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Surgical specialties & anaesthesia
General Surgery OHIP billing codes
General surgery consultations and visits, and the abdominal, colorectal, endoscopic, breast, endocrine and skin procedures that fill a general surgeon's week.
102 codes in 10 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 03 is in the full General Surgery listing.
Consultations & assessments — office
Hospital in-patient
- C035ConsultationConsultation - General Surgery (Hospital In-Patient)—
- C036Repeat consultation - non-emergency hospital in-patient—
- C033Specific assessmentA specific assessment rendered by a General Surgeon (03) to a non-emergency hospital in-patient. This service requires a detailed history and examination of the affected body part or system.—
- C034Specific re-assessmentA specific re-assessment of a non-emergency hospital in-patient by a General Surgery specialist, which requires a full, relevant history and physical examination of one or more systems.—
- C032Subsequent visit - first five weeksA subsequent visit for a non-emergency hospital in-patient rendered by a General Surgeon within the first five weeks of admission. Limited to one per patient, per day.—
- C037Subsequent visit - sixth to thirteenth week inclusive—
- C039Subsequent visit - after thirteenth weekSubsequent visit - after thirteenth week (General Surgery)—
- C038Subsequent visits per monthConcurrent care (per visit) - General Surgery—
Appendix, gallbladder & hernia
- S207AppendectomySurgical procedure for the removal of the appendix, applicable whether the appendix is intact or has ruptured (perforated).$524.60
- S287CholecystectomyA surgical procedure for the excision (removal) of the gallbladder.$544.30
- E794Cholecystectomy with intra-operative cholangiogramAdd-on to S287 for the performance of an intra-operative cholangiogram.$40.80
- E709CholecystectomyAn add-on fee for a surgeon who performs a cholecystectomy in conjunction with specific gastrectomy (S123, S125, S128) or pancreatectomy (S299, S300, S309) procedures.$139.00
- S323Inguinal and/or femoral hernia repair - adolescents and adultsSurgical repair of an inguinal and/or femoral hernia in an adolescent or adult patient.$357.80
- S322Inguinal and/or femoral hernia repair - infantsSurgical repair of an inguinal and/or femoral hernia performed on an infant (from 29 days up to, but less than, 2 years of age).$522.60
- S326Inguinal and/or femoral hernia repair - childrenSurgical repair of an inguinal and/or femoral hernia for a patient defined as a child (ages 2 to and including 15 years).$442.20
- S329Strangulated or incarcerated inguinal or femoral hernia - without resection of bowelSurgical repair of a strangulated or incarcerated inguinal and/or femoral hernia that does not require resection of the bowel.$425.00
- S330Strangulated or incarcerated hernia - with resection of bowelSurgical repair of a strangulated or incarcerated inguinal and/or femoral hernia that includes bowel resection.$660.50
- S332Umbilical hernia repair - adolescent or adultSurgical repair of an umbilical hernia in an adolescent or adult patient, with or without resection of incarcerated/strangulated contents.$324.20
- S333Umbilical hernia repair - childSurgical repair of an umbilical hernia on a child aged 2 to 15 years.$240.75
- S342Epigastric hernia repairSurgical procedure for the repair of an epigastric hernia.$239.20
- S340Hernia fascial defect repairSurgical repair of a ventral or incisional hernia where the fascial defect has a diameter less than 5 cm, or any size hernia that is repaired with primary closure.$370.95
- S344Hernia fascial defect (diameter 5 cm or greater) repaired with mesh closureSurgical repair of a ventral or incisional hernia with a fascial defect diameter of 5 cm or greater, utilizing a mesh closure technique.$569.35
- E726Repeat recurrent inguinal hernia (more than 2 repairs)An add-on fee for the surgical repair of a repeat recurrent inguinal hernia (i.e., third or subsequent repair). This code is billed in addition to the primary inguinal hernia repair procedure.$257.35
