What is OHIP billing code N564?

N564 is "Open myelotomy for lesion", an OHIP Otolaryngology code from the Ontario Schedule of Benefits (Physician Services).

How much does N564 pay?

The current OHIP fee for N564 is $1020.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill N564 to OHIP?

N564 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates N564 claims against the Schedule of Benefits rules before submission.

What codes are related to N564?

Codes related to N564 in the Schedule of Benefits include N529.

All codes

N564

N564 – Open myelotomy for lesion

OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits

Ask AI Bill This Code — Sign Up Free

An open surgical procedure to incise the spinal cord (myelotomy) to address a lesion. This can be performed on one side (unilateral) or both sides (bilateral). As a surgical service, payment is for the procedure itself when performed by the surgeon (suffix A), as well as separate, unit-based payments for an assistant (suffix B) and anaesthetist (suffix C). - **Assistant Fee (N564B)**: Calculated based on 8 base units plus time units as per . - **Anaesthesia Fee (N564C)**: Calculated based on 10 base units plus time units as per . Note: No decompressive codes are eligible for payment when rendered with N564.

When to Use

Use N564 for an open surgical myelotomy specifically performed to address an intramedullary lesion, such as a tumor or syrinx.
Select N564 when the primary surgical intent is the incision of the spinal cord parenchyma, distinguishing it from simple laminectomy or decompression procedures.

Common Pitfalls

Billing N564 in conjunction with any spinal decompressive procedure will result in a rejection, as the Schedule of Benefits explicitly prohibits concurrent payment for decompression.
Failure to document the specific nature of the lesion can lead to audit scrutiny, as N564 is a high-value surgical code that requires clear evidence of the myelotomy procedure performed.

Billing Tips

Ensure that the surgical assistant (N564B) and anaesthesiologist (N564C) claims are submitted with the same procedure date and service location to avoid processing delays.
If the procedure is performed after hours, apply the appropriate E-series premium (E409/E410 for the surgeon, E400B/E401B for the assistant, E400C/E401C for the anaesthesiologist) based on the exact commencement time of the surgery.

Have a specific question? Ask our billing assistant

Provider Fee$1,020.00

Surgical Assistant Fee$100.08

Anaesthetist Fee$154.90

Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in