OHIP Billing Codes

Specialty: Musculoskeletal System Surgical Procedures

Category: Shoulder Arm And Chest

Filter by section

Code Description Fee

Amputation

R617 Forequarter $490.95
R615 High humerus $423.30
R616 Shoulder disarticulation $373.10

Arthrodesis

R467 Shoulder $468.65

Arthroplasty

R438 Humeral prosthesis $449.20
R498 Removal prosthesis/no replacement $397.20
R240 Revision total arthroplasty shoulder $942.95
R487 Total prosthesis $784.05

Arthroscopy

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 $400.00

Arthrotomy

R411 Shoulder $223.65

Not finding what you’re looking for?

Dr.Bill is built on a team of medical billing experts. We are here to help out with daily billing needs or just to answer your questions.

Talk to an agent

Biopsy

Z220 Bone - needle/punch, xray control $89.70
R222 Incision and Drainage - Humerus/clavicle/scapula $262.60
R223 Incision and Drainage - Saucerization with bone graft $387.90
R225 Incision and Drainage - Sequestrectomy $290.55

Complete Study - 1 and 2 dimensions

G571 Professional component $96.20
G570 Technical component $118.95

COVID-19 Immunization

G593 COVID-19 vaccine $13.00

Deformity

R960 Osteotomy - Bone transport - circular external fixation (greater than 6 cm) $763.80
R959 Osteotomy - Bone transport - circular external fixation (less than or equal to 6 cm) $655.15
R958 Osteotomy - Double level correction circular external fixation $638.40
R235 Osteotomy - glenoid $279.35
R962 Osteotomy - Humeral lengthening - circular external fixation (greater than 6 cm) $655.15
R961 Osteotomy - Humeral lengthening - circular external fixation (less than or equal to 6 cm) $438.00
R260 Osteotomy - humerus $559.25
R957 Osteotomy - Single level correction circular external fixation $510.35

Dislocations - Acromio-clavicular/sterno-clavicular

D023 Open Reduction $231.10

Examination and Manipulation

Z223 Manipulation under general anaesthetic $49.20

Excision

R641 Clavicle or Acromion - Major tumour $290.55
R214 Clavicle or Acromion - Malignant tumour with reconstruction $484.35
R298 Clavicle or Acromion - Simple (includes ligament) $250.25
R292 Humerus - Head $299.75
R297 Humerus - Malignant tumour with reconstruction $681.10
R512 Joint - Excision of subacromial bursa (not to be claimed with R416, R593 or R594) $211.60
R422 Joint - Synovectomy and debridement $425.10
R416 Rotator cuff exploration includes acromioplasty, excision of coracoacromial ligament and subacromial bursa but excludes simple excision of clavicle $206.90

Reconstruction

R527 Muscles/soft tissues - Muscle transplant pectoralis major $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) $498.30
R593 Muscles/soft tissues - Rotator cuff repair - simple, endtoend or sidetoside (includes acromioplasty, excision of coracoacromial ligament and subacromial bursa ) $345.35
R353 Muscles/soft tissues - Scapulopexy congenital elevation $385.15
R685 Muscles/soft tissues - Tendon release with tenodesis biceps $314.60
R589 Muscles/soft tissues - Tendon repair or release biceps $227.40
R568 Muscles/soft tissues - Trapezius/sternomastoid transplant $338.65
R329 Pseudoarthrosis - Clavicle $514.80
R325 Pseudoarthrosis - Humerus $632.05
R956 Pseudoarthrosis - Humerus circular external fixation $291.40

Reduction

D025 Dislocations - Acromio-clavicular/sterno-clavicular - closed with anaesthetic $134.55
R596 Dislocations - Acromio-clavicular/sterno-clavicular - late $286.70
D014 Dislocations - Acromio-clavicular/sterno-clavicular - no reduction $67.80
D016 Dislocations - Glenohumeral joint - closed reduction with anaesthetic $111.40
D015 Dislocations - Glenohumeral joint - closed reduction without anaesthetic $49.20
D017 Dislocations - Glenohumeral joint - open reduction, early $323.85
R472 Dislocations - Glenohumeral joint - open reduction, late $580.90
R401 Dislocations - Glenohumeral joint - open reduction, recurrent $419.65
F110 Fractures - Clavicle - closed reduction with anaesthetic $62.20
F118 Fractures - Clavicle - open reduction $458.75
F051 Fractures - Neck with dislocation of head - closed reduction $183.80
F050 Fractures - Neck with dislocation of head - no reduction $67.80
F052 Fractures - Neck with dislocation of head - open reduction $559.85
F054 Fractures - Neck without dislocation of head - closed reduction $133.60
F053 Fractures - Neck without dislocation of head - no reduction $67.80
F055 Fractures - Neck without dislocation of head - open reduction $514.95
F119 Fractures - Scapula - no reduction $67.80
F121 Fractures - Scapula - open reduction $799.25
F043 Fractures - Shaft - closed reduction $147.60
F042 Fractures - Shaft - no reduction $67.80
F044 Fractures - Shaft - open reduction $655.50
F123 Fractures - Sternum - closed reduction $115.95
F047 Fractures - Tuberosity - no reduction $67.80
F049 Fractures - Tuberosity - open reduction (without cuff tear) $290.55
F048 Fractures - Turberosity - closed reduction $117.85

Release

R526 Sternomastoid $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

Search all OHIP billing codes

Lookup any OHIP billing code using our searchable database. Search by billing code or keyword.

An OHIP Expert in Your Pocket

Find codes and bill premiums with a tap. Try free for 45 days, no credit card required.

Get started

Ready to Get Started?

Register for Your Free 45-Day Trial

See .

Download the Dr.Bill App

Submit Your First Claim

45 Day Free Trial Offer.