How much does Z553 pay?

The current OHIP fee for Z553 is $196.65, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill Z553 to OHIP?

Z553 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates Z553 claims against the Schedule of Benefits rules before submission.

What codes are related to Z553?

Codes related to Z553 in the Schedule of Benefits include Z552.

All codes

Z553

Z553 – Peritoneoscopy, culdoscopy or laparoscopy with biopsy, lysis of adhesions, removal of foreign body or cautery of endometrial implants

OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Peritoneoscopy, culdoscopy or laparoscopy - with biopsy and/or lysis of adhesions and/or removal of foreign body and/or cautery of endometrial implants

When to Use

Use Z553 for diagnostic laparoscopy when a biopsy is performed or when therapeutic lysis of adhesions is required.
Use Z553 for the surgical management of endometriosis via cautery of implants.
Use Z553 for the removal of a foreign body (e.g., migrated IUD or surgical clip) identified during a laparoscopic procedure.

Common Pitfalls

Do not bill Z553 in combination with other major laparoscopic procedures on the same organ, as it is often considered inclusive to more definitive surgical codes.
Avoid billing Z553 if the procedure was purely diagnostic without biopsy, lysis, or cautery, as this may be considered an unbundled or incorrectly coded diagnostic service.
Ensure the operative report explicitly details the lysis of adhesions or cautery performed, as generic 'diagnostic laparoscopy' documentation will trigger audit rejections.

Billing Tips

If multiple distinct procedures are performed during the same session, ensure you are not violating the Multiple Procedure Rule by checking if Z553 is considered a 'minor' component of the primary procedure.
Always verify if the procedure qualifies for age-based premiums (e.g., AGE_PREMIUM_5Y_16Y) or after-hours premiums (E409/E410) to maximize the claim value beyond the base fee.

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Provider Fee$196.65

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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