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R491
R491 – Replacement acetabular liner and/or femoral head
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Replacement acetabular liner and/or femoral head. This surgical procedure is part of a revision total hip arthroplasty, specifically addressing the replacement of one or both of the modular components: the acetabular liner and/or the femoral head.
When to Use
- Use R491 for isolated modular component exchange, such as replacing a worn polyethylene liner or a damaged femoral head, without replacing the acetabular shell or femoral stem.
- Use R491 when performing a 'head-liner' exchange during a revision procedure where the primary fixation of the acetabular shell and femoral stem remains stable and intact.
Common Pitfalls
- Billing R491 in conjunction with major revision codes like R439 or R440 is generally considered unbundling; ensure the procedure performed is strictly limited to modular component exchange.
- Failing to document the specific modular components replaced can lead to audit scrutiny, as R491 is intended for the liner and/or head only, not the entire prosthesis.
Billing Tips
- If the procedure is performed non-electively after hours, ensure you append the appropriate E-code (E409 or E410) to the R491 base fee to maximize the procedural reimbursement.
Provider Fee$532.30
Surgical Assistant Fee$103.28
Anaesthetist Fee$159.60
Non-Anaesthetist Fee$159.60
Effective: April 1, 2026
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
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