OHIP Billing Codes
Specialty: Musculoskeletal System Surgical Procedures
Category: Shoulder Arm And Chest
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| Code | Description | Anes | Asst | Fee |
|---|---|---|---|---|
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Amputation |
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| R617 | Forequarter | 15 | 10 | $490.95 |
| R615 | High humerus | 6 | 6 | $423.30 |
| R616 | Shoulder disarticulation | 9 | 9 | $373.10 |
Arthrodesis |
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| R467 | Shoulder | 6 | 6 | $468.65 |
Arthroplasty |
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| R438 | Humeral prosthesis | 10 | 6 | $449.20 |
| R498 | Removal prosthesis/no replacement | 8 | 6 | $397.20 |
| R240 | Revision total arthroplasty shoulder | 15 | 9 | $942.95 |
| R487 | Total prosthesis | 10 | 8 | $784.05 |
Arthroscopy |
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| 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 | 10 | 6 | $400.00 |
Arthrotomy |
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| R411 | Shoulder | 7 | 6 | $223.65 |
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Biopsy |
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| Z220 | Bone - needle/punch, xray control | 6 | $89.70 | |
| R222 | Incision and Drainage - Humerus/clavicle/scapula | 7 | 6 | $262.60 |
| R223 | Incision and Drainage - Saucerization with bone graft | 7 | 6 | $387.90 |
| R225 | Incision and Drainage - Sequestrectomy | 7 | 6 | $290.55 |
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 | |
Deformity |
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| R960 | Osteotomy - Bone transport - circular external fixation (greater than 6 cm) | 6 | 6 | $763.80 |
| R959 | Osteotomy - Bone transport - circular external fixation (less than or equal to 6 cm) | 6 | 6 | $655.15 |
| R958 | Osteotomy - Double level correction circular external fixation | 6 | 6 | $638.40 |
| R235 | Osteotomy - glenoid | 6 | 6 | $279.35 |
| R962 | Osteotomy - Humeral lengthening - circular external fixation (greater than 6 cm) | 6 | 6 | $655.15 |
| R961 | Osteotomy - Humeral lengthening - circular external fixation (less than or equal to 6 cm) | 6 | 6 | $438.00 |
| R260 | Osteotomy - humerus | 7 | 6 | $559.25 |
| R957 | Osteotomy - Single level correction circular external fixation | 6 | 6 | $510.35 |
Dislocations - Acromio-clavicular/sterno-clavicular |
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| D023 | Open Reduction | 7 | 6 | $231.10 |
Examination and Manipulation |
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| Z223 | Manipulation under general anaesthetic | 6 | $49.20 | |
Excision |
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| R641 | Clavicle or Acromion - Major tumour | 7 | 6 | $290.55 |
| R214 | Clavicle or Acromion - Malignant tumour with reconstruction | 6 | 6 | $484.35 |
| R298 | Clavicle or Acromion - Simple (includes ligament) | 7 | 6 | $250.25 |
| R292 | Humerus - Head | 6 | 6 | $299.75 |
| R297 | Humerus - Malignant tumour with reconstruction | 6 | 6 | $681.10 |
| R512 | Joint - Excision of subacromial bursa (not to be claimed with R416, R593 or R594) | 7 | 6 | $211.60 |
| R422 | Joint - Synovectomy and debridement | 10 | 6 | $425.10 |
| R416 | Rotator cuff exploration includes acromioplasty, excision of coracoacromial ligament and subacromial bursa but excludes simple excision of clavicle | 10 | 6 | $206.90 |
Reconstruction |
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| R527 | Muscles/soft tissues - Muscle transplant pectoralis major | 6 | 6 | $434.25 |
| 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) | 10 | 6 | $498.30 |
| R593 | Muscles/soft tissues - Rotator cuff repair - simple, endtoend or sidetoside (includes acromioplasty, excision of coracoacromial ligament and subacromial bursa ) | 10 | 6 | $345.35 |
| R353 | Muscles/soft tissues - Scapulopexy congenital elevation | 6 | 6 | $385.15 |
