OHIP Billing Codes

Specialty: Knee

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Code Description Fee

Arthrodesis

R468 Knee $402.75

Arthroplasty

R483 Hemiarthroplasty - double component (e.g. Marmar) $619.90
R496 Hemiarthroplasty - Removal of hemiarthroplasty without replacement $242.25
R497 Hemiarthroplasty - Removal of total arthroplasty without replacement $368.40
R442 Hemiarthroplasty - Replacement Liner $353.25
R244 Hemiarthroplasty - Revision total arthroplasty knee $1,174.30
R482 Hemiarthroplasty - single component (e.g. MacIntosh) $351.70
R248 Hemiarthroplasty - Total knee replacement with take down of fusion $838.00
R441 Hemiarthroplasty -Total replacement/both compartments $631.20
R509 Patellar arthroplasty $241.60

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Arthroscopy

R493 Ankle total replacement $1,199.00
E498 Debridement (trauma) - substantial debridement of 1 or more focal flaps of unstable post-traumatic articular cartilage causing mechanical symptoms, includes when rendered for synovectomy, meniscal trimming and/or chondroplasty $299.00
E493 Drilling of defect (includes removal of loose body(ies) $251.55
R699 Knee arthroscopy set-up, non-degenerative disorders of the knee or acutely locked knee. $97.35
R687 Knee arthroscopy setup, includes when rendered synovial biopsy and/or resection or trimming of plica $97.35

Arthrotomy

R412 Knee with or without removal of loose body $207.90
R413 Osteochondritis dissecans with drilling and/or internal fixation $267.25

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

Excision

R501 Excision - Baker's cyst - Cysts of meniscus $126.25
R434 Excision - Baker's cyst - extensive $264.50
R429 Excision - Baker's cyst - Meniscectomy $241.30
R431 Excision - Baker's cyst - simple $148.50
R417 Excision - Debridement of joint without synovectomy $290.55
R318 Excision - Excision exostosis/cyst patella $126.25
R312 Excision - Patella - to include fascial repair $276.55
R506 Excision - Prepatellar bursae $149.45
R424 Excision - Synovectomy $430.65

Incision and Drainage

R444 Joint $193.00

Reconstruction

R539 Ligaments - removal of synthetics $213.45
R599 Ligaments - simple - one $361.95
R508 Meniscus - Suturing of medial or lateral meniscus $242.25
R584 Muscles/Tendons - Tenoplasty - one $144.80
Z238 Muscles/Tendons - Tenotomy - closed - multiple $72.35
Z237 Muscles/Tendons - Tenotomy - closed - one $49.20
R564 Muscles/Tendons - Tenotomy - open - one $232.00
R516 Muscles/Tendons - Tenotomy - Release patellar retinaculum $161.45

Reduction

D038 Dislocations - Knee - closed reduction $207.90
D039 Dislocations - Knee - open reduction $309.00
D031 Dislocations - Patella - closed reduction - with anaesthetic $97.35
D040 Dislocations - Patella - closed reduction - without anaesthetic $62.20
R515 Dislocations - Patella - open reduction - Congenital dislocation knee (open) $484.35
D041 Dislocations - Patella - open reduction - early $290.55
R255 Dislocations - Patella - open reduction - late $484.35
R403 Dislocations - Patella - open reduction - repair recurrent dislocation (includes inspection of joint) $422.15
F085 Fractures - Patella - no reduction $67.75
F087 Fractures - Patella - open reduction or excision with or without repair $288.25

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.

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