What is OHIP billing code S226?

S226 is "Perineal repair - major", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S226 pay?

The current OHIP fee for S226 is $536.20, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill S226 to OHIP?

S226 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S226 claims against the Schedule of Benefits rules before submission.

All codes

S226

S226 – Perineal repair - major

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

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A surgical procedure for the major perineal repair of a rectal prolapse. This procedure is eligible for payment to the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C). The fee calculation for the assistant and anaesthetist is based on units. The assistant service has 6 basic units, and the anaesthesia service has 6 basic units. Time units are added based on the duration of the service as described in the General Preamble (, ).

When to Use

Use S226 for the definitive surgical repair of a rectal prolapse via the perineal approach, such as an Altemeier procedure.
Select S226 when the clinical documentation confirms a major perineal repair, distinguishing it from minor local excisions or simple anal repairs that do not involve the rectal wall.

Common Pitfalls

Billing S226 alongside other anorectal procedures without checking for 'major procedure' rules; only the highest basic unit value applies when multiple procedures are performed.
Failing to document the start and end times for the procedure, which is required to calculate the time units for both the assistant (suffix B) and anaesthetist (suffix C) beyond the 6 base units.
Incorrectly applying after-hours premiums (E409/E410) to elective cases; these premiums are strictly reserved for non-elective procedures or elective cases delayed by an intervening emergency.

Billing Tips

Ensure the assistant and anaesthetist claims explicitly reference the 6 basic units plus the calculated time units to avoid automatic rejection or underpayment.
When performing S226 as part of a multi-procedure operative session, ensure the primary surgeon bills S226 as the major procedure to set the baseline for assistant and anaesthesia unit calculations.

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Provider Fee$536.20

Surgical Assistant Fee$77.46

Anaesthetist Fee$95.76

Non-Anaesthetist Fee$95.76

Effective: April 1, 2026

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