- S091Oesophageal hiatus hernia - abdominal or transthoracic approach with fundal plicationSurgical repair of an oesophageal hiatus hernia using an abdominal or transthoracic approach, including fundal plication.$750.00
- S079Massive paraesophageal hernia repairSurgical repair of a massive paraesophageal hernia, defined as having over 50% intrathoracic herniation of the stomach or herniation of the stomach with other abdominal organs through the crus.$1200.00
Colorectal
- S166Small and large intestine terminal ileum, cecum and ascending colon (right hemicolectomy)A surgical procedure involving the removal of the terminal ileum, cecum, and ascending colon (right hemicolectomy) with subsequent reconnection of the bowel (anastomosis).$1029.45
- S168Subtotal colectomyA surgical procedure involving the partial removal of the large intestine (subtotal colectomy) and creation of an external opening for waste (ileostomy).$1435.20
- S169Total colectomy with ileo-rectal anastomosisA surgical procedure involving the complete removal of the colon (total colectomy) with a subsequent reconnection of the ileum to the rectum.$1502.80
- S171Left hemicolectomy with anterior resection or proctosigmoidectomySurgical procedure for a left hemicolectomy with anterior resection or proctosigmoidectomy, which includes anastomosis below the peritoneal reflection and mobilization of the splenic flexure.$1290.55
- S213Anterior resection or proctosigmoidectomyA surgical procedure for the excision of the rectum, specifically an anterior resection or proctosigmoidectomy, with anastomosis performed below the peritoneal reflection.$1377.95
- S217Hartmann procedureSurgical excision of the rectum, also known as a proctectomy. This procedure may be eligible for a 25% premium when performed laparoscopically or with laparoscopic assistance.$1211.10
- S204Incision and drainage of abscessSurgical procedure for the incision and drainage of an abscess related to the appendix. Not payable with an appendectomy (`<billingCode>S207</billingCode>`).$273.60
- Z546Barron ligation(s)A surgical procedure for Barron ligation of hemorrhoids, limited to six services per patient in any one-year period.$39.40
- Z565Complete haemorrhoidectomy using cryotherapy and/or Barron ligation(s) including rectal dilationA surgical procedure for complete haemorrhoidectomy using cryotherapy and/or Barron ligation(s), which includes rectal dilation. This service is insured only for patients who have failed non-surgical therapy and have either Grade III/IV haemorrhoids or haemorrhoids with significant skin tags.$99.60
- Z545Thrombosed haemorrhoid(s)Incision of one or more thrombosed haemorrhoids. This service includes anoscopy (<billingCode>Z543</billingCode>). An additional premium, <billingCode>E542</billingCode>, is payable if the procedure is performed outside of a hospital.$25.25
- Z575Haemorrhoid injectionsInjection treatment for haemorrhoids, limited to a maximum of six services per patient per year.$27.05
- Z548Cauterization of fissureA surgical procedure for the cauterization of an anal fissure, typically performed under general anaesthesia.$34.90
- Z550Dilation of anal sphincterA surgical procedure for the dilation of the anal sphincter.$13.70
- Z757Excision of benign anal lesion(s)A surgical procedure for the excision of one or more benign lesions from the anus.$47.15
Endoscopy
- Z527GastroscopyA diagnostic endoscopic procedure of the upper gastrointestinal tract, which may include taking biopsies, photographs, and removing small polyps (≤ 1 cm).$82.90
- Z528Gastroscopy - subsequentGastroscopy - subsequent (within three months following previous gastroscopy)$67.85
- Z547Gastroscopy - with removal of foreign bodyThis service is a gastroscopy procedure performed for the removal of a foreign body from the stomach. It may be billed with add-on codes for the removal of large polyps.$99.75
- Z555Absence of signs or symptoms or risk factors, 50 years of age or older - sigmoid to descending colonColonoscopy from the sigmoid to descending colon for patients aged 50 or older who have no signs, symptoms, or risk factors. This service becomes uninsured if performed for the same patient within 10 years of a previous <billingCode>Z555</billingCode>.$51.95
