All codes
Z636
Z636 – Endoscopic ureterotomy or pyelotomy
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Endoscopic ureterotomy or pyelotomy. As per the commentary on page , Z636 is eligible for payment when rendered by percutaneous or retrograde route.
When to Use
- Use Z636 for endoscopic ureterotomy performed via a retrograde ureteroscopic approach to address ureteral strictures.
- Use Z636 for percutaneous endopyelotomy procedures performed to treat ureteropelvic junction obstruction.
- Use Z636 when the procedure involves internal incision or division of the ureter or renal pelvis endoscopically, rather than open surgical reconstruction.
Common Pitfalls
- Do not bill Z636 in combination with other major urological procedures performed under the same anaesthetic without checking the Schedule of Benefits for potential bundling or 'major procedure only' rules.
- Avoid billing Z636 for simple diagnostic ureteroscopy; ensure the operative report explicitly documents the therapeutic incision or division required for this code.
- Failure to obtain prior authorization for a surgical assistant via M400B will result in automatic rejection, as Z636 does not have an inherent assistant fee.
Billing Tips
- When an assistant is medically necessary, submit the claim using M400B and include a letter of justification to the medical consultant to secure payment.
- If performing multiple procedures, remember that anaesthesia and assistant basic units are calculated based solely on the major procedure performed during that session.
Provider Fee$293.00
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Category
T. Urogenital and Urinary Surgical Procedures
Subcategory
UROGENITAL AND URINARY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Urogenital and Urinary Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.