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Billing code

Z634A — Cystoscopic excision of multiple bladder tumours

Multiple bladder tumour removal

Bill for cystoscopic excision of multiple bladder tumours, including base and adjacent muscle.

Watch for: Don't bill cystoscopy Z606 separately when it is done with the tumour excision.

Code

Z634A

Description

Cystoscopic excision of multiple bladder tumours

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

Cystoscopic excision of multiple bladder tumours, including base and adjacent muscle.

What it covers

Z634 is cystoscopic excision of multiple bladder tumours, including the base and adjacent muscle and electrocoagulation if necessary (T7).

The excision codes are chosen by tumour size and number: Z632 single 1–2 cm, Z633 single over 2 cm, Z634 multiple tumours (T7).

Billing rules

• No additional claim for cystoscopy (Z606) when done at the same time as excision of tumour(s) (T8).
• Bladder 'E' add-ons on T7 are payable with this code unless noted otherwise (T6).
• No extra claim for examination under anaesthesia at cystoscopy (T6).
• Independent operative procedure (Z code): if you did the major pre-operative visit in the prior 12 months, only a partial assessment is payable before it that day; if the major pre-operative visit is the same day, no other assessment before it (SP4).
• Age premium of 10–30% for patients under 16 (GP64).

Often billed with

• E751 insertion of chemotherapeutic agent(s), a bladder add-on payable with Bladder Z codes (T6, T7).

Common rejections

• ADH: OHIP describes this as 'Cannot be billed together': cystoscopy Z606 isn't billed separately with tumour excision (T8).

Related codes: Z632, Z633, Z606, E781, E751, Z610

Source: Schedule of Benefits (July 1, 2026), Urogenital and Urinary Surgical Procedures, Bladder, page T7; bladder and urethra preamble T6.

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