OHIP Billing Codes
Specialty: Shoulder Arm And Chest
| Code | Description | Fee | ||
|---|---|---|---|---|
|
|
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| D014 | Dislocations Acromioclavicular/sternoclavicular no reduction | $69.15 | ||
| D015 | Dislocations Glenohumeral joint closed reduction without anaesthetic | $50.20 | ||
| D016 | Dislocations Glenohumeral joint closed reduction with anaesthetic | $113.65 | ||
| D017 | Dislocations Glenohumeral joint open reduction, early | $330.35 | ||
| D025 | Dislocations Acromioclavicular/sternoclavicular closed with anaesthetic | $137.25 | ||
| F023 | Fractures Radius and ulna Monteggia open reduction of ulna plus closed reduction radial head | $425.00 | ||
| F042 | Fractures Shaft no reduction | $69.15 | ||
| F043 | Fractures Shaft closed reduction | $150.55 | ||
| F044 | Fractures Shaft open reduction | $668.70 | ||
| F047 | Fractures Tuberosity no reduction | $69.15 | ||
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| F049 | Fractures Tuberosity open reduction (without cuff tear) | $296.40 | ||
| F050 | Fractures Neck with dislocation of head no reduction | $69.15 | ||
| F051 | Fractures Neck with dislocation of head closed reduction | $187.50 | ||
| F052 | Fractures Neck with dislocation of head open reduction | $532.25 | ||
| F053 | Fractures Neck without dislocation of head no reduction | $69.15 | ||
| F054 | Fractures Neck without dislocation of head closed reduction | $136.30 | ||
| F055 | Fractures Neck without dislocation of head open reduction | $525.30 | ||
| F110 | Fractures Clavicle closed reduction with anaesthetic | $63.45 | ||
| F118 | Fractures Clavicle open reduction | $467.95 | ||
| F119 | Fractures Scapula no reduction | $69.15 | ||
| F121 | Fractures Scapula open reduction | $389.05 | ||
| F123 | Fractures Sternum closed reduction | $118.30 | ||
| F124 | Sternum open reduction pleura open (see General Preamble GP12) | $118.30 | ||
| F125 | Sternum pleura closed (see General Preamble GP12) I.C | $118.30 | ||
| F131 | Ribs pleura closed (see General Preamble GP12) I.C | $118.30 | ||
| R214 | Clavicle or Acromion Malignant tumour with reconstruction | $494.10 | ||
| R219 | Phalanx/metacarpal/carpus incision and drainage | $186.60 | ||
| R222 | Incision and Drainage Humerus/clavicle/scapula | $267.90 | ||
| R223 | Incision and Drainage Saucerization with bone graft | $395.70 | ||
| R225 | Incision and Drainage Sequestrectomy | $296.40 | ||
| R228 | Acute | $308.65 | ||
| R235 | Osteotomy glenoid | $284.95 | ||
| R240 | Revision total arthroplasty shoulder | $961.90 | ||
| R260 | Osteotomy humerus | $298.25 | ||
| R292 | Humerus Head | $305.75 | ||
| R294 | Tumours Bone tumours exostosis | $168.50 | ||
| R295 | Tumours Bone tumours simple excision | $295.30 | ||
| R297 | Humerus Malignant tumour with reconstruction | $694.80 | ||
| R298 | Clavicle or Acromion Simple (includes ligament) | $215.85 | ||
| R298 | Clavicle or Acromion Simple (includes ligament) | $215.85 | ||
| R325 | Pseudoarthrosis Humerus | $353.10 | ||
| R329 | Pseudoarthrosis Clavicle | $274.50 | ||
|
E590
rigid external fixation pseudoarthrosis add
|
$77.65 | |||
| R353 | Muscles/soft tissues Scapulopexy congenital elevation | $392.90 | ||
| R353 | Muscles/soft tissues Scapulopexy congenital elevation | $392.90 | ||
| R401 | Dislocations Glenohumeral joint open reduction, recurrent | $428.10 | ||
|
E058
