What is OHIP billing code D035?

D035 is "Ankle dislocation - closed reduction", an OHIP Orthopaedic Surgery code from the Ontario Schedule of Benefits (Physician Services).

How much does D035 pay?

The current OHIP fee for D035 is $111.35, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill D035 to OHIP?

D035 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates D035 claims against the Schedule of Benefits rules before submission.

What codes are related to D035?

Codes related to D035 in the Schedule of Benefits include D036, R402.

All codes

D035

D035 – Ankle dislocation - closed reduction

OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Closed reduction of a dislocation of the ankle joint. A surgical procedure is defined in the Schedule as including specific elements in addition to the common elements. This includes pre-procedural, intra-procedural, and post-procedural care. See and for specific elements related to surgical assistant and anaesthesiologist services respectively.

When to Use

Use D035 for the closed reduction of an ankle dislocation when no fracture is present, or when the fracture is minor and does not require open reduction or internal fixation.
Use this code for the procedure itself; if you are also performing a separate, unrelated diagnostic procedure or a significant evaluation, ensure the documentation clearly supports the distinction to avoid bundling issues.

Common Pitfalls

Do not bill D035 if the procedure progresses to an open reduction; in such cases, you must use the appropriate open reduction code instead.
Avoid billing a separate office visit or consultation fee on the same day as D035 unless the visit is for a completely unrelated condition and is documented as such.
Failure to document the specific 'closed' nature of the reduction can lead to audit scrutiny, as the OHIP Schedule strictly differentiates between closed and open surgical approaches.

Billing Tips

If the procedure is performed after hours, ensure you append the correct E-code (e.g., E409 or E410) to the D035 claim to receive the procedural premium.
If you are the primary surgeon, ensure that any surgical assistant services are billed separately using the appropriate assistant codes, as D035 does not include the assistant's fee.

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Provider Fee$111.35

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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