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R423
R423 – Synovectomy/debridement
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the excision of the synovium or debridement of the hip joint. This service is listed under the Musculoskeletal System section of the Schedule of Benefits. Payment for this service includes the surgical procedure itself, as well as separate, unit-based calculations for surgical assistant and anaesthesia services if required.
When to Use
- Use R423 for open or arthroscopic debridement of the hip joint where the primary intent is the removal of loose bodies or diseased synovium.
- Select R423 when performing a synovectomy for chronic inflammatory conditions of the hip, provided the procedure does not escalate to a more complex reconstruction or total arthroplasty.
Common Pitfalls
- Billing R423 in conjunction with a total hip arthroplasty (THA) is a common audit trigger; debridement is typically considered an inherent component of the arthroplasty and is not separately billable.
- Failure to document the specific surgical findings, such as the volume of synovium excised or the nature of the debridement, can lead to claim rejection during post-payment review.
Billing Tips
- Ensure that if a second surgical assistant is required, you obtain and document prior authorization, as R423 is not on the Ministry's pre-approved list for multiple assistants.
Provider Fee$470.50
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Since Apr 2004, this fee has increased 0.0% vs 57.0% CPI inflation
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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