What is OHIP billing code R135?

R135 is "Preparation of microvascular recipient site for free island skin and bone flap", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R135 pay?

The current OHIP fee for R135 is $1048.60, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R135 to OHIP?

R135 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R135 claims against the Schedule of Benefits rules before submission.

What codes are related to R135?

Codes related to R135 in the Schedule of Benefits include R134, R140, R136.

All codes

R135

R135 – Preparation of microvascular recipient site for free island skin and bone flap

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

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Preparation of a microvascular recipient site for the transplantation of a free island skin and bone flap. This is a component of a complex microvascular reconstructive surgery. The service is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) fees. A second assistant's services are also payable without special authorization as per .

When to Use

Use R135 specifically for the recipient site preparation required for free island skin and bone flap transplantation, distinguishing it from general soft tissue debridement or simpler flap preparations.
Apply this code when the surgical procedure involves the complex preparation of a recipient site that will host a composite free flap containing both skin and bone components.

Common Pitfalls

Billing R135 in conjunction with other site preparation codes (such as R134 or R136) for the same anatomical site may trigger a rejection for unbundling if the services are considered inclusive.
Failure to document the specific nature of the 'skin and bone' flap recipient site preparation can lead to audit recovery if the claim is reviewed and the complexity does not meet the criteria for R135.

Billing Tips

Ensure that the second assistant is billed appropriately, as R135 explicitly allows for a second assistant's services without requiring prior authorization per GP90.
When performing this procedure on an emergency basis after hours, ensure the correct E-series premium (E409 or E410) is applied to the surgeon's fee to maximize the procedural reimbursement.

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Provider Fee$1,048.60

Surgical Assistant Fee$125.10

Anaesthetist Fee$154.90

Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

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