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S114 – Sleeve gastrectomy

OHIP Digestive System Surgical Procedures Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Sleeve gastrectomy is a surgical procedure performed for morbid obesity (defined as Body Mass Index [BMI] > 40). It is only eligible for payment under specific circumstances: 1. When a Roux-en-Y gastric bypass is not possible due to small bowel disease, adhesions, or previous surgery. 2. When it is performed as a planned staged surgery for patients with a BMI greater than 60, with the intention of enabling weight loss before a subsequent gastric bypass with Roux-en-Y. An additional 25% is payable on the surgical fee if the procedure is performed laparoscopically or is laparoscopically assisted, claimed using E793.

1. S114 Sleeve gastrectomy is only eligible for payment when: a. a Roux-en-Y gastric bypass is not possible due to small bowel disease/adhesions or previous surgery; or b. performed as a planned staged surgery in patients with a BMI > 60 to enable the patient to lose weight.

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