OHIP Billing Codes

Specialty: Intestines Except Rectum

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Code Description Fee

Colonoscopy

Z555 Absence of signs or symptoms or risk factors, 50 years of age or older sigmoid to descending colon $51.95
Z499 Absence of signs or symptoms, family history associated with an increased risk of malignancy (e.g. a first degree relative or at least two second degree relatives with colorectal cancer or a premalignant lesion) sigmoid to descending colon $51.95
Z496 Colonoscopy - For diagnosis or ongoing management - Presence of signs or symptoms sigmoid to descending colon $51.95
Z497 Confirmatory colonoscopy - sigmoid to descending colon $51.95
Z517 Excision of first polyp (10 mm to 19 mm) $150.15
Z516 Excision of first polyp (20 mm to 29 mm) $150.15
Z571 Excision of first polyp greater than or equal to 3mm through colonoscope $150.15
Z765 Excision of obstructive tumour or stricture through colonoscopy - 2 cm or greater $131.75
Z764 Excision of obstructive tumour or stricture through colonoscopy - less than 2 cm $69.80
Z492 Five year follow up of normal colonoscopy (Z499), absence of intervening signs or symptoms - sigmoid to descending $51.95

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Z498 Follow up of abnormal colonoscopy sigmoid to descending colon $51.95
Z491 Follow up of incomplete polyp resection $51.95
Z495 Follow up of unsatisfactory colonoscopy $51.95
Z494 Hereditary (e.g. Familial adenomatous Polyposis or Hereditary NonPolyposis Colorectal Cancer) or other bowel disorders (e.g. inflammatory bowel disease) associated with increased risk of malignancy $51.95
Z513 Hydrostatic Pneumatic dilatation of colon stricture(s) through colonoscope $107.50
Z493 Ten year follow up of normal colonoscopy (Z497, Z555), absence of intervening signs or symptoms sigmoid to descending $51.95

Complete Study - 1 and 2 dimensions

G571 Professional component $96.20
G570 Technical component $118.95

COVID-19 Immunization

G593 COVID-19 vaccine $13.00

Endoscopy

Z560 Duodenoscopy (not to be claimed if Z399 and/or Z400 performed on same patient within 3 months) $92.10
Z512 Endoscopy of ileostomy or colostomy, or reduction of obstructed Koch ileostomy $36.80
Z514 Endoscopy of ileostomy or colostomy, or reduction of obstructed Koch ileostomy - with biopsy $44.55
Z749 Subsequent procedure (within three months following previous endoscopic procedure) $72.55

Excision

S188 Ileostomy - Bowel resection without anastomosis (colostomy and mucous fistula) $770.55
S170 Ileostomy - plus total colectomy plus abdominoperineal resection $2,183.65
S168 Ileostomy - subtotal colectomy $1,260.40
S173 Ileostomy - Two-surgeon team - abdominal $1,812.00
S174 Ileostomy - Two-surgeon team - perineal $533.80
S189 Ileostomy -Intestinal bypass for morbid obesity $951.20
S178 Intestinal obstruction (mechanical) - Intestinal atresia (newborn) $1,512.75
S179 Intestinal obstruction (mechanical) - Meconium ileus $1,512.75
S176 Intestinal obstruction (mechanical) - One stage - with entero-enterostomy $894.85
S180 Intestinal obstruction (mechanical) - One stage - with enterotomy $824.80
S177 Intestinal obstruction (mechanical) - One stage - with resection $1,055.25
S175 Intestinal obstruction (mechanical) - One stage - without resection $712.35
S162 Local excision of lesion of intestine $528.85
Z750 Resection of exteriorized intestine $82.35
S167 Resection with anastomosis - Large intestine any portion $877.95
S171 Resection with anastomosis - Left hemicolectomy with anterior resection or proctosigmoidectomy (anastomosis below peritoneal reflection & mobilization of splenic flexure) $1,128.10
S166 Resection with anastomosis - Small and large intestine terminal ileum, cecum and ascending colon (right hemicolectomy) $899.85
S164 Resection with anastomosis - Small intestine - duodenum $1,015.15
S165 Resection with anastomosis - Small intestine - other $741.45
S169 Resection with anastomosis - Total colectomy with ileorectal anastomosis $1,313.65
S172 Resection with anastomosis - Total colectomy with mucosal proctectomy with ileal pouch, ileoanal anastomosis and loop ileostomy $2,247.70
S183 Revision of ileostomy or colostomy - Cecopexy or sigmoidopexy (as sole procedure) $314.80
S191 Revision of ileostomy or colostomy - Complete reconstruction of continent ileostomy to include valve repair $951.20
S182 Revision of ileostomy or colostomy - full thickness $467.90
S193 Revision of ileostomy or colostomy - Revision of standard ileostomy into continent ileostomy pouch $793.50
S192 Revision of ileostomy or colostomy - Simple revision of continent ileostomy pouch $387.40
S181 Revision of ileostomy or colostomy - skin level $131.75

Incision

S158 Enterotomy - Cecostomy $387.40
S155 Enterotomy - Colonoscopy with laparotomy $387.40
S157 Enterotomy - Colostomy $470.65
S160 Enterotomy - Enteroenterostomy $470.65
S156 Enterotomy - Exteriorization of intestine (Mickulicz) $406.85
S149 Enterotomy - Ileostomy $470.65
S151 Enterotomy - Insertion of feeding enterostomy $356.50
S154 Enterotomy - Large intestine including excision of polyps $406.85
S150 Enterotomy - Small intestine including excision of polyps or biopsy $406.85

Manipulation

Z539 Dilation of gastrostomy, enterostomy, colostomy, etc. $25.25
Z540 Intubation of small intestine (therapeutic or diagnostic) - with or without fluoroscopy $79.80
Z538 Reduction of prolapse $25.25

Sigmoidoscopy

Z580 Sigmoidoscopy (using 60 cm. flexible endoscope) $57.70

Suture

S185 Closure of colostomy or enterostomy with or without resection and/or anastomosis $504.70
S187 Plication of small intestine for adhesions $528.85
S184 Suture of intestine $314.80

The information presented on this page is general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.

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