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OHIP Billing Codes
Specialty: Knee
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| Code | Description | Anes | Asst | Fee |
|---|---|---|---|---|
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Arthrodesis |
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| R468 | Knee | 6 | 6 | $402.75 |
Arthroplasty |
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| R483 | Hemiarthroplasty - double component (e.g. Marmar) | 7 | 8 | $619.90 |
| R496 | Hemiarthroplasty - Removal of hemiarthroplasty without replacement | 7 | 6 | $242.25 |
| R497 | Hemiarthroplasty - Removal of total arthroplasty without replacement | 6 | 6 | $368.40 |
| R442 | Hemiarthroplasty - Replacement Liner | 8 | 8 | $353.25 |
| R244 | Hemiarthroplasty - Revision total arthroplasty knee | 8 | 8 | $1,174.30 |
| R482 | Hemiarthroplasty - single component (e.g. MacIntosh) | 6 | 6 | $351.70 |
| R248 | Hemiarthroplasty - Total knee replacement with take down of fusion | 8 | 8 | $838.00 |
| R441 | Hemiarthroplasty -Total replacement/both compartments | 8 | 8 | $631.20 |
| R509 | Patellar arthroplasty | 7 | 6 | $241.60 |
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Arthroscopy |
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| R493 | Ankle total replacement | 10 | 8 | $1,199.00 |
| E498 | Debridement (trauma) - substantial debridement of 1 or more focal flaps of unstable post-traumatic articular cartilage causing mechanical symptoms, includes when rendered for synovectomy, meniscal trimming and/or chondroplasty | 0 | $299.00 | |
| E493 | Drilling of defect (includes removal of loose body(ies) | 0 | $251.55 | |
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R687
Knee arthroscopy setup, includes when rendered synovial biopsy and/or resection or trimming of plica
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$97.35 | |||
| R699 | Knee arthroscopy set-up, non-degenerative disorders of the knee or acutely locked knee. | 7 | 6 | $97.35 |
| R687 | Knee arthroscopy setup, includes when rendered synovial biopsy and/or resection or trimming of plica | 7 | 6 | $97.35 |
Arthrotomy |
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| R412 | Knee with or without removal of loose body | 7 | 6 | $207.90 |
| R413 | Osteochondritis dissecans with drilling and/or internal fixation | 7 | 6 | $267.25 |
Complete Study - 1 and 2 dimensions |
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| G571 | Professional component | 0 | $96.20 | |
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G400
Physician-in-charge - 1st day
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$223.10 | |||
| G570 | Technical component | 0 | $118.95 | |
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G400
Physician-in-charge - 1st day
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$223.10 | |||
COVID-19 Immunization |
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| G593 | COVID-19 vaccine | 0 | $13.00 | |
Excision |
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| R501 | Excision - Baker's cyst - Cysts of meniscus | 6 | 6 | $126.25 |
| R434 | Excision - Baker's cyst - extensive | 7 | 6 | $264.50 |
| R429 | Excision - Baker's cyst - Meniscectomy | 6 | 6 | $241.30 |
| R431 | Excision - Baker's cyst - simple | 6 | 6 | $148.50 |
| R417 | Excision - Debridement of joint without synovectomy | 7 | 6 | $290.55 |
| R318 | Excision - Excision exostosis/cyst patella | 6 | 6 | $126.25 |
| R312 | Excision - Patella - to include fascial repair | 7 | 6 | $276.55 |
| R506 | Excision - Prepatellar bursae | 6 | 6 | $149.45 |
| R424 | Excision - Synovectomy | 7 | 6 | $430.65 |
Incision and Drainage |
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| R444 | Joint | 7 | 6 | $193.00 |
Reconstruction |
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| R539 | Ligaments - removal of synthetics | 7 | 6 | $213.45 |
| R599 | Ligaments - simple - one | 6 | 6 | $361.95 |
| R508 | Meniscus - Suturing of medial or lateral meniscus | 7 | 6 | $242.25 |
| R584 | Muscles/Tendons - Tenoplasty - one | 7 | 6 | $144.80 |
| Z238 | Muscles/Tendons - Tenotomy - closed - multiple | 7 | $72.35 | |
| Z237 | Muscles/Tendons - Tenotomy - closed - one | 6 | $49.20 | |
| R564 | Muscles/Tendons - Tenotomy - open - one | 7 | 6 | $232.00 |
| R516 | Muscles/Tendons - Tenotomy - Release patellar retinaculum | 7 | 6 | $161.45 |
Reduction |
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| D038 | Dislocations - Knee - closed reduction | 6 | $207.90 | |
| D039 | Dislocations - Knee - open reduction | 7 | 6 | $309.00 |
| D031 | Dislocations - Patella - closed reduction - with anaesthetic | 6 | $97.35 | |
| D040 | Dislocations - Patella - closed reduction - without anaesthetic | 0 | $62.20 | |
| R515 | Dislocations - Patella - open reduction - Congenital dislocation knee (open) | 7 | 6 | $484.35 |
| D041 | Dislocations - Patella - open reduction - early | 7 | $290.55 | |
| R255 | Dislocations - Patella - open reduction - late | 7 | 6 | $484.35 |
| R403 | Dislocations - Patella - open reduction - repair recurrent dislocation (includes inspection of joint) | 7 | 6 | $422.15 |
| F085 | Fractures - Patella - no reduction | 0 | $67.75 | |
| F087 | Fractures - Patella - open reduction or excision with or without repair | 7 | 6 | $288.25 |
The information presented on this page is general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.
