S420 – Nephroureterectomy, total, with resection of ureterovesical junction
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the total excision of a kidney and the entire ureter, including the resection of the ureterovesical junction (the point where the ureter enters the bladder). This procedure is eligible for a 25% fee increase when performed laparoscopically by adding E792. Assistant and anaesthesia services are calculated using a base unit plus time unit model. Assistant base units are 7 and Anaesthesia base units are 10.
When to Use
- Use S420 for a complete radical nephroureterectomy involving the total removal of the kidney and the entire ureter including the bladder cuff.
- Select S420 instead of a standard nephrectomy code (like S418) when the surgical plan specifically necessitates the resection of the ureterovesical junction for malignancy such as upper tract urothelial carcinoma.
Common Pitfalls
- Claiming S420 without the E792 add-on when the procedure is performed laparoscopically results in a 25% underpayment of the surgical fee.
- Billing S420 alongside a separate cystectomy code is often flagged as unbundling, as the resection of the ureterovesical junction is inclusive to the S420 procedure.
Billing Tips
- Always append E792 to your claim for S420 when using laparoscopic techniques to trigger the mandatory 25% fee increase.
- Ensure the surgical assistant uses suffix B and the anaesthesiologist uses suffix C to correctly trigger the specific base unit calculations of 7 and 10 respectively.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
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