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Surgical specialties & anaesthesia
Urology OHIP billing codes
Urology consultations, office cystoscopy and urodynamics, cystoscopic procedures, stones, prostate, kidney and ureter, scrotal and penile surgery, bladder and urethra.
107 codes in 10 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 35 is in the full Urology listing.
Consultations & assessments — office
Hospital in-patient
- C355Consultation - Non-Emergency Hospital In-Patient ServicesA consultation provided by a urologist for a non-emergency hospital in-patient, following a written request from a referring physician, nurse practitioner, or dental surgeon.—
- C356Repeat consultationA repeat consultation for a hospital in-patient, rendered by a urologist for the same presenting problem after another physician has provided care in the interim. A new written referral is required.—
- C353Specific assessmentA specific assessment by a urology specialist for a non-emergency hospital in-patient. This service includes a detailed history of the presenting complaint and a focused physical examination.—
- C354Specific re-assessmentA specific re-assessment for a non-emergency hospital in-patient performed by a urologist (specialty 35). This service requires a full, relevant history and physical examination of one or more systems.—
- C352Subsequent visit - first five weeksA routine assessment of a hospital in-patient rendered by a urologist, payable once per day during the first five weeks following admission. This service is performed in a non-emergency, in-patient setting.—
- C357Subsequent visit - sixth to thirteenth week inclusiveA subsequent visit to a non-emergency hospital in-patient from the sixth to thirteenth week after admission, limited to a maximum of three visits per patient per week.—
- C359Subsequent visit - after thirteenth week (maximum 6 per patient per month)A routine subsequent visit by a urologist for a hospital in-patient after the thirteenth week of their admission. This service is limited to a maximum of six visits per patient per month.—
- C358Concurrent careA routine assessment rendered in-hospital by a consultant providing continued directive care at the request of the Most Responsible Physician (MRP), following the consultant's initial major assessment.—
Office procedures & diagnostics
- Z606Diagnostic cystoscopyDiagnostic endoscopic procedure for visual examination of the bladder, with or without urethroscopy. This is a surgical procedure and can be billed with various add-on codes for additional therapeutic interventions.$77.00
- Z607Cystoscopy - repeat within 30 daysA repeat diagnostic cystoscopy, with or without urethroscopy, performed on a patient within 30 days of a prior cystoscopy (<billingCode>Z606</billingCode>).$38.05
- Z611Catheterization - hospital or officeHospital-based urinary catheterization performed personally by a physician for acute retention, catheter change, or medication instillation.$9.15
- Z603Catheterization - homeCatheterization performed in a patient's home. This service is limited to specific medical situations such as acute retention, changing a Foley catheter or suprapubic tube, or instilling medication, and must be performed personally by the physician.$16.25
- Z608Manual catheter declotting and irrigation of bladderA procedure for the manual declotting and irrigation of a bladder catheter.$58.65
- Z610Intravesical instillation of BCG or immunotherapeutic agent or chemotherapeutic agent for the treatment of bladder cancerIntravesical instillation of BCG, immunotherapeutic, or chemotherapeutic agents for treating bladder cancer. This service must be rendered personally by the physician and includes catheterization and preparation/disposal of the agents. Catheterization codes <billingCode>Z602</billingCode>, <billingCode>Z603</billingCode>, or <billingCode>Z611</billingCode> are not payable in addition.$25.65
- G900Residual urine measurement by ultrasoundMeasures residual urine volume using ultrasound. This service has specific billing restrictions and cannot be claimed with certain other pelvic ultrasound or urodynamic studies.$12.70
- Z712Prostate biopsy, needleA surgical procedure involving a needle biopsy of the prostate gland to obtain tissue for diagnostic examination.$91.60
- Z713Biopsy, needle with drainage abscessSurgical procedure for a needle biopsy of the prostate with drainage of an abscess.$98.70
- G476Prostatic massageA therapeutic procedure involving the massage of the prostate gland.$5.40
- G193Complete multichannel urodynamic assessmentto include monitoring of intravesicular, intra-abdominal, and urethral pressures, with or without pressure-flow studies$43.85
