What is OHIP billing code M067?

M067 is "Closure of antral fistula - under general anaesthetic", an OHIP Respiratory Surgical Procedures code from the Ontario Schedule of Benefits (Physician Services).

How much does M067 pay?

The current OHIP fee for M067 is $345.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill M067 to OHIP?

M067 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates M067 claims against the Schedule of Benefits rules before submission.

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M067

M067 – Closure of antral fistula - under general anaesthetic

OHIP Respiratory Surgical Procedures Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

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Closure of antral fistula under general anaesthetic, which may include a Caldwell-Luc procedure if necessary. As a non-'Z' code surgical service, the fee includes pre-operative hospital visits one or two days prior to surgery and post-operative care for up to two weeks (with the exception of the first and second post-operative visits, which are separately payable). For full details, see the Surgical Preamble (, ).

This procedure has 7 basic anaesthesia units. The total anaesthesia fee is calculated based on the sum of basic and time units multiplied by the anaesthesiologist unit fee ($15.49). See and for calculation rules.

Assistant services are not explicitly listed for this procedure. If an assistant is required, the service may be claimed under M400B (Surgical Assistant) upon authorization by a medical consultant, using the anaesthesia base units (7) as the basic units for the assistant's fee calculation. A letter from the surgeon outlining the reason the assistant was required must be submitted. See .

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