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R453
R453 – Metatarsophalyngeal (Swansons, etc.)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Arthroplasty of a single metatarsophalangeal joint, such as with a Swanson implant. This service is a surgical procedure and its fee includes all common elements and post-operative care by the surgeon. The fee listed is for the primary surgeon (suffix A). Assistant (suffix B) and anaesthetist (suffix C) services are calculated separately using base units and time units.
When to Use
- Use R453 for the primary implantation of a Swanson or similar silastic arthroplasty device in a single metatarsophalangeal joint.
- Use this code for isolated MTP joint arthroplasty when the procedure does not involve the complex reconstruction or fusion techniques defined by other codes.
Common Pitfalls
- Billing R453 in conjunction with R454 is prohibited as they are mutually exclusive; ensure you are not billing for multiple MTP joint procedures under the wrong code.
- Attempting to bill a second surgical assistant for R453 will result in rejection, as this code is not on the pre-approved list for second assistants and requires prior medical consultant authorization.
Billing Tips
- If performing a revision of a previously failed arthroplasty, remember to append the E564 add-on code to increase the surgical fee by 35%.
- Always verify the patient's age at the time of the procedure to ensure the appropriate age-based surgical premium (e.g., AGE_PREMIUM_5Y-16Y) is applied, as these are not automatically calculated by the system.
Provider Fee$376.60
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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