What is OHIP billing code S223?

S223 is "Anastomosis of rectum", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S223 pay?

The current OHIP fee for S223 is $555.90, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill S223 to OHIP?

S223 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S223 claims against the Schedule of Benefits rules before submission.

All codes

S223

S223 – Anastomosis of rectum

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

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S223 is a fee code for the surgical procedure involving the anastomosis of the rectum, as listed in the Digestive System section of the Schedule of Benefits. It can be billed with suffixes A (surgeon), B (assistant), and C (anaesthetist). Surgical Service (Suffix A): The fee for the surgeon is a flat rate as specified in the Schedule. Surgical Assistant Service (Suffix B): The fee is calculated based on a unit system. It includes 6 base units plus time units. Time units are calculated based on the duration of assistance provided (-). Anaesthesia Service (Suffix C): The fee is calculated based on a unit system. It includes 6 base units plus time units. Time units are calculated based on the duration of anaesthesia provided (-).

When to Use

Use S223 for the primary surgical procedure of rectal anastomosis when performing a colorectal resection.
Use S223 when the procedure is the definitive surgical step for restoring bowel continuity, distinct from the initial resection or mobilization phases.

Common Pitfalls

Billing S223 alongside other major abdominal procedures without verifying if the Schedule of Benefits considers the services bundled or subject to multiple procedure rules.
Failing to document the specific start and end times for the surgical assistant and anaesthetist, which are required to calculate the time-based unit fees correctly.
Incorrectly applying age-based premiums to anaesthesia services (Suffix C), as these premiums are strictly limited to the surgeon (Suffix A) and assistant (Suffix B).

Billing Tips

Ensure that the anaesthesia unit calculation includes all applicable extra units (e.g., E022C for ASA III, E020C for emergency surgery) to maximize the total unit value beyond the base 6 units.
When billing after-hours premiums (E400 series or E401 series), ensure the case commencement time is clearly recorded, as this single timestamp dictates the eligibility for both the surgeon and the assistant.

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Provider Fee$555.90

Surgical Assistant Fee$77.46

Anaesthetist Fee$95.76

Non-Anaesthetist Fee$95.76

Effective: April 1, 2026

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