What is OHIP billing code R243?

R243 is "Saucerization and graft", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R243 pay?

The current OHIP fee for R243 is $619.90, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R243 to OHIP?

R243 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R243 claims against the Schedule of Benefits rules before submission.

All codes

R243

R243 – Saucerization and graft

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

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Saucerization and graft is a surgical procedure performed on the femur under the 'Incision and Drainage' sub-category. It involves surgically scraping and shaping the bone to create a shallow, saucer-like depression, which is then filled with a bone graft. This procedure is eligible for billing by the surgeon (A suffix), a surgical assistant (B suffix), and an anaesthesiologist (C suffix). The assistant and anaesthesiologist services are based on 6 base units each, plus time units as defined in the General Preamble (, ).

When to Use

Use R243 for chronic osteomyelitis of the femur requiring surgical debridement (saucerization) followed by bone grafting to fill the resulting defect.
Select R243 when performing a formal excision of necrotic or infected bone tissue that necessitates a graft to restore structural integrity, distinguishing it from simple debridement codes like R242.

Common Pitfalls

Billing R243 alongside other orthopedic procedures on the same site may trigger a 'major procedure' rule; remember that assistant and anaesthesia units are only calculated on the highest-valued procedure.
Attempting to bill a second surgical assistant without prior medical consultant approval will result in automatic rejection, as R243 is not on the pre-approved list for dual assistance.

Billing Tips

Ensure the operative report explicitly details both the saucerization (shaping/scraping) and the graft placement to support the use of this specific code over a standard incision and drainage.
If the procedure is performed on an emergency basis, verify if the patient meets the criteria for the E420 trauma premium, which requires documented Injury Severity Scores (ISS) in the chart.

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Provider Fee$619.90

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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