- G192Video fluoroscopic multichannel urodynamic assessmentA comprehensive urodynamic study using fluoroscopy to assess bladder and urethral function, including pressure measurements and imaging during the filling and voiding phases, with interpretation.$73.65
- G194Complete multichannel urodynamic assessment - with EMGAn add-on service for performing electromyography (EMG) concurrently with a complete multichannel urodynamic assessment (<billingCode>G193</billingCode>).$8.35
- G477Interpretation of comprehensive urodynamic studiesFee for the professional interpretation of comprehensive urodynamic studies when the technical component of the procedure is performed by paramedical personnel.$5.40
- Z621Dilatation of stricture - male, local anaesthetic$20.60
- Z604Meatotomy and plastic repairA surgical procedure involving an incision and plastic repair of the urethral opening (meatus).$42.45
Cystoscopic procedures
- E781Cystoscopy with electrocoagulation of tumour(s)An add-on surgical procedure for the electrocoagulation of bladder tumour(s), typically performed during a cystoscopy.$53.50
- E782Cystoscopy with electrocoagulation of Hunner ulcerAn add-on procedure to diagnostic cystoscopy (Z606 or Z607) involving the use of electrocoagulation to treat a Hunner's ulcer in the bladder.$53.50
- E789Cystoscopy with removal of foreign body or calculusAn add-on procedure to a diagnostic cystoscopy for the endoscopic removal of a foreign body or calculus from the bladder.$106.85
- E775Cystoscopy with catheterization of the ureter and collection of the ureteral specimen, unilateralA surgical add-on to a cystoscopy procedure for the catheterization of one ureter to collect a specimen. This procedure is unilateral.$16.45
- E817Cystoscopy with catheterization of the ureter and retrograde injection of opaque media, unilateralAn add-on procedure to cystoscopy (Z606 or Z607) involving the catheterization of one ureter and retrograde injection of opaque media for diagnostic purposes. This service is billed per side.$16.45
- E818Cystoscopy with insertion of ureteric stent, unilateralAdd-on to diagnostic cystoscopy (e.g., `Z606`) for the unilateral insertion of a ureteric stent.$26.70
- E773Placement of ureteric stent past obstructing lesion (unilateral)An add-on to cystoscopy for the unilateral placement of a ureteric stent to bypass an obstructing lesion. Not payable with `<billingCode>E818</billingCode>` for the same obstruction.$53.50
- E790Removal of ureteric catheterA therapeutic procedure for the removal of a ureteric catheter, performed during and in addition to a primary cystoscopy procedure such as Z606.$9.45
- E824Bladder biopsy - general anaestheticA procedure for bladder biopsy performed via cystoscopy, which requires the patient to be under general anaesthetic. This service is typically billed in addition to the primary cystoscopy procedure (e.g., Z606).$53.45
- E751Cystoscopy with insertion of chemotherapeutic agent(s)An add-on to a primary cystoscopy procedure for the insertion of one or more chemotherapeutic agents into the bladder. This code is not eligible for payment with Z603 or Z611.$58.65
- E791Periurethral injection of bulking agentsA surgical procedure performed during a cystoscopy to inject periurethral bulking agents. This service is an add-on to a primary cystoscopy procedure.$50.70
- Z632Excision of single bladder tumour 1 to 2 cm diameterSurgical excision of a single bladder tumour measuring 1 to 2 cm in diameter. This procedure includes excision of the tumour base, adjacent muscles, and electrocoagulation if performed. Cystoscopy is not separately payable.$290.90
- Z633Single tumour over 2 cm diameterSurgical excision of a single bladder tumour greater than 2 cm in diameter, including the base and adjacent muscles. This procedure may include electrocoagulation and is performed endoscopically.$468.70
- E784Hydrodistention of bladder - general anaestheticAn add-on procedure to a diagnostic cystoscopy, involving the distention of the bladder with fluid, performed under general anaesthetic.$53.45
- E786Resection or incision bladder neck, femaleEndoscopic surgical procedure for the resection or incision of the bladder neck in a female patient, performed as an addition to a primary cystoscopy service.$106.85
- E787Resection or incision bladder neck, maleA surgical procedure performed via cystoscopy that involves the resection or incision of the bladder neck in a male patient. This procedure is billed in addition to a primary cystoscopy.$279.20
