What is OHIP billing code R064?

R064 is "Elevation of free island skin and subcutaneous flap and closure of defect", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R064 pay?

The current OHIP fee for R064 is $874.60, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R064 to OHIP?

R064 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R064 claims against the Schedule of Benefits rules before submission.

What codes are related to R064?

Codes related to R064 in the Schedule of Benefits include R013, R014, R015, R016, R055, R056, R065, R066.

All codes

R064

R064 – Elevation of free island skin and subcutaneous flap and closure of defect

OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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This service covers the surgical elevation of a free island flap of skin and subcutaneous tissue from a donor site. This service includes the closure of the resulting donor site defect. This procedure is a component of a microvascular free tissue transfer, often performed in reconstructive surgery, and is typically followed by preparation of a recipient site (e.g., R065) and transplantation of the flap (e.g., R066).

When to Use

Use R064 for the primary elevation of a free island flap from a donor site as part of a planned microvascular reconstruction.
Use R064 when the donor site defect is closed primarily or with a split-thickness skin graft as part of the same surgical session.

Common Pitfalls

Do not bill R064 in conjunction with R013-R016, as these codes are considered inclusive of the flap elevation when performed at the same site.
Avoid billing R064 for simple local tissue transfers or pedicled flaps, as this code is strictly intended for free tissue transfers requiring microvascular anastomosis.
Failure to document the specific donor site and the necessity of the free flap can lead to audit rejections when R064 is billed alongside recipient site preparation (R065).

Billing Tips

Always pair R064 with R065 (recipient site preparation) and R066 (transplantation/anastomosis) to accurately reflect the full microvascular reconstruction procedure.
Ensure the trauma premium (E420) is only applied if the ISS score is explicitly documented in the chart, as this is a high-scrutiny area for surgical claims.

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Provider Fee$874.60

Surgical Assistant Fee$125.10

Anaesthetist Fee$154.90

Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

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