What is OHIP billing code R385?

R385 is "Posterior dento-alveolar osteotomy, maxilla - both sides, separate segments", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R385 pay?

The current OHIP fee for R385 is $1187.50, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R385 to OHIP?

R385 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R385 claims against the Schedule of Benefits rules before submission.

All codes

R385

R385 – Posterior dento-alveolar osteotomy, maxilla - both sides, separate segments

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

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Posterior dento-alveolar osteotomy of the maxilla involving both sides, performed as separate segments. This is a surgical procedure typically performed to correct dentofacial deformities.

When to Use

Use R385 when performing a bilateral posterior maxillary dento-alveolar osteotomy where the segments are mobilized independently on both sides.
Select this code specifically for dentofacial deformity corrections involving posterior segment repositioning, as opposed to a Le Fort I osteotomy (R388) which involves the entire maxilla.

Common Pitfalls

Billing R385 in conjunction with a Le Fort I osteotomy (R388) often triggers a rejection for unbundling; ensure the surgical report clearly distinguishes the posterior segment work as a separate, distinct procedure if claiming both.
Failure to document the specific bilateral nature of the separate segments can lead to audit adjustments if the claim is reviewed against the description of a single-side procedure.
Attempting to bill a second assistant without prior authorization or a supporting letter will result in automatic denial, as R385 is not on the pre-approved list for second assistants.

Billing Tips

If the procedure is performed for trauma with an ISS score exceeding the threshold, ensure the ISS score is explicitly documented in the chart to support the E420 trauma premium claim.
Always bill the major pre-operative assessment separately if it was the visit where the decision to proceed with the R385 surgery was finalized and scheduled.

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Provider Fee$1,187.50

Surgical Assistant Fee$75.06

Anaesthetist Fee$232.35

Non-Anaesthetist Fee$232.35

Effective: April 1, 2025

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