S626 – Vasectomy
OHIP Urology Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
Vasectomy is a surgical procedure for male sterilization. This fee code applies to a unilateral or bilateral procedure, irrespective of the technique used. E545 is payable as an add-on when the procedure is performed outside of a hospital setting. As per the note on page , vasectomy reversal is an insured benefit only for treating significant symptomatology and requires prior approval; re-establishing fertility is not considered a valid reason for reversal under OHIP.
When to Use
- Use S626 for elective male sterilization procedures performed in either a hospital or an office-based surgical setting.
- Use S626 for both unilateral and bilateral vasectomies, as the fee is inclusive of the procedure regardless of the number of sides treated.
Common Pitfalls
- Attempting to bill S626 for vasectomy reversals without prior approval; reversals for fertility purposes are not insured benefits and will be rejected.
- Forgetting to append E545 when the procedure is performed in a clinic or office setting, as this add-on is not automatic and must be manually included in the claim.
Billing Tips
- Always include the E545 add-on code on the same claim as S626 when performing the procedure in an office setting to capture the additional $11.55 fee.
Effective: April 1, 2026
U. Male Genital Surgical Procedures
MALE GENITAL SURGICAL PROCEDURES
Surgical
Male Genital Surgical Procedures
Male
Vasectomy reversal is an insured benefit only for treatment of significant symptomatology, and requires prior approval. Re-establishing fertility does not constitute significant symptomatology.
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