What is OHIP billing code F019?

F019 is "Open reduction of scaphoid", an OHIP Anaesthesia code from the Ontario Schedule of Benefits (Physician Services).

How much does F019 pay?

The current OHIP fee for F019 is $637.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill F019 to OHIP?

F019 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates F019 claims against the Schedule of Benefits rules before submission.

What codes are related to F019?

Codes related to F019 in the Schedule of Benefits include F018, F020, F012, F013, F015, F102, F016, F017.

All codes

F019

F019 – Open reduction of scaphoid

OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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This service is for the open reduction of a fracture of the scaphoid (carpal navicular) bone. This is a surgical procedure and includes the necessary fixation. The amount payable for the surgical assistant and anaesthetist is calculated based on basic units plus time units. Assistant basic units: 6. Anaesthesia basic units: 7. See , , , and for full calculation details.

When to Use

Use F019 for open reduction and internal fixation (ORIF) of a scaphoid fracture when percutaneous fixation (F018) is insufficient due to fracture displacement or comminution.
Select F019 when performing an open approach to address a scaphoid non-union requiring bone grafting and hardware fixation.

Common Pitfalls

Billing F019 alongside other carpal procedures without applying the multiple procedure rule, which requires the major procedure to be billed at 100% and subsequent procedures at 85% or 50% as per the Schedule of Benefits.
Failing to document the specific fracture classification or the necessity of the open approach, which can lead to recovery during post-payment audits if the procedure is deemed equivalent to a simpler percutaneous fixation (F018).
Incorrectly billing for a surgical assistant when the procedure complexity does not meet the criteria for assistant eligibility, or failing to use the correct modifier for after-hours cases.

Billing Tips

Ensure the operative report explicitly details the open approach and fixation method, as this distinguishes F019 from closed reduction or percutaneous techniques (F018).
If performing bilateral scaphoid procedures, bill the first side at 100% and the second side at 85% of the fee, ensuring the bilateral modifier is correctly applied to avoid automatic rejection.

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Provider Fee$637.30

Surgical Assistant Fee$77.46

Anaesthetist Fee$111.72

Non-Anaesthetist Fee$111.72

Effective: April 1, 2026

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