Musculoskeletal system surgical procedures OHIP billing codes


Bone/Fascial/Dermis Grafts

Code Description Amount Ans Units Assist Units
Z279 Autogenous - different surgeon $193.00 N/A N/A
E553 - Homogenous banked bone or bone substitutes . . . add $25.15 N/A N/A
R200 Allograft - cadaver per long bone, each $144.80 N/A N/A
E547 - Fixation methyl methacrylate (not arthroplasty) . . . Add $59.40 N/A N/A
E590 - Fixation rigid external fixation pseudoarthrosis . . . Add $76.10 N/A N/A

Excision

Code Description Amount Ans Units Assist Units
R316 Bone - Proximal row carpectomy $338.75 7 6
R285 Bone - Carpal bone (one) $214.45 7 6
R317 Bone - Dorsal exostosis (triquetrum) $189.75 6 6
R286 Bone - Radial styloid $234.75 7 6
R283 Bone - Phalanx/metacarpal $193.00 7 6
R272 Bone - Bone tumour $0.00 N/A N/A
R425 Joint - Synovectomy/capsulectomy/debridement - finger joint $226.40 6 6
R414 Joint - Synovectomy/capsulectomy/debridement - two or more joints $339.65 7 6
R407 Joint - Synovectomy of extensor or flexor tendons $224.45 6 N/A
R418 Joint - Synovectomy/debridement wrist $342.55 7 6
R492 Joint - Radioulnar meniscectomy $231.10 7 6
R549 Soft tissue - Ganglion Simple or complex $177.80 6 6
R551 Soft tissue - Excision of fascia for Dupuytrens (palmar fibromatosis), single ray, with or without flaps $322.15 7 6
E832 - excision of fascia for Dupuytrens, one or more additional rays, to R551 . . . add $273.85 N/A N/A
R522 Muscle - simple $193.00 6 6
R523 Muscle - complex $484.35 7 6
E041 - Pseudoarthrosis intramedullary nail with distal and proximal locking screws tibia . . . ADD $81.55 N/A N/A
R287 Bone - Radial head $217.95 7 6
R643 Bone - Ulna lower end $193.00 7 6
R290 Bone - Olecranon $207.90 6 6
R291 Bone - Olecranon with fascial repair $309.00 7 6
R595 Bursae - Olecranon $101.25 6 6
R421 Joint Contents - Synovectomy/capsulectomy/debridement, etc. $311.85 7 6
R524 Muscles - Myositis ossificans $289.50 7 6
R591 Tumours - Soft tissues - superficial $196.05 6 6
R592 Tumours - Soft tissues - deep $484.35 7 6
R294 Tumours - Bone tumours - exostosis $165.20 7 6
R295 Tumours - Bone tumours - simple excision $289.50 7 6
R293 Tumours - Bone tumours - extensive with replacement $677.50 6 6
R298 Clavicle or Acromion - Simple (includes ligament) $211.60 7 6
R641 Clavicle or Acromion - Major tumour $290.55 7 6
R214 Clavicle or Acromion - Malignant tumour with reconstruction $484.35 6 6
R292 Humerus - Head $299.75 6 6
R297 Humerus - Malignant tumour with reconstruction $681.10 6 6
R422 Joint - Synovectomy and debridement $425.10 10 6
R512 Joint - Excision of subacromial bursa (not to be claimed with R416, R593 or R594) $211.60 7 6
R416 Rotator cuff exploration includes acromioplasty, excision of coracoacromial ligament and subacromial bursa but excludes simple excision of clavicle $206.90 10 6
R278 Maxilla, with exenteration of orbit and skin graft $532.95 7 6
R279 Maxilla advancement $440.15 8 6
R280 Mandible $353.10 7 6
R284 Mandibular condyle $276.55 7 6
R428 Temporomandibular meniscectomy $249.75 7 6
R639 Bone - Simple cyst, etc $338.75 7 6
R330 Bone - Major resection tumour $629.65 7 6
R216 Bone - Radical resection tumour $1,007.35 8 8
F115 Bone - Coccyx $208.80 6 6
R315 Bone - Head and neck, femur $452.90 6 6
R423 Joint - Synovectomy/debridement $470.50 7 6
R590 Bursae - GT trochanteric/ischial $201.40 7 6
R314 Bone - Simple cyst/exostosis $225.50 6 6
R311 Exostosis/cyst $201.40 6 6
R210 Fibular head $193.00 7 6
R253 Tumour - extensive with repair $648.20 6 6
R246 Tumour - Excision bony ridge to include interpositional materials $385.15 7 6
R299 Bone - Phalanx $127.15 6 6
R309 Bone - Metatarsal head $175.45 6 6
E587 - each additional . . . Add $41.70 N/A N/A
R305 Bone - Metatarsal head - Accessory navicular (scaphoid) $155.90 6 6
R302 Bone - Bunion/bunionette $150.30 6 6
R307 Bone - Calcaneal spur $139.25 6 6
R282 Bone - Exostosis (dorsal, subungual) $100.15 6 6
R308 Bone - Os calcis, talus $283.95 7 6
R301 Bone - Sesamoid, one or both $142.00 6 6
R306 Bone - Tarsal bar $230.20 7 6
R266 Bone - Tumour (foot) $241.30 6 6
R420 Joint - Ankle synovectomy $273.75 7 6
R576 Soft Tissue - Excision of fascia for Dupuytrens (planter fibromatosis), one or more rays $322.15 6 6

