S280 – Transduodenal sphincterotomy and choledochotomy (previous cholecystectomy)
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Transduodenal sphincterotomy and choledochotomy (previous cholecystectomy) is a surgical procedure listed in the Digestive System section of the OHIP Schedule of Benefits. It involves an incision into the common bile duct (choledochotomy) and an incision through the duodenum to access and cut the sphincter of Oddi. This procedure is performed on patients who have previously undergone a cholecystectomy (gallbladder removal). The service may be performed with an add-on code E704 for choledochoscopy. Payment for this service is determined by the role of the physician: - Surgeon (suffix A): Billed as a flat fee. - Assistant (suffix B): Billed based on 7 basic units plus time units. - Anaesthesiologist (suffix C): Billed based on 9 basic units plus time units.
When to Use
- Use S280 for patients requiring a transduodenal approach to the sphincter of Oddi specifically following a prior cholecystectomy.
- Choose S280 over S276 when the surgical intent involves a formal sphincterotomy via the duodenum rather than a simple choledochotomy.
Common Pitfalls
- Billing S280 without confirming the patient's history of cholecystectomy, as this is a specific prerequisite for this code.
- Failing to include the E704 add-on code on the same claim when a choledochoscopy is performed, resulting in missed revenue.
- Attempting to bill S280 alongside other biliary procedures without clear documentation of separate incisions or distinct surgical sites, which risks rejection for unbundling.
Billing Tips
- Always append the appropriate suffix (A, B, or C) to ensure the correct base units are applied for the surgeon, assistant, and anaesthesiologist.
- Ensure that if an after-hours premium (E409, E410, E400B, E401B, E400C, E401C) is claimed, the start time of the procedure is clearly documented to support the specific time-based eligibility.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
Base units are specific to the suffix used: Assistant (B) = 7 units, Anaesthesiologist (C) = 9 units.
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