OHIP Billing Codes

Specialty: Knee

Code	Description	Anes	Asst	Fee
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D031	Dislocations Patella closed reduction with anaesthetic	6		$99.30
D038	Dislocations Knee closed reduction	6		$212.10
D039	Dislocations Knee open reduction	7	6	$315.20
D040	Dislocations Patella closed reduction without anaesthetic	0		$63.45
D041	Dislocations Patella open reduction early	7		$296.40
E498	Debridement (trauma) substantial debridement of 1 or more focal flaps of unstable posttraumatic articular cartilage causing mechanical symptoms, includes when rendered for synovectomy, meniscal trimming and/or chondroplasty	0		$305.00
F021	Fractures Osteochondral open reduction	7	6	$400.30
F085	Fractures Patella no reduction	0		$69.10
F087	Fractures Patella open reduction or excision with or without repair	7	6	$281.20
N285	Exploration and/or decompression and/or transposition and/or neurolysis of major nerve (excluding carpal tunnel nerve)	7	7	$261.30
	E906 basic fee for neurolysis, tumour excision, nerve suture or graft when using operating microscope add 40%
	E925 basic fee for a repeat peripheral nerve procedure, (e.g. repair, transposition, graft or tumour excision) when repair delayed for more than 4 weeks add 30%
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R244	Hemiarthroplasty Revision total arthroplasty knee	8	8	$1,197.90
	E598 with associated patellar replacement or patelloplasty add			$96.50
R248	Hemiarthroplasty Total knee replacement with take down of fusion	8	8	$854.85
	E598 with associated patellar replacement or patelloplasty add			$96.50
R255	Dislocations Patella open reduction late	7	6	$494.10
R312	Excision Patella to include fascial repair	7	6	$282.10
R318	Excision Excision exostosis/cyst patella	6	6	$128.80
R403	Dislocations Patella open reduction repair recurrent dislocation (includes inspection of joint)	7	6	$401.30
R412	Knee with or without removal of loose body	7	6	$212.10
R413	Osteochondritis dissecans with drilling and/or internal fixation	7	6	$272.60
R417	Excision Debridement of joint without synovectomy	7	6	$296.40
R424	Excision Synovectomy	7	6	$439.30
R426	Denervation elbow	7	6	$263.20
R429	Excision Baker's cyst Meniscectomy	6	6	$246.15
R431	Excision Baker's cyst simple	6	6	$151.50
R434	Excision Baker's cyst extensive	7	6	$269.80
R441	Hemiarthroplasty Total replacement/both compartments	8	8	$632.35
	E598 with associated patellar replacement or patelloplasty add			$96.50
R442	Hemiarthroplasty Replacement Liner	8	8	$360.35
R444	Joint	7	6	$196.90
R482	Hemiarthroplasty single component (e.g. MacIntosh)	6	6	$358.75
	E598 with associated patellar replacement or patelloplasty add			$96.50
R483	Hemiarthroplasty double component (e.g. Marmar)	7	8	$632.35
	E598 with associated patellar replacement or patelloplasty add			$96.50
R493	Ankle total replacement	10	8	$1,201.15
R496	Hemiarthroplasty Removal of hemiarthroplasty without replacement	7	6	$247.10
R497	Hemiarthroplasty Removal of total arthroplasty without replacement	6	6	$375.80
R501	Excision Baker's cyst Cysts of meniscus	6	6	$128.80
R506	Excision Prepatellar bursae	6	6	$152.45
R508	Meniscus Suturing of medial or lateral meniscus	7	6	$247.10
R509	Patellar arthroplasty	7	6	$246.45
R515	Dislocations Patella open reduction Congenital dislocation knee (open)	7	6	$494.10
R516	Muscles/Tendons Tenotomy Release patellar retinaculum	7	6	$164.70
R539	Ligaments removal of synthetics	7	6	$217.75
R542	Ligaments extensive ligament reconstruction (including synthetics) includes when rendered preparation of intracondyar notch	7	6	$528.25
	E059 revision/repair following previous reconstruction of knee ligaments add 30%
R564	Muscles/Tendons Tenotomy open one	7	6	$236.65
R566	Muscles/Tendons Tenotomy open multiple	6	6	$258.40
R571	Muscles/tendons Lengthening of hamstrings Tendon or muscle transfer	7	6	$313.30
	E049 each additional add			$88.95
R584	Muscles/Tendons Tenoplasty one	7	6	$147.70
	E050 each additional add			$78.60
R587	Muscles/tendons Quadriceps repair reconstructive	7	6	$394.80
R589	Muscles/soft tissues Tendon repair or release biceps	7	6	$231.95
R599	Ligaments simple one	6	6	$369.25
R625	GrittiStokes or Callander	7	6	$311.40
R648	Oral vestibuloplasty with skin graft	6	6	$313.30
R687	Knee arthroscopy setup, includes when rendered synovial biopsy and/or resection or trimming of plica	7	6	$99.30
	E476 removal of symptomatic loose body(ies) and/or screw add			$195.85
	E489 microfracture and/or abrasion arthroplasty, for osteoarthritic cartilage deficiency (includes removal of loose body(ies) add			$255.05
	E491 lateral release add			$164.70
	E492 for diseased synovium, anterior, posterior or complete add			$235.95
	E494 1 or more compartments, must include substantial debridement of pathologic articular cartilage and includes when rendered synovectomy, meniscal trimming and/or chondroplasty add			$305.00
	E495 menisectomy, partial or total, for symptomatic meniscal tear add			$245.30
	E496 repair medial or lateral meniscus, includes when rendered debridement of attachment site add			$343.40
R699	Knee arthroscopy setup, nondegenerative disorders of the knee or acutely locked knee.	7	6	$99.30
Z219	Muscle needle biopsy, soft tissue, per site	0		$31.85
Z222	Manipulation under general anaesthetic	6		$24.60
Z226	Soft tissue or bursa, incision and drainage	7		$99.30
Z237	Muscles/Tendons Tenotomy closed one	6		$50.20
Z238	Muscles/Tendons Tenotomy closed multiple	7		$73.80
Z242	Bone open	7	6	$196.90
Z870	Bone punch, xray control	6		$123.15

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