All codes
S438
S438 – Retroperitoneal lymph node dissection for bladder cancer
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Retroperitoneal lymph node dissection for bladder cancer, specimen must include obturator, internal iliac and external iliac nodes as a minimum to the level of the iliac bifurcation, bilateral.
When to Use
- Use S438 when performing a formal bilateral pelvic lymph node dissection specifically for bladder cancer staging or treatment.
- Use this code when the surgical specimen includes the obturator, internal iliac, and external iliac nodes up to the iliac bifurcation, as required by the Schedule of Benefits.
Common Pitfalls
- Billing S438 for a limited or sentinel node biopsy will result in a rejection or audit recovery, as the code strictly mandates a full bilateral dissection to the iliac bifurcation.
- Attempting to bill S438 alongside a cystectomy code without checking for global fee restrictions or specific surgical bundling rules can lead to payment denials.
Billing Tips
- Ensure the operative report explicitly documents the removal of all three required node groups (obturator, internal iliac, and external iliac) to satisfy the mandatory anatomical requirements for this fee.
- If a second assistant is required for this complex procedure, you must submit a formal letter of justification to the Ministry to secure the 15% fee increase.
Provider Fee$675.35
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
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.