- Z492Follow up of normal colonoscopyA follow-up sigmoidoscopy to the descending colon for an asymptomatic patient, five years after a normal screening colonoscopy (<billingCode>Z499</billingCode>). This service is uninsured if performed within the five-year period following the initial <billingCode>Z499</billingCode>.$51.95
- Z495Follow up of unsatisfactory colonoscopyA follow-up colonoscopy to the sigmoid or descending colon, performed when a previous colonoscopy was technically unsatisfactory due to issues such as poor preparation or failure to reach the cecum.$51.95
- Z498Follow up of abnormal colonoscopy - sigmoid to descending colonA colonoscopy from the sigmoid to the descending colon performed as a follow-up for a patient with a previously identified abnormal colonoscopy, such as a prior malignancy or specific types of adenomatous polyps.$51.95
- E740Colonoscopy to splenic flexureAn add-on to specified colonoscopy procedures (`Z491`-`Z499`, `Z555`) for extending the examination to the splenic flexure.$51.75
- E741Colonoscopy to hepatic flexureAn add-on fee for a colonoscopy procedure that extends to the hepatic flexure. This code is intended to be billed in addition to a primary colonoscopy service.$31.15
- E705Colonoscopy into terminal ileumAn add-on procedure for extending a colonoscopy into the terminal ileum, payable in addition to a primary colonoscopy service.$30.30
- Z580Sigmoidoscopy (using 60 cm. flexible endoscope)Performance of a sigmoidoscopy, an endoscopic examination of the sigmoid colon, using a 60 cm flexible endoscope. This procedure is an endoscopic examination of the sigmoid colon.$57.70
- Z535Sigmoidoscopy with rigid scopeA sigmoidoscopy with or without anoscopy, performed using a rigid scope. This is a diagnostic endoscopic procedure of the rectum.$36.80
- Z536Sigmoidoscopy with biopsy(ies)An endoscopic procedure for the examination of the sigmoid colon using a rigid scope, which includes the taking of one or more biopsies.$44.55
- Z543Anoscopy (proctoscopy)Anoscopy (proctoscopy) is an endoscopic examination of the anus and rectum. This service is not separately payable when performed concurrently with certain other rectal procedures, such as haemorrhoid excision.$8.70
Breast
- R107Tumour or tissue for diagnostic biopsy and/or treatmentSurgical excision of a breast tumour or tissue for diagnostic biopsy and/or treatment. This applies to single or multiple lesions in the same breast for conditions such as carcinoma, fibroadenoma, or fibrocystic disease.$169.95
- Z141Needle biopsy - one or moreA surgical procedure for performing one or more needle biopsies of the breast for diagnostic purposes.$37.20
- R111Partial mastectomy or wedge resectionA surgical procedure for the partial removal of breast tissue (partial mastectomy or wedge resection) to treat conditions like carcinoma or extensive fibrocystic disease, which may or may not include a biopsy.$306.75
- R102Level 1 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancyA surgical procedure for a Level 1 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancy. Payment is contingent on the resected breast volume being 15% or less and specific surgical techniques being documented.$350.00
- R108Simple mastectomyA simple mastectomy for a female patient, performed with or without a biopsy. This procedure may also be applicable for patients approved for sex-reassignment surgery.$330.00
- R109Mastectomy, radical or modified radicalPerforms a radical or modified radical mastectomy, a surgical procedure for breast removal, which may include a biopsy. This is a surgical service eligible for surgeon, assistant, and anaesthetist fees, with skin grafts payable in addition.$780.00
- R117Skin sparing mastectomy performed with immediate breast reconstructionSkin sparing mastectomy performed with immediate breast reconstruction for malignancy or prophylaxis in high-risk female patients.$495.00
- E505Limited axillary node samplingAn add-on fee for performing limited axillary node sampling during a primary breast surgery, such as a partial mastectomy (R111) or simple mastectomy (R108).$178.05
