S133 – Pyloroplasty and vagotomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S133 is a surgical procedure for pyloroplasty and vagotomy, listed in the Digestive System section of the Schedule of Benefits. The service is billable by the surgeon (suffix A), assistant (suffix B), and anaesthesiologist (suffix C). - The surgeon's fee (S133A) is a flat fee. - The assistant's fee (S133B) is calculated based on 7 base units plus time units as per -. - The anaesthesiologist's fee (S133C) is calculated based on 7 base units plus time units as per -. An additional amount is payable to the surgeon for the suture of a bleeding peptic ulcer using the add-on code E731.
When to Use
- Use S133 for the definitive surgical management of chronic peptic ulcer disease involving both a pyloroplasty and a vagotomy.
- Use S133 when a patient requires gastric outlet obstruction relief via pyloroplasty combined with a vagotomy to reduce gastric acid secretion.
Common Pitfalls
- Failing to append the E731 add-on code when the procedure specifically involves the suture of a bleeding peptic ulcer, resulting in lost revenue.
- Incorrectly billing S133 as a standalone procedure when the complexity of the case or the patient's age (under 16) warrants the application of age-based premiums.
Billing Tips
- Ensure that the E731 add-on is submitted on the same claim as S133 to trigger the additional flat fee payment for the suture of a bleeding peptic ulcer.
- For anaesthesiologists, remember that S133C base units are fixed at 7; ensure that any applicable extra units for high BMI or ASA status are billed using the appropriate E-coded modifiers to maximize the total anaesthetic fee.
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