S275 – Partial lobectomy (excision greater than 5 cm)
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S275 describes a partial lobectomy, which is the surgical excision of a portion of a liver lobe. This specific code applies when the excised portion is greater than 5 cm. Payment for a second surgical assistant is allowed for this procedure without prior authorization from the Ministry of Health. This procedure may be performed via an open approach or laparoscopically, with a premium available for the laparoscopic approach (E793).
When to Use
- Use S275 when performing a non-anatomic partial liver resection where the maximum dimension of the excised specimen exceeds 5 cm.
- Select S275 for peripheral wedge resections of the liver that meet the size criteria, distinguishing it from formal anatomic lobectomies like S269 or S270.
Common Pitfalls
- Billing S275 alongside a cholecystectomy is a common rejection if the resection involves liver segments #4 or #5 due to specific anatomic restrictions.
- Failing to document the size of the excised specimen in the operative report creates an audit risk, as the >5 cm threshold is the primary determinant for using S275 over smaller excision codes.
Billing Tips
- Always append E793 to S275 when the procedure is performed laparoscopically to capture the 25% fee increase.
- Include E814 on the same claim if a portal lymphadenectomy is performed concurrently to receive the additional flat fee payment.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
A second assistant's service is eligible for payment with S275 and does not require authorization by a medical consultant.
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