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Surgical specialties & anaesthesia
Obstetrics & Gynaecology OHIP billing codes
Prenatal care, labour and delivery with premiums, repairs and postnatal care; office gynaecology, hysteroscopy, laparoscopy, hysterectomy and pelvic floor surgery.
105 codes in 12 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 20 is in the full OB/GYN listing.
Consultations & assessments — office
- A205Obstetrics and Gynaecology ConsultationA specialist consultation in Obstetrics and Gynaecology requested by a referring physician, nurse practitioner, or dental surgeon. Subject to frequency limits and requires a written referral and report back to the referring practitioner.—
- A206Repeat consultation—
- A203Specific assessment—
- A204Partial assessment—
Hospital in-patient
- C205ConsultationA consultation for a non-emergency hospital in-patient rendered by an Obstetrics and Gynaecology specialist, requiring a written request from a referring practitioner.—
- C206Repeat consultationA repeat consultation for a non-emergency hospital in-patient rendered by an Obstetrics and Gynaecology specialist. This service follows an initial consultation for the same problem, after care has been rendered by another physician in the interim.—
- C203Specific assessmentA specific assessment for a non-emergency hospital in-patient, rendered by a specialist in Obstetrics and Gynaecology.—
- C204Specific re-assessmentA specific re-assessment for a non-emergency hospital in-patient, performed by a specialist in Obstetrics and Gynaecology (20).—
- C202Subsequent visit - first five weeksA routine subsequent visit by an Obstetrician/Gynaecologist for a non-emergency hospital in-patient during the first five weeks of admission. Limited to one per day.—
- C207Subsequent visit - sixth to thirteenth week inclusiveA routine in-hospital subsequent visit by an Obstetrician/Gynaecologist for an admitted patient between the sixth and thirteenth week of their hospital stay, limited to a maximum of three visits per week.—
- C209Subsequent visit - after thirteenth weekA routine subsequent visit for a non-emergency hospital in-patient under the care of an Obstetrician/Gynaecologist, rendered after the thirteenth week of admission.—
- C208Concurrent care - per visitA routine assessment rendered by a consultant to a hospital in-patient when the family physician remains the most responsible physician but requests continued directive care from the consultant.—
Prenatal care
- P003General assessment (major prenatal visit)A major prenatal visit which constitutes a general assessment for an obstetrical patient, typically covering the initial review of antenatal risk factors.$93.85
- P004Minor prenatal assessmentA minor prenatal assessment for routine antenatal care. This service constitutes a limited assessment that includes a brief history and examination appropriate for a follow-up prenatal visit.$44.55
- P005Antenatal preventative health assessmentAn assessment by the most responsible physician for the initial review of antenatal risk, including a review of all current psychosocial, genetic, and medical issues. This service is limited to once per pregnancy.$55.70
- P002High risk prenatal assessmentA specialized assessment by a maternal-fetal medicine specialist for managing significant maternal and/or fetal risk factors, requiring a minimum of 20 minutes of direct patient contact.—
- P001Medical management of non-viable fetus or intra-uterine fetal demise between 14 and 20 weeks gestationMedical management for a non-viable fetus or intra-uterine fetal demise between 14 and 20 weeks gestation. Payment requires ultrasound confirmation of gestational age and active medical intervention.$479.55
- A920Medical management of early pregnancy - initial service$193.70
- A922Medical management of ectopic pregnancy - initial service$249.75
Labour & delivery
- P006Vaginal deliveryVaginal delivery of an infant. This service includes the repair of a first or second-degree tear or episiotomy extension.$512.65
- P009Attendance at labour and deliveryPayable to a physician, other than an obstetric consultant, for attending a labour and delivery to assist at a vaginal delivery or surgery, provide anaesthesia, or resuscitate the newborn.$512.65
- P020Operative deliveryOperative delivery, defined as any of: i) forceps or vacuum-assisted delivery, ii) breech delivery, or iii) shoulder dystocia using advanced maneuvers$535.60
- P018Caesarean sectionSurgical delivery of a fetus through an abdominal and uterine incision. This code is used for the primary delivery via caesarean section.$579.80
- P041Caesarean section including tubal interruptionA surgical service for performing a Caesarean section with a concurrent tubal interruption, billable by the surgeon, assistant, and anaesthetist.$609.20
