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E174

E174 – Orbit - blowout fracture of floor

OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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An open reduction procedure to repair a blowout fracture of the floor of the orbit. This surgical service includes the surgeon's work (<suffix>A</suffix>), and allows for claims for a surgical assistant (<suffix>B</suffix>) and anaesthetist (`<suffix>C</suffix>). The assistant's fee is calculated based on 6 basic units plus time units. The anaesthetist's fee is calculated based on 7 basic units plus time units. An additional fee, E934, may be claimed if a primary bone graft from a separate site is required. See the 'Notes' section for billing restrictions related to the add-on code.

When to Use

  • Use E174 for the definitive open reduction and repair of a symptomatic orbital floor blowout fracture, typically involving the placement of an implant or graft to restore orbital volume.
  • Use E174 when the procedure is performed via a transconjunctival or subciliary approach to access the orbital floor, distinguishing it from simple closed reductions or non-surgical management.

Common Pitfalls

  • Billing E934 (primary bone graft) is prohibited if you have already billed Z263, Z264, Z265, Z266, E975, or E976, as these codes are mutually exclusive for the graft component.
  • Attempting to bill E174 alongside other orbital or facial fracture repair codes without clear documentation of distinct surgical sites or separate procedures can lead to automatic claim rejection for unbundling.

Billing Tips

  • Ensure the E934 add-on is explicitly linked to the E174 claim on the same day to capture the additional $204.80 for the primary bone graft harvest.
  • Always verify the patient's age at the time of the procedure to apply the correct age-based surgical premium (e.g., 10% to 30% increase), as these are not automatically calculated by the system.
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Provider Fee$767.70
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72

Effective: April 1, 2026

Since Apr 2004, this fee has increased 138.1% vs 58.5% CPI inflation
Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

E934

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E174 – Orbit - blowout fracture of floor | OHIP Fee Schedule | SnapBill MD