What is OHIP billing code R477?

R477 is "Metatarsophalangeal arthrodesis", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R477 pay?

The current OHIP fee for R477 is $468.35, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R477 to OHIP?

R477 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R477 claims against the Schedule of Benefits rules before submission.

What codes are related to R477?

Codes related to R477 in the Schedule of Benefits include R466, R552, R471, E575, R695, E511, R696, E512.

All codes

R477

R477 – Metatarsophalangeal arthrodesis

OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Arthrodesis, which is the surgical fusion of the metatarsophalangeal joint. This procedure is performed to relieve pain and improve stability in the foot, typically for conditions like severe arthritis or deformity. This service is eligible for payment to the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C).

When to Use

Use R477 for the definitive surgical fusion of the first metatarsophalangeal joint to address end-stage hallux rigidus or severe hallux valgus deformity.
Select R477 when the primary intent is arthrodesis; do not use if the procedure is a simple cheilectomy (R456) or a soft tissue correction without joint fusion.

Common Pitfalls

Billing R477 alongside other foot reconstruction codes (e.g., R479) without clear documentation of separate incisions or distinct clinical indications, which may trigger a rejection for unbundling.
Failure to document the specific start and end times for the procedure, which is required to accurately calculate the time-based units for the surgical assistant (suffix B) and anaesthetist (suffix C).

Billing Tips

Ensure the surgical assistant (suffix B) claims are calculated using the 6 basic units plus 15-minute time increments, as per the rules in GP85/GP86, to avoid payment discrepancies.
When performing R477 as an emergency procedure, ensure the trauma premium (E420) or after-hours premiums (E409/E410) are applied correctly, noting that E420 is mutually exclusive with other special visit premiums.

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Provider Fee$468.35

Surgical Assistant Fee$75.06

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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