- E546Axillary node dissectionAdd-on fee for an axillary node dissection up to the level of the axillary vein, payable when performed with specific partial mastectomy or oncoplastic breast conserving surgery codes (R111, R102, R158, R159).$388.75
- Z140Drainage of intramammary abscess or haematomaDrainage of a single or multiloculated abscess or hematoma within the breast, performed under local anesthesia.$33.00
- Z740Drainage of intramammary abscess or haematoma - Single or multiloculated - general anaestheticSurgical drainage of a single or multiloculated intramammary abscess or haematoma performed under general anaesthetic. This is a surgical procedure listed on page <SectionPages>M25</SectionPages> of the Schedule of Benefits.$133.80
Thyroid & parathyroid
- S788Thyroidectomy - totalSurgical removal of the entire thyroid gland. This procedure is eligible for assistant and anaesthesia fees, and may be billed with an add-on code (<billingCode>E880</billingCode>) for parathyroid re-implantation.$777.30
- S789Thyroidectomy - subtotalSurgical procedure for the subtotal excision of the thyroid gland, which involves removing most but not all of the thyroid tissue.$656.25
- S790Thyroidectomy - hemiSurgical excision of one lobe (hemi) of the thyroid gland.$525.15
- S793Thyroidectomy - completion following previous subtotal or hemi-thyroidectomy- completion following previous subtotal or hemi-thyroidectomy$650.00
- Z771Aspiration biopsy, thyroid gland or nodule fine needle methodPerforms a fine needle aspiration biopsy of the thyroid gland or a thyroid nodule for diagnostic purposes. This procedure is eligible for age-based and after-hours premiums.$38.00
- Z726Aspiration, thyroid cystA therapeutic procedure involving the aspiration of fluid from a thyroid cyst.$38.00
Skin & soft tissue
- Z113Biopsy - any method, when sutures are not used$32.45
- Z116Biopsy - any method, when sutures are usedBiopsy - any method, when sutures are used.$32.45
- Z101Abscess or haematoma - Local anaesthetic - subcutaneous - one$28.20
- Z102Abscess or haematoma - General anaesthetic - subcutaneous - oneZ102 is a surgical procedure for an abscess or haematoma, performed under general anaesthetic, subcutaneous, one. Anaesthesia services are calculated based on basic and time units. Surgical assistant services are not eligible for payment with this code.$48.60
- Z114Foreign body removal - local anaestheticA surgical procedure code with a fixed fee. Specific details for Z114 are not available in the provided context, but general rules for surgical procedures apply, including eligibility for certain premiums.$27.65
- Z122Cyst, haemangioma, lipoma - single lesion - face or neck - local anaestheticsingle lesion$42.20
- Z125Cyst, haemangioma, lipoma - single lesion - other areasA surgical procedure identified by a 'Z' prefix. General rules for surgical procedures, including assistant and anaesthesia services, apply. Specific details for `<billingCode>Z125</billingCode>` are not provided in the context.$35.05
- Z096Lipoma - 5 to 10 cmRepresents a surgical procedure where specific details are not provided in the source context. Billing is governed by the general rules for surgical procedures, including requirements for surgical, assistant, and anaesthesia services.$87.65
- Z097Lipoma - over 10 cm$175.30
- R035Pilonidal cyst - simple excision or marsupializationSurgical procedure from the Musculoskeletal System section. The assistant's service is not payable. General rules for surgical procedures, including anaesthesia and potential age-based or after-hours premiums, apply.$219.10
- R054Pilonidal cyst - simple excision or marsupialization, if patient's BMI greater than 40$273.90
- R048Simple excision of single malignant lesion - face or neckSimple excision of a single malignant lesion on the face or neck. Payment requires a pathologist's report to be retained in the patient's record.$100.95
- R040Simple excision of two malignant lesions (other areas)Surgical service for the simple excision of two malignant lesions located on areas of the body other than the face or neck. Payment requires retention of a pathologist's report.$104.85
