What is OHIP billing code S490?

S490 is "Cystectomy - partial with reimplantation of ureters", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S490 pay?

The current OHIP fee for S490 is $786.35, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill S490 to OHIP?

S490 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S490 claims against the Schedule of Benefits rules before submission.

What codes are related to S490?

Codes related to S490 in the Schedule of Benefits include S482, S483, E792.

All codes

S490

S490 – Cystectomy - partial with reimplantation of ureters

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

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S490 is a surgical procedure for a partial cystectomy, which involves the excision of a tumour or diverticulum (single or multiple) from the bladder. A key component of this procedure is the reimplantation of both ureters. This procedure is eligible for a 25% fee increase when performed laparoscopically, claimed with add-on code E792. It allows for payment for surgeon (A), assistant (B), and anaesthetist (C) services, with specific base units assigned for assistant and anaesthesia calculations as per .

When to Use

Use S490 when performing a formal partial cystectomy specifically involving the excision of a bladder tumour or diverticulum that necessitates the reimplantation of both ureters.
Select S490 over simpler bladder procedures when the complexity of the ureteral reimplantation is the defining surgical component of the partial cystectomy.

Common Pitfalls

Billing S490 when only a simple excision is performed without the required reimplantation of both ureters, which would likely be more appropriately coded under a different procedure code.
Failing to append E792 when the procedure is performed laparoscopically, resulting in a 25% underpayment of the surgical fee.
Attempting to claim S490 in conjunction with other bladder procedures that include inherent ureteral work, which may trigger a rejection for unbundling.

Billing Tips

Always ensure the operative report explicitly details the reimplantation of both ureters to support the use of S490 over less intensive bladder excision codes.
When performing the procedure laparoscopically, confirm that E792 is submitted on the same claim to automatically trigger the 25% fee increase.

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Provider Fee$786.35

Surgical Assistant Fee$77.46

Anaesthetist Fee$111.72

Non-Anaesthetist Fee$111.72

Effective: April 1, 2026

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