What is OHIP billing code E166?

E166 is "Tumour or foreign body - anterior route", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E166 pay?

The current OHIP fee for E166 is $780.70, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill E166 to OHIP?

E166 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E166 claims against the Schedule of Benefits rules before submission.

What codes are related to E166?

Codes related to E166 in the Schedule of Benefits include E164, E102, E103, E109, E171, E941, E181, E167.

All codes

E166

E166 – Tumour or foreign body - anterior route

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

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Surgical excision of a tumour or foreign body from the orbit via an anterior route. This procedure has 6 basic units for anaesthesia (E166C) and 6 basic units for a surgical assistant (E166B).

When to Use

Use E166 for the surgical removal of a superficial orbital tumour or a palpable foreign body located in the anterior orbit that does not require deep dissection or orbital decompression.
Select E166 when the approach is strictly anterior (e.g., through a lid crease or conjunctival incision) rather than the lateral orbitotomy approach required for E167.

Common Pitfalls

Billing E166 in conjunction with E167 or E168 for the same anatomical site is considered unbundling and will lead to claim rejection or audit recovery.
Failure to document the specific anatomical location and the anterior route taken can lead to downgrades if the procedure is later audited as a simple excision (e.g., E102) rather than an orbital procedure.

Billing Tips

Ensure the operative report explicitly describes the anterior approach to justify the use of E166 over less invasive ocular surface excision codes.
If the procedure is performed on an emergency basis after hours, ensure the appropriate premium (E409 or E410) is applied to the base fee, as E166 is a surgical procedure eligible for these premiums.

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Provider Fee$780.70

Surgical Assistant Fee$77.46

Anaesthetist Fee$95.76

Non-Anaesthetist Fee$95.76

Effective: April 1, 2026

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