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S164
S164 – Resection with anastomosis - duodenum
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure involving the resection of the duodenum, which is the first part of the small intestine, followed by the creation of an anastomosis to restore continuity of the gastrointestinal tract. This procedure is listed under the Digestive System Surgical Procedures section.
For billing purposes, the appropriate suffix must be used:
- A for the surgeon
- B for an assistant
- C for an anaesthetist.
(Source: :, :).
When to Use
- Use S164 for formal resection of the duodenum with primary anastomosis, distinct from simple bypass procedures like S162.
- Use S164 when performing a segmental duodenal resection for localized pathology, such as a benign tumor or stricture, where intestinal continuity is restored.
Common Pitfalls
- Billing S164 in conjunction with other bowel procedures without verifying if the other procedure is considered 'included' or 'incidental' under the Schedule of Benefits.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium, which leads to automatic claim rejection during audits.
- Incorrectly billing S164 as a standalone procedure when the surgical approach involved a more extensive pancreaticoduodenectomy (Whipple procedure), which carries a different code.
Billing Tips
- Always append the appropriate suffix (A, B, or C) to ensure the claim is routed to the correct provider category and fee calculation logic.
- If an entero-cutaneous fistula is repaired during the same operative session, ensure E714 is submitted as an add-on code to capture the additional flat fee.
Provider Fee$1,155.95
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
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