What is OHIP billing code R404?

R404 is "Closed reduction of congenital/developmental dislocation of the hip", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R404 pay?

The current OHIP fee for R404 is $190.20, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R404 to OHIP?

R404 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R404 claims against the Schedule of Benefits rules before submission.

What codes are related to R404?

Codes related to R404 in the Schedule of Benefits include R405, R406, Z291.

All codes

R404

R404 – Closed reduction of congenital/developmental dislocation of the hip

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

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A surgical procedure for the closed reduction of a congenital hip dislocation. As per the listing, the fee for R404 is inclusive of any necessary tenotomy and the application of a cast. It is listed under the 'Congenital hip' subsection.

When to Use

Use R404 for the initial closed reduction of a congenital hip dislocation in an infant or young child where the procedure is performed without open surgical exposure.
Use R404 when the reduction is successfully achieved and stabilized via cast application, as the code is specifically defined to include both the reduction and the casting.

Common Pitfalls

Do not bill a separate fee for the application of a cast or any associated tenotomy, as these are explicitly included in the R404 fee and will be rejected as duplicate billing.
Avoid billing R404 if an open reduction is performed; open procedures require different surgical codes within the N40 subsection.
Failure to apply the correct age-based premium (e.g., under 30 days or under 1 year) results in significant underpayment, as these are not automatically calculated by the system.

Billing Tips

Ensure the claim includes the appropriate age-based premium percentage (10% to 30%) based on the patient's exact age at the time of the procedure to maximize the surgical fee.
If the procedure is performed on an emergency basis after hours, ensure the relevant E-code (E409 or E410) is appended to the R404 claim to trigger the 50% or 75% procedural premium.

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Provider Fee$190.20

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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