R314 – Bone - Simple cyst/exostosis
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This surgical procedure involves the excision of a simple cyst or exostosis from the femur. This service includes all common elements as described in - and specific elements for surgical services. When billed with a 'B' suffix, it represents the fee for the surgical assistant as per rules in . When billed with a 'C' suffix, it represents the fee for the anaesthesiologist as per rules in .
When to Use
- Use R314 for the surgical excision of a benign femoral bone cyst or exostosis where the procedure is limited to the removal of the lesion itself.
- Use R314 when the clinical documentation confirms the pathology is a simple cyst or exostosis, distinguishing it from more complex bone procedures like R330 (sequestrectomy) or R216 (osteotomy).
Common Pitfalls
- Billing R314 for procedures involving extensive bone grafting or internal fixation, which are not included in this code and require separate, more complex procedural codes.
- Failing to document the specific anatomical location on the femur, which can lead to audit scrutiny regarding the necessity and complexity of the excision.
- Attempting to bill an office visit or consultation on the same day as R314 without a clear, separate clinical indication, as the surgical fee includes the standard pre-operative assessment.
Billing Tips
- Ensure the pathology report is cross-referenced with your operative note to justify the 'simple' classification of the cyst or exostosis, as this is the primary determinant for using R314 over higher-valued musculoskeletal codes.
- If the patient is under 16, remember to apply the age-based premium (AGE_PREMIUM_LT16) to the R314 fee to ensure accurate reimbursement for pediatric musculoskeletal surgical services.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
All insured services must be documented in appropriate records that establish the service was provided, the service claimed is the service that was rendered, and the service was medically necessary as per .
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.