Neurosurgery OHIP billing codes


General Listings

Code Description Amount Ans Units Assist Units
A045 Consultation $121.10 N/A N/A
A046 Repeat consultation $58.25 N/A N/A
A043 Specific assessment $58.25 N/A N/A
A044 Partial assessment $30.00 N/A N/A

Skull Base Surgery – Resection Of Lesion(S) Endonasal Approach

Code Description Amount Ans Units Assist Units
N111 Pituitary lesion(s) - Transsphenoidal microscopic resection of lesion(s) originating in the sella turcica requiring simple closure, repair and/or reconstruction of surgical defect(s) $1,879.00 20 N/A
N114 Pituitary lesion(s) - Transsphenoidal endonasal endoscopic resection of lesion(s) originating in the sella turcica requiring simple closure, repair and/or reconstruction of surgical defect(s) $1,742.45 20 N/A
E887 - Pituitary lesion(s) resection of pituitary lesion(s) extending beyond the sella turcica to the optic nerve(s), optic chiasm or hypothalamus, to N111 or N114 . . . add $500.00 N/A N/A
N116 Non-pituitary lesion(s) - Endonasal endoscopic resection of nonpituitary lesion(s) not originating from pituitary tissue requiring simple closure, repair and/or reconstruction of surgical defect(s) $2,243.45 20 N/A
E888 - Nonpituitary lesion(s) Resection of nonpituitary lesion(s) involving the sellar region that extends to the optic nerve(s), optic chiasm or hypothalamus, to N116 . . . Add $500.00 N/A N/A
E889 - Complex endonasal endoscopic resection of pituitary and nonpituitary lesion(s) complex endonasal endoscopic resection from cranial nerves, to N114 or N116 . . . Add $800.00 N/A N/A
E890 - Complex endonasal endoscopic resection of pituitary and nonpituitary lesion(s) complex endonasal endoscopic resection from cavernous sinuses, to N114 or N116 . . . Add $800.00 N/A N/A
E891 - Complex endonasal endoscopic resection of pituitary and nonpituitary lesion(s) complex endonasal endoscopic resection from frontal or temporal lobe or brainstem, to N114 or N116 . . . Add $800.00 N/A N/A
E892 - harvesting of pedicled vascular flap(s) greater than 3cm in size for use in complex endoscopic closure, repair and/or reconstruction of surgical defect(s) to N111, N112, N114 or N116 . . . Add $500.00 N/A N/A
E893 - complex closure, repair and/or reconstruction of surgical defect(s) includes duroplasty when rendered to N111, N112, N114 or N116 . . . Add $555.00 N/A N/A

Skull Base Surgery – Surgical Access Endonasal Approach

Code Description Amount Ans Units Assist Units
N112 Surgeon not rendering resection of lesion(s) - Endonasal endoscopic or microscopic approach for surgical access to sella turcica $1,360.00 N/A N/A
E905 - Surgeon rendering resection of lesion(s) endonasal endoscopic or microscopic approach for surgical access to sella turcica . . . add $750.00 N/A N/A
E886 - Surgeon rendering resection of lesion(s) extended endonasal endoscopic approach . . . add $800.00 N/A N/A

Orbit

Code Description Amount Ans Units Assist Units
N211 Craniotomy - plus removal of orbital tumour $1,116.60 15 15
N212 Craniotomy - plus orbital decompression (roof of orbit with or without lateral wall) $1,045.45 15 15
N213 Craniotomy - for decompression of optic nerve(s) $1,116.60 15 15
E901 - Craniotomy plus excision Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour Craniotomy plus lobectomy with operating microscope . . . Add $234.65 N/A N/A

