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Billing code

S323A — Herniotomy - Inguinal And/or Femoral - Adolescents And Adults

Adult inguinal hernia repair

Bill S323 for inguinal or femoral hernia repair in an adolescent or adult, one side.

Watch for: Add E725 for a recurrent hernia; for both sides, the second repair is paid at 85%.

Code

S323A

Description

Herniotomy - Inguinal And/or Femoral - Adolescents And Adults

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

Inguinal and/or femoral hernia repair in adolescents and adults. The fee is for one side; add E725 when the hernia is recurrent.

What it covers

S323 is herniotomy for an inguinal and/or femoral hernia in an adolescent or adult. Infants are S322 and children S326; strangulated or incarcerated hernias are S329 (without bowel resection) or S330 (with), and a massive sliding inguinal hernia is S345 (S37).

The surgical fee covers preparing the patient, the operation, recovery-room care and follow-up until the first post-operative visit; it doesn't include the major pre-operative visit where the decision to operate was made (SP1–SP2, GP4). The listing carries 6 assistant and 7 anaesthesia basic units (S37).

Billing rules

• Surgical fees are for one side. For a bilateral repair, or another procedure under the same anaesthetic, the major procedure is paid in full and the other(s) at 85% (SP2, SP4).
• Add E725 for a recurrent hernia, or E726 for a repeat recurrent inguinal hernia (more than 2 repairs) (S37–S38).
• The surgeon can't bill the hospital or day care admission assessment unless it is the major pre-operative visit; the major pre-operative visit itself is billed separately, whenever it happened (SP2).
• A block you give for post-operative pain lasting more than 4 hours is billed as G224; shorter-acting blocks and local infiltration aren't payable (GP100–GP101, J70).
• Patients under 16 get the surgical age premium (10% from age 5 to under 16) (GP64).
• E676 can be added (E676A +25% surgeon, E676B +6 assistant units) once per patient per physician when the BMI over 40 is recorded in the chart and the surgery is under general anaesthesia; S323 is on the E676 list (SP6–SP7).
• Marked '#': the fee doesn't include premises, equipment, supplies or staff, which are funded by the hospital budget or ICHSC facility costs; patients can't be charged for them (GP13).

Often billed with

• A034 General Surgery partial assessment, or A035 consultation, at the major pre-operative visit, which the surgical fee doesn't include (SP2, A107).
• G224 when you give a post-operative pain block lasting more than 4 hours yourself (GP100–GP101, J72).
• E725 when the hernia is recurrent (S37).

Common rejections

• VH8: The date of birth on the claim doesn't match OHIP's record for that health number; correct it and resubmit.

Related codes: S322, S326, S328, S329, S330, S345, E725, E726

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Abdomen, Peritoneum and Omentum — Herniotomy, Inguinal and/or femoral, page S37; Surgical Preamble SP1–SP6

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