What is OHIP billing code N126?

N126 is "Intra-oral approach to lesions of the skull base and upper cervical spine", an OHIP Otolaryngology code from the Ontario Schedule of Benefits (Physician Services).

How much does N126 pay?

The current OHIP fee for N126 is $1442.95, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill N126 to OHIP?

N126 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates N126 claims against the Schedule of Benefits rules before submission.

What codes are related to N126?

Codes related to N126 in the Schedule of Benefits include N117, N115, Z818, Z813, N127, N113, N130, N109.

All codes

N126

N126 – Intra-oral approach to lesions of the skull base and upper cervical spine

OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits

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Intra-oral approach to lesions of the skull base and upper cervical spine. This is a major surgical procedure typically performed under general anaesthesia.

When to Use

Use N126 for direct transoral decompression of the craniocervical junction or resection of clival/upper cervical lesions where an intra-oral route is the primary surgical approach.
Select N126 when performing complex skull base surgery that specifically requires an intra-oral corridor, distinguishing it from the transcervical or posterior approaches covered by codes like N115 or N117.

Common Pitfalls

Billing N126 in conjunction with other skull base procedures without clear documentation of distinct surgical sites or separate operative approaches, which risks a rejection for unbundling.
Failing to include the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium, as this is a mandatory audit requirement for this procedure.

Billing Tips

Ensure the surgical assistant and anaesthesiologist claims are submitted with the correct basic units and time units, as N126 only provides a flat fee for the surgeon (suffix A).
If the procedure is performed after hours, verify the start time against the E409/E410 criteria, as these premiums are mutually exclusive with the E420 trauma premium.

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Provider Fee$1,442.95

Surgical Assistant Fee$187.65

Anaesthetist Fee$232.35

Non-Anaesthetist Fee$232.35

Effective: April 1, 2025

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