Skull

Code Description Amount Ans Units Assist Units
N161 Repair of skull defect - Acrylic or metal cranioplasty $600.85 11 11
N201 Repair of skull defect - Rib graft cranioplasty (defect less than 7.5 cm) $855.80 15 15
N202 Repair of skull defect - Replacement of bone flap $540.95 11 11
N203 Repair of skull defect - Skull tumour, excision $408.30 11 11
N206 Craniosynostosis, linear craniectomy - one suture $430.75 11 11
N207 Craniosynostosis, linear craniectomy - multiple sutures $563.50 15 15
N162 Morcellation procedure - one suture $430.75 11 11
N163 Morcellation procedure - multiple sutures $614.70 15 15
N164 Lateral canthal advancement - Unilateral - one surgeon $696.35 15 15
N165 Lateral canthal advancement - Unilateral - two surgeons, major portion $430.75 15 15
N166 Lateral canthal advancement - Unilateral - two surgeons, lesser portion $345.35 N/A N/A
N167 Lateral canthal advancement - Bilateral - one surgeon $952.55 15 15
N168 Lateral canthal advancement - Bilateral - two surgeons, major portion $614.70 15 15
N169 Lateral canthal advancement - Bilateral -two surgeons, lesser portion $461.10 N/A N/A
N208 Craniotomy - for craniofacial repair $918.15 15 15
E922 - . . . With repair of frontonasal encephalocele . . . Add $215.35 N/A N/A

Csf Shunting Procedures

Code Description Amount Ans Units Assist Units
N230 CSF shunting procedures - all types $737.00 11 11
N245 Revision of CSF shunt - operative - all types $420.70 7 7
Z801 Revision of CSF shunt - non-operative $51.50 N/A N/A
N174 Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial) - includes removal of existing shunt $420.30 7 7
N246 Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial) - Removal of shunt any type $289.70 7 7
Z809 Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial) - Insertion of CSF reservoir (Ommaya) including burr holes $370.50 11 11
N249 Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial) - Third ventriculostomy $777.80 11 11
Z821 Conversion of shunt (e.g. ventriculoperitoneal to ventriculoatrial) - Injection of diagnostic or therapeutic agent into shunt apparatus $53.10 N/A N/A

Carotid And Vertebral Arteries

Code Description Amount Ans Units Assist Units
N223 Vertebral endarterectomy $798.80 10 10
Z815 Temporal artery - biopsy, ligation or cryosurgery $200.00 6 N/A
Z808 Progressive carotid occlusion by Selverstone clamp $317.85 10 10
Z807 Removal of Selverstone clamp $266.60 10 10

Cranial Nerves

Code Description Amount Ans Units Assist Units
N258 Percutaneous coagulation or glyceral injection of gasserian (trigeminal) ganglion or root - unilateral $504.95 11 N/A
N259 V - Decompression or rhizotomy (partial or complete) trigeminal nerve $481.90 1 11
N265 VII - Differential section facial nerve for hemi-facial spasm (extracranial approach) $348.30 6 6
N266 Anastomosis hypoglossal or accessory to facial nerve $727.80 6 6
N267 Occipital and/or suboccipital craniectomy for compression, decompression or section of cranial nerves $1,232.35 11 11
E901 - Craniotomy plus excision Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour Craniotomy plus lobectomy with operating microscope . . . Add $234.65 N/A N/A
N269 XI - Division of nerves to sternomastoid in neck $292.25 7 6
Z826 Inferior dental neurectomy $184.00 6 6
Z827 Infraorbital or supraorbital neurectomy $158.45 7 6

Cerebral Injury

Code Description Amount Ans Units Assist Units
N148 Removal of intracerebral haematoma and/or debridement of traumatized brain (includes management of any skull fracture) $1,040.65 15 15
N149 Removal of foreign body from brain $968.50 15 15
N150 C.S.F. leak - intracranial repair (to include trans-sphenoidal approach) $1,065.45 15 15
N200 Decompressive craniectomy (frontal, subtemporal) $638.05 11 11
Z803 Subdural tap(s) - unilateral $53.10 N/A N/A

Cranio Cerebral Injuries

Code Description Amount Ans Units Assist Units
UVC Repair of lacerations - Removal of sutures only $0.00 N/A N/A
E208 - Peritomy (Gunderson conjunctival flap) $225.00 6 N/A
N139 Reduction of skull fracture - simple, depressed $634.90 7 7
N140 Reduction of skull fracture - compound $773.15 1 11
E912 - Reduction of skull fracture with repair of dural laceration . . . Add $233.30 N/A N/A
N143 Extracerebral haematoma and/or hygroma - Drainage by burr hole(s) unilateral $559.60 7 7
N144 Extracerebral haematoma and/or hygroma - Drainage and/or removal by craniotomy $863.25 11 11

