R441 – Total knee replacement - both compartments
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R441 is a surgical procedure on the musculoskeletal system. The fee schedule provides payment for the surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C). A second assistant's services are also payable for this procedure without requiring prior authorization from a medical consultant, as specified in the Schedule of Benefits on page .
When to Use
- Use R441 for a primary total knee arthroplasty involving both the medial and lateral compartments.
- Submit R441 when converting a unicondylar knee arthroplasty to a total knee replacement, provided no stems or augments are utilized.
Common Pitfalls
- Billing R441 in conjunction with other knee arthroplasty codes that are considered inclusive or mutually exclusive, leading to automatic claim rejection.
- Failing to append the E598 premium code when a patellar replacement or patelloplasty is performed during the same operative session.
Billing Tips
- Ensure that if a second surgical assistant is required, the claim is submitted with the appropriate suffix to trigger the automatic payment without needing prior authorization.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
From the list of services where a second assistant's services are payable and authorization is not required: R441.
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