OHIP Billing Codes

Specialty: Shoulder Arm And Chest

Code	Description	Anes	Asst	Fee
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D014	Dislocations - Acromio-clavicular/sterno-clavicular - no reduction	0		67.8
D015	Dislocations - Glenohumeral joint - closed reduction without anaesthetic	0		49.2
D016	Dislocations - Glenohumeral joint - closed reduction with anaesthetic	6		111.4
D017	Dislocations - Glenohumeral joint - open reduction, early	6	6	323.85
D023	Open Reduction	7	6	231.1
D025	Dislocations - Acromio-clavicular/sterno-clavicular - closed with anaesthetic	6	6	134.55
F042	Fractures - Shaft - no reduction	0		67.8
F043	Fractures - Shaft - closed reduction	6	6	147.6
F044	Fractures - Shaft - open reduction	6	6	655.5
F047	Fractures - Tuberosity - no reduction	0		67.8
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F048	Fractures - Turberosity - closed reduction	6	6	117.85
F049	Fractures - Tuberosity - open reduction (without cuff tear)	6	6	290.55
F050	Fractures - Neck with dislocation of head - no reduction	0		67.8
F051	Fractures - Neck with dislocation of head - closed reduction	6	6	183.8
F052	Fractures - Neck with dislocation of head - open reduction	6	6	559.85
F053	Fractures - Neck without dislocation of head - no reduction	0		67.8
F054	Fractures - Neck without dislocation of head - closed reduction	6		133.6
F055	Fractures - Neck without dislocation of head - open reduction	6	6	514.95
F110	Fractures - Clavicle - closed reduction with anaesthetic	7	6	62.2
F118	Fractures - Clavicle - open reduction	7	6	458.75
F119	Fractures - Scapula - no reduction	0		67.8
F121	Fractures - Scapula - open reduction	6	6	799.25
F123	Fractures - Sternum - closed reduction	0		115.95
R214	Clavicle or Acromion - Malignant tumour with reconstruction	6	6	484.35
R222	Incision and Drainage - Humerus/clavicle/scapula	7	6	262.6
R223	Incision and Drainage - Saucerization with bone graft	7	6	387.9
R225	Incision and Drainage - Sequestrectomy	7	6	290.55
R235	Osteotomy - glenoid	6	6	279.35
R240	Revision total arthroplasty shoulder	15	9	942.95
R260	Osteotomy - humerus	7	6	559.25
R292	Humerus - Head	6	6	299.75
R297	Humerus - Malignant tumour with reconstruction	6	6	681.1
R298	Clavicle or Acromion - Simple (includes ligament)	7	6	250.25
R325	Pseudoarthrosis - Humerus	6	6	632.05
R329	Pseudoarthrosis - Clavicle	6	6	514.8
R353	Muscles/soft tissues - Scapulopexy congenital elevation	6	6	385.15
R401	Dislocations - Glenohumeral joint - open reduction, recurrent	10	6	419.65
R411	Shoulder	7	6	223.65
R416	Rotator cuff exploration includes acromioplasty, excision of coracoacromial ligament and subacromial bursa but excludes simple excision of clavicle	10	6	206.9
R422	Joint - Synovectomy and debridement	10	6	425.1
R438	Humeral prosthesis	10	6	449.2
R467	Shoulder	6	6	468.65
R472	Dislocations - Glenohumeral joint - open reduction, late	10	6	580.9
R487	Total prosthesis	10	8	784.05
R498	Removal prosthesis/no replacement	8	6	397.2
R512	Joint - Excision of subacromial bursa (not to be claimed with R416, R593 or R594)	7	6	211.6
R526	Sternomastoid	7	6	296.05
R527	Muscles/soft tissues - Muscle transplant pectoralis major	6	6	434.25
R568	Muscles/soft tissues - Trapezius/sternomastoid transplant	7	6	338.65
R589	Muscles/soft tissues - Tendon repair or release biceps	7	6	227.4
R593	Muscles/soft tissues - Rotator cuff repair - simple, endtoend or sidetoside (includes acromioplasty, excision of coracoacromial ligament and subacromial bursa )	10	6	345.35
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	498.3
R596	Dislocations - Acromio-clavicular/sterno-clavicular - late	6	6	286.7
R615	High humerus	6	6	423.3
R616	Shoulder disarticulation	9	9	373.1
R617	Forequarter	15	10	490.95
R641	Clavicle or Acromion - Major tumour	7	6	290.55
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
R685	Muscles/soft tissues - Tendon release with tenodesis biceps	7	6	314.6
R956	Pseudoarthrosis - Humerus circular external fixation	7	6	291.4
R957	Osteotomy - Single level correction circular external fixation	6	6	510.35
R958	Osteotomy - Double level correction circular external fixation	6	6	638.4
R959	Osteotomy - Bone transport - circular external fixation (less than or equal to 6 cm)	6	6	655.15
R960	Osteotomy - Bone transport - circular external fixation (greater than 6 cm)	6	6	763.8
R961	Osteotomy - Humeral lengthening - circular external fixation (less than or equal to 6 cm)	6	6	438
R962	Osteotomy - Humeral lengthening - circular external fixation (greater than 6 cm)	6	6	655.15
Z220	Bone - needle/punch, xray control	6		89.7
Z223	Manipulation under general anaesthetic	6		49.2

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