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S422
S422 – Pyeloplasty
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Pyeloplasty is a surgical procedure for the repair of the kidney and upper urinary tract, specifically the renal pelvis. The procedure may or may not include nephropexy (fixation of a floating or mobile kidney). This service is eligible for add-on payments if performed laparoscopically using E792, or if it includes the removal of a calculus using E754.
When to Use
- Use S422 for the surgical repair of a ureteropelvic junction (UPJ) obstruction, regardless of whether a nephropexy is performed concurrently.
- Select S422 when performing an open pyeloplasty procedure; if the procedure is performed laparoscopically, you must also append E792 to capture the 25% premium.
Common Pitfalls
- Failing to append E754 when a calculus is removed during the pyeloplasty; this is a distinct add-on fee that is often missed.
- Attempting to bill E409 or E410 after-hours premiums in conjunction with the E420 trauma premium, which is prohibited by OHIP policy.
Billing Tips
- Always verify the patient's age at the time of the procedure to ensure the appropriate age-based surgical premium (ranging from 10% to 30%) is applied, as these are not automatically calculated by the system.
- If a second assistant is required for the pyeloplasty, you must submit a letter of justification from the surgeon to the Ministry to secure authorization for payment.
Provider Fee$972.35
Surgical Assistant Fee$90.37
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Category
T. Urogenital and Urinary Surgical Procedures
Subcategory
UROGENITAL AND URINARY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Urogenital and Urinary Surgical Procedures
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