What is OHIP billing code E953?

E953 is "Eyelid surgery with scleral graft", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E953 pay?

The current OHIP fee for E953 is $80.90, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill E953 to OHIP?

E953 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E953 claims against the Schedule of Benefits rules before submission.

What codes are related to E953?

Codes related to E953 in the Schedule of Benefits include E211.

All codes

E953

E953 – Eyelid surgery with scleral graft

OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits

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E953 is an add-on code for Lid lengthening procedure (E211) when performed with a scleral graft. It adds a flat amount of $80.90 to the base procedure. Blepharoplasty is only insured in those circumstances described in Appendix D - prior approval of the Ministry of Health is required.

When to Use

Use E953 as an add-on to E211 specifically when a scleral graft is harvested and inserted to achieve lid lengthening for cicatricial ectropion or severe lid retraction.
Apply this code only when the primary procedure E211 is medically indicated and meets the strict criteria for functional impairment outlined in Appendix D.

Common Pitfalls

Billing E953 without an approved prior authorization for the underlying blepharoplasty/lid procedure will result in an automatic rejection.
Attempting to bill E953 as a standalone procedure is invalid as it is strictly an add-on code that requires E211 to be present on the same claim.
Failure to document the specific use of a scleral graft in the operative report will lead to recovery during a Ministry audit.

Billing Tips

Ensure the claim includes both E211 and E953 on the same submission to trigger the correct fee calculation for the combined procedure.

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Provider Fee$80.90

Effective: April 1, 2025

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