revision/repair following previous glenohumeral joint surgery add 30%
|
||||
| R411 | Shoulder | $228.15 | ||
| R411 | Shoulder | $228.15 | ||
| R416 | Rotator cuff exploration includes acromioplasty, excision of coracoacromial ligament and subacromial bursa but excludes simple excision of clavicle | $211.05 | ||
| R422 | Joint Synovectomy and debridement | $433.65 | ||
| R438 | Humeral prosthesis | $458.25 | ||
| R467 | Shoulder | $478.05 | ||
| R472 | Dislocations Glenohumeral joint open reduction, late | $592.60 | ||
| R487 | Total prosthesis | $785.50 | ||
| R498 | Removal prosthesis/no replacement | $405.20 | ||
| R512 | Joint Excision of subacromial bursa (not to be claimed with R416, R593 or R594) | $215.85 | ||
| R521 | Muscles and tendons radical, e.g. muscle slide | $320.90 | ||
| R522 | Muscle simple | $196.90 | ||
| R523 | Muscle complex | $494.10 | ||
| R526 | Sternomastoid | $302.00 | ||
| R527 | Muscles/soft tissues Muscle transplant pectoralis major | $443.00 | ||
| R527 | Muscles/soft tissues Muscle transplant pectoralis major | $443.00 | ||
| R568 | Muscles/soft tissues Trapezius/sternomastoid transplant | $345.45 | ||
| R568 | Muscles/soft tissues Trapezius/sternomastoid transplant | $345.45 | ||
| R589 | Muscles/soft tissues Tendon repair or release biceps | $231.95 | ||
| R589 | Muscles/soft tissues Tendon repair or release biceps | $231.95 | ||
| R593 | Muscles/soft tissues Rotator cuff repair simple, endtoend or sidetoside (includes acromioplasty, excision of coracoacromial ligament and subacromial bursa ) | $352.30 | ||
| R593 | Muscles/soft tissues Rotator cuff repair simple, endtoend or sidetoside (includes acromioplasty, excision of coracoacromial ligament and subacromial bursa ) | $352.30 | ||
| R594 | Muscles/soft tissues Rotator cuff repair complex (includes implantation into bone, and as required, acromioplasty, excision of coracoacromial ligament, subacromial bursa and excision of distal clavicle) | $508.30 | ||
|
E057
revision/repair following previous rotator cuff surgery add 30%
|
||||
| R594 | Muscles/soft tissues Rotator cuff repair complex (includes implantation into bone, and as required, acromioplasty, excision of coracoacromial ligament, subacromial bursa and excision of distal clavicle) | $508.30 | ||
|
E057
revision/repair following previous rotator cuff surgery add 30%
|
||||
| R596 | Dislocations Acromioclavicular/sternoclavicular late | $292.45 | ||
| R615 | High humerus | $376.75 | ||
| R616 | Shoulder disarticulation | $380.60 | ||
| R617 | Forequarter | $500.80 | ||
| R641 | Clavicle or Acromion Major tumour | $296.40 | ||
| R684 | Shoulder arthroscopy setup, includes when rendered debridement, synovectomy, removal of loose body(ies) and/or screw, drilling of defect or microfracture, and/ or synovial biopsy | $408.05 | ||
|
E478
pinning of osteochondral fragment add
|
$256.60 | |||
|
E484
superior labral anterior posterior (SLAP) repair add
|
$343.40 | |||
|
E485
arthroscopic capsular release for frozen shoulder add
|
$245.35 | |||
| R685 | Muscles/soft tissues Tendon release with tenodesis biceps | $320.90 | ||
| R685 | Muscles/soft tissues Tendon release with tenodesis biceps | $320.90 | ||
| R956 | Pseudoarthrosis Humerus circular external fixation | $297.25 | ||
|
E590
rigid external fixation pseudoarthrosis add
|
$77.65 | |||
| R957 | Osteotomy Single level correction circular external fixation | $520.60 | ||
