S214 – Abdomino-perineal resection or pull through
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Abdomino-perineal resection or pull-through is a major surgical procedure involving the removal of the anus, rectum, and a portion of the sigmoid colon. This fee is for the complete procedure when performed by a single surgeon. The service includes all constituent and common elements of an insured service, as well as the specific elements of a surgical procedure which include pre-operative, intra-operative, and post-operative care as defined in the Schedule of Benefits. A second assistant's service is eligible for payment without prior authorization as per .
When to Use
- Use S214 when performing a complete abdominoperineal resection or pull-through as a single surgeon.
- Use S214 for the primary procedure when the surgery is performed laparoscopically or with laparoscopic assistance, ensuring the E793 premium is appended to capture the 25% increase.
Common Pitfalls
- Do not bill S214 if a two-surgeon team approach is utilized; you must use S215 for the abdominal surgeon and S216 for the perineal surgeon instead.
- Failure to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium even if the clinical criteria are met.
Billing Tips
- Always verify if the patient qualifies for the age-based premium (S214A/S214B) as this is a percentage increase applied to the base fee depending on the patient's age at the time of service.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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