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S476

S476Cutaneous vesicostomy

OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits

Cutaneous vesicostomy is a surgical procedure listed in the Urogenital and Urinary Surgical Procedures section of the Schedule of Benefits, under the INCISION sub-heading for the bladder.

When to Use

  • Use S476 for the surgical creation of a stoma between the bladder and the skin, typically for long-term urinary diversion in pediatric patients with neurogenic bladder.
  • Select S476 when performing a primary cutaneous vesicostomy, as opposed to a revision or closure procedure which would require different coding.

Common Pitfalls

  • Do not bill S476 in conjunction with other bladder procedures unless they are distinct, unrelated surgeries; otherwise, the Ministry may flag this as unbundling.
  • Failure to document the specific surgical approach or the underlying indication (e.g., neurogenic bladder) can lead to audit scrutiny regarding the necessity of the procedure.

Billing Tips

  • Ensure that age-based premiums are applied correctly to the S476 fee, as this procedure is frequently performed on pediatric patients who qualify for the 10% to 30% age-based increases.
Provider Fee$468.70
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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