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R479
R479 – Removal of prosthesis without replacement
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Removal of prosthesis without replacement
When to Use
- Use R479 for the definitive removal of a failed or infected orthopedic prosthesis (e.g., hardware or joint component) when no immediate replacement is performed.
- Select R479 when performing a two-stage revision procedure where the first stage involves removing the infected prosthesis and placing a spacer, provided the spacer placement is not billed as a separate primary replacement code.
Common Pitfalls
- Do not bill R479 in conjunction with a primary joint replacement code (e.g., R060) for the same joint, as the removal is typically considered an inclusive component of the replacement procedure.
- Avoid billing R479 when the removal is incidental to a more comprehensive procedure; ensure the removal is the primary intent of the surgical session to justify the fee.
Billing Tips
- If the removal is performed due to a complication of a previous surgery, ensure the operative report clearly distinguishes the removal from the original procedure to avoid 'unbundling' denials.
Provider Fee$193.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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