What is OHIP billing code M052?

M052 is "Median frontal sinusotomy (Draf III / Modified Lothrop)", an OHIP Ophthalmology code from the Ontario Schedule of Benefits (Physician Services).

How much does M052 pay?

The current OHIP fee for M052 is $660.20, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill M052 to OHIP?

M052 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates M052 claims against the Schedule of Benefits rules before submission.

What codes are related to M052?

Codes related to M052 in the Schedule of Benefits include M050, M083, Z318.

All codes

M052

M052 – Median frontal sinusotomy (Draf III / Modified Lothrop)

OHIP Ophthalmology Code · Schedule of Benefits

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Median frontal sinusotomy (Draf III / Modified Lothrop) performed via an endoscopic approach to the accessory nasal sinuses.

When to Use

Use M052 when performing a formal Draf III (Modified Lothrop) procedure to create a single, large frontal sinus cavity by removing the superior nasal septum and frontal sinus floor.
Choose M052 over M050 (Draf II) when the surgical scope extends to the resection of the superior nasal septum and the floor of both frontal sinuses.

Common Pitfalls

Claiming M083 alongside M052 when the ethmoidectomy is performed solely for surgical access to the frontal sinus, which is explicitly disallowed.
Failing to provide a supporting letter for M400B, as M052 has no pre-assigned assistant fee and requires manual consultant authorization.
Claiming E845 without explicit documentation in the operative report confirming distorted anatomy or proximity to critical structures like the carotid artery or optic nerve.

Billing Tips

Ensure the operative report clearly distinguishes between ethmoid pathology requiring M083 and access-related ethmoidectomy to avoid automatic rejection of the add-on code.
If an assistant is required, submit the M400B claim with a detailed letter justifying the necessity to ensure the 10 basic units are approved by the medical consultant.

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Provider Fee$660.20

Anaesthetist Fee$159.60

Non-Anaesthetist Fee$159.60

Effective: April 1, 2026

Service Type

Respiratory Surgical Procedures

Code Classes

Surgery

Must be documented in the operative report.

If E845 is claimed, documentation must support the specific clinical criteria (distorted anatomy or proximity to critical structures).

M050Frontal sinusotomy, extended, Draf II, unilateral M083Intranasal ethmoidectomy Z318Trephine or endoscopic frontal sinusotomy, including Draf I

M052 is not eligible for the morbid obesity premium (E676).

Multiple procedures rule: If performed with another procedure under the same anaesthesia, the major procedure is paid at 100% and the lesser at 85%.

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