- P042Caesarean section including hysterectomyA surgical procedure for a caesarean section that also includes a hysterectomy (surgical removal of the uterus), typically performed in a hospital setting.$1004.60
- P010Attendance of obstetric consultant(s) at deliveryPayable to an obstetric consultant for their attendance at a delivery.$211.20
- P038Attendance at labour - patient transferred to another centre for deliveryPayable for a physician's attendance during a patient's labour when the patient is subsequently transferred to another medical centre for the actual delivery.$211.20
- E411Sole delivery premiumA 100% premium added to specified labour and delivery fees when it is the physician's sole delivery for that calendar day. This premium is limited to a maximum of 25 per physician per fiscal year.+100%
- E499Second caesarean deliveryAn add-on fee for the second infant delivered by caesarean section during a multiple birth. This fee is claimed in addition to the primary caesarean section code (`<billingCode>P018</billingCode>`, `<billingCode>P041</billingCode>`, or `<billingCode>P042</billingCode>`).$397.75
- E500Third and subsequent deliveryA premium for the third and each subsequent infant delivered during a multiple birth, which is billed in addition to the primary delivery fee.$148.60
- E502Vaginal birth after caesarean section (VBAC)Fee for managing a trial of labour for a vaginal birth after a previous caesarean section (VBAC), payable whether the delivery is ultimately vaginal or by repeat caesarean section.$51.00
- C989Obstetrical Delivery with Sacrifice of Office HoursA special visit premium for the first non-elective obstetrical delivery of a day, which requires the physician to sacrifice scheduled office hours.$78.55
Labour management
- P023Oxytocin infusion for induction or augmentation of labourPayable for the use of an oxytocin infusion to induce or augment labour. This procedure may be billed in conjunction with <billingCode>P030</billingCode> for cervical ripening.$67.75
- P030Cervical ripeningCervical ripening using topical, oral or mechanical agents. This service is limited to once per pregnancy and is payable with <billingCode>P023</billingCode>, but is payable at nil if performed on the same day as a consultation or visit by the same physician.$58.60
- P025Non stress testA non-stress test performed for high-risk pregnancies. This service includes the interpretation of the trace, discussion with the patient, and a written report for the medical record.$9.65
- P031Prophylactic cervical cerclageProphylactic placement of a suture around the cervix to prevent premature dilation, performed using any technique. This code is used for non-emergency situations.$145.10
- P032Emergency cervical cerclageA surgical procedure for an emergency cervical cerclage performed when the cervix is dilated to 2 cm or more with visible or prolapsed membranes.$250.00
- P029Manual removal of retained placentaA referred obstetrical procedure for the manual removal of a retained placenta following delivery.$54.40
- P034Uterine inversion, manual replacementA surgical procedure for the manual replacement of an inverted uterus. This procedure is typically performed in a hospital setting with fees available for the surgeon and anaesthetist.$125.75
- Z777Breech presentation - external cephalic versionA procedure to manually turn a fetus from a breech presentation to a cephalic presentation. This service is performed in a hospital on patients after 35 weeks of gestation and is claimable once per pregnancy.$60.35
- Z774Postpartum haemorrhage - exploration of vagina and cervix, uterine curettageA surgical procedure to manage postpartum hemorrhage, involving the exploration of the vagina and cervix and performing uterine curettage.$113.65
- Z721Pharmacological suppression of premature labour by I.V. therapyPharmacological suppression of premature labour using I.V. therapy. This service can be claimed once per physician after providing 3 hours of supervision within the same institution.$67.75
Repairs
- P036Repair of vaginal lacerationSurgical repair of a vaginal laceration when this is the only service rendered by the physician.$54.40
- P039Repair of cervical lacerationA surgical procedure for the repair of a cervical laceration, typically performed as a referred service when it is the only service rendered.$54.40
- P045Repair of third degree tear or episiotomy extensionSurgical repair for a third-degree tear or episiotomy extension involving the perianal sphincter and perineum, typically performed following childbirth.$82.15
- P046Repair of fourth degree tear or episiotomy extensionSurgical repair of a fourth-degree perineal tear or episiotomy extension following childbirth. This procedure involves repairing the rectal mucosa, the perianal sphincter, and the perineum.—
Postnatal care
- P007Postnatal care in hospital and/or homeThis service covers postnatal care provided to a patient following delivery, rendered either in a hospital setting or in the patient's home.$65.55
