What is OHIP billing code R242?

R242 is "Bone - incision and drainage", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R242 pay?

The current OHIP fee for R242 is $425.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill R242 to OHIP?

R242 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R242 claims against the Schedule of Benefits rules before submission.

What codes are related to R242?

Codes related to R242 in the Schedule of Benefits include R245, R243, Z226.

All codes

R242

R242 – Bone - incision and drainage

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

Ask AI Bill This Code — Sign Up Free

A surgical procedure for the incision and drainage of the femur bone. The surgeon's fee (R242A) is a flat rate. When an assistant is required, the service is billed as R242B, with the fee calculated based on 6 base units plus time units. When anaesthesia is administered, the service is billed as R242C, with the fee calculated based on 7 base units plus time units. Various premiums for age, trauma, and after-hours services may also apply.

When to Use

Use R242A for the primary surgeon when performing an incision and drainage of the femur bone.
Use R242B when a surgical assistant is required, ensuring the claim includes the calculated base units plus time units.
Use R242C when an anaesthesiologist is present, applying the 7 base units plus the appropriate time unit calculation.

Common Pitfalls

Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium.
Attempting to stack E420 with after-hours premiums (E409, E410, E400B, E401B, E400C, E401C), as these are mutually exclusive.
Incorrectly calculating assistant or anaesthesiologist time units by failing to apply the tiered unit values for intervals exceeding one hour.

Billing Tips

When performing multiple or bilateral procedures under the same anaesthetic, ensure the base units for the assistant and anaesthesiologist are derived solely from the major procedure.
For R242B and R242C, always verify that the time units are calculated in 15-minute increments or parts thereof, adhering to the specific unit multipliers for the first hour versus subsequent time.

Have a specific question? Ask our billing assistant

Provider Fee$425.40

Surgical Assistant Fee$77.46

Anaesthetist Fee$111.72

Non-Anaesthetist Fee$111.72

Effective: April 1, 2026

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