Reconstruction

Code Description Amount Ans Units Assist Units
R321 Bone - Pseudoarthrosis/non-union/avascular necrosis - Phalanx, metacarpal $260.75 7 6
R322 Bone - Pseudoarthrosis/non-union/avascular necrosis - Scaphoid $500.00 6 6
R345 Bone - Pseudoarthrosis/non-union/avascular necrosis - Carpal bone, other than scaphoid $260.75 6 6
E497 - Bone Pseudoarthrosis/nonunion/avascular necrosis pedicled vascularized bone graft, to R322 or R345 . . . Add $350.00 N/A N/A
R257 Bone - Deformity - Osteotomy phalanx - terminal $162.65 6 N/A
R258 Bone - Deformity - Osteotomy phalanx - middle proximal or metacarpal $193.20 7 6
E591 - Bone Deformity Osteotomy phalanx each additional . . . Add $158.65 N/A N/A
R597 Ligaments - Simple/single repair wrist $301.60 7 6
R548 Ligaments - Extensive/multiple repair wrist $511.45 7 6
R601 Ligaments - Metacarpal phalangeal repair $316.75 7 6
R557 Tendon - Tenoplasty - one $223.65 7 6
E050 - Tendon Tenoplasty each additional . . . Add $77.05 N/A N/A
R559 Tendon - Tendon graft - one $306.30 7 6
E052 - Tendon Tendon graft each additional . . . Add $259.85 N/A N/A
R586 Tendon - Tendon graft - Reconstruction of flexor tendon pulley, per finger $97.35 N/A N/A
R554 Tendon - Silicone rod insertion - one $294.20 7 6
E051 - Tendon Silicone rod insertion each additional . . . Add $245.90 N/A N/A
R563 Tendon - Transplant/transfer - single $284.95 7 6
E054 - Tendon Transplant/transfer each additional . . . Add $236.10 N/A N/A
E056 - Transposition/transplantation/transfer each additional . . . Add $91.90 N/A N/A
R578 Tendon - Tendon repair extensor - single $164.10 7 6
E580 - Tendon Tendon repair extensor each additional. . . Add $70.95 N/A N/A
R585 Tendon - Flexor - single $307.60 7 6
E581 - each additional . . . Add $128.95 N/A N/A
R574 Tendon - Mallet finger - K-wire $133.95 7 N/A
R573 Tendon - Mallet finger - open $147.20 6 6
R577 Tendon - Boutonniere - open $147.30 6 6
R582 Tendon - Boutonniere - late $246.65 7 6
R602 Extremities - Pollicization $596.35 6 6
R603 Extremities - Digital reimplantation involving microvascular and neuro anastomosis $1,586.20 8 8
R604 Extremities - Revision of R602, R603 $0.00 N/A N/A
R605 Extremities - Reconstruction and plastic repair of traumatically amputated extremities $0.00 N/A N/A
R323 Bone - Pseudoarthrosis - Radius or ulna $304.40 7 6
R473 Bone - Pseudoarthrosis - Radius and ulna $411.20 6 6
R950 Bone - Pseudoarthrosis - Radius and ulna circular external fixation $291.40 7 6
R259 Bone - Deformity - Osteotomy - ulna $297.85 7 6
R261 Bone - Deformity - Osteotomy -radius with or without ulna $411.20 6 6
R324 Bone - Deformity - Osteotomy - radius and/or ulna with reconstruction congenital abnormality, synostosis etc $398.10 6 6
R951 Bone - Deformity - Osteotomy - Single level correction circular external fixation $638.40 7 6
R952 Bone - Deformity - Osteotomy - Double level correction circular external fixation $798.10 6 6
R953 Bone - Deformity - Bone transport - circular external fixation (less than or equal to 6 cm) $655.15 6 6
R954 Bone - Deformity - Bone transport - circular external fixation (greater than 6 cm) $763.80 7 6
R476 Fascia - Repair fascial defects - small $144.80 7 6
R478 Fascia - Repair fascial defects - large with or without synthetic graft or rotation flap $290.55 7 6
R556 Tenolysis - single $202.25 6 6
E599 - Tenolysis each additional . . . Add $87.20 N/A N/A
R583 Transposition/transplantation/transfer - Steindler flexoplasty $344.85 7 6
R329 Pseudoarthrosis - Clavicle $269.10 6 6
R325 Pseudoarthrosis - Humerus $346.15 6 6
R956 Pseudoarthrosis - Humerus circular external fixation $291.40 7 6
R527 Muscles/soft tissues - Muscle transplant pectoralis major $434.25 6 6
R353 Muscles/soft tissues - Scapulopexy congenital elevation $385.15 6 6
R568 Muscles/soft tissues - Trapezius/sternomastoid transplant $338.65 7 6
R589 Muscles/soft tissues - Tendon repair or release biceps $227.40 7 6
R685 Muscles/soft tissues - Tendon release with tenodesis biceps $314.60 7 6
R593 Muscles/soft tissues - Rotator cuff repair - simple, endtoend or sidetoside (includes acromioplasty, excision of coracoacromial ligament and subacromial bursa ) $345.35 10 6
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 10 6
R531 Facial paralysis - static slings $307.15 6 6
R532 Facial paralysis - dynamic slings $399.00 6 6
R533 Composite repair for facial paralysis, plication of paralyzed muscles, and resection for paralysis of over active muscles $511.90 7 6
E597 - Composite repair for facial paralysis, plication of paralyzed muscles, and resection for paralysis of over active muscles with meloplasty . . . Add $87.05 N/A N/A
R364 Pseudoarthrosis - Pelvis $580.90 10 8
R328 Pseudoarthrosis - Hip $477.90 6 6
R265 Osteotomy - Pelvis - infant $399.00 8 8
R273 Osteotomy - Pelvis - other $580.90 8 8
R263 Hip $539.15 7 6
Z232 Muscle/tendon - Tenotomy - closed adductors $49.20 N/A N/A
Z233 Muscle/tendon - Tenotomy - open adductors $97.35 N/A N/A
R545 Muscle/tendon - Tenotomy - iliopsoas $266.35 6 6
R570 Tendon transfer - Iliopsoas $520.60 7 6
R569 Tendon transfer - Abductor $339.65 6 6
R632 Fascial - simple $193.00 7 6
R633 Fascial - complex with or without synthetic graft or rotation flap $402.75 7 6
E048 - Pseudoarthrosis intramedullary nail with distal and proximal locking screws femur . . . Add $108.75 N/A N/A
R967 Pseudoarthrosis - Circular external fixation $291.40 6 6
R262 Deformity - Osteotomy femoral shaft $532.65 6 6
R215 Deformity - Osteotomy supracondylar $387.00 6 6
R963 Deformity - Single level correction circular external fixation $638.40 7 6
R964 Deformity - Double level correction circular external fixation $798.10 6 6
R965 Deformity - Bone transport circular external fixation (less than or equal to 6 cm) $655.15 6 6
R966 Deformity - Bone transport circular external fixation (greater than 6 cm) $763.80 6 6
R333 Leg length discrepancy - Femoral shortening $480.70 6 6
R332 Leg length discrepancy - Femoral lengthening $541.95 6 6
R968 Leg length discrepancy - Lengthening with circular external fixation (less than or equal to 6 cm) $546.55 6 6
R969 Leg length discrepancy - Lengthening with circular external fixation (greater than 6 cm) $763.80 6 6
R340 Leg length discrepancy - Femoral epiphysiodesis $301.60 7 6
R341 Leg length discrepancy - Tibial and femoral epiphysiodesis $426.90 7 6
R343 Leg length discrepancy - Femoral stapling $313.65 7 6
R344 Leg length discrepancy - Tibial and femoral stapling $387.00 6 6
R587 Muscles/tendons - Quadriceps repair - reconstructive $387.00 7 6
R530 Muscles/tendons - Quadriceps repair - Quadricepsplasty all types $381.40 7 6
R561 Muscles/tendons - Quadriceps repair - Iliotibial band $190.10 6 6
Z197 Muscles/tendons - Quadriceps repair -Closed release of iliotibial band $49.20 6 N/A
R543 Muscles/tendons - Tenotomy of hamstrings - single $168.85 7 6
R562 Muscles/tendons - Tenotomy of hamstrings - multiple $193.00 6 6
R571 Muscles/tendons - Lengthening of hamstrings - Tendon or muscle transfer $307.15 7 6
E049 - each additional . . . Add $87.20 N/A N/A
F094 Fractures - Closed reduction - traction infant or child $258.00 6 6
F095 Fractures - Closed reduction - traction - adult or adolescent $407.35 6 6
F097 Fractures - Closed reduction - cast $258.90 6 6
F096 Fractures - Closed reduction - open reduction $493.80 8 6
E048 - Pseudoarthrosis intramedullary nail with distal and proximal locking screws femur . . . Add $108.75 N/A N/A
R508 Meniscus - Suturing of medial or lateral meniscus $242.25 7 6
R584 Muscles/Tendons - Tenoplasty - one $144.80 7 6
E050 - Tendon Tenoplasty each additional . . . Add $77.05 N/A N/A
Z237 Muscles/Tendons - Tenotomy - closed - one $49.20 6 N/A
Z238 Muscles/Tendons - Tenotomy - closed - multiple $72.35 7 N/A
R564 Muscles/Tendons - Tenotomy - open - one $232.00 7 6
R566 Muscles/Tendons - Tenotomy - open - multiple $253.30 6 6
R516 Muscles/Tendons - Tenotomy - Release patellar retinaculum $161.45 7 6
R599 Ligaments - simple - one $361.95 6 6
R542 Ligaments - extensive ligament reconstruction (including synthetics) includes when rendered preparation of intracondyar notch $0.00 7 6
R539 Ligaments - removal of synthetics $213.45 7 6
R326 Pseudoarthrosis - Tibia/fibula $348.00 6 6
R327 Pseudoarthrosis - Bypass fibular graft $341.45 6 6
R372 Pseudoarthrosis - Congenital pseudoarthrosis $484.35 6 6
R970 Pseudoarthrosis - Circumferential external fixation $291.40 6 6
R289 Deformity - Osteotomy tibia and fibula adult or child $376.80 6 6
R971 Deformity - Single level correction circular external fixation $510.35 6 6
R972 Deformity - Double level correction circular external fixation $638.40 6 6
R973 Deformity - Bone transport - circular external fixation (less than or equal to 6 cm) $634.70 6 6
R974 Deformity - Bone transport - circular external fixation (greater than 6 cm) $763.80 6 6
R331 Leg length discrepancy - Tibial lengthening $470.50 6 6
R458 Leg length discrepancy - Tibial shortening $387.00 6 6
R339 Leg length discrepancy - Tibial epiphysiodesis $322.05 7 6
R342 Leg length discrepancy - Tibial stapling - one side $193.00 7 6
R460 Leg length discrepancy - Tibial stapling - both sides $242.25 6 6
R975 Leg length discrepancy - Lengthening with circular external fixation (less than or equal to 6 cm) $438.00 6 6
R976 Leg length discrepancy - Lengthening with circular external fixation (greater than 6 cm) $655.15 6 6
R363 Pseudoarthrosis - Malleoli $296.05 7 6
R276 Deformity - Osteotomy - metatarsals and phalanx $144.80 7 6
E596 - each additional . . . Add $41.70 N/A N/A
R277 Deformity - Osteotomy - midtarsal/tarsal $242.25 7 6
R337 Deformity - Shortening metatarsal - one $225.50 6 6
R338 Deformity - Shortening metatarsal - two or more $272.80 7 6
R977 Deformity - Shortening metatarsal - Circular external fixation without osteotomy* $583.75 6 6
R978 Deformity - Shortening metatarsal - Circular external fixation with osteotomy* $729.45 6 6
R979 Deformity - Shortening metatarsal - Circular external fixation with multiple osteotomies* $911.30 6 6
R430 Forefoot - Claw and hammer toe $151.25 6 6
E594 - each additional hammer toe . . . add $41.70 N/A N/A
R304 Forefoot - Hallux Valgus - e.g. Mayo, Keller $217.15 7 6
R355 Forefoot - Hallux Valgus - e.g. Joplin, McBride $267.25 7 6
R360 Forefoot - Hallux Valgus - Major forefoot reconstruction, must include the first MP joint and a minimum of 2 other MP joints $459.45 7 6
R446 Forefoot - Hallux Valgus - Overlapping 5th toe $136.35 7 6
R408 Club Foot - Posterior or medial release $312.70 7 6
R448 Club Foot - Posteromedial release, lateral shortening, tendon transfers and fusion $371.20 7 6
R313 Club Foot - Complex reconstruction or revision of previous club foot repair (not to include simple tendon releases) $468.65 6 6
R546 Club Foot -Plantar fascia release (Steindler) $165.20 6 6
R640 Tendons - Exploration tendon sheath $126.25 7 6
R565 Tendons - Tendon transfer foot and ankle - single $253.30 7 6
E055 - Tendons Tendon transfer foot and ankle each additional . . . Add $94.60 N/A N/A
R572 Tendons - Tendon transfer foot and ankle - Tenodesis $258.90 7 6
R560 Tendons - Tendon transfer foot and ankle - Graft $253.30 6 6
E053 - each additional . . . Add $94.60 N/A N/A
R579 Tendons - Tenotomy open - one toe $87.20 6 N/A
R581 Tendons - Tenotomy open - more than one toe $193.00 7 N/A
Z229 Tendons - Tenotomy closed - one toe $49.20 7 N/A
Z243 Tendons - Tenotomy closed - more than one toe $97.35 7 N/A
R544 Tendons - Achilles or tibialis anterior/posterior tenotomy - open $171.70 7 6
R555 Tendons - Achilles or tibialis anterior/posterior tenotomy - closed $132.70 6 N/A