- P008Postnatal care in officeRepresents the provision of postnatal care to a patient in a physician's office following childbirth.$43.80
Office gynaecology
- G378Insertion of intrauterine contraceptive deviceA procedure for the insertion of an intrauterine contraceptive device (IUD). An add-on premium (<billingCode>E542</billingCode>) is available when performed outside a hospital.$47.50
- G552Removal of intrauterine contraceptive deviceService for the removal of an intrauterine contraceptive device (IUD). This service is performed without general anaesthesia as noted on page <SectionPages>V5</SectionPages>.$23.80
- G365Collection of cervical cancer screening specimen(s)Payable for the collection of a specimen for cervical cancer screening. An additional amount (<billingCode>E430</billingCode>) is payable when performed outside of a hospital or ICHSC, and this service is included in the monthly management fee for nursing home patients (W010).$12.00
- E430Collection of cervical cancer screening specimen(s) - outside of hospital or ICHSCPremium added to `<billingCode>G365</billingCode>` when cervical cancer screening specimen(s) are collected outside a hospital or Integrated Community Health Services Centre (ICHSC).$11.95
- E432Pelvic exam including speculum performed outside of hospital or ICHSC$5.00
- Z770Endometrial samplingA diagnostic procedure for obtaining a sample of the endometrium, which can be performed in or out of a hospital setting.$38.85
- Z730Follow up colposcopy without biopsyA follow-up colposcopic examination of the lower genital tract without performing a biopsy. This procedure includes specimen collection for cytology or HPV testing if performed.$28.35
- Z787Follow-up colposcopy with biopsy(ies)A follow-up colposcopic examination of the lower genital tract, which includes the performance of one or more biopsies. This procedure also includes the collection of cervical cancer screening specimens for cytology or HPV testing if performed.$53.50
- Z720Biopsy - with or without fulgurationA surgical procedure for a biopsy of the cervix, which may or may not include fulguration. This code is also used for the excision of cervical polyps under general anaesthesia.$20.00
- Z766Loop Electrosurgical Excision Procedure (LEEP)A surgical procedure involving the conization of the cervix using a loop electrosurgical excision technique (LEEP). It is designated by a '#' prefix, indicating facility funding for equipment and supplies.$85.65
- Z729Cryoconization, electroconization or CO2 laser therapyA surgical procedure for a premalignant lesion of the cervix (dysplasia or carcinoma in situ) via cryoconization, electroconization, or CO2 laser therapy, performed as an out-patient procedure. This service includes curettage if performed.$38.35
- G398Pessary fittingInitial or re-fitting of a pessary for the medical management of prolapse. This service is limited to once per patient per 12-month period.$65.35
- G550Pessary care – pessary removal, care and reinsertionPessary care involving the removal, care, and reinsertion of a pessary. This service is limited to 6 claims per 12-month period and is not payable on the same day as <billingCode>G398</billingCode> (pessary fitting).$10.00
- Z733Condylomata - one or more - chemical and/or cryosurgeryChemical and/or cryosurgery for the treatment of one or more condylomata (genital warts) on the vulva or introitus.$12.00
- Z736Condylomata - surgical excision or electrodesiccation or CO2 laser - local anaestheticSurgical excision, electrodesiccation, or CO2 laser removal of single or multiple condylomata (genital warts) performed under local anaesthetic.$32.60
- Z714Abscess of vulva, Bartholin or Skene’s gland - incision and drainageIncision and drainage of an abscess of the vulva, Bartholin's gland, or Skene's gland, performed under local anaesthetic.$25.40
- Z716Marsupialization of Bartholin’s cyst or abscessA surgical procedure for the treatment of a Bartholin's gland cyst or abscess by creating a permanent opening for drainage (marsupialization).$110.95
- S706Cyst of Bartholin’s glandSurgical excision of a cyst of Bartholin's gland. This procedure is eligible for anaesthesia and surgical assistant fees.$161.40
Hysteroscopy, D&C & early pregnancy
- Z582Hysteroscopy - diagnosticDiagnostic endoscopic procedure for visual examination of the uterine cavity. This service is mutually exclusive with other hysteroscopy codes on the same day.$111.50
- Z583Hysteroscopy with uterine biopsy and/or D&CA surgical procedure involving endoscopic examination of the uterus (hysteroscopy), which includes performing a uterine biopsy and/or a dilation and curettage (D&C).$133.70
- Z587Hysteroscopy with resection of one or more endometrial polyps or fibroidsA hysteroscopic surgical procedure for the resection of one or more endometrial polyps. This procedure may also include a dilatation and curettage (D&C).$206.35
