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Billing code

S065A — Adenoidectomy

Adenoidectomy alone

Bill S065 for removal of the adenoids alone.

Watch for: When the tonsils are also removed, bill S063 only; the adenoidectomy is included.

Code

S065A

Description

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

Adenoidectomy (removal of the adenoids) alone.

What it covers

S065 is adenoidectomy (S2). Tonsillectomy that may include adenoidectomy is S063 (S2).

Billing rules

• Use S063 when the tonsils are also removed; adenoidectomy is included in S063 (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: S063, E839, Z914, Z912, Z298

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

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