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E169
E169 – Orbital decompression - two or more walls
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Decompression - two walls is a surgical procedure to relieve pressure within the eye socket (orbit) by removing or modifying two of the orbital walls.
When to Use
- Use E169 when performing a formal orbital decompression for thyroid eye disease or orbital tumors involving the surgical removal or modification of exactly two orbital walls.
- Select E169 when the surgical approach requires access to two distinct walls (e.g., medial and lateral, or floor and medial) to achieve sufficient volume expansion.
Common Pitfalls
- Do not bill E169 in conjunction with E170, as E170 is intended for three or more walls; billing both will result in a rejection for duplicate or overlapping service.
- Avoid billing E169 for simple orbital biopsies or minor explorations that do not involve the structural modification of two distinct orbital walls, as this will trigger an audit for upcoding.
Billing Tips
- Ensure the operative report explicitly details the specific walls addressed (e.g., medial wall and orbital floor) to justify the two-wall requirement of E169 during a post-payment review.
Provider Fee$1,267.55
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
Effective: April 1, 2026
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
OCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Ocular and Aural Surgical Procedures
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