R430 – Claw or hammer or overlapping 5th toe
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs the surgical correction of claw and hammer toe. This service is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) claims. The fee for assistant and anaesthesia services is calculated based on basic and time units. For each additional hammer toe corrected, use add-on code E594. This service is subject to various premiums, including those for age, after-hours services, and trauma, as outlined in the General Preamble. For details on assistant and anaesthesia calculations, see the Surgical Assistants' Services () and Anaesthesiologists' Services () sections of the General Preamble.
When to Use
- Use R430 as the primary procedure code for the surgical correction of a single claw, hammer, or overlapping 5th toe deformity.
- Use R430 in conjunction with E594 when performing corrective surgery on multiple toes during the same operative session.
Common Pitfalls
- Do not bill R430 multiple times for multiple toes; only the first toe is covered by R430, while all subsequent toes must be billed using add-on code E594.
- Failure to document the specific nature of the deformity (claw vs. hammer vs. overlapping) can lead to claim scrutiny during audits.
Billing Tips
- Ensure E594 is only applied to the second and subsequent toes corrected; the first toe is always the base R430 fee.
- Verify if the procedure qualifies for after-hours or age-based premiums, as these are calculated as a percentage increase on the total procedural fee including the R430 base.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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