- Z585Hysteroscopy with cannulization of tube(s), lysis of intrauterine adhesionsA hysteroscopic surgical procedure involving the cannulization of fallopian tube(s) and/or the lysis of intrauterine adhesions. This code is specifically for cases where the lysis of adhesions takes less than 60 minutes.$149.60
- Z586Hysteroscopy with lysis of intrauterine adhesions/synechiae requiring a minimum of 60 minutes of surgical timeA hysteroscopic procedure for the lysis of intrauterine adhesions (synechiae) that requires at least 60 minutes of surgical time. This procedure cannot be billed on the same day as other hysteroscopy codes such as `<billingCode>Z582</billingCode>`, `<billingCode>Z583</billingCode>`, `<billingCode>Z585</billingCode>`, or `<billingCode>Z587</billingCode>`.$368.75
- S754Diagnostic curettageA surgical procedure involving diagnostic curettage of the uterus. This service may also include cauterization, biopsy of the cervix, removal of polyps, or hysterosalpingography when performed during the same operative session.$97.20
- S752Induced abortion - up to and including 14 weeks gestationA surgical procedure for an induced abortion performed using any surgical technique for a pregnancy with a gestational age of up to and including 14 weeks. This service is eligible for surgeon (A) and anaesthetist (C) billing.$112.40
- S785Induced abortion after 14 weeks of gestationSurgical termination of pregnancy performed by any technique for a patient after 14 weeks of gestation. Payment is only eligible if the length of gestation is confirmed by ultrasound.$189.85
- S756Missed abortion or evacuation of molar pregnancySurgical evacuation of a missed abortion or a molar pregnancy by any surgical method.$120.45
- S768Spontaneous abortion, incomplete - including D&CSurgical management for a spontaneous, incomplete abortion, a procedure that includes dilatation and curettage (D&C).$113.40
- S772Endometrial ablationA surgical procedure for endometrial ablation using any method. This procedure includes anaesthesia and potential surgical assistance, and has specific restrictions on being billed alongside certain hysteroscopy codes.$225.90
Laparoscopy, tubes & ovaries
- E860Diagnostic laparoscopy prior to laparotomy$131.45
- E855Laparoscopy with dye injection$25.85
- E857D&C with laparoscopyAn add-on payment for a Dilatation and Curettage (D&C) when required for abnormal uterine bleeding and performed concurrently with tubal occlusion or diagnostic laparoscopy.$78.45
- S741Tubal occlusion or interruption for the purpose of sterilizationRepresents a surgical procedure on the musculoskeletal system. The fee is payable to the surgeon (suffix A), with separate fees for a surgical assistant (suffix B) and anaesthetist (suffix C). Assistant and anaesthesia fees are calculated based on time units and may be enhanced by various premiums for after-hours, patient age, and complexity.$155.70
- S738Salpingectomy or salpingo-oophorectomySurgical procedure on the female genital system. Payment includes the procedure itself and associated pre-operative and post-operative care as defined in the Schedule of Benefits. A second surgical assistant is payable without special authorization for this procedure.$366.20
- S736Salpingostomy$359.55
- S745Oophorectomy and/or oophorocystectomySurgical excision of one or both ovaries (oophorectomy) and/or ovarian cysts (oophorocystectomy), performed via laparotomy. This service is payable for unilateral or bilateral procedures.$366.20
- S747Para ovarian cystectomySurgical removal of a para-ovarian cyst. This procedure is performed via laparotomy and includes unilateral or bilateral services.$306.85
- S764MyomectomySurgical removal of uterine fibroids (myomas) by any technique except hysteroscopic. This fee is for the surgeon, with separate unit-based calculations for assistant and anaesthetist services.$406.90
- E863Laparoscopic premium for vaginal surgeonA 25% premium added to the fee for the vaginal surgeon's component (applicable to S730, S732, or S749) when a two-surgeon vaginal procedure is performed laparoscopically.+25%
Hysterectomy & pelvic floor
- S757Hysterectomy - abdominal - total or subtotalSurgical removal of the uterus via an abdominal incision (total or subtotal), which may include removal of adnexa. This is a surgical procedure for which the surgeon fee is a flat rate, while assistant and anaesthetist fees are calculated based on basic and time units.$643.35
- S816Vaginal hysterectomyA surgical procedure for the vaginal removal of the uterus, which may or may not include the removal of the ovaries and fallopian tubes (adnexa).$643.35
- S759Hysterectomy with anterior or posterior vaginal repairA surgical procedure for hysterectomy that includes either an anterior or posterior vaginal repair, and also includes enterocoele and/or vault prolapse repair when performed.$655.05