| R958 | Osteotomy Double level correction circular external fixation | $651.25 | ||
| R959 | Osteotomy Bone transport circular external fixation (less than or equal to 6 cm) | $668.30 | ||
| R960 | Osteotomy Bone transport circular external fixation (greater than 6 cm) | $779.15 | ||
| R961 | Osteotomy Humeral lengthening circular external fixation (less than or equal to 6 cm) | $446.80 | ||
| R962 | Osteotomy Humeral lengthening circular external fixation (greater than 6 cm) | $668.30 | ||
| Z214 | Bone open biopsy or taking of bone graft by other than operating surgeon | $147.70 | ||
| Z219 | Muscle needle biopsy, soft tissue, per site | $31.85 | ||
| Z220 | Bone needle/punch, xray control | $91.50 | ||
| Z223 | Manipulation under general anaesthetic | $50.20 | ||
| Z226 | Soft tissue or bursa, incision and drainage | $99.30 | ||
| Z228 | Soft tissue open | $99.30 | ||
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
-
- Family Practice & Practice In General (00)
- Anaesthesia (01)
- Dermatology (02)
- General Surgery (03)
- Neurosurgery (04)
- Community Medicine (05)
- Geriatrics (07)
- Plastic Surgery (08)
- Cardiac Surgery (09)
- Neurology (18)
- Ophthalmology (23)
- Gastroenterology (41)
- Internal And Occupational Medicine (13)
- Endocrinology & Metabolism (15)
- Nephrology (16)
- Vascular Surgery (17)
- Psychiatry (19)
- Obstetrics And Gynaecology (20)
- Genetics (22)
- Otolaryngology (24)
- Paediatrics (26)
- Infectious Disease (46)
- Laboratory Medicine (28)
- Physical Medicine & Rehabilitation (31)
- Diagnostic Radiology (33)
- Radiation Oncology (34)
- Urology (35)
- Medical Oncology (44)
- Respiratory Disease (47)
- Rheumatology (48)
- Clinical Immunology (62)
- Cardiology (60)
- Hematology (61)
- Nuclear Medicine (63)
- General Thoracic Surgery (64)
- Emergency Medicine
-
- Head And Neck
- Spine And Pelvis
- Chest And Abdomen
- Upper Extremities
- Skeletal Surveys
- Lower Extremities
- Gastrointestinal Tract
- Special Examinations
- Computed Tomography (CT)
- Genitourinary Tract
- Bone Mineral Density (BMD) Measurement
- Obstetrics And Gynaecology
- Miscellaneous Examinations
- Fluoroscopy By Physician With Or Without Spot Films
-
- Laboratory Medicine
- Nerve Blocks For Acute Pain Management
- Injections And Infusions
- Dialysis
- Haematology
- Home And Self Care Services
- Ophthalmology
- Otolaryngology
- Electrocardiography (ECG)
- Cardiovascular
- Nerve Blocks Interventional Pain Injections
- NonInvasive Cardiography
- Neurology
- Gastroenterology
- Allergy
- Urology
- Critical Care
- Nerve Blocks Peripheral / Other Injections
- Gynaecology
- Endocrinology And Metabolism
- Nephrology
- Psychiatry And Respiratory Disease
- Physical Medicine
- Dermatology
- Palliative Care
- Echocardiography
- Neurosurgery
- Sleep Studies
- Anaesthesia
-
- Fractures Of The Spine
- Anterior Spinal Decompression
- Posterior Spinal Decompression
- Posterior Spinal Arthrodesis Following Decompression Or Osteotomy
- Posterior Spinal Arthrodesis As Sole Procedure
- Anterior Spinal Arthrodesis With Instrumentation Without Decompression
- Procedures Involving Neural Elements
- Anterior Spinal Arthrodesis Following Decompression
- Meningocoele And Myelomeningocoele
- Deformities Of The Spine
- Revision Procedures For Spinal Surgery
- Procedures On Musculoskeletal Elements
- Tumours / Infections Of The Spine
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