Release

Code Description Amount Ans Units Assist Units
R575 Tendon - Tenolysis flexor and/or extensor tendon of - one digit $194.05 6 6
E537 - Tendon Tenolysis flexor and/or extensor tendon of each additional digit . . . Add $165.20 N/A N/A
R541 Flexor tenolysis with pulley preservation $309.00 6 6
Z247 Tenotomy or fasciotomy (closed) - Finger - one $49.20 6 N/A
Z248 Tenotomy or fasciotomy (closed) - Finger - two $72.35 7 N/A
Z249 Tenotomy or fasciotomy (closed) - Finger - three or more $99.15 6 N/A
Z231 Tenotomy or fasciotomy (closed) - Finger - three or more $73.70 7 N/A
R536 Tendon release (open) - finger/palm $156.50 6 N/A
E592 - more than one, to R536 . . . Add $133.05 N/A N/A
R537 Tendon release (open) - wrist $175.00 6 6
E571 - more than one, to R537 . . . Add $148.75 N/A N/A
R519 Muscles and tendons - simple, e.g. tennis elbow $136.35 6 6
R521 Muscles and tendons - radical, e.g. muscle slide $314.60 7 6
R526 Sternomastoid $296.05 7 6

Reduction

Code Description Amount Ans Units Assist Units
F004 Fractures - Phalanx - no reduction, rigid immobilization $49.20 N/A N/A
F005 Fractures - Phalanx - closed reduction $99.25 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E558 - Fractures Phalanx each additional . . . Add $22.25 N/A N/A
F007 Fractures - Phalanx - open reduction $298.45 7 6
F008 Fractures - Metacarpal - no reduction, one or more, rigid immobilization $49.20 N/A N/A
F009 Fractures - Metacarpal - closed reduction $99.25 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E504 - Fractures Metacarpal each additional . . . Add $22.20 N/A N/A
F011 Fractures - Metacarpal - open reduction $262.60 7 6
E559 - each additional (open) . . . Add $142.90 N/A N/A
F006 Fractures - Intra-articular - closed reduction $119.75 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E503 - each additional . . . Add $26.85 N/A N/A
F010 Fractures - Intra-articular - open reduction $335.80 7 6
F012 Fractures - Bennett's - no reduction, rigid immobilization $49.20 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F013 Fractures - Bennett's - closed reduction $119.80 6 6
F015 Fractures - Bennett's - open reduction $335.80 7 6
F102 Fractures - Carpus - no reduction, rigid immobilization $49.20 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F016 Fractures - Carpus - closed reduction, one or more $115.10 6 N/A
F017 Fractures - Carpus - open reduction, one or more $346.15 7 6
F018 Fractures - Scaphoid - no reduction, rigid immobilization $49.20 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F019 Fractures - Scaphoid - open reduction $480.00 7 6
F020 Fractures - Scaphoid - excision $193.00 7 6
D001 Fractures - Dislocations - Finger - closed reduction $57.50 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E576 - each additional . . . Add $10.25 N/A N/A
D003 Fractures - Dislocations - Finger - open reduction $195.00 6 6
D004 Fractures - Dislocations - Metacarpal/phalangeal - closed reduction $57.50 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E577 - each additional . . . Add $10.25 N/A N/A
D006 Fractures - Dislocations - Metacarpal/phalangeal - open reduction $181.85 7 6
D007 Fractures - Carpal - closed reduction $128.05 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
D008 Fractures - Carpal - open reduction $241.30 7 6
D009 Dislocations - Elbow joint - closed reduction $84.45 6 N/A
D010 Dislocations - Elbow joint - open reduction acute $252.45 7 6
R400 Dislocations - Elbow joint - repair chronic, recurrent $379.50 6 6
D012 Dislocations - Radial head - closed reduction, pulled elbow $39.00 6 N/A
D011 Dislocations - Radial head - open reduction - acute $193.00 7 6
R540 Dislocations - Radial head - open reduction - recurrent $227.40 7 6
R558 Dislocations - Radial head - open reduction - late $357.20 7 6
F029 Fractures - Epicondyle - no reduction $67.75 N/A N/A
F037 Fractures - Epicondyle - closed reduction $126.25 6 6
F038 Fractures - Epicondyle - open reduction $214.45 7 6
F039 Fractures - Transcondylar/condylar - no reduction $67.75 N/A N/A
F040 Fractures - Transcondylar/condylar - closed reduction $298.35 6 6
F045 Fractures - Transcondylar/condylar - closed reduction with traction $312.70 6 6
F041 Fractures - Transcondylar/condylar - open reduction $375.80 7 6
F034 Fractures - Olecranon - no reduction, rigid immobilization $126.25 6 N/A
F035 Fractures - Olecranon - closed reduction $129.00 6 6
F036 Fractures - Olecranon - open reduction $224.55 7 6
F024 Fractures - Radius and ulnar shaft - no reduction, rigid immobilization $67.75 N/A N/A
F025 Fractures - Radius and ulnar shaft - closed reduction $148.50 6 6
F026 Fractures - Radius and ulnar shaft - open reduction $368.40 7 6
F014 Fractures - Radius and ulna Monteggia - no reduction, rigid immobilization $67.75 N/A N/A
F022 Fractures - Radius and ulna Monteggia - closed reduction $144.80 6 N/A
F023 Fractures - Radius and ulna Monteggia - open reduction of ulna plus closed reduction radial head $242.25 7 6
F031 Fractures - Radius or ulna - no reduction, rigid immobilization $81.30 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F032 Fractures - Radius or ulna - closed reduction $117.85 6 6
F033 Fractures - Radius or ulna - open reduction $274.00 7 6
F027 Fractures - Radius distal, e.g. Colles', Smith's, or Barton's fracture - no reduction, rigid immobilization $67.75 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F028 Fractures - Radius distal, e.g. Colles', Smith's, or Barton's fracture - closed reduction, under local or regional anaesthetic $109.45 N/A N/A
F046 Fractures - Radius distal, e.g. Colles', Smith's, or Barton's fracture - closed reduction, under general anaesthetic $149.35 6 6
F030 Fractures - Radius distal, e.g. Colles', Smith's, or Barton's fracture - open reduction $420.00 7 6
F021 Fractures - Osteochondral - open reduction $392.40 7 6
F047 Fractures - Tuberosity - no reduction $67.80 N/A N/A
F048 Fractures - Tuberosity - closed reduction $117.85 6 6
F049 Fractures - Tuberosity - open reduction (without cuff tear) $290.55 6 6
F053 Fractures - Neck without dislocation of head - no reduction $67.80 N/A N/A
F054 Fractures - Neck without dislocation of head - closed reduction $133.60 6 N/A
F055 Fractures - Neck without dislocation of head - open reduction $327.55 6 6
F050 Fractures - Neck with dislocation of head - no reduction $67.80 N/A N/A
F051 Fractures - Neck with dislocation of head - closed reduction $183.80 6 6
F052 Fractures - Neck with dislocation of head - open reduction $385.15 6 6
F042 Fractures - Shaft - no reduction $67.80 N/A N/A
F043 Fractures - Shaft - closed reduction $147.60 6 6
F044 Fractures - Shaft - open reduction $323.05 6 6
F110 Fractures - Clavicle - closed reduction with anaesthetic $62.20 7 6
F118 Fractures - Clavicle - open reduction $300.00 7 6
F119 Fractures - Scapula - no reduction $67.80 N/A N/A
F121 Fractures - Scapula - open reduction $242.25 6 6
F123 Fractures - Sternum - closed reduction $115.95 N/A N/A
F124 Fractures - Sternum - open reduction pleura open $0.00 13 9
F125 Fractures - Sternum - pleura closed $0.00 6 6
F131 Fractures - Ribs - pleura closed $0.00 6 6
D014 Dislocations - Acromio-clavicular/sterno-clavicular - no reduction $67.80 N/A N/A
D025 Dislocations - Acromio-clavicular/sterno-clavicular - closed with anaesthetic $134.55 6 6
D023 Dislocations - Acromio-clavicular/sterno-clavicular - open reduction $231.10 7 6
R596 Dislocations - Acromio-clavicular/sterno-clavicular - late $286.70 6 6
D015 Dislocations - Glenohumeral joint - closed reduction without anaesthetic $49.20 N/A N/A
D016 Dislocations - Glenohumeral joint - closed reduction with anaesthetic $111.40 6 N/A