- S758Hysterectomy with anterior and posterior vaginal repair and including enterocoele and/or vault prolapse repairA surgical procedure for hysterectomy, with or without adnexa, that also includes anterior and posterior vaginal repair, as well as enterocoele and/or vault prolapse repair when rendered. This procedure is eligible for surgeon, assistant, and anaesthesia fees.$733.45
- S710Hysterectomy with omentectomy for malignancySurgical procedure for hysterectomy with or without adnexa, combined with omentectomy for the treatment of malignancy.$820.40
- S763Radical hysterectomy (Wertheim or Schauta) - includes node dissectionA radical hysterectomy (Wertheim or Schauta type) which includes node dissection. This is a major surgical procedure performed on the female genital system.$1081.80
- S716Anterior or posterior repairSurgical procedure for the repair of either the anterior or the posterior vaginal wall. This service includes fees for the surgeon, assistant, and anaesthetist.$250.65
- S718Repair of enterocoele and/or vault prolapseSurgical repair of both the anterior and posterior vaginal walls, which includes specific repair of an enterocoele (intestinal hernia) and/or vaginal vault prolapse.$432.45
- S720Anterior repair with or without posterior repair and repair of uterine prolapseSurgical repair of the anterior vaginal wall, which may also include posterior repair and repair of uterine prolapse.$432.45
- S722Post hysterectomy vault prolapse - repair by vaginal approachSurgical repair of post-hysterectomy vaginal vault prolapse performed through a vaginal approach. This procedure can also include the repair of an associated enterocoele, as well as anterior and posterior vaginal wall repair.$432.45
- E862Laparoscopic premium for retropubic urethropexyA 25% premium added to the surgical fee for specific urogenital and female genital surgical procedures (e.g., retropubic urethropexy, combined abdominal-vaginal sling procedures, hysterectomy, tubal plastic operations) when performed laparoscopically or with laparoscopic assistance.+25%
Fetal medicine
- Z773FetoscopyA diagnostic or therapeutic surgical procedure involving the direct visual examination of a fetus in utero using a fetoscope. This service may include associated procedures such as fetal blood sampling (<billingCode>Z776</billingCode>), cell harvesting, amniocentesis (<billingCode>Z778</billingCode>), or cordocentesis.$165.40
- Z776Fetal blood samplingA diagnostic procedure for obtaining a blood sample from a fetus, typically performed in high-risk pregnancies.$40.80
- Z779Chorionic villus samplingA diagnostic procedure involving the sampling of chorionic villi from the placenta for prenatal testing, typically for high-risk pregnancies.$153.00
- P050Therapeutic amnio-reductionA surgical maternal-fetal procedure involving the therapeutic reduction of amniotic fluid.$248.85
- P052Percutaneous fetal blood sampleA maternal-fetal procedure for obtaining a fetal blood sample percutaneously from the umbilical cord or fetal hepatic vein.$199.10
- P051Percutaneous fetal blood transfusion - into fetal hepatic veinA surgical procedure for the percutaneous transfusion of blood into the fetal hepatic vein. This service is eligible for surgical assistant, anaesthesia, and second assistant services, and may be billed in addition to `<billingCode>J149</billingCode>` (Ultrasonic Guidance) or `Z552` (Diagnostic Laparoscopy) where applicable.$348.40
- Z734Double set up examination to rule out placenta previa or trial of forceps - failed leading to caesarean sectionA specialized obstetrical procedure involving a double set-up examination performed either to rule out placenta previa or for a trial of forceps that subsequently fails, leading to a caesarean section by the same physician.$58.00
How to use this ob/gyn code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to obstetrics and gynaecology (specialty 20) — 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 ob/gyn 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 obstetrics & gynaecology bill?
The consultations & assessments — office section of this set starts with A205 (Obstetrics and Gynaecology Consultation). 4 codes are listed in that section.
What is in the Obstetrics & Gynaecology code set?
105 OHIP billing codes across 12 sections: Consultations & assessments — office; Hospital in-patient; Prenatal care; Labour & delivery; Labour management; Repairs; Postnatal care; Office gynaecology; Hysteroscopy, D&C & early pregnancy; Laparoscopy, tubes & ovaries; Hysterectomy & pelvic floor; Fetal medicine. Prenatal care, labour and delivery with premiums, repairs and postnatal care; office gynaecology, hysteroscopy, laparoscopy, hysterectomy and pelvic floor surgery.
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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