- E788Ureteral meatotomyA surgical procedure for endoscopic incision of the ureteral opening into the bladder, performed by any means. This is an add-on service, billed in conjunction with a primary cystoscopy.$99.70
Stones
- Z630Extracorporeal shock wave lithotripsyA non-invasive procedure using shock waves to break up kidney stones.$320.65
- E760Ureteroscopy with removal of calculusThis is an add-on fee payable in addition to diagnostic ureteroscopy (Z628) for the removal of a calculus.$174.55
- E761Intracorporeal lithotripsyAn add-on to diagnostic ureteroscopy (`Z628`) for the fragmentation of stones within the urinary tract using any intracorporeal method.$100.75
- E822Ureteroscopy to upper third of ureter or renal pelvisThis is an add-on service to Z628 for extending the diagnostic ureteroscopy to the upper third of the ureter or the renal pelvis. It is only payable in conjunction with the primary procedure.$39.60
- E819Diagnostic ureteroscopy of second ureterAdd-on fee for performing a diagnostic ureteroscopy on the second ureter. This service must be claimed in addition to Z628 for the primary ureteroscopy.$54.65
- E820Biopsy of ureter and/or pelvis using ureteroscopeThis is an add-on service for a biopsy of one or more sites in the ureter and/or renal pelvis performed with a ureteroscope during a diagnostic ureteroscopy (Z628).$53.35
- Z628Cystoscopy and diagnostic Ureteroscopy - above intramuralA surgical procedure involving cystoscopy and diagnostic ureteroscopy for the region `above intramural`. This procedure is not eligible for payment with `<billingCode>Z638</billingCode>`. Add-on codes for additional procedures may apply.$125.70
- S470Cystoscopy with manipulation and/or removal of calculus and retrograde pyelogramAn endoscopic procedure for cystoscopy involving the manipulation and/or removal of a urinary calculus, with an optional retrograde pyelogram if required, as described on page <SectionPages>T3</SectionPages>:<PDFPageNumber>709</PDFPageNumber>.$240.65
- E772Percutaneous removal of staghorn calculus filling renal pelvis and extending into calycesAdd-on fee for the percutaneous removal of a staghorn calculus that fills the renal pelvis and extends into the calyces. This code is billed in addition to Z627 (Removal of renal calculi).$188.15
- S405Nephrolithotomy or pyelolithotomyNephrolithotomy or pyelolithotomy - open or laparoscopic$603.45
- Z629Percutaneous nephrostomyA surgical procedure (`<billingCode>Z629</billingCode>`) to create a percutaneous opening into the kidney for drainage. Eligible for surgeon and anaesthetist fees.$164.40
- Z623Insertion of stentA percutaneous surgical procedure for the insertion of a stent into the kidney or upper urinary tract.$101.95
Prostate
- S655Endoscopic removal or destruction of prostatic tissueA surgical procedure for the endoscopic transurethral resection of the prostate. This service may include other procedures such as cystoscopy, meatotomy, dilatation of stricture, internal urethrotomy, or vasectomy, which are not separately billable.$483.05
- S654Endoscopic removal or destruction of prostatic tissue for residual or regrowthA transurethral resection of the prostate for residual or regrowth of tissue, only payable if performed within one year of a previous prostatectomy by the same surgeon. This is an endoscopic surgical procedure.$440.85
- S639Laser enucleation of the prostate including morcellation of prostatic tissue$550.00
- S650Prostatectomy - simple, by retropubic or suprapubic approachPerforms a simple retropubic prostatectomy, which is the surgical removal of the prostate gland through an incision in the lower abdomen. This procedure may include the removal of bladder stones and a vasectomy if performed, but does not include a separate investigative cystoscopy.$689.75
- S651Prostatectomy - radicalA radical retropubic prostatectomy, which is the surgical removal of the prostate gland. This procedure may be performed with or without the removal of bladder stones and includes vasectomy, repair of the bladder neck, and/or vesiculectomy when rendered.$1174.70
- S652Staging pelvic lymphadenectomy for prostatic cancerA surgical procedure for staging prostatic cancer via pelvic lymphadenectomy, performed either through open surgery or laparoscopically. The procedure requires, at a minimum, the removal of bilateral obturator nodes. An add-on premium, <billingCode>E792</billingCode>, is payable for the laparoscopic approach.$431.20
Kidney & ureter
- S416NephrectomySurgical removal of a kidney performed via a thoraco-abdominal approach or as a radical nephrectomy. This is a major surgical procedure eligible for surgeon, assistant, and anaesthetist fees.$972.35
