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S138
S138 – Closure of gastrostomy or other external fistula of stomach
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical closure of a gastrostomy or other external fistula of the stomach. The fee for the surgeon (S138A) is a flat rate. The fee for a surgical assistant (S138B) is based on 6 base units plus time units as described in -. The fee for an anaesthesiologist (S138C) is based on 7 base units plus time units as described in -. This service includes all applicable common elements as described in the Schedule of Benefits (-).
When to Use
- Use S138A for the definitive surgical closure of a persistent gastrostomy site or external gastric fistula that has failed conservative management.
- Select this code when performing a formal surgical excision of the fistula tract and layered closure of the gastric wall, rather than simple bedside tube removal.
Common Pitfalls
- Do not bill S138A for simple removal of a gastrostomy tube; this is considered a minor procedure that does not meet the criteria for a surgical closure fee.
- Avoid billing S138A in conjunction with other major gastric resections unless the fistula closure is a distinct, separate procedure performed at a different site or via a separate incision.
Billing Tips
- Ensure the operative report clearly describes the excision of the fistula tract and the multi-layer closure of the stomach wall to justify the surgical fee over minor procedural codes.
Provider Fee$345.85
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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