S467 – Late repair - upper 2/3
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This service covers the late surgical repair of a traumatic rupture or partial/complete transection of the upper two-thirds of the ureter. As a surgical procedure, the fee includes all common and specific elements as defined in the Schedule of Benefits (see , , , ), such as pre-operative evaluation, the anaesthetic procedure, post-operative care, and related administrative tasks. The fee is calculated based on basic units and time units for both the surgical assistant and anaesthesiologist.
When to Use
- Use S467 for the delayed surgical repair of a traumatic ureteral injury involving the upper two-thirds of the ureter when the procedure is performed after the acute phase.
- Select S467 over S465 or S466 when the injury involves the upper two-thirds of the ureter specifically, rather than the lower third or general ureteral reconstruction.
Common Pitfalls
- Attempting to bill a second surgical assistant without prior authorization, as S467 is not on the pre-approved list for multiple assistants.
- Failing to document the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium, which leads to automatic rejection.
- Incorrectly applying after-hours premiums (E409A/E410A) to the total claim rather than strictly to the surgeon's fee, or failing to verify the procedure start time.
Billing Tips
- Ensure the trauma premium E420 is submitted on the same claim as S467 and that the ISS is clearly recorded to avoid audit recovery.
- Verify that age-based premiums are applied only to the surgical and assistant fees, as they are explicitly excluded from anaesthesia fee calculations.
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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