S449 – Ureterectomy, including ureterovesical junction
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
S449 is a surgical procedure for Ureterectomy, including ureterovesical junction, listed under 'KIDNEY AND UPPER URINARY TRACT' in the Urogenital and Urinary Surgical Procedures section of the Schedule of Benefits. A second assistant's service is eligible for payment without requiring prior authorization by a medical consultant, as noted in . General rules for surgical procedures, including anaesthesia and assistant services, apply.
When to Use
- Use S449 for a complete ureterectomy that includes the resection of the ureterovesical junction.
- Choose S449 when performing a definitive removal of the ureter in cases of malignancy or chronic non-functioning ureter, specifically when the distal attachment is included in the procedure.
Common Pitfalls
- Billing S449 in conjunction with other bladder or kidney procedures without ensuring the 'major procedure' rule is applied to assistant and anaesthesia units.
- Failing to recognize that S449 is a standalone surgical code; it cannot be unbundled to bill for partial ureterectomy if the entire ureter and junction were removed.
Billing Tips
- Ensure the operative report explicitly details the resection of the ureterovesical junction to justify the use of S449 over less extensive ureteral procedures.
- If performing a bilateral procedure, ensure the claim is submitted with the appropriate bilateral indicator to receive the correct fee adjustment.
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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