What is OHIP billing code E865?

E865 is "Bilateral procedure add-on to M050", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E865 pay?

The current OHIP fee for E865 is $200.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill E865 to OHIP?

E865 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E865 claims against the Schedule of Benefits rules before submission.

What codes are related to E865?

Codes related to E865 in the Schedule of Benefits include M050, M083, E845.

All codes

E865

E865 – Bilateral procedure add-on to M050

OHIP Surgical Assists Code · Schedule of Benefits

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Bilateral procedure, to M050 (Frontal sinusotomy, extended, Draf II, unilateral)

When to Use

Use E865 when performing a Draf II extended frontal sinusotomy on both the left and right frontal sinuses during the same operative session as M050.
Use this code specifically when the surgical approach meets the criteria for an extended Draf II procedure bilaterally, rather than a standard Draf I (Z318) or the median Draf III (M052) approach.

Common Pitfalls

Billing E865 alongside M052 is a rejection risk, as M052 is inherently bilateral and represents a different surgical technique (median drainage).
Failing to link E865 to M050 on the same claim will result in a rejection, as E865 is strictly an add-on code dependent on the primary M050 procedure.
Attempting to bill E865 for a Draf I procedure is an audit risk; ensure the operative report clearly documents the extended Draf II criteria to justify the add-on.

Billing Tips

Always submit M050 and E865 on the same claim to ensure the bilateral status is recognized by the system.
If image guidance is utilized for the bilateral procedure, ensure E845 is included on the claim to capture the additional fee for distorted anatomy or proximity to critical structures.

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Provider Fee$200.00

Effective: April 1, 2026

Service Type

Surgery

Code Classes

Procedure

Must be performed using an endoscopic approach.

Documentation of medical necessity for bilateral procedure.

M050Frontal sinusotomy, extended, Draf II, unilateral M083Intranasal ethmoidectomy E845Image guided system add-on

M050 has 10 basic anaesthesia units; E865 does not add basic units but increases time units.

Assistant fee is not pre-set; use M400B if an assistant is required.