What is OHIP billing code S278?

S278 is "Cholecystostomy", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S278 pay?

The current OHIP fee for S278 is $408.05, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill S278 to OHIP?

S278 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S278 claims against the Schedule of Benefits rules before submission.

All codes

S278

S278 – Cholecystostomy

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

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S278 is a surgical procedure for the creation of an opening into the gallbladder (cholecystostomy). This service includes all constituent and common elements of an insured surgical service. The fee for the surgeon is a flat rate, while fees for the anaesthetist and surgical assistant are calculated based on basic and time units.

When to Use

Use S278 for the surgical creation of a cholecystostomy tube in patients who are too high-risk for a definitive cholecystectomy.
Use S278 when performing a percutaneous or open drainage procedure specifically for gallbladder decompression in acute cholecystitis.

Common Pitfalls

Do not bill S278 in conjunction with a cholecystectomy (e.g., S279), as the cholecystostomy is considered an inclusive component if the gallbladder is subsequently removed during the same operative session.
Avoid billing S278 for diagnostic imaging-guided aspirations that do not meet the criteria for a formal surgical cholecystostomy procedure.
Failure to document the specific clinical necessity for the cholecystostomy over a definitive cholecystectomy can lead to audit scrutiny regarding the appropriateness of the procedure code.

Billing Tips

Ensure that after-hours premiums (E409 or E410) are only applied if the procedure is non-elective or delayed by an intervening emergency, as S278 is often performed as an urgent intervention.
If a surgical assistant is utilized, ensure the assistant's claim is linked to the S278 fee and that the appropriate after-hours assistant premium (E400B or E401B) is applied if the start time falls within the designated windows.

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Provider Fee$408.05

Surgical Assistant Fee$87.57

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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