What is OHIP billing code Z809?

Z809 is "Insertion of CSF reservoir (Ommaya) including burr holes", an OHIP Psychiatric code from the Ontario Schedule of Benefits (Physician Services).

How much does Z809 pay?

The current OHIP fee for Z809 is $428.90, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill Z809 to OHIP?

Z809 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates Z809 claims against the Schedule of Benefits rules before submission.

All codes

Z809

Z809 – Insertion of CSF reservoir (Ommaya) including burr holes

OHIP Psychiatric Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits

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Z809 is a fee code for a surgical procedure within the Musculoskeletal System section of the Schedule of Benefits. As a surgical service, it is eligible for payment to the primary surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C). Payment calculations for assistants and anaesthetists are based on a combination of basic units and time-based units as specified in the Schedule of Benefits. The procedure is eligible for various add-on premiums, including: - Age-based premiums for services rendered to children under 16 (). - After-hours premiums (E400B, E401B, E409, E410, E400C, E401C) (, , ). - The trauma premium (E420) for severely injured patients (). - Special visit premiums for non-elective procedures (, ).

When to Use

Use Z809 for the primary procedure of inserting an Ommaya reservoir, which inherently includes the necessary burr hole creation.
Select Z809 when the primary intent of the surgery is the placement of the reservoir for CSF access, rather than a diagnostic biopsy or craniotomy.

Common Pitfalls

Do not bill Z809 in addition to other craniotomy or burr hole codes if the reservoir insertion is the sole purpose of the procedure, as this constitutes unbundling.
Failure to document the specific necessity of the Ommaya reservoir can lead to audit scrutiny regarding the medical necessity of the procedure compared to less invasive alternatives.

Billing Tips

Ensure the surgical report explicitly mentions the creation of the burr hole to justify the full fee of Z809, as the code description explicitly includes this step.
If the procedure is performed on an emergency basis after hours, ensure you append the appropriate E-series after-hours premium to the Z809 claim to maximize the procedural fee.

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Provider Fee$428.90

Surgical Assistant Fee$137.61

Anaesthetist Fee$170.39

Non-Anaesthetist Fee$170.39

Effective: April 1, 2025

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