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S596
S596 – Insertion of testicular prosthesis
OHIP Urology Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
Surgical insertion of a testicular prosthesis. Note: Insertion of testicular prosthesis performed at the time of orchidectomy is not eligible for payment. Commentary: See Appendix D - Sub-Surface Pathology under Congenital Deformities and Post-Traumatic Deformities.
When to Use
- Use S596 for a standalone procedure to insert a testicular prosthesis in a patient who has previously undergone an orchidectomy.
- Use S596 for the surgical correction of congenital absence of the testis (monorchism) or post-traumatic loss where the prosthesis is the primary surgical objective.
Common Pitfalls
- Billing S596 concurrently with an orchidectomy (S589 or S598) will result in a rejection, as the prosthesis insertion is considered inclusive to the primary surgery.
- Failure to document the specific clinical indication (e.g., congenital deformity or post-traumatic loss) can lead to audit scrutiny regarding the medical necessity of the prosthesis.
Billing Tips
- Ensure the claim includes the appropriate age-based premium if the patient is under 16 years old, as these are automatically applicable to the S596 base fee.
Provider Fee$212.20
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
Effective: April 1, 2026
Since Feb 1998, this fee has increased 35.2% vs 59.7% CPI inflation
Category
U. Male Genital Surgical Procedures
Subcategory
MALE GENITAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Male Genital Surgical Procedures
Insertion of testicular prosthesis performed at the time of orchidectomy is not eligible for payment.
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