Intracranial Abscess

Code Description Amount Ans Units Assist Units
N117 Craniotomy $1,416.50 15 15
N115 Burr hole - aspiration $578.85 7 7
Z818 Burr hole - subsequent aspiration through existing burr hole within 30 days $215.35 N/A N/A
Z813 Burr hole - plus needling of brain for biopsy $453.60 7 7
N127 Burr hole - Re-opening of craniotomy for postoperative haematoma or for removal of bone flap $518.85 11 11
N113 Burr hole - Craniotomy for brain biopsy (other than for tumour) $774.90 11 11
N130 Burr hole - Craniotomy plus midline commissurotomy $1,014.85 15 15
N109 Burr hole - Hemispherectomy $1,878.35 15 15
N110 Burr hole - Lobectomy and/or excision of cortical scar for epilepsy $2,184.20 15 15
N128 Burr hole - Repair of encephalocoele $798.80 15 15
N129 Burr hole - Posterior fossa decompression for Arnold Chiari malformation $1,110.00 15 15
E901 - Craniotomy plus excision Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour Craniotomy plus lobectomy with operating microscope . . . Add $234.65 N/A N/A
N126 Burr hole - Intraoral approach to lesions of the skull base and upper cervical spine $1,442.95 15 15
N123 Burr hole - Stereotaxis intracranial (to include ventriculography) $538.40 11 11
E931 - with implantation (and removal) of radioactive sources into brain tumour . . . Add $222.85 N/A N/A
E896 - sophisticated microelectrode recording during stereotaxis, to N123 . . . Add $400.40 N/A N/A
N124 Functional stereotaxy $1,551.20 11 9
N119 Functional stereotaxy - Intracranial implantation of chronic surface electrodes $901.25 11 11
Z823 Functional stereotaxy - Implantation or revision of stimulation pack or leads (peripheral nerve, brain) $307.40 6 6
Z824 Functional stereotaxy - Removal of chronic surface or depth electrodes $266.60 N/A N/A
Z802 Ventricular puncture through previous burr hole or fontanelle or puncture and/or aspiration of cisterna $81.65 7 N/A
Z825 Ventriculoscopy - to include burr hole $408.95 7 N/A
E916 - with biopsy . . . Add $233.30 N/A N/A
E917 - with interventriculostomy . . . Add $301.70 N/A N/A
E918 - with removal of foreign body . . . Add $132.80 N/A N/A
Z819 Ventriculoscopy - External ventricular drainage $215.35 7 N/A
Z820 Ventriculoscopy - Insertion of intracranial catheter or transducer for purposes of monitoring $317.85 7 N/A
Z812 Ventriculoscopy - Subsequent revisions or replacements within 30 days . . . Each $279.55 7 6

Intracranial Cyst

Code Description Amount Ans Units Assist Units
N158 Craniotomy plus evacuation - supratentorial $968.50 15 15
N159 Craniotomy plus evacuation - infratentorial $1,065.05 15 15
N160 Craniotomy plus evacuation - Burr hole plus aspiration $426.95 15 15

Spontaneous Intracerebral Haemorrhage

Code Description Amount Ans Units Assist Units
N104 Craniotomy plus removal - supratentorial $1,100.00 15 15
N157 Craniotomy plus removal - infratentorial $1,241.65 15 15
N120 Craniotomy plus removal - Burr hole plus drainage $481.90 15 15

Intracranial Endovascular Surgery

Code Description Amount Ans Units Assist Units
N122 Intracranial aneurysm repair - Endovascular approaches - Carotid circulation per vessel $2,140.15 20 15
N125 Intracranial aneurysm repair - Endovascular approaches - Vertebrobasilar circulation, including aneurysm of vein of Galen $2,140.15 20 15
E894 - Intracranial aneurysm repair Endovascular approaches aneurysm greater than 2.5 cm, to N122 or N125 . . . Add $229.55 N/A N/A
N107 Cerebral arteriovenous malformation - Endovascular approach for obliteration - Endovascular approach to include balloon catheter or embolization techniques for arteriovenous malformation $1,456.95 15 15
N118 Carotid-cavernous fistula - Endovascular approach to include balloon catheter or embolization techniques for dural arteriovenous fistula including carotid cavernous fistula $952.05 15 15

