedure (S011A) is a flat rate. Fees for surgical assistance (S011B) and anaesthesia (S011C) are calculated based on a base unit value of 6 units plus time units, as detailed in the General Preamble (-, -).

When to Use

Use S011A for full-thickness wedge resection of the lip vermilion to address localized pathology such as squamous cell carcinoma or persistent leukoplakia.
Select S011A when the procedure is limited to the vermilion wedge and does not require complex flap reconstruction or extensive mucosal advancement.

Common Pitfalls

Do not bill S011A alongside more extensive lip reconstruction codes; if the procedure involves complex closure or significant tissue rearrangement, S011A may be considered bundled or insufficient.
Avoid billing S011A for simple biopsies or superficial excisions, as these are typically covered by different codes; S011A specifically requires a wedge resection technique.

Billing Tips

Ensure the surgical report clearly describes the wedge resection technique to justify the use of S011A over simpler excision codes.
If the procedure is performed on a pediatric patient, remember to apply the appropriate age premium (e.g., AGE_PREMIUM_5Y_TO_16Y) to the S011A base fee.

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Provider Fee$98.45

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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