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R401
R401 – Glenohumeral joint - open reduction, recurrent
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service covers the open surgical reduction of a recurrently dislocated glenohumeral joint. An additional 30% premium may be claimed using E058A if the procedure involves a revision or repair following previous glenohumeral joint surgery, as noted on page . This procedure can be performed by a surgeon (suffix A), with assistance (suffix B), and under anaesthesia (suffix C).
When to Use
- Use R401 for open stabilization procedures specifically indicated for recurrent glenohumeral instability, such as a Bankart repair.
- Select R401 when performing an open capsular shift or reconstruction in a patient with a history of multiple dislocations, distinguishing it from primary traumatic reduction codes.
Common Pitfalls
- Billing R401 concurrently with R472 will result in an automatic rejection as they are mutually exclusive procedures for the same joint.
- Failing to append E058A when performing a revision of a previously failed stabilization surgery leads to a loss of the 30% premium entitlement.
Billing Tips
- Always claim E062 in addition to R401 when a Latarjet procedure or bone block graft is performed to address glenoid bone loss, ensuring the $350 flat fee is captured.
Provider Fee$524.55
Surgical Assistant Fee$77.46
Anaesthetist Fee$159.60
Non-Anaesthetist Fee$159.60
Effective: April 1, 2026
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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