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R209
R209 – First carpometacarpal joint ligament reconstruction and tendon interposition arthroplasty (LRTI)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R209 includes excision of the trapezium, suspensionplasty of the first metacarpal, ligament reconstruction with local tendon graft or allograft or nonbiologic material and interposition of soft tissue in the trapezial void and excision of the scaphotrapezoid joint, if performed.
When to Use
- Use R209 for primary treatment of advanced basal joint arthritis requiring complete trapeziectomy with ligament reconstruction and tendon interposition.
- Use R209 when performing a formal suspensionplasty of the first metacarpal combined with soft tissue interposition in the trapezial void.
Common Pitfalls
- Do not bill R209 in conjunction with R285 or R316, as these are restricted and will result in automatic claim rejection.
- Avoid billing R209 for simple trapeziectomy without the required ligament reconstruction or tendon interposition components, as this does not meet the full definition of the procedure.
Billing Tips
- If performing a revision of a failed previous arthroplasty, ensure E564 is appended to the R209 claim to capture the 35% fee increase.
- Ensure the operative report explicitly details the suspensionplasty and the specific method of tendon interposition to support the R209 claim during potential post-payment audits.
Provider Fee$775.00
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Since Oct 2005, this fee has increased 113.5% vs 52.9% CPI inflation
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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