What is OHIP billing code E478?

E478 is "Pinning of osteochondral fragment", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E478 pay?

The current OHIP fee for E478 is $251.55, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill E478 to OHIP?

E478 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E478 claims against the Schedule of Benefits rules before submission.

What codes are related to E478?

Codes related to E478 in the Schedule of Benefits include R682, R683, R684, R687, R688.

All codes

E478

E478 – Pinning of osteochondral fragment

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

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Pinning of an osteochondral fragment is a surgical add-on procedure performed arthroscopically. It is claimed in addition to the primary arthroscopy setup procedure for the corresponding joint: - Wrist: to `R682- Elbow: toR683- Shoulder: toR684- Knee: with knee arthroscopy (e.g.,R687) - Ankle: toR688`

When to Use

Use E478 when performing arthroscopic fixation of an osteochondral fragment in the knee, shoulder, elbow, ankle, or wrist in conjunction with the primary arthroscopy code (e.g., R687).
Use this code specifically for internal fixation (pinning) of a loose body or fragment that remains attached or is being reattached, rather than simple excision.

Common Pitfalls

Billing E478 alongside an F-prefix fracture code for the same anatomical site will trigger a rejection, as internal fixation of a fracture is considered inclusive in F-codes.
Attempting to claim E478 as a standalone procedure will result in rejection; it must be linked to the primary arthroscopic procedure code for the specific joint.

Billing Tips

Ensure the primary arthroscopy code (e.g., R682-R688) is billed on the same claim to avoid automatic rejection of the add-on fee.
If the patient is under 16, remember to apply the appropriate age premium percentage to E478 as it is a surgical procedure listed in the musculoskeletal section.

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Provider Fee$251.55

Effective: April 1, 2025

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