OHIP Billing Codes

Specialty: Shoulder Arm And Chest

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Code	Description	Anes	Asst	Fee
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Amputation
R617	Forequarter	15	10	$490.95
R615	High humerus	6	6	$423.30
R616	Shoulder disarticulation	9	9	$373.10
Arthrodesis
R467	Shoulder	6	6	$468.65
Arthroplasty
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
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
R411	Shoulder	7	6	$223.65
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Biopsy
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
G571	Professional component	0		$96.20
	G400 Physician-in-charge - 1st day			$223.10
G570	Technical component	0		$118.95
	G400 Physician-in-charge - 1st day			$223.10
COVID-19 Immunization
G593	COVID-19 vaccine	0		$13.00
Deformity
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
D023	Open Reduction	7	6	$231.10
Examination and Manipulation
Z223	Manipulation under general anaesthetic	6		$49.20
Excision
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
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
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
R526	Sternomastoid	7	6	$296.05

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