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Billing code

S063A — Tonsillectomy, with or without adenoidectomy

Tonsil removal

Bill S063 for a tonsillectomy, which may include an adenoidectomy.

Watch for: Don't also bill S065 for an adenoidectomy done at the same time; it is included in S063.

Code

S063A

Description

Tonsillectomy, with or without adenoidectomy

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Tonsillectomy, which may include adenoidectomy.

What it covers

S063 is tonsillectomy and may include adenoidectomy (S2). When 'may include' is used, the services named are part of the listed fee (GP4).

Adenoidectomy alone is S065. Uvulopalatopharyngoplasty (S036) includes tonsillectomy (S2).

Billing rules

• Don't bill S065 for an adenoidectomy done with S063; it is included (S2, GP4).
• Add E839 when done with a flexible endoscope (S2).
• Z298 nasopharynx exam under general anaesthetic is not payable with tonsillectomy and adenoidectomy (P1).
• Surgical procedures on children under 16 get the age premium (10–30% by age) (GP64).
• More than one procedure under the same anaesthetic: 100% for the major procedure and 85% for the others, including bilateral procedures, unless the Schedule says otherwise (SP2).

Often billed with

• E839 flexible endoscope (S2).
• Z914 ventilation tubes at the same operation, under the multiple-procedure rule (SP2).

Related codes: S065, S036, E839, Z298, Z914

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Oral Cavity and Pharynx, page S2.

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