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F064
F064 – Metatarsus - open reduction - one
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the open reduction of a fracture of one metatarsal bone, as listed in the Musculoskeletal System section of the Schedule of Benefits. It includes fee components for the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C).
When to Use
- Use F064 specifically for the open reduction of a single metatarsal fracture requiring surgical intervention.
- Select F064 when the procedure involves an incision to access and realign the bone, distinguishing it from closed reduction procedures like F061 or F062.
Common Pitfalls
- Billing F064 for multiple metatarsal fractures; this code is strictly for one metatarsal, and subsequent fractures require the use of the appropriate multiple procedure rules.
- Confusing F064 with F065, which is for metatarsal osteotomy; ensure the operative report clearly indicates a fracture reduction rather than a planned osteotomy to avoid audit recovery.
Billing Tips
- Ensure the operative report explicitly details the open reduction technique, as the distinction between open and closed reduction is a primary focus for OHIP surgical audits.
- If performing multiple metatarsal procedures, apply the multiple procedure rules (GP85) correctly to the secondary procedures to avoid claim rejection.
Provider Fee$358.05
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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