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S471
S471 – Excision of urachal cyst or sinus with or without umbilical hernia repair
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Surgical excision of a urachal cyst or sinus. The fee is inclusive of an umbilical hernia repair when performed at the same time, as per the 'with or without' clause defined in the Schedule of Benefits on . This procedure is eligible for a 25% premium (E792) when performed laparoscopically.
When to Use
- Use S471 for the surgical excision of a urachal cyst or sinus, regardless of whether a concurrent umbilical hernia repair is performed.
- Use S471 when the procedure is performed via an open approach, or add E792 if the procedure is completed laparoscopically.
Common Pitfalls
- Do not bill a separate umbilical hernia repair code, as S471 is explicitly inclusive of this repair.
- Do not attempt to bill a second surgical assistant for S471 without prior authorization, as it is not on the pre-approved list for multiple assistants.
- Failure to document the laparoscopic approach will result in the rejection or non-payment of the E792 premium.
Billing Tips
- Always append the E792 premium code to your claim when performing the excision laparoscopically to capture the 25% fee increase.
- Ensure the surgical assistant (S471B) and anaesthesiologist (S471C) understand that their fees are calculated based on 6 basic units plus time units per the Schedule of Benefits.
Provider Fee$317.65
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
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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