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E173
E173 – Orbit - open reduction rim/wall fracture - Zygomatic fracture dislocation
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E173 for the open reduction and internal fixation of a displaced zygomaticomaxillary complex (ZMC) fracture requiring surgical exposure.
- Select E173 when the procedure involves the reduction of a zygomatic fracture dislocation, distinguishing it from closed reduction procedures which are billed under different codes.
Common Pitfalls
- Billing E933 without specifying the number of major fracture lines treated, as E933 is billable per major fracture line per side.
- Attempting to bill E934 for bone grafting when using synthetic bone substitutes, as E934 is specifically for primary bone grafts harvested from a separate site.
- Double-billing E934 alongside excluded codes like E975 or E976, which will result in automatic claim rejection.
Billing Tips
- Ensure the operative report clearly identifies each distinct major fracture line (e.g., infraorbital, zygomatic-frontal) to justify multiple units of E933.
- Always verify if the procedure qualifies for the E420 trauma premium by documenting the Injury Severity Score (ISS) in the patient record, as this provides a 50% increase.
Provider Fee$594.70
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
Where mini-plate(s) are used with this procedure, one E933 fee per each major fracture line (e.g. infraorbital, malar-zygomatic, nasal-frontal, LeFort I, LeFort II and III) (per major fracture line per side) should be billed.
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