D017 Dislocations - Glenohumeral joint - open reduction, early $323.85 6 6
R472 Dislocations - Glenohumeral joint - open reduction, late $580.90 10 6
R401 Dislocations - Glenohumeral joint - open reduction, recurrent $379.50 10 6
F136 Fractures - Nasal bones to include manipulation of nasal septum - closed reduction $102.35 6 N/A
F137 Fractures - Nasal bones to include manipulation of nasal septum - open reduction $316.35 10 N/A
E825 - with miniplate(s)**, per major fracture line . . . Add $63.95 N/A N/A
F150 Fractures - Orbit with maxilla - closed reduction and dental wiring $256.40 7 N/A
F142 Fractures - Orbit with maxilla - with wiring and local fixation $685.20 7 6
E830 - with miniplate(s)**, per major fracture line . . . Add $107.20 N/A N/A
E932 - unilateral . . . Add $205.00 N/A N/A
E935 - bilateral . . . Add $307.70 N/A N/A
F143 Fractures - Midface fractures - middle ¼ facial $577.65 8 6
E830 - Fractures Orbit with maxilla with wiring and local fixation with miniplate(s)**, per major fracture line . . . Add $107.20 N/A N/A
F144 Fractures - Midface fractures - cranialfacial separation $1,594.90 10 6
E830 - Fractures Orbit with maxilla with wiring and local fixation with miniplate(s)**, per major fracture line . . . Add $107.20 N/A N/A
F134 Fractures - Pelvic ring - closed reduction $442.45 6 6
F135 Fractures - Pelvic ring - open reduction $680.30 8 6
F098 Fractures - Femoral neck trochanteric, subtrochanteric - closed reduction/traction $426.90 6 6
F099 Fractures - Femoral neck trochanteric, subtrochanteric - open reduction pin only $408.30 8 6
F100 Fractures - Femoral neck trochanteric, subtrochanteric - open reduction pin and plate/screws (cannulated included) $498.95 10 6
F101 Fractures - Femoral neck trochanteric, subtrochanteric - open reduction primary prosthesis, femur only (includes Moore, Thompson, Unipolar, Bipolar) $490.95 10 6
R600 Fractures - Femoral neck trochanteric, subtrochanteric - delayed/staged graft $289.50 8 6
R607 Fractures - Slipped epiphysis - closed reduction/traction $387.00 8 6
R642 Fractures - Slipped epiphysis - closed reduction/internal fixation $387.00 8 6
R627 Fractures - Slipped epiphysis - open reduction/fixation $580.90 8 6
D052 Dislocations - Acetabulum - open reduction lips $612.45 8 7
D046 Dislocations - Acetabulum - open reduction one pillar $967.90 10 6
D047 Dislocations - Acetabulum - open reduction two pillars $1,451.45 12 8
D042 Dislocations - Hip - closed reduction $268.25 6 N/A
D043 Dislocations - Hip - open reduction $406.45 7 7
R628 Dislocations - Hip - late, after four weeks open $774.90 10 7
D059 Dislocations - Sacro-iliac - closed, traction, spica, etc $428.50 6 N/A
D060 Dislocations - Sacro-iliac - open reduction $593.00 6 6
D061 Dislocations - Sacro-coccygeal - open, removal of coccyx $193.00 6 6
R404 Dislocations - Congenital hip - closed reduction (includes tenotomy and cast) $190.20 7 N/A
R405 Dislocations - Congenital hip - repeat (includes cast) $131.80 6 N/A
R406 Dislocations - Congenital hip - open reduction (includes tenotomy and arthrotomy) $472.35 7 7
Z291 Dislocations - Congenital hip - Application Pavlik Harness or C.D.H. Splint $24.10 N/A N/A
F085 Fractures - Patella - no reduction $67.75 N/A N/A
F087 Fractures - Patella - open reduction or excision with or without repair $275.65 7 6
D038 Dislocations - Knee - closed reduction $207.90 6 N/A
D039 Dislocations - Knee - open reduction $309.00 7 6
D040 Dislocations - Patella - closed reduction - without anaesthetic $62.20 N/A N/A
D031 Dislocations - Patella - closed reduction - with anaesthetic $97.35 6 N/A
D041 Dislocations - Patella - open reduction - early $290.55 7 N/A
R255 Dislocations - Patella - open reduction - late $484.35 7 6
R403 Dislocations - Patella - open reduction - repair recurrent dislocation (includes inspection of joint) $393.40 7 6
R515 Dislocations - Patella - open reduction - Congenital dislocation knee (open) $484.35 7 6
F078 Fractures - Tibia with or without fibula - no reduction, rigid immobilization $115.95 N/A N/A
F079 Fractures - Tibia with or without fibula - closed reduction $180.50 6 6
F080 Fractures - Tibia with or without fibula - open reduction shaft $356.40 6 6
E041 - Pseudoarthrosis intramedullary nail with distal and proximal locking screws tibia . . . ADD $81.55 N/A N/A
F081 Fractures - Intramedullary nail with distal and proximal locking screws - medial or lateral tibial plateau $394.45 6 6
F082 Fractures - Fibula - no reduction, rigid immobilization $67.75 N/A N/A
F083 Fractures - Fibula - closed reduction $101.25 6 N/A
F084 Fractures - open reduction $230.20 7 6
F074 Fractures - Ankle - no reduction rigid immobilization $67.75 N/A N/A
F075 Fractures - Ankle - closed reduction $144.80 6 6
F076 Fractures - open reduction - one malleolus $237.50 7 6
F077 Fractures - open reduction - multiple malleoli or ligaments $400.00 7 6
F104 Fractures - Ankle fracture with tibial Plafond burst - closed reduction $242.25 6 6
F108 Fractures - Ankle fracture with tibial Plafond burst - open reduction $362.95 6 6
F061 Fractures - Metatarsus - one or more $49.20 N/A N/A
F062 Fractures - Metatarsus - with rigid immobilization $67.75 N/A N/A
F063 Fractures - closed reduction - one or more $98.35 6 6
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F064 Fractures - open reduction - one $178.20 7 6
F065 Fractures - open reduction - two or more $249.65 7 6
F070 Fractures - Os calcis - no reduction rigid immobilization $97.35 N/A N/A
F071 Fractures - Os calcis - closed reduction $161.45 7 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F072 Fractures - open reduction - with repair of both the subtalar and calcaneocuboid joints $500.00 6 6
F056 Fractures - Phalanx - no reduction rigid immobilization $49.20 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E560 - each additional . . . Add $12.05 N/A N/A
F058 Fractures - Phalanx - closed reduction - one $72.35 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E561 - each additional . . . Add $14.90 N/A N/A
F060 Fractures - Phalanx - open reduction $172.30 7 6
F066 Fractures - Tarsus excluding os calcis - no reduction rigid immobilization $98.10 N/A N/A
F067 Fractures - Tarsus excluding os calcis - closed reduction $165.20 6 6
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F068 Fractures - Tarsus excluding os calcis - open reduction $237.50 N/A 6
F057 Fractures - Intraarticular fracture I.P. Joint - closed reduction $77.95 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
F059 Fractures - Intraarticular fracture I.P. Joint - open reduction $144.80 7 6
D035 Dislocations - Ankle - closed reduction $111.35 6 6
D036 Dislocations - Ankle - open reduction $252.45 7 6
R402 Dislocations - Ankle -recurrent dislocation and/or subluxation $367.45 7 6
D027 Dislocations - Interphalangeal - closed reduction $57.50 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E578 - each additional . . . Add $10.25 N/A N/A
D029 Dislocations - Interphalangeal - open reduction $151.25 6 6
D030 Dislocations - Metatarsophalangeal - closed reduction $57.50 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
E579 - each additional . . . add $10.25 N/A N/A
D032 Dislocations - Metatarsophalangeal - open reduction $163.35 7 6
D033 Dislocations - Tarsus - closed reduction $147.60 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
D034 Dislocations - Tarsus - open reduction $252.45 7 6
D026 Dislocations - Tarsus - Tarsometatarsal - closed reduction, one or more joints $147.60 6 N/A
D028 Dislocations - Tarsus - Tarsometatarsal - open reduction, one joint $300.00 6 6
E508 - each additional joint, to D028 . . . Add $85.00 N/A N/A