Neurosurgery Open Surgical Approach

Code Description Amount Ans Units Assist Units
N105 Intracranial aneurysm repair - Craniotomy approaches - Carotid circulation per vessel $2,140.15 20 15
N154 Intracranial aneurysm repair - Craniotomy approaches - Vertebrobasilar circulation, including aneurysm of vein of Galen $2,140.15 20 15
E901 - Craniotomy plus excision Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour Craniotomy plus lobectomy with operating microscope . . . Add $234.65 N/A N/A
E898 - Intracranial aneurysm repair Craniotomy approaches lesion greater than 2.5 cm, to N105 or N154 . . . add $229.55 N/A N/A
E979 - Intracranial aneurysm repair Craniotomy approaches clinoidal drilling for complex aneurysms, to N105 or N154 . . . add $396.70 N/A N/A
E908 - Intracranial aneurysm repair Craniotomy approaches removal of intracerebral and/or subdural haematoma in conjunction with a ruptured intracranial aneurysm or arteriovenous malformation, to N105 or N154 . . . add $304.30 N/A N/A
N106 Cerebral vascular malformation - Craniotomy - supratentorial $1,622.50 20 15
N155 Cerebral vascular malformation - Craniotomy - infratentorial $1,532.10 20 15
E901 - Craniotomy plus excision Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour Craniotomy plus lobectomy with operating microscope . . . Add $234.65 N/A N/A
E908 - Intracranial aneurysm repair Craniotomy approaches removal of intracerebral and/or subdural haematoma in conjunction with a ruptured intracranial aneurysm or arteriovenous malformation, to N105 or N154 . . . add $304.30 N/A N/A
E895 - Cerebral vascular malformation Craniotomy of cerebral arteriovenous malformation greater than 4 cm, to N106 or N155 . . . Add $373.80 N/A N/A
N218 Cerebral vascular malformation - Extracranialintracranial microvascular anastomosis superficial temporal artery $1,178.35 15 15
N156 Cerebral vascular malformation - Occipital artery $0.00 N/A N/A
E904 - posterior fossa . . . add $241.00 N/A N/A
N121 Cerebral vascular malformation - Extracranial-intracranial long venous bypass (from internal carotid in the neck or any of the trunk vessels in the neck or chest to a major intracerebral vessel, i.e. vertebral, internal carotid, middle cerebral) $1,711.40 15 15

Brain

Code Description Amount Ans Units Assist Units
N103 Craniotomy plus excision - Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour - supratentorial $1,562.90 15 15
N151 Craniotomy plus excision - Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour - infratentorial $1,726.80 15 15
N152 Craniotomy plus excision - Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour - Craniotomy plus lobectomy $1,575.80 15 15
E901 - with operating microscope . . . Add $234.65 N/A N/A
N102 Craniotomy plus excision - Meningioma and other tumourous lesions, including pituitary tumours - supratentorial $1,726.80 15 15
N153 Craniotomy plus excision - Meningioma and other tumourous lesions, including pituitary tumours - infratentorial or basal $2,345.00 15 15
E901 - Craniotomy plus excision Astrocytoma, oligodendroglioma, glioblastoma or metastatic tumour Craniotomy plus lobectomy with operating microscope . . . Add $234.65 N/A N/A
E902 - Craniotomy plus excision Meningioma and other tumourous lesions, including pituitary tumours lesion greater than 2 cm diameter, to N102 or N153 . . . Add $454.15 N/A N/A
E903 - Craniotomy plus excision Meningioma and other tumourous lesions, including pituitary tumours team fee for acoustic neuroma, same approach . . . Add $614.70 N/A N/A

Non Emergency Long Term Care In Patient Services

Code Description Amount Ans Units Assist Units
W045 Consultation $107.00 N/A N/A
W046 Repeat consultation $51.45 N/A N/A