- S411Partial or heminephrectomyA surgical procedure for the partial or heminephrectomy, which is the removal of part of a kidney. This procedure can be performed as an open surgery or laparoscopically with an add-on premium.$972.35
- S436Donor nephrectomySurgical removal of a donor's kidney for transplantation, which can be unilateral or bilateral. This fee includes renal perfusion with hypothermia when performed by the surgeon.$700.30
- S435Kidney transplantSurgical procedure for transplanting a kidney into a recipient. This fee is for the surgeon's service and does not include separate fees for anaesthesia, surgical assistance, or immunosuppressive therapy.$1585.10
- S401Drainage of renal or perirenal abscessA surgical procedure involving the incision and drainage of an abscess located within the kidney.$440.95
- S449Ureterectomy, including ureterovesical junctionUreterectomy, including ureterovesical junction. A second assistant's services are eligible for payment without special authorization.$477.50
- S427Bladder flap (Boari) - to include re-implantation of ureterA surgical procedure to create a bladder flap (Boari procedure), which includes the re-implantation of the ureter. An additional percentage-based premium is available for laparoscopic performance.$705.80
- S460Ureterolysis for periureteral fibrosis - unilateralA surgical procedure for the unilateral release of the ureter from constricting periureteral fibrous tissue. This procedure is not payable if performed with another surgical procedure on the same day by the same physician.$480.25
- E792Laparoscopic approach premiumA premium that adds 25% to the surgical fee of specific urogenital and male genital procedures when performed laparoscopically.+25%
Scrotum, testis & penis
- S626VasectomySurgical procedure for male sterilization involving the vas deferens, which can be performed unilaterally or bilaterally using any technique.$115.10
- S573Circumcision - for patients aged one year or olderMedically necessary circumcision for physical symptomatology in patients aged one year or older. This service is not insured for ritual, religious, cosmetic, or neonatal phimosis reasons, as per notes on page <SectionPages>U1</SectionPages> of the Schedule.$225.95
- S577Circumcision - for infants less than one year of ageSurgical circumcision for infants under one year of age. This procedure is only insured when medically necessary for physical symptomatology, not for ritual or cosmetic reasons.$201.60
- S589Orchidectomy - unilateralA surgical procedure involving the unilateral removal of a testis.$182.90
- S591Orchidopexy for undescended testisSurgical repair for an undescended testis (orchidopexy), performed in one or two stages. This service includes hernia repair when required.$465.20
- S593Exploration for undescended testicle, without orchidopexySurgical exploration for an undescended testicle where orchidopexy (repositioning of the testicle) is not performed. This procedure is eligible for surgeon, assistant, and anaesthesia fees.$465.20
- S598Orchidectomy - unilateral, radical for malignancyA surgical procedure for the unilateral removal of a testicle for malignancy. This procedure is eligible for surgeon, assistant, and anaesthetist fees.$361.45
- S600Reduction of torsion of testis or appendix testis and orchidopexySurgical correction for torsion (twisting) of the testis or appendix testis. This procedure includes orchidopexy, the fixation of one or both testicles to prevent recurrence.$456.95
- S611Hydrocele excision - unilateralA surgical procedure for the unilateral excision of a hydrocele, a fluid-filled sac around a testicle. This code is not to be used with a hernia repair; see `<billingCode>E727</billingCode>` instead.$222.80
- S630Hydrocele excision - singleSurgical procedure for the excision of a single hydrocele from the spermatic cord.$220.10
- S631Varicocele excision - singleSurgical excision of a single varicocele, a procedure performed on the spermatic cord.$220.10
- S601Spermatocele or spermatic granuloma excisionSurgical excision of a spermatocele (a cyst of the epididymis) or a spermatic granuloma. This procedure is listed under Male Genital Surgical Procedures.$222.80
- S596Insertion of testicular prosthesisSurgical insertion of a testicular prosthesis. This procedure is not eligible for payment if performed at the same time as an orchidectomy.$212.20
- Z701Condylomata - local anaestheticSurgical procedure for the treatment of condylomata on the penis, performed using a local anaesthetic.$34.95
- Z767Condylomata - general anaestheticSurgical procedure for the treatment of condylomata (genital warts) that requires the use of a general anaesthetic. This service is intended for the surgeon's professional fee.$84.25
