All codes
S028
S028 – Dentigerous cyst
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical excision of a dentigerous cyst. This procedure is eligible for payment for a surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C).
When to Use
- Use S028 for the definitive surgical excision of a confirmed dentigerous cyst associated with an unerupted tooth.
- Select S028 when the procedure involves the enucleation of the cyst lining from the jaw, distinguishing it from simple biopsy or incision and drainage procedures.
Common Pitfalls
- Do not bill S028 in conjunction with S900 (Excision of lesion of jaw) for the same site, as this constitutes unbundling; S028 is the specific code for this pathology.
- Avoid billing S028 for simple soft tissue cysts; ensure the documentation confirms the cyst is dentigerous (odontogenic) in origin to prevent audit recovery.
Billing Tips
- Ensure the pathology report is referenced in your records, as the diagnosis of a dentigerous cyst is histologically confirmed and required to justify the specific code over generic lesion excision codes.
Provider Fee$98.80
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
The section for Oral Cavity and Pharynx procedures includes nasopharynx, oropharynx, and hypopharynx unless otherwise specified.
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