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S215

S215Abdominal surgeon for abdomino-perineal resection or pull through

OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Represents the abdominal surgeon's component of a two-surgeon team procedure for abdomino-perineal resection or pull-through. This code is used in conjunction with S216, which is billed by the perineal surgeon. - Surgical Fee (Suffix A): Fee listed in the schedule. - Assistant Fee (Suffix B): Calculated based on 8 basic units plus time units. (see ) - Anaesthesia Fee (Suffix C): Calculated based on 10 basic units plus time units. (see )

When to Use

  • Use S215 exclusively when acting as the abdominal surgeon in a formal two-surgeon team performing an abdomino-perineal resection.
  • Use this code when the procedure is performed as a pull-through operation where the abdominal component is clearly delineated from the perineal component performed by a colleague billing S216.

Common Pitfalls

  • Billing S215 without a corresponding S216 claim from the perineal surgeon will trigger an audit or rejection, as this is a team-based code.
  • Attempting to bill for a second surgical assistant alongside S215 without prior authorization from a medical consultant will result in automatic rejection.
  • Failing to append the E793 premium when the abdominal portion of the procedure is performed laparoscopically, as this is an eligible code for the 25% increase.

Billing Tips

  • Ensure the operative report explicitly documents the division of labor between the abdominal and perineal surgeons to justify the use of the two-surgeon team codes.
  • If the procedure is performed after hours, apply the appropriate E409 or E410 premium to the S215 fee to maximize the claim value.
Provider Fee$1,426.45
Surgical Assistant Fee$103.28
Anaesthetist Fee$159.60
Non-Anaesthetist Fee$159.60

Effective: April 1, 2026

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Digestive System Surgical Procedures

Two surgeon team

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