- Z162Nevus - single lesionSurgical removal by excision and suture of a single nevus lesion. This service is not insured if performed for purely cosmetic purposes.$21.90
- Z163Nevus - two lesionsSurgical removal of two nevi by excision and suture. Add-on code <billingCode>E542</billingCode> is payable when performed outside of a hospital. This service is not insured if performed for purely cosmetic purposes.$29.05
- Z164Nevus - three or more lesionsSurgical removal by excision and suture of three or more nevi. This service is only insured when medically necessary due to clinical suspicion of disease or malignancy, and not for cosmetic purposes.$48.50
Access, drains & bedside
- Z456Insertion of implantable central venous catheterSurgical procedure for the insertion of an implantable central venous catheter. This service has specific add-on codes for infants and children and is eligible for various anaesthesia and surgical premiums.$296.50
- Z457Surgical removal or repair of tunneled central venous catheterSurgical procedure for the removal or repair of an implanted central venous catheter. This is a unit-based surgical procedure.$60.00
- Z341Tube thoracostomy for closed drainage (chest tube)A surgical procedure for the insertion of a chest tube for closed drainage, typically to remove air or fluid from the pleural space.$76.80
- Z363Removal of thoracostomy tube (chest tube)Surgical removal of a thoracostomy (chest) tube. This procedure is not payable on the same day as the insertion of a chest tube (<billingCode>Z341</billingCode>).$20.00
- Z332Aspiration for diagnosis or therapeutic drainagePerforms a therapeutic aspiration of the lung and pleura, also known as thoracentesis, to drain fluid, with or without taking a diagnostic sample. This is an Independent Operative Procedure (IOP).$104.40
- Z590Paracentesis - for diagnostic sampleA surgical procedure involving the aspiration of peritoneal fluid for diagnostic sampling. An additional fee (<billingCode>E542</billingCode>) is payable when performed outside of a hospital.$31.30
- Z591Paracentesis with therapeutic drainageA surgical procedure for the aspiration of fluid from the peritoneal cavity (paracentesis) primarily for therapeutic drainage, which may also include obtaining a diagnostic sample.$57.65
- Z532Percutaneous endoscopic gastrostomyA surgical procedure for the percutaneous endoscopic placement of a gastrostomy tube.$172.95
Add-ons
- E556Extensive debridement of compound fractures or dislocationsAdds a 50% premium to the fee for a reduction of a compound fracture or dislocation to account for extensive debridement.+50%
- E082Admission assessment by the MRPA 30% premium added to the fee for a hospital admission assessment (consultation) when the admitting physician becomes the Most Responsible Physician (MRP) for the patient.+30%
- E083Subsequent visit by the MRPA 30% premium added to the fee for an eligible subsequent visit or palliative care visit when rendered by the patient's Most Responsible Physician (MRP) in a hospital or other institution.+30%
- E084Saturday, Sunday or Holiday subsequent visit by the MRPA 45% premium added to eligible subsequent hospital or palliative care visits rendered by a designated Most Responsible Physician (MRP) on a Saturday, Sunday, or holiday.+45%
How to use this general surgery code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to general surgery (specialty 03) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a general surgery physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does general surgery bill?
The consultations & assessments — office section of this set starts with A035 (Consultation). 4 codes are listed in that section.
What is in the General Surgery code set?
102 OHIP billing codes across 10 sections: Consultations & assessments — office; Hospital in-patient; Appendix, gallbladder & hernia; Colorectal; Endoscopy; Breast; Thyroid & parathyroid; Skin & soft tissue; Access, drains & bedside; Add-ons. General surgery consultations and visits, and the abdominal, colorectal, endoscopic, breast, endocrine and skin procedures that fill a general surgeon's week.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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