What is OHIP billing code R066?

R066 is "Transplantation of free island skin and subcutaneous flap with microvascular anastomosis(es)", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R066 pay?

The current OHIP fee for R066 is $925.85, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R066 to OHIP?

R066 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R066 claims against the Schedule of Benefits rules before submission.

What codes are related to R066?

Codes related to R066 in the Schedule of Benefits include R013, R014, R015, R016, R055, R064, R065, R067.

All codes

R066

R066 – Transplantation of free island skin and subcutaneous flap with microvascular anastomosis(es)

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

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This surgical service covers the transplantation of a free island skin and subcutaneous flap. The procedure includes the microsurgical connection (anastomosis) of the flap's blood vessels to the recipient site's vessels to ensure its viability. This code represents the transplantation step of a free flap reconstruction.

When to Use

Use R066 specifically for the microvascular anastomosis phase of a free flap transfer, distinct from the flap harvest or recipient site preparation codes.
Apply this code when performing the definitive vascular connection of a free island skin and subcutaneous flap to ensure tissue viability in reconstructive surgery.

Common Pitfalls

Do not bill R066 in isolation; it must be accompanied by the appropriate donor site harvest code (e.g., R064) and recipient site preparation code (e.g., R065) to reflect the full procedure.
Avoid billing R066 for pedicled flaps, as this code is strictly reserved for free flaps requiring microvascular anastomosis.
Failure to document the specific microsurgical technique used for the anastomosis can lead to audit scrutiny regarding the necessity of the free flap versus a local or pedicled alternative.

Billing Tips

Ensure that the recipient site preparation (R065) and the transplantation (R066) are clearly delineated in the operative report to justify the separate procedural components.
If a second surgical assistant is required, you must obtain prior authorization from a medical consultant, as R066 is not pre-approved for second assistant billing on GP90.

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Provider Fee$925.85

Surgical Assistant Fee$125.10

Anaesthetist Fee$154.90

Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

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