Decompression/Denervation

Code Description Amount Ans Units Assist Units
R495 Fasciotomy for compartment syndrome (not including secondary closure wound) . $320.20 7 6
Z251 Catheter - insertion $49.20 N/A N/A
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
R426 Denervation - elbow $258.00 7 6
N184 Decompression of posterior tibial or common perineal nerve $165.20 7 6

Examination And Manipulation

Code Description Amount Ans Units Assist Units
Z223 Manipulation under general anaesthetic $49.20 6 N/A

Deformity

Code Description Amount Ans Units Assist Units
R260 Osteotomy - humerus $292.35 7 6
R235 Osteotomy - glenoid $279.35 6 6
R957 Osteotomy - Single level correction circular external fixation $510.35 6 6
R958 Osteotomy - Double level correction circular external fixation $638.40 6 6
R959 Osteotomy - Bone transport - circular external fixation (less than or equal to 6 cm) $655.15 6 6
R960 Osteotomy - Bone transport - circular external fixation (greater than 6 cm) $763.80 6 6
R961 Osteotomy - Humeral lengthening - circular external fixation (less than or equal to 6 cm) $438.00 6 6
R962 Osteotomy - Humeral lengthening - circular external fixation (greater than 6 cm) $655.15 6 6

Orthognathic Surgery

Code Description Amount Ans Units Assist Units
R382 Anterior dento-alveolar osteotomy, maxilla or mandible - one segment $803.80 15 6
R383 Anterior dento-alveolar osteotomy, maxilla or mandible - two segments $932.10 15 6
R349 Posterior dento-alveolar osteotomy, maxilla - one side $803.80 15 6
R351 Posterior dento-alveolar osteotomy, maxilla - both sides, single segment $932.10 15 6
R385 Posterior dento-alveolar osteotomy, maxilla - both sides, separate segments $1,187.50 15 6
R462 Posterior dento-alveolar osteotomy, mandible - one side $803.80 15 6
R463 Posterior dento-alveolar osteotomy, mandible - both sides $1,187.50 15 6
R502 Total U dento-alveolar osteotomy - mandible $1,228.70 15 6
R507 Total U dento-alveolar osteotomy - maxilla $1,315.70 15 6
R511 Total U dento-alveolar osteotomy - Mandibular or maxillary visor osteotomy for alveolar hypoplasia $1,146.40 15 6
R386 Genioplasty - one segment $384.60 10 6
R387 Genioplasty - two segments, or for laterognathia $575.45 10 6
R388 Genioplasty - three segments $767.85 10 6
R480 Mandibular osteotomies for prognathism - subcondylar $420.10 7 6
R384 Mandibular osteotomies for prognathism - vertical ramus $932.10 15 6
R518 Mandibular osteotomies for prognathism - sagittal split $932.10 15 6
R520 Mandibular osteotomies for retrognathia, any technique - advancement - up to 10 mm $932.10 15 6
R529 Mandibular osteotomies for retrognathia, any technique - advancement - 10 to 20 mm, inclusive $1,058.40 15 6
R535 Mandibular osteotomies for retrognathia, any technique - advancement - greater than 20 mm $1,356.90 15 6
E588 - Mandibular osteotomies for retrognathia, any technique for apertognathia or laterognathia . . . Add $256.40 N/A N/A
R379 LeFort I advancement - in one segment $803.80 20 10
E961 - LeFort I advancement in two segments . . . Add $296.60 N/A N/A
E962 - LeFort I advancement in three segments . . . Add $594.20 N/A N/A
R538 LeFort I intrusion - in one segment $1,059.35 20 10
E963 - LeFort I intrusion in two segments . . . Add $296.60 N/A N/A
E964 - LeFort I intrusion in three segments . . . Add $594.20 N/A N/A
R567 LeFort I extrusion - in one segment* $1,315.70 20 10
E965 - LeFort I extrusion in two segments . . . Add $296.60 N/A N/A
E966 - LeFort I extrusion in three segments . . . Add $594.20 N/A N/A
R580 LeFort I cleft palate - in one segment* $1,525.30 20 10
E967 - LeFort I cleft palate in two segments . . . Add $256.40 N/A N/A
E968 - LeFort I cleft palate in three segments . . . Add $511.90 N/A N/A
E969 - LeFort I cleft palate with SMR . . . Add $204.80 N/A N/A
E970 - LeFort I cleft palate with pharyngoplasty . . . Add $307.15 N/A N/A
E971 - LeFort I cleft palate with closure alveolar fistula with or without bone graft . . . Add $383.65 N/A N/A
E972 - LeFort I cleft palate with closure hard palate fistula with or without bone graft . . . Add $511.90 N/A N/A
R588 Nasomaxillary osteotomy without LeFort I* $803.80 15 6
R389 LeFort II maxillary osteotomy and advancement* $1,443.95 20 10
R395 Construction glenoid fossa and zygomatic arch* (Obwegeser technique) $1,402.75 20 10
R396 Construction absent condyle and ascending ramus* $803.80 10 6
R609 Combined LeFort I and LeFort III osteotomy in hemifacial microsomia $1,586.20 20 10
R145 Mandibular condylotomy $204.80 7 6
R618 Coronoidotomy $204.80 7 6
R644 Coronoidectomy $307.15 6 6
R334 Reconstruction mandible with bone grafts* and/or plate or prosthesis - Unilateral - partial $409.55 15 6
R335 Reconstruction mandible with bone grafts* and/or plate or prosthesis - Unilateral - complete $819.15 15 6
R645 Reconstruction mandible with bone grafts* and/or plate or prosthesis - Bilateral - partial $819.15 15 6
R646 Reconstruction mandible with bone grafts* and/or plate or prosthesis - Bilateral - complete $1,023.95 15 6
R647 Oral vestibuloplasty - with secondary epithelization $204.80 6 6
R648 Oral vestibuloplasty - with skin graft $307.15 6 6
R649 Temporomandibular ankylosis - excision bone or fibrous block $461.30 7 6
R650 Temporomandibular ankylosis - with insertion of prosthetic device or muscle flap $511.90 13 6
R651 Temporomandibular ankylosis - with construction of condyle and ascending ramus* $666.00 15 6
Z253 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Mandible - unilateral $394.80 N/A N/A
Z254 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Mandible - bilateral $507.45 N/A N/A
Z255 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Maxilla - unilateral $394.80 N/A N/A
Z256 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Maxilla - bilateral $507.45 N/A N/A
Z257 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Zygoma - unilateral $337.85 N/A N/A
Z258 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Zygoma - bilateral $450.50 N/A N/A
Z259 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Temporal - unilateral $450.50 N/A N/A
Z260 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Temporal - bilateral $563.10 N/A N/A
Z261 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Frontal - unilateral $450.50 N/A N/A
Z262 Onlay bone grafts or alloplastic reconstruction to face when not part of standard osteotomy for reconstruction - Frontal - bilateral $563.10 N/A N/A
Z239 Application of dental arch bars, or splint, for facial osteotomy - one arch bar $133.00 6 6
Z240 Application of dental arch bars, or splint, for facial osteotomy - two arch bars $204.80 7 6
R354 Interdental wiring for temporomandibular joint disorder $154.00 7 6
R652 Interdental wiring for temporomandibular joint disorder - Removal intermaxillary fixation devices under general anaesthesia - as sole procedure $102.35 6 N/A

