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R407
R407 – Synovectomy of extensor or flexor tendons
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This surgical procedure involves the removal of the synovial membrane surrounding the extensor or flexor tendons. It is listed under the Musculoskeletal System Surgical Procedures section for the hand and wrist. The service is billable by the surgeon (suffix A) or anaesthetist (suffix C). - The surgeon's fee (suffix A) is a set amount. - The anaesthetist's fee (suffix C) is calculated based on a base anaesthesia value of 6 units plus time units as described in the General Preamble (-). - Assistant services (suffix B) are not eligible for payment for this procedure.
When to Use
- Use R407 when performing a formal synovectomy of the tendon sheath for conditions like rheumatoid arthritis or chronic tenosynovitis, distinct from simple tendon release procedures.
- Select R407 for open surgical excision of the synovial membrane surrounding extensor or flexor tendons in the hand or wrist, rather than arthroscopic synovectomy which may require different coding.
Common Pitfalls
- Do not attempt to bill an assistant (suffix B) for this procedure; the Schedule of Benefits explicitly prohibits assistant claims for R407.
- Avoid billing R407 in conjunction with R425 (Tendon repair) unless the synovectomy is a distinct, separate procedure performed through a different incision or at a different site, as synovectomy is often considered an integral component of more complex tendon surgeries.
Billing Tips
- Ensure the operative report clearly distinguishes the synovectomy from any concurrent tendon repairs or releases to justify the claim if audited for unbundling.
- When performing this procedure on multiple tendons, verify if the Schedule of Benefits allows for bilateral or multiple-site modifiers, as R407 is typically a per-procedure fee.
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