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S243
S243 – Sphincterotomy(ies) under general anaesthesia
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Sphincterotomy(ies) under general anaesthesia (S243) is a surgical procedure on the rectum listed in the Digestive System section of the Schedule of Benefits. This procedure includes the services of a surgeon, an assistant, and an anaesthetist. It is differentiated from S241, which is the same procedure performed under local anaesthesia.
When to Use
- Use S243 when performing a sphincterotomy in an operating room setting where general anaesthesia is required for patient safety or procedure complexity.
- Use S243 for patients who cannot tolerate the procedure under local anaesthesia, which would otherwise be billed under S241.
Common Pitfalls
- Billing S243 when the procedure was performed under local anaesthesia, which is a direct violation of the Schedule of Benefits and will lead to audit recovery.
- Attempting to bill for a second surgical assistant without prior authorization, as S243 is not on the pre-approved list for multiple assistants.
Billing Tips
- Ensure the anaesthetic record clearly documents the use of general anaesthesia to support the use of S243 over S241.
- If the procedure is performed after hours, ensure the start time is documented to correctly apply the appropriate E-series after-hours premiums.
Provider Fee$227.75
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
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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