Orbito Cranial Surgery

Code Description Amount Ans Units Assist Units
R390 Bilateral periorbital correction Treacher-Collins Syndrome - with or without bone grafts* (extracranial) $1,699.45 20 10
R653 Bilateral periorbital correction Treacher-Collins Syndrome - with skull and muscle transpositions* (includes skull reconstruction) (intracranial) $2,196.35 25 10
R654 Pericranial flap to orbit or face - unilateral $307.15 6 N/A
E973 - when in conjunction with coronal approach for main operation . . . add $178.90 N/A N/A
R655 Pericranial flap to orbit or face - bilateral $409.55 7 N/A
E974 - when in conjunction with coronal approach for main operation . . . Add $297.55 N/A N/A
R378 LeFort III total maxillary advancement* $2,037.35 25 12
R656 LeFort III and subcranial hypertelorism correction* $2,590.35 25 12
R657 LeFort III and LeFort I maxillary advancement* $2,334.85 25 12
R658 LeFort II, subcranial hypertelorism correction Le Fort I maxillary advancement* $2,928.10 25 12
R659 Upper LeFort III advancement without occlusal change* - unilateral $932.10 10 6
R675 Upper LeFort III advancement without occlusal change* - bilateral $1,443.95 25 12
R676 Forehead advancement (bone grafts not included) - unilateral $1,187.50 25 12
R393 Forehead advancement (bone grafts not included) - bilateral $1,443.95 25 12
R394 Cranial vault reshaping* anterior or posterior half $1,525.30 20 10
R677 Total cranial vault reshaping* $2,078.35 25 12
R398 Medial transnasal canthopexy - unilateral $414.30 6 6
E557 - when done in conjunction with another procedure . . . Add $154.00 N/A N/A
R399 Lateral canthoplasty - unilateral $204.80 6 6
E930 - when done in conjunction with another procedure . . . Add $102.35 N/A N/A
R376 Hypertelorism correction - intracranial approach* $2,334.85 25 12
R377 Hypertelorism correction - subcranial U osteotomies* $1,950.15 25 12
R678 Hypertelorism correction - medial orbital wall osteotomies* $1,228.70 20 10
R679 Hypertelorism correction - medial and lateral orbital wall osteotomies* $1,612.30 20 10
R391 Orbital dystopia - intracranial approach $1,950.15 25 12
R392 Orbital dystopia - intracranial approach $1,485.10 20 10
R380 Orbital cranial osteotomy - intracranial approach $1,495.50 25 12
R381 Orbital cranial osteotomy - extracranial approach $1,121.50 20 10
R680 Late correction traumatic enophthalmos - intracranial $1,997.05 25 12
R681 Late correction traumatic enophthalmos - extracranial $1,443.95 20 10
Z263 Harvesting of bone graft when not included - Iliac bone graft $102.35 N/A N/A
Z264 Harvesting of bone graft when not included - Rib graft - one rib $154.00 N/A N/A
E975 - Harvesting of bone graft when not included Rib graft each subsequent rib . . . add $76.50 N/A N/A
Z265 Harvesting of bone graft when not included - Costochondral or chondral graft - one rib $230.65 N/A N/A
E976 - Harvesting of bone graft when not included Costochondral or chondral graft each subsequent rib . . . Add $154.00 N/A N/A
Z266 Harvesting of bone graft when not included - Costochondral or chondral graft - split cranial graft $204.80 N/A N/A

Surgery For Correction Of Down's Syndrome Facial Stigmata

Code Description Amount Ans Units Assist Units
Z267 Augmentation of zygoma (bilateral) - with prosthetic implant $184.60 N/A N/A
Z268 Augmentation of zygoma (bilateral) - with autogenous bone or cartilage* $230.65 N/A N/A
Z269 Augmentation of chin - with prosthetic implant $154.00 N/A N/A
Z270 Augmentation of chin - with autogenous bone or cartilage* $189.45 N/A N/A
Z271 Augmentation of chin - Horizontal resection, red lower lip $184.60 N/A N/A
R347 Bicoronal flaps $200.00 N/A N/A
E173 - Fractures Orbit open reduction rim/wall fracture Zygomatic fracture dislocation $594.70 7 6
E933 - Fractures Orbit open reduction rim/wall fracture Zygomatic fracture dislocation with miniplate(s)**, per major fracture line . . . Add $99.85 N/A N/A
E934 - Fractures Orbit open reduction rim/wall fracture Zygomatic fracture dislocation with primary bone graft (separate site) . . . Add $204.80 N/A N/A
E174 - Fractures Orbit blowout fracture of floor $667.00 7 6

Examination/Manipulation

Code Description Amount Ans Units Assist Units
Z222 Manipulation under general anaesthetic $24.10 N/A N/A
Z252 Manipulation - under general anaesthetic $39.00 6 N/A
R431 Excision - Baker's cyst - simple $148.50 6 6
R434 Excision - Baker's cyst - extensive $264.50 7 6
R501 Excision - Baker's cyst - Cysts of meniscus $126.25 6 6
R429 Excision - Baker's cyst - Meniscectomy $241.30 6 6
R417 Excision - Debridement of joint without synovectomy $290.55 7 6
R424 Excision - Synovectomy $430.65 7 6
R506 Excision - Prepatellar bursae $149.45 6 6
R312 Excision - Patella - to include fascial repair $276.55 7 6
R318 Excision - Excision exostosis/cyst patella $126.25 6 6
Z235 Club foot, etc. - manipulation and cast/strapping - without anaesthetic $19.45 N/A N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
Z224 Club foot, etc. - manipulation and cast/strapping - with anaesthetic $39.00 6 N/A

