What is OHIP billing code R376?

R376 is "Hypertelorism correction - intracranial approach", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R376 pay?

The current OHIP fee for R376 is $2334.85, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R376 to OHIP?

R376 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R376 claims against the Schedule of Benefits rules before submission.

What codes are related to R376?

Codes related to R376 in the Schedule of Benefits include R377, R678, R679.

All codes

R376

R376 – Hypertelorism correction - intracranial approach

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

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A surgical procedure for the correction of hypertelorism using an intracranial approach. The fee for this service is for the surgeon's work (suffix A). The service is also eligible for payment for a surgical assistant (suffix B) and an anaesthesiologist (suffix C), calculated using a unit-based system. Assistant (Asst) Units: 12 base units plus time units as per the rules on -. Anaesthesia (Anae) Units: 25 base units plus time units as per the rules on -. The service includes the harvesting and grafting of bone or cartilage, so separate billing for these grafts (e.g., Z263, Z264) is not permitted.

When to Use

Use R376 for the definitive intracranial surgical correction of hypertelorism, specifically when the procedure involves the mobilization of the orbits via a craniotomy approach.
Use this code when the surgical plan necessitates the harvesting and integration of autologous bone or cartilage grafts to stabilize the orbital repositioning, as these are considered inclusive to the procedure.

Common Pitfalls

Billing separately for bone or cartilage grafts using codes such as Z263 or Z264 will result in automatic claim rejection, as these are explicitly bundled into the R376 fee.
Failure to document the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium will lead to audit recovery, even if the procedure was performed within 24 hours of the trauma.

Billing Tips

Ensure that any applicable age-based surgical premiums (e.g., AGE_PREMIUM_UNDER_1Y) are applied to the R376 fee, as these are calculated as a percentage increase on the base procedural fee.

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Provider Fee$2,334.85

Surgical Assistant Fee$150.12

Anaesthetist Fee$387.25

Non-Anaesthetist Fee$387.25

Effective: April 1, 2025

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