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S116

S116Gastrotomy - with removal of tumour or foreign body

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

Gastrotomy with removal of tumour or foreign body. As a surgical procedure, this service includes the common elements of all insured services as described in -, and specific elements for surgical services including pre-operative evaluation, the surgical procedure itself, and post-operative care. When billed with suffix B (Assistant) or C (Anaesthetist), the fee is calculated based on basic and time units as outlined in the Schedule (, ).

When to Use

  • Use S116 for the surgical removal of a foreign body (e.g., bezoar or ingested object) via gastrotomy when the procedure does not involve a formal resection.
  • Use S116 for the excision of a gastric tumour where the procedure is limited to a gastrotomy approach rather than a partial gastrectomy (S117).

Common Pitfalls

  • Billing S116 in addition to a hospital admission assessment; this is disallowed unless the assessment qualifies as the 'major pre-operative visit' where the decision to operate was finalized.
  • Confusing S116 with S117 (Gastrectomy); S116 is specific to gastrotomy, whereas S117 covers more extensive gastric resections.

Billing Tips

  • Ensure the operative report clearly documents the removal of a specific tumour or foreign body to justify the use of S116 over a general exploratory laparotomy code.
Provider Fee$406.85
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Digestive System Surgical Procedures

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