What is OHIP billing code R363?

R363 is "Malleoli pseudoarthrosis", an OHIP Musculoskeletal System Surgical Procedures code from the Ontario Schedule of Benefits (Physician Services).

How much does R363 pay?

The current OHIP fee for R363 is $404.50, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill R363 to OHIP?

R363 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R363 claims against the Schedule of Benefits rules before submission.

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R363

R363 – Malleoli pseudoarthrosis

OHIP Musculoskeletal System Surgical Procedures Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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This surgical procedure involves the repair and reconstruction of a pseudoarthrosis, or non-union, of the malleoli. The malleoli are the bony prominences on each side of the ankle. This service is listed under the Musculoskeletal System section for foot and ankle reconstruction. When billed by a surgical assistant (suffix B), the service has 6 base units. When billed by an anaesthesiologist (suffix C), the service has 7 base units.

All insured services must be documented in appropriate medical records, establishing that an insured service was provided, the service claimed is the service rendered, and the service was medically necessary.

For trauma cases eligible for the E420 premium, the medical record must list the Injury Severity Score (ISS).

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