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S117

S117Pyloromyotomy (Ramstedt's)

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

Pyloromyotomy, also known as Ramstedt's procedure, is an incision into the pylorus muscle to relieve a congenital obstruction. This service is limited to newborns and infants. From .

When to Use

  • Use S117 for the definitive surgical treatment of infantile hypertrophic pyloric stenosis in newborns and infants.
  • Use S117 when performing a pyloromyotomy via either open or laparoscopic approach, as the code covers the procedure regardless of the surgical technique.

Common Pitfalls

  • Attempting to bill S117 for patients older than two years will result in an automatic rejection due to the age-based restriction.
  • Failing to apply the mandatory age-based surgical premium (30% for <30 days, 25% for 30 days-1 year, or 20% for 1-2 years) results in significant underpayment.
  • Billing for a second surgical assistant without prior authorization is a common audit trigger, as S117 is not pre-approved for multiple assistants.

Billing Tips

  • Always verify the patient's exact age in days at the time of the procedure to ensure the correct percentage-based age premium is appended to the base fee.
  • If the procedure is performed non-electively after hours, ensure the appropriate E-code (E409 or E410) is linked to the claim to capture the 50% or 75% premium.
Provider Fee$611.35
Surgical Assistant Fee$77.46
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

Age Restriction

Service is only eligible for payment for newborns and infants.

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