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S539
S539 – Insertion of artificial urinary sphincter
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the insertion of an artificial urinary sphincter. This service includes all constituent and common elements of an insured service as defined in the Schedule of Benefits. Assistant and anaesthetist services are payable with base units and time units.
When to Use
- Use S539 for the primary implantation of an artificial urinary sphincter device in patients with persistent stress urinary incontinence.
- Use S539 when performing the complete surgical placement of the cuff, pump, and reservoir components as a single operative procedure.
Common Pitfalls
- Do not bill S539 in conjunction with S540 (revision of artificial urinary sphincter) for the same anatomical site during the same session, as this constitutes unbundling.
- Failure to document the specific clinical indication for the sphincter placement can lead to audit recovery, as OHIP requires clear evidence of medical necessity for this high-cost device.
- Avoid billing S539 as a bilateral procedure; the code is intended for a single device insertion and is not subject to multiple procedure rules unless specifically authorized.
Billing Tips
- Ensure that the surgical assistant and anaesthetist fees are calculated based on the base units of S539, as it is the primary procedure.
- If the procedure is performed on an emergency basis after hours, ensure the claim includes E409 or E410 to capture the 50-75% procedural premium, provided the criteria for non-elective status are met.
Provider Fee$832.65
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
See also procedures for stress incontinence in Female Genital Surgical Procedures.
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