What is OHIP billing code E489?

E489 is "Microfracture and/or abrasion arthroplasty for cartilage deficiency", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E489 pay?

The current OHIP fee for E489 is $250.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill E489 to OHIP?

E489 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E489 claims against the Schedule of Benefits rules before submission.

All codes

E489

E489 – Microfracture and/or abrasion arthroplasty for cartilage deficiency

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

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Microfracture and/or abrasion arthroplasty, for cartilage deficiency (includes removal of loose body(ies)). As a surgical service, this fee includes all constituent and common elements of insured services as defined in the General Preamble of the Schedule of Benefits (see -). This encompasses pre-operative evaluation, the procedure itself, and post-operative care.

When to Use

Use E489 when performing arthroscopic microfracture or abrasion arthroplasty specifically to address focal chondral defects.
Use E489 when the procedure includes the debridement or removal of loose bodies as part of the primary cartilage repair service.

Common Pitfalls

Do not bill E489 in addition to other arthroscopic procedures performed on the same joint during the same session, as the General Preamble prohibits unbundling of constituent surgical elements.
Avoid billing E489 if the primary intent is simple diagnostic arthroscopy or routine meniscectomy, as it is specifically designated for cartilage deficiency repair.
Do not bill for local anesthetic administration or nerve blocks performed by the surgeon, as these are considered inclusive to the surgical fee, with the exception of G224.

Billing Tips

Ensure the operative report explicitly details the cartilage deficiency and the specific technique used (microfracture or abrasion) to support the claim in the event of an audit.
If performing a major or minor peripheral nerve block for post-operative pain control, bill G224 separately as it is the only permitted exception to the inclusive anesthesia rule for this procedure.

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Provider Fee$250.00

Effective: April 1, 2025

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