All codes
T405
T405 – T405
OHIP Other Code · Schedule of Benefits
When to Use
- Use T405 for the surgical management of a primary or recurrent inguinal hernia in patients aged 16 and older.
- Apply this code when performing a standard herniorrhaphy, including cases where mesh is utilized for reinforcement.
Common Pitfalls
- Billing T405 alongside a separate code for mesh insertion is prohibited, as the fee for T405 is considered inclusive of all components of the repair.
- Attempting to bill T405 for a femoral hernia repair is an error; use T407 instead for femoral hernia procedures.
Billing Tips
- If the hernia is bilateral, bill T405 with the appropriate bilateral modifier or secondary code as permitted by the Schedule of Benefits to ensure correct payment for both sides.
Provider Fee$359.94
Specialist Fee$359.94
Effective: April 1, 2025
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