- Z703AbscessSurgical incision and drainage of an abscess of the testis.$59.10
- Z707Incision of abscessA surgical procedure involving the incision and drainage of an abscess located on the epididymis.$59.10
- Z704Testis biopsy - singleA surgical procedure for the biopsy of a single testis.$59.10
- S597Penile prosthesis for impotenceSurgical implantation of a penile prosthesis for the treatment of impotence.$424.45
- S579Chordee repairSurgical repair of chordee, an abnormal curvature of the penis. This procedure is typically performed by a urologist and includes anaesthesia and may involve a surgical assistant.$231.35
Bladder surgery & incontinence
- S484Cystectomy - complete, without transplantA surgical procedure for the complete removal of the urinary bladder, without any form of transplant or urinary diversion.$848.90
- S453Cystectomy - with ureteroileal conduitSurgical removal of the bladder (complete cystectomy) with the creation of a ureteroileal conduit for urinary diversion.$1340.40
- S483Cystectomy - partial with reimplantation of ureterSurgical excision of a portion of the bladder, for conditions such as a tumour or diverticulum, which also involves the reimplantation of one ureter into the remaining bladder.$592.05
- S490Cystectomy - partial with reimplantation of uretersSurgical removal of a part of the bladder (partial cystectomy) for conditions like tumours, including the reimplantation of both ureters into the remaining bladder.$786.35
- S478Cystotomy or cystostomyA surgical procedure involving an incision into the bladder (cystotomy) or the creation of a new opening into the bladder (cystostomy).$215.80
- Z480Cystotomy with trochar and cannula and insertion of tubeA surgical procedure for creating an opening into the bladder (cystotomy) using a trochar and cannula, which includes the insertion of a tube.$91.45
- S539Insertion of artificial urinary sphincterSurgical insertion of an artificial urinary sphincter, a procedure typically performed to treat severe urinary incontinence.$832.65
- S540Revision or removal of artificial urinary sphincterA surgical procedure for the revision or removal of a previously implanted artificial urinary sphincter. This service is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees.$257.05
- 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%
- G869Botulinum toxin injection(s) of bladder detrusor muscleProvides for botulinum toxin injections into the bladder detrusor muscle. Payment is restricted to patients with symptomatic refractory overactive bladder and is limited to one treatment per day and one every 12 weeks. Subsequent treatments require documentation of the patient's response.$150.00
Urethra
- S532Urethrotomy - transurethral (visual)A surgical procedure for the incision of the urethra performed transurethrally under visual guidance. A repeat procedure within 6 months by the same surgeon should be billed as <billingCode>S538</billingCode>.$178.00
- S538Urethrotomy - repeat procedure within 6 months by same surgeonRepeat transurethral (visual) urethrotomy performed within 6 months of the initial procedure (<billingCode>S532</billingCode>) by the same surgeon.$102.65
- S547Removal of foreign body or calculusA surgical procedure for the endoscopic removal of a foreign body or calculus from the urethra, billable by the surgeon (suffix A) and anaesthesiologist (suffix C).$182.90
- Z618Urethral endoscopy with biopsyA surgical procedure to visually inspect the urethra using an endoscope and obtain a tissue sample (biopsy).$83.30
- S543Prolapse urethraSurgical excision for a prolapsed urethra. This procedure has 7 anaesthesia base units and 6 surgical assistant base units.$127.35
How to use this urology code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to urology (specialty 35) — 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 urology 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 urology bill?
The consultations & assessments — office section of this set starts with A355 (Consultation). 4 codes are listed in that section.
What is in the Urology code set?
107 OHIP billing codes across 10 sections: Consultations & assessments — office; Hospital in-patient; Office procedures & diagnostics; Cystoscopic procedures; Stones; Prostate; Kidney & ureter; Scrotum, testis & penis; Bladder surgery & incontinence; Urethra. Urology consultations, office cystoscopy and urodynamics, cystoscopic procedures, stones, prostate, kidney and ureter, scrotal and penile surgery, bladder and urethra.
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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