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S204
S204 – Incision and drainage of abscess
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the incision and drainage of an abscess in the appendiceal region. This service is listed under the Digestive System Surgical Procedures section of the Schedule. The fee is payable to the surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C). As per the payment rule on page , S204 is not eligible for payment with S207 (Appendectomy).
When to Use
- Use S204 for the incision and drainage of a localized abscess in the appendiceal region when an appendectomy (S207) is not performed.
- Use S204 when managing a post-operative intra-abdominal abscess or a periappendiceal collection that requires surgical drainage rather than percutaneous intervention.
Common Pitfalls
- Billing S204 in conjunction with S207 (Appendectomy) will result in an automatic rejection as they are mutually exclusive procedures.
- Attempting to claim S204 for percutaneous drainage performed by interventional radiology is incorrect; this code is specifically for surgical incision and drainage.
Billing Tips
- Ensure the operative report clearly describes the anatomical location of the abscess to justify the use of S204 over general incision and drainage codes.
- If the procedure is performed after hours, ensure you append the appropriate E-code (E409 or E410) to the claim to receive the procedural premium.
Provider Fee$273.60
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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