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R493
R493 – Ankle - total replacement
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Arthroplasty of the ankle involving total replacement of the joint. This procedure is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees. The fee for the surgical assistant (suffix B) is calculated using 8 base units plus time units. The fee for the anaesthesiologist (suffix C) is calculated using 10 base units plus time units.
When to Use
- Use R493 for primary total ankle arthroplasty procedures involving the complete replacement of the joint surfaces.
- Use R493 in conjunction with E564 when performing a revision of a previously failed total ankle arthroplasty.
Common Pitfalls
- Do not bill R493 with R694, as R694 (ankle liner replacement) is considered a component of the arthroplasty process and is mutually exclusive.
- Failure to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium if claimed.
Billing Tips
- Ensure the surgical assistant and anaesthesiologist use the correct suffixes (B and C respectively) to trigger the appropriate base unit calculations and time-based fee additions.
- When billing E564 for a revision, ensure it is applied as a 35% increase to the R493 base fee, but verify that the procedure does not conflict with R694 exclusions.
Provider Fee$1,204.50
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
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