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R420
R420 – Joint - Ankle synovectomy
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the excision of the synovial membrane (synovectomy) of the ankle joint. This service is listed under the Musculoskeletal System - Foot and Ankle section.
When to Use
- Use R420 for an open or arthroscopic synovectomy of the ankle joint specifically for chronic inflammatory conditions like rheumatoid arthritis.
- Use R420 when the primary surgical intent is the excision of the synovial membrane, distinguishing it from R425 (Ankle arthrotomy) which is primarily for drainage or exploration.
Common Pitfalls
- Billing R420 in conjunction with other major ankle procedures without applying the Multiple Procedure Rule, which typically reduces the secondary procedure fee by 50%.
- Failing to document the specific extent of the synovectomy, which can lead to claims being downgraded during an audit if the procedure is deemed less extensive than a full synovectomy.
Billing Tips
- Ensure the operative report clearly differentiates the synovectomy from any concurrent debridement or arthrotomy to justify the use of R420 over less specific musculoskeletal codes.
Provider Fee$316.25
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
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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