What is OHIP billing code E128?

E128 is "Anterior chamber - open evacuation of clot", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E128 pay?

The current OHIP fee for E128 is $496.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill E128 to OHIP?

E128 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E128 claims against the Schedule of Benefits rules before submission.

All codes

E128

E128 – Anterior chamber - open evacuation of clot

OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits

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A surgical procedure for the open evacuation of a clot from the anterior chamber of the eye. This procedure is billable by the surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C). The fees for the assistant and anaesthetist are calculated using a combination of base units and time-based units as specified in the General Preamble (, ). The surgeon's fee includes the procedure and associated post-operative care.

When to Use

Use E128 for the surgical evacuation of a hyphema from the anterior chamber when the procedure involves an open incision, distinguishing it from non-invasive or paracentesis-only procedures.
Use this code for urgent or emergent clot evacuation following ocular trauma or post-operative complications where the clot is obstructing visual axis or causing uncontrolled intraocular pressure.

Common Pitfalls

Do not bill E128 in conjunction with a simple anterior chamber paracentesis, as the evacuation procedure is considered more comprehensive and inclusive of the necessary entry.
Avoid billing E128 for minor debris removal that does not meet the clinical definition of a clot evacuation; ensure the operative report clearly describes the removal of organized blood or fibrin clot.
Failure to document the specific start time of the procedure can lead to the rejection of after-hours premiums (E409, E410) which are critical for non-elective, urgent cases.

Billing Tips

Ensure the operative report explicitly details the 'open' nature of the evacuation to support the use of E128 over less invasive ocular codes.
If performing this procedure on a trauma patient, verify the Injury Severity Score (ISS) is documented in the chart to support the 50% E420 trauma premium.

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Provider Fee$496.00

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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