Non Emergency Hospital In Patient Services

Code Description Amount Ans Units Assist Units
C045 Consultation $121.10 N/A N/A
C046 Repeat consultation $58.25 N/A N/A
C043 Specific assessment $58.25 N/A N/A
C044 Specific re-assessment $30.00 N/A N/A
C042 Subsequent visits - first five weeks … per visit $31.00 N/A N/A
C047 Subsequent visits - sixth to thirteenth week inclusive (maximum 3 per patient per week) … per visit $31.00 N/A N/A
C049 Subsequent visits - after thirteenth week (maximum 6 per patient per month) … per visit $31.00 N/A N/A
C048 Concurrent care … per visit $31.00 N/A N/A

Other

Code Description Amount Ans Units Assist Units
A935 Special surgical consultation (see General Preamble GP13) $160.00 N/A N/A
C935 Special surgical consultation (see General Preamble GP13) $160.00 N/A N/A
C122 Subsequent visits by the Most Responsible Physician (MRP) - day following the hospital admission assessment $58.80 N/A N/A
C123 Subsequent visits by the Most Responsible Physician (MRP) - second day following the hospital assessment $58.80 N/A N/A
C124 Subsequent visits by the Most Responsible Physician (MRP) - day of discharge $58.80 N/A N/A
C142 Subsequent visits by the MRP following transfer from an Intensive Care Area - first subsequent visit by the MRP following transfer from an Intensive Care Area $58.80 N/A N/A
C143 Subsequent visits by the MRP following transfer from an Intensive Care Area -second subsequent visit by the MRP following transfer from an Intensive Care Area $58.80 N/A N/A
C121 Subsequent visits by the MRP following transfer from an Intensive Care Area - Additional visits due to intercurrent illness (see General Preamble GP28) … per visit $31.00 N/A N/A
C982 Palliative care (see General Preamble GP34) … per visit $31.00 N/A N/A
Z811 Intravenous drug test for pain $54.10 6 N/A
E919 - intracranial duroplasty (greater than 2 cm diameter) to any intracranial procedure . . . add $244.80 N/A N/A
E921 - repeat cranial procedure payable in addition to any intracranial procedure and N111, N114 and N116 but excluding N127 . . . Add $252.20 N/A N/A
N108 Carotid-cavernous fistula - Obliteration of intracranial dural arteriovenous fistula (including carotid cavernous fistula) to include craniotomy and combined cervical and intracranial procedure $1,229.55 15 15
N188 Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition - minor nerve including digital, cutaneous or lateral femoral cutaneous nerve $153.70 7 6
N285 Exploration and/or decompression and/or transposition and/or neurolysis of major nerve (excluding carpal tunnel nerve) $256.15 7 6
N282 Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition - Brachial plexus (excluding thoracic outlet syndrome or cervical rib) $1,000.00 6 6
N177 Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition - Sciatic nerve in buttock $430.75 7 6
N286 Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition - Tumour or neuroma major nerve $317.85 7 6
N289 Nerve suture - minor (sensory/cutaneous nerve) $250.00 7 6
N287 Nerve suture - major (mixed sensory and motor nerve, or pure motor nerve) $500.00 7 6
N183 Nerve graft - minor (sensory/cutaneous nerve) $471.05 6 6
N288 Nerve graft - major (mixed sensory and motor nerve, or pure motor nerve) $927.55 6 6
E899 - for each additional cable, to N288 . . . Add $102.45 N/A N/A
Z816 Implantation of electrode for peripheral nerve stimulation $241.00 6 6
N290 Decompression median nerve at wrist (carpal tunnel syndrome) $156.75 6 6
N190 Exploration and/or decompression and/or neurolysis of ulnar nerve (elbow) $215.35 7 6
N189 Ulnar nerve transposition at elbow may include exploration, decompression and/or neurolysis $279.25 7 6
N283 Decompression, exploration for thoracic outlet syndrome including excision of cervical and/or first rib and to include scalenotomy $389.05 7 6
N295 Excision of Morton’s or subcutaneous neuroma, glomus or small cutaneous nerve tumour $109.95 6 6