OHIP Billing Codes

Specialty: 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

Destruction

Z548 Cauterization of fissure $34.90
Z758 Fulguration of condylomata - general anaesthetic $97.65
Z549 Fulguration of condylomata - local anaesthetic $30.95

Endoscopy

Z543 Anoscopy (proctoscopy) $8.70
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
Z536 Sigmoidoscopy with or without anoscopy - with biopsy(ies) $44.55
Z592 Sigmoidoscopy with or without anoscopy - with decompression of volvulus $49.40
Z535 Sigmoidoscopy with or without anoscopy - with rigid scope $36.80
Z749 Subsequent procedure (within three months following previous endoscopic procedure) $72.55

Excision

Z546 Barron ligation(s) (not to exceed 6 in any one year) $34.60
Z566 Barron ligation(s) plus cryotherapy (not to exceed 6 in any one year) $39.10
Z752 Biopsy of rectosigmoid or above for Hirschsprungs disease $82.35
S218 Colon reconstruction following Hartmann procedure $1,086.75
Z565 Complete haemorrhoidectomy using cryotherapy and/or Barron ligation(s) including rectal dilation $99.60
Z757 Excision of benign anal lesion(s) $47.15
S251 Fistulainano $213.15
S247 Haemorrhoidectomy, with or without sigmoidoscopy or repair of fissure(s) and/or sphincterotomy and/or anal dilation $260.15
S217 Hartmann procedure $1,063.60
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
S249 Local excision for malignancy $291.05
S162 Local excision of lesion of intestine $528.85
Z755 Polyps or tumours of rectum or sigmoid * - electrocoagulation base 2 to 5 cm, inclusive $142.40
Z761 Polyps or tumours of rectum or sigmoid * - electrocoagulation base over 5 cm $219.90
Z753 Polyps or tumours of rectum or sigmoid * - electrocoagulation base under 2 cm $24.25
Z784 Polyps or tumours of rectum or sigmoid * - excision and suture base 2 to 5 cm, inclusive $213.50
Z785 Polyps or tumours of rectum or sigmoid * - excision and suture base over 5 cm $582.95
Z754 Polyps or tumours of rectum or sigmoid * - excision base under 2 cm $82.35
S222 Presacral or transsacral proctotomy and excision of lesion $474.35
S214 Proctectomy - Abdominoperineal resection or pull through $1,524.20
S213 Proctectomy - Anterior resection or proctosigmoidectomy (anastomosis below peritoneal reflection) $1,204.50
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
S215 Two surgeon team - abdominal surgeon $1,107.50
S216 Two surgeon team - perineal surgeon $459.05

Incision

Z544 Biopsy $34.90
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
S243 Sphincterotomy(ies) under general anaesthesia $200.00
S241 Sphincterotomy(ies) under local anaesthesia $88.20
Z545 Thrombosed haemorrhoid(s) $25.25

Injection

Z575 Haemorrhoid injections (to a maximum of 6 per year) $27.05
Z576 Injections for anal fissure $35.90

Manipulation

Z541 Dilation and/or disimpaction or removal of foreign body under general anaesthetic (as sole procedure) $58.15
Z550 Dilation of anal sphincter $12.05
Z539 Dilation of gastrostomy, enterostomy, colostomy, etc. $25.25
Z756 Fecal disimpaction no anaesthetic $36.80
Z540 Intubation of small intestine (therapeutic or diagnostic) - with or without fluoroscopy $79.80
S248 Peter Lord procedure $43.60
Z538 Reduction of prolapse $25.25

Repair

S223 Anastomosis of rectum $488.20
S257 Anoplasty, for stenosis $275.05
S256 Excision of scar, for stenosis $142.40
S260 High imperforate anus repair (supralevator) $1,801.00
S253 Low imperforate anus repair $1,224.00
S227 Rectal prolapse - abdominal approach $688.75
S225 Rectal prolapse - excision of mucous membrane $239.20
S228 Rectal prolapse - insertion of Thiersh wire $190.85
S226 Rectal prolapse - perineal repair major $356.50
S258 Repair of anal sphincter $275.05
S259 Repair of anal sphincter and ano-rectal ring $356.50

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
S231 Closure of fistula - rectovaginal (any repair) $338.55
S525 Closure of fistula - rectovesical $446.90
S187 Plication of small intestine for adhesions $528.85
S184 Suture of intestine $314.80
S229 Suture of rectum, traumaexternal approach $355.45

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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