OHIP Billing Codes

Specialty: Shoulder Arm And Chest

Code Description Fee
D014 Dislocations - Acromio-clavicular/sterno-clavicular - no reduction 67.8
D015 Dislocations - Glenohumeral joint - closed reduction without anaesthetic 49.2
D016 Dislocations - Glenohumeral joint - closed reduction with anaesthetic 111.4
D017 Dislocations - Glenohumeral joint - open reduction, early 323.85
D023 Open Reduction 231.1
D025 Dislocations - Acromio-clavicular/sterno-clavicular - closed with anaesthetic 134.55
F042 Fractures - Shaft - no reduction 67.8
F043 Fractures - Shaft - closed reduction 147.6
F044 Fractures - Shaft - open reduction 655.5
F047 Fractures - Tuberosity - no reduction 67.8

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F048 Fractures - Turberosity - closed reduction 117.85
F049 Fractures - Tuberosity - open reduction (without cuff tear) 290.55
F050 Fractures - Neck with dislocation of head - no reduction 67.8
F051 Fractures - Neck with dislocation of head - closed reduction 183.8
F052 Fractures - Neck with dislocation of head - open reduction 559.85
F053 Fractures - Neck without dislocation of head - no reduction 67.8
F054 Fractures - Neck without dislocation of head - closed reduction 133.6
F055 Fractures - Neck without dislocation of head - open reduction 514.95
F110 Fractures - Clavicle - closed reduction with anaesthetic 62.2
F118 Fractures - Clavicle - open reduction 458.75
F119 Fractures - Scapula - no reduction 67.8
F121 Fractures - Scapula - open reduction 799.25
F123 Fractures - Sternum - closed reduction 115.95
R214 Clavicle or Acromion - Malignant tumour with reconstruction 484.35
R222 Incision and Drainage - Humerus/clavicle/scapula 262.6
R223 Incision and Drainage - Saucerization with bone graft 387.9
R225 Incision and Drainage - Sequestrectomy 290.55
R235 Osteotomy - glenoid 279.35
R240 Revision total arthroplasty shoulder 942.95
R260 Osteotomy - humerus 559.25
R292 Humerus - Head 299.75
R297 Humerus - Malignant tumour with reconstruction 681.1
R298 Clavicle or Acromion - Simple (includes ligament) 250.25
R325 Pseudoarthrosis - Humerus 632.05
R329 Pseudoarthrosis - Clavicle 514.8
R353 Muscles/soft tissues - Scapulopexy congenital elevation 385.15
R401 Dislocations - Glenohumeral joint - open reduction, recurrent 419.65
R411 Shoulder 223.65
R416 Rotator cuff exploration includes acromioplasty, excision of coracoacromial ligament and subacromial bursa but excludes simple excision of clavicle 206.9
R422 Joint - Synovectomy and debridement 425.1
R438 Humeral prosthesis 449.2
R467 Shoulder 468.65
R472 Dislocations - Glenohumeral joint - open reduction, late 580.9
R487 Total prosthesis 784.05
R498 Removal prosthesis/no replacement 397.2
R512 Joint - Excision of subacromial bursa (not to be claimed with R416, R593 or R594) 211.6
R526 Sternomastoid 296.05
R527 Muscles/soft tissues - Muscle transplant pectoralis major 434.25
R568 Muscles/soft tissues - Trapezius/sternomastoid transplant 338.65
R589 Muscles/soft tissues - Tendon repair or release biceps 227.4
R593 Muscles/soft tissues - Rotator cuff repair - simple, endtoend or sidetoside (includes acromioplasty, excision of coracoacromial ligament and subacromial bursa ) 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) 498.3
R596 Dislocations - Acromio-clavicular/sterno-clavicular - late 286.7
R615 High humerus 423.3
R616 Shoulder disarticulation 373.1
R617 Forequarter 490.95
R641 Clavicle or Acromion - Major tumour 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 400
R685 Muscles/soft tissues - Tendon release with tenodesis biceps 314.6
R956 Pseudoarthrosis - Humerus circular external fixation 291.4
R957 Osteotomy - Single level correction circular external fixation 510.35
R958 Osteotomy - Double level correction circular external fixation 638.4
R959 Osteotomy - Bone transport - circular external fixation (less than or equal to 6 cm) 655.15
R960 Osteotomy - Bone transport - circular external fixation (greater than 6 cm) 763.8
R961 Osteotomy - Humeral lengthening - circular external fixation (less than or equal to 6 cm) 438
R962 Osteotomy - Humeral lengthening - circular external fixation (greater than 6 cm) 655.15
Z220 Bone - needle/punch, xray control 89.7
Z223 Manipulation under general anaesthetic 49.2

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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