All codes
S816
S816 – Vaginal hysterectomy
OHIP Urology Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
Vaginal hysterectomy, with or without adnexa (unless otherwise specified). As per commentary, this procedure for benign conditions should only be performed when less invasive treatments have been found to be unsuccessful or are declined by the patient.
When to Use
- Use S816 for a vaginal hysterectomy performed for benign uterine pathology when conservative medical or surgical management has failed or is contraindicated.
- Use S816 in conjunction with E862 when the procedure is performed with laparoscopic assistance to address adnexal pathology or to facilitate the vaginal approach.
Common Pitfalls
- Attempting to bill S816 alongside restricted codes such as S722 or S760 will result in automatic rejection; these are considered inclusive of the hysterectomy fee.
- Failing to document the failure of conservative management in the patient record creates an audit risk, as the Schedule of Benefits explicitly mandates this for benign indications.
Billing Tips
- Always append E862 to your claim for S816 if any laparoscopic assistance is utilized, as this provides a mandatory 25% fee increase.
- Ensure that if a second surgical assistant is required for complex cases, you bill for their services separately, as this is permitted for S816 without prior authorization.
Provider Fee$643.35
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
V. Female Genital Surgical Procedures
Subcategory
FEMALE GENITAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Female Genital Surgical Procedures
Sex Restriction
Female
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.