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S113

S113Removal of gastric band

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

Removal of gastric band. Note: S113 is only eligible for payment when the gastric band requires removal due to: 1. Complications related to the gastric band; or 2. Conversion to gastric bypass.

When to Use

  • Use S113 when performing an urgent or elective removal of a gastric band due to documented mechanical complications such as band slippage, erosion, or port-site infection.
  • Use S113 when removing a gastric band as the initial step during a planned conversion procedure to a gastric bypass (e.g., Roux-en-Y).
  • Use S113 when a patient requires band removal due to chronic intolerance or failure to achieve weight loss goals, provided the clinical record clearly justifies the medical necessity.

Common Pitfalls

  • Billing S113 without explicit documentation of the complication or the intent for conversion, which will trigger a rejection or audit recovery.
  • Attempting to bill S113 in addition to a primary bariatric procedure code (like a gastric bypass) without ensuring the surgical notes support that the removal was a distinct, necessary component of the conversion.
  • Failing to append the E793 modifier when the removal is performed laparoscopically, resulting in a 25% underpayment of the surgical fee.

Billing Tips

  • Always append the E793 modifier to S113 if the procedure is performed laparoscopically to capture the 25% fee increase.
  • Ensure the operative report explicitly states the indication for removal (complication type or conversion plan) to satisfy the documentation requirements outlined in GP8.
Provider Fee$341.60
Surgical Assistant Fee$90.37
Anaesthetist Fee$159.60
Non-Anaesthetist Fee$159.60

Effective: April 1, 2026

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Digestive System Surgical Procedures

All insured services must be documented in appropriate records establishing that the service was provided, is the service submitted for payment, and was medically necessary, as per .

S113 is only eligible for payment when the gastric band requires removal due to: 1. Complications related to the gastric band; or 2. Conversion to gastric bypass.

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