OHIP Billing Codes by Specialty
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- Anaesthesia (01)
- Cardiac Surgery (09)
- Cardiology (60)
- Clinical Immunology (62)
- Community Medicine (05)
- Critical Care Medicine (11)
- Dermatology (02)
- Diagnostic Radiology (33)
- Emergency Medicine
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- Family Practice & Practice In General (00)
- Family Practice And Practice In General (00)
- Family Practive And Practive In General
- Gastroenterology (41)
- General Surgery (03)
- General Thoracic Surgery (64)
- Genetics (22)
- Geriatrics (07)
- Hematology (61)
- Infection Disease (46)
- Infectious Disease (46)
- Internal And Occupational Medicine (13)
- Internal And Ocucpational Medicine (13)
- Laboratory Medicine (28)
- Medical Oncology (44)
- Nephrology (16)
- Neurology (18)
- Neurosurgery (04)
- Nuclear Medicine (63)
- Obstetrics And Gynaecology (20)
- Ophthalmology (23)
- Opthalmology (23)
- Orthopaedic Surgery (06)
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- Otolaryngology (24)
- Paediatrics (26)
- Physical Medicine & Rehabilitation (31)
- Plastic Surgery (08)
- Psychiatry (19)
- Radiation Oncology (34)
- Respiratory Disease (47)
- Rheumatology (48)
- Urology (35)
- Vascular Surgery (17)
-
- Bone Mineral Density (BMD) Measurement
- Chest And Abdomen
- Computed Tomography (CT)
- Fluoroscopy - By Physician With Or Without Spot Films
- Gastrointestinal Tract
- Genitourinary Tract
- Head And Neck
- Lower Extremities
- Miscellaneous Examinations
- Obstetrics And Gynaecology
- Skeletal Surveys
- Special Examinations
- Spine And Pelvis
- Upper Extremities
-
- Allergy
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- Cardiovascular
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- Endocrinology And Metabolism
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- Injections And Infusions
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-
- Anaesthesiologists' Services
- Assessments
- Emergency Department By Emergency Department Physician
- Emergency Department Sessional Fees
- General Information
- Hospital And Institutional Consultations And Assessments
- Other Premiums
- Special Visit Premiums
- Special Visit Premiums - Long-Term Care Institution
- Supportive Care/Monitoring By Surgical Assistant Of Anaesthesiologist
- Surgical Assistants' Services
- Temporary COVID-19 Service
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- Anterior Spinal Arthrodesis Following Decompression
- Anterior Spinal Arthrodesis With Instrumentation Without Decompression
- Anterior Spinal Decompression
- Deformities Of The Spine
- Fractures Of The Spine
- Meningocoele And Myelomeningocoele
- Posterior Spinal Arthrodesis As Sole Procedure
- Posterior Spinal Arthrodesis Following Decompression Or Osteotomy
- Posterior Spinal Decompression
- Procedures Involving Neural Elements
- Procedures On Musculoskeletal Elements
- Revision Procedures For Spinal Surgery
- Tumours / Infections Of The Spine
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