Billing code
Z558A — Endoscopic Retrograde Cholangiopancreatography (ercp) - Including Sphincterotomy And May Include Removal Of One Or More Bile Duct Stones
ERCP with sphincterotomy
Bill for ERCP including sphincterotomy; removal of bile duct stones is included when done.
Watch for: Don't bill stone removal separately; E816 lithotripsy needs confirmed stones that failed standard extraction.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $300.25 | $0.00 | $0.00 | $95.76 | $95.76 |
- Code
- Z558A
- Description
- Endoscopic Retrograde Cholangiopancreatography (ercp) - Including Sphincterotomy And May Include Removal Of One Or More Bile Duct Stones
- 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
ERCP including sphincterotomy, which may include removal of one or more bile duct stones.
What it covers
Z558 is ERCP including sphincterotomy, and may include removal of one or more bile duct stones (S30).
When the description says 'may include', those parts are optional but are included in the fee when done (GP7). Plain ERCP with cannulation is Z561 (S30).
Billing rules
- Stone removal is included when done and is not billed separately (S30, GP7).
- E816 electrohydraulic lithotripsy is only payable for confirmed choledocholithiasis that is refractory to standard extraction methods (S30).
- Add-ons payable with Z561, Z558 or Z760: E702 biopsies, E666 manometry, E662 intraductal brushing or biopsy, E668 minor papilla cannulation, E680/E681 stents, E669 with oesophagoscopy-gastroscopy, E816 lithotripsy (S30).
- Anaesthesia is 6 basic units (S30).
- Patients under 16 get an age premium of 10% to 30% (GP64).
- It is a Z-code (IOP): if you decided on it at a visit in the past 12 months, only a partial assessment is payable that day before it (SP4 §13).
Often billed with
- E680 first endobiliary prosthesis or pancreatic stent (maximum 1), E681 each additional (maximum 3) (S30).
- E669 when an oesophagoscopy-gastroscopy is done with the ERCP (S30).
- E816 electrohydraulic lithotripsy, only for confirmed choledocholithiasis refractory to standard extraction (S30).
Related codes: Z561, Z760, E816, E680, E681, E669, Z593
Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Biliary Tract, page S30.
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