| R685 | Muscles/soft tissues - Tendon release with tenodesis biceps | 7 | 6 | $314.60 |
| R589 | Muscles/soft tissues - Tendon repair or release biceps | 7 | 6 | $227.40 |
| R568 | Muscles/soft tissues - Trapezius/sternomastoid transplant | 7 | 6 | $338.65 |
| R329 | Pseudoarthrosis - Clavicle | 6 | 6 | $514.80 |
| R325 | Pseudoarthrosis - Humerus | 6 | 6 | $632.05 |
| R956 | Pseudoarthrosis - Humerus circular external fixation | 7 | 6 | $291.40 |
Reduction |
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| D025 | Dislocations - Acromio-clavicular/sterno-clavicular - closed with anaesthetic | 6 | 6 | $134.55 |
| R596 | Dislocations - Acromio-clavicular/sterno-clavicular - late | 6 | 6 | $286.70 |
| D014 | Dislocations - Acromio-clavicular/sterno-clavicular - no reduction | 0 | $67.80 | |
| D016 | Dislocations - Glenohumeral joint - closed reduction with anaesthetic | 6 | $111.40 | |
| D015 | Dislocations - Glenohumeral joint - closed reduction without anaesthetic | 0 | $49.20 | |
| D017 | Dislocations - Glenohumeral joint - open reduction, early | 6 | 6 | $323.85 |
| R472 | Dislocations - Glenohumeral joint - open reduction, late | 10 | 6 | $580.90 |
| R401 | Dislocations - Glenohumeral joint - open reduction, recurrent | 10 | 6 | $419.65 |
| F110 | Fractures - Clavicle - closed reduction with anaesthetic | 7 | 6 | $62.20 |
| F118 | Fractures - Clavicle - open reduction | 7 | 6 | $458.75 |
| F051 | Fractures - Neck with dislocation of head - closed reduction | 6 | 6 | $183.80 |
| F050 | Fractures - Neck with dislocation of head - no reduction | 0 | $67.80 | |
| F052 | Fractures - Neck with dislocation of head - open reduction | 6 | 6 | $559.85 |
| F054 | Fractures - Neck without dislocation of head - closed reduction | 6 | $133.60 | |
| F053 | Fractures - Neck without dislocation of head - no reduction | 0 | $67.80 | |
| F055 | Fractures - Neck without dislocation of head - open reduction | 6 | 6 | $514.95 |
| F119 | Fractures - Scapula - no reduction | 0 | $67.80 | |
| F121 | Fractures - Scapula - open reduction | 6 | 6 | $799.25 |
| F043 | Fractures - Shaft - closed reduction | 6 | 6 | $147.60 |
| F042 | Fractures - Shaft - no reduction | 0 | $67.80 | |
| F044 | Fractures - Shaft - open reduction | 6 | 6 | $655.50 |
| F123 | Fractures - Sternum - closed reduction | 0 | $115.95 | |
| F047 | Fractures - Tuberosity - no reduction | 0 | $67.80 | |
| F049 | Fractures - Tuberosity - open reduction (without cuff tear) | 6 | 6 | $290.55 |
| F048 | Fractures - Turberosity - closed reduction | 6 | 6 | $117.85 |
Release |
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| R526 | Sternomastoid | 7 | 6 | $296.05 |
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
-
- Anaesthesia (01)
- Cardiac Surgery (09)
- Cardiology (60)
- Clinical Immunology (62)
- Community Medicine (05)
- Critical Care Medicine (11)
- Dermatology (02)
- Diagnostic Radiology (33)
- Emergency Medicine
- Endocrinology & Metabolism (15)
- 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)
- Orthorpaedic Surgery (06)
- 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)
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- 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
- Anaesthesia
- Cardiovascular
- Critical Care
- Dermatology
- Dialysis
- Echocardiography
- Electrocardiography (ECG)
- Endocrinology And Metabolism
- Gastroenterology
- Gynaecology
- Haematology
- Home And Self Care Services
- Injections And Infusions
- Injections Or Infusions
- Laboratory Medicine
- Nephrology
- Nerve Blocks - Interventional Pain Injections
- Nerve Blocks - Peripheral / Other Injections
- Nerve Blocks For Acute Pain Management
- Neurology
- Neurosurgery
- Non-Invasive Cardiography
- Ophthalmology
- Otolaryngology
- Palliative Care
- Physical Medicine
- Psychiatry And Respiratory Disease
- Sleep Studies
- Urology
-
- 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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