Incision And Drainage

Code Description Amount Ans Units Assist Units
R219 Phalanx/metacarpal/carpus - incision and drainage $182.90 6 6
R218 Phalanx/metacarpal/carpus - sequestrectomy $144.80 6 6
R217 Phalanx/metacarpal/carpus - saucerization and bone graft $242.25 7 6
R534 Phalanx/metacarpal/carpus - Tendon sheath $225.00 6 6
R228 Acute $302.55 7 6
Z226 Soft tissue or bursa, incision and drainage $97.35 N/A N/A
R231 Sequestrectomy $355.35 7 6
R229 Saucerization and bone grafting $452.90 7 6
Z234 Mandibular sequestrectomy $281.25 7 7
R269 Bone $290.55 7 6
R249 Sequestrectomy $379.50 7 6
R250 Saucerization and bone graft $627.30 6 6
R242 Bone $325.75 7 6
R245 Sequestrectomy $395.25 7 6
R243 Saucerization and graft $619.90 6 6
R444 Joint $193.00 7 6
R237 Bone $308.10 7 6
R239 Sequestrectomy $329.40 7 6
R238 Saucerization and bone grafting $411.20 7 6
R220 Bone $227.40 7 6
R201 Sequestrectomy $193.00 7 6
R202 Saucerization and bone graft $387.00 7 6

Decompression Denervation

Code Description Amount Ans Units Assist Units
N290 Decompression median nerve at wrist (carpal tunnel syndrome) $156.75 6 6
N285 Exploration and/or decompression and/or transposition and/or neurolysis of major nerve (excluding carpal tunnel nerve) $256.15 7 6

Fixation

Code Description Amount Ans Units Assist Units
R267 Removal of internal fixation device - general anaesthetic $158.65 6 6
R268 Removal of internal fixation device - local anaesthetic $54.85 6 6
R598 Removal of extensive external fixation device under general anaesthetic $48.25 6 N/A
Z280 Adjustment of circumferential external fixation - without general anaesthetic $72.35 N/A N/A
Z281 Adjustment of circumferential external fixation - with general anaesthetic $145.70 N/A N/A
Z210 Adjustment of circumferential external fixation - Insertion traction pin excludes fractures and dislocations $33.35 N/A N/A
E550 - Wound Care insertion of closed irrigation system during a surgical procedure for postoperative management . . . Add $63.15 N/A N/A

Wound Care

Code Description Amount Ans Units Assist Units
Z783 Secondary closure $97.35 7 N/A
R517 Excision of foreign body $107.70 6 N/A
Z250 Chronic Electrical Stimulation (not to include T.E.N.S.) external or internal $193.00 7 N/A
Z273 Muscle core biopsy using a 6mm or larger Bergstrom muscle biopsy needle or equivalent kit includes one or more biopsies $63.35 15 N/A

Orthopaedic Tumour Surgery

Code Description Amount Ans Units Assist Units
R226 Biopsy of suspected sarcoma, or resection of a complex bone or complex soft tissue tumour(s), per 15 minutes $100.00 15 10

Casts

Code Description Amount Ans Units Assist Units
Z201 Finger $10.25 N/A N/A
E584 - application of plaster cast outside hospital . . . Add $11.15 N/A N/A
Z202 Hand $14.90 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
Z203 Arm, forearm or wrist $24.10 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
Z199 Foot $14.90 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
Z213 Below knee, knee splints (Stove pipe, etc.) $24.10 6 N/A
Z211 Whole leg (mid thigh to toes) $28.80 6 N/A
Z198 Toes $10.25 6 N/A
E584 - Finger application of plaster cast outside hospital . . . Add $11.15 N/A N/A
Z205 Head and torso $97.35 6 6
Z208 Shoulder spica $97.35 7 6
Z206 Body cast $57.50 6 6
Z207 Hip spica - unilateral $97.35 6 6
Z209 Hip spica - bilateral $121.60 7 6
Z216 Wedging of casts in other than fracture treatment $10.25 N/A N/A
Z200 Application of Unna's paste $14.90 N/A N/A
Z873 Application of cast brace (must include hinge) $67.75 N/A N/A
Z204 Removal of plaster (not associated with fractures or dislocations within 2 weeks of initial treatment) $10.25 N/A N/A

Amputation

Code Description Amount Ans Units Assist Units
R606 Phalanx $161.45 6 N/A
R608 Metacarpal or metaphalangeal joint $190.20 7 N/A
E583 - each additional . . . add $94.60 N/A N/A
R610 Trans. metacarpal 2nd to 5th ray $279.35 7 N/A
R611 Hand all 'metacarpals $289.50 7 6
R612 Wrist $289.50 6 6
R629 Revision of amputated finger tip $241.55 6 6
R613 Through radius and ulna $306.30 7 6
R614 Elbow disarticulation $289.50 6 6
R617 Forequarter $490.95 15 10
R616 Shoulder disarticulation $373.10 9 9
R615 High humerus $369.35 6 6
R631 Hemipelvectomy hindquarter $796.20 15 10
R630 Hip disarticulation $449.20 10 10
R625 GrittiStokes or Callander $305.25 7 6
R626 Through femur $306.30 7 6
R624 Tibia/fibula $306.30 7 6
R620 Metatarsal/phalanx disarticulation $155.90 6 6
E585 - each additional . . . add $47.30 N/A N/A
R621 Ray (single) $217.15 6 6
R623 Symes $285.80 7 6
R622 Transmetatarsal/transtarsal $235.75 7 6
R619 Terminal Symes $144.80 6 6

Arthrodesis

Code Description Amount Ans Units Assist Units
R465 Finger-thumb $256.15 7 6
R466 Wrist $400.00 6 6
R467 Shoulder $468.65 6 6
R469 Sacro-iliac joint $395.25 7 6
R514 Symphysis pubis $387.00 7 6
R470 Hip $703.45 8 6
R468 Knee $402.75 6 6
R552 Ankle - revision of arthrodesis $506.65 7 6
R471 Interphalangeal $151.85 6 6
E575 - each additional . . . add $41.70 N/A N/A
R477 Metatarsophalangeal $247.25 7 6
R695 Subtalar $450.00 6 6
E511 - additional midtarsal(s), to R695 . . . Add $100.00 N/A N/A
R696 Midtarsal, single joint $500.00 6 6
E512 - additional midtarsal(s), to R696 . . . Add $100.00 N/A N/A
R697 Metatarsaltarsal (fusion of one or more joints) $300.00 6 6
R475 Pantalar, one stage $626.45 6 6

Arthroplasty

Code Description Amount Ans Units Assist Units
R437 Wrist - interposition $374.00 7 6
R485 Wrist - total $426.90 6 6
R479 Wrist - removal only $193.00 6 6
R435 Hand - interposition - single $254.35 7 6
R436 Hand - interposition - multiple $459.40 7 6
R489 Single joint total (arthrodesis and/or arthroplasties) maximum of 4 $290.55 7 6
R209 Basal thumb first carpometacarpal joint $363.05 7 6
R500 Removal only $144.80 6 6
R236 Carpal replacement $322.05 7 6
R281 Ulna replacement (lower end) $296.90 6 6
R288 Implant radial head $251.55 6 6
R499 Removal of total replacement $402.75 7 6
R486 Complete arthroplasty replacement $619.90 8 6
R510 Interposition arthroplasty $435.20 7 6
R438 Humeral prosthesis $449.20 10 6
R487 Total prosthesis $695.10 10 8
R240 Revision total arthroplasty shoulder $942.95 15 8
R498 Removal prosthesis/no replacement $397.20 8 6
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 10 6
E478 - Pinning of osteochondral fragment, to R682 . . . Add $251.55 N/A N/A
E484 - Superior labral anterior posterior (SLAP) repair, to R684 . . . Add $336.65 N/A N/A
E485 - Arthroscopic capsular release for frozen shoulder, to R684 . . . Add $240.50 N/A N/A
R433 Temporomandibular joint - unilateral $349.30 10 6
R439 Unipolar $490.95 10 6
R440 Total hip replacement - acetabulum and femur $696.00 10 8
R553 Total hip replacement with take down of fusion $972.90 15 8
R241 Revision total arthroplasty hip - one or both components - acetabular or femoral $1,304.80 15 8
E589 - bone graft to acetabulum . . . add $101.25 N/A N/A
E593 - acetabular reconstruction (extensive, including bone grafts) . . . add $194.00 N/A N/A
R481 Revision total arthroplasty hip - one or both components - Reattachment of greater trochanter (late) $290.55 8 6
R443 Removal only - noncemented $447.30 8 6
R488 Removal only - cemented $557.75 8 6
R491 Removal only - Replacement acetabular liner and/or femoral head $353.25 10 8
R509 Patellar arthroplasty $241.60 7 6
R482 Hemiarthroplasty - single component (e.g. MacIntosh) $351.70 6 6
R483 Hemiarthroplasty - double component (e.g. Marmar) $619.90 7 8
R441 Hemiarthroplasty -Total replacement/both compartments $619.90 8 8
R248 Hemiarthroplasty - Total knee replacement with take down of fusion $838.00 8 8
R244 Hemiarthroplasty - Revision total arthroplasty knee $1,174.30 8 8
E598 - with associated patellar replacement or patelloplasty, to R482, R483, R441, R248 or R244 . . . Add $94.60 N/A N/A
R442 Hemiarthroplasty - Replacement Liner $353.25 8 8
R496 Hemiarthroplasty - Removal of hemiarthroplasty without replacement $242.25 7 6
R497 Hemiarthroplasty - Removal of total arthroplasty without replacement $368.40 6 6
R493 Ankle total replacement $1,177.50 10 8
R694 Ankle liner replacement $353.25 10 8
R456 Metatarsophalyngeal interposition - single $144.80 6 6
E538 - Metatarsophalyngeal interposition each additional . . . Add $38.00 N/A N/A
R453 Metatarsophalyngeal (Swansons, etc.) $289.50 7 6
R454 Metatarsophalyngeal (Swansons, etc.) - multiple $387.00 7 6

