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R489
R489 – Single joint - total (arthrodesis and/or arthroplasties) maximum of 4
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service, listed on page , covers the total arthroplasty or arthrodesis of a single joint of the hand. A maximum of four services of this type (combining arthrodesis and/or arthroplasties) are payable.
When to Use
- Use R489 for total arthroplasty or arthrodesis of a single small joint of the hand when the procedure does not fall under more specific joint-specific codes.
- Select this code when performing a total joint reconstruction or fusion where the clinical intent is the complete replacement or permanent stabilization of the joint.
Common Pitfalls
- Exceeding the maximum of four services per patient, as R489 is strictly capped at four total procedures (arthrodesis and/or arthroplasties) combined.
- Attempting to bill R489 alongside R285 or R316 for the same anatomic location, which will result in an automatic rejection due to same-day billing restrictions.
- Failing to append the E564 revision premium when performing a revision of a previously failed arthroplasty, which is a common missed opportunity for a 35% fee increase.
Billing Tips
- Always verify the total count of previous R489 claims for the patient to ensure you remain within the four-service lifetime maximum.
- If performing multiple joint procedures during the same anaesthetic, remember that surgical assistant and anaesthesia units are calculated based on the major procedure only, not the cumulative count of R489 services.
Provider Fee$358.60
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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