Arthroscopy

Code Description Amount Ans Units Assist Units
R682 Wrist arthroscopy setup $400.00 7 6
E479 - Arthroscopy of midcarpal and/or distal radioulnar joint, through separate portals, to R682 . . . add $192.00 N/A N/A
E478 - Pinning of osteochondral fragment, to R682 . . . Add $251.55 N/A N/A
E480 - Triangular fibrocartilage complex repair, to R682 . . . Add $350.65 N/A N/A
E482 - Soft tissue capsular release, for contractures, without bone procedure, to R682 . . . add $251.55 N/A N/A
E483 - Synovectomy for inflammatory arthritis requiring a minimum of 90 minutes to resect, to R682 . . . Add $326.55 N/A N/A
R683 Elbow arthroscopy setup, includes when rendered debridement, synovectomy, synovial biopsy, removal of loose body(ies) and/or screw, drilling of defect or microfracture, and/or arthroscopic epicondylar release $400.00 7 6
E478 - Pinning of osteochondral fragment, to R682 . . . Add $251.55 N/A N/A
E482 - Soft tissue capsular release, for contractures, without bone procedure, to R682 . . . add $251.55 N/A N/A
E483 - Synovectomy for inflammatory arthritis requiring a minimum of 90 minutes to resect, to R682 . . . Add $326.55 N/A N/A
E481 - Osteochondroplasty (extensive bone and arthrofibrotic tissue removal requiring a minimum of 2 hours to resect), to R683 . . . Add $500.00 N/A N/A
R686 Hip arthroscopy set up, includes when rendered debridement, synovectomy, removal of loose body(ies) and/or screw, drilling of defect, microfracture, abrasion arthroplasty, and/or synovial biopsy $669.80 10 6
E482 - Soft tissue capsular release, for contractures, without bone procedure, to R682 . . . add $251.55 N/A N/A
E487 - Resection of labrum, to R686 . . . Add $240.00 N/A N/A
E488 - Repair of labrum, to R686 . . . Add $350.00 N/A N/A
E490 - Osteochondroplasty (extensive bone and arthrofibrotic tissue removal requiring a minimum of 2 hours to resect), to R686 . . . Add $500.00 N/A N/A
R687 Knee arthroscopy setup, includes when rendered synovial biopsy and/or resection or trimming of plica $97.35 7 6
E478 - Pinning of osteochondral fragment, to R682 . . . Add $251.55 N/A N/A
E476 - Removal of symptomatic loose body(ies) and/or screw, to R687 . . . Add $192.00 N/A N/A
E491 - Lateral release, to R687 . . . Add $161.45 N/A N/A
E492 - Synovectomy for diseased synovium, anterior, posterior or complete, to R687 . . . add $231.30 N/A N/A
E493 - Drilling of defect (includes removal of loose body(ies), to R687 . . . Add $251.55 N/A N/A
E494 - Debridement 1 or more compartments, must include substantial debridement of pathologic articular cartilage and includes when rendered synovectomy, meniscal trimming and/or chondroplasty, to R687 . . . Add $299.00 N/A N/A
E489 - Microfracture and/or abrasion arthroplasty, for osteoarthritic cartilage deficiency (includes removal of loose body(ies), to R687 . . . Add $250.00 N/A N/A
E495 - Menisectomy, partial or total, for symptomatic meniscal tear, to R687 . . . Add $240.45 N/A N/A
E496 - Repair medial or lateral meniscus, includes when rendered debridement of attachment site, to R687 . . . Add $336.65 N/A N/A
R688 Ankle 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 7 6
E478 - Pinning of osteochondral fragment, to R682 . . . Add $251.55 N/A N/A
E483 - Synovectomy for inflammatory arthritis requiring a minimum of 90 minutes to resect, to R682 . . . Add $326.55 N/A N/A
E481 - Osteochondroplasty (extensive bone and arthrofibrotic tissue removal requiring a minimum of 2 hours to resect), to R683 . . . Add $500.00 N/A N/A
E477 - Arthroscopy of subtalar and/or intratarsal joint(s), through separate portals, to R688 . . . Add $192.00 N/A N/A
R689 Excision of Os Trigonum (sole procedure) $230.00 7 6

Arthrotomy

Code Description Amount Ans Units Assist Units
R409 Finger $168.00 6 N/A
R410 Wrist $212.50 6 6
R445 Elbow, loose body, etc $199.55 N/A 6
R411 Shoulder $223.65 7 6
R547 Sacro-iliac joint $290.55 7 6
R415 Hip - with removal of loose body $301.60 7 6
R412 Knee with or without removal of loose body $207.90 7 6
R413 Osteochondritis dissecans with drilling and/or internal fixation $267.25 7 6
R503 Ankle - removal of loose body, etc. $167.10 6 6
E539 - with osteotomy of malleolus . . . add $117.85 N/A N/A
R504 Ankle - Midtarsals $144.80 7 6
R505 Ankle - Metatarsal/phalangeal $144.80 6 6

Biopsy

Code Description Amount Ans Units Assist Units
Z230 Bone - punch, xray control $89.70 6 N/A
Z214 Bone - open biopsy or taking of bone graft by other than operating surgeon $144.80 6 6
Z221 Joint - needle $49.20 N/A N/A
Z228 Soft tissue - open $97.35 6 N/A
Z219 Muscle needle biopsy, soft tissue, per site $31.20 N/A N/A
Z225 Bone - needle $72.35 N/A N/A
R432 Joint - open $171.45 6 6
Z220 Bone - needle/punch, xray control $89.70 N/A N/A
R222 Incision and Drainage - Humerus/clavicle/scapula $262.60 7 6
R225 Incision and Drainage - Sequestrectomy $290.55 7 6
R223 Incision and Drainage - Saucerization with bone graft $387.90 7 6
Z869 Bone - punch, simple $48.50 7 N/A
Z870 Bone - punch, x-ray control $120.70 6 N/A
Z242 Bone - open $193.00 7 6
Z212 Bone - punch needle $89.70 N/A N/A
Z217 Bone - under general anaesthetic $72.35 N/A N/A
R256 Soft tissue - Injection into bone cysts $117.00 N/A N/A

Denervation/Decompression

Code Description Amount Ans Units Assist Units
N188 Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition - minor nerve including digital, cutaneous or lateral femoral cutaneous nerve $153.70 7 6
N177 Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition - Sciatic nerve in buttock $430.75 7 6
R427 Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition - Denervation of hip $387.00 6 6

Other

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
F138 Mandible - closed reduction, includes maxillary-mandibular fixation $350.00 7 6
F139 Mandible - open reduction, per fracture, to include intermaxillary fixation $575.00 6 6
E828 - rigid internal fixation, any method, to F139 . . . Add $104.00 N/A N/A
F140 Mandible - removal of intermaxillary fixation device(s) $100.00 N/A N/A
F146 Mandible - complicated $0.00 N/A N/A
D062 Dislocations - Temporomandibular joint - closed reduction $51.65 6 N/A
D063 Dislocations - Temporomandibular joint - open reduction $256.40 7 6